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The effects of L-carnitine supplementation on glycemic control: a systematic review and meta-analysis of randomized controlled trials
Get PDFThe findings of trials investigating the effect of L-carnitine administration on glycemic control are controversial. This meta-analysis of randomized controlled trials (RCTs) was performed to explore the effects of L-carnitine intake on glycemic control. Two authors independently searched electronic databases including MEDLINE, EMBASE, Cochrane Library, Web of Science, PubMed and Google scholar from 1990 until February 2019, in order to find relevant RCTs. 37 studies with 44 effect sizes met the inclusion criteria and were eligible for the meta-analysis. L-carnitine supplementation resulted in a significant reduction in fasting plasma glucose (FPG) (WMD: -4.57; 95 % CI: -6.88, -2.25), insulin (WMD: -1.21; 95 % CI: -1.85, -0.57), homeostatic model assessment for insulin resistance (HOMA-IR) (WMD: -0.67; 95 % CI: -0.90, -0.44) and HbA1C concentrations (WMD: -0.30; 95 % CI: -0.47, -0.13). L-Carnitine supplementation significantly reduced FPG, insulin, HOMA-IR, and HbA1c levels
Procjena funkcije šake elektoničkim dinamometrom u bolesnika s reumatoidnim artritisom [Evaluation of the hand function using an electronic dynamometer in patients with rheumatoid arthritis]
Get PDFObjectives. In order to more detailed assessment of grip strength an innovative electronic
dynamometer system is produced and a new dynamic parameters of hand grip are derived.
The aim of this study was to determine the connection between the new evaluation
parameters of hand grip with measures of functional ability and disease activity in patients
with rheumatoid arthritis (RA).
Patients and methods. The study included 43 consecutive RA patients and 45 healthy
participants. The main outcomes were the dynamometric parameters of the handgrip:
strength, velocity, endurance (fatigue) and functional capacity. DAS28 (CRP) is used in
the assessment of disease activity, and functional ability is assessed by modified HAQDI
and ABILHAND-RA questionnaires. Based on the hand radiogram Steinbrocker score
was calculated, and the JAM scale was used to estimate deformities.
Results. A positive correlation was shown between the ABILHAND-RA and
dynamometric parameters. Measures of disease activity (PhGA, PtGA, tender joint count,
morning stiffness) were associated with grip force and functional potential (DAS28,
PhGA, tender joint count, morning stiffness). There was no association between grip
velocity and measures of functional ability and disease activity.
Conclusion. Evaluation of hand function with a new electronic dynamometer is useful in
assessment of patients with RA
Pulmonary artery banding in dilative cardiomyopathy of young children: review and protocol based on the current knowledge
Get PDFDilated cardiomyopathy (DCM) is a leading cause of cardiac death in children. Current therapeutic strategies are focused on improving symptoms of congestive heart failure (CHF); the potentials of cardiac regeneration especially in infants and young children are neglected in particular when DCM is classified as "end-stage". Heart transplantation (HTx) serves as the only life-saving option, despite is palliative character with limited survival time. Therapeutic alternatives are strongly needed, but already existing though less used; presupposed, that cardiac dysfunction and its treatment are not reduced to the four components of heart rate (rhythm), myocardial contractility, preload and afterload. A paradigm shift in the treatment of pediatric heart failure can be achieved by modifying ventricular afterload with improving contra-lateral ventricular function. Adverse ventricular-ventricular interactions (VVI) have the potential to harness them for therapeutic benefit. Surgical placement of a pulmonary artery banding (PAB) utilized in infants and young children with LV-DCM and preserved RV function are able to improve LV function via VVI; it is hypothesized, that functional recovery can be achieved in almost 80% especially of infants with LV-DCM despite criteria for listing to orthotopic HTx. The review summarizes details of the current perioperative treatment enabling each pediatric heart center to utilize rPAB as a strategy for functional recovery, even in centers without the option for Htx. Of course, future studies are needed to delineate the geometrical, temporal and molecular mechanisms of PA-banding-induced ventricular crosstalk and to examine their potential modulation through mechanical, electrophysiological and pharmacological interventions, but our patients are born, now
Genetski mehanizmi lizosomske disfunkcije u Parkinsonovoj bolesti [Genetic mechanisms of lysosomal dysfunction in Parkinson's disease]
Get PDFAccumulation of misfolded proteins in the brain is the main pathological hallmark of neurodegenerative diseases, including Parkinson’s disease (PD), suggesting that inadequate clearance of aggregation-prone proteins plays an important role in the disease pathogenesis. Studies on the rare inherited forms of PD have highlighted disturbed alpha-synuclein clearance through the autophagy-lysosomal pathway (ALP) as a key mechanism leading to PD. In order to characterize the putative underlying genetic mechanisms leading to ALP dysfunction in PD, we performed comprehensive analysis of genetic variants in ALP genes in PD patients using the custom LYSOGENE targeted next-generation sequencing panel, containing a set of 440 ALP related genes, as well as genes previously implicated in familial forms of PD. We identified a significant number of ALP gene variants among PD patients when compared to control subjects. These variants were involved in over 50 biological processes, with the greatest enrichment observed in categories of lysosome organization, organic substance transport, abnormal myelination and sphingolipid metabolism. In contrast, variants found exclusively in healthy subjects were not related to specific biological pathways.
Based on the NGS data, we selected genes ARSD, GALC and LRBA with the most over-represented genetic variants in PD patients and investigated their effects on lysosomal impairment, alpha-synuclein accumulation and neurotoxicity using SH-SY5Y cell lines stably expressing human alpha-synuclein. The results were compared to the effects of the knock-down of a known lysosome-related gene, ATP13A2, which causes a rare autosomal recessive form of juvenile-onset atypical PD (PARK9). Our knock-down experiments described for the first time the association between ARSD and LRBA genes with the accumulation of aSyn and confirmed the association between GALC gene and PD. This study confirmed a link between lysosomal dysfunction and alpha-synuclein accumulation
Clinical, biochemical and immunogenetical characteristics of celiac disease in Albanian pediatric patients from Kosovo
Get PDFIntroduction: Celiac disease is an immune-mediated chronic inflammatory disorder triggered
after gluten ingestion in genetically susceptible individuals. HLA-DQ2 and HLA-DQ8
heterodimers have been recognized as necessary - but not sufficient – genetic factors for the
occurrence of celiac disease. -----
Aim: To present the clinical and biochemical characteristics in celiac disease Kosovar Albanian
children as well as to analyse HLA class I and class II allele and haplotype polymorphism in
patients and matched controls.
Materials and methods: A total of 72 patients treated for celiac disease from 2005 to 2016 at
Pediatric Clinic, University Clinical Center of Kosovo and 124 age matched, unrelated healthy
children as control group were enrolled in the study. Serum antibody testing and small bowel
biopsies were performed in Kosovo while molecular HLA typing was done in Tissue Typing
Center, UHC Zagreb. -----
Results: Celiac disease was diagnosed due to classical form of presentation in 78% of patients.
Mean age at the time of diagnosis was 5.5 years, sex distribution showed a female predominance
(1.9:1). Among 60 confirmed celiac disease patients, 95.00 % carried at least one of the risk DQ
heterodimers (HLA-DQ2.5, DQ8, DQ2.2) in comparison with 40.32% of controls (p<0.0001,
OD=28; negative predictive value 96%). None of the nine clinically unconfirmed patients carried
the predisposing DQ heterodimer. The HLA-A*02-B*50-DRB1*07-DQA1*02:01-DQB1*02:02
was found as population specific celiac disease predisposing haplotype with a positive predictive
value of 83%. -----
Conclusion: Kosovar Albanian pediatric celiac disease patients show the same distribution of
predisposing HLA-DQ2 and DQ8 heterodimers as in other European and non-European
populations but some HLA genetic factors specific for Kosovar Albanian population have also
been determined
Kliničko značenje određivanja limfnoga čvora čuvara u ranim stadijima raka vrata maternice FIGO stadija IA2–IIA1
Get PDFResearch goals: Determine the success of sentinel lymph node detection in the early stages of cervical cancer by applying dilute methylene blue to 8 places in the uterine cervix. Determine the diagnostic value of the sentinel lymph node biopsy in assessing the status of pelvic lymph nodes. Determine the location of the sentinel lymph nodes in the early stages of cervical cancer. -----
Examinees and methods: This study included 49 patients who were treated for cervical cancer. We did not have complete data in 3 patients. The statistical analysis included 46 patients. Diluted methylene blue is injected intracervicaly prior to surgery at 4 quadrants and intracervicaly at 4 quadrants on the level of transition of the cervix to vaginal vaults. After detecting and removing the sentinel lymph nodes, complete pelvic lymphadenectomy and radical hysterectomy is performed in all patients. -----
Results: A total of 1338 lymph nodes (29 per patient) were removed, 254 were sentinel lymph nodes (5.5 per patient). Sentinel lymph node detection rate was 100%, and in all patients sentinel lymph nodes were detected bilaterally. There was no difference in sentinel lymph node detection rates depending on the age of the patient, stage of the disease and the size of the tumor. Lymph node metastases were found in 8 patients (17.4%). By patient-specific analysis, the sensitivity of lymph node biopsy was 87.5% and negative predictive value was 97.44%. By side-specific analysis, the sensitivity of lymph node biopsy was 88.89%, and negative predictive value was 98.81%. The lymph nodes were detected: 43.21% obturator region, 41.15% interiliac region, 14.4% external iliac region, 0.8% common iliac region and 0.4% parametrial. -----
Conclusion: Sentinel lymph node mapping by applying diluted methylene blue intracervicaly to 8 places is a quick, simple and easily applicable method. The results of this study show a high bilateral sentinel lymph node detection rate by using our labeling method. We recommend using our labeling method in further investigation of sentinel lymph node biopsy in cervical cancer. Bilateral negative sentinel lymph nodes accurately predict regional lymph node status
Utjecaj stresa na kliničke manifestacije infekcije humanim papiloma virusom [Influence of stress on clinical manifestations of human papilloma virus infection]
Get PDFBackground: Results of studies which have investigated the relationship between HPV infection and the effects of psychological stress are inconsistent. -----
Objectives: The aim of our study was to examine whether there are differences in the clinical manifestations of HPV infection due to the level of experienced stress. -----
Methods: The study included 213 subjects. The first group had manifested HPV infection and positive stress experience while the control group was patients who had manifested HPV infection with no significantly stressful experience. -----
Results: There were no statistically significant differences with respect to the impact of stress on clincal HPV infection. Significantly higher values of leukocytes, alpha-2 and beta globulins were observed in patients with significant stressful experience. Adaptive coping and lower perception of stress can significantly reduce the chances of belonging to a group that has the extragenital manifestations. The perception of stress significantly increases the likelihood of genital manifestations. -----
Conclusion: It can be concluded that a significant level of experienced stressful events do not influence the clinical incidence of HPV infection. There is impact on the increased value of leukocytes, alpha-2 and beta globulins but alostatic pressure was not strong enough to cause significant changes in susceptibility of HPV infection
Medicinsko svrdlo s protočnim hlađenjem otvorenoga tipa u koštano-zglobnoj kirurgiji [Medical drill with open type internal cooling in bone and joint surgery]
Get PDFBackground and aims: Drilling of the bone causes a temperature rise at the point of bone and drill contact. A temperature higher than 47°C can lead to thermal osteonecrosis. The aim of this research was to examine how stainless steel medical drill with open type cooling system affects the maximum temperature at the drilling site with drills of different degree of wear. Drill strength was also studied with regard to the changes required for the system for internal cooling. The influence of coolant on intramedullary pressure, distribution of coolant during drilling and specificity of sterilization of such drill was studied. -----
Methods and materials: For this research, through a standard 4.5 mm medical steel drill, with an electro-erosion process a channel was created. Due to the modification of the drill structure, experimental analysis of the technical properties and analysis of the finite elements was made. Afterwards, measurements of temperature increase at the point of drilling with a drill with open type internal cooling with different degree of wear were performed, also intramedullary pressure during drilling was measured. Intramedullary coolant distribution was showed with X-ray images. A study was carried out on sterilization efficiencies of drill bits with open type internal cooling system. Results: Experimental analysis of technical properties and analysis of finite elements proved that drilling modification has no effect on drill strength in clinical conditions. The maximum achieved temperatures at the drilling site with the open type internal cooling drills were less than critical regardless of the degree of wear of the drill while the temperatures of the drills without cooling were more than critical. Coolant fluid, entering the intramedullary channel, during drilling, has no effect on intramedullary pressure. During and after drilling coolant does not expand into the intramedullary channel but only remains in the bore. An open type internal cooling drill requires a prolonged cycle of sterilization cycles. -----
Conclusion: The open type internal cooling drill significantly reduces the maximum temperature at the point of bone and drill contact regardless of the degree of drill wear. Such a drill can be made of medical steel to meet standards for use in medicine and can be adequately sterilized for reuse. The coolant used during drilling does not affect the intramedullary pressure. The stainless steel medical drill with open type internal cooling is safe to use in bone and joint surgical procedures and is capable to avoid the formation of thermal osteonecrosis completely
Neuronal signaling by Thy-1 in nanodomains with specific ganglioside composition: shall we open the door to a new complexity?
Get PDFThy-1 is a small membrane glycoprotein and member of the immunoglobulin
superfamily of cell adhesion molecules. It is abundantly expressed in many cell types
including neurons and is anchored to the outer membrane leaflet via a glycosyl
phosphatidylinositol tail. Thy-1 displays a number of interesting properties such as fast
lateral diffusion, which allows it to get in and out of membrane nanodomains with
different lipid composition. Thy-1 displays a broad expression in different cell types
and plays confirmed roles in cell development, adhesion and differentiation. Here, we
explored the functions of Thy-1 in neuronal signaling, initiated by extracellular binding
of aVb3 integrin, may strongly dependent on the lipid content of the cell membrane.
Also, we assort literature suggesting the association of Thy-1 with specific components
of lipid rafts such as sialic acid containing glycosphingolipids, called gangliosides.
Furthermore, we argue that Thy-1 positioning in nanodomains may be influenced by
gangliosides. We propose that the traditional conception of Thy-1 localization in rafts
should be reconsidered and evaluated in detail based on the potential diversity of
neuronal nanodomains