Search

Background/Aim. Taking into consideration the justified popularity of total arterial revascularization, the saphenous vein graft (SVG) is still one of the most utilized conduits in coronary artery bypass grafting (CABG). One of the determining factors of this conduit’s durability is its endothelial integrity at the time of surgery. The aim of the study was to investigate the effect of different storage solutions on SVG endothelial integrity in patients with diabetes mellitus (DM) type 2 (T2DM) and non-T2DM patients undergoing CABG. The solutions under evaluation were heparinized saline solution (0.9% NaCl), heparinized autologous whole blood, Bretschneider (histidine-tryptophan-ketoglutarate – HTK) solution, and fresh frozen plasma (FFP) solution. Methods. Forty patients were included in this study and were divided into two groups: group A with 23 T2DM patients and group B with 17 non-T2DM patients. The effects of these solutions were examined by immunohistochemical staining with anti-CD34 antibodies and morphometric comparison in histologic samples of T2DM patients undergoing CABG between July 2021 and September 2022 with samples provided by non-T2DM patients. Results. In this study, the FFP solution showed the most prominent positive effect on the preservation of SVG endothelial integrity, with an average cell integrity preservation of 92.2%. HTK solution was found to be the least effective, with an endothelial cell preservation integrity of 26.77%. There was no marked statistically significant difference in results from groups A and B. There was a noticeable contrast in preserving SVG endothelial integrity between the two patient groups, T2DM and non-T2DM patients, although it was not statistically significant. Conclusion. The storage solution with the most beneficial effect on SVG endothelial integrity preservation was the FFP solution when harvested via the conventional open method in CABG.

Background/Aim. Coronary artery bypass grafting (CABG) is the treatment of choice for a significant number of patients with ischemic heart disease. Some of the postoperative complications are closely linked with the preoperative antiplatelet therapy (APT). The aim of this study was to compare the early clinical outcomes of CABG in patients with preserved platelet (PLT) function and patients with PLT function impaired by the residual therapeutic effect of APT. Methods. A total of 181 patients with isolated CABG were enrolled in this prospective, nonrandomized, observational study. Patients were divided into four groups: control group (arachidonic acid-dependent PLT aggregation group), with aspirin-induced platelet inhibition (ASPI) test ≥ 790 aggregation units (AU)/min; mild (M) acetylsalicylic acid (ASA) effect (MASAE) group, with ASPI test = 410–789 AU/min; pronounced (P) ASA effect (PASAE) group, with ASPI test ≤ 409 AU/min; dual (D) APT (DAPT) group, with ASPI test ≤ 789 AU/min and adenosine diphosphate (ADP) test ≤ 405 AU/min. Preoperative data, intraoperative characteristics, and postoperative outcomes were obtained and com-pared between the groups. Results. A significant difference was found regarding the average time of APT cessation be-tween groups (p < 0.001). The DAPT group had a significantly higher frequency of drainage compared to the control (p = 0.004), MASAE (p = 0.001), and PASAE (p = 0.006) groups. The PASAE group had a significantly higher rate of chest reexploration compared to the MASAE group (p = 0.032). The DAPT group required significantly more packed red blood cells (PRBC) compared to the control (p < 0.001) and MASAE (p = 0.009) groups. The PASAE group received significantly more PRBC compared to the control (p < 0.001) and MASAE (p = 0.019) groups. The DAPT group required higher amounts of PLTs compared to the control (p < 0.001), MASAE (p = 0.002), and PASAE (p < 0.001) groups. The DAPT group received higher amounts of cryoprecipitate compared to the control (p = 0.002), MASAE (p = 0.009), and PASAE (p = 0.016) groups. Conclusion. Patients with a residual effect of DAPT, as well as patients with a pronounced residual effect of ASA, have a higher risk of postoperative bleeding and chest reexploration, as well as increased transfusion demands.

Background/Aim. Despite the introduction of new oral anticoagulants (dabigatran, rivoroxaban, apixaban), vitamin K antagonists (VKA), such as warfarin and acenocoumarol are still the most widely used oral anticoagulants for the treatment of nonvalvular atrial fibrillation (NVAF). The time in therapeutic range (TTR) represents a measure of the quality of the anticoagulant effect of these drugs, and it is considered that the lower value of TTR is associated with the adverse effects of therapy. The aim of this study was to evaluate of the effectiveness of VKA therapy in patients with NVAF and to identify factors affecting the anticoagulation efficacy. Methods. A retrospective study was conducted on a population of 725 outpatients with NVAF, treated with VKA and followed in the Blood Transfusion Institute of Niš, Serbia, from January to December 2017. Laboratory control of the INR was done from capillary blood of patients on Thrombotrack Solo (Axis Shield, Norway) and Thrombostat (Behnk Elektronik, Germany). Targeted therapeutic INR was between 2.0 and 3.0. For each patient all available INR values were evaluated to calculate the individual TTR according to the Rosendaal method. Results. The study included a total of 725 patients with NVAF which had 6,105 INR measurements, what was 8.13 ± 2.47 INR measurements per patient. The mean value of TTR and was 60.15 ± 17.52%, but 49.72% of patients had TTR less than 60%. Patients were at high risk of thrombosis in 6.15% of time (INR < 1.5) and high risk of bleeding in 2.2% of time (INR > 4.5). The most significant independent factors affecting the quality of VKA therapy were gender, arterial hypertension, diabetes mellitus and the use of amiodarone and antiplatelet drugs (aspirin, clopidogrel). Conclusion. The TTR is undoubtedly useful indicator of the VKA treatment effectiveness. The most important predictors of poorer efficacy of VKA therapy are: arterial hypertension, diabetes mellitus, patients' gender and the use of amiodarone and antiplatelet drugs (aspirin, clopidogrel). To improve the quality of VKA therapy, education of patients and better collaboration with them, as well as a successful teamwork of clinicians are also imperative.

Background/Aim.Venous leg ulcers (VLU) are a significant health problem worldwide. It is well known that VLU are difficult to treat and that they have high tendency for recurrence. Compression therapy is the preferred treatment modality but there is growing evidence that correction of underlying venous disorder in early stages of the disease in addition to compression treatment may improve ulcer healing and reduce recurrence rate. Methods. An open, prospective, randomized, single-center study, with a 6-months follow-up was performed to determine the efficacy of two different treatment modalities (surgery alone versus surgery plus compression) in the treatment of VLU in patients with primary venous insufficiency. Patients with secondary venous insufficiency and/or thrombosis were excluded from the study. Overall, 71 patients were randomized (37 men, 34 women; mean age 60 years) into two groups: the group A – 34 patients who underwent surgical intervention (stripping) and postoperatively were treated with simple wound dressing only, and the group B – 37 patients who underwent surgical intervention (stripping) and wore a heelless open-toed elastic class III compression device knitted in tubular form –Tubulcus® (Laboratoires Innothera, Arcueil, France). All patients in group B were instructed to wear compression device continuously during the day and night. The study was performed at the Clinic for Cardiovascular and Transplant Surgery, Clinical Centre Niš (Serbia) with primary endpoint of the study being complete ulcer healing at 180 days. Results. The healing rate was 29.41% (10/34) in the group A, and 56.76% (21/37) in the group B (p < 0.01). Mean healing time in the group A was 141 ±15 days, and in the group B it was 98 ±12 days (Log-rank life table analysis: p < 0.001). Conclusion. This study suggests that for VLU in patients with primary venous insufficiency, surgery plus compression therapy provides higher healing rate and faster healing time compared to surgery only.

Background/Aim. The platelet aggregation, as a laboratory test for assessment of platelet function, is very efficient for optimal antiplatelet treatment and also to identify individuals who have suboptimal response to antiplatelet drugs, such as aspirin and clopidogrel. The aim of this study was to determine the level of inhibition of platelet aggregation using impedance aggregometry in the patients receiving different preparations of acetylsalicylic acid (ASA) in a dose of 100 mg per day. Methods. The examination included 215 patients (110 men and 105 women), treated with one of three different ASA preparations after acute myocardial infarction, as a single therapy or with clopidogrel. Among them, 89 patients were on Aspirin protect® (Bayer, Germany) – Group 1 and 66 patients were on Cardiopirin® (GL Pharma GMBH, Austria) – Group 2, while 60 patients were taking Andol® (Pliva, Croatia) – Group 3. The groups were equal in the presence of factors that can influence platelet aggregation (age, gender, smoking, diabetes, taking other drugs). The platelet function was measured using the impedance aggregometer Multiplate (Multiplate Platelet Function Analyzer, Roche) in the blood samples with heparin for the platelet aggregation activated by the arachidonic acid (ASPI) and by thrombin (TRAP) tests [the area under the aggregation curve (AUC) was used to express the aggregation response over the measured time (AU*min)]. Results. Efficacy of ASA preparations showed statistically significant differences among the three investigated groups (χKW2 = 46.279; p < 0.001), and it was also observed separately in the patients undergoing single therapy (χKW2 = 26.344; p < 0.001) and dual therapy (χKW2 = 23.498; p < 0.001). It was found that the patients who were taking Aspirin protect® obtained significantly better antiplatelet efficiency compared to the patients receiving Cardiopirin® (Z = 5.472; p < 0.001) and Andol® (Z = 5.387; p = 0.022). There is reduced efficiency of all ASA preparations in smokers, while patients receiving Aspirin protect® were 10.5 times more likely to be responders. Conclusion. Different ASA preparations observed in this study showed different efficiency on the platelet function as measured by the method of impedance aggregometry.

nema

Introduction. Intraoperative blood salvage (IBS) is a procedure involving recovering blood looses during surgery and reinfusing it into the patient with a purpose to reduce the perioperative morbidity and mortality associated with complications after administration of allogenic transfusion (AT). The aim of this study was to investigate whether the IBS reduces the need for allogenic transfusion requirements and for non-invasive ventilation (NIV) and/or oxygen supplementation and whether it was associated with decreased levels of inflammatory markers following abdominal aortic aneurysm (AAA) surgery. Methods. Throughout the period from February to October 2010, 51 patients underwent both elective and emergency AAA surgery. During the study period, IBS using 'Haemonetics cell saver 5+' was applied in 24 (46.2%) patients (CS group), while it wasn't used in 27 (51.9%) cases (NCS group). Values of certain inflammatory biomarkers included: white blood cell count (WBCC), C-reactive protein (CRP), procalcitonin (PCT) and fibrinogen were monitored during the first 48 hours postoperatively. Secondary outcome measures icluded: the need for allogenic transfusion and for non-invasive ventilation (NIV) and/or oxygen supplementation. Results. The requirements for intra and postoperative alogenic red blood cells transfusions was significantly higher in patients from NCS group compared to patients in CS group (3.63 vs. 0.58 units per patient; p< 0.001). Non-invasive respiratory support was more frequently used in patient from NCS group (4/27) compared to those in CS (1/24) group but difference was not statistically significant (p=0.17). The postoperatively average WBCC was significantly higher among patients in NCS group compared to those from CS group (12.89 x 109 vs. 10.44 x109; p=0.014). Also CRP plasma levels postoperatively were significantly higher in NCS group compared to CS group (67.18 mg.L-1 vs. 47.54 mg.L-1; p=0.015). Conclusion(s). The usage of intraoperative blood savage reduces postoperative requirements for allogenic blood transfusion and need for non-invasive respiratory support following major vascular surgery and might be associated with decreased levels of certain inflammatory markers.

Financial benchmarking (BM) is a technique of advanced managing with a view to establishing differences in financial performances, the so called gaps, compared to the competition. It represents an integral part of the overall benchmarking process the use of which involves identification of the backlogs in relation with an entity that has the function of the reference value, with the aim to find ways to overcome them. The use of financial BM is illustrated on the example of Serbian banking industry. In this process, we applied the partitioning clustering (grouping) in order to form homogenous groups from which the leaders are selected for comparison. The analysis was done on the basis of ratios for the past five years (period 2010 - 2014), which, thus, covered spatial and temporal dimensions of comparison. Following the comparison of ratios in the banking industry and non-financial corporations, their adaptation was performed taking into account the particularities of banks' operations. The benefits arising from the use of financial BM process are shown, but also the limitations considering that many important indicators are not publicly available.

nema

Lipopolysaccharide (LPS) is known to induce oxidative stress and inflammation, leading to significant damage in cardiac tissues. This study investigates the protective effects of melatonin (MLT) against LPS-induced oxidative damage, inflammation, and apoptosis in rat heart tissue. Rats were divided into four groups (n = 6 per group): control, melatonin-treated, LPS-treated, and LPS + melatonin-treated. Oxidative stress markers, including thiobarbituric acid-reactive substances (TBARSs) and advanced oxidation protein products (AOPPs), were measured. Additionally, inflammatory markers, such as interleukin-6 (IL-6) levels, inducible nitric oxide synthase (iNOS) and nitric oxide (NO) content, and apoptotic markers, caspase-3, caspase-9, and acidic DNase activity, were evaluated. LPS treatment significantly increased TBARS, AOPP, and IL-6 levels, as well as the activity of caspase-3, acidic DNase and iNOS and NO content compared to the control group. Co-treatment with melatonin significantly reduced the levels of TBARS and AOPP levels, and caspase-3 and acidic DNase activities nearly matched those of the control group, while caspse-9 was still slightly increased. Interestingly, IL-6, iNOS and NO levels were significantly decreased but did not fully match the values in the control group. Melatonin mitigates LPS-induced oxidative stress, inflammation, and apoptosis in rat heart tissue by affecting all studied parameters, demonstrating its potential as a therapeutic agent for conditions characterized by oxidative stress and inflammation. Further research is warranted to explore the clinical applications of melatonin in cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Medianae is the property of Acta Medica Medianae and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Let $ \Phi,\Psi $ Φ , Ψ be symmetrically norming (s.n.) functions, let $ { \boldsymbol{\mathcal C}_{\Psi }(\;\!\!{\mathcal H}\;\!\!) } $ C Ψ ( H ) be the ideal of compact Hilbert space operators, associated with the s.n. function Ψ, $ p\geqslant 2 $ p ⩾ 2 and let $ A,B,X\in \boldsymbol{\mathcal B}\;\!\!(\;\!\!{\mathcal H}\;\!\!) $ A , B , X ∈ B ( H ) be such that A, B are accretive and $ AX+XB\in { \boldsymbol{\mathcal C}_{\Psi }(\;\!\!{\mathcal H}\;\!\!) }. $ AX + XB ∈ C Ψ ( H ). Then $ \;\!\!\sqrt {\;\!\!A^*+A}X\;\!\!\sqrt {\;\!\!B+B^*}\in { \boldsymbol{\mathcal C}_{\Psi }(\;\!\!{\mathcal H}\;\!\!) } $ A ∗ + A X B + B ∗ ∈ C Ψ ( H ) as well, and \[ \left\vert{{\!\left\vert{\;\!\!\sqrt{\;\!\!A^*+A}X\;\!\!\sqrt{\;\!\!B+B^*}}\right\vert\!}}\right\vert_\Psi\leqslant\vert{{\:\!\!\vert{AX+XB}\vert\:\!\!}}\vert_\Psi, \] | | A ∗ + A X B + B ∗ | | Ψ ⩽ | | AX + XB | | Ψ , under any of the following conditions: $ \Psi :={\Phi ^{{^(\;\!\!^{{\;\!\! p}}\;\!\!^)}^{_{\;\!\!*}} }} $ Ψ := Φ ( p ) ∗ and A (resp. $ B^* $ B ∗ ) is quasinormal operator with its adjoint operator being 2-hyperaccretive and having the injective real part; if both A and $ B^* $ B ∗ are quasinormal operators with its adjoint operators being 2-hyperaccretive operators and having injective real parts. Also, for $ {\scriptstyle M},{\scriptstyle N}\in {\mathbb N} $ M , N ∈ N which are such that $ {\scriptstyle K}:=({\scriptstyle M}+{\scriptstyle N})/2\in {\mathbb N}, $ K := (M + N) / 2 ∈ N , for $ {\scriptstyle I},{\scriptstyle J}\in {\mathbb N}\cup \{{0}\}, $ I , J ∈ N ∪ { 0 } , for s.n. functions $ \Phi,\Psi, $ Φ , Ψ , for bounded Hilbert space operators $ A,B,X, $ A , B , X , such that A is $ ({\scriptstyle M}+{\scriptstyle I}) $ (M + I) -hyperaccretive and $ B^* $ B ∗ is $ ({\scriptstyle N}+{\scriptstyle J}) $ (N + J) -hyperaccretive, satisfying $ \Delta _{\scriptscriptstyle A\;\!\!,\;\!\! B}^{{\scriptscriptstyle K}}(X)\;\!\!\stackrel { {\tiny def}}=\;\!\!\sum _{k=0}^{\scriptscriptstyle K}\tbinom {{\scriptscriptstyle K}}{k} \;\! A^{{\scriptscriptstyle K}-k}XB^k\in { \boldsymbol{\mathcal C}_{\Psi }(\;\!\!{\mathcal H}\;\!\!) }, $ Δ A , B K (X) = def ∑ k = 0 K ( K k ) A K − k X B k ∈ C Ψ ( H ) , then there exists $ V_{\scriptscriptstyle \! A\;\!\!,\;\!\! B\;\!\!}^{{\scriptscriptstyle M}+{\scriptscriptstyle I},{\scriptscriptstyle N}+{\scriptscriptstyle J},-}\;\!\! X\;\!\!\stackrel { {\tiny def}}=\;\!\! \sideset {^{_{{\scriptstyle w}}}}{\phantom {}}\lim _{{\scriptscriptstyle T}\rightarrow {+\;\!\!\infty }} \left ({\Delta _{\scriptscriptstyle A^{*}\!,\;\!\! A}^{{\scriptscriptstyle M}+{\scriptscriptstyle I}}(I)}\right)^{ 1/\;\!\!2} $ V A , B M + I , N + J , − X = def lim w lim ⁡ T → + ∞ ⁡ (Δ A ∗ , A M + I (I)) 1 / 2 $ {\rm e}^{-{\scriptscriptstyle T} A} X \,{\rm e}^{-{\scriptscriptstyle T} B} \left ({\Delta _{\scriptscriptstyle B\;\!\!,\;\!\! B^*}^{{\scriptscriptstyle N}+{\scriptscriptstyle J}}(I)}\right)^{ 1/\;\!\!2} $ e − T A X e − T B (Δ B , B ∗ N + J (I)) 1 / 2 and $$\begin{align*} & \left\vert{{\!\left\vert{\left({\sum_{m=0}^{{\scriptscriptstyle M}+{\scriptscriptstyle I}}\!\!\tbinom{{{\scriptscriptstyle M}+{\scriptscriptstyle I}}}{m} A^{*m}\!\;\!\! A^{{\scriptscriptstyle M}+{\scriptscriptstyle I}{\rm -} m}}\right)^{\!\;\!\!{\;\!\!\frac12}}\! X\left({\sum_{n=0}^{{\scriptscriptstyle N}+{\scriptscriptstyle J}}\!\;\!\! \tbinom{{\scriptscriptstyle N}+{\scriptscriptstyle J}}{n}B^{{\scriptscriptstyle N}+{\scriptscriptstyle J}{\rm -} n} B^{*n}}\right)^{\!\;\!\!{\;\!\!\frac12}}-V_{\scriptscriptstyle\! A\;\!\!,\;\!\! B\;\!\!}^{{\scriptscriptstyle M}+{\scriptscriptstyle I},{\scriptscriptstyle N}+{\scriptscriptstyle J},-}\;\!\! X}\right\vert\!}}\right\vert_\Psi \\ & \leqslant\frac{\;\!\!\sqrt{\;\!\!({\scriptscriptstyle M}-1)! ({\scriptscriptstyle N}-1)!}}{\left({\frac{{\scriptscriptstyle M} +{\scriptscriptstyle N}}2-1}\right)!} \left\vert \!\left\vert \left({\sum_{i=0}^{{\scriptscriptstyle I}}\!\;\!\! \tbinom{{\scriptscriptstyle I}}{i}A^{*i} A^{{\scriptscriptstyle I} {\rm -} i}}\right)^{\!\;\!\!{\;\!\!\frac12}} \right.\right. \end{align*}$$ | | (∑ m = 0 M + I ( M + I m ) A ∗ m A M + I − m ) 1 2 X (∑ n = 0 N + J ( N + J n ) B N + J − n B ∗ n ) 1 2 − V A , B M + I , N + J , − X | | Ψ ⩽ (M − 1) ! (N − 1) ! ( M + N 2 − 1) ! | | (∑ i = 0 I ( I i ) A ∗ i A I − i ) 1 2 $$\begin{align*} & \quad \left.\left.\sum_{k=0}^{{\scriptscriptstyle K}}\!\;\!\! \tbinom{{\scriptscriptstyle K}}{k}A^{{\scriptscriptstyle K} {\rm -} k} XB^k \left({\sum_{j=0}^{{\scriptscriptstyle J}}\!\;\!\! \tbinom{{\scriptscriptstyle J}}{j}B^{{\scriptscriptstyle J} {\rm -} j}B^{*j}}\right)^{\!\;\!\!{\;\!\!\frac12}}\right\vert\!\right\vert_\Psi, \end{align*}$$ ∑ k = 0 K ( K k ) A K − k X B k (∑ j = 0 J ( J j ) B J − j B ∗ j ) 1 2 | | Ψ , hold under any of the following conditions: if $ p\geqslant 2,\Psi :={\Phi ^{{^(\;\!\!^{{\;\!\! p}}\;\!\!^)}^{_{\;\!\!*}} }} $ p ⩾ 2 , Ψ := Φ ( p ) ∗ and A or $ B^* $ B ∗ is normal (in which case $ V_{\scriptscriptstyle \! A\;\!\!,\;\!\! B\;\!\!}^{{\scriptscriptstyle M}+{\scriptscriptstyle I},{\scriptscriptstyle N}+{\scriptscriptstyle J},-}\;\!\! X=0 $ V A , B M + I , N + J , − X = 0), if both A and $ B^* $ B ∗ are normal (in which case $ V_{\scriptscriptstyle \! A\;\!\!,\;\!\! B\;\!\!}^{{\scriptscriptstyle M}+{\scriptscriptstyle I},{\scriptscriptstyle N}+{\scriptscriptstyle J},-}\;\!\! X=0 $ V A , B M + I , N + J , − X = 0), if $ \vert {{\:\!\!\vert {\cdot }\vert \:\!\!}}\vert _{\Psi }:=\vert {{\:\!\!\vert {\cdot }\vert \:\!\!}}\vert _1 $ | | ⋅ | | Ψ := | | ⋅ | | 1 and $ AX+XB\in \boldsymbol{\mathcal C}_{\;\!\!1}\;\!\!(\;\!\!{\mathcal H}\;\!\!). $ AX + XB ∈ C 1 ( H ). [ABSTRACT FROM AUTHOR]

The function of normal hemostasis is to prevent blood loss from an uninjured blood vessel and to stop excessive bleeding from a damaged blood vessel. Blood loss from an uninjured vessel is prevented by normal vessel structure and normal platelet function. Platelet aggregation is mediated by von Willebrand factor, a polymeric plasma glycoprotein. This protein binds to specific platelet membrane receptors and collagen. Primary aggregation of incoming platelets is facilitated by the action of thrombin. Aggregated platelets then release serotonin, thromboxane A2 and adenosine diphosphate (ADP) which stimulate vasoconstriction which is an additional stimulus for platelet aggregation and represents secondary aggregation. Many factors are related to bleeding during cardiac surgical procedures. Impedance aggregometry is a test of aggregation of platelets in whole blood, which allows us to observe the function of platelets in the presence of erythrocytes and leukocytes and prevents the artificial activation of platelets that occurs due to the separation process. Aggregometry is used to diagnose disorders of platelet function, which are rarely congenital, and most often acquired. In our research, we proved that 31% of patients had post-operatively impaired platelet function, with postoperative bleeding after 24 hours being statistically significantly higher in patients with ADP < 300 AU/min 24 hours after surgery, as well as TRAP < 500 AU/min 24 hours after surgery (p = 0.002). Twenty-two patients (22.0%) received a platelet transfusion 3 hours after surgery - ADP test ≤ 300 AU/min, ASPI ≤ 400 AU/min, TRAP ≤ 500 AU/min. On average, 11.14 ± 4.45 doses were administered. No patient in this study needed a transfusion of platelets 24 h after the procedure. Contemporary principles such as “time is life” together with modern clinical protocols and experienced personnel are essential in the treatment of hemostatic disorders during cardiac interventions. [ABSTRACT FROM AUTHOR]

Melatonin (MLT), earlier described as an effective anti-inflammatory agent, could be a beneficial adjunctive drug for sepsis treatment. This study aimed to determine the effects of MLT application in lipopolysaccharide (LPS)-induced sepsis in Wistar rats by determining the levels of liver tissue pro-inflammatory cytokines (TNF-α, IL-6) and NF-κB as well as hematological parameters indicating the state of sepsis. Additionally, an immunohistological analysis of CD14 molecule expression was conducted. Our research demonstrated that treatment with MLT prevented an LPS-induced increase in pro-inflammatory cytokines TNF-α and IL-6 and NF-κB levels, and in the neutrophil to lymphocyte ratio (NLR). On the other hand, MLT prevented a decrease in the blood lymphocyte number induced by LPS administration. Also, treatment with MLT decreased the liver tissue expression of the CD14 molecule observed after sepsis induction. In summary, in rats with LPS-induced sepsis, MLT was shown to be a significant anti-inflammatory agent with the potential to change the liver's immunological marker expression, thus ameliorating liver function. [ABSTRACT FROM AUTHOR]

Copyright of Timocki Medicinski Glasnik is the property of Timocki Medicinski Glasnik and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Objectives: Coagulation disorders during COVID-19 infection are associated with a poorer prognosis and higher disease severity because thrombosis and inflammation are two processes that interfere with each other. A very important issue for clinicians is timely and adequate hemostasis and inflammation monitoring to prevent and treat potentially lethal consequences. The aim of this study was to identify specific hemostatic parameters that are associated with a higher risk of intrahospital mortality. Materials and Methods: This study was approved by the Ethics Committee of the Clinical Center Nis in Serbia. One hundred and forty-two patients presented with COVID-19 ARDS and were admitted to the ICU in the Clinic for Anesthesiology at the Clinical Center Nis from 14 April 2020 to 25 May 2020. Upon admission, blood was collected for biochemical and coagulation testing. The data obtained were analyzed using the Statistical Package for Social Sciences (SPSS v. 25, Chicago, IL, USA). Results: Among all the parameters assessed, older age; increased levels of fibrinogen, INR, D-dimer, and presepsin; and higher results in the platelet aggregation tests (aggregation induced by adenosine diphosphate based on the ADP test (AU/min), aggregation induced by arachidonic acid based on the ASPI test (AU/min), and aggregation induced by thrombin based on the TRAP test (AU/min)) and some assays of the viscoelastic test (clot amplitude after 5 min in the extrinsic coagulation pathway based on the A5 EX-test (mm), clot amplitude after 10 min in the extrinsic coagulation pathway based on the A10 EX-test (mm), clot amplitude after 5 min regarding functional fibrinogen based on the A5 FIB-test (mm), clot amplitude after 10 min regarding functional fibrinogen based on the A10 FIB-test (mm), and maximum clot firmness based on the MCF FIB-test (mm)); and lower values of viscoelastic clotting time in the extrinsic coagulation pathway based on the CT EX-test (s) were significantly correlated with mortality. In the multivariate analysis, D-dimer levels above 860 ng/mL, higher TRAP test value bins, and values above the normal reference range of the A10 FIB test were found to be independent predictors of mortality. Conclusions: Sophisticated hemostasis parameters can contribute to early risk assessment, which has initially been performed only on the basis of patients' clinical status. Hypercoagulability is the main coagulation disorder in COVID-19 infection. [ABSTRACT FROM AUTHOR]

Lipopolysaccharide (LPS) is a constituent of Gram-negative bacterial cell walls, thus LPS injection has been widely used as a model of experimental acute kidney injury associated with sepsis. LPS-induced sepsis is caused by excessive secretion of proinflammatory mediators and reactive oxygen species (ROS). The neurohormone melatonin, which is mainly secreted by the pineal gland, regulates the circadian rhythm, has an anti-inflammatory and immunoregulatory role. Melatonin and its metabolites have been shown to scavenge various free radicals and reactive oxygen intermediates. The aim of this study was to evaluate the effect of melatonin in preventing endotoxemia-induced kidney damage caused by LPS, by analysing the concentration of urea and creatinine in the blood serum of rats. Twenty-eight Wistar albino rats were randomly divided into four groups (n = 7 per group) as follows: 1) Control group, 2) MLT group (50 mg/kg, per os), 3) LPS group (10 mg/kg, i.p.) and 4) LPS + MLT group (10 mg/kg + 50 mg/kg). Serum levels of creatinine and urea were significantly higher (p<0.05) in the LPS-treated animals compared with values in the control group. Co-application of LPS and MLT significantly reduced an increase in serum creatinine and urea levels (p<0.05). It can be concluded that oral administration of melatonin significantly alleviates LPS-induced acute nephrotoxicity in rats. It is likely that the beneficial effects of melatonin are related to its known antioxidant effects on kidney tissue, and possibly to some other less known/studied effects. [ABSTRACT FROM AUTHOR]

If A , B ∈ B (H) are normal accretive operators, X ∈ B (H) , 0 < α < 1 and Φ is a s.n. function, we proved that | ( A ∗ + A ) 1 − α X (B + B ∗ ) α | 2 ⩽ Γ (2 − 2 α) ∫ [ 0 , + ∞) e − t B ∗ ( B ∗ + B ) α | A X + X B | 2 × ( B ∗ + B ) α e − t B t 2 α − 1 d t , ∥ ( A ∗ + A ) 1 − α X (B + B ∗ ) α ∥ Φ ⩽ Γ (2 − 2 α) Γ (2 α) ∥ A X + X B ∥ Φ , i f A X + X B ∈ C Φ (H). Let A , B , X ∈ B (H) , A ⩾ 0 , B ⩾ 0 , η , θ ∈ R , α ∈ (0 , 1) and Φ be a s.n. function. If e i η A X + e i θ X B ∈ C Φ (H) , then we have the following generalization of Young's norm inequality in Jocić [Cauchy–Schwarz norm inequalities for weak*-integrals of operator valued functions. J Funct Anal. 2005;218:318–346], Corollary 4.1 | e i η + e i θ | ∥ A 1 − α X B α ∥ Φ ⩽ Γ (2 − 2 α) Γ (2 α) ∥ e i η A X + e i θ X B ∥ Φ. Various examples and applications of the obtained norm inequalities are also presented, including those related to the Heinz and Heron means and Zhan inequalities. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Medianae is the property of Acta Medica Medianae and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Timocki Medicinski Glasnik is the property of Timocki Medicinski Glasnik and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Medica Medianae is the property of Acta Medica Medianae and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Elderly patients scheduled for major elective vascular surgery are at high risk for a major adverse cardiac events (MACE). The objectives of the study were: (1) To determine the individual discriminatory ability of four risk prediction models and four biomarkers in predicting MACEs in elderly patients undergoing major elective vascular surgery; (2) to find a prognostic model with the best characteristics; (3) to examine the significance of all preoperative parameters; and (4) to determine optimal cut-off values for biomarkers with best predictor capabilities. We enrolled 144 geriatric patients, aged 69.97 ± 3.73 years, with a 2:1 male to female ratio. Essential inclusion criteria were open major vascular surgery and age >65 years. The primary outcome was the appearance of MACEs within 6 months. These were noted in 33 (22.9%) patients. The most frequent cardiac event was decompensated heart failure, which occurred in 22 patients (15.3%). New onset atrial fibrillation was registered in 13 patients (9%), and both myocardial infarction and ventricular arrhythmias occurred in eight patients each (5.5%). Excellent discriminatory ability (AUC >0.8) was observed for all biomarker combinations that included the N-terminal fragment of pro-B-type natriuretic peptide (NT-proBNP). The most predictive two-variable combination was the Geriatric-Sensitive Cardiac Risk Index (GSCRI) + NT-proBNP (AUC of 0.830 with a 95% confidence interval). Female gender, previous coronary artery disease, and NT-proBNP were three independent predictors in a multivariate model of binary logistic regression. The Cox regression multivariate model identified high-sensitivity C-reactive protein and NT-proBNP as the only two independent predictors. [ABSTRACT FROM AUTHOR]

Sigma 1 receptor antagonism is deemed a promising pain treatment approach. This research paper outlines conformational-independent QSAR modeling for a range of compounds which serve as Sigma 1 receptor antagonists. The SMILES notation and the local molecular graph invariants were utilized as descriptors for building conformation-independent QSAR models, with the Monte Carlo optimization method serving as a model developer. For the purpose of testing the developed models' quality, robustness, and predictability, various statistical methods were employed, including the ideality of correlation index. The results obtained were good. The molecular fragments accounting for the increase/decrease of the examined activity were defined and used for the computer-aided design of new compounds in order to determine their potential as analgesics. The final assessment of the developed QSAR models, as well as of the designed inhibitors, was performed with the use of molecular docking studies, highlighting exceptional correlation with the QSAR modeling results. [ABSTRACT FROM AUTHOR]

Introduction: The soluble urokinase-type plasminogen activator receptor (suPAR) in uPAR soluble form is produced when the uPAR is cleaved from the cell membrane during the inflammatory process. Postoperative atrial fibrillation (AF) is the most common perioperative cardiac arrhythmia. It is speculated that elevated suPAR has a role in the development of AF. The aim of our study was to investigate the predictive role of preoperative suPAR in the occurrence of AF during the first 6 months after major vascular surgery. Methods: We included 119 male and 63 female patients with an average age of 67.19 ± 6.02 years, without permanent/persistent AF. Basic predictive model (BASIC) included traditional risk factors for AF: age, gender, body mass index-BMI, smoking status, presence of arterial hypertension, diabetes mellitus and dyslipidemia. Results: Over the 6-month period, 19 (10.4%) patients had one new episode of atrial fibrillation and 2 patients (1.1%) had 2 episodes of paroxysmal atrial fibrillation. Paroxysms of AF were significantly more frequent in patients who had a resection of an abdominal aneurysm than in patients with other types of major vascular surgery. BASIC had good discriminatory ability in the prediction of AF paroxysms during the first 6 months after surgery (AUC = 0.715, 95%CI 0.590-0.840). Adding suPAR to the basic model significantly improved the discriminative ability of the predictive model for AF episodes (ΔAUC = 0.238, p < 0.001). The predictive performance of the model BASIC+CRP+suPAR, measured using AUC, NRI and IDI statistics, was very similar to the model BASIC+suPAR. Conclusion: AF is a common complication in surgical patients with high mortality and morbidity. suPAR could improve the ability of traditional risk factors to predict its occurrence up to 6 months after major vascular surgery. [ABSTRACT FROM AUTHOR]

Copyright of Timocki Medicinski Glasnik is the property of Timocki Medicinski Glasnik and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: Beside the intention of early detection and optimal treatment of deep venous thrombosis (DVT), the aim of this study was to investigate the influence of chronobiological rhythms on the etiopathogenesis of unprovoked deep vein thrombosis of the lower limbs with monitoring of seasonal variations in biochemical parameters. Patients and methodology: The prospective clinical trial included all consecutive hospitalized patients and outpatients diagnosed with DVT at the Vascular Surgery Clinic of the Clinical Center in Niš, starting from January 2013 to December 2014. Results: There was no statistically significant difference in correlation between the distribution of the incidence of DVT of the lower limbs (p = 0.582), sex (p = 0.350), age (p = 0.385) and localization (p = 0.886) and the seasons. Creatinine levels were significantly higher in patients who developed DVT in spring than in those who developed DVT in winter (p < 0.05), while LDL cholesterol levels were significantly higher in patients diagnosed with DVT in winter than in those diagnosed with DVT in autumn (p < 0.05). Conclusion: According to the results of the study, it can be concluded that in the territory of South Serbia, the seasons are not significantly related to the incidence, sex, age and localization of unprovoked DVT of the lower limbs. Creatinine levels were significantly higher in patients who developed DVT in spring than in those who developed DVT in winter, while LDL cholesterol levels were significantly higher in patients during winter than during autumn. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Medianae is the property of Acta Medica Medianae and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Medica Medianae is the property of Acta Medica Medianae and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Bleeding during and after cardiopulmonary bypass is a multifactorial and potentially lethal complication. That is why one of the most difficult tasks in cardiac surgery is the establishment of a timely, physiological hemostasis. The aim of this study was to diagnose the most common coagulation disorders in patients who underwent surgical revascularization of the myocardium (their frequency, follow-up complications) and therapeutic care of them. The prospective survey included 100 respondents (22 female females-22.0% and 78 male respondents -78.0%), who were subjected to single, double and triple surgical revascularization of the myocardium. Preoperative as well as 3 hours and 24 hours postoperatively determined the following parameters: blood count, coagulation status, platelet function parameters, rotational thromboelastometric parameters, blood and blood product use, use of synthetic hemostatic agents. The most commonly diagnosed hemostasis disorders are preoperative and postoperatively disrupted platelet function (up to 31% of patients), postoperative extrinsic coagulation factor concentration depletion (postoperatively) (21% of patients), intrinsic factor coagulation activity disorder (23% of patients after surgery) and disturbed concentration of functional fibrinogen and impaired fibrin clot polymerization in 17% of patients following surgery. During the study, 13% of patients received a cryoprecipitate transfusion after surgery, 10% of patients received frozen fresh plasma, 22% were transfunded with platelet concentrates, 20% of patients received desmopressin acetate, while 3 patients received a prothrombin complex concentrate in the postoperative course. [ABSTRACT FROM AUTHOR]