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Introduction: The COVID-19 virus belongs to the group of respiratory viruses. Due to the nature of their work, dentists are at greater risk of contracting the new coronavirus during dental interventions. Knowing the path of transmission of the virus is of great importance in preventing and suppressing the development of infection. Patients’ fear of infection during the coronavirus pandemic was significant, and because of this, visits to the dentist for standard dental services were postponed, and patients came only for emergencies. Adherence to protective measures directly affected patients’ satisfaction with dental services. The aim of this work was to examine patient satisfaction with dental services during the coronavirus pandemic. Materials and Methods: The study was designed as a cross-sectional study using an epidemiological questionnaire. A total of 120 patients were surveyed, 60 from private practice and 60 from the state sector. The questionnaire was anonymous and contained sociodemographic questions and questions related to knowledge of protocols and satisfaction with dental services. The data were processed in the SPSS 11.5 program. Results: Out of 120 respondents with an average age of 38.92 ± 13.08 years, 98% were familiar with the protocol for protection against the coronavirus. There were no dissatisfied people in either private practice or the public sector; the only difference was in the degree of satisfaction. In private practice, more respondents were very satisfied as the highest level of satisfaction, while in the public sector, it was very satisfied. Conclusion: A good knowledge of the protocol for protection and prevention of the spread of the virus raises awareness among dentists and patients. By following these measures, infection with the virus is reduced to a minimum, and therefore patient satisfaction with dental services is at a higher level.

This article discusses the effects of opioid withdrawal on striatal dopamine levels. The study found that in laboratory rats exposed to morphine injections, extracellular dopamine concentrations decreased in the ventral striatum during withdrawal, but increased in the dorsal striatum during naloxone-triggered withdrawal. These findings suggest that withdrawal symptoms can become paired with opioid availability, enhancing the incentive salience of the drug and promoting conditioned approach. The article also explores the implications of these findings for addiction treatment, suggesting that a medication that offsets the aversive effects of withdrawal while diminishing dopamine surges could be beneficial. [Extracted from the article]

In patients with pulmonary embolism (PE), the D-dimer assay is commonly utilized as part of the diagnostic workup, but data on D-dimer for early risk stratification and short-term mortality prediction are limited. The purpose of this study was to determine D-dimer levels as a predictive biomarker of PE outcomes in younger (<50 years of age) compared to older patients. We conducted retrospective analysis for 930 patients diagnosed with PE between 2015 and 2019 as part of the Serbian University Multicenter Pulmonary Embolism Registry (SUPER).All patients had D-dimer levels measured within 24 hours of hospital admission. The primary outcome was mortality at 30 days or during hospitalization. Patients were categorized into two groups based on age (≤ 50 and >50 years of age). Younger patients constituted 20.5% of the study cohort. Regarding all-cause mortality, 5.2% (10/191)of patients died in group under the 50 years of age; the short-term all-causemortality was 12.4% (92/739) in older group.We have found that there was significant difference in plasma D-dimer level between patients ≤ 50 years of age and older group (>50), p= 0.006.D-dimer plasma level had good predictive value for the primary outcome in younger patients (c-statistics 0.710; 95% CI, 0.640-0.773; p<0.031). The optimal cutoff level for D-dimer to predict PE-cause death in patients aged > 50 years was found to be 8.8 mg/l FEU(c-statistics 0,580; 95% CI 0.544-0.616; p=0.049). In younger PE patients, D-dimer levels have good prognostic performance for 30-day all-cause mortalityand concentrations above 6.3 mg/l FEU are associated with increased risk of death. D-dimer in patients aged over 50 years does not have predictive ability for all-caused short-term mortality. The relationship between D-dimer and age in patients with PE may need further evaluation. [ABSTRACT FROM AUTHOR]

(1) Background: The aim of our study was to determine the role of oxidative stress (OS) during early evaluation of acute ST-elevated myocardial infarction (STEMI) and non-ST-elevated myocardial infarction (NSTEMI) patients in order to define the role of redox balance in profiling the development of myocardial infarction (MI). (2) Methods: This prospective observational case-control study included 40 consecutive STEMI and 39 NSTEMI patients hospitalized in the coronary care unit of the cardiology clinic at the Kragujevac Clinical Center, Serbia, between 1 January 2016 and 1 January 2017. Blood samples were collected from all patients for measuring cardio-specific enzymes at admission and 12 h after admission to evaluate systemic oxidative stress biomarkers and the activity of antioxidant enzymes. (3) Results: In this study, participants were predominately female (52%), with a mean age of 56.17 ± 1.22 years old in the STEMI group and 69.17 ± 3.65 in the non-STEMI group. According to the Killip classification, the majority of patients (>50%) were at the second and third level. We confirmed the elevation of superoxide anion radicals in the non-STEMI group 6 h after admission in comparison with the STEMI and CTRL groups, but levels had decreased 12 h after admission. Levels of hydrogen peroxide were statistically significantly increased in the NSTEMI group. A positive correlation of superoxide anion radicals and levels of troponin I at admission was observed (r = 0.955; p = 0.045), as well as an inverse correlation between reduced glutathione and levels of NT-pBNP measured 6 h after admission (r = −0.973; p = 0.027). (4) Conclusions: We confirmed that superoxide anion radicals and reduced glutathione observed together with hs-troponin I at admission and NT-pBNP during hospital treatment could be predictors of ST evolution. [ABSTRACT FROM AUTHOR]

Background and Objectives: Polycystic ovary syndrome (PCOS) is a frequent multifactorial endocrinopathy affecting women in the reproductive period, often associated with infertility and metabolic disorders. The use of animal models helps to better understand etiopathogenesis, enabling the examination of the effects of certain drugs in order to discover the best possible therapeutic approach. We tried to investigate the additional effect of estradiol-valerate (EV) and high-fat diet (HFD) in female rats to explore PCOS-related alterations with special focus on oxidative stress. Materials and Methods: Animals were divided into three groups: control group (CTRL, n = 6), estradiol-valerate group (EV, n = 6), and estradiol-valerate group on HFD (EV + HFD, n = 6). PCOS was induced by single subcutaneous injection of long-acting EV in a dose of 4 mg/per rat. We tried to improve the metabolic characteristics of the PCOS animal model by adding HFD, so the CTRL and EV group had a regular diet, while the EV + HFD group had HFD during the induction period of 60 days. Results: We observed alterations of anthropometric parameters and hormonal disturbances, along with estrus cycle impairment reassembly to obese-type PCOS phenotype. Moreover, glucose metabolism was impaired after addition of HFD to EV protocol, contrary to EV administered alone. Histological analysis confirmed more numerous cystic follicles after the combination of EV and HFD protocol. The alterations of oxidative stress markers could be related to and serve as the mechanistic base for development of PCOS-related endocrine, reproductive, and metabolic properties. Conclusions: The additive effect of EV and HFD was obvious in the majority of the parameters observed. Our study strongly demonstrated metabolic as well as reproductive properties of PCOS in rats. [ABSTRACT FROM AUTHOR]

Introduction: There is little data on the association of metabolic syndrome and health status in Serbian men, so our intention was to investigate the prevalence of the metabolic syndrome in men with no history of diabetes or cardiovascular disease in New Belgrade, Serbia; to determine which of the anthropometric parameters (body mass index—BMI and waist circumference—WC) is best for the evaluation of health risks in primary care, especially the risk factors for metabolic syndrome. Research Methods and Procedures: The study involved 132 healthy men ages 44.73 ± 9.37 years. Anthropometric values were measured in all the patients. Blood pressure, blood biochemistry (high-density lipoprotein- cholesterol, low-density lipoprotein-cholesterol, triglycerides, blood glucose) and analysis of their medical records were also done. Analysis of consistency has been used in testing hypothesis. Results: The sample consisted of 132 patients with mean age 44.73 ± 9.37 years. The prevalence of the metabolic syndrome was 44.7%. Analysis of consistence showed differences in the combined predictive ability of anthropometric indicators and other factors of MetS. Conclusions: BMI andWCare the simple measures of adiposity most strongly associated with metabolic abnormalities. Our findings suggest that WC can not be used as a complementary measurement to identify health risks in any group of men

Polycystic ovary syndrome (PCOS) is the most frequent endocrinopathy during women's reproductive age. PCOS is a heterogeneous disorder featuring specific cardiometabolic properties. The association between the presence of metabolic disorders and PCOS supports the claim that the regulation of glycemic status is very important in these patients. There is a wide range of therapeutic options (including those treating diabetes mellitus type 2) with potential advantages available for the management of PCOS. Sodium–glucose cotransporter type 2 inhibitors (SGLT-2is) improve glucose metabolism, reduce fat tissue, lower blood pressure, reduce oxidative stress and inflammation, and protect the cardiovascular system. Currently, the use of SGLT-2is is not widespread in PCOS therapy, although these drugs represent a promising new therapeutic approach. Therefore, it is necessary to initiate further study in order to determine more effective therapies for PCOS and investigate the effect of SGLT-2is, both as a monotherapy and in combination with other drugs. It is necessary to understand the mechanisms underlying SGLT-2is in PCOS and their effects on long-term complications, especially since the gold standard treatment for PCOS, such as metformin and oral contraceptives, do not have long-term cardioprotective effects. The effects of SGLT-2is seem to involve cardiac protection, while diminishing endocrine and reproductive abnormalities in PCOS. In the current narrative review, we examine the most recent clinical evidence and discuss the potential applications of SGLT-2is for PCOS therapy. [ABSTRACT FROM AUTHOR]

As the ultimate pathophysiological event, heart failure (HF) may arise from various cardiovascular (CV) conditions, including sustained pressure/volume overload of the left ventricle, myocardial infarction or ischemia, and cardiomyopathies. Sacubitril/valsartan (S/V; formerly termed as LCZ696), a first-in-class angiotensin receptor/neprilysin inhibitor, brought a significant shift in the management of HF with reduced ejection fraction by modulating both renin-angiotensin-aldosterone system (angiotensin II type I receptor blockage by valsartan) and natriuretic peptide system (neprilysin inhibition by sacubitril) pathways. Besides, the efficacy of S/V has been also investigated in the setting of other CV pathologies which are during their pathophysiological course and progression deeply interrelated with HF. However, its mechanism of action is not entirely clarified, suggesting other off-target benefits contributing to its cardioprotection. In this review article our goal was to highlight up-to-date clinical and experimental evidence on S/V cardioprotective effects, as well as most discussed molecular mechanisms achieved by this dual-acting compound. Although S/V was extensively investigated in HF patients, additional large studies are needed to elucidate its effects in the setting of other CV conditions. Furthermore, with its antiinflamatory potential, this agent should be investigated in animal models of inflammatory heart diseases, such as myocarditis, while it may possibly improve cardiac dysfunction as well as inflammatory response in this pathophysiological setting. Also, discovering other signalling pathways affected by S/V should be of particular interest for basic researches, while it can provide additional understanding of its cardioprotective mechanisms. [ABSTRACT FROM AUTHOR]

(1) Background: the purpose of this study was a preliminary analysis of current methods of online teaching at the Faculty of Medical Sciences, University of Kragujevac, Republic of Serbia, in order to define the attitudes of biomedical students about education during the COVID-19 pandemic and to validate of the education medical questionnaire (eMedQ), a new tool for the assessment of the students' perceptions about digital education. (2) Methods: this was a qualitative cross-sectional observational study that used the originally developed 45-item questionnaire (eMedQ) as an assessment instrument conducted on biomedical students (n = 209) of all study years at the Faculty of Medical Sciences, University of Kragujevac (Republic of Serbia), during winter semester or between September 2021 and January 2022. (3) Results: In this study, a Cronbach's alpha value of 0.904 was obtained, which indicated good internal consistency; the correlation matrix revealed many coefficients greater than 0.3, denoting high correlations between the items. The Kaiser–Meyer–Olkin measure of sampling adequacy was 0.866 and Bartlett's test of sphericity was significant (p < 0.001). The PCA revealed the presence of seven components with characteristic values over one, while three factors explained the highest percentage of variance. (4) Conclusions: this research developed and validated a new tool for evaluation of biomedical student perceptions about digital education. [ABSTRACT FROM AUTHOR]

(1) Background: The aim of this study was to show the effects of swimming and nandrolone administration on cardiodynamic and morphometric parameters of the isolated rat heart. (2) The study included 72 Wistar rats, divided into three groups, scheduled to be sacrificed after the second, third, and fourth week. Each group was divided into four subgroups: control (T-N-), nandrolone (T-N+), swimming training (T+N-), and swimming training plus nandrolone (T+N+) group. The rats from T+N- and T+N+ swam 1 h/day, 5 days/week while ones from T-N+ and T+N+ received weekly nandrolone decanoate (20 mg/kg). The isolated hearts were perfused according to the Langendorff technique and measured parameters: dp/dt max/min, SLVP, DLVP, heart rate, and coronary flow. Hearts were fixed and stained with H/E and Masson trichrome dyes. (3) dp/dt max and dp/dt min were increased in the T-N+ group at higher perfusion pressure compared to the T-N- group. SLVP and DLVP were increased in all groups after the 4th week. Collagen content was increased in T-N+ by 403% and in T+N+ by 357% groups, while it was decreased in T+N- compared to the control after 4th week. (4) Conclusions: Nandrolone alone or combined with swimming had a deleterious effect on myocardial function and perfusion. [ABSTRACT FROM AUTHOR]

Objective: Many studies so far have shown that antipsychotic therapy may have an effect on the development of metabolic syndrome in patients diagnosed with schizophrenia. Our goal was to determine whether our respondents are at risk for developing metabolic syndrome and who is more predisposed to it. Methods: In a stable phase, 60 patients diagnosed with schizophrenia were equally divided into three groups according to the drug (risperidone, clozapine, and aripiprazole monotherapy). Control group had 20 healthy examinees. Patients were evaluated first using The Positive and Negative Syndrome Scale (PANSS). Prolactin, lipid status, glycemia, insulin, cytokine values (IL-33, TGF-β, and TNF-α) and C-reactive protein (CRP) were measured. Also, Body mass index (BMI), Homeostatic Model Assesment for Insulin Resistance (HOMA index), waist and hip circumference (WHR) and blood pressure (TA) measurement were performed in the study. Results: Patients treated with risperidone compared to healthy control subjects and aripiprazol group of patients had statistically significant difference in prolactin levels. In clozapine group compared to healthy control group values of HDL cholesterol and glucose level were statistically significant different. In aripiprazole group compared to healthy control group value of BMI was statistically significant different. Statistically significant correlations were found in TNF-α with glucose and HOMA index in risperidone treated patients and with BMI in clozapine group of patients; IL-33 with glucose in risperidone and with BMI in clozapine group of patients and TGF-β with glucose in risperidone group, with insulin and HOMA index in clozapine group and statistically significant negative correlation with LDL cholesterol in aripiprazole group of patients. Conclusion: Patients on risperidone and clozapine therapy may be at greater risk of developing metabolic syndrome than patients treated with aripiprazole. Statistically significant difference in concentration of TNF-α and TGF-β was in the group of patients treated with risperidone compared to healthy control group. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) represents the most common endocrinopathy among childbearing-age women, with oxidative stress (OS) underlying its etiopathogenesis. Metformin (MET) represents a frequently used agent in PCOS. However, weak results encourage alternative treatments. We aimed to investigate isolated and synergistic effects of Standardized Aronia melanocarpa extract (SEA) and MET for alleviating reproductive and metabolic PCOS abnormalities. PCOS induction was followed by 28-day treatment with MET, SAE, or MET + SEA. Bodyweight (BW), cyclicity, histological, and ultrasonographical ovarian analyses were performed. Hormonal, glycemic, and lipid profiles were accessed, as well as systemic and ovarian oxidative status; BW, cyclicity, ovarian histomorphology, ovarian volume, testosterone and progesterone levels, as well as LDL, triglycerides, and total cholesterol levels were aggravated after PCOS-induction and improved after MET, SEA, and MET + SEA treatment. MET + SEA had the greatest impact on glycoregulation. Alterations in OS parameters (TBARS, O2−, H2O2, catalase, superoxide dismutase, and reduced glutathione) could be responsible for observed differences; (4) Conclusions: Our findings confirmed that SAE alone or along with MET was capable of ameliorating reproductive and metabolic disturbances in the PCOS rat model, with the restoration of OS parameters. SAE alone did not alter the protective effects of MET in PCOS. [ABSTRACT FROM AUTHOR]

Byline: Aleksandra Stankovic (Department of Hygiene with Medical Ecology, Faculty of Medicine, University of Nis, Nis, Serbia, aleksandra@exe-mail.net); Dragana Nikic (Department of Hygiene with Medical Ecology, Faculty of Medicine, University [...]

This paper highlights the cardioprotective potential of sodium-glucose cotransporter 2 inhibitors (SLGT2i), as well as several most discussed mechanisms responsible for their cardioprotection. Cardiovascular diseases are considered a primary cause of death in nearly 80% of type 2 diabetes mellitus (T2DM) patients, with a 2–4-fold greater incidence of heart failure (HF) among diabetics. As novel hypoglycemics, SGLT2i showed exceptional cardiovascular benefits, reflected through robust reductions of cardiovascular mortality and hospitalization for HF in T2DM patients. Recently, those effects have been reported even in patients with HF and reduced ejection fraction irrespectively of diabetic status, suggesting that cardioprotective effects of SGLT2i are driven independently of their hypoglycemic actions. SGLT2i exerted hemodynamic and metabolic effects, partially driven by natriuresis and osmotic diuresis. However, those systemic effects are modest, and therefore cannot be completely related to the cardiac benefits of these agents in T2DM patients. Hence, increased circulating ketone levels during SGLT2i administration have brought out another hypothesis of a cardiac metabolic switch. Moreover, SGLT2i influence ion homeostasis and exert anti-inflammatory and antifibrotic effects. Their enviable influence on oxidative stress markers, as well as anti- and pro-apoptotic factors, have also been reported. However, since the main mechanistical contributor of their cardioprotection has not been elucidated yet, a joint action of systemic and molecular mechanisms has been suggested. In the light of ongoing trials evaluating the effects of SGLT2i in patients with HF and preserved ejection fraction, a new chapter of beneficial SGLT2i mechanisms is expected, which might resolve their main underlying action. [ABSTRACT FROM AUTHOR]

In our paper we aimed to increase the awareness among physicians, concerning coronavirus disease 2019 (COVID-19) severity, especially in patients with specific underlying comorbidities. Obesity is the second most common condition in hospitalized COVID-19 patients. Furthermore it has a major role in the development of obstructive sleep apnoea (OSA), which is highly involved in a severe COVID-19 development and its serious outcomes. Even though obese OSA patients had an increased pulmonary embolism (PE) risk, there is no enough evidence to support the interaction between obesity and OSA regarding PE development in the setting of COVID-19. Our patient is a 45-year-old obese male with COVID-19, who was admitted to the intensive care unit (ICU) with acute respiratory failure requiring high-flow nasal oxygenation. Clinical, laboratory and diagnostic findings pointed on severe COVID-19 form, complicated with PE. After recovery, the diagnosis of OSA was established. With this case, we wanted to alert the physicians on comorbidities, such as obesity and OSA, while those conditions, to some extent, may contribute to worse COVID-19 clinical presentation. [ABSTRACT FROM AUTHOR]

Introduction: Recent studies report that syncope is not a significant predictor of 30‐day mortality in pulmonary embolism (PE) patients, yet some data suggest sex‐related differences may be relevant. Objectives: To evaluate sex‐specific prediction significance of syncope for 30‐day mortality in PE patients. Methods: A multicentric, retrospective, observational, registry‐based study on consecutive PE patients was undertaken. Patients were allocated into either a men or a women group before comparisons were made between patients with syncope and those without syncope. A sex‐related prediction of the significance of syncope for 30‐day mortality was evaluated. Results: Overall 588 patients [294 (50%) men and 294 (50%) women] were included within the study. Among men, patients with syncope were older and had significantly higher parameters of increased 30‐day mortality then patients without syncope. Within the same group, however, difference in the 30‐day mortality rate was not significant (log rank P =.942). In contrast to the men, fewer differences in admission characteristics were noticed among women, but those with syncope had significantly increased signs of the right ventricular dysfunction and increased 30‐day mortality rate, as compared with those without syncope (log rank P =.025). After adjustment for age in a Cox regression analysis, syncope was a significant predictor of 30‐day mortality in women (HR = 2.01, 95%CI 1.02‐3.95). Conclusion: Although syncope is associated with other predictors of higher early mortality in both male and female PE patients, only in women it is a significant predictor of 30‐day mortality. [ABSTRACT FROM AUTHOR]

The aim of this research was to determine the interdependence between calcium and magnesium in drinking water, and the morbidity from ischemic heart disease (IHD). A structured epidemiological questionnaire was used to collect information on the amount of drinking water consumed by 200 respondents in areas with the highest and lowest values of Ca and Mg. In addition, information on various risk factors for IHD (smoking, physical activity) was assembled for the same population group. In order to determine the average daily intake of Mg and Ca among the respondents, we ran a semi-quantitative questionnaire on frequency of food intake over the course of the previous year. The correlation between risk factors was assessed using linear regression and Pearson's coefficient of linear correlation. Finally, ROC analysis was employed to determine the minimal protective values for Mg and Ca. Despite the daily intake of drinking water in the respondents averaging less than 2l, a negative correlation between Ca and Mg from drinking water and risk factors for IHD were still observed. The analysis concluded that from the standpoint of preventing IHD, it would be necessary to have a daily intake of Ca and Mg of at least 75 mg Ca and 7 mg of Mg consumed through drinking water. [ABSTRACT FROM AUTHOR]

Cadmium is widely abundant in the air, water, soils and foodstuffs. Cadmium exposure and accumulation in the body start at a young age. Accumulation occurs in various tissues and organs, especially in the kidney cortex. This study was initiated to examine the total intake of cadmium among pre- school children. The study group consisted of 275 children aged 1 to 6 years. Estimation of daily intake of cadmium was calculated using the recommended formula, which takes into consideration all the potential means of children's exposure to cadmium. The average daily cadmium intake in children aged 1 to 3 years was 1.06 pg/kg, while for the children aged 4 to 6 years, the average daily cadmium intake was 1.06 pg/kg. Biomonitoring methods were used to assess the effects of a contaminated environment on the children's health. Our research showed that children take in the highest amount of cadmium from food. It is estimated that by the age of 1-3 years, children have accumulated 1.31 mg of cadmium in the body, while those aged 4-6 years have accumulated 8.80 mg. The persistence in the environment of this metal requires a long-term move toward minimizing human exposure through environmental management and preservation of lower cadmium levels wherever possible. [ABSTRACT FROM AUTHOR]

The aim of this study has been to estimate effects of indoor air pollutants on children’s health. An anamnestic retrospective study was done on 1074 children aged between 7 and 11 years old who lived in Nis (Serbia). An original questionnaire was used in an interview between training physicians and children’s parents. Interview data were processed by using Microsoft Excel and Epiinfo 6. The investigation determined that children who were more often exposed to combustion by-products had respiratory and nonspecific symptoms. Parental smoking was strongly associated with wheezing, bronchitis, headache and fatigue. There was no association between health and keeping pets, apart from partial nasal congestion. Presence of insects (e.g., cockroaches) and rats in households was a significant risk factor for all symptoms and diseases estimated except for asthma and pneumonia. Homes abundant in textiles were the cause of nasal congestion, wheezing and fatigue in children. Old mattresses were associated with respiratory symptoms, bronchitis, and nonspecific symptoms. It has been concluded that indoor air quality plays a major role in children’s health. Sources of indoor air pollution are present in every home. Being aware of the risks associated with indoor air quality problems, consequently, leads to their mitigation. [ABSTRACT FROM AUTHOR]

The purpose was to study the effect of long-term exposure to ambient air pollution on the prevalence of dry eye disease (DED) among women. A total of 1356 women, who were recruited in two locations, with different levels of black smoke and sulphur dioxide from the city of Nis were examined to establish the prevalence of DED. A 13-point questionnaire, Tear film break-up time (TBUT), Schirmer's test and Rose Bengal test were used to diagnose dry eye. The univariate and multivariate regression analysis were used to investigate the relationship between long-tem exposure of air pollution and DED adjusted for potential confounding factors (age, passive smoking, keeping of pets, home dampness and use of biomass fuels). Multivariate logistic regression analysis demonstrated signifcant associations between the presence of DED and exposure to outdoor air pollution (OR = 1.92, 95% CI 1.47-2.52, p<0.001) and passive smoking (OR = 1.13, 95%CI 1.04-1.64, p<0.001). According to our study, exposure to outdoor air pollution of black smoke and sulphur dioxide appear to have a very significant effect on the occurrence of DED at women. [ABSTRACT FROM AUTHOR]

Acute pulmonary embolism (PE), due to hemodynamic disturbances, may lead to multi-organ damage, including acute renal dysfunction. The aim of our study was to investigate the predictive role of renal dysfunction at admission regarding the short-term mortality and bleeding risk in hospitalized PE patients. The retrospective cohort study included 1330 consecutive patients with PE. The glomerular filtration rate (GFR) was calculated using the serum creatinine value and Cocroft-Gault formula, at hospital admission. Primary outcomes were all-cause mortality and PE-related mortality in the 30 days following admission, as well as major bleeding events. Based on the estimated GFR, patients were divided into three groups: the first with GFR < 30 mL/min, the second with GFR 30–60 mL/min, and the third group with GFR > 60 mL/min. A multivariable analysis showed that GFR at admission was strongly associated with all-cause death, as well as with death due to PE. Patients in the first and second group had a significantly higher risk of 30-day all-cause mortality (HR 7.109, 95% CI 4.243–11.911, p < 0.001; HR 2.554, 95% CI 1.598–4.081, p < 0.001). Fatal bleeding was recorded in 1.6%, 0.5% and 0.8% of patients in the first, second and in the third group (p < 0.05). There were no significant differences regarding major bleeding rates among the groups. Renal dysfunction at admission in patients with acute pulmonary embolism is strongly associated with overall PE mortality. • Glomerular filtration rate has a predictive role in pulmonary embolism. • Patients with pulmonary embolism and renal dysfunction have poor prognosis. • Renal dysfunction is associated with higher bleeding rates in pulmonary embolism. [ABSTRACT FROM AUTHOR]

Abstract Factors associated with provoked PE may influence a biomarker's predictive value for the primary outcome. The aim of this study was to investigate the value of BNP, cTnI, CRP and D-Dimer measurements taken soon after hospital admission for the prediction of 30-day PE-caused death in patients with spontaneous versus provoked PE.Data were extracted from a pool of 726 consecutive PE patients enrolled in the multicenter Serbian PE registry. Blood concentrations of BNP, cTnI, CRP and D-dimer were measured during the first 24 h of hospitalization. BNP blood level had strong predictive value for the primary outcome in spontaneous PE (c-statistics 0.943, 95% CI 0.882–1.000, p =.001) and a slightly lower predictive outcome in provoked PE (c-statistics 0.824, 95% CI 0.745–0.902, p <.001). NRI and IDI showed that none of the markers, when added to BNP, could improve Cox regression prediction models for 30-day PE-related mortality in either the spontaneous or provoked PE group. Blood levels of BNP measured during the first 24 h of hospital admission had an excellent predictive value for 30-day PE-related mortality in spontaneous PE and slightly lower predictive value in provoked PE, whereas CRP, cTnI and D-Dimer did not contribute significantly to the predictive value of BNP in either group. Highlights • BNP has the strongest predictive value for spontaneous and provoked PE. • CRP and cTnI have very predictive value for spontaneous PE. • D-dimer had very weak predictive value in provoked PE. [ABSTRACT FROM AUTHOR]