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Astma i kronična opstruktivna bolest pluća vodeći su uzroci pobola i smrtnosti u cijelom svijetu čime uzrokuju značajne ekonomske i društvene posljedice. Bolesnici mogu imati klinička obilježja obje bolesti, a ovo stanje naziva se preklapanje astme i KOBP-a. Prevalencija astme i KOBP-a uvelike varira zbog razlika u dijagnostičkim metodama koje se koriste, kriterijima i analitičkim pristupom prikupljanja podataka. Prevalenciju je moguće izračunati ako se provede istraživanje udjela oboljelih na reprezentativnom uzorku stanovnika te prema tome napravi procjena. Druga mogućnost dobivanja epidemioloških podataka je temeljem redovitog praćenja zabilježenih posjeta pojedinim zdravstvenim djelatnostima pod tom dijagnozom i praćenjem smrtnosti, kao i usporedbom tog pokazatelja s drugim državama. Hrvatska se po vrijednostima dobno-standardiziranih stopa smrtnosti od astme i KOBP-a nalazi u razini drugih tranzicijskih država, ali i nekih razvijenih europskih država. S obzirom na navedeno svakako treba nastaviti i pojačati mjere primarne, ali i ostalih razina prevencije što uključuje aktivno promicanje nepušenja, odvikavanje od pušenja, provođenje zdravog načina života i pravovremenu dijagnozu i liječenje., SUMMARYAsthma and chronic obstructive pulmonary disease are one of the leading causes of morbidity and mortality worldwide, which bring about significant economic and social consequences. Patients may have clinical features of both diseases, and this condition is called asthma-COPD overlap. The prevalence of asthma and COPD varies greatly due to differences in the diagnostic methods used, the criteria, and the analytical approach to data collection. The prevalence can be calculated by conducting a survey of the proportion of patients on a representative sample of the population and making an estimate accordingly. Another possibility of obtaining epidemiological data is based on regular surveillance of recorded visits to certain healthcare services under that diagnosis, and reporting mortality, as well as comparing this indicator with other countries. In terms of age-standardized rates of asthma and COPD mortality, Croatia is at a similar level as other transition countries, as well as some developed European countries. In view of this, it is certainly necessary to continue and intensify the measures of primary and other levels of prevention, which includes the active promotion of non-smoking, quitting smoking, implementing healthy lifestyles and timely diagnosis and treatment.

Sažetak. Celijakija je kronična autoimunosna bolest karakterizirana nepodnošljivošću glutena. Klinička slika obuhvaća nekoliko tipova bolesti i simptome različitih organskih sustava. Prevalencija je u porastu, a ne provodi se masovni probir. Zlatni standard dijagnoze jesu biopsija sluznice tankog crijeva i određivanje serumskih antitijela, ali često se celijakija ne dijagnosticira na vrijeme te se pacijenti vode pod drugim dijagnozama, što povećava učestalost komplikacija bolesti, hospitalizacija, invaliditeta i troškova liječenja. Kvaliteta života pacijenata smanjena je. Liječenje obuhvaća uvođenje bezglutenske prehrane i njezino kontinuirano pridržavanje. U Hrvatskoj je u 2015. evidentirano nekoliko tisuća oboljelih od celijakije, a na listama HZZO-a postoji bezglutensko brašno za pacijente s dokazanom celijakijom. Troškovi liječenja iznose do nekoliko milijuna kuna, no niži su nego troškovi prije postavljanja dijagnoze ove bolesti. Zaključno, celijakija je neprepoznat rastući globalni javnozdravstveni problem te bi radi boljeg nadzora, pravodobne dijagnoze i prikladnog liječenja trebalo podizati svijest o ovoj bolesti., Summary. Celiac disease is a chronic autoimmune disease characterized by gluten intolerance. Clinical presentation includes several clinical types of the disease and symptoms of various organ systems. The prevalence of the disease is rising and there is no mass screening. Gold standard in diagnostics are small intestinal mucosal biopsy and determination of specific serum antibodies, although most patients are not diagnosed on time and have the wrong diagnosis which increases the frequency of complications, number of hospitalizations, disability and expenses. The quality of life is also reduced. The treatment is gluten-free diet and continuous adherence to it. In Croatia in 2015 there were several thousand patients registered with the diagnosis of celiac disease. On the Croatian Health Insurance Fund lists there is gluten-free flour available for diagnosed patients. Total therapy expenses rise up to several million kuna but they are still smaller than expenses before making the right diagnosis. In conclusion it can be said that celiac disease is not yet recognized as a global public health burden that is rising in its importance. The main goal should be raising the awareness about this disease for better supervision and timely diagnosis and treatment.

Ova publikacija nastavlja se na publikaciju objavljenu 2016. godine „Europska zdravstvena anketa u Hrvatskoj 2014. - 2015. Osnovni pokazatelji“ u kojoj su pokazatelji vezano uz korištenje zdravstvene zaštite bili analizirani na ukupnom uzorku i prema spolu, dok su u ovoj publikaciji detaljnije analizirani prema dobi, stanovanju u urbanoj/ruralnoj sredini, stupnju obrazovanja, radnom statusu i prihodima kućanstva. Europsku zdravstvenu anketu u Hrvatskoj proveo je Hrvatski zavod za javno zdravstvo tijekom 2014. i 2015. godine u suradnji sa zavodima za javno zdravstvo županija i Grada Zagreba, Državnim zavodom za statistiku i Ministarstvom zdravstva.

Nacionalni preventivni programi probira za karcinome imaju dugu povijest u europskim zemljama. Trenutno su u većini zemalja aktualna tri programa, programi probira za rak dojke, rak vrata maternice, i rak debelog crijeva. Jedan od nužnih preduvjeta uspješnosti programa ranog otkrivanja karcinoma je postignut zadovoljavajući odaziv ciljne populacije. Ukoliko je odaziv manji od preporučenog, program ne može biti isplativ niti učinkovit u smislu smanjenja incidencije i mortaliteta od malignih bolesti, zbog čega su nužna istraživanja razloga nedovoljnog odaziva

INTRODUCTION: Road traffic accidents are one of the leading death causes in population worldwide and also represent great burden of disease due to premature death as well as invalidity. OBJECTIVES: The objective is to analyse road traffic mortality trends in Croatia, compare mortality according to age and gender and compare them to other countries. METHODS: We used data on standardized mortality rates from WHO Health for all database and data from Ministry of internal affair published in Buletin on road security. RESULTS: The mortality of deaths caused by road traffic accidents in Croatia is 9.14/100 000 in 2013. and in past decade showed continuous slight drop. In comparison to EU standards, Croatia shows significantly higher rates. When divided by age, the highest mortality can be seen in two groups: 15-29 and 70+ years. According to Ministry of internal affairs, in 2014 from 308 deaths in traf fic, 249 were caused by drivers. Between them, 62 of drivers were under influence of alcohol and 62 of them were under age of 31. The males have four times higher incidence than females, what can be connected by risky male behaviour due to testosterone and cultural influence. CONCLUSION: It is our opinion that the mortality rates in road traffic accidents decreased due to implementation of numerous laws directed towards road safety, young drivers and driving under the alcohol influence of other substances. According to other countries experience, this trend could be continued with better education and involvement of not only politics but also media, schools and changes in prehospital and hospital emergency health care (trauma system).

Europska zdravstvena anketa je standardizirana zdravstvena anketa koja se planira provoditi redovito, svake pete godine u svim zemljama članicama EU u istoj godini u cilju dobivanja sveobuhvatnih i usporedivih podataka o zdravstvenom stanju, korištenju zdravstvene zaštite i odrednicama zdravlja stanovništva. Prvi ciklus ankete proveden je u većini zemalja EU tijekom 2007.- 2010. godine, a drugi ciklus se provodi u razdoblju 2013-2015. Provedba ankete je u potpunosti usklađena metodologiji koju propisuje EUROSTAT (Statistički ured EU). Upitnik je testiran i prilagođen korištenju u Hrvatskoj a sastoji se od 4 modula: demografski i socio-ekonomski pokazatelji, samoprocijena zdravstvenog stanja, korištenje zdravstvene zaštite i odrednice zdravlja. Provođenjem ankete na reprezentativnom uzorku dobit će se uvid u zdravstveno stanje, korištenje zdravstvene zaštite i odrednice zdravlja stanovništva starijeg od 15 godina. Rezultati ankete će se koristiti u svrhu planiranja i evaluacije aktivnosti na području promocije zdravlja, prevencije kroničnih nezaraznih bolesti i organizacije zdravstvene zaštite. Podaci su usporedivi s obzirom na dob, spol, demografska i socio-ekonomska obilježja a što trenutno nije moguće prema raspoloživoj rutinskoj zdravstvenoj statistici. Na temelju rezultata mogu se identificirati prioritetni zdravstveni problemi za koje postoji potreba za preventivnim aktivnostima. Kako bi što uspješnije proveli EHIS u Hrvatskoj osnovana je koordinacijska radna skupina u kojoj sudjeluju predstavnici Ministarstva zdravlja, Državnog zavoda za statistiku i Hrvatskog zavoda za javno zdravstvo. Na razini županijskih zavoda i Grada Zagreba određeni su koordinatori i kontrolori za provođenje samog istraživanja na terenu. Svi ispitanici će na svoju kućnu adresu dobiti pozivno pismo kojim ih se poziva da sudjeluju u anketi. Kako bi rezultati ispitivanja bili reprezentativni pozivamo sve ispitanike da se odazovu i ispune anketu. Ispitanike će kontaktirati prije posebno osposobljeni anketari koji posjeduju identifikacijske kartice s imenom i prezimenom i slikom anketara.

Colorectal cancer (CRC) is global problem with 1.36 million new cases each year. Moreover it is the third most common cancer in men worldwide (746,000; 10%) and second most common in women (614,000 cases; 9.2%). The main characteristic of colorectal cancer is slow development and long presympthomatic phase, so it make possible for early diagnose as well as prevention by removing polyps. Faecal occult blood testing (FOBT) for early detection of colorectal cancer is an evidence based, cost-effective screening strategy and is the most commonly chosen approach in organised population-based colorectal cancer screening programmes throughout the world. There are two main kinds of tests-one guaiac based which detects hem in haemoglobin and other, immunochemical directed to detect protein part globuline. All FOBT positive persons are sent to colonoscopy. CRC incidence and mortality data in Croatia still show high values, especially in males so national colorectal cancer screening programme started in Croatia under the auspices of the Ministry of Health and Welfare (now the Ministry of Health) at the end of 2007. All citizens age 50-74 years are invited to programme. First cycle lasted longer due to legal and financial difficulties related to the harmonization of legislation with EU law and finished in 2012. Response rate was 21%, so the second cycle started in September 2013thin reorganized form which includes educational and promotive campaign and participation of primary care physicians and field nurses., Rak debelog crijeva globalni je problem s 1.36 milijuna novih slučajeva svake godine. Štoviše, u muškaraca je to treće najučestalije sijelo (746,000; 10%) i drugo u žena (614,000 cases; 9.2%). Glavna osobina raka debelog crijeva je spori razvoj bolesti i dugo razdoblje do pojave prvih znakova, što ga čini pogodnim za rano otkrivanje kao i prevenciju uklanjanjem polipa. Testiranje na skrivenu krv u stolici za rano otkrivanje kolorektalnog raka je utemeljeno na dokazima i kost-učinkovita je strategija, pa je najčešći pristup provedbom organiziranih populacijskih programa diljem svijeta. Dvije su glavne vrste testova na skrivenu krv u stolici- gvajakov koji otkriva hem u hemoglobinu i imunokemijski temeljen na reakciji s globulinskim dijelom. Sve osobe s pozitivnim testom upućuju se na kolonoskopjiju. Pojavnost i smrtnost od raka debelog crijeva u Hrvatskoj još uvijek pokazuju visoke vrijednosti, osobito u muškaraca, te je 2007. god. započeo nacionalni program ranog otkrivanja u organizaciji Ministarstva zdravlja. Svi građani u dobi 50-74 godine pozivaju se u program. Prvi ciklus trajao je dulje od planiranog zbog zakonskih i financijskih problema vezanih uz harmonizaciju zakona sa zakonima EU, te je završio 2012. godine. Odaziv je bio 21%, a drugi ciklus počeo je u rujnu 2013. u reorganiziranom obliku što uključuje edukacijsku i promotivnu kampanju te učešće obiteljskih liječnika i patronažnih sestara.

Introduction: Colorectal cancer (CRC) is a major public health burden among malignant diseases worldwide affecting over 1 million people each year. In Croatia it is the second cause of cancer mortality in men (N=1063, 49.77/100.000), as well as women (N=803, 34.89/100.000) in 2009. There is clear evidence that early detection and removal of CRC or its precursor lesions by population screening can reduce mortality and improve outcomes. In almost all of the developed EU countries some screening programs are organized. Methods: Croatian National population program for CRC screening was established by the Ministry of Health and Social Welfare and its implementation started at September, 2007. The coordinators in each county institute of public health are obliged to ensure performing of fecal occult blood testing (FOBT), followed by colonoscopy in all positive cases. The FOBT is performed by hypersensitive guaiac-based Hemognost card test with detection limit of 0.2 ml blood in 500 g of stool. The test and short questionnaire are delivered to home addresses of all citizens age 50–74 consecutively during two years. Each participant is required to fulfill the questionnaire, and send it together with the stool specimen on 3 test cards back to the institute for further analysis. According to screening results of other authors, it was expected that 4% FOBT positive cases would be found in normal risk population and model calculations pointed out a need for 24000 colonoscopies per year. Results: Till the end of 2010 total of 1056694 individuals were invited to screening (born between 1933-1945. and 1952-1957.). 203 846 persons (19.3%) returned envelope with fulfilled questionnaire and 178 570 of them returned correctly done FOB test cards. Until now, 12 523 positive FOBT patients were found (7.2%). Colonoscopy was performed in 7 736 cases (compliance 62%). Screening has identified colorectal cancers in 462 patients (3.6% of FOBT-positive and 0.26% of all screened individuals). Polyps were found and removed in 3089 (39% of FOBT-positive) patients. Conclusion: Characteristics of Croatian CRC National program in first three years were: low percentage of returned FOBT, higher number of FOBT-positive tests than usually can be expected in normal population, and very high number of pathologic findings (polyps and cancers). These results suggest a need for further strengthening of Croatian CRC screening National program. Successful intervention strategies include organizational changes, improving colonoscopy network, providing reminders to users about screening opportunities, educational strategies to improve awareness of usefulness of CRC screening and multifactor interventions aimed at increasing participation rates.

Background: Both colorectal cancer incidence and mortality rates, in Croatia, are on the increase. Currently it is ranking second in both men ( after lungs ) and women ( after breast ) with the total incidence rate of 62.4/100, 000 ( 2006 ). High mortality rates heve been recorded ( 40.6/100, 000, 2006 ), probably due to a low percent ( less than 10% ) of newly diagnosed cases with localised lesions. In the Osijek-Baranja County ( Eastern region ), more rapid increase in mortality rates, compared to the whole of Croatia, can be observed. The Osijek-Baranja County has a long-lasting experience in performing activities on primary prevention on early detection of colorectal cancer. The east region of Croatia has been faced with the devaststing effects of the war and the overwhelming poverty in the post-war period. Based on unfavourable statistics, The Croatian Governament has passed the Conclusion on The National Program of the Prevention and Early Detection of Colorectal Cancer, which has started on 1th Nowember 2007. Main goals of the program are: to decrease prevalence of risk factors in the population, to reduce mortality rates by 15% 5 years after the program started and to increase percentage of diagnosed pre-clinical and localised cancers. Methods: Conventional screening method for the early detection of colorectal cancer Faecal Occult Blood Test ( FOBT ) by 2 yearly examination protocol is being applied in asymptomatic population at average risk, aged 50-74 years. Target population accounts approximately 1, 200, 000 persons ; 600, 000 persons are accepted to be tested every year with minimum coverage of 60%. The Croatian Public Health Institute in collaboratio with the county institutes is responsible for the invitation organization, coordination and the monitoring of the action, collecting and evaluation of data. Invitation letters have been sent by mail. In an envelope, , there are three testing cards together with the instructions for their use, questionnaire about risk factors and educational brochure to ensure invited persons be informed on the screening. Invited persons have been asked to mail applied testind-cards back, together with filled questionnaire. Persons testing positive have been invited for colonoscopy in the nearest endoscopic unit. Results: A total of 206000 invitation letters heve been sent until the end of January 2009 to persons born 1933-1937. According to preliminary results, responding rates are low ( average 20.5%, 38.5% maximum ) ; in the Osijek-Baranja County 22.8%. Estimations are based on the total number of envelopes mailed back, while some samples are useless. The percent of FOBT positive tests is 9.7%, and 11.8% in Osijek-Baranja County. There are123 newly discovered carcinomas ( 5, 6% of thoose who underwent colonoscopy), 25 in Osijek-Baranja County, 653 polyps, 102 in Osijek-Baranja County, 266 diverticula, 28 in Osijek-Baranja County. Conclusions: Initial analyses indicate a weak response, therefore, the activities which motivate the population for being tested, must be intensified. In order to achieve that, it is required to improve the collaboration with family doctors, a more intensive media campaign and simplified instructions. In order to mantain monitoring, appropriate software is necessary, currently it is inadequate.

Background: Both colorectal cancer incidence and mortality rates, in Croatia, are on the increase. Currently, it is ranking second in both men (after lungs) and women (after breast) with the total incidence rate of 62.4/100, 000 (2006). High mortality-rates have been recorded (40.6/100, 000, 2006), probably due to a low percent (less than 10%) of newly diagnosed cases with localized lesions. In the Osijek-Baranya County (Eastern Region), more rapid increase in mortality rates, compared to the whole of Croatia, can be observed. The Osijek-Baranya County has a long-lasting experience in performing activities on primary prevention and early detection of colorectal cancer. The East region of Croatia has been faced with the devastating effects of the war and the overwhelming poverty in the post-war period. Based on unfavourable statistics, The Croatian Government has passed the Conclusion on The National Program of the Prevention and Early Detection of Colorectal Cancer, which has started on 1st November 2007. Main goals of the Program are: to decrease prevalence of risk factors in the population, to reduce mortality rates by 15% 5 years after the Program started and to increase percentage of diagnosed pre-clinical and localised cancers. Methods: Conventional screening method for the early detection of colorectal cancer Faecal Occult Blood Test (FOBT) by 2 yearly examination protocol is being applied in asymptomatic population at average risk, aged 50-74 years. Target population accounts approximately 1, 200, 000 persons ; 600, 000 persons are expected to be tested every year with minimum coverage of 60%. The Croatian Public Health Institute in collaboration with the county institutes is responsible for the invitation organization, coordination and the monitoring of the action, collecting and evaluation of data. Invitation letters have been sent by mail. In an envelope, there are three testing-cards together with instructions for their use, questionnaire about risk factors and educational brochure to ensure invited persons be informed on the screening. Invited persons have been asked to mail applied testing-cards back, together with filled questionnaire. Persons testing positive have been invited for colonoscopy in the nearest endoscopic unit. Results: A total of 206 000 invitation letters have been sent until the end of January 2009 to persons born 1933- 1937. According to preliminary results, responding rates are low (average 20.5%, 38.5% maximum) ; in the Osijek-Baranya County 22, 8%. Estimations are based on the total number of envelopes mailed back, while some samples are useless. The percent of FOBT positive tests is 9.7%, and 11, 8% in Osijek-Baranya County. There are 123 newly discovered carcinomas (5, 6% of those who underwent colonoscopy), 25 in Osijek-Baranya County, 653 polyps, 102 in Osijek-Baranya County, 266 diverticula, 28 in Osijek-Baranya County. Conclusions: Initial analyses indicate a weak response, therefore, the activities which motivate the population for being tested, must be intensified. In order to achieve that, it is required to improve the collaboration with family doctors, a more intensive media campaign and simplified instructions. In order to maintain monitoring, appropriate software is necessary, currently it is inadequate.

The aim of the study was to investigate the association between methylenetetrahydrofolate (MTHFR) genotypes and levels of homocysteine (Hcy), folate, vitamin B12 and lipids as well as the association between apolipoprotein E (apo E) genotypes and levels of lipids in a Croatian healthy control group and a group of patients with > 70% carotid stenosis (CS). The study included 98 Croats, 38 patients with > 70% carotid stenosis and 60 age- and sex-matched controls. The MTHFR and apo E genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), Hcy by enzyme immunoassay, vitamins by immunochemiluminiscence, and lipids by spectrophotometric method. There was no difference between control subjects and CS patients in the distribution of C677T MTHFR genotypes (p=0. 786) and alleles (p=0.904), however, differences in the frequencies of apo E genotypes (p=0.012) and alleles (p=0.029) were statistically significant. The odds ratio for apo E 3/4 genotype was 3.93 (95% CI 1.23-12.61). Hyperhomocysteinemia (> or =15 micromol/L) was found in 11% of CS patients and 5% of control subjects. Total cholesterol, triglycerides, vitamin B12 and folate were statistically different in "all MTHFR genotypes" (p

CILJ: odrediti trend mortaliteta osoba sa šećernom bolesti u razdoblju od 1983.-2003., u kontekstu sve većeg broja učinkovitih terapijskih pristupa. MATERIJALI I METODE: Mortalitetni podaci dobiveni su iz baze umrlih Državnog zavoda za statistiku. Uz proporcionalni mortalitet određene su dobno standardizirane stope (korištena svjetska populacija) i kumulativne stope mortaliteta šećerne bolesti za navedeno razdoblje. REZULTAT: Proporcionalni mortalitet kretao se u rasponu od 1, 16%-2, 48% (muškarci 0, 81%-1, 85%, žene 1, 54%-3, 13%) uz značajan porast na kraju razdoblja u odnosu na početak (2, 03% u odnosu na 1, 16%, muškarci: 1, 16% u odnosu na 0, 81%, žene: 2, 46% u odnosu na 1, 54%). Isti blagi trend porasta opažen je i u druga dva promatrana parametra. Standardizirane stope mortaliteta na početku promatranog razdoblja iznosile su 10, 37/100 000 a na kraju 13, 08/100 000 (min 7, 95/100 000, max.19, 25/100 000) dok su kumulativne stope mortaliteta od početnih 3, 70% do kraja promatranog razdoblja porasle na 5, 44% (min 2, 73%, max. 7, 27%). ZAKLJUČAK: Rezultati ukazuju na porast udjela mortaliteta od šećerne bolesti u ukupnom mortalitetu, dobno standardiziranih i kumulativnih stopa mortaliteta tijekom promatranog razdoblja. Nakon početnog blagog pada slijedi porast promatranih obilježja sve do 1997. nakon kojeg kretanje slijedi oblik slova V sa najmanjim vrijednostima u 2001. Obzirom na opažene fluktuacije nije moguće sa sigurnošću utvrditi statistički značajan obrazac kretanja koji bi omogućio procjenu parametara u slijedećim godinama. Unatoč sve boljim terapijskim mogućnostima u liječenju šećerne bolesti ona i dalje jedan od vodećih uzroka smrti u RH uz prisutan trend porasta u ukupnom mortalitetu.

Cilj rada bio je odrediti trend mortaliteta osoba sa šećernom bolesti u proteklom desetljeću, u kontekstu sve većeg broja učinkovitih terapijskih pristupa dostupnih posljednjih godina u R Hrvatskoj. Mortalitetni podaci za razdoblje od 1995.-2003.godine dobiveni su iz baze umrlih Hrvatskog zavoda za javno zdravstvo. Uz proporcionalni mortalitet određene su dobno standardizirane stope (korištena svjetska populacija) i kumulativne stope mortaliteta šećerne bolesti za navedeno razdoblje. Proporcionalni mortalitet kretao se u rasponu od 2, 48%-1, 62% (muškarci 1, 26%-1, 85%, žene 1, 96%-3, 13%) uz neznačajni pad na kraju promatranog razdoblja u odnosu na početak (2, 03% u odnosu na 2, 12%, muškarci: 1, 61% u odnosu na 1, 43%, žene: 2, 46% u odnosu na 2, 79%). Isti blagi trend pada opažen je i u druga dva promatrana parametra. Standardizirane stope mortaliteta na početku promatranog razdoblja iznosile su 15, 28/100 000 a na kraju 13, 08/100 000 (min 10, 44/100 000, max.19, 25/100 000) dok su se kumulativne stope mortaliteta od početnih 5, 99% do kraja promatranog razdoblja smanjile na 5, 44% (min 3, 80%, max. 7, 27%). Unatoč sve boljim terapijskim mogućnostima u liječenju šećerne bolesti ona je i dalje jedan od glavnih uzroka smrti u R Hrvatskoj bez prisutnog jasnog kontinuiranog silaznog trenda. Smanjenje stope mortaliteta od šećerne bolesti zahtijevat će stoga provođenje multidisciplinarnih mjera primarne i sekundarne prevencije.

Alcoholic liver cirrhosis is one of the major organ diseases in chronic alcoholics. In Croatia, during the year 2002, 1363 people have died and 3869 were hospitalized due to alcoholic liver disease and cirrhosis. Great efforts are done in researching the pathogenesis of changes during liver fibrosis. Endothelin (ET) is a potent vasoconstrictor peptide, made up of 21 amino acids. It is produced and released from endothelial cells in the form of preproendothelin. Endothelin-induced contraction of stellatae cells contributes to the increase of portal pressure. Liver cirrhosis is accompanied by the onset of ascites, portal hypertension and chabges of systemic and regional hemodynamics. Increased ET levels have been reported in liver cirrhosis patients related to the deranged systemic circulation. The aim of this study was to compare ET (1-21) levels in patients with various degrees of alcoholic liver cirrhosis as well as with some clinical data. ET (1-21) was measured in plasma by ELISA test (Biomedica, Graz, Austria) with a detectable linit of 0.05 pmol/L. Sixty proven alcoholic liver cirrhosis patients and 86 healthy volunteers, matched for sex and age, were included in study. Statistical analysis was made using Sigmastat and Excel computer programs. ET (1-21) levels were significantly higher in patients (0.55, range 0- 6.19) than in the healthy control group (0.12, range 0-1.67 pmol/L, p

Endotelin (ET) je protein sastavljen od 21 aminokiseline, a ima snažan vazokonstrikcijski učinak. Nastaje i otpušta se iz endotelijskih stanica u obliku preproendotelina, pričem nastaje me|uproizvod, veliki endotelin. Ciroza jetre je bolest kod koje nastaju ascites i portalna hipertenzija praćena promjenom sistemne i regionalne hemodinamike. Povišene razine ET na|ene su u plazmi bolesnika s alkoholnom cirozom jetre. Cilj rada bio je usporediti razine ET(1- 21) u bolesnika s različitim stupnjevima alkoholne ciroze jetre. ET(1-21) je mjeren u plazmi bolesnika pomoću enzimskog imunotesta (Biomedica, Graz, Austrija) s pragom mjerljivosti od 0, 05 pmol/L. U studiju je bilo uključeno 60 bolesnika s dokazanom alkoholnom cirozom jetre i 86 zdravih ispitanika odgovarajuće dobi i spola. Statistička analiza napravljena je pomoću kompjutorskog programa Sigmastat i Excel. Razine ET(1-21) bile su značajno više u bolesnika (0, 55, raspon 0-6, 19 pmol/L) nego u zdravih ispitanika (0, 12, raspon 0-1, 67 pmol/L, p

Cilj rada bio je odrediti hepatocitni faktor rasta (HGF), endotelin (ET), i antioksidativni status (TAS) u bolesnika sa alkoholnom bolesti jetre (ABJ), usporediti sa vrijednostima zdravih ispitanika i ispitati klinički značaj njihovog određivanja. Specifični cilj je bio usporediti vrijednosti sa ostalim nalazima (UZV jetre, endoskopskim i drugim biokemijskim nalazima u dijagnostici ABJ), te pratiti kinetiku vrijednosti tijekom 4 i 6 mjeseci nakon početka ispitivanja. U studiju su uključena 32 ispitanika s klinički i laboratorijski potvrđrnom dijagnozom ABJ (uključivši biopsiju jetre) i 44 zdrava ispitanika. ET i HGF određivani su enzim-imuno analizom a TAS kolorimetrijskom metodom. Skupina bolesnika i zdravih ispitanika nije se međusobno značajno razlikovala po dobi, spolu i pokazatelju tjelesne mase, a bolesnici su na telju Child-Turcott-Pughovoj klasifikaciji na A, B i C podskupinu. Vrijednosto HGF razlikovale su se između zdravih ispitanika i bolesnika u sve 3 točke mjerenja (p0, 05), međutim, vrijednosti su više u bolesnika sa ascitesom te sa varikozitetima jednjaka. Značajna pozitivna korelacija HGF-a zabilježena je sa stupnjem bolesti (tj. CTP zbrojem), bilirubinom, ukupnim proteinima, a negativna sa protrombinskim vremenom i albuminima. Visoka specifičnost (98%) i osjetljivost (97%) HGF-a ukazuje na njegovu vrijednost kao dijagnostičkog biljega i pokazatelja ishoda liječenja. Vrijednosti ET razlikovale su se značajno samo u trećem mjerenju u odnosu na zdrave ispitanike (p=0, 028), dok su značajno više vrijednosti nađene u bolesnika sa varikozitetima jednjaka nego kod zdravih ispitanika (p=0, 024). Podskupine bolesnika B i C imale su niže vrijednosti u odnosu na zdrave ispitanike u posljednjem mjerenju (p=0, 07). Vrijednosti TAS-a bile su niže samo kod trećeg mjerenja u bolesnika (p=0, 009), međutim, vrijednosti TAS-a u podskupinama prema težini bolesti, iako niže, nisu se statistički razlikovale. U zaključku može se utvrditi da HGF ima visoku kliničku učinkovitost, dobro ukazuje na stupanj bolesti i ishod šestomjesečnog liječenja bolesnika. Usprkos nekim dijagnostičkim vrijednostima, određivanje TAS-a i ET nema zadaovoljavajuću kliničku učinkovitost zbog izrazitog preklapanja sa vrijednostima zdravih ispitanika. Endotelin je viši u bolesnika sa varikozitetima jednjaka, te u bolesnika s težim stupnjem bolesti prilikom trećeg mjerenja što upućuje na to da je njegova vrijednost tek u bolesnika s dugotrajnom bolešću.

Ateroskleroza je vodeća bolest arterija. Osnovni je uzrok bolesti srca i infarkta te 50% smrtnosti u zapadnim zemljama. U razvomju ateroskleroze sudjeluju genetski i negenetski činitelji ...

Činitelj rasta jetre (HGF) je citokin uključen u regeneraciju tkiva, angiogenezu i nastanak kolaterala. Otkriven je kao protein koji potiče rast hepatocita, no ima učinak i na druga tkiva. Endotelin (ET) je protein sačinjen od 21 aminokiseline s važnim fiziološkim i patofiziološkim djelovanjem u nastanku zatajenja srca. Najvažnija je periferna vazokonstrikcija i poticanje miocita i fibroblasta. Cilj rada je bio ispitati mogu li vrijednosti HGF i ET u plazmi bolesnika biti od koristi u dijagnozi akutnog infarkta miokarda. ET i HGF su mjereni u plazmi 42 zdrava ispitanika i 31 bolesnika s akutnim infarktom miokarda prilikom hitnog prijma u bolnicu. Uključeni su u studiju prema standardnim biokemijskim i kliničkim kriterijima. Razine ET i HGF mjerene su enzimimunološkim testom (Biomedica, Austria, odnosno R&D, SAD). Statistička analiza učinjena je kompjutorskim programom Sigmastat. Značajnost razlike izme|u skupina ispitanika testirana je Mann-Whitneyevim testom, a klinička valjanost analizom ROC. Razine HGF bile su više u gotovo svih bolesnika nego u zdravih ispitanika: 12, 446 (1, 007-12, 858) ng/mL u odnosu na 0, 854 (0, 517-1, 347) ng/mL, p

Cardiovascular stress and ischemic-reperfusion events are important stimuli to disarrangement of balanced two opposite systems which participate in the blood pressure and sodium homeostasis. The plasma levels of big endothelin-1 (vasoconstrictor) and proatrial natriuretic peptide (vasodilatator), the most stabile biological precursor of active peptides ANP and ET-1 was investigated during PCI and 6 hours after. 29 patients (33-80 yrs ; median=62) within 2 hours of pain onset addmitted in Coronary Care Unit for PCI and their EDTA blood samples from periferal vein were taken before and 6 hours after PCI and have determinated by enzymimmunoassay, Biomedica, Wien. Mann-Whitney and Pearson correlation tests were used for statistical evaluation. The medians of BigET-1 and proANP (fmol/ml) in all groups of samples were elevated according to reference values except values of 6V proANP: 0A=3, 20 ; 0V=3, 0 ; 6V=3, 7 and 0A=1925, 5 ; 0V=2986, 0 ; 6V=1244, 5, respectively. ProANP values of all tree groups of samples were statistically different among each other (P=0, 011). However, BigET-1 measurements are coherent between groups. Weak positive correlation was observed between plasma values of 6VproANP and ages (r=0, 52 ; P=0, 0049). Strong positive relations were found for all pairs of proANP - 0A:0V (r=0, 840 ; P

Acute renal insufficiency has high mortality rate among critically ill septic patients. Extensive investigations have been undertaken to elucidate mechanism of the complication and to find predictive factors for its occurence. We determined biochemical markers, proANP (EIA, fmol/ml) and cystatin C (immunoturbidimetric, mg/L), in septic patients on admittance to the ICU an correlated it with the development of acute renal insufficiency (RI). ProANP is a prohormone of atrial natriuretic peptid released from right atria and has diuretic and natriuretic properties. Cystatin C is a new marker for noninvasive estimation of glomelurular filtration rate and for early renal impairament. 29 critically ill septic patients were included in the study. ProANP, cystatin C and standard biochemical variables were determined on admittance to the ICU. EDTA blood samles from periferal vein were collected. General condition of patients was determined using clinical scoring systems APACHE II and MODS . Haemodynamic variables obtained by measurements using pulmonary artery catheter and effects of inotropeic drugs were analysed, as well. Acute renal insufficiency was determined according to the standard definition as creatinin value of 267 ěmol/ or diuresis < 30 mL/h in patient with no history of cronic renal impairment. Statistical analysis between groups with and without renal insufficiency was done using Mann - Whitney U test. Corrrelation between proANP, cystatin C, biochemical and clinical variables were analysed using linear regression. Our resultes showed that proANP is significantlly higher in the group with renal insufficiency, (medians with RI=1971, without RI=7220 ; P

Atherosclerosis is most common arterial disease and the leading cause of cardiac disease (CAD). One of the candidate genes for the genesis of atherosclerosis is apolipoprotein E (apo E), with a recently identified indicator, methylenetetrahydrololate reductase (MTHFR). MTHFR is one of the major regulatory enzymes in the metabolism or homocysteine (Hcy), a recently identified risk factor for atherosclerosis. The aim of the study is to evaluate importance of genetic (apo E and MTHFR) and biochemical (Hcy) markers in patients with CAD. Genotypes were determined by PCR-RFLP method and Hcy level by EIA in samples of healthy controls (n=60) and angiographically-confirmed patients with CAD (, n=33). In CAD group a significant different apo E genotype (p0.05) was found. Hyperhomocysteinemia (>15 ƒÝM) was determined in 5% of controls and 7% of patients. Association of MTHFR with apo E genotype as well as MTHFR genotype and Hcy level was not found. The preliminary results obtained in this study revealed an association of apo E, but no MTHFR genotype and Hcy level with CAD. Additional studies in larger patient groups are needed to confirm these observations.

A ion-selective electrode analyzers for measuring lithium (Li/ISE) in serum became available in early 1987. Since that time, several ionophores for determination of lithium in serum have been described. NOVA 10 (NOVA Biomedical, Waltham, MA) is a direct, ion-selective electrode analyzer for measuring sodium, potassium, chloride, total calcium and lithium in serum, plasma, CSF and urine. The aim was to evaluate the analytical performance of the instrument according to the ECCLS guidelines (imprecision, accuracy, carryover, linearity and comparison study for lithium (Li) in serum. Venous blood from patients receiving lithium therapy was collected in to vacutainer tubes (Becton Dickinson Co, Rutherford, UK) with no anticoagulant, and allowed to clot. Serum was separated by centrifugation. Control material used in the study included Stat Profile Control 1-3, Precinorm U, Precipath U and Serodos. Randomly chosen patient sera were used in comparison study for lithium on a flame photometer PHF-104 (Hycel, France). Intra-assay CV was 1.08%. While interassay CV ranged from 1.05% to 1.15%. Carryover was negligible (K

Uvod: Endotelin (ET) je snažan vazokonstriktorni peptid, koji sadrži 21 aminokiselinu. Sintetizira se i izlučuje iz endotelijalnih stanica u obliku preproendotelina, nakon čega nastaje intermediarni produkt, veliki-endotelin. Najznačajniji je učinak endotelina na kardiovaskularnu i bubrežnu funkciju. Povišenje razine ET1zapaženo je u nizu bolesti povezanih s poremećajem sistemne cirkulacije, posebice u bolesnika s alkoholnom cirozom jetre (ALC). Cilj: Cilj rada je bio odrediti značaj mjerenja ET1u blaže i teže dekompenziranih bolesnika s alkoholnom cirozom jetre. Materijali i metode: ET1 je mjeren u plazmi 42 zdrava dobrovoljca i 28 bolesnika s dekompenziranom alkoholnom cirozom jetre. Bolesnici su uključeni na osnovu biokemijskih i kliničkih kriterija. Razina ET1 mjerena je pomoću ELISA ET1-21 test (Biomedica, Graz, Austria) s pragom osjetljivosti 0.05 pmol/l. Statistička analiza učinjena je pomoću Sigmastat Jendel i Excel kompjuterskog programa. Razlike između podskupina testirane su Studentovim t-testtom ili Mann-Whitneyevim testom, korelacije između biokemijskih pokazatelja i ET1 pomoću Pearsonovog koeficijenta korelacije, a klinička pouzdanost ROC analizom. Rezultati: Razine ET1 su bile značajno više u skupini bolesnika nego u zdravih ispitanika (ciroze 0.6, raspon 0.4-0.95; vs. zdravi ispitanici 0.1, raspon 0.1-0.6 pmol/l, p

Endothelin (ET) is a potent vasoconstrictor peptide, made up of 21 amino acids. It is produced and released from endothelial cells in the from of preproendothelin where an intermediate big-endothelin is derived. Their function is the control of cardiovascular and renal function. Increased ET1 levels have been reported in various diseases related to deranged systemic circulation. ET1 was measured in plasma of 42 healthy volunteers, 28 liver cirrhosis and 31 myocardial infarction patients (included according to clinical and biochemical criteria). ET1 levels were measured by ELISA ET1-21 test (Biomedica, Graz, Austria) with a detectable limit of 0.05 pmol/l. Statistical analysis was made by Sigmastat computer program. Differences between groups were tested by one-way analysis of variance, correlation between biochemical tests and ET1 by Pearson correlation coefficient, and clinical accuracy by ROC analysis. ET1 levels were significantly higher in both patient groups than in healthy volunteers (cirrhotics 0.6, range 0.4-0.95; infarction 0.7, range 0.4-0.95 pmol/l, p

Ateroskleroza je vodeća bolest krvnih žila s okolišnim i genetskim utjecajem. MTHFR (metilentetrahidrofolat reduktaza) ima važnu ulogu u metabolizmu homocisteina, a njegov gen nalazi se na prvom kromosomu. Mutacija C677T povezuje se s pojavnošću ateroskleroze. Apo E je polipeptid sa značajnom ulogom u metabolizmu lipida i razvoju ateroskleroze krvnih žila. Njegov se gen nalazi na 19-om kromosomu, a polimorfizam je označen zamjenom amino kiselina Arg i Cys na mjestima 112 i 158 (E2: Cys 112/Cys 158, E3: Cys 112/Arg 158 and E4: Arg112/Arg 158). Cilj ove studije je da se ispita povezanost apo E i MTHFR genotipa s aterosklerotskom bolesti karotida. MTHFR i apo E genotip određen je metodom PCR-RFLP u grupi zdravih dobrovoljaca (n=67) i 40 bolesnika s dijagnosticiranom stenozom karotida (color doppler; stenoza>50%). U podskupini SC s apo E 3/4 i 2/3 genotipom (n=20) nađeno je 50%, a u podskupini zdravih ispitanika (n=19) 28% ispitanika s apo E 3/4 i 2/3 genotipom. U navedenim podskupinama SC i zdravih nađena je podjednaka raspodjela zdravog i hetrozigotno-mutiranog MTHFR genotipa. Statističkom obradom rezultata nije nađena značajna razlika (p>0.05, c2 –test) za apo E i MTHFR genotipove i alele u skupini bolesnika u odnosu na zdrave dobrovoljce. Preliminarni rezultati upućuju na potrebu daljnjeg istraživanja MTHFR i apo E genotipa uključujući veliki broj ispitanika kako zdravih tako i ispitanika s aterosklerozom krvnih žila bez obzira na njezino mjesto.

Introduction: Endothelin (ET) is a potent vasoconstrictor peptide, made up of 21 aminoacids. It is produced and released from endothelial cells in the from of preproendothelin where an intermediate big-endothelin is derived. Their function is the control of cardiovascular and renal function. Increased ET1 levels have been reported in various diseases related to deranged systemic circulation, especially in alcoholic liver cirrhosis (ALC) patients. Aim: The aim of this study was to evaluate significance of ET1 measurement in various degrees of decompensated alcoholic liver cirrhosis patients. Materials and methods: ET1 was measured in plasma of 42 healthy volunteers and 28 liver cirrhosis patients (included according too clinical and biochemical criteria). ET1 levels were measured by ELISA ET1-21 test (Biomedica, Graz, Austria) with a detectable limit of 0.05 pmol/l. Statistical analysis was made by Sigmastat and Excel computer program. Differences between groups were tested by Student's t-test or Mann-Whitney test, correlation between biochemical tests and ET1 by Pearson correlation coefficient, and clinical accuracy by ROC analysis. Results: ET1 levels were significantly higher in liver cirrhosis groups than in healthy volunteers (cirrhotics 0.6, range 0.4-0.95; vs. healthy 0.1, range 0.1-0.6 pmol/l, p

Elevated serum creatinine is the usual marker of impaired renal function. Testing the clearance of Technetium DTPA allows the glomerular filtration rate (GFR) measuring. The low molecular weight protein cystatin C produced by cells within body and eliminated by glomerular filtration has been suggested as an indicator of GFR.In the group of 81 children (aged 0.04 to 14 years), cystatin C, creatinine and GFR by DTPA clearance were measured. DAKO Cystatin C kit was used for determination of cystatin C on an Olympus AU 600 analyzer. GFR ranged from 60-145 ml/min. The cystatin C and creatinine values significantly correlated with GFR rcysC=0.47 and rcreat=0.59, respectively (p

Ateroskleroza je vodeća bolest krvnih žila s okolišnim i genetskim utjecajem. MTHFR (metilentetrahidrofolat reduktaza) je u središtu znanstvenog interesa kao jedan od novijih genetskih biljega bolesti krvnih žila. MTHFR je enzim s važnom ulogom u metabolizmu homocisteina, a njegov gen nalazi se na prvom kromosomu. Mutacija C677T povezuje se s pojavnošću ateroskleroze. Apo E je polipeptid sa značajnom ulogom u metabolizmu lipida i razvoju ateroskleroze krvnih žila. Njegov se gen nalazi na 19-om kromosomu, a polimorfizam je označen zamjenom amino kiselina Arg i Cys na mjestima 112 i 158 (E2: Cys 112/Cys 158, E3: Cys 112/Arg 158 and E4: Arg112/Arg 158). Cilj ove studije je da se ispita povezanost apo E i MTHFR genotipa s aterosklerotskom bolesti karotida. U tu svrhu u studiju je uključeno 40 ispitanika sa dijagnosticiranom stenozom karotida (color doppler, stenoza >50%) i 48 zdravih dobrovoljaca. DNA je izolirana standardnom metodom, a genotipiziranje apo E i MTHFR mutacije provedeno je metodom PCR-RFLP. Preliminarnim ispitivanjem statistička značajna razlika (p

Glomerularna filtracija je jedan od najvažnijih pokazatelja bubrežne funkcije u djece. Uobičajeni indirektni biljezi GF, npr. serumski kreatinin ili recipročne vrijednosti kreatinina pokazuju nedostatke zbog postojanja individualnih razlika, kako u proizvodnji endogenog kreatinina, tako i varijabilnosti njegove tubularne sekrecije i odstranjivanja. Nisko-molekularni protein cistatin C, koji se stvara u gotovo svim tjelesnim stanicama, odstranjuje se iz organizma glomerularnom filtracijom. Stoga se preporuča kao noviji pokazatelj, osobito prikladan za primjenu u pedijatriji s obzirom na jednostavnost izvođenja i neovisnost o dobi djeteta. Ovim radom željeli smo ispitati značaj određivanja serumskog cistatna C u skupini djece. Uključeno je 84 djece u dobi od 1 mjesec do 14 godina. Pomoću klirensa Tehnecija DTPA izmjerena je GF, a određen im je cistatin C te kreatinin u serumu. Razina cistatina C je mjerena pomoću DAKO Cystatin C test reagensa na Olympus AU 600 višekanalnom automatskom analizatoru. Statistička obrada rezultata učinjena je pomoću Sigmastat i Excel program, a korišteni su slijedeći testovi: opisna statistika, Pearsonova korelacija, te ROC analiza dijagnostičke pouzdanosti (engl. receiver operator curve). Raspon GF je bio od 60-145 ml/min. Vrijednosti cistatina C i kreatinina značajno su korelirali s GF (rcysC-GF=0.66; rcreat-GF=0.72, p

Ionized calcium (Ca++) is the physiologically active form of calcium, which compprises aproximately 40 percent-50 percent of total calcium in plasma. It is essential for the contractility of smooth vascular muscle, and it plays a vital part in cardiovascular function. The aim of this study was to test the effect of two different forms of heparin on ionized Ca measurement. The analysis was performed on a Ciba Corning 865 automatic system (Ciba Corning, Medfield, MA, USA). The instrument is used for determination of pH, blood gases, sodium, potassium, Cl, and Ca++ concentration, and makes an adjustment for pH (only when pH at 37 0C is between 7.2 and 7.7), glucose, lactate, tHb and hemoglobin derivatives in arterial, venous and capillary whole blood samples. Two different types of capillaries were used: disposable capillaries for gas analysis heparinized with 80 U/ml Na-heparin , 175 l, (Vitrex, Denmark), and Multi Cap containing 130- 200 U/ml Na+, Li+, Ca++ heparin titrated with KCl (Chiron Diagnostic Corp. East Walpole, MA, USA), 140 l. The measurements of actual ionized calcium referred to the actual patient pH and adjustment of ionized calcium to standard pH at pH 7.4 was done in whole capillary blood samples of 100 subjects. Results were statistically processed by the normality test. Significance of differences was caculated by the Wilcoxon signed rank test for pair data and Passing Bablok non- parametric regression procedure. Results of the comparison showed statistically significant differences between median Ca++ values measured in two different capillaries at actual pH as well as at adjusted pH (p is less than 0.001). The Passing Bablok analysis also yielded significant differences between the two types of capilaries (correlation coefficient r=0.953, p is more than 0.05). Results the both for slope and intercept showed statistically significant differences. According to the results, we conclude that heparin binds calcium and significantly reduces free calcium, and should not be used for Ca++ determination, while capillaries containing a coating of balanced heparin, designed to eliminate heparin-binding of ions, provide the precise results.

Helicobacter pylori (HP) is a major cause of inflammation and peptic ulcer disease. Immune response at the mucosal level is predominantly of the IgA type. A majority of HP infected patients also respond by activating humoral immune response against the organism, and these specific anti-HP antibodies of IgG and IgA class of immunoglobulins can be measured or detected by several methods. One of diagnostic non-invasive tests is quantitative enzyme-linked immunosorbent assay. It has high specificity and sensitivity. The aim of this study was to evaluate the significance of anti-HP IgG and IgA antibody measurement in patients with dyspeptic illness by quantitative serologic method. The ELISA Pyloriset EIA-G and EIA-A (Orion Diagnostica, Finland) were used for measuring anti-HP in plasma of 88 patients with dyspeptic illness. A cut-off titer of anti-HP IgG and anti-HP IgA was 300 g/l and 250 g/l, respectively. All patients were examined endoscopically and biopsies were obtained from either ulcer edges and/or locations typical for HP growth. The data were analyzed by descriptive statistics. All study patients had IgG levels below the upper limit, and median IgG was 145.5 g/l (range 86-279 g/l). Eleven (12.5 percent) patients had specific IgA antibodies to Helicobacter pylori above the upper limit, median 130 g/l (range 86-610 g/l). Ten (11.4 percent) IgA positive patients had biopsy specimens positive for HP, suggesting different immunoreactivity in some patients who react by producing IgA antibodies rather than IgG antibodies to HP. In conclusion, testing for IgA antibody may be useful in some cases of dyspeptic illness when specific IgG antibodies are not elevated. It is not advisable to base the diagnosis and treatment solely on positive serologic tests, but they can help us in screening certain patient populations to decide on the need of endoscopy.

There is no doubt that Helicobacter pylori infections results in inflammation of the gastric mucosa, called chronic superficial gastritis, which leads to peptic ulceration in some patients. Diagnostic tests are divided into two major categories: non-invasive tests and invasive methods using endoscopy. The aim of this study was to monitor anti-HP IgG by the ELISA Pyloriset EIA-G (Orion diagnostica, Finland) during triple eradication therapy. Specific IgG were measured before treatment and then two, four and six months thereafter in plasma of 34 patients with positive history of dyspeptic illnes. The mean percentage of titer decline was greatest two months after treatment (49 percent, p

The role of free radicals in the etiology and pathogenesis of cardiac diseases and in the development of atherosclerosis has recently attracted ever more interest. The body has a complex antioxidative mechanism of protection which eliminates or neutralizes the toxic effects of free radicals.The aim of the study was to determine the value of total antioxidative system (TAS) and activities of the superoxide dismutase enzyme (SOD) in patients with ischemic heart disease. Thirty patients were included in the study, i.e. 18 with myocardial infarction (IM) and 12 with angina pectoris (AP). Control group (C) consisted of 60 healthy age-matched subjects of both sex. Blood samples were obtained at 12, 36, 84 and 120 h after the onset of chest pain. Serum TAS values and erythrocyte SOD activity were determined (Randox Lab, UK). In both groups of patients, the mean TAS values were significantly lower compared to the control group (xIM=1.54 +/- 0.54,  xAP= 1.44 +/-0.48,  xC= 1.67 +/- 0.2 mmol/L, p is less than 0.05). The mean values of SOD activity were also significantly lower in both patients groups compared to the control group ( xIM=137.17 +/- 49,  xAP=128.33 +/- 36.76,  xC=160 +/- 31.6 U/L, p is less than 0.05). A reduced functional capacity of the antioxidative system is a complex disorder influencing the development of ischemic heart disease.

Hepatocyte growth factor (HGF) is multifunctional cytokine and the most potent hepatocyte mitogen. Its gene is localized on chromosome 7. It is composed of 18 exons and 17 introns. The HGF structure consists of four kringle domains. The first and second kringle play the crucial role in the HGF binding to HGF-receptor, thus enabling its biologic function. Exons 4 and 5 code the first kringle domain. The aim of this study was to investigate the HGF-exon 4 polymorphism in healthy and liver cirrhotic subjects by two different methods of detection; RFLP and SSCP. The HGF-exon 4 polymorphism was investigated by PCR-RFLP and PCR-SSCP in 30 healthy and 20 cirrhotic subjects. Genomic DNA was isolated from blood by standard procedure. HGF exon 4 fragment (214 bp) was amplified in a total PCR reaction volume of 100 ml including 0.3 mg DNA, 200 mM dNTP-s, 0.1 mM of each primers and 2.5 U Taq polymerase. Each sample was subjected to 35 cycles of 95°C/20 s, 53°C/20 s , and 72 °C/ 30 s on thermal cycler. Initial denaturation was at 95°C/2 min and final extension at 72°C/5 min. For PCR-RFLP the amplicon was cut using the restriction enzymes Mva I, Alu I and Dde I (Boehringer Mannheim) at 37°C/3 hours. For PCR-SSCP the amplicon was denatured by 95% formamide loading buffer at 95°C/5 min. Restriction fragments were detected by 15% PAGE and ssDNA by 10% PAGE, and silver-stained. Results showed neither Mva I, Alu I or Dde I restriction fragment nor ssDNA polymorphism on exon 4. The preliminary results, obtained by the two different methods of polymorphism detection, suggest that there is no mutation on HGF exon 4. Further polymorphism studies are needed to investigate the role of HGF in liver disease patients.

There are still many questions about mechanisms of liver regeneration in liver cirrhosis caused by alcohol damage The possible answer could be a discovery of hepatocyte growth factor (HGF) as a most potent mitogen for hepatocytes which is activated by several steps after liver injury. The aim of this study was to determine whether the hepatocyte growth factor levels correlate with the grade of alcoholic liver cirrhosis and could it be used in classification of illness. The HGF levels were measured in 33 alcoholic liver cirrhosis patients and 42 healthy volunteers by ELISA, Otsuka Pharmaceuticals, Tokyo, Japan, with detection limit of 0.1 ng/ml.. The patients were subdivided in two subgroups according to grade of illness (by Child-Pugh- Turcot classification). The HGF levels were higher in cirrhotics than in healthy volunteers (0.78*0.38 vs. 0.2*0.06 ng/ml, p

The most recent researches have directed attention to the oxidative theory of atherosclerosis. Important role in its initiation have free radicals being produced during physiological and pathological processes. The aim of the study was to determine total antioxidant status and activity of superoxid dismutase in patients with ischemic heart disease. Blood samples of 30 patients with ischemic heart disease (12 with angina pectoris and 18 with myocardial infarction) were analyzed 12, 36, 84 and 120 hours after the onset of disease. The TAS values and the SOD activities were measured at the same time with other markers of heart disease (CK, LD, CK-MB). The preliminary results showed that SOD activities in both groups of patients have been significantly lower compared to the control group of healthy volunteers (n=60, p

Impaired immunodefense and infections are very common and often fatal complications in liver alcoholic cirrhosis patients. The results of studies on circulating lymphocytes ability to undergo blast transformation with polyclonal mitogens in vitro are different. On the other side, the hepatocyte growth factor is a multifunctional cytokine, the most potent mitogen for hepatocytes, but also for multipotent hemopoietic cells. HGF levels usually increase during liver regeneration. The aim of the study was to determine whether the ability of blast transformation and HGF levels change in liver cirrhosis. Blast transformation of lymphocytes was measured with polyclonal mitogens and HGF levels by the ELISA method in 33 patients with alcoholic cirrhosis and in a group of 42 healthy volunteers. Blast transformation of lymphocytes with Pha, ConA and PWM was diminished in 72.7%, 78.8%, and 66.7% patients, respectively. In healthy volunteers blast transformation was within the normal range. HGF levels were higher in cirrhotics than in healthy volunteers (0.98*0.38 vs. 0.2*0.06 ng/ml, p

Helicobacter pylori (HP) infection results in inflammation of the gastric mucosa, termed chronic superficial gastritis, developing peptic ulceration in some patients. Proper treatment includes eradication of the causative microorganism. The aim of this study was to monitor the efficacy of anti-HP treatment by noninvasive quantitative serologic methods. The concentration of specific anti-HP IgG was measured in serum of 86 patients with positive dyspeptic illness history before treatment, and two, four and six months after the treatment by ELISA Pyloriset EIA-G (Orion Diagnostica, Finland) with a cutoff titer of 300 mg/l. Results showed that the mean percentage of titer decrease was greatest two months after treatment (47%, p

Čimbenik rasta jetre (HGF) je multifunkcionalan citokin i najmoćniji mitogen za hepatocite. Razine HGF u serumu su povišene za vrijeme regeneracije jetre. S druge strane, imunološki status je poremećen u bolesnika s kroničnom alkoholnom bolesti jetre (KABJ), i često su u povećanom riziku nastanka infekcija. U ovom radu mjerene su razine HGF, osnovni biokemijski pokazatelji jetrene funkcije i in vitro imunološki status 33 bolesnika s potvrđenom dijagnozom alkoholne bolesti jetre i 42 zdrava ispitanika. Bolesnici su podijeljeni prema težini bolesti (Childova klasifikacija) na dvije podskupine. Razina HGF mjerena je ELISA testom i HGF se pokazao kao najpouzdaniji u odnosu na ostale pokazatelje- ima specifičnost 100% i osjetljivost 93%. Nađena je statistički značajna razlika između vrijednosti HGF zdravih ispitanika i bolesnika (0.2 ą 0.06 : 0.78 ą 0.38 ng/ml, p

The goal of this study was to evaluate biochemical indicators of liver cirrhosis and electrophoretoc hepatopoietin protein bands in patients with liver cirrhosis (n=30) and compare the results with the results obtained from healthy controls. After isolation hepatopoietin plasma extracts were submitted the electrophoretic separation using SDS-PAGE electrophoresis. In doing so three protein bands were separated in the area between 30, 000 and 50, 000 D. Comparing the results of biochemical indicators with those of liver cirrhosis it was found that 73.3& of patients carry positive band A, 93, 3% band B and 60% band C. In controls there were 80% subjects with band A, 88& with band B and 80% with band C.

From serum of 72 patients with liver disease hepatopoietin extract was isolated and its protein fractions were separated by SDS-PAGE electrophoresis. Three fractions in the area of Mr 38000 +/- 5000ć A-41700, B-3800 and C-33800 were com, pared with activity of transaminases, alkal phosphatasen, gamaGT, CHE , LDH and total bilirubin. Hepatopoietin fraction A was found in 87.5% of liver patients, B in 95.8% and C in 79%. Frequency of hepatopoietin fractions in patients with values of biochemical values 3SD higher than the mean amounts 70%-100%.