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Chronic obstructive pulmonary disease (COPD) is a disease with periods of remission and exacerbation and consequential defect of the pulmonary function. It is estimated that around 3 million people die from it annually and predicted that until 2030 the number of deaths will be up to 6 million per year. According to the reports of the World Health Organization and Global initiative for chronic obstructive lung disease (GOLD) it is predicted that COPD in the next decade will be the third leading cause of death in the world.[ 1, 2 ] It is characterized by limited air flow in the breathing pathways which is not completely reversible to therapy. Since there are systemic inflammations at COPD, the mechanisms of the processes have consequences outside the lungs also. Comorbidities are frequent at patients with the Chronic obstructive lung disease and they affect the disease prognosis substantially. The most common comorbidities are cardiovascular diseases, metabolic syndrome, diabetes, anemia, osteoporosis, anxiety and depression, pulmonary embolism.

Predictors of improved quality of life after coronary artery bypass surgery (CABG) are still incompletely known. To determine the predictors of improving the quality of life six months after coronary artery bypass surgery. We studied 208 consecutive patients, who underwent elective CABG. The Nottingham Health Profile Questionnaire part 1 was used as the model for quality of life determination. Questionnaire contains 38 subjective statements divided into six sections: physical mobility, social isolation, emotional reaction, energy, pain and sleep. We distributed the questionnaire to all patients before CABG and six months after CABG. The mean age of patients was 58,8 ± 8,2 years, 82% were males. The comparison between mean preoperative and postoperative scores showed that improvement was found in 53.7% of patients, worsening in 12.5%, quality of life before and after the intervention was normal in 26.7%, and no changes in quality of life was at 7.08%. Independent predictors of patients improvement by CABG were as follows: absence of previous myocardial infarction in the physical mobility section (p=0.03; OR=0.59; CI 0.40-0.92), higher CCS angina class in the physical mobility (p=0.006; OR=2.34; CI 1.46-3.32), energy (p=0.02; OR=1.70; CI 1.29-2.64) and pain sections (p

Main point of prevention of tuberculosis is the existence of basic knowledge about risk factors (smoking habit, alchohol abuse) which contribute to appearance of tuberculosis and influence to therapy. In order to assess the influence of potential risk factors a cross-analysis was made for the years 2002-2004, 2007-2009 and 2012-2014 . During the period of 12 years, 230 cases of TB were included in the study. The mean age of all subjects was 45.81±16.98. There were (61.7-73.2%) males and this observation is supported by reports that males had significantly higher risk for more severe lung destruction (69.2-84.6%), as evidenced by bilateral lung cavitation (86.1-100%) than females. In total 45.6-76.7% were smear-positive. Alcohol use disorders increased (11.8-29.4%; p=0.02) as a smoking habit (44.1-47.1%). In cases with severe lung destruction as a lung cavitation increased cigarette smoking (46.6-60.0%) and alcoholism (19.4-50.0%; p=0.007). Linear regression analysis confirmed a statistically significant correlation between severe form of TB and smoking habit (>20 cigarettes per day, p=0.04) and alcohol use disorders (p=0.004). Successful control in reducing smoking, alcohol use disorders and, could favorably impact the TB morbidity rate.

Introduction: Intima-media thickness (IMT) of the carotid artery is a widely accepted parameter for detection and quantification of atherosclerosis. The aim of the study was the evaluation of the impact of changes of IMT on the mortality of patients on hemodialysis. Methods: The study was organized as a prospective and observational one. Intima-media thickness was determined by ultrasound in 194 patients who were evaluated every year during a three-year period. We analyzed the mortality rate of patients on hemodialysis in relation to their biochemical parameters, demographic and anthropometric characteristics, type of dialysis, smoking habits and statin therapy. Results: Female gender and hemodiafiltration emerged as good predictors of long-term survival. Baseline IMT values were significantly lower than those at the end of the second (p <0.001) and third years of the study (p <0.001). The baseline values positively correlated with uric acid levels (p =0.027) and body mass index (p =0.024), while at the end of the second year, IMT positively correlated with LDL-cholesterol (p =0.037) and triglyceride levels (p =0.018) and body mass index (p =0.045). Patients on hemodiafiltration had significantly higher values for erythrocytes (p =0.047), hemoglobin (p =0.005), creatinine (p =0.048), Kt/V (p =0.026), albumin (p =0.012), LDL-cholesterol (p <0.001), body mass index (p <0.00 1),and lower IMT values at the end of the first year (p =0.039), compared to patients on bicarbonate hemodialysis. Predictors of death were the duration of hemodialysis (p <0.001), and IMT at the end of the first (p =0.008) and second years of the study (p =0.005). Conclusion: Dynamic changes of IMT of the carotid arteries during the first two years were found in our study to be predictors of mortality in patients on hemodialysis. [ABSTRACT FROM AUTHOR]

Objective: Many studies have reported insufficient support from surgical services, resulting in nephrologists creating arteriovenous fistulas in many centers. The aim of this study was to compare risk factors of arteriovenous fistula dysfunction in patients whose fistulas were created by nephrologists versus vascular surgeons., Methods: This was a retrospective, analytical study of interventions by nephrologists and vascular surgeons during a period of 15 years. Out of a total of 1,048 fistulas, 764 (72.9%) were created by nephrologists patients, while vascular surgeons were responsible for 284 (27.1%) fistulae. Laboratory, demographic, and clinical parameters which might affect functioning of these arteriovenous fistulae were analyzed., Results: Patients whose arteriovenous fistula was formed by nephrologists differed significantly from those created by vascular surgeons in relation to the preventive character of the arteriovenous fistula (p = 0.011), lumen of the vein (p < 0.001) and systolic blood pressure (p = 0.047). Multivariate logistic regression of arteriovenous fistula dysfunction showed that risk factors were female gender (odds ratio [OR] = 1.56, 95% CI 1.16-2.07), whether the fistulae were created by vascular surgeons or nephrologists (OR = 1.38; 95% CI 1.01-1.89) and the site of the arteriovenous fistula (OR = 0.64; 95% CI 0.48-0.85)., Conclusions: Arteriovenous fistulae created by vascular surgeons, female gender, and the location are risk factors of dysfunction., (© 2020 The Author(s). Published by S. Karger AG, Basel.)

Background and objectives: In patients on hemodialysis, erectile dysfunction is an independent mortality factor. This study aimed to determine the risk factors that affect the survival of hemodialysis patients with erectile dysfunction. Materials and Methods: During a seven-year period, erectile dysfunction was identified among the fatalities reported in patients receiving chronic hemodialysis, on the basis of the International Index of Erectile Function questionnaire. The study covered 70 patients of mean age 57 ± 6.7 years. During the examined period, 42 (60%) patients died at the mean age 57 ± 6.8 years. The study was completed by 28 (40%) patients, aged 57 ± 6.55 years. Laboratory, demographic, anthropometric, and clinical characteristics were recorded using standard methods. Results: Statistically significant differences between the two groups of respondents were found concerning dialysis duration ( p < 0.001), number of leukocytes ( p = 0.003), adequacy of hemodialysis ( p = 0.004), intima media thickness of the carotid artery ( p < 0.001), presence of cardiovascular disease ( p = 0.03), residual diuresis ( p = 0.04), and hemodiafiltration ( p < 0.001). Hemodialysis adequacy (B = -9.634; p = 0.017), intima media thickness (B = 0.022; p = 0.003), residual diuresis (B = -0.060; p = 0.007), and lower rates of cardiovascular disease (B = 0.176; p = 0.034) were significant survival predictors among our patients with erectile dysfunction. Conclusions: Risk factors that are associated with improved survival of patients on hemodialysis with erectile dysfunction in our study are: preserved diuresis, high-quality hemodialysis, lower incidence of cardiovascular disease, and less thickening of the intima media of the carotid arteries.

Background: Exercise induces a multitude of physiological and biochemical changes in blood that can affect its redox status. Exercise causes an increase in oxygen consumption by the whole body and particularly by the exercising muscle. As a result of this process there is a rise in the production of reactive oxygen species (ROS), which are capable to trigger a chain of damaging biochemical and physiological changes known as lipid peroxidation and oxidative stress. Since the early work of Dillard et al. in 1978, and findings of increased lipid peroxidation following acute aerobic exercise, the topic of exercise-induced oxidative stress has received considerable attention., Objectives: The aim of this study was to examine how swimming to the point of exhaustion affects oxidative stress generation and nonenzymatic antioxidant activity in an animal model., Material and Methods: The experiments were conducted on 10 male Dunkin-Hartley guinea pigs, and the swimming program used in the study, described as swimming to exhaustion, was defined by Dawson and Horvath. Peripheral blood samples were taken at rest and immediately after the exercise test, and the following parameters were evaluated: total plasma peroxide concentration (TPPC), total plasma thiols (TPT), plasma xanthine oxidase activity (XOD), plasma antioxidant capacity and total plasma proteins., Results: No significant difference was found between TPPC measured at rest and immediately after exercise swimming test (p = 0.138). Two other parameters--TPT and XOD activity--showed significant differences before and after the swimming exercise test: After the test the TPT value decreased significantly (p = 0.022), while XOD activity increased significantly (p = 0.039). Comparing antioxidant activity in plasma before and after the exercise test, although the value decreased, the difference was not statistically significant (p = 0.755)., Conclusions: The results of this study show that exercise to exhaustion induces the generation of oxidative stress primarily by oxidative modification of protein molecules. The results also indicated that the prooxidative enzyme xanthine oxidase is an important source of ROS during exercise-induced oxidative injury.