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Poznato je da je trening s otporom učinkovita strategija za povećanje mišićne mase kod ljudi. Mišićna hipertrofija predstavlja kronično stanje koje karakterizira povećanje poprečnog presjeka mišićnih vlakana. Iako mehanizmi zaslužni za pokretanje hipertrofijskih procesa nisu u potpunosti istraženi, pretpostavlja se da mehanička napetost, metabolički stres te mišićno oštećenje imaju određenu ulogu u navedenim procesima. Programi treninga s otporom sadrže varijable koje uključuju volumen, intenzitet, frekvenciju, intenzitet napora, interval odmora, vrstu mišićne akcije, trajanje ponavljanja, izbor vježbi, redoslijed vježbi i opseg pokreta. Primjerenom manipulacijom navedenih trenažnih varijabli moguće je značajno utjecati na kronične adaptacije mišićnog sustava. Ovaj diplomski rad pruža detaljan opis utjecaja pojedine varijable u treningu mišićne hipertrofije zajedno s praktičnim smjernicama. It is well known that resistance training is an effective strategy for increasing muscle mass in humans. Muscle hypertrophy is a chronic condition characterized by an increase in the cross-section of muscle fibers. Although the mechanisms responsible for the initiation of hypertrophic processes have not been fully investigated, it is assumed that mechanical tension, metabolic stress and muscle damage play a certain role in the aforementioned processes. Resistance training programs contain variables that include volume, intensity, frequency, intensity of effort, rest interval, type of muscle action, repetition duration, exercise selection, exercise order, and range of motion. Adequate manipulation of the mentioned training variables can significantly influence the chronic adaptations of the muscular system. This thesis provides a detailed description of the influence of individual variables in muscle hypertrophy training together with practical guidelines.

Dobrobiti provođenja redovite tjelovježbe odavno su dokazana i potvrđena, omogućuje nam dug i samostalan život. Očuvanje mišićne i koštane mase igra važnu ulogu kada se radi o održavanju zdravog života. Prakticiranje treninga s otporom pokazalo se kao odličan trenažni operator za očuvanje koštane i mišićne mase, kao i za povećanje mišićne mase. Da bi se potaknule značajnije promjene u organizmu, odnosno u lokomotornom sustavu, preporučljivo je provoditi trening s otporom pri opterećenjima većim od 70% od 1 maksimalnog ponavljanja (1RM). Veća opterećenja potiču aktivaciju brzih mišićnih vlakana Tipa 2 te dovode do promjena u mišiću kao što je pojava hipertrofije i povećanje snage. No za provedbu takvog tipa treninga treba biti fizički zdrav kako bi organizam moga podnijeti velike napore. Takav trening nije preporučljiv za starije osobe, osobe u procesu rehabilitacije ili bilo koga tko ne smije raditi s velikim opterećenjima. Upravo zato pojava okluzijskog ili treninga sa smanjenim protokom krvi izaziva veliko zanimanje znanstvenika. Kod takvog tipa treninga pomoću vanjskog pomagala koje se postavlja na ekstremitet koji provodi rad, a može biti manžeta ili traka za zatezanje, postiže se efekt okluzije, odnosno smanjenje protoka krvi s time da se ta pojava želi postići u venskom, ali ne i u arterijskom protoku. Na taj način krvi može ući u mišić, a izlazi u znatno manjoj količini ili se u potpunosti zadržava u mišiću. Time dolazi do nakupljanja krvi, što vodi do naticanja stanica u mišiću i stvaranja anaerobnih uvjeta rada, odnosno osjećaj kao da radimo s velikim opterećenjem. Značajan dio provedbe ovakve vrste treninga je da se vježbanje može provoditi već od 20% 1RM pa do najviše 50% 1RM, a promjene i efekti u organizmu su kao da se radi s velikim opterećenjem od 70% 1RM na dalje. Upravo iz navedenih razloga, potencijal ove metode treninga je vrlo značajan, budući da se može primjenjivati kod stariji osoba, ozlijeđenih pojedinaca te kod osoba koje su u procesu rehabilitacije. Provedena su mnoga istraživanja na navedenu temu, kako na osobama koje imaju naviku bavljenja sportom , tako i na starijim osobama pa čak i na osobama koje nemaju mogućnost kretanja. U većini rezultata navedena metoda treninga pokazala je pozitivne rezultate, pogotovo kada se radi o mišićnom rastu, a negativne posljedice nisu zabilježene. The implementation of regular exercise has proven and confirmed great benefits and it enables long and independent life. Providing healthy musculoskeletal system can be crucial when trying to maintain a healthy life. Practicing resistance training has proven to be an excellent training operator for maintaining bone and muscle mass as well as for increasing muscle mass. In order to encourage significant changes in the body, especially in lockomotor system, it is recommended to practice resistance training with loads heavier than 70% of 1 repetition maximum (1RM). Higher loads stimulate the activation of fast Type 2 muscle fibers and lead to changes in the muscle such as the occurrence of hypertrophy and an increase in strength. But to perform this type of training it is necessary to be physically healthy so that the body can withstand great efforts. Such training is not recommended for the elderly, people in the process of rehabilitation or anyone who should not work with heavy loads. That is why the appearance of occlusal or training with reduced blood flow is of great interest to scientists. With this type of training, with the help of an external device that is placed on the extremity that performs the work which can be a cuff or tensioning band, the effect of occlusion is achieved by reducing the blood flow with the aim of achieving this in venous but not arterial flow. This way blood can enter the muscle and come out in a much smaller amount or be completely retained in the muscle. This leads to the accumulation of blood, which leads to swelling of the cells in the muscle and the creation of anaerobic working conditions or a feeling of work with a heavy load. A significant part of the implementation of this type of training is that the exercise can be performed at 20% 1RM to a maximum of 50% 1RM and the changes and effects in the body are similar to working with a large load of 70% 1RM onwards. For these reasons, the potential of this method of training is very significant as it can be applied to the elderly, injured individuals and people who are in the process of rehabilitation. A lot of research has been done on this topic both on people who practice exercising regularly, on the elderly and even on people who do not have the ability to move. In most of the results, the blood flow restriction training showed positive results, especially when it comes to muscle growth and no negative consequences were recorded.

Background: During acute myocardial infarction, phosphorylated TnI levels, Ca2+ sensitivity and ATPase activity are decreased in the myocardium, and the elevation in Ca2+ levels activates protease I (calpain I), leading to the proteolytic degradation of troponins. Concurrently, hypoxia enhanced the expression of hypoxia inducible factor 1 alpha (HIF-1a) increasing the level of apelin, which limits infarct size, and improves myocardial function. ----- Methods: In this prospective observational study, 100 consecutive patients meeting the following criteria were included: continuous chest pain lasting > 30 min, an electrocardiogram (ECG) with ST-segment elevation (measured at the J-point) ≥ 2.5 mm in men < 40 years, ≥ 2 mm in men ≥ 40 years, or ≥ 1.5mm in women in leads V2-V3 and/or ≥ 1mm in other leads [in the absence of left ventricular (LV) hypertrophy or left bundle branch block (LBBB)], rise of specific biomarkers such as troponin I and the MB fraction of creatine kinase (CKMB), and patients who underwent reperfusion therapy. The levels of apelin-12, creatine kinase (CK), the MB fraction of creatine kinase (CKMB), troponin I, NT-proBNP, CRP, triglycerides, LDL and HDL cholesterol, and other routine laboratory parameters are measured. In particular, we evaluated the levels of apelin-12 and troponin I on the first and seventh days after reperfusion therapy in all patients. ----- Results: There was variability in apelin values on the first day (Kruskal-Wallis test) relative to segmental wall motion abnormalities (SWMAs) (p=0.046) and on the seventh day relative to different numbers of coronary lesions and stenoses (p2.2 for the association of apelin with MACE was determined, and the AUC was 0.71 (95% CI, 0.58–0.84). Survival analysis using the Kaplan-Meier method showed a lower rate of MACE among patients with apelin levels >2.2 (p = 0.002), and the ROC curve analysis showed a statistically significant difference in the area under the curve (p = 0.004). Pearson’s correlation between apelin-12 and creatine kinase-MB on the first day in patients without reperfusion injury was characterized with a p value, Uvod: Razina fosforiliranog troponina I, osjetljivost Ca2+ i aktivnost ATP-aze snižena je u miokardu tijekom akutnog infarkta miokarda. Porast razine Ca2+ aktivira proteazu I (kalpain I) koja proteolizom razgrađuje troponine. Istovremeno, hipoksija potiče ekspresiju hipoksijom induciranog faktora 1 alfa (HIF-1a) koji potiče porast razine apelina. Apelin ograničava veličinu infarkta i poboljšava funkciju miokarda. ----- Metode: U ovu prospektivnu opservacijsku studiju bilo je uključeno 100 uzastopnih bolesnika koji su ispunjavali sljedeće kriterije: neprekinuta bol u prsima u trajanju > 30 min, elevacija ST-spojnice u elektrokardiogramu (EKG) (mjerena od J-točke) ≥ 2.5 mm u muškaraca < 40 godina, ≥ 2 mm u muškaraca ≥ 40 godina ili ≥ 1.5 mm u žena u odvodima V2-V3 i/ili ≥ 1mm u drugim odvodima (uz odsutnost hipertrofije lijeve klijetke ili bloka lijeve grane), porast specifičnih biomarkera poput troponina I, MB frakcije kreatin kinaze (CKMB), i bolesnici koji su bili podvrgnuti reperfuzijskoj terapiji. Mjerena je razina apelina-12, kreatin kinaze (CK), MB frakcije kreatin kinaze (CKMB), troponina I, NT-proBNP, CRP, triglicerida, LDL i HDL kolesterola te rutinskih laboratorijskih parametara. Posebna pozornost data je na mjerenje razine apelina-12 i troponina I prvi i sedmi dan nakon reperfuzijske terapije kod svih bolesnika. ----- Rezultati: Pronađena je varijabilnost u razini apelina prvog dana (Kruskal-Walisov test) relativna u odnosu na segmentalne abnormalnosti gibanja stijenke (SWMAs) (p=0.046) i sedmog dana relativna u odnosu na različiti broj koronarnih lezija i stenoza (p 2.2 bila je određena za povezanost apelina s MACE, a površina ispod krivulje (AUC) bila je 0.71 (95% interval podudarnosti CI, 0.58-0.84). Analiza preživljenja (koristeći Kaplan-Meierovu metodu) pokazala je nižu stopu MACE u bolesnika s razinom apelina > 2.2 (p=0.002), a ROC krivulja je pokazala statistički značajnu razliku u površini ispod krivulje (p=0.004). Pearsonova korelacija između apelina-12 i kreatin kinaze-MB prvog dana u bolesnika bez reperfuzijske ozljede bila je okarakterizirana sa p-vrijednosti

Bodywight trening označava ono što mu i sam prijevod znači - vježbanje vlastitim tijelom, odnosno težinom. Iako je danas ta vrsta treninga na vrhuncu popularnosti zbog različitih dobrobita, to je ujedno i jedan od najstarijih oblika vježbanja. U suvremenom svijetu, čovjek se svakodnevno susreće s mnogobrojnim izazovima, javljaju se tjelesna i mentalna degradacija koje su posljedica užurbanog i nekvalitetnog načina života. Jedan od načina nošenja sa svim izazovima je fizička aktivnost koja ima mnogobrojne pozitivne učinke na ljudsko tijelo. Osim fizičke aktivnosti, potrebno je i vježbati, odnosno razvijati jakost, izdržljivost i mobilnost. Pri treniranju jakosti s vlastitim tijelom, opterećenje se može postići na više načina, a za uspješnije treniranje mišićne izdržljivosti potrebno je poznavati zone opterećenja. Treniranje kardiorespiratorne izdržljivosti poboljšava prijenos kisika kroz ljudsko tijelo. Uz brojne prednosti treninga s vlastitim tijelom, također se razvijaju i fleksibilnost, brzina, koordinacija i ravnoteža te postoje mnogobrojni testovi kojima se utvrđuje trenutno stanje vježbača. Da bi vježbač, kojem je glavni rekvizit vlastito tijelo, postigao hipertrofiju mišića, potrebno je češće treniranje mišićnog sustava. Dakle, bodyweight trening, uz nebrojene prednosti koje donosi i jednostavno implementiranje u svakodnevni život, ipak zahtijeva određeno predznanje kako bi se odabrale potrebne vježbe sa svrhom postizanja željenih rezultata. Bodyweight training means what the translation itself means to him – exercising with his own body, by weight. Although today this type of training is at the peak of popularity due to various benefits and it is also one of the oldest forms of exercise. In the modern world, man is faced with many challenges in every day life, physical and mental degradation occurs as a result of hectic and poor quality of life. One way to cope with all of this challenges is physical activity which has many positive effects on the human body. In addition to physical activity, it is necessary to exercise, develop strength, endurance and mobility. When training strength with your own body, the load can be achieved in several ways, and for more successful training of muscular endurance it is necessary to know the load zones. Cardiorespiratory endurance training improves oxygen transfer through the human body. In addition to the many benefits of training with your own body, flexibility, speed, coordination and balance are also developed, and there are numerous tests that determine the current state of the exerciser. In the order for an exerciser, whose main is his own body, to achieve muscle hypertrophy, it is necessary to train the muscular system more often. It means, bodyweight training, in addition to countless benefits it brings and easy implementation in everyday life, still reguires some prior knowledge in order to select the necessary exercise in odred to achieve the desired results.

Pretilost je vrlo česta i kompleksna metabolička bolest koja se očituje prvenstveno promjenama u strukturi masnog tkiva. Cilj ovog rada bio je istražiti utjecaj visokokalorične prehrane na strukturu masnog tkiva gravidnih Sprqague-Dawley štakorica. Istraživanje se provodilo kao dio studije RECOOP-CMSC SENIOR SCIENTIST (RCSS) GRANT 2018-2020 #012 „The role of obesity-induced low- grade inflammation in the adipokine signaling in pregnant rat uterus“, voditelj: Dr. Gáspár Róbert. U eksperimentu su korištene dvije skupine životinja, kontrolna skupina gravidnih životinja hranjenih standardnom prehranom i eksperimentalna skupina gravidnih životinja hranjenih HFHSD ('' high fat high sugar diet'') prehranom. Životinje su žrtvovane odmah nakon poroda. U istraživanju je praćena promjena površine adipocita visceralnog i gonadalnog masnog tkiva u ove dvije skupine životinja, došlo je do hipertrofije adipocita, te promjena brojnosti mastocita unutar navedenih tkiva. Uočeno je povećanje površine adipocita eksperimentalne skupine životinja u oba tipa tkiva, dok je broj mastocita ostao nepromijenjen u usporebi s kontrolnom skupinom.

Namen diplomske naloge je ustvariti program vadbe, s katerim želimo doseči cilj povečanje mišične mase pri ektomorfnih tipih ljudi. Ker sem ektomorf tudi sam, sem želel v diplomski nalogi predstaviti posebnosti, s katerimi se ektomorfi srečujemo v procesu pridobivanja mišične mase, in poskusil ustvariti trenažni postopek, ki bi olajšal ta proces. V uvodu smo se osredotočili na pomembne dejavnike, ki vplivajo na trenažni postopek. Opisali smo delovanje mišic ter pojem moči in to povezali s procesom mišične hipertrofije. Zajeli smo tudi prehrano in vse skupaj navezali na značilnosti ektomorfnih ljudi. Na koncu smo prikazali program vadbe, ki temelji na podlagi opisanih načel in komponent trenažnega postopka. Vadbeni program je sestavljen iz dveh makrociklov in traja 8 tednov. Program sta izvajala posameznika stara 17 in 18 let, ki se po konstituciji uvrščata med ektomorfne tipe ljudi. Končna analiza programa je pokazala, da sta s programom uspešno dosegla cilj povečanja mišične mase poleg povečanja obsegov telesnih segmentov sta pridobila tudi na moči. The purpose of this diploma thesis is to create an exercise programme with the goal of building muscle mass for ectomorph body types. Being an ectomorph myself, I want to present the individualities which ectomorphs encounter in the process of building muscle mass and try to create a training routine that would facilitate this process. In the introduction, we focused on the important factors that affect the training routine. We described the function of muscles and the concept of strength, which we connected with the process of muscle hypertrophy. We also included nutrition and implied all together at the characteristichs of ectomorphs. At the end we presented the training routine, that is based on described principles and components of the training process. The exercise programme consists of two macrocycles and lasts 8 weeks. The programme was carried out by two individuals aged 17 and 18 who, by constitution have an ectomorph body type. Final analysis of the program showed that the individuals successfully achieved the goal of increasing muscle mass in addition to increasing the circumference of the body segments they also gained strength.

Glavni cilj ovog diplomskog rada je istražiti utjecaj cheating metode na maksimalni broj ponavljanja u vježbi pregib podlaktica EZ šipkom stojeći. Uzorak ispitanika činila je zdrava, tjelesno aktivna muška populacija (n = 8). Testiranje se provodilo u dva odvojena mjerenja, izvedba vježbe pregiba podlaktica u kontroliranim uvjetima i izvedba iste vježbe u uvjetima dozvoljenog varanja. T-testom za zavisne uzorke je utvrđeno postojanje statistički značajne razlike u broju ponavljanja između uvjeta (t = -8,23; p < 0,001). Veličina učinka (Cohenov d) izračunata je za promjene između prvog i drugog mjerenja te je utvrđena velika veličina učinka (d = 8,7). Veličinom porasta izraženo je ukupno povećanje broja ponavljanja koje iznosi 128,89%. Rezultati indiciraju na to da je cheating metodom moguće produljiti trajanje jedne serije, čime se ostvaruje veći volumen rada, koji je potencijalno značajan za veći hipertrofijski učinak. Produljenim trajanjem rada prouzrokujemo veću mehaničku napetost, koja je umnožak intenziteta (veličina opterećenja) i vremena pod napetosti, što rezultira većom aktivacijom motoričkih jedinica, a time i većim hipertrofijskim odgovorom. Korištenje cheating metode umjerenim intenzitetom i izvedbom u zoni sigurnosti može poslužiti kao alat kojim je moguće utjecati na razvoj mišićne hipertrofije. This paper aimed at investigating the effect of the cheating method on the maximum number of repetitions in the EZ barbell forearm curl standing exercise. The sample consisted of a healthy, physically active male population (n = 8). Testing was performed in two separate measurements, performing the forearm curl exercise under controlled conditions and performing the same exercise under allowed cheating conditions. T-test for dependent samples has revealed that there is a statistically significant difference in the number of repetitions between conditions (t = -8.23; p < 0,001). The effect size (Cohen's d) was calculated for the changes between the first and the second measurement and a significant change size has been determined (d = 8.7). The size of increase expressed a total increase in the number of repetitions, which amounted to 128.89%. The results indicate that the cheating method can extend the duration of one series thus achieving a higher volume of work, which is significant for a higher hypertrophic effect. Prolonged work causes greater mechanical tension, which is the product of intensity (load value) and time spent under tension, which results in greater activation of motor units, and thus a greater hypertrophic response. The use of the cheating method with moderate intensity and performance in the safety zone can serve as a tool by which we will influence the development of hypertrophy.

Glavni cilj diplomskog rada je objasniti teoriju i primjenu Heavy duty treninga kao metode viskointenzivnog treninga s otporima za unaprjeđenje mišićne jakosti i hipertrofije. Takav trening je kratkog trajanja, manje učestalosti i maksimalnog intenziteta. Adekvatan živčano-mišićni podražaj postiže se s jednom radnom serijom do mišićnog otkaza, te primjenom tehnika za podizanje intenziteta koje omogućavaju maksimalno mišićno naprezanje. Niska učestalost treninga potrebna je kako bi se živčani i mišićni sustav u potpunosti oporavili, te bili spremni na sve veće trenažne zahtjeve. Heavy duty metoda je osmišljena s idejom da se vježbač nikad ne dovede u stanje pretreniranosti, da progresivno povećava težine od treninga do treninga, te da postigne svoj maksimalni mišićni potencijal u granicama genetskih predispozicija. The main objective of the thesis is to explain the theory and application of Heavy duty training as a method of high-intensity training with resistance to improve muscle strength and hypertrophy. Such training is of short duration, less frequency and maximum intensity. Adequate neuromuscular stimulation is achieved with a single work series until muscle failure, and by the application of intensification techniques that allow for muscular strain. A low frequency of training is required to fully nerve and muscular the system and be prepared for the increasing training requirements. The Heavy duty method is designed with the idea that the trainer should never be put into a state of overtraining, progressively increase weights from training to training, and to reach his maximum muscular potential within the limits of genetic predisposition.

Gestational diabetes involves disorder of glucose metabolism first diagnosed in pregnancy. Obese women undoubtedly have more often complications in reproductive age, such as fertility difficulties, spontaneous and recurrent miscarriages, premature births, and various obstetric and surgical complications related to the course of pregnancy, delivery and puerperium. Children of obese pregnant women are more likely to develop obesity in childhood and adulthood. We analyzed the outcome of 51 pregnancies in obese pregnant women and 50 pregnant women with normal body mass index. All women in both groups were diagnosed with gestational diabetes by the IADPSG criteria. We analyzed gestational age at delivery and mode of delivery, gestational weight gain, presence of concomitant diagnosis of gestational or chronic hypertension, difference in birth weight, and prevalence of hypertrophic newborns. There was no significant difference in gestational age at pregnancy termination and in the mode of delivery. There was a significant difference in gestational weight gain, number of pregnant women with hypertension, neonatal birth weight and number of hypertrophic children. Based on the data presented, we conclude that obesity is an unfavorable factor for pregnancy outcome. It also influences birth weight and fetal hypertrophy, as well as gestational weight gain., Gestacijski dijabetes podrazumijeva poremećaj metabolizma glukoze koji se prvi puta dijagnosticira u trudnoći, a njegova incidencija je u porastu. Pretile žene nedvojbeno imaju češće probleme i komplikacije u reproduktivnim godinama, što podrazumijeva teškoće pri zanošenju, spontane i habitualne pobačaje, prijevremene porođaje i različite opstetričke i kirurške komplikacije vezane za tijek trudnoće, porođaja i babinja. Djeca iz takvih trudnoća češće razvijaju pretilost u djetinjstvu kao i u odrasloj dobi. S obzirom na navedeno analizirali smo ishod trudnoća u 51 pretile trudnice i 50 trudnica s urednim indeksom tjelesne mase, pri čemu su sve trudnice (u objema skupinama) imale dijagnozu gestacijskog dijabetesa prema kriterijima IADPSG. Analizirali smo gestacijsku dob, način dovršenja trudnoće, prirast na težini trudnica, prisutnost istodobnih dijagnoza gestacijske ili kronične hipertenzije, razliku u težini novorođenčadi te učestalost hipertrofične novorođenčadi. Rezultati su pokazali da ne postoji statistički značajna razlika u gestacijskoj dobi kad je završena trudnoća niti u načinu dovršenja porođaja. Utvrđena je statistički značajna razlika u dobivenim kilogramima tijekom trudnoće, broju trudnica s hipertenzijom, porođajnoj masi novorođenčadi i broju hipertrofične djece. U zaključku, pretilost u trudnoći s gestacijskim dijabetesom je nepovoljan čimbenik za ishod trudnoće, porođajnu masu i prekomjeran rast novorođenčadi, kao i za prirast tjelesne mase trudnice tijekom trudnoće.

Objectives: The purpose of this study is to confirm whether there is a correlation between adenoid hypertrophy and the incidence of otitis media with effusion in children that are of school age or younger. Additionally, this study aims to clarify which age groups are at greater risk in having high grade adenoid hypertrophy associated with otitis media with effusion, and which are the most common presenting symptoms among those patients. Methods: Sixty- five patients aged 2-12 years old were included, and were placed into three groups according to age (2-5, 6-9, and 10-12). All of the patients were diagnosed with OME and were treated surgically (myringotomy with ventilation tube insertion and an adenoidectomy). Each patient had undergone pre-operative diagnostic procedures, including a detailed hetero-anamnesis and a clinical examination (otoscopy, rhinoscopy, and oropharyngoscopy). The diagnostic exams undertook include flexible nasofiberendoscopy of the nasopharynx and audiologic evaluations, including tympanometry and tonal audiometry. Results: There was an observed statistically significant incidence of patients with grades II and III grades of AH (P, Ciljevi: Cilj rada je ispitati povezanost veličine adenoidnih vegetacija i kronične upale srednjeg uha s izljevom, potom ispitati u kojoj dobnoj skupini djece s ovom bolesti je najveća prosječna veličina adenoidnih vegetacija te koji su najčešći prezentirajući simptomi od povećanih adenoidnih vegetacija. Metode: U istraživanje je uključeno šezdeset petero djece između 2 i 12 godina koja su podijeljena u 3 dobne skupine (2-5, 6-9 i 10-12 godina) s dijagnozom kronične upale srednjeg uha s izljevom, koja su podvrgnuta operativnom zahvatu postavljanja aerizacijskih cjevčica i adenoidektomiji. Svoj djeci je urađena preoperativna dijagnostika koja uključuje detaljnu heteroanamnezu, klinički pregled koji uključuje otoskopiju, rinoskopiju, orofaringoskopiju te dijagnostičke pretrage koje uključuju fiberendoskopiju epifarinksa i audiološku obradu– timpanometriju i tonalnu audimetriju. Rezultati: Rezultati rada pokazuju da su najčešći gradusi AH II i III (P

Trening s otporima sastavni je dio programa svakog rekreativca i sportaša koji želi poboljšati svoje sposobnosti, postizati vrhunske rezultate, smanjiti rizik nastanka ozljede, te povoljno utjecati na vlastiti zdravstveni status. Nekoliko ključnih principa treninga kao što su veličina opterećenja, specifičnost, adaptacija, progresija i individualizacija utječu na učinkovito i sigurno upravljanje tijekom treninga s otporima. Razvoj mišićne jakosti i hipertrofije uvelike ovisi o pravilnom manipuliranju programskim varijablama treninga koje je potrebno poznavati kako bi učinci treninga bili maksimalni. Volumen i intenzitet treninga jedne su od najvažnijih varijabli koje utječu na jakost i hipertrofiju, međutim, uz njih interval odmora također ima važnu ulogu u programiranju treninga s otporima. Definiran je kao vrijeme posvećeno oporavku između serija i vježbi, a njegovo trajanje može značajno utjecati na metaboličke i hormonalne odgovore, kao i izravno na intenzitet treninga: što je interval odmora kraći, veći je intenzitet u sljedećoj seriji. Kako bi se tijelo uspješno oporavilo i prilagodilo na buduće napore, te kako bi učinci treninga na razvoj sposobnosti bili maksimalni, potrebno je poznavati specifičnosti pravilnog upravljanja intervalom odmora. Stoga je cilj ovog rada prikazati, objasniti i vrednovati ulogu intervala odmora u razvoju jakosti i mišićne hipertrofije, te objasniti mehanizme metode vježbanja u bodybuildingu za povećanje intenziteta vježbanja – interval odmora. Ključne Resistance training is an integral part of every program for amateur and professional athlete who wants to improve their skills, achieve top performance, reduce the risk of injury and have a beneficial affect on its health status. Several key principles such as load, specificity, adaptation, progression and individualisation affects on safe and effective managing during resistance training. The development of muscle strength and hypertrophy largely depends on proper manipulation of acute programme variables which needs to be known to maximize the effects of training. Training volume and intensity are one of the most important variables that affects muscle strength and hypertrophy, but also the rest interval have a significant role in programming resistance training. It is defined as a time dedicated to recovery between sets and exercises that affects metabolic and hormonal responses and directly influences on intensity of training: if the rest interval is shorter, the greater intensity is in the next set. In order for the body to fully recover and adapt on future efforts, it is necessary to properly manipulate the rest interval in order to maximize effects of training on abilities. Therefore, the aim of this paper is to show, explain and evaluate the role of rest interval in order to develop smuscle strength, and hypertrophy and explain the mechanisms of bodybuilding exercise method to increase the intensity of exercise- rest interval.

Do prekida rada u osnovnim vježbama dolazi kada najslabiji mišići koji sudjeluju u izvedbi vježbe dosegnu mišićni otkaz. U vježbama povlačenja su to najčešće mišići koji osiguravaju stisak šake, odnosno čvrst hvat. Kako bi se to izbjeglo, postoje različite metode i pomagala kojima se on može pojačati. Jedan od njih je i primjena fitnes gurtni. Stoga je cilj ovog rada bio utvrditi može li i u kojoj mjeri primjena fitnes gurtni prilikom izvedbe zgibova s vlastitom tjelesnom masom do otkaza povećati broj ponavljanja u odnosu na izvedbu zgibova bez primjene fitnes gurtni u jednoj seriji. Muška, tjelesno aktivna populacija (n = 10) izveli su maksimalan broj zgibova sa, odnosno bez primjene fitnes gurtni. Razlike su utvrđene t-testom za zavisne uzorke te je izračunata veličina porasta i veličina učinka. Rezultati t-testa pokazuju statistički značajnu razliku (t = 4,64; p = 0,001) u rezultatima izvođenja zgibova s primjenom (11,6 ± 3,95) i bez primjene gurtni (9,9 ± 4,12). Veličina porasta iznosi 17,17 %, dok veličina učinka iznosi 0,41. Dobiveni rezultati pokazuju da povećani broj ponavljanja izveden s gurtnama omogućuje povećanje ukupnog rada i vremena mišića pod napetošću, što može biti važno za razvoj jakosti i hipertrofije mišića. Stoga se preporuča dozirano korištenje gurtni na siguran način prema precizno definiranim ciljevima trenažnog procesa. Interruption of work in basic exercises occurs when the weakest muscles participating in the exercise reach muscle failure. In pulling exercises, this most often pertains to grip flexor muscles, i.e. muscles that ensure a firm grip. In order to avoid this, there are different methods and aids that can amplify it. One of them is the use of fitness wrist straps. Thus, this paper aims to establish whether and to which extent the use of fitness wrist straps in the performance of bodyweight pull-ups to failure can increase the number of repetitions in relation to the performance of pull-ups without the use of fitness wrist straps in one set. Physically active male population (n = 10) performed the maximum number of pull-ups with or without the use of fitness straps. The differences were established in a t-test for dependent samples and the increase and effect sizes were calculated. The t-test results point to a statistically significant difference (t = 4.64; p = 0.001) in results of the performance of pullups with (11.6 ± 3.95) and without the use of fitness straps (9.9 ± 4.12). The increase size reaches 17.17%, whereas the effect size is 0.41. The results obtained show that the increased number of repetitions performed with straps allows for an increase in the total work and muscle time under tension, which can be important for the development of muscle strength and hypertophy. Therefore, a dosed use of fitness straps in a safe way in line with precisely defined objectives of a training process is recommended.

Sodobni trendi, kot so industrializacija, ekonomski razvoj in globalizacija trgovskih tokov, so prispevali k hitrim spremembam življenjskega sloga in prehranjevalnih navad (Burgos et al., 2015). Zahodno dieto imenujemo tudi standardna ameriška prehrana. Zanjo sta značilna povečan vnos živil z visoko vsebnostjo maščob in sladkorja ter pretirano uživanje rdečega mesa, rafiniranih žitaric in mlečnih izdelkov z visoko vsebnostjo maščob (Odermatt, 2011). Zanimalo nas je, ali zahodna dieta, poleg tega da povzroča debelost, vpliva tudi na notranje organe, natančneje na trebušno slinavko. Trebušno slinavko, z drugim imenom pankreas, na histološki ravni sestavljajo tako eksokrine kot tudi endokrine žleze, zaradi česar ima dve popolnoma različni, a zelo komplementarni funkciji: i) proizvodnjo encimov, pomembnih pri prebavi hrane, in ii) izločanje hormonov, potrebnih za uravnavanje homeostaze glukoze in drugih energijsko bogatih molekul (Danielsson et al., 2014). V magistrski nalogi smo pokazali, da zahodna dieta vpliva na eksokrini del pankreasa. S svetlobno in z elektronske mikroskopijo smo ugotovili, da je v strukturi in ultrastrukturi tkiva veliko razlik. Na slikah svetlobne mikroskopije smo opazili, da so v tkivu miši, hranjenih z zahodno dieto, vakuole v primerjavi s kontrolno skupino mnogo številnejše. Prav tako so bile v tkivu eksperimentalnih miši nekrotične celice in lipidne kaplje. V programu Python smo dokazali hipertrofijo celic pri tkivu miši, hranjenih z zahodno dieto. Na podlagi rezultatov na ultrastrukturni ravni smo potrdili hipotezo, da je v eksokrinem delu trebušne slinavke miši, hranjenih z zahodno dieto, vidna avtofagija. V tkivu so bili vidni številni avtofagosomi, avtolizosomi, rezidualna telesa in avtofagne vakuole. Z elektronskim mikroskopiranjem acinarnih celic eksperimentalnih miši smo opazili tudi napihnjene mitohondrije. Mnogi izmed njih so bili v fazi razpada. To lahko povežemo z dejstvom, da so napihnjeni mitohondriji tudi ena od glavnih značilnosti nekrotične celične smrti (Niemann & Rohrbach, 2016). Modern trends, such as industrialization, economic development and the globalization of trade flows, have contributed to the rapid changes in lifestyle and eating habits (Burgos et al., 2015). A Western diet is also called a standard American diet. It is characterized by an increased intake of foods with high fat and sugar content, excessive consumption of red meat, refined cereals and high fat milk products (Odermatt, 2011). In this research we tried to find out whether the Western diet, in addition to causing obesity, also affects the internal organs, more specifically the pancreas. On the histological level, the pancreas consists of both exocrine and endocrine glands. Because of this, the pancreas is an organ with two completely different but nevertheless complementary functions: i) the production of enzymes that participate in digestion and ii) the secretion of hormones needed to control the homeostasis of glucose and other energy-rich nutrients (Danielsson et al., 2014). In this master's thesis, we show that the Western diet affects the exocrine part of the pancreas. With the use of electron and light microscopy, we found that there are many differences in tissue structure and ultrastructure. When we examined the images obtained with the light microscope, we found that in the tissue of mice fed with the Western diet there are much more numerous vacuoles. In the tissue of experimental mice, necrotic cells and infiltrated fat were also present. Using the Python program, we demonstrated and quantified cell hypertrophy in the tissue of the mice treated with the Western diet. Using the electron microscopy results, at the ultrastructural level, we confirmed the hypothesis that autophagy is present in the exocrine part of the pancreas of mice fed with the Western diet. In the tissue, many autophagosomes, autolysosomes, residual bodies and autophagic vacuoles were visible. We also observed inflated mitochondria in the experimental mice tissue under the electron microscope. This can be related to the fact that the inflated mitochondria are also one of the main features of necrotic cell death (Niemann & Rohrbach, 2016).

Vadba z zmanjšanim krvnim pretokom predstavlja edinstveno vadbeno metodo, kjer so rezultati vidni že pri uporabi zelo nizkih obremenitev. Ishemični dražljaj, ki se pojavi pri vadbi z zmanjšanim krvnim pretokom, lahko povzroči hipertrofične učinke že pri 20 % 1RM. Poleg povečanja prečnega preseka in mase mišice v raziskavah poročajo tudi o izboljšani aerobni vzdržljivosti, vzdržljivosti v moči in maksimalni moči. Delna okluzija v okončini povzroča ishemično in hipoksično okolje, kar povzroča določene fiziološke prilagoditve na vadbo. Raziskave so pokazale, da vadba z zmanjšanim krvnim pretokom vpliva tudi na delovanje živčnega sistema, kjer lahko vplivamo na aktivacijo in rekrutacijo hitrih mišičnih vlaken. Kljub pomislekom o moteni hemodinamiki in zaskrbljenosti glede ishemičnih reperfuzijskih poškodb se je vadba z zmanjšanim krvnim pretokom izkazala kot varna. Pravilna uporaba in izvajanje naj ne bi predstavljala večjih zdravstvenih tveganj od klasične vadbe za moč. Vsekakor pa je njena uporabnost vidna v zgodnjih fazah rehabilitacije. Posluževanje te metode pride v poštev tudi pri delu s starejšo populacijo, ki jim visoko intenzivni trening predstavlja preveliko fizično obremenitev. Nekateri avtorji so izpostavili uporabnost celo v kardiološki rehabilitaciji. Glede na zmanjšano srčno predobremenitev (polnjenje prekata) bi lahko vadbo z zmanjšanim krvnim pretokom izvajali tudi srčno-žilni bolniki Blod flow restriction training is a unique training method with visible results even with low load. Ishemic stimulus that occurs in blod flow restriction training can have hypertrophic effects already with 20% 1RM. In addition to the increase of the cross-sectional area and muscle mass, studies also report of increased aerobic capacity, increased muscular strenght and increased maximal muscle strenght. Partial occlusion in the limb generates ishemic and hypoxic environment, which causes certain physiological adaptations to the training. Studies have shown that blod flow restriction training also affects the nervous system activity, where we can affect the activation and recruitment of fast-twitch muscle fibers. Despite scepticism regarding disrupted hemodynamics and concerns about ishemia-reperfusion injuries, blod flow restriction training proved to be safe. Correct application and exectution should not present any greater health risks than classic weight training. Its usefulness can in any case be seen in the early stages of rehabilitation. Using this method is also suitable when working with older population, for whom high intensity training presents too much physical burden. Some authors even emphasize the suitability of blod restriction training for cardiac rehabilitation. Considering the reduction of cardiac preload (ventricular filling), blod flow restriction training could be performed by patients with cardiovascular diseases.

Namen diplomske naloge je predstaviti problem pridobivanja mišične mase pri ektomorfnih tipih ljudi in podati smernice ter program za optimalen napredek pri povečanju deleža mišične mase. Ektomorfi so ljudje, ki jim njihova visoka in gracilna postava ter hiter metabolizem povzročajo največ preglavic pri pridobivanju mišične mase. Za dosego tega cilja morajo vložiti več časa in truda. Še posebej morajo biti disciplinirani pri sledenju navodil, tako pri fizičnem delu kot pri prehranskem delu. V diplomskem delu smo razložili pomen antropometrije in konstitucijskih tipov ter opisali zgodovino merjenja telesnih komponent. V jedru smo se osredotočili na pojem hipertrofije oziroma pridobivanja mišične mase. Pojasnili smo zakone in principe, ki jih moramo upoštevati za dosego rezultatov ter našteli metode, ki pridejo v poštev pri načrtovanju treninga pridobivanja mišične mase za ektomorfne tipe ljudi. Na koncu smo prikazali primer začetnega in nadaljevalnega programa pridobivanja mišične mase za ektomorfne tipe ljudi ter podali nekaj smernic o prehrani. Diplomsko delo je namenjeno vsem, ki potrebujejo pomoč pri pridobivanju mišične mase in ne le ektomorfnim ljudem. Namenjeno je tudi tistim, ki želijo osvežiti svoje znanje o metodah in načinih treniranja za pridobivanje mišične mase. The purpose of this diploma thesis is to present the problem of gaining muscle mass for ectomorphs and to give guidance for optimal progress at building muscle mass. Ectomorphs are people whom tall and graceful posture combined with a fast metabolism create the most problems when trying to gain lean muscle mass. To accomplish this goal they have to invest much more time and effort while showing extreme discipline in following the program. Despite many obstacles and setbacks, this goal is far from impossible. In this diploma thesis, we explained the purpose of anthropometry and constitutional types and gave people insight into the history of measuring body components. We focused on hypertrophy or gaining muscle mass. We explained laws, principles, and methods that we must oblige in order to achieve maximum results in gaining lean muscle mass for ectomorphs. We also showed an example of beginners’ and advanced training routines for building muscle mass for ectomorphs. There are also a few nutrition guidelines to follow for improved progress. This diploma thesis is meant for all those that need help in building muscle mass, especially for ectomorphs. It is also important for those who want to refresh their knowledge of methods and principles of training for muscle mass.

Zaradi vedno večje popularnosti vadbe za moč v fitnes centru, smo se odločili, da v diplomski nalogi zberemo osnovne informacije, ki so potrebne, če želi vadeči razumeti proces povečanja moči in mišične mase. Opisali smo delovanje živčno-mišičnega sistema, opredelili moč kot gibalno sposobnost in predstavili različne metode za povečanje moči. Opredelili smo načela in zakonitosti vadbenega procesa, navedli sredstva za razvoj moči ter poudarili varnostne ukrepe pri vadbi. Na koncu smo priložili primer programa vadbe za začetnika, v katerem se postopno povečuje obremenitev. Diplomska naloga je napisana kot osnovni priročnik za vadeče, ki nimajo oziroma imajo le malo izkušenj z vadbo za moč. Ravno zaradi tega je še bolj pomembno, da se v samem začetku vadbe upošteva vadbena načela, ki so opisana v diplomski nalogi. Naloga bo lahko v pomoč vsakemu, ki želi nekaj več informacij o vadbi za moč, kot tudi strokovnim delavcem na področju športa pri načrtovanju vadbenih programov. The popularity of recreational strength exercise is rising and that is why we decided to collect primary knowledge which is important if someone wants to understand the process of increasing maximal strength and muscle mass. We described function of neuromuscular system, defined strength as motor ability and described some different methods for increasing strength. We also defined principles and laws of training process and also stated accessories for strength development with highlights of safety. In the end we attached an example of training pograme with gradually increasing intensity for a beginner. The thesis is written like a basic guide for recreational athlete with no or little experience with strength exercise. This is also the reason why described principles are so important. This thesis can help anyone who wants more information about strength exercise and also professional trainers can use this thesis when planning programs for athletes.

Pretprotetska kirurgija je grana oralne kirurgije koja se bavi uspostavljanjem poremećenih anatomskih odnosa s ciljem da se postignu uvjeti za nošenje protetskih nadomjestaka. Indikacije za pretprotetske kirurške zahvate možemo podijeliti na nepovoljnu anatomsku građu, atrofiju i hipertrofiju mekih i tvrdih tkiva usne šupljine. U nepovoljnu anatomsku građu ubrajamo različite koštne neravnine i izbočenja te zadebljanje frenuluma jezika i usnica te povećanja obraznih papila. Atrofija se očituje kao smanjenje alveolarnoga grebena, a može biti fiziološka ili patološka. Fiziološka atrofija nastaje kao posljedica gubitka zuba, a patološka kao odgovor na patološke procese. Hipertrofija označava porast tkiva ili organa. Najčešće nastaje u području pomične sluznice alveolarnog grebena kao odgovor na dugotrajni podražaj.Terapija svih tih stanja je kirurška i može se izvesti u lokalnoj anesteziji. Neravnine i koštane izbočine alveolarnog grebena niveliramo pomoću dlijeta i freze za kost, a takav zahvat nazivamo modelacija alvolarnog grebena. Druga vrsta zahvata koja se izvodi naziva se vestibuloplastika. Indikacije za njeno provođenje su ravnomjerna atrofija alvolarnog grebena te hipertrofija mekih tkiva na alveolarnom grebenu i u području vestibuluma. Kirurške metode vestibuloplastike možemo podijeliti u tri grupe; zatvorena, otvorena i metoda s transplantatom. Preprosthetic surgery is oral surgery discipline which engages establishment of disrupted anatomical relations in order to achieve conditions for prosthetic appliances carrying. Indications for preprosthetic surgery procedures can be divided into adverse anatomical structure, atrophy and hipertrophy of soft and hard tissues of oral cavity. Unfavourable anatomical structure includes different bone bumps and distortions as well as thickening of tongue and mouth frenulum and facial papillae enlargement. Atrophy is reflected as alveolar ridge shrinkage and it can be physiological or pathological. Physiological atrophy arises from loss of teeth and pathological as response to pathological processes. Hypertrophy indicates tissue or organ enlargement. Most frequently, it develops in area of alveolar ridge movable mucosa as response to long-term stimulant.Therapy of above mentioned conditions is surgical and it can be performed under local anesthesia. Aveoral ridge bone bumps are leveled by chisel and bone planer and such procedure is called alveolar ridge modeling. Another type of surgery that is performed is called vestibuloplasty. Indications for its implementation are evenly aveoral ridge atrophy as well as hypertrophy of soft tissues on aveoral ridge and in vestibule area. Vestibuloplasty surgical methods can be divided into three groups: open, closed and methods with graft.

Skeletal muscle is an abundant tissue compromising 40–50 % of the body mass in humans (Sakuma et al., 2014). Its main role is to generate force for posture maintenance and performance of daily movements, but it also acts as a metabolically active organ. Muscle mass and function are of particular importance for health and well-being as well as for the athletic performance in sports (Wolfe, 2006). On the contrary, muscle loss is undesired process characterising the consenquence of various diseases and/or catabolic conditions and leads to weakness, frailty and even death (Schiaffino et al., 2013). Thus, investigations of physiological and genetic factors underlying muscle mass and force is crucial for solving and improving health issues of society. Mouse is the most widely used mammalian species in biomedical research. There are several reasons for its popularity. Firstly, analysis of mouse genome has shown that about 99 % of mouse genes have a homolog in the human genome (Guénet, 2005). Secondly, distinct mouse strains show significant variation in phenotypic traits facilitating identification of genes responsible for those traits. Thirdly, contrary to the inbred mice, humans present an outbred population complicating analysis of association between genes and phenotypic traits. Moreover, genetically engineered mice with mutations of specific genes, as in case of myostatin knockout (KO) mice (McPherron et al., 1997), provide a useful tool in identifying functions of those genes. Finally, studies of mice are cost effective due to small body size and relatively short lifespan which is 30 times shorter than in humans (Chang, 2013). Physiological factors that influence the relationship between skeletal muscle mass and force are of large interest. Both these traits to a large extent are determined by genetic factors (Pescatello et al., 2013). Mice of distinct genetic backgrounds (strains) vary substantially in body and skeletal muscle mass (Lionikas et al., 2013a). Large body and skeletal muscle mass in the Berlin High (BEH) and Dummerstorf High (DUH) strains compared to other mouse strains, including a “classic” C57BL/6J strain, is a result of the selective breeding for large body mass and/or carcass protein accretion (Bünger et al., 2004). It is, however, unclear how these enlarged skeletal muscles differ from skeletal muscles of other strains. It is often believed that muscle force is proportional to muscle mass and muscle force per cross-sectional area (CSA) or specific force is a constant value with the exception of pathological conditions as Duchenne muscular dystrophy (Gregorevic et al., 2004). However, this is an oversimplified view. There might be an optimal range of skeletal muscle mass for force production. Beyond this range muscle force might be compromised (Amthor et al., 2007). For instance, changes in an architecture or concentration of contractile proteins in hypertrophied muscles might affect force generation (Degens et al., 2009; Van der Meer et al., 2011; Qaisar et al., 2012). In vivo studies on humans do not allow us to examine these factors comprehensively. Methodological limitations such as difficulties in evaluating the actual muscle mass, influences of neural activation and coactivation of antagonistic muscles complicate assessment of specific muscle force (Erskine et al., 2010). Mouse model permits ex vivo experimentation where skeletal muscle can be isolated and stimulated electrically, thus avoiding most of those issues. Therefore, an identification of mouse strains that differ in specific force could be an important initial step, which would facilitate search for the relevant genetic factors and physiological mechanisms responsible for variation in specific muscle force. Myostatin dysfunction, which was a main focus of this thesis, is the one of the known genetic factors affecting skeletal muscle mass and force. After myostatin discovery by Se-Jin Lee and colleagues it quickly attracted the attention of scientists from various fields including pharmacologists, physiotherapists and even sport scientists (McPherron et al., 1997). Myostatin is a natural inhibitor of muscle growth and protein synthesis. Mice with a deleted function of the myostatin gene (Mstn) display a striking increase in skeletal muscle mass which results a double-muscle phenotype (McPherron et al., 1997). On the other hand, muscle-specific overexpression of myostatin induces a significant reduction in skeletal muscle mass in mice (Reisz-Porszasz et al., 2003). In addition to the prominant muscularity, myostatin-deficient mice show improved bone formation, reduced adiposity as well as increased resistance to weight gain and insulin sensitivity when fed high fat diet (McPherron, Lee, 2002; Hamrick et al., 2006; Wilkes et al., 2009; Elkasrawy, Hamrick, 2010). Altogether, this suggests that myostatin inhibition might be an effective treatment against various muscle wasting conditions including aging-related sarcopenia as well as metabolic dysfunctions such as obesity and diabetes. Indeed myostatin blocking antibodies have a positive effect on muscle mass and function on mdx mice representing a model of Duchenne muscular dystrophy (Bogdanovich et al., 2002; Wagner et al., 2002). There is also some interest in the myostatin inhibition effect on skeletal muscle mass and function of otherwise-normal individuals (e.g. athletes). Large muscles and fast glycolytic fibre profile in myostatin-deficient animals might be beneficial in strength and power events in sports (Girgenrath et al., 2005). Indeed, whippets which are heterozygotes for myostatin mutation are excellent performers in dog races (Mosher et al., 2007). Moreover, the woman who is heterozygous for myostatin mutation and gave birth to the homozygous child is a former sprinter (Schuelke et al., 2004). However, before considering myostatin inhibition as a performance enhancing strategy, more research should be done on physiological effects of myostatin dysfunction using animal models. In fact, studies of myostatin-deficient mice demonstrate that force in isolated skeletal muscles of these animals might be compromised compared to the wild type (WT) animals with the normal myostatin function (Amthor et al., 2007; Qaisar et al., 2012). There is also a gap in knowledge about a plasticity of skeletal muscles in myostatin-deficient animals, because little research has been carried out on adaptability to exercise training of these animals. Several studies examined effect of endurance training on skeletal muscle of myostatin-deficient mice (Savage, McPherron, 2010; Matsakas et al., 2010; Matsakas et al., 2012) but there is a lack of research about adaptations to high resistance training. Thus we carried out a study on compensatory hypertrophy of skeletal muscles in myostatin-deficient animals. Indeed athletes involved in strength training but not endurance training might be those who could benefit from myostatin inhibition. It is well established that an increase of myostatin expression is a key factor in every type of skeletal muscle atrophy examined to date (Allen et al., 2010). Most of the studies are focused on myostatin inhibition in pathological conditions such as Duchenne muscular dystrophy (Bogdanovich et al., 2002; Wagner et al., 2002). However, the otherwise normal individuals might be subjected to catabolic stimuli as well. For instance, they might undergo skeletal muscle wasting either involuntary due to starvation, bed rest and/or space flight (Hegarty, Kim, 1981; Fitts et al., 2010; Sandonà et al., 2012). Various dietary regimes often involve intermittent fasting which reduces lean body mass (Varady, 2011). Thus, muscle wasting can be a result of conscious manipulations involving caloric restriction in order to achieve cosmetic goals which are associated with body shape and appearance. However, caloric restriction is also associated with improved health and longevity biomarkers in rodents and humans (Heilbronn et al., 2006; Ingram et al., 2006). It seems that caloric restriction will be popular in near future as new dietary interventions are being developed (Varady et al., 2015). In this scenario myostatin inhibition might be a useful strategy to preserve skeletal muscle mass during caloric restriction. Moreover, myostatin inhibition is a promising target for an enhanced fat loss as well (McPherron, Lee, 2002). To date, few attempts have been made to investigate effects of myostatin deficiency on skeletal muscle mass after food deprivation (FD) (Allen et al., 2010; Collins-Hooper et al., 2015). These studies have produced contradictory results and more research is needed. Effects of FD on contractile properties of skeletal muscle also need to be examined in this regard. It appears that FD causes reduction in muscle mass which is associated with an increase in specific force of fast-twitch skeletal muscles of myostatin-deficient mice (Collins-Hooper et al., 2015). Similar findings have been reported after 5 week caloric restriction study (Matsakas et al., 2013). Based on these evidences, we carried out a study in which we examined effects of myostatin dysfunction on skeletal muscle mass and force in both predominantly slow-twitch and fast-twitch muscles following FD. Slow- and fast-twitch muscles are showing different metabolic and functional properties as well as a content of myostatin-binding ActRIIB receptors (Mendias et al., 2006). Therefore effects of myostatin dysfunction and FD might be muscle specific. Moreover, we also examined how a genetic background affects these parameters following FD. THE AIM OF THE RESEARCH was to examine effects of genetic background and myostatin dysfunction on specific force and mass of skeletal muscles after muscle hypertrophy and atrophy. RESEARCH OBJECTIVES: 1. To investigate effects of genetic background on skeletal muscle mass and force. 2. To investigate effects of myostatin dysfunction on skeletal muscle mass and force before and after functional overload. 3. To investigate effects of myostatin dysfunction and genetic background on skeletal muscle atrophy and muscle force during food deprivation. RESEARCH HYPOTHESES: 1. We studied skeletal muscles in mouse strains which differ significantly in body size. On the basis that larger muscle hypertrophy might lead to unfavourable for force production changes in muscle architecture and/or contractile material maintainence (Kawakami et al., 1995; Amthor et al., 2007; Ikegawa et al., 2008), our hypothesis was that specific muscle force will be dependent on muscle size and it will decrease with increase in body and muscles mass of the studied mouse strains. 2. Myostatin-deficient mice have increased glycolytic type II fibre content in muscles (Girgenrath et al., 2005; Gentry et al., 2011) which are more prone to hypertrophy (Verdijk et al., 2009). It appears that only muscle mass reduction toward wild type phenotype could restore force production in myostatin-deficient mice (Matsakas et al., 2013; Collins-Hooper et al., 2015). Thus, we hypothesized that ablation of the gastrocnemius muscle will be associated with greater compensatory hypertrophy of soleus and its function deterioration in BEH mice with dysfunctional myostatin compared to BEH+/+ mice carrying the wild type myostatin. 3. We studied mass and force of the hindlimb muscles in BEH and BEH+/+ mice as well as in the C57BL/6J background. Our hypothesis was that myostatin dysfunction which positively affects a net muscle protein turnover by enhanced protein synthesis (Morrisete et al., 2009; Lipina et al., 2010) will prevent loss of muscle mass and improve force during food deprivation. We also hypothesized that there might be differences in loss of muscle mass between genetic backgrounds due to possible changes in a body composition and/or metabolic peculiarities (Konarzewski, Diamond, 1995). CONCLUSIONS Study 1: 1. Skeletal muscles of mouse strains vary significantly in muscle mass and force generation capacity. Specific muscle force, however, does not change with increase in body size and as a result of muscle growth during maturation. 2. DUH background shows lower specific muscle force compared to both BEH+/+ and C57BL/6J backgrounds. Study 2: 1. Myostatin dysfunction is associated with increased muscle mass, but reduced specific muscle force. 2. Myostatin dysfunction is also associated with reduction in hypertrophy and impairment in force generation capacity of soleus muscle after functional overload. Study 3: 1. Skeletal muscle atrophy after food deprivation is dependant on myostatin dysfunction, genetic background and muscle properties. Myostatin dysfunction is associated with a greater loss of muscle mass. C57BL/6J background is more susceptible to muscle atrophy than BEH+/+ background under these conditions. 2. After food deprivation, the slower contracting soleus shows less severe muscle atrophy, but greater loss of specific muscle force compared to a faster contracting extensor digitorum longus., Griaučių raumenys yra gausus audinys, sudarantis 40–50 proc. žmogaus kūno masės (Sakuma et al., 2014). Pagrindinis jų vaidmuo –išvystyti jėgą, reikalingą laikysenai palaikyti ir kasdieniams judesiams atlikti, tačiau jie taip pat veikia ir kaip metaboliškai aktyvus organas. Raumenų masė ir funkcija yra svarbios ne tik sveikatai ir gerai savijautai, bet ir atletiniam pajėgumui (Wolfe, 2006). Raumenų netekimas yra nepageidautinas procesas, būdingas įvairioms ligoms ir (arba) katabolinėms būsenoms, veda prie silpnumo, trapumo ar netgi mirties (Schiaffino et al., 2013). Todėl fiziologinių ir genetinių veiksnių, lemiančių raumeninę masę, jėgą ir jų tarpusavio ryšį, tyrimai yra svarbūs, gerinant visuomenės sveikatą. Raumenų masė ir jėga labai priklauso nuo genetinių veiksnių (Pescatello et al., 2013). Skirtingų genetinių fonų (linijų) pelės labai skiriasi kūno ir griaučių raumenų mase (Lionikas et al., 2013a). Didelė Berlyno (angl. Berlin high; BEH) ir Dumerstorfo (angl. Dummerstorf high; DUH) linijų kūno ir griaučių raumenų masė, lyginant su kitomis linijomis, įskaitant klasikinę C57BL/6J, yra selektyvaus veisimo didelei kūno masei ir (arba) karkasinių baltymų susikaupimui rezultatas (Bünger et al., 2004). Tačiau neaišku, kaip šie padidinti griaučių raumenys skiriasi nuo kitų pelių linijų raumenų. Dažnai manoma, kad raumens jėga yra proporcinga raumens masei ar skerspjūvio plotui (angl. cross-sectional area; CSA), todėl vadinamoji specifinė jėga yra gana pastovus dydis, išskyrus patalogines būsenas, tokias kaip Diušeno raumenų distrofija (Gregorevic et al., 2004). Vis dėlto, tai yra supaprastintas požiūris. Gali egzistuoti optimalus jėgos išvystymui griaučių raumenų masės dydis, kurį peržengus raumenų jėga suprastėtų (Amthor et al., 2007). Pavyzdžiui, architektūriniai ar kontraktilinių baltymų koncentracijos pokyčiai hipertrofuotuose raumenyse gali paveikti jėgos išvystymą (Degens et al., 2009; Van der Meer et al., 2011; Qaisar et al., 2012). In vivo tyrimai su žmonėmis neleidžia išsamiai panagrinėti šių veiksnių. Tokie metodologiniai trūkumai, kaip faktinės raumeninės masės įvertinimo sunkumas, nervinės aktyvacijos įtaka ir raumenų antagonistų koaktyvacija, sunkina specifinės raumenų jėgos nustatymą (Erskine et al., 2010). Pelės modelis leidžia ex vivo bandymus, kurių metu griaučių raumenys gali būti izoliuojami ir stimuliuojami elektra, taip išvengiant daugumos išvardytų problemų. Todėl pelių linijų, besiskiriančių specifine jėga, nustatymas galėtų būti svarbus žingsnis, palengvinantis svarbių genetinių veiksnių ir fiziologinių mechanizmų, atsakingų už specifinės raumenų jėgos variaciją, paiešką. Miostatino disfunkcija, kuriai šiame darbe buvo skiriamas pagrindinis dėmesys, yra vienas iš žinomų genetinių veiksnių, veikiančių griaučių raumenų masę ir jėgą. Po to, kai Se-Jin Lee su kolegomis atrado miostatiną, jis greitai patraukė įvairių sričių mokslininkų dėmesį – farmacininkų, fizioterapeutų ir netgi sporto mokslo tyrėjų (McPherron et al., 1997). Miostatinas yra natūralus raumenų augimo ir baltymų sintezės slopintojas. Pelių, kurioms panaikinta miostatino geno (Mstn) funkcija, būdingas įspūdingas griaučių raumenų masės padidėjimas, kuris lemia vadinamąjį dvigubo raumeningumo fenotipą (McPherron et al., 1997). Ir priešingai, raumenims būdingas miostatino aktyvacijos padidėjimas sukelia reikšmingą pelių griaučių raumenų masės sumažėjimą (Reisz-Porszasz et al., 2003). Be akivaizdaus raumeningumo, miostatino stokojančios pelės taip pat pasižymi pagerėjusiu kaulų formavimusi, sumažėjusiu riebaliniu audiniu, padidėjusiu atsparumu svorio augimui ir dideliu insulino jautrumu, kai joms buvo skirta riebi dieta (McPherron, Lee, 2002; Hamrick et al., 2006; Wilkes et al., 2009; Elkasrawy, Hamrick, 2010). Tai rodo, kad miostatino slopinimas gali būti veiksmingas įvairių ligų, tokių kaip įvairus raumenų nykimas, įskaitant su senėjimu susijusią sarkopeniją, metabolinės disfunkcijos (nutukimas, diabetas), gydymo būdas. Miostatiną blokuojantys antikūnai turi teigiamą poveikį mdx pelių, kurios yra Diušeno raumenų distrofijos modelis, raumenų masei ir funkcijai (Bogdanovich et al., 2002; Wagner et al., 2002). Taip pat yra domimasi miostatino slopinimo poveikiu sveikų individų griaučių raumenų masei ir funkcijai (pvz., sportininkams ar individams, kuriems būdingos katabolinės būsenos). Miostatino stokojančių pelių tyrimai rodo, kad šių gyvūnų specifinė raumenų jėga gali būti suprastėjusi, lyginant su laukiniais gyvūnais (angl. wild type; WT), kurių miostatino funkcija normali (Amthor et al., 2007; Qaisar et al., 2012). Be to, trūksta žinių apie sveikų gyvūnų, stokojančių miostatino, griaučių raumenų plastiškumą, nes buvo atlikta labai mažai tyrimų apie šių gyvūnų adaptaciją prie fizinių krūvių. Keletas tyrimų nagrinėjo ištvermės treniruočių poveikį miostatino stokojančių pelių griaučių raumenims (Savage, McPherron, 2010; Matsakas et al., 2010; Matsakas et al., 2012), bet nėra tyrimų, nagrinėjančių adaptacijos poveikį pasipriešinimo treniruotėms (hipertrofiniam stimului). Todėl mes tyrėme griaučių raumenų kompensatorinės hipertrofijos poveikį miostatino stokojančių pelių raumenų masei ir jėgai. Iš tikrųjų jėgos, bet ne ištvermės, šakų sportininkais galėtų būti tie, kurie pajustų miostatino slopinimo naudą. Taip pat neaišku, ar miostatino slopinimas galėtų apsaugoti sveikų individų, patiriančių katabolines būsenas, raumeninę masę ir jėgą. Tam yra aiškių prielaidų, nes miostatino stoka teigiamai veikia pelių raumenų baltymų sintezę (Morrisete et al., 2009; Lipina et al., 2010), o padidėjusi miostatino ekspresija būdinga įvairioms griaučių raumenų atrofijoms (Allen et al., 2010). Sveiki individai gali sąmoningai netekti raumenų dėl kalorijų apribojimo, siekdami kosmetinių tikslų, susijusių su kūno forma ir išvaizda, ar priverstinai dėl maisto stygiaus ar netgi badavimo. Iki šiol buvo tik keli mėginimai ištirti miostatino stokos poveikį griaučių raumenų masei ir jėgai badavimo metu (Allen et al., 2010; Collins-Hooper et al., 2015), buvo gauti prieštaraujantys vieni kitiems rezultatai. TYRIMO TIKSLAS buvo ištirti genetinio fono ir miostatino disfunkcijos poveikį griaučių raumenų masei ir specifinei jėgai, esant hipertrofijos ir atrofijos stimulams. TYRIMO UŽDAVINIAI: 1. Ištirti genetinio fono poveikį griaučių raumenų masei ir jėgai. 2. Ištirti miostatino disfunkcijos poveikį griaučių raumenų masei ir jėgai prieš funkcinę apkrovą ir po jos. 3. Ištirti miostatino disfunkcijos ir genetinio fono poveikį griaučių raumenų masei ir jėgai badavimo metu. TYRIMO HIPOTEZĖS: 1. Mes tyrėme pelių linijų, kurios labai skiriasi kūno dydžiu, raumenis. Remdamiesi tuo, kad didesnė raumenų hipertrofija gali sukelti jėgos išvystymui nepalankius raumenų architektūros ir (arba) kontraktilinio aparato palaikymo pokyčius (Kawakami et al., 1995; Amthor et al., 2007; Ikegawa et al., 2008), kėlėme hipotezę, kad raumens specifinė jėga priklauso nuo raumens dydžio ir mažės didėjant pelių kūno ir raumenų masei. 2. Miostatino stokojančių pelių yra padidėjęs II tipo skaidulų kiekis raumenyse (Girgenrath et al., 2005; Gentry et al., 2011), jos labiau linkusios hipertrofuoti (Verdijk et al., 2009). Atrodo, kad tik raumeninės masės sumažėjimas link fenotipo, būdingo laukinėms pelėms, galėtų atgauti pelių, stokojančių miostatino, jėgos išvystymą (Matsakas et al., 2013; Collins-Hooper et al., 2015). Mūsų hipotezė – BEH pelių su miostatino disfunkcija blauzdos dvilypio raumens pašalinimas bus susijęs su didesne plekšninio raumens kompensatorine hipertrofija ir jo funkcijos pablogėjimu labiau nei BEH+/+ pelių, kurių miostatinas normalus. 3. Tyrėme BEH ir BEH+/+ pelių bei C57BL/6J genetinio fono užpakalinių kojų raumenų masę ir jėgą. Mūsų hipotezė buvo, kad miostatino disfunkcija, teigiamai veikianti bendrą raumenų baltymų balansą, didindama baltymų sintezę (Morrisete et al., 2009; Lipina et al., 2010), apsaugos nuo raumeninės masės netekimo ir pagerins jėgos išvystymą po badavimo. Mes taip pat iškėlėme hipotezę, kad raumeninės masės netekimo skirtumai tarp genetinių fonų gali būti dėl galimų kūno kompozicijos pokyčių ir (arba) metabolinių ypatumų (Konarzewski, Diamond, 1995). IŠVADOS 1 tyrimas: 1. Skirtingų pelių linijų griaučių raumenys labai skiriasi savo mase ir jėgos išvystymo pajėgumu. Vis dėlto, specifinė raumenų jėga nekinta didėjant kūno dydžiui ir raumenims augant brendimo metu. 2. DUH genetinis fonas rodo mažesnę raumenų specifinę jėgą, lyginant su BEH+/+ ir C57BL/6J genetiniais fonais. 2 tyrimas: 1. Miostatino disfunkcija yra susijusi su padidėjusia raumenine mase, bet sumažėjusia raumenų specifine jėga. 2. Miostatino disfunkcija taip pat yra susijusi su plekšninio raumens hipertrofijos sumažėjimu ir jėgos išvystymo pajėgumo blogėjimu po funkcinės apkrovos. 3 tyrimas: 1. Griaučių raumenų atrofija po badavimo priklauso nuo miostatino disfunkcijos, genetinio fono ir raumenų savybių. Miostatino disfunkcija yra susijusi su didesniu raumeninės masės praradimu, o C57BL/6J genetinis fonas yra jautresnis raumenų atrofijai nei BEH+/+ genetinis fonas tokiomis pat sąlygomis.

Bodybuilding je sport u kojem sportaši savladavanjem različitih vrsta opterećenja oblikuju svoje tijelo prema određenim principima. Cilj natjecatelja je postići vizualno što bolji izgled mišića prema normama koje su postavljene u natjecateljskom bodybuildingu. Bodybuilding natjecanje traži od sportaša da ostvare što veću proporcionalnu raspoređenu mišićnu masu, uz što manje potkožnog masnog tkiva. Opterećenja se mijenjaju prema određenim principima kako bi izazvala različite reakcije i adaptacije sportaševa tijela što dovodi do izgradnje kvalitetne mišićne mase koja je potrebna sportašu na natjecanju. Osim izgradnje mišića benefiti koje sportaš ostvaruje bodybuilding treningom su različiti. Savladavanjem različitih opterećenja sportaš razvija i neke sposobnosti koje se mogu iskoristiti u drugim sportskim aktivnostima. U bodybuildingu cilj sportaša je generiranje što veće i kvalitetnije mišićne mase. Sportaš to može postići jedino pravilno planiranim i programiranim treningom jakosti i snage koji će rezultirati različitim oblicima hipertrofije, i oblikovati tijelo sportaša prema unaprijed utvrđenim ciljevima. Mišićno tkivo raste, povećava svoju veličinu kroz proces nazvan hipertrofija. Mišićna hipertrofija je znanstveno dokazana, dok se o mišićnoj hiperplaziji (povećavanje broja mišićnih vlakana) kao posljedici treninga sa opterećenjem još uvijek vode rasprave da li postoji. Hipertrofijski proces dovodi do povećanja količine mišićnih proteina u samom mišiću. Cilj ovog rada je pokazati različite vrste treninga u bodybuilding pripremama za natjecanje. To može pomoći sportašima u nekim drugim sportovima. Sportaši u drugim sportovima mogu implementirati pojedine dijelove ili cijeli sustav u svoj trenažni program i tako poboljšati svoju sportsku izvedbu. Bodybuilding treningom možemo utjecati na poboljšanje zdravlja, podižemo razinu motoričkih i funkcionalnih sposobnosti, neproporcionalne dijelove tijela možemo ispraviti, upotrijebiti takav oblik treninga kao prevencija od ozljeda, rehabilitacija nakon ozljede. Također možemo utjecati na poboljšanje cjelokupne kondicijske pripremljenosti sportaša. Bodybuilding is sport in wich athletes master the different resistance and they are changing their body by some principles. The main goal of bodybuilder is to get as much possible better visual shape and form by some standards in competitive bodybuilding. Bodybuilding competition requires from athlete to achive as much possible muscle tissue in perfect proportion, with as less possible fat tissue on body. The resistances are changing by specific principles just to make reaction and adapt athletes body to get the best muscle mass and muscle tissue, witch bodybuilder need to show on competition. In bodybuilding maing goal is to build as much as possible more clean muscle mass. Athlete can achive that only with right planned and programed strength training witch will result with different forms of hypertrophy, and form ther body by wanted goals. Muscle tissue grow, enlarge its mass throu process called hypertrophy. Muscle hypertrophy is scientificly proven, but there are still some debats about muscye hyperplasia (enlargment number of muscle fibers) as result training with resistnces. By mastering different loads athlete develop some other abilities witch can be used in some other sports. Main goal of this thesis is to show different stages of bodybuilding preparations in competitive season. This can help athletes in other sports by implementing some parts or full training program, and help them in their sport performance. With Bodybuilding training we can upgrade our health, get better motoric and functional abilities, some unproportional body parts we can fix and make more proportional, we can use bodybuilding training for prevention of injuries or in rehabilitation. Also, we can affect on full condition preparation of athlete.

ALPPS (Associated Liver Partition and Portal Vein Ligation for Staged Hepatectomy) is an innovative surgical procedure which was presented for the first time in 2012, and in last two years it has become widely accepted by hepatobiliary surgeons and cosequently three ALPPS procedures have been performed at our institution so far. Considering that ALPPS is a relatively new method, indicated only in carefully selected patients, we still expect studies on larger number of patients, but according to last results ALPPS has proved to be a very successful surgical method which allows resectability of tumors that were considered irresectable, by promoting surprisingly fast and intensive hypertrophy of future liver remnant., {"references":["Schnitzbauer A, Lang S A, Fichtner-Feigl, et al. In situ split with portal vein ligation induces rapid left lateral lobe hypertrophy enabling two-staged extended right hepatic resection. Berlin: Oral Presentation; 2010. p. 35.","Bertens KA, Hawel J, Lung K, Buac S, Pineda-Solis K, Hernandez-Alejandro R. ALPPS: challenging the concept of unresectability – a systematic review. Int J Surg 2015 Jan;13: 280–287.","Alvarez FA, Ardiles V, de Santibanes M, Pekolj J, de Santibanes E. Associating liver partition and portal vein ligation for staged hepatectomy offers high oncological feasibility with adequate patient safety: a prospective study at a single center. Ann Surg 2015 Apr;261(4): 723–732.","Torres OJ, Moraes-Junior JM, Lima e Lima NC, Moraes AM. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): a new approach in liver resections. Arquivos brasileiros de cirurgia digestiva: ABCD. Brazilian archives of digestive surgery 2012;25(4): 290–2. Epub 2013/02/16.","Tschuor C, Croome KP, Sergeant G, et al. Salvage parenchymal liver transection for patients with insufficient volume increase after portal vein occlusion – an extension of the ALPPS approach. European journal of surgical oncology: the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 2013;39(11): 1230–1235.","Vyas SJ, Davies N, Grant L, et al. Failure of portal venous embolization. ALPPS as salvage enabling successful resection of bilobar liver metastases. J Gastrointest Cancer 2014.","Hernandez-Alejandro R, Bertens KA, Pineda-Solis K, Croome KP. Can we improve the morbidity http://www.kbc-zagreb.hr/and mortality associated with the associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) procedure in the management of colorectal liver metastases? Surgery. 2014. Epub 2014/10/06.","Nadalin S, Capobianco I, Li J, Girotti P, Königsrainer I, Königsrainer A. Indications and limits for associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) lessons learned from 15 cases at a single centre. Z Gastroenterol 2014;52(1): 35–42.","Schadde E, Ardiles V, Slankamenac K, et al. ALPPS offers a better chance of complete resection in patients with primarily unresectable liver tumors compared with conventional-staged hepatectomies: Results of a multicenter analysis. World J Surg. 2014;38(6): 1510–1519.","Schadde E, Ardiles V, Robles-Campos R, et al. Early Survival and Safety of ALPPS: First Report of the International ALPPS Registry. Ann Surg 2014;260(5): 829–838.","Herman P, Krüger JAP, Perini MV, Coelho FF, Cecconello I. High Mortality Rates After ALPPS: the devil is the indication. J Gastrointest Cancer 2015."]}

The aim of the study was to assess the use of echocardiographic measurements in newborns of diabetic mothers. Maternal diabetes is associated with an increased risk of morbidity and mortality in pregnancy and in perinatal period. Thirty-five newborns of diabetic mothers (pregestational or gestational diabetes; case group) and thirty-five controls (control group), born between January 2009 and December 2012 in Cluj-Napoca (north-west of Romania), were included in this study. A Logiq e ultrasound with an 8 MHz transducer was used to measure echocardiographic parameters. The interventricular septal thickness in case group was higher as compared with control group (at end systole = 6.61±1.64 mm vs. 5.75±0.95 mm, p=0.0371; at end diastole = 4.61±1.59 mm vs. 3.42±0.70 mm, p=0.0001). A risk ratio of 2.333 (0.656, 8.298) was obtained for septal hypertrophy. A higher proportion of septal hypertrophy was identified in the newborns of mothers with gestational diabetes compared to the newborns of pregestational diabetes mothers (p=0.0058). The mean birth weight was significantly higher in newborns of diabetic mothers (3695.57±738.63) as compared with controls (3276.14±496.51; p=0.0071). Infants born to mothers with diabetes proved to be at a high risk of septal hypertrophy., Cilj je bio procijeniti primjenu ehokardiografskih mjerenja u novorođenčadi dijabetičnih majki. Majčin dijabetes udružen je s povećanim rizikom pobola i smrtnosti u trudnoći i tijekom perinatalnog razdoblja. U ispitivanje je bilo uključeno 35 novorođenčadi dijabetičnih majki (predgestacijski ili gestacijski dijabetes; ispitna skupina) i 35 kontrolne novorođenčadi (kontrolna skupina) rođene između siječnja 2009. i prosinca 2012. godine u području Cluj-Napoca (sjeverozapadna Rumunjska). Ehokardiografski parametri mjereni su pomoću ultrazvučnog uređaja Logiq e s pretvornikom od 8 MHz. Debljina interventrikulskog septuma bila je viša u ispitnoj skupini u usporedbi s kontrolnom skupinom (na kraju sistole = 6,61±1,64 mm prema 5,75±0,95 mm, p=0,0371; na kraju dijastole = 4,61±1,59 mm prema 3,42±0,70 mm, p=0,0001). Omjer rizika za septalnu hipertrofiju bio je 2,333 (0,656; 8,298). U novorođenčadi majki s gestacijskim dijabetesom zabilježen je veći udio hipertrofije septuma u usporedbi s novorođenčadi majki s predgestacijskim dijabetesom (p=0,0058). Srednja porođajna težina novorođenčadi dijabetičnih majki (3695,57±738,63) bila je značajno viša u usporedbi s kontrolnom skupinom (3276,14±496,51; p=0,0071). Kod novorođenčadi majki s dijabetesom utvrđen je visok rizik od hipertrofije septuma.

Višak hormona rasta u akromegaliji stimulira rast raznih tkiva, a budući da miociti posjeduju receptore za hormon rasta i IGF-1, njihov višak u akromegaliji dovodi do razvoja specifične akromegalijske kardiomiopatije. Prvi stupanj akromegalijske kardiomiopatije susreće se u mladih bolesnika s kratkim trajanjem bolesti, a karakterizira ga hiperkinetska lijeva klijetka, porast kontraktilnosti i minutnog volumena te smanjen periferni vaskularni otpor. Drugi stupanj obuhvaća koncentričnu ili ekscentričnu hipertrofiju lijeve klijetke, poremećaj dijastoličke funkcije u mirovanju te oslabljenu srčanu funkciju tijekom opterećenja. Ako ostane neliječena, akromegalija može dovesti do posljednjeg stadija kardiomiopatije: bolesti srčanih zalistaka te oslabljene sistoličke i dijastoličke funkcije s niskim minutnim volumenom i u mirovanju, što može uzrokovati kongestivno zatajivanje srca. Uz razvoj specifične kardiomiopatije, čimbenici rizika udruženi s akromegalijom poput arterijske hipertenzije, dislipoproteinemije, šećerne bolesti i periferne inzulinske rezistencije dovode do činjenice da je zahvaćenost kardiovaskularnog sustava među glavnim uzrocima povećanog morbiditeta i mortaliteta u akromegaliji.

Sustav pripreme u bodybuildingu uključuje razmatranje optimalnog treninga odnosno faktora koji najbolje utječu na pojedinu vrstu hipertrofije te redukciju potkožnog masnog tkiva pa tako i na uspjeh na natjecanju. Budući da su zahtjevi postavljani pred bodybuildera- natjecatelja veliki, moraju biti ispunjeni mnogi uvjeti: genetska predispozicija, tehnička oprema, materijalni uvjeti te, kao najvažniji, precizan plan i program treninga kao i dobro izbalansirana prehrana. Zbog toga je glavni cilj ovog rada prikazati i objasniti primjere programa specifičnog treninga bodybuildera u pripremnom mezociklusu kojemu je, u konačnici, cilj izgraditi što veću i proporcionalnu mišićnu masu kao i što više smanjiti količinu potkožnog masnog tkiva. Kako bi se dobio što bolji uvid u sami program i efekte hipertrofijskog treninga pojašnjene su i osnove mišićne hipertrofije kao i njezina fiziologija. Osnove prehrane i suplementacije sa cjelovitim programima prehrane u fazi mase i definicije uključene su kao jedna od najvažnijih komponenta programa bodybuildera. Rad također sadrži osnovne planiranja i programiranja kao i primjere programa treninga u fazi mase i u fazi definicije.

Sustav pripreme u bodybuildingu uključuje razmatranje optimalnog treninga odnosno faktora koji najbolje utječu na pojedinu vrstu hipertrofije te redukciju potkožnog masnog tkiva pa tako i na uspjeh na natjecanju. Budući da su zahtjevi postavljani pred bodybuildera- natjecatelja veliki, moraju biti ispunjeni mnogi uvjeti: genetska predispozicija, tehnička oprema, materijalni uvjeti te, kao najvažniji, precizan plan i program treninga kao i dobro izbalansirana prehrana. Zbog toga je glavni cilj ovog rada prikazati i objasniti primjere programa specifičnog treninga bodybuildera u pripremnom mezociklusu kojemu je, u konačnici, cilj izgraditi što veću i proporcionalnu mišićnu masu kao i što više smanjiti količinu potkožnog masnog tkiva. Kako bi se dobio što bolji uvid u sami program i efekte hipertrofijskog treninga pojašnjene su i osnove mišićne hipertrofije kao i njezina fiziologija. Osnove prehrane i suplementacije sa cjelovitim programima prehrane u fazi mase i definicije uključene su kao jedna od najvažnijih komponenta programa bodybuildera. Rad također sadrži osnovne planiranja i programiranja kao i primjere programa treninga u fazi mase i u fazi definicije.

Cilj: Svrha ovog istraživanja je da se odredi uticaj non-dipping profila krvnog pritiska na strukturu, dijastolnu i globalnu funkciju desne komore (DK) kod novootkrivenih pacijenata sa arterijskom hipertenzijom. Metodologija: Ova studija preseka je uključila 167 hipertenzivnih pacijenata sa novootkrivenom hipertenzijom. Svim ispitanicima je urađeno 24-časovno praćenje krvnog pritiska i kompletan ehokardiografski pregled (dvodimenzioni pregled, pulsni i tkivni Doppler). DK hipertrofija je definisana debljinom zida DK ≥ 6.0 mm kod muškaraca i ≥ 5.5 mm kod žena. Rezultati: Dipping profil krvnog pritiska je nađen kod 101 (60%) pacijenta, dok je non-dipping profil bio prisutan kod 66 (40%) hipertenzivnih pacijenata. Dijastolna i globalna funkcija leve komore (LK) su značajno više bile poremećene kod non-dippera u poređenju sa dipperima. Većina parametara dijastolne funkcije LK (E/A, e´/a´, E/e´) se značajno i postepeno pogoršavala idući od ekstremnih dippera ka inverznim dipperima. Nasuprot tome, strukturni parametri LK (IVS, RWT, LK masa indeks) su se značajno razlikovali samo kada su dipperi i ekstremni dipperi poređeni sa ostalim pacijentima. Debljina zida DK kao i (E/e´)t odnos i Tei indeks DK su statistički bili značajno povišeni kod non-dippera u odnosu na dippere. Svi navedeni parametri (debljina zidova DK, (E/e´)t i Tei indeks) progresivno su se rasli od ekstremnih dippera prema inverznim dipperima. Analize rezultata su pokazale da su noćni sistolni i dijastolni pritisak, kao i (E/e´)t odnos nezavisno povezani sa debljinom zida desne komore (p < 0.01 za sve). Non-dipping profil, debljina zida DK, relativna debljina zida LK, (E/e´)m i sistolni oritisak u desnoj komori su nezavisno prediktori dijastolne funkcije DK (E/e´)t, dok su dnevne vrednosti sistolnog i dijastolnog pritiska, kao i noćni dijastolni pritisak i inverzni dipping profil predstavljali prediktore globalne funkcije DK (Tei index DK). Zaključak: Struktura, dijastolna i globalna funkcija DK su značajno poremećene kod non-dippera. Non-dipping i inverzni dipping profil krvnog pritiska predstavljaju nezavisne prediktore dijastolne i globalne funkcije DK. Objective: The purpose of this study was to determine the influence of a non-dipping arterial blood pressure pattern on the right ventricular (RV) structure, diastolic, and global function in recently diagnosed hypertensive patients. Methods: This cross-sectional study included 167 recently diagnosed hypertensive patients. All participants underwent 24 h ambulatory blood pressure monitoring and a complete two-dimensional, pulsed and tissue Doppler echocardiography. RV hypertrophy was defined by RV wall thickness at least 6.0mm in men and at least 5.5 mm in women. Results: The dipping blood pressure pattern was found in 101 (60%) participants, whereas the non-dipping pattern was present in 66 (40%) hypertensive patients. Left ventricular (LV) diastolic and global function were more impaired in non-dippers comparing with dippers. Most of the parameters of the left ventricular diastolic function (E/A, e´/a´, E/e´) significantly and progressively deteriorated from the extreme dippers to the reverse dippers. In contrast, LV structural parameters (IVS, RWT, LV mass index) showed a statistically important difference only by comparing the dippers and the extreme dippers with the rest of the patients. The RV wall thickness as well as the (E/e´)t ratio and the RV Tei index were significantly increased in the non-dippers comparing with dippers. All these parameters (RV wall thickness, (E/e´)t and Tei index) progressively increased from extreme dippers to inverse dippers. Analyses revealed that night-time systolic and diastolic blood pressure, and (E/e´)t ration were independently associated with RV wall thickness (p < 0.001 for all). Non-dipping profile, RV wall thickness, relative wall thickness, (E/e´)m and systolic pressure in right ventricle were identified as independent predictors of RV diastolic function (E/e´)t, whereas daytime systolic and diastolic blood pressure, night-time diastolic blood pressure and inverse dipping profile were independent predictors of RV global function (RV Tei index). Conclusion: RV structure, diastolic, and global functions were significantly impaired in non-dippers. A non-dipping and inverse dipping blood pressure patterns represent the independent predictors of RV diastolic and global function.

Tema nastoji ukazati na suvremenu ideologiju medikamentalizacije života, shvaćene kao potpunog zdravstvenog blagostanja u kojoj hedonističke tendencije potpunog psiho-fizičkog zadovoljenja, nastoje preuzeti centralno mjesto na ljestvici suvremenih vrednota postmodernog biomedicinskog društva. Ta nastojanja, posljedično uzrokuju sve veći naglasak na “kvaliteti života“ koja potiče razvoj “medicine želja“ i “farmakoloških ovisnosti/medikamentalohodrije“, nudeći mit slijepog “zdravstveno-religioznog obožavanja“ kulta vječne mladosti. Povodeći se za tim irealnim idealima, njeni hipohondrično- opsesivni sljedbenici postaju 'bolesni od aspiracijskog blagostanja' i ovisni o 'vitalnim dinamizmima' koji im se nude ekonomskom propagandom i menadžmentom farmaceutskih kuća, nemogavši razaznati irealne ponude zdravstvene hipertrofije tzv. medicinske svemoćnosti, koja se više ne zadovoljava samo nužnim parametrima zdravlja (prevencije/terapije/rehabilitacije), već teži prema utopiji potpunog psiho-fizičkog blagostanja. Kroz tendenciju tog pokušajnog ostvarenja, često bivaju ignorirane ostale antropološke i moralno-bioetičke vrijednosti.

U sportskoj gimnastici odnos mase tijela i snage jedan je od odlučujućih faktora koji determiniraju uspješnost u ovom sportu. Naime, suština gimnastičkih vježbi je efikasna manipulacija tijelom po spravama – ; različitim gimnastičkim disciplinama. Što je tijelo teže, teže će biti i manipulirati njime. Mišićno i masno tkivo relativno se lako mogu dobiti i izgubiti u procesu treninga. Kako mišićno tkivo ima puno veću gustoću od masnog tkiva, hipertrofija mišića može uzrokovati znatno veće povećanje mase tijela. Stoga trening snage koji ima za cilj povećanje mišićne mase mora se vrlo pažljivo koristiti u treningu gimnastičara. Mišićne skupine koje nisu od bitne važnosti za efikasno izvođenje gimnastičkih kretnih struktura ne bi smjele hipertrofirati, dok mišići koji su važni trebaju hipertrofirati, ali unutar striktnih limita.

Rad s vanjskim opterećenjem kao stimulator mišićnih kontrakcija proizvodi dva osnovna adaptativna efekta na tijelu čovjeka. Jedan efekt se odnosi na efikasnije funkcioniranje organskih sustava koji su dominantno angažirani u radu, a drugi na promjene u građi istih organa. Mišićno tkivo raste povećavanjem veličine svojih komponenata u procesu koji je poznat pod nazivom hipertrofija, ali i povećavanjem broja svojih komponenata u procesu koji je poznat pod nazivom hiperplazija. U ovom radu definirana su i objašnjena oba procesa te predstavljeni metodički postupci kojima je moguće takve procese potaknuti.

Autori prikazuju slučaj 58 godišnje pacijentice s opsežnom hipertrofijom mekog tkiva gornjeg predvorja usne šupljine. Slučaj se prikazuje radi hipertrofije uzrokovane neadekvatnim protetskim nadomjestkom, kao i primjer pacijenta niske zdravstvene prosvijećenosti. U ovom slučaju otvorena metoda plastike gornje vestibularne brazde ponovo je pokazala svoje kvalitete, osobito za rješavanje velikih hipertrofija, koje se nalaze u pomičnoj sluznici gornjeg alveolarnog grebena., The authors evaluate the case of a 58 year-old patient with extensive hypertrophy of soft tissue in the uper vestibulum of the oral cavity. The case report illustrates how hypertrophy developed as a results of an inadequate prosthesis and poor health care. The open plastic procedure of the vestibular furrow in the upper jaw is advantageous in correcting extensive hypertrophy in the mobile mucosa of the alveolar ridge.