I. Tasic

The efficiency of immunoenzyme assay in the diagnosis of lambliosis

The aim of this study is to determine the difference in efficiency of direct immunoenzyme-linked assay (EIA) and conventional microscopy (CM) plus conventional concentration technique (CCT) using comparative analysis in the diagnosis of symptomatic and asymptomatic lambliosis when only one stool sample is to be tested. The study enrolled 577 examinees: 208 patients and 369 asymptomatic examinees. Lambliosis was diagnosed using CM plus CCT (three stool samples) and direct EIA (the first sample). All statistical parameters of the EIA method were 100% in the patients with symptoms of infection. In addition to that, in the group of asymptomatic carriers of Giardia lamblia (G. lamblia) some very high values of these parameters were recorded too, with sensitivity and negative predictive value being both at 100%. In contrast to the EIA method, CM plus CCT of the first stool sample demonstrated significantly lower sensitivity (66.67%) compared to the reference standard. The study did not demonstrate any statistically significant differences in diagnostic efficiancy between the EIA testing of one stool sample and CM plus CCT (p<0.05). However, the observed difference in diagnostic efficiency between the methods was very close to the cut-off value for statistical significance (p=0.06).

PC-1 (ENPP1) K121Q polymorphism in overweight and obese type 2 diabetic coronary heart disease patients.

Aim — The aim of the present study was to investigate the prevalence of the PC-1 121Q allele and to test its association to cardiovascular risk factors in type 2 diabetes mellitus (DM) patients. Methods — A total of 103 unrelated Caucasians from Serbia, including 71 DM patients without CHD (aged 59.4±8.9years, with a mean body mass index (BMI) of 33.3±4.8kg/m2) and 32 DM patients who suffered from coronary heart disease (DM+CHD) (aged 59.3±8.0years, with a mean BMI of 30.37±3.71kg/m2), were genotyped for PC-1 K121Q using a mutagenic separated PCR assay. Results — The prevalence of the PC-1 121Q allele was significantly higher in DM+CHD, compared to DM (P<0.001) and control (P<0.001) groups, since it was found in 10 (14%) DM patients, 13 (41%) DM+CHD patients and 10 (17%) control subjects.When the association of PC-1 121Q allele and the risk of suffering from CHD were assessed within the DM group in a binary logistic regression model adjusting for age and sex, PC-1 121Q allele carriers had a 76% lower risk (OR 0.24; 95% CI: 0.08-0.67, P=0.006) for developing CHD compared to subjects who exhibited PC-1 wild-type. Conclusion — The prevalence of the PC-1 121Q allele was significantly higher in type 2 diabetic patients who suffered from CHD, compared to type 2 diabetic patients without CHD. However, after a binary logistic regression model analysis, adjusting for age and sex., PC-1 121Q allele carriers had a 76% lower risk (OR 0.24; 95% CI: 0.08-0.67, P=0.006) for developing CHD compared to subjects who exhibited PC-1 wild-type. Since these data were cross-sectional, the potential patient selection and survival bias, as well as community underdiagnosis of DM and CHD, could most likely substantially underestimate the genetic influence.

Impact of depression on sexual dysfunction and HRQoL in CAD patients

BackgroundThe aim of this study was to assess the impact of the depression on sexual dysfunction and the health-related quality of life (HRQoL) in coronary artery disease (CAD) patients admitted for cardiovascular rehabilitation within 3 months after an acute myocardial infarction (AMI). Methods. In all, 745 consecutive CAD patients (502 men and 243 women, aged 60.9 ± 9.3 years) admitted for cardiovascular rehabilitation within 3 months after an AMI, were enrolled in the study and divided into 4 groups according to Beck depression inventory (BDI) score range. HRQoL was estimated using the SF-36 questionnaire for total QoL and dimensions for physical and mental health [physical and mental component summary scores (PCS, MCS)]. Sexual dysfunction was assessed using the ASEX scale.ResultsThe HRQoL decreased following the range of depression, as demonstrated for significantly higher PCS in minimal compared to mild, moderate and severe depression groups (P<0.001). The MCS was significantly higher in minimal compared to mild, moderate and severe depression groups (P<0.001). The ASEX score was significantly higher in minimal, compared to mild, moderate and severe depression groups, as well as in mild and moderate compared to severe depression group. A significant association was found between depression score range and age, self-reported regular exercise, type 2 diabetes mellitus, and cigarette smoking.ConclusionsDepression significantly affected HRQoL and sexual dysfunction in CAD patients, as demonstrated by the significant decrease of PCS, MCS, and significant increase of ASEX score following the range of the depression according to BDI.

Relation between bone density and certain parameters of lipid status in postmenopausal women

The aim of the paper was to examine the relation between bone density and certain parameters of lipid status in postmenopausal women. The research involved 300 women referred to densitometric examination as they belonged to the risk group of postmenopausal women. All the examinees had the following biochemical parameters determined: total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, glycemia, serum Ca and P. Univariate logistic regression analyses showed that each year of age, menopause duration, AH are significantly connected to risk increase for the appearance of osteopenia or osteoporosis. Increase in values of SBP, DBP, cholesterol, LDL and triglyceride are connected with significant risk increase for the appearance of osteopenia or osteoporosis. Patients with AH are connected to 11 times elevated risk for the appearance of osteopenia or osteoporosis, cigarette smoking increased the risk by seven times, physical inactivity even by 52 times, CVD in the family anamnesis by eight times, and osteoporosis in the family anamnesis is connected to the risk by four times. In our research, atherogenic lipoproteins negatively correlate with lumbar bone density. Disturbed lipide status is a risk factor for cardiovascular diseases, but also a risk factor for the appearance of osteoporosis.

Correlation between total cardiovascular risk and bone density in postmenopausal women

The aim of the paper was to examine the correlation between the total risk of cardiovascular events, determined by the SCORE (Systematic Coronary Risk Evaluation) system, and bone density in postmenopausal women. Examinees and method: The research involved 300 postmenopausal women. On the basis of bone density measurements, the participants were divided into three groups: group I — 84 examinees had osteoporosis, group II — 115 examinees had osteopenia, and group III — 101 examinees had normal bone mineral density (BMD). Results: Participants with high SCORE risk were statistically significantly older compared to low-risk women (60±3 vs. 55±5; p<0.001). They had significantly lower BMD and T scores (−1.09±0.94 vs. −2.86±0.63; p<0.001). Elevation of the SCORE risk by 1% caused a BMD decrease of 0.033 g/cm2(0.029 to 0.036 gr/cm2). Multivariate logistic regression analysis showed that the following factors caused a significant increase in the risk of decreasing BMD: every year of life by 20%, menopause duration by 26%, increase in systolic blood pressure (BP) by 1 mm Hg by 7%, increase in SCORE risk by 1% by 5.31 times, physical inactivity by 5.96 times, and osteoporosis in the family history by 3.91 times. Conclusion: Postmenopausal women who are at high risk for cardiovascular diseases have a lower BMD than those who are not at high risk for cardiovascular diseases.

QTc dispersion and Cornell duration product can predict 10-year outcomes in hypertensive patients with left ventricular hypertrophy

Persistent and adequate treatment of patients with arterial hypertension leads to more favorable disease outcome.

Health-related quality of life in patients with coronary artery disease after coronary revascularization

The aim of this study was to investigate the quality of life (HRQoL) in coronary artery disease(CAD) patients, admitted for rehabilitation within 3 months after an acute coronary event, in relation to treatment strategy [conservative treatment without revascularization (WR), percutaneous transluminal coronary angioplasty (PTCA), coronary artery bypass graft (CABG)]. Methods: Overall 719 consecutive CAD patients were involved in the study: WR (n=170), PTCA (n=226), CABG (n=323). HRQoL was estimated using the SF-36 questionnaire for total QoL and its two dimensions for physical and mental health [physical and mental component scores (PCS, MCS)]. Sexual dysfunction was assessed using the ASEX scale. Results: Significantly higher PCS, MCS and total SF-36, but lower ASEX score, were found in men compared with women. The ASEX score was significantly affected by age. Significantly higher PCS was found in PTCA group compared with that of CABG group. In multivariate analysis a significant positive association was obtained between PCS/MCS and male sex, between regular exercise, hyperlipoproteinemia, and permanent stress. ASEX was significantly positively associated with the age, CHF and non smoking. Conclusion: The results of this study have demonstrated significantly better HRQoL in men, younger CAD patients, patients who underwent PTCA and in patients without self-reported exposition to stress.

Asymptomatic giardiasis-more prevalent in refugees than in native inhabitants of the city of Nis, Serbia

Giardiasis is a parasitic infection of the digestive tract, most commonly occurring in closed communities such as schools, kindergartens, prisons, and campuses. The civil war in the former Yugoslav republics and in Kosovo caused a large number of refugees to take shelter in the territory of Serbia. Such large numbers of refugees could be accommodated only in the collective centers. Our aim was to examine the differences in the prevalence of asymptomatic giardiasis among 122 refugees from the former Yugoslav republics who lived in the collective centers in Nis, Serbia, and 241 native Nis inhabitants. Conventional microscopic examination (CME) of three stool samples with or without concentration technique and the enzyme immunoassay (EIA) methods were used. The CME method of three stool samples is considered the gold standard in our statistical survey. Asymptomatic giardiasis is found in 7 refugees (5.7%) using the EIA method, while using the CME (3 samples) Giardia duodenalis (G. duodenalis) was detected in 6 persons (4.9%). Using the EIA method and the CME (3 samples) G. duodenalis was detected in only 1 person in the population group of native inhabitants (0.4%). Asymptomatic giardiasis was more prevalent in the population group of refugees accommodated in collective centers than in native inhabitants in the Nis municipality, Serbia.

Significance of asymptomatic hyperuricemia in patients after coronary events

Abstract The goal of the present study was to determine the prevalence of hyperuricemia in patients with coronary artery disease (CAD), within three months after coronary events. Also, we aimed to determine whether the presence of hyperuricemia holds correlation with severe CAD, overall heart functioning and risk factors for CAD. The study included 505 consecutive CAD patients, 385 males and 120 females, aged 60.9 ± 9.6 years, with a mean body mass index (BMI) 28.0 ± 3.7 kg/m2. All patients were admitted to specialized cardiovascular rehabilitation within three months post-acute myocardial infarction (AMI) without revascularization (32.6%), percutaneous coronary intervention (PCI) with myocardial infarction (32.1%) and with coronary bypass graft (35.3%). The mean value of serum acidum uricum (SUA) was 345.5 ± 100.3 µmol/L, where 115 (22.8%) patients had asymptomatic hyperuricemia. Patients with asymptomatic hyperuricemia had significantly higher average number of risk factors, lower HDL cholesterol and higher creatinine and triglycerides levels, lower ejection fraction (EF). Multivariate stepwise analysis revealed that five parameters were capable to predict SUA levels. We can conclude that in patients with CAD, SUA levels are independently associated with BMI, triglyceride and creatinine levels and negatively with EF. Thus, one can say that asymptomatic hyperuricemia is not significantly associated with the severity of CAD.

Predictive value of metabolic syndrome definitions in patients with myocardial infarction with ST segment elevation – are they all the same?

Abstract Objectives: We sought to determine the predictive power of metabolic syndrome (MS) definitions on the prognosis in patients with myocardial infarction with ST-segment elevation (STEMI). Methods: We prospectively included 507 patients with STEMI who were admitted for primary percutaneous coronary intervention and could be identified for MS using the AHA-NHLBI, NCEP-ATP III and IDF definitions. After applying these criteria, we divided the group in patients with MS and without MS; we compared baseline characteristics, clinical findings and outcomes among these patients. Results: The prevalence of MS was lowest with the NCEP-ATP III definition (37.87%), followed by the AHA-NHLBI definition (42.80%) and highest when using the IDF definition (44.38%). During follow-up, the occurrence of new myocardial infarction and new revascularization was significantly higher in patients with MS. Only in a group of patients with MS according to the NCEP-ATP III definition, a higher number of strokes were recorded. Multivariate analysis shows that MS according to the NCEP-ATP III definition was an independent predictor for MACE (OR 1.830, 95% CI 1.238–2.704, p = .002) but not for mortality. Conclusion: Metabolic syndrome according to the NCEP-ATP III definition was associated with increased risk of the development of new cardiovascular events among the patients with STEMI.