Slavica Radjen

Effects of Acclimation on Cognitive Performance in Soldiers during Exertional Heat Stress

This study investigates the effects of exertional heat stress and acclimation status on physiological and cognitive performance. Forty male soldiers performed an exertional heat stress test (EHST) either in a cool (20 degrees C, 16 degrees C wet bulb globe temperature), or in a hot environment (40 degrees C, 29 degrees C wet bulb globe temperature), unacclimatized, or after 10 days of passive or active acclimation. Mean skin and tympanic (Tty) temperatures and heart rates (HR) measured physiological strain. A cognitive test (the computerized Cambridge Neuropsychological Test Automated Batteries attention battery) is administered before and immediately after EHST. EHST in hot conditions induced physiological heat stress (increase in Tty and HR), which caused mild deficits in attention in U group (decreased number of correct responses, and prolonged movement time). Acclimated (passive and active) soldiers suffered no detrimental effects of exertional heat stress, despite almost the same degree of heat strain, measured by Tty and HR.

Metabolic syndrome and carotid artery intima-media thickness in military pilots.

BACKGROUND The common carotid artery intima-media thickness (CCAIMT) is an independent predictor of cardiovascular events and diabetes mellitus in apparently healthy men. The relationship between features of metabolic syndrome (MS) and CCAIMT is not fully understood. We conducted this study to assess the cross-sectional relationship between CCAIMT and MS parameters in military pilots during their regular annual medical physical examinations. METHODS There were 179 pilots (ages 39.69 +/- 5.56 yr) free of cardiovascular disease and diabetes mellitus included in our study. MS was defined according to the International Diabetes Federation criteria. The CCAIMT was measured in the posterior wall of both common carotid arteries within 1 cm proximal to the carotid bulbus, by high-resolution B-mode ultrasonography. RESULTS We identified MS in 51 (28.5%) and CCAIMT > or = 0.9 mm in 72.1% of subjects, and found the means of CCAIMT in subjects grouped according to the absence and presence of 3, 4, and 5 MS features to be 0.98, 1.05, 1.14, and 1.18 mm respectively, with statistically significant differences between those without and those with 4 and 5 components, as well as between those with MS and those with 5 MS features. A simple logistic regression analyses showed that HDL-c, triglycerides, triglycerides/HDL-c, pulse pressure, and smoking were not associated with CCAIMT > or = 0.9 mm, while multiple logistic regression analysis indicated that total cholesterol and body mass index were independent predictors of CCAIMT. CONCLUSIONS The increase in MS features in our study group correlated with the increase in CCAIMT and total cholesterol and body mass index were identified as the independent predictors of CCAIMT.

Retroperitoneal fibrosis and constrictive pericarditis-IgG4 related diseases: A case report

Retroperitoneal fibrosis (RPF) is a rare disease characterized by infiltration of inflammatory cells and deposition of thickened fibrous tissues. The present study presents the case of a 53-year-old patient treated for generalized weakness and fatigue for 1 year prior to hospitalization. A cardiac ultrasound revealed pericardial effusion that required pericardiocentesis, during which 1,400 ml serous fluid with the characteristics of an exudate was aspirated. A pericardiectomy was performed due to persistent effusion and histological examination indicated pericardial fibrosis. A thoracic-abdominal computed tomography scan revealed the presence of retroperitoneal fibrosis. The patient was treated with corticosteroids and azathioprine. Follow-up examinations showed a significant reduction in the amount of abdominal fibrous tissue and no increase in pericardial effusion 1 year following the end of treatment. The patient continues to have regular follow-up control examinations with a cardiologist and nephrologist.

Health-related quality of life in patients undergoing hemodialysis

Background/Aim. Chronic renal disease is one of the growing problems all over the world. Health-related quality of life (HRQoL) is an important indicator for those with a chronic disease, such as chronic renal disease, because it may serve as predictor of mortality and hospitalization. The aim of this study was to assess HRQoL in patients on chronic maintenance hemodialysis (HD), and compare it with patients suffering from hypertension (HTA), and normal controls of the same age and gender (C). Methods. The study enrolled 224 males and females older than 18 years: 67 in the HD group, 78 in the HTA group, and 79 in the C group. HRQoL was assessed in all groups using 15-D questionnaire. Results. Significantly higher level of education was recorded in the HD group compared to other two groups. In the HD group there were significantly less employed persons (9%) and significantly more retired (67.2%). All groups were similar regarding an average monthly income and marital status. We found significantly lower total HRQoL score in patients in the HD group, compared to normal controls (0.78 ± 0.16 vs. 0.89 ± 0.10 in the HTA and 0.95 ± 0.06 in the C group) as well as specific scores in almost all investigated domains, except in speech, eating and mental functions. Patients in the HD and HTA groups had similar self-reported quality of life in additional 3 domains: hearing, elimination and distress, while the HD group reported significantly lower scores in remaining 9 domains: mobility, vision, breathing, sleeping, usual activities, discomfort and symptoms, depression, vitality and sexual activity. Patients in the HTA group had significantly lower scores than normal controls in 8 domains (hearing, sleeping, elimination, usual activities, discomfort and symptoms, depression, distress and vitality) as well as in total quality of life, while in remaining 4 domains there was no significant difference (mobility, vision, breathing, sexual activity). Conclusion. Both investigated chronic diseases lead to impairment of HRQoL, which is substantially stronger in hemodialysis than in hypertension. Considering the relationship between depression and HRQoL measures, it may be useful to treat depression of HD patients in order to improve their quality of life.

Role of Diet on Risk of Diabetes

It is clear that dietary components can modulate blood glucose levels. Diets that improve glycemic control are rich in whole grains, fruits, vegetables, legumes, and nuts; poor in refined grains, red or processed meats, and sugar-sweetened beverages; and moderate in alcohol consumption. Low-carbohydrate, low-glycemic index, Mediterranean, and high-protein diets should be considered in the overall strategy of diabetes management.

New nutrition recommendations for healthy aging.

Population aging shows a global rising trend. The World Health Organization (WHO) foresees that 1.2 billion elderly will live on Earth in 2025, two thirds of them in underdeveloped regions . Actual studies have confirmed that most prevailing diseases in adults and/or elderly result from inadequate nutrition, that nutritional risk factors influence aged persons falling ill still in their early years and that risks only accumulate in time and affect synergistically the physiological changes in aging . Also, the WHO experts consider that nutrition risk prevention is a vital investment into the future .