Browsing by Author "Tasic, Nebojsa (6603322581)"

Background: Prognostic value of concomitant aprtic regurgitation (AR) in patients operated for severe aortic stenosis (AS) is not clarified. The aim of this study was to prospectively examine the impact of presence and severity of concomitant AR in patients operated for severe AS on long-term functional capacity, left ventricular (LV) function and mortality.Methods: Study group consisted of 110 consecutive patients operated due to severe AS. The patients were divided into AS group (56 patients with AS without AR or with mild AR) and AS+AR group (54 patients with AS and moderate, severe or very severe AR). Follow-up included clinical examination, six minutes walk test (6MWT) and echocardiography 12 and 104 months after AVR.Results: Patients in AS group had lower LV volume indices throughout the study than patients in AS+AR group. Patients in AS group did not have postoperative decrease in LV volume indices, whereas patients in AS+AR group experienced decrease in LV volume indices at 12 and 104 months. Unlike LV volume indices, LV mass index was significantly lower in both groups after 12 and 104 months as compared to preoperative values. Mean LVEF remained unchanged in both groups throughout the study. NYHA class was improved in both groups at 12 months, but at 104 months remained improved only in patients with AS. On the other hand, distance covered during 6MWT was longer at 104 months as compared to 12 months only in AS+AR group (p = 0,013), but patients in AS group walked longer at 12 months than patients in AS+AR group (p = 0,002). There were 30 deaths during study period, of which 13 (10 due to cardiovascular causes) in AS group and 17 (12 due to cardiovascular causes) in AS+AR group. Kaplan-Meier analysis showed that the survival probability was similar between the groups. Multivariate analysis identified diabetes mellitus (beta 1.78, p = 0.038) and LVEF < 45% (beta 1.92, p = 0.049) as the only independent predictor of long-term mortality.Conclusion: Our data indicate that the preoperative presence and severity of concomitant AR has no influence on long-term postoperative outcome, LV function and functional capacity in patients undergoing AVR for severe AS. © 2011 Catovic et al; licensee BioMed Central Ltd.

Background: There is ongoing debate regarding the efficacy of the radial artery (RA) as an aortocoronary conduit, with few solid data regarding long-term clinical results. We sought to determine if the use of the RA as the second arterial conduit, beside left internal thoracic artery (LITA), would improve long-term clinical outcome after CABG as compared to saphenous vein graft (SVG). Methods: Between March 2001 and November 2003, 200 patients underwent isolated CABG and were randomized in 1:1 fashion to receive either LITA and RA grafts or LITA and SVGs. The primary end point was composite of cardiovascular mortality, non-fatal myocardial infarction and need for repeat myocardial revascularization (either surgical or percutaneous). Results: There was no significant difference in absolute survival, with 12 deaths in each group during the study period (log rank = 0.01, p = 0.979). There were 3 and 2 cardiac deaths in RA and SVG groups, respectively. There was no difference in long-term clinical outcome between the groups (log rank = 0.450, p = 0.509). Eleven patients in RA group had one or more non-fatal events; 7 patients suffered a myocardial infarction, 9 patients underwent percutaneous coronary angioplasty, and 1 patient required redo coronary surgery. Likewise, 13 patients in SVG group had non-fatal event; 7 patients had myocardial infarction, 13 patients had percutaneous coronary intervention and 3 patients required redo coronary surgery. Angiograms were performed in 23 patients in RA group (patency rate 92%) and 24 in SVG group (patency rate 86%) (p = 0.67). Conclusion: In this small randomised study our data indicate that there is no difference in the 8year clinical outcomes in relatively young patients between those having a RA or a saphenous vein graft used as a second conduit, beside LITA, for surgical myocardial revascularisation. © 2015 Petrovic et al.

Ischemic heart disease and cerebral ischemia represent the leading causes of mortality worldwide. Both entities share risk factors, pathophisiology and etiologic aspects by means of a main common mechanism, atherosclerosis. The autors aimed to investigate differences and similarities in epidemiology and risk factors that could be found between both entities. In a retrospective sudy 403 patients were included and divided into two groups: group of 289 patients with history of myocardial infarction (AMI), and group of 114 patients with history of ischemic stroke (IS). All patients were evaluated for nonmodifiable risk faktors, which included age and sex, and modifiable, such as hypertension, dyslipidemia, diabetes, obesity, physical activity and smoking. Differences in some epidemiological aspects were also considered: occupation, marital status, alcohol consumption, exposure to stress. Patients with history of IS were significantly older then AMI patients (64.0 ± 9.9 vs 64.0 ± 9.9, p=0,028), with higher diastolic blood pressure (87,1 ± 10,2 vs 83,6 ± 10,4, p=0,003) and higher Sokolow-Lyon index in ECG, an also index of left ventricular hypertrophy (19,2 ± 9,1 vs 14,7 ± 6,5). There were no significant differences between groups in the estimated body mass index and waist circumference. Differences between groups in stress exposure, occupation, alcohol consumption or physical activity were no significant. Patients in AMI group were more frequently male (199 (69%) vs 59 (52%), p=0,001), married (252 (87%) vs 88 (77%), p=0,037), smokers (162 (56%) vs 50 (44%), p=0,018) and with higher incidence od dyslipidemia (217 (75%) vs 73 (64%), p=0,019) compared with IS group. Incidence of arterial hypertension and diabetes was similar in both groups. Both entities share similar pathophysiological mechanisms and, consequently, main traditional risk factors. However, incidence of myocardial infarction increases with male sex, dyslipidemia, smoking and marital status, while incidense of ischemic stroke increases with age, higher diastolic blood pressure and also with ECG signs of left ventricular hypertrophy. © 2017, University of Kragujevac, Faculty of Science. All rights reserved.

The values of whey as a healthy and therapeutically useful drink are well known, and in folk medicine it has often been attributed miraculous powers and possibilities. This is nothing new, bearing in mind that in 460 BC, the father of medicine Hippocrates emphasized the value of whey in the treatment of tuberculosis, jaundice, diseases of the liver and digestive system, skin diseases and many other diseases. Whey is obtained during milk processing and cheese production, where it is present in almost 90% of the total mass. The composition of whey is specific. Water makes up to 93% of the composition, the rest consists of sugars and minerals, B vitamins, as well as a great wealth of probiotic bacteria. Whey is the largest source of essential amino acids compared to plant or animal sources. The concentration of amino acids in whey is 43% compared to oats (21%), wheat husk (21%) and wheat (22%), milk 39%, casein 34% and eggs 32%) or meat proteins (38%). Whey proteins contain almost 50% of essential amino acids and about 26% of branched-chain amino acids. Their composition is similar to the amino acid composition of human muscles, which allows their faster absorption than other sources of protein. The share of free amino acids in whey is 4 to 10 times higher than in milk. They have a significant effect on protein synthesis and a very strong anabolic effect in the body. Whey amino acids stimulate skeletal muscle regeneration, reduce fatigue, increase synthesis, and reduce muscle protein breakdown. Whey proteins increase the levels of antioxidant enzymes, especially glutathione and catalase. Positive effect on the reduction of the levels of TBARS (thiobarbituric acid reactive substance) is an important indicator of the decreasing process of lipid peroxidation. Reduction of oxidative stress process in the liver has positive consequences on inflammation and the content of lipids in the liver tissue and atherosclerosis process. Recent research indicates a positive effect on glucose metabolism, improving insulin sensitivity and preventing the development of fatty liver syndrome and type 2 diabetes. It has a positive effect on weight control, so whey proteins are integral parts of healthy medical diets, sport drinks, with approved efficacy in obesity treatments. Essential amino acids also act as neurogenic active substances, and they are also known as precursors of biogenic amines and neurotransmitters, so it is logical that there is a growing interest in researching their potential in psychiatry. © 2023, Serbian Medical Society. All rights reserved.