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Filipovic B.,Clinical and Hospital Center Bezanijska Kosa | Kovcevic N.,Institute for Digestive Diseases | Randjelovic T.,Clinical and Hospital Center Bezanijska Kosa | Kostic S.,Clinical and Hospital Center Bezanijska Kosa | Filipovic B.,Niko Niko

Background/Aims: Malnutrition appears to be a major and noticeable problem for hospitalized patients and often present in patients with gastrointestinal diseases. This study attempts to evaluate differences in nutritional status parameters and nutritional state differences among hospitalized patients with various gastrointestinal diseases and disorders. Methodology: Our study included 154 males and 146 females, aged 18-84 years old, with various gastrointestinal diseases and disorders. All patients underwent baseline nutritional assessment, including subjective global assessment (SGA), anthropometric measurements, bioelectrical impedance analysis (BIA), and biochemical markers. Results: Prevalence of malnutrition was 45.7%. The highest prevalence was detected among patients suffering from gastrointestinal malignancies and chronic pancreatitis. All parameters decreased with malnourishment levels, except CRP and in-hospital stay which rose with malnourishment grade. SGA and length of hospital stay negatively correlated with all analyzed variables of nutritional assessment, except CRP. Conclusions: Patients suffering from gastrointestinal malignancies, inflammatory bowel disease and peptic ulcer disease have more pronounced level of malnutrition. Body mass index, triceps skin fold thickness, mid-arm circumference, MAMC, wrist circumference, total protein level, albumin, cholesterol, glucose level, lymphocyte count, basal metabolic rate, body fat mass, fat free mass, muscle mass, total body water and resistance appeared to be inversely correlated with malnutrition. However, CRP level correlated positively with the malnutrition severity. SGA malnutrition level is dependant of hospitalization length. © H.G.E. Update Medical Publishing S.A. Source

Bozinovski S.Z.,Serbian Institute of Physiology | Bozinovski S.Z.,University of Belgrade | Krstic S.,Institute for Digestive Diseases | Krstic S.,University of Belgrade | And 4 more authors.
Clinical Laboratory

Background: Vascular endothelial growth factor (VEGF) is a glycoprotein which exerts mitogenic effects on endothelial cells, enhances neoangiogenesis and microvascular permeability, influences leukocyte kinetics when upreg-ulated by hypoxia and high-glucose concentration in experimental conditions and in human pathology. Peritoneal synthesis of VEGF has been demonstrated in patients on peritoneal dialysis (PD) treated with glucose-based dialy-sate solutions.Methods: The aim of the study was to determine the serum and peritoneal effluent VEGF concentrations in patients on chronic PD and to assess the relationship between age, gender, comorbidities, dialysis modality and vintage, therapy with erythropoiesis stimulating agents (ESA), angiotensin-converting enzyme inhibitors (ACEi) and statins and VEGF concentrations. Data on the use of ACEi, ESA, and statins were collected from patients' medical histories. VEGF was measured in serum and peritoneal effluent using the quantitative sandwich enzyme immunoassay (ELISA) kits (Quantikine® Human VEGF, R&D Systems, USA & Canada). Complete blood count and standard biochemical analyses (serum glucose, urea, creatinine, total protein, albumin, cholesterol, triglycerides, sodium, potassium, chloride, iron, total iron-binding capacity, ferritin, fibrinogen, C-reactive protein, and intact parathyroid hormone) were performed in fasting venous blood samples. Dialysis and residual components of Kt/V and normalized weekly creatinine clearance were calculated based on 24-hour urine and effluent collections. Peritoneal transport type was determined using the peritoneal equilibration test.Results: Samples from 63 PD patients (39 males and 24 females, average age 61.97 ± 11.01 years) were analyzed. The average serum and effluent VEGF concentrations (231.84 ± 173.91pg/mL and 38.39 ± 49.38pg/mL, respectively) correlated significantly (p = 0.002). No significant difference was found in serum and effluent VEGF concentrations in relation to demographic characteristics, comorbidities, dialysis modality, therapy with ESA, ACEi, and statins. Patients treated with PD longer than 5 years had significantly higher serum VEGF levels (p < 0.05). Correlation analysis showed a statistically significant relationship between statin therapy and lower effluent VEGF concentration (p = 0.030). Serum VEGF concentration significantly correlated with fibrinogen serum concentration (p = 0.034) and glycemia (p = 0.004). Effluent VEGF concentration significantly correlated with cholesterolemia (p = 0.004).Conclusions: Serum VEGF concentrations were significantly higher in long term PD patients, and peritoneal effluent VEGF concentrations were significantly lower in patients receiving statins, suggesting a protective effect of those drugs on peritoneal membrane. Source

Mladenovic D.,University of Belgrade | Ninkovic M.,Military Medical Academy | Vucevic D.,University of Belgrade | Colic M.,Military Medical Academy | And 4 more authors.
Journal of the Serbian Chemical Society

The aim of this study was to investigate the effects of binge drinking on paracetamol-induced oxidative stress in mice liver. Male Swiss mice were divided into groups: control; ethanol-treated group (E) in five sequential doses of 2 g kg-1, administered through an orogastric tube; paracetamol-treated group (P) in a dose of 300 mg kg-1, intraperitoneally and a group that received paracetamol 12 h after the last dose of ethanol (PE). Blood and liver samples were collected for the determination of oxidative stress parameters 6, 24 and 48 h after treatment. Prior binge drinking potentiated the paracetamol-induced increase in the liver malondialdehyde level 48 h after treatment in comparison with the P and E groups (17.14±1.98 vs. 13.14±0.82 and 12.99±1.18 μmol L-1, respectively, p < 0.01). Ethanol and paracetamol in combination induced a more pronounced decrease in the liver GSH level than either of the individual substances alone at all time intervals (p < 0.01). Total liver superoxide dismutase (SOD) activity was significantly lower in PE 48 h after treatment in comparison with the P and E groups (251.73±80.63 vs. 707.62±179.92 and 1179.62±147.94 U mg-1 protein, respectively, p < 0.01). The lowest MnSOD activity in the PE group was detected 48 h after treatment (86.52±28.31; 41.13±11.07 and 23.16±5.18 U mg-1 protein in the P, E and PE groups, respectively, p < 0.05). Prior binge ethanol drinking potentiates paracetamolinduced reduction of antioxidative capacity of hepatocytes due to GSH depletion and SOD activity reduction, simultaneously increasing lipid peroxidation caused by paracetamol. Source

Trbojevic-Stankovic J.,Clinical Center Dr Dragisa Misovic Dedinje | Obradovic M.,University of Belgrade | Trpinac D.,University of Belgrade | Lausevic Z.,Institute for Digestive Diseases | Stojimirovic B.,Institute of Urology
Vojnosanitetski Pregled

Background/Aim. During peritoneal dialysis (PD) an exchange of substances between blood and dialysate takes place through specific histological structures of peritoneum. Peritoneal double-layered serous membrane has, so far, mostly been studied with electron microscopy on experimental animals. The aim of this study was to assess integrity of peritoneal tissue in end-stage renal disease (ESRD) and PD patients using standard light microscopy and immunohistochemical methods. Methods. Peritoneal tissue biopsies were performed on 25 persons: 8 healthy donors during nephrectomy, 9 ESRD patients upon insertion of PD catheter, and 8 PD patients upon removal of the catheter for medical indications. The samples were fixed and prepared routinely for immunocytochemical staining by standardized streptavidin biotin AEC method using a LSAB2 ® HRP kit (Dako ®, Denmark) for collagen IV and analyzed by light microscopy. Results. We observed mesothelial detachment from lamina propria, duplicated basement membrane and much thicker blood vessel walls in ESRD and PD patients, compared to healthy subjects. Differences in histological structure, emphasized with immunostaining, indicated pathological alterations of peritoneal tissue in the renal patients. Conclusions. Imu-nohistochemistry can be used in studying histological alterations of peritoneal tissue in ESRD and PD patients. This method may indicate possible problems in filtration and secretion processes in this tissue. Source

Lausevic Z.,Institute for Digestive Diseases | Krstic S.,Institute for Digestive Diseases | Trbojevic-Stankovic J.,Center for Urology | Trpinac D.,University of Belgrade | Zunic-Bozinovski S.,University of Belgrade
Journal of Animal and Veterinary Advances

Investigating peritoneal membrane alterations caused by peritoneal dialysis fluid during peritoneal dialysis in humans is still intriguing but limited. Animal models provide important information about peritoneal changes during long term peritoneal dialysis. The aim of the study was to investigate the possibilities of histological (light and transmission electronic microscopy) and morphometric analyses of peritoneal blood vessels using a modified non-uremic infusion model of peritoneal dialysis on rabbits. The study was done on five adult Chincilla rabbits. A part of infusion system Tro-soluset (Troge Medical GMBH, Germany) was used as peritoneal catheter for daily dialysate instillations. The rabbits tolerated surgical and instillation procedure well, increased body weight and no infection signs nor catheter opstruction were observed during the follow up. Peritoneal tissue samples were obtained during the catheter placement and removal. Morphometric parameters of peritoneal blood vessels (determined with analy SIS 3.1 Soft Imaging System GMbH) showed statistically significant differences before and after peritoneal dialysis. This modified model of peritoneal dialysis on rabbits provided peritoneal tissue samples suitable for histological and morphometric analysis and can be used to study the effects of dialysis solutions on rabbit peritoneal membrane. © Medwell Journals, 2011. Source

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