The influence of inflammatory markers and CRP predictive value in relation to the target hemoglobin level in patients on chronic hemodialysis.

UNLABELLED: The aim of this study was to determine the influence of inflammatory markers, predictive values of CRP and target hemoglobin (Hb) in patients on chronic hemodialysis. MATERIAL AND METHODS: Made is a cross-sectional study of inflammatory agents serum levels-CRP, fibrinogen and ferritin before hemodialysis in 114 patients divided into two groups according to the achieved or unachieved target hemoglobin level in the Cantonal Hospital in Zenica. RESULTS: The 57 patients (test group) did not reached the target hemoglobin in the range from 10-12 g/dl and CRP values were significantly higher compared to the control group (57 patients) who had reached targeted hemoglobin values. Levels of fibrinogen and ferritin were not significantly different between the control and the test group. CRP values are in negative correlation with the Hb concentration, while fibrinogen and ferritin values had a positive correlation. Significant negative correlation was only found in case of CRP, respectively, higher CRP was at lower levels of blood Hb. It was found that the predictive value of CRP is 6.5 mg/L to achieve target Hb level. If the CRP increases by 1 mg/L, possibilities to achieve the target Hb level in dialysis patients is reduced by 7.5%, with a sensitivity of 51% and specificity of 77%. Ferritin was elevated due to iatrogenic iron saturation, because all patients received intravenous iron and was treated with erythropoietin. By identification and analysis of inflammatory agents and duration ofhemodialysis, are explored the primary influence on hematopoiesis, of course, with the primary application of erythropoietin and adjuvant agents. It has been shown that CRP alone has an impact on the target Hb level, depending on the hemodialysis duration. CONCLUSION: The research results show how what looks as routine findings may be helpful in the timely detection of threatening complications and their treatment, and provide extended and improved quality of life for patients on hemodialysis.

Pneumonia as the most common lower respiratory tract infection.

INTRODUCTION: Pneumonia is the most serious inflammatory disease of the respiratory system and also the most common infectious disease. Even now, in the 21(st) century, pneumonia occupies a prominent place in clinical medicine and public health. We are confronted daily with the increased number of patients, as well as the constant increase in annual mortality due to this infectious disease. GOAL: The goal was to investigate the prevalence and pneumonia characteristics as the most serious lower respiratory tract infection, the incidence of typical and atypical pneumonia, hospitalization duration of the patients at the Clinic of Infectious Diseases, Clinical Center of Sarajevo University CCUS. PATIENTS AND METHODS: From January 2011 until December 2012 the study involved 100 hospitalized patients with infections of the lower respiratory tract at the Clinic of Infectious Diseases CCUS. RESULTS: Among the most common infections the pneumonia is highly represented. Lung X-Ray in two planes, by all protocols, demonstrated with the auscultatory finding has the highest value in the diagnosis of clinical pneumonieae. A statistically significant difference among our hospitalized patients, compared to typical and atypical pneumonia, is in favor of the first-typical bacterial pneumonia. Hospitalization duration ranges between 7-14 days. CONCLUSION: We believe that the introduction of the pneumococcal vaccine (PCV) should reduce the number of pneumonia caused by this bacterium. Recommendations for its use also come from the WHO. Until December 2012, WHO added 86 states in the PCV immunization as a part of their national immunization programs. Pneumococcal conjugate vaccine (PCV) is safe and effective for the reduction in number of patients suffering from pneumonia caused by St. pneumoniae. In particular, the vaccine is a significant protection for children, who due to age and severity of the disease must remain under medical supervision. In elderly vaccine is important and useful as preventive measure, due to their biological characteristics and life circumstances which mark this group as vulnerable population, like the youngest, and can be fatal for them.

The influence of hemodialysis duration on the concentration of inflammatory agents in chronic hemodialysis patients.

GOAL: The goal of this study is to determine the effect of the hemodialysis durations on the concentration of inflammatory agents C-reactive protein concentration, fibrinogen and ferritin in hemodialysis patients. There is not enough reliable research data about the primary causes of the increase of these agents levels in the serum. The role of inflammatory agents in the development of primary renal disease, pathogenesis and morphogenesis and in particular the development of complications and comorbidities is unclear. PATIENTS AND METHODS: The study included 114 chronic hemodialysis patients who were on dialysis three times a week for 4 hours, according to the regular protocol of hemodialysis at the Cantonal Hospital Zenica, Department for hemodialysis. RESULTS AND DISCUSSION: Patients were analyzed according to the hemodialysis duration (years) and on the basis of duration of hemodialysis are divided into 3 groups: According to the average values of fibrinogen in all three groups was p < 0.05 which is not statistically significant difference according to the hemodialysis duration. Average values of ferritin in group 1 (patients less than 1 year on hemodialysis) was 612 +/- 543 in group 2 (patients with hemodialysis duration between 1-10 years) was 1056 +/- 852, and in group 3 (patients with hemodialysis duration over 10 years) was 610 +/- 700. According to the average values of ferritin in all three groups we see that p < 0.05. In the second group ferritin concentrations were highest. In the third group of patients the results were the same as in the first group. CONCLUSION: It was found that the duration and type of hemodialysis does not affect the concentration of inflammatory agents in the blood.

[Influence of lasting diabetes and non-adjustable glycosylated haemoglobin on occurrence of retinopathy]. / Utjecaj trajanja dijabetesa i neregulirane glikemije na nastanak retinopatije.

The aim of this study was to investigate the effect of the duration of diabetes and glycemia on the development of diabetic retinopathy in diabetes types 1 and 2 and the prevalence of retinopathy by sex. It examined 278 diabetics in 1999 and 2004, a questionnaire was used to collect data and results of fasting glucose, HbA1c, glycosuria and ketonurie were recorded. Retinopathy was noted in 80 (28.78%) and 187 (67.27%) patients during 1999 and 2004, respectively (p < 0.001). The number of patients with the nonproliferative and preproliferative (p < 0.001) as well as with proliferative retinopathy (p < 0.01) was significantly higher in 2004 in the comparision with 1999. The average HbA1c in 1999 was 13.02%, whereas in 2004 it was 10.57%. Poor control of diabetes was present during both investigations.