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Cilj istraživanja: Cilj ovog istraživanja je bio utvrditi razlike u razdiobi indeksa fibroze jetre (FIB-4) u osoba sa šećernom bolesti tipa 2 i ispitati utjecaj drugih varijabli na FIB-4 kao što su duljina trajanja šećerne bolesti, preboljenje i težina COVID-19, HbA1c i laboratorijski parametri te utvrditi postojanje međuovisnosti navedenih varijabli. Materijali i metode: U istraživanje je uključeno ukupno 100 ispitanika. Svi ispitanici koji su sudjelovali u istraživanju liječe se od šećerne bolesti tipa 2 u Centru za dijabetes KBC-a Split. Ispitanici su ispunili anketni upitnik koji je sadržavao pitanja o općim podacima ispitanika i ispitanikove šećerne bolesti, informacije o preboljenju i težini SARS-CoV2 infekcije te informacije o cjepnom statusu. Zabilježeni su antropometrijski parametri (visina, težina i BMI) te su uzeti podaci iz laboratorijskih testova (HbA1c, ALT, AST, trombociti i lipidogram). Uz pomoć trombocita, jetrenih enzima (ALT i AST) i broja godina pacijenta, izračunat je FIB-4 indeks. Rezultati: Nije zabilježena statistički značajna razlika prilikom usporedbe FIB-4 indeksa s obzirom na preboljenje (P=0,539) i težinu kliničke slike COVID-19 (P=0,137). Također, nije se pokazala značajna razlika kod usporedbe pojedinih vrijednosti indeksa fibroze jetre s obzirom na preboljenje (P=0,539) i težinu kliničke slike (P=0,289) COVID-19. Prilikom usporedbe vrijednosti HbA1c i FIB-4 indeksa, pokazala se blaga, ali statistički neznačajna korelacija (P=0,126). Također, nije se pokazala značajna razlika kod usporedbe HbA1c između različitih kategorija FIB-4 (P=0,587). Nije se pokazala značajna razlika u distribuciji težine bolesti između cijepljenih i necijepljenih pacijenata (P=0,539). Kod usporedbe razina HbA1c s obzirom na težinu COVID-19 se nije pokazala značajna razlika. Kod usporedbe FIB-4 indeksa s obzirom na duljinu trajanja šećerne bolesti, pokazala se statistički neznačajna korelacija (P=0,109). Između koncentracije FIB-4 i vrijednosti TG-a, LDL-a, HDL-a i ukupnog kolesterola pokazala se negativna statistički neznačajna korelacija (P=0,253, P=0,833, P=0,269, P=0,957). Zaključci: Ovo istraživanje je pokazalo da se distribucija FIB-4 indeksa nije statistički značajno promijenila u ovisnosti o preboljenju COVID-19, težini kliničke slike COVID-19, vrijednostima HbA1c-a, duljini trajanja šećerne bolesti te o abnormalnim vrijednostima lipida u krvi. Također, nije pronađena statistički značajna razlika u distribuciji težine bolesti između cijepljenih i necijepljenih pacijenata. Nisu zabilježene ni značajno veće vrijednosti HbA1c u osoba s težom kliničkom slikom COVID-19. Postoje statistički signali za gotovo sve pretpostavljene ishode te je za očekivati da bi istraživanje s većim brojem bolesnika potvrdilo ove hipoteze., Objectives: The aim of this study was to determine the differences in the distribution of the liver fibrosis index (FIB-4) in people with type 2 diabetes and to examine the influence of other variables on FIB-4 such as the duration of diabetes, recovery and severity of COVID-19, HbA1c and laboratory parameters and determine the existence of interdependence of the mentioned variables. Subjects and methods: A total of 100 respondents were included in the research. All subjects who took part in the research are being treated for type 2 diabetes in the Diabetes Center of KBC Split. Respondents filled out a survey questionnaire that contained questions about the respondent's general information and the respondent's diabetes, information on recovery and severity of SARS-CoV2 infection, and information on vaccination status. Anthropometric parameters (height, weight and BMI) were recorded and data from laboratory tests (HbA1c, ALT, AST, platelets and lipidogram) were taken. With the help of platelets, liver enzymes (ALT and AST) and the age of the patient, the FIB-4 index was calculated. Results: No statistically significant difference was found when comparing the FIB-4 index with regard to recovery (P=0.539) and the severity of the clinical symptoms of COVID-19 (P=0.137). Also, no significant difference was shown when comparing individual liver fibrosis index values with regard to recovery (P=0.539) and the severity of the clinical symptoms (P=0.289) of the COVID-19. When comparing the values of HbA1c and FIB-4 index, a slight but statistically insignificant correlation was shown (P=0.126). Also, no significant difference was shown when comparing HbA1c between different FIB-4 categories (P=0.587). There was no significant difference in the distribution of disease severity between vaccinated and unvaccinated patients (P=0.539). When comparing HbA1c levels with regard to the severity of the COVID-19, no significant difference was shown. When comparing the FIB-4 index with regard to the duration of diabetes, a statistically insignificant correlation was shown (P=0.109). A statistically insignificant negative correlation was shown between the concentration of FIB- 4 and the values of TG, LDL, HDL and total cholesterol (P=0.253, P=0.833, P=0.269, P=0.957). Conclusion: This research showed that the distribution of the FIB-4 index did not change statistically significantly depending on the recovery from the COVID-19, the severity of the clinical picture of the COVID-19, the HbA1c values, the duration of diabetes and the abnormal blood lipid values. Also, no statistically significant difference was found in the distribution of disease severity between vaccinated and unvaccinated patients. No significantly higher HbA1c values were recorded in persons with a more severe clinical picture of COVID-19. There are statistical signals for almost all assumed outcomes, and it is to be expected that research with a larger number of patients would confirm these hypotheses

Objectives : The main objectives of this study were to assess nutritional status and quality of life of patients who are enterally feeding via percutaneous endoscopic gastrostomy for a period of at least 3 months in the home environment. Materials and methods: This study included a total of 31 participants, aged between 21 and 85 years, who have been feeding via percutaneous endoscopic gastrostomy for a period of at least 3 months in the home environment. Quality of life was assessed by EQ-5D-3L questionnaire and Liverpool PEG questionnaire, while nutritional status was assessed with the Malnutrition Universal Screening Tool (MUST). Statistical data analysis was done by statistical software MedCalc (Ostend, Belgium; version 11.5.1.0) for Windows. Results: The study included 21 male and 10 female patients who are enterally feeding via percutaneous endoscopic gastrostomy tube in the home environment. The median body mass index (BMI) was 22.5 kg/m2 (Q1-Q3: 18.6-24.4; min-max: 12.1-30.7). Low, medium and high risks of malnutrition among participants were 52%, 19% and 29%, respectively. If the high risk of malnutrition is compared with the other combined risks of malnutrition (combined low and medium risks), it turns out that the high risk is 2.44 times lower than the other risks (x2 = 5.7, P = 0.017). The mean value of the EQ-VAS score was 37.3 ± 29; the median value was 30 (Q1-Q3: 10-50; min-max: 1-99) (95% CI: 20-50). The percentage of patients who wanted to remove PEG in the group with EQ VAS score > 30 was 61% (n = 8). This was 5.5 times more than the percentage of patients (11%; n = 2) who wanted to remove PEG in the group with EQ VAS score ≤30 (P = 0.006). Percentage of patients who were thinking that PEG did not affect their overall quality of life was 4.3 times higher. The proportion of patients who were thinking that PEG does not affect their overall quality of life is 81% (95% CI: 63-95). Conclusion: The high overall risk of malnutrition is statistically significantly lower compared to the combined low and medium overall risks of malnutrition among patients who are enterally feeding via percutaneous endoscopic gastrotomy tube in the home environment. Based on this research, it could be concluded that the population of patients who are enterally feeding via PEG in the home environment estimate the median health-related quality of life between 20 and 50 according to EQ VAS score with 95% probability. Patients who had a better overall health-related quality of life according to the EQ VAS score were more prone to the option of removing the PEG. The majority of patients who are enterally feeding via PEG in the home environment report that PEG does not affect their overall quality of life., Ciljevi: Procijeniti nutritivni status i kvalitetu života bolesnika koji se enteralno hrane putem perkutane endoskopske gastrostome u razdoblju od najmanje 3 mjeseca u kućnom okruženju. Materijali i metode: Ovo istraživanje obuhvatilo je ukupno 31 sudionika, u dobi od 21 do 85 godina, koji su se hranili putem perkutane endoskopske gastrostome u razdoblju od najmanje 3 mjeseca u kućnom okruženju. Kvaliteta života procijenjena je sa EQ-5D-3L upitnikom i Liverpool PEG upitnikom, dok je nutritivni status procijenjen sa Malnutrition Universal Screening Tool (MUST) upitnikom. Statistička analiza podataka napravljena je statističkim softverom MedCalc (Ostend, Belgija; verzija 11.5.1.0) za Windows. Rezultati: Istraživanje je obuhvatilo 21 muškog i 10 ženskih bolesnika koji se enteralno hrane putem perkutane endoskopske gastrostome u kućnim uvjetima. Medijan indeksa tjelesne mase (BMI) bio je 22,5 kg/m2 (Q1-Q3: 18,6-24,4; min-max: 12,1-30,7). Niski, srednji i visoki rizici od pothranjenosti među sudionicima bili su 52%, 19% i 29%. Ako se visoki rizik od pothranjenosti usporedi s ostalim kombiniranim rizicima pothranjenosti (kombinirani niski i srednji rizici), uočava se da je visoki rizik 2,44 puta manji od ostalih rizika (x2 = 5,7, P = 0,017). Srednja vrijednost EQ-VAS rezultata bila je 37,3 ± 29; medijan je bio 30 (Q1-Q3: 10-50; min-max: 1-99) (95% CI: 20-50). Postotak pacijenata koji su htjeli ukloniti PEG u skupini s EQ VAS rezultatom > 30 bio je 61% (n = 8). To je bilo 5,5 puta više od postotka pacijenata (11%; n = 2) koji su željeli ukloniti PEG u skupini s EQ VAS rezultatom ≤30 (P = 0,006). Postotak pacijenata koji su smatrali da PEG ne utječe na njihovu ukupnu kvalitetu života bio je 4,3 puta veći. Udio pacijenata koji su mislili da PEG ne utječe na njihovu ukupnu kvalitetu života je 81% (95% CI: 63-95). Zaključci: Visoki ukupni rizik od pothranjenosti statistički je značajno niži u usporedbi s kombiniranim niskim i srednjim ukupnim rizikom od pothranjenostiu pacijenata koji se enteralno hrane putem perkutane endoskopske gastrostome u kućnom okruženju. Na temelju ovog istraživanja može se zaključiti da populacija pacijenata koji se enteralno hrane putem PEG-a u kućnom okruženju procjenjuju medijan kvalitete života povezane sa zdravljem između 20 i 50 prema EQ VAS rezultatu s 95% vjerojatnosti. Pacijenti koji su imali bolju ukupnu kvalitetu života povezanu sa zdravljem prema EQ VAS rezultatu bili su skloniji opciji uklanjanja PEG-a. Većina pacijenata koji se enteralno hrane preko PEG-a u kućnom okruženju navodi da PEG ne utječe na njihovu ukupnu kvalitetu života.

Objectives: The present study aimed to examine whether the application of a topical cutaneous medication, compared to standard subcutaneous lidocaine infiltration, prior to radial artery puncture in the setting of diagnostic coronary angiography will impact the occurrence of radial artery spasm, pain experienced by the patient during the procedure, and mean attempts of radial artery cannulation. Patients and methods: Cumulative meta-analysis of data derived from 7 randomized controlled or prospective non-randomized placebo-controlled trials was performed. The primary outcomes of interest included relative risk of radial artery spasm during cannulation, mean pain score as perceived by the patient and quantified by visual analogue scale, and mean radial artery cannulation attempts. Risk ratio (RR) with 95% confidence intervals (95% CI) was used for the effect measurement of radial artery spasm while fixed effects method was applied. The mean difference was calculated by using the random effects model due to data exhibiting moderate to high heterogeneity. Meta-analysis was performed by using the Cochrane’s Review Manager software. Results: The data derived from seven studies enrolling a total of 1425 patients were included in the analysis. A total of 106 radial artery spasm events were recorded. Radial artery spasm occurred in 5.57% of cases in the experimental arm (topical solution), while in the arm receiving standard treatment radial vasospasm occurred in 9.32% of cases. This yielded a relative risk reduction of 41% in patients receiving topical medication (RR 0.59; 95% CI 0.41 to 0.86, P=0.005), compared to control arm. Analysis of 1342 patients from 6 studies in regards to pain quantified by VAS, the results showed a significant reduction in pain score by 1.54 points (MD -1.54; 95% CI -2.94 to -0.14 points, P=0.030) among patients that received topical medications vs. standard treatment. The mean number of radial artery cannulation attempts were recorded in 4 studies, including 744 patients. The results showed -0.07 fewer cannulation attempts in the experimental vs. control arm (MD -0.07, 95% CI -0.14 to 0.01), however, this result was not statistically significant (P=0.070). Conclusions: Preprocedural application of topical cutaneous medication, compared to standard-of-care consisting of subcutaneous lidocaine infiltration, prior to radial artery cannulation in the setting of transradial angiography in patients with stable or suspected CAD was associated with a significant reduction in the occurrence of radial spasm and pain perceived by the patient. Application of topical cutaenous medication, however, did not reduce the mean number of radial artery cannulation attempts, when compared to subcutaneous lidocaine infiltration., Ciljevi: Ova studija je kao glavni cilj imala istražiti je li primjena topikalnih lijekova koji se apliciraju na kožu, u usporedbi sa supkutanom infiltracijom lidokaina, a prije punkcije radijalne arterije za vrijeme dijagnostičke koronarne angiografije ima učinak na učestalost spazma radijalne arterije, bol koju pacijent osjeća za vrijeme kanulacije kao i prosječan broj pokušaja kanulacije radijalne arterije. Pacijenti i metode: Izvršena je kumulativna meta-analiza podataka koji su sakupljeni iz 7 randomiziranih kliničkih pokusa ili nerandomiziranih prospektivnih placebom kontroliranih studija. Glavni ishodi od posebnog interesa su bili relativni rizik spazma radijalne arterije za vrijeme kanulacije, prosječan osjećaj boli koju pacijent osjeća za vrijeme radijalne kanulacije, a koji je kvantificiran korištenjem vizualno-analogne skale te prosječan broj kanulacija radijalne arterije. Omjer rizika (RR) sa 95% intervalima pouzdanosti je korišten kao mjera učinka ishoda spazma radijalne arterije, a za istu je korištena statistička metoda fiksnih učinaka. Razlika u prosječnom zbroju bola i pokušaja kanulacije je analizirana korištenjem statističke metode nasumičnih učinaka obzirom da su navedeni podatci pokazali umjerenu do visoku heterogenost. Meta-analiza je izvršena korištenjem Cochraneovog Review Manager programskog paketa. Rezultati: Analizirani su ishodi 1,427 pacijenta iz sedam studija uključenih u analizu. Ukupno je zabilježeno 106 događaja spazma radijalne arterije. Spazam radijalne arterije zabilježen je u 5,57% slučajeva u grupi pacijenata koji su dobili topikalni lijek (eksperimentalna grupa) te u 9,32% slučajeva u grupi pacijenata koji su dobili standardnu skrb (kontrolna grupa). Navedena eksperimentalna intervencija bila je povezana sa smanjenjem relativnog rizika za spazam radijalne arterije za 41% (omjer rizika 0,59; 95%-tni interval pouzdanosti 0,41-0,86, P=0,005). Analizom ishoda boli prilikom kanulacije radijalne arterije kod 1,342 pacijenta iz 5 studija, pokazalo se da je intervencija topikalnim lijekom dovela do značajnog smanjenja boli za 1,54 boda u percepciji boli izmjerene VAS skalom u usporedbi sa pacijentima koji su dobili standardnu skrb (razlika u prosječnim vrijednostima -1,54 boda na VAS skali; 95%-tni interval pouzdanosti -2,94 do -0,14 bodova, P=0,030). Ishod prosječnog broja kanulacija radijalne arterije je analiziran u 744 pacijenta iz 4 studije. Za ovaj ishod nije utvrđena statistički značajna razlika između dvije skupine iako je u skupini pacijenata koji su primili topikalni lijek utvrđen trend smanjenja prosječnog broja pokušaja kanulacije radijalne arterije (razlika u prosječnim vrijednostima -0,07; 95%-tni interval pouzdanosti -0,14 do 0,01 pokušaja, P=0,070). Zaključci: Aplikacija kutanog topikalnog lijeka prije kanulacije radijalne arterije, u usporedbi sa standardnom skrbi korištenja supkutane infiltracije lidokainom u pacijenata koji se podvrgavaju transradijalnoj angiografiji je bila povezana sa značajnim smanjenjem rizika radijalnog spazma kao i smanjenjem percipirane boli za vrijeme kanulacije radijalne arterije. Intervencija sa topikalnim lijekom, međutim, nije smanjila prosječan broj pokušaja kanulacije radijalne arterije u usporedbi sa supkutanom infiltracijom lidokaina.

Objectives: The aims of this study were to determine the incidence of renal artery stenosis (RAS) in patients undergoing diagnostic coronary angiography for stable coronary artery disease (CAD) or suspected coronary artery disease. Additionally, to investigate the influence of risk factors and certain clinical characteristics on the risk of finding significant RAS during diagnostic coronary angiography. Patients and methods: Systematic review and quantitative meta-analysis included a total of 28 observational cohort studies that were primarily designed to determine the prevalence and risk factors for RAS in patients with coronary artery disease. The main outcomes of interest were the mean incidence of significant, severe, and bilateral RAS in the previously described population, statistically adjusted for individual study size. The second objective was to investigate the potential association of established cardiovascular risk factors, comorbidities, and angiographic parameters of the severity of coronary disease with the frequency of RAS. Relative risk (RR) with 95% confidence interval (95% CI) was used as the main outcome measure, and a random effect model and the Mantel-Haenszel statistical algorithm were used for meta-analysis. Results: The average frequency of RAS in the mentioned population was 13,82% (95% CI 10,69-17,27%), 6,46% (95% CI 4,36-8,95%) and 4,03% (95% CI 2,58-5,78%) for significant, severe and bilateral RAS. Chronic kidney disease was associated with almost 3-fold higher relative risk for RAS (RR 2,80, 95% CI 2,03-3,38), followed by peripheral artery disease (RR 2,46, 95% CI 1,85-3,27), left-main artery disease (RR 1,86, 95% CI 1,30- 2,67) and three-vessel disease (RR 1,56, 95% CI 1,28-1,90). Of the classic risk factors for cardiovascular disease, arterial hypertension (RR 1,33, 95% CI 1,22-1,45), diabetes (RR 1,22, 95% CI 1,09-1,37) and dyslipidemia (RR 1,12, 95% CI 1,06-1,19) were significant associated with a higher relative risk for significant RAS. Smoking was not significantly associated with a higher risk of RAS (RR 1,02, 95% CI 0,94-1,12). Female gender was associated with a 33% higher relative risk for RAS compared to the male gender (RR 1,33, 95% CI 1,07-1,66). Finally, patients with RAS were significantly older that those without RAS (+4,6 years of age, 95% CI 3,50-5,02). Conclusion: This study showed that significant RAS is present in nearly 14 out of 100 patients undergoing routine cardiac catheterization for coronary artery disease. Variables that were significantly associated with a higher risk of finding RAS were older age, female sex, chronic kidney disease, peripheral artery disease, diabetes mellitus, arterial hypertension, and dyslipidemia. Of the angiographic variables, RAS was found to be significantly more frequent in patients with left-main disease and three-vessel disease., Ciljevi: Glavni ciljevi ove studije su bili utvrditi učestalost stenoze bubrežnih arterija (SBA) u bolesnika koji se podvrgavaju dijagnostičkoj koronarnoj angiografiji zbog stabilne koronarne bolesti (kroničnog koronarnog sindroma) ili sumnje na koronarnu bolest. Također je cilj bio istražiti utjecaj čimbenika rizika i određenih kliničkih karakteristika na rizik pronalaska značajne SBA za vrijeme dijagnostičke koronarografije. Pacijenti i metode: Sustavni pregled i kvantitativna meta-analiza su uključile ukupno 28 opservacijskih presječnih istraživanja koja su bila primarno osmišljena s ciljem utvrđivanja prevalencije i rizičnih faktora za nastanak SBA u bolesnika s koronarnom bolesti. Glavni ishodi od interesa su bili srednja učestalost značajne, teške i bilateralne SBA u prethodno opisanoj populaciji, statistički prilagođeno za veličinu pojedinačnih studija. Drugi cilj je bio istražiti potencijalnu povezanost etabliranih kardiovaskularnih čimbenika rizika, komorbiditeta te angiografskih parametara težine koronarne bolesti sa učestalosti SBA. Relativni rizik (RR) sa 95%-tnim intervalima pouzdanosti (95% CI) je korišten kao glavna mjera ishoda, a model s nasumičnim učinicima i Mantel-Haenszel statističkim algoritmom je korišten za meta-analizu. Rezultati: Prosječna učestalost SBA u navedenoj populaciji iznosila je 13,82% (95% CI 10,69- 17,27%), 6,46% (95% CI 4,36-8,95%) te 4,03% (95% CI 2,58-5,78%) za značajnu, tešku i bilateralnu SBA. Kronična bubrežna bolest je bila povezana sa gotovo 3-puta većim relativnim rizikom za SBA (RR 2,80, 95% CI 2,03-3,38), nakon čega je slijedila periferna arterijska bolest (RR 2,46, 95% CI 1,85-3,27), stenoza debla lijeve koronarne arterije (RR 1,86, 95% CI 1,30- 2,67) te trožilna koronarna bolest (RR 1,56, 95% CI 1,28-1,90). Od klasičnih čimbenika rizika za kardiovaskularnu bolest, arterijska hipertenzija (RR 1,33, 95% CI 1,22-1,45), šećerna bolest (RR 1,22, 95% CI 1,09-1,37) i dislipidemija (RR 1,12, 95% CI 1,06-1,19) bili su značajno povezani sa većim relativnim rizikom za značajnu SBA. Pušenje nije bilo značajno povezano sa većim rizikom za SBA (RR 1,02, 95% CI 0,94-1,12). Ženski spol je bio povezan sa 33% višim relativnim rizikom za SBA u odnosu na muški spol (RR 1,33, 95% CI 1,07-1,66). Konačno, bolesnici sa SBA su bili značajno stariji od onih kojima nije pronađena SBA (+4,6 godina starosti, 95% CI 3,50-5,02). Zaključci: Ovo istraživanje je pokazalo da je značajna SBA prisutna u gotovo 14 od 100 bolesnika koji se podvrgavaju rutinskoj kateterizaciji srca zbog koronarne bolesti. Varijable koje su bile značajno povezane sa većim rizikom za pronalazak SBA bile su starija životna dob, ženski spol, kronična bubrežna bolest, periferna arterijska bolest, šećerna bolest, arterijska hipertenzija te dislipidemija. Od angiografskih varijabli pronađeno je da je SBA značajno učestalija u bolesnika sa stenozom debla i trožilnom koronarnom bolesti.

Ciljevi: Svrha ovog istraživanja bila je ispitati klinička obilježja IgA vaskulitisa kod pacijenata liječenih u Klinici za unutarnje bolesti KBC-a Split u petnaestogodišnjem razdoblju. Ispitanici i postupci: Istraživanje je obuhvatilo 36 bolesnika s dijagnosticiranim IgA vaskulitisom u razdoblju od 2007. do 2022. godine. Prikupljeni podaci dobiveni su iz stacionara i dnevne bolnice Zavoda za reumatologiju i imunologiju Klinike za unutarnje bolesti KBC-a Split. Podatci su tijekom prikupljanja unošeni u Microsoft Excel program dok je u statističkoj obradi korišten program MedCalc. Od testova su pritom korišteni χ2 test, Mann-Whitney test, Pearsonova korelacija i logistička regresija. Rezultati: Istraživanje je obuhvatilo 36 bolesnika s dijagnozom IgA vaskulitisa tijekom petnaestogodišnjeg razdoblja od kojih je bilo 29 muškaraca (80,6%) i 7 žena (19,4%). Medijan životne dobi iznosio je 62 godine (min-maks: 20-86 godina, Q1-Q3: 48-72 godine). Pokazala se statistički značajna razlika u razinama IgA u serumu između pacijenata starijih i mlađih od 60 godina kao i statistički značajna korelacija slabije snage između dobi i razina IgA u serumu. Od kliničkih očitovanja, najučestaliji simptom je bila purpura, zatim artritis i/ili artralgija, potom zahvaćenost bubrega te najrjeđe zahvaćenost gastrointestinalnog sustava. U konačnici se nije pokazala značajna razlika u kliničkom očitovanju kod pacijenata starijih i mlađih od 60 godina. U terapiji IgA vaskulitisa koristila se prvenstveno glukokortikoidna i imunosupresivna linija lijekova koja je u većini slučajeva dovela do poboljšanja stanja. Pritom se nije pokazala statistički značajna razlika u terapijskom izboru između definiranih dobnih skupina. Kod 10 pacijenata se određeni lijekovi mogu promatrati kao potencijalni okidači IgA vaskulitisa. Na kraju se pokazala statistički značajna razlika u broju pacijenata s poboljšanjem stanja kod uspoređivanih dobnih skupina. Zaključci: Istraživanje je pokazalo 2,4 dijagnosticirana IgA vaskulitisa godišnje i omjer muškaraca i žena od 4:1. Također, utvrđena je statistički značajna razlika u razinama IgA u serumu između mlađih i starijih pacijenata te značajna korelacija slabije snage između dobi i razine IgA u serumu. Utvrđeno je kako ne postoji značajna razlika u simptomatologiji između mlađih i starijih pacijenata, a da je pritom učestalost promatranih simptoma jednaka u oba spola. Simptomi od češćih prema rjeđima su purpura, artritis i/ili atralgija; zahvaćenost bubrega i gastrointestinalnog sustava. Najčešće primjenjivani lijekovi su kortikosteroidi i imunosupresivi koji su u većini slučajeva doveli do poboljšanja stanja, a penicilini i cefalosporini mogu biti okidači pojave IgA vaskulitisa., Objectives: The purpose of this study was to examine the clinical features of IgA vasculitis in patients treated in the Clinic for internal diseases at University Hospital of Split over a fifteen-year period. Subjects and methods: The research included 36 patients diagnosed with IgA vasculitis in the period 2007-2022. The collected data were obtained from Department of rheumatology and immunology in the Clinic for internal diseases at University Hospital of Split. Data were entered into the Microsoft Excel program during the collection, while the MedCalc program was used for statistical processing. Among the tests, the χ2 test, Mann-Whitney test, Pearson's correlation and logistic regression were used. Results: The research included 36 patients diagnosed with IgA vasculitis over a fifteen-year period, of whom there were 29 men (80.6%) and 7 women (19.4%). The median age was 62 years (min-max: 20-86 years, Q1-Q3: 48-72 years). A statistically significant difference in serum IgA levels between patients older and younger than 60 years was shown, as well as a statistically significant correlation of weaker strength between age and serum IgA levels. Of the clinical manifestations, the most common symptom was purpura, followed by arthritis and/or arthralgia, then kidney involvement, and the least frequent, involvement of the gastrointestinal system. In the end, no significant difference in clinical manifestations was shown in patients older than and younger than 60 years. In the therapy of IgA vasculitis, primarily glucocorticoid and immunosuppressive drugs were used, which in most cases led to improvement of the condition. There was no statistically significant difference in the choice of therapy between defined age groups. In 10 patients, certain drugs can be seen as potential triggers of IgA vasculitis. In the end, a statistically significant difference was shown in the number of patients with improved conditions in the compared age groups. Conclusions: The research showed 2.4 diagnosed IgA vasculitis per year and a male to female ratio of 4:1. Also, a statistically significant difference in serum IgA levels was found between younger and older patients, as well as a significant weaker correlation between age and serum IgA levels. It was found that there is no significant difference in symptomatology between younger and older patients, while the frequency of observed symptoms is the same in both sexes. Symptoms from more common to less common are purpura, arthritis and/or arthralgia; involvement of the kidneys and gastrointestinal system. The most used drugs are corticosteroids and immunosuppressants, which in most cases lead to an improvement in the condition, while penicillin and cephalosporins can be triggers for the appearance of IgA vasculitis.

Cilj: Cilj ovoga rada bio je procijeniti rizik prijeloma u pacijenata s kroničnom opstrukcijskom plućnom bolesti (KOPB) s obzirom na specifične čimbenike rizika vezane uz bolest, a povezane s razvojem osteoporoze i prijeloma. Ispitanici i metode: Istraživanje je provedeno u Klinici za plućne bolesti Kliničkog bolničkog centra Split tijekom travnja i svibnja 2021. godine. Sudjelovalo je 35 ispitanika oboljelih od KOPB-a. Podatci su prikupljeni anketnim upitnicima i uvidom u medicinsku dokumentaciju. Za svakog ispitanika izračunat je desetogodišnji rizik za prijelome pomoću alata FRAX. Pacijenti su uspoređivani po skupinama ovisno o broju akutnih egzacerbacija u prethodnoj godini dana, ukupnoj dnevnoj dozi inhalacijskih kortikosteroida i stupnju bronhalne opstrukcije prema GOLD-u. Rezultati: Usporedbom pacijenata koji su imali visok rizik za razvoj akutnih egzacerbacija s onima niskog rizika nije dobivena statistički značajna razlika rizika prijeloma kuka P=0,420 i velikog osteoporotskog prijeloma P=0,398. Iako je rizik za prijelom kuka u skupinama pacijenata koji su uzimali nisku i umjerenu dozu inhalacijskih kortikosteroida bio povećan (5,45% i 3,60%) u odnosu na skupinu bez terapije inhalacijskim kortikosteroidima, nije pronađena statistička značajna razlika u povećanju rizika među skupinama za prijelom kuka ili veliki osteoporotski prijelom (P=0,410 i P=0,328). Pacijenti koji su prema GOLD-u bili u skupini 3 i 4 nisu imali statistički značajno povećan rizik za prijelom kuka i veliki osteoporotski prijelom u odnosu na pacijente iz skupine 1 i 2 po GOLD-u (P=0,363 i P=0,644). Zaključci: Istraživanje je pokazalo da većina pacijenata s KOPB-om ima visoki rizik za prijelom kuka, ali ne i za veliki osteoporotski prijelom. Nije dokazan statistički značajno viši rizik prijeloma u pacijenata s visokim rizikom za razvoj akutnih egzacerbacija u odnosu na one s niskim rizikom. Također nije dokazan statistički značajno viši rizik prijeloma u onih koji uzimaju višu dnevnu dozu inhalacijskih kortikosteroida u odnosu na one s nižom dnevnom dozom ili na one bez inhalacijskih kortikosteroida u terapiji. Nije dokazan povećan rizik prijeloma u pacijenata s višim stupnjem bronhalne opstrukcije (skupine 3 i 4 po GOLD-u) u odnosu na one s nižim stupnjem (skupine 1 i 2 po GOLD-u). Da bi mogli donijeti ispravne zaključke potrebna su daljna istraživanja s većim brojem ispitanika.Cilj: Cilj ovoga rada bio je procijeniti rizik prijeloma u pacijenata s kroničnom opstrukcijskom plućnom bolesti (KOPB) s obzirom na specifične čimbenike rizika vezane uz bolest, a povezane s razvojem osteoporoze i prijeloma., Objectives: The aim of this study was to assess fracture risk in patients with chronic opstructive pulmonary disease in relation to specific risk factors related to the disease, and responsible for the development of osteoporosis and fractures. Subjects and methods: The research was conducted at the Clinic for Lung Diseases of the University Hospital of Split during April and May 2021. 35 patients with COPD were included in this study. The data were collected by survey questionnaires and by examining medical documentation. Ten year fracture risk was calculated for each patient using the FRAX tool. Patients were compared by groups depending on the number of acute exacerbations in the previous year, the total daily dose of inhaled corticosteroids and the grade of airflow limitation classified by GOLD. Results: No statistically significant difference in hip fracture risk P=0.420 and major osteoporotic risk fracture P=0.398 was found comparing patients who had been at high risk for development of acute exacerbations with those at low risk. Although the risk for hip fracture in groups of patients on low and moderate dose of inhaled corticosteroids was increased (5.45% and 3.60%) in relation to group without inhaled corticosteroids, statistically there was no significant difference between groups for hip or major osteoporotic risk fracture (P=0.410 and P=0.328). Patients in GOLD groups 3 and 4 didn’t have a statistically significantly increased risk for hip fracture and major osteoporotic fracture compared to patients in GOLD groups 1 and 2 (P=0.363 and P=0.644). Conclusions: This research has shown that most COPD patients have a high risk for hip fracture, but not for a major osteoportic fracture. However, a statistically significantly greater risk wasn’t found in patients with high risk for development of acute exacerbations compared to low risk patients. Furthermore greater risk wasn’t found in patients on higher daily doses of inhaled corticosteroides opposite to those on low doses or those who didn’t take any inhaled corticosteroides. No increased risk of fractures was found in patients with higher (GOLD groups 3 and 4) compared to those with lower grade of airflow limitation (GOLD groups 1 and 2). Further research with a larger number of subjects is neccessary to draw correct conclusion.

Cilj istraživanja: Ciljevi istraživanja bili su odrediti ekspresiju proteina SATB1 i Ki-67 iz arhiviranih uzoraka fiksiranih stanica suspenzija koštane srži bolesnika s AML-om i MDS-om i utvrditi moguće korelacije njihove ekspresije s kontrolnom skupinom, kliničko-patološkim podatcima i citogenetičko-prognostičkim skupinama. Ispitanici i metode: U ovo retrospektivno istraživanje bilo je uključeno 30 bolesnika iznad 18 godina, s dijagnozom AML-a i MDS-a u ispitivanoj skupini. Kontrolna skupina ispitanika uključivala je 23 bolesnika koji su podvrgnuti biopsiji koštane srži u dijagnostičke svrhe, a u kojih je isključena maligna bolest hematopoetskog sustava. Svi bolesnici obrađeni su pri Klinici za dječje bolesti KBC-a Split, u razdoblju od lipnja 2018. do svibnja 2021. Prikazani su podatci o citogenetičkom nalazu, spolu, dobi, broju leukocita, eritrocita, trombocita, koncentraciji hemoglobina i laktat dehidrogenaze u vrijeme inicijalne dijagnoze. Analiza uzoraka stanica koštane srži izvršila se imunofluorescencijom, metodom dvostrukog bojanja. Rezultati: U ovom istraživanju pronađene su slične ekspresije SATB1 (P=0,101) i Ki-67 (P=0,149) u ispitivanoj i kontrolnoj skupini. U studiji smo pokazali niže ekspresije SATB1 ovisno o citogenetičkom nalazu u usporedbi s kontrolnom skupinom, a 91% bolesnika iz skupine AML/MDS s kompleksnim kariotipom ima negativnu ekpresiju na SATB1 (P=0,045). Srednja vrijednost dobi u ispitivanoj skupini bolesnika s negativnom ekspresijom na SATB1 bila je 68,53 godina, dok je srednja vrijednost dobi u bolesnika s pozitivnom ekspresijom bila 55 godina (P=0,082). Srednje vrijednosti ekspresije Ki-67 u kontrolnoj (25,96%) i ispitivanoj skupini (24,77%) bile su gotovo podjednake. Zaključci: Kromatin remodelirajući protein, SATB1, ima nedostatnu ekspresiju u specifičnom biološkom entitetu mijeloidnih poremećaja ovisno o citogenetičkom nalazu, a najniža ekspresija se pokazala u bolesnika muškog spola, starije životne dobi i s kompleksnim kariotipom te može biti važan čimbenik u leukemogenezi., Objectives: The aim of the study was to determine expression of SATB1 and Ki-67 in archived bone marrow aspirate samples of patients with AML and MDS and the correlation of their expression with control group, clinical-pathological information and cytogenetic risk categories. Materials and methods: This retrospective study included 30 patients above age of 18 with the diagnosis of AML and MDS. Control group consisted of 23 patients, without hematologic malignancy, who underwent bone marrow biopsy for diagnostic purposes. All patients were processed in Cytogenetics laboratory of the Clinic for Children's Diseases of the University Hospital of Split from June 2018. until May 2021. Data included cytogenetic findings, gender, age, blood cell count, hemoglobin concentration and lactate dehydrogenase levels at the diagnosis. Bone marrow specimen were analyzed using double immunofluorescence staining. Results: This study showed similar expression of SATB1 (P=0,101) and Ki-67 (P=0,149) in examined and control group of patients. There was significantly lower SATB1 expression depending on cytogenetic findings (P=0,045), in comparison to control group, and 91% of patients with complex karyotype had negative SATB1 expression. Mean age of patients in examined group with negative SATB1 expression was 68,53 years, while the mean age of those with positive SATB1 expression was 55 years (P = 0,082). Mean values of Ki-67 were almost equal, 25,96% and 24,77% in control and examined group, respectively. Conclusions: Chromatin-remodeling protein, SATB1, expression was inadequate in specific biologic entity of myeloid disorders depending on cytogenetic findings, and the lowest expression was found in males of older age, and complex karyotype, which suggest that it can play an important role in leukemogenesis.

Cilj istraživanja: Glavni cilj istraživanja bio je procijeniti prevalenciju šećerne bolesti i predijabetesa u bolesnika s PTSP-om. Ispitanici i postupci: U istraživanje je bilo uključeno 100 veterana koji su se najmanje godinu dana liječili od PTSP-a kroz Program oporavka od traume. Svi ispitanici su bili muškarci. Istraživanje je provedeno u Kliničkom bolničkom centru Split u period od travnja 2018. do svibnja 2019. Ispitanicima su izmjerene antropometrijske mjere, arterijski tlak te vrijednost HbA1c. Ispitanici su podijeljeni u dvije skupine na osnovu vrijednosti HbA1c. U skupinu ispitanika kojima je dijagnosticirana šećerna bolesti i predijabetes uključeno je 54 ispitanika, a u skupinu ispitanika kojima nije dijagnosticirana šećerna bolesti i predijabetes uključeno je 46 ispitanika. Rezultati: Od 100 ispitanika s PTSP-om, prema vrijednostim HbA1c, šećerna bolest je dijagnosticirana u 20% ispitanika, dok je predijabetes ustanovljen u 34% ispitanika. Od ukupnog broja ispitanika kojima je dijagnosticirana šećerna bolest, 35% ispitanika nije znalo da boluje od šećerne bolesti, dok svi ispitanici kojima je dijagnosticiran predijabetes nisu znali za postojanje istog. Skupina ispitanika s PTSP-om i dijagnosticiranom šećernom bolesti i predijabetesom imala je statistički značajno veću masu (P=0,023), indeks tjelesne mase (P=0,027), opseg struka (P=0,012) u odnosu na skupinu ispitanika kojima nije dijagnosticirana šećerna bolest i predijabetes. Statistički značajno više ispitanika s arterijskom hipertenzijom (P=0,030) i hiperlipidemijom (P=0,020) je bilo u skupini ispitanika s PTSP-om s dijagnosticiranom šećernom bolesti i predijabetesom. Zaključci: Ovo istraživanje dokazalo je veliku prevalenciju šećerne bolesti i predijabetesa u bolesnika s PTSP-om i veliki postotak nedijagnosticirane šećerne bolest i predijabetesa. Bolesnici s PTSP-om i šećernom bolesti ili predijabetesom imaju veći indeks tjelesne mase, opseg struka, učestalije arterijsku hipertenziju i hiperlipidemiju u odnosu na bolesnike s PTSP-om koji nemaju šećernu bolest ili predijabetes., Objectives: The main aim of the study was to assess the prevalence of diabetes and prediabetes in patients with PTSD. Subjects and Procedures: The study included 100 male veterans who had been treated for PTSD through a trauma recovery program for a minimum period of one year. The study was conducted at the Clinical Hospital Center Split in the period from April 2018 to May 2019. The subjects were measured anthropometric measures, arterial pressure and HbA1c. Subjects were divided into two groups based on HbA1c values. The group of subjects diagnosed with diabetes and prediabetes included 54 subjects, and the group of subjects who were not diagnosed with diabetes and prediabetes included 46 subjects. Results: Out of 100 subjects with PTSD, according to HbA1c values, diabetes was diagnosed in 20% of subjects, while prediabetes was diagnosed in 34% of subjects. Out of total number of subjects diagnosed with diabetes, 35% of subjects were not aware they had diabetes, while all subjects diagnosed with prediabetes did not know of its existence. The group of subjects with PTSD and diagnosed diabetes and prediabetes, statistically had a significantly higher weight (P=0,023), body mass index (P=0,027), waist circumference (P=0,012) compared to the group subjects who were not diagnosed with diabetes and prediabetes. Statistically, significantly more subjects with arterial hypertension (P=0,030) and hyperlipidemia (P=0,020) were in the group of subjects with PTSD diagnosed with diabetes and prediabetes. Conclusions: This study demonstrated a high prevalence of diabetes and prediabetes in patients with PTSD and a high percentage of undiagnosed diabetes and prediabetes. Patients with PTSD and diabetes or prediabetes have a higher body mass index, waist circumference, more frequent arterial hypertension, and hyperlipidemia compared with patients with PTSD who do not have diabetes or prediabetes.

Cilj istraživanja: Utvrditi utjecaj inzulina glargin U-300 i inzulina degludec na vrijednosti hemoglobina, hematokrita, broja eritrocita, trombocita, leukocita i CRP-a te utvrditi postoji li razlika u njiovom utjecaju na te iste parametre. Metode i materijali: Ovo istraživanje koristilo je podatke iz ukrižene studije naziva „Usporedba učinaka inzulina degludec i glargin U-300 na glukovarijabilnost, oksidacijski stres i parametre krvožilne funkcije u bolesnika sa šećernom bolešću tipa 2“. U nju je ukupno bilo regrutirano 25 pacijenta, a za izradu ovog rada korišteni su i statistički obrađeni podaci njih 19. Prosječna dob ispitanika bila je 57,6 godina. Ispitanici su u studiju bili uključivani pojedinačno, te su randomizrani u dvije skupine. Jedna skupina je istraživanje započela terapijom inzulinom glargin U-300 (n=11), a druga s inzulinom degludec (n=7). Nakon završetka terapije prvim inzulinom uslijedio je wash out period i nakon njega su ispitanici započeli terapiju drugim inzulinom. Sumirani su podaci za jedan i za drugi inzulin. Parametri promatrani u ovom radu (Hgb, Hct, broj eritocita, trombocita, leukocita i CRP) mjereni su iz krvi ispitanika. Svakom ispitaniku uzorak krvi uzet je u 4 točke, tj. svaki put prije početka terapije jednim od inzulina i nakon terapije svakim od inzulina. Rezultati: Terapija inzulinom glargin U-300 nije dovela do statički značajne promjene niti jednog od promatranih parametara. Aritmetička sredina iznosi za: Hgb 0,716 (P=0,302), Hct -0,009 (P=0,61), broj eritrocita 0,08 (P=0,244), broj trombocita -13,474 (P=0,20), broj leukocita -0,221 (P= 0,612) i CRP -0,716 (P=0.472). Ni terapija inzulinom degludec nije dovela do statistički značajne promjene niti jednog od navedenih parametara. Aritmetička sredina iznosi za: Hgb 0,527 (P=0,769), Hct 0,001 (P=0,859), broj eritrocita 0,025 (P=0,675), broj trombocita -0,684 (P=0,897), broj leukocita 0.374 (p=0,274) i CRP 1,109 (P=0,317). Rezultati dobiveni za usporedbu inzulina međusobno također nisu pokazali statističku značajnost: Hgb 2,000 (P=0,323), Hct 0,010 (P=0,164), broj eritrocita 0,105 (P=0,221), broj trombocita 12,789 (P=0,362), broj leukocita 0,592 (P=0,317) i CRP -0,347 (P=0,806). Zaključak: Ni inzulin degludec ni inzulin glargin U-300 ne utječu na hematološke i upalne parametre promatrane u ovom radu, niti ima razlike u njihom učinku na navedene parametre., Objective: To determine the effect of insulin glargine U-300 and insulin degludec on the values of hemoglobin, hematocrit, erythrocyte count, platelet count, leukocyte count and CRP and to determine whether there is a difference in their effect on these same parameters. Methods and Materials: This study used data from a croosover study titled „Comparison of the impact of insulin degludec and glargine U-300 on the glucose variability, the oxidative stress and the vascular function in patients with diabetes mellitus type 2“. The study was conducted in the period from October 1, 2017 to July 2018 at KBC Split. Initially, 25 patients were recruited, and data of 19 patients were statistically processed and used for the preparation of this paper. The average age of the participants was 57,6 years. Subjects were included in the study individually, and then randomized into two groups. One group started the study with insulin glargine U-300 (n = 11) and the other with degludec insulin (n = 7). After the end of the first insulin therapy, a wash out period followed and after that the subjects started the second insulin therapy. At the end, the data for each insulin were summarized. The parameters observed in this study (Hgb, Hct, erythrocyte count, platelet count, leukocyte count and CRP) were measured from the subjects' blood. A blood sample was taken from each subject 4 times, each time before starting the treatment with one of the insulins and after the treatment with each of the insulins. Results: Glargine U-300 did not lead to a statically significant change in any of the observed parameters. The arithmetic mean is for: Hgb 0,716 (P=0,302), Hct -0,009 (P=0,61), erythrocyte count 0,08 (P=0,244), platelet count -13,474 (P=0,20), leukocyte count -0,221 (P=0,612) and CRP -0,716 (P=0,472). Neither degludec insulin therapy resulted in a statistically significant change in any of these parameters. The arithmetic mean is for: Hgb 0,527 (P=0,769), Hct 0,001 (P=0,859), erythrocyte count 0,025 (P=0,675), platelet count -0,684 (P=0,897), leukocyte count 0,374 (P=0,274) and CRP (P=0,317). The results obtained for comparing insulins with each other also did not show statistical significance: Hgb 2,000 (P=0,323), Hct 0,010 (P=0,164), erythrocyte count 0,105 (P=0,221), platelet count 12.789 (P=0,362), leukocyte count 0,592 (P = 0,317) and CRP -0,347 (P=0,806). Conclusion: Neither insulin degludec nor insulin glargine U-300 affected the haematological and inflammatory parameters observed in this study, nor any differences in their effect on these parameters were found.

Cilj: Svrha ovog istraživanja bila je usporediti rizike prijeloma u postmenopauzalnih žena s hipotireozom u odnosu na postmenopauzalne žene bez hipotireoze. Materijali i metode: Ovo istraživanje je provedeno u Regionalnom centru za dijabetes, endokrinologiju i bolesti metabolizma Kliničkog bolničkog centra Split. Podatci su prikupljani u razdoblju od 21. siječnja 2019. godine do 15. veljače 2020. godine. U istraživanju je sudjelovalo 19 postmenopauzalnih žena s hipotireozom i 19 kontrolnih ispitanica. Sve uključene ispitanice su anketirane za vrijeme redovnih pregleda. Za prikupljanje podataka o ispitanicama korišten je anketni upitnik, nalaz denzitometrije iz kojih je izračunat FRAX i nalaz TBS-a. Rezultati: Nisu pronađene statistički značajne razlike između skupine ispitanica s hipotireozom i kontrolne skupine u prosječnoj vrijednosti BMD-a kuka (P=0,76), prosječnoj vrijednosti BMD-a vrata bedrene kosti (P=0,45), kao ni u prosječnoj vrijednosti BMD-a slabinske kralježnice (P=0,85). Skupina ispitanica s hipotireozom i kontrola skupina je imala osteopeniju prema nalazu prosječne T-vrijednosti vrata bedrene kosti i slabinskog dijela kralježnice, ali nije ustanovljena statistički značajna razlika među promatranim skupinama u T-vrijednostima (P=0,41 te P=0,86). Skupina ispitanica koje su liječene zbog hipotireoze, u odnosu na kontrolnu skupinu je imala nešto niže T-vrijednosti za kuk, ali nije ustanovljena statistički značajna razlika među promatranim skupinama (P=0,77). Prema rezultatima TBS-a slabinske kralježnice ispitanice s hipotireozom imale su narušenu mikroarhitekturu kosti, ali nije ustanovljena statistički značajna razlika među promatranim skupinama (P=0,48). Nijedna skupina ispitanica, prema rezultatima FRAX-a, nije imala visok desetogodišnji rizik za velike osteoporotičke prijelome ni za prijelome kuka i nije bilo statistički značajne razlike među promatranim skupinama u desetogodišnjem rizik za velike osteoporotičke prijelome (P=0,28) ni za prijelome kuka (P=0,17). Zaključak: Ovo istraživanje je pokazalo da su postmenopauzalne žene s hipotireozom imale podjednaku mineralnu gustoću kosti i trabekularnu strukturu kosti u odnosu na zdrave postmenopauzalne žene. Rizik prijeloma u bolesnica s hipotireozom bio je jednak riziku prijeloma zdravih postmenopauzalnih žena., Objectives: The aim of this study was to compare risk fractures between postmenopausal women with hypothyroidism and postmenopausal women without hypothyroidism. Materials and methods: This study was conducted at the Regional Center for Diabetes, Endocrinology and Metabolic Diseases of the Clinical Hospital Center Split. Data were collected in the period from 21st of January 2019 to 15th of February 2020. It included a total of 19 postmenopausal women with hypothyroidism and 19 control subjects matched for age and BMI. All respondents were interviewed during regular examinations. A survey questionnaire, densitometry findings from which FRAX was calculated, and TBS findings were used to collect data on the respondents. Results: Statistically significant differences weren't found between group of subjects with hypothyroidism and control group in mean values of BMD for hip (P=0,76), mean values of BMD for femoral neck (P=0,45) and in mean values of BMD for lumbar spine (P=0,85). Group of subjects with hypothyroidism and control group had osteopenia according findings of average T-score at femoral neck, but there was no statistically significant differences between observed groups in T-score (P= 0,41 and P=0,86). Group of subjects that were under treatment of hypothyroidism, compared to control group, had lower T-score for hip, but there was no significant differences between observed groups (P=0,77). According to results of TBS for lumbar spine, group of subjects with hypothyroidism had impaired microarchitecture bone, but no statistically significant difference was found between the observed groups (P=0,48). Both groups of subjects, according to the results of FRAX, did not have a high 10-year probability of a major osteoporotic fracture and hip fracture and there was no statistically significant difference between the observed groups in the 10-year probability of a major osteoporotic fracture (P=0,28) and hip fracture (P=0,17). Conclusions: This study showed that postmenopausal women with hypothyroidism had equal bone mineral density and bone trabecular structure compared to healthy postmenopausal women. The risk of fracture in patients with hypothyroidism was equal to the risk of fracture in healthy postmenopausal women.

Uvod: Bolesnici s kroničnom bubrežnom bolesti (KBB) imaju visoku učestalost arterijske hipertenzije (AH) te visok kardiovaskularni rizik koji se povećava s progresijom KBB. Poremećaji nutritivnog statusa česti su u bolesnika s KBB i predstavljaju netradicionalni čimbenik kardiovaskularnog rizika. Cilj navedenoga istraživanja bio je istražiti povezanost čimbenika kardiovaskularnog rizika (AH, prekomjerne tjelesne težine, albuminurije, lipidograma) s nutritivnim statusom (antropometrijskim parametrima i sastavom tijela) bolesnika s KBB i AH. Nadalje, cilj je bio i istražiti učestalost rezistentne arterijske hipertenzije (RAH) te prekomjerne tjelesne težine i pretilosti među ovom populacijom bolesnika, te istražiti postoje li razlike u ispitivanim parametrima kardiovaskularnog rizika i nutritivnog statusa s obzirom na spol, indeks tjelesne mase (ITM) i postojanja RAH. Također, cilj je bio istražiti i povezanost albuminurije s parametrima nutritivnog statusa. Materijali i metode: U istraživanje su uključena 32 ispitanika s KBB i AH, medijan dobi 67,5 (IQR=19), 19 (59,38%) muškaraca i 13 (40,62%) žena. Glavne mjere ishoda za svakog ispitanika u istraživanju bile su ITM, omjer struk/visina (WHtR), postotak masnog tkiva izmjeren kaliperom, razina glomerularne filtracija (GF), vrijednosti centralnog sistoličkog (CSKT) i dijastoličkog krvnog tlaka (CDKT), perifernog sistoličkog (PSKT) i dijastoličkog krvnog tlaka (PDKT), srednjeg arterijskog tlaka (MAP) te pulsnog tlaka (PP) za centralni (CMAP, CPP) i periferni krvni tlak (PMAP, PPP), količina mišićnog i masnog tkiva izražena u postotcima i kilogramima, količina visceralnog masnog tkiva i masa bezmasnog tkiva izražene u kilogramima te skeletna mišićna masa izražena u kilogramima i postotcima. Svim ispitanicima određene su i vrijednosti: ureje, kalcija, glukoze, triglicerida, kolesterola – ukupnog, LDL (engl. low-density lipoprotein) kolesterola, albumina, hemoglobina, kreatinina, urata te razina albuminurije. Za mjerenja arterijskog tlaka u ovoj studiji korišten je uređaj „Agedio B900“, koji na neinvazivan način mjeri centralni i periferni arterijski tlak, a za procjenu sastava tijela koristilo se Tanita MC780 Multi Frequency segmentni analizator sastav tijela. Rezultati: Rezultati ukazuju kako su muškarci imali statistički značajno više vrijednosti albuminurije (P= 0,016), mase bezmasnog tkiva (P=0,001), mišićne mase (P=0,001), skeletne mišićne mase izražene u kilogramima i postotcima (P=, Introduction: There is a high frequency of arterial hypertension (AH) among patients suffering of chronic kidney disease (CKD), as well as a high cardiovascular risk that increases along with CKD’s progression. Nutritional status disorders often manifest at CKD patients and represent a non-traditional factor of cardiovascular risk. The goal of this research is to explore the connection between the factors of cardiovascular risks (AH, excessive body weight, albuminuria, lipidogram) and nutritional status (anthropomorphic parameters and body composition) of patients with CKD and AH. Furthermore, the goal is also to investigate the occurrence frequency of resistant arterial hypertension (RAH) as well as overweight and obesity within this patient population and analyse the data for differences in the examined parameters of cardiovascular risk and nutritional status with respect to gender, body mass index (BMI) and the existence of RAH. Likewise, the goal was to research the connection of albuminuria with the parameters of nutritional status. Materials and methods: The study involves 32 patients with CKD and AH, age median 67.5 (IQR=19), 19 (59.38%) men and 13 (40.62%) women. The main outcome measures for every patient in the study were BMI, waist to height ratio (WHtR), percentage of body fat measured by a caliper, level of glomerular filtration (GF), worth of central systolic (CSBP) and diastolic blood pressure (CDBP), peripheral systolic (PSBP) and diastolic blood pressure (PDBP), mean arterial pressure (MAP), pulse pressure (PP) for central (CMAP, CPP) and peripheral blood pressure (PMAP, PPP), quantity of muscle and mass tissue expressed in percentage and kilograms, quantity of visceral mass tissue and fat free mass expressed in kg and skeletal muscle mass expressed in kilograms and percentages. All patients were subjected to value determination of following: urea, calcium, glucose, triglycerides, cholesterol – total, low-density lipoprotein (LDL) cholesterol, albumin, haemoglobin, creatinine, urate and albuminuria. “Agedio B900” was used for the measuring of arterial pressure in this study, a device that measures central and peripheral arterial pressure in a non-invasive matter. For assessing body composition Tanita MC780 Multi Frequency segment analyser was used. Results: Results display a statistically significantly higher values of albuminuria (P=0.016), fat free mass (P=0.001), muscle mass (P=0.001), skeletal muscle mass expressed in kg and percentage (P

Svrha istraživanja: Cilj ovog istraživanja jest analizirati čimbenike rizika u bolesnika sa STE-ACS i bolesnika s NSTE-ACS. Ispitanici i metode: U ovo presječno istraživanje je uključeno 37 ispitanika s akutnim koronarnim sindromom koji su liječeni u Klinici za kardiologiju Kliničkog bolničkog centra Split. Podatci o ispitanicima prikupljeni su iz anketnih upitnika. Ispitanici su podijeljeni u dvije skupine: 19 bolesnika u skupini STE-ACS te 18 bolesnika u skupini NSTE-ACS. Rezultati: U ovom istraživanju između skupina bolesnika sa STE-ACS i NSTE-ACS nije bilo statistički značajne razlike u zastupljenosti prema spolu (P=0.749), dobi (P=0.88) i nije bilo značajne razlike u prosječnoj vrijednosti indeksa tjelesne mase (P=0.347). Nadalje, skupine ispitanika sa STE–ACS i NSTE-ACS nisu se statistički razlikovale u zastupljenosti arterijske hipertenzije (P=0.50), šećerne bolesti (P=0.08), displipidemije (P=0.94) i pušenja (P=0.13). Zaključak: Ovo istraživanje je pokazalo da bolesnici liječeni zbog STE-ACS značajno se ne razlikuju od bolesnika s NSTE-ACS prema dobi, spolu i indeksu tjelesne mase. Bolesnici sa STE-ACS nemaju značajno veću zastupljenost arterijske hipertenzije, šećerne bolesti, displipidemije i pušača u odnosu na bolesnika s NSTE-ACS., Objectives: The purpose of this study was to evaluate risk factors in patients with acute coronary syndrome with ST segment elevation and without ST segment elevation. Materials and methods: This cross-sectional study included 37 patients with acute coronary syndrome treated at Department of cardiology of University Hospital of Split. Personal data were collected from poll. Patients were divided in two groups: 19 in STE-ACS group and 18 in NSTE-ACS group. Results: In this study there was no statistical difference between groups by sex (P=0.749), age (P=0.88) and there was no statistical difference in average value of body mass index (P=0.347). Furthermore, STE-ACS and NSTE-ACS groups had no statistical differences in prevalence of: arterial hypertension (P=0.50), diabetes (P=0.08), dyslipidemia (P=0.94) and smoking (P=0.13). Conclusion: This study showed that patients treated from STE-ACS are not statistically different from patients treated from NSTE-ACS by: age, sex and body mass index. Patients with STE-ACS have no statistically bigger prevalence of: arterial hypertension, diabetes, dyslipidemia and smoking in relation with patients with NSTE-ACS.

Ciljevi : Cilj ovog istraživanja bio je procijeniti rizik prijeloma u žena liječenih zbog karcinoma dojke u odnosu na postmenopauzalne žene bez karcinoma dojke. Materijali i metode: Istraživanje je provedeno u Regionalnom centru za dijabetes, endokrinologiju i bolesti metabolizma Kliničkog bolničkog centra Split. U istraživanju je sudjelovalo 86 postmenopauzalnih žena. Glavnu skupinu činile su 43 ispitanice koje su liječene od karcinoma dojke, a kontrolnu skupinu 43 ispitanice koje nisu bolovale od karcinoma dojke. Za prikupljanje podataka o ispitanicama korišten je anketni upitnik, nalaz denzitometrije iz kojih se računao FRAX te nalaz TBS-a. Rezultati: Ispitanice liječene zbog karcinoma dojke i postmenopauzalne žene koji nisu liječene zbog karcinoma dojke imali su niže vrijednosti BMD-a, a prema prosječnoj T- vrijednosti na vratu bedrene kosti obje skupine ispitanica imale su osteopeniju. Rezultati su pokazali da nema statistički značajnih razlika među promatranim skupinama u vrijednostima BMD lumbalne kralježnice (P= 0,07), BMD kuka (P= 0,15) i BMD vrata bedrene kosti (P= 0,29), kao i u T-vrijednosti za lumbalnu kralježnicu (P= 0,14), T-vrijednosti za kuk (P= 0,171) i T-vrijednost za vrat bedrene kosti (P=0,17). Ispitanice liječene zbog karcinoma dojke i zdrave, postmenopauzalne žene imale su narušenu mikroarhikteturu kosti, ali nije ustanovljena statistički značajna razlika među promatranim skupinama u TBS -u (P=0,55). Naposljetku, obje skupine ispitanica, prema rezultatima FRAX-a, nisu imale visok desetogodišnji rizik za velike osteoporotične prijelome i prijelome kuka i nije bilo statistički značajne razlike među promatranim skupinama u desetogodišnjem riziku za velike osteoporotične prijelome (P= 0,49) i prijelome kuka (P= 0,62). Zaključak: Naše istraživanje je pokazalo da su bolesnice liječene zbog karcinoma dojke imale podjednaku mineralnu gustoću kosti i trabekularnu strukturu kosti u odnosu na zdrave, postmenopauzalne žene. Rizik prijeloma u bolesnica liječenih zbog karcinoma dojke bio je jednak riziku prijeloma zdravih, postmenopauzalnih žena. Daljnja istraživanja s većim uzorkom su potrebna kako bi se mogli donositi zaključci., Objectives: The aim of this study was to assess fracture risk in women treated for breast cancer compared to postmenopausal women without breast cancer. Materials and methods: The research was conducted at the Regional Center for Diabetes, Endocrinology and Metabolism Diseases of the Clinical Hospital Center Split. 86 postmenopausal women participated in the study. The main group consisted of 43 subjects treated for breast cancer, and the control group consisted of 43 subjects who did not have breast cancer. To collect data on subjects we used a survey questionnaire, TBS results and densitometry findings from which FRAX was calculated. Results : Subjects treated for breast cancer and postmenopausal women not treated for breast cancer had lower BMD values, and according to the average T-score in the femoral neck, both groups of subjects had osteopenia. The results showed that there were no statistically significant differences between the observed groups in the BMD values of the lumbar spine (P=0,07), hip (P=0,15) and femoral neck (P=0,29), as well as in the T-scores for the lumbar spine (P=0,14), hip (P=0,171) and femoral neck (P=0,17). Subjects treated for breast cancer and healthy, postmenopausal women had impaired bone microarchitecture, but no statistically significant difference was found between the observed groups in TBS (P=0,55). Finally, both groups of subjects, according to FRAX results, did not have a high ten-year risk neither for major osteoporotic fractures nor hip fractures and there were no statistically significant differences between the observed groups in the ten-year risk for major osteoporotic fractures (P=0,49) and hip fractures (P=0,62). Conclusion: : Our study showed that patients treated for breast cancer had equal bone mineral density and trabecular bone structure compared to healthy, postmenopausal women. The fracture risk in patients treated for breast cancer was equal to the fracture risk in healthy, postmenopausal women. Further research with a larger sample is neccessary in order to draw more detailed conclusions.

Uvod: Cilj navedenoga istraživanja je bio istražiti povezanost čimbenika kardiovaskularnog rizika s nutritivnim statusom bolesnika s funkcionalnim transplantiranim bubregom i arterijskom hipertenzijom (AH). Materijali i metode: U istraživanje je uključeno 55 bolesnika s funkcionalnim transplantiranim bubregom i AH, medijan dobi bio je 63 godine, 33 muškarca (60%) i 22 (40%) žene. Za svakog ispitanika prikupljeni su podatci o spolu, dobi, tjelesnoj težini i visini, opsegu struka i nadlaktice te su izračunati indeks tjelesne mase (ITM), omjer struka i visine (WHtR) te razina glomerularne filtracije (GF). Također, uvidom u medicinsku dokumentaciju prikupljeni su podatci o duljini liječenja dijalizom prije TX, vremenu protekolom od TX bubrega, vrsti i broju antihipertenzivnih lijekova te su određeni biokemijski parametri. Uređaj „Agedio B900“ korišten je za mjerenje centralnog i perifernog arterijskog tlaka te su njime dobiveni podatci za vrijednosti centralnog sistoličkog (CSKT) i dijastoličkog krvnog tlaka (CDKT), perifernog sistoličkog (PSKT) i dijastoličkog krvnog tlaka (PDKT), srednjeg arterijskog tlaka (MAP) te pulsnog tlaka (PP) za centralni (CMAP, CPP) i periferni krvni tlak (PMAP, PPP). Za procjenu sastava tijela korišten je Tanita MC780 Multi Frequency segmentni analizator pomoću kojeg su dobiveni podatci o tjelesnoj masnoći (kg, %) te masi visceralnog masnog tkiva. Rezultati: Od ukupnog broja ispitanika 21 (38,18%) ispitanik imao je RAH, a 17 (30,90 %) KBB. Usporedbom ispitivanih parametara s obzirom na postojanje RAH rezultati ukazuju kako su ispitanici s RAH bili statistički značajno stariji (P=0,032) dok značajne razlike u drugim ispitivanim parametrima nije zabilježeno. Rezultati su pokazali kako je 38 (69%) ispitanika imalo prekomjernu tjelesnu težinu (ITM ≥ 25 kg/m2), a među njima je 12 (22,64%) ispitanika bilo pretilo (ITM > 30 kg/m2). Statistički značajni pozitivni prediktori PSAT bili su ITM (β (SE) 1,71 (0,55), P= 0,003), opseg nadlaktice (β (SE) 0,95 (0,43), P= 0,032), opseg struka (β (SE) 0,41 (0,18), P= 0,025), WhTR (β (SE) 85,22 (36,2), P= 0,023), količina masnog tkiva izražena u postocima (β (SE) 0,6 (0,27), P=0.,030), količina masnog tkiva izražena u kilogramima (β (SE) 0,69 (0,25), P=0,008 te visceralno masno tkivo (β (SE) 1 (0,42), P=0,021) Nadalje, statistički značajni pozitivni prediktori CSAT su ITM (β (SE) 1,38 (0,55), P= 0,016) i opseg nadlaktice (β (SE) 1,02 (0,44), P= 0,025). Zaključak: Rezultati istraživanja pokazali su visoku učestalost RAH, KBB te prekomjerne težine i pretilosti u bolesnika s transplantiranim bubregom i AH te ukazali na njihovu moguću povezanost., Introduction:The aim of our study was to evaluate correlations between cardiovascular (CV) risk factors and parameters of nutritional status in renal transplant recipients (RTRs) with functioning kidney graft and arterial hypertension (AH). Materials and methods: Subjects of our study were 55 hypertensive RTRs, age median 63, of whom 33 men (60%) and 22 women (40%). Data about sex, age, body weight and height, waist circumference and upperarm circumference was collected and body mass index (BMI), waist-to-height ratio (WHtR) and glomerular filtration rate (eGFR) were calculated for each study subject. Also, data about length of dialysis treatment before kidney transplantation (KTX), time after KTX, quantity and type of antihypertensive drugs were collected as well as laboratory parameters. “Agedio B900” device was used for assessment of central and peripheral blood pressure and data about central systolic (CSBP) and diastolic blood pressure (CDBP), peripheral systolic (PSBP) and diastolic blood pressure (PDBP), mean arterial pressure (MAP), pulse pressure (PP) for central (CMAP, CPP) and peripheral blood pressure (PMAP, PPP) was collected. Body composition was assessed by Tanita MC780 Multi Frequency segment analyser and data about body fat (%, kg) and visceral body fat were collected. Results: Out of 55 RTRs, 21 (38.18%) had RAH, 17 (30.90 %) had CKD. When we compared assesed parameters regarding persistence of RAH, results showed that RTRs with RAH were statistically significantly older (P=0.032), but we found no further difference in nutritional status or CV risk parameters. Results showed that 38 (69%) RTRs were overweight (BMI ≥ 25 kg/m2) and among them 12 (22.64%) were obese (BMI > 30 kg/m2 ). Statistically significant positive predictors of PSBP were BMI (β (SE) 1,71 (0,55), P= 0,003), upperarm circumference (β (SE) 0,95 (0,43), P= 0,032), waist circumference (β (SE) 0,41 (0,18), P= 0,025), WhTR (β (SE) 85,22 (36,2), P= 0,023), fat mass in percentage (β (SE) 0,6 (0,27), P=0.,030), fat mass in kilograms (β (SE) 0,69 (0,25), P=0,008 and visceral fat tissue (β (SE) 1 (0,42), P=0,021) Furthermore, statistically significant positive predictors of CSBP were BMI (β (SE) 1,38 (0,55), P= 0,016) and upperarm circumference (β (SE) 1,02 (0,44), P= 0,025). Conclusion: Results of our study showed high prevalence of RAH, CKD, obesity and overweight in hypertensive RTRs and suggested possible interconnection between these parameters.

Cilj istraživanja: Cilj istraživanja bio je ispitati i usporediti parametre koštane snage i rizika za prijelom između postmenopauzalnih žena koje boluju od šećerne bolesti tipa 2 (DM2) i zdravih postmenopauzalnih žena. Materijali i metode: U istraživanje je uključeno ukupno 26 postmenopauzalnih žena. Glavnu skupinu činilo je 12 postmenopauzalnih žena koje boluju od DM2, a kontrolnu skupinu 14 zdravih postmenopauzalnih žena. U istraživanje su uključene žene koje su došle na denzitometrijsko snimanje u Regionalni centar za dijabetes, endokrinologiju i bolesti metabolizma KBC-a Split u razdoblju od 15. siječnja 2019. do 15. ožujka 2020. godine. Ispitanice su ispunile anketni upitnik koji je obuhvatio osobne podatke i podatke potrebne za izračunavanje desetogodišnjeg rizika za prijelom pomoću Alata za procjenu rizika prijeloma (FRAX). Vrijednosti parametara koštane snage uzete su iz medicinske dokumentacije, a rizik za prijelom izračunat je pomoću FRAX-a koristeći podatke iz anketnog upitnika. Rezultati: Nije pronađena statistički značajna razlika u mineralnoj koštanoj gustoći (BMD) kuka, vrata bedrene kosti niti kralježaka L1-L4 između promatranih skupina (P=0,217, P=0,816, P=0,102). Prosječna vrijednost indeksa trabekularne strukture kosti (TBS) u skupini ispitanica s DM2 iznosila je 1,26±0,11 što znači da imaju narušenu mikroarhitekturu kosti, no nije pronađena statistički značajna razlika u usporedbi s kontrolnim ispitanicama (P=0,446). Desetogodišnji rizik za veliki osteoporotični prijelom i prijelom kuka u promatranim skupinama se također nisu statistički razlikovali (P=0,118, P=0,129). Zaključak: Ovo istraživanje je pokazalo da su postmenopauzalne žene s DM2 imale podjednaku mineralnu gustoću kosti i trabekularnu strukturu kosti u odnosu na zdrave, postmenopauzalne žene. Rizik za prijelom u postmenopauzalnih žena s DM2 bio je jednak riziku za prijelom zdravih, postmenopauzalnih žena., Aim: The aim of the study was to examine and compare the parameters of bone strength and fracture risk between postmenopausal women with type 2 diabetes (DM2) and healthy postmenopausal women. Patients and methods: A total of 26 postmenopausal women were included in the study. The main group consisted of 12 postmenopausal women with DM2, and the control group consisted of 14 healthy postmenopausal women. The study included women who came for densitometric imaging at the Regional Center for Diabetes, Endocrinology and Metabolic Diseases of the Clinical Hospital Center Split in the period from January 15, 2019 and March 15, 2020. Respondents completed a questionnaire that included personal data and data needed to calculate a ten-year fracture risk using the Fracture Risk Assessment Tool (FRAX). Values of bone strength parameters were taken from medical records, and fracture risk was calculated using FRAX and data from the survey questionnaire. Results: No statistically significant difference was found in bone mineral density (BMD) of the hip, femoral neck, or lumbar spine between the observed groups (P=0.217, P=0.816, P=0.102). The average value of the trabecular bone score (TBS) in the group of subjects with DM2 was 1.26±0.11, which means that they have impaired bone microarchitecture, but no statistically significant difference was found compared to control subjects (P=0.446). The ten-year risk for major osteoporotic fracture and hip fracture in the observed groups also did not differ statistically (P=0.118, P=0.129). Conclusion: This study showed that postmenopausal women with DM2 had equal bone mineral density and bone trabecular structure compared to healthy, postmenopausal women. The risk of fracture in postmenopausal women with DM2 was equal to the risk of fracture in healthy, postmenopausal women.

Cilj istraživanja: Prikazati klinička obilježja i laboratorijske parametre pri prijemu te moguće komplikacije bolesti u bolesnika koji su pod dijagnozom dijabetičke ketoacidoze zahtijevala intenzivno liječenje.Materijali i metode: U istraživanje su uključeni punoljetni ispitanici koji su zbog dijabetičke ketoacidoze liječeni na Intenzivnom odjelu Interne klinike KBC-a Split u razdoblju od 1.siječnja 2013. do 31. prosinca 2018. godine. Retrospektivno je analizirana medicinska dokumentacija. U radu se koriste metode grafičkog i tabelarnog prikazivanja kojima se prezentira struktura promatranih varijabli u odabranom šestogodišnjem razdoblju. Rezultati: U istraživanje su uključena 82 bolesnika,33 bolesnika su žene (40,24%), dok je muškaraca 49 (59,76%). Prosječna dob je bila 43 godine. Najčešći ishod liječenja je preživljenje, 81 put učestalije u odnosu na smrtni ishod, te je zastupljenost preživljavanja prevladavajuća (p, OBJECTIVES: To present clinical characteristics, laboratory parameters and possible complications of patients with diabetic ketoacidosis (DKA) requiring intensive care treatment at the time of admission. MATERIAL AND METHODS: The study included adult subjects who were treated for DKA in the Intensive Care Unit of the Internal Medicine Clinic of the University Hospital Split during the period from January 1st 2013. until December 31st 2018. Medical records were retrospectively analyzed. In thesis, methods of graphical and tabular presentation that present the structure of the observed variables in the selected six-year period, are being used. RESULTS: The study included 82 patients, 33 patients were women (40.24%), while men were 49 (59.76%). The mean age was 43 years. The most common treatment outcome was survival, 81 times more common than death, and the prevalence of survival was predominant (p

Cilj istraživanja: Cilj ovog istraživanja bio je utvrditi postoji li i kolika je promjena BeAM vrijednosti i prosječnih koncentracija glukoze u krvi ujutro natašte i navečer prije spavanja nakon korištenja bazalnog inzulina degludec, odnosno nakon korištenja bazalnog inzulina glargin U-300, odnosno utvrditi postoji li razlika između ova dva inzulina u učinku nanavedene parametre. Ispitanici i metode: Provedena je ukrižena studija koja je uključivala 22 ispitanika (7 žena i 15 muškaraca) s dijabetesom tipa 2. Podaci za ovu studiju dobiveni su mjerenjem glikemije koje se provodilo u 4 točke, prije i poslije korištenja bazalnog inzulina degludec te prije i poslije korištenja bazalnog inzulina glargin U-300. U svakoj točki glikemija se mjerila 3 dana u nizu u sedam standardiziranih termina Analizom vrijednosti glukoze pred spavanje i natašte u sve četiri točke izračunate su i uspoređene promjene BeAM vrijednosti i promjene samih vrijednosti glukoze natašte i pred spavanje nakon primjene svakog inzulina. Rezultati: Nije dokazano statistički značajno povećanje BeAM vrijednosti nakon uvođenja bazalnog inzulina degludec (Δ BeAM D = -0,038, P = 0,926, SD = 1,911). Također nije dokazano statistički smanjenje BeAM vrijednosti u pacijenata koji su primali glargin U-300 (Δ BeAM D = -0,038, P = 0,926, SD = 1,911). Uspoređujući razliku promjena BeAM vrijednosti nakon primjene glargina U-300 u odnosu na degludec nije pronađena statistički značajna razlika (Δ Δ BeAM = 0,315, P = 0,564, SD = 2,516). Dokazano je statistički značajno smanjenje prosječne koncentracije glukoze u krvi natašte ( Δ prosječna koncentracija glukoze u krvi D = 1,837, P = 0,012, SD = 3,139) i prije spavanja ( Δ prosječna koncentracija glukoze u krvi D = 1,799, P = 0,010, SD = 2,993) nakon uvođenja bazalnog inzulina degludec. Nije dokazano statistički značajno smanjenje prosječne koncentracije glukoze u krvi natašte (Δ prosječna koncentracija glukoze u krvi G = 1,11, P = 0,085, SD = 2,882) i prije spavanja (Δ prosječna koncentracija glukoze u krvi G = 1,386, P = 0,068, SD = 3,377) nakon uvođenja bazalnog inzulina glargin U-300. Uspoređujući razliku promjena prosječnih koncentracija glukoze natašte (Δ Δ prosječna koncentracija glukoze u krvi natašte = -0,728, P = 0,387 SD = 3,866) i prije spavanja (Δ Δ prosječna koncentracija glukoze u krvi navečer prije spavanja = -0,413, P = 0,663, SD = 4,374) nakon primjene degludeca u odnosu na glargin U-300 nisu pronađene statistički značajne razlike. Zaključci: Nije dokazano značajno povećanje BeAM vrijednosti nakon uvođenja bazalnog inzulina degludec, te značajno smanjenje BeAM vrijednosti nakon uvođenja bazalnog inzulina glargin U-300. Ovim istraživanjem nije dokazana značajna razlika u promjenama BeAM vrijednosti nakon korištenja bazalnog inzulina glargin U-300 u odnosu na bazalni inzulin degludec. Što se tiče prosječnih koncentracija glukoze ujutro natašte i navečer prije spavanja, ovo istraživanje je dokazalo značajno smanjenje tih koncentracija nakon uvođenja bazalnog inzulina degludec te nije dokazalo značajno smanjenje tih koncentracija nakon uvođenja bazalnog inzulina glargin U-300. Ovim istraživanjem nije dokazana značajna razlika u promjenama prosječnih koncentracija glukoze ujutro natašte i navečer prije spavanja nakon korištenja bazalnog inzulina glargin U-300 u odnosu na bazalni inzulin degludec., Objective: The aim of this study was to determine whether and how much there is a change in BeAM values and average fasting blood glucose levels and average pre-sleep blood glucose levels after using basal insulin degludec, or after using basal insulin glargine U-300, or to determine if there is a difference between these two insulins in effect on the above parameters. Patients and methods: A crossover study involving 22 subjects (7 women and 15 men) with type 2 diabetes U-300 was conducted. Data for this study were obtained by measuring glycemia performed at 4 points, before and after the use of basal insulin degludec and before and after the use of basal insulin glargine U-300. At each point, glycemia was measured for 3 consecutive days in seven standardized terms. By analyzing pre-sleep and fasting glucose levels at all four points, changes in BeAM values and changes in pre-sleep and fasting glucose levels after administration of each insulin were calculated and compared. Results: There was not statistically significant increase in BeAM values after introduction of basal insulin degludec (Δ BeAM D = -0.038, P = 0.926, SD = 1.911). There also was not statistically significant decrease in BeAM value in patients receiving glargine U-300 (Δ BeAM D = -0.038, P = 0.926, SD = 1.911). Comparing the difference in changes in BeAM values after application of U-300 glargine compared to degludec, no statistically significant difference was found (Δ Δ BeAM = 0.315, P = 0.564, SD = 2.516). There was a statistically significant decrease in the average fasting blood glucose concentration (Δ average blood glucose concentration D = 1,837, P = 0,012, SD = 3,139) and pre-sleep blood glucose concentration (Δ average blood glucose concentration D = 1,799, P = 0,010, SD = 2,993) after introduction of basal insulin degludec. Statistically significant decrease in average fasting blood glucose concentration (Δ average blood glucose concentration G = 1.11, P = 0.085, SD = 2.882) and pre-sleep blood glucose concentration (Δ average blood glucose concentration G = 1.386, P = 0.068, SD = 3,377) was not proved after the introduction of basal insulin glargine U-300. Comparing the difference between changes in average fasting glucose concentrations (Δ Δ average fasting blood glucose concentration = -0.728, P = 0.38 SD = 3.866) and pre-sleep blood glucose concentration (Δ Δ average pre-sleep blood glucose concentration = -0.413, P = 0.663, SD = 4.374) after application of degludec compared to glargine U-300 no statistically significant differences were found. Conclusion: There was not significant increase in BeAM value after the introduction of basal insulin degludec, and significant decrease in BeAM value after the introduction of basal insulin glargine U-300. This study did not prove significant difference in changes in BeAM value after use of basal insulin glargine U-300 compared to basal insulin degludec. Regarding average fasting blood glucose concentrations and pre-sleep blood glucose concentrations, this study showed significant decrease in these concentrations after the introduction of basal insulin degludec but significant decrease in these concentrations after the introduction of basal insulin glargine U-300 was not found. This study did not prove significant difference in changes in average fasting blood glucose concentrations and pre-sleep blood glucose concentrations after using basal insulin glargine U-300 compared to basal insulin degludec.