Search

Introduction/Objective. There is very limited data regarding the need for transfusion and its effect on the overall mortality of patients with coronavirus disease 2019 (COVID-19). The aim of our study is to determine the need for blood component transfusion in patents treated for COVID-19 infection. Methods. This retrospective observational study included 4426 COVID-19-positive patients treated at the Bežanijska Kosa University Hospital Medical Center between June 23, 2020 and May 2, 2021. Of these patients, 826 were treated in the intensive care units of the hospital. Of the total number of patients, 326 (7.4%) received transfusions. The clinical presentation, the structure of the applied transfusion therapy, the laboratory parameters, and the treatment outcome were analyzed in this study. Results. Of the 828 patients treated in the intensive care units, 151 (18.2%) patients required transfusion, while transfusion was necessary in a total of 4.9% of patients treated in the hospital wards. Of the total number of all transfused patients, 86% received erythrocytes, one-third of them received fresh frozen plasma, 10% received cryoprecipitate, while platelets were administered in around 6% of the patients. The mortality rate in the tested group was 46%. Conclusion. The frequency of the application of blood components was significantly higher in patients with a severe form of the disease. The presence of comorbidities did not affect the need for transfusion therapy. In the group of patients treated in the intensive care units, 85% received erythrocytes, 39% received fresh frozen plasma, 19% received cryoprecipitate and 7% received platelets.

The clinical efficacy of chemotherapy, as a recognized therapeutic approach for malignant diseases, usually has certain limitations due to its cardiotoxicity (CT) and consequent cardiomyopathy, or even heart failure. CT is defined as any cardiac injury connected with oncology treatment, whether it is chemo-, radio-, targeted or immunotherapy, or cancer by itself, and it represents a great challenge for clinicians in everyday practice. A wide spectrum of factors related to chemotherapy (type of drug, dose during each cycle, cumulative dose, schedule, method of application, combination with other cardiotoxic drugs or association with radiotherapy) and patient characteristics (age, presence of cardiovascular risk factors, previous cardiovascular disease) are the determining factors that influence the frequency of CT. Imaging methods for morphological and functional monitoring of the heart muscle are used for monitoring CT. The quest for diagnostic tools for early CT detection is of great significance. In line with this, the measurement of some cardiac biomarkers has found its place in clinical settings as an early determinant of myocardial injury. Therefore, in this review article, special attention will be paid to certain well-established, as well as certain novel cardiac biomarkers, and their role in recognizing asymptomatic CT, in order to gain deeper insight into their diagnostic utility.

Background/Aim. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global threat and a huge problem for our community. There are so many open questions. The aim of this study was to establish the frequency of gastrointestinal (GI) symptoms in hospitalized patients with infection caused by this virus (coronavirus disease-19 –COVID-19), but also to compare if patients with GI symptoms have a higher computed tomography (CT) scan severity score of interstitial pneumonia (IP) compared to patients with COVID-19 without GI symptoms. Methods. Our database comprised 322 patients with COVID-19 who were divided into two groups, patients with and without GI symptoms. All information was taken from anamnestic data and patients’ history, followed by statistical analysis. Results. Thorax CT scans of 206 patients (63.9%) were described as bilateral IP, of which 76 CT scans (36.9%) were described by radiologists as the peak of infection. Moreover, 130 patients (40.4%) had GI symptoms, and even 58 out of 130 patients (44.6%) reported GI symptoms as the first manifestation of COVID-19 infection. The most commonly reported one was the lack of appetite (73 patients or 56.15%). Furthermore, 65 (50%) patients reported diarrhea, 25 (19.2%) patients reported nausea and vomiting, and 9 (6.9%) patients reported abdominal pain. In addition, among patients with bilateral IP and GI tract symptoms, 31 (40.79%) of them did not have a higher CT scan severity score at the peak of the disease compared to the patients without GI symptoms (45 of them or 59.2%), (p = 0.704). Conclusion. GI symptoms often are the first manifestation of COVID-19. Therefore, every patient with newly formed digestive tract symptoms should be tested for COVID-19. On the other hand, GI symptoms do not indicate COVID-19 patients will have a severe form of IP.

At the end of December 2019, a certain number of patients with pneumonia of unknown etiology appeared in the Chinese city of Wuhan. The etiological agent of corona virus disease (COVID-19) was identified as a virus from the Coronaviridae family called Novel Coronavirus, or SARS-CoV-2 (Severe Acute Respiratory Coronavirus 2). COVID-19 took on the proportions of a pandemic. Therapeutic options for COVID-19 include antiviral, anticoagulant, corticosteroid, biological, antibiotic, multivitamin, symptomatic therapy, and oxygen support. Corticosteroid immunosuppressive and anti-inflammatory role is helpful for a disease with immune response dysregulation and excessive cytokine production. The effect of corticosteroids in the treatment of COVID-19 depends on disease severity, the time of initiation, and the appropriate dose. Individual risk/benefit assessment is required before initiating treatment. Corticosteroids have beneficial effects on patients on oxygen support, especially on those who are on mechanical ventilation. Their use in those with mild forms of the disease and comorbidities carries an increased risk of complications. The benefits of corticosteroids are shorter hospitalization, reduced admission in intensive care units, and reduced need for non-invasive and invasive mechanical ventilation. The results of previous research have facilitated the administration of corticosteroids in the treatment of patients with COVID-19 infection, but further research is needed to remove the existing doubts.

Obstructive sleep apnea (OSA) as a worldwide prevalent condition carries risk for cardiovascular and metabolic diseases, ultimately increasing overall mortality rates. Non-alcoholic fatty liver disease (NAFLD) can be considered as the primary metabolic disease, but also as a coexisting OSA comorbidity. Although prevalence of NAFLD covers quarter of world population, it increases with OSA presence. It can be speculated that chronic intermittent hypoxia (CIH) and sympathetic nervous system overactivity are involved in NAFLD pathogenesis and progression from simple steatosis through steatohepatitis to fibrosis. CIH provides the environment for liver oxidative stress, inflammation and increases the expression of genes involved in cholesterol and fatty acids synthesis. Catecholamines increase b-oxidation in liver and release free fatty acids from adipose tissue in plasma which inhibit insulin effects. Obesity and insulin resistance as key players in NAFLD development and advancement, deepen vicious circle of oxidative stress, inflammation and dyslipidemia. If not treated, OSA in NAFLD patients has been associated with inflammation, hepatocytes' necrosis, and fibrosis. Continuous positive airway pressure (CPAP) represents gold standard for OSA therapy, allowing the unimpeded air passage through upper parts of respiratory system. However, it has been demonstrated that CPAP therapy have beneficial effects on cardiometabolic outcomes and slow liver degeneration.

Patients with heart failure, reduced ejection fraction, and signs of myocardial dyssynchrony have a poor prognosis. Cardiac resynchronization therapy is a proven therapeutic modality that reduces symptoms of heart failure as well as morbidity and mortality in these patients. Better identification of patients who could benefit from cardiac resynchronization therapy is an important factor because a significant percentage of patients do not experience clinical improvement after CRT implantation. Cardiac magnetic resonance is a useful, non-invasive, sophisticated diagnostic tool that can provide useful information on the aetiology of heart failure and the severity of mechanical dyssynchrony of the left ventricle. It helps evaluate the myocardial scar burden, which can predict a possible unsatisfactory response to therapy and helps improve clinical outcomes by enabling optimal positioning of the LV lead. Cardiac magnetic resonance in patient follow up after CRT implantation is proven to have significant clinical value. Conclusion: Cardiac magnetic resonance is a non-invasive imaging modality that can provide better identification of the patients who could respond well to cardiac resynchronization therapy. By providing valuable information about the severity of mechanical dyssynchrony, the myocardial scar burden and optimal positioning of the LV lead, it is useful in improving clinical outcomes after CRT implantation.

Introduction. Hypokalemic thyrotoxic paralysis is a very rare form of periodic paralysis in Caucasian population. In this population, a more frequent form is familiar hypokalemic periodic paralysis with the same clinical presentation. It is flaccid paralysis of proximal muscles in extremities. Having in mind that clinical presentation of hyperthyroidism in these patients is milder than it could be expected with given values of thyroid hormones, differential diagnosis to other forms of hypokalemic paralysis is essential. Case report. We presented a case of a young male with hyperthyroidism and severe periodic flaccid paralysis particularly of leg muscles. Laboratory findings showed elevated thyroid hormones levels and hypokalemia during the attacks with normalized potassium levels between attacks. The patient had no relatives with the similar condition. Also, he never had anything like these attacks prior to development of hyperthyroidism. After differential diagnosis, other reasons for hypokalemic periodic paralysis were excluded. We intensified the hyperthyroidism treatment and resolved hypokalemic periodic paralysis attacks with potassium chloride (KCl) infusions. The patient was advised to start a definitive treatment of hyperthyroidism after stabilization of hormonal levels. Conclusion. Hypokalemic thyrotoxic paralysis is a rare and potentially dangerous condition which, if recognized, can be prevented by resolving hyperthyroxinemia and the use of nonselective β blockers.

Aims: Natriuretic peptide (NP) uptake varies in Emergency Departments (EDs) across Europe. The 'Peptide for Life' (P4L) initiative, led by Heart Failure Association, aims to enhance NP utilization for early diagnosis of heart failure (HF). We tested the hypothesis that implementing an educational campaign in Western Balkan countries would significantly increase NP adoption rates in the ED. Methods and results: This registry examined NP adoption before and after implementing the P4L‐ED study across 10 centres in five countries: Bosnia and Herzegovina, Croatia, Montenegro, North Macedonia, and Serbia. A train‐the‐trainer programme was implemented to enhance awareness of NP testing in the ED, and centres without access received point‐of‐care instruments. Differences in NP testing between the pre‐P4L‐ED and post‐P4L‐ED phases were evaluated. A total of 2519 patients were enrolled in the study: 1224 (48.6%) in the pre‐P4L‐ED phase and 1295 (51.4%) in the post‐P4L‐ED phase. NP testing was performed in the ED on 684 patients (55.9%) during the pre‐P4L‐ED phase and on 1039 patients (80.3%) during the post‐P4L‐ED phase, indicating a significant absolute difference of 24.4% (95% CI: 20.8% to 27.9%, P < 0.001). The use of both NPs and echocardiography significantly increased from 37.7% in the pre‐P4L‐ED phase to 61.3% in the post‐P4L‐ED phase. There was an increased prescription of diuretics and SGLT2 inhibitors during the post‐P4L‐ED phase. Conclusions: By increasing awareness and providing resources, the utilization of NPs increased in the ED, leading to improved diagnostic accuracy and enhanced patient care. [ABSTRACT FROM AUTHOR]

An abdominal aortic aneurysm rupture (AAAR) is an acute, potentially fatal clinical condition which needs to be treated surgically as soon as possible. The process of making the diagnosis and providing treatment for patients with this clinical condition exceeds by far the resources and capabilities of the Emergency Medical Service. However, if the possibility of this diagnosis is taken into account during first contact, initial treatment and transport of these patients to the hospital, it is possible to significantly shorten the time before the patient is taken to the operating room and the bleeding put under control. This is crucial for the survival of these patients. Therefore, the Emergency Medical Service does not have a passive role in treating patients with this condition, but rather is a crucial link that enables an adequate initial treatment and quick transport to a hospital capable of providing surgical treatment and is key to their survival. A standardized and generally accepted system of initial care and transport that is universally applicable in all healthcare systems for patients with AAAR does not exist, but teamwork and addressing possible problems in providing adequate care on all levels does provide a larger number of patients with a chance to survive the condition that is almost synonimous to death.

Introduction: Infection is the leading cause of complications in critically ill, and its presence significantly influences the treatment outcome. Empirical antibiotic therapy (EAT) is justified if limited to the time required for isolation and identification of pathogen, which is considered not to exceed 72 hours. Aim: the aim of this study was to determine the rate of prolonged empirical antibiotic therapy (PEAT) in adult intensive care unit (ICU)-treated patients at the third level hospital and to assess factors influencing the antibiotic prescription practice in the hospital. The study also aimed to assess in-hospital mortality in patients treated with empirical antibiotic therapy (EAT) and to find parameters that were associated with fatal outcome. Subjects and Methods: Prospective observational study involved 51 consecutive patient who underwent EAT. Demographic, clinical and laboratory data were collected. The rate of PEAT was determined as the ratio of the total number of patients who received EAT longer than 72 hours divided by the total number of patients who received EAT regardless the length of its duration. Results: the rate of PEAT was 80%. In patients with diagnosed infection, length of EAT depended on the time needed for bacteria isolation. However, EAT was introduced and even prolonged in 33% of patients, in which infection was never confirmed. In-hospital mortality was 20%, and factors associated with death outcome were ongoing sepsis and longer EAT. Conclusions: the practice of prescribing prolonged antibiotic therapy is very common in this study. This is associated with higher mortality, so it is necessary to find the cost-effective diagnostic method that helps in adjustment of rational empirical antibiotic treatment in ICU.

Introduction. Myxoma is the most common primary benign heart tumor. The most frequent location is the left atrium, the chamber of the heart that receives oxygen- rich blood from the lungs. Myxomas usually develop in women, typically between the ages of 40 and 60. Symptoms may occur at any time, but most often they are asymptomatic or oligosymptomatic for a long period of time. Symptoms usually go along with body position, and are related to compression of the heart cavities, embolization and the appearance of general symptoms. The diagnosis of benign tumors of the heart is based on anamnesis, clinical features and findings of the tumor masses by use of non-invasive and invasive imaging methods. Extensive surgical resection of the myxoma is curative with minimal mortality. Long term clinical and echocardiographic follow-up is mandatory. Case report. We reported a case of a 62-year-old male, presented with 15 days of intermittent shortness of breath, dizziness and feeling of heart palpitations and subsequently diagnosed with right atrial myxoma based on transthoracic echocardiography . The patient was emergently operated in our hospital. Long-term followup did not reveal recurrence. Conclusion. Our case was an atypical localisation of right atrial myxoma. Whether the intracardiac mass is benign or malignant, early surgery is obligatory in order to prevent complications.

The aim of this paper was to investigate the differences in morphometric characteristics and histological structure of m. semitendinosus, between gilts and barrows of German Landrace breed at the end of the fattening period. Morphometric characteristics (weight, length, diameter and cross sectional area) of m. semitendinosus were not significantly different, while gender as a factor influenced the histological properties of this muscle. A very high statistical difference (p

The small Green Monkey (Cercopithecus aethiops sabeus) in large groups inhabits the African savannah. The animals delivered to us were from East Africa, that is from Kenya, Uganda and Tanzania. The length of the animal is 110 cm, and the tail itself is 50 cm long. They can often be seen in Zoos. According to data, mostly by zoo gardens, these monkeys live for about 15 to 17 years, exceptionally for 20 years. The objective of our work was to investigate a part of their cardiovascular system so in that way to contribute to a better knowledge of this animal body structure and accordingly to comparative anatomy in general. The investigation included 6 Small Green Monkeys, of both gender, 3-4 years old, body weight 2000-3000 grams, obtained from The Institute for Virusology, vaccines and serums from Belgrade. For obtaining the hindlimb arterial vascularization, after exsanguination of the animal, contrast mass of gelatin coloured with tempera was injected into the abdominal aorta. After injecting, the blood vessels were prepared and photographed. In the Small Green Monkey, femoral artery (A. femoralis) is an continuation of the external iliac artery (A. iliaca externa). The branches of the femoral artery are: A. profunda femoris, A. saphena, A. genus descendens and A. caudalis femoralis. A. profunda femoris separates to A. circumflexa femoris lateralis, Ramus muscularis and A. circumflexa femoris medialis. In humans A. femoralis branches into: A. epigastrica superficialis, A. circumflexa ilium superficialis, Aa. pudendae externae, A. profunda femoris and A. genus descendens (A. descendens genus). A. profunda femoris branches into: A. circumflexa femoris lateralis, A. circumflexa femoris medialis and Aa. perforantes. In domestic animals, mammals, the branches of the femoral artery (A. femoralis) are: A. circumflexa femoris lateralis, A. saphena, A. genus descendens and Aa. caudales femoris In the Small Green Monkey, humans and domestic mammals A. femoralis branches into A. genus descendens. The femoral artery of both Small Green Monkey and humans branches into A. profunda femoris. In the Small Green Monkey and domestic mammala, A. femoralis branches into A. saphena and A. caudalis femoris, that is Aa. caudales femoris in domestic mammals, while in humans it branches into A. epigastrica superficialis, A. circumflexa ilium superficialis and Aa. pudendae externae. The branches of A. profunda femoris in the Small Green Monkey and humans are: A. circumflexa femoris lateralis, A. circumflexa femoris medialis, in the Small Green Monkey also Ramus muscularis, and in humans Aa. Perforantes, too. In domestic mammals A. circumflexa femoris lateralis is a branch of A. femoralis. Based on the results of our studying of the Small Green Monkey femoral artery (A. femoralis), we have concluded that some blood vessels branch from A. femoralis in the same way as in humans, and some as in domestic animals - mammals.

A ground squirrel is a hibernator, which hibernation lasts, depending on the age and sex, since the end of the summer until the spring. During this period in the body of ground squirrel, as well as in other hibernators, starts lowering of all vital functions, what has been proven by numerous physiological, biochemical and histological examinations of some organ systems of this animal. The objective of our work was to investigate a part of cardiovascular system of ground squirrel so in that way to contribute to a better knowledge of this animal body structure and accordingly to comparative anatomy in general. The investigation included 6 ground squirrels, of both gender, body weight 200-300 grams. For obtaining head and neck arterial vascularization, after exsanguination of the animal, contrast mass of gelatin coloured with tempera was injected into thoracic aorta (Aorta thoracica). After injecting, the blood vessels were prepared and photographed. For obtaining the corrosive preparations of head and neck arterial blood vessels, after exsanguination of the animal, Biocryl (a mixture of liquid biocryl - methil - methacrylate monomer and biocryl in powder - methil - methacrylate polymer) was injected into thoracic aorta (Aorta thoracica). After injecting the preparations were placed into 5% NaOH, for 96 hours or into 10% NaOH for 48 hours. After that they were rinsed in hot water and photographed. A. facialis in ground squirrel is an extension of A. maxillaris. The branches of A. facialis are: A. labialis inferior, A. bursae buccalis dorsalis, A. labialis superior, A. dorsalis nasi and A. angularis oculi. The obtained results regarding A. facialis in ground squirrel (Citellus citellus) were compared to the same ones in rats. In rats, A. facialis is the biggest branch separating from A. carotis externa. The branches of A. facialis in rats are: Ramus glandularis, A. submentalis, A. masseterica ventralis, A. labialis inferior, A. angularis oris, A. labialis superior, Rami musculares, A. lateralis nasi and A. angularis oculi. Based on the above mentioned results, it can be concluded that both in ground squirrel and rat A. facialis branches into A. labialis inferior, A. labialis superior and A. angularis oculi. In ground squirrel the branches of A. facialis are also A. bursae buccalis dorsalis and A. dorsalis nasi, and in rat those are Ramus glandularis, A. submentalis, A. masseterica ventralis, A. angularis oris, Rami musculares and A. lateralis nasi.

nema

Since the renin-angiotensin-aldosterone system (RAAS) was originally described, it has become one of the best described hormonal systems, especially regarding the fact that it plays an important role in regulating blood volume and systemic vascular resistance, and thus indirectly influencing blood pressure (BP). On the other hand, arterial hypertension is one of the most pertinent disorders which plays an important role, not only in the progression of renal failure, but also represents a risk factor for the occurrence of end stage renal disease. Several epidemiological studies pointed out the fact that genetic predisposition accounts for about 30% of the BP variability. Up to date, there are several RAAS genes that may have effect in long-term BP control, but ACE is the most important and the most thoroughly examined. In this review, we present available data regarding the influence of gene polymorphisms of ACE on its function, within the RAAS related BP regulation. Therefore, by specially describing all its potential physiological roles, it will likely offer a new insight in the renal regulation of the BP, along with its other, not less important, roles.

Background: Systemic inflammatory response syndrome (SIRS) changes cortisol dynamics and indicates dissociation between the adrenal cortex and the hypothalamo-pituitary unit. The aim of this study was to assess the cortisol response after stimulation with ACTH1-24 in patients with SIRS at admission to the Respiratory Intensive Care Unit (RICU) and seven days later. Methods: Fifty-four subjects were included in the study, and SIRS was defined according to the Consensus Conference criteria from 1992. Severity of the disease was determined using the APACHE II score, and organ dysfunction using the SOFA score. Low-dose (1 mg) ACTH test (LDT) was performed in all patients, and cortisol was determined along with basal ACTH. Data were analyzed using parametric and nonparametric tests and regression analysis. The results are presented as mean ± standard deviation, and P< 0.05 was considered statistically significant. Results: There were no differences in cortisol values between the two LDTs. Cortisol increment lower than 250 nmol/L during the LDT was found in 14/54 (25.9%) subjects at the onset of SIRS. Five out of 54 (9.6%) patients died within 7 days from the onset of SIRS. Female sex and maximal cortisol response (D max) on LDT predicted the duration of hospitalization in RICU, while APACHE II and SOFA scores best predicted the duration of hospitalization, mortality outcome as well as overall survival outcome. Conclusions: A difference was found in D max at the diagnosis of SIRS and seven days later. D max, and primarily the clinical scores APACHE II and SOFA predicted the outcomes of hospitalization and overall survival.

Ground squirrel is the only representative of its genus in our country. As experimental animal is used in microbiology, parasitology, immunology and pharmacology. The aim of this study was to examine a part of ground squirrel cardiovascular system and thus help better understanding of anatomy of the body of this specific animal as well as to contribute to comparative anatomy. The studies were perfomed on six ground squirrels, both sexes, weight between 200- 300 g. In order to obtain the arterial vascularization of the kidney, contrast mass gelatin stained with painting tempera was injected into the abdominal aorta after bleeding out. After the injection, blood vessels were prepared and photographed. Corosive preparations of the vein blood vessels of the kidneys were obtained by injection of Byocril into the right azygos vein after bleeding out. After injection, the preparations were placed into 5% NaOH for 96 hours or 10% NaOH for 48 hours. After that the preparations were rinsed with hot water and photographed. A. renalis dextra arises from the lateral wall of the abdominal aorta, 3-4 mm caudal to A. mesenterica cranialis. In most cases, this vessel divides into two or three branches before entering the hilus of the right kidney. A. renalis sinistra arises from the lateral wall of the abdominal aorta, 7-9 mm caudal to the right renal artery. Often, instead of one left renal artery, there are two, rarely three. Based on the results of our study, we concluded that in ground squirrel there is one A. renalis dextra and often two, rarely three Aa. renales sinistrae. In renal venous vascularization, both right and left renal vein are involved. Before entering the kidney, both of them divide into cranial and caudal branch, undergoing renal hilus, enter the renal sinus and continues to branch out into smaller branches.

nema

Introduction: Telomeres are protective chromosomal ends. Short telomeres are a proven biomarker of biological aging. We aimed to find an association of telomere length and telomerase activity in circulating leukocytes and thromboaspirates of patients with acute myocardial infarction. Furthermore, association of the telomere-telomerase system with oxidative stress markers (as common risk factors for coronary artery disease (CAD)) was tested. Material and methods: Patients were selected from the patients admitted to the intensive care unit with acute myocardial infarction with ST-segment elevation (STEMI), with the following inclusion criteria - STEMI patients between 18 and 80 years old of both genders and candidates for primary percutaneous coronary intervention, with infarction pain present for a maximum of 12 h. In all the patients leukocyte telomere length, telomerase activity and scores related to oxidative-stress status (Protective, Damage and OXY) were evaluated. Results: Patients were divided into different groups: with stable angina pectoris (AP) (n = 22), acute myocardial infarction with: STEMI (n = 93), non-obstructive coronary arteries (MINOCA) (n = 7), blood vessel rupture (n = 6) at three time points, and compared to the group of 84 healthy subjects. Telomerase activity was significantly higher in all CAD sub-groups compared to the control group (AP = 0.373 (0.355-0.386), STEMI = 0.375 (0.349-0.395), MINOCA = 0.391 (0.366-0.401), blood vessel rupture = 0.360 (0.352-0.385) vs. CG = 0.069 (0.061-0.081), p < 0.001), while telomeres were significantly shorter in STEMI, MINOCA and blood vessel rupture groups compared to the control group (STEMI = 1.179 (0.931-1.376), MINOCA = 1.026 (0.951-1.070), blood vessel rupture = 1.089 (0.842-1.173) vs. CG = 1.329 (1.096-1.624), p = 0.030]. Values of OXY score were significantly higher in STEMI and MINOCA patients compared to the control group and AP patients (5.83 (4.55-7.54) and 10.28 (9.19-10.72) vs. 4.94 (3.29-6.18) and 4.18 (2.58-4.86), p < 0.001). Longer telomeres and higher telomerase activity were found in thromboaspirates, compared to the peripheral blood leukocytes in the same patients (1.25 (1.01-1.84) vs. 1.18 (0.909-1.516), p = 0.036; and 0.366 (0.367-0.379) vs. 0.366 (0.367-0.379), p < 0.001, respectively). In addition, telomere length and telomerase activity had good diagnostic ability to separate STEMI patients from healthy persons. Conclusions: Leukocyte telomere length and telomerase activity can differentiate CAD patients from healthy persons, and relate CAD to oxidative stress. [ABSTRACT FROM AUTHOR]

Background/Aim. Colorectal cancer (CRC) is one of the most frequent diseases and early diagnosis has a potential role to improve survival. The aim of this study was to analyze influence of delay in diagnosis on survival in patients with colorectal cancer. Methods. A total of 119 patients with pathohystological diagnosis of CRC were included in the study. They were operated at our Department for Surgery from 2000 to 2002. They were divided into two groups according to the duration of symptoms: early operated patients - EOP (symptoms were presented for 3 months) and late operated patients - LOP (duration of symptoms was more than 3 months). Follow-up period was 5 year. Results. Weight loss, intermittent abdominal pain and anorexia were more frequent in LOP (p < 0.01). Young age, blood in stool, and tumor localized in rectum were dominant characteristics in EOP (p < 0.05). Overall delay in diagnosis was 2.19 ± 0.79 months in EOP and 11.37 ± 5.68 months in LOP. There was highly statistically significant difference between these two groups (p < 0.01). Overall survival was 44.75%. Five years survival was 65.9% in the group of EOP and 26.5% in the group of LOP (χ2 = 28.16, p < 0.01) Weight loss was dominant characteristics in the patients who did not survive five years (χ2 = 14.26, p < 0.01). A period of 2 months in delay in diagnosis is 'cut-off' value in prediction of death (sensitivity of 75.5% and specificity of 90.3%). Conclusion. A delay in diagnosis and stage of the disease are highly significant factors of patients with CRC survival. In everyday medical practice higher importance should be put on weight loss, intermittent abdominal pain, change in bowel habits, as well as on syderopenic anaemia.