CREATINE KINASE IN PATIENTS WITH RHABDOMYOLYSIS ACUTELY INTOXICATED WITH PSYCHOTROPIC AND CHEMICAL SUBSTANCES.

The aim of this study was to determine the CK activity and its association with the length of hospital stay in acutely intoxicated patients with psychotropic and chemical substances. Rhabdomyolysis is defined as a creatine kinase (CK) > 250 U/L. We included adult patients ≥ 18 years of age, with rhabdomyolysis acutely intoxicated with psychotropic and chemical substances in the first 48 hours. We excluded patients with rhabdomyolysis in muscle trauma as a result of a traumatic accident, myocardial infarction, cerebral vascular infarction, cerebral hemorrhage, and chronic hepatic and renal disease. In all patients with rhabdomyolysis, the mean CK on the first, third and fifth day was consequently 5715.9±16088.8 U/L with a maximum value of 129077 U/L vs. 5548.5±9851.5 U/L with a maximum value of 63947U/L vs. 2970.42±7161.68 U/L with a maximum value of 53672 U/L. The comparison for the whole sample in the three measurement times, for p <0.05, showed a significant difference (Friedman Test: N = 62; Chi-Square = 34.935; df = 2; p = 0.00001). For the whole sample of patients with rhabdomyolysis, as well as in the group of psychotropic intoxications, for p < 0.05, the level of CK on the first day was confirmed as an independent predictor that significantly affected the variability of the length of hospitalization by 5.2% (R2 = 0.052) vs. 20% (R2=0.200). In rhabdomyolysis, as a result of acute intoxication with psychotropic and chemical substances it is important to examine the creatine kinase. Creatine kinase levels were higher in rhabdomyolysis in acutely intoxicated patients with psychoactive compared to chemical substances. In the group intoxicated with psychoactive substances creatine kinase as an independent predictor significantly affected the length of hospitalization.

Schoolchildren thyroid volume in North Macedonia: data from a national survey in an iodine-sufficient country.

PURPOSE: North Macedonia is historically iodine deficient, but due to the longstanding and effective preventive measures, it has been considered iodine replete since 2003. The aim of the recent national survey was to re-evaluate iodine status and to measure thyroid volume (TVol) by ultrasound in schoolchildren as a representative of the general population. METHODS: A stratified probability proportionate to size cluster sampling was used to obtain a representative national sample of school children aged 7-10 years between the 28th of March and 4th of October 2016. Thyroid volume (TVol) was measured using ultrasonography in 1188 children. All TVol measurements were done by a single operator and their medians were compared with an international reference standard. RESULTS: Significant positive correlation was found between Tvol and age, height, weight, body surface area (BSA), body mass index (BMI) in both girls and boys (p < 0.001), but not between TVol and urinary ioidine concentration (UIC). The most important predictors for Tvol in all children were age, height, weight, BMI, and BSA ( all p < 0.001). In multivariate regression, independent predictors for TVol were only BSA (p < 0.001) and age (p = 0.004) after being adjusted for sex, BMI, and UIC (R2 = 0.291). The 97th percentile of Tvol in our survey was generally higher than in the reference study and goiter prevalence of 18.3% in boys and 15.6% in girls was found compared to the international standard. CONCLUSION: In our survey, Tvol of schoolchildren was larger than in the international reference study, although iodine nutritional status of the country has been considered sufficient for many years. In countries and regions with long and effective, well-documented iodine prophylaxis, the optimal way to have realistic normative TVol would be to create their TVol reference limits. Therefore, the provided data for TVol measured in our survey could be proposed as the national reference TVol for schoolchildren aged 7-10 years.

Correlation of serum leptin with anthropometric parameters and abdominal fat depots determined by ultrasonography in overweight and obese women.

Leptin is an adipocytokine that has an important role in energy homeostasis and therefore in the patho-physiology of obesity. Leptin levels are influenced by many factors such as gender, race, energy intake, fat mass, etc. The aim of our study is to investigate the relationship of circulating leptin levels to anthropometric parameters and to the subcutaneous and visceral fat tissue determined by ultrasonography in healthy overweight and obese women. The study included 50 healthy women, with body mass index (BMI) above 25 kg/m2. Measurements of anthropometric parameters were performed with a standardized technique. The subcutaneous and visceral fat tissue was measured with ultrasound 1 cm above the umbilicus. Leptin was determined by radioimmunoassay. The serum leptin levels presented a positive correlation between the levels of leptin and BMI (r-0.73, p<0.05) waist circumference (r-0.73, p<0.05) hip circumference (r-0.74, p<0.05), thigh circumference (r-0.56, p<0.05) and abdominal subcutaneous fat tissue (r- 0.46, p<0.05). There was no correlation between leptin and visceral fat tissue, waist to hip and waist to thigh ratio. The results of our study confirmed the correlation between leptin and BMI. The correlation between leptin and all measured circumferences cannot be attributed to a particular fat depot, but rather reflect the correlation between this adipocytokine and the total body fat. The subcutaneous fat depot determined by ultrasound showed a correlation with leptin, while this kind of connection was not established for the visceral fat tissue.

Definition of formulation design space, in vitro bioactivity and in vivo biodistribution for hydrophilic drug loaded PLGA/PEO-PPO-PEO nanoparticles using OFAT experiments.

Modified nanoprecipitation method was used for improved incorporation of hydrophilic drug (irinotecan hydrochloride) into the PLGA/PEO-PPO-PEO blended and blended/adsorbed nanoparticles. One factor at a time (OFAT) variation experiments were conducted in order to determine key formulation factors (concentration and volume of drug solution, evaporation rate and PLGA/PEO-PPO-PEO ratio) influencing nanoparticle properties (particle size and size distribution, encapsulation efficiency, drug content, zeta potential, drug dissolution rate, as well as protein binding capacity). The insight into in vivo behavior of prepared nanoparticles and their potential for effective anticancer treatment was gained by performing biodistribution and cell culture studies as part of OFAT experiments. The mean particle size, mainly dependent upon PLGA/PEO-PPO-PEO ratio, was in the range of 112-125 nm, with narrow unimodal distribution (PDI∼0.1). Encapsulation efficiency (32-63%) was impacted by evaporation rate and PLGA/PEO-PPO-PEO ratio. Drug content (0.2-1.51%) and controlled release properties were related to the influence of all tested formulation factors. Structural information for the studied nanoparticles was obtained using DSC and FT-IR spectroscopy. Zeta potential values indicated that presence of PEO-PPO-PEO in the formulations shielded the high surface negative charge of PLGA. PEO-PPO-PEO surface coverage of PLGA/PEO-PPO-PEO blended as well as blended/adsorbed nanoparticles depended upon amount of used PEO-PPO-PEO during preparation procedure and was related to the protein resistant characteristics of nanoparticles. Results from in vivo studies evidenced prolonged blood circulation time of the prepared nanoparticles, while cell culture studies indicated higher in vitro bioefficacy compared to free drug. Performed experiments defined possible design space and justified further optimization of formulation using experimental design studies.

N-terminal-proB natriuretic peptide in patients with stable coronary artery disease evaluated for ischemia with myocardial perfusion imaging.

BACKGROUND: Natriuretic peptides have emerged in the last years as useful diagnostic and prognostic biomarkers in patients with stable CAD. Myocardial ischemia per se might increase NT-proBNP levels. OBJECTIVES: The aim of the present study was to determine whether NT-proBNP levels in patients with stable CAD and preserved left ventricular function are elevated and second, to compare NT-proBNP in patients with verified ischemia on myocardial perfusion imaging (MPI) to non-ischemic subjects with known CAD. METHODS: 117 patients were prospectively included, divided in two groups: group A (26 patients)--with normal MPI and without known CAD and group B (91 patients)--with abnormal MPI or known CAD. Patients from group B were further divided according to the presence of ischemia on MPI in non-ischemic (29 pts) and ischemic (62 pts) subgroup. RESULTS: Levels of NT-proBNP in group B were significantly higher compared to group A (median 53 vs 21 pg/ ml, p = 0.012). End diastolic and end systolic volumes were higher, and ejection fraction after stress and at rest was lower in group B (63% vs 71%, p = 0.0004 and 69% vs 75%, p = 0.008). No significant difference in NT-pro BNP levels (median 48 vs 62 pg/ml, p = 0.5) and functional parameters between the ischemic and nonischemic subjects was found. CONCLUSION: Our data show that patients with stable coronary artery disease and preserved left ventricular function have elevated levels of NT-proBNP. We could not demonstrate that the presence of myocardial ischemia per se was an additional factor leading to increase of the natriuretic propeptide (Tab. 4, Ref. 12).

Correction of iodine deficiency in Macedonia.

A national survey conducted in 1995-96 showed that mild to moderate iodine deficiency existed in Macedonia (median urinary iodine [UI] concentration 117 microg/l). It was concluded that a new legal regulation should be introduced concerning the iodination of table salt for human consumption. The iodine level was recommended to be 20-30 mg/kg salt, exclusively in the form of the more stable potassium iodate. The new regulations were instituted and became effective in October, 1999. National surveys performed in 2000 and 2001 showed increased median UI concentrations (154.1 microg/l in 2000 and 164.5 microg/l in 2001). In 2001, UI excretion was assessed in 490 pregnant and lactating women (median UI concentration 140 microg/l). During the last three surveys, household salt specimens were assessed for iodine content. The findings showed an increase of the percentage of the optimal iodine content in household salt (42-69%), which correlated with the higher IU excretion results. The new regime of salt iodination was proved to be highly effective in correcting the iodine deficiency in Macedonia.