The key risk indicators of road traffic crashes in Serbia, Nis region.

Traffic crashes are a serious public health and socio-economic problem, and they are one of leading causes of death of males in Serbia. In order to determine the main causes of road traffic crashes in Nis region, Republic of Serbia, nine key risk indicators of road traffic crashes are identified, organized into four groups (number and structure of crashes, consequences of traffic crashes, temporal and spatial location of traffic crashes, causes and sanctions), and described in detail. The indicators are ranked based on group fuzzy analytic hierarchy process (AHP), where experts from insurance companies, professionally engaged in the process of risk assessment, with different previous experience present different impact on the final ranking. In relation to the most influential factors in the assessment of traffic crashes, improper and unadjusted vehicle speed, overtaking and passing, as well as the physical condition of the driver have the highest effect.

Impact of acute exercise on antioxidant enzymes activity and lipid status in blood of patients with hypertension.

BACKGROUND/AIM: Many studies support the hypothesis that oxidative stress is involved in the pathogenic process of a variety of diseases including hypertension. In humans, hypertension is also considered a state of oxidative stress that can contribute to the development of arteriosclerosis and other hypertension-induced organ damage. The aim of this study was to evaluate an influence of acute physical exercise on antioxidative enzymes activity and lipid status in patients with hypertension. METHODS: Fourty patients with hypertension and 20 age-matched controls were included in the study. To assess an influence of acute exercise on lipids and antioxidative enzymes activity the following parameters were determined at rest and immediately after the acute cardiopulmonary exercise cycloergometer test: triglycerides (TG), total cholesterol, low density cholesterol (LDL), oxidised LDL cholesterol (OxLDL), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and plasminogen activator inhibitor (PAI). RESULTS: In basal condition, hypertensive patients compared to the control group had increased, but not significantly, level of Ox LDL (88.61 +/- 14.06 vs 79.00 +/- 29.26 mmol/L), PAI (3.06 +/- 0.56 vs 2.6 +/- 0.35 U/mL) and activity of GSH-Px (50.22 +/- 15.20 vs 44.63 +/- 13.73 U/g Hb). After acute exercise test, there was significantly greater level of Ox LDL (79.0 +/- 29.26 vs 89.3 +/- 29.07 mmol/L; p < 0.05) only in the control group. GSH-Px activity was significantly decreased only in hypertensive patients after acute exercise (50.22 +/- 15.2 vs 42.82 +/- 13.42 U/g Hb; p < 0.05), but not in the controls. CONCLUSION: No significantly elevated Ox LDL, GSH-Px and PAI-1 levels were found in hypertensive patients during basal condition in comparison with healthy subjects. Decreased GSH-Px activity was associated with those in acute exercise only in hypertensive patients. It could be an important indicator of deficiency of physiological antioxidative defense mechanism in hypertensive patients during an acute exercise.

[Oxidized LDL and C-reactive protein level in relation to carotid intima-media thickness in population with risk factors for atherosclerosis].

INTRODUCTION: Elevated levels of oxidized LDL cholesterol (OxLDL) are considered to be a key factor of initiating and accelerating atherosclerosis. It promotes atherosclerosis through inflammatory and immunologic mechanisms that lead to the formation of macrophage foam cells. OBJECTIVE: To determine the relationship among OxLDL, C-reactive protein (CRP) level and carotid intima-media thickness (IMT) in population with risk factors for atherosclerosis. METHODS: The study group consisted of 125 clinically healthy, hypercholesterolaemic subjects (49.3 +/- 5.7 years; 75 females and 50 males) compared with 100 age-matched population-based control subjects. The study group was divided into two subgroups: subgroup A (the levels of LDL cholesterol > 5 mmol/L) and subgroup B (the levels of LDL cholesterol < 5 mmol/L). None of the subjects had history of cerebrovascular, ischaemic heart disease, hypertension or diabetes mellitus. Lipid profiles were measured by enzymatic methods. OxLDL was measured by using a specific monoclonal antibody, mAb4E6. CRP was measured using hemiluminescent methods (Immulite-DPC). The common carotid IMT was measured by the B-mode ultrasound. RESULTS: Compared to controls, the study group had higher levels of OxLDL (119.97 +/- 43.15 vs. 82.03 +/- 25.99 IU/L; p < 0.01) and CRP (6.20 +/- 3.55 vs. 2.68 +/- 3.04 mg/ml; p < 0.05). IMT was significantly higher in study subjects (1.14 +/- 0.38 vs. 0.72 +/- 0.24 mm; p < 0.05). We also found that, in the whole study group, IMT significantly positively correlated with OxLDL (r = 0.442; p < 0.05). We found that in the study subgroup A, IMT positively correlated with CRP (r = 0.792; p < 0.01). In controls, we found a significantly positive association between IMT and OxLDL (r = 0.781; p < 0.01) and CRP (r = 0.748; p < 0.01). CONCLUSION: The elevated levels of OxLDL and CRP are associated with higher common carotid intima-media thickness in population with risk factors for atherosclerosis.

[Diagnosis of osteoporosis occurring in autoimmune thyroid gland disease].

Osteoporosis or porotic bone is a general, systemic bone disease, which is manifested by fracture as its consequence. The main characteristic of this disease is the loss of bone microarchitecture, bone mass reduction, and its increased fragility. The result, thereof, is susceptibility to fracture. Etiology of osteoporosis is polymorph. Its socio-medical importance is enormous, since there is one osteoporotic fracture every 20 sec. worldwide. Million and six hundred thousand osteoporotic fractures occur annualy throughout the world. Thyroid gland is susceptible to autoimmune reactions that lead to autoimmune diseases, just like many other organs. The autoimmune disorder is a final consequence of a failure, in some instance, within the crucial mechanism of regulation of self tissue tolerance. The main goal is to prove the presence of osteoporosis, its inexpensive and quick diagnostics; to make a distinction among the causes that lead to it. In addition, to indicate the importance of osteoporosis that is caused by normal, metabolic processes which are an inevitable part of ageing. Diagnosis of osteoporosis can be done through laboratory, which is a tiresome, time consuming task. Measurements of BMD could be also performed by using new devices. Osteometers could be constructed on the basis of X-ray photon energy or US. Utilization most contemporary one uses laser beam, and it approximates the distance of additional tissue that also absorbs part of energy changing absorption of the reception unit and thus making the measurement results accurate. In diagnosing BMD by osteometer, one faces with certain difficulties. When axial quantitative CT is used, the value may be falsely lower, because of the loss of energy absorbed by aorta which is often calcified in elderly people. In devices with transversal scanning, of the same nature and technology, a part of the energy is being absorbed by transversal and spinal vertebrals. After the research, one may conclude that the most accurate results can not be achieved. But, this is not considered so important. Values that are to be compared are available anyway. Therapy, if adequate, will show certain improvement which can not be detected even by osteometers. Following the physiatrist treatment, particularly by exercise of muscle strength, the muscle structure will be enhanced and, consequently, a part of pressure will be handled, which would be otherwise taken over by the bone. The movements of the patients will be better in coordinated, which undoubtedly reduces the number of falls and fractures. Results of the research that was conducted at the Clinical Hospital Centre "Dr. Dragisa Misovic" in Belgrade, with over 200 cases, two years, are compatible with literature data. Working with MediTech osteometer DTU ONE that uses ultrasound source in demineralized medium, with indispensable US gel, on constant temperatures, yielded results corresponding to those in patients that were treated by Bisphosphonates, Alphacalcidol and Calcium therapy.