CARDIOPROTECTIVE EFFECTS OF LIRAGLUTIDE PRETREATMENT ON ISOPRENALINE-INDUCED MYOCARDIAL INJURY IN RATS

Type 2 diabetes mellitus (T2DM) increases the risk of cardiovascular disease, especially myocardial injury. Due to their hypoglycemic effects, glucagon-like peptide-1 receptor agonists (GLP-1RAs) are efficiently used for T2DM management. GLP-1RAs also have anti-inflammatory and antioxidative effects, and can improve cardiac function. The aim of this study was to investigate the cardioprotective effects of liraglutide, a GLP-1RA, on isoprenaline-induced myocardial injury in rats. The study included 4 groups of animals. They were pretreated with saline for 10 days + saline on days 9 and 10 (control), saline for 10 days + isoprenaline on days 9 and 10 (isoprenaline group), liraglutide for 10 days + saline on days 9 and 10 (liraglutide group), and liraglutide for 10 days and on days 9 and 10 they were administered isoprenaline. This study evaluated ECG, myocardial injury markers, oxidative stress markers, and pathohistological changes. The results showed that liraglutide mitigated the isoprenaline-induced cardiac dysfunction recorded by ECG. Liraglutide reduced serum markers of myocardial injury such as high-sensitive troponin I, aspartate aminotransferase, alanine aminotransferase, reduced TBARS, increased catalase and superoxide dismutase activity and increased reduced glutathione, and improved lipid profile. Liraglutide induced antioxidative protection and alleviated isoprenaline-induced myocardial injury.

Homocysteine, Vitamins B6 and Folic Acid in Experimental Models of Myocardial Infarction and Heart Failure—How Strong Is That Link?

Cardiovascular diseases are the leading cause of death and the main cause of disability. In the last decade, homocysteine has been found to be a risk factor or a marker for cardiovascular diseases, including myocardial infarction (MI) and heart failure (HF). There are indications that vitamin B6 plays a significant role in the process of transsulfuration in homocysteine metabolism, specifically, in a part of the reaction in which homocysteine transfers a sulfhydryl group to serine to form α-ketobutyrate and cysteine. Therefore, an elevated homocysteine concentration (hyperhomocysteinemia) could be a consequence of vitamin B6 and/or folate deficiency. Hyperhomocysteinemia in turn could damage the endothelium and the blood vessel wall and induce worsening of atherosclerotic process, having a negative impact on the mechanisms underlying MI and HF, such as oxidative stress, inflammation, and altered function of gasotransmitters. Given the importance of the vitamin B6 in homocysteine metabolism, in this paper, we review its role in reducing oxidative stress and inflammation, influencing the functions of gasotransmitters, and improving vasodilatation and coronary flow in animal models of MI and HF.

Short-term effects of carrying a school bag on the distribution of force and plantar pressure during walking of children of different levels of physical activity

Introduction: Carrying a school bag is a dominant activity that a child performs during daily productive activities. The aim of the research is to examine how carrying a school bag of different weights affects the distribution of force and plantar pressure during normal walking on the flat terrain of children of varying levels of physical activity.Methods: The pilot study included 124 students aged 11-12 from Banja Luka. According to the protocol, each group of respondents was treated with an intervention-customized school bag and a comparator-school bag that the child only opted for. For the research, the Physical Activity Questionnaire for Older Children, measurement of anthropometric parameters, school bag weight, and Zebris tape (Zebris Medical GmbH, Germany) were used for gait analysis.Results: Inactive children achieved the lowest and active children’s highest walking speed during normal walking without a bag, with their customized school bag. When carrying a custom school bag: The highest maximum force is projected on the left heel 330.72 N in inactive children, and the lowest 265.93 N in moderately active children, the highest maximum pressure on the left heel is registered in inactive children, 27.60 N/cm2, and the lowest 21.85 N/cm2 in moderately active children. The maximum force-time of % of standing time on the left foot in the middle part lasted the longest in inactive children, and the shortest active children carried their school bag 40.31% and a custom school bag 39.76%.Conclusion: High physical activity and individual adjustment to distribute the burden well allow the child to adequately respond to the loads carried by the weight of the school bag.

Major adverse cardiovascular events after implantation of absorb bioresorbable scaffold: One-year clinical outcomes

Background/Aim: Bioresorbable vascular scaffold (BVS) represents a novel generation of intracoronary devices designed to be fully resorbed after healing of the stented lesion, delivering antiproliferative drug to suppress restenosis, providing adequate diameter of the coronary vessel and preserving the vascular endothelial function. It was supposed that BVS will reduce neointimal proliferation and that their late bioresorption will reduce the negative effects of traditional drug-eluting stents, including the late stent thrombosis, local vessel wall inflammation, loss of coronary vasoreactivity and the need for the long-term dual antiplatelet therapy. The purpose of this research was to investigate efficacy and safety of Absorb everolimus-eluting BVS implantation and the prevalence of major adverse cardiovascular events (MACE) at the mid-term follow-up. Methods: The study encompassed 42 patients selected for BVS implantation and fulfilling inclusion criteria - 37 male and 5 female - admitted to the Dedinje Cardiovascular Institute, Belgrade, Serbia over the one-year period (from January 2015 to January 2016) for percutaneous coronary intervention (PCI). Coronary vessel patency before and after stenting was assessed by the Thrombolysis in Myocardial Infarction flow (TIMI) grades. After the index PCI procedure with BVS all patients were clinically followed by regular (prescheduled or event-driven) visits during the next 12-month period. Results: In the intention-to-treat analysis, all Absorb BVS procedures were successful, without the need for conversion to other treatment modalities. The complete reperfusion (TIMI flow grade 3) after the intervention was established in 97.6 % of patients and 100 % of them achieved the TIMI flow grade ≥ 2. The presence of angina pectoris was reduced significantly by the BVS procedure: stable angina 57.1 % to 11.9 %, (p < 0.001) and unstable angina 31 % to 0 %, respectively (p < 0.001). After the one-year follow-up, the MACE rate was 11.9 %. Myocardial infarction occurred in 4.8 % and the need for PCI reintervention in 2.4 % of cases (not influenced by the gender or the age of patients). There were 4 cases of death (all patients were older and had lower values of left ventricular ejection fraction). Conclusion: The results of the current research demonstrated a high interventional success rate of the Absorb BVS implantation, followed by the early improvement of the anginal status. However, that was not translated into the favourable mid-term clinical outcomes, opening debate about the current status of Absorb BVS and the need for future refinements of stent design and implantation techniques.

Parents' knowledge and attitudes when choosing their children's school bag: An introductory study

Background/Aim: A school bag is a device whose purpose is to store things that are necessary for a child in performing daily productive activities. The aim of the research was to examine how much parents are informed about the school bag and which specifications are crucial when choosing a school bag for their children. Material and methods: The prospective study included 150 parents of students aged 11 to 12 from Banja Luka. For the purposes of the research, a questionnaire with closed and open questions was used. Results: More than 97 % of the surveyed parents belonged to the age range of 30 to 49 years. The largest number of surveyed parents have had secondary education 44 %, but the number of university-educated parents was also very high 39.3 %. Ninety-six percent of students used a backpack. School bags in 97.4 % of cases were purchased in stores. Only in 10 % of cases, school bags fully meet the basic criteria. In the remaining 90 % of cases, there was an absence of at least one or more desired characteristics. Using the Chi-squared test (ch2 = 245.45; p < 0.001), a significant difference between the desired and the achieved result was statistically proven. 77.3 % of parents did not receive information about the school bag. Salespeople (11.3 %), other parents and friends (9.3 %) were the main source of information before purchasing a school bag. In the future, 54 % of parents would like to get information about the school bag through lectures and practical workshops for children and parents. Conclusion: Greater information enables adequate selection and reduces the possibility of marketing tricks and influences on consumers when choosing the desired product such as a school bag. Parents have an important role to play in ensuring unhindered growth and development during the educational process and in raising children's awareness and supervision of the proper use of the school bag.

Correlation of physical activity with stress, depression and anxiety in female students

Background/Aim: The period of beginning of studies is a stressful period of life in which students are expected to develop skills and abilities with which they will be able to take on the most important roles in all areas of social activity. Physical activity (PA) triggers and remodels mental health. The aim of the study was to determine the correlation between PA and stress, anxiety and depression in female students. Methods: Epidemiological observational study was performed and included a representative sample of 408 healthy female students aged 19 to 22 years. Questionnaires were used and anthropometric measurement of weight and body mass index (BMI) calculation was performed. Used questionnaires were: a socio-demographic questionnaire, standardised tests: DASS-21 test (short version) for mental health assessment and International Physical Activity Questionnaire-IPAQ test (long version). Results: Mean age of female students was 20.5 ± 0.72 years, average height 168.65 ± 6.01 cm, body weight 63.09 ± 9.9 kg, and BMI 22.1 ± 3.2. A significant negative correlation was found between high PA and anxiety (r =-0.160, p = 0.001), PA and depression (r =-0.118, p = 0.01), while the category of stress had a low correlation with PA. Conclusion: This research shows that a high level of PA has no effect on stress but has an effect on reducing anxiety and depression. Carefully planned physical activities can affect the emotional status of young female students.

Internal carotid and vertebral arteries diameters and their interrelationships to sex and left/right side

BACKGROUND

The available anatomical data about diameters of inflow vessels to the circle of Willis reflect various diagnostic and imaging methods used, sample sizes, levels of measurements, and lack of possible specific ethnic, regional or genetic data. Additionally, the data are often without distinctions about left-right or sex.

MATERIALS AND METHODS

Therefore, using computed tomography angiography (CTA) we investigated diameters of internal carotid (ICA) and vertebral (VA) arteries in 70 adult persons (28-75 years) of both sexes (34 males and 36 females), at predefined cervical parts of ICA (2 cm above carotid bifurcation) and of VA (5 mm before VA penetrated the dura).

RESULTS

Sex differences were expressed as highly significant larger diameters of left VA (LVA) in males (3.49 mm) than in females (3.00 mm), and as significantly larger diameters of right VA (RVA) in males (3.20 mm) than in females (2.82 mm), as well as of right ICA (RICA) diameters in males (5.04 mm) than in females (4.56 mm), but without such difference for left ICA (LICA) between males (4.82 mm) and females (4.60 mm). Intrasex (in males or in females) left-right differences of ICA and VA diameters were not significant. Significant positive correlations were found in females between RICA and RVA, and in males between RICA and LICA. Calculated mean sum of ipsilateral diameters of right arteries (RAA = RICA + RVA) was in males 8.25 mm, in females 7.38 mm, and of left arteries (LAA = LICA + LVA) was in males 8.31, and in females 7.60 mm, without statistically significant difference between RAA and LAA, neither in males, nor in females. Statistically highly significant larger sums of diameters were in males than in females for both, RAA and LAA.

CONCLUSIONS

Our findings, as the first data about diameters of ICA and VA systematically obtained by CTA in the population of western Balkans, suggest that in the studies of these diameters is absolutely necessary to analyse separately the data for sex, and to use defined standard levels.

The impact of high-intensity interval training and moderate-intensity continuous training regimes on cardiodynamic parameters in isolated heart of normotensive and hypertensive rats

This study aimed to assess the impact of high-intensity interval training (HIIT) vs. moderate-intensity continuous training (MIT) on cardiodynamic parameters in isolated rat heart. Wistar albino rats were randomly assigned to groups according to running protocol: sedentary control, MIT, and HIIT; spontaneous hypertensive rat (SHR) sedentary control, SHR + MIT, and SHR + HIIT. HIIT groups performed the running in 5 sprints × 45-55 m/min for 30-90 s, with 2 min of rest after each sprint, while MIT groups performed the running of 10-15 m/min for 1 h with 3 min of rest every 100 m; both protocols were implemented 5 days/week over 4 weeks with 1 week of adaptation before protocols started. Isolated rat hearts were perfused according to Langendorff technique at gradually increased coronary perfusion pressures (40-120 cmH₂O). Using a sensor placed in the left ventricle, we registered maximum and minimum rate of pressure development in the left ventricle, systolic and diastolic left ventricular pressure, and heart rate. Coronary flow was measured flowmetrically. MIT was connected with cardiac depression in normotensive conditions, while HIIT leads to cardiac depression in hypertensive rats. HIIT induced more significant increase of contractile and relaxation parameters of the isolated rat heart, especially in hypertensive animals.

Bone Metabolism Markers and their Correlation with Body Mass Index in Aerobic Physical Activity

Introduction: Bone formation marker osteocalcin (OC) and bone resorption marker C-terminal telopeptide of type 1 collagen (CTX) can be used to detect or to monitor the early responses of the skeleton to physical activity. Literature suggests that it is likely that higher body mass index (BMI) has positive effect on bones and can postpone onset of osteoporosis.Aim of the Study: The aim of this study is to:1.Determine the effect of aerobic physical acitivity on OC and CTX in young women2.Investigate correlation of OC, CTX and BMI in young women engaged into structured aerobic excerciseMaterial and methods: Study included 64 healthy young women, aged 19 to 25 years, devided into two groups: intervention group (n=32) and control group (n=32). The study duration was six weeks with follow-up period of four weeks. The intervention group underwent structured aerobic physical activity program for six weeks, but the control group did not receive such program. Level of OC, CTX and BMI were measured at baseline, after 6-week aerobic program, and after 4-week follow up (only intervention group).Results: There was significant increase of OC level after 6-week aerobic program, while level of CTX did not changed. OC level was at its maximum immediately after finishing the program in the participants with normal BMI (p<0.001). There was no statistically significant interaction of BMI and CTX level.Conclusion: Aerobic physical activity increases level of osteocalcin, suggesting that it has positive influence on bone formation in young women, primarily in women with normal BMI.

Sex and level differences in the diameters of extradural segment of vertebral artery: computed tomography angiographic study

BACKGROUND

We investigated diameters of prevertebral - V1, and atlantic - V3 parts of extradural segment of vertebral artery (VA). Variable results from the literaturę about VA diameters reflect variety of diagnostic and imaging methods, various sample sizes, different levels of measurements, and lack of possible specific ethnic, regional or genetic data. Additionally, the data are often without distinctions of left-right or of sex.

MATERIALS AND METHODS

For this computed tomography (CT) angiographic study 91 adult people (182 VAs) of both sexes (47 males and 44 females) and of age between 33 and 75 years were selected. Diameters were measured at fixed predefined points of VA, marked as inferior (A) point (at V1 part in region of VA origin), as middle (B) point (the end of V1 part), and superior (C) point, at V3 part - 5 mm before VA penetrated the dura. Inferior (A) and middle (B) points actually represent locations at beginning (A) and at terminal (B) regions of V1 part of VA, and superior point C represents terminal part of V3.

RESULTS

In total sample ipsilateral (both left [L] and right [R] sided) diameters on investigated levels of VA showed progressive and highly significant decreases. The mean values were on the right side at point A - 3.63 mm, at B point - 3.31 mm, and at C point - 3.08 mm. On the left side, mean values were at point A - 3.76 mm, at B point - 3.50 mm, and at point C - 3.21 mm. Pattern of increasing sex differences in diameters of VA, was ranging from no differences (point A), trough significant (point B), to highly significant differences (point C). For inferior point (A) we did not find significant differences in VA diameters between males (R 3.78 mm; L 3.89 mm) and females (R 3.50 mm; L 3.62 mm), in middle (B) point sex differences were significant (males: R 3.44 mm, L 3.66 mm; females: R 3.18 mm, L 3.33 mm) and in most superior point (C) differences were highly significant (males: R 3.278 mm, L 3.39 mm; females: R 2.88 mm, L 3.01 mm). However, we did not find significant intrasex (in males or in females) left-right differences in mean values of VA diameters for all three investigated levels.

CONCLUSIONS

Our findings, as the first data about diameters of VA systematically obtained by CT angiography in the population of western Balkans and wider, suggest that in design of future studies of VA diameters is necessary to analyse separately the data for sex, as well as to use defined standard levels.

EXPLOSIVE MUSCLE POWER ASSESSMENT IN ELITE ATHLETES USING WINGATE ANAEROBIC TEST

ABSTRACT Introduction: Maximal effort physiological tests provide information about the current functional capacity of athletes. Objective: The aim of this study was to evaluate anaerobic performance parameters in elite athletes and to compare them in terms of the specific demands of each sport. We also created and applied the new software which enables us to quantify a new parameter -explosive muscle power (EP), a major component in sports requiring explosive bursts of movement lasting from a few seconds to 1 or 2 minutes. This new parameter reflects the velocity of energy transformation from intramuscular ATP and high-energy phosphates into mechanical power. Methods: All Wingate test parameters (standard parameters) - anaerobic power (AP), anaerobic capacity (AC), and explosive power (EP) as the new parameter were recorded in 104 subjects: 30 non-athletes and 74 athletes divided into different groups depending on their sport specialty (20 rowers, 28 wrestlers and 26 soccer players). Results: Anaerobic power (AP), anaerobic capacity (AC) and explosive power (EP) were significantly higher in the group of athletes compared to non-athletes. Among athletes, significant differences were observed in some parameters according to the type of activities they are involved in. The highest values were recorded in the group of wrestlers (AP=836W; AC=16.6kJ; EP=139W/s). The values of AP (absolute values) and EP (absolute and relative values) were significantly higher in wrestlers than in soccer players and rowers, but there was no significant difference in AC among these groups. The EP variable had a distribution similar to AP. Conclusions: Alongside anaerobic power and anaerobic capacity, the assessment of explosive power may complement the anaerobic profile of athletes. Experts in the field of sports medicine and exercise physiology could find these results useful in improving test variables, which are more important for specific sports, and for evaluating and monitoring training progress. Level of Evidence I; Diagnostic studies - Investigating a diagnostic test.

Assessment of elbow extensors endurance in young athletes

The aim of this study was to compare different endurance parameters of elbow extensors between senior and junior athletes. A group of 23 junior (16.2 ± 0.8 years, BMI 21.8 ± 2.9 kg/m(2)) and 16 senior athletes (23.1 ± 6.2 y, BMI 23.6 ± 4.2 kg/m(2)) volunteered for the study. Strength measurements were performed on the isoacceleration dynamometer (5 sets of 10 maximal elbow extensions, 1 min resting period between each set). The following strength parameters were measured: maximal strength (MS), endurance strength (ES), fatigue rate (FR) and decrease in strength (DS). Both arms triceps brachii muscle mass (MM) was calculated using a series of cross-sectional images of upper arms obtained by the MRI. Triceps brachii muscle mass for both arms in senior athletes showed significantly higher values (1286.9 ± 323.7 g) compared to young athletes (948.9 ± 171.1 g, p<0.01). ES was 50% higher in seniors, while FR was 10% higher in juniors. MS was 35% higher in seniors, but no difference was discovered when this parameter was expressed in relation to muscle mass. DS was significantly different between juniors and seniors, except in absolute values. No significant correlation was found between triceps brachii muscle mass and FR or DS. Different values of strength decrease throughout multiple contractions could be attributed to different characteristics of various sports.

Specific alterations of physiological parameters in competitive race walkers

Race walking is the technical and athletic expression of fast walking and it can be considered as a type of endurance performance. The purpose of this study was to examine whether 12 weeks of a specially designed training program results in the further training enhancement of endurance performance and the related physiological parameters in already well-trained race walkers competing at the national and international level. The investigation protocol consisted of determining the maximal oxygen uptake (VO2peak) and related gas exchange values using an automated cardiopulmonary exercise system and of determining blood lactate variables (aerobic threshold - LTAer and the maximal lactate steady state - MLSS) during walking with proper technique at 8, 10, 12 and 14 km·h-1 for 4 minutes without rest in between. Thereafter, the speed on the treadmill was increased by 0.5 km·h-1 every two minutes until exhaustion to determine VO2peak. After 12 weeks of a specially designed endurance training, statistically significant increases in VO2peak (61.8±8.5 mL·kg-1·min-1 pre vs. 66.9±9.5 mL·kg-1·min-1 post training; p<0.05) and blood lactate variables (VO2-LTAer and VO2-MLSS; p<0.05) were noted. The obtained results suggest that the applied training program can improve endurance and race performance in previously well trained race walkers.

99m Tc-sestamibi scintimammography in detection of recurrent breast cancer

The aim of this study was to asses the accuracy of 99mTc-sestamibi scintimammography in patients with suspected recurrent breast cancer in the breast or loco regional tissues. After routine analyses in twenty-eight women (clinical examination, ultrasound, X-ray mammography, and fine needle aspiration biopsy) they were examined by scintimammography. All patients with suspected recurrent cancer in the breast or loco regional tissues (19) undergone surgery and the final diagnosis was determined by histopathological examination. Another 9 patients were followed 6-24 months. The scintigraphic studies were correlated with radiological findings and/or with histopathology. There were 19 patients with recurrent tumours (15 with loco-regional recurrent and 4 in another breast). X-ray mammography identified 13 of these cancers. 99mTc-sestamibi scintimammography identified seventeen of recurrent breast cancers. In the seven out of nine patients without cancer, scintimammography were reported as having no changes consistent with cancer. X-ray mammography showed suspected cancer lesions in four out of nine patients without cancer. There were two false-positive scintimammograms and one false negative. Axillary lymph node recurrence occurred in four patients. All of them were positive on scintimammography. 99mTc-sestamibi scintimammography showed higher sensitivity, specificity and accuracy per patient than did X-ray mammography (90,9% vs. 63,6%, 71,4% vs. 57,1% and 83,3% vs. 61,1%, respectively). To identifying recurrent breast cancer disease is better to use scintimammography than X-ray mammography.

Ventilator function improvement in patients undergoing regular hemodialysis: relation to sex differences

Uremic lung is different entity then oedema present in cardiovascular diseases or in adult respiratory distress syndrome as well. This state is one of the possible complications in patients with chronic renal failure (CRF) receiving regular hemodialysis (HD). There are several studies suggesting that in these patients in 30-40% cases pulmonary hypertension was developed. It is known that patients with primary pulmonary hypertension have peripheral airway obstruction The data also showed that primary as well secondary pulmonary hypertension are more often developed in females; even real reason is still unknown. The aim of the study was to estimate the ventilator function improvement in patients with CRF receiving regular HD related to sex differences. The study population consisted in 39 patients with CRF, with no cardiac and pulmonary diseases. These patients were treated by regular hemodialysis using bicarbonate or acetate mode, respectively. They were divided into two groups according to the sex. Spirometry parameters before and after onset of hemodialysis were recorded. The results were analyzed using Student t-test and presented as mean +/-SD. All p values <0,05 were considered significant. The result showed that ventilatory function in male patients is significantly improved, especially VC and FEV1, whereas in female patients improvement had not statistical significance. It can be concluded that one of the possible reasons for slight improvement of ventilator function in female patients is pulmonary hypertension.