Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
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Aim To evaluate the relationship between cardiovascular remodelling and glomerular filtration rate (eGFR) in pre-dialysis chronic kidney disease (CKD) patients without cardiovascular diseases (CVD) and in renal transplant recipients (RTR). Methods The cross-sectional study included 83 patients with eGFR<60 mL/min/1.73m2 (45 with CKD 3 stage and 38 with CKD 4 stage). Thirty six RTR had eGFR 67.8 (57.3-73.7) mL/ min/1.73m2 and control group consisted of 44 patients with eGFR>60 mL/min/1.73m2. ⋯ In multivariate regression analysis the risk factor for calcifications of the mitral and aortic valve, as well as for CAA was the decline in eGFR (p<0.001). Conclusion Renal transplant recipients have a higher incidence of CV remodelling than patients with CKD 3 and less than patients with CKD 4 stage, indicating incomplete regression of CV calcifications and LVH after kidney transplantation. A decrease of renal function represents a significant risk factor for valvular and vascular calcifications occurrence in CKD patients.
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Aim To systematically review the scientific evidence of biomarker validity, reliability, specificity and sensitivity in identifying malnutrition in the elderly. Methods Peer-reviewed journals were searched using PUBMED and EBSCO from January 1998 to April 2018. The articles included description of the association between malnutrition blood biomarkers and validated nutritional status assessment instruments and studies were conducted among community-dwelling elderly or nursing home residents. ⋯ A total of sixteen blood biomarkers were identified. Six studies found a significant association between the nutritional assessment score and albumin level. Conclusion Combining serum concentrations of malnutrition biomarkers with nutritional status assessment tools has a great potential in identifying the risk of malnutrition in the elderly, while also increasing sensitivity and specificity.
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Aim To develop and validate a screening questionnaire for migraine without aura with sufficient diagnostic accuracy to be used in primary care settings. Methods The study was designed as cross-sectional, multicentric, diagnostic accuracy trial of new questionnaire for screening patients who visit general practitioners, with an aim to reveal migraine without aura. The instrument was constructed for the purpose of this study, and validated on the sample of 429 primary care outpatients. ⋯ The study also confirmed a high percentage of patients with hidden migraine without aura (MWA) (52.9%) revealed by the BMSQ and the ICHD-III criteria that would otherwise remain undiagnosed. Conclusion The BMSQ is a valid and reliable clinical instrument for revealing migraine without aura, which could be easily selfadministered by patients. It has high screening yield, discovering majority of patients with previously undiagnosed migraine without aura, whose definite diagnosis should later on be confirmed by the attending physicians using the ICHD-III criteria.
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Aim To evaluate the frequency of refractive errors in premature children in retinopathy of prematurity (ROP) screening to find mutual connection of the prematurity level, disease activity and refractive errors. Methods A retrospective study was conducted in the Eye Clinic of the University Clinical Centre Sarajevo, between December 2013 and January 2017. A total of 126 patients of gestational age ≤ 34 weeks and birth weight ≤ 2000 g underwent ROP screening program. ⋯ The average gestational age was 29.7±0.3 weeks in patients without and 29.0 ± 0.3 weeks in patients with refractive errors (p=0.126). Conclusion The birth weight and the gestational age were significantly lower in patients with the active form of ROP. Lower gestational age and birth weight of premature children increase the chance for the development of refractive errors such as hyperopia in all premature children and myopia in patients with active form of ROP.
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Aim To identify short-term effects of extracorporeal shock wave lithotripsy (ESWL) on renal function in children and adolescents with single kidney stones. Methods In a 4-year period 30 children (15 boys and 15 girls) from 10 to 18 years of age were treated for unilateral renal stones with ESWL. Inclusion criteria were: up to 18 years of age, kidney stone (from 4 to 20 mm in diameter) visible on X-ray, first ESWL treatment, unilateral lithotripsy treatment without previous kidney surgery, patients without infravesical obstruction, patients without proven urinary infection, repeated use of one (the same) analgesic, patients without anticoagulant and antihypertensive therapy, patients without use of nephrotoxic drugs prior to and during the treatment, normal blood pressure, non-pregnancy patients with normal renal function. ⋯ Serum cystatin C level was also significantly increased during the first four days after ESWL treatment (p<0.05) and returned to baseline on post-treatment day 5. There was a statistically significant difference in the level of uNGAL in urine before and 24 hours after ESWL treatment (p<0.05). Conclusion The ESWL is a safe and curative procedure for the treatment of kidney stones in children and adolescents with no evidence of serious adverse effects on renal function.