Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
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Observational Study
Fetuin-A Thr256Ser gene polymorphism as a mortality predictor in patients with chronic kidney disease on maintenance haemodialysis in Medan, Indonesia.
Aim To investigate an impact of Fetuin-A Thr256Ser gene polymorphism on the mortality rate of chronic kidney disease on maintenance haemodialysis patients in Indonesia. Methods This is an analytic-longitudinal observational study using survival analysis with nine-month follow up on 106 maintenance haemodialysis patients. The PCR-RFLP is used to determine Fetuin-A Thr256Ser gene polymorphism and Fetuin-A serum level measured by using ELISA methods. ⋯ The group of patients with IL-6 level ≥86.9 pg/mL had higher mortality with 3.64 times greater risk compared to those with IL-6 level, <86.9 pg/mL (p=0.03). Conclusion This study revealed a significant dominance independent impact of the Fetuin-A Thr256Ser gene polymorphism on the survival rate of maintenance haemodialysis patients. These results suggest that genotype variation of Fetuin-A gene could be a potential marker to identify high mortality risk in Indonesia's maintenance haemodialysis patients, especially in Medan.
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Aim To correlate the maximum anterior sagittal curvature (Kmax) changes and uncorrected (UDVA) and corrected distance visual acuity (CDVA) in keratoconus patients after the cross-linking (CXL) procedure. Methods Forty-four eyes of 34 patients with keratoconus were analysed after the standard Dresden protocol CXL procedure had been performed. All patients underwent complete preoperative examination with a follow-up of 12 months with focus on UDVA, CDVA and Oculus Pentacam (Scheimpflug technology) analysis. ⋯ Even Kmax is the most relevant and most followed parameter for progression and regression of keratoconus, its lowering was not directly correlated with the visual acuity improvement (both uncorrected and corrected) in the first 6 months after corneal CXL procedure. Kmax was changed significantly in the period of 12 months post cross linking, but not in the first 6 months. Conclusion Corneal CXL should be considered as a procedure not just for corneal stiffening and stabilization, but also for visual acuity improvement in keratoconus patients.
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Aim To evaluate vertebral bone marrow adiposity (BMA) using magnetic resonance spectroscopy (MRS) in postmenopausal women and to determine an association of bone density with bone marrow fat content. Methods This cross-sectional study included 120 postmenopausal women referred for osteoporosis screening. All women underwent assessment of bone mineral density by dual X-ray absorptiometry (DXA), who were divided based on T scores into osteoporosis (OST; n=60) and control group (CG; n=60). ⋯ FC was significantly negatively associated with BMD at lumbar spine (Rho=-0.042; p<0.001) and with BMD at hip (Rho=-0.64; p<0.001). In logistic regression model, FC remained independently associated with osteoporosis after controlling for confounders (age, menopause duration, reproductive period duration and body mass index) (OR=1.3; 95% CI 1.1-1.6). Conclusion Bone marrow adiposity is an independent predictor of low bone mass in postmenopausal women suggesting its role as a therapeutic target in postmenopausal osteoporosis management.
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Aim To assess obesity and weekly physical activity among medical students at the University of Banja Luka, Bosnia and Herzegovina, related to gender and years of study profile. Methods This is a prospective, descriptive study conducted among the student population across all six years, comprised of a validated survey instrument Youth Risk Behaviour Survey Questionnaires. The study was approved by the Ethics Committee of the School of Medicine and carried out as an anonymous survey, during the winter semester of the academic year 2017/2018. ⋯ Most female students, 255 (75.7%) had normal weight, while 132 (61.1%) males were overweight. Physical inactivity was found among 349 (64.3%) students; 11 (2%) exercised regularly twice a week and 16 (2.9%) exercised five times a week. Conclusion This study should help better understanding and identifying the onset of obesity among the students of the School of Medicine in Banja Luka and promote awareness of the obesity problem among them that would have benefit for health of this population group.
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Aim Alpha2-Heremans-Schmid glycoprotein (AHSG), a circulating plasma protein, plays an essential role in bone and vascular mineralization. The impact of AHSG gene polymorphisms on aortic calcification in haemodialysis patients was inconsistent. We performed this study to clarify precise association among AHSG gene Thr256Ser single-nucleotide polymorphisms and aortic calcification. ⋯ The bivariate analysis showed that Thr256Ser polymorphism (G allele) was associated with increased risk for aortic calcification (PR=2.03; 95% CI 1.48-2.80; p<0.001). However, overall results from multivariate analysis showed that Fetuin-A level <204 pg/mL (PR=22.0; 95% CI 3.32-145.91; p=0.001) and IL-6 level ≥53.05 mg/dL (PR=19.50; 95% CI 2.87-132.41; p=0.002) were the major risk factors for the occurrence of aortic calcification. Conclusion AHSG Thr256Ser gene polymorphism showed an association with aortic calcification in regular haemodialysis patients, but Fetuin-A and IL-6 have a dominant role in the development of aortic calcification.