Petar Šušnjara

Background/Objectives: Chronic topical antiglaucoma therapy may affect the ocular surface. We assessed documented dry eye disease (DED) and its associations with active-ingredient burden, treatment duration, and preservative exposure. Methods: This retrospective cross-sectional study included 357 adults receiving topical antiglaucoma therapy at a tertiary center who had complete treatment and ocular-surface data. Ocular-surface testing was prompted by symptoms or clinical judgment. The first eligible visit identified during chronological record review was analyzed for each patient. DED was based on the treating ophthalmologist’s documented diagnosis. Logistic regression evaluated treatment-related factors. Results: DED was documented in 171/357 patients within this selected sample (47.9%; 95% CI 42.8–53.1%). Prevalence was higher with at least two versus one active IOP-lowering ingredient (60.6% vs. 23.1%; p < 0.001). Each additional ingredient was associated with higher DED odds after adjustment for age, sex, and glaucoma subtype (adjusted odds ratio [aOR] 2.65, 95% confidence interval [CI] 1.88–3.74). Longer treatment duration was also associated with higher odds (aOR 1.12 per 12 months, 95% CI 1.05–1.20). In the linear extended model, active-ingredient count was not associated with documented DED (aOR 1.02, 95% CI 0.69–1.51), whereas an exclusively preservative-free regimen was associated with lower odds (aOR 0.011, 95% CI 0.001–0.084) and fixed-combination therapy with higher odds (aOR 3.23, 95% CI 1.74–5.98). However, categorical modeling of ingredient count significantly improved extended-model fit (likelihood-ratio p < 0.001), indicating sensitivity to functional form. Documented DED occurred in 1/91 (1.1%) exclusively preservative-free patients versus 170/266 (63.9%) preserved-exposure patients, with sparse PF events limiting interpretation. Conclusions: Documented DED was common in this selected cohort undergoing ocular-surface assessment. Active-ingredient count was associated with DED in the primary adjusted model, but its interpretation in the extended model depended on the functional form used. The marked inverse association with an exclusively preservative-free regimen requires prospective confirmation because sparse data, limited overlap between treatment groups, treatment selection, and residual confounding preclude causal inference.

Acute neuromuscular responses to running may vary according to exercise duration and physiological demands. This study compared changes in vastus medialis contractile properties, quadriceps maximal voluntary isometric contraction (MVIC), and interlimb asymmetry following 5 km and half-marathon running trials. Twenty-eight male recreational runners (36.96 ± 11.35 years) completed both trials 10 days apart. Maximal radial displacement (Dm), contraction time (Tc), and contraction velocity (Vc) were assessed using tensiomyography, while quadriceps MVIC was assessed using isometric dynamometry before and after each trial. Absolute interlimb asymmetry and its direction were also analysed. The unadjusted analysis showed a greater pre-to-post increase in Dm following the half-marathon; however, the effect of the running trial on post-running Dm was not significant after adjustment for baseline Dm. Tc and MVIC decreased after both trials, whereas Vc increased, with no significant running trial × time interactions for these outcomes. TMG- and MVIC-derived absolute interlimb asymmetry remained unchanged. Acute post-running responses differed according to the neuromuscular characteristic assessed rather than consistently according to running distance. Changes in contractile properties and maximal force-generating capacity were not accompanied by a systematic increase in the magnitude of between-leg differences.

Sprinters and jumpers differ in their force–velocity demands, so this exploratory study compared their acute countermovement jump (CMJ) response to isometric conditioning. Methods: Twenty-two competitive track and field athletes (10 sprinters, 12 jumpers; 19.1 ± 3.3 y) were alternately allocated from a randomised list to a 3 × 5 s isometric knee-extension or isometric half-squat (n = 11 each). Discipline was not manipulated, and no control condition was included. CMJ height was assessed from flight time by frame-by-frame video analysis, with take-off and landing timestamps read to the nearest 0.01 s. The best of three jumps was the primary trial summary. Percentage change (ΔCMJ) was the primary outcome. Results: Sprinters increased (+2.40 ± 4.46%) whereas jumpers decreased (−2.02 ± 6.44%). Discipline and protocol were analysed jointly in one additive model. The protocol contrast was small and imprecise (−0.25 percentage points [ISO-SQ relative to IKE], 95% CI −5.50 to 5.00; p = 0.921). The unadjusted discipline difference was non-significant (4.42 percentage points, 95% CI −0.46 to 9.30; p = 0.074) and the parallel Mann–Whitney U test was borderline and implementation-dependent (p = 0.043–0.050). After age adjustment it attenuated to +2.51 percentage points (95% CI −2.65 to 7.66; p = 0.320), whereas age remained associated with ΔCMJ (−0.86% per year; p = 0.042). Post hoc averaged trial summaries gave larger contrasts. Conclusions: The primary comparison was inconclusive and materially attenuated by age adjustment but directionally consistent across trial summaries and protocols. The observed discipline-dependent pattern is hypothesis-generating and requires confirmation in adequately powered, controlled trials.

Background: Retinal microvascular assessment has emerged as a promising non-invasive approach for evaluating vascular health. Recent advances in retinal imaging technologies have enabled detailed characterization of retinal vascular structure and function, raising interest in their potential role as biomarkers of exercise-related vascular adaptation. This systematic review with narrative synthesis aimed to summarize current evidence regarding the relationship between exercise, physical fitness, and retinal microvascular biomarkers. Methods: A systematic literature search was conducted in PubMed, Scopus, and Web of Science for studies published from January 2021 to June 2026, followed by a supplementary update search to identify eligible publications available through 31 July 2026. Search terms combined retinal microvascular assessment techniques with terms related to exercise, physical activity, physical fitness, and exercise training. Following screening and eligibility assessment, 42 publications were included in the final qualitative synthesis, comprising 20 publications identified through the initial search and 22 additional publications identified through the supplementary update search. Several publications represented complementary analyses of the same or overlapping study cohorts and were therefore not considered independent replications. Results: The included studies comprised observational studies and exercise intervention trials involving healthy individuals and clinical populations. Retinal biomarkers assessed included vessel diameters, arteriovenous ratio (AVR), vessel density, perfusion density, foveal avascular zone (FAZ), retinal oxygen extraction, wall-to-lumen ratio (WLR), and choriocapillaris perfusion parameters. Several studies reported measurable acute and chronic retinal vascular responses to exercise, although the direction, magnitude, and clinical meaning of these changes varied according to population, exercise modality, imaging technique, and biomarker. Observational studies generally reported associations between higher physical activity or cardiorespiratory fitness and a more favorable retinal vascular profile, but causal interpretation remains limited. Conclusions: Retinal microvascular biomarkers appear sensitive to acute physiological stress and may reflect selected adaptations associated with longer-term exercise exposure. However, retinal responses are heterogeneous and biomarker-specific, and their biological and clinical significance remains incompletely established. Methodological heterogeneity, overlapping study cohorts, and the limited number of adequately powered randomized and longitudinal studies constrain causal interpretation and generalizability. Retinal vascular measures should therefore currently be regarded as candidate biomarkers and research tools rather than validated surrogate outcomes or routine clinical measures.

Although significant progress has been made in reducing salt consumption over the past decade, most Croatian adults still exceed the recommended intake. This study aimed to identify demographic, socioeconomic, lifestyle, and clinical factors associated with high salt intake in the general adult population of Croatia. We included a random sample of 1067 adults with reliable 24-h urine samples. A structured questionnaire was used to collect sociodemographic, lifestyle, and clinical data. Anthropometric and blood pressure (BP) measurements were performed. Laboratory analyses included the measurement of sodium, potassium, and creatinine in adequate 24-h urine samples, as well as relevant cardiometabolic and kidney-related biomarkers. Participants consuming > 10 g/day of salt were older and had higher systolic blood pressure, fasting glucose, serum uric acid, and triglyceride levels, lower HDL cholesterol levels, and greater BMI. High salt intake was more common among men, ex-smokers, participants with diabetes, and those with lower socioeconomic status (SES). In multinomial logistic regression analysis, male sex, diabetes, higher systolic BP, more frequent processed meat consumption, lower fish consumption, residence outside the Adriatic region, and higher ePWV were associated with high salt intake. High salt intake was associated with lower socioeconomic status, residence in rural and continental areas, obesity, former smoking, and less favorable dietary patterns. Conversely, lower salt intake was associated with residence in the Adriatic region and dietary patterns characterized by more frequent consumption of fish and olive oil.

High-intensity 5 km running offers an ideal framework to analyze the organism’s multidimensional responses. Since previous research primarily analyzed isolated aspects of fatigue, this study aimed to examine the integrated acute neuromuscular, metabolic, and perceptual responses to a 5 km run. Twenty-one recreational male runners participated. Pre- and post-race assessments included body composition, blood lactate, m. rectus femoris ultrasound thickness, quadriceps maximal voluntary isometric contraction (MVIC), heart rate, perceived exertion (Borg CR10), and 5 km finish time. Statistical analysis was performed in the Jamovi software, utilizing descriptive statistics, the Shapiro–Wilk test of normality, the Wilcoxon signed-rank test with effect size calculation, and Spearman’s correlation coefficient, at a significance level of p < 0.05. Post-race measurements revealed a significant decrease in quadriceps MVIC (pre: 305 ± 99 N vs. post: 259 ± 88 N; p = 0.002) and an increase in blood lactate (pre: 0.8 ± 0.4 vs. post: 6.9 ± 1.4 mmol/L; p < 0.001), alongside high average heart rates (165 ± 16 bpm). However, ultrasound-assessed muscle architecture remained unchanged. The 5 km run induced pronounced neuromuscular and metabolic fatigue. Unchanged muscle architecture suggests that acute strength decline is primarily mediated by metabolic and neural mechanisms, rather than immediate structural–morphological factors. These findings highlight the value of an integrated assessment approach for understanding acute fatigue responses following high-intensity 5 km running and may contribute to more precise training-load prescription and recovery monitoring in recreational runners.

High-intensity 5 km running offers an ideal framework to analyze the organism's multidimensional responses. Since previous research primarily analyzed isolated aspects of fatigue, this study aimed to examine the integrated acute neuromuscular, metabolic, and perceptual responses to a 5 km run. Twenty-one recreational male runners participated. Pre- and post-race assessments included body composition, blood lactate, m. rectus femoris ultrasound thickness, quadriceps maximal voluntary isometric contraction (MVIC), heart rate, perceived exertion (Borg CR10), and 5 km finish time. Statistical analysis was performed in the Jamovi software,utilizing descriptive statistics, the Shapiro–Wilk test of normality, the Wilcoxon signed-rank test with effect size r calculation, and Spearman’s correlation coefficient, at a significance level of p < 0.05. Post-race measurements revealed a significant decrease in quadriceps MVIC (pre: 305.26 ± 98.83 N vs. post: 258.85 ± 88.47 N; p = 0.002) and an increase in blood lactate (pre: 0.81 ± 0.35 vs. post: 6.90 ± 1.44 mmol/L; p < 0.001), alongside high average heart rates (165 ± 16 bpm). However, ultrasound-assessed muscle architecture remained unchanged. The 5 km run induced pronounced neuromuscular and metabolic fatigue. Unchanged muscle architecture suggests that acute strength decline is primarily mediated by metabolic and neural mechanisms, rather than immediate structural-morphological factors.

Hypertension and chronic kidney disease (CKD) are closely linked conditions and represent common global health problems. Hypertension is a leading risk factor for cardiovascular disease, which is the main cause of mortality in CKD. Endothelial injury underlies the etiopathogenesis of both hypertension and CKD. The endothelial glycocalyx (eGC) is a dynamic, negatively charged, carbohydrate-rich layer that covers the luminal surface of endothelial cells. Its primary physiological function is to protect the endothelium, including the regulation of vascular permeability and homeostasis. Damage to the eGC, known as “shedding”, is an early predictor of endothelial dysfunction and is driven by oxidative stress and low-grade inflammation. In hypertension, loss of eGC integrity—often impaired by a high-salt diet—can reduce the bioavailability of nitric oxide (NO) and increase arterial stiffness. Similarly, in CKD, uremic toxicity, hypertension, and inflammation damage the eGC, resulting in increased permeability, albuminuria, and higher cardiovascular risk. This review summarizes current evidence and underscores the potential of eGC shedding markers, especially syndecan 1 (SDC-1) and hyaluronic acid (HA), as early predictors of vascular risk and disease progression in hypertension and CKD.

Objective: Vascular function serves as an early indicator of cardiovascular (CV) risk. The intake of n-3 polyunsaturated fatty acids (PUFAs) has been reported to improve arterial properties and reduce CV risk, but evidence in healthy individuals remains limited. This study investigated the effects of consuming n-3 PUFAs-enriched chicken meat on vascular reactivity at both microvascular and macrovascular levels in healthy young adults. Materials and Methods: In this placebo-controlled, double-blind, randomized interventional trial (ClinicalTrials.gov: NCT05725486), 39 participants (aged 20–26 years) were assigned to either the Control group (n = 20; approximately 118 mg n-3 PUFAs/day) or the n-3 PUFA group (n = 19; approximately 1500 mg n-3 PUFAs/day) for three weeks. Microvascular reactivity was assessed via post-occlusive reactive hyperemia (PORH), acetylcholine-induced dilation (AChID), local thermal hyperemia (LTH), and sodium nitroprusside-induced (SNPID) responses. Macrovascular reactivity was measured by brachial artery flow-mediated dilation (FMD) and nitroglycerine-mediated dilation (NTG-MD). Body composition and blood pressure (BP) were recorded before and after the intervention. Results: Both microvascular (PORH, AChID, and LTH) and macrovascular (FMD) endothelium-dependent vasodilation increased in the n-3 PUFAs group following the dietary protocol compared to the Control group. Conversely, the three-week dietary intervention did not influence endothelium-independent dilation in either the microvasculature (SNPID) or macrovasculature (NTG-MD) within the groups compared to baseline, nor were any differences observed between the groups. No significant changes were noted in BP or body composition after either diet. Conclusions: In healthy young adults, consuming the n-3 PUFAs-enriched chicken meat for three weeks improved endothelium-dependent vasodilation in both micro- and macrocirculation, without affecting endothelium-independent responses. These findings suggest that dietary n-3 PUFA intake may provide vascular benefits even in healthy, disease-free individuals at rest.

Background/Objectives: This study investigated the effect of the consumption of carnosine-enriched chicken meat on endothelium-dependent and independent microvascular reactivity and inflammatory mediators in patients with chronic coronary syndrome (CCS). Materials and Methods: In total, 38 CCS participants were randomized to two groups: the Control group (N = 19), who consumed regular chicken meat, and the Carnosine group (N = 19), who consumed carnosine-enriched chicken meat for 3 weeks. Skin microvascular reactivity in response to vascular occlusion (PORH), acetylcholine (ACh ID), sodium nitroprusside (SNP ID), and local thermal hyperemia (LTH) was measured. Arterial blood pressure (BP), heart rate (HR), biochemical parameters, anti- and proinflammatory cytokine levels, and markers of oxidative stress were assessed before and after the intervention. Results: The consumption of carnosine-enriched chicken meat improved endothelium-dependent (PORH, LTH) and endothelium-independent vasodilation (SNP ID). Systolic BP (SBP), diastolic BP (DBP), and mean BP (MAP), as well as serum concentrations of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and endoglin, decreased from the initial measurements. Conclusion: The consumption of carnosine-enriched chicken meat enhances microvascular endothelium-dependent and independent vasodilatation. Patients with CCS can benefit from carnosine-enriched chicken meat consumption through improved hemodynamic parameters, reduced inflammation, and enhanced microvascular relaxation.