Boris Dojčinović

Patients suffering from cholelithiasis have an increased risk of developing cardiovascular complications, particularly ischemic myocardial disease. Ursodeoxycholic acid (UDCA), already used in clinical practice for the treatment of cholelithiasis and related conditions, has proven antioxidative, anti-inflammatory, and cytoprotective effects. Therefore, the aim of this study was to investigate the cardioprotective effect of UDCA pre-treatment on isoprenaline-induced myocardial injury in rats. Male Wistar albino rats were randomized into four groups. Animals were pre-treated for 10 days with propylene glycol + saline on days 9 and 10 (control), 10 days with propylene glycol + isoprenaline on days 9 and 10 (I group), 10 days with UDCA + saline on days 9 and 10 (UDCA group), and 10 days with UDCA + isoprenaline on days 9 and 10 (UDCA + I group). UDCA pre-treatment significantly reduced values of high-sensitivity troponin I (hsTnI) and aspartate aminotransferase (AST) cardiac markers (p < 0.001 and p < 0.01, respectively). The value of thiobarbituric acid reactive substances (TBARS) was also decreased in the UDCA + I group compared to the I group (p < 0.001). UDCA also significantly increased glutathione (GSH) levels, while showing a tendency to increase levels of superoxide dismutase (SOD) and catalase (CAT). The level of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) expression, a key regulatory gene of inflammation, was diminished when UDCA was administered. A reduction of cardiac damage was also observed in the UDCA pre-treated group. In conclusion, UDCA pre-treatment showed a cardioprotective effect on isoprenaline-induced myocardial injury in rats, primarily by reducing oxidative stress and inflammation.

Introduction. Hyperglycemia causes the well-known microvascular complications of diabetes mellitus (DM) such as diabetic retinopathy, polyneuropathy and nephropathy, but it can also affect the inner ear, and hearing loss (HL) can be considered as one of the microvascular complications. The aim of the study was to evaluate association between HL and values of glycated hemoglobin A1c (HbA1c) in patients with diabetes mellitus type 2 (DMT2).Methods. In this retrospective-observational cross sectional study, we included 80 patients divided into two groups: experimental group consisting of 40 patients with DMT2 and control group consisting of 40 patients who were not previously diagnosed with DM. Data were retrieved from electronic medical records of patients treated in outpatient clinic of the Ear, Nose and Throat Department, University clinical center of Republic of Srpska (UCC RS) from 2023 to 2024. Results. Out of 40 patients from experimental group, 15 were males (37.5%) and 25 were females (62.5%). Regarding glycoregulation patterns in experimental group, patients were stratified into three subgroups: HbA1c < 7% (N 17; 42.5%), HbA1c-9% (N 17; 42.5%) and HbA1c > 9% (N 6; 15%). In the experimental group, a significant (p<0.000) greater number of patients had HL, and significant greater number of patients had bilateral HL (N 32; 80%, p<0.05) with predominantly pronounced sensorineural HL (N 36; 90%, p<0.05).Conclusion. Patients with DMT2 had a higher incidence of HL compared to controls. The sensorineural type of HL showed a significantly high prevalence among patients with DMT2. HbA1c levels may be a potentially significant predictor of HL in DMT2.

Background and Objectives: PoCUS ultrasound applications are widely used in everyday work, especially in the field of emergency medicine. The main goal of this research was to create a diagnostic and therapeutic protocol that will integrate ultrasound examination of the lungs, ultrasound measurements of the inferior vena cava (assessment of central venous pressure) and BREST scores (risk stratification for heart failure), with the aim of establishing a more effective differential diagnostic approach for dyspneic patients. Materials and Methods: A cross-sectional study was conducted in the emergency medicine department with the educational center of the community health center of Banja Luka. Eighty patients of both sexes were included and divided into experimental and control groups based on the presence or absence of dyspnea as a dominant subjective complaint. Based on the abovementioned variables, the LUSBI protocol (lung ultrasound/BREST score/inferior vena cava) was created, including profiles to determine the nature of the origin of complaints. The biochemical marker of heart failure NT pro-BNP served as a laboratory confirmation of the cardiac origin of the complaints. Results: The distribution of NT pro BNP values in the experimental group showed statistically significant differences between individual profiles of the LUSBI protocol (p < 0.001). Patients assigned to group B PLAPS 2 had significantly higher average values of NT pro-BNP (20159.00 ± 3114.02 pg/mL) compared to other LUSBI profiles. Patients from the experimental group who had a high risk of heart failure according to their BREST scores also had a significantly higher average maximum expiratory diameter compared to those without heart failure (p = 0.004). A statistically significant difference (p = 0.001) in LUSBI profiles was observed between the groups of patients divided according to CVP categories. Conclusion: The integration of the LUSBI protocol into the differential diagnosis of dyspnea has been shown to be very effective in confirming or excluding a cardiac cause of the disease in patients.