The most frequent disease of the arteries is atherosclerosis which is characterized by lumen reduction of blood vessels due to local thickening of internal blood vessels caused by plaque/atheroma. As a cardiovascular disease, atherosclerosis is an interdisciplinary problem and one of the leading causes of death in developed countries. It begins in childhood, goes a long time without manifesting symptoms, increasing with age it begins to seriously threaten health. The most dangerous risk factors for the development of atherosclerotic disease are: Hyperlipidaemia, hypertension, smoking, diabetes, high fibrinogen, excessive weight and physical inactivity.

The pathogenesis of obesity-related vascular disorders has not been fully elucidated. The fundamental role of inflammation in aging process is now widely recognized, particularly for atherosclerotic disease which begins before birth. The number of obese individuals worldwide has reached two billion, leading to an explosion of obesity-related vascular disorders associated with increased morbidity and mortality. Obesity, as a chronic low grade inflammatory process, is important risk factor for metabolic and cardiovascular disease. Despite a well-known genetic component, this risk appears to originate from several abnormalities in adipose tissue function associated with a chronic inflammatory state. In particular, obesity as the most common nutritional disorder in industrialized countries, is closely related to impaired endothelial function, a well-known marker of preatherosclerotic disease. These conditions disrupt vascular homeostasis by causing an imbalance between the nitric oxide pathway and the endothelin-1 system, with impaired insulin-stimulated endothelium-dependent vasodilation. Having in mind the growing population of overweight and obese people worldwide, along with an increasingly aging population, understanding the pathophysiology of obesity on cardiovascular system is essential. The mechanisms linking obesity-related vascular disorders and low grade inflammation in aging process are the focus of this paper.

Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) play a complex role in the pathogenesis of atherosclerosis. We compared (1) the histopathological findings in patients with abdominal aortic aneurysms (AAA) and aortoiliac occlusive disease (AOD); (2) the expression of MMP-2/MMP-9 and TIMP-1/TIMP-2 in aortic layers, inflammatory cells and smooth muscle cells (SMCs), aiming to identify the common underlying pathogenic mechanisms of the disease development. Samples were obtained from 30 patients with AAA and 30 with AOD. Aortic histology and immunohistochemistry were performed to evaluate inflammatory changes and MMP and TIMP expression. Thrombosis and ulceration were more frequent in AOD than in AAA. The MMP-9 expression was elevated in all aortic layers of AAA patients and in media/adventitia of AOD patients, mainly followed by lower expression of its inhibitor TIMP-1. Higher MMP-9 expression was also found in SMCs and macrophages of both AAA and AOD specimens, while higher TIMP-1/TIMP-2 were Received May 3, 2017. Accepted February 3, 2018. The study was supported by the Ministry of Science and Technology of the Republic of Srpska. Corresponding author: Snezana Pejic, “Vinca” Institute of Nuclear Sciences, P.O. Box 522, 11001 Belgrade, Serbia. Phone: (+381) 11 3408 303; Fax: (+381) 11 64 555 61; e-mail: snezana@ vin.bg.ac.rs. Abbreviations: AAA – abdominal aortic aneurysms, AOD – aortoiliac occlusive disease, ECM – extracellular matrix, HE – haematoxylin-eosin, HP – histopathological, MMPs – matrix metalloproteinases, SMCs – smooth muscle cells, TIMPs – tissue inhibitors of metalloproteinases. predominantly observed in the lymphocytes and macrophages of the aneurysm. These results showed that both conditions exhibited increased MMP-9 expression; however, the MMP expression pattern differed to some degree between the aneurysms and occlusive disease. The variations in molecular mechanisms underlying dilatative/stenosing disease warrant further investigation.

Introduction. Hemodialysis patients with chronic renal failure, suffer from affective dysfunction to a variable extent. The aim of our study was to evaluate the cognitive and affective status in patients before and after hemodialysis. Apart from this, the goal of the study was to examine and compare the cognitive status of patients on dialysis in relation to the control group, but also in relation to laboratory parameters. Material and Methods. This research was a prospective study including 30 hemodialysis patients with chronic renal failure treated at the Department of Nephrology of the Health Center in Kosovska Mitrovica. The cognitive status of the subjects was evaluated by determining the simple reaction time to auditory and visual stimuli before and after hemodialysis sessions and using the Mini Mental Status Examination, while the affective status was evaluated by using the Beck Depression Inventory. Results. The analysis of the obtained results showed a statistically significantly lower auditory and visual simple reaction times (p = 0.014) after dialysis (p = 0.023). The results have confirmed a statistically significantly decreased simple reaction time to visual stimuli (p = 0.001), while a statistical significance (p = 0.137) was not obtained for the auditory stimuli when compared to the control group. The Mini Mental Status Examination and the Beck Depression Inventory did not indicate a significant cognitive status damage or presence of depression. Conclusion. The importance of hemodialysis in the improvement of cognitive function is clearly evident, even though the general state of cognitive status in patients on hemodialysis is lower compared to the healthy population. Evaluation of the cognitive and affective status using simple reaction time, Folstein's Mini Mental State Examination and the Beck Depression Inventory, should be used on daily basis in hemodialysis patients.

SUMMARYIntroduction/Objective Subtrochanteric fractures are unstable, tending to a varus, antecurvatum, and shortening deformity. The aim of this paper was to compare operation time and fluoroscopy time between different internal fixation methods in the treatment of subtrochanteric fractures. Method The prospective study of the group of 27 patients with a subtrochanteric fracture treated by the SIF (selfdynamisable internal fixator with a trochanteric unit) method had been done. Operation time and fluoroscopy time values from this group were compared to the same parameters data from the literature for intramedullary (IM) nails, proximal femur locking plates (PF-LCP), dynamic condylar screws (DCS), and the 95°-angled blade plate. Results In the SIF group, operation time was 62.2 (25–140) minutes and fluoroscopy time was 43 (20–95) s. Average operation time from the literature data was: 102.1 (43–181) minutes for IM nail, 94.2 (75–129) minutes for PF-LCP, 105.3 (70–166) minutes for DCS and 221.5 (171–272) minutes for blade plate. Average fluoroscopy time from the literature data was: 109.6 (34–250) seconds for IM nail, 102.3 (47–180) seconds for PF-LCP, 238 seconds for DCS. Operation time and intraoperative fluoroscopy time were higher in IM nail, PF-LCP, DCS and blade plate comparing to SIF method (p < 0.05). Conclusion The above mentioned difference could be explained by a degree of required accuracy in the initial operative technique maneuvers, by used number of screws and by the type of the fracture reduction performance in different fixation methods. Operation time during IM nailing of subtrochanteric fractures sometimes can be shorter than average operation time in SIF method, what could be explained by the skill of the surgeon to perform as fast closed reduction for insertion of guide wire.