Uvod. Poremecaji funkcije desnog srca su prediktori lose prognoze kod pacijenata na programu hronicne hemodijalize (HD). U ovoj studiji ispitivana je validnost ehokardiografije u procjeni sistolne i dijastolne funkcije desne komore kod pacijenata na HD. Metode. Istraživanjem je obuhvaceno 30 pacijenata (55±11 godina) na hronicnoj HD kojima su rađene standardna 2D ehokardiografija i tkivni Doppler, prije i nakon HD. Rezultati. Ispitivanje sistolne funkcije desne komore prije i poslije HD je pokazalo da su frakciona promjena povrsine – FAC (36%±11 vs. 34%±11, p=0,464) i amplituda sistolne pokretljivosti anulusa trikuspidne valuvle –TAPSE (25,2mm±4,8 vs. 24,2mm±5, p=0,207) bile u granicama normalnih vrijednosti, nezavisno od smanjenja ukupnog volumena krvi nakon HD, dok je frakciono skracenje – Fs (43,8%±11,6 vs. 39,3%±13,2, p=0,014) bilo znacajno manje nakon HD, sto pokazuje zavisnost ovog parametra od smanjenja cirkulatornog volumena. Tei indeks desne komore pokazao je normalne vrijednosti, nezavisno od smanjenja punjenja desne komore nakon HD (0,59±0,44 vs. 0,69±0,27, p=0,18). Evaluacija dijastolne funkcije desne komore preko brzina transtrikuspidnog protoka (E talas, E/A) pokazala je znacajno smanjenje brzina nakon smanjenja volumena poslije HD, dok je odnos brzina E/E’ (6,02±3,19 vs. 5,66±1,83, p=0,599) ostao u granicama normalnih vrijednosti i nakon HD. Zakljucak. Ehokardiografska procjena sistolne funkcije desne komore pomocu FAC i TAPSE, kao i procjena globalne funkcije miokarda pomocu Tei indeksa, su pouzdane metode kod pacijenata na HD, posto se njihove vrijednosti nisu mijenjale u uslovima smanjenja cirkulatornog volumena nakon HD. Kao pouzdan parametar za procjenu dijastolne funkcije kod pacijenata na HD se može koristiti odnos brzina E/E’, koji se u ovom istraživanju nije znacajno mijenjao usljed smanjenja volumena krvi nakon HD.

Uvod. Tinitus se definise kao percepcija zvuka u usima ili glavi bez prisutnih vanjskih izvora zvuka. Zujanje u uhu i nesposobnost bolesnika da se prilagode ovoj pojavi može da dovede do ispoljavanja emocionalnih tegoba, kao sto su depresija i anksioznost. Cilj ove studije je bio da se procijeni stepen depresivnih tegoba koje prate hronicni tinitus i ispita veza između prisustva tinitusa i simptoma depresije kod pacijenata sa hronicnim subjektivnim tinitusom. Metode. Studijom su obuhvacena 73 bolesnika sa tinitusom i 47 ispitanika bez tinitusa, a obje grupe su uparene po polu i uzrastu. Bolesnici su podvrgnuti otorinolaringoloskom pregledu i popunili su samostalno Tinitus hendikep upitnik i Beck-ov upitnik depresije. Tonalna liminarna audiometrija je urađena kod obje grupe ispitanika. Rezultati. Audioloskim ispitivanjem je otkriveno da 7 (9,6%) bolesnika sa tinitusom nema ostecenje sluha, a vecina (41-56,2%) je imalo nagluvost lakog stepena, dok je među ispitanicima bez tinitusa 28 (59,6%) imalo normalan sluh. Bolesnici su najcesce imali visoke frekvencije tinitusa (63-86,3%), a u odnosu na intenzitet 48 (65,8%) bolesnika je imalo srednje jak tinitus (5-20 dB). Tinitus hendikep upitnikom dobijen je skor koji je klasifikaovao subjektivni doživljaj hendikepa kao zanemarljiv kod 26 (35,6%) bolesnika, blag kod 12 (16,4%), umjeren kod 23 (31,5%), težak kod 7 (9,6%) i veoma težak kod 5 (6,8%) bolesnika. Beck-ovim upitnikom depresije utvrđeno je normalno raspoloženje kod 59 (80,8%) bolesnika, odnosno kod 43 (91,5%) ispitanika bez tinitusa (U=1282.0, Z=-2.35, p<0,05). Između skorova dobijenih koriscenjem ova dva upitnika utvrđen je visok stepen korelacije (ρ=0,436, p<0,001). Zakljucak. Znacajna korelacija između skorova dobijenih Tinitus hendikep upitnikom i Beck-ovim upitnikom depresije ima znacaja u pristupu lijecenju ovih bolesnika. Kako depresija dodatno smanjuje kvalitet života, neophodno je da se adekvatnim tretmanom utice na bržu adaptaciju na tinitus.

Introduction. Orthodontic treatment is a common dental procedure in developed countries. Assessment of orthodontic treatment need is important for health services planning and population trends monitoring. The aim of this study was to assess the need for orthodontic treatment among children in Foca, Bosnia and Herzegovina. Methods. The study involved 81 students of two primary schools in the municipality of Foca, aged 11-13 years. The subjects underwent clinical examinations, the dental impressions were taken, study models were made and analyzed, and digital photographs of anterior dentition were taken too. Index of Complexity, Outcome and Need (ICON) was used to assess the need for orthodontic treatment. The number of orthodontists, which would be sufficient to meet the needs of this population of children, was estimated. Results. ICON index results showed that 56.8% of children needed orthodontic treatment. There was no statistical significance in the need for orthodontic treatment between the subjects of different gender and age. The study showed that 22.2% of boys and 34.6% of girls needed orthodontic treatment. In relation to age, 21% of eleven- and 21% of twelve-year-olds needed orthodontic treatment and 14.8% of thirteen-year-olds. The incidence of crowding was 80.2%. Crossbite was present in 23.5% of examined students, open bite in 2.5%, deep bite in 29.6% and irregular dental esthetics anterior teeth in 28.4%. Class II/1 malocclusion was found in 39.5% of children, II/2 class in 9.9%, class I in 38.3%, while class III malocclusion was found in 9.9% of examined children. Conclusion. The study shows that a large percentage of children in Foca need orthodontic treatment. Percentage of the need for orthodontic treatment is higher in comparison to most of the countries in Europe and the world. The development of prevention programs and early caries therapy can greatly reduce the need for orthodontic treatment.

Objective: We aimed to explore correlates and predictors of bereavement severity and persistence (triggered by “loss of a loved one”; referent group partner loss) in the Rotterdam cohort. Method: We used linear regression to examine factors associated with grief severity using a cross-sectional analysis and logistic regression to determine prospective associations. Results: Cross-sectionaly, females, child-lost, higher depressive symptoms, lower education, and difficulties in daily activities were independently associated with a higher bereavement severity. Prospectively (6 years; response rate 71%), the baseline value of the grief severity was the single predictor significantly associated with grief persistence. Discussion: Our results suggest that only grief severity is independently associated with grief persistence. Further studies are needed to confirm our findings.

Aims/hypothesisIn this study, we aimed to examine the association between age at natural menopause and risk of type 2 diabetes, and to assess whether this association is independent of potential mediators.MethodsWe included 3639 postmenopausal women from the prospective, population-based Rotterdam Study. Age at natural menopause was self-reported retrospectively and was treated as a continuous variable and in categories (premature, <40 years; early, 40–44 years; normal, 45–55 years; and late menopause, >55 years [reference]). Type 2 diabetes events were diagnosed on the basis of medical records and glucose measurements from Rotterdam Study visits. HRs and 95% CIs were calculated using Cox proportional hazards models, adjusted for confounding factors; in another model, they were additionally adjusted for potential mediators, including obesity, C-reactive protein, glucose and insulin, as well as for levels of total oestradiol and androgens.ResultsDuring a median follow-up of 9.2 years, we identified 348 individuals with incident type 2 diabetes. After adjustment for confounders, HRs for type 2 diabetes were 3.7 (95% CI 1.8, 7.5), 2.4 (95% CI 1.3, 4.3) and 1.60 (95% CI 1.0, 2.8) for women with premature, early and normal menopause, respectively, relative to those with late menopause (ptrend <0.001). The HR for type 2 diabetes per 1 year older at menopause was 0.96 (95% CI 0.94, 0.98). Further adjustment for BMI, glycaemic traits, metabolic risk factors, C-reactive protein, endogenous sex hormone levels or shared genetic factors did not affect this association.Conclusions/interpretationEarly onset of natural menopause is an independent marker for type 2 diabetes in postmenopausal women.