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Diabetic osteopathy
Ili? Jana,Kovaev Branka
Medicinski Pregled , 2005, DOI: 10.2298/mpns0504147i
Abstract: Introduction. The aim of this study was to point out some dilemmas about the existence and pathogenesis of primary diabetic osteopathy as a separate entity, based on currently available studies. Expert disagreements are present not only about the occurrence of generalized osteopathy with diabetic disease, but also about direct relationship between metabolic diabetes control and bone metabolism and influence of disease duration and sex on bone changes. Pathogenesis of diabetic osteopathy Decreased bone formation is the basic mechanism leading to decreased bone mass. Biochemical markers showed no clear connection with bone density measurement. Insulin and insulin-like growth factor (IGF) affect bone metabolism. Osteopathy in patients with diabetic disease-type 1 Some clinical studies have shown that patients with diabetic disease-type 1 have a mild decrease in bone mass, while others have not presented such results. Osteopathy in patients with diabetic disease-type2 In patients with diabetic disease-type 2 the risk for osteopathy is even less defined. Patients treated with oral hypoglycemics present with higher decrease of bone mass has than patients treated with insulin therapy. This could partly be explained by anabolic effects of insulin on bones. Bone fractures in patients with diabetic disease Literature data are contradictory concerning the occurrence of bone fractures in diabetic patients. A survey of bone fracture occurrence in diabetic patients was performed in "Veljko Vlahovi Medical Center" in Vrbas and it included a group of 100 patients with diabetic disease. The results show that 12 patients had some fractures: mostly females in postmenopause, aged and with secondary insulin-dependent diabetes and most frequently arm fractures. Considering contradictory literature data, further longitudinal studies are necessary. .
Effects of hyperthyroidism on bone mass in women of reproductive age
Ili? Jana,Kovaev Branka,Todorovi?-?ilas Ljiljana R.
Medicinski Pregled , 2004, DOI: 10.2298/mpns0404111i
Abstract: Introduction Hyperthyroidism is one of the most frequent endocrinopathies in women of reproductive age. Consequently, increased risk of osteoporosis may be expected. Material and methods The research has included a group of 30 hyperthyroid women and a control group of 30 healthy women of reproductive age. Age and some clinical characteristics were analyzed, as well as some anthropometric parameters. Bone mass parameters were determined by measuring bone mineral density using ultrasound devices (SAHARA-Hologic). Results Bone mass parameters in hyperthyroid women are significantly lower than in controls (BUA: 63.25±12.17; 69.73±10.02 dB/MHz respectively; SOS:1523.90± 24.47; 1540.19±26.59 m/s respec. QUI/STIFF 79.78±13.95; 89.09±13.99 % respec.) Duration of hyperthyroidism affects bone density and reduces it. Discussion Obtained results were expected, having in mind that hyper- thyroidism is a condition characterized by increased bone catabolic rate. Also, negative correlation between the duration of hyperthyroidism and bone mass parameters (BUA, SOS) was expected, because it is logical that consolidation of bone mass in adult life cannot be maintained in circumstances in which metabolic rate is increased. During hyperthyroidism, bone loss is expected. In order to confirm this, future studies of bone markers are necessary. Conclusion Based on results obtained in the study, the following conclusions were made: hyperthyroidism is accompanied by decreased values of bone mass parameters; this effect depends on duration of hyperthyroidism. We confirmed that hyperthyroidism may be the cause of decrease in bone mass, particularly if it lasts more than a year. To prevent osteoporosis in women of reproductive age with hyperthyroidism and involution osteoporosis later in life, early diagnosis and effective therapy of hyperthyroidism is imperative.
Effects of alendronate on the markers of bone metabolic activity in postmenopausal women with osteoporosis
Ili? Jana,Kovaev Branka,Babi? Ljiljana J.,?uri? Nikola
Medicinski Pregled , 2005, DOI: 10.2298/mpns0508393i
Abstract: Introduction Bisphosphonates are synthetic compounds used in treatment of osteoporosis and inhibition of bone resorption. Material and methods The research included a group of 30 postmenopausal women with osteoporosis, treated with alendronate (70 mg per week -Fosamax tablets in combination with calcium and active vitamin D - Alpha D3 0.25mcg). The control group included 20 women with osteoporosis treated with hormone substitution therapy (HST), calcitonin and deca duraboline. Bone metabolic activity, was evaluated using osteocalcin for bone formation and cross-laps for bone resorption. Blood samples were taken before therapy and 6-8 weeks after. Results The serum levels of osteocalcin and cross-laps during application of alendronate were statistically significantly lower comparing to those in pre-therapy. The serum levels of osteocalcin and cross-laps during the therapy applied in the control group were statistically insignificantly lower than values in pretherapy. Osteocalcin has a tendency of decreasing in both groups, and it was slightly more evident in alendronate group. Cross-laps demontrated the same tendency of decreasing in both groups, and it was more evident in alendronate group. Discussion Our results have shown the efficacy of alendronate in preventing bone loss, which was highly statistically significant. They have also shown its suppressive effect on bone formation and resorption, but the effects were statistically less significant. Conclusion Alendronate significantly reduces the level of bone resorption in postmenopausal women with osteoporosis. Its effects on bone formation are less expressed. Alendronate's effects on bone metabolism become evident not later than 6-8 weeks after therapy application. Parameters of bone metabolic activity are very useful diagnostic means in evaluation of alendronate effect on bone metabolic activity and in the prognosis of bone mass loss.
Bone metabolism during substitution therapy of primary hypothyroidism
Pejin Radoslav,?uri? Nikola,Kovaev-Zavi?i? Branka,Todorovi?-?ilas Ljiljana
Medicinski Pregled , 2009, DOI: 10.2298/mpns0910407p
Abstract: Introduction. The relation between thyroid hormones and bone metabolism markers in hyperthyroidism is well known. Earlier studies indicate the possibility of bone metabolism acceleration during the excessive replacement therapy with l-thyroxin in hypothyroid patients especially in one with other risk factors for bone metabolism impairment. This study evaluated the effect of physiological l-thyroxine treatment on bone metabolism in patient with primary hypothyroidism. Material and methods. In the study group of 30 hypothyroid patients individual thyroxine replacement was performed targeting euthyroid status. Bone and calcium metabolism parameters (osteocalcin-OC, alkaline phosphates-ALP, C-terminal cross-linking telopeptide type I-CL, parathormone-PTH, Ca, ionized Ca, P), thyroid hormone levels (T3, T4, TSH) were measured before treatment and when euthyroid status was achieved. Results and discussion. A significant treatment effect was observed for bone formation and resorption parameters before and during the therapy; OC (p=0.000024), CL (p=0.002648). Ionized calcium levels also showed significantly higher values in euthyroid status confirming bone metabolism acceleration during the l-thyroxine therapy (p= 0.020). Thus, calcium metabolism hormone regulators were not significantly different before and after the therapy; PTH (p=0.27). Thyroid hormone levels showed significant correlation with bone metabolism parameters before the therapy whereas this correlation was not found during therapy because of different individual l-thyroxine doses. Conclusion. It can be concluded that physiological doses of l-thyroxine therapy accelerate bone metabolism in hypothyroid patients. Thus, the argument against bone loss during physiological substitution is highly specific mutual correlation between bone formation and resorption parameters. These assumptions require further investigations in long term prospective studies in patients on replacement l-thyroxine therapy.
Efficacy of ibandronat 150 mg given once a month in the treatment of postmenopausal osteoporosis on the basis of biochemical bone markers: Adhero study
Kovaev-Zavi?i? Branka,Ristanovi? Vesna,I?in Tijana,Paro Novakovi? Jovanka
Medicinski Pregled , 2012, DOI: 10.2298/mpns1210379k
Abstract: Introduction. Menopausal osteoporosis is a disease of older age, and its development is related to the cessation of ovarian function together with a number of risk factors. Monthly dosing regimens are welcomed by women because of higher satisfaction and better adherence. This study was aimed at assessing the therapeutic effect of ibandronate given once a month to women with postmenopausal osteoporosis on the basis of biochemical bone markers. Material and Methods. We examined 168 patients of 268 patients in ADHERO study. RocheDiagnostics, Elecsys -CrossLaps and -NMID- Osteocalcin were used to measure beta-crosslaps before the therapy and 3 months after the therapy had been introduced as well as osteocalcin, which was measured in 12 patients. Results. The value of beta-crosslaps before treatment was 0.5264±0.2926, that being above the upper limit of normal values for women in generative period, indicating an average of slightly increased bone resorption. Betacross-laps decreased and reached normal values for women in generative period 0.2277±0.1863 three months after the introduction of monthly ibandronat at a dose of 150 mg orally. This difference was highly statistically significant (t=13.648, p ≤ 0.0001). In 18 patients osteocalcin was measured before and three months after the introduction of the therapy. Osteocalcin was 31.3056±14.8209 before the treatment, which is normal for women of childbearing period. Osteocalcin decreased to 22.1822±6.9943 after three months, which is also within the normal range for women in the childbearing period of life. This difference was statistically significant (t=2.951, p ≤ 0.001). Conclusion. Monthly ibandronat suppresses bone resorption three months after the introduction of therapy. Biochemical bone markers quickly confirm the effect of medication, and they can be used in the assessment of effects on bone mineral density and future fracture risk.
The quality of life in patients with diabetes mellitus type 2
Bosi?-?ivanovi? Dragana,Medi?-Stojanoska Milica,Kovaev-Zavi?i? Branka
Vojnosanitetski Pregled , 2012, DOI: 10.2298/vsp1210858b
Abstract: Background/Aim. Through its various activities, World Health Organization (WHO) contributed to increasing the understanding of the concept of quality of life. People with diabetes have a lower quality of life than people without chronic illnesses. The aim of this study was to examine the differences in the quality of life, related to health, in patients with diabetes mellitus (DM) type 2 by age, gender and type of therapy. Methods. We performed a cross-sectional study at the outpatient department of the Clinical Center in Novi Sad and the Health Center Ruma - General Practice. The group consisted of 90 patients with DM type 2, 41 men and 49 women. The age of respondents was from 40 to 80 years and they were classifed into four groups according to the ten-year age intervals. We applied WHO Quality of life questinnaire - BREF 100 composed of four domains: physical health, psychological health, social relationships and environment. The general questionnaire asks questions about socio-demographic data, duration of diabetes, the last value of blood glucose and glycosylated hemoglobin, training for self-control and its implementation, informing patients about their disease, therapy and its impact on daily activities and the presence of comorbidity. In statistical analysis the following tests were used: Student’s t-test, Ftest, ANOVA (one way). Results. The average duration of DM type 2 was 11.2 ± 9.2 years. Most of the patients (76%) were trained to self-control and 91% received enough information about their disease. Oral hypoglycemic preparations were used by 49%, insulin by 21%, and oral drugs and insulin by 29% patients while 1% were on a special regime of a diet therapy. Daily activities were performed without difficulties by over 29%, with some difficulties by 41% and 30% of patients who could not perform daily activities. The patients with DM type 2 had significantly lower scors in all 4 domains of quality of life (physical health, psychological health, social relations, environment). The biggest influence was on physical domains (51.31). Education level had an impact on physical and psychological domains. Comorbidity was found in 83% of the respondents. The most common were: arterial hypertension (63%), chronic cardiovascular disease (46%), neuropathy (23%), impaired vision 24%, elevated blood lipids (39%) and amputation of toes or feet (2.2%). The average value HbA1C in the group with comorbidity was 8.47% and in the group without comorbidity 6.46%. The subjects with comorbidity had low quality of life assessment in relation to the group without como
Biochemical bone markers and biological effects of osteoporosis therapy
Kovaev-Zavi?i? Branka,Novakovi?-Paro Jovanka,?uri? Nikola,I?in Tijana
Vojnosanitetski Pregled , 2012, DOI: 10.2298/vsp1205432k
Abstract: nema
Modern trends in the development of agriculture and demands on plant breeding and soil management
Kova?evi? Du?an,Lazi? Branka
Genetika , 2012, DOI: 10.2298/gensr1201201k
Abstract: Agriculture is usually developed as much and just society where there is a branch of the economy. Today, there are different directions from industry agriculture to many concepts based on ecological principles. Future of agriculture development in the XXI century will imply sustainable agriculture as the alternative to the industrial agriculture. Conventional agriculture as an intensive one has a duty to ensure maximum production in terms of quantity and quality with the low cost. For this purpose we have many cultural practices, sometimes in addition to the expected positive but sometimes with many unexpected long-term negative effects in agroecosystems. Organic agriculture is one of the most interesting current trends in agriculture completely based on strong ecological principles and the absence of application of agrochemicals (pesticides, fertilizers, hormones), GMO, etc. Organic agriculture is a holistic way of farming: besides production of goods of high quality (better flavor, high content dry matter, vitamins, antioxidants); conservation of the natural resources (soil, water) and richness of biodiversity.
Suspenzijski poli(vinil-klorid) i rizici njegove proizvodnje / Suspension grade poly(vinyl chloride) and hazards of its production
Tonka KOVA?I?,Branka ANDRI?I?
Polimeri , 2006,
Abstract: Poli(vinil-klorid) (PVC) najstariji je i vi e od 70 godina jedan od najva nijih polimera, na kojeg otpada oko 20 % ukupne svjetske proizvodnje polimera. Usprkos svim tehni kim i gospodarskim problemima vezanim za proizvodnju PVC-a, prigovorima za titara okoli a i prirode o rizi nosti proizvodnje i uporabe PVC-a te op enito opasnosti klorne kemije za okoli , procjenjuje se kako e godi nja potro nja PVC-a u svijetu do 2010. rasti po stopi od 4,5 %.1 PVC se proizvodi polimerizacijom vinil-klorida (VC) slobodno-radikalskim procesima u suspenziji, emulziji ili u masi. Na svjetskoj razini, 80 % PVC-a proizvodi se suspenzijskom polimerizacijom, 12 % emulzijskom, a 8 % polimerizacijom u masi. U suspenzijskom postupku monomer, ukapljeni vinil-klorid, mehani ki se dispergira u vodi i polimerizira s pomo u u monomeru topljiva inicijatora, uz dodatak za titnog koloida. Proces je diskontinuiran, a provodi se u zatvorenom sustavu. S ekolo koga gledi ta, suvremena suspenzijska polimerizacija optere ena je relativno malim brojem problema, od kojih je najve i kancerogenost monomera, vinil-klorida, objavljena 1973. Ubrzo, alarmiranjem svjetske javnosti te anga iranjem tehnologa, lije nika i znanstvenika prona ena su rje enja kojima je uklonjena opasnost od emisije monomera tijekom tehnolo kog procesa, izlo enost radnika kancerogenom VC-u te opasnost od visoke koncentracije ostatnog monomera u polimerizatu. Definirane su maksimalne dopu tene koncentracije VC-a. Suvremeni postupak proizvodnje, uz otplinjavanje i rekuperaciju neizreagiranog vinil-klorida, demonomerizaciju polimerne suspenzije i obradu otpadnih voda te dobru kontrolu proizvodnog procesa, omogu uje siguran rad postrojenja i uporabu PVC-a u prehrambenoj i farmaceutskoj industriji te za medicinske potrebe. / Poly(vinyl chloride) (PVC) has, for more than 70 years been one of the most important polymers, with a worldwide capacity of about 20 % of the total plastic production. Despite all technical and economic problems on the production of PVC and public debates about the ecology and environmental hazards of PVC production and use, and chlorine chemistry, in general, PVC production worldwide grows at the rate of more than 9 % per year.1 PVC is obtained by free-radical polymerizations of vinyl chloride (VC) in suspension, emulsion or in bulk. Worldwide, 80 % of total PVC production is obtained by suspension polymerization, 20 % by emulsion polymerization and 8 % by bulk polymerization. In suspension polymerization the monomer, liquid VC, is mechanically dispersed in water and polymerized by monomer-soluble initiat
Free Radical Scavenging Activity and Phenolic Content in Strawberry Fruit and Jam
Danijela Bursa? Kova?evi?,Branka Levaj,Verica Dagovi?-Uzelac
Agriculturae Conspectus Scientificus (ACS) , 2009,
Abstract: Fresh fruit of three strawberry cultivars Fragaria ananassa × Duch. (cvs. ‘Clery’, ‘Honeoye’ and ‘NF 421’ (Asia)) were investigated and used to produce jams, which were analyzed before and after dark storage at 20 °C for six months. The aim of this investigation was to characterize all the samples in relation to the total phenolics, flavonoids, nonflavonoids, total anthocyanins and antioxidant activity. Among investigated strawberry fruit cv. Clery showed the highest amount of total phenolics, while regarding to total anthocyanins, cvs. ‘Honeoye’ and ‘NF 421’ showed higher amounts of total anthocyanins. The jam processing under applied conditions had appreciable effects on preserving stability of polyphenolics.Our results showed that total phenolics were more stable during processing in comparison with total anthocyanins. Furthermore, in all investigated samples flavonoids were predominant. Relevant differences among cultivars were observed when total phenolics, total anthocyanins, flavonoid and nonflavonoid contents in jams were compared. After six months storage, in all investigated samplesanthocyanins were at least stable, without marked influences of cultivar. Compared to the strawberry fruits, the jams also represented a significant source of antioxidant compounds, even considering the lower content of phenolic compounds. Six month storage had influence on further decrease of antioxidant activity. Among investigated samples, the highest correlation was found in the total anthocyanins contents and the DPPH. Hence, the obtained results showed that besides fresh strawberry fruit, the strawberry jams also possess noticeable content of important bioactive compounds with considerable antioxidant activity.
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