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Biomedical subjects

Katarina Paunović

Publications and source records attributed to Katarina Paunović.

13 recordsLinked to original sources
PubMed2006

Left ventricular hypertrophy in hypertensive obese women.

OBJECTIVE: Left ventricular hypertrophy (LVH) is an independent predictor of cardiovascular and general mortality. Both arterial hypertension and obesity cause changes in structure and function of the left ventricle. Given the rising global epidemic of obesity, it is likely that adverse health consequences of excess adiposity will escalate in the future. The aim of this investigation was to assess the relation and predictive value of obesity on the occurrence of left ventricular hypertrophy in hypertensive middle-aged women. METHODS AND RESULTS: Investigation was conducted on a sample of 64 middle-aged women, diagnosed with arterial hypertension and treated longer than 10 years in the absence of other chronic diseases or heart failure. Based on anthropometric parameters, 14 women (21.9%) had a body mass index (BMI) within the normal range, 17 (26.6%) were overweight, and 33 (52.5%) were obese. Left ventricular hypertrophy was assessed by electrocardiographic and echocardiographic criteria. The influence of anthropometric parameters on left ventricular hypertrophy and patterns in left ventricular geometry was assessed using multivariate regression analyses. The prevalence of LV hypertrophy was 7.1% among normal-weight hypertensive women, 41.2% among overweight and 66.7% among obese women. Compared to normal-weight women, overweight and obese hypertensive subjects had higher mean values of all ECG and echo parameters. The strong correlation between anthropometric and left ventricular parameters was observed. Multivariate analysis showed that percent of body fat (OR = 1.226; 95% CI 1.011-1.486) was the only independent predictor of left ventricular hypertrophy. Being overweight was identified as predictor for the development of eccentric LV hypertrophy (OR = 31.824; 95% CI 1.225-826.850), and for concentric left ventricular remodelling (OR = 20.755; 95% CI 1.119-385.029). CONCLUSIONS: Heart abnormalities occurring in arterial hypertension in conjunction with overweight/obesity include left ventricular hypertrophy and structural changes in the left ventricle. These findings support weight control and the regulation of blood pressure for the prevention of left heart abnormalities.

Body Mass Index↗
PubMed2006

[Importance of personality traits and psychosocial factors for the development of coronary heart disease].

BACKGROUND/AIM: Numerous studies have provided clear and convincing evidence that psychosocial factors contribute to the pathogenesis and expression of coronary heart disease (CHD). These factors have been related to the following psychosocial domains: personality factors and character traits, depression, anxiety, social isolation and chronic life stress. The aim of this study was to estimate the influence of personality traits and psychosocial risk factors for the development of coronary heart disease. METHODS: The investigation was conducted as observational cross-sectional (case-control) study. Based on medical records all subjects were divided into two groups: the group of patients with CHD (61 participants), and the control group of 41 healthy participants. All participants fulfilled the Eysenck Inventory Questionnaire, Paykel stress scale and Bortner scale of A-B self-estimation. RESULTS: The participants with CHD were shown to have lower education than healthy participants, but were comparable by gender, age and place of residence. According to the Bortner scale, most participants with CHD expressed type A personality, whereas most healthy participants expressed types B and AB. The patients with CHD achieved higher scores on the Paykel stress scale of life events, and they had the higher level of neurotic and psychotic tendencies, as well as the lower level of extroversion compared to the healthy participants. Multivariate logistic regression model identified chronic stress (odds ratio 1.018; 95% confidence interval 1.007-1.028) as an important predictor for the occurrence of coronary heart disease, when adjusted for age, gender, nourishment and blood pressure. On the other side, the lower risk for the occurrence of CHD was observed among the participants who had the higher level of extroversion (odds ratio 0.859; 95% confidence interval 0.636-0.902). CONCLUSION: Chronic stress and introversion can be considered important risk factors for the development of coronary heart disease, independent of other predictors such as obesity and hypertension, supporting the biopsychosocial model of the occurrence of coronary heart disease.

Adult↗
PubMed2006

Road traffic noise and sleep disturbances in an urban population: cross-sectional study.

AIM: To explore the relationship between sleep disturbances caused by traffic noise and relevant personality traits, such as extroversion-introversion, neuroticism, and subjective noise sensitivity. METHODS: A cross-sectional study was carried out from January to April 2005 in a central municipality of Belgrade, the capital of Serbia and Montenegro. Noise measurements were performed at 12 measurement sites three times at daytime and twice at night. On the basis of noise measurement results, three streets with the highest and three streets with the lowest values of equivalent sound pressure level (Leq) were chosen to represent noisy (>65 dB(A)) and quiet (<55dB(A)) areas, respectively. The respondents from both areas were asked to fill out the questionnaire on noise-related health problems. The final sample consisted of 310 respondents, 192 from noisy area and 118 from quiet area. RESULTS: Respondents from noisy area reported having significantly more difficulties with falling asleep, being woken up by noise at night more often, and having more difficulties with falling back to sleep. They also complained of poorer sleep quality and tiredness after sleep and they slept by an open window in summer less often. Noise annoyance, subjective noise sensitivity, and neuroticism were significantly correlated with difficulties with falling asleep, time needed to fall asleep, poorer sleep quality, tiredness after sleep, and use of sleeping pills. After adjustment for potential modifying personality traits including subjective noise sensitivity, neuroticism, and extroversion, residence in noisy area was shown to be a significant predictor for difficulties with falling asleep (odds ratio [OR], 2.71; 95% confidence interval [CI], 1.27-5.80), difficulties with falling back to sleep (OR, 1.87; 1.02-3.40), waking up at night (OR, 2.60; 1.49-4.52), sleeping by closed windows (OR, 13.51; 5.84-31.25), having poor sleep quality (OR, 2.99; 1.13-7.89), and feeling tired after sleep (OR, 2.50; 1.11-5.63). CONCLUSION: Urban population living in noisy area was at higher risk for sleep disturbances than population living in the quiet area. Furthermore, sleep disturbances were significantly and positively related to personality traits of neuroticism, subjective noise sensitivity, and noise annoyance.

Adult↗
PubMed2004

Alcohol consumption and mortality in Serbia: twenty-year follow-up study.

AIM: To investigate the connection between alcohol consumption and general and specific mortality in the Serbian population. METHODS: Total of 286 healthy middle-aged participants of both genders enrolled in a prospective follow-up study in 1974. During the following 20 years, 80 deaths occurred. The data on underlying causes of death were obtained from official death certificates. Alcohol consumption was estimated from a multiple-choice questionnaire. According to the total daily alcohol intake, subjects were classified into 3 groups: none- or rare drinkers, moderate, and heavy drinkers. The relative risks (RR) adjusted for gender, smoking, body mass index, and blood pressure were calculated using non-drinkers as a reference category. RESULTS: Heavy drinkers exhibited significantly higher adjusted ratios for all-cause mortality (RR=1.970, 95% confidence interval [CI]=1.062-3.651; p=0.031) and myocardial infarction (RR=2.463, 95% CI=1.050-5.775; p=0.038), and non-significantly higher risk for death from other causes. Moderate drinkers exhibited lower adjusted risk ratios for all-cause mortality, myocardial infarction and death from other causes, but this decrease did not reach the significance level. Further, overall probability of survival at every time point was the highest among moderate drinkers and lowest among heavy drinkers. CONCLUSION: Among Serbian middle-aged population moderate alcohol consumption reduced mortality from all causes, myocardial infarction and other causes of death, and increased the probability of survival in a twenty year follow-up period. Heavy drinking increased mortality rates from all causes and reduced the twenty year-survival probability in comparison with non-drinkers.

Adult↗
PubMedDate not supplied

[Mechanisms of protective effects of moderate alcohol consumption on the cardiovascular system].

Consumption of alcoholic beverages has been known in many cultures since the ancient civilizations, so harmful consequences of excessive alcohol intake have been well explained. Many epidemiological studies confirmed lower morbidity and mortality rates of cardiovascular diseases in persons who drink alcohol "moderately" (1-2 drinks a day), independently of the kind of alcoholic beverage. This paper presents the review of molecular mechanisms that are believed to explain cardioprotective effect of moderate drinking--alcohol effects on lipoproteins, endothelial cells, blood clot formation and dissolution, as well as genetic and gender variances modifying the relation. A simple recommendation regarding the increase of alcohol consumption cannot be made on population level. The professionals must therefore concentrate on other preventive methods in order to reduce other significant risk factors of cardiovascular diseases.

Alcohol Drinking↗
PubMedDate not supplied

[Adaptation and mental-hygienic characteristics of internally displaced adolescents].

The change in socio-economic status, drastic decrease in living standards, war, and the introduction of sanctions to our country were complicated in addition by a large number of internally displaced people from Kosovo, which culminated with the 1999 NATO bombing. The aim of this investigation was to estimate the influence of internal displacement on the adaptation and mental health of adolescents. The investigation was conducted on 238 adolescents, comprising a control group of 206 adolescents from Belgrade and 32 internally displaced adolescents from Kosovo. A specific questionnaire regarding habits, behaviour, and psychosomatic state was used, as well as the Cornell Medical Index and the Eysenck Personality Questionnaire. Internally displaced adolescents from Kosovo exhibited greater difficulties in adapting and had worse school records than adolescents from Belgrade, one year after the change in their location. Immediately after the NATO bombing, both groups reacted in the same way: they often talked about the events they had survived, they were afraid of the sounds of alarm sirens and of aeroplanes, and in addition had similar dreams (no statistical variation between the groups). Emotional disturbances, one year after the bombing, were not observed in 40.6% of adolescents from Kosovo, compared to the figure of 74.8% for adolescents from Belgrade. Adolescents from Belgrade consumed alcohol significantly more often: 75.7% compared to 56.3% for adolescents from Kosovo. In addition, 20.4% of adolescents from Belgrade consumed psychoactive substances compared to 6.3% of adolescents from Kosovo. There was no significant difference between the examined groups in the total scores on the scale for neuroticism. All in all, the girls from both examined groups displayed neurotic tendencies more frequently than the boys.

Adaptation, Psychological↗
PubMedDate not supplied

[Thoracic electrical bioimpedance in the follow-up of patients with cardiovascular disorders].

Thoracic electrical bioimpedance is a new non-invasive technique for obtaining haemodynamic parameters. The method involves the passing of low amperage, high frequency current through the thorax. The current induces a change of resistance within the thorax, which is registered by electrodes. The overall impedance of the thorax is a measure of the electrical resistance of the thorax to this high frequency, low amplitude current. In clinical practice, thoracic electrical bioimpedance has been applied in diagnostic, therapeutic, and prognostic use in patients with heart failure and hypertension, patients with pacemakers, within the scope of early diagnosis of implant rejection following heart transplantation, as well as in patients with kidney disorders, before and after dialysis. However, one of its most important applications is in the determination of antihypertensive therapy, because it provides the parameters that reflect the genesis of arterial blood pressure. In assessing these parameters, optimal therapy adjusted to the haemodynamic status of each patient can be prescribed.

Cardiography, Impedance↗
PubMedDate not supplied

[Assessment of diet therapy effect on blood pressure of obese persons with and without antihypertensive therapy].

BACKGROUND: Arterial hypertension is a multicausal chronic disease often accompanied by obesity. The aim of this investigation was to examine the effect of diet therapy in the treatment of obese hypertensives with and without antihypertensive therapy. METHODS: The investigation was conducted at the Department of Nutrition on a sample of 110 obese hypertensive patients on diet therapy. Subjects were divided into two groups: the group on diet therapy with antihypertensive drugs E1 (n=78), and the group on diet therapy without pharmacotherapy E2 (n=32). Nourishment state i.e., obesity level was assessed by body mass index (BMI). All the patients belonged to the obese group--BMI > 30 kg/m2. Besides blood pressure values, the following parameters were monitored: serum cholesterol, trygliceride levels and BMI. RESULTS: The obtained results in the group with diet therapy combined with antihypertensive therapy showed highly significant decrease of anthropometrical parameters: body weight (99.14 kg vs. 90.16 kg) (p<0.001) and BMI (37.32 vs. 34.09) (p<0.001); percent body fat (41.97 vs. 38.78) (p<0.001); systolic (154.81 vs. 141.91) (p<0.001), and diastolic pressures (95.42 vs. 87.36) (p<0.001); cholesterol (6.39 vs. 5.99) (p<0.002), and triglycerides concentration (2.69 vs. 2.21) (p<0.019). In the group on single diet therapy, highly significant decrease of body mass (99.33 vs. 90.18) (p<0.001), BMI (34.79 vs. 31.58) (p<0.001), percent body fat (39.27 vs. 36.70) (p<0.001), systolic (148.44 vs. 132.74) (p<0.001), and diastolic pressures (93.97 vs. 82.90) (p<0.001), was achieved, while the differences between initial and final cholesterol and triglyceride concentrations, although observed, were not statistically significant. CONCLUSION: The obtained results implicated that diet therapy significantly helped the normoregulation of both systolic and diastolic blood pressure. Considering this, during physicians' routine practice in the treatment of hypertension, attention should be paid on the reduction of the corresponding level of obesity.

Antihypertensive Agents↗
PubMedDate not supplied

[Alcohol consumption, arterial blood pressure and general mortality rate--twenty-years follow-up study].

BACKGROUND: Alcohol consumption has both adverse and beneficial effects on health and survival. The aim of this prospective study was to examine the association between alcohol consumption and arterial hypertension as well as general mortality rate. METHODS: The study included 286 participants, middle-aged men and women examined in 1974, and again in 1994 during twenty years of follow-up (mean age at the beginning of the study 43.61 +/- 7.09 years). Alcohol consumption was assessed by the specific questionnaire. Consumption levels were grouped into three categories: rare drinkers (consuming less than 6 drinks a week), moderate drinkers, who consume 1-2 alcohol drinks a day and heavy drinkers (consumers of 3 or more drinks a day). RESULTS: In both phases of the follow-up the lowest values of systolic and diastolic pressure were recorded in the group with moderate alcohol consumption, and the highest values in the group with excessive consumption. The observed differences were statistically significant. The general mortality rates were the highest among participants reporting excessive alcohol consumption (relative risk 3.2; 95% confidence interval 1.84-5.62), and among the abstainers (relative risk 1.8; 95% confidence interval 0.99-3.36), compared to the moderate consumption group. CONCLUSION: Analysis of the obtained results suggested the protective effect of moderate alcohol consumption on cardiovascular system.

Adult↗
PubMedDate not supplied

[Adipose tissue as an endocrine organ].

The traditional function attributed to white adipose tissue of energy storage in the form of triglycerides has been challenged by results from recent studies, showing that adipose tissue is, in fact, a highly active metabolic and endocrine organ. A radical change in perspective followed the discovery of a large number of proteins secreted from white adipocytes, such as leptin, resistin, adiponectin, adipsin, acylation-stimulating protein, angiotensinogen, tumour necrosis factor a, interleukin-6, retinol-binding protein, plasminogen activator inhibitor-1, tissue factor, fasting-induced adipose factor, fibrinogen/angiopoetin-related protein, and metallothionein. The effects of specific proteins may be either autocrine or paracrine, meaning that they might act in adipose tissue itself or in more distant target tissues. Some of these proteins induce insulin resistance, some play a role in glucose and lipid metabolism, some are inflammatory cytokines, while others are involved in vascular haemostasis. The key challenges for future investigations of adipose tissue's secretory functions will be to identify all of its secreted proteins, to establish the function of each secreted protein, and to assess the pathophysiological consequences of changes in adipocyte protein production due to problems, such as obesity, fasting, or diabetes mellitus type 2.

Adipose Tissue↗
PubMedDate not supplied

[Max Josef von Pettenkofer--founder of modern hygiene (1818-1901)].

Max Josef von Pettenkofer was one of the leading personalities in the world of medicine in the 19th century. He was the founder of the modern science of hygiene. In his experimental work, he was involved in the research of problems dealing with the relationship between human beings and the environment, including such topics as soil and air pollution, water supply, sewage water management, room ventilation and heating, as well as the function of clothing and the cleanliness of homes and streets. Pettenkofer also studied the onset, the course, and the consequences of infectious diseases, such as cholera and typhus. He realised the great economic value of public health and emphasised that personal preventive measures should be supplemented with the improvement of factors in communal and work environments. His efforts lead to hygiene becoming a part of medical studies in 1865. The Institute for Hygiene at the School of Medicine in Munich was established in 1879. It was constructed according to his drawings and was considered to be the most modern institute for hygiene in the world. Since hygiene was a subject on the school curriculum in the German Empire in 1882, Pettenkofer became the Chairman of Hygiene in Berlin in 1885. Research institutions established by Pettenkofer and the fact that many of his students became professors of hygiene speak about the importance of his work. One of his students was professor Milan Jovanović Batut, founder of the Institute for Hygiene at the School of Medicine in Belgrade.

Germany↗