Southeastern European Medical Journal

Instead of an Editorial

2024-02-09T11:41:05+00:00

Statistics on First Five-Year Period of Publication of Southeastern European Medical Journal (SEEMEDJ), 2017-2022

Anti-Inflammatory and Antioxidant Response in COVID-19 Infection: Nrf2/HO-1 Pathway

2024-02-09T09:29:48+00:00

SARS-CoV-2 virus infection starts with the internalization of the viral particle into the host cells, mainly the upper respiratory system epithelial cells which have the highest expression of the ACE2 receptor which is essential for the internalization process. The pathophysiology of severe forms of COVID-19 disease results not only from direct, cytopathic viral effect but also from immune response dysregulation of the host resulting in hyperinflammatory state and oxidative stress. The nuclear factor erythroid 2-related factor 2 (Nrf2) ability to protect cells and induce a rapid anti-inflammatory and antioxidant response primarily depends on its constitutive cellular expression, which can be affected by numerous endogenous and exogenous factors. The binding of Nrf2 to cellular receptors leads to the transcription of a large number of genes encoding various antioxidant enzymes and other cytoprotective molecules, including heme oxygenase-1(HO-1). Activation of HO-1 results in antioxidant, anti-inflammatory and anti-apoptotic effects. Based on previous studies, the Nrf2/HO-1 pathway provides protection against oxidative stress and inflammatory and immune response which is significant in COVID-19 infection, which is characterized by a strong hyperinflammatory response. This narrative review aims to describe the role of the hyperinflammatory response in the development of COVID-19 infection, with a focus on the NrF2/HO-1 pathway.

The Physiology of Thermoregulation in Exercise: A Brief Review

2024-02-09T09:30:08+00:00

During physical exercise, the production of heat in the working skeletal muscles increases, imposing heat stress on the body. Thermoregulatory mechanisms induce adjustments of cutaneous vascular conductance and thus skin blood flow (SkBF), sweating rate, and increased cardiac output to achieve thermal homeostasis. The response depends on the intensity, type, duration of exercise, and environmental temperature: during extreme exercise in a hot environment SkBF can attain up to 7 L/min compared to 300 mL/min at rest whereas the sweating rate can reach as high as 4 L/h. Due to opposing non-thermal reflexes, the thermoregulatory response of SkBF during exercise differs from that at rest: the threshold to induce vasodilation in the skin is shifted to higher body core temperature and the sensitivity of the “SkBF to-core temperature” slope is altered. Regular training induces better adaptations to physical stress which enable sportsmen to eliminate additional heat more optimally. The review emphasizes physiological mechanisms involved in thermoregulation during exercise and exposes some thoughts regarding the estimation t of the core temperature in humans, as well as some new approaches for an up-to-date assessment of parameters important for appropriate heat dissipation thereby maintaining core temperature.

Home-Based Exercise During the Coronavirus Pandemic – A Useful, yet Challenging Treatment Strategy for Improvement of Mental Health, Glycemic Control and COVID-19 Outcomes in Patients With Diabetes

2024-02-09T09:30:32+00:00

Lockdown measures to control disease transmission were implemented at the start of the COVID-19 era, worsening the already existing sedentary lifestyle. Reduced physical activity (PA) and unhealthy eating habits have a negative impact on mental health in chronically ill patients, including diabetes patients. Mental illness, on the other hand, encourages a sedentary lifestyle, exacerbating all components of metabolic syndrome. While well-controlled diabetic patients with an HbA1c of less than 7% had a less severe clinical presentation and COVID-19 mortality rates, the favorable effect of PA on immunomodulation and immunoregulation should not be neglected. Given recent data indicating that a sedentary lifestyle is the third independent risk factor for COVID-19 complications and death (after advanced age and organ transplant), including regular PA has never been more vital. Since PA has a major impact on both glycemic control and mental health, implementing structured home-based activity programs could improve glycemic control and psychological well-being, hence positively impacting COVID-19 outcomes.

Verification of the Automated ELISA Assay for Hepcidin-25 in Human Serum

2024-02-09T09:30:59+00:00

Introduction: Hepcidin-25, the bioactive form of hepcidin, is the master protein in regulating iron homeostasis. Serum concentrations, measured by different methods, are often incomparable and complicate results interpretation.

Materials and Methods: The aim was to verify the first fully automated enzyme-linked immunosorbent assay (ELISA) method, using the DRG Hybrid XL analyzer (DRG Instruments, Marburg, Germany) standardized against the mass spectrometry method. Intra- (CVi) and inter-assay (CVg) precision and bias were performed using commercially available controls with low (C1) and high (C2) concentrations. The reference interval was verified by analyzing serum samples of 20 healthy males.

Results: CVi = 9.1% (C1), 4.5% (C2); CVg = 8.9% (C1), 5.6% (C2); calculated bias was 33% for C1 and 20% for C2, respectively.

Conclusion: Verification of the fully automated ELISA method for hepcidin-25 in serum on the DRG Hybrid XL analyzer met the analytical acceptance criteria.

Pathophysiological and Diagnostic Aspects of Sarcopenia in Hemodialysis Patients

2024-02-09T09:31:20+00:00

Chronic kidney disease and renal replacement therapy, particularly hemodialysis, contribute to the development of negative protein balance and muscle dysfunction in dialysis patients, from the development of protein-energy malnutrition to sarcopenia. Due to multifactorial etiology and complex pathophysiological patterns, sarcopenia has proven to be a significant predictor of cardiovascular events and is associated with a higher risk of overall mortality. Screening methods of chronic kidney patients and patients on hemodialysis who are at higher risk of developing sarcopenia, as well as diagnostic methods for this group of patients are not clearly defined, hence methods used for the general population of elderly patients, especially based on the revised European consensus on definition and diagnosis of sarcopenia of the European Working Group on Sarcopenia in Older People (EWGSOP2), are utilized in this subpopulation as well. Therefore, there is a need to define new biomarkers of sarcopenia such as the existing 24h urine excretion of creatinine, a product of estimated glomerular filtration of cystatin C and creatinine or myostatin and their use in routine work with dialysis patients to identify this condition among them and reduce morbidity and mortality.

Computer Vision Solutions for Range of Motion Assessment

2024-02-09T09:31:46+00:00

Joint range of motion (ROM) is an important indicator of physical functionality and musculoskeletal health. In sports, athletes require adequate levels of joint mobility to minimize the risk of injuries and maximize performance, while in rehabilitation, restoring joint ROM is essential for faster recovery and improved physical function. Traditional methods for measuring ROM include goniometry, inclinometry and visual estimation; all of which are limited in accuracy due to the subjective nature of the assessment. With the rapid development of technology, new systems based on computer vision are continuously introduced as a possible solution for more objective and accurate measurements of the range of motion. Therefore, this article aimed to evaluate novel computer vision-based systems based on their accuracy and practical applicability for a range of motion assessment. The review covers a variety of systems, including motion-capture systems (2D and 3D cameras), RGB-Depth cameras, commercial software systems and smartphone apps. Furthermore, this article also highlights the potential limitations of these systems and explores their potential future applications in sports and rehabilitation.

The 2022 Reviewers

2024-02-09T09:32:11+00:00

Thank You all the reviewers