Background/Aim. Custodiol is a hyperpolarizing cardioplegic solution which has been used in our national cardiac surgical practice exclusively for the heart transplant surgery. Owing to its numerous advantages over the standard depolarizing solutions, Custodiol became cardioplegia of choice for all other cardiac surgical procedures in many cardiosurgical centers. This study evaluates myocardial protection of Custodiol compared to modified St. Thomas cardioplegia in coronary artery bypass surgery. Methods. In a prospective four-month study 110 consecutive adult patients who underwent primary isolated elective on-pump coronary artery bypass grafting (CABG) were randomized into Custodiol group (n=54) and modified St.Thomas group (n=50), based on the type of administered cardioplegia; six patients were excluded. Cardiac protection was achieved as antegrade cold crystalloid cardioplegia by one of the solutions. Myocardial preservation was assessed through following outcomes: spontaneous rhythm restoration post crossclamp, and postpoperative cardiac specific enzymes level, ejection fraction (EF) change, inotropic support, myocardial infarction (MI), atrial fibrillation (AF), and death. Results. Preoperative and intraoperative characteristics were similar except for a considerably longer cross-clamp time in the Custodiol group (49.1±19.0 vs. 41.0±12.9 minutes; p=0.022). Custodiol group exhibited a higher rate of return to spontaneous rhythm (31.5% vs. 20.0%; p=0.267), lower rates of AF (20.4% vs. 28%; p=0.496), MI (1.8% vs. 10.0%; p=0.075) and inotropic support (9.0% vs. 12.0%; p=0.651), albeit not statistically significant. There was an insignificant difference in peak value of Troponin I (5.0±3.92µg/L vs. 4.5±3.39µg/L; p=0.755) and Creatine Kinase-MB (26.9±15,4µg/L vs. 28.5±24.2µg/L; p=0,646) 6 hours post-surgery. EF reduction was comparable (0,81% vs. 1.26%; p=0.891). There were no deaths. Conclusions. Custodiol and modified St.Thomas cardioplegia have comparable cardioprotective effects in CABG surgery. The trends of less frequent MI, AF and inotropic support, despite the longer cross-clamp time in the Custodiol group may suggest that its benefits could be ascertained in a larger study. ApstraktUvod/Cilj. Custodiol je hiperpolari iraju i kardiolegi ni rastvor koji je kori en, u na oj nacionalnoj kardiohirur koj praksi, isklju ivo u transplantacionoj hirurgiji. Zbog svojih brojnih prednosti u odnosu na standarde, depolari iraju e rastvore, Custodiol je, u mnogim kardiohirur kim centrima, postao kardioplegija i bora a sve kardiohirur ke procedure. Cilj studije je procena miokardne protekcije rastvorom Custodiol-a u poređenju sa modifikovanom St. Thomas kardioplegijom u koronarnoj hirurgiji. Metode. Tokom prospektivne etveromese ne studijie, 110 u astopnih odraslih pacijenata podvrgnutih primarnoj, izolovanoj, elektivnoj operaciji aortokoronarnog bajpas su randomizirani na osnovu primenjene kardioplegije u Custodiol grupu (n=54) i modifikovanu St.Thomas

The transformation of clinical laboratories towards digitalization requires processes that improve digital maturity. This requires establishing connectivity, end-to-end workflow, and advanced analytical technologies and techniques. Digital technologies have the key role here, directing laboratory personnel and scientists to move their focus from routine to more complex and meaningful work. This requires their empowerment in working with new instruments and software. Strategies leading clinical laboratories through this transformation are not without challenges, but different models are being developed to overcome them. The essential is the role of interoperability.

Total iron-binding capacity (TIBC) values are determined on Olympus AU2700 automated chemistry analyzer as the sum of serum iron and unsaturated iron-binding capacity (UIBC)-(calculated TIBC, TIBC cal). Considering that Olympus AU2700 automated analyzer was recently brought in function and TIBC values calculated from serum iron and UIBC values were significantly lower than those obtained by a direct and fully automated TIBC assay, it was necessary to determine the reference interval for TIBC, according to the recommendation that every laboratory should have its own reference ranges. The »calculation method« of TIBC determination showed satisfactory accuracy (p > 0.001) and precision, with CV values ranging from 0.91% to 1.63% within-run and from 2.30% to 2.80% day-today. The correlation between the TIBC values obtained with the »calculation method« using Olympus AU2700 analyzer (y) and those obtained with the direct method (x) was: y = 0.919x + 2.319 mmol/L (r = 0.980; Sy,x = 1.814; p < 0.001; N = 85). The reference interval for TIBC was determined using sera collected from 125 healthy individuals of both sexes, 15 to 80 years old. Since the values did not depend on sex, the reference interval calculated for the whole studied population ranged between 42.0 mmol/L and 64.3 mmol/L.

Hemostatic system, as an integral part of biological homeostatic mechanism in humans, is subject to changes due to effect of hormonal therapy used in preparation for in vitro fertilization. The objective of the study was to analyze the impact of hormonal changes on homeostatic parameters during four cycles of preparation, according to long-term protocol for in vitro fertilization. The following parameters were determined in the study: prothrombin time, activated partial thromboplastin time, fibrinogen, antithrombin III, plasminogen, a2-antiplasmin and plasminogen activator inhibitor. In the period of ovarian hyperstimulation and in postovulatory period, significantly lower PT, APTT, AT III, PAI-1 and a2-APL values were obtained (p<0.05), while fibrinogen concentration was significantly higher (p<0.05), in relation to the first two periods. PLG activity was significantly decreased in postovulatory period in relation to former three periods (p<0.05). Data obtained by Pearson?s correlation analysis show that there is significant negative correlation in postovulatory period between PLG and a2APL, as well as between APTT and PAI-1 (Rp>0.404, for p<0.05). These changes are manifested as more pronounced procoagulant forms, which are suppressed by simultaneous activation of fibrinolytic system as the opposite response, what keeps the balance in homeostatic system and prevents the development of adverse thrombotic complications.