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Anti-inflammatory effects of exercise training in the early period after myocardial infarction
No full textThe aim of this investigation was to determine the effect of exercise training on the levels of plasma cytokines and
acute phase reactants in the early post acute myocardial infarction (AMI) period. Sixty patients were enrolled into this
three-week cardiac rehabilitation study. The mean time from AMI was 7.081.60 days, and the patient mean age was
6010 years. Subjects were randomly assigned to one of the two groups: the control group treated with standard measures,
and the group with additional regular moderate-intensity exercise training. Physical activity was based on the
ergospirometry test results. Apart from clinical follow-up and routine laboratory analysis we determined the levels of
plasma cytokines: tumor necrosis factor (TNF-), soluble TNF- receptor 1(TNF-SR1), interleukin (IL)-8, IL-10, and
acute phase reactants: high sensitivity C-reactive protein (hsCRP) and fibrinogen. The obtained results confirmed the hypothesis
that the early post AMI period is an inflammatory state the intensity of which gradually decreases with standard
treatment during the first month after AMI, while including patients into early exercise training improves their inflammatory
profile by decreasing the level of acute phase reactant and TNF-SR1
Erectile dysfunction after myocardial infarction-myth or a real problem?
No full textErectile dysfunction is a common problem whose relation to cardiovascular diseases has scientifically been proved,
but it has not been studied sufficiently in patients recovering from myocardial infarction. The objective of this study was
to establish the frequency of erectile dysfunction in patients recovering from myocardial infarction. We examined 89 patients
(aged 30 to 75 years) included in the program of cardiac rehabilitation after myocardial infarction. The results
were compared with 91 healthy examinees of the same age. Even 82% of the patients who recovered from myocardial infarction
have problems with erectile dysfunction, compared to 42.9% of healthy examinees. The prevalence of erectile dysfunction
increases with the age in both groups. In the group of patients recovering from myocardial infarction aged 30 do
39 years, the erectile dysfunction decreased after 6 months, while in other age subgroups and between controls, there were
no significant changes in erectile dysfunction prevalence during the analysed time period.We concluded that erectile dysfunction
is a significant problem in patients recovering from myocardial infarction. It should be recognized on time in
order to provide a better life quality for the patient with a multidisciplinary approach
Left ventricle diastolic dysfunction in obese patients with newly diagnosed arterial hypertension
No full textBackground: The frequent coexistence of obesity and arterial hypertension is well known. Although both conditions have been identified as independent risk factors for impaired left ventricular diastolic function, there is a paucity of data on the dysfunction among obese patients with newly diagnosed arterial hypertension. The study was performed to determine the prevalence of diastolic dysfunction in obese individuals with newly diagnosed arterial hypertension and to compare it with the prevalence in normotensive obese persons.
Methods: We enrolled 125 obese patients: 65 with newly diagnosed hypertension and 60 normotensive patients matched for age, sex and body mass index. Left ventricular diastolic function was assessed from the following Doppler-echocardiographic measurements: mitral inflow velocities (E and A wave), E wave deceleration time, isovolumetric relaxation time, left atrial and left ventricular diameters, left ventricular wall thickness and left ventricular heart mass index. Diastolic dysfunction was considered when the E/A ratio was <1.
Results: We found significantly higher A wave, lower E/A ratio, longer E deceleration time and a bigger left atrium in obese patients with newly diagnosed arterial hypertension. We did not find significant differences in E wave peak velocities between the two groups. Although there was no difference in left ventricle heart mass or the prevalence of left ventricle hypertrophy, the prevalence of diastolic dysfunction was higher in the group with newly diagnosed arterial hypertension.
Conclusion: This study suggests that newly diagnosed arterial hypertension significantly contributes to impairment of left ventricular diastolic function in obese patients before development of structural aberrations detectable on echocardiography
Predictive parameters of gestational diabetes mellitus
No full textGestational diabetes mellitus is a carbohydrate intolerance recognized in pregnancy. The objective of this study was to
determine the prevalence of gestational diabetes mellitus (GDM) of all deliveries at the University Hospital Rijeka, Croatia
(34 997 deliveries over 10-year period) using 2-hour 75 g oral glucose tolerant test and to evaluate the impact of
GDM on neonatal outcomes and mother’s health. Gestational diabetes was diagnosed in 55 of 128 pregnant women with
suspected glucose intolerance. Logistic regression analysis was used to examine the relationship between fasting plasma
glucose, age, family history, body mass index, maternal weight gain, neonatal weight, neonatal head diameter and Apgar
score in the gestational diabetes group and in the non-diabetes group. The results indicate that fasting plasma glucose
greater than 7.0 mmol/L and maternal overweight are strong predictors for GDM and macrosomia. There was no difference
in the mode of delivery, and vitality and metabolic complications among the infants of all analyzed mothers.We concluded
that to prevent GDM as well as to reduce the rate of macrosomic infants good glycemic control should be initiated
as soon as possible. The 2-hour 75 g OGTT is worth enough to evaluate GDM. Women should be counseled and encouraged
to lose weight before or at the beginning of the conception period
Die tuberkulöse Epididymoorchitis und die Zentralnervensystemkomplikation
No full textEinleitung: Der Hydrozephalus ist eine äußerst seltene Komplikation der tuberkulösen Epididymoorchitis. In diesem Fall war der Hydrozephalus die Folge einer Dissemination der Tuberkulose (Tbc). Kasuistik: Ein 28-jähriger Mann wurde wegen linksseitiger Epididymoorchitis ärztlich behandelt. Es entwickelte sich das klinische Bild eines erhöhten Hirndrucks. Der Hydrozephalus wurde durch die Computertomographie (CT) nachgewiesen. Weitere Untersuchungen haben die disseminierte Tbc als Enddiagnose bestätigt. Schlussfolgerung: Das Urogenitalsystem wird selten von Tbc befallen, insbesondere wenn dabei gleichzeitig drei verschiedene Organsysteme betroffen werden. Die zahlreichen, unspezifischen Symptomen, die sogar einen Urogenitaltumor imitieren können, stellen ein großes diagnostisches und therapeutisches Problem dar. Falls die antimikrobielle Standardtherapie keine Besserung bei der Epididymoorchitis bringt, ist es an die Tbc als eine differenzialdiagnostische Möglichkeit zu denken
Massive subcutaneous bleeding as a first manifestation of chronic myeloid leukemia in chronic phase
No full text
Clinical, epidemiological and epizootic features of Q fever in the northern coastal part of Croatia from 1989 to 1998
No full textLow sero-prevalence of Lyme borreliosis in the forested mountainous area of Gorski Kotar, Croatia
No full textAim. Clin i cal forms of Lyme dis ease in Gorski Kotar have oc curred only spo rad i cally, in con trast to the north west ern Croatia
and the neigh bor ing ar eas of Slovenia, which are well-known Lyme borreliosis en demic re gions. Our aim was to as sess the
level of sero-prevalence of Borrelia burgdorferi sensu lato in a high-risk pop u la tion of for estry work ers in the moun tain ous
re gion of Gorski Kotar, Croatia, and com pare it with the sero-prevalence in the res i dents of that area and the neigh bor ing lit to -
ral re gion.
Methods. A sero-epidemiological study was con ducted on 520 healthy sub jects, di vided in 3 groups: the first group in cluded
234 for estry work ers, res i dents of Gorski Kotar, the sec ond 100 res i dents of var i ous pro f es sions in the same re gion, and the
third 186 sub jects of var i ous pro fes sions from the neigh bor ing lit to ral re gion. The sera were col lected dur ing the win ters of
two suc ces sive years, 1997 and 1998. Lyme borreliosis se rol ogy was per formed by in di rect immunofluorescence as say. Sera
from 10 hunt ing dogs from Gorski Kotar were also an a lyzed.
Results. The IgG an ti bod ies to B. burgdorferi sensu lato were found in 11 examinees (4.7%) from the group of for estry work -
ers, in 3 (3%) from the sec ond group, and in 5 (2.7%) from the third group. Four out of 10 dogs (40%) had IgG an ti bod ies
against B. burgdorferi.
Conclusion. Our re sults show that the for est and moun tain ous area of Gorski Kotar, Croatia, has the char a c ter is tics of a low
sero-prevalence area, in con trast to the en demic neigh bor ing ar eas