Objectives
This study aimed to directly measure pH in the lungs, determine lactate dehydrogenase (LDH), C-reactive protein (CRP), and glucose levels in serum and bronchoalveolar aspirate, and ...identify bacterial pathogens from bronchoalveolar fluid during acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
Methods
We performed an observational, analytical case–control study from February 2015 to March 2017. We included 84 patients with AECOPD and 42 with stable chronic obstructive pulmonary disease (COPD). All participants underwent detailed medical anamnesis, a clinical examination, chest radiography, spirometry, an arterial blood gas test, bronchoscopy, bacterial culture, and serum/bronchiolar aspirate laboratory testing.
Results
The mean pH of bronchoalveolar fluid was significantly higher in patients with AECOPD than in patients with stable COPD. The mean lung pH value, bronchoalveolar and serum LDH levels, and serum CRP levels in patients with isolated bacteria were higher than those in patients without isolated bacteria in the AECOPD patient group. Lung pH values in patients with AECOPD were significantly correlated with bronchoalveolar LDH and glucose levels.
Conclusions
AECOPD is associated with local cell and tissue injury in the lungs, especially in the presence of bacterial pathogens, which is accompanied by a low systemic inflammatory response.
The aim of the study was to assess perinatal outcome of pregnancy burdened with maternal addiction in comparison with an unselected population from a European transition country.
Data on pregnancies ...complicated by illicit drug abuse (n = 85) managed during a 10-year period (1997-2007) at Split University Hospital were analyzed. Data on the type of drug, course of gestation and labor, and on perinatal outcome were considered. Data on all non-dependence pregnancies recorded during the study period were used as a control group.
During the study period, there were 85 dependence-complicated pregnancies (0.2%). Use of heroin alone during pregnancy was recorded in 51 women (50%), methadone alone in 6 (7%), and a combination of heroin and methadone in 9 (11%). Premature delivery was significantly more common in the group of pregnant addicts (21% vs. 6%); 49% of pregnant addicts were carriers of hepatitis C virus (HCV) and 14% of hepatitis B virus (HBV). Neonatal abstinence syndrome developed in 61 infants (7%) born to addicted mothers. There were 4 cases (4.6%) of early neonatal death; 7 neonates had 5-minute Apgar score < or = 7 (8%); 29 neonates had low birth weight for age (33%); and 7 neonates had congenital anomalies (8%). The risk of various congenital anomalies was 3-fold in the group of children born to addicted mothers.
Addiction pregnancies present a small but high-risk group according to perinatal outcome. Appropriate obstetric and neonatal care can reduce the rate of complications in these pregnancies and improve perinatal outcome.
Pseudocyesis is a rare condition in the pediatric population characterized by all signs and symptoms of pregnancy except the existence of a fetus 1. In some patients it is associated with organic ...etiology, in others with mental disorders, also occurs in those without disorders in their medical history. Pseudocyesis occurs in both sexes, but more frequently in women. An effective treatment is a combination of psychotherapy and pharmacotherapy with antidepressants and antipsychotics 2. We present a 15,9-year old girl with pseudocyesis as a cause of abdomen enlargement, who comes from an ordinary family with a negative history of psychiatric illness. The organic etiology of her condition was excluded, and therefore she was treated with antidepressants which contributed to the resolution of her case.
Hypertriglyceridemia is a known but underestimated cause of acute pancreatitis. Although the connection between acute pancreatitis and type I, IV, and V hyperlipoproteinemia has been described, using ...Fredrickson’s classification, the connection between type IIb hyperlipoproteinemia and associated pancreatitis has only been reported in a few more rare cases. That is why we present a female patient with recurrent hyperlipidaemic pancreatitis with type IIb hyperlipidaemia.
Hipertrigliceridemija je poznat, ali podcijenjen uzrok akutnog pankreatitisa. Iako je već opisana veza između akutnog pan-kreatitisa i hiperlipoproteinemije tipa I, IV i V, korištenjem Fredricksonove klasifikacije, veza između hiperlipoproteinemije tipa IIb i pridruženog pankreatitisa zabilježena je samo u još nekoliko rijetkih slučajeva. Upravo zbog toga prikazujemo pacijenticu s rekurentnim hiperlipidemijskim pankreatitisom s hiperlipidemijom tipa IIb.
There are conflicting data about gender differences in short-term mortality after acute myocardial infarction (AMI) after adjusting for age and other prognostic factors. Therefore, we investigated ...the risk profile, clinical presentation, in-hospital mortality and mechanisms of death in women and men after the first AMI.
The data were obtained from a chart review of 3382 consecutive patients, 1184 (35%) women (69.7+/-10.9 years) and 2198 (65%) men (63.5+/-11.8 years) with a first AMI. The effect of gender and its interaction with age, risk factors and thrombolytic therapy on overall mortality and mechanisms of death were examined using logistic regression.
Unadjusted in-hospital mortality was higher in women (OR 1.77, 95% CI 1.47-2.15). Adjustment that included both age only and age and other baseline differences (hypertension, diabetes mellitus, hypercholesterolemia, smoking, AMI type, AMI site, mean peak CK value, thrombolytic therapy) decreased the magnitude of the relative risk of women to men but did not eliminate it (OR 1.26, 95% CI 1.03-1.54 and OR 1.31 95% CI 1.03-1.66, respectively). Multivariate analysis revealed that female gender was an independent predictor of in-hospital mortality after the first AMI. Women were dying more often because of mechanical complications - refractory pulmonary edema and cardiogenic shock (P=0.02) or electromechanical dissociation (P=0.03), and men were dying mostly by arrhythmic death, primary ventricular tachycardia/fibrillation (P=0.002). Female gender was independently associated with mechanical death (OR 1.56, 95% CI 1.35-2.58; P=0.01) and anterior AMI was independently associated with arrhythmic death (OR 0.54, 95% CI 0.34-0.86; P=0.01).
Our results demonstrate significant differences in mechanisms of in-hospital death after the first AMI in women and men, suggesting the possibility that higher in-hospital mortality in women exists primarily because of the postponing AMI death due to the gender-related differences in susceptibility to cardiac arrhythmias following acute coronary events.
We investigated the effects of acute intake of antioxidants on hyperoxia-induced oxidative stress, reduction of plasma nitrite and change in arterial stiffness. Twelve healthy males randomly consumed ...either placebo or an oral antioxidant cocktail (vitamin C, 1000 mg; vitamin E, 600 IU; alpha-lipoic acid, 600 mg). Every therapy was consumed once, a week apart, in a cross-over design, 30 min before the experiment. The volunteers breathed 100% normobaric oxygen between 30th and 60th min of 1-h study protocol. Plasma levels of nitrite, lipid peroxides (LOOH) and vitamin C, arterial stiffness (indicated by augmentation index, AIx) and arterial oxygen (Ptc O2 ) pressure were measured before and after hyperoxia. Exposure to oxygen caused a similar increase of Ptc O2 in both placebo and antioxidants groups, confirming comparable exposure to hyperoxia (438 ± 100 versus 455 ± 83 mm Hg). Vitamin C was increased in the antioxidants group confirming successful application of antioxidants (69 ± 14 versus 57 ± 15 μm). Hyperoxia resulted in increased AIx and LOOH and decreased nitrite in placebo (-32 ± 11 versus -47 ± 13%, 72 ± 7 versus 62 ± 6 μm H2 O2 and 758 ± 184 versus 920 ± 191 nm, respectively), but not in the antioxidants group (-42 ± 13 versus -50 ± 13%, 64 ± 9 versus 61 ± 8 μm H2 O2 and 847 ± 156 versus 936 ± 201 nm, respectively). The acute intake of selected antioxidants was effective in preserving bioavailabity of ˙NO and vascular function, against hyperoxia-induced oxidative stress.
BACKGROUND: There are conflicting data about gender differences in short-term mortality after acute myocardial infarction (AMI) after adjust*ing for age and other prognostic factors. Therefore, we ...investigated the risk profile, clinical presentation, in-hospital mortality and mechanisms of death in women and men after the first AMI. METHODS: The data were obtained from a chart review of 3382 consec*utive patients, 1184 (35%) women (69.7±10.9 years) and 2198 (65%) men (63.5±11.8 years) with a first AMI. The effect of gender and its interaction with age, risk factors and thrombolytic therapy on overall mortality and mechanisms of death were examined using logistic regression. RESULTS: Unadjusted in-hospital mortality was higher in women (OR 1.77, 95% CI 1.47-2.15). Adjustment that included both age only and age and other base-line differences (hypertension, diabetes mellitus, hy*percholesterolemia, smoking, AMI type, AMI site, mean peak CK value, thrombolytic therapy) decreased the magnitude of the relative risk of women to men but did not eliminate it (OR 1.26, 95% CI 1.03-1.54 and OR 1.31 95% CI 1.03-1.66, respectively). Multivariate analysis revealed that female gender was an independent predictor of in-hospital mortal*ity after the first AMI. Women were dying more often because of me*chanical complications--refractory pulmonary edema and cardiogenic shock (P=0.02) or electromechanical dissociation (P=0.03), and men were dying mostly by arrhythmic death, primary ventricular tachycar*dia/fibrillation (P=0.002). Female gender was independently associated with mechanical death (OR 1.56, 95% CI 1.35-2.58; P=0.01) and anterior AMI was independently associated with arrhythmic death (OR 0.54, 95% CI 0.34-0.86; P=0.01). CONCLUSION: Our results demonstrate significant differences in mech*anisms of in-hospital death after the first AMI in women and men, sug*gesting the possibility that higher in-hospital mortality in women exists primarily because of the postponing AMI death due to the gender-re*lated differences in susceptibility to cardiac arrhythmias following acute coronary events.
Hipertrigliceridemija je poznat, ali podcijenjen uzrok akutnog pankreatitisa. Iako je već opisana veza između akutnog pan-kreatitisa i hiperlipoproteinemije tipa I, IV i V, korištenjem Fredricksonove ...klasifikacije, veza između hiperlipoproteinemije tipa IIb i pridruženog pankreatitisa zabilježena je samo u još nekoliko rijetkih slučajeva. Upravo zbog toga prikazujemo pacijenticu s rekurentnim hiperlipidemijskim pankreatitisom s hiperlipidemijom tipa IIb.
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