To test the psychometric properties of the Croatian version of the Chronic Venous Insufficiency Quality of Life (CIVIQ) Questionnaire and to assess the quality of life in patients with chronic venous ...disorders of all stages.
This cross-sectional study performed between 2014 and 2015 in a private family practice assessed the factorial validity, cross-sectional validity, and reliability of the Croatian CIVIQ 20-item questionnaire completed by 428 adult patients (78% women) with chronic venous disorders classified according to the Clinical-Etiologic-Anatomic-Pathophysiologic (CEAP) C classification as stages C1-C6.
Median patient age was 52 years (5th-95th percentile, 30-77). The distribution according to the clinical stages of chronic venous disorders was as follows: C1 (n=78, 18%), C2 (n=192, 45%), C3 (n=53, 12%), C4 (n=44, 10%), C5 (n=13, 3%), and C6 (n=48, 11%). The CIVIQ-20 factorial structure was unstable, and six items were excluded from the analysis to test the psychometric properties of the shortened version (CIVIQ-14). CIVIQ-14 has three dimensions (physical, psychological, and pain). Internal consistency reliability is high for the entire CIVIQ-14 (Cronbach α=0.92) and for all CIVIQ-14 dimensions (α≥0.80). The median quality of life significantly decreased with higher CEAP C stages as follows: C1/C2 (86, 50-100); C3/C4 (75, 36-98); C5/C6 (67, 31-95) (P<0.001). Post-hoc analysis showed a higher quality of life in C1/C2 than in other groups (P<0.001).
The shortened CIVIQ-14 version is useful for assessing the quality of life in patients with chronic venous disorders in everyday clinical practice. To achieve a stable validated instrument, we recommend a cross-cultural validation of items that have loadings on more than one factor.
Chronic heart failure (CHF) is a clinical syndrome resulting from interaction of different structure and functional disturbances leading to decreased heart ability to ensure adequate supply of ...oxygenized blood to tissues and ensure adequate metabolic needs in the cases of normal or increased afterload. Endothelial dysfunction (ED) is a pathological condition characterized by general imbalance of all major endothelial mechanisms with key role in development and progression of atherosclerotic disease. ED has been associated with most cardiovascular risk factors. There is increasing interest in assessing endothelial function non-invasively, leading to development and evaluation of new diagnostic methods. We suggest that MRI is safe and reliable test that offers important advantages over ultrasound for the detection of ED and monitoring of the expected therapeutic effect. We believe that ED plays a pivotal role in chronic heart failure development and progression, regardless of its etiology, and that MRI should be introduced as a “gold standard” in diagnostic procedure and treatment.
Razdoblje između dva svjetska rata u Hrvatskoj je obilježio visok stupanj organizacije zdravstveno-promotivnih aktivnosti. U žarištu tadašnjih tečajeva bile su higijenska ispravnost hrane i ...prevencija zaraza, a aktivnosti su bile usmjerene unaprjeđenju organizacije domaćinstava i podizanju ukupne zdravstvene svijesti. Tečajevi su osim teorijskih znanja uključivali vrlo raznovrstan praktični rad u grupama, demonstracijske vježbe, radionice te studijske posjete. Suvremeno unaprjeđenje zdravlja najslabije rezultate pokazuje u području napora za promjenu nezdravih životnih navika koje čine temelj epidemije kroničnih nezaraznih bolesti. Planski organizirani i pragmatično usmjereni postizanju konačnih ciljeva, ovi bi međuratni tečajevi i danas mogli poslužiti kao efikasan model za provedbu javnozdravstvenih akcija.
Objective: The aim of the study was to identify predictors of heart-focused anxiety in patients with heart failure. A better understanding of such predictors may help in detecting the comorbidity ...underlying heart-focused anxiety and identifying patients who need psychological help. Methods: In order to account for multiple sources of heart-focused anxiety, we included psychological, lifestyle, and medical/laboratory predictors. The study involved 148 patients, of whom 74 had a leading diagnosis of worsening heart failure and were hospitalized during the COVID-19 epidemic. A second group of 74 patients suffering from cardiovascular diseases without a diagnosis of acute heart failure, were examined in various out-patient cardiology clinics. The sample consisted of 37.8% females and 62.2% males, with an average age of 63.35 years. The patients completed the Cardiac Anxiety Questionnaire, the Generalized Anxiety Disorder scale, the Patient Health Questionnaire, and the Intolerance of Uncertainty Scale. Results: Patients with heart failure with higher levels of depression and intolerance of uncertainty had higher overall levels of heart-focused anxiety, higher levels of fear about chest and heart sensations. Older patients with higher levels of depression had higher levels of activity avoidance, especially activities believed to elicit cardiac symptoms. Cardiac patients with higher level of anxiety and with anaemia as comorbidity had higher levels of heart-focused attention and monitoring of cardiac activity. Conclusion: In patients with heart failure, the presence of heart-focused anxiety significantly reduces the quality of life, leads to avoidant behaviours, and is associated with anxiety and depressive symptoms. These patients are more likely to seek medical help and specialist services, but the need for psychological help is very rarely recognized.
Aim To identify the risk factors of a repeated episode of severe
febrile neutropenia (FN) and to build an accurate and
easy-to-use predictive model.
Methods This single-center retrospective cohort ...study
conducted at the Clinical Hospital Center Children’s Hospital
Rijeka from January 1, 2008 to December 31, 2016
included pediatric patients with malignant diseases who
experienced at least one FN episode. The association of
the second severe FN episode appearance with relevant
clinical and laboratory data was analyzed by logistic regression Results Out of 45 patients with one FN episode, 25 (56%)
had severe FN and 11 (24%) had repeated severe FNs. Significant
predictors of a repeated severe FN episode were
the first FN episode duration of 9 or more days and red
blood cells ≤3.0 × 1012/L. The predictive model constructed
by crossing these two indicators had the accuracy of
87% (95% confidence interval CI 73%-94%), sensitivity
of 82% (95% CI 53%-97%), and specificity of 88% (95% CI
79%-93%).
Conclusion The first FN episode duration and anemia are
significantly associated with the risk for severe FN re-occurrence.
These factors may be useful in the identification of
children with cancer who are at high risk for adverse outcome
at any future fever onset and may benefit from early
intensive treatment.
Erectile 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.
Abstract Chronic heart failure (CHF) is a clinical syndrome resulting from interaction of different structure and functional disturbances leading to decreased heart ability to ensure adequate supply ...of oxygenized blood to tissues and ensure adequate metabolic needs in the cases of normal or increased afterload. Endothelial dysfunction (ED) is a pathological condition characterized by general imbalance of all major endothelial mechanisms with key role in development and progression of atherosclerotic disease. ED has been associated with most cardiovascular risk factors. There is increasing interest in assessing endothelial function non-invasively, leading to development and evaluation of new diagnostic methods. We suggest that MRI is safe and reliable test that offers important advantages over ultrasound for the detection of ED and monitoring of the expected therapeutic effect. We believe that ED plays a pivotal role in chronic heart failure development and progression, regardless of its etiology, and that MRI should be introduced as a “gold standard” in diagnostic procedure and treatment.
We evaluated the efficiency of a six-month outpatient weight loss treatment program combining healthy diet, fat reduction, psychological counseling, exercise, and orlistat treatment, by measuring ...body weight and levels of cardiovascular risk factors in 476 subjects with BMI over 30 or 28 with increased blood pressure, cholesterol, and sugar at the baseline and at the end of program. After four weeks of adjustment to a mild low-calorie diet (1600 kcal/day) and counseling, subjects started receiving orlistat (120 mg TID). The mean weight loss after 6 months was 10.9%. Systolic pressure dropped by 6.7%, diastolic by 4.2%, fasting blood glucose by 10.1%, and total cholesterol by 9.8%. Only 9 subjects (7.8%) poorly tolerated the treatment. More men than women were able to maintain the achieved weight loss six months after the program (70.6% vs. 58.3%, respectively). The healthy weight loss program was an efficient approach to obesity treatment.
Nove europske smjernice za zatajivanje srca objavljene u svibnju 2016. donose važne novosti u odnosu prema prethodnom izdanju iz 2012. Prema ejekcijskoj frakciji lijevog ventrikula, bolesnici sa ...zatajivanjem srca sada se dijele u tri, a ne u dvije skupine. Osim već poznate kategorije zatajivanja srca s reduciranom i one s očuvanom sistoličkom funkcijom sada je uvedena nova grupa koja obuhvaća bolesnike s ejekcijskom frakcijom srednjeg raspona. Prevencija razvoja simptoma i znakova zatajivanja srca, kao i prevencija smrtnog ishoda prije pojave ovih kliničkih manifestacija, novosti su kojima prijašnje smjernice nisu pridavale važnost. Uz jasan algoritam za dijagnosticiranje zatajivanja srca napretke nalazimo i u području terapije. Ključna novìna je uvođenje potpuno novog lijeka: LCZ696 ili sakubitrila/valsartana. U ovim smjernicama promijenjen je i algoritam za resinkronizacijsku terapiju, a znatno su obogaćeni i sadržaji vezani uz akutno zatajivanje srca.
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