Various positive effects of pet ownership on cardiovascular health are well known. The aim of this prospective and controlled longitudinal study was to determine the effects of everyday dog-walking ...on physical capacity in elderly patients during the first year after myocardial infarction. Regularly dog-walking for at least 15 minutes three times a day is related to significantly higher work load on the bicycle exercise test (72.5 +/- 10.75 versus 67.6 +/- 11.6 W p < 0.05) in the "dog-walking" group (N = 29, mean age 72.5 years) at 12 months compared to the control group (N = 30, mean age 71.7 years). Our results suggest that dogs may help to maintain continuous physical activity in elderly cardiovascular patients promoting their physical capacity. Further researches are needed to confirm this association as well to identify other possible influences of dog ownership on the cardiovascular health and on the outcome in patients after myocardial infarction.
Cilj: Infekcijski endokarditis (IE) je infekcija endokarda zalistaka ili muralnog endokarda uzrokovana infektivnim agensima. Cilj našeg istraživanja je bio prikazati klinički i epidemiološki profil ...pacijenata s dijagnozom IE-a hospitaliziranih u Kliničkom bolničkom centru (KBC) Rijeka na Zavodu za kardiovaskularne bolesti Klinike za internu medicinu u periodu od siječnja 2012. do siječnja 2017. godine.
Ispitanici i Metode: Provedeno je retrospektivno istraživanje, u kojemu smo izdvojili ukupno 74 pacijenata s dijagnozom IE-a postavljenoj prema Duke kriterijima. Istraživanje se temeljilo na podacima Zavoda za kardiovaskularne bolesti, KBC-a Rijeka te je napravljena analiza demografskih, kliničkih, laboratorijskih i ehokardiografskih parametara.
Rezultati: Od ukupno 74 pacijenata, bilo je 29 žena (39,2%) te 45 muškaraca (60,8%). Medijan dobi svih pacijenata bio je 76 (32-88) godina, dok je prosječno trajanje hospitalizacije bilo 25 dana. Povišenu tjelesnu temperaturu kod prijama imalo je 52,7% pacijenata. Hemokultura je bila pozitivna u 83,6% slučajeva. Od uzročnika su najčešće bili izolirani S.aureus (24,6%) i E.faecalis (24,6%). Ehokardiografski vidljive vegetacije imalo je 93,2% pacijenata. Najčešće su bile zahvaćene aortna (40,5%) i mitralna valvula (40,5%). Zahvaćenu umjetnu valvulu je imalo 28,4% pacijenata. Najčešći komorbiditeti bili su: arterijska hipertenzija (64,9%), anemija (51,4%) te šečerna bolest (36,5%). Bolnička smrtnost bila je 12,2%.
Zaključak: Prema našim rezultatima, pacijenti s IE-om su starije životne dobi s brojnim komorbiditetima. IE je ozbiljna bolest s visokim mortalitetom. S obzirom na velik broj afebrilnih pacijenata, na IE treba misliti i kod osoba koje ne pokazuju znakove infekcije te treba usmjeriti obradu prema postavljanju dijagnoze, uz što raniji početak liječenja ove bolesti.
Transtorakalna ehokardiografija (TTE) slikovna je metoda koja daje detaljan uvid u morfologiju i funkciju srčanih struktura i velikih krvnih žila. Mogućnost prikupljanja velikog broja važnih ...kliničkih informacija, niska cijena i visoka reproducibilnost čine ju metodom izbora u dijagnostici i praćenju većine kardiovaskularnih bolesti. Široka zastupljenost metode sve jasnije nalaže osnovno poznavanje ehokardiografskih načela i u zdravstvenih djelatnika koji nisu kardiolozi. Da bi pružio jasnu kliničku informaciju, nalaz mora imati jasnu logičku strukturu, biti pisan na razumljiv način i sadržavati sva definirana obavezna standardna mjerenja. Radna skupina za slikovne metode u kardiologiji Europskoga kardiološkog društva izdala je preporuke i smjernice za standardizaciju TTE-postupaka i pisanje nalaza, čiji je cilj unaprijediti kvalitetu informacije koju pruža TTE-izvješće. Uz obavezne opće podatke o bolesniku, kliničko pitanje, obavezna standardna mjerenja i datum pretrage, izvješće mora sadržavati i opisnu interpretaciju mjerenja s kliničkom interpretacijom i naglaskom na mogućim ograničenjima pretrage.
Porast prevalencije debljine postaje ozbiljan globalni javnozdravstveni problem. Osim nezdrave prehrane i smanjene tjelesne aktivnosti, razni kemijski spojevi koji se nalaze svuda oko nas mogu biti ...jedan od etioloških čimbenika razvoja debljine i njezine rastuće prevalencije. Kemijski spojevi koji ometaju rad hormonskog sustava čovjeka nazivaju se endokrini disruptori. U tu skupinu spadaju obezogeni koji ometaju normalan razvoj masnog tkiva i ravnotežu metabolizma lipida. Obezogeni su sastavni dio kozmetike, elektronike, plastike, ali se nalaze i u zraku, vodi i hrani koju svakodnevno konzumiramo. Razdoblje ranog razvoja (in utero, novorođenčad) najosjetljiviji je period pa izloženost ploda obezogenima tijekom njega putem mlijeka ili preko posteljice može biti predisponirajući čimbenik za razvoj debljine u odrasloj dobi. S gledišta suočavanja s epidemijom debljine posebno je važno uspostaviti kontrolu nad obezogenima i pokušati spriječiti ili barem ograničiti izloženost ljudi, posebice djece i trudnica, tim opasnim spojevima.
Summary Endothelial dysfunction (ED) is actively involved in the mechanism of occurrence, development and progression of all the degrees of atherosclerosis. The established impact of ED on the ...progress and outcome of cardiovascular diseases, together with convincing indications of a possible successful therapeutic modification, necessitate the changeover of ED assessment from experimental to a routine practice. As there is no appropriate method for a clinical practice, scientists anticipate significant research efforts in the further development. Among numerous methods already available, von Willebrand Factor (vWF) stands out significantly. In accordance with the accepted leading diagnostic role of vWF baseline levels in the group of peripheral endothelial markers, and earlier scientific observations on the absence of its expected reactivation during physical exercise, we hypothesised this promising theory. We believe that a constant stronger release of vWF in endothelial cell injury leads to the exhaustion of its stores in Weibel–Palade bodies with the consequent absence of the expected rise of concentration during the exercise. Therefore, we hypothesised that ED could be exhaustible vWF endothelopathy and the exercise induced release of vWF a new, simple, safe and reliable test for the detection of ED and monitoring of the expected therapeutic effect. In order to have a final clinical usability of the proposed diagnostic model, it is necessary to test its reliability in different pathological and risk states, and establish susceptibility in therapeutic procedures. The correlation with invasive functional angiographic tests and the flow mediated dilatation test of peripheral arteries also needs to be validated. We expect the proposed test of vWF inducibility to find its place in clinical practice, i.e. in prevention, prediction and therapy of cardiovascular diseases.
The heart in Fabry’s disease Skorup, Lea; Grgić Romić, Ivana; Šimić, Jelena ...
Cardiologia Croatica,
05/2019, Letnik:
14, Številka:
3-4
Journal Article, Web Resource
Odprti dostop
Introduction: Fabry disease is rare X-linked, recessive lysosomal storage disorder expressed as deficiency in enzyme α-galactosidase A that leads to progressive accumulation of globotriaosylceramide ...and related glycosphingolipids in various tissues. In cardiac tissues, progressive globotriaosylceramide accumulation leads to irreversible cardiac damage.1,2 Males are primarily affected by Fabry disease, but female heterozygotes may also have symptoms.3
Case report: Our patient is 47-years-old who has been suffering from chronic kidney disease since he was 23 years old. Only twelve years later he developed end-stage renal disease and has been undergoing
regular haemodialysis in Dialysis Centre Prijedor (Bosnia and Herzegovina). He started his journey towards kidney transplantation in 2014 in University Hospital Centre Rijeka, which was performed
in May 2018. In 2014, during pretransplantation workup, echocardiography was performed revealing concentric cardiac hypertrophy without left ventricle outflow tract obstruction (Figure 1 and Figure 2) associated with contractility and diastolic filling impairment. Following suspicion on Fabry disease, diagnosis was made by measuring α-galactosidase enzyme activity in leukocytes and molecular genetic testing of GLA gene mutation. Enzyme replacement therapy was started with intravenous infusion of recombinant α-galactosidase A (agalsidase beta).
Conclusion: Renal disease and echocardiographic features of hypertrophic cardiomyopathy combined with electrocardiographic and clinical criteria should be considered as “red flags” for Fabry disease.
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