Cilj: Simptomi donjega mokraćnog sustava imaju visoku prevalenciju u muškaraca i u žena, a jedan od najčešćih simptoma jest nokturija. Prema definiciji Međunarodnog društva za kontinenciju nokturija ...je karakterizirana kao buđenje tijekom glavnog perioda spavanja radi mokrenja. Najnovija istraživanja su pokazala da je noćna poliurija jedan od najčešćih uzroka nokturije u oba spola. Noćna poliurija se tumači kao prekomjerna proizvodnja mokraće tijekom glavnog perioda spavanja. Cilj ovog rada bio je pregled najnovije medicinske literature o definiciji, etiologiji, patofiziologiji, dijagnostičkoj procjeni i dostupnim metodama liječenja nokturije i noćne poliurije.
Metode: Pretraženi su medicinski podatci pomoću baze podataka PubMed za razdoblje od 1. siječnja 2017. do 1. siječnja 2022. Rezultati: Nokturija je multifaktorijalno stanje koje može koegzistirati s drugim simptomima donjega mokraćnog sustava. Nokturija ima veliki utjecaj na kvalitetu života i može biti povezana s povećanim rizikom od nastanka drugih bolesti kao što su šećerna bolest i arterijska hipertenzija. Većina ljudi s nokturijom ne odlazi pravovremeno na liječnički pregled, prihvaćajući je kao prirodnu posljedicu starenja. Rano prepoznavanje nokturije i noćne poliurije i shvaćanje njihove etiologije i patofiziologije važno je za planiranje odgovarajućeg tretmana. Zaključci: Ovaj pregledni članak iznosi sadašnja stajališta o prevenciji, ranoj dijagnozi i liječenju nokturije i noćne poliurije. Odgovarajuće liječenje se temelji na boljem razumijevanju njihove etiologije i patofiziologije, što može doprinijeti smanjenju pojave komplikacija i poboljšanju kvalitete života bolesnika.
Aim: To determine the differences in comorbidities, therapy and echocardiographic measures among patients hospitalized for heart failure relative to gender.Methods: The study included patients ...hospitalized for heart failure at the Department of Cardiovascular Diseases of the Clinical Hospital Center Osijek in the period from 1 January 2020 to 30 March 2021.Results: There were 200 patients included in the study, of which 100 (50%) were male and 100 (50%) were female. Female patients were older, while male patients more frequently had a history of coronary artery disease. Men had a higher dose of loop diuretic on admission to the hospital. No significant difference was found in the representation of beta blockers and ACE inhibitors in therapy with regard to gender. On the other hand, men more frequently used MRA, sacubitril/valsartan and antiplatelet medication at hospital admission. Male patients had a larger left ventricular end-diastolic diameter, left ventricular end-systolic diameter and a lower left ventricular ejection fraction (EF). Regarding the type of heart failure according to EF, 72% of men had HFrEF, 20% HFmrEF and 8% HFpEF. In women, 47% had HFrEF, 33% HFmrEF and 20% HFpEF. During hospitalization due to heart failure, 22 patients died, an equal number of men and women.Conclusion: This research confirmed the differences in risk factors and pathophysiology of heart failure between males and females. Medicine is progressing towards an individual approach to each patient, so further research will be needed to find the best therapy for both male and female patients.
Pheochromocytoma is a rare cause of hypertension in pregnancy. Unrecognized, it carries a great risk for both mother and the foetus. The main reason for missing the diagnosis is the misconception ...that any hypertension occurring in pregnancy is gestational hypertension or pre (eclampsia). As many as 90% of patients report one or more pheochromocytoma-related symptoms antenatally, but the diagnosis is made in 75% of patients, meaning that 3 out of 10 patients are diagnosed after childbirth or post-mortem. The symptoms are similar to other more common causes of hypertension in pregnancy, which presents a major diagnostic challenge. The diagnosis is based on determination of metanephrines in plasma or 24-hour urine. Magnetic resonance imaging (MRI) and ultrasound (US) are used to localize the tumour. If the diagnosis is made before the 24th week of pregnancy, laparoscopic removal of the tumour in the second trimester is recommended. If diagnosed later, the tumour could be removed during or after delivery. Preoperative preparation with alpha blockers is required to stabilize blood pressure. The decision on the mode of delivery depends on several factors, so an experienced multidisciplinary team is needed to minimize maternal and foetal mortality.
Aim.
Comorbidities pose a major challenge for 21st century medicine. The mutual pathophysiological effect of one disease on another can significantly affect their course and prognosis. The aims of ...this study were to examine the frequency of comorbidities and the most common psychiatric and somatic comorbidities and to determine the difference in the incidence of certain diseases by gender and age.
Methods.
Data were recorded in several groups: demographic characteristics, psychiatric and somatic diagnoses classified according to gender, age, and the legally determined ability to work, and correlations of somatic and psychiatric diagnoses.
Results.
The most common psychiatric diagnoses in men were post-traumatic stress disorder (PTSD) (25%) and alcoholism (23%), while in women these were recurrent depressive disorder (19%) and psychosis (10%). A statistically significant difference was found in the incidence of alcoholism and PTSD, which are more common in men than in women. The most common somatic diseases in both sexes were arterial hypertension (M = 33%, F = 46%) and diabetes mellitus (M = 18%, F = 32%). Statistically significant differences were found in the frequency of hypertension (p = 0.03) and epilepsy (p = 0.002), which are more common in men. The ratio alcoholism-hypertension (p = 0.03), alcoholism-diabetes (p < 0.0001), alcoholism-COPD (p < 0.001) was statistically significant.
Conclusion.
It is extremely important to improve the multidisciplinary approach and cooperation in treatment in order to reduce the number of hospitalizations, emergency interventions and suicides and to improve the patients’ quality of life and life expectancy.
Lipidni profil kod žena u postmenopauzi Marušić, Romana; Ormanac, Klara; Marczi, Saška ...
Medica Jadertina (Zagreb),
08/2023, Letnik:
53, Številka:
2
Journal Article
Recenzirano
Objectives: The main objectives of the research are to examine the incidence of hyperlipoproteinemia in postmenopausal women and to determine the differences in lipid profile considering age, ...duration of menopause and body mass index in postmenopausal women. Respondents and methods: The research is structured as cross-sectional with historical data. The research used data collected during regular check-ups in primary health care clinics in Osijek Health Center from November 2021 to March 2022. Collected data: demographic data, information on the duration of menopause, body mass, body height, body mass index, values of total, LDL, HDL cholesterol and triglycerides, and data on associated diseases. Results: 98 postmenopausal women were included in the research, of which over 50% had elevated total and LDL cholesterol values, and 39.8% had elevated triglyceride values. Subjects aged 45 to 65 years and subjects with a duration of menopause of 10 or more years had significantly higher values of total and LDL cholesterol while no difference was observed in the lipid profile with regard to the body mass index. Using the SCORE2 table, it was estimated that 65% of the subjects had a very high cardiovascular risk, and only 6% of the subjects achieved the target values of LDL cholesterol in accordance with the cardiovascular risk. Conclusion: There is a very high incidence of hyperlipoproteinemia in postmenopausal women, and the age and duration of menopause have an impact on the poorer achievement of the target values of the lipid profile, while the body mass index showed no impact. Given the high prevalence of subjects with a very high cardiovascular risk (SCORE 2 tables), intensive interventions are needed at all levels of health care, especially at the primary level of health care, which include non-pharmacological and pharmacological methods of treating hyperlipoproteinemia.
Cilj istraživanja: Osnovni ciljevi istraživanja jesu ispitati incidenciju hiperlipoproteinemije u žena upostmenopauzi i utvrditi razlike u sastavnicama lipidnog profila obzirom na dob, trajanje menopauze iindeks tjelesne mase.Ispitanici i metode: Istraživanje je ustrojeno kao presječno s povijesnim podacima. Za istraživanje suse koristili podaci prikupljeni u ambulantama primarne zdravstvene zaštite u Domu zdravlja Osijek, odstudenoga 2021. do ožujka 2022. g. a prikupljeni su na redovitim kontrolama. Prikupljeni podaci:demografski podaci, podaci o trajanju menopauze, tjelesna masa, tjelesna visina, indeks tjelesne mase,vrijednosti ukupnog, LDL, HDL kolesterola i triglicerida, te podaci o pridruženim bolestima.Rezultati: U istraživanje je uključeno 98 ispitanica od kojih preko 50 % njih ima povišene vrijednostiukupnog i LDL kolesterola, a 39,8 % povišene vrijednosti triglicerida. Ispitanice starosti 45 do 65 godina iispitanice s trajanjem menopauze od 10 ili više godina imaju značajno više vrijednosti ukupnog i LDLkolesterola, dok nije uočena razlika u lipidnom profilu obzirom na indeks tjelesne mase. UpotrebomSCORE2 tablice procijenjeno je da 65 % ispitanica ima vrlo visok kardiovaskularni rizik, a samo 6 %ispitanica postiglo je ciljne vrijednosti LDL kolesterola u skladu s kardiovaskularnim rizikom.Zaključak: Incidencija hiperlipoproteinemije u postmenopauzalnih žena je vrlo visoka, a starija dob idulje trajanje menopauze povezani su sa slabijim postizanjem ciljnih vrijednosti lipidnog profila, dokindeks tjelesne mase nije pokazao utjecaj. Obzirom na visoku zastupljenost ispitanica s vrlo visokimkardiovaskularnim rizikom (SCORE 2 tablice), potrebne su intenzivne intervencije na svim razinamazdravstvene zaštite, posebice primarnoj razini zdravstvene zaštite, a koje uključuju i nefarmakološke ifarmakološke metode liječenja hiperlipoproteinemija.
Aim
To determine the most common indications for measuring metanephrine and normetanephrine in plasma by gender and age and to compare the concentrations of metanephrine and normetanephrine by ...indication, gender and age.
Methods
The study was conducted on 224 patients whose plasma metanephrine and normetanephrine concentrations were measured at the Clinical Institute for Laboratory Diagnostics at the University Hospital Centre Osijek for one year, until 1st January 2020.
Results
The most frequent indications for biochemical testing were adrenal incidentaloma, 138 (6.6 %), and symptoms of pheochromocytoma, 41 (18.3%). Metanephrine concentration was lower in females (p=0.009). No significant correlation was found between age and metanephrine concentration, while age and normetanephrine concentration were positively correlated (p=0.01). Of the 224 patients, only one patient was diagnosed with pheochromocytoma, whose indication for measurement of metanephrine and normetanephrine was adrenal incidentaloma.
Conclusion
Adrenal incidentalomas and symptoms suggestive of pheochromocytoma are very common in the general population, while the incidence of pheochromocytoma is extremely low. Clear guidelines for the referral of patients for biochemical testing are needed to avoid unnecessary costs and to identify the correct diagnosis promptly
Cilj: Prikazati slučaj pacijenta obrađenog zbog gubitka na tjelesnoj masi i anksioznosti kojemu je utvrđen tumor srži nadbubrežne žlijezde, a naknadnim uvidom u medicinsku dokumentaciju utvrđene su i ...višegodišnje povremene palpitacije, tahikardije i skokovi tlaka. Prikaz slučaja: Prikazan je šezdesetdvogodišnji pacijent koji se žalio na oslabljen apetit unatrag 3 mjeseca, gubitak na tjelesnoj masi 10 kg te anksioznost. Ultrazvukom abdomena utvrđena je, a kompjutoriziranom tomografijom (CT) abdomena potvrđena, oštro ograničena heterogena tvorba desne nadbubrežne žlijezde promjera 4,2 x 5 cm i denziteta 26 Hounsfieldovih jedinica. Iz medicinske dokumentacije saznaje se da je prethodnih 4 godina povremeno imao palpitacije i supraventrikularne tahikardije s vrijednostima krvnog tlaka do 190/100 mmHg. Endokrinološkom obradom utvrđene su povišene vrijednosti metanefrina i normetanefrina u plazmi (12 i 9 puta). Nakon operacije patohistološki je potvrđena dijagnoza feokromocitoma. Kontrolni nalazi metanefrina i normetanefrina bili su uredni. Planira se kontrola metanefrina i normetanefrina u plazmi jedanput godišnje. Zaključak: U ovom prikazu slučaja želi se istaknuti važnost postavljanja sumnje i pravovremenog utvrđivanja feokromocitoma te sprječavanja mogućih komplikacija. Ako postoji klinička sumnja na feokromocitom ili je tijekom obrade incidentaloma nadbubrežne žlijezde CT-om isključeno da se radi o adenomu, potrebno je učiniti biokemijsku obradu feokromocitoma. Ako se ne prepoznaju na vrijeme, ovi tumori zbog svoje hipersekrecije katekolamina imaju visok kardiovaskularni morbiditet i mortalitet.
Aim: This case report presents a patient with diagnosed adrenal medulla mass. The patient presented with weight-loss and anxiety. Additional examination of medical records has revealed occasional palpitations, tachycardia and fluctuating blood pressure. Case report: A 62-year-old male patient presented with arterial hypertension, type 2 diabetes, hypercholesterolemia, anxiety, appetite and weight loss of 10 kg in three months. Adominal ultrasound showed and abdominal computerised tomography (CT) scan confirmed a sharply defined heterogenous mass on the right adrenal gland of 4.2x5 cm in diameter, with a density of 26 Hounsfield units. Medical records showed that during the previous four years the patient occasionally suffered from palpitation and supraventricular tachycardia with blood pressure levels up to 190/100mmHg. The laboratory analysis showed elevated plasma levels of metanephrine and normetanephrine (12 and 9 times). Following the surgery, the histopathological examination confirmed the diagnosis of pheochromocytoma. The metanephrine and normetanephrine follow-up results were normal. Annual follow-up is recommended once a year. Conclusion: This case study shows the importance of suspicion of pheochromocytoma with its early detection and the prevention of possible complications. If there is a clinical suspicion of pheochromocytoma or if CT scan rules out adenoma, a biochemical evaluation for pheochromocytoma is mandatory. Unless recognized on time, these tumors have high cardiovascular morbidity and mortality due to their hypersecretion of catecholamines.
Uvod: Anksiolitici su jedni od najčešće propisivanih lijekova te su veoma popularni zbog svoje široke terapijske
primjene. Cilj: Cilj je ispitati učestalost korištenja anksiolitika kod studenata ...medicine.
Metode: U istraživanju je sudjelovalo 222 studenata od 1. do 6. godine Studija medicine na Medicinskom fakultetu
Osijek rješavajući anonimni upitnik. Rezultati: Od 222 studenata 19,5 % koristilo je benzodiazepin. Djevojke ih koriste
značajno češće od muškaraca. Najčešće indikacije za korištenje su osjećaj tjeskobe i anksioznost. Najčešće korišten
benzodiazepin je alprazolam. Najviše ih koriste studenti 6. godine medicine, dok ih studenti 1. godine ne koriste.
Razlozi za korištenje razlikuju se prema godinama studiranja; glavni razlog korištenja na 3. godini je nadolazeći
ispit, dok su na 5. i 6. godini razlozi uzimanja benzodiazepina obiteljski i ljubavni problemi. Jednom u više mjeseci
benzodiazepine koristi 59,1 % studenata, dok ih 5 % koristi svaki dan, 20,9 % studenata koristi i smatra korisnima
biljne preparate za smirenje. Pomoć stručnjaka za svoje probleme potražilo je 32,6 % studenata koji su koristili
benzodiazepine, dok ih je 41,9 % o tome razmišljalo. Zaključci: Unatoč tome što su studenti medicine izloženi velikom
stresu te anksiolitike koriste češće nego opća populacija, njihova je uporaba racionalna i kontrolirana.
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