Purpose: The study evaluates the changes in quality of life (QOL) six months after coronary artery bypass grafting (CABG) related to the patients' age. Methods: The total of 243 consecutive patients completed the Nottingham Health Profile Questionnaire part 1 before and six months after CABG. Postoperative questionnaire was completed by 226 patients. Patients were divided into four examined groups (<50, 50-59, 60-69 and ≥70 years), according to their age. Results: Six months after CABG, the quality of life in different sections has been significantly improved in most patients.The analysis of the relation between the age and the changes in QOL of patients six months after CABG showed a significant correlation among the patients' age and the improvement of QOL in the sections of physical mobility (r = 0.18, p = 0.008), social isolation (r = 0.17, p = 0.01) and energy ( r = 0.21, p = 0.002). The most prominent improvement was found in older patients. The age was not an independent predictor of QOL deterioration after CABG. Conclusions: The most noticeable improvement of QOL six months after CABG was found in older patients. Age is not the independent predictor of deterioration of QOL after CABG.
Thyroid storm is an acute and severe complication of thyrotoxicosis. It is characterized by high fever, sweating, tachycardia, and often heart failure too. The objectives of the paper is to present the case of a patient with thyroid storm developed after the trauma of the chest at previously apparently healthy individuals, diagnosed on the basis of clinical preview and based on the diagnostic criteria according to Burch and Wartofsky. The most common complication is Mb. Graves - Basedow, but often associated with multi-nodose goiter. Thyroid storm is the most severe form of thyrotoxicosis with a mortality rate of 8 to 25 %. Case report. We present an interesting case from our practice: thyroid storm caused after chest trauma in apparently healthy people, but with unrecognized hyperthyroidism and thyroid gland nodule. Conclusion. The objectives of this presentation were to raise awareness of the association between signs and symptoms of thyroid storm that dominate the clinical picture and complicate the initial presentation and the evolution of the situation caused by trauma. The treatment of hyperthyroidism resulted in conversion in sinus rhythm, withdrawal of symptoms and signs heart failure, and normalization of artery pressure.
Pominjanje artritisa koji se javlja posle uretritisa ili dijareje (dizenterije) potiče još iz perioda pre naše ere. Benjamin Brodie je 1818. godine objavio rezultate lečenja pet bolesnika koji su imali sve odlike Reiterove bolesti (RB) : uretritis, konjuktivitis, artritis. Od predloženih brojnih dijagnostičkih kriterijuma smatramo da je za praktične svrhe najpogodniji sledeći: posturetritisni ili postenterokolitisni artritis je Reiterova bolest (RB). Nalaz hlamidija u sinovijskoj tečnosti ili sinovijskom tkivu ukazuje da bi artritis u Reiterovoj Bolesti mogao biti infekcijske a ne reaktivne prirode.Ključne reči: Reiterova bolest, hlamidija, sinovija, artritis PREGLEDNI ČLANCI AUTORI SAŽETAK KORESPONDENT ZLATICA MIRKOVIĆ
Uvod: SAPHO sindrom se karakteriše košanozglobnim i kožnim simptomima, Akronim "SAPHO" je skraćenica za promene na koštanozglobnom sistemu i koži: S-sinovitis; A-akne; P-pustulosis; H-hiperostosis; O-osteitis. SAPHO sindrom sreće se pod 50 različitih imena koja se koriste u literaturi. On je za sada nepoznate etiologije, spada u grupu seronegativnih spondilartopatija. U terapiji SAPHO sindroma koriste se NSAIL, glukokortikoidi, bolest modifikujući lekovi (BML), antibiotici, bisfosfonati i anti TNF-alfa lekovi sa promenljivim uspehom. Prikaz slučaja: Pacijent P.Z. životne dobi 47.g. ženskog pola, dolazi zbog bolova u predelu grudne kosti, propagacije bola u desno rame i jutarnje ukočenost u krstima kraćeg trajanja. Recidivantne kožne promene na dlanovima obostrano u vidu gnojnih pustula, kojima prethodi svrab. Urađena je scintigrafija kostiju: Uočava se jasno pojačano vezivanje radiofarmaka u projekciji desnog sternoklavikulanog zgloba, diskretno jače u oba ramena i oba kolena. PH nalaz: Pustulosis palmoplantaris. U terapiji uveden azithromycin u dozi od 500mg 2x1 nedeljno u sledećih 16 nedelja u dva navrata. Pacijentkinja je nakon jedne godine bez recidiva artritisa i kožnih lezija. Zaključak: Ovaj rad ima za cilj da se proširi znanje o ovom retkom entitetu i da se on lakše prepoznaje. Da se o ovom entitetu pored reumatologa, dermatologa, pedijatara upoznaju i ostale komplementarne grane.
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