BackgroundData from developing countries on the rates of kidney disease are scarce. The study aimed to estimate population-based prevalence of self-reported kidney disease (SRKD) in Serbia, describe co-occurrence of chronic diseases/conditions/functional limitations in respondents with SRKD and explore association between SRKD and possible risk factors.MethodsWe performed a secondary analysis of 2013 National Health Survey data. Data on a total of 14,587 respondents aged 15 years or older were analyzed using means of descriptive statistics, principal component analysis and logistic regression analysis.ResultsOut of all study respondents, 5.6% (95%CI 5.2–6.0) reported presence of kidney disease. Prevalence of all analyzed morbidities and functional limitations was higher in respondents with SRKD, and they had 8 times higher likelihood of being diagnosed with cirrhosis, 6.3 times higher likelihood of being diagnosed with urinary incontinence, more than 3 times higher likelihood of being diagnosed with degenerative disorder of bone and joint system. For cardiovascular diseases we obtained odds ratios (ORs) from 2.27 (95%CI 2.32–3.44) for heart attack to 2.95 (95%CI 2.43–3.57) for coronary heart disease. Number of co-occurrence patterns of kidney and other chronic diseases/conditions varied depending on inclusion of obesity in models. Logistic regression analysis showed that age explained most part of variability in the prevalence of SRKD and in the prevalence of two morbidities in respondents with SRKD, whereas the presence of three or more morbidities were associated with female gender, aging and low education level.ConclusionsOur study provided evidence that the presence of kidney disease was significantly associated with socio-demographic, lifestyle characteristics and a number of morbidities in Serbia. There is a need for integrated care and public health interventions, tackling management of NCDs and their risk factors. Detailed well-designed studies, as part of cost-effective preventive approach, are needed for chronic kidney disease screening.
Although regular BH measurements enable early recognition of growth retardation, patients' mean age and degree of growth retardation indicate that GHD is still diagnosed relatively late. A high incidence of other pituitary hormone deficiencies requires a detailed investigation of the etiology of disorders and evaluation of all pituitary functions in each child with confirmed GHD.
Ishemijska bolest srca je najčešći uzrok bloka leve grane (LBBB). Neinterpretabilni elektrokardiogram (EKG), izmenjena pokretljivost septuma, kao i specifičnosti koronarnog protoka kod ovih pacijenata značajno limitiraju senzitivnost neinvazivnih dijagnostičkih metoda u proceni koronarne bolesti. Prikazujemo slučaj bolesnice sa nižom intermedijernom pre-test verovatnoćom za postojanje koronarne bolesti, kojoj smo tek na osnovu nalaza različitih neinvazivnih testova za procenu miokardne ishemije indikovali invazivnu koronarografiju i dalje adekvatno lečenje. blok leve grane, ishemijska bolest srca, neinvazivna procena
96 Stress echocardiography sured using 2D speckle tracking. Functional capacity was assessed with a treadmill stress test and expressed as metabolic equivalents (METs). We analyzed left atrial strain values with functional capacity through linear correlations (Bonferroni type adjustment). Results: In our group of patients, the relationship between left atrial ejection fraction and METs were not shown to be significant (r=0.11, p=0.34), but atrial strain values were significant predictors of functional capacity. Left atrial strain was significantly related to the diastolic patron, assessed by E/E' valor (r= -0.26, p=0.0269). We found a direct proportional relationship between peak atrial strain measured during the left atrial reservoir phase and METs (r=0.55, p<0.001) and an inverse relationship between the strain rate measured during the conduit phase and METs (r= -0.55, p<0.001). In our sample, we did not find any statistically significant association between E/E' rest with exercise capacity (r= -0.17, p=0.146). Conclusion: In our preserved left ventricular function group of patients, left atrial function assessed with speckle tracking was a significant predictor of functional capacity, better than left atrial ejection fraction or E/E' rest. Background: ST-segment elevation in lead aVR is an important predictor of acute left main (LM) coronary artery obstruction, but its predictive value in a setting of exercise treadmill testing is still unclear. Purpose: The aims of our study were to assess the incidence and predictors of LM/ostial left anterior descending (LAD) coronary artery and/or ostial circumflex (Cx) artery stenosis in patients referred to exercise testing presenting with exercise-induced ST segment elevation in lead aVR. Methods: Out of 9052 patients who underwent stress echocardiography testing from 2012 to 2016 in our laboratory, we identified 76 patients (55 men; mean age of 61±8.4 years), presenting with ST segment elevation in lead aVR during exercise. All the patients underwent coronary angiography. Significant LM/ostial LAD or ostial Cx stenosis was defined as narrowing ≥50% of diameter stenosis. We analyzed baseline clinical characteristics, hemodynamic response to exercise, rest and stress electrocardiograms as well as baseline and peak exercise echocardiography images in all patients. We calculated Duke treadmill score and changes in wall motion score index (delta WMSI). Results: Significant LM/ostial LAD or ostial Cx stenosis was present in 26/76 patients (34%) with exercise-induced ST segment elevation in lead aVR. There were no statistically significant differences in majority of baseline clinical characteristics and hemodynamic response between patients with and without significant LM/ostial LAD or ostial Cx stenosis. However, patients with LM/ostial LAD and ostial Cx stenosis were older (63±8 years vs. 60±9 years, p=0.19), with a lower Duke treadmill score (-7±6 vs. -3±4, p=.004) in comparison to those without significant LM/ostial LAD or ostial Cx stenosis, and the showed more severe w...
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