Introduction. The foramen Vesalius is a variable foramen located at the skull base, anteromedial to the foramen ovale behind and lateral to the foramen rotundum. This foramen is also known as emissary sphenoidal foramen. The aim of the research was to determine the anatomical characteristics of the foramen Vesalius in adult human skulls and foramina classification according to their type, shape, and sex distribution. Material and Methods. The study included 26 dry adult human skulls of both sexes from the collection of the Depart?ment of Anatomy, Faculty of Medicine of the University of Novi Sad. The skulls were macroscopically analyzed according to the presence or absence of the foramen Vesalius. Results. The foramen Vesalius was found in 16 skulls (61.54%) and it was absent in 10 skulls (38.46%). The incidence of bilateral and unilateral foramen Vesalius was 87.5% (14 skulls) and 12.5% (2 skulls), respectively. The foramen Vesalius was found in 10 male skulls (62.5%) and in 6 female skulls (37.5%). Conclusion. Based on the morphological analysis of the skulls, the study showed that the foramen of Vesalius can be unilateral or bilateral. The bilateral foramen was more common and it was usually round and symmetrical. In regard to the sex prevalence, the foramen was more prevalent in male than in female skulls. The results of the study showed that foramen Vesalius is not an uncommon anatomical variation, and its presence and morphological appearance are important information for physicians in various fields.
Introduction. Human immunodeficiency virus infection is a disease of the modern era and it is estimated that there are more than 30 million infected individuals worldwide. Although the major cause is still unclear, patients infected with human immunodeficiency virus are at higher risk of ardiovascular diseases by 61% compared to general population. Material and Methods. This study included 111 male patients infected with human immunodeficiency virus treated at the Clinic of Infectious Diseases, Novi Sad, Serbia from January 2008 to December 2018. Five cardiovascular risk scores were used: Data Collection on Adverse Events of Antihuman immunodeficiency virus Drugs, Framingham 10-year Heart Score, Framingham 5-year Heart Score, prediction algorithm for cardiovascular disease and atherosclerotic cardiovascular disease risk estimator, at the beginning of the treatment, whereas cardiovascular events were recorded during the following 10 years. Results. Data Collection on Adverse Events of Anti-human immunodeficiency virus Drugs, Framingham 10-year Heart Score, Framingham 5-year Heart Score, and prediction algorithm for cardiovascular disease are tools that can identify individuals infected with human immunodeficiency virus at cardiovascular risk with statistical significance. The prediction algorithm for cardiovascular disease provides superior risk estimation compared to other scores. The atherosclerotic cardiovascular disease risk estimator did not show to be a marker of cardiovascular risk prediction among this population of patients. Conlusion. The above mentioned cardiovascular risk prediction algorithms, developed for general population, and Data Collection on Adverse Events of Anti-human immunodeficiency virus Drugs score, specific for population infected with human immunodeficiency virus, allow accurate cardiovascular risk estimation. Until the development of more specific algorithms, these scores are adequate tools for identification of patients at risk, providing prevention measures and treatment of cardiovascular disease.
Introduction. Cardiac lipomas are rare benign cardiac tumors. The symptoms they cause and the diagnosis depend on their size and location. Case Report. We report the case of a 69-year-old male, whose main symptom was progressive dyspnea on exertion and in the supine position. The diagnosis of a large subepicardial lipoma in the wall of the right atrium, causing superior vena cava compression and consecutive obstructive sleep apnea syndrom, was made using different imaging techniques. The patient underwent open heart surgery, and the tumor was extracted with no intraoperative and postoperative complications. During a 1-year follow up, he remained asymptomatic, with no clinical signs of obstructive sleep apnea after the surgery. Conclusion. When it comes to the diagnosis and treatment of obstructive sleep apnea, cardiac tumors should be considered.
Introduction. The causes of dilated cardiomyopathy can be divided into ischemic and nonischemic. Although the importance of thyroid hormones for proper functioning of the cardiovascular system is well known, dilated cardiomyopathy is a rare presentation of hypothyroidism. Case Report. This is a case report of a 38-year-old man admitted to the Intensive Cardiac Care Unit with signs and symptoms of advanced heart failure. Dilated cardiomyopathy was established by echocardiography, while blood test showed highly elevated levels of thyroid stimulating hormone and decreased levels of free triiodothyronine and free thyroxine. The ejection fraction was significantly improved with levothyroxine replacement therapy. Conclusion. Hypothyroidism should always be considered as the cause of dilated cardiomyopathy. Thyroid hormone tests should be performed in all patients with dilated cardiomyopathy.
Introduction. Beta blockers play an essential role in the treatment of cardiovascular diseases, but also various other endocrinological, gastroenterological, ophthalmological and neurological disorders. The most important effects of beta blockers are a reduction in myocardial oxygen consumption and inhibition of renin secretion. Beta blockers are divided into three generations according to their selectivity - non-selective, cardioselective and vasodilating beta blockers. Beta blockers and obstructive pulmonary diseases. Patients with obstructive pulmonary diseases are significantly more likely to develop cardiovascular diseases compared to general population, largely due to common risk factors such as smoking, systemic inflammation, age, and genetic predisposition. The use of nonselective beta blockers carries a great risk for patients with obstructive pulmonary diseases, while cardioselective beta blockers can be used more extensively. Reversible airway obstruction is predominantly present in asthma, so that the adverse effects of beta blockers on the airways are significantly more pronounced in asthma compared to chronic obstructive pulmonary disease. Conclusion. In both asthma and chronic obstructive pulmonary disease, the use of highly cardioselective beta blockers such as bisoprolol and nebivolol is preferred. The use of beta blockers in patients with asthma requires great caution due to the possibility of bronchial obstruction, while in patients with chronic obstructive pulmonary disease they are somewhat safer. Patients must be closely monitored by a physician, with special attention focused on clinical signs of airway obstruction such as wheezing, shortness of breath, and prolonged expiration.
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