[Recommendations for care of patients with cerebral accident. Part One: Organization of care for patients with cerebral accidents, treatment of cerebral accident and neurorehabilitation]. / Preporuke za zbrinjavanje bolesnika s mozdanim udarom. Prvi Dio: Organizacija skrbi za bolesnike s mozdanim udarom, lijecenje mozdanog udara i neurorehabilitacija.

Stroke is the leading cause of disability in modern society. In developed countries stroke is the second or the third cause of death, and in Croatia it is the leading cause of death. Therefore, stroke is not only a great medical, but also economic burden. Figures show that the incidence of stroke in transitional countries is increasing, so the epidemic of stroke could be expected in the forthcoming years. The Croatian Society for Neurovascular Disorders of the Croatian Medical Association and the Croatian Stroke Society wrote the recommendations for stroke management. The first part presents the recommendations for organization of stroke care, stroke treatment and neurorehabilitation, and the second part will present the recommendations for prevention of stroke.

[Recommendations for management of patients with cerebral stroke. Part Two: Primary and secondary prevention of cerebral stroke]. / Preporuke za zbrinjavanje bolesnika s mozdanim udarom. Drugi Dio: Primarna i sekundarna prevencija mozdanog udara.

Despite the enormous progress done in the course of last years in diagnosis, treatment and rehabilitation of stroke patients, prevention is still main strategy in approaching the stroke. After the comprehensive review of the organization of stroke care, treatment and neurorehabilitation of stroke patients, this part shows the recommendations of the Croatian Society for Neurovascular Disorders of the Croatian Medical Association and the Croatian Stroke Society for primary and secondary prevention of stroke.

Serum levels of ICAM-1, VCAM-1 and E-selectin in early postoperative period and three months after eversion carotid endarterectomy.

AIM: To determine the influence of eversion endarterectomy on circulating adhesion molecules (CAMs): E-selectin, intercellular circulating adhesion molecule-1 (ICAM-1) and vascular circulating adhesion molecule-1 (VCAM-1). METHODS: Forty patients underwent carotid endarterectomy. Venous blood samples have been gathered before operation, one hour and six hours after the operation and three months after the procedure. Levels of CAMs have been determined by sandwich ELISA test. RESULTS: Statistically significant decrease of the ICAM-1 levels one hour and six hours after the endarterectomy compared to levels before the operation have been found. There were no statistically significant changes in concentration of VCAM-1 and E-selectin. Three months after the operation levels of CAMs where similar to those before the operation. There was a statistically significant decrease of systolic arterial blood pressure levels within early postoperative period. CONCLUSION: Results suggest that decrease of ICAM-1 could be a possible marker of endothelial de-activation after plaque removal. Endarterectomy has a positive influence on systolic arterial blood pressure in early postoperative period. Further investigations are necessary to better understand and prevent the development of atherosclerotic plaque.