Diagnostic value of MPO in patients admitted for suspected acute coronary syndrome--a study of adult in Mostar, Bosnia and Herzegovina.

We assessed the diagnostic efficacy of plasma Myeloperoxidasis (MPO) alone or in combination with cardiac troponin I (cTnI) for detecting ACS in patients presenting with chest pain initiating within 24 h before the hospital admission. In this prospective cohort study were included all respondents who have visited outpatient clinic of internal diseases, University Hospital Mostar because of chest pain and suspected acute coronary syndrome within 24 h of the onset of the period of 6 months and the total sample consisted of 114 patients. Troponin and myeloperoxidase were significantly positively correlated at the beginning of treatment, myeloperoxidase was significantly positively associated with adverse cardiovascular events during hospitalization and myocardial infarction (p < 0.05), with the regression analysis did not show a significant predictor in the development of myocardial infarction (p > 0.05). Sensitivity of myeloperoxidase as a valid test detection of myocardial infarction at baseline was 0.15 and specificity was 0.85, suggesting good diagnostic value usable in the clinical practice.

Prognostic value of Helicobacter pylori sinonasal colonization for efficacy of endoscopic sinus surgery.

Compared with rhinologic patients without chronic rhinosinusitis (CRS), a higher prevalence of sinonasal Helicobacter pylori (HP) in patients with CRS was found. This study investigated if HP sinonasal colonization has a prognostic value for efficacy of functional endoscopic sinus surgery (FESS). Nasal polyps of 40 patients with CRS, undergoing FESS, were analyzed for presence of HP using immunohistochemistry (IHC). Patients were categorized as to whether the IHC was positive (HP+ group) or negative (HP- group). HP+ group and HP- group were compared according to the nasal polyp eosinophil density, and to the improvement (difference between pre- and post-operative scores) of the subjective symptom scores, and the nasal endoscopic scores. Nasal polyps in 28 (70%) patients were positive for HP. There were no significant differences between HP+ group and HP- group comparing the eosinophils, and the improvement of the single symptom and the total symptom scores. HP+ group had significantly greater improvement of the nasal endoscopic scores (F[1.38] = 6.212; P = 0.017). There is no influence of sinonasal HP on tissue eosinophilia and on CRS symptoms. There is a prognostic value for endonasal findings: CRS patients with HP have statistically significant greater improvement of the postoperative endoscopic scores.

Association of Glomerular Filtration Rate and Carotid Intima-Media Thickness in Non-Diabetic Chronic Kidney Disease Patients over a 4-Year Follow-Up.

Patients with chronic kidney disease (CKD) have increased risk of cardiovascular events. However, the association of glomerular filtration rate (GFR) and carotid intima-media thickness (CIMT) in non-diabetic CKD patients is under-investigated. This prospective study was conducted at University Clinical Hospital Mostar over a 4-year period and enrolled a total of 100 patients with stage 2 and 4 CKD (50 patients per group). Stage 4 CKD group had significantly higher baseline CIMT values (1.13 ± 0.25 vs. 0.74 ± 0.03 mm, P < 0.001), and more atherosclerotic plaques at the study onset (13 (26%) vs. 0 (0%), P < 0.001) compared to stage 2 CKD. A statistically significant 4-year increase in GFR (coefficient of 2.51, 3.25, 2.71 and 1.50 for 1-year, 2-year, 3-year and 4-year follow-up, respectively, P < 0.05) with non-significant CIMT alterations has been observed in stage 2 CKD. Furthermore, linear mixed effects analysis revealed significant decrease in GFR (coefficient of -6.69, -5.12, -3.18 and -1.77 for 1-year, 2-year, 3-year and 4-year follow-up, respectively, P < 0.001) with increase in CIMT (coefficient of 0.20, 0.14, 0.07 and 0.03 for 1-year, 2-year, 3-year and 4-year follow-up, respectively, P < 0.001) in stage 4 CKD. GFR and CIMT showed significant negative correlation in both CKD groups during all follow-up phases (P < 0.001). Furthermore, multiple linear regression analysis revealed significant independent prediction of CIMT by baseline GFR (B = -0.85, P < 0.001), while there was no significant prediction of CIMT with other covariates. In conclusion, this study demonstrates significant association of GFR and CIMT in non-diabetic stage 2 and stage 4 CKD during the 4-year follow-up.

The Significance of Thallium-201-Chloride SPECT Myocardial Perfusion Imaging in the Management of Patients With Stable Chronic Coronary Artery Disease.

BACKGROUND: Patients with stable coronary artery disease (CAD) can be evaluated for myocardial viability by examining reverse redistribution of Thallium-201 (201TI) through cardiac scintigraphy. There is limited knowledge about association of a reverse redistribution with favorable cardiac outcomes. In this study, we hypothesized that higher left ventricular ejection fraction (LVEF), lower myocardial necrosis, fewer ischemic events, and less angina will be associated with reverse redistribution of 201TI imaging. METHODS: Adult patients with stable CAD included in this study underwent exercise-redistribution Thallium single-photon emission computed tomography (SPECT) and were followed for one year. LVEF and regional wall motion abnormalities were evaluated with echocardiography, exercise duration by bicycle testing, and myocardial ischemia and viability by Thallium SPECT. RESULTS: We studied 159 patients (87 men, 72 women, median age 60 years, range: 38-84) with well-developed collaterals. Those with reverse redistribution on SPECT (n = 61, 38.3%) had significantly better exercise tolerance (⩾85%; P < .001). Subjects with reverse redistribution had better LVEF (P < .001), wall motion parameters (P < .001), a lower degree of myocardial necrosis (P < .05), less angina during follow-up (P = .02), and fewer ischemic events whether treated with OMT or PCI (P < .001). CONCLUSIONS: Reverse redistribution of 201Tl on scintigraphic images is a predictor of myocardial viability. Evidence from our study suggests that optimally treated chronic CAD patients with reverse redistribution may have lower likelihood of future adverse cardiovascular events and better prognosis.

Tonsillar colonization is unlikely to play important role in Helicobacter pylori infection in children.

OBJECTIVE: To determine (i) seroprevalence of Helicobacter pylori (HP) infection in children undergoing tonsillectomy, (ii) possible HP colonization on tonsils of children and its importance in HP transmission, and (iii) if four examined socio-economic factors are the risk factors for HP transmission and HP colonization on tonsils in children. METHODS: Rapid urease test (RUT) of tonsils, and serologic blood tests for HP were performed in 77 children (aged 4-14 years) in Bosnia and Herzegovina (B-H), undergoing tonsillectomy. RUT positive tonsils were cultured for HP. RUT positive children were tested using (13)Carbon-urea breath test ((13)C-UBT). Information about socio-economic potential risk factors was obtained from the parents. RESULTS: Out of 139 pharyngeal and palatine tonsils, 17 palatine tonsils in 14 children were RUT positive and had negative HP culture. Eight children had positive both RUT and (13)C-UBT. There was no significant difference between children with hypertrophy and those with recurrent tonsillitis comparing their serologic tests results. There was no significant difference between seronegative (n=61) and seropositive (n=16) children comparing their age, sex, parental education level, owning a family courtyard, attending a children's collective, and owning a pet cat. CONCLUSIONS: The results in this prospective study do not support the notion that tonsils are an important reservoir for HP transmission in children in B-H. The examined socio-economic factors did not enhance HP seropositivity rate in children.