Pregnancy-related severe pelvic girdle pain caused by unilateral noninfectious sacroiliitis. A case report and literature review.

Pelvic girdle pain during and after pregnancy is the clinical syndrome of persistent musculoskeletal pain localized in the posterior and/or anterior aspect of the pelvis originating from sacroiliac joints and/or pubic symphysis due to dynamic instability. We report the case of severe and disabling postpartum pelvic girdle pain caused by unilateral noninfectious sacroiliitis which resolved after 2 months by nonsteroidal anti-inflammatory drug and physical therapy. A short literature review is given on epidemiology, etiology, clinical presentation, therapy, and prognosis of pregnancy-related pelvic girdle pain.

The dynamics of soluble Fas/APO 1 apoptotic biochemical marker in acute ischemic stroke patients.

PURPOSE: Until recently, neuronal death in ischemic stroke infarction was ascribed exclusively to necrotic process. However, experimental animal models of cerebral ischemia suggest apoptosis to play a role in the pathogenesis of cerebral infarction. The aim of this study was to determine the level and monitor the dynamics of soluble Fas/APO 1 (sFas/APO 1) in serum and cerebrospinal fluid of acute ischemic stroke patients. MATERIAL AND METHODS: This prospective study included 23 patients with first ever, computed tomography verified acute ischemic stroke and 20 control subjects with other functional neurologic disorders. Serum and cerebrospinal fluid sFas/APO 1 levels were determined on several occasions. Blood samples were obtained on day 1, 3 and 12, and lumbar puncture on day 3 and 12 of disease onset. Quantitative sandwich ELISA method was used on sFas/APO 1 determination. RESULTS: On day 1 of disease onset, serum and cerebrospinal fluid sFas/APO 1 levels were significantly higher in stroke patients as compared to control subjects, and then gradually declined during the period of monitoring. CONCLUSION: Study results confirmed the dynamic pattern of sFas/APO 1 in serum and cerebrospinal fluid of patients with acute ischemic stroke, suggesting the possible role of apoptosis in the pathogenesis of cerebral infarction.

[Assessment of heart rate variability in patients after myocardial infarct]. / Procjena varijabilnosti srcanog ritma kod bolesnika s preboljelim infarktom miokarda.

Heart rate variability (HRV) is used for stratification of risk for sudden death due to malignant arrhythmias after myocardial infarction (MI). HRV was analysed in 221 consecutive patients who underwent cardiac rehabilitation within 4 weeks to 3 months after acute MI. Patients with MI had significantly lower all measures of HRV in comparison with control group (SDNN 125 +/- 37 vs. 152 +/- 38 ms, p < 0.0001). Patients with anterior MI had lower overall HRV (SDNN 116 +/- 35 vs. 132 +/- 37 ms, p = 0.001) and higher heart rate than those with inferior MI. Diminished HRV persists 3 months after MI. It is assumed that patients with anterior MI had higher potential risk of malignant arrhythmias and sudden death than those with inferior MI.

[Reversible impairment of renal function during treatment with lisinopril, an ACE-inhibitor (case report)]. / Reverzibilno ostecenje bubrezne funkcije tijekom lijecenja ACE-inhibitorom lizinoprilom (Prikaz bolesnika).

ACE inhibitors are group of drugs whose use over the last ten years has largely expanded. New members of this group of drugs are developed and registered and today in Croatia exist a dozen ACE inhibitors from different pharmaceutical companies like lisinopril, cilazapril, ramipril, trandolapril, enalapril etc. Notable side effects of ACE inhibitors are: hypotension, dry cough, rash, angioneurotical edema, impaired renal function and acute renal failure. The aim of the article was to present a 72 year old patient with reversible impairment of renal function during treatment with ACE inhibitor lisinopril.

Attitudes, behaviour and knowledge on sexuality among female adolescents in Zagreb, Croatia.

The aim of this study was to estimate the level of knowledge about sexuality, attitudes and sexual behaviour of female adolescents. The study included 194 female students, 117 from Medical High School (MHS) and 77 from General High School (GHS) in Zagreb. Data was collected using an anonymous self-administered questionnaire. In addition to items on personal data (age, parental education etc.), the participants were asked to define terms about sexuality (e.g. menstruation, puberty) the definitions of which are found in biology textbooks for the fifth and eighth grade of primary school. The aim of the third part of the survey was to collect information about attitudes and behaviour of female adolescents. The results showed a low level of knowledge in students of both schools. General High School students showed a higher level of knowledge than their Medical High School peers. One fifth of General High School students and 1/3 of Medical High School students were unable to define the term "menstruation". The majority of adolescents talk about sexuality with their friends, 92.1% of General High School and 81.2% of Medical High School students. Almost 50% of students of both schools would like to talk about sexuality with their school doctor. 6.9% of Medical High School students had at least one sexual intercourse while none of the General High School students had been sexually active at the time of the survey. As the majority of students were not sexually active and results showed a rather low level of knowledge, this seems to be the ideal period for the implementation of educational programs aimed at increasing the level of knowledge, and thus preventing unwanted consequences (STD, pregnancy, abortion, infertility).