[Prognostic role of troponin I level in ischemic stroke--preliminary report]. / Znaczenie prognostyczne stezenia troponiny I w udarach niedokrwiennych mózgu--doniesienie wstepne.

THE OBJECTIVE: The purpose of this research was to establish if determined at the reception level of troponin I could be such kind of factor. Presented data represent preliminary report of this study. MATERIAL AND METHODS: The analyzed data base on 196 patients with IS: 166 discharged from hospital and 30 with clinical course terminated by death. The IS was confirmed by computed tomography (CT). The conducted recording consists of data like e.g.: age, sex and risk stroke factors. Also the following factors were evaluated on admission: state of consciousness, level of neurological deficiency according to Scandinavian Stroke Scale (SSS). After half of year again SSS level was evaluated. RESULTS: The studied groups differed in level of neurological deficiency determined on admission. The direct mortality within IS group and increased level of troponin I represents 20.90% and with correct level of troponin I represents 12.40% (p=NS). The half year mortality group recording has not been considered yet because research is still continuing and database is continually updated. CONCLUSION: The increased level of troponin I on admission is not a prognostic factor of direct mortality within IS patients. We noticed that occurrence of disturbances in patient's EKG places those patients in the group of increased risk of death.

Serum troponin I and myoglobin after monophasic versus biphasic transthoracic shocks for cardioversion of persistent atrial fibrillation.

This study compared the effects of standard monophasic versus biphasic direct current shocks for cardioversion of atrial fibrillation (AF) on the release of cardiac troponin I (cTnI) and myoglobin (Myo). We randomized 48 patients with persistent AF (mean age = 61.4 +/- 10.7 years, 33 men) to monophasic (45.2%) or biphasic (54.8%) cardioversion. Plasma concentrations of cTn1 and Myo were measured before, and 6 and 24 hours after the procedure. Cardioversion was significantly more effective (88% vs 100%, P < 0.04) and required less energy (348.1 +/- 254.1 vs 187.6 +/- 105.3 J; P < 0.001) in the biphasic than the monophasic group. A significant increase in mean plasma cTnI concentration over 24 hours (0.23 +/- 0.18 vs 0.41 +/- 0.37 ng/mL, P < 0.04), and mean Myo concentration were recorded in the monophasic group over the first 6 hours following the procedure (38.2 +/- 14.2 vs 221.9 +/- 51.3 ng/mL, P < 0.001), whereas no significant increase was observed in the biphasic group. Increases in cTnI and Myo in the monophasic group correlated closely with the cumulative energy delivered (Spearman correlation coefficient r = 0.58, P = 0.004 for Myo and r = 0.67, P < 0.001 for cTnI). In addition, there was a positive correlation between cumulative cardioversion energy load and increase in Myo and cTnI indexed with left ventricular mass (r = 0.45, P < 0.02 for Myo and r = 0.47, P = 0.01 for cTnI). It is concluded that in cardioversion of AF, biphasic are more effective than monophasic and may cause less myocardial injury.

[Usefulness of saliva estradiol determinations for monitoring of hormonal fluctuancy]. / Przydatnosc oznaczania estradiolu w slinie w monitorowaniu stanu hormonalnego.

Synthesis and catabolism of estradiol, the main estrogen from the period of maturation to menopause, is regulated for very complicated manner. Also many factors are involved in the process of absorption of orally given hormone. From this reason the body concentration of estradiol needs of permanently control. We studied of possibility to replace blood serum by saliva compared the concentrations of this hormone in the both body fluids. In this purpose estradiol was determined by the method of microparticle enzyme immunoassay (MEIA) in the blood and in the saliva obtained by the method of absorption with three different kits called "Salivette" in 25 women with pregnancy and in childbed. High correlation between concentrations of estradiol in saliva and blood serum was stated; the highest for polyester like absorption material.

[Myoglobin and troponin I as markers of myocardial damage during cardioversion of atrial fibrillation]. / Mioglobina i troponina I jako markery uszkodzenia miesnia sercowego podczas kardiowersji migotania przedsionków.

UNLABELLED: We performed direct comparison of safety and efficacy of monophasic and biphasic shock cardioversion (CV) of atrial fibrillation (AF). Troponin I (cTnl) and myoglobin (My) were used as markers of potential myocardial and skeletal muscle damage during the procedure. METHODS: 63 patients (p.t.s.) with persistent, nonvalvular AF (F/M 18/45; mean age 61.6 +/- 11.4 years) were randomized to CV either with monophasic (F/M 10/24, Group I) or biphasic (F/M 8/21, Group II) shock. Plasma levels of cTnl and My were measured before CV, 6 hours and 24 hours after CV. RESULTS: The efficacy of CV was significantly higher in Group II (93% vs 85%, p < 0.04). Sinus rhythm restoration required lower total energy used during procedure with biphasic shock (379.8 +/- 301.5 vs 192.8 +/- 100.6 J; p 0.001). There was no significant difference in mean values of cTnl before CV in both groups (0.3 +/- 0.2 vs 0.2 +/- 0.1 ng/mL, p > 0.15). In 14 pts (41%) from Group I and 3 pts (10%) from Group II plasma cTnl concentration above discriminatory level (0.9 ng/mL) were noted. There was a significant increase in mean plasma cTnl level (0.3 +/- 0.2 vs 1.9 +/- 0.9 ng/mL, p < 0.04) 24 hours after the procedure in Group I. We did not observed significant differences in cTnl plasma concentration 6 and 24 hours after CV in Group II (0.2 +/- 0.1 vs 0.4 +/- 0.2 ng/mL, p > 0.15). Both study groups did not significantly differ in mean serum My level at baseline (39.1 +/- 14.2 vs 43.1 +/- 20.9 ng/mL). In Group I mean My serum concentration increased during the first 6 hours after CV (43.1 +/- 20.9 vs 247.9 +/- 53.3 ng/mL, p < 0.02) and there was a significant decreasing in My serum level during the further observation (247.9 +/- 53.3 vs 104.5 +/- 46.1 ng/mL, p < 0.03). Mean serum My concentration remained within normal ranges during the 24 hour follow-up after the biphasic shock CV (43.1 +/- 20.9 vs 43.6 +/- 29.1 ng/mL). Increased of cTnl and My in Group I may be due to myocardial and skeletal muscle damage and correlate closely with cumulative energy delivered (Spearmann correlation index (r) = 0.55, p < 0.01 for My and r = 0.66, p < 0.01 for cTnl). In Group I positive correlation between cumulative energy used during CV and increase of studied markers indexed with left ventricular mass (r = 0.6, p < 0.05 for My and r = 0.74, p < 0.04 for cTnl) was observed. There was no significant correlation between delivered energy and increase of heart markers in Group II noted. CONCLUSIONS: We observed the significant increase in mean serum cTnl and My level 24 hours after CV with monophasic shock and its positive correlation with total energy used during the procedure. There is a conclusion that biphasic shock used during CV of AF is more efficient and may cause less myocardial and skeletal muscle damage due to lower energy delivered.