RESUMEN
Asymptomatic atherosclerotic disease is prevalent in the middle-aged group of kidney transplant recipients. In order to improve the estimation of their cardiovascular risk, dyslipidaemia pattern is very important to be evaluated. Knowledge of the lipid particle spectrum in patients undergoing kidney transplantation could help the clinicians to timely start intervention and prevention of atherosclerosis with an early hypolipidemic statin treatment (Tab. 2, Ref. 20).
Asunto(s)
Aterosclerosis/sangre , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Dislipidemias/sangre , Fallo Renal Crónico/sangre , Trasplante de Riñón , Lipoproteínas IDL/sangre , Lipoproteínas VLDL/sangre , Adulto , Aterosclerosis/prevención & control , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/prevención & control , Estudios de Casos y Controles , Dislipidemias/tratamiento farmacológico , Femenino , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Fallo Renal Crónico/cirugía , Masculino , Persona de Mediana Edad , Tamaño de la Partícula , Factores de RiesgoRESUMEN
BACKGROUND: The use of antiplatelet agents is strongly recommended for the secondary prevention of ischemic events such as myocardial infarction, stroke/transient ischemic attack (TIA). OBJECTIVES: The aim of our study was to analyse the use of antiplatelet medication in patients after myocardial infarction, stroke/TIA, and patients with both conditions and to identify patient-related characteristics, which determine the use of such drugs in elderly patients. METHODS: Study sample (n=372) was derived from 2,157 patients admitted to long-term care departments of three municipal hospitals. The study included patients aged ≥65 years after myocardial infarction, stroke/TIA or both. RESULTS: Antiplatelet medications were prescribed in 54.8 % and 68.5 % of patients at hospital admission and discharge, respectively. Hospitalisation led to a significant increase in the use of antiplatelet medication in patients after myocardial infarction and in those with the combination of both events. However, in patients after only stroke/TIA, we did not find any significant difference comparing the use of antiplatelet medication at the time of hospital admission and discharge, respectively. CONCLUSION: Our study revealed that physicians are more aware of the benefits of antiplatelet medication in elderly patients after myocardial infarction or those after both myocardial infarction and stroke/TIA in comparison with patients after only stroke/TIA (Tab. 3, Ref. 32).
Asunto(s)
Hospitalización/estadística & datos numéricos , Ataque Isquémico Transitorio/tratamiento farmacológico , Infarto del Miocardio/tratamiento farmacológico , Inhibidores de Agregación Plaquetaria/uso terapéutico , Pautas de la Práctica en Medicina/estadística & datos numéricos , Accidente Cerebrovascular/tratamiento farmacológico , Factores de Edad , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Femenino , Hospitales Municipales , Humanos , Cuidados a Largo Plazo , Masculino , Alta del Paciente , EslovaquiaRESUMEN
UNLABELLED: The aim of Guidelines of the Angiology Section of the Slovak Medical Chamber (AS SMC) is to address a last european guidelines for the management of thrombophlebitis superficialis, as well as results in evidence basedâ medicine (EBM) in order to assess their contribution to our expanding knowledge on rational management of thrombophlebitis superficialis. DISCUSSION: Superficial thrombophlebitis is a common disease, usually considered to be benign. However, the practice of systemic duplex ultrasonography has revealed a large number of cases of deep vein thrombosis concomitant with superficial thrombophlebitis. Assessment of clinical probability of deep vein thrombosis and venous tromboembolism and systematic duplex ultrasound investigation has been proposed in the initial management of superficial thrombophlebitis, to detect the presence of any underlying deep vein thrombosis. In contrast with extensive information on the management of deep vein thrombosis, there is little knowledge about the most appropriate treatment of the superficial thrombophlebitis. CONCLUSION: The treatment of superficial thrombophlebitis should improve local symptoms while preventing the development of complications such as venous thromboembolism. The most effective therapeutic approach to superficial thrombophlebitis seems to be represented by fondaparinux (a synthetic selective indirect inhibitor of factor Xa) which have been shown to prevent VTE events and the extension and/âor recurrence of superficial thrombophlebitis.
Asunto(s)
Anticoagulantes/uso terapéutico , Inhibidores del Factor Xa/uso terapéutico , Polisacáridos/uso terapéutico , Tromboflebitis/tratamiento farmacológico , Medios de Contraste , República Checa , Medicina Basada en la Evidencia , Fondaparinux , Humanos , Recurrencia , Tromboflebitis/clasificación , Tromboflebitis/diagnóstico por imagen , Ultrasonografía Doppler Dúplex , Trombosis de la Vena/diagnóstico por imagen , Trombosis de la Vena/tratamiento farmacológicoRESUMEN
Antiplatelet therapy by acetylsalicylic acid (aspirin) provided pivotal advances in the prevention and treatment of organovascular (cardiovascular, cerebrovascular, extremitovascular, renovascular, genitovascular, mesenteriovascular, bronchopulmovascular, oculovascular, otovascular and other) arterial ischemic diseases. Currently available antiplatelet drugs have some limitations which might be overcomed by improved dosing regimens, use of combination of agents affecting different platelet functions and, in particular, by the new antiplatelet drugs (new arterial antithrombotics) with distinct pharmacodynamic properties offering new advantages, including faster onset of action, greater potency, and reversibility of effects. Document (Guidelines) of the Angiology Section of the Slovak Medical Chamber (AS SMS, 2013).
Asunto(s)
Aspirina/uso terapéutico , Inhibidores de Agregación Plaquetaria/uso terapéutico , Aspirina/efectos adversos , República Checa , Esquema de Medicación , Quimioterapia Combinada , Drogas en Investigación/efectos adversos , Drogas en Investigación/uso terapéutico , Predicción , Humanos , Isquemia/tratamiento farmacológico , Activación Plaquetaria , Inhibidores de Agregación Plaquetaria/efectos adversos , Pruebas de Función Plaquetaria , Trombosis/tratamiento farmacológico , Enfermedades VascularesRESUMEN
AIM: The aim of Guidelines of the Angiology Section of the Slovak Medical Chamber is to address a last European guidelines for the management of dyslipidaemias, as well as results in evidencebasedâmedicine (EBM) in order to assess their contribution to our expanding knowledge on reducing of residual organovascular risk. DISCUSSION: Lipid metabolism can be disturbed in different ways, leading to changes in plasma lipoprotein function and/âor levels. This by itself and through interaction with other vascular risk factors and endothelial dysfunction may affect the development of atherosclerosis and other vascular diseases. Therefore, dyslipidaemias cover a broad spectrum of lipid abnormalities, some of which are of great importance in organovascular prevention. Dyslipidaemias may be related to other diseases (secondary dyslipidaemias) or to the interaction between genetic predisposition and environmental factors. Dyslipidaemias may also have a different meaning in certain subgroups of patients which may relate to genetic predisposition and/âor coâmorbidities. This requires particular attention complementary to the management of the total CV risk. Optimal LDLcholesterol levels are the primary strateging task in the therapeutical preventive approaches. However, at present increasing attention has focused on the role of inflamation, levels of HDLcholesterol and triglycerides in the process of atherosclerosis. Statins represent basic pillar in dyslipidemia treatment. Despite the intensive management of all conventional vascular risk factors and the intensified treatment with statins, residual organovascular risk remains high. Therefore the interest is focused on finding the place of combined antidyslipidemic treatment and the development of new antidyslipidemics. CONCLUSION: Strategies for preventing of organovascular diseases have emphasized vascular risk factors effective modification using treatment approaches supported by evidencebasedâmedicine (EBM).
Asunto(s)
Dislipidemias/terapia , Conductas Relacionadas con la Salud , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Hipolipemiantes/uso terapéutico , Masculino , EslovaquiaRESUMEN
Recommendations from the cardiological professional companies working in the area of primary prevention of cardiovascular diseases put an emphasis on regular aerobic physical activity. Its positive effect on both cardiovascular and overall mortality has repea-tedly been proven by the observations of prospective and crossâsectional epidemiological studies. One of the possible explanations of this positive effect is a change in the concentration of lipoprotein classes and their subclasses, which is expressed as a change in their average size. In a group of young healthy men and women with a sedentary lifestyle we observed the effect of medium intensive physical exercise in the form of a 30-âminute slow run per day lasting for 14 days. The concentration of lipoprotein classes and subclasses were determined through the method of a linear electrophoresis in polyacrylamide gel. In the observed group we found a statistically significant decrease of VLDL, large IDL particles, medium sized LDL, small dense LDL, and medium sized HDL particles. In the light of current knowledge all these lipoprotein particles are deemed as atherogenic. Thus, as little as 14 days of regular exercising has a positive effect on the concentration of plasmatic lipoproteins, and emphasises the role of regular physical activity in the primary prevention of cardiovascular diseases.
Asunto(s)
Ejercicio Físico , Lipoproteínas/sangre , Adulto , Femenino , Humanos , Masculino , Conducta Sedentaria , Adulto JovenRESUMEN
Type 2 diabetes mellitus leads to the typical known form of dyslipidaemia among the patients. This dyslipiademia type re-presents prognostically important type of atherogenic dyslipiadaemia, that significantly increases the risk of atherothrombosis. Estimation of the size of lipoprotein particles with Lipoprint method among newly diagnosed, untreated patients with these patients have not been evaluated yet. Dyslipidaemia among patients with type 2 diabetes mellitus has its course and changes after the treatment. At the beginning i tis characterized by the significant increase of VLDL, large and middle size IDL lipoprotein particles, as well as by lowering of HDL particles. This lipoprotein profile has its own atherogenic potential. The course of the disease later leads to the change of dyslipidaemia, characterized by the increase of LDL levels (small dense particles), triglyceride levels and the persistence of the lower levels of HDLcholesterol. Hypolipidemic treatment leads to the significant lowering of cardiovascular risk, however despite treatment with statin or fibrate residual cardiovascular risk remains still very high.
Asunto(s)
Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/complicaciones , Dislipidemias/sangre , Lipoproteínas/sangre , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/etiología , Dislipidemias/etiología , Femenino , Humanos , Lípidos/sangre , Masculino , Factores de RiesgoRESUMEN
BACKGROUND: Slovakia belong to the European Union countries with the high incidence and prevalence of cardiovascular diseases in general and IHD in particular. METHOD: Homocystein-Slovakia is crossectional population study realised in subjects in high risk age 35-75 years in two groups. The first consists of patients with verified stable ischemic heart disease (IHD) (M= 152; F = 167) aged 60.8±9.37 yrs (males) res. 63.1±7.56 years (females) (NS) who were randomly selected from two cardiological registrars. Second population was formed by general population who were dichotomised according their medical records into IHD patients (M= 31, F= 53) and apparently healthy controls (M= 47; F = 55), the later in significantly younger age as patients, but in same age for intergender comparison 49.6±10.3 vs 46.6±9.2 yrs (NS). RESULTS: We found very high prevalence of classic as well as newer risk factors and risk markers both in IHD patients and in controls. Increased homocysteinen (Hcy >15 µmo/l for males and Hcy >13 µmo/l for females) was found even in 32.9 % of patients and 13.6 % of controls (p<0.001). Comparison of regulating vitamins levels between IHD patients and controls demonstrated similar prevalence. CONCLUSION: Homocystein Slovakia study found very high prevalence of hyperhomocysteinemia in patients with stable ischemic heart disease. Even the prevalence in healthy controls correspond to data reported for MI patients in Western countries. Vitamins regulating metabolism of homocysteine also shown high prevalence, however, without differences between IHD patients and controls (Tab. 5, Fig. 1, Ref. 27).
Asunto(s)
Hiperhomocisteinemia/epidemiología , Adulto , Anciano , Femenino , Hemodinámica , Homocisteína/sangre , Humanos , Hiperhomocisteinemia/diagnóstico , Lípidos/sangre , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/sangre , Isquemia Miocárdica/epidemiología , Factores de Riesgo , Eslovaquia/epidemiología , Vitaminas/sangreRESUMEN
Parenteral heparin and oral coumarin preparations represent the standard antithrombotics widely used in the prevention and treatment of venous thromboembolism (VTE). Unfractionated heparin, low molecular weight heparins, and fondaparinux have been shown to be effective and safe in reducing VTE risk. Despite high efficacy these medicaments have limitations which become to be more apparent with current widening of the indications for either primary thromboprophylaxis (PTP) or indefinite and even lifelong secondary thromboprophylaxis (STP). There is a need for new effective and safe medicaments with specific antithrombotic action, oral administration and convenient dosing without monitoring. During the last decade new antithrombotics have been developed either blocking selectively one coagulation enzyme or inhibiting particular step in coagulation cascade. Document of the Angiologists Section of the Slovak Medical Chamber (AS SMC).
Asunto(s)
Anticoagulantes/uso terapéutico , Modalidades de Fisioterapia , Tromboembolia Venosa/prevención & control , Terapia Combinada , HumanosRESUMEN
The aim of our study was to analyse the foot infections in diabetic patients. We analysed foot ulcerations in 124 diabetics who attended outpatient foot clinic, or were hospitalized in the period from 1996 to 2006. Basic neuropathy screening examination was made with cotton wisp, pin-prick, tuning fork, and monofilament. For evaluation of leg ischemia, besides the evaluation of the presence of pedal pulses, the ankle-brachial pressure index was measured. If the infection of foot ulceration was clinically present, bacteriology examinations was performed. In the case of deep wound infection, x-ray examination was made. If bone destruction was present, osteomyelitis was diagnosed by technecium bone scanning and by technecium-labelled leukocyte scan. Deformation and destruction of the bone without infection was appoited as Charcot neuroarthropathy. Foot ulcer infection was found in 58 % diabetic patients, wounds were more often deep (80 %). Infection was not associated with special location of foot ulcer. Two-third of the total infected wounds were associated with leg ischemia and 30.6 % of infected ulcer ended with leg amputation. More foot ulcer infections were found in the diabetics with HbAlc over 8 %. Infection was coupled with diabetic retinopathy (in 63 % patients) (p=0.023), and also with diabetic nephropathy (in 66 % patients) (p=0.012). Bacteriology examination revealed most often Staphylococci (45.8 %), antibiotic therapy was made most often with chinolones. Osteomyelitis was present in 34.7 % of foot ulcer infections. In 14 diabetics (56 %) after antibiotic therapy it was not necessary to perform a leg amputation. HbAlc seems to be a significant predictor of osteomyelitis (p<0.02; OR=1.76). In conclusion, we confirmed that diabetic foot infections, especially on ischemic leg, in diabetics with poor metabolic control and chronic diabetic microvascular complications, are associated with a higher risk of leg amputations. Further, it is possible to cure osteomyelitis successfully without surgery in more than half the cases (Tab. 1, Ref. 24). Full Text in free PDF www.bmj.sk.
Asunto(s)
Infecciones Bacterianas/complicaciones , Pie Diabético/complicaciones , Anciano , Pie Diabético/microbiología , Pie Diabético/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Osteomielitis/complicaciones , Factores de RiesgoRESUMEN
OBJECTIVES: Determination of non-atherogenic and atherogenic plasma lipoproteins, including small dense LDL, in patients with newly diagnosed arterial hypertension and identification of the phenotype of lipoprotein profile: non-atherogenic phenotype A vs. atherogenic lipoprotein phenotype B, in plasma of examined subjects. BACKGROUND: Atherogenic lipoproteins play an important role in the pathogenesis of arterial hypertension. Impaired lipoprotein metabolism results in overproduction of triglyceride-rich particles and LDL 3-7 subfractions - small dense LDL - a strongly atherogenic LDL subpopulation accelerating the development of arterial hypertension. METHODS: Total cholesterol and triglycerides were analyzed by enzymatic CHOD-PAP method, Roche Diagnostics, Germany. Lipoprotein profiles of plasma described as atherogenic lipoprotein phenotype B or a nonaterogenic lipoprotein phenotype A were examined by a new method of lipoprotein separation by means of electrophoresis on polyacrylamide gel (Lipoprint LDL system). Prostacyclin and thromboxane A2 in plasma were analysed by ELISA method. Score of Atherogenic Risk was determined as a ratio of atherogenic and non-atherogenic plasma lipoproteins. RESULTS: 1) High percentage of atherogenic hypertriacylglycerolemia (93%) and atherogenic mixed hyperlipemia (86 %) in subjects with arterial hypertension. 2) Low percentage of atherogenic hypercholesterolemia (52 %) in subjects with arterial hypertension. 3) Atherogenic normolipemia (7%) in control group of healthy subject. CONCLUSION: Contribution of this method lies in benefits as follows: A) Quantification of non-atherogenic and atherogenic plasma lipoproteins. B) Identification of high percentage of atherogenic dyslipoproteinemia (86-93%) in subjects with arterial hypertension. C) Presence of small dense LDL in plasma is decisive for declaring the atherogenic lipoprotein profile in both hyperlipemia and normolipemia (Tab. 5, Ref. 24).
Asunto(s)
Aterosclerosis/sangre , Hipertensión/sangre , Lipoproteínas/sangre , Aterosclerosis/complicaciones , Presión Sanguínea , Femenino , Humanos , Hipertensión/etiología , Hipertensión/fisiopatología , Lípidos/sangre , Lipoproteínas LDL/sangre , Masculino , Persona de Mediana Edad , Prostaglandinas/sangreRESUMEN
Arterial hypertension belongs to the most important factors of origin and lasting of tinnitus. We have studied 18 subjects suffering from tinnitus without the history of diagnosed or treated arterial hypertension. ABPM method was used for diagnosing arterial hypertension. 12 patients (66%) fulfilled the criteria for arterial hypertension. Our results illustrate that arterial hypertension diagnosis is devoted an insufficient attention in patients with tinnitus. ABPM should therefore be used in all patients with tinnitus, immediately after its manifestation and also repeatedly during its course. With early diagnosis and treatment of hypertension, some complications, such as myocardial infarction, stroke, heart and/or kidney failure can be thus prevented (Tab. 1, Fig. 5, Ref. 10). Full Text in free PDF www.bmj.sk.
Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial , Hipertensión/diagnóstico , Acúfeno/etiología , Adulto , Femenino , Humanos , Hipertensión/complicaciones , Masculino , Persona de Mediana EdadRESUMEN
Method of lipoprotein determination on polyamideacryl gel Lipoprint enables an exact quantification nonatherogenic and atherogenic plasma lipoproteins. For its use in human medicine this method was recently approved by FDA. According to majority of nonatherogenic, or atherogenic lipoproteins in their spectrum this method can distinguish nonatherogenic type A vs atherogenic type B. After their identification, there is the possibility for exact means of interventions among patients with higher cardiovascular risk. Also in the group of clinically healthy asymptomatic controls with normolipemia it is possible using this method to estimate the certain group of risk of development of premature atherothrombosis.
Asunto(s)
Dislipidemias/diagnóstico , Lípidos/sangre , Lipoproteínas/sangre , Adulto , Aterosclerosis/sangre , Dislipidemias/sangre , Electroforesis en Gel de Poliacrilamida , Femenino , Humanos , Masculino , Adulto JovenRESUMEN
AIM: The aim of this study was to evaluate the direct and indirect costs of selected cardiovascular diseases, namely hypertension (HT), metabolic syndrome (MS) and diabetes mellitus (DM) in the Slovak Republic. METHODS AND RESULTS: This study analyzes the data of 1,000 patients, randomly selected from NEMESYS database (10,300 patients). Average direct pharmacotherapeutic costs of hypertension per year were 257 Euros in men and 264 Euros in women. Costs of metabolic syndrome were 334 Euros in men and 321 Euros in women. Finally, the costs of diabetes mellitus were 392 Euros in men and 384 Euros in women. The most expensive pharmacotherapy was used in patients with a combination of all three diagnoses (HT+MS+DM), namely 452 Euros in men and 455 Euros in women. Indirect costs represent an even more serious financial burden. The highest indirect costs were in patients with diabetes mellitus, namely 5,227 Euros in men and 5,365 Euros in women. CONCLUSIONS: The study proved the assumption of increasing the direct pharmacotherapeutic costs in correlation with the increased severity of disease. The gender differences on the other hand, were smaller in patients with more serious conditions. The indirect costs represented the greatest financial burden, and were 13 to 17 times higher than the direct pharmacotherapeutic costs (Tab. 4, Ref. 17).
Asunto(s)
Diabetes Mellitus/economía , Gastos en Salud , Hipertensión/economía , Síndrome Metabólico/economía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Costo de Enfermedad , Diabetes Mellitus/terapia , Costos de los Medicamentos , Femenino , Costos de la Atención en Salud , Humanos , Hipertensión/terapia , Masculino , Síndrome Metabólico/terapia , Persona de Mediana Edad , Eslovaquia , Adulto JovenRESUMEN
Impaired baroreflex sensitivity (BRS) is a marker of autonomous dysfunction, which may play an important role in the long-term development of arterial hypertension, disease progression as well as complications related to global cardiovascular risk. The aim of the study was to evaluate the clinical significance of baroreflex sensitivity in hypertensives with/without major cardiovascular events. We found out that essential hypertension is associated with decreased BRS, and that grade of hypertension is inversely related to BRS values. Spontaneous BRS values in hypertensives with major cardiovascular event (stroke, myocardial infarction) were significantly lower even 6 months and more after myocardial infarction and stroke onset compared to remaining patients (p < 0.05). BRS is a clinically applicable, noninvasive method for assessing early dysfunction of autonomic nervous system, which seems to be an additive emerging marker of cardiovascular risk stratification in hypertensive patients.
Asunto(s)
Barorreflejo , Enfermedades Cardiovasculares/etiología , Hipertensión/fisiopatología , Adulto , Anciano , Anciano de 80 o más Años , Sistema Nervioso Autónomo/fisiopatología , Conservación de la Sangre , Femenino , Humanos , Hipertensión/complicaciones , Hipertensión/tratamiento farmacológico , Masculino , Persona de Mediana EdadRESUMEN
New examination approaches in biochemical analysis of lipoproteins can identify and quantify atherogenic plasma lipoproteins, including small dense LDL and characterise a lipoprotein spectrum as a non-atherogenic lipoprotein profile phenotype A, respectively as an atherogenic lipoprotein profile phenotype B. Identification of a non-aterogenic hypercholesterolemia (48%), atherogenic hypertriglyceridemia (93%), atherogenic normolipemia (13%) in patients with arterial hypertension and an atherogenic normolipemia in control group of healthy subjects (7%), is an essential contribution of this new laboratory diagnostics.
Asunto(s)
Hipertensión/sangre , Lipoproteínas/sangre , Aterosclerosis/fisiopatología , Femenino , Humanos , Hiperlipidemias/complicaciones , Hiperlipidemias/fisiopatología , Hipertensión/complicaciones , Lipoproteínas/fisiología , Masculino , Persona de Mediana EdadRESUMEN
New method of lipoprotein determination on polyacrylamid gel with Lipoprint LDL system quantifies non atherogenic and atherogenic plasma lipoproteins, including small dense LDL, the potent atherogenic lipoprotein subpopulations. According to majority of non atherogenic versus atherogenic lipoprotein in the whole lipoprotein spectrum, this method distinguishes a non atherogenic lipoprotein profile phenotype A from an atherogenic lipoprotein profile phenotype B. Definitely, the contribution of this method is focusing on the atherogenic lipoprotein profile phenotype B in 80% of patients with an extremito-vascular ischemic disease and on the existence of control subgroup ofnormolipemic subjects with an atherogenic lipoprotein profile (7% ofprobands of control group). These persons represent a risk population. Till now, the facilities for identifying of these "normolipemic persons at risk" are limited.
Asunto(s)
Pierna/irrigación sanguínea , Lipoproteínas/sangre , Enfermedades Vasculares Periféricas/sangre , Femenino , Humanos , Isquemia/sangre , Masculino , Persona de Mediana EdadRESUMEN
Extremitovascular ischemic disease (peripheral arterial disease of extremities - PAD) is an important manifestation of systemic atherosclerosis and other arterial diseases of vascular system. The lower the anklebrachial pressure index, the greater the risk of serious cardiovascular events (e.g., acute myocardial infarction, stroke). Prevention and treatment ofextremitovascular disease is discussed in this article.
Asunto(s)
Pierna/irrigación sanguínea , Enfermedades Vasculares Periféricas/prevención & control , Enfermedades Vasculares Periféricas/terapia , Humanos , Isquemia/prevención & control , Prevención Primaria , Prevención SecundariaRESUMEN
Superficial thrombophlebitis (ST) is a common disease, usually considered benign. However, the practice of systemic duplex ultrasonography has revealed a large number of deep-vein thromboses concomitant with ST. In contrast with extensive information on the management of deep vein thrombosis, little is known about the most appropriate treatment of the ST. Systematic duplex ultrasonography investigation has been proposed in the initial management of ST, to detect the presence of any underlying deep vein thrombosis. Because ST may extend into the deep venous system and potentially engender pulmonary embolism, treatment with low-molecular-weight-heparins might be the best choice. In our work diagnostic and therapeutic procedures for ST, proposed by Slovak angiological society, Slovak society for vascular surgeons, Slovak dermatological society, Slovak society for haemostasis and thrombosis, Slovak surgical society and Slovak internistic society are discussed.
Asunto(s)
Tromboflebitis/diagnóstico , Tromboflebitis/terapia , Humanos , Tromboflebitis/etiologíaRESUMEN
Increased concentration of uric acid (UA) is positively associated with the clinical severity but negatively associated with the prognosis of heart failure (HF). However, data related to the association between UA concentration and N-terminal pro brain natriuretic peptide (NT-proBNP) are still lacking. The aim of the study was to analyze the relationships between UA, NT-proBNP, clearance of creatinine and NYHA function class and echocardiographic variables in the Slovak population of primary care patients diagnosed with HF. The association between UA and NT-proBNP was assessed by multivariate analysis. 848 patients (402 men, 446 women) with HF were included in the study. NT-proBNP correlated with UA in both men and women after adjustment based on age, BMI and glomerular filtration rate (r=0.263, p<0.0001; r=0.293, p<0.0001). UA concentration rose with the severity of the NYHA class and was significantly higher in patients with moderate and severe systolic dysfunctions as well as with diastolic dysfunction in the multivariate analysis. In conclusion, our study in Slovak population with HF has revealed a positive correlation between the concentration of UA and NT-proBNP, and the independency of this association on confounding factors. The results support the role of UA as a biochemical marker of HF severity and prognosis.