Pub Date : 2014-08-01DOI: 10.2478/s11536-013-0279-x
T. R. Gimenez, A. Calvo, J. G. Vicent
Acute pancreatitis is a common disease with a benign course in the majority of patients, but it is associated with serious morbidity, and mortality close to 20% in up to 20% of cases. The incidence of acute pancreatitis seems to be rising in western countries. About 75% of all cases are caused by gallstones or alcoholism. The relative rate of gallstones versus alcohol as etiology depends on the age and the area of enrolment. A thorough evaluation allows cause identification in another 10% of cases, leaving about 15–20% as idiopathic. The most common causes, and a growing list of less frequent and sometimes very rare and controversial etiologies, are reviewed in this article. A classification on the pathogenic mechanisms of causes of acute pancreatitis based is used in this Review. The approach, or suggested plan of investigations, to determine the etiology of acute pancreatitis, based on the most recently published Guidelines is outlined.
{"title":"Etiology of acute pancreatitis","authors":"T. R. Gimenez, A. Calvo, J. G. Vicent","doi":"10.2478/s11536-013-0279-x","DOIUrl":"https://doi.org/10.2478/s11536-013-0279-x","url":null,"abstract":"Acute pancreatitis is a common disease with a benign course in the majority of patients, but it is associated with serious morbidity, and mortality close to 20% in up to 20% of cases. The incidence of acute pancreatitis seems to be rising in western countries. About 75% of all cases are caused by gallstones or alcoholism. The relative rate of gallstones versus alcohol as etiology depends on the age and the area of enrolment. A thorough evaluation allows cause identification in another 10% of cases, leaving about 15–20% as idiopathic. The most common causes, and a growing list of less frequent and sometimes very rare and controversial etiologies, are reviewed in this article. A classification on the pathogenic mechanisms of causes of acute pancreatitis based is used in this Review. The approach, or suggested plan of investigations, to determine the etiology of acute pancreatitis, based on the most recently published Guidelines is outlined.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"530-542"},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0279-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68850455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-08-01DOI: 10.2478/s11536-013-0282-2
N. Zambudio, K. Muffak, T. Villegas, A. Becerra, Y. Fundora, D. Garrote, A. Ferrón
IntroductionWe review the most recent advances in the management of pancreatitis following publication of the latest clinical practice guidelines. The most significant innovations have taken place in the surgical treatment of pancreatitis, specifically regarding when a patient should be intervened and what procedure should be used. Moreover, changes that have occurred in the classification of pancreatitis seek to harmonize diagnostic criteria and facilitate comparisons among centers.MethodsWe reviewed three of the latest guidelines and review articles published since 2008 following an electronic search through Medline, Embase and the Cochrane Library.ConclusionsAlthough diverse guidelines and review articles coincide on many key points, they need to be updated with regard to the numerous surgical innovations that have emerged recently in the management of pancreatitis.
{"title":"Evidence-based management of pancreatitis","authors":"N. Zambudio, K. Muffak, T. Villegas, A. Becerra, Y. Fundora, D. Garrote, A. Ferrón","doi":"10.2478/s11536-013-0282-2","DOIUrl":"https://doi.org/10.2478/s11536-013-0282-2","url":null,"abstract":"IntroductionWe review the most recent advances in the management of pancreatitis following publication of the latest clinical practice guidelines. The most significant innovations have taken place in the surgical treatment of pancreatitis, specifically regarding when a patient should be intervened and what procedure should be used. Moreover, changes that have occurred in the classification of pancreatitis seek to harmonize diagnostic criteria and facilitate comparisons among centers.MethodsWe reviewed three of the latest guidelines and review articles published since 2008 following an electronic search through Medline, Embase and the Cochrane Library.ConclusionsAlthough diverse guidelines and review articles coincide on many key points, they need to be updated with regard to the numerous surgical innovations that have emerged recently in the management of pancreatitis.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"594-600"},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0282-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68850518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-07-31DOI: 10.2478/s11536-013-0313-z
D. Protic, S. Baltić, N. Stupar, S. Pavlov-Dolijanovic, S. Mugoša, Z. Todorović
Statins might cause and/or aggravate the immune-mediated myositis in patients on long-term, stable treatment. We provide a case of polymyositis with an immunological background and gastrointestinal and urinary manifestations in patient on long-term, stable atorvastatin treatment for the past six years. The diagnose of polymyositis was established based on clinical symptoms and signs, electromyography and laboratory test results (elevated aspartate aminotransferase 279 U/L, reference range 0–40 U/L; alanine aminotransferase 198 U/L, 0–33 U/L; lactate dehydrogenase 2200 U/L, 103-227 U/L; creatine kinase 7820 U/L, 15–84 U/L; and positive antinuclear antibodies test, titer of 1:160, with suspect antisynthetase antibodies). Polymyositis was probably related to atorvastatin treatment (Naranjo score, 5). Other probable causes of the myositis were rejected. Coricosteroid therapy, methotrexate and supplementation with vitamin D did not improve the condition. The patient remained bedridden and died two months after the hospital discharge due to the acute myocardial infarction.
{"title":"A case of myositis with immunological background associated with statin use","authors":"D. Protic, S. Baltić, N. Stupar, S. Pavlov-Dolijanovic, S. Mugoša, Z. Todorović","doi":"10.2478/s11536-013-0313-z","DOIUrl":"https://doi.org/10.2478/s11536-013-0313-z","url":null,"abstract":"Statins might cause and/or aggravate the immune-mediated myositis in patients on long-term, stable treatment. We provide a case of polymyositis with an immunological background and gastrointestinal and urinary manifestations in patient on long-term, stable atorvastatin treatment for the past six years. The diagnose of polymyositis was established based on clinical symptoms and signs, electromyography and laboratory test results (elevated aspartate aminotransferase 279 U/L, reference range 0–40 U/L; alanine aminotransferase 198 U/L, 0–33 U/L; lactate dehydrogenase 2200 U/L, 103-227 U/L; creatine kinase 7820 U/L, 15–84 U/L; and positive antinuclear antibodies test, titer of 1:160, with suspect antisynthetase antibodies). Polymyositis was probably related to atorvastatin treatment (Naranjo score, 5). Other probable causes of the myositis were rejected. Coricosteroid therapy, methotrexate and supplementation with vitamin D did not improve the condition. The patient remained bedridden and died two months after the hospital discharge due to the acute myocardial infarction.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"619-624"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0313-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68851451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-07-31DOI: 10.2478/s11536-013-0337-4
B. Rybojad, G. Niedzielska, E. Rudnicka-Drożak
Foreign-body aspiration in children results in diagnostic problems, mainly because of nonspecific signs. Therefore, in this study, we placed particular stress on false-positive and -negative predictors. Charts of 139 consecutive paediatric patients aged 6.0 months to 15.5 years who underwent bronchoscopy for a suspected foreign body aspiration were analysed retrospectively. A foreign body was found in 95 cases (68%). The anamnesis was positive in 91%. Cough was the most common clinical symptom (91%) with a sensitivity and specificity of 94% and 23%, respectively. There were no significant correlations between clinical symptoms and the locations of foreign bodies. The majority of focal hyperinflation (24%) and atelectasis (15%) were seen in chest radiographs, with a sensitivity and specificity of 33% and 89% (hyperinflation) and 15% and 82% (atelectasis), respectively. Chest X-rays were normal in 46 cases; however, an object was removed in 25. Persistent infiltrates were present in 14 X-rays, and a foreign body was extracted during bronchoscopy in 4. A highly significant correlation between the type of foreign body and radiological signs was noted (p = 0.00001). Anamnesis, clinical symptoms, and radiological findings are helpful in confirming aspiration, but can be misleading. Chronic or recurrent pneumonia should prompt further bronchoscopic diagnosis.
{"title":"Diagnosis of paediatric airway foreign body: is it easy?","authors":"B. Rybojad, G. Niedzielska, E. Rudnicka-Drożak","doi":"10.2478/s11536-013-0337-4","DOIUrl":"https://doi.org/10.2478/s11536-013-0337-4","url":null,"abstract":"Foreign-body aspiration in children results in diagnostic problems, mainly because of nonspecific signs. Therefore, in this study, we placed particular stress on false-positive and -negative predictors. Charts of 139 consecutive paediatric patients aged 6.0 months to 15.5 years who underwent bronchoscopy for a suspected foreign body aspiration were analysed retrospectively. A foreign body was found in 95 cases (68%). The anamnesis was positive in 91%. Cough was the most common clinical symptom (91%) with a sensitivity and specificity of 94% and 23%, respectively. There were no significant correlations between clinical symptoms and the locations of foreign bodies. The majority of focal hyperinflation (24%) and atelectasis (15%) were seen in chest radiographs, with a sensitivity and specificity of 33% and 89% (hyperinflation) and 15% and 82% (atelectasis), respectively. Chest X-rays were normal in 46 cases; however, an object was removed in 25. Persistent infiltrates were present in 14 X-rays, and a foreign body was extracted during bronchoscopy in 4. A highly significant correlation between the type of foreign body and radiological signs was noted (p = 0.00001). Anamnesis, clinical symptoms, and radiological findings are helpful in confirming aspiration, but can be misleading. Chronic or recurrent pneumonia should prompt further bronchoscopic diagnosis.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"648-652"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0337-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68852704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-07-31DOI: 10.2478/s11536-013-0318-7
N. Stoynev, K. Kalinov, G. Kirilov, T. Tankova
AimTo evaluate the serum levels of sFas and sFasL in normotensive subjects with different degree of impairment of glucose tolerance as well as in type 2 diabetic patients with treated and treatment-naïve hypertension (AHT).Material and methods124 subjects (63 males and 61 females), of mean age 46,31±10,78 years are included in the study, divided in 5 age-matched groups: 19 subjects with type 2 diabetes (DM) and drug-controlled AHT; 30 subjects with type 2 DM and drug-naïve AHT; 30 normotensive subjects with type 2 DM; 26 normotensive subjects with prediabetes and 19 healthy controls. Serum sFas and sFasL levels are determined by highly sensitive enzyme immunoassay technique.ResultsNo significant differences in sFas are observed among the studied groups. The levels of sFasL are decreased in normotensive subjects with type 2 DM (p<0,05), while subjects with prediabetes have intermediate values. In both hypertensive groups with DM sFasL levels are further decreased.ConclusionsSerum sFas levels probably are not associated with the presence of impairment of glucose tolerance or AHT. Serum sFasL values tend to be decreased in subjects with impairment in glucose tolerance; further decrease is observed in hypertensive subjects with type 2 DM. Antihypertensive treatment does not influence the levels of sFasL.
{"title":"Serum levels of sFas and sFasL in subjects with type 2 diabetes — the impact of arterial hypertension","authors":"N. Stoynev, K. Kalinov, G. Kirilov, T. Tankova","doi":"10.2478/s11536-013-0318-7","DOIUrl":"https://doi.org/10.2478/s11536-013-0318-7","url":null,"abstract":"AimTo evaluate the serum levels of sFas and sFasL in normotensive subjects with different degree of impairment of glucose tolerance as well as in type 2 diabetic patients with treated and treatment-naïve hypertension (AHT).Material and methods124 subjects (63 males and 61 females), of mean age 46,31±10,78 years are included in the study, divided in 5 age-matched groups: 19 subjects with type 2 diabetes (DM) and drug-controlled AHT; 30 subjects with type 2 DM and drug-naïve AHT; 30 normotensive subjects with type 2 DM; 26 normotensive subjects with prediabetes and 19 healthy controls. Serum sFas and sFasL levels are determined by highly sensitive enzyme immunoassay technique.ResultsNo significant differences in sFas are observed among the studied groups. The levels of sFasL are decreased in normotensive subjects with type 2 DM (p<0,05), while subjects with prediabetes have intermediate values. In both hypertensive groups with DM sFasL levels are further decreased.ConclusionsSerum sFas levels probably are not associated with the presence of impairment of glucose tolerance or AHT. Serum sFasL values tend to be decreased in subjects with impairment in glucose tolerance; further decrease is observed in hypertensive subjects with type 2 DM. Antihypertensive treatment does not influence the levels of sFasL.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"704-708"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0318-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68851404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-07-31DOI: 10.2478/s11536-013-0309-8
S. Kostić, I. Tasic, D. Mijalković, D. Lovic, D. Djordjević, T. Savić, N. Tasić, Aleksandra Aranđelović
AbstractOur aim was to establish the association of carotid intima-media thickness (CIMT) and ankle-brachial index(ABI) with the severity of coronary artery dissease (CAD). The study enrolled 150 examinees and divided them into two groups. The patients with stenotic changes in the coronary artery, constituted the first group (CP)(n=100); the second group consisted of the examinees without CAD — control goup (CG) (n=50). The following methods were used in the study: Color Doppler sonography of the carotid arteries, ABI, calculation of SCORE risk and coronary angiography.ResultsThe number of coronary blood vessels affected by atherosclerosis was significantly higher with the increase of CIMT, CV risk score, and waist-hip ratio by one measurement unit: CIMT by 0.729; p<0.05; CV risk score by 0.033; p<0.05; and waist-hip ratio by 3.182; p<0.01. With each increase of ABI value by one measurement unit, the number of involved blood vessels dropped by 0.844; p<0.05.ConclusionsOur results demonstrated that reduced ABI value, increased CIMT and number of plaques in the carotid arteries were in correlation with the severity of coronary artery disease.
{"title":"Association of the thickness of carotid intima-media complex and ancle brachial index with coronary disease severity","authors":"S. Kostić, I. Tasic, D. Mijalković, D. Lovic, D. Djordjević, T. Savić, N. Tasić, Aleksandra Aranđelović","doi":"10.2478/s11536-013-0309-8","DOIUrl":"https://doi.org/10.2478/s11536-013-0309-8","url":null,"abstract":"AbstractOur aim was to establish the association of carotid intima-media thickness (CIMT) and ankle-brachial index(ABI) with the severity of coronary artery dissease (CAD). The study enrolled 150 examinees and divided them into two groups. The patients with stenotic changes in the coronary artery, constituted the first group (CP)(n=100); the second group consisted of the examinees without CAD — control goup (CG) (n=50). The following methods were used in the study: Color Doppler sonography of the carotid arteries, ABI, calculation of SCORE risk and coronary angiography.ResultsThe number of coronary blood vessels affected by atherosclerosis was significantly higher with the increase of CIMT, CV risk score, and waist-hip ratio by one measurement unit: CIMT by 0.729; p<0.05; CV risk score by 0.033; p<0.05; and waist-hip ratio by 3.182; p<0.01. With each increase of ABI value by one measurement unit, the number of involved blood vessels dropped by 0.844; p<0.05.ConclusionsOur results demonstrated that reduced ABI value, increased CIMT and number of plaques in the carotid arteries were in correlation with the severity of coronary artery disease.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"601-608"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0309-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68851013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-07-31DOI: 10.2478/s11536-013-0311-1
S. Hromis, B. Zvezdin, I. Kopitović, Senka Milutinov, V. Kolarov, M. Vukoja, B. Zarić
Spontaneous pneumomediastinum (SPM) is a rare clinical condition that may be mild but also dramatic with sudden onset of chest pain and dyspnea accompanied by swelling and subcutaneous crepitations. The objective of this study was to analyze the clinical presentation and outcome of SPM in a specialized pulmonary tertiary care centre over a 10 years year period. In subsequent followup, we received information related to recurrence episodes of SPM by patients or their GPs physicians. Eighteen patients, 15 (83%) men, mean age 24 years (SD ±7.86) were diagnosed with SPM. Predominant symptoms were chest pain and cough (n=11) then dyspnea (n=9). Asthma was the most common predisposing condition (n=12). Pneumomediastinum was present on chest radiograph in 17 cases (94%), and in one case it was detected only by computed tomography. The mean length of hospital stay was 7 days (SD ±4.4 days). All our patients recovered and there were no complications. Recurrent event occurred in one asthma patient, 2 years after the first episode. Although, SPM is usually a self-limiting and benign condition, close monitoring is necessary. Recurrence is rare, but possible, with no evidence that routine monitoring of those patients is needed.
{"title":"Spontaneous pneumomediastinum: ten years of our experience in diagnosis and outcome","authors":"S. Hromis, B. Zvezdin, I. Kopitović, Senka Milutinov, V. Kolarov, M. Vukoja, B. Zarić","doi":"10.2478/s11536-013-0311-1","DOIUrl":"https://doi.org/10.2478/s11536-013-0311-1","url":null,"abstract":"Spontaneous pneumomediastinum (SPM) is a rare clinical condition that may be mild but also dramatic with sudden onset of chest pain and dyspnea accompanied by swelling and subcutaneous crepitations. The objective of this study was to analyze the clinical presentation and outcome of SPM in a specialized pulmonary tertiary care centre over a 10 years year period. In subsequent followup, we received information related to recurrence episodes of SPM by patients or their GPs physicians. Eighteen patients, 15 (83%) men, mean age 24 years (SD ±7.86) were diagnosed with SPM. Predominant symptoms were chest pain and cough (n=11) then dyspnea (n=9). Asthma was the most common predisposing condition (n=12). Pneumomediastinum was present on chest radiograph in 17 cases (94%), and in one case it was detected only by computed tomography. The mean length of hospital stay was 7 days (SD ±4.4 days). All our patients recovered and there were no complications. Recurrent event occurred in one asthma patient, 2 years after the first episode. Although, SPM is usually a self-limiting and benign condition, close monitoring is necessary. Recurrence is rare, but possible, with no evidence that routine monitoring of those patients is needed.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"642-647"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0311-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68851241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-07-31DOI: 10.2478/s11536-013-0330-y
M. Ángeles Valcárcel-García, Carlos Aliste-Santos, A. González-Quintela, J. Díaz-Peromingo
Kikuchi-Fujimoto disease is a rare histiocytic necrotizing lymphadenitis that affects typically young women causing fever and painful laterocervical lymphadenopathy. The etiology is unknown, but several viral infections and autoimmune diseases have been related with the disease. Bacterial infections are less frequent. Diagnosis needs for excisional lymph node biopsy that shows paracortical areas of coagulative necrosis with abundant debris, distortion of the nodal architecture, and a large amount of histiocytes at the margins of the necrotic areas. There is no specific treatment for the disease. We present the case of a young woman with Kikuchi-Fujimoto disease associated with lower respiratory tract infection by Streptococcus pneumoniae and review the literature.
{"title":"Association between Kikuchi-Fujimoto disease and Streptococcus pneumoniae infection","authors":"M. Ángeles Valcárcel-García, Carlos Aliste-Santos, A. González-Quintela, J. Díaz-Peromingo","doi":"10.2478/s11536-013-0330-y","DOIUrl":"https://doi.org/10.2478/s11536-013-0330-y","url":null,"abstract":"Kikuchi-Fujimoto disease is a rare histiocytic necrotizing lymphadenitis that affects typically young women causing fever and painful laterocervical lymphadenopathy. The etiology is unknown, but several viral infections and autoimmune diseases have been related with the disease. Bacterial infections are less frequent. Diagnosis needs for excisional lymph node biopsy that shows paracortical areas of coagulative necrosis with abundant debris, distortion of the nodal architecture, and a large amount of histiocytes at the margins of the necrotic areas. There is no specific treatment for the disease. We present the case of a young woman with Kikuchi-Fujimoto disease associated with lower respiratory tract infection by Streptococcus pneumoniae and review the literature.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"709-713"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0330-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68852196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-07-31DOI: 10.2478/s11536-013-0287-x
B. H. Teneva, E. Karaslavova
Background/AimsAccurate assessment of renal function in patients with liver cirrhosis is difficult and of great prognostic importance. The present study aimed to determine the prognostic significance of certain renal markers and to investigate the priority of serum cystatin C (CysC) levels on one-year mortality in cirrhotic patients.MethodsRenal function of 45 liver cirrhotic patientss was evaluated by levels of blood urea nitrogen (BUN), serum creatinine (Cr), CysC, as well as 24-hour creatinine clearance (CCl) and estimated glomerular filtration rate obtained by Cockroft-Gault and MDRD formulas. The endpoint of the follow up was mortality within one year. Spearman’s correlation, linear regression analysis and receiver operating characteristic curves were used to investigate prognostic factors.Results42 men and 3 women (mean age 53.18 ± 9.71 years) were enrolled in the study. Eleven of the patients (24.4%) died as a result of liver cirrhosis within one year. In predicting mortality, levels of BUN, serum Cr and CysC showed area under the curves (AUC) values of 0.719 (95% CI, 0.539–0.899, p = 0.03), 0.726 (95% CI, 0.541–0.911, p = 0.026) and 0.770 (95% CI, 0.620–0.920, p = 0.008). Sensitivity and specificity of a CysC level of >1.3 mg/l in predicting mortality were 72% and 68%, respectively. Univariate regression analysis showed that elevated levels of CysC above the referent ones, increased the risk of one-year mortality nearly six times (p = 0.02, Exp (B) = 5.81).ConclusionsSerum CysC could be used as a good prognostic marker in patients with cirrhosis and normal Cr levels.
{"title":"Prognostic value of serum cystatin C levels in cirrhotic patients with normal serum creatinine","authors":"B. H. Teneva, E. Karaslavova","doi":"10.2478/s11536-013-0287-x","DOIUrl":"https://doi.org/10.2478/s11536-013-0287-x","url":null,"abstract":"Background/AimsAccurate assessment of renal function in patients with liver cirrhosis is difficult and of great prognostic importance. The present study aimed to determine the prognostic significance of certain renal markers and to investigate the priority of serum cystatin C (CysC) levels on one-year mortality in cirrhotic patients.MethodsRenal function of 45 liver cirrhotic patientss was evaluated by levels of blood urea nitrogen (BUN), serum creatinine (Cr), CysC, as well as 24-hour creatinine clearance (CCl) and estimated glomerular filtration rate obtained by Cockroft-Gault and MDRD formulas. The endpoint of the follow up was mortality within one year. Spearman’s correlation, linear regression analysis and receiver operating characteristic curves were used to investigate prognostic factors.Results42 men and 3 women (mean age 53.18 ± 9.71 years) were enrolled in the study. Eleven of the patients (24.4%) died as a result of liver cirrhosis within one year. In predicting mortality, levels of BUN, serum Cr and CysC showed area under the curves (AUC) values of 0.719 (95% CI, 0.539–0.899, p = 0.03), 0.726 (95% CI, 0.541–0.911, p = 0.026) and 0.770 (95% CI, 0.620–0.920, p = 0.008). Sensitivity and specificity of a CysC level of >1.3 mg/l in predicting mortality were 72% and 68%, respectively. Univariate regression analysis showed that elevated levels of CysC above the referent ones, increased the risk of one-year mortality nearly six times (p = 0.02, Exp (B) = 5.81).ConclusionsSerum CysC could be used as a good prognostic marker in patients with cirrhosis and normal Cr levels.","PeriodicalId":50709,"journal":{"name":"Central European Journal of Medicine","volume":"9 1","pages":"625-631"},"PeriodicalIF":0.0,"publicationDate":"2014-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2478/s11536-013-0287-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68850607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-07-31DOI: 10.2478/s11536-013-0323-x
R. Brunnerova, J. Lebl
Turner syndrome is among the most common chromosomal aberrations. It is caused by a missing or anomaly of one X chromosome, alternatively a chromosomal mosaicism. It is often connected with a more frequent occurrence of some ocular diseases. In our study 81 girls and women with Turner syndrome from the age of 5 to 23 years old were examined. The occurrence of ocular diseases and their possible connection with karyotype was the main focus of our attention. Myopia had the highest incidence in these girls, further there were hyperopia, epicanthus, colour vision deficiency, amblyopia, strabismus and ptosis. The occurrence of colour vision deficiency was higher than in the general population where it differs in sexes. The occurrence of strabismus and ptosis was higher than in the general population. The total range of refractive errors was slightly higher than in the general population, with a different distribution according to karyotype. Hyperopia was recorded more often at the 45,X karyotype, namely 28 %, while for chromosomal mosaicism it was only in 18%. For myopia the ratio was reversed — chromosomal mosaicism in 31% and in 45,X karyotype in 26 %.In total, while comparing individual eye defects incidence in 45,X karyotype and chromosomal mosaicism, similar findings were recorded. These results were also assessed with the help of statistics.
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