Associations between Cardiometabolic and Behavioral Risk Factors and Cardiovascular Diseases
Martin SAMOHÝL, Katarína HIROŠOVÁ, Diana VONDROVÁ, Ľubica ARGALÁŠOVÁ, Ivana KACHÚTOVÁ, Jana JURKOVIČOVÁ
Ústav hygieny Lekárskej fakulty Univerzity Komenského, Bratislava, prednostka prof. MUDr. J. Jurkovičová, CSc.
SUMMARY
Background: The aim of this study was to compare the prevalence of cardiometabolic and behavioral risk factors between the group of patients with diagnosed cardiovascular disease (CVD) and control group, to estimate the impact of selected risk factors on the development of CVD and to evaluate treatment goals and target values achievement in the group of patients.
Sample and methods: The sample consists of 406 respondents (38.2 % of men) in the mean age of 44.6 ± 9.8 years (30 – 69 y). They were divided into a group of CVD patients and a control group with no CVD history. To determine behavioral risk factors prevalence we used a modified version of Cardiovascular Risk Assessment Questionnaire. Objectively examined cardiometabolic parameters were obtained from medical records.
Results: We found significant differences between the group of CVD patients and control group in terms of higher prevalence of smoking, overweight/obesity, diabetes, positive family history, worse values of lipid parameters, and higher BP in CVD patients. We confirmed the significant association of the presence of CVD and physical inactivity (p < 0.001), longer sleep duration (> 8 h/day; p < 0.05), higher consumption of fried (p < 0.001) and sweetened (p < 0.05) foods and insufficient vegetable intake (p < 0.05). A high number of patients did not reach treatment goals. In the control group, 12.2 % of respondents were at high risk (SCORE) and 53.9 % had three or more CVD risk factors.
Conclusion: We confirmed the impact of cardiometabolic and behavioral risk factors on the development of CVD and their inadequate treatment. We recommend improvement of the treatment process in terms of not only better monitoring of cardiometabolic parameters in current patients, but also in the positive influence of lifestyle changes and eating habits in potential patients.
Key words: cardiovascular diseases, cardiometabolic risk factors, lipid profile, behavioral risk factors, life style, nutritional habits.
Lek Obz (Med Horizon), 2019; 68(11): 355 – 360
Prevalence and spectrum of developmental malformations and chromosomal anomalies in reproductive losses
Jana MALOVÁ, Daniel BÖHMER, Andrea PASTORÁKOVÁ, Michaela LAPŠOVÁ, Tatiana BRAXATORISOVÁ
Ústav lekárskej biológie, genetiky a klinickej genetiky, Lekárska fakulta Univerzity Komenského v Bratislava, prednosta
doc. MUDr. D. Böhmer, PhD.
SUMMARY
The presented thesis is concerned on developmental abnormalities of embryos and fetusses from spontaneous and induced abortions and stillborn fetuses and is retrospective morphologic and analysis of file 4098 investigated samples of reproductive losses for the years 1992 to 2017 at the Department of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine. Developmental abnormalities occured in 511 cases (12.4 %). Isolated developmental defects accounted for 41.48 % of the total number of samples and multiple developmental defects accounted for 58.52 %. Malformations of central nervous system constituted the largest group (23.96 %). From the analyzed file normal karyotype was detected in 181 cases (35.42 %), chromosomal aberrations in 124 cases (24.27 %). The purpose of this study was presentation the overall frequency of developmental abnormalities and the developmental abnormalities of the each group that occurred as a single defect or as multiple developmental defects. At the same time karyotyping allowed to differentiate developmental abnormalities, which are part of monogenic and chromosome syndromes and others which are multifactorial.
Key words: developmental abnormalities, reproduction losses, spontaneous abortion, chromosomal aberrations, karyotype.
Lek Obz (Med Horizon), 2019; 68(11): 361 – 367
Hirudotherapy in the Reconstructive Surgery
Drahomír PALENČÁR1, Mária PLIŠOVÁ1, Miroslav MENDEL1, Ondřej BELEJ1, Jerguš KOCOUR2, Jozef BEŇUŠKA3
1Klinika plastickej chirurgie LFUK, SZU a UNB, prednosta MUDr. D. Palenčár, PhD.
2Oddelenie chirurgie ruky UNB, primár MUDr. L. Košťál
3I. ortopedicko-traumatologická klinika LF UK, SZU a UNB, prednosta MUDr. A. Švec, PhD.
SUMMARY
Background: Treatment with leeches has been in the renaissance in recent years. In reconstructive surgery, it is used to rescue tissues at risk of venous congestion.
Patients: The paper presents cases of using hirudotherapy in problematic venous drainage of replanted parts or free flaps. Patients consist of five cases over a twelve-month period.
Methods: The study retrospectively reports each of the five cases of using hirudotherapy with treatment progress and outcomes. The survival of reconstructed tissues is compared.
Results: In three cases, tissues threatened by insufficient venous outflow were recovered. Necrectomy was necessary in two cases. Both were replanted distal finger phalanxs without venous microanastomoses.
Conclusion: Hirudotherapy can be considered as a sufficient auxiliary method of improving the venous drainage of endangered tissues. Especially in the case if the venous system drainage itself was partially reconstructed at least.
Key words: hitudotherapy, free flaps, replantations.
Lek Obz (Med Horizon), 2019; 68(11): 368 – 372
Screening, indication of treatment and treatment of hyperlipoproteinaemia (a)
Alexandra LISOVSZKI1, Eliška FATĽOVÁ1, Eva SZABÓOVÁ2, Alojz RAJNIČ1
1IV. interná klinika UPJŠ LF a UNLP, Košice, prednosta prof. MUDr. I. Tkáč, PhD.
2Angiologická klinika UPJŠ LF a VÚSCH, a.s., Košice, prednosta doc. MUDr. E. Szabóová, PhD.
SUMMARY
Despite of constant advances in medicine, sudden and unexpected death is still a common primomanifestation of cardiovascular disease. Restriction fo these deaths is conditional only on primary prevention and subsequent appropriate treatment. Although lipoprotein (a) is relatively refractory to lifestyle changes and treatment intervention, hypolipidemics are known to reduce lipoprotein (a) leves. More recent knowledge of screening and indication of treatment hyperlipoproteinaemia (a), as well as its tratments opportunities is presented in the article.
Key words: lipoprotein (a), screening, indication of treatment, treatment of hyperlipoproteinaemia (a).
Lek Obz (Med Horizon), 2019; 68 (11): 373 – 377
Pigmented lesions of oral mucosa
Peter HARICH1, Tatiana KIMÁKOVÁ2, Vladimíra SCHWARTZOVÁ1, Zuzana SCHWARTZOVÁ1, Michal BERNADIČ3
1I. stomatologická klinika Lekárskej fakulty Univerzity Pavla Jozefa Šafárika v Košiciach a Univerzitnej nemocnice L. Pasteura Košice, prednostka MUDr. S. Timková, PhD.
2Ústav verejného zdravotníctva a hygieny Lekárskej fakulty Univerzity Pavla Jozefa Šafárika v Košiciach, prednostka doc. MUDr.
K. Rimárová, CSc., mim. prof.
3Klinika chirurgickej onkológie LF SZU a NOÚ, Bratislava, prednosta doc. MUDr. D. Pinďák, PhD.
SUMMARY
During intraoral examination, the dentist encounters color changes in the mucous membranes, which can represent primary or secondary manifestations of disease processes. The correct and early diagnosis of hyperpigmentation is important to recognize malignancies from harmless lesions to the mucosa. We present the role of melanocytes in the epithelium of the oral mucosa, melanin pigmentation and pigment lesions on the oral mucosa – melanotic macula, melanocytic nevi and mucosal malignant melanoma. We describe the negative effects of smoking on smoker’s melanosis.
Key words: oral mucosa, pigmented lesions, malignant melanoma, smoker’s melanosis.
Lek Obz (Med Horizon), 2019; 68(11): 378 – 381
Osteoarthritis – Inflammatory Degenerative Disease
Jozef ROVENSKÝ1, Jana SEDLÁKOVÁ2, Marián BERNADIČ3
1V. interná klinika LF UK a UNB, prednosta prof. MUDr. J. Payer, PhD., MPH, FRCP
2Národný ústav reumatických chorôb Piešťany, Nábrežie I. Krasku, Piešťany, riaditeľ prof. MUDr. R. Imrich, DrSc.
3Ústav patologickej fyziológie LF UK, prednosta prof. MUDr. F. Šimko, PhD., FESC
SUMMARY
Osteoarthritis (OA) is the most common involvement of the locomotive system and is also the cause of pain and impaired function of the affected area. Changes in cartilage homeostasis, especially in activated arthrosis, are approximated by inflammatory processes occurring e.g. in rheumatoid arthritis. In the prevention and treatment of OA, the importance of learning about disease, regulating diet and using non – medicamentous drugs is underlined (1). Pharmacotherapy is currently enriched with a new class of non – steroidal anti – inflammatory drugs – coxibs. Their advantage is that they block only cyclooxygenase 2 (COX-2) and do not affect cyclooxygenase 1 (COX-1), which is responsible for frequent side effects in the GIT region. In surgical treatment, the future is represented mainly by transartroscopic methods of cartilage restoration and tissue engineering, autologous chondrocyte transplantation or directly cartilage.
Key words: osteoarthrosis, inflammatory disease, degenerative disease, cartilage.
Lek Obz (Med Horizon), 2019; 68 (11): 382 – 390
Physiotherapy as a Part of Thoracic Outlet Syndrom Therapy
Katarína MELICHERČÍKOVÁ1,3,4, Vladimír ŠEFRÁNEK2, Katarína GAZDÍKOVÁ1
1Fakulta ošetrovateľstva a zdravotníckych odborných štúdií SZU, Bratislava
2Klinika cievnej chirurgie Lekárskej fakulty SZU, Bratislava
3Fyziatricko-rehabilitačné oddelenie NÚSCH, a. s., Bratislava
4Vysoká škola zdravotníctva a sociálnej práce sv. Alžbety, Bratislava
SUMMARY
The thoracic outlet syndrome (TOS) is one of the best known compression syndromes in which vascular and neurological symptomatology occurs.
It is manifested primarily by neurological and arterial symptoms, less often by venous symptoms. Symptoms are usually provoked by certain movements of the arms and head.
Etiopathogenetically is compression a consequence of congenital anomalies such as excess cervical ribs and an elongated transverse process of the cervical vertebra. However, the hypotrophy of the muscles of the shoulder girdles, or vice versa, hypertrophy in the overloading of the upper limbs in some sports or professions can also lead to compression and cause TOS symptomatology. The first references about TOS in the literature are dated back to the end of the 19th century. Surgical procedures have been dominating treatments historically but also nowadays. Current experience from physiotherapeutic departments highlights the benefits of comprehensive rehabilitation treatment prior to the surgical treatment of TOS.
The authors report on rehabilitation methodologies, focused mainly on correction of body posture and movement stereotypes, manual techniques, physical treatment options and preventive measures. They emphasize the importance of good patient cooperation and propose a conservative treatment algorithm for TOS.
Key words: thoracic outlet syndrom, physiotherapy, compressive syndroms.
Lek Obz (Med Horizon), 2019; 68 (11): 391 – 394
Hundred years of Faculty of Medicine of Comenius University in Bratislava and its Influence on Formation of Slovak angiology
Viera ŠTVRTINOVÁ1, Katarína DOSTÁLOVÁ2, Mária GRÓFOVÁ3, Ján ŠTVRTINA4
1I. interná klinika LF UK a UNB Bratislava, prednostka doc. MUDr. S. Kiňová, PhD.
2Slovenská zdravotnícka univerzita, Bratislava
3Archív Univerzity Komenského v Bratislave
4Ústav sociálneho lekárstva a lekárskej etiky, LF UK Bratislava, prednosta doc. MUDr. V. Ozorovský, CSc.
SUMMARY
The establishment of Comenius University (CU) in Bratislava in 1919 was of great significance for the development of Slovak education, science and culture.
The Faculty of Medicine is the oldest of all thirteen actual CU faculties. It has been one hundred years exactly, since the Faculty of Medicine CU became involved in a process of medical doctors education and developing their scientific knowledge. Slovak angiology is closely associated with Faculty of Medicine CU. There is a little parallel between the creation of CU and slovak angiology. In both events the narrow cooperation with czech collegues and their help is evident. The article gives a view on formation of slovak angiology and the impact of professors and scientists of Faculty of Medicine Comenius University on the development of this field of medicine.
Key words: Comenius University, Faculty of Medicine, slovak angiology, Slovak Angiological Society, Slovak Medical Association.
Lek Obz (Med Horizon), 2019; 68 (11): 395 – 399
From anabolics to bilateral pheochromocytoma
Juraj SMAHA1, Martin KUŽMA1, Ján MALINA2, Juraj PAYER1
1V. interná klinika LF UK a UN Bratislava, prednosta prof. MUDr. J. Payer, PhD., MPH, FRCP
2Klinika chirurgickej onkológie SZU a NOÚ Bratislava, prednosta doc. MUDr. D. Pinďák, PhD.
SUMMARY
Pheochromocytoma is a rare neuroendocrine tumor that produces catecholamines. It represents 0,1 – 1 % of all causes of secondary arterial hypertension. About 10 – 25 % of tumors are part of hereditary syndromes such as multiple endocrine neoplasia type 2, von Hippel-Lindau disease or neurofibromatosis type 1. Hereditary forms are often multifocal or bilateral and appear in younger age. The most common symptoms are sustained or paroxysmal hypertension, tachycardia, palpitations, headache and diaphoresis. The single best diagnostic method is measurement of plasma free metanephrines. Next step in diagnostic algorithm is localization of tumor with imaging studies. Causal treatment is adrenalectomy. Our case-study is about 26-year-old man with anabolic steroids consumption, whose anabolic abuse was overlapping the real cause of his secondary hypertension.
Key words: secondary arterial hypertension, pheochromocytoma, diagnosis, treatment, endocrine tumor.
Lek Obz (Med Horizon), 2019; 68(11): 400 – 404
Chronic bilateral posterior shoulder dislocation treated by reverse total shoulder artroplasty
Andrey ŠVEC1, Norbert KRAJCSOVICS1, Ján PASIAR1, Silvia VAJCZIKOVÁ2
1I. ortopedicko-traumatologická klinika, LF UK, SZU a UNB v Bratislave, prednosta MUDr. A. Švec, PhD., MPH
2II. ortopedicko-traumatologická klinika, LF UK a UNB v Bratislave, prednosta doc. MUDr. B. Šteňo, PhD., MPH
SUMMARY
Bilateral posterior dislocation of the shoulder is a rare problem that occurs due to direct trauma or epileptic seizure. Posterior dislocation is often misdiagnosed and sometimes is treated like frozen shoulder syndrome with aggressive rehabilitation that makes the present osseous defects worse. We present a case of the 67 years old patient, who had an epileptic seizure and sustained a fracture of Th6 and injury of both shoulders with initially misseddiagnosed posterior dislocation. After seven months of conservative treatment, he presented to our institution, and he still complained of both shoulders. CT showed bilateral posterior shoulder dislocations with massive reverse Hill-Sachs defect. We decided to treat this condition with reverse shoulder arthroplasty with good functional outcome. In the literature, a variety of case reports exists of bilateral shoulder dislocation, but no of them were treated by reverse shoulder arthroplasty. A reverse shoulder arthroplasty was a good option in our patient for treatment of neglected posterior dislocation of the shoulder.
Key words: bilateral posterior shoulder dislocation, misdiagnosed, epileptic seisure, reverse shoulder arthroplasty.
Lek Obzor (Med Horizon), 2019; 68 (11): 405 – 408
