24 research outputs found
Sudden sensorineural hearing loss treatment
Akutna zamjedbena nagluhost je idiopatski, jednostrani gubitak sluha perceptivnog porijekla koji se razvija u manje od 72 sata. VeÄina pacijenata opisuje buÄenje s oÅ”teÄenim sluhom bez oÄitog vanjskog uzroka. OÅ”teÄenje sluha može biti jedva zamjetno do izrazito, a gluhoÄa je rijetki ishod. Neki pacijenti imaju i Å”um u zahvaÄenom uhu. Postoje brojni moguÄi uzroci iznenadnog gubitka sluha (virusni, vaskularni ili autoimuni), ali Äesto uzrok ostane nepoznat pa govorimo o idiopatskom zamjedbenom oÅ”teÄenju sluha. Dijagnoza se postavlja kod pacijenata s navedenim simptomima i potvrÄuje Weberovim testom koji lateralizira u zdravo uho. 35 do 60 % bolesnika se oporavi u potpunosti, uglavnom unutar 2 tjedna. Najbolja metoda lijeÄenja za idiopatsko zamjedbeno oÅ”teÄenje sluha joÅ” nije otkrivena zbog Äinjenice da mnogo pacijenata pokazuje spontani oporavak, bez obzira na lijeÄenje. VeÄina otologa preporuÄuje propisivanje sistemskih kortikosteroida u pacijenata koji nemaju kontraindikacije. Glukokortikoidi su standardna terapija idiopatske zamjedbene nagluhosti. MeÄutim, s obzirom na to da su sistemski kortikosteroidi povezani s brojnim nuspojavama, raÄene su studije njihove primjene intratimpaniÄnim putem, koje pokazuju nedosljedne rezultate. Postoji takoÄer potreba za kvalitetnijim istraživanjem hiperbariÄne oksigenoterapije u lijeÄenju iznenadnog gubitka sluha. Vremenski okvir za uÄinkovitu terapiju je kratak, stoga je važno da svaki lijeÄnik bude svjestan ovog stanja kako bi pacijenta uputio otorinolaringologu na vrijeme.Sudden sensorineural hearing loss refers to unexplained, unilateral hearing loss of sensorineural origin developing in less than 72 hours. Most patients describe waking up with hearing loss that has no apparent external cause. Hearing loss can range from barely detectable to profound, with deafness as an uncommon outcome. Some patients experience tinnitus in the affected ear. There are a lot of possible causes of sudden hearing loss (viral, vascular, or autoimmune causes), but often the cause remains unknown and is termed idiopathic sudden sensorineural hearing loss. The clinical diagnosis is made in patients presented with the symptoms mentioned and is confirmed by the Weber test, in which we can see lateralization to the healthy ear. Thirty-five to sixty percent of patients recover completely, most within 2 weeks. The best treatment for idiopathic sudden hearing loss has not been found yet due to the fact that a lot of patients show spontaneous improvement, regardless of treatment. Most otologists stay united in prescribing systemic corticosteroids to patients who have no contraindications. Glucocorticoids are the standard treatment for idiopathic sudden sensorineural hearing loss. However, as systemic steroids are associated with significant side effects, there were studies with intratympanic steroid therapy, which showed inconsistent results. There is also a need to fully investigate the effects of hyperbaric oxygenation for treatment of sudden hearing loss. The time frame for effective therapy is short, so it is important for every doctor to be aware of this condition and refer the patient to an otolaryngologist in time
Sudden sensorineural hearing loss treatment
Akutna zamjedbena nagluhost je idiopatski, jednostrani gubitak sluha perceptivnog porijekla koji se razvija u manje od 72 sata. VeÄina pacijenata opisuje buÄenje s oÅ”teÄenim sluhom bez oÄitog vanjskog uzroka. OÅ”teÄenje sluha može biti jedva zamjetno do izrazito, a gluhoÄa je rijetki ishod. Neki pacijenti imaju i Å”um u zahvaÄenom uhu. Postoje brojni moguÄi uzroci iznenadnog gubitka sluha (virusni, vaskularni ili autoimuni), ali Äesto uzrok ostane nepoznat pa govorimo o idiopatskom zamjedbenom oÅ”teÄenju sluha. Dijagnoza se postavlja kod pacijenata s navedenim simptomima i potvrÄuje Weberovim testom koji lateralizira u zdravo uho. 35 do 60 % bolesnika se oporavi u potpunosti, uglavnom unutar 2 tjedna. Najbolja metoda lijeÄenja za idiopatsko zamjedbeno oÅ”teÄenje sluha joÅ” nije otkrivena zbog Äinjenice da mnogo pacijenata pokazuje spontani oporavak, bez obzira na lijeÄenje. VeÄina otologa preporuÄuje propisivanje sistemskih kortikosteroida u pacijenata koji nemaju kontraindikacije. Glukokortikoidi su standardna terapija idiopatske zamjedbene nagluhosti. MeÄutim, s obzirom na to da su sistemski kortikosteroidi povezani s brojnim nuspojavama, raÄene su studije njihove primjene intratimpaniÄnim putem, koje pokazuju nedosljedne rezultate. Postoji takoÄer potreba za kvalitetnijim istraživanjem hiperbariÄne oksigenoterapije u lijeÄenju iznenadnog gubitka sluha. Vremenski okvir za uÄinkovitu terapiju je kratak, stoga je važno da svaki lijeÄnik bude svjestan ovog stanja kako bi pacijenta uputio otorinolaringologu na vrijeme.Sudden sensorineural hearing loss refers to unexplained, unilateral hearing loss of sensorineural origin developing in less than 72 hours. Most patients describe waking up with hearing loss that has no apparent external cause. Hearing loss can range from barely detectable to profound, with deafness as an uncommon outcome. Some patients experience tinnitus in the affected ear. There are a lot of possible causes of sudden hearing loss (viral, vascular, or autoimmune causes), but often the cause remains unknown and is termed idiopathic sudden sensorineural hearing loss. The clinical diagnosis is made in patients presented with the symptoms mentioned and is confirmed by the Weber test, in which we can see lateralization to the healthy ear. Thirty-five to sixty percent of patients recover completely, most within 2 weeks. The best treatment for idiopathic sudden hearing loss has not been found yet due to the fact that a lot of patients show spontaneous improvement, regardless of treatment. Most otologists stay united in prescribing systemic corticosteroids to patients who have no contraindications. Glucocorticoids are the standard treatment for idiopathic sudden sensorineural hearing loss. However, as systemic steroids are associated with significant side effects, there were studies with intratympanic steroid therapy, which showed inconsistent results. There is also a need to fully investigate the effects of hyperbaric oxygenation for treatment of sudden hearing loss. The time frame for effective therapy is short, so it is important for every doctor to be aware of this condition and refer the patient to an otolaryngologist in time
Hitna traheotomija kod trahealne stenoze - prikaz sluÄaja
Airway management in an emergency department is the first step in critical care of
an urgent patient. When orotracheal intubation is not possible due to upper airway obstruction, such
an emergency is known as a ācannot intubate ā cannot ventilateā situation. Then, emergency tracheotomy
is indicated. We present a case of a 70-year-old patient complaining of progressive dyspnea. The
patient was conscious, highly tachydyspneic, and tachycardic. Loud stridor and a scar from previous
tracheostomy suggested upper airway obstruction. Patient history confirmed previous partial laryngectomy
and temporary tracheostomy due to laryngeal cancer 10 months before. Differential diagnosis
of tracheal stenosis was set, and an ENT specialist was requested. Flexible fiberoptic laryngoscopy
demonstrated a 1-mm subglottic tracheal stenosis. Emergency surgical tracheotomy below the obstruction
in awake state using local anesthesia was performed to secure the airway. Early postoperative
care was complicated by incipient right-sided pneumonia, which may have provoked narrowing of the
existing subglottic stenosis in the first place. Tracheal stenosis is an important differential diagnosis
of airway obstruction in patients with previous malignant diseases of the upper respiratory system.
Emergency physicians should promptly recognize these situations based on clinical examination to
secure appropriate airway management.Zbrinjavanje diÅ”noga puta u hitnoj službi prvi je korak u procjeni i lijeÄenju hitnog bolesnika. Situacije u kojima orotrahealna
intubacija nije moguÄa zbog opstrukcije gornjih diÅ”nih putova poznate su pod nazivom ānemoguÄe intubirati ā nemoguÄe
ventiliratiā (cannot intubate ā cannote ventilate). U takvim situacijama indicirana je hitna kirurÅ”ka traheotomija. Autori
prikazuju sluÄaj 70-godiÅ”njeg bolesnika koji se žalio na progresivni osjeÄaj nedostatka zraka. Bolesnik je bio pri svijesti,
izrazito tahidispnoiÄan i tahikardan. Glasan stridor i ožiljak od prethodne treaheotomije ukazali su na opstrukciju gornjih
diÅ”nih putova. AnamnestiÄki se doznaje da je kod bolesnika prije 10 mjeseci uÄinjena parcijalna laringektomija i privremena
traheotomija zbog karcinoma grkljana. Postavljena je dijagnoza trahealne stenoze i pozvan je specijalist otorinolaringologije.
Fleksibilna fiberoptiÄka laringoskopija pokazala je subglotiÄnu trahealnu stenozu promjera 1 mm. Zbog osiguranja diÅ”nog
puta uÄinjena je hitna kirurÅ”ka traheotomija ispod mjesta opstrukcije u budnom stanju u lokalnoj anesteziji. Rani poslijeoperacijski
oporavak kompliciran je poÄetnom desnostranom upalom pluÄa koja je možda i izazvala suženje postojeÄe
subglotiÄke stenoze. Trahealna stenoza važna je diferencijalna dijagnoza opstrukcije diÅ”nih putova u bolesnika s prethodnim
malignim bolestima gornjega diÅ”nog sustava. Na temelju kliniÄkog pregleda nužno je odmah prepoznati ovakve situacije
kako bi se primjereno zbrinuo diŔni put
Fibromatosis colli ā izazov za otorinolaringologe
Fibromatosiscolli,ili fibromatoza vrata, rijetka je benigna infiltrativna proliferacija vezivnog tkiva u
sternokleidomastoidnom miÅ”iÄu, koja se javlja kod 0,4% novoroÄenÄadi. Bolest nastaje dva do Äetiri tjedna
nakon roÄenja kao bezbolna oteklina na vratu u projekciji sternokleidomastoidnog miÅ”iÄa. Kontrakcije
fibroznog tkiva unutar lezije mogu prouzroÄiti miÅ”iÄni tortikolis, Å”to naposlijetku može dovesti do
kraniofacijalne asimetrije. Fizikalna terapija glavna je metoda lijeÄenja, a kirurÅ”ki zahvat nužan je u
refraktornim sluÄajevima i nejasnim situacijama. Diferencijalna dijagnoza otekline na vratu kod novoroÄenÄeta
je Å”iroka i ukljuÄuje upalne i benigne procese, kao i maligne neoplazme. Poseban izazov u diferencijalnoj
dijagnozi predstavljaju benigni mezenhimalni tumori, kao Ŕto je infantilna fibromatoza koja može biti
nepredvidivoga tijeka, a naglim rastom u dojenaÄkoj dobi može dovesti i do smrtnog ishoda.
Autori predstavljaju sluÄaj muÅ”kog novoroÄenÄeta starog dva tjedna koji se prezentirao naglo nastalom
oteklinom na desnoj strani vrata. UÄinjena je dijagnostiÄka obrada (UZV vrata, MR vrata i aspiracijska biopsija
tankom iglom), te je bolesnik prikazan na multidisciplinarnom timu za tumore glave i vrata, uz sudjelovanje
djeÄjeg kirurga i ortopeda. MoguÄnosti lijeÄenja svedene su na fizikalnu terapiju, biopsiju lezije ili kompletnu
resekciju. Kao optimalni modalitet lijeÄenja izabran je kirurÅ”ki pristup. Postoperativno se ultrazvuÄnim
pregledima prati oporavak miÅ”iÄa uz zdravo napredovanje djeteta.
ZakljuÄno, unatoÄ dobroÄudnoj prirodi bolesti, zdravstvene reperkusije fibromatoze vrata mogu biti znaÄajne
u sluÄaju odgoÄenog kirurÅ”kog lijeÄenja. Jasne smjernice u pogledu zahvaÄenosti samog miÅ”iÄa kada je
dostatna konzervativna terapija ne postoje, te je na kliniÄarima teÅ”ka odluka kada se odluÄiti za operativno
lijeÄenje koje, kao i u naÅ”em sluÄaju, može imati odliÄan estetski i funkcionalni rezultat
The Correlation between Iron Deficiency and Recurrent Aphthous Stomatitis: A Literature Review
Aphthous lesions of the oral mucosa are a very common symptom and can be seen in both family medicine practice, dental medicine practice, and dermatology or otorhinolaryngology clinics. Some patients develop a chronic recurrent condition, which is clinically known as recurrent aphthous stomatitis (RAS). These ulcers are round, clearly defined, and can be visible on the movable part of the oral mucosa, with variations in size. A prodromal symptom like the burning or stinging sensation can precede the appearance of lesions. The main reason why patients seek medical help is oropharyngeal pain with lack of appetite.
The exact etiopathogenesis of RAS remains unknown. Immune disorders, nutritional deficiencies, allergies, mechanical injuries, and even psychological disorders are being studied as potential causes of this condition. Some authors claim that iron deficiency may be a possible causative factor of RAS due to its role in DNA synthesis, mitochondrial function, and enzymatic activity. In iron deficiency, epithelial cells turn over more rapidly and produce an immature or atrophic mucosa. Such mucosa is vulnerable and can be a fertile soil for chronic inflammation and development of aphthae.
Finally, our goals were to describe the clinical aspects and etiology of RAS, as well as to determine whether RAS may be related to iron deficiency, in order to identify potential patients with iron deficiency in everyday work
Psychiatric approach to tinnitus
Tinnitus is a symptom with a significant incidence in the general population, usually of unclear etiology,
that can cause serious difficulties in people\u27s daily functioning, significantly impair the quality of life, and
have a negative impact on mental health.
The paper aims to present a brief overview of current knowledge about this frequent and unpleasant
phenomenon, including epidemiology, etiology, clinical presentation, diagnosis, and treatment.
The paper highlights contemporary theories of tinnitus that link damage to the peripheral organ of
hearing and the consequent neuronal changes involved in the subjective experience, which are the target
sites for treating psychological disorders associated with tinnitus. The psychiatric approach to tinnitus is
aimed not so much at reducing the sound intensity as at reducing the negative experience of this
phenomenon and preventing the development or worsening of existing psychological disorders.
The results of previous researches indicate numerous therapeutic options for treating tinnitus, including
drugs, cognitive-behavioral therapy, and neuromodulation techniques with promising results
GENDER DIFFERENCES IN THE INCIDENCE AND CLINICAL PRESENTATION OF ACUTE MYOCARDIAL INFARCTION IN EMERGENCY MEDICINE
Cilj: Glavni cilj ovog istraživanja bio je ispitati postoje li spolne razlike u uÄestalosti, dobnoj distribuciji i kliniÄkoj prezentaciji kod bolesnika s akutnim infarktom miokarda koji su zatražili intervenciju Hitne medicinske službe. Metode: UÄinjena je retrospektivna analiza baze podataka naÅ”eg Zavoda za hitnu medicinu u razdoblju od travnja 2014. do listopada 2019. godine. Koristili smo program e-Hitna te ukljuÄili sve bolesnike s dijagnozom akutnog infarkta miokarda (I21 prema MKB-
10 klasifi kaciji). Za sve bolesnike analizirali smo nekoliko karakteristika: dob, spol, prisutnost Å”eÄerne bolesti te tri kliniÄke karakteristike (bol u prsima, poremeÄaj svijesti, hemodinamska nestabilnost). Rezultati: Ukupno je ukljuÄeno 377 pacijenata s dijagnozom akutnog infarkta miokarda. MuÅ”karaca je bilo 219 (58,1 %), a žena 158 (41,9 %) (p < 0,001). ProsjeÄna dob obolijevanja muÅ”karaca iznosila je 64 godine, a žena 73 godine (p<0,001). Nije zabilježena razlika u pojavnosti Å”eÄerne bolesti izmeÄu spolova (p=0,88). Å to se tiÄe kliniÄkih karakteristika bolesnika, nije zabilježena razlika u pojavnosti i jaÄini boli u prsima (p=0,07) te hemodinamske nestabilnosti (p=0,49) izmeÄu muÅ”karaca i žena. MeÄutim, žene ÄeÅ”Äe imaju poremeÄaj svijesti (62,2 %) u odnosu na muÅ”karce (37,8 %) (p<0,01). Rasprava: Akutni infarkt miokarda ÄeÅ”Äi je u muÅ”karaca Å”to potvrÄuju i brojne studije. NaÅ”e istraživanje pokazalo je da se infarkt miokarda javlja u starijoj dobi kod žena s razlikom prosjeÄne dobi obolijevanja od Äak 9 godina. Takva razlika tumaÄi se drugaÄijim utjecajem riziÄnih Äimbenika na razvoj kardiovaskularnih bolesti izmeÄu spolova te protektivnim djelovanjem estrogena u žena prije menopauze. Od navedenih kliniÄkih karakteristika poremeÄaj svijesti javlja se ÄeÅ”Äe u žena Å”to je u skladu s mnogim istraživanjima koja navode da žene ÄeÅ”Äe imaju atipiÄne simptome. ZakljuÄak: Kardiovaskularne bolesti se javljaju ÄeÅ”Äe u muÅ”karaca, ali su glavni uzrok smrti u oba spola. MuÅ”karci obolijevaju i do 10 godina ranije, ali spolne se razlike starenjem smanjuju. Potrebna su daljnja istraživanja o uzroku razlika u kliniÄkoj prezentaciji akutnog infarkta miokarda izmeÄu spolova.The main objective of this study was to investigate whether there are gender differences in the incidence, age, distribution and clinical presentation of patients with acute myocardial infarction requiring emergency medical intervention. Retrospective analysis of the data base of our Department of Emergency Medicine from April 2014 to October 2019 was performed. We used the e-Hitna program and included all patients with acute myocardial infarction (I21 according to the ICD-10 classifi cation). For all patients involved, we analyzed the following characteristics: age, gender, presence of diabetes, and three clinical characteristics (chest pain, disorders of consciousness, and hemodynamic instability). A total of 377 patients with acute myocardial infarction were included. There were 219 (58.1%) men and 158 (41.9%) women (p<0.001). The average age of men and women was 64 and 73 years, respectively (p<0.001). There was no gender difference in the incidence of diabetes (p=0.88). Regarding clinical characteristics of patients, there was no difference in the incidence and severity of chest pain (p=0.07) and hemodynamic instability (p=0.49). However, women were found to be more likely to have a disorder of consciousness (62.2%) than men (37.8%) (p<0.01). In conclusion, acute myocardial infarction is more common in men, as confi rmed by numerous studies. Our study shows that myocardial infarction occurs in older women, with a 9-year difference in the average age. Such a difference is interpreted by different infl uence of risk factors for the development of cardiovascular diseases between the genders and the protective effect of estrogen in women before menopause. Of these clinical characteristics, consciousness disorders occur more frequently in women, which is consistent with numerous studies reporting that women have atypical symptoms more often. In conclusion, cardiovascular diseases occur more frequently in men, but are the leading cause of death in both genders. Men have myocardial infarction 10 years earlier on average, but gender differences are decreasing with age. Further studies on the cause of differences in the clinical presentation of acute myocardial infarction between genders are required
NIJEMI AKUTNI INFARKT MIOKARDA KOD BOLESNIKA SA Å EÄERNOM BOLESTI U IZVANBOLNIÄKOJ HITNOJ MEDICINI
Aim of the Study: Silent acute myocardial infarction occurs commonly in diabetic patients. Currently, it is not fully understood whether altered perception of ischemia also predisposes atypical presentations, and therefore leads to under-diagnosing the acute myocardial infarction (AMI) in diabetic patients. In this study, we tried to determine whether chest pain in AMI occurred less frequently in diabetic patients. Methods: In this retrospective study, we included patients admitted from April 2014 to November 2019. Data were collected using eHitna and BIS as the nation-wide programs for patient tracking and registry in Croatia. All patients included in the study had initially called Department of Emergency Medicine of Brod-Posavina County, which then resulted in an intervention. Patients were then transferred to Dr Josip BenÄeviÄ General Hospital, where they were hospitalized. All patients had discharge letters with the diagnosis speciļ¬ ed by ICD-10 classiļ¬ cation as I21 spectrum (I21.0, I21.1, I21.2, I21.3, I21.4, I21.9), i.e. AMI. Results: In this study, we included 180 patients having suffered AMI who were hospitalized and treated. There were 35 (19%) diabetic patients (DP) and 145 (81%) non-diabetic patients (non-DP). Chest pain was absent in nine (26%) DP and 13 (9%) non-DP (p=0.007). There was no difference in sex distribution within the two groups, with 60% and 68% male patients in DP and non-DP, respectively (p=0.395). The mean patient age was signiļ¬ cantly different between the two groups, i.e. 69 years in DP and 64 years in non-DP (p=0.034). Discussion: AMI in diabetic patients could have altered clinical presentation, which has often been researched therefore. Some researchers have reported that atypical or silent presentations are more frequent in DP with AMI, whereas others found no differences when compared to non-DP. In our study, absence of chest pain as a characteristic of silent AMI was experienced by 17% more DP as compared to non-DP, suggesting that DM inļ¬ uences clinical presentation of AMI. It is important to emphasize the importance of such ļ¬ ndings in emergency medicine where patients often describe their various symptoms. The mean age of DP having suffered AMI was signiļ¬ cantly higher (even up to 5 years) in comparison to non-DP. Despite the fact that DM is a risk factor for developing AMI, this ļ¬ nding could be explained by the fact that DM is more common in elderly population. Conclusion: Chest pain occurs signiļ¬ cantly less frequently in DP that develop AMI than in non-DP. Therefore, DP have a higher probability of developing silent AMI.Cilj: Nijemi akutni infarkt miokarda (AIM) se pojavljuje ÄeÅ”Äe u bolesnika s dijabetesom. Predisponira li izmijenjena percepcija ishemije atipiÄnu prezentaciju te se zbog toga nedovoljno dijagnosticira AIM u bolesnika s dijabetesom, nije joÅ” dovoljno istraženo. U ovoj studiji pokuÅ”ali smo utvrditi pojavljuje li se bol u prsiÅ”tu kod AIM rjeÄe kod bolesnika s dijabetesom. Metode: U ovu retrospektivnu studiju ukljuÄili smo bolesnike primljene od travnja 2014. do studenoga 2019. godine. Koristili smo bazu podataka programa āe-hitnaā i āBISā te sakupljali i analizirali podatke o bolesnicima koji su zatražili intervenciju izvanbolniÄke hitne medicinske službe u naÅ”oj županiji, bili prevezeni u OpÄu bolnicu āDr. Josip BenÄeviÄā, hospitalizirani te im je kao otpusna dijagnoza postavljena prema klasiļ¬ kaciji MKB-10 bila u spektru dijagnoze I21 (I21.0, I21.1, I21.2, I21.3, I21.4, I21.9), tj. AIM. Dijabetes je zabilježen kod bolesnika koji su bili na inzulinu ili oralnim hipoglikemicima, ukljuÄujuÄi dijabetes tip 1 i tip 2. Rezultati: U studiju smo ukljuÄili 180 bolesnika koji su doživjeli AIM. Od tog broja ih je 35 (19,4 %) imalo dijabetes (DP), a 145 (80,6 %) nije imalo dijabetes (ne-DP). Bol u prsiÅ”tu nije bila prisutna u devet (26 %) DP i 13 (9 %) ne-DP (p=0,007). Nije bilo znaÄajne razlike u distribuciji prema spolu ni u jednoj skupini bolesnika (p=0,35). MuÅ”karaca je bilo 60 % u DP i 68 % u ne-DP. ProsjeÄna dob znaÄajno se razlikovala u dvjema skupinama. U DP je prosjeÄna dob bila 69 godina, a u ne-DP 64 godine (p=0,034). Rasprava: Akutni infarkt miokarda u bolesnika s dijabetesom može se prezentirati izmijenjenom kliniÄkom slikom i zbog toga se Äesto istraživao. Neki istraživaÄi su pokazali da je atipiÄna ili nijema prezentacija infarkta ÄeÅ”Äa u bolesnika s dijabetesom, dok drugi nisu pronaÅ”li razlike u usporedbi s nedijabetiÄarima. U ovoj studiji smo primijetili da je izostanak boli u prsiÅ”tu kao karakteristika nijemog AMI uÄestaliji u dijabetiÄara s AIM. To dovodi do zakljuÄka da dijabetes utjeÄe na kliniÄku sliku AIM. Treba istaknuti važnost takvog rezultata u izvanbolniÄkoj hitnoj medicini gdje se bolesnici Äesto prezentiraju raznim simptomima. Srednja vrijednost dobi dijabetiÄara koji su doživjeli AIM bila je znaÄajno veÄa nego u nedijabetiÄara. UnatoÄ Äinjenici da je dijabetes riziÄni Äimbenik za razvoj AIM, ovaj rezultat možemo tumaÄiti Äinjenicom da je dijabetes zastupljeniji u starijoj populaciji. ZakljuÄak: Bol u prsiÅ”tu se javlja rjeÄe u bolesnika s dijabetesom koji imaju AIM nego u onih koji nemaju dijabetes. Zbog toga dijabetiÄari imaju veÄe izglede da razviju nijemi AIM.