Are patients undergoing treatment of hyperlipidaemia with statins the best candidates for early cardiac rehabilitation?

The role of statins in the primary and secondary prevention of cardiovascular events is well known. An important adverse event associated with statin treatment is myopathy; intensive physical effort in patients treated with statins increases the risk of muscle injury/myopathy. In this article we discuss the benefits and risks associated with statin treatment in patients undergoing cardiac rehabilitation after acute coronary syndromes and/or coronary revascularization procedures. In our opinion, the benefits of the secondary prevention of coronary heart disease achieved with statins seem to outweigh the hazards associated with statin therapy. The careful selection of patients for both treatment with statins and the gradual intensification of physical training in the course of cardiac rehabilitation appears to constitute an important element of the therapeutic approach

Early brain perfusion improvement after ventriculoperitoneal shunt surgery in patients with idiopathic normal pressure hydrocephalus evaluated by 99mTc-HMPAO SPECT — preliminary report

BACKGROUND: Idiopathic normal pressure hydrocephalus (iNPH) is a clinical syndrome that consists of the triad: gait disturbance, mental deterioration and urinary incontinence associated with normal cerebrospinal fluid pressure (CSF), without pre-existing abnormalities. The most popular treatment option is surgical implantation of a shunt. Brain perfusion increase occurring months or years after successful shunt surgery is well described in the literature. Early improvement of perfusion is not well documented. Therefore, the objective of the present study was to determine patterns of brain perfusion changes 3–6 days after the ventriculoperitoneal shunting in patients with iNPH by using 99mTc-HMPAO SPECT. MATERIAL AND METHODS: Sixteen patients with iNPH (9 women, 7 men, mean age 64.1 ± 12.7 years) who underwent ventriculoperitoneal shunt surgery were included into the study group. Indications for implanting a shunt were based on clinical history, neuroimaging and CSF dynamic studies with an infusion test. Brain perfusion SPECT was performed 1–2 days before and 3–6 days after the surgical treatment. For comparison of perfusion before and after the surgery SPECT scans were assessed visually and semiquantitatively with voxel based analysis. RESULTS: No side effects were observed after the surgery. Brain perfusion improvement after shunting was observed in 10 patients (62.5%). Patterns of perfusion changes varied between patients, with combinations of different bilateral and lateralized brain regions involved. Perfusion increased in the whole brain (3 patients), in the right cerebral hemisphere (1 patient) or in the separate cerebral regions (6 patients): frontal, parietal, temporal, cerebellum, cingulate gyrus. Perfusion improvement was predominantly observed in the frontal lobes: right frontal (3 cases, 18.8%), left frontal (3 cases, 18.8%). CONCLUSIONS: Cerebral perfusion is recovered promptly after ventriculoperitoneal shunt surgery in about 60% of patients with iNPH. This improvement may be global or regional in different cerebral areas with prevalence of the frontal lobes

Association between rs7901695 and rs7903146 polymorphisms of the TCF7L2 gene and gestational diabetes in the population of Southern Poland

Objectives: The etiology of gestational diabetes mellitus (GDM) remains to be fully elucidated. Elevated risk for type 2 diabetes in patients with history of GDM and for GDM in women with familial history of diabetes may suggest that GDM and type 2 diabetes share a common genetic and environmental background. The TCF7L2 (Transcription Factor 7 Like 2) gene is one of the most important genetic factors of the established correlation with type 2 diabetes, and it may also play a role in the pathophysiology of GDM.The aim of the study was to assess the influence of two polymorphisms of the TCF7L2 gene (rs7901695 and rs7903146), which are associated with the development of type 2 diabetes, in women with GDM.Material and methods: The study included 50 women with glucose tolerance disorders diagnosed for the first time during the current pregnancy. Single nucleotide polymorphisms (SNPs) were genotyped using allelic discrimination. The results were confirmed using the sequencing method. Selected clinical parameters were also analyzed.Results: No correlation between the studied polymorphisms of the TCF7L2 gene and GDM was observed. Glycemic control with diet or diet and insulin was associated with better control of the weight gain during pregnancy.Conclusions: No correlation between rs7903146 and rs7901695 polymorphisms of the TCF7L2 gene and GDM was found. Glycemic control with diet or diet and insulin is associated with better control of the weight gain during pregnancy

Ocena profilu dobowego ciśnienia tętniczego metodą 24-godzinnego ambulatoryjnego monitorowania ciśnienia (ABPM) u pacjentów z cukrzycą typu 2

Wstęp W ostatnich latach obserwuje się wzrost częstości występowania cukrzycy typu 2, która stanowi znaczący czynnik ryzyka chorób układu sercowo-naczyniowego. Istotnym czynnikiem rozwoju późnych powikłań naczyniowych choroby jest nadciśnienie tętnicze. Celem pracy była ocena dobowej zmienności ciśnienia tętniczego u pacjentów z cukrzycą typu 2. Materiał i metody Zbadano 111 chorych na cukrzycę typu 2 bez rozpoznanego nadciśnienia tętniczego w okresie poprzedzającym badanie holterowskie oraz 80 osób zdrowych bez zaburzeń gospodarki węglowodanowej, stanowiących grupę kontrolną. W obu grupach przeprowadzono 24-godzinne ambulatoryjne monitorowanie ciśnienia tętniczego (ABPM), oceniając wartość ciśnienia tętniczego w dzień i w nocy. Wyniki Stwierdzono znamienne różnice w wartościach skurczowego ciśnienia tętniczego (SBP) między grupą chorych a grupą kontrolną w ciągu doby. W ciągu dnia wykazano wyższe wartości SBP u pacjentów z cukrzycą typu 2: SBP 128,29 &#177; 14,3 mm Hg v. 121,81 &#177; 8,69; p < 0,05. Zaobserwowano znamiennie większe wartości SBP i rozkurczowego ciśnienia tętniczego (DBP) w godzinach nocnych w grupie chorych na cukrzycę typu 2 w porównaniu z grupą osób zdrowych: SBP 117,01 &#177; 15,29 mm Hg v. 101,39 &#177; 7,06 mm Hg; p = 0,000000 oraz DBP 68,3 &#177; 11,92 mm Hg v. 60,92 &#177; 6,15 mm Hg; p = 0,000005. Wnioski 1. U większości (83,8%) pacjentów z cukrzycą typu 2 i prawidłowym ciśnieniem tętniczym w pomiarach gabinetowych stwierdzono zniesienie rytmu dobowego ciśnienia tętniczego. 2. W porównaniu z grupą osób zdrowych u pacjentów z cukrzycą typu 2 zaobserwowano podwyższone SBP w ciągu dnia i w nocy. 3. U pacjentów z cukrzycą typu 2, w odniesieniu do grupy osób zdrowych, stwierdzono podwyższone DBP w nocy

Canonical relationship between sensory motor functions and cognitive factors in traumatic brain injury

Access to thesis permanently restricted to Ball State community onlyAccess to abstract permanently restricted to Ball State community onlyDepartment of Educational PsychologyThesis (Ph. D.

Canonical relationship between sensory motor functions and cognitive factors in traumatic brain injury

Access to thesis permanently restricted to Ball State community onlyAccess to abstract permanently restricted to Ball State community onlyThesis (Ph. D.)Department of Educational Psycholog