The prevalence of cardiovascular disease risk factors in patients from Croatian Zagorje County treated at Department of Medicine, Zabok General Hospital from 2000 to 2006

The aim of the study was to assess the prevalence of risk factors for cardiovascular disease in patients treated for coronary heart disease (CHD) at Department of Medicine, Zabok General Hospital during the 2000-2006 period. Cardiovascular diseases are a group of diseases that occur due to arterial. The risk factors that lead to the development and occurrence of cardiovascular disease are hypertension, cigarette smoking, hyperholesterolemia, hypertriglyceridemia, diabetes mellitus and positive family history. Additional factors favoring the occurrence of cardiovascular disease include overweight, inadequate physical activity, and emotional stress. Data on all patients hospitalized and diagnosed with CHD at Department of Medicine, Zabok General Hospital during the 2000-2006 period were analyzed for the prevalence of risk factors for CHD, i.e. hypertension, cigarette smoking, hypercholesterolemia, hypertriglyceridemia, diabetes mellitus and positive family history of cardiovascular disease. Hypercholesterolemia was defined by a cholesterol level higher than 5.1 mmol/L, hypertension from history data and blood pressure measurement on admission greater than 140/90 mmHg, diabetes mellitus from history data, and hypertriglyceridemia by a triglyceride level greater than 1.7 mmol/L. Information on heredity and cigarette smoking was collected from history and a questionnaire filled out on admission. All laboratory values were determined on patient admission to the hospital. Analysis of the risk factors for CHD recorded in patients from Zagorje County during the 2000-2006 period revealed hypertension to be the most common risk factor in our patients. According to sex, CHD was found to show a male preponderance. According to age at admission, CHD predominated in the > 70 age group, which accounted for one third of all patients, followed by a comparable proportion of the 50-60 and 60-70 age groups, i.e. still active population groups. As CHD is one of the leading health threats worldwide, estimated to remain so at least by 2020, it is fully justified to invest all efforts in the study of cardiovascular disease. New research projects should be focused on the prevention and early detection of the disease, improvement of diagnosis procedures, introduction of novel therapeutic options, use of new concepts, and due survey of the measures taken. CHD poses great socioeconomic burden upon every community in industrialized societies because of the ever younger age at onset. Actions should be taken to improve awareness of the CHD risks and morbidity in the population at large, stimulating favorable lifestyle and dietary modifications, and one's own health awareness, in order to upgrade the control of risk factors for and morbidity of cardiovascular disease

The Prevalence of Cardiovascular Disease Risk Factors in Patients from Croatian Zagorje County Treated at Department of Medicine, Zabok General Hospital from 2000 to 2006

The aim of the study was to assess the prevalence of risk factors for cardiovascular disease in patients treated for coronary heart disease (CHD) at Department of Medicine, Zabok General Hospital during the 2000–2006 period. Cardiovascular diseases are a group of diseases that occur due to arterial. The risk factors that lead to the development and occurrence of cardiovascular disease are hypertension, cigarette smoking, hyperholesterolemia, hypertriglyceridemia, diabetes mellitus and positive family hystory. Additional factors favoring the occurrence of cardiovascular disease include overweight, inadequate physical activity, and emotional stress. Data on all patients hospitalized and diagnosed with CHD at Department of Medicine, Zabok General Hospital during the 2000–2006 period were analyzed for the prevalence of risk factors for CHD, i.e. hypertension, cigarette smoking, hypercholesterolemia, hypertriglyceridemia, diabetes mellitus and positive family history of cardiovascular disease. Hypercholesterolemia was defined by a cholesterol level higher than 5.1 mmol/L, hypertension from histoy data and blood pressure measurement on admission greater than 140/90 mmHg, diabetes mellitus from history data, and hypertriglyceridemia by a triglyceride level greater than 1.7 mmol/L. Information on heredity and cigarette smoking was collected from history and a questionnaire filled out on admission. All laboratory values were determined on patient admission to the hospital. Analysis of the risk factors for CHD recorded in patients from Zagorje County during the 2000–2006 period revealed hypertension to be the most common risk factor in our patients. According to sex, CHD was found to show a male preponderance. According to age at admission, CHD predominated in the > 70 age group, which accounted for one third of all patients, followed by a comparable proportion of the 50–60 and 60–70 age groups, i.e. still active population groups. As CHD is one of the leading health threats worldwide, estimated to remain so at least by 2020, it is fully justified to invest all efforts in the study of cardiovascular disease. New research projects should be focused on the prevention and early detection of the disease, improvement of diagnosis procedures, introduction of novel therapeutic options, use of new concepts, and due survey of the measures taken. CHD poses great socioeconomic burden upon every community in industrialized societies because of the ever younger age at onset. Actions should be taken to improve awareness of the CHD risks and morbidity in the population at large, stimulating favorable lifestyle and dietary modifications, and one’s own health awareness, in order to upgrade the control of risk factors for and morbidity of cardiovascular disease

Monosystem Multifocal Langerhans Cell Histiocytosis (Multifocal Eosinophilic Granulomas of the Bone) in a 36-Year Old Patient: Case Report, Therapeutic Doubts and Review of Literature

Our aim is to provide review of available studies on Langerhans cell histiocytosis (LCH) and discuss treatment for polyostotic monosystem form of disease based on our clinical experience. LCH is an enigmatic disease with insufficiently understood etiology, pathophysiology, and variety of clinical presentations ranging from solitary eosinophilic granuloma to severe multisystem disease. It is marked by formation of granuloma in practically any organ. We present rare case of multifocal bone disease in 36-year old patient without visceral involvement. Treatment protocols for adult LCH patients, especially for uncommon form in our case have not yet been defined. Our therapeutical trial with corticosteroids showed limited success with numerous side-effects. We conclude that LCH treatment can commence only after diagnosis and staging of the disease. Other factors like patient’s age, comorbidity, general condition, severity of symptoms and contraindications for therapy modalities should also be considered. In our experience expectative approach has better clinical outcome than immunosuppressive therapy in patients suffering from polyostotic multifocal form LCH with mild symptoms

Risk Factor Analysis and Diagnoses of Coronary Heart Disease in Patients with Hypercholesterolemia from Croatian Zagorje County

Our aim is to determine if there exists a difference in risk factors and diagnosis between patients being treated on internal medicine ward for coronary heart disease who have higher levels of cholesterol in their blood and other patients, without proved higher levels of cholesterol, hospitalized for coronary heart disease. We followed patients hospitalized in General Hospital Zabok for coronary heart disease for the period between 2004–2006y. On admission patients were diagnosed with coronary heart disease based on laboratory markers specific for the disease (CK, troponin, LDH,CRP), ECG and history taking. We analyzed two groups of patients for diagnosis and risk factors on discharge from the hospital: one group with proven hypercholesterolemia, the other with coronary heart disease without hypercholesterolemia. For the duration of the study there were no significant alternations concerning risk factors for coronary heart disease, and hypertension was the most prevalent of these factors in both groups. Values of HDL, as an indirect indicator of coronary heart disease, were lower in both groups for the duration of the study. In group of patients with hypercholesterolemia myocardial infarction with a ST segment elevation, as a discharge diagnosis, was a more prevalent complication of the disease, while for the group of patients without hypercholesterolemia stable angina pectoris was more prevalent and this is explained as atheroma plaque stabilization when there are normal values of blood cholesterol

Risk factor analysis and diagnoses of coronary heart disease in patients with hypercholesterolemia from Croatian Zagorje County

Our aim is to determine if there exists a difference in risk factors and diagnosis between patients being treated on internal medicine ward for coronary heart disease who have higher levels of cholesterol in their blood and other patients, without proved higher levels of cholesterol, hospitalized for coronary heart disease. We followed patients hospitalized in General Hospital Zabok for coronary heart disease for the period between 2004-2006y. On admission patients were diagnosed with coronary heart disease based on laboratory markers specific for the disease (CK, troponin, LDH,CRP), ECG and history taking. We analyzed two groups of patients for diagnosis and risk factors on discharge from the hospital: one group with proven hypercholesterolemia, the other with coronary heart disease without hypercholesterolemia. For the duration of the study there were no significant alternations concerning risk factors for coronary heart disease, and hypertension was the most prevalent of these factors in both groups. Values of HDL, as an indirect indicator of coronary heart disease, were lower in both groups for the duration of the study. In group of patients with hypercholesterolemia myocardial infarction with a ST segment elevation, as a discharge diagnosis, was a more prevalent complication of the disease, while for the group of patients without hypercholesterolemia stable angina pectoris was more prevalent and this is explained as atheroma plaque stabilization when there are normal values of blood cholesterol

ACUTE COLONIC PSEUDO-OBSTRUCTION WITH COMPLICATION – CASE REPORT

Prikazan je slučaj kirurškog liječenja megakolona i njegovih komplikacija kod sedamnaestogodišnjeg mladića. Dovezen je u hitni kirurški prijam zbog boli u trbuhu i izostanka stolice zadnjih 7 dana. Saznaje se da je mladić od rane mladosti imao problema sa stolicom. Sfinkter kontrolira od 5. godine. Hospitaliziran je kao dijete, te mu je isključena dijagnoza kongenitalnog megakolona (patohistološki pregled biopsije rektuma uredna je nalaza). Od tada je defecirao svaki 4. do 5. dan, uz povremeno primanje laksativa. Nakon hospitalizacije na našem odjelu konzervativnim se metodama pokušala uspostaviti normalna peristaltika. Kako se stanje bolesnika pogoršavalo, napravljena je operacija po Hartmannu (resekcija sigmoidnog kolona). Postoperacijski je oporavak uredan te se devet mjeseci nakon prve operacije uspostavlja kontinuitet debelog crijeva. Mladić se redovito kontrolira i nema tegoba pri defekaciji.This case report examines the surgical treatment of megacolon and its complications in a 17-year-old male patient. He was examined in the surgical emergency unit because of severe abdominal pain and absence of stool for one week. Detailed history revealed that the patient had difficulties in defecation from the early childhood. Sphincter control was not established by the age of five. During hospitalzation as a child, the diagnosis of congenital megacolon was excluded (pathohistological examination of rectal biopsy material showed normal findings). He was followed-up regulary, had stool every four to five days and few times received laxatives to relieve constipation. The patient was hospitalized at the Department of Abdominal Surgery and primarily treated with conservative methods trying to induce intestinal peristaltics. As the patient’s condition worsened, Hartmann’s procedure was performed (sigmoid colon resection). Postoperative recovery was successful and after nine months we established colon continuity. The patient reports for check-ups without any difficulty in defecation

ACUTE COLONIC PSEUDO-OBSTRUCTION WITH COMPLICATION – CASE REPORT

Prikazan je slučaj kirurškog liječenja megakolona i njegovih komplikacija kod sedamnaestogodišnjeg mladića. Dovezen je u hitni kirurški prijam zbog boli u trbuhu i izostanka stolice zadnjih 7 dana. Saznaje se da je mladić od rane mladosti imao problema sa stolicom. Sfinkter kontrolira od 5. godine. Hospitaliziran je kao dijete, te mu je isključena dijagnoza kongenitalnog megakolona (patohistološki pregled biopsije rektuma uredna je nalaza). Od tada je defecirao svaki 4. do 5. dan, uz povremeno primanje laksativa. Nakon hospitalizacije na našem odjelu konzervativnim se metodama pokušala uspostaviti normalna peristaltika. Kako se stanje bolesnika pogoršavalo, napravljena je operacija po Hartmannu (resekcija sigmoidnog kolona). Postoperacijski je oporavak uredan te se devet mjeseci nakon prve operacije uspostavlja kontinuitet debelog crijeva. Mladić se redovito kontrolira i nema tegoba pri defekaciji.This case report examines the surgical treatment of megacolon and its complications in a 17-year-old male patient. He was examined in the surgical emergency unit because of severe abdominal pain and absence of stool for one week. Detailed history revealed that the patient had difficulties in defecation from the early childhood. Sphincter control was not established by the age of five. During hospitalzation as a child, the diagnosis of congenital megacolon was excluded (pathohistological examination of rectal biopsy material showed normal findings). He was followed-up regulary, had stool every four to five days and few times received laxatives to relieve constipation. The patient was hospitalized at the Department of Abdominal Surgery and primarily treated with conservative methods trying to induce intestinal peristaltics. As the patient’s condition worsened, Hartmann’s procedure was performed (sigmoid colon resection). Postoperative recovery was successful and after nine months we established colon continuity. The patient reports for check-ups without any difficulty in defecation