56 research outputs found
Regular Dog-Walking Improves Physical Capacity in Elderly Patients after Myocardial Infarction
Various positive effects of pet ownership on cardiovascular health are well known. The aim of this prospective and
controlled longitudinal study was to determine the effects of everyday dog-walking on physical capacity in elderly patients
during the first year after myocardial infarction. Regularly dog-walking for at least 15 minutes three times a day
is related to significantly higher work load on the bicycle exercise test (72.5 Ā± 10.75 versus 67.6 Ā± 11.6 W, p<0.05) in the
Ā»dog-walkingĀ« group (N=29, mean age 72.5 years) at 12 months compared to the control group (N=30, mean age 71.7
years). Our results suggest that dogs may help to maintain continuous physical activity in elderly cardiovascular patients
promoting their physical capacity. Further researches are needed to confirm this association as well to identify
other possible influences of dog ownership on the cardiovascular health and on the outcome in patients after myocardial
infarction
Mucins help to avoid alloreactivity at the maternal fetal interface
During gestation, many different mechanisms act to render the maternal immune system tolerant to semi-allogeneic trophoblast cells of foetal origin, including those mediated via mucins that are expressed during the peri-implantation period in the uterus. Tumour- associated glycoprotein-72 (TAG-72) enhances the already established tolerogenic features of decidual dendritic cells with the inability to progress towards Th1 immune orientation due to lowered interferon (IFN)- Ī³ and interleukin (IL)-15 expression. Mucine 1 (Muc 1) supports alternative activation of decidual macrophages, restricts the proliferation of decidual regulatory CD56(+) bright natural killer (NK) cells, and downregulates their cytotoxic potential, including cytotoxic mediator protein expression. Removing TAG-72 and Muc 1 from the eutopic implantation site likely contributes to better control of trophoblast invasion by T cells and NK cells and appears to have important immunologic advantages for successful implantation, in addition to mechanical advantages. However, these processes may lead to uncontrolled trophoblast growth after implantation, inefficient defence against infection or tumours, and elimination of unwanted immunocompetent cells at the maternal-foetal interface. The use of mucins by tumour cells to affect the local microenvironment in order to avoid the host immune response and to promote local tumour growth, invasion, and metastasis confirms this postulation
Regular Dog-Walking Improves Physical Capacity in Elderly Patients after Myocardial Infarction
Various positive effects of pet ownership on cardiovascular health are well known. The aim of this prospective and
controlled longitudinal study was to determine the effects of everyday dog-walking on physical capacity in elderly patients
during the first year after myocardial infarction. Regularly dog-walking for at least 15 minutes three times a day
is related to significantly higher work load on the bicycle exercise test (72.5 Ā± 10.75 versus 67.6 Ā± 11.6 W, p<0.05) in the
Ā»dog-walkingĀ« group (N=29, mean age 72.5 years) at 12 months compared to the control group (N=30, mean age 71.7
years). Our results suggest that dogs may help to maintain continuous physical activity in elderly cardiovascular patients
promoting their physical capacity. Further researches are needed to confirm this association as well to identify
other possible influences of dog ownership on the cardiovascular health and on the outcome in patients after myocardial
infarction
Regular Dog-Walking Improves Physical Capacity in Elderly Patients after Myocardial Infarction
Various positive effects of pet ownership on cardiovascular health are well known. The aim of this prospective and
controlled longitudinal study was to determine the effects of everyday dog-walking on physical capacity in elderly patients
during the first year after myocardial infarction. Regularly dog-walking for at least 15 minutes three times a day
is related to significantly higher work load on the bicycle exercise test (72.5 Ā± 10.75 versus 67.6 Ā± 11.6 W, p<0.05) in the
Ā»dog-walkingĀ« group (N=29, mean age 72.5 years) at 12 months compared to the control group (N=30, mean age 71.7
years). Our results suggest that dogs may help to maintain continuous physical activity in elderly cardiovascular patients
promoting their physical capacity. Further researches are needed to confirm this association as well to identify
other possible influences of dog ownership on the cardiovascular health and on the outcome in patients after myocardial
infarction
Patohophysiological and molecular bases of cognitive dysfunction in cancer patients
U suvremenoj znanstvenoj i struÄnoj literaturi sve je viÅ”e navoda o kognitivnim poremeÄajima u oboljelih od zloÄudnih bolesti koji mogu biti uzrokovani samim zloÄudnim procesom (smjeÅ”taj unutar srediÅ”njeg živÄanog sustava ili oÅ”teÄenje tkiva u sklopu paraneoplastiÄkog sindroma), njegovim lijeÄenjem (radioterapijom, kemoterapijom ili kirurÅ”kim tehnikama), genetskim Äimbenicima, infekcijom, anemijom, promjenama u imunoloÅ”kom sustavu, metaboliÄkim poremeÄajem i/ili nutritivnim deficitima. Mogu se pojaviti u ranoj fazi zloÄudne bolesti, neposredno prije njezinog otkrivanja ili zapoÄinjanja lijeÄenja, u tijeku lijeÄenja, a mogu trajati dugo nakon uspjeÅ”nog izljeÄenja. PoremeÄaji pamÄenja, uÄenja, koncentracije, raÄunanja ili razmiÅ”ljanja bilježe se u rasponu od blagih do vrlo teÅ”kih poremeÄaja, koji sliÄe presenilnoj demenciji. Kognitivni poremeÄaji za oboljele od zloÄudne bolesti predstavljaju znaÄajne smetnje zbog svog utjecaja na kvalitetu života, radnu sposobnost i druÅ”tvene aktivnosti, stoga se danas u svjetu podupiru istraživanja patofizioloÅ”kih mehanizama nastanka kognitivnih poremeÄaja u takvih pacijenata. Cilj je otkriti pacijente sa zloÄudnom boleÅ”Äu koji imaju poveÄanu sklonost razvoja kognitivnih poremeÄaja u Äasu postavljanja dijagnoze ili na samom poÄetku lijeÄenja na osnovi svoje genske predispozicije, kako bi se terapija zloÄudne bolesti mogla tome prilagoditi i po moguÄnosti sprijeÄiti posljedice kognitivnih oÅ”teÄenja. U ovom radu prikazujemo pregled literature i dosadaÅ”nje spoznaje o patofizioloÅ”kim i imunopatofizioloÅ”kim mehanizmima povezanosti zloÄudne bolesti i kognitivnih funkcija.Recent studies showed clear evidence of neurocognitive deficits in patients with malignant disease. Cognitive disorders in these patients may be due to the malignant tumor (localization in the CNS or tissue damage as a part of the paraneoplastic syndrome), its treatment, infection, anemia, immune, genetic and metabolic disorders, nutritional deficiency, or a combination of these and many other factors. The first studies on this topic have focused on cognitive dysfunction as a side effect of chemotherapy, but recent evidence shows that they can occur at any stage of the malignancy, even before diagnosis, during therapy and long time after succsessful cure. Learning, memorizing, concentration, thinking and other cognitive and psychomotor disturbances could vary from very mild to serious deficits like dementia. Cognitive dysfunction in cancer patients is an important issue, because of its impact on the everyday quality of life, especially in the working, cognitive and social activities. Although many previous studies on the subject found some role of various cytokines, genes and other factors, scientists agree that we are still far from complete explanation of complex etiology of cognitive impairment in patients with malignant diseases. The aim of those studies was to discover and prevent cognitive deterioration in vulnerable cancer patients.We present here the literature review and the findings on patophysiological and immunopatophysiological mechanisms of cognitive disfunctions in cancer patients
Patohophysiological and molecular bases of cognitive dysfunction in cancer patients
U suvremenoj znanstvenoj i struÄnoj literaturi sve je viÅ”e navoda o kognitivnim poremeÄajima u oboljelih od zloÄudnih bolesti koji mogu biti uzrokovani samim zloÄudnim procesom (smjeÅ”taj unutar srediÅ”njeg živÄanog sustava ili oÅ”teÄenje tkiva u sklopu paraneoplastiÄkog sindroma), njegovim lijeÄenjem (radioterapijom, kemoterapijom ili kirurÅ”kim tehnikama), genetskim Äimbenicima, infekcijom, anemijom, promjenama u imunoloÅ”kom sustavu, metaboliÄkim poremeÄajem i/ili nutritivnim deficitima. Mogu se pojaviti u ranoj fazi zloÄudne bolesti, neposredno prije njezinog otkrivanja ili zapoÄinjanja lijeÄenja, u tijeku lijeÄenja, a mogu trajati dugo nakon uspjeÅ”nog izljeÄenja. PoremeÄaji pamÄenja, uÄenja, koncentracije, raÄunanja ili razmiÅ”ljanja bilježe se u rasponu od blagih do vrlo teÅ”kih poremeÄaja, koji sliÄe presenilnoj demenciji. Kognitivni poremeÄaji za oboljele od zloÄudne bolesti predstavljaju znaÄajne smetnje zbog svog utjecaja na kvalitetu života, radnu sposobnost i druÅ”tvene aktivnosti, stoga se danas u svjetu podupiru istraživanja patofizioloÅ”kih mehanizama nastanka kognitivnih poremeÄaja u takvih pacijenata. Cilj je otkriti pacijente sa zloÄudnom boleÅ”Äu koji imaju poveÄanu sklonost razvoja kognitivnih poremeÄaja u Äasu postavljanja dijagnoze ili na samom poÄetku lijeÄenja na osnovi svoje genske predispozicije, kako bi se terapija zloÄudne bolesti mogla tome prilagoditi i po moguÄnosti sprijeÄiti posljedice kognitivnih oÅ”teÄenja. U ovom radu prikazujemo pregled literature i dosadaÅ”nje spoznaje o patofizioloÅ”kim i imunopatofizioloÅ”kim mehanizmima povezanosti zloÄudne bolesti i kognitivnih funkcija.Recent studies showed clear evidence of neurocognitive deficits in patients with malignant disease. Cognitive disorders in these patients may be due to the malignant tumor (localization in the CNS or tissue damage as a part of the paraneoplastic syndrome), its treatment, infection, anemia, immune, genetic and metabolic disorders, nutritional deficiency, or a combination of these and many other factors. The first studies on this topic have focused on cognitive dysfunction as a side effect of chemotherapy, but recent evidence shows that they can occur at any stage of the malignancy, even before diagnosis, during therapy and long time after succsessful cure. Learning, memorizing, concentration, thinking and other cognitive and psychomotor disturbances could vary from very mild to serious deficits like dementia. Cognitive dysfunction in cancer patients is an important issue, because of its impact on the everyday quality of life, especially in the working, cognitive and social activities. Although many previous studies on the subject found some role of various cytokines, genes and other factors, scientists agree that we are still far from complete explanation of complex etiology of cognitive impairment in patients with malignant diseases. The aim of those studies was to discover and prevent cognitive deterioration in vulnerable cancer patients.We present here the literature review and the findings on patophysiological and immunopatophysiological mechanisms of cognitive disfunctions in cancer patients
Perforin Expression after Acute Myocardial Infarction ā A Pilot Study
Perforin is an important mediator of inflammatory reactions. It is a quick-action cytotoxic mediator accumulated in
the cytoplasmic granules of effector immunity cells (T lymphocytes, NK and NKT cells) which provide death signal in infected
or transformed cells. Perforin-positive cells were previously detected in myocardial tissue during Trypanosoma
cruzi infection and viral myocarditis while its role in chronic and progressive cardiovascular inflammatory disease such
as atherosclerosis is almost completely unexplored. The perforin activity is also untested during acute coronary events
that represent unexpected atherosclerotic complications due to the inflammatory destabilisation and atherosclerotic plaque
rupture. The aim of this study was to investigate the presence of perforin, an important immunological inflammatory
molecule in peripheral blood lymphocytes during the early period after acute myocardial infarction. We analyzed three
subject groups: women with ST-segment elevation acute myocardial infarction (STEMI) treated with primary percutaneous
coronary intervention (PCI), conservatively treated women with acute myocardial infarction without ST-segment
elevation (NSTEMI) and a control group of healthy volunteers. The STEMI and NSTEMI groups did not basically differ
in medication neither in levels of routine laboratory tests, while troponin I were significantly higher in the STEMI
group. In the study, we detected an early decrease of perforin-positive lymphocytes in STEMI patients that were in contrast
with their persisting elevation among NSTEMI patients. Despite greater myocardial necrosis in the STEMI group,
results of this pilot-study indicated the prolonged perforin-mediated inflammatory response in patients with NSTEMI.
This perforin down-regulation that follows the coronary interventional reperfusion in STEMI emphasized the possible
anti-inflammatory role of primary PCI among patients with acute myocardial infarction. Given that the issue of routine
primary PCI in NSTEMI is nowadays highly topical, the results we expect in the wake of this pilot study could demonstrate
a significant impact on clinical practice. Further research is needed to confirm these results, compare the perforin-
mediated activity to other inflammatory mediators in acute coronary events and to examine their impact on the
long-term outcome
Endothelial dysfunction in sepsis
U fizioloÅ”kim uvjetima, endotel predstavlja dinamiÄku strukturu važnu u održavanju tonusa krvnih žila, regulaciji protoka krvi uz stijenke krvnih žila, vaskularne propusnosti, puteva zgruÅ”avanja i adhezije leukocita. U sepsi, djelovanjem patogena i njihovih topljivih Äimbenika dolazi do aktivacije endotela, oÅ”teÄenja endotelnog glikokaliksa (EG) te pokretanja brojnih mehanizama koji imaju kljuÄnu ulogu u razvoju i progresiji sepse. Nadalje, disfunkcija endotela i oÅ”teÄenje EG ima za posljedicu snažni proupalni, prokagulacijski, proadhezivni i proapoptotiÄni odgovor koji dovodi do disregualacije vaskularnog tonusa, poveÄane propusnosti krvnih žila, poveÄane adhezije i migracije leukocita uzrokujuÄi razvoj Å”oka i viÅ”eorganskog zatajenja. U ovom preglednom radu prikazani su struktura i funkcija endotela i EG, opisani su mehanizmi njihovoga oÅ”teÄenja tijekom sepse te posljedice koje nastaju njihovom disfunkcijom. Nadalje, iznijete su do sada poznate Äinjenice o metodama detekcije endotelne disfunkcije te moguÄnostima njenog lijeÄenja u sepsi s ciljem unapreÄenja lijeÄenja septiÄnih bolesnika.Under physiological conditions, the endothelium is a dynamic structure important for maintaining blood vessel tone, regulating blood flow along vessel walls, vascular permeability, coagulation pathways, and leukocyte adhesion. In sepsis, exposure to pathogens and their soluble factors leads to activation of the endothelium, damage to the endothelial glycocalyx (EG), and initiation of numerous mechanisms that play a key role in the development and progression of sepsis. In addition, endothelial dysfunction and damage to the EG result in a potent proinflammatory, procoagulant, proadhesive, and proapoptotic response, leading to dysregulation of vascular tone, increased vascular permeability, increased leukocyte adhesion and migration, and the development of shock and multiorgan failure. In this review, the structure and function of the endothelium and EG are summarized and the mechanisms of their damage during sepsis as well as the consequences of their dysfunction are described. In addition, available knowledge about the methods of detecting endothelial dysfunction and the
possibilities of its treatment in sepsis are presented, with the aim of improving the treatment of septic patients
The estimation of anemia degree in patients after heart valve replacement and coronary artery bypass surgery
Cilj: Utvrditi prisutnost, vrstu i stupanj anemije u bolesnika nakon operacije zamjene
srÄanih zalistaka i aortokoronarnog premoÅ”tenja tijekom prva tri tjedna rane stacionarne medicinske
rehabilitacije. Ispitanici i postupci: Podaci su dobiveni analizom medicinske dokumentacije
na temelju odobrenja EtiÄkog povjerenstva Specijalne bolnice za medicinsku rehabilitaciju
bolesti srca, pluÄa i reumatizma āThalassotherapia ā Opatijaā iz Opatije u skladu sa
svim primjenjivim smjernicama Osnova dobre kliniÄke prakse i HelsinÅ”ke deklaracije. Istraživanje
je obuhvatilo 145 bolesnika s aortokoronarnim premoŔtenjem i 67 bolesnika sa zamijenjenim
srÄanim zaliskom. Obje skupine podijeljene su na skupinu muÅ”karaca i žena, a rezultati usporeÄivani
sa zdravim ispitanicima koriŔtenjem neparametrijskih testova Kruskal-Wallis i
Mann-Whitneyjeva U-testa. Rezultati: U skupini žena i muÅ”karaca nakon operacije zamjene srÄanih
zalistaka i nakon uÄinjenog aortokoronarnog premoÅ”tenja broj eritrocita, koncentracija
hemoglobina i hematokrit statistiÄki su znaÄajno sniženi (sva tri P < 0,001) u odnosu na skupinu
zdravih ispitanika, no nismo utvrdili znaÄajnu razliku u hematoloÅ”kim indeksima izmeÄu navedenih
skupina. Rasprava: U ispitivanih bolesnika postoje promjene u eritrogramu u smislu
smanjenja broja normokromnih i normocitnih eritrocita, iako promjene nisu dostatne za proglaŔenje
anemije. Zbog poznate poveÄane stope smrtnosti od anemije u srÄanih bolesnika potrebno
je tragati za razvojem anemije, procjenjivati stupanj i odrediti njezin uzrok, s ciljem pravovremenog
i odgovarajuÄeg lijeÄenja. ZakljuÄak: Radi se o stanju koje se relativno
jednostavno može lijeÄiti preparatima željeza i vrlo oprezno lijekovima koji potiÄu eritrocitopoezu
u bolesnika sa zatajivanjem bubrežne funkcije, Å”to može sprijeÄiti ili smanjiti potrebu za
transfuzijama deplazmatiziranih eritrocita, koje u srÄanih bolesnika nose viÅ”e neželjenih reakcija.Aim: To determine the presence, type and degree of anemia in patients after heart
valve replacement and coronary artery bypass grafting during the first three weeks of early
stationary medical rehabilitation. Patients and methods: Data were obtained by analyzing
medical records of the subjects following the approval of the Ethics Committee of Special hospital
for medical rehabilitation of heart, lungs and rheumatism āThalassotherapy ā Opatijaā
from Opatija in accordance with all applicable guidelines in basics of good clinical practice and
the Declaration of Helsinki. Research included 145 patients with coronary artery bypass and
67 patients with heart valve replacement. Both groups were divided into a group of men and
women, and the results were compared with healthy subjects using nonparametric Kruskal-
Wallis and Mann-Whitney U test. Results: In the group of women and men after heart valve
replacement surgery and coronary artery bypass grafting the number of erythrocytes, hemoglobin
concentration and hematocrit were significantly decreased compared to the control
group (all P < 0,001), but no significant difference in hematological indexes were found. Discussion: In patients under observation there are changes
in erythrogram in reducing the number of normochrome and
normocyte erythrocytes, although the changes are not profound
to declare the anemia. Because of the known increased
mortality rates of anemia in cardiac patients, we should look
for anemia, evaluate and determine its cause, in order to provide
appropriate treatment in time. Conclusions: It is a condition
that can be treated relatively easily with iron and very
cautiously with drugs stimulating erythropoesis, particularly
in patients with kidney insufficiency. It can prevent or decrease
need for blood transfusions, which carry more side effects
in cardiac patients
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