22 research outputs found
Acupuncture for Headache Treatment - Therapy or Placebo?
Akupunktura je starokineska metoda lijeÄenja s pomoÄu igala koje se zabadaju u toÄno odreÄene toÄke na koži. PoÄela se primjenjivati u Kini, a prva knjiga u kojoj se opisuje datira iz 475. godine pr. Kr. Godine 1979. Svjetska zdravstvena organizacija sastavila je listu od 43 bolesti u kojima se akupunktura pokazala korisnom. Na konferenciji National Institute of Health održanoj 1997. godine pregledano je viÅ”e od 2000 znanstvenih studija o temi akupunkture te je zakljuÄeno da postoje dokazi koji podupiru primjenu akupunkture kao adjuvantne metode lijeÄenja. Postoji nekoliko razliÄitih teorija o mehanizmima djelovanja akupunkture. Studije sugeriraju da akupunktura dovodi do inhibicije transmisije boli u srediÅ”nji živÄani sustav stimulacijom aferentnih A-delta i C-vlakana te dovodi do neuromodulacije. TakoÄer dovodi do otpuÅ”tanja antialgogenih tvari ukljuÄujuÄi endorfine. Akupunktura je iznimno sigurna metoda. NajÄeÅ”Äe su nuspojave blage i ukljuÄuju manje modrice ili krvarenje na mjestu uboda, pogorÅ”anje postojeÄih simptoma, pospanost, opuÅ”tanje ili euforiju (koja se Äesto doživljava kao neÅ”to ugodno) i bol na mjestu uboda igle. Godine 2016. objavljeni su u Cochraneovoj bazi pregledni radovi koji su potvrdili uÄinkovitost akupunkture u profilaksi epizodiÄne tenzijske i migrenske glavobolje. Neupitno je da je akupunktura metoda stara 5000 godina i da se i dalje primjenjuje u terapiji razliÄitih bolnih sindroma te je predmet izuÄavanja mnogih studija, za razliku od brojnih farmakoloÅ”kih i nefarmakoloÅ”kih metoda koje su bile jako popularne nekoliko godina ili desetljeÄa te su zatim potpuno izbaÄene iz primjene zbog nedjelotvornosti i nuspojava.Acupuncture is an old Chinese method of treatment with needles that are inserted into designated areas on the skin. The practice of acupuncture began in China and the first book describing the treatment dates back to 475 BC. In 1979 the World Health Organization created a list of 43 diseases that may benefit from acupuncture. After more than 2,000 scientific studies concerning acupuncture were reviewed at the National Institute of Health conference held in 1997, it was concluded that there were sufficient evidence supporting the use of acupuncture as an adjuvant treatment method. Several different theories about the mechanism of action have been identified for acupuncture. Studies suggested that acupuncture could result in inhibition of pain transmission to the central nervous system by stimulation of afferent A-delta and C fibres, as well as in neuromodulation. Acupuncture also facilitates the release of anti-algal agents, including endorphins. It is an extremely safe method of treatment if performed by adequately trained practitioners. The most common side effects are mild and include the following: minor bruising or bleeding where the needles puncture the skin, worsening of pre-existing symptoms, drowsiness, relaxation or euphoria (often experienced as a pleasant feeling) and pain where the needles puncture the skin. The 2016 Cochrane Database of Systematic Reviews includes reviews that demonstrate the effectiveness of acupuncture for the prophylaxis of episodic tension-type headaches (TTH) and migraines. Acupuncture is undoubtedly a 5000-year-old method that continues to be used in the treatment of various pain syndromes. It is the subject-matter of numerous studies, unlike other pharmacological and non-pharmacological methods whose popularity lasted a few years or decades until their complete discontinuation in clinical practice due to their ineffectiveness and adverse effects
Parkinsonās Disease ā Challenges in New Drug Development
Idiopathic Parkinsonās disease (IPD) is the second most common neurodegenerative disorder after Alzheimerās disease.
Treatment aims in IPD include the provision of symptomatic relief, reduction of functional disability, halting or
slowing of the neurodegenerative process, and the prevention of long-term complications by proper initiation of therapy.
At present, pharmacotherapeutic strategies allow the amelioration of motor symptoms of IPD only, whereas non-motor
manifestations are not helped by dopamine replacement strategies. In addition, levodopa-induced fluctuation and dyskinesia
are still challenging, particularly in long-term treatment. Despite advances in pharmacotherapy that have improved
quality of life for these patients, the mortality rate remains largely unchanged. Sustained interest in IPD will
hopefully allow increased funding of research to develop new and better treatments
Translation of the HeadacheAttributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire into the Croatian language, and its diagnostic validation
Despite increasing awareness promoted by the Global
Campaign against Headache (1,2) and the Global Burden
of Disease (GBD) study (3-5), knowledge and understanding of the burdens attributable to headache disorders remain incomplete in many countrie
Je li kardioloÅ”ka rehabilitacija korisna u bolesnika s koronarnom boleÅ”Äu starijih od sedamdeset godina?
Elderly patients with coronary heart disease (CHD) are frequently not referred to cardiac rehabilitation programs. The aim of the study was to assess the effect of 3-week inpatient cardiac rehabilitation in CHD patients older than seventy. The study included 103 consecutive CHD patients older than 70 who underwent 3-week inpatient rehabilitation. A history of myocardial infarction was recorded in 77% of patients, whereas 23% had previously undergone coronary artery bypass surgery. The patients who could not perform exercise test or those with congestive heart failure were not included in the study. Functional capacity, lipid profile, blood glucose, body weight and body mass index were determined before and at the end of rehabilitation. After 3-week inpatient cardiac rehabilitation, functional capacity markedly improved (p<0.0001). The levels of cholesterol (p<0.0001), triglycerides (p=0.01), LDL-cholesterol (p<0.0001) and blood glucose (p=0.004) were significantly lower in comparison with initial values. There were no significant differences in HDL-cholesterol, body weight and body mass index between initial values and those measured at the end of rehabilitation. Results of the study suggest that elderly patients with CHD benefit from cardiac rehabilitation and should be routinely referred to cardiac rehabilitation and encouraged to attend these programs.Bolesnici s koronarnom boleÅ”Äu starije životne dobi Äesto se ne upuÄuju na kardioloÅ”ku rehabilitaciju. Cilj ovoga rada bio je procijeniti uÄinak trotjedne stacionarne kardioloÅ”ke rehabilitacije u bolesnika s koronarnom boleÅ”Äu starijih od 70 godina. U studiju je bilo ukljuÄeno 103 uzastopnih bolesnika starijih od 70 godina tijekom trotjedne stacionarne kardioloÅ”ke rehabilitacije. Infarkt miokarda bilo je preboljelo 77% bolesnika, dok ih je 23% bilo prethodno podvrgnuto kirurÅ”koj revaskularizaciji miokarda. Bolesnici koji nisu mogli izvesti ergometrijsko testiranje ili oni s kongestivnim srÄanim popuÅ”tanjem nisu bili ukljuÄeni u studiju. Funkcionalni kapacitet, lipidogram, razina glukoze u krvi, tjelesna težina i indeks tjelesne mase mjereni su prije te odmah nakon zavrÅ”etka rehabilitacije. Nakon trotjedne kardioloÅ”ke rehabilitacije funkcionalni se kapacitet znaÄajno poboljÅ”ao (p<0,0001). Razine kolesterola (p<0,0001), triglicerida (p=0,01), LDL-kolesterola (p<0,0001) i glukoze u krvi (p=0,004) bile su znaÄajno niže u odnosu na poÄetne vrijednosti. Nije bilo znaÄajne razlike u razini HDL-kolesterola, tjelesnoj težini i indeksu tjelesne mase na kraju rehabilitacije u odnosu na poÄetne vrijednosti. Rezultati ovoga rada pokazali su da kardioloÅ”ka rehabilitacija koristi bolesnicima s koronarnom boleÅ”Äu starijim od 70 godina, te da ih treba rutinski upuÄivati i poticati na provoÄenje ovih programa
The Effect of 3-Weeks Stationary Cardiac Rehabilitation on Plasma Lipids Level in 444 Patients with Coronary Heart Disease
The aim of this study was to investigate the effect of 3- weeks stationary cardiac rehabilitation on plasma lipids level in patients with CHD. The study included 444 consecutive patients (364 male and 80 female, mean age 58Ā±9 year) with CHD who underwent 3-weeks stationary cardiac rehabilitation. Patients were divided into groups depending on their baseline levels of cholesterol and medication therapy: patients with normal ( 5 mmol/L, group II, 315 patients) and subgroups Ia and IIa (with statin in therapy), Ib and IIb (without statin in therapy). After 3-weeks cardiac rehabilitation, the levels of Total cholesterol 5.75Ā±1.34 vs. 5.17Ā±1.08 mmol/l; p<0.001, triglycerides 2.04Ā±1.33 vs. 1.81Ā±1.06 mmol/L; p=0.004, LDL-cholesterol 3.77 Ā±1.14 vs. 3.21Ā±0.96 mmol/L; p<0.001 were significantly lower while the level of HDL- cholesterol 0.94Ā±0.28 vs. 0.99Ā±0.27 mmol/L; p=0.008 were significantly higher in comparison with the baseline values. Furthermore, we found significant changes in lipid profile at the end of rehabilitation in each group of patients compared with the baseline values. There were no significant differences in plasma lipids level between group of patients with or without statin in therapy at the end of rehabilitation. The results of this study suggest that moderate regular physical activity and diet alone or in combination with hypolipidemic drugs already after 3 weeks have a favourable effect on plasma lipids level and should be propagate in the prevention of CHD
Diagnostic Criteria and Classification of Migraine
Migrena je primarna, funkcionalna, periodiÄna, srednje jaka do jaka glavobolja koja nelijeÄena traje izmeÄu 4 do 72 sata. Äesto je praÄena muÄninom i/ili povraÄanjem, fotofobijom i fonofobijom, a za nju je karakteristiÄno pogorÅ”anje simptoma tijekom fiziÄke aktivnosti. EpidemioloÅ”ki podatci nedvojbeno pokazuju da je migrena Äesta bolest s prevalencijom oko 14 % u opÄoj populaciji. Važno je istaknuti da je broj dijagnosticiranih bolesnika Äesto podcijenjen. Razlozi tomu mogu biti relativno rijetko pojavljivanje napadaja zbog kojih se oboljeli ne javlja lijeÄniku obiteljske medicine ili neurologu, loÅ”e uzeta anamneza te druge dijagnostiÄke poteÅ”koÄe. TakoÄer, neophodno je naglasiti znatan socioekonomski aspekt migrene. Migrena je velik troÅ”ak druÅ”tvu u cjelini, uzimajuÄi u obzir njezinu uÄestalost te Äinjenicu da znatan udio bolesnika s migrenom obiÄno ne može normalno funkcionirati za vrijeme trajanja napadaja. BuduÄi da se radi o bolesti u kojoj se dijagnoza postavlja na temelju detaljno uzete anamneze i kliniÄke slike, MeÄunarodno druÅ”tvo za glavobolje objavilo je meÄunarodnu klasifikaciju glavobolja te ju revidiralo zadnji put 2018. Detaljno poznavanje te klasifikacije neophodno je za svakodnevnu kliniÄku praksu.Migraine is a primary, functional and recurrent moderate to severe headache which, when untreated, lasts 4-72 hours. It is often associated with nausea and/or vomiting, photophobia and phonophobia. The symptoms of migraine are characteristically aggravated by physical activity. Epidemiological data undoubtedly show that migraine is a common disease with a prevalence of around 14% in the general population. It is important to point out that the number of diagnosed patients is often underestimated. This might be due to the relatively rare occurrence of migraine attacks which do not prompt the patient to consult their family physician or a neurologist, inefficient past patient history taking or other diagnostic difficulties. Furthermore, it is necessary to emphasize the significant socioeconomic aspects of migraine. Migraine is a great burden to society as a whole, considering its frequency and the fact that a considerable portion of patients with migraine cannot function normally during an attack. Since migraine is a disease which is diagnosed based on taking a detailed patient history and clinical presentation, the International Headache Society published The International Classification of Headache Disorders, the latest edition of which dates from 2018. A detailed knowledge of this classification is essential for everyday clinical practice
Povezanost apolipoproteina E Īµ2 s kasnijim poÄetkom epilepsije temporalnog režnja
The aim of the study was to evaluate the possible association between Apo E polymorphisms and age at seizure onset in patients with non-lesional temporal lobe epilepsy. Eighty patients with non-lesional temporal lobe epilepsy with or without bilateral tonic-clonic propagation were analyzed. Age at seizure onset was defined as age at the first unequivocal seizure (excluding febrile convulsions). ApoE alleles were determined by a procedure where genome DNA was amplified by chain reaction along with polymerase, using the LightCycler kit (Roche) for ApoE mutations on codons 112 and 158. There was a statistically significant difference between the groups of patients with ApoE Īµ2/3 and Īµ3/4 genotypes (p=0.03), but not between patients with ApoE Īµ2/3 and Īµ3/3, and those with ApoE Īµ3/4 and Īµ3/3. In conclusion, the results of our study suggested positive association of a specific ApoE genotype and onset of non-lesional temporal lobe epilepsy.Cilj ovoga istraživanja bio je utvrditi moguÄu povezanost genskog polimorfizma ApoE s dobno ranijim poÄetkom bolesti kod bolesnika s epilepsijom temporalnog režnja i negativnim nalazom magnetske rezonancije mozga. U istraživanje je bilo ukljuÄeno 80 bolesnika s epilepsijom temporalnog režnja i negativnim nalazom magnetske rezonancije mozga. Dob poÄetka bolesti definirana je kao dob pojavnosti prvog neprovociranog epilepsijskog napadaja (iskljuÄujuÄi febrilne konvulzije). ApoE aleli su odreÄeni postupkom pri kojem je genomska DNA amplificirana lanÄanom reakcijom uz polimerazu, a koriÅ”ten je detekcijski kit LightCycler (Roche) za mutacije ApoE na kodomu112 i 158. UtvrÄena je znaÄajna statistiÄka razlika izmeÄu skupina bolesnika s genotipom ApoE Īµ2/3 i Īµ3/4 (p=0,03), dok izmeÄu bolesnika s ApoE Īµ2/3 i Īµ3/3 i onih s ApoE Īµ3/4 i Īµ3/3 nije bilo znaÄajne statistiÄke razlike. Rezultati istraživanja ukazuju na moguÄu povezanost specifiÄnog genotipa ApoE i dobi poÄetka bolesti kod bolesnika s epilepsijom temporalnog režnja i negativnim nalazom magnetske rezonancije mozga