The H1N1 Influenza Pneumonia as Early Complication after Heart Transplantation – Experience from the Dubrava University Hospital, Zagreb, Croatia

In April 2009, a novel influenza A (H1N1) virus was initially detected, and only after two monthsWorld Health Organization declared pandemic, while virus became globally present. We report here a confirmed case of patient suffering from H1N1 influenza pneumonia in an early period after heart transplantation. Complications of influenza A and B include viral pneumonia, secondary bacterial pneumonia and possibly acute allograft rejection in the setting of weaning of immunosuppression. In our case H1N1 influenza pneumonia was treated according to the published guidelines and had a mild course of disease, but nevertheless emphasis should be put on the prevention of disease applying known general infection control procedures and vaccination while disease course cannot be predicted

Prevalence of the Metabolic Syndrome in the Old Institutionalized People in Zagreb, Croatia

Metabolic syndrome (MeS) is defined by a cluster of abnormalities comprising obesity, hypertension, carbohydrate intolerance and dyslipidemia. MeS increases the risk of developing various diseases, including coronary heart disease, stroke, peripheral angiopathy and type 2 diabetes1,2. In our study, the subjects were 561 persons, residents of 11 homes for the elderly in Zagreb, Croatia. There were 160 men (28,5%) and 401 women (71.5%), aged from 56 to 96 years (the average being 79 years). Physical examination was conducted, which included blood pressure measurement, and body height and weight. Blood samples were taken for biochemical analysis. Along with other biochemical parameters, the levels of glucose, triglycerides and cholesterol (LDL, HDL-C) were also measured. The results have shown the prevalence of MeS in the elderly instutionalised people to be in the range of 20.8%, according to WHO criteria. The most common MeS component was hypertension, and it was significantly more frequent in women than in men; also, the elevated triglyceride levels were more often found in women; the difference between men and women was also statistically significant. MeS is a serious and growing health problem not only in Croatia but worldwide as well. Further studies are needed to verify the prevalence of MeS in Croatia, as it is a major risk for CVD and many other severe diseases

Thrombosis of bare metal and patent drug eluting stent in patient operated for colorectal carcinoma: the utility of new guidelines in patients with malignancy

Percutaneous coronary intervention with stent placement is widely used to achieve revascularization of the myocardium, especially in acute coronary syndrome. There is increasing number of reports published concerning stent thrombosis both in bare metal stents as in drug eluting stents. According to the newest ACC/AHA/SCAI 2007th guidelines, bare-metal stent or balloon angioplasty is recommended as an optimal solution if surgery is to be performed in 6-12 months time after stent placement. We present a case of a 56-year-old male with colon carcinoma who suffered from post-operational myocardial infarction due to bare metal stent thrombosis, while the drug eluting stent remained patent. Currently, in our opinion, high level evidence is lacking in the literature in support for recommendations published in current ACC, AHA and SCAI 2007th guidelines regarding the choice of stent, antiaggregation and anticoagulation therapy. This case, together with others previously published suggests a need for development of an applicable strategy for selection and treatment of patients with increased perioperative risk of in-stent thrombosis in order to ensure optimal medical treatment