Hyponatremia in chronic heart failure

Hiponatrijemija je biljeg povećanog rizika za neželjeni ishod u bolesnika s kroničnim srčanim zatajivanjem i klinički parametar koji u rutinskom radu zahtjeva posebnu pažnju. Uz terapijske opcije među kojima raspolažemo restrikcijom unosa tekućine, primjenom hipertonične otopine NaCl, diuretika Henleove petlje, ACE-inhibitora, antagonista AVP-receptora i njihovim kombinacijama, uz mnogobrojna otvorena pitanja, sada se ključnim nameće detaljna procjena bolesnika i individualna prilagodba terapijskog pristupa. Hipovolemijska hiponatrijemija samo je jedna od značajnih inačica ovog kliničkog stanja o kojoj moramo voditi računa pri liječenju. Očekuju se rezultati novih prospektivnih, dvostruko slijepih i placebom kontroliranih studija za konačno definiranje otvorenih pitanja unutar ovog iznimno značajnog područja suvremene kardiološke prakse.Hyponatremia is a marker of increased risk for adverse outcome in patients with chronic heart failure and a clinical parameter that requires special attention in routine practice. In addition to the treatment options including the restriction of fluid intake, by administering hypertonic saline, loop diuretics, ACE-inhibitors, antagonists of AVP-receptors and combinations thereof, in addition to numerous open questions, now the detailed assessment of patients and individual adaptation of the therapeutic approach is imposed as a crucial issue. Hypovolemic hyponatremia is just one of the most significant versions of this clinical condition which we have to take into account during the treatment. The results of new prospective, double-blind and placebo-controlled studies are expected as to finally define the open issues within this extremely important area of contemporary cardiology practice

Život na zelenom otoku: intervju s prim. dr. sc. Sinišom Carem

Poznat po široku osmijehu, cijenjen i uvijek rado viđen, ostvaren na stručnom i znanstvenom polju, kardiolog koji je razvio trajnu elektrostimulaciju u Varaždinu, uz doktorat znanosti i primarijat, nastavnik i erudit, dr. Siniša Car izazvao je veliku pozornost hrvatskih medija kada se odazvao apelima za preuzimanje ordinacije obiteljske medicine na otoku Mljetu. Iako su mnogi bili iznenađeni, a sama je vijest poprimila pomalo senzacionalistički karakter, veliki broj prijatelja i znanaca dr. Cara doživio je potez logičnim i na neki način očekivanim

Znanje dostupno svima – smjernice Europskoga kardiološkog društva

Europsko kardiološko društvo (European Society of Cardiology – ESC) stručna je i znanstvena organizacija posvećena trajnom unaprjeđenju kardiovaskularne prakse zasnovane na dokazima. ESC okuplja nacionalna kardiološka društva i s iznimnom uspješnošću potiče sve ključne elemente u razvoju suvremene kardiologije. Posvećenost znanju jedno je od ključnih opredjeljenja ESC-a pa se na mrežnim stranicama društva mogu potpuno besplatno preuzeti integralni tekstovi svih smjernica te drugi korisni edukativni materijali

Weight Loss and Maintenance in Overweight and Obese Patients with Cardiovascular Disease

We assessed 87 overweight and obese patients with cardiovascular disease in order to explore the weight change over time, and related psychological, behavioural and environmental variables. After hospitalisation, all patients received recommendations for decreased calorie intake combined with physical activity. All of them were contacted for a follow-up after 6 to 23 months in person (N = 43) or in a telephone interview (N = 44). Results show that patients who attended the follow-up in person increased their weight significantly less and maintained their body weight more successfully in comparison with the group of patients contacted over telephone. In the present study, the most desirable techniques for weight reduction seem to be the low calorie diet and exercise. However, the level of attendance at received recommendations for dieting and exercise was not satisfactory. Patients reported different reasons that interfered with their weight loss attempt, such as problems at work or financial problems. We have discussed the necessity of continued contact and support for patients in the period of loss and maintenance of weight loss, considering their psychological, behavioural and environmental problems, and particularities

CARDIAC REHABILITATION : PREPARATION AND TRAINING FOR PERMANENT SECONDARY PREVENTION

Kardiovaskularne bolesti vodeći su uzrok smrti u razvijenom svijetu i najvažniji javnozdravstveni problem. U ovom članku predstavljamo odrednice, protokole, kliničku cjelovitost i važnost kardiološke rehabilitacije i sekundarne kardiološke prevencijeCardiovascular diseases are the leading cause of death in developed societies, representing the most important public health problem. In this article, we are presenting the background, protocols, implementation and importance of cardiac rehabilitation and secondary cardiac preventio