Korelacija arterijskih kalcifikacija dojke na mamogramu s čimbenicima rizika povezanim s načinom žiovta

The aim of the study was to investigate the association between some lifestyle-attributable risk factors of atherosclerosis, such as body mass index (BMI), oral contraceptives, hormone replacement therapy, smoking and alcohol consumption with breast arterial calcification (BAC) and its intensity on mammograms, and to assess the impact of these lifestyle risk factors on mammography findings of BAC. This prospective study included 300 women aged 47-69, i.e. a group of 149 women with BAC on mammograms and control group of 151 women without BAC. Self-reported BMI, use of oral contraceptives, hormone replacement therapy, smoking and alcohol consumption were recorded by medical interview. The presence of BAC and its intensity on mammography was compared according to the presence of high BMI and use of hormone therapy, smoking and alcohol consumption. The results showed the highest proportion of smokers (28.9%) in the group with mild BAC as compared with the groups without calcification (14.6%) and with intense calcification (12.1%). Women taking oral contraceptives had a higher level of calcified breast arteries but no significant between-group difference was found for high BMI, hormone therapy and alcohol consumption. Thus, study results showed the mammographic finding of BAC to be inadequate to identify women with some lifestyle-attributable risk factors such as BMI, hormone replacement therapy, smoking and alcohol consumption.Istraživala se povezanost određenih čimbenika rizika ateroskleroze povezanih s načinom života poput indeksa tjelesne mase (ITM), uzimanja oralnih kontraceptiva, hormonske nadomjesne terapije, pušenja i konzumiranja alkohola s arterijskim kalcifikacijama dojke i njihovim stupnjem intenziteta na mamografiji. Ova prospektivna studija je uključila 300 žena u dobi od 47 do 69 godina, od kojih je skupina od 149 žena imala arterijske kalcifikacije dojki na mamografiji, a druga kontrolna skupina od 151 žene je bila bez arterijskih kalcifikacija. Medicinskim intervjuom dobiveni su podaci o tjelesnoj težini i visini ispitanica, prema kojima se izračunao ITM te anamnestički podaci o prethodnoj uporabi oralnih kontraceptiva, hormonske nadomjesne terapije, pušenju i konzumiranju alkohola. Uspoređen je nalaz arterijskih kalcifikacija dojki i njihovog stupnja na mamografiji s ITM-om i uporabom hormonske terapije te pušenjem i konzumiranjem alkohola. U skupini žena s blažim kalcifikacijama dojki bio je najveći udio pušača (28,9%) u odnosu na skupinu bez kalcifikacija (14,6%) ili skupinu s intenzivnim kalcifikacijama (12,1%). Rezultati su pokazali statistički značajnu povezanost arterijskih kalcifikacija dojki s oralnom kontracepcijom, dok nije nađena statistički značajna povezanost između arterijskih kalcifikacija dojki na mamogramu i uporabe hormonske nadomjesne terapije, ITM-a, pušenja i konzumiranja alkohola. Dakle, mamografski nalaz arterijskih kalcifikacija dojki nije dostatan za identificiranje žena s nekim čimbenicima rizika ateroskleroze povezanim s načinom života, odnosno nalaz istih na mamogramu ne upućuje na čimbenike rizika na koje se može utjecati, kao što su visok ITM, uporaba hormonske terapije, pušenje i konzumiranje alkohola

Magnetska rezonancija u dijagnostici zloćudnih tumora maksilofacijalnog područja

Magnetic resonance imaging (MRI) is a radiological imaging method that has not yet found routine application in the detection and assessment of malignant tumors of the maxillofacial region. The aim of this study was to evaluate MRI in the detection, diagnosis and differential diagnosis of malignant tumors of the maxillofacial region. This prospective study included 42 patients with clinically confirmed malignant tumors of the maxillofacial region. All patients were examined by MRI. This imaging method was evaluated for the ability to detect tumor location and to analyze dimensions and structure of the tumor, bone involvement, effect on neurovascular structures and extension to soft tissues. MRI results were compared with histopathologic and intraoperative findings as the ‘gold standard’ methods. MRI identified all of the clinically confirmed tumors. The sensitivity for tumor location was 94.4%, tumor necrosis 93%, hemorrhage 93.3% and bone involvement 91.4%. The specificity for tumor location was 84%, tumor necrosis 92.8%, hemorrhage 92.8% and bone involvement 85.7%. In the evaluation of soft tissue tumor extension to bone structures, MRI sensitivity and specificity was 94.4% and 88.2%, respectively. The sensitivity for perineural infiltration and tumor involvement of vascular structures was 91% and 91.6%, respec-tively. The specificity for perineural infiltration was 96.7% and for tumor involvement of vascular structures 88%. MRI sensitivity and specificity for intracranial extension, intraorbital propagation, extension to pterygopalatine fossa and other surrounding anatomic spaces was 93.5% and 90.9%, respectively. MRI proved advantageous for the ability to distinguish neurovascular structures from adjacent soft tissues without the use of intravenous contrast media. Study results demonstrated MRI to provide valuable information in the analysis of tumor structure, bone involvement and extension to soft tissues of malignant tumors of the maxillofacial region.Magnetska rezonancija (MRI) je radiologijska slikovna metoda koja još uvijek nije pronašla rutinsku primjenu u otkrivanju i procjeni malignih tumora maksilofacijalnog područja. Svrha ove studije je bila pokazati vrijednost MRI u otkrivanju, dijagnostici i diferencijalnoj dijagnostici malignih tumora maksilofacijalnog područja. Ova prospektivna studija uključila je 42 bolesnika s klinički potvrđenim zloćudnim tumorom maksilofacijalnog područja. Svi bolesnici su bili obrađeni pomoću MRI. Analizirala se lokalizacija, dimenzije i struktura tumora, zahvaćenost koštanih struktura, utjecaj naneurovaskularne strukture, proširenost na okolne mekotkivne strukture i prostore. Rezultati su se uspoređivali s patohistologijskim i intraoperacijskim nalazom kao „zlatnim“ standardom. MRI je prikazao sve klinički potvrđene tumore. U procjeni lokalizacije tumora osjetljivost je bila 94,4%; zone nekroze 93%; zone krvarenja 93,3%; te promjene koštane strukture 91,4%. U procjeni lokalizacije tumora specifičnost je bila 84%; zone nekroze 92,8%; zone krvarenja 92,8%; te promjene koštane strukture 85,7%. U procjeni zahvaćenosti koštanih struktura mekotkivnim tumorskim procesom osjetljivost MRI je bila 94,4%, a specifičnost 88,2%. Osjetljivost kod procjene perineuralne infiltracije je bila 91%, a utjecaja tumora na vaskularne strukture 91,6%. Specifičnost kod procjene perineuralne infiltracije je bila 96,7%, a utjecaja tumora na vaskularne strukture 88%. MRI je pokazao osjetljivost od 93,5% i specifičnost od 90,9% za intrakranijsku i intraorbitalnu propagaciju,prodor u pterigopalatinalnu udubinu i druge okolne anatomske prostore. Prednost MRI je u sposobnosti razlikovanja neuralnih i vaskularnih struktura bez primjene intravenskog kontrastnog sredstva. Naši rezultati su potvrdili vrlo važnu ulogu MRI u procjeni strukture tumora, koštanih promjena i proširenosti tumora u okolne strukture i prostore

Etiology of Deafness in Children Cochlear Implant Candidates in Croatia

The aim of this study was to provide more information on the causes of sensorineural hearing loss (SNHL) in children cochlear implant candidates in Croatia. The retrospective study included 270 children candidates for cochlear implantation between January 1997 and January 2005 at our institution. The medical assessment of the candidates included the history, physical examination, radiologic evaluation of the temporal bone and audiologic assessment. A family history of SNHL had 82 (30.4 %) candidates. The prematurity and/or complicated perinatal course was found in 35 (12.9%) of candidates. Computerized tomography (CT) scan analysis identified 44 (16.3%) candidates presenting with an inner ear malformation. Overall, a definite or probable cause of SNHL was identified in 58.9% of candidates and 41.1% had no obvious cause. The results of the study might give us better insight into the potential causes of SNHL and allow more timely intervention, allowing children with SNHL to reach their potential

THE POSITIVE EFFECTS OF RUNNING ON MENTAL HEALTH

Working as a team with patients who are also recreational runners and managing a running school in the City of Mostar had made us thinking on how recreational running affects the mental health in individuals. Previous literature is pretty old dated, so we found this even more interesting. We have wondered why there is no more recent literature on this subject. So, while working on this mini review and discussing on this subjects we came up with an idea on a research about self esteem and life quality of individuals pre and post running school experience. Previous studies show that consistent running results in a number of positive psychological changes among diverse populations. In a study of Kenneth E.C. ordinary nonprofessional runners were surveyed about the psychological aspects of running. Many of the respondents had started running to improve their health, and almost all noted mental and emotional benefits including relief of tension, improved self-image, and better mood. Considering therapeutic effects of running Greist et al. define running as not expensive, and unlike sorne other treatments, it has beneficiai physical side effects. Their results compare favorably with those of patients in psychotherapy and have persisted for at !east one year in follow-up. Taking in mind all of the previously published research it can be concluded that running can be a therapeutic tool for a sereies of negative psychological conditions, such ass depression, anxieta, tension, mood changes, low self esteem etc. Although, these research are a few decades old there is still no recipe or dosage for running, especially in the area of physical ilness prevention. There is much to research and to be discovered in this field

Nadomjesna terapija hormonom rasta u bolesnika s Cushingovom bolešću

In this retrospective study, the benefit of growth hormone in replacement therapy was assessed in comparison with standard hormone replacement therapy in patients with panhypopituitarism. The study included ten female patients aged 29-44 (mean age 37.6±8.6) years, who had undergone adenectomy for pituitary tumor and Cushing\u27s disease. After adenectomy, the patients received conventional hormone replacement therapy for panhypopituitarism, consisting of hydrocortisol (Cortef), L-thyroxine (Euthyrox) and ovarian hormones, for 6 months. After 6 months of therapy, both subjective and objective recovery was quite poor, as indicated by the following parameters: cholesterol, triglycerides, blood glucose, body weight, body height, waist circumference, diastolic and systolic blood pressure at rest, and body mass index. The growth hormone basal and peak values as determined by insulin tolerance test (ITT) test, and insulin-like growth factor (IGF-I) were below the normal range. All patients were indicated TRH nonreactive on TRH testing. Then, growth hormone was added to their conventional therapy in a dose of 2 IU/day s.c., and the same parameters were determined after 6 months of therapy. The criteria for the introduction of growth hormone in therapy were as follows: subjectively and objectively inadequate recovery after adenectomy; growth hormone and IGF-I values below the normal range in basal conditions; and inappropriate growth hormone result on ITT test (patients were administered 0.1 IU insulin per kg body weight, where after peak growth hormone level was measured). On TRH testing, patients were administered 200 mg TRH; where-after growth hormone levels were measured. After 6 months of therapy with Cortef, Euthyrox, ovarian hormones and growth hormone, all patients felt much better subjectively (three of them still reported ostealgia, whereas densitometry showed no improvement in only four of ten patients). Objective test results also improved (cholesterol, triglycerides, blood glucose, body weight, body height, waist circumference, diastolic and systolic blood pressure at rest, and body mass index). The mean plasma concentration of total cholesterol decreased from 6.95±1-05 to 4.9±1.8 mmol/L, plasma triglycerides from 4.39±1.61 to 1.94±0.76 mmol/L, plasma glucose from 7.83±3.17 to 5.12±1.22 mmol/L, mean body weight from 80.2±5.2 to 74.7±4.7 kg, mean body mass index from 29.1± 2.1 to 26.8±1.6 kg/m2, waist circumference from 0.827±0.093 to 8.814±0.064 m, pulse from 82.2±7.8 to 71±11.0 per min, systolic blood pressure from 148.5±11.5 to 141±9.0 mm Hg, and diastolic blood pressure from 89±16.0 to 84.5±5.5 mm Hg. Osteoporosis was reduced, ostealgia and podagra disappeared in most patients. It was concluded that the introduction of growth hormone in standard hormone replacement therapy led to a considerably better patient recovery as compared with standard hormone replacement therapy alone.Deset bolesnica s tumorom hipofize i Cushingovom bolešću praćeno je u ovom retrospektivnom istraživanju. Sve bolesnice su operirane i imale su panhipopituitarizam nakon operacije. Kroz 6 mjeseci provođena je standardna hormonska nadomjesna terapija Cortefom, Euthyroxom i gonadnim hormonima. Nakon 6 mjeseci terapije provedene su pretrage i bolesnice su odgovorile na manji upitnik o subjektivnom osjećanju. Pretrage su uključile kolesterol, trigliceride i glukozu u krvi, tjelesnu težinu i tjelesnu visinu, opseg struka, indeks tjelesne mase, puls u mirovanju, sistolički i dijastolički tlak, denzitometriju i prisutnost kostobolje. Objektivni pregled, subjektivno osjećanje i nalazi laboratorijske obrade pokazali su kako nijedna bolesnica nije postigla zadovoljavajući poslijeoperacijski oporavak. U naknadnim pretragama mjerena je bazalna razina hormona rasta i vršna vrijednost dobivena testom ITT, te IGF-I. Nađene su niske vrijednosti u bazalnim uvjetima i u testu. Test TRH pokazao je nedostatan odgovor hormona rasta u svih bolesnica. Nakon analize dobivenih nalaza donesena je odluka o terapiji hormonom rasta uza standardnu nadomjesnu hormonsku terapiju (nadbubrežna žijezda, štitnjača i gonade), što je provedeno kroz slijedećih 6 mjeseci. Testiranje je ponovljeno nakon 6 mjeseci, kada su mjereni isti parametri kao i odmah nakon operacije, tj. kolesterol, trigliceridi, glukoza u krvi, tjelesna težina, tjelesna visina, opseg struka, indeks tjelesne mase, puls u mirovanju, sistolički i dijastolički tlak. Subjektivni upitnik sadržavao je pitanja o kostobolji, a napravljena je i denzitometrija. Analiza je pokazala kako su bolesnice koje su uzimale hormon rasta uza standardnu hormonsku nadomjesnu terapiju prema svim parametrima nakon 6 mjeseci terapije postigle puno bolje rezultate, te da se subjektivno bolje osjećaju. Rezultati su pokazali kako je pozitivan učinak hormona rasta nakon operacije tumora hipofize neosporan, te da se stupanj oporavka koji se postiže nakon uključivanja hormona rasta u terapiju ne može postići standardnom hormonskom nadomjesnom terapijom

Korelacija nalaza kalcificiranih arterija dojki s aterosklerotskim promjenama karotidnih arterija [Correlation between breast arterial calcifications and atherosclerotic changes of carotid arteries]

Cerebrovascular diseases in all its forms according to the frequency and the high percentage of lethality and mortality are at the very top of the problems of modern medicine. The goal of modern medical science is the prevention of cerebrovascular disease . In this research breast arterial calcifications in mammograms were detected predominantly within The National programme of early detection of breast cancer in Croatia which has been implemented in the Republic of Croatia since 2006. The aim of the research was to investigate a connection between calcified arteries on breast mammograms and atherosclerotic changes in the carotid arteries. The second objective was to determine the association of certain risk factors : age , smoking, diabetes, hypertension and hyperlipidemia, BMI, peripheral artery disease, atrial fibrillation, oral contraceptives and previous stroke /TIA/RIND/IM with the degree of intramammary arterial calcifications on mammograms. The study aimed to assess the importance of mammography findings of breast arterial calcifications (finding to which attention was not paid in everyday diagnosis ) as an important indicator for the presence of atherosclerotic changes in the carotid arteries, and thus contribute to the early detection of the risk for cerebrovascular disease. This was a prospective study that included 300 women aged 47-69 years. Breast arterial calcifications were found in mammograms of 149 women while the control group consisted of 151 women without breast arterial calcifications in mammograms . The hypothesis of the study was : 1. Mammographic finding of breast arterial calcifications represents an increased risk for the existence of atherosclerotic changes of the carotid arteries, which are a significant risk factor for cerebrovascular disease. 2. The degree of breast arterial calcification is correlated with the degree of atherosclerotic changes in the carotid artery and carotid artery stenosis assessed by ultrasound. 3. The occurrence of breast arterial calcification is associated with age, smoking, elevated blood glucose, high blood pressure, lipids, BMI (body mass index ), peripheral artery disease , previous stroke / TIA / RIND / MI , atrial fibrillation , taking oral contraceptives, hormon replacement therapy . All patients were included in mammography and Doppler ultrasound of carotid arteries with the risk factor anlaysis. During the analysis of mammograms two independent radiologists recorded breast arterial calcifications and based on their visual assessement classified them according to the degree of intensity in two stages: 1. First degree indicates gentle arterial calcifications 2. Second degree indicates intense arterial calcifications In order to assess the presence and degree of stenosis duplex Doppler ultrasound with spectral flow quantification was done. The common carotid artery ( CCA) throughout the course , in the transverse and longitudinal sections was examined , then the bifurcation and the internal carotid artery (ICA) and external carotid artery (AC ). Stenoses were diagnosed by consensus on performing Doppler ultrasound adopted by a group of experts under the auspices of the Society of Radiologists in ultrasound in San Francisco ( USA ) in the year of 2002 . Assessment of atherosclerotic lesions of the carotid arteries was performed in four stages: O. level - normal Doppler ultrasound of the carotid arteries 1. degree - mild atherosclerotic changes in terms of wall thickening and ACI initial small plaque 2. degree - moderate atherosclerotic changes in terms of larger plaques and stenosis of up to 50 % 3. degree - advanced atherosclerotic changes in terms of stenosis over 50 % All subjects underwent blood test analysis with attention to the risk factors for atherosclerosis ( triglycerides, cholesterol, glucose ) . The results were statistically analyzed and presented numerically and in tables . In this study, the average age of subjects was 61.95 ± 6.41 years , range 47-69 years. Groups of patients were compared by age and with regard to the result of mammography by age and the resulting variable whose averages are statistically significantly different in groups was based on statistical analysis. Insight into the mean age in groups, it is evident that there is a correlation between the findings of the age group of subjects with an intense calcification and atherosclerotic changes in the carotid artery ( F = 5.494 , p < .05 ) . The above tabular and graphical data indicate a slight, statistically significant correlation between mammography findings with mild calcified arteries and changes in circulation disorder of the carotid arteries on Doppler test ( τ = ,149 , p < 0.05 ). With the increasing arterial calcification on mammography the result of Dopler test is increasing to some extent. This connection is manifested in mild percent reduction proper findings and a slight increase of stenosis on Doppler test with increasing calcifications on mammography. It can be determined that there is a statistically significant correlation between the results of intensive calcifications on mammography and the results of the Doppler test based on the data from the table and graphic display and the resulting chi-square test ( χ2 = 8.242 , p < 0.05 ). There is less proportion of patients with a normal Doppler and a greater proportion of those with stenosis ( especially stenoses < 50 % ) in the group with intense breast arterial calcifications. In the research all respondents underwent blood tests with an analysis of known risk factors for cerebrovascular disease including: cholesterol, triglycerides and glucose . The average blood glucose value was 6 ± 1.75 mmol / L , with a range from 4 to 25.95 mmol / L. The average amount of cholesterol in the blood was 5.37 ± 0.94 mmol / L , with a range from 3.94 to 8.8 mmol / L. The average value of triglycerides in the blood was 1.45 ± 0.5 mmol / L with a range of 0.74 to 4.23 mmol / L. There is no statistically significant correlation between breast arterial calcifications and these risk factors. History data related to cerebrovascular disease risk factors: smoking, alcohol consumption, data about previous use of oral contraceptives and taking hormone replacement therapy , hypertension , a prior morbidity from cardiovascular disease and peripheral arterial disease , BMI, atrial fibrillation were obtained from the respondents. Smoking is the only one variable of the three observed variables( smoking, hypertension, taking oral contraceptives) that is not allocated equally by both groups of respondents compared to mammography ( χ2 = 9.450 , p < 0.05 ) . In the group with gentle(mild) calcification is the highest proportion of smokers ( 28.9 %) compared to the group without calcification (14.6 %) or the group with intense calcification (12.1 %) . It is evident that the index of smoking was 0.33, for alcohol consumption 0.006 and 0.33 for hypertension. Also low indices were for body mass index, hormone replacement therapy, atrial fibrillation, peripheral arterial disease and the number of births . The results of this study confirmed a statistically high correlation between the intensive breast arterial calcifications and the presence of atherosclerotic changes in the carotid arteries. Mammographic finding of intense calcifications is a significant predictor of a positive result on Doppler or subjects with intense calcifications are 3,037 times more likely to have thickening of the carotid wall or stenosis. The results showed small statistically significant correlation with age and also with taking oral contraceptives. The probability of an increase in breast artery calcification slightly increases with age. Also, women taking oral contraceptives have a higher level of calcified breasts arteries

Correlation between breast arterial calcifications and atherosclerotic changes of carotid arteries

Ciljevi provedenog istraživanja bili su: istražiti povezanost kalcificiranih arterija dojki na mamogramu i njihovog stupnja, s aterosklerotskim promjenama i njihovim stupnjem u karotidnim arterijama, odrediti povezanost određenih rizičnih čimbenika: dob, pušenje, dijabetes, hipertenzija i hiperlipidemija, BMI, periferna arterijska bolest, fibrilacija atrija, oralni kontraceptivi, te prethodni CVI/TIA/RIND/ sa stupnjem kalcifikacija intramamarnih arterija na mamogramu, i dokazati značaj mamografskog nalaza kalcificiranih arterija dojki kao važnog pokazatelja za postojanje aterosklerotskih promjena karotidnih arterija, te tako pridonijeti ranom otkrivanju rizika za cerebrovaskularnu bolest. U ovom istraživanju je uključeno 300 ispitanica koje su razvrstane u dvije skupine: ispitivana skupina sa 149 ispitanica s arterijskim kalcifikacijama dojki na mamogramu, i kontrolna skupina sa 151 ispitanicom bez arterijskih kalcifikacija dojki na mamogramu. U ispitivanoj grupi su dvije podgrupe ispitanica - ispitanice s nježnim i ispitanice s intenzivnim kalcifikacijama. Svim ispitanicama učinjen je Dopler karotida, uzeti su anamnestički podaci i učinjene su laboratorijske pretrage. Istraživanje je, temeljem statističke obrade, pokazalo statistički značajnu povezanost kalcificiranih arterija dojki na mamografiji, i stupanj ateroskleroze karotidnih arterija na ultrazvučnom Dopler testu kod ispitivanih. Obradom je utvrđena statistički značajna povezanost nalaza srednje intezivnih kalcificiranih arterija dojki i uzimanja oralne kontracepcije, te dobi ispitanica. Statistički nema značajne povezanosti arterijskih kalcifikacija dojki s rizičnim čimbenicima u krvi (kolesterol, trigliceridi, glukoza), pušenjem, konzumacijom alkohola, kardiovaskularnim bolestima i BMI. Dobiveni rezultati ovog ispitivanja su potvrdili statistički visoku korelaciju između grupe intenzivnih kalcifikacija arterija dojki i postojanja aterosklerotskih promjena u karotidnim arterijama. Logističkom regresijom utvrđeno je da je nalaz intenzivnih kalcifikacija značajan prediktor pozitivnog rezultata na Dopleru. Ispitivanjem je potvrđena hipoteza, da nazočnost kalcificiranih stijenki arterija dojke na mamografskom pregledu, upućuje na veću vjerojatnost aterosklerotičnih promjena stijenki karotidnih arterija. Mamografski nalaz kalcificiranih stijenki arterija dojki predstavlja povećan rizik za postojanje aterosklerotskih promjena karotidnih arterija, koje su značajan čimbenik rizika cerebrovaskularne bolesti.Cerebrovascular diseases in all its forms according to the frequency and the high percentage of lethality and mortality are at the very top of the problems of modern medicine. The goal of modern medical science is the prevention of cerebrovascular disease . In this research breast arterial calcifications in mammograms were detected predominantly within The National programme of early detection of breast cancer in Croatia which has been implemented in the Republic of Croatia since 2006. The aim of the research was to investigate a connection between calcified arteries on breast mammograms and atherosclerotic changes in the carotid arteries. The second objective was to determine the association of certain risk factors : age , smoking, diabetes, hypertension and hyperlipidemia, BMI, peripheral artery disease, atrial fibrillation, oral contraceptives and previous stroke /TIA/RIND/IM with the degree of intramammary arterial calcifications on mammograms. The study aimed to assess the importance of mammography findings of breast arterial calcifications (finding to which attention was not paid in everyday diagnosis ) as an important indicator for the presence of atherosclerotic changes in the carotid arteries, and thus contribute to the early detection of the risk for cerebrovascular disease. This was a prospective study that included 300 women aged 47-69 years. Breast arterial calcifications were found in mammograms of 149 women while the control group consisted of 151 women without breast arterial calcifications in mammograms . The hypothesis of the study was : 1. Mammographic finding of breast arterial calcifications represents an increased risk for the existence of atherosclerotic changes of the carotid arteries, which are a significant risk factor for cerebrovascular disease. 2. The degree of breast arterial calcification is correlated with the degree of atherosclerotic changes in the carotid artery and carotid artery stenosis assessed by ultrasound. 3. The occurrence of breast arterial calcification is associated with age, smoking, elevated blood glucose, high blood pressure, lipids, BMI (body mass index ), peripheral artery disease , previous stroke / TIA / RIND / MI , atrial fibrillation , taking oral contraceptives, hormon replacement therapy . All patients were included in mammography and Doppler ultrasound of carotid arteries with the risk factor anlaysis. During the analysis of mammograms two independent radiologists recorded breast arterial calcifications and based on their visual assessement classified them according to the degree of intensity in two stages: 1. First degree indicates gentle arterial calcifications 2. Second degree indicates intense arterial calcifications In order to assess the presence and degree of stenosis duplex Doppler ultrasound with spectral flow quantification was done. The common carotid artery ( CCA) throughout the course , in the transverse and longitudinal sections was examined , then the bifurcation and the internal carotid artery (ICA) and external carotid artery (AC ). Stenoses were diagnosed by consensus on performing Doppler ultrasound adopted by a group of experts under the auspices of the Society of Radiologists in ultrasound in San Francisco ( USA ) in the year of 2002 . Assessment of atherosclerotic lesions of the carotid arteries was performed in four stages: O. level - normal Doppler ultrasound of the carotid arteries 1. degree - mild atherosclerotic changes in terms of wall thickening and ACI initial small plaque 2. degree - moderate atherosclerotic changes in terms of larger plaques and stenosis of up to 50 % 3. degree - advanced atherosclerotic changes in terms of stenosis over 50 % All subjects underwent blood test analysis with attention to the risk factors for atherosclerosis ( triglycerides, cholesterol, glucose ) . The results were statistically analyzed and presented numerically and in tables . In this study, the average age of subjects was 61.95 ± 6.41 years , range 47-69 years. Groups of patients were compared by age and with regard to the result of mammography by age and the resulting variable whose averages are statistically significantly different in groups was based on statistical analysis. Insight into the mean age in groups, it is evident that there is a correlation between the findings of the age group of subjects with an intense calcification and atherosclerotic changes in the carotid artery ( F = 5.494 , p < .05 ) . The above tabular and graphical data indicate a slight, statistically significant correlation between mammography findings with mild calcified arteries and changes in circulation disorder of the carotid arteries on Doppler test ( τ = ,149 , p < 0.05 ). With the increasing arterial calcification on mammography the result of Dopler test is increasing to some extent. This connection is manifested in mild percent reduction proper findings and a slight increase of stenosis on Doppler test with increasing calcifications on mammography. It can be determined that there is a statistically significant correlation between the results of intensive calcifications on mammography and the results of the Doppler test based on the data from the table and graphic display and the resulting chi-square test ( χ2 = 8.242 , p < 0.05 ). There is less proportion of patients with a normal Doppler and a greater proportion of those with stenosis ( especially stenoses < 50 % ) in the group with intense breast arterial calcifications. In the research all respondents underwent blood tests with an analysis of known risk factors for cerebrovascular disease including: cholesterol, triglycerides and glucose . The average blood glucose value was 6 ± 1.75 mmol / L , with a range from 4 to 25.95 mmol / L. The average amount of cholesterol in the blood was 5.37 ± 0.94 mmol / L , with a range from 3.94 to 8.8 mmol / L. The average value of triglycerides in the blood was 1.45 ± 0.5 mmol / L with a range of 0.74 to 4.23 mmol / L. There is no statistically significant correlation between breast arterial calcifications and these risk factors. History data related to cerebrovascular disease risk factors: smoking, alcohol consumption, data about previous use of oral contraceptives and taking hormone replacement therapy , hypertension , a prior morbidity from cardiovascular disease and peripheral arterial disease , BMI, atrial fibrillation were obtained from the respondents. Smoking is the only one variable of the three observed variables( smoking, hypertension, taking oral contraceptives) that is not allocated equally by both groups of respondents compared to mammography ( χ2 = 9.450 , p < 0.05 ) . In the group with gentle(mild) calcification is the highest proportion of smokers ( 28.9 %) compared to the group without calcification (14.6 %) or the group with intense calcification (12.1 %) . It is evident that the index of smoking was 0.33, for alcohol consumption 0.006 and 0.33 for hypertension. Also low indices were for body mass index, hormone replacement therapy, atrial fibrillation, peripheral arterial disease and the number of births . The results of this study confirmed a statistically high correlation between the intensive breast arterial calcifications and the presence of atherosclerotic changes in the carotid arteries. Mammographic finding of intense calcifications is a significant predictor of a positive result on Doppler or subjects with intense calcifications are 3,037 times more likely to have thickening of the carotid wall or stenosis. The results showed small statistically significant correlation with age and also with taking oral contraceptives. The probability of an increase in breast artery calcification slightly increases with age. Also, women taking oral contraceptives have a higher level of calcified breasts arteries

Correlation between breast arterial calcifications and atherosclerotic changes of carotid arteries

Ciljevi provedenog istraživanja bili su: istražiti povezanost kalcificiranih arterija dojki na mamogramu i njihovog stupnja, s aterosklerotskim promjenama i njihovim stupnjem u karotidnim arterijama, odrediti povezanost određenih rizičnih čimbenika: dob, pušenje, dijabetes, hipertenzija i hiperlipidemija, BMI, periferna arterijska bolest, fibrilacija atrija, oralni kontraceptivi, te prethodni CVI/TIA/RIND/ sa stupnjem kalcifikacija intramamarnih arterija na mamogramu, i dokazati značaj mamografskog nalaza kalcificiranih arterija dojki kao važnog pokazatelja za postojanje aterosklerotskih promjena karotidnih arterija, te tako pridonijeti ranom otkrivanju rizika za cerebrovaskularnu bolest. U ovom istraživanju je uključeno 300 ispitanica koje su razvrstane u dvije skupine: ispitivana skupina sa 149 ispitanica s arterijskim kalcifikacijama dojki na mamogramu, i kontrolna skupina sa 151 ispitanicom bez arterijskih kalcifikacija dojki na mamogramu. U ispitivanoj grupi su dvije podgrupe ispitanica - ispitanice s nježnim i ispitanice s intenzivnim kalcifikacijama. Svim ispitanicama učinjen je Dopler karotida, uzeti su anamnestički podaci i učinjene su laboratorijske pretrage. Istraživanje je, temeljem statističke obrade, pokazalo statistički značajnu povezanost kalcificiranih arterija dojki na mamografiji, i stupanj ateroskleroze karotidnih arterija na ultrazvučnom Dopler testu kod ispitivanih. Obradom je utvrđena statistički značajna povezanost nalaza srednje intezivnih kalcificiranih arterija dojki i uzimanja oralne kontracepcije, te dobi ispitanica. Statistički nema značajne povezanosti arterijskih kalcifikacija dojki s rizičnim čimbenicima u krvi (kolesterol, trigliceridi, glukoza), pušenjem, konzumacijom alkohola, kardiovaskularnim bolestima i BMI. Dobiveni rezultati ovog ispitivanja su potvrdili statistički visoku korelaciju između grupe intenzivnih kalcifikacija arterija dojki i postojanja aterosklerotskih promjena u karotidnim arterijama. Logističkom regresijom utvrđeno je da je nalaz intenzivnih kalcifikacija značajan prediktor pozitivnog rezultata na Dopleru. Ispitivanjem je potvrđena hipoteza, da nazočnost kalcificiranih stijenki arterija dojke na mamografskom pregledu, upućuje na veću vjerojatnost aterosklerotičnih promjena stijenki karotidnih arterija. Mamografski nalaz kalcificiranih stijenki arterija dojki predstavlja povećan rizik za postojanje aterosklerotskih promjena karotidnih arterija, koje su značajan čimbenik rizika cerebrovaskularne bolesti.Cerebrovascular diseases in all its forms according to the frequency and the high percentage of lethality and mortality are at the very top of the problems of modern medicine. The goal of modern medical science is the prevention of cerebrovascular disease . In this research breast arterial calcifications in mammograms were detected predominantly within The National programme of early detection of breast cancer in Croatia which has been implemented in the Republic of Croatia since 2006. The aim of the research was to investigate a connection between calcified arteries on breast mammograms and atherosclerotic changes in the carotid arteries. The second objective was to determine the association of certain risk factors : age , smoking, diabetes, hypertension and hyperlipidemia, BMI, peripheral artery disease, atrial fibrillation, oral contraceptives and previous stroke /TIA/RIND/IM with the degree of intramammary arterial calcifications on mammograms. The study aimed to assess the importance of mammography findings of breast arterial calcifications (finding to which attention was not paid in everyday diagnosis ) as an important indicator for the presence of atherosclerotic changes in the carotid arteries, and thus contribute to the early detection of the risk for cerebrovascular disease. This was a prospective study that included 300 women aged 47-69 years. Breast arterial calcifications were found in mammograms of 149 women while the control group consisted of 151 women without breast arterial calcifications in mammograms . The hypothesis of the study was : 1. Mammographic finding of breast arterial calcifications represents an increased risk for the existence of atherosclerotic changes of the carotid arteries, which are a significant risk factor for cerebrovascular disease. 2. The degree of breast arterial calcification is correlated with the degree of atherosclerotic changes in the carotid artery and carotid artery stenosis assessed by ultrasound. 3. The occurrence of breast arterial calcification is associated with age, smoking, elevated blood glucose, high blood pressure, lipids, BMI (body mass index ), peripheral artery disease , previous stroke / TIA / RIND / MI , atrial fibrillation , taking oral contraceptives, hormon replacement therapy . All patients were included in mammography and Doppler ultrasound of carotid arteries with the risk factor anlaysis. During the analysis of mammograms two independent radiologists recorded breast arterial calcifications and based on their visual assessement classified them according to the degree of intensity in two stages: 1. First degree indicates gentle arterial calcifications 2. Second degree indicates intense arterial calcifications In order to assess the presence and degree of stenosis duplex Doppler ultrasound with spectral flow quantification was done. The common carotid artery ( CCA) throughout the course , in the transverse and longitudinal sections was examined , then the bifurcation and the internal carotid artery (ICA) and external carotid artery (AC ). Stenoses were diagnosed by consensus on performing Doppler ultrasound adopted by a group of experts under the auspices of the Society of Radiologists in ultrasound in San Francisco ( USA ) in the year of 2002 . Assessment of atherosclerotic lesions of the carotid arteries was performed in four stages: O. level - normal Doppler ultrasound of the carotid arteries 1. degree - mild atherosclerotic changes in terms of wall thickening and ACI initial small plaque 2. degree - moderate atherosclerotic changes in terms of larger plaques and stenosis of up to 50 % 3. degree - advanced atherosclerotic changes in terms of stenosis over 50 % All subjects underwent blood test analysis with attention to the risk factors for atherosclerosis ( triglycerides, cholesterol, glucose ) . The results were statistically analyzed and presented numerically and in tables . In this study, the average age of subjects was 61.95 ± 6.41 years , range 47-69 years. Groups of patients were compared by age and with regard to the result of mammography by age and the resulting variable whose averages are statistically significantly different in groups was based on statistical analysis. Insight into the mean age in groups, it is evident that there is a correlation between the findings of the age group of subjects with an intense calcification and atherosclerotic changes in the carotid artery ( F = 5.494 , p < .05 ) . The above tabular and graphical data indicate a slight, statistically significant correlation between mammography findings with mild calcified arteries and changes in circulation disorder of the carotid arteries on Doppler test ( τ = ,149 , p < 0.05 ). With the increasing arterial calcification on mammography the result of Dopler test is increasing to some extent. This connection is manifested in mild percent reduction proper findings and a slight increase of stenosis on Doppler test with increasing calcifications on mammography. It can be determined that there is a statistically significant correlation between the results of intensive calcifications on mammography and the results of the Doppler test based on the data from the table and graphic display and the resulting chi-square test ( χ2 = 8.242 , p < 0.05 ). There is less proportion of patients with a normal Doppler and a greater proportion of those with stenosis ( especially stenoses < 50 % ) in the group with intense breast arterial calcifications. In the research all respondents underwent blood tests with an analysis of known risk factors for cerebrovascular disease including: cholesterol, triglycerides and glucose . The average blood glucose value was 6 ± 1.75 mmol / L , with a range from 4 to 25.95 mmol / L. The average amount of cholesterol in the blood was 5.37 ± 0.94 mmol / L , with a range from 3.94 to 8.8 mmol / L. The average value of triglycerides in the blood was 1.45 ± 0.5 mmol / L with a range of 0.74 to 4.23 mmol / L. There is no statistically significant correlation between breast arterial calcifications and these risk factors. History data related to cerebrovascular disease risk factors: smoking, alcohol consumption, data about previous use of oral contraceptives and taking hormone replacement therapy , hypertension , a prior morbidity from cardiovascular disease and peripheral arterial disease , BMI, atrial fibrillation were obtained from the respondents. Smoking is the only one variable of the three observed variables( smoking, hypertension, taking oral contraceptives) that is not allocated equally by both groups of respondents compared to mammography ( χ2 = 9.450 , p < 0.05 ) . In the group with gentle(mild) calcification is the highest proportion of smokers ( 28.9 %) compared to the group without calcification (14.6 %) or the group with intense calcification (12.1 %) . It is evident that the index of smoking was 0.33, for alcohol consumption 0.006 and 0.33 for hypertension. Also low indices were for body mass index, hormone replacement therapy, atrial fibrillation, peripheral arterial disease and the number of births . The results of this study confirmed a statistically high correlation between the intensive breast arterial calcifications and the presence of atherosclerotic changes in the carotid arteries. Mammographic finding of intense calcifications is a significant predictor of a positive result on Doppler or subjects with intense calcifications are 3,037 times more likely to have thickening of the carotid wall or stenosis. The results showed small statistically significant correlation with age and also with taking oral contraceptives. The probability of an increase in breast artery calcification slightly increases with age. Also, women taking oral contraceptives have a higher level of calcified breasts arteries