17 research outputs found
Prevention and treatment of ischemic stroke in patients with atrial fibrillation
Atrial fibrillation (AF) is the most common sustained arrhythmia. It affects a considerable number of patients in the world and is responsible for ischemic stroke (IS) in many of them. Age greater than 75 years, congestive heart failure, arterial hypertension, diabetes mellitus, tobacco smoking and other structural lesions of the heart represent the main risk factors for IS in AF patients. Long-term anticoagulation therapy with warfarin is considered the most effective therapy for IS prevention in selected patients with AF and other risk factors. However, management of the drug presents with some challenges such as need for frequent monitoring, interactions with food and other medications, variability in metabolism and delayed onset of action. Antiplatelet therapy may provide some benefit for patients who can't tolerate warfarin. Recently, direct oral thrombin inhibitor dabigatran and oral factor Xa inhibitors rivaroxaban and apixaban are approved by the Food and Drug Administration (FDA). Non-pharmacologic approaches to IS prevention in AF focus on occlusion or ligation of the left atrial appendage, which is often the location of thrombus formation and on percutaneous techniques that may not require anticoagulation afterwards as well. New diagnostic modalities detect paroxysmal AF and expand the potential impact of preventive strategies on the population.Scripta Scientifica Medica 2013; 45(3): 7-15
Serum lipid anomalies in adult patients with acute ischemic stroke
Introduction: There is rising evidence of the role of hyperlipidemia and dyslipidemia in the development of acute ischemic stroke (AIS). There is a considerable risk for AIS in adult individuals with these abnormalities. Our purpose was to reveal the incidence rate of the disorders of lipid metabolism in adult AIS patients.Material and methods: We examined 129 male and 129 female patients with AIS at a mean age of 70.59Β±7.22 years hospitalized in the First Clinic of Neurology, St. Marina University Hospital of Varna in 2007-2013. The serum levels of total cholesterol, triglycerides, HDL- and LDL-cholesterol at admission were examined. Statistical data processing was performed by ANOVA as t-criterion was considered significant if p<0.05.Results: The mean values of total cholesterol and LDL-cholesterol were slightly elevated while those of triglycerides were slightly reduced. The mean values of total cholesterol and triglycerides were higher in males than in females. Total cholesterol values were considerably more commonly higher in females than in males as the mean total cholesterol concentrations were higher in the female patients with normal, decreased and increased levels of this parameter. LDL-cholesterol was more commonly elevated as its mean values were higher in the female patients with its normal, decreased and increased levels.Conclusion: A regular control of the parameters of lipid metabolism and keeping-up the healthy life-style in adult individuals and in patients with cardiovascular diseases could ensure a successful prevention of ischemic stroke
Age-related metabolic disturbances in adult patients with acute ischemic stroke
INTRODUCTION. There is rising evidence of the role of hyperglycemia, hyperlipidemia and dyslipidemia in the etiopathogenesis of acute ischemic stroke (AIS). There is a considerable risk for AIS in adult individuals in advanced and senile age with these abnormalities. Our purpose was to reveal the incidence rate of the disorders of glucose and lipid metabolism in the adult patients with AIS.Material and methods. We examined 129 male and 129 female AIS patients at a mean age of 71 years hospitalized in the First Clinic of Neurology, St. Marina University Hospital of Varna, in 2007-2013. The levels of blood glucose and of serum total cholesterol, triglycerides, HDL- and LDL-cholesterol at admission were examined. Statistical data processing was performed by variation (ANOVA as t-criterion was considered significant if p<0.05) and correlation (Pearson`s coefficient) analyses.Results. Males aged Γ’β°Β€65 years and females aged 71-75 years presented with the highest mean blood glucose values. There are much more males with higher blood glucose concentrations than females aged Γ’β°Β€70 and 76-80 years. Both mean and maximal concentrations of total cholesterol were highest at the age 71-75 years, those of HDL-cholesterol - in males aged 66-70 years and those of LDL-cholesterol - in females aged 71-75 years. The differences between the mean levels of total cholesterol in males and females aged Γ’β°Β€65 years as well as those of LDL-cholesterol in males and females aged Γ’β°Β₯81 years were statistically significant (p<0.01).Conclusion. A regular control of the parameters of glucose and lipid metabolism in adults is necessary. Keeping-up individual`s healthy life-style could ensure a more effective AIS prevention
Disorders of blood glucose levels in adult patients with acute Ischemic stroke
Introduction: Effective and timely prevention of acute ischemic stroke (AIS) is characterized by a rising socio-medical importance as this is the most common cerebrovascular disease worldwide and in Bulgaria as well. Our purpose was to reveal the incidence rate of the disorders of glucose metabolism in AIS development among adult patients.Material and methods: We examined 129 male and 129 female patients with AIS at a mean age of 70.59Β±7.22 years hospitalized in the First Clinic of Neurology, St. Marina University Hospital of Varna in 2007-2013. Blood glucose concentrations at admission were examined. Statistical data processing was performed by variation (ANOVA as t-criterion was considered significant if p<0.05) and correlation (Pearson`s coefficient) analyses.Results: Mean fasting blood glucose levels were most commonly elevated and total ones were higher in males than in females except for the minimal value. The males with abnormally elevated blood glucose values present with higher mean and maximal values than the females. The number and relative share of the patients with increased blood glucose values at admission considerably prevailed. The difference between the number of the males with increased values and that of those with normal values was statistically significant (t=3.33; p<0.01). There was moderate correlation between the level of blood glucose and the preceding diabetes mellitus (r=0.431) and a strong one between this level and the newly-diagnosed diabetes mellitus (r=0.733) among our AIS patients.Conclusion: The regular control of blood glucose by the general practitioners and the promotion of the healthy life-style in cardiovascular disease patients could successfully prevent AIS in Bulgaria
Autonomic cardiovascular disorders in stroke - electrocardiographic changes and risk of sudden cardiac death
ΠΠ°ΡΡΡΠ΅Π½ΠΈΡΡΠ° Π½Π° ΠΊΠ°ΡΠ΄ΠΈΠΎΠ²Π°ΡΠΊΡΠ»Π°ΡΠ½ΠΈΡΠ΅ Π°Π²ΡΠΎΠ½ΠΎΠΌΠ½ΠΈ ΡΡΠ½ΠΊΡΠΈΠΈ ΡΠ° ΡΠ΅ΡΡΠΎ ΡΡΠ΅ΡΠ°Π½ΠΈ ΠΏΡΠΈ ΠΌΠΎΠ·ΡΡΠ½ΠΎ-ΡΡΠ΄ΠΎΠ²Π° Π±ΠΎΠ»Π΅ΡΡ, ΠΈΠΌΠ°Ρ Π³ΠΎΠ»ΡΠΌΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ½ΠΎ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ ΠΈ ΡΠ° Π½Π°ΠΉ-ΠΎΡΡΠ΅ΡΠ»ΠΈΠ²ΠΎ ΠΏΡΠΎΡΠ²Π΅Π½ΠΈ Π² ΠΎΡΡΡΠ°ΡΠ° ΡΠ°Π·Π° Π½Π° ΠΈΠ½ΡΡΠ»ΡΠ°. ΠΡΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Ρ ΠΌΠΎΠ·ΡΡΠ΅Π½ ΠΈΠ½ΡΡΠ»Ρ ΡΠ΅ Π½Π°Π±Π»ΡΠ΄Π°Π²Π°Ρ Π΅Π»Π΅ΠΊΡΡΠΎΠΊΠ°ΡΠ΄ΠΈΠΎΠ³ΡΠ°ΡΡΠΊΠΈ ΠΏΡΠΎΠΌΠ΅Π½ΠΈ; ΠΏΠΎΠ²ΠΈΡΠ°Π²Π° ΡΠ΅ ΡΠ΅ΡΡΠΎΡΠ°ΡΠ° Π½Π° ΡΠΈΡΡΠΌΠ½ΠΈΡΠ΅ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ Π½Π° ΡΡΡΡΠ΅ΡΠΎ, ΠΏΠ»Π°Π·ΠΌΠ΅Π½ΠΈΡΠ΅ Π½ΠΈΠ²Π° Π½Π° ΠΊΠ°ΡΠ΅Ρ
ΠΎΠ»Π°ΠΌΠΈΠ½ΠΈΡΠ΅ ΠΈ ΡΡΡΠ΄Π΅ΡΠ½ΠΈΡΠ΅ Π΅Π½Π·ΠΈΠΌΠΈ. ΠΠ°ΡΠΈΠ°Π±ΠΈΠ»Π½ΠΎΡΡΡΠ° Π½Π° ΡΡΡΠ΄Π΅ΡΠ½Π°ΡΠ° ΡΠ΅ΡΡΠΎΡΠ° (ΠΠ‘Π§) ΠΏΡΠ΅Π΄ΡΠΊΠ°Π·Π²Π° Π² ΠΏΠΎ-Π³ΠΎΠ»ΡΠΌΠ° ΡΡΠ΅ΠΏΠ΅Π½ ΡΠ°Π½Π½Π°ΡΠ°, Π²Π½Π΅Π·Π°ΠΏΠ½Π° ΡΠΌΡΡΡΠ½ΠΎΡΡ.Disturbances of cardiovascular autonomic function are common in patients with cerebrovascular disease (CVDs), have great clinical importance and are most clearly manifested in the acute phase of stroke. In patients experienced stroke are observed electrocardiographic (ECG) changes, increased frequency of heart rhythm disorders, plasma catecholamine levels and cardiac enzymes. Heart rate variability (HRV) shows higher risk of sudden cardiac death
Application of the Rey-Osterrieth complex figure test for assessment of cognitive impairment in multiple sclerosis
INTRODUCTION: Cognitive impairment is frequent in multiple sclerosis and predominantly affects visuospatial abilities, memory, attention, and executive functions. Because of the specific cognitive profile, different from that in Alzheimer's disease and other frequent disorders presenting with dementia, specific neuropsychological instruments need to be used in multiple sclerosis. The aim of the present study is to assess the applicability of the Rey-Osterrieth complex figure test (ROCFT) for assessing cognitive impairment in patients with multiple sclerosis in comparison with a control group.MATERIAL AND METHODS: One hundred and two persons, 70 patients with MS and 32 healthy control subjects were assessed using ROCFT. A standardized system for assessment by points and percentiles was used. The results of both groups were compared statistically using independent samples t-test.RESULTS: On the copying task, the differences between patients and controls reached statistical significance, p<0.05 for the raw score, and p<0.001 after results were grouped by percentiles. On the drawing by memory task the differences between the two groups also showed statistical significance, p<0.01.CONCLUSION: ROCFT shows statistically significant differences between patients with multiple sclerosis and healthy subjects. Highest levels of significance were observed for copying, scored by percentiles, and for drawing by memory. The application of ROCFT can provide valuable information about cognitive dysfunction in multiple sclerosis
Cardiovascular autonomic dysfunction in acute stroke - Biochemical markers
ΠΠ°ΡΠ΄ΠΈΠΎΠ²Π°ΡΠΊΡΠ»Π°ΡΠ½Π°ΡΠ° Π°Π²ΡΠΎΠ½ΠΎΠΌΠ½Π° Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΡ ΡΠ»Π΅Π΄ ΠΈΠ½ΡΡΠ»Ρ ΠΈΠΌΠ° Π³ΠΎΠ»ΡΠΌΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ½ΠΎ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅, ΡΡΠΉ ΠΊΠ°ΡΠΎ Π²Π»ΠΎΡΠ°Π²Π° ΠΏΡΠΎΠ³Π½ΠΎΠ·Π°ΡΠ° ΠΈ ΠΌΠΎΠΆΠ΅ Π΄ΠΎ Π΄ΠΎΠ²Π΅Π΄Π΅ Π΄ΠΎ Π²Π½Π΅Π·Π°ΠΏΠ½Π° ΡΠΈΡΡΠΌΠ½Π° ΡΠΌΡΡΡ. ΠΠΎΠ²ΠΈΡΠ΅Π½Π°ΡΠ° ΡΠΈΠΌΠΏΠ°ΡΠΈΠΊΠΎΠ²Π° Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡ ΡΠ»Π΅Π΄ ΠΈΠ½ΡΡΠ»Ρ ΠΌΠΎΠΆΠ΅ Π΄Π° Π΄ΠΎΠ²Π΅Π΄Π΅ Π΄ΠΎ Π°Π±Π½ΠΎΡΠΌΠ½ΠΎΡΡΠΈ Π² ΠΠΠ, ΡΡΡΠ΄Π΅ΡΠ½ΠΈ Π°ΡΠΈΡΠΌΠΈΠΈ ΠΈ Π½Π΅ΠΊΡΠΎΠ·Π° Π½Π° ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π°.ΠΠ°ΡΠ΅Π΄ Ρ ΠΏΡΠΎΡΠ²ΠΈΡΠ΅ Π½Π° ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΡΠ½Π° Π°ΡΠΈΠ΄ΠΎΠ·Π° ΡΠ΅ ΠΏΠΎΠ²ΠΈΡΠ°Π²Π°Ρ ΠΏΠ»Π°Π·ΠΌΠ΅Π½ΠΈΡΠ΅ Π½ΠΈΠ²Π° Π½Π° ΡΠ΅Π΄ΠΈΡΠ° Π±ΠΈΠΎΡ
ΠΈΠΌΠΈΡΠ½ΠΈ ΠΌΠ°ΡΠΊΠ΅ΡΠΈ- Π½ΠΎΡΠ΅ΠΏΠΈΠ½Π΅ΡΡΠΈΠ½, Π΅ΠΏΠΈΠ½Π΅ΡΡΠΈΠ½ ΠΈ Π΄ΠΎΠΏΠ°ΠΌΠΈΠ½; ΡΡΡΠ΄Π΅ΡΠ½ΠΈ Π΅Π½Π·ΠΈΠΌΠΈ ΠΈ ΠΌΠ°ΡΠΊΠ΅ΡΠΈ:ΠΊΡΠ΅Π°ΡΠΈΠ½ ΠΊΠΈΠ½Π°Π·Π°ΡΠ° ΠΈ ΠΊΡΠ΅Π°ΡΠΈΠ½ ΠΊΠΈΠ½Π°Π·Π°ΡΠ° -ΠΠ, ΡΡΠΎΠΏΠΎΠ½ΠΈΠ½ I ΠΈ B-ΡΠΈΠΏ Π½Π°ΡΡΠΈΡΡΠ΅ΡΠΈΡΠ΅Π½ ΠΏΠ΅ΠΏΡΠΈΠ΄.ΠΠΎΠ²ΠΈΡΠ΅Π½ΠΈΡΠ΅ Π½ΠΈΠ²Π° Π½Π°ΠΊΠ°ΡΠ΅Ρ
ΠΎΠ»Π°ΠΌΠΈΠ½ΠΈΡΠ΅ΡΠ°Π½Π°ΠΉ-ΡΡΠ½ΠΎ ΠΈΠ·ΡΠ°Π·Π΅Π½ΠΈΠΏΡΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Ρ Π»Π΅Π·ΠΈΠΈ Π² ΡΠ΅ΡΠΈΡΠΎΡΠΈΡΡΠ° Π½Π° Π΄ΡΡΠ½Π° ΡΡΠ΅Π΄Π½Π° ΠΌΠΎΠ·ΡΡΠ½Π° Π°ΡΡΠ΅ΡΠΈΡ ΠΈ ΡΠ° Π·Π½Π°ΡΠΈΠΌΠΎ ΠΏΠΎ-Π²ΠΈΡΠΎΠΊΠΈ ΠΏΠΎ Π²ΡΠ΅ΠΌΠ΅ Π½Π° ΠΎΡΡΡΠ°ΡΠ° ΡΠ°Π·Π° Π½Π° ΠΈΠ½ΡΡΠ»Ρ.Cardiovascular autonomic dysfunction after stroke has great clinical importance because worse prognosis and may lead to sudden arrhythmic death. Increased sympathetic activity after a stroke may lead to abnormalities in ECG, cardiac arrhythmias and myocardial necrosis. Along with the manifestations of metabolic acidosis increased plasma levels of several biochemical markers- norepinephrine, epinephrine and dopamine; cardiac enzymes and markers: creatine kinase and creatine kinase -MV, troponin I and B-type natriuretic peptide. Elevated levels of catecholamines are most pronounced in patients with lesions in the territory of the right middle cerebral artery, and were significantly higher during the acute phase of stroke
Association between blood glucose on admission and 2-hour glucose during oral glucose tolerance test in patients with acute coronary syndrome without known diabetes
ΠΡΠ²Π΅Π΄Π΅Π½ΠΈΠ΅: Π₯ΠΈΠΏΠ΅ΡΠ³Π»ΠΈΠΊΠ΅ΠΌΠΈΡΡΠ° ΠΏΠΎ Π²ΡΠ΅ΠΌΠ΅ Π½Π° ΠΎΡΡΡΡ ΠΊΠΎΡΠΎΠ½Π°ΡΠ΅Π½ ΡΠΈΠ½Π΄ΡΠΎΠΌ (ΠΠΠ‘) ΠΏΡΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Π±Π΅Π· ΠΈΠ·Π²Π΅ΡΡΠ΅Π½ Π΄ΠΈΠ°Π±Π΅Ρ Π΅ ΡΠ΅ΡΡΠ° ΠΈ ΡΠ΅ ΡΡΠΈΡΠ°, ΡΠ΅ Π΅ `ΡΡΡΠ΅ΡΠΎΠ²Π°`. ΠΡ Π΄ΡΡΠ³Π° ΡΡΡΠ°Π½Π° ΡΡ ΠΌΠΎΠΆΠ΅ Π΄Π° Π΅ ΠΏΡΡΠ²Π°ΡΠ° ΠΈΠ½Π΄ΠΈΠΊΠ°ΡΠΈΡ Π·Π° ΠΏΡΠ΅Π΄Ρ
ΠΎΠ΄Π½ΠΎ Π½Π΅ΡΠ°Π·ΠΏΠΎΠ·Π½Π°ΡΠΎ Π³Π»ΠΈΠΊΠ΅ΠΌΠΈΡΠ½ΠΎ Π½Π°ΡΡΡΠ΅Π½ΠΈΠ΅.Π¦Π΅Π»: ΠΠ° ΡΠ΅ ΠΏΠΎΡΡΡΡΠΈ Π²ΡΡΠ·ΠΊΠ° ΠΌΠ΅ΠΆΠ΄Ρ ΠΊΡΡΠ²Π½Π°ΡΠ° Π³Π»ΡΠΊΠΎΠ·Π° (ΠΠ) ΠΏΡΠΈ ΡΠΏΠ΅ΡΠ½Π° Ρ
ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΡ ΠΏΠΎΡΠ°Π΄ΠΈ ΠΠΠ‘ ΠΈ Π³Π»ΡΠΊΠΎΠ·Π½ΠΈΡΠ΅ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ Π² Ρ
ΠΎΠ΄Π° Π½Π° ΠΎΡΠ°Π»Π΅Π½ Π³Π»ΡΠΊΠΎΠ·ΠΎΡΠΎΠ»Π΅ΡΠ°Π½ΡΠ΅Π½ ΡΠ΅ΡΡ (ΠΠΠ’Π’).ΠΠ°ΡΠ΅ΡΠΈΠ°Π»ΠΈ ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΈ: ΠΡΠΈ 96 Π»ΠΈΡΠ° Ρ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° KAPCI ΠΈ Π±Π΅Π· Π°Π½Π°ΠΌΠ½Π΅Π·Π° Π·Π° Π³Π»ΠΈΠΊΠ΅ΠΌΠΈΡΠ½ΠΈ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ ΡΠ΅ ΠΏΡΠΈΠ»ΠΎΠΆΠΈ ΡΡΠ°Π½Π΄Π°ΡΡΠ΅Π½ ΠΠΠ’Π’ ΠΌΠ΅ΠΆΠ΄Ρ 3ΠΈ-10ΠΈ Π΄Π΅Π½ ΡΠ»Π΅Π΄ Π΄Π΅Ρ
ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΡΡΠ°. ΠΠ»ΡΠΊΠΎΠ·Π½ΠΈΡΡ ΡΡΠ°ΡΡΡ ΡΠ΅ ΠΊΠ»Π°ΡΠΈΡΠΈΡΠΈΡΠ° ΡΠΏΠΎΡΠ΅Π΄ ΠΊΡΠΈΡΠ΅ΡΠΈΠΈΡΠ΅ Π½Π° Π‘ΠΠ - 2006 Π³., Π·Π° ΠΏΠ»Π°Π·ΠΌΠ΅Π½Π° Π³Π»ΡΠΊΠΎΠ·Π° Π½Π° Π³Π»Π°Π΄Π½ΠΎ (ΠΠΠ) ΠΈ ΠΏΠ»Π°Π·ΠΌΠ΅Π½Π° Π³Π»ΡΠΊΠΎΠ·Π° Π½Π° 2ΡΠΈ ΡΠ°Ρ (2-Ρ-ΠΠ). ΠΠ½Π°Π»ΠΈΠ·ΠΈΡΠ°Π½Π° Π΅ ΠΠ ΠΏΠΎ Π²ΡΠ΅ΠΌΠ΅ Π½Π° ΡΠΏΠ΅ΡΠ΅Π½ ΠΏΡΠΈΠ΅ΠΌ ΠΏΡΠΈ 39 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΈ Ρ ΠΠΠ‘.Π Π΅Π·ΡΠ»ΡΠ°ΡΠΈ: Π£ΡΡΠ°Π½ΠΎΠ²ΠΈΡ
ΠΌΠ΅ Π½Π°ΡΡΡΠ΅Π½ Π³Π»ΡΠΊΠΎΠ·Π΅Π½ ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΠ·ΡΠΌ ΠΏΡΠΈ 64.58%, a Ρ
ΠΈΠΏΠ΅ΡΠ³Π»ΠΈΠΊΠ΅ΠΌΠΈΡ Π½Π° 2ΡΠΈ ΡΠ°Ρ (β₯7,8 ΠΌΠΌΠΎΠ»/Π») - ΠΏΡΠΈ 52.1% ΠΎΡ ΠΈΠ·ΡΠ»Π΅Π΄Π²Π°Π½ΠΈΡΠ΅ ΡΠ»Π΅Π΄ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ ΠΠΠ’Π’. Π‘ΡΠ΅Π΄Π½Π°ΡΠ° ΠΠ ΠΏΡΠΈ ΡΠΏΠ΅ΡΠ½ΠΎ ΠΏΡΠΈΠ΅ΠΌΠ°Π½Π΅ Π½Π° Π»ΠΈΡΠ°ΡΠ° Ρ Π½ΠΎΠ²ΠΎΠΎΡΠΊΡΠΈΡ ΡΠΈΠΏ 2 Π·Π°Ρ
Π°ΡΠ΅Π½ Π΄ΠΈΠ°Π±Π΅Ρ (Π½Π’2ΠΠ) Π±Π΅ΡΠ΅ 9,55Β±1,93 ΠΌΠΌΠΎΠ»/Π», ΠΊΠΎΡΡΠΎ Π±Π΅ΡΠ΅ Π·Π½Π°ΡΠΈΠΌΠΎ ΠΏΠΎ-Π²ΠΈΡΠΎΠΊΠ° ΡΠΏΡΡΠΌΠΎ ΡΠ°Π·ΠΈ Π½Π° Π»ΠΈΡΠ°ΡΠ° Ρ ΠΏΡΠ΅Π΄ΠΈΠ°Π±Π΅Ρ (7,22Β±2,01 ΠΌΠΌΠΎΠ»/Π»; p=0,006) ΠΈ Π½ΠΎΡΠΌΠ°Π»Π΅Π½ Π³Π»ΡΠΊΠΎΠ·Π΅Π½ ΡΠΎΠ»Π΅ΡΠ°Π½Ρ (6,31Β±2,08 ΠΌΠΌΠΎΠ»/Π»; p=0,0007). ΠΠ ΠΏΡΠΈ ΡΠΏΠ΅ΡΠ½ΠΎ ΠΏΡΠΈΠ΅ΠΌΠ°Π½Π΅ ΠΏΠΎΠΊΠ°Π·Π° ΠΏΠΎ-ΡΠΈΠ»Π½Π° ΠΏΡΠ°Π²Π° Π²ΡΡΠ·ΠΊΠ° Ρ 2-Ρ-ΠΠ (r=0,55; p=0,0003), ΠΎΡΠΊΠΎΠ»ΠΊΠΎΡΠΎ Ρ ΠΠΠ ΠΈ HbA1c. Π§ΡΠ΅Π· ROC Π°Π½Π°Π»ΠΈΠ· ΠΎΡΠ΅Π½ΠΈΡ
ΠΌΠ΅ ΡΡΠΎΠΉΠ½ΠΎΡΡΠΈΡΠ΅ Π½Π° ΠΠ ΠΏΡΠΈ ΡΠΏΠ΅ΡΠ΅Π½ ΠΏΡΠΈΠ΅ΠΌ Π·Π° ΠΎΡΠΊΡΠΈΠ²Π°Π½Π΅ Π½Π° Π΄ΠΈΠ°Π±Π΅Ρ. ΠΡΠ°Π³ΠΎΠ²Π°ΡΠ° ΡΡΠΎΠΉΠ½ΠΎΡΡ (Ρut off) >7,4 ΠΌΠΌΠΎΠ»/Π» ΠΏΠΎΠΊΠ°Π·Π° Π½Π°ΠΉ-Π΄ΠΎΠ±ΡΠ° ΠΊΠΎΠΌΠ±ΠΈΠ½Π°ΡΠΈΡ ΠΎΡ 91.7% ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»Π½ΠΎΡΡ ΠΈ 67.9% ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡ (area under the ROC=0,82; SE 0,06; 95% CI 0.698Γ·0.953; p=0,001).ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅: ΠΠ ΠΏΡΠΈ ΡΠΏΠ΅ΡΠ΅Π½ ΠΏΡΠΈΠ΅ΠΌ ΠΏΠΎΠΊΠ°Π·Π° Π½Π°ΠΉ-ΡΠΈΠ»Π½Π° ΠΊΠΎΡΠ΅Π»Π°ΡΠΈΡ Ρ 2-Ρ-ΠΠ, ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π° Π² Ρ
ΠΎΠ΄Π° Π½Π° ΠΠΠ’Π’. ΠΠ°ΠΌΠ΅ΡΠΈΡ
ΠΌΠ΅, ΡΠ΅ ΡΡΠΎΠΉΠ½ΠΎΡΡΡΠ° Π½Π° 2-Ρ-ΠΠ (ΠΠΠ’Π’) Π΅ Π΄ΠΎΡΠΈ ΠΏΠΎ-Π²ΠΈΡΠΎΠΊΠ° ΠΎΡ ΠΠ ΠΏΡΠΈ ΡΠΏΠ΅ΡΠ½Π° Ρ
ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΡ. ΠΠ° ΠΎΡΡ
Π²ΡΡΠ»ΡΠ½Π΅ Π½Π° Π³Π»ΠΈΠΊΠ΅ΠΌΠΈΡΠ½ΠΎ Π½Π°ΡΡΡΠ΅Π½ΠΈΠ΅ ΠΏΡΠΈ ΡΡΠΎΠΉΠ½ΠΎΡΡ Π½Π° ΠΠ ΠΏΡΠΈ ΡΠΏΠ΅ΡΠ΅Π½ ΠΏΡΠΈΠ΅ΠΌ > 7,4 ΠΌΠΌΠΎΠ»/Π» ΠΈΠ·Π³Π»Π΅ΠΆΠ΄Π° ΠΏΠΎ-ΠΏΠΎΠ΄Ρ
ΠΎΠ΄ΡΡΠΎ ΠΏΡΠΎΠ²Π΅ΠΆΠ΄Π°Π½Π΅ΡΠΎ Π½Π° ΠΠΠ’Π’.Introduction: Hyperglycemia during acute coronary syndrome (ACS) in patients without known diabetes is common and is considered `stress hyperglycemia`. On the other hand, it could be the first indication for previous unrecognized glycemic abnormality.Aim: To search for correlation between blood glucose (BG) at acute admission due to ACS and glycemic parameters during oral glucose tolerance test (OGTT). Materials and methods: A standard OGTT 3-10 days after hospital discharge was applied in 96 patients without history of glucose abnormalities who underwent coronary angiography (CA) percutaneous coronary intervention (PCI). Glucose tolerance was defined according to WHO-2006 criteria for fasting plasma glucose (FPG) and 2-hour-plasma glucose (2-h-PG). The BG at acute admission in 39 ACS patients was analyzed.Results: We found impaired glucose metabolism in 64.58% and 2-hour-hyperglycemia (β₯7,8 mmol/L) in 52,1% of study participants after the OGTT. Mean BG at acute admission in subjects with newlydiagnosed type 2 diabetes mellitus (nT2DM) was 9,551,93 mmol/L. It was significantly higher co
Clinico>statistical study of patients with Diseases related with an increased risk for Ischemic stroke lbased on the material of first Clinic of neurology, st. Marina university Hospital of varnar
In the present paper, the results from the clinical analysis of the patients with ischemic stroke and diagnosed risk diseases were analysed. During the period from 2007 to 2012, a total of 960 patients who had survived ischemic stroke, 456 males (47,50%) and 504 females (52,50%), aged between 32 and 94 years and hospitalized in the First Clinic of Neurology, St. Marina University Hospital of Varna, were examined. Some cerebrovascular, cardiovascular and metabolic diseases belonged to the most common pathology related with enhanced risk for ischemic stroke. The patients within the age groups between 40 and 59 years represented a considerable part among this contingent. There were statistically significant differences between males and females concerning the incidence rate of heart rhythm disturbances (p<0,001). A further more detailed analysis of the mutual relationships between ischemic stroke and the diseases related with higher risk for it will be carried out