BACKGROUND: Fractures of thoracolumbar spine in the field of ankylosing diseases such as ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) can by surgically treated with miniinvasive posterior transpedicular fixation. The exact length of implant is the subject of several studies. In our study, we retrospectively evaluated the treatment of B3 fractures of the ankylosed thoracolumbar spine with use a shorter versus longer implant, always with 8 screws. MetHODS: A total of 46 patients were included in the study (36 men and 10 women). Sixteen patients had AS and 30 patients had DISH. Patients treated between 2018 and 2022 with minimally invasive dorsal transpedicular fixation using 8 transpedicular screws were included in this study. We compared two groups where the first consisted of patients operated on with fixation of a maximum of 4 segments and the second group of patients consisted of patients in whom longer stabilization was used, at least 5 to 8 segments, with skipping of some vertebra between screws. We compared the effect of fixation length on reduction and retention before surgery, after surgery, and after 6 and 12 months. We evaluated the effect of reduction and retention on the basis of differences in the measurement of the Cobb angle and the angle, which we called “vege”, which was formed by dislocation of the fracture. Furthermore, we monitored demographic data, the length of surgery, the number of complications, the number of concomitant injuries, the presence of a neurological deficit, and the result was assessed by the AO Spine PROST questionnaire. RESULTS: In the entire group of 46 patients, the difference in the “vege” angle was significant (p<0.001). When comparing the reduction between the groups with short and longer fixation, the difference was not significant (p=0.829). The difference of the Cobb angle before and after the surgery in the comparison between the two groups did not show a statistically significant difference (p=0.434). Measurements of the Cobb angle bisegmentally after 6 and 12 months showed a progressive change in terms of kyphotization, which was smaller in the group with longer fixation, this difference was not statistically significant (p=0.709). Complete reduction was achieved in the group with short fixation vs 75% vs 63.3% with longer fixation (p-0.739). At the check-up after 6 months, all incomplete intraoperative reductions were spontaneously reduced. CONCLUSIONS: Based on this study, we could conclude that both used constructions are comparable in terms of treatment results. It can be observed that longer fixation is more resistant to kyphotization at 6 and 12 months, but we would need a larger group of patients to confirm this hypothesis. In all incomplete reduced fractures through the surgery, complete reduction after verticalization occurred within 6 months in both groups. The angle of reduction was greater in the group with longer fixation, but the difference was not significant (Tab. 6, Fig. 8, Ref. 31).
BACKGROUND: Acute coronary syndrome (ACS) is a major health problem and the leading cause of death and disability in Slovakia. This is the first study to describe the prevalence rate of conventional cardiovascular risk factors in patients hospitalized for ACS. METHODS: Hypertension, diabetes mellitus, hyperlipidemia and cigarette smoking were documented in 1,567 cases (mean age, SD: 66.1±12.0 years, 34.8% of females) enrolled in the SLOVAKS registry from August 2011 through September 2011. RESULTS: Overall, 83.5% (95% CI, 81.6-85.2%) of the patients with ACS had hypertension, 65.0% (62.5-67.2%) had a hyperlipidemic profile, 32.6% (30.3-34.9%) were diagnosed with diabetes, and 27.6% (25.1-29.8%) were smokers at the time of a heart-related event. Only 5% of patients with ACS lacked any of the 4 conventional risk factors. Higher prevalence rates of all major risk factors, except smoking, were detected in women than in men, in older (≥65 years of age) than younger patients, and in rural (<2,000 inhabitants) than in urban areas. Premature ACS (<45 years of age) was associated with smoking in men, and smoking and hypertension in women. Smoking, in all risk factor combinations, reduced the age at the time of a heart-related event, on average, by 10.0 years in men and by 12.4 years in women. CONCLUSIONS: The results of this study suggest an appreciable burden of major cardiovascular risk factors and also highlight differences that may aid the targeting of public health interventions.
- MeSH
- akutní koronární syndrom epidemiologie etiologie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- prevalence MeSH
- registrace MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- věkové faktory MeSH
- zdravotnické přehledy MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Slovenská republika epidemiologie MeSH
The objective of the study was to determine some Cardiovascular Disease (CVD) risk factors in relation to cigarette smoking in 174 Roma children and adolescents (88 males and 86 females) and 131 non-Roma probands (males and females) aged 7-18 in central Slovakia. In this biethnic study, 26.4% of the Roma children and adolescents (more than twice contrary to the control group) were smokers. Among the studied ethnicities, the majority of smokers was Roma (79.3%, 46 subjects). Smoking Roma have higher means of TG, Lp(a) and WHR compared with non-smoking non-Roma. The most frequent CVD risk predictors of smoking Roma probands was low serum levels HDL-C, apo A (the Fisher test confirmed a significant relationship between cigarette smoking and HDL-C, apo A; p < 0.01). The results of the research should help to develop an effective preventative health education programs focused on Roma education (who live in a higher-risk environment compared to the majority population) in order to stem the spread of CVD as well as morbidity and mortality in this ethnic group living in Slovakia.
- MeSH
- cholesterol krev MeSH
- dítě MeSH
- financování organizované MeSH
- index tělesné hmotnosti MeSH
- kardiovaskulární nemoci epidemiologie etnologie krev MeSH
- komorbidita MeSH
- kouření epidemiologie etnologie krev MeSH
- krevní tlak MeSH
- lidé MeSH
- lipoproteiny krev MeSH
- mladiství MeSH
- poměr pasu a boků MeSH
- prevalence MeSH
- rizikové faktory MeSH
- Romové statistika a číselné údaje MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Slovenská republika MeSH
The objective of the study was to determine some Cardiovascular Disease (CVD) risk factors in 174 Roma children and adolescents (88 males and 86 females) aged 7-18 in 3 Central Slovakian cities (44 from Zilina, 39 from Bansk, Bystrica and 91 from Rimavská Sobota). Venous blood samples were drawn in the morning, after a 12 hour overnight fast for biochemical analysis. Total cholesterol (TC) and triglycerides (TG) were determined enzymatically. HDL-cholesterol (HDL-C) after selective precipitation lipoproteins containing apolipoprotein B and LDL-cholesterol (LDL-C) was calculated by the Friedewald Formula. Serum levels of apolipoproteins (apo A, apo B) were analyzed immunochemically. Concentration of lipoprotein a [Lp(a)] was analyzed by immunonephelometric method (Beckman-Coulter System). Anthropometric measurements, including weight, height, waist and hip circumference were used to calculate the sum of the body mass index (BMI) and waist to hip ratio (WHR). Measured blood pressure (BP) was used to classify for hypertension. Significant differences were determined in serum levels of LDL-C (p < 0.05; by Tukey HSD test multiple comparison more significant difference was determined between Zilina and Rimavská Sobota p < 0.046), TG (p = 0.008), apo A (p < 0.001), Lp(a) (p = 0.042), WHR (p < 0.001), BMI (p < 0.001), sBP (p < 0.001) and dBP (p = 0.012) in Roma individuals of all locality groups. The Roma population from Rimavsk, Sobota had (in comparison to the examined populations) statistically higher values of TC, TG, LDL-C, lower HDL-C. The population showed significant relation of TG and stress at home (p = 0.03) and at school (p = 0.01), HDL-C and cigarette smoking (p = 0.004), apo A and cigarette smoking (p = 0.02) and socioeconomic status (p = 0.006), WHR and cigarette smoking (p = 0.02). Risk values of WHR, apo B and Lp(a) were mostly determined in Zilina's population (WHR significantly connected with family history CVD p = 0.03, cigarette smoking p = 0.02 and leisure time physical activity p < 0.001) and BMI, apo A and BP in Banská Bystrica. WHR was positively correlated to BP and negatively to HDL-C and TG only in Roma participants from Rimavská Sobota. BMI was positively correlated to systolic BP in populations from Banská Bystrica and Rimavská Sobota. The results of the study should improve the paediatric health treatment and prevention of CVD risk predictors for Roma from different cities.
- MeSH
- adipozita MeSH
- charakteristiky bydlení MeSH
- dítě MeSH
- financování organizované MeSH
- kardiovaskulární nemoci etnologie prevence a kontrola MeSH
- lidé MeSH
- lipidy krev MeSH
- mladiství MeSH
- rizikové faktory MeSH
- Romové statistika a číselné údaje MeSH
- životní styl MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- multicentrická studie MeSH
- Geografické názvy
- Slovenská republika MeSH
Cieľ: Porovnať klinický profil, nálezy na urgentnej koronarografii a včasný priebeh u pacientov so STEMI v mladom a vysokom veku. Súbor a metodika: retrospektívna analýza pacientov vo 2 vekových skupinách: do 50 rokov (sk. A) a nad 75 rokov (sk. B), u ktorých bola vykonaná urgentná koronarografia pre STEMI. Vyhodnotené boli anamnestické ukazovatele, koronarografické nálezy, funkcia ĽK, spôsob liečby a hospitalizačná mortalita. Výsledky: v sledovanom období bolo na našom pracovisku hospitalizovaných pre STEMI v sk. A 90 pac. vo veku 26-50 (priemerne 44,6) rokov a v sk. B 87 chorých vo veku 75-89 (priemerne 78,3) rokov. V skupine mladších pacientov bol podiel mužov 79 (87,7 %) vs. 39 (44,8 %) (p < 0,001), pozitívna rodinná anamnéza kardiovaskulárnych ochorení bola v sk. A u 55 (61,1 %) oproti 25 (28,7 %) pac., p < 0,001. Prítomnosť hypertenzie bola v sk. A u 36 (40 %) a v sk. B u 61 (70,1 %) chorých, p < 0,001 a diabetes mellitus u 6 (6,7 %) oproti 26 (29,9 %) pac., p < 0,001. V sk. A fajčilo 68 (75,6 %) oproti 13 (14,9 %) pac. v sk B (p < 0,001). Po infarkte myokardu bolo v sk. A 10 (11,1 %) a v sk. B 18 (20,7 %) pac., p=0,036 a po mozgovej príhode 2 (2,2 %) oproti 24 (27,6 %) pacientov, p < 0,001. Postihnutie 1 cievy na koronarografii bolo hodnotené u 47 (52,2 %) pac. v sk. A vs 21 (24,1 %) v sk. B (p < 0,001). Priemerná EFĽK dosahovala 48 % v sk. A vs 41 % v sk. B (p < 0,001). Priamu PKI podstúpilo 79 (87,8 %) pac. v sk. A a 71 (81,6 %) chorých v sk. B, p=ns, konzervatívne bolo liečených 11 (12,2 %) pac. v sk. A oproti 16 (18,4 %) v sk. B, p=ns. Úmrtie počas hospitalizácie nastalo v sk. A u 3 chorých (3,3 %) oproti 12 pac. (13,4 %) v sk. B (p=0,01). Záver: Pacienti so STEMI vo veku nad 75 rokov predstavujú rizikovú skupinu s významnou komorbiditou a častým nálezom viaccievneho postihnutia koronárneho riečiska na vstupnej koronarografii. V porovnaní s chorými liečenými pre STEMI vo veku do 50 rokov majú vyšší výskyt prekonaného infarktu myokardu alebo cievnej mozgovej príhody v minulosti. Tento rizikový profil sa následne odráža aj v horšej globálnej systolickej funkcii ľavej komory a vo zvýšenej nemocničnej mortalite po priamej PKI.
Aim: To compare clinical profile, findings on urgent coronarographyc and early course in patients with STEMI at young and old age. Patients and methods: retrospective analysis of patients in 2 age groups: up to 50 yrs (group A) and over 75 yrs (group B) who underwent urgent coronarography for STEMI. History, coronarographic findings, function of left ventricle, therapy and hospital mortality were evaluated. Results: the followed - up at our work place, there were hospitalized during evaluated period of time in our department for STEMI in group A 90 pts.at the age of 26-50 (mean age 44.6) years and 87 pts. in group B at the age of 75-89 (mean 78.3) years. In the group of younger patients the ratio of males was 79 (87.7 %) vs 39 (448 %) (p < 0.001), positive family history of cardiovascular diseases was in group A in 55(61.1 %) vs 25 (28.7 %) pts., p < 0.001. Presence of hypertension was in group A in 36 (40 %) and in group B in 61 (70.1 %) pts., p < 0.001 and diabetes mellitus in 6 (6.7 %) vs 26 (29.9 %) pts., p < 0.001. In group A there were 68 (75.6 %) smokers vs 13 (14.9 %) pts. In group B (p < 0.001).Ten patients (11.1 %) in group A were after myocardial infarction, in group B 18 patients (20.7 %) pts., p=0.036 and 2 (2.2 %) vs 24 (27.6 %) pts. after stroke, p < 0.01. Lesion of 1 vessel on coronography was evaluated in 47 (52.2 %) pts. in group A vs 21 (24.1 %) in group B (p < 0.001). Average LVEF achieved 48 % in group A vs 41 % in group B (p < 0.001). 79 (87.8 %) pts. in group A and 71 (81.6 %) pts .in group B underwent direct PCI, p=ns, conservative therapy was applied in 11 (12.2 %) pts. in group A vs 16 (18.4 %) in group B, p=ns. Death during hospitalization was reported in group A in 3 pts. (3.3 %) vs 12 pts. (13.4 %) in group B (p=0.01). Conclusion: Patients with STEMI at the age over 75 years represent a risk group with significant comorbidity and frequent findings of multivascular lesions of coronary bed at initial coronarography. Compared with patients treated for STEMI at the age of 50 years they have history of myocardial infarction or stroke in the past. This risk profile reflects worse global systolic function of the left ventricle and higher hospital mortality after direct PCI.
- Klíčová slova
- Arteknit Ra K,
- MeSH
- aorta chirurgie MeSH
- biologické jevy MeSH
- cévy - implantace protéz MeSH
- experimenty na zvířatech MeSH
- fibrinogen MeSH
- polyestery MeSH
- psi MeSH
- thromboxan A2 MeSH
- vápník diagnostické užití MeSH
- zvířata MeSH
- Check Tag
- psi MeSH
- zvířata MeSH
Infarkt myokardu s eleváciami segmentov ST (STEMI), bez elevácií segmentov ST (NSTEMI) a nestabilnú anginu pectoris (NAP) zahŕňame pod označenie akútne koronárne syndrómy (AKS). Hoci majú viaceré spoločné rysy, líšia sa často tak v charaktere postihnutia koronárneho riečiska, ako aj v indikácii invazívnej diagnostiky a revaskularizačnej liečby. Autori sa v článku zamerali na retrospektívne porovnanie súborov chorých so STEMI a NSTEMI/NAP z hľadiska ich klinických a anamnestických charakteristík, nálezov pri koronárnej angiografii a ďalšej liečebnej stratégie.
Myocardial infarction with ST segment elevation (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina (UAP) represent an acute coronary syndrome. Although these disorders have many common features they often differ in coronary arteriography findings and in invasive diagnostic consideration and revascularization treatment decision. This article presents retrospective comparison of clinical characteristics, angiografic findings and treatment strategies between STEMI group and NSTEMI/NAP patients.
