[Stable and unstable coronary atherosclerotic plaque].
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Biomedical subjects
Publications and source records attributed to D Tavciovski.
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UNLABELLED: The aim of the study was to examine if there existed a risk from interference of cellular phones on patients with implanted permanent pacemakers. The study comprised 144 patients (134 VVI/VVIR and 10 DDD/DDDR) with permanent pacemakers of different manufactures. METHODS: During the routine pacemaker check, cellular phone aerial (Nokia 1610; GSM Standard) was placed against the skin of patients above the spot of pacemaker implantation, while the phone calls were repeated and ECG was continuously monitored. The effect of cellular phone on pacemaker was established upon: a) preexisting parameters of electric pacemaker stimulation; b) minimal ventricular rate of 90 beats/min, while electric stimulation parameters were set to their most sensitive values (MSV). RESULTS: Only in 9 (6.25%) patients was observed intermittent pacemaker inhibition, when pacemaker settings were on preexisting values of electric stimulation, while in 17 patients (11.8%) inhibition was noticed, when pacemaker settings were changed to their MSV. Besides, programmed values of electric stimulation in our patients remained unchanged. CONCLUSION: Although the electromagnetic interference interactions of cellular phones on pacemaker function were observed in relatively small number of our patients, we were of the opinion that pacemaker-dependent patients should avoid the use of cellular phones.
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Beside dyslipoproteinemia, one of the key risk factors for the onset of brain atherosclerosis, as well as ischemic brain disease (IBD) is arterial hypertension. Significant number of patients is not aware of their hypertension, and a paradoxical blood pressure decrease can occur at the onset of IBD, due to the failure of autoregulation mechanisms. Likewise, valid anamnestic data can not frequently be obtained due to difficulties in communication with patients. Regarding these facts, our hypothesis was that ophthalmoscopy in patients with IBD had the greatest sensitivity in the diagnosis of hypertensive disease, its duration and severity. For that reason, the purpose of this study was to determine the significance of ocular fundus examination in those patients with IBD who were not aware of their hypertension, or the high blood pressure was not registered at the admission. Study comprised 140 IBD patients selected upon the following criteria: ophthalmoscopy was performed by the same ophthalmologist, and IBD was diagnosed according to clinical criteria and by brain computerized tomography. Results of the study demonstrated that 26 (18.6%) patients, although not aware of having hypertensive disease, had grade I hypertonic fundus, 14 (10%) had grade II, and 8 (5.5%) had grade III hypertonic fundus, which indicated the high sensitivity of ophthalmoscopy in the diagnosis of hypertensive disease, as well as its duration and severity. This is particularly important in patients with negative history of hypertension, and also suggests the significance of routine ophthalmoscopy in normotensive patients.
Heart and brain vascular diseases are the leading causes of mortality in the world. Cardiac complications can frequently occur during the development of cerebral ischemia. The aim of this study was to establish the possible changes in fractions of creatinine-phosphokinase as the sensitive laboratory index of parenchymal lesion of brain parenchyma and the presence/absence of risk factors for ischemic brain and heart disease. The study comprised 80 patients with acute ischemic brain disease (AIBD), without the history of previous coronary disease. Blood samples were taken in all patients within the first 48 hours from AIBD onset aiming to determine a total (muscular MM) and heart fraction of creatinine-phosphokinase (MB), and brain parenchyma ischemia was confirmed by CT or MR scan of the head. A detailed history of the risk factors for ischemic brain disease (IBD) and ischemic heart disease was taken from all patients with AIBD, and the profile of glycemia and lipid status were determined, and blood pressure was measured 6 times a day. Independent variables in statistical analysis were: age, degree of severity and the side of neurologic event, size of ischemic lesion and maximal values of systolic and dyastolic pressure. Dependent variables were the values of fractions of creatinine-phosphokinase (CPK). Control group (n = 40) comprised patients with neurologic diseases of non-vascular origin. All parameters as well as their interrelations were statistically analyzed. The results revealed significant correlation of the increased levels of CPK of MM and MB fraction with the size and place of ischemic lesion in the right cerebral hemisphere, which was highly significant for MB fraction in the total group of patients with AIBD, and for MM fraction, only for cases of more severe IBD. Highly significant increased values of those fractions were also observed compared to the control group of patients.
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The adequacy of therapeutic program for hypertensive disease in the patients with ischemic brain disease was analyzed in the study related to the administration of the drugs divided by the groups of antihypertensive drugs. The results had demonstrated that in over 50% patients the therapy had to be changed by introducing at least one hypertensive drug from the other group. In many cases were observed inadequate doses of antihypertensive drugs and the prescription of antihypertensive drug in minimal dose, although therapeutic response was not adequate. In significant number of cases (over 80%), the patients were irregularly taking the prescribed therapy, and only 18% had the regular controls. The results of this investigation indicated that on one side did not exist the adequate therapeutic program for hypertension control and on the other the significant number of patients irregularly used the proposed therapy and did not control the disease regularly.
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