Purpose: The study evaluates the changes in quality of life (QOL) six months after coronary artery bypass grafting (CABG) related to the patients' age. Methods: The total of 243 consecutive patients completed the Nottingham Health Profile Questionnaire part 1 before and six months after CABG. Postoperative questionnaire was completed by 226 patients. Patients were divided into four examined groups (<50, 50-59, 60-69 and ≥70 years), according to their age. Results: Six months after CABG, the quality of life in different sections has been significantly improved in most patients.The analysis of the relation between the age and the changes in QOL of patients six months after CABG showed a significant correlation among the patients' age and the improvement of QOL in the sections of physical mobility (r = 0.18, p = 0.008), social isolation (r = 0.17, p = 0.01) and energy ( r = 0.21, p = 0.002). The most prominent improvement was found in older patients. The age was not an independent predictor of QOL deterioration after CABG. Conclusions: The most noticeable improvement of QOL six months after CABG was found in older patients. Age is not the independent predictor of deterioration of QOL after CABG.

Background The aim of this study was to analyse the relationship between the clinical manifestations, disease severity based on radiography images, functional activity level, and quality of life in patients with knee osteoarthritis in a rural population living in Serbian enclaves in Kosovo, as well as to determine the correlation between the WOMAC and the EQ-5D questionnaire in this population. Method The cross-sectional study was conducted at the Internal Medicine Clinic, Clinical Hospital Center Pristina-Gracanica, located in Laplje Selo from February to December 2013. One hundred patients with confirmed (American College of Rheumatology criteria) knee osteoarthritis completed the EQ-5D and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires, rated pain on a visual analogue scale (VAS), and underwent knee radiographic examinations. Result Most patients were obese with moderate radiographic changes according to the Kellgeren–Lawrence scale and suffered from very severe pain according to the VAS scale. The duration of disease significantly correlated with the WOMAC scores, VAS score, and all of the scores on the EQ-5D, except for mobility. The age of participants showed a similar correlation with the same variables. The patients with higher Kellgren–Lawrence scores (3-4) were significantly older, with a significantly higher body mass index (BMI) and longer duration of disease than patients with lower scores (1-2). Significantly higher VAS, pain/discomfort EQ-5D, and WOMAC pain and function scores were also recorded among patients with more significant radiological changes. The correlations between WOMAC and EQ-5D were satisfactory. Conclusion The severity of clinical manifestations and radiographic area changes may affect functional ability and the quality of life in knee OA patients living in rural areas, which requires adequate treatment and physical therapy.

Cerebrovascular insult (CVI) is a known and important risk factor for the development of diabetic ketoacidosis (DKA); still, it seems that the prevalence of DKA among the patients suffering CVI and its influence on stroke outcome might be underestimated. Diabetic ketoacidosis itself has been reported to be a risk factor for the occurrence of stroke in children and youth. A cerebral hypoperfusion in untreated DKA may lead to cerebral injury, arterial ischemic stroke, cerebral venous thrombosis, and hemorrhagic stroke. All these were noted following DKA episodes in children. At least some of these mechanisms may be operative in adults and complicate the course and outcome of CVI. There is a considerable overlap of symptoms, signs, and laboratory findings in the two conditions, making their interpretation difficult, particularly in the elderly and less communicative patients. Serum pH and bicarbonate, blood gases, and anion gap levels should be routinely measured in all type 1 and type 2 diabetics, regardless of symptomatology, for the early detection of existing or pending ketoacidosis. The capacity for rehydration in patients with stroke is limited, and the treatment of the cerebrovascular disease requires intensive use of osmotic and loop diuretics. Fluid repletion may be difficult, and the precise management algorithms are required. Intravenous insulin is the backbone of treatment, although its effect may be diminished due to delayed fluid replenishment. Therefore, the clinical course of diabetic ketoacidosis in patients with CVI may be prolonged and complicated.

Kratak sadržajUvod. Inhibitori protonske pumpe (IPP) primenjuju se u terapiji acido peptičkih poremećaja uključujući peptički ulkus, gastroezofagusni reflex, erozivni i neerozivni ezofagitis, Zollinger-Elissonov sindrom, Helicobacter pylori infekcije i profilaksu stres ulkusa. Dobro dokumentovana efikasnost i relativna bezbednost primene, doprineli su značajnom propisivanju IPP u praksi. Neželjena dejstva IPP nisu ozbiljna i javljaju se kod približno 1-3% lečenih pacijenata, bez značajnijih razlika među pojedinačnim predstavnicima. Dugotrajna terapija IPP povećava rizik od razvoja rebound hipersekrecije želudačne kiseline, pneumonije i enteralnih bakterijskih infekcija (dijareja izazvana sa Clostridium difficile), preloma kostiju i kardiovaskularni rizik pri istovremenoj primeni sa klopidogrelom. IPP ne izazivaju deficit gvožđa i vitamina B12, ali povećavaju rizik od razvoja hipomagnezemije. Većina iznetih podataka potiče iz retospektivnih kohort i case-control studija. Da bi se utvrdila tačna uzročno posledična povezanost između IPP i neželjenih događaja neophodno je sprovesti velika prospektivna, randomizirana, kontrolisana klinička ispitivanja. Mnogo racionalnija upotreba IPP smanjila bi troškove u zdravstvu i osigurala njihovu bezbedniju primenu.Ključne reči: inhibitori protonske pumpe, dugotrajna primena, neželjena dejstva UvodInhibitori protonske pumpe (IPP) predstavljaju najefikasniju grupu antisekretornih lekova, koji su za samo nekoliko godina postali lekovi prvog izbora za sva stanja koja su praćena hiperaciditetom tj. pojačanim lučenjem želudačne kiseline. Tako su glavne indikacije za njihovu primenu peptički ulkus, erozivni i neerozivni refluksni ezofagitis, Zollinger-Ellisonov sindrom, infekcija izazvana bakterijom Helicobacter pylori (u okviru kombinovane terapije), kao i profilaksa stres ulkusa. Derivat benzimidazola -omeprazol prvi je

Prediktori pobolјšanja kvaliteta života nakon hirurške revskularizacije miokarda su još uvek nepotpuno poznati. Cilj rada je bio da ispita prediktore poboljšanja kvaliteta života šest meseci nakon hirurške revaskularizacije miokarda. Ispitivali smo 208 uzastopnih pacijenata koji su podvrgnuti hirurškoj revaskularizaciji miokarda. Za ispitivanje kvaliteta života korišćen je upitnik Nottingham Health Profile Questionnaire prvi deo. Upitnik se sastoji od 38 pitanja koji su podeljeni u 6 odeljaka: fizička pokretljivost, socijalna izolacija, emocionalne reakcije, energija, bol i san. Upitnik je podeljen svim pacijentima pre i šest meseci nakon operacije. Prosečna starost ispitivanih pacijenata je bila 58,8 ± 8,2 godine, 82% su bili muškarci. Poređenje pre i postoperativnih skorova je pokazalo da se poboljšanje nalazi kod 53,76% bolesnika, pogoršanje kod 12,46%, normalan KŽ pre i posle operacije kod 26,70%, dok je KŽ nakon operacije bez promene kod 7,08% bolesnika. Nezavisni prediktori poboljšanja kod pacijenata nakon operacije su bili: odsustvo prethodnog infarkta miokarda u odeljku fizička pokretljivost (p=0,03; OR=0,59; CI 0,40-0,92), viša CCS klasa angine u odeljcima fizička pokretljivost (p=0,006; OR=2,34; CI 1,46-3,32), energija (p=0,02; OR=1,70; CI 1,29-2,64) i bol (p<0,001; OR=4,64; CI 2,27-7,31), muški pol u odeljku bol (p=0,03; OR=0,45; CI 0,26-0,62) i mlađe starosno doba u odeljku bol (p=0,01; OR=0,69; CI 0,41-0,85). Prediktori poboljšanja kvaliteta života šest meseci nakon hirurške revaskularizacije miokarda su viša CCS klasa angine, odsustvo prethodnog infarkta miokarda, muški pol i mlađe starosno doba.