BACKGROUND: Electrocardiogram (ECG) signs on admission can serve as a prognostic marker in patients treated for myocardial infarction (MI). AIM: The aim of the study was to determine the predictive role of modified Anderson–Wilkins (MAW) ECG score of acuteness on the extent of myocardial injury, left ventricular (LV) remodeling, and clinical outcome in patients with acute MI. METHODS: Prospective, observational cohort study on patients treated for MI at the University Clinic for Cardiology. Subjects were analyzed for their demographic, clinical, ECG, LV functional, angiographic variables, course of treatment, and in-hospital outcome. MAW score was calculated for each patient. Patients were comparatively analyzed divided in two groups (score <3 and ≥3). RESULTS: One hundred fifty patients (70% males and 30% females), aged 60.9 years were included in the study. Sixty-eight patients had MAW score <3 (mean 1.7), and 82 had score ≥3 (mean 3.5), p>0.001. Patients with ST-segment elevation MI had OR 2.1 (p>0.000), and patients with multiple locations (excluding anterior) had OR 2.1 (p > 0.000) of having MAW score ≥3. They received mechanical reperfusion 1.9 (p = 0.032) times more often. High MAW score was associated with stress hyperglycemia (OR 2.1; p = 0.032); low potassium (OR 2.8; p = 0.032), lower creatinine (p = 0.050), and higher NT-proBNP (OR 2.5; p = 0.050). High MAW score was associated with decreased LV function and increased LV dimensions on the follow-up echocardiography (p = 0.050 and 0.012, respectively). CONCLUSION: ECG is an important prognostic tool in MI patients. ECG-derived MAW score demonstrates a strong correlation with stress hyperglycemia, potassium, creatinine, and natriuretic peptides level and can serve as an early marker of LV remodeling after MI.
Aim:in older people with Parkinson's disease the symptoms are more expressed.Background:Essential change in Parkinson's disease is the impaired neurotransmission in basal ganglia. Idiopathic Parkinson's disease (IPD) is the most frequent type of Parkinsonism, being present in about 70% of the patients with Parkinsonism.Material and methods:This study has been prospective, clinically one, which has been lasting for whole 2 years. This study comprised a total of 32 subjects with clinically verified diagnosis for idiopathic Parkinson's disease, 18 men and 14 women (with mean age of 52,7 years). Control group consisted of 31 randomly selected, literally healthy persons, at similar age, with similar gender representation without clinical and anamnestic data for Parkinsonism and similar clinical entities. This study was made at the University Clinic of Neurology in Skopje, Medical Faculty, University “St. Cyril and Methodius”. The persons investigated had idiopathic Parkinson's disease (IPD), in whom IPD was verified by means of detailed anamnesis, detailed clinical neurologic examination, strictly keeping to Brain Bank Criteria, and by means of neurophysiologic investigations, neuroimaging investigations and neuropsychologic investigations. Minimal symptoms of IPD after UPDRS were present in 34,4% of the examinees, there were 40,6% with slight signs, while equal number of the examinees 4 (12,5%) had pronounce and very expressed symptoms of Parkinson's disease after UPDRS.Conclusion:Parkinson's disease is with more expressed signs and symptoms and with slight symptoms in older patients with this diagnosis.
Migraine is a common headache disorder that causes significant disabilities. Non-selective cyclooxygenase (COX) inhibitors (piroxicam, ketoprofen and ibuprofen) are most widely-prescribed NSAIDs treatment of headaches. Celecoxib is another NSAID therapy that has been approved in the last several years, with different mechanisms of action. The purpose of the study is to follow the renal function and comparisons of nephrotoxicity of different types of NSAID based on COX inhibition, in patients with cefalea-migraine that has been treated for a long period. Besides conventional markers of renal function (serum/urine creatinine determined by Jaffe's methods of enzymatic assay for urea in serum), we used nephelometry by β2 microglobulin (β2M) and photoelectric colorimetry for microalbuminuria in urine, to monitor glomerular and tubular functioning. Any history of kidney diseases was exclusion criteria to enter the study. The results show that the greatest deviations are observed in β2M in terms of its increase in all patients treated with piroxicam and ketoprofen, in 91.7% of the patients treated with ibuprofen, and in 50% of patients treated with celecoxib. The most frequent decrease was shown in creatinine values in urine, in 50% of the patients of piroxicam-treated group, 66.7% of the group treated with ketoprofen and ibuprofen, and 75% of the patients treated with celecoxib. Following the levels of specific biomarkers in urine we can recommend constant monitoring of renal functions during usage of different groups of NSAIDs and be careful while using analgesic-anti-inflammatory drugs. Keywords: adverse renal effects, non-steroidal anti-inflammatory drugs, migraine
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