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41.
AIM: To study the 15-year trends of blood pressure (BP) values in inhabitants of Estonia, three independent random samples of the population of Tallinn aged 20-54 years were examined in 1984/86, 1992/94 and in 1999/2001. RESULTS: A substantial decrease in BP values was observed in the population of Tallinn by the early 1990s; it continued to a smaller extent during the late 1990s. An improvement in some factors contributing to the development of arterial hypertension: decrease in body mass index (BMI) mean values and positive dietary changes were observed during this period. In the late 1990s, the changes in contributing factors were less synonymous. In men, the BMI mean values, intake of calories and alcohol increased but smoking rates dropped substantially; physical activity and P/S ratio increased. In women, the BMI mean values, which decreased considerably between the 1980s and early 1990s, remained stable, as well as smoking rates; physical activity increased and positive changes in nutrition were more pronounced than in men. The BP values also decreased in women to a greater extent than in men. CONCLUSION: Favourable trends in BP and contributing factors were found in Estonia during the transition period accompanied by a cardiovascular disease mortality decline since 1995.  相似文献   
42.

Aims

The objective of the present substudy was to examine whether aspirin poor/high responsiveness (APR/AHR) is associated with increased rates of major adverse cardiovascular events (MACE) and serious bleeding after primary percutaneous coronary intervention (PPCI).

Methods

We analyzed 961 consecutive ST-elevation acute myocardial infarction patients who underwent PPCI between February 2008 and June 2011. Multiplate analyser (Dynabite, Munich, Germany) was used for the assessment of platelet reactivity. APR/AHR were defined as the upper/lower quintiles of ASPI values, determined 24 h after aspirin loading. APR patients were tailored using 300 mg maintenance dose for 30 days. The co-primary end points at 30 days were: MACE (death, non-fatal infarction, ischemia-driven target vessel revascularization and ischemic stroke) and serious bleeding according to the BARC classification.

Results

One hundred and 90 patients were classified as APR, and 193 patients as AHR. At admission, compared with aspirin sensitive patients (ASP), patients with APR had more frequently diabetes, anterior infarction and heart failure, while AHR patients had reduced values of creatine kinase, leukocytes, heart rate and systolic blood pressure. Compared with ASP, the rates of 30-day primary end points did not differ neither in APR group including tailored patients (MACE, adjusted OR 1.02, 95%CI 0.47-2.17; serious bleeding, adjusted OR 1.92, 95%CI 0.79-4.63), nor in patients with AHR (MACE, adjusted OR 1.58, 95%CI 0.71-5.51; serious bleeding, adjusted OR 0.69, 95%CI 0.22-2.12).

Conclusions

The majority of APR patients were suitable for tailoring. Neither APR including tailored patients nor AHR were associated with adverse 30-day efficacy or safety clinical outcomes.
  相似文献   
43.
Cardiogenic shock (CS) is a complex multifactorial clinical syndrome with extremely high mortality, developing as a continuum, and progressing from the initial insult (underlying cause) to the subsequent occurrence of organ failure and death. There is a large spectrum of CS presentations resulting from the interaction between an acute cardiac insult and a patient's underlying cardiac and overall medical condition. Phenotyping patients with CS may have clinical impact on management because classification would support initiation of appropriate therapies. CS management should consider appropriate organization of the health care services, and therapies must be given to the appropriately selected patients, in a timely manner, whilst avoiding iatrogenic harm. Although several consensus‐driven algorithms have been proposed, CS management remains challenging and substantial investments in research and development have not yielded proof of efficacy and safety for most of the therapies tested, and outcome in this condition remains poor. Future studies should consider the identification of the new pathophysiological targets, and high‐quality translational research should facilitate incorporation of more targeted interventions in clinical research protocols, aimed to improve individual patient outcomes. Designing outcome clinical trials in CS remains particularly challenging in this critical and very costly scenario in cardiology, but information from these trials is imperiously needed to better inform the guidelines and clinical practice. The goal of this review is to summarize the current knowledge concerning the definition, epidemiology, underlying causes, pathophysiology and management of CS based on important lessons from clinical trials and registries, with a focus on improving in‐hospital management.  相似文献   
44.
Starch, glycogen, and cellulose are all around us. They are eaten and used on a daily basis but they are not understood completely. Even though these carbohydrates are simple, concerning their repeating unit, they are hard to characterize. In order to try to understand as much as possible about their structure and the relationship between their molecular structure and physical properties, it is very practical to create such polysaccharides, for instance enzymatically, characterize them, and use them as standards for the characterization of natural ones. Therefore, the main objective of this Trend article is to outline different enzymatic routes to such carbohydrates, possibilities for their characterization, and the characterization of natural ones.  相似文献   
45.
46.
Several single nucleotide polymorphisms in survivin gene promoters, notably -31G/C, have been shown to modulate the expression and activity of the survivin protein. Consequently, the -31G/C polymorphism has been identified as a risk factor for the development of several types of tumors. The aim of this study was to investigate a possible association between the -31G/C polymorphism and the risk for keratocystic odontogenic tumor (KCOT) development. DNA from 52 biopsy specimens of KCOTs and from 82 buccal swabs of healthy individuals was subjected to PCR restriction fragment length polymorphism analysis to identify individual genotypes. The distribution of genotypes in KCOT and control groups, respectively, was: GG: 30 (57.7%) vs. 26 (31.7%); CG: 17 (32.7%) vs. 45 (54.9%); and CC: 5 (9.6%) vs. 11 (13.4%), respectively. These differences were statistically significant. The G allele was more common in the KCOT group than in the control group: 76 (74%) vs. 96 (59%), respectively. Logistic regression analysis showed that GC heterozygotes had a considerably decreased susceptibility for KCOTs compared with GG homozygotes. The same was true for GC+CC vs. GG. The GG genotype of the -31G/C polymorphism might be a risk factor for KCOT development.  相似文献   
47.
Ventricular septal defects (VSDs) are a common congenital heart disease. Usually, surgical repair with cardiopulmonary bypass (CPB) is the treatment of choice, whereas percutaneous techniques have technical limitations, predominantly a mismatch of catheter size and body weight. A 7-year-old girl underwent periventricular closure of a perimembranous VSD on the beating heart. Echocardiography guided implantation through a minimally invasive sternotomy was uneventful. The described approach adds favorably to the current practice avoiding the use of CPB. Cosmetic aspect and rapid early postoperative recovery are convincing.  相似文献   
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We examined changes in weight‐specific health‐related quality of life (HRQOL) and the relation to weight loss in a Serbian population undergoing diet‐induced weight loss treatment. HRQOL was assessed at intake and after 1 year using the Impact of Weight on Quality of Life‐Lite (IWQOL‐Lite) questionnaire. Study sample consists of 135 obese patients. After 1 year of diet therapy, patients experienced an average weight loss of ~12%, and significant improvements were noted in all IWQOL‐Lite domains (Physical Function, Self‐esteem, Sexual Life, Public Distress and Work). Amount of weight loss was closely linked to all domains (F = 27.49; p < 0.001), except Sexual Life (F = 2.08; p = 0.108). In patients with weight reductions of 5%–9.99%, there was a great improvement in physical function and self‐esteem. In those with ≥10% weight loss, there was improvement in all dimensions of IWQOL‐Lite. With the prevalence of obesity rising worldwide, including in Serbia, the positive effects of weight loss on weight‐specific HRQOL are encouraging. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.  相似文献   
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