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Dragila Ž, Lozert M, Canecki-Varžić S, Selthofer-Relatić K. Prevalence of familial hypercholesterolemia in patients with acute coronary syndrome. Med Glas (Zenica) 2024; 21:29-35. [PMID: 38341639 DOI: 10.17392/1678-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 11/20/2023] [Indexed: 02/12/2024]
Abstract
Aim To investigate the prevalence of familial hypercholesterolemia in patients with acute coronary syndrome (ACS). Methods The study included fifteen patients with first or repeated ACS and treated/nontreated dyslipidaemia admitted to the Department of Cardiovascular Diseases of Clinical Hospital Centre Osijek between 1 January 2020 and 1 January 2021. The cut-off value of low-density lipoprotein (LDL)-C was 4.5mmol/L as a possible cut-off value for familial hypercholesterolemia presence. Data were collected from medical history and during patient's follow-up. Results Included patients that fulfilled criteria were predominantly male - 14 (93%), mean age 61 years. The median level of LDL cholesterol at admission because of ACS was 5.14 mmol/L, whereas the follow-up level after one year was 2.27 mmol/L (p=0.001). At first follow-up, 7 (46%) patients were treated with atorvastatin 80 mg or rosuvastatin 40 mg, 3 (20%) atorvastatin 80mg + ezetimibe 10mg, 2 (13%) with rosuvastatin 40 mg+ ezetimibe 10 mg, other patients were treated with a lower dose of statin or ezetimibe. According to LDL-C profile and by calculating the Dutch Lipid Clinic Network Score, one (of 15) patient was categorized as having definite familial hypercholesterolemia and two (of 15) as having probable familial hypercholesterolemia leading to the use of triple hypolipidemic therapy (statin+ezetimibe+PCSK9 inhibitor) in 2 (13%) patients (one female and one male). Conclusion LDL-C level of 4.5 mmol/L and higher represents an indication for screening for familial hypercholesterolemia in patients with ACS. The prevalence of familial hypercholesterolemia in ACS, estimated by the Dutch Lipid Clinic Network Score, could be higher than previously reported.
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Affiliation(s)
- Željka Dragila
- Emergency Department, University Hospital Centre Osijek, Osijek, Croatia
- School of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Matea Lozert
- Division of Gastroenterology, Endocrinology and Diabetes, Department of Internal Medicine, General Hospital Slavonski Brod, Slavonski Brod, Croatia
| | - Silvija Canecki-Varžić
- School of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- Division of Endocrinology, Department of Internal Medicine, University Hospital Centre Osijek, Croatia
| | - Kristina Selthofer-Relatić
- School of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- Division of Cardiology, Department of Internal Medicine, University Hospital Centre Osijek, Osijek, Croatia
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Marušić R, Dragila Ž, Levaković A, Lekić I, Mihaljević D, Debeljak Ž, Bačun T. The most common indications for measuring metanephrine and normetanephrine in plasma - a rational approach. Med Glas (Zenica) 2023; 20. [PMID: 37300464 DOI: 10.17392/1588-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/16/2023] [Accepted: 03/10/2023] [Indexed: 06/12/2023]
Abstract
Aim To determine the most common indications for measuring metanephrine and normetanephrine in plasma by gender and age and to compare the concentrations of metanephrine and normetanephrine by indication, gender and age. Methods The study was conducted on 224 patients whose plasma metanephrine and normetanephrine concentrations were measured at the Clinical Institute for Laboratory Diagnostics at the University Hospital Centre Osijek for one year, until 1st January 2020. Results The most frequent indications for biochemical testing were adrenal incidentaloma, 138 (6.6 %), and symptoms of pheochromocytoma, 41 (18.3%). Metanephrine concentration was lower in females (p=0.009). No significant correlation was found between age and metanephrine concentration, while age and normetanephrine concentration were positively correlated (p=0.01). Of the 224 patients, only one patient was diagnosed with pheochromocytoma, whose indication for measurement of metanephrine and normetanephrine was adrenal incidentaloma. Conclusion Adrenal incidentalomas and symptoms suggestive of pheochromocytoma are very common in the general population, while the incidence of pheochromocytoma is extremely low. Clear guidelines for the referral of patients for biochemical testing are needed to avoid unnecessary costs and to identify the correct diagnosis promptly.
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Affiliation(s)
- Romana Marušić
- School of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- Department of Internal Medicine, National Memory Hospital "Dr. Juraj Njavro", Vukovar, Croatia
| | - Željka Dragila
- School of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- Department of Emergency Medicine, University Hospital Centre Osijek, Osijek, Croatia
| | | | | | - Dubravka Mihaljević
- Division of Nephrology, Department of Internal Medicine, University Hospital Centre Osijek, Osijek, Croatia
| | - Željko Debeljak
- Clinical Department of Laboratory Diagnostics, University Hospital Centre Osijek, Osijek, Croatia
| | - Tatjana Bačun
- School of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- Division of Endocrinology, Department of Internal Medicine, University Hospital Centre Osijek, Osijek, Croatia
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Dragila Ž, Ćosić K, Grubešić I, Čalošević S, Šolić K, Bačun T. PRECIPITATING FACTORS AND SYMPTOMS IN PATIENTS WITH DIABETIC KETOACIDOSIS. Acta Clin Croat 2023; 62:65-74. [PMID: 38304369 PMCID: PMC10829968 DOI: 10.20471/acc.2023.62.01.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Indexed: 02/03/2024] Open
Abstract
The aim of the study was to determine the most common precipitating factors and symptoms of diabetic ketoacidosis and the possible difference according to age, gender and severity of diabetic ketoacidosis. Medical records from January 1, 2017 until December 31, 2019 were reviewed and patients diagnosed with diabetic ketoacidosis were selected. The study included 52 patients, median age 34 (interquartile range 21-56) years. There was no statistically significant difference between male and female gender. The severity of diabetic ketoacidosis was moderate in the majority of cases (65.4%; p=0.005). The most common precipitating factor was infection (61.7%). In patients with moderate diabetic ketoacidosis, respiratory infections were more common, while gastrointestinal infections were more common in severe diabetic ketoacidosis (33% and 25%, respectively; p=0.03). Nausea (median age 32 years; p=0.004) and vomiting (median age 31 years; p=0.01) were more common in younger age groups, while altered mental status was more common in the older age group (median age 61 years; p=0.001). Infection was the most common precipitating factor. The most common symptoms in younger age groups were nausea and vomiting, and altered mental status in the older age group.
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Affiliation(s)
- Željka Dragila
- Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Klara Ćosić
- Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Ivana Grubešić
- Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Srđan Čalošević
- Emergency Medical Center of the Osijek-Baranja County, Osijek, Croatia
| | - Krešimir Šolić
- Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- Osijek Faculty of Electrical Engineering, Computer Science and Information Technology, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Tatjana Bačun
- Osijek Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- Division of Endocrinology, Department of Internal Medicine, Osijek University Hospital Center, Osijek, Croatia
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Dragila Ž, Rudić D, Ćosić K, Bačun T. Serum glucose, sodium and potassium concentrations in patients with diabetic ketoacidosis. Med Glas (Zenica) 2022; 19. [PMID: 35633202 DOI: 10.17392/1471-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/04/2022] [Accepted: 03/13/2022] [Indexed: 06/15/2023]
Abstract
Aim To investigate possible differences in serum glucose and sodium and potassium concentrations with respect to age, gender and severity of diabetic ketoacidosis. Methods Medical records from 1 January 2017 to 31 December 2019 were reviewed and patients with the diagnosis of diabetic ketoacidosis were selected. Results The study included 52 patients. Glucose concentration was significantly higher in the age group of 25-44 and >65 years compared to the group of 18-24 years (p=0.02). Sodium concentration was significantly higher in the age group 18-24 and >65 years compared to groups 25-44 and 45-65 years (p=0.002). Females had significantly higher sodium concentration than males (p=0.002). Potassium concentration was significantly higher in the age group 25-44 years compared to other groups (p=0.01). Males had significantly higher potassium concentration (p =0.01). Conclusion This study showed that significant differences exist in electrolyte concentration between specific age groups, male and female gender as well as DKA severity. Knowing these differences could help clinicians to promptly recognize and treat electrolyte derangements, leading to better outcome of patients with DKA.
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Affiliation(s)
- Željka Dragila
- School of Medicine Osijek, Josip Juraj Strossmayer, University of Osijek, Osijek, Croatia
| | - Dora Rudić
- School of Medicine Osijek, Josip Juraj Strossmayer, University of Osijek, Osijek, Croatia
| | - Klara Ćosić
- School of Medicine Osijek, Josip Juraj Strossmayer, University of Osijek, Osijek, Croatia
| | - Tatjana Bačun
- School of Medicine Osijek, Josip Juraj Strossmayer, University of Osijek, Osijek, Croatia
- Division of Endocrinology, Department of Internal Medicine, University Hospital Centre, Osijek, Croatia
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