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Background and Goal of Study: Spinal anesthesia is a preferred method of anesthesia for lower limb surgery. Antinociceptive synergism between local anesthetics and opioids is well studied. Dexmedetomidine, selective alpha2-agonist, is relatively new as an intrathecal agent. The main goal of this study was to compare dexmedetomidine with opioids as adjuvant to spinal anesthesia, in terms of its ef fect on postoperative analgesia, as well as its ef fect on hemodynamic stability in elderly patients. Materials and Methods: Spinal anesthesia was performed on thirty ASA Grade II and III geriatric patients undergoing hip surgery. Before the procedure all patients received 500 mL of i.v. saline. Noninvasive blood pressure, heart rate and SpO2 were noted every 5 minutes. NRS(numeric rating scale) was assesed 2, 4, 6, 8, 10 and 12 hours af ter spinal block. Patients were randomly assigned into two groups: control group (n=15) received levobupivacaine by body height nomogram with 2.5 mcg (0.5 mL) of sufentanil, while subject group (n=15) received levobupivacaine by body height nomogram with 5 mcg of dexmedetomidine. Groups were compared by hemodynamic parameters(systolic pressure, pulse) and NRS score in early postoperative stage of recovery. Results and Discussion: Baseline patients’ characteristics were comparable in both groups. Analysis of hemodynamic data showed that incidence of hypotension, defined as systolic blood pressure lower than 90 mmHg, was not significantly dif ferent between groups. When comparing analgesic ef fect, dexmedetomidine showed significantly better analgesic ef fect than opioids 10 and 12 hours af ter spinal block (p=0.03 and p

Coronary artery disease is a common and serious disease which is a consequence of plaque build-up in the coronary arteries. As a result, the artery cross-sectional area is reduced which restricts the blood flow. In this study, a numerical analysis of the blood flow through an idealised stenosed artery is presented. The effects of rheological models of blood on the flow characteristics is studied. Blood is modeled as a Newtonian, a generalized Newtonian and a viscoelastic fluid. For generalized Newtonian fluid modelling, the Carreau-Yasuda model is used. For viscoelastic fluid modelling, the simplified Phan-Thien-Tanner (sPTT) model is used. Flow is studied as steady and transient for three different stenosis geometries at Reynolds number values of 50 and 200. Results show that the Carreau-Yasuda model predicts the smallest boundary layer size and significantly lesser velocity magnitudes at the artery axis in comparison to the other models. The differences between model predictions are more noticeable when the stenosis is more severe and at higher velocities. Koronarna bolest srca je česta i ozbiljna bolest koja nastaje kao posljedica nakupljanja plaka na koronarnim arterijama. Uzrokuje smanjenje površine poprečnog presjeka arterije što otežava protok krvi. U ovom radu napravljena je numerička analiza strujanja krvi kroz idealiziranu stenotičnu arteriju. Analiziran je utjecaj reološkog modela krvi na strujne karakteristike. Krv je modelirana kao Newtonovski, generalizirani Newtonovski te viskoelastični fluid. Za modeliranje generaliziranog Newtonovskog fluida korišten je Carreau-Yasuda model, a za modeliranje viskoelastičnog fluida korišten je pojednostavljeni Phan-Thien–Tanner (sPTT) model. Proučavano je stacionarno i nestacionarno strujanje za tri različite geometrije stenoze pri vrijednostima Reynoldsovog broja 50 i 200. Rezultati pokazuju da Carreau-Yasuda model predviđa najmanji granični sloj i znatno manje magnitude brzina u osi arterije u usporedbi s ostalim modelima. Razlike između modela su primjetnije kada je stenoza veća te pri većim brzinama strujanja.

The study aimed to determine if the non-dipping pattern of blood pressure (BP) influences preterm delivery in gestational hypertension (GH), but also maternal clinical findings and birth weight. Sixty women with GH, i.e. 30 women with a dipping BP profile (control group) and 30 non-dippers (study group), were included in the study. Echocardiography was performed in all subjects, as well as ambulatory blood pressure monitoring (ABPM) during third trimester. ABPM was repeated 6-8 weeks after delivery. Thirteen women with preterm delivery were classified as non-dippers and only four as dippers (p=0.01). The average and peak systolic and diastolic night-time BP had negative linear correlation with birth weight (p, Cilj ovoga istraživanja bio je utvrditi povezanost non-dipping profila krvnog tlaka (KT) s prijevremenim porođajem, porođajnom težinom novorođenčeta te kliničkim i ehokardiografskim parametrima kod žena s gestacijskom hipertenzijom (GH). Istraživanje je obuhvatilo 60 žena s GH, 30 s dipping profilom KT (kontrolna skupina) i 30 non-dippera (ispitna skupina). Sve žene podvrgnute su kompletnoj ehokardiografiji i 24-satnom ambulantnom praćenju krvnog tlaka (ambulatory blood pressure monitoring, ABPM) tijekom trećeg trimestra, a ABPM je ponovljen 6-8 tjedana nakon porođaja. Ukupno 17 žena imalo je prijevremeni porođaj. Trinaest žena s prijevremenim porođajem imalo je non-dipping profil KT, dok su samo četiri žene imale dipping profil KT (0,01). Prosječni i maksimalni sistolički i dijastolički noćni KT imali su negativnu linearnu korelaciju s porođajnom težinom (p

Introduction: Type 2 Diabetes Mellitus (T2DM) is a prevalent cause of morbidity and mortality, particularly due to chronic complications development, most commonly cardiovascular diseases. Among markers for assessment of clinical and subclinical signs of cardiovascular disease, the presence of arteriosclerosis, and stiffening of arterial walls as indicated by the arterial stiffness, was proven to be an important predictor of adverse cardiovascular events. Carotid-femoral pulse wave velocity (PWV) is considered as gold standard for arterial stiffness measurement. On the other side, moderate red wine (RW) consumption was shown to have cardioprotective effects by multiple epidemiologic and experimental studies. Objective: The objective of this study was to examine the effects of moderate daily red wine intake on arterial stiffness and hemodynamic parameters in participants with well controlled T2DM. Subjects and Methods: 18 well controlled-T2DM participants (taking metformin alone or with oral antidiabetic drugs as chronic therapy) were included in the cross-over interventional study during five weeks; the first two weeks being the drive-in period with no alcohol consumption (control), followed by three weeks of moderate, 300 ml per day, consumption of red wine Plavac mali with meals (intervention). At the end of each experimental period we assessed anthropometric data (body mass index), performed biochemical blood analysis (fasting plasma glucose, and HbA1c), while oscillometric and tonometric measurements of arterial stiffness (pulse wave velocity, peripheral and central augmentation indices) and hemodynamic parameters (heart rate, peripheral and central systolic, diastolic and pulse pressure) were performed by Arteriograph and SphygmoCor devices, respectively. Results: Moderate RW consumption in well-controlled T2DM participants induced significant decrease of PWV (7.42±1.44 m/s for control, no alcohol period vs. 6.98±1.44 m/s for intervention, wine consumption period, P=0.013) and peripheral arterial diastolic pressure (79.72±11.47 mmHg in control, no alcohol period vs. 76.39±11.15 mmHg for intervention, wine consumption period, P=0.034), while other arterial stiffness and hemodynamic parameters were not significantly changed although showing a trend of decline. Conclusion: In a cohort of subjects with well controlled T2DM, in whom clinical symptoms of cardiovascular disease were not yet expressed, there was a decrease in PWV. This indicates an improvement in arterial stiffness even after moderate consumption of red wine of relatively short duration., Uvod: Šećerna bolest tipa 2 važan je uzrok obolijevanja i smrtnosti posebice zbog razvoja kroničnih komplikacija od kojih su najčešće kardiovaskularne bolesti. Među markerima za procjenu kliničkih i subkliničkih znakova kardiovaskularnih bolesti, smanjenje arterijske elastičnosti, arterioskleroza, i pojava ukrućivanja stijenke arterija, engl. arterial stiffness, pokazalo se pouzdanim prediktorom kardiovaskularnog rizika. Karotidno-femoralna brzina pulsnog vala smatra se zlatnim standardom procjene arterijske elastičnosti/krutosti. S druge strane, kardioprotektivni učinci umjerene konzumacije crnog vina pokazani su u epidemiološkim i eksperimentalnim istraživanjima. Cilj: Istražiti učinke umjerene konzumacije crnog vina na hemodinamske parametre i parametre arterijske elastičnosti u ispitanika oboljelih od šećerne bolesti tipa 2, kod kojih je bolest dobro nadzirana. Ispitanici i metode: U ukriženo intervencijsko istraživanje uključeno je 18 ispitanika s dobro nadziranom šećernom bolesti tipa 2 (uz kroničnu terapiju metforminom) tijekom pet tjedana: dva tjedna bez konzumacije ikakvih alkoholnih pića, drive-in faza pokusa (kontrolna), nakon kojega je slijedilo tri tjedna umjerene konzumacije crnog vina sorte Plavac mali od 300 ml dnevno uz obrok (intervencija). Na kraju svake faze pokusa ispitanicima su izmjereni antropometrijski parametri (indeks tjelesne mase), učinjena biokemijska analiza krvi (plazmatska koncentracija glukoze natašte i koncentracija HbA1c), a hemodinamski parametri (srčana frekvencija, periferni i središnji sistolički, dijastolički i pulsni tlak) i parametri arterijske elastičnosti (brzina pulsnog vala, periferni i središnji augmentacijski indeksi) određeni su oscilometrijskom (Arteriograph) i tonometrijskom (SphygmoCor) metodom. Rezultati: Nakon umjerene konzumacije vina došlo je do smanjenja brzine pulsnog vala (7,42±1,44 m/s u kontrolnoj fazi pokusa bez konzumacije alkoholnih pića vs. 6,98±1,44 m/s nakon intervencije, P=0,013) i perifernog dijastoličkog tlaka (79,72±11,47 mmHg u kontrolnoj fazi pokusa bez konzumacije alkoholnih pića vs. 76,39±11,15 mmHg nakon intervencije, P=0,034), dok su promjene ostalih hemodinamskih parametara i parametara arterijske elastičnosti bili statistički neznačajne, unatoč ostvarenom trendu smanjena. Zaključci: U kohorti ispitanika s dobro nadziranom šećernom bolesti tipa 2, kod kojih još nisu izraženi klinički simptomi kardiovaskularne bolesti, došlo je do smanjenja brzine pulsnog vala. To ukazuje na poboljšanje arterijske elastičnosti čak i nakon umjerene konzumacije crnog vina relativno kratkog trajanja.

Ciljevi istraživanja: Izmjeriti razlike u demografskim pokazateljima, usporediti vrijednosti plućnog i perifernog vaskularnog otpora te vrijednosti troponina kod bolesnika podvrgnutih operaciji aortokoronarnog premoštenja, zamjeni zalistaka ili objema operacijama. Nacrt studije: retrospektivno istraživanje Materijal i metode: U istraživanje je bilo ukljućeno 108 kardiokirurških bolesnika operiranih od 4. siječnja 2016. do 25. svibnja 2016. kojima su analizirane povijesti bolesti i ispisi hemodinamskih vrijednosti. Bolesnici su bili podijeljeni u tri skupine s obzirom na operacijski zahvat. U ispitanim skupinama uspoređeni su demografski pokazatelji, laboratorijski nalazi i hemodinamske vrijednosti. Svi podatci analizirani su uporabom t-testa i χ2 test, Fisherova egzaktnog test, ANOVA testa te Pearsonove korelacije. Rezultati: Ispitivane skupine nisu se razlikovale po dobi i spolu. Najčešći komorbiditet u svim skupinama bila je hipertenzija (94, 44 %). Prosječne vrijednosti indeksa tjelesne mase bile su veće od 29. Vrijednosti eritrocita (E), hemoglobina (Hg) i trombocita (Trc) bile su najmanje kod bolesnika kojima je učinjena operacija valvule (E = 3, 42, Hg = 102, 75, Trc = 110, 34). Najviše vrijednosti troponina imala je skupina bolesnika kojima su učinjene obje operacije, a najniže kojima je učinjeno aortokoronarno premoštenje. Postoji pozitivna povezanost između troponina, plućnog i perifernog vaskularnog otpora, troponina i srednjeg tlaka u plućnoj arteriji, a negativna između troponina, udarnog i minutnog volumena (p

There is limited evidence showing that elevated arterial blood pressure in surgical patients may be associated with increased perioperative risk; however, cardiovascular instability frequently occurs during anesthesia. The most commonly used anesthetic agents, both intravenous and inhalation ones, produce a decrease in arterial blood pressure. Magnesium, acting as a natural calcium-channel blocker, induces direct and indirect vasodilatation, thus playing a role in the treatment of arterial hypertension. In this research, we assessed the effects of magnesium sulfate on cardiovascular stability in patients undergoing diverse planned surgical procedures (abdominal, orthopedic, urology) under general balanced anesthesia, who were diagnosed with arterial hypertension grade 1 and 2. The research encompassed 100 patients of both sexes, aged from 20 to 65. Immediately before induction of anesthesia with propofol, the patients in the experimental group (50 study subjects) received 30 mg/kg bolus dose and magnesium sulfate infusion at 10 mg/kg/h, whereas the subjects in the control group (50 patients) were administered normal saline. Anesthesia was achieved and maintained with sevoflurane, fentanyl and rocuronium. The hemodynamic variables of mean arterial pressure and heart rate were measured every five minutes, starting immediately before magnesium infusion. Statistical analysis of the categorized values of mean arterial pressure and heart rate revealed a statistically significant between-group difference at 60th and 90th minute of anesthesia. In conclusion, magnesium sulfate as an adjuvant to anesthesia in patients with arterial hypertension reduces hemodynamic changes during anesthesia., Postoje određeni dokazi koji ukazuju na postojanje povišenog perioperacijskog rizika kod kirurških bolesnika s povišenim arterijskim tlakom, a kardiocirkulacijska nestabilnost je česta pojava tijekom anestezije. Najčešće upotrebljavani intravenski i inhalacijski anestetici izazivaju snižavanje arterijskog tlaka. Magnezij kao prirodni blokator kalcijevih kanala izaziva vazodilataciju te može imati ulogu u terapiji hipertenzije. U istraživanju su ispitani učinci magnezij sulfata na kardiocirkulacijsku stabilnost kod bolesnika s hipertenzijom prvog i drugog stupnja koji su podvrgnuti različitim elektivnim operacijskim zahvatima (abdominalna, ortopedska kirurgija, urologija) u općoj balansiranoj anesteziji. Studija je obuhvatila sto bolesnika oba spola u dobi od 20 do 65 godina. Neposredno prije intravenskog uvoda u opću anesteziju propofolom bolesnici u eksperimentalnoj skupini dobili su magnezij sulfat u dozi od 30 mg/kg intravenski, a zatim je infuzija magnezij sulfata nastavljena po stopi od 10 mg/kg/h, dok su bolesnici u kontrolnoj skupini dobili 0,9%-tnu otopinu natrij klorida. Anestezija se održavala primjenom sevoflurana i fentanila, a mišićna relaksacija primjenom rokuronija. Hemodinamski parametri, srednji arterijski tlak i srčana frekvencija mjereni su svakih 5 minuta, počevši neposredno prije infuzije magnezij sulfata. Statistička analiza pokazala je statistički značajnu razliku između eksperimentalne i kontrolne skupine u vrijednostima srednjeg arterijskog tlaka i srčane frekvencije u 60. i 90. minuti anestezije. Magnezij sulfat kao adjuvans kod bolesnika s hipertenzijom smanjuje hemodinamske promjene tijekom anestezije.

Selection of anesthetic drugs for cesarean section requires many considerations. Anesthetic drugs for this purpose must prevent hemodynamic stress due to tracheal intubation, while inducing neonatal complications. This study was conducted to determine the effects of paracetamol given before induction of anesthesia on cardiovascular responses to tracheal intubation and postoperative pain in the mother, and on neonatal Apgar score. This double-blind randomized placebo- controlled trial included 60 women in ASA I, without underlying diseases and fetal distress, who were candidates for elective cesarean section under general anesthesia. Patients were divided into two groups of 30 patients. Patients in the paracetamol group received 1 g intravenous (IV ) paracetamol 20 min before the operation, while those in the placebo group received 1 cc normal saline at the same time. In both groups, anesthesia was induced by sodium thiopental and succinylcholine. Maternal systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR ) were measured before and immediately upon induction of anesthesia,and at first and fifth minute after tracheal intubation. Neonatal effects were assessed by Apgar score. Postoperative pain was assessed by use of the visual analog scale (VAS). The dose of analgesic used and the time of the first analgesic request by patients postoperatively were recorded. The SBP, DBP, MAP and HR were controlled significantly better in paracetamol group than in placebo group (P, Odabir anestetika kod carskog reza zahtijeva ozbiljno promišljanje. Anestetici koji se primjenjuju za ovu namjenu moraju spriječiti hemodinamski stres zbog trahealne intubacije, ali ne smiju izazvati komplikacije kod novorođenčeta. Cilj ove studije bio je utvrditi učinke paracetamola danog prije indukcije anestezije na kardiovaskularni odgovor na intubaciju traheje i poslijeoperacijsku bol kod majke, te na Apgar indeks novorođenčeta. U ovo dvostruko slijepo randomizirano placebom kontrolirano ispitivanje bilo je uključeno 60 žena, ASA I, bez osnovnih bolesti i fetalnog distresa, kod kojih je bio predviđen elektivni carski rez u općoj anesteziji. Trudnice su podijeljene u dvije skupine od po 30 žena. Žene u skupini paracetamol dobile su 1 g paracetamola intravenski 20 minuta prije operacije, dok su one u skupini placebo u isto vrijeme primile 1 cc normalne fiziološke otopine. U objema skupinama anestezija je inducirana natrij tiopentalom i sukcinilkolinom. Majčin sistolički krvni tlak (SKT), dijastolički krvni tlak (DKT), srednji arterijski tlak (SAT) i srčana frekvencija (SF) mjereni su prije i neposredno nakon indukcije anestezije te u 1. i 5. minuti nakon trahealne intubacije. Učinci na novorođenče procijenjeni su pomoću Apgar indeksa. Poslijeoperacijska bol procijenjena je pomoću vizualne analogne ljestvice (VAS). Zabilježena je doza analgetika i vrijeme kad je prvi put zatražen analgetik nakon operacije. Utvrđeno je da su SKT, DKT, SAT i SF značajno bolje regulirani u skupini na paracetamolu u usporedbi sa skupinom koja je primila placebo (P

Although inflammatory periodontal disease has been proven to be related to carotid intima media thickness, it has been recently suggested that even an alteration of carotid hemodynamics might contribute to atherosclerosis in patients with periodontal disease. A 52-yearold female patient was referred to periodontology department due to painful alveolar mucosa. On the basis of dental history, we concluded that the patient had a severe form of generalized aggressive periodontitis that led to complete edentulism. The patient was advised to undergo ultrasonography of carotid arteries with arterial stiffness measurements at neurology department. A diagnosis of the right internal carotid artery occlusion was established. Inflammatory periodontal disease may affect arterial hemodynamics and even lead to artery occlusion. It is advisable that patients with a severe form of periodontitis should be referred for carotid artery ultrasonography., Iako je dokazano da parodontna bolest može biti povezana s debljinom intime-medije, tek je u novije vrijeme uočeno da i promjene u arterijskoj hemodinamici mogu doprinijeti aterosklerozi kod pacijenata s parodontitisom. Pedesetdvogodišnja pacijentica je upućena na odjel parodontologije zbog bolne alveolarne mukoze. Na temelju stomatološke anamneze zaključeno je da je pacijentica bolovala od generaliziranog agresivnog parodontitisa koji je doveo do potpune bezubosti. Pacijentici je predložen ultrazvučni pregled karotidnih arterija i određivanje arterijske krutosti na odjelu neurologije. Postavljena je dijagnoza okluzije desne unutarnje karotidne arterije. Upalna parodontna bolest može utjecati na arterijsku hemodinamiku i dovesti do arterijske okluzije. Preporučljivo je da se pacijenti s uznapredovalim oblikom parodontitisa upute na ultrazvučni pregled karotidnih arterija

After the implantation of the left ventricular assisted device (LVAD), patients are admitted in intensive care unit (ICU). During the period of first several days, the goal of the postoperative care is to stabilize the patients’ hemodynamics. Monitoring the continuous cardiac output, filling volumes and outflow resistance is necessary for the proper functioning of the pump. The use of pulmonary artery catheter and the transesophageal echocardiography are primary procedures. During the operation of the left ventricular support, the measuring of proper ventricular function and the early recognition of its dysfunction is important for a positive outcome. Further potential complications in connection with these patients are an increased risk of hemorrhage and thromboembolism. The infection of drivelines and devices in the early postoperative period occurs in up to 40 % of these patients. In case of a cardiac arrest, a special procedure has to be performed in patients in whom LVAD was implanted. Finally, we have shown the anesthesiologic management in cases when patients with LVAD have to undergo noncardiac surgery., Nakon ugradnje lijevostrane srčane potpore (LSP), bolesnici se zaprimaju u jedinicu intenzivne medicine. Tijekom ovog razdoblja od nekoliko dana, osnovni cilj poslijeoperacijskog liječenja je stabilizacija bolesnikove hemodinamike. Praćenje kontinuiranog minutnog volumena, tlakova punjenja i sustavne rezistencije je neophodno za ispravno funkcioniranje LSP-a. Uporaba plućnog arterijskog katetera s kontinuiranim mjerenjem minutnog volumena te transezofagijska ehokardiografija su primarni postupci. Za vrijeme rada LSP, praćenje funkcije desne klijetke te rano uočavanje njene disfunkcije od krucijalnog su značaja za dobar ishod bolesnika. Daljnje moguće komplikacije u ovih bolesnika su povećani rizik od krvarenja, kao i od nastanka tromboembolija. Incidencija infekcija u ovih bolesnika je visoka, i kreće se do 40%, osobito infekcije kanila. U slučaju zastoja rada srca, primjenjuju se posebni postupci oživljavanja, koji se razlikuju od uobičajenih algoritama. Na kraju, prikazane su i specifičnosti anesteziološkog postupka u ovih bolesnika ukoliko postoji potreba za nekardijalnom operacijom.

Aggressive large volume resuscitation is obligatory to achieve necessary tissue oxygenation. An adequate venous preload normalizes global hemodynamics and avoids multiorgan failure (MOF) and death in patients with multiple injuries. Large volume resuscitation is associated with complications in minimally monitored patients. A properly guided resuscitation procedure will finally prevent MOF and patient death. Transpulmonary thermodilution technique and gastric tonometry are used in venous preload monitoring, calculating volumetric hemodynamic variables and estimating splanchnic perfusion as well. We present a 24-year-old man with multiple injuries resuscitated with large volume infusions and monitored by transpulmonary thermodilution technique and gastric tonometry. It is very important to monitor regional hemodynamics that enables clinician to maintain the required relations between global and regional hemodynamics. It prevents the development of MOF and patient death., Agresivna reanimacija velikim volumenom je neophodna kako bi se postigla potrebna tkivna oksigenacija. Dostatnom prethodnom venskom opskrbom normalizira se opća hemodinamika i izbjegava višeorgansko zatajenje i smrt kod bolesnika s višestrukim ozljedama. Reanimacija velikim volumenom udružena je s komplikacijama u slučaju nedostatnog nadzora bolesnika. Ispravno vođen postupak reanimacije u konačnici će spriječiti višeorgansko zatajenje i smrt bolesnika. Tehnika transpulmonalne termodilucije i želučana tonometrija primjenjuju se u nadzoru venske opskrbe, izračunavanju volumetrijskih hemodinamskih varijabla i procjeni visceralne prokrvljenosti. Prikazuje se slučaj 24-godišnjeg mladića s višestrukim ozljedama, kod kojega je provedena reanimacija infuzijama velikog volumena i nadzor pomoću tehnike transpulmonalne termodilucije i želučane tonometrije. Vrlo je važno nadzirati regionalnu hemodinamiku, jer to kliničaru omogućuje održavanje potrebnih odnosa između opće i regionalne hemodinamike. Time se priječi razvoj višeorganskog zatajenja i smrt ovakvog bolesnika.

U predavanjim je obrađena fiziologija krvotoka i prikazan matematički model s koncentriranim parametrima, te analizirani dobiveni rezultati.

Pregled novih mogućnosti i metoda hemodinamskog nadzora bolesnika te smjernice za liječenje s obzirom na dobivene podatke

Previous investigations indicated cerebral hemodynamic changes in terms of increased mean blood flow velocities (mBFV) detected with transcranial dopler ultrasonography (TCD) in patients (pts) with posttraumatic stress disorder (PTSD). The aim of this study was to determine correlation between level of stress hormones and cerebral hemodynamic changes in PTSD pts. We examined 50 pts with acute PTSD, aged between 30 and 50 years (yrs), as well as 50 healthy subjects similar ages as control group. On the first day after hospitalization TCD was done and the measures of vanilmandelic acid (VMA) in 24-hour urine (as metabolit of adrenalin and nor-adrenalin) were analyzed in PTSD pts. The same diagnostic procedures were repeated after in PTSD pts 21-day long psychiatric treatment and in control subjects. In the first analysis 34 PTSD pts had increased mBFV, 29 of them (85.26%) had increased level of VMA. After 21-day long psychiatric treatment 9 PTSD pts had increased mBFV and 8 of them (88.88%) had increased level of VMA. The difference between two measures was statistically significant (p

Previous investigations indicated cerebral hemodynamic changes in terms of increased mean blood flow velocities (mBFV) detected with transcranial dopler ultrasonography (TCD) in patients (pts) with posttraumatic stress disorder (PTSD). The aim of this study was to determine correlation between level of stress hormones and cerebral hemodynamic changes in PTSD pts. We examined 50 pts with acute PTSD, aged between 30 and 50 years (yrs), as well as 50 healthy subjects similar ages as control group. On the first day after hospitalization TCD was done and the measures of vanilmandelic acid (VMA) in 24-hour urine (as metabolit of adrenalin and nor-adrenalin) were analyzed in PTSD pts. The same diagnostic procedures were repeated after in PTSD pts 21-day long psychiatric treatment and in control subjects. In the first analysis 34 PTSD pts had increased mBFV, 29 of them (85.26%) had increased level of VMA. After 21-day long psychiatric treatment 9 PTSD pts had increased mBFV and 8 of them (88.88%) had increased level of VMA. The difference between two measures was statistically significant (p

Poremećaji hemodinamike i transporta kisika u teškim hiperglikemičnim stanjima i dijabetičkoj komi.