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Introduction: sudden cardiac death (SCD) is an unexpected natural death due to cardiac causes in a short time period in a person with or without preexisting heart disease. Incidence of SCD in general population is 1/1000 inhabitants. Aims: to determine the incidence of SCD at a territory of Zivinice municipality. Patients and methods: this study is a prospective examination of SCD by using the data from death certificates, data received from interviews with competent physicians, witnesses and family members. Definition and criteria of SCD by European Society of Cardiologist and American Heart Association from 2001 and use of International Classification of Diseases, version 10, were applied to determine the number of SCD. Results: sudden cardiac death is the single most frequent cause of death in inhabitants of the Živinice municipality. The incidence of SCD at the municipal Živinice was 1 .4 cases per 1000 inhabitants per year. Mean age was 66.3 (±12,6) years; in average, men were 7.2 years younger than women. The risk for SCD was 1.24-fold higher in men than in women. Correlation between the age and numbers of SCD was high (r=0.89; p<0.005). The most frequent risk factors were age, family history of SCD and/or cardiovascular disease and inadequate physical activity; leading conventional risk factor was hypertension. Witnesses of sudden cardiac death were present in 58.0% cases. None of the persons with out-of-hospital SCD received adequate first aid from bystanders. Conclusion: Sudden cardiac death is the single most frequent cause of death among inhabitants of Zivinice municipality; proportion of SCD within all other causes of death was 22.3%. Incidence of SCD however, is not significantly higher when compared to industrialized countries. A risk for sudden cardiac death is significantly higher and directly depends on the presence and number of risk factors. [ABSTRACT FROM AUTHOR]

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The study was designed to determine pre-, intra-and postoperative serum cortisol and prolactin (PRL) concentrations in patients subjected to low abdominal surgery under total intravenous anesthesia (TIVA) with propofol-fentanyl, and under general balanced anesthesia with isoflurane-fentanyl. The prospective study included 50 patients of both sexes, aged between 35 and 60 years, subjected to elective low abdominal surgery. Patients were randomly divided into two groups: an experimental group, consisting of 25 ASA I/II (American Society of Anesthesiologists I/II classification) patients treated under TIVA with propofol-fentanyl, and a control group consisting of 25 ASA I/II patients treated under balanced anesthesia with isoflurane-fentanyl. The length of the surgery and the degree of the surgical trauma did not differ significantly between the two anesthesia groups. Blood samples for cortisol and PRL measurements were drawn at exact time points: 30 minutes before the beginning of the surgery (T0), 30 minutes after the beginning of the surgery (T1), at the end of the surgery (T2), 2 hours after the surgery (T3), and 24 hours after the surgery (T4). Serum levels of cortisol and PRL were measured using commercially available kits. The results were evaluated with the nonparametric Mann-Whitney test. The serum concentration of cortisol measured at T1 time point in patients treated under TIVA was significantly lower (p=0.04) than that in patients treated under general balanced anesthesia. The average circulating levels of PRL measured at T1, T2 and T3 time points in patients treated under TIVA were significantly lower (p=0.003; p=0.002; p<0.05; respectively) than those in patients treated under balanced anesthesia. The results obtained suggest that the endocrine stress response developed in response to surgery is probably attenuated in patients treated under TIVA with propofol-fentanyl and, thus, that these patients are less stressed in comparison to patients treated under general balanced anesthesia with isoflurane-fentanyl. [ABSTRACT FROM AUTHOR]

Copyright of Acta Medica Saliniana is the property of Jzu Univerzitetski Klinickui Centar Tuzla and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Medica Saliniana is the property of Jzu Univerzitetski Klinickui Centar Tuzla and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: To determine pre-, intra-and postoperative serum glucose and lactate concentrations in patients subjected to low abdominal surgery under total intravenous anesthesia (TIVA) with propofol-fentanyl, and in those under general balanced anesthesia with isoflurane-fentanyl. Materials and Methods: This prospective study included 50 patients of both sexes, aged between 35 and 60 years, subjected to low abdominal surgery. Patients were randomly divided into two groups: experimental group of 25 ASA I/II American Society of Anesthesiologists I/II classification) patients treated under TIVA, and control group of 25 ASA I/II patients treated under balanced anesthesia. The length of surgery and the degree of surgical trauma did not differ significantly between the two anesthesia groups of patients. Blood samples for glucose and lactate measurements were drawn at exact time points: 30 minutes before the beginning of the surgery (T0), 30 minutes after the beginning of the surgery (T1), at the end of the surgery(T2), 2 hours after the surgery (T3), and 24 hours after the surgery T4). Serum levels of glucose and lactate were measured using commercially available kits. The results were evaluated with nonparametric Mann-Whitney test. Results: Serum concentrations of glucose measured at T1, T2 and T3 time points in patients treated under TIVA with propofol-fentanyl were significantly lower (P=0.03, P=0.001 and P < 0.001, respectively) than those in patients treated under general balanced anesthesia with isoflurane-fentanyl. The mean circulating level of lactate measured at T4 point in patients treated under TIVA was significantly lower (P=0.001) than that in patients treated under balanced anesthesia, while T1 lactate was lower in patients treated under balanced anesthesia(P=0.01). The mean serum concentrations of glucose and lactate measured at T1, T2, and T3 points were significantly higher related to their baseline levels in patients treated under balanced anesthesia (P < 0.001). Both T2 and T3 values of glucose were above the normal range. The mean serum levels of glucose determined at T1, T2, T3, and T4 in patients under TIVA were significantly higher (P < 0.001; P=0.001) than the baseline level, however, only the level measured at T2 point exceeded the upper normal value. Serum lactate levels measured at T1, T2, T3, and T4 were significantly higher than the baseline level (P < 0.001) in patients under TIVA. Conclusions: The results obtained suggested the metabolic response to surgery to be probably attenuated and thus improved in patients treated under TIVA with propofol-fentanyl in comparison with that in patients treated under general balanced anesthesia with isoflurane-fentanyl. [ABSTRACT FROM AUTHOR]