Title
Ređi humoralni faktori rizika za ishemijski moždani udar i njihov prognostički značaj
Creator
Markišić, Merdin, 1968-
Copyright date
2017
Object Links
Select license
Autorstvo-Nekomercijalno-Bez prerade 3.0 Srbija (CC BY-NC-ND 3.0)
License description
Dozvoljavate samo preuzimanje i distribuciju dela, ako/dok se pravilno naznačava ime autora, bez ikakvih promena dela i bez prava komercijalnog korišćenja dela. Ova licenca je najstroža CC licenca. Osnovni opis Licence: http://creativecommons.org/licenses/by-nc-nd/3.0/rs/deed.sr_LATN. Sadržaj ugovora u celini: http://creativecommons.org/licenses/by-nc-nd/3.0/rs/legalcode.sr-Latn
Language
Serbian
Cobiss-ID
Inventory ID
D-3093
Theses Type
Doktorska disertacija
description
Datum odbrane: 29.11.2017.
Other responsibilities
mentor
Pavlović, Dragan, 1953-
predsednik komisije
Tončev, Gordana, 1956-
član komisije
Miletić-Drakulić, Svetlana.
član komisije
Živković, Miroslava.
Academic Expertise
Medicinske nauke
University
Univerzitet u Kragujevcu
Faculty
Fakultet medicinskih nauka
Publisher
[M. Markišić]
Format
168 listova
Abstract (en)
Introduction. Ischemic stroke (IS) is the third leading mortality cause in the world and the most common cause of disability. Knowing the risk factors and prognostic factors of ischemic stroke is very important.
Patients and methods. We studied 50 consecutive patients with IS to assess levels of humoral rare vascular risk factors: vitamins B12 and D, homocysteine and thyroid hormones after IMU and functional status of patients using Brthel Index, modified Rankin Score, the National Institutes of Health Stroke Scale and cognitive status through the Mini Mental State Examination, a test of frontal function "Go-No Go" as well as the Geriatric Depression Scale,
3 and 6 months after IS.
Results. In the study, there were more women than men with IS what can be seen as artifact of the small groups, whereas age was consistent with other studies, where the women
were older than men. Blood pressure, blood glucose, lipids and C-reactive protein (CRP)
showed a statistically significant reduction, and calcium elevation after the IS.
Homocysteine significantly positively correlated with depression and unfavorable
outcome, and negatively with executive functions and functional outcome. Vitamin B12
showed a statistically significant increase in the monitoring period, which positivly correlated
with the outcome and functionality, cognition, and negatively with depression. Vitamin D
positively correlated with executive functions and functional status. Folic acid and thyroid
hormones are difficult to interpret because of the unreliability of the methods of
determination. D dimer negatively correlated with cognitive measures, and positively with
depression. CRP negatively correlated with outcome measures and functions.
Conclusion. There is a significant association of vascular risk factors. Our research has
shown the importance of influence of rarer humoral risk factors but also an association of
more frequent and "rarer" factors. In each case, there is a need to assess multiple risk factors
and their combined impact on the occurrence of IS.
Abstract (sr)
Uvod. Ishemijski moždani udar (IMU) je treći vodeći uzrok smrtnosti u svetu,
a najzastupljeniji uzrok invaliditeta. Poznavanje uzroka IMU i prognostičkih
faktora je veoma značajno.
Bolesnici i metode. Ispitivano je 50 konsekutivnih bolesnika sa IMU kod
kojih su određivani ređi humoralni faktori rizika: vitamini B12 i D, homocistein
i tireoidni hormoni) posle IMU) i funkcionalni status bolesnika pomoću BI,
modifikovani Rankinov skor, National Institutes of Health Stroke Scale (NIHSS) kao i
kognitivni status putem Mini Mental testa (Mini Mental State Examination - MMSE),
Testa frontalnih funkcija „Idi-ne idi“ kao i Gerijatrijske skale depresivnosti, 3
do 6 meseci posle ishemijskog možda udara.
Rezultati. U studiji je bilo više žena nego muškaraca sa IMU što se može
posmatrati kao artefakt male grupe, dok je životno doba bilo u skladu sa drugim studijama, odnosno žene su bile starije od muškaraca. Vrednosti krvnog pritiska,
glikemija, lipida i C-reaktivnog proteina (CRP) su pokazala statistički značajno
sniženje, a kalcijuma povišenje posle IMU.
Viši nivoi homocisteina značajno pozitivno korelišu sa depresivnošću i
nepovoljnijim ishodom, a negativno sa egzekutivnim funkcijama funkcionalnim
ishodom. Vrednosti vitamina B12 su pokazale statistički značajan porast u periodu
praćenja što je pozitivno korelisalo sa ishodom i funkcionalnošću, kognicijom, a
negativno sa depresijom. Vitamin D je pozitivno korelisao sa egzekutivnim
funkcijama i funkicionalnošću. Nalaze folne kiseline i tireoidnih hormona je
teško tumačiti zbog nepouzdanosti metoda određivanja. D dimer je negativno
korelisao sa kognitivnim merama, a pozitivno sa deprrsivnošću. CRP je negativno
korelisao sa merama ishoda i funcije.
Zaključak. Veoma je značajna veza odnosno udruženost više vaskulnih faktora
rizika. U našem istraživanju je pokazan značaj uticaja ređih humoralnih faktora
rizika ali i udruženosti češćih i „ređih“ faktora. U svakom pojedinačnom slučaju,
nameće se potreba procene multiplih faktora rizika i njihovog udruženog uticaja na
pojavu IMU.
Authors Key words
ischemic stroke, vitamin B12, vitamin D, thyroid hormones, functional
outcome, cognition
Authors Key words
ishemijski moždani udar, vitamin B12, vitamin D, tireoidni
hormoni, funkcionalni ishod, kognicija
Classification
616.831-005.1-084:577.161.1
Subject
Moždani udar - Faktori rizika - Prevencija
Type
Tekst
Abstract (en)
Introduction. Ischemic stroke (IS) is the third leading mortality cause in the world and the most common cause of disability. Knowing the risk factors and prognostic factors of ischemic stroke is very important.
Patients and methods. We studied 50 consecutive patients with IS to assess levels of humoral rare vascular risk factors: vitamins B12 and D, homocysteine and thyroid hormones after IMU and functional status of patients using Brthel Index, modified Rankin Score, the National Institutes of Health Stroke Scale and cognitive status through the Mini Mental State Examination, a test of frontal function "Go-No Go" as well as the Geriatric Depression Scale,
3 and 6 months after IS.
Results. In the study, there were more women than men with IS what can be seen as artifact of the small groups, whereas age was consistent with other studies, where the women
were older than men. Blood pressure, blood glucose, lipids and C-reactive protein (CRP)
showed a statistically significant reduction, and calcium elevation after the IS.
Homocysteine significantly positively correlated with depression and unfavorable
outcome, and negatively with executive functions and functional outcome. Vitamin B12
showed a statistically significant increase in the monitoring period, which positivly correlated
with the outcome and functionality, cognition, and negatively with depression. Vitamin D
positively correlated with executive functions and functional status. Folic acid and thyroid
hormones are difficult to interpret because of the unreliability of the methods of
determination. D dimer negatively correlated with cognitive measures, and positively with
depression. CRP negatively correlated with outcome measures and functions.
Conclusion. There is a significant association of vascular risk factors. Our research has
shown the importance of influence of rarer humoral risk factors but also an association of
more frequent and "rarer" factors. In each case, there is a need to assess multiple risk factors
and their combined impact on the occurrence of IS.
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