Background: The possibility to predict the change in (the) quality of life after coronary artery bypass surgery (CABG) being unclear, the aim was to evaluate the change of quality of life and predictors of worsening of quality of life in patients six months after CABG. Methods: We studied 208 consecutive patients, who underwent elective CABG. The Nottingham Health Profile Questionnaire part 1 was used as the model for quality of life determination. The questionnaire contains 38 subjective statements divided into six sections: physical mobility, social isolation, emotional reaction, energy, pain, and sleep. We distributed the questionnaire to all patients before CABG and six months after CABG. One hundred ninety-two patients filled in the postoperative questionnaire. Results: The comparison between mean preoperative and postoperative scores showed an improvement in all sections of quality of life (p < 0.001). New York Heart Association functional class was significantly improved after CABG (2.23 ± 0.65 vs. 1.58 ± 0.59, p<0.001). Independent predictors of patients worsened by CABG were as follows: female gender in the pain section (p = 0.002; OR = 4.27; CI 1.74–10.47), diabetes mellitus in the physical mobility section (p = 0.003; OR = 8.09; CI 2.04–32.09), low ejection fraction in the physical mobility (p = 0.047; OR = 0.73; CI 0.56–0.95) and emotional reaction (p = 0.03; OR = 0.86; CI 0.60–0.93) sections, and postoperative complications in the social isolation (p = 0.002; OR = 4.63; CI 1.79–11.99), sleep (p = 0.03; OR = 2.71; CI 1.12–6.51), and pain (p = 0.005; OR = 3.39; CI 1.45–7.97) sections. Conclusion: The predictive factors for quality of life worsening six months after CABG are female gender, diabetes mellitus, low ejection fraction, and the presence of postoperative complications.

Background.Increased lactate production is frequent in unregulated/complicated diabetes mellitus.Methods.Three groups, each consisting of 40 patients (type 2 diabetics with myocardial infarction, DM+AMI, nondiabetics suffering myocardial infarction, MI, and diabetics with no apparent cardiovascular pathology, DM group), were tested for pH, serum bicarbonate and electrolytes, blood lactate, and CK-MB.Results. Blood lactate levels were markedly higher in AMI+DM compared to MI group (4.54±1.44versus3.19±1.005 mmol/L,p<0.05); they correlated with the incidence of heart failure(ρ=0.66), cardiac rhythm disorders(ρ=0.54), oxygen saturation(ρ=0.72), CK-MB levels(ρ=0.62), and poor short-term outcome. Lactic acidosis in DM+AMI group was not always related to lethal outcome.Discussion. The lactate cutoff value associated with grave prognosis depends on the specific disease. While some authors proposed cutoff values ranging from 0.76 to 4 mmol/L, others argued that only occurrence of lactic acidosis may be truly predictive of lethal outcome.Conclusion. Both defective glucose metabolism and low tissue oxygenation may contribute to the lactate production in diabetic patients with acute myocardial infarction; high lactate levels indicate increased risk for poor outcome in this population comparing to nondiabetic patients. The rise in blood lactate concentration in diabetics with AMI was associated with increased incidence of heart failure, severe arrhythmias, cardiogenic shock, and high mortality rate.

Objective: The different aspects of quality of life (QOL) in patients of different sex structure have been examined as well as the presumption that s

Body mass index (BMI) is the most widespread and the simplest method for the evaluation of body mass; it is often used as a sole technique in the diagnosis of obesity in children. The objective of the study was to evaluate the relationship between anthropometric and biochemical parameters and the incidence of the metabolic syndrome in obese children.A total of 110 children, aged 2–17 years, participated in the study. No overweight children (BMI 85–95 percentiles) were included. BMI was interpreted using the 2000 Centers for Disease Control and Prevention Growth Charts. The skinfold measurements were performed using an John Bull British Indicators Ltd. calipers, and interpreted using an the reference table values.In addition to lower sensitivity (mentioned in several earlier studies), BMI also shows a lower specificity in the diagnosis of obesity in children: BMI showed at least 10% of non-concomitance with skinfold thickness and waist circumferences and 8% with waist-to-height ratio. In addition, subscapular skinfold thickness, waist circumference, and waist/height ratio showed stronger correlations with serum insulin levels, low-density lipoprotein cholesterol, and family history than BMI itself.The unreliability of BMI as the sole parameter for diagnosing obesity in children was found in our study. Even when overweight children were excluded from the study, the lack of specificity of BMI was demonstrated. We propose utilization of waist circumference and waist/height ratio along with the BMI for definitive diagnosis instead of relying on BMI only. In addition, waist circumference and subscapular fold thickness may be even better in estimation of metabolic risk than BMI.