Hippokratia
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Current approaches to cardiac rehabilitation services tailoring are often based on patient demographics or readiness for behavior change. However, the success of interventions acceptance and improved adherence to recommendations could be much higher when considering and adapting to a patient's lifestyle, such as sleep and stress. ⋯ The outcomes of the study can support the development of e-health and home-based interventions design and strategies to promote adherence to physical activity. Tailoring an intervention to a daily behavioral pattern of a patient, such as sleep, can support the planning of the physical activity in a form to be easier accepted by the patient. This finding emphasizes the need for further investigation of the association with a larger population sample and the use of objective physical activity and sleep-related measure instruments. HIPPOKRATIA 2019, 23(1): 15-20.
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Currently, direct-acting antivirals (DAAs) are the first-line treatment for patients with chronic hepatitis C (CHC) and mixed cryoglobulinemia syndrome (MCS). However, the prognosis is variable as the achievement of sustained virological response (SVR) is not always associated with clinical remission of MCS. ⋯ Patients with CHC-MCS vasculitis would benefit from antiviral treatment with GLE/PIB. HIPPOKRATIA 2019, 23(1): 30-32.
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In the literature, several reports are describing the coexistence of Huntington's disease (HD) or myasthenia gravis (MG) with other neurodegenerative and autoimmune disorders. Herein, we report a rare case of HD in a 66-year-old male with MG. Description of the case: The diagnosis of MG was established by acetylcholine receptor antibodies testing and compatible clinical presentation. The diagnosis of HD was based on clinical features, family history, and DNA testing. Several immunologic mechanisms have been proposed regarding the pathogenesis of HD and MG, respectively. Sharing a common autoimmune aspect could be an uncertain but potential association between the two disorders. ⋯ The probability of HD and MG occurring in the same patient is extremely small. While a number of neurological and autoimmune disorders have been reported with HD and MG, this is the first described coexistence of these two entities. HIPPOKRATIA 2019, 23(1): 28-29.
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The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is a disorder which is characterized by the inability to suppress the secretion of antidiuretic hormone (ADH), leading to impaired water excretion and hyponatremia. The syndrome should be suspected in any patient with hyponatremia, hypo-osmolality and a urine osmolality >100 mOsm/kg, while urine sodium concentration is above 40 mEq/L. ⋯ The patient suffered from chronic idiopathic hyponatremia and osteoporosis, which often coexists in patients with chronic idiopathic SIADH and was treated with alendronate/cholecalciferol. The scenario of the presence of SIADH was further strengthened by the fact that hyponatremia did not improve after isotonic normal saline administration, but only with fluid restriction. HIPPOKRATIA 2019, 23(1): 42-44.
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Tourette syndrome (TS) is a neurodevelopmental motor disorder. The first diagnosis during adult life involves cases of pre-existing undiagnosed TS. ⋯ Despite delays in TS diagnosis, only a few patients remain undiagnosed by the age of 45. Both TS under- and misdiagnosis have an impact on patients' outcomes. HIPPOKRATIA 2019, 23(1): 47-48.