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Biomedical subjects

B Gligić

Publications and source records attributed to B Gligić.

12 recordsLinked to original sources
PubMedDate not supplied

[Myocardial reinfarction].

A total number of 1924 patients were treated for acute myocardial infarction (AMI) at the Clinic for Urgent Medicine at the Military Medical Academy during the period of seven years (1991-1997). These myocardial infarctions were at different locations, the mean age of patients was 63.7 +/- 6.2, in male patients 1192 (61.9%) and 732 (38.1%) in female ones. Out of that number of patients, 406 (21.1%) had recurrent myocard infarction (RMI), 254 (62.6%) males and 152 (37.4%) females, of average age 64.8 +/- 8.3 years. Statistically, no significant differences were observed in those two groups of patients, concerning their age, location of myocardial infarction and administration of fibrinolytic therapy. There were, however, significant differences concerning the complications, primarily cardiac insufficiency, malignant arrhythmias, AV block II0 and III0, applications of temporary or permanent pacemaker and finally mortality. During intrahospital phase of treatment, in the first few months, obtained results revealed that the patients suffering from RMI had multiple and serious complications and that cardiac insufficiency was the main cause of high mortality rate in those patients.

Female↗
PubMedDate not supplied

The value of ophthalmoscopy in the diagnosis of arterial hypertension in patients with ischemic brain disease.

Beside dyslipoproteinemia, one of the key risk factors for the onset of brain atherosclerosis, as well as ischemic brain disease (IBD) is arterial hypertension. Significant number of patients is not aware of their hypertension, and a paradoxical blood pressure decrease can occur at the onset of IBD, due to the failure of autoregulation mechanisms. Likewise, valid anamnestic data can not frequently be obtained due to difficulties in communication with patients. Regarding these facts, our hypothesis was that ophthalmoscopy in patients with IBD had the greatest sensitivity in the diagnosis of hypertensive disease, its duration and severity. For that reason, the purpose of this study was to determine the significance of ocular fundus examination in those patients with IBD who were not aware of their hypertension, or the high blood pressure was not registered at the admission. Study comprised 140 IBD patients selected upon the following criteria: ophthalmoscopy was performed by the same ophthalmologist, and IBD was diagnosed according to clinical criteria and by brain computerized tomography. Results of the study demonstrated that 26 (18.6%) patients, although not aware of having hypertensive disease, had grade I hypertonic fundus, 14 (10%) had grade II, and 8 (5.5%) had grade III hypertonic fundus, which indicated the high sensitivity of ophthalmoscopy in the diagnosis of hypertensive disease, as well as its duration and severity. This is particularly important in patients with negative history of hypertension, and also suggests the significance of routine ophthalmoscopy in normotensive patients.

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PubMedDate not supplied

[Assessment of embolism risk in deep vein thrombosis in various locations using radionuclide phlebography and perfusion scintigraphy of the lungs].

With the aim of the estimation of embolism at certain locations of deep vein thrombosis (DVT) 3 groups comprising 22 patients were investigated in whom isolated thrombosis in one of the deep veins segments: lower leg, upper leg, and pelvis was determined by radionuclide phlebography (RNF) and contrast phlebography. Afterwards, all necessary investigations relevant for pulmonary thromboembolism (PTE), including perfusion scintigraphy of the lungs (PSL) were performed. Out of all patients with DTV, 17% were with pulmonary changes confirming PTE. Out of patients with DVT, 59% were with the changes in the upper leg segment, and 66% of patients were with changes in pelvic segment, respectively.

Humans↗
PubMedDate not supplied

[Value of the stress test in the evaluation of the severity of ischemic heart disease].

Loading test was used in 156 patients with ischemic heart disease and the results of their selection are presented. In all patients occlusive coronary disease was detected by selective coronarography. They were divided in three groups. Two groups of patients had a high risk ischemic heart disease requiring surgical revascularization of the myocardium and selective coronarography. The first of these two groups comprised 48 patients with significant stenosis of the main tree of the coronary artery and the second comprised 35 patients with equivalent stenosis of this artery. The third group comprised 73 patients with ischemic heart disease of small risk in whom occlusive changes of the coronary arteries were of distal localization. The statistically significant difference was found between the two groups of patients with high risk and the third group with small risk according to early development of ST depression in the first minutes of loading, its degree, number of leads with ST depression, form and its maintenance after cessation of loading. The difference was also significant regarding the submaximal pulse rate and systolic blood pressure during loading test. It has been concluded that by using loading test as a functional diagnostic method patients with a high risk ischemic heart disease can be selected stressing the advantage of physiology over morphology.

Adult↗
PubMedDate not supplied

[Combined myocardial infarct of the left and right ventricle].

Combined myocardial infarction of left and right ventricle (CMILRV) of inferoposterior localization represents simultaneous acute necrosis of both myocardial ventricles and belongs, due to associated and frequent complications, to more severe damages of the myocardium with high mortality. Our group consisted of 100 patients of both sexes, mean age of 67.4 years, of which 50 were with inferoposterior left ventricular infarction and 50 with CMILRV of the same localization. The diagnosis was confirmed clinically, by ECG, by the analysis of enzymes, echocardiographically and scintigraphically using radionuclide ventriculography with 99Tcm PyP. Selective coronarography was performed in all the survived patients, and autopsy of the dead. On the basis of clinical presentation of some forms of dynamic weakness of the heart, in acute stage of CMIRLV, we have established that there are 4 categories of these patients, so that each of these groups represents also a special clinical form, which are: 1. CMIRLV without signs of heart failure, established in 20 (40%) cases, which clinically and prognostically do not differ from inferoposterior left ventricular infarction. 2. CMIRLV with predominant failure of the right ventricle was found in 17 (34%) of the patients with a specific clinical feature and the way of treatment. 3. CMIRLV with marked failure of the left ventricle, found in 8 (16%) of the patients, which required combined treatment measures. 4. CMIRLV with general heart failure, established in 5 (10%) cases, is characterized by cardiogenic shock and falls into the most severe forms of this kind of myocardial infarction. Total mortality in the patients with CMILRV was 10% (5.50), that is 40% (2.5) in both the second and the fourth subgroup, 20% (1/5) in the third group, while in the first one as well as in the control group with inferoposterior infarction there was no mortality. Good knowledge of the above mentioned clinical forms of CMILRV are necessary prerequisite for application of specific and corresponding therapeutic measures and the best prevention of associated complications and high mortality of such patients.

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