Biomedical subjects

Bećir Heljić

Publications and source records attributed to Bećir Heljić.

15 recordsLinked to original sources

PubMed2006

Immunosuppressive therapy protocols in kidney transplantation in adults.

In practical terms, regardless of HLA compatibility level, whenever tissues are transplanted from one person to another it is essential to suppress the immune response of the recipient. A variety of methods are available however, the most frequently used ones have the disadvantage of being immunologicaly non specific. The consequence is a difficult balance between immunosuppression sufficient to prevent the tissue rejection and maintenance of immune system at the level of ability to adequately deal with an infection. The goal, not yet achieved, is to find a way of generating donor specific immunosuppression that leaves the immune machinery otherwise completely intact. The major approaches to immunosuppression are described below.

Adult↗

PubMed2006

Effects of hyperglycemia and iron deficiency on kidney and heart function in type 2 diabetes disease.

Untreated anemia can caused significant cardiac and kidney damage. The aim of this study was to investigate the efficiency of anemia and hyperglycemia treatment in type 2 diabetes and their impact on kidney and heart impairment. The study is clinical retrospective and prospective and it was conducted in Clinic of Endocrinology, Diabetes Mellitus and Metabolic Diseases, University Clinical Center of Sarajevo. Prior to the study all patients were taking oral hypoglycemic drugs included sulfonylureas and biguanides. These subjects were put on 2 times daily fix mix insulin and biguanides after lunch. Each day, subjects received Iron tab 1 x 100 mg/ day, and C vitamin 1 x 100 mg/day. The results of our study are showing that effective treatment of glycaemia and anemia in patients with diabetes, reduces blood pressure, urine albumin secretion and pulse rate, diminishing cardiovascular damage and improving kidney function.

Anemia, Iron-Deficiency↗

PubMed2006

[Evaluation of the tumor of the pituitary gland (hypophysis) between 2000-2005. On the intensive care of The Endocrinology Clinic of the Clinical Center of the University of Sarajevo].

INTRODUCTION: Tumors of the pituitary gland can be adenomas, and more often, cancers, representing 10-15% of intracranial neoplasm. We make a difference between them according to their size, expansion, hormone's activity and local and endocrinological manifestations. The goal of the research was to reveal the presence of tumors of the pituitary gland in the period 2000-2005 among patients hospitalized on the Intensive Care of the Endocrinology Clinic. PATIENTS AND METHODS: Data from anamnesis of all patients with verified tumor of the pituitary gland between 2000.-2005 were used in the research work. RESULTS: Total number of patients with the tumor of pituitary gland was 40, 29 women and 11 men, and 35 % of patients were aged between 45 and 60. Main symptoms: headache -16, eye trouble -17, sexual dysfunction -8, growth of acres -5, and others symptoms -8 patients. There were 23 (57,5%) cases of micro adenoma and 17 (42,5 %) macro adenomas. From the total number of patients 23 were operated, 8 micro adenomas and 15 macro adenomas. The number of secreting adenomas was 25 (62,5 %) and 15 (37,5 %) were non-secreting. Secreting adenomas were: prolactinomas--14, acromegalies -7, Cushing syndromes -2, TSH producing -2. Non-secreting adenomas were: craniopharyngeomas--11, meningiomas -2, and 2 non-secreting micro adenomas. Most of prolactinomas were treated with drugs, and 3 cases of prolactinoma were operated. 6 cases of acromegaly were operated and 1 micro adenoma is still under medical supervision, with the therapy of bromocriptine. 3 of those patients have the residuum, and 4 of them have high level of hGH. 11 craniopharyngeomas were operated and all patients, except one, are under substitution therapy. 2 meningiomas were operated and those patients are also under substitution therapy. 1 case of TSH producing tumor was operated, but residuum and hyperthyroidism are still presents, and the micro adenoma, for the hyperplasia reason, disappeared with adequate substitution therapy. The Cushing syndrome, confirmed with MRI diagnostics, wasn't operated; it remained under conservative therapy, and in the other case, where we didn't isolate a pathological substrate, the patient exited. CONCLUSION: Tumors of the pituitary gland we mainly treat applying surgery methods, together with post operational substitution therapy or additional therapy with drugs. Only prolactinomas are tumors which are successfully treated with drugs.

Female↗

PubMed2006

[Vaccine for prevention of type 1 diabetes mellitus].

Diabetes mellitus type 1, known as insulin dependent diabetes mellitus (IDDM), results from a chronic autoimmune destruction of the insulin secreting pancreatic beta cells. This autoimmune process is marked by circulating auto antibodies to beta cell antigens. GAD 65 (Glutamic Acid Decarboxylase) auto antibodies are present in 70-80% of newly diagnosed patients with type 1 diabetes, and it can be detected many years before clinical onset of the disease. New knowledge in the imunopathogenesis have given expectation that imunotherapy will become routine manner for cure of diabetes mellitus type 1.

Autoantibodies↗

PubMed2005

[Contemporary methods of prevention and treatment diabetic kidney disease].

The number of people with diabetes is increasing worldwide. Diabetes is the leading cause of end-stage renal disease. Diabetic kidney disease has been reported to occur in 25-40% of people with type 1 or type 2 diabetes. Recent studies have demonstrated that the onset and course of diabetic nephropathy can be significantly improved by intervention in early stage of the development of this complication. In this article we will review the current recommendations regarding the prevention and treatment of diabetic nephropathy.

Diabetic Nephropathies↗

PubMed2005

A simple method of DNA extraction in solving difficult criminal cases.

AIM: We examined combined use in house method and DNA IQ system (Promega) procedure for the extraction DNA from biological trace in order to help the solving some crime cases. METHOD: Simple and efficient method for extraction of the DNA from biological trace samples included the well washed trousers and the knife without any visual biological trails (from some one hard criminal case). In this method there were used: centrifuge, microwave oven, shaker, chelex, proteinase K, DNA IQ System (Promega). RESULTS: The extraction of DNA could be done within 2.5 hours or over the night. The DNA prepared on this way was good quality and could be used for STR analysis. CONCLUSIONS: This combined, simple, and safe method could be used for extraction DNA from samples containing a minute amount of the biological trace.

DNA↗

PubMed2005

[LEAP (Lantus Early Access Programme) in Sarajevo].

LEAP is multicentric study in phase IV. The first aim was to affirm Lantus efficacy and safety in every day practice, in local conditions. The second aims were to verify therapy successful by measuring fast blood glucose (FBG) and HbA1c and to estimate patients' pleasure. Duration of study was 2 months. Lantus was administrated subcutaneously daily. Doses were individual. HbA1c was measured at the begining of therapy and at the last control. Blood glucose was measured every day. The study included patients who did not reach the control of glycemy, or patients with frequent hypoglycemic crysis, older then 6 year. LEAP study in Sarajevo included 114 patients. Fifty four patients (47%) were men, and 60 (53%) were women. 46% diabetics have type 1 of diabetes mellitus and 54% have type 2 diabetes mellitus. The results of study demonstrated statistically significant decreasing of FBG and HbA1c in both groups (I group--patients younger than 18 years and II group--patients older than 18 years), p<0.05. FBG in I group on the start of Lantus therapy was 9.9+/-3.9 mmol/l but on ending control was 8.7+/-4.4 mmol/l (p<0.05). HbA1c on start of therapy was 9.4+/-1.9%, but on end control was 8.0+/-1.8% (p<0.05). FBG in II group on start was 13.6+/-4.7 mmol/l but on finish was 7.3+/-2.9 mmol/l (p<0.01). HbA1c on start was 9.3+/-1.8% and on end was 7.2+/-1.2% (p<0.01). These results showed that the Lantus is very efficacious for good glycoregulation. Just for two months, HbA1c decreased for 2%. Undesirable effects were not registered. We concluded that Lantus is very safe. Most patients (89%) were satisfied with therapy.

Adolescent↗

PubMed2005

The effects of valsartan on lipid profile in normotensive type 2 diabetic patients.

Valsartan as angiotensin-II receptor antagonist in normotensive diabetic may provide kidney and heart protection. It also increases insulin receptor sensitivity. The aim of this study was to investigate the effect of valsartan on lipid profile in normotensive type 2 diabetic patients. Fifteen normotensive patients with type 2 diabetes mellitus, mean age 58.6+/-5.6 years, with mean BMI 28.6+/-2.5 kg/m2, were treated with valsartan in doses 20-80 mg per day. After a year of treatment with valsartan we witnessed significant decrease in total cholesterol level (6.8+/-1.4 to 5.4+/-0.9 mmol/l, p<0.05) and low density lipoprotein (LDL) from 4.5 to 2.7 mmol/l. Triglycerides were not affected significantly. Albumin excretion in urine significantly decreased. Level of basal insulin (from 256 to 78 pmol/l) has, also, decreased. In type 2 diabetes mellitus, the use of angiotensin-II receptor antagonists reduces the progression from micro to macro albuminuria. These results suggest that the angiotensin-II receptor antagonist decreases lipid serum levels in normotensive diabetes mellitus type 2 patients.

Angiotensin II Type 1 Receptor Blockers↗

PubMed2004

[Unilateral pheochromocytoma and adrenal gland hyperplasia].

Woman, forty two years old, has been hospitalized because of frequent headache, palpitation and tremor of lips with paroxysmal increase of blood pressure. The adrenals have examined. The status of the hormones has checked many times but showed increased values of VMA and 17-OH steroids only once. There is no possibility to measure the catcholamines. Analysis of other hormones has showed normal values except of paradoxal hGH increase during suppressive hGH test and hypoglycemia in OGTT test. The changes of the left adrenal, which size was 25x18 and 30x25 mm, have diagnosed by MRI of adrenals. It has been suspected microadenoma by MRI of pituitary gland. The left adrenalectomy has been done. During the surgery hypertension and tachyarrhythmia has occurred and treated by fentolamin and propranolol. No complications have been noticed after the surgery. The status of the adrenals hormones are in the normal range. Patohystological analysis has proved phcochromocytoma and hyperplasy.

Adrenal Gland Neoplasms↗

PubMed2004

[Detection of antibodies against cytomegalovirus in donors and recipients of kidney transplants].

UNLABELLED: The paper analyzed the values and titer of IgM and IgG antibodies on CMV in donors and recipients of kidney transplntats. The objective was to investigate the presence of CMV in donors and recipients. SUBJECT AND METHODS: Test enzignost anti CMV/IgM was used. Detection of antibodies in 15 donors before transplantation and in 22 patients-recipients before and after the transplantation was done. RESULTS: From total of 15 donors, the values of IgM ranged from 0,002 I.U. do 0,080 I.U. One case was positive. Four patients were seropositive and treated by Gancyclovirom 10 mg/kg/b.w (body weight) in period of 3 month. IgM values ranged from 0.88399 to 25978. The control finding 3 patients was negative, in 1 patient positive (IgM 0.569). In 18 patients the finding was negative. Refererent value for IgM is < 0.10 the result is negative. For IgG four times greater value comparing to the basic value was found. CONCLUSION: The most significant factor for reactivation of CMV infection is iatrogenic Immunosuppressive therapy. Exclusion of CMV infection in donors and negative finding in recipient decrease.

Adult↗

PubMed2002

[Obesity as a risk factor for the onset of type 2 diabetes mellitus].

Today overweight is the biggest public health problem in the world. According to statistical data, its occurrence is the most frequent among the English 53%, than German 51%, USA 48%, Italian and Spanish 40%, in French 38%, Swedish 30% and Russian 34%. According to available data 0.3% of the BiH population is overweight. Overweight can be related to collection of fat depos--obesity, or enlarged muscle mass--muscle hypertrophy. Criteria for evaluating of overweight are BMI (Body Mass Index). Obesity is the remarkable risk factor for the human health and it performs the background for many diseases--cardiovascular, diabetes mellitus, respiratory diseases, malignant diseases of gastrointestinal tract, joint-bone system diseases etc. For the regulation of optimal body weight, energy balance between input of energy by the food and its consumption is needed.

Diabetes Mellitus, Type 2↗

PubMed2002

[Direct fluorescence microscopy in the diagnosis of glomerulonephritis].

The use of the method of direct immunofluorescence (DIF) in the examination of the renal biopsy tissue, differentiation of various forms of glomerulonephritis, identification of immunopathogenetic mechanisms of the disease and mediators of immune reaction, are presented. In the study are described the characteristics findings of DIF in differentiation of morphologic groups of glomerulonephritis, made after light microscopy (LM). Here are presented the type and localisation of immune deposits within the kidney tissue (glomerules, blood vessels, tubules and interstitium). It was performed 52 renal biopsies in the period between 1997 and 2001 year, at the Institute of Nephrology in Sarajevo, than divided after DIF and LM in 11 different groups, with dominant membranous glomerulopathy (11 cases), diffuse mesangioproliferative with IgA nephropathy (9 cases) and minimal change glomerulonephritis (9 cases), between them. It was described the method of renal biopsy, the preservation and preparation of biopsy spacemen, and the act of fluorescence microscopy.

Complement System Proteins↗

PubMed2002

[Effect of anti-thyroid agents in the treatment of hyperthyroidism].

The treatment for hyperthyreoidism is usually conservative and consists of medications that limit the production of thyroid hormones. The diagnose of hyperthyreoidism was set up according to clinical finding, to determine the level of FT3, FT4, TSH with thyroid scintigraphy, and ultrasonography. In this study we showed the result in the therapy of the hyperthyreoidism with Favistan-Tiamazol tbl. during the period 2000-2001.

Adult↗

PubMed2002

[Arterial hypertension as a risk factor for multifocal atherosclerosis].

BACKGROUND: It is well known that atherosclerosis as systemic disease have a significant correlation with score of multiple risk factors (MRF). Atherosclerosis as a multifocal disease, produces multisegmental stenotic changes of various arterial segments which arises simultaneously as a pre-existing asymptomatic disease. Aim of this study is to evaluate the presence of multifocal atherosclerotic disease among pts. with predominant arterial occlusive disease (AOD), and to correlate arterial hypertension as a major independent risk factor and multifocal atherosclerotic disease. METHODS: We included 109 consecutive patients treated at our Institute in the period Dec 1999--Dec 2000, all with clear arterial occlusive disease (AOD). According to Fontaine clinical staging of their AOD, we made three groups--group FII, clinical stage Fontaine II 63 pts, group FIII, clinical stage Fontaine III 32 pts, and group FIV, clinical stage Fontaine IV 14 pts. We evaluated clinical variables: age, gender, arterial hypertension (HTA), tobacco, hyperlipidemia (HLP), obesity (BMI), diabetes mellitus, coronary heart disease (CHD), and cerebrovascular disease (CVD). Score of MRF is calculated as x/9. Special focus has been made to pts. with positive HTA. All pts. were evaluated according to clinical evidence of CHD and CVD, respectively. RESULTS: We had 109 pts, 89 males and 20 females, average age of 62 yrs, males 63 and females 60 yrs. In the FII group were 63 pts. with average MRF 4.27, in the FIII group 32 pts. with MRF 3.97, in the FIV group 14 pts. with MRF 3.93. Out of the total number of pts. 52 were hypertensive (47.7%), 41 males, and 11 females, with average age 64.8 yrs, males, and 61.8 yrs, females. Isolated systolic HTA had 33 pts. (63.5%), and 19 pts. (36.5%) systolic and diastolic HTA. In whole group (n-109), multifocal disease, AOD + CHD, had 22 (20.21%) pts. (MRF score 4.86), AOD + CVD had (5.5%) 6 pts. (MRF score 3.66) and AOD + CHD + CVD had 8 (7.33%) patients (MRF score 6.13). In hypertensive pts. multifocal atherosclerotic disease, AOD + CHD, had 12 pts. (23.1%), and AOD + CHD + CVD, 2 pts (7.6%). Among clinical variables, tobacco was of high risk, 97 pts. positive (89.9%), what is of high significance, p < 0.001. CONCLUSIONS: We have a clear connection of multifocal disease with elevated MRF score, especially clinical variables, smoking (p < 0.001) and arterial hypertension (p < 0.01). Multifocal atherosclerotic disease was present in 36 pts. (33.1%), and among hypertensive pts. multifocal atherosclerotic disease was present in 14 pts. (26.9%). There is a high positive correlation rank of multifocal disease, HTA and score of MRF, r = .70, and borderline correlation rank of multifocal disease and score of MRF, r = .40.

Arteriosclerosis↗

PubMed2002

[Role of C-reactive protein in systemic lupus erythematosus].

We prospectively estimated the CRP and erythrocyte sedimentation rate (ESR) level in the blood of patients with systemic lupus erythematosus (SLE), with aim to find the difference between relapse and infection, especially because the high fever is the same clinical sign for both. After following this problem, considering the relation between SLE and infection, we have found that: When SLE is active disease, the infection is common complication, Immunosuppressive therapy, particularly with steroids, prepares the conditions for infection, Infection and SLE are going together, and here is believe that infection is making the worsening of basic disease, A lot of SLE syndromes are differentiated with difficulties from syndromes caused from infection (pneumonia, arthritis, serositis). During 2 (two) years follow up of 10 patients suffering from SLE and fulfilled ARA criteria, we found 5 relapses and 3 infections, and all of them were followed and analyzed. We used the additional criteria for the estimation of the disease activity every patient separately. The CRP blood level was measured every month. According to a lot of clinicians, normal values of CRP are 0-0.5 mg/dl (0-5 mg/L) and ESR between 12-20 mm. Levels over 15 mg/L (1.5 mg/dl) are found with 4 SLE patients (5 SLE relapses), and 2 patients with infections (3 cases of infection). The median value of CRP in the course of infection was more than 60 mg/L, in comparison with SLE relapse (16.5 mg/L). All patients with SLE relapse had increased ESR level, but CRP wasn't, while with infection ESR and CRP were regularly increased in all cases. Measuring CRP in SLE is helpful in differentiating between infection and relapse, only under one condition: that serositis previously wasn't present.

Adult↗