PubMed Health⌕ Search

Biomedical subjects

Boris Vucelić

Publications and source records attributed to Boris Vucelić.

9 recordsLinked to original sources
PubMed2006

Incidence of inflammatory bowel disease in Primorsko-goranska County, Croatia, 2000-2004: A prospective population-based study.

OBJECTIVE: It has been suggested that the incidence of inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn's disease (CD), is higher in northern than in southern Europe. Recent epidemiological studies showed the loss of the previously described geographical north-south gradient. The aim of this study was to investigate the incidence of UC and CD in Primorsko-goranska County, Croatia. MATERIAL AND METHODS: In the period 1 January 2000 to 31 December 2004 (5 years) all new patients diagnosed with IBD were prospectively identified according to a standard protocol for case ascertainment and definition. A total of 178 residents (81 F, 97 M) were newly diagnosed as having IBD during the study period. Of these, 70 had UC and 100 CD. Eight patients had indeterminate IBD. The data on patients were collected using a data form completed by gastroenterologists. RESULTS: Annual age-standardized incidence rates were 4.3/10(5) (95% CI 2.6-6.0) for UC and 7.0/10(5) (95% CI 3.4-10.6) for CD. The highest incidence rate was observed in the age group 35-44 years for UC and the 25-34 years age group for CD. The incidence of IBD was higher in the urban than in the rural population, with the exception of on the islands. CONCLUSIONS: The incidence of IBD was higher than previously observed in Croatia. Our results suggest that CD incidence rates in the northern coastal part of Croatia are currently comparable with those reported in northern Europe.

Adolescent↗
PubMed2005

[Viral hepatitis: Croatian consensus statement].

There has been a dramatic improvement in diagnostic procedures and therapy of viral hepatitis in the last 20 years. Improvements in therapy caused an increase in actual cost, however, with significant long-term savings through a decreased cost of treatment of advanced liver disease including liver transplantation. The Croatian National Board for Viral Hepatitis has decided to initiate the organization of consensus conference on viral hepatitis enabling the leading experts in the country to give the best possible recommendations for the diagnosis, prophylaxis and therapy in our circumstances. The Consensus Conference took place in Zagreb in June 2004, with update in March 2005, organized by the Croatian National Board for Viral Hepatitis, Reference Centers of the Ministry of Health for Chronic Liver Diseases, Infectious Diseases and AIDS, Croatian Society of Gastroenterology--Hepatology Section, Croatian Society for Nephrology, Dialysis and Transplantation, and Croatian Institute for Health Insurance. Invited experts provided written reports on the respective subjects that appear in this issue and their recommendations resulting in this consensus statement.

Consensus Statements as Topic↗
PubMed2005

[Viral hepatitis: clinical and histological assessment].

Viral factors are important in the pathogenesis of liver disease either directly, through cell injury associated with the accumulation of intact virus or viral proteins, or indirectly, through the host immune response. The immune response of the host is more important than viral factors in the pathogenesis of liver injury caused by HBV. There is little genomic variability in HBV, but mutant forms of HBV with mutations in the precore, surface and X genes, as well as the core promoter region have been implicated in a number of clinical syndromes. The mechanisms of viral persistence and hepatocellular injury in patients with hepatitis C infection are poorly understood. Viral infection can produce cellular injury by direct cytotoxicity and by indirect immune-mediated injury. The range of histologic findings in patients with hepatitis B and C is broad, from minimal inflammatory changes to fulminant hepatitis, liver cirrhosis and hepatocellular carcinoma. The goal of histologic analysis is quantitative and qualitative assessment of necroinflammatory lesions and fibrosis, changes of liver structure and follow-up of histologic changes due to the natural course of the disease or antiviral therapy. Subjective impression in the assessment of histologic changes is not satisfactory and numerical indices should be used. Presently, Knodell's index is being replaced by METAVIR system and Ishak system. Clinical assessment of patients with viral hepatitis must include detailed physical examination, description of the clinical course and extrahepatic manifestations, definition of viral factors, histologic assessment of inflammatory activity and degree of fibrosis, and a number of relevant laboratory parameters.

Acute Disease↗
PubMed2004

Palliative treatment of hepatocellular carcinoma with percutaneous ethanol injection using tumor's feeding artery occlusion under the ultrasonic color Doppler guidance.

We evaluate the efficacy of PEIT in patients with HCC using duplex color Doppler US. The study included 27 HCC patients admitted to the University Hospital Centre Zagreb, between 1993 and 1997. PEIT was performed for ablation of tumor supplying vessels in HCCs of < 5 cm in diameter, and as a palliative measure for tumor feeding vessel obliteration in larger tumors. The efficacy of PEIT was evaluated with duplex color Doppler US, and controlled by dynamic CT scan (16 patients) or selective angiography of hepatic artery (11 patients). All patients had well vascularized tumors before PEIT, and after therapy 25 of them showed absent or minimal tumor vascularization. Recanalization of the tumor feeding vessel was detected with Doppler US within 9 months after therapy. Study results suggested that duplex color Doppler US should be the method of choice in the evaluation of PEIT as well as in the follow-up of HCC patients after PEIT.

Adult↗
PubMed2003

[Helicobacter pylori infection and chronic gastritis as extra-esophageal factors in gastroesophageal reflux disease].

INTRODUCTION: Some substances, for example amoniac, that appear during an infection caused by Helicobacter Pylori (HP), can neutralise acid. It is assumed that a HP infection can attribute to the worsening of GERB disease with antral predominant gastritis and a defensive factor eith corpus-predominant gastrytis or esofagitis. AIMS: The aim of this study is to ascertain the role of HP infection in the modification of GORD through a prospective study, that is to see does a HP infection prospectively influence the disease or not, with a special focus on symptomatology with pathohistological findings of the antrum and the corpus of the gaster through a monitoring period of 12 months. MATERIALS AND METHODS: 50 patients of the main group were involved in this prospective study with symptoms of GORD, or that eventually had a black stool. A control group of 47 patients was formed that had Gerb positive symptomatology, identical to the first group. During endoscopic act eventual changes in oesophagus in view of GORD, so they have been graduated according to Sawary-Millerov graduation from 1991: via Standard Olympus byoptic tongs byoptic specimens were taken with changes in view of GORD, and corpus and antrum mucosac of gaster and they were put into 2% formalin, so analyses has been done at Institute for pathology in Sarajevo. A special attention has been made to the graduation of gastritis, so Sydney classification has been followed. A modification lasted for four weeks since dg has been made, so two groups were formed, one with eradicated HP and second with HP presence. In the second part of this study both groups were followed without treatment in the period of 12 months, meaning that the natural course of illness has been followed up. RESULTS: The results of tests of significant differences between treated and control group after 12 months gr. I Sawary-Miller: normal differences n.s. (t = 0.122); chronic differences n.s. (t = 0.724), reflux esophagitis difference n.s.t = 0.733). Tests of differences between treated and control group of pts according to topographic classification of gastritis for GORD gr. I (X2 = 1.076)-n.s.; za GORD gr. II (X2 = 0.999) non significant. Tests between groups of PTS for treated group (X2 = 1.4) n.s., for control group (X2 = 5.073) significant result for p < 0.05; GORD gr. II for treated group (X2 = 1.051) n.s. The results of tests of significant difference between pathohistological findings of corpus antrum treated and control group within gr. I Sawary-Miller: the difference is not statistically significant t = 0.816. The results of test significant differences of antrum after 12 months between treated and control group: within gr. I X2 = 1.623 difference n.s.; within gr. II t = 0.015 difference n.s. CONCLUSION: This study proved that eradication of HP infection acts to GORD course by improvement of endoscopic findings by Sawary-Miller and pathohistological findings on oesophagus, as well as with decrease of activity predominant antral atrophic gastritis in I degree of GORD 12 months after and by decreasing daily acid symptoms. The eradication of HP infection in GORD do not influence on activity of predominant corpus gastritis, as well as on heartburn symptom, weekly acid symptom nor chest pain.

Chronic Disease↗
PubMed2003

[Treatment of viral hepatitis].

The primary goals of treatment for viral hepatitis are to eradicate the infection early in the course of the disease, to prevent progression to end-stage liver disease, and to prevent the development of hepatocellular carcinoma. The secondary goal is to decrease the number of chronic carriers who serve as a reservoir for viral transmission. The major step in the management of hepatitis B was the introduction of successful vaccination. The treatment of hepatitis B includes nucleoside analogues (lamivudine and adefovir) and interferon. The major problem in lamivudine treatment is the development of resistant viral mutants. Hepatitis D can worsen hepatitis B and lead to progressive liver disease. The recommended treatment is interferon. Hepatitis C, due to the lack of vaccine and tendency to develop chronic liver disease, is the major health problem and the leading indication for liver transplantation today. The recommended treatment is the combination of pegylated interferon and ribavirin.

Antiviral Agents↗
PubMed2002

[Effect of eradication of Helicobacter pylori infection on endoscopic findings and symptoms of gastroesophageal reflux].

Gastroesophageal reflux disease (GORD) represents an illness which reflects a syndrome caused by returning of acid gastric, alkaline pancreatic and bowels content into the oesophagus, which is in the stomach, because of the protective mechanisms of oesophageal loss. The aim of this study was that this prospective study should explain the role of Helicobacter pylori infection in modification of GORD, respectively whether the Helicobacter pylori infection acts protectively or by deterioration of the disease. According to the settled rules, the inquiry was performed as well as the selection of 97 candidates to undergo research in this study. Helicobacter pylori infection has been proved by immunoassay in all pts in the beginning of this study. Endoscopy has been performed in all pts, the degree of gastroesophageal reflux disease by Sawary-Miller was done. The main group consisted of 50 candidates in whom the eradication of Helicobacter pylori infection was done with triple therapy, pantoprazol + amoxycilin + klaritromicin, which was proven by an immunoassay test. Two groups of pts were formed: the main one with eradicated Helicobacter infection, and a controlled one with a Helicobacter positive infection, which was subject to modification of life style. During 12 months, this study consisted of endoscopic evaluations and monthly evaluation of pts daily difficulties. The eradication of Helicobacter pylori infection acts on the improvement of gastroesophageal disease course by improvement of endoscopic findings by Sawary-Miller, and by decreasing daily acid symptoms. The eradication of Helicobacter pylori infection in gastroesophageal reflux disease does it act at the symptoms such as heartburn, weekly acid symptoms and chest pain.

Gastroesophageal Reflux↗
PubMedDate not supplied

[Percutaneous endoscopic gastrostomy: 5-year experience at out center (1997-2002)].

Gauderer and Ponsky first described percutaneous endoscopic gastrostomy (PEG) in 1979. It was introduced as a routine method in the Division of Gastroenterology, University Hospital Rebro, Zagreb, in 1995. Over the years the number of PEG insertions has increased significantly. We reviewed the available literature and compared the results with our experience according to indications, complications and efficacy of the procedure. We inserted PEG in 86 patients from January 1, 1997 until January 31, 2002. There were 40 females and 46 males. The most frequent indication for PEG insertion was a neurological condition (60/86). There were no deaths directly related to the procedure. One patient had a leakage of PEG feeding into the peritoneal cavity that caused severe peritonitis and required urgent laparatomy within 24 hours of the PEG insertion. Two patients had local infection and the tube had to be removed. The antibiotic prophylaxis has been given to 65 patients. Our experience confirms that PEG is a relatively safe and well tolerated procedure.

Adolescent↗