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Biomedical subjects

D Horvat

Publications and source records attributed to D Horvat.

At least 19 recordsLinked to original sources
PubMed2001

[Reconstruction of mental health services in Bosnia and Herzegovina].

Psychiatric services in Bosnia-Herzegovina before the war disaster was fairly developed and one of the best organized services amongst the republics of the former Yugoslavia. The psychiatric care system was based on psychiatric hospitals and small neuropsychiatric wards within general hospitals, accompanied by psychiatric services in health centers. The onset of war in B&H brought devastation and destruction in all domains of life, including the demolition and closing of numerous traditional psychiatric institutions, together with massive psychological suffering of the whole civilian population. Already during the war, and even more so after the war, the reconstruction and reorganization of the mental health services was undertaken. The basis of mental health care for the future is designed as a system where majority of services is located in the community, as close as possible to the habitat of the patients. The key aspect of the system of the comprehensive health care is primary health care and the main role is assigned to family practitioners and mental health professionals working in the community. Large psychiatric institutions were either closed or devastated, or have their capacities extensively reduced. There will be no reconstructions or reopening of the old psychiatric facilities, nor the new ones will be built. The most integrated part of the psychiatric system are the Community based mental health centers. Each of these centers will serve a particular geographic area. The centers will be responsible for prevention and treatment of psychiatric disorders, as well as for the mental health well being. Chronic mental health patients without families and are not able to independently live in the community will be accommodated in designated homes and other forms of protected accommodation within their communities. The principal change in mental health policy in B&H was a decision to transfer psychiatric services from traditional facilities into community, much closer to the patients. Basic elements of the mental health policy in B&H are: Decentralization and sectorization of mental health services; Intersectorial activity; Comprehensiveness of services; Equality in access and utilization of psychiatric service resources; Nationwide accessibility of mental health services; Continuity of services and care, together with the active participation of the community. This overview discusses the primary health care as the basic component of the comprehensive mental health care in greater detail, including tasks for family medicine teams and each individual member. 1. Comprehensive psychiatric care is implemented by primary health care physicians, specialized Centers for community-based mental health care, psychiatric wards of general hospitals and clinical centers in charge of brief, "acute" inpatient care; 2. Primary mental health care is implemented by family practitioners (primary care physicians) and their teams; 3. Specialized psychiatric care in community is performed professional teams specialized mental health issues' within Mental health centers in corresponding sectors; 4. A great deal of relevance is given to development of confidence and utilization of links between primary health care teams and specialized teams in Mental health centers and psychiatric in patient institutions; 5. Psychiatric wards within general cantonal hospitals, departments of psychiatric clinics in Sarajevo, Tuzla, and Mostar, and Cantonal Psychiatric hospital in Sarajevo (Jagomir) shall admit acute patients as well as chronic (with each new relapse). Treatment in these facilities is brief an patients are discharged to return to their homes, with further treatment referral to their family practitioner or designated Mental health center; 6. Chronic mental patients with severe residual impairment in social, psychological, and somatic functioning, shall live in the community with their families or independently. Those chronic patients without families and economic and other resources to live independently shall be placed in supervised Homes in the communities where they live. The above delineated strategy of mental health care program in B&H has several fundamental and specific objectives, among which the most important are: Reduction of incidence and prevalence of some mental disorders, particularly war stress-related disorders and suicide; Reduction of level of functional disability caused by mental disorders through improvement of treatment and care of individuals with mental health problems; Improvement of psychosocial well being of people with mental health problems, through implementation of comprehensive and accessible service for community mental health care; and Respect of basic human rights of individuals with mental health disabilities. The program has been updated since 1996, after the two-year pilot program. The main goals for current two- and five-year period are: Implement the mental health care reform program by launching all 38 Mental health centers in the Federation of BiH by 2002; Complete the 10-day education and re-education of at least 50% of all professionals employed in mental health services in FB&H by 2002; and Achieve that 80 percent of all mental health problems are treated by family medicine teams (primary care practitioners) and specialized mental health services (Community mental health care centers) by 2005.

Bosnia and Herzegovina↗
PubMed1999

Pharmacokinetics and acute tolerance of a double virus inactivated plasma derived factor VIII concentrate.

To further reduce the risk of possible viral disease transmission, an additional virucidal step was performed in the manufacturing process of a solvent/detergent treated factor VIII concentrate, which consisted of heating the lyophilized preparation at 100 degrees C for 30 min (Emoclot DI; ISI, Italy). Because thermal treatment may modify factor VIII bioavailability, the pharmacokinetic parameters and the acute tolerance of the single viral inactivated concentrate (preparation A) were compared with that of the double viral inactivated one (preparation B). Fifteen patients with severe haemophilia A and positive for HAV Ab were enrolled in a double-blind cross-over study and injected with 32.5 IU kg-1 of preparation A and 27 IU kg-1 of the preparation B. No significant differences between terminal half-life, area under the curve/dose, clearance/kg, volume of distribution at the steady state, in vivo recovery and acute tolerance of the two preparations was observed. The only statistical difference was restricted to Cmax.

Adolescent↗
PubMed1999

Pantoprazole versus omeprazole in the treatment of reflux esophagitis.

Pantoprazole is a new proton pump inhibitor with a potent antisecretory activity, well defined pharmacokinetics and safety profile. The aim of this single blind, randomized clinical trial was to compare the efficacy of pantoprazole (PAN) 40 mg/day and omeprazole (OME) 20 mg/day in patients with grade I and II GERD (Savary-Miller classification). A total of 120 patients were included (PAN = 60 and OME = 60). In the per protocol/analysis, healing rates at 4 weeks were 76.3% PAN and 71.2% OME (ns), and at 8 weeks 94.7% PAN and 92.9% OME (ns). In the intention to treat analysis, healing rates at 4 weeks were 75% PAN and 70% OME (ns), and at 8 weeks 90% PAN and 86.6% OME (ns). Both pantoprazole and omeprazole were well tolerated with no serious drug related adverse events. Pantoprazole 40 mg/day was found to be safe and effective therapy comparable to omeprazole 20 mg/day in the short-term treatment for reflux esophagitis (grade I and II).

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1997

Chromosome aberrations induced in human lymphocytes by U-235 fission neutrons. Part III: Evaluation of the effect of the induced alpha and beta activity on the chromosomal aberration yield.

AIM: Further experiments were performed to explain a difference in chromosomal aberration yield found between samples cultivated immediately after fission neutron irradiation and samples which were cultivated with 96 h delay after irradiation. MATERIAL AND METHOD: Human peripheral blood samples were irradiated in mixed fission neutron/gamma field (1800 s) and biological effect assessed in the mean of analysis of unstable chromosome aberrations with a time delay in culturing cells of 12, 24, 48, and 96 h. Additional measurements were performed on irradiated and blank blood samples with the aim to detect any increase in alpha and beta activity after fission neutron irradiation. No difference was found. Results were compared to theoretically calculated values of the alpha and beta activity released from natural radioactive isotopes. RESULT AND CONCLUSION: As a conclusion it is shown that in our experimental conditions the secondary effects resulting from nuclear transformations of natural or induced radioactive isotopes, recoil reactions and accompanying alpha, beta, and gamma radiation are not the reason for the increase observed in chromosomal aberration yield in blood samples cultured with a time delay of at least 24 hours.

Alpha Particles↗
PubMed1997

Another therapeutic schedule in eradication of Helicobacter pylori.

In this study, the efficacy and tolerability of two different therapeutic schedules in eradicating Helicobacter pylori and healing duodenal ulcer were evaluated. The study included 60 patients with duodenal ulcer and Helicobacter pylori infection. They were randomly allocated to either of two groups: group 1 (N = 30) received omeprazole 20 mg for 28 days, amoxicillin 3 x 500 mg for 7 days and metronidazole 3 x 500 mg for 5 days, and group 2 (N = 30) received omeprazole 20 mg for 28 days, ACA (amoxicillin 500 mg plus clavulanic acid 125 mg) 3 x 625 mg for 7 days and metronidazole 3 x 500 mg for 5 days. Endoscopic examination, bioptic urease test and histologic examination were performed before, and 30 and 90 days after the treatment. Endoscopic examination was also performed one month after the beginning of the treatment, when healing of duodenal ulcer was observed in 90% (27/30) of the group 1 patients and in 93.3% (28/30) of the group 2 patients. The Helicobacter pylori eradication achieved in group 1 and 2 was 76.7% (23/30) and 83.3% (25/30), respectively. Side effects were present in 20% (6/30) of the group 1 patients and in 23.3% (7/30) of the group 2 patients. Side effects were mild and did not require interruption of the treatment. A higher rate of eradication was achieved in group 2 than in group 1, but the difference was not statistically significant.

Adult↗
PubMed1997

Lansoprazole versus omeprazole in the treatment of reflux esophagitis.

To evaluate the therapeutic potential of the newly developed proton pump inhibitor lansoprazole in patients with reflux esophagitis (grade I and II according to Savary Müller criteria), the authors performed a single blind, randomized clinical trial comparing 20 mg omeprazole and 30 mg lansoprazole, involving 60 patients at two clinical hospitals. The treatment period was or 8 weeks, and main efficacy variables were healing of endoscopic changes and relief of reflux symptoms. No significant difference in terms of healing and relief of reflux symptoms was found either after 4 or after 8 weeks of treatment. In conclusion, 30 mg lansoprazole daily was found to be safe and effective therapy comparable to omeprazole in the short-term treatment for reflux esophagitis (grade I and II).

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1997

In vitro assessment of asbestos fibers genotoxicity.

This study was carried out in order to assess the genotoxic effect of in vitro exposure to commercial chrysotile asbestos. V 79 cell line, known as a well-established cellular model, was used for detection of asbestos genotoxic potency. Conventional structural chromosomal aberration analysis and sister chromatid exchange (SCE) method were both used for asbestos genotoxicity assessment. Within the experimental protocol applied, V 79 cells were treated with asbestos in concentrations of 100 and 200 micrograms/ml F-10 (HAM) media during 90 days, respectively. Analysis of changes in chromosome structure as well as of cell ploidy was performed each tenth day of the experimental course, consecutively. Two hundred well spread metaphases were taken into account for chromosomal aberration analysis. Frequency of sister chromatid exchanges was observed in 50 cells per sample. The results of cytogenetic tests revealed structural chromosomal damages, SCE-elevation and changes in cell ploidy. Cytogenetic effect of asbestos obviously depended on the dose applied and on the period of incubation. The results of this study suggest that significant cytogenetic changes occurring after asbestos treatment might directly or indirectly be the part of the biological events responsible for eliciting asbestos-induced carcinogenesis.

Animals↗
PubMed1996

Work environment influence on cytostatics-induced genotoxicity in oncologic nurses.

The aim of the study was to point out the influence of workplace conditions on chromosomal damage incidence in nurses handling cytostatics. The study comprised two groups of 17 oncologic nurses each and the same number of matched controls. Sister chromatid exchange method (SCE) was used for genotoxicity assessment. In the group of nurses provided with a safe working environment, the SCE-frequency was insignificantly increased when compared to the controls (p > 0.8), although wide SCE-ranges were obtained. By contrast, in the group of nurses provided with neither such an environment nor with the appropriate personal protective equipment, the SCE-frequency was significantly higher, not only compared to the controls (p < 0.001), but also to the first test group (p < 0.001).

Adult↗
PubMed1995

Potential genotoxic risk related to simultaneous exposure to radionuclides and cytostatics.

The aim of the study was to evaluate the genotoxic risk to medical personnel concurrently exposed to ionizing radiation and antineoplastics, using changes in their lymphocyte cell genome as a bioindicator. The study comprised 12 female nurses employed in the nuclear medicine hospital department and an equal number of matched controls. For each examinee, both conventional structural chromosomal aberration analysis and sister chromatid exchange test (SCE) were carried out. According to Student's t-test, neither the incidence of structural chromosomal aberrations (p > 0.6) nor the mean SCE-frequency rate (p > 0.3) were significantly increased among the exposed subjects. Nevertheless, in those exposed, irreparable chromosomal damages and wide SCE-ranges were observed. Such findings suggest the possibility of genotoxic implications of concurrent occupational exposure to ionizing radiation and antineoplastic drugs.

Adult↗
PubMed1994

Evaluation of serial application of capillaroscopy, photoplethysmography, and dermothermometry in diagnosis and prevention of radiolesions of peripheral microvessels.

This study was performed with the aim of evaluating the justifiability of serial application of nailfold capillaroscopy, digital dermothermometry and digital photoplethysmography in the diagnosis of vascular radiolesions in subjects occupationally exposed to ionizing radiation. Thirty-eight exposed examinees, as well as 30 control persons, were included in the study. In order to establish the condition of the peripheral blood flow, each subject was examined by all the three methods. The results of this work and their statistical evaluation showed the nailfold capillaroscopy and digital dermothermometry to be the most suitable combination of methods for detection of initial changes on the smallest skin blood vessels, subsequent to skin irradiation, while the use of photoplethysmography should be limited to such cases where alterations of digital arterioles are expected.

Adult↗
PubMed1992

The correlation between the frequency of micronuclei and specific chromosome aberrations in human lymphocytes exposed to microwave radiation in vitro.

Human whole-blood samples were exposed to continuous microwave radiation, frequency 7.7 GHz, power density 0.5, 10 and 30 mW/cm2 for 10, 30 and 60 min. A correlation between specific chromosomal aberrations and the incidence of micronuclei after in vitro exposure was observed. In all experimental conditions, the frequency of all types of chromosomal aberrations was significantly higher than in the control samples. In the irradiated samples the presence of dicentric and ring chromosomes was established. The incidence of micronuclei was also higher in the exposed samples. The results of the structural chromosome aberration test and of the micronucleus test were comparatively analyzed. The values obtained showed a positive correlation between micronuclei and specific chromosomal aberrations (acentric fragments and dicentric chromosomes). The results of the study indicate that microwave radiation causes changes in the genome of somatic human cells and that the applied tests are equally sensitive for the detection of the genotoxicity of microwaves.

Cells, Cultured↗
PubMed1992

Chromosomal analysis of Chinese hamster V79 cells exposed to multiple gamma-ray fractions: induction of adaptive response to mitomycin C.

Chinese hamster V79 cells were irradiated daily with 0.3 Gy of gamma-rays 5 times per week for 12 weeks (total 18 Gy). These cells were challenged with an additional dose of 15. Gy gamma-rays or treated with 5 micrograms/ml of mitomycin C (MMC) for 2 h. In spite of the high total accumulated dose of gamma-rays, the number of chromosomal aberrations and sister-chromatid exchanges (SCEs) did not significantly increase in the preirradiated cells, as compared to control cells. If preirradiated cells were challenged with an additional 1.5 Gy of gamma-rays, an insignificant decrease in the yield of chromatid aberrations was observed. In contrast, preirradiated cells became significantly more resistant to the induction of chromosomal damage when challenged with mitomycin C. Our results suggest that multiple fractions of gamma-rays can induce the adaptive response to mitomycin C in preirradiated cells.

Adaptation, Physiological↗
PubMed1992

[Potential genotoxic effects of cytostatics in occupationally-exposed persons].

The aim of the study was to determine possible mutagenic implications of occupational exposure to cytostatic agents. Twenty-one nurses handling antineoplastic drugs and a matching control group were examined. The conventional method for testing chemical mutagens, that of sister chromatid exchanges, SCE, was used. Although the results obtained in the exposed group did not significantly differ from those obtained for the controls, wide ranges of SCE values observed among the medical personnel handling cytostatic drugs confirm the suspicion of the genotoxic effect of those agents.

Adult↗
PubMed1992

Chromosome aberrations induced in human lymphocytes by U-235 fission neutrons. Part II: Evaluation of the effect of the induced Na-24 activity on the chromosomal aberration yield.

Blood samples were spiked with Na-24 to study the separate effect of this nuclide on the incidence of chromosomal aberrations in neutron irradiated blood samples. A delay of 96 h was allowed before cultivation, so the results of chromosomal aberration analysis could be compared with the results obtained by direct irradiation of blood samples with U-235 fission neutrons [7]. The absorbed dose was calculated using a simple conservative model. From the results obtained we can conclude that Na-24 alone was not the reason for the difference in the incidence of chromosomal aberrations between blood samples cultivated immediately after "in vitro" irradiation by U-235 fission neutrons and samples which were cultivated after 96 h storage.

Absorption↗
PubMed1991

Chromosomal abnormalities among nurses occupationally exposed to antineoplastic drugs.

The effect of handling antineoplastic drugs was examined in 42 nurses working in an oncology department, and the same number of nurses not exposed to antineoplastic drugs acted as controls. The exposure effect was evaluated by analysis of sister chromatid exchanges (SCE) incidence and structural chromosomal abnormalities. SCE as well as chromosomal abnormalities in the exposed group were increased (p less than 0.001 and p less than 0.01, respectively). Sign test for paired sample was used for statistical assessment.

Adult↗
PubMed1991

The relationship between colony-forming ability, chromosome aberrations and incidence of micronuclei in V79 Chinese hamster cells exposed to microwave radiation.

Cultured V79 Chinese hamster fibroblast cells were exposed to continuous radiation, frequency 7.7 GHz, power density 0.5 mW/cm2 for 15, 30 and 60 min. The effect of microwave radiation on cell survival and on the incidence and frequency of micronuclei and structural chromosome aberrations was investigated. The decrease in the number of irradiated V79 cell colonies was related to the power density applied and to the time of exposure. In comparison with the control samples there was a significantly higher frequency of specific chromosome aberrations such as dicentric and ring chromosomes in irradiated cells. The presence of micronuclei in irradiated cells confirmed the changes that had occurred in chromosome structure. These results suggest that microwave radiation can induce damage in the structure of chromosomal DNA.

Animals↗
PubMed1991

[Mutagenic and carcinogenic effects of vinyl chloride monomers in humans].

The use of vinyl chloride monomer in industry dates back to the late 1930s. Today the number of occupationally exposed industrial workers is estimated to be several million. After the first described cases of cancer among workers exposed to high concentrations of this gas, extensive research was initiated into its possible mechanism of action on the living organism. This paper is a review of some current knowledge about the action of vinyl chloride monomer as a substance which after metabolic activation in the organism becomes a strong carcinogenic and mutagenic agent.

Carcinogens↗