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Biomedical subjects

D Mandarić

Publications and source records attributed to D Mandarić.

13 recordsLinked to original sources
PubMed2003

[Prognostic factors in resectable non-small-cell bronchial carcinoma].

This study represents the univariate and multivariate analysis of prognostic factors of resectable non small cell-lung cancer (NSCLC) that included 360 patients who underwent a surgical treatment because of primary (NSCLC) in the aforementioned institution in a period between 1985 and 1992. Patients with incomplete resection were rejected, perioperative deaths were not included in the analysis. In the analysed group there were 2931 (81.38%) males and 67(18.62%) females--M:F ratio 4.37:1. Age of the operated patients was 36-75 years with the mean age of 55.15 years. Right-sided tumours existed in 197(54.72%) patients, left-sided tumours in 163(45.28%) patients. Based on pTNM, 157, 65, 114, 18 and 6 patients were classified into stages I, II, IIIA, IIIB and IV respectively. In the univariate analysis, survival curves were obtained using the life table method, with the statistical analysis of the obtained data using the Gehan-Wilcoxon method. In the multivariate analysis--Cox regression analysis was performed. Multivariate analysis found only T-stage, N-stage and the stage of the disease as significant independent prognostic factors. Mode of influence of factors that were found significant in the univariate analysis (age 60 years, tumour diameter 60 mm, involvement of the visceral pleura, indirect tumour signs) is discussed and compared with literature data. Survival differences depending on other factors (tumour location, bronchoscopic aspect, extent of the resection), although without statistical significance, can be useful for the clinician, in the same time contributing to the better comprehension of informations obtained by basical investigations, especially of lymphatic spread of the disease and tumour pathology.

Adult↗
PubMed1995

[The effect of performance of diagnostic and therapeutic procedures on successful treatment of hemopneumothorax in isolated thoracic trauma].

Influence of performed diagnostic and therapeutic procedures on the outcome of the treatment of traumatic hemopneumothorax during isolated chest trauma. The aim of this study is the assessment of the influence of performed diagnostic and therapeutic procedures on the outcome of hemopneumothorax as a part of isolated chest trauma. The main group consists of 51 patients with hemopneumothorax. Patients with pneumothorax without effusion represent the first control group; the second control group consist of patients treated because of iatrogenic pneumothorax. In the main and control groups the analysis of clinical, roentgenographic and functional parameters was made, together with the analysis of particular therapeutic procedures, the estimation of the success of the treatment was based on roentgenographic and functional parameters. The higher incidence of hemopneumothorax compared with control groups during chest trauma in the analyzed material is statistically significant. The occurrence of bilateral hemopneumothorax in 10% of cases emphasizes the need of adequate roentgenographic assessment of injured patients. Regardless of the intensity of the trauma, symptoms do not always indicate the existence of hemopneumothorax. The number of fractured ribs is not of significant importance in terms of the occurrence of hemopneumothorax or pneumothorax. Severe dyspnea can be accompanied even with a smaller collapse of the lung independently of the amount of blood in the pleural cavity. Oxygenation in the arterial blood is impaired with the great and small pulmonary collapse. Hemodynamic disorders existed in 14% all cases. The higher frequency of operative treatment in the main group is statistically significant. The majority of cases of traumatic hemopneumothorax can be successfully treated by the conservative treatment. Accompanying complications do not have greater influence on the outcome.

Adult↗
PubMedDate not supplied

[Nontraumatic subcutaneous emphysema. Diagnostic and therapeutic problems].

Nontraumatic subcutaneous emphysema is less frequent than traumatic. Its occurrence, unless synchronous with the treatment of spontaneous pneumothorax, usually is the consequence of exacerbation of COPD or of the obstruction of major bronchi. However, in routine clinical practice, the occurrence of subcutaneous emphysema without evident underlying disease, in combination with normal chest x-ray, still is a diagnostic and therapeutic problem. In this study typical mechanisms of this phenomenon are presented; air-trapping at the level of the main bronchus caused by endobronchial tumour growth, progressive destruction of alveoles by diffuse lung disease irrespective of its nature, and mechanism of its occurrence during dealing with the urgent clinical problem in the intensive care unit. This study does not deal with subcutaneous emphysema during the attack of severe asthma assuming it as well known situation that usually does not cause a major therapeutic problem. The sequence of necessary diagnostic and therapeutic steps is discussed taking account of possible pitfalls that usually exist in all of three described pathophysiological situations.

Humans↗