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D Perković

Publications and source records attributed to D Perković.

5 recordsLinked to original sources
PubMed2000

Early cardiac rupture following streptokinase in patients with acute myocardial infarction: retrospective cohort study.

AIM: To assess the incidence and timing of cardiac rupture following streptokinase (SK) administration in acute myocardial infarction (AMI). METHODS: We analyzed retrospectively the clinical sheets of AMI patients treated at the Coronary Care Unit in University Hospital Split, Croatia, between January 1, 1996, and December 31, 1998. We selected the patients who died after SK administration (1.5 million U in a 30 min iv. infusion), with a discharge diagnosis of "AMI" and "cardiac tamponade - ventricular rupture". AMI was defined by typical chest pain, ECG, and/or enzymatic changes. Echo or autopsy verified diagnosis of cardiac tamponade and/or rupture, as well as pericardial effusion and/or free-wall rupture. RESULTS: Out of 726 AMI patients, 136 (18.7%) were treated with SK, and 6 had cardiac rupture (4 men and 2 women; 4.4%). Autopsy revealed that 1 patient had ischemic and 2 had transmural hemorrhagic AMI. Three out of 6 patients died 2-4, and 3 died 5-7 hours after SK administration. Six patients who died from cardiac rupture (mean age 72.3+/-9.0) were significantly older than AMI survivors treated with SK (121 patients, mean age 60.5+/-12.0 years, p<0.001). CONCLUSION: In case of unexplained clinical deterioration in AMI patients over 70 during the first hours after SK administration, cardiac tamponade due to a free-wall rupture should be suspected. SK administration in patients with AMI over 70 years should be a selective and not a routine treatment.

Aged↗
PubMed1989

[Disability and arthrotic changes in the lower extremity].

From a sample of occupationally disabled persons who had retired because of a disease of the locomotive system 48 men and 22 women with pronounced arthrotic changes in lower extremities were selected for the study. A comparative group, which was matched to the experimental one by age (53.8 +/- 4.2 years) and sex, consisted of occupationally disabled persons who had rheumatic complaints, but no arthrotic changes in the lower extremities. All the subjects in the study were given a questionnaire to answer and underwent a clinical examination and an X-ray of the locomotive system. Marked symptoms of arthrosis were manifest in those aged 46 +/- 6 years. Besides occupation (coxarthrosis and gonarthrosis occurred more frequently among unskilled (54.2%) and skilled (25%) workers) a major risk factor were injuries (37.1% as against 5.7% in the comparative group). At clinical examination men complained much more often of spontaneous pain in the hip joints (60% as against 22.3% in women), whereas women more often complained of painful movements (63.6% as against 45.8% in men). The objective symptoms of gonarthrosis, crepitations and restricted movements in the first place, were present in men and women alike. The relative body mass (RBM), expressed as percentage of decline from ideal was, particularly among women, a significant risk factor for the occurrence and development of coxarthrosis and gonarthrosis. As much as 50% of the women with arthrosis had RBM higher than 140%, and another 40% had RBM between 120 and 140%. In the comparative group the respective percentage was 27.3% (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Disability Evaluation↗
PubMedDate not supplied

[Sepsis caused by Yersinia enterocolitica in a female patient with liver cirrhosis].

As a primarily intestinal pathogen. Yersinia enterocolitica (Y. e.) may cause generalized infection in patients with malignant and other serious diseases or immunodeficient subjects. In certain conditions, elevated serum and tissue iron concentrations represent an additional risk factor for systemic infection with this opportunistic bacterium. In our patient, Y. e. septicemia developed during liver cirrhosis decompensation. Clinical signs of infection were alleviated by appropriate antibiotic therapy (gentamycin, cefuroxime), but as septicemia had been present for several days prior to therapy, it aggravated the patient's general condition, which entailed the development of hepatorenal syndrome and eventually lethal outcome.

Female↗