Biomedical subjects

D Prgomet

Publications and source records attributed to D Prgomet.

15 recordsLinked to original sources

PubMed1999

Prognostic factors in carcinoma of the larynx: relevance of DNA ploidy, S-fractions and localization of the tumour.

The influence of the cell cycle profile and the site of the primary tumour on the overall survival were examined in 36 patients with squamous cell carcinoma of the larynx. DNA ploidy (p = 0.0091), the overall proliferative activity (p = 0.0001), the overall proliferative activity of diploid tumour cells (p = 0.0017) and primary tumour site (p = 0.0008) were found to be significant single prognostic factors of the overall survival. Multivariate analysis showed that only the overall proliferative activity was prognostically significant (p = 0.013). The results of the study show that the supraglottic site of the tumours correlates significantly with DNA ploidy (p = 0.0334) and the overall proliferative activity of tumour cells (p = 0.0159), whereas the correlation with proliferative activity of diploid tumour cells (p = 0.1416) has not been confirmed by this study. Glottic tumours showed a prognostically significant correlation with the overall proliferative activity (p = 0.0037) and proliferative activity of diploid tumour (p = 0.0054). Such a prognostic correlation was not found for DNA ploidy (p = 0.6542).

Adult↗

PubMed1999

Injuries caused by antipersonnel mines in Croatian Army soldiers on the East Slavonia front during the 1991-1992 war in Croatia.

During the war in Croatia, antipersonnel mines were mostly laid without plan by both sides, with no minefield layout, especially on the East Slavonia front. A group of Croatian disabled war veterans wounded by antipersonnel mines at the East Slavonia front from June 1, 1991, to September 1, 1992, were analyzed. The front line between the Croatian Army units and Serbian paramilitary units mostly ran along a lowland, partially swampy and wooded ground, convenient for large-scale laying of antipersonnel mines, especially so-called surprise mines. Fifty-seven soldiers suffered injuries caused by antipersonnel mines, 27 (47.4%) of them by pressure-activated mines and 30 (52.6%) by pull-action mines. The severity of wounds was assessed according to the Abbreviated Injury Scale (AIS). In the group of patients with wounds inflicted by pressure-activated mines, the mean AIS score was 4.0 +/- 0.7, with injuries to the lower extremities (mostly feet) ranging from foot-mutilating defects to partial lower-leg amputation. In the group of patients with injuries caused by pull-action mines, the mean AIS score was 3.0 +/- 0.9, indicating relatively minor injuries of different types according to the mechanism of wounding and localization. A failure to comply with minelaying regulations made protection impossible and resulted in a relatively high proportion of the wounded. The same problems are now encountered on mine removal. According to estimates, at least 10 years of intensive work of 2,000 to 3,000 trained experts will be required to clear some 2 million mines laid all over the area.

Abbreviated Injury Scale↗

PubMed1999

Type, severity, location, and timing of battle casualties in a Croatian Army brigade during an offensive action in 1992.

AIM: To analyze the type, severity, location, and timing of casualties in a Croatian Army brigade during an offensive action against enemy forces of about two infantry battalions timely prepared for defense. METHODS: Casualties were analyzed according to bilateral manpower and equipment conditions, morale, time of the day, weather conditions, type of ground where the action took place, quality of planning and steering the course of the action, and especially the medical help. The action was carried out along one main and two auxiliary directions, including river crossing. The action involved about 1,000 soldiers and took 7 hours. It was divided into three phases: approaching the enemy, direct contact, and self-imposed retreat and evacuation. Medical care for the injured soldiers was organized in echelons, relying on civilian health care institutions. RESULTS: During the action, 92 casualties were recorded. The mean injury severity according to the Abbreviated Injury Scale (AIS) was 2.9+/-1.4. The highest proportion of casualties occurred on the main direction (48 or 52.2%) but the most severe injuries were inflicted on the second auxiliary direction (mean AIS, 2.6+/-1.4). Extremely severe injuries (mean AIS, 2.0+/-1. 4) were recorded on the second auxiliary direction during the phase of retreat after a successfully performed action. However, regarding the whole action, the observed differences did not prove to be statistically significant. CONCLUSIONS: Offensive action was properly planned and successfully led during the first two phases. Evacuation and retreat of the brigade were in part poorly organized. Health care for the soldiers functioned well throughout the action.

Croatia↗

PubMed1998

War injuries to the head and neck.

During the 1991-1992 war in Croatia, 7,043 wounded persons were treated at Dr Josip Bencević General Hospital in Slavonski Brod. Among them, 728 (580 soldiers and 148 civilians) had war injuries to the head and neck and were admitted to the Department of Otorhinolaryngology and Cervicofacial Surgery. There were 541 (74.3%) patients with head injuries, 117 (16.0%) with neck injuries, and 70 (9.6%) with a combination of head and neck injuries. The wounds were mostly inflicted by shell and bomb fragments (542 wounds, or 74.5%). War injuries of the facial bones were preliminarily or definitively treated. Preliminary treatment was used for the wounds with multifragmentary fractures and extensive soft-tissue defects. Definitive treatment was used in lesions of cervical structures. Immediate exploration of the neck was performed on 84 patients with penetrating neck wounds. Exploration was positive in 49 patients. Concerning long-term complications, two cases of partial paralysis of the cranial plexus and one case each of quadriplegia, hemiplegia, and glottic paralysis were recorded. To our knowledge, primary closure of war wounds to the head and neck (supported by antibiotic therapy) and reconstruction of extensive laryngotracheal injuries with the medial layer of the cervical deep fascia were used for the first time as war surgery procedures.

Blast Injuries↗

PubMed1998

Mortality caused by war wounds to the head and neck encountered at the Slavonski Brod Hospital during the 1991-1992 war in Croatia.

From July 1, 1991, until January 1, 1993, a total of 7,720 patients (soldiers and civilians) with war wounds were treated at Dr. Josip Bencević General Hospital in Slavonski Brod, Croatia. Treatment was provided for 7,043 patients, whereas 677 individuals (8.8%) killed in action (KIA) were examined at the Forensic Department. There were 1,456 patients (18.9%) with head and neck wounds: 1,176 soldiers and 280 civilians. The mortality rate was significantly greater in patients with head and neck wounds (N = 271, 40.0%) than in those with injuries to the thorax (N = 163, 24.1%) and abdomen (N = 62, 9.2%; p < 0.01 for both). During treatment, 188 patients (2.4%) died of wounds (DOW). The DOW mortality was 5.2% (61 of 1,185), 4.0% (41 of 1,026), and 2.9% (25 of 867) for wounds of the head and neck, thorax, and abdomen, respectively. There was no significant difference in the mortality rate between head and neck and thorax wounds: however, the former exceeded the mortality rate recorded for abdominal wounds (p < 0.05). No significant differences were observed between soldiers and civilians with head and neck injuries either in the KIA (205 of 1,176, 17.4% vs. 66 of 280, 23.5%, respectively) or the DOW group (51 of 971, 5.3% vs. 10 of 214, 4.7%, respectively. According to the mechanism of head and neck wounding, there were 1,046 explosive (71.9%), 226 gunshot (15.5%), and 184 other (12.6%) wounds. Lethal outcome was significantly more common in gushot than in explosive wounds (79 of 226, 35% vs. 243 of 1,046, 23.2%; p < 0.01). The proportion of head and neck injuries did not differ significantly from literature reports on recent conventional wars. The site of wounding, i.e., at the battlefield or elsewhere, had no effect on the prognosis of wounds to the head and neck. Gunshot head and neck injuries showed a significantly higher mortality rate.

Abdominal Injuries↗

PubMed1998

Influence of nasal fontanel receptors on the regulation of tracheobronchal vagal tone.

AIM: To test the hypothesis according that the receptors located in the nasal fontanels influence the regulation of the tracheobronchial tree vagus tone. METHODS: Changes in respiratory parameters (forced expiratory volume in the first second- FEV1 and total resistance- Rt) occurring consequentially to light mechanical nasal stimulation were determined in healthy volunteer, non-smokers using spirometric and body plethysmographic measurements. The parameters were measured before and at 15 and 60 min after mechanical stimulation with cotton pledge. RESULTS: In subjects in whom the middle nasal meatus was stimulated by a cotton pledge soaked in saline, FEV1 decreased (p=0.01) and Rt increased (p=0.03). In subjects in whom the middle nasal meatus was stimulated by a cotton pledge soaked in 5% cocaine solution, no change was observed. In the control group of subjects, in whom the inferior nasal concha was stimulated by a cotton pledge soaked in saline, only a statistically significant decrease for FEV1 (p=0.04) was found. CONCLUSION: There is a reflex communication between the nasal fontanel receptors and lungs, which is regulating the tracheobronchial vagal tone and resistance in lung airways. Further studies of this important physiologic relation are needed.

Administration, Intranasal↗

PubMed1997

Sanitation of the liberated territories in Croatia after the Storm campaign: the example of Lika-Senj County.

More than 6,000 km2 of the central and southern areas of the Republic of Croatia were liberated by the Storm campaign, August 4 to 7, 1995. On August 8, 1995, the Ministry of Health sent expert teams to the newly liberated areas, to ensure the basic conditions for the displaced persons to return and live there. To describe the public health measures taken we used the examples of Lika-Senj County (3,746 km2 and 71,215 population). By October 1, 1995, 50 bodies, killed in action, had been detected, pathologically and forensically examined, and then buried. Two hundred thirty-three mostly elderly and sick persons were admitted to the reception center in Gospić; 93 of them returned to their homes, 133 were accommodated with their relatives and friends, and 7 were referred for treatment (4 of them died). Two hundred ten cattle carcasses were buried using adequate sanitation measures, whereas 5,575 sheep, 3,138 head of horned cattle, 298 head of hoofed animals, and 300 head of other cattle were caught alive. The procedures of disinfection, disinfestation, and deodorization were performed in 720 apartments, 2 hotels, 3 schools, 1 kindergarten, 1 health care unit, 1 sports hall, and 5 shops. The main water pump was cleared of mines and partially repaired, whereas some 20 water supply facilities were placed under surveillance. Three food depots were found and properly treated. The entire territory was closely observed for possible occurrence of infectious disease.

Croatia↗

PubMed1996

Management of war-related neck injuries during the war in Croatia, 1991-1992.

From 1 September 1991 to 31 December 1992, a total of 7,043 wounded patients were treated in the War Hospital in Slavonski Brod. Seven hundred and twenty eight patients with head and neck injuries were treated in the Department of Otorhinolaryngology and Cervicofacial Surgery. Of this number, 187 had neck injuries. Ninety-two (49.2%) of them were treated in outpatient facilities and 95 (50.8%) as inpatients. Immediate exploration was done in 84 patients with penetrating neck injuries. Vital structures were involved in 49 patients: major blood vessels (40 cases), larynx (17 cases), pharynx (8 cases), trachea (5 cases), thyroid gland (3 cases) and esophagus (2 cases). Definitive treatment was given to all of these injuries. Primary wound closure was performed upon exploration in 74 patients who were treated within the first 6 h after trauma. Secondary wound closure was performed in 10 patients with neck exploration performed more than 6 h after injury, and in those with extensive defects of tissue requiring the use of larger local flaps or free flaps. The mortality among patients with neck injuries was 2.1%.

Adolescent↗

PubMed1996

Acute laryngeal trauma: a comparison between peace time and war injuries.

Thirty-six patients with acute laryngeal trauma are presented. Sixteen patients had peace-time and 20 had war injuries. Peace-time injuries were mostly due to car accidents, violence and suicide using a knife, whereas the war injuries were caused by shell and mine fragments. Nine patients were treated conservatively (eight peace-time and one war-time) and 27 by surgery (eight peace-time and 19 war-time). Surgical experience showed that acute laryngeal trauma must be treated within the first 24 hours after injury. Primary treatment must be a definite one. In that way complications and uncontrolled healing can be successfully avoided.

Accidents, Traffic↗

PubMed1996

Organization and work of medical service during 1992 military operations in north Bosnia (Bosanska Posavina).

During military operations in Bosanska Posavina in 1992, 6,105 soldiers of the army of the Croatian Defence Council (Bosnian Croats and Muslims) were treated at various health care levels: 920 soldiers were killed, 3,258 were heavily wounded, and 1,927 lightly wounded. The treatment was provided in medical units organized on the front line, in the combat area, and in the communication area. On the front line, medical service was organized as battalion units, whereas the area in general was medically covered by the Slavonski Brod Medical Center in Croatia. Slavonski Brod played a key role with surgical treatment of 5,418 wounded, and definitive care was offered to most subjects seeking medical aid. Scarcity of medical personnel on the front lines and long lines of transportation resulted in a 6.5% death rate (354 patients) during transportation from Bosnian battlefields to Slavonski Brod. In contrast, the mortality rate in the Slavonski Brod Hospital was 3.0% (161 patients). Convalescence homes were established in the Slavonski Brod surroundings, whereas specialized health institutions and rehabilitation centers throughout Croatia accommodated those needing advanced treatment.

Bosnia and Herzegovina↗

PubMed1995

Reconstruction of laryngotracheal war injuries with the median layer of the deep cervical fascia.

Surgical exploration and immediate reconstruction with the median layer of the deep cervical fascia (MLDCF) was performed in 8 of 22 patients with exogenous war injuries of larynx and cervical trachea. A surgical technique of reconstruction with the median layer of the deep cervical fascia is described. The 7 surviving patients had good respiration without signs of stenosis of the larynx and/or the trachea. Four had good and 3 satisfactory, phonation, and none had swallowing difficulties. Owing to the simplicity of the surgical approach, its size and biological properties, the median layer of deep cervical fascia proved itself to be a suitable material in the immediate reconstruction of exogenerous war injuries of the larynx and cervical trachea.

Adolescent↗

PubMed1995

Laryngeal war injuries.

During the war in Croatia in the region of Brodska Posavina at the Medical Center in Slavonski Brod, 7,043 wounded were treated. The Otolaryngology and Oral Surgery Service treated 728 wounded, of whom 20 had laryngeal injuries. Most of the injuries were caused by shrapnel from shells, mines, and hand grenades. Nineteen wounded had associated injuries of the neck, head, and the neck and/or other parts of the body. The authors performed in 8 surgical explorations and immediate reconstruction with the median layer of the deep cervical fascia (MLDCF). Upon termination of the treatment, the nineteen wounded had good respiration without signs of stenosis of the larynx. Twelve had good phonation, five satisfactory phonation, and two bad. None had swallowing difficulties. Among the eight wounded on whom the reconstruction of the larynx was done with cervical fascia, four had very good phonation, three satisfactory, and the eight died on the sixth postoperative day because of associated injuries to the cervical spine. The cervical fascia proved itself to be a suitable material in the immediate reconstruction of exogenous war injuries of the larynx.

Adolescent↗

PubMed1995

Work of the Slavonski Brod General Hospital during the war in Croatia and Bosnia and Herzegovina in 1991-1992.

Between September 1, 1991, and December 31, 1992, 7,043 wounded persons, 4,566 of them heavily wounded, were treated at the Slavonski Brod General Hospital. There were three characteristic periods in the work of the hospital during the war. Until March 31, 1992, the hospital provided care for the wounded from the east- and west-Slavonian fronts, at the level of the fourth echelon. The second period started with war actions in Bosanska Posavina and Bosnia and Herzegovina, when the Slavonski Brod General Hospital was the only place offering appropriate care to the wounded from the area. During that period, surgical professions and, to a limited extent, conservative professions were working at the hospital. The third period began with the fall of Bosanska Posavina, toward the end of October 1992, and lasted until the end of the year. During that period, the number of the wounded and previously surgically treated at the Tolisa War Hospital, in the unoccupied area of Bosnia and Herzegovina, admitted to the Slavonski Brod General Hospital, decreased. The total mortality rate in the treated subjects was 2.66%, whereas during the war in Bosanska Posavina it was 3.0%. Throughout the war, there was no interruption in the work of hospital conservative professions, although the extent of their work was reduced.

Bosnia and Herzegovina↗

PubMedDate not supplied

Neurologic recovery after penetrating craniocerebral war injury.

From June 1, 1991, until December 31, 1992, 116 patients with penetrating craniocerebral war injuries inflicted at the east Slavonian front were treated at the Osijek University Hospital. There were 26 (22.4%) gunshot wounds and 90 (77.6%) wounds inflicted by explosive devices and projectiles. Four years after the injury, a study of the survivors' condition was carried out. No difference was recorded in the survival rate between the patients with gunshot wounds compared with explosive wounds. Rehabilitation produced good results in the survivors, in the prevention of both acute and chronic complications and permanent damage. Older age, lower Glasgow Coma Scale, and level of consciousness were found to be prognostic indicators of outcome.

Adolescent↗

PubMedDate not supplied

[Improvement of sanitation conditions in the liberated Croatian regions after the "Storm" campaign--the Lika-Senj County example].

More than 6,000 sq km of the central and southern areas of the Republic of Croatia were liberated by the Storm campaign, August 4-7, 1995. On August 8, 1995, the Ministry of Health sent expert teams to the newly liberated areas, in order to ensure the basic conditions for the displaced persons to return and live there. To describe the public health measures taken we used the example of the Lika-Senj County (3,746 sq km and 71,215 population). Until October 1, 1995, 50 bodies, killed in action, were detected, pathologically and forensically examined, and then buried. Two hundred and thirty-three mostly elderly and sick persons were admitted to the reception center in Gospić; 93 of them returned to their homes, 133 were accommodated with their relatives and friends, and seven were referred for treatment (four of them died). Two hundred and ten cattle carcasses were buried using adequate sanitation measures, whereas 5,575 sheep, 3,138 head of horned cattle, 298 head of hoofed animals and 300 head of other cattle were caught alive. The procedures of disinfection, disinfestation and disodoration were performed in 720 apartments, 2 hotels, 3 schools, one kindergarten, one health care unit, one sports hall and 5 shops. The main water pump was cleared of mines and partially repaired, whereas some 20 water supply objects were placed under surveillance. Three food depots were found and properly treated. The entire territory was closely observed for a possible occurrence of infectious diseases.

Croatia↗