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Biomedical subjects

D Velimirović

Publications and source records attributed to D Velimirović.

At least 19 recordsLinked to original sources
PubMed1998

Absorbable suture technique: solution to the growth problem in pediatric pacing with endocardial leads.

Endocardial pacing system implantation has been performed in 15 children of mean age 37 months (ranging from 1 day to 89 months). Endocardial lead fixation was performed by means of slowly resorbable suture (Dexon) to allow spontaneous lead migration as the child grows. During a mean follow-up period of 61 months (range 17-108 months), none of the patients needed reintervention for correcting the lead length to allow growth.

Benzenesulfonates↗
PubMed1997

Popliteal artery war injuries.

The early postoperative results of 44 surgically treated popliteal arterial injuries from the Yugoslav civil war are reported. Of these patients, 41 (93%) were males and three (7%) were females, average age was 28 (range 6-45) years. Twenty patients (45%) had gunshot wounds and 24 (55%) explosive wounds. Twelve (28%) suffered isolated vascular damage, while 32 (72%) suffered concomitant bone fractures. Isolated arterial lesions were found in 24 (55%) cases, and concomitant arterial and venous lesions in 20 (45%). Twenty-four (55%) had primary reconstructions after haemostasis in the initial war hospital, and 20 (45%) secondary reconstructions after inadequate primary reconstruction in a regional war hospital. Artery procedures included 19 reverse saphenous vein graft interpositions, 10 reverse saphenous vein bypasses, 12 'in situ' saphenous vein bypasses and five lateral subcutaneous saphenous vein bypasses. The early graft patency rate was 100%, and limb salvage 72%. Major amputation was performed in 28%. Concomitant bone fractures, secondary reconstructions, secondary haemorrhage from an infected graft, and explosion wounds significantly increased the amputation rate (P < 0.01). Eleven amputations were performed after an anatomic, and only one after an extra-anatomic reconstruction (P < 0.01). The authors recommend an in situ or lateral subcutaneous reconstruction in cases of complicated popliteal artery injuries, such as concomitant bone fractures accompanied by massive soft tissue damage, and this type of reconstruction should also be used if infection is present or the procedure is delayed.

Adolescent↗
PubMed1996

[The importance of the sonographic image in the differential diagnosis of acute rejection in kidney transplantation].

Between October 1987 and October 1992 110 biopsies of transplanted kidney. Histologic examination showed 36 cases of acute rejection (Ac), 19 cases of chronic rejection (Chr), 16 cases of acute tubular necrosis (ATN) and 39 cases of cyclosporin nephrotoxicity. Sonographic characteristics as: hyperechogenicity of the cortex, hypoechogenicity of central pyelovascular zone, large and sonolucent pyramids, spherical configuration of renal allograft, were coelating with histologic and relevant clinic sings of disease. The results show statistically significant correlation with sonographic sings of acute rejection and relevant histologic and clinical findings. There was no correlations in other groups of diseases. These results confirm ultrasound as the primary imaging tool and an invaluable diagnostic modality in the renal transplant patient.

Acute Disease↗
PubMed1996

[Urinary system tumors in patients with endemic nephropathy on chronic hemodialysis].

We studied 161 patients who started dialysis from January 1st 1979 to December 31st 1993. Out of 79 males, 26 (32.91%) had the diagnosis of urothelial tumors, and out of these 22 patients (84.61%) had tumors of the upper urothelium. Twenty one (80.76%) of the patients were operated. The predialysis period starting with tumor diagnosing was 61.92 months averaging. The average survival of these hemodialysed patients was 46.07 months. Out of 82 females, 22 (26.82) had tumors of the urinary tract, and out of these 21 patients (95.45%) had tumors of the upper urothelium. Eighteen (81.81%) of them were operated. The predialysis period starting with tumor diagnosing was 84 months, on the average. The average survival was 37.39 months. The results confirm high frequency of tumors of the upper urothelium in patients with endemic nephropathy.

Adult↗
PubMed1996

[Renal size as an ultrasonographic parameter in the differential diagnosis of primary and secondary glomerulopathy].

Between October 1987. and October 1992. 289 biopsies of the kidney in patients with glomerular diseases were performed. Pathohistologic analysis showed 218 cases with primary and 71 cases with secondary glomerular diseases. In all patients kidneys were measured by ultrasound examinations. The results showed significant difference in longitudinal diameter of kidneys in patients with primary from those with secondary glomerular diseases. These results can help a nephrologist to diagnose glomerular disease.

Diagnosis, Differential↗
PubMed1996

[Idiopathic membranoproliferative glomerulonephritis (structural-functional relationship)].

We investigated 12 patents with idiopathic membranoproliferative glomerulonephritis. Discriminatory analysis was used for structural functional relationship in order to determine discriminatory power of certain clinical and pathohistological parameters. Semiquantitatively were determined pathohistological parameters: glomerular index in range 0-10, vascular index 1-4, interstitial fibrosis 0-10, interstitial infiltration 0-3, tubular atrophy 0-3. Nephrotic syndrome (symbolic value), quantitative proteinuria and creatinine clearance (continual variable) were used as clinical parameters. Discriminatory power was determined as a degree of decreasing Shennon's entropy dy distinction of patients according to value of creatinine clearance at the time of biopsy. Discriminatory power was measured in the information measurement units (bit). The most powerful was glomerular index (discriminatory power 0.29) in moderately reduced glomerular filtration rate (creatinine clearance 80 ml/min) at the time of biopsy. In severely reduced glomerular filtration rate (creatinine clearance 40 ml/min) vascular index had the greatest discriminatory power (0.24) while interstitial infiltration and interstitial fibrosis had less powerful discriminatory power (0.13). Negative predictive value of reduced glomerular filtration rate at the time of biopsy in membranoproliferative glomerulonephritis has been confirmed in other studies.

Adult↗
PubMed1996

[Renal function and histologic findings in immunoglobulin A nephropathy].

We investigated 28 patients with IgA nephropathy. Discriminatory analysis was the method used to determine discriminatory power of certain clinical and pathohistological parameters. Semiquantitatively were determined pathohistological parameters: glomerular index in range 0-10, vascular index 1-4, interstitial fibrosis 0-10, interstitial infiltration 0-3, tubular atrophy 0-3. Nephrotic syndrome (symbolic value), quantitative proteinuria and creatinine clearance at the time of biopsy and year after (continual variable) were used as clinical parameters. Discriminatory power was determined as a degree of decreasing Shennon's entropy by distinction of patients according to value of creatinine clearance at the time of biopsy, and a year after biopsy. Discriminatory power was measured in he information measurement units (bit). Based on discriminatory-predictive analysis we determined that glomerula changes and interstitial fibrosis had an equal effect (discriminatory power) on renal function at the time of biopsy and a year latter, as well as predictive value of these histological parameters and creatinine clearance at the time of biopsy.

Adult↗
PubMed1996

[Cyclosporine in the treatment of primary focal-segmental glomerulosclerosis].

Cyclosporin A (CyA) was administered at the Clinic of Nephrology, CCS, in treatment of 8 patients with steroid-resistant nephrotic syndrome (NS) caused by focal segmental glomerulosclerosis (FSG), Cyclophosphamide (CP) treatment was attempted in 6 of these cases, but without success. Prior to the onset of CyA therapy, CP treatment was interrupted, and the dose of prednisone was reduced to 0.4 mg/kg/48 h. CyA was applied in the initial dose of 5 mg/kg/bw/24h, and then adjusted so that CyA blood level was 80-120 ng/ml. Although CyA treatment caused proteinuric decrease in most of the patients (from 12.1 g/24 h to 8.2 g/24 h), complete NS remission was achieved in only one patient, the same as the incomplete one. The female patient with a positive response to CyA treatment behaved as "CyA-dependent" and each discontinuation of CyA therapy soon led to recurrent NS. Insignificant CyA effect on NS or renal function was registered in 4 patients, and the therapy was interrupted in two cases due to renal function impairment. Apart from nephrotoxicity, other CyA side effects were absent.

Adolescent↗
PubMed1994

[Percutaneous transluminal angioplasty of the abdominal aorta using the "kissing balloon" technic].

Percutaneous transluminal angioplasty (PTA) of the distal abdominal aorta is still rarely performed procedure. Sporadic reports come from selected institutions with extensive experience in the field of PTA. Procedure is performed using so called "kissing-balloon" technique, and may be an alternative to the surgical treatment in well selected cases. We present a 45 years old woman with intermittent claudications and infrarenal abdominal aortic stenosis, treated successfully using above mentioned technique.

Angioplasty, Balloon↗
PubMed1992

Assessment of long-term stability of chronic ventricular pacing thresholds in steroid-eluting electrodes.

Sixteen patients with Medtronic 4003 steroid-eluting electrodes implanted in the ventricular position were followed over 5 years. In each patient a special type of Medtronic 2443 pacemaker was implanted to allow programming of output at 1.35 V. Chronic threshold values in these patients measured at an output of 1.35 V were stable over the first 18 months of follow-up. Mean values were: 0.06 +/- 0.03 msec at 6 months and 0.08 +/- 0.02 msec at 18 months; these did not differ from each other significantly. However, during the period from 18 to 36 months postimplantation, a significant increase in mean pacing threshold was observed: 0.08 +/- 0.02 msec at 18 months postimplantation versus 0.14 +/- 0.05 msec at 36 months (P < 0.01). After 36 months, the chronic pacing threshold remained stable until the end of the 5-year follow-up period. Further long-term study of chronic threshold behavior of steroid-eluting electrodes measured at low amplitudes is warranted.

Cardiac Pacing, Artificial↗
PubMed1991

Beta 2-microglobulinuria as a predictor of death in a population exposed to Balkan endemic nephropathy.

During the year 1974, urinary beta 2-microglobulin (beta 2mu) was measured at monthly intervals using the first-morning urine sample of randomly selected individuals from the BEN affected village of Petka (416 persons) and from the nearby situated control village of Stubica (216 persons). Initial compliance was complete; over 90% of villagers had at least 10 tests performed. beta 2mu, as assessed by radial immunodiffusion (RID), was repeatedly (at least twice) positive in 12% and 1.4% of the populations of the endemic and control villages, respectively. Over the 15 years of follow-up (1974 to 1988), none from the control village developed BEN, while many medical records of the cohort exposed to BEN contained data suggestive of BEN. Death from/with BEN was used as a measure of outcome. Incidence density of 12 was 3.3 per 1000 person/years of observation (19/5723). A single positive beta 2mu test was a sensitive predictor of BEN death (sensitivity = 89.5%). Selecting two or more positive tests as the cut-off point, the specificity and positive predictive value were considerably increased. Using the sulfosalicylic acid test for detection of significant proteinuria, a similar level of validity indices was reached only by four testings.

Aged↗
PubMed1991

Beta 2-microglobulinuria in a population exposed to Balkan endemic nephropathy: inferences from repeated cross-sectional studies.

Baseline data from a study run in 1974, which comprised beta 2-microglobulinuria (beta 2mu) measurements at monthly intervals from 416 members in 112 households from the BEN affected village of Petka, were compared with the results of two subsequent, cross sectional studies. In June 1988, retesting involved 320 available persons from the same households. Another collection of 284 urine specimens took place in October 1989. Prevalence of tubular proteinuria was the same in 1988 and 1989 as it was in 1974, indicating that the level of exposure to nephrotoxic agent did not change over time. Over 94% of the individuals who were always beta 2mu negative in 1974 remained negative in 1988. By contrast, over two thirds (68.7%) of those who were positive two or more times 14 years ago, tested positive upon re-examination in 1988. Particular interest arises from the data on those initially repeatedly positive persons in whom the overt disease did not occur over time; moreover, some appeared to be unaffected in 1988 and 1989 according to our set of laboratory criteria. The results suggest occasional slow progression and even possible reversibility of tubular lesions in individuals living in the BEN affected environment.

Adult↗
PubMed1990

[Pathologic morphology and clinical significance of the anomalous origin of the left circumflex coronary artery from the right coronary artery. General review and autopsy analysis of 30 cases].

After an extensive analysis of the world literature (121 references), beginning from the first reported case by Antopol and Kugel, 1933, the general review of the problem stressed especially the following morphologic characteristics and clinical significance of the anomalous origin of the left circumflex coronary artery (LCxA) from the right coronary artery (RCA): The place of the anomalous origin of LCxA from RCA among all other variations and anomalies of LCxA. The anatomical and topographical characteristics of LCxA originating from RCA in normal heart as well as in congenital heart diseases--CHD (especially complete transposition of great arteries--TGA). The formal genesis of LCxA from RCA according to original new Ogden's theory, taking into account the dual origin of the coronary arteries and the peritruncal angioblastic ring that surrounds the developing aorta and pulmonary artery. The frequencies of the origin of LCxA from RCA in autopsy and coronarography series. The importance of LCxA (by its origin and/or caliber) in determination of the right, left or codominance of the coronary arteries including the peculiarities in cases of isolated aortic stenosis and bicuspid aortic valve. The importance of recognizing LCxA from the RCA during implantation of artificial aortic, mitral and tricuspid heart valves, during mitral valve anuloplasty, closure of ostium primum defect as well as during aorto-coronary venous bypass. The LCxA from RCA, especially its proximal segment, shows more frequent and an earlier, faster and heavier obstructive atherosclerosis, causing different manifestations of coronary heart disease and sudden death. Also, mitral insufficiency can be caused by ischemia of the papillary muscles of the left ventricle. The awareness of the possibility that LCxA may arise from the RCA can prevent many complications during cannulations of the coronary arteries for diagnostic coronarography and myocardial perfusion during heart operations. The authors presented their 30 autopsied cases of LCxA from RCA, analysing morphological and topographic data as well as their clinical significance and association with other CHD. There were 6 isolated cases and 24 cases associated with other CHD (20 with TGA and 4 with other CHD). Our first autopsied case of LCxA from RCA was diagnosed as associated with tetralogy of Fallot in 1964. During the period 1964-1985 we had 1015 cases of CHD (including 132 cases of TGA).(ABSTRACT TRUNCATED AT 400 WORDS)

Coronary Vessel Anomalies↗
PubMed1984

Clustering of the upper urothelial tumours in a family.

In a Balkan nephropathy endemic area, 5 siblings developed haematuria over a period of 10 years. 4 of them were operated on and pathohystological examination revealed papillary transitional cell tumours of the renal pelvis and/or ureters. Both these tumours and the Balkan nephropathy affected only 1 generation of the family members. This fact, as well as the other relevant evidence, indicated that environmental factors played an important role in the process of carcinogenesis.

Aged↗
PubMed1978

[Therapy of cancer of the cardia].

The paper contains analysis on 120 patients with malign neoplasms of cardia and lower third of the esophagus, who have been medicaly treated at the II surgical clinic of the Medical Faculty in Belgrade. Diagnose methods are presented and pointed out importance of early diagnosis and indications for operative (surgical) treatment. Criterious of radical and palliative surgical intervention are stated. Radicaly treated patients were 64 (53,4%). Palliatively treated and not operable patients were 56 (46,6%). There were decided that only by resection of gaster and seized esophagus i.e. by remoting of sick tissue radical treatment can be reached. There were stated postoperative complications and early results of palliative treated patients (mortality 19,8%) and radicaly operated patients (postoperative--hospitality mort. 23,4%).

Adult↗