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Biomedical subjects

I Hozo

Publications and source records attributed to I Hozo.

13 recordsLinked to original sources

Dermatological indicators of coronary risk: a case-control study.

OBJECTIVE: We examined the association of dermatological signs such as baldness, thoracic hairiness, hair greying and diagonal earlobe crease with the risk of myocardial infarction in men under the age of 60 years. METHODS: A hospital-based, case-control study included 842 men admitted for the first non-fatal myocardial infarction, the controls were 712 men admitted with noncardiac diagnoses, without clinical signs of coronary disease. The relative risks were estimated as odds ratios. Logistic regression was used to control for the confounding variables. RESULTS: Baldness, thoracic hairiness and earlobe crease were approximately 40% more prevalent in cases (P<10(-6) in each case). In both cases and controls, baldness and thoracic hairiness were frequently coexistent, as well as hair greying and earlobe crease (P<10(-4) in each case). After allowing for age and other established coronary risk factors, the relative risk of myocardial infarction for fronto-parietal baldness compared with no hair loss was 1.77 (95% CI 1.27-2.45) and it was 1.83 (95 CI 1.4-2.3) for men with thick, extended thoracic hairiness. The presence of a diagonal earlobe crease yielded a relative risk of 1.37 (95% CI 1.25-1.5), while hair greying was associated with myocardial infarction only in men under the age of 50 years. CONCLUSION: It appears that baldness, thoracic hairiness and diagonal earlobe crease indicate an additional risk of myocardial infarction in men under the age of 60 years, independently of age and other established coronary risk factors.

Adult

Triggers of acute myocardial infarction regarding its site.

We have studied the incidence of possible triggers of the myocardial infarction regarding its site in 750 patients with anterior and 731 patients with inferior infarction. Infarctions occurred most frequently without recalling any triggering activity, especially in patients with anterior infarction (67 vs. 44%). Physical effort as the possible precipitator was also more frequent in anterior infarctions (22 vs. 16%). However, the onset of inferior infarction was more frequent during meteorological stress (9 vs. 2%), emotional stress (10 vs. 3%), after overeating (13 vs. 3%) and nicotine abuse (6 vs. 1.5%). These triggers were independent and highly significant (P < 0.02 in each case) discriminators of the site of myocardial infarction. Bimodal circadian rhythm, with primary peak between 6 and 9 h a.m. and the secondary peak between 3 and 6 p.m. was observed in patients which did not recall any triggering activity, and this was more pronounced in patients with inferior infarction. These results support the hypothesis that the influence of the vegetative tone is most pronounced in the onset of myocardial infarction of inferior wall.

Circadian Rhythm

Venous tone in glaucoma and hypertension.

The aim of this study was the assessment of physiological venous reflexes in systemically hypertensive and normotensive subjects with primary open-angle glaucoma. The experimental group consisted of 20 normotensive and 20 untreated systemically hypertensive patients with open-angle glaucoma. The control group consisted of 31 volunteers divided into two subgroups: 16 control normotensives and 15 untreated hypertensives. The assessment of venous tone changes was performed by testing venous reflexes. Venoconstriction responses to physiological stimuli were significantly decreased in normotensive glaucoma patients, compared to normotensive controls [for the Valsalva manoeuvre 93.4 +/- 80.2 vs. 413.3 +/- 335.4 venoconstrictive units (VCUs), p = 0.02, and for a deep breath 89.1 +/- 100.1 vs. 316.8 +/- 343.2 VCUs, p = 0.03]. The intensity of venous reflexes in hypertensive glaucoma patients did not differ significantly from that seen in hypertensive controls, due to a significantly weaker flex venoconstriction in hypertensive controls when compared to normotensive controls subjects. This study confirmed the presence of venous dysregulation in subjects with primary open-angle glaucoma and visual field loss as a part of an autonomic dysfunction. Systemic hypertension does not make this condition worse.

Aged

Venous reflex testing in glaucoma.

The aim of this study was the assessment of physiological venous reflexes in open angle glaucoma. The study was carried out by a controlled clinical experiment. The experimental group consisted of 17 glaucoma patients with controlled intraocular pressure. The control group consisted of 15 healthy volunteers. The assessment of venous tone changes was performed by means of the test of "venous reflexes". Venoconstriction responses to physiological stimuli were significantly decreased in glaucoma patients (p < 0.05). The results suggested venous dysregulation as part of sympathetic dysfunction in glaucoma.

Glaucoma, Open-Angle

Vinylchloride monomer exposure by the plastic industry workers basic condition for liver angiosarcoma appearance.

The retrospective study of vinylchloridemonomer (VCM) exposure at 37 workers in the period from 1969 till 1987 was done, average time of exposition was 1.843 +/- 1.105 h, average VCM concentration was 543 +/- 228 ppm and average total exposure amount ("cumulative concentration of VCM") was 1.103811 +/- 1.050 766 ppmh at the time of autoclave cleaning 0.4 +/- 0.1 h. According updata investigations, high VCM concentration is essential for liver angiosarcoma (ASL) occurrence although the length of exposure is of concern. The possibility of new cases of angiosarcoma of liver is warned about.

Adult

[A controlled clinical trial of methylprednisolone in patients with the cholestatic form of alcoholic liver cirrhosis].

Fourty patients with alcoholic liver cirrhosis and refractory hyperbilirubinaemia were included in a prospective, double blind, comparative trial. Twenty of them were randomized to methylprednisolone (1 mg/kg/day i.m. over 3 days), and 20 to placebo (saline) of identical shape. In the active group a significant decrease in the bilirubin level (from 248 to 191 mumol/l, a drop by 23%; p < 0.05) was observed, which was not the case in the control group (from 292 to 300 mumol/l, an increase by 2.7%; p > 0.05). A decrease in the alkaline phosphatase activity was observed in both groups (by 11% in the active and by 20% in the control group: p < 0.05) while the encephalopathic indices did not improve in either. It is concluded that a short course of corticosteroid could speed-up the hospital stay and possibly slow down the progression of alcoholic cirrhosis.

Adult

Diagnostic entropy as a function of therapeutic benefit/risk ratio.

Current clinical practice is based upon 'out stubborn quest for diagnostic certainty' which in turn is considered as one of the major reasons for ever-increasing health costs. We linked a treatment-threshold concept with classic information theory to show that measurable clinical variables, such as benefit and risk of available treatments, can be used to calculate the acceptable levels of diagnostic uncertainties associated with a particular clinical situation. Our analysis shows that practising physicians should aim for diagnostic certainty only when the benefit of treatment is equal to its associated risk. In all other cases, decisions about treatment do not have to rely on maximum diagnostic certainty. Determination of acceptable levels of diagnostic uncertainty according to the concepts outlined here should lead to improvement of clinical practice and decrease healthcare costs.

Appendicitis

Nonspecific immunity in diabetes: hyperglycemia decreases phagocytic activity of leukocytes in diabetic patients.

Phagocytic activity of leukocytes in blood was examined in 70 patients with diabetes mellitus. 40 of them had insulin-dependent diabetes--(IDDM) or type I, while there were 30 patients with noninsulin-dependent diabetes (NIDDM) or type II. Phagocytic activity of leukocytes was determined by quantitative method of ingestion, on the principle of quantifying phagocytized fungi (Saccharomyces cerevisiae) and free phagocytes (nonphagocytizing leukocytes) by means of a phase-contrast microscope. The data have been statistically processed by the Student t-test and variance analysis test (Duncan test). The index of phagocytosis amounted to 3.2 +/- 0.77 in diabetic patients, while it was 3.47 +/- 0.29 in healthy examinees from the control group, thus yielding a statistically significant difference, p < 0.05. Out of all examined parameters (blood glucose, glycosylized hemoglobin, mean glucose value) phagocytic activity of leukocytes showed a statistically significant correlation with mean value of glucose in blood. Patients with mean glucose value higher than 12 mmol/l showed a significantly lower index of phagocytosis (2.9 +/- 0.84) than patients whose mean glucose value was lower than 12 mmol/l (3.5 +/- 0.59), p < 0.05. Neither age and sex of the patients nor chronic complications caused by diabetes affected the phagocytic activity of leukocytes in diabetic patients. There was no significant difference in the phagocytic activity of leukocytes between patients with IDDM and those with NIDDM.

Blood Glucose

[Relation between the quantity, type and duration of alcohol drinking and the development of alcoholic liver cirrhosis].

Patients with alcoholic liver cirrhosis in Dalmatian region are presented in this paper and their social and medical characteristics are reviewed. The alcohol drinking habits of 211 patients with established clinical-laboratory criteria of alcoholic liver cirrhosis were investigated. The obtained results have been compared with the results of the control group. The average age of the patients was 51.6 years. Males were more numerous (2/3 of all examinees), while the average duration of alcohol consumption was 25.4 years. Wine was the most frequently consumed beverage (about 90% of cases) and the average daily intake was 151 g of pure alcohol. The authors prove by mathematical model that the occurrence of liver cirrhosis increases exponentially with the increase of the amount of alcohol consumed. Relative risk of the development of alcoholic liver cirrhosis increases many fold with the increase of the amount of alcohol consumed.

Alcohol Drinking

Two new cases of liver angiosarcoma: history and perspectives of liver angiosarcoma among plastic industry workers.

In this report of two new cases of liver angiosarcoma (ASL) among plastic industry workers, the authors present the history and perspectives of this problem. The first cases of ASL have been registered since 1974, and in 1984, the European register of angiosarcoma was founded. In this register, 11 cases of ASL and one case of haemangiopericytoma have been registered from Croatia, all from a single plastics plant near Split. Two new cases of ASL (in retired autoclave cleaners, who were exposed to a concentration of 500-1000 ppm vinyl chloride monomer (VCM) during the working process) in the same plant are represented. They were detected with combined techniques of ASL detection, and both are still alive. The diagnoses have been histologically confirmed: one of them was surgically treated with segmental liver resection. The appearance of new cases of ASL confirms the perspective presented in the last report by the same authors.

Adult

[Primary actinomycosis of the liver--case report].

The liver is a rare site of actinomycotic abscess localization. A 36-year-old man admitted to the hospital because of pain under the right costal margin with skin hyperemia and edema in that region is presented. Clinical and laboratory examinations disclosed liver actinomycotic abscess. Surgical drainage was done followed by 8 months of antibiotic (penicillin) therapy. Discussed are the difficulties in diagnostic procedure and the lack of consensus in the therapeutic approach.

Actinomycosis

[Liver tumors after exposure to vinyl chloride monomers: new cases of liver angiosarcoma].

Two workers exposed to elevated concentrations of vinyl chloride monomer (VCM) in a plastic industry plant are presented. They both died of hepatic tumors: one of liver angiosarcoma after ten or more years of exposition to about 500 ppm VCM. On the basis of former studies the authors predict future incidence of such malignant tumors at a rate of about one per year in the same plant, notwithstanding the protective measures, because of "cumulative" VCM concentration in the working medium.

Hemangiosarcoma

Calculating confidence intervals for threshold and post-test probabilities.

We describe a method and a computer program, written in JavaScript, for calculating confidence intervals. The method uses Taylor's series to approximate the standard errors of a post-test probability and threshold probabilities and, from them, to obtain the associated confidence intervals. This method is valid if the variables of interest are stochastically independent.

Adult