PubMed Health⌕ Search

Biomedical subjects

I Malcić

Publications and source records attributed to I Malcić.

At least 19 recordsLinked to original sources
PubMed1995

[Incipient pericardial tamponade as the first symptom of systemic lupus erythematosus in 2 children].

Two patients (a boy and a girl), with systemic lupus erythematosus (SLE), in which pericarditis with threatening tamponade was an initial symptom of disease, are presented. Pericardial tamponade is very rare initial manifestation, described in only 1-3% of all the cases of SLE. The typical clinical features of tamponade are described (tachycardia, hypotension, venous congestion) and the importance of echocardiography in early diagnosis of pericarditis and pericardial tamponade is pointed out. Therefore, the echocardiography is considered as the complementary method in diagnosis of SLE.

Cardiac Tamponade↗
PubMed1994

Decision trees based on automatic learning and their use in cardiology.

Computerized information systems, especially decision support systems, have become an increasingly important role in medical applications, particularly in those where important decision must be made effectively and reliably. But the possibility of using computers in medical decision making is limited by many difficulties, including the complexity of conventional computer languages, methodologies and tools. Thus a conceptual simple decision making model with the possibility of automating learning should be used. In this paper we introduce a cardiological knowledge-based system based on the decision tree approach supporting the mitral valve prolapse determination. Prolapse is defined as the displacement of a bodily part from its normal position. The term mitral valve prolaps (PMV), therefore, implies that the mitral leaflets are displaced relative to some structure, generally taken to the mitral annulus. The implications of the PMV are the following: disturbed normal laminar blood flow, turbulence of the blood flow, injury of the chordae tendinae, the possibility of thrombus's composition, bacterial endocarditis, and finally hemodynamic changes defined as mitral insufficiency and mitral regurgitation. Uncertainty persists about how it should be diagnosed and about its clinical importance. It is our deep belief that the echocardiography enables properly trained experts armed with proper criteria to evaluate PMV almost 100%. But unfortunately, there are some problems concerned with the use of echocardiography. In that manner we have decided to start a research project aimed at finding new criteria and enabling the general practitioner to evaluate PMV using conventional methods and to select potential patients from the general population.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Mitochondrial cardiomyopathy and scapuloperoneal spinal muscular atrophy in a child.

A 14-year old boy was admitted for signs of heart failure and scapuloperoneal muscle weakness. He fulfilled the clinical, functional and diagnostic criteria for dilated cardiomyopathy. There was also a moderate increase in pulmonary vascular resistance. The immunohistochemical examination of the heart muscle revealed a slightly positive phytohemagglutinin reaction and minimal IgM deposits without complement. The electron microscopy examination disclosed increased numbers of abnormal mitochondria disrupting the usual cell structure; the mitochondria were of various sizes with irregular and abnormal structure of the cristae. The scapuloperoneal spinal muscular atrophy was mild and diagnosed according to clinical and electromyographic findings. Light microscope examination of the skeletal muscle revealed hypotrophic fibers. This patient is presumed to have postinflammatory mitochondriopathy and is currently being managed on low-dose digitalis, diuretics and captopril.

Adolescent↗
PubMed1992

Cor triatriatum dextrum.

Cor triatriatum dextrum was an incidental echocardiographic finding in a 5 year old boy and a 9 year old girl, who were evaluated for the presence of a heart murmur. Apart from slightly enlarged right atria, they had otherwise normal hearts and were symptomless. Most of the patients reported until then had been symptomatic due either to the persistent right sinus venosus valve or to commonly associated structural heart anomalies. Therefore, the clinical significance of asymptomatic cor triatriatum dextrum remains coniectural, but might lie in the possibility of development of arrhythmia, progressively worsening interference with the systemic venous return and thrombus formation.

Child↗
PubMed1991

Cardiomyopathies in children with neuromuscular disorders.

In this paper eight patients with myogenic or neurogenic muscle disorders are presented, in whom cardiomiopathy was also found. Six patients developed a dilated cardiomiopathy associated with neurogenic atrophies or progressive muscular dystrophy. In patients with Mb. Friedreich and HSNM type II together with the total dilatation of the septum hypertrophy was observed and in patients with spinal muscular amyotrophy of scapuloperoneal type atriomyopathy dominated. In two patients with mitochondrial disorders a hypertrophic cardiomyopathy was found. One of them had mitochondrial encephalomyoneuropathy and the other mitochondrial encephalopathy with myoclonic epilepsy. In none of them a restrictive cardiomyopathy was found. From the presentation could be concluded that in neurogenic muscle diseases and progressive muscular dystrophy respectively most frequently dilated cardiomyopathies have been developed. Hypertrophic cardiomyopathies are usually found in children with mitochondrial disorders.

Adolescent↗
PubMed1985

Verapamil in primary pulmonary hypertension.

An 8 year old girl with primary pulmonary hypertension and signs of heart failure was given 17.5 mg of verapamil injected into the pulmonary artery over 25 minutes to test for the reversibility of pulmonary arteriolar obstruction. Pulmonary artery pressure fell from 70/50 to 35/25 mm Hg. Treatment with 40 mg verapamil by mouth four times daily was started, and she was discharged. She gradually became asymptomatic and resumed the activities of a normal child of school age. On recatheterisation seven months later her pulmonary artery pressure was 30/10 mm Hg. She was still doing well 12 months after the start of treatment.

Blood Pressure↗
PubMed1979

[Pelger-Huet anomaly].

A homozygot carrier of a congenital nuclear anomaly of blood cells/Pelger-Huet's anomaly: abnormal segmentation of granulocytic leukocytes) is described. The morphologic analysis of blood samples in 4 family members showed similar Pelger-Huet's anomalies. The phagocytic activity, the "killing test" and the inhibition test of leucocyte migration of the patients neutrophils were in normal ranges.

Child↗
PubMedDate not supplied

[Residual postoperative murmurs in children with congenital heart defects].

Fifty-four children without postoperative complications were admitted to the Department of Pediatrics, University Hospital Rebro, following a complete surgical correction of ventricular septal defect (VSD), atrial septal defect - secundum type (ASD II) and patent ductus arteriosus (PDA) in the period from June, 1989, to February, 1991. Twenty-two patients were treated surgically for VSD, 17 for ASD II and 15 for PDA. There were 23 male and 31 female children. In the early postoperative period, 57% of all the examinees had a murmur with the innocent or functional characteristics. The murmur was significantly more frequent among children with VSD than among children of other groups (ASD II, PDA). Sex, age and hematocrit did not influence this difference. There were 8 anemic children (3 with operated VSD, 4 with ASD II, and 1 with PDA). From this, it may be concluded that anemia also did not cause this difference. However, anemic children represented 50% of the examinees with a murmur among the operated for ASD II and 33% among those treated surgically for PDA. When these anemic children were eliminated, the others operated on for ASD II and PDA probably had the innocent murmurs, since the proportion of examinees with a murmur fits into the incidence of innocent murmurs in the population. The children operated for VSD have had a greater proportion of examinees with a murmur, and most likely, some of these murmurs do not belong to a group of innocent or functional murmurs. Their cause is unknown, as yet (probably, small organic lesion).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Cardiomyopathy in children].

Cardiomyopathies (CMP) are rare diseases in childhood. There are three different types (dilated, hypertrophic and restrictive). Exact epidemiologic drawing are not well-known, and the numerous nosologic problems still exist. The basic classification distinguishes primary (not well-knows cause) and secondary CMP (cardiac changes have been developed as any influence of the well-known diseases of the cardiovascular system). Dilated forms make 55%, hypertrophic 40% and restrictive only 5% of all CMP. The tendency of this paper is introduce the knowledge of new approaches to cardiomyopathies, the definition of which was taken at 1983. The mean consideration includes etiology and therapeutic approach of different types of CMP. The chapter on dilated CMP was mainly aimed to discuss their development after virus myocarditis, immunologic processes and complicated therapeutic treatment (different in acute, subacute and chronic phase). The purpose of this paper is to call the attention on the CMP in children, as the main problem in pediatric cardiology after congenital heart diseases.

Cardiomyopathies↗
PubMedDate not supplied

[Electrocardiographic changes in children with surgery for defects of the atrial septum].

Electrocardiograms obtained prior to surgery, after surgery and in the period between 6 months and 2 years following the surgery were analyzed in 44 children operated because of atrial septal defect. The following electrocardiographic parameters were selected: the P wave, PQ interval, QRS complex and right bundle branch block The P wave narrowing developed gradually, i.e. not earlier than the follow-up period, and it was statistically significant (p = 0.001). The duration of the PQ interval decreased significantly right after the operation (p = 0.001). No changes were seen in the width of the QRS complex neither following the surgical procedure nor in the later postoperative period. The number of children with right bundle branch block decreased significantly immediately after the surgery (p = 0.0108). Willson's right bundle branch block disappeared gradually after operation (p = 0.0282).

Child↗
PubMedDate not supplied

[Modern diagnosis and treatment of pheochromocytoma in children].

Pheochromocytoma is a rare tumor of chromaffin tissue of the adrenal gland that synthesizes, stores and releases cathecolamines. In 10% of the patients it arises outside the adrenal gland, and has been called paraganglioma. The following study describes our experience in the diagnostic process and treatment of pheochromocytoma in two children, a 8-year-old boy with the right ureteral paraganglioma, and a 8-year-old girl with pheo-chromocytoma of the leftsuprarenal gland. Characteristic clinical features with predominant signs of hypertension, as well as the diagnostic flow diagram, have been presented. We have analysed recent diagnostic possibilities, sensitivity of diagnostic methods (ultrasonography, CT, selective angiography and J131 MIBG scintigraphy), indications for their use, and the importance of appropriate preoperative management. The major role of the J131-metaiodobenzilguanidine scintigraphy in diagnostic assessment, especially in precise preoperative localization and postoperative verification of tumour removal, has been stressed.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

[Relation between the size of the left-right shunt and pulmonary resistance in congenital heart defects].

Relation between pulmonary vascular resistance (PVR) and left-to-right (L-D) shunt has been statistically tested in 87 patients with congenital heart diseases. In all patients, PVR and L-D shunt were calculated from the catheterization test results. Among 87 patients, 45 (52%) were female and 42 (48%) male children. The average age at the catheterization was 4.63 (min 6 mo, max 15 yr). Patients were divided into two groups with regard to the level of PVR. The first group consisted of patients with PVR higher than 160 dyn sec cm-5, and the second group with PVR lower than 160 dyn sec cm-5. The whole group was also divided according to VSD, and separate correlation was done for ASD with PVR below 160 dyn sec cm-5. A negative statistically significant correlation was observed between the height of PVR and size of L-D shunt among the entire group with PVR higher than 160 dyn sec cm-5, regardless of congenital heart disease (N = 29, r = -0.4676, P < 0.05). Also, a negative statistically significant correlation was found between PVR and L-D shunt in VSD, with PVR higher than 160 dyn sec cm-5 (N = 17, r = -0.669, P < 0.05). Among patients with low PVR, there was no negative statistically significant correlation between PVR and L-D shunt, neither for the whole group (N = 58, r = 0.1174, P > 0.05), nor among the patients with VSD r = -0.0133, P > 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗
PubMedDate not supplied

[Growth and development in children with congenital heart defects].

Growth and development have been analyzed in 222 children with congenital heart disease. Results were compared to a group of 50 control children. There was no significant difference in age and sex between the groups (p < 0.05). Thirty-three children (12.16%) had cynotic congenital heart disease (tetralogy of Fallot and transposition of the great arteries) and 189 (87.84%) acyanotic congenital heart disease (ventricular septal defect, atrial septal defect, patent ductus arteriosus and aortic and pulmonary stenosis). A statistically significant growth retardation was noted in all children with cardiac disease as compared to the control group, and it was evaluated by percentile values of body weight and height (p < 0.01). Weight retardation was more marked than retardation in body height (p < 0.01). Growth retardation was more significant in the cyanotic children that in those with acynotic heart disease (p < 0.01). Among the children with left-to-right intracardial shunt, growth retardation was found to increase proportionally with the size of the shunt and was most significant in patients with large left-to-right shunt (QP/QS > 1.80). No statistically significant difference in growth retardation was established among the children with acyanotic heart disease (p > 0.01).

Adolescent↗