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Biomedical subjects

J Morović-Vergles

Publications and source records attributed to J Morović-Vergles.

10 recordsLinked to original sources

Hypokalemic metabolic alkalosis--three case reports.

The two most common forms of inherited normotensive hypokalemic metabolic alkalosis are Bartter's and Gitelman's syndromes. Bartter's syndrome typically present with normal or increased calcium excretion. Hypomagnesemia occurs in only one third of affected individuals. In contrast, hypomagnesemia and hypocalciuria are considered hallmarks of Gitelman's syndrome. In most patients, the symptom of muscle weakness and polyuria occur early in life, which may be attributed to potassium depletion. Despite hyperaldosteronism, the patients tend to be normotensive, which is at least explained by vascular hyperresponsiveness to prostaglandins. Therapeutic approaches to Bartter's and Gitelman's syndromes include potassium supplementation, prostaglandin synthesis inhibitors (nonsteroid anti-inflammatory agents), aldosterone antagonists and converting enzyme inhibitors. Three patients with hypokalemia, normal blood pressure, metabolic alkalosis, hyperreninemia and hyperaldosteronism are described. Two patients had Bartter's syndrome and one patients had Gitelman's syndrome.

Adult↗

[Dermatomyositis and malignant disease--case report].

The case of patients with dermatomyositis and malignant disease has been described. The diagnosis of malignant disease was made after death of the patient, when the malignant undifferentiated cells were found in the ascites. We think that dermatomyosistis was caused by malignant disease. The similar cases of disease were described and published in the literature.

Aged↗

[Vasculitis].

The term "vasculitis" encompasses a heterogeneous group of clinicopathologic entities characterized by inflammation and damage of blood vessels. Many attempts have been made to classify vasculitis into categories that will facilitate patients diagnosis and management since the first attempt by Zeek in 1952. The classification scheme that will be used in this review was proposed by the 1993 Chapel Hill Consensus Conference and has been widely accepted.

Humans↗

Renal vascular resistance in essential hypertension: duplex-Doppler ultrasonographic evaluation.

Duplex Doppler ultrasonography has been validated as a noninvasive method to evaluate hemodynamic features of renal blood flow in renal and intrarenal arteries in patients with various renal diseases. The significance of duplex Doppler sonography in the evaluation of renal vascular resistance in essential hypertension has not yet been clearly determined. The aim of the present study was to evaluate the renal vascular resistance in patients with essential hypertension by measuring intrarenal arterial resistance (RI) and to correlate RI with renal functional tests and other clinical and laboratory data. Duplex Doppler ultrasonography was used to measure RIs in intrarenal arteries in 128 patients with essential hypertension and 61 age-matched normotensive control examinees. The renal vascular resistance index (RI) was determined by use of Doppler ultrasound. Hypertension was classified according to the 1997 Joint National Committee Guidelines (JNC-VI). Mean RI in hypertensive patients was 0.66 +/- 0.05 (+/- sd) and in healthy controls 0.60 +/- 0.03 (+/- sd) (p = 0.0001). RI correlated significantly with patient's age (r = 0.577, p = 0.001), duration of hypertension (r = 0.335, p= 0.001), stage of hypertension according to the JNC-VI classification (r = 0.315, p = 0.006), creatinine clearance (r = -0.383, p = 0.001), systolic blood pressure (SBP, r = 0.41, p = 0.001) and mean blood pressure (MBP, r = 0.30, p = 0.002). RI values did not correlate significantly with plasma renin concentration (r = -0.198 NS), diastolic blood pressure (DBP, r = 0.17, p = 0.06), and cardiac pulse (r = -0.10, p = 0.16). Multiple regression analysis showed that independent variables for RI were the patient's age (multiple R = 0.53, signif. F = 0.001) and systolic blood pressure (multiple R = 0.57, signif. F = 0.03). The renal Doppler resistance index (RI) is increased in essential hypertension and it correlates with renal functional tests as well as with patient's age, duration of hypertension, with a stage of hypertension according to the JNC-VI classification, and with systolic and mean blood pressure. The increased renal vascular resistance (RI) in hypertensive patients could be a sign of developing hypertensive nephrosclerosis and consequently renal failure. The utilization of the renal vascular resistance index (RI), provides a new noninvasive parameter in the followup of patients with essential hypertension.

Adult↗

[Case report of a patient with knee gout].

A 46-years old male presented with an attack of gout (knee arthritis or gonagra). It is interesting that the patient was HLA B27 positive antigen found a couple of years ago, but on admission he had a normal findings of uric acid in serum, while cytological examination of synovial fluid obtained from knee joint no urates were found. Therefore, diagnostically besides gout arthritis a reactive arthritis as well as other connective tissue diseases were considered. In further diagnostic procedure arthroscopy was performed and in biopsy specimen from the cyst of lateral condyle of right femur urates were found. One day after the arthroscopy was performed a clear clinical picture of podagra developed. After the diagnosis was made the treatment of gout arthritis with Indometacyn began, and with improvement of inflammation, surgery was performed--cyst excochelation of lateral condyle of right femur with filling of the defect with an autologous graft from iliac crest.

Gout↗

[Acute pancreatitis caused by Ascaris lumbricoides in acute renal failure: case report].

A 26-year-old female patient with severe acute pancreatitis caused by Ascaris lumbricoides and consecutive acute renal failure is described. Acute pancreatitis is mostly caused by gallstones and acute or chronic alcohol ingestion. Ascariasis as an etiologic factor of acute pancreatitis does not occur very often except in the tropical and subtropical regions, where it is widely distributed. The goal of this case report was to worn the clinicians to pay attention to this, in our country rarely occurring cause of acute pancreatitis. In special circumstances of great migration of refugees and displaced persons with very low hygienic standards this rare possibility should be taken into account.

Acute Disease↗

Intrarenal duplex Doppler sonographic evaluation of unilateral native kidney obstruction.

RIs were measured in intrarenal arteries in 66 kidneys of 33 examinees without renal impairment and in 42 kidneys of 21 patients with unilateral urinary obstruction. The mean RI in normal kidneys was 0.593 +/- 0.040. Patients with unilateral obstruction had a mean RI of 0.709 +/- 0.039 in obstructed kidneys and a mean RI of 0.591 +/- 0.033 in contralateral nonobstructed kidneys. Statistically significant differences have been noticed in the groups of normal versus obstructed kidneys (P < 0.001) and of obstructed versus contralateral nonobstructed kidneys (P < 0.001). The mean dRI was 0.118 +/- 0.034 in patients with unilateral obstruction, and it was 0.014 +/- 0.012 in examinees without renal impairment (P < 0.001). A comparison of RI values between the right and left kidneys in a patient with unilateral obstruction proved more useful than using a 0.7 RI cutoff value in a Doppler sonographic diagnosis of unilateral obstruction.

Adult↗

[The tumor lysis syndrome: case report and review of the literature].

Tumor lysis syndrome is specific acute renal failure. This syndrome is usually a complication of cytostatic therapy in patients with acute lymphoblastic leukemia and lymphoblastic lymphoma. Tumor cell lysis following chemotherapy may lead to metabolic complications and renal failure. We report herein, two patients with acute lymphoblastic leukemia who developed tumor lysis syndrome after chemotherapy. Furthermore, we describe important measures to prevent tumor lysis syndrome in high risk patients.

Adolescent↗

[Rhabdomyolysis: case report and review of the literature].

We report a case with rhabdomyolysis, myoglobinuria and acute renal insufficiency. Rhabdomyolysis has been due to toxic effect of ethanol and excessive physical activity. The characteristics of rhabdomyolysis, the outlines of therapy and prevention of recurrence of rhabdomyolysis have been described.

Adult↗

Effect of cyclophosphamide on tumor cell sensitivity to the action of immunological effectors.

A single sublethal dose of cyclophosphamide (CY) given to mice with Ehrlich ascites carcinoma (EAC) kills tumor cells and inhibits tumor growth for the first five days after its administration. From day 7 on, treated tumor cells reassume their growth, but their transplantability in normal recipients is greatly reduced for further three weeks more. On the other hand, the transplantability of untreated (control) and CY-treated cells in T cell-deficient mice is similar. Experiments with criss-cross immunization and challenge have shown that CY-treated cells are equally, or even less, immunogenic than un-treated cells. On the other hand, CY-pretreated cells are several times more sensitive to immunological attack of passively transferred immune spleen cells. These data show that CY does not increase the tumor cell immunogenicity but only increases its sensitivity to immunological attack.

Animals↗