Biomedical subjects

J Vincelj

Publications and source records attributed to J Vincelj.

9 recordsLinked to original sources

PubMed2001

Diagnostic accuracy of transesophageal echocardiography for detection of atrial masses.

The aim of this study was to assess the diagnostic accuracy of transthoracic (TTE) and transesophageal echocardiography (TEE) for the detection of atrial masses. The authors' own experiences with the use of TTE and TEE images in the assessment of atrial masses are reported. These masses included tumors, thrombi, and valvular vegetations. The study groups consisted of 14 consecutive patients (7 women an 7 men), age range 24-72 (mean age 56.6 < +13.4) years. Eleven patients had left atrial tumor, two patients had atrial thrombi, and one patient had vegetation in left atrium detected with TEE. Eight patients had left atrial myoma, two patients had right atrial myxoma, and one patient had right atrial leiomyosarcoma. There was no false negative and no false positive TEE diagnosis, yielding a 100% sensitivity and specificity of TEE in detecting atrial masses. TEE detected atrial masses in six (43%) patients, provided poor images in five (36%) patients, and failed to reveal atrial masses in three (21%) patients. The TEE diagnosis was confirmed by surgery and pathohistology in all patients. The ability of TEE to visualize both atria with great diagnostic accuracy makes it a very valuable procedure in the assessment of atrial masses.

Adult↗

PubMed2000

Pilocarpine in the prevention of postirradiation xerostomia.

During radiation therapy to the head and neck region, salivary gland hypofunction commonly develops. The aim of our study was to evaluate whether the sialogogue pilocarpine given during radiation therapy may reduce the severity of xerostomia and salivary dysfunction. Our results showed the pilocarpine-treated group to have a lower frequency of oral symptoms during the treatment than the placebo-treated group. Although salivary flow decreased in all patients, the pilocarpine-treated group had smaller flow reductions. No drug effect was observed in the glands that were completely irradiated. Thus, pilocarpine appeared to stimulate salivary tissues outside the radiation field.

Double-Blind Method↗

PubMed1999

Clinical and echocardiographic features of two large left atrial parietal thrombi.

A 62-year-old woman with severe mitral stenosis and two large parietal thrombi inside the left atrium is described. The patient was admitted to the hospital because of heart failure. Transthoracic and transesophageal echocardiography showed a severe calcific mitral stenosis and two large (56.9 and 46.2 mm in diameter) parietal thrombi inside the left atrium attached to the interatrial septum and associated with severe spontaneous echo contrast. This severe spontaneous echo contrast was detected in the left atrium and in the left atrial appendage. The patient was referred for cardiac surgery. The two large parietal thrombi were removed, and the valve was replaced with a Sorin-Bicarbon mitral valve prosthesis. Intraoperative transesophageal echocardiography after replacement of the mitral valve prosthesis and removal of the thrombotic mass showed absence of any spontaneous echo contrast in the left atrium and in the left atrial appendage. This report describes the diagnostic approach and successful surgical treatment of two very large parietal thrombi inside the left atrium associated with severe mitral stenosis and atrial fibrillation, which is a rare occurrence.

Echocardiography↗

PubMed1999

Clinical interpretation of brainstem evoked response audiometry abnormalities in cochlear pathology.

This investigation involved 45 patients with sensorineural hearing loss (SNHL): 24 with Meniere's disease, 18 with acoustic trauma, and 3 with SNHL due to ototoxic drugs. They all underwent pure tone audiometry and standard brainstem evoked response audiometry (BERA). In patients without wave I in auditory brainstem response, electrocochelography (ECochG) was performed. The findings are presented showing that cochlear lesions (beside threshold elevation) cause latency prolongation of wave I, III and V relative to normal latencies at the actual click hearing level. At high stimulation levels, this effect is almost completely compensated for by the fact that cochlear recruiting ears exhibit steeper latency-intensity curves than do normal ears. But, at the same time this pathology does not cause latency prolongation of central conduction time (CCT). Beside this, cochlear lesions will cause, in some cases, deterioration of replicability (poor waveform resolution) of waves preceding wave V. In such cases, the authors strongly recommend electrocochleography (ECochG) to make wave I visible, because they think that it is the best way to verify the diagnosis of cochlear lesion using BERA.

Adolescent↗

PubMed1998

Vertigo as a prognostic factor in sudden hearing loss.

A group of 87 patients suffering from unilateral sudden hearing loss were investigated. They were divided into two groups with and without vertigo, and were evaluated according to the severity of initial hearing loss and shape of tonal audiogram. Twenty-five percent of the patients had accompanying vertigo. Vertigo occurred more often in patients with severe hearing loss in high tone frequencies. Hearing recovery of high tone frequencies was poorer in the patients with vertigo than in those without it, although the initial hearing loss was the same.

Adolescent↗

PubMed1997

Serum total, LDL, HDL cholesterol and triglycerides related to age, gender and cigarette smoking in patients with first acute myocardial infarction.

The aim of this study was to examine relationships between total cholesterol, LDL, HDL cholesterol, triglycerides and age, gender, and cigarette smoking in 190 patients (132 men and 58 women) aged 34-87 years with first AMI. The control group included 103 patients (57 men and 46 women) aged 29-90 years without a history of angina pectoris or AMI. High total cholesterol (over 5.2 mmol/L) was observed in 75% of patients with AMI vs. 48% of patients in the control group (p < 0.001). Patients with AMI had significantly higher total cholesterol and LDL cholesterol levels than controls (p < 0.0001). HDL cholesterol levels were significantly lower among patients with AMI than among the control group patients (p < 0.0001). Serum total cholesterol and LDL cholesterol is higher in patients with AMI up to 60 years old, but lower in patients older than 60 years. Women aged less than 50 years had significantly higher HDL cholesterol (p < 0.001), lower LDL cholesterol (p < 0.001), and lower total cholesterol (p < 0.05) than those over 50 years. Smokers with AMI who smoked over 20 cigarettes per day had significantly higher total cholesterol, LDL cholesterol and triglycerides levels than the non-smokers (p < 0.05). These findings suggest important influences of hyperlipoproteinemia and cigarette smoking upon development of myocardial infarction, especially in younger patients.

Adult↗

PubMed1996

Syncope caused by carotid body tumor.

A 71-year-old woman with a syncope and carotid body tumor is described. On palpation of the tumor on the left side of the neck, the patient felt vertiginous and has a syncope, while ECG showed an asystolic pause of 7.6 s. The tumor was completely surgically removed. After the surgery, massage of the left side of the neck provoked neither sinus bradycardia nor asystole, and the pacing electrode was removed. Temporary pacemaker is recommended in patients with syncope caused by carotid body tumor for the safe performance of diagnostic and surgical procedures. This report describes the successful operation of carotid body tumor as a rare cause of syncope. The patient feels well one year after the surgery.

Aged↗

PubMed1995

[Cardiogenic shock in acute myocardial infarct].

Cardiogenic shock is the most important fatal complication of acute myocardial infarction (AMI). This syndrome may be considered as a severe form of left ventricular failure and the mortality rate is very high. According to the clinical classification, Killip class IV ranges from 60 to 95%, depending on authors. Shock occurs in about 15-20% of patients with AMI and accounts for at least 70% of the in-hospital deaths. During 1994, 168 patients with AMI were treated at the Intensive Care Unit of the Zagreb General Hospital, of which 14 (8.2%) developed cardiogenic shock. Ten patients experienced the first myocardial infarction, and 4 were admitted because of the second myocardial infarction, that time of anterior localization. Signs of cardiogenic shock were present in 8 (57.1%) patients already on admission. Three patients developed cardiogenic shock during the first 10 hours of hospitalization and further 3 patients during the initial 4 to 15 days of treatment. Older age prevailed. Eleven (78.5%) persons were older than 60 years of age. Eight patients demonstrated anterior infarction, 4 had inferior infarction and 2 non-Q-wave infraction. All patients had signs of left ventricular failure evidenced by pulmonary edema (Killip class IV) and later complicated by arrhythmia. Of the 14 patients who had AMI with the shock syndrome, 13 (92.8%) died; 5 (35.7%) patients during the first 2 hours, 3 (21.4%) within 24 hours of infarction, and 5 (35.7%) patients during the initial 4 to 25 days of treatment. Patients were treated conservatively, and only 3 patients received thrombolytic therapy, namely, streptokinase.

Aged↗

PubMedDate not supplied

[Auditory evoked potentials in alcoholics].

In this paper, auditory brain stem potentials in the group of 26 alcoholics were studied and a significantly delayed latencies of the peaks II through V as compared to the healthy control subjects were found. In addition, a statistically significant prolongation of brain stem transmission time (BTT) in alcoholics was observed. The study also suggests the possibility of monitoring the level of pathohistological changes of the central auditory pathway caused by excessive alcohol consumption.

Adult↗