Biomedical subjects
M Dokić
Publications and source records attributed to M Dokić.
[Simultaneous acute infection with viral hepatitis A and B].
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[Experience to the present time in the use of peritoneal dialysis in the Belgrade urology clinic].
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[Viral hepatitis C. Personal experience with diagnostic, monitoring and epidemiologic studies].
In the period from 1991 to 1993, 18 patients with the acute viral hepatitis type C were treated and followed up--13 men and 5 women, the average age of 42 years. The group of 6 patients (4 men and two women) with the "old" proven liver cirrhosis, whose etiology was unknown for 20 years, was analyzed. The investigations showed that the acute viral hepatitis type C usually began with the mild subjective disorders. The half of the patients did not have either jaundice or hepatomegaly, only half of them recover, and the first cases of cirrhosis could have been expected almost as early as a year after the beginning of illness. The developed liver cirrhoses remained compensated for years. About 58% of patients got infected parenterally, and the rest of them could have gotten infected in other manner. ELISA test showed great reliability in proving the antibodies against the viral hepatitis type C in the confirming the diagnosis of illness.
[Clinical manifestations of infectious erythema in adults].
The infectious erythema is usually childhood disease associated with rash and caused by parvovirus B19. At the beginning of 1993., at the Clinic for infectious and tropical diseases of the Military Medical Academy 36 patients were treated for this disease, the average age 21 years. The prodromal phase of illness lasted approximately 2.9 days, the elevated temperature 5.2 days, and 17 patients had temperature above 39 degrees C. The rash was usually maculo-papullous and lasted about 6 days. Four patients had the recurrence of rash. The polyarthralgia appeared for short in six patients and in one patient lasted longer than 4 months. The mild anemia during infectious erythema was observed in 18 patients. IgM antiparvo B19 antibodies were proven in serum in 91.7%, and IgG antibodies in 58.3% of patients.
[Endotoxemia in patients with food poisoning].
In 22 patients with alimentary toxoinfection caused by salmonella and other gram-negative bacteria, endotoxemia was proved in 8 (36%) patients. The causative agent of the disease was proved in 11 (50%) of cases. In 6 (54%) patients the causative agent were from salmonella species: S. enteritidis, S. typhimurioum, S. hadar and S. heidelberg. Endotoxemia and positive coprocultures, that is, hemocultures were found in two patients respectively. In two patients with positive coprocultures and hemocultures, endotoxemia was found as well as in two patients with unknown causative agent. In patients with alimentary toxoinfection caused by salmonella and other gram-negative bacteria, endotoxemia occurred relatively often. Early detection of endotoxemia is important for application of urgent therapeutic measures and procedures, especially in immunocompromised patients.
[Changes in thyroid hormone levels in patients with acute viral hepatitis].
In 10 patients with acute viral hepatitis A or B the dynamics of the concentrations of the thyroid hormones thyroxine (T4), triiodothyroxine (T3) and their coefficient T3/T4, and thyroid stimulating hormone (TSH) in all phases of hepatitis have been studied. In acute phase and in the fully developed clinical picture of the diseases, the increased T4 values and decreased values of T3, T3/T4 coefficient and TSH were found. These changes are explained by the slowed down deiodinization of T3 and T4 in hepatocytes as well as by the disturbed secretion of the thyroid hormone in hepatitis and they could be of some value in diagnosis and prognosis.
[Clinical characteristics of Lyme disease].
Clinical characteristics of Lyme disease were analysed in 22 patients. Erythema migrans was found in 20 (91%), arthralgia in 18 (81%), neuralgia in 8 (36%), encephalitis in 3 (13%), carditis in 2 (9%) and arthritis in 2 (9%) patients. The positive antibody titer was found in 14 (63%) patients. Favourable effects of antibiotic therapy was achieved in all patients. Erythema migrans has been manifested up to 12 days after tick sting and arthralgia, arthritis, neuralgia, hepatitis and chronic dermatitis within a year. Carditis and encephalitis have been developing from a month to ten years after tick sting. Lyme borreliosis is commonly manifested as a systemic disease. Together with the skin, most commonly have been involved ankle joints, heart and nervous system. The time from tick sting to the onset of first signs of the diseases varies by the involved organs.
[Personal experience in the treatment of chronic viral hepatitis B with recombinant interferon B alfa-2].
Twelve patients were treated with alpha-2 recombinant interferon during 4 months. Patients were given daily dose of 3 million units three times a week. Therapeutic effect expressed as the percentage of HBeAG seroconversion or by the loss of antibodies for the core antigen in IgM fraction and by the core antigen loss from hepatic tissue, was achieved in 41.6% of patients. Corticosteroids, administered before interferon, could improve therapeutic effect. Better response to therapy was observed in patients with higher serum transaminase levels and with histopathologically confirmed chronic hepatitis. Predictive value of each immunological parameter of therapeutic effect requires further study.
[Infectious erythema caused by parvovirus B19--2 case reports].
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[A severe form of leptospirosis].
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The significance of immunoglobulins in the treatment of patients with sepsis and septic shock.
Inappropriate body response is, besides the infectious agent, responsible for the genesis of sepsis and septic shock. It is non-specific and in cascade of events it can hardly be controlled. The results of immunoglobulins administration compared to the disease course and outcome have been compared and analyzed in 135 patients with sepsis and septic shock. A hundred and four patients were treated for sepsis. Immunoglobulins were administered to 18, of whom 17 patients (94.55%) were cured, while one (5.55%) developed septic shock with lethal outcome. Out of the other 86 patients who did not receive immunoglobulins, 82 (95.35%) were cured, while in 4 (4.65%) patients the outcome was lethal. No difference was observed between studied groups. Among 31 patients with septic shock, 13 received immunoglobulins. Seven (53.85%) patients were cured, and 6 (46.15%) died. In relation to the favorable disease outcome the difference was observed (statistically non-significant) in the group that received immunoglobulins, compared to the group that did not (53.85% vs. 44.45%). The importance of immunoglobulins administration, in sepsis and septic shock should be emphasized.