PubMed Health⌕ Search

Biomedical subjects

M Opacić

Publications and source records attributed to M Opacić.

15 recordsLinked to original sources
PubMed2005

Evaluation of oxidative stress after repeated intravenous iron supplementation.

Parenteral iron has been recommended for the treatment of iron deficiency in the majority of maintenance hemodialyzed (HD) patients. However, iron supplementation and consequent over saturation of transferrin and high iron levels, may aggravate oxidative stress already present in these patients. This study aimed to further clarify the role of repeated intravenous iron therapy as a supplementary cause of oxidative stress in HD patients. Markers of free radical activities (carbonyl reactive derivatives, CRD, thiol groups, SH, malondialdehyde, MDA) and antioxidant enzyme activities (superoxide dismutase, SOD and glutathione peroxidase, GPX) were determined in plasma and red blood cells (RBC) of 19 hemodialysis patients given a total iron dose of 625 mg (ferrogluconat, Ferrlecit, 62.5 mg). Blood samples were taken before the first and after the last dose of iron. Twenty apparently normal subjects served as healthy controls. Before iron treatment, HD patients exhibited increased concentrations of MDA and CRD in plasma and red blood cells, accompanied with impaired antioxidant capacity. All patients responded to iron therapy with a significant increase in their serum ferritin, serum iron, hemoglobin, and red blood cells levels. However, iron treatment resulted in enhanced oxidative stress in plasma of HD patients, since significant increase in plasma MDA and CRD concentrations, together with a decrease in nonprotein SH groups levels were detected. Supplementation with iron did not significantly influence plasma SOD and GPX activities, nor did any of the red blood cell parameters tested. Our data show that, despite improvement in hematological parameters, an increase in iron stores due to supplementation could also contribute to increased free radical production in HD patients.

Adult↗
PubMed2003

Comparison of colonoscopies performed under sedation with propofol or with midazolam or without sedation.

BACKGROUND: Previous studies have shown that some patients are not able to tolerate colonoscopy without sedation because of low pain threshold, anxiety, colonic sensitivity and anatomical variations. Benzodiazepines are most commonly used, often in combination with pethidine. Our study compares sedation with propofol to midazolam and colonoscopy without sedation. METHODS: In this study 147 patients were examined. The patients were divided into three groups: The first group included patients in whom propofol was used for sedation, the second group included patients sedated with midazolam, and the third group was comprised of patients who received no sedation. Oxygen saturation and heart rate were recorded continuously by pulse oxymetry. Arterial blood pressure (BP) was monitored at 3-min intervals. RESULTS: A decrease in blood pressure and heart rate was documented in the first two groups (P < 0.001), whereas in group 3 we found an increase in both BP and heart rate (P < 0.001). Oxygen saturation dropped below 90 % in 11/102 patients sedated with propofol and in 9/23 sedated with midazolam. Two of 22 patients in whom no sedation was used were found to have oxygen saturation below 90 %. The recovery time was shorter (7 min) in group 1 (propofol) than in group 2 (midazolam), in which it was found to be 20 min. CONCLUSIONS: Our results showed that propofol provided good sedation with excellent pain control, a short recovery time and no significant haemodynamic side effects.

Adolescent↗
PubMed1997

[Palliative treatment of malignant esophageal obstruction with a new endoscopically administered self-expanding nitinol stent: case report].

The endoscopic methods of palliative treatment in malignant esophageal stenoses caused by neoplasm which have been performed so far unfortunately do not provide permanently satisfying results. The implantation of self-expanding stents with the purpose of removing malignant esophageal obstructions has recently become the most acceptable method of treatment. By using that method it is possible to reduce or even completely remove difficulties in swallowing. In that way a significant improvement in life quality of patients with inoperable esophageal cancer is possible. The various types of metal endoprostheses used for the palliative treatment of esophageal malignant stenoses are described in this paper. Here is also presented a case of nitinol stent implantation in a 50 year old woman suffering from esophageal cancer. This type of therapeutic treatment has been applied in Croatia for first time.

Alloys↗
PubMed1997

Primary malignant melanoma of the rectum: a case report.

The aim of the study was to describe the diagnostic procedure, indications for operation and operative result in a patient with primary malignant melanoma of the rectum. In the patient, hospitalized at the Department of Surgery, School of Medicine in Zagreb, a malignant melanoma of the rectum was diagnosed by rectoscopy and histology. Tumor staging was determined by endorectal ultrasonography. Operation was indicated for malignant disease with partial obstruction of the rectum. Since the tumor was locally inoperable, with liver metastases a palliative operative procedure (sigmoidal colostoma) was performed. The operative finding confirmed the tumor stage obtained by ultrasonography. The patient died 5 months after the operation due to widespread dissemination of the malignant disease. Thereby, the accuracy of preoperative tumor staging by ultrasonography was confirmed. We believe that, in view of its accuracy, endorectal ultrasonography can be used for tumor staging in patients with primary melanoma of the rectum. Therefore, expensive diagnostic imaging methods like CT and MRI are no longer necessary.

Aged↗
PubMed1996

Percutaneous pancreatography under ultrasonographic guidance.

PURPOSE: The aim of the study was to evaluate percutaneous pancreatography as an alternative method for pancreatic duct visualisation in patients with pancreatic disease. MATERIAL AND METHODS: In 21 patients with pancreatic disease and previously unsuccessful ERCP, puncture of the pancreatic duct was carried out under ultrasonographic guidance with an 0.7-mm Chiba needle, and contrast injection was made under fluoroscopic control in the pancreatic duct. RESULTS: The procedure was successful in 18 patients (86%). In 10 patients, chronic pancreatitis was found, and in 8 patients, pancreatic carcinoma. CONCLUSION: Percutaneous pancreatography is a good alternative method for visualisation of the pancreatic duct in patients with pancreatic disease and previously unsuccessful ERCP.

Anesthesia, Local↗
PubMed1995

Comparison of injection sclerotherapy and laser photocoagulation for bleeding peptic ulcers.

BACKGROUND AND STUDY AIMS: The most widely used endoscopic procedures in the management of patients with bleeding peptic ulcer are at present sclerotherapy and thermal methods. In an attempt to assess the most effective method of achieving hemostasis, we compared injection sclerotherapy and laser photocoagulation in terms of the efficacy of initial hemostasis, rebleeding, need for surgery, mortality, and the appearance of the ulcer after the hemostatic procedure. PATIENTS AND METHODS: In this prospective, randomized trial, 160 patients were treated with injection sclerotherapy (1% polidocanol), and 155 patients with laser photocoagulation (Nd:YAG laser) in cases of Forrest I, Forrest IIa, and Forrest IIb hemorrhage. The bleeding activity was classified according to the modified Forrest criteria. Polidocanol injection and Nd:YAG laser photocoagulation were not preceded by epinephrine administration. RESULTS: There were no significant overall differences between the groups in the outcome in terms of definitive hemostasis, rebleeding, urgent surgery, and death (p = 0.487). In the case of the subgroup with Forrest I lesions, laser photocoagulation was more efficacious than sclerotherapy (p = 0.0078). In the Forrest IIa and Forrest IIb subgroups, the two methods were equally effective (p = 0.202 and 0.513 respectively). In the sclerotherapy patients, definitive initial hemostasis in Forrest IIa was achieved in 100%, whereas in the laser group this rate was 92%, with 28% of patients initially developing hemorrhage after one or two laser pulses. Ulcer healing was slower following sclerotherapy than after photocoagulation. CONCLUSION: Injection sclerotherapy and laser photocoagulation are equally effective in achieving definitive hemostasis in bleeding peptic ulcers. Laser photocoagulation is more efficacious in patients with active bleeding, whereas injection sclerotherapy is more effective in patients with a nonbleeding visible vessel.

Adult↗
PubMed1991

Prophylactic administration of ranitidine after sclerotherapy of esophageal varices.

The present trial was carried out to determine the usefulness of H2-receptor antagonist drug therapy for the prevention of esophageal bleeding and esophageal varices in patients who underwent sclerotherapy. According to randomization, out of the 58 patients, 28 received, along with the usual standard therapy, ranitidine and 30 received placebo. Ranitidine, 50 mg, was administered intravenously over a period of 3 days every 8 hours, and then 150 mg of ranitidine was given per os in the evening for one month. For improvement of hemostasis and during the elective sclerotherapies, 1% polidocanol was used as the sclerosant. During each puncture, 2 ml was injected. Injections were paravasal and intravasal. After sclerotherapy, endoscopic examinations were carried out on the third day and one month later. Necrosis was noted in 42% of the patients and esophageal mucosal inflammation in 26%. Esophageal ulcers did not occur. There was no statistically significant difference between the two groups in terms of age, sex ratio, cause of liver cirrhosis, and the Child's classification. The size of the esophageal varices had no effect on the development of esophageal mucosal changes in correlation with the quantity of sclerosant. The comparison of the two groups of patients, sclerosed for hemorrhage and sclerosed electively, showed no statistically significant difference regarding esophageal mucosal changes. No differences between the ranitidine and placebo groups of patients were observed in this indication. It can be concluded that esophageal mucosal changes probably arise as a consequence of the sclerosant, its concentration, quantity and mode of application.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1991

Thoracocentesis under ultrasonographic control.

Chest ultrasonography has been advocated as an effective tool for diagnosis and localization of pleural effusion. To determine if chest ultrasonography would be beneficial, when thoracocentesis was performed, 71 patients with suspected pleural effusion were evaluated. Two groups of patients were formed according to the presence of small or large suspected effusion ascertained by chest posteroanterior roentgenogram. Chest ultrasound was found very useful, both for establishing diagnosis of pleural fluid and for obtaining adequate fluid samples of small effusions. This technique had no such advantage during thoracocentesis of large effusions. During and after thoracocentesis, there were no complications in any group of patients. Authors concluded that ultrasound method seems to be very useful in choosing the optimal site for thoracocentesis, particularly of small effusions.

Humans↗
PubMed1989

[Lymphangiomyomatosis of the lungs].

Pulmonary lymphangiomyomatosis (LAM) is a rare disease at the women's child bearing age, characterized by the proliferation of smooth muscles along the lymphatics in the lung, in mediastinal and retroperitoneal lymph nodes as well as in retroperitoneal lymph vessels. The disease manifests itself as a progressive dyspnea, chylous pleural effusions and reccurent pneumothorax. Uncured the disease progresses to a serious respiratory insufficiency and death within a period of ten years since the manifestation of the first symptoms. We studied a female patient in whom the diagnosis of pulmonary lymphangiomyomatosis was established on clinical findings and pathohistologic analysis of biopsy material. The patient was offered progesterone which, according to some authors, stops further progression of the disease. The progesterone treatment was carried out for a year and it is going to be continued. During the period mentioned, repeatedly controlled lung diffusing capacity and arterial blood gas analysis remained basically unchanged compared to these before treatment. It is noteworthy, that once formed changes in the parenchyma are irreversible, so early diagnosis and timely started treatment are of basic importance.

Adult↗
PubMedDate not supplied

[Ultrasound in the diagnosis of pulmonary and pleural diseases].

Ultrasound as a method in evaluation of pleural diseases, peripheral pulmonary infiltrates and tumors has already been accepted throughout the world. However we haven't yet been applying it widely. In this work the possibilities of ultrasound as a method in pleural and lung diseases diagnostics have been described, together with the typical findings and examination technique. Indications of thoracic ultrasound which along with unavoidable X-ray examinations represent a new increase of quality in the diagnostics of pleural and lung diseases are specified.

Humans↗
PubMedDate not supplied

[The effect of atmospheric conditions on the occurrence of peptic ulcer hemorrhage].

The influence of atmospheric factors on the frequency of bleeding from the peptic ulcer was studied within the period from April 1, 1984, to March 31, 1989, consequently through 1826 days. The average daily atmospheric pressure, the average daily temperature and the relative humidity have been examined. There were 1102 cases of bleeding peptic ulcer, 537 bleeding gastric ulcers and 565 bleeding duodenal ulcers. During the study period there were 454 days with bleeding form ventricular ulcer and 465 days with bleeding from duodenal ulcer. There was 793 days with bleeding form either lesion. The discriminatory analysis demonstrated that the atmospheric pressure is the variable that discriminates the days with bleeding and the days prior to bleeding from the days without bleeding. The relative humidity occurs as the relevant discriminatory variable in the days prior to bleeding for the duodenal ulcer group and for the entire group. The centroids of the discriminatory function demonstrate that the days with ulcer bleeding are characterized by the fall of atmospheric pressure. The factor analysis of meterological variables clearly shows the correlation of the atmospheric pressure and the bleeding regardless to the localisation of bleeding ulcer, where the greatest number of bleedings is correlated with lower atmospheric pressure. We conclude that the incidence of bleeding form the peptic ulcer of the stomach and duodenum correlates in great measure with low atmospheric pressure in the days prior to bleeding and in the days of bleeding, as well as with fall of atmospheric pressure in the days of bleeding with respect to previous day.(ABSTRACT TRUNCATED AT 250 WORDS)

Atmospheric Pressure↗