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Biomedical subjects

M Savić

Publications and source records attributed to M Savić.

At least 37 records · Page 2Linked to original sources
PubMedDate not supplied

[Importance of self-assessment of functional and communication abilities on the outcome of rehabilitation in patients with hemiplegia after cerebrovascular stroke].

INTRODUCTION: Cerebrovascular insult causes focal damage of the central nervous system structures consequently causing loss or disturbance of their functions. Motor deficit is often associated with personality alterations generally speaking, as well as changes in behavior and loss of numerous neuropsychological functions. Rehabilitation of such patients should be defined by all members of the team, including the patient himself and members of his family. MATERIAL AND METHODS: This is a case report on a male patient 49 years of age with rightsided paralysis accompanied by aphasia. Thirty days after cerebrovascular insult he was transferred from the Clinic of Neurology in Novi Sad to the Clinic of Medical Rehabilitation. Functional disability assessment was made using Barthel Index, whereas communication was assessed by Boston Diagnostic Aphasia Examination. The rehabilitation program included, apart from the usual team, the patient himself and members of his family. The patient became the center of the team and was informed about the disease. Personal assessment of the patient on his functional and communication abilities and their importance for further progress was used to set the objectives of the rehabilitation program. The rehabilitation program was performed by a speech therapist and a psychologist, including kinesis, work activities, occupational therapy, individual and group therapy. RESULTS: The outcome of the rehabilitation program in this patient was significantly better than expected. DISCUSSION AND CONCLUSION: This case report shows that being the center of the rehabilitation team the patient takes an active part in setting objectives of the rehabilitation program, whereas involvement of the family, knowledge on necessary medical issues about the disease, contribute to better motivation and better outcome of the rehabilitation program in patients with hemiplegia caused by cerebrovascular insult.

Aphasia↗
PubMedDate not supplied

[Nonparasitic true cysts of the spleen].

Nonparasitic true cysts of the spleen are rare, but not so rare as it has been thought. Thanks to the new imaging techniques, first of all ultrasonography, they are discovered easily and quickly. Usually, there is only one cyst. Rarely, the patient may have the polycystic liver and the kidney, and the pancreatic disease. We present four patients with nonparasitic true cysts of the spleen. There were three women and one man, 37-years-average age (range from 31 to 45 years). Three patients had solitary splenic cysts. In one patient a large dominant cyst and many small cysts up to 0.5 cm in diameter were found. All patients suffered from left subcostal pain. The size of cysts varied from 6 to 8.5 cm in diameter (average size of 7 cm). All patients were treated surgically by splenectomy, without complications or mortality. Histological findings revealed lyphangiomatic cysts in three patients and epidermoid cyst in one subject. All patients are symptom-free so far.

Adult↗
PubMedDate not supplied

[Pseudocyst of the adrenal gland causing hypertension].

We describe a 45-year-old women in whom during the investigation of hypertension a small, 2 cm in diameter, cyst of the left adrenal gland was found, which continued to grow up to 9 cm in diameter for a year. At the operation a three-locular cyst of the left adrenal gland was entirely removed with all surrounding organs undamaged. The postoperative recovery was uneventful. Histological examination showed a pseudocyst probably of posthaemorrhagic origin. Blood pressure dropped to normal and left abdominal pain disappeared. Since then the is symptom-free.

Adrenal Gland Diseases↗
PubMedDate not supplied

[Peripheral nerve injuries during the 1991-1993 war period].

In the period 1991 - 1993, 931 casualties with 1435 injured peripheral nerves were surgically treated at the Clinic for Neurosurgery of the Military Medical Academy. The statistical analyses of these series was done according to the type of the injured nerves, the age and sex of the wounded. The cause of injuries, associated and combined injuries, distribution of single and multiple lesions of certain nerves, as well as employed surgical procedures were analyzed.

Adolescent↗
PubMedDate not supplied

[Anatomic characteristics and clinical signs of congenital anomalies in the circle of Willis].

Anatomical characteristics and clinical importance of congenital anomalies of cerebral arteries were examined based on the results obtained by dissection of the circle of Willis blood vessels of 70 native cadaveric brains. Anomalies were most frequently found in posterior communicant artery and their most frequent type was hypoplasia of the blood vessel. Multiple anomalies of the circle of Willis were found in 3 cadavers. Premortal neurological symptomatology (PNS) existed in 5 cadavers. There was no significant difference in PNS occurrence at autopsy in cases with or without anomalies. Association of aneurisms with anomalies of the circle of Willis was found in two cases, but it was not significant in comparison to the control group with no anomalies.

Circle of Willis↗
PubMedDate not supplied

[Progression of chronic renal insufficiency in chronic rejection: the role of chronic transplantation glomerulopathy].

Chronic rejection of kidney transplant is a chronic and progressive decline of kidney transplant function related to certain morphologic changes, such as obliterate vasculopathy, interstitial fibrosis, tubular atrophy, and transplant glomerulopathy [1]. The purpose of this study was to investigate the involvement of chronic transplant glomerulopathy in the progression of chronic renal failure. METHOD, PATIENTS: Of 16 transplant patients with histologic diagnosis of chronic kidney transplant rejection in biopsy specimens, 8 patients had chronic transplant glomerulopathy (ChR-1), and in the other 8 patients glomeruli were relatively preserved (ChR-2). Transplant biopsies were performed between the seventh and the 15th month in ChR-1, and between the ninth and the 34th month in ChR-2 group. Morphologic vasculopathy cv2 changes, tubular atrophy ct1 and ct2 in the half of each group, and interstitial fibrosis ci2, were graded according to the BANFF criteria [2]. During the follow up the patients received similar doses of prednisone, as well as of azathioprine and cyclosporine A. IMMUNOHISTOCHEMICAL INVESTIGATION: The expression of MHC I antigen, MHC II antigens, CD3, CD25, CD54 (ICAM-1) was analyzed by indirect immunoperoxidase technique of staining on the frozen sections, (DAKOPATTS). The immunoreactivity score was 0 to 3. BIOCHEMICAL INVESTIGATION: The renal function was expressed as reciprocal serum creatinine values (1/mumol/L) reflecting the mean monthly levels, over the period between the third and the 22nd month following the transplantation. In each patient a decline in kidney functioning was determined in two ways: 1. by the slope of the curve representing the function of regression of the reciprocal serum creatinine over time, started from the third month after the transplantation, 2. by the rate of regression (percent) of the reciprocal serum creatinine values at the sixth, the ninth, the 18th and the 22nd month, compared to the attained serum creatinine level at the third posttransplantation month. RESULTS AND DISCUSSION: Glomeruli with present chronic transplant glomerulopathy (patients of the ChR-1 group) had moderate expression of MHC I antigen [1-2], week expression of ICAM-1 (CD54), whereas DR antigens were almost absent. In cortical tubuli the expression of MHC I antigen was very low. The relatively preserved glomeruli in patients without chronic transplant glomerulopathy (ChR-2 group) showed high expression of MHC I antigen [2], moderate expression of ICAM-1, and low (up to 1) DR expression. The CD25 molecules were not detected in any analyzed glomeruli (62 in total), except a positive cellular crescent formation, seen in 3 patients with chronic transplant glomerulopathy. The regression slopes of reciprocal serum creatinine values according to months, over the third and the 22nd month were similar in both groups of patients, and the speculating mean graft survival time was 44 months, in both groups. However, 4 of 8 patients of the ChR-1 group, and only 1 of 8 patients of the ChR-2 group returned to the haemodialyses because of the graft functioning loss. Besides, the mean percentual rate of the decline in renal functioning, as the rate of decrease of serum reciprocal creatinine values in the chosen growing periods in time after the third month were higher in group ChR-1 with present chronic transplant glomerulopathy in biopsy specimens. The difference was of statistical significance at the end of the 18th month, t = 4.10, p less than 0.01. In this period proteinuria exceeding 3 grams a day was discovered in 6 patients of ChR-1 group, and in 4 patients in ChR-2 group. Our results suggest that the early appearance of chronic transplant glomerulopathy induces a slightly higher loss of function of the kidney transplant with chronic rejection, despite of the absence of the immune activation in the glomeruli with the present chronic transplant glomerulopathy. (ABSTRACT TRUNCATED)

Chronic Disease↗
PubMedDate not supplied

[Lesions of the peripheral nerves associated with pseudoaneurysms of the major arteries caused by gunshot wounds].

Ten wounded persons, operated on for gunshot-induced peripheral nerve lesion in which pseudoaneurysm of the main artery was found intraoperatively, were presented. Preoperative clinical course, intraoperative neurovascular topography and pathoanatomy, operative procedures and postoperative results were analyzed. The correlation was established between preoperative neurologic deficit and intraoperative findings on arteries and nerves. It was concluded that such patients have to be operated on as soon as possible, but not later than five days from the beginning of neurologic aggravation, to prevent the development of irreversible neural damage.

Adult↗
PubMedDate not supplied

[New trends in immunosuppressive therapy in patients with kidney transplants].

Following the transplantation of visceral organs, two populations of immunocytes survive which derived from the donor's and the recipient's bone marrow. The rejection process of transplanted organ or graft versus host reaction could result from their mutual stimulation. On the other hand, the immunocytes of the donor and recipient could deny the effects of their MHC antigen disparities directed against each other, to favor the transplant acceptance through the processes of the donor specific tolerance. The spontaneous chimerism has been shown even in patients with the heart or kidney allografts which contain few numbers of donor's passenger lymphocytes. The frequency of chimerism is augmenting more than 1000 times following the combined and simultaneous transplantation of both kidney allograft and donor bone marrow cells. Theoretically, the continuous peroraly giving of high doses of synthetic peptides homologous to immunodominate epitope(s) of the donor MHC molecules could sustain the state of "stable chimerism" with donor immunocytes. This immunosuppressive protocol permits long-term survival of organ (kidney) allograft without diminishing the donor immune system that provokes the present immunosuppressives with non-specific effects.

Graft Rejection↗