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Biomedical subjects

R Raicević

Publications and source records attributed to R Raicević.

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

The value of ophthalmoscopy in the diagnosis of arterial hypertension in patients with ischemic brain disease.

Beside dyslipoproteinemia, one of the key risk factors for the onset of brain atherosclerosis, as well as ischemic brain disease (IBD) is arterial hypertension. Significant number of patients is not aware of their hypertension, and a paradoxical blood pressure decrease can occur at the onset of IBD, due to the failure of autoregulation mechanisms. Likewise, valid anamnestic data can not frequently be obtained due to difficulties in communication with patients. Regarding these facts, our hypothesis was that ophthalmoscopy in patients with IBD had the greatest sensitivity in the diagnosis of hypertensive disease, its duration and severity. For that reason, the purpose of this study was to determine the significance of ocular fundus examination in those patients with IBD who were not aware of their hypertension, or the high blood pressure was not registered at the admission. Study comprised 140 IBD patients selected upon the following criteria: ophthalmoscopy was performed by the same ophthalmologist, and IBD was diagnosed according to clinical criteria and by brain computerized tomography. Results of the study demonstrated that 26 (18.6%) patients, although not aware of having hypertensive disease, had grade I hypertonic fundus, 14 (10%) had grade II, and 8 (5.5%) had grade III hypertonic fundus, which indicated the high sensitivity of ophthalmoscopy in the diagnosis of hypertensive disease, as well as its duration and severity. This is particularly important in patients with negative history of hypertension, and also suggests the significance of routine ophthalmoscopy in normotensive patients.

Aged↗
PubMedDate not supplied

Significance of de-novo IgD and IgM synthesis in CSF of patients with relapsing-remitting form of disseminated demyelinating disease of CNS.

Disseminated demyelinating disease of the central nervous system (DDD CNS) is immunologically mediated, with confirmed significant intrathecal immunoglobulin production. According to recently known immunopathogenic occurrences and activation of humoral immune response, we have assumed that the presence of oligoclonal immunoglobulins of M and D classes can be confirmed in cerebrospinal fluid (CSF) of patients with DDD CNS. With the aim of its further determination in CSF of relapsing-remitting DDD CNS patients in either remission and relapse phase, respectively, we have confirmed the presence of oligoclonal IgD and IgM bands, the association of this production and the presence of new demyelinating zones found by MRI of endocranium, as the time elapsed from the last relapse until the obtaining of CSF for further analyses. Method of isoelectric focusing with Western blott procedure was used for the confirmation of oligoclonal IgM and IgD bands presence in CSF. Significant presence of intrathecally synthetized oligoclonal IgM and IgD in patients with DDD CNS in exacerbation phase was presented. Almost in all patients in this phase was found at least one indicator of acute phase (positive MRI finding, presence of oligoclonal IgM or IgD bands). Significant decrease of positive findings of oligoclonal Ig bands in CSF was correlated with the time elapsed from the onset of relapse until the obtaining of CSF for the analysis due to short half-life of those Ig in CSF.

Adult↗
PubMedDate not supplied

The significance of determination of the fraction of creatinine-phosphokinase in patients with acute ischemic brain disease.

Heart and brain vascular diseases are the leading causes of mortality in the world. Cardiac complications can frequently occur during the development of cerebral ischemia. The aim of this study was to establish the possible changes in fractions of creatinine-phosphokinase as the sensitive laboratory index of parenchymal lesion of brain parenchyma and the presence/absence of risk factors for ischemic brain and heart disease. The study comprised 80 patients with acute ischemic brain disease (AIBD), without the history of previous coronary disease. Blood samples were taken in all patients within the first 48 hours from AIBD onset aiming to determine a total (muscular MM) and heart fraction of creatinine-phosphokinase (MB), and brain parenchyma ischemia was confirmed by CT or MR scan of the head. A detailed history of the risk factors for ischemic brain disease (IBD) and ischemic heart disease was taken from all patients with AIBD, and the profile of glycemia and lipid status were determined, and blood pressure was measured 6 times a day. Independent variables in statistical analysis were: age, degree of severity and the side of neurologic event, size of ischemic lesion and maximal values of systolic and dyastolic pressure. Dependent variables were the values of fractions of creatinine-phosphokinase (CPK). Control group (n = 40) comprised patients with neurologic diseases of non-vascular origin. All parameters as well as their interrelations were statistically analyzed. The results revealed significant correlation of the increased levels of CPK of MM and MB fraction with the size and place of ischemic lesion in the right cerebral hemisphere, which was highly significant for MB fraction in the total group of patients with AIBD, and for MM fraction, only for cases of more severe IBD. Highly significant increased values of those fractions were also observed compared to the control group of patients.

Acute Disease↗
PubMedDate not supplied

[Effect of aging on visual evoked potentials].

Experimental and clinical studies, aiming to establish the influence of aging on latence, amplitude and types of waves of visual evoked potentials (VEP) are numerous. It was concluded that P-100 latence prolonged with aging, particularly after the age of 55, while P-100 amplitude had been gradually decreased during the life. During the aging, senile changes in the eye and optic nerve (for example, senile miosis, degenerative retinal changes, geniculostraital defect) can be reflected to the changes in VEP (P-100). Aim of our study was to establish if the aging influences the alteration in latence and wave amplitude in VEP, as well as to standardize normal values of VEP in different ages. VEP was registered in 135 subjects classified into 3 groups. Group I comprised 49 subjects, aged 17-30 (average age 20.92 years), group II comprised 34 subjects aged 31-54 years (average 42.55 years). Group III--over 55 years (average age 69 years) comprised 52 subjects. There were 55 females and 80 males. Results have shown that the mean value of amplitude for both eyes in the first two groups of younger subjects was 9.03 microV and 8.91 microV, respectively, while in the group of older subjects, it was slightly decreased--8.54 microV. P-100 latence prolonged insignificantly until the age of 55, and afterwards in every 5 years it increased for 1.5 ms. Amplitude was insignificantly lower latence in VEP was insignificantly prolonged until the age of 55, and afterwards, the increase was significant. Amplitude was decreased insignificantly, gradually during the life.

Adolescent↗
PubMedDate not supplied

[Therapeutic value of antioxidants and calcium channel blockers in patients in the acute phase of closed head injuries].

Knowing that uncontrolled calcium signalization with excessive production of reactive oxidative matters is present in case of neurotrauma, aim of the investigation was to establish therapeutic value of combined administration of antioxidants (AO) and calcium channel blockers (CCB) in patients with closed head injury (CHI). Investigation comprised 120 patients with CHI who received AO (vitamins C and E) parenterally during 10 days and CCB (nimodipine), and control group was comprised of 60 patients with CHI who did not receive these medicinals in therapeutic program. We have established the influence of the therapy on neurologic and functional deficiency and consciousness disorder, respectively. Results of the investigation confirmed better recovery of all three observed parameters (degree of neurologic deficiency, degree of functional deficiency and consciousness disorder) in a group of patients receiving AO and CCB, which was statistically significant. It can be concluded that the administration of AO and CCB in patients with CHI in the acute phase should be included into therapeutic program of this significant clinical syndrome.

Adult↗
PubMedDate not supplied

[Septic encephalopathy--prognostic value of the intensity of consciousness disorder to the outcome of sepsis].

Septic encephalopathy (SE) is a common term indicating the development of signs of progressing cerebral dysfunction and is associated with the presence of microorganisms and their toxins in the blood. Aim of this investigation was to analyze the frequency of this complication considering the consciousness disorders in quantitative sense and prognosis of the survival in patients with SE. The investigation comprised patients (n = 54) with positive hemoculture and signs of septic syndrome by the accepted criteria (fever, clinical signs of infection, respiratory frequency, heart rate, plasma lactate, oliguria). Patients with confirmed cerebral injury, hemorrhage or cerebral ischemia were excluded from the study. Lumbar punction and CT-scan of the brain were performed in all patients in order to exclude visible lesions of cerebral parenchyma and eventual presence of cerebral nervous system (CNS) infection as the causes of sepsis. Results of the investigation demonstrated that in 30 (55%) of patients existed mild consciousness disorder at the level of somnolescence, in 18 (33%) consciousness disorder at the level of sopor and in 6 (11%) consciousness disorder at the level of deep coma. Level of consciousness disorder was in positive correlation with the outcome of sepsis syndrome, which was additionally confirmed by the fact that only in the group of patients with deep coma lethal outcome was observed in 3 cases (50% of this subgroup) regardless of intensive antibiotic, metabolically active and symptomatic therapy. It can be concluded that SE syndrome has a favorable prognosis if macroscopic lesion and dissemination of microorganisms in CNS are not present, and simultaneously it represents changes in metabolic-electrolytic state with early presentation of consciousness disorders that represent clinically significant indicator for sepsis syndrome outcome.

Aged↗
PubMedDate not supplied

Brain oxidative stress in the syndrome of mutual aggravation on the model of combined injury in Mongolian gerbils.

General reaction of an organism (survival, body temperature, hematocrit, glycemia) was followed in Mongolian gerbils subjected to isolated head injury (brain ischemia--LD5), to peripheral injury (ischemia of both hind limbs--LD20), and to combined injury (head injury + peripheral injury). In the early period (1 hour) after the injury, parameters of oxidative stress were followed in the brain cortex (superoxide anion, index of lipid peroxidation, activity of superoxide dismutase and glutathione reductase). Obtained results indicate that the combined peripheral and central injury of low lethality leads to the worsening of general response of the organism with high lethality of experimental animals (LD80). Likewise, the increased cortical production of superoxide anion and index of lipid peroxidation, as well as the disturbances of antioxidative enzymes activity suggest on an important role of brain oxidative stress in the development of the syndrome of mutual aggravation in animals subjected to combined injury.

Animals↗
PubMedDate not supplied

[Diagnostic and prognostic significance of long latency reflexes, somatosensory evoked potentials and the blink reflex in cerebral ischemia].

In order to determine diagnostic and prognostic value of long latency reflexes, blink reflex and somatosensory evoked potentials in patients with ischemic brain disease (IBD), examinations were done in 32 patients of both sexes with IBD, average age 44-76 years. First examinations were performed within first week of the onset of IBD and in majority of patients repeated after 3 and 6 months. Changes of electrophysiological characteristics compared with the degree of IBD, clinical presentation, localization, extent of infarction zone (measured by CT) and functional recovery where analyzed. Electrophysiological changes were predominantly associated with amplitude of physiological response and were in correlation with the degree of IBD, localization and the extent of infarction zone. Latencies were prolonged only in case of subcortical ischemic lesions. Correlation between functional recovery and electrophysiological changes was present only within the structures responsible for certain components of electrophysiological responses and localization of ischemic lesion. In conclusion, electrophysiological examinations are of high diagnostic and predictive value in IBD.

Adult↗
PubMedDate not supplied

The significance of hemispheric localization of ischemic brain lesion for the early prognosis of ischemic brain disease.

The possibility of early prediction of ischemic brain disease (IBD) is extremely significant for the creation of the individually designed treatment program. The aim of this study was to determine the significance of hemispheric localization of ischemic brain lesion as possible factor for the early prediction of IBD outcome. The study included 170 patients with IBD, whose score of neurologic and functional impairment was determined after admission by using the standard scales. The values of hemorrheological parameters-erythrocyte sedimentation rate (ESR), fibrinogen and alpha 2 globulin were also determined, so as the extensity of ischemic lesion by CT and MR brain examinations. After the treatment, the score of neurologic and functional impairment was also determined and the degree of ischemic disturbance was estimated-transitory ischemic attack (TIA), reversible ischemic attack (RIA) and cerebral infarction. The lower scores were noticed for neurologic and functional impairment, meaning the more severe degree of ischemic disorder with ischemic lesion localization in right cerebral hemisphere (RCH), in acute stage and at the end of treatment. The higher values of ESR, slightly less of fibrinogen and alpha 2 globulin were revealed in the case of ischemic lesion localization in RCH, so as the higher frequency of RCH lesions in percentages connected with the more severe ischemic disorders. It was concluded that the ischemic lesion localization in RCH might be the predictor of poorer IBD outcome.

Blood Sedimentation↗