PubMed Health⌕ Search

Biomedical subjects

S Pavlovic

Publications and source records attributed to S Pavlovic.

48 records · Page 3Linked to original sources
PubMed1996

[Objective determination of refractive changes in silicon oil filled eyes--effect of head position on refraction].

BACKGROUND: The refraction of the eye is altered significantly after silicone oil instillation into the vitreous cavity due to its high refractive index. The degree of the refractive change varies during the daily course and depends on the position of the head. PATIENTS AND METHODS: To analyze the degree and time course of the refractive change depending on the head position we performed refractive measurements in 5 aphakic and 5 phakic silicone oil-filled eyes with attached macula by an automatic handrefractometer. This new device was used for 25 measurements at short intervals in each patient at different eye positions (supine position, prone position and primary eye position). RESULTS: Mean visual acuity in all patients valued 0.14 (+/- 0.05). The highest shift in refraction of +5.95 (+/- 2.63) dpt in spherical equivalents occurred in the aphakic eyes and of +2.45 (+/- 0.71) dpt in the phakic eyes after position change from face up to face down. Three minutes after position change the refraction remained stable in nearly all eyes. Only slight changes in cylinder and corresponding axis were found during the measurements with a mean axial shift of 10.1 (+/- 5.1) degrees. CONCLUSION: Immediately after change of the head position especially aphakic eyes demonstrated remarkable refractive shifts. The results of this study explain patients' complaint of visual changes during the daily course after intraocular silicone oil injection. Refractive alterations evoked by silicone oil stabilized a few minutes after change of the head position.

Adult↗
PubMed1995

[Long-term outcome after silicone oil removal].

In order to reduce the incidence of postoperative complications in silicone-filled eyes, many authors recommend that silicone oil should be removed from the eye as soon as a stable retinal situation is achieved. Even in the eyes with completely attached retina and a clinically stable situation there is a risk of retinal redetachment and other complications after silicone oil removal. In a retrospective study we analyzed 324 cases after silicone oil removal regarding the postoperative redetachment rate and risk of complications from this procedure. The indication for primary surgery was retinal detachment with PVR in 167 (51.5%) cases, proliferative diabetic retinopathy in 87 cases (26.8%), complications of penetrating ocular injuries in 48 cases (14.8%), giant tear retinal detachment in 9 cases (2.7%) and retinal detachment with a central hole in 13 cases (4%). At the time of silicone oil removal retina was completely attached in 277 eyes. Local retinal redetachment central to the encircling band existed in 47 eyes at the time of silicone removal. Follow-up time ranged from 6-63 months. Silicone oil removal was combined with a cataract operation in 42 cases (12.9%), penetrating keratoplasty in 9 cases (2.8%) and membrane peeling in 54 eyes (16.7). In the postoperative period the retina detached in 39 (12%) eyes. In the eyes with preoperatively completely attached retinas, redetachment occurred in 23 eyes (8%), whereas in the group of eyes with an unstable preoperative retinal situation, the retina redetached in 16 eyes (34%). The duration of the silicone oil tamponade had no effect on the redetachment rate. In the group of eyes with an unstable preoperative retinal situation, preoperative laser photocoagulation at the cerelage buckle, as well as central to the local detachment, reduced the incidence of redetachment after silicone oil removal significantly (25% vs. 53%). In the group of eyes with a preoperatively stable retinal situation, this effect was not significant. Our results show that in eyes with completely attached retinas, the risk of complications and redetachment after silicone oil removal is relatively low. In selected cases, even in eyes with incompletely attached retinas, silicone oil could be removed. Nevertheless, a relatively high risk of postoperative complications has to be taken into consideration. In eyes with an incompletely attached retina, preoperative laser photocoagulation at the cerclage buckle, as well as central to the local redetachment significantly reduced the incidence of redetachment after silicone oil removal.

Adult↗
PubMed1995

[Changes in bulbus geometry after conventional detachment surgery. Study using video keratoscopy].

Conventional detachment surgery produces scleral indentation and can therefore lead to changes in the geometry of the bulbus. The aim of this research was to analyze the influence of scleral buckling (group A) and encircling elements (group B) on corneal topography, surgical induced astigmatism and axial length. In 19 cases with peripherally detached retinas we performed keratometry, videokeratoscopy and measured axial length preoperatively in the first week as well as 1 and 3 months postoperatively. Total preoperative astigmatism in group A was 0.49 D and in Group B 0.84 D. The surgically induced astigmatism calculated by vectoral analysis was in the first postoperative week 0.98 D and 1.92 D. 1 month postoperatively it was 0.74 D and 1.26 D, and after 3 months 0.89 D and 1.31 D. There was minimal change in the average axial length: 0.09 mm reduction in group A and 0.21 mm increase in group B after 3 months. Computerized videokeratoscopy was very effective in determining this slight, surgically induced astigmatism.

Astigmatism↗
PubMed1994

Why do our patients die of active tuberculosis in the era of effective therapy?

SETTING: All patients with tuberculosis as a primary or underlying cause of death who were autopsied at the Institute for Lung Diseases and Tuberculosis, Sremska Kamenica, in the former Yugoslavia, between 1981 and 1990 were investigated. OBJECTIVE: To study why people die of active tuberculosis in the era of effective chemotherapy and to identify factors contributing to death. DESIGN: In a retrospective investigation, this index group was compared with a control group consisting of patients who suffered from tuberculosis over the same period but who improved and were discharged from hospital. RESULTS: A significant difference in age (P < 0.05) was found between those patients who died with an antemortem-established diagnosis and those who died with unrecognised tuberculosis (median 49 and 60 years respectively). When it came to the index group, 28 patients (56%) had one or more risk factors and the frequency of alcohol abuse was significantly higher (P < 0.001). Antituberculosis treatment had been introduced in 27 cases (54%). The median duration of hospitalization before therapy was 2 days and the median duration of antituberculosis therapy was 7 days. Of the 23 untreated tuberculosis patients, 74% died within the first 4 days. CONCLUSION: Delay in the detection of tuberculosis was the main factor contributing to death in our patients.

Adult↗
PubMed1991

Epidural lead fracture caused by material processing fault.

Fracture of the epidural lead (Pisces Quad 3487) is documented in four out of eight patients with an implanted Itrel pacing system for treatment of peripheral vascular disease. In two patients, lead fracture was established during x-ray fluoroscopy. In the remaining two patients, x-ray examination did not reveal any fracture, due to proximity of the fragments. Microscopic examination of the extracted lead, however, confirmed lead fracture, as well as the presence of tissue fluid and thrombus between the two ends of the spiral shaped lead, but no insulation defect was observed. A cross-sectional area on the fracture line of the broken lead was examined using scanning electron microscopy. It was found, by tracing the radial marks to their point of convergence, that the initial microcrack started from a large inclusion of the calcium-silicon type at the lead surface. The initial microcrack was propagated by the fatigue mechanism. The presence of a large inclusion at the surface suggests that the main cause of the failure of the investigated epidural leads could be improper fabrication of the material. The high incidence of epidural lead fracture in our group suggests that this complication should be considered as a possible cause of epidural spinal electrical stimulation pacing system dysfunction.

Adult↗
PubMed1989

Circadian variations of heart rate and STIM-T interval: adaptation for nighttime pacing.

In order to determine the optimal pacing rate for pacemaker patients at night, 150 normal subjects with regular sinus rhythm and free of manifest heart disease, were studied using 24-hour Holter monitoring. Minimum and average heart rates were analyzed on an hourly basis. The study group was divided into six age groups, 25 subjects each, ranging from 20-29 years to 60-69 years. The minimum heart rate during the night was found to be lower than 65 ppm for all groups. The youngest subjects showed the largest variation in the minimum heart rate. The results suggest that an automatic lowering of the pacing rate during the night would allow for longer periods of sinus rhythm, thereby improving hemodynamic performance and reducing pacemaker power consumption. Suitable sensors for automatic lowering of the pacing rate include inbuilt 24-hour clock systems and the QT interval that lengthens during sleep.

Adult↗
PubMed1988

The validity of radiolabeled anti fibrin antibody for deep vein thrombosis imaging.

Having previously established the specificity of a newly developed radiolabeled polyclonal anti fibrin antibody (AFA) for tagging fibrin depositions, clinical experiments for validation of this agent for imaging deep vein thromboses (DVT) were carried out in comparison with labeled human serum albumin (HSA) and labeled platelets. Patients with DVT were studied with dual tracers on a computerized scintillation camera, four with simultaneous application of 131I-AFA and 99mTc-HSA, and eight with 131I-AFA and 111In-platelets. The results showed that: a) Labeled AFA predominantly delineated thrombi while labeled HSA prevailingly delineated blood pool within a particular vein. b) Labeled AFA was found to be superior in both ways to labeled platelets for DVT imaging, i.e. by imaging effect and by semiquantitative "thrombus:blood pool" (obtained in counts/pixel) ratio index (RI). Average RI with SD obtained with labeled AFA (9 patients) was 2.44 +/- 0.48 and 1.55 +/- 0.27 with labeled platelets (7 patients). The results indicate that a monoclonal AFA, if labeled with 99mTc, 111In or 123I, might have potential for an optimum agent for DVT imaging.

Adult↗
PubMed1988

Association between stimulated QT interval and ventricular rhythm disturbances: influence of autonomic nervous system.

To examine the association between ventricular rhythm disturbances and changes in the pacemaker-induced stimulated T interval (STIM-T interval), we compared findings from monitoring of two patient groups. The first group consisted of 15 patients with QTX microprocessor pacemakers and the second group consisted of 198 patients with documented ventricular rhythm disturbances and coronary artery disease (CAD). In the first group, which was free of ventricular rhythm disturbances and manifest coronary artery disease, the STIM-T interval was measured every 4 hours over a 36-hour period at four pacemaker frequency settings (70, 80, 90, and 100) in order to observe the circadian variation of the STIM-T interval as a function of changes in autonomic nervous system (ANS) tone. The second group was comprised of patients with CAD and over 30 VES/hrs (Lown grade classification 1-5), and taking no antiarrhythmic medication. These patients were followed using 24-hour Holter monitoring over a minimum of 23 hours and with less than 5% artifact/recording. Information regarding mean hourly heart rate, total number of VES, VES pairs, VT runs, and ischemic episodes in this group was compared with changes in the STIM-T interval in the first group. The STIM-T interval was found to be shorter during the day and longer at night at all heart rate settings. The total frequency of VES, of VES pairs, VT runs, and ischemic episodes in the second group varies in a similar circadian fashion. The greatest total number of VES, of VES pairs, VT runs, and ischemic episodes was recorded in the waking hours, at the same time when the STIM-T interval is the shortest, while this number was significantly lower during sleep, when the STIM-T interval of the first group is the longest. This coincidence of circadian variation pattern between STIM-T interval in group I, and ventricular arrhythmias and ischemic episodes in group II, suggests that alterations in ANS tone reflected in the STIM-T interval may be an important factor in the occurrence of these untoward events.

Adult↗
PubMedDate not supplied

Surgical treatment of penetrating ocular injuries with retained intraocular foreign bodies.

A total of 40 cases of retained intraocular foreign bodies (IOFB) presenting to the University Eye Clinic of Novi Sad between January 1988 and December 1994 were evaluated and surgically treated. The group most affected were males with a mean age of 33 years, who had been occupationally injured, presenting with either corneal or scleral single laceration. Thirty-seven injuries (92%) were due to metallic foreign bodies. Two eyes presented with initial clinical signs of endophthalmitis (5%). Five eyes (12.5%) were war-injuries, with tremendous destruction of all ocular structures. After an average of 12 months follow-up 70% of total eyes achieved postoperative good or useful vision, 50% of these with visual acuity 0.5 or better.

Adolescent↗
PubMedDate not supplied

Combined temporal phacoemulsification and pars plana vitrectomy for the treatment of cataract and giant retinal tear in a buphthalmic eye.

The standard approach to a three-port to pars plana vitrectomy is by placing the sclerotomies in the superotemporal and superonasal quadrant and the infusion port in the inferotemporal quadrant. This approach may be adjusted in selected cases that exhibit structural abnormalities of the globe at the superior site by placement of the sclerotomies in the temporal quadrants. We describe a case of a buphthalmic eye with a huge filtering bleb from previous glaucoma surgery that successfully underwent combined cataract and vitreoretinal surgery from a temporal approach for the repair of a giant retinal tear with cataract.

Cataract↗