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Biomedical subjects

S Vuckov

Publications and source records attributed to S Vuckov.

10 recordsLinked to original sources
PubMed2002

Transformation of health services from civilian to wartime medical corps--example from Bosnia and Herzegovina.

In the multiethnic Bosnia and Herzegovina, Croats and Muslims, attacked by the Yugoslav army and Serbs, had to employ rationally their poorly provisioned civilian health services so that they could respond to the extremely numerous and prompt needs of war conditions. The health services in the areas controlled by Croats and Muslims had to be reorganized twice because of sudden changes of wartime conditions. With further development of the situation, when all three sides participated in the conflict, the number of wounded increased rapidly. In the meantime, a large-scale population shift on an ethnic basis occurred in all parts of Bosnia and Herzegovina, thus giving rise, along with a greater number of the wounded, to a severe humanitarian crisis. Civilians were therefore another heavy burden to the wartime health services. This created enormous problems for the inadequately provisioned health services of Bosnia and Herzegovina in the area under the control of Croats and Muslims. However, poorly equipped with personnel as well as everything else, the health services in the area controlled by Croats and Muslims, through appropriate reorganization, successfully accomplished their task in the wartime medical corps. Besides this correctly executed transformation from civilian health services into a wartime medical corps, high motivation of medical staff also greatly contributed to successful operation of the medical corps in the war zone despite the long duration of the war. In the majority of cases, the wounded were within 30-40 minutes from the moment of injury in the hands of a surgical team and within the next ten minutes were already in the operating theater. After primary wound dressing, the wounded were sent to one of the well-organized main war hospitals for further treatment. This resulted, along with secure evacuation routes, in a minimum number of lifelong invalidity among the wounded.

Bosnia and Herzegovina↗
PubMed2001

Treatment of supracondylar humerus fractures in children: minimal possible duration of immobilization.

In the period from January 1980 until December 1990 we treated 147 children and adolescents with supracondylar humerus fracture, and followed the outcome in 127 of them. Three (2.4%) patients had no displacement of fractured bones and were treated only with plaster cast immobilization. Twenty three (18.1%) underwent closed reduction of fragments and application of a plaster cast. The majority (97; 76.4%) required manual reduction and the fixation of segments with Kirschner's wires laterally and medially. Four (3.1%) patients were treated with open reduction and fixation with Kirschner's wires. Both plaster cast immobilization and fragment fixation with Kirschner's wires lasted only 14 days and were immediately followed by rehabilitation. Such a short immobilization of extremities or fixation offragments did not result in any complication. Of 56 children available for long-term follow-up, we achieved excellent treatment results in 43 (76.6%) of the patients, good and fair in 12 (21.5%), and a poor result in only 1 patient (1.8%). There were no permanent vascular or neurological complications apart from slight weakness of the ulnar nerve in 3 patients. In conclusion 14 days seemed to be the biological minimum of time needed for this type offracture to heal in children and adolescents. Fixation of the fragments with Kirschner's wires and immobilization of the extremity for only 14 days brings a significant reduction of total treatment expenses, avoids repeated x-ray examination, facilitates early physical therapy and returns the child to its family.

Adolescent↗
PubMed1999

Our experience in the treatment of the vesico-ureteral reflux with Lich-Gregoir antireflux surgical procedure.

In the period between January 1980 and December 1990 we had applied the operative Lich-Gregoir antireflux method on 166 patients, all of whom were children and adolescents, and performed 275 antireflux surgical procedures. The application of the above mentioned method on our patients yielded a success of 97.8%. There have been no intraoperative complications which would affect the ultimate successful result of this antireflux operative method. However, early postoperative complications occurred in two of our patients, causing infection of the wound, which resulted in further ureter stenoses. Recurrent reflux occurred in 4 (2.2%) and the stenoses also in other 4 (2.2%) operated ureters. The follow-up lasted from 4 up to 14 years. We added our personal detail to the original Lich-Gregoir antireflux method considering it to be a further improvement in achieving better results. We fixed the ureter to the detrusor with additional stitches in the newly formed hiatus, i.e. at the exit of the ureter out of the new submucous canal. The possibility of arousing postoperative paraostial diverticula is thus avoided, enabling us, at the same time, to enhance the newly formed ureteral hiatus in the detrusor. In this way the possibility of postoperative ureter stenoses is reduced. According to our experience the above mentioned antireflux method does not give good postoperative results in patients with greatly dilated and aperistaltic ureter (megacystis-megaureter type), while all other examples show a high percentage of postoperative success.

Adolescent↗
PubMed1999

Cancer incidence in eastern Adriatic isolates, Croatia: examples from the islands of Krk, Cres, Losinj, Rab and Pag.

As an extension of previous research this study investigates the incidence of cancer in five genetic isolate island populations of the Eastern Adriatic, Croatia. Thorough anthropological research over the past three decades has established some of those populations as outstanding examples of genetic isolates. A previous study which found higher cancer incidence in 5 Eastern Adriatic islands than in a control population supported a hypothesis that among the founders of these populations there were genetic variants (especially with recessive inheritance) responsible for genetic susceptibility to certain types of cancer. This study sought to investigate cancer incidence in 5 further island populations. All cancer cases in five island populations (Krk, Cres, Losinj, Rab and Pag) over the 20-year period (1971 to 1990) was extracted from the data of the Croatian Cancer Registry. The mainland populations of Istrian and Primorsko-Goranska County, characterized by similar environmental factors but an outbred genetic structure, represented a control population. After standardization by by sex and age, cancer incidence was higher in the island populations than in the control population in both sexes. The cancer sites primarily responsible for the excess incidence were prostate, stomach and pancreatic cancer in males, and ovarian, breast, stomach, bowel, and brain cancer in females. The reasons for the increased cancer incidence are uncertain and may be due to different environmental exposure between the two populations. However, it is possible that genetic isolation and inbreeding are important factors. Further investigations of cancer in these isolate populations are warranted to explore these findings further.

Adult↗
PubMed1998

Organization and activity of the health service in the Croatian province of Lika in the first year of the war.

The aim of this report is to present the various aspects of the reorganization of the health service in the Croatian province of Lika during the first year, 1991-1992, of the war in Croatia. In the former Socialist Republic of Yugoslavia, the health service was completely in the hands of the state, and Croatia was not able to transform it in the first year of its independence. The paper documents the personnel, supplies, and equipment that the health service of Lika had at its disposal in the first year of the war, the division of the health service into the stationary and front-line medical corps, and the evacuation protocols developed to transfer surgical patients to the rear-area hospital. The response of the health service allowed for rapid and successful patient treatment, emphasized by the fact that the usual time elapsed between wounding and delivery of the patient to the operating table was less than 30 minutes. All surgeries, with the exception of those involving severe craniocerebral injuries, were performed in the war hospitals of Lika. After stabilization of their postoperative condition, generally within 30 minutes, patients were evacuated to the rear-area hospital in Rijeka, with artificial respiration. The distance by road from the war hospitals in Otocac and Gospić to the reararea hospital in Rijeka was 120 and 170 km, respectively. Collectively, the results of our work demonstrate that a nonmilitary health service can be transformed successfully and efficiently into a war medical service. Yet, we believe that this is possible only under the extreme conditions of a defensive war.

Croatia↗
PubMed1997

[Relation between successful treatment of urinary tract inflammation and the disappearance of changes in the bladder mucosa in children and adolescents with cystoscopically proven cystitis cystica].

Bladder epithelium nodular changes called cystitis cystica are commonly found in children and adolescents suffering from long-term lower urinary tract infection. Recurrent urinary infection was found in pediatric patients with urinary tract abnormalities as well as in others without it with nearly the same frequency. The authors studied 63 pediatric patients with recurrent urinary tract infection and cystitis cystica of which 59 (94%) were females. The age of the examined patients varied from 1 to 16 years, mean 7.35 years. Thirty five of them (55.5%) had diverse anomalies of the urinary tract. Vesicoureteric reflux was demonstrated on the cystogram in 41.1% patients. Escherichia coli was found to be the major pathogenic organism in the urine. Thirty eight (60.3%) children and adolescents were treated medically for months (two years mostly) by reason of prolonged recurrent urinary tract infection before nodular changes of the bladder mucosa at cystoscopy were detected. Even thirteen (39.7%) of all studied patients were treated medically more than five years. In the present study only 47 (74.6%) of the observed patients have had an adequate follow-up and might be considered. In these cases repeated cystoscopy was performed and the successively sterile urine cultures were obtained. Twenty-one (44.3%) patients were medically treated up to one year before the urinary tract infection was eradicated and nodular mucosal changes disappeared. In 6 (12.8%) patients more than five years were needed to achieve this result.

Adolescent↗
PubMedDate not supplied

[Does the Lich-Gregoir antireflux procedure belong to the past?].

The Lich-Gregoir antireflux surgical procedure was applicable in 166 children and adolescents with primary vesicoureteric reflux of all grades. In these patients we have done 275 antireflux plastics and reflux was cured in 97.8% operated ureters. This procedure is not applicable in patients with grossly dilated ureters on the excretory urogram, but gives highgrade success in all others cases. The operation is extravesical, with minimal risk of damaging urinary structures and adjacent tissue, and is simple to perform. The patients recover quickly and easily. This practical and safe antireflux operative method has been unduly neglected and it has its place in the future.

Adolescent↗
PubMedDate not supplied

[Therapeutic dilemmas in children with esophageal achalasia].

Two patients with oesophageal achalasia are presented. The first patient, a 22-month-old girl, had medical, endoscopic and surgical treatment. The effectiveness of drug therapy with nifedipine was good but short in duration. Endoscopic bougienage dilatation has not been definitely successful. Operative treatment, two years after the first symptoms, permanently resolved the problem of spastic lower oesophageal sphincter. The second girl, 13.5 years old, responded very well to nifedipine therapy during hospitalisation. Because of inadequate drug usage, oesophageal myotomy was performed relatively soon. In follow-up both girls were in good health condition. The treatment of oesophageal achalasia in children is still controversial. Therapeutic approach and decision on the treatment strategy depend primarily on patient's age, duration and severity of clinical signs and symptoms Etiology, pathogenesis, and possibilities of achalasia treatment are discussed.

Adolescent↗