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V Jeremić

Publications and source records attributed to V Jeremić.

12 recordsLinked to original sources
PubMed2004

[Intrahepatic B3 cholangiojejunostomy in the palliative surgery of high unresectable malignant biliary obstruction].

Palliating the effects of biliary obstruction is a major goal of therapy in patients with unresectable cancer at the hepatic duct confluence. We reviewed our expirience with intrahepatic holangioenteric bypass to the segmental bile duct B3 as a palliative therapy in patients with unresectable malignant diseases involving the ductal confluence or the common hepatic duct. Since March 2001, we have performed intrahepatic segmental bile duct B3 cholangiojejunostomy by Roux-en-Y fashion utilizing a round ligament approach in 13 patients with malignant obstructive jaundice due to unresectable hilar holangiocarcinoma (8 cases) and gallbladder cancer (5 cases). Mean hospital stay was 123 days and mean blood loss was 25060 mL. Postoperative complications occurred in 3 patients (23%), but there was no surgical complications such as postoperative bleeding, bile leakage or abscess formation. 30-day mortality was 7.7% (1 patient). Late complications (37.5%) were observed in 3 of the 8 patients who survived for more than 5 months after the surgery. Median survival after B3 cholangiojejunostomy was 9 months (range, 10 days-22 months). Median survival time was significantly greater in patients with hilar cholangio-carcinoma (11.8 months; range: 2-22 months) compared with those with gallbladder cancer (4.6 months; range: 10 days-11.5 months) (P-0.032 log rank test; P-0.049 Tarone-Ware test). Intrahepatic B3 cholangiojejunostomy when combined with careful patient selection, can provide useful palliation from jaundice, pruritus and cholangitis with acceptable mortality and morbidity rates.

Aged↗
PubMed2002

[Second hemorrhage in patients with splenic injuries].

Although the diagnosis of spleen injuries is not a considerable clinical problem today, subsequent ruptures of this organ may occur in a smaller number of patients (2-5% of total proportion of spleen injuries) following the so-called "free interval". Such injuries are most commonly explained by present hematoma localized in the central spleen, which becomes larger in time, and eventually causes its rupture. This form of lesion may be found both in isolated blunt abdominal injuries and in associated injuries. When it is the question of delayed hemorrhage, our results as well as data obtained from foreign literature, suggest three basic rise factors of the etiology of this type of injury. These are as follows: a) spleen injuries in severe trauma or polytrauma, b) older patients (over 65 years of age), and c) in cases when more than a single blood unit had to be administered for the initial hemodynamic stabilization of a patient. Delayed hemorrhage, which is occult in polytraumatized patients since it is frequently "disguised" by severity of clinical picture and traumatic shock, may subsequently cause sudden fall of hemogram and hemodynamic parameter values, and if immediate surgery is not performed, it may lead to heavy bleeding and lethal outcome of the patient.

Adult↗
PubMed1989

[Surgical treatment of polytrauma].

This report is based on the review of 230 victims of multiple injuries, treated during 8 months period. There were 156 casualties with dominant Chest and Abdominal injuries. In the immediate treatment of these patients we applied modification of an original scheme by Schweiberer. We also introduced our own procedure of life-saving measures of high priorities. In evaluation of the most accident victims governed by priority of the severity of the multiple injuries, a complete, orderly examination by X-ray, Ultrasonic and CT scanning was undertaken.

Humans↗
PubMed1976

New pathway of conversion of pyridoxal to 4-pyridoxic acid.

The only enzyme demonstrated so far to catalyze the formation of 4-pyridoxic acid, the final excretory product of vitamin B6, was aldehyde oxidase. In this paper we have presented an evidence that another enzyme, NAD+-dependent aldehyde dehydrogenase, is capable of catalyzing this reaction. Rat mutants with high, low and no aldehyde oxidase activity excrete the same amount of isotope after a single injection of 3H-pyridoxol in a 12-day experiment; 4-pyridoxic acid is also present in the urine of animals without aldehyde oxidase activity. There is no correlation between the proportion of the excreted acid and the amount of pyridoxal excreted, after the injection of a single dose of the aldehyde form. The Km values for pyridoxal and NAD+, at pH 9.6, have been found to be 75 and 260 mumol/l, respectively. NAD+-dependent pyridoxal dehydrogenase was partially purified from the rat tissues, and the following specific enzyme activities (nmol-min-1-mg-1 protein) were found: red blood cell 71.5 +/- 3.0, intestine 64.9 +/- 9.0, muscle 61.4 +/- 1.6, brain 39.5 +/- 6.0, liver 34.4 +/- 3.3, kidney 21.1 +/- 5.6, heart 18.8 +/- 0.9, and lung 6.5 +/- 2.0. This is believed to be the first report demonstrating pyridoxal oxidation, catalyzed by an NAD+-dependent aldehyde dehydrogenase.

Aldehyde Oxidoreductases↗
PubMed1976

An improved UV-spectrophotometric method for routine barbiturate monitoring.

A simple, rapid, quantitative, low-cost UV-differential spectrophotometric method for the routine monitoring of phenobarbital in serum and cerebrospinal fluid is described. This method can also be used for monitoring methylphenobarbital (Phemiton) and primidone (Mysoline), since the major active metabolite of both drugs is phenobarbital. The basis for our procedure is Goldbaum's method (Anal. Chem., 24, 1604 (1952)). This method was improved with several modifications including a single extraction technique with dichloroethane, which has produced a very simple but still accurate method. The whole analysis takes less than 20 minutes. This procedure is accurate in the range from 1-100 mg/1 of phenobarbital in serum or cerebrospinal fluid.

Humans↗
PubMedDate not supplied

[Health care cooperatives. The role and contributions of this movement in the protection and improvement of the national health status from 1921 to 1949].

After the First World War in the devastated and destroyed country, besides hard economic problems, also many social and sanitary problems required appropriate solutions. Loss of a great number of physicians and other sanitary personnel during the war was badly reflected on health care of the population, especially in rural areas. In these conditions and on suggestions made by a young physician, dr. Gavrilo Kojitsh (Gavrilo Kojić), many health cooperatives were established. Funds were secured by membership fees payed by the members to the so-called patients' funds. These financial resources were intended for covering of expenses in case of illness or death of a cooperative member or a member of his family. Monthly payment depended on the number of family members and degree of health insurance. A cooperative was composed of 300-500 families. The first health cooperatives were established in 1921 and up to 1939 there were 87 cooperatives with 97 physicians and 71 pharmacists. The price of a doctor's consultation was 3-4 times smaller than that in a private doctor's office, and prices of medications and drugs were reduced. In addition to curative treatment, the outpatient service of these cooperatives included maternal and infant care centres with visiting nursing service, sections for fight against infectious disease (vaccination), especially tuberculosis, education, rebuilding of villages, better water-supply, etc. In 1949 these health cooperatives were integrated into the new system of public health services.

Delivery of Health Care↗
PubMedDate not supplied

[Hyperfractionated radiotherapy and adjuvant chemotherapy in patients with malignant gliomas].

INTRODUCTION: Malignant gliomas are the most common primary brain tumours in adults. Postoperative radiation therapy significantly improves survival when compared to surgery alone. It is occasionally followed by the adjuvant chemotherapy (CHT). Since this approach carries a significant hazard of local recurrence, new approaches have been tested in order to improve survival figures, hyperfractionated radiation therapy (HFX RT) and recent multiagent CHT. MATERIAL AND METHODS: Fourty eight adult patients with malignant glioma were treated with HFX RT to a total TD of 72 Gy in 60 fractions in 30 treatment days, 1.2 Gy b.i.d. fractions with an interfraction interval of 4.5-6.0 hr. Four weeks after HFX RT, CHT was introduced consisting of BCNU, Vincristine, Procarbazine, and Cisplatin. Six cycles were planned to be administered but CHT was stopped because of tumour progression. Toxicity criteria were made on the basis of joint RTOG/EORTC toxicity criteria. RESULTS: Median survival time in all 48 patients was 52 weeks, and 1-3 year survival time was 48%, 29%, and 29%, respectively. Median progression-free survival was 30.5 weeks. Patients with AA achieved better results than those with GBM, regarding the overall survival and progression-free survival (p = 0.0000). The univariate analysis revealed that the age, performance status, and extent of surgery were important prognostic factors influencing the overall survival and progression-free survival, as well as tumour location and interfraction interval. The multivariate analysis revealed that the performance status, tumour location, and interfraction interval were independent prognostic factors in patients with GBM. Toxicity of this treatment approach was generally considered as mild, with no late toxicity attributed to HFX RT. CHT-related toxicity was mostly haematological. DISCUSSION: The results of this study are in agreement with those using standard and various altered fractionated regimens in malignant glioma. They add evidence that this combined approach is feasible and well tolerated by the patients. Although there is some controversy about dose-escalation in HFX studies in the past, the studies reporting no significant improvement in survival for HFX RT were probably due to somewhat lower total doses used in them. Since this approach contributed to a 3-year survival of 83%, and 3-year progression-free survival of 70% in AA patients (all treated with 4.5 hr interfraction interval), they could serve as a basis for further studies measuring late effects as an endpoint, since there are data showing that aggressive treatment might be hazardous in patients with AA.

Antineoplastic Combined Chemotherapy Protocols↗