PubMed Health⌕ Search

Biomedical subjects

V Skatarić

Publications and source records attributed to V Skatarić.

At least 19 recordsLinked to original sources
PubMed1996

[Epidemiology of poststreptococcal glomerulonephritis in the military population].

Acute poststreptococcal glomerulonephritis appears often in children and our interest is the incidence of the disease in young adults (aged 18 to 22 years) especially in military people. In Nephrology Clinic of the Military Medical Academy (In the period from 1978 to the end of 1993) 153 patients were treated and sporadic cases developed after respiratory infection. Only 5 patients developed the disease after skin infection with Streptococcus B hemolyticus group A. A large number of patients acquired the disease in the period from February to April and from October to December and most of them in the time interval from 5 to 7 years. A substantial, number of patients were treated in 1982 (13), followed by 22 in 1989, and the trend continued in 1990 (24 patients) while only 6 patients presented in 1993. So, the incidence of the disease in the military population is not high (10 +/- 6 patients year and it was sporadic cases and more after respiratory infection.

Adolescent↗
PubMed1996

[Nephrotic proteinuria in poststreptococcal glomerulonephritis].

Nephrotic proteinuria in acute poststreptococcal glomerulonephritis is rare. In 62 patients aging from 18 to 22 years, proteinuria of > 3 g/24 hrs was found ins 5 (8%) patients, 0.3 to 3 g/24 hrs in 36 (58%) and 0.15 to 0.3 g/24 hrs in 21 (34%) patients. Proteinuria in many patients disappeared after 3 months and in later follow up it was found in about 30% of patients. Out of 5 patients with proteinuria of > 3 g/24 hrs 3 had persistent pathological urinary analysis, 2 patients were rebiopsied after 5 and 3 years from the disease onset, the morphological changes were moderate. In 2 patients after acute phase had been over came to the clinical healthy (with normal urinary analysis) lasting for 2 years and in the rebiopsy less marked pathological changes were described. Immunofluorescent analysis in the all patients were negative. Patients with initial nephrotic proteinuria in poststreptococcal glomerulonephritis have bad prognosis and often develop chronic disease.

Acute Disease↗
PubMedDate not supplied

[Pulsed doses of cyclophosphamide in the treatment of Wegener's granulomatosis].

The aim of the study was to analyze the efficacy and toxicity of the therapy with pulse dose of cyclophosphamide in patients with Wegener's granulomatosis. The diagnosis was established in three patients (2 male, 1 female, average age 58.3 years) upon the clinical picture, laboratory-immunologic and histopathologic findings. The initial therapy was conducted by pulse doses of cyclophosphamide (0.6 and 0.8 g/kg), glucocorticoids (0.5 g), repeated plasmapheresis and pulse doses of immunoglobulin (0.4 g/kg). All patients achieved remission with complete recovery of renal function in one patient. The therapy with pulse doses of cyclophosphamide (time-period between pulses from 1 to 3 months), together with glucocorticoids taken orally for 24 months, was continued for the following 18 months. Stable remission (4-15 months) was maintained in all the patients after the immunosuppressive therapy was over. The treatment of Wegener's granulomatosis by cyclophosphamide and glucocorticoid pulse doses with the application of plasmaphereses and immunoglobulin pulse doses in the initial therapy lead to the remission of progressive types of long duration.

Cyclophosphamide↗
PubMedDate not supplied

[Amyloid tumor in a patient on a regular hemodialysis program].

Amyloidosis is frequent complication in the patients subjected to hemodialysis, and is most frequently manifested in carpal tunnel syndrome, scapulohumeral periarthritis, osseous cysts and exceptionally as solitary tumor. A patient in presented, aged 72 years, who had undergone chronic dialysis for 10 years, in the last 4 years with symptoms and signs of amyloidosis, such as scapulohumeral periarthritis and erosive arthritis of the knee with recurrent effusions. A year ago he had noticed a tumor in the left popliteal cavity that had been progressively increasing and had limited the movements of the knee. After the extirpation, the diagnosis of amyloid tumor was confirmed by histopathologic analysis.

Aged↗
PubMedDate not supplied

[Complications of percutaneous transluminal renal angioplasty--case report].

Complications of percutaneous transluminal renal angioplasty (PTRA) most frequently occur on dilated artery, and rarely on peripheral punctured artery. In the study was presented 24-year old female patient in whom the painful tumor developed five days after PTRA at the spot of axillary artery punction. Tumor caused the lesion of brachial plexus by the compression, which was the reason for urgent surgery.

Adult↗
PubMedDate not supplied

[Treatment of chronic viral hepatitis B in secondary membranoproliferative glomerulonephritis using recombinant alfa-2 interferon].

A patient suffering from viral hepatitis B and secondary membranoproliferative glomerulonephritis was presented. He was treated with recombinant alfa-2 interferon. The therapy led to clinical and biochemical remission of the liver and kidney lesions. The example of our patient justifies the use of recombinant alfa-2 interferon in the patients with chronic viral hepatitis B and secondary glomerulonephritis.

Adult↗
PubMedDate not supplied

[Acute post-streptococcal glomerulonephritis in adults--corticosteroid therapy, yes or no?].

The aim of this study was to investigate the influence of the corticosteroid therapy on the development and prognosis of proststreptococcal glomerulonephritis (PSGN) in the period of five years. The investigation included a group of 54 patients who were in the acute phase of poststreptococcal glomerulonephritis (PSGN) when they were 18-22 years old. Corticosteroids were administered per os with the starting dose of 0.5 mg/kg bm, and the dose was subsequently decreased by 5 mg every 10 days to 20 mg/per day within 8 weeks of therapy. We have treated ten patients and all were with severe clinical manifestations of the disease (acute renal failure, oliguria, edemas, hypertension) and severe histopathologic (HP) finding of kidney tissue on the initial biopsy. On the basis of clinical parameters, HP changes on the repeated biopsy of the kidney and five years follow-up, we have concluded that the remission of the disease was achieved in patients who had received corticosteroid therapy. Clinical findings were confirmed by PH findings of repeated biopsies with less expressed residues of the disease. Corticosteroid therapy should be administered in adult patients who are in the acute phase of the disease, with clinical and HP severe form of PSGN, since the risk for the further progress of more serious sequelae of the disease is significantly decreased.

Acute Disease↗
PubMedDate not supplied

[Hypertension in patients with post-streptococcal glomerulonephritis].

Sixty two patients with poststreptococcal glomerulonephritis (PSGN), aged 18-22 (mean = 19 +/- 0.5 years) were examined and treated at the Clinic of Nephrology of the M.M.A. from the beginning of 1986 to the end of 1990. Hypertension (diastolic pressure over 13 kPa, that is, 97.5 mmHg) in the acute phase was found in 59 (95.16%) patients, being of milder degree and short-term course. Transient increase of blood pressure required sometimes a short therapy (with furosemide mainly). With normalization of the glomerular filtration rate, withdrawal of edema, and normalization of the plasma volume, the blood pressure has been also normalized in the majority of patients (within 3-5 days). Observing PSGN evolution in the period from 2 to 5 years, hypertension was found in 3 (6.8%) of 44 patients. All three patients had the clear clinical evolution (proteinuria and erythrocyturia) without signs of renal insufficiency. The rebiopsy of the kidneys showed milder morphologic changes which were more manifested compared to the group without hypertension. Hypertension was present in the majority of patients in acute phase of PSGN while it was rarely found during the evolution of the disease and its presence has been poor prognostic sign in evolution since it contributed to development of glomerulosclerosis and later on renal insufficiency.

Acute Disease↗
PubMedDate not supplied

[Acute renal insufficiency in poststreptococcal glomerulonephritis and its significance in evaluation of disease development in adults].

Importance of ARF occurring in the acute phase of PSGN in the disease evolution is still disputable because reported results are varying and even contradictory. Examination included 44 patients between 18 and 22 with the acute phase of PSGN. The serum creatinine levels over 124 mmol/l were found in 17 patients, while 27 of them were without ARF in the acute phase of the disease. The aim of the study was, after diagnosing APSGN, to form groups of patients according to the ARF presence and to examine its influence in the initial phase of PSGN on its evolution and prognosis. On the basis of clinical parameters, pH changes, renal rebiopsy and ARF associated with the type of evolution, severity of clinical presentation and pH changes it was shown that occurrence of ARF in the acute phase of PSGN was of no significant importance for clinical presentation of the disease, but it could have some influence on the degree of morphologic changes found by renal rebiopsy.

Acute Kidney Injury↗
PubMedDate not supplied

The correlation of clinical and laboratory parameters of the acute phase with the evolution of poststreptococcal glomerulonephritis in adults.

Prospective clinical study included the group of 44 patients who had the acute phase of poststreptococcal glomerulonephritis (PSGN) between the age of 18 and 22 during their military service. After the acute phase the patients were followed up to 5 years in order to investigate the influence of some clinical and laboratory parameters in the acute phase of PSGN on the evolution of this disease. The evolution of the disease, estimated on the basis of pathological findings in urine (proteinuria and erhytrocyturia), was found in 61% of patients. It was shown that severity of the clinical picture and the degree of proteinuria in the acute phase of PSGN were in direct correlation with the evolution of disease. On the other hand, the elevated concentrations of circulatory immune complexes (CIC) and cryoglobulin in the acute phase did not significantly affect the evolution of the disease although in some degree it contributed to the severity of pathological findings in the urine.

Acute Disease↗
PubMedDate not supplied

[Endemic nephropathy in the region of Bela Crkva in Banat].

The village of Kusić is situated 8 km southwestern of Bela Crkva, at the very border, separated from Romania by the river Nera. Due to frequent disease occurrence in the village Kusić, the pelustration of population was done in 1978 and 1989, and during the later follow-up, many patients were examined either in hospital or in outpatient clinics. The aim was to confirm a suspicion on the existence of the focus of endemic nephropathy in the village of Kusić. In 1978 and 1989 abnormal proteinuria was found in 17.7% and 16.7% examines from the village of Kusić, respectively-significantly higher than in surrounding villages: Grebenac, Vracev Gaj, Banatska Palanka and Kruscica (p < 0.01). Slow progression to the lasser degree of anemia was found in the patients with proteinuria, compared to the control group. Eight of 10 regularly dialyzed patients died, and in 4 patients urothelial carcinoma was diagnosed. In all of them nephroureterectomy was performed, and one patient with advanced disease died 6 months after surgery. On the basis of cited data, by their comparison and further prospective observation of the patients from the village of Kusić, it was concluded that the new focus of endemic nephropathy existed in southeastern Banat.

Adolescent↗
PubMedDate not supplied

[Posttraumatic acute renal insufficiency].

Acute renal insufficiency is a severe, but most frequent reversible illness followed by sudden onset, oliguria or anuria of indefinite duration, by rapid increase in decomposition products of protein catabolism in serum, by acidosis and fluid balance and electrolytes disorder. The aetiologic factors of acute renal insufficiency are various. A very significant aetiological factor in the appearance of acute renal insufficiency is a trauma caused by any kind or type of weapons, arms or instruments [1-5, 6, 9-13, 15]. Of a total number of injured persons who were treated in our institution (4,086 injured persons), 251 (6.14 percent) were with acute renal insufficiency, and of that number with all signs and symptoms of acute renal insufficiency 37 (0.9 percent) were treated with haemodialysis. Of the number of dialysed patients 30 (80 percent) patients had oliguric form of acute renal insufficiency and 7 (19 percent) were with non oliguric form of acute renal insufficiency. The most frequent injuries were to abdomen and then to extremities, liver, chest and kidneys. The smallest percentage concerned isolated injuries in extremities. According to a pathogenic mortality mechanism, the highest mortality was in patients with haemorrhagic syndrome and in septic condition, and the minimal in patients with other syndromes, such as crush syndrome, etc. In 25 (68 percent) patients acute renal insufficiency was associated with haemorrhagic syndrome, in 7 (18.9 percent) with crush syndrome and in 5 (13.5 percent) with septic condition. In 36 (97 percent) patients haemodialysis was performed and in 1 (3 percent) subject peritoneal dialysis. The reason for such a small number of peritoneal dialysis are severe injuries to abdomen and chest, since this type of dialysis could not be performed for technical reasons. In 27 (73 percent) patients haemodialysis was performed as a type of intermittent heparinization. In 5 (14 percent) patients heparinization was a type of continual heparinization. Thanks to prompt haemodialysis together with medical therapy and surgical treatment, the mortality rate in our patients was lower in comparison to mortality rate in other centres (Table 3). The main causes of acute renal insufficiency in our patients were: Acute tubular nercosis, peripheral blood flow insufficiency (hypovolaemia, cardiovascular failure), and postrenal insufficiency (excretory obstruction, intrarenal obstruction, urinary organ ruptures, haemorrhagic shock) and the underlaying kidney disease. Acute renal insufficiency can be divided into acute renal insufficiency, primary parenchymal renal insufficiency and postrenal azotaemia [1-6, 9, 12, 13]. During the therapy of these patients it is important to evaluate the dehydration degree of patients by clinical and laboratory parameters. In case of hypovolaemia the complete compensation of fluid should consist of infusion together with administration of diuretics. The central venous pressure should be maintained at the values in a range from 6 to 8 cm H2O. In case of oliguric acute renal insufficiency the fluid intake should be equal to diuresis plus every other loss of fluids. Diet should be high-caloric with carbohydrates in the amount of 100 mg, and that amount should be given three to four times daily (both parenterally and orally) together with restriction of potassium intake due to a well known effect of potassium on myocardium function. Dosage of drugs which are eliminated via kidney should be managed promptly by parenteral administration of antibiotic agents [7, 8, 13-16]. Haemodialysis should be started at the very beginning of the patients admission to the hospital and should be associated with anticoagulant therapy for avoiding haemorrhages. Thanks to haemodialysis performed in time, the mortality rate in our patients was reduced in comparison to health centres where haemodialysis was delayed. Thanks to such treatment of patients with many severe injuries in whom the mortality rate is usuall

Acute Kidney Injury↗
PubMedDate not supplied

[Characteristics of membranous glomerulonephritis].

The diagnosis of primary glomerulonephritis was made in 20 patients from January 1990 to December 1995. They were followed-up up to 5 years. Various therapeutic modalities were applied: 12 patients were treated with pronison per os, in 5 patients (42%) the disease remission was achieved, the other 5 (42%) patients had frequent recurrences of nephrotic syndrome, while 2 patients (16%) were with renal failure. In 7 patients at the beginning of treatment "pulse" methil prednisolone of 500 mg/48 h and 200 mg/48 h of cyclophosphamide was administered per os. Remission was achieved in 5 (71%) patients, and renal failure developed in 1 patient. Four patients, refractery to previous therapy, were treated with cyclosporin A and remission was achieved in 1 patient with proteinuria less than 2 g/d. The other patient had relapses of nephrotic syndrome, and renal failure has developed in the other two patients. Corticosteroids are drugs of choice in the treatment of lighter forms of MGN. In case of resistence to corticosteroid therapy or the progression of renal failure, cyclophosphamide should be included in the therapy, but in the patient refracte to this treatment, therapy with cyclosporin A should be attempted.

Adult↗