Biomedical subjects

Z Duraković

Publications and source records attributed to Z Duraković.

At least 19 recordsLinked to original sources

PubMed1992

The preexcitation syndrome: epidemiological and genetic study.

A sample of 4210 subjects of both sexes aged 35-54 years was examined, chosen at random from six regions of Croatia. An electrocardiogram at rest was performed in all subjects and changes analyzed by the Minnesota code. A short P-R interval together with a widening QRS complex and a delta wave was found in 0.05%, while 42 (1.0%) of the examinees had a short P-R interval, but only 0.21% were symptomatic. Three years after the first examination 0.06% of the subjects had preexcitation with a delta wave, and in one subject it appeared after three years. 0.35% of the subjects had a short P-R interval after three years but only 0.18% were symptomatic and in 22 (0.65%) it had disappeared in three years. After 13 years these subjects did not appear for an examination, and the short P-R interval did not appear in any of other subjects during this period. There were more short P-R intervals: 3.22% in females and 1.96% in males, but 0.33% only were symptomatic. Antigens of the human leukocyte group A (HLA) system were analyzed in 46 patients: the Wolff-Parkinson-White syndrome was found in 35, while 11 had the Lown-Ganong-Levine syndrome. Antigens of the HLA-A, HLA-B and HLA-DR locuses were determined by the microlymphocytotoxicity method. The results of the frequency of HLA system antigens were compared to the results of the control group of a Croatian population consisting of 175 people. There was an increased frequency of HLA-A9 and HLA-B5 (P = 0.026 and 0.0092) in the investigated population as a whole. The participation of HLA-A3 antigen was significantly less among patients (P = 0.03), while HLA-B14 antigen was not found in patients with preexcitation. Within 10 HLA-DR locuses, HLA-DR7 antigen was rather more frequently present, although this was not statistically significant (P = 0.173).

Adult↗

PubMed1991

[Relation between helper and suppressive/cytotoxic T lymphocytes in the peripheral blood in patients with dilated cardiomyopathy].

In 32 patients with dilated cardiomyopathy the percentages of helper (CD4+) and suppressor (CD8+) T lymphocytes, as well as their ratio, have been analyzed. The percentage of CD8+ lymphocytes in the group with dilated cardiomyopathy was 20.62 +/- 8.27% (X +/- SD), vs. 26.38 +/- 6.19% in control group; the difference was not statistically significant. The percentages of CD4+ lymphocytes were similar in both groups, 39.55 +/- 12.86% vs. 40.52 +/- 6.59%. The CD4+/CD8+ ratio was markedly higher in the group with dilated cardiomyopathy, 2.49 +/- 2.10 vs. 1.65 +/- 0.49, but the difference was not statistically significant, probably because of great variability in the group. In the subgroup of 12 patients with possible alcoholic etiology of dilated cardiomyopathy, the values were almost identical to those of the remaining 20 patients. No correlation between echocardiographic fractional shortening of the left ventricle and any of the aforementioned values of T lymphocytes in the group of patients with dilated cardiomyopathy was found. The tendency toward decline in number of suppressor T lymphocytes is in accordance with the hypothesis that the "overreacting" inflammatory response to (viral) myocarditis might be the cause of dilated cardiomyopathy. However, the specificity of the decline of suppressor activity in respect to the other causes of heart failure is questionable and the analysis of its significance is complex. This is due to dynamic character of immune disorders, and a considerable number of other theories considering the etiology and pathogenesis of the disease also exist. The need to perform complex studies is anticipated, including continual observation of clinical, immunologic and bioptic parameters of the disease.

Adult↗

PubMed1990

[Ethylene glycol poisoning treated with hemodialysis].

The paper deals with the course of illness in a patient aged 56 years who had ingested accidentally an unknown amount of alcoholic drink followed by 150 ml of 95 percent solution of ethylene glycol. The patient was admitted to the intensive care unit 28 hours after the accident. The serum ethylene glycol concentration reached 14 mg/100 ml. The slow elimination of ethylene glycol during 28 hours before haemodialysis could be explained by the protective effect of ethanol which the patient had consumed before ethylene glycol. The method of extracorporeal haemodialysis was applied for four hours; the membrane surface was 1.3 m2 and blood velocity 200 ml/min. The rate of clearance of ethylene glycol and its metabolites was 110-150 ml/min. The total amount of ethylene glycol eliminated during four hours of haemodialysis came to about 5 g. Four hours from the beginning of the treatment the serum ethylene glycol concentration was not measurable. As the patient developed signs of acute renal failure the haemodialysis method was applied two more times. The patient was dismissed from hospital in good clinical condition, with normal diuresis and repaired renal function on the 13th day from admission.

Ethylene Glycol↗

PubMed1990

[Use of extracorporeal circulation in the treatment of 2,4-dichlorophenoxyacetic acid poisoning].

The paper presents the course of illness in four patients poisoned by the 2,4-dichlorophenoxyacetic acid. The first patient, 50 years old, attempted suicide by taking 400 ml of 40% solution of the 2,4-dichlorophenoxyacetic acid (2,4-D). He was hospitalized in a comatous state 6 hours after intoxication. He was treated by the extracorporal hemodialysis and the course of the illness was successfull. The second patient, 80 years old, drank up 100 ml of 40% solution of 2,4-D accidentally. He was admitted in a comatous state a few hours after intoxication. He was treated by hemodialysis and resin hemoperfusion (XAD-4) successfully. Before treatment, the serum 2,4-D concentration reached 177 mg/100 ml, with the 2,4-D clearance of 56.3 ml/min. The third patient, 24 years old, attempted suicide by taking 200 ml 40% solution of 2,4-D, but it remained questionable whether it was 2,4-D or paraquat intoxication. He was admitted to hospital 10 hours after intoxication. He was treated by hemodialysis and hemoperfusion methods (XAD-4) successfully. The serum 2,4-D concentration reached the amount of 122.5 mg/100 ml, and the clearance of 2,4-D was 85.4 ml/min. The fourth patient, 50 years old, drank 100-200 ml of 40% solution of 2,4-D accidentally. He was hospitalized in a comatous state 3 hours after intoxication. He was treated by the hemodialysis method successfully. The serum 2,4-D concentration before the treatment reached the amount of 37 mg/100 ml, and the clearance of 2,4-D was 96 ml/min.(ABSTRACT TRUNCATED AT 250 WORDS)

2,4-Dichlorophenoxyacetic Acid↗

PubMed1990

[Quantification of mitral regurgitation using Doppler echocardiography].

Examining 18 patients without regurgitation (control group) and 20 patients with mitral regurgitation the method of Doppler echokardiography, the pulsating and continual wave, was applied. Both groups consisted of patients with heart diseases in whom a heart catheterization was indicated for the evaluation of the actual state. Thus, the competence of the mitral orifice was also evaluated. The aim of the investigation was to quantify or more accurately estimate the degree of mitral regurgitation. The accuracy of the Doppler method was tested by means of the measured cardiac stroke volumes of the right heart side in both groups with the probability higher than 80% but lower than 90% (0.80 less than p 0.23 less than 0.90), and by testing the cardiac stroke volumes of the right heart and the diastolic volumes of the left heart (control group: mitral and pulmonal orifice) with the probability higher than 70% and lower than 80% with the error of 6% of the measured volume. The regurgitation mitral fraction (RF) was presented as the difference between the total forwards volume (TFV) in the mitral orifice and the net forwards volume (NFV) in the pulmonal orifice and calculated in cm3, and as the regurgitation fraction index (RFI) in percentages (RFI = 1--NFV/TFV). It was also expressed as the regurgitation volume index (RVI) whose values were divided into degrees, according to the literature data. Numerical values of the regurgitation fraction and the regurgitation fraction index were classified in the mitral insufficiency degrees from 1 to 4. A fast regurgitation screening was possible due to the regurgitation fraction index, which is lower than the 45% of the diastolic volume in the cases of mild mitral insufficiency, while the values over 45% denote severe mitral insufficiency. The obtained values of the regurgitation fraction and index divided into degrees showed a close correlation with the angioventriculographic degrees obtained by heart catheterization. Cardiac output measured by the Doppler and Fick methods in the group with regurgitation showed a high correlation coefficient (r = 0.85) (0.60 less than p 0.47 less than 0.70).

Echocardiography, Doppler↗

PubMed1990

[Evaluation of the effectiveness of streptokinase in acute myocardial infarct with respect to the pump function of the heart].

During 2 years and 3 months 230 patients suffering from acute myocardial infarction were treated at an Intensive Care Unit and a Department of Cardiology. Streptokinase was given intravenously to 54 of them. Out of 54 patients, in 52% the localisation of the myocardial infarction was in the anterior and in 48% in the posterior wall. The patients were divided in the three categories according to the onset of symptoms: up to 2 hours, 2-4 hours and 4-6 hours. The dose of streptokinase was 1,500,000 i.u. during 1.5 hours. The CPK and MBCPK level reached the maximum values up to 12 hours and was to lowest in the first group. In 74% of the patients the serum enzyme level showed successful reperfusion of a coronary artery. Electrocardiographic findings of a successful myocardial reperfusion amounted to 36% in the first, 40% in the second, and 17% in the third group. Malignant ventricular arrhythmias appeared in the first group in 3.6%, in the second in 12.5% and in the third group in 14.2%. The criteria for successful myocardial reperfusion by echocardiography (analysed regional wall motion) were present in 52% in the first, in 50% in the second, and in 17% in the third group. Coronarography and ventriculography were performed in 17 patients after 21 days of treatment, with successful results in 88% (15 out of 17 patients). In a group of 176 patients unable to be treated with streptokinase because of the onset of symptoms of myocardial infarction (more than 6 hours) or because of contraindications for that treatment, the lethality rate reached 17.6%. The lethality rate in the group of 54 patients treated with streptokinase was 5.5%. Local complication (hemorrhage) during the treatment was observed in one patient (2%).

Heart↗

PubMed1989

[Changes in the electrocardiogram in patients with coma due to poisoning].

The paper deals with changes in the electrocardiogram in a group of 20 patients in a comatose state due to intoxication. They were treated in an Intensive Care Unit. Special attention is directed to the corrected Q-T interval. The etiology of comatose states differed from ethanol, pesticides, antidepressives to anxiolytics, antiepileptics, sedatives, hypnotics, trichloroethylene and chlorpropamide. According to the criteria of Reed, nine patients were in a comatose state of the 0 or I degree, seven in a state of the II or III degree, and four in a state of the IV degree. The length of comatose states was between one hour and six days. Four of these patients died. According to ECG changes, in eleven patients sinus tachycardia, in two atrial fibrillation, and in seven a regular heart rhythm were diagnosed. The corrected Q-T interval was prolonged in fifteen out of 20 patients on the admission and reached the values of 0.664 seconds: it as also prolonged in two of the patients showing a normal range on the admission. In one of the patients malignant ventricular arrhythmia was observed.

Adolescent↗

PubMed1989

[Corrected Q-T interval in the electrocardiogram in patients with anorexia nervosa].

This paper examined the corrected Q-T interval in a group of 15 patients with anorexia nervosa and in 30 patients of a control group. Prolonged corrected Q-T interval was found in 2 of 15 patients with anorexia nervosa (13%) and in one of 30 patients of a control group (3%). The correlation between corrected Q-T interval and body mass index in patients with anorexia nervosa was not found (r = +0.13). Relative risk for prolonged corrected Q-T interval in patients with anorexia nervosa was high (4.5) compared with a control group. It is well known that prolonged corrected Q-T interval is connected with a high risk for sudden death because of a malignant ventricular arrhythmias.

Adolescent↗

PubMed1988