Biomedical subjects

Zdenko Sonicki

Publications and source records attributed to Zdenko Sonicki.

15 recordsLinked to original sources

PubMed2006

Preoperative serum levels of c-erbB-2 do not seem to be useful in management of patients with rectal cancer.

BACKGROUND AND AIM: Soluble c-erbB-2 oncoprotein has been proven as a useful marker in the management of breast cancer patients, but its value in diagnostics and follow-up of colorectal cancer patients remains controversial. The aim of this study was to evaluate the usefulness of serum c-erbB-2 monitoring in diagnostics and prediction of disease outcome in rectal cancer patients. MATERIALS AND METHODS: Serum samples from 88 patients with rectal adenocarcinoma before surgery and from 41 healthy controls were tested for the presence of c-erbB-2 oncoprotein by ELISA, and the patients were followed up for at least 5 years after the surgery. RESULTS: Preoperative serum c-erbB-2 levels were significantly higher in stage IV patients than in healthy controls (P<0.001) and did not show correlation with preoperative CEA levels. Elevated preoperative serum c-erbB-2 levels showed relatively high specificity (88%) and low sensitivity (44%) in the diagnosis of rectal cancer. Elevated preoperative oncoprotein levels were predictive neither for overall survival nor for development of local recurrence/distant metastases. CONCLUSION: Although preoperative serum c-erbB-2 levels were significantly higher in rectal cancer patients than in healthy controls, the soluble c-erbB-2 does not seem to be useful in the diagnosis of rectal cancer due to its low sensitivity. Preoperative serum levels of this oncoprotein were predictive neither for overall survival nor for local recurrence/distant metastases in rectal cancer patients.

Adenocarcinoma↗

PubMed2006

The effect of propofol and fentanyl as compared with sevoflurane on postoperative vomiting in children after adenotonsillectomy.

Postoperative vomiting (PV) after adenotonsillectomy in children is a common problem with an incidence as high as 40-80%. Only few studies in the recent literature compared the effect of different anesthetic techniques concerning PV in children. The aim of this study was to compare the incidence of PV in two groups of children who underwent two different general anesthesia techniques in order to determine what type of anesthetic technique is more related to less PV. The clinical trial included 50 children (physical status ASA I, 3-12 years old) divided into 2 groups and monitored for PV 24 hours following the surgery. Group one (G1) consisted of 25 children who underwent general anesthesia with gas mixture 60% nitrous oxide and 40% oxygen and anesthetic propofol, opioid fentanyl and muscle relaxant vecuronium intravenously and group two (G2) included 25 children to whom volatile anesthesia with sevoflurane in the same gas mixture was given. Demographic characteristics (gender, age, weight, history of motion sickness and earlier PV) as well as surgical data (length of surgery and anesthesia, intraoperative blood loss) were recorded. There were no significant differences considering demographic characteristics and surgical data between the investigated groups. The incidence of PV was relatively low 3 children (12%) in G1 group and 5 children (20%) in G2 group. Statistically there was no significant difference between the groups regarding the incidence of PV and both anesthetic techniques can be used equally safe regarded to PV.

Adenoidectomy↗

PubMed2005

Long-term treatment with vaginal estradiol tablets--an impact on uterine artery blood flow.

OBJECTIVE: We investigated, using color Doppler ultrasound, possible detectable blood changes of prolonged treatment with 17-beta-estradiol tablets on uterine artery blood flow, in a cohort of low risk postmenopausal women. METHODS: 39 postmenopausal women, who were taking local estrogen therapy for at least 6 months, were examined in the study group. Forty-two women who never used hormone replacement therapy consisted a control group. They were examined with color Doppler ultrasound and the pulsatility index of the uterine artery was measured. The groups were divided into three subgroups (the age, the duration of the postmenopause, and the duration of the treatment) and the data were compared among groups and within subgroups. RESULTS: The overall mean age of the patients was 66 years, the mean duration of the postmenopause was 15 years, the overall mean PI was 1.96 +/- 0.90, and the mean duration of taking vaginal estradiol tablets was 1.97 years for the study group; and 64 years, 13 years and 2.88 +/- 0.96 for the control group, respectively. There was a difference in the mean PI among groups. No significant differences in pulsatility index values in the subgroups were found. CONCLUSION: Long-term treatments with vaginal estradiol tablets in low risk women causes lowering of the uterine artery PI values compared to the women who are not receiving hormone replacement therapy.

Administration, Intravaginal↗

PubMed2005

Early detection of left ventricular diastolic dysfunction in hypertensive heart disease by color Doppler myocardial imaging.

AIM: To determine if Color Doppler myocardial imaging could provide evidence of diastolic dysfunction in patients with hypertension whose pulse-wave Doppler parameters were normal. METHOD: The study included 33 patients (mean age 48+/-7.3 years) and a control group of 13 sex- and age-matched healthy individuals. Patients were divided into two groups according to mean blood pressure (BP) values during 24-hour blood pressure monitoring while under antihypertensive therapy: those with uncontrolled hypertension (n=22) and those with controlled hypertension (n=11). All study participants underwent complete standard echocardiography (2D, M-mode, pulsed and continuous Doppler) and a Color Doppler myocardial imaging study. RESULTS: Conventional Doppler parameters indicated relaxation disturbances in patients with uncontrolled hypertension, but were within a normal range in patients with controlled hypertension at baseline and follow-up. Parameters of global diastolic function measured by Color Doppler myocardial imaging revealed that E'/A', the ratio between E'-wave (early filling phase) and A'-wave (late diastolic wave due to atrial contraction), was <1 in 57% of segments at baseline in patients with uncontrolled hypertension, and did not significantly change at follow-up. In patients with controlled hypertension, E'/A'<1 was noted in 4.7% of segments at baseline and in 28.6% of segments at follow-up. CONCLUSION: Regional diastolic dysfunction measured by Color Doppler myocardial imaging was the first sign of myocardial dysfunction due to arterial hypertension, while the parameters of global diastolic dysfunction measured by conventional Doppler and Color Doppler myocardial imaging were still normal. Furthermore, in patients with uncontrolled hypertension with manifested global diastolic dysfunction, there was a change in late diastolic parameters. Our results point to a potentially important role of Color Doppler myocardial imaging in diagnosing hypertensive heart disease as well as in follow-up of treatment.

Adult↗

PubMed2005

Levosimendan as a new strategy during off-pump coronary artery bypass grafting: double-blind randomized placebo-controlled trial.

AIM: To determine if levosimendan could improve cardiac performance during off-pump coronary artery bypass grafting in patients with normal preoperative left ventricular function. METHODS: Twenty-four patients included in this double-blind randomized controlled trial received either placebo (n=12) or 12 microg/kg loading dose of levosimendan (n=12) during a period of 15 minutes before the surgery. The heart rate, cardiac index, stroke volume index, and left ventricular ejection fraction were measured before and 10 and 60 minutes after the drug administration. RESULTS: The baseline measurements of hemodynamic parameters did not differ between the groups. Heart rate was not significantly different between the placebo and levosimendan group. Compared with placebo group, cardiac index and left ventricular ejection fraction were significantly higher 10 and 60 minutes (p=0.018 for all) after administration of levosimendan. After 60 minutes, the cardiac index increased from the baseline value of 2.18 to 2.84 L/min/m2. Left ventricular ejection fraction increased by 14% after 10 minutes, and by 10% after 60 minutes. Stroke volume index was significantly higher at 10 minutes (p=0.018), but not at 60 minutes (p=0.063) after the administration of levosimendan. CONCLUSION: Administration of 12 microg/kg of levosimendan enhances the left ventricular performance and offers a promising therapeutic option during off-pump coronary artery bypass grafting in patients with good preoperative left ventricular function.

Aged↗

PubMed2004

Gluten-free diet has a beneficial effect on chromosome instability in lymphocytes of children with coeliac disease.

OBJECTIVES: Children with coeliac disease (CD) have an increased number of chromosome aberrations in peripheral blood lymphocytes. Whether genetically determined or a secondary phenomenon in CD, chromosome abnormalities may be involved in the predisposition to cancer in CD patients. The aim of the study was to follow a group of children with CD in whom the initial frequency of chromosome aberrations at diagnosis was known and to measure the same variable after a minimum of 2 years on a gluten-free diet. METHODS: Chromosome aberrations in peripheral blood lymphocytes were determined in 17 patients with CD, before and after at least 24 months of a gluten free diet (mean, 33 months), and in 15 healthy children. The differences in the frequency of aberrations were analyzed by Mann-Whitney U test and Wilcoxon matched-pairs signed-ranks test. RESULTS: Twelve patients adhered to the diet and had a significantly lower frequency of chromosome aberrations than did 5 patients not following the diet (0.16% v 1.2%; P = 0.03), whereas at presentation there had been no difference (1.54% v 1.2%; P = 0.09). The frequency of aberrations at follow-up in patients who were diet adherent was significantly lower than at presentation (1.54% v 0.16%; P = 0.02) and remained unchanged in patients who were not diet adherent (1.2% v 1.2%; P = 1). After at least 24 months of a gluten-free diet, children with CD did not differ from healthy control subjects (0.16% v 0.27%; P = 0.54), whereas children not following the diet had an increased frequency of aberrations (1.2% v 0.27%; P = 0.05). CONCLUSIONS: The frequency of chromosome aberrations in peripheral blood lymphocytes of patients with CD decreased significantly on a gluten-free diet. We conclude that genomic instability is a secondary phenomenon, possibly caused by chronic intestinal inflammation.

Adolescent↗

PubMed2004

Levosimendan in off-pump coronary artery bypass: a four-times masked controlled study.

We tested the hypothesis that levosimendan produced beneficial hemodynamic effects during and after off-pump coronary artery bypass grafting in patients with good preoperative left ventricular function. Levosimendan at low dose (12 microg/kg), high dose (24 microg/kg), or placebo were administered in thirty-one patients in a randomized and four-times masked controlled study. Heart rate was not significantly different between experimental groups. Significant increases in cardiac output and left ventricular ejection fraction occurred after high-dose (P < 0.001; P = 0.006) and low-dose levosimendan (P = 0.001; P = 0.002). Both doses of levosimendan produced significant increased stroke volume and decreased systemic vascular resistance. Mean arterial pressure, pulmonary capillary wedge pressure, and left ventricular end-systolic volume were not significantly different between groups. The low-dose levosimendan produced better hemodynamic response than high-dose and may be preferable in patients undergoing off-pump coronary artery bypass grafting.

Anesthesia↗

PubMed2004

Atherosclerosis of retinal arteries in men: role of serum lipoproteins and apoproteins.

AIM: To explore the relationship between retinal vessel atherosclerosis and serum concentrations of total cholesterol, triglycerides, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, HDL(2) cholesterol, HDL(3) cholesterol, apoprotein B, apoprotein A-I, and apoprotein A-II. METHODS: Lipids and lipoproteins were measured in 101 male patients aged between 26 and 69 years (median, 48 years), and the degree of their retinal vessels atherosclerosis (stage 1-4 according to Scheie) was determined. Diabetics, alcoholics, hypertensive, extremely obese patients, and patients with thyroid, liver, or kidney diseases were excluded from the analysis. The results were compared with those in 47 apparently healthy men aged between 22 and 65 years (median, 47 years) with no retinal vessel changes. Direct ophthalmoscopy for the fundus examination was carried out by a single ophthalmologist unaware of the patients' group. RESULTS: Retinal vessel atherosclerosis strongly correlated with total serum cholesterol, LDL cholesterol, triglycerides, and apoprotein B concentrations. The higher these lipid and apoprotein values, the more advanced the stage of the disease. No significant association between HDL cholesterol as well as HDL(2) and HDL(3) cholesterol and atherosclerosis of retinal arteries could be proved but an inverse association, although a very weak one, between the low serum concentration of HDL cholesterol and the stage of the retinal artery atherosclerosis was found. CONCLUSION: Changes in lipoproteins and apoproteins associated with atherosclerosis of the retinal arteries correspond well to those associated with coronary artery atherosclerosis.

Adult↗

PubMed2004

5, 10-Methylenetetrahydrofolate reductase (MTHFR) 677 C --> T genetic polymorphism in 228 Croatian volunteers.

5, 10-Methylenetetrahydrofolate Reductase (MTHFR) is one of the key enzymes in the metabolism of homocysteine, where it catalyses its remethylation. The autosomal recessive bp 677 C --> T mutation in the MTHFR gene leads to the substitution of valine for alanine. Individuals who are homozygous for this C677T mutation exhibit a decreased specific activity and increased thermolability of this enzyme. This leads to increased plasma levels of homocysteine, which is a known risk factor for atherosclerosis and various manifestations of the atherosclerotic disease. The aim of this study was to find out the distribution and frequency of this mutation in the general Croatian population. A group of 228 volunteers (175 males and 53 females) has been analyzed for the MTHFR polymorphism, which revealed the following distribution: 105 (46.05%) individuals were without mutation (C/C), 102 (44.74%) were heterozygous (C/T) and 21 (9.21%) homozygous (T/T). These findings are within the results of studies on other European populations.

5,10-Methylenetetrahydrofolate Reductase (FADH2)↗

PubMed2003

Youth and AIDS--a study of attitudes, knowledge, behavior and risks in the post-war Croatia.

According to the latest reports, the Eastern Europe currently exhibits the greatest relative increase in the number of newly registered HIV infections in the world. At the same time, Central Europe remains relatively spared from the epidemic, with reported rates significantly lower than those in both Eastern and Western Europe. Croatia geographically affiliates to Central Europe, but it has two specific potential risk factors in comparison to neighboring countries: recent War events and a summer season when immigration of large number of tourists from Central and Eastern Europe is expected. Therefore, it is critical to examine AIDS attitudes in young people, increase their knowledge, monitor their behavior and warn on risks in order to prevent larger spread of epidemics from Eastern Europe to Croatia. In this study, we report on a large related survey and education program among 17-year-old high school pupils that was conducted in years immediately following the War (1996-1999).

Acquired Immunodeficiency Syndrome↗

PubMed2003

Center for Disease Control (CDC) flow cytometry panel for human immunodeficiency virus infection allows recognition of infectious mononucleosis caused by Epstein-Barr virus or cytomegalovirus.

AIM: To analyze the distribution of lymphocyte subsets in the peripheral blood of patients with infectious mononucleosis caused by Epstein-Barr virus (EBV) and cytomegalovirus (CMV) and to investigate the possible diagnostic usefulness of flow cytometry panel recommended by the Center for Disease Control and Prevention (CDC) for HIV-1 infection. METHODS: The study included 130 immunocompetent adults with infectious mononucleosis caused by EBV (n=103) and CMV (n=27) and 50 controls. EBV-infected patients were divided into two groups based on typical (n=92) or atypical (n=11) clinical presentation of the disease. Lymphocyte subpopulations were determined by flow cytometry and a panel of monoclonal antibodies recommended by the CDC for the immunophenotyping of patients infected with human immunodeficiency virus (HIV). RESULTS: Patients with typical and atypical presentation of EBV-induced infectious mononucleosis showed increased percentages of total T-cells, cytotoxic-suppressor CD8(+) T cells and activated HLA-DR(+) T cells compared to healthy controls. Percentages of CD4(+) T cells, as well as CD4/CD8 ratio, were significantly decreased. Absolute counts of CD4(+) T cells and percentages of B cells did not differ from healthy controls. Pattern of changes in CMV-infected patients was completely identical to that in healthy controls, although less pronounced. CONCLUSION: Lymphocyte subpopulations represented in the CDC panel for HIV are sufficient for the recognition of patients with infectious mononucleosis caused by EBV and CMV. Flow cytometry can be useful support for reaching diagnosis in patients with atypical clinical presentation of EBV-induced infectious mononucleosis.

Adult↗

PubMed2002

Clinical utility of molecular detection of human papillomavirus in cervical samples by hybrid capture technology.

High-risk human papillomaviruses (HPVs) are the primary risk factor for developing cervical carcinoma. Hybrid capture II HPV Test (HCII) is a standardized test for molecular detection of HPV DNA in cervical swabs. The aim of the study was to evaluate the clinical utility of the HCII when used in combination with conventional cytology in a group of 171 women who were followed-up with both, cytology and molecular testing for 3 years. At the end of the study, only women positive for high-risk HPV at baseline had retained or worsened cervical intraepithelial neoplasia (CIN). In most women who were negative for high-risk HPV, CIN had resolved within 3 years. These results are in concordance with earlier studies reporting the highly negative predictive value of high-risk HPV testing. Both cytology and high-risk HPV testing provide significant clinical information on the current cervical status of a woman. They should be used in combination for primary screening of CIN, which will provide a more selective and cost-effective follow-up.

Female↗

PubMed2002

Survival of primary arteriovenous fistula in 463 patients on chronic hemodialysis.

AIM: To assess the survival of the primary arteriovenous fistula created for dialysis in 463 chronic hemodialysis patients, because the main causes of morbidity among such patients are associated with vascular access-related complications. METHOD: We analyzed 269 (58%) men and 194 (42%) women with median age of 58 years (range 12-83), who underwent 0-14,784 (median 1,584) hours of hemodialysis. Data analyzed were age, gender, body weight loss during hemodialysis session, smoking habits, cause of renal failure, diabetes, myocardial infarction, stroke, malignant neoplasm, arterial hypertension or hypotension, drugs (salicylates, dipyridamole, coumarin anticoagulants, heparin, oral antidiabetics, insulin), number of hemodialysis sessions and hours of hemodialysis per week, fistula location, platelet count, hematocrit, institution in which the fistula had been created, and dialysis center where the fistula had been used. Kaplan-Meier and univariate analysis (Mantel-Cox and generalized Wilcoxon test) with 0.05 statistical significance were used for data analysis, and the outcome of the fistula survival was determined with logistic regression. RESULTS: Out of 597 patients with primary arteriovenous fistula, 134 patients were lost to follow-up. In the remaining 463 patients the fistula survival was 73%, 63%, 52%, 44%, 36%, 10%, 3%, and <1% after 1, 2, 3, 4, 5, 10, 15, and 20 years, respectively. Factors affecting the survival of arteriovenous fistula were administration of heparin (p=0.004) and dipyridamole (p=0.012), hemodialysis-dependent hypotension (p=0.045), diabetes (p=0.009), presence of malignant neoplasm (p=0.003), institution in which the fistula had been created (p<0.001) or used (p=0.037), hours of hemodialysis per week (p=0.023), and number of hemodialysis sessions per week (p=0.007). CONCLUSION: Primary arteriovenous fistula survival was shorter in end-stage renal disease patients with diabetes, hypotension, who underwent less than 3 hemodialysis sessions (<12 h) per week without heparin administration. Insufficient surgical experience, dipyridamole administration, and concomitant neoplasm contributed to arteriovenous fistula failure.

Adolescent↗

PubMed2002

Data mining server--on-line knowledge induction tool.

The aim of this paper is to present an on-line data mining tool and illustrate its use on example of real medical data. Data from the Laboratory for in-vitro Thyroid diagnostics at the Sisters of Charity University Hospital in Zagreb were used. Preparation of the data set and one session of knowledge induction is described.

Croatia↗

PubMed2002

Impact of data encoding and thyroids dysfunctions.

In medical environments it is usual to previously encode some variables following medical criteria. In the context of thyroids dysfunctions, the levels of the hormones T3, T4 or TSH are usually treated as low, normal or high instead of using their numerical form, and this is a very common practice in other items. In medical environments it is also frequent to need a clustering process to analyze data. Clus-tering algorithms use always some distance or similarity coefficient to decide which elements have to be grouped in a cluster. The nature of the data determines which distance/similarity can be used, and can change results. In this paper, the impact of preprocessing numerical levels of hormones into categorical labels for clustering is studied, by means of a real sample of patients from a Hospital in Zagreb (Croatia).

Algorithms↗