Acta medica Iugoslavica最新文献

This paper presents the epidemiological study of respiratory viral infections in Croatia from 1 September 1986 till 31 August 1987. A total of 527 patients with acute respiratory diseases were examined. Their nasopharyngeal secretion and/or throat swab were taken and the viruses were demonstrated by the method of direct viral diagnosis (isolation and rapid immunofluorescent detection). This 12-month study on acute respiratory infections in Croatia in 1986/1987 shows that viruses were the agents in 47.2% of these infections. Out of a total of 527 patients with acute respiratory disease, 177 patients had RSV (prevalence 33.6%), 40 adenovirus (prevalence 7.6%), 18 enterovirus (prevalence 3.4%), 12 parainfluenza (prevalence 2.3%), 8 herpes simplex virus (prevalence 1.3%) and 3 influenza virus (prevalence 0.6%) infection; (9 patients had mixed infections with two viruses). Viral etiology was proved in 44.0% of upper respiratory tract infections, 86.5% of bronchiolitis, 63.3% of pneumonia, 57.5% of bronchitis, and 33.3% of croup. The epidemical wave of RSV infections started in October 1986 and lasted for the next 7 and a half months with a peak in December 1986. Infections with parainfluenza occurred in November 1986 and subsided in March 1987 with a peak in December 1986. An epidemic of adenovirus occurred in two waves and lasted throughout 9 months. Enteroviruses caused infections during the fall and at the beginning of the winter 1986 but also again in the spring 1987.

Medical documentation is getting more extensive, it is not standardised and can hardly be used to provide the exact and proper feedback. The crisis of data storage, processing and uninterrupted flow of information is becoming concial in the medical institutions as well. An example of informatic model of observation of postoperative complications following cataract surgery is presented in this work. The model has a very flexible pattern, and can, therefore, with minor changes, be used in observation of all postoperative complications in ophthalmology. It is based on the use of personal computer with professional software support (data base III programme was used for creation of data base, while statistical graphic analysis was carried out by following programmes: MICROSTAT, ABSTAT, STATGRAPHIC and FRAMEWORK). It has to be pointed out that any doctor, after only a short (optional) education, could prepare such models for his own purposes, and could thus assist in overcoming the information in medicine. In conclusion, the authors state computer is simple to work with, fast, economical and precise. Computerisation of health service shall include it in one of the aspects of practical realisation of the third technological revolution.

Immunologic reactivity of patients with psoriatic arthritis and the influence of the activity of psoriatic arthritis on immunologic reactivity were analysed. The group of psoriatic arthritis patients, aged 17 to 65 years, consisted of 36 males and 13 females with confirmed diagnosis. 51 age and sex-matched volunteers served as the control group (32 males and 19 females aged 21 to 62 years). The following parameters of immunologic reactivity were analysed: number of leucocytes, percentage of the lymphocytes in peripheral blood, number and percentage of T lymphocytes with positive CD3, CD4 and CD8, number and percentage of B lymphocytes, number and percentage of B lymphocytes with surface IgG, IgA and IgM, number and percentage of large granular lymphocytes (LGL), lymphocytic transformation by phytohaemagglutinin and phagocytic index. The authors found statistically significant reduction of the number and percentage of CD4 T lymphocytes, number and percentage of B lymphocytes with surface IgG as well as significantly decreased lymphocyte transformation and phagocytic activity of peripheral granulocytes in patients with psoriatic arthritis in comparison to control group.

Two groups, with 4 patients each were selected for study out of 155 patients on regular hemodialysis (HD): Group I, with hematocrit (PCV) less than 20% and group II, with PCV greater than 30%. The patients in both groups had been anemic at the start of HD treatment, but a significant improvement in their anemia had occurred only among the patients in the Group II. The main difference between the two patient groups, other than the degree of anemia, was found to be in serum erythropoietin (Ep) levels. No significant differences were observed between the two groups in serum urea, creatinine, parathyroid hormone or CFU-E growth inhibition. Acquired cystic disease of the kidney was found in five patients from group I, and in 11 patients from group II. The correlation between the number of cysts in the kidneys and the patient's PCV and serum Ep levels proved significantly positive. The results presented could be regarded as another proof that diseased kidney is capable of functioning as an Ep producing organ despite the loss of excretory function.

Sarcoidosis is characterized by granuloma formation, the macrophage being the most important building block. The activated macrophage in sarcoidosis produces interleukin-1 (II-1). It is well known that interleukin-1, among other functions, stimulates the hepatic production of C-reactive protein. We therefore prospectively measured the serum C-reactive protein in 17 patients with active pulmonary sarcoidosis, 10 patients with other chronic interstitial lung diseases of unknown etiology, 11 patients with active lung tuberculosis, and 10 healthy volunteers. Serum C-reactive protein was assayed by enzymoimmunodiffusion test. The serum C-reactive protein was negative in 13 patients suffering from active sarcoidosis and positive in four. Patients with other interstitial lung diseases had negative results in 7 and positive in 3 cases. The analyses of C-reactive protein in patients with sputum positive lung tuberculosis were positive in 10 cases. All the healthy controls had negative C-reactive protein measurements. The difference between the groups was statistically significant when sarcoidosis and tuberculosis serum C-reactive protein measurements were compared (p less than 0.01), as well as the difference between the group of other interstitial lung diseases and tuberculosis (p less than 0.01). In this respect, the measurements of serum C-reactive protein are valuable in the differentiation of sarcoidosis and other chronic interstitial lung diseases of unknown etiology from tuberculosis and other diseases which are known to induce an acute phase response.

The authors' experience with surgical complications following kidney transplantation is presented. From 1973 till May 1990, 136 transplantations were performed, out of which 21 before and 117 after 1983. Surgical complications occurred in 20 patients, thus reaching the incidence of 14.5% which corresponds with the incidence reported by other institutions. The incidence of vascular complications was 5.0%, of urological 4.3%, of lymphatic 1.4%, of wound infections 2.2%, and of graft ruptures 1.4%. Urological and vascular complications made for 65% of all the surgical complications which in 40% resulted in the loss of the graft. Out of the total number of the lost grafts, surgical complications were responsible in 28.1%.

The authors analysed and compared three groups of patients who had undergone surgery. In the first group of 72 patients with diabetes and cataract, intraocular lens implantation was carried out. In the second group of 96 patients with diabetes and cataract, cataract surgery was not followed by intraocular lens implantation. The third group of 100 nondiabetic patients, selected by random choice, had intraocular lens implanted after the cataract surgery. Retinal status, postoperative complications and visual acuity were the parameters analysed in correlation with the intraocular lens implantation. In the authors' opinion, the prognosis following cataract surgery and intraocular lens implantation in diabetic patients is good, if diabetic complications do not occur, particularly retinopathy and vitreal hemorrhage which impair the vision considerably. Intraocular lens can be implanted even in cases of maculopathy and preproliferative diabetic retinopathy, provided a thorough diagnostic evaluation has been performed (echography, fluorescein angiography). Laser photocoagulation procedure should also be carried out before surgery and repeated as long as the transparence of the lens enables it. The treatment should be resumed two weeks after the cataract surgery and intraocular lens implantation at the latest. Intraocular lens implantation is contraindicated in proliferative diabetic retinopathy, and especially iridal rubeosis, as the risk of neovascular glaucoma development is considerable.

Chest ultrasonography has been advocated as an effective tool for diagnosis and localization of pleural effusion. To determine if chest ultrasonography would be beneficial, when thoracocentesis was performed, 71 patients with suspected pleural effusion were evaluated. Two groups of patients were formed according to the presence of small or large suspected effusion ascertained by chest posteroanterior roentgenogram. Chest ultrasound was found very useful, both for establishing diagnosis of pleural fluid and for obtaining adequate fluid samples of small effusions. This technique had no such advantage during thoracocentesis of large effusions. During and after thoracocentesis, there were no complications in any group of patients. Authors concluded that ultrasound method seems to be very useful in choosing the optimal site for thoracocentesis, particularly of small effusions.

The results of karyotypic analysis of a new case of endometrial adenocarcinoma revealed in all analyzed diploid or near-diploid cells two chromosomes 1 of normal morphology and the presence of a marker or markers derived from chromosome 1. No other common chromosome marker was observed. Among a total of 25 endometrial adenocarcinoma cases reported in literature, including the case we reported, the most frequent chromosome abnormality-observed was trisomy and tetrasomy of the long arm of chromosome 1 which may represent a specific karyotypic change in at least one subtype of this tumor.

The authors have analysed the mortality of malignant haemopathies in Yugoslavia from 1978 to 1987. The standardized rate of mortality among all malignant haemopathies was from 6.5 to 7.2%000. These rates were higher in males (7.8-8.8%000), than in the females (4.8-5.9%000). The mortality of this group of malignant tumors shows a decreasing tendency, which is more evident in females than in males. Since Hodgkin's disease and lymphoid leukemia participate with about 50% in the structure of mortality from all malignant hemopathies, and for that reason, mortality from these two diseases is especially analysed. The standardized rate of mortality from Hodgkin's disease was between 1.7-2.5%000 (males 2.1-3.2%000; females 1.3-2.0%000). Mortality from this malignant haemopathy has a tendency of decreasing, which is approximately of the same intensity in both sexes. Mortality from lymphoid leukemia in the period between 1978 and 1987 was from 0.7 to 1.2%000 (males 0.9-1.7%000; females 0.5-1.0%000). The mortality trend from lymphoid leukemia shows a similar slight decrease in males and females.