Acta medica Iugoslavica最新文献

A follow-up study in cotton workers (35 female and 31 male) was performed ten years after the original cross-sectional study. The prevalence of byssinosis considerably increased during the follow-up study in female (22.9%; 42.9%) and in male (25.8%; 51.6%) workers. Similarly, the prevalence of almost all respiratory symptoms was significantly higher during the follow-up study than at the time of the initial study. Significant acute reductions of FVC and FEV1 during the work shift were recorded in both surveys. The mean annual decline in ventilatory capacity was greater than expected for both female (FVC: -0.036 L/year; FEV1: -0.059 L/year) and male workers (FVC: -0.059 L/year; FEV1: -0.068 L/year). The mean total airborne dust concentration was 3.95 mg/m3 with an average respirable dust concentration of 0.97 mg/m3. Our study demonstrated an association between exposure to cotton dust and increasing prevalence of respiratory symptoms and progressive impairment of ventilatory capacity.

During the last four decades, parallel to the strategic and practical innovations that have occurred in social psychiatry, the concepts of the normal and the pathological have changed. As the normal and the pathological are determined and recognisable in both the spatial and the temporal framework, a change in these concepts can be assessed by tracing the shifts in their above mentioned fundamental dimensions. The spreading of the ideas and the practice of the community-centred psychiatry has brought about the greatest difficulties in defining the normal and the pathological.

The cerebral perfusion was evaluated in 8 patients with stroke, caused by stenosis or occlusion of the carotid artery, and in 4 neurologically healthy subjects, using Tc99m labeled microspheres (LMS). By measuring activity in the brain and lungs after intracarotid injection of LMS, the existence of brain shunts in patients with stroke was demonstrated. It seems that brain ischaemia triggers the opening of shunts which appear to be one of the important autoregulatory and protective mechanisms to cerebral haemodynamic changes after brain infarction.

Clinical and morphological findings of lymph nodes in 150 consecutive untreated non-Hodgkin lymphoma (NHL) patients were retrospectively studied. One hundred and fifteen (77%) patients had B-NHL and 35 (23%) T-NHL, 96 (64%) patients had NHL low grade malignancy and 54 (36%) NHL of high grade malignancy according to the Kiel classification. Lymph nodes exceeding 2 cm in diameter (p less than 0.05), hepatomegaly (p less than 0.05), splenomegaly (p less than 0.05), and the duration of lymphadenopathy for more than 6 months preceding diagnosis (p less than 0.01) were significantly more common in low than high grade malignancy of NHL patients. Febrile episodes at the diagnosis were significantly more common in high than in low grade malignancy of NHL patients (p greater than 0.05). Lymph nodes exceeding 2 cm in diameter (p less than 0.05) in B-NHL, and lymph nodes above the diaphragm (p less than 0.05) and skin infiltration (p less than 0.001) were more common in T-NHL than in B-NHL patients. At the diagnosis low grade NHL patients have significantly more often splenomegaly, hepatomegaly, large palpable lymph nodes, and long lasting lymphadenopathy before diagnosis. High grade malignancy NHL patients have more often general symptoms, B-NHL patients have more often large palpable lymph nodes, T-NHL patients have more often skin infiltration and lymph nodes above the diaphragm. Precise clinical characterization of patients in addition to pathohistological diagnosis are very important in this highly variable disease.

The authors deal with uveitis and cataract from two aspects. The occurrence of uveitis was analysed both before cataract surgery and postoperatively. The authors found in their material that uveitis occurred before cataract surgery in 1.8% and postoperative uveitis in 1.2% of cases. Special emphasis is put on the occurrence of postoperative complications in such eyes and the indications for the IOL implantation in uveitis patients.

The influence of HLA-B27 antigen on clinical, radiological and laboratory features of rheumatoid arthritis (RA) was studied. The group with B27 antigen comprised: 4 males and 20 females aged 28 to 71 and a group of patients free from B27 antigen consisted of 2 males and 21 females aged 26 to 69. RA patients possessing the B27 antigen did not differ regarding the age of the onset of disease, the distribution of affected joints during the follow-up (3-10 years), the development stages of the disease and the presence of rheumatoid factor when compared with B27 negative RA patients. The arthritis of the radiocarpal joints (p less than 0.01) was significantly more often the first sign of the disease in patients with B27 antigen. In these patients low back pain and morning stiffness in the low back were twice as frequent as they were in patients not possessing this antigen. The clinical pattern of the affected spine was also found more frequently in B27 carriers (p less than 0.05). B27 positive RA patients showed also the clinical pattern of sacroiliitis (SI) (p less than 0.05) and x-ray SI (p less than 0.01) significantly more often than the patients free from this antigen. In addition, symmetric arthritis of the peripheral joints was more often diagnosed in patients free from B27 antigen.

The aim of the study was to answer the question whether the serum level and the urine level of N-acetyl-beta-D-glucosaminidase (NAG) could be the indicator of liver and kidney lesions, and the indicator of the stage of the lesions, in cases of endotoxemia and endotoxin shock. The authors performed the experiment using 60 rabbits as experimental animals. The animals were divided into six groups (10 rabbits in each group); control animals received an equal volume (1.0 ml/kg of body weight) of physiological saline solution. Endotoxin (Lipopolysaccharide E. coli 055 B-5) in doses of 20, 40, 60, 80, and 100 micrograms/kg of body weight were administered in a single intravenous injection to each animal of I-V experimental groups. Using endotoxin in that dose of application, the authors provoked different stages of endotoxemia on the rabbits in the first four experimental groups, and the endotoxin shock on the rabbits of the fifth experimental group. After 18 hours, the rabbits were decapitated, and the levels of NAG in serum, urine, kidney and liver tissues determined. The results showed that the serum increase of NAG activity is caused not only by the lesions of kidney parenchyma, but by the lesions of liver parenchyma too, in the cases of endotoxemia and endotoxin-produced shock; the increase is statistically significant. Urine increase of NAG activity is significant even in cases in which the authors administered very low doses of endotoxin (20 micrograms/kg of body weight), so it can be said that urine NAG activity is a very good indicator of early kidney parenchyma lesions. But, the urine increase of NAG activity is (absolutely) in correlation with the dose of administered endotoxin, so it can be said that urine activity of NAG is the indicator of stage of kidney lesions in cases of endotoxemia and endotoxin-provoked shock.

In Yugoslavia cancer of the larynx has an important position in the group of malignant tumours, especially among the malignomas of the respiratory system. According to the data on mortality, laryngeal cancer accounts for 2.67% of all tumours and 11.59% of all respiratory tract tumours during the period from 1977 to 1988. In that period the average age-adjusted mortality rate of laryngeal cancer was 3.09 per 100,000 population, much higher in mean--6.29%(000) than the women--0.53%(000). The linear trend in laryngeal cancer mortality from 1977 to 1988 points to a slight increase (y = 2.97 +/- 0.02x), in men (y = 6.03 +/- 0.04x), while in women it shows a decrease (y = 0.60--0.01x). Age specific mortality rates of laryngeal cancer are low in the age groups to 39 years in men and 49 years in women. It augments steadily from 40 and 50 years of age respectively, with the highest rates in patients above 70 years of age (39.66%(000) for men and 4.05%(000) for women).

The aim of this study was to investigate in what way the outcome of treatment could be influenced by some traits of personality and its functioning, described in psychological literature as "ego strength". Here, one has to take into account the difficulties in studying the complex process of treatment involving numerous personality and environmental factors, which cannot be separated and observed, measured and assessed as isolated values. Therefore, conclusions about the influence of personality strength on the outcome of treatment have a relevant but not absolute significance. The authors presumed that one of the reasons for the unfavourable outcome of treatment was to be found in the alcoholic's personality system. They tested this presumption on samples of successfully and unsuccessfully treated alcoholics, who received the same treatment, and on a control group. As a measuring instrument for assessing the effectiveness of the personality system, Barron's Ego Strength Scale was used. The study showed that the group of unsuccessfully treated alcoholics had statistically significant lower scores on the ES scale, and that they differed from the successfully treated group. Between successfully treated alcoholics and the control group there were no statistically significant ES Scale differences. The study has indicated that it would be appropriate to use ES Scale before beginning the treatment of alcoholics. Thus in the treatment of those with lower scores, additional attention and activities could be devoted to other systems, those of family and work, within the general system of "man-environment", in order to compensate for the relative inadequacy of the personality system.

The aim of the present study was to analyse the correlation between the neuropsychological functioning and the intensity of the recent withdrawal syndrome. The authors compares two groups of alcoholics hospitalized for the acute withdrawal syndrome: of the predelirious character (N = 23) and alcoholic delirium (N = 21). Both groups of patients were treated identically in order to suppress the acute withdrawal syndrome. On the tenth day of the treatment the scores on the Gross Evaluation Scale and the Scale of Medical Risks were identical (p less than 0.01) in both groups of patients. On the fifteenth day of hospitalization, after five days without any psychopharmacological therapy, the patients underwent psychological testing: the Wechsler-Bellevue test, separately for the complete, verbal, and nonverbal scales and the Bender-Gestalt test. Statistically significant differences between the two groups of patients were found in the complete scale (p less than 0.05) and the verbal scale (p less than 0.05) of the Wechsler-Bellevue test, as well as in the subtests of the verbal scale: achievement (p less than 0.05), cognition (p less than 0.05), and concepts (p less than 0.01). These differences may be understood as a result of the intensity of the recent withdrawal syndrome, i.e., the patient just cured of delirium showed more serious disturbances in the complete scale and some subtests of the verbal scale of the Wechsler-Bellevue test.