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Biomedical subjects

D Milosevic

Publications and source records attributed to D Milosevic.

At least 19 recordsLinked to original sources

The value of urine citrate/calcium ratio in the estimation of risk of urolithiasis.

The urine saturation is considered as the better parameter for the estimation of risk of urolithiasis than any single urinary constituent. However, the determination of urine saturation is unsuitable for routine clinical practice. To evaluate a simpler and cheaper test than urine saturation for distinguishing stone formers from healthy individuals, urinary citrate/calcium ratio was determined in 30 children with urolithiasis, 36 children with isolated hematuria, and 15 healthy control children. The ratio was significantly lower in urolithiasis group comparing to controls, and significantly higher in hematuria than in urolithiasis group. The cut-off points between normal children and children with urolithiasis, accuracy, specificity and sensitivity were determined and compared with those of the urine saturation calculated with the computer program EQUIL 2. The data mining Weka software was used for the determination of the cut-off points. Children with urolithiasis had citrate/calcium ratio below 1.38 and urine saturation above 5.285. The citrate/calcium ratio showed in comparison to urine saturation similar high accuracy (91.11 vs. 88.89%), somewhat lesser specificity (73.33% vs. 93.33%) and much better sensitivity (100% vs. 86.89%) in discrimination of stone formers from normal children. The advantage in comparison to urine saturation is that it can be easily performed in clinical practice.

Analysis of Variance↗

[Value of Holter ECG in the diagnosis of sleep apnea syndrome in patients with massive obesity].

OBJECTIVE: Assess the diagnostic contribution of cyclic nocturnal variations in heart rate in sleep apnea syndrome. PATIENTS AND METHODS: Holter recordings performed in a population of 30 patients with massive obesity defined as a body mass index greater than 40 kg/m2 and sleep apnea syndrome defined by an apnea index greater than 5 apneas per hour were analyzed retrospectively. The control group was composed of 15 patients with massive obesity but without sleep apnea syndrome. High variability in nocturnal heart rate was assessed using a visual criterion defined as repeated episodes of progressive reduction in heart rate followed by a sudden acceleration reaching a difference of 30 bpm between the highest and lowest heart rate and occurring at least 5 times during one consecutive hour of recording. RESULTS: Increased nocturnal variability in heart rate was evidenced in all the patients with sleep apnea syndrome (30/30) but was not observed in any of the control subjects (0/15). CONCLUSION: These results suggest that Holter recordings can be a useful tool for the diagnosis of sleep apnea syndrome.

Adult↗

[A double-blind, placebo-controlled study on the efficacy of Rinasek in symptomatic treatment of seasonal and non-seasonal rhinitis].

In order to assess the efficacy of Rinasek in symptomatic treatment of seasonal and nonseasonal rhinitis, 40 ambulatory otorhinolaryngologic patients were multicentrically examined in a placebo controlled double-blind study. Clinical and other findings show that the drug worked excellent in 46.6%, well in 13.3%, weak in 13.3% and in 10% of patients it had no effects. Consequently, Rinasek worked positively in 73.2%, and that is the best reason to recommend its application.

Adult↗

Computer quantitated evaluation of cardiac arrhythmias.

The identification of a cardiac arrhythmia depends on the interpretation of both the QRS complexes and the P waves. P wave detection is unreliable and hence automated diagnostic systems are often imperfect. An alternative is a system which detects QRS only and which classifies the QRS events; the physician then has a detailed quantitated QRS analysis to aid in diagnosis. The ATREC system has an analog QRS detector, which suppresses the P wave and the T wave frequencies and feeds a minicomputer (Mitra 15/35) with signals for the RR interval, the QRS duration, and polarity. The computer classifies these signals as either narrow or wide complexes. The narrow complexes are analyzed for irregular rhythm, bradycardia, pauses, transient or continuous tachycardia, and fibrillation. The wide complexes are classed by their coupling interval, bi- or trigeminy, doublets, or salvos, and the number per hour. The system gives a trend of the 16 beat mean, and the minimum and maximum heart rate. The data is presented on several displays.

Analysis of Variance↗

[Comparison of the efficacy of aprindine and quinidine in chronic ventricular rhythm disorders].

The object of this study was to compare the efficacity and the side effects of Aprindine and Quinidine in patients with stable ventricular arrhythmias. A series of 33 patients with chronic stable ventricular arrhythmias were given successively Aprindine and Quinidine on the principle of extrasystoles (VES) determined by computer analysis of Holter recordings. The VES were counted every hour and the statistical study used analysis of variance followed by linear contrast and also the sign test. The stability of the arrhythmia was verified by several control Holter recordings without therapy (average : 3,3 per patient). Low dose regimes were used in 17 patients (an average of 50 to 60mg/day Aprindine, and 481 mg Quinidine base), and Quinidine was shown to be the more active (p less than 0.05 to 0.003 according to the test used), reducing the number of VES by 39% compared to an average of 21% for Aprindine. In the other 16 patients with a higher dosage regime, 109 mg Aprindine and 707 mg Quinidine base, there was no significant difference between Quinidine and Aprindine (p less than 0.08 to 0.12), Quinidine reducing the number of VES by an average of 54%, and Aprindine by 36%. Quinidine caused diarrhoea in I patient on the low dose and 4 patients in the high dose regime. Aprindine caused neurological side effects in 2 patients on the low dose, and 7 patients on the high dose regime. Aprindine at 100 mg/day may therefore be used in the same manner as Quinidine at usual dosages as regards the incidence of side effects of the two drugs. However, the ratio of effective dose/toxic dose is lower with Aprindine than with Quinidine.

Aprindine↗

[Ventricular tachycardia in bursts. Electrophysiological and therapeutical study].

22 patients with salvoes of ventricular tachycardia were investigated electrophysiologically and pharmacologically to determine the mechanism of the arrhythmia. The appearance of the ventricular complexes was suggestive of a septal origin. The arrhythmia appeared to occur and regress within precise limits of sinus rhythm. 24 hour ECG recording and endocavitary stimulation techniques showed its essentially variable character, but occasionally a fixed coupling interval with the first extrasystole was observed, suggesting the presence of an unprotected parasystolic focus. The repetition of the extrasystolic activity, which could be triggered and terminated at will, is explained by phenomena of delayed after potentials. The results of the systematic investigation of the effects of quinidine-like drugs, beta-blockers and verapamil do not invalidate these hypotheses and show a difference of degree but not of nature between the two populations A and B of patients classified according to the quantitative character of the extrasystolic activity over 24 hours (more or less than 1000/hour). The observation of intermediate forms with simple extrasystoles and other forms with sustained tachycardia extends the significance of these results to many forms of ventricular arrhythmia.

Adolescent↗

[Ventricular arrhythmias and mitral valve prolapse. A study of 35 cases].

35 patients with mitral valve prolapse (MVP) underwent investigation by Holter monitoring with computerised analysis. Ventricular arrhythmias were observed in 70% patients with MVP. There does not seem to be a close correlation between the severity of the arrhythmia and the degree of prolapse. The mechanisms of the ventricular arrhythmia are variable: two patients had the necessary criteria for ventricular reentry, at least six had parasystolic foci, protected or not from the sinus rhythm. The most severe ventricular arrhythmias are characterised by their variable morphology (but usually showing right bundle branch block), a clear diurnal rhythm, the inducing role of exercise or emotion and a greater diurnal variation of the sinus rhythm suggesting increased sympathetic tone. The results of beta blockade are better in the patients with the most marked diurnal rhythms.

Arrhythmias, Cardiac↗

[Quantitative evaluation of the efficacy of anti-arrhythmia agents in chronic ventricular arrhythmia].

The authors describe a computer system for the analysis of ventricular arrhythmias and its use in the evaluation of anti-arrhythmic drugs. Provided the arrhythmia is stable, this method allows an estimation of the onset and duration of action of the drug and gives guidelines for the choice of an appropriate drug regimen. Using this system, a comparison can be made between different drugs based on quantification of their efficacy.

Amiodarone↗

[Open injuries of the knee].

The authors discuss the therapeutic approach to 9 cases with open injuries of the knee which they have encountered during the past 5 years. All patients were hospitalized in a state of serious traumatic shock and all had multiple injuries. All 5 cases were operated on within 2--3 hours of the injury. The authors used the following postulates in treating this type of trauma: prevention of traumatic shock, early meticulous primary surgical treatment of the wound, closure of the joint with the drainage of the synovial cavity and periarticular space, strict immobilization, reinacting the extensor mechanism, fixation of the condylar fragment and the administration of antibiotics. The surgical treatment was restricted to only the minimal, patelectomy (3 cases) sec. McLaughlin, and in one case the medial condyle was fixed to the femur. Postoperative infection was not noted. All five patients returned to full working capacity and exhibited only minimal loss of extension at the knee.

Humans↗

The privilege to be old.

BACKGROUND: Ample evidence has proven that the functional property of cells decreases over the years. Nevertheless, although it has taken decades to convince ourselves that elderly people belong to a specific age group both biologically and medicinally, and in whom special criteria have to be taken into consideration, it seems that even they themselves do not present an homogenous group. OBJECTIVE: Today we often hear of authors of studies speaking of two subpopulation groups--one group that ages by all the laws of aging that we have encountered and accepted thus far, and the other group that seems to postpone aging due to 'programmed death', or more specifically due to low mastery/low emotional support or because of additional reasons; however, the existence of the two groups seems eminent. METHODS: The identification of these two groups would allow us to find more realistic results in studies, and therefore a more efficient therapy for certain diseases. RESULTS: This hypothesis does not contradict the theories of aging that we have accepted (at least not the majority) and also does not contradict the fact that there is a large interindividual variability. This hypothesis doubts and claims there are exceptions to the initial assumption of geriatrists and gerontologists that 'parallel to the aging process, the functions of all organs and organ systems lessen.' CONCLUSION: The identification of these two groups would allow us to find more realistic results in studies, and therefore more efficient therapy for certain diseases.

Adaptation, Physiological↗

Malignant pleural effusions treated with high dose intrapleural doxycycline: clinical efficacy and tolerance.

Chronic malignant pleural effusion may be treated by instillating products in the pleural space to induce pleurodesis. We used intrapleural doxycycline at doses greater than 2000 mg in 16 malignant pleural effusion (14 patients). Patient survival ranged from 1 day to 19.5 months. Mean drainage duration was 7.5 days (range, 5-10 days). Pain (moderate n=7; severe n=2) was the most frequent side-effect with hypotension (moderate n=3; severe n=1). Five cases were not evaluable at one month because of death during the month following treatment (n=3) or during treatment (n=2). At one month follow-up, success was defined as no pleural effusion (n=5), partial response as minimal effusion (n=4) and we considered that treatment had failed if pleural drainage was necessary (n=2). Five patients died within one month and 5 had more than 3 months survival (4 without recurrence).

Adult↗