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Biomedical subjects

F Pavicić

Publications and source records attributed to F Pavicić.

At least 19 recordsLinked to original sources

Diagnosis and treatment of asthma--new approach.

Asthma is a serious health problem around the world, and affects approximately 10-15% of children and 5-10% of adults. Asthma is chronic inflammatory disorder of the airways. This inflammation causes period of illness exacerbation and period without symptoms. The therapy is based on stepwise approach on the basis of clinical features of asthma before treatment and on lung function measurement (FEV1 and PEF). To control asthma help "controllers" (especially anti-inflammatory agents) which suppress the inflammation and prevent airway remodeling, and "relivers" which makes quick relief of symptoms and treat attack (shortacting bronchodilator), but all therapy must include patient education.

Adult↗

[Education of patients with asthma, chronic bronchitis and pulmonary emphysema].

Patients' education belongs to the most efficient therapeutic measures in the management of asthma, chronic bronchitis and pulmonary emphysema. The following paper reports the experience in the educational programme at the Polyclinic for Respiratory Diseases in Zagreb. Each patient's education lasted 5 days, 3 lessons per day, in groups of 10-15 persons. The education was carried out by a teaching team consisting of pulmonologists, psychosomatologist, pharmacist, physiotherapist and biometeterologist. From March 1995 to February 1996 135 persons completed the educational programme, 65 of whom were asthma patients. Data on cough and dyspnoea, skills in inhaler and breathing technique were collected at the beginning and 3 months after the education in all asthma patients. Three months after the education the asthma patients showed a significant decrease in dyspnoea and a significant improvement in inhaler and breathing technique. A standard questionnaire was given to all patients at the end of the education and in more than 80% the education was well accepted by the patients. Initial results are encouraging and the programme should be expanded to all parts of Croatia.

Adolescent↗

[Respiratory findings in textile workers employed in dyeing wool and cotton].

The prevalence of acute and chronic respiratory symptoms and diseases and ventilatory capacity were studied in 97 textile workers employed in dyeing wool and cotton fibres and in 76 non-exposed control workers. The prevalence of chronic respiratory symptoms was significantly higher in the textile workers compared to controls. The symptoms of occupational asthma were recorded in 7.2 per cent of the textile workers. The prevalence of respiratory symptoms was higher in exposed smokers than in exposed non-smokers. The textile workers employed for more than 10 years had a higher prevalence of all respiratory symptoms than those with a shorter period of employment. The textile workers showed a high prevalence of acute symptoms which developed during work shift. Significant acute reductions of ventilatory capacity tests on maximum expiratory flow-volume curves (MEFV) in textile workers varied from 5.1% for FVC to 12.4% for FEF25. Ventilatory capacity tests in the textile workers before work shift were significantly diminished in comparison to the predicted values. Our data indicate that work in the textile dyeing industry may cause the development of respiratory symptoms and diseases as well as impairment of ventilatory capacity.

Adult↗

Pulmonary function in adolescents with idiopathic scoliosis.

Two groups of patients, with an average age of 15 years, have been studied to establish the improvement in pulmonary function after surgical correction in relation to the amount of correction achieved. The first group of 33 patients were treated surgically; an average Cobb angle of 72 degrees was reduced to 32.6 degrees. The second group of 30 patients with an average Cobb angle of 33 degrees were not operated on. Results of tests undertaken have shown that pulmonary function was improved by surgical correction, but the improvement does not match the degree of correction achieved. Statistical analysis of the two groups shows a difference in cardiopulmonary function to the advantage of those who were not operated on. This suggests that there is partial irreversibility of ventilation and perfusion in those who are treated surgically.

Adolescent↗

Cardiorespiratory function in surgically treated thoracic scoliosis with respect to degree and apex of scoliotic curve.

We studied the relationship of deterioration of cardiorespiratory function with respect to degree and localisation of apex of spinal curvature. The study comprised 33 patients (27 females and 6 males) aged 15 (11-21) years, surgically treated for an average scoliotic angle of 72 degrees (55-129 degrees, after Cobb) which was postoperatively reduced to 32.6 degrees (13-74 degrees). The static and dynamic cardiorespiratory function parameters were tested (pre-operatively and 24 months after surgery) by spirometry and plethysmography, arterial blood gas analysis, and the exercise tolerance test. In terms of the site and apex of the thoracic curve as determined by spine X-ray, patients were divided into two groups: upper thoracic scoliosis with the apex between T5 and T8 and lower thoracic scoliosis with the apex between T9 and T11. Only upper thoracic scoliosis with Cobb angle of more than 70 degrees correlated (r = -1) with restrictive ventilation disorder (vital capacity 68%) and latent hypoxaemia (uptake O2 ml/kg/min 63%) demonstrated during the exercise tolerance test (p > 0.05). The results of the test have demonstrated that surgically obtained 54% correction of the scoliotic curve improves pulmonary function (p < 0.05). However, the improvement does not match the degree of achieved scoliotic curve correction, what means that even in surgically treated high-angled thoracic scoliosis exists an increased risk of morbidity and mortality.

Adolescent↗

[Evaluation of ventilatory function of the small airways].

The results of functional tests and the values of flow-volume and spirometric parameters were reevaluated in 1174 randomly selected patients with no evidence of heart disease. There were 533 patients with normal ventilation and 327 patients with no restrictive disorders. In the latter group 11% of the patients had normal FEV1 and lowered FEF50 and FEF75 values. In those patients obstructive changes would not have been found if expiratory flow rates had not been taken into account as one of the criteria for evaluating airway obstruction. In further 13% of the patients a mild airway obstruction would have been found had only FEV1 been evaluated without taking account of expiratory flow rates. It is concluded that expiratory flow rates along with anamnestic data and clinical status are important indicators of obstructive changes of ventilation, especially as they serve to identify functional disorders while these are still reversible and therapy can be useful.

Forced Expiratory Flow Rates↗

[How should pharmacodynamic tests for respiratory tract obstruction be evaluated?].

The factors that could influence the results of pharmacodynamic testing with beta 2 agonists in lung function diagnostics are discussed. These are: hypersecretion of the mucus, acute respiratory infection, tachyphylaxis of the adrenoceptors, therapy in the past 48 hours, patient's cooperation, and ambient or environmental pollution. The correct application, by inhalation, of selective sympathomimetics is described and differences between the basic values of lung function parameters and those following the salbutamol test are discussed.

Asthma↗

Primary hypertrophic osteoarthropathy (PHO) and changes in the joints. Clinical, X-ray, scintigraphic, arteriographic and histologic examination of 19 patients.

Nineteen patients with PHO with onset in childhood are presented. In 7 cases the syndrome was found in other family members too. In clinical, X-ray scintigraphic, arteriographic, and plethysmographic investigations, joint affection was found in 14 patients. Clubbing of the fingers and toes was seen in all the patients and a periosteal reaction was found in the long bones in 11 patients. Arteriography was carried out in 5 patients and showed hypervascularization and arteriovenous anastomoses in the clubbed fingers. The gas analysis of the arterial blood did not show any pathological changes. The histological finding showed poorly vascularized and oedematous periarticular tissue and ossification in the periosteal area, while in the synovial membrane, slight, nonspecific inflammatory changes were seen.

Adult↗