Search PubMed⌕ Search

Biomedical subjects

J Dimitrijevic

Publications and source records attributed to J Dimitrijevic.

6 recordsLinked to original sources
PubMed1999

[Cerebrovascular accidents in Sarajevo during the war].

PURPOSE: Neurologists in the main hospital in Sarajevo (Bosnia-Herzegovinia), we worked in the neurological department throughout the war and the siege of the town, from 1992/4/6 to 1995/12/15. We report on strokes which happened during that period, comparing stroke incidence and severity in relation to those two years before. We reviewed 3002 cases of stroke recorded in the neurological department registry from 01/01/90 to the end of the war. RESULTS: The activity of the department was reduced by about 40 p. 100, as was the population of the town. Yet the number of strokes decreased only by 26.5 p. 100. The comparative incidence of strokes increased by 25 p. 100 during the war. Sex ratio and age incidence were the same. The relative role of atherosclerosis, cardiac embolic sources, intracranial and meningeal hemorrhage remained the same. The incidence of intracranial hemorrhage increased by 20 p. 100. Death, evaluated after one month, increased by 36 p. 100. Death by intracranial hemorrhage increased by 30 p. 100, those by cardiac embolic infarction by 26 p. 100 and those by atherosclerosis by 20 p. 100. At the end of the first year of the war, mortality was 65 p. 100 in comparison with the previous year and death by meningeal hemorrhage increased by 74 p. 100 for the first two years of the war. The major changes in life conditions have produced change in medical conditions. Patients had to stop their treatment because there was no more medecine in the city, and, among others, no more drugs for anticoagulation, diabetes mellitus, cardiopathy.... In the hospital, medical doctors, nurses, drugs, food and even heating were missing. So stopping the treatment for vascular disease together with the high level of stress generated by daily shelling can explain the increase in stroke incidence and especially, the hemorragic cases. The poor life conditions which weakened people and the lack of treatment at the acute stage of the disease and also later, when secondary events occurred, can explain the high mortality observed. CONCLUSION: We recognize the bias of our study: the war itself, the condition in which we have carried out this work and the use of a hospital registry. Nevertheless, it seems that morbidity not directly due to the battle can change during a war like this one. This study also demonstrates, "a contrario", that preventive treatment and care of stroke at the acute phase, as they are currently recommended, are useful.

Acute Disease↗
PubMed1998

Effects of captopril on morphologic changes in kidney of spontaneously hypertensive rats with adriamycin nephropathy.

Antihypertensive therapy has been shown to slow down the progression of chronic renal failure. Angiotensin converting enzyme inhibitors and calcium antagonists have been emphasized as the agents with the most protective effect. Our previous study showed that captopril slowed down renal function deterioration in the early course of adriamycin (ADR) nephropathy in spontaneously hypertensive rats (SHR). The present study was undertaken with the aim to examine morphologic changes associated with that slower renal function deterioration. Adult (24 weeks) female SHR were randomly divided into the following groups: the control group (n = 12) was given tap water to drink; the adriamycin (ADR) group (n = 25) was treated with ADR; the ADR-captopril (ADR-C) group (n = 27) was treated with ADR and thereafter with captopril (60 mg/kg/day). Rats were sacrificed at weeks 6, 12 and 18 and histologic analysis was semiquantitatively performed. In the control group the glomeruli exhibited only minor changes at the end of the study. In the ADR group slight glomerular mesangial hypercellularity appeared in the sixth week and progressed in focal and segmental sclerosis. Some glomeruli showed segmental proliferation and increased fibrular matrix of a tuft adherent to a fibrocellular crescents. In the ADR-C group, glomeruli with a slight increase of mesangial matrix were seen at the end of the sixth week, mesangial hypercellularity developed until the end of the sixth week, mesangial hypercellularity developed until the end of the 12th week and segmental glomerulosclerosis until the end of the study. Semiquantitative analysis revealed that the mean semiquantitative scores for mesangial expansion and glomerular sclerosis were significantly lower in ADR-C group than in ADR group throughout the study. We concluded that captopril slowed down mesangial expansion and reduced the development of glomerular sclerosis.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1987

[Occlusion of the vertebral artery (100 personal cases)].

Occlusion of the vertebral artery is usually due to atherosclerosis. According to the site and extension of the arterial lesions 3 clinico-pathologico-angiographic situations can be encountered: segmental occlusion (proximal: V1 or distal: V3, V4), multisegmental (mainly V1-V2, sometimes V1-V2-V3) or extensive (V1 or V4). Subsequent infarctions are localized in ipsilateral cerebellar lobes and ipsilateral lateral part of the medulla oblongata; supra-medullary involvement is rare and indicates a propagation of the vertebral thrombus into the basilar artery. Cerebellar, vestibular or cerebello-vestibular strokes and Wallenberg's syndrome are the more frequent clinical disorders. They are often preceded by occipito-cervical headache. Contrary to a common belief, the vital risk in vertebral artery occlusion is not negligible. Among 160 cases, 100 of which are personal, mortality was 25%. In fact benign segmental and proximal occlusion adequately compensated, specially when isolated, must be opposed to segmental distal occlusion and extensive occlusion. Angiography and Döppler examinations localize arterial lesions and subsequent hemodynamic disorders. The treatment is often symptomatic only. Surgery of the proximal vertebral artery may in some cases be the only hope of preventing occlusion.

Adult↗
PubMedDate not supplied

[Microscopic polyangiitis].

Microscopic polyangiitis is a very rare disease characterized by the lesions of arteriolae, venulae and capillaries--mainly of the kidneys and lungs, but also of other systems and organs. The elevated titer of anti-myeloperoxidase ANCA is very important immunological indicator. The main changes in our patient were related to the lung bleeding and rapidly progressive glomerulonephritis. The treatment has started according to the standard Fauci scheme adjusted to the level of disease severity and the age of patient (prednisone 60 mg/24 h, along with the gradual dosage decrease, cyclophosphamide 150 mg/24 h) and has lead to the clinical-laboratory remission. The patient had the leukocyte values irregularly controlled during the immunosuppressive therapy and agranulocytosis thus caused was not spotted in time, leading to the inadequate treatment of pneumonia that brought on the lethal outcome.

Antibodies, Antineutrophil Cytoplasmic↗