Biomedical subjects

J Vavrinec

Publications and source records attributed to J Vavrinec.

At least 37 records · Page 2Linked to original sources

PubMed1999

Use of a skin explant model for predicting GVHD in HLA-matched bone marrow transplants - effect of GVHD prophylaxis.

Over the last decade we have successfully evaluated the use of a human skin explant assay for predicting acute GVHD in HLA-matched sibling transplants. In the present study, we modified GVHD prophylaxis on an individual patient basis depending on the GVHD outcome predicted by the skin explant model. We have summarised our previous data describing how the skin explant assay results correctly predict GVHD occurrence and severity in 45/56 patients (80%); P< 0.0001, chi2 19.97, df = 1. In a further cohort of 19 patients, all were predicted to develop grade II or above GVHD. These patients were given increased GVHD prophylaxis with the addition of methotrexate and a significant reduction in the expected incidence of GVHD was observed (P = 0.02; chi2 7.7, df = 1; Fisher exact test P = 0.04). The results from these studies suggest that modifying GVHD prophylaxis, based on skin explant assay results, may reduce the expected incidence and severity of GVHD. We suggest that the technique might be used for selective GVHD prophylaxis in T cell non-depleted HLA matched sibling transplants.

Adolescent↗

PubMed1993

[Relation between retinopathy and glucose compensation in diabetic children and adolescents].

The fundus of the eye was examined in 302 children and adolescents with insulin dependent diabetes (mean age 14.2 years, SD 3.60, mean duration of diabetes 6.4 years, SD 3.83) by prolonged chromato-ophthalmoscopy and the finding was classified according to the authors' own extended classification of diabetic retinopathy. In 295 patients the authors assessed the mean value of glycosylated protein during the period of 3-6 months before assessment of the retina. When these values were compared with the retinal findings, a statistically highly significant relationship of retinopathy and the glucose compensation of diabetes was found (p < 0.001). The increase of the mean glycoprotein value during adolescence, as compared with the prepubertal period, was also statistically significant, while adolescents without retinopathy had lower mean glycoprotein values as compared with the group as a whole.

Adolescent↗

PubMed1992

[Extended classification of diabetic retinopathy in children and adolescents].

The authors submit their own modification of the classification of diabetic retinopathy elaborated on the background of several years experience with the examination of children and adolescents with insulin dependent diabetes. The extended classification pattern makes it possible to differentiate and classify more accurately even slight incipient changes detected by chromatooophthalmoscopy. The presence of microaneurysms reflects well the degree of retinal damage in early stages. Special attention must be paid to intraretinal microvascular abnormalities (IRMA). The classification pattern is presented in a table included in the text.

Adolescent↗

PubMed1992

[Occurrence of diabetic retinopathy in children and adolescents and its relation to the duration of diabetes and patient age].

In a retrospective investigation the authors give an account of a group of 302 children and adolescents with insulin dependent diabetes (mean age 14.2 years, mean duration of diabetes 6.4 years) whom they examine regularly by chromatoophtalmoscopy and evaluate the findings according to their own extended classification of diabetic retinopathy. In 29% of the patients the finding was positive and in 25% the finding was suspect. The most frequent pathological change were microaneurysms; intraretinal microvascular abnormalities (IRMA) were detected in 13 patients. The trend towards proliferative changes is apparent in some patients surprisingly soon. The authors emphasize the sensitivity of the method which along with the extended classification of retinopathy makes its monitoring possible. The authors discuss the value of fluorescent angiography in the initial stages of retinal damage. They provide evidence of a statistically significant relationship of diabetic retinopathy and the duration of diabetes (p < 0.001) and age (p < 0.001).

Adolescent↗

PubMed1992

[Relation of retinopathy to puberty and sex in insulin-dependent diabetics].

The authors examined by chromatoophtalmoscopy the optic fundus in 302 children and adolescents with insulin dependent diabetes. They classified the findings according to their own classification and selected from the entire number two groups of patients where the common sign was persistence of diabetes for a period of 5-8 years. Group A (n = 32) was, however, formed only by children under 11 years, while group B (n = 35) comprised adolescents aged 16-20 years. In group A the authors found incipient retinopathy in 12.5% children, in group B in 48.6% of the patients (p < 0.005). The degree of retinopathy was also more severe in older subjects. Comparison of the whole group by sex did not reveal a significant relationship (p > 0.05). In the conclusion the authors draw attention to the necessity of careful follow up of the optic finding in child diabetics, in particular during adolescence.

Adolescent↗

PubMed1989

[What do we owe the families of diabetic children?].

An enquiry by means of questionnaire in 211 families of diabetic children in Prague and the Central Bohemian region with the aim to express objectively the influence of diabetes of the child in the socio-economic position of the family.

Adolescent↗

PubMed1989

[The effect of heart surgery during extracorporeal circulation and deep hypothermia on glucose metabolism in infants and young children].

Authors examined levels of glucose, insulin, and C-peptide in the plasma of 6 infants and small children with the isolated transposition of the great arteries (3 pts) and ventricular septal defect (3 pts) in the course of open-heart surgery in deep hypothermia. The mean age of the patients was 7.2 months (6 to 15) and weight 5.6 kg (5.2-7.5). Exogenous intake of glucose during the operation was excluded. Methods of anaesthesia, operation technique, and conduction of extracorporeal circulation (ECC) were constant in all patients. Fresh ACD blood diluted with Hartman solution approximately 1:1 was used for the prime of ECC circuit (content 800 ml) to get the hematocrit 0.27 +/- 0.2 after mixing the prime with the patient's blood volume. Glycemia was determined by Beckman ERA 2001 analyzor, and levels of insulin and C-peptide by radioimmunoassay kits MJ-96 (Poland) and Novo (Denmark). Significant hyperglycemia was found in all patients during the period of hypothermia, and was overlasting to the rewarming period until the end of the operation and 1 hour postoperatively. Then level of glycemia was decreasing to the normal values which were found in the last sample (17 hours post-op). The raise of glycemia was not a stimulus to the proportional increase of insulin and C-peptide levels in plasma. It proved transitional suppress of insulin secretion in the beta cells of the pancreas in the cooling period. Levels of insulin and C-peptide significantly and concordantly increased after 20 min. of rewarming (r = 0.83). However, hyperglycemia overlasted during the course of rewarming, too.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Glucose↗

PubMed1988