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Biomedical subjects

L Jovanović

Publications and source records attributed to L Jovanović.

16 recordsLinked to original sources
PubMed1993

[Calcium antagonists as the initial monotherapy in arterial hypertension].

The most modern trends in the artery hypertension treatment recommend using the individual remedy. The modern approach to the therapy of this disease points more and more to the use of the calcium antagonists but in the scope of monotherapy. In the total mass of the cured (200), in the treated group are used Nifedplan and Verapamil, while the tested patients of the control group were treated by metilodop and hyginic--dietetics treatment. With regard to the medication the patients matched in number. The use and the impact of Nifedipine and Verapamil onto the systolic and diastolic components of blood pressure point to the statistically significant antihypertensic efficiency of both preparations. The unwanted effects are practically irrelevant which gives to the calcium antagonists priority at choice. Introducing the calcium antagonists into clinical practice is a great progress in the pharmacotherapy of many cardiovascular illnesses. They are nowadays irreplaceable at discussing the effective treatment of artery hypertension, heart ishemical illnesses, heart arrhythmias and hypertrophic obstructive myocardiopathy.

Adult↗
PubMed1991

[Lactates in the cerebrospinal fluid in patients with bacterial and viral meningitis--significance in differential diagnosis].

Lactate concentrations were determined in the cerebrospinal fluid of patients with purulent, tuberculous and viral meningitis. The control group consisted of 10 patients with meningism (the presence of the meningeal syndrome with a normal cytobiochemical finding of the cerebrospinal fluid). The enzymatic kinetic method of the firm "Behringer" was used. In all the patients with purulent meningitis lactate values were elevated (above 6.2 mmol/l), and the highest values (above 15.0 mmol.l) were found in the patients who also developed respiratory failure. The lactate values in the cerebrospinal fluid of patients with purulent meningitis were higher in statistical significance than in all other examined groups of patients (p less than 0.01). The lactate values were in correlation with the total number of leukocytes (r = 0.78, p less than 0.01) and with the percent of polimorphonuclear leukocytes in the cerebrospinal fluid (r = 0.80, p less than 0.01). Elevated lactate values (above 2.95) were also found in all the patients who had tuberculous meningitis and statistically they differed significantly from the cerebrospinal fluid values of the patients with viral meningitis and meningism (p less than 0.01). There was no difference in the cerebrospinal fluid lactates of patients with viral meningitis and meningism (p greater than 0.05). Elevated lactate values were also found in 2 patients who had paraneoplastic meningitis and in 3 patients with cerebral cysticercosis and hydrocephalus, but without meningitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacterial Infections↗
PubMed1990

[Cerebellitis during Mycoplasma pneumoniae infection].

Mycoplasma pneumoniae is the primary cause of respiratory system diseases in school children and young adults. Most often an infection of the upper respiratory airways is in question, with or without pharyngitis, while clinically manifest pneumonia occurs in only 3-10% of patients. However, multisystemic manifestations of Mycoplasma pneumoniae infections can also occur, usually during the first 14 days after the start of respiratory symptomatology, but can also occur as isolated in some cases, with no prior respiratory illness, nor its later occurrence. In our patient there came to a development of pneumonia, exudative pleuritis, sinusitis and cerebellitis. The duration of the disease was protracted, but recovery was complete, without sequelae. The etiological diagnosis was set retrospectively on the basis of the dynamics of the titer of complement fixating antibodies. Mycoplasma pneumoniae should be considered as a possible etiological agent of various clinical syndromes.

Cerebellar Diseases↗
PubMedDate not supplied

[Preemptive analgesia in cholecystectomy using pethidine].

INTRODUCTION: Preemptive analgesia given before noxious stimulation prevents or reduces subsequent pain. Pain associated with central sensitization is called pathological pain. Preemptive analgesia could be defined as analgesia that prevents the development of pathological pain. The clinical significance of central sensitization lies in prediction that preemptive analgesia may prevent the establishment of central sensitization and reduce pain experienced following peripheral injury. Various pharmacological agents and methods have a potential in prevention of acute postoperative pain by blocking the somatosensory system and abolishing hypersensitivity. But the role of preemptive analgesia in postoperative pain is still controversial. The goal of the present study was to examine whether pethidine administration before skin incision is more effective in reducing postoperative pain than the same dose of pethidine given intraoperatively. MATERIAL AND METHODS: Thirty patients (ASA 1 to 2), aged from 40 to 65 years, admitted for elective laparotomic cholecystectomy entered the study. Group 1 (n = 15) received 1 mg/kg of pethidine i.v. 5 minutes before induction of anaesthesia (before skin incision) and 0.9% NaCl of equal volume intraoperatively (after peritoneal opening). Group 2 (n = 15) received pethidine and 0.9% NaCl in a reverse manner. Premedication was omitted. No other analgesics were administered at induction and intraoperatively. Anaesthesia was induced with midazolam, thiopentone and succinylcholine for tracheal intubation. Pancuronium was administered for muscle relaxation and halothane with O2/N2O for maintenance of anaesthesia. The duration of surgery (time from skin incision to skin closure) and time from skin closure to the first analgesic request were measured and recorded. In the ward, patients were given metamizol (2500 mg) i.m. at request during the first 12 h. If the regimen was not sufficient, piritramide (2 mg) i.m. was given at request. The intensity of pain was estimated before the first analgesic request and 4, 8, 12 and 24 h thereafter. Pain scores were recorded using VAS (0 = no pain; 10 = worst pain). Data are presented as mean values with their standard deviations and as the ranges of each parameter. The differences in data between two groups were evaluated with Student's t-test. P > 0.05 was considered statistically significant. RESULTS: Demographic data, duration of surgery and time from skin closure to the first analgesic request are presented in Table 1. No significant difference was found between the two groups. The postoperative analgesic requirements in two groups were similar and piritramide requirement was omitted. VAS scores at each time (Table 2) did not differ between the two groups. DISCUSSION: The findings of many clinical investigations remain controversial. Some clinical studies comparing the same analgesic intervention before and after the painful stimulus have shown a benefit of preemptive analgesia. The results of our study did not show a significant difference in pain scores neither in analgesic requirements of patients who received systemic pethidine before the painful stimulus compared with the patients treated with the opioid intraoperatively. However, epidural opioid administration may be more effective (17,18). It is important to say that inhalational anaesthetics, including N2O and some i.v. anaesthetic agents may have preemptive effects themselves, significantly reducing spinal sensitization (19,20). In clinical studies when the preemptive effect of analgesics is under investigation, inhalational and i.v. anaesthetics which are administered to induce and maintain anaesthesia are given before surgery. Therefore development of central sensitization may be attenuated or prevented by the anaesthetics overlapping the preemptive effect of analgesics. CONCLUSION: The results of this study did not demonstrate a preemptive effect of pethidine. (ABSTRACT TRUNCATED)

Adult↗