Biomedical subjects

M Ivanisević

Publications and source records attributed to M Ivanisević.

At least 19 recordsLinked to original sources

PubMed2002

Histoenzymatic and immunocytochemical characteristics of extravillous trophoblast cells of placental basal plate as parameter of their function in hypertensive pregnancy.

An intense activity of enzymes which actively participate in the renin-angiotensin-aldosterone system was shown in extravillous trophoblast cells which are involved in the performing of spiral arteries into uteroplacental vessels. The hydrolase activity in villous trophoblast underwent important variations, but it was constant in cells of the extravillous trophoblast. Activity of lysosomal hydrolases, of leucine aminopeptidase and N-acetyl glucosaminidase type, was markedly positive in X-cells, while negative in the villous trophoblast. Beta glucuronidase activity has shown moderate activity in cells of extravillous trophoblast, while in villous trophoblast it was weakly emphasized or negative. Intense activity of prostaglandin E2 dehydrogenase in the way of strongly emphasized microsomal reaction was noted exclusively in extravillous cells of basal plate, especially in perivascular cell groupings. Within all examined enzymes activities, only the membranous activity of alkaline phosphatase was of the same intensity in cells of extravillous trophoblast. Lacking of penetration of these cells into the spiral arteries wall in EPH-gestosis, which also means loss of their close contact with the blood of a pregnant, implicates the practical meaning of these observations.

Acetylglucosaminidase↗

PubMed2002

The incidence and seasonal variations of acute primary angle-closure glaucoma.

The incidence and seasonal variations of acute primary angle-closure glaucoma (APACG) was studied. It was based on a retrospective chart review of 121 hospital patients in Split, Croatia for the fifteen-year period from 1985 through 1999. The average incidence was 4.1 cases per 100,000 per year in the total population and 7.1 per 100,000 in those aged 30 years and older. APACG affects women almost twice more often than men. The incidence rate increased with age. No seasonal variations in the occurrence of APACG and no correlation with the mean duration of light exposure per season were found.

Acute Disease↗

PubMed2002

Hyperbaric oxygen therapy in two patients with non-arteritic anterior optic neuropathy who did not respond to prednisone.

Recent advances in understanding the effects of hyperbaric oxygen (HBO) on retinal anoxia gave rise to new interest in the possibility of using it as therapeutic treatment for ischemic conditions of the retina and optic nerve. Two patients with non-arteritic anterior ischemic optic neuropathy due to a high-grade ophthalmic artery stenosis were treated with HBO at 2 atm abs in an effort to increase oxygen delivery for the eye. Both patients showed marked improvements of visual acuity and visual field 3-5 months following the event. Our results are intriguing although the achieved improvement could be coincidental.

Anti-Inflammatory Agents↗

PubMed2001

Treatment of a retained placenta with intraumbilical oxytocin injection.

The aim of the study was to assess the effect of intraumbilical administration of oxytocin in the management of retained placenta. This prospective double-blinded clinical study included 31 mothers with retained placenta. The women were divided into three groups: group 1 (n = 19) was given 20 IU syntocinon in 20 ml 0.9% NaCl saline intraumbilically into the vein (IUV); group 2 (n = 8) received 20 ml 0.9% NaCl saline; and group 3 (n = 4) received 0.2 mg ergometrine IUV in 20 ml 0.9% NaCl saline. Intraumbilical injection was used 30-45 min after delivery, and the distal cord segment was clamped to the umbilical vein.--In group 1, placental expulsion within 60 min of IUV oxytocin injection occurred in 13 (68.4%) women; in group 2, placental expulsion was recorded in one (12.5%) woman, whereas no placental expulsion occurred in group 3 women (p < 0.001). Complications in terms of major hemorrhage were not observed in group 1, whereas a hemorrhage of > 500 ml was recorded in one group 2 and 3 woman each. Febrility developed in one woman, and abdominal pain in two women from each group. Manual lysis of the placenta was performed in seven group 1, seven group 2, and all four group 3 women. IUV oxytocin injection provides a useful and inexpensive non-surgical, non-aggressive, cheap and pharmacological method which should be included in the treatment protocol for retained placenta before turning to the procedure of manual lysis of the placenta.

Adult↗

PubMed2001

Review on prostaglandin and oxytocin activity in preterm labor.

The principal difference between term and preterm labor is how they are activated. It has been proposed that term labor results from physiological activation of the common terminal pathway, whereas preterm labor is a pathological condition caused by multiple etiologies that activate one or more of the components of this pathway. Increased uterine contractility at preterm labor results from activation and stimulation of the myometrium. Myometrium is stimulated by increased concentrations ofprostaglandins and oxytocin. Increased production of stimulatory prostaglandins by intrauterine tissues is generally considered a central component of the cascade of events leading to preterm parturition. Prostaglandins act to mediate cervical ripening and to stimulate uterine contractions and indirectly to increase fundally dominant myometrial contractility by up regulation of gap junctions, oxytocin and arginine vasopressin receptors and synchronizations of contractions. The authors tried to explain the role and influence of oxytocin in human parturition, as well as the novel therapy in inhibiting the contractions in preterm labor. The selective oxytocin inhibitor was tested in vitro on human myometrium and decidua by the author of this article among the first in the world.

Adult↗

PubMed2001

Antiphospholipid antibody syndrome and fetal outcome.

The presence of antiphospholipid antibodies, lupus anticoagulant and anticardiolipin antibody in patients with systemic lupus erythematosus has been associated with the clinical features of thrombosis, fetal loss and thrombocytopenia, and the syndrome is designated as antiphospholipid antibody syndrome (APS). APS has been increasingly diagnosed in patients without underlying autoimmune disease and is most frequently seen in obstetric patients suffering spontaneous abortion, preeclampsia and intrauterine growth restriction. The hypothesis underlying most research into the pathophysiology of APS is that autoantibodies are not only the markers of the disease, but also directly contribute to the development of clinical features. This review summarizes recent information on the pathophysiology and potential roles of autoantibodies in the obstetric patients suffering, particularly in the subgroup of repeated spontaneous abortions.

Abortion, Habitual↗

PubMed1999

Influence of hyperglycemia on early embryonal growth in IDDM pregnant women.

The association between maternal diabetes mellitus and congenital anomalies is well established. Congenital malformations in the offspring of diabetic mothers account for approximately forty percent of perinatal deaths. The aim of the study was to identify incidence of early embryonal delay in diabetic and normal pregnancies, and to examine relationship between the HbA1c values and early embryonal growth delay. One hundred twenty IDDM and fifty and four healthy women enrolled into the study. Pregnancy duration was confirmed by beta-HCG measurements within a fortnight from the missed menstrual period. No statistical difference was detected between the studied groups for gestational age, prepregnancy weight, newborns' birthweight and sex. The risk of spontaneous abortion in IDDM pregnancy with delayed embryonal growth was eight times higher than in IDDM pregnancies with normal growth pattern. No fetal malformations were determined in fetuses or newborns of either groups. The mean value and standard deviation of HbA1c in the IDDM patients with normal embryonic growth was 7.3 +/- 1.5%, and in the group of early embryonic growth, delay 9.39 +/- 2.37% respectively (F = 7.79; p = 0.006). This study confirmed the relationship between embryonal growth, spontaneous abortions and abnormal metabolic control of IDDM pregnancies.

Abortion, Spontaneous↗

PubMed1998

Effects of preeclampsia and eclampsia on cord blood coagulation tests.

Blood coagulation tests were determined in fifty-three paired umbilical cord blood and maternal venous blood samples originating from term singleton vaginal cephalic deliveries. The index group comprised seventeen deliveries complicated by preeclampsia or eclampsia, and the control group comprised thirty-six healthy women with uneventful pregnancies and deliveries. Mean values obtained from the coagulation and fibrinolytic assays did not significantly differ between study groups, except for antithrombin III levels in index group of neonates, which were significantly lower. Comparison of coagulation and fibrinolytic characteristics between mothers and their neonates produced expected level of difference due to immaturity of their haemostatic mechanisms. We found alterations in maternal blood coagulation and fibrinolysis and evidence of increased intravascular coagulation with severe preeclampsia and IUGR.

Blood Coagulation Factors↗

PubMed1998

[Automatic refractometry, reliability of the determination of type and degree of refraction anomalies].

The authors report on their experience with and results of using the AR-1000 autorefractometer made by Nidek, particularly with the pre-school children, school children, and students up to 24 years of age. They stress the significance, as well as speed and accuracy of automatic refractometry findings in large groups of testees (regular checkups) as a valuable indicator in one of numerous necessary tests with the aim to determine and correct visual acuity. There is a significant error reduction in the estimate of dioptries when autorefractometry is done in cycloplegia as compared to autorefractometry without cycloplegia.

Adolescent↗

PubMed1998

Ponderal index and disproportionate fetal growth in IDDM pregnancies.

Disproportionate macrosomia refers to excessive weight characterized by a high weight/length ratio. Disproportionate macrosomia is associated with an increased likelihood of neonatal complications. The aim of the study was to investigate incidence of ponderal indexes and disproportionate fetal growth rate in newborns originating from IDDM and healthy pregnancies. 144 IDDM pregnancies and 432 uneventful pregnancies with normal findings of oral glucose tolerance test were studied, and matched 1:3 for gestational age, sex of newborn, mothers's parity and year of delivery. The pregnancies selected terminated between 30-40th gestational week and resulted with live birth. Mean birth weight (+/- SD) in IDDM group was 3558 +/- 817.6 compared to 3132.4 +/- 534.4 grams of control group (F = 51.49; p < 0.001), mean birth length was 49.8 +/- 3.5 vrs 49.1 +/- 2.5 (F = 8.55; p < 0.005), mean gestation age by examination for both study groups 37.9 +/- 1.9, mean ponderal index of IDDM group was 2.82 +/- 0.28 vrs. 2.63 +/- 0.24 (F = 64.52; p < 0.001) of control group, rate of Apgar score < 7 was 21.14% vrs. 5.08% (chi 2 = 30.30; p < 0.001). 53.4% of IDDMs had macrosomia compared with 8.33% of control infants (chi 2 = 140.25; p < 0.001), and 35.24% of IDDMs had disproportionate macrosomia compared with 5.79% of control infants. Significantly higher rate of both proportionally and disproportionally grown infants with macrosomia was found among IDDMs than among control infants. The rate of disproportionate macrosomic infants significantly differ among study group.

Adolescent↗

PubMed1998

Assessment of the nutritional status in Croatian pregnant women by measuring skinfolds.

In a transversal study, we assessed the changes of body composition, body weight gain, skinfold thickness and the distribution of body fat during pregnancy in 181 healthy pregnant women in Zagreb. Weight gain in pregnant women was 14.4 kg on average, out of which 5.7 kg was the total increase in body fat. In healthy pregnant women the weight gain of more than 12 kg causes excessive accumulation of body fat and has no effect on the weight of placenta and newborn. There is no significant correlation between the body weight gain of pregnant women and the weight of newborns. The increase in skinfold thickness is neither proportional nor simultaneous. Changes in biceps and triceps skinfolds indicate the dependency on the level of estrogen, and subscapular and suprailiac skinfolds on the level of progesterone in the blood of pregnant women. The index of centripetal fat pattern decreases significantly in pregnancy and is referred to peripheral redistribution of body fat in regular pregnancy. The expected weight of the newborn (eBW) may be determined by the body mass index (BMI) and triceps skinfold thickness.

Adolescent↗

PubMed1998

Intraocular pressure and visual field defects.

During a five-year study period, therapeutic levels of intraocular pressure (IOP) and visual field defects were assessed in 108 patients with open-angle glaucoma. In a group of 53 glaucoma patients with non-progressive visual field changes (mean age 65.2 +/- 6.3 years), the IOP level was 15.8 +/- 2.6 mm Hg, whereas in a group of 58 patients with progressive visual field changes (mean age 68.7 +/- 8.3 years) the IOP level was 19.9 +/- 2.9 mm Hg. Study results suggested that preservation of the visual field in glaucoma patients requires therapeutic IOP levels of < 16 mm Hg.

Disease Progression↗

PubMed1997

Venous tone in glaucoma and hypertension.

The aim of this study was the assessment of physiological venous reflexes in systemically hypertensive and normotensive subjects with primary open-angle glaucoma. The experimental group consisted of 20 normotensive and 20 untreated systemically hypertensive patients with open-angle glaucoma. The control group consisted of 31 volunteers divided into two subgroups: 16 control normotensives and 15 untreated hypertensives. The assessment of venous tone changes was performed by testing venous reflexes. Venoconstriction responses to physiological stimuli were significantly decreased in normotensive glaucoma patients, compared to normotensive controls [for the Valsalva manoeuvre 93.4 +/- 80.2 vs. 413.3 +/- 335.4 venoconstrictive units (VCUs), p = 0.02, and for a deep breath 89.1 +/- 100.1 vs. 316.8 +/- 343.2 VCUs, p = 0.03]. The intensity of venous reflexes in hypertensive glaucoma patients did not differ significantly from that seen in hypertensive controls, due to a significantly weaker flex venoconstriction in hypertensive controls when compared to normotensive controls subjects. This study confirmed the presence of venous dysregulation in subjects with primary open-angle glaucoma and visual field loss as a part of an autonomic dysfunction. Systemic hypertension does not make this condition worse.

Aged↗

PubMed1997

The natural history of untreated rhegmatogenous retinal detachment.

In this study, the late secondary changes of the eye in long-standing, untreated rhegmatogenous retinal detachment (RRD) were examined. The most common complications were cataract (61.1%), strabismus (45.5%), toxic uveitis (27.3%) and development of proliferative vitreoretinopathy (100.0%). Complete loss of vision was found in all cases. Maximal visual acuity was hand motion, but only in 9.1% of cases. In the late follow-up period of untreated RRD, anatomic changes of the eye, permanent loss of vision and esthetic defects will appear.

Adult↗

PubMed1997

The effect of coagulation parameters on the placental respiratory and nutritive function in women having chronic hypertension with superimposed preeclampsia.

The aim of this study was to explore the relationship between coagulation and fibrinolytic system parameters with nutritive and respiratory placental function. We have analysed 79 pregnant women, of which 39 with severe preeclampsia (index group) and 41 healthy pregnant women. When comparing the study groups in third trimester, significantly lower platelet counts, fibrinogen values and antithrombin III values have been found in the index group compared to the control group. Factor VII levels were not found to be significantly different. The control group revealed significantly higher levels of coagulation factors II, V and VIII, compared to the index group. The increase of FDP, reduction of fibrinogen and increase of fibrinolysis in index group, when compared to the control group of healthy pregnant women, are the reflection of the intravascular fibrin deposition that leads to the described coagulation changes and consecutively to the foetal growth retardation. Indirect evidence are the correlation between newborns' weight and fibrinogen levels/fibrinolytic activity.

Adult↗

PubMed1997

Holistic approach to analysis of medical data: vulvar cancer.

This paper continues the series of studies introducing holistic approach to analysis of clinical data. Namely, besides the information regarding his/her disease, each hospitalized cancer patient also provides the variety of data regarding his/her psychological, cultural, social, economical, genetic, constitutional and medical background. The aim of this study was to introduce a holistic approach to analysis of medical data, in this case clinical data regarding cancer of the vulva. Such approach requires the collection of data regarding different aspects of the cancer patients, and after the satisfactory sample size is obtained (which should be at least five times greater than the number of examined patient characteristics), the performance of factor analysis. In this study, the authors have processed the data regarding 25 characteristics of all 755 vulvar cancer patients treated between 1938 and 1990 at the Department for Gynecological Oncology of the University Hospital for Gynecology and Obstetrics, Zagreb, Croatia. In factor analysis, the principal components were rotated after the initial extraction (the authors recommended the use of oblimin rotation) in order to obtain better ground for interpretation of the obtained results. The next step in this approach was the stepwise exclusion of characteristics with smallest commonality according to Kaiser-Meyer-Olkin criteria, and retaining the characteristics and components with the most significant impact on the explained system variance. When the number of principal components and initial analyzed characteristics was reduced to 3-4 and 7-10, respectively, the ultimate interpretations and conclusions were made. This approach outlined some clusters of correlations between medical data which are difficult to identify using other statistical procedures, primarily the impacts of various socioeconomic and hereditary-constitutional variables on overall survival.

Adult↗

PubMed1997

Venous reflex testing in glaucoma.

The aim of this study was the assessment of physiological venous reflexes in open angle glaucoma. The study was carried out by a controlled clinical experiment. The experimental group consisted of 17 glaucoma patients with controlled intraocular pressure. The control group consisted of 15 healthy volunteers. The assessment of venous tone changes was performed by means of the test of "venous reflexes". Venoconstriction responses to physiological stimuli were significantly decreased in glaucoma patients (p < 0.05). The results suggested venous dysregulation as part of sympathetic dysfunction in glaucoma.

Glaucoma, Open-Angle↗

PubMed1997

Glycosylated hemoglobin and fetal growth in normal, gestational and insulin dependent diabetes mellitus pregnancies.

Aims of the study were: evaluation of HbA1c levels in the peripheral blood of pregnant women with insulin dependent diabetes, gestational diabetes, glucose intolerance, and healthy pregnant controls; implications of HbA1c concentration on detection and the control of women with impaired carbohydrate metabolism in pregnancy; comparison of HbA1c levels with appearance of miscarriages, and premature deliveries; comparison of weight gain during pregnancy to HbA1c levels; comparison of difference from ideal body weight with HbA1c in diabetic pregnant women; comparison of neonatal birth weight and HbA1c levels. 290 pregnant women were enrolled to the study. The highest value of HbA1c was in the group IDDM pregnant women (7.7% +/- 1.8%), and the lowest value of HbA1c was in the control group (4.1% +/- 0.5%). Statistically significant coefficients were found between HbA1c and weight gain during pregnancy, between weight deviation from ideal body weight and HbA1c (r = 0.54 and r = 0.48 respectively); and between newborns weight and HbA1c (r = 0.51). Well regulated glycemia and intensive pregnancy follow-up of diabetic women reduces stillbirths, neonatal complications and neonatal macrosomia incidence.

Adult↗