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N Stefanović

Publications and source records attributed to N Stefanović.

At least 19 recordsLinked to original sources
PubMed1998

Quantitative analysis of the renal changes in Balkan endemic nephropathy.

The volume densities of the cortical interstitium (CI), glomeruli and proximal tubular epithelium have been investigated on a sample involving 18 patients suffering from Balkan endemic nephropathy (BEN), classified into three groups with regard to the clearance of 99mTc-DTPA. In comparison with the control group, the evolution of the disease is marked by a significant increase of the CI volume (p<0.001), as well as a significant reduction of glomerular (p<0.01) and tubular volume densities (p<0.001). The most intensive changes of CI and glomerular volumes are characteristic of the initial stage of the disease when glomerular filtration (GF) has shown no signs of deterioration yet. On the other hand, a significant reduction of the tubular epithelium volume density is characteristic of the advanced stages. The specified changes, particularly those taking place at the level of interstitium bear the key responsibility for the BEN progression. However, a number of links constituting the chain of BEN morphogenesis remained insufficiently clarified. This urges for a precise quantification of all histological changes taking place in different stages of the disease, starting from the earliest, in order to get a better insight into the order and dynamics of their occurrence.

Balkan Nephropathy↗
PubMed1996

[Clinical use of hematopoietic growth factors--general principles].

Biology of haematopoietic growth factors in the process of haematopoiesis is well known, but their clinical utilization started with production of recombinant preparations. Today only preparations of Erythropoietin, GM-CSF and G-CSF are commercially at disposal. Absolute indications for utilization of haematopoietic growth factors are states caused by decreased production of certain classes of blood cells as a consequence of shortage of a growth factor necessary for production of a certain class. As these states are very rare, relative indications spread to other states characterized by a decreased number of blood cells or necessity for stimulation of haematopoiesis due to any other reason. This paper contains results of clinical researches only for those growth factors which are not commercially utilized.: M-CSF, Interleukin 3, PIXY321, SCF, Interleukin 6, Interleukin 11, Interleukin 1, Interleukin 2 and Thrombopoietin. Our institution utilizes only the preparations of Erythropoietin (Eprex) and G-CSF (Neuprogen) in 38 patients.

Hematopoiesis↗
PubMed1996

[Clinical use of erythropoietin].

Humoral regulation of erythropoiesis has been known for 100 years, while clinical utilization of recombinant human erythropoietin (rhEPO) only for two decades. It can be said that there is much experience in regard to indications, models and results of its clinical utilization. According to the standpoint of secretion of erythropoietin, anemias can be divided into those where secretion is increased and satisfactory, those where it is increased but not satisfactory and into those where it is not increased or it is even decreased. Anemias of the first group are not an indication for rhEPO utilization, the second group is relative and the third group absolute indication for its utilization. The best results are achieved with absolute indications and it is anemia in chronic renal insufficiency and nonphysiologic anemia of premature babies. Good results can be expected, but not predicted in relative indications, such as anemias in chronic infections, anemias in malignant diseases, myelodysplastic syndrome, aplastic anemia and other secondary anemias. Utilization of rhEPO is useful also in certain states without anemia, especially in transfusiology.

Anemia↗
PubMed1994

[Prognosis in patients with myelodysplastic syndromes based on cytomorphologic and clinico-biologic parameters].

Under myelodysplastic syndromes we presume a heterogeneous group of malignant hemopathies with clearly described characteristics of the disease given by a cooperative group of French, American and British authors. Myelodysplastic syndromes most frequently occur at older age. Survival of these patients, after the diagnosis is made, is mostly short because the disease evolves into acute leukemia. Myelodysplastic syndrome is characterized by appearance of refractive anemia, leukemia, thrombocytopenia with signs of expressed dishematopoiesis of the bone marrow. Clear criteria which could define forms with fast or slow course leading to acute leukemia don't exist, so there is a need to group patients into those with good or with bad outcome. The investigation included following parameters important for the outlook of the disease: 1. enlargement of lymph nodes, liver and spleen, 2. biochemical examination of peripheral blood, 3. cytomorphologic changes in the peripheral blood cells and bone marrow. By a follow-up of described parameters a statistically significant influence on survival of the sick concerning the degree of present anemia, absolute number of granulocytes, number of thrombocytes, dishematopoiesis of the peripheral blood and bone marrow, lymphadenomegaly, hepatomegaly and splenomegaly was not found. The percentage of blast in the peripheral blood and bone marrow has a statistically significant influence on patients' short survival.

Adult↗
PubMed1992

[Cytometric study of blast cells in acute leukemias and their prognostic value].

Cytometric assessment of the leukemic blasts was performed in the course of diagnosing acute leukemia. The results of the cytometric study were used as prognostic parameters. We measured the surface of the nucleus and of the cytoplasm, and calculated the nucleus-cytoplasm ratio. The investigation was carried out on peripheral blood and bone marrow smears in 50 patients with acute leukemia, classified according to the FAB classification. The results showed that the mean surface of the nucleus in all groups was significantly bigger in bone marrow cells than in the peripheral blood. In non-lymphoblastic leukemia no significant differences of the mean leukemic blast nucleus surface were found among the subgroups either in the bone marrow or in the peripheral blood. Concerning the mean surface of the blast cytoplasm in the peripheral blood it has been established that in the subgroup M-2 it is significantly the smallest in nonlymphoblastic leukemia subgroups, while in the bone marrow it is significantly bigger in M-2 and M-4 subgroups than in the peripheral blood. In lymphoblastic leukemia the mean surfaces of the cytoplasm in the peripheral blood were not significantly different from those in the bone marrow, while concerning the mean surface of the nucleus the difference was registered in favor of the bone marrow. The nucleus-cytoplasm ratio was rather high in the blasts of the peripheral blood and the bone marrow.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1992

[Our experiences in the treatment of myelodysplastic syndromes].

From 1987 an abrupt increase of the number of patients presented with MDS has been registered. We present our experiences in the treatment of 42 patients. The number of the male patients was two times larger than of the females. They were most frequently diagnosed as having RAB (43%) and RAEBt (28.5%). RA was found in 14%, RARS in 9.5% and CMML. in only 5% of the cases. The treatment was accomplished with ultralow (3 mg/m2/12h s.c.) and low doses (10 mg/m2/12h s.c.) of ARA-C in 75% of the patients with RAEBt and 44.4% with RAEB, while the CMML group received hydroxyurea. The treatment improved hematologic results but the complete remission lacked. In 23.8% of the cases the disease developed into acute nonlymphoblastic leukemia. Patients excepted from cytostatic therapy were observed by the use of androgens, anabolics, vitamin A+D3 and transfusion of separated erythrocytes. In 38% of the patients with MDS a lethal outcome followed. Life of those in whom the disease developed into acute leukemia in statistically significatly shorter (p < 0.05). There was no statistically significant difference in the survival rate between the treated and nontreated patients (p > 0.05). Further treatment of these patients includes, apart from ultralow doses of ARA-C, the use of retinoic acid, a growth factor (GM-CSF) and bone marrow transplantation.

Adult↗
PubMed1990

[Allogenic transplantation of bone marrow in hematologic diseases. Preparation and completion of transplantation at the Hematology Clinic in Novi Sad].

The paper deals with the results of clinical preparations for the application of allogenic bone marrow transplantation at the Clinic of Hematology in Novi Sad. The obligation of the definite treatment of patients below 45 years by allogenic and autologous bone marrow transplantation results from the acceptance of the Yugoslav protocols for acute leukaemia treatment. Thus immunogenotypical analyses, so far performed in patients with severe aplastic anaemia have been extended to patients with acute leukaemia as well and then to patients with chronic myelogenous leukaemia, high risk lymphocYtic lymphoma and myeloma multiplex with resistance to standard chemotherapy and their potential sibling donors. The bone marrow transplantation Unit has been set up, the team of specialists has been formed and educated and the protocol for allogenic transplantation with Busulfan and cyclophosphamide combination for pretransplant conditioning has been adopted. In research work concerning the field of bone marrow transplantation a particular emphasis has been put on the working out of a mathematical model for optimal timing of bone marrow transplantation in patients with acute myelogenous leukaemia.

Adult↗
PubMed1987

Selective ACTH insensitivity associated with autonomic nervous system disorders and sensory polyneuropathy.

A 10-year-old boy is described with a syndrome of adrenal insufficiency due to selective ACTH insensitivity associated with autonomic nervous system disorders. In addition to insufficient production of glucocorticoids and adrenal androgens, achalasia, defective lacrimation, anisocoria and hyperkeratosis of palms and soles we also found defective sweating, permanent cutis anserina and sensory polyneuropathy, which have not been reported previously in this rare syndrome.

Adrenal Cortex Diseases↗
PubMed1979

[Liver injury during combined chemotherapy of acute leukemias].

The authors observed 70 patients with acute leukemia treated by polychemotherapy. In 2 patients the signs of severe liver damage were found. The occurrence, course and results of laboratory tests suggested Purinethol predominantly as the cause of development of these alterations. The complication did not occur frequently in our patients. The changes regressed in a satisfactory way after the withdrawal of the hepatotoxic cytostatic from the therapy.

Acute Disease↗