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T Ivković-Lazar

Publications and source records attributed to T Ivković-Lazar.

At least 19 recordsLinked to original sources
PubMed1996

[Epidemiologic analysis of emergency conditions in the diabetic population as observed in the work of emergency medical services in the area of Novi Sad].

The authors analyzed a group of 236 diabetic patients in the municipality of Novi Sad who asked for the help of the Emergency medical service of the Health Center "Novi Sad". A special emergency team which manages vitally endangered patients acted on their requests. After anamnestic data were gathered and physical examination done, electrocardiographic monitoring was performed. Glycemia was determined from semiquantitative analysis of the capillary blood, while glycosuria and acetonuria from urine. In regard to these patients the gathered results point to predominant presence of chronic, degenerative complications, especially of the cardiovascular apparatus. However, this was the case due to the fact that these were elderly persons (62.78 +/- 12.21 years of age) suffering from diabetes mellitus for about 8 years, which is sufficient for development of chronic, degenerative complications of diabetes. Although the studied group was metabolically unregulated (glycemia: 18.13 +/- 5.43 mmol/l, glycosuria positive in 4.54%, acetonuria in 2.20% of patients) there were no elements for diagnosis of some acute metabolic complications. The decrease of acute metabolic complications may be connected to better organization of the antidiabetic service in the municipality of Novi Sad. It is especially important to point out the occurrence of serious hypoglycemias caused by oral hypoglycemics (64.28%) which require, according to contemporary approach, a long-term hospital treatment.

Adolescent↗
PubMed1996

[The role and significance of sagittal abdominal diameter in the determination of adipose tissue distribution].

Up-to-now trials have pointed out the importance of determining the type of obesity because the central type of obesity is joined with glucose tolerance disturbance, hyperinsulinemia and insulin resistance. The sagittal abdominal diameter proved to be the method of choice in routine clinical practice for visceral fat tissue detection. We examined a group of 60 females in whom, apart from standard measures (body weight, height, body mass index, perimeters of waist and hips), the sagittal abdominal diameter was measured by means of specially constructed caliper (Holtain Kahn Abdominal Caliper). Gathered parameters were compared with the results of an examination performed on 30 healthy females of normal body weight (control group). Results show a statistically significant higher sagittal abdominal diameter in females with central type of obesity in comparison to the control group, which points to greater quantity of visceral fat tissue in this type of obesity.

Abdomen↗
PubMed1996

[The metabolic syndrome and hyper-Lp(a)-lipoproteinemia in peripheral obliterative atherosclerosis: 2 case reports].

One of the characteristics of peripheral vascular disease in diabetic patients is that it occurs at the time of detection of diabetes mellitus. As one of the possible pathogenic mechanisms, in non-smokers, is the sol-called metabolic syndrome (obesity, disorders in regard to metabolism of lipids and carbohydrates and hypertension). Lipoprotein Lp(a) is the most atherogenic among lipoproteins. While data on coronary arterial disease exist, although contradictory, there is a small number of those which document the same for peripheral vascular occlusive disease in diabetics. Two patients, non-smokers, with characteristic constellation of risk factors, are described as possible models for further epidemiologic examinations.

Arteriosclerosis Obliterans↗
PubMed1996

[Modern principles of therapy of hypertension in diabetic patients].

Arterial hypertension is the most frequent cardiovascular complication of diabetes mellitus. Diabetes mellitus-type-1 occurs in about 30% of patients and it is connected to development of diabetic nephropathy, while type-2 occurs in as much as 70% of cases, having fast atherosclerosis as a base in its etiopathogenesis. The therapy of arterial hypertension in diabetic patients is specific and in some ways different depending on the type of diabetes mellitus as well as other complications characteristic for diabetes. Apart from drug therapy, it includes: body weight reduction in obese patients, restriction of sodium chloride, proteins and alcohol drinking, as well as other risk factors (smoking, for example). Drug therapy means application of different groups of antihypertensive agents (selective beta-blockers, diuretics, angiotensin-converting enzyme inhibitors, calcium channel antagonists and postsynaptic alpha-1 blockers). Some of them have adverse effects on metabolism of lipids, while some have other adverse effects which must be taken into account when determining therapy. However, angiotensin-converting enzyme inhibitors and calcium channel antagonists are the most preferred today as the most effective and with least adverse effects.

Diabetes Complications↗
PubMed1996

[Relation between the abdominal sagittal diameter, fat tissue distribution and metabolic complications].

Numerous epidemiological and clinical studies point to association of android type of obesity with metabolic complications, such as glyco-regulation, hyperlipoproteinemia, accelerated atherosclerosis which all lead to cardiovascular diseases. As the waist-hip ratio did not prove to be specific enough for determining association between fat tissue distribution and risk from development of obesity complications, measurement of the sagittal abdominal diameter has been established. Studies carried out up to now reveal that there is a better connection between these measurements and obesity complications. A group of 45 women was examined: 30 obese and 15 healthy non-obese women being the control group. The following was measured: body height, body weight, waist and hip circumferences, blood pressure, body mass index (BMI), waist-hip ratio (WHR) and a special caliper was used to measure the sagittal abdominal diameter. In order to study glyco-regulation all obese women underwent GTT (Glucose tolerance test) with determination of insulinemia; in regard to lipidic parameters total cholesterol, high-density lipoproteins (HDL) and low-density lipoproteins (LDL) cholesterol and index of atherosclerosis were determined. Gathered results show that in the group of obese women values of sagittal abdominal diameter were significantly higher than in the control group, while metabolic parameters show that in these patients there is a metabolism disorder of lipids and lipoproteins as well as hyperinsulinemia and reactive hyperinsulinemia and higher values of systolic and diastolic blood pressure. Our results of examination in the group of android obese women show that there is a significant association among values of sagittal abdominal diameter and lipid disorders, disorders of glycoregulation, especially hyperinsulinism and insulin resistance.

Abdomen↗
PubMed1992

[Hypophyseal pseudomacroadenoma in primary hypothyroidism--2 case reports].

Primary hypothyroidism is often accompanied with hyperprolactinemia and if the untreated disease persists longer hypophyseal adenoma consisting of thyreotropic cells might develop. On the other hand, although rarely, simultaneous occurrence of primary hypothyroidism and hypophyseal prolactin adenoma might be encountered. If substitutional therapy, after the establishment of euthyroid status, does not eliminate clinical signs of hyperprolactinemia and normalize prolactin levels, a decision can be made in favor of hyperprolactinemia within primary hypothyroidism. In that case possible tumor changes in the hypophysis will show regressive tendency towards final disappearance. However if clinical signs and hyperprolactinemia persist after the establishment of euthyroid status, especially if accompanied with compressive signs this should be regarded as a coincidence of primary hypothyroidism and hypophyseal prolactin tumor. We report two female patients with primary hypothyroidism and hypophyseal pseudomacroadenoma.

Adult↗
PubMed1992

[Psychological characteristics of obese persons with special reference to periods of modified fasting].

It is well known fact that the results of modified fasting can be improved if the basic therapeutic method is combined with psychotherapeutic procedures. We have analyzed the data taken by a poll from 55 extremely obese women treated by modified fasting regimen. The results absolutely justify the above mentioned remark that radical reduction cures may cause critical moments most frequently recognized in hunger crisis when patients feel a need for conversion with medical staff. With no doubt, any help from a qualified person might be perfectly beneficial. Besides, obese persons are more inclined to depressive moods which may aggravate during these cures. In order to maintain the achieved result for a longer period of time if not for good, a continuous team work which include psychotherapeutic measures is of special significance. On the highest level it would be smart to establish an association of treated obese people, which would be a link between a patient and a professional.

Adult↗
PubMed1992

[The metabolic X syndrome--4 case reports].

The study reviews current knowledge about metabolic X syndrome characterized by android obesity, arterial hypertension, insulin resistance with hyperinsulinemia and disturbed carbohydrate tolerance, a decrease of HDL cholesterol and an increase of the triglyceride rich VLDL particle level. The study describes 4 female patients having been diagnosed for this syndrome. Only an ontime and vigorous reduction of overweight, along with intensified physical activity can prevent later development of serious complications, first of all, in cardiovascular system.

Adult↗
PubMed1990

[Case report of pheochromocytoma with an atypical localization].

One of the endocrine causes of arterial hypertension is pheochromocytoma, usually located in the adrenal gland medulla. Extra-adrenal tumor locations are seldom encountered, and this can considerably complicate the diagnostic procedure. If a distinct clinical manifestation exists, supported by the finding of elevated catecholamine values, it is essential to persistently and carefully search for the place of their increased production. Such an attitude is completely justified in regard to the knowledge that this endocrinologically conditioned hypertension can be permanently and successfully solved with a surgical procedure. A case of pheochromocytoma has been presented with an atypical mediastinal location, prolonged and complicated diagnostic procedure, which has been successfully solved by surgery.

Adult↗
PubMed1990

[Drug therapy of obesity--results of treatment with dexfenfluramine].

The paper presents the results of treatment in 22 obese persons with hypoenergetical nutrition of 4200 kJ with the simultaneous application of dexfenfluoramine in the daily dose of 30 mg in the course of three months. During this period of time an average weight loss of 7.5 kg was achieved, and a loss of 10 kg and more in one third of the patients. The controlled laboratory parameters did not show any significant deviations, and side effects in the form of mouth dryness and diarrhea were rare, and of a lighter intensity so that they did not demand the stop of therapy. When correctly indicated, dexfenfluoramine presents a valuable supplement in the therapeutic arsenal for obesity treatment, because thanks to its anorexigenic effect it eases the conducting of hypoenergetical nutrition and improves the treatment effect of this pathological condition.

Adult↗
PubMedDate not supplied

Orlistat, a gastrointestinal lipase inhibitor, in therapy of obesity with concomitant hyperlipidemia.

Orlistat, a gastrointestinal lipase inhibitor, decreases fat absorption and thus it reduces caloric intake. The objectives of this placebo-controlled, double-blind, multicentre trial were to evaluate the efficacy of orlistat in terms of weight reduction, the effects on serum lipid levels and its tolerability profile. 119 obese patients (body mass index, BMI > or = 30 kg/m2) with hyperlipidemia (LDL-cholesterol > or = 4, 2 mmol/l) were randomized to receive either orlistat capsules 120 mg (n = 60) or placebo capsules (n = 59), three times daily, during 24 weeks. All patients were also on a mild hypocaloric diet. Mean weight reduction was 10.75 kg (10.7%) in orlistat group and 7.34 kg (7.5%) in placebo group. All serum lipid parameters improved in the orlistat group. The only adverse event more frequently noted with orlistat was stool fat. Orlistat in combination with diet provides increased weight loss than diet alone, improvements of serum lipids in subjects with hyperlipidemia and it has a good tolerability profile without systemic effects.

Adult↗
PubMedDate not supplied

[News in oral therapy of diabetes mellitus].

INTRODUCTION: Recent interest in regard to therapy of diabetes mellitus has focused on novelties in the field of insulin and other kinds of therapies disregarding the contemporary achievements in oral therapy. DIETARY PLANT FIBER: Dietary habits and food preferences in developed countries reveal lack of dietary plant fiber associated with the epidemiologic expansion of widespread noninfectious diseases (metabolic, cardiovascular and some malignant neoplasms). INHIBITORS OF INTESTINAL ALPHA-GLYCOSIDASES: These are substances which competatively and reversibly inhibit the intestinal alpha-glycosidases. The best known among them is acarbose, already in clinical usage for some time. Its wide application has been limited due to fairly distressing side effects. NEW ORAL HYPOGLYCEMIC AGENTS: Although metformin is not a new agent, it deserves attention because it is a novelty in our country. It is extremely useful in therapy of obese diabetics with insulin resistance and hyperinsulinemia. Furthermore, glimepiride--a new sulphonyluretic agent is also at disposal, being better than the previous due to not inhibiting vasodilatory reaction and so it can be used in treatment of some heart diseases. A completely new group of oral hypoglycemics is represented by thiazolidine agents which represent the so-called insulin sensitisers. Apart from that, they have a favourable effect on some lipid fractions and arterial blood pressure. SOME OTHER HYPOGLYCEMIC AGENTS: Among numerous substances with hypoglycemic effect it seems that in the future sulphonyluretic agents might be replaced by benzoic acid preparations.

Acarbose↗
PubMedDate not supplied

[Current diagnostic methods of the specific distribution of adipose tissue].

INTRODUCTION: The classification of obesity into male or the android type and female or the gynoid type dates from the first clinical observations of J. Vague in the distant 1947. Researches carried out in the recent years show that in the android type of obesity there is an insulin resistance and hyperinsulinism as a metabolic bases for accelerated atherosclerosis. These insights imposed a need to determine body composition, and within it also the mass and the fat tissue distribution. The simplest anthropometric parameter which gives us insight into the nutritional status is BMI, while waist/hip ratio (WHR) offers orientation for the fat tissue distribution. MATERIAL AND METHODS: The subcutaneous fat tissue is measured by standard calipers. A particularly important anthropometric parameter which has been increasingly applied in the recent years is the sagittal abdominal diameter (SAD) measured by a simple caliper constructed by Kahn. This anthropometric indicator measures only the visceral fat tissue. As for other techniques, in the first place one should mention measuring of body density which presents a relation between the body mass an volume. Tetrapolar bioelectric impedance analysis is based on measuring the resistance of the body exposed to the impact of alternating current of 50 kHz and the strength of 800 microA. Double photon absorptiometry and X ray absorptiometry are precise methods for the determination of body composition, but they require expensive equipment and X ray absorptiometry also exposes the organism to certain radiation. Radio-isotopic techniques are based on measuring the total body liquid by marked deuterium or tritium and measuring of the total body potassium. Infrared spectrometry is a simple and not a particularly reliable method based on application of two sources of monochromatic light. Ultrasonographic measuring of fat tissue is a very favoured technique by which one can measure both the subcutaneous and visceral fat tissue. Measuring is carried out by transducer of 7.5 mHz for the subcutaneous and 3.5 mHz for visceral fat tissue. It is certain that fat-tissue depots can be most exactly measured by computerized tomography and nuclear magnetic resonance which, however, require a very expensive equipment. CONCLUSION: Modern concept of obesity implies an obligatory determination not only of the degree, but, which is even more important, of the type of obesity. Within these activities, besides the techniques already used so far (BMI, WHR), it is recommended to introduce measuring of the visceral fat tissue by SAD and ultrasonographic measuring of both fat-tissue depots into the everyday routine work.

Adipose Tissue↗