{"title":"Amino acid supplemented diet vs. selective low protein diet in chronic renal failure.","authors":"D Vujić, L Djukanović","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Two groups of patients with chronic renal failure (creatinine clearance 13 ml/min) were treated with two different low protein diets: unselected protein diet with 0.35 g of protein/kg/day supplemented with amino acids (first group; 10 patients) and selective protein restricted diet with 0.6 g/kg/day of high biologically valuable proteins (second group; 9 patients). Both diets showed a good patient compliance. The serum urea level decreased significantly only in the first group of patients with a simultaneous disappearance of uremic gastrointestinal side effects. Progression of renal failure, shown by plotting the reciprocal of the serum creatinine concentration against the time, was significantly slower in the first group of patients and therefore their survival without dialysis was longer than that in the second group. The nutritional state was well maintained in both groups. Comparison of two low protein diets showed that the unselected protein diet supplemented with amino acids is more effective in delaying the progression of renal failure. The clinical state of patients is improved and their protein nutrition maintained.</p>","PeriodicalId":7058,"journal":{"name":"Acta medica Iugoslavica","volume":"44 4","pages":"377-87"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13247297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Approach to ultrasound in oncology.","authors":"A Cardinale, R Lagalla, G Mercadante","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In a multicenter investigation carried out in 13,590 patients, 85 primitive and secondary abdominal neoplastic lesions were detected, the incidence being 0.6%. On the basis of this investigation, the role of ultrasonography in the clinical diagnosis, staging, and follow-up of oncologic diseases is summarized. Ultrasonography is employed for three basic steps in the staging of neoplastic lesions: 1. detection of lesions, 2. diagnosis of their nature, 3. balance of extension (TNM). Ultrasonography provides a lower diagnostic accuracy than CT and MRI as the balance of extension is concerned, but it yields reliable results for the diagnosis of malignancy if completed by ultrasonography guided percutaneous biopsy. The possibility of ultrasonography in the follow-up of neoplastic lesions and its applications in the treatment of some tumors are discussed.</p>","PeriodicalId":7058,"journal":{"name":"Acta medica Iugoslavica","volume":"44 4","pages":"415-24"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13247301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"New noninvasive index of the left ventricular inotropic state.","authors":"D Huml, M Buksa","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In order to confirm in clinical material a new contractile index, the systolic circumferential wall stress/end systolic muscle index ratio (SCS/ESMI), there were compared two groups of patients with pressure overload ventricular hypertrophy, with and without global compliance disturbances (Group B1 = 36; Group B2 = 28) and two groups of age and body surface area-matched healthy individuals (Group A1 = 36; Group A2 = 28). The new index of the contractile or muscle function, the SCS/ESMI ratio, was so effective in the research sample as the systolic circumferential wall stress/cavitary volume ratio, the SCS/ESVI. The product of the systolic contractile index, the SCS/ESVI, and ejection fraction (SCI X EF), as an integrated left ventricular parameter, showed that the ejection or pump function reduction was artificial in patients with an increased afterload and normal preload. The confidence limit for the SCI X EF on the level of 95% is 3.5, and for the product of the new systolic muscle index and ejection fraction, the SMI X EF, is 99. The inaugurated functional parameters could serve for revealing \"false positive\" cardiac failure or they could reveal the true reduction of the muscle contractile cardiac function by the artificially increased and \"normal\" ejection phase indices.</p>","PeriodicalId":7058,"journal":{"name":"Acta medica Iugoslavica","volume":"44 1","pages":"21-34"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13294388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V Sarnavka, D Mardesić, G Gjurić, M Vlatković, M Dumić, D Milicić, J Popović
{"title":"Screening of newborns for congenital hypothyroidism in Croatia--organization and first results.","authors":"V Sarnavka, D Mardesić, G Gjurić, M Vlatković, M Dumić, D Milicić, J Popović","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In 1985 a newborn screening programme for the detection of congenital hypothyreosis was introduced in Croatia in addition to the already existing one for phenylketonuria. The paper delineates the organization of the screening programme, the method used, and the first results. Clinical manifestations, somatic and mental development, as well as laboratory findings of the first eleven children with congenial hypothyroidism detected by the screening programme and followed-up regularly are presented in more detail.</p>","PeriodicalId":7058,"journal":{"name":"Acta medica Iugoslavica","volume":"44 1","pages":"3-14"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13487115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Intensive radiotherapy and polychemotherapy, clinical stage and systemic manifestations of the disease as parameters important in the prognosis for Hodgkin's disease].","authors":"J Maras, M Dubravcić, M Konstantinović, N Stula","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the period from 1961 to 1982, 82 patients (36 females and 46 males) with Hodgkin's disease were treated. The median age was 40 years. According to the way of treatment, the patients were divided into two groups, the first group with 30 patients treated by local x-rays and/or monochemotherapy (treated up to 1971) and the second group with 52 patients treated by aggressive tele-cobalt therapy and/or MOPP polychemotherapy (after 1972). In the first group of patients, complete remission was achieved in 9 cases, partial remission in 15, while there was no remission in 6 cases. In the second group, complete remission was achieved in 40 cases, partial remission in 9, while no remission could be achieved in 3 cases. The difference in the number of remissions achieved between the patients treated up to 1971 and patients treated later is statistically significant (chi 2 = 15.52 p less than 0.0001). The median age was significantly higher in the group of patients treated by aggressive therapy (65:12 months). Seven patients from the first group survived for more than 5 years, 5 being still alive. In the second groups 29 patients survived for more than 5 years, 24 of them being still alive. The difference in survival between these two groups is significant (chi 2 = 11.37; p less than 0.001). There is a significant difference in surviving between patients in different stages of the disease (chi 2 = 27.47; p less than 0.00001). Between the patients without general symptoms (A) and the patients with systemic manifestations (B) the difference in numbers of remissions is statistically significant (chi 2 = 8.44; p less than 0.005). The difference in survival between these two groups of patients is also significant (chi 2 = 16.52; p less than 0.0001).</p>","PeriodicalId":7058,"journal":{"name":"Acta medica Iugoslavica","volume":"44 1","pages":"35-46"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13487116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Narcissistic depression in schizophrenia].","authors":"M Trbović","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In individual analytically oriented psychotherapy as a research method, observing a random sample of 34 schizophrenics with the symptoms of depressive syndrome, the author has found that depression in schizophrenia is determined by narcissistic injuries, by a collapse of narcissistic satisfactions through the loss of \"ego\" functions, completeness, competitiveness, and competence. The depressive model is most frequently encountered in florid schizophrenic psychosis, at the beginning of hospitalization, but depending on the intensity and depth of narcissistic traumas and losses, it can develop also in any phase of the therapeutic process and the course of illness. In the author's view, the depressive model in schizophrenia is not conditioned by the neuroleptic treatment. Its recognition is very important for the therapy of suicidal tendencies, and for their prevention in particular.</p>","PeriodicalId":7058,"journal":{"name":"Acta medica Iugoslavica","volume":"44 1","pages":"59-64"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13487119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S Ilić, M Bogićević, V Savić, P Vlahović, V Stefanović
{"title":"[The effect of thyroxine on renal function in experimental acute renal insufficiency].","authors":"S Ilić, M Bogićević, V Savić, P Vlahović, V Stefanović","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of the study was to investigate the influence of exogenous thyroxine upon the kidney function in the experimental renal failure induced by the uranyl acetate application. Acute renal failure was induced by uranyl acetate in 32 rats, divided into 4 groups, each consisted of 8 rats. The group of untreated animals and the group of animals treated with thyroxine only were used as controls. Then glomerular filtration rate was determined in all the rats taken in the experiment. The comparison was made between the control or the group with acute renal failure without the thyroxine treatment and the groups treated with a single application of thyroxine before, simultaneously and after the uranyl acetate injection. An improvement of the glomerural filtration rate and a decrease of the blood nitrogen retention were obtained in rats with acute renal failure pretreated with thyroxine. Necrotic alterations of the kidney cortex were less marked in this group than in the group without thyroxine treatment. The improvements of the kidney function and morphology in acute renal failure suggest the possibility of the protective effect of thyroxine.</p>","PeriodicalId":7058,"journal":{"name":"Acta medica Iugoslavica","volume":"44 2","pages":"105-16"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13502800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V Gasparović, Z Puretić, B Vrhovac, M Gjurasin, D Puljević
{"title":"[Use of recombinant erythropoietin on secondary anemia in patients in the terminal phase of renal insufficiency on hemodialysis].","authors":"V Gasparović, Z Puretić, B Vrhovac, M Gjurasin, D Puljević","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A group of 6 patients with a history of end-stage renal insufficiency on hemodialysis was receiving erythropoietin (EPO) in a dosage of 50 IU/kg body weight i. v. The hemogram values were followed regularly every week and the patients underwent other laboratory evaluations every month. At the beginning of the study, the number of erythrocytes amounted to 2.2 +/- 0.3 x 10(12)/l. After 4 weeks it was 2.3 +/- 0.4 (NS) (p = 0.001), after 8 weeks 2.8 +/- 0.4 (p = 0.007), and after 12 weeks 3.2 +/- 0.3. At the beginning, hemoglobin was 70 +/- 8 g/l, after 4 weeks 76.3 +/- 13.7 (NS), after 8 weeks 95.7 +/- 14.3 (p = 0.008), and after 12 weeks 102.2 +/- 12 (p = 0.001). The hematocrit value rose from 21.4 +/- 3.4 at the beginning of the study to 32.1 +/- 3.6 (p = 0.001) after 12 weeks. The trial showed no significant effect of EPO on serum potassium which amounted to 5.3 +/- 0.4 mmol/l at the beginning of the trial and 5.6 +/- 0.8 (NS) after 12 weeks; the rate of the rise of platelets from 132.8 +/- 2.4 x 10(9)/l to 155.2 +/- 42.2 was not significant either. The results demonstrate a marked improvement in the red blood cells of patients receiving EPO in the end-stage of renal insufficiency and its influence on their general condition. One female patient was excluded from the study participation because of a severe bone pain.</p>","PeriodicalId":7058,"journal":{"name":"Acta medica Iugoslavica","volume":"44 2","pages":"129-35"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13502801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J Grujić, Z Petković, M Stojcević-Polovina, M Visnar-Klobucar, D Vignjević
{"title":"Primary prevention of perinatal impairments in the newborn.","authors":"J Grujić, Z Petković, M Stojcević-Polovina, M Visnar-Klobucar, D Vignjević","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The effects of intrauterine hypoxia on the motorial development of forty infants was studied by synthesizing the findings obtained by a team of obstetricians, neonatologists and physiatrists. The pH of the blood of the examinees was measured during delivery to detect hypoxia. Analyses of the results obtained have shown that the degree of deviation from a normal neurophysiological development is directly proportional to the degree of hypoxia. The findings indicate the importance of the early detection of intrauterine hypoxia.</p>","PeriodicalId":7058,"journal":{"name":"Acta medica Iugoslavica","volume":"44 3","pages":"243-6"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13546092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I Rotkvić, P Sikirić, J Jukić, S Krizanac, V Zjacić-Rotkvić, T Anić, M Duvnjak, S Mise, S Knezević
{"title":"[Spontaneous bacterial peritonitis in patients with decompensated liver cirrhosis and \"tense\" ascites].","authors":"I Rotkvić, P Sikirić, J Jukić, S Krizanac, V Zjacić-Rotkvić, T Anić, M Duvnjak, S Mise, S Knezević","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the study 52 patients with decompensated liver cirrhosis and \"tense\" ascites were included. According to the clinical picture, ascites cultures and the number of polymorphonuclears in cmm of the ascitic fluid, all patients were selected in one of the following groups: 1. group of patients with sterile ascites (28), 2. group of patients with spontaneous peritonitis (16), and 3. group of patients with bacterascites (8). The results have shown that the incidence of spontaneous peritonitis is much higher in the group of \"tense\" ascites patients than in the group of all patients with ascites, the ratio being 30.7% compared to 6% in all cirrhotic patients with ascites. Spontaneous bacterial peritonitis correlates with increased polymorphonuclears in the ascitic fluid (p less than 0.05), decreased pH values (p less than 0.0), and increased amounts of total proteins in the ascitic fluid (p less than 0.05). The lethality rate in the group of spontaneous peritonitis and sterile ascites was 43.7% and 7.1% respectively. Early diagnosis and, of course, adequate therapy are the main points in spontaneous bacterial peritonitis.</p>","PeriodicalId":7058,"journal":{"name":"Acta medica Iugoslavica","volume":"44 4","pages":"285-95"},"PeriodicalIF":0.0,"publicationDate":"1990-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13246693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}