- Type of paper
: Book
Title: MANAGEMENT OF COMMON POISONING IN THE INTENSIVE CARE UNIT
- Authors:
- Gašparović, Vladimir
- Gjurašin, Mirko
- Ivanović, Dragutin
- Radonić, Radovan
- Kvarantan, Marino
- Kakarigi, Davor
- Merkler, Marijan
Publisher: A.P.I.C.E.
Year: 1995
Number of pages: 15
Number of references: 25
Language: engleski
Summary: Accidental poisonings are most frequent (herbicides, carbon
monoxide, nicotine, alcohol), followed by suicidal poisonings (drugs, less
commonly other poisons), while criminal poisonings occur rarely. Acute
poisonings are often emergencies demanding an appropriate approach
(identification of poison, prevention of further absorption, removal of
poison, symptomatic measures as maintenance of vital functions and
administration of antidotes). Technological advances accompanying
development ofcivilization have faced man variety of potentially poisonous
substances. Currently, some 12 million of chemical compounds are being
produced. However, in common clinical pratice, the number of intoxications
is much smaller and they may be subdivided in two groups. The first is
caused by drugs which, in overdosage, account for approximately 50% of all
serious poisonings. The secound group is caused by compounds that man
encounters in his surroundings, and which in dependence of the route they
enter the organism exert toxic effects. Patients admitted to the internal
intensive care unit for serious lifethreatening poisonings in most cased
require additional medical procedures. One of the greatest problems in the
adequate management of acute poisoning is identification of the toxic
substrance the patients was exposed to. Severe consciousness distrubances
are frequentllly encountered, and if case history cannot be obtained the
observance of the clinical syndrome guides (cholinergic, anticholinergic,
sympathomimetic, severe metabolic acidose) further diagnostic procedures
and treatment.
This review will deal with the treatment of the most common poisonings in
the intensive care unit.
Keywords: poisoning, clinical syndrome, diagnostic, management.
- Type of paper
: Paper in journal
Title: ELIMINATION OF ANTIBODIES BY PLASMAEXCANGE IN ABO
INCOMPATIBLE BONE MARROW TRANSPLANTATION
- Authors:
- Gašparović, Vladimir (144840)
- Labar, Boris
- Puljević, Davor (136571)
- Skodlar, J
- Bogdanić, V
- Ivanović, Dragutin
- Gjurašin, Mirko
Journal: BONE MARROW TRANSPLANTATION
Number: 3
Volume: 4
Year: 1989
Pages: from 109 to 109
Number of references: 8
Language: engleski
Summary: Significant quantity of circulating antibodies may be
eliminatedby PE. BMT in major ABO incompatibility is possible after
PE,without acute hemolitic crisis or acute renal insufficiency.
Keywords: Bone marrow transplantation, plasmapheresis, ABO incompatibility.
- Type of paper
: Paper in journal
Title: MUCHROOM POISONING WITH A LONG PERIOD OF INCUBATION
- Authors:
- Gašparović, Vladimir (144840)
- Puljević, Davor (136571)
- Radonić, Radovan
- Gjurašin, Mirko
- Ivanović, Dragutin
- DeWolf, Frederic
- Pišl, Zoran
Journal: LIJEČNIČKI VJESNIK
Number: 1
ISSN: 0024-3477
Volume: 113
Year: 1991
Pages: from 16 to 20
Number of references: 26
Language: hrvatski
Summary: A group of 87 patients with the signs of poisoning with
mushroomswith along period of incubation (t=12.4 +/- 6.2 h) has
beenreported. Nausea, vomiting and diarrhea dominate in the clinicalpicture
in the first phase. Forty-one patients /47.l%) had "only"clinical symptoms
without severe parenchymatous impairments.Forty-six (54.9%) had evidence of
a hepatic lesion and 8 patients(10.8%) had renal function impaired, 6 of
which neededhemodialysis.There was a significant correlation
betweenelevation of serum transaminaases and prolongation ofprothrombin
complex, resulting from the decreased synthetic liverfunction
(SGPTl/PTlr=-0.424, p=0,00:SGOTl/PVlr=-0.448, p=0.000)during the first days
after poisoning Hepatic and renal damagewas not identical in all the cases,
and there was no correlationbetween the elevation of serum transaminases
and retention ofnitrogen substances. When analysing the effect of therapy
onelevation of serum transaminases and prolongation of prothrombincomplex,
a significant difference between elevation of serumtransaminases and
prolongation of prothrombin time was found inpatients on competitive
inhibition with penicillin or silibinin,as compared to the patients only on
plasmapheresis.
Keywords: Mushroom poisoning, long incubation time.
- Type of paper
: Paper in journal
Title: CORONARY VASCULARISATION IN PATIENT MAINTAINED ON CHRONIC
HEMODIALYSIS
- Authors:
- Sutlić, Željko
- Husedžinović, Ino
- Rudež, Vlado
- Gašparović, Vladimir
Journal: ACTA MEDICA CROATICA
Volume: 46
Year: 1992
Pages: from 0 to 133
Number of references: 21
Language: engleski
Summary: A patient, maintained on hemodialysis for 16 years because
ofchronic renal failure caused by chronic glomerulonephritis, whounderwent
surgical coronary revasculariyation, is presented. Theauthors conclude that
preoperative hemodialysis, carefulhydration of the patient, right
management of cardiopulmonarybypass, use of hemodilution and aprotinine can
contribute toescivating of hemofiltration and heterologue blood transfusion
inuremic patients who undergo well timed coronaryrevascularization.
Keywords: Coronary artery disease, hemodialysis, coronary surgery.
- Type of paper
: Paper in journal
Title: THE SIGNIFICANCY OF IMMUNOCOMPROMISATION IN VACCINATION
AGAINST B HEPATITIS IN CHRONIC RENAL FAILURE
- Authors:
- Gašparović, Vladimir
- Mihaljević, Ivanka
- Gjurašin, Mirko
- Delimar, Nataša
- Borčić, Berislav
- Gašparović, Hrvoje
- Mihaljević, Ivanka
Journal: ACTA MEDICA CROATICA
Volume: 47
Year: 1993
Pages: from 61 to 65
Number of references: 21
Language: engleski
Summary: The paper presents the immunogenecity of hepatitis
vaccine(obtained by genetic engineering) in immunocompromised patientswith
preterminal renal insufficiency defined by depression ofcreatinine
clearance of 10 to 25 ml/min. The study consisted of28 randomized patients
with impaired renal function. Sixteenpatients received a single dose and,
twelve a double dose ofvaccine. Revaccination following 3 intramuscular
doses of vaccinehad been undertaken after 24 weeks if antibodies were
notdetected or their titer was 10 i.u. or less. All patientsobtained a
booster dose following 52 weeks. There was nostatistically significant
difference in titer values betweenimmunocompromised patients regardless of
whether they werevaccinated with a single or double dose. The antibody
titer inpatients with chronic renal isufficiency was significantly loweras
compared with the results of vaccination in healthypopulation. It may be
concluded that it is more beneficial andless expencive to use a single dose
vaccine and revaccination ifthe titer is negative or insufficiently high.
Keywords: Chronic renal insufficiency, vaccination, hepatitis B.
- Type of paper
: Paper in journal
Title: TICLOPIDINE IMPROVES DIALYSIS CLEARANCES OF SOLUTES BY
REDUCING BLOOD CLOTHING IN DIALYSERS FIBERS
- Authors:
- Milutinović, Slobodan
- Gašparović, Vladimir
- Milutinović, Eva
- Buturović-Ponikvar, J
Journal: JOURN ART ORG.
Number: 4
Volume: 16
Year: 1992
Pages: from 15 to 123
Number of references: 7
Language: engleski
Summary: Ticlopidine, a platelet aggregation inhibitor was, tsted,
in abouble blind comparative cross-over study versus placebo, in
51dialysed uremic patients who had increased dialyser bloodclotting (> 25
fibers clotted/dialyser).At the end of a 7-daytreatment period with 250 mg
daily, the clearance of urea,creatinine and phosphate from 165 +/- 41 to
182 +/- 35 (p <0,01), 135 +/- 37 TO 143 +/- 35 (P<0,05), AND 120 +/- 36 TO
130+/- 35 (P<0,05) ml/min, respectively, at 30 min of HD and asimilar
effect was seen after 210 min of dialysis. The number of dialyser libers
clotted after dialysis was reduced byticlopidine therepy from 110 +/- 8
(p<0,05); no change inplatelet or erythrocyte count was observed. Two out
of 51patients experienced an adverse reaction from ticlopidine(cutaneous
haematoma and minor gingival bleeding). We concludethat ticlopidine is an
efficient and safe drug for dialyseduremic patients since it can reduce
blood clotting and therebyincrease dialysis efficiency.
Keywords: Ticlopidine, dialysis, blood clotting clearances
- Type of paper
: Paper in journal
Title: ACUTE RENAL FAILURE IN HEART TRANSPLANT RECIPIENTS
- Authors:
- Gašparović, Vladimir (144840)
- Planinc, Danijel
- Sutlić, Željko
- Biočina, Bojan
- Sokolić, Josip
- Gjurašin, Mirko
Journal: LIJEČNIČKI VJESNIK
ISSN: 0024-3477
Volume: 115
Year: 1993
Pages: from 152 to 155
Number of references: 19
Language: hrvatski
Summary: In this stady incidence and the develpment of acute renal
failure(ARF) in heart transplant recipients is presented. Among thethirteen
heart transplant recipients eight of them developedoliguric or nonoliguric
ARF. Besides the known factors such asactual condition of the patient,
kidney function, periandpost-operative compromised circulation, our results
demonstratethe significance of postoperative cyclosporin concentration
incombination with the use of other drugs. The results also showthe
importance of the way cyclosporin has been adminstrated.
Keywords: Acute renal failure, heart transplantation
- Type of paper
: Paper in journal
Title: THE ROLE OF ULTRASOUND IN DIAGNOSTICS AND TREATMENT OF
SEPTIC PATIENTS IN INTENSIVE CARE UNIT
- Authors:
- Radonić, Radovan
- Merkler, Marijan
- Kvarantan, Marino
- Ivanović, Dragutin
- Gašparović, Vladimir
- škorak, Ivan
- Gjurašin, Mirko
Journal: LIJEČNIČKI VJESNIK
Number: 1
ISSN: 1330-4917
Volume: 1S
Year: 1994
Pages: from 25 to 26
Number of references: 10
Language: hrvatski
Summary: In this article, the authors have shown the usefulness of
ultrasound examination in detecting the source of sepsis in intensive care
unit patients. Amoung 47 patients with sepsis, ultrasound examination was
performed in 39, and it gave significant contribution to the diagnosis in
21. Invasive procedures (ultrasound quided punctures and drainages) were
performed in 13 of those patients. Our experience shows that bedside
24/hour available ultrasound examination is a very useful tool in the
hands of experienced internsive care physicians for the diagnosis and
treatment of septic patients.
Keywords: ultrasound, sepsis, ICU.
- Type of paper
: Paper in journal
Title: ACUTE POISONINGS / FREQUENCY AND PROGNOSIS
- Authors:
- Gašparović, Vladimir
- Gjurašin, Mirko
- Ivanović, Dragutin
- Kvarantan, Marino
- Radonić, Radovan
- Merkler, Marijan
- Puljević, Davor (136571)
- Pišl, Zoran
Journal: LIJEČNIČKI VJESNIK
Number: S1
ISSN: 1330-4917
Volume: 116
Year: 1994
Pages: from 44 to 46
Number of references: 17
Language: hrvatski
Summary: Over a period of 8 years, 249 patients with acute poisoning
were admitted to the Intensive Care Unit, Department of Internal Medicine.
University Hospital Rebro, Zagreb. Poisoning by drugs was most common and
was involved in 127 cases (51.0%), mushrooms in 54 (21.6%), caustics in 27
(10.8%), pesticides in 20 (8%) and ethylenglicol in 7 patients (2,8%).
Among the drug intoxications, the most frequent cause of poisoning were
psychotherapeutics, although there were also intoxications with
antiarrhythmics, digitalis and other drugs. According to our findings, drug
poisoning resulted in a lower death rate with regard to intoxications with
other substances, such as caustics and pesticides (pž0,01). Age represented
a significant prognostic parameter in poisonings. The older age groups
showed significantly higher death rate than the younger ones (pž0,00l).
Inflammatory processes were the most usual complication of intooxications.
Hospital acquired infestions of the respiratory tract required artificial
ventilation in 46 patients. A serious problem also represented sepses due
to hospital/acquired basĐcteries introduced into the tissue through a
vascular assess. Urinary tract infections were also very common because of
the introduction of a urinary cather in the majority of patients,
extracoproreal drug eliminatio and&or poisons was initiated in order to
achieve a quicker substance elimination from the blood stream. Among the
procedures of extracorporeal elimination, hemoperfusion as a result of a
lower number of side/effects in cases when all the three procedures are
used.
Keywords: poisoning, prognosis.
- Type of paper
: Paper in journal
Title: IMMUNOTHERAPY OF SEPSIS AND SEPTIC SHOCK
- Authors:
- Ivanović, Dragutin
- Gjurašin, Mirko
- Gašparović, Vladimir (144840)
- Radonić, Radovan
- Kvarantan, Marino
- Merkler, Marijan
Journal: LIJEČNIČKI VJESNIK
Number: 2
ISSN: 1330-4917
Volume: 117
Year: 1995
Pages: from 8 to 11
Number of references: 25
Language: hrvatski
Summary: An extraordinary advance in basic sciences and technology
did not reduce high lethality rate of the septic shock patients. The
lethality rate of those patients was and still is around 50%. A new
knowledge about a role of an inflammatory response on the infection in the
later fatal course of the septic patients, led to the new approach in the
treatment. A trial to block and endotoxin, cytokines, especially TNF and
IL/l, as well as some other substances, in experimental models of sepsis,
in spite of inconsistent results, is promising. A clinical ezperiences are
disappointing, at first because of our still poor knowledge about various
cytokines cascade, feedback mechanisms, cellular protective mechanisms,
ets. The new chapter on the treatment of that hightlly lethal syndrome is
open, though a final achievement of that approach is not clear till now.
Keywords: sepsis, septic shock.
- Type of paper
: Paper in journal
Title: ETHIOLOGY OF DISTURBED CONSCIOUSNESS IN INTERNAL INTENSIVE
CARE UNITS
- Authors:
- Gašparović, Vladimir (144840)
- Gjurašin, Mirko
- Kakarigi, Davor
- Ilekovi', Kristina
- Gjurašin, Mirko
- Radonić, Radovan
- Ivanović, Dragutin
- Kvarantan, Marino
- Merkler, Marijan
- Pišl, Zoran
Journal: LIJEČNIČKI VJESNIK
Number: S2
ISSN: 1330-4917
Volume: 117
Year: 1995
Pages: from 57 to 59
Number of references: 7
Language: hrvatski
Summary: Tha present study on 5330 patients admitted to the
internal intensive care unit over the five year period (1990/1994)
indicated that consciousness disorders are most frequently associated with
poisoning. On admission, the state of consciousness of 665 of these 5330
patients was retrospectively evaluated.Poisoning by drugs was most common
among intoxications (93 patients of 154 cases of poisoning). Coma, which
is the most severe manifestation of consciousness disorder, occurred very
often in these patients. Poisoning caused by other agents was connected
with other forms of consciousness disorders. Low Glasgow Coma Score (GSC)
was a severe predictor, while the number of deaths among patients with GCS
10 or more, was low. Sepsis was the next most common cause of
consciousness disorder among our patients (88 patients). Death rate in
these patients was high, amounting to almost 50%, regardless of GCS on
admission, suggesting that the severity of main event determines the
outcome. Glycemia disorders, including hypoglycemia, hyperglycemia as well
as hyperosmotic state, did not result in lethal outcome, regardless of GCS
on admission. The highest death rate was registered in patients with
cardiopulmonary arrest and lowest GCS on admission. Patients with
cardiogenic shock, despite high GCS on admission, had high death rate.
Keywords: ethiology,disturbed consciousness, ICU.
- Type of paper
: Paper in proceedings
Title: WAR CONDITION AND FREQUENT ACUTE INTOXICATIONS
- Authors:
- Gašparović, Vladimir (144840)
- Ivanović, Dragutin
- Gjurašin, Mirko
Proceedings title: TOKSIKOLOŠKA SLUŽBA U OBRANI DOMOVINE
Language: hrvatski
Place: Zagreb
Year: 1993
Pages: from 85 to 99
Summary: Urgent diagnostic and therapeutic approach to the
acutelypoisoned patient calls for a very experienced physician. Database of
possible poisons should be constantly available, becausemany poisonous
substances are rarely met in clinical practice.The approacht to the basic
clinical signs, complications andtreatment in acute poisoning is described.
The picture andtreatment of the most frequent acute poisonings are
presented.Modes of poisoning, removal of poisons from the body and the
roleof antidotes are stressed. Some groups of clinical signs could
becharacteristic and could be a guide to the poison which was notrecognized
at admission. The authors own experiences in thetreatment of acute
poisoning are also presented.