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Published papers on project 3-01-045


Quoted papers: 0
Other papers: 12
Total: 12


  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. 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

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.


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