Tonci Batinic

University of Split-School of Medicine, Spalato, Splitsko-Dalmatinska, Croatia

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Publications (7)6.34 Total impact

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    ABSTRACT: The objective of this study is to determine the time elapsed from the onset of pain in patients with AMI to their hospital admission (pain to door time) and fibrinolytic administration (door to needle time). The objective is also to determine whether there is a difference between the frequency of fibrinolytic administration to patients and the survival rate of patients with AMI with respect to the location they are transported from. This prospective clinical study included patients manifesting clear clinical, electrocardiographic and biochemical evidence of AMI, according to criteria of ECS (European Society of Cardiology), and who were admitted to the Coronary Care Unit of Split Clinical Hospital in the period from 1 January to 31 December 1999. On the basis of their residence, the patients were divided into three groups: 1. patients from Split and the surrounding area distant up to 15 km from the city; 2. patients from the surrounding area within 15 km from Split, 3. patients living on the islands of Central Dalmatia. 409 patients with AMI were admitted to hospital in the period in question. The first group consisted of 207, the second of 163, and the third of 39 subjects (254:39; p < 0.001). The median time from the onset of pain to hospital admission for all patients with AMI was 7.3 hours, for patients from the islands 13 hours, whereas for those coming from locations distant more than 15 km from Split it amounted to 7.6 hours (p < 0.001). The number of patients that were administered fibrinolysis is extremely low (17.1%) and there is no significant difference in the frequency of fibrinolytic administration between certain patient groups (p > 0.05). Similarly, the mortality rate prior to hospital discharge is high (18.8%) and does not vary among the three studied groups (p > 0.05). The results of this study are in opposition to the assumption that the mortality rate will be lower in patients living in Split and the immediate surroundings when compared to the mortality rate of patients living on the islands of Central Dalmatia (21.7%: 15.4%).
    Collegium antropologicum 09/2012; 36(3):813-9. · 0.61 Impact Factor
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    Journal of cardiovascular ultrasound 09/2012; 20(3):163-4.
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    Journal of cardiovascular ultrasound 06/2012; 20(2):114-5.
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    ABSTRACT: Apnea divers hyperinflate the lung by taking a deep breath followed by glossopharyngeal insufflation. The maneuver can lead to symptomatic arterial hypotension. We tested the hypotheses that glossopharyngeal insufflation interferes with cardiac function further reducing cardiac output (CO) using cardiac magnetic resonance imaging (MRI) to fully sample both cardiac chambers. Eleven dive athletes (10 men, 1 woman; age = 26 ± 5 yr, body mass index = 23.5 ± 1.7 kg·m(-2)) underwent cardiac MRI during breath holding at functional residual capacity (baseline), at total lung capacity (apnea), and with submaximal glossopharyngeal insufflation. Lung volumes were estimated from anatomic images. Short-axis cine MR images were acquired to study biventricular function. Dynamic changes were followed by long-axis cine MRI. Left and right ventricular end-diastolic volumes (LVEDV, RVEDV) decreased during apnea with and without glossopharyngeal insufflation (baseline: LVEDV = 198 ± 19 mL, RVEDV = 225 ± 30 mL; apnea: LVEDV = 125 ± 38 mL, RVEDV = 148 ± 37 mL, P < 0.001; glossopharyngeal insufflation: LVEDV = 108 ± 26 mL, RVEDV = 136 ± 29 mL, P < 0.001 vs baseline). CO decreased during apnea (left = -29 ± 4 %, right = -29 ± 4 %) decreasing further with glossopharyngeal insufflation (left = -38% ± 4%, right = -39% ± 4%, P < 0.05). HR increased 16 ± 4 bpm with apnea and 17 ± 5 bpm with glossopharyngeal insufflation (P < 0.01). Ejection fraction moderately decreased (apnea: left = -5% ± 2%, right = -7% ± 2%, glossopharyngeal insufflation: left = -6% ± 2%, right = -10% ± 2%, P < 0.01). With continued apnea with and without glossopharyngeal insufflation, LVEDV and CO increased over time by a similar but small amount (P < 0.01). The major finding of our study was that submaximal glossopharyngeal insufflation decreased CO further albeit by a small amount compared to maximal inspiratory apnea. The response was not associated with severe biventricular dysfunction.
    Medicine and science in sports and exercise 05/2011; 43(11):2095-101. · 4.48 Impact Factor
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    ABSTRACT: To analyze pre-hospital delay in patients with myocardial infarction from mainland and islands of Split-Dalmatian County, southern Croatia. The study included all patients with myocardial infarction transported by ambulance to the University Hospital Split in 1999, 2003, and 2005. Pre-hospital delay was analyzed in the following intervals: pain-to-call, call-to-ambulance, ambulance-to-door, and door-to-coronary care unit interval. Patients were categorized according to the location from which they were transported: Split, mainland >15 km from Split, and islands. There were 1314 patients (62.9% men) transported and hospitalized for myocardial infarction. Total pre-hospital delay (pain-to-hospital) was significantly reduced from 1999 to 2005 (5.2 hours vs 4.3 hours, P=0.011). Seventy-five patients (5.7%) were admitted to the coronary care unit within the recommended time-frame of less than 90 minutes, none of which was from the islands, while 248 patients (18.9%) were admitted more than 12 hours from the onset of pain. Pre-hospital delay in patients with myocardial infarction in southern Croatia is still too long, especially in patients coming from outside of Split. Prognosis and survival of such patients may be improved by introducing changes to the health care system in remote areas, such as out-of-hospital thrombolysis, greater use of telemedicine, training of lay persons and paramedics in defibrillation, introduction of quality assessment mechanisms, and improved patient transport.
    Croatian Medical Journal 10/2010; 51(5):423-31. · 1.25 Impact Factor
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    ABSTRACT: Aim To analyze pre-hospital delay in patients with myocardial infarction from mainland and islands of Split-Dalmatian County, southern Croatia. Methods The study included all patients with myocardial infarction transported by ambulance to the University Hospital Split in 1999, 2003, and 2005. Pre-hospital delay was analyzed in the following intervals: pain-to-call, call-to-ambulance, ambulance-to-door, and door-to-coronary care unit interval. Patients were categorized according to the location from which they were transported: Split, mainland >15 km from Split, and islands. Results There were 1314 patients (62.9% men) transported and hospitalized for myocardial infarction. Total prehospital delay (pain-to-hospital) was significantly reduced from 1999 to 2005 (5.2 hours vs 4.3 hours, P = 0.011). Seventy- five patients (5.7%) were admitted to the coronary care unit within the recommended time-frame of less than 90 minutes, none of which was from the islands, while 248 patients (18.9%) were admitted more than 12 hours from the onset of pain. Conclusion Pre-hospital delay in patients with myocardial infarction in southern Croatia is still too long, especially in patients coming from outside of Split. Prognosis and survival of such patients may be improved by introducing changes to the health care system in remote areas, such as out-of-hospital thrombolysis, greater use of telemedicine, training of lay persons and paramedics in defibrillation, introduction of quality assessment mechanisms, and improved patient transport.
    Croatian Medical Journal (cmj@mef.hr); Vol.51 No.5.
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    ABSTRACT: The aim of the study was to evaluate the safety and efficacy of endovascular treatment of abdominal aorta aneurysm (AAA) with Talent stent-graft (TSG). From October 1999 to February 2002, 18 patients (17 male and one female) aged 65-77, with AAA >5 cm in diameter, were treated by bifurcated Talent stent grafting. In all patients, postinterventional CT was performed 24 hours after stent grafting. The sutures were removed on the seventh to ninth day after the procedure, and the patients were released for home care. Regular spiral CT control evaluation was scheduled at 1, 3, 6, 9, 12 and 24 months after stent grafting. The mean follow up time was 11 months. Talent stent grafting procedure was initially successful in all patients. During regular controls, the TSGs were not occluded. In two (11%) patients, Talent stent grafting was preceded by preinterventional embolization. In five (27%) patients, control spiral CT after stent grafting showed a small endoleak. In these patients, systemic heparinization was interrupted and spiral CT was repeated after seven days. Repeat spiral CT after seven days showed absence of endoleak in four of five (80%) patients. A small endoleak in one patient disappeared spontaneously a month after TSG placement. The mean annual reduction in aneurysmal sac diameter was 7.3 (0 to 28) mm. TSG placement is a safe and efficient method of AAA treatment. In patients with accurately determined indication for the procedure, it is today considered a justified alternative to surgery.
    Acta Clinica Croatica; Vol.41 No.2 Separat 1.