Lada Zibar

University Hospital Osijek, Osik, Osječko-Baranjska, Croatia

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Publications (36)21.96 Total impact

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    ABSTRACT: Aim: We have analyzed the effects of renin-angiotensin-aldosterone system (RAAS) inhibitors on evolution of hemoglobin (Hb) and hematocrit (Htc) levels as well as on the evaluation of kidney graft function in stable renal transplant recipients (RTRs) in respect with initially higher or lower Hb and Htc values. Methods: The study group comprised of 270 RTRs with stable graft function. Besides other prescribed antihypertensive therapy, 169 of them have been taking RAAS inhibitors. Results: We wanted to analyze the effect of the use of RAAS inhibitors on Hb and Htc in patients with initially higher or lower Hb/Htc values. For this analysis, only RTRs that were taking RAAS inhibitors were stratified into two groups: one with higher Hb and Htc (initial Hb≥150g/L and Htc≥45%) and another one with lower Hb and Htc (initial Hb<150g/L and Htc<45%) values. Thirty-four RTRs with initially higher Hb and 41 RTRs with initially higher Htc had a statistically significant decrease in Hb (p=0.006) and Htc (p<0.0001) levels after 12-months of follow-up. In the group of patients with initially lower Hb (135 RTRs) and Htc (128 RTRs) there was a significant increase in Hb (p=0.0001) and Htc (p=0.004) levels through the observed period. The use of RAAS inhibitors has been associated with a trend of slowing renal insufficiency in RTRs (p=0.03). Conclusion: RAAS inhibitors lower Hb and Htc only in RTRs with initially higher levels. In patients with initially lower Hb and Htc levels, the use of these drugs is followed by beneficial impact on erythropoiesis and kidney graft function.
    No preview · Article · Jan 2016 · European Journal of Internal Medicine
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    ABSTRACT: B-large cell lymphoma (B-LCL) is the most common non-Hodgkin's lymphoma (1). There are certain molecular and immunohistochemical prognostic markers in patients with B-LCL, but their cost and technical constraints make their routine application impractical and expensive. Therefore, finding surrogate prognostic markers, presents an important contribution to the establishment of an individual risk assessment. The aim of this study was to analyze the prognostic value of baseline inflammation biomarkers, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and Glasgow prognostic score (GPS) in B-LCL patients.
    Full-text · Conference Paper · Sep 2015

  • No preview · Article · Sep 2015 · Nefrologia: publicacion oficial de la Sociedad Espanola Nefrologia
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    ABSTRACT: To determine the prognostic value of baseline red blood cell distribution width (RDW) in diffuse large B cell lymphoma (DLBCL) patients. Data from 81 DLBCL patients diagnosed from 2006 to 2013 at the University Hospital Center Osijek, Osijek, Croatia, were reviewed. We evaluated disease outcome, overall survival (OS) and event-free survival (EFS), and demographic, clinical and laboratory factors affecting outcome. Univariate analysis and Cox regression analysis were used. Median age of patients was 64 years, 29 were men (35.8%). Higher RDW levels (%) were found in patients with advanced Ann Arbor clinical stage (14.94±1.82 vs 13.55±1.54, P=0.001) and in those with poor response to therapy (14.94±1.82 vs 13.55±1.54, P=0.001). Patients with RDW>15% (cut-off was calculated by receiver operating characteristics) had significantly worse OS (median [range], 33 months [20-46] vs 74 months [65-82], P<0.001) and EFS (27 months [15-40] vs 68 months [59-77], P<0.001). Cox regression analysis showed that RDW>15% was an independent prognostic factor for OS (HR 3.654, 95% CI 1.128-11.836) and EFS (HR 2.611, 95% CI 1.012-6-739). High baseline RDW is an independent prognostic marker of poor outcome in patients with DLBCL. RDW could be an easily available and inexpensive marker for the risk stratification in patients with DLBCL.
    Full-text · Article · Aug 2015 · Croatian Medical Journal
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    Tomić J. · Mrđenović S. · Zibar L.
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    ABSTRACT: To examine the risk for sleep apnea (SA) by STOP (Snoring Tired Observed Pressure) questionnaire in patients undergoing 24-hour ambulatory blood pressure monitoring (ABPM). The study included 43 hypertensive patients, median age 48 years (20-80), 20 men, subjected to 24-hour ABPM at University Hospital Centre Osijek and fulfilled the Croatian version of the STOP questionnaire and the Epworth Sleepiness Scale (ESS). Their body weight, height and body mass index (BMI) were obtained. High risk subjects had two or more of four positive STOP questionnaire points. Normal (1-6 points), borderline (7 and 8 points) or excessive (8-24 points) daytime sleepiness was determined by ESS. The data were analyzed using SPSS 15.0 with statistical significance at P<0.05. STOP revealed 31 patients with risk for SA. 28 patients had normal, 8 had borderline and 7 excessive daytime sleepiness by ESS. Men and women did not differ in the risk for SA or in the daytime sleepiness. Patients at risk for SA were older than patients without the risk, with statistically borderline significance (P=0.056, Mann-Whitney test), and had higher BMI (P=0.055). Daytime sleepiness did not differ in respect with age, but was more pronounced in patients with higher BMI (P=0.053). There was no difference in 24-hour blood pressure regarding the risk of SA or the level of the daytime sleepiness. According to the STOP questionnaire the risk for SA in patients with AH was determined in almost three quarters of the respondents. Given the possibility that SA is often an unrecognized cause of AH, it is necessary to perform polysomnography in patients within this risk group. Thus, in addition to the SA diagnosing, sensitivity, specificity and applicability of the screening questionnaire would be validated in that group of patients.
    Full-text · Conference Paper · Nov 2014
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    ABSTRACT: Chronotype is a characteristic of a person in a certain point of one's lifetime and it slowly changes with age. Adolescents start to go to bed later while schools impose early starting hours, which may become a problem for students who are unable to adapt their circadian rhythm. The aim of this study was to determine if differences in school starting times affect the students' chronotype, school success, or daytime sleepiness. We tested a total of 1020 students from four high schools in Osijek, Croatia. The students had alternating school shifts (school starting hours 7 AM or 13 PM and 8 AM or 14 PM, every other week, alternatively, respectively). The participants were tested using the Epworth Sleepiness Scale and the Morningness--Eveningness Questionnaire. Earlier chronotypes were characteristic of the students starting school earlier, but without significant difference in daytime sleepiness in comparison with those starting school later. Differences were also found between different age and gender groups, female and older students having earlier chronotypes. Students going to school earlier showed better school success than the latter. In conclusion, the study shows that students starting school earlier also have earlier chronotypes, which might be consequence of the adaptation to one hour earlier school starting time.
    Full-text · Article · Sep 2014 · Collegium antropologicum
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    Full-text · Conference Paper · Mar 2014
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    ABSTRACT: Mammographic density is an independent risk of breast cancer. This study has evaluated the radiologists' reproducibility and subjectivity in breast density estimation and in order to decrease the radiologists' subjective errors the computer software was developed. The very good reproducibility existed in the strong correlation with the first and the second mammogram assessment after three month period for each radiologist (correlation coefficient 0.73-1, p < 0.001). The strong correlation was present in the case of all 5 radiologists when compared among themselves and compared with software aided MDEST-Mammographic Density Estimation (correlation coefficient 0.651-0.777, p < 0.001). Detected differences in glandular tissue percentage determination occurred in the case of two experienced radiologists, out of 5 (one radiologist with more than 5 year experience and one with more than 10 year experience, p < 0.01), but in the case of breast type determination (American College of Radiology-ACR I-IV), the detected difference occurred in one radiologist with the least experience (less than 5 years, p < 0.001). It can be concluded that the estimation of glandular tissue percentage in breast density is rather subjective method, especially if it is expressed with absolute percentage, but the determination of type of breast (ARCI-IV) depends on the radiologist's experience. This study showed that software aided determination of glandular tissue percentage and breast type can be of a great benefit in the case of less experienced radiologists.
    No preview · Article · Dec 2013 · Collegium antropologicum
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    ABSTRACT: Introduction: Sleep is necessary for normal psychophysical functioning. Throughout their lives people go to bed and get up in accordance with their chronotype. Aim: Considering the fact that medical students spend a lot of time studying, we were interested in how they manage to adjust learning habits to their chronotype and how it reflects on their academic success. Subjects and methods: We examined a total of 332 medical students in Osijek (97 males). Information on chronotype, learning habits, academic success and basic information on the respondents were acquired using an anonymous questionnaire. Results: There were no significant gender differences in chronotype, success and study time. Statistically significant differences were observed in chronotype when comparing students of different academic success – less successful students had later chronotypes. There was no significant difference in the study time in groups by academic success or chronotype. Significant differences exist in the amounts of time of studying among the students in relation with age - younger students study more. The difference in chronotype distribution between students of different classes was not observed. Conclusion: Differences in chronotype exist between students of different academic success, while differences in the amount of studying time exist between medical students of different years in Osijek.
    Full-text · Conference Paper · Apr 2013
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    ABSTRACT: Introduction: It is known that Medicine is one of the most demanding disciplines and that the obligations associated with it put a great amount of pressure on Medical students. Aim: To determine the amount of sleep that medical students acquire during their studies, and how it affects their daytime sleepiness. Materials and methods: A total of 332 medical students in Osijek (97 males) were examined. Information on study and sleep habits, academic success and basic information on the respondents were acquired using an anonymous questionnaire, containing the Epworth Sleepiness Scale. Results: Significant differences in study time were found when comparing students at the beginning of the college with those at the end – younger students studying more. Better students did not study significantly more than the latter. Excessive daytime sleepiness was found in 29.5% of the students, which peaked in the 2nd year of Medicine and may be caused by insufficient sleep; only 21.7% of students slept 8 hours or more in average, older students sleeping somewhat more. No significant gender differences were found in daytime sleepiness, sleep duration or study habits. Conclusion: Medical students tend to have insufficient sleep, which may lead to excessive daytime sleepiness. Younger students tend to study significantly more than older students.
    Full-text · Conference Paper · Apr 2013
  • Jelena Banjeglav · Lada Zibar
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    ABSTRACT: To determine the prevalence of anemia and risk factors that can affect on it six months after kidney transplantation (TX) at the University Hospital Osijek (KBCO) in period from 2007 to March 2012. The study included 55 patients, mean age 49 +/- 11 (27 - 70) years, after deceased donor kidney TX in KBCO from 2007 to March 2012. Two grafts did not survive a week (one for sudden death and another for the renal artery thrombosis, in the first 24 hours, respectively). The method of the survey comprised of taking data from the medical records and statistical analysis (SPSS). Posttransplantation anemia (PTA) and is defined by serum hemoglobin (Hb) concentration less than 110 g/l at 3 months after TX. The prevalence of PTA was 28.85%. PTA was more frequent among women (P=0,025). Patients with PTA were significantly longer hospitalized (P=0.002). PTA was more frequent in patients with sepsis after TX (P=0,03), in those with dehiscent postoperative wound (P=0,021) and in the patients with acute kidney transplant rejection (P=0.004). Although delayed graft function was not found significantly related to the PTA, decreased kidney function indicating feature, i.e. number of hemodialysis (HD) needed after TX (P=0.004) and after HD duration (P=0,008), were associated with the PTA significantly. Furthermore, serum creatinine concentration, at the time of hospital release, were significantly higher in those with PTA (P=0.035). There is statistically significant correlation between mean Hb and cratininemia at 3 months after TX. Immunosuppressive drugs and other studied medication, frequently used by kidney transplanted patients, were not related to the PTA. The anemia required crythropoietin substitution in 20 of 53 patients, while 20 patients received blood transfusions. PTA presents a great problem among the kidney transplanted patients with prevalence in our patients similar to that in previously published reports. This study had confirmed some of the well known risk factors for anemia in kidney transplant patients, like gender and graft function, but also there had been noticed few risk factors that can be prevented, like dehiscent postoperative wound and sepsis. PTA often requires erythropoietin substitution and blood transfusions, increasing the expenses of kidney transplantation and posttransplantation treatment. Therefore, prevention of PTA is, both medically and economically, justifide.
    No preview · Article · Oct 2012 · Acta medica Croatica: c̆asopis Hravatske akademije medicinskih znanosti
  • Petra Lukinac · Lada Zibar
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    ABSTRACT: To determine prevalence of delayed graft function (DGF) in renal transplant patients at the Clinical Hospital Center in Osijek (KBCO) and its association with graft function 6 months after transplantation (TX). The study included 55 patients, mean age 49 +/- 11 (27 - 70) years, after deceased donor kidney TX in KBCO from 2007 to March 2012. Two grafts did not survive a week (one for sudden death and another for the renal artery thrombosis, in the first 24 hours, respectively). The method of the survey comprised of taking data from the medical records and statistical analysis (SPSS). DGF, defined as the need for hemodialysis (HD) for more than 7 days after TX, was found in 28 of 53 recipients. DGF was more common in women (p=0.022). Patients with DGF had significantly higher creatininemia at discharge (p=0.003). Using multivariate analysis, none of the examined characteristics (recipient's gender, age at TX, basic renal illness, previous TX number, pretransplantation dialysis method and duration, donor's age and cause of death, number of HLA mismatches, cold ischemia duration and donor's creatininaemia, initial immunosuppressive therapy) showed significant impact on the occurrence of DGF. Patients with DGF did not differ from those without DGF in creatininemia 6 months after TX. The overall incidence of DGF was high and similar to that in previously published reports, but more common in women. In this study, previously known risk factors, like cold ischemia time and cause of death of the donor, were not associated with the development of DGF. Although DGF unfavorably impacts posttransplantation course, the study did not found its association with renal graft function 6 months after TX.
    No preview · Article · Oct 2012 · Acta medica Croatica: c̆asopis Hravatske akademije medicinskih znanosti
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    Jakov Milić · Ana Kvolik · Lada Zibar · Marija Heffer
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    ABSTRACT: Introduction: Circadian rhythm is determined by multiple factors. Genes involved in its determination also affect metabolism. Social factors are also of great importance. It is known that enough sleep is crucial for the normal development of children, and unadapted circadian rhythms may lead to sleep deprivation. Methods: We tested a total of 1,020 students from four high schools in Osijek, Croatia. The participants were tested with the use of the Epworth Sleepiness Scale and the Morningness – Eveningness Questionnaire. A questionnaire was also used to gather basic information about the participants. Results: Chronotypes were significantly later for younger high school students. No significant correlation between BMI and chronotype or daytime sleepiness was observed. Less sleepy students were more successful in school. Gender related differences in chronotype were also observed. Conclusion: Differences in chronotype, sleepiness and BMI exist throughout the age and gender groups and they have impact on school success.
    Full-text · Conference Paper · Apr 2012
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    ABSTRACT: The aim of the study was to assess the frequency of SNP896A/G in the Toll-like receptor (TLR) 4 gene and SNP1350T/C in the TLR2 gene in patients with acute myocardial infarction (AMI) and to analyse the association of these SNPs with risk factors for atherosclerosis and clinical aspects of AMI in a sample of the Croatian population. We included 240 participants in the study: 120 AMI patients and 120 sex- and age-matched healthy blood donor controls. The SNP1350T/C variant in the TLR2 gene showed a lower frequency in the AMI patient group than in the control group (P = 0.033). The frequency of SNP896A/G variants in the TLR4 gene between the patients and the controls did not differ (P = 0.286). Significantly, fewer people had SNP1350T/C in the TLR2 gene (P = 0.003) among the participants with arterial hypertension than those without it. The frequency of SNP896A/G in TLR4 was the same in hypertensive patients compared with normotensive subjects (P = 0.088). SNP1350T/C in TLR2 was less frequent in the AMI patients and in those with hypertension. Thus, SNP1350T/C in TLR2 might play a protective role against AMI and arterial hypertension. The frequency of SNP896A/G in the TLR4 gene was not associated with AMI and arterial hypertension. Other risk factors for atherosclerosis and clinical aspects of myocardial infarction were not associated with the genotype distribution of the examined genes.
    Full-text · Article · Jan 2012 · Scandinavian Journal of Immunology
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    ABSTRACT: Introduction: Humans adhere to certain chronotype during their lifetime, except in adolescence and during the process of aging. Adolescents start to go to bed later. In addition, schools impose early starting hours, and that may become a problem for students who are unable to adapt their circadian rhythm to socially determined schedule. That may lead to sleep deprivation and eventual psyhoemotive problems. Our aim was to determine if students are able to modify their sleep habits when starting their school one hour earlier. Methods: We tested students from four high schools in Osijek. Out of 821 students, 452 students start school from 7.00, while 299 start school from 8.00. Students had school in the morning one week, and in the afternoon, the next. All participants were tested using The Epworth Sleepiness Scale to determine daytime sleepiness and The Morningness – Eveningness Questionnaire to determine the chronotypes. Results: When comparing time when school starts and students’ daytime sleepiness, we see no significant difference (p = 0.118). Earlier set chronotypes were characteristic for students starting school at 7.00 compared with students starting school at 8.00, (p<0.001). Conclusion: The study suggests that students are able to modify their chronotypes, shifting to a earlier chronotype as a mean of compensation for a one hour earlier beginning of school.
    Full-text · Conference Paper · Nov 2011
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    ABSTRACT: Background: Arterial hypertension (AH) associated with cardiovascular disease is often responsible for morbidity andmortality in chronic hemodialysed patients (CHD). Noncompliance with antihypertensives could be related to distorted view on normal blood pressure (NBP). Purpose: To examine if CHD patients consider increased blood pressure (BP) for normal and consequently have poor compliance with antihypertensive therapy. Patients and Methods: 202 CHD patients (aged 25-85 years) at University Hospital Centre Osijek, Croatia, completed a questionnaire onmaximal NBP, compliance to antihypertensives and symptoms related to BP variations. Data on medical history and AH control were obtained from their medical records. Optimal BP before hemodialysis (HD) session was considered <140/90 mmHg, mean arterial pressure (MAP) <107 mmHg, corresponding to the high normal BP according to guidelines ESH-ESC 2007. Result: 57% of 202 patients declared maximum acceptable systolic BP >139 mmHg (median 150, range 140-180). Majority of them would not take antihypertensives and reported symptoms accurring by BP lower than preferred. The year of AH diagnosis differed significantly from the initial year of antihypertensive therapy (P<0.001), indicating delayed treatment. Patients with distorted view on NBP were older (P=0.012), took more antihypertensives (P=0.043) and had higher predialysis MAP (P=0.019) in comparison with other patients. Conclusion: CHD patients consider NBP to be higher than officially recommended. Majority had poorly regulated AH due to noncompliance with antihypertensives therapy. Different view on NBP could be attributed to their symptoms occurring by BP lower than preferred. They seem to be adapted to increased BP. The question remains whether this is a consequence of delayed AH treatment or inadequate guidelines for CHD patients.
    No preview · Article · Nov 2011 · Periodicum Biologorum
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    ABSTRACT: The renin-angiotensin system (RAS) has been shown to have important role in blood pressure regulation. Inconsistent results have been reported regarding the association of the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism (NCBI ref. SNP ID: rs1799752) and hypertension as well as a contributing factor in the development of diabetic nephropathy. Aim of the study was to investigate the significance of insertion/deletion polymorphism of angiotensin-converting enzyme as contributing factor to blood pressure regulation in type 2 diabetic patients with diabetic nephropathy and those with preserved renal function. Genomic DNA was extracted from whole blood of 100 patients with diabetic nephropathy and 102 diabetic patients with normal renal function (urinary protein excretion rate less than 300 mg/day and creatinin clearence level > or = 80 ml/min). Blood pressure measurement was done 3 times by a nurse in the supine position, in 15 minutes intervals. Mean arterial pressure (MAP) was calculated according to the standard equation- (systolic pressure + 2 x diastolic pressure)/3, for all measurements. Genotyping was carried out using primers and fluorescent probes in a Lyght Cycler System. Statistical analysis was performed using software package SPSS 16.0 (SPSS inc, Chicago, IL, USA). Genotype frequencies of the ACE I/D) polymorphysm were in accordance with the Hardy-Weinberg equilibrium. In all subjects, the frequencies of the DD. ID and II genotypes were 0.32; 0.45 and 0.23 respectively. The allelic frequency of the D allele in nephropatby group was 0.82 and 0.72 in the control group. The highest systolic blood pressure was in the subjects with DD genotype. Systolic and mean, arterial pressure were significantly higher in diabetic nephropathy patients compared to patients with preserved kidney function, only if D allele was present (systolic blood pressure: DD t=2,877, p=0,006; ID t=2.733, p=0,008; mean arterial pressure: DD t=2,687, p=0.009; ID t=2,843, p=0,006). Individuals with type 2 diabetes mellitus who carry the D allele appear to be susceptible to development of the end stage renal disease. D allele might be an additional risk factor for the uncontrolled hypertension in diabetic nephropathy patients.
    No preview · Article · Oct 2011 · Acta medica Croatica: c̆asopis Hravatske akademije medicinskih znanosti
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    ABSTRACT: Despite of routinely practised living kidney transplantation, data on consequences and impact of unilateral nephrectomy on the quality of life and health of donors are scarce. The aim of the present study was to examine long-term changes and function of the remnant kidney after unilateral nephrectomy in an animal model. Thirty six female Sprague - Dawley rats at 4 months of age were randomized into the three groups: unilaterally nephrectomized, sham operated and naïve rats. The nephrectomy was done at inclusion in the experiment and their blood was taken at inclusion and six months thereafter. There was a significant increase in serum creatinine concentrations six months after unilateral nephrectomy (39.7 ± 0.8 μmol/l) in comparison with the sham operated (30.1 ± 1.1 μmol/l) and the naïve rats (26.3 ± 3 μmol/l) (p ≤ 0.001). Serum sodium levels remained unchanged (p=0.116). Blood haemoglobin concentration did not differ between the three groups (p=0.115). Although it has been very well established that kidney possesses huge capacity to compensate severe loss of renal mass, our results implicate that renal function undergoes significant deterioration with time after unilateral nephrectomy. Fortunately, in everyday clinical practice we do not see severe renal dysfunction in patients with a single kidney. However, prolongation of the human life span in the future could face us with renal impairment in living kidney donors. Future examination of specific biomarkers in our rat model (e.g. growth factors) could support our findings.
    No preview · Article · Aug 2011 · Medicinski glasnik
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    ABSTRACT: Angiotensin converting enzyme (ACE) inhibitors provide well known cardiorenal-protective benefits added to antihypertensive effects in chronic renal disease. These agents are underused in management of patients receiving hemodialysis (HD) because of common concern of hyperkalemia. However, few studies have investigated effect of renin angiotensin aldosterone system (RAAS) blockade on serum potassium in hemodialysis patients. We assessed the safety of ramipril in patients on maintenance HD. We enrolled 28 adult end stage renal disease (ESRD) patients treated by maintenance HD and prescribed them ramipril in doses of 1.25 to 5 mg per day. They underwent serum potassium concentration measurements before ramipril introduction and in 1 to 3 months afterwards. No significant increase in kalemia was found. Results of our study encourage the use of ACE inhibitors in chronically hemodialyzed patients, but close potassium monitoring is mandatory.
    Preview · Article · Jun 2011 · Collegium antropologicum
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    ABSTRACT: The aim of the study was to examine a perfusion and integrity of small bowel in 60 subsequent patients during the major open abdominal surgery which lasted from 2 to 7 hours. Two samples of the intestinal mucosa were removed: at the beginning, and at the end of the surgical procedure in general anaesthesia. A mucosal injury was classified into 4 grades. pH, PCO2 and lactate level were measured in the blood samples from the arterial and mesenteric vein in one hour time intervals. The changes of intestinal mucosa were found in 31 patients (51.7%): in 19 patients (31.7%) grade 1 changes were recorded, in 10 patients (16.7%) grade 2, and in 2 patients (3.3%) grade 3. Grade 4 lesions were not recorded. There was a statistically significant correlation between grades of the mucosal damage and the surgery duration (p = 0.001). Analysis during the one hour intervals showed that there was no exact time point when the significant aggravation of the pathohistological changes in intestinal mucosa occurred. However, when patients were allocated into two subgroups with surgical procedures lasting less than 4 hours and more than 4 hours, there was a statistically significant difference in the grades of mucosal damage between subgroups (p < 0.05). More biopsies without pathohistological changes were observed in the patients whose procedure duration was < 4 hours. A significantly higher lactate concentrations in arterial and mesenteric venous blood were observed in the patients with pathohistological changes at 6 hours time point as compared to 2 hour time point in the patients without pathohistological changes (p < 0.05). During the open abdominal surgery in general anaesthesia, the length of the procedure influences the grade of the intestinal mucosa injury. Deterioration of the pathohistological findings in the intestinal mucosa correlates with high lactate blood level, suggesting that the cause of these changes may result from tissue hypoxia.
    Full-text · Article · Jun 2011 · Collegium antropologicum

Publication Stats

60 Citations
21.96 Total Impact Points

Institutions

  • 2006-2015
    • University Hospital Osijek
      Osik, Osječko-Baranjska, Croatia
  • 2011-2012
    • University of Osijek
      Osik, Osječko-Baranjska, Croatia