The hemostatic system function of patients with severe forms of diphtheria

Hemostasis of 100 patients with severe diphtheria infection was studied throughout the disease. The patients were found to have marked procoagulant, anticoagulant and fibrinolytic disorders. Antithrombogenic activity of the vascular wall was also abnormal. The above impairments correlated with the symptoms severity and are interpreted as DIC syndrome which ran subclinically or as hemorrhagic syndrome. The majority of the patients underwent a hyperhypocoagulant phase of DIC syndrome.     

Immunohistochemical expression of p53 and c-erbB-2 in breast carcinoma: relation with epidemiologic factors, histologic features and prognosis

We have performed immunohistochemical staining for p53 and c-erbB-2 on formaldehyde-fixed, paraffin-embedded primary invasive ductal carcinomas from 112 patients, with a minimal follow-up time of 60 months. All of them had received postoperative chemoradiation therapy. We have analyzed the association of these factors with epidemiologic risk factors, histopathologic features and hormonal receptor status and the influence on prognosis. Our results indicate that the expression of c-erbB-2 protein defines a group of node-negative patients with poor prognosis. The overexpression of c-erbB-2 has shown a significant association with estrogen receptor status (those tumors expressing c-erbB-2 are usually estrogen receptor negative), presence of fibrosis and lymphoplasmacytoid infiltrates. P53 expression has shown no relation either with prognosis or with any other histopathologic or clinical feature. The only factors with prognostic influence in our series have been tumor size, the presence of node metastases, TNM stage and the prognostic morphometric index (Baak's index), apart from c-erbB-2 in node-negative patients. However, only the TNM stage showed an independent association with prognosis after a multivariate analysis. In summary, in our experience the expression of p53 protein has no prognostic influence on breast carcinoma, and TNM stage remains to be as the most powerful prognostic factor in these patients.     

Outcome of transplantation for standard-risk leukaemia with grafts depleted of lymphocytes after conditioning with an intensified regimen

One hundred and eighty-one consecutive patients with standard-risk leukaemia were transplanted with HLA-identical sibling grafts depleted of lymphocytes using counter-flow centrifugation. In 116 patients, standard conditioning was intensified by the addition of anthracyclines. Multivariate analysis revealed significantly more acute GVHD > or = grade 2 and a trend towards more chronic GVHD in patients conditioned with the addition of anthracyclines. For all patients the risk for chronic GVHD, but not for acute GVHD increased with a higher number of T cells in the graft. The projected 5-year probability of relapse was significantly lower in the group of patients conditioned with anthracyclines; 26% versus 52% (P = 0.015). In multivariate analysis the addition of anthracyclines to the conditioning regimen was the only significant factor contributing to a lower probability of relapse. The projected 5-year probability of leukaemia-free survival [LFS] in the patients conditioned with and without the addition of anthracyclines was 56% and 36%, respectively (P = 0.004). In multivariate analysis the addition of anthracyclines to the conditioning regimen correlated significantly with a lower number of mixed chimaeras in patients at 6 and 12 months after BMT. Mixed chimaerism at 6 months after transplantation did not significantly correlate with a higher incidence of relapse in further follow-up. In contrast, mixed chimaerism at 12 months after BMT was significantly associated with higher relapse rate. We conclude that the addition of anthracyclines to the conditioning regimen improves outcome of BMT using T-cell-depleted grafts.     

Documentary basis for research on the transfer of Islamic medical science to the European West

The last decades of the twentieth century are witness of increased interest in the study of scientific heritage in the Islamic world. The already established opinion of Islamic science as only intermediary between classical Greece and Latin West is seriously challenged. The reason for this are original sources from which the historians of our century have extracted solid evidence of high level of originality achieved by Muslim scientists in the past. Through their work in Bagdad, Buhara, Samarkand, Reyy, Kairo, Maraga, Damascus, Kordova they have shown that Islamic sciences including medicine had theoretical and practical answers to the problems characteristic of their times. Throughout its History Bosnia and Herzegovina itself has been exposed to various cultural influences from the West as well as from the Islamic East. When we try to study the history of medicine and health profession generally, we have to take into account the early Arabic sources of which short survey is given in this paper. With this in mind, one can make one preliminary conclusion at least; Islamic medicine has reached respectable level of practical and theoretical achievements while the volume of books and number of people engaged in its practice produced series of biographies and bibliographies as clear proof of its growth and level it has attained.     

Pharmacies during the transformation of health care. IV. Sociologic study of pharmacy service

In Slovakia, similarly as in the Czech Republic, marked changes in the pharmaceutical services have gradually been taking place since 1990. Principal legal and organizational changes have been connected also with the extent and standard of provided pharmaceutical services. The present paper reports the results of a questionnaire research regarding the evaluation of the standard of pharmaceutical services in the year 1995 where there existed both state-owned and private public pharmacies. The questionnaire research was carried out in 20 pharmacies of the Region of West Slovakia, 407 questionnaires were evaluated. The questionnaires were evaluated from the viewpoint of sociological classification of respondents (economically active persons, old-age pensioners) as well as the sex of pharmacy customers. The results confirmed relatively little significant differences between the satisfaction with pharmaceutical services either according to the sex or the social position of the respondents. A relatively significant proportion of the respondents have expressed critical views about the participation of the patient in covering the costs of drugs and slow execution of order of drugs.     

Evaluation of the effectiveness of continuous renal replacement therapy in critical patients after cardiovascular surgery

The efficacy of continuous methods of renal substitute therapy (RST) in patients with multiple organ failure is assessed. The patients were divided in 2 groups administered different types of PST. Group 1 were 16 patients subjected to RST by peritoneal dialysis, in group 2 (n = 16) GP and/or GDP were used. Hemodynamics, hematological and biochemical values, and clearance of inflammation mediators were monitored and hemohydrobalance and complications of therapy assessed in the course of RST. Both RST methods proved to be highly effective. The possibility of differentiated use of peritoneal dialysis and GP/GDP permits an individual approach to treatment, and equally high efficacy of both methods solves the problem of treating total renal insufficiency in the majority of patients with multiple organ failure following cardiovascular surgery.     

The effect of an antiphlogistic incorporated in liposomes on experimentally induced inflammation

The antiphlogistic Ibuprofen incorporated in liposomes caused a decrease of the inflammatory edema induced by Carrageenan in the distal part of the rat's hind leg after both the intramuscular and percutaneous administration. The antiphlogistic effect of free Ibuprofen in the cream was weaker. Intramuscular administration of empty liposomes slowed down in the initial stages the development of inflammation and slightly diminished the size of edema.