[Liver injury during combined chemotherapy of acute leukemias]. / Ostecenje jetre u toku polihemioterapije akutnih leukemija.

The authors observed 70 patients with acute leukemia treated by polychemotherapy. In 2 patients the signs of severe liver damage were found. The occurrence, course and results of laboratory tests suggested Purinethol predominantly as the cause of development of these alterations. The complication did not occur frequently in our patients. The changes regressed in a satisfactory way after the withdrawal of the hepatotoxic cytostatic from the therapy.

[Therapy of resistant ascites using the peritoneojugular (Leveen shunt)]. / Terapija rezistentnog ascita peritoneojugularnim (Le Veen) santom.

Since 1984 the peritoneovenous shunt has been installed in 33 patients (10 females - 30.3%; 23 males - 69.7%) of the average age of 54 +/- 8, all in the phase of therapeutically resistant ascites (alcoholic cirrhosis 28 - 84.85%; 4 - 12.12% posthepatitic cirrhosis; and 1 - 3.03% hepatic amyloidosis). The control group consisted of 39 patients (11 females - 28.2% and 28 males - 71.8%) treated in an identical time span with the strict conduction of medicament-diet therapy. The aim of this study was to check the value of this method on our own clinical-patient material, and therefore establish the incidence of complications. By the use of a unique protocol we followed mortality, morbidity, body weight, belly circumference, diuresis, the ultrasonographic finding of the abdominal cavity and the complications which appeared. Out of the group operated on 19 (57%) of the patients died, and so did all the control group patients as well. The average life duration was 275 +/- 810 days in the group operated on, and 44 +/- 29 (p less than 0.005) in the control group. All those alive (14.33-42.42%) lived longer than six months. Six patients lived longer than one year (42.85%), 4 (28.47%) longer than two years, and one (7.14%) longer than three years. There is a statistically significant decrease in body weight, belly circumference, diuresis increase and the consequent ascites withdrawal. DIC occurred in 2 patients, shunt malposition in 2, saccular dilatation in 1, plastic peritonitis in 6, and ileus in 1 patient. Not one of the listed complications resulted by death.(ABSTRACT TRUNCATED AT 250 WORDS)

[Acute gastrointestinal hemorrhage after placement of a peritoneojugular shunt]. / Akutna gastrointestinalna krvarenja nakon ugradnje peritoneojugularnog santa.

Since 1984 the peritoneovenous (LeVeen) shunt has been installed in 33 patients (10 females 30.3%, and 23 males 69.7%), with the average age of 54 +/- 8 years all in the oedema--ascitic decompensation phase of their primary illness. The control group consisted of 39 patients with identical etiology and primary illness stadium, sex and age structure and duration of primary illness, all treated with medicament - diet therapy. All the operated patients and those treated with medicament--diet regime died. Their autopsy findings were confronted. The aim of this study was to indicate the type and frequency of digestive hemorrhage in this population on our own clinical--patient material. Gastrointestinal hemorrhage was the cause of death in 8 (24.24%) patients out of the group operated on, and 6 (15.3%) from the control group. The isolated rupture of esophageal varices was the cause of death in one (3.03%) patient out of the group operated on, and in 5 (12.12%) patients from the control group, the rupture of esophageal varices with toxic vasculitis in 3 (0.09%) patients from the group operated on, and not in one out of the control group; rupture of esophageal varices associated with toxic vasculitis and disorders of the hemostatic mechanism appeared in 4 (12.12%) of patients from the group operated on, and in 1 (2.56%) of the control group. On the basis of the presented it can be concluded that gastrointestinal hemorrhage is a significantly more frequent cause of death in the group operated on than in the control group, and that hemorrhages are of an all the more complex etiology when the flow-in of ascites into circulation is greater. Hemodilution and endotoxins are to blame for their occurrence and it is necessary to preoperatively conduct, beside the control of the hemostatic mechanism, also the test of ones own ascitic burdening and to determine the level of endotoxin in the ascites.

[Modern trends in the treatment of ulcer disease (clinical study of nizatidine "Galitidine")]. / Savremeni trendovi u lecenju ulkusne bolesti (Klinicko ispitivanje nizatidina "Galitidina").

By an analysis of nizatidine vs ranitidine activity, the authors show a contemporary controlled approach to the treatment of ulcer disease. In a prospective, randomized, double-blind, parallel comparative, multicentric study, the treatment of duodenal ulcer was carried out in 120 patients with H2-receptor blockers, nizatidine and ranitidine. The treatment lasted one or two months with endoscopic control of the results. The recovery of the ulcer nische in patients who received nizatidine, 150 mg twice daily over a month, was achieved in 89.75% of the cases, while in those who at the same time received ranitidine twice daily ulcer was suppressed in 84.61% of the patients; in those who received Nizatidine, 300 mg once daily it was suppressed in 88.24% of the patients. Statistically, x2 = 2.177 with p > 0.3 which shows that there is no statistically significant differences between the groups although the first group shows the best results. Adverse effects of the drugs were not observed.

[Helicobacter pylori in patients with diseases of the upper part of the gastrointestinal tract]. / Helicobacter pylori u bolesnika sa oboljenjima gornjih delova gastrointestinalnog trakta.

Among the patients subjected to esophoagogastroduodenoscopy because of different clinical indications, 108 were examined for the presence of Helicobacter pylori in the antral gastric mucosa. Microbiological analysis of the antral gastric mucosa biopsies were conducted by direct microscopy, the urease test and by growing in nutritious media. Positive findings were recorded in 38 (86.36%) patients with endoscopically diagnosed chronic gastritis, 29 (80.56%) patients with duodenal ulcer and 19 (67.86%) patients with ventricular ulcer. The majority of the positive findings were recorded by direct microscopy--86 (79.63%) while the bacterial culture was positive in 66 (61.11%) cases.

[The postoperative status of the gastroduodenum--clinical and endoscopic analysis of 2 years' of hospital data]. / Postoperativna stanja gastroduodenuma--klinicka i endoskopska analiza dvogodisnjeg hospitalnog materijala.

In 72 patients operated on for gastric ulcer, hospitalized at the Clinic of Gastroenterology and Hepatology in Novi Sad within two years (1989, 1990) we analyzed clinical disorders, biochemical status and endoscopic findings. 75% of the patients were males and 25% females, mean age being 49 years. In 70.83% the two-thirds Billroth II resection was performed, in 15.28% the two thirds Billroth I resection, in 9.72% truncal vagotomy with pyloroplasty, while in 4.17% supraselective vagotomy was carried out. The mean period of time after the operation was 12 years. The majority of patients complained about gastrointestinal disorders, and manifest hemorrhage was detected in 4.17% of the patients. The symptoms of the afferent loop syndrome and early dumping syndrome were verified in one patient from each group. The endoscopic finding was normal in only 2.78%, reflux esophagitis in 6.94%, chronic gastritis with and without erosions in 86.11%, chronic anastomositis in 69.44%, recurrent ulcer in 29.16% out of which hemorrhagic ulcer was found in 4.17%. Malignant neoplasm of the stomach stump was endoscopically evidenced and histologically proved in 2.78%. Multiple associated endoscopic changes were found in 58.33%. The analysis indicates the diversity of postoperative disorders after one of the operations on gastroduodenum, requiring postoperative follow ups of the patients with subjective discomfort, appropriately set diagnosis and individual therapeutical approach to prevent more serious complications.