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Cardiac abnormalities are frequently associated with myotonic dystrophy (MD), and electrocardiographic (ECG) changes are not rare in these patients. The most common ECG abnormalities are PQ or QT interval prolongation, low P wave amplitude, ST elevation or depression, negative T waves, conduction and rhythm abnormalities. We analysed ECG changes in 42 patients with MD. ⋯ We found no ST alterations. ECG changes were more frequent in patients with severe disease, but it was not statistically significant. There was no correlation between age and ECG abnormalities in our patients.
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In order to define the cerebrospinal fluid (CSF) profile indicative of multiple sclerosis (MS), it is essential that each laboratory specifies the percentage of clinically definite MS patients with as well as the ranges of obtained values for each CSF parameter in these patients. CSF of 92 patients with clinically defined MS were analysed for cell count, concentrations of total protein, albumin and IgG, blood-CSF barrier function as assessed by CSF/serum albumin quotient, quantitative measurements of intrathecal IgG production (IgG index and IgG daily synthesis rate) and the presence of CSF oligoclonal IgG. For the detection of CSF oligoclonal IgG the isoelectric focusing (IEF) of unconcentrated CSF on agarose with transfer of proteins to cellulose nitrate and immunoperoxidase staining, was performed. ⋯ In 99% of MS patients, the total protein was <980 mg/L, the albumin <740 mg/L and the total cell count <20 cells per mm3. According to our data, the CSF findings that support the diagnosis of clinically definite MS are: 1) the presence of intrathecally produced CSF oligoclonal IgG by IEF; 2) normal or slightly to moderately elevated level of CSF proteins and albumin; 3) normal CSF-brain barrier function or slight to, rarely, moderate CSF-brain barrier dysfunction as assesed by CSF/serum albumin quotient, and 4) normal cell count or slight pleocytosis. If this profile is not found in a patient suspected of MS, the diagnosis should be questioned or a complication should be expected.
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During an outbreak of haemorrhagic fever with renal syndrome (HFRS) in 1989, five children (3 girls, 2 boys, aged 6.8-16 years) with severe clinical form of the disease, were treated at the Institute of Mother and Child Health of Serbia; four of them were followed-up 22-28 months thereafter. The main clinical features were: fever, headache, myalgia, abdominal and back pains, and vomiting in all, and haemorrhagic syndrome in three; renal syndrome with severe acute renal failure in all five patients. ⋯ It was not possible to differentiate these two serogroups on the basis of clinical features. This finding gave further evidence of circulation of different hantaviruses causing severe HFRS in Serbia.
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Growth hormone (GH) response to dexamethasone (DEX) in 10 poorly controlled insulin dependent diabetic patients (IDDM) without clinical evidence of diabetic complications and in 10 healthy controls, was studied. GH responses to DEX were compared with pituitary GH response to growth hormone releasing hormone (GHRH). ⋯ The peak GH responses to GHRH and DEX were similar in the controls and IDDM patients (23.8 +/- 6.49 vs 38.87 +/- 7.26, p > 0.05 in GHRH test and 13.71 +/- 3.59 vs 17.33 +/- 5 23, p > 0.05 in DEX test). No significant difference between area under curve during GHRH (1386. +/- 490.69 vs 1966.89 +/- 561.46, p > 0.05) and during DEX test (1085.8 +/- 239 856 vs 501.87 +/- 847.16, p > 0 05) in the controls and IDDM patients, were established There was no significant correlation between basal and peak GH values and AUC during both tests, and HbA1C and duration of diabetes It is concluded that GH response to GHRH was normal and that our patients had preserved the integrity of the hypothalamo-pituitary axis, thanks to the suggested mechanism of dexamethasone action via somatostatin.
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The galeal-temporal flap consists of galeal aponeurosis and superficial temporal fascia. The goal of this experiment is the testing of the use of the galeal-temporal flap in reconstruction of defects of the maxillo-facial region and establishing of indications for the use of this flap. Over the period from 1989 to 1992 at the Department of Maxillo-Facial Surgery within the School of Dentistry, University of Belgrade, 15 galeal-temporal flaps in 14 patients who agreed with this reconstruction, were performed. ⋯ Of 15 used flaps in 12 patients it was completely taken (80%). Epithelization of the galea in the oral cavity was clinically verified between 9 and 14 days. Indications for the use of galeal-temporal flap in maxillo-facial surgery were as pollows: large intraoral defects, full thickness cheek defects, craniofacial deformities and scalp defects involving external bone previously treated by radiation, as the basis for the free skin graft.