Observational study of patients switched to the fixed travoprost 0.004%/timolol 0.5% combination in Croatia.

The purpose of this study was to assess both the benefits of a 3-month travoprost 0.004%/timolol 0.5%fixed combination (trav/tim) regimen in comparison with previous medications for the control of intraocular pressure (IOP) and the tolerability of these drug regimens in glaucoma patients. An observational, non-interventional, open-label study of 406 eyes with primary open angle glaucoma and ocular hypertension was thus undertaken. One drop of trav/tim fixed combination was administered in the evening for 3 months. Patients were divided into five groups according to previous drug regimens: timolol 0.5% monotherapy; betaxolol 0.5% monotherapy; latanoprost 0.005% monotherapy; travoprost 0.004% monotherapy; and dorzolamide 2%/timolol 0.5% fixed combination. Upon medication substitution, the trav/tim fixed combination provided better IOP control and tolerability in all five patient groups. At the 3-month follow up, the mean IOP changes from previous therapy were as follows: 5.2 ± 2.7 mmHg (20.8% change) in timolol 0.5% group; 5.7 ± 2.2 mmHg (22.5% change) in betaxolol 0.5% group; 3.8 ± 2.6 mmHg (24.5% change) in latanoprost 0.005% group; 4.4 ± 2.8 mmHg (20% change) in travoprost 0.004% group; and 3.4 ± 4.1 mmHg (14.5% change) in dorzolamide 2%/timolol 0.5% fixed combination group. The difference between baseline and trav/tim combination patient satisfaction at the 3-month follow-up was significant. Thus, the trav/tim fixed combination provided better IOP control and tolerability than previous mono- or polytherapies.

[Automatic refractometry, reliability of the determination of type and degree of refraction anomalies]. / Automatska refraktometrija, pouzdanost odredivanja vrste i visine refrakcijske anomalije.

The authors report on their experience with and results of using the AR-1000 autorefractometer made by Nidek, particularly with the pre-school children, school children, and students up to 24 years of age. They stress the significance, as well as speed and accuracy of automatic refractometry findings in large groups of testees (regular checkups) as a valuable indicator in one of numerous necessary tests with the aim to determine and correct visual acuity. There is a significant error reduction in the estimate of dioptries when autorefractometry is done in cycloplegia as compared to autorefractometry without cycloplegia.

Comparison of chlorthalidone, propranolol and bopindolol in six-month treatment of arterial hypertension.

The aim of this study was to test the hypothesis that prolonged treatment of mild to moderate hypertension with low-dose thiazide diuretics or beta blockers does not induce any of the major untoward biochemical changes, such as hypertriglyceridemia, hypercholesterolemia, hyperuricemia and electrolyte imbalances. The effect of these drugs was analyzed in 100 outpatients (52 males and 48 females) aged 52.0 +/- 7.9 years with mild to moderate hypertension, in a prospective 6-month study. After an appropriate workup, the patients were randomized to either 25 mg chlorthalidone (40 patients), 120 mg propranolol (30 patients), or 2 mg per day bopindolol (30 patients). A significant reduction of approximately 10% in systolic and diastolic blood pressure was recorded in all the groups. At the end of the 6th month, in the chlorthalidone group triglycerides increased to 3.0 +/- 2.1 mmol/l from 2.8 +/- 1.6 mmol/l, while cholesterol after an initial increase to 6.6 +/- 1.6 from 6.4 +/- 1.6 mmol/l returned to the baseline level. Uricemia and serum potassium concentration decreased by 4%. The body weight was reduced to 83.8 +/- 13.4 kg from 86.1 +/- 13.4 kg. There was no change in serum glucose level. In the propranolol group, as expected, heart rate decreased by 20%, but there were no significant changes in glucose and potassium plasma concentration. Triglycerides did not change significantly, while cholesterol, after a small increase, returned to the initial levels. Similar results were obtained in the bopindolol group, apart from the triglycerides, which increased significantly (to 2.5 +/- 1.1 from 2.2 +/- 0.4 mmol/l), probably because of the lower baseline concentration. We conclude that in prolonged treatment, chlorthalidone, propranolol and bopindolol do not induce significant untoward biochemical changes that alone might increase cardiovascular risk.

[Copper levels in the tissues of patients with Wilson's disease]. / Koncentracije bakra u tkivima bolesnika s Wilsonovom bolescu.

The evaluation of tissue copper concentration is essential for the diagnosis of Wilson's disease. It is characterized by symptoms of the damages to parenchymatous organs, primarily liver and brain, due to chronic copper intoxication. The paper presents the autopsy tissue analysis of a 39-year-old patient diagnosed to suffer from the Wilson's disease while still alive. The patient died from sepsis due to burns caused by direct flame exposure. The standard histochemical staining of tissue samples failed to demonstrate the presence of copper but it was qualitatively proved by line spectrum-based mass spectrography. The copper concentrations in the liver, brain, and kidney (240, 73.8, and 30 micrograms/g wet tissue weight, respectively), measured by flame-atomic absorption spectrometry, were significantly elevated. In this study, the Wilson's disease was verified by a postmortem determination of increased copper concentration in the tissues. The results obtained contribute to the understanding of this rare disease.

Deaths of drug addicts in Split.

Since the beginning of the war in Croatia, the number of drug addicts and of fatal intoxications in the Split region has increased. Drug-related fatalities (n = 25) were investigated over a 12-month period in 1995. Data about the cause of death were based on the information from police reports, autopsy findings and toxicological analyses. The main drug involved was heroin. Other drugs were rarely reported. Blood tests for alcohol were performed in all cases. Alcohol consumption increased the risk of heroin overdosing.

Fatal poisonings in the city of Zagreb.

The paper deals with the results of analysis of fatal poisonings in the city of Zagreb from 1981 to 1990. The work is an extension of earlier analyses for the same area that were carried out from the foundation of the Department for Forensic Medicine and Criminology, School of Medicine, University of Zagreb in 1934 to 1967, and from 1968 to 1980. Comparative analysis of all data shows that despite the increasing rate of poisoning the number of cases of fatal poisoning has been steadily diminishing--from 11 cases per 100,000 population in the 1934-1967 period and eight cases between 1968 and 1980 to five cases in the latest period 1981-1990.

[Etiopathogenic characteristics of posterior uveitis in children]. / Etiopathogenetske karakteristike posteriornih uveitisa u djece.

Nine children with acute posterior uveitis were treated for period of 3 years (3.2% of all children treated during that period). The authors speak in favor of the investigation of the HLA-system and the analysis of humoral and cellular immunologic parameters. In this study they present the relationship between these characteristics and the clinical diagnosis. Three of 9 children have with eye diseases associated HLA-B5 and HLA-B12 antigens and grave consequences for the sight of both eyes already as children. The results of immunologic tests in the examined group compared to the control group differ significantly in the total number of lymphocytes, total number of B lymphocytes and serum values of IgG, as well as C3 values of complement component (P < 0.05). Seen in percentage, however, the ratio of T to B lymphocytes, as well as the total number of leukocytes don't show significant differences. We consider that a proper and well-aimed history and complete etiologic detection according to the protocol have contributed to a clearer understanding and better insight into the prognosis of our patients.