Hexagon TB for the rapid diagnosis of lung TBC in praxis.

Hexagon TB is intended for the rapid diagnostics of tuberculosis. Tuberculosis is a contagious and epidemic disease. According to the data published by WHO, 3-4 millions of patients are diagnosed with this disease annually. In 2004, 107 new cases were discovered in the area of Tuzla Municipality. Annual incidence of this disease is 62,9 per 100 000 inhabitants in Bosnia and Herzegovina; 28,9 in Slovenia; 33,2 in FYRM; 48,5 in Croatia; 41,8 in Serbia and Montenegro. Western European countries have a rather low rate of the disease--5-10 cases per 100 000 inhabitants. Efficiency of Hexagon TB examination method was tested on 100 patients. The subjects were patients with clinical symptoms of active TBC infection, persons who were in contact with TBC patients and persons earlier cured of TBC. All the subjects were tested with Hexagon TB, and the results were compared against lungs X-rays and sputum test for BK and LOW. Hexagon TB is intended for rapid, qualitative detection of IgG, IgA, IgM antibodies against M. tuberculosis and mycobacterium in human serum, plasma or whole blood as an aid in the early diagnostics of tuberculosis infections for professional use. Hexagon TB was positive in 11 of the examined patients. 10 patients had changes suggesting TBC. 1 patient was directly positive for BK and 3 patients were positive for LOW. Of all the examined patients, 3 were positive for all tests positive. According to our results, Hexagon TB has significant importance in practice of rapid TBC diagnostics compared to lungs X-ray and examination of sputum for BK and LOW.

Intensive observation of toxic side effects after several-year of cyclosporin treatment in kidney transplant patient.

In this work we are going to show results of intensive observation of adverse reactions of cyclosporine therapy during 18 months. The research was applied on 30 patients with kidney transplant. The medium time of kidney transplant survival was 9,7+/-2,3 years, with time span of 6 to 15 years. All the patients were subjects to several years' cyclosporine treatment, which was applied on a daily basis with a dosage of 2 to 5 mg/kg of body weight. The concentration of cyclosporine in blood was measured once a month. The concentration of cyclosporine in blood in 19 patients was in referent values of 122,50 nag/ml up to 280,50 nag/ml of blood. In 4 of the patients the concentration was heightened up to 370 to 538 nag/ml (X=766,37 nag/ml), and in 7 patients cyclosporine was below normal dosage down to 30,78 to 96,30 nag/ml in blood (x=77,12 nag/ml). We noticed these toxic side effects: increased values of systolic and diastolic arterial blood pressure in 5 patients, neurotoxic tremor effects in 4 patients, hyperplasia gingival and hirsute in 1 patient each.

Left ventricular diastolic dysfunction in essential hypertension.

T Diastolic dysfunction is very frequent and is actually sign of manifest heart weakness. Over 40% of patients with heart weakness have isolated left ventricular diastolic dysfunction (LVDD). New diagnostics methods as Doppler Echocardiography with close monitoring enables precise and early LVDD diagnose. In all diastolic phases artery hypertension weakens relaxation and left ventricular hypertrophy (LVH) weakens compliance also. The purpose of this study is to demonstrate importance of all LVDD. Doppler echocardiography parameters usage and its important echocardiography characteristic in case of hypertensive patients. This study represents 64 patients with essential hypertension - random sample. Three patients had atrial fibrillation. Besides anamnestic data collection, echocardiography evaluation was undertaken on all patients. For LVDD diagnose following parameters were used: isovolumic relaxation time (IVRT), peak early filling velocity (E), peak atrial filling velocity (A), E/A ratio, DT (deceleration time), left ventricular (LV) mass. Left ventricular hypertrophy (LVH) was verified for 57 patients. Seven hypertensive patients didn't have verified LVH. Comparing patients with LVH with those without LVH differences were observed: patients with LVH had a longer IVRT, lower E/A ratio, A wave growth, IVRT directly correlates with LV mass increase and backward correlation LV mass with E/A was noticed. Among patients with LVH with E/A ratio =or> 1-1,5 and based on transmitral flow we used IVRT duration and pulse Doppler with volume sample over lateral mitral annulus measuring mitral annulus velocity. It appeared that it corresponds with IVRT duration in LVDD evaluation. Patients with atrial fibrillation had considerably extended IVRT that indicates LVDD existence. Patients with left ventricular hypertrophy were older and they have higher left ventricular mass comparing with patients without left ventricular hypertrophy. In case of patients with essential hypertension all above mentioned LVDD parameters have to be defined, specially IVRT duration for determination of LVDD existence in case of all patients with essential hypertension with and without LVH and in case of associated atrial fibrillation presence. It is necessary to tend to, as early as possible, detect LVDD and it's prevention with improved essential hypertension monitoring.

[Aortic stenosis and atrial septal defect in pulmonary hypertension caused by aorto-pulmonary fenestration]. / Aortna stenoza i atrijalni septalni defekt kod plucne hipertenzije prouzrokovane aorto-pulmonalnom fenestracijom.

This article writes about a 37-year-old patient with Eissemanger's syndrome. The catheterization was done when he when he was 7 years old and was diagnosed as follows: VSD, ASD and pulmonary hypertension. After repeated catheterization when patient was 23 years old the final diagnosis was established: Fenestra aortico pulmonalis, VSD, ASD, aortic stenosis gr II and pulmonary hypertension. The patient has been treating conservatively