Biological markers of alcohol related disorders.

The authors in this study lay out a relatively new approach to the diagnostics of alcoholism. Measuring the biological markers of this disease is a useful extension of the standard clinical examination and a promising method for improving prevention. Studies about markers of alcoholism provide a new, exact and quantitative way of diagnosing alcoholism, by means of determining the "state" markers, which include markers of the cerebral process of dependency development and markers of acute and chronic intoxication by alcohol; and by means of determining the "trait" markers, which suggest the disposition for the development of alcohol disease. The authors believe that measuring the biological markers is a promising new approach that should improve the diagnostics and prevention of alcoholism.

Tuberculosis and alcoholism in Croatia.

Alcoholism and tuberculosis represent very difficult problem in treatment because both illnesses require complex treatment which cannot be adequately obtained on classic wards. Tuberculosis in the last 50 years showed the constant decline of incidence--in Croatia (4,500,000 inhabitants) from approximately 20,000 to approximately 2000 cases per year. This study compares preliminary results of AUDIT (Alcohol Use Disorders Identification Test) in the group of tuberculosis patients with the diagnosis of alcoholism (group 1) and in the group of tuberculosis patients who had not the diagnosis of alcoholism (group 2) and who all were admitted to the Hospital for pulmonary diseases and tuberculosis Klenovnik where is an organised unique ward management for tuberculosis and alcoholic patients functioning for the last 25 years on the basic principles of therapeutic community. Their average AUDIT score was 25.44--very high, and all patients scored above 8, what indicated on harmful and hazardous drinking. Additionally, in the group of patients admitted for hospital treatment of tuberculosis without diagnosis alcoholism there were more than 50% of harmful or hazardous alcohol drinkers who ranged 8 or more on AUDIT score, what could indicate that modern identification of hazardous drinking (for example using AUDIT) should be used in all pulmonary and tuberculosis wards. Patients for whom diagnostic procedure shows that they drink harmfully or hazardously should be treated simultaneously for tuberculosis and alcohol use disorders. Because of hidden alcohol problems the group sociotherapy should be organised for all patients at all wards for treatment of tuberculosis in a common and special alcohologic way.

[Use of angioscopy in vascular surgery bypass with an in situ approach--first year experience]. / Upotreba angioskopije u vaskularnoj kirurgiji premosnice (by pass) izvedene postupkom in situ--prva godina iskustva.

Femoropopliteal and femorocrural bypass, managed by "in situ" procedure with the use of angioscope, became a standard surgical method in the treatment of occlusive process in the arteries of lower extremities in the Department of Vascular Surgery, Clinical Hospital "Sestre milosrdnice" in Zagreb. The capabilities of angioscopy in diagnosis and in surgery are presented, with special emphasis on bypass "in situ" procedure. Technical difficulties encountered in bypass formation and our solutions are described. From December 1993 to December 1994, eleven patients were operated. Common femoral artery was used for proximal anastomosis in four patients. Superficial femoral artery was used in five patients, and profound femoral artery was used in two patients. The third segment of popliteal artery was used for distal anastomosis in five cases. In six cases crural bypass was done. Three of them were on posterior tibial artery, two were on fibular artery and one was on anterior tibial artery. Two out of four or 50% of femoropopliteal bypasses are patent after the first year. One patient died of cardiorespiratory complications in the early postoperative period. Femorocrural bypasses are patent in five out of six patients or 83.3%. Bypass with great saphenous vein "in situ" is the procedure of choice, especially in femorocrural position.

[Aneurysms of the extracranial part of the carotid artery]. / Aneurizme ekstrakranijskog dijela karotidne arterije.

The purpose of this article is to take firm position on the surgical treatment of the carotid artery aneurysm on the basis of ten years of experience, considering their rare occurrence and significant pathology. From January 1984 to December 1994, ten patients with aneurysms or pseudoaneurysms of extracranial carotid arteries were diagnosed and operated in the Department of Vascular Surgery, Clinical Hospital "Sestre milosrdnice" in Zagreb. In the same period, eight hundred operations of extracranial carotid arteries were performed. Special emphasis is put on the etiology of the disease where atherosclerosis is prevalent, but cases of traumatic, mycotic and postoperative aneurysms are also shown. In symptomatology, signs of palpable local tumor dominated in six patients, while in three patients central nervous system symptoms were found. All patients with neurologic symptoms were in the group with atherosclerotic aneurysms. In nine patients resection of the aneurysm and reconstruction with the interposition of a part of vena saphena magna or with allograft was performed. In one patient, neoanastomosis of the internal carotid artery in the common carotid artery was performed following the resection of a small aneurysm. In the early postoperative period there was no morbidity nor mortality. In view of frequent preoperative neurologic complications and good postoperative results, surgical treatment is indicated in all cases. Reconstruction is always indicated, and the procedure of choice is reconstruction with the interposition of a part of great saphenous vein.