Cases of acute poisoning admitted to Clinical Hospital Merkur in Zagreb in 1999.

This paper describes 170 cases of acute poisoning in 60 men and 110 women admitted to emergency room from January through November 1999. Ninety-eight percent of acute poisonings were self-inflicted, and 90% occurred at home. Drugs were used in 134 (79%) suicide attempts. Eighty-one acute poisonings were caused by benzodiazepines (48%) and 19 by antidepressants (11%). Alcohol intoxication, alone or combined with the intake of psychoactive drug (28 cases, 16%) predominated in men. Cocaine was the most common narcotic drug, taken by 31 patients (16%). Other acute poisonings involved ecstasy (4 cases), CO (6 cases), and HCl inhalation (2 cases). Previous suicide attempts due to depression were found in 68 patients (40%). Fifty patients (29%) were comatose on admission, 24 were transferred to intensive care, and 3 died. Data such as these can be very useful for handling self-inflicted acute poisonings and for planning long-term health care activities.

[Serum levels of beta 2-microglobulin in various types of hemodialysis]. / Serumska koncentracija beta 2-mikroglobulina u razlicitim vrstama hemodijalize.

beta 2-microglobulin (beta 2 m) is the major constituent of amyloid fibrils in dialysis-related amyloidosis (DRA), which is considered to be one of the most severe adverse effect of long-term dialysis. In this study we evaluated the efficiency of beta 2 m removal during different dialysis procedures. A total of 45 patients undergoing hemodialysis were divided in five groups: cuprophane dialysis (n = 10), high-flux polysulphone dialysis (n = 10), postdilutional hemodiafiltration (n = 10), conventional postdilutional hemofiltration (n = 10) and predilutional on-line hemofiltration (n = 5). Serum level of beta 2 m was determined before and after different procedures using ELISA. In the group of patients on cuprophane dialysis was registered an elevation of beta 2 m and of 16.8 +/- 11.4% on the average. Serum level of beta 2 m was decreased following all other procedures on the average of 40.7 +/- 16.4% after high-flux polysulphone dialysis, 42.0 +/- 13.7% after conventional hemofiltration, 64.7 +/- 9% after hemodiafiltration and 67.9 +/- 10.1% after predilutional hemofiltration. The best removal of serum beta 2 m was realized by predilutional hemofiltration. Also, we have noticed that patients treated with high-flux synthetic membranes in the longer time-period have lower predyalisis value of beta 2 m compared to patients treated with cuprophane membrane. Further long-term studies will be necessary to conclude whether these procedures could be successful prophylactic and/or therapeutic regimen for dialysis-related amyloidosis.

[Use of fibrin glue prepared from recycled cryoprecipitate in experimental liver surgery]. / Primena fibrinskog lepka pripremljenog reciklaznom krioprecipitacijom u eksperimentnoj hirurgiji jetre.

Fibrin glue (FG) is a two-component biologic system with adhesive, sealant and topical hemostatic properties, containing fibrinogen (Fg), factor XIII (FXIII), fibronectin (Fn), thrombin, some antifibrinolytic agent if needed and ionized calcium. In this study, FG component 1 was prepared by recycling cryoprecipitation from single-donor plasma. The mean concentrations of Fg, FXIII and Fn were: 54.2 +/- 19.9 g/l, 8.03 +/- 2.3 IU/ml and 3103.1 +/- 148.91 mg/l, respectively. Horizontal tensile strength of FG was 1.076 +/- 0.18 N/cm2 in the average. Using a rat model, the efficacy of the FG-treatment in liver surgery was evaluated on the basis of the 24 hour survival ratio and hematological parameters of the experimental animals and control group. Survival of rats subjected to partial and total lobectomy and FG-treated was significantly (p < 0.001) higher than in FG-non-treated animals. Survival of animals subjected to liver incision was not significantly different, although the differences in hematological parameters were significant (p < 0.001 to p < 0.09) in favor of FG-treated animals. Our findings confirmed that high quality FG can be prepared by recycling cryoprecipitation from single-donor plasma--with sufficient yield of fibrinogen, FXIII and fibronectin and with the risk of disease transmission not greater than with the use of single unit of blood or plasma--which have efficient hemostatic and therapeutic properties.