Data: 30/03/2002 00:48
Da: Vladimir Krsljanin
Oggetto: FREEDOM ASSOCIATION WARNS: MILOSEVIC'S LIFE UNDER
THREAT!

FREEDOM ASSOCIATION
/YUGOSLAV COMMITTEE TO LIBERATE PRESIDENT MILOSEVIC/

WARNS:



HEALTH AND LIFE OF PRESIDENT MILOSEVIC

UNDER THREAT!





Level of health protection in former Nazi prison in the Hague is the
same like in Nazi concentration camps

(two prisoners already dyed due to lack of medical care)!

60-year old president Milosevic with malignant hypertension and
specific form of angina pectoris in an endless "trial" every day whole
day is treated by aspirins, when he got a flu (according to prison
doctor - general practician) with more then 10 days of high temperature!

He is under total life risk in such circumstances,

say medical experts of Belgrade University!



He needs urgent check-up by medical specialists, which NATO "tribunal"
prohibits up to now!



ACTION MUST BE TAKEN!



After the "tribunal's" negative answer to first such initiative,
Freedom Association sends the following letter (with medical
documentation enclosed) to "judges", "prosecution" and "amici curiae"
of the now-days Gestapo

(in accordance with their "rules"),

warning them about the criminal responsibility:








UNITED NATIONS

International Criminal Tribunal

for the Former Yugoslavia


To the III Trial Chamber





Your Excellencies,



Bearing in mind the intensive dynamic of the so-called trial, to which
President Slobodan Milosevic is exposed from day to day, we must warn
you that you carry the responsibility for his health and life.



Since you are evidently not enough informed with the general,
but with the current as well, state of health of President Milosevic,
and since, no matter of his illness, you do not show interest enough
for the improvement of his health, that is the reason why we are
compelled, as National Committee for liberation of Slobodan Milosevic,
towarn you about that. We especially bear in mind your responsibility
for the state of health of President Milosevic that derives from your
Statute and Rulebook on Procedure and Evidence and a number of other
international documents. The treatment of President Milosevic as a
whole finds itself in full collision with the Convention on torture and
other brutal, humiliating sanctions and proceedings, adopted by the
United Nations General Assembly on December 10, 1984, came into force
on June 26, 1987 and is in collision with the equivalent Convention,
adopted by the Council of Europe.



If however, for the sake of accomplishing an
unprecedented "project" of a trial, you will further on allow, as it
has been the case so far, the deterioration of President Milosevic's
health, you will carry full responsibility for that.



Therefore, we demand to enable a number of medical experts
(first of all specialists for cardio-vascular diseases) from
Yugoslavia, to make an urgent examination of President Milosevic and
give a proposal for adequate treatment, in order to stop the further
deterioration of his health. The team of experts would be comprised out
of Prof. Dr. Med. Sc Bozina Radevic (cardio-vascular surgeon), Prof.
Dr. Med. Sc Zdravko Mijailovic (cardiologist), Doc. Dr. Med. Sc Dragana
Bojic (cardiologist), and Prof. Dr. Med. Sc Vojislav Suvakovic
(infectologist).



Starting from Rule 74bis of the Rulebook on Procedure and
Evidence of the Tribunal, according to which you are proprio motu able
to issue such an order, we demand from you to immediately enable a
consilium medical examination of President Milosevic.



Attached you will find the reports of Prof. Dr. Med. Sc.
Zdravko Mijailovic of the Military Medical Academy of Belgrade, dating
from May 31, 2001 and June 4, 2001 (both in English), together with the
copies of the originals in Serbian, as well as the medical report dated
from March 25, 2002 related to the state of health of President
Milosevic.



Belgrade, March 26, 2002



For "SLOBODA" ("Freedom") Association

The National Committee for the

Liberation of Slobodan Milosevic



Bogoljub Bjelica, President







MEDICAL REPORT

RE: SLOBODAN MILOSEVIC



Inspection of medical documentation and his previosly, well known healt
problems insigate and underline further facts:



The majority of people know what is hypertension. It is not secret that
hypertension has an inportant role of cardiovascular mortality and
morbidity. Effective treatment significantly reduces relative risk of
stroke up to 40%, and of myocardial infraction by 20%. Slobodan
Milosevic does not have simply elevated blood preasure, he has
hypertensive crisis or malignant hypertension. His diastolic blood
pressione often, with abrupt onset exceeds 130 mmHg, systolic 200 mmHg.
What does it mean?



Accelerated (malignant) hypertension occurs most commonly in patients
with essential hypertension. The risk of complication is more closely
linked with the rate of rise in blood preasure than the absolute blood
preasure level, because patients auto regulate to compensate for
chronic hypertension. When blood preasure rises rapidly as Milosevics'
case, celebral, retinal and renal damage may ensue and the patient may
develop acute cardinale failure. It carries a high mortality risk:
untreated, 1-year survival in approximately 25%; with treatment, 1-year
survival is around 90%. Rapid control of escalating blood presure is
essential, but it has to be achieved by slow, sustained reduction.
There is no prison hospital which can obtain this treatment. They can
provide only aggressive treatment. Aggressive reduction can cause
tissue and celebral ischaemia and infraction, because in most cases the
tissues have auto regulated to require a grater than normal perfusion
pressure.



His another heath problem is Prinzmetal's variant angina pectoris.
There is no pearson who does not understand what means "angina
pectoris". In the last few months Milosevic has been having chest pain
due to coronary arterial spasm which can not be relieved by sublingual
nitroglycerin. It occurs at rest with abrupt onset or rapid
deterioration of previously stable condicion. Reason for deteriration
his condicion is inappropriate coronary vasoconstriction whish has been
shown to occur during exposure to mental stress.



In the other hand, anxiety is a normal reaction to cardial illness and
many patient will have symptoms as a result. The tendency to categorize
patient's symptoms as "genuine" and "non-cardiac" is unhelpful.
Relaxation and stress management are fundamental problems particularly
useful in managing angina where (after exertion) stress is the second
most likely precipitant of symptoms.



Slobodan Milosevic is in the prison where there is no possibility for
appropiate medical treatment. He probably can get pills or doctors'
supervision. But underlying conditions ask for high educated
consultants, intesive care unit and above all relaxsation. Only in this
condition his cardiac properties will not function related his chance
to present evidence of his innocent.



Prolonger trial and stress continuity increase risk of major
cardiovascular events. Slobodan Milosevic is undergoing extreme
phychical effort. Everyday rapid deterioration of his health can cause
sudden death. That is why he must be rewieved and under care of medical
experts from Yugoslavia who know his medical history. They need to see
him and after serious examination decide about further treatment.



We are not talking about quality of life we are fighting for
life!



Professors of Belgrade University:

Dragana Bojic, Ph.D., MD, cardiologist

Vojislav Suvakovic, Ph.D., MD, infectologist

Milos Janicijevic, Ph.D., MD, neuro-surgeon



Done in Belgrade, March 25, 2002







FOLLOW-UP CARDIOLOGY EXAMINATION

PATIENT: SLOBODAN MILOŠEVIC



The patient is 61 years old.

Risk factors for coronary arterial disease: smoker, hyper lipidaemia,
heredity, high stress, arterial hypertension (in earlier check-ups over
many years arterial tension ranged most frequently around 135-140/ 85-
90 mmHg, with occasional therapy. Maximum blood pressure readings
ranged around 150/95mmHg and rarely 150/100 mmHg).

He is also aware of small cysts in kidneys.

Echo examination of abdomen a year and a half ago, changes in gall
bladder observed, like a polyp or calculus but no further investigation
made because of the patients’ rejection.



Occasionally administered medicines:Presolol 100mg ¼ ili ½, Upsarin
effervettes 1 in the morning. Between 11.04.2001 and 13.04.2001 he was
hospitalized in the Military Medical Academy Hospital, where:

During echo cardiography: significant hypertrophy of myocardium was
proven in the left ventricles, global EF around 45%, but with akinesy
of the distal third of the septum, top of heart and distal third of
frontal and lateral wall of the left ventricle (Docent dr.A. Neskovic-
KBC Dedinje).

The selective coronography revealed coronary bridge ) suffocation of
the left coronary artery). Naked microcirculation and on other segments
epicardial coronary arteries only negligible changes. Left ventricle of
normal size, of hyperopic walls, in systole like hypertrophy
cardiomiopathy.

Under the decision of the medical consultation team the patient was
dismisses with medical therapy (dismissal letter attached).

In the meantime a check-up was undertaken (223.04.2001) when it was
concluded that the arterial hypertension has not been cured, with the
existence of probable angina pectoris, more intensive medicinal therapy
and additional examinations (ophthalmology examination, neurological
examination, analysis of the adrenal glands, abdominal echo and kidney
and adrenal glands echo, 24 hour halter monitoring of blood pressure
and halter ECG...follow up of ECG and additional assessment of
microcirculation (scintigraphy of the heart or PET scan..).

In the meantime he occasionally complained of chest sharp pain
propagating to the jaws and numbness in the jaws...he did not take
nitroglicerine... those disorders appear when in the state of rest, but
more often while walking when he occasionally sweats. Then he must sit
down and rest, when the troubles pass away gradually.

Occasionally he feels lack of air and speedy or irregular hear beat.

Sometimes mild headaches felt.



Regularly controlled blood pressure and pulse by the attending doctor.
Maximum measured blood pressure readings 220/13p mmHg on 30.05.2001,
pulse 120/mm.

The lowest TA value in the period under review was 140/100mmHg and
pulse 88/min, once on 21.04.2001.

The most frequent TA readings were 190/115 mmHg and pulse around 100/mm.

Regularly were monitored electro cardiograms, where sinus tachicardy
was observed of around 10/min, with symmetrically negative T waves in
D1, AVL and V2 to V6.

ECG dated 11.05.2001 shows sinus tachicardy around 11/min with deeply
negative T waves in D1, AVL, V2 to V6 even up to around 1.5 cm with
lowering of ST clip 2-3 cm.



Planned and appointed examinations suggested earlier were not carried
out in the meantime because the patient was not motivated.



According to the patient, the medication proposed earlier has been
regularly administered.



OBJECTIVE FINDING

Cordially compensated. Presently a febrile.



Obese according to general type. Veins in the neck not tense.

Over the neck arteries no suboclussion murmur is heard.

On the lungs vesicular breathing with rare low tone whistling.

Heart action is rhythmical, speeded to about 120/min, tones somewhat
quiet, without pathological noise. TA:200/120mmHg (after regular
therapy taken this morning).

Liver and spleen not palpable. No sensitivity of gall bladder to
palpation.

No signs of free liquid in the abdomen.

Kidney lobes insensitive to succusion.

No visible cardiac edema on lower legs, or deformities.



ECG : sinus tachicardy around 120/min, PQ=0.16, negative T in D1, AVL,
V2 to V6 with lowering of ST clip in the left pericardial drains up to
2mm



DG: Hypertensio arterialis (unregulated)

Hypertrohpy of myocardium of the left ventricle

Angina pectoris (cor,bridge...microvasc.??)



TH: Dilatrend 12.5mg, 1 in the morning with the control of
TA and pulse. If TA remains unregulated, the dose may be corrected with
additional 1 in the evening. Enalapril 20mg 1+1+0 with the check up of
TA

Lometazid 1-2 a week.

Nitroglycerin as needed.

Demetrine tab. 2x1



OPINION:



Present hypertension and unregulated with the existing therapy (max.
220/130 mmHg and most often 190/115 mmHg with a pulse of some 100/min).

The above readings of hypertension increase the risk exponentially for
fatal events (relative risks of stroke is above 4, and for an acute
coronary event between 3.5-4).

According to the patient, he was taking the therapy regularly, but as
evident from the above analyses arterial hypertension is unregulated.

Apart from it the patient feels troubled chest of angina type with
clear changes in ECG, which are maintained.



Based on the above and starting from scientific, professional and moral
standards it is necessary to:



1. Ensure regular intake of adequate therapy

2. Complete the examinations recommended earlier (Ophthalmology,
neurology, analysis of hormones of adrenaline gland, analysis of kidney
function, abdominal echo, ultra sound adrenaline gland check, 24 hour
Halter monitoring of blood pressure, supplemental examination of
hypertrophy of myocardium, scinthigraphy of the heart, PET scan and
others..)

3. If the patient shall have repeated problems behind the sternum of
anginoide character, dizziness or the similar, ECG should be repeated,
cardio specific enzyme and promptly proceed along the principles of
care of such patients.

4. If the disorders will persist, the blood pressure reading cannot
be corrected and the proposed examinations cannot be carried out in
view of the above mentioned risks of fatal events in such patients, it
shall be necessary to ensure via competent means an adequate correction
of blood pressure, additional examinations of hypertrophy of
myocardium, microcirculation of the heart as well as other
examinations in hospital (VMA..) conditions.



31.05/2001 in Belgrade




Col.Ass.Prof. MD, PhD

Zdravko
M.Mijailovic







FOLLOW-UP CARDIOLOGY EXAMINATION

PATIENT: SLOBODAN MILOŠEVIĆ



Follow-up examination of 04.06.2001

The patient was examined previously on 31.05.2001.See the finding
attached.

The patient is 61 years old.

Of risk factors from coronary disease: smoker, hiperlipidaemia,
heredity, arterial hypertension ranging during many years in the past
around 135-140/85-90 mmHg with intermittent therapy.

Maximum readings of the blood pressure used to be 150/95mmHg, and on
rare occasions 150/100 mmHg.

He is aware of smaller cists in kidneys.

On the earlier abdominal examination, changes were observed on the gall
bladder, which resembles of gallbladder polyp, although calculosis
could not have been excluded. Follow-up gastro enterologic examination
with a repeated echo examination of abdomen was not made due to lack of
motivation on the part of the patient.

Of drugs he was using Presolol 100mg ½ or ¼ in the morning and Upsarin
eff.



Between 11.04.2001 and 13.04.2001 he was treated in VMA hospital where
on Chocardiography considerable hypertrophy of myocardium was evidenced
on left ventricle (1.4cm), global EF around 45%, but with akinezy of
distal third of the septum, peak of the heart and distal third of
frontal and lateral walls of the left ventricle (Ass.Prof.
Dr.A.Neskovic- KBC Dedinje).

At the selective coronorography: visible coronary bridge (suffocation
of the left coronary artery( naked microcirculation, and on other
segments of epycardiac coronary arteries only negligible changes. The
left ventricle of normal size, of hypertrophic walls, in systole and by
type of hyperthrophic cardiomyopathy.

By the decision of the doctoral consultation team the patient was
dismisses with medicinal therapy (Letter of dismissal attached).



In the meantime a follow up was done (23.04.2001) when it was concluded
that arterial hypertension is unregulated with probable presence of
angina pectoris, the therapy was strengthened, and additional
examinations advised for abdomen and echo of kidneys and adrenaline
gland, 24 hour Halter monitoring of blood pressure and Halter ECG...
follow up of ECG, as well as supplemental assessment of
microcirculation (Scintigraphy of the heart or PET scan...).

Blood pressure readings were regularly controlled and pulse by the
attending doctor.

Maximum values of blood pressure were 220?130 mmHg on 30.05.2001, pulse
120/min.

The lowest read TA value over the period was 140/100mmHg and pulse
33/min, only once on 21.04.2001.

The most frequently obtained TA values were 190/115 mmHg with pulse of
around 100/mm.



Electro cardio grams were also regularly followed, where sinus
tahicardy was observed of some 100/mm, with symmetrically negative T
waves in D1, AVL and V2 to V6. ECG of 11.05.2001 revealed tahicardy
around 110/mm, with deeply negative T waves in D1, AVL, V2 do V6 even
up to 1.5cm with a drop of ST clip 2-3mm.

Planned and appointed examinations proposed earlier were not completed
due to the lack of motivation on the part of the patient.



In the meantime, since 31.05.2001 till today, he continued to com-plain
here and there to the chest pain propagating to the jaws and numbness
in the jaws...he did not take nitroglicerin...these troubles appear at
rest but more often while walking when he sometimes sweats. Then he
must sit down and take a rest, and the disorders pass away
spontaneously.

From time to time he feels lack of air and irregular and speedy hart
beat.

Sometimes he has light headache.

Since 31/05.2001 till today no blood pressure was measured and no
examinations made, no electrocardiogram, either.

The planned and appointed examinations proposed earlier were not
completed in the meantime due to the lack of motivation by the patient.



OBJECTIVE FINDING



Cordially compensated. Now a febrile.

Obese according to general type. Veins of the neck not tense.

On lungs vesicular breathing, with rare low tone whistling.

Heart action is rhythmic, speedy up to some 130/min, tones somewhat
quieter without pathological hums.

TA 230?130 mmHg (following the morning regular therapy, Dilatrend
12.5mg, Enalapril 20mg, Lometazid...).

Liver and spleen not palpable. Gall bladder is not sensitive to
palpation.No signs of free liquid in the abdomen.

Kidney archinephrons insensitive to succussion.

No visible cardiac edema on lower legs or deformities.



ECG sinus tahicardy around 130min,PQ= 0,16, negative T in D1,AVL,V2 up
toV6, with lowering of 3T of clips in the left perocardial drains up to
2mm.

DG. Hypertensio arterialis (unregulated)

Hypertrophy of myocardium of the left ventricle

Angina pectoris (cor. “bridge”...microvasc.?? )

Obs.polypus(calculosis) v.feleae



TH. Dilatrend 12.5mg 2 in the morning with control of TA and
pulse. If TA remains unregulated the dose may be corrected with an
addition in the evening.

Enalpril 20 mg i+i+0 with the control of TA.

Norvasc 5mg 0+i=i

Isosorb R 2x1

Lasix i-2 a week

Bromazepam 3mg 2x1

Nitroglicerin as needed



OPINION



The extremely high value of arterial hypertension continued, and was
not regulated with the existing therapy (max. 230/130 mmHg at a pulse
rate of 130/min, and most often 190/115 mmHg with pulse rate of around
100/min.). These values of arterial hypertension exponentially increase
a risk of fatal incidents (brain stroke, acute myocardial infarct, hear
arrest, malignant disorders in heart rhythm...).



Next to that the patient has chest pain of angina type with clear
changes in ECG that are reflected.

These disorders could be an indication of threatening fatal coronary
accidents, and particularly in combination with enormous hypertension
which ranges on average to 195/115 mmHg for over two months, proven
hypertension of myocardium, alterations in microcirculation, found
phenomenon of “suffocation of left coronary artery” and enormous stress
the patient has been permanently exposed to).



Despite all measures undertaken as evident from the above stated
findings, the arterial hypertension remains uncorrected, angina
disorders are repeated and ECG alterations persist.



Based on the above, starting from high risk to the patient, and since
the treatment so far failed to yield results, and starting from
scientific, professional and ethic norms:



1. It is necessary immediately in hospital conditions to ensure an
adequate correction of blood pressure; implement earlier planned
additional examinations, ophthalmology examination, neurological

examination, analysis of the hormone of adrenaline gland,
analysis of kidney function, abdominal echo with ultra sound
examination of adrenaline, 24 hour Halter monitoring of blood pressure,
Halter ECG, supplemental examination of the nature of hypertrophy of
myocardium and assessment of microcirculation, possibly burden test,
scintigraphy of heart, PET scan and others...).



04.06.2001 in Belgrade
Col. Ass.Prof.MD, Phd,


Zdravko M.Mijailovic



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