Srp Arh Celok Lek [JOURNAL]
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200 papers
Prevalence of Internet Addiction among Schoolchildren in Novi Sad.
Ac-Nikolić E, Zarić D, Nićiforović-Šurković O
Srp Arh Celok Lek · 2015 · PMID 26946768 · Publisher ↗
INTRODUCTION: Internet use has increased rapidly all over the world. Excessive Internet use tends to lead to the creation of a non-chemical addiction, most commonly known as "Internet addiction." OBJECTIVE: The aim of th...
INTRODUCTION: Internet use has increased rapidly all over the world. Excessive Internet use tends to lead to the creation of a non-chemical addiction, most commonly known as "Internet addiction." OBJECTIVE: The aim of this study was an assessment of the prevalence of Internet use and Internet addiction among school children aged 14-18 years in the Municipality of Novi Sad, Serbia, and influence of sociodemographic variables on Internet use. METHODS: A cross-sectional study was conducted in Novi Sad among final-year students from elementary and first- and second-year students from high schools.The prevalence of Internet addiction was assessed by using Young's Diagnostic Questionnaire. RESULTS: Out of 553 participants, 62.7% were females, and the average age was 15.6 years. The sample consisted of 153 elementary school students and 400 high school students. Majority of respondents had a computer in their household. Our study showed widespread Internet use among adolescents. Facebook and YouTube were among most visited web-sites. The main purpose of Internet use was entertainment. Estimated prevalence of Internet addiction was high (18.7%), Mostly among younger adolescents (p = 0.013). CONCLUSION: Internet addiction was found in every fifth adolescent. Accessibility and availability of Internet use is constantly growing and therefore it is necessary to define more sensitive diagnostic tools for the assessment of Internet addiction and its underlying causes, in order to implement effective preventive programs.
Long-Term Treatment with Olanzapine in Hospital Conditions: Prevalence and Predictors of the Metabolic Syndrome.
Popović I, Ravanić D, Janković S … +5 more , Milovanović D, Folić M, Stanojević A, Nenadović M, Ilić M
Srp Arh Celok Lek · 2015 · PMID 26946767 · Publisher ↗
INTRODUCTION: The risk of metabolic abnormalities is greatly increased in schizophrenic patients started on an atypical antipsychotic medication. Patients with psychiatric disorders exceed mortality ranges resulting from...
INTRODUCTION: The risk of metabolic abnormalities is greatly increased in schizophrenic patients started on an atypical antipsychotic medication. Patients with psychiatric disorders exceed mortality ranges resulting from, among others, increased risk of cardiovascular events. Other factors contributing to the development of metabolic syndrome include prolonged duration of illness, increasing age, female sex and lifestyle factors. OBJECTIVE This cross-sectional study was taken up to assess the prevalence of the metabolic syndrome (MetS) in schizophrenic patients receiving olanzapine monotherapy for at least six months and to determine the most important risk factors associated with metabolic syndrome presence in these patients. METHODS A total of 93 long term hospitalized schizophrenic patients (71 men, 22 women), had a screening of the following: case-history data, psychiatric scales, anthropometric measures, blood (fasting glucose, lipid status, C-reactive protein--CRP) and urine samples (microalbuminuria). RESULTS: Prevalence of MetS according to International Diabetes Federation criteria in our study was 34.4%. The multivariate analysis distinguished the following significant predictors of MetS presence (in order of appearance): data about diabetes mellitus in family history (p = 0.002), body mass index > 25 kg/m2 (p = 0.002), hyperlipidemia in family history (p = 0.008), and elevated CRP value (p = 0.042). CONCLUSION: High rate of MetS in patients treated with olanzapine in this study exceeds MetS prevalence in general population. Among observed parameters, our study pointed to several "high risk" predictors associated with MetS presence. Regular monitoring of cardiometabolic risk factors is highly recommended. Positive heredity distress mentioned above may direct a psychiatrist to prescribe some other drug than olanzapine in the long term treatment of schizophrenia.
Epidemiological Surveillance of Leishmaniasis in Montenegro, 1992-2013.
Medenica S, Jovanović S, Dožić I … +3 more , Milicić B, Lakićević N, Rakocević B
Srp Arh Celok Lek · 2015 · PMID 26946766 · Publisher ↗
INTRODUCTION: The diseases caused by Leishmania are spread worldwide and represent a significant public health problem. OBJECTIVE: The aim of this study was to present the results of epidemiological surveillance of leish...
INTRODUCTION: The diseases caused by Leishmania are spread worldwide and represent a significant public health problem. OBJECTIVE: The aim of this study was to present the results of epidemiological surveillance of leishmaniasis in humans in Montenegro in the period from 1992 to 2013. METHODS: The study was planned and realized as a descriptive epidemiological study.The sample included patients of leishmaniasis in Montenegro in the period from 1992 to 2013. The health and demographic data were collected from medical records.The disease was microbiologically proven in the patients. For statistical analysis the χ2-test was used, which examined the significance of the incidence rate. RESULTS: During this period, 66 cases of leishmaniasis were identified (40 men and 26 women) aged 0 to 62 (mean 15.61 ± 16.76 years). A visceral form of the disease was diagnosed in 65 (98%) patients, and one patient was diagnosed with cutaneous leishmaniasis. The average incidence rate for the abovementioned period is 0.48 per 100,000 inhabitants. The highest average incidence rate was identified in patients up to seven years of age (3.50 per 100,000 inhabitants). The highest average incidence rates of leishmaniasis were identified in the coastal region of Montenegro, while seasonal distribution indicates that the disease occurs throughout the year with predominance in late spring and summer. CONCLUSION: The research has shown that Montenegro is among the countries with low incidence of leishmaniasis. Nevertheless, because of leishmaniasis re-emergence in the entire Mediterranean Basin, a comprehensive research of ecological and epidemiological characteristics of leishmaniasis, including better monitoring and notification system, is required.
Parental Factors Associated with Intrauterine Growth Restriction.
Haşmaşanu MG, Bolboaca SD, Drugan TC … +2 more , Matyas M, Zaharie GC
Srp Arh Celok Lek · 2015 · PMID 26946765 · Publisher ↗
INTRODUCTION: Linear growth failure is caused by multiple factors including parental factors. OBJECTIVE: The aim of this study was to evaluate parental risk factors for intrauterine growth restriction (IUGR) on a populat...
INTRODUCTION: Linear growth failure is caused by multiple factors including parental factors. OBJECTIVE: The aim of this study was to evaluate parental risk factors for intrauterine growth restriction (IUGR) on a population of Romanian newborn infants in a tertiary level maternity facility for a period of 2.5 years. METHODS: A retrospective matched case-control study was conducted in the Emergency County Hospital of Cluj-Napoca, a university hospital in North-Western Romania. The sample was selected from 4,790 infants admitted to the Neonatal Ward at 1st Gynecology Clinic between January 2012 and June 2014. RESULTS: The age of mothers was significantly lower in the IUGR group compared to controls (p = 0.041). A significantly higher percentage of mothers had hypertension in the IUGR group compared to those in the control group (p<0.05). No other significant differences were identified with regard to the investigated characteristics of mothers between IUGR infants compared to controls (p > 0.13). The age of fathers of infants with IUGR proved significantly lower compared to controls (p = 0.0278).The analysis of infants'comorbidities revealed no significant difference between groups for respiratory distress, hyperbilirubinemia, hypocalcaemia, and heart failure (p > 0.27). Intracranial hemorrhage, necrotizing enterocolitis and hypoglycemia were significantly higher in the IUGR group compared to controls. The logistic regression identified hypertension as a significant risk factor for IUGR (OR = 2.4, 95% Cl [1.3-4.5]). CONCLUSION: Although the age of the mothers and fathers proved significantly lower in the IUGR group compared to controls, only hypertension in the mothers proved significant risk factors for IUGR.
Analysis of Macronutrients Intake and Body Mass Index in Preschool Children in the Western Region of the Republic of Srpska.
Djermanović M, Miletić I, Pavlović Z
Srp Arh Celok Lek · 2015 · PMID 26946764 · Publisher ↗
INTRODUCTION: Childhood obesity is currently considered to be one of the most prevailing and challenging public health issues in industrialized countries and some developing countries, including the Republic of Srpska. O...
INTRODUCTION: Childhood obesity is currently considered to be one of the most prevailing and challenging public health issues in industrialized countries and some developing countries, including the Republic of Srpska. OBJECTIVE: Our objective was to determine macronutrients intake in collective diet of preschool children and to estimate the rate of obesity in this population. METHODS: Samples of food intended for preschool children diet were collected in a preschool facility in the western region of the Republic of Srpska. In daily portions, the content of proteins, fats, carbohydrates, water and mineral matter were determined using standard methods. The body mass index was determined on the basis of anthropometric measurements. RESULTS An average daily meal contained 17.5 g of fats, 19.1 g of proteins and 101.5 g of carbohydrates. The energy value was 676 Kcal. The analysis of the data from the menu showed that the number of consumed servings of fruits, vegetables, legumes, milk and dairy products was less than one portion per day. However, the amount of consumed meat and meat products exceeded one portion per day. Out of the total number of children, 10.0% were undernourished, 16.7% were overweight and 13.3% were obese. CONCLUSION: Daily portions in the preschool facility are not in accordance with the recommended dietary allowance for energy and carbohydrates intake, and the composition of meals is inadequate. Parents and caregivers should be encouraged to expose young children to a wide variety of fruit and vegetables, whole grains, low-fat dairy products, and to balance food intake with the requirements.
Assessment of the Reliability of the Serbian Version of the Sickness Impact Profile Questionnaire in Patients with Chronic Viral Hepatitis.
Majstorović B, Janković S, Dimoski Z … +3 more , Kekuš D, Kocić S, Mijailović Ž
Srp Arh Celok Lek · 2015 · PMID 26946763 · Publisher ↗
INTRODUCTION: Health-related quality of life (HRQL) of chronic patients has been researched as the ultimate goal of modern treatment of chronic diseases to improve patients'quality of life. OBJECTIVE: The objective was t...
INTRODUCTION: Health-related quality of life (HRQL) of chronic patients has been researched as the ultimate goal of modern treatment of chronic diseases to improve patients'quality of life. OBJECTIVE: The objective was to assess the reliability of the Serbian version of the Sickness Impact Profile (SIP) questionnaire on the sample of patients with chronic viral hepatitis. METHODS: The research covered 102 patients with chronic hepatitis (47 type B and 55 type C). The assessment of the reliability of the SIP questionnaire was performed by testing the internal consistency of the questions by calculating the Cronbach's alpha coefficient. The factor analysis was used to assess whether the grouping of the questions within dimensions matches the distribution of the questions in the original English version of the questionnaire administered to U.S. patient population. RESULTS: The Cronbach's alpha coefficient for the entire questionnaire is 0.925, 0.869 for the physical dimension, and 0.857 for the psychosocial dimension. After running a factor analysis of the psychosocial dimension, "emotional instability" was extracted as the key factor, confirming the results of previous research. Compared with the English version of the questionnaire, the Cronbach's alpha coefficient of the Serbian version does not diverge significantly, whereas the factor analysis confirms the classification of the questionnaire into two dimensions. CONCLUSION: Our study has shown that the Serbian version of the SIP questionnaire is a reliable tool for assessing the HRQL of patients with chronic hepatitis B and C before starting treatment.
Scoring System Development and Validation for Prediction Choledocholithiasis before Open Cholecystectomy.
Pejović T, Stojadinović MM
Srp Arh Celok Lek · 2015 · PMID 26946762 · Publisher ↗
INTRODUCTION: Accurate precholecystectomy detection of concurrent asymptomatic common bile duct stones (CBDS) is key in the clinical decision-making process. The standard preoperative methods used to diagnose these patie...
INTRODUCTION: Accurate precholecystectomy detection of concurrent asymptomatic common bile duct stones (CBDS) is key in the clinical decision-making process. The standard preoperative methods used to diagnose these patients are often not accurate enough. OBJECTIVE: The aim of the study was to develop a scoring model that would predict CBDS before open cholecystectomy. METHODS: We retrospectively collected preoperative (demographic, biochemical, ultrasonographic) and intraoperative (intraoperative cholangiography) data for 313 patients at the department of General Surgery at Gornji Milanovac from 2004 to 2007. The patients were divided into a derivation (213) and a validation set (100). Univariate and multivariate regression analysis was used to determine independent predictors of CBDS. These predictors were used to develop scoring model. Various measures for the assessment of risk prediction models were determined, such as predictive ability, accuracy, the area under the receiver operating characteristic curve (AUC), calibration and clinical utility using decision curve analysis. RESULTS: In a univariate analysis, seven risk factors displayed significant correlation with CBDS. Total bilirubin, alkaline phosphatase and bile duct dilation were identified as independent predictors of choledocholithiasis. The resultant total possible score in the derivation set ranged from 7.6 to 27.9. Scoring model shows good discriminatory ability in the derivation and validation set (AUC 94.3 and 89.9%, respectively), excellent accuracy (95.5%), satisfactory calibration in the derivation set, similar Brier scores and clinical utility in decision curve analysis. CONCLUSION: Developed scoring model might successfully estimate the presence of choledocholithiasis in patients planned for elective open cholecystectomy.
The Burden of Gastroesophageal Reflux Disease on Patients' Daily Lives: A Cross-Sectional Study Conducted in a Primary Care Setting in Serbia.
Bjelović M, Babić T, Dragicević I … +2 more , Corac A, Goran Trajković
Srp Arh Celok Lek · 2015 · PMID 26946761 · Publisher ↗
INTRODUCTION: Recent data from the studies conducted in the Western countries have proved that patients with gastroesophageal reflux disease have significantly impaired health-related quality of life compared to general...
INTRODUCTION: Recent data from the studies conducted in the Western countries have proved that patients with gastroesophageal reflux disease have significantly impaired health-related quality of life compared to general population. OBJECTIVE: The study is aimed at evaluating the burden of reflux symptoms on patients'health-related quality of life. METHODS: The study involved 1,593 patients with diagnosed gastroesophageal reflux disease.The Serbian version of a generic self-administered Centers for Disease Control and Prevention questionnaire was used. Statistical analyses included descriptive statistics, Pearson chi-square test and a multiple regression model. RESULTS: Among all participants, 43.9% reported fair or poor health. Mean value of unhealthy days during the past 30 days was 10.4 days, physically unhealthy days 6.4 days, mentally unhealthy days 5.3 days and activity limitation days 4.3 days. Furthermore, 24.8% participants reported having ≥ 14 unhealthy days, 14.9% had 14 physically unhealthy days, 11.8% reported 14 mentally unhealthy days, and 9.4% had ≥ 14 activity limitation days. CONCLUSION: This study addressed complex relationships between reflux symptoms and patients'impaired everyday lives.
Evaluation of Surfactant Replacement Therapy Effects--A New Potential Role of Lung Ultrasound.
Lovrenski J, Sorantin E, Stojanović S … +2 more , Doronjski A, Lovrenski A
Srp Arh Celok Lek · 2015 · PMID 26946760 · Publisher ↗
INTRODUCTION: Previous studies suggested that effects of the surfactant administration in preterm intants with respiratory distress syndrome cannot be followed by lung ultrasound (L-US). OBJECTIVE: The aim of the paper i...
INTRODUCTION: Previous studies suggested that effects of the surfactant administration in preterm intants with respiratory distress syndrome cannot be followed by lung ultrasound (L-US). OBJECTIVE: The aim of the paper is to evaluate the surfactant replacement therapy effects using a new, proposed grading system for L-US findings. METHODS: We report the series of 12 preterm infants with clinical and radiographic signs of respiratory distress syndrome, in whom L-US examinations were performed prior to, and within the first 24 hours after surfactant administration. To evaluate the surfactant replacement therapy effects, we proposed a new grading system (1 to 6) for L-US findings at each examined lung area, based on the presence of normal finding, the amount of B-lines and subpleural consolidations. RESULTS: All preterm infants had an improvement of L-US findings from one to four grades observed within the first 24 hours after surfactant administration, which has not been previously reported. The improvement of L-US findings was most commonly observed in anterior lung areas. CONCLUSION: L-US might enable an early detection of the surfactant replacement therapy effects. Further prospective studies are necessary to define the role of L-US in this field.
Changes in Cervical Lordosis and Cervicovertebral Morphology in Different Ages with the Possibility of Estimating Skeletal Maturity.
Lazić E, Glišić B, Stamenković Z … +1 more , Nedeljković N
Srp Arh Celok Lek · 2015 · PMID 26946759 · Publisher ↗
INTRODUCTION: During growth, proportions of craniofacial and cervical structures are changed. Craniofacial and cervicovertebral structures are morphologically and functionally connected, but their each other's influence...
INTRODUCTION: During growth, proportions of craniofacial and cervical structures are changed. Craniofacial and cervicovertebral structures are morphologically and functionally connected, but their each other's influence is still unknown. OBJECTIVE: The aim of this study was to determine the changes in cervical lordosis and cervicovertebral morphology in different age periods and the possibility of estimating skeletal maturity, based on the percentage of anterior cervical vertebrae body height sum in the total anterior C2-C5 height. METHODS: The study included lateral radiographs of 120 patients of both sexes, divided into three different age groups: eight, 12-13 and 17-18 years of age. Five craniofacial and 15 cervical parameters were measured and analyzed. RESULTS: The results showed significant correlation between cervical lordosis angle and age, gender, anterior and posterior body height of C3, C4, C5, anterior C4-C5 and posterior C2-C3, C3-C4, C4-C5 intervertebral space, anterior body height of C2-C5. Overall values of all cervical body heights were more present in the total height of the spine in females, while all intervertebral spaces were more present in males. The percentage of anterior and posterior C2, C3, C4, C5 body height sum compared to total C2-C5 height increases with age. CONCLUSION: The cervical lordosis becomes more curved and vertebral bodies occupy more space in females, while intervertebral spaces occupy more in males. Skeletal maturity could be estimated following vertebral percentage distribution in the total anterior C2-C5 part.
Complications in Cochlear Implantation at the Clinical Center of Vojvodina.
Dankuc D, Vlaški L, Pejaković N … +1 more , Mrdjanov V
Srp Arh Celok Lek · 2015 · PMID 26946758 · Publisher ↗
INTRODUCTION: The first modern cochlear implantation in Serbia was performed on November 26, 2002 at the Center for Cochlear Implantation of the Clinic for Ear, Nose and Throat Diseases, Clinical Center of Vojvodina. OBJ...
INTRODUCTION: The first modern cochlear implantation in Serbia was performed on November 26, 2002 at the Center for Cochlear Implantation of the Clinic for Ear, Nose and Throat Diseases, Clinical Center of Vojvodina. OBJECTIVE: The aim of the paper is the analysis of intraoperative and postoperative complications. Major complications include those resulting in the necessity for revision surgery, explantation, reimplantation, severe disease or even lethal outcomes. Minor complications resolve spontaneously or can be managed by conservative therapy and do not require any prolonged hospitalization of the patient. METHODS: In the 2002-2013 period, 99 patients underwent surgical procedures and 100 cochlear implants were placed. Both intraoperative and postoperative complications were analyzed in the investigated patient population. RESULTS: The analysis encompassed 99 patients, the youngest and the oldest ones being one year old and 61 years old, respectively. The complications were noticed in 11 patients, i.e. in 10.5% of 105 surgical procedures. The majority of procedures (89.5%) were not accompanied by any post-surgical complications. Unsuccessful implantation in a single-step procedure (4.04%) and transient facial nerve paralysis can be considered most frequent among our patients, whereas cochlear ossification (1.01%) and transient ataxia (2.02%) occurred rarely. Stimulation of the facial nerve (1.01%), intraoperative perilymph liquid gusher (1.01%), device failure and late infections (1.01%) were recorded extremely rarely. CONCLUSION: Complications such as electrode extrusion, skin necrosis over the implant or meningitis, which is considered the most severe postoperative complication, have not been recorded at our Center since the very beginning. Absence of postoperative meningitis in patients treated at the Center can be attributed to timely pneumococcal vaccination of children.
Representations of Lancet or Phlebotome in Serbian Medieval Art.
Pajić S, Jurišić V
Srp Arh Celok Lek · 2015 · PMID 26727878 · Publisher ↗
The topic of this study are representations of lancet or phlebotome in frescoes and icons of Serbian medieval art. The very presence of this medical instrument in Serbian medieval art indicates its usage in Serbian medic...
The topic of this study are representations of lancet or phlebotome in frescoes and icons of Serbian medieval art. The very presence of this medical instrument in Serbian medieval art indicates its usage in Serbian medical practices of the time. Phlebotomy is one of the oldest forms of therapy, widely spread in medieval times. It is also mentioned in Serbian medical texts, such as Chilandar Medical CodexNo. 517 and Hodoch code, i.e. translations from Latin texts originating from Salerno-Montpellier school. Lancet or phlebotome is identified based on archaeological finds from the Roman period, while finds from the Middle Ages and especially from Byzantium have been scarce. Analyses of preserved frescoes and icons has shown that, in comparison to other medical instruments, lancet is indeed predominant in Serbian medieval art, and that it makes for over 80% of all the representations, while other instruments have been depicted to a far lesser degree. Examination of written records and art points to the conclusion that Serbian medieval medicine, both in theory and in practice, belonged entirely to European traditions of the period.
Perinatal Outcomes of Pregnancies Conceived by Assisted Reproductive Technologies.
Šljivančanin T, Kontić-Vučinić O
Srp Arh Celok Lek · 2015 · PMID 26727877 · Publisher ↗
Recent epidemiological studies showed significantly higher incidence of perinatal complications in newborns and women after the use of assisted reproductive technologies (ART). Multiple pregnancies are more frequent afte...
Recent epidemiological studies showed significantly higher incidence of perinatal complications in newborns and women after the use of assisted reproductive technologies (ART). Multiple pregnancies are more frequent after the use of ART. Singleton pregnancies following ART are more prone to preterm birth, low and very low birth weight (LBW and VLBW), small for gestational age (SGA) and perinatal mortality. ObjectiveThe aim of this study was to summarize the results of relevant articles and to evaluate whether the mode of conception is the determining factor for different pregnancy outcomes after assisted and natural conceptions. Methods Eleven studies were included in this review. The following outcomes were observed: preterm and very preterm birth, SGA, LBW, VLBW, perinatal mortality, admission to neonatal intensive care unit (NICU), and Apgar score (As) ≤7 at fifth minute. Qualitative analysis nd quantitative assessment were performed. Results For singletons, odds ratios were 1.794 (95% confidence interval 1.660-1.939) for preterm birth, 1.649 (1.301-2.089) for LBW, 1.265 (1.048-1.527) for SGA. Admission to NICU, As≤7 at fifth minute and perinatal mortality showed significantly different frequency after assisted conception. Summary of results for twin gestations showed no significant difference between ART and spontaneous conception for preterm birth (32-36 weeks), very preterm birth (<32 weeks), LBW and VLBW. Conclusion Analyzed studies showed that infants from ART have significantly worse perinatal outcome compared with natural conception. More observational studies should be conducted in order to establish
Fixed Combinations of Glaucoma Medications.
Babić N
Srp Arh Celok Lek · 2015 · PMID 26727876 · Publisher ↗
The first line treatment in the management of glaucoma is topical medical therapy. Many patients with glaucoma require multiple medications for adequate intraocular pressure control. For patients who need multi-dose regi...
The first line treatment in the management of glaucoma is topical medical therapy. Many patients with glaucoma require multiple medications for adequate intraocular pressure control. For patients who need multi-dose regimens to control intraocular pressure, fixed combinations offer convenience, efficacy and safety. This review summarizes the role, efficacy, mechanism of action and indications for use of modern fixed combination of topical glaucoma medications.The review shows the advantages and disadvantages of a prescribing fixed combination in daily clinical practice.
Not to Declare Dead Someone Still Alive - Case Reports.
Andjelić S, Savić S
Srp Arh Celok Lek · 2015 · PMID 26727875 · Publisher ↗
INTRODUCTION: Diagnosing death represents an activity that carries a great deal of public responsibility for medical professionals and is continually exposed to the control of citizens and media. Although this is a taboo...
INTRODUCTION: Diagnosing death represents an activity that carries a great deal of public responsibility for medical professionals and is continually exposed to the control of citizens and media. Although this is a taboo subject in medical circles, unfortunately in medical practice there are situations when the physician issues a death diagnosis form without even examining the person or for an already buried person. Such physician's action is impermissible and it leads to the possibility of professional and criminal law punishment. CASE OUTLINE: By giving examples from practice, we wish to point out the need for exceptional caution when confirming and diagnosing death in order to diagnose the true, i.e. rule out apparent death and consequently avoid the mistake of declaring dead someone still alive. Conclusion When confirming and declaring death, exceptional caution of the physician is necessary so as not to declare dead someone still alive!
[Peripheral Primitive Neuroectodermal Tumor of the Small Bowel Mesentery - Report of a Case].
Marić H, Cvijanović R, Ivanov I … +3 more , Gvozdenović L, Ivanov D, Lalović N
Srp Arh Celok Lek · 2015 · PMID 26727874 · Publisher ↗
INTRODUCTION: Primitive neuroectodermal tumor or Ewing's sarcoma is a tumor of undifferentiated small round cells that arise from the soft tissues, and is believed to be of neural origin. It occurs most often in children...
INTRODUCTION: Primitive neuroectodermal tumor or Ewing's sarcoma is a tumor of undifferentiated small round cells that arise from the soft tissues, and is believed to be of neural origin. It occurs most often in children, followed by adolescents and young adults. CASE OUTLINE: A case of a 24-year-old patient with ulcerostenosans Ewing's sarcoma of the initial part of the small intestine is presented in our paper. Reviewing the literature and using as an example the case of a female patient with signs of sideropenic anemia caused by primitive neuroectodermal tumor of the small intestine, an attempt was made to clarify the etiology, clinical presentation, diagnosis and therapy with the aim of its rapid detection and treatment. CONCLUSION: Mesenteric primitive neuroectodermal tumor is a rare neoplasm in adults, while it usually occurs in children and young adults. Surgical resection of the lesions with the application of chemotherapy is the main form of treatment of patients suffering from this disease.
Is It Possible That This Patient is Asymptomatic? The Role of Multidetector CT Angiography in Detection of Ulcerated Plaques in Patients with Asymptomatic Carotid Stenosis: Case Report.
Tanasković S, Babić S, Aleksić N … +4 more , Matić P, Gajin P, Jocić D, Radak D
Srp Arh Celok Lek · 2015 · PMID 26727873 · Publisher ↗
INTRODUCTION: Although intervention in patients with symptomatic carotid disease is generally accepted as beneficial, the management of asymptomatic disease is still controversial. We wanted to introduce and discuss trea...
INTRODUCTION: Although intervention in patients with symptomatic carotid disease is generally accepted as beneficial, the management of asymptomatic disease is still controversial. We wanted to introduce and discuss treatment options in a patient with asymptomatic carotid stenosis and high embolic potential lesions of common and internal carotid artery detected by multidetector computed tomography (MDCT). CASE OUTLINE: A 78-year-old female patient was admitted to our institution for diagnostics and surgical treatment of asymptomatic high-grade carotid stenosis. Upon admission, color duplex ultrasonography of the carotid arteries revealed the left common carotid artery (CCA) stenosis of 50% and the ipsilateral internal carotid artery (ICA) stenosis of 60%, while the right CCA was narrowed by 60% and the ipsilateral ICA by 80%. Because of the left subclavian artery (LSA) occlusion, also described by ultrasonography, MDCT angiography was performed to assess arterial morphology for possible angioplasty. In addition to LSA occlusion, MDCT angiography surprisingly revealed significant left CCA (>80%) and ICA (>70%) narrowing by ulcerated plaques with high embolic potential. Surgical treatment of the left CCA and ICA was indicated and Dacron® tubular graft interposition was performed. The postoperative course was uneventful and the patient was discharged from the Institute on the third postoperative day. After the six-month follow-up the patient was doing well with well-preserved graft patency. Conclusion Although color duplex ultrasonography is reliable and safe imaging modality in carotid stenosis diagnosis, MDCT angiography plays a significant role in patients with asymptomatic carotid stenosis since plaques with high embolic potential could be detected, which, if left untreated, could have severe neurological ischemic consequences.
Bilateral Coronary Artery - Pulmonary Artery Fistula with Recurrent Ventricular Tachycardia: Case Report.
Stojišić-Milosavljević A, Bikicki M, Ivanović V … +3 more , Šobot N, Popin TM, Kovačević D
Srp Arh Celok Lek · 2015 · PMID 26727872 · Publisher ↗
INTRODUCTION: Bilateral coronary artery fistulae to pulmonary artery with ventricular tachycardia have not yet been described in the literature. CASE OUTLINE: A case of a 23-year-old male patient who was treated at our c...
INTRODUCTION: Bilateral coronary artery fistulae to pulmonary artery with ventricular tachycardia have not yet been described in the literature. CASE OUTLINE: A case of a 23-year-old male patient who was treated at our clinic for recurrent ventricular tachycardia is presented. The patient was born with six fingers on his left hand, which was surgically corrected in his early childhood. Perfusion scintigraphy demonstrated reversible ischemia at the irrigation zone of the right coronary artery. The coronary angiography revealed two coronary to pulmonary artery fistulae. The right coronary artery fistula drained through a tubular vessel formation into the pulmonary artery, but the left anterior descendent fistula drained via multiple thin tortuous vessels into the pulmonary artery. The right coronary artery fistula was ligated surgically. The control scintigraphy registered no perfusion defect subsequently, but during the procedure ventricular tachycardia occurred. An electrophysiology study followed, but ventricular tachycardia could not be provoked. Two months later ventricular tachycardia occurred again. Two subsequent electrophysiology studies showed no ventricular tachycardia.The patient was treated with an implantable cardioverter defibrillator.Ventricular tachycardia was terminated four times during the first year follow-up. CONCLUSION: The mechanism of the ventricular tachycardia was unclear.The electrophysiology study was not sufficiently reliable in the patient with recurrent ventricular tachycardia and bilateral coronary artery to pulmonary artery fistulae. The therapy of choice and the prevention of sudden death in this case was an implantable cardioverter defibrillator.
Late Presentation of Congenital Diaphragmatic Hernia - Case Report.
Radović SV
Srp Arh Celok Lek · 2015 · PMID 26727871 · Publisher ↗
INTRODUCTION: Congenital diaphragmatic hernia (CDH) is a defect of the diaphragm with the penetration of organs of the abdominal cavity into thorax. Localization and size of the defect of the diaphragm condition the time...
INTRODUCTION: Congenital diaphragmatic hernia (CDH) is a defect of the diaphragm with the penetration of organs of the abdominal cavity into thorax. Localization and size of the defect of the diaphragm condition the time and range of clinical manifestation. The most common is unilateral, without hernia sac, located on the left side, through posterolateral opening of the diaphragm and with clinical manifestation during the neonatal period. Smaller subgroup consists of patients with presentation outside the neonatal period with anatomic defect on the right side as is the case with our patient. CASE OUTLINE: Female infant aged seven months was hospitalized because of repeated episodes of shortness of breath and cough, with lack of progress in body weight. The discomforts had been present for the previous two months with an inadequate response to bronchodilator and antibiotic therapy used. After clinical, radiographic, ultrasound and computed tomography treatment, the right-sided diaphragmatic hernia was diagnosed, so surgical treatment followed. The defect of the diaphragm with hernia sac, through which the right lobe of the liver with visible line of entrapment, in the form of "hourglass", is pushed into thoracic cavity, was intraoperatively identified. The reposition of the right lobe of the liver in the abdominal cavity along with reconstruction of the diaphragm using interrupted mattress sutures was performed. CONCLUSION: The late manifestation of CDH should be suspected in cases of inexplicable acute or chronic respiratory or gastrointestinal symptoms with pathological radiography of the thorax. Accurate diagnosis and timely minimally invasive surgical intervention ensure an excellent prognosis.
[Auricular Acantholytic Squamous Cell Carcinoma with Neck Metastasis and Lethal Outcome - Case Report].
Jotić A, Ješić S, Milovanović J … +1 more , Krstić B
Srp Arh Celok Lek · 2015 · PMID 26727870 · Publisher ↗
INTRODUCTION: Acantholytic squamous cell (adenosquamous) carcinoma of the skin are relatively rare subtype of squamous cell carcinoma, usually found in elderly on sun-exposed areas of the skin, predominately head, neck a...
INTRODUCTION: Acantholytic squamous cell (adenosquamous) carcinoma of the skin are relatively rare subtype of squamous cell carcinoma, usually found in elderly on sun-exposed areas of the skin, predominately head, neck and upper extremities. Incidence of metastasis is 2-14%. CASE OUTLINE: A case of a 76-year-old male, with the signs of left-sided facial palsy and cervical mass on the same side, is presented. Five months prior to the visit, due to acantholytic squamous cell carcinoma, an excision of the ulceration of the superior third of the left auricle was performed. Patient underwent surgical treatment, after pathohistological and radiological confirmation of the infiltrative neck metastasis. Postoperatively, rapid locoregional progression of the disease was noted in the patient, with a lethal outcome. CONCLUSION: Squamous cell carcinoma (including acantholytic subtype) with lesions bigger than 4 cm in size in auricular-temporal region, signs of deep tissue invasion, and lymphovascular and perineural invasion have higher local metastatic potential. More frequent oncological check-ups with radiological examination are necessary in detecting locoregional metastasis.
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