Srpski Arhiv Za Celokupno Lekarstvo[JOURNAL]
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200 papers
A Case of Autoimmune Cholangitis Misdiagnosed for Cholangiocarcinoma: How to Avoid Unnecessary Surgical Intervention?
Ignjatović II, Matić SV, Dugalić VD … +4 more , Knežević DM, Micev MT, Marko D Bogdanović, Knežević SM
Srp Arh Celok Lek · 2015 · PMID 26259410 · Publisher ↗
INTRODUCTION: Autoimmune cholangitis or immunoglobulin G4-associated cholangitis (IAC) has been recently regarded as a new clinical and histopathological entity and is a part of a complex autoimmune disorder--IgG4-relate...
INTRODUCTION: Autoimmune cholangitis or immunoglobulin G4-associated cholangitis (IAC) has been recently regarded as a new clinical and histopathological entity and is a part of a complex autoimmune disorder--IgG4-related systemic disease (ISD). ISD is an autoimmune disease with multi-organic involvement, characterized with IgG4-positive plasmocytic infiltration of various tissues and organs with a consequent sclerosis, which responds well to steroid therapy. Most commonly affected organs are the pancreas (autoimmune pancreatitis, [AIP]) and the common bile duct (IAC). IAC and cholangiocarcinoma (CCA) share many clinical, laboratory and imaging findings. CASE OUTLINE: We present a case of a 60-year-old male with a biliary stricture of a common bile duct, which was clinically considered as a bile duct carcinoma and treated surgically. Definite histopathological findings and immunohistochemistry revealed profound chronic inflammation, showing lymphoplasmacytic IgG-positive infiltration of a resected part of a common bile duct, highly suggestive for the diagnosis of IAC. In addition, postoperative IgG4 serum levels were also increased. CONCLUSION: It is of primary clinical importance to make a difference between IAC and CCA, in order to avoid unnecessary surgical intervention. Therefore, IAC should be considered in differential diagnosis in similar cases.
[The Laparoscopic Enucleation for Branch Duct Type Intraductal Papillary Mucinous Neoplasms Located at the Body of Pancreas: A Case Report].
Stevanović D, Stojanović D, Mitrović N … +4 more , Jašarović D, Milenković S, Bokun-Vukašinović Z, Radovanović D
Srp Arh Celok Lek · 2015 · PMID 26259409 · Publisher ↗
INTRODUCTION: Intraductal papillary mucinous neoplasms (IPMN) are among the most common cystic neoplasms of the pancreas, but they represent only 1-3% of all exocrine pancreas tumors. With the development of diagnostic p...
INTRODUCTION: Intraductal papillary mucinous neoplasms (IPMN) are among the most common cystic neoplasms of the pancreas, but they represent only 1-3% of all exocrine pancreas tumors. With the development of diagnostic possibilities the number of patients with IPMN is constantly increasing and represents approximately 20% of all surgically treated pancreatic tumors.The development of laparoscopic surgery has led to advances in the treatment of cystic tumors of the pancreas with the emergence of new surgical dilemma in the choice of surgical techniques in patients with IPMN. CASE OUTLINE: A 23-year-old patient was admitted to the hospital with non-specific symptoms of upper abdomen. Performed diagnostics indicated the existence of a tumor formation at the periphery of the pancreas, in the region of the proximal corpus, 8x5 cm in diameter. The cystic formation, wall thickness 3 mm, was filled with dense contents and injected into the tissue of the pancreas, but did not lead to an extension of the pancreatic duct. After adequate preoperative preparation the patient was operated on, when a laparoscopic enucleation of cystic tumor with coagulation and cutting off communication between the peripheral pancreatic duct and pancreatic tumors was performed by using ultrasound scissors. Histopathological analysis of the specimen indicated an IPMN of the branch duct type (BD-IPMN) with a low grade dysplasia. The line of resection was without cellular atypia. Immunohistochemical analysis showed positivity on tumor mucins (MUC-5 and MUC-2), which is typical for gastric type of BD-IPMN. Six months postoperatively the patient showed no signs of recurrence of the disease. CONCLUSION: Surgical treatment is the dominant choice for the treatment for IPMN. Although minimally invasive, laparoscopic enucleation of BD-IPMN is able to achieve an adequate level of radicality without the accompanying complications and with short postoperative recovery period.
Splenic Artery Aneurysms: Two Cases of Varied Etiology, Clinical Presentation and Treatment Outcome.
Pejkić S, Tomić I, Opačić D … +4 more , Pejinović L, Grubor N, Činara I, Davidović L
Srp Arh Celok Lek · 2015 · PMID 26259408 · Publisher ↗
INTRODUCTION: Splenic artery aneurysms are potentially lethal lesions. We report two illustrative cases and discuss etiology, diagnosis and treatment of these aneurysms. OUTLINE OF CASES: Both patients, age 31 and 80 yea...
INTRODUCTION: Splenic artery aneurysms are potentially lethal lesions. We report two illustrative cases and discuss etiology, diagnosis and treatment of these aneurysms. OUTLINE OF CASES: Both patients, age 31 and 80 years, were biparous women.The younger woman, otherwise healthy, was referred from a local hospital 3 weeks after she underwent a left subcostal laparotomy and exploration for symptomatic abdominal mass diagnosed by CT. Angiography established the diagnosis of a large, non-ruptured splenic artery aneurysm. Elective aneurysmectomy with splenectomy was performed using the approach through the upper median laparotomy and bursa omentalis. Postoperative course was uneventful. Histopathology demonstrated cystic medial necrosis with chronic dissection. The other patient, elderly woman, presented urgently with acute abdominal pain and syncope and was diagnosed by computed tomography with a huge, ruptured splenic artery aneurysm. She underwent immediate aneurysmectomy with splenectomy using the same, above-mentioned approach. External pancreatic fistula and pancreatic pseudocyst complicated the postoperative course, requiring open pseudocyst drainage and cystojejunostomy. After a protracted hospitalization patient eventually recovered. The pathological diagnosis was atherosclerotic aneurysm. CONCLUSION: Splenic artery aneurysms are infrequent lesions, with varied etiology and clinical presentation. Timely diagnosis and adequate treatment prevent life-threatening rupture and lessen the risk of operative morbidity and mortality.
Hand-held Echo is Not So Handy in Everyone's Hands: Misdiagnosing Congenital Septal Defects in Patients with Heart Murmurs.
Putniković B, Stanković I, Miličević P … +2 more , Marjanović M, Nešković AN
Srp Arh Celok Lek · 2015 · PMID 26259407 · Publisher ↗
INTRODUCTION: Echocardiography is a highly operator-dependant technique which requires adequate training and skills that are frequently not present, considering the widespread use of cardiovascular ultrasound. This could...
INTRODUCTION: Echocardiography is a highly operator-dependant technique which requires adequate training and skills that are frequently not present, considering the widespread use of cardiovascular ultrasound. This could particularly be true for hand-held echo devices which made echocardiography more accessible but are frequently used by non-cardiologists and non-experts. OUTLINE OF CASES: We present a 45-year-old female and a 37-year-old male with heart murmurs due to atrial and ventricular septal defect, respectively. Congenital septal defects were undiagnosed in both patients during several outpatient examinations due to challenging image acquisition. C reful re-evaluation revealed that, depending on the scanning technique, it was possible to detect or overlook the real cause of the murmur using either hand-held or high-end echo device. CONCLUSION: Our report underlines the need of adequate knowledge and training of medical professionals performing pocket-size hand-held echocardiography, since potential misdiagnoses may not be related to limited imaging capabilities of pocket-sized echo devices only, but also to inability of insufficiently trained users to obtain good quality images and interpret them adequately.
Congenital Cervical Bronchogenic Cyst: A Case Report.
Kiralj A, Vučković N, Mijatov I
Srp Arh Celok Lek · 2015 · PMID 26259406 · Publisher ↗
INTRODUCTION: Bronchogenic cysts are rare congenital anomalies of the embryonic foregut. They are caused by abnormal budding of diverticulum of the embryonic foregut between the 26th and 40th day of gestation. Bronchogen...
INTRODUCTION: Bronchogenic cysts are rare congenital anomalies of the embryonic foregut. They are caused by abnormal budding of diverticulum of the embryonic foregut between the 26th and 40th day of gestation. Bronchogenic cysts can appear in the mediastinum and pulmonary parenchyma, or at ectopic sites (neck, subcutaneous tissue or abdomen). So far, 70 cases of cervical localization of bronchogenic cysts have been reported. Majority of bronchogenic cysts have been diagnosed in the pediatric population. Bronchogenic cysts of the cervical area are generally asymptomatic and symptoms may occur if cysts become large or in case of infection of the cyst. The diagnosis is made based on clinical findings, radiological examination, but histopathologic findings are essential for establishing the final diagnosis. Treatment of cervical bronchogenic cyst involves surgical excision. CASE OUTLINE: Authors present a case of a 6-year-old female patient sent by a pediatrician to a maxillofacial surgeon due to asymptomatic lump on the left side of the neck. The patient had frequent respiratory infections and respiratory obstructions. Magnetic resonance imaging (MRI) of the neck was performed and a well-circumscribed cystic formation on the left side of the neck was observed, with paratracheal location. The complete excision of the cyst was made transcervically. Histopathological findings pointed to bronchogenic cyst. CONCLUSION: Cervical bronchogenic cysts are rare congenital malformations. Considering the location, clinical findings and the radiological features, these cysts resemble other cervical lesions. Surgical treatment is important because it is both therapeutic and diagnostic. Reliable diagnosis of bronchogenic cysts is based on histopathological examination.
Colorectal Adenocarcinoma Metastasizing to the Oral Mucosa of the Upper Jaw.
Baranović M, Vidaković B, Sauerborn D … +3 more , Perić B, Uljanić I, Mahovne I
Srp Arh Celok Lek · 2015 · PMID 26259405 · Publisher ↗
INTRODUCTION: Metastases to the oral cavity are uncommon, accounting for only 1% of all oral malignant tumors. When they occur they mostly originate from primary tumors of the lungs, kidney, breast and prostate. Oral met...
INTRODUCTION: Metastases to the oral cavity are uncommon, accounting for only 1% of all oral malignant tumors. When they occur they mostly originate from primary tumors of the lungs, kidney, breast and prostate. Oral metastases from the primary colorectal carcinoma are much more infrequent. CASE OUTLINE: We present an unusual case of a 78-year-old man with a soft tissue oral metastasis originating from the primary colorectal carcinoma.The patient was referred to the Department of Otorhinolaryngology, Head and Neck Surgery with an intraoral mass on the right side of the maxilla. The diagnosis was confirmed by histopathologic examination and immunohistochemical analysis. CONCLUSION: Oral metastases occur rarely and often can mimic much more common benign lesions, therefore they should be considered as a possibility in a differential diagnosis.
Primary Merkel Cell Carcinoma of the Eyelid-- Clinical, Histopathological, Immunohistochemical and Electron Microscopical Features: A Case Report.
Radovanovit AB, Latkovie Z, Borovie ML … +1 more , Rašić DM
Srp Arh Celok Lek · 2015 · PMID 26259404 · Publisher ↗
INTRODUCTION: Merkel cell carcinoma (MCC) is a rare eyelid neoplasm which can cause significant diag- nostic and especially therapeutic challenges. CASE OUTLINE: This is the first documented report of the case of primary...
INTRODUCTION: Merkel cell carcinoma (MCC) is a rare eyelid neoplasm which can cause significant diag- nostic and especially therapeutic challenges. CASE OUTLINE: This is the first documented report of the case of primary MCC of the eyelid in Serbia. CONCLUSION: The optimal therapy must be individualized in any given patient and, early diagnosis and meticulous follow-up are mandatory to achieve a long-term cure.
Alcohol Consumption among Students--A Cross-Sectional Study at Three Largest Universities in Serbia.
Višnjić A, Jović S, Grbeša G
Srp Arh Celok Lek · 2015 · PMID 26259403 · Publisher ↗
INTRODUCTION: The prevalence of unhealthy alcohol use among university students is increasing in many countries. OBJECTIVE: The aim of the study was to investigate alcohol consumption and alcohol-related knowledge, attit...
INTRODUCTION: The prevalence of unhealthy alcohol use among university students is increasing in many countries. OBJECTIVE: The aim of the study was to investigate alcohol consumption and alcohol-related knowledge, attitudes and risky behaviors among Serbian university students. METHODS: The cross-sectional study was carried out at the three state universities from January to June in the academic year 2009/2010 and included 2,285 students of both genders. The students filled out a questionnaire consisting of 70 questions with respect to demographic and socioeconomic characteristics, their lifestyle habits, styles and attitudes, health assessment, as well as exposure to different risk factors. RESULTS: It was found that 77.7% of students drank alcohol occasionally, 4.6% of them consumed it on a daily basis. Friedman's test (p < 0.001) showed that students prefer drinking beer to all other alcoholic beverages. Students in Belgrade and students of Technical faculties are undisputed champions when it comes to how often they drink six or more drinks on a single occasion. Older students in Serbia drink more and get drunk more frequently. CONCLUSION: A high percentage of Serbian students consume alcohol, and even though they have their first drink at an early age, they generally drink less than students in many other countries.
The Presence of Some Humoral Immunologic Indicators and Clinical Manifestations in Cryoglobulin Positive Heroin Addicts without Evidence of Hepatitis Virus Infection.
Simonovska N, Chibishev A, Bozinovskal C … +3 more , Grchevska L, Dimitrovskil K, Neceva V
Srp Arh Celok Lek · 2015 · PMID 26259402 · Publisher ↗
INTRODUCTION: Cryoglobulins are single or mixed immunoglobulins that are subject to reversible precipitation at low temperatures. OBJECTIVE: The aims of this paper were: 1. Comparison of cryoglobulin positive (CP), cryog...
INTRODUCTION: Cryoglobulins are single or mixed immunoglobulins that are subject to reversible precipitation at low temperatures. OBJECTIVE: The aims of this paper were: 1. Comparison of cryoglobulin positive (CP), cryoglobulin negative (CN) heroin addicts and the control group (CG) in terms of serum immunoglobulins IgG, IgA and IgM and complement components C3 and C4; 2. Comparison of CP and CN heroin addicts in terms of rheumatoid factor (RF) and circulating immune complexes (CIC); 3. Assessment of clinical manifestations in CP heroin addicts. METHODS: This is a comparative study of cases (outpatients) treated at the University Clinic of Toxicology in Skopje over 3.5 years, from January 2009 to June 2012. In this study 140 heroin addicts without HbsAg were examined, seronegative for HCV and HIV infections.They were divided into 2 groups: 70 CP and 70 CN heroin addicts. A previously designed self-administered questionnaire was used as a data source on participants. All heroin addicts underwent the following analyses: urea and creatinine in serum; creatinine in urine; proteinuria; 24-hour proteinuria; IgM, IgG, IgA, C3, C4; RF; CIC; creatinine clearance; ECG; toxicological analyses for opioids in a urine sample; cryoglobulins. In addition to these 2 groups, IgG, IgA, IgM, C3 and C4 were also examined in 70 healthy subjects (CG). RESULTS: The study showed that there was no statistically significant difference between CP, CN heroin addicts and CG regarding the concentration of IgA, IgG, IgM, C3 and C4, and between CP and CN regarding the concentration of CIC. There was significant difference between CP and CN regarding the concentration of RF. The following conditions were significantly more frequently manifested in CP than in CN heroin addicts: arthralgia, Raynaud's phenomenon, respiratory difficulties, neurological disorders, manifested skin changes, hematuria, 24-hour proteinuria levels, and decreased renal clearance. CONCLUSION: There were no differences in concentrations of IgG, IgA, IgM, C3, C4 and CIC, while there was a difference in concentration of RF between CP and CN heroin addicts. Clinical manifestations (arthralgias, Raynaud's phenomenon, respiratory, neurologic, renal disorders and skin changes) were more common in CP heroin addicts.
Nonmelanoma Skin Cancer in the Population of the City of Belgrade in the Period 1999-2011.
Videnović G, Miljuš D, Ilić D … +2 more , Krasić D, Živković S
Srp Arh Celok Lek · 2015 · PMID 26259401 · Publisher ↗
INTRODUCTION: Nonmelanoma skin cancers in the literature are mainly related to basal cell and squamous cell skin carcinoma. OBJECTIVE: The aim of the study was to determine the trend in the incidence of histological type...
INTRODUCTION: Nonmelanoma skin cancers in the literature are mainly related to basal cell and squamous cell skin carcinoma. OBJECTIVE: The aim of the study was to determine the trend in the incidence of histological types of nonmelanoma skin cancers in the population of the city of Belgrade from 1999 to 2011. METHODS: From the Serbian National Cancer Registry we extracted all recorded cases of skin cancer in Belgrade from January 1st 1999 to December 31st 2011. Incidence rates were standardized by the method of direct standardization with the world population as the standard population. Trends and annual percentage change (APC) of incidence rate were calculated by performing joinpoint regression analyses. RESULTS: Incidence rate of nonmelanoma skin cancer showed significantly increasing trend between 1999 and 2006 with APC of 8.6% (95% Cl: 5.6-11.7), basal cell carcinoma increased with APC of 8.4% (95% Cl: 5.2-11.6) and squamous cell skin carcinoma with APC of 9.33% (95% Cl: 5.7-13.1). The incidence increased with age for both men and women, especially after the age of 60. CONCLUSION: Our results showed a continuously increasing incidence trend of both basal cell and squamous cell skin carcinomas in the population of the city of Belgrade between 1999 and 2011. Adequate primary and secondary prevention would certainly be successful in reducing this type of cancer in the future.
Adverse Effects of Pharmacological Therapy of Benign Prostatic Hyperplasia on Sexual Function in Men.
Stojanović N, Ignjatović I, Djenić N … +1 more , Bogdanović D
Srp Arh Celok Lek · 2015 · PMID 26259400 · Publisher ↗
INTRODUCTION: The development of effective medications makes pharmacological therapy of BPH the dominant mode of treatment today. It improves urinary symptoms and prevents disease progression while producing side effects...
INTRODUCTION: The development of effective medications makes pharmacological therapy of BPH the dominant mode of treatment today. It improves urinary symptoms and prevents disease progression while producing side effects on male sexual function. OBJECTIVE: The aim of the study is to present the effects of BPH pharmacological treatment on the occurrence of sexually adverse effects in men: changes in sexual desire, erectile, ejaculatory and the orgasmic function. METHODS: A prospective study involving 156 BPH patients.The average age was 61.16 ± 2.97. Four groups of 39 patients each were formed.The 4 groups were administered tamsulosin (alpha-blocker), finasteride (5-alpha reductase inhibitor), combination therapy (tamsulosin and finasteride) respectively, while the control group received no treatment. PSS-QoL, IIEF and MSHQ-EjD questionnaires were used to evaluate the symptoms of voiding and sexual function. Follow-up examinations were performed 3 and 6 months into treatment. RESULTS: Voiding symptoms improved in all groups receiving therapy. The side effects on the sexual function in all these groups include significant disorders of ejaculation and the orgasmic function. Ejaculation disorders: tamsulosin (-4.38 ± 2.55; p < 0.001), combined therapy (-3.89± 2.84) and finasteride (-1.49 ± 2.52). Orgasmic function disorders: tamsulosin (-1.03 ± 1.94), combined therapy (-0.76 ± 2.07) and finasteride (-0.54 ± 1.68). Complete absence of ejaculation was experienced by 23% of patients on combined therapy, 15% on tamsulosin and 5% on finasteride. CONCLUSION: Pharmacological therapy of BPH improved voiding symptoms producing different effects on male sexual function. The main adverse effect on sexual function in men is the deterioration in ejaculation or the absence thereof. Clinical consideration of BPH should include the elements of male sexual function, patients' age, the characteristics and effects of each group of drugs.
Splenomegaly in Sarcoidosis: Frequency, Treatment, Prognosis and Long-term Follow-up.
Pavlović-Popović Z, Zarić B, Kosjerina Z … +1 more , Petrović D
Srp Arh Celok Lek · 2015 · PMID 26259399 · Publisher ↗
INTRODUCTION: The splenic involvement is common in sarcoidosis, but its real frequency is still obscure depending doubtless on the method of splenomegaly detection. Splenomegaly may be accompanied with pain or anemia, le...
INTRODUCTION: The splenic involvement is common in sarcoidosis, but its real frequency is still obscure depending doubtless on the method of splenomegaly detection. Splenomegaly may be accompanied with pain or anemia, leucopenia and thrombocytopenia. OBJECTIVE: The aim of this study was to investigate the frequency of splenomegaly related to clinical characteristics of sarcoidosis and to solve the dilemma--whether to introduce medicaments, and when to perform splenectomy. METHODS: The method of the study is a retrospective and prospective analysis of the patients'material. RESULTS: The study included 540 patients with sarcoidosis in a 20-year period. Of them, 26% had splenomegaly detected by computerized tomography screening. Splenomegaly was more frequently registered in the patients with a longer history of sarcoidosis (38%), as compared to those with a shorter history of the disease (23%) (p < 0.05). Splenomegaly was more frequently registered in the patients with other extrapulmonary lesions detected (33%) than in those who had no extrapulmonary manifestations of sarcoidosis (17%) (p < 0.01). Indications, possible benefits and complications of splenectomy were analysed in 11 sarcoidosis patients undergoing this intervention for various reasons, of which the follow-up period ranged from one to 20 years. CONCLUSION: Splenomegaly was more frequent in chronic cases or in the patients with established sarcoid lesions of other extrapulmonary organs.The primary treatment of uncomplicated symptomatic splenic sarcoidosis includes medicamentous therapy. Occasionally, splenectomy is required. Prognostically, splenomegaly indicates an unfavorable course of the disease.
Legionella pneumophila in Bronchoalveolar Lavage Samples of Patients Suffering from Severe Respiratory Infections: Role of Age, Sex and History of Smoking in the Prevalence of Bacterium.
Faradonbeh FA, Khedri F, Doosti A
Srp Arh Celok Lek · 2015 · PMID 26259398 · Publisher ↗
INTRODUCTION: Legionellapneumophila is the most commonly detected cause of legionellosis, which is an acute respiratory tract infection with high morbidity and mortality rates. OBJECTIVE: The aim of this study was to inv...
INTRODUCTION: Legionellapneumophila is the most commonly detected cause of legionellosis, which is an acute respiratory tract infection with high morbidity and mortality rates. OBJECTIVE: The aim of this study was to investigate the prevalence rate of L. pneumophila in bronchoalveolar lavages and study the role of sex, age and history of smoking as risk factors or susceptibility to the bacterium. METHODS: One hundred bronchoalveolar lavage samples were collected from the Iranian health centers and immediately transferred to laboratory. The samples were cultured and those that were L. pneumophila positive were subjected to PCR method with respect to the 16S rRNA gene. RESULTS: Twelve out of 100 samples were positive for L. pneumophila (12%). Patients older than 70 years had the highest incidence of L. pneumophila (17.77%). Prevalence of L. pneumophila in male and female patients was 14.81% and 8.69%, respectively. Total incidence of L pneumophila in patients with and without history of smoking was 18% and 6%, respectively. There were significant differences in the incidence of bacterium between groups of our study. CONCLUSION: Sex, age and history of smoking are predominant risk factors for the occurrence of L. pneumophila. However, more studies should be undertaken to confirm these results.
Pharyngeal Airway Changes after Bimaxillary Orthognathic Surgery--Preliminary Results.
Stefanović NLj, Glišić B, Nikolić PV … +2 more , Juloski J, Palomo JM
Srp Arh Celok Lek · 2015 · PMID 26259397 · Publisher ↗
INTRODUCTION: Dentofacial deformity, a deviation from normal facial proportions and dental relationships, is corrected by jaw repositioning in all three spatial planes, which changes the position and tension of the surro...
INTRODUCTION: Dentofacial deformity, a deviation from normal facial proportions and dental relationships, is corrected by jaw repositioning in all three spatial planes, which changes the position and tension of the surrounding tissues, bones and muscles. These changes may also affect the dimensions of the pharyngeal airways (PA). OBJECTIVE: The aim of this study was to evaluate and compare three-dimensional PA changes in patients treated by a combination mandibular set-back/maxillary advancement versus patients that had bimaxillary advancement with genioplasty. METHODS: The sample consisted of 7 patients treated by combined mandibular set-back/maxillary advancement and 7 patients treated with bimaxillary advancement surgery. Nasopharyngeal (NP) volume, oropharyngeal (OP) volume and the area of maximum constriction (AMC) in the OP were measured on CBCT scans (2 mA/120 kV/12" FOV) taken before (T1) and 3 months after surgery (T2). Paired samples t-test was used for analyzing statistical significance of changes (p ≤ 0.05). RESULTS: OP volume and AMC increase after bimaxillary advancement was statistically significant, while for the mandibular set-back group the increase was non-significant. NP volume was not reduced in any of the two groups. No significant differences in PA dimensions were found between groups at neither T1 nor T2 time points. CONCLUSION: Results suggest that the combination of mandibular set-back/maxillary advancement did not reduce airway dimensions, while bimaxillary advancement surgery led to a statistically significant increase in the OP dimensions.
The Influence of Liners on the Pulp Inflammation.
Davidović L, Ćuk M, Sandić MŽ … +2 more , Grga D, Živković S
Srp Arh Celok Lek · 2015 · PMID 26259396 · Publisher ↗
INTRODUCTION: The study included application of liners and dental composites in to cavities of six experimental animals-rabbits (Oryctolagus cuniculus). OBJECTIVE The aim of the study was to investigate rabbit dental pul...
INTRODUCTION: The study included application of liners and dental composites in to cavities of six experimental animals-rabbits (Oryctolagus cuniculus). OBJECTIVE The aim of the study was to investigate rabbit dental pulp response to different liners. Methods Cavity preparation for class V were made on the maxillary central incisors and one lower incisor, while the second lower incisor served as a control tooth. These teeth were restored with the use of one of the following liners--Calcimol LC, ANA Liner and Fuji II LC Improved, and Ceram-X mono dental composite. After an observation period of five days animals were sacrificed and prepared for histological analysis.The existence and degree of the pulp inflammation was determined by using a light microscope. RESULTS: Results showed that the used liners do not cause distortion of the structure and continuity of the odontoblastic layer. Inflammation was not registered in the control group, while in each group of tested materials one tooth with mild signs of hyperemia was registered. Results showed that all three tested liners demonstrated favorable effects on the pulp of the tooth and did not lead to inflammatory reactions. CONCLUSION: Histological analysis of the dental pulp of experimental animals suggests that the liners used in this study do not compromise the integrity of the odontoblastic layer, if it is applied over a thin layer of dentin. In each group of tested materials one tooth with mild signs of hyperemia and vasodilation was registered.
Versatility of Radial Forearm Free Flap for Intraoral Reconstruction.
Jeremić JV, Nikolić ŽS
Srp Arh Celok Lek · 2015 · PMID 26259395 · Publisher ↗
INTRODUCTION: The radial forearm free flap has an important role in reconstruction of the oncologic defects in the region of head and neck. OBJECTIVE: The aim was to present and evaluate clinical experience and results i...
INTRODUCTION: The radial forearm free flap has an important role in reconstruction of the oncologic defects in the region of head and neck. OBJECTIVE: The aim was to present and evaluate clinical experience and results in the radial forearm free transfer for intraoral reconstructions after resections due to malignancies. METHODS: This article illustrates the versatility and reliability of forearm single donor site in 21 patients with a variety of intraoral oncologic defects who underwent immediate (19 patients, 90.5%) or delayed (2 patients, 9.5%) reconstruction using free flaps from the radial forearm. Fascio-cutaneous flaps were used in patients with floor of the mouth (6 cases), buccal mucosa (5 cases), lip (1 case) and a retromolar triangle (2 cases) defects, or after hemiglossectomy (7 cases). In addition, the palmaris longus tendon was included with the flap in 2 patients that required oral sphincter reconstruction. RESULTS: An overall success rate was 90.5%. Flap failures were detected in two (9.5%) patients, in one patient due to late ischemic necrosis, which appeared one week after the surgery, and in another patient due to venous congestion, which could not be salvaged after immediate re-exploration. Two patients required re-exploration due to vein thrombosis.The donor site healed uneventfully in all patients, except one, who had partial loss of skin graft. CONCLUSION: The radial forearm free flap is, due to multiple advantages, an acceptable method for reconstructions after resection of intraoral malignancies.
Professor Yukio Fukuyama (1928-2014).
Vranješević D
Srp Arh Celok Lek · 2015 · PMID 26012140 · Publisher ↗
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Learning medical English: a prerequisite for successful academic and professional education.
Milosavljević N, Vuletić A, Jovković L
Srp Arh Celok Lek · 2015 · PMID 26012139 · Publisher ↗
The aim of this paper is to present specificities of the English language teaching necessary for successful education and professional training of medical students. In contemporary globalized world the English language h...
The aim of this paper is to present specificities of the English language teaching necessary for successful education and professional training of medical students. In contemporary globalized world the English language has become the basic language of communication in all scientific fields including the field of medical science. It is well established that Medical English teaching should primarily focus on stable linguistic competence in English that is created by means of content and context based curriculum, thus preparing students for active use of English upon graduation. In order to achieve this it is very important that English language teaching be based on specific real situations in which the language is to be used. In addition, students should be encouraged to adapt practical skills applicable in specific future professional setting. Medical English teaching represents constant challenge for teachers because they need to be flexible, open to new approaches and methods, make decisions and adapt themselves to constant changes. In addition, long-term learning is at the core of higher education, and being equal partners, both students and teachers should be aware that education is a two-way process.
[Contribution of novel anticoagulants fondaparinux and dabigatran to venous thromboembolism prevention].
Antonijević N, Kanjuh V, Živković I … +3 more , Jovanović L, Vukčević M, Apostolović M
Srp Arh Celok Lek · 2015 · PMID 26012138 · Publisher ↗
The data that episodes and sequels of venous thromboembolism (VTE) are recorded in a significant percentage of patients receiving standard anticoagulants as VTE prophylaxis (unfractionated, low-molecular-weight heparin a...
The data that episodes and sequels of venous thromboembolism (VTE) are recorded in a significant percentage of patients receiving standard anticoagulants as VTE prophylaxis (unfractionated, low-molecular-weight heparin and vitamin K inhibitors) as well as the fact that these drugs have significant limitations and that they may cause serious side-effects in some patients indicate the need for the introduction of new anticoagulant drugs. Fondaparinux, a selective inhibitor of Factor Xa, administered following major orthopedic surgeries having a high risk for the development of VTE, is more efficient than enoxaparin sodium used in European and North-American approved doses. The increased incidence of major bleeding (excluding fatal) due to fondaparinux could be perhaps lowered by dosage reduction in patients with a mildly decreased creatinine clearance. Dabigatran, a peroral direct thrombin inhibitor, administered for VIE prophylaxis in elective hip and knee surgery, showed in to date studies the efficacv comparable (if dabiqatran is given in both dosage regimes of 150 mg and 220 mg daily) or superior (if dabigatran is given at a dose of 220 mg daily) to enoxaparin administered in European-approved doses, while North American-approved doses of enoxaparin were superior than dabigatran in VTE reduction. No significant differences in bleeding rates were determined in any of the study groups. We consider that the introduction of new anticoagulants, including fondaparinux and dabigatran, will contribute to the establishment of a better safety profile and efficacy, and will also enable adequate therapy individualization for each patient depending on his/hers clinical characteristics. The introduction of novel peroral anticoagulants will, inter alia, significantly contribute to improvement in the quality of life, release the patient from numerous limitations in nutrition, interreaction, frequent laboratory monitoring, and also significantly improve therapeutic predictability.
[High rate of native arteriovenous fistulas: how to reach this goal?].
Jemcov T, Milinković M, Končar I … +10 more , Kuzmanović I, Jakovljević N, Dragaš M, Ilić N, Diorić P, Dimić A, Banzić I, Kravljača M, Nešić V, Davidović L
Srp Arh Celok Lek · 2015 · PMID 26012137 · Publisher ↗
The types of vascular accesses for hemodialysis (HD) include the native arteriovenous fistula (AVF), arteriovenous graft (AVG) and central venous catheter (CVC). Adequately matured native AVF is the best choice for HD pa...
The types of vascular accesses for hemodialysis (HD) include the native arteriovenous fistula (AVF), arteriovenous graft (AVG) and central venous catheter (CVC). Adequately matured native AVF is the best choice for HD patients and a high percentage of its presence is the goal of every nephrologist and vascular surgeon. This paper analyses the number and type of vascular accesses for HD performed over a 10-year period at the Clinical Center of Serbia, and presents the factors of importance for the creation of such a high number of successful native AVF (over 80%). Such a result is, inter alia, the consequence of the appointment of the Vascular Access Coordinator, whose task was to improve the quality of care of blood vessels in the predialysis period as well as of functional vascular accesses, and to promote the cooperation among different specialists within the field. Vascular access is the "lifeline"for HD patients. Thus, its successful planning, creation and monitoring of vascular access is a continuous process that requires the collaboration and cooperation of the patient, nephrologist, vascular surgeon, radiologist and medical personnel.
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