Srpski Arhiv Za Celokupno Lekarstvo[JOURNAL]
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200 papers
Terson's Syndrome - A Report of Two Cases.
Karadžić J, Kovačević I, Stefanović I … +1 more , Risimić D
Srp Arh Celok Lek · 2015 · PMID 26727869 · Publisher ↗
INTRODUCTION: Vitreous or retinal hemorrhage occurring in association with subarachnoid hemorrhage is known as Terson's syndrome. In Terson's syndrome, intracranial hemorrhages are followed by intraocular hemorrhage, cla...
INTRODUCTION: Vitreous or retinal hemorrhage occurring in association with subarachnoid hemorrhage is known as Terson's syndrome. In Terson's syndrome, intracranial hemorrhages are followed by intraocular hemorrhage, classically in the subhyaloid space, but may also include subretinal, retinal, preretinal, and vitreal collections. Vitreous hemorrhage recovery is usually spontaneous in six to 12 months, otherwise vitrectomy is considered. OUTLINE OF CASES: We report of two cases of Terson's syndrome. The.first was in a hypertensive middle-aged female, following anterior communicating artery aneurismal subarachnoid hemorrhage, after post-neurosurgical interventions.The second case report was of a young male who suffered from the bilateral vitreous hemorrhage after a severe traumatic brain injury. CONCLUSION: Terson's syndrome should be considered in patients who had previous cerebral hemorrhage and are referred to eye specialist because of loss of vision. However, this phenomenon has only rarely been described in association with subdural and epidural hematomas or traumatic subarachnoid hemorrhage.
Suicides among Serbian War Veterans - An Autopsy Study.
Mihailović Z, Savić S, Damjanjuk I … +2 more , Jovanović A, Vuković S
Srp Arh Celok Lek · 2015 · PMID 26727868 · Publisher ↗
INTRODUCTION: The risk of suicide among war veterans is a controversial issue, where findings so far have been contradictory. OBJECTIVE: This study focusses on suicide in Serbian veterans from the wars in former Yugoslav...
INTRODUCTION: The risk of suicide among war veterans is a controversial issue, where findings so far have been contradictory. OBJECTIVE: This study focusses on suicide in Serbian veterans from the wars in former Yugoslavia in the 1990s in order to create appropriate preventive measures and reduce the number of these fatal cases. METHODS: The autopsy protocols of all 44 suicides committed by war veterans in the Belgrade District population over a period between 1992 and 2000 were investigated. Data were obtained from autopsy records, results of toxicological investigations and psychological autopsy protocols. RESULTS: Symptoms of posttraumatic stress disorder were present in 27.3%, major depression in 9.1% and schizophrenia in 6.8% of veterans. The majority of suicides (84.1%) were committed by recruits in the Yugoslav National Army, spending between three and eight months in the zone of war operations. Six committed suicide during the first 30 days after their war activities, while the majority of suicides occurred between five and six years after combat. The most frequent manner of suicide was the use of handguns (56.8%) and bombs (18.2%). CONCLUSION: The results of this research may give useful information about the individuals with the highest suicidal risk in order to alleviate the consequences of war psychotraumas in veterans and prevent their growth into a permanent handicap or suicide.
Predictors of Depression Problems of Adults Who Live in the Security Endangered Territory.
Mirković M, Djurić S, Trajković G … +2 more , Milošević J, Sojević Timotijević Z
Srp Arh Celok Lek · 2015 · PMID 26727867 · Publisher ↗
INTRODUCTION: By the year 2020, if current trends for demographic and epidemiological transition continue, the burden of depression will have increased to 5.7% of the total burden of disease, thus becoming the second lea...
INTRODUCTION: By the year 2020, if current trends for demographic and epidemiological transition continue, the burden of depression will have increased to 5.7% of the total burden of disease, thus becoming the second leading cause of disability-adjusted life year (DALY) lost. Early detection of people at risk of developing any mental disorder is extremely important in the prevention of all mental disorders. OBJECTIVE: The objective of the study was to determine depression predictors among adult residents in four Kosovo and Metohia municipalities predominantly inhabited by Serbian population. METHODS: This cross-sectional study included the representative sample of adults in Leposavić, North Kosovska Mitrovica, Gnjilane and Priština and was performed in October/November of 2009. The sample was selected from the list of citizens older than 18, received in the above mentioned municipalities. The Goldberg General Health Questionnaire (GHQ-28) was used as a research instrument. The methods of statistical analysis included descriptive statistics, simple and multiple logistic regression analysis, and analysis of variance, with a significance level of 0.05. RESULTS: Problems with depression have been significantly associated with female sex (OR=2.24), older age (OR=1.01), lower levels of education (OR=0.50), unemployment (OR=1.09), poor financial situation (OR=0.45), abuse (OR=0.08) and assessment of the future political and security situation as a highly risky one (OR=3.01). CONCLUSION: To determine risk groups being in greater risk to suffer from depression is important for planning, enhancing, promoting and implementing the prevention strategies for this disease.
Levels of Vascular Endothelial Growth Factor during First Six Months of Peritoneal Dialysis.
Stojimirović B, Jovanović N, Trbojević-Stanković J … +3 more , Krstić S, Nešić D, Žunić-Božinovski S
Srp Arh Celok Lek · 2015 · PMID 26727866 · Publisher ↗
INTRODUCTION: Chronic peritoneal dialysis (PD) up-regulates vascular endothelial growth factor (VEGF) synthesis and VEGF is found in drained dialysate (dd). OBJECTIVE: Aims of this prospective study were to evaluate seru...
INTRODUCTION: Chronic peritoneal dialysis (PD) up-regulates vascular endothelial growth factor (VEGF) synthesis and VEGF is found in drained dialysate (dd). OBJECTIVE: Aims of this prospective study were to evaluate serum (s) and ddVEGF concentration during the first six months of PD, relationships between these concentrations and demographic and biochemical parameters, presence of diabetes, peritonitis, and the use of medications. METHODS: The study included 20 patients, with the mean age of 62.9±12.69, 11 of whom were affected by diabetes mellitus. Fasting venous blood samples were taken at the beginning and after six months of PD, in tri-potassium ethylenediaminetetraacetic acid (K3EDTA) vacutainer. RESULTS: After six months of PD, sVEGF concentrations increased significantly, without significant change in ddVEGF. Concentrations of sVEGF at the beginning of chronic PD treatment directly significantly correlated with serum fibrinogen, and after six months with fibrinogen and glycemia. In patients receiving erythropoiesis-stimulating agent (ESA), levels of sVEGF and ddVEGF were lower at baseline, while after six months of PD ddVEGF increased. in patients not receiving ESA, sVEGF increased more prominently, while ddVEGF decreased.The changes were not statistically significant. Patients receiving angiotensin-converting-enzyme inhibitor (ACEi) had sVEGF and ddVEGF levels insignificantly lower than those not using ACEi, however sVEGF significantly increased during six months of PD. After six months of PD, ddVEGF was significantly higher compared to those not using ACEi. Treatment with statins did not significantly influence levels of sVEGF and ddVEGF during the follow-up. Concentrations of sVEGF were continually lower than those of ddVEGF and increased more, while concentrations of ddVEGF were higher in patients using statins. CONCLUSION: Serum and drained dialysate concentrations of VEGF in PD patients were connected with poorer metabolic profile, while the role of inflammation and treatment agents should be studied further.
Neonatal Abstinence Syndrome - Diagnostic Dilemmas in the Maternity Ward.
Lazić Mitrović T, Miković Ž, Mandić V … +4 more , Avramović LH, Ćećez D, Stanimirović A, Janković B
Srp Arh Celok Lek · 2015 · PMID 26727865 · Publisher ↗
INTRODUCTION: Neonatal abstinence syndrome (NAS) refers to a newborn neurological, gastrointestinal and/or respiratory disorder if a newborn was exposed to psychoactive substances in the intrauterine period. NAS is diffi...
INTRODUCTION: Neonatal abstinence syndrome (NAS) refers to a newborn neurological, gastrointestinal and/or respiratory disorder if a newborn was exposed to psychoactive substances in the intrauterine period. NAS is difficult to diagnose due to unreliability of the data on addictive substances use during pregnancy, limited possibilities of the prenatal exposure diagnosis and postnatal substance detection, which all lead to diagnostic dilemmas. OBJECTIVE: The aim of this study was to indicate the problems in patients with early NAS diagnosis in the maternity ward and the importance of clinical presentation used as a guide toward the diagnosis. METHODS: This retrospective study included five term eutrophic newborns with high Apgar score, good adaptation in the first day and with clinical presentation of NAS during the second day of life. The clinical presentation was dominated by irritability, increased wakefulness, increased muscle tone, shrilly crying, tremors, problems with accepting food, tachypnea, subfebrility and hyperhidrosis. Finnegan scale was introduced in order to diagnose NAS and apply the therapy. Single-medication therapy of phenobarbitone was applied in four cases and a combination of phenobarbitone and morphine in one case. For toxicological analysis newborns'urine samples were used. RESULTS: Conditions such as perinatal asphyxia, infection, hunger, polycythemia, hypoglycemia or hypocalcemia were excluded. Finnegan score implied that pharmacological treatment had to be administered. The discrepancy between the NAS anamnesis and toxicological analysis existed. Response to the treatment was positive in all cases. CONCLUSION: NAS is a multisystemic disorder and should be suspected when it is noticed that children exhibit characteristic signs. However, other pathological conditions have to be excluded. Quantification according to the adopted scales for NAS leads toward appropriate treatment and recovery of the newborns.
[Cardiorespiratory Disorders of Infants of Diabetic Mothers].
Hrabovski I, Milašinović L, Bogavac M … +2 more , Grujić Z, Grujić I
Srp Arh Celok Lek · 2015 · PMID 26727864 · Publisher ↗
INTRODUCTION: One of the characteristics of modern era is the explosion of diabetes in the world. Today more than 400,000,000 people suffer from diabetes in the entire world. During the last decade the number of women wi...
INTRODUCTION: One of the characteristics of modern era is the explosion of diabetes in the world. Today more than 400,000,000 people suffer from diabetes in the entire world. During the last decade the number of women with the disorder of glucose homeostasis is six to seven times greater than in the previous period. Therefore, the re-evaluation of the impact of glucose intolerance on the course and outcome of pregnancy is very current. OBJECTIVE: The aim of the study was to evaluate the data on the influence of mothers' glucose homeostasis disturbances on the occurrence of cardiorespiratory disorders in newborns, as well as their influence on the perinatal outcome. METHODS: Prospective examination included 102 newborns in total - 31 infants of mothers with glucose homeostasis disorder (Group 1) and 71 infants of healthy mothers (Group II). Average age, body height, body weight, body mass index, parity and illness duration of the pregnant women had been determined, as well as the delivery method. Every newborn was provided with physical examination, Apgar score was calculated, body weight and body length were measured. Also, electrocardiography and brain ultrasound, as well as the basic hematology biochemical and microbiological analysis, were performed within the examinations of the infants. RESULTS: The average weight and obesity incidence with diabetic women was higher than in the control group and their infants were heavier and with lower gestational age. Heart failures were diagnosed in five (16.1%) infants of diabetic mothers and in one (1.4%) infant of a healthy woman (p<0.01). Respiratory disorders were diagnosed in 48.4% infants of diabetic mothers and in 12.6% of healthy mothers (p<0.01). Forty-two percent of infants of diabetic mothers and 19.7% infants of healthy mothers needed additional oxygen. CONCLUSION: Congenital anomalies of the cardiovascular system and respiratory disorders in the infants of diabetic mothers were six to eight times more frequent than in the infants of healthy mothers.
[The Role of Two-Dimensional Echocardiography in Diagnostics of Coarctation of the Aorta in Newborns].
Ilisić T, Parezanović V, Ilić S … +8 more , Djukić M, Vukomanović G, Vulićević I, Kalanj J, Mimić B, Milovanović V, Stefanović I, Jovanović I
Srp Arh Celok Lek · 2015 · PMID 26727863 · Publisher ↗
INTRODUCTION: Diagnosis of neonatal coarctation of the aorta (CoA) still presents a challenge in routine practice because of absence of reliable morphologic and functional parameters for early detection of this congenita...
INTRODUCTION: Diagnosis of neonatal coarctation of the aorta (CoA) still presents a challenge in routine practice because of absence of reliable morphologic and functional parameters for early detection of this congenital heart defect in newborns. OBJECTIVE: The aim of this study is to identify easy obtainable two-dimensional echocardiographic parameters for detection of the CoA in newborns. METHODS: Echocardiographic evaluation was performed in 30 newborns with CoA and 20 healthy neonates (control group). Measurements of the proximal transverse arch (PTA), distal transverse arch (DTA), isthmus, distance between the left common carotid artery (LCCA) at the origin of the left subclavian artery (LSA), were obtained by two-dimensional echocardiography. Aortic arch hypoplasia was defined using Mouleart, Karl and Mee criteria, and Z-value. Index 1 was calculated as a ratio of DTA and distance between origins LCCA-LSA, Index 2 was calculated as a ratio of the ascending aorta and the distance between LCCA-LSA origins, and Index 3 was calculated as a ratio of PTA and distance between LCCA-LSA origins. RESULTS: Index 1 was significantly lower in patients with CoA in comparison with control group (0.50 vs. 1.39; p≤0.01). A cut-off point at 0.39, for Index 1, showed a sensitivity of 92% and specificity of 99% for the diagnosis of neonatal CoA, while cut off points at 0.69 and 0.44, for Index 2 and Index 3, showed the highest sensitivity and specificity for the diagnosis of CoA in newborns. CONCLUSION: By using these echo indexes, two-dimensional echocardiographic aortic arch measurement becomes a simple, reliable noninvasive method for the evaluation of aortic coarctation in newborns and may lead to earlier diagnosis and subsequent surgical correction.
[Approach to the Treatment of Atrial Fibrillation in Patients with Cardiovascular Risk Profile: Multicentric International Study].
Pavlović SU, Kirćanski B, Radovanović N … +5 more , Raspopović S, Jovanović V, Nikčević G, Živković M, Milašinović G
Srp Arh Celok Lek · 2015 · PMID 26727862 · Publisher ↗
INTRODUCTION: Atrial fibrillation (AF), the most common arrhythmia that requires treatment, does not come out of the focus of researchers. Monitoring its prevalence and effects of therapy is a good guideline approach to...
INTRODUCTION: Atrial fibrillation (AF), the most common arrhythmia that requires treatment, does not come out of the focus of researchers. Monitoring its prevalence and effects of therapy is a good guideline approach to the growing population of patients in which this arrhythmia occurs. OBJECTIVE: The aim of the study was to evaluate the efficacy of treatment of AF and cardiovascular profiles in the observed population. METHODS: In this observational, cross-sectional, multicenter, international study, 584 patients in 30 centers in Serbia and Slovenia, older than 18 years and with AF or in sinus rhythm with a history of AF, were included. The assessment of the efficacy of treatment of AF was performed by analyzing the frequency of adequate therapeutic effect of medication in rhythm or frequency control in patients with AF. RESULTS: The results confirmed that the highest incidence of AF duration is more than seven days, and is accompanied by symptoms. Inadequate frequency regulation was registered at 8.9% of patients. Hypertension was registered in two-thirds of all patients, while other cardiovascular risk factors were registered in about one-third of patients. An echocardiographic finding in the group of patients with AF confirms generally adequate left ventricular function with a slightly enlarged left atrium (4.6±0.8 cm). Increasing age and time from the first episode of AF decreases the probability of maintaining sinus rhythm, while symptomatic AF had a positive impact on the presence of sinus rhythm. Propafenone, sotalol and amiodarone showed a statistically significant connection with a positive therapeutic response, while 3-blockers had a negative impact on the probability of establishing and maintaining sinus rhythm. CONCLUSION: Characteristics of therapeutic approaches, risks, comorbidity of patient populations in Slovenia and Serbia correspond to the fullest extent with the recommendations for good clinical practice, which further stresses the need for extensive measures in these regions.
[Pathophysiology, Clinical Manifestation and Management of Angioedema - Our Experience].
Aleksić A, Bogić M, Tomić-Spirić V … +3 more , Perić-Popadić A, Vranješ D, Bosančić B
Srp Arh Celok Lek · 2015 · PMID 26727861 · Publisher ↗
INTRODUCTION: Angioedema is characterized by subcutaneous and/or submucosal swelling usually localized to the lips, eyelids, tongue, oral cavity, larynx and pharynx. Various types of angioedema, caused by different patho...
INTRODUCTION: Angioedema is characterized by subcutaneous and/or submucosal swelling usually localized to the lips, eyelids, tongue, oral cavity, larynx and pharynx. Various types of angioedema, caused by different pathophysiologic mechanisms, can have the same or very similar clinical picture and require different diagnostic and therapeutic procedures. The immediate threat to life as a result of rapidly developed edema of the pharynx and larynx with airway obstruction requires endotracheal intubation or emergency tracheotomy. Standard therapy, which includes epinephrine, second-generation antihistamines and steroids, is not effective in the treatment of all types of angioedema. OBJECTIVE: On the basis of the clinical presentation and course of angioedema, this retrospective study was aimed at contributing to a better understanding of the etiopathogenesis of the disease and at helping determine the most effective available treatment modalities. METHODS: This retrospective study included patients treated under the diagnosis of angioedema of the upper aerodigestive tract between 2000 and 2012 in the Department of Otorhinolaryngology, Clinical Center of Banja Luka. RESULTS: A total of 76 subjects were included in the study. The average age was 62.8 years. There were 40 (52.6%) male and 36 (47.4%) female patients. The largest number of patients (44.7%) had type II angioedema. Almost half of the patients or 36 patients (47.4%) were on treatment with an angiotensin-converting enzyme inhibitor (ACEi), but there was no statistically significant difference under the total number of patients (p=0.678). CONCLUSION: Better understanding of pathophysiologic mechanisms and the adoption of diagnostic protocols contributes to more effective treatment of angioedema.
[Oral Health in Children with Asthma].
Marković D, Perić T, Sovtić A … +2 more , Minić P, Petrović V
Srp Arh Celok Lek · 2015 · PMID 26727860 · Publisher ↗
INTRODUCTION: It has been suggested that asthmatic patients may have a higher risk for oral diseases, both as a result of the medical condition and effects of medications. OBJECTIVE: The aim of the study was to determine...
INTRODUCTION: It has been suggested that asthmatic patients may have a higher risk for oral diseases, both as a result of the medical condition and effects of medications. OBJECTIVE: The aim of the study was to determine the oral health status of children with asthma and to evaluate the oral health parameters according to the medications and severity of the disease. METHODS: The study group consisted of 158 children with asthma and 100 healthy control subjects aged 2-18 years. The diagnosis of dental caries was performed using the Decayed, Missing, and Filled Teeth (DMFT/dmft) criteria. The oral hygiene, periodontal status and gingival health were assessed with the Simplified Oral Hygiene Index (Greene-Vermillion), Community Periodontal Index of Treatment Needs and Gingival Index (Löe-Silness), respectively. RESULTS: Thirty (19%) patients with asthma and 43 (43%) healthy children were caries-free (p<0.001). There were no significant differences between asthmatic and control children in caries experience (for children with asthma mean DMFT=2.1±1.8, mean dmft=4.2±3.3; for healthy children mean DMFT=2.5±0.9, mean dmft=5.2±1.3). Level of asthma control did not have influence on dental health, while dose of inhaled corticosteroid had impact on primary dentition. Periodontal status and gingival health did not differ between asthmatic and control children. However, children with asthma had poorer oral hygiene (p<0.001). CONCLUSION: Results of the study do not show a relationship between asthma and oral diseases. However, further improvement could be made in educating children and parents on the importance of good oral hygiene and prevention of oral diseases.
[The Presence of Non-Carious Lesions in Children].
Demko Rihter I, Jovanov G, Petrović B … +4 more , Blagojević D, Petrović D, Marković D, Dmitrović J
Srp Arh Celok Lek · 2015 · PMID 26727859 · Publisher ↗
INTRODUCTION: A non-carious lesion (NCL) is the loss of hard dental tissue on the neck, tuberculum and incisal edges of the teeth. Interest in clinical presence and in unclear etiology of these lesions allows for their f...
INTRODUCTION: A non-carious lesion (NCL) is the loss of hard dental tissue on the neck, tuberculum and incisal edges of the teeth. Interest in clinical presence and in unclear etiology of these lesions allows for their future prevention and treatment. OBJECTIVE: The aim of the study was to determine presence and clinical characteristics of NCLs and dentine hypersensitivity (DH), as well as their possible risk factors in children, in the population of the city of Novi Sad. METHODS: A total of 55 subjects were included in the present study, aged between three and 18 years. Each subject completed a structured questionnaire related to the etiological factors, and all teeth of each subject were examined by two independent clinical dentists to determine NCLs and DH. In the case of small children, their parents or guardians filled out the questionnaire. Teeth with NCLs and DH were diagnosed according to the Basic Erosive Wear Examination (BEWE) index and by a blast of air according to Schiff and Hypersensitivity Index. The review was carried out by inspection and probing. RESULTS: The data were analyzed by clinical examination and comparison of the answers to the questionnaires. We observed an increased presence of non-caries lesions on primary teeth, compared to permanent teeth, with a statistically significant difference (X2=3.86, df=1, p=0.04). The changes were observed in 82 teeth, and were most frequent on the canine deciduous teeth (65%) and canine permanent teeth (51%). BEWE index was 10-11% to 92-100% in permanent, and 51-57% in deciduous teeth. Majority of patients with primary teeth (89.36%) did not respond to air stimulus, while most patients with permanent teeth (74.29%) did not react to Schiff Index. In the estimate of sensitivity, the respondents reported hypersensitivity on 6.38% of the deciduous teeth and 22.86% of the permanent teeth. Comparison of etiology factors did not reveal a direct link with the appearance of NCLs. CONCLUSION: Research has shown that despite the lack of subjective symptoms, these lesions have distinct clinical characteristics. The fact that they occur even in deciduous dentition justifies the need for further investigations.
The Role of 24-hour Ambulatory Blood Pressure Monitoring in Hypertensive Patients with Normal-tension Glaucoma.
Marjanović I, Marjanović M, Stojanov V … +4 more , Hentova-Senćanić P, Marković V, Božić M, Vukčević-Milošević G
Srp Arh Celok Lek · 2015 · PMID 26727858 · Publisher ↗
INTRODUCTION: Extreme dippers are patients with a nocturnal fall of blood pressure (BP) of more than 20%, dippers have normal diurnal rhythm and decrease of BP of 10-15%, while patients with a nocturnal BP fall of less t...
INTRODUCTION: Extreme dippers are patients with a nocturnal fall of blood pressure (BP) of more than 20%, dippers have normal diurnal rhythm and decrease of BP of 10-15%, while patients with a nocturnal BP fall of less than 10% are considered to be non-dippers. OBJECTIVE: The aim of this study was to compare 24-hour ambulatory BP monitoring results of normal-tension glaucoma (NTG) patients with NTG suspects, as well as to determine whether NTG patients are more prone to daytime/nighttime systemic arterial BP and heart rate oscillations in comparison to NTG suspects. METHODS: This was a prospective, cross-sectional and observational study of 57 hypertensive patients (39 female and 18 male), all examined at the Eye and the Cardiology Clinic, Clinical Center of Serbia in Belgrade, between November 2011 and March 2012. Before 24-hour ambulatory BP monitoring, complete ophthalmological examination was performed (intraocular pressure was measured with both Goldmann applanation and dynamic contour tonometer, as well as with computerized perimetry and Heidelberg retinal tomography). RESULTS: There was no statistically significant difference between NTG patients and NTG suspects both in systolic daytime (131.86-141.81 mmHg, SD=±l 4.92 vs. 129.67-141.83 mmHg, SD=±l3; p=0.53) and nighttime measurements (117.1-129.7 mmHg, SD=±l 8.96 vs. 112.11-127.59 mmHg, SD=±16.53; p=0.53) as well as diastolic daytime (74.55-80.37 mmHg, SD=±8.72 vs. 75.19-82.41 mmHg, SD=±7.72; p=0.58) and nighttime measurements (65.66-71.48 mmHg, SD=±8.73 vs. 67.12-73.78 mmHg, SD=±7.1 1; p=0.34). There was no statistically significant difference between NTG patients and NTG suspects in heart rate during the day (72.73-76.36 beats per minute [bpm], SD=±5.44 vs. 72.15-76.45 bpm, SD=±4.59; p=0.43) nor during the night (64.4-71.9 bpm, SD=±6.74 vs. 68.02-72.48 bpm, SD=±4.76; p=0.11). CONCLUSION: No statistically significant difference was found between NTG patients and NTG suspects in regard to their systolic and diastolic BP measured both during daytime and nighttime. NTG patients had fall (both systolic and diastolic) than NTG suspects.
Cerebral Vasomotor Reactivity and Apnea Test in Symptomatic and Asymptomatic High-Grade Carotid Stenosis.
Prokin AL, Slankamenac P, Kovačević P … +2 more , Kaloci SR, Živanović ŽD
Srp Arh Celok Lek · 2015 · PMID 26727857
INTRODUCTION: Cerebral vasomotor reactivity (VMR) represents an autoregulatory response of the arterial trunks on the specific vasoactive stimuli, most commonly CO2. OBJECTIVE: The aim of this retrospective study was to...
INTRODUCTION: Cerebral vasomotor reactivity (VMR) represents an autoregulatory response of the arterial trunks on the specific vasoactive stimuli, most commonly CO2. OBJECTIVE: The aim of this retrospective study was to compare VMR in high-grade symptomatic (SCAS) and asymptomatic carotid stenosis (ACAS), using the apnea test to evaluate the hemodynamic status. METHODS: The study included 50 patients who were hospitalized at the neurology and vascular surgery departments as part of preparation for carotid endarterectomy. We evaluated VMR by calculating the breath holding index (BHI) in 34 patients with SCAS and 16 patients with ACAS, with isolated high-grade carotid stenosis. We evaluated the impact of risk factors and collateral circulation on BHI, as well as the correlation between the degree of carotid stenosis and BHI. RESULTS: A pathological BHI was more frequent in the SCAS group (p<0.01). There was no difference in the range of BHI values between the groups, both ipsilaterally and contralaterally. Only male gender was associated with pathological BHI in both groups (p<0.05). Collateral circulation did not exist in over 60% of all subjects. We confirmed a negative correlation between the degree of carotid stenosis and BHI. CONCLUSION: SCAS and ACAS patients present with different hemodynamics. While ACAS patients have stable hemodynamics, combination of hemodynamic and thromboembolic effects is characteristic of SCAS patients.
Editing the journal Serbian Archives of Medicine in the 2012-2015 period.
Milenković P
Srp Arh Celok Lek · 2015 · PMID 26727856
Abstract loading — click title to view on PubMed.
Benefits of Student-Centered Tandem Teaching in Medical English.
Antić Z
Srp Arh Celok Lek · 2015 · PMID 26506766 · Publisher ↗
This paper addresses some of the key notions about English for special purposes with special regard to English for medical purposes. The content was determined by observations and based on authors' professional experienc...
This paper addresses some of the key notions about English for special purposes with special regard to English for medical purposes. The content was determined by observations and based on authors' professional experience. The starting point of a medical English course is a thorough analysis of students' needs, which is then used in course design and definition of appropriate learning goals. The student is at the center of learning and it is necessary to establish a positive cooperation between students and teachers. As medical English course is highly context-based, the inclusion of medical teachers can offer many opportunities for a successful learning process.
Multiple Sharp Force Injuries to the Head - The Crime of Passion.
Nikolić S, Živković V
Srp Arh Celok Lek · 2015 · PMID 26506765 · Publisher ↗
INTRODUCTION: The Institute of Forensic Medicine was founded by Professor Milovan Milovanovid (1884-1948) in 1923 as part of School of Medicine of the University of Belgrade, and also established the Institute's forensic...
INTRODUCTION: The Institute of Forensic Medicine was founded by Professor Milovan Milovanovid (1884-1948) in 1923 as part of School of Medicine of the University of Belgrade, and also established the Institute's forensic collection worthy of a museum.This paper illustrates the way Professor Milovanovie made this collection into a teaching aid for student education. We present a case of crime of passion from the year 1931, from our Institute's collection. CASE OUTLINE: The victim was a 30-year-old woman with multiple stab wounds of the head, neck and arms. It was noted in the case history that the deceased woman was a maid with a wealthy merchant, as well as that she had "dubious morals" for that time, with three wooers at the same time. Injuries to the forearms and the index finger prove that the victim tried to defend herself. In the autopsy record there is a drawn figure of a kitchen knife with a rounded blade tip, which explains the absence of stab wounds to the skull, and the presence of the impression skull fractures and crushed skull bones. It was concluded that the death occurred due to exsanguination, in turn due to transection of the left carotid artery, probably caused by sharp force, while the manner of death was homicide. Some of the most prominent autopsy findings were multiple mutilating overkill sharp force injuries, localized on the head, indicated sexually motivated murder. CONCLUSION: Combining the museum specimen, diagrams with injuries, drawn figure of the kitchen knife used, and photographs taken during the autopsy and the police investigation, Professor Milovanovie was able to properly illustrate this intriguing case to students without a computer or a PowerPoint presentation.
[The Stem-Cell Application in Ischemic Heart Disease: Basic Principles, Specifics and Practical Experience from Clinical Studies].
Banović M, Obradović S, Beleslin B
Srp Arh Celok Lek · 2015 · PMID 26506764 · Publisher ↗
Longer life duration, different clinical presentations of coronary disease, as well as high incidence of comorbidity in patients with ischemic heart disease have led to an increase in the incidence of ischemic heart fail...
Longer life duration, different clinical presentations of coronary disease, as well as high incidence of comorbidity in patients with ischemic heart disease have led to an increase in the incidence of ischemic heart failure. Despite numerous and new treatment methods that act on different pathophysiological mechanisms that cause heart failure, and whose aim is to slowdown or stop the progression of this devastating disease, morbidity and mortality in these patients remain high. These facts have firstly led to the introduction of the experimental, and then clinical studies with the application of stem cells in patients with ischemic heart disease. Previous studies have shown that the application of stem cells is a feasible and safe method in patients with acute coronary syndrome, as well as in patients with chronic ischemic cardiomyopathy, but the efficacy of these methods in both of the abovementioned clinical syndromes has yet to be established.This review paper outlines the basic principles of treatment of ischemic heart disease with stem cells, as well as the experience and knowledge gained in previous clinical studies.
Techniques of the Tympanomastoidectomy with Reconstruction of the Posterior Bone Wall of the External Auditory Canal.
Dankuc D, Vlaški L, Pejaković N
Srp Arh Celok Lek · 2015 · PMID 26506763 · Publisher ↗
A combined tympanoplasty method, the mobile-bridge tympanoplasty, has been applied at the Clinic for Ear, Nose and Throat Diseases in Novi Sad since 1998. Mobile-bridge tympanoplasty is performed at our Clinic by applyin...
A combined tympanoplasty method, the mobile-bridge tympanoplasty, has been applied at the Clinic for Ear, Nose and Throat Diseases in Novi Sad since 1998. Mobile-bridge tympanoplasty is performed at our Clinic by applying Feldmann's procedure utilizing a microsurgical oscillating saw. It is a combination of closed and open techniques for surgical treatment of middle ear diseases. In addition to this technique, a method for reconstruction of the posterior bone wall of the external auditory canal was introduced. This procedure is applied in cases of damage or impairment of the bony ear canal wall using mastoid cortical temporal bone graft or modeled cartilage of the concha. Maintenance of general anatomical relations in the middle ear enables good ventilation of pneumatic spaces of the middle ear and Eustachian tube permeability, thus providing good conditions for ossicular chain reconstruction. The incidence of recurrent cholesteatoma in combined mobile-bridge tympanoplasty and tympanoplasty with reconstruction of the posterior bone wall was 6% in total. The incidence values for the recurrent cholesteatoma in closed tympanoplasty and in cases of open techniques were 10%. Mobile-bridge tympanoplasty and reconstruction of the posterior bone wall of external auditory canal are methods of choice in surgical treatment of middle ear cholesteatoma that progressed to the attic space, sinus tympani and facial recess.
Streptococcal Necrotizing Fasciitis with Toxic Shock Syndrome and Rapid Fatal Outcome.
Kojič M, Mikič D, Nožić D … +1 more , Rakonjac B
Srp Arh Celok Lek · 2015 · PMID 26506762 · Publisher ↗
INTRODUCTION: Streptococcal necrotizing fasciitis (NF) is a serious soft tissue infection with rapid progression of inflammatory process among superficial or deep fascia, systemic host response to infection leading to to...
INTRODUCTION: Streptococcal necrotizing fasciitis (NF) is a serious soft tissue infection with rapid progression of inflammatory process among superficial or deep fascia, systemic host response to infection leading to toxic shock syndrome (TSS), and multiple organ failure. Lethality is high. CASE OUTLINE: A 46-year-old male without co-morbidities was admitted to the Emergency Department with redness, swelling and pain on his right lower leg. He became sick two days earlier with malaise, chills and shivering. On admission he was hypotensive, anuric, with erythematous rash on his face, neck and chest, with acute renal failure and elevated creatine phosphokinase level. During the next several hours, the changes on his right lower leg rapidly spread to the whole leg, followed by skin destruction and subcutaneous bleeding, indicating NF. Aggressive antimicrobial, supportive and symptomatic therapy was initiated immediately and on the same evening surgical intervention was performed. Despite these measures, a rapid development of severe TSS, with lethal outcome, occurred in less than 40 hours after the admission. Streptococcus pyogenes (group A β-hemolytic Streptococcus) was isolated from the throat, skin and tissue obtained during the surgery. CONCLUSION: Necrotizing fasciitis is a very serious disease with unpredictable course. For that reason doctors must devote a great deal of attention to early, i.e. timely diagnosis of this disease, whose treatment with a multidisciplinary approach is very important.
Isolated Fallopian Tube Torsion - A Challenge for the Timely Diagnosis and Treatment.
Jokić R, Lovrenski J, Lovrenski A … +1 more , Trajković V
Srp Arh Celok Lek · 2015 · PMID 26506761 · Publisher ↗
INTRODUCTION: Isolated torsion of the fallopian tube is a rare cause of acute lower abdominal pain and infrequent indication for surgical treatment. CASE OUTLINE: A 16-year-old girl was referred to the hospital due to th...
INTRODUCTION: Isolated torsion of the fallopian tube is a rare cause of acute lower abdominal pain and infrequent indication for surgical treatment. CASE OUTLINE: A 16-year-old girl was referred to the hospital due to the non-specific symptoms over period of a few months and pain acutization in the right infraumbilical region lasting for two days. Complete laboratory analyses were normal. Ultrasound examination revealed a round mass (23x14 mm) within the right fallopian tube with color Doppler whirlpool sign, normal ovary, and a simple ipsilateral paratubal cyst (50x40 mm). Laparoscopy showed a dilated and two times torquated right fallopian tube, as well as signs of chronic appendicitis. The tube was twisted about its longitudinal axis and it was livid, but not gangrenous. After appendectomy, fallopian tube was detorquated, cyst extracted and preservation of the tube was performed. Postoperatively, antibiotic therapy was administered based on antibiogram. On follow-up examinations within the next four months postoperative course was uneventful. CONCLUSION: Since there are no pathognomonic symptoms, clinical or laboratory findings, diagnosis of this condition is challenging. Familiarity with Doppler whirlpool sign can enable a timely diagnosis and treatment of isolated fallopian tube torsions. However, the diagnosis is rarely made before operation. Unlike in our case, surgery is often performed too late, and delay of intervention may result in failure to save the fallopian tube.
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