Srpski Arhiv Za Celokupno Lekarstvo[JOURNAL]
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200 papers
Anaphylaxis on Graft Reperfusion during Orthotopic Liver Transplantation: A Case Study.
Andjelić N, Erdeljan S, Popović R … +1 more , Božić T
Srp Arh Celok Lek · 2015 · PMID 26506760 · Publisher ↗
INTRODUCTION: Hemodynamic instability is a common occurrence during liver transplantation (LT). Hypotension and hemodynamic instability during graft reperfusion are most commonly consequences of the postreperfusion syndr...
INTRODUCTION: Hemodynamic instability is a common occurrence during liver transplantation (LT). Hypotension and hemodynamic instability during graft reperfusion are most commonly consequences of the postreperfusion syndrome (PRS). CASE OUTLINE: In this report, we present a case of severe cardiovascular collapse leading to cardiac arrest which occurred in the course of graft reperfusion during LT. Persistent hypotension, non-responsive to regular measures such as volume filling and the use of vasopressors, yielded the question of whether other mechanisms were involved in causing it. Diffuse redness of the face and body, swelling of the face, lips and tongue with tongue prolapse, accompanied with severe cardiovascular collapse indicated that it was an anaphylactic reaction. This caused a dilemma as to what instigated the reaction. The trigger may have been the pharmacological substance administered during the graft reperfusion, or the one administered immediately prior to the reperfusion.The substances in question would most likely be either the University of Wisconsin preservation solution (UW), which was administered during the reperfusion, or Hepatect, which the patient received immediately prior to reperfusion. CONCLUSION: The clinical syndrome resulting from degranulation of mast cells and basophils in anaphylaxis is very similar to the PRS in LT. Clinical features play the most important role in establishing a timely diagnosis and early treatment of anaphylaxis. Swift administration of epinephrine reduces the chances of a fatal outcome. Better information on both donor and recipient can improve the efficiency of therapy and prophylaxis for anaphylaxis.
Hybrid Procedure for a Descending Thoracic and Subclavian Artery Aneurysm in a Patient with Previous Abdominal Aortic Surgery: Case Report.
Radak D, Tanasković S, Unić-Stojanović D … +3 more , Jović M, Babić S, Sagić D
Srp Arh Celok Lek · 2015 · PMID 26506759 · Publisher ↗
INTRODUCTION: Hybrid procedures represent staged or simultaneous endovascular and open surgical techniques in the treatment of complex pathologies of the thoracic and abdominal aorta. We are presenting a patient with pre...
INTRODUCTION: Hybrid procedures represent staged or simultaneous endovascular and open surgical techniques in the treatment of complex pathologies of the thoracic and abdominal aorta. We are presenting a patient with previous abdominal aortic surgery in whom hybrid vascular procedure for descending aorta and left subclavian artery aneurysm was performed. CASE OUTLINE: A 63-year-old female patient was admitted for computed tomography angiography. Descending aorta aneurysm (7.6 cm) as well as aneurysm of the left subclavian artery (LSA) was noted. Eight years ago she underwent abdominal aortic aneurysm resection and aortoiliac bypass. Standard TEVAR (thoracic endovascular aortic repair) procedure couldn't be done due to small dimensions of previous "Y" graft (12x6 mm), so first we did LSA transposition and after three days hybrid procedure. After "Y" graft exposure, anastomosis between the corps of "Y" graft and tubular graft 10 mm was created and through this conduit thoracic stent-graft was placed followed by complete "Y"graft replacement. After 6 months angiography showed regular postoperative findings. CONCLUSION: Combined surgical and endovascular procedures in thoracic aorta pathology treatment could be useful solutions with favorable outcome.
Inflammatory Myofibroblastic Tumours of the Respiratory Tract: A Series of Three Cases with Varying Clinical Presentations and Treatment.
Tegeltija D, Lovrenski A, Stojanović G … +3 more , Bijelović M, Jeličić I, Eri Ž
Srp Arh Celok Lek · 2015 · PMID 26506758 · Publisher ↗
INTRODUCTION: Inflammatory myofibroblastic tumor in the respiratory system is a rare and controversial disease. It is macroscopically well-circumscribed, non-encapsulated, firm and usually a yellowish-white mass. Histolo...
INTRODUCTION: Inflammatory myofibroblastic tumor in the respiratory system is a rare and controversial disease. It is macroscopically well-circumscribed, non-encapsulated, firm and usually a yellowish-white mass. Histologically it is composed of the following spindled and inflammatory cells: lymphocytes, plasma cells, and histiocytes, including Touton type multinucleated giant cells. CASE OUTLINE: The series included a 49-year-old man with a tracheal inflammatory myofibroblastic tumor who complained of hoarseness; a 42-year-old man who was coughing and had a blood-stained sputum, and inflammatory myofibroblastic tumor was in the right main and intermediate bronchus; and a 32-year-old man with chest pain and inflammatory myofibroblastic tumor as a solitary peripheral nodule in the left lower lobe. In all the cases, the tumor was resected bronchoscopically and surgically. CONCLUSION: Inflammatory myofibroblastic tumor of the lung and the trachea is rare. Complete resection, when possible, should be the choice of treatment. After the complete removal, prognosis is generally excellent and recurrences are rare.
The Lipomatosis of the Parapharyngeal and Retropharyngeal Space: A Case Report.
Luczak K, Dorobisz K, Krecicki T … +3 more , Janczak D, Chabowski M, Zatonski T
Srp Arh Celok Lek · 2015 · PMID 26506757 · Publisher ↗
INTRODUCTION: Lipomas are the most common benign mesenchymal tumors, which account for almost 50% of all soft-tissue tumors. CASE OUTLINE: The case of a 75-year-old patient with a slow growing lesion of para- and retroph...
INTRODUCTION: Lipomas are the most common benign mesenchymal tumors, which account for almost 50% of all soft-tissue tumors. CASE OUTLINE: The case of a 75-year-old patient with a slow growing lesion of para- and retropharyngeal space was reported. The patient was suffering from progressive dysphagia, respiratory obstruction and sleep apnea. CONCLUSION: An external surgical approach is the treatment of choice. Etiology, differential diagnosis and therapy of head and neck lipomas has been discussed.
Unilateral Adie's Tonic Pupil and Viral Hepatitis - Report of Two Cases.
Karadžić J, Jaković N, Kovačević I
Srp Arh Celok Lek · 2015 · PMID 26506756 · Publisher ↗
INTRODUCTION: Adie's (tonic) pupil is a neuro-ophthalmological disorder characterized by a tonically dilated pupil, which is unresponsive to light. It is caused by damage to postganglionic fibers of the parasympathetic i...
INTRODUCTION: Adie's (tonic) pupil is a neuro-ophthalmological disorder characterized by a tonically dilated pupil, which is unresponsive to light. It is caused by damage to postganglionic fibers of the parasympathetic innervation of the eye, usually by a viral.or bacterial infection. Adie's syndrome includes diminished deep tendon reflexes. OUTLINE OF CASES: We report data of a 59-year-old female with unequal pupil sizes. She complained of blurred vision and headache mainly while reading. She had a 35-year history of hepatitis B and liver cirrhosis. On exam, left pupil was mydriatic and there was no response to light and at slit lamp we saw segments of the sphincter constrict. We performed 0.125% pilocarpine test and there was a remarkable reduction of size in the left pupil. The second case is a 55-year-old female who was referred to the University Eye Clinic because of a headache and mydriatic left pupil. She had diabetes mellitus type 2, as well as hepatitis A virus 20 years earlier. On exam, the left pupil was mydriatic, with no response to light. Test with diluted pilocarpine was positive. Neurological examinations revealed no abnormality in either case so we excluded Adie's syndrome. CONCLUSION: Adie's tonic pupil is benign neuro-ophthalmological disorder of unknown etiology. Most patients commonly present no symptoms and anisocoria is noticed accidentally. Although the etiology is unknown, there are some conditions that cause tonic pupil. It may be a part of a syndrome in which tonic pupil is associated with absent deep tendon reflexes.
Astasia-Abasia and Ganser Syndrome in a Preadolescent Girl: A Case Report.
Stanković M, Kostić J, Grbeša G … +2 more , Tošić T, Stanković S
Srp Arh Celok Lek · 2015 · PMID 26506755 · Publisher ↗
INTRODUCTION: Astasia is the inability to maintain an upright body position without assistance in the absence of motor weakness or sensory loss. Abasia is described as the inability to walk or as uncoordinated walking, w...
INTRODUCTION: Astasia is the inability to maintain an upright body position without assistance in the absence of motor weakness or sensory loss. Abasia is described as the inability to walk or as uncoordinated walking, while preserving mobility of the lower limbs. Ganser syndrome is described as a dissociative disorder characterized by approximate answers, somatic conversion symptoms, clouding of consciousness, as well as visual and auditory pseudohallucinations. The aim of this study is to present a case that seemed like a combination of neurological and internal disturbances, but actually represented a psychogenic disorder. CASE OUTLINE: This paper presents the case of a 13-year-old patient with the first manifestation of the inability to walk and stand. Medical history, diagnostic instruments and differential diagnostic methods have been presented in detail. The clinical manifestation was initially interpreted as a neurological disorder. However, after the application of diagnostic procedures and a change in family circumstances, the patient was diagnosed with a psychogenic movement disorder, astasia-abasia, with progressive clinical presentation that included dissociative psychotic reactions (Ganser syndrome). Differential diagnosis as well as the elements of the therapeutic approach have been discussed. CONCLUSION: Presenting a case of psychogenic astasia-abasia in children contributes to a better understanding and differentiating between conditions with a clinical presentation of signs and symptoms dealt with by other branches of medicine.
[Toxoplasmosis and Pregnancy: Reliability of Internet Sources of Information].
Bobić B, Štajner T, Nikolić A … +3 more , Klun I, Srbljanović J, Djurković-Djaković O
Srp Arh Celok Lek · 2015 · PMID 26506754 · Publisher ↗
INTRODUCTION: Health education of women of childbearing age has been shown to be an acceptable approach to the prevention of toxoplasmosis, the most frequent congenitally transmitted parasitic infection. OBJECTIVE: The a...
INTRODUCTION: Health education of women of childbearing age has been shown to be an acceptable approach to the prevention of toxoplasmosis, the most frequent congenitally transmitted parasitic infection. OBJECTIVE: The aim of this study was to evaluate the Internet as a source of health education on toxoplasmosis in pregnancy. METHODS: A group of 100 pregnant women examined in the National Reference Laboratory for Toxoplasmosis was surveyed by a questionnaire on the source of their information on toxoplasmosis. We also analyzed information offered by websites in the Serbian and Croatian languages through the Google search engine, using "toxoplasmosis" as a keyword. The 23 top websites were evaluated for comprehensiveness and accuracy of information on the impact of toxoplasmosis on the course of pregnancy, diagnosis and prevention. RESULTS: Having knowledge on toxoplasmosis was confirmed by 64 (64.0%) examined women, 40.6% (26/64) of whom learned about toxoplasmosis through the Internet, 48.4% from physicians, and 10.9% from friends. Increase in the degree of education was found to be associated with the probability that pregnant women would be informed via the Internet (RR=3.15, 95% CI=1.27-7.82, p=0.013). Analysis of four interactive websites (allowing users to ask questions) showed that routes of infection were the most common concern, particularly the risk presented by pet cats and dogs, followed by the diagnosis of infection (who and when should be tested, and how should the results be interpreted). Of 20 sites containing educational articles, only seven were authorized and two listed sources. Evaluation confirmed that information relevant to pregnant women was significantly more accurate than comprehensive, but no site gave both comprehensive and completely accurate information. Only four sites (20%) were good sources of information for pregnant women. CONCLUSION: Internet has proved itself as an important source of information. However, despite numerous websites, only a few offer reliable information to the Serbian (or Croat) speaking community, and none present complete and accurate information relevant to pregnant women.
Influenza B Viruses in the Population of Province of Vojvodina during the 2012/2013 Season: Differentiation of B/Yamagata and B/Victoria Lineages by Real-time RT-PCR, Antigenic and Phylogenetic Characterization.
Radovanov J, Milošević V, Cvjetković IH … +8 more , Ristić M, Djilas M, Nikolić N, Patić A, Kovačević G, Galović AJ, Petrović T, Mikić SS
Srp Arh Celok Lek · 2015 · PMID 26506753 · Publisher ↗
INTRODUCTION: At present, two phylogenetically distinct influenza B virus lineages, B/Yamagata and B/ Victoria, co-circulate worldwide and can cause significant morbidity and mortality. OBJECTIVE: The aim of this study w...
INTRODUCTION: At present, two phylogenetically distinct influenza B virus lineages, B/Yamagata and B/ Victoria, co-circulate worldwide and can cause significant morbidity and mortality. OBJECTIVE: The aim of this study was to determine the prevalences of two influenza B virus lineages in the population of Vojvodina and to identify their antigenic and phylogenetic properties. METHODS: A total of 369 and 334 nasopharyngeal, or nasal/throat swab samples, collected during the 2012/2013 and 2013/2014 seasons, respectively, were tested using specific singleplex influenza A, influenza B, influenza B/Yamagata and influenza B/Victoria real-time reverse transcription polymerase chain reaction (RT-PCR) assays. Antigenic and genetic testing were done by hemagglutination inhibition assay and hemagglutinin and neuraminidase gene sequence analysis, respectively. RESULTS: During the 2012/2013 season, influenza B viruses were present in 53.4% (101/189) of influenza positive samples.The B/Yamagata-like viruses (81.2%) significantly predominated over the B/Victoria-like viruses (18.8%). Comparing to B/Victoria-like positive patients, among B/Yamagata-like positive patients, children 5-14 years of age were significantly more represented (5.3% vs. 35.4%, respectively), as well as patients with mild form of illness (15.8% vs. 45.1%, respectively). The results of sequence analysis and antigenic testing showed that tested viruses were not closely related to B/Wisconsin/1/2010, the vaccine virus for 2012/2013. During the 2013/2014 season influenza B viruses were not detected. CONCLUSION: The results of this study confirmed the health significance of influenza B viruses and indicated that B/Yamagata-like viruses were significantly more prevalent than B/Victoria lineage viruses, during the 2012/2013 season. They also showed a sub-optimal match between the tested viruses and the vaccine virus for season 2012/2013.
[Parameters of Anaerobic Physiological Profile of Elite Athletes].
Jakovljević DK, Lukač D, Grujić N … +2 more , Drapšin M, Klašnja A
Srp Arh Celok Lek · 2015 · PMID 26506752
INTRODUCTION: Anaerobic capacity is much less evaluated in literature compared to aerobic component. Anaerobic performance of athletes can be measured using different motoric tests, lasting 20 to 30 seconds, one of them...
INTRODUCTION: Anaerobic capacity is much less evaluated in literature compared to aerobic component. Anaerobic performance of athletes can be measured using different motoric tests, lasting 20 to 30 seconds, one of them being the Wingate anaerobic test (WAnT). OBJECTIVE: The aim of this study was to determine the work performed and power generated by athletes and non-athletes during a 30-second high intensity exercise, as well as to compare explosive characteristics of subjects using a new parameter of WAnT, named explosive power, or slope of power. METHODS: All parameters of anaerobic power were investigated in 152 subjects classed into different groups depending on their physical fitness and sport specialties as follows: non-athletes (n=31), rowers (n=26), volleyball players (n=37), handball players (n=34) and judo players (n=24). The WAnT, as well as basic anthropometric measurements, was administrated to all participants. RESULTS: Values of anaerobic parameters were higher in the group of athletes compared to physically inactive subjects.The highest values of the WAnT parameters were registered in the group of volleyball players (AP=1 006 W; relative AP=11.4 W/ kg, AC=19.8 kJ), compared to athletes of other sport disciplines (volleyball, rowing and judo). The new parameter of the WAnT, explosive power, also showed highest values in volleyball players (EP=1 54 W/s; relative EP=1.74 W/s/kg). These differences were statistically significant (p<0.05). CONCLUSION: The results of laboratory tests can provide useful information on improvements in training processes. The new parameter of the WAnT could be implemented in further analyses of explosive characteristics of muscle contraction.
Severe Blunt Hepatic Trauma in Polytrauma Patient - Management and Outcome.
Doklestić K, Djukić V, Ivančević N … +5 more , Gregorić P, Lončar Z, Stefanović B, Jovanović D, Karamarković A
Srp Arh Celok Lek · 2015 · PMID 26506751 · Publisher ↗
INTRODUCTION: Despite the fact that treatment of liver injuries has dramatically evolved, severe liver traumas in polytraumatic patients still have a significant morbidity and mortality. OBJECTIVE: The purpose of this st...
INTRODUCTION: Despite the fact that treatment of liver injuries has dramatically evolved, severe liver traumas in polytraumatic patients still have a significant morbidity and mortality. OBJECTIVE: The purpose of this study was to determine the options for surgical management of severe liver trauma as well as the outcome. METHODS: In this retrospective study 70 polytraumatic patients with severe (American Association for the Surgery of Trauma [AAST] grade III-V) blunt liver injuries were operated on at the Clinic for Emergency Surgery. RESULTS: Mean age of patients was 48.26±16.80 years; 82.8% of patients were male. Road traffic accident was the leading cause of trauma, seen in 63 patients (90.0%). Primary repair was performed in 36 patients (51.4%), while damage control with perihepatic packing was done in 34 (48.6%). Complications related to the liver occurred in 14 patients (20.0%). Liver related mortality was 17.1%. Non-survivors had a significantly higher AAST grade (p=0.0001), higher aspartate aminotransferase level (p=0.01), lower hemoglobin level (p=0.0001), associated brain injury (p=0.0001), perioperative complications (p=0.001) and higher transfusion score (p=0.0001). The most common cause of mortality in the "early period" was uncontrolled bleeding, in the "late period" mortality was caused by sepsis and acute respiratory distress syndrome. CONCLUSION: Patients with high-grade liver trauma who present with hemorrhagic shock and associated severe injury should be managed operatively. Mortality from liver trauma is high for patients with higher AAST grade of injury, associated brain injury and massive transfusion score.
Minimally Invasive Esophagectomy for Cancer: Single Center Experience after 44 Consecutive Cases.
Bjelović M, Babič T, Gunjić D … +2 more , Veselinović M, Špica B
Srp Arh Celok Lek · 2015 · PMID 26506750 · Publisher ↗
INTRODUCTION: At the Department of Minimally Invasive Upper Digestive Surgery of the Hospital for Digestive Surgery in Belgrade, hybrid minimally invasive esophagectomy (hMIE) has been a standard of care for patients wit...
INTRODUCTION: At the Department of Minimally Invasive Upper Digestive Surgery of the Hospital for Digestive Surgery in Belgrade, hybrid minimally invasive esophagectomy (hMIE) has been a standard of care for patients with resectable esophageal cancer since 2009. As a next and final step in the change management, from January 2015 we utilized total minimally invasive esophagectomy (tMIE) as a standard of care. OBJECTIVE: The aim of the study was to report initial experiences in hMIE (laparoscopic approach) for cancer and analyze surgical technique, major morbidity and 30-day mortality. METHODS: A retrospective cohort study included 44 patients who underwent elective hMIE for esophageal cancer at the Department for Minimally Invasive Upper Digestive Surgery, Hospital for Digestive Surgery, Clinical Center of Serbia in Belgrade from April 2009 to December 2014. RESULTS: There were 16 (36%) middle thoracic esophagus tumors and 28 (64%) tumors of distal thoracic esophagus. Mean duration of the operation was 319 minutes (approximately five hours and 20 minutes). The average blood loss was 173.6 ml. A total of 12 (27%) of patients had postoperative complications and mean intensive care unit stay was 2.8 days. Mean hospital stay after surgery was 16 days. The average number of harvested lymph nodes during surgery was 31.9. The overall 30-day mortality rate within 30 days after surgery was 2%. CONCLUSION: As long as MIE is an oncological equivalent to open esophagectomy (OE), better relation between cost savings and potentially increased effectiveness will make MIE the preferred approach in high-volume esophageal centers that are experienced in minimally invasive procedures.
The Analysis of the Risk Factors in the Arterial Switch Operation for Treatment of D-Transposition of the Great Arteries in One Pediatric Cardiac Center in Serbia.
Popović MS, Šehić I, Prijić S … +2 more , Vukomanović V, Košutić J
Srp Arh Celok Lek · 2015 · PMID 26506749
INTRODUCTION: The arterial "switch" operation has been the operation of choice for children born with D-transposition of the great arteries (D-TGA) for more than 30 years in countries with developed pediatric cardiac sur...
INTRODUCTION: The arterial "switch" operation has been the operation of choice for children born with D-transposition of the great arteries (D-TGA) for more than 30 years in countries with developed pediatric cardiac surgery program. After two decades of successful treatment of these children with the atrial "switch" corrections (Mustard or Senning operative techniques), the arterial "switch"operation (ASO) had been introduced as a routine technique in one pediatric cardiac center in Serbia. OBJECTIVE: The aim of this study was the analysis of the identified risk factors involved with the ASO in the preoperative, operative and postoperative period and their impact on the survival of the operated children. METHODS: A retrospective nonrandomized study of 52 operated patients with D-TGA by the ASO in the period between May 1, 2003 and December 31, 2011, divided into two groups. The data collection consisted of preoperative, operative and postoperative factors during the in-hospital stay and until the discharge from the hospital. Descriptive and differential statistical methods were used for analysis. RESULTS: Ten individual risk factors were identified as significant for the immediate survival of children operated with the ASO technique. CONCLUSION: The arterial "switch" surgical operative technique is a complex neonatal/young infant procedure in which the preoperative status carried a significant risk as well as the surgical technique itself. These results differ from the results published throughout the world and are a representation of an evolutionary process of one center in Serbia starting the ASO procedure.
Histological Effects of Enamel Matrix Derivative on Exposed Dental Pulp.
Bajić MP, Danilović V, Prokić B … +3 more , Prokić BB, Manojlović M, Živković S
Srp Arh Celok Lek · 2015 · PMID 26506748
INTRODUCTION: Direct pulp capping procedure is a therapeutic application of a drug on exposed tooth pulp in order to ensure the closure of the pulp chamber and to allow the healing process to take place. OBJECTIVE: The a...
INTRODUCTION: Direct pulp capping procedure is a therapeutic application of a drug on exposed tooth pulp in order to ensure the closure of the pulp chamber and to allow the healing process to take place. OBJECTIVE: The aim of this study was to examine the histological effects of Emdogain® on exposed tooth pulp of a Vietnamese pig (Sus scrofa verus). METHODS: The study comprised 20 teeth of a Vietnamese pig. After class V preparation on the buccal surfaces of incisors, canines and first premolars, pulp was exposed. In the experimental group, the perforations were capped with Emdogain® (Straumann, Basel, Switzerland), while in the control group pulp capping was performed with MTA® (Dentsply Tulsa Dental, Johnson City, TN, USA). All cavities were restored with glass-ionomer cement (GC Fuji VIII, GC Corporation, Tokyo, Japan). The observational period was 28 days, after which the animal was sacrificed and histological preparations were made. A light microscope was used to analyze dentin bridge formation, tissue reorganization and inflammation, and the presence of bacteria in the pulp. RESULTS: The formation of dentin bridge was observed in the experimental and control groups. Inflammation of the pulp was mild to moderate in both groups. Angiogenesis and many odontoblast-like cells, responsible for dentin bridge formation, were observed. Necrosis was not observed in any case, nor were bacteria present in the pulp. CONCLUSION: Histological analysis indicated a favorable therapeutic effect of Emdogain® Gel in direct pulp capping of Vietnamese pigs. Pulp reaction was similar to that of MTA®.
Paranoid Schizophrenia versus Schizoaffective Disorder: Neuropsychological Aspects.
Leposavić L, Leposavić I, Šaula-Marojević B … +1 more , Gavrilović P
Srp Arh Celok Lek · 2015 · PMID 26506747 · Publisher ↗
INTRODUCTION: Neuropsychological aspects of paranoid schizophrenia have still not been examined enough.These disorders are usually not studied separately, but are included in the studies about schizophrenic patients with...
INTRODUCTION: Neuropsychological aspects of paranoid schizophrenia have still not been examined enough.These disorders are usually not studied separately, but are included in the studies about schizophrenic patients with positive symptoms. Despite the fact that schizophrenia represents a heterogeneous group of mental disorders, usually it is not separated from schizoaffective disorder in neuropsychological researches. OBJECTIVE: The essence of this research is to evaluate cognitive functioning of patients with paranoid schizophrenia and schizoaffective disorder by applying neuropsychological tests. METHODS: The research included 91 subjects, right handed, from 30 to 53 years old, who were classified into three groups: inpatients with paranoid schizophrenia in remission (n=31), inpatients with schizoaffective disorder in remission (n=30) and healthy subjects (n=30). RESULTS: Both groups of patients showed poorer achievements than healthy subjects in most of the applied tests. Patients with schizoaffective disorder showed global loss of intellectual efficiency, executive dysfunction and compromised visual-construction organization. Patients with paranoid schizophrenia expressed partial loss of intellectual efficiency with verbal IQ and executive functions preserved. CONCLUSION: In the remission phase, patients with paranoid schizophrenia expressed cognitive disorders in moderate degree, but when it comes to patients with schizoaffective disorder, more massive cognitive, deficits were registered.
Midline Shift Threshold Value for Hemiparesis in Chronic Subdural Hematoma.
Juković MF, Stojanović DB
Srp Arh Celok Lek · 2015 · PMID 26506746 · Publisher ↗
INTRODUCTION: Chronic subdural hematoma (CSDH) has a variety of clinical presentations, with numerous neurological symptoms and signs. Hemiparesis is one of the leading signs that potentially indicates CSDH. OBJECTIVE: P...
INTRODUCTION: Chronic subdural hematoma (CSDH) has a variety of clinical presentations, with numerous neurological symptoms and signs. Hemiparesis is one of the leading signs that potentially indicates CSDH. OBJECTIVE: Purpose of this study was to determine the threshold (cut-off) value of midsagittal line (MSL) shift after which hemiparesis is likely to appear. METHODS: The study evaluated 83 patients with 53 unilateral and 30 bilateral CSDHs in period of three years. Evaluated computed tomography (CT) findings in patients with CSDH were diameter of the hematoma and midsagittal line shift, measured on non-contrast CT scan in relation with occurrence of hemiparesis. Threshold values of MSL shift for both types of CSDHs were obtained as maximal (equal) sensitivity and specificity (intersection of the curves). RESULTS: MSL is a good predictor for hemiparesis occurrence (total sample, AUROC 0.75, p=0.0001). Unilateral and bilateral CSDHs had different threshold values of the MSL for hemiparesis development. Results suggested that in unilateral CSDH the threshold values of MSL could be at 10 mm (AUROC=0.65; p=0.07). For bilateral CSDH the threshold level of MSL shift was 4.5 mm (AUROC=0.77; p=0.01). CONCLUSION: Our study pointed on the phenomenon that midsagittal line shift can predict hemiparesis occurrence. Hemiparesis in patients with bilateral CSDH was more related to midsagittal line shift compared with unilateral CSDH. When value of midsagittal line shift exceed the threshold level, hemiparesis occurs with certain probability.
Changes Needed in the Classification of Anxiety Disorders in Childhood: Options for ICD-11.
Stanković M, Grbeša G, Kostić J … +2 more , Stanković S, Stevanović J
Srp Arh Celok Lek · 2015 · PMID 26259415 · Publisher ↗
Considering the intensive preparation of the 11th revision of the International Classification of Diseases (ICD-11), we discussed the justification of the existing classification of emotional disorders with onset specifi...
Considering the intensive preparation of the 11th revision of the International Classification of Diseases (ICD-11), we discussed the justification of the existing classification of emotional disorders with onset specific to childhood. This paper presents the citations from the ICD-10 (F93 block) and the authors' comments as a critical review of the justification of further existence of emotional disorders with onset specific to childhood as a separate block in ICD-11 classification. We concluded that the block F93 is insufficiently defined and should be completely changed or removed from the ICD-11 classification. Additionally, the specificities of the clinical picture of anxiety disorders in children should be adequately described within the future category of anxiety and phobic disorders by giving an explicit set of instructions for identifying clinical manifestations which vary by age.
Salt Content in Ready-to-Eat Food and Bottled Spring and Mineral Water Retailed in Novi Sad.
Paplović LB, Popović MB, Bijelović SV … +2 more , Velicki RS, Torović LD
Srp Arh Celok Lek · 2015 · PMID 26259414
INTRODUCTION: Salt intake above 5 g/person/day is a strong independent risk factor for hypertension, stroke and cardiovascular diseases. Published studies indicate that the main source of salt in human diet is processed...
INTRODUCTION: Salt intake above 5 g/person/day is a strong independent risk factor for hypertension, stroke and cardiovascular diseases. Published studies indicate that the main source of salt in human diet is processed ready-to-eat food, contributing with 65-85% to daily salt intake. OBJECTIVE: The aim of this paper was to present data on salt content of ready-to-eat food retailed in Novi Sad, Serbia, and contribution of the salt contained in 100 g of food to the recommended daily intake of salt for healthy and persons with cardiovascular disease (CVD) risk. METHODS: In 1,069 samples of ready-to-eat food, salt (sodium chloride) content was calculated based on chloride ion determined by titrimetric method, while in 54 samples of bottled water sodium content was determined using flame-photometry. Food items in each food group were categorized as low, medium or high salt. Average salt content of each food group was expressed as a percentage of recommended daily intake for healthy and for persons with CVD risk. RESULTS: Average salt content (g/100 g) ranged from 0.36 ± 0.48 (breakfast cereals) to 2.32 ± 1.02 (grilled meat). The vast majority of the samples of sandwiches (91.7%), pizza (80.7%), salami (73.9%), sausages (72.9%), grilled meat (70.0%) and hard cheese (69.6%) had a high salt profile. Average amount of salt contained in 100 g of food participated with levels ranging from 7.2% (breakfast cereals) to 46.4% (grilled meat) and from 9.6% to 61.8% in the recommended daily intake for healthy adult and person with CVD risk, respectively. Average sodium content in 100 ml of bottled spring and mineral water was 0.33 ± 0.30 mg and 33 ± 44 mg, respectively. CONCLUSION: Ready-to-eat food retailed in Novi Sad has high hidden salt content, which could be considered as an important contributor to relatively high salt consumption of its inhabitants.
[Poor Ovarian Response to Stimulation for In Vitro Fertilization].
Spremović-Radjenović S, Bila J, Gudović A … +3 more , Vidaković S, Dokić M, Radunović N
Srp Arh Celok Lek · 2015 · PMID 26259413 · Publisher ↗
The term "poor respond (POR) patients" is used for the group of women who respond badly to usual doses of gonadotropins in in vitro fertilization (IVF) treatments; the consequence is low pregnancy rate. A consensus was r...
The term "poor respond (POR) patients" is used for the group of women who respond badly to usual doses of gonadotropins in in vitro fertilization (IVF) treatments; the consequence is low pregnancy rate. A consensus was reached on the minimal criteria needed to define POR. At least two of the following three features must be present: 1. advanced maternal age (40 years or more) 2. previous POR (3 or less oocytes with a conventional stimulation protocol) 3. abnormal ovarian reserve (AMH 0.5-1.1 ng/ml or AFC 5-7).The aim is to find better therapeutic options for these patients. Increased levels of day 3 follicle stimulating hormone (FSH) and estradiol (E2), as well as decreased levels of anti-Müllerian hormone (AMH) and antral follicle count (AFC), can be used to assess ovarian reserve, as indirect predictive tests. A larger number of well designed, large scale, randomized, controlled trials are needed to assess the efficacy of different management strategies for poor responders: flare up gonadotropin releasing hormone (GnRH) agonist protocols, modified long GnRH agonist mini-dose protocols, luteal initiation GnRH agonist stop protocol, pretreatment with estradiol--GnRH antagonist in luteal phase, natural cycle aspiration or natural cycle aspiration GnRH antagonist controlled, adjuvant therapy with growth hormone or dehydroepiandrosterone (DHEA). The results of up to now used protocols are unsatisfactory and stimulation of the ovulation in poor responders remains a challenge, especially when bearing in mind that in the majority of cases the patients will be menopausal in relatively short period of time.
[Cardiac Manifestations in Antiphospholipid Syndrome--A Brief Review of the Literature].
Djoković A, Stojanović L
Srp Arh Celok Lek · 2015 · PMID 26259412 · Publisher ↗
Antiphospholipid syndrome (APS) or Hughes syndrome represents a systemic autoimmune disorder characterized by arterial and/or venous thrombosis, multiple and recurrent fetal losses, accompanied by persistently elevated l...
Antiphospholipid syndrome (APS) or Hughes syndrome represents a systemic autoimmune disorder characterized by arterial and/or venous thrombosis, multiple and recurrent fetal losses, accompanied by persistently elevated levels of antiphospholipid antibodies (aPL). This syndrome is considered primary if unassociated with any other connective tissue disease, or secondary if it appears in association with other autoimmune disorders, mainly systemic lupus erythematosus. Cardiac manifestations in APS are integral part of the syndrome. aPL are involved in the pathogenesis of pseudoinfective endocarditis (Libman Sacks) and other valvular manifestations presented as their thickening and dysfunction. Intracardiac thrombi and myxomas, pulmonary hypertension and left ventricular dysfunction are also distinguishing features of APS. On the other hand, accelerated atherosclerosis, proven in APS and also aPL mediated, is accountable for the development of coronary and peripheral artery disease. This leads to higher cardiovascular mortality rate in the population of patients with low incidence of the traditional atherosclerosis risk factors. Furthermore, recent studies implied that presence of certain aPL could be a risk factor for a specific cardiac manifestation. Bearing all this in mind, early diagnosis of cardiac manifestations, control and abolition of traditional risk factors, as well as close cardiac follow-up of APS patients, are crucial in reducing their cardiovascular mortality.
[Favorable Outcome of Hepatosplenic Candidiasis in a Patient with Acute Leukemia].
Čolović N, Arsenijević VA, Suvajdžić N … +2 more , Djunić I, Tomin D
Srp Arh Celok Lek · 2015 · PMID 26259411 · Publisher ↗
INTRODUCTION: Acute leukemias treatment requires strong chemotherapy. Patients that develop bone marrow aplasia become immunocompromised, thus becoming liable to bacterial and fungal infections. Fungal infections caused...
INTRODUCTION: Acute leukemias treatment requires strong chemotherapy. Patients that develop bone marrow aplasia become immunocompromised, thus becoming liable to bacterial and fungal infections. Fungal infections caused by Candida are frequent. Hepatosplenic candidiasis (HSC) is a frequent consequence of invasive candidiasis which is clinically presented with prolonged febrility unresponsive to antibiotics. CASE OUTLINE: A 53-year-old patient with acute myeloid leukemia was submitted to standard chemotherapy "3+7" regimen (daunoblastine 80 mg i.v. on days 1 to 3, cytarabine 2 x 170 mg i.v. during 7 days) and achieved complete remission. However, during remission he developed febrility unresponsive to antibiotics. Computerised tomography (CT) of the abdomen showed multiple hypodense lesions within the liver and spleen. Haemocultures on fungi were negative. However, seroconversion of biomarkers for invasive fungal infection (FI) (Candida and Aspergillus antigen/Ag and antibody/Ab) indicated possible HSC. Only high positivity of anti-Candida IgG antibodies, positivity of mannan and CT finding we regarded sufficient for the diagnosis and antimycotic therapy.Three months of treatment with different antimycotics were necessary for complete disappearance of both clinical symptoms and CT findings. CONCLUSION: In patients with prolonged febrile neutropenia IFI has to be strongly suspected. If imaging techniques show multiple hypodense lesions within liver and spleen, HSC has to be taken seriously into consideration. We believe that, along with CT finding, positive laboratory Candida biomarkers (mannan and IgG antibodies) should be considered sufficient for"probable HSC" and commencement of antifungal therapy, which must be long enough, i.e. until complete disappearance of clinical symptoms and CT findings are achieved.
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