bluuebunny/crossref_metadata_2025 huggingface dataset:
Children without parental care as a vulnerable category
Authors: Kvrgic Svetlana , Jovovic Jelena
Published: July 2006

Introduction Health protection and health promotion are the primary goals of modern medicine. Since children's health is the cornerstone of adult's health, it must be in the center of all social and health care strategies. Vulnerability concept Vulnerability means exposure to harmful influences, risks or stress, which increases disease probability. The most vulnerable are categories that are exposed to influence of many harmful factors, which have minimal chances for survival and lowest quality of life. Vulnerability of children without parental care Vulnerability of children without parental care is caused by lack and/or inadequate family environment. These children are usually emotionally unstable; they frequently develop conduct disorders and have low self-esteem. As adolescents, these children have tendency to risky behavior, which greatly decreases their health potentials. Health status and quality of life All three components of health are endangered with children without parental care. These children present with physical, psycho-motoric and intellectual impairments. There are no studies about quality of life regarding these children, but we can assume that their quality of life is lower than in children who experience protective family environment, since quality of psychosocial factors and family environment are very important predictors of quality of life. Conclusion Children without parental care are an extremely vulnerable category, because they are subjected to various risk factors. Therefore, in order to improve health potentials and quality of life, special measures are required in health care, psychological care and social welfare.
Research on psychopathological consequences of refugeeism
Authors: Opalic Petar
Published: July 2006

The study examined mental and psychopathological consequences of refugeeism and included (109) refugees from refugee camp in Krnjaca. Their reactions were compared with the reactions of (70) somatically injured patients from Orthopedic Hospital of the Clinical Centre in Belgrade and subjects (105) from Belgrade denying any traumatic experience whatsoever. Apart from the questionnaire on socio-demographic features, subjects were asked to provide answers to Post Traumatic Stress Disorder (PTSD-10) scale, Brief Eysenck?s Personality Inventory, Family Homogeneity Inventory and Impact of Events Scale. By implementation of appropriate statistical procedures (variance analysis), the significance of differences among certain features within the experimental group of refugees was examined, as well as the difference concerning presence of mental and psychopathological features among all three subgroups. It was determined that within the refugee group, males more significantly and more frequently reacted with PTSD symptoms, as well as with signs of general neuroticism and that married refugees more frequently presented with PTSD symptoms. In comparison to non-refugees, refugees more significantly and more frequently present with PTSD symptoms, which is probably caused by PTSD chronicity in this category of subjects. Subjects denying any significant traumatic experience in their lives presented with symptoms of general neuroticism more than the rest of examinees. This is an interesting finding that can be explained by the fact that the same group achieved the highest values on the extraversion scale (using the same Eysenck instrument), or may be correlated to the increase of neurotic reactions in the whole population of Serbia and Montenegro. The above mentioned and other results were compared to the findings of similar researches performed by other authors.
Obesity and hormonal status of patients with polycystic ovary syndrome
Authors: Radulovic Aleksandar , Bogavac Mirjana , Pjevic Mirko , Andjelic Luka
Published: July 2006

Introduction Polycystic ovary syndrome is commonly associated with hyperandrogenism and anovulation. The aim of this study was to investigate the impact of obesity on hormonal status in patients with polycystic ovary syndrome. Material and methods The study was performed at the Ward of Obstetrics and Gynecology of the General Hospital in Subotica. A retrospective investigation comprised 39 patients with polycystic ovary syndrome . All patients were in the fertile age-range: 18-38 years. Following ultrasonographic examination and anamnestic data, patients underwent hormonal analyses of follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, prolactin and insulin obtained from the pooled serum sample. Results Values of testosterone and insulin in the group of obese patients with polycystic ovary syndrome were significantly higher than in normal weight patients. Patients with normal body weight index had significantly increased levels of LH in regard to those with increased body weight index. Values of FSH, prolactin and LH/FSH ratio were not significantly different in both groups of polycystic ovary syndrome patients. Increased values of insulin were recorded in 43% of obese and 18.2% of normal weight patients. Conclusion Analysis of investigated results confirmed that obese patients with polycystic ovary syndrome and insulin resistance have been a special clinical entity, whereas an open question remains whether obesity is directly connected with polycystic ovary syndrome or it is only an additional factor interfering with metabolic and hormonal status of genetically predisposed and phenotypically indoctrinated women with polycystic ovary syndrome.
The importance of dynamometry during medical rehabilitation of stroke patients
Authors: Tomasevic Snezana , Filipovic Danka , Hajdu Laslo , Naumovic Nada
Published: July 2006

Introduction Rehabilitation centers pay great attention to recovery of motor functions. Dynamometry is used for monitoring and objective overall assessment of damage and recovery of motor functions. Material and methods The aim of this investigation was estimation of upper limb muscle strength, with stroke patients during medical rehabilitation. It included 80 right-handed examinees of certain age and sex distribution. The clinical part of examination estimated motor recovery, applying Signe-Brunnstr?m staging, as well as estimation of upper limb muscle strength, using dynamometry during inpatient rehabilitation. Results Average values of muscle strength of the affected hand with patients who had right-sided hemiparesis increased by 22.01%, whereas with patients who had left-sided hemiparesis by 36.38%, compared with values from the beginning of treatment. Examination results showed that muscle strength values in both hands after rehabilitation were statistically, considerably improved (p<0.05), compared with the results from the beginning of treatment. However, they did not reach values of the control group. Discussion and Conclusion Muscle strength improvement at the end of treatment is affected by complex changes of the neural system, leading to lesion regression, as well as by positive effects of rehabilitation treatment. Result of examination help decision making regarding treatment duration and speak in favor of early rehabilitation applying facilitation techniques for fast and significant recovery.
Low-intensity laser therapy of pleuritis
Authors: Milojevic Momir , Kuruc Vesna
Published: July 2006

Introduction Low-intensity lasers have been utilized in medicine in two ways: for local stimulation and for stimulation of acupuncture points. Literature data reveal that this method has been indiscriminately applied in physiatry, rheumatology, gynecology, dermatology, otorhinolaryngology, in diverse acute and chronic pains, inflammations, vascular disorders, angina pectoris, bronchial asthma. Most commonly reported clinical effects are analgesia, spasmolytic and anti-inflammatory effects, as well as faster wound and bone healing. Material and methods This prospective study analyses effects of laser biostimulation on patients with pleurisy. The analysis included 25 patients treated at the Institute of Lung Diseases in Sremska Kamenica during 2000, 2001 and 2002. Appart from conservative treatment, these patients were treated with laser biostimulation of acupuncture points and local region for ten days. During treatment, changes of present clinical signs, general symptoms, radiological findings, as well as changes of some relevant biochemical parameters were recorded. Results Results were compared with the control group which included the same number of patients, who differed from the examined group only by not being exposed to laser biostimulation. The examined group of patients with pleuritis presented with quicker resorption of pleural effusion, less pleural adhesions, more significant decrease of clinical symptoms, especially pain, as well as more significant increase of cortisol and immunoglobulin A and decrease of circulating immune complexes (CIC), leukocytes and sedimentation rate than the control group. Discussion Mechanisms of laser biostimulation in treatment of pleurisy were described in detail and the obtained results were correlated to those reported by other authors. Conclusion 1. Patients with pleurisy undergoing laser stimulation presented with faster resorption of effusion and remission of the subjective symptoms, as well as significant decrease of biochemical acute inflammation parameters in the peripheral blood and therefore with faster recovery. 2. In patients with pleurisy laser treatment increases regenerative mechanisms of the pleural surface, thus decreasing the quantity of formed adhesions and resulting in better mobility of the diaphragm.
Forensic significance of skull development abnormalities
Authors: Pilija Vladimir , Vukovic Radenko , Mihalj Marija , Savovic Slobodan , Eric Mirela
Published: July 2006

Introduction In the course of bone tissue development some genetic disorders such as exostoses and enostoses, may occur. Exostoses and enostoses represent bone tissue hyperplasia that can develop at any part of skeleton. Neurotrauma can cause fatal biological consequences, which is directly associated with skull development abnormalities. Case report This is a case report of a male cadaver 36 years of age. The autopsy revealed massive hemorrhage on the left side of the neck and the right side of the lower jaw. A major fissure of the arterial wall was found on the basilar artery. A bony, wart-like excrescence was found on the clivus of the occipital bone. Discussion Coinciding ruptures and consequential bleeding from basilar artery with presence of development abnormalities in the clivus region, suggest that one has to clearly distinguish the result of the injury from anomalies already existing in the skull. The position of the attacker can be determined by concise and objective investigation. Conclusion This is a case report of an anomaly in bone development: a bony, wart-like excrescence on the right side of the clivus. Due to neurotrauma and consequential sliding of brain structures, the damage of basilar artery and of the bony excrescence occurred, which led to bleeding and fatal outcome.
Preeclampsia and eclampsia in parturients from the in vitro fertilization program
Authors: Tabs Dunja , Vejnovic Tihomir , Radunovic Nebojsa
Published: July 2006

Women from in vitro fertilization program are at higher risk for developing pregnancy induced hypertension, so we analyzed the incidence of preeclampsia and eclampsia in women who conceived in an in vitro fertilization program. A seven-year study included 144 parturients from in vitro fertilization program. The control group consisted of 39.112 parturients from general population. We analyzed only women with singleton pregnancies. There were 2.08% parturients from the in vitro fertilization program, and 0.40% from the control group, with diagnosis of preeclampsia, withc2=6,24; p0,10). Parturients from in vitro fertilization program are at statistically significantly higher risk for preeclampsia, but not for eclampsia, when compared with women from general population.
Corticosteroid therapy of zoster-associated pain
Authors: Cvjetkovic Dejan , Jovanovic Jovana , Hrnjakovic-Cvjetkovic Ivana , Djordjevic-Aleksic Mirjana , Radojcic Aleksandra , Bogdanovic Mirjana
Published: July 2006

Introduction Lack of exact clinical studies on effects of corticosteroids in therapy and prevention of herpes zoster-related pain, elicited many controversies in the past. The aim of our study was to estimate effects of prednisone on frequency, intensity and duration of postherpetic neuralgia. Material and methods 68 immunocompetent herpes zoster patients, 8-90 years of age (37 females and 31 males, mean age 55,7 years) were enrolled for study; 30 patients were treated with acyclovir (5x800 mg daily for a 7-day period) and prednisone (initial daily dose 60 mg, tapering over 14 days), and the control group of 38 patients with acyclovir only. Patients were clinically followed up for 3 months after complete resolution of skin lesions. Chi-square test was used in statistical data analysis. Results The difference regarding incidence of postherpetic neuralgia in acyclovir/prednisone group and acyclovir group (although slightly less in the former one) was not significant. Duration of postherpetic neuralgia over 3 months was similar in both groups. Mild postherpetic pain was more common in the acyclovir/prednisone group (44.4%) than in the acyclovir group (28.6%); however, statistical validation requires more patients to be studied. Discussion Results of our study didn?t confirm efficiency of prednisone regarding occurrence and characteristics of postherpetic neuralgia. Failure of prednisone therapy may be partly contributed to advanced age of patients and delayed onset of therapy. Conclusion Use of corticosteroids in zoster patients gives neither reliable protection from appearance of postherpetic neuralgia, nor shortens its duration. Further investigations are necessary to estimate their effects on postherpetic pain.
Neurotoxic effects of organic solvents among workers in paint and lacquer manufacturing industry
Authors: Jovanovic Jovica , Jovanovic Milan
Published: July 2006

Introduction Organic solvents are chemically different compounds with one common feature: they dissolve fats, oils, resins, cellulose acetate and cellulose nitrate, which makes them widely used in industry. Most often organic solvents are used in paint and lacquer industries, in production of pesticides, plastics, explosives, rubber, cellulose, air conditioners, in pharmaceutical industry and in leather industry. The aim of this research was to analyze the working environment and professional hazards in paint and lacquer manufacturing industry and evaluate effects of chronic exposure to mixture of organic solvents on nervous system of exposed workers. Methodology The exposed group consisted of 50 workers professionally exposed to these noxae, while the control group consisted of 30 workers who have never been exposed to these noxae. Results Examination of working environment in departments of paint and lacquer manufacturing revealed presence of white spirit and toluene above allowed levels. Exposed workers more frequently complained of fatigue, hand numbness, enhanced excitation, and concentration difficulties, forgetfulness and headaches, than workers from the control group. Electroneurographic examination of n. medianus showed reduced motor and sensitive conduction velocity among exposed in comparison to workers from the control group. Reduced motor and sensitive conduction velocity was correlated with duration of exposure to these noxae. Terminal latency of n. medianus was statistically, significantly longer in the exposed group than in the control group. Workers in the exposed group have statistically significantly longer reaction time in response to acoustic and visual stimuli. Discussion Segmental demyelination and axonal degeneration, as forms of damage to peripheral nerves, were identified as responsible for peripheral neuropathy associated with occupational exposure to organic solvents. Conclusion Results of this study show possible neurotoxic effects of noxae detected in the phase of analysis of working conditions and working environment of examined workers.
The role of parasites and fungi in secondary infertility
Authors: Kranjcic-Zec Ivana , Dzamic Aleksandar , Mitrovic Sanja , Arsenijevic-Arsic Valentina , Radonjic Ivana
Published: July 2006

Introduction Parasite-host relationships can cause diminished or absent ability to conceive, ectopic pregnancy or pregnancy with undesired course. Literature review There are reports that some protozoa, helminths and fungi may impair women's reproductive capacity, causing deformites of genital tract, so that conception is impossible, or, if it does occur, normal implantation and development of placenta are impossible. Schistosoma haematobium may cause vulvar papule, swelling, tumors, irregular vaginal hemorrhage, tubular infertility and ectopic pregnancies. Patients with cirrhosis caused by schistosomas have gonadal dysfunction and schistosomiasis itself can lead to tubular infertility. Some authors found microfilaria of Mansonella perstans in folicular aspirates in patients with tubular adhesions. Chronic Entamoeba histolytica infection can cause pelvic pain and dyspareunia in some patients. Although Trichomonas vaginalis is a common cause of tubal inflammation, this protozoa affects semen quality and leads to secondary infertility. Soluble parasite extract of T. vaginalis can lead to impaired motility of 50% spermatozoa in vitro and affects semen quality by increased viscosity and amount of debris, or damage spermatozoid membrane. In enterobiosis, presence of adult worms and eggs in fallopian tube, can be followed by chronic salpingitis and tubal occlusion. Also in ascariosis, presence of adult forms and eggs can lead to acute colpitis, chronic endometritis, salpingitis or ovarian abscess. The concequence of fungal infections, such as colpitis and endometritis, caused by Candida albicans, may be infertility. Also, according to some reports, C. albicans leads to decreased spermatozoan motility. Conclusion Hence parasites and fungi can cause infertility, we recommend examination of both partners in treatment of infertility.
New knowledge on the diagnosis of oral leukoplakia
Authors: Bokor-Bratic Marija , Vuckovic Nada
Published: July 2006

Introduction There have been many discussions and debates in the literature over appropriate criteria for diagnosing oral leukoplakia and for predicting its prognosis. Clinical aspects In general, two clinical variants of leukoplakia are being recognized: the homogeneous and non-homogeneous type. Clinical subdivisions of leukoplakia in these two types can be used for cases in -which no biopsy is available. Diagnostic procedures A 2-4 week interval to observe a possible regression or disappearance of a white lesion, after elimination of possible causative factors, seems to be a fully acceptable period of time before taking a biopsy. Taking a biopsy in homogeneous leukoplakia and espacially non-homogeneous leukoplakia should be a standard rule. It is recommended that the histologie report should include a statement on absence or presence of epithelial dysplasia and an assessment of its severity. This recommendation -was made in order to provide a classification and staging system reflecting the size and histopathologic findings. disappearance of a white lesion, after elimination of possible.
Pin fixation in treatment of dislocated lateral condyle of the humerus in pediatric population
Authors: Gajdobranski Djordje , Maric Dusan , Tatic Milanka , Zivkovic Dragana , Mikov Aleksandra , Nedeljkovic Miroslav
Published: July 2006

Introduction Fractures of lateral condyle represent 17% of all pediatric fractures of the distal humerus, and in current pediatric orthopedics there is still no agreement regarding optimal treatment modalities. We presented a treatment protocol for pediatric dislocated fractures of the lateral condyle of the humerus used at the Pediatric Surgery Clinic in Novi Sad. Material and methods Over the study period (1991-2000) a total of 48 patients with dislocated fractures of the lateral condyle of the humerus were hospitalized at the Pediatric Surgery Clinic. Orthopedic reduction and percutaneous pin fixation under radiological supervision was done in 15 patients, while 33 patients needed surgical reduction and pin fixation. Results Satisfactory results were obtained in 42 patients (91.3%), out of which 29 patients (63.1%) presented with excellent resuls. Good results were obtained in 8 patients (17.4%), and fair results in 5 patients (10.8%). Unsatisfactory results were present in 4 patients (8.7%). Two patients were lost to follow-up. Discussion Dislocation fractures of the lateral condyle represent high risk for development of complications. Adequate diagnosis and treatment represent basic conditions for successful post-interventional result. Orthopedic reduction with percutaneous pin fixation is recommended for fractures that may be anatomically reduced. In cases of unsatisfactory results of reduction, as well as in cases with completely dislocated and rotated fragments, surgical reduction and pin fixation is necessary. Conclusions Satisfactory results in 91.3% of cases, and long-term experience suggest that the recommended therapeutic option is adequate in treatment of dislocated fractures of the lateral condyle of the humerus in pediatric population.
Identification of anti-HLA-A1 antibodies in a multi-transfused patient: Case report
Authors: Vojvodic Svetlana , Popovic Stevan , Urosevic Ivana
Published: July 2006

Introduction HLA antibodies develop as a result of alloimmunization to HLA class I and II antigens. Their appearance is associated with frequent blood transfusions, allogeneic tissue and organ transplantation, pregnancy and immunization. It is established that after usage of single dose HLA nonmatched leukocytes, circulating lymphocytotoxic antibodies appear in serum of recipients, 10 to 12 days after alloimmunization. Case report This article describes a case report of a multi-transfused patient, with identified HLA-A1 antibodies established by using microlymphocytotoxicity test and two different panels of HLA typed lymphocytes. The case report shows occurrence of febrile posttransfusion nonhemolytic reaction (FNHTR) in our patient after application of 410 ml resuspended erythrocytes. After transfusiologists recommendations for detecting lymphocytotoxic antibodies in patient's serum, we determined a specificity of monospecific antibody which caused posttrasnfusion FNHTR. Discussion and conclusion FNHTR may be caused by antileukocyte antibodies or immunoinflammatory cytokines. It is more frequent in patients receiving platelet concentrates (15-30%) than those receiving red blood cell products (1%). This case report shows that FNHTR was caused by HLA-A1 antibody in a patient who received 111 various blood products.
Sexual behavior of adolescents
Authors: Mijatovic-Jovanovic Vesna , Ukropina Snezana , Kvrgic Svetlana , Surkovic-Niciforovic Olja
Published: July 2006

Introduction Numerous studies have shown that sexual behavior increases among adolescents. Disharmony between biological and psychosocial maturity among young people may cause risky behavior, and endanger psychophysical and reproductive health of young persons. Material and methods A questionnaire on sexual behavior was completed by 169 adolescents, 1st and 4th year high school students. Results Every 6th first grade and every 2nd forth grade adolescent is sexually active. Male adolescents begin sexual activities significantly earlier (at the age of 15.6) than female adolescents (16.5). Also, young men have significantly more partners (3.6) than girls (1.3), and more parallel sexual relations than girls. Only 1/3 of sexually active adolescents always use some kind of contraception, more frequently boys (41.9%) than girls (26.7%). Discussion Early commencement of sexual activity results with longer active period before realization of the reproductive function, which increases risk for reproductive health disorders. Unprotected sexual intercourse and large number of partners also present significant risk factors. Conclusion Sexual life of adolescents begins at the age of 16, on average, and only every third always uses contraceptive protection, which points to a need for better education on reproductive health by using contemporary methods. It is also necessary to increase availability of contraceptives (condoms) at all places where adolescents spend time (in schools, bars, cinemas, disco clubs etc.) in order to achieve responsible sexual behavior and protection of reproductive health among youth.
The role of laparoscopy in gynecologic oncology
Authors: Zivaljevic Milica , Majdevac Ivan , Novakovic Petar , Vujkov Tamara
Published: July 2006

In some patients and when performed by a skillful surgeon, gynecologic oncologist familiar with advanced laparoscopic techniques, laparoscopy results with less surgical trauma, reduced blood loss and hospitalization, and faster recovery. The complication rate has been found to increase as the complexity of the operation rises, but it is not higher than in open surgery. Preliminary studies show that recurrence and survival rates are comparable to those reported for patients treated by a standard abdominal approach. Future randomized trials are necessary to deal with long term recurrences and survival data and benefits of laparoscopy in management of gynecologic malignancies. At our institution 97 cancer patients underwent laparoscopic procedures, without complications: explorative and staging laparoscopies with biopsies of ovaries, peritoneal biopsies, retroperitoneal and mesenteric tumors; second look laparoscopy, ovariectomy, laparoscopic assisted vaginal hysterectomy (LAVH). Advanced ovarian cancer was found in 3 patients and laparotomy was performed. No complications were stablished.
Histological characteristics of oral leukoplakia
Authors: Vuckovic Nada , Bokor-Bratic Marija , Vuckovic Dejan
Published: July 2006

Introduction Leukoplakia (LKP) is defined as a white patch or plaque on the mucosa of oral cavity, vulva, vagina etc., which cannot be removed and cannot be clinically or microscopically explained by presence of a disease. LKP is included in the group of lesions with malignant potential. Microscopic characteristics Basic microscopic characteristics of oral LKP include hyperkeratosis of ortho- or parakeratotic type and acanthosis of the epithelium, with various degrees of chronic inflammatory infiltrates in lamina propria. Also, various degrees of epithelial dysplasia may occur. Some of the most important microscopic characteristics of dysplasia are: loss of polarity of basal cells, increased nuclear cytoplasmic ratio, irregular epithelial stratification, increased number of abnormal mitotic figures and their presence in the superficial epithelium, cellular and nuclear pleomorphism, keratinization of single cell groups. Malignant potential LKP is the most common oral mucosal lesion (evident in 3% of adults). At the same time, up to 85% of all precancerous lesions are manifested as LKP. Overall malignant potential of LKP does not exceed 4%, but some authors found that even 16% LKP with some degree of dysplasia, have a potential to transform to carcinoma. Microscopic differential diagnosis The most important differential diagnostic criteria are listed for lesions with similar microscopic appearance. Conclusion Nowdays LKP is diagnosed more frequently than before, probable due to a better patients' education and dentists' caution, but not due to real increase in incidence.
Possibilities of endoscopic treatment of primary vesicoureteral reflux
Authors: Varga Jan , Zivkovic Dragana , Dobanovacki Dusanka , Petrovic Slobodan
Published: July 2006

Introduction Vesicoureteral reflux, urinary infection and pyelonephritic scarring represent a well known triad in pediatric practice that may lead to severe scarring of kidneys, and development of so called reflux nephropathy. Apart from standard therapeutic options (conservative treatment and surgical therapy), endoscopic correction of refluxing vesicoureteral junction has been introduced into clinical practice. Material and methods This study included endoscopically treated patients with primary vesicoureteral reflux over a 9-year period, as well as certain clinical parameters. Results Endoscopic correction of primary vesicoureteral reflux with teflon paste has been successful in up to 93.5% of patients. After one application vesicoureteral reflux disappeared in 58.8% of cases. After two applications 86.0% of ureters were cured, whereas the third application had no further effect on existing reflux. Improvement with spontaneous regression of reflux was established in 7.5% of treated ureters. Discussion Endoscopic correction should be performed in all patients with third grade vesicoureteral reflux, and in selected patients with second and fourth grade reflux. First grade reflux should be treated conservatively, and fifth grade reflux should be treated surgically. Conclusion Endoscopic treatment of primary vesicoureteral reflux is an easy, simple, fast and safe procedure that prevents regurgitation of urine from bladder to upper parts of the urinary system in most of cases.
Sense of smell in patients with bilateral nasal polyposis
Authors: Savovic Slobodan , Pilija Vladimir , Buljcik Maja , Kljajic Vladimir , Lemajic Slobodanka
Published: July 2006

Introduction Sense of smell is susceptible to various changes, both in physiological and in numerous pathological conditions. Of quantitative disorders of smell, hyposmia and anosmia are quite common, whereas of qualitative disorders parosmia is most frequent. The aim of this paper was to examine impact of bilateral nasal polyposis on olfactory function. Material and methods The research was carried out at the Nose, Ear and Throat Clinic in Novi Sad. It included 80 examinees, 40 (20 male, 20 female) with bilateral nasal polyposis, while 40 examinees belonged to the control group (20 male, 20 female) without symptoms of nasal polyposes. Fortunato-Niccolini olfactometer was used for this examination. Results and discussion In patients with bilateral nasal polyposis the average perception threshold values for examined odors were 15.50 ccm of odorous air, while in the control group they were 10,20 ccm of odorous air. The average identification threshold values for examined odors in patients with bilateral nasal polyposis were 18.80 ccm of odorous air, while in the control group they were 13.55 ccm of scented air. T-test showed that values of both tresholds were statistically significantly higher (p< 0,01) in patients with bilateral nasal polyposis in relation to the control group. Conclusion Olfactory deficit in patients with bilateral nasal polyposis is explained by difficult or impossible passage of odors into the olfactory region.
Heredity of psoriasis
Authors: Belic Dobrila , Ristic-Nikolic Sonja , Damjan Saveta , Ratkov Iljana , Ceke Matilda
Published: July 2006

INTRODUCTION Epidemiological studies of twins show that there is a genetic predisposition to psoriasis. Researches conducted so far show that psoriasis is a multifactorial polygenetic disease with reduced gene penetration. They also show that heredity is more significant than the "trigger" factor whose influence is limited to the exchange of phenotypes. Researches in USA, Canada and Europe identified four most important loci (psoriasis susceptibility - 1-4). At least one is in MHC (major histocompatibility complex) due to the connection between psoriasis and alleles of human leukocyte antigen (HLA). OBJECTIVE Our study included 117 patients and examined the indicators of genetic predisposition to psoriasis: frequency of psoriasis among relatives of psoriatic probands; frequency of psoriasis among relatives (I and II degree) of psoriatic patients; age of probands and other relatives at the onset of illness. Material and methods We have used a structured questionnaire for collection of data about existence of psoriasis in relatives of I and II degree of psoriatic probands and about the age of probands and relatives at the time of onset. Results and discussion Twenty six (21.85%) probands have at least one ill relative. The examined patients who have diseased relatives get ill much earlier than those who do not. Probands with two or more diseased relatives get ill much earlier than those who have just one diseased relative. Analysis of our sample shows a significant statistical difference regarding the onset of illness of diseased parents and their children. Children get ill earlier. CONCLUSIONS We have concluded that in our sample there is a hereditary component which is related to frequency and onset of psoriasis.
Parent-child parallel nutritional status assessment using silhouette rating scales
Authors: Jorga Jagoda , Marinkovic Jelena , Maksimovic Milos , Kentric Brana , Djordjevic Ivana
Published: July 2006

Introduction The aim of this study was to determine the validity of silhouettes in assessing genetic factors of obesity in school children aged 12-14. Material and methods 290 primary school students aged 12-14 from Belgrade had undergone body height and weight measurements as well as answering questionnaires. Silhouette rating scales were used to assess the nutritional status of students (6-silhouette scale) and their parents (9-silhouette scale). Results Significant differences in body mass index (BMI) were found among children whose parents had been rated "normal" and those rated ?problematic?. BMI status and gender significantly affected assessment of the nutritional status. An interaction between factors was found (F (1.230) =7.017, p<0.01). The majority of children from the normal BMI category (64.5%) selected silhouettes 3 and 4 to describe their current appearance. On the other hand, 70% of children with problematic BMI selected silhouettes 5 and 6. Girls generally selected significantly smaller silhouettes than boys. Girls within the problematic BMI category selected significantly bigger silhouettes for their mother's than the other children. Boys within the normal BMI category, selected significantly bigger silhouettes representing their father?s body size. Discussion According to the results, silhouette rating scales appear to be reliable in parallel assessment of the nutritional status of children and their parents. This subject can be further developed by acquiring data on parents` height and body mass.
Acquired amegakaryocytic thrombocytopenia: Three case reports and a literature review
Authors: Antonijevic Nebojsa , Terzic Tatjana , Jovanovic Vesna , Suvajdzic-Vukovic Nada , Milosevic Rajko , Basara Nada , Elezovic Ivo
Published: July 2006

Introduction Acquired amegakaryocytic thrombocytopenia (AAT) is a rare disease characterized by thrombocytopenia due to selective reduction/absence of bone marrow (BM) megakaryocytes. In the BM culture isolated reduction of colony-forming units-megakaryocyte (CFU-Mk) may occur. Material and methods BM aspirates and trephine biopsies were obtained from all patients and processed by routine methods. In vitro BM culture and cytogenetic analysis was performed in one patient. Results This article presents three patients with manifested signs of hemorrhagic syndrome due to severe thrombocytopenia caused by an absence/significant reduction of BM megakaryocytes. Eexistence of systemic or any other disease was excluded in all patients. BM culture of the second patient showed reduction of all hematopoietic progenitors. In the subsequent course of the disease in this patient, signs of dysplastic erythrocytic series and megakaryocytes were also noted, although there were no positive proofs of evolution into myelodysplastic syndrome. Discussion AAT is a disease of hematopoietic stem cells manifesting in a certain period as amegakaryocytic thrombocytopenia which subsequently may progress into aplastic anemia or myelodysplastic syndrome. Patients were treated with corticosteroids, lithium carbonate, androgens, vincristine, immunoglobulins, folic acid, platelet and erythrocyte transfusions along with plasma substitution. The first patient reacted positively to the therapy. In two other patients a minimal, short-term therapeutic effect was achieved, followed by improvement of hemorrhagic syndrome and an insignificant increase in platelet count. In one patient the treatment was stopped after 4 months and the other died of bleeding after 4 months. Conclusion AAT is a rare disease with unpredictable course. This is a case report of three patients with AAT and different therapeutic effects.
The role of surgical decompression of Cauda equina in lumbar disc herniation in recovery of bladder function
Authors: Radulovic Danilo , Tasic Goran , Jokovic Milos , Nikolic Igor
Published: July 2006

INTRODUCTION Cauda equina syndrome from lumbar disc herniation accounts for up to 2-3% of all disc herniations. The aim of this study was to investigate whether recovery of bladder function after surgery depends on preoperative duration of disease. Patients and methods This retrospective study included 47 patients who underwent surgery for cauda equina syndrome due to a herniated disc in the period between 1997 and 2002. Eleven patients were female and 36 male, with a mean age of 43 years (range 23-67). All presented with sciatica and saddle hypoesthesia, whereas 13 presented with motor weakness of legs. All patients had been catheterized at the time of admission to the Neurosurgical unit. Levels of herniation were L4-L5 in 27 (57%), L5-S1 in 14 (30%), and L3-L4 in 6 (13%) patients. In 7 (15%) patients, surgery was performed within 48 hours of the cauda equina syndrome onset. None underwent surgery within 24 hours. 13 (28%) patients were operated between the 2nd and 7th day and 27 (57%) after 7th day of the cauda equina onset. The role of preoperative duration of symptoms in recovery of bladder function was examined (chi 2 analysis). RESULTS The follow-up ranged from 15 to 74 months (mean 24.2 months). In 33 patients (70%) excellent result were achieved, in 9 (19%) patients good results and 5 (11%) patients presented with poor results. There was no statistically significant difference concerning the time between the onset of symptoms and surgical decompression and subsequent recovery of bladder function (p>0.05). CONCLUSION After accurate diagnosis and adequate operative treatment, postoperative results of cauda equina syndrome due to lumbar disc herniation appear satisfactory regardless of the timing of surgery.
Value of assessing adrenocorticotropic hormone (ACTH) levels in differential diagnosis of hypercorticism
Authors: Penezic Zorana , Zarkovic Milos , Vujovic Svetlana , Beleslin Biljana , Ciric Jasmina , Drezgic Milka
Published: July 2006

Diagnosis and differential diagnosis of Cushing's syndrome remains a challenge in clinical endocrinology. The aim of this study was to establish the value of assessing adrenocorticotropic hormone (ACTH) levels in differential diagnosis of hypercorticism using receiver operating characteristic (ROC) curve. We have evaluated 114 patients with Cushing's syndrome testing the value of pathohistological examination and postoperative testing. The control group consisted of 53 obese healthy persons. ACTH level was determined using a commercial RIA (CIS, France). ACTH secreting pituitary adenoma was found in 56.14% examinees, ectopic secretion in 6.14%, cortisol secreting adrenal adenoma in 37.57%, and adrenal carcinoma in 6.14% of all patients with Cushing's syndrome. Basal ACTH level for pituitary adenoma was 107.29?75.69 pg/mL; for ectopic secretion 181.63?149.84 pg/mL; for adrenal adenoma 4.22?2.32 pg/mL; for adrenal carcinoma 5.50 ?7.72 pg/mL; and 34.76 ?10.07 pg/mL in control group. Testing the value of assessing ACTH the area under ROC curve was 0.9965?0.0071. Test sensitivity was 99.89% and test specificity was 97%. For ACTH cut-off level of 8 pg/mL, test sensitivity was 88.50%, with specificity of 99%. For ACTH cut-off level of 22 pg/mL, test sensitivity was 99.30%, with specificity of 98%. Our intermediate zone from 8 to 22 pg/mL confirms that assessment of ACTH level is a reliable tool in differential diagnosis of Cushing's syndrome.
Human babesiosis: Recent discoveries
Authors: Mitrovic Sanja , Kranjcic-Zec Ivana , Arsic-Arsenijevic Valentina , Dzamic Aleksandar , Radonjic Ivana
Published: July 2006

Introduction Babesiosis is caused by intraerythrocytic parasites of the genus Babesia, which is a common animal infection worldwide. This protozoa requires both a competent vertebrate and a nonvertebrate host (Ixodes sp. etc.) to maintain the transmission cycle. Human babesiosis Human babesiosis is predominantly caused by Babesia microti (rodent-borne piroplasm, an emerging zoonosis in humans in North America) and by Babesia divergens (bovine pathogen, in Europe). Occasionally, infection in America is caused also by a newly recognized species, so-called WA1 piroplasm. The spectrum of human babesiosis in the USA is broad, and ranges from an apparently silent infection to a fulminant. In Europe, babesiosis is considerably rarer, but more lethal (42% mortality rate in Europe and 5% in the USA, for clinically apparent infections) and mostly in splenectomized patients. Various determinants are involved in the severity of infection, such as age, immunocompetence and coinfection with other pathogens (Borrelia burgdorferi). B. microti antigens can trigger specific activation of T-cells and the infection can be effectively controlled by a Th1-dominant CD4% T-cell response. The diagnosis of babesiosis should include examination of blood smears stained by Giemsa, as well as serologic evaluation with indirect immunofluorescent antibody tests and possibly PCR. The treatment of babesiosis depends on severity of cases; if it is mild it resolves spontaneously, whereas very severe cases with B. divergens require prompt treatment that includes erythrocyte exchange transfusion along with intravenous clindamycin and oral quinine to arrest hemolysis and prevent renal failure. This paper offers an overview of recent developments in the investigation of Babesia sp. and babesiosis. .
Cortisol in plasma and cerebrospinal fluid of patients with brain ischemia
Authors: Selakovic Vesna
Published: July 2006

Introduction One of the reactions to ischemia is increased release of glucocorticoid hormones, included in regulation of effects of numerous mediators/modulators that could be released in the acute phase of brain ischemia. The aim of our investigation was to define temporal dynamics of cortisol concentrations in plasma and cerebrospinal fluid of patients with different types of ischemic brain disease. Material and methods The study included 263 patients of both sexes, aged 55-68 years. History, clinical examination and cerebral computerized tomography were performed to establish the diagnosis. 97 patients had brain infarction, 66 had a reversible ischemic attack, 66 had a transient ischemic attack, and 34 patients had chronic encephalopathy. The control group included 22 age- and sex- matched patients, subjected to diagnostic lumbar radiculography, without disturbances in the cerebrospinal fluid passage. Cortisol concentrations were measured by direct radioimmunoassay. Results and discussion Results obtained in this research showed that in acute brain ischemic period there was a significant increase of cortisol concentration in plasma and cerebrospinal fluid. The increase was highest in patients with brain infarction, somewhat lower in reversible ischemic attack, and the lowest in transient ischemic attack compared to controls (331.7?92.8 pmol/ml of plasma and 2.5?1.1 pmol/ml of cerebrospinal fluid). Maximum concentrations were found during the first two days after insult. The main potentially protective effects of increased cortisol concentrations in patients with acute stroke could be the decrease of effects of deleterious reactions induced by ischemia. This mechanism might be an attempt of organism to compensate for disturbed homeostasis. Conclusion Measurement of cortisol in plasma and cerebrospinal fluid in patients with acute stroke is significant for monitoring the intensity of response of an organism to acute brain damage.
Surgical site infections at the Surgery clinic of the Clinical hospital center in Kragujevac
Authors: Ilic Milena , Markovic-Denic Ljiljana , Canovic Dragan , Stefanovic Srdjan , Tepic Ksenija
Published: July 2006

Introduction Surgical site infections are the most prevalent nosocomial infections in majority of studies conducted in the last decades in the world and in our country. Material and methods The purpose of this study was to assess the incidence rate of surgical site infections at Surgery Clinic of the Clinical Hospital Center in Kragujevac. The incidence study was performed from August 1 to 31, 2001, followed Centers for Disease Control (CDC) guidelines. In this period 186 patients were admitted and underwent operation at Surgery Clinic of the Clinical Hospital Center in Kragujevac. Results and discussion Incidence rate of surgical site infections was 9.1%. The highest rate was recorded at the Department of vascular surgery (29.2%). The lowest rate was established at the Department of gastrointestinal surgery unit (3.3%). At Departments of neurosurgery, dermatology and maxillofacial surgery surgical site infections were not recorded. The most frequent isolated causative agents were Staphylococcus aureus and Pseudomonas species.
Role of systematic lymphadenectomy in postoperative mortality and morbidity in patients with gastric cancer
Authors: Stevanovic Dejan , Radovanovic Dragan , Pavlovic Ivan , Mitrovic Nebojsa
Published: July 2006

Introduction Surgical techniques and postoperative care for gastric cancer have significantly improved in recent years. However, whether postoperative morbidity and mortality rates after gastrectomy for gastric cancer have been reduced or not in recent years is still unclear. In this study we would like to point out the role of systematic lymphadenectomy in postoperative mortality and morbidity. Material and methods In this investigestion we analyzed two groups of patients. The first group of 126 patients with gastric carcinoma underwent peritumor lymphadenectomy D1. The second group of 114 patients with gastric carcinoma underwent more radical types of lymphadenectomy (D2, D2%, D3). In this study we analyzed differences between these two groups of patients in regard to:1) early postoperative mortality, 2) early postoperative complications and 3) long-term postoperative complications. Results Early postoperative mortality rate was 4.76% in D1 group and 5,26% in group with systematic lymphadenectomy (SL). 14.3% of patients in D1 group and 15.7% of patients in SL group had postoperative complications. The most frequent complications in D1 group were non-surgical complications of the respiratory system. In SL group the most common postoperative complications were anastomotic leakage (5/18, 27.77%) and wound infection (6/18. 33.3%). The most common long-term complications in both groups were: ventral postoperative hernia, anemia, small bowel obstruction and gallbladder calculosis. Discussion Early postoperative death occurred in patients with stage IV gastric cancer. The rates of anastomotic leakage, as main cause of early postoperative mortality and morbitity in patients with systematic lymphadenectomy, were reduced in the last few years with stapling surgery. Conclusions There were no significant differences in the postoperative mortality and morbidity rates between the two analyzed groups in our investigation.