bluuebunny/crossref_metadata_2025 huggingface dataset:
Fine-needle aspiration cytology in Hodgkin’s lymphoma
Authors: Nedeljkov-Jancic Ruzica , Mihaljevic Biljana , Bogdanovic Andrija , Petrovic Milan
Published: December 2010

Background. Cell composition of tumor tissue in Hodgkin?s lymphoma is considered to be specific. According to some authors, precise cytomorphological analysis of the specimen obtained by fine needle enables the diagnosis of the histologically well-defined form of lymphoma in a high percentage of cases. However, other authors consider the precise diagnosis of HL based on cytological analysis of a lymph node puncture specimen extremely difficult. The aim of this study was to a assess the diagnostic accuracy of cytomorphological analysis, as well as the possibility of application of this method in establishing the preliminary or even final diagnosis of this form of lymphoma. Methods. Thirty four samples were analyzed, obtained by fine needle aspiration, in patients examined and treated at the Institute of Hematology, Clinical center of Serbia, Belgrade. Smears were stained by May-Gr?nvald-Giemsa and Papanicolau methods. Results. The finding of typical multinucleate Reed-Sternberg cells in the smears of lymph node puncture specimen was diagnostically significant, as well as the finding of mononuclear variances of the neoplastic cells of anunusual morphology (Hodgkin?s cells). The cell environment in the background of the above-mentioned tumor cells was heterogeneous. It was composed of small lymphocytes, plasma cells, eosinophils and reticular cells. These cell forms, found in cell preparations, resembled those seen in the tissue sections of the relevant extirpated lymph nodes. The comparison of the cytological findings in the fine needle specimen to the subsequently established histological diagnoses of HL revealed a high correlation of 85.2%. Conclusion. Cytological examination of fine needle lymph node specimens is still significant for the diagnosis of HL in spite of the development of more sophisticated methods used for verification of the diagnosis of this neoplasm.
Histopathologic investigations of nifedipine-induced gingival hyperplasia in Wistar rats
Authors: Brkic Zlata
Published: December 2010

Background. Nifedipine, a calcium channel blocker, used in the therapy of cardiovascular diseases, can induce gingival overgrowth. The aim of the study was to assess the influence of nifedipine on the deeper periodontal tissues of the experimental animals concerning connective tissue and blood vessels proliferation. Methods. The research was performed on Wistar rats, and they received the precise doses of nifedipine water suspension while the changes were followed up in pre-determined time intervals. The analyses of samples of tissues were done on the cross-sections of papilla from the top to the bottom on five levels. Results. Considerable level of changes was observed in the area of dental alveolar edge and in the gingivo-dental interspace. Epithelial hyperplasia and inflammatory subepithelial infiltration of lymphoplasmocyte type were also present. Alveolar bone destruction, the increased number of osteoclasts and periodontal destruction were found, as well. Conclusion. The results of this study showed a significant gingival hyperplasia in the experimental animals which received high doses of drug during extended period of time.
Effects of circumferential rigid wrist orthoses in rehabilitation of patients with radius fracture at typical site
Authors: Djurovic Aleksandar , Zivotic-Vanovic Mirjana , Railic Zoran
Published: December 2010

Background. The use of orthoses is a questionable rehabilitation method for patients with the distal radius fracture at typical site. The aim of this study was to compare the effects of the rehabilitation on patients with radius fracture at the typical site, who wore circumferential static wrist orthoses, with those who did not wear them. Methods. Thirty patients were divided into 3 equal groups, 2 experimental groups, and 1 control group. The patients in the experimental groups were given the rehabilitation program of wearing serially manufactured (off-the-shelf), as well as custom-fit orthoses. Those in the control group did not wear wrist orthoses. Evaluation parameters were pain, edema, the range of the wrist motion, the quality of cylindrical, spherical, and pinch-spherical grasp, the strength of pinch and hand grasp, and patient's assessment of the effects of rehabilitation. Results. No significant difference in the effects of rehabilitation on the patients in experimental groups as opposed to control group was found. Patients in the first experimental group, and in control group were more satisfied with the effects of rehabilitation, as opposed to the patients in the second experimental group (p<0,05). Conclusion. The effects of circumferential static wrist orthoses in the rehabilitation of patients with distal radius fracture at the typical site were not clinically significant. There was no significant difference between the custom and off-the-shelf orthoses.
Effects of orthodontic treatment after adenoidectomy on jaw relations in the sagittal plane
Authors: Milic Jasmina
Published: December 2010

Aim. To evaluate the orthodontic treatment effects, performed immediately after adenoidectomy, on lips relation, overjet and class (Angle). Methods. Three groups of patients, aged 6?17 years, were observed: group K - patients with oral respiration caused by adenoidal enlargement; group 1 - patients with adenoidectomy performed five and more years previously; group 2 - patients with one year of orthodontic treatment performed immediately after adenoidectomy. Lips and overjet status and class (Angle) was measured in the examined patients. Results. In all of the three examined groups, there was a statistically highly significant increase (p<0.01) of competent lips. In the patients of group K, the overjet values ranged from 1 mm up to 12 mm where 90% of them had overjet > 4 mm and 6% < 1 mm. The front open bite, low overbite and reversed overjet was found in the patients with low overjet in this group, as well. Overjet values in the patients of group 1 ranged from -2 mm up to 12 mm where 86% had overjet > 4 mm and 10% < 1 mm. Significantly higher increase (p<0.01) of overjet values (1?4 mm in 94% of patients) was observed in the patients of group 2 in comparison to the values found in the patients from groups 0 and 1. Class II (Angle) was recorded in 81% of the patients in group 0, and 79% in group 1, while class I (Angle) was observed 100% only in the patients of group 2. Conclusion. Orthodontic treatment immediately after adenoidectomy was necessary for achieving the competition lips relation, normal overjet and class I (Angle).
Influence of manufacturing procedure on stability of Unguentum contra perniones preparations
Authors: Boskovic Mirjana , Toskic-Radojicic Marija
Published: December 2010

Background. Application of various technological procedures for the manufacture of officinal preparation ointment against chilblains (Unguentum contra perniones) produce essential variations in the quality and stability of the final product. Changing the sequence of admixing active substances into the ointment base indicated the presence of incompatibility between the active substances, as well as between the active substances and the ointment base components. The aim was to examine the influence of various technological manufacturing procedures on quality and stability of the preparation. Methods. Changes in the samples of ointments and aqueous solutions of active substances were analyzed microscopically. Results. Microscopic analysis of hydrosoluble active substance solutions demonstrated destruction of ichthammol, induced by an acidic medium due to the dissolution of tannin and resorcinol, which is well known from the literature. It also demonstrated the destruction of tannin and resorcinol in aqueous solution, which had not been described in the literature. Application of the prescribed procedure for the manufacturing of ointment against chilblains, conceals the incompatibility reactions due to a slow dissolution of the tannin suspended in the officinal ointment base Unguentum cera lanae. Admixture of an ready-made aqueous solution of tannin caused an instant contact between ichthammol and the acidic medium, which caused the destruction or the complete absence of the formation of emulsion droplets. The problem of incompatibility reactions between lanolin alcohols in the ointment base and ichthammol and resorcinol, as well as the reaction between Peruvian balsam and sulfur from the ichthammol sulfate ion was observed. Numerous incompatibility reactions of ointment against chilblains, components indicated that it was necessary to introduce alterations in both the qualitative and quantitative composition of the preparation. Conclusion. Excipient preparation procedure, as well as the technological procedure for incorporation of active ingredients can cause the incompatibilities and therefore the formulation stability problems.
Dual chamber pacemaker in the treatment of paroxysmal atrial fibrillation
Authors: Radjen Goran , Rafajlovski Sasa , Perisic Zoran , Romanovic Radoslav
Published: December 2010

Background. Atrial fibrillation is the most frequent cardiac dysrhythmia. The aim of this study was to show the role and the efficacy of a dual chamber pacemaker with the algorithm of atrial dynamic overdrive, in the suppression of paroxysmal atrial fibrillation. Case report. A woman with a classical bradycardia-tachycardia syndrome, and frequent attacks of atrial fibrillation, underwent the implantation of a single chamber permanent pacemaker (VVI). Pacemaker successfully treated the episodes of symptomatic bradycardia, but the patient had frequent attacks of atrial fibrillation, despite the use of different antiarrhythmic drugs, which she did not tolerate well. The decision was made to reimplant a permanent dual chamber pacemaker with the algorithm of atrial dynamic overdrive. The pacemaker was programmed to the basic rate of 75/min, while rate at rest was 55/min. In addition, sotalol was administered. After three months, the patient became asymptomatic with only 4 short ? term episodes of atrial fibrillation, and a high level of atrial pacing (99%). Conclusion. In selected patients with bradycardia?tachycardia syndrome, atrial-based pacing seemed to be very effective in reducing the incidence of paroxysmal atrial fibrillation.
Discoloration of gingiva in the presence of fixed dental restorations
Authors: Ristic Ljubisa , Miljkovic Zivorad , Ilic Srbislav , Djuric Tatjana
Published: December 2010

Aim. To investigate the frequency of discoloration of gingiva in the presence of fixed dental restorations, regarding the type of alloy of which restorations were made, and to show histopathological changes of discolored gingiva. Methods. One hundred and eighty four patients of both sexes were examined. The average age of the examinees was 52. They were divided into four groups according to the alloys from which their restorations were made. Standardized history questionnaires and clinical examination procedures were developed for this study. In ten examinees, whose teeth were indicated for extraction and who had a discoloration of gingiva, the samples of tissue were taken from the discolored gingiva for histopathological examination. Results. Our results showed the presence of discolored gingiva in all four groups. It was most frequent in the examinees with fixed restorations made of Ni-Cr alloy (43,5%) and less frequent in those with fixed dental restorations made of gold alloy (26,5%). Histopathological examination showed the presence of tissue foreign body granulomas with giant cells in which the metal particles were found, partially as small and partially as large particles. Conclusion. Results suggested that grayish discoloration of gingiva was present in all four groups of examinees. The highest number of examinees with discolored gingiva was in the group with restorations made of Ni-Cr alloy. Grayish discoloration of gingiva was a consequence of incorporation of metal particles into gingival tissue.
Superior vena cava syndrome caused by epitheloid hemangioma
Authors: Ilic Radoje , Trifunovic Zoran , Mandaric Vladimir , Tisma Svetislav
Published: December 2010

Aim. A case is presented of the surgical treatment of epitheloid hemangioma as a rare cause of superior vena cava syndrome. Case report. A 53-year old woman was admitted to the clinic with the symptoms and signs of superior vena cava syndrome. After clinical evaluation and diagnostic tests, she was operated on through median sternotomy, and the desobliteration of the superior vena cava through longitudinal ca votomy was done. After the desobliteration by the removal of benign tumor from its cavity, vena cava was reconstructed with the continuous prolen suture. Pathohistologicaly, there was the evidence of epitheloid hemangioma that made the subtotal obliteration of the vena cava superior by its expansive growing at the entry in the right atrium. Postoperatively, there was a complete disappearance of the symptoms and signs of superior vena cava syndrome. After an uneventful recovery, the patient was discharged from the hospital.
Comparison of two therapeutic protocols in patients with antiphospholipid antibodies and recurrent miscariages
Authors: Jeremic Katarina , Pervulov Miroslava , Gojnic Miroslava , Dukanac Jelena , Ljubic Aleksandar , Stojnic Jelena
Published: December 2010

Aim. To compare the effects of two therapeutic protocols for the patients with recurrent miscarriages associated with the presence of antiphospholipid (anticardiolipin) antibodies. Methods. A prospective observational study included 20 patients with antiphospholipid antibodies in the first group who received low-molecular heparin and aspirin. The second group of 20 patients, in addition to this therapy, received immunotherapy (intravenous immunoglobulin). Aspirin was administered at the time of a positive pregnancy test, and low molecular heparin not before the fetal heart activity registration by ultrasound. Intravenous immunoglobulin was given prior to the conception or at the beginning of the pregnancy. We compared these groups according to the pregnancy outcomes and the occurrence of complications during pregnancy, using standard statistical tests. Results. The rate of positive gestational outcome in the patients treated with aspirin and low-molecular heparin was 85% (17/20), and in the second group it was 90% (18/20). There was no significant difference in pregnancy outcomes between these groups (p > 0.05), except for the occurrence of preeclampsia and thrombocytopenia, which were recorded only in the aspirin and low-molecular heparin group, but with no statistical significance (p > 0.05) compared to the second group, which received immunoglobulin additionally. Conclusion. There was no significant difference (p > 0.05) in pregnancy outcomes between the two studied therapeutic protocols, but the therapy with aspirin and low-molecular heparin was cheaper and easier to apply than the therapy with immunoglobulins. The results of our study confirmed that the final pathogenic mechanisms in recurrent fetal miscarriages were inflammation and thrombosis of the uteroplacental blood vessels.
Urban noise and arterial hypertension
Authors: Belojevic Goran , Slepcevic Vesna , Stojanov Vesna , Jakovljevic Branko
Published: December 2010

 Rezultati dosadasnjih epidemioloskih studija o vezi saobracajne buke i hipertenzije kontradiktorni su. Znacajan broj istrazivanja ima metodoloske propuste u nedovoljno kontrolisanim pridruzenim faktorima. U epidemioloskim studijama koje su utvrdile statisticki znacajnu pozitivnu povezanost izlaganja saobracajnoj buci i obolevanja od arterijske hipertenzije interval relativnih rizika bio je od 1,68 do 2,35 kod stanovnika izlozenih ekvivalentnom nivou buke od 60 do 75 dB (A). Medjutim, iz ovih studija nije mogao da se dobije podatak o odnosu doza-odgovor koji je znacajan za kauzalno zakljucivanje. Nekonzistentan odnos nadjen je i kada je za kriterijum izlaganja uzimano subjektivno ometanje bukom. Interval relativnih rizika u ovoj grupi istrazivanja bio je 1,29-1,81. Uocena je veca tendencija za povisen rizik od arterijske hipertenzije kod muskaraca izrazito ometenih bukom u odnosu na zene.
Nosocomial infections in the departments of orthopedics and traumatology
Authors: Maksimovic Jadranka , Markovic-Denic Ljiljana , Bumbasirevic Marko , Marinkovic Jelena
Published: December 2010

Aim. To determine the incidence and the localization of nosocomial infections (NI) in the departments of orthopedics and traumatology. Methods. A prospective cohort study carried out between February 1 and July 31, 2002 included all of the surgical patients who were hospitalized longer than 48 hours, as well as 30 days after the discharge. The patients were examined and their diagnoses made according to the definition of NI, that was based on the clinical and/or laboratory findings. Results. Out of 277 hospitalized patients, 78 had a total of 91 NIs. Sixty seven (85.8%) of the patients had 1 registered NI each, 9 (11.6%) of the patient had 2 NIs each, while only the 2 (2.6%) were with 3 NIs. The incidence of the patients with HAI was 28.2% (95% IP = 22.9-33.5), while the incidence of HAI was 32.8%. The patients who developed a NI were hospitalized almost twice as long as the patients who did not (t test = 6.0, DF = 275, p < 0.001). In regard to the duration of hospitalization, the incidence of NI was 12.3 per 1000 patient-hospital days. The patients operated on most frequently had the surgical-site infections (69.2%). Of 63 infections of the surgical site, 3 patients (4.8%) were diagnosed as having the NI at that localization following the discharge, and then the urinary tract infections, 25.3% (23/91), and sepsis, 5.5% (5/91). Conclusion. Epidemiological surveillance was the first step towards the prevention and the eradication of NI. The results of this study could be of use in planning of the adequate measures for the prevention of NI in the departments of orthopedic surgery.
Early results of cementless hip arthroplasty in the treatment of femoral head posttraumatic and atraumatic osteonecrosis
Authors: Jeremic Dragan , Nikolic Dragan , Ilic Srbislav , Draskovic Vlajko
Published: December 2010

Aim. To evaluate the value of cementless hip arthroplasty in the treatment of posttraumatic and atraumatic osteonecrosis (ON) of the femoral head. Methods. The study was conducted at the Department of Orthopedics and Traumatology, Military Medical Academy, between January 1st, 1999 and December 31st, 2003. Twenty five patients with 27 implanted endoprostheses, and the diagnosis of osteonecrosis of the femoral head, and radiographically confirmed Arlet-Ficat stage III and IV were evaluated retrospectively. The results were evaluated according to Harris Hip Score (HHS). The research included 10 patients with traumatically induced osteonecrosis and 15 patients (17 endoprothesis) with osteonecrosis of the femoral head. The mean age of the patients in the group with posttraumatic osteonecrosis of the femoral head was 41 (19-62) years, and in the group of the patients with atraumatic osteonecrosis of the femoral head it was 40.2 (21-53) years. Complications included one case with postoperative luxation, and one case with iatrogenic sciatic nerve palsy. Results. The average Harris Hip Scores in the group of posttraumatic osteonecrosis were 31 points preoperatively and 86 points postoperatively. In the group of osteonecrosis of atraumatic etiology, the average Harris Hip Score was 28 points preoperatively, and 77 points postoperatively. Postoperative Harris Hip Scores were compared with the Student's t-test and the results showed no statistically significant difference (p = 0,125). Conclusions. Our study did not find any significant difference between the results of posttraumatic and atraumatic osteonecrosis of the femoral head treated with cementless endoprosthesis.
Surgery of eye injuries in an eight-year period
Authors: Vukosavljevic Miroslav
Published: December 2010

Background. Eye injuries constitute a leading problem in eye surgery worldwide, as well as at our department. Their treatment is very complex, and requires a wide surgical knowledge and surgical skills supported by the material and the equipment. Aim. To analyze the results of vitreoretinal surgery on 647 patients with severe penetrating eye injuries in the period from 1991 to 1998. Methods. The study included a retrospective analysis of the treatment of 647 injuries, out of which 500 were penetrating, and 147 were severe contusion injuries. Attention was payed to the penetrating injuries with intraocular foreign body (IOFB), to the number of the performed pars plana vitrectomies (VPP), to the number of the extirpated foreign bodies, as well as to the number of the conventional retinal ablation surgeries. Also significant proved the consequences of contusion injuries, and the method of their complete surgical management - the surgery combined with the implantation of intraocular lens, as well as their functional results. Results. Inside the said period, 558 VPPs were performed, 60 conventional retinal ablation surgeries, and 29 combined anterior/posterior segment surgeries. VPP was applied in 286 (51.3%) of the cases with penetrating injuries with IOFB, and in 58 (10.4%) of the cases with contusion injuries. VPP in one eye was applied in 464 (83%) of the cases, in both eyes in 65 (11.8%) of the cases, and in a single eye in 29 (5.2%) of the cases. Following VPP, silicone oil tamponade was done in 352 (63%) of the cases, air tamponade in 123 (22%) of the cases, and Ringer-BSS tamponade in 83 (15%) of the cases. Laser photocoagulation (LFC) was performed in 484 (87%) of the cases, cryocoagulation in 45 (8%), while neither of them was done in 29 (5%) of the cases. In all of the cases of the conventional retinal ablation (n = 60), a placement of a serclage was applied and exocryocoagulation was performed, while in the 52 cases a placement of a scleral flap was applied. Combined surgery - lensectomy, VPP, and an anterior chamber intraocular lens (AC IOL), was applied in 16 of the cases, and phacoemulsification, VPP and a posterior chamber intraocular lens (PC IOL) in 13 of the cases. Conclusion. Vitrectomy was the most frequently applied surgery in solving the complex eye injuries. The eye injuries treated in our department were with the IOFB, and the retinal ablation. The IOFBs in our patients were almost completely extirpated. The applied combined anterior/posterior segment surgeries had the potential to safely and successfully condense those separate procedures in one surgery. A relatively high incidence of endophthalmitis was recorded in the injuries treated in our department.
FLAIR MR sequence in the diagnosis and follow-up of low-grade astrocytomas
Authors: Stosic-Opincal Tatjana , Gavrilov Mihail , Stosic Srboljub , Lavrnic Slobodan , Peric Vesna , Grujicic Danica
Published: December 2010

Aim. To evaluate the sensitivity of fluid-attenuated inversion recovery (FLAIR) sequence in the diagnosis and follow-up of the patients with low-grade astrocytomas compared with T2-weighted (T2W) sequence. Methods. Twenty-four patients with biopsy- confirmed low-grade astrocytoma (age range, 15-66 years) underwent T1- weighted (T1W), T2W and FLAIR imaging with a superconducting unit 1.0 T. FLAIR images were qualitatively evaluated by comparison with T2W images by the three experienced neuroradiologists. To evaluate the diagnostic value of FLAIR, the neuroradiologists individually assessed the possibilities of the detection of lesions, as well as the possibilities of the differentiation of tumor from the surrounding edema on FLAIR vs. T2W images. Every examiner ranked FLAIR sequence vs. T2W in three degrees: worse, equal and better. Results. The comparison of FLAIR with T2W spin-echo (SE) images with regard to the detection of the lesions showed that 82.8% of FLAIR studies were superior, 17.2% were of similar diagnostic value, and none was inferior to the T2W images. The comparison of images with regard to the differentiation of tumor boundaries vs. surrounding edema showed that 92.5% of FLAIR studies were superior, 7.5% were of similar diagnostic value, and none was inferior to the T2W images. Conclusion. Our results were similar to the previous studies' results concerning the advantages of FLAIR sequence in the diagnosis of low grade astrocytomas over T2W sequence. FLAIR was better at showing different tumor components, and at distinguishing CSF from the cystic component, and the postoperative cavity, compared with T2W images. Our conclusion was that FLAIR could be routinely used in the evaluation and follow-up of low-grade astrocytomas.
Effects of air pollution on children's health in Nis and Niska Banja
Authors: Nikic Dragana , Stojanovic Dusica , Nikolic Maja
Published: December 2010

Background. Epidemiological studies point out that air pollution in the cities was a major risk for health of the exposed population. In particular, the effects of air pollutants were adverse to the respiratory tract. In Nis and Niska Banja, the concentrations of pollutants were mainly below the threshold values. However, according to the literature, even these concentrations could exert negative effects, especially the health of the most sensitive group, such as the preschool children. The aim of our study was to evaluate the effects of the current levels of air pollutants in the city of Nis on respiratory symptoms and diseases. Methods. A pilot, cohort, retrospective study included 1 385 children of 1-5 years of age from the zones with statistically significant concentrations of air pollutants, in the period after the birth of the children. The prevalence of respiratory symptoms and diseases was determined on the basis of a modified WHO standard questionnaire completed by the parents. Results. It was revealed that in the more polluted of the studied zones, the prevalence of some respiratory symptoms (cough with cold and phlegm), and the lower respiratory tract diseases was significantly higher. Conclusion. The results of our study showed that the current concentrations of air pollutants in Nis and Niska Banja could represent the important etiological factor for the development of respiratory symptoms and diseases. Our study showed that in the children of up to 5 years of age, the frequency of respiratory symptoms and diseases was significantly higher in more polluted than in less polluted environments.
Effects of topical application of metronidazole-containing mucoadhesive lipogel in periodontal pockets
Authors: Toskic-Radojicic Marija , Nonkovic Zorka , Loncar Irma , Varjacic Milomir
Published: December 2010

Introduction. Metronidazole is the drug of choice in the treatment of periodontal pockets up to 5 mm in depth. It is topically applied - directly into the periodontal pockets. There are no registred trademark preparations for this purpose in the market of Serbia and Montenegro. The aim of our latest research was to test the efficacy of newly formulated preparation containing 25% metronidazole suspended in a lipogel in vitro - in anaerobic cultures isolated from the periodontal pockets, and in vivo - by the direct application into periodontal pockets. Methods. Preparation efficacy was tested in a randomized controlled study involving 25 patients, and was confirmed by the membrane-free agar diffusion method on the anaerobic strains isolated from the periodontal pockets. The duration of the testing was 30 days. The preparation was applied twice - immediately after the taking of the first swab, and on day 15, when the control swab was taken for the assessment of the effects of the applied preparation. Results. Seven anaerobic strains were isolated and tested, and each was confirmed as highly susceptible to metronidazole. Anaerobic strains were not isolated in any of the pockets treated with metronidazole-containing lipogel. The strains isolated in the control pockets were the same as were those at the beginning of the study. Conclusion. Metronidazole, in a lipogel-type base applied in the concentration of 25%, provided an efficient treatment of anaerobic infection in the periodontal pockets.
Occurrence of autoimmune chronic hepatitis in siblings
Authors: Nozic Darko , Dimitrijevic Jovan , Knezevic-Usaj Slavica
Published: December 2010

Background. Autoimmune hepatitis is a chronic inflammatory disease of the liver of unknown etiology, characterized by the loss of tolerance against hepatic tissue, leading to the destruction of hepatic parenchyma. It predominantly affects females, and rarely occurs in the same family. Case report. In this paper we presented brother and sister with autoimmune hepatitis according to the criteria of the International Autoimmune Hepatitis Group. Conclusion. Because of a possible genetic predisposition to autoimmune hepatitis, the occurrence of the disease in a family member suggested the need to examine other family members.
Analysis of heart rhythm variability by linear and non-linear dynamics methods
Authors: Vuksanovic Vesna , Gal Vera
Published: December 2010

Introduction. Spectral analysis of heart rhythm variability is a noninvasive method to study cardiovascular autonomic control. Nonlinear methods of analysis of heart rhythm variability may provide an additional information on properties of RR interval dynamics, which cannot be revealed by linear methods. The aim of this study was to investigate and to compare some parameters of deterministic chaos, tractal and spectral properties of heart rhythm variability in healthy subjects. Methods. Sixty healthy subjects, who participated in this study, were divided in four different age groups: children (< 15 years old), young (15-24 years), adults (25-39 years) and middle-aged (40-61 years). We analyzed the heart period variability extracted from a 5-minute electrocardiograms recordings in supine rest. Short-term fractal scaling exponent, sample entropy, minimum embedding dimension and the largest Lyapunov exponent along with the spectral measures (low-frequency and high-frequency power) were determined. Results. Heart frequency, short-term fractal scaling exponent, and the largest Lyapunov exponent did not differ between the tested groups (p > 0.05). Middle-aged subjects had the lower low-frequency power as compared to the children (p < 0.001) and the young (p < 0.05), and the lower high frequency power as compared to the other three groups (p < 0.001). Middle-aged also had a significantly lower power of high frequency and sample entropy as compared to the other three groups (p < 0.001). Children had lower values of minimum embedding dimension compared to the middle aged (p<0.001). Significant negative correlation between the age of the tested subjects, and the low-and, high-frequency power and sample entropy was found. Conclusion. The obtained results suggested that healthy aging was associated with significant alteration in heart rhythm dynamics reflected on a higher regularity and lower variability of heart rhythm time-series. Significant decrease in a high-frequency power with aging suggested that reduction in parasympathetic activity was the basic cause of these changes.
Persistent strabismus after cataract extraction
Authors: Dujic Mirjana , Misailovic Katarina , Kovacevic Milena
Published: December 2010

Background. Transient ocular misalignment as a complication of parabulbar and peribulbar anesthesia has already been reported in the literature. The aim of our study was to present a case of irreversible iatrogenic vertical strabismus after cataract surgery, which had to be operated on. Methods. Clinical and orthoptic evaluation of a female patient with vertical diplopia after phacoemulsification cataract surgery. Results. One week after the uneventful surgery, a 68-year-old patient complained of a sudden vertical deviation in the operated eye. The patient had not had a history of previous motility disorders. On examination, the patient showed hypertropia in the left eye of 15?20 degrees in primary position. Three and 6 months postoperatively, there was no a spontaneous improvement, while the persistent vertical deviation was 40 prism dioptres. Strabismus surgery was required 1 year after the cataract surgery. Conclusion. Diplopia is a complication of peribulbar anesthesia which could be persistent. The superior and inferior rectus muscle are especially vulnerable. Its occurrence may be technique - related and the incidence increases when hyaluronidase is not available.
Risk factors for the development of pneumonia in acute psychotropic drugs poisoning
Authors: Vucinic Slavica
Published: December 2010

Background/Aim. Pneumonia is the most frequent complication in acute psychotropic drugs poisoning, which results in substantial morbidity and mortality, but which also increases the costs of treatment. Risk factors for pneumonia are numerous: age, sex, place of the appearance of pneumonia, severity of underlying disease, airway instrumentation (intubation, reintubation, etc). The incidence of pneumonia varies in poisoning caused by the various groups of drugs. The aim of this study was to determine the incidence and risk factors for pneumonia in the patients with acute psychotropic drugs poisoning. Methods. A group of 782 patients, out of which 614 (78.5%) with psychotropic and 168 (21.5%) nonpsychotropic drug poisoning were analyzed prospectively during a two-year period. The diagnosis of pneumonia was made according to: clinical presentation, new and persistent pulmonary infiltrates on chest radiography, positive nonspecific parameters of inflammation, and the microbiological confirmation of causative microorganisms. To analyze predisposing risk factors for pneumonia, the following variables were recorded: sex, age, underlying diseases, endotracheal intubation, coma, severity of poisoning with different drugs, histamine H2 blockers, corticosteroids, mechanical ventilation, central venous catheter. The univariate analysis for pneumonia risk factors in all patients, and for each group separately was done. The multivariate analysis was performed using the logistic regression technique. Results. Pneumonia was found in 94 (12.02%) of the patients, 86 of which (91.5%) in psychotropic and 8 (8.5%) in nonpsychotropic drug poisoning. In the psychotropic drug group, pneumonia was the most frequent in antidepressant (47%), and the rarest in benzodiazepine poisoning (3.8%). A statistically significant incidence of pneumonia was found in the patients with acute antidpressant poisoning (p < 0.001). Univariate analysis showed statistical significance for the following parameters: sex (p < 0.05), chronic alcohol intake (p < 0.05), underlying diseases (p < 0.01), central venous catheter (p < 0.05) vasopressors (p < 0.05), coma (p < 0.001), H2 blockers (p < 0.001) and corticosteroids (p < 0.001). The multivariate analysis retained endotracheal intubation and antidepressant drug poisoning as an independent risk factor for pneumonia. Conclusion. Using univariate and multivariate analysis, risk factors for developing pneumonia were disclosed. Some of these factors may be modified by simple medical procedures, thus the incidence and mortality rate of pneumonia in drug poisoning might be substantially reduced.
Comparative analysis of the efficacy and biocompatibility of various methods of dialysis
Authors: Zivanovic Milenko , Hrvacevic Rajko , Kovacevic Zoran , Veljancic Ljubisa , Vujanic Svetlana
Published: December 2010

Background/Aim. The efficacy and biocompatibility of hemodialysis have a singnificant impact on dialysis patient morbidity and mortality rate. The aim of our study was to compare the efficacy and biocompatibility of different hemodialysis modalities in our patients. Methods. A total of 55 patients were included in the study, and on the basis of dialysis modality, they were divided in four groups: group I - postdilution on-line hemodiafiltration (n = 15), group II - bicarbonate high-flux polysulphone hemodialysis (n = 15), group III - bicarbonate low-flux polysulphone hemodialysis (n = 15), and groupe IV - bicarbonate cuprophane hemodialysis (n = 10). The efficacy was evaluated on the basis of urea reduction rate (URR), urea Kt/V index and serum ?2-microglobuline reduction rate, and the biocompatibility was evaluated on the basis of the leukocyte count fall during the first fifteen minutes of dialysis session, and of the serum C-reactive protein (CRP) level. Results. The highest mean URR was achieved in the group I (70.53 ? 6.49 %), and it was significantly higher in comparison with the average URR in the group IV (54.8 ? 6.35%) (p = 0.001). The average value of urea Kt/V index in the group I (1.48 ? 0.22) was significantly higher in comparison with the average value in the groupe II 1.30 ? 0.22 (p < 0.05), group III (1.05 ? 0.22), and group IV (0.98 + 0.22) (p = 0.001). Serum ?2-microglobuline reduction rate was 68.93 ? 8.25% in the group I, and 58.86 ? 7.98% in the groupe II (p = 0.01). During the first 15 minutes of hemodialysis the leukocyte number was decreased by 12.57 ? 9.35% in the group I, 13.61 ? 9.64% in the group II, 18.3 ? 13.24 in the group III and 62.3 ? 15.4 in the group IV, on average. The mean serum level of CRP was 9.4 ? 6.47 mg/l in the group IV, and less than 3.5 mg/l in the group I of the patients (p = 0.001). Conclusion. Postdilution on-line hemodiafiltration in comparison with standard hemodialysis provided the more effective elimination of small and middle uremic toxins molecules and a significantly higher degree of biocompatibility. The patients treated with standard hemodialysis frequently do not achieve the minimal value of urea Kt/V index prescribed by National Kidney Foundation - Dialysis Outcomes Quality Inatiatives standards. These patients also have significantly higher serum CRP values which suggest the state of chronic microinflammation.
Possibility of the use of serological method for the determination of immunoglobuline a antibody against early antigene of Epstein-Barr virus as a marker in the diagnosis of nasopharyngeal tumors
Authors: Stosic-Divjak Svetlana , Djukic Vojko , Petrovic Zeljko , Nesic Vladimir , Racic Alek , Tatic Zoran , Kanjuh Vladimir
Published: December 2010

Background/Aim. According to the data from immunological, biological and molecular researches, there is a close association between the undifferentiated carcinoma of nasopharyngeal type (UCNT) and Epstein-Barr virus (EBV). To use IgA EA antibody as a serological marker in our patients with nasopharyngeal carcinoma from a clinical viewpoint. Methods. 91 patients were followed in the period from 1989?1998. In 11 of the patients the antibody titre serum for the early antigen of EBV virus were determinated before the treatment, and in 24 of the patients 3 years after the treatment. There were three control groups of patients: 20 voluntary blood donors, 26 patients with squamocellular laryngeal carcinoma, and 10 patients with squamocellular nasopharyngeal carcinoma. Results. In the group of 11 patients with UCNT before the treatment, the value of anti-EA IgA titre was 31.09, and in the patients after the treatment anti-EA IgA antiody titre was 14.56. In the control groups of patients the results were: in the blood donors 5.00; in the group with the diagnosis of squamocellular laryngeal carcinoma, the titre was 5.00; in the patients with squamocellular nosopharyngeal carcinoma, the titre anti-EA IgA was 5.36. Conclusion. These results were statistically highly significant (p < 0.01). Our research clearly showed that anti-EA IgA EBV marker could be useful in diagnosing, differential diagnosing and prognosing as well.
Azotni oksid, neurodegeneracija i Parkinsonova bolest
Authors: Dzoljic Eleonora , Nesic Zorica , Stojanovic Radan , Divac Nevena , Todorovic Zoran , Vuckovic Sonja , Kostic Vladimir , Prostran Milica
Published: December 2010

 Brojni rezultati velikih studija pokazuju znacajnu ulogu NO u kaskadi dogadjaja koji dovode do smrti dopaminergickih neurona. Zna se da MPTP uzrokuje neurotoksicnost putem NO sintetisanog pomocu nNOS, ostecujuci primarno dopaminergicka vlakna i zavrsetke u strijatumu, dok NO stvoren uz pomoc iNOS deluje prvenstveno na tela dopaminergickih neurona u pars compacta substantia nigra. Ostecenje uzrokovano NO iz nNOS moze sluziti kao katalizator aktivacije iNOS i glioze. Slican sled dogadjaja moze se primeniti na ostecenje dopaminergickih neurona kod ljudi, bilo usled idiopatske PB ili usled intoksikacije MPTP. Znacaj ovih otkrica je ne samo u osvetljavanju cinioca koji ucestvuju u progresiji neurodegeneracije i PB vec i u upucivanju na nove terapijske mogucnosti.
A pharmacokinetic comparison of three pharmaceutical formulations of nimesulide in healthy volunteers
Authors: Jovanovic Dusan , Kilibarda Vesna , Todorovic Veljko , Potrebic Olivera
Published: December 2010

Background/Aim. Switching the patient from one pharmaceutical formulation of the same drug to another, may lead to therapeutic inadequancy in some cases. To minimize the risk, careful pharmacokinetic studies are desired in the pre-registration period and afterwards. Methods. A randomized, crossover design with one-week wash-out period between each dose was applied. Serum samples, obtained before dosing and at various appropriate time points up to 15 hours, were analyzed for nimesulide content by a high-performance liquid chromatographic method with ultraviolet (UV) detection. The pharmacokinetics and relative bioavailability of three different pharmaceutical formulations containing nimesulide, manufactured by the same pharmaceutical factory, were studied prospectively in 12 healthy subjects of both sexes. A single 100-mg oral dose of nimesulide was given to the volunteers in the form of conventional tablets, mouth dissolving tablets or as a suspension. Analysis of variance, power analysis, 90% confidence intervals, and two one-sided tests were used for the statistical analysis of pharmacokinetic parameters. Results. The tolerability of all preparations was excellent. The respective confidence intervals of the ratios of geometric means of Cmax and AUC0- ? of nimesulide were out of acceptable limits either for conventional tablets in comparison with suspension or for mouth dissolving tablets when compared with conventional tablets. A comparison of mouth dissolving tablets with suspension showed a statistically significant difference between Cmax values (suprabioavailability of mouth dissolving tablets), while the point estimate of the ratio of geometric means of AUC0- ? was 0.945 with the corresponding 90% confidence interval of 0.902 ?0.991. At the 5% level of significance, there were no differences between the formulations under the study in times elapsed to peak serum concentrations, as revealed by the non-parametric Wilcoxon signed ranks test. Conclusion. Only a 90% confidence interval for the relative differences of log-transformed AUC0- ? values of nimesulide absorbed from mouth dissolving tablets vs. suspension was included in the 80% to 125% interval proposed by the Food and Drug Administration (FDA). On that basis, mouth dissolving tablets (Nimulid-MD ?) were considered bioequivalent to Nimulid ? suspension according to the extent of drug absorption. Concerning the comparable amounts of nimesulide available in the systemic circulation after application of these formulations the one might not expect therapeutic failure after switching the patient from one to another.
The aqueous humour antioxidative capacity in different types and color of the age-related cataract
Authors: Zoric Lepsa , Aleksic Petar , Koracevic Darinka , Trajkovic Goran
Published: December 2010

Background/Aim. Oxidative stress results from increased oxidative processes, decreased antioxidative protection, or both processes simultaneously. Photooxidative stress, as a form of oxidative stress, induced by the energy of solar radiation, today is considered as crucial in the age-related cataractogenesis. Other known and unknown, endogenous and egsogenous factors that contribute to the oxidative stress intensity, can influence the cataract type and brunescence. Thus the oxidative stress intensity and its form might determine the cataract type and brunescence, and also make the efforts in cataract prevention more complex. Hence, the objective of the present paper was to investigate the current amount of antioxidative capacity in aqueous humour during the cataract genesis of different types and pigmentation of cataract. Methods. Transversal review of 80 samples of humour aqueous obtained during extracapsular cataract extraction. Aqueouses were analyzed by tiobarbituric acid (TBA) method for the total antioxidant activity estimation, expressed as %iMDA, and by using 0.1 ml of aqueous. Results. The mixed type of cataract showed the statistically significantly lower values of the intensities of antioxidative protection in aqueous humour compared to cortical and nuclear cataracts (p < 0.001, respectively). Between pure nuclear and cortical cataracts we found the small differences of the investigated parameter, but they pointed to the decreased level of antioxidative protection, i.e. the increased intensity of the aqueous humour oxidative stress in the cortical cataract type. A significant correlation between the cortical cataract maturation and the %iMDA (p < 0.05) was found. Conclusions. The role of the oxidative stress, here expressed as the antioxidative capacity of aqueous humour, could not be the same for all the cataract types. The lower level of antioxidative protection of aqueous in brunescent and mixed cataracts may point to the higher intensity of oxidative stress in those cataract types. The correlation between the cortical cataract maturity and %iMDA points to the significant decrease of the aqueous antioxidative protection in the cataract progression.
Epidemiological importance of humans and domestic animals as reservoirs of verocytotoxin-producing Escherichia coli
Authors: Lazic Srdjan , Cobeljic Miloje , Dimic Bane , Opacic Dolores , Stojanovic Valentina
Published: December 2010

Background/Aim. A "new" pathogenic agent, verocytotoxin - producing Escherichia coli (VTEC) emerged in the last 20 years, causing an increased number of sporadic cases, as well as of outbreaks of diarrhoeal diseases. Humans and animals can be infected with VTEC, but their epidemiological importance as a reservoir of this agent is not quite clear, especially in the Balkan region. Therefore, the aim of this study was to investigate the frequency of isolation of VTEC from the intestinal tract of humans and animals and to determine the serogroups of the isolated strains. Methods. A total of, 3 401 stool samples from humans and 2 660 samples from five different species of domestic animals were tested for the presence of this pathogen. Results. VTEC was isolated from 20 (0.6%) humans stools and from 431 (16.2%) animal fecal samples (p < 0.001). Only 15 (3.3%) VTEC strains belonged to human infection-associated serogroups (O26, O55, O111, O128 and O 157), designated as enterohaemorrhagic E. coli (EHEC). The most known serogroup- O157 was identified in 6 (1.3%) of the isolated VTEC strains; of them, 1 (5%) was of human origin and 5 (1.2%) were animal strains. Conclusion. This study revealed that domestic animals were a more important reservoir of VTEC than humans, and that the isolated VTEC strains rarely belonged to O157, as well as to other EHEC serogroups that might explain rare sporadic cases and the absence of epidemic occurrence of diarrhoeal diseases caused by VTEC in this geographic region.