bluuebunny/crossref_metadata_2025 huggingface dataset:
The prevalence of hypertension and microalbuminuria in diabetes mellitus type 1 and type 2
Authors: Vasovic Olga , Zamaklar Miroslava , Lalic Katarina , Milosevic Dragoslav , Zikic Ljiljana , Popovic Ljiljana
Published: July 2008

INTRODUCTION. The prevalence of hypertension is two times higher in diabetics than in non-diabetics. In type 1 diabetes mellitus (T1DM), the incidence of hypertension is similar to the incidence of nephropathy. In obese patients with type 2 DM (T2DM) there can be associated complications of hyperinsulinaemia, dyslipidaemia, and hypertension, which can lead to coronary artery disease and stroke. These associated complications are the result of a genetic defect that produces insulin resistance - Syndrome X. Increased microalbuminuria correlates with increased levels of blood pressure (BP) and increased LDL cholesterol, and this is why microalbuminuria is associated with an increase in cardiovascular deaths in diabetics, even in the absence of renal failure. AIM. The aim of this study was to research the influence of a patient's age, diabetes duration, and obesity on the frequency of hypertension and its association with microalbuminuria inT1DM and T2DM. METHOD. 168 hospitalized patients with DM (79T1DM, 89T2DM) were analyzed. The main outcome measures were: 24-hour urinary albumin excretion rate by radioimmunoassay (MA=30-30O mg/24h), arterial hypertension (systolic BP>140 mm Hg and/or diastolic BP>90 mm Hg), and body mass index (BMI). RESULTS. Microalbuminuria was detected in 42% of patients with T1DM and 47% of patients with T2DM. 34% of T1DM patients and 78% of T2DM patients were hypertensive. Patients were divided into four groups, according to the presence of hypertension and microalbuminuria; Group I - patients with hypertension and MA, Group II - patients with hypertension but without MA, Group III - patients without hypertension and MA, Group IV - patients without hypertension but with MA. 44% of T1DM patients were without hypertension and microalbuminuria, while the most frequent T2DM patients were those with hypertension (37% with and 41% without microalbuminuria). A significant correlation between BMI and diastolic BP in both types of DM (p<0.01 for T1 DM, and p<0.05 for T2DM) was discovered. T2DM hypertensive patients were obese and there was a significant correlation between a patient's systolic BP and his or her age (p<0.05). CONCLUSION. These results suggest that hypertension can be prevented in patients with T2DM with weight reduction. There was a significant association between hypertension and microalbuminuria, especially in T1DM patients. Tight control of blood pressure is essential for the reduction of microalbuminuria as well as further micro- and macro-vascular diabetic complications.
Prognostic value of early post-infarction angina in elderly patients
Authors: Erceg Predrag , Davidovic Mladen , Vasiljevic Zorana , Mitrovic Predrag , Vukcevic Vladan , Milosevic Dragoslav , Stevic Radmila , Rajic Miodrag
Published: July 2008

Although numerous studies have shown that early post-infarction angina was a predictor of poor prognosis in patients with acute myocardial infarction, not a single study has considered this issue in the elderly. The goal of this study, based on a five-year follow-up of elderly patients with acute myocardial infarction, was to determine whether early post-infarction angina in the elderly had any influence on mortality and the incidence of additional coronary events. The study population consisted of 51 patients, aged 60 years or more, with acute myocardial infarction. Early post-infarction angina occurred in 31 subjects (Group 1), while it did not in 20 subjects (Group 2). Patients were monitored for five years and the incidences of death and new coronary events were recorded. A survival analysis was carried out using the Kaplan-Meier method. The survival analysis showed no difference between the observed groups concerning the following probabilities: death (p=0.9459), cardiac death (p=0.8253), myocardial reinfarction (p=0.7405), new coronary events (p=0.1708), unstable angina (p=0.1788), myocardial revascularisation (p=0.0691), and heart failure (p=0.7047j. In contrast to the younger population, where numerous studies have confirmed the link between early post-infarction angina and poor long-term prognosis, such findings could not be replicated in this study of the elderly population.
HIV infection and the kidneys, Part II: Morphologic changes and their diagnostic significance
Authors: Basta-Jovanovic Gordana , Radojevic Sanja , Savin Marina , Terzic Tatjana , Nenadovic Maja , Stojimirovic Biljana , Skodric Stevo , Nesic Vidosava , Dikman Steve
Published: July 2008

HIV-infected patients may be faced with a variety of renal problem patterns. HIV-associated nephropathy is a unique pattern of sclerosing glomerulopathy and represents the most rapidly progressive form of focal segmental glomerulosclerosis. This study involved the examination of 32 renal biopsies: by light, immunofluorescence, and electron microscopy, in order to determine the most accurate and reliable diagnostic procedure. The findings show that the most sensitive and accurate procedure is electron microscopy, capable of detecting specific EM changes very early on, which is sufficient for the diagnosis of HIV-associated nephropathy.
The importance of aminotransferases and platelets count in non-invasive evaluation stages of chronic hepatitis C
Authors: Pavic Sladjana , Svirtlih Neda , Simonovic Jasmina , Boricic Ivan
Published: July 2008

143 patients with chronic hepatitis C were investigated. The following two parameters were determined: the asparate to alanine aminotransferase ratio and the asparate aminotransferase to platelets count index. A liver biopsy was performed for every patient and stages of liver fibrosis were evaluated. Both parameters confirmed a positive correlation with liver fibrosis, which can be useful in predicting the progression of chronic hepatitis C.
Adaptation and mental-hygienic characteristics of internally displaced adolescents
Authors: Maksimovic Milos , Kocijancic Radojka , Backovic Dusan , Ille Tatjana , Paunovic Katarina
Published: July 2008

The change in socio-economic status, drastic decrease in living standards, war, and the introduction of sanctions to our country were complicated in addition by a large number of internally displaced people from Kosovo, which culminated with the 1999 NATO bombing. The aim of this investigation was to estimate the influence of internal displacement on the adaptation and mental health of adolescents. The investigation was conducted on 238 adolescents, comprising a control group of 206 adolescents from Belgrade and 32 internally displaced adolescents from Kosovo. A specific questionnaire regarding habits, behavior, and psychosomatic state was used, as well as the Cornell Medical Index and the Eysenck Personality Questionnaire. Internally displaced adolescents from Kosovo exhibited greater difficulties in adapting and had worse school records than adolescents from Belgrade, one year after the change in their location. Immediately after the NATO bombing, both groups reacted in the same way: they often talked about the events they had survived, they were afraid of the sounds of alarm sirens and of airplanes, and in addition had similar dreams (no statistical variation between the groups). Emotional disturbances, one year after the bombing, were not observed in 40.6% of adolescents from Kosovo, compared to the figure of 74.8% for adolescents from Belgrade. Adolescents from Belgrade consumed alcohol significantly more often: 75.7% compared to 56.3% for adolescents from Kosovo. In addition, 20.4% of adolescents from Belgrade consumed psychoactive substances compared to 6.3% of adolescents from Kosovo. There was no significant difference between the examined groups in the total scores on the scale for neuroticism. All in all, the girls from both examined groups displayed neurotic tendencies more frequently than the boys.
Therapies for Lennox-Gastaut syndrome
Authors: Djuric Milena
Published: July 2008

The treatment of Lennox-Gastaut Syndrome (LGS) has been improved with the introduction of the new anti-epileptic drugs: lamotrigine and topiramate, the employment of a ketogenic diet, and the availability of vagal nerve stimulation. It is difficult to provide recommendations for the treatment of LGS, in the absence of comparative trials. However, suggestions can be made on the basis of the best evidence available. Treatment should commence with valproate and continue with lamotrigine or topiramate. If seizure control is not sufficient, felbamate, a ketogenic diet, and vagal nerve stimulation are recommended. A partial callosotomy may be performed for the treatment of frequent drop attacks. Other anti-epileptic drugs may be used after a risks-benefits evaluation.
Istorijat, znacaj i mogucnosti primene autogenog treninga
Authors: Jojic Boris
Published: July 2008

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Multimodal evoked potential abnormalities in patients with Wilson's disease
Authors: Ilic Tihomir , Svetel Marina , Petkovic Stevan , Kostic Vladimir
Published: July 2008

The aim of this study was to investigate the involvement of the following functional systems: somatosensory evoked potentials (SSEP), visual evoked potentials (VEP), and event related potentials (ERP), in twenty patients with Wilson's disease (WD). VEP and SSEP abnormalities were discovered in S patients respectively (40%), whereas ERP were either absent or, in the case of 10 patients (50%), had significantly prolonged P-300 latencies. Taken together, at least one evoked potential abnormality was discovered in 17 patients (85%]. Only in 3 patients (15%), involving either the isolated hepatic type of disease or short illness duration of the neurological type, were normal evoked potential findings observed. Our findings suggest the usefulness of multimodal evoked potential abnormalities in the evaluation of subclinical manifestations in patients with WD.
Clinical manifestations of cow milk protein intolerance in infants
Authors: Mladenovic Marija , Radlovic Nedeljko , Lekovic Zoran , Ristic Dragana , Zivanovic Dragana , Vuletic Biljana , Radlovic Petar
Published: July 2008

Introduction. The disorder of cow milk protein intolerance is characterized by a wide spectrum of clinical manifestations caused by hypersensitivity of type I, II, or IV, and occurs in 2-3% of children, mostly infants. Objective. The aim of this study was to present our experiences and observations of clinical signs and symptoms of cow milk protein intolerance in infants aged below 12 months. Method. The investigation was carried out on a sample of 55 infants, aged between 1.5-9 months (x=4.2l?1.25), who had cow milk protein intolerance. Diagnosis of illness was based on characteristic anamnestic, clinical, and laboratory parameters, as well as on an adequate patient's response to antigen elimination. Results. The clinical presentation of cow milk protein intolerance was dominated by cutaneous problems, found in 40/55 (72.73%) infants, followed by digestive disorders, found in 31 (56.36%), while respiratory tract disorders were observed least frequently (14.55%). None of the patients developed anaphylactic shock. Changes involving only one system were found in 35 (63.64%) patients; of these 20 (36.36%) were cutaneous and 15 (27.27%) digestive. Twenty (36.36%) infants displayed multisystemic changes; of these 12 were cutaneus with digestive, 4 were cutaneus with respiratory, while 4 infants had cutaneous, digestive, and respiratory disorders. Of the 55 infants with cow milk protein intolerance, 26 (47.27%) had urticaria, 22 (40.00%) perioral erythema, 21 (38.18%) diarrhoea (15 haemorrhagic, 6 non-haemorrhagic), 13 (23.64%) vomiting, 12 (21.82%) Quincke's oedema, 12 (21.82%) eczema, 5 (9.09%) obstructive bronchitis, while 3 (5.45%) infants had laryngitis. In 5 (9.09%) patients we found a significant body weight deficit and in 3 (5.45%), sideropenic anaemia, while longitudinal growth retardation was not registered in any of the patients. Conclusion. Our study showed that the disorder of cow milk protein intolerance predominantly involved cutaneous disorders as well as combinations of cutaneous and digestive disorders, while respiratory system disorders proved to be relatively rare.
Frequency and characteristics of hepatitis B infection in children with malignant diseases
Authors: Jovanovic Nada , Janic Dragana , Dokmanovic Lidija , Skoric Dejan , Lazic Jelena
Published: July 2008

Introduction. Hepatitis B, a complication of blood transfusion or other means of transmission, occurs with variable frequency in children with malignant diseases. Objective. The objective of this study was to determine the frequency of hepatitis B virus infection in children with malignant diseases, to investigate the clinical course of the illness, and to analyze the influence of hepatitis on cytotoxic treatment. Method. The study included children diagnosed and treated for malignant diseases at the University Children's Hospital in Belgrade from 1997 to 2003. HBs Ag was analyzed in all patients who had elevated transarninases of twice normal value, in children who had icterus, and in one group of patients treated routinely after 2001 before, during, and after therapy. Results. A total of 137 male and 107 female children who had malignancies were treated. From 113 children who were evaluated for the presence of HBs Ag at the beginning of treatment, 2(1.7%] were HBsAg+. In this group of patients HBsAg was tested in 58 (51%) children during and after chemotherapy, and HBsAg was discovered in 17 (29%) of them. Of 123 children, in whom HBsAg was not tested at the beginning of their illness, 36 (55%) out of 66 (51%) tested patients were HBsAg+. No statistical difference between those two groups of patients was ascertained (X2=3.27, p>0.05). In summary, the presence of HBsAg was discovered in 53 patients, 22% out of 244 patients and 43% of tested patients. Nine patients had the icteric form of illness, with one case proving fatal due to fulminating hepatitis. Conclusion. Taking into consideration the uncertain long-term prognoses of these patients, follow-up and treatment is essential.
Subclinical peripheral neuropathy in type 1 diabetic adolescents and its relationship with metabolic control
Authors: Sajic Silvija , Petrovic Rada
Published: July 2008

Professional management of paediatric diabetology, according to consensus guidelines, involves the screening of micro-vascular complications at puberty. The subclinical form of peripheral neural dysfunction in diabetic teenagers is reported with a frequency of 50-88%, by different authors. The purpose of this study was to evaluate the frequency of subclinical distal neuropathy (DSMN) in type 1 diabetic pediatric patients during the second decade of life, and its relationship with metabolic control. The Endocrinology Department and the Neurology-Physiology Laboratory of the Pediatric Clinic in Belgrade carried out a longitudinal follow-up study (lasting 18 months, beginning in November 2000) on a selection of patients with poor metabolic control. During routine clinical treatment, patients were evaluated using the electrophysiological diagnostic method on peripheral neural dysfunction, a subclinical form of neuropathy. Metabolic control was manifested through HbA1c levels, measured every 3 months, using ion-exchange chromatography. Finally, here is the data collected from the clinical follow-up investigation of 60 children, aged 13-19 (median 1S.S?2.2), with duration of diabetes from 2-16 years (median b.3?3.b), and on the following therapies: 43 CT-conventional and 17 IIT-intensive, and insulin dose/day, median 1.02 (0.6-2.1) U/kg. Detected DSMN parameters at the beginning and at the end of the study were also noted. DSMN frequency was positive, at 64% for HbA1c of 9.44; DSMN dysfunction was reversed in 5% of the patients, for HbA1c of 10.17; the worst result was the progression of DSMN at 6.7% for HbA1c of 10.52; 6.7% had negative DSMN, with improved metabolic control, for HbA1c of 8.4; 15% of the examinations were unfinished (+/*). ANOVA statistical analysis showed a significant statistical relationship between metabolic control (HbA1c levels) and DSMN neuropathy (sig. 0.043, p<0.05). There was no significant relationship between the reversion of DSMN and improved HbA1c, although a numeric distinction did exist. On the clinical aspect, there was a significant relationship between insulin dosage and age (p<0.01, sig. 0.007). This data demonstrates the influence of metabolic regulation on neuropathy. Better metabolic control can slow the progression of subclinical peripheral neural dysfunction (DSMN) in diabetic children.
Drainage as a rare cause of intestinal incarceration
Authors: Kadija Sasa , Sparic Radmila , Zizic Vojislav , Stefanovic Aleksandar
Published: July 2008

Silicone drains are often placed in the abdominal cavity for prophylactic reasons. One complication resulting from drainage includes visceral herniation at the drain site of the abdominal wall defect An 82-year-old woman underwent a laparotorny for a large pelvic mass. After the operation, she developed small bowel incarceration, which was caused by aggressive drain extraction. Subsequent surgical treatment resulted in the patient's full recovery. This case emphasises the unusual causative mechanism of intestinal obstruction. Drains should be placed carefully in the abdominal cavity in strictly selected cases, only when it is reasonable to do so.
Boleslas Matuszewski: Pioneer of medical film-making
Authors: Matanovic Dragana
Published: July 2008

Boleslas Matuszewski, born in 1856, was a pioneer in medical film-making. He worked simultaneously on improving his movie camera, film-making, collecting film documentation, and the idea of establishing an archive of medical films. Although his first attempts at filming and showing surgical operations didn't gain widespread approval, he was not discouraged, and succeeded in garnering support from a number of French doctors, who realized the importance of his ideas, not only in filming and forming medical film documentation, but also in the use of film for educative purposes. His visionary ideas gained acceptance when Dr. Doyen, on the occasion of the 66th Convention of the British Medical Society, in 1898, used film material as part of his lecture. Shortly afterwards, the Medical Academy took steps to show certain operative techniques, which represented both the confirmation and fruition of Matuszewski's ideas about filmmaking and the establishment of an archive of medical films.
Hydrocephalic risk factors after spontaneous subarachnoidal haemorrhaging of aneurysmal aetiology
Authors: Jovanovic Vladimir , Tasic Goran , Djurovic Branko , Janicijevic Milos
Published: July 2008

INTRODUCTION Hydrocephalus is one of the most significant complications of spontaneous subarachnoidal haemorrhaging that can be treated surgically. OBJECTIVE We analyzed risk factors that caused spontaneous subarachnoidal haemorrhaging. Patients were divided into two groups: shunt-dependent and shunt-independent. METHOD We retrospectively analyzed 174 patients (63 men and 111 women), surgically treated at the Institute of Neurosurgery of Clinical Center of Serbia in the period from January 2002 to January 2004. RESULTS The prevalence of hydrocephalus in patients with a shunt (shunt-dependent) was most significant in women (18%:9.5%), but not statistically significant (p>0.05). Concerning the significance of age (years), we found that hydrocephalus in patients with a shunt was most significant in older patients (p<0.025).The HiH and Fisher grading were not statistically significant in our study (p>0.05%). In patients with intraventricular haemorrhaging (29.3%:10.5%) and vasospasms (34.6%:6.5%), the prevalence of shunt-dependent hydrocephalus was statistically very significant (p<0.005; p<0.001). The frequency of ventriculomegania in the initial CT scan was greater for patients with a confirmed diagnosis, but of no statistical significance (p>0.05). The prevalence of shunt-dependent hydrocephalus with aneurysms in the a. basillaris basin was 47.4%, with multiple aneurysms 17.2%, and with aneurysms of the anterior segment 9.5%, which represents a statistically significant difference (p<0.001). CONCLUSION We discovered that hydrocephalus, as a complication of spontaneous subarachnoidal haemorrhaging, was most frequent in patients older than 50 years, manifesting in ventricular haemorrhaging, vasospasm, and aneurysms of the posterior segment.
Influence of proprioceptive training in the improvement of neuromuscular performance after ACL reconstruction
Authors: Dubljanin-Raspopovic Emilija , Matanovic Dragana , Kadija Marko
Published: July 2008

ACL injury leads to a decrease in proprioceptive abilities, which can be improved with ACL surgery and postoperative rehabilitation. The goal of our study was to investigate whether the impact of coordinative training can be differentiated from the influence of surgery on proprioceptive improvement, and whether there is a correlation between improvement in coordinative abilities and other objective parameters of functional recovery. This follow-up study included 45 patients who had undergone ACL reconstruction and who were randomized into a conservative (TH-C) and an intensive (TH-I) rehabilitation group. In the TH-I group, coordinative training began earlier due to unrestricted weight-bearing. The groups were first compared preoperatively, then postoperatively, after 6 weeks, 4,6,9, and 12 months via the single leg stance test, the one leg hop test, the Lysholm knee score, and the Tegner score. A faster recovery of coordinative skills was registered in the TH-I group. Already after 6 weeks, highly statistically significant progress in one leg stance abilities was noticed, while in the TH-C group the same was not noticed until 4 months after surgery (p<0.01). Such a result speaks for the distinct influence of proprioceptive training on coordinative abilities. Also, a highly statistically significant correlation was noticed between the single leg stance, one leg hop, Lysholm, and Tegner tests (p<0.01), which points out the importance of a good rehabilitation programme, since neuromuscular performance cannot be separated from other parameters of functional recovery.
Localisation of main and ancillary foramina within the mesial and distal roots of the first lower molars
Authors: Jovanovic-Medojevic Milica , Zivkovic Slavoljub
Published: July 2008

Introduction. Understanding the morphology of the root canal system, and especially its apical third, represents the basic precondition for the successful treatment of diseased pulp and the apical endodontium. Aim. The aim of this study was to precisely locate the main and ancillary foramina in the mesial and distal first lower molars. Method. One hundred extracted first lower molars, originating from persons of both sexes and three different age groups, were used in the study. Results. The analysis of the sampled molars? apical third was carried out using a binocular magnifier and a digital X-ray scanner (Trophy). The results showed that the main mesial and distal root foramina were located mostly on the distal surface. The ancillary mesial and distal root foramina were located at the lingual end, in most cases. Statistical analysis demonstrated the congruence of results achieved using the binocular magnifier and digital x-ray in 100% of cases if the main foramen is located on the very top of the mesial root (?2 =17.23; p<0.001), and in 92.9% of cases if the main foramen is localised on the very top of the distal root of the first lower molar (?2 =12.07; p<0.001). Conclusion. The most common localisation of the main foramina for all age categories and in both mesial and distal roots is on the distal surface of the root. The greatest number of ancillary foramina was observed in the youngest age category, while they were localised most often on the lingual side of the mesial and distal root.
Influence of heart failure severity on heart rate variability
Authors: Zamaklar-Trifunovic Danijela , Seferovic Petar , Zivkovic Mirjana , Jelic Vera , Vukomanovic Goran , Petrovic Milan , Milic Natasa , Ristic Arsen , Simeunovic Dejan
Published: July 2008

Introduction. Autonomic regulation of cardiovascular functions in congestive heart failure is characterised by enhanced sympathetic and diminished parasympathetic activity. The long term predominance of sympathetic tone is a significant factor in arrhythmogenesis, sudden cardiac death, and progressive pump failure. Heart rate variability (HRV) is a noninvasive method for estimating the sympatho vagal balance in cardiovascular control. Aim. The aim of this study was to analyse the influence of heart failure severity on HRV. Method. HRV was estimated through the spectral analysis of short term ECG (Cardiovit AT 60, Schiller, CH) in 63 patients (78% male, mean age 56.9?10.9 years) and 14 healthy volunteers (57.1% male, mean age 53.1?8.2 years). The following spectral components were measured: VLF (very low frequency), LF (low frequency), HF (high frequency), and total power (Tot Power). Results. All spectral components were statistically, significantly lower in patients with heart failure in comparison to healthy controls (VLF: 159.89?147.02 vs. 285.50?202.77 ms2; p=0.023, LF: 161.48?204.01 vs. 474.57?362.93 ms2; p<0.001, HF: 88.58?102.47 vs. 362.71?318.28 ms2; p<0.001), as well as total power (Tot Power: 723.39?644.52 vs. 1807.29?1204.74 ms2; p<0.001). A significant, negative correlation between HRV parameters and NYHA class was detected in heart failure patients (VLF: r=-0.391; p=0.002, LF: r=-0.401; p=0.001, and Tot Power r=-0.372; p=0.003). Ejection fraction proved to be in significant, positive correlation to VLF (r=0.541; p=0.002), LF (r=0.531; p=0.003), HF (r=0.418; p=0.020), and Tot Power (r=0.457; p=0.013). Conclusion. Significant HRV reduction is a precursor to incipient heart failure (NYHA I). In heart failure progression, total power as well as the power of all spectral components is progressively reduced. LF and Tot Power are the most prominent parameters for discriminating between the different stages of heart failure. These results could promote HRV as an important decision-making tool in heart failure treatment as well as in monitoring the results of that treatment.
Effectiveness of peritonaeal dialysis
Authors: Jovanovic Natasa , Lausevic Mirjana , Nesic Vidosava , Stojimirovic Biljana
Published: July 2008

Introduction. In the last few years, an increasing number of patients suffering from terminal renal disease of various leading causes was treated with renal replacement therapy. Peritonaeal dialysis involves an exchange of water and solutes between blood in the peritonaeal capillaries and dialysate in the peritonaeal cavum throughout the peritonaeum. Effective dialysis treatment should provide good quality of life, decrease the number of physical complaints, and bring the incidence of morbidity and mortality closer to the incidence of morbidity and mortality in the healthy population. Aim. The aim of this study was the evaluation of peritonaeal transport characteristics and dialysis effectiveness in 58 patients affected by terminal renal disease who underwent peritonaeal dialysis treatment during August 2003 at the Clinic of Nephrology of the Clinical Centre of Serbia. Method. We examined 30 male and 28 female patients, with an average age of 52 years (range 26 to 78 years). The average duration of peritoneal dialysis treatment was 20 months (ranging from 2 to 66 months), and the end-stage renal failure was caused by different leading disease in our patients. We applied different dialysis modalities: continuous ambulatory peritonaeal dialysis (CAPD) with three to five 2- or 3-litre exchanges daily, cyclic peritonaeal dialysis (CCPD), intermittent peritonaeal dialysis (IPD), or automatic peritonaeal dialysis (APD), according to the transport characteristics of the peritonaeal membrane, the residual renal function (RRF), and the clinical status of the patients, in order to perform adequate depuration as suggested by the new international criteria. A peritonaeal equilibrium test (PET) was performed according to the new international advice; urea and creatinine clearances (Kt/V and Ccr) as well as RRF were calculated using the internationally suggested formulas. Results. Most of our patients received effective dialysis treatment, thanks to the modulation of number, volume, and timing of exchanges. Conclusion. Adequate dialysis improved blood count, nutritional status, and quality of life in our patients, while reducing the incidence of infection to a significant degree.
Autogenic training as a therapy for adjustment disorder in adults
Authors: Jojic Boris , Leposavic Ljubica
Published: July 2008

Introduction. Autogenic training is a widely recognised psychotherapy technique. The British School of Autogenic Training cites a large list of disorders, states, and changes, where autogenic training may prove to be of help. We wanted to explore the application of autogenic training as a therapy for adjustment disorder in adults. Our sample consisted of a homogeneous group of 35 individuals, with an average age of 39.3?1.6 years, who were diagnosed with adjustment disorder, F 43.2, in accordance with ICD 10 search criteria. Aim. The aim of our study was to research the effectiveness of autogenic training as a therapy for adjustment disorder in adults, by checking the influence of autogenic training on the biophysical and biochemical indicators of adjustment disorder. Method. We measured the indicators of adjustment disorder and their changes in three phases: before the beginning, immediately after the beginning, and six months after the completion, of a practical course in autogenic training. We measured systolic and diastolic arterial blood pressure, brachial pulse rate as well as the levels of cortisol in plasma, of cholesterol in blood, and of glucose. During that period, autogenic training functioned as the sole therapy. Results. The study confirmed our preliminary assumptions. The measurements we performed demonstrated that arterial blood pressure, pulse rate, concentration of cholesterol and cortisol, after the application of autogenic training among the subjects suffering from adjustment disorder, were lower in comparison to the initial values. These values remained lower even six months after the completion of the practical course in autogenic training. Conclusion. Autogenic training significantly decreases the values of physiological indicators of adjustment disorder, diminishes the effects of stress in an individual, and helps adults to cope with stress, facilitating their recuperation.
Necrosis of the duodenum resulting from acute necrotising pancreatitis and treated with complete duodenopancreatectomy
Authors: Colovic Radoje , Grubor Nikica , Radak Vladimir , Colovic Natasa , Jovanovic Miodrag , Stojkovic Mirjana
Published: July 2008

Necrosis of the duodenum resulting from acute necrotising pancreatitis is a rare but potentially lethal complication. A small number of cases has been reported so far, the majority of which having, unfortunately, had a lethal outcome. We present the cases of two patients, a 21-year-old woman and a 54- year-old man, both suffering from extensive duodenal necrosis stemming from acute necrotising pancreatitis, and both cases involving the second and third sections of the duodenum, one of which was probably caused by the thrombosis of nutritive blood vessels, the other by an abscess of the head of the pancreas. Due to the extent of the necrosis of the duodenum, there was no option to close so large a hole or to employ any less drastic procedure, so that a complete duodenopancreatectomy had to be performed. One patient survived and has remained in good health for a period of almost ten years, to date. The other patient died six days after surgery due to infection, in spite of an absence of any sort of anastomic complications.
Suicide by intravenous injection of rocuronium-bromide: Case report
Authors: Nikolic Slobodan , Atanasijevic Tatjana , Nesic Zorica , Spasic Andjelka
Published: July 2008

Suicides by intravenous injection of an overdose of medicaments are uncommon. In this paper, we present the case of a suicide by rocuronium-bromide injection in combination with an oral overdose of metoprolol. Unfortunately, in Belgrade, there is no toxicological laboratory capable of detecting rocuronium. The interpretation of autopsy and toxicological data in this case was made difficult due to the extreme putrefaction of the body of the deceased. So, by forensic investigation, the case was solved indirectly, through circumstantial evidence: an empty ampoule of rocuronium found near the body, as well as a plastic syringe and cloth-bandage found in the left hand of the deceased.
Basic principles of aggressive rehabilitation after anterior cruciate ligament reconstruction
Authors: Dubljanin-Raspopovic Emilija , Kadija Marko , Matanovic Dragana
Published: July 2008

Rehabilitation after ACL (anterior cruciate ligament) reconstruction has drastically changed over the last decade, with the adoption of a more aggressive approach, right from the first day after surgery. Progress in the effectiveness of rehabilitation is based on improvements in operative techniques, as well as on the encouraging results of histological studies regarding graft healing. Despite a huge amount of research papers on this topic, a rehabilitation golden standard still has not been established, due to the complexity of this problem. In this review, we point out the basic principles of rehabilitation after arthroscopically assisted ACL reconstruction based on actual practices, as well as the importance of specific procedures for the prevention of complications during the postoperative period. The importance of range-of-motion exercises, early weight bearing, an appropriate gait scheme, patella mobilisation, pain and oedema control, as well as stretching and balance exercises is explained. The functional advantages of closed kinetic chain exercises, as well as their influence on the graft are also described, in comparison to open kinetic chain exercises. The fundamentals of returning to sports are revealed and the specific aspects of rehabilitation regarding graft choice are pointed out. While waiting for new clinical investigations, which are expected to enable the establishment of a rehabilitation golden standard, the outlined principles should be followed. The complexity of this injury requires treatment in highly specialised institutions.
Changes of the glomerular size during the human fetal kidney development
Authors: Dakovic-Bjelakovic Marija , Vlajkovic Slobodan , Cukuranovic Rade , Antic Svetlana , Bjelakovic Goran , Mitic Dejan
Published: July 2008

Introduction. Newborns adaptation on postnatal conditions includes significant morphological and functional renal changes. Every kidney contains a constant number of nephrons, at the end of the nephrogenesis period, which extends from week 8 to 34 of gestation. Mature juxtamedullary nephrons possess higher filtration capacity than primitive superficial nephrons, which have insufficient vascularization. Objective. The objective of the study was to calculate an average glomerular diameter in cortical zones of the kidney during development, to define periods of their most intensive growth, and to record differences of glomerular size between different cortical zones. METHOD A total of 30 human fetal kidneys aged from IV to X lunar months were analyzed. Stereological methods were used for calculating the average glomerular diameter in superficial, intermediate and juxtamedullary zone of the kidney cortex. Results. Glomeruli in the superficial cortical zone had the lowest average diameter. The average glomerular diameter continually increased from IV lunar month (0.057?0.004 mm) to X lunar month (0.082?0.004 mm), with highly significant correlation with gestational age (r=0.755; p<0.01). The average glomerular diameter in the intermediate zone increased from 0.081?0.004 mm (IV lunar month) to 0.096?0.004 mm (X lunar month) with low linear correlation with gestational age (r=0.161). Juxtamedullary glomeruli were the biggest ones. Their average diameter, during the IV LM ranged from 0.093?0.006 mm to 0.101?0.004 mm. In the newborns (X lunar month), juxtamedullary glomeruli had spherical structures with an average diameter of 0.103?0.004 mm, and low negative correlation (r=-0.032) with gestational age. In the IV and V lunar months of gestation, there was significant difference (p<0.01; p<0.05) between the average glomerular diameter in the different zones of the kidney cortex. Conclusion. Superficial glomeruli had the smallest diameter, while juxtamedullary glomeruli were the largest. The average glomerular diameter increased during intrauterine development in all zones, most intensive in the X lunar month. There was a significant difference of the glomeruli between different cortical zones in the young fetuses. Such significant difference receded as gestational age increased.
The effect of urinary tract calculosis to levels of low molecular inhibitors of crystallization in the urine
Authors: Milenkovic Dragica , Lalic Natasa
Published: July 2008

The incidence of urinary tract calculosis continuously progresses. The triggering event in the process of stone formation is decreased urinary level of crystallizing inhibitors. The aim of our study was to investigate whether the existing stone or applied therapeutic procedure - extracorporeal shock waves lithotripsy (ESWL) - has effect to urinary levels of Mg, citrate and pyrophosphate. Study included 128 patients with the upper urinary tract stones. ESWL using the Lithostar (Siemens) device was used as a mode of treatment. Out of all patients, 76 (59%) were free of stone particles before 1 month, while 52 (41%) had residual stone fragments even 3 months after ESWL. Mg, citrate and pyrophosphate were measured in 24hurine specimens: before, between days 2 and 3, as well as 1 and 3 months after ESWL. The analysis of the results revealed that stone itself had no effect on urinary crystallizing inhibitors. Detected increased urinary levels of Mg, citrate and pyrophosphate after ESWL, compared with pre-treatment values, could be attributed to applied therapeutic procedure.
Triple pelvic osteotomy: Complications and how to avoid them
Authors: Vukasinovic Zoran , Spasovski Dusko
Published: July 2008

Authors reviewed their eight-year long experience with triple pelvic osteotomy. They explained the way of introduction of this procedure into everyday clinical practice. Seventy hips were operated using Tonnis-Vladimirov method in fifty nine patients of an average age of 15 years and one month. Treatment results were evaluated, both anatomically and functionally. Anatomic improvement was recorded by measuring the CE angle of Wiberg. Preoperatively, it ranged from -6 to 33 degrees (16.1?10.2 degrees), and at the end of treatment, it ranged from 15 to 68 degrees (43.1?11.1 degrees) - the difference proved to be highly significant (Student test t=-14.27, p<0.01). Functional improvement (absence of waddling gait or limp as well as better range of motion) was noted in almost all cases, although the difference was not statistically significant. In addition, the authors presented some very rare complications - asymptomatic pubic and/or ischial nonunion in seven patients.
Relationship between nutritional status and some inflammatory markers
Authors: Sevic Ljiljana , Maksimovic Milos , Djurisic Nebojsa , Gajic Milan , Jorga Jagoda
Published: July 2008

Introduction. Obesity is well known risk factor of metabolic complications and CVD. On the other hand, CRP as a marker of inflammation has lately aroused huge interest as predictor of cardiovascular risk. Objective. The objective of the study was to determine whether the nutritional status parameters were related to some inflammatory markers and what was the extent of such relation. Method. The study involved 220 patients, 40.5 ? 14.5 years old, who referred to Nutrition Clinic of the Institute of Hygiene in order to get a dietetic advice or nutritional medical therapy. Nutritional status was assessed by BMI (kg/m?), calculated from measured values of body weight and height, the waist measurement and body fat percentage according to WHO recommendations. Biochemical parameters and inflammatory markers were measured from blood samples collected after a twelve-hour fast. Results. The subjects were categorized into quartiles of BMI (kg/m?) and % body fat. The inflammatory markers followed the increase of BMI and % body fat, as odds ratio (95% CI) of elevated level of CRP was observed to be highest in the fourth quartiles of BMI [1.55 [(OR = 0.731 - 3.296] as well as in the fourth quartile of % body fat - 1.34 [(OR = 0.598 - 3.009)]. This was confirmed by analysis of linear correlation which resulted in r = 0.148 for BMI (p < 0.05) and r = 0.164 (p < 0.05) for fat percentage. In addition, there was highly significant positive correlation between fibrinogen level, C3 and BMI (p < 0.01), and body fat (p < 0.01). Conclusion. The results showed that determination of inflammatory markers should become a routine screening procedure in all patients with elevated anthropometric parameters in order to prevent the consequences of atherosclerosis as quickly as possible.
Record of successful sertraline treatment of a pathological gambler
Authors: Milovanovic Srdjan , Leposavic Ljubica , Barisic Jasmina , Nikolic-Balkoski Gordana
Published: July 2008

This is a case report of 26-year old, advanced university student of the Faculty of Science, Department of Mathematics, single. He has never been a psychiatric patient, but being unable to suppress the gambling impulse, he presented for treatment, on his own initiative, to the outpatient department. Patient met the criteria for diagnosis of pathological gambler, over the period of two years (International Classification of Diseases -ICD X, WHO, 1992). Various phases of the treatment as well as the applied protocols were presented. Initially, therapy was initiated by clomipramine, and abandoned because of adverse effects. During presentation of this case, positive therapeutic response was noted to mono therapy with sertraline in the period of six months, and a total remission was achieved. Progression of the applied therapy was presented in four phases. Observations of the patient concerning the control over impulse disorder were described in his own words. Data on neurobiological concepts as well as phychopharmaceuticals which, according to our knowledge so far, have been used in therapy of pathological gambling were discussed in our study.
Surgical treatment of pain in chronic pancreatitis
Authors: Stefanovic Dejan , Knezevic Srbislav , Djordjevic Zoran , Kerkez Mirko , Bulajic Predrag , Markovic Ljiljana
Published: July 2008

INTRODUCTION: The principal indication for surgical intervention in chronic pancreatitis is intractable pain. Depending upon the presence of dilated pancreatic ductal system, pancreatic duct drainage procedures and different kinds of pancreatic resections are applied. OBJECTIVE: The objective of the study was to show the most appropriate procedure to gain the most possible benefits in dependence of type of pathohistological process in chronic pancreatitis. METHOD: Our study included 58 patients with intractable pain caused by chronic pancreatitis of alcoholic genesis. The first group consisted of 30 patients with dilated pancreatic ductal system more than 10 mm. The second group involved 28 patients without dilated pancreatic ductal system. Pain relief, weight gain and glucose tolerance were monitored. RESULTS: All patients of Group I (30) underwent latero-lateral pancreaticojejunal - Puestow operation. 80% of patients had no pain after 6 month, 13.6% had rare pain and 2 patients, i.e. 6.4%, who continued to consume alcohol, had strong pain. Group II consisting of 28 patients was without dilated pancreatic ductal system. This group was subjected to various types of pancreatic resections. Whipple procedure (W) was done in 6 patients, pylorus preserving Whipple (PPW) in 7 cases, and duodenum preserving cephalic pancreatectomy (DPCP) was performed in 15 patients. Generally, 89.2% of patients had no pain 6 month after the operation. An average weight gain was 1.9 kg in W group, 2.8 kg in PPW group and 4.1 kg in DPCP group. Insulin-dependent diabetes was recorded in 66.6% in W group, 57.1% in PPW group and 0% in DPCP group. CONCLUSION: According to our opinion, DPCP may be considered the procedure of choice for surgical treatment of pain in chronic pancreatitis in patients without dilatation of pancreas ductal system because of no serious postoperative metabolic consequences.
Sideropenic anemia in preschool children and risk factors
Authors: Stojanovic Dusica , Nikic Dragana , Jelenkovic Bratimirka
Published: July 2008

INTRODUCTION: Sideropenic anemia is one of the most common nutritional disorders in the world. The children are at higher risk of iron deficiency than adults due to their rapid growth during infancy and relatively higher requirements of iron. OBJECTIVE: The objective of our study was to investigate the prevalence of sideropenic anemia in pre-school children and relevant risk factors. METHOD: Study on sideropenic anemia of preschool children was performed in Zajecar Municipality in 2003. Subjects: all children, age 6-7 years, who lived in the Zajecar Municipality (554 children). The investigation included: interview of children's parents and laboratory analysis of blood. RESULTS: The frequency of sideropenic anemia was 5.23% in tested children (hemoglobin level less than 11g/dl). Sex and place of residence had no significant impact on hemoglobin concentration in blood of children. Likewise, social status and education of parents had no significant impact on iron deficiency anemia. Higher incidence of infections was found in children with lower hemoglobin concentration in blood (p<0.05). It made no difference if children attended the kindergarten or not. Nutrition of children in kindergarten does not correct domestic nutrition, which should be one of its basic roles. CONCLUSION: Since sideropenic anemia gives rise to serious health problems, such as poor cognitive and motor development and behavioral problems, it is important to take corrective measures regarding domestic and social nutrition of children. Therefore, it is necessary to take action in preventing the sideropenic anemia and provide normal growth and development.
Tubular adenoma of the gallbladder with squamous metaplasia
Authors: Colovic Radoje , Grubor Nikica , Radak Vladimir , Micev Marjan , Colovic Natasa , Stojkovic Mirjana
Published: July 2008

Adenomas of the gallbladder are rare tumors. They may be papillar or tubular. Tubular adenoma appears in middle aged and older patients, although it may develop even in children. This is a case report of forty-year old woman in whom a polypoid lesion was discovered in the gallbladder during regular ultrasonographic control after the liver surgery for hemangioma. The gallbladder was removed during an open surgery. A polypoid tumor of 20x7x5mm in size on wide pedicle was found in the gallbladder. Histology showed tubular adenoma with mild epithelial dysplasia in some places and with antral and squamous metaplasia. The recovery was uneventful.