bluuebunny/crossref_metadata_2025 huggingface dataset:
Body fat mass in normal weight subjects
Authors: Stokic Edita , Srdic Biljana , Peter Andrea , Ivkovic-Lazar Tatjana
Published: July 2006

Obesity is characterized by excessive body fat accumulation which may lead to serious health problems and complications. Body mass index is the most optimal parameter to evaluate the level of nutritional status and diagnose obesity. However, modern techniques studying body composition can more accurately determine whether the gain of body weight was on the account of body fat, lean body mass or total body water. If one's body mass index is in the range of normal values but the amount of body fat is above normal range, we talk about sarcopenic obesity. In order to evaluate presence of sarcopenic obesity, a group of 140 normal weight students of the Faculty of Medicine in Novi Sad were measured. Apart from standard anthropometrical parameters the amount of body fat was also determined by using the method of bioelectrical impedance analysis. Sarcopenic obesity was diagnosed in 25.71% of examined students. By using body mass index values this type of obesity cannot be diagnosed, and knowing that a higher amount of body fat in normal weight persons can lead to complications, especially metabolic, it is of great importance to evaluate the amount of body fat accurately.
Blood pressure circadian rhythm and obesity: Blood pressure variations and obesity
Authors: Despotovic Nebojsa
Published: July 2006

Introduction The association between obesity and arterial hypertension has been established in a great number of studies. Our objective was to investigate whether circadian rhythm of blood pressure is disturbed among obese people. Material and methods In this cross-sectional, randomized study, Schiller BR-102 device was used for ambulatory blood pressure monitoring. One hundred and twenty outpatients were divided into three randomized groups: obese body mass index 30 kg/m2 (52 patients), overweight (28 patients), with body mass index 25,0-29,9 kg/m2 and normal weight (control group) (48 patients), with body mass index 18,5-24,9 kg/m2. In all patients we investigated the following blood pressure parameters: average blood pressure (total, day-time and night-time), maximal blood pressure and dipping or non-dipping blood pressure pattern during night (for systolic and diastolic blood pressure, respectively). Results In body mass index beyond 30 kg/m2 only systolic blood pressure parameters were significantly higher - average blood pressure - during daytime (P=0.034) and during night (P=0.014); maximal blood pressure (P=0.001). In body mass index beyond 30 kg/m2, absence of normal blood pressure during night was significantly more often registered (P=0.007). Discussion and Conclusion The non-dipping blood pressure pattern and increase of systolic blood pressure only reveal hyper activation of sympathetic nervous system as a leading pathophysiological mechanism causing arterial hypertension in obese patients.
The significance of early rehabilitation of a severely polytraumatized child: Case report
Authors: Kovac Milena , Serpak Dragoslav , Vucinic Jovanka , Borovcanin Daliborka , Krstic Tatjana
Published: July 2006

Case presentation This is a case presentation of an eight-year-old boy, a traffic accident victim with severe polytrauma. The boy was admitted to hospital with lacerations and contusion injuries of the left basal frontal and left temporal brain region, moderate brain tissue edema and fracture of the left clavicle which were diagnosed by CT (computer tomography). The boy was in coma (Glasgow Coma Scale - 5). Oral feeding and catheter removal were established after one month. Three months later his state of consciousness improved, he could carry out simple orders, started vocalization and visited ambulance by wheel chair. Speech and independent walking were achieved 4 months after the accident. Physical therapy Physical therapy included: neural-stimulation by Vojta and sclerodermal massage from seventh day. Later on, speech and work therapy were applied. Drug therapy Drug therapy included: muscle relaxants and tranquilizers while orthopedic treatment meant plastic immobilization. Control CT revealed chronic subdural hemathoma in the right frontal-parietal region. The boy could walk, talk, have normal diet, and controlled sphincters four months after severe trauma. Now, he is functional and on the level of moderate mental retardation. Early rehabilitation was extremely important in his recovery.
Nutrition knowledge and eating behavior in schoolchildren and their parents in Vojvodina
Authors: Niciforovic-Surkovic Olja , Kvrgic Svetlana , Ac-Nikolic Erzebet
Published: July 2006

Introduction Unbalanced diet, as a risk factor, has an important influence on health, not only of adults but even more of children and adolescents. Therefore, it is very important to assess knowledge, habits and behavior considering nutrition among youth. The aim of this study was to assess knowledge and behavior regarding nutrition among schoolchildren and their parents, as well as to establish how much knowledge and behavior are related to age and other socio-demographic characteristics, and how they are connected with knowledge and behavior of parents. Material and methods The study was performed in a random sample of 210 children in 4 elementary schools and their parents in Vojvodina using specially designed questionnaires. Results and discussion Results showed that knowledge about healthy food, as an important factor of healthy behavior, is quite good, and increases with age. There is a significant discrepancy between knowledge and behavior. Although children know which food is healthier, they often consume less healthy food. This discrepancy is present in all offered pairs of food, but particularly expressed when it is about consuming bread: about 80% of pupils know that dark breads are healthier than white breads, but only 13.5% among them actually eat dark breads. Conclusion This study showed that children's and parents' level of knowledge about healthy food is satisfactory, but it is not enough for healthy behavior, so there is a need for additional effort in health education and health promotion in youth population.
Childhood vitiligo
Authors: Prcic Sonja , Djuran Verica , Poljacki Mirjana
Published: July 2006

Introduction Vitiligo is an acquired, sometimes familial skin depigmentation disorder due to selective destruction of melanocytes. Vitiligo is primarily a disease of the young; in about half of patients it occurs before the age of twenty. The aim of this study was to investigate some epidemiological and clinical characteristics of vitiligo in children, in relation to adults with vitiligo and children without vitiligo. Material and methods The research was conducted in fifty children with clinically diagnosed vitiligo (2 to 16 years of age). Children were compared with control groups of children with other skin diseases (age 2 to 16) and with adults with vitiligo. Each group comprised 30 patients. A detailed history was obtained and physical examination performed in each patient to determine the age of onset, clinical type (segmental or generalized), family history of vitiligo and other autoimmune and/or endocrine diseases, association with halo nevi, poliosis and Koebner phenomenon. Results Of the 50 children with vitiligo, 29 (58%) were girls and 21 (42%) boys. The mean age at first visit was 9 years and the mean age of onset was 7 years. Children with vitiligo had positive family history of vitiligo and autoimmune and endocrine diseases more often compared to children without vitiligo (p<0.05). Children with vitiligo had poliosis, especially in cases of segmental vitiligo, more often compared to their age group (p<0.001). Children had an increased incidence of segmental vitiligo compared to adults (p<0.05). Halo nevi were more common in children with generalized vitiligo, in comparison with children without vitiligo (p<0.01) and adults with vitiligo (p<0.05). Discussion and conclusion Our results show that segmental vitiligo and halo nevi occurred significantly more often in children than adults with vitiligo.
Near-total laryngectomy (Pearson's method): Radical surgical procedure with preservation of phonatory function
Authors: Jovic Rajko , Swoboda Herwig
Published: July 2006

Introduction Patients with advanced T3 and T4 laryngeal and hypopharyngeal carcinoma need surgical treatment - total laryngectomy. Excision of the larynx affects enormously the quality of patient's life. Near total laryngectomy appeared about twenty years ago, and was accepted worldwide during the last decade of the twentieth century. Two years ago we started performing this operative procedure. Although we still don't have great experience, first results are satisfying. We point to the importance of this procedure especially in developing countries, where phonatory protheses are expensive, patients' education of esophageal speech is not satisfactory and number of those who were successfully trained is small. The aim of this paper was to introduce near total laryngectomy as a surgical procedure which improves quality of life of patients with advanced stages of laryngeal and hypopharyngeal carcinoma. Near total laryngectomy The original procedure described by Pearson was very complicated to understand, so we accepted Monux procedure which is easier. The resection of the laryngeal structures corresponds to those in total laryngectomy, but we spare a small part of cricoid cartilage and whole or 2/3 of the healthy vocal cord. Conclusion A number of arguments, presented in this paper, speak in favor of near total laryngectomy. This technique has the same oncological results as total laryngectomy, but much better functional results and quality of life in patients with laryngeal and some hypopharyngeal carcinomas.
Antibiotics in otorhinolaryngology practice
Authors: Stefan-Mikic Sandra , Sabo Ana , Jovancevic Ljiljana , Jovicevic Jasna , Vasovic Marija , Jakovljevic Vida
Published: July 2006

Introduction This study investigated utilization of antibacterial agents at the Ear, Nose and Throat Department of the Outpatient Service of the Health Center Novi Sad - Liman and at the Ear, Nose and Throat Clinic of the Clinical Center Novi Sad, in the period February - March 2001. Material and methods All antibacterial agents were classified as group J, regarding Anatomic-Therapeutic-Chemical Classification. Data on drug utilization were presented in Defined Daily Doses (DDD). Patients who were under observation were all treated with antibiotics. Results In regard to prescribed treatment in the Ear, Nose and Throat Department of the Outpatient Service of the Health Center Novi Sad - Liman, most outpatients were treated with macrolide antibiotics - in 26.21%; combination of penicillin and beta-lactamase inhibitors in 20.83% and pyranosides in 16.12%. At the Ear, Nose and Throat Clinic of the Clinical Center Novi Sad, macrolides and lincosamines were most frequently used - in 20.46%; cephalosporins in 19.87% and penicillins susceptible to beta-lactamase in 18.85%. It is extremely positive and in agreement with current pharmacotherapeutic principles that in both institutions peroral ampicillins have not been prescribed. Aminoglycosides have been prescribed in less than 1% of patients of the Ear, Nose and Throat Department of the Outpatient Service of the Health Center Novi Sad - Liman, whereas they were much more frequently prescribed at the Ear, Nose and Throat Clinic of the Clinical Center Novi Sad - in 11.25%. Although there is a positive postantibiotic effect in regard to these antibiotics and it is recommended to use them once a day, in both examined institutions aminoglycosides were given twice a day. In regard to bacterial identification it was done in 80.76% of patients of the Ear, Nose and Throat Department of the Outpatient Service of the Health Center Novi Sad - Liman, while in the Ear, Nose and Throat Clinic of the Clinical Center Novi Sad it was done only in 32.42%. Conclusions Although treatment performed on empirical basis and clinical findings is usually correct, a greater percentage of antibiotic prescriptions should be confirmed by antibiograms providing optimal therapy and decreased degree of resistance.
Surgical treatment of perforated gastric ulcer
Authors: Korica Milan , Petakovic Goran , Gavrilovic Sava
Published: July 2006

Introduction Peptic ulcer perforation is a complication of ulcer disease which requires urgent surgical treatment. The aim of this paper was to point out our experience in surgical treatment of perforated peptic ulcer. Material and methods This retrospective study analyzes results of surgical treatment in 365 patients with perforated peptic ulcer during the period January 1996 to December 2000. Results During the last 5-year period 365 patients were treated following peptic ulcer perforation. The average age was 43.53?8.26, with the span from 18 to 86. The most frequent surgical procedures in treatment of peptic ulcer perforation were: simple closure with biopsy (55.88%), excision of the ulcer with a pyloroplasty and vagotomy (35.29%) as nonresection surgical procedures and stomach resection after Billroth II (8.83%). The postoperative mortality was 4.41%. Conclusions The methods of choice in surgical treatment of gastric ulcer perforation are nonresection surgical procedures with drug therapy and eradication of Helicobacter pylori, if present.
Neurocysticercosis: A five-year experience
Authors: Doder Radoslava , Madle-Samardzija Nadezda , Canak Grozdana , Vukadinov Jovan , Turkulov Vesna , Sevic Sinisa
Published: July 2006

Introduction Neurocysticercosis (NCC) is the most common parasitic disease with wide distribution which is caused by larval forms of Taenia Solium. Our aim was to: show the most common clinical manifestations of patients with NCC and their importance in diagnosing this disease; examine the value of serologic diagnostic methods in blood and cerebrospinal fluid; to emphasize the value of radiological diagnostic methods ? CT and MRI of the brain, in relation to the applied protocol of therapy, as well as the impact of anti-parasitic therapy on the outcome of this disease. Material, methods and results 13 patients with NCC (from 35 to 63 years of age, median age 49; 61,5% male and 38,5% female) were treated at the Clinic of Infectious Diseases in Novi Sad during a five-year period. Two patients had a positive epidemic data of parasitic diseases of the intestinal tract in childhood. The most common clinical manifestation was headache in 61,5% of patients, and generalized convulsions and hemiparesis in 46,2%. Meningeal inflammation was present in 27,3% of patients. Two of five patients had positive ELISA test for cysticercosis in the serum and cerebrospinal fluid. CT and MRI findings confirmed parenchimal form of NCC in 30,8% of patients, while calcifications were found in 69,2% of patients. All patients were treated with Albendazole, 800 mg a day, in two doses. 30,76% of patients had a favorable outcome of the disease, 53,7% of patients were discharged with complications, and one patient died. Conclusion The most common manifestation of NCC in our patients was headache, followed by general convulsions and hemiparesis. Radiological diagnostic methods ? CT and MRI ? proved to be most valuable both in diagnostics and follow-up of lesions. All our patients were treated with Albendazole; Dexamethasone was applied in patients with severe inflammatory reaction, and anti-convulsive drugs in patients with convulsions.
Serologic profile of Epstein-Barr virus infection in acute infectious mononucleosis
Authors: Brkic Snezana , Jovanovic Jovana , Preveden Tomislav , Vukobratov Zita
Published: July 2006

The aim of our study was to determine classes of antibodies in different clinical forms of Epstein-Barr Virus (EBV) primary infections. The investigation included 100 patients with acute mononucleosis who were hospitalized at the Clinic for Infectious Diseases in Novi Sad during 1995-1997. Apart from clinical and laboratory parameters, 5 different ELISA assays were performed: IgM EBVVCA, IgG EBVVCA, IgG EBNA, IgA EBVEA and IgG EBVEA. All patients were IgM EBVVCA positive, only 42% IgG EBVVCA positive and 6% IgG EBNA positive. Antibodies due to EBVEA IgA were established in 58% of patients and IgG class in 41%. Serologic profile of early EBV primary infection was established in 25%, acute EBV primary infection in 69% and late EBV primary infection in 6%. A statistically significant difference regarding absolute lymphocyte count and serologic response to early antigens of EBV infection was established in patients with positive findings. Clinical findings in the throat correlated with serologic response to early EBV proteins. We didn't find any correlation due to duration of illness, fever clinical forms of EBV primary infection and liver damage. Paul Bunnell test was positive only in 42% of our patients, with significantly higher number of negative results in groups of early and late EBV primary infections.
Epidemiology of mental disorders in the North Banat region
Authors: Hovan-Somborac Jaroslava , Hacko Branislav
Published: July 2006

Introduction Mental disorders are recognized as a significant socio-medical problem within WHO European Region with prevalence of 5%. They constantly have an increasing rate and comprise series of pathologies including neuroses and psychosocial pathologies, organic psychoses and neural disorders. Over the past decade, as a result of crisis, enhancement of mental disorders has been established in our population. The objective of this paper was to analyze occurrence and epidemiology of mental disorders in adult population of the North Banat region in the period from 1997 to 2000. Methodology We performed a comprehensive measurement and analysis of registered morbidity using official statistics issued by departments of general practitioners Results and discussion We analyzed registered morbidity in 6 health centers and established that neural-, stress- and somatotropic disorders make 3-7% of general morbidity in regard to 10 most frequent groups of illnesses Prevalence of mental disorders differs in the examined region, but not significantly. We assume that this is the result of different approaches to this problem by physicians who establish the diagnosis. Conclusion As our current research shows, mental disorders had a slight increasing during the last five years. Difference regarding health care approach is apparent, as well. We propose a health care program for mental health of the entire population as well aw appropriate education of health professionals.
Compositae dermatitis
Authors: Jovanovic Mirjana , Poljacki Mirjana
Published: July 2006

Introduction Compositae dermatitis is an allergic contact dermatitis caused by plant species of the Compositae family. The first report of a cutaneous reaction to the Chrysanthemum genus was made by Howe JS in 1887. In 1895 Maiden JH reported about skin lesions among men working with Tagetes minute Case reports of contact allergic-ragweed dermatitis appeared in the American literature as early as 1919. The North American feverfew - Parthenium Hysterophorus was brought to India from America in 1956 and it caused thousands of cases of so-called parthenium dermatitis. Ragweed and parthenium dermatitis became prototypes for the classic, so-called 'airborne' Compositae dermatitis, that affects primarily exposed skin surfaces, and produces a universal erythroderma. Epidemiology The frequency of contact allergy to Compositae in Europe is higher than previously believed. It occurs most frequently in middle-aged and elderly persons, but also in all age groups During the two past decades a more equal sex ratio has been established. The prevalence varies from 0.7-1.4% in the general population, up to 4.5% among occupationally exposed persons. Compositae allergy is among the top ten contact sensitivities in Europe. In North Europe plants were the cause of 4.4% cases of occupational allergic contact dermatitis. Etiology and pathogenesis Among cultivated Compositae plants, Chrysanthemum is considered to be a major sensitizer in Europe (60%). Among the edible types, it is lettuce - Lactuca sativa and endive Cichorium endivia (20-30%), and wild-growing feverfew - Tanacetum parthenium (70-90%), tansy - Tanacetum vulgare (54%), and dandelion - Taraxacum officinale (65%). Sesquiterpene lactones are the main sensitizers of the Compositae family. Other components thiophenes and acetylenes are said to elicit only phytophotodermatitis, but recent studies have demonstrated that some thiophenes and benzofuran derivates possess not only phototoxic activity, but also sensitizing properties. Photosensitivity is present in 22-75% Compositae sensitive individuals. Extracts from Compositae are known to be phototoxic in vitro Photoreactivity of alpha-methylene-gamma-lactone group of sesquiterpene-lactone directed towards the DNA base thymine, thus producing intermolecular 2+2 photoadducts (antigen within the cell), was also thought to be related to photosensitivity. Clinical manifestations vary from generalized eczema (20-30%), eczema of hands and face (24%), hand (36-44%) or facial eczema (11-28%). 65% of patients have vesicular hand eczema Diagnosis Routine patch testing with sesquiterpene lactone mix, aimed testing with Compositae extracts screening mix, Compositae plants, and with their extracts, whereas the treatment of choice is a specific allergen-immunotherapy.
Unilateral laryngeal paralysis
Authors: Mitrovic Slobodan , Mumovic Gordana , Jovic Rajko , Kljajic Vladimir
Published: July 2006

Introduction Phoniatric rehabilitation is mainly aimed at restoring satisfactory phonation. Voice quality depends on the capacity of intact vocal cords to compensate the deficiency involved, as well as on automatism of phonation. Material and methods The study included 50 patients. All subjects underwent history taking, reported symptoms that urged them to visit a phoniatrician; they were submitted to a clinical otorhinolaryngologic and phoniatric examinations, voice assessment by subjective acoustic analysis spectral analysis by digital sonography and laryngostroboscopy. All patients underwent Seeman's method of laryngeal compression. Results The examined group of 50 subjects included 17 males (34%) and 33 females (66%). Vocal cord palsy was most often due to neck surgery (strumectomy) in 19 patients (38%) followed by an idiopathic palsy involved in 12 patients (24%). Disocclusion of 1-2 mm and 3-3 mm was registered in 54 % and 24% patients, respectively After treatment total occlusion was established in 20 % of patients, while disocclusion of up to 1mm, 1-2 mm or 2-3 mm persisted in 36 %, 20% and 2% of patients, respectively. T-test revealed a statistically significant difference in glottic incompetence prior to and after treatment (p<0.01). After treatment, using Seeman's method of digital compression of the larynx 48 % of patients regained satisfactory speech and voice clarity and 50% of them still presented mild dysphonia. Moderate dysphonia was registered in 2% but none of the patients had severe dysphonia. Discussion Central laryngeal palsies made 4% of our examined group, while according to the literature they make 1.2-8.7% of all laryngeal palsies. In majority of cases, paralysis of the recurrent laryngeal nerve was due to neck surgery (38%), but literature reports indicate that iatrogenic palsies are mostly due to operation of the thyroid. The well known fact that the left recurrent nerve is more frequently paralyzed, has been confirmed in our study as well. Conclusion Accurate and efficient treatment of unilateral laryngeal palsies requires team work Phoniatric rehabilitation of the disorder using Seeman's method has proved efficient in diminishing the glottic incompetence and dysphonia. Patients who fail to respond to phoniatric rehabilitation should be treated using other therapeutic modalities.
Pulmonary thromboembolism and deep vein thrombosis in antiphospholipid syndrome: Case report
Authors: Vucicevic-Trobok Jadranka , Bogdanov Biljana , Trifkovic Miroslava
Published: July 2006

Introduction Systemic lupus erythematosus is a multisystemic disease of unknown etiology with diverse clinical symptoms depending on the organ affected. Plasma of affected patients contains a specific anticoagulant called lupus anticoagulant. It is an antibody which belongs to the class of antiphospholipid antibodies which bind to phospholipid-binding proteins molecules of natural coagulation inhibitors, thus increasing the risk of thrombosis. Systemic lupus erythematosus commonly affects the skin, joints serosa, hematopoietic tissue, kidneys and the nervous system. Pulmonary symptoms may manifest as pleurisy, pneumonia, chronic interstitial pulmonary disease, but pulmonary thromboembolism is the most common pulmonary manifestation. Case Report This is a case report of a young female patient who has been suffering from systemic lupus erythematosus for twenty years She was treated for superficial thrombophlebitis for several times. She was admitted to our hospital a year before, when she developed pulmonary thromboembolism following deep venous thrombosis of the right leg, although at that time she was treated by oral anticoagulants. She was discharged from hospital with vena cava filter placement and further anticoagulant treatment In a one year period she was hospitalized again due to relapse pulmonary of thromboembolism. Discussion Thrombotic complications in systemic lupus are more frequent in patients with antiphospholipid antibodies. Prevention of thrombotic complications by anticoagulant agents in patients who already developed thrombotic manifestations is considered necessary. Conclusion Anticoagulant treatment should be, for preventive reasons, introduced in all patients with a systemic disease and with anticoagulant factor, even if they haven't developed a thrombotic attack and they should undergo prothrombin time measurements and INR: 3-4.
Contralateral acoustic suppression of transient evoked otoacoustic emissions: Activation of the medial olivocochlear system
Authors: Komazec Zoran , Filipovic Danka , Milosevic Dusan
Published: July 2006

Medial olivocochlear pathway represents the final part of efferent acoustic pathway which comes from the superior olivary complex ending at outer hair cells. Activation of medial olivocochlear system (MOCS) alters the cochlear output decreasing the travelling wave within cochlea. Stimulation of MOCS provides protection against moderate levels of noise, encoding noise signals as well as selecting hearing attention. Activation of MOCS can be performed using contralateral acoustic stimulation. The principal result of presentation of contralateral acoustic stimulation during screening of transient evoked otoacoustic emission (TEOAE) is an attenuation of the TEOAE amplitude. Thirty-eight ears were examined in this study: twenty-eight ears from 14 normal-hearing adults and 10 patients with unilateral deafness. Healthy subjects were exposed to contralateral broad-band noise of various intensities (40, 30, 20 and 10 dB SL), as well as 30 dB SL pure tone stimulation (1 kHz and 4 kHz). A decrease of TEOAE amplitudes during contralateral stimulation with 40 and 30 dB SL broad-band noise and pure tones was established. This effect was a result of MOCS activation. A greater intensity of contralateral stimulation evoked greater decrease of TEOAE amplitude; stimulation with broad-band noise caused greater attenuation than with pure tone stimulation. Contralateral stimulation of deaf ears in the group with unilateral deafness was also performed. Statistically significant difference between TEOAE amplitude before and during contralateral stimulation was not established. This circumstance explains that activation of MOCS and consequent reduction of outer hair cells motility is very possibly caused by contralateral acoustic stimulation. Apart from studying physiological significance of efferent auditory system, results of this and similar studies can be used for production of hearing aids improving speech discrimination in noisy environment.
Tonsillectomies and adenoidectomies performed over a sixty-year period, 1939-1998, at the Department of Otolaryngology at Subotica Municipal Hospital
Authors: Sente Marko , Sente Ruza
Published: July 2006

Introduction This paper presents available epidemiological data on number and types of surgeries of Waldeyer?s ring over a sixty-year period, as well as their interactions. Results Out of 80.477 patients operated on in the period from December 1, 1939 to Dec 31, 1998, statistical survey included 56.564 patients (Table 1). 26.808 (46.57%) patients were operated in local anesthesia, 23.833 (41.40%) under ether narcosis, and 6.923 (12.026%) patients were operated on under general endotracheal anesthesia. 38.846 (67.48%) tonsillectomies, 12.864 (22.34%) tonsilloadenoidectomies and 5.854 (10.16%) adenoidectomies were performed. Discussion The percentage of these surgeries is very high, but in the past ten years it has fallen below 50%. General endotracheal anesthesia is being used at the Department since 1966, and ether anesthesia is not being used since 1991. We believe that the number of tonsillectomies is high, because it also includes surgeries performed under local anesthesia, in patients over ten years of age. However, we can conclude that anesthesiological procedures effectively followed trends of medical science.
Correlation between clinical symptoms and diagnosis of trichomoniasis in women
Authors: Radonjic Ivana , Mitrovic Sanja , Dzamic Aleksandar , Arsic-Arsenijevic Valentina , Kranjcic-Zec Ivana
Published: July 2006

The aim of this study was to investigate correlation between clinical symptoms and diagnosis of trichomoniasis in women. 200 women were included in the study. Swabs were taken from all patients from the posterior vaginal fornix's. Each sample was examined using the following five methods: wet mount Giemsa stain, acridine orange fluorescence stain, cultivation in Diamond medium and PCR method. Trichomoniasis was diagnosed in 27 women using any of the applied methods and 33.3% presented with typical frothy yellow-green discharge, characteristic for trichomoniasis and yellowish discharge characteristic for the third group of vaginal discharge. White discharge characteristic for Candida infection, was found in 18.5% of patients with diagnosed trichomoniasis. Finally, 14.8% of positive patients had a normal discharge. Based on the results of our study we came to the conclusion that microbiological investigations are necessary for accurate diagnosis of trichomoniasis, as well as for revealing asymptomatic infections, in order to prevent spreading of this relatively common disease.
Prognostic significance of tumor-induced angiogenesis in colorectal cancer
Authors: Fenyvesi Attila
Published: July 2006

Introduction Tumor-induced angiogenesis is a central pathogenic step in the process of tumor growth, invasion and metastasis. The aim of this study was to analyze the quantitative expression of angiogenesis in colorectal carcinoma and to determine if and how angiogenesis correlates with other clinicopathologic factors and prognosis. Material and methods This study included 40 patients who underwent curative resection of colorectal cancer at the Department of Surgery of the Senta General Hospital with complete 5 years follow-up or till death. Microvessels were identified immunohistochemically using monoclonal CD31 antibodies. The microvessel count was assessed by means of stereology with test grid M42, as well as vascular surface density in the stromal volume at the invasive front of colorectal cancer. Results Tumor-induced angiogenesis count of colorectal carcinomas statistically significantly correlated with stage of disease and histologic tumor grade There was no significant correlation between intratumoral microvessel density and sex and age of patients, localization and histologic tumor type Five-year survival rate in patients with hypervascular colorectal tumors was statistically significantly lower than in patients with hypovascular tumors Thus, microvessel density in colorectal cancer is an independent prognostic factor, but its significance is less than the importance concerning stage of disease and histologic grade of tumor. Conclusions Intratumoral microvessel density quantification in histologic specimens of colorectal carcinoma reflects the biological malignant potential of tumors and may be a useful additional predictive marker. Assessment of intratumoral microvessel count might be used for determining the pathologic stage when adjuvant therapy is concerned. Microvessel density in tumor specimens is valuable in stratifying patients in planning appropriate adjuvant and antiangiogenic therapy after surgery.
Dyslipidemia in subclinical hypothyroidism
Authors: Caparevic Zorica , Bojkovic Gradimir , Stojanovic Dragos , Ilic Vesna
Published: July 2006

Introduction Subclinical hypothyroidism is defined as an increased serum TSH and normal serum FT4 concentration. In subclinical hypothyroidism, thyroid peroxidase and thyroglobulin antibodies are frequently present. Subclinical hypothyroidism may have endogenous or exogenous causes. The prevalence of subclinical hypothyroidism is rather high. The number of patients progressing to overt hypothyroidism may be higher. These patients may be asymptomatic, or have only mild symptoms or a single symptom. Material and methods We investigated 35 patients with subclinical hypothyroidism in order to establish the type and degree of dyslipidemia and effects of therapy with L-thyroxine (50 micrograms/d) during three months. Results Serum cholesterol LDL-cholesterol and apo B were increased. A significant reduction of serum cholesterol, LDL-cholesterol and apo B concentrations was established during thyroid hormone replacement. Discussion and conclusion Only a few studies reported higher LDL and lower HDL-cholesterol values in subclinical hypothyroidism. Much interest was thus aroused to evaluate whether or not subclinical hypothyroidism is associated with hypercholesterolaemia. Only patients with serum thyrotropin (TSH) concentration above 10 mU/L had a significant reduction of serum cholesterol concentration during thyroid hormone replacement. Most patients with subclinical hypothyroidism should be treated with thyroxine to prevent progression to overt hypothyroidism Thyroid hormone replacement therapy may slow the progression of coronary heart disease, because of its beneficial effects on lipids. These findings and especially high rate of progression towards overt hypothyroidism suggest early thyroxine treatment.
Esophageal reconstruction using free jejunal grafts: Case report
Authors: Kiralj Aleksandar , Mirkovic Milan , Janjic Zlata
Published: July 2006

Introduction Portions of gastrointestinal tract may be used as microvascular transfers for reconstruction of hypo pharynx and esophagus. Colon, jejunum and portions of stomach have also been successfully used Intestinal transfer by revascularization was reported by Seidenberg in 1959 long before the development of other free tissue transfers.Material and methods When an appropriate piece of jejunum is being selected for transfer the important considerations are its shape and its vascular supply. Because of multiple curves of jejunum, it is difficult to obtain straight lengths longer than 12-15 cm without separating it from its mesentery at both ends Discussion Mucous production is very important in the first postoperative days. When edema decreases and patients can swallow fluids well, oral intake can gradually be increased to full fluids and eventual regular diet. It is important to monitor jejunum following its transfer. Anastomosis thrombosis and unrecognized gangrene of jejunum may cause serious neck infections Conclusion Portions of gastrointestinal tract may be used as microvascular transfers for reconstruction of hypo pharynx and esophagus. Intestinal transfer by revascularization was reported by Seidenberg in 1959. It is important to monitor jejunum following its transfer.
Regional metastases of lower lip squamous cell carcinoma
Authors: Ilic Miroslav , Dzolev Asen , Kiralj Aleksandar
Published: July 2006

Introduction Lower lip squamous cell carcinoma is the most common oral carcinoma. In relation to other oral carcinomas, it has a better clinical course. If regional metastases appear, lower lip carcinoma has a very poor prognosis. Methods This study included patients treated for lower lip squamous cell carcinoma in the period 1984-2001. We examined neck metastases and time of their appearance after operation of the primary neoplasm. Results Our retrospective study included 305 patients with lower lip carcinoma in a twelve-year period. Out of this number, 293 had no positive neck lymph nodes, and only 12 patients had (4%). More than 75% of metastases appeared in the first year after surgery of the primary neoplasm. Contralateral metastases were most common. Conclusion Taking into consideration the percentage of metastases, particularly during the first year after surgery, we suggest identification of sentinel lymph nodes and depending on PH finding one should decide about the type of neck operation. Frequent check-ups are necessary, especially during the first year.
Voice characteristics of patients with glottic carcinoma analyzed using 'RBH' and 'GIRBAS' scales
Authors: Mitrovic Slobodan
Published: July 2006

Introduction Subjective voice analysis represents a diagnostic tool in phoniatry and is a part of everyday practice if a phoniatrist has a 'trained ear'. Material and methods This clinical prospective study included a sample of 20 male patients with malignant tumors involving one vocal cord - right or left. All patients underwent otorhinolaryngological and phoniatric examinations. Subjective acoustic analysis was done when patients pronounced numbers from 1 to 10. Afterwards, voice quality was evaluated separately by two professionals using a 4-levels scale: RBH scale (roughness-breathiness-hoarseness) and GIRBAS scale (grade-instability-roughness-breathiness-asthenia-strain). Results 60% of patients presented with vocal cord immobility. Subjective acoustic analysis revealed hoarseness in 100% of patients (the most frequent value was Mod=3 intense hoarseness in 45% patients). Instability existed in 100% of patient (40% moderate, 40% intense). Strained voice existed in 100%, most frequently intense (45%). Conclusions All patients with glottic carcinoma presented with hoarseness, strain and instability of phonation. Non vibration of vocal cord significantly affects the degree of dysphonia, roughness, strain and instability. Aerodynamic changes affect voice hoarseness. RBH scale is simple, but GIRBAS scale described more psyhoacoustic phenomena most important in patients with glottic carcinoma.
Emotional stress as a health-related risk factor
Authors: Lazetic Bogosav , Sudakov Konstantin , Drapsin Miodrag , Karaba Dea
Published: July 2006

Introduction Emotions represent reactions of living organisms to changes of one's inner sphere, as well as to different factors from our surroundings. Emotions manifest in many ways. Failing to fulfill one's needs on chronic or acute basis leads to conflict situations. These needs may be either biological or social. Conflict situations occur prior to stress itself. Emotional stress Modern technology development provides no friendly environment for workers, with many consequences causing psycho-somatic disorders. Researches have been made to evaluate the amount of inflicted stress on patients. One of successful theories regarding this question is the theory of functional systems. The idea was to quantify processes of everyday living. Prophylaxis and rehabilitation of persons exposed to emotional stress The primary goal was to measure one's adaptation abilities. In order to follow up these parameters a machine was created. This appliance can determine the level of stress, by measuring certain physiological parameters. That is way scientists may apply preventive measures in order to increase stress resistance. Conclusion We differ hereditary and individual resistance to stress factors. That is why it is necessary to assess each patient individually. This type of individual approach offers an opportunity to create a specific program, in order to increase stress resistance.
Chronic infectious mononucleosis
Authors: Brkic Snezana , Jovanovic Jovana , Preveden Tomislav
Published: July 2006

Introduction Chronic infectious mononucleosis is a clinical entity recognized 15 years ago with clearly defined serological criteria: high titres of IgG Epstein-Barr virus (EBV) virus capsid antigen (VCA), IgG EBV early antigen without IgG Epstein-Barr nuclear antigen (EBNA) antibodies. Material and methods This follow-up study lasted for 2 years and included 100 acute infectious mononucleosis patients who were investigated every 6 months. Apart from physical examination we evaluated history, complete blood count and liver function together with 5 commercial ELISA tests: IgM EBV VCA, IgG EBV VCA, IgG EB NA, IgG EBV EA and IgA EBV EA. Results Although malaise and fatigue with cervical lymphadenopathy were the most frequent symptoms, their statistical significance was not established. All laboratory analyses were completely normal during the follow-up period, but there were four patients with acute hepatitis due to hepatitis A virus and adenoviruses. After 6 months of acute illness, two patients without IgG EB NA antibodies who were candidates for chronic disease, presented no other serological findings for chronic disease. It was confirmed that they had delayed serological response due to EBV infection, because one year later they had a completely normal immune status on EBV infection. Conclusion Chronic infectious mononucleosis seems to be an extraordinary event after acute disease. This conclusion corresponds with literature reports of sporadic cases of this disease.
Pseudomembranous colitis during antibiotic therapy
Authors: Canovic Predrag , Todorovic Zoran , Gajovic Olgica , Nesic Ljiljana , Mijailovic Zeljko
Published: July 2006

Introduction The use of antibiotics is commonly accompanied by diarrhea: idiopathic diarrhea with a benign process and diarrhea caused by Clostridium difficile and pseudomembranous colitis. Clostridium difficile colonizes the gastrointestinal tract and produces a toxin in cases when normal flora is suppressed by antibiotics. Pseudomembranous colitis most frequently appears after application of clindamycin, lincomycin, ampicillin, cephalosporins and other antibiotics. Diagnosis is established after rectoscopic findings of adherent pseudomembrane and pathohistological verification. The diagnosis is confirmed if there is evidence of Cl. difficile toxin in feces. Case report We report about the clinical course of two patients with antibiotic-associated colitis. The diagnoses were made by clinical examinations, rectoscopy and pathohistologic verification of biopsy specimen of the intestinal mucosa. Neutralization test was not done due to technical reasons. Patients were treated with metronidazole. Unwanted side-effects of metronidazole therapy were not observed. Discussion Both our patients confirmed that they previously used different antibiotics. In the first case, diarrhea appeared during the antibiotic therapy, and in the second case, after finishing it. After antibiotic use, diarrhea appears in 5.30% cases, but fortunately pseudomembranous colitis is rare. However, taking into consideration that pseudomembranous colitis has a severe course and requires urgent treatment, one has to consider the possibility of pseudomembranous colitis when diarrhea appears during and after antibiotic use in order to initiate adequate therapy.
Diagnostic significance of synovial biopsy in patients with Reiter’s syndrome
Authors: Pavlica Ljiljana , Tatic Vujadin , Draskovic Nada , Nikolic Dragan
Published: July 2006

Introduction Arthritis in Reiter's syndrome (RS) is a reactive synovitis associated with a localized infection of the urogenital or gastrointestinal tract with a genetic predisposition. The pathogenetic mechanisms for synovitis in RS are still unknown. Our aim was to examine some of the pathogenetic mechanisms in Reiter's syndrome looking for morphologic changes, immunoprotein deposits and microorganism antigens in synovial biopsies and to determine whether synovial biopsy is useful in diagnosis of RS. Material and methods Thirty patients with urogenital form of RS were examined within a four-year period. Table 1 illustrates laboratory findings in our patients. We performed synovial biopsies looking for histopathological changes, deposits of immunoproteins and microorganism antigens. Analysis of synovial biopsy specimens was performed using light and immunofluorescence microscopy and fluorescein-labelled monoclonal antibodies to Chlamydia trachomatis. Results Histopathological examination of synovial membrane revealed marked proliferation of the synovial lining cells (SLC) with less or more abundant papillary projections, hypertrophic and edematous tissue with marked vascularisation in 28 (93.3%) cases. Fibrinoid necrosis foci were seen on the surface of synovial tissue. Chronic inflammatory cells (CIC) were diffusely distributed. Edema of the vessel walls, swollen endothelial cells, fibrinoid necrosis in vessel walls as well as multilaminated basement membranes were observed. All histopathologic changes are presented in Table 2. Immunofluorescent techniques in 12 out of 30 (40%) synovial membranes showed immunoglobulin deposits: IgG and IgA deposits were found in vessel walls in 7 cases each and IgM in 10 biopsy specimens. C3 was present perivascularly or within the vessel wall in 4 (13.3%) cases. Sections treated using fluorescein-conjugated antibody revealed Chlamydia in the synovial tissue in 2 patients. Conclusion Biopsy specimens with previously described changes in patients with suspected Reiter's syndrome can be useful to confirm the diagnosis. According to our experience, multiple biopsies of abnormal synovia are recommended in these patients.
Treatment of chronic hepatitis C with pegylated-interferon
Authors: Fabri Milotka , Bozic Milena , Delic Dragan , Jesic Rada , Nozic Darko
Published: July 2006

Introduction Since the discovery of the hepatitis C virus, the etiology of chronic liver diseases has been revealed in great number of patients. However, the treatment of hepatitis C viral infection still hasn?t been completely resolved. Antiviral and immunomodulatory effects of interferon, and antiviral effect on the nucleoside analogs were efficient only in small number of patients. Discovery of pegylated interferon brings progress in therapeutic success rates. Material and methods Combined therapy with peginterferon alfa-2a (Pegasys) 180mg once a week plus Ribavirin 800mg a day during a 24-week period was conducted in 20 patients (13 were previously treated with standard antiviral therapy). The aim of this study was to determine the safety and the efficacy of therapy in our patients. Results and discussion Analysis of safety of the combined therapy was conduced in all 20 patients, and analysis of efficiency in 18 patients. Efficacy of the combined therapy was assessed regarding to biochemical response (normalization of aminotransferase activity at the end of therapy and at the end of 6-month follow-up) and virologic response (disappearance of RNA HCV in serum at the end of 6-month follow-up). 30% of treated patients experienced no troubles during treatment. Influenza-like symptoms, weight loss, depression, hair loss and reaction at the site of injection were mild and did not exclude patients from their usual activities in family, society and work place. Neutropenia, thrombocytopenia and anemia as well as elevated aminotransferase activity demanded periodical dose modification in 20% of patients. Unexpected unwanted effect emerged in one patient after cessation of therapy (pulmonary sarcoidosis). Good effects of combined therapy at the end of follow-up period showed biochemical and virologic response in 66% of patients. Conclusion Combined therapy with Pegasys 180mg/week and Ribavirin 80mg/day is safe and well tolerated. Sustained biochemical and virologic response was achieved in 66% of patients.