bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of oral leukoplakia
Authors: Bokor-Bratic Marija
Published: July 2006

Introduction This paper reviews epidemiologic studies on prevalence of oral leukoplakia. Special emphasis is placed on population selection, diagnostic criteria, type and training of examiners and risk factor assessment. Prevalence of leukoplakia in these studies has ranged from 0.6% to 4.6%. Variations in prevalence among the studies could depend on methodology, especially studied populations and diagnostic criteria. Most investigations have investigated the entire available adult population in a geographic region or a random sample. Others have comprised selected populations, such as hospital or clinic patients. Our study has shown that prevalence of oral leukoplakia was 2.2% in a relatively small and highly selected population. Age and gender The onset of leukoplakia usually takes place after the age of 30 years. Our study showed that oral leukoplakia occurred in men over 40 years of age and in women over 50 years of age. These results are supported most previous findings. Gender distribution varies in most studies, ranging from a strong male predominance (4:1), to almost 1:1 in the Netherlands. Smoking and prevalence of oral leukoplakia Tobacco smoking is the most important known etiological factor in development of oral leukoplakia. Smokers have a six-fold increase in the risk of developing leukoplakia of the oral mucosa in regard to non-smokers. Six European studies, including our study, found a prevalence of smoking between 56 and 97 percent in leukoplakia patients. Our study also showed that the majority of smokers with leukoplakia (74.0%) smoked more than 20 cigarettes per day compared to 34.5 % of those without leukoplakia. Alcohol and prevalence of oral leukoplakia Smoking and alcohol consumption are often coexistent factors making it difficult to assess the effects of these factors individully. In our study the higest prevalence of leukoplakia (33.3%) was established in subjects who smoked cigarettes and consumed alcohol, compared to those who smoke tobacco only (18.2%).
Lipid abnormalities in elderly patients with subclinical hyperthyroidism
Authors: Caparevic Zorica , Stojanovic Dragos , Ilic Vesna , Bojkovic Gradimir , Stojanovic Mirjana
Published: July 2006

Introduction Sensitive thyroid-stimulating hormone (TSH) assays provide identification of many patients with subclinical hyperthyroidism resulting from excessive production or excessive replacement of thyroid hormone. Subclinical hyperthyroidism is defined by a TSH below normal (suppressed) with normal serum T3 and T4 levels. Subclinical hyperthyroidism is the goal of thyroid hormone therapy in patients with thyroid cancer, solitary thyroid nodules, multinodular or diffuse goiters, or a history of head and neck irradiation. Benefits of TSH suppression in these patients, were thought to exceed the risks of subclinical hyperthyroidism. Subclinical hyperthyroidism also occurs in patients with thyroiditis and those with autoimmune thyroid disease. Other causes of TSH suppression, such as use of glucocorticoids, severe illness and pituitary dysfunction should be excluded. Material and methods This investigation included 55 elderly patients with subclical hyperthyroidism in order to establish the type and degree of lipid abnormalities and effects of therapy with antithyroid drugs (methimazole 10 mg/day) during three months. These patients presented with no or minimal symptoms of thyroid hormone excess, but 56% of patients experienced atrial fibrillation and cardiac hypertrophy. Results Levels of serum cholesterol, LDL-cholesterol and HDL-cholesterol were decreased. We found a significant increase of serum cholesterol, LDL-cholesterol and HDL-cholesterol levels after treatment. Discussion and Conclusion Subclinical hyperthyroidism in elderly individuals is difficult to diagnose because it may present only with cardiac manifestations including atrial fibrillation and cardiac hypertrophy. There is general agreement that measurement of serum TSH is the most sensitive indicator of thyroid hormone activity in its target tissues. Patients with subclinical hyperthyroidism tend to have low serum total cholesterol, LDL-cholesterol anf HDL-cholesterol levels. These values increase after treatment. Most patients with subclinical hyperthyroidism should be treated with antithyroid drugs to prevent cardiovascular complications and bone loss, particulary among postmenopausal women.
Osteomas of the middle ear
Authors: Sente Marko , Topolac Radivoj
Published: July 2006

INTRODUCTION Osteomas of the middle ear are small, single, usually unilateral, peduncular growths, off-white in color, with smooth or multilobular surface, asymptomatic or causing functional disorders (progressive hearing loss, pathological appearance of the eardrum, vertigo and otorrhea), of unclear or unknown etiology. Fleury described three types of osteomas: massive, diffuse atticoantral and localized type. The therapy is surgical. Small and asymptomatic ones are followed-up. Cremers suggests surgical intervention in cases of progressive growth and increased hearing loss. Case description Discharge and pain in the left ear started twelve years ago, accompanied by impaired hearing and tinnitus. Four months ago the symptoms aggravated and discharge and pain increased. Otomicroscopic findings revealed: perforation in the posterior attic and a prominent polypous, clustered bright red formation. Sch?ller X-ray showed total absence of pneumocyte cells, with distinct sclerotic changes. Retroauricular access showed a biventricular bony formation in the cavum and partly in the antrum. A cholesteatoma extended from the cavum into the antrum, above the osteatoma. The bony formation was separated transmeatally from the grip in the posterior attic using a chisel, partially removing the bone wall of the exterior aural tube, removing it completely through the mastoid antrum. The removed bony mass, sized 5 x 8 x 8 mm, included also the incus. DISCUSSION Osteoma was discovered accidentally. Regarding clinical features, it belonged to the second group, due to progressive hearing loss, recurrent episodes of otorrhea, pain, biventricular shape and association with cholesteatoma. It was removed using a combined method. It was not possible to establish when the osteoma exactly started generating. It is possible that the initial complaints twelve years ago were the first signs of illness, and chronic otitis may have occurred as a consequence of the tumor.
Psychiatric adverse effects induced by recombinant interferon alfa in patients with chronic hepatitis C
Authors: Nesic Zorica , Delic Dragan , Prostran Milica , Stojanovic Radan , Vuckovic Sonja , Todorovic Zoran
Published: July 2006

Introduction Hepatitis C virus infection is a slowly progressive chronic disease and the most common cause of chronic liver disease. Presently, interferon alfa based therapies, with or without ribavirin, are standard treatment for chronic hepatitis C virus infection. The most troublesome psychiatric side effects of interferon therapy in our patients are: insomnia, irritability, anxiety, mood changes, short temper, emotional and affective lability, impaired cognitive function, apathy, loss of motivation and the most serious depression with or without suicidal ideas. Material and methods In our study we treated 82 patients chronically infected with HCV divided into 3 groups: the first group of 31 patients (20 male and 11 female) received IFN-alfa in standard doses of 3 MU three times a week (t.i.w) during 24 weeks; the second group of 36 patients (25 male and 11 female) received IFN-alfa, 3 MU t.i.w plus ribavirin 1000-1200 mg per day during 24 weeks; the third group of 15 patients (11 male and 4 female) received IFN-alfa, 3 MU t.i.w plus ribavirin 1000-1200 mg per day during 48 weeks. The follow-up period after therapy in all groups lasted 24 weeks. Results During treatment, we observed at least one psychiatric side effect in 21 (26%) patients: insomnia in 11 (13%), emotional and affective lability in 9 (11%), anxiety, irritability and short temper in 8 (10%), impaired cognitive function in 7 (8%) apathia and loss of motivation in 6 (7%) treated patients. Depression, the most serious side effect, was established in 8 (10%) patients. All of these side effects were observed during later stages of treatment (between 5th and 22nd weeks of treatment). The incidence of all psychiatric side effects was significantly higher in women than in men (p < 0,01). We observed higher prevalence of depression among patients with history of alcohol and drug abuse. Treatment was temporarily discontinued (from 2 to 4 weeks) in all patients with depression, but it was not permanently discontinuated in any patient due to psychiatric side effects. Conclusion Interferon causes psychiatric disorders that are usually mild and reversible. They disappear either spontaneously, while patients are still receiving therapy or after temporary cessation of interferon alfa therapy. .
Current status and potential perspectives in classical radiotherapy technology
Authors: Dabic-Stankovic Kata , Stankovic Jovan , Radosevic-Jelic Ljiljana
Published: July 2006

Introduction and potentials of classical radiotherapy After purchase of radiotherapy equipment in 2003, classic radiation therapy in Serbia will reach the highest world level. In order to define the highest standards in radiation technology, we analyzed the current status and potential perspectives of radiation therapy. Technological levels of radiotherapy in developed countries An analysis of present situation in the USA, assumed as the most developed in the world, was done. Available data, collected in the last 3 years (equipment assortment, therapy modalities, workload and manpower) for 284 radiotherapy centers, out of potential 2050, were analyzed. Results were presented as crude percentage and mached to point current status. Results of analysis and discussion The analysis showed that CLINAC accelerators are the most popular (82.7%), as well as, ADAC (43.7%) and Focus (CMS) (27.4%) systems for therapy planning. Movement towards virtual simulation is evident (59.3%), although classic ?simulation? is not fully eliminated from the radiotherapy chain. The most popular brachytherapy afterloader is Microselectron HDR (71%). About 64.4% centers use IMPAC communication/verification/record system that seems more open than Varis. All centers practice modern radiotherapy modalities and techniques (CFRT, IMRT, SRS/SRT, TBI, IORT, IVBHRT, HDR BHRT, etc.). CT and MRI availability is out of question, but PET is available in 3% of centers, however this percentage is rapidly growing. Up to 350 new patients per year are treated by one accelerator (about 35 pts. a day). Centers are relatively small and utilize 2-3 accelerators on average. Average FTE staffing norm is 4 radiation oncologists, 2-3 medical radiotherapy physicists, about 3 certified medical dosimetrists and about 6 radiotherapy technologists. Technological aspects and conclusion In the past 5 years relative stagnation in classic radiotherapy has been observed. In spite of substantial investments in technology and consequent improvements, as well as wide introduction of computers in radiotherapy, radiotherapy results have not changed significantly. Vendor development strategies do not point that this trend will change in the next 5 years. On the other hand, wide introduction of the PET in each radiotherapy chain ring (diagnostics, planning, follow-up), could improve results (local and regional control, as well as quality of patients' life).
Fistulas in gynecologic and obstetric surgical procedures
Authors: Cetkovic Nenad , Draca Tatjana , Draca Petar , Radeka Gordana
Published: July 2006

Introduction The study pointed to the significance and most frequent causes of development of fistula following gynecologic and obstetric surgical procedures. Prevention and management of fistulas Some possibilities of prevention, i.e. the necessity of correct administration of surgical procedures have been described. The authors pointed to the imperative of knowing the structure of vesicovaginal region and administration of adequate surgical technique. They described surgical procedures in most frequent gynecologic operations in prevention of ureteral injuries. They have presented 25-year result of operative treatment of these patients and treatment of postoperative fistulas at the Department of Obstetrics and Gynecology in Novi Sad. In regard to the number of gynecologic operations in that period (23067), the incidence of fistulas was not high (43). Conclusion During the last years, the incidence is constantly decreasing, due to application of appropriate surgical techniques, careful manipulation, and administration of up-to-date surgical materials.
Effects of nutrition in pregnancy on hematological parameters
Authors: Suvacarev Slobodana
Published: July 2006

INTRODUCTION Pregnancy is one of the most important periods in a woman's life. A daily caloric increase of 150kcal throughout the first and 350kcal during the second and third trimesters is recommended. There are also increased requirements for some nutritive components. The aim of this study was to explore nutritive risk factors which affect hematological parameters and thus pregnancy and labor. It tested the hypothesis that there was a positive correlation between obese and underweight pregnant women and their nutrition, on one side, and hematological disorders of pregnant women on the other side. Material and methods The sample included 92 overweight, 65 underweight and 95 normally nourished pregnant women (control group). Blood analysis was compared with the results of the questionnaire on weekly consumption of different food groups. Results and discussion The incidence of anemia was very high in both nutritive risk groups, while the increased number of leukocytes was dominant in underweight pregnant women. Food questionnaire confirmed inadequate intake of nutritive components in risk groups. CONCLUSIONS All these facts may have important repercussions on pregnancy and labor, and anemia is often associated with prematurity, low birth-weight of infants, greater number of premature labors, as well as the increased perinatal mortality. This study has confirmed the hypothesis that well balanced nutrition is really very important for regular functioning of the whole body, especially in risk population such as pregnant women.
Clinical evaluation of fecal continence after posterior sagittal anorectoplasty in anorectal abnormalities
Authors: Bukarica Svetlana , Marinkovic Smiljana , Zrnic-Pekovic Vesna , Dobanovacki Dusanka , Borisev Vladimir , Likic Jelena
Published: July 2006

Introduction Posterior sagittal anorectoplasty (PSAKP) was introduced in 1982, by Repa and de Vries, as a new surgical procedure for patients with anorectal malformations. It was supposed to provide better chance for normal fecal continence. Meterial and methods Between 1991 and 2000, 50 patients with anorectal abnormalities underwent PSARP. In 43 patients PSARP was primary operation and in 7 it was a secondary procedure. At the time of study patients were not younger than 3, and not older than 13 years. Patients and their parents were interviewed, and fecal continence was graded as follows: voluntary bowel contractions, soiling less than once a week, soiling more than once a week, daily soiling and constipation. Results Amongst patients who underwent primary surgical correction, 74% had voluntary bowel contractions. Babies with perineal fistula, rectal atresia and stenosis presented with best results in term of voluntary bowel contractions (100%), as with vestibular fistula, ten of eleven patients. Only 18% of patients (atresia without fistula, vestibular fistula and bulbourethral fistula) had soiling. Patients with perineal fistula and rectal atresia and stenosis 40% were totally continent (voluntary bowel movements without soiling). The most frequent sequel was constipation, which appeared in 48%, without coincidence with frequency of soiling. The problem of constipation was surprisingly more frequent in patients with expected better prognosis in fecal continence. Conclusion Although PSARP offers a good esthetic result, only two third of patients have voluntary bowel movements and in about half there exists a problem with constipation, with necessary further treatment.
Goodpasture's syndrome: Case report
Authors: Vuckovic Biljana , Ilic Tatjana , Mitic Igor , Knezevic Violeta , Vodopivec Slavenka , Curic Slobodan
Published: July 2006

Introduction Goodpasture's syndrome is a rare, autoimmune disease characterized by pulmonary hemorrhage, glomerulonephritis and production of anti-GBM (glomerular basement membrane) antibodies. The etiology of this syndrome is still unknown. Goodpasture's syndrome usually starts with pulmonary hemorrhage, which is followed by symptoms of kidney disease. Laboratory findings often include: anemia, microhematuria, proteinuria, increased levels of urea and creatinine and anti-GBM antibodies. Diagnosis of this syndrome can be established by presence of pulmonary hemorrhage, pulmonary radiography, kidney biopsy and positive result of circulating anti-GBM antibodies. Treatment of this syndrome should be initiated as soon as possible using a combination of cortocosteroids, cytostatics and plasmapheresis. Case report The first symptoms in a nineteen-year-old female patient were caused by anemia. Two months later she reported symptoms of pulmonary hemorrhage. At that point of time she already had renal insufficiency and was immediately hospitalized. The same day we started therapy with cortocosteroids, endoxan and plasmapheresis was initiated. Recovery of pulmonary function was obtained, but kidney function was lost. Discussion and Conclusions The most important thing in regard to Goodpasture's syndrome is quick diagnosis. Because of that, if patients report any kind of pulmonary hemorrhage, this syndrome must be considered. At that point of time, kidney function is usually not irreversibly damaged. The second important thing in Goodpasture's syndrome is that treatment must be very aggressive using a combination of immunosuppressives and plasmapheresis. This is the only chance for these patients to avoid hemodialysis or death.
Emergency contraception: Current trends, possibilities and limitations
Authors: Bjelica Artur , Kapamadzija Aleksandra , Pavlov-Mirkovic Miroslava
Published: July 2006

Introduction Emergency contraception has been used for over three decades. Indications for emergency contraception are intercourse without contraceptive protection or inadequate application of other contraceptive means. Also, this method is the only way out in situations when sexual intercourse has proceeded not only without protection, but also without voluntary agreement of both partners. Contraception means Despite of their proven efficiency, it is thought that application of contraception means, even in countries with highly developed systems of health care, is far below optimal. Contemporary studies have pointed out some new possibilities and novel, modified methods of emergency contraception have been proposed. Basic methods of emergency contraception include use of hormonal preparations and postcoital insertion of intrauterine copper devices. Hormonal preparations that are used in emergency contraception are: combined hormonal contraceptive pills, levonorrgestrel and antiprrjgestin mifepristone. In 1998, the method with levonogestrel only, was indicated by World Health Organization as a "golden. standard" in hormonal emergency contraception. The article gives a survey of new trends, possibilities and limitations of modem emergency contraception, with the aim of popularization of this form of contraception in our country.
External fixator by Mitkovic in the treatment of comminuted intraarticular fractures of the distal radius
Authors: Micic Ivan , Mitkovic Milorad , Mladenovic Desimir , Karalejic Sasa , Milenkovic Sasa , Gajdobranski Djordje
Published: July 2006

Introduction Comminuted intraarticular fractures of the distal radius metaphysis are a major challenge for orthopedic surgeons. The aim of this study was to present results of the survey on treatment of these fractures using an external fixator. Material and methods 73 patients (30 females and 43 males) with closed comminuted intraarticular fractures of the distal radius, type C AO/ASIF (based on radiography at the moment of injury) were treated by a Mitkovic external fixator and followed-up for at least 2 years. An external fixator and Kirschner wires were used in 43 patients. An external fixator without Kirschner wires was used in 30 patients. Results At the end of treatment, functional results and outcomes were excellent in 39 (53.4%), good in 19 (26%), fair in 10 (13.7%), and poor in 5 (6.8%) patients according to Jakim score. Lesser degree of limitation of the movement of the wrist joint was established in 19 patients (26%). Joint incongruity of the distal radius, 0-2 mm, was observed in 22 patients (30%) and over 2 mm in 3 patients. A minimal degree of posttraumatic osteoarthrosis was recorded in 21 patients (28.7%) and moderate ostheoarthrosis in 5 patients (6.8%). Conclusion The anatomic reduction of the articular surfaces and healing of the fracture in a proper functional position are prerequisites for adequate function of the wrist and hand. It appears that an external fixator, with or without Kirschner wires, can be a method of choice in treatment of these complex articular fractures.
Frequency of occupational injuries and the health status of workers
Authors: Jovanovic Jovica , Jovanovic Milan
Published: July 2006

Introduction Occupational injuries are the leading cause of morbidity and mortality among workers. The aim of this study was to analyze the frequency of occupational injuries and health status of workers. Material and methods The examined group consisted of 3.750 workers with health disorders. The control group included 1.800 healthy workers. Both groups were similar in terms of many factors that could contribute to the occurrence of occupational injuries. The injury rates were calculated in both groups. Results Workers with psychomotor and sensorimotor disorders, neuroses, obstructive sleep apnea, arterial hypertension, diabetes mellitus, hearing, vascular and sight impairments have been frequently injured compared to workers with other diseases. Discussion Due to the belief that accidents and occupational injuries are preventable, it is an imperative to study those factors which are likely to contribute to occurrence of accidents. The contributing factors could be the physical and mental state of workers. Conclusion Occupational injuries are significantly more common in the examined group than in controls.
Associated congenital anomalies: Vestibular fistula, duodenal atresia and obstructive refluxing megaureter
Authors: Bukarica Svetlana , Marinkovic Smiljana , Borisev Vladimir , Antic Jelena , Stanic-Canji Danica
Published: July 2006

Congenital gastrointestinal anomalies include spectrum of malformations, simple ones as well as complex, which are associated with anomalies of other organs and systems of organs. Most infants (50-60%) with imperforate anus also have genitourinary, cardiovascular, gastrointestinal and vertebral anomalies. This case report is of a female newborn with prenatally diagnosed duodenal atresia and right hydronephrosis. Clinical investigation revealed an imperforate anus with vestibular fistula. A plain abdominal x-ray showed a "double-bubble? sign, characteristic for duodenal atresia. Intraluminal membrane was excised and sigmoid colostomy was performed in general anesthesia on the first day of life. Ultrasound and intravenous pyelography confirmed a hydronephrotic right kidney and obstructive megaureter after Pena. In the fifth month of life, the ureter was tapered and reimplanted. Six months later, posterior sagittal anorectoplasty was performed. In the sewentheenth month of life the colostomy was closed. This child attained normal growth and development, normal bowel control, fecal continence without soiling, obstipation and urinary infections.
Side effects of cellular and acellular DPT vaccine in children aged from 3 months to 5 years
Authors: Durmisevic Smajil , Durmisevic-Serdarevic Jasminka
Published: July 2006

Introduction Both mild and severe local and systemic postvaccination reactions are seen more rarely in infants immunized with DTPa than in those immunized with DTPw vaccine. Material and methods By analysis of medical records and follow-up of patients, the authors searched for sings of adverse effects of DPT vaccines, comparing cellular and acellular vaccines in children aged from three months to five years. The results of investigation were analyzed using X2. Results Out of the total number of 940 applied vaccines, 329 were cellular and 611 were acellular. Body temperature over 38.5oC occurred in 3% of children immunized with cellular DTPw, and vomiting occurred in 0.8% of those immunized with acellular DTPa vaccine. Vomiting occurred (more than five times) in 0.9% of children immunized with DPTw and in 0.32% of children immunized with DPTa. Other undesirable symptoms like swelling, redness and pain in the arm were found in 0.6% of children immunized with DPTw, and in 0.32% of children immunized with DPTa; prolonged crying (three hours or longer) was registered in 0.3% of cases immunized with DPTw, and in 0.16% of immunized with DPTa vaccine. Convulsions and collapse appeared only in 0.3% of children immunized with DPTw. Discussion Our investigation shows that local and generalized undesirable postvaccination reactions occurred in 5.4% of children immunized with DPTw and in 1.64 of children immunized with DPTa. The latest clinical investigations show that acellular pertussis vaccines are successful in prevention of pertussis and that they are quite safe for infants; in our investigations, local and generalized reactions were markedly rare in children immunized with DPTa. Conclusion Undesirable postvaccination reactions after application of acellular DPT vaccines are less frequent than it is described in relevant references. The most frequent postvaccination reactions was raised body temperature (38.5oC). Convulsions and collapses were not registered in children immunized with DPTa vaccine. This investigation points to significantly rarer unwanted postvaccinationl reactions of acellular DPT vaccine in comparison with DPTw (p<0.01).
Evaluation of large intestinal mucosa regeneration in ulcerative colitis using linear measurements
Authors: Djolai Matilda
Published: July 2006

Ulcerative colitis is a chronic inflammatory condition characterized by three phases: active, regression and remission phase. The active phase is followed by atrophy of the large intestinal mucosa. Although its evaluation is sometimes difficult, quantification of ceratin mucosal parameters can be used as an accessory method. The aim of the study was to determine the parameters of linear micrometry in order to estimate the regeneration of the large intestinal mucosa in ulcerative colitis, and to evaluate the efficiency of this method in everyday work. The measurements were performed on routine bioptic samples after qualitative histologic analysis and determination of the type and stage of the disease. The measurements were carried out to determine: the number of crypts per unit length, the height of crypt epithelium, diameter of crypts, their lumen and interstices; also, the quotient between the diameters of crypts and interstices was calculated. The analysis of the measured parameters points to presence and degree of regeneration and/or atrophy of mucosa, particularly by following the parameters of crypt epithelium. Linear measurements can be used in estimation of regeneration and atrophy of large intestinal mucosa. .
Efficacy of bolus intravenous iron treatment in peritoneal dialysis patients
Authors: Jovanovic Natasa , Lausevic Mirjana , Nesic Vidosava , Grujic-Adanja Gordana , Stojimirovic Biljana
Published: July 2006

Introduction. Normocytic, normochromic anemia is one of the first signs of chronic renal failure and it is common in patients on chronic dialysis treatment. It causes decrease in oxygen supply to tissues, increases cardiac minute volume, causes left ventricular hyperthrophy, cardiac insufficiency, disorders related to cognitive functions and immune response, and increases morbidity and mortality rates. The leading cause of anemia in patients on chronic peritoneal dialysis (PD) is iron depletion and most patients on PD need oral or parenteral iron supplementation. The aim of this study was to evaluate our first experience with bolus intravenous ferrogluconate therapy in patients on chronic peritoneal dialysis at the Nephrology Clinic of the Clinical Center of Serbia (CCS). Material and Methods. We examined 11 patients, 7 males and 4 females, mean-age 49 years (range 31 to 68 years) on chronic PD. All patients received blood transfusions, oral or intramuscular iron supplementation before 465 to 665 mg ferrogluconate therapy was given in 500 ml. saline intravenous infusion; 5 of them were on erythropoietin therapy and 2 of them started with EPO therapy after the ferrogluconate therapy. Results. The blood count improved during the first 3 months after application of bolus intravenous iron therapy (ferrogluconate); erythropoietin dose was not increased during the follow-up. Some patients suffered from side effects during infusion and 6 patients received the complete treatment. Discussion. Blood count improves in a number of patients affected by end-stage renal disease during the first months on continuous ambulatory peritoneal dialysis (CAPD) treatment. But a large number of patients on chronic CAPD treatment are iron-depleted and they require oral or parenteral substitution. Side effects and complications of intravenous iron therapy were not severe and only one patient suffered from allergic manifestations. Ferremia and blood count improved in patients who did not receive erythropoietin during the follow-up, and patients on erythropoietin therapy required lower doses after receiving the intraveonous iron therapy. Conclusion. Blood count improvement and the lack of severe side effects speak in favor of further iron supplementation with bolus intravenous iron replacement. .
Is Vojvodina a risk area for contact weed allergies?
Authors: Poljacki Mirjana , Jovanovic Marina , Boza Pal , Mimica-Dukic Neda , Petrovic Aleksandra , Novovic Zdenka
Published: July 2006

Introduction After detecting erythema multiforme due to contact with weeds, dandelion (Taraxacum offwinale, Compositae) and common chickweed (Stellaria media, Caryophyllaceae), which are ubiquitous plants in Vojvodina, and concerning properties of commercial screening allergens in detection of allergy to plants, we investigated contact allergy to dandelion and to common chick-weed, using their extracts. Material and methods Epicutaneous tests were performed using originally prepared ether extracts of these plants, 0.1% and 3% pet., in 263 individuals: 43 with extrinsic atopic dermatitis, 55 with allergic contact dermatitis, 118 with non-allergic chronic inflammatory skin diseases and 47 healthy adults. Results Our results have shown that testing with both extracts (both concentrations) represents a safe method, since no irritation or sensibilization occurred. The overall prevalence of allergy to dandelion extract was 1.14%, and for common chickweed extract 2.28%. Discussion Plant allergies (especially Compositae) cannot always be detected by standard screening allergens. Additional testing with dandelion extract can detect most cases, which is in agreement with our results. Isolation of essential oil from common chick-weed proved the allergenic potential of this plant. The prevalence of detected allergy to dandelion as well as to common chickweed was higher than 1 %. Conclusion These ubiquitous weeds and high prevalence of detected allergies have included Vojvodina into a risk zone for getting contact sensitivity to dandelion and common chickweed. Dandelion extract should be considered for Compositae screening series and common chickweed extract for specific plant series in Vojvodina. .
C-reactive protein as an independent risk factor for carotid a therosclerosis in hemodialysis patients
Authors: Tirmenstajn-Jankovic Biserka , Dimkovic Nada
Published: July 2006

C-reactive protein is a known risk factor for cardiovascular diseases, but the association of CRP with the early phase of atherosclerosis has been insufficiently investigated. The aim of the present study was to investigate the relationship between CRP and indicators of subclinical atherosclerosis in hemodialysis patients. Intima-media thickness, lumen-diameter and cross-sectional intima-media area (CSIM area) of the common carotid artery were established using B-mode ultrasound imaging in 43 HD patients and 21 age- and gender-matched healthy controls. CSIM area and LD were significantly higher in HD patients compared with control subjects. Inflammation (CRP>10 mg/l) was present in 58.1% of HD patients and was associated with higher values of all ultra-sonographic markers of atherosclerosis, as well as higher prevalence of atherosclerotic vascular diseases. Higher CSIM area was associated with elevated CRP level (r=0.619, p=0.000), advanced age (R=0.704, p=0.005) and smoking habits (R=0.742, p=0.039). Results of our investigation support the concept on key role of inflammation in the development of atherosclerosis in HD patients. .
Diabetic osteopathy
Authors: Ilic Jana , Kovacev Branka
Published: July 2006

Introduction. The aim of this study was to point out some dilemmas about the existence and pathogenesis of primary diabetic osteopathy as a separate entity, based on currently available studies. Expert disagreements are present not only about the occurrence of generalized osteopathy with diabetic disease, but also about direct relationship between metabolic diabetes control and bone metabolism and influence of disease duration and sex on bone changes. Pathogenesis of diabetic osteopathy Decreased bone formation is the basic mechanism leading to decreased bone mass. Biochemical markers showed no clear connection with bone density measurement. Insulin and insulin-like growth factor (IGF) affect bone metabolism. Osteopathy in patients with diabetic disease-type 1 Some clinical studies have shown that patients with diabetic disease-type 1 have a mild decrease in bone mass, while others have not presented such results. Osteopathy in patients with diabetic disease-type2 In patients with diabetic disease-type 2 the risk for osteopathy is even less defined. Patients treated with oral hypoglycemics present with higher decrease of bone mass has than patients treated with insulin therapy. This could partly be explained by anabolic effects of insulin on bones. Bone fractures in patients with diabetic disease Literature data are contradictory concerning the occurrence of bone fractures in diabetic patients. A survey of bone fracture occurrence in diabetic patients was performed in "Veljko Vlahovic Medical Center" in Vrbas and it included a group of 100 patients with diabetic disease. The results show that 12 patients had some fractures: mostly females in postmenopause, aged and with secondary insulin-dependent diabetes and most frequently arm fractures. Considering contradictory literature data, further longitudinal studies are necessary. .
Technetium-99m radiopharmaceuticals for in vivo diagnostics
Authors: Djokic Divna
Published: July 2006

Technetiiim-99m is an ideal radionuclide with optimum decay characteristics. It can be obtained in sterile, pyrogen-free and carrier-free condition, as sodium pertechnetate (Na99mTcO4), from 99Mo/99Tc generator. Because of its six-hour physical half-life and monochromatic 140 keV photons free of -radiation, administration of small amounts of 99mTc solution is possible, without a significant radiation damage to the patient. Technetium eluted from the 99Mo/99mTc generator is in the highest oxidation form (+7). It can be used for diagnostic purposes alone, but it is often used for labeling different organic and inorganic compounds. As it is unreactive, reduction with a chemical reductant, (+1), (+3) and (+5) oxidation are necessary before use. Nowadays almost 80% of radiopharmaceuticals are based on 99mTc. Radiopharmaceuticals. Radiopharmaceuticals are radionuclides or radioactive compounds used in diagnosis and therapy of human diseases. A pharmaceutical is chosen based on its localization in the organ, or its participation in its physiological function. Radiation emitted from a radionuclide is detected by a radiation detector. The ability to incorporate available radionuclides into tracer molecules has been the main goal in developing radiopharmaceuticals. As radionuclides with nuclear characteristics used as either diagnostic or therapeutic radiopharmaceuticals, are predominantly metals, they can be designed as metal essential, whereby biological distribution is determined by coordination compound, or metal tagged, in which case the properties of the carrier molecule (ligand system) determine the biological distribution. This paper reviews the development of 99mTc-radiopharmaceuticals. .
Deciduosis peritonei: A case report
Authors: Fenjvesi Atila , Zivkovic Slobodan
Published: July 2006

Introduction The occurrence of ectopic decidua (deciduosis) has been observed most often in the ovaries, uterus, and cervix. It has been established in approximately 90% of patients who have undergone laparotomy during pregnancy. A peritoneal localization is less frequent and usually an asymptomatic incidental finding, but is occasionally associated with massive and potentially fatal hemoperitoneum, abdominal pain and dystocia. Ectopis decidua is a physiological phenomenon of pregnancy and arises from a progesterone-induced metaplasia of subserosal stromal cells. Case report A 32-year-old G1P1 female underwent cesarean section at 39 weeks gestation because of imminent fetal asphyxia. The laparotomy revealed a greyish-yellow soft nodule on the parietal peritoneum. On histologic examination the biopsy lesion was highly vascular and was composed of large polygonal decidualized cells with abundant eosinophilic, focally vacuolated cytoplasm. The nuclei were regular, with fine chromatin and inconspicuous nucleoli. Ectopic decidua was infiltrated by blood and surrounded with adipose tissue necrosis and mild chronic inflammation. Discussion and conclusion The differential diagnosis of peritoneal deciduosis included deciduoid mesothelioma, metastatic carcinoma (especially if decidual cells have a vacuolated cytoplasm mimicking signetring cells), and metastatic melanoma. Decidual cells showed immunoreactivity for vimentin and progesteron receptors and focal positivity for desmin and smooth muscle actin. The presence of cellular atypia, mitotic activity, and immunoreactivity for cy-tokeratin 5/6 and calretinin will assist in making the diagnosis of deciduoid mesothelioma. The diagnosis of metastatic carcinoma is assisted by the nuclear features and cytokeratin immunoreactivity. A positive immunostain for S-100 and/or HMB-45 will assist in the diagnosis of metastatic melanoma. .
Urogenital abnormalities and atresia of the gastrointestinal tract
Authors: Dobanovacki Dusanka , Marinkovic Smiljana , Jokic Radoica , Zivkovic Dragana , Stanic-Canji Danica , Borisev Vladimir
Published: July 2006

Introduction. The goal of the study was to investigate the frequency of urogenital congenital abnormalities among atresias of the digestive system and analyze fetal maldevelopment. The study also deals with gastrointestinal and urogenital embryology. Material and methods. This retrospektive study analyzed the clinical status of 55 new-borns admitted to the Pediatric Surgery Clinic in Novi Sad due to atresia of the gastrointestinal tract during 1995-2003. All atresias were classified at primordial gut levels (foregut, midgut and hindgut). The incidence of associated abnormalities, especially urogenital, was analyzed. Diagnostic procedures included standard methods: clinical investigation, ultrasound, native and contrast medium radiography, etc. Results. Results showed that urogenital anomalies were present in 21 (38.18%) newborns with gastrointestinal atresia. Foregut atresia was diagnosed in 14 newborns and it was associated with urogenital congenital anomalies in 9 (64.28%) newborns. Midgut atresias were found in 15 patients and in 4 (22.22%) they were associated with urogenital anomalies. Hindgut atresias were established in 23 and in 8 (34.78%) cases they were associated with urogenital anomalies. Discussion and conclusions. It was confirmed that foregut atresias are commonly accompanied by associated abnormalities. That is why the fourth gestational week is important when both gastroinestinal and urogenital systems are developed. When midgut differentiates into its own derivates, the frequency of congenital anomalies decreases for a short period, and then increases again during foregut development (seventh and eighth gestational weeks). There were no information on environmental teratogenic factors in maternal history. These abnormalities may be explained by complex urorectal development and separation of two systems. .
Noninvasive diagnosis of fetal anemia in RH-alloimmunized pregnancies by color Doppler
Authors: Mandic Vesna , Mikovic Zeljko , Filimonovic Dejan , Djukic Milan , Vasiljevic Mladenko , Bogavac Mirjana
Published: July 2006

Introduction. Fetal anemia is usually diagnosed by invasive procedures, such as amniocentesis and cordocentesis. As these procedures carry a substantial risk for pregnancy loss, a nonivasive method for diagnosing fetal anemia is needed. Doppler allows measurement of blood flow velocity in fetal vessels. In anemic fetuses increased velocities in medial cerebral artery (MCA) are registered. The aim of our study was to evaluate if there were changes in blood flow waveforms in anemic fetuses' MCA, and if these changes correlated with values of fetal hematological parameters. Material and methods. A clinical study evaluated 172 pregnancies of gestational age between 28 and 32 weeks, in which cordocentesis was performed due to maternal Rh-alloimmunization. During sonographic examination we evaluated blood flow velocities and pulsatility index (Pi) in MCA. We registered hematological parameters such as hemoglobin and hematocrit. Based on hemoglobin levels, all fetuses were divided into four groups: nonanemic (140 g/l); mild anemia (120-139.9 g/l); moderate anemia (100-119.9 g/l) and severe anemia requiring intrauterine transfusion (99.9 g/l). We compared mean systolic velocities and Pi between groups and studied the correlation between MCA mean systolic velocities and hemoglobin and hematocrit values. Statistical analysis was done using AN OVA test and parameter linear correlation. The difference was considered to be significant if p < 0.05. Results Out of 172 fetuses, 60 (34.09%) were nonanemic, 56 (31.82%) showed mild anemia, 56 (31.82%) moderate anemia and 24 (13.64%) fetuses had severe anemia. Anemic fetuses had significantly higher MCA flow velocities compared to nonanemic fetuses. Values of Pi decreased in severe forms of fetal anemia, but the difference wasn't significant. Levels of hemoglobin and hematocrit showed inverse correlation with the values of MCA mean systolic velocities, while correlation with the values of Pi wasn't observed. Discussion. Cerebral blood flow velocity in medial cerebral artery was assessed to diagnose fetal anemia. MCA mean systolic velocity is increased in anemic fetuses and correlates with the degree of anemia. The main advantage of this parameter is that advanced software programs are not necessary. We can conclude that in cases of Rh-alloimmunization in anemic fetuses increased MCA mean systolic velocities are registered. There is an inverse correlation between MCA mean systolic velocities and hemoglobin and hematocrit values. We suggest that measurements of MCA mean systolic velocities should be used in fetuses at risk for anemia and in selection of fetuses requiring invasive procedures. .
Epidemiology of obesity in adult population of Vojvodina
Authors: Grujic Vera , Martinov-Cvejin Mirjana , Ac-Nikolic Erzebet , Niciforovic-Surkovic Olja
Published: July 2006

Introduction. The prevalence of overweight and obesity is increasing world?wide at an alarming rate and is due to changes in nutritional patterns and physical activity that adversely affect the health status. Obesity is a complex disorder with multiple interactive causes. It is associated with many chronic, debilitating diseases with important health care cost and it is basically the consequence of sedantery life style and excessive energy intake. Our objective was to measure the prevalence of obesity in adult population of Vojvodina and to describe its characteristics. Material and methods. This cross-sectional study was conducted in representative sample of 2467 adults from Vojvodina (in adult population of Vojvodina aged 20 years and over). The sample size was determined based on estimated frequency, exposition to risk factors, relative risks and level of statistical significance. All those who completed household interviews attended physical examination. Results. The prevalence of overweight and obesity (BMI>25 kg/m2) in both sexes was 58.5%. Among them, 35.5% were overweight while 23% were obese (BMI>30kg/m2). The frequency of obesity was higher among females (26%) than among males (19.6%) (p<0.01). It showed a steady increase to the age of 65, after which the number of obese decreased. The obesity rate was higher in rural (26.7%) than urban areas (19%) (p<0.01), and among people with lower level of education and socioeconomic status. Conclusion. Considering the existing situation concerning the high prevalence of obesity, urgent public action is necessary. It is essential to develop preventive strategies which would affect the whole society. Healthy lifestyle, balanced diet and increased physical activity must be promoted. However, it is not the responsibility of individuals. Health services, the community, food industry, mass media etc, have a crucial role in modifying body weight. Strategies for prevention and management of obesity should be in accordance with the existing public health policy and programs for prevention of noncommunicable diseases. .
Systemic lupus erythematosus in pregnancy: Case report
Authors: Radeka Gordana , Novakov-Mikic Aleksandra , Mitic Igor
Published: July 2006

Systemic lupus erythematosus (SLE) is a chronic inflammatory connective tissue disease commonly diagnosed after the age of 20, mostly around the age of 30 years. It is more common in women than in men, especially during the fertile period. Women with SLE are at higher risk for spontaneous abortions, intrauterine fetal death, preeclampsia and eclampsia, preterm delivery and intrauterine growth retardation. This paper is a case report of a pregnant woman with SLE complicated with preeclampsia, but it also discusses follow-up of such pregnancies.