bluuebunny/crossref_metadata_2025 huggingface dataset:
Significance of punch biopsy and endocervical curretage in diagnostics of cervical intraepithelial lesions
Authors: Panjkovic Milana , Ivkovic-Kapicl Tatjana
Published: December 2010

Background/Aim. Diagnostic procedures during the detection of cervical intraepithelial lesions (CIN) are a combination of cytology, colposcopy, punch biopsy and endocervical curretage. An optimal therapeutic approach according to the distribution, size and grade of cervical lesions is the result of this diagnostic protocol. This study was carried out to assess reliability of the punch biopsy and endocervical curretage in diagnostics of cervical intraepithelial lesions. Methods. Fifty patients undergoing cervical conization were studied retrospectively to evaluate the correlation between the grade of preoperative punch biopsy and endocervical curretage, and the grade of the dysplastic epithelial changes in the cone biopsy. CIN grade was established according to the WHO/ISGYP classification and comparation of the results was performed after that. Results. Out of the total number of patient, 89.36% of them with dysplastic epithelial changes on cone biopsy had also dysplastic changes in the preoperative punch biopsy. An exact correlation between CIN grades was identified in 56% of the cases, 20% in CIN2, and 36% in CIN3 cases. There were 24.14% patients with negative endocervical curretage, while only in one case the cone biopsy was negative, too. Among the remaining 22 patients with CIN changes in endocervical curretage specimens, only one had a negative cone biopsy. An exact correlation of CIN grade was identified in 37.93% of the cases, 13.79% of CIN2, and 24.14% of the CIN3 cases. Conclusion. There was a positive cor relation between the CIN grades in punch and cone biopsy, as well as between the grade on the endocervical curretage and cone biopsy specimen, but with the lower degree than previous.
Histometric analysis of gingival hyperplasia in Wistar rats during nifedipine administration
Authors: Brkic Zlata
Published: December 2010

Background/Aim. The use of calcium channel blockers, especially nifedipine, causes gingival hyperplasia which leads to the destruction of the deeper periodontal tissues. During this process, inflammatory changes and the changes of colagen fibers occur. The aim of this study was to metrically compare the extent of proliferation of connective tissue in the deeper periodontal tissue in experimental animals regarding the dose and duration of nifedipine administration. Methods. The study involved 50 Wistar rats to which water solution of nifedipine was given in certain time intervals and doses. Before starting the experiment, i.e. before nifedipine administration, and in the defined time intervals, measuring of the morphology of gingival size was performed including the buccolingual and mesiodistal wideness and vertical altitude of the central interdental papilla. The measurement was performed by the use of a special graduated probe. Histometric analyses of the tissue samples were done on the sagital cross-sections in the direction from the top to the bottom of papilla on five levels. For the statistical analysis of the data, the established values to the extent of the most present changes were used. The mesiodistal and buccolingual diameters for the levels L2 and L3 were quantitively determined and compared. These values were compared to the vertical diameter of gingival growth determined before the onset of patohistologic analyses of the tissue samples. Results. At the beginning of the experiment, the volume of the lower incisive central papilla in the rats was 12 mm3. The central interdental papilla vertical altitude was 6.6 mm in rats which had received a lower dose of nifedipine, 8 mm in rats which had received a higher dose in the defined time intervals while the value for the control group was 3.8 mm. Conclusion. The obtained results showed that the administration of nifedipine led to the extensive gingival hyperplasia in the experimental animals. Gingival hyperplasia correlates with both the dose of nifedipine and the duration of its administration.
Polymorphisms in the genes of citohrom oxidase P450 2D6 (CYP2D6), paraoxonase 1 (PON1) and apolipoproteine E (APOE) as risk factors for Parkinson's disease
Authors: Djuric Gordana , Svetel Marina , Illarioskin Nikolaevic , Dragadjevic Natasa , Gavrilovic Jelena , Kostic Vladimir
Published: December 2010

Background/Aim. The presence of Parkinson's disease (PD) among the members of a family is a clear indication of the significance of genetics in its development. In spite of that, the majority of patients with PD shows a sporadic form of the disease induced as a result of interaction of both environmental and genetic factors. The aim of this study was to examine the effects of polymorphisms in the genes of cytohrome P450 2D6(CYP2D6), paraoxonase 1 (PON 1) and apolipoprotein E (APOE), as risk factors for PD. Methods. We examined 106 patients with PD (65 men and 41 women) and 75 ethnically matched control subjects. The mean age at onset of PD in the patients was 46.9?9.4 years (ranging from 30 to 70 years). Genotyping was performed using standard PCR amplification and restriction endonuclease digestion protocols described for known polymorphism in the candidate genes under study. Results. The genotype A/A polymorphisms 2D6* gene of CYP2D6 and genotype M/M polymorphisms L54M gene of PON1 were significantly more frequent in the patients with PD than in the control group. The patients with genotypes A/A and M/M had 3.4 and 3.2 higher risk of PD, respectively than the control group (p = 0.01). The relation between genotypes A/A gene of CYP2D6 and M/M gene of PON1 was modified by the age at onset. The genotypes were associated with early onset of PD (p = 0.001, p = 0.004). The carriers of the A and M alleles in homozygote had 2.4 and 4.2 years respectively earlier onset of PD than carriers of other genotypes with these polymorphisms. The frequency allele ?4 gene of APOE was higher in the PD patients with early onset (20%) than in PD with later onset (7.4%), while the genotype ?3/?3 was associated with PD late onset (p = 0.024). Combined genotype I (carriers of the two risk allels in homozygote and one alleles risk in heterozygote) and combined genotype II (carriers of the three alleles risk in homozygote) caused early PD. Combined genotype II was detected in 12.7% of the patients in the group of early onset, and in 2.4% of the patients with the onset after 45 years. Conclusion. The results of our study suggest that the genotypes A/A and M/M genes of CYP2D6 and PON1, and allele ?4 gene are an important risk for the development of PD, causing its early onset. The cumulative effects of the risk genes cause an early onset of PD.
Pulsative hematoma: A penile fracture complication
Authors: Nale Djordje , Micic Sava
Published: December 2010

Background. Fracture of the penis is a direct blunt trauma of the erect or semi-erect penis. It can be treated by conservative or surgical means. Retrospective analyses of conservative penile fracture treatment reveal frequent immediate and later complications. Case report. We presented a 41- year-old patient with pulsative hematoma caused by an unusual fracture of the penis. Fracture had appeared 40 days before the admittance during a sexual intercourse. The patient was treated surgically. Conclusion. Pulsative hematoma (pulsative diverticulum) is a very rare, early complication of a conservatively treated penile fracture. Surgical treatment has an advantage over surgical one, which was confirmed by our case report.
Foreign bodies in the torax
Authors: Cerimagic Zenaida , Guska Safet , Kadic Kenan , Banjanovic Bedrudin
Published: December 2010

Background. Metallic foreign bodies in the lung could be recognized using radiography. Non-metallic foreign bodies make difficulties because they are not as dense as metals. The aim of this report was to present the case of nonmetallic foreign bodies in the lung. Case report. A soldier of the Federation Army of Bosnia and Hertzegovina, injured in the explosion in 1998 was presented. The soldier was subjected to thoracic drainage and surgery tretment of the wound. After one year, the pulmologist treated him with tuberculostatics because of hemoptysis and pulmonary infiltration shown by a radiogram. This therapy had no effects, and the pulmologist presented this case to the thoracic surgeon who made thoracotomy removing a piece of wood (13 ? 2 ? 0.7 cm), 20 different-size pieces of wood, and a piece of textile from the lung. Conclusion. Patients with penetrating explosive lung injuries without metallic foreign bodies shown by a radiogram, with complications as hemoptisis, lung abscess, bronchiectasis, obstruction of the bronchus, chronic pneumonia should be subjected to thoracotomy for removing suspected foreign bodies without resecting the lung.
Influence of the double antiplatelet therapy on patency of the infarct related artery after acute myocardial infarction with ST-segment elevation
Authors: Djordjevic-Radojkovic Danijela , Perisic Zoran , Tomasevic Miloje , Pavlovic Milan , Apostolovic Svetlana , Jankovic Ruzica , Damjanovic Miodrag , Salinger-Martinovic Sonja , Bozinovic Nenad , Milenkovic Dusan
Published: December 2010

Background/Aim. Most patients with acute myocardial infarction with ST-segment elevation (STEMI) are still treated with pharmacological reperfusion, which is not always successful. That is the reason for searching possibilities for a better success of reperfusion with adding new antiplatelet drugs. The aim of this study was to investigate weather addition of clopidogrel as a second antiplatelet drug, improves the patency of the infarct-related artery after STEMI. Methods. We prospectively enrolled 65 patients, 29?72 years old, hospitalized due to the first STEMI within 6 hours after the onset of a chest pain. They were treated with a fibrinolytic agent (streptokinase or tissue plasminogen activator ? tPA), aspirin, and low molecular heparin (enoxaparin). A group of 50 patients, beside this therapy, received clopidogrel. Coronary angiography was performed between 5th and 10th day of hospitalization to assess for late patency of the infarct-related artery. Infarct-related artery was considered as patent if thrombolysis in myocardial infarction (TIMI) flow grade was 2 or 3, and as occluded if TIMI flow grade was 0 or 1. Results. In the group of patients who received double antiplatelet therapy (aspirin and clopidogrel), infarct-related artery was occluded in 3 cases (6%); in the group of patients without clopidogrel, infarct-related artery was occluded in 4 patients (26.7%), p < 0.05. There were less frequency of postinfarction angina (6% vs 13.3%), and rarer necessity for rescue percutaneous coronary intervention (4% vs. 13.3%) in the first group, but without statistical significance. Conclusion. Adding of clopidogrel to the standard reperfusion pharmacotherapy, as a second antiplatelet drug, increases the number of patients with patent infarct-related artery and the success of reperfusion.
Amblyopia screening
Authors: Stankovic Branislav
Published: December 2010

 S obzirom na neujednacenu pokrivenost zemlje oftamoloskom sluzbom, resurse i edukaciju trebalo bi usmeriti, pre svega, na pedijatre i lekare opste medicine koji su ukljuceni u pregled ociju dece. Takodje, bila bi potrebna standardizacija optotipa i protokola ispitivanja. Trebalo bi poboljsati i informisanost roditelja putem stampanog materijala koji bi trebalo da bude dostupan, kako u primarnoj tako i u sekundarnoj i tercijarnoj zdravstvenoj zastiti.
Patophysiology of the lung inhalation injuries
Authors: Vulovic Tatjana , Djordjevic Gordana
Published: December 2010

 U ovom radu prikazani su neki od patofizioloskih aspekata inhalacionih povreda pluca, nezavisno od toga da li su bile udruzene s opekotinama ili nisu. Mada tacan mehanizam akutne inhalacione povrede pluca nije razjasnjen u potpunosti, na osnovu mnogobrojnih istrazivanja moze se zakljuciti da ogromnu ulogu u tim procesima imaju NO, PARP i opstrukcija vazdusnih puteva.
Nasopalatine duct cyst
Authors: Matijevic Stevo , Gazivoda Dragan , Marjanovic Marjan , Udovicic Bozidar
Published: December 2010

Background. Nasopalatine duct cyst is a developmental, nonodontogenic cyst of jaw. Case report. We presented a 46-year-old male with nasopalatine duct cyst. The clinical examination revealed fluctuant swellings of the anterior palate, without pain, 4?5 cm in diametar. Both radiographs showed the presence of an ovoid radiolucency located in the midline of the maxilla between the roots of central maxillary incisor teeth with peripheral sclerosis, 25 ? 35 cm in diametar. Surgical treatment was performed under local anaesthesia (ArticainchloridumTM 4% ? 3M ESPE) using a palatine approach. Postoperatively, no paresthesia of the anterior palate in inervation area of nasopalatine nerve was registrated. Pathohistologic findings proved both clinical and radiological diagnosis. Conclusion. Nasopalatine duct cyst is a rare lesion which slowly develops. The diagnosis is mainly based on radiography, tooth vitality testing and histologic findings. After a correctly applied clinical diagnosis procedure and surgicel treatment, recurrence is rare.
Forensic evaluation of persons with destructive behavior in the postwar Bosnia and Herzegovina
Authors: Novakovic Milan , Cabarkapa Milanko , Ille Tanja , Ilankovic Andrej
Published: December 2010

Background/Aim. Different persons show forensic differences related to aggressive behavior in criminal and violation acts. The aim of this study was to forensically analyze the influence of socio-dynamic conditions and stress in testing the forensic hypothesis of hetero-destruction, and analysis of persons with destructive behavior in Bosnia and Herzegovina (B&H) in the period from 1996?2005. Methods. The experimental group consisted of 125 persons who had committed a crime according to the Criminal Law of B&H and, thus were under security measures or treatment. The control group consisted of 125 persons who had committed a violation. The following psychometric tests/questionnaires were used in the study: Eysenek Personality Questionnaire (EPQ), Beck Anxiety Inventory (BAI) and Profile Index of Emotions (PIE). Results. There were a significant difference between the respondents? groups related to gender (p < 0.01), while broken family, migration, and family comorbidity showed insignificant differences. EPQ test showed statistically significant differences between the groups for all four variables, and Beck test found significant differences only for some ones. PIE test proved the relations of the basic emotions confirmed by discriminative function. Conclusion. High level of hetero-destruction in crime was proven in the study. Criminal acts and violations were committed by the persons without psychopathology, as well as by the persons with mental diseases, which rendered a forensic responsibility and analysis of such an influence on behavior.
Effects of acclimation on water and electrolitic disbalance in soldiers during exertional heat stress
Authors: Radakovic Sonja , Maric Jelena , Rubezic Velimir , Surbatovic Maja , Radjen Slavica
Published: December 2010

Background/Aim. Exertional heat stress is a common problem in military services. The aim of this study was to examine changes in body water and serum concentrations of some electrolites in soldiers during exertional heat stress (EHST), as well as effects of 10-day passive or active acclimation in a climatic chamber. Methods. Forty male soldiers with high aerobic capacity, performed EHST either in cool (20 ?C, 16 ?C WBGT-wet bulb globe temperature), or hot (40 ?C, 25 ?C WBGT) environment, unacclimatized, or after 10 days of passive or active acclimation. The subjects were allowed to drink tap water ad libitum during EHST. Mean skin (Tsk) and tympanic (Tty) temperatures and heart rates (HR) measured physiological strain, while sweat rate (SwR), and serum concentrations of sodium, potassium and osmolality measured changes in water and electrolyte status. Blood samples were collected before and immediately after the EHST. Results. Exertional heat stress in hot conditions induced physiological heat stress (increase in Tty, HR, and SwR), with significant decrease in serum sodium concentration (140.6?1.52 before vs 138.5?1.0 mmol/l after EHST, p < 0.01) and osmolality (280.7?3.8 vs 277.5?2.6 mOsm/kg, p < 0.05) in the unacclimatized group. The acclimated soldiers suffered no such effects of exertional heat stress, despite almost the same degree of heat strain, measured by Tty, HR and SwR. Conclusion. In the trained soldiers, 10-day passive or active acclimation in a climatic chamber can prevent disturbances in water and electrolytic balance, i.e. decrease in serum sodium concentrations and osmolality induced by exertional heat stress.
Activity of antioxidative defense enzymes in the blood of patients with liver echinococcosis
Authors: Lilic Aleksandar , Dencic Srdjan , Pavlovic Sladjan , Blagojevic Dusko , Spasic Mihajlo , Stankovic Nebojsa , Saicic Zorica
Published: December 2010

Background/Aim. Chronic echinococcocal disease is the parasite human disease caused by the penetration of larval (asexual) stages of the canine tapeworm (Echinococcus granulosus) in the liver of humans. After the penetration of the parasite, the host organism react by activating complement- depending immune response. The aim of this study was to elucidate the influence of larval form of Echinococcus granulosus in the liver on the activity of antioxidative defense enzymes in the blood of patients before and after the surgical intervention. Methods. We investigated the activity of antioxidative defense enzymes: copper/zinc containing superoxide dismutase (CuZn SOD), catalase (CAT), glutathione peroxidase (GSH-Px), glutathione reductase (GR) and glutathione-S-transferase (GST) in the blood of patients before and after the surgical intervention in respect to the controls, clinically healthy persons. Results. Our results showed that the activity of the GSH-Px was significantly decreased in the plasma of the patients with echinocococal disease before the surgery in respect to the controls. The activity of GST was significantly higher in the blood of the patients after the surgery in comparison to the controls. Conclusion. Chronic liver echinoccocal disease caused significant changes of some antioxidative defense enzymes, first of all Se-dependent enzyme GSH-Px, which could be a suitabile biomarker in the biochemical evaluation of the disease. This work represents a first comprehensive study of the activity of antioxidative defense enzymes in cronic liver echinococcocosis in the patients before and after the surgical intervention in respect to the clinically healthy persons.
Comparison between basal insulin glargine and NPH insulin in patients with diabetes type 1 on conventional intensive insulin therapy
Authors: Pesic Milica , Zivic Sasa , Radenkovic Sasa , Velojic Milena , Dimic Dragan , Antic Slobodan
Published: December 2010

Background/Aim. Insulin glargine is a long-acting insulin analog that mimics normal basal insulin secretion without pronounced peaks. The aim of this study was to compare insulin glargine with isophane insulin (NPH insulin) for basal insulin supply in patients with type 1 diabetes. Methods. A total of 48 type 1 diabetics on long term conventional intensive insulin therapy (IIT) were randomized to three different regimens of basal insulin substitution: 1. continuation of NPH insulin once daily at bedtime with more intensive selfmonitoring (n = 15); 2. NPH insulin twice daily (n = 15); 3. insulin glargine once daily (n = 18). Meal time insulin aspart was continued in all groups. Results. Fasting blood glucose (FBG) was lower in the glargine group (7.30?0.98 mmol/l) than in the twice daily NPH group (7.47?1.06 mmol/l), but without significant difference. FBG was significantly higher in the once daily NPH group (8.44?0.85 mmol/l; p < 0.05). HbA1c after 3 months did not change in the once daily NPH group, but decreased in the glargine group (from 7.72?0.86% to 6.87?0.50%), as well as in the twice daily NPH group (from 7.80?0.83% to 7.01?0.63%). Total daily insulin doses were similar in all groups but only in the glargine group there was an increase of basal and decrease of meal related insulin doses. The frequency of mild hypoglycemia was significantly lower in the glargine group (6.56?2.09) than in both NPH groups (9.0?1.65 in twice daily NPH group and 8.13?1.30 in other NPH group) (episodes/patients-month, p < 0.05). Conclusion. Basal insulin supplementation in type 1 diabetes mellitus with either twice daily NPH insulin or glargine can result in similar glycemic control when combined with meal time insulin aspart. However, with glargine regimen FBG, HbA1c and frequency of hypoglycemic event are lower. These facts contribute to better patients satisfaction with insulin glargine versus NPH insulin in IIT in type 1 diabetics.
Analysis of Y chromosome microdeletions and CFTR gene mutations as genetic markers of infertility in Serbian men
Authors: Dinic Jelena , Kusic Jelena , Nikolic Аleksandra , Divac Aleksandra , Ristanovic Momcilo , Radojkovic Dragica
Published: December 2010

Background/Aim. Impaired fertility of a male partner is the main cause of infertility in up to one half of all infertile couples. At the genetic level, male infertility can be caused by chromosome aberrations or gene mutations. The presence and types of Y chromosome microdeletions and cystic fybrosis transmembrane conductance regulator (CFTR) gene mutations as genetic cause of male infertility was tested in Serbian men. The aim of this study was to analyze CFTR gene mutations and Y chromosome microdelations as potential causes of male infertility in Serbian patients, as well as to test the hypothesis that CFTR mutations in infertile men are predominantly located in the several last exons of the gene. Methods. This study has encompassed 33 men with oligo- or azoospermia. The screening for Y chromosome microdeletions in the azoospermia factor (AZF) region was performed by multiplex PCR analysis. The screening of the CFTR gene was performed by denaturing gradient gel electrophoresis (DGGE) method. Results. Deletions on Y chromosome were detected in four patients, predominantly in AZFc region (four of total six deletions). Mutations in the CFTR gene were detected on eight out of 66 analyzed chromosomes of infertile men. The most common mutation was F508del (six of total eight mutations). Conclusion. This study confirmed that both Y chromosome microdeletions and CFTR gene mutations played important role in etiology of male infertility in Serbian infertile men. Genetic testing for Y chromosome microdeletions and CFTR gene mutations has been introduced in routine diagnostics and offered to couples undergoing assisted reproduction techniques. Considering that both the type of Y chromosome microdeletion and the type of CFTR mutation have a prognostic value, it is recommended that AZF and CFTR genotyping should not only be performed in patients with reduced sperm quality before undergoing assisted reproduction, but also for the purpose of preimplantation and prenatal diagnostics in couples in which in vitro fertilization has been performed successfully.
Impact of some constitutional characteristics on the development of basal cell carcinoma
Authors: Raznatovic Milena , Maksimovic Natasa , Jankovic Janko , Music Davor
Published: December 2010

Background/Aim. Basal cell carcinoma (BCC) is the most common form of skin cancer in the white population. Increasing incidence of BCC imposes the requirement to identify the risk factors due to eventual preventive action. The aim of this study was to assess the role of some constitutional characteristics in development of BCC among the Montenegrin population. Methods. A case-control study was conducted at the Dermatology Department of Clinical Center of Montenegro in Podgorica from 2002?2003. The study group included 100 histopatologically confirmed BCC cases, while the control group consisted of 100 patients from the same department, who did not present skin cancer and who were individually matched to the cases by sex and age (?5 years). All participants were interviewed using an epidemiological questionnaire. For statistical analysis t test and McNemar ?2 test for matched pairs and multivariate logistic regression analyses were used. Results. The risk for development of BCC was increased among the persons with lighter hair color (t = 4.63; df = 99; p < 0.001), fair skin (t = 2.37; df = 99; p = 0.020), lighter eyes color (t = 2.86; df = 99; p = 0.005), with nevuses (OR = 13.13; p = 0.025; 95% IP = 1.39-12.03), and among those whose skin tone after sun exposure remained light (OR = 3.14; p = 0.001; 95%IP = 1.59-6.18). Conclusion. Our study confirmed the significance of constitutional characteristics such as lighter hair color, fair skin, lighter eyes color, and the presence of nevuses in the development of BCC. .
Influence of perioperative administration of amino acids on thermoregulation response in patients underwent colorectal surgical procedures
Authors: Zeba Snjezana , Surbatovic Maja , Jevtic Miodrag , Filipovic Nikola , Popovic Nada , Radakovic Sonja , Slavkovic Zoran
Published: December 2010

Background. Hypothermia in the surgical patients can be the consequence of long duration of surgical intervention, general anesthesia and low temperature in operating room. Postoperative hypothermia contributes to a number of postoperative complications such as arrhythmia, myocardial ischemia, hypertension, bleeding, wound infection, coagulopathy, prolonged effect of muscle relaxants. External heating procedures are used to prevent this condition, but some investigations reported that infusion of aminoacids during surgery can induce thermogenesis and prevent postoperative hypothermia. Case report. We reported two males who underwent major colorectal surgery for rectal carcinoma. One patient received Aminosol 15% solution, 125 ml/h, while the other did not. The esophageal temperatures in both cases were measured every 30 minutes during the operation and 60 minutes after in Intensive Care Unit. We were monitoring blood pressure, heart rate, ECG, and shivering. Patient who received aminoacids showed ameliorated postoperative hypothermia without hypertension, arrhythmia, or shivering, while the other showed all symptoms mentioned above. Conclusion. According to literature data, as well as our findings, we can conclude that intraoperative intravenous treatment with amino acid solution ameliorates postoperative hypothermia along with its complications. .
Intestinal and extraintestinal manifestations in familial adenomatous polyposis
Authors: Nagorni Aleksandar , Bjelakovic Goran , Katic Vuka , Veselinovic Dragan
Published: December 2010

 U radu su opisane intestinalne i ekstraintestinalne manifestacije familijarne adenomatozne polipoze koje mogu imati dijagnosticki i prognosticki znacaj. Pojava tumora izvan kolona znacajna je za razvoj ozbiljnih simptoma bolesti (opstrukcija, krvarenje), ali i za malignu alteraciju i razvoj karcinoma, posebno u duodenumu (karcinom duodenuma i dezmoidni tumori su najcesci uzrok smrti kod bolesnika sa familijarnom adenomatoznom polipozom nakon kolekotmije). Poseban znacaj imaju dezmoidni tumori, koji su benigni po svojoj prirodi, ali koji lokalnom invazijom mogu dovesti do smrtnog ishoda, a najcesce ispoljavaju tendenciju rasta nakon hirurske resekcije creva. Kongenitalna hipertrofija pigmentnog epitela retine je prediktivni marker koji omogucava postavljanje dijagnoze familijarne adenomatozne polipoze i pre otkrivanja adenoma debelog creva.
Botulinum toxin type a for the treatment of spasticity in children with cerebral palsy
Authors: Dimitrijevic Lidija , Stankovic Ivona , Zivkovic Vesna , Mikov Aleksandra , Colovic Hristina , Jankovic Irena
Published: December 2010

Background/Aim. Cerebral palsy (CP) is the most common physical disability in childhood. Children have problems with motor functions as a result of limbs spasticity, which leads to severe contractures and limbs deformity. There is a growing interest in the therapeutic role of botulinum toxin type A (BTA) in CP. The aim of this study was to examine the effects of BTA on spasticity, active range of motion and functional motor outcomes in children with CP. Methods. This study included 42 children of both sexes, aged 2?6 years, with spastic CP, divided into two groups: group I (21 child) treated with BTA and physical therapy, and group II (21 child) treated with physical therapy only. The following parameters were analyzed: spasticity; active range of motion of the hip, knee and ankle, and functional motor outcome. These parameters measurements were carried out four times in both groups: before the treatment, three, eight and 16 weeks after the beginning of the treatment. The obtained results were statistically processed and compared. Results. There was no evidence of any significant difference between the groups before the treatment. After eight weeks there was a remarkable difference concerning spasticity reducing on behalf of the group I (group I - 0.76?0.51 vs. II group - 2.17?0.64; p < 0.0001). There was statistically significant difference concerning active range of motion increasing on behalf of the group I (hip abduction: group I - 44.37?1.130 vs. group II - 32.61?8,070, p < 0,01; knee extension: group I - 0,77?1.820 vs. II group - 14.99?7.610, p < 0.01; dorsiflexion of the foot: group I - 11.50?6.080 vs. group II - 8.98?7.850, p < 0,01). A statistically significant difference was found after 16 weeks in functional motor outcome as well, on behalf of the group I: functional motor abilities level in the group I was 1.86 vs. 2.71 in the group II, p < 0.05. Conclusion. Botulinum toxin type A application leads to an important spasticity decreasing, active range of motion increasing, as well as to functional abilities in children with CP. .
Non-alcoholic fatty liver disease in obese persons with diabetes
Authors: Tomasevic Ratko , Golubovic Gradimir , Stankovic Dragana , Gluvic Zoran , Dugalic Predrag , Pavlovic Aleksandar
Published: December 2010

Background. Obesity, diabetes and different lipid metabolic disorders are the most frequent risk factors for nonalcoholic fatty liver disease, presented with a high variability in clinical and histological findings. Case report. We presented a case of 37-year-old male, suffering from type 2 diabetes mellitus, grade III obesity (BMI 45 kg/m2) and multiple metabolic disorders. Abdominal ultrasound revealed hepatomegaly during the last six months. Laboratory diagnostics showed increased serum transaminase levels. Serologic markers for viral hepatitis B and C were negative. The patient denied significant alcohol consumption. Liver biopsy and pathohistologic finding revealed macro- (III grade) and microvesicular (I grade) fatty degeneration, as well as mixed-cell portal infiltration with moderate liver fibrosis, corresponding to the typical presentation of NASH (Non Alcoholic Steatohepatitis). Conclusion. NASH treatment options include the reduction of body mass and an adequate antidiabetic and dislipidemia treatment. The aim of all therapeutic measures was to stop the progression of the disease, to prevent the progression of fibrosis and the development of of cirrhosis. .
Gastrointestinal stromal tumors: Microscopic and immunihistochemical features
Authors: Rancic Gorana , Katic Vuka , Jankovic-Velickovic Ljubinka , Rancic Milan
Published: December 2010

Background/Aim. Gastrointestinal (GI) stromal tumors (GIST) are the most common mesenchymal tumors of GI tract. The most frequent localization is gastric (60-70%) followed by intestinal localization (20-30%). The histogenesis, classification, diagnostic criteria and biological behavior of GIST are still discussable. Gastrointestinal stromal tumors are thought to originate from interstitial pacemaker intestinal cells of Cajal. Histologic appearance of a GIST is complicated and biologic potential unpredictable. The aim of of tha study was to investigate anatomic localization , the size of the tumor, incapsulation, microscopic and immunohistochemical characteristics. Methods. The study involved 21 GIST taken by a complete resection in the period from 1994-2006. The analysed parameters were the localization, size, microscopic (mitotic index, nectosis, bleeding, invasivity) and immunohistochemical characteristics (CD117 (ckit), CD34, desmin, vimentin, smooth muscle actin and s- 100 protein expression. Results. Gastrointestinal stromal tumors (n=21) size varied from 10-150 mm were most frequently gastric localised with predominance of malignant tumors (85.72%). Most GIST were comprised of a uniform spindle cell population, but some were dominated by epitheloid cells. Eosinophilic cells stained CD117, CD34 and vimentin positively, were usually arranged in fascicles with the presence of skeinoid fibers. Positive correlation of biologic potential and tumor size, haemorrhagia and mitotic index were found, so as negative correlation of biologic potential and incapsulation. Conclusion. The above results, a specially localization, tumor size, mitotic index, CD117, CD34 and vimentin positivity, may be helpful for setting of a widespread criteria for diagnostic and differential diagnosis of GIST and their use in practice and therapy. .
Clinical parameters of the local anesthetic effects of bupivacaine applied with and without a vasoconstrictor in oral implantology
Authors: Duka Milos , Lazic Zoran , Stamatovic Novak , Tatic Zoran , Bubalo Marija , Veljovic Milic
Published: December 2010

Background/Aim. Bupivacaine (Marcaine?), homologue of mepivacaine, chemically related to lidocaine, is used as a local anesthetic for local infiltration, peripheral nerve block, retrobulbar block, symphathetic block, and caudal and epidural anesthesia. The aim of this investigation was to determine and to compare clinical parameters of the local anesthetic effects of bupivacaine applied with and without a vasoconstrictor. Methods. This investigation included a total of 30 randomly selected patients, who ranged in age from 30?60 years, with partial or total anodontia in the molar region of the mandible. These patients with total or partial edentulous molar part of the mandible, scheduled for dental implantation placement, were asked to participate in the study. In the first phase of the investigation, the patients were subjected to local anesthesia with 3.5 cm3 of 0.5% bupivacaine with a vasoconstrictor (adrenalin, 1: 200 000) in the right side of the mandible. After administering local anesthesia, the placement of blade, cylindrical, transdental (B.C.T.) implants was performed. In the second stage of the investigation, in 7?10 days period after the first oral surgery, the patients were subjected to local anesthesia with 3.5 cm3 of 0.5% bupivacaine, but without a vasoconstrictor, in the left side of the mandible. After administering local anesthesia, the placement of B.C.T. implants was performed. During the performance of both oral surgery procedures, the following clinical parameters of the local anesthetic effects were monitored: latent period, duration and the potency of anesthesia, and the evaluation of the postoperative pain level. Results. The latent period under local anesthesia with 3.5 cm3 of 0.5% bupivacaine and vasoconstrictor was statistically significantly shorter than without vasoconstrictor. The duration of local anesthesia was longer without vasoconstrictor. There was no difference in the potency of anesthesia with or without a vasoconstrictor, while the lowest level of postoperative pain was found after administering bupivacaine without a vasoconstrictor use. Conclusion. The results of this investigation show that bupivacaine without a vasoconstrictor is efficient when used for local anesthesia in placing dental implants since it provides better blood circulation required for good dental implant osseointegration. .
Superficial urinary bladder tumors treatment results: A 10-year experience
Authors: Stankovic Jablan , Dinic Ljubomir , Pavlovic Svetlana
Published: December 2010

Background/Aim. The most common urinary bladder tumors are superficial tumors. Due to their tension to relapse and progress towards deeper layers after surgical therapy, an adequate therapy significantly contributed to the improvement of the results of urinary bladder tumors treatment. Staging and gradus of the tumor, presence of the carcinoma in situ (CIS) or relapses significantly influenced the choice of the therapy. The aim of this study was to ascertain the effectiveness of the intravesicelly applied BCG (Bacille Colmette - Guerin) vaccine or chemiotherapy in the prevention of the relapses and further progression of superficial urinary bladder tumors. Methods. All of the diagnosed superficial tumors of bladder were removed by transurethral resection (TUR). After receiving the patohistological finding they were subjected to adjuvant therapy, immune BCG vaccine or chemiotherapy (epirubicin, doxorubicin, mitomycin-C). The third group did not accept adjuvant therapy, but had regularly scheduled cystoscopic controls. The appearance of relapses, progression of stage and grades of the tumor, as well as possible unwanted effects of adjuvant therapy were registered. Results. The applied immunotherapy (BCG) influenced decreased tumor relapses (7%) and statistically important difference between patients who had taken adjuvant chemotherapy (relapses 18.4%) and those without this therapy was acknowledged. Grades of tumor did not show statistically significant difference on tumor relapse. A significantly longer period of time in the appearance of tumor relapse after BCG (29.33 months), had significant importance comparing to chemio (9.44 months) or non-taken adjuvant therapy (9.84 months). Very small number of unwanted effects suggested an obligatory undertaking adjuvant therapy after TUR of superficial tumors. Conclusion. A significant decrease of relapses as well as avoidance of further progression of urinary bladder tumors, has introduced adjuvant therapy in all of the protocols, while the dosing scheme is not unique yet due to trying to find the optimal dose, the length of application and possible dose maintenance. .
The safety of enoxaparine use in elderly with acute myocardial infarction
Authors: Despotovic Nebojsa , Loncar Goran , Nikolic-Despotovic Maja , Ilic Marjan , Dimkovic Sinisa
Published: December 2010

Background/Aim. Enoxaparin (ENOX), the lowmolecular- weight heparin, used in acute myocardial infarction (AMI) could lead to hemorrhage. The aim of this study was to determine whether bleeding was more often in AMI patients older than 65 or 75 years who receive ENOX or unfractionated heparin (UFH). Methods. Among the patients with AMI hospitalized during three successive months receiving ENOX or UFH, three group of parameters were investigated: demographic, ischemic and bleeding TIMI criteria. Results. Among 85 hospitalized patients with signs of AIM, there were 35 (41.2%) old 65 years or less, 32 (38.5) old 66-75 years and 18 (21.2%) older than 75 years. In AMI elderly patients, according to the received ENOX/UFH: ischemic complication (18.2 vs. 21.4%) were insignificantly lower and the number of lethal outcomes (18,2 vs. 17,8%) were insignificantly more often in ENOX group; represented only by one patient (age beyond 75 years), major and non-major bleeding events occurred only in UFH group. Conclusion. The ENOX usage in AMI in patients older than 65 years did not show any significant difference in efficacy and bleeding rate comparing to UFH.
Risk factors for nutritional status determination and indications for preventive nutrition therapy in hospitalized gastroenterological patients
Authors: Roganovic Branka , Peric Sasa , Tarabar Dino
Published: December 2010

Background/Aim. Risk factors for the intrahospital nutritional status worsening (NSW) have not been precisely defined in the literature. The objective was defining thoese factors among gastroenterological patients and defining the risk patients requiring a preventive nutritional therapy. Methods. In 650 gastroenterological patients, NSW was evaluated on the basis of reducing of the six parameters: body weight, body mass index (BMI), triceps skinfold thickness (TSF), midupper arm muscle circumference (MAMC), serum albumin level (ALB), and lymphocyte count (LYM). The influence on NSW was tested for 13 factors concerning characteristics of the patient, disease, and diagnostic procedures. Among the factors influencing significantly the NSW, primary and secondary risk factors were selected. After scoring of risk factors had been performed, the risk-score for NSW (RSNSW) was defined. The critical value of RSNSW which required preventive nutritional therapy was also calculated. Results. The incidence of NSW was in the range 29.2%?57.9%. The presence of general complications and severe disease activity were considered as primary risk factors, whereas malignant disease, age above 71, hepato-billiary tract involvement, hospitalization longer than 14 days, and mobility worsening were considered as secondary risk factors. The best predictive value for the NSW was proved for the RSNSW ? 6. Because of that, preventive nutritional therapy should be indicated in patients presenting with both primary risk factors or in patients presenting with one primary factor combined with three secondary risk factors at least. Conclusion. There are 7 risk factors for NSW in gastroenterological patients, but they are not of the same importance - two primary and five secondary risk factors can be differentiated. Preventive nutritional therapy is indicated only in patients having both primary risk factors or in those presenting with one primary risk factor combined with three secondary risk factors at least.
Effect of hypertonic-hyperoncotic solution infusion on tissue perfusion during surgical treatment of the abdominal aorta
Authors: Soskic Ljiljana , Davidovic Lazar , Milicic Biljana , Kocica Mladen , Kovacevic Natasa , Simic Tijana
Published: December 2010

Background/Aim. Decreasing of arterial flow below the critical level leads to capillary endothelium edema and to further worsening of tissue perfusion. Hypertonic solution infusion provides mild and short plasma osmolality increasing, while colloidal solutions intensify that effect. The aim of this study was to investigate the effect of hypertonic-hyperoncotic solution (HH) on the organs perfusion during reconstructive surgical procedure on the abdominal aorta (AA). Methods. The study included 40 patients submitted to AA reconstruction due to aneurysm or Leriche?s syndrome. A clamp was put transversally to the aorta, under the outlets of the renal arterias. According to the solution received when a clamp was on the aorta, the patients were divided into two groups containing 20 patients each: the tested group (A) which received 4 ml/kg of the solution (7.2% NaCl/10% dextran), and the control group (B) which received 0.9% NaCl. The study excluded the patients with the preoperative creatinine level more than 139 ?mol/l, and ejection heart fraction less than 40%. Results. The mixed venous blood oxygen saturation increased from 73.3?7.33 to 74.95?6.19% in the group A, while it decreased from 65.35?10.39 to 62.65?10.42% in the group B (p = 0.001). The quantity of the provided oxygen in the group A increased significantly from 684.44?244.34 to 1362.45?2351.01 ml/min, while it decreased from 668.2?382.12 to 651.7?313.98 ml/min in the group B (p = 0.016). Alveolo-arterial difference in oxygen decreased from 23.12?14.74 to 21.1?10 mmHg in the group A, while it increased from 23.79?15.22 to 26.33?13.78 mmHg in the group B (p = 0.05). Conclusion. Satisfactory perfusion of organs during the AA surgery is obtained by using both HH and an isotonic solution. Due to maintaining the optimal values of the minute heart volume, saturation of vein blood blended with oxygen, and alveoli- arterial difference in oxygen, it is recommended to use HH solution for reanimation of patients in declamping shock.
Total bilateral hip arthroplasty in one surgical procedure
Authors: Popovic Zoran , Rajovic Jovo , Radunovic Aleksandar
Published: December 2010

Background/Aim. Primary coxarthrosis occurs often in older population. There is possibility of implanting both endoprothesis simultaneously in bilateral coxarthrosis which decreases hospitalization and reduces the expenses and possibility of complication that can occur during general anesthesia. The most serious indications for bilateral total hip arthroplasty in one procedure are younger patients with serious bilateral osteoarthrosis of the hips, without added diseases. Absolute contraindication is found in patients with persistent ductus arteriosus and septal defect. The aim of this study was to point out the possibility and advantages of a single-staged bilateral hip arthroplasty and introducing it in our orthopedic practice. Methods. The procedure was accomplished in 19 patients. The standard total hip arthroplasty surgical technique was performed, followed by the usual antibiotic and anticoagulant therapy. Results. Only one complication - acetabular part instability we recorded, followed by luxation that was surgically managed. Conclusion. This procedure can be performed routinely in selected population and should be reserved for major medical centers capable to provide adequate postoperative care.
Electromagnetic field and osteogenesis
Authors: Zecevic-Lukovic Tanja , Milosevic Oliver , Ristic Branko
Published: December 2010

 Poslednjih 50 godina postignuti su odlicni rezultati primenom elektrobioloske stimulacije osteogeneze. Precizno objasnjenje mehanizma dejstva EMP jos uvek nije dato, sto je jedan od razloga razlicitih pristupa i rezultata lecenja prema iskustvima klinicara i eksperimentnih studija. Uzimajuci u obzir studije sa dobrim bioloskim protokolom, preciznom dozimetrijom i definisanim eksperimentnim uslovima, stimulacija osteogeneze EMP ostace aktuelna i u buducnosti.