bluuebunny/crossref_metadata_2025 huggingface dataset:
Autologous Osteochondral Mosaicplasty for Osteochondritis Dissecans of the Elbow in Teenage Athletes
Authors: Iwasaki Norimasa , Kato Hiroyuki , Ishikawa Jyunichi , Masuko Tatsuya , Funakoshi Tadanao , Minami Akio
Published: September 2010

BACKGROUND:

Although autologous osteochondral mosaicplasty is widely used as a procedure for osteochondritis dissecans lesions, the effectiveness of this procedure in elbow lesions remains unclear. Our aim was to clarify the surgical efficacy of mosaicplasty for teenage athletes with advanced lesions of capitellar osteochondritis dissecans.

METHODS:

From 2001 to 2006, nineteen teenage male patients who were competitive athletes and had advanced lesions of capitellar osteochondritis dissecans underwent mosaicplasties. The mean age of the patients was 14.2 years. The surgical technique involved obtaining small-sized cylindrical osteochondral grafts with a mean diameter of 3.5 mm from the lateral periphery of the femoral condyle at the level of the patellofemoral joint and transplanting the grafts (mean, 3.3 grafts) to prepared osteochondral defects. The patients were evaluated clinically and radiographically at a mean of forty-five months after surgery.

RESULTS:

Eighteen patients were free from elbow pain, and one had mild pain occasionally. The mean total arc of elbow motion and standard deviation increased significantly from 112° ± 17° preoperatively to 128° ± 12° postoperatively (p < 0.005). The mean clinical score described by Timmerman and Andrews (with a maximum of 200 points) improved significantly from 131 ± 23 points preoperatively to 191 ± 15 points postoperatively (p < 0.0001). All patients except one had an excellent or good clinical result. All donor knees were graded as excellent on the basis of the Lysholm knee scoring system. All patients except two returned to a competitive level of the sport they had previously played. Neither loose-body formation nor secondary osteoarthritic changes were found in any patient.

CONCLUSIONS:

The current midterm results indicate that mosaicplasty can provide satisfactory clinical outcomes for teenage athletes with advanced capitellar osteochondritis dissecans lesions.

LEVEL OF EVIDENCE:

Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

ORIGINAL ABSTRACT CITATION:

“Autologous Osteochondral Mosaicplasty for Osteochondritis Dissecans of the Elbow in Teenage Athletes” (2009;91:2359-66).
Long-Term Outcome After Surgical Treatment of Unresolved Osgood-Schlatter Disease in Young Men
Authors: Pihlajamäki Harri K. , Visuri Tuomo I.
Published: September 2010

BACKGROUND:

Surgical treatment of Osgood-Schlatter disease is occasionally warranted, but its long-term prognosis remains poorly investigated. We studied the rate of occurrence of surgical treatment of unresolved Osgood-Schlatter disease as well as the clinical course, radiographic characteristics, and long-term outcomes after that treatment in a large population of military recruits.

METHODS:

During a thirteen-year period, 178 consecutive recruits underwent surgery for unresolved Osgood-Schlatter disease, and 107 of them (117 knees) who met the inclusion criteria participated in a follow-up examination. We obtained data from the original medical records and radiographs as well as follow-up information from physical and radiographic examinations, interviews, and questionnaires to determine functional outcomes.

RESULTS:

The rate of occurrence of surgically treated unresolved Osgood-Schlatter disease was forty-two per 100,000 military recruits. The median age at the onset of symptoms was fifteen years. After a median duration of follow-up of ten years after the surgery, ninety-three patients (87%) reported no restrictions in everyday activities or at work and eighty (75%) had returned to their preoperative level of sports activity. The median modified Kujala score was 95 points, and the median visual analog score for pain was 7 mm. Forty-one patients (38%) reported a complete absence of pain when kneeling. Six patients had experienced minor postoperative complications, and two had undergone a reoperation for the treatment of the Osgood-Schlatter disease. After resection, the mean tibial tuberosity thickness decreased by 47%. The mean Insall-Salvati index was 1.0 preoperatively and 1.09 postoperatively (p = 0.003), and the corresponding mean Blackburne-Peel indexes were 0.85 and 0.95 (p = 0.003). With the numbers studied, the symptom duration, surgical methods, and radiographic indexes were not found to have an effect on the outcome of surgery.

CONCLUSIONS:

In the great majority of young adults, the functional outcome of surgical treatment of unresolved Osgood-Schlatter disease is excellent or good, the residual pain intensity is low, and postoperative complications or subsequent reoperations are rare.

LEVEL OF EVIDENCE:

Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

ORIGINAL ABSTRACT CITATION:

“Long-Term Outcome After Surgical Treatment of Unresolved Osgood-Schlatter Disease in Young Men” (2009;91:2350-8).
Net Neutrality Is Bad Broadband Regulation
Authors: Litan Robert , Singer Hal J
Published: September 2010

With America desperate for jobs, now is the worst time for the Federal Communications Commission to be imposing net-neutrality and potentially scaring away billions of dollars in telecommunications investment, according to Robert Litan of the Kauffman Foundation and Brookings Institution and Hal Singer of Navigant Economics.
Incidencija infekcija operativnog mesta posle operacija na otvorenom srcu
Authors: Markovic-Denic Lj. , Mihajlovic B. , Cemerlic-Adjic N. , Nicin S. , Pavlovic K. , Golubovic M.
Published: September 2010

Introduction: Despite modern surgical techniques, preoperative preventive use of antibiotics and optimal treatment of operative site, surgical site infections (SSI) are significant medical problem in the countries worldwide. Objective: The aim of this paper was to estimate the frequency of SSI after open heart surgery and to identify the most frequent causes of these infections. Material and methods: A prospective cohort study was performed during the period from January 2008 to December 2009 at the Clinic of Cardiovascular Surgery of the Institute of Cardiovascular Diseases, Vojvodina. The surveillance was consistent throughout the study period. During hospitalization, patients were evaluated daily by the infection control nurse. Isolation, identification and sensitivity tests of causative agents to antimicrobial drugs, obtained from patients' material, were carried out by standard microbiological methods. The descriptive epidemiological method was used. The incidence rates of hospital infections were calculated. Results: During the study period, among 23 patients, 24 SSIs were registered. The average incidence rate of patients with SSI was 0.98% and SSI rate was 1.02% (ranged from 0% to 3.7%). There was no difference in the incidence rates according to gender (p=0.65).The mean age of patients with SSI was 64.7 years. Except one, all patients had the ASA score higher than 2. The patients with SSIs were hospitalized approximately 3.8 times longer than the patient without SSI (p=0.03). The most common causes of SSI were: Staphylococcus aureus (30%), coagulasa-negative Staphylococcus spp, Acinetobacter spp (8%), Enterococcus spp and Klebsiella pneumoniae. Conclusion: Although the incidence rate of hospital infections is low, it is necessary to maintain continuous surveillance of surgical site infections and to implement the preventive measures.
Prolene Hernia System, Ultrapro Hernia System and 3D patch devices in the treatment of inguinal, femoral, umbilical and small incisional hernias in outpatient surgery
Authors: Dabic D. , Cerovic S. , Azanjac B. , Maric B. , Kostic I.
Published: September 2010

Introduction: The employment of a diversity of prosthetic materials and several types of mesh different in construction is opening a new chapter in hernia surgery and tension-free techniques are becoming a 'golden standard' for repairing abdominal wall defects, whereas the conventional methods, i.e. the tension techniques are performed on young patients having small direct, indirect, or femoral hernias. Aim: The aim of this retrospective study is to present the results of using Prolene Hernia System (PHS), Ultrapro Hernia System (UHS) and 3D Patch (3DP) devices in the treatment of inguinal, femoral, umbilical and small incisional hernias in outpatient surgery. Material and methods: From January 2006 to January 2009, 70 patients were operated on for abdominal wall hernias (54 inguinal, 4 femoral, 8 umbilical and 4 small incisional hernias) using PHS, UHS and 3DP devices. All the patients underwent surgery under local infiltrative anaesthesia. All the surgical operations were performed by a single surgeon, 19 of them in the General Hospital and 51 in a private polyclinic. Results: The mean size of the hernia defect in the inguinal, femoral and umbilical hernias was 2.5cm (1- 4cm), while in the incisional hernias it was 4.5cm (3- 6cm). The mean operating time was 2.4hrs (2-6hrs). There were no requirement for urinary drains. The mean follow-up was 18 months (0-36 months). The incidence of infection, chronic pain and recurrence was 0%. Three of the patients had complications: seroma in one patient with an incisional hernia and hematoma in two patients after inguinal hernia repair. Conclusion: The employment of PHS, UHS and 3DP devices, which have not yet been widely accepted in our hospitals, has had outstanding results in outpatient surgery. In addition, the type of anaesthesia and the 3D mesh construction prepare the way for a short hospital stay, smooth recovery and a swift return to normal activity.
The presentation and management of presacral tumors
Authors: Mazreku A. , Karaj A. , Avdia I. , Bilali S.
Published: September 2010

Objectives: Retrorectal masses are uncommon lesions. They remain a difficult diagnostic and therapeutic challenge despite the use of newer imaging modalities and improvement in preoperative care. Although useful for planning a resection, neither CT nor MRI can provide a definitive diagnosis. The objective was to remove the entire lesion as revealed by the radiological study to avoid any recurrence of disease and malignant degeneration, but with the least amount of consequential impairment. Methods: We present our experience with 9 (nine) presacral tumors during 10 year period 1998-2007. The files and charts of adults' patients who underwent treatment for presacral tumors were collected and retrospectively reviewed.Results: From January 1998 to December 2007, a total of 9 adult patients were evaluated for primary tumors originating in retrorectal space in Surgical Clinic of Oncology near University Hospital Center 'Mother Teresa'. Four patients were males and five were females. The diagnosis of these retrorectal tumors were, developmental tail gut cyst, teratoma, chordoma and chondrosarcoma. In six patients were achived good results during surgical treatment. Coccygeal resection in one case. In three cases we couldn't perform sarectomy. Conclusion: In conclusion, presacral tumors are uncommon. They can be congenital or acquired, benign or malignant, which forms the basis for a simple classification. Their treatment is always surgical. The good results were obtained in the benign lesions.
Stricture recanalisation of the distal urether with various endoprothesis
Authors: Mladenovic A. , Davidovic K. , Markovic B. , Anojcic P. , Stojadinovic M. , Maksimovic H.
Published: September 2010

Introduction: Application of the metallic stents in the interventional uroradioligy is the result of continuous development of the new generation methods percutaneous nephrostomy (PCN), ballon catheter dilatation (BCD), methal and covered stent application. Application of metal stents in the renal canal system was attempted in order to eliminate BCD and PCN - related limitations as well as poor therapeutic results of these methods in a number of etiopathogenic groups of urinary stasis. Years - long application of interventional uroradiology methods, until the development of metallic stengts had shown the following therapeutics facts: PCN is incapable to resolve the cause of urinary obstruction. Permanent good therapeutic BCD results mostly depend on pathohistological aspect of the stricture, metallic stents are most frequently the last choice in therapeutics approch to urinary tract obstructions and their application is directly dependent on previous therapeutics results accomplished by PCN and BCD. In therapeutical sequences new generation of covered stents have important place as method of selection in patients of irreversible uroopstruction of distal ureter. Objective: The main goal of this study was to analyze therapeutics results, advanteges and shortages of insercion plastics and opened metallic endoprothesis, and to analyze results of covered methal applications on the contrary of using older interventional uroradiology methods. Method: Sixthytwo patients with distal urether strictures threated in the Deparment of interventional uroradiology Institute of Radiology Clinical centre of Serbia in Belgrade, participated in the study. Results were analyzed with Person's 2- test, Fisher test and Student T-test. Results: In our study we had highly significant differences in comparison with number of patients and type of stents during the time after recanalization was reached. Also it was highly significant differences according the type of used interventional uroradiology method that treated proliferation and the success of recanalization. Conclusion: Application of covered temporary uretheral stents have number advantages against using generation older permanent methal endoprothesis.
Penetrate injuries of colon: Our experience
Authors: Lazovic R. , Krivokapic Z. , Dobricanin V.
Published: September 2010

In attempt to determine the place of primary repair in management of colon injuries, an open, non randomized clinical study was performed. Retrospective (RS) group of 62 patients according to exclusion criteria by Stone (S/F) and Flint (Fl) was managed by one or two stage surgical procedure. Prospective (PR) group of 34 patients was managed using one stage repair non-selectively: two stage procedures were performed in 3 cases of advanced peritonitis and multi-segmental lacerations with impaired circulation of colon. In RS group 36 patients were managed by primary repair and in PR group, 31 were managed by primary repair. Both groups were of similar age/sex. Indexes of trauma severity were similar (TS, ISS, PATI). The latent time was shorter in PR group. Associated injuries to other body regions and abdominal organs were similar in both groups. S/F criteria and Flint grading in both (RS vs. PR) groups were similar. Comparison of attempted and successful primary repairs justifies the more liberal use of primary repair in early management of colon injuries.
Anesteziolosko zbrinjavanje dece sa neurotraumom
Authors: Simic D. , Bumbasirevic V. , Milojevic I. , Markovic M. , Milenovic M. , Jovanovic B. , Budic I.
Published: September 2010

Neurotrauma is a leading cause of childhood mortality. Physicians are in a continuous search for means to decrease mortality and morbidity caused by head injury. Treatment of these patients requires familiarity with both cerebral pathophysiology and actions of anesthetic agents on brain. Early treatment of hypotension and hypoventilation would cut mortality rate by at least one third. Prevention of increased intracranial pressure is the best treatment for head injury. Anesthetist, neurosurgeon and radiologist should all be members of a team which can secure timely diagnosis and treatment of an injured child. Paying attention to every detail is of huge significance. Treatment of the child in a pediatric trauma center or an accident and emergencies center for adults with both personnel and equipment capable for handling pediatric patients offers greater probability of survival.
Cystic mesenchimal hamartoma of the liver in two years old patient: Case report
Authors: Sretenovic A.Lj. , Krstic Z.D. , Vujovic D.R. , Pavicevic P.K. , Janic N.D.
Published: September 2010

Mesenchymal hamartoma is an uncommon benign hepatic tumor arising from the mesenchyme of the portal triad. This lesion is relatively uncommon, representing 5% of all primary hepatic pediatric tumors. This form of hamartoma usually presents before the age of 2 years, typically with abdominal swelling as theinitial symptom. The classic management of these lesions has been excision either by hepatic lobectomy or wedge resection. We present a case of 2 years old girl with a right hepatic lobe tumor, 66 x 57 x 71 in diameter that was completely removed by right hepatic lobectomy.
Population genetics of Drosophila ananassae: Chromosomal association studies in Indian populations
Authors: Singh Pranveer , Singh B.N.
Published: September 2010

Forty-five natural populations of Drosophila ananassae and laboratory stocks made from these flies were analyzed for chromosome inversions. Quantitative data on the frequencies of these inversions were utilized to test intra- and interchromosomal interactions in D. ananassae. In most of the natural as well as laboratory populations no significant deviation from randomness of intra- and interchromosomal associations (2L-3L, 2L-3R, 3L-3R) was found hence, providing evidence for random associations. However, in some instances, significant deviation from randomness was found in both natural and laboratory populations, which could be due to excess of certain combinations, deficiency of others and complete absence of some combinations. Possible role of genetic drift could be implicated due to tight-linkage between linked gene arrangements. This strengthens the previous suggestion that there is lack of genetic coadaptation in D. ananassae.
Distribution of paraoxonase 1 coding region polymorphisms in Serbian population
Authors: Pejin-Grubisa I. , Buzadzic I. , Jankovic-Orescanin B. , Barjaktarovic-Vucinic N.
Published: September 2010

Serum paraoxonase 1 (PON1) in humans is a protein component of high-density lipoprotein (HDL) particles that protects against oxidative damage, detoxifies toxic metabolites of organophosphorus pesticides and nerve agents and activates or inactivates specific drugs. It has been reported that PON1 gene coding region polymorphisms, L55M and Q192R, could influence both expression level and catalytic activity of PON1, and their link with a broad spectrum of diseases has been described. The aim of this study was to determine the frequencies of PON1 coding region polymorphisms Q192R and L55M in Serbian population. The most frequent alleles were Q (0.77) for Q192R and L (0.68) for L55M. Genotypes QQ (0.60) and LL (0.47) and combined genotype QQ/LL (0.26) were the most frequent in examined population.
Multivariate analysis for head weight and yield performance of experimental cabbage hybrids (Brassica oleracea var. capitata L.)
Authors: Cervenski Janko , Gvozdanovic-Varga Jelica , Vasic Mirjana , Glogovac Svetlana
Published: September 2010

This paper reviews characters of 18 cabbage genotypes (9 experimental hybrids vs 4 cultivars and 5 hybrids from the domestic commercial production). The experimental genotypes differed in head weight, growing season and yield performance. The analysis of variability of the characters was performed by the PCA method. The two characters selected by the scree test accounted for 57.7% of the variability. Based on head weight and yield performance, the tested hybrids were classified into two clusters that differed quantitatively.
Genetic base of durable resistance to Puccinia triticina of two Serbian varieties
Authors: Prijic Zeljana , Jerkovic Zoran
Published: September 2010

The durable resistant varieties were developed more than 15 years ago. The basis of the resistance was investigated at seedling stage according to reaction type (RT) at air temperatures 20-25?C. The F2 generations of varieties Anastasia or Selekta x Lr 1, Lr 2a, Lr 3, Lr 13, Lr 14a, Lr 16 or Lr 26 were tested with isolates producing low RT on first two mentioned Lr lines. The presence of these single resistant genes in the varieties was excluded by presence of susceptible plants in F2 progenies of adequate crosses. The resistant combinations were Lr 3+B as Lr3+C in Selekta and Lr26+E, Lr26+C as EC in Anastasia. According to lower infection efficiency and yellowing of the above tip top part the C was similar or Lr 34. The Lr 13 and 14a were near the same effective at seedlings when were added to proposed combinations in parents. According to F1 results in field the most effective over season combination was achieved by crossing the investigated varieties because of two LP prolong able complementary genes and accumulation of three infection severity responsible ones.
Visual assessment of sweet maize lines phenotype, according to UPOV descriptor, as indicator of heterosis
Authors: Babic Vojka , Pajic Zorica , Prodanovic Slaven , Babic Milosav , Filipovic Milomir
Published: September 2010

The organisation of germplasm into genetically divergent groups is of extreme importance for the development of hybrid varieties in which the identification and exploitation of heterosis is very important for the final result of breeding. It can also be beneficial for breeding of self-pollination varieties, clones and synthetics. The discovery of heterotic groups in standard grain quality maize significantly improved the process of testing. The improvement in sweet maize was relatively modest in comparison to standard grain quality maize due to a relatively narrow genetic base of sweet maize, then poorly defined heterotic relations, scarce sources of germplasm that satisfy commercial standards, poor seed vigour, low quality of root and stalk, as well as, a short period of time for the estimation of yield and quality. The efficiency of hybrid breeding programmes would be significantly higher if heterosis could be predicted prior to the evaluation in the field. The application of the multivariate analysis method to data of phenotypic characterization according to the UPOV Descriptor was an attempt to establish whether such a procedure can be beneficial for the determination of related groups and whether the phenotypic distance, obtained on the basis of a visual estimation of a plant group, can be an indicator of heterosis. Obtained results indicate that clustering is highly analogous to the pedigree. Since sweet maize breeders have at their disposal less significant genetic variability and search for the development and defining of heterotic groups, as such a procedure can be useful in both, the process of the hybrids development and the process of new inbreed development and genetic variability increasing. Certainly, further systematic studies aimed at this direction are necessary to reliably ascertain that the phenotypic distance is a justifiable indicator of heterosis.
Effect of 'Gutingen V' as an intensive training system on agromorphological characters of some apple cultivars in Karaj region of Iran
Authors: Dadashpour Ahmad , Talaei Alireza , Shahi-Gharahlar Ali
Published: September 2010

V-shape systems represent an efficient and popular option to increase yields and fruit quality in fruit trees. Hence, this paper attempts to compare some vegetative and yield characteristics of five apple cultivars grown at horticultural research station in Karaj, Iran. The selected apple cultivars were included: 'Golab-kohans' (Iranian cultivar), 'Fuji', 'Gala', 'Starking' and 'Delbar estival' (commercial foreign cultivars) that were grafted on M.9 rootstock which were trained in a V system. All of these trees were planted in winter 2005. The time of irrigation started from the second experimental year after planting and the method of irrigation was drip irrigation system. Results showed that the 'Golab-kohans' had the most tree height (278.63 cm), trunk cross sectional area (7.308 cm2) and mean shoot length (100.58 cm). Also 'Delbar estival' had the most yield (0.98 kg), yield efficiency (0.550 kg/cm2). Consistently, Results revealed that among the investigated cultivars, 'Delbar estival' can be introduced as a prone and productive cultivar for V system in Karaj's climatic conditions.
Application of molecular markers in apple breeding
Authors: Maric Sladjana , Lukic Milan , Cerovic Radosav , Mitrovic Milisav , Boskovic Radovan
Published: September 2010

Apple is economically the most important species of genus Malus Miller. In respect of production, trade and consumption, it ranks first among deciduous fruit and third on a global scale among all fruit species. Apple breeding is carried out on a large scale in several scientific institutes throughout the world. Due to this activity, apple is a fruit species with the highest number of described monogenic traits; 76 genes, encoding morphological traits, pest and disease resistance, as well as 69 genes encoding enzymes. The development of molecular markers (RFLPs, AFLPs, SCARs and SSRs) has allowed the mapping of the apple genome and the development of several saturated genetic maps, to which genes controlling important traits are assigned. Markers flanking these genes not only play an important role in selecting parental combinations and seedlings with positive traits, but they are also particularly important in detecting recessive traits, such as seedless fruit. In addition they enable pre-selection for polygenic quantitative traits. In recent years, particular attention has been paid to biochemical and physiological processes involved in the pathway of important traits e.g., ripening and the storage capability of apple fruit.
Function of the left ventricular myocardium in patients with systemic sclerosis
Authors: Deljanin-Ilic Marina , Ilic Stevan , Stamenkovic Bojana
Published: September 2010

Deposits of myocardial fibrosis are the principal cause of myocardial dysfunction and poor prognosis in the patients with systemic sclerosis. Our aim was to assess whether there are changes in regional function of the left ventricular myocardium in female patients with systemic sclerosis without clinical signs and symptoms of cardiovascular disease. The study included 23 female patients with systemic sclerosis (without cardiovascular disease and with normal global systolic and diastolic function of the left ventricle) and 21 healthy female controls. In both groups, pulsed wave tissue Doppler imaging was done at rest and during exercise stress test echocardiography. The myocardial function was assessed from the basal segments in systola and diastola. The level achieved and duration of exercise tests were significantly reduced in the patients with systemic sclerosis compared to the controls (P<0.001 for both). The patients had significantly lower baseline regional systolic (P<0.02) and diastolic (P<0.001) myocardial functions, which became even more evident after the exercise test. During the test, those with systemic sclerosis demonstrated a smaller increase of systolic (20.6%) and diastolic (6.5%) function compared to the controls (systolic by 32.3% and diastolic by 25.0%). Quantification of regional function of the left ventricular myocardium using pulsed wave tissue Doppler imaging demonstrated an impaired systolic and diastolic myocardial function in the female patients with systemic sclerosis who had no clinical signs and symptoms of a cardiovascular disease.
The impact of inhaled corticosteroids on cough and bronchial hyperreactivity in cough variant asthma
Authors: Stankovic Ivana , Pejcic Tatjana , Rancic Milan , Milenkovic Branislava
Published: September 2010

Introduction Classic asthma is characterized by cough, wheezing and dyspnea. Cough, however, may be the sole presenting symptom of asthma and this type of asthma is known as cough-variant asthma. The therapeutic approach to cough variant asthma is similar to that of the typical form of asthma. A diagnosis of cough-variant asthma is made when a chronic cough is associated with airway hyperresponsiveness and a favorable response to asthma therapy in the absence of other discernible cause. The aims of this study were to analyze the influence of inhaled corticosteroids on cough and bronchial hyperresponsiveness. Material and methods The study included 55 patients with cough as the sole presenting symptom. 40 patients (Group A) were treated with inhaled corticosteroids and beta2 agonists for eight weeks while 15 patients (Group B) were treated only with oral beta2 agonists. The non-specific bronchoprovocative test with histamine was performed on all the patients before the treatment and after the examination and there was established the provocative dose of histamine causing the 20% fall in FEV1 (PD20). Results At the end of the study in Group A we found a statistically significant decrease of PD20 0.98?0.86 vs 1.58?1.06 (p<0.005), while in Group B there were no significant changes. In 90% of the patients treated with inhaled corticosteroids the cough was completely relieved while in 80% of the patients treated with only beta2 agonists the cough has remained unchanged. Conclusion Inhaled corticosteroids are choice drugs for the treatment of cough-variant asthma because they relieve cough and decrease bronchial hyperresponsiveness, thus ultimately reducing the risk of classic asthma.
Early axtubation in cardiac surgery
Authors: Neskovic Vojislava , Milojevic Predrag , Unic Dragana , Ilic Ivan , Popovic Nada
Published: September 2010

Introduction An early extubation in cardiac surgery (fast track cardiac anesthesia) refers to mechanical ventilation during 1-6 hours after the intervention, the extubation criteria being the same as for any other surgery. Different protocols have been established for managing patients undergoing fast track anesthesia, with high-thoracic epidural anesthesia being increasingly used in the last few years. Material and methods Thirty-five consecutive patients scheduled for OPCAB surgery, who were planned for very fast track cardiac anesthesia (planned extubation within one hour after the end of the operation), were included in the study. Combined high-thoracic epidural and general anesthesia was performed in all patients, with bupivacain as a local anesthetic and inhalational or intravenous anesthetic used for general anesthesia. Results Thirty three of 35 patients (94.3%) were extubated early, with the mean duration of the mechanical ventilation of 56?92 minutes. Very fast track cardiac anesthesia was performed successfully in 24/35 (68,8%) patients; these patients had higher ejection fraction, lower Euroscore, shorter duration of the surgery, and fewer numbers of grafts, as compared to the patients extubated early. Euroscore was the only independent predictor of the early extubation (higher score - longer mechanical ventilation time). Discussion and conclusion Our results suggest that high-toracic epidural anesthesia enables successful early tracheal extubation in the population of patients scheduled for OPCAB cardiac surgery. We had no complications related to this type of anesthesia and very good perioperative results.
Clinical relevance of KIRs in hematopoietic stem cell transplantation
Authors: Vojvodic Svetlana , Popovic Stevan
Published: September 2010

Introduction Natural Killer cells (NK cells) represent the subset of peripheral lymphocytes that play critical role in the innate immune response to virus-infected and tumor transformed cells. Lysis of NK sensitived target cells could be mediated independently of antigen stimulation, and unlike cytotoxic T-lymphocytes, they do not require peptide presentation by the major histocompatibility complex (MHC) molecules. NK cell cytotoxic activity is controlled by considerable number of cell surface Killer cell Immunoglobulin like Receptors (KIRs), which can exist in both inhibitory and activating isoforms. The inhibitory KIRs are mostly specific for HLA class I ligands and I HLA class like molecules, while the specificity of activating receptors is regarded to lectine-like superfamily. The role of NK cells in allogeneic haematopoietic stem cell transplantation (HSCT): NK cells are the first lymphocyte subset that reconstitute the peripheral blood following allogeneic HSCT. By selecting donors mismatched for relevant HLA ligands in the context of recipients KIR genotype, multiple roles for alloreactive donor NK cells have been demonstrated, in diminishing Graft vs. Host Disease (GvHD) through selective killing of recipient dendritic cells, prevention of graft rejection by killing recipient T cells and participation in Graft vs. Leukaemia (GvL) effect through destruction of residual host tumor cells. Conclusion Investigation of KIRs heterogenity play an important role in the field of HSCT, because it is useful for the early diagnosis of post transplant complications and can serve as a predictive risk factor for GvHD development.
Vein thromboembolism prevention in stroke patients
Authors: Savic Dejan , Savic Ljiljana
Published: September 2010

Introduction Having in mind the rate of occurrence and clinical importance, venous thromboembolism implies venous thrombosis and pulmonary embolism as a result of embolisation of the thrombotic particles from deep veins or pelvic veins. Venous thrombosis of the deep veins may result in chronic vein insufficiency, but the primary medical problem is the possibility of development of pulmonary embolism which may cause permanent respiratory function damage or even fatal outcome. Venous thromboembolism prevention in stroke The high incidence of deep vein thrombosis (30% clinically and up to 50% subclinically) in acute stroke hemiparetic and bed ridden patients within two weeks from the onset and 1-2% pulmonary embolism with the fatal outcome in the first month clinically and 17% of all fatal outcomes in postmortem investigations present a necessity for the early venous thromboembolism prevention. On the other hand, the most powerful prevention strategy - anticoagulation has important limitations in acute stroke patients: almost impossible to be used in cerebral haemorrhage and a great risk for the development of hemorrhagic transformation in cerebral infarction. The fact that other prevention strategies have limited value requires an estimation of efectivity-risk ratio in venous thromboembolism prevention in stroke. Conclusion Venous thromboembolism prevention in stroke patients is necessary because of a greater risk for venous thromboembolism in these patients according to the nature of illness and functional disability, but also a problem because of limited possibility to recommend the proper medicament according to the risk of serious complications. The necessity of preventing venous thromboembolism and estimation of efficiency-risk ratio in stroke patients, beside plenty of studies and consensus conferences, remain individual and often very difficult.
Possibilities of the primary and secondary prophylaxis in treatment of childhood asthma
Authors: Petrovic Slobodanka , Tomic Jelena , Ljustina-Pribic Radmila
Published: September 2010

Introduction The natural course of asthma is unpredictable and appears to be unaffected by any therapeutic strategy. Under such circumstances, the attention must be focused on the opportunities for prevention of a disease which is chronic, life long and incurable, even thought it can be very effectively controlled. During the past decades, a lot of a studies have been performed and started, in which relatively large numbers of children were included and followed prospectively to determine the incidence of risk factors for asthma in childhood. All these studies have contributed significant new information. The levels of prevention must be considered in all patients. There are two main separate components to the strategy. Primary prophylaxis Primary prophylaxis (time course of allergic sensitization, timing of exposure to allergens, influence of tobacco smoke, maternal health and allergen exposure) is introduced before there is any evidence of sensitization to factors which might have caused the disease. There is increasing evidence that allergic sensitization is a very common precursor to the development of asthma. Secondary prophylaxis Secondary prophylaxis (allergen avoidance, hygiene hypothesis) is important after primary sensitization to allergen has occurred, but before there is any evidence of asthma. Conclusion In this article the authors reviewed all results of studies about primary and secondary prophylaxis of asthma and its influence on the course of disease.
Potential risk factors for developing diabetes mellitus type 2
Authors: Zivanovic Dusica , Sipetic Sandra , Stamenkovic-Radak Marina , Milasin Jelena
Published: September 2010

Introduction Type 2 diabetes mellitus is a common multifactorial genetic syndrome, which is determined by several genes and environmental factors. The aim of the present study was to investigate the presence of risk factors for developing diabetes type 2 among diabetic individuals and to compare the presence of risk factors among diabetic individuals with and without positive family history for type 2 diabetes. Material and methods This study was conducted in Cuprija during the period from February to June 2002. The case group included 137 individuals having diagnosis type 2 diabetes. The control group included 129 subjects having the following diagnoses: hypertension, angina pectoris, chronic obstructive lung disease, gastric ulcer or duodenal ulcer. All participants were interviewed at the Medical Center Cuprija using structural questionnaire. The data were collected regarding demographic characteristics, exposure to various chemical and physical agents, stress, smoking, obesity, physical inactivity and family history of diabetes. In the statistical analysis chi square test was used. Results The diabetic individuals were statistically significantly older (40 and more years old) (p=0,000), and they came from rural areas more frequently (p=0,006) than the individuals without diabetes. Significantly more diabetics had lower educational level (p=0,000) and they were agriculture workers and housewives significantly more frequently (p=0,000) than nondiabetic individuals. Furthermore, obesity (p=0,000) and physical inactivity (p=0,003) were significantly more frequent among the diabetic individuals than the nondiabetics. The diabetic individuals had significanly (p=0,000) more numbers of relatives with diabetes mellitus type 2 than the nondiabetics. The diabetic individuals with positive family history of diabetes were significantly older (p=0,021) and more frequently from urban areas (p=0,018) than the diabetic individuals without the positive family history of diabetes. Also they were significantly less exposed to physical agents (p=0,004). Discussion In our study, like in many others, age, place of residence, education, occupation, obesity, physical inactivity, positive family history of diabetes type 2 and exposure to physical agents were identified as potential risk factors for diabetes type 2. Conclusion Different risk factors are probably responsible for developing type 2 diabetes among individuals with and without positive family history of type 2 diabetes.
Application of ultrasound in diagnosing and follow-up of endocrine orbitopathy
Authors: Cekic Sonja , Stankovic-Babic Gordana
Published: September 2010

Endocrine orbitopathy or ophthalmopathy is an organ-specific, genetically conditioned autoimmune disease, resulting from a thyroid disorder. It is the most common cause of unilateral and bilateral proptosis in adults. Endocrine orbitopathy occurs most frequently in women aged 30 to 50 years. Ultrasound diagnostic is of primary importance in orbital pathology because of its safety, non-invasiveness, rapid application, and no need for preparation of the patient. The A scan in endocrine orbitopathy shows the echographical widening of the peripheral orbital space, a widening of the muscle echo, and the B scan shows a high internal echo of the connective tissue septa, increased reflection of the muscle belly, and distension of the retrobulbar optic nerve sheaths, enlargement of lacrimal gland and dilatation of the superior ophthalmic vein. All ultrasound features of the endocrine orbitopathy can be explained by immunological abnormalities and histological changes in orbital adipose tissue and extraocular muscles.
Agreeing in assessment of hyperactivity in children
Authors: Golubovic Spela , Tubic Tatjana
Published: September 2010

Introduction The study analyzes the accuracy and agreeability in evaluating hyperactivity in children. Material and methods The study sample was made of 139 children of pre-school age who participated in organized forms of physical activity. The mean age in the sample was 6.38, with a standard deviation of 1.00 years. Conner's Rating Scale was used to measure hyperactivity, and tests were also conducted to evaluate attention levels. Four independent reviewers observed each child's behavior by completing the scale. Results and discussion Eighteen children, or 13.5 percent of the sample, were identified as hyperactive in the analysis. These children also scored lower in the attention level tests. The results of the study show a correlation between the evaluators to be relatively high, bearing in mind the sources' independence. Conclusion It can be concluded that there is a mid to high-level correlation between certain reviewers' evaluations. However, even with a clearly defined view on categorizing certain behaviors as problematic, category labels still differ among evaluators.
Laryngeal mask airway as the only choice for primary airway control in newborn with tracheal stenosis
Authors: Draskovic Biljana , Uram-Benka Anna , Kljajic Vladimir
Published: September 2010

Congenital tracheal stenosis is a rare disorder characterized by the presence of focal or diffuse complete tracheal cartilage rings, resulting in a fixed tracheal narrowing. The prognosis for this disorder is currently assumed to be poor, with some sources stating that the natural outcome of this problem is inevitably fatal. tracheal stenosis requires a tracheostomy at delivery for the infant to survive before the definitive reconstruction. The laryngeal mask airway is the most commonly used airway device in pediatric anesthesia as well as the primary airway control during the resuscitation. We present a premature infant with congenital tracheal stenosis, in whom the airway could be controlled only by the laringeal mask. In this case the laryngeal mask airway was a life saving device for the airway control in the period before tracheostomy was done. Tracheostomy was made in first few hours after birth. In severe tracheal stenosis the laryngeal mask airway can be a device of choice for the initial control of the airway. .
Ten Ways to Restrict Children's Freedom to Play: The Problem of Surplus Safety
Authors: Wyver Shirley , Tranter Paul , Naughton Geraldine , Little Helen , Sandseter Ellen Beate Hansen , Bundy Anita
Published: September 2010

Play and playgrounds provide essential experiences for young children's growth, development and enjoyment of life. However, such play experiences are now limited for many children due to excessive fear of risk, or ‘surplus safety’. In this article, the authors examine the pervasiveness of surplus safety in the lives of young children. They argue that restrictions now imposed on children's play to promote safety may, paradoxically, expose children to more serious short and longer term threats of illness and limit children's life opportunities. By comparing experiences from Australia and Norway, the authors demonstrate that surplus safety is not a necessary outcome of living in a modern Western society.
Working with Young Children Who are Victims of Armed Conflict
Authors: Lloyd Eva , Penn Helen
Published: September 2010

Young children are particularly vulnerable to war and armed conflict. Although the long-term priority is always to try to unravel and reduce violence and conflict, in the short term some interventions may reduce suffering. In this article the authors report on recent evidence on psychosocial interventions designed to mitigate the impact of armed conflict on young children's development. A systematic review method was used to explore evaluations of interventions addressing the cognitive and psychosocial development of young children directly affected by armed conflict. In general the literature suggests therapeutic interventions drawing on the concept of post-traumatic stress disorder run the risk of imposing cultural norms from the global North. In contrast, more general psychosocial interventions and normalisation routines are likely to be more effective. But recent reviews also suggest that evaluation of interventions with children affected by armed conflict is weak. More robust evidence is badly needed.
Lessons in Safety: Cultural Politics and Safety Education in a Multiracial, Multiethnic Early Childhood Education Setting
Authors: Saltmarsh Sue
Published: September 2010

Young children learn about safety from a variety of sources, including formal lessons and informal activities provided through early childhood education and care (ECEC) services. For many ECEC centres in Australia, scheduled visits from police and fire departments are a highlight of safety education activities. Such visits offer children the opportunity to see and touch safety equipment, to meet police and fire department personnel, and to discuss and ask questions about safety issues. This article analyses ethnographic data generated in a multiracial, multiethnic ECEC setting in the outer western suburbs of Sydney, Australia in 2006. Part of a larger, ongoing study concerning childhood and popular culture, this article analyses the cultural politics of safety education visits from police and fire department personnel in one research site. Drawing on Foucauldian notions of power-knowledge, together with critical race theories, the article argues that children's knowledge of fire and police services is culturally situated, and impacts significantly on the effectiveness of such visits as a means of communicating lessons in personal safety. In particular, the article considers how the children's responses to safety lessons are shaped by gendered and racialised relations of biopolitical power and state-sanctioned violence that produce discursive norms between individuals, communities and state institutions.
Household Size and Water Availability as Demographic Predictors of Maternal and Child Mortality in Delta State: Implications for Health Education
Authors: Ogbe Joseph O.
Published: September 2010

The purpose of this study was to stimulate action to address and identify maternal, child and community needs towards the improvement in health of pregnant women, children and communities. Four null hypotheses were generated from the research questions while multiple regression analysis was used to analyse the data. The study found that household size and water availability were not predictive of maternal or child mortality in Delta State, Nigeria.