bluuebunny/crossref_metadata_2025 huggingface dataset:
Fosinopril and amlodipine in the treatment of isolated systolic hypertension
Authors: Pavlovic Katica , Benc Dragan , Kmezic-Grujin Jasna , Stojiljkovic Jadranka , Cemerlic-Adjic Nadica , Miljkovic Tatjana , Mesaros Piroska
Published: July 2006

The aim of this study was to assess the therapeutic effects of fosinopril (F) and amlodipine (A) on regulation and circadian rhythm of blood pressure, and to evaluate left ventricle mass index (LVMI) in patients over 60 years of age with isolated systolic hypertension, after three months of administration period. After one-week placebo run-in period, 60 patients were randomized into two groups, each including 30 patients, to receive either fosinopril or amlodipine for three months. Clinical, echocardiographic examinations and 24h ambulatory blood pressure measurements were performed at baseline, and after 3 months of therapy. The goal blood pressure was ? 140/90 mmHg. It was accomplished in more than two thirds of cases (F 76.6%, and A 79.9%), with lower drug doses needed in the group treated with F. In 13 patients goal values were not accomplished, therefore the therapy was prolonged for one additional month, with combination of two drugs. In 10 of these patients (76.9%), adequate regulation of blood pressure was achieved. Both fosinopril and amlodipine efficiently control blood pressure by once-a-day administration, both significantly influencing its circadian rhythm and resulting in regression of myocardial hyperthrophy. Adequate control of blood pressure and beneficial effects on circadian rhythm of blood pressure are achieved with lower doses of fosinopril.
Prescription-only drugs in Banja Luka region: Utilization analysis
Authors: Stojakovic Natasa , Skrbic Ranko , Stoisavljevic-Satara Svjetlana , Babic-Djuric Dragana , Nezic Lana , Sabo Ana
Published: July 2006

Introduction Using the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) methodology, we analyzed utilization of prescription-only drugs in Banja Luka region in 2000 - 2001. Material and methods A retrospective study on drug utilization, according to ATC classification, was conducted on the basis of data received from Central City Pharmacy Banja Luka, and results were presented in terms of DDD/1000 inhabitants/day. Results Pharmaco-epidemiological analysis showed that the list of 20 most frequently prescribed drugs in 2000 included 8 cardiovascular drugs and 6 anti-infective drugs. In 2001, 20 most frequently prescribed drugs, included 9 cardiovascular drugs, and 4 anti-infective drugs. Regarding anti-infective agents, the most frequently prescribed antibiotics were amoxicillin, doxycyline, co-trimoxazole and gentamicin. The most frequently prescribed drug in 2000 was diazepam (5,33 DDD/1000 inhabitants/day). The use of this drug significantly increased in 2001 (7,95 DDD/1000 inhabitants/day). Discussion and conclusion Based on total analysis, it can be concluded that the positive drug list, defined by the Health Insurance Fund, significantly affected the drug utilization profile, but some drugs are considered to be irrationally prescribed.
Effects of hyperthyroidism on bone mass in women of reproductive age
Authors: Ilic Jana , Kovacev Branka , Todorovic-Djilas Ljiljana
Published: July 2006

Introduction Hyperthyroidism is one of the most frequent endocrinopathies in women of reproductive age. Consequently, increased risk of osteoporosis may be expected. Material and methods The research has included a group of 30 hyperthyroid women and a control group of 30 healthy women of reproductive age. Age and some clinical characteristics were analyzed, as well as some anthropometric parameters. Bone mass parameters were determined by measuring bone mineral density using ultrasound devices (SAHARA-Hologic). Results Bone mass parameters in hyperthyroid women are significantly lower than in controls (BUA: 63.25?12.17; 69.73?10.02 dB/MHz respectively; SOS:1523.90? 24.47; 1540.19?26.59 m/s respec. QUI/STIFF 79.78?13.95; 89.09?13.99 % respec.) Duration of hyperthyroidism affects bone density and reduces it. Discussion Obtained results were expected, having in mind that hyper- thyroidism is a condition characterized by increased bone catabolic rate. Also, negative correlation between the duration of hyperthyroidism and bone mass parameters (BUA, SOS) was expected, because it is logical that consolidation of bone mass in adult life cannot be maintained in circumstances in which metabolic rate is increased. During hyperthyroidism, bone loss is expected. In order to confirm this, future studies of bone markers are necessary. Conclusion Based on results obtained in the study, the following conclusions were made: hyperthyroidism is accompanied by decreased values of bone mass parameters; this effect depends on duration of hyperthyroidism. We confirmed that hyperthyroidism may be the cause of decrease in bone mass, particularly if it lasts more than a year. To prevent osteoporosis in women of reproductive age with hyperthyroidism and involution osteoporosis later in life, early diagnosis and effective therapy of hyperthyroidism is imperative.
The role of cellular development and cell death in neurochemical organization and integrative brain functions: Normal and pathological
Authors: Sherstnev Vladimir
Published: July 2006

In terms of systemic aspects of common molecular mechanisms of development, important part of which is the process of cellular death and integrative activity of nervous system, a omplex clinical-experimental study of effects of various neurotrophic and apoptotic factors (proteins S100b, HLDF, brain lectins CSL and R1) on learning and memory and ishemic stroke was performed. Data concerning specific and heterochronic participation of these factors in neurochemical mechanisms of learning and memory in mechanisms of ishemic stroke formation were established. Changes of examined factors and their antibodies as well as the dynamics of changes in sera and cerebro spinal fluid can be considered as prognostic markers of ischemic stroke and efficiency of therapy.
Pregnancy as a psychological event
Authors: Bjelica Artur , Kapor-Stanulovic Petronila
Published: July 2006

Introduction Apart from physiological and somatic changes, pregnancy is a complex phenomenon which also includes psychological and social changes. Pregnancy, especially the first one, represents a powerful psychological event. This paper deals with pregnancy as a psychological event, considering psychological changes in the course of pregnancy as a stressful event. Psychological changes during pregnancy Pregnancy is always associated with changes in psychological functioning of pregnant women. It is usually associated with ambivalence, frequent mood changes, varying from anxiety, fatigue, exhaustion, sleepiness, depressive reactions to excitement. During pregnancy, changes include body appearance, affectivity and sexuality, whereas the position and role of women attains a new quality. Even thoughts of pregnancy can bring about numerous worries about its course and outcome, and especially of the delivery itself, which may be so intense that they acquire a features of phobia (which may be the reason for avoiding pregnancy). Pregnancy as a stressful event Pregnancy is identified as a potent stressor that can seriously affect the psychic status of pregnant women, perinatal outcome, but also psychic functioning of the new-born individual. Appropriate relationship of partners and support of the society play an important role in overcoming stress during pregnancy. Conclusion Pregnancy is an event that involves numerous somatic and psychological changes. However, pregnancy can also be a potent stressor. Existence of prenatal maternal stress may lead to different perinatal complications that may have long-term consequences on the newborn. In prevention of maternal stress emphasis has to be put on partner?s emotional support, as well as empathy of the social environment. However, in certain cases, professional psychotherapeutic support is necessary, in form of short supportive treatment. Preventive measures should include adequate psychological support during pregnancy, especially the first one, provided for all pregnant women, but also for those women that plan to get pregnant in the near future.
Predictors of mortality in dialysis patients: Association between malnutrition, inflammation and atherosclerosis (Mia syndrome)
Authors: Perunicic-Pekovic Gordana , Rasic-Milutinovic Zorica , Pljesa Steva
Published: July 2006

Introduction Numerous recent studies have shown increased comorbidity and mortality in dialysis patients with malnutrition. Protein-energy malnutrition with muscle wasting occurs in a large proportion of patients with chronic renal failure and is, in addition to atherosclerosis, a strong risk factor for mortality in patients undergoing dialysis. Malnutrition is also associated with increased cardiovascular mortality in dialysis patients. Pathogenic factors of malnutrition in dialysis patients Malnutrition is associated with a number of metabolic and vascular abnormalities. These factors include hypoalbuminemia, dyslipidemia with raised triglyceride concentrations, low-density lipoprotein and very low-density lipoprotein centrations, insulin resistance and high concentrations of acute-phase proteins. Low serum albumin concentration, usually used as an index of malnutrition, is highly associated with increased mortality risk in dialysis patients. However, serum albumin is affected by factors other than malnutrition and high concentrations of acute-phase proteins, such as C-reactive protein (CRP), which correlate with low serum albumin in malnourished patients on dialysis. Oxidative stress has emerged as an important cofactor for development of endothelial dysfunction as premature atherosclerosis. In this context, malnutrition, inflammation and markers of oxidative stress are associated with vascular diseases. Etiology of malnutrition in dialysis patients In recent studies several reports have suggested that inflammation, alone or in combination with low protein intake, plays a significant role in etiology of malnutrition in uremic patients. Lipid abnormalities may not only be a consequence of renal disease, but also contribute to its progression. Lipoprotein (a) is also associated with various atherosclerotic diseases. Therapy options New treatment strategies, such as high protein/energy vs. standard protein/energy nutritional regimens, are necessary as well as food intake and dietary supplements. Intensive supplementation of (1,5 g protein/kg/d and 45 kcal/kg/d) is necessary to improve nutritional status of dialysis patients. Conclusion Cellular basis of pathogenetic factors in malnutrition is unclear. It is, however, now recognized that oxidative stress and inflammatory cytokine aggravates the nutritional status of these patients.
Occupational stress and arterial hypertension
Authors: Jovanovic Jovica , Jovanovic Milan
Published: July 2006

Introduction Arterial hypertension is an important medical, social and economic problem in the working population. Factors of occupational exposure lead to a much faster and more frequent occurrence of this disease and its consequential complications. Among these factors the following take an important place: noise, carbon monoxide, job dissatisfaction, microclimate conditions, chemical agents, shift work, night work, monotonous work and so on. The purpose of this study was to analyze working conditions, working environment, work demands and identification of occupational Stressors and their influence on development of arterial hypertension. Material and methods This investigation included 3470 workers and it examined technological processes, working time, job satisfaction, interpersonal relations and physical and chemical hazards of their workplaces. The exposed group consisted of 2270 workers occupationally exposed to Stressors. Control group included 1200 workers whose workplaces were without Stressors. Workers of exposed group were divided into 14 subgroups in regard to presence of occupational hazards. Results Arterial hypertension was established in 39.9% of workers of exposed group, which is statistically significantly more than in controls (25.7%). The highest prevalence of arterial hypertension was at workers who were dissatisfied with the job and who were at the same time occupationally exposed to noise and carbon monoxide. Family predisposition and smoking have cumulative effects with occupational hazards. Discussion Possible mechanisms of arterial hypertension development include activation of adrenergic nervous system, renin-angiotensin aldosteron system, higher concentrations of steroids, catecholamines and free radicals caused by occupational hazards. Conclusion Occupational Stressors are significant factors in development of arterial hypertension of exposed workers. The most important Stressors are noise, carbon monoxide and job dissatisfaction.
Treatment of metastatic neck squamous cell carcinomas with unknown primary
Authors: Petrovic Zeljko , Jelic Svetislav
Published: July 2006

Introduction Treatment of metastatic neck squamous cell carcinomas of unknown primary is one of the most serious problems in head and neck oncology. Material and methods Fifty-one patients were analyzed during the period 1977-1997. All patients underwent clinical examination of head and neck, hematological and laboratory tests, X-ray of paranasal sinuses, esophagus and lungs, scintigraphy of the thyroid gland, epipharyngoscopy, esophagoscopy and laryngotracheobronchoscopy, biopsy of suspected changes and blind biopsy of suspected regions (epipharynx, tongue base, piriform sinus), ipsilateral tonsillectomy (17 patients), examination of gastrointestinal tract, kidneys, prostate, testicles, and breasts and ovaries, respecti- vely. Results Almost half of metastases developed in the II level of the neck (49.01%; 25/51). Most metastases were 3-6cm in diameter (N2) - 60.76% (31/51). Forty patients were surgically treated by various neck dissection methods and postoperative radiotherapy (60 Gy). Palliative radiotherapy was applied in patients with inoperable metastases. Eighteen patients had a five-year disease free survival (35.29%). Discussion Metastases localized in the II and III levels of the neck and in the upper two-thirds of the V level, should be primarily treated by neck dissection. Lymph nodes up to 3cm in diameter (N1) are operated by a modified radical neck dissection. Lymph nodes over 3cm (N2) and 6cm in diameter (N3) are operated by radical or extended radical neck dissection. Conclusion Primary surgery plus postoperative radiotherapy provide satisfactory results in therapy of metastatic squamous cell carcinomas of the neck with unknown primary.
Contact allergy to Compositae plants in patients with atopic dermatitis
Authors: Jovanovic Marina , Poljacki Mirjana , Djuran Verica , Vujanovic Ljuba , Sente Ruza , Stojanovic Slobodan
Published: July 2006

To investigate the frequency of Compositae sensitivity is one of the most important goals of current dermatology and allergology. We have patch tested 30 adult patients suffering from ?extrinsic? atopic dermatitis with sesquiterpene lactone mix and Compositae mix including Compositae mix individual ingredients, extracts of arnica (Arnica montana), chamomile (Chamomilla recutita), tansy (Tanacetum vulgare), feverfew (Tanacetum parthenium) and yarrow (Achillea millefolium) as well as with specific series for patients with atopic dermatitis. All allergens were purchased from Hermal-Trolab (Reinbek, Germany). There were 6 (20%) patients positive to Compositae mix only, and 3 (10%) patients positive to both Compositae mix and sesquiterpene lactone mix. Among 9 Compositae mix-sensitive patients 8 (88.8%) were positive to at least 1 of its individual ingredients: 5 (55.5%) to chamomile, 4 (44.4%) to arnica, 2 (22.2%) to tansy, and 2 (22.2%) to feverfew. Among Compositae-sensitive patients 78.8% had other contact allergies, most often to nickel (33.3%). Since our study represents the first report on contact allergy to Compositae among patients with "extrinsic" type of atopic dermatitis, it substantiates the statement that atopy represents a risk factor for Compositae allergy. In conclusion, the overall prevalence of 30% Compositae-sensitive among patients with ?extrinsic? atopic dermatitis detected in our study represents a basal sesquiterpene lactone mix detection rate of 10%, reinforced and safely supplemented by 20% by testing with the Compositae mix.
Biological motivations in the neurodynamic structure of psychopathological states: Experimental approach
Authors: Kotov Aleksandar
Published: July 2006

Some trigger mechanisms of pathological and biological motivations were investigated in experimental models of animal behavior (feeding, drinking, stereotypic acts, experimental alcoholism, and so on), as well as high level of brain-specific molecular synthesis responsible for development of pathological motivations. Neurophysiological processes transforming some biological drives to pathological motivations are described and discussed.
Insulin secretion: mechanisms of regulation
Authors: Radosavljevic Tatjana , Todorovic Vera , Sikic Branka
Published: July 2006

Regulation of insulin secretion Beta cells are unique endocrine cells. They respond positively, in terms of insulin secretion, not only to changes in the extracellular glucose concentration, but also to activators of the phospholipase C (cholecystokinin or acetylcholine), and to activators of adenylate cyclase (glucagon, glucagon-like peptide-1, or gastric inhibitory polypeptide). Major messengers which mediate glucose action for insulin release are Ca2%, adenosine triphosphate (ATP) and diacylglycerol (DAG). Major pathways of insulin release stimulation There are four major pathways involved in stimulation of insulin release. The first pathway is KATP channel-dependent pathway in which increased blood glucose concentrations and increased b-cell metabolism result in a change in intracellular ATP/ADP ratio. This is a contributory factor in closure of ATP-dependent K% channels, depolarization of b-cell membrane, in increased voltage-dependent L-type Ca2%channel activity. Increased Ca2% influx results in increased intracellular Ca2% and stimulated insulin release. KATP channel-independent pathway augments Ca2%-stimulated insulun secretion of KATP channel-dependent pathway. Major potentiation of release results from hormonal and peptidergic activation of receptors linked to adenylyl cyclase. Adenylyl cyclase activity is stimulated by hormones such as vasoactive intestinal peptide (VIP), glucagon-like peptide-1 (GLP-1), and so on. These hormones, acting via G protein, stimulate adenylyl cyclase, thus causing a rise in cyclic adenosine monophosphate (cAMP) and activation of protein kinase A (PKA). Increased activity of PKA results in potentiation of insulin secretion.
Possible complications of erythropoietin therapy in patients with chronic renal failure
Authors: Pljesa Steva
Published: July 2006

Introduction There have been many publications in the past 20 years about positive effects of human recombinant erythropoietin, which is used in treatment of anemia, especially in patients on dialysis. Complications The most important complications in patients treated with erythropoietin include: hypertensive reactions; thrombosis of AV fistula in patients on hemodialysis and appearance of severe anemia as a part of Pure Red Cell Aplasia (PRCA). The first two complications were managed quite easily with adequate erythropoietin dosage, and slower establishment of normal hemoglobin kevel, hematocrit level and red blood cell count, (our "target" Hb varied between 100 and 110 g/dl). Pure Red Cell Aplasia (PRCA) Pure Red Cell Aplasia is a progressive, marked anemia with sudden appearance of signifacnt loss or complete absence of erythrocyte precursor cells in normal bone marrow. In patients with end stage renal disease treated with erythropoietin PRCA appears in acute form as a consequence of production of neutralizing antibodies to erythropoietin. Time period between the beginning of erythropoietin therapy and appearance of PRCA is from 3 weeks to approximately 9 months. Symptoms and signs PRCA is characterized by sudden appearance of anemia in patients who had a satisfactory response to erythropoietin therapy till that moment. In PRCA, anemia is normocytic, normochromic with normal survival of red blood cells, without deficit in components such as iron, folic acid or vitamin B12, low reticulocyte count, decrease in Hg and normal platelet count. Diagnosis Diagnosis is based on clinical data (marked anemia), bone marrow biopsy, which shows a lower number of precursor red blood cells and presence of antibodies against erythropoietin. Before PRCA is diagnosed, all other causes for erythropoietin resistance must be excluded. Therapy Therapy of PRCA is based on cessation of erythropoietin therapy (all kinds), and correction of anemia with blood transfusions. Incidence PRCA is very rare and occurs in less than 1:10.000 patient-years in patients treated with erythropoietin, not lethal by itself and generally reversible. Till December 31, 2002. PRCA has been diagnosed in 142 patients world wide. In Serbia and Montenegro till this moment there hasn't been a single case of this syndrome. Preventive measures Continuous follow-up of reticulocyte count is the first step. Although this is a very rare disease, most of European Societies of Nephrology made protocols that recommend only intravenous application of -epoetin. Considering this new situation, Nephrology Society of Serbia and Montenegro recommends that -epoetin should be given to patients on hemodialysis only intravenously, while subcutaneous application of -epoetin is recommended in patients before beginning the dialysis treatment and in patients on hemodialysis, or who had undergone kidney transplantation.
External genital abnormalities in male schoolchildren: an epidemiological study
Authors: Zivkovic Dragana , Varga Jan , Grebeldinger Slobodan , Dobanovacki Dusanka , Borisev Vladimir
Published: July 2006

Introduction External genital abnormalities represent the most common congenital anomalies. Proper, not delayed diagnosis and treatment of certain abnomalities (undescended testis, hypospadia, varicocele) is of great importance for future fertility potential of children. Material and methods An epidemiological study, that consisted of an urological check-up, was performed among school-aged boys in two elementary schools. Prevalence of external genital, and inguinal region was examined. Results A total of 1229 elementary school boys were examined. The incidence of external genital abnomalities was 27.8%. Certain anomalies were already surgically treated in 7.8% of boys. Phimosis was found in 66 patients (5,5%), which represents 26.6% of all abnomalities. Discussion In this study the incidence of undescended testis was 2.0%. Although it is similar to literature data, the fact that undescended testis was found in 25 boys older than 7 years (two of them 15 years old!) suggests that the primary health care is not satisfactory. The incidence of inguinal hernia and hydrocele varies according to different authors from 0.8-4.4% to 13.44%. In this study the incidence was 2.4%. Varicocele represents a developmental anomaly and the incidence is increasing with age. It is rare in boys up to 10 years of age, but the incidence of varicocele in boys aged 15 years (15.8%) reaches the level of incidence in adults (19.82%). The incidence of phimosis in this study was 5.5%. Conclusion High incidence of external genital abnormalities in school aged boys suggests a need for further education of physicians in primary health care services as well as of parents.
Effects of fluoride in drinking water on health of deciduous teeth
Authors: Blagojevic Duska , Stojsin Ivana
Published: July 2006

INTRODUCTION High incidence of decayed deciduous teeth, as well as lack of adequate therapy, makes tooth decay prevention very important. One of the simplest ways to reduce tooth decay is fluoridation of drinking water. The optimal concentration of fluoride in drinking water is 1 ppm/l, and many waters naturally contain this quantity. Waters in Vojvodina are mainly poor in fluoride, except in a few regions. It has long been postulated that fluoride has a prophyilactic effect during intrauterine life. Today a theory of greater local impact of fluoride as well as its role in de- and remineralization of solid tooth tissue. Material and methods This epidemiologocal study was performed in the area of Vojvodina, in places with various fluoride concentrations in drinking water (0.18 - 1.04 ppm/l). Dental examination was performed among 145 children, 6 years of age. For tooth decay detection dmf index was used. Results and discussion In places with low and optimal fluoride concentration in drinking water the percentage of children with decayed teeth is different, but without statistical significance. The percentage of affected deciduous teeth is high in all places. In places with low fluoride concentration it is 24.2 - 32.3%, in places with optimal concentration is 27 - 32%. Everidge value DMF in all places is between 4.7 - 6.4. These results show that optimal fluoride concentration in drinking water decreases the incidence of tooth decay, but this difference is not significant. CONCLUSION Presence of fluoride in drinking water doesn't affect health of deciduous teeth. Decreased incidence of decayed deciduous teeth can be achieved only with combined usage of fluoride (local and systemic), as well as with an intensive health education program.
Life style and behavior of school children without parental care
Authors: Kvrgic Svetlana , Grujic Vera , Martinov-Cvejin Mirjana
Published: July 2006

Indroduction Life style (behavior) is one of the most significant factors affecting health. Although a number of factors participate in creating behavior, family is one the most important. The goal was to analyze the life style of children without parental care. Material and methods The research was done using cross-sectional data from "Children village" in Sremska Kamenica (N=127), and a questionnaire was especially created for this purpose. Results and discussion It was established that 75% of elementary school children and 43% of high school children are physically active. The greatest health risk is smoking (only 50% of students reported never to smoke cigarettes, while 17.5% were daily smokers). The problem is greatest in high school children (43% polled are daily smokers). Alcohol consumption is less common than in the general population of the same age (10% polled drink beer and wine several times a month, while 5% drink spirits - brandy, whisky etc.). Attitudes to sports, smoking and alcohol are mainly positive, but at older age there is an increased number of children with negative attitudes. Knowledge regarding healthy diet is on a lower level comparing with general population, meals are more regular, but with less desirable food. Conclusion From the aspect of health, life style of children without parental care is characterized by risky behavior, particularly in high school children.
Experimental models of epilepsy
Authors: Stanojlovic Olivera , Zivanovic Dragana
Published: July 2006

Introduction An epileptic seizure is a clinical event and epilepsy is rather a group of symptoms than a disease. The main features all epilepsies have in common include: spontaneous occurrence, repetitiveness, and ictal correlation within the EEG. Epilepsies are manifested with distinct EEG changes, requiring exact clinical definition and consequential treatment. Current data show that 1% of the world's population (approximately 50 million people) suffers from epilepsy, with 25% of patients being refractory to therapy and requiring search for new substances in order to decrease EEG and behavioral manifestations of epilepsies. Material and methods In regard to discovery and testing of anticonvulsant substances the best results were achieved by implementation of experi- mental models. Animal models of epilepsy are useful in acquiring basic knowledge regarding pathogenesis, neurotransmitters (glutamate), receptors (NMDA/AMPA/kainate), propagation of epileptic seizures and preclinical assessment of antiepileptics (competitive and non-competitive NMDA antagonists). Results and conclusions In our lab, we have developed a pharmacologic model of a (metaphit, NMDA and remacemide-cilastatin) generalized, reflex, and audiogenic epilepsy. The model is suitable for testing various anticonvulsant substances (e.g. APH, APV, CPP, Mk-801) and potential antiepileptics (e.g. DSIP, its tetra- and octaanalogues).
Pregnancy as a stressful life event and strategies for coping with stress in women with pregnancy-induced hypertension
Authors: Bjelica Artur
Published: July 2006

Introduction Pregnancy-induced hypertension (PIH) represents an extremely important problem in perinatology. Despite numerous clinical observations and studies, the etiology and exact sequence of pathophysiological events accompanying this specific disorder have remained still unresolved. The concepts most often considered are those that include genetic, endocrine and immunological mechanisms. Besides, one can also find in the literature considerations addressing potential participation of psychological factors in pregnancy-induced hypertension. Material and methods The study included two groups of women - 100 women with PIH and 100 of women with normal course of pregnancy, which were tested using two questionnaires concerning pregnancy as a stressful event and using strategies for coping with stress. Results and discussion Women with PIH experience pregnancy in a more stressful way than women with regular course of pregnancy. However, it is necessary to point out that respondents of both groups thought that pregnant women seek attention from everyone from their environment, and that their husbands/partners should pay special attention to them during pregnancy. The importance of relationship between partners during pregnancy and the emotional life of pregnant woman has been also examined by other researchers. These data suggest that pregnancy is an emotionally vulnerable period during which women demand special attention from the environment and especially from their husbands/partners. In view of using particular strategies to cope with stress, certain differences have been registered between the two groups of women. Namely, women with PIH utilize much more the mechanism of seeking social support and much less the mechanism of positive redefinition, compared with women with normal course of pregnancy. Conclusion From the psychosocial approach, pregnancy may be considered as a specific state of high emotional tension, which can represent a potent stressor. In the frame of specific reactions to stress, pregnancy as a stress-inducing situation may lead to transformation of emotional tension to biochemical and vegetative response, and thus contribute to onset of pregnancy-induced hypertension.
Development of paraventricular nucleus (PVN) associated with immuno-reactivity to tyrosine hydroxylase (TH) in the second half of gestation
Authors: Babovic Sinisa , Mijatov-Ukropina Ljilja , Stojsic-Dzunja Ljubica , Srdic Biljana
Published: July 2006

The aim of this stady was to shed more light on the developmental characteristics of human paraventricular nucleus (PVN) and hypothalamus in general, using modern immunohistochemical techniques to detect the activity of tyrosine hydroxylase (TH) in the synthesis of catecholamine (CA). Fetal brains were examined at 12, 16, 20 and 23 weeks gestation. Immunohistochemical staining used for sections is a qualitative method for detection and distribution of the chosen protein. The amplification of positive signals was cared out using AVIDIN/BIOTIN technique. The first positive results were obtained at 16th week of gestation and immunoreactivity grew with the advancement of gestation and that there was no homogenisation of immunoreactivity in some parts of the nucleus. The PVN showed to be an oval formation, nearly parallel with the lateral wall of the 3 rd cerebral ventricle, where the upper apex of the nucleus is situated closer to the ependymal ventricular layer. There was an ascendant dorsal movement of the nucleus in the embryonic phase of hypothalamus development.
Multiorgan resection in patients with gastric cancer
Authors: Radovanovic Dragan , Stevanovic Dejan , Pavlovic Ivan , Bajec Aleksandar , Vekic Berislav , Mitrovic Nebojsa
Published: July 2006

Introduction Multiorgan resection for a malignancy is a very comlicated procedure, but there is always the question: does it work? In everyday clinical practice gastric cancer in phases III and IV is rather frequent. Unfortunately, our patients are under the age of 55 years. D2 lymphadenectomy is not as extensive as D2 %/ or D3, so one must ask himself if multiorgan resection is worth the risk. Material and methods We evaluated two groups of patients: group I consisted of 34 patients who underwent total or subtotal gastrectomy, systematic lymphadenectomy and resection of one or more organs; group II (control) consisted of 167 patients who underwent total or subtotal gastrectomy and systematic lymphadenectomy. These two groups of patients were analzyed in regard to: Bormann's classification, histopathologic type, early mortality, early postoperative complications, lymph node dissection and long-term survival. Results According to Bormann's classification the most common type of carcinoma in both groups was ulcerovegetativ tumor (70.6% in I and 58% in II). In the first group of patients a great number of patients had poorly differentiated adenocarcinomas (47%), while in the second group the most common histologic type was well differentiated intestinal carcinoma (28%). Patients with multiorgan resections had higher rates of early postoperative mortality and morbiditiy (mortality - 14.7% and complications - 26.5%) than patients in control group (mortality - 4.8% and complications - 11.4%). The most frequent causes of postopertive mortality and morbidity were anastomotic leakage and wound infections in both groups. Metastatic lymph node invelvement was higher in the first group (41%), than in the second (28%). Long-term survival was best in the control group (38.5 months). Patients with multiorgan resection had better survival (25.4 months) than inoperable cases (only 5 months). Discussion Patients undergoing multiorgan resection usually have advanced gastric cancer with tumor infiltration in surrounding structures. Only these cases are absolute indications for this radical operation, because patients have better chances fo survival. Conclusion Multiorgan resections are extensive procedures with high rates of postoperative mortality and morbiditiy, but represent the only way for better survival of patients with advanced gastric cancer.
Pesticides and the environment
Authors: Kristoforovic-Ilic Miroslava
Published: July 2006

In the period 1981-2000, an investigation was conducted on organochlorine insecticide (OCI) residues in the environment and their effects on human health. The analyses encompassed drinking and surface waters, air, foodstuffs, ready-made meals, human serum and human autopsy material. OCI residues were not detected in drinking water originating from great distributive systems in Vojvodina (purified and conditioned water) but in some sub-artesian wells there were HCH and aldrin residues. OCI residues were quantified in surface water of the river Danube which is in the required group, except for HCH in 1990/91, when it was in the III-IV group. Air was analyzed in Novi Sad, Zrenjanin, Kikinda, Beocin and Apatin. OCI residues are regularly tested in Zrenjanin (1996-2000): the most frequently detected are: HCH residues (37.83% samples), lindane (21.72% samples), heptachlor (17.60% samples) and rarely DTD and aldrin; aldrin (in traces), heptachlor and HCH were detected in Novi Sad. Heptachlor, lindane and HCH were also rarely determined in Kikinda. OCI have an affinity for fat tissues and their residues can be found particularly in foodstuffs originating from animals. They are not eliminated by thermal processing and it was established in pre-school institutions, student restaurants and homes for the aging; most frequently detected was p,p?DDE isomer, rarely p,p?DDT as well as HCH and rarely lindane. Although use of OCI is forbidden, due to their long persistence in the environment, they can be found in human tissues, which was proved by human serum analyses. Analyses of human autopsy material indicated presence of DDT metabolite - p,p?DDE as well as lindane in all analyzed samples (brain, liver, fat and tumorous tissues).
Health status of adolescents deprived of parental care
Authors: Marinkovic Jelena , Backovic Dusan , Kocijancic Radojka
Published: July 2006

Introduction Children deprived of parental care are a vulnerable population with complex needs and health problems. The aim of our study was to assess health status of this population and compare it with children living in their biological families. Material and methods Our study included 41 adolescents living in foster families (22 boys and 19 girls, mean age 14.66?1.39 and 43 adolescents living in child foster homes (16 boys and 27 girls, mean age 14.99?1.3). The control group consisted of their classmates living with their biological families (45 adolescents, 20 boys and 25 girls, mean age 14.69?1.43). Health status was assessed by analyzing their medical records. Results There were no differences in regard to anthropometric characteristics (body weight, body height, body mass index) and prevalence of body deformities in studied groups. Acute bronchitis was significantly more frequent in children living in foster families (41.5%) than in other two groups (16.3% - foster homes; 17.8% - biological families). Headaches were significantly more common in groups living in foster families (31.7%) and foster homes (25.6%) than in children living with their biological families. The same was established for myopia (46.3% - foster families; 32.6% - foster homes; 17.8% - biological families). Conclusion Even though there were no differences in regard to characteristics which are indicators of general health, it is apparent that children deprived of parental care present with particularities of health status. Additional researches are necessary in order to get insight into the causality of these phenomena.
Classification and qualification of nose injuries: Clinical and forensic aspects
Authors: Pilija Vladimir , Buljcik Maja , Mihalj Marija , Savovic Slobodan , Stojiljkovic Goran
Published: July 2006

Introduction Nose injuries are of great importance in ENT and medico-legal practice. The importance lies in the frequency of injuries, diverse approaches to diagnosis, treatment and qualification of injuries used in legal proceedings in court. Objective assessment of health impairments due to an injury, requires knowledge about morphofunctional nasal characteristic, therapeutic procedures and medico-legal expertise. Nose injures: etiology and diagnosis Nasal fractures are the most common types of facial fractures which occur in different situations. They are often combined with soft tissue injuries. The diagnosis of nasal injuries involves clinical examination, radiography and nasal endoscopy. Classification and therapy of nose injuries There are several classifications of nasal injuries depending on pathological findings. The most acceptable one is the modified categorization after Harrison. The treatment of nasal injuries depends on the type of injury and possible complications. Qualification of nose injuries Nasal soft tissue injuries, nasal fractures, dislocations and partial dislocations should be assessed at the time of diagnosis. Conclusion Medical assessment of injuries is of utmost importance for legal purposes and regarding medico-legal aspects. .
Takayasu arteritis
Authors: Misovic Sidor , Draskovic Miroljub , Jevtic Miodrag , Sarac Momir
Published: July 2006

Introduction. Giovanni Battista Morgani reported the first case with Takayasu arteritis (TA) in 1761. The disease affects the aortic arch and large blood vessels. It is found in every race and in every age-group, predominantly in female population aged 20-40 years. There are four types of TA: type I affects blood vessels of aortic arch; Type II is syndrome of middle aorta (thoracal and abdominal aorta); Type III affects aortic arch and abdominal aorta; Type IV affects pulmonary artery. Clinical manifestations. TA has three phases; 1. weakness, fever, anemia, loss of appetite: 2. inflammation of blood vessels: 3. symptoms of stenosis and occlusive lesions. Pathoanatomical disorder includes inflammation of all three layers of blood vessels. Case report. This is a case report of a 41-year-old woman with TA. She suffered from chest pain, fatigue and pain in both legs, predominatly in the right. Clinical presentation of the disease varies whereas development of 1A is unpredictable. Angiograplty is an important method in diagnosis of the disease and in planning surgical treatment. In our patient five arterial stenoses were established by angiography. ECHO Color Doppler angiography may be useful. Diagnostic criteria include: age under 40 years, occlusion of the right and left subclavian artery and nine minor criteria. Corticosteroid and anti-inflammatory therapy is indicated. One third of patients needs surgery. Discussion and conclusion. In our opinion surgical treatment should be delayed until acute phase is over. Surgical treatment in our patient included: aortobifemoral bypass and left carotid-axillary bypass grafting. Some patients need multiple surgical treatments, like our patient. They also need post-surgical controls. .
Epidemiological characteristics of salmoneilosis in Vojvodina
Authors: Petrovic Vladimir , Stefanovic Slavica , Djuric Predrag
Published: July 2006

Introduction Salmonella infections are the most common food-born diseases transmitted from animals to humans. Epidemics of salmonellosis occur after eating improperly cooked contaminated foods. Material and methods A descriptive epidemiological method was used to analyze epidemiological characteristics of salmonellosis in Vojvodina in the period 1978-2003. Results During this period there were 26 851 cases of salmonellosis (mean annual incidence of 51.1/100 000 and mean annual mortality of 0.9/100 000). Mean annual case fatality ratio during this period was 0.1%. The specific incidence was highest in 12-24 month-old children (251/100 000), and lowest in the oldest age group (13.9/100 000). Lethality was highest in children younger than 1 year, and persons older than 50 years (84%). The number of cases registered in food-born epidemics makes 41.7% of all registered cases. A mayority of 772 registered epidemics were small epidemics among families, relatives and friends. The great epidemics with large number of infected persons were due to an industrial bakery with 1713 ill persons and a public restaurant with 311 ill persons during the 80 's. An epidemic was due to sandwiches from an industrial bakery distributed through the whole territory of Vojvodina with the highest incidence of salmonellosis in 1987 (137.7/100 000). The most common serotype was S. enteritidis (69.7%), but 68 more serotypes were isolated. The most common cause of epidemics were eggs and egg products (76.2%). Salmonella spp. was isolated from food in small number of epidemics (less than 20%), because epidemics were discovered usually 2 or 3 days after their beginning. .
Von Meyenburg complex associated with adult polycystic liver disease
Authors: Lalosevic Dusan , Milosevic Pavle , Vuckovic Nada , Uzurov Vera , Andjelkovic Zlatibor , Djolai Matilda
Published: July 2006

Introduction. The von Meyenburg complex (bile duct hamartoma) is a rare developmental disorder, manifested by multiple bile ducts. The polycystic liver disease is a rare congenital anomaly which may remain undiscovered until adult life, occurring more frequently in women. It is mostly asymptomatic, but sometimes surgical intervention is necessary. In the majority of cases, it is combined with cysts in the kidney and, rarely, in other organs as well. The cysts may vary in diameter from I mm to 20 cm, or even more. Case report A 55-year-old woman underwent surgery based on clinical diagnosis: suspected Echinococcus liver cyst. Liver biopsy was performed, and a parenchymal tissue of 6.5x4x3 cm, with a cyst with a diameter of 2.5 cm, was resected. Within the cyst lumen there was a necrotic, mushy, yellow contents. Microscopically examined, it showed plenty of cholesterol crystals. The wall of the cyst consisted of hypocellular connective tissue. In the surrounding liver parenchyma, there were cystical formations of the same structure, measuring 1-2 mm. Also, there were some multiple bile duct hamartomas. The ducts were encircled by a delicate connective tissue. Discussion and conclusion These changes correspond to von Meyenburg complex, i.e. biliary microhamartoma combined with adult polycystic disease. In our case, in the wall of the cyst there were numerous cholesterol crystals, pointing to its retention character and, probably, to the mechanism of its origin. After degeneration of biliary epithelium, the cyst wall grew very thick, due to proliferation of the connective tissue evoked by the aggressive chemical contents of the bile. Frequent development of cholangiocarcinoma within the cyst wall also points to long-term chemical irritation. .
Streptococcus suis infection: Clinical manifestations
Authors: Dragojlovic Julijana , Milosevic Branko , Sasic Neda , Pelemis Miomir , Sasic Milan
Published: July 2006

Introduction Streptococcus suis is a bacterium causing a disease in pigs and rarely in humans. This zoonosis is mostly found as a sporadic disease in individuals that were in contact with the affected or infected pigs: farmers, veterinarians and workers engaged in fresh pork processing. It is assumed that the bacterium enters the body through a cut abrasion in the skin. Initially, the condition resembles a flu, followed by signs of bacteriemia and sepsis. The most frequent clinical manifestation of Streptococcus suis infection is meningitis, leading to hearing loss in over 75% of patients, and subsequent arthritis, endophtalmitis, endocarditis and pneumonia. Toxic shock syndrome with hemorhagic manifestations rarely develops. Material and methods This study included five male patients aged 22 to 63 years treated in the Intensive Care Unit of the Institute of Infectious and Tropical Diseases in Belgrade, due to Streptococcus suis infection. The aim of this study was to point to the existence of this bacteria in our environment, to describe clinical manifestations of the disease and to point out the importance of its prevention. Results All patients had epidemiological evidence of being in contact with pork meat. There were no data about diseased pigs. The estimated incubation period was 4 to 8 days. All patients had meningeal signs. Clinical symptoms included shivering, fever, vomiting, headache, malaise, vertigo and tinitus. Three patients presented with alerterd level of awareness. Four patients developed very severe bilateral hearing impairemnt, whereas one endophtalmtis and one developed endocarditis. The cerebrospinal fluid (CSF) was opalescent in four patients, and only one patient presented with clear CSF. CSF examination showed typical changes characeteristic for bacterial meningitis. Streptoccocus suis was isolated in CSF in all patients, and in one patient the bacteria was isolated in blood as well. All patients underwent treatment with II and III generation cephalosporins and one with one aminoglycosides. All patients were cured, but 4 of them developed sequelae like permanent sensorineural deafness and mild ataxia. Conclusions Streptococcus suis infection is present as a zoonosis in pigs, while humans are contracted occasionally, most frequently related to occupational risk. In cases with bacterial meningitis with sepsis and hearing loss, Streptococcus suis infections must be suspected. Effective prevention requires collaboration between epidemiologists, veterinarians and human medicine physicians. .