bluuebunny/crossref_metadata_2025 huggingface dataset:
Physical activity of school children and their parents in Vojvodina
Authors: Niciforovic-Surkovic Olja , Ac-Nikolic Erzebet , Ukropina Snezana , Mijatovic-Jovanovic Vesna
Published: July 2006

Introduction. Physical activity is very important for normal physical and psychic growth and development. Recent studies in developed and developing countries have shown that today's schoolchildren are spending more and more time in front of the TV and computer, and less and less are engaged in sports. Such lifestyle has a negative effect on health. That is why it is very important for children to develop active habits for life, in order to sustain and promote their health. Material and methods. The study included, a random sample of 210 children from 4 elementary schools and their parents in Vojvodina. Specially designed questionnaires were used. Results and Discussion. The obtained results showed that 75% of schoolchildren are engaged in physical activity, but only 56.5% play sports regularly (every day or 2-3 times a week). There is a significant difference between boys and girls: about 75% of boys and 35% of girls are engaged in physical activity regularly. Similar results have been obtained by other authors (O'Reilly and Shelley, Faucette, Heath etc). Common reasons for physical activity are health, fitness and fun. Pupil's attitude to sports significantly depends on their parent's opinion about physical activity and also on their attitude to recreation in their future life. Parents are not active as their children, only 40% of fathers and 30% of mothers are engaged in various activities regularly. Conclusion. This study showed that schoolchildren are engaged in physical activity, but not enough. On the other hand, their parents are very inactive, although they see the importance of it. Considering the fact that present recreational habits are correlated with the attitude to recreation in the future, an additional effort should be made in health education and health promotion in young population. .
Treatment of colorectal liver metastases with a combination of liver resection and radiofrequency ablation
Authors: Radovanovic Dragan , Stevanovic Dejan , Vekic Berislav , Stojanovic Dragos , Pavlovic Ivan
Published: July 2006

Introduction. Radiofrequency ablation is a new invasive procedure that is being increasingly used in the treatment of colorectal liver metastases. Resection as the only potential cure for colorectal liver metastases is limited by the size and the itrahepatic localization of lesions. Radiofrequency ablation may extend the limitations of classic surgery. In this work we analyzed the combination of surgical liver resection and radiofrequency ablation of liver metastases. Material and methods. This study included 11 patients with colorectal metastases. Colon resection and radiofrequency ablation have been performed in five (5) patients, three (3) patients underwent liver resection and radiofrequency ablation, and in three (3) patients colon resection, liver resection and radiofrequency ablation were performed. Results. In our study group, there were 6 (54.54%) men and 5 (45.45%) women aged 55 to 66 years and 52 to 67 years of age, respectively. During operations, we treated 30 liver metastases, 2.72 metastases per patient. There were from 2 to 4 ablation metastases. The diameter of colorectal metastases was between 11 mm and 44 mm. Most of ablation metastases (12 or 40%) were between 2.1 cm and 3 cm in diameter. Only 10% of ablation metastases were over 40 mm in diameter. Discussion. The majority of patients with metastatic colorectal hepatic tumors are not candidates for surgical resection, due to tumor size, location and multifocality. However, we can treat advanced colorectal cancers and colorectal liver metastases with a combination of liver resection and radiofreqency ablation. In this way we can operate and give a chance to patients with multifocal metastases and metastases with a diametar over 40 mm. Conclusion A combination of liver resection and radiofreqency ablation in treatment of advanced colorectal cancers with liver metastases is a good treatment modality which increases the number of operable cases.
Assessment of maternal cerebral blood flow in patients with preeclampsia
Authors: Mandic Vesna , Mikovic` Zeljko , Djukic Milan , Vasiljevic Mladenko , Filimonovic Dejan , Bogavac Mirjana
Published: July 2006

Introduction Systemic vasoconstrktion in preeclamptic patients increases vascular resistance, and is manifested by increased arterial blood flow velocity. The aim of the study is to evaluate if there is a change of Doppler indices in maternal medial cerbral artery (MCA) in severe preeclampsia due to: 1) severity of clinical symptoms, 2) the beginning of eclamptic attack and 3) the application of anticonvidsive therapy. Material and methods A prospective clinical study included 92 pregnant women, gestational age 28-36 weeks. They were divided into three groups: normotensive (n=30), mild preeclampsia (n=33), and severe preeclampsia (n=29). We investigated maternal cerebral circulation by assessing the MCA. We registrated: pulsatility index (Pi), resistance index (Ri), Systolic/diastolic ratio (S/D), and the maximum systolic, end diastolic and medium velocity. Patients with severe preeclampsia were divided into two subgroups: subgroup 1 included patients without symptoms of threatening eclampsia (n=18; 62.06%); while subgroup 2 included those with symptoms of preeclampsia (n=11; 37.94%). All patients with severe preeclampsia were treated with magnesium sulfate (MgSO4), and cerebral blood flow was measured before and after the treatment. Statistical analysis was done by oneway ANOVA, Student t-test and t-paired sample test. The difference was considered to be significant if p < 0.05. Results Significantly increased Pi, Ri and all velocities were established in the group of patients with severe preeclampsia compared with the other two groups. In the group with severe preeclamsia we registrated significantly increased values of all velocities (patients with signs of threatening eclampsia). After MgSO4 treatment in patients with severe preeclampsia significantly decreased values of Pi, Ri, S/D ratio and all velocities were registered. Discussion In the studied group of patients with severe preclampsia we found increased velocity values, Pi and Ri, especially in patients with signs of threatened eclampsia, suggesting that blood vessels changes are most prominent in severe preeclampsia. Cerebral blood flow measurements can be used as a clinical test for the prediction of eclampsia. Magnesium-sulfate (MgSO4) has a significant role in prophylaxis and treatment of eclampsia, and, therefore, positive influence on reduction of cerebral ishemic lesions can be expected. Conclusion We can conclude that changes of the cerebral blood flow can be evaluated by evaluating blood flow velocities in the medial cerebral artery. Velocities tend to increase in severe preeclampsia, especially with signs of threatening eclampsia, and decrease after treatment with magnesium sulfate. Serial measurements of blood flow in medial cerebral artery in patients with severe preeclampsia may be used in prediction of eclampsia and in evaluation of magnesium sulfate therapy effects.
Marital dysfunction and personality characteristics of partners
Authors: Draganic-Gajic Saveta , Lesic-Tosevski Dusica , Calovska-Hercog Nevena , Nagulic Desanka , Stamenkovic-Rudic Bojana , Dimic Sara
Published: July 2006

Introduction A number of studies indicate that an early trauma is of extreme importance (most often experienced in the family of origin) in developing personality disorders. Researches on correlations between family dysfunction and individual psychopathology have been rare and controversial. The reason for this stems from an attempt to establish links between traditional medical models and systemic family therapy. The aim of this research was to explore specific personality structures of married couples and the way they relate to the type of dysfunction within the partner relationship. Material and methods The sample consisted of 25 families in the middle of divorce. The examinees were aged 25-45. Specific interactional behavioral patterns were examined by Dyadic Adjustment Scale (DAS), while personality profile data were obtained using Millon Clinical Multiaxial Inventory (MCMI). Results and conclusions In both groups dependency and obsessivness were marked, while males also presented with marked narcissism. Related to structural personality disorders, we have found only a group of men with significantly increased paranoid dimension. Concerning clinical syndromes, the obtained results revealed anxiety and depressive disorder in both genders and a tendency towards alcohol abuse among men. Results indicated to correlation of communication-interactive family patterns on one hand, and certain personality traits on the other. .
Diagnostic value of certain methods for isolation of Mycobacterium tuberculosis in children with suspected pulmonary tuberculosis
Authors: Petrovic Slobodanka
Published: July 2006

Introduction The aim of this study was to find out if bronchoalveolar lavage (BL) is better than gastric lavage (GL) or sputum (SP) examination for isolation of Mycobacterium tuberculosis in childhood pulmonary tuberculosis. Material and methods The study included a group of 30 children with suspected pulmonary tuberculosis, aged 6 months to 18 years. Gastric lavage was done on 4 consecutive mornings after overnight fast. Sputum was examined in 12 patients older than 10 years, (4 consecutive samples). BL was performed on the same day as the last GL and SP, using a rigid bronchoscope. Specimens were examined for the existence of BL acid fast bacilli (AFB) and culture for Mycobacterium tb. Results Out of 30 cases, Mycobacterium tb was grown in 13 BL samples (43.33%), and in 10 GL samples from the same patients (33.33%). Comparative analysis of microbiological samples of sputum and bronchoalveolar lavage fluid in 12 children showed that 6 patients had SP+ cultures and 6 patients had SP-cultures of Mycobacterium tb. All SP+ patients where also BL+, but 1 SP- patient was BL+. Smear examination of BL fluid samples was positive for AFB in 10 patients with positive cultures for Mycobacterium tb. Conclusion The results of our study indicate that BL examination is better than GL and SP examination for bacteriological diagnosis of childhood tuberculosis. .
Current issues in contraception
Authors: Draca Petar , Jakovljevic Branislava
Published: July 2006

Introduction. The authors analyze contemporary methods of contraception. Regarding oral contraception, they point to agents which decrease the efficacy of oral contraception. They also deal with agents which increase the level of estrogen, thus increasing side effects (paracetamol, vitamin C). Oral contraceptives Oral contraceptives may also have an impact on the efficacy of some medications (anticonvulsants, antidepressants). Health risks of oral contraceptives are also mentioned, as well as WHO's, guidelines for women using contraceptives based on risks and benefits. Other methods of contraception The authors also offer criteria for use of bioactive intrauterine devices (IUD), with recommendations of WHO. Besides men's, there are women's condoms, which are very reliable protection against infections, but their negative side is that they are rather expensive. Bad sides of vaginal wash are also emphasized, although this method is rather widespread in the world. Conclusion. At the end, the authors quote the International Family Planning Fund (IFPF) which considers IUD to be the most reliable method of contraception nowadays. .
Abdominal adipose tissue: Significance and methods of detection
Authors: Srdic Biljana , Stokic Edita , Polzovic Agneza , Babovic Sinisa
Published: July 2006

Introduction. The presence of excess fat in the abdomen, out of proportion to total body fat, is associated with increased risk for cardiovascular and metabolic diseases and other complications of obesity. Histoanatomical characteristics of the abdominal adipose tissue In regard to subcutaneous fat, accumulation of visceral abdominal adipose tissue is more associated with increased metabolic risk. However, mean have more visceral fat than pre-menopausal women. Compared with pre-menopausal women, postmenopausal women have 49% more intraabdominal fat, regardless of age and total fat mass. Measurement of abdominal fat depots Various anthropometric indicators have been suggested for measuring body fat distribution. All of them have advantages and disadvantages, in relation to their interpretation and use. Many are specified as ratios and are difficult to interpret biologically, whereas a change in body fat distribution may exhibit little or no change in the ratios. Waist circumference and sagittal abdominal diameter are good predictors of visceral fat. But, extreme individual variations in visceral to subcutaneous ratio demonstrate the limitations of external anthropometry. The best methods to estimate the amount of visceral fat are imaging techniques like computed tomography or magnetic resonance, but they are expensive and inconvinient in routine practice. Conclusion. Further investigations should provide a simple and optimal indicator of abdominal obesity which should correlate with the amount of viscelar fat and the risk. .
Epidemiological characteristics of gastric cancer
Authors: Sipetic Sandra , Tomic-Kundakovic Sladjana , Vlajinac Hristina , Maksimovic Natasa , Knezevic Anita , Kisic Darija
Published: July 2006

Introduction. Gastric cancer was the third most common cancer worldwide in 2000, accounting for approximately 876 000 new cases or 9% of the global cancer burden. Epidemiological characteristics As a result of changes in diet, the incidence of gastric cancer has decreased in most countries. Now days, consumption of fresh vegetables and fruits is increasing in regard to canned food. In addition to unhealthy diet, the main risk factors for gastric cancer are H. pylori infection, alcohol consumption, smoking, gastritis, stomach ulcer, gastrectomy, stomach polyposis, positive family history for gastric cancer, pernicious anemia and blood type A. Diet rich in vegetables and fruits, and reduced salt intake can prevent 65-75% of gastric cancer cases among nonsmokers. Prevention of Helicobacter pylori infection can also reduce the incidence of this malignant disease. .
Effects of estro-progestagens on lipid and hormonal profiles in women with premature primary ovarian failure
Authors: Ivanisevic Maja , Vujovic Svetlana , Drezgic Milka
Published: July 2006

Introduction Premature primary ovarian failure (PPOF) is defined as cessation of menstruation before the age of 40, Women with PPOF have hypergonadotropic amenorrhea and hypoestrogenia. The incidence of PPOF is 0.9-3%, and its etiology is midtifactorial (genetic, enzyme deficit, virus infections, autoimmune diseases and idiopathic). PPOF is an independent risk factor for cardiovascular diseases. Untreated women are at higher risk for coronary disease, due to increase of total cholesterol, LDL, triglycerides and decrease of HDL. The aim of this investigation was to study effects of estro-progestagens on lipid and hormonal profiles in PPOF.: Material and methods. This study included: 30 healthy women aged 41 ?2.3 years; body mass index 25?3.2 kg; hip/waist ratio 0.76?0.04; amenorrheic for three years on average. Blood samples were taken for glycemia, cholesterol, HDL, LDL, FSH, LH, prolactin, estradiol, and progesterone measurement at 8 am, before and during the therapy with Trisequens. Hormone analysis: radioimmunoassay (PJA) (INEP, Zemun). Statistics: T-test and linear correlation. Results. Total cholesterol, HDL and LDL have decreased, while prolactin, estradiol and progesterone have increased significantly. Discussion. Women receiving hormone replacement therapy (HRT) have reported reduced mortality and morbidity (30% to 50%) and risk for coronary diseases (61%). Neither has Gaspard's study, nor has ours, found changes in concentrations of triglycerides due to higher synthesis of insulin and higher insulin sensitivity. However, 19-nortestosterone, in some studies, decreases HDL significantly. In our study, the decrease of HDL was not significant, because subjects were younger, with normal BMI. Women with PPOF have to start hormone therapy immediately, in order to prevent cardiovascular diseases, osteoporosis, depression, etc. and to improve their quality of life. .
Tumor volume in advanced gastric cancer as a prognostic factor correlating with lymph node involvement
Authors: Radovanovic Dragan , Mitrovic Nebojsa , Stevanovic Dejan , Pavlovic Ivan , Vukovic Milena , Radojevic Dejan
Published: July 2006

Introduction It has been established that measurement of tumor volume, rather than its diameter, is a better indicator of the depth of tumor invasion and lymph node involvement. The present study evaluates the significance of tumor volume as a prognostic factor in gastric cancer. Material and methods This prospective clinical trail included 87 patients with gastric cancer admitted to Surgery Clinic "Dr. Dragisa Misovic" in Belgrade from 1998 to 2003. All patients were evaluated by standard diagnostic procedures, and after that underwent radical surgical treatment. Oncologic-surgical principles recommended by Japanese Research Society for Gastric Cancer were respected. Tumor volume was determined by measurement of specimens that had been obtained during surgery and by histopathological analysis. These criteria were analyzed and correlated with the lymph node status and clinicopathological factors. Results Single-factor analysis showed that lymph node metastases correlated with larger tumor diameter, larger tumor volume, depth of tumor invasion, diffuse and low-grade differentiation of the intestinal type of gastric carcinoma. Using a linear correlation coefficient, it was found that there was a highly significant correlation of tumor volume and number of metastatic nodes in groups between lymph nodes r=0.567; p<0,0001 in drainage group I, r=0.511; p<0.0001 in drainage group II, r=0.579; p<0.0001 in drainage group III. Also, there was highly significant correlation with the total number of metastatic nodes (r=0.577; p<0.0001) and significant correlation with the depth of tumor invasion and tumor diameter (p<0.05). With 97% sensitivity and 88% specificity, "cut off point was established by determining the tumor volume above which there were metastases into lymph nodes. In this study that volume was 2750 cmm. Conclusion Tumor volume can be used as a valuable prognostic factor for advanced gastric cancer, and hopefully it will be calculated preoperatively by 3D-EUS volumetric analysis.
Constipation: A common problem in childhood
Authors: Bukarica Svetlana , Marinkovic Smiljana , Grebeldinger Slobodan , Dobanovacki Dusanka , Tatic Milanka , Antic Jelena
Published: July 2006

Introduction Constipation in children is defined as the infrequent and difficult passage of hard stool, not necessarily associated with infrequent stools. All healthy newborns have their first stool within the first 24 to 48 hours after birth. Intestinal transit time increases with age, therapy decreasing the frequency of stooling. Anatomy and Physiology of Anus and Rectum Acquisition of fecal continence requires: normal internal and external anal sphincters, puborectal muscle as well as intact sensory input from both the rectal vault and anal canal. Etiology and Differential Diagnosis During the first year of life, failure to have bowel movement every other day warrants evaluation. During infancy, constipation is usually due to dietary manipulations, malnutrition or some other functional abnormalities. Anatomic causes are found only in 5% of patients. Diagnosis and Therapy Diagnosis relies on history and physical examination. Digital rectal examination usually reveals a shorter anal canal with decreased sphincter tone. The rectal ampulla is dilated and filled with stool. Anorectal manometry is helpful in differentiating functional constipation from aganglionosis or other neurologic problems. Treatment varies depending on the underlying cause. Bowel retraining, aimed at establishing regular daily bowel movement, is of utmost importance in children. The response to treatment is usually dramatic. Conclusion Constipation in children causes anxiety in the family and successful treatment requires persistent reassurance and repeated reevaluation.
Effects of alendronate on the markers of bone metabolic activity in postmenopausal women with osteoporosis
Authors: Ilic Jana , Kovacev Branka , Babic Ljiljana , Curic Nikola , Radosavljevic Jovanka
Published: July 2006

Introduction Bisphosphonates are synthetic compounds used in treatment of osteoporosis and inhibition of bone resorption. Material and methods The research included a group of 30 postmenopausal women with osteoporosis, treated with alendronate (70 mg per week -Fosamax tablets in combination with calcium and active vitamin D - Alpha D3 0.25mcg). The control group included 20 women with osteoporosis treated with hormone substitution therapy (HST), calcitonin and deca duraboline. Bone metabolic activity, was evaluated using osteocalcin for bone formation and cross-laps for bone resorption. Blood samples were taken before therapy and 6-8 weeks after. Results The serum levels of osteocalcin and cross-laps during application of alendronate were statistically significantly lower comparing to those in pre-therapy. The serum levels of osteocalcin and cross-laps during the therapy applied in the control group were statistically insignificantly lower than values in pretherapy. Osteocalcin has a tendency of decreasing in both groups, and it was slightly more evident in alendronate group. Cross-laps demontrated the same tendency of decreasing in both groups, and it was more evident in alendronate group. Discussion Our results have shown the efficacy of alendronate in preventing bone loss, which was highly statistically significant. They have also shown its suppressive effect on bone formation and resorption, but the effects were statistically less significant. Conclusion Alendronate significantly reduces the level of bone resorption in postmenopausal women with osteoporosis. Its effects on bone formation are less expressed. Alendronate's effects on bone metabolism become evident not later than 6-8 weeks after therapy application. Parameters of bone metabolic activity are very useful diagnostic means in evaluation of alendronate effect on bone metabolic activity and in the prognosis of bone mass loss.
Jejuno-jejunal intussusception in adults secondary to submucosal leiomyoma
Authors: Draskovic Miroljub , Misovic Sidor , Kronja Goran , Krsic Jovan , Tomic Aleksandar , Sarac Momir
Published: July 2006

Introduction Intussusception is the invagionation of a segment of the intestine into itself. It is a serous condition that most commonly affects infants and children, but can also occur in adults. Intussusception in adults is usually caused by tumors, benign or malignant. Early diagnosis is essential to avoid treatment delays, which can increase morbidity and mortality. In older patients and adolescents the diagnosis can be complicated due to lower incidence and variable subacute symptoms. Case report We report a rare case of a 27-year-old patient with increasing abdominal discomfort over several weeks. The patient experienced increasing colics, recurrent vomiting, dehydration and weight loss. Finally he was transferred to the surgical ward of our hospital. Intussusception of the small bowel was diagnosed by CT examination. Laparotomy revealed a jejunojejunal intussusception caused by a small bowel tumor. Conclusion The tumor in the jejunum, almost completely obstructed the intestinal lumen and it was resected and bowel continuity was restored. Histopathological examination revealed a submucosal leiomyoma of the jejunum.
Primary hypothyroidism associated with empty sella turcica and hypopituitarism
Authors: Milosevic Maja , Stojanovic Milos , Nesovic Milica
Published: July 2006

Introduction Empty sella syndrome is a rather frequent neuroradiological finding in the general population and can be associated with hypopituitarism. Examinations reveal low pituitary hormone levels and lack of response to stimuli. Most patients suffer from central hypothyroidism as part of pituitary insufficiency. Primary hypothyreoidism is a rare finding in these patients. Case report We present 3 patients: one female and two male, suffering from complete hypopituitarism, as part of the empty sella syndrome diagnosed due to low concentrations of all pituitary hormones, elevated TSH and low thyroid hormones. TRH, LHRH, ACTH and ITT tests, as well as IGF1 have confirmed hypopituitarism and primary hypothyroidism. CT and NMR in all three patients showed empty sella without a tumor in it. The diagnosis of primary hypothyrodism in the first patient was made before hypopituitarism has taken place, or at the same time in the second patient, whereas in the third patient it was diagnosed twenty years later. In two patients anti-TPO and anti-Tg antibody levels were high, and in the third patient they were not elevated. It can be assumed that the etiology of primary hypothyrodism in all three patients was of autoimmune origin, which caused thyroid hypofunction. High level of TSH in all three patients and especially in the patient whose hypopituitarism was diagnosed twenty years later, showed presence of thyrotrophic cells in the pituitary. Evaluation of the hypothalamic-pituitary-thyroid axis was carried out during the complete substitution therapy of hypopituitarism. Conclusion Diagnosing primary hypothyrodism associated with hypopituitarism helps improving the knowledge on empty sella syndrome and points to different clinical syndromes characterized by lack of mixoedema, although approach to therapy is the same for both primary and central hypothyroidism.
The role of enteroclysis and roentgen anatomy of jejunum and ileumin Crohn's disease
Authors: Krivokuca Dragan , Saranovic Djordjije , Vukovic Milivoje , Puskas Laslo , Stankovic Gordana , Srdic Biljana
Published: July 2006

Introduction The aims of this research were: I) to establish the value ofen-teroclysis in detection of morphological changes of jejunum and ileum in cases with suspected Crohn's disease and 2) to establish types of morphological changes of jejunum and ileum in patients with Crohn's disease. Material and methods The study compared two groups of people who voluntarily accepted to be examined: a control group and a study group. The control group included 11 healthy people, without gastrointestinal symptom. The study group included 16 patients with Crohn's disease. Single and double-contrast enteroclysis were performed in both groups. Afterwards, we defined parameters which were compared in these groups. Conclusions We concluded that according to statistics there are significantly lower values of the width of the jejunal and Heal lumen and the number of mucosa/folds (per I cm) of the jejunal and Heal wall in the examined group in contrast to the control group. Also, according to statistics there are significantly higher values of the width of the jejunal and ileal wall and the thickness of mucosal folds of the jejunum and ileum in the study group in contrast to the control group.
A study of alloreactivity in couples with habitual abortions of unknown etiology
Authors: Protrka Zoran , Jovanovic Bozidar , Protrka Olivera , Varjacic Mirjana
Published: July 2006

During 2003, we investigated 22 couples with three or more consecutive spontaneous abortions without liveborn children. The study group consisted of 9 couples with three or more successive spontaneous abortions without liveborn children and without known endogenous or exogenous causes of habitual abortions. The first control group comprised 9 couples with liveborn children, while the second one included 9 randomly selected couples without children. The Immunologic status was evaluated in regard to functional capacity of lymphocytes, response of T-lymphocytes to disabled histocompatible antigens of partner's lymphocytes, and T-lymphocytes to partner's alloantigens. In women from study and control groups there were no statistically significant differences in general Immunologic status (functional capacity of lymphocytes). In women from the study group, T-lymphocytes response to stimulation by disabled partner's lymphocytes was significantly lower compared to both control groups (P 0.05). However, the immunologic reaction of women from the study group to alloantigens of men from control groups did not show any significant difference compared to contra/ groups results (P > 0,05). According to our study, it can he concluded that imnntnologic factors have an important role in a great proportion of habitual abortions with unknown etiology.
Quality of life assessment inosteoporotic patients with and without vertebral fractures
Authors: Vujasinovic-Stupar Nada , Radunovic Goran , Smailji Medija
Published: July 2006

Introduction Vertebral fractures are associated with back pain and disability, but relatively little is known about their impact on quality of life of these patients. The aim of the study was to compare the quality of life of osteoporotic patients with and without vertebral fractures. Material and methods Hone mineral density measurement was done by dual-energy X-ray absorptiometry using LUNAR DPX-L in patients with osteoporosis divided into 2 groups: Group I (33 patients) with and Group II (30 patients) without vertebral fractures. Quality of life assessment was done using the Qualeffo-41. Statistical analysis was done using student t-test and Mann-Whitney U test Results The results of Qualeffo-41 questionnaire suggest highly significant differences in quality of life between patients with and patients without vertebral fractures (p<0.001). Impaired quality of life in patients with vertebral fractures was evident in all domains of the questionnaire: pain (p=0.017), activities of daily living (p<0.001), jobs around the house (p=0.007), mobility (p<0.001), leisure, social activities (p=0.002), general health perception (p=0.002) and mental function (p=0.025). Discussion Health-related quality of life may be assessed using generic or disease-specific instruments. The Qualeffo-41 questionnaire is a disease-specific instrument which was developed by a working group of the European Foundation for Osteoporosis and has a great face and content validity in assessing quality of life in osteoporotic patients. Conclusion Osteoporotic patients with vertebral fractures have a significantly impaired quality of life compared with osteoporotic patients without vertebral fractures.
Familial obesity as a predictor of child obesity
Authors: Mirilov Jelena
Published: July 2006

Introduction Studies carried out in various parts of the world indicate that family obesity significantly affects the incidence of obesity in children. This is especially a characteristic of children whose both parents are obese. Material and methods The study was conducted using a polling method. Questionnaires were filled out by parents and brothers and sisters, including their body height and weight. The collected data served as the basis for assessing the family nutritional status. Results Statistical analysis of the results showed that obese children frequently have obese parents, brothers and sisters in regard to normal-weight children. Differences are statistically significant in relation to fathers (r=0.043), i.e. statistically obese schoolchildren have more frequently obese fathers than those of normal nutritional status. Other differences could not be considered significant (p > 0.05). Discussion Obese children have more often obese parents, brothers and sisters than normal-weight children. It was found that the nutritional status of moderately and extremely obese children was quite different from that of normal-weight children and that there was a statistically significant dependence between the nutritional status of children and their fathers. Conclusion This research showed that family obesity is a potential contributing factor to obesity of schoolchildren.
Hospital infections in neonatal intensive care units
Authors: Djurisic Jasna , Markovic-Denic Ljiljana , Ilic Slobodanka , Ramadani Ruzdi
Published: July 2006

Introduction Sick newborn babies in the neonatal intensive care units (NICU) are al increased risk for hospital-acquired infections (HI). The aim of our study was to determine the incidence and localization of neonatal hospital infections in NICU. Material and methods A prospective, six-month study was carried out in a NICU. All patients hospitalized in NICU longer then 48 hours were examined according to their basic descriptive-epidemiological characteristics and the incidence of all hospital-acquired infections (diagnosed using CDC criteria) were accounted for. Results The incidence of patients with HI was 46.1% while the incidence of HI was 57.2%. On the basis of patients' records in the NICU, the incidence of HI was 43.9 per WOO patient- hospital days. Patients with HI were hospitalized significantly longer in NICU than patients without HI (t=9.2 DF=267 p<0.001). In terms of localization of HI, a large number of patients had pneumonia - 74.7% (115/154), followed by sepsis (37/154), while two had meningitis. Conclusion This study suggests that it is necessary to maintain continuous surveillance of HI in NICU, as well as infection control measures, which are also very beneficial.
A typical presentation of right coronary artery occlusion
Authors: Ivanovic Vladimir , Jelkic Nikola , Srdic Svetozar , Bikicki Miroslav , Canji Tibor , Srdanovic Ilija
Published: July 2006

Introduction Inferior wall myocardial infarctions are usually benign and uncomplicated and rarely result in ventricular disturbances of the heart rhythm. An unusual presentation of an inferior acute myocardial infarction (AMI) with atypical symptoms, and ventricular tachycardia is described. Case report A 44-year-old patient was admitted to the coronary care unit (CCU) due to atypical chest pain during exercise and ECG abnormalities in leads L2. L3 and aVF. On admission, ECG could mimic myocarditis, pericardia/ effusion, left anterior bundle branch block or early repolarization. Two-dimensional echo-cardiography revealed a hypertrophic myocardium without abnormal regional wall motion, good left ventricular function and ejection fraction of 65%. The presumptive prediction of a culprit artery based on the ECG recorded on admission was conclusive for inferior AMI. Fibrinolytic therapy was started 3 hours after the onset of chest pain. Resolution of ST segment elevation and relief of chest pain occurred within one hour of the infusion. On the fifth day after admission, the patient had a nonsustained ventricular tachycardia (VT) which was resolved with amioda-one. Angiography showed acute occlusion of the mid portion, right coronary artery (RCA) and collateral circulation in the distal portion. Discussion and conclusion Malignant ventricular arrhythmias can result from isolated inferior wall AMI, but literature reports on this phenomenon are rather rare. Collateral circulation can prevent myocardial ischemia and preserve myocardial function, but does not provide protection against exercise-induced myocardial ischemia.
Treatment of neglected and abused children and their families in the context of complicated divorce
Authors: Draganic-Gajic Saveta , Calovska-Hercog Nevena , Lecic-Tosevski Dusica , Pilija Vladimir
Published: July 2006

Introduction Conceptualization of complicated divorce, as an escalation of systemic dysfuncttoning in a highly disturbed and unbalanced system, acquires attributes of trauma-organized-system, and yields itself for therapeutic interventions. Complicated divorce issues The authors comment on their experience while treating families sent by Court order in divorce custody disputes, with explicit aim of evaluating parental competence. This type of systemic dysfunction is severely affecting communication styles, family rules and norms, whereas parenting is frequently marked by tendency to repeat relational-style experienced in marital, partners' conflicts. Feelings of discontent and resentment are projected onto children, and may take form of disqualifications, rejection, discrimination or else, those feelings stemming out of personal ambition such as favoring children. Parental rivalry worsens these processes, leading to attempts of establishing inappropriate level of control over children (instrumentalisation or favorisation). Therefore, care and protection of children is inadequate and children are emotionally neglected. Discussion and conclusion Many of these highly disturbed families, especially those sent by Court order are engaged in a network of different social, legal and mental health institutions. Intervention plans are thus conceived and specifically tailored to suit individual families, confronting dysfunctional patterns and appealing to enhance parental responsibilities. Overcoming family crisis of complicated divorce where children?s emotional needs are neglected is highly indicated for systemic intervening. The authors discuss their experience in treating such families and offer their questions, dilemmas and recommendations.
Effect of glycemic control on microalbuminuria and arterial blood pressure in patients with type 1 diabetes
Authors: Vasovic Olga , Zamaklar Miroslava , Lalic Katarina , Milosevic Dragoslav , Zikic Ljiljana , Popovic Ljiljana
Published: July 2006

Introduction Diabetic nephropathy is the leading cause of hypertension in type 1 diabetes. Microalbuminuria is usually the first manifestation of renal disease and antedate hypertension. The aim of this study was to investigate relationships between glycemic control, hypertension and microalbuminuria in type 1 diabetics. Material and methods We studied 27 type 1 diabetics, 18 male and 9 female, aged 18-50 years, with a duration of diabetes <20 years. Glycemic control was assessed using glycosylated hemoglobin (HbAlc) measurements, fructosamine and lipid analysis. 24-h urinary albumin excretion rate was evaluated by radioimmunoassay. Patients with persistent urinary albumin excretion rate 30-300 nig/24 h were defined as microalbuminuric (Group A -41% patients) and lower than that, as normoalbuminuric (Group B -59%). We examined them twice: first in poor glycemic control and then in good glycemic control. Results We found significant differences (Student's t-test) between groups in regard to microalbuminuria (p<0.01), diabetes duration (p<0.05), systolic blood pressure (BP) and diastolic BP (p<0.05). Systolic BP (p<0.01), diastolic BP (p<0.01) and microalbuminuria (p=0,05) positively correlated (Spearman's rho) with poor glycemic control in Group A. In both groups there was a significant improvement in glycemic control and regression in systolic and diastolic BP (p<0.01), but only Group B showed significant reduction in urinary albumin excretion rate (p<0.0l). Discussion and conclusion In this study, type 1 diabetics showed regression in systolic and diastolic hypertension with improvements of glycemic control regardless of presence of microalbuminuria, but only normoalbuminuric showed significant reduction in urinary albumin excretion rate.
Computer-assisted spatial reconstruction of cerebral blood vessels and intracranial aneurysms
Authors: Nikolic Igor
Published: July 2006

Introduction. Today, many medical procedures are based on image analysis with the aim of providing accurate diagnosis and optimal treatment. The goal of this report was to present clinical implications of computer-assisted geometric design of carotid aneurysms. Material and methods. In this study, the three-dimensional reconstruction was based on the approximation power of the parametric spline function, which achieves interpolation and surface fitting of the arterial information obtained by conventional angiography. Two views of conventional angiograms (anterioposterior and lateral views) were used with a personal computer and commercial software. Results. This method of three-dimensional generated images was applied in 45 cases of cerebral aneurysms in carotid bifurcation. 3D reconstructions were made in approximately 20 minutes. They contributed to assessing vascular structures, and it was possible to rotate the three-dimensional image in different angles. Conclusion. Three-dimensional reconstruction of cerebral vessels is very useful for discussing surgical strategies preoperatively. Furthermore, it could also be used in endovascular procedures. .
Gross characteristics of placentas from an assisted reproduction program
Authors: Tabs Dunja , Vejnovic Tihomir , Lalosevic Dusan , Radunovic Nebojsa
Published: July 2006

Introduction. Even though placentas from assisted reproduction programs often differ from placentas of women who conceived naturally, they are rarely examined. The aim of our investigation was to determine some gross characteristics of placentas of women who conceived with assisted reproduction. Material and methods. We examined 30 placentas from an assisted reproduction program (20 from in vitro fertilization and 10 from intrauterine insemination) and 30 placentas of women who conceived naturally. All women were age matched. All the women were at term. Results. The mean weight of placentas from assisted reproduction program was 573 g and of those after natural conception - 582.67g. The mean length of the umbilical cords was 64.3cm after assisted reproduction and 66.3cm after natural conception. The mean placenta thickness after assisted reproduction was 2,22 cm and after natural conception 2.28 cm. Eight pla?centas of the study group had a marginal insertion of the umbilical cord, which lead to a statistically significant difference when compared to placentas of women who conceived naturally: ?? =7.07; p>0.01. Discussion. Marginal cord insertion into the placenta after assisted reproduction is also often described in the literature (as a possible "consequence " of embryo-transfer). Conclusion. There were no statistically significant differences in the mean weight and dimensions of placentas, length of the umbilical cord, gross pathological features of placentas and cords, mean birth weight of babies and placental/fetal ratios between women from assisted reproduction program and those who conceived naturally. .
Head-to-head comparison of clinical, biochemical and functional effects of fosinopril and enalapril in patients with systolic heart failure
Authors: Otasevic Petar , Putnikovic Biljana , Vukajlovic Zelimir , Ilisic Bojan , Neskovic Aleksandar
Published: July 2006

Introduction. The aim of this study was to evaluate short-term clinical, bio?chemical and functional effects of fosinopril versus enalapril in patients with heart failure. Material and methods. 59 consecutive patients (mean age 57?8 years, EF 18.9?6.3%, NYHA III or IV class 19/59) -were randomized to receive fosinopril or enalapril for three months. All patients underwent echocardiography, metabolic testing, and a 6-minute walk test and completed the Minnesota questionnaire on inclusion and three months later. Additionally, serum creatinine, BUN, total cholesterol and triglycerides were measured. Kaplan-Meier curve was created to assess event-free survival for cardiac death and hospitalization for heart failure. Results. There was no statistically significant difference in event-free survival between patients on fosinopril and enalapril (86.7% vs. 82.8%, log rank 4.21 p=0.43). However, time to the event was longer in patients on fosinopril (77.0?25.35 vs. 40.2?6.8days, p=0.04). At the end of the study, no difference between fosinopril and enalapril group existed with respect to maximal oxygen consumption (20.90?4.47 vs. 20.89?6.86 ml/kg/mm), ejection fraction (20.5?7.4 vs. 2L4?7.8%), distance during the 6-minute test walk (313?74 vs. 352?129 meters) and quality of life (23.8?15.8 vs. 25.6?20.3 points), but patients on enalapril had higher creatinine (99?13 vs. 113?17 umol/L, p=0.002) and BUN (7.28?1.7vs. 8.89?2.39 mmol/L, p=0.01) levels. Increase in fosinopril dose during the study was higher than increase in enalapril dose (24.1%?23.8% vs. 9.5?24.5%, p=0.04). Conclusions. Fosinopril and enalapril have similar short-term effects on event-free survival, ejection fraction, functional capacity and quality of life in patients with heart failure. Patients on fosinopril presented with longer survival without event and had lower creatinine and BUN at the end of the follow-up. Additionally, fosinopril can be easily titrated to the maximum therapeutic dose. .
Esophageal atresia and situs inversus - an unusual association of abnormalities - a case report
Authors: Bukarica Svetlana , Marinkovic Smiljana , Borisev Vladimir , Antic Jelena
Published: July 2006

We present a case report of a neonate with esophageal atresia and tracheoesophageal fistula. In the 31st week of gestation, maternal polyhydramnions was observed by prenatal ultrasonography. Postnatal insertion of an orogastric tube into the stomach was unsuccessful. On auscultation, the apex of the heart was heard at the right side of the thorax, while the liver was palpable I cm below the left rib cage. Esophageal atresia with tracheoesphageal fistula and situs inversus of the thoracic and abdominal organs was diagnosed. During the first day of life, left transpleural thoracotomy was performed. The fistula was closed and esophageal anastomosis performed. One year after the operation the child had no difficulties when eating solid and liquid foods. More than 50% of infants with esophageal atresia have associated anomalies and the esophagogram showed good passage of contrast with anastomotic stricture. This was the first report of esophageal atresia with tracheoesophageal fistula repair in a patient with situs inversus treated in our Clinic. .
Hypertension in peritoneal dialysis patients
Authors: Lausevic Mirjana , Jovanovic Natasa , Bontic Ana , Stojimirovic Biljana
Published: July 2006

Introduction. Continuous ambulatory peritoneal dialysis (CAPD) is effective in reducing blood pressure. Mean arterial pressure falls within 6 months of starting CAPD in the majority of patients. This improved blood pressure control reflects removal of excess fluid volume and body sodium. However, after several years, there is a decline in the efficacy of CAPD in controlling blood pressure. High incidence of hypertension in long-term CAPD patients may be related to hypervolemia as a consequence of loss of residual renal function (RRF), loss of ultrafiltration (UF) due to functional or structural changes in the peritoneal membrane, to a more liberated intake of sodium and fluid, or to administration of erythropoietin. The aim of the present study was to compare the efficacy in blood pressure control in peritoneal dialysis patients depending on the dialysis modality and duration, RRF and dialysis adequacy. Material and methods. This study was a retrospective analysis of 67 patients who attended our Clinic monthly in 2003. All patients received antihy?pertensive therapy (monotherapy-16 pts, two drugs-27 pts, three drugs-22 pts and four-2 pts.). Results. The prevalence of hypertension (TA > 140/90 mmHg) was 73.13%. Most of them (50.75%) had mild hypertension (mean value TA < 160/100 mmHg). There was no statistically significant difference in hypertension prevalence between diabetic (78.27%) and non-diabetic patients (75%). The prevalence of hypertension in patients with residual diuresis of more than 1000 ml was 36.6%, but there were 80.64% patients with residual diuresis less than 500 ml. A statistically significant negative correlation was found between D/DO, UF volume and systolic blood pressure and RRF, D/DO and Ccr and diastolic blood pressure. A statistially significant positive correlation was found between age, body weight, duration of dialysis and systolic blood pressure and age and diastolic blood pressure. Conclusion. We can conclude that duration of PD treatment has a negative effect on blood pressure control. Residual renal function plays an important role in volume and blood pressure control. High and high average transporters are the two groups of patients at increased risk of developing hypertension, especially if they are anuric. .