bluuebunny/crossref_metadata_2025 huggingface dataset:
Maternal smoking during pregnancy and socioeconomic factors as predictors of low birth weight in term pregnancies in Nis
Authors: Stojanovic Miodrag , Bojanic Vladmila , Musovic Dijana , Milosevic Zoran , Stojanovic Dusica , Visnjic Aleksandar , Vucic Miodrag , Milosavljevic Ivica , Vidanovic Miroslav
Published: December 2010

Background/Aim. Low birth weight (LBW) is a result of preterm birth or intrauterine growth retardation, and in both cases is the strongest single factor associated with perinatal and neonatal mortality. It is considered that socioeconomic factors, as well as mothers bad habits, play the most significant role in the development of LBW, which explains notable number of researches focused on this particular problem. The aim of this study was to characterize socioeconomic factors, as well as smoking habits of the mothers, and their connection with LBW. Methods. The questionnaire was carried out among mothers of 2 years old children (n = 956), born after 37 gestational weeks. The characteristics of mothers who had children with LBW, defined as < 2 500 g, (n = 50), were matched with the characteristics of mothers who had children ? 2 500 g, (n = 906). For defining risk factors, and protective factors as well, we used univariant and multivariant logistic modeles. Results. As significant risk factors for LBW in an univariant model we had education level of the mothers, smoking during pregnancy, smoking before pregnancy, the number of daily cigarettes, the number of cigarettes used during pregnancy, paternal earnings and socioeconomic factors. In a multivariant model the most significant factors were socioeconomic factors, education level of the mothers, paternal earnings and mothers smoking during pregnancy. Conclusion. Smoking during pregnancy and socioeconomic factors have great influence on LBW. Future studies should be carried out in different social groups, with the intention to define their influence on LBW and reproduction, as well. This should be the proper way of adequate health breeding planning for giving up smoking, the prevention of bad habits and melioration of mothers and children health, as the most vulnerable population.
Psychological assessment of persons following suicide attempt by self-poisoning
Authors: Dedic Gordana , Djurdjevic Slavisa , Golubovic Boris
Published: December 2010

Background/Aim. Urgent psychiatric help and effective psychotherapeutic treatments are required soon after revival of a person after suicide attempt by self-poisoning. The aim of this article was to define an assessment of actual psychological characteristics of a person after suicide attempt by self-poisoning in order to apply psychotherapeutic crisis intervention after suicide attempt, as well as to show an approach to the treatment guided by the assessment that uses a psychodynamic model of suicidal crisis intervention based on our clinical experience. Methods. Hamilton Depression Rating Scale (HAMD), Center for Epidemiological Studies- Depression Scale (CES-D), Defensive Questionnaire Scale (DSQ-40), Scaling of Life Events (Paykel), and Pierce Suicide Intent Scale (SIS) were applied in 30 hospitalized persons following suicide attempt by self-poisoning and in 30 patients who had asked for psychiatric examination at the outpatient clinic due to various life crises not resulting in suicide attempt. The examinees of both groups were matched by sex, age, and education, professional and marital status. Comparison of the patient groups was done by the ttest. Logistic regression analysis was used for suicidal risk assessment. Results. The suicide attempters were depressed (HAMD = 22.60 ? 5.93, CES-D = 29.67 ? 7.99), with medium suicide risk factor (SIS = 4.5 ? 4.17), using immature (projection, dissociation, devaluation, acting-out) and neurotic (altruism) defense mechanisms. The most important motives for suicide attempt were separation problems, problems with parents and a problem of loneliness. The commonest feelings and thoughts of a subject preceding suicide attempt were a wish to escape an unbearable situation, loss of control, desire to show love for a partner and wish to be helped. After a suicide attempt, 90% of the persons felt relief because the attempt failed, although almost half of them intend to repeat it. The risk of repeated suicide attempt was 1.8 (90% CI = 0.09-37.70, p < 0.001) times higher if values on the SIS Total Score were increased and 1.62 (90% CI = 0.03-81.39, p < 0.001) times higher if values on the SIS 1 (Circumstances Score) subscale were increased, too. Conclusion. Before starting with psychotherapy for persons after suicide attempt by self-poisoning it is very important to define psychological assessment of a person, choose the treatment (out-patient clinic or inpatient/ hospital), assess indications for pharmacotherapy and psychotherapy that also must include a selection of patients for application of this therapeutic method. Assessment of conscientious and unconscientious conflicts leading to a suicide attempt represents initial basis for a therapist's work with a patient after suicide attempt and for application of psychotherapeutic crisis intervention.
Splenomegaly and thrombocytopenia in patients with liver cirrhosis
Authors: Djordjevic Jelena , Svorcan Petar , Vrinic Dusica , Dapcevic Branka
Published: December 2010

Backgroud/Aim. Splenomegaly is a frequent finding in patients with liver cirrhosis and portal hypertension and may cause hypersplenism. The occurrence of thrombocytopenia in those patients can be considered as an event with multiple etiologies. Two mechanisms may act alone or synergistically with splenic sequestration. One is central which involves either myelosuppression because of hepatitis viruses or the toxic effects of alcohol abuse on the bone marrow. The second one involves the presence of antibodies against platelets. It also depends upon the stage and etiology of liver disease. The aim of the study was to investigate a correlation between the platelet count and spleen size and the risk factors for thrombocytopenia in patients with liver cirrhosis. Methods. We studied 40 patients with decompensated liver cirrhosis who were hospitalized in the Department of Gastroenterohepatology. The liver function was graded according to Child Pugh score. Spleen size was defined ultrasonografically on the basis of craniocaudal length. Suspicion of portal hypertension was present when longitudinal spleen length was more than 11 cm. Thrombocytopenia was determined by platelet count under 150 000/mL. Results. We did not find any significant correlation between hepatic dysfunction and spleen size (p = 0.9), and between hepatic dysfunction and thrombocytopenia (p = 0.17). Our study did not find any significant correlation between spleen size and peripheral platelet count (p = 0.5), but we found a significant correlation between thrombocytopenia and etiology of cirrhosis - decreased platelet count was more common among patients with cirrhosis of alcoholic etiology than in other etiologies of cirrhosis (p = 0.001). Conclusion. According to our study, liver cirrhosis, portal hypertension and thrombocytopenia could be present even in the absence of enlarged spleen suggesting the involvement of other mechanisms of decreasing platelet account.
Two male patients with incontinentia pigmenti
Authors: Minic Snezana , Novotny Gerd , Medenica Ljiljana , Obradovic Miljana , Stefanovic Bratislav , Trpinac Dusan
Published: December 2010

Background. Incontinentia pigmenti (IP) is a rare, complex, X-linked genodermatosis in which skin changes are combined with defects of other organs. It appears almost exclusively in females and is usually lethal in men. It is estimated that according to the available reported cases, there have been approximately 900-1 200 affected individuals, out of which 60 males. The aim of the study was to report two additional individual male cases with IP. Case reports. We discovered two male patients with IP according to standard IP diagnostic criteria. The diagnosis was made by a dermatologist and confirmed by cutaneous histopathology and ultrastructural analysis. The pedigrees, karyotype analyses and routine laboratory findings were made. Two male probands were the only ones with IP in their families, with no history of miscarriages. Both probands had normal karyotype. In one proband, acrocentric chromosomes of the group D had tendency of forming associations. Histopathological and ultrastructural skin analyses revealed findings typical for IP. Conclusion. The detection of each male case is very valuable because of their rarity. Application of the standard diagnostic criteria is necessary for comparison and epidemiological analysis. Monitoring such probands allows a better determination of how genetic transmission occurs, and is important because of the different degrees of severity of IP.
Blink and masseter inhibitory reflexes in Parkinson's disease
Authors: Stamenovic Jelena , Djuric Stojanka , Djuric Vanja
Published: December 2010

Background/Aim. Idiopathic Parkinson's disease (PD) is a chronic, progressive, neurodegenerative disorder with prevalence from 60 to 187 per 100 000 persons in general population. The aim of the study was to determine the abnormalities of the blink reflex (BR) and the masseter inhibitory reflex (MIR) in parkinsonian patients, as indices of the functional status of brainstem neuronal network, and abnormality level dependence on disease progression. Methods. The investigation was conducted at the Clinic of Neurology, Clinical Center Nis, comprising a group of 60 subjects of both sexes, suffering from idiopathic Parkinson's disease in I-IV stages, according to the Hoehn and Yahr scale. The control group included 30 healthy subjects of both sexes and corresponding age. Testing of the patients was performed during the 'on' phase by registering MIR and BR. Results. Latency of polysynaptic R2 and R2' blink reflex responses and latency of polysynaptic S2 response, as well as a silent period of MIR, are linearly shortened in the subjects with PD, and more expressed in the subsequent stages of the disease compared to the control group. Conclusion. There is a positive correlation between the applied neurophysiological tests results and clinical stage of PD.
Topographic localization of an intraocular foreign body by B-scan echography
Authors: Stefanovic Ivan , Dacic Bojana , Novak Sasa , Veselinovic Dragan , Jovanovic Predrag , Dzunic Boban , Tomasevic Branislav
Published: December 2010

Background/Aim. In cases of blurred optic media the ultrasound diagnostics offers useful data about eventual presence of intraocular foreign body as well as about its precise localization in the eye. The aim of this study was to retrospectively analyze echographic findings in patients with the diagnosis of intraocular foreign body with a special interest in localizations of a intraocular foreign body in the eye and the presence of an eventual infection - endophthalmitis. The aim of this study was also to confirm the localization of intraocular foreign body by echography and to test the precision of this method. Methods. We performed analysis of all cases that had been referred to the ultrasound diagnostices, in which the presence of intraocular foreign body had been confirmed in the period of one year. All examinations were done with B-scan and were confirmed during the surgery - vitrectomy. Results. In the one-year period we were contacted by 27 patients with intraocular foreign body. In one injured eye the intraocular foreign body was in the lens (3.7%), in 10 injured eyes (37.03%) intraocular foreign body was in the vitreal body. In 15 patients (55.5%) intraocular foreign body was fixed in the retina. In one patient (3.7%) there was a perforating injury, intraocular foreign body was found in the retrobulbar part of the orbit. In 7 injured eyes (25.9%), with the presence of intraocular foreign body, we found signs of endophthalmitis (organized blurring in vitreal space, thickened choroid). Other accompanying echographic findings were: blood in vitreal space, haemophthalmus in 12 cases (44.4%), retinal detachment in 5 cases (18.5%) and subretinal hemorrhagies in 4 cases (14.8%). Conclusion. Ultrasound diagnostics can very precisely show the localization of intraocular foreign body in the eye that is very important in the choice of approach and timing of surgical treatment. Also the echographic diagnostics may find an accompanying endophthalmitis in the posterior segment of the eye, that is very important for an urgent therapeutic approach.
Comparative analysis of two different methods of anaerobic capacity assessment in sedentary young men
Authors: Klasnja Aleksandar , Drapsin Miodrag , Lukac Damir , Drid Patrik , Obadov Slavko , Grujic Nikola
Published: December 2010

Background/Aim. The Wingate anaerobic test is a valid and reliable method of measuring anaerobic capacity. The aim of this study was to determine whether other modified test can be used instead of the Wingate test. Methods. A group of 30 sedentary young men were first tested with a cycle ergometer (classic Wingate test), and then with a dynamometer during 30 s of 'all out' leg extension exercise (modified Wingate test; WAnTe) in order to test anaerobic capacity. Subsequent correlations between these tests were made. Results. Peak power, mean power on cycling ergometer in absolute and relative values were 463 ? 105 W, 316.7 ? 63.8 W, 5.68 ? 1.17 W/kg, 3.68 ? 0.78 W/kg, respectively. On a dynamometer absolute and relative values of maximal and mean load in kg and power in Watts were 136.54 ? 21.3 kg, 1.67 ? 0.26; 128.65 ? 19.93 kg, 1.57 ? 0.24 kg, 657 ? 125.87 W, and 8 ? 1.54 W/kg, respectively. There was no correlation between 5 s intervals of the classic Wingate test and WAnTe during the first, fourth and fifth intervals, but in the second (r = 0.49, p < 0.05), third (r = 0.38, p < 0.05) and last 5 s intervals (r = 0.39, p < 0.05), and also in peak power and mean power (r = 0.42, p < 0.05 and r = 0.45, p < 0.05 respectively), a significant positive correlation was detected. Conclusion. A modified Wingate test of leg extension on a dynamometer in sedentary young men shows a correlation with the classic Wingate test only in parameters of peak power, and mean power and the second, the third and the last 5 s intervals. Because of that it should only be used for orientation, whereas for precise measurements of anaerobic capacity the classic Wingate test should be used.
Possible factors for ankle fractures
Authors: Tabakovic Dejan , Manojlovic Radovan , Kadija Marko , Ille Mihailo , Turkovic Goran , Vukasinovic Zoran
Published: December 2010

Background/Aim. Classification of ankle fractures is commonly used for selecting an appropriate treatment and prognosing an outcome of definite management. One of the most used classifications is the Danis-Weber classification. To the best of our knowledge, in the available literature, there are no parameters affecting specific types of ankle fractures according to the Danis-Weber classification. The aim of this study was to analyze the correlation of the following parameters: age, body weight, body mass index (BMI), height, osteoporosis, osteopenia and physical exercises with specific types of ankle fractures using the Danis-Weber classification. Methods. A total of 85 patients grouped by the Danis-Weber classification fracture types were analyzed and the significance of certain parameters for specific types of ankle fractures was established. Results. The proportion of females was significantly higher (p < 0.001) with a significantly higher age (59.9 years, SD ? 14.2) in relation to males (45.1 years, SD ? 12.8) (p < 0.0001). Type A fracture was most frequent in the younger patients (34.2 years, SD ? 8.6), and those with increased physical exercises (p = 0.020). In type B fracture, the risk factor was osteoporosis (p = 0.0180), while in type C fracture, body weight (p = 0.017) and osteoporosis (p = 0.004) were significant parameters. Conclusion. Statistical analysis using the Danis-Weber classification reveals that there are certain parameters suggesting significant risk factors for specific types of ankle fractures.
Influence of healthcare institution managers' proactive approach to communication activities on patient satisfaction
Authors: Filipovic Vinka , Cicvaric Slavica , Stavljanin Velimir , Damnjanovic Vesna , Radojicic Zoran , Zarkic-Joksimovic Nevenka , Gogic Aleksandra
Published: December 2010

Background/Aim. Over the recent years customer satisfaction program as a tool for patient satisfaction has been recognized as an important issue in healthcare services. The aim of this preliminary study was to explore an influence of healthcare institution managers' approach and attitudes to marketing and public relations activities (communication activities), in the context of implementation of customer satisfaction programs, on patient satisfaction. Methods. The study was conducted among managers from different state-owned healthcare institutions (healthcare centers, clinics, hospitals) in Serbia. The structured questionnaire form, comprising both open and closed questions, was used as a main research tool. The total number of sent questionnaires was 120; 56 questionnaires were sent back, while 49 of them were valid. Results. It was shown that 42.9% of healthcare institutions apply proactive media approach, and that 35.7% of the organizations have a person who, besides his/her basic engagements, performs activities connected with marketing and public relations. Using Chi-square likelihood ratio test it is confirmed that these activities have a significant role in supporting customer satisfaction program implementation (p < 0.05). The results showed that in 69.4% cases, positive attitude of healthcare institutions managers toward marketing and public relations activities had positive influence on patient satisfaction (p < 0.05). Conclusion. Managers in healthcare sector in Serbia who used proactive approach toward media and who had already institutionalized communication activities with external stakeholders have a positive attitude to implementation of customer satisfaction program. Furthermore, managers' attitude toward communication activities has influence on patient satisfaction.
Hyperbaric oxygenation effects determination in the therapy of chronic occlusive lower extremities arteries disease by the use of perfusion scintigraphy
Authors: Zoranovic Uros , Jevtic Miodrag , Jovanovic Milan , Pucar Dragan , Cizmic Milica
Published: December 2010

Background/Aim. Hyperbaric oxygenation (HBO) is a medical treatment of a patient with 100% oxygen inspiration under the pressure higher than atmospheric in a special unit designed to let the whole patient's body rest in a chamber. The aim of the study was to determine the effect of the application of HBO treatment on the patient's lower extremities with chonic inoperabile occlusive disease by measning the parameters of perfusion scintigraphy (perfusion reserve, relative perfusion). Methods. This investigation included 22 patients (19 males and 3 famales). Following clinical assessment of lower extremities condition according to the skin appearance and its adnexa, claudication distance was performed. Clinical condition was graded by the use of 5-point nominal scale. In all of the patients 99mTctetraphosmine lower extremities scintigraphy was done ten days prior to the treatment start and ten days after the treatment with HBO. Lower legs were imaged from the posterior view. Prior to imaging the patients were obligatory lying approximately half an hour. Results. In 18 (86%) of the patients there was an improvement manifested as better subjective condition and better skin and its adnexa appearance. Following HBO treatment there was a statistically significant change in collecting the radiopharmac at rest. This finding indicates an increased viability of muscles as well as an increased perfusion reserve. Perfusion reserve mean values increased from 39.99 to 50.86%, and from 38.46 to 49.33% for the right and the left lower leg, respectively. This parameter clearly indicates favorable effects of HBO treatment pertaining neoangiogenesis and, consequently, increased viability of the lower leg muscles. It was also obvious in visual analysis of the obtained images. Conclusion. The obtained results confirm that muscle perfusion measured by the parameters of perfusion scintigraphy using 99mTc-tetrophosmine (perfusion reserve, relative perfusion) in patients with inoperable occlusive disease of the lower leg arteries significantly increases after the application of HBO treatment.
Vasculature of the distal part of optic nerve
Authors: Nagulic Mirjana , Cetkovic Mila , Manojlovic Radovan , Nikolic Igor , Alempijevic Djordje , Vitosevic Zdravko
Published: December 2010

Background/Aim. Vascularisation of the distal, namely intracranial and intracanalicular parts of the optic nerve have not been explained in conventional textbooks of anatomy, while there have been explanations of proximal, that is intraorbital segment. The aim of this research was to study the pattern of arterial supply of the intracranial and intracanalicular part (the distal part) of human optic nerve. Methods. The optic nerve and the ophthalmic artery (OA), predominately in their intracranial and intracanalicular parts, were investigated in 25 human specimens by three different methods: macroscopic, stereomicroscopic, and histological observations. Mixture with 10% of India ink and gelatin was injected through the intracranial part of the internal carotid artery, and the most proximal part of the OA. Each optic canal specimen was fixed in formaldehyde and finally paraffin embedded, sectioned, and stained with Masson trichrome, Azan, Toluidin blue, and Van Gieson methods. Results. OA passed through the optic canal within the dural sheath of the optic nerve. In 44% of our specimens the OA was on the inferomedial side of the optic nerve at the entrance point to the optic canal. OA left the optic canal at its lateral border in the apex of the orbit in 72% of our specimens. The intracanalicular portion of the optic nerve receives arterial blood principally from the intracanalicular part of OA. OA gives one (72% of the specimens) to two branches that supply the intracanalicular part of the optic nerve. Each branch pierces the dura mater from below and then supplies the nerve through the pia mater. These arteries then terminate in a pial vascular network of continuous transverse centripetal arterioles and capillaries that surround each optic nerve. The rich anastomoses with branches of superior hypophyseal artery, from the cranial cavity, which take part in the optic nerve vascularization in its hole length, was observed. There were no intraaxial vessels in the intracranial and intracanalicular parts of the nerve in our specimens. Conclusion. These anatomical data offer important informations for understanding the variety of the pathology in the region of optic canal and orbitocranial junction, and is also useful for designing operative strategies. This report indicates the delicacy and vulnerability of the intracranial and intracanalicular capillary network to traumatic disruption.
Suicide risk factors in the professional military personnel in the Army of Serbia
Authors: Dedic Gordana , Panic Milivoje
Published: December 2010

Background/Aim. Recognition of suicide risk factors is important in taking adequate suicide preventive measures, Suicide Prevention Program for Professional Military Personnel (PMP) implemented in the Army of Serbia in 2003. The aim of our study was to establish suicide risk factors in PMP of the Army of Serbia. Methods. Analysis of suicide risk factors in PMP was carried out on the basis of data obtained by psychological suicide autopsy. The controls were demographically similar psychiatric outpatients with no history of suicidal behavior. A descriptive statistics method was used for risk factors analysis. The t-test was used for testing statistical hypotheses. Results. A total of 30 PMP, aged 22-49 years (30.53 ? 6.24 on average) committed suicide within the period 1998-2007. Distal suicide risk factors in PMP were considered to be not being married, psychiatric heredity, having no outpatient psychiatric treatment, gambling, regular physical practice (bodybuilding), less transfer to a different post, low motivation for military service (p < 0.001), not having children, parental loss in early childhood, alcohol abuse (p < 0.005), low salary (p < 0.01) uncompleted military school, debts in the family (p < 0.05). The commonest proximal suicide risk factors were: actual family problems (36.6%), actual mental problems (13.3%), burnout (13.3%), negative balance of accounts (13.3%), professional problems (6.7%), behavioral model while for 10.0% PMP suicide risk factors could not be established. Conclusion. According to the presence of multiple suicide risk factors, Suicide Prevention Program for PMP in the Army of Serbia is directed to the prevention of both proximal and distal suicide risk factors.
Principles of surgical treatment of congenital, developmental and acquired female breast asymmetries
Authors: Novakovic Marijan , Lukac Marija , Kozarski Jefta , Stepic Nenad , Djordjevic Boban , Vulovic Dejan , Rajovic Milica , Milev Bosko , Milicevic Sasa
Published: December 2010

Background/Aim. There is a natural asymmetry in normal female brests. When the difference in the shape, size or position of the breast and nipple-areola complex is visible, surgical correction is the only treatment option and presents one of the greatest challenges for a plastic surgeon. Based on the Nahai classification presented in details, the aim of the study was to present the possibilities of plastic surgery to correct primary (congenital), secondary (developmental) and tertiary (acquired) brest asymmetries. Methods. We conducted a retrospective analysis of female breast asymmetry surgeries performed in the Clinic for Plastic Surgery and Burns, Military Medical Academy (MMA), Belgrade over the last seven years (January 2002 - January 2009). Results. During the above mentioned period, 82 female patients, 18 - 65 years of age, underwent surgery for breast asymmetry. The most frequent asymmetries were developmental, 'pubertal' (n = 43); acquired asymmetries as a consequence of tumor surgery were found in the other 22 patients, while 7 patients were diagnosed with primary asymmetries such as congenital chest-wall asymmetry (Sy. Poland), accessory and tuberous breasts. All patients underwent preoperative ultrasound examination, while hormone status was determined in those with developmental, 'pubertal' asymmetries. The selection of surgical procedure for correction of breast asymmetry depended upon clinical examination findings and patient's wish relating to the shape and size of the breasts. The most of breast asymmetries were corrected by a combination of surgical procedures including primary and secondary reconstruction, reduction, suspension or augmentation mammoplasty. Having combined different surgical procedures, we managed to achieve satisfactory results. The hypertrophic scar formation after reduction mamoplasty was seen in some cases, however, they caused no significant patient's discomfort. Conclusion. Application of plastic, reconstructive and aesthetic surgical principles can considerably contribute to achieving excellent results in corrective surgery for breast asymmetries. In addition to most suitable breast asymmetry surgical procedures choice, motivation of a patient is also very important for achieving satisfactory results.
Neuroendocrine gastric carcinoma in a young patient
Authors: Svorcan Petar , Alimpijevic Tamara , Usaj Slavica , Bojic Danijela , Protic Marjana , Djordjevic Jelena , Vrinic Dusica , Krstic Miodrag , Dapcevic Branka
Published: December 2010

Background. Neuroendocrine tumors cover a spectrum of neoplasms showing wide variations in their clinicopathological and pathogenetic features, as well as prognosis. They may develop throughout the whole gastrointestinal tract. Case report. We described a case of gastric neuroendocrine carcinoma in a 29-year-old male. The patient presented with chronic continuous abdominal pain and weight loss over a 6- month period. Preoperative diagnosis, operative findings, histology and immunohistochemistry of the tumor confirmed the diagnosis of the rare neuroendocrine gastric carcinoma, stage T2N1. Conclusion. Case reports of this rare tumor are important, because of the paucity of studies noted in the gastrointestinal literature as a result of poor identification prior to the advent of modern immunohistochemistry. Significance of accurately diagnosing gastrointestinal neuroendocrine tumors is crucial for an appropriate treatment.
Risk of Lyme disease development after a tick bite
Authors: Mladenovic Jovan , Cekanac Radovan , Stajkovic Novica , Krstic Milena
Published: December 2010

Background/Aim. Despite numerous research of Lyme disease (LD), there are still many concerns about environmental of infectious agent of LD, as well as its prophylaxis, diagnosis and treatment. The aim of this work was to determine the risk of LD in relation to the way of removing ticks and duration of tick attachment. Methods. In the period from 2000 to 2007 a prospective study was conducted including persons with tick bite referred to the Institute of Epidemiology, Military Medical Academy, and followed for the occurrence of early Lyme disease up to six months after a tick bite. Epidemiological questionnaire was used to collect relevant information about the place and time of tick bites, the way of a removing tick, duration of tick attachment, remnants of a tick left in the skin (parts of the mouth device) and the signs of clinical manifestations of LD. Duration of tick attachment was determined on the basis of size of engorged tick and epidemiological data. Removed ticks were determined by the key of Pomerancev. Professional removing of attached tick was considered to be removing of tick with mechanical means by healthcare personnel. Fisher's exact test, Chi squares test and calculation of the relative risk (RR) were used for data analysis. Results. Of 3 126 patients with tick bite, clinical manifestations of LD were demonstrated in 19 (0.61%). In the group of subjects (n = 829) in which a tick was not removed professionally there were 17 (2.05%) cases with LD, while in the group of respondents (n=2 297) in who a tick was removed professionally there were 2 (0.09%) cases with LD after tick bite (RR, 23.55; p < 0.0001). The disease was most frequent in the group of respondents with incompletely and unprofessionally removed ticks (2.46%). In the groups of patients with unprofessionally but completely removed ticks LD occurred in 0.89%, while in the group of subjects with a tick removed by an expert, but incompletely in 0.78% cases. The disease occurred rarely in the group with a tick removed completely and professionally (0.05%). There was no case of LD in the group of patients with a tick removed within 24 hours. The longer time of exposure after 24 hours, the higher absolute risk of disease was reported. Conclusion. In prevention of Lyme disease it is important to urgent remove a tick, to use a correct procedure of removing and to remove the whole tick without any remnants.
Monitoring of cytomegalovirus infection after allogeneic stem cell transplantation
Authors: Kuljic-Kapulica Nada , Stamatovic Dragana , Savic Dejana , Jovanovic Dragutin , Tukic Ljiljana , Andjelkovic Nebojsa
Published: December 2010

Background/Aim. More than 90% of worldwide population is infected with human cytomegalovirus (CMV), one of the most common agents which complicate immunocompromised patients. Viral infections, in particular CMV ones are still a major cause of moratality and morbidity after stem cell transplantation (SCT). Monitoring is performed by detecting CMVAg or virus DNA in peripheral blood. Risk factors are donor/ recipient CMV status, type of transplant and acute graft versus host disease. The aim of the study was to determine the extent of validity of CMV infection monitoring after transplantation as a reliable parameter of further CMV replication course in patients with hematopoietic stem cell transplantation. Methods. A total of 49 patients with stem cell transplantation were studied prospectively during a 2-year period after transplantation for the presence of CMV DNA. Polymerase chain reaction (PCR) CMV DNA was performed on 222 full blood samples using Cobas Amplicor assay. Results. Activation of CMV was detected in 10/49 (20.48%) of the patients. The median posttransplantation time for the first positive PCR result was 6 weeks for the stem cell transplant patients. Viremia became negative in all the cases after the antiviral therapy with ganciclovir. Conclusion. Our data show that the level of CMV-DNA load at the time of initial CMV detection after transplantation could be a possible predictor for further course of CMV replication in patients receiving hematopoietic stem cell.
Otoacoustic emissions in hearing screening in children
Authors: Babac Snezana , Petrovic-Lazic Mirjana , Tatovic Milica , Stojanovic-Kamberovic Vesna , Ivankovic Zoran
Published: December 2010

Background/Aim. Prevention of the consequences of hearing loss can be accomplished by early hearing screening of the cochlear function in newborus, but also with continuous hearing screening in the early childhood. The aim of this study was to investigate the reliability and feasibility of otoacoustic emissions (OAE) in hearing screening in children, evaluate the frequency and type of hearing loss and determine etiological factors of these losses. Methods. In the study, 133 children, aged 2 to 7.5 years, were tested on both ears with transient evoked otoacoustic emissions (TEOAE) and distortionproduct otoacoustic emissions (DPOAE). Before screening tests all children had undergone otoscopic examination. If children had not passed either or both hearing screening tests and/or abnormal otoscopic findings in at least one ear, audiological evaluation was scheduled to confirm or exclude hearing loss. Results. Eighty-five percent of children passed the hearing and otoscopic screening bilaterally. For additional audiologic tests 15% of children were referred. Agreement between otoscopic examination and screening tests was very good (agreement for TEOAE 95%, for DPOAE 93%). The results showed that normal tympanograms were very likely to be associated with normal screening tests. Sensitivity of TEOAE test was 94.12%, specificity 78.95%, while DPOAE sensitivity was 87.50% and specificity 75%. Hearing loss was found in 6.76% of the cases, conductive in 6.01% and sensorineural in 0.75%. Conductive hearing loss was a consequence of chronic otitis media with effusion in 25% of the cases, and a consequence of adhesive process in the middle ear in 8.33% of cases. Sensorineural hearing loss was a consequence of using ototoxic medications. Conclusion. TEOAE and/or DPOAE tests are reliable, noninvasive, and feasible methods for hearing screening in childhood.
Status of bone mineral content and body composition in boys engaged in intensive physical activity
Authors: Madic Dejan , Obradovic Borislav , Smajic Miroslav , Obradovic Jelena , Maric Dusan , Boskovic Ksenija
Published: December 2010

Background/Aim. It is well known that physical activity has an anabolic effect on bone tissue. But there is a lack of information about the effect of intensive physical activity in childhood, particularly at the prepubertal stage. To examine the influence of training on body composition and bone mineral density we have studied a group of prepubertal soccer players as well as a group of inactive prepubertal boys at the starting phase of their peak bone mass acquisition. Methods. A total of 62 healthy prepubertal boys took part in this study. They were divided into two groups. The first one consisted of 32 soccer players (aged 10.7 ? 0.5 years), who had been playing football for at least 1 year (10-15 h per week). The second group a control group 30 boys (aged 11.2 ? 0.7 years) doing 1.5 h per week physical activity at school. Body composition was assessed by a Body Fat Analyzer 'BES 200 Z'. Bone mineral density measurements of the left and the right calcaneus were done by using ultrasound densitometer 'Sahara' (Hologic, Inc., MA, USA). Results. There were significant differences between soccer players and the control group in fat mass (p = 0.01). Besides, a significant difference was determined between the group of athletes and the control group in bone mineral density of both calcaneal bones (p = 0.01). Conclusion. The results of this study confirm the significant effects of physical activity on reducing body mass and increasing bone density. Considering that football training can be very easily implemented in the broader population of children and young people, which does not apply to many other sports, it should be used more in the prevention of obesity and osteoporosis.
Evaluation of morphological changes of the liver caused by heroin abuse in forensic practice
Authors: Ilic Goran , Gligorijevic Jasmina , Milosavljevic Ivica , Karadzic Radovan
Published: December 2010

Background/Aim. A study of morphological lesions in the liver of heroin addicts enables a precise overview of the type and degree of the liver damages caused by intravenous (iv) heroin abuse, additive effects of viral infections and alcohol consumption, as well as whether the expressiveness of these lesions depends on the duration of the time period of heroin application. The aim of the study was to investigate histopathological, ultrastructural and morphometric features of the liver of heroin addicts in forensic samples of the liver. Methods. The study involved the autopsy conducted on 40 bodies of iv heroin addicts and 10 control autopsies. The investigated group consisted of liver samples of 36 male subjects and 4 female subjects aged 35-40 years and the control group of 8 male and 2 female cadaveric bodies aged 15-35 years. The liver tissue samples were prepared for light microscopy. Sections of the tissue paraffin blocks 5 ? thick were stained using classical Hematoxylin and Eosin method (H&E), as well as PAS Van Gieson, Gomori, and Congo Red techniques. For investigation purposes of ultrastructural changes, liver tissue was fixed in glutaraldehyde and molded with epon. The analysis was performed using the method of transmission electron microscopy. Morphometric investigation of the liver sinusoidal macrophages was performed by using the M42 test system. Results. In the investigated group of iv heroin addicts, the liver autopsy samples showed degenerative vesicular and fat changes, chronic hepatitis, cirrhosis, sedimentation of pathologic protein amyloidosis, dysplastic changes, reduction in the amount of glycogen in hepatocytes, as well as the change in the number of Kupfer and endothelial cells. The established changes correlated with the duration of iv heroin abuse, whereas sinusoidal macrophages were activated in cases with active hepatitis, and no significant change in their number was found in hepatocytes with alcohol-related fatty changes. Conclusion. The study showed that the most present change in the hepatocytes of drug addicts was vesicular degeneration, and it is the only direct consequence of the effect of heroin. Other morphological changes were present due to viral infections and they correlated with the duration of narcotic abuse. The finding of dysplastic changes in this susceptible population of young people is particularly significant. The forensic significance of the established changes in the liver tissue is in the possibility of their practical application for determination of the immediate cause of death of iv heroin addicts, as well as the differential diagnosis of not only heroin, but also alcohol, sedative and other substances abuse, and all that on the basis of morphological damages of the liver.
Transient lesion in the splenium of the corpus callosum and a sudden antiepileptic drugs withdrawal: A case with focal epilepsy in presurgical evaluation
Authors: Ristic Aleksandar , Lavrnic Slobodan , Zovic Ljubica , Vojvodic Nikola , Jankovic Slavko , Skrijelj Fadilj , Ercegovac Marko , Sokic Dragoslav
Published: December 2010

Introduction. A sudden withdrawal of antiepileptic drugs gives higher rate of epileptic seizures in the settings of video electroencephalography (vEEG), monitoring that is a subject to further registration and analysis. A very rare complication of this method is transient lesion of the splenium of corpus callosum (SCC) detected with brain MRI. Case report. We presented a patient with a 5-year history of pharmacoresistant epilepsy admitted to the Institute of Neurology (August, 2008) for vEEG monitoring. Interictal epileptic discharges but none seizure were recorded after the sudden withdrawal of antiepileptic medications, during 5 days of vEEG monitoring Initial brain MRI three days after vEEG monitoring revealed focal lesion in SCC, hyperintense on T2 and FLAIR sequence. A longitudinal radiological follow-up (7 and 49 days after initial acquisition) confirmed transient nature of the lesion without diffusion coefficient changes. Conclusion. SCC lesion, reversible and harmless, may occur after a sudden antiepileptic withdrawal. Its early detection makes further extensive neuroradiological and clinical examinations unnecessary.
Marsupialization and enucleation of keratocystic odontogenic tumor with the use of Carnoy's solution
Authors: Jovanovic Goran , Buric Nikola , Mihailovic Dragan , Tijanic Milos
Published: December 2010

Introduction. Keratocystic odontogenic tumors (KCOT) or odontogenic keratocysts are aggressive and expansive odontogenic neoplasms with high recurrence rate (25%- 60%). There are a small number of publications about the combination of marsupialization and enucleation with the use of Carnoy's solution for the treatment of KCOT. Case report. In a female patient, aged 24, marsupialization KCOT was done in the first stage, and enucleation with the use of Carnoy's solution in the second stage, six months later. Lost sensibility of the lower lip was reestablished after three months. A postoperation defect was completely filled in seven months. One year later orthopantomographic x-ray showed the presence of a newly formed bone tissue, whereas in 7 years a completely preserved new mandibular bone and recanalisation of mandibular canal were observed. Conclusion. We consider that our method was successful in the treatment of KCOT, with no occurrence of recidives seven years later. However, it is necessary to follow the patient periodically because of a possible late recidive.
Magnetic resonance imaging and bone scintigraphy in bone metastasis detection: A comparative study
Authors: Lucic Silvija , Nikoletic Katarina , Peter Andrea , Lucic Milos , Jovanovic Dusan
Published: December 2010

Background/Aim. Bone scintigraphy is well-known method for the detection of neoplastic lesions with a high sensitivity and, at the same time, a lower specificity. On the other hand magnetic resonance imaging (MRI) is previously established noninvasive imaging method regarding its diagnostic specificity. The aim of this study was to determine the possibilities and to correlate two different diagnostic methods - bone scintigraphy and MRI in the detection of bone metastasis in the spine and pelvic bones. Methods. A total of 123 patients who underwent both bone scintigraphy and spine and pelvic MRI on 1.5 T MR imager were enrolled in this study. Scans were subsequently analyzed in total and divided in regions of interest (cervical, upper, middle and lower thoracic, upper and lower lumbar and pelvic region, which includes sacral spinal segment); afterwards the total number of 585 matching regions were compared and statistically analyzed. Results. The statistical analysis demonstrated significant correlation between the findings of both methods in total. Divided by regions of interest, significant degrees of correlation were demonstrated in all of them, except in the cervical spine region where the r-value was in the range of low correlation. Conclusion. Having a high mutual correlation, bone scintigraphy and MRI are to be considered as the complementary diagnostic methods in the detection of bone metastases. Still, increased diagnostic potential of MRI may highlights negative bone scintigraphy findings in the patients with solitary metastatic lesions or diffuse vertebral infiltration. Advances in the bone scintigraphy (single photon emission tomography - SPECT, SPECTcomputed tomography - SPECT-CT) and MRI (whole body MRI, diffusion MRI), make it possible the diagnostic potential of both methods will result in a further improvement in bone metastasis detection.
Histopathological evaluation of bone regeneration using human resorbable demineralized membrane
Authors: Tatic Zoran , Stamatovic Novak , Bubalo Marija , Jancic Snezana , Racic Alek , Mikovic Nikola , Tatic Natalija , Rakic Mia
Published: December 2010

Background/Aim. Filling a bone defect with bone substitution materials is a therapy of choice, but the infiltration of connective tissue from the mucoperiostal flap may compromise a healing of bone substitutions with bony wall defects. Application of membrane as a barrier is indicated as a solution to this problem. The aim of this study was to show a pathohistological view of bone regeneration and the significance of human resorbable demineralized membrane (HRDM), 200 ? thick in bone regeneration regarding mandibular defects in an experiment on dogs. Methods. The experiment was performed on six dogs. Bone defects were created in all six dogs on the right side of the mandible after the elevation of the mucoperiostal flap. One defect was filled with human deproteinised bone (HDB), and in between HDB and soft tissue RHDM of 200 ? thick was placed. In the second defect, used as a control one, only HDB without RHDM was placed. Two dogs were sacrificed two months after the surgery, another two dogs four months after the surgery and the last two dogs six months after the surgery. After that, samples of bone tissue were taken for histopathological analysis. Results. In all the six dogs with defects treated with HDB and RHDM the level of bone regeneration was much higher in comparison with the control defects without RHDM. Conclusion. Membrane, as a cover of bony defect, is useful and benefits bone regeneration. Bony defects covered with RHDM show better bony healing despite the fact that bone regeneration was not fully complete for as long as six months after the RHDM implantation.
Comorbidity of depression and type 2 diabetes: Risk factors and clinical significance
Authors: Stankovic Zana , Jasovic-Gasic Miroslava
Published: December 2010

nema