bluuebunny/crossref_metadata_2025 huggingface dataset:
Dialysis modalities as risk factors in the development of atherosclerosis
Authors: Damjanovic Tatjana , Dimkovic Nada
Published: July 2006

Introduction Atherosclerosis is a major risk factor for increased cardiovascular morbidity and mortality in dialysis patients. First clinical symptoms are usually associated with initial atherosclerotic changes of blood vessels. The aim of this study was ultrasound evaluation of intimae media thickness (IMT) of carotid arteries in dialysis patients and its correlation with certain risk factors. Patients and methods IMT was measured in 45 dialysis patients with no signs of cardiovascular diseases:15 continuous ambulatory peritoneal dialysis (CAPD) patients, 30 haemodialysis (HD) patients and in 20 healthy controls. IMT was correlated with certain risk factors for atherosclerosis (general parameters - age, gender, duration of dialysis cause of renal diseases, parameters of nutrition, parameters of calcium and phosphorus metabolism, lipid parameters, blood pressure and smoking). Results The mean carotid artery IMT was significantly higher in dialysis patients than in the control group (p<0.05). In addition, the mean IMT was statistically significantly higher in PD than in HD patients (p<0.05). In CAPD patients there was a significant correlation between IMT and total and LDL cholesterol. In the second group (HD patients) IMT was significantly correlated with diastolic blood pressure, BMI and smoking. Conclusion Although atherosclerotic cardiovascular disease may not manifest in dialysis patients, IMT of carotid arteries significantly increases. Major risk factors affecting IMT are lipid disturbances in patients on peritoneal dialysis and hypertension, obesity and smoking in HD patients.
Role and significance of polyunsaturated fatty acids in nutrition in prevention and treatment of atherosclerosis
Authors: Ristic Vanja , Ristic Gordana
Published: July 2006

Introduction Hyperlipoproteinemia is a key factor in development of atherosclerosis, whereas regression of atherosclerosis mostly depends on decreasing the plasma level of total and LDL-cholesterol. Many studies have reported the hypocholesterolemic effect of linolenic acid. Types of polyunsaturated fatty acids (PUFA) Linoleic and ?-linolenic acids are essential fatty acids. The main sources of linoleic acid are vegetable seeds and of ?-linolenic acid - green parts of plants. ?-linolenic acid is converted to eicosapentaenoic and docosahexaenoic acid. Linoleic acid is converted into arachidonic acid competing with eicosapentaenoic acid in the starting point for synthesis of eicosanoids, which are strong regulators of cell functions and as such, very important in physiology and pathophysiology of cardiovascular system. Eicosanoids derived from eicosapentaenoic acid have different biological properties in regard to those derived from arachidonic acid, i.e. their global effects result in decreased vasoconstriction platelet aggregation and leukocyte toxicity. Role and significant of PUFA The n-6 to n-3 ratio of polyunsaturated fatty acids in the food is very important, and an optimal ratio 4 to 1 in diet is a major issue. Traditional western diets present absolute or relative deficiency of n-3 polyunsaturated fatty acids, and a ratio 15-20 to 1. In our diet fish and fish oil are sources of eicosapentaenoic and docosahexaenoic acid. Refined and processed vegetable oils change the nature of polyunsaturated fatty acids and obtained derivates have atherogenic properties.
Tubulointerstitial dysfunction in early post-transplant period
Authors: Djurdjevic-Mirkovic Tatjana , Curic Slobodan , Vodopivec Slavenka , Sedlak-Vadoc Valerija , Stosic Zoran , Mitic Igor , Bozic Dusan , Petrovic Lada , Ilic Tatjana
Published: July 2006

Dysfunction of a transplanted kidney may develop at any time in the post-transplant period. The aim of this study was to differentiate levels of early dysfunction of a transplanted kidney. The study included 45 examinees undergoing kidney transplantation. They were divided into four groups, in regard to length of hospitalization and post-transplant complications: group I (up to 15 days, complication-free); group II (up to 15 days, with complications); group III (up to 30 days); group IV (up to 60 days). The control group included patients undergoing abdominal surgery, without uropoietic system disorders. The following parameters were examined on a daily basis a month after transplantation on average: creatinine clearance, creatinine and urea. Statistical analysis of these parameters revealed the following levels of renal dysfunction: control group - circulatory tubular dysfunction without azotemia; group I - polyuric acute tubular necrosis; group II and group III - severe or moderately severe polyuric acute tubular necrosis and group IV - polyuric acute tubular necrosis.
A successful population-based smoking cessation program
Authors: Hovan-Somborac Jaroslava
Published: July 2006

Introduction Our country is in the third place in Europe concerning tobacco smoking. Although strict law regulations regarding indoor smoking have been brought, the law banning all tobacco advertising, and the behaviour of our population are inadequate. Our objective was to persuade smokers for the 'Quit and Win' campaign and to establish the number of smokers in health personnel employed in health facilities. Material and methods This population-based smoking cessation campaign was coordinated by Federal Institute of Public Health, through a network of Public Health Institutes within the country with the support of national and local media. Results and discussion Quit and Win campaign was organized for the third time. The campaign was realized with the financial support and sponsorship at community level throughout the country. The Federal Ministry provided a national health award. The national and local media accompanied the campaign. The campaign included 3.178 smokers and 2.575 supporters, that is 0.1% of the population over 18 years of age. This is in accordance with participants in some other countries, who had a better support. More than 60% of health care facility employees are smokers. Conclusions Our tradition, habits in the society and overall situation encourage smoking habits to spread in general population. Our campaign has proved that people should be motivated to quit smoking, but they need to be informed. Actions taken in general population and based on a positive smoking cessation program in which smokers are willing to stop smoking have given unexpectedly good results.
Serum copper levels in patients with threatening miscarriage and infection
Authors: Mitreski Anita , Visnjevac Vule , Radeka Gordana , Curcic Aleksandar , Visnjevac Dubravka , Ivanovic Ljiljana
Published: July 2006

Introduction The study evaluates serum levels of copper, chorionic gonadotropin, estradiol, progesterone and prolactin in patients with symptoms of miscarriage and in uncomplicated pregnancies in cases with or without cervical or vaginal infections detected by vaginal or cervical smears, as well as Chlamydia testing. Material and methods The study included 50 patients with symptoms of threatening miscarriage and 50 patients with uncomplicated pregnancies. Hormone levels were determined by ELISA method and copper was evaluated by acid medium colorimetry. Results We found that values of serum copper, estradiol, progesterone and prolactin were significantly lower in patients with lower genital tract infection. Conclusion Decreased levels of serum copper could be used as a method of choice for detecting infection during the first trimester of pregnancy.
Development and differentiation of adipose tissue
Authors: Ivkovic-Lazar Tatjana
Published: July 2006

Introduction For years adipose tissue has been considered inert, serving only as a depot of energy surplus. However, there have been recent changes, undoubtedly due to advancement of methods for studying the morphology and metabolic activities of adipose tissue (microdialysis and adipose tissue catheterization). In normal-weight subjects, adipose tissue makes 10-12% with males and 15-20% with females. About 80 % of adipose tissue is located under the skin, and the rest envelops the internal organs. With humans there are white and brown adipose tissues, which is predominant with infants and small children. Histologic characteristics From a histological point of view, it is a special form of reticular connective tissue, which contains adipocytes with netlike structure. Human adipose tissue has four types of adrenergic receptors with different topographic dispositions, which manifest different metabolic activity of adipocytes of particular body organs. Changes in adipose tissue are associated with the process of adipocyte differentiation. Critical moments for this process are last months of pregnancy, the first six months of infancy and then puberty. However, the differentiation process may also begin during maturity. Namely, as size of adipocytes can increase to a certain limit, this process can be activated after reaching a 'critical' adipocyte volume. The differentiation process is affected by a number of hormones (insulin, glucagon, corticosteroids, somatotropin (STH), thyroid gland hormones, prolactin, testosterone), but also by some other substances (fatty acids, prostaglandins, liposoluble vitamins, butyrate, aspirin, indomethacin, metylxanthine, etc.).
Ovarian epithelial carcinoma: A malignant disease sparing no age groups
Authors: Mandic Aljosa , Nincic Dejan , Vujkov Tamara
Published: July 2006

Introduction Ovarian epithelial carcinoma is one of the most common gynecologic malignancies and the fifth most frequent cause of cancer death in women. Ovarian cancer affects women 65 years of age and older more frequently than younger women. Material and methods Four young patients with ovarian epithelial carcinoma were treated at the Institute of Oncology in Sremska Kamenica, Serbia and Montenegro, in the period 1981-2000. The median age at diagnosis was 17,3 years. Final histopathological findings revealed cystadenocarcinoma, either mucinous or serous. The stage of the disease was established using International Federation of Gynecology-Obstetrics (FIGO) Classification. Spread of the disease dictated the extent of operation and postoperative chemotherapy. Patients were strictly followed-up at the Institute. Results The first two patients underwent unilateral adnexectomy as initial treatment. Final histopathological examination revealed an epithelial ovarian carcinoma, stage IIIa and IIb. Total hysterectomy with unilateral adnexectomy and total omentectomy were performed in both patients as second treatment with chemotherapy, according to the Cisplatin/Carboplatin and Cyclophosphamide (CP) protocol following surgery. Another two patients underwent total hysterectomy with bilateral adnexectomy and total omentectomy as initial treatment with chemotherapy, CP protocol, following surgery. Both patients had stage IIc. Despite treatment, in two patients with stage IIIa and IIc, metastases were diagnosed. In 2 patients survival was over five years. One patient lived less than 3 years, and one less than 4 years. Discussion Ovarian carcinomas are difficult to diagnose at early stage. Histologic confirmation of the diagnosis, surgical staging, and aggressive surgical debulking, when possible, are all part of the initial evaluation and treatment. In most cases, surgery is followed by chemotherapy. The risk increases from 15.7 to 54 per 100,000 in the age group 40-79 years. Our study included 4 patients, medium age 17,3, with epithelial ovarian carcinoma which warns us to think twice when we get an adolescent patient with an adnexal mass. Conclusion Advancing age, the major risk factor for development of ovarian carcinoma is, of course, unalterable. We investigated 4 patients medium age 17,3 years, with epithelial ovarian carcinoma. Pelvic masses found in women of reproductive age, must also be evaluated preoperatively to determine the probability of malignancy.
The role of intravenous cholangio-cholecystography in assessment of asymptomatic choledocholithiasis
Authors: Stojanovic Dragos , Stojanovic Mirjana , Caparevic Zorica , Lalosevic Djordje , Bojkovic Gradimir , Milojevic Predrag
Published: July 2006

Introduction Standard diagnostic procedures (anamnesis, physical examination, laboratory analyses, ultrasound diagnosis), commonly used in diagnosis and preparation for surgical intervention of patients with cholelithiasis, are in most cases a reliable indicator for evaluation of the disease and conditions planned for surgery. Discussion In some cases by application of these narrow diagnostic models, some conditions, anatomic variations and biliary tract malformations remain unrecognized. Asymptomatic ('silent') choledocholithiasis (2.02%) represents a special diagnostic and therapeutic problem. Conclusion Our extended diagnostic protocol includes routine intravenous cholangio-cholecystography as a standard diagnostic procedure for evaluation of cholecysto-choledocholithiasis prior planning cholecystectomy.
Selective neck dissection in the treatment of pN1/2 neck lymph-node metastases
Authors: Jovic Rajko , Canji Karol , Mitrovic Slobodan , Kljajic Vladimir
Published: July 2006

Introduction As yet there is no single reliable and accurate method for detection of neck lymph node metastases. Therapeutic approaches differ from one author to other. The aim of this paper was to establish the extent to which, with good control of primary process, we can control spreading of malignant disease by means of selective neck dissection. Material and method This retrospective study included 595 surgically treated patients in the period 1990 - 1998. There were 525 patients with malignant laryngeal tumors, and 70 patients with malignant hypopharyngeal tumors. Preoperative diagnostics of enlarged lymph nodes was based on palpation of the neck without CT, US, NMR diagnostics. With all risky N0 patients, selective neck dissection was performed for presence of occult metastases. Intraoperative frozen section analysis was not performed. Adjuvant radiotherapy was performed in all patients in whom presence of neck lymph node metastases was histologically proved. Results Selective lateral neck dissection was performed in 389 (65.4%) patients. In 78 (20%) patients, lymph node metastases were patohistologically detected. In 5 (6.4%) transitional cellular cancer was histologically diagnosed, and the remaining 73 (93.6%) presented with squamous cell cancer. Postoperative radiation therapy was applied in 54 patients (69.2%) while 24 (30.8%) were not irradiated. 5-year survival was achieved in 18 (23.1%), and 3-year survival was achieved in 15 (19.2%) patients. Out of 45 patients who lived less than tree year, 18 (40%) presented with metastatic relapse and fatal outcome. Relapse of neck metastases appeared in 12 (11.9%) on the side and in the zones of lymph nodes which were included in neck dissection. Recurrence of neck metastases appeared in 8.3% of patients who were not irradiated postoperatively and in 32.1% of cases irradiated postoperatively. Discussion This study includes comparison of our results with results of literature data. Conclusion Neck lymph node metastases point to advanced malignant process of the third or forth stage of the disease when results are the worst and 5-year survival decreases with or without adjuvant radiotherapy.
Infections and the elderly
Authors: Vukadinov Jovan , Sevic Sinisa , Canak Grozdana , Madle-Samardzija Nadezda , Turkulov Vesna , Doder Radoslava
Published: July 2006

Epidemiology Aging is a natural process and a part of our lives, but nowadays there is an increase in the number of persons aged 65 and over. Today infectious diseases are still responsible for one-third of all deaths in the world. The elderly population is most vulnerable to serious infections and at greatest risk for death and complications. Among geriatric population pneumonia and influenza are the fourth most common cause of death Vaccination One of the goals of preventive medicine is to reduce the rate of complications and mortality from infectious diseases by increasing immunization rates. Influenza and pneumococcal vaccines are indicated for persons aged 65 and over. Despite well-recognized benefit of such vaccination, less than 50% of eligible patients receive the vaccine each year. Infections Older persons generally have increased susceptibility to infections because of multiple risk factors and they are the most vulnerable population to nosocomial and health-care associated infections. Older persons may manifest infectious diseases atypically, with acute confusion or delirium which can lead into delay in diagnosis and therapy. It is important to know that the older present with delayed or poor response to antimicrobial therapy and high rates of adverse reactions to drugs, including antibiotics Conclusion As elderly population is rapidly growing, majority of patients with serious or life-threatening infections are old. Geriatric issues have not typically been a focus of training in infectious diseases, but we must become aware of and knowledgeable about special and unique aspects of infections in this population.
Immunoglobulin A nephropathy: Basic characteristics
Authors: Petrovic Lada , Curic Slobodan , Mitic Igor , Bozic Dusan , Vodopivec Slavenka , Sakac Vladimir , Djurdjevic-Mirkovic Tatjana , Ilic Tatjana
Published: July 2006

Introduction Immunoglobulin A nephropathy (IgAN) is one of the most common forms of primary glomerulonephritis in many countries. Most clinical features of IgAN point to a renal problem, such as recurrent macroscopic hematuria or asymptomatic microscopic hematuria and proteinuria. Pathologic features of IgAN present with different types and different degrees of glomerular tubulointerstitial and vascular lesions. The aim of this study was detailed analysis of clinical and laboratory findings, as well as findings of immunofluorescence and light microscopy. We also investigated associations between these factors. Material and methods We investigated 60 patients who underwent renal biopsy. The study was partly retrospective and partly prospective. Results The average age of patients was 34.19 years. Male female ratio was 2.33:1. IgAN was most frequently asymptomatic (83.33%) as microhematuria and proteinuria, while gross hematuria was found in 16.667%. Renal biopsy material was analyzed by light microscopy revealing changes in all glomerular structures. Immunofluorescence microscopy demonstrated dominant IgA deposits. This study established association of glomerulosclerosis with clinical features of disease. Discussion and conclusions IgAN frequently develops in the 4th decade of life, mostly in males and presents as asymptomatic (83.33%). Patohistological changes include all glomerular structures. There is no specific serological test for IgAN, but pathological changes affect clinical features of the disease, as proteinuria and increase of creatinine concentration.
Ovarian conservation and repositioning in radical hysterectomy performed for cervical cancer: Experimental and clinical observations
Authors: Draca Petar
Published: July 2006

The author presented an experimental procedure of subperitoneal repositioning of the ovaries into the region of abdominal wall associated with conservation of infundibulopelvic ligament, in female dogs. Relaparatomy was performed a year later. There were no significant changes in ovaries displaced both subperitoneally and subcutaneously. In seven patients under 36 years of age, who underwent the surgical procedure of radical hysterectomy for cervical cancer, ovaries were repositioned intraperiotoneally into the region of lower rim of the kidney associated with conservation of vascularization across the infundibulopelvic ligament. One patient presented with a cystic degeneration of the right ovary, whereas the others presented with normal ultrasonographic findings. Urinary estrogen values, estimated a year following the surgical procedure, ranged within normal values.
Osteosynthesis with Kirschner wires in treatment of unstable supracondylar fractures of the humerus in children
Authors: Gajdobranski Djordje , Maric Dusan , Tatic Milanka , Djuric-Nosek Dusanka , Mikov Aleksandra
Published: July 2006

Introduction Elbow fractures account for 7-9% of all fractures in childhood, while the supracondylar type is the most common (up to 70%). 84% of all supracondylar elbow fractures occur under the age of 10 years (most often between the age of 5 and 8). The aim of this study was to present the technique and results of treatment of supracondylar fractures with grade III fragment dislocation in pediatric population. Treatment included orthopedic repositioning and percutaneous pin fixation. Material and methods Over the period 1991-2000, 255 patients were hospitalized due to supracondylar fracture of the humerus with grade III fragment dislocation at the Pediatric Surgery Clinic in Novi Sad. All patients were aged 3-15 years. Orthopedic repositioning and percutaneous pin fixation under X-ray control was performed in 243 patients (95.29%). Results This study included 167 (65.5%) patients with full documentation. Extensor type of fracture was verified in 151 patients (90.42%). Male patients predominated over female patients - 119:48. The average follow-up period was 4,5 months. On the basis of clinical examination, and after completed rehabilitation, satisfactory results were obtained in 158 patients (94.6%), while in 9 patients the final outcome was unsatisfactory. Discussion Literature analysis points to advantages of orthopedic repositioning and percutaneous pin fixation, with certain modifications in the treatment of supracondylar elbow fractures with grade III dislocation. Conclusions Obtained results of treatment, advantages of this procedure, and our experience, suggest that orthopedic repositioning and percutaneous pin fixation is a procedure of choice in treatment of supracondylar elbow fractures with third III dislocation in children.
Effects of smoking on resorption of the residual alveolar ridges in complete denture wearers
Authors: Markovic Dubravka , Jefic Bojana , Blagojevic Duska , Blazic Larisa
Published: July 2006

Introduction Based on literature data it is obvious that there is a connection between smoking and periodontal diseases. Alveolar bone loss increases with smoking. Tobacco smoking affects the proportion of subgingival bacterial flora by influencing oxidoreduction potential of dental plaque and thus making conditions for development of anaerobic bacteria. According to some researchers, smoking affects the mineral component of bone tissue. Orthopantomograms show higher level of alveolar bone loss in smokers than in nonsmokers with the same level of oral hygiene. The aim of this study was to establish if smoking affects alveolar bone loss in complete denture wearers. Material and methods Our clinical investigation included 60 patients of both sexes (30 smokers and 30 nonsmokers) all complete dentures wearers. All patients met study criteria: jaw relation and smokers who smoke over 20 cigarettes per day. All subjects were interviewed, and after that orthopantomograms were made. They were used to calculate the degree of alveolar bone loss. Results The examined subjects were approximately of the same age. Mean age of smokers was 59.9 and nonsmokers 61.8. It was established that differences regarding resorption in men were not significant. The degree of resorption in women smokers and women nonsmokers was different, but differences were not significant. Discussion It has been proven that the number of cigarettes smoked per day is very important. It is considered that the risk of oral epithelial dysplasia increases when smoking more than 20 cigarettes per day. Considering our results regarding resorption of edentulous alveolar ridge in smokers and nonsmokers, we concluded that there were no significant differences. There are opinions in literature that smoking is not an etiological factor in resorption, but there are some opinions that smoking is connected with the degree of resorption in periodontium. The analyses of resorptive changes in edentulous smokers were done only around implants and it was estimated that smoking has more influence than other clinical risk factors. Conclusion On the bases of our research we may conclude that smoking does not directly affect the degree of resorption of edentulous alveolar ridge with complete denture wearers.
Optimal therapy of epilepsy by measuring serum concentration of antiepileptic drugs with least adverse effects
Authors: Jovicevic Mirjana , Diklic-Jeremic Vera , Divjak Ivana , Zarkov Marija , Jovanovic Aleksandar
Published: July 2006

The study comprised 150 epileptic patients treated at the Institute of Neurology of the Clinical Centre Novi Sad. The optimal therapy with least adverse effects and seizures was achieved in patients in whom measurement of serum concentration of antiepileptic drugs was performed. Patients were divided into five groups with respect to the therapy they received: I - carbamazepine; II - valproic acid; III - polytherapy with phenobarbitone and diphenylhydantoin; IV - phenobarbitone and valproic acid; and V - phenobarbitone, valproic acid and carbamazepine. No adverse effects were recorded in over 60% of patients on monotherapy, 35% of patients who received two anticonvulsants, and 30% of patients who received three anticonvulsants. Significant correlation between drug dosage and blood drug concentration (r>0.5) was found in polytherapy with phenobarbitone, carbamazepine and valproic acid (r=0,66); and phenobarbitone and diphenylhydantoin (r=0,53).
Postoperative nausea and vomiting
Authors: Tatic Milanka , Skoric Svetlana , Miskovic Sanja , Komarcevic Milena , Dobanovacki Dusanka , Tomic Gordana
Published: July 2006

Postoperative nausea and vomiting (PONV) and pain are the most common complaints following anesthesia and surgery, and due to negative emotional impact on patients, they cause prolonged postoperative recovery. The incidence of PONV is 20-30% during the first 24h after anesthesia. Both peripheral and central mechanisms are involved in control of emesis. Factors Many factors associated with anesthesia and surgery may affect PONV: patient's age and sex, history of PONV after pervious anesthesia, administration of antiemetics prior to operation, type and duration of operation, type of premedication, induction agent, maintenance agent, reversal of muscle relaxation, treatment of postoperative pain and movement of patients. Antagonists of 5-hydroxytryptamine-3 (5-HT3) receptors Ondansetron is a competitive serotonin type 3 receptor antagonist important in prevention of PONV. However, if 5-HT 3 receptor antagonists are effective against nausea and vomiting after a variety of anesthetic and surgical procedures, then at last we may have the key to the mechanism of PONV. Prophylaxis with a combination of antiemetic drugs is more effective in prevention of PONV.
Hormones and female sexuality
Authors: Bjelica Artur , Kapamadzija Aleksandra , Maticki-Sekulic Milana
Published: July 2006

Introduction In contrast to animal species in which linear relationships exist between hormonal status and sexual behaviour sexuality in human population is not determined so simply by the level of sexual steroids. The article analyses female sexuality in the light of hormonal status. Administration of sexual steroids during pregnancy and sexual differentiation High doses of gestagens, especially those with high androgen activity, widely used against miscarriages may lead to tomboys, but without differences in sexual orientation. However, it has been observed that the frequency of bisexual and lesbian women is higher in women with congenital adrenogenital syndrome. Hormones sexual desire and sexuality during menstrual cycle It has been established that sexual desire, autoeroticism and sexual fantasies in women depend on androgen levels. There are a lot of reports claiming that sexual desire varies during the menstrual cycle. Hormonal contraception and sexuality Most patients using birth control pills present with decreased libido. But, there are reports that progestagens with antiandrogenic effect in contraceptive pills do not affect sexual desire. Hormonal changes in peri- and postmenopausal period and sexuality Decreased levels of estrogen and testosterone in older women are associated with decreased libido, sensitivity and erotic stimuli. Sexuality and hormone replacement therapy Hormonal therapy with estrogen is efficient in reference to genital atrophy, but not to sexual desire. Really increased libido is achieved using androgens. Also, therapy with dehydroepiandrosterone (DHEA) and tibolone have positive effects on female libido. Conclusion Effect of sexual steroids on sexual sphere of women is very complex. The association between hormones and sexuality is multidimensional, as several hormones are important in regulation of sexual behaviour. Still, it should be pointed out that sexuality is in the domain of hormonal, emotional-motivational and social factors.
Significance of systemic lymphadenectomy in regard to the extent of metastatic lymph node involvement in patients operated for gastric carcinoma
Authors: Stevanovic Dejan , Radovanovic Dragan , Pavlovic Ivan , Mitrovic Nebojsa , Vukovic Milena , Radojevic Dejan
Published: July 2006

Introduction Formation of lymphatic metastasis is an important prognostic factor in treatment of gastric carcinoma. In this paper we would like to point to the importance of systematic lymphadenectomy in regard to extent of metastatic lymph node involvement in patients with gastric carcinoma. Material and methods This investigation included 114 patients with diagnosis of gastric carcinoma undergoing systematic lymphadenectomy. We analyzed metastatic lymph node involvement considering: 1. tumor localization; 2. histopathologic type; 3. depth of tumor invasion; 4. extent of lymph node resection; 5. stage of disease. Results In the course of this study, 2100 lymph nodes were extracted by systematic lymphadenectomy (18.42 lymph nodes per patient on average). Out of this number, about 27% of lymph nodes were involved with metastasis, and 60% of positive lymph nodes belonged to the first, 25.7% to the second, 10.2% to the third and 3.8% to the fourth drainaged group. The most frequent localization (over 56%) of tumors was the distal third region of stomach. Histopathologically, most common type of carcinoma was intestinal carcinoma, with metastasis in first and second drainage group. A great number of patients have tumors with infiltration of the serosa. Those patients had metastases in lymph nodes in over 42%. Most patients (58%) belonged to IV stage of disease and presented with highest number of involved metastatic lymph nodes in all drainage groups. Discussion In our patients high metastatic involvement of all four drainage groups of lymph nodes was established. Up to date standard lymphadenectomy (D1) which has been performed increased the length of survival of these patients. Conclusion By systematic lymphadenectomy we removed a great number of metastatic lymph nodes with beneficial effect on survival of patients with gastric carcinoma.
Suppurative otitis media after tympanostomy tube placement
Authors: Baljosevic Ivan , Subarevic Vladan , Mircetic Nikola , Jecmenica Jovana , Karanov Jovica , Vasiljevic Zorica
Published: July 2006

Suppurative otitis media after tympanostomy tube placement is the most frequent complication of this surgical intervention. Otorrhea that occurs in the first two weeks following tube placement is called early, late otorrhea occurs at least two weeks following placement. Early otorrhea is usually a result of either an infection that already existed when the tube was placed, or contamination of the external auditory canal during operation. Late otorrhea is mostly a result of upper respiratory tract infection. Material and methods Our investigation was performed at the ENT Department, Mother and Child Health Care Institute in Belgrade. The research included children treated for secretory or recurrent otitis media. Results and discussion We have examined 411 children implanted with 796 tympanostomy tubes in the last three years. We investigated changes within two weeks after operation. Suppuration was recorded with 81 children (19.7%). Staphylococcus aureus was established in 33 (40.7%) Pseudomonas aeruginosa in 26 (32%), Haemophilus influenzae in 12 (15%) and Streptococcus pneumoniae in 10 (12.3%) cases. All children were treated with antibiotic ear drops according to the antibiogram for a period of 7 days. Full recovery was achieved after treatment with Ciprofloxacin drops in 67%, Neomycin in 18% and Gentamycin in 9% of cases. In other cases a combination of drops and oral antibiotics was used. Conclusion In cases of suppurative otitis media after implantation of tympanostomy tubes, the secret should be treated with suction and after that antibiotic drops should be applied during 5 to 7 days. If suppuration is persistent, drops should be used with oral antibiotics.
Crime and punishment: Work of god?
Authors: Takac Sandor , Popovic Dragisa , Simic Milan , Stojanovic Predrag
Published: July 2006

Introduction This paper deals with coincidental deaths of persons previously engaged in violent behaviour. In victimology, violent deaths rest on legal authorities and public prosecutor. In some cases the clearance of circumstances is 'sui generis', as a consequence of 'vis maior'. However, in some cases, depending of circumstances, perpetrators are uncovered without further investigations. Case report This paper presents some of the most interesting cases from our Forensic practice: infanticides, 'jealovsy' killing, other murders. All crimes were recovered and sanctioned. History is full of cases like these described. Man is the only primate who kills and tortures other men. Nothing can fill the soul as hatred. Hatred is stronger than love. Love can easily lead to hate. Man is afraid of being killed, but often acts like a victim. The man proves himself worthy through his life, not death.
Risk factors for hepatitis C virus infection
Authors: Mijailovic Zeljko , Canovic Predrag , Gajovic Olgica , Todorovic Zoran , Nesic Ljiljana
Published: July 2006

Introduction Hepatitis C viral infection represents a major health problem in the world. The estimated global incidence is about 3%, whereas the number of chronic hepatitis C virus (HCV) carriers worldwide is estimated to be between 150-300 million people. Material and methods This retrospective analysis included 82 patients whose diagnosis of viral hepatitis C infection was based upon the following criteria: case history, physical examination, laboratory and abdominal ultrasound examination, histological examination of the liver, radiological examination, serological analysis and viral analysis. Descriptive statistics were used to describe general data on patients of the study group, risk factor analysis and follow-up results. Results The most prominent risk factor in our study group was intravenous use of drugs in 37 patients (37%), and blood transfusion in 13 patients (13%). Less important risk factors of viral hepatitis C infection included: promiscuity (8%), sexual contact with hepatitis C carriers (5%), surgical intervention (5%), haemodialysis (3%), intranasal use of cocaine (2%). Discussion Hepatitis C viral infection has become the illness of young and middle-aged population. This is due to the epidemic profile of this illness, due to intravenous use of drugs as the most prominent risk factor. Conclusion Due to the number of infected, numerous risk factors and complications of viral hepatitis C, hepatitis C virus has become the most prominent hepatotrophic virus.
Histological characteristics of placentas from assisted reproduction programs
Authors: Lalosevic Dusan , Tabs Dunja , Krnojelac Dijana , Vejnovic Tihomir , Radunovic Nebojsa
Published: July 2006

Placentas from assisted reproduction programs are a poorly investigated research material. The aim of this investigation was to perform microscopic examination of placentas from assisted reproduction programs and to compare them with placentas from spontaneous pregnancies. The investigation comprised 12 placentas from assisted reproduction programs and 12 placentas from spontaneous pregnancies. We found a statistically significant increa of villous edema in investigated placentas (p=0,001). We also found a statistically significantly increased incidence of microcalcifications in placentas from assisted reproduction programs (p=0,04). There was no statistically significant difference between the two groups in regard to syncytial knots (?2=0,67, p>0,25). Microscopic examination showed that placentas from assisted reproduction programs present with more frequent pathological findings. Further investigations of placentas from assisted reproduction programs could provide better understanding of different pathological conditions of pregnancies and labor in women with artificial insemination.
Erythropoietin therapy in predialysis patients
Authors: Dimkovic Nada
Published: July 2006

Introduction Anemia is recognized as a very important non-traditional risk factor for cardiovascular morbidity and mortality in patients with uremia. Despite many advantages of erythropoietin therapy, the number of patients treated with this drug is modest, particularly during the pre-end stage renal disease. Patients with chronic renal failure are at risk to develop coronary artery disease, left ventricular hypertrophy and chronic heart failure when hemoglobin concentration falls below 10 g/dl and creatinine clearance under 60 ml/min. Erythropoietin therapy Early erythropoietin treatment prevents not only cardiovascular morbidity and mortality, but also progression of renal failure towards end-stage renal disease. Anti-oxidant, anti-hypoxic and anti-apoptotic effects of erythropoietin prevent tubular lesions and interstitial fibrosis. There still remains a confusion regarding the optimum target hemoglobin concentration in the pre-dialysis phase. Guidelines in Europe and US are probably not appropriate for all patients and it is important that renal anemia patients are considered as individuals. It may be appropriate to normalize hemoglobin concentration in young patients who have active lifestyles and no severe co-morbidity. In contrast, partial correction is more appropriate for the elderly with significant co-morbidities. Special attention should be paid to patients with diabetes, where anemia starts earlier and is more profound than in other renal patients. There is no risk of early anemia treatment using erythropoietin and this regime does not increase the total cost of treatment. Conclusion Early referral to a nephrologist is the key how to define underlying renal disease, slow down the progression of renal failure, prevent co-morbid conditions and to prepare patients for end-stage renal disease treatment.
Evaluation of lipid status parameters in the working population of Gradiska municipality with age and gender distributions
Authors: Mirjanic-Azaric Bosa , Djeric Mirjana , Uletilovic Snjezana , Ivanc Marija , Sukalo Dusanka
Published: July 2006

Introduction The aim of this investigation was to establish the frequency of hyperlipoproteinemia, as well as the distribution of desired, elevated and high risk values of certain lipid status parameters among working population of the Gradiska municipality with age and sex distribution. Material and methods This investigation included 250 workers,109 male and 141 female, 25-60 years of age of the Gradiska municipality on a regular checkup. Standard biochemical methods were used to determine values of total serum cholesterol, triglyceride and HDL cholesterol. LDL cholesterol and LDL to HDL cholesterol ratio were calculated. Results Total serum cholesterol was elevated in 44.04% of males and 44.68% of females, triglyceride in 20.02% of males and 19.15% of females and LDL cholesterol in 31.96% of males and 21.43% of females. High risk values of total cholesterol were established in 43.12% of males and 39.01% of females, and of triglyceride in 37.61% of males and 9.93% of females. HDL cholesterol was decreased in 55.96% of males and 41.84% of females, while highly decreased values were established only in 5.5% of males and 1.42% of females. Increase of total cholesterol and LDL cholesterol correlated with workers' age, but values of triglyceride did not. Hyperlipoproteinemia was evident in 76.4% of examinees. Discussion All tested parameters vary dramatically from desired levels. These results are probably associated with unhealthy food habits and lifestyle. Conclusion Our results point to the need to perform regular laboratory diagnostic procedures and routine check-ups in the working population.
Therapeutic management of idiopathic infertility
Authors: Nikolov Bogoje , Folic Miroslav , Tabs Dunja , Nikolic Romana
Published: July 2006

Introduction During the period 1996-2000, we investigated 900 couples with infertility. In 71 (7.9%) couples no cause of sterility was revealed. These patients were divided according to age, parity and infertility duration. Material and methods We established the cumulative conception rate and cycle fecundity after three months without therapy, after three cycles of intrauterine insemination and after three cycles of in vitro fertilization (eventually intracytoplasmic sperm injection). Among patients with less than three years of infertility, cumulative conception rate was 34.8% after three months without therapy, 27.3% after three cycles of intrauterine insemination and 66.7% after three cycles of in vitro fertilization. Results and Discussion In patients with infertility longer than three years, cumulative conception rate without therapy was 12.5%, with intrauterine insemination 16.1% and with in vitro fertilization 40.5%. Differences regarding the age of patients were significant. Based on these findings, we proposed an optimal therapy regimen: three months therapy delay is desirable in patients under 30 years of age with infertility duration under three years. If there is no pregnancy in that period, intrauterine insemination is performed in three to four cycles. In case of intrauterine insemination failure in these women, in vitro fertilization and embryo transfer should be applied. In the group of women over 30 years of age, with infertility longer than three years, the possibility for occurrence of pregnancy with intrauterine insemination is slightly increased. If more than 4 follicles develop during preparations for intrauterine insemination, it is advisable to change the course to in vitro fertilization. In women older than 35, with primary or secondary infertility, in vitro fertilization should be performed from the very beginning.
Results of supraglottic partial horizontal laryngectomies
Authors: Petrovic Zeljko
Published: July 2006

Introduction Supraglottis is a part of larynx comprising two sub regions: epilarynx (suprahyoid epiglottis - including lingual and laryngeal surface, aryepiglottic folds - laryngeal surface, and arytenoids) and supraglottis without epilarynx (infrahyioid epiglottis and ventricular folds). Material and methods A total of 234 patients with supraglottic squamous cell carcinoma undergoing primary surgery were analyzed in the period 1976-1996. The tumor was localized in epilarynx in 84 (25%) patients, and in supraglottis without epilarynx in 261 (75%) cases. Results T1 tumor was present in 145 (42%) patients, T2 tumor was found in 178 (52%) patients, while T3 was reported in 22 (6%) cases. Clinically negative neck (N0) was found in 290 (84%) patients, and palpable metastases (N1) manifested in 55 (16%) cases. Local recurrences were established in 18 (5%) patients, and subsequent postoperative cervical metastases were found in 45 (13%) cases. Five-year disease-free survival was reported in all patients approximately 12 days following surgery. 27 patients developed laryngeal stenosis and only 2 patients were not decanulated. Voice and speech functions were satisfactory. Discussion Supraglottic laryngectomy, extended supraglottic laryngectomy is fully justified from oncological and functional aspects. Selective neck dissection in N0 cervical findings provides detection of occult metastases and indicates need for postoperative radiotherapy. Conclusion Oncological and functional results of supraglottic laryngeal surgery, along with simultaneous treatment of neck by selective, modified radical neck dissection and postoperative radiotherapy offer hope for treatment of supraglottic laryngeal cancer.
Patella fracture following anterior cruciate ligament reconstruction: A case report
Authors: Milankov Miroslav , Kecojevic Vaso , Ninkovic Srdjan , Gajdobranski Djordje
Published: July 2006

Introduction The most frequent procedure in treatment of acute or chronic anterior cruciate ligament (ACL) rupture is the so called bone-tendon-bone reconstruction. A transverse dislocated patella fracture is a rare complication of this procedure with an incidence of 0.23%-2.3%. In a five year period, (1998-2002), 407 arthroscopic reconstructions of the anterior cruciate ligaments were done at our Clinic, and there was only one case of patella fracture. Case report An 18-year-old female patient, a handball player, suffered an acute rupture of anterior cruciate ligament of the left knee, so arthroscopic bone-tendon-bone reconstruction of the anterior cruciate ligament was performed. After adequate skin incision, a bone graft was taken from the patella and upper part of trapezoid tibia, which was 25 mm long, 10 mm wide and 5 mm thick, together with a part of patellar ligament. After the remains of the anterior cruciate ligament had been arthroscopically removed, tunnels were made in tibia and femur and a graft was inserted and fixed with two metal interference screws. Knee stability was tested, and drainage was put in the knee joint. The wound was closed by layers. The quadriceps exercises and passive knee movements started immediately. Full range of movements was accomplished six weeks later when the patient started to walk with full weight-bearing on her operated leg. Three weeks later, (nine weeks after the operation), the patient has accidentally lost her balance and fell. A transverse, dislocated fracture of the left patella was diagnosed and osteosynthesis of the fractured patella with two Kirschner wires and a metallic loop was performed. Postoperatively, full range of movement was allowed. Six months later, the patient felt no pain, there was no swelling, full range of knee movement was achieved, while the Lachman Test was identical in both knees and the pivot shift test was negative. Discussion Fracture of patella after ACL reconstruction is due to several reasons: size and shape of the graft, technique of its taking, disturbed patellar blood supply, incomplete filling of patella defect after graft taking, and inappropriate postoperative rehabilitation. If a patellar fracture occurs after anterior cruciate ligament reconstruction, the best treatment is firm osteosynthesis, which enables bone healing and immediate continuation of the previously resumed rehabilitation program. However, this complication prolongs the rehabilitation period and slows down return to sports.