bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical pathology services: remapping our strategic itinerary
Authors: Blanckaert Norbert
Published: May 2010

Both technological advances and economic drivers have led to major changes in clinical laboratories across the world, with vastly improved testing productivity. However, the production process capability advances have far outpaced the clinical pathologists' success in assuring optimal test utilization and interpretation. While productivity of ‘commodity’ testing increases, our healthcare value productivity decreases. Such developments constitute a serious threat to our clinical pathology specialty, not only because pathologists may lose direct control of the commodity testing production activities, but also because the present evolution exposes a failure of our core clinical activities, the pathologist's knowledge processes that translate ‘commodity’ results into medical outcomes optimization. At a time when a revolution in health care organization is inescapable in the years ahead, clinical pathology must proceed from a merely reactive strategy (to fulfill the ‘more with less’ demands) to a proactive strategy where we build excellence and visibility in knowledge services on a strong foothold of operational excellence. Based on a Strengths-Weaknesses-Opportunities-Threats analysis, we argue that clinical pathology should safeguard and expand its healthcare value productivity by assuming leadership in building integrated laboratory services networks. We also suggest that the core knowledge processes deserve a system approach, for example, by applying a risk-based quality management system.

Clin Chem Lab Med 2010;48:919–25.
A link betweenp-type electrical conduction and microwave dielectric loss in highly ordered Ba(Co1/3Nb2/3)O3ceramics
Authors: Li Ming , Feteira Antonio , Mirsaneh Mehdi , Lanagan Michael T. , Sinclair Derek C.
Published: May 2010

BaCo1/3Nb2/3O3ceramics, with a high density and a similar, high degree of 1:2 B-site cation ordering, exhibit very different quality factors, Q. The ceramics exhibitp-type behavior with higher conductivity and lower Q for samples processed in O2as compared with those processed in air. It is proposed that unavoidable Co loss during high-temperature ceramic processing leads top-type doping that must be compensated by oxygen vacancies to impede hole formation. The composition exhibiting only intrinsic conduction and optimized Q is not achieved with processing in atmospheric oxygen due to filling of oxygen vacancies and hole formation during cooling.
Deformation and crystallization of Zr-based amorphous alloys in homogeneous flow regime
Authors: Tao Min , Chokshi Atul H. , Conner Robert D. , Ravichandran Guruswami , Johnson William L.
Published: May 2010

The purpose of this study is to experimentally investigate the interaction of inelastic deformation and microstructural changes of two Zr-based bulk metallic glasses (BMGs): Zr41.25Ti13.75Cu12.5Ni10Be22.5(commercially designated as Vitreloy 1 or Vit1) and Zr46.75Ti8.25Cu7.5Ni10Be27.5(Vitreloy 4, Vit4). High-temperature uniaxial compression tests were performed on the two Zr alloys at various strain rates, followed by structural characterization using differential scanning calorimetry (DSC) and transmission electron microscopy (TEM). Two distinct modes of mechanically induced atomic disordering in the two alloys were observed, with Vit1 featuring clear phase separation and crystallization after deformation as observed with TEM, while Vit4 showing only structural relaxation with no crystallization. The influence of the structural changes on the mechanical behaviors of the two materials was further investigated by jump-in-strain-rate tests, and flow softening was observed in Vit4. A free volume theory was applied to explain the deformation behaviors, and the activation volumes were calculated for both alloys.
Thermal and mechanical properties of hybrid methylsilsesquioxane/poly(styrene-b-4-vinylpyridine) low-kdielectrics using a late porogen removal scheme
Authors: Che Mu-Lung , Huang Cheng-Ying , Choang Shindy , Chen Yu-Hen , Leu Jihperng
Published: May 2010

A late porogen removal scheme was used to make low-kmaterials (k= 2.72 to 2.02) using methylsilsesquioxane (MSQ) and a high-temperature porogen, poly(styrene-b-4-vinylpyridine) (PS-b-P4VP), to circumvent the reliability issues related to as-deposited porous dielectric. Based on the nanoindentation and Fourier transform infrared spectroscopy (FTIR) analysis, the moduli of the hybrid films were found to be higher than their porous forms, and even better than the dense MSQ film, for porogen loading below a critical level (˜69.5 vol%). This could be attributed to their enhanced degree of cross-linking in MSQ as evidenced by the network/cage structural ratios. Besides, high-temperature porogen plays different roles during the cross-linking of MSQ depending on its loadings. In this study, with immediate loading at 16.7 vol%, PS-b-P4VP can serve as plasticizer to enhance the degree of cross-linking, but at a large loading >16.7 vol%, it becomes a steric hindrance reducing the degree of cross-linking.
Further analysis of energy-based indentation relationship among Young’s modulus, nominal hardness, and indentation work
Authors: Ma Dejun , Ong Chung Wo
Published: May 2010

In our previous study, we modeled the indentation performed on an elastic–plastic solid with a rigid conical indenter by using finite element analysis, and established a relationship between a nominal hardness/reduced Young’s modulus (Hn/Er) and unloading work/total indentation work (We/Wt). The elasticity of the indenter was absorbed in Er ≡ 1/[(1 − ν2)/E + (1 − νi2)/Ei], where Ei and νi are the Young’s modulus and Poisson’s ratio of the indenter, and E and ν are those of the indented material. However, recalculation by directly introducing the elasticity of the indenter show that the use of Er alone cannot accurately reflect the combined elastic effect of the indenter and indented material, but the ratio η = [E/(1 − ν2)]/[Ei/(1 − νi2)] would influence the Hn/Er–We/Wt relationship. Thereby, we replaced Er with a combined Young’s modulus Ec ≡ 1/[(1 − ν2)/E + 1.32(1 − νi2)/Ei] = Er/[1 + 0.32η/(1 + η)], and found that the approximate Hn/Ec–We/Wt relationship is almost independent of selected η values over 0–0.3834, which can be used to give good estimates of E as verified by experimental results.
In situ spherical B2 CuZr phase reinforced ZrCuNiAlNb bulk metallic glass matrix composite
Authors: Liu Jinmin , Zhang Haifeng , Fu Huameng , Hu Zhuang-Qi , Yuan Xiaoguang
Published: May 2010

In situ microlevel spherical B2 CuZr phase reinforced Zr49.5Cu36.45Ni4.05Al9Nb1 bulk metallic glass matrix composite was prepared successfully by the copper mold casting method. It was found that mechanical properties of Zr50.5Cu36.45Ni4.05Al9 alloy were improved largely due to the Nb addition. The room-temperature compressive fracture strength and plastic strain for Zr49.5Cu36.45Ni4.05Al9Nb1 rod with a diameter of 5 mm reaches 2037 MPa and 8%, respectively. The improvements are attributed to the precipitation of the spherical B2 CuZr phase distributed uniformly in amorphous matrix, which effectively hampers the propagation of shear bands by deflecting them at the interface and by a multiplication mechanism.
Synthesis, microstructure, and photoluminescence properties of thornlike SiC:Tb nanostructures
Authors: Zhou Jinyuan , Xu Xianbo , Song Xi , Chen Zhiyong , Zhou Ming , Chen Changchen , Liu Yanxia , Song Jie , Xie Erqing
Published: May 2010

Thornlike Tb-doped SiC (SiC:Tb) nanostructures were synthesized through a carbothermal reduction of electrospun Tb-doped SiO2nanofibers (SiO2:Tb). The synthesized SiC nanostructures annealed at a high temperature of 1300 °C displayed a unique morphology and a high crystalline quality with the β-SiC phase. Strong green-light emissions were detected from the SiC:Tb samples. Photoluminescence excitation results show that, besides a small amount of energy coming from the SiC cores (464 nm), most of the energy needed for the excitation of Tb3+ions comes from the light absorption of the SiO2–Tb surface layers (295 nm) and near-interface regions in the samples (388 nm). Transmission electron microscopy, energy dispersive spectrometry, and Raman analyses suggested that the formations of Tb clusters and SiO2surface layers are very important to the enhancement of the luminescence behaviors of Tb3+ions. Finally, we have constructed an excitation model and further proposed an energy transfer mechanism for these thornlike SiC:Tb nanostructures.
Electronic structure of the thermoelectric materials PbTe and AgPb18SbTe20 from first-principles calculations
Authors: Lu Pengxian , Shen Zigang , Hu Xing
Published: May 2010

To investigate the effects of substituting Ag and Sb for Pb on the thermoelectric properties of PbTe, the electronic structures of PbTe and AgPb18SbTe20 were calculated by using the linearized augmented plane wave based on the density-functional theory of the first principles. By comparing the differences in the band structure, the partial density of states (PDOS), the scanning transmission microscope, and the electron density difference for PbTe and AgPb18SbTe20, we explained the reason from the aspect of electronic structures why the thermoelectric properties of AgPb18SbTe20 could be improved significantly. Our results suggest that the excellent thermoelectric properties of AgPb18SbTe20 should be attributed in part to the narrowing of its band gap, band structure anisotropy, the much extrema and large DOS near Fermi energy, as well as the large effective mass of electrons. Moreover, the complex bonding behaviors for which the strong bonds and the weak bonds are coexisted, and the electrovalence and covalence of Pb–Te bond are mixed should also play an important role in the enhancement of the thermoelectric properties of the AgPb18SbTe20.
Property engineering in BaTiO3 films by stoichiometry control
Authors: Ihlefeld J.F. , Daniels P.R. , Aygün S.M. , Borland W.J. , Maria J-P.
Published: May 2010

BaTiO3 thin films were prepared on metallic foil substrates using chemical solution deposition. The impact of A to B site cation ratios on the phase assemblage and microstructural and dielectric properties was investigated by characterizing a sample set that includes stoichiometric BaTiO3 and 1, 2, 3, 4, and 5 mol% excess BaO. Each composition was subjected to a high-temperature anneal step with maximum dwell temperatures of 1000, 1100, and 1200 °C for 20 h. Excess barium concentrations greater than 3% lead to dramatic grain growth and average grain sizes exceeding 1 μm. Despite the large deviations from stoichiometry and the 20 h dwell time at temperature, x-ray diffraction, and high-resolution electron microscopy analysis were unable to detect secondary phases until films with 5% excess barium were annealed to 1200 °C. Thin films with 3% excess barium were prepared on copper substrates and annealed at 1060 °C, the practical limit for copper. This combination of BaO excess and annealing temperature produced an average lateral grain size of 0.8 μm and a room-temperature permittivity of 4000. This is in comparison to a permittivity of 1800 for stoichiometric material prepared using identical conditions. This work suggests metastable solubility of BaO in BaTiO3 that leads to enhanced grain growth and large permittivity values. This technique provides a new solid-state means of achieving grain growth in low thermal budget systems.
In situ and ex situ transmission electron microscopy investigation of Cu–Al–Cu–Ti reactive metallic multilayer coatings
Authors: Yajid M.A. Mat , Bagshaw H. , Möbus G.
Published: May 2010

Metallic multilayers of Cu/Al/Ti composition were studied by transmission electron microscopy (TEM) and plasmon energy-loss mapping as prototypes of nanoscale reactive multilayer systems with exothermic alloy formation in oxygen-free conditions. The selection and arrangement of alloy phases by the system during ex situ and in situ heating experiments were found to depend not only on temperature but strongly on the initial volume ratios of metals, and to a lesser degree on the dimensionality of the reactive sample. Here, a two-dimensional sample was represented by ex situ heating of the full multilayer structure, a one-dimensional sample refers to in situ heating of thin cross-sectional TEM specimens, while a zero-dimensional sample (or metallic dot-array) was obtained after cutting thin pillars using focused ion beams. Lamellar self-organized alternation between Heusler phase and Cu9Al4 was found.
Design of nonaqueous polymer gels with broad temperature performance: Impact of solvent quality and processing conditions
Authors: Mrozek Randy A. , Cole Phillip J. , Cole Shannon M. , Schroeder John L. , Schneider Duane A. , Hedden Ronald C. , Lenhart Joseph L.
Published: May 2010

Polymer gels have potential use for a wide variety of applications, primarily due to the ability to tailor the gel properties by varying several material parameters. While substantial attention has focused on water-based hydrogels, the use of these materials is limited due to a narrow operational temperature range. This report describes a nonaqueous polymer gel, composed of a cross-linked polybutadiene network swollen with low volatility polymer plasticizers. Thermal, mechanical, and adhesive characterization illustrated that the gels exhibit performance over an extremely broad temperature range (−60–70 °C). Solvent quality and loading played a critical role in the operational temperature window with small solvent solubility parameter deviations dramatically reducing the operational temperature range. In addition, the processing conditions had a large impact on the gel mechanical properties. As a result, it is important to consider the influence of processing conditions and solvent quality when tailoring polymer gels for practical applications.
Microstructure, thermal, and mechanical characterization of rapidly solidified high strength Fe84.3Cr4.3Mo4.6V2.2C4.6
Authors: Schlieter A. , Kühn U. , Eckert J. , Seifert H-J.
Published: May 2010

Systematic microstructural and mechanical investigations of the Fe84.3Cr4.3Mo4.6V2.2C4.6 alloy cast under special manufacturing conditions in the as-cast state and after specific heat treatment are presented to point out that the special manufacturing of the alloy led to high compression strength (up to 4680 MPa) combined with large fracture strain (about 20%) already in the as-cast state. One select chemical composition of the alloy, which was mentioned previously [Kühn et al., Appl. Phys. Lett.90, 261901 (2007)] enhanced mechanical properties already in the as-cast state. Furthermore, that composition is comparable to commercial high-speed steel. By the special manufacturing used, a high purity of elements and a high cooling rate, which led to a microstructure similar to a composite-like material, composed of dendritic area (martensite, bainite, and ferrite) and interdendritic area (e.g., complex carbides). The presented article demonstrates an alloy that exhibits already in the as-cast state high fracture strength and large ductility. Furthermore, these outstanding mechanical properties remain unchanged after heating up to 873 K.
How Does Older Age Influence Oncologists' Cancer Management?
Authors: Foster Jill A. , Salinas Gregory D. , Mansell Dorcas , Williamson James C. , Casebeer Linda L.
Published: May 2010

Background.

Over half of new cancer cases occur in patients aged ≥65 years. Many older patients can benefit from intensive cancer therapies, yet evidence suggests that this population is undertreated.

Methods.

To assess preferences and influential factors in geriatric cancer management, practicing U.S. medical oncologists completed a survey containing four detailed vignettes exploring colon, breast, lung, and prostate cancer treatment. Participants were randomly assigned one of two surveys with vignettes that were identical except for patient age (<65 years or >70 years).

Results.

Physicians in each survey group (n = 200) were demographically similar. Intensive therapy was significantly less likely to be recommended for an older than for a younger, but otherwise identical, patient in two of the scenarios. For a woman with metastatic colon cancer (Eastern Cooperative Oncology Group [ECOG] score, 1) for whom chemotherapy was recommended, nearly all oncologists chose an intensive regimen if the patient's age was 63; but if her age was 85, one fourth of the oncologists chose a less intensive treatment. Likewise, for stage IIA breast cancer (ECOG score, 0), 93% recommended intensive adjuvant treatment for a previously healthy patient aged 63; but only 66% said they would do so if the patient's age was 75. Oncologists commonly identified patient age as an influence on treatment choice, but were even more likely to cite performance status as a determining factor.

Conclusions.

Advanced age can deter oncologists from choosing intensive cancer therapy, even if patients are highly functional and lack comorbidities. Education on tailoring cancer treatment and a greater use of comprehensive geriatric assessment may reduce cancer undertreatment in the geriatric population.
Understanding How Out-of-Pocket Expenses, Treatment Value, and Patient Characteristics Influence Treatment Choices
Authors: Wong Yu-Ning , Hamilton Olivia , Egleston Brian , Salador Kevin , Murphy Camara , Meropol Neal J.
Published: May 2010

Purpose.

Cost sharing, intended to control the “overuse” of health care resources, may also reduce use of necessary services. The influence of cost on the treatment choices of patients with life-threatening illness, such as cancer, is unknown.

Methods.

A convenience sample of patients undergoing surveillance following curative treatment for localized cancer completed a paper survey that included three scenarios to elicit the maximum copayment they would be willing to pay for better treatment outcomes. Scenario A described a treatment for a curable cancer in terms of recurrence risk. Scenarios B and C described treatments for noncurable cancer in terms of the 2-year survival probability and median life expectancy.

Results.

The sample (n = 60) was 78% female, 83% aged <65 years, and 58% college graduates. Thirteen percent reported making financial sacrifices to pay for treatment. Patients were willing to pay higher copayments for more effective treatments (p < .05 for all three scenarios). In scenario B, patients who were employed demonstrated a greater willingness to pay (WTP) (odds ratio [OR], 12.6; 95% confidence interval [CI], 2.0–80.4), when controlling for efficacy. In scenario C, college graduates showed greater WTP (OR, 5.0; 95% CI, 1.2–20.9) and patients who reported previous financial sacrifices showed lower WTP (OR, 0.2; 95% CI, 0.04–0.6).

Conclusion.

This pilot study suggests that patients may be less willing to pay high copayments for treatments with modest benefit. Even among this relatively young, affluent, and educated population, demographic variables were related to WTP. Larger studies in more diverse populations should be conducted to better understand how cost may influence treatment decisions and cancer treatment outcomes.
Mapping Structures that Control Contaminant Migration using Helicopter Transient Electromagnetic Data
Authors: Pellerin Louise , Beard Les P. , Mandell Wayne
Published: May 2010

Tooele Army Depot, Tooele County, Utah has developed a hydrogeological model to predict spatio-temporal changes in trichloroethylene contamination originating from sources on the base. Established in 1942 to store World War II supplies, ammunition, and combat vehicles, the Depot is situated in the Basin and Range Providence about [Formula: see text] west of Salt Lake City, Utah. In order to better define this hydrogeological framework, a helicopter-borne, time-domain electromagnetic system, known as SkyTEM, was used to survey a [Formula: see text] area of the Depot. Areas where carbonate basement is known from prior studies to be at or near the surface were clearly delineated in the SkyTEM data as a high resistivity zone, which begins near the ground surface and continues to the deepest samples at about [Formula: see text]. In some places the basement appears to be conductive rather than resistive. In areas where unconsolidated sedimentary cover is known to be thick, such as in the northwest part of the survey area, resistivities were low throughout the sample intervals. The SkyTEM data supports the existence of some, but not all, of the hydrological boundaries hypothesized from potentiometric information. Shallow high-resistivity layers in the east and southeast portions of the survey area appear to be underlain by more conductive sediments, and so should not necessarily be interpreted as shallow bedrock, but possibly as resistive sediments such as dry sand and gravel. One of the most significant results of the survey is the delineation of a narrow unit, interpreted as a paleochannel, at depths greater than [Formula: see text] that may be responsible for migration of contamination to the northwest.
Hydro-geophysical Configuration for the Quaternary Aquifer of Nuweiba Alluvial Fan
Authors: Khalil Mohamed H.
Published: May 2010

Nuweiba is one of Egypt’s strategic marine harbors and tourist sites located on the western coast of the Gulf of Aqaba. The absence of freshwater resources in Nuweiba necessitates investigations of local groundwater aquifers. Determination of the hydro-geophysical parameters of the Nuweiba alluvial fan constitutes the basic foundation for optimizing groundwater exploitation over time. Fifteen Schlumberger vertical electrical soundings (maximum [Formula: see text]), augmented by borehole stratigraphic data, aquifer tests, hydro-chemical analysis, and numbers of measured and/or calculated hydraulic parameters, were carried out in the study area. The fresh to brackish aquifer of Quaternary and pre-Quaternary alluvium sediments was effectively delineated with true resistivity and thickness ranges of [Formula: see text] and [Formula: see text], respectively. The western part of the aquifer has a large volume of fresh ground water for extraction and is characterized by a gradual increase in thickness [Formula: see text], grain size, transmissivity [Formula: see text], and a possible decrease in total dissolved solids levels [Formula: see text] and electrical anisotropy (1.10–1.11). Porosity (30.3–30.4%), tortuosity (1.348), formation factor (6) and hydraulic conductivity [Formula: see text] are essentially constant across the aquifer. The measured storativity of the aquifer is [Formula: see text], which is in accordance with the typical value of the unconfined aquifer at shallow depths.
Health habits, attitudes and behavior towards oral health of psychiatric patients
Authors: Jovanovic Svetlana , Gajic Ivanka , Mandic Jelena , Mandic Bojan
Published: May 2010

Introduction. People with psychiatric disorders are at high risk of oral diseases due to the impact of their primary psychiatric condition and the side-effects of antipsychotic medications. Objective. The aim of this study was to identify habits, attitudes and behavior towards oral health of hospitalized psychiatric patients with psychotic disorders, including mood disorders with psychotic characteristics, as well as to identify factors that could influence those habits, attitudes and behavior. Methods. The experimental group consisted of 186 hospitalized patients with psychiatric disorders (87 males and 99 females), aged from 18 to 59 years (mean age 46.0?8.0 years). The control group consisted of 186 healthy persons matched for age and gender. Data were obtained by using specially designed questionnaires with questions about the subjects' social, economic and demographic characteristics, as well as their habits, attitudes and behaviour concerning their oral health, in a form of a standardized interview. Other medical data were collected from medical documentation of disease history. Statistical analysis was performed by Student's t-test, Chi-square test, ANOVA, Logistic Regression and simultaneous multiple regression. Results. Psychiatric patients have worse habits, attitudes and behavior concerning their oral health in comparison with healthy persons (p<0.001): they wash their teeth more rarely and in a shorter time, have less knowledge of oral diseases and their effect on general health, and visit their dentist more rarely. The obtained results depend on social, economic and demographic characteristics and on the underlying illness of patients. Conclusion. Health educational work concerning oral health of patients should be included in psychiatric treatment, as a part of an existing therapy with the aim of improving the general quality of their life.
Ophthalmological findings in series of incontinentia pigmenti patients from Serbia
Authors: Minic Snezana , Novotny Gerd , Stefanovic Ivan , Obradovic Miljana , Trpinac Dusan
Published: May 2010

Introduction. Incontinentia pigmenti (IP) is a rare complex X-linked genodermatosis in which skin changes are combined with anomalies of other organs. Mutations of the NEMO gene localized on chromosome Xq28 are responsible for IP. Clinical manifestations of IP according to evolution and prognosis can be considered as skin changes and dental, eye and central nervous system changes. Objective. The aim of our study was to investigate type and frequency of ocular features in Serbian population. Methods. We investigated the total of 9 families with 22 subjects, 20 females and 2 males, at the Institute of Dermatovenerology, Clinical Centre of Serbia, in the period from 1989 to 2009. Our subjects were diagnosed clinically by a dermatologist and the diagnosis confirmed by cutaneous histopathology and ultrastructural analysis. The pedigrees, karyotype analyses, routine laboratory findings, additional specialized clinical examinations were done for all subjects. Results. Among 22 IP patients from our study, different ophthalmological anomalies were observed in 16% of subjects. In female subjects, all of them with clinical characteristics of IP, we observed the following anomalies: retinal detachment, microphthalmia, cataract, strabismus and nystagmus. Conclusion. Compared to available literature data, our percentage of IP patients with anomalies was lower. It may be due to differences in examined populations or due to the fact that the patients in our study were firstly admitted to the Institute of Dermatology. Ophthalmological findings may be often considered as very severe anomalies in IP. It is very important to detect IP as early as possible, medically help and monitor these patients.
Influence of psychological and coronary parameters on coronary patient rehospitalization
Authors: Nikolic Gordana , Miljkovic Srbobran , Stojkovic Aleksandar , Manojlovic Snezana , Ciric Zoran , Zikic Olivera , Vucurevic Mara
Published: May 2010

Introduction. Psychological reactions are often comorbid with coronary risk factors and could be important for a six-month outcome. Objective. Determination of anxiety level, depression and aggression, persistence of risk health behaviour, stress life events, and coronary risk factors after coronary event and a predictive value of those parameters for six-month rehospitalization. Methods. In the group with Angina Pectoris (E1=30) and the group with Acute Myocardial Infarction (E2=33), there were applied, at baseline and after 6 months, the following: Semistructured Clinical Interview based on ICD-10, for depressive episode and anxiety disorder, Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), KON-6 sigma Scale for aggression, Holms-Rahe Scale (H-R) for stress events and Questionnaire for risk behaviour: alcohol consumption, smoking, lack of physical activity. Group differences were assessed by t-test and chi-square test, p<0.05, regression analysis for assessing initial variables, a predictive value for six month rehospitalization. Results. After acute coronary event, the anxiety and depression levels were mild and aggression was low in E1 and mild in E2. Stress event score was significantly higher in E2 (H-R=115.18) than in E1 (H-R=72.20), p<0.05. After 6 months, the results were the same except for a significantly lower stress event score in E1 (H-R=49.48), and in E2 (H-R=91.65), but still significantly higher than in E1. Coronary parameters were reduced, smokers' rate was increased in E1. Alcohol consumption, hypercholesterolaemia and hereditary tendency were predictive for six- month rehospitalization. Conclusion. After acute cardiac event, hospitalized coronary patients had a mild anxiety, depression and aggression level as well as after six months. The infarct patients had experienced more stress life events in the previous year than the angina patients. Risk health behaviour did not change in the following six months, with the increased smokers' rate in the angina group. Alcohol consumption, smoking and heredity were predictive for rehospitalization.
Newborns from deliveries with epidural anaesthesia
Authors: Avramovic Lidija , Cutura Nedjo , Soldo Vesna , Curkovic Aleksandar , Lazic-Mitrovic Tanja
Published: May 2010

Introduction. The use of epidural anaesthesia in delivery with the purpose to reduce pain and fear in a pregnant woman has the influence on the physiological status of the woman in childbirth and the course of delivery. From the epidural space of the pregnant woman, one part of free anaesthetic comes in the foetal circulation through the mother's circulation and placenta and connects with the foetal proteins. A lower value of albumins and serum proteins in the foetal circulation give bigger free fraction of anaesthetic which is accumulated in the foetal liver, brain and heart full of blood. Objective. The aim of the study was to examine the influence of epidural anaesthesia on the newborn. Methods. Retrospective study of 6,398 documents of newborns was performed in our Clinic of Gynaecology and Obstetrics 'Narodni front' during 2006. The first group was made of 455 newborns from deliveries with epidural anaesthesia and the second was the control group of 5,943 remaining newborns. In both groups we analysed the following: sex, week of gestation, weight, Apgar score, measure of care and resuscitation, perinatal morbidity and then the obtained results were compared. Results. Most of deliveries were vaginal without obstetric intervention (86.6%). The number of deliveries finished with vacuum extractor (4.6%) was statistically significantly bigger in the group with epidural anaesthesia than in the control group. Most of the newborns in the first group were born on time (96.5%) in 39.0?1.0 week of gestation and with foetal weight 3448?412 grammes. There was no statistical significance in Apgar score between both groups. Epidural anaesthesia does not increase the degree of the newborn's injury. Lower pH of blood was found in the newborns from deliveries with vacuum extractor or operated on (the Ceasarean section). Conclusion. Application of epidural anaesthesia decreases duration of delivery and has no adverse effects on the newborn and hypoxic encephalopathy is lower.
Glasgow coma scale in acute poisonings before and after use of antidote in patients with history of use of psychotropic agents
Authors: Poplas-Susic Tonka , Klemenc-Ketis Zalika , Komericki-Grzinic Marija , Kersnik Janko
Published: May 2010

Introduction. Data on emergency interventions in poisonings are scarce. Objective. To determine the effectiveness of antidote therapy in acute poisoning-related emergency medical services (EMS) interventions. Methods. A prospective observational study included all poisoning-related intervention cases over 3 years (1999-2001) in the Celje region, Slovenia, covering 125,000 inhabitants. Data were recorded on an EMS form. Results. Psychoactive agents were present in 56.5% out of 244 poisoning-related EMS interventions. Prescription drugs were a cause of intoxication in 93 (39.2%) cases alone or in combination with alcohol or illegal drugs. More than one fifth of poisonings were due to the use of illegal drugs in 52 (21.9%) cases, 43 (18.1%) out of them heroin related. At the time of EMS arrival, more patients who ingested illegal drugs were in coma or comatose than the rest. 24 (45.3%) vs. 32 (17.3%) of poisoned patients were in coma (p<0.001). Glasgow Coma Scale (GCS) at the first contact was lower in patients who ingested illegal drugs than in the remaining patients (9.0 vs. 11.6, p=0.001). In 23.2% of the cases, an antidote was administered. In 29 (12.2%) naloxone and in 16 (6.7%) flumazenil was administered. Mean GCS after intervention was higher in all cases but significantly higher in illegal drug cases, 13.4 vs. 12.2 (p=0.001), with a mean positive change in GCS of 4.5 vs. 0.6 (p<0.001). In illegal drug users, mean change after antidote administration was 8.2 vs. 0.5 without antidote administration (p<0.001). Conclusion. High rate of successful antidote use during the intervention indicated the importance of good EMS protocols and the presence of a skilled doctor in the EMS team.
Knowledge, attitudes and behavior of adolescents about reproductive health at Belgrade territory
Authors: Kisic-Tepavcevic Darija , Steric Milena , Kisic Vesna , Popovic Aleksandra , Pekmezovic Tatjana
Published: May 2010

Introduction. Over the past few years, the results of numerous studies have emphasized the importance of adolescents' insufficient knowledge about reproductive health (RH), which implies an increasing trend of unwanted pregnancies and sexually transmitted diseases (STDs). Objective. The aim of this study was to investigate knowledge, attitudes and behaviour of adolescents about RH in the population of Belgrade. Method. The study comprised 292 students from three secondary schools in Belgrade involved in the research February 1-15, 2008. The semistructured questionnaire about adolescents' knowledge, attitudes and behaviour about RH was filled in by themselves in presence of a student-investigator who provided assistance when necessary. Statistical analysis included ?2 test and correlation analysis. Results. Most adolescents (70.5%) showed the medium level of knowledge about RH. In our study, 33.6% of adolescents were sexually active. Sexually active students achieved a better score on the test about RH compared with the students who have not had sexual intercourse yet (?2-test=34.003; p<0.01). The average age of the first sexual intercourse was 16.5 years for females, and 15.7 years for males. The students with a lower average grade in school education experienced the first sexual intercourse earlier compared to the adolescents with a higher average grade during the school education (?=0.485; p<0.01). The most common (73.4%) source of information about RH is mass media. Conclusion. The results of our study indicate the need for more intensive and comprenhensive educational programmes in the area of RH for adolescents in our country.
Iodization of table salt and attitudes and habits in relation to the use of salt in general population
Authors: Sbutega-Milosevic Gorica , Djordjevic Zorica , Marmut Zoran , Mugosa Boban
Published: May 2010

Introduction. Combating nutritional deficiencies of micronutrients, such as iodine, represents a priority task of health care organizations. In 2003, the World Health Organization (WHO) published the publication: Global Prevalence of Iodine Deficiency Disorders (IDD), according to which some 2,2 billion people live in areas poor in naturally occurring iodine. Approximately 13% of the world population suffer from goitre - one of the IDD. The recommended iodine content in table salt is 20-40 mg/kg, which should satisfy the daily iodine requirements of an adult. Objective. The authors sought to ascertain whether iodization of table salt in Montenegro was carried out in accordance with the existing legislature. An assessment was also carried out of the attitudes and habits of the population regarding the use of salt in nutrition and the level of awareness in relation to the relevance of table salt iodization. Methods. The research was carried out in 2004 and was sponsored by UNICEF. A sample of 594 homes from the municipalities of Bar and Podgorica was chosen: 354 homes from urban and 240 from rural areas. The participants completed a questionnaire related to the daily use and intake of salt, as well as their understanding of the relevance of table salt iodization. Iodine content was tested in 15 samples of table salt at production level, 170 samples at retail level and 126 samples taken from domestic use. Results. The analysis of table salt samples showed an optimal iodine level in 73.3% of samples from production, in 81.2% from retail, and in 73.0% from domestic use. A lower level of iodine was found in 8.8% retail samples and 15.1% samples from home use. A greater concentration of iodine was found in 26.7% production, 10.0% retail and 11.9% samples from domestic use. Conclusion. Although the application of the WHO programme has led to an improvement in iodization of table salt in Montenegro, both at production and retail levels, this still falls short of the standards recommended by WHO to combat IDD. The levels of iodine in table salt in domestic use also fail to comply with the WHO criteria for elimination of IDD.
Hip dislocation following the treatment of femoral neck fracture: Case report
Authors: Vukasinovic Zoran , Seslija Igor , Dulic Borislav
Published: May 2010

Introduction. Femoral neck fractures are very rare in young patients and are frequently complicated by femoral head osteonecrosis and femoral neck nonunion. Case Outline. A 19-year-old girl with hip dislocation following the treatment of the femoral neck fracture is presented. The femoral neck fracture was initially treated by open reduction and three-screw fixation. After detecting the nonunion of femoral neck, valgus osteotomy was done. Secondary, iatrogenic, hip dislocation appeared. The patient had pains, and in clinical findings a shorter leg and limited range of motion in the hip - altogether 40 degrees. She was then successfully treated by open reduction, together with Chiari pelvic osteotomy and joint transfixation. Transfixation pin was removed three weeks following the operation. After that, the patient was put into the abduction device and physical therapy was started. The mentioned regimen lasted four months after the surgery, then the abduction device was removed and walking started. Full weight bearing was allowed eight months after surgery. Conclusion. As we have not found the literature data concerning the above mentioned problem, we solved it in the way that we usually do for the treatment of developmental dislocation of the hip in adolescence.
Medial subtalar dislocation: Case report
Authors: Manojlovic Radovan , Starcevic Branislav , Tabakovic Dejan , Tulic Goran , Lesic Aleksandar , Bumbasirevic Marko
Published: May 2010

Introduction. Subtalar dislocation (SI) is a term that refers to an injury in which there is dislocation of the talonavicular and talocalcanear joint, although the tibiotalar joint is intact. Case Outline. A case of medial subtalar dislocation as a result of basketball injury, so-called 'basketball foot', is presented. Closed reposition in i.v. anaesthesia was performed with the patient in supine position and a knee flexed at 90 degrees. Longitudinal manual traction in line of deformity was carried out in plantar flexion. The reposition continued with abduction and eversion simultaneously increasing dorsiflexion. It was made in the first attempt and completed instantly. Rehabilitation was initiated after 5 weeks of immobilization. One year after the injury, the functional outcome was excellent with full range of motion and the patient was symptom-free. For better interpretation of roentgenogram, bone model of subtalar dislocation was made using the cadaver bone. Conclusion. Although the treatment of such injury is usually successful, diagnosis can be difficult because it is a rare injury, and moreover, X-ray of the injury can be confusing due to superposition of bones. Radiograms revealed superposition of the calcaneus, tarsal and metatarsal bones which was radiographically visualized in the anterior-posterior projection as one osseous block inward from the talus, and on the lateral view as in an osteal block below the tibial bone. Prompt recognition of these injuries followed by proper, delicately closed reduction under anaesthesia is crucial for achieving a good functional result in case of medial subtalar dislocation.
Investigation of Balkan endemic nephropathy in Serbia: How to proceed?
Authors: Djukanovic Ljubica , Stefanovic Vladisav , Basta-Jovanovic Gordana , Bukvic Danica , Glogovac Stevan , Dimitrijevic Jovan , Djuric Suncica , Jankovic Slavenka , Lukic Ljiljana , Maric Ivko , Nikolic Jovan , Novakovic Ivana , Pejovic Vesna , Radisavljevic Snezana , Rakic R
Published: May 2010

Balkan endemic nephropathy (BEN) presents an unsolved puzzle despite fifty years of its investigation. Academy of Medical Sciences of the Serbian Medical Society organized a round table discussion on current unsolved problems related to BEN. The present paper summarizes presentations, discussion and conclusions of this meeting. During the last fifty years, the course of BEN prolonged and it shifted towards the older age in all endemic foci. Data on the incidence of BEN have been controversial and frequently based on the data on the number of BEN patients starting haemodialysis treatment. In Serbia, BEN patients present 6.5% of haemodialysis population and this percentage differs among different centres ranging from 5% (Leskovac) to 46% (Lazarevac). Maintenance of high prevalence of BEN patients on regular haemodialysis indicates that BEN is not an expiring disease. In addition, recent data have shown more frequent microalbuminuria and low-molecular weight proteinuria in children from endemic than from nonendemic families. Aetiology of BEN is still unknown despite numerous investigations of environmental and genetic factors. Today, there is a very current hypothesis on the aetiological role of aristolochic acid but the role of viruses, geochemical factors and genetic factors must not be neglected. Morphological features of BEN are nonspecific and characterized by acellular interstitial fibrosis, tubular atrophy and changes on preand postglomerular vessels. New immunohistochemical and molecular biology methods offer a new approach to BEN investigation. Association of BEN with high incidence of upperurothelial tumours is well-known. Recent studies have shown significant changes of demographic characteristics of patients suffering upper-urothelial tumours, their prevalence in different endemic foci and characteristics of tumours. Further studies of BEN should be directed to determination of incidence and prevalence of disease in different endemic foci, investigations of different insufficiently examined aetiological factors as well as pathomorphological features of the disease by the use of modern methods.
Effect of oral hygiene training on the plaque control in patients undergoing treatment with fixed orthodontic appliances
Authors: Matic Sava , Ivanovic Mirjana , Nikolic Predrag
Published: May 2010

Introduction. During orthodontic treatment, there is increased risk of periodontal disease and caries. Therefore these patients must be trained to maintain proper oral hygiene to minimize risks. The aim of this study was to examine the effects of oral hygiene training with different devices as well as a motivation and remotivation in oral hygiene using brochures, verbal methods and tablets for plaque identification. Material and Methods. The study included 80 subjects, both genders, divided in control (20) and experimental groups (60). All examinees in the experimental groups used toothbrush Curaprox CP5460 for oral hygiene. Subjects in experimental group 1 used mouthwash Curasept ADS 205, in the experimental group 2 orthodontic toothbrush CD Ortho 60 and proximal toothbrush Curaprox CPS14 while subjects in experimental group 3 used proximal toothbrush Curaprox CPS14 and mouthwash Curasept ADS 205. All participants were given tablets erythrosine and brochure in which was explained and illustrated the use of the aforementioned means for oral hygiene. Control check ups were conducted at the beginning, after the first, third and sixth month of the preventive program. Results. The values of the examined parameters, plaque index (PI), gingival index (GI) and gingival bleeding index (GBI), in experimental groups were significantly lower compared to control group (p<0.05). Conclusion. Motivation, compliance and implementation of all preventive procedures proposed by this program, as well as regular controls, contributed in maintaining gingival health during orthodontic treatment.
Treatment possibilities of jaws bone defects: A case report
Authors: Tanaskovic Nenad , Ristic Sinisa , Lucic Miroslav
Published: May 2010

Large bone defects in the jaws can occur as a result of previous trauma, tumor or bone destruction caused by infection. Significant loss of bone volume also may be caused by premature loss of teeth, application of inadequate extraction technique, periodontitis or trauma caused by incorrect prosthetic reconstruction. Very few of these defects are treated using materials for bone augmentation or regeneration in order to preserve the total volume of bone. Depending on the size of a defect, spontaneous bone regeneration of untreated defects is limited by proliferation of surrounding soft tissue. Bone replacement by connective tissue leads to loss of stability, reduces function and disturbs anatomical form of the jaws. The aim of the study was to present a case from clinical praxis which demonstrates bone regeneration provided by bone substitute or its combination with bone grafts.
Celecoxib increases retinoid sensitivity in human colon cancer cell lines
Authors: Liu Jian-Pei , Wei Hong-Bo , Zheng Zong-Heng , Guo Wei-Ping , Fang Jia-Feng
Published: May 2010

Retinoid resistance has limited the clinical application of retinoids as differentiation-inducing and apoptosis-inducing drugs. This study was designed to investigate whether celecoxib, a selective COX-2 inhibitor, has effects on retinoid sensitivity in human colon cancer cell lines, and to determine the possible mechanism of said effects. Cell viability was measured using the MTT assay. Apoptosis was detected via Annexin-V/PI staining and the flow cytometry assay. PGE2 production was measured with the ELISA assay. The expression of RARβ was assayed via western blotting. The results showed that celecoxib enhanced the inhibitory effect of ATRA in both COX-2 high-expressing HT-29 and COX-2 low-expressing SW480 cell lines. Further study showed the ATRA and celecoxib combination induced greater apoptosis, but that the addition of PGE2 did not affect the enhanced growth-inhibitory and apoptosis-inducing effects of the combination. Moreover, NS398 (another selective COX-2 inhibitor) did not affect the inhibitory effects of ATRA in the two cell lines. Western blotting showed that the expression of RARβ in HT-29 cell lines was increased by celecoxib, but not by NS398, and that the addition of PGE2 did not affect the celecoxib-induced expression of the retinoic acid receptor beta. In conclusion, celecoxib increased the expression of RARβ and the level of cellular ATRA sensitivity through COX-2-independent mechanisms. This finding may provide a potential strategy for combination therapy.