bluuebunny/crossref_metadata_2025 huggingface dataset:
Active epidemiological surveillance in the program of poliomyelitis eradication in Serbia
Authors: Jevremovic Ivana , Antonijevic Bozidar , Loncarevic Goranka
Published: December 2010

The main strategy of the worldwide Program of Poliomyelitis Eradication is based on immunization with oral poliovirus vaccine and active epidemiological surveillance aimed to demonstrate the absence of wild poliovirus circulation. The specification of the surveillance in the program, reporting and investigation of certain syndrome ? the acute flaccid paralysis - as a specific feature of surveillance of poliomyelitis, is a new experience both for clinicians and epidemiologists. Along with the achieved results, problems in conducting the active epidemiological surveillance in Serbia, applied measures, and suggestions for improving its quality were presented. This experience might help in implementing the active surveillance for some other diseases that could be prevented by vaccine immunization.
Current therapy of the right ventricle myocardial infarction
Authors: Orozovic Vjekoslav , Gligic Branko , Krgovic Momcilo , Rafajlovski Sasa , Markovic Milic , Spasic Radenko , Ratkovic Nenad , Romanovic Radoslav
Published: December 2010

Background. Acute myocardial infarction of the right ventricle (AMI-RV) is a separate subgroup within the scope of inferoposterior infarction of the left ventricle. It still represents the population of patients at high risk due to numerous, often hardly predictable complications and high mortality rate. Methods. In fifteen-year period (1987-2001) 3?765 patients with the acute myocardial infarction (AMI) of different localizations of both sexes ? 2?283 males and 1?482 females of the average age 61.4???4.6 years were treated in our institution. Anterior myocardial infarction was diagnosed in 2?146 (56.9%) patients, inferior in 1?619 (43.1%) patients, out of whom right ventricular infarction (RVI) was confirmed in 384 (23.7%). Thrombolytic therapy was administered in 163 (42.4%) patients with RVI, and in 53 (41.7%) of these patients balloon dilatation was performed with coronary stent implantation in 24 (45.2%). Results. Favorable clinical effect of the combined thrombolytic therapy and percutaneous transluminal coronary angioplasty (PTCA) was achieved in 51 (96.1%), and in only 2 (3.9%) of patients the expected effect wasn't achieved. Myocardial revascularization was accomplished in 6 (3.6%) and 1 patient died. In 3 (3.4%) patients primary balloon dilatation with the implantation of intracoronary stent was performed within 6 hours from the onset of anginal pain. In the other group of 221 (57.5%) patients with RVI who did not receive thrombolytic therapy, or it had no effect, 26 (11.7%) patients died, which indicated the validity and the efficacy of this treatment (p<0,01). In the whole group of patients with myocardial infarction of the right ventricle 31 (8.1%) died; in the group that received thrombolytic therapy and PTCA 5 (3.1%) died, while in the group treated in a conservative way 26 (11.7%) died. Conclusion. Combined therapy was successful in the treatment of patients with RVI and should be administered whenever possible, since it was the best prevention of life-threatening complications and the decrease in the mortality of those patients.
Age and body mass related changes of cardiovascular risk factors in women with polycystic ovary syndrome
Authors: Macut Djuro , Micic Dragan , Parapid Biljana , Cvijovic Goran , Sumarac-Dumanovic Mirjana , Kendereski Aleksandra , Milic Natasa , Tulic Lidija , Muharemagic Azra , Zoric Svetlana , Pejkovic Danica
Published: December 2010

Polycystic ovary syndrome (PCOS) is considered a metabolic disorder closely related to obesity, insulin resistance (IR), hyperinsulinemia and unfavorable lipid profile, all increasing the risk for the occurrence of cardiovascular diseases. The aim of this study was to assess age and body mass index (BMI) related changes of cardiovascular risk factors in 90 women with PCOS. The cut-off age point was 30 years and for BMI 27.8 kg/m2. In all patients systolic and diastolic blood pressure (BP), metabolic parameters comprising values of glucose and insulin during oral glucose tolerance test (OGTT), and basal lipid values were determined. Significant increase in blood pressure (BP) indices, basal insulin values and insulin resistance (IR) assessed by HOMA model were observed with aging and the increase of BMI, while the parameters of glucose metabolism, total cholesterol and triglycerides were significantly elevated only with aging. However, the correlation between the indices of arterial blood pressure, and lipid and glucose metabolism parameters occurred only in patients over 30 years of age, pointing to the causative relation and the consequent deterioration of IR and lipid profile with aging, influencing cardiovascular function in women with PCOS.
Co-induction in outpatient anesthesia
Authors: Djordjevic Biljana , Loncar-Stojiljkovic Dragana , Ivanovic Dragan , Ivanovic Gordana , Stojiljkovic Milos
Published: December 2010

Cilj. Koindukcija u anesteziji je veoma korisna: sinergisticki efekti dva indukciona leka mogu da smanje indukcionu dozu i pojavu nezeljenih efekata. Cilj rada bio je da se ispitaju i uporede dve tehnike anestezije za kratke ginekoloske intervencije u ambulantnim uslovima. Grupa od 80 zena zakazana za hirurski prekid trudnoce podeljena je metodom slucajnog uzorka na dve jednake grupe - kontrolnu i koindukcionu. Metode. Prva grupa dobila je: atropin 0,5 mg, iv., alfentanil 0,5 mg iv. i propofol kao frakcionisani iv. bolus do gasenja refleksa trepavica. Druga grupa je dobila: atropin 0,5 mg, alfentanil 0,5 mg, midazolam 3 mg i propofol na isti nacin kao i prva grupa. Anestezija je odrzavana dodatnim dozama. Registrovani su kardiovaskularni parametri, kvalitet anestezije, nezeljena dejstva i brzina oporavka. Rezultati. Kod osoba koje su dobijale midazolam indukciona doza propofola bila je znacajno niza, dok kardiovaskularni parametri nisu bili znacajno razliciti. Oporavak posle anestezije bio je nakon koindukcije malo duzi, sto nije imalo klinicki znacaj. U koindukcionoj grupi uoceno je smanjenje nezeljenih dejstava. Zakljucak. Rezultati studije pokazali su da u ambulantnoj anesteziji koindukcija kombinacijom midazolam-propofol u poredjenju sa propofolom ima sledece prednosti: smanjenje doze propofola, bolji kvalitet anestezije i smanjenje nezeljenih dejstava. Oporavak je bio brzi u grupi koja nije dobijala midazolam, sto nije imalo klinicki znacaj. Zakljucak je da koindukcija kombinacijom midazolam-propofol ima prednost kod intervencija u ambulantnim uslovima.
Manufacture of tetracaine hydrochloride lozenges preparation by direct compression and wet granulation methods
Authors: Gazikalovic Emilija , Obrenovic Dusan , Nidzovic Zivorad , Colic Olivera
Published: December 2010

The results of quality testing of lozenges made by direct compression and by wet granulation procedure (Ph. Jug. IV) are presented. The aim was to determine hardness, friability and disintegration of the lozenges. Considering the fact that the produced tetracaine hydrochloride lozenges were not transported, but were made according to the needs of the Clinic of Gastroenterology, Military Medical Academy, time of disintegration, not hardness and friability, was the priority in making a choice of formulation. That is why tetracaine hydrochloride lozenges made with 3.5% solution of carmellose sodium, which have the longest disintegration were chosen, which made possible the longest contact of the local anesthetic with mucous membrane of mouth and throat.
Isolation of Chlamydia trachomatis or Ureaplasma urealyticum from the synovial fluid of patients with Reiter's syndrome
Authors: Pavlica Ljiljana , Draskovic Nada , Kuljic-Kapulica Nada , Nikolic Dragan
Published: December 2010

Background. The aim of this study was to contribute to the insight of the role of the infectious agent in ethiopathogenesis of the Reiter?s syndrome development, which could directly influence the choise of treatment of these patients. Methods. Eighteen patients with urogenital form of the Reiter?s syndrome and 16 controls (6 with rheumatoid arthritis and 10 with pigmented villonodular synovitis) were included in the study. In all patients standard laboratory analyses of the blood, urine and stool were made; antibody titer to Chlamydia trachomatis and Ureaplasma urealyticum was determined in synovial fluid and serum; isolation of Chlamydia trachomatis and Ureaplasma urealyticum in urethral, cervical and conjunctival swabs, as well as in prostatic and synovial fluid, was also made. HLA typing was done, too. Chlamydia was isolated in the McCoy cell culture treated with cycloheximide while Ureaplasma was identified according to its biochemical properties grown on cell-free liquid medium. Results. Chlamydia trachomatis was isolated from the synovial fluid of 4 patients with Reiter's syndrome 22.2%), while Ureaplasma urealyticum was isolated in 7 of them (38.9%). These microorganisms were not found in any synovial fluid of the control group patients. Conclusion. Presence of these bacteria in the inflamed joint might be an important factor in etiopathogenesis of this disease, and it supports the hypothesis that arthritis in Reiter's syndrome is probably of the infectious origin.
Surgical management of hand deformities in hereditary dystrophic epidermolysis bullosa
Authors: Panajotovic Ljubomir , Kozarski Jefta , Ribnikar Vladislav
Published: December 2010

In the period 1996-2001 in the Clinic for Plastic Surgery and Burns of the Military Medical Academy, 18 patients. 12 male and 6 female, with hereditary dystrophic epidermolysis bullosa (HDEB) and hand deformities were surgically treated, to achieve the complete separation of fingers, correction of the thumb adduction contracture and flexion or extension contracture of finger joints. The period of wound healing on flat surfaces after surgery, and the period between two operations was estimated. The most common deformity was the flexion contractures of metacarpophalangeal (MP) joints (45%) and one or both interphalangeal (IP) joints (types A1, A2). In 20% of the hands MP joint was streched with the flexion contracture in distal interphalangeal (DIP) or both IP joints (types B1, B2). In 35% of hands MP joint was in hyperextension with folded proximal interphalangeal (PIP) or both IP joints (C1 i C2). The adduction deformity of the thumb type 1, without the possibility of abduction, was present in 15%, type 2, when the thumb was placed above the palm in 60% and type 3, when the thumb was fused in the palm in 25%. Pseudosyndactyly of the first degree (till PIP joint) was found in 30% of hands, the second degree (till DIP joint) in 25%, and the third degree (the whole finger length) in 45% of hands. Fingers were completely separated and stretched surgically. The period of spontaneous healing was 15 days on the average. EBDC represents great medical and social problem that requires multidisciplinary approach of physicians of various specialties (surgeons, dermatologists, pediatrists, geneticists, nutritionists physiatrists, ophtalmologists, dentists, ENT, as well as specially trained persons and families). The efficient specific systemic therapy aiming to increase the skin resistence to mechanical trauma does not exist yet, and should be developed in the field of gene therapy. The surgical correction of hand deformities, acrylate glove use in the longer post operative period combined with physiotherapy, the active use of hands, the protection of injuries and skin care are the measures which prolong the period between the recurrence of contractures.
Relationship between QT dispersion and reperfusion in the acute myocardial infarction
Authors: Gligic Branko , Romanovic Radoslav , Radjen Goran , Tavciovski Dragan , Djuran Predrag , Obradovic Slobodan
Published: December 2010

Background. QT dispersion (QTd) represents the parameter of the expanded heterogeneity of myocard of ventricles. The aim of this study was to examine the dynamics of changes of QTd during the first 5 days of the acute myocardial infarction (AMI) in dependence to noninvasively estimated success of thrombolytic therapy. Methods. Thirty six patients with AMI were included in the study. All patients were treated with alteplaze according to rapid protocol. QTd (QTc max-QTc min) was measured immediately after the reception (0 min), after the thrombolytic therapy (90 min) and since the 2nd to the 5th day of the hospitalization. Reperfusion was estimated on the basis of electrocardiographic and biohumoral parameters. Results. In the group of 36 patients, 22 male and 11 female, both parameters of the reperfusion were not compatible in 3 patients. The other 23 patients had the reperfusion, while 10 patients did not have it. At the reception there was no significant difference of QTd between the group with reperfusion (79?34 ms) and the group without reperfusion (65?19 ms). After receiving alteplase, the average QTd in the group with reperfusion was 67?31 ms, which was not shorter in relation to the group without reperfusion (70?23 ms). Since the 2nd day of AMI, significantly smaller QTd in patients with reperfusion was not registered compared with the patients without the reperfusion (54?17 vs.73?20 ms), whereas since the 3rd day the difference became significant (46?16 vs. 87?24 ms). On the 4th day it was 43?12 vs. 78?21 ms, and on the 5th day it was 38?11 vs. 62?23 ms. On the 1st day significant difference of QTd between the groups with and without reperfusion was not registered in the group of patients with anterior AMI (0 min: 97?47 vs. 72?16; 90 min 68?47 vs. 72?20) whereas on the 2nd day it became statistically significant (51?15 vs. 74?20 on the 2nd day, 51?20 vs. 88?24 on the 3rd day, 46?10 vs. 81?19 on the 4th day and 40?8 vs. 69?22 ms on the 5th day. In the group of patients with inferolateral AMI, only on the 3rd day significant difference of QTd between the group with and the group without reperfusion was registered (43?14 vs. 69?29 ms), while in all other measuring it was not registered (0 min: 69?22 vs. 42?9; 90 min: 67?20 vs. 67?41; 55?19 vs. 60?25 on the 2nd day; 41?14 vs. 51?6 on the 4th day and 51?12 vs. 37?8 ms on the 5th day). Conclusion. Qt dispersion was of significantly shorter duration in patients with the successfully performed reperfusion in relation to the patients without the reperfusion. In patients with the anterior AMI, QTd was significantly different in patients with in relation to the patients without the reperfusion in distinction with the patients with inferolateral AMI.
Protein S and ischemic brain disease
Authors: Raicevic Ranko , Jovicic Aco , Mandic-Radic Slavka , Djordjevic Dragana , Markovic Ljubo , Dincic Evica
Published: December 2010

Ischemic brain disease (IBD) represents clinical entity participating with almost 80% in all vascular brain diseases. Ethiopatogenesis and pathophysiology of the ischemic brain disease are apparently most complex in human medicine. In addition to the significant progression in understanding of ethiopatogenesis and pathophysiology of the ischemic brain disease, we are currently aware of the fact that in one third of these patients the source - the disorder or the disease of crucial importance for this sequence of events in the opposing direction cannot be diagnosed with certainty. This case report presents a 32-year-old patient with the verified ischemic lesion of brain parenchyma, in whom the lowered concentrations of protein S were registered by comprehensive clinical and biochemical examinations. The lower concentrations of protein S are a significant co-factor of anticoagulant system, in the absence of other significant diseases, disorders or abnormalities which could ethiopatogenetically be significant for IBD.
Aortic valve stenosis: Prognosis and therapy
Authors: Ristic-Andjelkov Andjelka , Gligic Branko , Damnjanovic Milorad , Milovanovic Jovanka , Matunovic Radomir , Obradovic Slobodan
Published: December 2010

There is a long latent period in the clinical course of aortic valve stenosis in adults. Symptoms usually occur in the case of critical stenosis, when aortic orifice area is under 0.7cm2 (0.4 cm2/m2). In this study 78 patients with critical aortic valve stenosis were investigated. The first manifestation of the disease was dyspnea (78.2%), angina (52.5%), less often a syncope (34.6%), while 17.9% of patients were asymptomatic. Left ventricular systolic function was preserved in 77% of patients, while left ventricular dyastolic dysfunction occured in almost all the patients. In 42 patients (53.4%) aortic valve replacement was performed. Left ventricular systolic function improved in 88.1% of patients postoperativelly, as well as in patients with preoperativelly preserved or poor systolic function. Recovery was fast particularly during the first 6 postoperative months. After the surgery the improvement of the left ventricular dyastolic function was slower then systolic, particularly in patients with extreme hypertrophy of myocardium in whom the process of recovery might last several years.
Chlorambucil effect on B lymphocites in the peripheral blood of patients with chronic lymphocytic leukemia: Cell ultrastructure investigation
Authors: Brajuskovic Goran , Marjanovic Slobodan , Skaro-Milic Andjelija
Published: December 2010

B type Chronic Lymphocytic Leukemia (B-CLL) is a malignant disease characterized by the progressive accumulation of morphologically mature, but immunologically dysphunctional CD 5+ lymphocytes in the blood, bone marrow and lymphatic organs in the early phase of the cell cycle. B-CLL is an example of human malignancy caused by alternations in the pathways of programmed cell death - apoptosis. Recent investigations showed a probable role of apoptosis as a prognostic parameter in B-CLL patients. Since the introduction of chlorambucil in the therapy in 1952, besides all the achievements in modern oncology, chlorambucil remained the most common antineoplastic agent in the treatment of CLL. Numerous experimental studies both in vitro and in vivo, showed the capability of antineoplastic agents to induce the process of apoptosis of neoplastically transformed cells. In this study the effect of chlorambucil on B lymphocites was monitored in 16 samples of peripheral blood tarlen from B-CLL diagnosed patients. According to the investigations performed in this study by ultrastructure analysis of B-CLL cells, it was concluded that chlorambucil either induced apoptosis in B-CLL cells, or activated cell response to the stress.
Mesenteric and splenic venous thrombosis in a female patient with essential thrombocytosis and the resistance to activated protein C
Authors: Marisavljevic Dragomir , Elezovic Ivo , Bilanovic Dragoljub , Petrovic Natasa , Janjic Mirjana , Sefer Dijana
Published: December 2010

Splenic venous thrombosis is a rare disease in which an underlying hypercoagulable state can often be found. A 27-years old female patient with recurrent mesenteric venous and splenic thrombosis as a severe complication of an association of resistance to activated protein C and essential thrombocythemia is presented in this report. Establishing the diagnosis of essential thrombocytosis was particularly difficult because this was the case of the so called "silent" myeloproliferative disorder. The number of thrombocytes was almost normal before the splenectomy performed because of the splenic venous thrombosis. Thus, spontaneous growth of erythroid and megakaryocyte colonies in vitro and the clinical course of the disease were the clues for establishing the diagnosis, because the number of thrombocytes reached the values over 1500?109/l after only 1.5 years of the follow-up. The case of this patient was interesting particularly from the surgical point of view because of the management strategy.
Hypoxic-ischemic encefalopathy: Clinical course and prognosis
Authors: Cosic-Cerovac Natasa , Todorovic Slobodanka , Jovic Nebojsa , Prostran Milica
Published: December 2010

Background. Establishing the value of neurological examination, and additional diagnostic methods (ultrasonography and magnetic resonance imaging of the brain) in the diagnosis and prognosis of hypoxic-ischemic encephalopathy and its treatment, tracking the clinical course, and making the prognosis of neurological development in newborn infants with hypoxic-ischemic encefalopathy. Methods. The group of 40 term newborn infants with suspected intrauterine asphyxia was examined. All the infants were prospectivelly followed untill the 3rd year of age at the Clinic for Neurology and Psychiatry for Children and Youth in order to estimate their neurological development and to diagnose the occurence of persistent neurological disorders. All the infants were analyzed by their gestational age and Apgar score in the 1st and the 5th minute of life. They were all examined neurologically and by ultrasonography in the first week of life and, repeatedly, at the age of 1, 3, 6, 9, 12, 18, as well as in the 24th month of life. They were treated by the standard methods for this disease. Finally, all the infants were examined neurologically and by magnetic resonance imaging of the brain in their 3rd year of age. On the basis of neurological finding infants were devided into 3 groups: infants with normal neurological finding, infants with mild neurological symptomatology, and infants with severe neurological disorders. Results. It was shown that neurological finding, ultrasonography and magnetic resonance imaging of the brain positively correlated with the later neurological development of the infants with hypoxic-ischemic encephalopathy. Conclusion. Only the combined use of these techniques had full diagnostic and prognostic significance emphasizing that the integrative approach was very important in the diagnosis of brain lesions in infants.
The significance of cytologic examination of urine in the diagnosis of renal allograft dysfunction
Authors: Tatomirovic Zeljka , Bokun Radojka , Ignjatovic Ljljana , Aleksic Anastasija , Skuletic Vesna , Dimitrijevic Jovan
Published: December 2010

Background. This paper presents our experience with cytologic examination of urine in diagnosing renal allograft dysfunction. Methods. The study group included 23 patients with renal allograft dysfunction, selected from 56 patients who underwent renal transplantation. Etiologic diagnosis was made according to the clinical picture, histological findings during allograft biopsy, and cytologic examination of urine. Urine sediment was obtained in cytocentrifuge and was air dried and stained with May Grunwald Giemsa. Results. Out of 23 patients with allograft dysfunction in 18 (78.3%) patient it was caused by acute rejection, and in 5 (8.9%) patients by allograft infarction, cyclosporine nephrotoxicity, acute tubular necrosis and chronic nephropathy. In eighteen patients (78.3%) cytologic examination of urine was pathologic, while in 16 (70%) clinical and histology findings coincided with urine cytology findings. Out of 18 patients with acute allograft rejection in 15 patients cytologic examination of urine coincided with acute rejection. Out of 7 patients with expressed cyclosporine nephrotoxicity, in 5 cytologic examination of urine confirmed the cause of allograft dysfunction, as well as in one of 2 patients with acute tubular necrosis. Cytologic examination of urine indicated parenchymal damage in 2 patients with reccurent disease (membranoproliferative and focal sclerosing glomerulonephritis). In 4 of 5 patients suffering from chronic rejection in a year?s monitoring period, urine sediment periodically consisted of lymphocytes, neutrophilic leucocytes, monocyte/macrophages, tubular cells and cilindres, without the predominance of any cell type. In 3 patients allograft dysfunction was caused by infective agents (bacteria, fungus cytomegalovirus). Conclusion. Cytologic examination of urine might be an alternative to histological in diagnosing acute allograft rejection and acute tubular necrosis or nephtotoxicity. Also it might indicate parenchymal disease while the importance of urine cytology in chronic allograft nephropathy needs to be investigated further.
Soldiers’ quality of life during military service
Authors: Dedic Gordana
Published: December 2010

Quality of life of soldiers is the ability to participate in professional activities during the military service in accordance with intrapsychic state. The aim of this study was to establish the categories of quality of life, which are important for soldiers' adjustment during the military service. The investigation was performed on the subjects of the two squads of soldiers of Yugoslav Armed Forces, divided into three groups according to the period of investigations: after the first month, after the basic training, and at the end of military service. The applied instruments of the investigation were sociodemografic questionnaire and Quality of Life Scale (QLS). Statistical analysis of the obtained data was made by t-test. Investigation results showed that quality of life of soldiers during the military service depended on intrapsychic state, interpersonal relations and solidiers? adjustment to common objects and activities, and did not depend on their occupational role.
Savremeni trend razvoja klinicke elektromiografije
Authors: Petkovic Stevan
Published: December 2010

 Kombinovana primena EMG tehnika uz pomoc kompjutera i standardizovanih softvera omogucava novi pristup u sagledavanju mikrofiziologije i mikropatologije MJ: od nivoa pojedinacnih misicnih vlakana (mikro EMG), preko njihove funkcije i anatomske strukture unutar jedne MJ (standardni EMG i skenirajuci EMG) do elektrofizioloskih karakteristika celokupne teritorije MJ u ispitivanom misicu (makro EMG) (slika 13). Navedene elektrofizioloske tehnike mogu da opisu fizioloski status MJ i pojedinacnih misicnih vlakana u vise detalja nego sto je to bilo moguce ranije koriscenjem samo standardne EMG. Ove tehnike pruzaju dragocenu pomoc ne samo u dijagnostici vec i u razumevanju patofizioloskih procesa koji se desavaju u NB.
Operative treatment of the displaced intraarticular fractures of the calcaneus
Authors: Popovic Zoran , Rajovic Jovo
Published: December 2010

Most calcaneal fractures occur in male industrial workers, having significant economic repercussions. Although current operative treatment has improved the outcome of the treatment in many patients, there is still no consensus on the classification, treatment, operative technique, or postoperative management. Computed tomographic scanning has improved our understanding of these fractures substantially, and has allowed the consistent analysis of the results of the treatment. The focus of current treatment is on the operative methods, internal fixation by leg-screw and plate through the lateral Kocher approach. Between April 1998 and July 2002, we treated operatively 6 displaced intraarticular fractures of the calcaneus. A lateral Kocher incision, leg-screw, and plate fixation were used. Neither infection, nor nonunion, or malunion occurred. All the patients presently have painless foot, use normal footwear, and are capable of normal activities.
Surveillance of some bacterial causative agents of nosocomial infections during the war and peace period
Authors: Suljagic Vesna , Mirovic Veljko , Tomanovic Branka
Published: December 2010

Surveillance based on laboratory findings of bacteria isolated from hospitalized patients is an important activity in epidemiologic surveillance of nosocomial infections. It provides the insight into the circulation and management of some causative agents of nosocomial infections in hospitals which facilitates defining of proper measures for the prevention and suppression of nosocomial infections caused by these agents. The aim of this study was to analyze and compare surveillance data collected in Military Medical Academy (MMA) during June 1999 (the period of war) and June 2000 (the period of peace). Isolation frequency of bacteria that were the most common agents of nosocomial: Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli, Acinetobacter spp. and Enterococcus spp., was monitored in patients from 5 various surgical wards of MMA. In the war period, the increase of number of isolates of all these bacteria was registered, but the increase of isolated Acinetobacter spp. was the most significant. The total number of isolates was greater in June 1999 in comparison to June 2000. Most isolates were recovered from wound cultures when the increased number of Enterococcus spp. Methicillin-resistant Staphylococcus aureus isolated from the blood was registered. In the period of peace isolates of Pseudomonas aeruginosa manifested reduced resistance to quinolones, imipenem and 3rd generation cephalosporins. Barrier infection control measures are necessary in preventing nosocomial transmission particularly in the wartime. Thus, preventive medicine is important for performing efficient surveillance, and suggesting the adequate measures for prevention and repression of nosocomial infections, particularly in the period of war.
Health promotion and health education: Theory and practice
Authors: Beric Bojana , Dzeletovic Andjelka
Published: December 2010

Background. Since health promotion and health education are developing concepts around the world, the purpose of this paper was to compare theory and practice, at certain point in time in various countries. Methods. Data were collected using the structured direct interview. We approached 16 participants at the XVI World Conference on Health Promotion and Education. The responses of 11 participants were analyzed. Results. Health promotion is a separate profession in 4 out of 11 countries. Physicians are responsible for health promotion and education in all 11 countries. School was identified as a health promotion setting in all 11 countries, while community and hospital in 10. The Ottawa Charter (1986) guided the definition of health promotion for all participants, while 7 participants defined health promotion and health education differently. Conclusion. Unified definition of terms may allow similar practice at the international level; comprehensive approach to health includes all aspects of health, determinants, settings and practitioners; there occurs the need for health education as a separate profession globally.
Occurrence of hemorrhagic fever with renal syndrome in military unit stationed in the combat zone
Authors: Ciric Slavisa , Djenic Vesna , Mitrovic Vekoslav , Mitrovic-Perisic Natasa , Djenic Nebojsa , Ciric Slobodan
Published: December 2010

Since it has been recognized as a separate disease during the Korean war hemorrhagic fever with renal syndrome (HFRS) has often been discovered among the members of different armies in various countries, military personnel being the highest risk group for the disease. In the period from March to May 1999 we treated 6 soldiers coming from the military formation stationed at Kosovo and Metohia. The reaction of indirect hemagglutination test proved the presence of antibodies against Hantavira in each of them. They were infected during the stay in a dugout in the area with great population of field rodents. Only one patient was slightly ill, on the admission to the hospitalall. The others had severe clinical and laboratory findings: several days lasting fever, strong abdominal pain, as well as the pain in the loins dyspeptical discomfort, manifold increased blood urea nitrogen and serum creatinine values, thrombocytopenia, etc. Oliguria occurred in 4 patients. Hemorrhagic manifestations were slight (epistaxis, petechial rash conjunctival injection), or absent. Because of the aggravation of the acute renal failure, hemodialysis was performed in 3 patients, while other 3 underwent conservative treatment. Two of the patients had severe anemia because of which transfusions of erythrocytes and plasma were performed. Complications occurred in 2 patients (convulsive crises and lung infections). All patients recovered completely.
Chylous effusions
Authors: Tomic Ilija , Plavec Goran , Karlicic Vukojica , Spasic Vuleta , Rusovic Sinisa , Stanic Vojkan , Cvijanovic Vlado , Ristanovic Aleksandar
Published: December 2010

This paper presents 4 patients with chylothorax, and one patient with bilateral chylothorax and chyloperitoneum. The chylous effusions were of benign etiology, developed as a complication of miliary tuberculosis (1 patient), after L-2 vertebral body fracture (1 patient), and idiopathic (2 patients). The diagnosis was confirmed by the presence of chylomicrons and high content of triglycerides in the effusion, ranged 11,9-29,1 mmol/l. Lymphangiography showed multiple abnormalites of lymphatic system, the obstruction of ductus thoracicus, dilatation and convulsion of lymphatic channels, but the site of lymphatic leak was not detected. The treatment included an extended period of pleural and peritoneal drainage with total parenteral nutrition (1 patient), pleurodesis using Corynebacterium parvum (2 patients), and surgical partial parietal pleurectomy with continous drainage (1 patient). The treatment was successful in all patients.
Influence of the elevated ambient temperature on immunoglobulin G and immunoglobulin G subclasses in sera of Wistar rats
Authors: Jurhar-Pavlova Maja , Petlichkovski Aleksandar , Trajkov Dejan , Efinska-Mladenovska Olivija , Arsov Todor , Strezova Ana , Dinevska-Kjovkarova Suzana , Mitev Slavcho , Spiroski Mirko
Published: December 2010

The aim of our research was to examine changes in the immune system of the rats influenced by the elevated ambient temperature. Male Wistar rats were divided, into 2 groups and housed at 20 ? 2?C (n=64, control group) and 35 ? 1?C (n=74, experimental group), during precise timing of 1, 4, 7, 14, 21, and 30 days. All the animals were given food and water ad libitum, and were lighted during 12 hours per day. We have measured IgG, IgG1, IgG2a, IgG2b and IgG2c. The obtained results showed significant elevation in the level of IgG after 4 and 7 days (+32%), IgG2a after 7th (+88%), 14th and 21nd day (+110%), IgG2b after 14 days (+60%) at 35 ? 1?C compared with the control group at 20 ? 2?C. IgG1 level was not affected and IgG2c showed significant decrease after 21st day at 35 ? 1?C. In conclusion, during the elevated ambient temperature the immune system is activated as one of the regulation mechanisms in homeostasis and survival of the population.
Surgical treatment of pertrochanteric fractures by dynamic methods of external and internal fixation
Authors: Milenkovic Sasa , Mitkovic Milorad , Radenkovic Mile , Mladenovic Desimir , Soldatovic Gordana , Micic Ivan , Stanojlovic Milos
Published: December 2010

Pertrochanteric fractures usually occur in patients over 65 years of age, with greater loss of skeletal mass (osteoporosis). Nonsurgical methods of treatment are accompanied by relatively high lethality rate. Moreover, they do not produce satisfactory anatomical and functional results. Surgical treatment by using dynamic implants represents a method of choice in the fixation of pertrochanteric fractures. This paper presents the treatment results of 110 patients, 61 with pertrochanteric fractures, who were surgically treated by the dynamic method of internal fixation, and 49 patients who were treated by the method of external fixation. Dynamical implants enabled both dynamization and compression of the fracture in the axis of the neck, as well as the diaphysis of the femur, which lowered the risk of mechanical complications, and, at the same time, provided effective healing of the fracture, early activation, and mobilization of the patients on whom the surgery was performed. In patients infected by various diseases, for whom surgical trauma represents a life threat, the external fixation is recommended as a method of choice.
Diagnostic value of F-response in the localization of the level of the lesion of peripheral motor neuron
Authors: Cvetkovic Biljana , Petkovic Stevan
Published: December 2010

F-wave is a secondary muscle response, which occurs by antidromic activation of the limited number of alphamotoneurons. Based on M- and F-response and the nerve length, the conduction time, conduction velocity, and the ratio of F-response can be determined. These parameters help in assessing the data about functional condition of peripheral motor neurons along the most proximal segment in relatively simple and non-invasive way. In routine practical work, minimal latency of F-wave is measured, while F-wave conduction time, F-wave conduction velocity and F-ratio are not measured. The aim of this research was to examine the importance of F-wave latency, F-wave conducution time, F-wave conduction velocity, and F-ratio in the localization of level of lesion of peripheral motor neurons. Electromyoneurography examination included 50 patients with radiculopathies of lumbosacral part of spinal cord, 50 patients with neuropathy, and 25 healthy persons. Minimal latency of F-wave for tibial nerve and peroneal nerve was determined after 10 stimulations. F-wave latency, F-wave conduction time, F-wave conduction velocity, and F-ratio were determined in accordance with the formulas defined by Kimura. The results of our test have shown that F-wave latency, F wave conducution time, F-wave conduction velocity, were important electrophysiological parameters, while F-ratio was found to be highly sensitive, which made it the most valid electro-physiological parameter in the differentiation of proximal and distal lesion of peripheral motor neuron.
Acute poisoning by cardiovascular agents
Authors: Vucinic Slavica , Vucinic Zarko , Segrt Zoran , Joksovic Dragan , Jovanovic Dusan , Todorovic Veljko
Published: December 2010

In order to determine the frequency, severity of poisoning, and the efficacy of the applied therapeutic measures, retrospective study of 391 patients treated for acute drug poisoning was performed during one-year period at the Clinic for Emergency and Clinical Toxicology and Pharmacology. In 49 (12.5%) patients cardiovascular agents were the cause of poisoning, most frequently beta-blockers and calcium antagonists (77.5%). Poisoning with antihypertensive agents was registered in 12.2% of patients, antiarrhythmics in 8.2%, and cardiotonics in 2.1%. Beta-blockers and calcium antagonists caused severe poisoning in over 40% of cases. Predominant clinical manifestations were registered on cardiovascular system, while central nervous system effects occured secondary to cardiotoxicity. Symptomatic and supportive measures were performed most frequently, while specific agents, glucagon, calcium salts, and others, were used less often.
Colchine in dermatology
Authors: Karadaglic Djordjije , Popovic Milica
Published: December 2010

 Kolhicin je stari lek cija je primena, kao monoterapija ili u kombinaciji sa drugim lekovima, aktuelna i u savremenoj medicini. Najznacajnija mu je primena za lecenje i profilaksu perzistentne palmoplantarne pustuloze i oralnih aftoznih ulceracija, lecenje Svitovog sindroma, Beh?etove bolesti, sklerodermije i fibromatoze penisa.
Changes in the oral cavity caused by scurvy
Authors: Dakovic Dragana , Ljuskovic Besir , Mileusnic Ivan , Tepsic Vesna
Published: December 2010

This report presents a case of a psychiatric patient with scurvy. Upon the clinical examination of the oral cavity, dry and pale lips were noted. Gingiva was highly edematous, soft, purple blue with ulcerated margins. Bleeding was noted upon slightest provocation. Teeth were also affected by the vitamin C deficiency with multiple caries. The patient was asthenic and adynamic. Petechial bleeding and hematomas were present on the skin of extremities. Therapy consisted of rehydration and vitamin C compensation - 2 g daily i.v. during 10 days period, and 1.5 g daily orally during the following 2 months. The patient maintained only partial plaque control, and complete recovery of the oral cavity was not established because the patient didn?t comply. Concerning that scurvy is a rare disease nowadays, it is very important to recognize its clinical signs, and to establish a valid and prompt diagnosis, because, when untreated, scurvy can have severe consequences on the entire organism.
Influence of nifedipine on gingiva of Wistar rats
Authors: Brkic Zlata
Published: December 2010

Noninflammatory hyperplastic growth of gingiva induced by calcium channel blockers, mostly nifedipine, is often seen in everyday dental practice. In order to establish an association of nifedipine and gingival hyperplasia, experimental model was used. Wistar rats were given water solution of nifedipine in different daily doses, using specially designed cannula. At the beginning of the experiment, before the application of nifedipine and in the determined time periods, gingival volume was measured. The volume of lower incisors interdental central papillas, represented multiplied values of vertical hight, mesio-distal width, and bucco-lingual depth, expressed in millimeters. The results indicated that gingival hyperplasia was more excessive in the experimental animals, which were given higher doses of the drug for longer time period. Nifedipine is a drug which induces gingival fibroblasts to produce higher quantity of collagen that causes gingival overgrowth.
Osteoid osteoma: A ten-years treatment experience
Authors: Starcevic Srdjan , Nikolic Dragan , Tatic Vujadin , Popovic Zoran
Published: December 2010

Aim. To review ten-years experience in diagnostics and operative treatment of osteoid osteoma. Methods. A total of 15 patients were retrospectively analyzed in this study. Clinical diagnosis was based on medical check-up, aspirin test, and conventional laboratory and radiographic examinations. CAT scan radionuclide bone scan, and magnetic resonance were performed in certain cases. All the patients were operatively treated by local resection of the tumor-infested bone. The resected part of the bone was intraoperatively checked by X-ray. The aim of this examination was to verify nidus in the resected bone. Afterwards, the resected bone with nidus was histologically analyzed. Results. Osteoid osteoma was histologically verified in 86.6% of cases. Other forms of bone tumors were verified in 13.3%. In the early postoperative period patients were without previous discomforts. Future treatment consisted of regular medical check-up of all the patients. In order to verify the final results, in February 2002 another medical check-up was performed for 11 patients, upon their consent. All of the patients with verified osteoid osteoma were without discomforts. Medical findings were regular in each case. Conventional radiography showed a solid bone remodelling in place of resected bone. Conclusion. Osteoid osteoma is a benign bone tumor with typical clinical and radiographic findings. Operative treatment represents a method of choice and demands accurate preoperative localization of the lesion, with the help of computer-assisted tomography.
Expression of Bcl-2-family proteins in peripheral blood B-lymphocytes in patients with cronic lymphocytic leukemia
Authors: Brajuskovic Goran , Vukosavic Slobodanka , Dimitrijevic Jovan , Cerovic Snezana , Usaj-Knezevic Slavica , Marjanovic Slobodan , Romac Stanka , Milic-Skaro Andjelija
Published: December 2010

Chronic lymphocytic leukemia (CLL) is a neoplastic disease characterized by the accumulation of morphologically mature monoclonal CD 5+ B cells in the early phase (G0/G1) of the cell cycle. It is considered that the accumulation of neoplastically transformed lymphocytes B (CLL cells) is primarily the consequence of the disturbance, i.e., blockade of these cells' apoptosis process. Apoptosis is the specific process of programmed cell death regulated by numerous extracellular and intracellular mechanisms. The Bcl-2 proteins are well-known modulators of this process. Some of these proteins (such as Bcl-2, and Bcl-Xl) are anti-apoptotic, while others (such as Bad or Bax) are pro-apoptotic. Our study included the analysis of 20 peripheral blood specimens from 20 patients with CLL, and 20 peripheral blood specimens of healthy persons who represented the control group. Using Western blotting analysis, we quantitatively examined the protein expression of Bcl-2 family (Bcl-2, Bax, Bad, and Bcl-Xl). The level of Bcl-2 (p=3,68?10-10), Bax (p=0,019), and Bad (p=0,073) proteins expression was significantly increased in all the analyzed peripheral blood samples of patients, while the level of Bcl-Xl protein (p=0,75) did not significantly differ in peripheral blood samples of patients, compared to the controls. The results of this study showed that the increased level of expression of Bcl-2, Bax, and Bad protein represented the most striking feature of CLL cells. Moreover, the variations in the expression of only one protein of the Bcl-2 family could not represent the prognostic parameter in the treatment of this disease.
Primary ciliary dyskinesia
Authors: Plavec Goran , Tomic Ilija , Skaro-Milic Andjelija , Radojcic Branko , Acimovic Slobodan
Published: December 2010

In patients with chronic respiratory diseases that last since the early childhood, primary ciliary dyskinesia (PCD) needs to be considered. Four patients reviewed in this paper were with typical disease history and clinical picture, as well as clear ciliary axonema damage. Complete examination was performed in all the patients, including bronchoscopy with bronchography, and the examination of the biopsy samples of respiratory airways? mucous membrane, obtained by transmission electron microscope (TEM). In two of the patients spermatozoa were also examined by TEM. Large anatomic deffects of airways were found in all the patients, but pulmonary function was normal (except in one case), representing one of PCD?s significant characteristics. First two cases fulfilled the criteria for Kartagener?s syndrome, which was initially sufficient for the diagnosis of PCD.
Evaluation of usefulness of single-strand conformation polymorphism method for rapid detection of rifampicin-resistant mycobacterium tuberculosis
Authors: Tesic Jelena , Lepsanovic Zorica , Mirovic Veljko
Published: December 2010

The aim was to evaluate the Single-Strand Conformation Polymorphism method as a potential tool for rapid detection of rifampicin-resistant strains by the use of 39 rifampicin-resistant Mycobacterium tuberculosis strains isolated in Serbia. SSCP analysis on acrylamide gel detected 56.4% of the rifampicin-resistant M. tuberculosis strains and showed the inability to detect one of the most frequent mutations, TCG?TTG mutation in codon 531 of the rpoB gene, which was shown by automated sequencing.
Breast reconstruction by pedicled transverse rectus abdominis myocutaneous flap
Authors: Kozarski Jefta , Djordjevic Boban , Sijan Goran , Stankovic Goran , Stanojevic Bojan
Published: December 2010

Reconstruction of the amputated breast in female patients after surgical management of breast carcinoma is possible with the use of autologous tissue, synthetic implants, or by combining autologous tissue and synthetic materials. Autologous tissue provides soft and sufficiently elastic tissue which is usable for breast reconstruction and eventually obtains original characteristics of the surrounding tissue on the chest wall. The use of the TRAM flap for breast reconstruction was introduced in 1982 by Hartrampf Scheflan, and Black. The amount of the TRAM flap tissue allows breast reconstruction in the shape most adequate to the remaining breast. The possibilities of using the TRAM flap as pedicled myocutaneous flap or as free TRAM flap make this flap a superior choice for breast reconstruction in comparison with other flaps.