bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical and radiological manifestations of paraneoplastic syndrome of bronchogenic carcinoma
Authors: Goldner Branislav , Milosevic Zorica , Sadikovic Sead , Stojanovic Milan
Published: July 2008

The objective of this study was to present some clinical and radiological manifestations of PNS in relation to bronchogenic carcinoma (BC) and to evaluate the usefulness of imaging findings in the diagnosis of asymptomatic BC. In the study group of 204 patients (146 male and 58 female) with proven bronchogenic carcinoma, PNS was present in 18 (8.62%) patients. The patients with PNS were divided into two groups. The first one consisted of 13 (72.2%) patients with symptoms related to primary tumours while the second one consisted of 5 (27.7%) patients with symptoms, at initial appearance, indicative of disorders of other organs and systems. The predominant disorder was Lambert-Eaton Syndrome, associated with small-cell carcinoma. Endocrine manifestations included: inappropriate antidiuretic hormone production syndrome (small-cell carcinoma), a gonadotropin effect with gynaecomastia and testicular atrophy (planocellular carcinoma, small-cell carcinoma), a case of Cushing Syndrome (small-cell carcinoma), and hyper-calcaemia, due to the production of the parathyroid hormone-related peptide, which was associated with planocellular carcinoma. A rare case of bilateral exophthalmos was found as PNS at adenocarcinoma. Digital clubbing and hypertrophic osteoarthropathy (HO) were associated with planocellular and adenocarcinoma, while clubbing was much more common than HO, especially among women. The differences between the two groups were related to the time of PNS appearance. In the first group, PNS occurred late on in the illness, while in the second group, PNS preceded the diagnosis of BC. Alternatively, the disappearance of a clinical or a radiological manifestation of PNS after surgery or chemotherapy may be an indicator of an improvement in health or PNS may be the first sign of illness recurrence. Radiological manifestations of PNS in asymptomatic patients may serve as a useful screen for identifying primary BC. In symptomatic patients, it may be an indicator of a higher likelihood of metastatic disease.
Primary pancreatic non-Hodgkin's lymphoma
Authors: Colovic Natasa , Cemerikic Vesna , Colovic Radoje , Grubor Nikica
Published: July 2008

Diffuse large-cell B lymphoma of the pancreas is a rare disease, representing less than 1% of all non-Hodgkin's lymphomas and less than 0.9% of all malignant tumors of the pancreas. About 150 cases of the disease have been observed so far. The tumors are more frequent in the head of the pancreas then in other parts of the organ. They are usually larger (average size of 8 cm) and are non-resectionable. As a rule, exact diagnosis is based on the histology and the immunohistology of the specimen taken during open surgery performed for general diagnosis of the pancreatic tumor. Very rarely can a very reliable and experienced cytopathologist establish a proper diagnosis based on material obtained from a fine needle biopsy. The disease usually responds positively to immunochemotherapy according to protocol R-CHOP. Occasionally, additional radiotherapy may be required. We present two women, 66 and 49 years old, in whom a diagnosis of large-cell B lymphoma of the pancreas was established, based on the histology and the immunohistochemistry of a specimen taken during open surgery performed in order to remove pancreatic tumors, which turned out to be non-resectionable. After immunochemotherapy, the symptoms disappeared and the tumors shrank, in one patient after additional radiotherapy. The authors would like to point out the importance of a proper histological diagnosis, which permitted the application of immunochemotherapy alone or together with additional radiotherapy with at least temporarily favorable results.
Bronchogenic cyst of the abdomen
Authors: Colovic Radoje , Micev Marjan , Radak Vladimir , Grubor Nikica , Stojkovic Mirjana , Colovic Natasa
Published: July 2008

A bronchogenic cyst is a rare congenital anomaly that appears in the thorax, usually the lungs or the mediastinum, being much rarer in the retrosternal space, within the pericardium or the diaphragm, as well as in the neck, while localization within the abdomen is extremely rare, with only about 30 reported cases. We present the case of a 68-year-old woman. During an investigation for an epigastric pain, a cystic lesion in the area of the body and tail of the pancreas was found. During open surgery, a cystic lesion, spanning 95x75x70 mm, above the body and tail of the pancreas was excised. The wall of the cyst was 8-12mm thick; it contained viscous fluid, the culture of which stayed sterile. Histology determined that it was a bronchogenic cyst. After an early uneventful recovery, the patient developed a left colonic fistula, which healed spontaneously within 3 weeks, probably because of the unnoticed operative damage to the splenic flexure of the colon during splenectomy, which was adherent to the cystic mass and impossible to save during excision. Six months after surgery, the patient continued to remain symptom free.
Gingival and dental parameters in the evaluation of aesthetic characteristics of fixed restorations (II)
Authors: Obradovic-Djuricic Kosovka
Published: July 2008

This paper is a continuing evaluation of dental and facial parameters in the estimation of aesthetic characteristic of fixed restorations. First of all, attention is paid to the phenomenon describing the tooth tissue's characteristics (transiucency, opalescence, and transparency). The paper also discusses tooth color as a special occurrence, the position of the lower lip line as well as the symmetry of the smile. In addition to these fundamental objective criteria, the paper also deals with subjective criteria (tooth arrangement and position, variation in tooth form, and relative crown length), which play a part in the successful aesthetic integration of fixed restorations.
Thoracic electrical bioimpedance in the follow-up of patients with cardiovascular disorders
Authors: Stojanov Vesna , Saranovic Mirko , Jakovljevic Branko , Paunovic Katarina
Published: July 2008

Thoracic electrical bioimpedance is a new non-invasive technique for obtaining haemodynamic parameters. The method involves the passing of low amperage, high frequency current through the thorax. The current induces a change of resistance within the thorax, which is registered by electrodes. The overall impedance of the thorax is a measure of the electrical resistance of the thorax to this high frequency, low amplitude current. In clinical practice, thoracic electrical bioimpedance has been applied in diagnostic, therapeutic, and prognostic use in patients with heart failure and hypertension, patients with pacemakers, within the scope of early diagnosis of implant rejection following heart transplantation, as well as in patients with kidney disorders, before and after dialysis. However, one of its most important applications is in the determination of antihypertensive therapy, because it provides the parameters that reflect the genesis of arterial blood pressure, in assessing these parameters, optimal therapy adjusted to the haemodynamic status of each patient can be prescribed.
HIV infection and the kidneys, Part I
Authors: Basta-Jovanovic Gordana
Published: July 2008

HIV- (Human immunodeficiency Virus) infected patients may be faced with a variety of renal problem patterns. Acute renal failure is common and most often the result of sepsis, hypertension, and toxic agents. Besides acute renal failure, HIV-associated nephropathy occurs in many HIV-positive patients, representing a unique pattern of sclerosing glomerulopathy, Many authors consider it to be the most rapidly progressive form of focal segmental sclerosis.
Physiological aspects of altitude training and the use of altitude simulators
Authors: Rankovic Goran , Radovanovic Dragan
Published: July 2008

Altitude training in various forms is widely practiced by athletes and coaches in an attempt to improve sea level endurance. Training at high altitude may improve performance at sea level through altitude acclimatization, which improves oxygen transport and/or utilization, or through hypoxia, which intensifies the training stimulus. This basic physiological aspect allows three training modalities: live high and train high (classic high-altitude training), live low and train high (training through hypoxia), and live high and train low (the new trend). In an effort to reduce the financial and logistical challenges of traveling to high-altitude training sites, scientists and manufactures have developed artificial high-altitude environments, which simulate the hypoxic conditions of moderate altitude (2000-3000 meters). Endurance athletes from many sports have recently started using nitrogen environments, or hypoxic rooms and tents as part of their altitude training programmes. The results of controlled studies on these modalities of high-altitude training, their practical approach, and ethics are summarized.
Implantable "loop recorder": A new diagnostic tool for syncope of unknown cause
Authors: Milasinovic Goran , Zivkovic Mirjana , Jovanovic Velibor , Jelic Vera , Savic Dragutin , Pavlovic Sinisa , Calovic Zarko
Published: July 2008

Introduction. The implantable loop recorder (ILR) is a new diagnostic tool in cardiology for establishing The causes of unexplained syncope in patients where standard conventional tests, invasive tests included, have failed. The device is a diagnostic "pacemaker," surgically implanted underneath the skin of the chest, with leads attached to the case of the device, not requiring endovenous lead implantation. Heart rhythm is monitored continuously on the basis of an endless loop, up to a maximum period of 14 months. Recording is carried out either by applying an outside activator whenever symptoms occur, or automatically, according to a preset algorithm for bradycardia, tachycardia, and/or asystolic detection. Objective. The aim of this study was to present this new diagnostic method as well as our first experiences with its implementation. METHOD We followed 5 patients (3 male, 2 female, mean age: 46.4?19) who had ILRs ("Reveal Plus," Medtronic Inc., USA) implanted at our centre, over a period of 14 months (7.6 ?5.5], concentrating on their clinical course, symptom occurrence, and electronically monitored heart rhythm at the time of ILR auto activation and/or recordings triggered by outside activation whenever a patient's symptoms were discernible. Results. In three patients, the ILR revealed syncope aetiology by documenting heart rhythm at the time of its occurrence. In one patient, involving a lethal outcome, the ILR was not explanted, so that the rhythm at the time of the fatal syncope, although assumed, remained undocumented, in one, most recently implanted patient, follow-up is still in progress. Conclusion. The implantable loop recorder represents an important innovation and a step forward in establishing the causes of recurrent syncope, which cannot be determined by standard invasive and non-invasive testing.
Brain abscesses in neonates: Neurosonographic diagnosis and long-term follow-up
Authors: Obradovic Slobodan , Stojkovic-Andjelkovic Andjelka , Vuletic Biljana , Radovanovic Marija
Published: July 2008

Brain abscesses were neurosongraphically diagnosed in 3 out of 44 neonates who had confirmed purulent meningitis. In two cases, the cause was Proteus mirabillis, whereas in one the cause could not be isolated. The ultrasound finding indicated abscess cavities localized in the frontal (in one case bilaterally) and temporal regions of the CNS. Neurosurgical interventions were carried out on all of the neonates who had abscesses (including the evacuation of purulent cavity contents, and later on a ventriculoperitoneal shunt in two cases, because of the development of hydrocephalus). Follow-up on the operated infants revealed that one infant died at the age of 9 months; one, who had a bilateral abscess, demonstrated significant neurodevelopmental retardation in the third month of his life (so far it has not been brought under control); while the third one, whom we monitored until the age of 2, displayed regular psychomotor development (preserved intellect, motor skills, sight, and hearing).
Focal nodular hyperplasia
Authors: Colovic Radoje , Grubor Nikica , Radak Vladimir , Colovic Natasa
Published: July 2008

Thanks to ultrasonography, computed tomography, and nuclear magnetic resonance, not only symptomatic but also asymptomatic liver tumors are discovered more frequently than before. Focal nodular hyperplasia (FNH) is one such tumor, most frequently an asymptomatic tumor of the liver, which predominantly appears in women during the generative period, who have taken oral contraceptives for several years. We present a 27-year-old woman, who has never taken either oral contraceptives or other hormones, in whom a left lobe liver tumor was unexpectedly discovered during a routine investigation performed for psychiatric complaints. The tumor, removed by left lateral bisegmentectomy (segments II and 111), was composed of two tumoral nodes: 70x58x47 mm and 20x20x20 mm, the bigger one of which had a light grey central stellate scar. Histology revealed a focal nodular hyperplasia. The postoperative recovery was uneventful and the patient stayed symptom free for more than three years after surgery.
Oncogenic viruses and their role in tumor formation
Authors: Cupic Maja , Lazarevic Ivana , Kuljic-Kapulica Nada
Published: July 2008

Oncogenic viruses trigger persistent infections, which can stimulate uncontrolled cell growth by inducing cell transformation. Different oncogenic viruses use different mechanisms for infecting cells. Most oncogenic DNA viruses integrate transforming sets of genes into the host chromosome and encode proteins that bind and inactivate cell growth regulatory proteins, such as p53 and retinoblastoma gene product. Tumorous RNA viruses use different oncogenic mechanisms. Some of them encode oncogenic proteins that are almost identical to the cellular proteins involved in the control of cellular growth. The overproduction or altered function of these oncogenic materials stimulates cell growth. These RNA viruses can cause tumors rapidly. The second group of oncoviruses integrates their promoter sequences and viral enhancers near to the cellular growth-stimulating gene, initiating the transformation of the cell. The third group of RNA tumor viruses encodes a protein tax that transactivates the expression of cellular genes. Virus-induced malignant transformation of the cell represents the first step in the complex process of oncogenesis.
Surgical revascularisation of the heart in patients with chronic ischaemic cardiomyopathy and left ventricular ejection fraction of less than 30%
Authors: Velinovic Milos , Kocica Mladen , Vranes Mile , Djukic Petar , Mikic Aleksandar , Vukomanovic Vlada , Davidovic Lazar , Obrenovic-Kircanski Biljana , Cvetkovic Slobodan , Soskic Ljiljana , Ristic Arsen
Published: July 2008

INTRODUCTION Patients suffering from chronic ischaemic cardiomyopathy and left ventricular ejection fraction (LVEF) lower than 30% represent a difficult and controversial population for surgical treatment. OBJECTIVE The aim of this study was to evaluate the effects of surgical treatment on the early and long-term outcome of these patients. METHOD The patient population comprised SO patients with LVEF< 30% (78% male, mean age: 583 years, range; 42-75 years) who underwent surgical myocardial revascuiarisation during the period 1995-2000. Patients with left ventricular aneurysms or mitral valve insufficiency were excluded from the study. The following echocardiography parameters were evaluated as possible prognostic indicators; LVEF, fraction of shortening (FS), left ventricular systolic and diastolic diameters (LVEDD, LVESD) and volumes (LVEDV, LVESV), as well as their indexed values (LVESVI). RESULTS Fifteen patients (30%) died during the follow-up, 2/50 intraoperatively (4%). The presence of diabetes mellitus, previous myocardial infarction, main left coronary artery disease, and three-vessel disease, correlated significantly with the surgical outcomes. The patient's age, family history, smoking habits, hypertension, hyperlipidaemia, history of stroke, peripheral vascular disease, and renal failure, did not correlate with the mortality rate. A comparison of preoperative echocardiography parameters between survivors and non-survivors revealed significantly divergent LVEF, LVEDD, LVESD, LVEDV, LVESV, and LVESVI values. Preoperative LVESVi offered the highest predictive value (R=0.595). CONCLUSION Diabetes mellitus, history of myocardial infarction, stenosis of the main branch, and three-vessel disease, significantly affected the peci opera five and long-term outcome of surgical revascuiarisation in patients with ischaemic cardiomyopathy and LVEF<30%. in survivors, LVEF, FS, and systolic and diastolic echocardiography parameters, as well as their indexed values, significantly improved after surgical revascuiarisation. LVESVI provided the highest predictive value for mortality.
Measuring quality of life in patients with heart failure
Authors: Terzic Zorica , Bjegovic Vesna , Marinkovic Jelena , Draganic Gordana , Ljubic Branimir , Seferovic Jelena
Published: July 2008

INTRODUCTION The quality of life in patients with heart failure is diminished by symptoms of disease, affected social connections, frequent hospitalizations, side effects caused by medication, and costs of treatment borne by the patient himself. OBJECTIVE The objective of this research was to measure the quality of life of patients with heart failure and assess any potential changes during a six-month period. METHOD This research is a follow-up study, and comprised 56 patients who were treated from September 1998 to August 1999 at the Institute for Cardiovascular Diseases of The Clinical Center of Serbia. During the first hospitalization, an initial baseline measurement of quality of life was conducted. The measurement was then repeated after three and six months, during check-ups. The measurement was conducted by using a special questionnaire for patients suffering from heart disorders, the "Minnesota Living with Heart Failure Questionnaire." RESULTS The results showed a considerable improvement in the overall quality of life between the baseline and seeable improvement in the physical dimension of quality of life between the baseline and first measurements (F=6.797; p=0.016) and between the baseline and second measurements (F=5.351;p=0.030). CONCLUSION Thanks to the application of the special Minnesota questionnaire, it was possible to measure small but considerable changes in the patients? quality of life.
Casual and ambulatory blood pressure monitoring in children with renal scarring
Authors: Milosevski Gordana , Kostic Mirjana , Babic Dragan , Jovanovic Olga , Kruscic Divna , Stanic Mirjana , Peco-Antic Amira
Published: July 2008

INTRODUCTION Renal scarring is the most common cause of arterial hypertension in children. High blood pressure (BP) and microalbuminuria contribute to the progression of chronic renal disease. OBJECTIVE The aims of the study were: to assess BP in children with renal scarring by continuous ambulatory blood pressure measurement (ABPM) in comparison to the casual method (CBP), and to determine the correlation between ambulatory blood pressure (ABP) and/or casual blood pressure (CBP) values and proteinuria in children with renal scarring. METHOD This forward-looking study comprised thirty-five children (26 girls and 9 boys), aged between 3-13 years, 10.4?3.9, X+SD. Blood pressure was measured using the casual method (CBP) with a mercury manometer; BP was measured three times and the average was taken as a referent value. ABPM was performed using the oscillometric method with the Space Labs device, model 90207. RESULTS 45.71% of patients were classified as hypertensive by ABPM, while only 22.6% of CBP measurements were above the 95th percentile (p<0.01). "White coat hypertension" was present in 40% of the patients. Non-dipping BP alteration was detected in 37.14% of the patients. CONCLUSION Nocturnal systolic hypertension (systolic non-dipping alteration) is very frequent in children with renal scarring. Nocturnal diastolic blood pressure, detectable only via ABPM, is positively correlated with proteinuria and may be an initial sign of the progression of renal scarring. ABPM is more sensitive than CBP in the evaluation of BP in children with renal scarring.
Autogenic training as a therapy for adjustment disorder in adolescents
Authors: Jojic Boris , Leposavic Ljubica
Published: July 2008

INTRODUCTION Autogenic training is a widespread technique used in psychotherapy. The British school of autogenic training cites a large list of diseases, health states, and life changes, in which autogenic training can be of help. We wanted to explore the application of autogenic training as a therapy for adjustment disorder in adolescents. The sample consisted of a homogeneous group of 31 individuals, with an average age of 17.3?0.2 years, who were diagnosed with adjustment disorder, F 43.2, in accordance with ICD 10 search criteria. OBJECTIVE The aim of our work was to figure out the influence of autogenic training on adjustment disorder, through biophysical and biochemical indicators, and to research the efficacy of autogenic training as a therapy for adjustment disorder in adolescents. METHOD We observed adjustment disorder indicators and their changes in three phases, using initial, final, and control values, which we measured immediately before the beginning, immediately after the completion, and six months after the completion, of the practical course in autogenic training. We measured systolic and diastolic arterial blood pressure, brachial pulse rates, cortisol levels in plasma, cholesterol levels in blood, as well as glucose concentrations. During that period, autogenic training was employed as the sole therapy. RESULTS The study confirmed our preliminary assumptions. The measurements we performed showed that arterial blood pressure, pulse rates, cholesterol and cortisol concentrations, after the application of autogenic training among adolescents suffering from adjustment disorder, were lower than the initial values. They remained lower even six months after the completion of the practical course in autogenic training. CONCLUSION We concluded that autogenic training significantly decreases the values of physiological indicators of adjustment disorder, diminishes the effects of stress in an individual, and eases the adaptation of adolescents to stress, helping with recovery.
Bilateral angiomyolipoma of the kidney in patient with tuberous sclerosis
Authors: Colovic Radoje , Colovic Natasa , Grubor Nikica , Radak Vladimir , Micev Marijan , Stojkovic Mirjana
Published: July 2008

Angiomyolipomas are relatively frequent tumors of the kidney. It is believed that about 10 million people worldwide have such a tumor. About 1/10 of these 10 million are patients who suffer from tuberous sclerosis. The tumors are frequently bilateral, slow growing, and usually a symptomatic, as well as being rare in children. Due to the benign nature of angiomyolipomas, surgical treatment and embolisation of the tumors are generally not recommended, unless renal function is endangered, the symptoms are severe, or the kidney in question becomes completely dysfunctional. This is particularly the case in patients with tuberous sclerosis in whom these tumors are either already bilateral or may become so. We present a 24-year-old woman with tuberous sclerosis in whom bilateral kidney tumors were diagnosed 7 years earlier and in whom we carried out a left nephrectomy of a 5300 gram angiomyolipoma, which caused pain and complete loss of function. Although timorous, the right kidney was functional, so it was left untouched. After an uneventful recovery, a close follow-up was recommended, as well as HLA typing, as it is highly probable that the right kidney will gradually become inadequate or completely dysfunctional, so that haemodialysis and/or kidney transplantation along with nephrectomy will become necessary.
Multiple endometrial polyps in patient undergoing long-term gestagen therapy
Authors: Zamurovic Milena , Srbinovic Pavle , Petrovic Jovana
Published: July 2008

Endometrial polyps represent a limited focal, circumscribed overgrowth of the endometrium. Their aetiopathogenesis has not been completely explained yet. They are often found in perimenopausal women; during the reproductive period they are less common. We present the case of a 32-year-old patient, who came for a check-up to the Gynecology and Obstetrics Clinic "Narodni Front" because of irregular bleeding. The patient was subjected to hormonal linestrenol therapy, which she had administered herself, without further consultations with her gynecologist, during the previous 10 years. Complete diagnostic examinations were performed. Contrast sonohysterography enabled the visualization of multiple polyps inside the uterine cavity, which were confirmed by histopathological analysis of material obtained via explorative curettage. Histopathological material contained over 30 endometrial polyps. A control check-up after one month, as well as subsequent quarterly check-ups, resulted in normal findings. Analysis of the described case has indicated that the loss of sensitivity of progesterone receptors in endometrial cells is possible if there is a continuous presence of progesterone agonists in circulation, as is true of linestrenol in this case. The loss of sensitivity of progesterone receptors upsets normal hormonal activity during the secretory phase of the menstrual cycle, leading to copious, irregular bleeding. These changes may, however, have even deeper effects. More recent research shows that, if the agent causing the loss of sensitivity of the receptors is present in circulation over a longer time period, changes may also appear at the DNA molecular level, i.e. in the cell genome itself. This, in turn, may lead to the beginning of the process of oncogenesis and the formation of timorous tissue.
Rigid telescopy and contact endoscopy in the diagnosis and surgery of Reinke’s oedema: Clinical and histological assessment
Authors: Jovanovic Milan , Perovic Jelena , Milenkovic Sanja
Published: July 2008

We focussed our attention on the use of both rigid telescopy and contact endoscopy in order to assess their effectiveness in the diagnosis and surgery of Reinke?s oedema. Changes were observed in a sample of 40 patients, suffering from different stages of Reinke?s oedema, who had undergone microlaryngoscopies. For the first time during our laryngological praxis, we discussed a number of parameters that appeared to be significant in the monitoring and detailed evaluation of this vocal fold disease. With contact endoscopy, during the early stages of the disease, the cells and nuclei of normal squamous layered epithelium continued to display uniform morphological features. The appearance of epithelial changes helps to distinguish between different stages of Reinke?s oedema, which can be associated with severe inflammation or keratinisation. With latter-stage oedemas, the following was observed: various changes in the blood vessels of the glottis, which when viewed through the endoscope have an unusual ?loop-like? or ?branching? appearance, as well as elongated and varicose blood vessels, and the build-up of erythrocytes inside atypical capillaries. Both endoscope techniques are non-invasive and very appropriate for precisely diagnosing Reinke?s oedema within a relatively short period of time. Rigid telescopy has the advantage of enabling the systematic observation of many details in the large area of both vocal fold mucosae, particularly when access to the larynx is difficult. This enables dynamic monitoring and immediate pathology consultations inside the operating theatre. The special contribution of contact endoscopy is that, both in vivo and in situ, it allows a detailed scanning and mapping to be performed of all cell changes and of vascularisation throughout the entire mucosa surface. Video-assisted telescopy does not permit a completely first-rate surgical resection of Reinke?s oedema, because of unsatisfactory control or insufficient stability of the instrument during the operation using the one-handed method.
Molecular epidemiology of rotaviruses in preschool children
Authors: Vuletic Biljana , Obradovic Slobodan , Ristanovic Elizabeta , Kostic Gordana , Radlovic Petar
Published: July 2008

Numerous epidemiological studies, conducted in both developed and developing countries, have shown that the rotavirus is an important aetiological agent in severe diarrhoeal diseases among preschool children. In recent years, different biochemical techniques for the genetic and phenotypic analysis of rotaviruses have been developed. The aim of this study was to define the biological and genetic differences among rotaviruses isolated from the faeces of affected children, by using the Polyacrylamide Gel Electrophoresis technique, as well as to type the viruses and establish the number of strains circulating within our population. In total, 124 faeces samples from children up to 5 years of age were analysed. With the use of the ELISA test, rotaviruses were isolated in 10.3% of cases. The extraction of viral RNA was carried out directly from the faeces samples, which was followed by electrophoresis, and finally observation using a UV lamp, and documentation with a photo camera. The analysis of viral RNA, using Polyacrylamide Gel Electrophoresis (PAGE), revealed equal mobility in all segments of the genome. The results of our analysis demonstrated that the same strains of rotaviruses do circulate within our population. Such a result can be explained as a consequence of our years-long isolation as well as of the decreased mobility of our population. However, the results do not signify that the rotavirus genome in this region will not be susceptible to variations and that, consequently, new strains will not be created.
Effect of infusion of hypertonic-hyperoncotic solution on cardiovascular function in surgery of the abdominal aorta during the perioperative period
Authors: Soskic Ljiljana , Milicic Biljana , Milakovic Branko , Davidovic Lazar , Vranic Ivana , Simic Tijana , Kovacevic-Kostic Natasa , Velinovic Milos , Sindjelic Radomir
Published: July 2008

Introduction. When blood flow is decreased, as in prolonged hypovolaemia and hypotension, or in the course of transversal clamping of the aorta during aortic reconstruction, nutritive tissue perfusion can also fall below the critical level. Aim. The objective of this study was to analyse the effects of hypertonic-hyperoncotic solution on cardiovascular function during reconstruction of the abdominal aorta. Method. This prospective randomised study included 40 patients. All patients underwent surgery of the abdominal aorta under general endotracheal anaesthesia. Based on the type of solution infused from the time of clamping to the moment of the removal of the transversal aortic clamp, the patients were divided into two groups of 20. The study group was infused with a small volume of hypertonic-hyperoncotic solution, while the controls were administered infusions of isotonic solution. Patients with a preoperative creatinine level over 130 ?mol L-1 and an ejection fraction of less than 40% were excluded from the study. Results. Cardiac output increased from 5.67?2.95 to 7.05?3.39 L min-1 in the study group, in comparison to the controls, where it increased from 4.98?2.06 to 5.99?3.02 L min-1 (p=0.004). Central venous pressure increased from 8.75?3.67 to 9.30?2.77 mm Hg in the study group, in comparison to the controls, where the values decreased from 6.84?2.73 to 6.45?2.50 mm Hg (p=0.022). Diastolic pulmonary artery pressure increased from 15.92?5.61 to 16.65?6.53 mm Hg in the study group, in comparison to the controls, where it decreased from 12.65?4.28 to 11.85?3.91 mm Hg (p=0.021). The amount of given crystalloids 24 hours after the removal of the aortic clamp totalled 2562.5?485.82 mL in the study group, versus 3350?727.29 mL in the control group (p=0.000). The amount of given human albumins 24 hours after the removal of the aortic clamp totalled 30?49.74 mL in the study group versus 100?4.34 mL in the control group (p=0.001). Conclusion. Haemodynamic stability of patients and adequate organ perfusion during surgery are achieved through the infusion of hypertonic-hyperoncotic solution, which maintains optimal values of: cardiac output, mixed venous oxygen saturation, and delivery of oxygen, while reducing alveolo-arterial oxygen difference. The balance of fluids, 24 hours after the removal of the aortic clamp, was maintained with the aid of hypertonic-hyperoncotic solution, while isotonic solution produced an excess of over 1000 mL of fluid in the control patients. Hypertonic-hyperoncotic solution increases cardiac output considerably more than does isotonic solution, and its application significantly reduces the accumulation of crystalloid solutions and human albumins.
Aetiological factors in left-handedness
Authors: Milenkovic Sanja , Belojevic Goran , Kocijancic Radojka
Published: July 2008

Lateralisation associates the extremities and senses of one side of the body, which are connected by afferent and efferent pathways, with the primary motor and sensory areas of the hemisphere on the opposite side. Dominant laterality denotes the appearance of a dominant extremity or sense in the performance of complex psychomotor activities. Laterality is manifested both as right-handedness or left-handedness, which are functionally equivalent and symmetrical in the performance of activities. Right-handedness is significantly more common than left-handedness. Genetic theory is most widely accepted in explaining the onset of lateralisation. According to this theory, the models of brain organisation asymmetry (anatomical, functional, and biochemical) are strongly, genetically determined. However, the inability to clearly demonstrate the association between genetic factors and left-handedness has led researchers to investigate the effects of the environment on left-handedness. Of particular interest are the intrauterine environment and the factors influencing foetal development, of which hormones and ultrasound exposure are the most significant. It has been estimated that an extra five cases of nonright-handed lateralisation can be expected in every 100 males who were exposed to ultrasound in utero compared to those who were not. Socio-cultural pressure on left-handed individuals was much more severe in the past, which is confirmed by scientific findings that left-handedness is present in 13% of individuals in their twenties, while in less than 1% of individuals in their eighties.
Providing expert medical testimony
Authors: Bajic-Milosavljevic Aleksandra , Orozovic Sonja
Published: July 2008

This paper represents an effort at making expert medical testimony, one field of the medical profession, more accessible to our junior medical colleagues. As there is no department for expert medical testimony at the Belgrade School of Medicine, neither textbooks on providing expert medical testimony, experiences and knowledge are not unified and have to be collected together from many sources. The work of the medical expert is not aimed at improving the health of a patient, but on the realization of a patient?s rights, which very often depend on the patient?s health. The medical expert confirms medical facts, which may be of legal significance, and, consequently represents a link between medicine and the law. The effects of that link also impinge into the financial sphere. Expert medical testimony is, therefore, an interdisciplinary activity and the medical expert must also have knowledge outside of medical science, in other words, knowledge of the potential legal significance of medical facts. The authors of this paper are professional medical experts and wanted to make precisely that knowledge, which falls outside of medicine but is essential in medical testimony, more accessible to their junior colleagues. This is knowledge of the rights on which their patients can rely from insurance companies (based on health or invalid insurance) or in court. Such knowledge can also help their patients with legal regulations, ethical principles, and establishing their legal rights.
Attribution style of patients with delusion disorder
Authors: Leposavic Ivana , Leposavic Ljubica
Published: July 2008

Introduction. Attribution style represents a tendency to explain events by our own actions, or actions of forces and causes, persons or surroundings, which are external. Objective. The objective of our study was the analysis of specific way in which patients with delusion disorders ascribe meanings to events. Method. The test group included 30 patients with delusional disorder, of both sexes, aged between 30 and 53, without serious organic or somatic disorders. In order to determine the specific attribution system, through a wider frame of cognitive style, Rorschach?s cognitive techniques was applied. RESULTS An average value of MMSE score amounted to 28.43 and IQ - to 103.86. The data were evaluated by Comprehensive interpretation system of John Exner, and only those parameters were used that were the most indicative for this analysis. Patients with delusional disorder belonged to ambitent experience type, which pointed to inconsistency because the role of emotions varied during the process of decision making. Processing quality was temporarily significantly reduced to less mature and unsophisticated level, especially in complex situations. Thinking was strongly fixed and inflexible. More than other people, they applied intellectualization in order to annihilate affective experiences, leading thus to delusional thinking disorder in extreme cases. Sometimes, internal conflicts between high self value and awareness that it might not be valid, could lead to delusional expressions, if the environment was especially unsupportive. Conclusion. Attribution style of patients with DD is externalized and implies the ascribing of negative experiences to another person?s action. Marked self-centering and experience of increased personal value dominate over the perception of the environment in these patients, while discrepancy between real self and an ideal is decreased by specific ascribing.
Computerized occlusal analysis in bruxism
Authors: Lazic Vojkan , Todorovic Aleksandar , Zivkovic Slavoljub , Martinovic Zeljko
Published: July 2008

Introduction. Sleep bruxism as nocturnal parafunction, also known as tooth grinding, is the most common parasomnia (sleep disorder). Most tooth grinding occurs during rapid eye movement - REM sleep. Sleep bruxism is an oral habit characterized by rhythmic activity of the masticatory muscles (m. masseter) that causes forced contact between dental surfaces during sleep. Sleep bruxism has been associated with craniomandibular disorders including temporomandibular joint discomfort, pulpalgia, premature loss of teeth due to excessive attrition and mobility, headache, muscle ache, sleep interruption of an individual and problems with removable and fixed denture. Basically, two groups of etiological factors can be distinguished, viz., peripheral (occlusal) factors and central (pathophysiological and psychological) factors. The role of occlusion (occlusal discrepancies) as the causative factor is not enough mentioned in relation to bruxism. Objective. The main objective of this paper was to evaluate the connection between occlusal factors and nocturnal parafunctional activities (occlusal disharmonies and bruxism). Method. Two groups were formed- experimental of 15 persons with signs and symptoms of nocturnal parafunctional activity of mandible (mean age 26.6 years) and control of 42 persons with no signs and symptoms of bruxism (mean age 26.3 yrs.). The computerized occlusal analyses were performed using the T-Scan II system (Tekscan, Boston, USA). 2D occlusograms were analyzed showing the occlusal force, the center of the occlusal force with the trajectory and the number of antagonistic tooth contacts. Results. Statistically significant difference of force distribution was found between the left and the right side of the arch (L%-R%) (t=2.773; p<0.02) in the group with bruxism. The difference of the centre of occlusal force - COF trajectory between the experimental and control group was not significant, but the trajectory of COF was longer in the group of bruxists (67.3?24.4mm). In addition, the significant difference of COF position in relation to the center of the elliptic fields was not found in bruxists (?2=1.63; p> 0.05), but obtained results directly revealed uneven distribution of the occlusal forces which caused the excessive attrition and mobility of tooth. Conclusion. Our study failed to find direct correlation between occlusal factors and bruxism, so they are basically contributing factors.
Ambulatory blood pressure values in healthy children
Authors: Paripovic Dusan , Peco-Antic Amira
Published: July 2008

Ambulatory blood pressure monitoring (ABPM) is an important tool in the diagnosis and management of childhood hypertension. Normal ambulatory blood pressure (ABP) values in children with body heights between 100 and 120 cm have not been reported. The aim of the study was to establish the normal range of values for ABPM in these children. 24-hour ABPM was performed in 40 normotensive (auscultatory casual blood pressure was obtained before ABPM) subjects, aged from 4 to 6 years (26 males, 14 females) with body heights between 95 and 125 cm. ABPM was carried out on non-dominant arm using the oscillometric device (SpaceLab 90207) with appropriate cuff size. The monitor was programmed to measure BP every 15 min. during the day (6 a.m. to 10 p.m.) and every 30 min. during the night (10 p.m. to 6 a.m.). The mean daytime SBP/DBP in boys and girls was 108+/-6/67+/-5 and 105+/-5/66+/-1, respectively. The mean nighttime SBP/DBP in boys and girls was 98+/-6/56+/-5 and 97+/-7/56+/-4, respectively. There was a significant difference between day and night readings of SBP, DBP and heart rate (nocturnal fall was observed). The distribution of ABP noted in this study could serve as preliminary reference. A multicenter study should be performed to provide normal ranges of ABP.
Use of gastric segment in urinary bladder replacement after total cystectomy
Authors: Stijelja Borislav , Mladenovic Ljubisa , Aleksic Predrag , Soldatovic Zivko
Published: July 2008

Drainage of urine by abnormal way is urinary derivation. Various forms of urinary derivations are available for urinary bladder replacement after radical cystectomy for invasive bladder tumor. Construction of continent urinary reservoir, so called pouch, from different bowel segments is named continent urinary derivations. If such urinary reservoir is connected with urethra, then it is about orthotopic derivation and reservoir is defined as neobladder. Upon satisfactory results of introduction of continent urinary derivations with Mainz pouch I and Orthotopic Mainz pouch, we performed continent orthotopic urine derivation with isolated gastric segment in 74-year old male patient who had previously undergone radical cystoprostatectomy because of the invasive urothelial cancer of the urinary bladder. Even though there were no major surgical complications in the near postoperative course, the patient had to be operated ten months later for ileus; 20 months after the procedure, significant loss of neobladder capacity, bilateral vesicoureteral reflux, persistent urinary infection and incipient renal failure were manifested. In the further course, reoperation was needed and neobladder augmentation by ileal pouch along with both ureteral reimplantations into the pouch wall was carried out. After this reintervention, the patient was alive in the following three years with satisfactory quality of life and preserved renal function. Our conclusion is that gastric neobladder should not be the first method of choice for urinary bladder replacement after radical cystectomy in older patients.
Demographic and audiological factors as predictors of hearing handicap
Authors: Leposavic Ljubica , Leposavic Ivana , Jasovic-Gasic Miroslava , Nikolic-Balkoski Gordana , Milovanovic Srdjan
Published: July 2008

INTRODUCTION Currently available evidence reveals comparatively few studies of psychological effects of hearing impairments, in spite of the fact that clinicians have for a long time been aware of a connection between the acquired hearing impairment and mental disorders. They are focused on the investigation of dysfunction in general. Thus, three domains of the auditory imbalance may be distinguished: disorder, disability and handicap. 'Handicap', according to the definition of the World Health Organization, is a hindrance in an individual that results from an impairment or disability and represents psychological response of the individual to the impairment. OBJECTIVE Validation of acquired hearing impairment as a risk factor of psychical disorders as well as an analysis of relation of some demographic factors (sex, age, education) and audiological factors (degree and duration of the impairment) with the frequency of hearing handicap. METHOD MMPI-201 has been applied in 60 subjects affected with otosclerosis, potential candidates for stapedectomy, before and after the surgery. RESULTS Individuals with acquired hearing impairment manifest more frequent disorders of psychical functioning in comparison with general population, while demographic and audiometric parameters did not correlate with acquired hearing handicap. CONCLUSION It may be assumed that the very recognition of demographic and audio-logical factors can not help much in the understanding of the psychological stress associated with hearing impairment.
Plasma levels of cortisol and opioid peptide beta-endorphin during spontaneous vaginal delivery
Authors: Arsenijevic Ljubica , Kojic Zvezdana , Popovic Nada , Scepanovic Ljiljana
Published: July 2008

INTRODUCTION Labor pain is very frequent in clinical practice, but the underlying mechanisms as well as numerous neuroendocrine responses activated by such pain have not been fully explained yet. OBJECTIVE The objective of the study was to determine the influence of labor pain on plasma levels of cortisol and opioid peptide ?-endorphin. METHOD Cortisol and ?-endorphin levels were measured in blood plasma of: health, non-pregnant women (group 1, n=8), health pregnant women (group 2, n=8) and in parturitions, through fourth ages (group 3, n=8), Plasma level of cortisol was measured by radioimmunoassay, and ?-endorphin by enzyme immunoassay. Data were expressed as mean ? standard error of mean and were analyzed by Student's t test and Mann Whitney test. RESULTS Plasma level of cortisol in group 2 was significantly increased compared to the group 1. During labor progression, plasma level of cortisol was rising till the third labor age. Plasma level of cortisol in fourth labor age was not significantly different from the ag.e one and group 1. Plasma level of ?-endorphin was (n.g/L): in group 1:64?20, group 2:70?22, group 3:the first labor age: 75?15, the second labor age: 193?54, the third labor age: 346+97 and the fourth labor age: 114?31. CONCLUSION These results indicate that both ?-endorphin and cortisol are involved in regulation and modulation of labor pain and stress.