Vol 43, No 1 (2014)
Published: 01.01.2014.
Authors in this issue:
A. Arsovic, A. Dutina, A. Milic, A. Odalovic, B. Djerkovic, B. Djordjevic, B. Krdzic, B. Lazic, D. Kostadinovic-Momcilovic, D. Odalovic, D. Rasic, D. Vukicevic, G. Nikolic, G. Trajkovic, I. Grbic, I. Stasevic, J. Dukanac-Stamenkovic, J. Krdzic-Milovanovic, J. Milovanovic, K. Pjescic, L. Vitkovic, Lj. Popovic, M. Cukalovic, M. Jovanovic, M. Mijovic, M. Miletic, M. Milosevic, M. Nenadovic, M. Saranovic, M. Sipic, N. Deletic, N. Katanic, N. Mitic, N. Nenadovic, P. Simonovic, R.N. Mitic, S. Jovicic, S. Lazic, S. Matejic, S. Pajovic, S. Sovtic, T. Filipovic, T. Milanovic, V. Jaksic, V. Nedeljkovic, V. Peric, Z. Marcetic, Z. Martinovic,
Edited by:
prof. dr Bojana Kisić
Author guidelines
Editorial Policy
34
Issues481
ArticlesBECOME A REVIEWER
We invite you to become an Praxis Medica reviewer.
Archive
See all
Volume 53, Issue 4, 2025
Volume 53, Issue 3, 2025
Volume 53, Issue 2, 2025
Volume 53, Issue 1, 2025
01.12.2013.
Professional paper
PROGNOSTIČKI ZNAČAJ GLEASON SCORE-A 7 (3+4) I GLEASON SCORE-A 7 (4+3) U ADENOKARCINOMU PROSTATE U ODNOSU NA KLINIČKI STADIJUM, TKIVNI ANDROGEN STATUS I STEPEN NEUROENDOKRINE DIFERENCIJACIJE
Prognoza i izbor terapije adenokarcinoma prostate (ADKP) direktno zavise od brojnih prediktivnih faktora, među kojima su najznačajniji zbirni histološki gradus tumora (Gleason score, koji predstavlja zbir prvog i drugog dominantnog histološkog gradusa) i klinički stadijum. Novija istraživanja u ove faktore ubrajaju i tkivni androgen status i neuroendokrinu diferencijaciju. Važnost prvog i drugog dominantnog histološkog gradusa naročito postaje značajan kod ADKP Gleason score-a 7. Smatra se da goru prognozu imaju ADKP višeg Gleason score-a, uznapredovalog kliničkog stadijuma, androgen nezavisni tumori i tumori koji pokazuju veći stepen neuroendokrine diferencijacije. Cilj rada je odrediti prediktivni značaj ADKP Gleason score-a 7 (3+4) i ADKP Gleason score-a 7 (4+3) u odnosu na klinički stadijum, tkivni androgen status i stepen fokalne neuroendokrine diferencijacije. Istraživanje je obuhvatilo 33 ADKP Gleason score-a 7, odnosno 26 (78,79%) ADKP 7 (3+4) i 7 (21,21%) ADKP 7 (4+3). Svi tumori su najčešće dijagnostikovani u stadijumu D2 kada su već postojale udaljene metastaze. ADKP Gleason score-a 7 (4+3) dijagnostikovani su u većem procentu u ovom stadijumu, među njima ima više androgen nezavisnih tumora i pokazuju veći stepen fokalne neuroendokrine diferencijacije. Svi dobijeni rezultati u saglasnosti su sa podacima iz literature i navode na zaključak da ADKP Gleason score-a 7 (4+3) imaju goru prognozu od ADKP Gleason score-a 7 (3+4).
M. Mijovic, D. Vukicevic, B. Djerkovic, V. Nedeljkovic, L. Vitkovic
01.12.2013.
Professional paper
KLINIČKE MANIFESTACIJE OSTEOARTRITISA KOLENIH ZGLOBOVA
Osteoartritis kolenih zglobova je degenerativno oboljenje čije su glavne karakteristike oštećenje i gubitak zglobne hrskavice, zgušnjavanje kosti neposredno ispod hrskavice (subhondralna kost) i hipertrofija kosti na rubovima zgloba. Klinički, OA kolenih zglobova se, u zavisnosti od faze bolesti, ispoljava bolovima u degenerativno izmenjenom zglobu, ukočenošću, ograničenjem opsega pokreta, krepitacijama, izlivom u zglob, deformacijama i različitim stepenom upale. U radu je obrađeno 100 ispitanika i prezentovani su rezultati kliničkih manifestacija oboljenja, koji uključuju anamnestičke i objektivne parametre, sociodemografski status, radiološki nalaz i prisustvo komorbidnih stanja.
G. Nikolic, B. Djordjevic
01.12.2013.
Professional paper
DNA identification of war and mass catastrophies victims
After the armed conflicts throughout the nineties of the twentieth century occurred in former Yugoslavia, identification of war victims is a challenging task. This paper gives a detailed description of exhumed remains identification process. One of the study objectives has been a comparison between DNA results and traditional forensic identification methods. This paper deals with the identification of human remains that were exhumed in Kosovo and Metohia in the period 2001-2012, belonging to Serbs and other non-Albanian ethnic communities (Montenegrins, Bosniaks, Roma, Gorani, and others), as well as much lower number of Albanians who were also killed during the war and post-war period.The experience of this process and the experience of other countries show that there is a need to organize appropriate services for identification of human remains in Serbia, capable to react effectively in case of mass disaster.
S. Matejic, M. Miletic, M. Milosevic, V. Jaksic, T. Filipovic, M. Saranovic, N. Deletic
01.12.2013.
Professional paper
Electrocardiography changes in patients with acute myocardial infarction in late hospital phase
One of possibilities to estimate size of myocardial injury during the acute myocardial infarction are electrocardiographic changes,
forming of QS formation (ECG signs of scares changes). This investigation which included three groups of patients receiving thrombolytic, nitrates or beta blockers in acute phase of myocardial infarction has aim to analyze 12-chanels electrocardiogram and to establish difference between this therapeutics groups in sum of QRS score, but also to indicateon frequency of periinfarction heart insufficiency in this therapeutics groups, comparing with observed ECG changes. Analysis shows significant differences between groups
in value of QRS score, and also significant lower value of QRS score in patients with acute myocardial infarction treated with thrombolytic therapy. This difference relative to other two groups shows lower level of myocardial injury during acute myocardial infarction in patients treating with thrombolytic therapy.
Z. Marcetic, S. Sovtic, M. Sipic, V. Peric, S. Lazic
01.12.2013.
Professional paper
SINDROM OPSTRUKCIONE APNEJE U SPAVANJU KOD DECE
Sindrom opstrukcijske apneje u spavanju (SOAS) je poremećaj disanja u kome se javlja delimična ili potpuna opstrukcija gornjih disajnih puteva, što ometa normalnu ventilaciju pluća i tako remeti normalan obrazac spavanja. Klinički se ispoljava habitualnim hrkanjem, često udruženim sa zastojem u disanju, i znacima napornog disanja tokom spavanja, kao i različitim neurobihejvioralnim problemima koji se javljaju tokom dana. Neprepoznat i nelečen SOAS može dovesti do trajnih, pa i životno opasnih posledica. Svaki pacijent sa smetnjama disanja vezanim za spavanje trebalo bi da bude podvrgnut polisomnografskom ispitivanju tokom noći.
M. Cukalovic, D. Odalovic, J. Krdzic-Milovanovic, T. Milanovic
01.12.2013.
Professional paper
ASTROCITOM SA KLINIČKOM SLIKOM SLOŽENIH FOKALNIH NAPADA I POSTOPERATIVNE PSIHOZE
Prikaz slučaja bolesnice sa Astrocitomom u predelu parahipokampalne regije leve hemisfere kod koga je nakon
resekcije levog temporalnog režnja došlo do razvoja shizofreniformne psihoze. Psihički i neurološki status, Skala za
procenu pozitivnog i negativnog sindroma shizofrenije (PANSS), Mini internacionalni neuropsihijatrijski intervju (MINI) ,
verzija 4,4., subkategorija N za psihotične sadržaje, Šihanova skala narušavanja sposobnosti (SSNS), Hamiltonova
skala za procenu depresije Hamiltonova skala zaprocenu anksioznosti, Montgomeri-Asberg skala za depresiju, elektroencefalogram (EEG), standardno i registrovanje nakon deprivacije spavanja, kompjuterizovanatomografija glave
(CT) i neuromagnetna rezonanca endokranijuma (NMR). Bolesnica stara 51 godinu, od 12-te godine života ima epileptičke napade, koji su definisani kao jednostavni i složeni žarišni u vidu zagledanja, motornih ambulatornih automatizama sa retkom sekundarnom generalizacijom i postiktalnom zbunjenosti. Nakon što je učinjen NMR endokranijuma
kojim je utvrdjen tumor u levoj parahipokampalnoj formaciji, uradjena resekcija levog temporalnog režnja, gde je
patohistološki utvrdjeno da se radi o Astrocitomu II stepena. Nakon intervencije došlo do razvoja polimorfne simptomatologije, sa dominacijom paranoidno-depresivne simptomatologije i epileptičkih napada sa aurom straha, spaciotemporalnom dezorijentacijom i gubitkom svesti. Pacijentkinja tretirana racionalnom antiepileptičkom politerapijom
i neurolepticima nakon čega je došlo do kliničkog poboljšanja slike psihoze i smanjenja učestalosti epileptičkih napada. Nakon temporalne lobektomije došlo je do razvoja „de novo psihoze“ sa kliničkom slikom shizofreniformne epileptičke psihoze.
P. Simonovic, D. Kostadinovic-Momcilovic, Z. Martinovic, M. Nenadovic
01.12.2013.
Professional paper
POVEĆANA VREDNOST KARDIJALNOG TROPONINA I U HIPERTROFIČNOJ KARDIOMIOPATIJI I DIJASTOLNOJ SRČANOJ SLABOSTI
U radu je prikazana žena stara 73 godine koja je hospitalizovana u jedinicu Intenzivne nege zbog osećaja nedostatka vazduha i atpičnog diskomfora u grudima unazad dva sata. Krvni pritisak na prijemu je bio veoma povišen (240/130 mmHg), kardijalni troponin i iznad referentnih vrednosti (2,1 ng/ml) a inicijalni EKG zapis bio je sugestibilan za infarkt miokarda bez ST elevacije. Ehokardiografska evaluacija i koronarna arteriografija koje su usledile isključile su akutni koronarni sindrom kao uzrok povećanog kardijalnog troponina.
S. Lazic, D. Rasic, B. Lazic, Z. Marcetic, V. Peric, M. Sipic, S. Pajovic
01.12.2013.
Professional paper
APERT SYNDROME (ACROCEPHALOSYNDACTYLY)
Apert syndrome is named for the French physician, Eugen Apert who was, in 1906. described anomalous shape of the skull with coronary suture synostosis and hypoplasia sphenoethmoidmaxillary part of the face and fingers syndactyly of hands and feet. Apert syndrome accounts for about 4,5% of all craniosynostosis. With the prevalence of 1:160 000-200 000, inherited in an autosomal dominant, and in 25% of cases are fresh mutations in the gene. This syndrome has no predilection by gender and race, varies in severity form in witch it is manifested. Anomality of internal organs are very rare, but half of the patients with this syndrome have mental retardation. Apert syndrome has no cure, but surgery can help to correct some of the problems.
J. Milovanovic, M. Cukalovic, B. Krdzic, D. Odalovic, T. Milanovic
01.12.2013.
Professional paper
FIBROADENOM AKCESORNOG TKIVA DOJKE U AKSILI
Development of accessory breast tissue is a consequence the lack of regression remanths of milk line during embryogenesis. These remanths can be found anywhere on the ventral side of the body, extending from the axilla to the pubic region and most of them can be found in the axillary region. On such a tissue may appear almost identical changes that affect the normal breast, from benign non-tumor changes to malignant tumors. In our case report, the case is a 23 year-old woman who had a unilateral solitary lesions in the axilla, which was surgically removed. Starting diagnosis was " Limphadnopathia axillaris lateris sinistri." After removal and histopathological evaluation of the change, it was found that there is a tumor - fibroadenoma. There were also performed immunohistochemical ( IHH ) staining, with finding of a conventional fibroadenoma of the breast as expected. Accessory breast tissue in the axilla is a rare finding, and the tumors in this tissue even rarer. Histopathological confirmation is mandatory, with the need to exclude malignant tumors which are more common in these cases, and they occur at an earlier age.
B. Djerkovic, N. Mitic, D. Vukicevic, V. Nedeljkovic, L. Vitkovic
01.12.2013.
Professional paper
THE COURSE AND OUTCOME OF A PREGNANCY WITH A PREMATURA PRETERM RUPTURE OF MEMBRANES DILEMA OR LIABILITY
Preterm premature rupture of membranes (PPROM) is in obstetrics with incidence of 0,4% of , with risk for chorioamnionitis 35%, risk for premature deli very 19%, and sepsis risk of 1%. Primary risk for fetus is pulmonal hypoplasia due to oligohydramnios in 29%, RDS in 66 % of such pregnancies, sepsis in 19%, and contrac ture of extremities in 3%. Fetal death is more than 30% of cases. Patient came to regular pregnancy check up in 22th week of gestation. US exami nation revealed decreased fluid volume AFI 50, with regular morphology and fetal dynamic. She was admitted to hospital. She was given cortico-steroids and antibiotics. In further course of pregnancy amniocentesis was performed in 32th week of preg nancy to rule out the infection and to check pulmonal maturity. In absence of infection and lung maturity pregnancy was continued until 36th week of gestation when Cesarean Section was. Baby went well and is now healthy child in the age of three. Some studies suggested that delivery can be significantly prolonged. In our case we menaged to gain 14 weeks,from 22th to 36th gestational week. Firstly gynaecologyst nightmare to ask the woman is she accept therapy. The aim is to deliver a healthy child without neurological and other consequen ces and mother with preserved reproductive function. Controversy still exists when is the appropriate time to finish pregnancy with prolonged PPROM.
M. Jovanovic, J. Dukanac-Stamenkovic
01.12.2013.
Professional paper
Post-streptococcal glomerulonephritis
Post-streptococcal glomerulonephritis (PSGN) is a frequent cause of acute nephritis in children. This case study was done with the aim to point out that the infections caused by Group A streptococci, in spite of antibiotic era, are still present in the population. An 8-year old boy was admitted in our hospital with a two-day history of fewer, tonsillopharyngitis. After hospital admission, patient was treated with penicillin during the period of 10 days, antihypertensive medications (captopril, furosemide), including restricted diet of salt. After the treatment, patient became better. On demission it was found proteinuria and microhematuriaPSGN is very serious disease, which leaves severe complications if the valid therapy with penicillin is not used in propriety time, during the recommended period of 10 days.
A. Odalovic, N. Katanic, A. Milic, A. Arsovic
01.12.2013.
Professional paper
ANALYSIS OF FATALITIES OF HOSPITALIZED PATIENTS OF THE CLINIC FOR MENTAL DISORDERS DR LAZA LAZAREVIC IN 2011 AND 2012
Increased mortality rate for patients with mental disorders and their shorter lifespan compared to the general public is stated by numerous authors. Services on the Clinic for mental disorders “Dr Laza Lazarević” were reorganized, by introducing intensive care units – level two, i.e. contemporary intensive care of patients was introduced, only without life support. Primary objective of the research was to determine if the introduction of intensive care to the Clinic led to a statistically significant change in the number of fatal outcomes of hospitalized patients. The research was designed as a cross-sectional study and it included 62 patients that have died while being hospitalized at the Clinic for mental disorders “Dr Laza Lazarević” in Belgrade, in 2011 and 2012. Data were collected by retrospective insight in the histories of illnesses and treatment protocols of the Clinic and institutes for pathology and forensic medicine of the Faculty of Medicine in Belgrade. Obtained data were statistically analysed with Student’s T-test and ANOVA test, with a significance level of 0.05. Statistically significant difference was determined in fatalities in 2011 compared to 2012 with p = 0.007, and there were significantly less fatalities in 2012. Statistically significant difference in frequency of fatal outcomes when comparing 2011 to 2012 was determined only when comparing the ward of previous intensive care on one side with the newly established psychiatric intensive care units – level two on the other. High level of significance was determined with p = 0.005. New organizational concept introduced in 2012 has led to more efficient twenty-four-hour care and monitoring of hospitalized patients, suppression of accompanying somatic illnesses which altogether led to a significant reduction of fatal outcomes.
I. Grbic, M. Nenadovic, S. Jovicic, N. Nenadovic, G. Trajkovic, I. Stasevic, A. Dutina, K. Pjescic
01.12.2013.
Professional paper
NECESSITY AND FREQUENCY OF INVOLUNTARY HOSPITALIZATION IN PSYCHIATRIC INSTITUTION
Involuntary hospitalization for treatment of mental patients is a necessity in modern scientific psychiatric practice. Hospitalization is generally an act of psychological and social disruption of individual’s homeostasis, which is a very important and complex problem for the mentally ill. The goal of the study was to confirm the necessity of involuntary treatment of mental patients in a medical institution, in the interest of patients and the society. The research was conducted as a cross sectional study of hospitalized patients in 2012 at the Clinic for psychiatric disorders "Dr Laza Lazarevic" in Belgrade. It included 2286 inpatients, especially involuntarily hospitalized 236 and 719 admitted for hospital treatment with the assistance of the police. The data were statistically analysed by methods of descriptive statistics: χ2 - test and multiple logistic regression analysis, using the software package SPSS v. 20. The results show that 255 patients were admitted to the hospital for the first time with the assistance of the police. Patients hospitalized with the assistance of the police in compared to those hospitalized without the assistance of the police were, with statistical significance: younger, more frequently males, most frequently in the diagnostic group of schizophrenia and less frequently in the group of organic and affective disorders, most often it was their first, and involuntary hospitalization. During the studied period, 236 (10%) of the total number treated patients were involuntarily hospitalized. There were 176 (74.58%) patients detained for treatment by force, with the assistance of police. There is a necessity for involuntary hospitalization of mental patients. The justification of detaining patients in the health institution by such measures is accomplished through legislation in the best interest of the patient.
M. Nenadovic
01.12.2013.
Professional paper
INFLUENCE OF FREE RADICALS ON MUSCLE FUNCTION AND ADAPTATION IN EXERCISE
The first suggestion that physical exercise results in free radical-mediated damage appeared in 1978, and since that time the sources of oxidant production during exercise continue to be debated. Many researchers focused on the damaging effects of oxidants in muscle (oxidative damage of proteins and lipids), but the examination of cell-signaling effects of free radicals on muscle activity became today's main issue. Free radicals can modulate a number of cell signaling pathways and regulate the expression of multiple genes, contributing to the muscle adaptation on exercise and improving the muscle force production. Those effects are provided by changes in calcium handling by muscle cells or changing in the sensitivity of myofilaments to calcium. As a conclusion we can say that low and physiological levels of free radicals are required for normal force production in skeletal muscle and antioxidant adaptation, while high levels of free radicals promote contractile dysfunction resulting in muscle weakness and fatigue.
Lj. Popovic, R.N. Mitic