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Online ISSN:
2560-3310

ISSN:
0350-8773

Volume 44 , Issue 3, (2015)

Published:
01.08.2015.

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Vol 44, No 3 (2015)

Published: 01.08.2015.

Authors in this issue:

A. Jovanovic, A. Karadžov-Nikolić, A. Pavlovic, A. Vujačić, B. Balov, B. Dejanovic, D. Djikic, D. Peric, D. Rasic, G. Nikolic, I. Marjanovic, J. Mladenovic, J. Pavlović, J. Rasic, K. Vitosevic, L. Dejanovic, M. Bozic, M. Filipovic, M. Janicijevic, M. Kocic, M. Milenkovic, M. Miletic, M. Milosevic, M. Relic, M. Saranovic, M. Sipic, M. Todorovic, N. Djukic, N. Relic, N. Savic, N. Videnovic, N. Vujasinović-Stupar, P. Mandic, P. Otasevic, R. Zaric, R. Zdravkovic, S. Ivanovic, S. Lazic, S. Matejic, S. Milićević, S. Simić, S. Sovtic, S. Trpkovic, T. Filipovic, T. Radevic, V. Jaksic, V. Maric, V. Markovic, V. Peric, V. Videnovic, V. Vukićević, Z. Bukumirić, Z. Stojanovic, Z. Timotijevic-Sojevic,

01.08.2015.

Professional paper

Comparative analysis of numerical density of ganglion cells with certain content of lipofuscin pigment in the parts of symphatetic trunk during the aging

The neurons of the sympathetic trunk as well as the other nerve cells undergo of many changes during life. The most striking of these morphological changes, during normal aging, is the accumulation of lipofuscin-filled vacuoles or neuromelanin. Considering that the pigment is a non-biodegradable and can not be removed by exocytosis, the process of its accumulation in cells is unavoidable. The role of lipofuscin and its impact on cell function is not quite clear. Some authors consider that pigment does not damage the function of the cell, unless it contains lipofuscin in large quantities, and then it mechanically prevents its function so that could lead to cell death. Since we found a very little data in the literature about using morphometric methods in accumulation of pigment in ganglion cells or quantified observed changes, we set that the aim of this study is to confirm the presence of pigment in ganglionar cells of the symphatetic trunk, when it occurs in grater extent, as well as dinamics of its accumulation (quantification of ganglionar cells without pigment, those with partial presence of pigment, and those that were complitely filled with pigment) by using numerical density. For morphometric analysis we used test system M42. To determine the numerical density of ganglionar cells we used a method for thick cuts by Floderus. We found that interneuronal accumulation of lipofuscin is directly correlated with the aging process.

T. Filipovic, P. Mandic, M. Filipovic, N. Djukic, S. Matejic, M. Saranovic

01.08.2015.

Professional paper

Comparative analysis of biochemical parameters of atherosclerosis adiponectin and resistin in patients with diabetes mellitus and coronary heart disease

The most important adipocytokines affecting the formation and the regression of atheromas plaque in the coronary blood vessels are adiponectin and resistin. The essence of this test is to determine the correlation of the leading biochemical parameters of atherosclerosis, adiponectin and resistin and determine their interdependence with other biochemical parameters in patients with diabetes mellitus and coronary heart disease. Our study group consisted of 140 patients and 40 control group (healthy), 50 with diabetes mellitus and 50 with coronary heart disease (myocardial infarction and angina pectoris). We find that the average value of adiponectin in the group with type 2 diabetes mellitus were significantly lower than in the control group (4.38 to 6.74, p = 0.001, p <0.05). In the same study group average value of resistin was significantly higher than in the control group (15.8 to 7.88, p <0.001). The average value of adiponectin and resistin in patients with myocardial infarction and angina pectoris are no different from the value obtained in diabetes mellitus (4.94 to 4.38 and p = 0.397, p> 0.05). In the same study group average value of resistin was significantly higher than in the control group (15.73 to 7.88, p = 0.001, p <0.01) and not different than in the group with diabetes mellitus. Values Pearsonovg correlation coefficient shows that the biggest falls inversely proportional dependence of adiponectin with a simultaneous increase in resistin is expressed in patients with myocardial infarction, which is expressed very good correlation coefficient (-0.36). In all the groups, shows that there is a negative correlation between resistin and adiponectin, with increasing values of resistin values of adiponectin are reduced.

D. Rasic, V. Peric, J. Rasic, S. Lazic, G. Nikolic, B. Dejanovic

01.08.2015.

Professional paper

Changes in plasma brain natriuretic peptide levels during exercise stress echocardiography tests in patients with idiopathic dilated cardiomyopathy with or without preserved left ventricular contractile reserve

Introduction: The study of importance of left ventricular contractile reserve presence and changes plasma brain natriuretic peptide levels (BNP) during exercise in patinets with idiopathic dilated cardiomyopathy is very popular today, but these two parametres have rarely been interconnected. The study of response BNP during echocardiography stress tests in patients with idiopathic dilated cardiomyopathy with or without preserved left ventricular contractile reserve. We studied 55 consecutive patients with idiopathic dilated cardiomyopathy (mean age 54.98 ± 9.84, 49 (89.1%) male) treated in the outpatient clinic for heart failure at the Institute of Cardiovascular Diseases "Dedinje". All the patients underwent the echocardiography stress test. Contractile reserve was assessed by measuring of the changes of the left ventricle ejection fraction basally and in the first minute after the strongest stress. Level of BPN was measured at rest, in the first minute and after 20 minutes of maximal exercise stress. Following the kinetics of BNP level during stress testing, we find that in patients with preserved left ventricular contractile reserve BNP level is rising at maximum load achieved (Mediana (IQR) - 59 (22-113) vs. 91 (37-135) vs. 78 (30-159) ng/L, p<0.001), whereas in patients without preserved left ventricular contractile reserve BNP level does not change significantly (Mediana (IQR) – 89 (50-322) vs. 119.5 (61.3-321.8) vs. 136 (72- 281), p=0.102). The increase in BNP in the peak load compared to its value at rest was positively correlated with preserved contractile reserve (r=0.38, p=0.009), better WMSI at rest (r=-0.28, p=0.04), greater difference in the double product (r=0.40, p=0.002), as well as the work accomplished on the test (r = 0.47, p <0.001), and longer duration of the test (r = 0.43, p = 0.001). The increase in BNP during physical exercise in patients with idiopathic dilated cardiomyopathy suggests a preserved contractile reserve of the left ventricle.

V. Peric, S. Sovtic, D. Peric, A. Jovanovic, D. Djikic, S. Lazic, M. Sipic, P. Otasevic

01.08.2015.

Professional paper

Comparative analysis of parameters of oxygenation, ventilation and acid-base status during intraoperative application of conventional and protective lung ventilation

The aim of this study was to perform a comparative analysis applied conventional (traditional) and protective mechanical lung ventilation in clinical conditions with regard to intraoperative parameters changes of oxygenation, ventilation and acid-base status. This was a prospective study that included 240 patients. All patients underwent the same elective surgery (classic cholecystectomy). Patients were divided into two groups of 120 patients, A and B. In group A during the operation had received conventional lung ventilation with tidal volume of 10-15 ml/kg body weight, respiratory rate 12/min. and a PEEP zero. In group B was applied protective lung ventilation with a tidal volume of 6-8 ml/kg body weight, respiratory rate 12/min. and a PEEP of 7 mbar. Monitoring of oxygenation included the monitoring SaO2 and PaO2. Monitoring of ventilation included the determination of the value of tidal volume and minute volume ventilation, peak inspiratory pressure (Ppeak), medium pressure in the airway (Paw.mean), PEEP, PaCO2 and EtCO2. Monitoring of acid-base status was performed via determination of the pH values of arterial blood. Monitoring was carried out in four intervals: T1 - 5-10 minutes after the establishment of the airway, T2 - after opening peritoneum, T3 - after removal of the gallbladder, T4 - after the closure of the abdominal wall. All monitoring results are presented as mean. The statistical significance of differences in mean values was tested by t - test mean values in the case of two independent samples. As a statistical significance test taken as standard values p <0.01 and p <0.001. Comparative analysis of the value of SaO2, PaO2, Ppeak did not reach statistical significance. Statistical significance there is in the analysis of values of tidal volume and Paw.mean (p <0.001). Analysis of PaCO2 and pH of arterial blood showed no statistical significance in the first interval measurements but did interval T2-T4 (p <0.001). Based on the results of this study, it can be concluded that the applied types of mechanical ventilation of lungs during the performance of surgical procedures of medium duration, have not led to significant changes in terms of maintaining the parameters of oxygenation, ventilation and acid-base status, and they stayed in normal, physiological range.

N. Videnovic, S. Trpkovic, J. Mladenovic, A. Pavlovic, M. Filipovic, V. Videnovic, R. Zdravkovic

01.08.2015.

Professional paper

The influence of microbiologic flora on the clinical course of malignant otitis externa

Necrotizing otitis externa, also known as malignant type of the inflammatory process, represents an infection of the skin of external hearing canal, a fast development of tissue necrosis and infection spreading to the surrounding structures. Basic clinical characteristics are: strong earache, leaking from ear, granulation findings at the bottom of the hearing canal, the disorder of hearing function and a potential possibility of complications (paralysis of facial nerve, intracranial infections). Mycrobiologically the most present bacerium is Pseudomonas aeruginosa. Other microorganisms that can be isolated are Aspergillus species, Staphylococcus aureus, Proteus mirabilis, Klebsiella oxytoca, Candida parapsilosis. The disease is more common in patients with general diseases, mostly of metabolic nature (diabetes mellitus). The approach to diagnosis and therapy is usually urgent in order to prevent the development of serious complications. This paper shows the results of the analysis of clinical process of malignant otitis in 25 patients from the Clinic of ORL and MFS KCS according to the type of the cause and the development of potentially severe and life threatening complications.

M. Janicijevic

01.08.2015.

Professional paper

Analysis of the factors influencing the frequency ofpathological fractures in postmenopausal women with osteoporosis

Introduction: Osteoporosis is a disease characterized by bone strength disorder and weakness of the entire skeleton causing the predisposition to fractures to grow. Identification of factors which may influence pathological fractures in postmenopausal women and determining which of the identified factors have the largest influence on the development of osteoporotic fractures. A retrospective study has included 400 postmenopausal women with newly diagnosed osteoporosis examined at the Institute of Rheumatology in Belgrade. We have examined demographic data and the following fracture risk factors: physical activity, menarche, menopause, fractures after the age of forty, osteoporotic fractures in the family, comorbidity: inflammatory rheumatic diseases, intestine diseases, chronic kidney insufficiency and endocrinopathy (hyperthyroidism and diabetes) and taking glucocorticoid therapy. The value of bone density has been measured using DXA method in the spine and hip, and the body mass index has been calculated based on the body height and weight. Logistic regression has been used as the method for analyzing the relation between binary results and potential predictors. Statistical hypotheses have been tested at the statistical significance level of 0.05. In the model of multivariate logistic regression, the significant predictors of osteoporotic fractures are as follows: older age (B = 0.13; p = 0.001), higher BMI values (B = 0.094; p = 0.022) and lower BMD values (hip) (B = -3.060; p = 0.023). Elderly overweight women with lower BMD values in the hip are more susceptible to fractures due to osteoporosis; therefore this subgroup of postmenopausal women is important for the application of the measures of primary and secondary prevention of osteoporotic fractures.

A. Karadžov-Nikolić, N. Vujasinović-Stupar, S. Milićević, Z. Bukumirić

01.08.2015.

Professional paper

The prospect of exhumation and identification of the people who are still listed as missing in armed conflict happened in Kosovo and Metohija 1998/99

During the armed conflict in Kosovo and Metohija, and after it, were killed more than 5 000 people, and according to the International Red Cross Committee in March 2001, 3,338 people were still missing. Until the conclusion of this study, the number of missing persons in Kosovo and Metohia for which the trail is about 1700. This list includes people from all ethnic communities. The primary objective of the forensic investigation is to determine the identity of the missing persons and after that their remains returne to the families, in accordance with Geneva protocols. Experts post-mortem examination after the exhumation determine the cause and manner of death, which indicates a violation of human rights and war crimes.Conclusion. We are facing with reasonable fear that with the passage of time, less interest will be devoted to this issue and the activities on finding and identifying missing persons will completely stop.

S. Matejic, M. Miletic, M. Milosevic, V. Jaksic, M. Todorovic, K. Vitosevic, R. Zaric

01.08.2015.

Professional paper

Morphological caracteristics of malocclusion class II

Class II malocclusion are complex anomalies of the skeletal and dental systems. The aim of this study is that the rengenkefalometrics analysis closer determine the morphological characteristics of this malocclusion. For this study were used 30 patients aged 18-30, previously clinically diagnosed class II, before the planned orthodontic treatment. The results analisis lateral cephalometric radiographs were compared with the 30 patients with class I malocclusion. Analyzed three linear and two angular cranial base dimensions and nine angular and four linear measures from the facial skeleton. The Results show: No statistically significant differensis in cranial base angle (SNBa) and anterior cranial base length (S–N) between class II and control Class I. Angle maxillar prognathism ( SNA) is no signifikant different between class I and Class II but SNB angle were signifikant smaller. The length of maxillary base (A`-SnP) is longer and the length of mandibule (Pg`-MT1/MT) is signifficantly smaller. The gonial angle (ArGo–Me) was smaller with open articular angle (GoArSN). Morphological characteristics of class II malocclusion are , retrognathic and smaller mandibular ligth, normognathic and longer maxilla, open articular angle with vertical tendency of the craniofacial growth pattern.

J. Pavlović, S. Simić, V. Vukićević, A. Vujačić

01.08.2015.

Professional paper

Quality of life and dermatovenerology

Quality of life (QoL) is used in the natural and social sciences as a relatively new category which deserves more attention in research. Quality of life related to health is a term commonly used when QoL on health. An increasing number of research studies that are based on an examination of the QoL. This paper analyzes the concept of the QoL, the possibilities of measuring the QoL, a special emphasis is placed on measuring QoL in dermatovenereology. Given that the skin disease are of particular significance for the patient, the said indices are dermatologically quality of life, especially the quality of life of patients dermatological (DLQI).

M. Relic, Z. Timotijevic-Sojevic, T. Radevic, L. Dejanovic, N. Relic

01.08.2015.

Professional paper

Influence of kinesiophobia on activities of daily living of elder institutionalized persons with chronic pain

Aging of population leads to limitations in functional abilities and in activities of daily living (ADL) which are the essential elements of independent care of oneself. Limitations in performing these activities result in increasing need for assistance and institutionalizing of the elderly. The aim of this study was to investigate the influence of fear of movement, or kinesiophobia, on ADL in elder institutionalized people with chronic pain. The research included 60 individuals older than 65 suffering from chronic musculoskeletal pain, institutionalized in Gerontoloski Centar Nis. The participants` fear of movement was assesed by Tampa Scale of Kinesiophobia, performing ADL was assesed by Katz index and pain intensity was evaluated by Numerical Rating Scale. We found that a large number of participants had high degree of kinesiophobia (63%), as well as that there is statistically significant negative correlation between the values of Katz index and Tampa Scale (r=-0.583, p<0.01). There is no statistically significant negative correlation between the values of Numerical Rating Scale and Katz index (r=0.139, p<0.289). There is no statistically significant positive correlation between the values of Numerical Rating Scale and Tampa Scale (r=0.215, p=0.098). The research showed that kinesiophobia has influence on ADL in elder institutionalized people with chronic pain. Higher degree of fear of movement corresponds to greater dependence of the participants in performing ADL. Pain intensity influenced neither the fear of movement nor the dependence/independence in performing ADL.

M. Milenkovic, M. Kocic, B. Balov, Z. Stojanovic, N. Savic, S. Ivanovic

01.08.2015.

Professional paper

Fear of falling

Fear of falling (FOF) is a significant health problem that can be present in the elderly, both in those that had experienced falling and in those that hadn`t. The aim of the study was to establish correlation of FOF with the following characteristics of the participants: sex, age, education, marital status and the number of falls in the previous year. Performed from October to December 2014, the research included 100 participants from general population older than 65 and covered by health visiting service of Dom Zdravlja Nis. The questionnaire for assessment of FOF - Falls Efficacy Scale (FES) and the epidemiological questionnaire were used in all participants. We established that there is statistically significant difference of FES values (hi-kvadrat=7.668, p<0.05) between different age groups. It was found that median value of FES questionnaire is statistically significantly higher in participants living as singles in relation to those living in a community (U=828.0, p<0.05). There is satistically significant medium correlation between FES values and the number of falls in the previous year (r=0.661, p<0.01). This research established that FOF is associated with age and the number of falls in the previous year, that implies the need for prevention of FOF, especially in elder people and in people that experienced one or more falls. Implementation of prevention is also important in people living alone because FOF is excessive in their case.

Z. Stojanovic, M. Kocic, B. Balov, M. Milenkovic, N. Savic, S. Ivanovic

01.08.2015.

Professional paper

Central corneal thickness, corneal curvature and refractive error in patients with primary angle-closure glaucoma and primary open-angle glaucoma

Primary angle-closure glaucoma (PACG) is highly prevalent in Asian countries, compared with primary open-angle glaucoma (POAG), which is reported predominant disease among Whites and that is the reason for paucity of reports about central corneal thickness (CCT) and corneal curvature (CC) in eyes with PACG in Europe. To determine central corneal thickness, corneal curvature and refractive error in patients with primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG). A total of 288 patients were enrolled into this study; 132 patients with PACG (mean age of 73 ± 7 years) compared with 156 patients with POAG (mean age of 70 ±7 years). The data was collected from all PACG patients who underwent Laser peripheral iridotomy at the Clinic for Eye Diseases, Clinical Center of Serbia in Belgrade between January 2012 and October 2012 and controls with POAG examined in the same period. Data from the right eye was used for analysis. In PACG/POAG mean CCT was 549±38/547±35 µm (p=0.353) and mean radius of corneal curvature (Cr) was 7.92±0.22/7.75±0.29 mm (p=0.003). There was no statistically significant correlation between IOP and mean Cr in PACG (p=0.244 ) and POAG ( p=0.637) while it was in POAG group with refractive error (p=0.005) and CCT (p<0.001). We found that CCT in PACG and POAG group were in normal range and there was no diference between them. Our results showed that the eyes with PACG had the flatter corneas than eyes with POAG and were hyperopic.

V. Maric, V. Markovic, M. Bozic, I. Marjanovic

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