01.12.2019.
Professional paper
Relationship between ACR and other determinants of microalbuminuria in T2DM patients
Introduction: The occurrence of microalbuminuria in type 2 diabetes mellitus (T2DM) patients is regarded as an early clinical sign of incipient kidney damage. Microalbuminuria is often evaluated as urinary albumin to urinary creatinine ratio (ACR). Aim: To assess determinants of microalbuminuria in T2DM patients without prior diagnosis of nephropathy using ACR cut-off values. Materials and Methods: ACR was measured in a total of 90 T2DM patients, during two months in three non-consecutive days, and routine biochemical analyses were performed, including glycated hemoglobin (HbA1c), serum uric acid (SUA), and atherogenic index of plasma (AIP). The cut-off values of ACR were ≤ 2.5 mg/mmol in males, and ≤ 3.5 mg/mmol in females. Duration of T2DM, history of hypertension, HbA1c, estimated glomerular filtration rate (eGFR), AIP, and SUA were investigated for association with microalbuminuria. Results: According to ACR patients were considered as non-albuminuric (n= 57) and microalbuminuric (n = 33). Compared to non-albuminuric group, microalbuminuric group had increased urinary creatinine, urinary albumin, HbA1c, triglycerides and SUA, whilst decreased HDL-cholesterol levels. Although eGFR was generally reduced, the correlation between LogACR and eGFR was not significant (p > 0.05). However, the correlation between LogACR and LogHbA1c was significant. The multiple logistic regression analysis revealed HbA1c (t = 3.42; p = 0.012) and SUA (t = 2.44; p = 0.040) as independent predictors of microalbuminuria in T2DM patients. Conclusion: At ACR cut-off values, concentrations of HbA1c and SUA were independent predictors of microalbuminuria in T2DM patients not yet diagnosed with nephropathy.
Dijana Mirić, Bojana Kisić, Dragana Puhalo-Sladoje, Bratislav Mirić, Dragiša Rašić, Ilija Dragojević, Dragana Pavlović
01.12.2019.
Professional paper
Uticaj porođajne mase i aktuelne težine deteta na nastanak prevremenog puberteta
Introduction: Puberty is a juvenile developmental period accompanied by intensive growth and acquisition of reproductive ability. The onset of puberty is influenced by many factors: genetics, neuropeptides and glycoproteins, gonadotropins, sex hormones and the child's nutrition status. Premature puberty is defined as the appearance of secondary sexual characteristics in girls before the age of 8, and in boys before the age of 9. The aim of this paper is to analyze the published results on the importance and influence of factors such as birth weight, current weight and BMI on the development of premature puberty. Results: Eating disorders caused by eating high-calorie foods lead a child to obesity, which is accompanied by premature puberty. On the other hand, conditions characterized by reduced nutrition may be accompanied by delayed puberty. According to the results of this study, children with more pronounced manifestations of precocious puberty had a significantly lower birth weight Discussion: Birth weight of less than 2500g, as well as newborns' SGA (small for gestational age), are directly related to earlier pubertal maturation. Five decades ago, Frich et al. found that reaching a body weight of 48 kg in girls is a "critical mass" for development of menarche. Conclusion: The occurrence of secondary sexual characteristics is more frequent in children with increased body weight and correlates inversely with the child's birthweight.
Snežana Marković-Jovanović, Maja Ješić, Vlada Bojić, Aleksandar Jovanović, Zorica Živković, Andrijana Karanović, Vera Zdravković
01.12.2019.
Professional paper
Frequency and histological-cytological correlation of premalignant and malignant changes in the cervix in women of different ages
Introduction: Cervical cancer is the fourth most common and accounts for about 6.6% of all cancers in women. Aim: The aim was to determine the frequency of premalignant and malignant changes in the cervix, to examine the histological-cytological correlation of premalignant and malignant changes in the cervix and the correlation of the women's age with the stage of cervical disease. Material and Methods: A retrospective study analyzed 186 cervical biopsy specimens and cervical smears (Papanicolau test) at the Institute of Pathology of the Faculty of Medicine in Pristina, based in Kosovska Mitrovica, over a three-year period from 2016 to 2018. Results: Of the 186 subjects, 62 had mild premalignant changes of type LSIL, 22 HSIL, and as many as 20 (10.75%) cervical cancer. There was a statistically significant positive association between histological and cytological findings (r = 0.854; p <0.001). There was a statistically significant difference in the age of the subjects with regard to histological findings (F = 11,327; p <0.001). Subjects with HSIL were significantly older than those diagnosed with cervicitis chronica (p = 0.029). Subjects diagnosed with planocellular carcinoma were significantly older than women with cervicitis chronica (p <0.001) and LSIL (p <0.001). Conclusion: There is an increasing trend of cervical cancer in Northern Kosovo and in the Serbian enclaves in central Kosovo and Metohija. Subjects with cervical cancer were significantly older than subjects with mild premalignant cervical changes. There is a significant histologic-cytological correlation of cervical findings, so we believe that more massive cervical screening, especially in younger women, could reduce the incidence of premalignant and malignant diseases of the cervix.
Dejan Mihajlović, Zoran Bukumirić, Nenad Šulović, Goran Relić, Slaviša Stanišić, Saša Cvetković, Momir Dunjić, Tanja Mirković, Milica Milentijević, Novica Đoković, Mirjana Stojanović-Tasić
01.12.2019.
Professional paper
Errors and artifacts on radiographs
Introduction: The process of recording a patient includes a procedure with several separate segments during work that together provide the imaging to be obtained for adequate radiological analysis. Throughout the process, it is possible to experience errors that create artifacts on X-rays which ultimately results in an inadequate recording that is not for valid analysis. Aim: Determine the total number of radiological films that are not for valid analysis. Sort out and analyze errors in radiographs according to the work process. Provide recommendations for improving the quality in the process of recording the patient. Material and methods: A prospective study was conducted at the Radiology Clinic of the Clinical Hospital Center Pristina-Gracanica, for two calendar years. All films that are not for valid analysis were considered. The radiological procedure of patient imaging was broken down into logical segments so that possible errors could be observed. We have summarized the causes of the artifacts in five appropriate groups (errors made by the recording technique, during the acquisition of the image, caused by the object of recording, during the processing of films in an automated machine and improper handling of films). Results: The total amount of used X-ray films is 32600 pieces, of which 242 (0.74%) were errors and artifacts. The most common format of a film with an error or artifact was 30x40 cm. A frequency of errors according to the cause of the occurrence is classified into appropriate groups. The largest number was in a group 1 - 155 (64.04%), in a group 2 - 3 (1.24%), in a group 3 - 13 (5.37%), in a group 4 - 67 (27.69%), and in a group 5 - 4 (1.66%). Conclusion: In the proper systematization of all observed errors and artifacts of X-ray film, it allows us to realise the place of error during the whole process of recording and processing of the film. We hereby wish to propose their elimination and improve the quality of the radiology department.
Simon Nikolić, Aleksandra Milenković, Bojan Tomić, Branislava Radović, Miloš Gašić
01.12.2019.
Professional paper
Strategije suočavanja sa anksioznošću u situaciji testiranja engleskog jezika kod studenata visokog i niskog samopoštovanja
Introduction: Different types of tests present a great part of the academic life, and the tests themselves are extremely stressful situations for most students. The question of strategies used for coping with anxiety in testing situations is raised by the anxiety experienced by students and the levels of their self-esteem during tests. Aim of the paper: The aim of the paper is to take into consideration language anxiety, self-esteem and social and demographic variables as predictors of active use of strategies for coping with the testing situation. Material and methodology: This research included 338 students from five faculties/colleges, with an average age of 21.82±2.561, who were administered the following scales: Rosenberg's Self-esteem Scale, the Coping with the Testing Situation Scale and Foreign Language Classroom Anxiety Scale. Results: The Subscale for Language Anxiety during Testing has the highest reversed predictive value (beta=-0.43, p<0.001) of coping strategies for the testing situation; older respondents have less expressed ability of coping with the testing (beta=-0.23, p<0.001), and the higher the level of fear from negative evaluation (beta=0.21, p<0.001), the more the respondents are coping with the testing situation. Conclusion: The higher the testing anxiety, the less will the students use coping strategies, and the older students cope less with stressful testing situations, but the greater the presence of a more expressed fear of inefficiency, the more will the respondents cope with the testing situation through various strategies.
Marina Malobabić, Ivana Nešić, Vesna Jokanović
01.12.2019.
Professional paper
Bruxism
Bruxism is a parafunctional activity of the masticatory system, which is characterized by clenching or scraping of teeth. This condition is often accompanied by a change in the shape and size of the teeth, as well as the function of the stomatognathic system. Bruxism can occur during sleep and in the waking state. The etiology is multifactorial and all causes can be divided into peripheral and central. The clinical signs and symptoms of bruxism are primarily characterized by temporomandibular disorders, the appearance of bruxofacets and changes in the hard dental tissues, supporting apparatus of the teeth and masticatory muscles, as well as headaches. The diagnosis of bruxism is made on the basis of anamnesis and clinical signs and symptoms, while electromyography and polysomnographic analysis are used in scientific researches. Therapy is aimed at controlling etiological factors and reducing symptoms. Occlusal splints are the most commonly used in the treatment of bruxism. Medications are used in situations when other methods, including psychotherapy, do not give positive results. Given the multifactorial etiology, the therapeutic approach must be multidisciplinary. The approach to the patient must be individual in order to treat as effectively as possible.
Nadica Đorđević, Jelena Todić, Dragoslav Lazić, Meliha Šehalić, Ankica Mitić, Radivoje Radosavljević, Aleksandar Đorđević, Ljiljana Šubarić
01.12.2019.
Professional paper
Oral health in patients with chronic kidney disease
Objective: In the available literature data, there is not much information about problems of patients with end stage kidney disease in relation to oral health. Our objective was to show the importance of oral diseases for patients on hemodialysis. Data sources: In this review article, the sources of data are review articles and scientific articles in the English language published in MEDLINE database. The choice of studies was based on keywords: Chronic kidney disease, Hemodialysis, Oral health, Periodontal diseases. Results: It is assumed that almost 90% patients with chronic kidney disease manifest some symptoms of oral disease. Therefore, it is important to determine the impact of periodontal disease on the progression of kidney failure in these individuals, to evaluate inflammatory parameters in this patient population, to assess the degree of bone loss and periodontal disease index, to determine the presence of bacterial strains, paradontopathy of gingival fluid and antibody titers, to examine correlations of proinflammatory cytokines in the gingival sulcus and serum, as well as to determine the relationship between periodontal tissue and inflammatory mediators. Periodontal diseases can increase the possibility of developing chronic kidney disease by 1.5 to 2 times. These oral diseases include gingival hyperplasia, periodontitis, xerostomia, unpleasant breath, changes in the oral mucosa, malignancies, oral infections, dental abnormalities and bone lesions. Conclusion: This requires serious cooperation between nephrologists and dentists to make proper communication possible, in order to provide quality dental care for this growing patient population in accordance with new treatment strategies.
Radojica Stolić, Vekoslav Mitrović, Naja Suljković, Dušica Miljković-Jakšić, Aleksandra Balović, Roksanda Krivčević, Sanja Jovanović
01.12.2019.
Professional paper
Mehanizam kontrakcije i relaksacije miometrijuma, interakcija okcitocina i prostaglandina
Regulation of uterine activity during pregnancy is due to the nature of the loss of humoral sympathetic, holinergical and peptidergic inervation. So far, nothing found that would indicated that the mechanism of premature birth and its pathogenesis different from the normal mechanism of delivery, except for different maturity of the fetus. Since a large number of substances that participate in the contraction and relaxation of miometrium (estrogen, progesterone, cortisol, etc.). Today's modern research has focused on prostaglandins and oxytocin, or their interaction. Accepting oxytocin as substance initiation deliveries it is difficult for two reasons: the level of oxytocin in the blood can not lift before the delivery and release of oxytocin remains constant during pregnancy. Oxytocin probably plays a role in support delivery for decidual cells stimulates the synthesis of uterine PGF2a.
Goran Relić, Vujadin Mujović, Nenad Šulović, Slaviša Minić
01.12.2019.
Professional paper
Jarisch-Herxheimer reaction during therapy of neuroborreliosis
Introduction. Jarisch-Herxheimer reaction implies trembling, headache, temperature, rash, meningitis, respiratory problems, liver, kidney and heart dysfunction during antibiotic treatment of Lyme disease. Case outline. A 47-year-old patient in May 2016 had circular redness on the thigh, fatigue, myalgia, nausea and headache. Borrelia Burgdorferi IgM antibodies were positive. She took doxycycline 200 mg/day, four weeks. Western blot IgM and IgG were positive as well. Retreated with Azithromycin, 500 mg/day, three weeks. Next year, there was a sleep and memory disorder, fatigue, dizziness, right leg paresthesia and burning in the soles, muscle weakness, decreased sensitivity and right foot hyperreflexia. Electromyography showed axonal degeneration of the peroneus and the tibialis. Pleocytosis (5 leucocytes/mm³) and intrathecal IgG were found. Magnetic resonance of the head in order. Neuroborreliosis was diagnosed and treatment included ceftriaxone, 2 grams/day, three weeks. After the second dose, trembling, myalgia, headache, nausea, flushed nose, dizziness and nausea started. Temperature 37.8°C. No changes on the skin. The antibiotic was not interrupted, symptomatic therapy was administered, and after two days the symptoms stopped. Neurological disorders have not completely disappeared. Titre antibodies still present. Conclusion. Jarisch-Herxheimer reaction occurs in 7.0-30.0% of patients treated for Lyme disease. Causes are multifactorial. Spirochetes release toxins, hypersensitivity is present, phagocytes destroy agents, complements and cytokines are activated. It is often not recognized. Tremor, fever, myalgia and skin rashes are present before the antibiotic, and the worsening is attributed to the underlying disease or allergy. Doctors should expect it during the treatment of spirochete-related diseases and provide appropriate care.
Snežana Knežević, Jelena Vulović, Marijana Jandrić-Kočić
01.12.2019.
Professional paper
Postpartal depression and thyroid disorders
Introduction: Postpartum depression negatively affects a woman's quality of life and the development of a relationship with her child, which can have far-reaching consequences on the cognitive, behavioral and emotional development of the child. Etiology includes genetic predisposition, sudden hormonal changes, and sociodemographic factors. Case report: A 28-year-old patient, married, mother of a one-month-old boy. She graduated from the High school of economics, unemployed. She appears in the family medicine clinic due to chronic fatigue and bad mood, at the insistence of her husband, who thinks that she needs professional help. She grew up in a harmonious family. He gets along well with his wife, there are no existential problems. It denies previous illnesses. Neat appearance, inconspicuous posture and behavior, psychomotor diskette slowed down, more sparse spontaneous verbalization, slightly compromised volitional instinctual dynamisms, lowered basic mood. In the laboratory findings, hypothyroidism with elevated thyroid peroxidase antibody and antithyreoglobulin antibodies is detected. The thyroid ultrasound verifies the right lobe of 46x14x15mm, the left lobe of 48x13x12mm, inhomogeneous and easily hypoechoic structure. The Edinburgh Postnatal Depression Scale indicates the presence of depression (total score 18). The patient is referred for a consultative examination by a psychiatrist and a nuclear medicine specialist. Psychiatrist indicates the introduction of Sertralin 50 mg tablets (1x1/2 for the first seven days, then 1x1) and Bromasepam tablets 1,5 mg (2x1/2), nuclear specialist Levotiroskin sodium tablets 50 mcg (1x1/2 for 5 days and 1x1 for 2 days). After six months, withdrawal of the symptoms of the disease and exclusion of therapy by a psychiatrist. Conclusion: Autoimmune thyroid disease is a significant and often unrecognized cause of postpartum depression. Early detection and timely therapeutic intervention of these have a significant role in the prevention and successful treatment of postpartum depression.
Marijana Jandrić-Kočić
01.12.2019.
Professional paper
The immediate effects of the Covid-19 pandemia on postpartum women
The new pandemic, caused by the corona viral disease 2019 (Covid-19), has brought with it a series of restrictive measures that have drastically altered people's way of life and which restrict freedom of movement, behavior and social engagement. At the time of pandemia, almost all aspects of each individual lifestyle have been impaired, especially in members of vulnerable groups, particularly women in postpartum women. Acute psychological reactions to a pandemia may include insomnia, fear of infection, anxiety, frustration, panic attacks, loneliness, but also depressive episodes. Non-psychotic postpartum mood and anxiety disorders can occur as an inability to adapt to stressful life situations. A comprehensive understanding of the impact of the pandemia on the mental health of women in the postpartum period is needed, in order to devise adequate approaches to recovery from such a major disaster as the Covid-19 pandemic.
Jelena Stojanov, Aleksandar Stojanov, Miodrag Stanković, Olivera Žikić
