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Volume 52, Issue 4, 2023
Online ISSN: 2560-3310
ISSN: 0350-8773
Volume 52 , Issue 4, (2023)
Published: 17.02.2025.
Open Access
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Contents
15.02.2025.
Case Reports
IDIOPATHIC PULMONARY HYPERTENSION – CASE PRESENTATION
Pulmonary hypertension (PH) is a hemodynamic condition characterized by a mean pulmonary artery pressure (mPAP) ≥ 25 mmHg at rest, pulmonary arterial wedge pressure (PAWP) ≤ 15 mmHg, and pulmonary vascular resistance (PVR) > 240 dyn·s·cm⁻⁵. The annual incidence of pulmonary arterial hypertension (PAH) is approximately 3–10 new cases per million adults. It is estimated that the prevalence of pulmonary hypertension in individuals over 65 years of age is around 10%.The aim of this study is to present the case of a female patient with progressive dyspnea in whom PAH remained undiagnosed for a prolonged period.A 74-year-old female patient, M.P., was hospitalized in the Coronary Care Unit of the Clinical Center in Kosovska Mitrovica due to symptoms of shortness of breath, choking, fatigue, leg swelling, and weakness. The admission ECG revealed: sinus rhythm, normal axis, high R wave in V2, ST depression, and negative T waves in leads II, III, aVF, and V4–V5. Echocardiography findings showed right ventricular enlargement (2.9 cm), pulmonary artery dilation (3.3 cm), 1–2+ pulmonary regurgitation, and 3+ tricuspid regurgitation, with a systolic pulmonary artery pressure (SPAP) of up to 126 mmHg. The right ventricle measured 5.3 cm in the 4Ch view, with a TAPSE of 1.8 cm. Right heart catheterization revealed the following pressures: PA 78/34/57 mmHg, RV 74/8/10 mmHg, RA 6/6/7 mmHg, CO 4.3 l/min, and LV 99/10/8 mmHg. Although primary pulmonary hypertension is predominantly a disease of younger individuals, it should also be considered in older patients presenting with progressive dyspnea in the absence of structural heart disease.
Kristina Bulatović, Vladan Perić, Maja Šipić, Jovana Milošević, Erdin Mehmedi, Sanja Jovanović
15.02.2025.
Original scientific paper
THE PREVALENCE OF ALCOHOL CONSUMPTION AMONG STUDENTS AT THE UNIVERSITY OF BELGRADE
Introduction/Objective
The objective of this study was to determine the prevalence of alcohol use in the student population of the University of
Belgrade.
Methods
The cross-sectional study was conducted in a population of 2,000 students of the Belgrade University. Four faculties (Medicine, Geography,
Economics, Electrical Engineering) from which the students participating in this research were chosen by the method of random choice (by computer
listing), conducted in the period April - June 2010.
Results
Among our respondents, the highest amount of spirits is consumed by respondents from the Faculty of Electrical Engineering, with 22% of
them consuming more than 6 shots on each occasion, while the smallest number of students who drink more than 6 shots on each occasion are from
the Faculty of Economics, with 8%. Students from the Faculty of Electrical Engineering, who have the lowest prevalence of cigarette use, consume
alcohol in a binge drinking pattern. The highest frequency of binge drinking in the past year and in the past month before the survey was among
respondents from the Faculty of Geography.
Conclusion
There is a need for developing a conscience about all the effects that alcohol has, especially physical ones which are not usually noticed
immediately; taking responsibility for own actions; working on a healthy life style and educating people to enhance and improve their health control.
Mirjana Stojanovic-Tasic, Mirjana Virijevic, Kristina Rakic, Emilija Novakovic, Ivana Stasevic Karlicic, Nenad Milosevic, Jelena Aritonovic Pribakovic, Jovana Milosevic, Milica Bogdanovic, Suzana Adzic, Katarina Bisevac, Mary Vuksa
15.02.2025.
Original scientific paper
RECOMMENDATIONS FOR THE APPROACH TO PATIENTS WITH DISORDERS OF THYRIOD GLAND FUNCTION IN THE DENTAL OFFICE
Thyroid hormones, thyroxine and triiodothyronine, affect the work of all organs and organ systems. Whether they are in excess or in deficit, they lead to significant disturbances in the homeostasis of the organism, changing first of all the metabolic processes and leading to significant clinical manifestations, primarily in the cardiovascular, but also in other organ systems. The imbalance of thyroid hormones also has oralmanifestations, which are often the reason why patients visit the dentist. However, what worries dentists the most is the possibility of acute decompensation of hyper or hypothyroidism, with the appearance of thyrotoxic storm or myxedema coma, which are life-threatening conditions. Therefore, a valid pre-procedural evaluation and preparation of patients with thyroid hormone function disorders for pre-planned dental interventions is of great importance. During dental procedures, it is necessary to adhere to recommendations regarding the choice of local anesthetics, hemostasis, drug interactions, the possibility of infection and minimizing stress, all in order to avoid acute decompensation of thyroid imbalance.
Radomir Mitić, Nina Dimitrijević Jovanović, Hristina Ugrinović, Jelena Vulović, Milena Šibalić, Nevena Kalezić
17.02.2025.
Professional paper
THE IMPACT OF COVID-19 PANDEMIC ON THE CONSUMPTION OF ANTIDIABETIC DRUGS IN SERBIA: A JOINPOINT TREND ANALYSIS
Background: People with diabetes more often experienced severe clinical forms of COVID-19. However, it has been hypothesized that certain antidiabetic drugs may be associated with better outcomes in COVID-19 patients. The aim of this study was to analyze whether the COVID-19 pandemic influenced the change in consumption of antidiabetic drugs in Serbia.
Methods: This descriptive analysis was carried out using publicly accessible data obtained from the official website of the Medicines and Medical Devices Agency of Serbia during the period 2006-2022. The joinpoint regression analysis was applied to investigate the dynamics of antidiabetic drugs utilization over time.
Results: In the Republic of Serbia, this study analyzed the use of 28 antidiabetic drugs between 2006 and 2022.The results showed that at the beginning of the COVID-19 pandemic, there was an increase in consumption of dulaglutide (starting from 2020) and a decrease in consumption of insulin detemir (starting from 2019), insulin lispro (combined) and insulin lispro (fast-acting) (starting from 2020).
Conclusion: Our study revealed significant changes in the usage of certain antidiabetic drugs, such as increased consumption of dulaglutide and decreased use of various insulin types. These changes reflect the evolving strategies in diabetes treatment to better support patients during this global health crisis.
Key words: antidiabetic drugs, impact of Covid-19, consumption, Serbia
Jelena Filimonovic
17.02.2025.
Professional paper
INFEKCIJA H. PYLORI KOD PACIJENATA SA DISPEPSIJOM: KLINIČKI, ENDOSKOPSKI I HEMATOLOŠKI NALAZI
Uvod: Dispepsija je čest gastroenterološki sindrom koji značajno narušava kvalitet života. Infekcija bakterijom Helicobacter pylori (H. pylori) ključni
je faktor u razvoju organske dispepsije, dok njena povezanost sa funkcionalnom dispepsijom ostaje predmet istraživanja.
Cilj: Ispitati prevalenciju H. pylori infekcije kod pacijenata sa dispepsijom i njenu povezanost sa simptomima, endoskopskim nalazima i hematološkim
parametrima
Metode: Retrospektivna studija obuhvatila je 117 pacijenata sa dispepsijom pregledanih tokom 2023. godine na Internoj klinici KBC Priština-Gračanica
u Lapljem Selu. Svi su podvrgnuti gornjoj gastrointestinalnoj endoskopiji i testiranju na H. pylori antigen u stolici. Analizirani su demografski podaci,
simptomi, endoskopski i hematološki nalazi.
Rezultati: H. pylori infekcija je potvrđena kod 63,25% pacijenata, bez značajne razlike između polova. Zabeležen je trend porasta prevalencije sa
godinama, ali bez statističke značajnosti (p=0,060). Epigastrični bol (p=0,0068) i gorušica (p<0,0001) su bili značajno češći kod H. pylori pozitivnih
pacijenata, dok su hronični gastritis (p=0,005) i duodenalni ulkus (p=0,029) bili dominantni endoskopski nalazi kod ove grupe. Značajno veći procenat
H. pylori pozitivnih pacijenata imao je snižene vrednosti broja eritrocita i hemoglobina u odnosu na negativnu grupu (p<0,01). Prosečan hematokrit
bio je niži u H. pylori pozitivnoj grupi (p=0,013), ali se nije značajno razlikovao od referentnih vrednosti.
Zaključak: H. pylori infekcija je česta među pacijentima sa dispepsijom i povezana sa specifičnim simptomima, patološkim endoskopskim nalazima i
hematološkim promenama. Testiranje na H. pylori je ključno u proceni dispepsije, dok H. pylori negativni pacijenti sa upornim simptomima zahtevaju
dodatnu dijagnostiku.
Ključne reči: Helicobacter pylori; dispepsija; simptomi; endoskopski nalaz; hematološki parametri
Marko Stalević
17.02.2025.
Professional paper
INFORMISANOST, UPOTREBA I STAVOVI STUDENATA MEDICINE O KOGNITIVNIM POJAČIVAČIMA
Uvod: Kognitivni pojačivači (KP) poboljšavaju kognitivne funkcije putem neurotransmitera CNS-a. Čine raznorodnu grupu supstanci koje se
svakodnevno uzimaju kao napici nalik kafi, biljni lekovi i dijetetski suplementi (“meki pojačivači”) ili lekovi koji se koriste u lečenju bolesti
(nootropici). Upotreba i zloupotreba su česte u studentskoj populaciji sa brojnim etičkim pitanjima.
Cilj: Utvrđivanje informisanosti studenata medicine, njihovih stavova o upotrebi i stepenu rizika od neželjenog delovanja KP, na osnovu pretpostavke
da je upotreba ovih supstanci redovna.
Materijal I metode: Studija preseka je sprovedena po tipu anonimnog anketnog istraživanja na Medicinskom fakultetu Priština sa privremenim
sedištem u Kosovskoj Mitrovici. U ispitivanju su dobrovoljno učestvovali studenti medicine prve tri godine integrisanih studija koji nisu položili ispit iz
predmeta Farmakologija sa toksikologijom. Upitnik je obuhvatio socio-demografske podatke, podatke o koncentraciji i navikama u učenju, stepen
informisanosti, procenu upotrebe i procenu rizika korišćenja KP. Stratifikacija uzorka je izvršena prema polu studenata, a Likert-ova skala je poslužila
za rangiranje stavova ispitanika.
Rezultati: Od ukupnog broja anketiranih (n=249) u konačnu statističku analizu podataka uključeno je 169 anketnih upitnika (M 32,5 %, Ž 67,5%).
Najviše studenata je bilo sa druge godine studija (40%), dok je najviše studentkinja bilo sa prve godine (48,2%). Uočena je statistički značajna razlika
između ispitivanih grupa u odnosu na godinu studiranja (p=0,009). Informacije o KP su novina za 40,2% ispitanika (M 49,1%, Ž 36%). Da je o njihovoj
primeni dovoljno informisano smatra 23,7 % ispitanika (M 20%, Ž 25,4%). Postoji statistički značajna razlika u upotrebi internet baza za informisanje o
KP (p<0,001).Najveći broj studenata (71,6%) koristi internet za informisanje o KP, pri čemu je korišćenje internet baza bilo statistički značajno veće
kod žena u odnosu na muškarce (M 56,4 %,Ž 78,9 %; p=0,002). Više od polovine ispitanika (50,3%) koristi Mediately bazu kao pouzdanu bazu podataka o
lekovima. Od ukupnog broja studenata 40,8% upotrebljava neki od navedenih KP (M 43,6%, Ž 39,5%). Najčešći razlozi za upotrebu kod obe grupe
ispitanika su poboljšanje koncentracije (M 27,3%, Ž 28,9%) i uspešnije polaganje ispita (M 25,5%, Ž 15,8%). Oba pola najviše koriste ginko bilobu (M
29,1%, Ž 32,5%) i metilksantine (M 29,1%, Ž 17,5%). Studenti znatno češće upotrebljavaju kreatin u odnosu na studentkinje (M 20%; Ž 2,6%; p=0,003).
Obe grupe studenata su prema medijani i interkvartilnom opsegu (25-75%) uočenog rizika od neželjenih reakcija rangirale kokain (M 9,0; Ž 9,0),
metamfetamin (M 8,0; Ž 8,0) i amfetamin (M 8,0; Ž 7,0) kao najopasnije, dok je ginko biloba procenjena kao najbezbedniji KP (M 3,0; Ž 3,0).
Zaključak: Većina studenata nije dovoljno informisana o kognitivnim pojačivačima, iako ih koriste samoinicijativno, radi postizanja boljih rezultata na
studijama. Neophodno je studente uputiti na adekvatne izvore informisanja i organizovati vannastavne tribine i predavanja o bezbednosti i efikasnosti
KP pre upotrebe. U skladu sa trendovima u svetu, može se očekivati porast zloupotrebe nootropika na univerzitetima i u našoj zemlji. Smatramo da bi
trebalo ponoviti ili organizovati slično ispitivanje kroz par godina, po mogućstvu u većem obimu.
Ključne reči: kognitivni pojačivači, informisanost studenata, stavovi studenata
Aleksa Ilić Keljanović
17.02.2025.
Professional paper
TRANSPOZICIJA TETIVE EKSTENZOR INDICIS PROPRIJUS ZA EKSENZOR POLICIS LONGUS U CILJU REKONSTRUKCIJE EKSTENZIJE PALCA - PRIKAZ SLUČAJA
Ruptura potkožne tetive ekstenzora policis longusa (EPL) je jedna od najčešćih povreda tetiva ekstenzora šake. Ova vrsta povrede može biti posledica
trauma ručnog zgloba. Češće se javlja kao posledica degenerativne ili inflamatorne bolesti. Ponekad se to dešava bez predisponirajućeg stanja, zbog
kontinuiranih pokreta savijanja i opružanja palca šake.
Ruptura tetive EPL-a se obično dešava u predelu Listerove kvrge gde su trenja najveća. Kontinuirano ponavljanje mikrotrauma može da uzrokuje
rupturu. Engkvist i Lundborg [1] su postavili hipotezu o patogenezi mehanizama ove povrede. Smatrali su da nakon trauma ili zapaljenja formiran
hematom unutar omotača tetive dovodi do povećanja pritiska u neelastičnom prostoru. Povećanje pritiska može izazvati promene u snabdevanju krvi i
može dovesti do nekroze i rupture struktura tetiva. Nakon prekida kontinuiteta tetive EPL-a, retrakcija proksimalnog okrajka je praćena
degenerativnim procesima koji ugrožavaju direktnu suturu.
Predloženi su mnogi tretmani, artrodeza interfalangealnog (IP) zgloba palca ili transpozicija tetive ekstenzor indicis proprius (EIP) koju je razvio
Mensch 1925. god. [1].
Transpozicija tetive šake je hirurška procedura која uključuje repozicioniranje funkcionalne tetive како bi se obnovila funkcija oštećene tetive šake.
Ova operacija ima za cilj da vrati pokret, funkciju i snagu šake.
U ovom radu prenosimo naše iskustvo u lečenja traumatske rupture tetive EPL-a metodom transpozicije tetive EIP-a. Opisujemo operativnu tehniku
transfera tetive EIP-a na tetivu EPL.
Ključne reči: trasnpozicija tetive, ekstenzor policis longus, ekstenzor indicis proprius, funkcija.
Aleksandra Petrović
15.02.2025.
Professional paper
EXAMINATION OF INTRACRANIAL TRANLUCENCY AS A MARKER FOR EARLY DETECTION OF OPEN SPINA BIFIDA
This article focuses on the sonographic axamination techique for evaluation of intracranial translucencies during the first trimester ultrasound scan. Appropriate knowledge of sonographic landmarks is the most important factor for evaluation normal as well as abnormal brain structure, and this examination may enable detection of open spina bifida and Arnold – Chiari anomaly at an early stage of fetal develpoment.
Nenad Šulović, Goran Relić
15.01.2025.
Case Reports
THE IMPORTANCE OF EARLY DETECTION OF DIABETES INSIPIDUS IN CHILDHOOD
Introduction:
Diabetes insipidus (DI) is a disease that occurs due to inappropriate secretion of anti-diuretic hormone from the pituitary, or as a result of disorder in which the level of the kidneys cannot adequately respond to the secretion of this hormone. Also, it is known as central diabetes insipidus. The most common causes are head traumas, tumors of the hypothalamus and pituitary glands, inflammatory processes, histiocytosis, anomalies in the development of brain. It can appear in the form of familial diabetes insipidus or in certain syndromes (Wolfram syndrome). It is characterized by hypotonic polyuria higher than 3l/24h (which persists if even taking liquids stops), then by nocturia and compensatory polydipsia. Enuresis often occurs among children.
Case report:
A boy, aged 11, lives with his mother and brothers. Mother noticed that the boy was urinating frequently in last few months (diuresis 4.6 l/24h, and 3.25 l/24h). After two months, the boy developed double images and severe headaches, vomiting, inability to see, squinting in the right eye and headache in the back of the head. MNR of the endocranium indicates the presence of a tumor formation. The tumor was surgically removed, and the boy started with chemotherapy and radiotherapy. Due to persistent diabetes insipidus, the boy started using desmopressin-acetate - in tablet form. Active substance desmopressin - acts in the same way as the natural hormone vasopressin and regulates the kidney's ability to concentrate urine. The positive effect of taking the drug appeared after three weeks from the start of taking the therapy.
Conclusion:
Central (neurogenic) DI occurs as a result of a relative or absolute deficiency of antidiuretic hormone, which is responsible for the osmolality of body fluids. Based on this case, we want to show the importance of early diagnosis of the disease in order to improve the prognosis and the necessity of careful monitoring of these patients.
Danijela Jovanović, Snezana Marković- Jovanović, Teodora Tubić
15.02.2025.
Case Reports
VITAMIN D - „SOLAR VITAMIN“
The discovery that sunlight can cure rickets was first scientifically confirmed in 1919. Shortly thereafter, in 1924, it was found that inactive lipids in the diet and skin are converted into antirachitic substances under the influence of UV light. Vitamin D (Vit D), also known as the "sunshine vitamin,"
was first identified in 1931. In recent decades, it has regained the focus of interest among the broader scientific community and dermatologists.
Specifically, certain dermatoses have been associated with low Vit D levels, leading to its supplementation in patients. On the other hand, some
dermatoses worsen with sun exposure, necessitating strict avoidance of sunlight and the therapeutic use of Vit D preparations.We are witnessing a
growing number of cases of melanoma and non-melanoma skin cancers, with excessive sun exposure being the primary etiological factor in most
cases. This paper provides a literature review on the historical discovery of Vit D and presents findings from studies examining Vit D levels not only in
various dermatoses but also in other diseases. The number of studies, as well as the spectrum of diseases in which the role of Vit D is being
investigated, continues to increase.
Milijana Relić, Snežana Relić, Tanja Kostić Grujić, Marijana Trajković, Zorica Timotijević, Tamara Jovanovic, Goran Relić