Contents
01.12.2021.
Professional paper
Analysis of the characteristics of traffic trauma
Introduction: It is estimated that an average of 1,308 people die in traffic accidents in the world every day. Traffic accidents are caused by factors of the road, vehicles and the human factor, which occur alone or in combination with other factors in over 90% of cases. Material and methods: The retrospective systematic research included all cases of traffic trauma that were brought to the admission surgical outpatient clinic in the Clinical Hospital Center Kosovska Mitrovica in the period from January 2020 to December 2022. Results: In the observed period, 126 patients were registered. The age of the respondents differs statistically according to gender (p=0.030), and the highest frequency is male (81.8%) in the working population (18-59 years). The age of the subjects showed no statistical association with the types of injuries in traffic trauma (p=0.151). Friday and Saturday are the days with the highest risk (25.3% of injuries), and Sunday is the day with the least number of injuries (3.6%). The lowest number of injuries was recorded from January to May (n=12, 9.5%), and the highest was in the period August to October (n=54, 42.9%). A male patient, 20 years old, an alcoholic, required urgent surgical treatment (splenectomy) due to abdominal injuries. Alcoholism and the age of the subjects did not show statistical significance (p=0.495), and 24.6% of patients had a diagnosis of alcoholism. The age of the subjects showed a statistical association with hospitalization (p=0.004), male gender and age between 18-59 years. Only 2 patients required transport to a highly specialized facility. The fatal outcome showed a statistically significant correlation with the age of the respondent (p=0.016), there was only one patient (between 12-18 hours), a female, 85 years old as a passenger of a motor vehicle. Conclusion: The results of our study indicate a statistically significantly more frequent injury and hospitalization of male patients, that Friday and Saturday are the days of greatest risk and that the fatal outcome occurs in extremely elderly patients. Our findings favour the need to raise public awareness through the media, public actions and forums.
Mladen Kasalović, Aleksandar Jakovljević, Nikola Miljković, Gojko Igrutinović, Milica Milentijević, Aleksandra Milenković
01.12.2021.
Professional paper
Fructose metabolism: The pathogenic potential of a little molecule
In recent decades, the use of fructose in diet has increased worldwide, and coincided with increase of obesity, metabolic syndrome, diabetes, and non-alcoholic liver disease. This review presents molecular aspects of fructose metabolism, its characteristics and contemporary knowledge about control mechanisms in order to answer how this small molecule can exert pathogenic effects. When present in small, physiological amounts, fructose actually exerts protective glycoregulatory effects. However, long-term exposure to supraphysiological amounts of fructose creates conditions for the development of certain pathological states. In such conditions, lipogenesis is intensified causing dyslipidemia, gluconeogenesis is also intensified leading to hyperglycemia and compensatory hyperinsulinemia, while insulin signaling through IP3K/Akt is blocked. Moreover, exposure to high fructose levels can induce inflammation, redox balance disruption and a decline in energy synthesis. It is most likely that the ability of the liver to metabolize large amounts of fructose and the absence of autoregulatory and hormonal control mechanisms are responsible for pathogenic potential of fructose.
Dijana Mirić, Bojana Kisić, Dragana Pavlović, Ilija Dragojević, Sladoje Puhalo
01.12.2021.
Professional paper
Cor triatriatum sinister as an incidental finding in elderly woman
Cor triatriatum is a rare condition. It comprises around 0.1% to 0.4% of all congenital heart malformations. There are two types of this anomaly: cor triatriatum sinister (CTS), which is more common and accounts for 92% of all cases, and cor triatriatum dexter (CTD). This condition usually presents at an early age and is diagnosed mainly during early childhood. In some patients, who have less severe cases of CTS, diagnosis could be made in adulthood. We report an unusual case of a 78-year-old woman who was diagnosed with CTS for the first time. The patient was admitted to the cardiology department with symptoms of chest pain and dyspnoea. Physical examination revealed diffusely diminished breath sounds, with focal wheezing, and irregular heart rate, with no murmurs, while blood pressure was 140/90 mmHg. A transthoracic echocardiogram revealed an accessory membrane in the left atria suggestive of CTS.
Dalila Šačić, Mirza Šačić, Mirsad Šačić
01.12.2021.
Professional paper
Operative treatment of supracondylar elbow fracture in a child using the percutaneous method
Supracondylar fractures are the most common elbow injuries in children and are associated with prolonged morbidity due to possible complications that can lead to deformity. The decision on the treatment method is made based on Gartland's classification (I, II, III and IV types) and the treatment can be non-operative (I and II type) and operative (III and IV type). When it comes to the percutaneous method, the main dilemma for its implementation is related to pinning from the medial side of the elbow because there is a high possibility of injury to the n. ulnaris which, according to data from the literature, occurs in some 15% of cases. The aim of treatment is pain relief and maintenance of the patient's functional status. The case presented in this paper represents a patient with whom the clinician is most likely to encounter and shows the clinical assessment of the patient's condition, the way of deciding on the treatment method and the outcome of the treatment undertaken. Agirl, 8 years old, was injured when she fell while playing. At the Department of Orthopedic Surgery and Traumatology, Clinical Hospital Center Kosovska Mitrovica, the patient was clinically and radiographically examined, and the injury was defined as a supracondylar fracture type III according to Gartland. After adequate preoperative preparation under general anesthesia, without the use of a drape - Turniquet, with the use of a C-bow, repositioning is performed and after obtaining a satisfactory position of the fragments, they are fixed percutaneously with 3 Kirschner needles, two medially and one laterally. The patient was discharged 3 days after admission with controls performed for 7 days. The Kirschner pins were removed on the 5th week after the operation and physical treatment was started, after which the movements of flexion and extension as well as pronation and supination were fully restored. Similar results are found in the literature. This information can be helpful in advising parents about what to expect after their child's injury. Also, they represent evidence of good clinical practice for orthopedic doctors and physiotherapists.
Đorđe Kadić, A. Bozović, G. Radojević, Lj. Jakšić, M. Milić
01.12.2021.
Professional paper
Ellis-van Creveld syndrome
Introduction: Ellis-van Creveld syndrome is a rare genetic disorder characterized by short limb dwarfism, additional fingers and/or toes (polydactyly), abnormal development of fingernails and, in over half of the cases, congenital heart defects. Motor development and intelligence are normal. This disorder is inherited as an autosomal recessive condition. Some boys with this condition have been described with undescended testicles (cryptorchidism) or an abnormally located opening of the urine canal in the penis (epispadias). Abnormalities in the chest wall, spine and respiratory system have also been reported. Case report: The boy, aged two (2) years and eight (8) months, lives with parents and two brothers, in good living conditions. From the perinatal anamnesis, we can see that it is the third child from the third monitored pregnancy, delivered naturally at 39.gestational weeks, with normal birth parameters (3980/51/36), Apgar score 9. Immediately after birth, has been spotted complete postaxial polydactyly on both hands and postaxial poly-syndactyly (3,4,5,6) on the left foot, and ultrasound of the hips in early infancy indicated their unusual morphology and delayed bone maturation, which led to further medical investigation and treatment. Conclusion: Ellis-van Creveld syndrome is an extremely rare disease (this is the first registered case in our country). On the basis of this case, we want to express the importance of early diagnosis in order to improve the prognosis of the disease, and necessity of careful monitoring of these patients.
Danijela Jovanović, Snežana Marković-Jovanović, Ljiljana Vukadinović
01.12.2021.
Professional paper
Obesity and consequent changes in the body
Obesity is one of the most common chronic, non-infectious diseases in the world and our country, and it is characterized by excessive accumulation of fat tissue in the body and an increase in body weight. The increase in the number of obese people is an important global health problem. Obesity is associated with cardiometabolic and psychosocial comorbidities, and may also affect years of healthy life and reduce life expectancy. Numerous factors, such as biological predisposition, socioeconomic factors and environmental factors, interact and influence the development and maintenance of obesity. Excess adipose tissue in the body and its dysfunction is associated with inflammation and increased risk of metabolic, mechanical and mental complications. It is very important to monitor the incidence of obesity and its impact on the development of chronic non-communicable diseases and life expectancy due to the development and implementation of strategies to prevent the increase in the number of obese people.
Bojana Kisić, Dragana Puhalo-Sladoje, Dijana Mirić, Dragiša Rašić, Tatjana Novaković
01.12.2021.
Professional paper
Prevention of micronutrient deficiencies in the elderly
The ageing process is characterized by numerous changes in the body that negatively affect the health, lifestyle and diet of the elderly. An adequate and balanced diet plays a vital role in the quality of life of the elderly, including physical, mental and social health. Physiological decline in food intake in the elderly is a risk factor for certain micronutrient deficiencies such as osteoporosis, anaemia and decreased immunity. To prevent these public health diseases, it is suggested to promote the intake of foods of animal origin (offal, meat) to prevent iron and vitamin B group deficiency. An adequate intake of anthocyanidins, fruits and vegetables with blue-purple pigments is recommended for the prevention of anaemia. Adequate intake is also important, i.e. intake of at least two portions of dairy products per day and fish products per week in combination with physical activity can provide adequate intake of calcium and vitamin D for the prevention of osteoporosis. The intake of fresh or minimally processed foods has played a significant role in ensuring an adequate intake of vitamin C, which, in addition to improving iron absorption and preventing anaemia, also affects the proper functioning of the immune system. For the same reason, it is recommended to take vitamin A from offals or beta-carotene from yellow-brown and orange fruits and vegetables. In general, appropriate nutritional interventions can be effective and financially effective forms of preventing and treating micronutrient deficits, thus improving the overall quality of life of the elderly
Dora Serenče, Hajnalka Požar
01.12.2021.
Professional paper
Case report of Parkinson's disease and orthostatic hypotension
Introduction: Parkinson's disease is an idiopathic, slow progressive neurodegenerative condition with the loss of dopaminergic neurons in the substantia nigra compacta of the midbrain. Due to cardiovascular dysautonomia and impaired baroreflex function in Parkinson's disease, the development of orthostatic hypotension is most common, along with increased blood pressure variability, supine hypertension, nocturnal hypertension, etc. Orthostatic hypotension in Parkinson's disease increases the risk of developing coronary heart disease, myocardial infarction, and the risk of overall, and cardiovascular mortality. Case report: Orthostatic hypotension in Parkinson's disease is associated with an increased risk of gait disturbances, loss of balance, falls resulting in injuries and limb fractures, and mortality. In this paper, we presented a patient who had previously been treated for arterial hypertension, with the current clinical presentation of symptomatic orthostatic hypotension in Parkinson's disease. After neurological evaluation and the implementation of pharmacological and non-pharmacological therapy for orthostatic hypotension, gradual improvement and stabilization of blood pressure values are achieved, along with a reduction in orthostatic hypotension symptoms and a decrease in subjective discomfort. Conclusion: In the presence of orthostatic hypotension in Parkinson's disease, in addition to pharmacological therapy, nonpharmacological treatment measures are very important for stabilizing blood pressure values and reducing the symptoms of orthostatic hypotension.
Miloš Mijalković, Nikola Vukašinović
01.12.2021.
Professional paper
Understanding wedge resection research productivity with visualization: A scientometric attitude
This research paper presents a scientometric analysis of wedge resection research productivity. The study aims to evaluate the evolution and different types of literature on wedge resection, identify the principal countries, institutions, and sources that have contributed to publications on wedge resection, track the increase of literature on wedge resection citations each year, and determine the most frequently discussed topics in wedge resection research publications. To achieve these objectives, the study utilized a scientometric approach that involved a systematic analysis of existing research on wedge resection and productivity, with a focus on the application of scientometric methods. The results of the analysis provide a comprehensive examination of wedge resection productivity, which can be used to guide future research in the field. The study demonstrates the potential of scientometric methods in examining research output and productivity in various fields, including wedge resection. Overall, this research paper provides valuable insights into wedge resection productivity that can inform future research and decision-making in the field.
Tushar Khachane, Bidhan Dolai
01.12.2021.
Professional paper
Lower leg fractures treated with an external fixator at the Department of Orthopedics and Traumatology of the Clinical Hospital Center of Kosovska Mitrovica
IIntroduction: Fractures of the lower leg are frequent fractures of long bones that are of great importance in traumatology. The role of external fixation (SF) as a type of surgical treatment is significant and widely applied. There are 3 methods of using SF to treat tibial fractures: SF as primary and definitive treatment, SF combined with internal fixation, and conversion of SF to internal fixation. Objective: To show the possibilities of SF as a definitive way of treating lower leg fractures. Methods: In our paper, we analyzed 254 lower leg fractures treated with SF according to Mitković M20, which were treated at the Department of Orthopedics and Traumatology of CHC Kosovska Mitrovica. This series included 172 men or 68% of the total number of patients, and 83 or 32% women. Results: The average age of patients treated with this method is between the third and fourth decades of life. Falling on the leg with twisting of the table or the entire lower part of the leg is the most common type and cause of injuries in 69%. A closed lower leg fracture was diagnosed in 220 patients (A AO 59.%, B AO 26% and C AO 15%). Adequate position of the bone fragments was achieved by the closed reposition method in 190 (%), the average healing time was 18.4 weeks. In 93% of patients, we achieved bone union. Conclusion: The simple placement technique, the simplicity of the instrumentation, the wide range of indications where SF can be used, have led to the fact that it is a type of surgical treatment of great importance for lower leg fractures in small areas.
Saša Jovanović, Z. Elek, P. Denović, N. Miljković, J. Tomašević, D. Petrović
