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Volume 53, Issue 4, 2025

Online ISSN: 2560-3310

ISSN: 0350-8773

Volume 53 , Issue 4, (2025)

Published: 30.06.2025.

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01.12.2019.

Professional paper

Anatomical variants of circle of Willis

Introduction: The circle of Willis is the major source of collateral blood flow between the carotid and vertebrobasilar system. Its potential depends on the presence and size of arteries that vary greatly among normal individuals and therefore their adequate observation by a radiologist is necessary. Aim: Determine the type of the circle of Willis and their frequency. Determine the type, frequency and localization of anatomical variants of arteries, as well as their average diameter. Compare these variables according to the age and gender of the examinees. Material and methods: A retrospective study was performed at the Center for Radiology of the Clinical Center Nis during 2017. All subjects underwent CT or MR angiography according to a standard endocranial protocol. The anterior and posterior parts of the circle were specially observed, with an emphasis on the presence or absence of anatomical variants of the arteries, with the measurement of their diameter. The obtained data were classified into variants of the front or rear part of the ring as well as the type of ring according to integrity. The frequency of these variables and their comparison by sex and age were measured. Results: The research included 92 examinees. According to the configuration of the Willis arterial ring, the adult type was the most often represented (71.7%). The most common type in terms of integrity was partially complete. The most common anatomical variants obtained in our work was aplasia of AcoA (27.2%) and aplasia of one or both PCoA (21%). PcoA hypoplasia was occured in women with a frequency of 13.5% while in men it was not present. Conclusion: Adequate understanding of the morphology of the circle of Willis by radiological methods is a good guide for neurosurgical and radiological intervention procedures. In this way, potentially significant neurological complications and the risk of morbidity and mortality could be reduced.

Aleksandra Milenković, Slađana Petrović, Simon Nikolić, Branislava Radović, Aleksandra Ilić, Miloš Gašić, Bojan Tomić

01.12.2019.

Professional paper

The frequency of bucal and palatal impaction maxillary canines

Introduction: Maxillary canines are usually impacted teeth the second after third molar. Frequency of impacted maxillary canines is about 1 to 3% of population (in 85% of the cases palataly, and in 15% of the cases bucaly). The aim of this research was to find the frequency of bucal and palatal impacted maxillary canines in relation to sex and position of impacted tooth. Matherial and method: We analyzed three-dimensional computed tomography images (CBCT) of 64 examinees (aged 12 to 33 years) with 80 unerupted maxillary canines to plan the orthodontic therapy. Results: Among 64 examines with impactions, 80 impacted maxillary canines are diagnosed. The average age of all respondents in the survey is 16,3±4,3. Of 64 examinees in research 41(64.1%) were female which is significantly more important than the representation of male examinees whose number was 23(35.9%). Frequency of unilateral impactions of maxillary canines is three times higher 48 (75%) in comparison to bilateral impactions 16 (25%). Of total 80 impacted maxillary canines 19 (23.75%) were bucal impacted, 3 (2.75%) in the middle of alveolus and 58 (72.5%) palatally. With the bucal and palatal impaction usually was represented partially vertical impaction (70%); completely horizontal impaction (10%) was represented only in the palatal impaction. Conclusion: The analysis of CBCT images of maxilla shows a statistically significant frequency of partially vertical, unilateral and paltally localized impacted maxillary canines.

Sanja Simić, Jasna Pavlović, Vladanka Vukićević, Amila Vujačić

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

Thyroid storm after chest trauma

Thyroid storm is an acute and severe complication of thyrotoxicosis. It is characterized by high fever, sweating, tachycardia, and often heart failure too. The objectives of the paper is to present the case of a patient with thyroid storm developed after the trauma of the chest at previously apparently healthy individuals, diagnosed on the basis of clinical preview and based on the diagnostic criteria according to Burch and Wartofsky. The most common complication is Mb. Graves - Basedow, but often associated with multi-nodose goiter. Thyroid storm is the most severe form of thyrotoxicosis with a mortality rate of 8 to 25 %. Case report. We present an interesting case from our practice: thyroid storm caused after chest trauma in apparently healthy people, but with unrecognized hyperthyroidism and thyroid gland nodule. Conclusion. The objectives of this presentation were to raise awareness of the association between signs and symptoms of thyroid storm that dominate the clinical picture and complicate the initial presentation and the evolution of the situation caused by trauma. The treatment of hyperthyroidism resulted in conversion in sinus rhythm, withdrawal of symptoms and signs heart failure, and normalization of artery pressure.

Tatjana Novaković, Bogdan Dejanović, Zdravko Vitošević, Nenad Milošević, Jovana Milošević, Ljiljana Jovićević, Emilija Novaković, Miloš Mirković, Zlatica Mirković

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

Diagnostic, prognostic and predictive parameters in prostate cancer

Prostate cancer (CP) is the most common malignancy in men in America, while it is the second most common in Europe. It is responsible for about 10% of cancer deaths in the same population. It is clinically manifested in various forms, from slow-growing to aggressive forms with pronounced metastatic potential. Diagnosis is made by a well-defined algorithm, which begins with the determination of serum prostate specific antigen values and ends with prostate biopsy as the "gold standard". Pathohistological diagnostic criterias are based on architectural, cytoplasmic, nuclear and characteristics of intraluminal structures, as well as periacinar cleftings, which are deffined as helpfull diagnostic criteria of undoubted importance. Prognostic and predictive parameters are classified into three categories. Some of them are an integral part of routine pathohistologicat report, while others are considered as the diagnostic process progresses. Modern knowledge introduces biomarkers into the everyday practice of personalized medicine, especially when is necessary to treat prostate cancer patients.

Milica Mijović, Vladica Nedeljković, Danica Vukićević, Nebojša Mitić, Branislav Đerković, Julijana Rašić, Vesna Premović

01.12.2019.

Professional paper

Parents' knowledge about the effects of oral hygiene, proper nutrition and fluoride prophylaxis on oral health in early childhood

Introduction: Health education, as one of the important aspects of preventive dentistry, plays an important role in promoting good oral health. The aim of this study was to determine and define the influence of parents' knowledge about the effects of oral hygiene, proper nutrition and fluoride prophylaxis on oral heath in early childhood. Methods: The survey was conducted in four pedagogical-education institution on Kosovo and Metohia, Serbia. The study included 403 parents of children, aged between 3-6 years. Parents were asked to fill a questionnaire about oral hygiene, nutrition and fluoride prophylaxis. Results: Parents from urban (64.8%) and parents from rural (63.5%) areas were informed that the teeth should be brushed at least twice a day. Only 3.4% parents from urban and 3% parents from rural were informed how often should a child toothbrush be changed. Awareness about nutrition showed that parents from rural areas were better informed than parents from urban areas. Parents from urban (31.4%) and rural (31.7%) areas belived that tooth decay may be caused by prolonged breastfeeding. Awareness about fluoride prophylaxis in preventive and pediatric dentistry was poor. Conclusion: The study showed that parents knowledge about the impact of oral hygiene, nutrition and fluoride on the oral health in early childhood is not good.

Aleksandrija Đorđević, Jasna Pavlović, Brankica Martinović

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

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

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

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