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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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01.08.2015.

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 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

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

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

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

01.12.2015.

Professional paper

Chlamydia trachomatis as a cause of trachoma

Trachoma is keratoconjunctivitis caused by ocular infection with Chlamydia trachomatis. Endemic trachoma is caused by serovars A, B, Ba and C. Trachoma is probably the third most common cause of blindness worldwide, after cataracta and glaucoma. Active trachoma affects an estimated 84 million people; another 7.6 million have end-stage disease, of which about 1.3 million are blind. Most trachoma programmes use the WHO simplified grading system, by presence or absence of five clinical signs. The World Health Organization is leading a global effort to eliminate blinding trachoma by the year 2020, through the implementation of the SAFE strategy. This involves surgery for trichiasis (S-surgery), antibiotics for infection (A-antibiotic), facial cleanliness (F-face) and environmental improvements to reduce transmission of the organism (Eeducation). Tratment for trachoma includes local and systemic administration of appropriate antibiotics. Surgical correction of trachomatous trichiasis reduces the risk of progressive corneal opacification and blindness.

V. Maric, S. Djukic

01.12.2015.

Professional paper

Chemical risk factors responsible for the formation of wedge-shaped lesions

Introduction: Non-carious tooth substances loss pose a major health problem of a modern man. The literature often collectively describes all non-carious lesions and is therefore difficult to compare results obtained by different authors. Chemical factors are one of the predisposing factors responsible for the formation of wedge-shaped erosions. Aim: Examination of chemical risk factors as one of the predisposing causes responsible for the formation of wedge-shaped lesions. Method: We examined 62 patients with wedge-shaped erosions (mean age 45.52 ± 12.03 years, 58.1% of men) and 60 patients without erosions in the control group (mean age 34.40 ± 9.28 years, 60% men) . The entire examination was completed by using a questionnaire at the Dental Clinic of the University of Pristina - Kosovska Mitrovica. salivary pH was measured by the pH meter. Results: The results show that the wedge-shaped lesions often occur equally in both men and women. Considerably often it might appear in older people but can also occur in teenagers. Patients with wedge-shaped erosion have increased acidity of saliva, a heightened sense of acid in the mouth and consume a lot more carbonated drinks compared to patients without erosions. Conclusion: Wedge-shaped lesions are more common in people older than 40 years. Taking into account the results obtained in this study it can be concluded that the chemical risk factors truly fall within the predisposing factors that may be responsible for the creation of wedge-shaped erosions.

Dejan Peric, M. Zivkovic, V. Matvijenko, Lj. Subaric, D. Zivkovic, D. Jovanovic

01.12.2015.

Professional paper

Our experience with the surgical treatment of appendicitis

Acute appendicitis is the most common surgical disease in the pathology of the population. Incidence in the general population is 6%. In the period from 15.01.2002 to 08.16.2014 as any 627 appendix which je12,4% of the 5055 total patients. Prevalent patients males 55.5% compared to 44.5% female. According to the age of the children present in 393 (68.47%) and 181 adults (31.53%). The greatest incidence is in children aged age group of 15-20 years, 131 (23.06%). In the adult group the highest incidence is represented in the third decade of 21-30 years, with 77 (13.4%). The most common disease of acute appendicitis is in the second decade of the 258 cases (44.9%). Intraoperative pathomorphologically highest incidence wearing Appendicitis phlegmonosa with 317 (52.1%). Peritonitis acuta is the most common complication of severe forms of appendicitis acuta 231 (71.96%). Anterograde apendectomia was performed in 532 (87.5%) patients and retrograde in 76 (12.5%). Abdominal drainage procedures were performed in 145 (23.85%) patients. Postoperative complications 6 (4.68%). Surgical wound infection 4. Fistula appendicularis 1 (3.12%). Mortality 1 (0.16%).

Slobodan Arandjelovic

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

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

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