Contents
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
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
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
01.12.2020.
Professional paper
Respiratory epithelium: Place of entry and / or defense against SARS-CoV-2 virus
Coronavirus Disease (COVID-19) is caused by the RNA virus SARS-CoV-2. The primary receptor for the virus is most likely Angiotensin-converting enzyme 2 (ACE2), and the virus enters the body by infecting epithelial cells of the respiratory tract. Through the activation of Toll Like Receptors (TLRs), epithelial cells begin to synthesize various biologically active molecules. The pathophysiology of the COVID 19 is primarily attributed to the hyperactivation of host's immune system due to direct damage to the cells, with consequent release of proinflammatory substances, but also due to the activation of the innate immune response through the activation of alveolar macrophages and dendrite cells (DC). A strong proinflammatory reaction causes damage to alveolar epithelial cells and vascular endothelium. Respiratory epithelial cells, alveolar macrophages and DC are likely to be the most important cells involved in the innate immune response to the virus, since prolonged and excessive SARS-CoV-2-induced activation of these cells leads to the secretion of cytokines and chemokines that massively attract leukocytes and monocytes to the lungs and cause lung damage.
Snežana Leštarević, Slađana Savić, Leonida Vitković, Predrag Mandić, Milica Mijović, Mirjana Dejanović, Dragan Marjanović, Ivan Rančić, Milan Filipović
01.12.2020.
Professional paper
Dijabetesna ketoacidoza kod bolesnika sa cerebrovaskularnim insultom - uzroci, mehanizmi, dijagnostika i naše smernice za terapiju
Although cerebrovascular disease may be a well recognised trigger for diabetic ketoacidosis (DKA), literature data on the precise mechanisms, characteristics, or treatment guidelines are rare. The risk of developing an ischemic stroke is doubled in adults with diabetes compared to people with normal glucose metabolism. It is important to point out that even children with DKA have a significantly increased risk of cerebrovascular insult and that they can have a stroke with a frequency of about 10%. Given the significant overlap of symptoms between these two diseases, it can be assumed that attributing DKA symptoms as a manifestation of stroke is not uncommon, especially in elderly and less communicative patients. In addition, pH, bicarbonate concentration, and anion gap are not routinely measured in all diabetics suffering from stroke, at least not in secondary health institutions.Children who develop cerebrovascular stroke during DKA often at the beginning have a preserved consciousness or only mild confusion or lethargy. After a few hours, with the institution of therapy, however, loss of consciousness may occur accompanied by signs of increased intracranial pressure. It was previously thought that the cause was too fast fluid replacement. Recent data suggest that reperfusion injury may be a more likely mechanism. Although most of these studies relate to younger individuals with ketoacidosis, it is clear that at least some of them may be operative in adult DKA. Literature therapeutic guidelines for adult diabetics with stroke-related diabetic ketoacidosis are almost lacking, although it is clear that they could not be the same as those utilised in population with normal glucose metabolism. In this paper, we have tried to define our treatment guidelines for these particular patients.
Aleksandar Jovanović, Vladan Perić, Snežana Marković-Jovanović, Tatjana Novaković, Slavica Pajović, Saša Sovtić, Srbislava Milinić
01.12.2020.
Professional paper
Orthodontic treatment of a disto-occlusion with and favorable growth pattern
The variety of etiological factors contributing to the development of distal bite various form, as well as the structures that are affected by the disorders determine the deegre of complexity of the malocclusion itself, and thus the choice of therapeutic procedure by which it will be treated. An 11-year-old female patient was diagnosed with this type of malocclusion with a certain degree of presence of other irregularities. After a detailed diagnostic procedure, and determining the type of growth, we approach the therapeutic procedure in two phases. By applying the funcional therapy in the first phase, we correct the vertical growth type, and then in the second phase of therapy using a fixed technique we achieve harmonious intermaxillary relations, an adequate molar and canine Class I relationship as well, thus improving the aesthetics of the patient's face.
Dragana Ćorović, Amila Vujačić, Vladanka Vukićević
01.12.2020.
Professional paper
The ectopic spleen-incidental finding on pelvic magnetic resonance imaging
The ectopic spleen (ES) is a rare variation occurred depend on the absence or laxity of the suspensory ligaments. The ES is a rarely diagnosed clinical condition. Less than 500 symptomatic patients have been reported. Less than 0.25% of splenectomies are performed on the ES. Patients are usually asymptomatic. It's diagnosed incidentally in general. The incidence is not clear. ES incidence is reported less than 0.5%. However, this rate covers all of the relocations. The spleen can be found anywhere in the abdomen or pelvis, depends on the length of the vascular pedicle. The pelvic ES is a rarely encountered situation. Knowing this anomaly is essential for early diagnosis and prevention serious problems such as torsion, infarction and acute abdomen. A 21 years old female patient with ES was presented on pelvic magnetic resonance imaging.
Güney Bunyamin, Emrah Doğan, Murat Özdemir, Kılınç Mihriban
01.12.2020.
Professional paper
The role of the electrocardiogram in identifying the risk of sudden cardiac death
Introduction: Sudden cardiac death (SCD) represents the unexpected and sudden death of young apparently healthy people. Alarge number of examined cases referred to professional athletes. There is not enough data in the literature related to those who performed sports in a sporadic and recreational manner. In order to prevent SCD, a screening protocol was determined, in which, an ECG performed at rest plays a important role. Based on the established criteria, changes on the ECG can be treated as normal, borderline and abnormal. An abnormal result indicates a risk of SCD. Objective: The aim of this study was to determine the risk of SCD in students who practice physical activity recreationally. Methods: The research involved 500 students (both sexes) of the 1st and 3rd year of study on the University of Pristina situated in Kosovska Mitrovica. As part of the regular systematic examination, an ECG was performed at rest. The risk of SCD was determined by analyzing the changes on the ECG and grouping them based on screening recommendations. Results: The obtained results show that 44% of students had changes on the ECG and that 8% of students had an abnormal result indicated a possible risk of sudden cardiac death. Conclusion: Therefore, timely recognizing and interpreting ECG changes in accordance with screening recommendations is an imperative for identification and possible prevention of SCD.
Biljana Zogović, Miljan Stašević, Ivan Radić
01.12.2020.
Professional paper
Analysis of the occurrence, location and treatment of laryngeal carcinoma recurrence
Introduction: The efficacy of the applied model of laryngeal cancer treatment is measured by recurrence. Recurrence significantly reduces survival and determines the type of subsequent treatment. Objective: To determine the incidence of laryngeal cancer recurrence, the location of recurrence, and the definitive treatment of laryngeal cancer recurrence concerning different types of surgical treatments applied. Results: In the period from 2002 to 2017, 844 subjects with primary operated laryngeal squamous cell carcinoma were analyzed. Recurrence developed in 191/844 (22.6%) subjects. The mean recurrence time is 12.6 months. Supraglottic carcinoma is more likely to recur than glottic carcinoma 35.93% / 17.46%, p = 0.000. In N0 necks the recurrence rate is 14.42% and in N + necks it is 45.91, p = 0.000. In more advanced stages of the disease, the number of recurrence increases, p = 0.000. The most common area of recurrence is the neck with 45%, followed by local recurrence with 25.1%. Recurrence most often occurs in subjects with total laryngectomy and partial pharyngectomy, 50%. The most common development of regional recurrence is in the N3 category and extracapsular spread, 72.7%. The definitive treatment of recurrence usually involves radical neck dissection and total laryngectomy. Subjects with recurrence have a significantly lower three-year overall survival compared to those without recurrence, 47.6% / 92.3%, p = 0.000. Conclusion: Recurrence is expected in every fourth patient in the first 36 months following any type of surgical treatment of laryngeal carcinoma. The efficacy of treatment is directly related to recurrence. Recurrence is more common in more advanced stages of disease, extracapsular spread, and present metastases in the neck. Recurrence significantly reduces the overall survival of patients with laryngeal cancer.
Jugoslav Gašić, Rajko Jović, Zmajko Vučinić
01.12.2020.
Professional paper
Secondary hyperaldosteronism and hypertension
Introduction: Arterial hypertension is a major cardiovascular risk factor affecting about 10-40% of the adult population. Secondary endocrine hypertension most often results from excessive aldosterone secretion. Complications related to excessive aldosterone secretion include atrial fibrillation, myocardial infarction, myocardial fibrosis, left ventricular hypertrophy, stroke, and increased cardiovascular mortality. Case report: This report presents a hypotensive woman with hypertensive reactions, newly diagnosed unilateral hyperplasia of the left adrenal gland and secondary hyperaldosteronism. Due to good blood pressure and normalized electrolyte status as a result of antihypertensive drug therapy and absence of damage to target organs, surgical treatment of unilateral adrenal hyperplasia was postponed. Conclusion: In case of midlife and late-life hypertension, it is necessary to consider a cause in the patient's endocrine system. AUTHORS SUMMARY SRPSKI 2021; 50 (1,2) 51-54
Miloš Mijalković, Slavica Pajović, Aleksandar Jovanović, Maja Šipić
