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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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01.12.2013.

Professional paper

MALIGNANT OTITIS EXTERNA -VARIABILITY OF CLINICAL COURSE AND DIFFICULTIES OF DIAGNOSTICS

This paper shows the case of a 70-year-old diabetic patient who was admitted to the ORL and MFS clinic as an emergency case with the right ear otalgia, in the right mastoid extension, facialis paralysis and the right ear suppuration all of which lasted for a month before the hospitalization. On admission, the innitial diagnostics stated canal skin edema of the external hearing canal which made the eardrum impossible to visualize. Granulations at the bottom of the canal were visible. During the admission, the patient was submitted to conservative and surgical treatments which confirmed that it was the case of malignant otitis externa.

Milos Janicijevic

01.12.2013.

Professional paper

ANALIZA PRISUSTVA FAKTORA RIZIKA KOD GOJAZNIH PACIJENATA SA KORONARNOM BOLEŠĆU, SA I BEZ DIJABETES MELITUSA TIP DVA

Dijabetes melitus tip 2 je jedno od vodećíh hroničnih oboljenja u svetu pa i u našoj zemlji, koje predstavlja
značajan faktor rizika u nastanku kardiovaskularnog morbiditeta i mortaliteta. Cilj ovog istraživanja je ispitivanje koji
faktori rizika doprinose nastanku koronarne bolesti kod gojaznih pacijenata sa dijabetes melitusom tip 2. U studiju je
uključeno 82 gojazna pacijenta, od toga 52 sa dijabetes melitusom i 30 bez dijabetes melitusa, sa angiografski dokazanom koronarnom bolešću. Kod svih je sprovedeno kliničko ispitivanje, laboratorijske analize i ehokardiografski pregled. Na osnovu rezultata ispitivanja utvrdili smo da je distribucija faktora rizika kao što su arterijska hipertenzija,
porodično opterećenje koronarnom bolešću, pušenje, konzumacija alkohola bila istovetna u gojaznih pacijenata sa i
bez dijabetes melitusa. Ehokardiografki je nađena statistički značajno veća leva komora, niža ejekciona frakcija, veća
leva pretkomora i značajna mitralna regurgitacija u grupi sa dijabetesom. U grupi sa dijabetesom je takođe češće,
statistički značajno, bila prisutna višesudovna koronarna bolest. Uprkos malom uzorku može se zaključiti da je prisustvo dijabetes melitusa kod gojaznih pacijenata presudno u nastanku težih oblika koronarne bolesti. Težina se ispoljila kroz značajnije strukturne i funkcionalne promene leve komore i broj obolelih koronarnih arterija.  

Danjela Vasic, B. Ivanovic, T. Novakovic, G. Nikolic, B. Orbovic, K. Andjelkovic, V. Karadzic

01.12.2013.

Professional paper

MIKSOFIBROLIPOSARKOM I KARAKTERISTIKE TUMORA

Miksofibroliposarkom je miksoidni mekotkivni tumor. Za postavljanje tacne dijagnoze, potrebno je da se drzimo
nekoliko kriterijuma, uglavnom patoloskih. Najvazniji je,svakako, pleomorfozam sa celijskom atipijom izrazenom u,
najmanje,10% tkiva..Većina nastaje u površnim slojevima potkožnog tkiva ili u dermisu. Jasna razlika izmedju low
grade MFLSa i high grade MFLSa nije jasna. Medjutim, rekurentni low grade miksofibroliposarkom je infiltrativan, a
zna da bude vrlo agresivan.Tako metastatske tumore mozemo naci u mezenterijumu,plucima,bubrezima,pleuri i
kostima,i drugim udaljenim organima. Ovakva vrsta tumora vrlo je cesta u donjim ekstremitetima starijih pacijenata.Prognoza i terapija varira od slučaja do slučaja. Lečenje je hirurško a ponekad podrazumeva i hemioterapiju i zračenje. 

Maja Nikolic-Zivanovic, R. Grbic

01.12.2013.

Professional paper

Electrocardiography changes in patients with acute myocardial infarction in late hospital phase

One of possibilities to estimate size of myocardial injury during the acute myocardial infarction are electrocardiographic changes,
forming of QS formation (ECG signs of scares changes). This investigation which included three groups of patients receiving thrombolytic, nitrates or beta blockers in acute phase of myocardial infarction has aim to analyze 12-chanels electrocardiogram and to establish difference between this therapeutics groups in sum of QRS score, but also to indicateon frequency of periinfarction heart insufficiency in this therapeutics groups, comparing with observed ECG changes. Analysis shows significant differences between groups
in value of QRS score, and also significant lower value of QRS score in patients with acute myocardial infarction treated with thrombolytic therapy. This difference relative to other two groups shows lower level of myocardial injury during acute myocardial infarction in patients treating with thrombolytic therapy. 

Z. Marcetic, S. Sovtic, M. Sipic, V. Peric, S. Lazic

01.12.2013.

Professional paper

NECESSITY AND FREQUENCY OF INVOLUNTARY HOSPITALIZATION IN PSYCHIATRIC INSTITUTION

Involuntary hospitalization for treatment of mental patients is a necessity in modern scientific psychiatric practice. Hospitalization is generally an act of psychological and social disruption of individual’s homeostasis, which is a very important and complex problem for the mentally ill. The goal of the study was to confirm the necessity of involuntary treatment of mental patients in a medical institution, in the interest of patients and the society. The research was conducted as a cross sectional study of hospitalized patients in 2012 at the Clinic for psychiatric disorders "Dr Laza Lazarevic" in Belgrade. It included 2286 inpatients, especially involuntarily hospitalized 236 and 719 admitted for hospital treatment with the assistance of the police. The data were statistically analysed by methods of descriptive statistics: χ2 - test and multiple logistic regression analysis, using the software package SPSS v. 20. The results show that 255 patients were admitted to the hospital for the first time with the assistance of the police. Patients hospitalized with the assistance of the police in compared to those hospitalized without the assistance of the police were, with statistical significance: younger, more frequently males, most frequently in the diagnostic group of schizophrenia and less frequently in the group of organic and affective disorders, most often it was their first, and involuntary hospitalization. During the studied period, 236 (10%) of the total number treated patients were involuntarily hospitalized. There were 176 (74.58%) patients detained for treatment by force, with the assistance of police. There is a necessity for involuntary hospitalization of mental patients. The justification of detaining patients in the health institution by such measures is accomplished through legislation in the best interest of the patient.

M. Nenadovic

01.12.2013.

Professional paper

POVEĆANA VREDNOST KARDIJALNOG TROPONINA I U HIPERTROFIČNOJ KARDIOMIOPATIJI I DIJASTOLNOJ SRČANOJ SLABOSTI

U radu je prikazana žena stara 73 godine koja je hospitalizovana u jedinicu Intenzivne nege zbog osećaja nedostatka vazduha i atpičnog diskomfora u grudima unazad dva sata. Krvni pritisak na prijemu je bio veoma povišen (240/130 mmHg), kardijalni troponin i iznad referentnih vrednosti (2,1 ng/ml) a inicijalni EKG zapis bio je sugestibilan za infarkt miokarda bez ST elevacije. Ehokardiografska evaluacija i koronarna arteriografija koje su usledile isključile su akutni koronarni sindrom kao uzrok povećanog kardijalnog troponina.

S. Lazic, D. Rasic, B. Lazic, Z. Marcetic, V. Peric, M. Sipic, S. Pajovic

01.12.2013.

Professional paper

RAZLIKE U KLINIČKIM KARAKTERISTIKAMA BOLESNIKA SA DILATACIONOM KARDIOMIOPATIJOM U ZAVSINOSTI OD POSTOJANJA OČUVANE KONTRAKTILNE REZERVE LEVE KOMORE PROCENJENE STRES EHOKARDIOGRAFSKIM TESTOM FIZIČKIM OPTEREĆENJEM

Očuvana kontraktilna rezerva leve komore podrazumeva sposobnost hipokinetičnih segmenata miokarda da pod dejstvom različitih inotropnih stimulusa poprave svoju kontraktilnost. Utvrditi razlike u kliničkim karakteristikama kod pacijenata sa dilatacionom kardiomiopatijom u zavisnosti od očuvane kontraktilne rezerve leve komore. U studiju je uključeno uzastopnih 55 bolesnika sa idiopatskom dilatativnom kardiomiopatijom. Svim bolesnicima uključenim u studiju urađen je stres ehokardiografski test fizičkim opterećenjem po standardnom protokolu. Postojanje očuvane kontraktilne rezerve je određivano uz pomoć promene ejekcione frakcije leve komore. Prosečna starost ispitivanih bolesnika je bila 54,98 ± 9,84 godina, 49 (89,1%) je bilo muškog pola. Na osnovu promene ejekcione frakcije leve komore kao kriterijuma kontraktilne rezerve leve komore, očuvanu kontraktilnu rezervu je imalo 25 bolesnika (45,5%). Bolesnici bez očuvane kontraktilne rezerve leve komore znatno češće u anamnezi imaju zastupljenu arterijsku hipertenziju (46,7 vs. 20,0%, p=0,038). Nema značajne razlike u zastupljenosti ostalih faktora rizika. Pacijenti sa očuvanom kontraktilnom rezervom leve komore imaju manju dimenziju leve komore na kraju sistole (49,64 ± 7,26 vs. 55,27 ± 8,36 mm, p=0.011), manji indeks volumena leve komore na kraju dijastole (77,35 ± 26,41 vs. 94,59 ± 34,97 ml/m2, p=0,005) i na kraju sistole (59,31 ± 26,05 vs. 78,62 ± 34,42 ml/m2, p=0,002), veću ejekcionu frakciju leve komore (25,48 ± 8,32 vs. 18,33 ± 6,49%, p=0,002) i niži indeks pokreta zidova leve komore (2,23 ± 0,27 vs. 2,48 ± 0,27, p=0,002). Kod bolesnika sa očuvanom kontraktilnom rezervom leve komore nalazimo manju zastupljenost arterijske hipertenzije i morfološki i funkcionalno manje oštećenu levu komoru.

V. Peric, A. Jovanovic, D. Rasic, M. Todorovic, S. Lazic, D. Djikic, T. Novakovic, M. Sipic, D. Aleksovski, B. Dejanovic, B. Sovrlic

01.12.2013.

Professional paper

INCIDENCE OF RICKET CLINICAL SYMPTOMS AND RELATION BETWEEN CLINICAL AND LABORATORY FINDINGS IN INFANTS

Rickets presents osteomalacia which is developed due to negative balance of calcium and / or phosphorus during growth and development. Therefore it appears only in children. The most common reason of insufficient mineralization is deficiency of vitamin D, which is necessary for inclusion of calcium in cartilage and bones. As result, proliferation of cartilage and bone tissue appears, creating calluses on typical places. Bones become soft and curve, resulting in deformities. Our present study included 86 infants, in whom, besides other diseases, clinical and laboratory signs of rickets were identified. In our study, rickets is most common (82.5%) in infants older than 6 months. By clinical picture, craniotabes is present in 46.5% of cases, Harisson groove in 26.7%, rachitic bracelets in 17.4%, rachitic rosary in 17.4% and carpopedal spasms in 2.3% of cases. Leading biochemical signs of vitamin D deficient rickets is hypophosphatemia (in 87.3% of cases), normal calcemia (in 75.6% of cases) and increased values of alkaline phosphatase (in 93% of cases). It has been shown that rickets in infant age may later affect higher incidence of juvenile diabetes, infection of lower respiratory tract, osteoporosis, and so on.

M. Cukalovic, J. Krdzic-Milovanovic, A. Odalovic, D. Jaksic

01.12.2013.

Professional paper

Comparative analysis of suicidal poisoning autopsied at the Institute of forensic medicine in Belgrade

Number of poisons which surround the modern man is constantly on the rise and hence therefore the frequency of intoxication. The aim of the study was to determine the type of poison which causes the suicidal poisoning, sex, age, occupation, place of poisoning, events and seasonal distribution of poisoned. This paper analyzes the suicidal poisoning, autopsied at the Institute of Forensic Medicine in Belgrade in two periods (1965-1969) and (2000-2004) years . To test for statistical significance was used Pearson's X2 test. Comparative analysis of the obtained results shows that a significantly more frequent suicidal poisoning in the first analyzed period (1965-1969), P<0.01 compared to the second (2000-2004) In the first research period, the suicidal purposes are often used caustic poisons (44.0%) and drugs (36.4%) with a slight dominance of the older age groups among the poisoned. According to the frequency of poisoning drugs no statistically significant differences in the analyzed periods (x2=0.248 , df=1, p=0.6) . In second research period, significantly dominated by males (79.5%) (x2=33.911 , df=1, p<0.0001), younger age groups (20-49 years , 86.99%), which were poisoned significantly more frequent in spring and summer (55%) compared to the first period. In both studied periods had no significant statistical difference in relation to occupation, place of poisoning and the clinical picture. The highest percentage of deaths (servants and housewives) in both periods were without clinical picture, because they were found dead in their own homes. Length of outliving period of several hours is significantly higher in the second examined period, because of application of more sophisticated, more toxic and simple to use poisons.

Vladimir Jaksic, S. Matejic, T. Atanasijevic, M. Milosevic

01.12.2013.

Professional paper

FIZIČKA NEAKTIVNOST, KAO FAKTOR RIZIKA ZA NASTANAK DIJABETES MELLITUSA TIP 2

Oštećena tolerancija glukoze,pojam poznat kao predijabetes , predstavlja stepenicu ispred razvoja dijabetes mellitusa tip 2 i može se javiti i deceniju pre manifestnog oblika dijabetesa i sve je češći u mlađoj populaciji. Cilj rada bio je da utvrdi uticaj fizicke neaktivnosti na pojavu predijabatesa i dijabetes mellitusa tip 2. Obrađeno je 80 bolesnika u endokrinološkoj ambulanti Interne klinike KBC Priština-Gračanica, u Lapljem Selu.Ispitanici su anketirani uputnikom iz vodiča Nacionalnog programa za prevenciju dijabetesa tip 2 Republike Srbije. Svim ispitanicima su odrađene polne, demografske i antropometrijske karakteristike kao istepen intolerancije glukoze. Od 80 pacijenata, 33 (41,25%) su muškog pola, a 47 (58,75%) su ženskog pola. Nema statističke značajnosti Hi² testa raspodele ispitanika prema familijarnoj anamnezi (=0,007, p>0,05). Fizička neaktivnost je registrovna u 16 ispitanika (20%), a ostalih 64 ispitanika je fizički aktivno. Normalna glikemija natašte u fizički neaktivnih ispitanika je bila u 56,25% (9), a glikemiju veću od 7 mmol/l je imalo 18,75% ispitanika. Pozitivan OGTT nalaz kod fizički neaktivnih ispitanika je potvrđen u 62,5% , a pozitivan OGTT nalaz kod fizički aktivnih je registrovan u samo 5 ispitanika (11,36%). Ispitanici sa rizikom za nastanak dijabetesa tip 2 (skor 12 i više) u 60% su bili fizički neaktivni. Umerena fizička aktivnost uz korekciju telesne mase ,može znatno da „odloži“ nastanak dijabetes mellitus-a tip 2.

S. Pajovic, R. Stolic, S. Lazic, Lj. Smilic, M. Stanic, D. Stamenkovic

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