Contents
01.12.2021.
Professional paper
Lichen planus disseminatus partim vesiculosus after COVID-19 vaccine
Introduction: Lichen planus is an autoimmune inflammatory disease that can be associated with infections, drugs and vaccines. As concerning the potential triggering effect of vaccine, there is evidence a few cases of new-onset lichen planus that appeared after COVID vaccine, particularly the Pfizer/BioNTech vaccine. Case report: This report is a case of a newonset lichen planus triggered by the Pfizer/BioNTech vaccine administration in a healthy young female. Dermatological examination revealed polygonal, itchy, erythematous papules on trunk, upper and lower limbs, that coalesced into brownish plaques in the ankles, flexural wrist and knee. No mucosal involvement was noted. In view of the clinical picture, the timing of the skin eruption with respect to the vaccine and the histopathologic findings, a vaccine-induced lichen planus triggered by the COVID-19 vaccine has been diagnosed. Conclusion: Lichen planus or lichenoid-like eruption as a cutaneous manifestation following COVID-19 vaccines are rare, and the pathogenesis for its development is still unclear. Clinical trials showed that the leading vaccines upregulate Tcell response (Th1) and incrementing inflammatory cytokines involved in the pathogenesis of autoimmune diseases, such as lichen planus. Although we still do not completely understand its pathogenesis, dermatologists should be aware of the possibility and keep an eye out for worsening or debut of this disease after the COVID-19 vaccine. Vaccinated patients should be monitored for skin manifestations, and dermatological evaluation should be offered, when needed.
Dragica Milosavljević, Milijana Relić, Mirjana Stojanović-Tasić
01.12.2021.
Professional paper
Differential diagnosis distinction of nummular headache and Lichen planopilaris
Introduction: Nummular headache is a type of primary headache of chronic character, with a large number of described varieties in the clinical picture, and therefore the differential diagnostic consideration must include a large number of disorders related to changes in epicranial structures. Certain dermatological disorders can also include pain in a limited area of the scalp with itching, burning or burning sensation, such as Lichen Planopilaris. Case report: This is a report of a patient who was initially diagnosed with Lichen planopilaris, but after determining the parameters of the distinction and the necessary additional diagnostic procedures, a diagnosis of Nummular headache was made. Conclusion: In this presentation, we have presented another important differential diagnostic item and we believe that the work is a small contribution to everyday practice, but also to further research.
Snežana Filipović-Danić, Vekoslav Mitrović, Nenad Milošević, Aleksandar Stevanović
01.12.2021.
Professional paper
Factors associated with involuntary hospitalization
In clinical practice, involuntary hospitalization in psychiatry is a procedure that patients with severe mental disorders are subject to due to the inability to make rational treatment decisions.. The prevalence of involuntary hospitalizations varies widely within and between countries. Involuntary admission to a hospital for psychiatric treatment can be life-saving and may be considered beneficial to some people in the long run. However, the experience of involuntary treatment can be traumatic, intimidating, stigmatizing, and lead to long-term avoidance of mental health services and an increased risk of rehospitalization. In this paper, we have considered the risk factors for involuntary hospitalizations and their frequency in the region and Europe.
Emilija Novaković, Ivana Stašević-Karličić, Mirjana Stojanović-Tasić, Tatjana Novaković, Jovana Milošević, Vladan Đorđević
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
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
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
01.12.2020.
Professional paper
Examination of early adaptation of newborns small for gestational age
Introduction: Children with low body weight for gestational age are five times more likely to die in the neonatal period and 4.7 times more likely to die in the first years of life compared to children born at term. The aim To analyze early adaptation to extrauterine life of low body weight for gestational age. Material and methods: Retrospective study with the observation period January-September 2018. The data were obtained by reviewing the medical histories of newborns. As parameters of early adaptation, we observed the Apgar score in the 1st and 5th minute as well as the presence of polycythemia at birth. Results: Out of a total of 405 newborns, 52 had low body weight for gestational age. Apgar score in the 1st and 5th minute was statistically significantly lower in children small for gestational age compared to children with normal body weight for gestational age (p <0.05). Polycythemia is a mechanism of adaptation statistically significantly more often present in children of small body weight for gestational age (p <0.05). Conclusion: Children of low body weight for gestational age have a lower Apgar score in the first and fifth minutes as well as more frequent polycythemia compared to children with normal body weight and we can take them as good indicators of adaptation to early extrauterine life.
Zlatko Noveski, Dejan Mihajlović, Tatjana Nikolić, Zoran Petrović
01.12.2020.
Professional paper
The impact of neuropsychological assessment in epileptic focus localization
Introduction: Epilepsy that takes place in the temporal lobe is manifested through three symptoms: aura, temporal pseudoabsence and automatisms, while right-sided temporal lobe epilepsy had been also linked with visual or image learning and memory deficits. Case outline: Patient 24 years old in 2020. In July 2020 had complex partial seizures with an unordinary psychomotoric reactions and verbalization, followed by qualitative conscience change in the form of confusion and amnesia. Therapy with paroxetine showed no result. Neuropsychological evaluation showed no other cognitive deficit than severe visuoconstruction dyspraxia and discrete decrease in complex attention. In behavioral aspect prodromal symptoms of tension, anxiety and depression were occurred. Conclusion: Neuropsychological assessment is, along the magnetic resonance imaging and electroencephalographic, the most important method for indicating cognitive deficit in epilepsy and determining the epileptic focus.
Marina Malobabić, Boban Biševac, Vesna Stokanović
01.12.2020.
Professional paper
Sensory processing disorders in premature infants
Introduction. Children born prematurely have an increased risk of immediate medical complications, as well as socioemotional, cognitive, linguistic and sensory processing disorders later in life. Studies have examined the effects of prematurity on developmental outcomes, such as cognition, however, there is a need for a more detailed examination of sensory processing disorders in preterm infants. Not only is prenatal neurosensory development interrupted in utero, but these children may also experience intense stimulation in the neonatal unit, which can further alter the development and function of the sensory system. Objective. The paper presents an overview of research on sensory processing disorders in premature infants, with special emphasis on the impact of the environment of the neonatal unit. Method. Insight into the relevant literature was performed by specialized search engines on the Internet and insight into the electronic database. Results. Sensory processing disorders affect 39% to 52% of newborns born prematurely, with some evidence to suggest that children born before 32 weeks are most at risk. The literature to date has consistently reported difficulties in sensory modulation of preterm infants, within the tactile, vestibular, auditory, oral, and visual domains. Conclusion. Sensory processing disorders in preterm infants appear to occur as a result of their immature neurological and biological system and being in the environment of a neonatal intensive care unit, which is unable to meet the sensory needs of preterm infants. Altered sensory experiences, during periods of neurodevelopmental vulnerability and fragility, can result in sensory processing disorders, which may include enhanced responses or less response to stimuli (hyper or hyposensitivity).
Jelena Todorović, Mirjana Petrović-Lazić
01.12.2020.
Professional paper
Suconjunctval hemorrhages
Introduction:Subconjunctival hemorrhage or suffusion is bleeding that occurs between the conjunctiva and episclera. It has a distinctive look and often frightens patients. The causes can be varied. Objective: The research was undertaken in order to determine the characteristics of patients within whomsubconjunctival hemorrhage occur. Methods: Retrospective analysis of patients of the Eye Department of the Health Center in KosovskaMitrovica, during 6 months. Results were analyzed SPSS ver 22, i GraphPad INSTAT software package. Results: The change was observed in 63 patients. Male gender was significantly more frequent. The age of patients was diverse-between 5 and 86 years. The causes and conditions associated with subconjunctival hemorrhages are usually eye trauma, in young,and arterial hypertension in elderly patients. Conclusion: Subconjunctival hemorrhage is a relatively common diagnosis in ophthalmology. The change is benign and spontaneously disappears during one to two weeks. It is important to note that the subconjunctival hemorrhage occur in patients with certain risk factors.
Jana Mirković, Isidora Mrkić, Olivera Đokić
