Contents
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
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
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
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
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
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
01.12.2020.
Professional paper
Piriformis: Sparing approach, is it better?
Hip fractures as well as coxarthrosis are conditions that are becoming more common in everyday orthopedic practice. With the aging of the world's population, there is an increasing need for partial (HA) or total hip arthroplasty (THA). No elective procedure is as important to quality of life as total hip arthroplasty, and partial hip arthroplasty is a method of treatment in elder population who suffered fracture of the femoral neck. There are several hip approaches that can be used for arthroplasty. Hip dislocation is a serious complication after hip arthroplasty and occurs somewhat more frequently when the posterior hip approach is used. The aim of this study is to show that the piriformis sparing technique gives better results in terms of reducing the frequency of dislocations in the early postoperative period (one year). We operated od 249 patients, and after follow-up that lasted from 13 to 22 months we had four dislocations, three in patient with THA(0.021) and one after HA(0.009). Preservation of the piriformis tendon is a minor modification in the operative technique that can lead to a great benefit in the quality of treatment and a reduced risk of complications.
Korica Stefan, Ivana Glišović-Jovanović, Uroš Moljević, Dejan Tabaković, Dejan Virijević, Slađana Matić, Marko Kadija
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
