Contents
01.12.2019.
Professional paper
Ebstejn's anomaly in patients perioperative period during a non-cardiac surgery operation
Introduction: Ebstein anomaly, a congenital heart defect characterized by a morphological and functional abnormality of the tricuspid valvula while moving the mouth of the tricuspid valvula towards the apex of the right chamber. Case report: A patient aged 39 years on the Department of Surgery was admitted under the image of an acute abdomen and the need for emergency surgical treatment. Routine preoperative preparation, laboratory treatment, examination of internist and examination of anesthesiologist on the part of the part was carried out. He has a history of occasional breathing problems during respiratory infection, a smoker. Clinical status, other than primary problems, is orderly. Operational treatment passed neatly, on the fourth postoperative day the patient complained of suffocation, lack of air and chest pain, translated into intensive care monitored (spo2 87% f about 110/min TA 90/60), blood gas analysis done and laboratory treatment (fibrinogen, D dimer) due to suspected pulmonary thromboembolia consulted cardiologist, dilation of the right atrium seen by ultrasound. Discussion: Non-cardiac surgeries in patients with pre-existing congenital heart defects are high-risk surgeries with increased mobility and mortality in the perioperative period. In accordance with the accompanying pathoanatomical and pathophysiological changes that define the congenital heart defect, a detailed plan must be made - anesthesiological management for each patient separately. Hemodynamic and respiratory stability with avoidance of hypoxia and paradoxical arrhythmias are the basic postulates in patients with Ebstein's anomaly.
Ljubiša Mirić, Tijana Smiljković, Vladan Perić, Slađana Mirić, Tjaša Ivošević
01.12.2019.
Professional paper
Benefit of the first phase of the cardiac rehabilitation after cardiac surgery
Introduction: Cardiovascular diseases (CVD) are leading factor in global mortality and morbidity. It is the cause of 1/3 of total annual mortality, while coronary heart disease (CHD), as one of the CVD entities, is responsible for 85% of deaths worldwide. The aim of the study is to show the importance of the first phase of cardiac rehabilitation (CR) in patients who are going on cardiac surgery, as well as the impact on respiratory function, the occurrence of pulmonary complications and the length of hospitalization. Methods: A sample of 18 patients was included in the randomized observer study. First phase of CR was carried out according to a predefined protocol. We used arterial blood gases (ABG) to evaluate the respiratory function, "two-minute walk test" (2MWT) to assess the functional capacity Data taken from medical documentation are the duration of mechanical ventilation (MV), the length of stay in the ICU, occurrence of the postoperative pulmonary complications and duration of total hospitalization. Results: The test sample consisted of 12 men (60.58 ± 8.33) and 6 women (66.00 ± 6.51). The mean value of CR was 6.15 ± 3.98 days and MV 19,67±11,23 hours. There were no pulmonary complications in 61,11% patients. Using ABG, a statistically significant difference was found in PO2 after extubating and at the last day in ICU (p = 0.01). 2MWT preoperatively significantly correlated with the examined on the last day of hospitalization (r = 0.648 p-value <0.001) well as the length of postoperative hospitalization and duration of mechanical ventilation (r = 0.708 p-value <0.001). Conclusion: The study showed that first phase of cardiac rehabilitation may positively affect the improvement of functional capacity.
Sonja Nejkov, Nataša Đukić-Macut, Vesna Bokan-Mirković
01.12.2019.
Professional paper
The role of computerized tomographic angiography in the diagnosis of pathologically modified renal arteries
Introduction: The most common causes of renal artery disease are stenosis, as a consequence of atherosclerosis and fibromuscular dysplasia. Computed tomographic (CT) angiography is a non-invasive method, which enables visualization of vascular structures and walls of blood vessels, as well as morphology of the renal parenchyma. Objective: To determine the importance of CT angiography in detecting the cause and degree of renal arterial disease. Methods: A total of 45 patients were included in the cross-sectional study conducted from March 2017 to March 2019 in the KBC DR Dragiša Mišović-Dedinje, Belgrade, Serbia. Criteria for inclusion were suspicion of secondary arterial hypertension, patients in preparation for kidney transplantation and in the follow-up period after transplantation, as well as patients with suspected traumatic lesions. We analyzed the causes of the disease, the morphology of the blood vessel wall, the percentage of stenosis, and the renal parenchyma. Results: The most common causes of renal arterial disease are atherosclerosis, which was found in 33 (73%) patients, renal artery aneurysm was found in 5 (11%) subjects, fibromuscular dysplasia in 4 (8.9%) and trauma in 1 (2) , 3%) of the patient. There were 10 (22.2%) patients with a significant (average 80 ± 14.5%) degree of stenosis. The sensitivity of CT angiography in the detection of atherosclerotic changes in the renal arteries was 87.9%, while the sensitivity of CT angiography in the detection of fibromuscular dysplasia was 75%. A statistically significant correlation was found between atherosclerotic stenosis of the renal arteries and a positive CTA finding (p = 0.0002). Conclusion: CT angiography is an important method of visualization and quantification of pathological changes in the renal arteries.
Miloš Gašić, Sava Stajić, Ivan Bogosavljević, Milena Šaranović, Aleksandra Milenković, Sanja Gašić
01.12.2019.
Professional paper
Uticaj porođajne mase i aktuelne težine deteta na nastanak prevremenog puberteta
Introduction: Puberty is a juvenile developmental period accompanied by intensive growth and acquisition of reproductive ability. The onset of puberty is influenced by many factors: genetics, neuropeptides and glycoproteins, gonadotropins, sex hormones and the child's nutrition status. Premature puberty is defined as the appearance of secondary sexual characteristics in girls before the age of 8, and in boys before the age of 9. The aim of this paper is to analyze the published results on the importance and influence of factors such as birth weight, current weight and BMI on the development of premature puberty. Results: Eating disorders caused by eating high-calorie foods lead a child to obesity, which is accompanied by premature puberty. On the other hand, conditions characterized by reduced nutrition may be accompanied by delayed puberty. According to the results of this study, children with more pronounced manifestations of precocious puberty had a significantly lower birth weight Discussion: Birth weight of less than 2500g, as well as newborns' SGA (small for gestational age), are directly related to earlier pubertal maturation. Five decades ago, Frich et al. found that reaching a body weight of 48 kg in girls is a "critical mass" for development of menarche. Conclusion: The occurrence of secondary sexual characteristics is more frequent in children with increased body weight and correlates inversely with the child's birthweight.
Snežana Marković-Jovanović, Maja Ješić, Vlada Bojić, Aleksandar Jovanović, Zorica Živković, Andrijana Karanović, Vera Zdravković
01.12.2019.
Professional paper
Diagnostic, prognostic and predictive parameters in prostate cancer
Prostate cancer (CP) is the most common malignancy in men in America, while it is the second most common in Europe. It is responsible for about 10% of cancer deaths in the same population. It is clinically manifested in various forms, from slow-growing to aggressive forms with pronounced metastatic potential. Diagnosis is made by a well-defined algorithm, which begins with the determination of serum prostate specific antigen values and ends with prostate biopsy as the "gold standard". Pathohistological diagnostic criterias are based on architectural, cytoplasmic, nuclear and characteristics of intraluminal structures, as well as periacinar cleftings, which are deffined as helpfull diagnostic criteria of undoubted importance. Prognostic and predictive parameters are classified into three categories. Some of them are an integral part of routine pathohistologicat report, while others are considered as the diagnostic process progresses. Modern knowledge introduces biomarkers into the everyday practice of personalized medicine, especially when is necessary to treat prostate cancer patients.
Milica Mijović, Vladica Nedeljković, Danica Vukićević, Nebojša Mitić, Branislav Đerković, Julijana Rašić, Vesna Premović
01.12.2019.
Professional paper
Parents' knowledge about the effects of oral hygiene, proper nutrition and fluoride prophylaxis on oral health in early childhood
Introduction: Health education, as one of the important aspects of preventive dentistry, plays an important role in promoting good oral health. The aim of this study was to determine and define the influence of parents' knowledge about the effects of oral hygiene, proper nutrition and fluoride prophylaxis on oral heath in early childhood. Methods: The survey was conducted in four pedagogical-education institution on Kosovo and Metohia, Serbia. The study included 403 parents of children, aged between 3-6 years. Parents were asked to fill a questionnaire about oral hygiene, nutrition and fluoride prophylaxis. Results: Parents from urban (64.8%) and parents from rural (63.5%) areas were informed that the teeth should be brushed at least twice a day. Only 3.4% parents from urban and 3% parents from rural were informed how often should a child toothbrush be changed. Awareness about nutrition showed that parents from rural areas were better informed than parents from urban areas. Parents from urban (31.4%) and rural (31.7%) areas belived that tooth decay may be caused by prolonged breastfeeding. Awareness about fluoride prophylaxis in preventive and pediatric dentistry was poor. Conclusion: The study showed that parents knowledge about the impact of oral hygiene, nutrition and fluoride on the oral health in early childhood is not good.
Aleksandrija Đorđević, Jasna Pavlović, Brankica Martinović
01.12.2019.
Professional paper
Relationship between ACR and other determinants of microalbuminuria in T2DM patients
Introduction: The occurrence of microalbuminuria in type 2 diabetes mellitus (T2DM) patients is regarded as an early clinical sign of incipient kidney damage. Microalbuminuria is often evaluated as urinary albumin to urinary creatinine ratio (ACR). Aim: To assess determinants of microalbuminuria in T2DM patients without prior diagnosis of nephropathy using ACR cut-off values. Materials and Methods: ACR was measured in a total of 90 T2DM patients, during two months in three non-consecutive days, and routine biochemical analyses were performed, including glycated hemoglobin (HbA1c), serum uric acid (SUA), and atherogenic index of plasma (AIP). The cut-off values of ACR were ≤ 2.5 mg/mmol in males, and ≤ 3.5 mg/mmol in females. Duration of T2DM, history of hypertension, HbA1c, estimated glomerular filtration rate (eGFR), AIP, and SUA were investigated for association with microalbuminuria. Results: According to ACR patients were considered as non-albuminuric (n= 57) and microalbuminuric (n = 33). Compared to non-albuminuric group, microalbuminuric group had increased urinary creatinine, urinary albumin, HbA1c, triglycerides and SUA, whilst decreased HDL-cholesterol levels. Although eGFR was generally reduced, the correlation between LogACR and eGFR was not significant (p > 0.05). However, the correlation between LogACR and LogHbA1c was significant. The multiple logistic regression analysis revealed HbA1c (t = 3.42; p = 0.012) and SUA (t = 2.44; p = 0.040) as independent predictors of microalbuminuria in T2DM patients. Conclusion: At ACR cut-off values, concentrations of HbA1c and SUA were independent predictors of microalbuminuria in T2DM patients not yet diagnosed with nephropathy.
Dijana Mirić, Bojana Kisić, Dragana Puhalo-Sladoje, Bratislav Mirić, Dragiša Rašić, Ilija Dragojević, Dragana Pavlović
01.12.2019.
Professional paper
Frequency and histological-cytological correlation of premalignant and malignant changes in the cervix in women of different ages
Introduction: Cervical cancer is the fourth most common and accounts for about 6.6% of all cancers in women. Aim: The aim was to determine the frequency of premalignant and malignant changes in the cervix, to examine the histological-cytological correlation of premalignant and malignant changes in the cervix and the correlation of the women's age with the stage of cervical disease. Material and Methods: A retrospective study analyzed 186 cervical biopsy specimens and cervical smears (Papanicolau test) at the Institute of Pathology of the Faculty of Medicine in Pristina, based in Kosovska Mitrovica, over a three-year period from 2016 to 2018. Results: Of the 186 subjects, 62 had mild premalignant changes of type LSIL, 22 HSIL, and as many as 20 (10.75%) cervical cancer. There was a statistically significant positive association between histological and cytological findings (r = 0.854; p <0.001). There was a statistically significant difference in the age of the subjects with regard to histological findings (F = 11,327; p <0.001). Subjects with HSIL were significantly older than those diagnosed with cervicitis chronica (p = 0.029). Subjects diagnosed with planocellular carcinoma were significantly older than women with cervicitis chronica (p <0.001) and LSIL (p <0.001). Conclusion: There is an increasing trend of cervical cancer in Northern Kosovo and in the Serbian enclaves in central Kosovo and Metohija. Subjects with cervical cancer were significantly older than subjects with mild premalignant cervical changes. There is a significant histologic-cytological correlation of cervical findings, so we believe that more massive cervical screening, especially in younger women, could reduce the incidence of premalignant and malignant diseases of the cervix.
Dejan Mihajlović, Zoran Bukumirić, Nenad Šulović, Goran Relić, Slaviša Stanišić, Saša Cvetković, Momir Dunjić, Tanja Mirković, Milica Milentijević, Novica Đoković, Mirjana Stojanović-Tasić
01.12.2019.
Professional paper
Antimicrobial treatment of Acinetobacter neuii invasive infections: A systematic review
Aims: The objectives of this study were to find out whether and to what extent Actinomyces neuii is pathogenic to humans in terms of causing invasive infections and to ascertain the most appropriate and effective antibiotic therapy against this bacterium. Material and method: This study was designed as a systematic review article. MEDLINE, Google Scholar, SCIndex, Cochrane database of published clinical trials - Central and Clinicaltrials.gov databases were systematically searched for primary case reports or case series describing invasive infection with Actinomyces neuii. Results: A literature search identified 23 studies that met the inclusion criteria, describing cases of patients with an invasive infection caused by Actinomyces neuii. It was found that A. neuii could cause endocarditis, endophthalmitis, osteomyelitis, pleural empyema, soft tissue abscesses, neonatal sepsis, ventriculoperitoneal shunt infections and periprosthetic tissue infections. The most prescribed antibiotics for the treatment of Actinomyces neuii infections were amoxicillin and vancomycin (n = 10; 12.3%), followed by penicillin (n =9; 11.1%), gentamicin (n = 6; 7.4%), ampicillin (n = 5; 6.2%) and ceftazidime (n = 4; 4.9%). Antibiotic treatment of infections caused by A. neuii was followed by clinical improvement or complete cure of all patients, with no recorded deaths. Conclusion: A. neuii has a relevant pathogenic potential to cause invasive infections of various organs and tissues, especially in immunocompromised individuals of any age. For the treatment of mild infections caused by this bacterium, the antibiotics of choice are penicillin or amoxicillin, while vancomycin should be used to treat severe infections caused by Actinomyces neuii.
Milica Milentijević, Nataša Katanić, Jelena Aritonović-Pribaković, Aleksandar Kočović, Jovana Milosavljević, Miloš Milosavljević, Srđan Stefanović, Đorđe Ivković
01.12.2019.
Professional paper
Strategije suočavanja sa anksioznošću u situaciji testiranja engleskog jezika kod studenata visokog i niskog samopoštovanja
Introduction: Different types of tests present a great part of the academic life, and the tests themselves are extremely stressful situations for most students. The question of strategies used for coping with anxiety in testing situations is raised by the anxiety experienced by students and the levels of their self-esteem during tests. Aim of the paper: The aim of the paper is to take into consideration language anxiety, self-esteem and social and demographic variables as predictors of active use of strategies for coping with the testing situation. Material and methodology: This research included 338 students from five faculties/colleges, with an average age of 21.82±2.561, who were administered the following scales: Rosenberg's Self-esteem Scale, the Coping with the Testing Situation Scale and Foreign Language Classroom Anxiety Scale. Results: The Subscale for Language Anxiety during Testing has the highest reversed predictive value (beta=-0.43, p<0.001) of coping strategies for the testing situation; older respondents have less expressed ability of coping with the testing (beta=-0.23, p<0.001), and the higher the level of fear from negative evaluation (beta=0.21, p<0.001), the more the respondents are coping with the testing situation. Conclusion: The higher the testing anxiety, the less will the students use coping strategies, and the older students cope less with stressful testing situations, but the greater the presence of a more expressed fear of inefficiency, the more will the respondents cope with the testing situation through various strategies.
Marina Malobabić, Ivana Nešić, Vesna Jokanović
