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Volume 52, Issue 4, 2023

Online ISSN: 2560-3310

ISSN: 0350-8773

Volume 52 , Issue 4, (2023)

Published: 17.02.2025.

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15.01.2025.

Case Reports

THE IMPORTANCE OF EARLY DETECTION OF DIABETES INSIPIDUS IN CHILDHOOD

Introduction:

Diabetes insipidus (DI) is a disease that occurs due to inappropriate secretion of anti-diuretic hormone from the pituitary, or as a result of disorder in which the level of the kidneys cannot adequately respond to the secretion of this hormone. Also, it is known as central diabetes insipidus. The most common causes are head traumas, tumors of the hypothalamus and pituitary glands, inflammatory processes, histiocytosis, anomalies in the development of brain. It can appear in the form of familial diabetes insipidus or in certain syndromes (Wolfram syndrome). It is characterized by hypotonic polyuria higher than 3l/24h (which persists if even taking liquids stops), then by nocturia and compensatory polydipsia. Enuresis often occurs among children.

Case report:

A boy, aged 11, lives with his mother and brothers. Mother noticed that the boy was urinating frequently in last few months (diuresis 4.6 l/24h, and 3.25 l/24h). After two months, the boy developed double images and severe headaches, vomiting, inability to see, squinting in the right eye and headache in the back of the head. MNR of the endocranium indicates the presence of a tumor formation. The tumor was surgically removed, and the boy started with chemotherapy and radiotherapy. Due to persistent diabetes insipidus, the boy started using desmopressin-acetate - in tablet form. Active substance desmopressin - acts in the same way as the natural hormone vasopressin and regulates the kidney's ability to concentrate urine. The positive effect of taking the drug appeared after three weeks from the start of taking the therapy.

Conclusion:

Central (neurogenic) DI occurs as a result of a relative or absolute deficiency of antidiuretic hormone, which is responsible for the osmolality of body fluids. Based on this case, we want to show the importance of early diagnosis of the disease in order to improve the prognosis and the necessity of careful monitoring of these patients.

Danijela Jovanović, Snezana Marković- Jovanović, Teodora Tubić

15.01.2025.

Professional paper

IMPACTED MAXILLARY CENTRAL INCISORS WITH SUPERNUMERARY TOOTH - CASE REPORT

Introduction:

Presence mesiodens is not uncommon in clinic practice. It is cause of impacted permanent maxillary central incisors. Diagnosis of the delayed tooth is usually made on the basis of clinical and radiographic findings. The treatment include surgical exposure of the impacted maxillary central incisors and extraction of supernumerary tooth, because it is a direct obstruction for the eruption of maxillary central incisors. Impacted maxillary central incisors is moved into it's proper position with orthodontic traction. The aim is presented surgical-orthodontic treatment of impacted teeth, which is necessary to achieve stability esthetic and functional results.

Case report:

This case report describes a surgical-orthodontic treatment of 9.5-old boy with both impacted permanent maxillary central incisors with supernumerary tooth which disturbs their normal eruption.

Conclusion:

The gnathometric evaluation of spaces in dental arch, the assessment of dental age and radiographic analysis are preconditions of successful therapy. The impacted maxillary central incisors were successfully positioned in the maxillary arch, with an adequate width of attached gingiva. The careful and persuasive treatment planning of an orthodontist, oral surgeon and periodontist are the key to success in resolving such cases.

Sanja Simić, Branko Mihailović, Jasna Pavlović, Amila Vujačić, Vladanka Vukićević, Jelena Stanišić Zindović, Zoran Arsić

15.01.2025.

Professional paper

STANDARD AND ADVANCED METHODS FOR DIAGNOSIS OF METABOLIC SYNDROME AND ITS COMORBIDITIES IN CHILDREN

The metabolic syndrome (MS) is a clinical entity of substantial heterogeneity, represented by the combination of obesity (especially central obesity),insulin resistance, impaired glucose tolerance, atherogenic dyslipidemia (high triglyceride levels and low levels of HDL-cholesterol (HDL-C)), and hypertension. Childhood obesity has become more common as a result of urbanization, bad diets, and more sedentary lifestyles.

The incidence of metabolic syndrome is ten times higher in children with obesity, and a special risk factor is the presence of obesity in the pediatric population, the classification of metabolic syndrome is based on standards set by the International Diabetes Federation (IDF).

Our goal is to summarize the diagnostic procedure of metabolic syndrome as well as comorbidity based on conventional methods and modern imaging procedures by analyzing the published papers.

Snezana Markovic Jovanovic, Aleksandar Jovanović, Jadranka Mitić, Slavica Pajovic, Danijela Jovanovic, Emin Bajramlic

15.01.2025.

Professional paper

THE METHOD OF ULTRASOUND URINARY BLADDER WEIGHT CALCULATION

Objective:

To investigate correlation between ultrasonically calculated urinary bladder weight and lower urinary tract symptoms (LUTS).

Methods:

3D and 2D measurement of parameters necessary to determine bladder weight: Inner and outer radius of the bladder, in 10 male and 10 female patients with LUTS, with urinary bladder filled to at least 200 ml of urine volume.

Results:

Average urinary bladder weight in males was 53,8 g and in female patient was 45,2 g. We found no statistically significant difference between male and female patients, all with LUTS. We also found that patients in LUTS have hypertrophied bladder, which means that urinary bladder mass should be larger and results in an increase of blader weight and both inner and outer radius of the urinary bladder, that should be detected ultrasonographically, but not too much over of pre- determined variations of normal bladder weight.

Conclusion:

Estimation of urinary bladder weight should be considered as non-invasive approach to patients with LUTS. However, it is more plausible to measure only urinary bladder wall thickness ultrasonically than to calculate urinary bladder weight without built-in software.

Petar Jovanović

15.02.2025.

Case Reports

VITAMIN D - „SOLAR VITAMIN“

The discovery that sunlight can cure rickets was first scientifically confirmed in 1919. Shortly thereafter, in 1924, it was found that inactive lipids in the diet and skin are converted into antirachitic substances under the influence of UV light. Vitamin D (Vit D), also known as the "sunshine vitamin,"
was first identified in 1931. In recent decades, it has regained the focus of interest among the broader scientific community and dermatologists.
Specifically, certain dermatoses have been associated with low Vit D levels, leading to its supplementation in patients. On the other hand, some
dermatoses worsen with sun exposure, necessitating strict avoidance of sunlight and the therapeutic use of Vit D preparations.We are witnessing a
growing number of cases of melanoma and non-melanoma skin cancers, with excessive sun exposure being the primary etiological factor in most
cases. This paper provides a literature review on the historical discovery of Vit D and presents findings from studies examining Vit D levels not only in
various dermatoses but also in other diseases. The number of studies, as well as the spectrum of diseases in which the role of Vit D is being
investigated, continues to increase.

Milijana Relić, Snežana Relić, Tanja Kostić Grujić, Marijana Trajković, Zorica Timotijević, Tamara Jovanovic, Goran Relić

17.02.2025.

Professional paper

DAMAGE CONTROL U TRAUMATOLOGIJI

Sveži prelomi u ortopedskoj hirurgiji i traumatologiji, dovode do hemodinamske nestabilnosti celokupnog organizma. Kod otvorenih preloma, stepen
 hemodinamske nestabilnosti organizma je značajno veći. Prioritet u lečenju svežih preloma ima DAMAGE CONTROL IN ORTHOPEDIC (DCO). DCO je
 invazivna procedura koja ima ulogu kako u stabilizaciji preloma, tako i u kontroli krvarenja. Prelomi dugih kostiju kao i prelom karlice su apsolutna
 indikacija za DCO. Slobodno možemo reći da ova procedura prestavlja prioritet u lečenju svežih preloma. Procedura je individualizovana u zavisnosti
 od težine povrede kao i  hemodinamskog statusa povređenog pacijenta. U ortopedskoj hirurgiji i traumatologiji kao standardna procedura u DCO
 koristi se spoljašnji fiksator po Mitkoviću. Ortopedski hirurzi moraju biti jako prisebni i obazrivi kod pregledapacijenata sa politraumom i da
 prepoznaju tkzv. trougao smrti. Trougao smrti čine: acidoza, hipotermija i koagulopatija. Svaka karika je medjusobno povezana jedna sa drugom
 dovode do ireverzibilnih promena u organizmu što za posledicu ima smrtni ishod. DCO se sprovodi u tri faze: 1) podrazumeva kontrolu kvarenja,
 smanjenje kontaminacija bakterijama, kao i privremenu fiksaciju preloma. Sve ovo je neophodno uraditi u roku od 1-2h.; 2)  obuhvata stabilizaciju
 vitalnih parametara u JIN-e kao i reanimacija pacijenta ordiniranjem neophodne terapije, krvi i krvnih derivata.; 3) podrazumeva definitivna metoda
 lečenja u smislu nastavka lečenja preloma spoljasnjim fiksatorom ili konverzija u neku drugu metodu lečenja.

Saša Jovanović

15.01.2025.

Original scientific paper

USE OF PSYCHOACTIVE SUBSTANCES AMONG BELGRADE UNIVERSITY STUDENTS WITH DIAGNOSED SOMATIC OR MENTAL DISORDERS

Introduction/Objective

The objective of this study was to examine the relationship between use of psychoactive substances among University students and diagnosed somatic or mental disorders.

Methods

The cross-sectional study was conducted in a population of 2,000 students of the Belgrade University. Four faculties (Medicine, Geography, Economics, Electrical Engineering) from which the students participating in this research were chosen by the method of random choice (by computer listing), conducted in the period April - June 2010.

Results

We observed that are more numerous students who used psychoactive substances among students with diagnosed somatic illnesses compared to those without them. Statistical significance was found among students who used tobacco (p=0.027), alcohol (p=0.002), sedatives (p<0.001) and cannabis (p=0.021). Mental disorders are also connected to use of psychoactive substances. The statistical significance was achieved for all psychoactive substances except for alcohol.

Conclusion

Use of psychoactive substances is an important issue among University students with diagnosed somatic or mental disorder. Therefore, it is essential to recognize the symptoms and consequences of such behavior, and above all and connection thereof, the importance of prevention which may enhance better solution-seeking via proper education.

Mirjana Stojanovic-Tasic, Mirjana Virijevic, Kristina Rakic, Emilija Novakovic, Ivana Stasevic Karlicic, Nenad Milosevic, Jelena Aritonovic Pribakovic, Jovana Milosevic, Milica Bogdanovic, Suzana Adzic, Katarina Bisevac, Mary Vuksa

01.11.2024.

Professional paper

DEMOGRAPHIC AND CLINICAL VARIATIONS IN THE OCCURRENCE OF PEPTIC ULCER - TRENDS OVER A TEN-YEAR PERIOD

Introduction: Peptic ulcer is a chronic recurrent disease of the gastrointestinal tract, which most often occurs as gastric or duodenal ulcer. Peptic ulcer is characterized by certain geographical and temporal trends.

Objective: The aim of this study is to determine the frequency of gastric and duodenal ulcers among subjects who underwent esophagogastroduodenoscopy (EGDS) endoscopy due to dyspeptic complaints, as well as to analyze the trend of ulcer disease over a period of 10 years.

Material and Methods: The data of a total of 4074 subjects with an average age of 54.53 ± 15.03 years, both sexes, 1841 men and 2233 women, who underwent EGDS in 2005 and 2015 calendar years were retrospectively analyzed. Results: This study showed that the trend of ulcer disease significantly decreased in the observed ten-year period, accompanied by concomitant decrease in the prevalence of duodenal ulcers, while the frequency of gastric ulcers retained approximately at the same level. The results showed that men were at greater relative risk than women for the development of duodenal ulcers, in both calendar years. In the ten-year period, the average age of patients with ulcer disease increased by about 4 years, especially in the group with duodenal ulcer, and particularly within women with duodenal ulcer. Compared to 2005, the average age of subjects undergoing EGDS in 2015 increased by about 2 years, regardless of whether or not they were diagnosed with ulcer disease.

Conclusions: In the period 2005 - 2015, the age of patients with peptic ulcer tended to increase, whilst the prevalence of ulcer disease, especially duodenal ulcer, has decreased. The relative risk for duodenal ulcer in men was higher than in women. 

Aleksandra Vojinović, Tomica Milosavljević, Biljana Miličić

01.11.2024.

Original scientific paper

SYNCOPA IN CHILDREN AND ADOLESCENTS OUR EXPERIENCE

Introduction: Syncope is a sudden, short-lived, transient loss of consciousness associated with the inability to maintain postural tone. The aim of this paper is: to determine the frequency of syncope in children and adolescents in our conditions, to analyze the characteristics of syncopal episodes and clinical presentation in order to identify the etiology of seizures, and to provide diagnostic protocols, i.e. guidelines for streamlining clinical trials.

Methodology: The diagnosis of the disease was made clinically on the basis of well-taken anamnestic data and a detailed description of the quality of the attack, physical examination and routine laboratory analyzes: (CBC, glycemia, standard ECG). Additional tests were selectively performed: Holter ECG, ergometry, Tilt table test, Echocardiogram, NMR, EEG.

Results: Out of the total number of examined children in the outpatient Children’s Hospital, Department of Pediatric Cardiology, 139 patients (0.6%) reported due to short-term loss of consciousness. The largest number of children was between 15 and 18 years old. Ninety-two ( 66%) of those 139 were girls, and 47 (34%) were boys (p <0.05). Regarding the cause of syncope, it was found in 117 (84%) patients, and in 22 (16%) children the cause of syncope was unknown (p <0.05). Etiologically spreaking, syncope was divided into 3 groups: autonomic (vasovagal, situational, orthostatic, increased vagus tone in athletes) was the most common, in 88 patients (75%), cardiogenic in 5 (4%) and non-cardiogenic in 24 patients.(21%). There was also a recurrence of the attack. In two children, the syncopal attack was repeated 4 times.

CONCLUSION: Syncope most often occurs in teenagers and is mostly benign. To assess syncope, it is necessary to gather a detailed history of the attack, to conduct a detailed physical examination and routine laboratory analyzes: CBC, glycemia and standard ECG. Supplementary diagnostics should be performed exclusively in patients where there is a reasonable suspicion of heart disease or neurological diseases. 

Ljiljana Šulović, Danić Filipović, Vladimir Šulović, Zorica Živković, Milica Popović

01.11.2024.

Professional paper

KAWASAKI DISEASE

Kawasaki disease (KD) is an acute, self-limited vasculitis of unknown etiology that occurs predominantly in children under the age of 5 years. In addition to the progress of modern medicine, the cause of KD is currently unknown and specific diagnostic tests for definitive diagnosis does not exist. The differential-diagnostic enigma is the exclusion of other diseases with similar clinical features. The primary treatment in the acute phase of KD is intravenous immunoglobulin (IVIG) and acetylsalicylic acid (ASA/aspirin). There is not a recommendation to a uniform therapeutic approach in refractory KD. The role of corticosteroids is still controversial, but there are studies that support its use as adjuvant treatment. Most patients have a good prognosis. The focus of future research should be the formulation of new algorithms for detection, differential diagnostic triage and treatment of KD. 

Slađana Anđelić

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