Pub Date : 2019-10-01DOI: 10.5455/medarh.2019.73.359-361
Zorica Knezović, I. Stojanović, Ivka Djaković, D. Vrdoljak, V. Kosec, D. Butorac
Introduction: Hemiperitoneum caused by venous bleeding from the hilum of the spleen is a rare cause of acute abdomen in the last trimester of pregnancy. Material and Methods: We are presenting a case of a twenty-nine-year-old primipara with the clinical picture of acute abdomen. Case report: Primipara in the 36th week of pregnancy presented with the clinical picture of acute abdomen with the ultrasound finding of free fluid in the abdominal cavity and foetal bradycardia. Considering the clinical picture of the mother and the risks for the foetus, it was decided to complete the pregnancy with an emergency caesarean section. During the procedure, exploration of the abdominal cavity found the bleeding site from the venae gastricae breves, and a surgeon stopped active bleeding. Conclusion: Non-obstetric bleedings are not common in pregnancy, but they are life-threatening both to the mother and the foetus. The exact cause is usually found during the surgical procedure. If a pregnant woman presents with a clinical picture of abdominal pain, and the signs of foetal distress or clinical instability of the mother are also present, an emergency surgical procedure is indicated. In this case, the indication was foetal bradycardia, and the child was born alive by a caesarean section, while an extended surgical procedure saved the mother’s life.
{"title":"Spontaneous Rupture of Venae Gastricae Breves in Pregnancy: Case Report","authors":"Zorica Knezović, I. Stojanović, Ivka Djaković, D. Vrdoljak, V. Kosec, D. Butorac","doi":"10.5455/medarh.2019.73.359-361","DOIUrl":"https://doi.org/10.5455/medarh.2019.73.359-361","url":null,"abstract":"Introduction: Hemiperitoneum caused by venous bleeding from the hilum of the spleen is a rare cause of acute abdomen in the last trimester of pregnancy. Material and Methods: We are presenting a case of a twenty-nine-year-old primipara with the clinical picture of acute abdomen. Case report: Primipara in the 36th week of pregnancy presented with the clinical picture of acute abdomen with the ultrasound finding of free fluid in the abdominal cavity and foetal bradycardia. Considering the clinical picture of the mother and the risks for the foetus, it was decided to complete the pregnancy with an emergency caesarean section. During the procedure, exploration of the abdominal cavity found the bleeding site from the venae gastricae breves, and a surgeon stopped active bleeding. Conclusion: Non-obstetric bleedings are not common in pregnancy, but they are life-threatening both to the mother and the foetus. The exact cause is usually found during the surgical procedure. If a pregnant woman presents with a clinical picture of abdominal pain, and the signs of foetal distress or clinical instability of the mother are also present, an emergency surgical procedure is indicated. In this case, the indication was foetal bradycardia, and the child was born alive by a caesarean section, while an extended surgical procedure saved the mother’s life.","PeriodicalId":18414,"journal":{"name":"Medical Archives","volume":"25 1","pages":"359 - 361"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73435720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-01DOI: 10.5455/medarh.2019.73.321-325
N. Rustempašić, Martina Gengo
Introduction: Color Doppler and CT angiography are diagnostic methods commonly used to determine the degree of carotid stenosis. Aim: To evaluate how the degree of carotid stenosis determined by the Color Doppler correlates with the degree of stenosis determined by the CT angiography. Material and Methods: The study was designed as a retrospective study. It included 42 patients with carotid stenosis. From medical records we collected anamnestic data (gender, age and risk factors - hypertension, hyperlipidemia, diabetes, smoking and obesity) and the results regarding the degree of carotid stenosis determined by Color Doppler and CT angiography. Results: Out of the total number of patients (n=42), 73.8% were males and 26.2% were females. Average age of examined patients was 65.24±8.61. Most frequent risk factor of atherosclerosis was hypertension, followed by hyperlipidemia and smoking. NASCET grading distinguishes: first (0-29%), second (30-69%) and third (70-99%) degree of carotid stenosis. According to the Color Doppler evaluation findings, the second degree had 8 patients and 34 patients had the third degree of carotid stenosis. CT angiography have shown that 35 patients had third degree carotid stenosis, while 7 patients had the second degree carotid stenosis. In only one case results of evaluated methods differed regarding assessment of carotid stenosis. We have found that there is a significant positive correlation of the degree of carotid stenosis determined by the Color Doppler with the degree of stenosis determined by CT angiography (p=0.0002). Risk factors of atherosclerosis did not have a significant correlation with the degree of carotid stenosis (p>0.05). Conclusion: The degree of carotid stenosis estimated by the Color Doppler positively correlates with the degree of stenosis estimated by CT angiography.
{"title":"Assesment of Carotid Stenosis with CT Angiography and Color Doppler Ultrasonography","authors":"N. Rustempašić, Martina Gengo","doi":"10.5455/medarh.2019.73.321-325","DOIUrl":"https://doi.org/10.5455/medarh.2019.73.321-325","url":null,"abstract":"Introduction: Color Doppler and CT angiography are diagnostic methods commonly used to determine the degree of carotid stenosis. Aim: To evaluate how the degree of carotid stenosis determined by the Color Doppler correlates with the degree of stenosis determined by the CT angiography. Material and Methods: The study was designed as a retrospective study. It included 42 patients with carotid stenosis. From medical records we collected anamnestic data (gender, age and risk factors - hypertension, hyperlipidemia, diabetes, smoking and obesity) and the results regarding the degree of carotid stenosis determined by Color Doppler and CT angiography. Results: Out of the total number of patients (n=42), 73.8% were males and 26.2% were females. Average age of examined patients was 65.24±8.61. Most frequent risk factor of atherosclerosis was hypertension, followed by hyperlipidemia and smoking. NASCET grading distinguishes: first (0-29%), second (30-69%) and third (70-99%) degree of carotid stenosis. According to the Color Doppler evaluation findings, the second degree had 8 patients and 34 patients had the third degree of carotid stenosis. CT angiography have shown that 35 patients had third degree carotid stenosis, while 7 patients had the second degree carotid stenosis. In only one case results of evaluated methods differed regarding assessment of carotid stenosis. We have found that there is a significant positive correlation of the degree of carotid stenosis determined by the Color Doppler with the degree of stenosis determined by CT angiography (p=0.0002). Risk factors of atherosclerosis did not have a significant correlation with the degree of carotid stenosis (p>0.05). Conclusion: The degree of carotid stenosis estimated by the Color Doppler positively correlates with the degree of stenosis estimated by CT angiography.","PeriodicalId":18414,"journal":{"name":"Medical Archives","volume":"17 1","pages":"321 - 325"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84173572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-01DOI: 10.5455/medarh.2019.73.326-330
S. Drnda, E. Suljic
Introduction: Neurophysiological tests allow accurate assessment of the function of the peripheral nervous system. Detection of neurophysiological changes allows us to understand the neurological clinical symptoms and signs of patients with type 1 and type 2 diabetes and the possibility for their symptomatic treatment. Aim: Evaluate the effect of diabetes mellitus on the “cutaneous silent period” in detecting diabetic polyneuropathy. Material and Methods: The study included 150 subjects, 90 suffering from diabetes, divided into three groups of 30, depending on the disease duration, and a control group of 60 respondents not suffering from diabetes or other polyneuropathies. The control group are referred for EMG analysis on another basis (cervical radiculopathy, brachialgia, etc.). Group 1 consisted of 30 subjects with diabetes mellitus type 2 and duration of illness up to 5 years. Group 2 consisted of 30 subjects with type 2 diabetes mellitus 2 and illness duration from 5 to 10 years. Group 3 consisted of 30 patients with type 1 diabetes mellitus. The study groups consisted of patients referred for EMNG analysis to the EMG office of the Clinical Center of Sarajevo University, Neurology Clinic and the Neurophysiology Laboratory in Ljubljana, from July 1, 2011 to May 1, 2016. All patients were examined neurologically and electroneurographic analysis was performed. Results: A statistically significant difference was found in the incidence of pathologic CSP with respect to the study groups, χ2 = 26.153; p=0.001. Pathologic CSP was more common in group 1 and group 2 of subjects (56.17%) compared to group 3 and control subjects, where it occurred in 13.3% of the cases. Conclusion: The pathological cutaneous period of silence was more frequent in subjects of group 1 and group 2, that is, in subjects with DM type 2, compared to subjects with DM type 1.
{"title":"Diabetes Mellitus Type Has Impact on Cutaneous Silent Period","authors":"S. Drnda, E. Suljic","doi":"10.5455/medarh.2019.73.326-330","DOIUrl":"https://doi.org/10.5455/medarh.2019.73.326-330","url":null,"abstract":"Introduction: Neurophysiological tests allow accurate assessment of the function of the peripheral nervous system. Detection of neurophysiological changes allows us to understand the neurological clinical symptoms and signs of patients with type 1 and type 2 diabetes and the possibility for their symptomatic treatment. Aim: Evaluate the effect of diabetes mellitus on the “cutaneous silent period” in detecting diabetic polyneuropathy. Material and Methods: The study included 150 subjects, 90 suffering from diabetes, divided into three groups of 30, depending on the disease duration, and a control group of 60 respondents not suffering from diabetes or other polyneuropathies. The control group are referred for EMG analysis on another basis (cervical radiculopathy, brachialgia, etc.). Group 1 consisted of 30 subjects with diabetes mellitus type 2 and duration of illness up to 5 years. Group 2 consisted of 30 subjects with type 2 diabetes mellitus 2 and illness duration from 5 to 10 years. Group 3 consisted of 30 patients with type 1 diabetes mellitus. The study groups consisted of patients referred for EMNG analysis to the EMG office of the Clinical Center of Sarajevo University, Neurology Clinic and the Neurophysiology Laboratory in Ljubljana, from July 1, 2011 to May 1, 2016. All patients were examined neurologically and electroneurographic analysis was performed. Results: A statistically significant difference was found in the incidence of pathologic CSP with respect to the study groups, χ2 = 26.153; p=0.001. Pathologic CSP was more common in group 1 and group 2 of subjects (56.17%) compared to group 3 and control subjects, where it occurred in 13.3% of the cases. Conclusion: The pathological cutaneous period of silence was more frequent in subjects of group 1 and group 2, that is, in subjects with DM type 2, compared to subjects with DM type 1.","PeriodicalId":18414,"journal":{"name":"Medical Archives","volume":"14 1","pages":"326 - 330"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78758801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-01DOI: 10.5455/medarh.2019.73.268-271
Waseem Almeflh, Ahmad AlRaymoony, Mohammad Aldaaja, Baha Abdullah, Ahmad Oudeh
Introduction: Umbilical hernia is a common pediatric disorder that pediatric surgeons are usually asked to manage. Most cases will be closed spontaneously during the first 4-5 years of life. Low number of studies regarding umbilical defects in children does not allow a definitive guideline to be drawn about their natural history, indications and optimal timing for repair. In this systematic review, we evaluated the existing literature where pediatric umbilical hernias are addressed in regards to watchful waiting versus recommendations on timing of operative repair and we compared our institutional results with current literature Aim: The aim of our study is to review and evaluate the current guidelines in management of umbilical hernias in children and to compare the results with our experience in management of umbilical hernia in our institution. Methods: Online literature search for studies that published about umbilical hernias in pediatric using literature’s search of ACP Journal Club, Clinical Evidence, Dynamed, Cochran Controlled Trial Register (1945-2015), UpToDate, and PubMed. We reviewed the recommendations of these studies regarding conservative treatment, rule and time of surgery, complications, and its natural history trend to close spontaneously. We compared the literature results and recommendations to our institutional results. We also conducted a retrospective medical charts review of 520 children aged between 1 month and 14 years presented to our institution for surgical consultation for asymptomatic umbilical hernia between 2007 and 2017. We only included children with umbilical hernia who are less than 14 years old and without other associated disorders. Results: A Total of 7 studies that met the inclusion criteria were reviewed. These studies examined the possibilities of spontaneous closure of hernia defect in pediatric, incidence of complications from watchful waiting and current recommendations for surgery timing. In general, spontaneous resolution were unlikely to be seen beyond the age of 5 years. Our institutional results found that of 442 cases treated conservatively between 2007 and 2017, 85% are closed spontaneously by 1-5 years of age. Conclusion: There is minimal top-notch clinical data guiding pediatric surgeons on management protocols in regards to umbilical hernias in children. Current published studies and our institutional retrospective study recommend that conservative management of asymptomatic, uncomplicated umbilical hernias until age 4-5 years is both safe and practical.
{"title":"A Systematic Review of Current Consensus on Timing of Operative Repair Versus Spontaneous Closure for Asymptomatic Umbilical Hernias in Pediatric","authors":"Waseem Almeflh, Ahmad AlRaymoony, Mohammad Aldaaja, Baha Abdullah, Ahmad Oudeh","doi":"10.5455/medarh.2019.73.268-271","DOIUrl":"https://doi.org/10.5455/medarh.2019.73.268-271","url":null,"abstract":"Introduction: Umbilical hernia is a common pediatric disorder that pediatric surgeons are usually asked to manage. Most cases will be closed spontaneously during the first 4-5 years of life. Low number of studies regarding umbilical defects in children does not allow a definitive guideline to be drawn about their natural history, indications and optimal timing for repair. In this systematic review, we evaluated the existing literature where pediatric umbilical hernias are addressed in regards to watchful waiting versus recommendations on timing of operative repair and we compared our institutional results with current literature Aim: The aim of our study is to review and evaluate the current guidelines in management of umbilical hernias in children and to compare the results with our experience in management of umbilical hernia in our institution. Methods: Online literature search for studies that published about umbilical hernias in pediatric using literature’s search of ACP Journal Club, Clinical Evidence, Dynamed, Cochran Controlled Trial Register (1945-2015), UpToDate, and PubMed. We reviewed the recommendations of these studies regarding conservative treatment, rule and time of surgery, complications, and its natural history trend to close spontaneously. We compared the literature results and recommendations to our institutional results. We also conducted a retrospective medical charts review of 520 children aged between 1 month and 14 years presented to our institution for surgical consultation for asymptomatic umbilical hernia between 2007 and 2017. We only included children with umbilical hernia who are less than 14 years old and without other associated disorders. Results: A Total of 7 studies that met the inclusion criteria were reviewed. These studies examined the possibilities of spontaneous closure of hernia defect in pediatric, incidence of complications from watchful waiting and current recommendations for surgery timing. In general, spontaneous resolution were unlikely to be seen beyond the age of 5 years. Our institutional results found that of 442 cases treated conservatively between 2007 and 2017, 85% are closed spontaneously by 1-5 years of age. Conclusion: There is minimal top-notch clinical data guiding pediatric surgeons on management protocols in regards to umbilical hernias in children. Current published studies and our institutional retrospective study recommend that conservative management of asymptomatic, uncomplicated umbilical hernias until age 4-5 years is both safe and practical.","PeriodicalId":18414,"journal":{"name":"Medical Archives","volume":"6 1","pages":"268 - 271"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78447615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-01DOI: 10.5455/medarh.2019.73.276-281
E. Mesic, M. Aleckovic-Halilovic, Mirha Pjanic, E. Hodzic, Maida Dugonjic-Taletovic, Alma Halilcevic, Amila Jašarević, Adnan Altumbabic, Naida Morić, S. Trnačević
Introduction: Acute kidney injury (AKI) is one of the major public health issues with constantly increasing incidence, with epidemiology and outcomes that vary substantially across the world. Aim: Aim of our study was to determine epidemiological characteristics and causes of AKI and to provide a comparison of our findings with data from other low and middle income countries. Methods: This retrospective observational study conducted during an 18-month period included 84 patients. Data were collected from hospital information system and patients’ medical records. All data were analyzed using descriptive statistics. Results: More than two-thirds of patients were older than 56 years. Most cases of AKI (54,76%) were hospital-acquired and predominantly developed in intensive care units (32,14%). Dominant risk factor was underlying chronic kidney disease (48,81%) and chronic heart failure (45,24. In majority of patients (73,81%) were identified multiple factors that may have contributed to AKI: infection (90,48%), prerenal factors (77,38%), nephrotoxic agents (69,05%), and sepsis (28,57%). Multiple organ failure was identified in 94,05% of patients: cardiovascular (64,56%), respiratory (58,23%) and hematological (56,96%) system. Half of all patients were alive at last observation day. Leading cause of death was infection/sepsis (21,43%), followed by cancer (16,67%) and shock (14,28%). Conclusion: Data on AKI show great variation, but general picture of AKI resembles more that from high income countries. The need for dialysis and overall mortality remains high. This highlights the importance of early recognition of AKI, timely referral to nephrologist and need for national guidelines and standardized protocols for AKI.
{"title":"Recent Pattern of Acute Kidney Injury in Bosnia and Herzegovina","authors":"E. Mesic, M. Aleckovic-Halilovic, Mirha Pjanic, E. Hodzic, Maida Dugonjic-Taletovic, Alma Halilcevic, Amila Jašarević, Adnan Altumbabic, Naida Morić, S. Trnačević","doi":"10.5455/medarh.2019.73.276-281","DOIUrl":"https://doi.org/10.5455/medarh.2019.73.276-281","url":null,"abstract":"Introduction: Acute kidney injury (AKI) is one of the major public health issues with constantly increasing incidence, with epidemiology and outcomes that vary substantially across the world. Aim: Aim of our study was to determine epidemiological characteristics and causes of AKI and to provide a comparison of our findings with data from other low and middle income countries. Methods: This retrospective observational study conducted during an 18-month period included 84 patients. Data were collected from hospital information system and patients’ medical records. All data were analyzed using descriptive statistics. Results: More than two-thirds of patients were older than 56 years. Most cases of AKI (54,76%) were hospital-acquired and predominantly developed in intensive care units (32,14%). Dominant risk factor was underlying chronic kidney disease (48,81%) and chronic heart failure (45,24. In majority of patients (73,81%) were identified multiple factors that may have contributed to AKI: infection (90,48%), prerenal factors (77,38%), nephrotoxic agents (69,05%), and sepsis (28,57%). Multiple organ failure was identified in 94,05% of patients: cardiovascular (64,56%), respiratory (58,23%) and hematological (56,96%) system. Half of all patients were alive at last observation day. Leading cause of death was infection/sepsis (21,43%), followed by cancer (16,67%) and shock (14,28%). Conclusion: Data on AKI show great variation, but general picture of AKI resembles more that from high income countries. The need for dialysis and overall mortality remains high. This highlights the importance of early recognition of AKI, timely referral to nephrologist and need for national guidelines and standardized protocols for AKI.","PeriodicalId":18414,"journal":{"name":"Medical Archives","volume":"56 1","pages":"276 - 281"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76727426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-01DOI: 10.5455/medarh.2019.73.234-239
S. Marković, Z. Žigić, A. Cerovac, Suad Kunosic, M. Lelić, Fejzo Džafić
Introduction: Knowledge of the size of surfaces available for transport is important for assessing the amount of nutrients that can be transmitted to the fetus for its normal growth and development. Aim: The aim of our study, was to determine the stereological structural parameters of the parenchymal part of placenta, ratio of birth weight and placental weight, and to determine their correlation with the body length and head circumference of the newborns of adolescent pregnant women. Methods: The study was conducted on a total of 60 human placentas of term pregnancy, divided into two groups according to the age of pregnant women. The experimental group consisted of 30 placenta of pregnant women aged 13-19. The control group consisted of 30 placenta of pregnant women aged 20-35. Computer assisted morphological analysis of images of histological preparations using stereological methods was performed. Results: Surface density of terminal villi of adolescent placentas is significant higher than the control group (t = 14,179, df = 29, p <0,0001). The T-test (t = -5,868, df = 29, p <0,0001) showed statistically significant difference in the surface density of fibrinoid in two compared groups. T-test (t = 6.438, df = 29, p <0.0001) found that total surface of terminal villi was significantly higher in adolescent placentas. The T-test (t = -6,747, df = 29, p <0,0001) found that total surface of fibrinoid was significantly lower in adolescent group. The T-test (t = 4.203, df = 29, p <0.0001) found that the ratio of birth weight of newborn and adolescent placental weight was significantly higher in relation to the control group. Conclusion: Adolescent placentas was more efficient in increasing the weight of newborns, compared to the control group placentas.
简介:了解可用于运输的表面大小对于评估可传递给胎儿正常生长发育的营养物质的量是重要的。目的:研究青春期孕妇胎盘实质部分的体视结构参数、出生体重和胎盘重量的比值及其与新生儿体长、头围的相关性。方法:选取人类足月妊娠胎盘60块，按孕妇年龄分为两组。试验组为30例13 ~ 19岁孕妇胎盘。对照组为30例20 ~ 35岁孕妇胎盘。计算机辅助形态学分析图像的组织学准备使用立体方法进行。结果:青春期胎盘终绒毛表面密度显著高于对照组(t = 14,179, df = 29, p <0,0001)。经t检验(t = -5,868, df = 29, p <0,0001)，两组患者纤维蛋白表面密度差异有统计学意义。t检验(t = 6.438, df = 29, p <0.0001)发现，青春期胎盘终绒毛总表面积显著增高。t检验(t = - 6747, df = 29, p < 0.0001)发现，青少年组纤维蛋白总表面明显降低。经t检验(t = 4.203, df = 29, p <0.0001)发现，新生儿出生体重与青少年胎盘重量之比显著高于对照组。结论:与对照组胎盘相比，青春期胎盘对新生儿增重更有效。
{"title":"Stereological Analysis of Adolescent Placentas and Anthropometric Characteristics of Newborns","authors":"S. Marković, Z. Žigić, A. Cerovac, Suad Kunosic, M. Lelić, Fejzo Džafić","doi":"10.5455/medarh.2019.73.234-239","DOIUrl":"https://doi.org/10.5455/medarh.2019.73.234-239","url":null,"abstract":"Introduction: Knowledge of the size of surfaces available for transport is important for assessing the amount of nutrients that can be transmitted to the fetus for its normal growth and development. Aim: The aim of our study, was to determine the stereological structural parameters of the parenchymal part of placenta, ratio of birth weight and placental weight, and to determine their correlation with the body length and head circumference of the newborns of adolescent pregnant women. Methods: The study was conducted on a total of 60 human placentas of term pregnancy, divided into two groups according to the age of pregnant women. The experimental group consisted of 30 placenta of pregnant women aged 13-19. The control group consisted of 30 placenta of pregnant women aged 20-35. Computer assisted morphological analysis of images of histological preparations using stereological methods was performed. Results: Surface density of terminal villi of adolescent placentas is significant higher than the control group (t = 14,179, df = 29, p <0,0001). The T-test (t = -5,868, df = 29, p <0,0001) showed statistically significant difference in the surface density of fibrinoid in two compared groups. T-test (t = 6.438, df = 29, p <0.0001) found that total surface of terminal villi was significantly higher in adolescent placentas. The T-test (t = -6,747, df = 29, p <0,0001) found that total surface of fibrinoid was significantly lower in adolescent group. The T-test (t = 4.203, df = 29, p <0.0001) found that the ratio of birth weight of newborn and adolescent placental weight was significantly higher in relation to the control group. Conclusion: Adolescent placentas was more efficient in increasing the weight of newborns, compared to the control group placentas.","PeriodicalId":18414,"journal":{"name":"Medical Archives","volume":"32 1","pages":"234 - 239"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73202376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-01DOI: 10.5455/medarh.2019.73.285-287
G. El Hasbani, R. Assaker, Sutasinee Nithisoontorn, William Plath, Edgardo Olvera Lopez, J. Gamarra, Ahmad Kofahi, Christopher Bertely, V. Dimitrov
Introduction: Madelung’s disease (MD) is a rare disorder of unknown etiology defined as the presence of multiple and symmetrical fatty accumulations most commonly involving the upper trunk, neck, and head. Excessive alcohol ingestion has been linked traditionally to the pathogenesis of the disease. The central and peripheral nervous system could both be affected. Presenile dementia, without alcohol abuse, has been rarely reported in the literature as a complication. Aim: The aim of this case report is to highlight that multiple symmetric lipomatosis can be complicated by presenile dementia even if the patient is non-alcoholic. Case Report: This case report describes a middle age non-alcoholic woman who presented for increased forgetfulness. Brain CT scan showed cerebral and cerebellar atrophy inappropriate for her age. Despite being started on anticholinergic drug, her MMSE decreased 3 points in 1 year. Conclusion: Clinicians should consider early onset dementia as a potential complication of Madelung’s disease even in patients with no preceding history of alcoholism. A brain MRI and MMSE can aid with identifying such a complication.
{"title":"Madelung’s Disease Leading to Presenile Dementia in a Non-alcoholic Patient","authors":"G. El Hasbani, R. Assaker, Sutasinee Nithisoontorn, William Plath, Edgardo Olvera Lopez, J. Gamarra, Ahmad Kofahi, Christopher Bertely, V. Dimitrov","doi":"10.5455/medarh.2019.73.285-287","DOIUrl":"https://doi.org/10.5455/medarh.2019.73.285-287","url":null,"abstract":"Introduction: Madelung’s disease (MD) is a rare disorder of unknown etiology defined as the presence of multiple and symmetrical fatty accumulations most commonly involving the upper trunk, neck, and head. Excessive alcohol ingestion has been linked traditionally to the pathogenesis of the disease. The central and peripheral nervous system could both be affected. Presenile dementia, without alcohol abuse, has been rarely reported in the literature as a complication. Aim: The aim of this case report is to highlight that multiple symmetric lipomatosis can be complicated by presenile dementia even if the patient is non-alcoholic. Case Report: This case report describes a middle age non-alcoholic woman who presented for increased forgetfulness. Brain CT scan showed cerebral and cerebellar atrophy inappropriate for her age. Despite being started on anticholinergic drug, her MMSE decreased 3 points in 1 year. Conclusion: Clinicians should consider early onset dementia as a potential complication of Madelung’s disease even in patients with no preceding history of alcoholism. A brain MRI and MMSE can aid with identifying such a complication.","PeriodicalId":18414,"journal":{"name":"Medical Archives","volume":"28 1","pages":"285 - 287"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90024899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-01DOI: 10.5455/medarh.2019.73.262-267
S. Bursać, S. Jandrić, G. Talić
Introduction: Complications on the lower extremities are a major cause of morbidity, disability, emotional and physical suffering in people with diabetes. Diabetic neuropathy (DN) is the most frequent complication of both types of diabetes. Lack of performance of the musculoskeletal system of lower leg and foot can results in high focal plantar pressures with increased ulceration risk in patients with neuropathy. Aim: To determine the impact of the severity of distal symmetric polyneuropathy (DSPN) on the foot and ankle muscle strength and the range of motion (ROM) at ankle joint (AJ), subtalar joint (SJ) and first metatarsophalangeal joint (I MTP). Methods: A cross-sectional study was conducted among 100 diabetic patients. The level of DSPN was assessed using the Neuropathy Disability Score. Function of ten foot and ankle muscles has been evaluated by manual muscle testing. Muscle strength was scored by semiquantitative grading system used in the Michigan Diabetic Neuropathy Score. ROM at the AJ, SJ and I MTP was measured with goniometer. Results: The average patients age was 61.91±10.74 and diabetes duration 12.25±8.60 years. DSPN was present in 45% of patients. The average strength of foot and ankle muscles expressed by muscle score was 11.56±5.08. The average ROM at AJ was 47.85°, at SJ 35.10° and at I MTP 72.70°. Correlations between the severity of the DSPN and muscle function, ROM at AJ, SJ and I MTP were statistically significant. ROM at SJ and I MTP declines significantly with progression of neuropathy but not significant at AJ. Conclusion: The severity of DSPN is significantly associated with foot and ankle muscle weakness and ROM at the SJ and the I MTP, but not significantly with the ROM at the AJ.
{"title":"Influence of Diabetic Distal Symmetric Polyneuropathy on the Performance of the Musculoskeletal System of Lower Leg and Foot","authors":"S. Bursać, S. Jandrić, G. Talić","doi":"10.5455/medarh.2019.73.262-267","DOIUrl":"https://doi.org/10.5455/medarh.2019.73.262-267","url":null,"abstract":"Introduction: Complications on the lower extremities are a major cause of morbidity, disability, emotional and physical suffering in people with diabetes. Diabetic neuropathy (DN) is the most frequent complication of both types of diabetes. Lack of performance of the musculoskeletal system of lower leg and foot can results in high focal plantar pressures with increased ulceration risk in patients with neuropathy. Aim: To determine the impact of the severity of distal symmetric polyneuropathy (DSPN) on the foot and ankle muscle strength and the range of motion (ROM) at ankle joint (AJ), subtalar joint (SJ) and first metatarsophalangeal joint (I MTP). Methods: A cross-sectional study was conducted among 100 diabetic patients. The level of DSPN was assessed using the Neuropathy Disability Score. Function of ten foot and ankle muscles has been evaluated by manual muscle testing. Muscle strength was scored by semiquantitative grading system used in the Michigan Diabetic Neuropathy Score. ROM at the AJ, SJ and I MTP was measured with goniometer. Results: The average patients age was 61.91±10.74 and diabetes duration 12.25±8.60 years. DSPN was present in 45% of patients. The average strength of foot and ankle muscles expressed by muscle score was 11.56±5.08. The average ROM at AJ was 47.85°, at SJ 35.10° and at I MTP 72.70°. Correlations between the severity of the DSPN and muscle function, ROM at AJ, SJ and I MTP were statistically significant. ROM at SJ and I MTP declines significantly with progression of neuropathy but not significant at AJ. Conclusion: The severity of DSPN is significantly associated with foot and ankle muscle weakness and ROM at the SJ and the I MTP, but not significantly with the ROM at the AJ.","PeriodicalId":18414,"journal":{"name":"Medical Archives","volume":"16 1","pages":"262 - 267"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77734253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-01DOI: 10.5455/medarh.2019.73.282-284
Nina Žiga, Alma Biscevic, M. Pjano, Ajla Pidro
Introduction: Marcus Gunn syndrome is a rare phenomenon with very less number of cases reported in literature. It may be congenital or acquired. Aim: The aim of this case report was to report the clinical characteristics of Marcus Gunn patient from our Clinic. Case report: A comprehensive opthalmologic examination, CDVA (corrected distance visual acuity), fundus examination and photography, was conducted in Marcus Gunn patient. Clinical findings of patient presented as - chin positioned slightly upwards, extraocular motility normal on both eyes, cover test with normal findings, pupillary examination normal on both eyes. Left upper eyelid was in a lower position than the right one. On right eye, rima interpalpebrarum was 9 mm with upgaze of 13mm. On the left eye, rima interpalpebrarum was 5 mm with upgaze of 6 mm, and with open mouth, left rima interpalpebrarum was 10 mm. Visual acuity on both eyes was 1.0. Cycloplegic refraction on both eyes was +0,75 diopters (D), and Lang test was normal. In the differential diagnosis of patients with ptosis, Marcus Gunn jaw winking syndrome should be considered especially if it improves during feeding, sucking, chewing, smiling or any kind of mouth movement. In case of ptosis always do the jaw test. Have the infant bottle-feed. An older child can chew gum. Have the patient open the mouth, move the jaw from side to side, or protrude the jaw forward. Conclusion: Address first to treatment of any amblyopia if present - eyeglasses, patching etc., or strabismus. Think twice before deciding to operate.
Marcus Gunn综合征是一种罕见的现象，文献报道的病例很少。它可能是先天性的，也可能是后天的。目的:本病例报告的目的是报告本诊所Marcus Gunn患者的临床特征。病例报告:对Marcus Gunn患者进行了全面的眼科检查、CDVA(矫正距离视力)、眼底检查和摄影。患者临床表现为:下巴微上，双眼眼外运动正常，眼罩检查正常，双眼瞳孔检查正常。左上眼睑比右上眼睑低。右眼睑间膜9mm，上视13mm。左眼睑间膜5 mm，上视6 mm，张口左睑间膜10 mm。双眼视力1.0。双眼单眼屈光+0,75屈光(D)， Lang试验正常。在对上睑下垂患者的鉴别诊断中，应考虑Marcus Gunn下颌眨眼综合征，特别是在进食、吸吮、咀嚼、微笑或任何口腔运动时，如果该综合征有所改善。如果是上睑下垂，一定要做下颚测试。给婴儿喂奶。大一点的孩子会嚼口香糖。让患者张开嘴巴，左右移动下颌，或将下颌向前伸出。结论:如果存在弱视，应首先进行治疗-眼镜，贴片等，或斜视。做手术前要三思。
{"title":"Marcus Gunn Jaw-Winking Syndrome: a Case Report","authors":"Nina Žiga, Alma Biscevic, M. Pjano, Ajla Pidro","doi":"10.5455/medarh.2019.73.282-284","DOIUrl":"https://doi.org/10.5455/medarh.2019.73.282-284","url":null,"abstract":"Introduction: Marcus Gunn syndrome is a rare phenomenon with very less number of cases reported in literature. It may be congenital or acquired. Aim: The aim of this case report was to report the clinical characteristics of Marcus Gunn patient from our Clinic. Case report: A comprehensive opthalmologic examination, CDVA (corrected distance visual acuity), fundus examination and photography, was conducted in Marcus Gunn patient. Clinical findings of patient presented as - chin positioned slightly upwards, extraocular motility normal on both eyes, cover test with normal findings, pupillary examination normal on both eyes. Left upper eyelid was in a lower position than the right one. On right eye, rima interpalpebrarum was 9 mm with upgaze of 13mm. On the left eye, rima interpalpebrarum was 5 mm with upgaze of 6 mm, and with open mouth, left rima interpalpebrarum was 10 mm. Visual acuity on both eyes was 1.0. Cycloplegic refraction on both eyes was +0,75 diopters (D), and Lang test was normal. In the differential diagnosis of patients with ptosis, Marcus Gunn jaw winking syndrome should be considered especially if it improves during feeding, sucking, chewing, smiling or any kind of mouth movement. In case of ptosis always do the jaw test. Have the infant bottle-feed. An older child can chew gum. Have the patient open the mouth, move the jaw from side to side, or protrude the jaw forward. Conclusion: Address first to treatment of any amblyopia if present - eyeglasses, patching etc., or strabismus. Think twice before deciding to operate.","PeriodicalId":18414,"journal":{"name":"Medical Archives","volume":"68 1","pages":"282 - 284"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75440144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-01DOI: 10.5455/medarh.2019.73.228-233
Reuf Karabeg, Fikret Veljović, A. Voloder, S. Bećirbegovic, Dženan Jahić, Senad Burak, E. Begić, I. Masic
Introduction: Achilles tendon injuries usually occur with abrupt movements at the level of the ankle and foot, and the consequence is the overload of the Achilles tendon. Aim: Examine the Achilles tendon load as a function of the landing angle, and find the critical point at which the tendon overload begins and when a further increase in the landing angle can lead to rupture. Methods: The study has a prospective character. The input data represent the anthropometric values of the respondents, who are professional basketball players in the senior national team of Bosnia and Herzegovina and were processed in the CATIA v5-6 software solution. Software data processing analyzed the landing angles and the transfer of force to the Achilles tendon. The end result is a regression curve, which projects the angle at which the Achilles tendon is overloaded, and indicates an increased risk of possible injury to the tendon itself. Results: The onset of overloading starts at an angle of 32.28° and at an angle of 35.75° the overloaded load occurs, indicating the need for the subject to change the position of the foot to prevent damage to the tendon itself. Conclusion: An angle of 35.75° is the critical point at which the Achilles tendons are overloaded at the very landing. Prevention of injury should go in the direction of practicing the feet for a particular position at the time of the landing, and in the direction to develop adequate footwear that would mitigate the angle at the landing.
{"title":"A Mathematical Model of Achilles Tendon Overload During Jump Shot","authors":"Reuf Karabeg, Fikret Veljović, A. Voloder, S. Bećirbegovic, Dženan Jahić, Senad Burak, E. Begić, I. Masic","doi":"10.5455/medarh.2019.73.228-233","DOIUrl":"https://doi.org/10.5455/medarh.2019.73.228-233","url":null,"abstract":"Introduction: Achilles tendon injuries usually occur with abrupt movements at the level of the ankle and foot, and the consequence is the overload of the Achilles tendon. Aim: Examine the Achilles tendon load as a function of the landing angle, and find the critical point at which the tendon overload begins and when a further increase in the landing angle can lead to rupture. Methods: The study has a prospective character. The input data represent the anthropometric values of the respondents, who are professional basketball players in the senior national team of Bosnia and Herzegovina and were processed in the CATIA v5-6 software solution. Software data processing analyzed the landing angles and the transfer of force to the Achilles tendon. The end result is a regression curve, which projects the angle at which the Achilles tendon is overloaded, and indicates an increased risk of possible injury to the tendon itself. Results: The onset of overloading starts at an angle of 32.28° and at an angle of 35.75° the overloaded load occurs, indicating the need for the subject to change the position of the foot to prevent damage to the tendon itself. Conclusion: An angle of 35.75° is the critical point at which the Achilles tendons are overloaded at the very landing. Prevention of injury should go in the direction of practicing the feet for a particular position at the time of the landing, and in the direction to develop adequate footwear that would mitigate the angle at the landing.","PeriodicalId":18414,"journal":{"name":"Medical Archives","volume":"15 1","pages":"228 - 233"},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90605156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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