B. Starcevic, Stefan Korica, Z. Radojicic, I. Djorić, M. Kadija, A. Starcevic
Introduction/Objective. Analysis of clinical outcomes of non-surgical conservative and operative management of patients with posterior acetabular wall fractures. Methods: We investigated 88 fractures of the acetabular joint, 31 of which were treated surgically and 57 non-surgically. Only screws or reconstruction plates and screws were used for surgical treatment and traction in patients who underwent nonsurgical treatment. The study period lasted at least three years. The measures used to assess the outcome of operative, surgical and non-operative, conservative approach were Merle D'Aubigne modified score, Harris hip score, and Matta radiometric criteria. Results. Matta evaluation criteria showed excellent score for 40.40% in conservatively treated patients; 19.4% in patients who underwent surgery; good score for 49.10% in conservatively treated patients; 48.40% in patients who underwent surgery. Comparation between two group patients differently treated, by Merle D?Aubigne tool, showed excellent results for 56.10% conservatively-treated patients and 25.8% in those patients who underwent surgery and good results in 29.8% conservatively-treated patients and 38.7% in patients who underwent surgery. Harris Hip Score (excellent results were showed in 54.4% for non-operative-treated patients) showed also statistical significance, p < 0.005. Conclusion. Proper diagnostics and proper definitive diagnosis can avoid surgical treatment if the fracture cannot be treated surgically, making the postoperative period more comfortable for the patient.
{"title":"A retrospective analysis of different treatments of posterior acetabular wall fracture","authors":"B. Starcevic, Stefan Korica, Z. Radojicic, I. Djorić, M. Kadija, A. Starcevic","doi":"10.2298/sarh221214039s","DOIUrl":"https://doi.org/10.2298/sarh221214039s","url":null,"abstract":"Introduction/Objective. Analysis of clinical outcomes of non-surgical conservative and operative management of patients with posterior acetabular wall fractures. Methods: We investigated 88 fractures of the acetabular joint, 31 of which were treated surgically and 57 non-surgically. Only screws or reconstruction plates and screws were used for surgical treatment and traction in patients who underwent nonsurgical treatment. The study period lasted at least three years. The measures used to assess the outcome of operative, surgical and non-operative, conservative approach were Merle D'Aubigne modified score, Harris hip score, and Matta radiometric criteria. Results. Matta evaluation criteria showed excellent score for 40.40% in conservatively treated patients; 19.4% in patients who underwent surgery; good score for 49.10% in conservatively treated patients; 48.40% in patients who underwent surgery. Comparation between two group patients differently treated, by Merle D?Aubigne tool, showed excellent results for 56.10% conservatively-treated patients and 25.8% in those patients who underwent surgery and good results in 29.8% conservatively-treated patients and 38.7% in patients who underwent surgery. Harris Hip Score (excellent results were showed in 54.4% for non-operative-treated patients) showed also statistical significance, p < 0.005. Conclusion. Proper diagnostics and proper definitive diagnosis can avoid surgical treatment if the fracture cannot be treated surgically, making the postoperative period more comfortable for the patient.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68731103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miodrag Glisic, Vladan Stevanovic, Aleksandar Jevtic, Milan Mirkovic, Ljubomir Dakovic, Angelica Stankovic, Sanja Mirkovic, Lazar Miceta
Introduction/Objective Heel deformity accompanied by pain at the attachment of the Achilles tendon is generally known as Haglund?s syndrome. The prominence of the posterosuperior part of the heel bone generates pressure on the retrocalcaneal bursa and Achilles tendon, causing swelling and pain. The condition itself can be treated using surgical or non-surgical methods. The aim was to present our first experiences in the endoscopic treatment of Haglund?s syndrome, employing the three-portal technique. Methods This study includes ten patients whose surgeries were performed during the period between January 2019, and May 2020. All interventions were endoscopic with the three-portal technique used. The diagnosis was made based on the anamnesis, clinical examination, X-rays, and magnetic resonance imaging diagnostics. For the evaluation of results, the AOFAS (American Orthopedic Foot and Ankle Society) score was used. Results The endoscopic findings in all patients revealed a hypertrophic retrocalcaneal bursa and prominence at the posterosuperior part of the calcaneus, generating pressure on the Achilles tendon. By employing the three-portal technique, considerably better visualization is obtained, enabling easy removal of the degenerated tissue. The radiographic control image was satisfactory. The result of the AOFAS score showed a significant improvement after the surgery. Conclusion The endoscopic approach and the use of the three-portal technique in resolving Haglund?s syndrome is a secure procedure that produces good results. It enables faster recovery and fewer complications compared to open surgery.
{"title":"The advantage of endoscopic treatment of Haglund's syndrome with the three-portal technique","authors":"Miodrag Glisic, Vladan Stevanovic, Aleksandar Jevtic, Milan Mirkovic, Ljubomir Dakovic, Angelica Stankovic, Sanja Mirkovic, Lazar Miceta","doi":"10.2298/sarh23033089g","DOIUrl":"https://doi.org/10.2298/sarh23033089g","url":null,"abstract":"Introduction/Objective Heel deformity accompanied by pain at the attachment of the Achilles tendon is generally known as Haglund?s syndrome. The prominence of the posterosuperior part of the heel bone generates pressure on the retrocalcaneal bursa and Achilles tendon, causing swelling and pain. The condition itself can be treated using surgical or non-surgical methods. The aim was to present our first experiences in the endoscopic treatment of Haglund?s syndrome, employing the three-portal technique. Methods This study includes ten patients whose surgeries were performed during the period between January 2019, and May 2020. All interventions were endoscopic with the three-portal technique used. The diagnosis was made based on the anamnesis, clinical examination, X-rays, and magnetic resonance imaging diagnostics. For the evaluation of results, the AOFAS (American Orthopedic Foot and Ankle Society) score was used. Results The endoscopic findings in all patients revealed a hypertrophic retrocalcaneal bursa and prominence at the posterosuperior part of the calcaneus, generating pressure on the Achilles tendon. By employing the three-portal technique, considerably better visualization is obtained, enabling easy removal of the degenerated tissue. The radiographic control image was satisfactory. The result of the AOFAS score showed a significant improvement after the surgery. Conclusion The endoscopic approach and the use of the three-portal technique in resolving Haglund?s syndrome is a secure procedure that produces good results. It enables faster recovery and fewer complications compared to open surgery.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135262222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The COVID-19 pandemic occurred at a high spreading rate with sudden pattern changes, high variability, and unpredictability. This generated uncertainty making it hard for authorities to predict, plan and conventionally prepare preventive and suppressive actions. As a result, governments worldwide had to find new, more comprehensive, and complex solutions to manage the health sector in a turbulent environment. The paper's main objective is to analyze different organizational practices that respond to the COVID-19 crisis regarding healthcare sector resilience and describe best practices. Health sector authorities should consider applying the ?new mode of governance,? which refers to a policy not limited to a single approach with less hierarchy and formalism and with a flatter governance structure. Countries that have had more success in COVID-19 crisis suppression applied "dynamic resilience" with decentralization in decision-making, a more important role of front-line healthcare providers, high transparency, and flexibility enabling continuous adaptation to rapidly changing conditions.
{"title":"Insights into health sector governance in a turbulent environment - towards best-practice approach","authors":"Predrag Jovanovic, Sanja Stojkovic-Zlatanovic, Mladen Cudanov","doi":"10.2298/sarh220629084j","DOIUrl":"https://doi.org/10.2298/sarh220629084j","url":null,"abstract":"The COVID-19 pandemic occurred at a high spreading rate with sudden pattern changes, high variability, and unpredictability. This generated uncertainty making it hard for authorities to predict, plan and conventionally prepare preventive and suppressive actions. As a result, governments worldwide had to find new, more comprehensive, and complex solutions to manage the health sector in a turbulent environment. The paper's main objective is to analyze different organizational practices that respond to the COVID-19 crisis regarding healthcare sector resilience and describe best practices. Health sector authorities should consider applying the ?new mode of governance,? which refers to a policy not limited to a single approach with less hierarchy and formalism and with a flatter governance structure. Countries that have had more success in COVID-19 crisis suppression applied \"dynamic resilience\" with decentralization in decision-making, a more important role of front-line healthcare providers, high transparency, and flexibility enabling continuous adaptation to rapidly changing conditions.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135441504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction. The clinical course of premature infants born to mothers with coronavirus disease 2019 (COVID-19) has not been well characterized. The aim of this paper was to report a complicated clinical course with pulmonary air leak syndrome (pneumomediastinum and pneumothorax) in a premature infant born to mother with COVID-19. Case outline. The patient was a male infant born at 35 weeks of gestation. The mother had confirmed coronavirus pneumonia 6 days prior to delivery. At approximately 25 hours of age, chest X-ray showed pneumomediastinum, giving the classic ?spinnaker sail? sign. After intubation, chest X-ray showed the typical ?angel wing? sign, which represents pneumomediastinum and bilateral pneumothorax (pulmonary air leak syndrome). Conclusion. Based on the presented case, we believe that the mother's COVID-19 infection is an additional risk factor for the occurrence of pulmonary air leaks in the infant. To confirm this hypothesis as well as explain the exact pathophysiology of air leakage in COVID-19, larger, prospective, and well-designed studies are needed.
{"title":"Pulmonary air leak syndrome in premature infant born to mother with coronavirus disease","authors":"Lidija Banjac, Boban Banjac","doi":"10.2298/sarh220928103b","DOIUrl":"https://doi.org/10.2298/sarh220928103b","url":null,"abstract":"Introduction. The clinical course of premature infants born to mothers with coronavirus disease 2019 (COVID-19) has not been well characterized. The aim of this paper was to report a complicated clinical course with pulmonary air leak syndrome (pneumomediastinum and pneumothorax) in a premature infant born to mother with COVID-19. Case outline. The patient was a male infant born at 35 weeks of gestation. The mother had confirmed coronavirus pneumonia 6 days prior to delivery. At approximately 25 hours of age, chest X-ray showed pneumomediastinum, giving the classic ?spinnaker sail? sign. After intubation, chest X-ray showed the typical ?angel wing? sign, which represents pneumomediastinum and bilateral pneumothorax (pulmonary air leak syndrome). Conclusion. Based on the presented case, we believe that the mother's COVID-19 infection is an additional risk factor for the occurrence of pulmonary air leaks in the infant. To confirm this hypothesis as well as explain the exact pathophysiology of air leakage in COVID-19, larger, prospective, and well-designed studies are needed.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135711575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Optical coherence tomography with angiography (OCT-A) is a non-invasive imaging technique that enables three-dimensional visualization of perfusion through the vascular network of the retina and choroid. The possibilities of OCT-A for glaucomatologists will expand in the near future. The possibility of detecting and monitoring glaucoma with this technology will also be expanded. All of these systems will undoubtedly offer software updates, making it easier for examiners to use the device itself, and thus monitor disease. OCT-A represents the future in the diagnosis of retinal diseases and glaucoma.
{"title":"Optical coherent tomography with angiography in glaucoma","authors":"Ivan Marjanovic, Vesna Maric, Marija Bozic","doi":"10.2298/sarh230211096m","DOIUrl":"https://doi.org/10.2298/sarh230211096m","url":null,"abstract":"Optical coherence tomography with angiography (OCT-A) is a non-invasive imaging technique that enables three-dimensional visualization of perfusion through the vascular network of the retina and choroid. The possibilities of OCT-A for glaucomatologists will expand in the near future. The possibility of detecting and monitoring glaucoma with this technology will also be expanded. All of these systems will undoubtedly offer software updates, making it easier for examiners to use the device itself, and thus monitor disease. OCT-A represents the future in the diagnosis of retinal diseases and glaucoma.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135505598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jelena Vasilijevic, Jelica Pantelic, Jelena Mirkovic, Barri Al, Igor Kovacevic
Introduction. Von Hippel-Lindau disease is a hereditary, autosomal dominant, tumor syndrome with predisposition to development of various benign and malignant tumors. Retinal hemangioblastoma is often the presenting manifestation. We report a case of Von-Hippel-Lindau disease in a 13-year-old girl with bilateral eye involvement. Case Outline. The patient was referred to the Eye Clinic, University Clinical Center of Serbia with diagnosis of Coats disease. Clinical examination revealed that best corrected visual acuity was 20/20 on her right eye, while her left eye showed counting fingers at twenty centimeters distance. Dilated fundoscopy of the right eye revealed multiple tortuous feeding vessels leading to orange-reddish, sharply demarcated multiple lesions on the far periphery of the upper retina, corresponding to retinal hemangioblastoma. Left eye showed edematous optic nerve head, tortuous retinal vessels, exudates, and retinal detachment including macula. Considering that patient had multiple bilateral retinal hemangioblastomas and that her father had pathohistologically proven brain hemangioblastoma and numerous visceral tumors, Von Hippel-Lindau disease was assumed. Focal argon laser photocoagulation was performed in the region of all visible vascular tumors and feeding vessels in the right eye. Patient?s visual acuity remained unchanged five months after the disease detection. Conclusion. The importance of education about dominant inheritance pattern of Von Hippel-Lindau disease cannot be overemphasized. Role of an ophthalmologist is critical in early diagnosis of both retinal hemangioblastoma and Von Hippel-Lindau disease.
{"title":"Photocoagulation for retinal hemangioblastoma in Von Hippel-Lindau disease","authors":"Jelena Vasilijevic, Jelica Pantelic, Jelena Mirkovic, Barri Al, Igor Kovacevic","doi":"10.2298/sarh230526094v","DOIUrl":"https://doi.org/10.2298/sarh230526094v","url":null,"abstract":"Introduction. Von Hippel-Lindau disease is a hereditary, autosomal dominant, tumor syndrome with predisposition to development of various benign and malignant tumors. Retinal hemangioblastoma is often the presenting manifestation. We report a case of Von-Hippel-Lindau disease in a 13-year-old girl with bilateral eye involvement. Case Outline. The patient was referred to the Eye Clinic, University Clinical Center of Serbia with diagnosis of Coats disease. Clinical examination revealed that best corrected visual acuity was 20/20 on her right eye, while her left eye showed counting fingers at twenty centimeters distance. Dilated fundoscopy of the right eye revealed multiple tortuous feeding vessels leading to orange-reddish, sharply demarcated multiple lesions on the far periphery of the upper retina, corresponding to retinal hemangioblastoma. Left eye showed edematous optic nerve head, tortuous retinal vessels, exudates, and retinal detachment including macula. Considering that patient had multiple bilateral retinal hemangioblastomas and that her father had pathohistologically proven brain hemangioblastoma and numerous visceral tumors, Von Hippel-Lindau disease was assumed. Focal argon laser photocoagulation was performed in the region of all visible vascular tumors and feeding vessels in the right eye. Patient?s visual acuity remained unchanged five months after the disease detection. Conclusion. The importance of education about dominant inheritance pattern of Von Hippel-Lindau disease cannot be overemphasized. Role of an ophthalmologist is critical in early diagnosis of both retinal hemangioblastoma and Von Hippel-Lindau disease.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135506892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Milena Kostic, Marina Fišeković-Kremić, Mira Kiš-Veljković
Introduction/Objective. Mild cognitive impairment (MCI) is a state of progressive cognitive decline, rarely recognized by general practitioners (GPs), which is a reason of late treatment and fast progression towards more serious conditions. The main obstacles for the timely treatment of MCI are lack of diagnostic protocols and clinical guidelines as well as lack of knowledge and disbelief in the pharmacological therapeutic possibilities. The aim of this investigation was to assess level of recognition of MCI symptoms by general practitioners (GPs), and to estimate their perception of distinct risk factors significance for MCI development. Methods. Participants (general practitioners) of the ?Days of General Medicine? Conference (Serbia, March 2018), n = 340, completed 12 items questionnaire about recognition and treatment of the MCI patients. We have used descriptive statistics, Chi-square, Mann-Whitney U tests, binary logistic regression analysis for results presentation, sub-groups comparison, to assess predictors of drug therapy selection, respectively. Results. Study showed GPs recognize diabetes as most important factor for MCI, then hypercholesterolemia, smoking and sedentary behavior, while hypertension and obesity are perceived as less important. Those GPs who estimated diabetes and hypercholesterolemia as more important for all patients are significantly more prone to prescribe symptomatic therapy (pentoxifylline and vinpocetine), p < 0.05 according to Chi-square test. Logistic regression analysis regarding therapy predictions showed that years of GP experience is the most important predictor of drug therapy selection (p < 0.01). Conclusion. Results of this investigation pointed a need for MCI education for young physicians, in order to improve diagnosis and treatment of these patients.
{"title":"Recognition and treatment of mild cognitive impairment in Serbian general practice","authors":"Milena Kostic, Marina Fišeković-Kremić, Mira Kiš-Veljković","doi":"10.2298/sarh210620007k","DOIUrl":"https://doi.org/10.2298/sarh210620007k","url":null,"abstract":"Introduction/Objective. Mild cognitive impairment (MCI) is a state of progressive cognitive decline, rarely recognized by general practitioners (GPs), which is a reason of late treatment and fast progression towards more serious conditions. The main obstacles for the timely treatment of MCI are lack of diagnostic protocols and clinical guidelines as well as lack of knowledge and disbelief in the pharmacological therapeutic possibilities. The aim of this investigation was to assess level of recognition of MCI symptoms by general practitioners (GPs), and to estimate their perception of distinct risk factors significance for MCI development. Methods. Participants (general practitioners) of the ?Days of General Medicine? Conference (Serbia, March 2018), n = 340, completed 12 items questionnaire about recognition and treatment of the MCI patients. We have used descriptive statistics, Chi-square, Mann-Whitney U tests, binary logistic regression analysis for results presentation, sub-groups comparison, to assess predictors of drug therapy selection, respectively. Results. Study showed GPs recognize diabetes as most important factor for MCI, then hypercholesterolemia, smoking and sedentary behavior, while hypertension and obesity are perceived as less important. Those GPs who estimated diabetes and hypercholesterolemia as more important for all patients are significantly more prone to prescribe symptomatic therapy (pentoxifylline and vinpocetine), p < 0.05 according to Chi-square test. Logistic regression analysis regarding therapy predictions showed that years of GP experience is the most important predictor of drug therapy selection (p < 0.01). Conclusion. Results of this investigation pointed a need for MCI education for young physicians, in order to improve diagnosis and treatment of these patients.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68724448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tijana Petrović, M. Bogdanović, T. Atanasijević, V. Popovic, Milena Jovanovic, Irina Banjanin, B. Radnic
Introduction. Without a comprehensive postmortem investigation it is impossible to determine the cause of death among the SARS-CoV-2 suspected and positive patients. To discuss the postmortem detectability of SARS-CoV-2 virus and RNA stability in biological samples we present two cases. Outline of cases. Case No. 1: a 40-year-old man where the autopsy was performed four days after death. The body was stored at 4?C. Bilateral pneumonia was confirmed grossly and histopathologicaly. Molecular testing was positive for IgM antibodies, but negative for SARS- CoV-2 RNA. Case No. 2: 28-year-old professional basketball player who suffered from SARS- CoV-2 about a month earlier. The autopsy was performed two days after death. The body was stored at 15?C. Gross autopsy findings revealed advanced putrefactive changes and an enlarged heart, with visible fibrotic focuses. The histopathological finding corresponded to the sudden cardiovascular death due to the cardiac dysrhythmia most probably formed in one of the fibrotic focuses. Tests for SARS-CoV-2 RNA and antibodies (IgM, IgG) were positive in the analyzed samples. Conclusion. This paper suggest that SARS-CoV-2 virus can be isolated in the biological samples even after a long post-mortem prolongation of molecular analyses. We emphasize the necessity of wider studies that will define the infectiveness and biological stability of the virus in postmortem tissues.
{"title":"Postmortem detectability and viability of SARS-COV-2 virus in various biological specimens","authors":"Tijana Petrović, M. Bogdanović, T. Atanasijević, V. Popovic, Milena Jovanovic, Irina Banjanin, B. Radnic","doi":"10.2298/sarh220118014p","DOIUrl":"https://doi.org/10.2298/sarh220118014p","url":null,"abstract":"Introduction. Without a comprehensive postmortem investigation it is impossible to determine the cause of death among the SARS-CoV-2 suspected and positive patients. To discuss the postmortem detectability of SARS-CoV-2 virus and RNA stability in biological samples we present two cases. Outline of cases. Case No. 1: a 40-year-old man where the autopsy was performed four days after death. The body was stored at 4?C. Bilateral pneumonia was confirmed grossly and histopathologicaly. Molecular testing was positive for IgM antibodies, but negative for SARS- CoV-2 RNA. Case No. 2: 28-year-old professional basketball player who suffered from SARS- CoV-2 about a month earlier. The autopsy was performed two days after death. The body was stored at 15?C. Gross autopsy findings revealed advanced putrefactive changes and an enlarged heart, with visible fibrotic focuses. The histopathological finding corresponded to the sudden cardiovascular death due to the cardiac dysrhythmia most probably formed in one of the fibrotic focuses. Tests for SARS-CoV-2 RNA and antibodies (IgM, IgG) were positive in the analyzed samples. Conclusion. This paper suggest that SARS-CoV-2 virus can be isolated in the biological samples even after a long post-mortem prolongation of molecular analyses. We emphasize the necessity of wider studies that will define the infectiveness and biological stability of the virus in postmortem tissues.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68726903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ana Vlajkovic-Ivanovic, M. Stevic, Ivana Petrov-Bojicic, Marija Marinkovic, D. Simić
The beginnings of pediatric anesthesiology go back to the center of nineteenth century, and it?s associated with a rural physician Crawford W. Long, MD, who in the 1842 recorded the first case of giving diethyl ether anesthesia to an eight-year-old boy. The start of development of contemporary pediatric anesthesia is considered to be in 1930: which marked two periods of progress. In the first period were developed anesthesia techniques and accessories adjusted to different children's ages. In the second period, modern anesthetic medications and supervision are introduced into everyday clinical practice in order to better protect vital organs and their functions in the child's body. In 1955 was established the first multidisciplinary pediatric intensive care unit at the Children?s Hospital of Goteburg in Sweden. Dr. Branka Mitrovic is considered to be the beginner of pediatric anesthesiology in our country, as she founded the Department of anesthesiology and reanimation in the University children's hospital in 1955. The history of pediatric regional anesthesia began after it?s introduction in adults, which occurred after the invention of cocaine in 1884. The Ministry of Health of the Republic of Serbia, in 2018, approved a specialisation in pediatric anesthesiology. The development of pediatric anesthesia is fascinating because it completely followed the development of pediatric surgery. Modern pediatric anesthesiology is entirely prepared to meet the needs of the most complex surgical interventions, as well as the treatment of critically ill children, and significantly contribute to the better outcomes of the treatment of pediatric surgical patients.
儿科麻醉学的起源可以追溯到19世纪中叶，而它呢?这与一位乡村医生Crawford W. Long有关，他在1842年记录了第一例给一名8岁男孩使用乙醚麻醉的病例。现代小儿麻醉的发展被认为是在1930年开始的:这标志着两个发展时期。在第一阶段，我们开发了麻醉技术和配件，以适应不同儿童的年龄。第二阶段，将现代麻醉药物和监护引入日常临床实践，以更好地保护儿童体内的重要器官及其功能。1955年，儿童医院建立了第一个多学科儿科重症监护室。瑞典哥德堡医院。Branka Mitrovic博士被认为是我国儿科麻醉学的初学者，因为她于1955年在大学儿童医院创立了麻醉学和复苏部。小儿区域麻醉的历史是从什么时候开始的呢?在1884年可卡因发明之后，美国将其引入成人。塞尔维亚共和国卫生部于2018年批准了儿科麻醉学专业。小儿麻醉的发展是令人着迷的，因为它完全跟随小儿外科的发展。现代儿科麻醉学完全可以满足最复杂的手术干预的需要，以及对危重儿童的治疗，并显著有助于儿科外科患者治疗的更好结果。
{"title":"The history of pediatric anesthesia","authors":"Ana Vlajkovic-Ivanovic, M. Stevic, Ivana Petrov-Bojicic, Marija Marinkovic, D. Simić","doi":"10.2298/sarh220824044v","DOIUrl":"https://doi.org/10.2298/sarh220824044v","url":null,"abstract":"The beginnings of pediatric anesthesiology go back to the center of nineteenth century, and it?s associated with a rural physician Crawford W. Long, MD, who in the 1842 recorded the first case of giving diethyl ether anesthesia to an eight-year-old boy. The start of development of contemporary pediatric anesthesia is considered to be in 1930: which marked two periods of progress. In the first period were developed anesthesia techniques and accessories adjusted to different children's ages. In the second period, modern anesthetic medications and supervision are introduced into everyday clinical practice in order to better protect vital organs and their functions in the child's body. In 1955 was established the first multidisciplinary pediatric intensive care unit at the Children?s Hospital of Goteburg in Sweden. Dr. Branka Mitrovic is considered to be the beginner of pediatric anesthesiology in our country, as she founded the Department of anesthesiology and reanimation in the University children's hospital in 1955. The history of pediatric regional anesthesia began after it?s introduction in adults, which occurred after the invention of cocaine in 1884. The Ministry of Health of the Republic of Serbia, in 2018, approved a specialisation in pediatric anesthesiology. The development of pediatric anesthesia is fascinating because it completely followed the development of pediatric surgery. Modern pediatric anesthesiology is entirely prepared to meet the needs of the most complex surgical interventions, as well as the treatment of critically ill children, and significantly contribute to the better outcomes of the treatment of pediatric surgical patients.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68729483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Živković, H. Čolović, D. Zlatanovic, M. Vlajković
Introduction/Objective. Dysfunctional Voiding and Incontinence Scoring System (DVISS) was created to help diagnose functional voiding disorders in children based on their clinical symptoms. However, its role in prognosticating treatment outcome in dysfunctional voiding (DV) was not explored. The aim was to analyze the pre-treatment DVISS score's ability to predict treatment outcomes in a pediatric population with DV was the study's main objective. Methods. A total of 86 patients were divided into two groups at random. In addition to standard urotherapy, group A also received pelvic floor and diaphragmatic breathing exercises, while group B only received standard urotherapy. Initial and final DVISS scores for the 12-month treatment period were recorded. Both before and after the treatment, uroflowmetry with pelvic floor electromyography were performed together with residual urine volumes measurement. The treatment outcome (non-, partial and full response) was defined according to the objective improvement in daytime and nighttime wetting, constipation, urinary infections and uroflowmetry findings. The cut-off values, sensitivity, and specificity of the pre-treatment DVISS score in predicting non/partial and full response in group A and B were determined using Receiver Operating Characteristic (ROC) curve analysis. Results. Pre-treatment DVISS score could not predict full response in both groups (the area under the ROC curve < 0.50) nor non-/ partial response in A group (p = 0.127). In B group, sensitivity and specificity of the initial DVISS score (cut-off value 9.5) in prediction of non-/partial response was 73.1% and 33.3%, respectively (p = 0.043). Conclusion. DVISS cannot be used in the treatment result prediction in DV.
{"title":"Can pre-treatment dysfunctional voiding and incontinence scoring system score predict treatment outcome in children with dysfunctional voiding - a randomized trial","authors":"V. Živković, H. Čolović, D. Zlatanovic, M. Vlajković","doi":"10.2298/sarh221023068z","DOIUrl":"https://doi.org/10.2298/sarh221023068z","url":null,"abstract":"Introduction/Objective. Dysfunctional Voiding and Incontinence Scoring System (DVISS) was created to help diagnose functional voiding disorders in children based on their clinical symptoms. However, its role in prognosticating treatment outcome in dysfunctional voiding (DV) was not explored. The aim was to analyze the pre-treatment DVISS score's ability to predict treatment outcomes in a pediatric population with DV was the study's main objective. Methods. A total of 86 patients were divided into two groups at random. In addition to standard urotherapy, group A also received pelvic floor and diaphragmatic breathing exercises, while group B only received standard urotherapy. Initial and final DVISS scores for the 12-month treatment period were recorded. Both before and after the treatment, uroflowmetry with pelvic floor electromyography were performed together with residual urine volumes measurement. The treatment outcome (non-, partial and full response) was defined according to the objective improvement in daytime and nighttime wetting, constipation, urinary infections and uroflowmetry findings. The cut-off values, sensitivity, and specificity of the pre-treatment DVISS score in predicting non/partial and full response in group A and B were determined using Receiver Operating Characteristic (ROC) curve analysis. Results. Pre-treatment DVISS score could not predict full response in both groups (the area under the ROC curve < 0.50) nor non-/ partial response in A group (p = 0.127). In B group, sensitivity and specificity of the initial DVISS score (cut-off value 9.5) in prediction of non-/partial response was 73.1% and 33.3%, respectively (p = 0.043). Conclusion. DVISS cannot be used in the treatment result prediction in DV.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"27 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68729944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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