{"title":"The Vojnosanitetski pregled in 2022: Challenges as an incentive for improvement","authors":"D. Vučević","doi":"10.2298/vsp2301005v","DOIUrl":"https://doi.org/10.2298/vsp2301005v","url":null,"abstract":"<jats:p>nema</jats:p>","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","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":"68340551","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}
Milica Zeravica, A. Matic, M. Matic, Miloš Pajić, S. Prcic
Introduction. Infantile hemangiomas (IHs) are the most common vascular tumors of infancy. Their frequency increases with decreasing gestational age. Periorbital IHs (PIHs), although rare, have a high complication rate, with a substantial risk of impaired vision and aesthetic consequences. Thus, they are considered high-risk IHs and require treatment. In the available literature there is little information about the treatment of IHs in very and extremely preterm infants. Case report. We present three male infants (one very and two extremely prematurely born) with PIHs involving the upper eyelid. In all three cases IHs were solitary but with different subtypes according to soft-tissue depth (superficial; combined; deep). In none of the cases no additional congenital anomalies were found. An individualized approach to the management of each patient was applied. All infants were treated with oral propranolol, with careful monitoring for potential side effects and adjustment of treatment accordingly. Introduction of oral propranolol was carried out in a hospital setting, with a gradual increase of the drug dose, until the target dose is reached. Conclusion. In the case of PIH, an ophthalmologist is an inevitable part of the medical team. Very and extremely preterm infants are already under the supervision of an ophthalmologist due to mandatory screening for retinopathy of prematurity, but if they also have PIHs, monitoring must be particularly detailed and long-lasting.
{"title":"Infantile hemangioma of the upper eyelid in one very and in two extremely preterm infants","authors":"Milica Zeravica, A. Matic, M. Matic, Miloš Pajić, S. Prcic","doi":"10.2298/vsp240402038z","DOIUrl":"https://doi.org/10.2298/vsp240402038z","url":null,"abstract":"Introduction. Infantile hemangiomas (IHs) are the most common vascular tumors of infancy. Their frequency increases with decreasing gestational age. Periorbital IHs (PIHs), although rare, have a high complication rate, with a substantial risk of impaired vision and aesthetic consequences. Thus, they are considered high-risk IHs and require treatment. In the available literature there is little information about the treatment of IHs in very and extremely preterm infants. Case report. We present three male infants (one very and two extremely prematurely born) with PIHs involving the upper eyelid. In all three cases IHs were solitary but with different subtypes according to soft-tissue depth (superficial; combined; deep). In none of the cases no additional congenital anomalies were found. An individualized approach to the management of each patient was applied. All infants were treated with oral propranolol, with careful monitoring for potential side effects and adjustment of treatment accordingly. Introduction of oral propranolol was carried out in a hospital setting, with a gradual increase of the drug dose, until the target dose is reached. Conclusion. In the case of PIH, an ophthalmologist is an inevitable part of the medical team. Very and extremely preterm infants are already under the supervision of an ophthalmologist due to mandatory screening for retinopathy of prematurity, but if they also have PIHs, monitoring must be particularly detailed and long-lasting.","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","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":"68341035","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}
Background/Aim. The stage of oral cavity carcinoma (OCC), and the nodal involvement define the treatment selection, outcome and the prognosis of the disease. In determining the stage of OCC, the most widely applied methods are computerized tomography (CT) and magnetic resonance imaging (MRI), whose limitations can be overcome to some extent by using intraoral ultrasound. The aim of the study was to evaluate the imaging presentation of early-stage OCC, to determine the depth of invasion (DOI) and the largest diameter of the tumor (greatest dimension - GD) by intraoral ultrasound (IOUS) and CT methods, and to compare it with histopathological (HP) findings. Methods. The study was designed as a prospective one, with the time limitation of 3 months. Eleven patients with clinical earlystage OCC, underwent a native CT examination of the head and neck as well as contrast enhanced phase and then, IOUS of the lesion was performed. Using both methods, DOI and GD values were measured, and the values were correlated with HP findings. The analysis of the obtained data was performed using the statistical package SPSS 22 and Pearson correlation coefficient. Results. A significant correlation (p = 0.001) was established between the DOI values measured by IOUS and CT examination with the measurements obtained by HP processing. On the other hand, by comparing the GD measured on IOUS and CT examination, no correlation was established with the HP report. Conclusion. Measurements of DOI obtained by IOUS significantly correlated with those in HP report, while overcoming the limitations of the CT method in the evaluation of small sized tumors and tumors that cannot be shown due to artifacts.
{"title":"Comparative assessment of the depth of invasion of early-stage oral cavity carcinomas based on intraoral ultrasound and computerized tomography findings","authors":"Biljana Markovic-Vasiljkovic, Svetlana Antic, Drago Jelovac","doi":"10.2298/vsp221202048m","DOIUrl":"https://doi.org/10.2298/vsp221202048m","url":null,"abstract":"Background/Aim. The stage of oral cavity carcinoma (OCC), and the nodal involvement define the treatment selection, outcome and the prognosis of the disease. In determining the stage of OCC, the most widely applied methods are computerized tomography (CT) and magnetic resonance imaging (MRI), whose limitations can be overcome to some extent by using intraoral ultrasound. The aim of the study was to evaluate the imaging presentation of early-stage OCC, to determine the depth of invasion (DOI) and the largest diameter of the tumor (greatest dimension - GD) by intraoral ultrasound (IOUS) and CT methods, and to compare it with histopathological (HP) findings. Methods. The study was designed as a prospective one, with the time limitation of 3 months. Eleven patients with clinical earlystage OCC, underwent a native CT examination of the head and neck as well as contrast enhanced phase and then, IOUS of the lesion was performed. Using both methods, DOI and GD values were measured, and the values were correlated with HP findings. The analysis of the obtained data was performed using the statistical package SPSS 22 and Pearson correlation coefficient. Results. A significant correlation (p = 0.001) was established between the DOI values measured by IOUS and CT examination with the measurements obtained by HP processing. On the other hand, by comparing the GD measured on IOUS and CT examination, no correlation was established with the HP report. Conclusion. Measurements of DOI obtained by IOUS significantly correlated with those in HP report, while overcoming the limitations of the CT method in the evaluation of small sized tumors and tumors that cannot be shown due to artifacts.","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","volume":"12 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":"135446543","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}
Julija Radojicic, Branislav Trifunovic, Aleksandra Radojicic, Tatjana Cutovic
nema
尼玛
{"title":"Orthodontic therapy in children with bilateral cleft lip and palate: presurgical orthopedic aspects in the newborn period","authors":"Julija Radojicic, Branislav Trifunovic, Aleksandra Radojicic, Tatjana Cutovic","doi":"10.2298/vsp230728056r","DOIUrl":"https://doi.org/10.2298/vsp230728056r","url":null,"abstract":"nema","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","volume":"22 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":"136008209","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}
D. Kostić, M. Misovic, Filip Vuckovic, Djuro Crevar, Igor Sekulic, B. Georgievski-Brkic, S. Kostic, E. Dinčić
Background/Aim.Since 2014 and the publication of the results of the first study on the accumulation of gadolinium contrast, we have witnessed a growing body of evidence on the deposition and retention of gadolinium in the brain after the use of gadolinium-based contrast agents (GBCAs). However, there is still no strong clinical evidence of the adverse effects of GBCAs on the brain. The aim of the study was to determine the existence of gadolinium deposits in the brain of patients with realpsing-remiting (RR) multiple sclerosis (MS), after a 10-year follow-up period. During this period the patients have regularly,each year, undergone magnetic resonance imaging (MRI) with the administration of gadolinium contrast (gadopentetate dimeglumine - Magnevist?) in order to follow the course of the disease. Methods. A cohort of 20 patients was formed for the aim of this study. The ratio of the values of the signal intensity (SI) of different regions of the brain-to- cerebrospinal fluid (CSF) was compared , for each patient, on the initial MRI examination, and on MRI examination 10 years later . Results. Frontal cortex -to-CSF (p<0.01), occipital cortex-to-CSF (p <0.01), the white matter of the radial corona-to-CSF (p <0.01), parietal cortex-to-CSF (p <0.05), thalamus-to-CSF (p = 0.051), putamen-to-CSF (p =0.06), and anterior and posterior limb of the capsula interna -to-CSF (p=0.062) SI ratios increased after multiple gadopentetate administrations. Conclusion. In the cohort of 20 patients there was a statistically significant increase in SI in the pre-contrast T1W sequence in the following structures: frontal, parietal, and occipital cortex, as well as supratentorial white matter. An increase in the absolute values of the T1W signal in ? patients was registered in the frontal and occipital cortex and cerebellar hemispheres. Slightly less, but more than 55-65% of increase in SI was registered in structures of the parietal cortex, putamen, cornu anterior and posterior of the capsule interna, corpus callosum (CC) splenium, pons, thalamus, nucleus caudatus (NC), substantia nigra (SN), CC genu and temporal cortex.This result speaks in favor of the existence of chronic accumulation of gadolinium contrast agent gadopentetate dimeglumine, in brain structures.
{"title":"Gadolinium deposition in the brain of patients with relapsing-remitting multiple sclerosis after 10 years of follow-up","authors":"D. Kostić, M. Misovic, Filip Vuckovic, Djuro Crevar, Igor Sekulic, B. Georgievski-Brkic, S. Kostic, E. Dinčić","doi":"10.2298/vsp220314018k","DOIUrl":"https://doi.org/10.2298/vsp220314018k","url":null,"abstract":"Background/Aim.Since 2014 and the publication of the results of the first study on the accumulation of gadolinium contrast, we have witnessed a growing body of evidence on the deposition and retention of gadolinium in the brain after the use of gadolinium-based contrast agents (GBCAs). However, there is still no strong clinical evidence of the adverse effects of GBCAs on the brain. The aim of the study was to determine the existence of gadolinium deposits in the brain of patients with realpsing-remiting (RR) multiple sclerosis (MS), after a 10-year follow-up period. During this period the patients have regularly,each year, undergone magnetic resonance imaging (MRI) with the administration of gadolinium contrast (gadopentetate dimeglumine - Magnevist?) in order to follow the course of the disease. Methods. A cohort of 20 patients was formed for the aim of this study. The ratio of the values of the signal intensity (SI) of different regions of the brain-to- cerebrospinal fluid (CSF) was compared , for each patient, on the initial MRI examination, and on MRI examination 10 years later . Results. Frontal cortex -to-CSF (p<0.01), occipital cortex-to-CSF (p <0.01), the white matter of the radial corona-to-CSF (p <0.01), parietal cortex-to-CSF (p <0.05), thalamus-to-CSF (p = 0.051), putamen-to-CSF (p =0.06), and anterior and posterior limb of the capsula interna -to-CSF (p=0.062) SI ratios increased after multiple gadopentetate administrations. Conclusion. In the cohort of 20 patients there was a statistically significant increase in SI in the pre-contrast T1W sequence in the following structures: frontal, parietal, and occipital cortex, as well as supratentorial white matter. An increase in the absolute values of the T1W signal in ? patients was registered in the frontal and occipital cortex and cerebellar hemispheres. Slightly less, but more than 55-65% of increase in SI was registered in structures of the parietal cortex, putamen, cornu anterior and posterior of the capsule interna, corpus callosum (CC) splenium, pons, thalamus, nucleus caudatus (NC), substantia nigra (SN), CC genu and temporal cortex.This result speaks in favor of the existence of chronic accumulation of gadolinium contrast agent gadopentetate dimeglumine, in brain structures.","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","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":"68337718","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}
Hüsniye Yazıbaşı, H. Pekmez, I. Agir, F. Üçkardeş, Büşra Zenci̇rci̇, Merve Aydin
Background/Aim. The radial inclination (RI) and volar cortical (VC) angle values used in the treatment of radial distal end fractures may vary depending on factors such as the age and sex of the patient. This puts up the question of how compatible can be the standard anatomical plates, which are frequently used in surgical treatment of these fractures. This study was aimed to evaluate VC and RI angles depending on age and gender of subjects and to determine the correlation between these two angles. Methods. A total of 121 individuals, 59 females and 62 male, adolescents and adults aged between 10-65 yrs, were included in the study. The individuals were divided into two groups: a group of 60 adolescents (31 female,29 males), the age was 10- 20 yrs, and a group of 61 adults (28 females,33 males) aged 20-65 yrs. The subjects were also evaluated between themselves, independently, within each age group. Radiographic images were evaluated by using the 3.0.1.55 version of the KarPacsViewer application. Measurement points were determined, and angles between these points were measured. Statistical analyzes were made using the SPSS 15.0 program. Results. When the correlation for 121 individuals was assessed independently of their sex, no statistically significant relationship was found between RI angle and age (p=0.616; r=-0.046). A statistically negative (or opposite) relationship was found between VC angle and age (p<0.001; r=-0.396). When women and men were compared in terms of RI and VC angles, no statistically significant difference was found (p=0.958; p=0,165, respectively). VC angle decreased as the age increased in females (p = 0.004; r=-0.365), while both the RI and VC angles decreased with increasing age in males ( p= 0.032, r=-0,273; p<0.0001, r=-0,445, respectively). Conclusion. In conclusion, our findings regarding RI and VC angles offer an advantage in terms of determining which plate designs are most appropriate in planning surgical procedures and treatment processes.
{"title":"Correlation of the angle in the distal part of the radius with the volar cortical angle and age-related changes of these angles","authors":"Hüsniye Yazıbaşı, H. Pekmez, I. Agir, F. Üçkardeş, Büşra Zenci̇rci̇, Merve Aydin","doi":"10.2298/vsp220727011y","DOIUrl":"https://doi.org/10.2298/vsp220727011y","url":null,"abstract":"Background/Aim. The radial inclination (RI) and volar cortical (VC) angle values used in the treatment of radial distal end fractures may vary depending on factors such as the age and sex of the patient. This puts up the question of how compatible can be the standard anatomical plates, which are frequently used in surgical treatment of these fractures. This study was aimed to evaluate VC and RI angles depending on age and gender of subjects and to determine the correlation between these two angles. Methods. A total of 121 individuals, 59 females and 62 male, adolescents and adults aged between 10-65 yrs, were included in the study. The individuals were divided into two groups: a group of 60 adolescents (31 female,29 males), the age was 10- 20 yrs, and a group of 61 adults (28 females,33 males) aged 20-65 yrs. The subjects were also evaluated between themselves, independently, within each age group. Radiographic images were evaluated by using the 3.0.1.55 version of the KarPacsViewer application. Measurement points were determined, and angles between these points were measured. Statistical analyzes were made using the SPSS 15.0 program. Results. When the correlation for 121 individuals was assessed independently of their sex, no statistically significant relationship was found between RI angle and age (p=0.616; r=-0.046). A statistically negative (or opposite) relationship was found between VC angle and age (p<0.001; r=-0.396). When women and men were compared in terms of RI and VC angles, no statistically significant difference was found (p=0.958; p=0,165, respectively). VC angle decreased as the age increased in females (p = 0.004; r=-0.365), while both the RI and VC angles decreased with increasing age in males ( p= 0.032, r=-0,273; p<0.0001, r=-0,445, respectively). Conclusion. In conclusion, our findings regarding RI and VC angles offer an advantage in terms of determining which plate designs are most appropriate in planning surgical procedures and treatment processes.","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","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":"68339167","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}
Background/Aim. There is a constant surge in need to use third-party reproductive cells among couples with inability to conceive with one's own reproductive cells, or in order to prevent passing of an inherited genetic disease to the child. The goal of the paper is to present a theoretical overview and perform a practical analysis of the use of social marketing strategies using the first technologies of analysing the attitudes of potential donors of reproductive cells in the Republic of Serbia, which would go in the direction of more specific adaptation to the target group. Methods. Empirical research in the paper is based on questionnaire about willing to be donator of reproductive cells and about having information about donation of reproductive cells in which women and men in Republic of Serbia participated. The data was obtained during 2021. and questionnaire was focused on special group of population. The questionnaire was sent to people who were 20 to 34 years old, who could be potential donors of reproductive cells. 201 women and men from Republic of Serbia participated in the research. The first part of the questionnaires were tested for internal consistency. Internal consistency was tested by Cronbach alpha coefficient calculation (?). Values of ? lower than 0.5 refers that the questionnaire possesses unacceptable consistency. Results. Empirical research conducted within the target group of potential donors gave the following results: 57% were informed about reproductive cell donation through internet, 29% by friends and family, and 11% were informed by doctors. Only 32% participants are informed and 25.1% are partially informed about donation of reproductive material in Republic of Serbia. 43 % participants were not informed about donation of reproductive material. Most of participants, 54 % said that they maybe donate their reproductive material if they had more information, 20% would donate and 26% refuse reproductive material donation. Conclusion. The target group of potential donors of reproductive cells is present in the Republic of Serbia. In addition to the analysis of attitudes, further planning, and implementation measures for the promotion of donation could influence raising awareness about the lack of reproductive material and increase the recruitment of gamete donors.
{"title":"Practical analysis of social marketing strategies impact on attitudes of potential reproductive cell donors in the Republic of Serbia","authors":"B. Djordjevic, A. Mitrovic-Jovanovic, R. Janičić","doi":"10.2298/vsp221115006d","DOIUrl":"https://doi.org/10.2298/vsp221115006d","url":null,"abstract":"Background/Aim. There is a constant surge in need to use third-party reproductive cells among couples with inability to conceive with one's own reproductive cells, or in order to prevent passing of an inherited genetic disease to the child. The goal of the paper is to present a theoretical overview and perform a practical analysis of the use of social marketing strategies using the first technologies of analysing the attitudes of potential donors of reproductive cells in the Republic of Serbia, which would go in the direction of more specific adaptation to the target group. Methods. Empirical research in the paper is based on questionnaire about willing to be donator of reproductive cells and about having information about donation of reproductive cells in which women and men in Republic of Serbia participated. The data was obtained during 2021. and questionnaire was focused on special group of population. The questionnaire was sent to people who were 20 to 34 years old, who could be potential donors of reproductive cells. 201 women and men from Republic of Serbia participated in the research. The first part of the questionnaires were tested for internal consistency. Internal consistency was tested by Cronbach alpha coefficient calculation (?). Values of ? lower than 0.5 refers that the questionnaire possesses unacceptable consistency. Results. Empirical research conducted within the target group of potential donors gave the following results: 57% were informed about reproductive cell donation through internet, 29% by friends and family, and 11% were informed by doctors. Only 32% participants are informed and 25.1% are partially informed about donation of reproductive material in Republic of Serbia. 43 % participants were not informed about donation of reproductive material. Most of participants, 54 % said that they maybe donate their reproductive material if they had more information, 20% would donate and 26% refuse reproductive material donation. Conclusion. The target group of potential donors of reproductive cells is present in the Republic of Serbia. In addition to the analysis of attitudes, further planning, and implementation measures for the promotion of donation could influence raising awareness about the lack of reproductive material and increase the recruitment of gamete donors.","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","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":"68339756","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}
Toma Kovacevic, Natalija Milisavljevic, T. Kovačević
Introduction. The reconstruction of large postoperative defects after oncologic surgery of head and neck remains challenging. Regional flaps are considered less expensive reconstructive option compared to free flaps. Pectoralis major flap is one of the most versatile choices for reconstruction of large head and neck defects. Case report. We present technical key points for safe harvesting of pectoralis major flap for two cases in a university affiliated tertiary care medical center. Both patients were male, in their seventh decade. Defect sites were: anterior side of neck and lateral neck region. Flaps were used for pharyngocutaneous fistula after total laryngectomy and irradiation. Donor site was closed primary. Both flaps healed primarily without complications. Conclusion. Pectoralis major flap has constant vascular pedicle and can successfully be used for reconstruction of large head and neck defects. Operative technique must be meticulous for obtaining absolute flap survival.
{"title":"Pectoralis major flap for pharyngocutaneous fistula after total laryngectomy- two different approaches","authors":"Toma Kovacevic, Natalija Milisavljevic, T. Kovačević","doi":"10.2298/vsp230403031k","DOIUrl":"https://doi.org/10.2298/vsp230403031k","url":null,"abstract":"Introduction. The reconstruction of large postoperative defects after oncologic surgery of head and neck remains challenging. Regional flaps are considered less expensive reconstructive option compared to free flaps. Pectoralis major flap is one of the most versatile choices for reconstruction of large head and neck defects. Case report. We present technical key points for safe harvesting of pectoralis major flap for two cases in a university affiliated tertiary care medical center. Both patients were male, in their seventh decade. Defect sites were: anterior side of neck and lateral neck region. Flaps were used for pharyngocutaneous fistula after total laryngectomy and irradiation. Donor site was closed primary. Both flaps healed primarily without complications. Conclusion. Pectoralis major flap has constant vascular pedicle and can successfully be used for reconstruction of large head and neck defects. Operative technique must be meticulous for obtaining absolute flap survival.","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","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":"68340672","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}
D. Sekulić, A. Tomić, A. Dimić, Aleksandar Mitrović, L. Davidović, D. Paunović, D. Nikolić, Uros M. Miladinovic, Igor Sekulic, N. Rančić, Momir Sarac, I. Marjanović, Ivan Leković, B. Milev
Background/Aim. The best treatment for the occlusion of the largest artery in the thigh is a femorodistal (FD) bypass. Ankle-brachial index (ABI) and multi-detector computed tomographic (MDCT) angiography are the gold standards for diagnosing peripheral arterial occlusive disease. The finite element method can help measure the quantity of blood flow and arterial pressure in the arteries in the leg. The aim of this study was to examine the possibility of using finite element analysis (FEA) method in predicting the outcome of FD bypass surgery. Methods. The research involved 45 patients who were indicated for FD arterial reconstruction from December 1, 2021, to March 31, 2023. MDCT angiography of the arteries of the lower extremities was done pre-operatively and post-operatively in all patients, based on which models were made using the finite element method, for measurement ABI. All patients had their ABI measured pre-operatively and post-operatively using the Doppler ultrasound and sphygmomanometer. Based on the findings of the pre-operative MDCT angiography, a post-operative virtual surgical model was made using the finite element method, for measurement of ABI too. The values of ABI were divided into 5 groups: ABI measured preoperatively (ABI pre-op), ABI measured postperatively (ABI post-op), ABI measured on FEA models based on the MDCT findings [ABI (sim) pre-op], ABI sim post-op, ABI measured on virtual surgery model [ABI sim post-op (virtual)]. The ABI of the models were statistically compared with pre-operative and post-operative measurements done on patients. Results. The values based on the virtual ABI model did not show significant differences compared to the values obtained using Doppler sonography /sphygmomanometer and MDCT angiography (p< 0.001). A strong statistically significant correlation was shown between the virtual ABI and the values obtained by the other two methods (p< 0.001). Conclusion. Virtual simulation based on the MDCT angiography parameters of peripheral blood vessels can be successfully used to predict the immediate outcome of the FD bypass surgery.
{"title":"Virtual ankle-brachial index - Can we predict the immediate outcome of femorodistal bypass surgery?","authors":"D. Sekulić, A. Tomić, A. Dimić, Aleksandar Mitrović, L. Davidović, D. Paunović, D. Nikolić, Uros M. Miladinovic, Igor Sekulic, N. Rančić, Momir Sarac, I. Marjanović, Ivan Leković, B. Milev","doi":"10.2298/vsp230516033s","DOIUrl":"https://doi.org/10.2298/vsp230516033s","url":null,"abstract":"Background/Aim. The best treatment for the occlusion of the largest artery in the thigh is a femorodistal (FD) bypass. Ankle-brachial index (ABI) and multi-detector computed tomographic (MDCT) angiography are the gold standards for diagnosing peripheral arterial occlusive disease. The finite element method can help measure the quantity of blood flow and arterial pressure in the arteries in the leg. The aim of this study was to examine the possibility of using finite element analysis (FEA) method in predicting the outcome of FD bypass surgery. Methods. The research involved 45 patients who were indicated for FD arterial reconstruction from December 1, 2021, to March 31, 2023. MDCT angiography of the arteries of the lower extremities was done pre-operatively and post-operatively in all patients, based on which models were made using the finite element method, for measurement ABI. All patients had their ABI measured pre-operatively and post-operatively using the Doppler ultrasound and sphygmomanometer. Based on the findings of the pre-operative MDCT angiography, a post-operative virtual surgical model was made using the finite element method, for measurement of ABI too. The values of ABI were divided into 5 groups: ABI measured preoperatively (ABI pre-op), ABI measured postperatively (ABI post-op), ABI measured on FEA models based on the MDCT findings [ABI (sim) pre-op], ABI sim post-op, ABI measured on virtual surgery model [ABI sim post-op (virtual)]. The ABI of the models were statistically compared with pre-operative and post-operative measurements done on patients. Results. The values based on the virtual ABI model did not show significant differences compared to the values obtained using Doppler sonography /sphygmomanometer and MDCT angiography (p< 0.001). A strong statistically significant correlation was shown between the virtual ABI and the values obtained by the other two methods (p< 0.001). Conclusion. Virtual simulation based on the MDCT angiography parameters of peripheral blood vessels can be successfully used to predict the immediate outcome of the FD bypass surgery.","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","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":"68340692","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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