Medicinski pregled最新文献

{"title":"Predictors of hypotension during surgical management of femoral fractures in spinal anesthesia","authors":"Milica Gojković, A. Uvelin, M. Tatic, Vladimir Vrsjakov, D. Mihajlovic, Aleksandra Lučić-Prokin","doi":"10.2298/MPNS1808235G","DOIUrl":"https://doi.org/10.2298/MPNS1808235G","url":null,"abstract":"Introduction. Femoral fractures are the most common cause of morbidity and mortality in the elderly. The aim of this study was to establish the predictors of hypotension in the elderly patients with femoral fractures during surgery in spinal anesthesia. Material and Methods. This retrospective study included 454 patients and investigated the relationship between hypotension and predictive factors for the development of hypotension using binary logistic regression. A paired sample T-test for dependent variables was used to compare the mean arterial pressure before and after the surgical procedure. Three mean arterial pressure values were compared between subjects receiving bupivacaine and subjects who received levobupivacaine: preoperative, the lowest value during the surgery, and the mean arterial pressure at the end of the surgery. Results. The age of the subjects ranged from 20 to 93 years (mean = 71.56; standard deviation = 13.26, median = 74). The mean arterial pressure values during the preoperative evaluation (103.2 ± 14.7) were higher than the last mean arterial pressure during surgery (84.8 ± 13.6) and these differences were statistically significant (p < 0.001). The group of subjects who received levobupivacaine presented with higher values of median arterial pressure (73.99) than the group receiving bupivacaine (70.76). Conclusion. The predictors of hypotension during surgery of patients with femoral fractures in spinal anesthesia are elderly age and preoperative use of beta blockers.","PeriodicalId":18511,"journal":{"name":"Medicinski pregled","volume":"30 10 1","pages":"235-240"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72694296","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}

{"title":"The history of nursing education in Serbia and development of a department of nursing","authors":"D. Milutinović, I. Andrijević","doi":"10.2298/MPNS18S1007M","DOIUrl":"https://doi.org/10.2298/MPNS18S1007M","url":null,"abstract":"In addition to the introduction of new methods of nursing standards, one of the biggest advances made in the field of nursing in the second half of the 20th century was definitely the founding of nursing faculties in developed countries worldwide. In the time of former Yugoslavia there were several schools of higher professional education in Belgrade, Zagreb, Rijeka, Ljubljana and Sarajevo, and afterwards the others were also founded. Nevertheless, the number of senior nurses was disproportionate when compared with the number of nurses with secondary education, which certainly affected the quality of professional work and thus contributed to the development of the profession. The complexity of care in the nursing profession and the need to maintain competency and professional responsibility have forced many nurses to acquire the relevant knowledge at the related faculties (pedagogy, defectology, i.e. special education and rehabilitation or healthcare management) in an arduous and indirect way [1].","PeriodicalId":18511,"journal":{"name":"Medicinski pregled","volume":"55 1","pages":"7-8"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86256659","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}

{"title":"Treatment history: Factors that affect the outcome of hepatitis C virus treatment with interferon-alpha 2a/b and ribavirin","authors":"Tijana Spasojevic, Nevenka Bujandrić, Miloš Vujanović","doi":"10.2298/MPNS1804114S","DOIUrl":"https://doi.org/10.2298/MPNS1804114S","url":null,"abstract":"Introduction. Until the 1990s, there was no available treatment for chronic hepatitis C, but during this decade the benefits of interferon-alfa therapy were reported. At the end of the 1990s, the pegylated interferon-alfa 2a/b has significantly altered the treatment, whereas direct acting antivirals have significantly affected the treatment. The aim of this study was to show the most significant predictive factors of therapy response among patients with chronic hepatitis C treated with pegylated interferon-alfa 2a/b and ribavirin. Material and Methods. A non-randomized retrospective study included 292 patients with chronic hepatitis C treated at the Clinic for Infectious Diseases, Clinical Center of Vojvodina, from 2008 to 2015. Results. The study showed that therapeutic response was not affected by sex, serum viral load, or if the therapy was applied for the first time or repeated. A sustained virological response was statistically significantly more frequent in younger patients, as well as in patients without extrahepatic manifestations. Cases with higher progression of fibrosis were associated with lower chance for sustained virological response. Genotype 1 showed to be a predictor of adverse response to therapy, and genotype 3 as a predictor of sustained virological response. Steatosis was significantly less frequent in patients with genotype 1 with sustained virological response. Patients with a shorter duration of infection were more prone to sustained virological response. Conclusion. A positive response to pegylated interferon-alfa 2a/b and ribavirin was found in 70.20% of patients with chronic hepatitis C. Elderly age, late detection of the infection, hepatitis C virus 1 genotype, fibrosis progression, presence of hepatic steatosis, and extrahepatic manifestations were risk factors for poor treatment outcome.","PeriodicalId":18511,"journal":{"name":"Medicinski pregled","volume":"40 1","pages":"114-120"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87768423","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}

{"title":"Management of pulmonary embolism","authors":"B. Lazovic, V. Žugić","doi":"10.2298/MPNS1810330L","DOIUrl":"https://doi.org/10.2298/MPNS1810330L","url":null,"abstract":"Introduction. Pulmonary embolism is a common condition with high morbidity and mortality, particularly if misdiagnosed or untreated. It has non-specific clinical manifestations, often presenting with symptoms similar to other cardiovascular or common respiratory diseases. Dyspnea is the most common symptom. The main goals of pulmonary embolism therapy are to stop blood clots from getting bigger and prevent formation of new clots. The aim of this article was to review the clinical presentation, incidence, diagnostic algorithms and prevention of pulmonary embolism. Management of pulmonary embolism. The management of pulmonary embolism depends on patients' hemodynamic stability (hemodynamically stabile and hemodynamically unstable patients), as well as on specific conditions (population who cannot receive the same therapy as the previously mentioned patients). The management is largely focused on medical therapy of pulmonary embolism, as the first line therapy (emergency) and then on medical options for this disease. Special attention was given to urgent intravenous thrombolytic therapy in hemodynamically unstable patients, considering that these patients are the most vitally compromised, in shock and with high mortality rate. The initial treatment in hemodynamically stable patients consists of low molecular weight heparin and unfractionated heparin, which is later replaced by long term oral anticoagulation therapy. Its duration depends on the nature of the basic disease. Some populations cannot receive any thrombolytic therapy (pregnant women, patients suffering from malignant diseases and heparin-induced thrombocytopenia). These patients may receive low molecular weight heparin, unfractionated heparin and warfarin; patients with malignant diseases receive life-long anticoagulation therapy; argatroban or lepirudin are used in the management of heparin-induced thrombocytopenia. Conclusion. Prevention of pulmonary embolism is lifesaving. It includes prophylactic medical regimens and 'mechanical' supportive therapy (elastic graduated compression stockings, inferior vena cava filters).","PeriodicalId":18511,"journal":{"name":"Medicinski pregled","volume":"56 1","pages":"329-334"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89038760","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}

{"title":"Endocardial endothelium as a blood-heart barrier","authors":"Sonja Smiljic, S. Savic, Z. Milanović, Goran Grujić","doi":"10.2298/mpns1802060s","DOIUrl":"https://doi.org/10.2298/mpns1802060s","url":null,"abstract":"Introduction. Endocardial endothelium is formed from a single layer of closely related cells with complex interrelationships and extensive overlap at the junctional edges. Morphological characteristics of blood-heart barrier. Endocardium is composed of three layers: endocardial endothelium, subendothelial loose connective tissue and subendocardium. The fibrous component of the subendothelium consists of small amount of collagen and elastic fibers. Several cell types are present in subendocardium: telocytes, fibroblasts and nerve endings. Intercellular bonds between the endocardial endothelial cells. Endocardial endothelial cells are attached to one another via sets of binding proteins forming solid, adherent and communicating connections. Communicating connections form transmembrane channels between the neighboring cells, while solid and adherent connections form pericellular structures like stitches. The maintenance of the presumed transendocardial electrochemical potential difference provides a high gradient for certain ions as well as a selective boundary barrier, basal lamina, preventing ionic leakage. The negatively charged glycocalyx also modulates endothelial permeability. Electrophysiological characteristics of heart-blood barrier. Electrophysiological studies have shown the existence of a large number of membrane ion channels in the endocardial endothelial cells: inward rectifying K+ channels, Ca2+ dependent K+channels, voltage-dependent Cl- channels, volume-activated Cl- channels, stretch-activated cation channels and one carrier mediated transport mechanism - Na+K+adenosine triphosphatase. Conclusion. Numerous diseases of the cardiovascular system may be a consequence, but also the cause of the endocardial endothelium dysfunction. Selective damage to the endocardial endothelium and subendocardium is found in arrhythmia, atrial fibrillation, ischemia/reperfusion injury and heart failure. Typical lesions of endocardial and microvascular endothelium have also been described in sepsis, myocardial infarction, inflammation and thrombosis. The result of endothelial dysfunction is the weakening of the endothelial barrier regulation and electrolyte imbalance of the subendocardial interstitium.","PeriodicalId":18511,"journal":{"name":"Medicinski pregled","volume":"12 1","pages":"60-64"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79273098","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}

{"title":"Work with children with disabilities: The teachers' attitudes towards inclusion","authors":"Branka Protić-Gava, K. Boskovic, Miroslav Smajić, D. Simic-Panic, N. Naumović","doi":"10.2298/MPNS1808227P","DOIUrl":"https://doi.org/10.2298/MPNS1808227P","url":null,"abstract":"Introduction. The aim of this paper was to determine the attitudes of physical education teachers and primary school teachers towards inclusive physical education in Serbia. Material and Methods. The research included 132 examinees of both genders: 59.09% females and 40.91% males. Data were collected using an anonymous questionnaire with a 4-point Likert scale. The questionnaire dealt with teachers' previous experience, their qualifications for implementation of inclusive physical education, support and additional training for realization of inclusive physical education. Data were processed using Statistical Package for the Social Sciences 20. Normality distribution was tested by Kolmogorov-Smirnov and Shapiro-Wilk test, whilst the differences between groups (sexual dimorphism, environment, professional orientation) were examined using Mann- Whitney and Kruskal-Wallis tests at the significance level of p ≤ 0.05. Results. The findings showed that the average scores were inclined towards positive attitudes to inclusive physical education. The findings also showed that there was no statistically significant gender-related difference of attitudes between physical education teachers and primary school teachers. However, there was a statistically significant difference related to geographical background in terms of qualification levels (p = 0.02) for work with children with disorders and disabilities, as well in terms of additional training (p = 0.02) and professional orientation, since physical education teachers have less experience working with students with developmental disorders. Conclusion. Both physical education teachers and primary school teachers have positive attitudes towards inclusion. Physical education teachers have less experience working with challenged students than primary school teachers, therefore additional training programs may be required.","PeriodicalId":18511,"journal":{"name":"Medicinski pregled","volume":"165 1","pages":"227-234"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76873936","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}

{"title":"Correlation between eye and renal complications of diabetes","authors":"Katarina Anisic, S. Davidović","doi":"10.2298/MPNS1810296A","DOIUrl":"https://doi.org/10.2298/MPNS1810296A","url":null,"abstract":"Introduction. Complications of diabetes can affect almost all tissues and organs, causing high morbidity, disability and mortality. The aim of this study was to examine eye and kidney disorders of patients with patients with diabetes, and assess the correlation between them. Material and Methods. This retrospective study included 45 patients suffering from type 2 diabetes for more than ten years. The patients were divided into three groups of 15 subjects each: patients without diabetic retinopathy, patients with non-proliferative retinopathy, and patients with proliferative diabetic retinopathy. Results. The average levels of fasting blood glucose and glycosylated hemoglobin were highest in patients with proliferative diabetic retinopathy (11.27 mmol/l and 8.48%, respectively). Of 30 patients with diabetic eye diseases, diabetic maculopathy was found in 60% of cases; of those, 20% had nonproliferative retinopathy and 40% had proliferative retinopathy. The mean values of best corrected visual acuity, in both eyes, were 0.45 in patients with proliferative diabetic retinopathy, while mean values of serum urea and creatinine, creatinine clearance, and 24-h albuminuria in this group were 7.37 mmol/l, 106.13 μmol/l, 72.80 ml/min, and 346.31 mg/24h, respectively. Conclusion. Severe forms of diabetic retinopathy and nephropathy were found in patients with poor metabolic regulation. A correlation between diabetic eye and kidney diseases was established, and the level of visual damage correlated with the degree of renal function impairment.","PeriodicalId":18511,"journal":{"name":"Medicinski pregled","volume":"23 1","pages":"295-299"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82016391","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}

{"title":"Current principles of diagnosis and treatment of reactive arthritis","authors":"K. Boskovic","doi":"10.2298/mpns1810325b","DOIUrl":"https://doi.org/10.2298/mpns1810325b","url":null,"abstract":"Introduction. Reactive arthritis is an autoimmune inflammatory rheumatic disease which develops as a reaction to urogenital or intestinal infections. Clinical Signs and Symptoms. It manifests as a peripheral asymmetrical monoarthritis or polyarthritis, mainly involving the lower extremities. Apart from joints, it can also affect the spinal cord, but also involve the muscle attachment sites, tendons, bursae, conjunctiva, anterior segment of the eye, damage to the skin and mucous membranes, causing typical asymmetrical sausage-like edema of fingers and/or toes. Diagnosis. The diagnosis is based on the Berlin Diagnostic Criteria including the characteristics of peripheral arthritis and evidence of previous infection. Approximately 65% - 85% of patients with reactive arthritis are positive for human leukocyte antigen - B27. Treatment of Reactive Arthritis. The therapy includes antibiotics chosen according to the antibiogram for the causative agent of the infection. The therapy is aimed at pain management and control of the autoimmune response of synovial lining of the joints, i.e. at prevention of articular damage. Drug therapy includes non-steroidal anti-inflammatory drugs, analgesics, steroids, immunosuppressive agents and biological drugs. Other methods of treatment are also recommended, such as rest in the acute phase of the disease, physical therapy and patient's education. Conclusion. Development of new diagnostic methods, particularly molecular diagnostics, and new therapeutic modalities using new generation drugs, has created conditions for more efficient treatment of reactive arthritis.","PeriodicalId":18511,"journal":{"name":"Medicinski pregled","volume":"126 1","pages":"323-327"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89884210","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}

{"title":"Evaluation of the cognitive and affective status in hemodialysis patients with chronic renal failure","authors":"Aleksandra Jakovljevic, V. Nestorovic, M. Dejanović, Z. Bukumirić, A. Jakovljević, Novica Djokovic","doi":"10.2298/MPNS1808222J","DOIUrl":"https://doi.org/10.2298/MPNS1808222J","url":null,"abstract":"Introduction. Hemodialysis patients with chronic renal failure, suffer from affective dysfunction to a variable extent. The aim of our study was to evaluate the cognitive and affective status in patients before and after hemodialysis. Apart from this, the goal of the study was to examine and compare the cognitive status of patients on dialysis in relation to the control group, but also in relation to laboratory parameters. Material and Methods. This research was a prospective study including 30 hemodialysis patients with chronic renal failure treated at the Department of Nephrology of the Health Center in Kosovska Mitrovica. The cognitive status of the subjects was evaluated by determining the simple reaction time to auditory and visual stimuli before and after hemodialysis sessions and using the Mini Mental Status Examination, while the affective status was evaluated by using the Beck Depression Inventory. Results. The analysis of the obtained results showed a statistically significantly lower auditory and visual simple reaction times (p = 0.014) after dialysis (p = 0.023). The results have confirmed a statistically significantly decreased simple reaction time to visual stimuli (p = 0.001), while a statistical significance (p = 0.137) was not obtained for the auditory stimuli when compared to the control group. The Mini Mental Status Examination and the Beck Depression Inventory did not indicate a significant cognitive status damage or presence of depression. Conclusion. The importance of hemodialysis in the improvement of cognitive function is clearly evident, even though the general state of cognitive status in patients on hemodialysis is lower compared to the healthy population. Evaluation of the cognitive and affective status using simple reaction time, Folstein's Mini Mental State Examination and the Beck Depression Inventory, should be used on daily basis in hemodialysis patients.","PeriodicalId":18511,"journal":{"name":"Medicinski pregled","volume":"71 1","pages":"222-226"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87345792","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}

{"title":"Ruptured abdominal aortic aneurysm after endovascular repair","authors":"J. Pasternak, V. Popović, S. Budinski","doi":"10.2298/MPNS1806195P","DOIUrl":"https://doi.org/10.2298/MPNS1806195P","url":null,"abstract":"Introduction. An aneurysm is a localized, permanent dilation of an arterial blood vessel with a diameter greater than 50% of the usual diameter for that aortic segment. It is treated with endovascular stent graft placement or open surgery. Endovascular stent grafting of the abdominal aorta has become popular as an elective treatment. but one of the complications is increased aneurysm diameter that may lead to rupture. Case Series. This case series reviews open reconstructive surgery of ruptured abdominal aortic aneurysms in three patients treated with endovascular repair. The diameter of the aneurysm increased due to endoleak or stent graft migration, leading to rupture. Due to the inability to extract the stent graft in two patients, the graft was transversely cut at the proximal part, where upper anastomosis was created using a Dacron graft prosthesis. Conclusion. Regular annual controls for the rest of patients lives are of great importance in order to avoid fatal complications after endovascular aneurysm repair. One of the methods after the abdominal aortic rupture after endovascular stent graft treatment that significantly shortens the duration of the surgery and gives a more stable upper anastomosis, is transverse stent graft cut in the proximal part. Complete prevention remains a challenge because a rupture may occur even if the abnormalities are not evident. The ultimate goal is to increase the survival rate after the ruptured abdominal aortic aneurysm.","PeriodicalId":18511,"journal":{"name":"Medicinski pregled","volume":"103 1","pages":"195-200"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77191459","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}