09 - imscns

Transcription

09 - imscns

IMSCNS - International Medical Students’ Congress in Novi Sad 2009
4th International Medical Students’ Congress
In Novi Sad
Abstract Book
2009
July 16th – 19th 2009 Novi Sad, Serbia
Page | 1
Editors
Miroslav Petković
Nikola Rokvić
Dajana Lendak
Ivan Čapo
Vladimir Galić
Dunja Glišić
Nadj Zeljko
Publisher:
Faculty of Medicine Novi Sad
Copyright:
Medicinski fakultet Novi Sad, 2009.
Glavni i odgovorni urednik:
prof. dr Nikola Grujić
Uredivacki odbor:
prof. dr Stevan Popovic
prof. dr Aleksandar Milicic
prof. dr Milan Simic
prof. dr Dorde Povazan
prof. dr Nevena Secen
prof. dr Jovan Popovic
prof. dr Mirjana Martinov-Cvejin
prof. dr Dubravka Markovic
prof. dr Tomislav Cigic
dr sci. med. Silvija Brkic
Goran Mitrovic
Printed by:
Štamparija «Stojkov»
Tiraž: 200 kom
Page | 2
Contents
Introduction & Preface
4
Programme
7
Plenary Session I ( anatomy )
9
Plenary Session II ( pathology, histology & embryology, forensic medicine)
20
Plenary Session III ( biophysics, biochemistry, physiology )
30
Plenary Session IV ( microbiology & imunology, epidemiology )
39
Plenary Session V ( dentistry, otorinolaryngology, ophtalmology )
53
Plenary Session VI ( biochemistry, pathophysiology, dermatovenerology )
64
Plenary Session VII ( psichiatry, neurology )
77
Plenary Session VIII ( pediatrics)
89
Plenary Session IX ( internal medicine - cardiology, pulmology, nephrology )
97
Plenary Session X ( surgery – abdominal surgery, urology, emergency, pediatric surgery )
108
Plenary Session XI ( internal medicine – endocrinology, gastroenterology,haematology)
119
Plenary Session XII
131
(neurosurgery, vascular & transplantation surgery, plastic surgery)
Plenary Session XIII ( pharmacology)
139
Plenary Session XIV ( radyology, gyneacology & obstetrics )
152
Plenary Session XV ( infectious diseases )
166
Scientfic board
177
Honorary board of the 4th IMSCNS
178
Organisation Committee of the 4th IMSCNS
179
Friends & Partners
180
Authors Index
184
About Novi Sad
186
Map
187
Page | 3
Respected students, teachers and colleagues,
Welcome to the fourth International Medical Students’ Congress in Novi
Sad. This congress will offer a presentation for approximately 150 selected papers in
the areas of medicine, dentistry, pharmacy, molecular biology and genetics, whilst
Novi Sad will become a gathering place for about 200 students from all over the
world. We sincerely hope that the upcoming years will grant us with an even higher
number of presented papers of quality superior than the year before and that the
following congresses will be a good opportunity to converse with your foreign
colleagues.
It is an honor to be the organizer of a student congregation, applauding to
the willpower of the students to pursue their scientific research despite many scholar
engagements. Thirst for knowledge and new in formations while searching the
unknown is a motor for all sciences, especially medicine. Knowledge in medicine is
vastly expending, it actually doubles in a period of three years, many problems are
being solved, new drugs are found, but also, new questions are raised and ignorance
is born. This will always be so. Constant improvement and scientific curiosity,
forbearing, straightforward and caring relationship with the patient are a good
foundation of a solid medical worker.
Dear students, your papers have showed that you posses all of these
qualities and that you represent the future of our medical science and practice. I am
thankful for your work and effort, for your mentors with their guidance, teaching
and help. I wish you a good presentation of the results of your scientific research on
this congress while having the opportunity to exchange your first scientific
proficiencies and just have a nice time.
I hope we will be good hosts for you.
Prof. dr Stevan Popović
Dean Of Medical Faculty Novi Sad
Page | 4
Dear participants, colleagues and friends
We are honored to welcome you at the 4th International Medical Students’
Congress in Novi Sad. Founded in 2006 by students with the aim of creating a
platform for young researchers from different fields, the IMSCNS became an
institution for exchange of ideas, and experiences. Over the past four years, the
IMSCNS established a way of bringing researchers and medical staff with different
interests, but more importantly different countries together.
During the four days, the Congress will gather a great number of
professionals from Serbia and our dear colleagues from abroad. The scientific
program will seek to address the main areas of interest and current research within
the field of fundamental and applied neuroscience, and also various issues in the
spheres of theoretical, experimental and practical medicine.
We invite you to share experience and knowledge and make new
acquaintances at this event in the next four days. You can meet old friends and
develop new friendships and scientific collaborations. In addition to an intensive
scientific program, the participants will also enjoy a social program and have the
opportunity to visit beautiful Petrovaradin Fortress and several cultural and
historical attractions in Novi Sad. We hope you will find time to enjoy the relaxing
atmosphere and cultural heritage of our beautiful medieval city.
I would like to thank the Organizing Committee of the 4th IMSCNS. I
admire the work you have done and challenges you have overcome while organizing
this meeting. Also, I would like to thank the organisations and institutions that have
sponsored the Congress.
We hope that each and every one of us will benefit from this event. We
trust, that the 4th IMSCNS will mean another step towards better understanding of
something which is future of medicine. I sincerely believe that it will provide a
useful forum for exchange of ideas and the latest results in wide range of areas, as
well as an opportunity to meet experts from all over the world.
I would like to wish to all the participants success in their activities, good
health, optimism and approval of their work by others.
Yours faithfully,
Student Vice-Dean
Goran Mitrovic
Page | 5
Page | 6
Programme
10:00 – 18:00
20:00 – 21:00
21:00
July 16th 2009 - Thursday
Registration ( Faculty of Medicine, Info desk )
Opening ceremony ( Faculty of Medicine, amphitheatre I )
Dinner & Party
July 17th 2009 - Friday
07:30 – 08:30
08:30 – 10:00
10:00 – 10:30
10:30 – 12:00
12:00 – 13:00
13:00 – 14:00
14:00 – 14:30
14:30 – 16:00
21:00
Breakfast
Plenary sessions I -V ( Faculty of Medicine, amphitheatres and classrooms )
Workshop A : VATS ( The Institute for Lung Diseases, Sr. Kamenica )
Workshop B : Little school of Ultrasonography
( Clinic for Gyneacology & Obstetrics, Novi Sad )
Coffee break
Plenary sessions VI-X ( Faculty of Medicine, amphitheatres and classrooms)
Lunch ( cafe „Scenario“ )
Lecture No. 1 ( Brant Watson, Ph.D )
Coffee break
Workshop C : Emergency - Solving lifethreatining situations
Workshop D : 3D Radiotherapy - Brachitherapy
Workshop E : MRI in Neurologic disorders
Dinner & Party on the Beach
July 18th 2009 - Saturday
07:30 – 08:30
08:30 – 10:00
10:00 – 10:30
10:30 – 11:30
11:30 – 13:00
13:00 – 14:00
14:00 – 14:30
20:00 – 21:00
17:00 – 20:00
21:00
Breakfast
Plenary sessions XI-XV (Faculty of Medicine, amphitheatres and classrooms)
Coffee break
Lecture No. 2 ( Aleksandar Berić, MD Ph.D )
Lunch ( cafe „Scenario“ )
Lecture No. 3 ( Miodrag Stojković, Ph.D )
Cofee break
Workshop C : Emergency
Workshop D : 3D Radiotherapy - Teletherapy
Workshop E : MRI in Neurologic disorders
Closing ceremony ( Dress code required )
Sightseeing Tour
Dinner & Party ( boat „Zeppelin“ )
09:00 – 19:00
July 19th 2009- Sunday
Post-congress tour ( salaš 137 )
14:30 – 16:00
Page | 7
Page | 8
PLENARY Session I
(Anatomy)
Page | 9
MEDIAN ARCUATE LIGAMENT
COMPRESSION SYNDROME
OF
THE
DIAPHRAGM
(oral presentation )
Field of medicine: anatomy
Author(s): A.C. TRIFAN, A. Tamas-Szora, F.M. Tamasy, S.S. Ster, S.V. Trifoi, Paula Cornelia Varga
Supervisor(s): Precup Dorel MD, PhD
Country: Romania
Introduction: Compression and stenosis of the celiac artery by the median arcuate
ligament of the diaphragm is a well-recognized angiographic and surgical finding,
characterized by the following: moderate to severe stenosis of the proximal celiac
artery, post stenotic dilatation, and the formation of collateral vessels.
Aims: In the present study, different positions of the median arcuate ligament in
relation to the celiac trunk as well as the approach between the two structures were
investigated. In addition, histological studies of the diaphragm crura and the median
arcuate
ligament
were
performed.
Means and Method : One hundred and twenty-seven cadavers of both sexes were
studied. Dissections of the celiac trunk were performed after the preparation of the
peritoneal cavity. Regarding morphologic analysis under light microscopy, three
cadavers were randomly chose, and fragments measuring 3.5 cm height versus 2.3
cm length of the median arcuate ligament were removed. Sections of 5 µm were
stained and evaluated.
Results : The positions of the median arcuate ligament were as following, in 23
cadavers (18,11%) it overlapped the celiac artery, in 39 cadavers (30,71%) it ouched
the artery and in 65 cadavers (51,18%) the ligament was distant from the artery. The
histological analysis of the median arcuate ligament showed dense connective tissue,
adipose cells, blood vessels, nerves, intertwined with striated skeletal muscle fibers.
Conclusions :The ligament can be cathegorized in three groups: with muscular fiber
predominance, with fibrous tissue predominance and mixed. The compression of the
celiac artery by the median arcuate ligament is a fairly common situation, but in a
few cases it can become symptomatic. For the correct assessment of this condition
the investigations of choice are Computed Tomographic Angiography, Magnetic
Resonance Imaging, and Doppler Ultrasound.
Page | 10
THE EFFECTS OF A SUPPORTED EMPLOYMENT PROGRAM
ON PSYCHOSOCIAL INDICATORS
Author(s): WILLIAM M.K. TROCHIM
Country:
This paper describes the psychosocial effects of a program of supported
employment (SE) for persons with severe mental illness.
The SE program involves extended individualized supported employment
for clients through a Mobile Job Support Worker (MJSW) who maintains contact
with the client after job placement and supports the client in a variety of ways. A
50% simple random sample was taken of all persons who entered the Thresholds
Agency between 3/1/93 and 2/28/95 and who met study criteria.
The resulting 484 cases were randomly assigned to either the SE condition
(treatment group) or the usual protocol (control group) which consisted of life skills
training and employment in an in-house sheltered workshop setting. All participants
were measured at intake and at 3 months after beginning employment, on two
measures of psychological functioning (the BPRS and GAS) and two measures of
self esteem (RSE and ESE).
Significant treatment effects were found on all four measures, but they
were in the opposite direction from what was hypothesized. Instead of functioning
better and having more self esteem, persons in SE had lower functioning levels and
lower self esteem. The most likely explanation is that people who work in lowpaying service jobs in real world settings generally do not like them and experience
significant job stress, whether they have severe mental illness or not.
The implications for theory in psychosocial rehabilitation are considered.
Page | 11
FASCICULAR PATTERN OF SURAL NERVOUS COMPLEX
(poster presentation )
Author(s): NEVENA RISTIC, Predrag Stojanovic, Olivera Jelenkovic, Julijana Popovic
Supervisor(s):Ass. prof Sladjana Ugrenovic
Country: Serbia
Introduction
Fascicular morphology of peripheral nerve has very big significance for
diagnosis, prognosis and treatment for lesions of peripheral nerves.
Aim
The aim of the study is to investigate morphological and morphometrial
charecteristics of fascicular structure of human sural nerve.
Material and methods
For a material of investigetion it was used tissue of sural nerve, taken from
the external ankles of subjects different ages. Sample of the nerve was directly fixed
at 10% sollution puffered formalin and molded in paraplast, after what cross sections
were made in the nervous tissue thicker than 5 μm and collored with hematoxylin
eosin. Morphometrial analisys was done with the programme for analisys and with
proccesing of digital images.
Results
Sural nerve belongs to the type of oligofascicular nerves with average 7
fascicles. 68 fascicles were scaled and their cross section wasn’t more than 600 µm
(0,6mm). The most common were fascicles with the cross section 0,3-0,4mm,
approximately 29%. It is consolidated that there is a positive correlation between the
cross section and thickness of perineurial blanket, which shows that fascicles whit
bigger cross section have thicker perineurium. Average value of perineurial index is
5,15. Comparing average values of perineurial fascicle’s index each investigated
sample of nerve with the ages of investigated subjects, it is noted it’s increase with
ages.
Conclusion
Sural nerve belongs to the type of oligofascicular nerves with average 7
fascicles. The most common were fascicles with the cross section 0,3-0,4mm.
Thickness of perineurial blanket depends on dimension of fascicles. Perineurial
index was bigger in the elderly which shows that perineurial blanket of nerves are
thicked in elderly.
Page | 12
TYPES OF THE POSTERIOR PART OF THE CEREBRAL
ARTERIAL CIRCLE IN HUMAN ADULT CADAVERS
Author(s): TRANDAFILOVIC MILENA
Supervisor(s):Vasovic Ljiljana MD PhD
Country: Serbia
Introduction
There is a high incidence of anomalies of the posterior communicating
artery and the posterior cerebral artery (vascular components of posterior part of
cerebral arterial circle – CAC) diameters, but there is an insufficient data about types
ofthe posterior part of CAC in adult period.
Aim
This morphological study had as the aim to add new facts about
angioarchitecture of CAC
Classification of the posterior part of CACs into types and subtypes, by
already formed types from literature, was performed on 52 human adult brains
during the frensic autopsies.
Results
Incidences of bilateral transitory type was 1.92%; fetal - 3.85%; adult 63.46%; and incidence of bilateral asymmetric types were: adult-transitory - 11.54%
andadult-fetal-19.23%.
Conclusion
Investigation proved domination of symmetrical types of the posterior part
of CAC configuration, independent of age, sex or cause of death.
Page | 13
DETECTION AND SEMIQUANTITATIVE ANALISYS OF THE
EXPRIMED C-FOS PROTEIN IN FRAGILE REGIONS OF THE
RAT HIPPOCAMPAL FORMATION AS THE REACTION ON
ISHAEMIA
Field of medicine:anatomy
Author(s): OGNJEN BOJOVIĆ, Ana Zekovic, Aleksandar Mitrović, Aleksandar Mihailović, Marija
Despotović, Nevena Jocić, Miloš Sladojević, Aleksandar Bogićević, Helga Denc
Supervisor(s):Prof.dr Laslo Puškaš
Country:Serbia
Introduction
By artificially provoking ischemic attacks on rat brains accomplished by
occlusion of four blood vessels we semiquantitativly analyzed the amount of formed
c-fos protein in fragile regions of the hippocampal formation.
The amount of formed c-fos protein was analyzed after one and after two
repeated ischemic attacks conducted by use of the Pulsinelli method. By Pulsinelli
method, rats were treated on two ways and divided in two groups: as total ischemia
(by ligature of four blood vessels i.e. coagulation of vertebral artery,with billateral
ligature of carotid arteries) and as ischemic tolerant attack (by ligature of four blood
vessels i.e. coagulation of vertebral artery, with bilateral repeated ligature of carotid
arteries).
Results
By comparing the results of these two groups of rats, and by comparing
them with the control group, we determined lower concentration of the formed c-fos
in the rats brain on which repeated ischemia was conducted.
Conclusion
This fact implies that certain resistance towards ischemia was gained inthe
rat’s nervous system. This characteristic of the nervous system and c-fos
synthesis can therefore be potentially used to lower neuronal damage during and
after future ischemic attacks.
Keywords
Brain ischemia, gyrus dentatus, rats, c-fos protein
Page | 14
MAPPING AND SEMIQUANTITATIVE ANALYSIS OF THE DIFFERENCE OF
PROTOONCOGENE EXPRESSION AFTER REPEATED AND NON REPEATED
ISHAEMICAL ATTACKS ON THE RAT BRAIN
Author(s):OGNJEN BOJOVIC, Ana Zekovic, Aleksandar Mitrović, Aleksandar Mihailović,
Marija Despotović, Nevena Jocić, Miloš Sladojević, Bojana Milošević
Supervisor(s): Prof. Dr Laslo Puškaš, ass. dr Siniša Babić
Country: Serbia
Introduction: During ischemia of the brain, early genes are exprimated, out of which one
is c-fos gene. Various parts of brain are different by their resistance. Larger expression of
c-fos after ishemia was similar to the less resistant regions, while more resistant regions
expressed lower expression.
Aim: Mapping of the distribution of c-fos protein on various levels of brain sections of
the rat on the Paksinos atlas.
Methods: Ischemy of the brain was conducted by Pusilinellis method. Total (nonrepeated) ischemy was conducted by coagulation of vertebral arteries. The repeated
ishemy of the brain is a repeated ishemical attack repeated in 72. Imunohistochemical
procedures were conducted by the avidin-biotin-peroxidase method. Antibodies on c-fos
have been used. Results were semiquantitative analysed by the software “Scion Image
2000”. Cross sections on various levels of rat brains have been examined and cross
sections with most obvious results have been presented.
Results: On various cross sections of brain various density of formed proteins was
observeddepending of the sensitivity of that part of the brain and in correlation with the
type of ischemic attack. On the cross section of the rat brain that was not exposed to
ischemy (control), minimum quantity of c-fos proteins was observed. On rats with total
ischemy conducted, in region nc. supraopticus the highest expression of the c-fos was
observed. Lower expression was observed on the cross section on the level of nc.
paraventricularis, and even lower on the level of nc. hypothalamicus anterior. Highest
expression of c-fos protein was observed in the specimen of the rat brain that has been
exposed to the transitory ischemy- (non-repeated) ischemy, lower expression of c-fos
after repeated ishemy, and minimal expression on the brain which represented the control
specimen.
Conclusion: The ammount of the formed c-fos protein depends from type of the ishemy
and the region of the brain which is exposed to the ishemy. After the non-repeated
ishemy a higher ammount of c-fos is being formed, and after the repeated ishemy of the
brain, c-fos showed lower expression, from which can be concluded that the brain tissue
gains a ammount of protection from ishemia after the repeated ishemical attack
Page | 15
MORPHOLOGICAL
HEARTH SEPTUM
INVESTIGATIONS
OF
INTERATRIAL
Author(s):SASA RAJSIC, Tijana Rakic
Supervisor(s): prof. dr Gordana Teofilovski-Parapid, prof. dr Slobodan Savić
Country: Serbia
Introduction
Interatrial hearth septum has an anatomic and functional role in separating
right from left atrium. During the intrauterine period of life a physiological
communication between heart atria is realized through foramen ovale which is
getting closed till the end of the first year after delivery, though in some individuals
this closure does not happen at all.
Aim
To establish persistence and clinical importance of patent foramen ovale in
our population.
Gender, cause of death, age of deceased, as well as anatomic and
functional condition of foramen ovale have been analyzed in the sample of 1302
autopsy protocols from the Institute of Forensic Medicine in Belgrade from 2007.
Results. Anomaly of interatrial septum of human hearth in our research is noted in
51 of 1302 cases (3.92%) considering 34 from 1187 adults (2.86%), of both genders
(21 male and 11 female) age between 24 and 87 (average age 60), then, in 9 infants
(7.83%), of both genders (6 male and 3 female) averagely old 10 weeks and 8
premature babies (6.96%) averagely old from 32 weeks.
Conclusion
The relatively low frequency of anomalies of foramen ovale in the
performed research could be explained by the fact that research did not include the
whole population but only forensic autopsy material. Another possible explanation is
that existing patent foramen ovale was overlooked during the autopsy examination.
In spite of its relatively low frequency, patent foramen ovale could be very
important
in
both
positive
and
negative
sense.
Key words
Patent foramen ovale, paradoxical embolism, interatrial communication.
Page | 16
FREQUENCY OF ABSENSE OF PALMARIS LONGUS MUSCLE
Field of medicine: anatomy-surgery
Author(s): NIKOLA VUČINIĆ
Supervisor(s): Mirela Erić, MD, MSc and Dragan Krivokuća, MD, PhD
Country: Serbia
Introduction
Palmaris longus muscle is frequently described as one of the most variable muscles
in human body, yet is often missing in its entirety.
Aim
The main goal of this research was to establish the frequency of absense of
palmaris longus muscle within the general population in relation to the gender and
the position on the human body.
Material and Methodology
The research was conducted on the sample of 200 male and equal number of female
examinees. The existence of palmaris longus muscle was examined on both left and right
forearm of each particular examinee, using standard and other tests. Absolute and relative
numbers as well as statistical significance tests were utilized during processing of the acquired
statistical data, with results presented with
graphic and in the form of charts.
Results
By the utilization of the statistical data processing, it has been established that
within general population, palmaris longus muscle is more frequently missing on a single arm,
rather than both (24.25% vs. 18%), that is, more frequently on the left rather than right forearm
(15% vs. 9.25%). Frequency of absense of palmaris longus muscle on the right (12.55) and left
(10.55) forearm within male examinees is found to be statistically insignificant, while the
frequency of absence of the above muscle on the right (6%) and left (19.5%) forearm within
female examinees was statistically significant. The palmaris longus muscle was found to be
entirely missing within 20% of male and 16% of female examinees. Palmaris longus muscle of
the right forearm is found to be more frequently missing within male gender, while on the left
within females. The difference is statistically significant.
Conclusion
Palmaris longus muscle is found to be more frequently missing on the left forearm
within general population. The said muscle is more frequently missing on the right forearm
within male gender, while on the left within females. The absence of palmaris longus muscle
on both forearms is more frequent within male than
female population.
Page | 17
ANATOMICAL
PROCEDURE
OBSTACLES
IN
CATHETER
ABLATION
Field of medicine: fundamental or cardiology
Author(s):ADREI CISMARU, Gabriel Cismaru
Supervisor(s): Mihut Calin
Country: Romania
Introduction: Electrophysiologists recognize a so-called "isthmus" in the right
atrium through which passes the reentrant circuit of common atrial flutter. Ablative
lesions placed in this narrow channel have proved effective in breaking the circuit
The majority of anatomical structures within the heart during typical atrial flutters'
ablation, are invisible or blurred. Therefore it is very important to know in details
interior right atrial structures during such procedures.
Materials: 26 hearts (16 mens, 10 womens, mean age : 65) from patients whose
death was not cardiologic in origin, were examined. Classical macroscopic methods
of anatomical evaluation were used. The following measurements were made: the
Eustachian valve (EV), the tricuspid valve (TV) longitudinal and transversal
diameter, diameter of the coronary sinus orifice (CS) diameter of cavotricuspid
isthmus (CTI), thickness of cavotricuspid isthmus, the angle between ICT and vena
cava inferior (VCI), distance between VCI-SC, distance between VT-SC, presence/
absence of anatomical obstacles: ridges, pouches, recesses, and trabeculations.
Results: Eustachian valve =4,5mm, tricuspid valve =28,5 respectiv 18mm; coronary
sinus orifice =8,6mm; the cavotricuspid isthmus measured 24,5 +/- 5,5 mm ( range
19-40 )mm ; thickness of cavotricuspid isthmus =12mm; angle between ICT and
vena cava inferior ~80˚, distance VCI-SC =10,5mm; distance VT-SC =17mm;. A
deep recess due to a prominent EVR was observed in 3 of 26 hearts; In 4 hearts a
large Eustachian valve was detected and considered obstacle for catheter ablation. 2
hearts were with extreme thinness of the atrial wall at the site of ablation- there is a
high risk of perforation evenwhen right endoatrial catheter ablation is performed
with low energy shocks;.
Conclusion: There are considerable anatomic variations in the atrial wall that
comprises the so-called isthmus. The presence of recesses and membranous areas in
some hearts and the variations in isthmus thickness are relevant in improving
ablation procedure. Ridges, pouches, recesses, and trabeculations. may limit the
success of radiofrequency ablation
Page | 18
ONTOGENETIC DEVELOPMENT OF THE ABDOMINAL MUSCLES
Author(s): GREAVU MIHAI
Country: Romania
Introduction:Because of a great number of theories concerning the genesis of the walls
of the trunk, the present work aims to verify which theory is valid and possibly, by using
the results, to develop a theory concerning the development of the rightbdominal muscle.
Material and Methods:This study was carried out on a number of 15 subjects: 9 adult
embryos and fetus and 6 human adult corpses. The macroscopic study involved the
inspection of the anterolateral abdominal wall, supplemented by the dissection, the
parietal and umbilical morphometry and the study by transillumination.
Results :The study showed that the non-differentiated mesenchyme dominates the
anterolateral zone of the abdominal wall at 45 days of age. We have also observed, in the
parietal superumbilical area, a muscular mass belonging to the broad muscles of the
abdomen where one can see mononucleated myoblasts.The whole parietal subcutaneous
space is occupied by primary mesenchymatic tissue, while the process of myoblastic
differentiation is in an early stage. At the age of 8 weeks, the embryo has two special
characteristics: the fibers of the parietal muscles have an aspect of plasmodiums, while
the muscle has a prevalent fascicular structure. Thus, at the age of 8 weeks, the
abdominal wall has a different aspect, given by the presence in the superumbilical portion
of many plasmodiums organized in a fascicular way and rare myoblasts, while on the
underumbilical level, there are numerous myoblasts and little plasmodiums which cannot
be considered groupings of fascicules. At the age of 10 weeks, we can observe the
fascicular organization of muscle fibers of the right abdominal muscle; the muscles are
also
surrounded
by
isolated
muscle
fibers.
With a higher age, of 11 weeks, the number of muscle fibers grouped in fascicles
increases, we can not notice yet the sarcolemma in striated fibers yet, while in the
interfibrillar
mesenchyme
there
are
myoblasts
beside
striated
fibers.
In the following stage of age, 12 weeks, the number of myoblasts in conjunctive tissue is
relatively reduced, the muscle fibers being generally organized in fascicles.
Conclusions :The cranio-caudal plication and the primary migration of the mesenchyme
give rise to the right abdominal muscle. The differences in development between the
cranial and caudal ends represent the explanation for the differences in development in
the superumbilical portion compared to the underumbilical one. The right abdominal
muscle does not appear as a consequence of a dorsolateroventral migration, according to
the traditional assertion, but following a cranio-caudal migration. The dorsolateroventral
plication determines the somitic migration of the mesenchyme which, in its turn, appears
after the cranio-caudal migration.
Page | 19
PLENARY Session II
(Pathology, Histology & Embryology, Forensic medicine)
Page | 20
THE RETROSPECTIVE ANALYSIS OF MATERNAL DEATH IN
THE POST-DELIVERY PERIOD (IN THE CITY OF ALMATY)
Field of medicine:pathology
Author(s): MURZAGALIYEVA G.ZH.
Supervisor(s): MD-PhD Sapargaliyeva A.D.
Country: Kazakhstan
Introduction : Morphological criteria of diagnostics of causes of maternal death rate are
objective criteria of the quality of obstetric care because of high maternal death rates in
the city of Almaty.
Material and methods: We analyzed 12 cases of maternal death. Women were 24-30
years old and they died in maternity hospitals in the period from 2006 to 2008. The cause
of maternal death was obstetrical hemorrhage.
Results: In eight cases women had first pregnancies, in four cases – repeated pregnancies
(primiparas). In all cases preeclampsia was diagnosed (mild and severe). In seven out of
twelve cases, women were diagnosed with diseases as chronic pyelonephritis, in a stage
of remission; in two cases with cytomegalovirus’s infection; and in one case with
malignant bilateral pheochromocytoma in adrenal glands. So in all cases pregnancy
proceeded with complications and accompanying diseases. And even small bleeding
could be cause of serious complications.Premature or early flow of amniotic fluid was
observed in five cases and the time period after waters broke was more than 12 hours. It
demanded prevent procedure of infection complications. In seven cases the indications
for emergency caesarian section included premature separation of placenta and uttering
bleeding in the volume of 500-700 ml. In all 12 cases the post-delivery period was
complicated by uterine bleeding (2,100-3,000 ml), which became a ground for total
hysterectomy. Uterine bleeding was complicated by hemorrhage shock which caused
death. In ten cases death happened in 13-24 days after the birth of the child and in one
case (malignant pheochromocytoma) – in 40 hours after the birth. Morphological
research confirmed hemorrhage shock manifested in sequestration of blood in
microcirculatory channel in the brain tissue and internal organs.
Conclusion: The analysis of 12 cases of maternal deaths demonstrated the following:
1. Such methods as stop bleeding (manual inspection), a lot of operative interventions,
massive treatment and long reanimation was caused atonical uterus bleeding.
2.
Premature
separation
of
placenta
caused
hemorrhage
shock.
3. The death of those women can be explained by the delay with medical aid.
To sum up, it would be desirable to note that, maternal death is one of the basic
criteria of an estimation of the organization of public health services, quality of rendering
of medical aid and efficiency of introduction of scientific achievements in practice of
public health services.
Page | 21
COLORECTAL CANCER IN YOUNG PATIENTS
Field of medicine: pathology
Author(s):JULIJANA POPOVIC, Stevan Vujic, Ristic Nevena
Supervisor(s):Prof. Dr Vuka Katic
Country: Serbia
Introduction
Cancer of the colon and rectum is the first most commonly occuring
gastrointestinal malignancy in our contry and worldwide.Although primarly a
disease of older patients, 4 to 8 percent of these cancers are found in patients
younger than 40 years of age.
Aim
This study was undertaken to review the experience with colorectal cancer
in patients less than 40 years of age at the Institute of Pathology, to assess prognostic
factors associated with decreased survival.
The biopsy registry of the Institute of Pathology was reviewed over a 5year period. One child and 14 patients younger than 40 years of age with colorectal
cancer were identified.
Results
The marked increase in the incidence of right-sided lesions (11 patients)
was noted; the rectal localization was found only in 4 patients; a preponderance of
males (10 patients) was found among young patients. Duke’s classification-right
sided localization: stage B (2 patients), stage C (6 patients), and stage D (3 patients),
two with liver and one with Krukenber’s metastases. Duke’s classification-left sided
localization: stage B (2 patients) and stage C (2 patients). Histologically, the tumors
of right-sided were both mucin-producing and poorly differentiated in 72% and left
side in 25%.
Conclusion
Cancer of colon and rectum in patients less than 40 years of age is
associated with a poor prognosis that is partially attributive to the occurrence of
more aggressive, poorly differentiated tumors. Young patients presenting with
symptoms suggestive of colorectal malignancy, therefore, demand timely, complete
investigation of large bowel despite their youth.
Keywords : Colorectal Neoplasms;Prognosis;Diagnosis
Page | 22
EXPRESSION OF P53 PROTEIN IN INFILTRATING DUCTAL
CARCINOMA OF THE BREAST
Author(s): KISELICKI DRAGAN, Vlajnic Tamara
Supervisor(s): Tatjana Ivkovic-Kapicl
Country: Serbia
Introduction: The p53 gene is a tumor suppressor gene which mutations remain the
most common genetic change identified in human neoplasia. P53 mutation is also
associated with more aggresive form of the breast cancer and worse overall survival.
The aim of study: The aim of the study was to determine the frequency of p53
protein expression in infiltrating ductal carcinoma of the breast as well as to
determine if there is a correlation between over-expression of p53 protein and
standard prognostic factors such as tumor size, histological grade and lymph node
status.
Material and methods: A total of 120 cases of breast carcinoma, who underwent
surgery for breast carcinoma at the Surgical clinic for operative oncology, Institute
of Oncology Vojvodina, were included in this study. The immunohistochemical
staining for p53 protein were evaluated.
Results: P53 protein overexpression was present in 10 out of 63 T1 lesions (16%),
in 13 out of 44 T2 lesions (30%), in 4 out of 6 T4 lesions (67%), while in T3 lesions
not found. Protein overexpression was found in 11 out of 21 grade III tumors (52%)
and 16 out of 72 grade II tumors (22%). Overexpression was not detected in grade I
tumors.
Conclusion: Statistically significant correlation was found between p53 protein
overexpression with large tumor size and high histological grade ( p<0,01;chi-square
test), but there was no positive correlation with axillary nodal status and tumor
supresor gene. Our findings showed that the expression of p53 protein might point
out an aggressive tumor phenotype. This marker might help to stratify patients for an
appropriate therapy on an individual basis and, thus, offer the possibility of a more
effectively tailored treatment program.
Key words: infiltrative ductal breast cancer, p53 protein, imunohostochemistry,
prognosis
Page | 23
EXPRESSION OF CYTOKERATINE 5/6 IN INFILTRATING
DUCTAL CARCINOMA OF THE BREAST
Author(s): VLAJNIC TAMARA,Dragan Kiselicki
Supervisor(s): Ass.dr Tatjana Ivkovic Kapicl
Country: Serbia
Goal:
The goal of this study was to determine the frequency of expression of
basal cytokeratine 5/6 in infiltrative ductal breast carcinoma (non-specific type) and
to establish the correlation between the expression of CK5/6 and histological grade
of the tumor.
The research has been done on 121 randomly selected patients with
infiltrative ductal breast carcinoma in the grade II A (T1 N1 i T2 N0), patients were
operated at the Institute of Oncology Vojovodine.
Results:
Positive expression of cytokeratine 5/6 was found in 29 cases (23,97%). In
the sample of breast carcinoma was determined statisticly notably correlation
between expression of CK5/6 and histological grade of tumor (p =0,011c2 - test,
c=0,263).CK 5/6 negative tumors were high grade and mid grade differentiated
(HG1, HG2), a CK5/6 positive were low grade diferentiated (HG3).
Conclusion: Basal cytokeratine 5/6 expression in the breast carcinoma could be
indicator of low grade diferentiation and it could be marker of basaloid tumor
fenotype (which caracteristic is very agressive biological behaviour).
Keywords: Cytokeratine 5/6; Ductal infiltrating breast carcinoma
Page | 24
ANALYSIS OF RECENT TRENDS OF BENIGN PROSTATIC
HYPERPLASIA AND PROSTATE CANCER AMONG MALE PATIENTS
FOR 2005 AND 2006 IN CANTON TUZLA, BOSNIA AND HERZEGOVINA
Author(s):TOMISLAV STJEPIC, Amra Nadarevic
Supervisor(s):prof. med. sc. Ermina Iljazovic
Country: Bosnia & Herzegovina
Introduction
The prostate is a small gland that, in young adult men, is about the size
and shape of a walnut. As men become older, many of them will develop Benign
Prostatic Hyperplasia (BPH), which can pass into prostate cancer, or cancer can
become de novo”.
Aim
To determine the frequency of BPH and Prostate carcinoma among tested
males in UCC Tuzla during the period of 2005-2006, and the frequency of
pathohistological changes by age distribution.
Material and Methods
The study has been conducted by a retrospective analysis, using
information from the Department of Pathology UCC Tuzla. All samples were taken
using needle biopsy and/or total or partial prostatectomy of patients with prostate
problems. This study included 582 patients, aged from 44 to 86, and tested over a
period of two years from 2005 and 2006.
Results
The most affected age group is the 65 to 75 years old category. We have
found 75.08% patients with BPH diagnosis, 21.47% with adenocarcinoma and
2.74% patients with other diagnoses. The biggest frequency of BPH is in the 65-75
age group: 38.31% patients. The same age group is the most affected by
adenocarcinomas: 11.68%.
Discussion
Almost every male over the age of 50 has BPH. Notable portion of them
have adenocarcinom, diagnosed “de novo” or BPH to adenocarcinoma transition.
Every male older than 50 should do at least one digitorectal prostate examination per
year. It is the easiest and cheapest examination. Also, it is very effective in
diagnosing benign or malignant prostate changes.
Page | 25
HPV INFECTIONS OF THE FEMALE GENITAL TRACT AND ITS
ASSOCIATION WITH CERVICAL CANCER IN CANTON TUZLA,
BOSNIA AND HERZEGOVINA
Field of medicine: pathology, oncology, gynecology
Author(s): AMRA NADAREVIC, Tomislav Stjepic, Amir Nadarevic
Supervisor(s): prof.dr.Ermina Iljazovic
Introduction
Cervical cancer (CC) is caused by different types of human papillomavirus
(HPV) and it represents the second most common cancer among Bosnian women.
Aim
Aim is to determine the frequency of HPV infections and its association
with cervical cancer and to determine if there is a statistical significance of increased
number of High Grade Squamous Intraepithelial Lesion (HGSIL) and CC in
different age groups and to determine cytomorphological changes.
Study has been conducted by a retrospective analysis, using information
from Department of Pathology, UCC Tuzla. Samples of the cervical smear for the
PAP test and HPV analysis were taken during routine gyneacological examinations.
Identification of the presence of HPV was carried out by the Digene Hybride
Capture II test. The cytomorphological changes were classified according to the
Bethesda classification.
Results
In this study we included 2674 women, tested in 2005-2007 and the total
number of women who tested positive was 992 (37%). According to critical value of
χ2=3.84 p>0.05 there is a significant trend in reduction of positive HPV tests in last
three years. There is statistical significance in increased number of CC comparing
women born 1961-1979 with other age groups χ2=4.63 and p>0.05.
Discussion
As HPV infections are very common among Bosnian women it is
important to inform and educate the public about its association with CC. We
emphazise to improve the current prevention strategies and screening practices. HPV
testing and vaccine could reduce incidence and mortality from CC in Tuzla.
Page | 26
CHARACTERISTICS OF TEETH DEVELOPMENT IN FETUS
WITH CLEFT LIP AND PALATE
Field of medicine: histology and embriology
Author(s): PJEVAC SANDRA, Aleksandar Vlasačević
Supervisor(s): Prof.dr Dušan Lalošević
Country: Serbia
Introduction
Clefts of the primary and secondary palates are the result of failure of
growth or lack of fusion of the three palatine processes with each other and with the
overlying nasal septum. Clefts of the palate create many problems, the severity
varying according to their extent. The prevalance of dental anomalies and disorder in
teeth development associated with cleft lip and palate is remarkable.
Aim
Research histological characteristics of teeth development at fetus with
cleft lip and palate.
Fetal human tissues of maxilla and mandibula were fixed in 10 % formalin
and decalcinaded in 10 % acidum formicum, histological preparations provided with
classical paraffin technique and cut into sections of 5 micrometers and histologicaly
analyzed using hematoxylin & eosin stain.
Results
Our case of cleft palate belongs in 4th group of the Veau system of
classification for lip and the palate.That is bilateral cleft lip and complete bilateral
cleft palate. Histologicaly analyzed of preparations we found hypodontio of incisors
and hyperdontio of molars, with normal mineralisation of teeth tissues and
development of all dental structures.
Conclusion
Comparated with group of fetuses without malformations histologicaly
analyzed preparations of maxilla and mandibula of fetus with cleft lip and palate we
found hypodontio in frontonasal processes and hyperdontio in maxillary processes,
normal mineralisation and normal development of teeth.
Key words: tooth, maxilla, hypodontio, hyperdontio, cleft palate.
Page | 27
THE COMPARISON OF ATHEROSCLEROSIS GRADE
ARTERIES USED AS GRAFTS -MORPHOMETRICS STUDY
OF
Field of medicine: histology
Author(s): TIJANA RAKIĆ, Saša Rajšić
Supervisor(s): Asist. dr Milica Labudović Borović
Country:Serbia
Introduction
In the surgical revascularization of the myocardium the following arterial
grafts are used: a. thoracica interna, a. radialis, a. epigastrica inferior and a.
gastroepiploica dextra.
Aim
In this work we will compare the grade of atherosclerosis of arteries used
as grafts in the surgical revascularization of the myocardium, by using two basic
morphometric parameters: the thickness of the intima and the intima-to-media ratio.
We were analysed 56 arteria from 38 persons of both gender, forty years
old or older. The method of light microscopy is used, along with histochemical
techniques. As mark of the grade of atherosclerosis we analysed the thickness of
intima, as well as the intima-to-media ratio. These results were compared with the
results in the control group of coronary arteries.
Results
There is significant polarization of arteries in the grade of the
aterosclerosis. The inferior epigastric artery and the internal thoracic artery are with
minimal grade of atherosclerosis, while right gastroepiploic artery is with more
extensive atherosclerotic lesions. The radial artery, and the coronary arteries are
distinguished by extremly high grade of the atherosclerosis.
Conclusion
The analysis of the relevant morphometric data get us to the conclusion
that the inferior epigastric artery as well as the internal thoracic artery do represent
ideal grafts considering the development of the atherosclerosis.
Key words
Atherosclerosis, tunica intima, tunica media, graft, artery
Page | 28
CHARACTERISTICS
AND
METHODS
USED
IDENTIFICATION OF UNIDENTIFIED BODIES AT
INSTITUTE FOR FORENSIC MEDICINE
FOR
THE
Field of medicine: forensic medicine
Author(s): GORAN MILOŠEVIĆ, Sanja Milošević
Supervisor(s): Ass. dr Aleksandar Stanojević
Country: Serbia
Introduction
Identification is an integral part of medicolegal autopsy, and is performed
in all forensic cases, but imposes a problem in cases of injuries and/or postmortal
changes which aggravate identification, i.e. putrefaction, carbonification, heavy
mutilation of the bodies.
Aim
The aim of this paper is to establish a database of unidentified bodies at
the Institute for forensic medicine, to estimate their number in eight year period, to
assess the used methods for identification, estimate their own effectiveness, as well
as the efficiency of simultaneous use of multiple identification methods.
The retrospective study was performed for the period from 2001 to 2008.
The sample consisted of 851 unidentified bodies.
Results
Body description – gender (37,6%), age (37,1%), hight (36,1%), as well as
visual identification (36,2%) and recognition of clothes (32,3%) – helped in
determining identity in a third of all unidentified bodies. 32 cases couldn’t be
identified using preliminary methods, so the comparation between their DNA and
relatives DNA profile was performed.
Conclusion
In most cases, identification methods that are used at Institute of forensic
medicine enable positive identification, based on analysed data and results. In our
paper, we showed that the simultaneous use of different identification methods has
significantly influenced the positive identification.
Key words: identity, identification, identification methods.
Page | 29
PLENARY Session III
(Biophysics, Biochemistry, Physiology)
Page | 30
STUDY OF CITOTOXITY EFFECT OF NONEQUILIBRIUM
PLASMA
Field of medicine: biophysic
Author(s): MARINA PETROVIĆ, Igor Petrusić
Supervisor(s): Dr Vladimir Trajković
Country: Serbia
Introduction
Lately, nonequilibrium atmospheric discharges have drawn considerable
attention due to their enormous potential for applications in treatments of sensitive
material of biological origin. Because of its mild plasma, low gas temperature and
geometry, plasma needle is especially convenient for medical applications.
Aim
To determine the effect of nonthermal atmospheric discharge on cell
culture when changing power transmitted to the plasma and duration of the
treatment.
Cell cultures of C6 rat glioma cells were prepared for treatment by using
standard techniques. Distance from the tip of the needle and treated cell culture was
1 mm. Three different powers and five different durations of treatments were used.
Afterwards, viability (crystal violet) test was used and wells containing cells were
examined using light microscopy.
Results
By using viability test it is determined that the percentage of the cells that
have survived plasma treatment was highest in the wells which were treated for 15 s
and lowest power (0.1 W) and that it had lowest value in the case of longest times
and highest power (0.56 W)
Conclusion
From the results that were obtained we can conclude that nonequilibrium
plasma has the highest citotoxity effect on the cells in cultures which were treated
with the highest power and longest treatment time and that effect of treatment with
nonthermal plasma depends on several parameters; power transmitted to the plasma
and
duration
of
treatment
being
the
most
important
ones.
Key words: nonequilibrium plasma, plasma needle, C6 rat glioma.
Page | 31
EVALUATION OF STEM CELLS RADIOSENSITIVITY ON IONIZING
RADIATION
Field of medicine: cell biology
Author(s): VASILE FORIS
Mentor(s): Cernea Valentin
Country: Romania
Introduction
Stem cell therapy represents a major breakthrough in treatment of various
diseases. Mesenchymal stem cells (MSCs) are known to be implicated in
regeneration of various tissues. However, little is known about these cells’ behavior
in a radiation exposed environment. This is why the aim of our study was to evaluate
the radiosensitivity of MSCs on various doses of gamma irradiation.
Materials and Methods
We obtained MSCs from the illiac crest and osteoblasts, both from the
illiac crest (ICOs) and the patella (POs). Viability was checked by MTT assay. In
order to investigate the radisensitivity we used the alkaline version of the Single Cell
Electroforesis Assay (Comet Assay)according to Tice’s protocol. 0.5 Gy, 1 Gy, 2 Gy
and 4 Gy were the doses that we used for irradiating the cells.
Results
Cell lines showed a substantial variability concerning biological
parameters of radiosensitivity: basal DNA damage, radiation-induced DNA damage
and capacity of repair. Cells irradiated with 0.5 Gy and 1 Gy have higher amounts of
DNA damages than others irradiated with 2 Gy and 4 Gy. In addition to this the
proliferation of irradiated MSCs, POs and ICOs is stimulated within two weeks after
irradiation with 0.5 Gy and 1 Gy.
Conclusion
Human mesenchymal stem cells and comet assay could be good tools for
further investigating stem cell radiosensitivity. The capacity of the cells to repair the
DNA lesions induced by irradiation is important for the fate of the cells after
radiotherapy.
Page | 32
THE EFFECT OF PERINATAL APPLICATION OF PHENCYCLIDINE ON
THE TOTAL SULFHYDRILE CONTENT IN THE RAT'S BRAIN
Field of medicine: biochemistry
Author(s):ANA GLIGIĆ
Supervisor(s): Doc. dr Nataša Petronijević; Ass. dr Nevena Radonjić
Country: Serbia
Introduction
Phencyclidine (PCP) is a noncompetitive NMDA antagonist in brain.
Phencyclidine induces positive and negative signs of schizophrenia, as well as
cognitive disfunction. Parental administration of phencyclidine is one of the
currently accepted animal models of schizophrenia. It is considered that one of the
factors included in the etiopathogenesis of the disease is the oxidative stess.
Purpose
The aim of this study was to determine the effect of parental
administration of phencyclidine on the total sulfhydrile content in the adult rat’s
brain before and after application of the test dose of phencyclidine.
Materials and methods
The animals were treated with PCP (10 mg per BM) or with saline
solution (0,9 % NaCl) on the 2nd, 6th, 9th and the 12th postnatal day. Concentration
of sulfhydrile groups was determined by the standard Ellman’s test in samples
prepared by the extraction of certain structures of the rat’s brain.
Results
Perinatal administration of phencyclidine induces rise in the total
sulfhydrile content in the adult rat s cortex. After administration of the test dose of
phencyclidine, structure-specific lowering of the total sulfhydrile content is evident:
in cortex in the group of rats perinatally treated with phencyclidine and in
hippocampus and thalamus in the group of rats perinatally treated with saline
solution.
Conclusion
Perinatal administration of phencyclidine induces longlasting rise in the
total sulfhidrile content in the rat’s cortex, whereas administration of the test dose of
phencyclidine induces structure-specific lowering of the total -SH content in rat’s
brain. Further investigations are inevitable for enlightning connection between redox
state of cortical neurons and NMDA receptor antagonist, phencyclidine.
Page | 33
CYTOTOXICITY OF (PENTANE-2,4-DIONE)2ETHANE-1,2-DIAMINE
SCHIFF BASE COMPLEXES WITH COPPER AND NICKEL ON RAT
ASTROCYTES AND C6 GLIOMA CELLS IN VITRO
Author(s): ANDJELKA ISAKOVIC, Natasa Cvetinovic, Nina Gusic
Supervisor(s): Assist. dr Sonja Misirlic Dencic
Country: Serbia
Introduction
Schiff base complexes have significant role as chemotherapeutic drugs.
Especially important are platinum, nickel, copper, cobalt and zinc complexes.
Aim
Aim of this study was to investigate cytotoxic activity of two novel nickel
and copper Schiff base complexes, as well as determination of possible mechanisms
of such activity.
Experiments were conducted on primary culture of rat astrocytes and C6
glioma line. Cells were exposed to complexes for 24 hours. Viability rate of treated
cells was measured by acid-phosphatase test. Cells were stained with propidiumiodide
in
order
to
analyze
cell
cycle
by
flow
cytometry.
Results
Our study showed decrease of viability of astrocytes after treatment with
copper complex, concentration 100μM and after treatment with 700μM nickel
complex. Decrease of C6 viability was shown after treatment with 60μM copper
complex and 300μM nickel complex. Greater decrease of viability of C6 cells
comparing to astrocytes after the treatment with same concentration complex was
shown, for both complexes. Analysis of cell cycle showed increased percentage of
cells in subG0 faze of cell cycle of astrocytes, comparing to control, for both
complexes.
Conclusion
Both examined complexes show cytotoxicity on both examined cell lines.
Copper complex shows cytotoxicity used in lower concentrations compared to
nickel complex, which is unexpected, considering amount of copper existing in
biological systems, so this fact implicates further exploration. Possible cytotoxic
mechanism is apoptosis, what was pointed out on astrocytes, but more specialized
tests to confirm this statement are needed.
Page | 34
EXPRESSION OF NUCLEOSIDES TRANSPORTERS ON
PRIMARY RAT ASTROCYTES IN CULTURE FOLLOWING
EXPOSURE TO ADENOSINE
Author(s): BRANISLAV ROVCANIN, Marija Dulovic, Maja Stukalov, Ognjen Bojovic
Supervisor(s): Doc.dr Ivanka Markovic
Country: Serbia
Introduction
The role of purine nucleosides is very important and widespread in
organism. In central nervous system, adenosine modulates sleep and awakness,
memory, analgesia, movement etc. Physiological concentration od extracellular
adenosine is about 1 µmol/L, but in conditions like ischaemia and inflammation it
can be rised to 100 µmol/L. It is considered that this concentration rising is
neuroprotective.
Aim
To show the expression patterns of ENT1, ENT2 and CNT2 nucleoside
transporters in rat’s primary astrocytes culture model, and to quantify expression of
transporters in cells which are chronically exposed to adenosine.
Cells were cultivated in 5 mL of RPMI medium, on 37°C in weat
atmosphere enriched with 5% CO2. Three flasks were used (three experimental
groups); first contained cells which were not treated with adenosine (they
represented control group), second contained cells which were treated with 25
µmol/L adenosine and third contained cells which were treated with 100 µmol/L
adenosine. After RNA isolation and quantification, reverse transcription was
conducted. Finally, quantification of nucleoside transporters expression, was
determined by RT-PCR.
Conclusion
We can conclude that C6 cells express ENT1, ENT2 and CNT2 nucleoside
transporters, but the CNT2 transporter is dominant transportes in astrocytes cells
membranes. The chronic exposure to adenosine in supraphysiological
concentrations, increases gee expression of all three nucleoside transporters.
Key words: astrocytes, adenosine, nucleoside transporters, RT-PCR
Page | 35
INFLUENCE OF PHENCYCLIDINE ON SPECIFIC ENZYMES OF
THE MITOCHONDRIA RESPIRATORY CHAIN IN THE RAT
BRAIN AFTER PERINATAL ADMINISTRATION
Author(s): ANA ZEKOVIC, Ognjen Bojović
Supervisor(s): Doc. Dr Nataša Petronijević
Country: Serbia
Introduction
Phencyclidine (PCP), dissociative anesthetic, is the antagonist of NMDA
receptors, one subtype of glutamatergic receptors. PCP can induce both positive and
negative signs of schizophrenia, as well as cognitive disfunction. Perinatal
application of PCP to rats is accepted as o animal model of schizophrenia.
In this experiment we used newborn Wistar rats. The activety of
cytochrome c oxidase was measured using the method of Hess and Pope.
Aim
The aim of this study was to determine the activity of cytochrome c
oxidase in the brains of rats, perinataly (four times in period from 2. to 12. day)
treated with phencyclidine (10mg/kg).
Results
A significant increase in measured activity of cytochrome c oxidase was
noticed in cortex and hippocampus of rats treated with PCP.
Conclusion
Perinatal phencyclidine administration caused increase in cytochrome c
oxidase activity in the brain of rats 13 days old. These changes are indicative for
increased metabolic rate of neurons immediately after application of phencyclidine.
Further studies of mechanisms of phencyclidine neurotoxicity, as well as the
assessment of the roles of changes in respiratory chain and oxidative stress in
pathogenesis of schizophrenia are needed.
Key words: phencyclidine, cytochrome c oxidase, schizophrenia
Page | 36
THE EFFECTS OF ACETYLSALICILIC ACID ON THE HCV-RNA AND NS5A
PROTEIN EXPRESSION
Field of medicine: fundamental sciences
Author(s): CHIOREAN ROXANA-MARIA (Romania)
Supervisor(s): Ana-Maria Rivas Estilla,Clara Patricia Rios Ibarra
Background: The infection with Hepatitis C Virus(HCV) represents a major health
problem.Chronicised,it leads to viral C hepatitis,which progresses to hepatic cirrhosis and
hepatocelular carcinoma.The current therapy of viral C hepatitis resumes at a combination between
pegylated Interferon and Ribavirin.Still,there are patients who don’t respond at this treatment,which
makes necessary finding alternative treatments.It has been reported recently that sodium
salicilates,including acetylsalicylic acid(used as non-steroid anti-inflammatories),inhibit the
replication of Flaviviruses and also that COX-2 might be involved in replication of HCV.
Aim: The goal of this study is to investigate the effects of acetylsalicylic acid over the replication of
HCV ,on the Huh-7 Replicon cell line.
Materials and methods :Cells belonging to Huh-7 Replicon cell line have been incubated with
acetylsalicylic acid,in concentrations of 2,4 and 8 Mm,for 24,48 and 72 hours.We have also incubated
untreated cells,at the same intervals of time.We extracted RNA with Trizol,at 24,48 and 72 hours and
quantified it by RT-PCR.We have measured cell viability,by counting the cells,to determine whether
the antiviral effect of acetysalicylic acid is due to its citotoxicity or it has a real effect on cell
proliferation. We have also extracted viral proteins and COX-2 ,at 24,48 and 72 hours andquantified
it by Western Blot.
Results: Acetylsalicilic acid has decreased the level of HCV-RNA in a dose-dependent manner and
time-dependent manner,on treated cells,compared to untreated cells.There were no significant
differences between the viability of the treated and untreated cells.We considered the concentration of
4 Mm as optimal and used it for our further experiments .Results have also shown a decrease of
expression of viral protein NS5-A and COX-2 levels in the treated cells,compared to
untreated cells.
Conclusions: Acetylsalicylic acid,in concentrations of 4 Mm inhibits the replication of viral C
Hepatitis virus,on Huh-7 Replicon cell line,in a dose and time dependent manner and also the
expression of NS5A viral protein.The decrease of COX-2 level in treated cells shows a possible
involvement of this enzyme in the mechanism of inhibition of C virus replication by the
acetylsalicylic acid.
Results: The results show that,in the future,acetylsalicylic acid might be used as adjuvant therapy in
the treatment of viral C hepatitis.
Discussions: This study demonstrates that in vitro,acetylsalicylic acid inhibits the expression of
HCV.On pacients,the effect of this kind of therapy is not known very well,because Huh-7 Replicon
cell line might not totally reproduce the mechanisms that appear in liver cells,during the infection
with C virus.
Page | 37
EVALUATION OF BODY FAT MASS AND ANAEROBIC
CAPACITY IN SPORTSMEN AND NON-SPORTSMEN
Field of medicine: physiology
Author(s): MARIJA JAKOVLJEV
Supervisor(s): ass. dr Dea Karaba – Jakovljevic
Country: Serbia
Introduction
Total human energetic capacity is most commonly classified into aerobic
and anaerobic component. Sports of strength and short intensive utilization are based
in anaerobic part of energetic capacity. A most practical test for evaluation of
anaerobic capacity is Wingate test, which measures four parameters: peak power,
mean power, total work and explosive power. Anthropometric measurements are
methods for evaluation of body composition.
Aim: To measure anthropometric parameters and anaerobic capacity in sportswomen
(athletes) and non-athletes (students of medical sciences), and to deduce significant
difference between two examined groups.
Material and method: Fourteen sportswomen ( athletes) and sixteen nonsportswomen (students of medical sciences) were included into research.
Anthropometric measurements and the Wingate test were conducted to all
participants.
Results: Body mass index, which is calculated in anthropometrical measurements,
did not show significant statistical difference among groups (sportswomen 21.0,
non-sportswomen 20.6 ; p>0.05). Body fat mass percentage, which is measured by
method of bioelectrical impedance showed statistically significant difference
between groups in favor of athletes (sportswomen 16.0%, non-sportswomen 19.2% ;
p<0.05). All the parameters of anaerobic capacity measured by Wingate test, were
higher in the group of athletes, as expected, and the difference was statistically
significant (sportswomen: peak power - 346.25 W, explosive power – 45.5 W/s,
total work – 7717.08 J ; non-sportswomen: peak power – 292.8 W, explosive power
– 37.77 W/s, total work – 6295.0 J ; p<0.05).
Conclusion: Continual physical activity, such as training, leads to body composition
adaptations, by decreasing body fat mass and increasing muscular mass and
anaerobic part of total energetic capacity.
Key words : Sport; Anaerobic capacity; Percentage of body fat mass;Wingate test
Page | 38
PLENARY Session IV
(Microbiology & Imunology, Epidemiology)
Page | 39
BREAST TUMOR INDUCTIONAL METHOD
Field of medicine: imunology
Author(s):KATERINA MARTINOVA
Supervisor(s):prof.dr.Nebojsa Arsenijevic
Country: Serbia
Introduction
Breast tumors are the leading cause of death among women between the
ages of 35-44. For inducing tumor, we used the breast carcinoma cell line 4T1
(ATCC, CRL-2539). 4T1 cells were derived from a single spontaneously arising
mammary tumor from a BALB/C mouse. The 4T1 cells grow rapidly at the primary
site and forms metastases in lungs, liver, bone and brain over a period of 3-6 weeks
upon injection, via the hematogenous route.
Goals
To establish mouse primary tumor model, to define the ideal number of
cells for injestion and defining the ideal incubation period for development of
primary tumor and forming metastatic cell colonies.
Materials and methodsFemale BALB/C (n=7), aged 8 to 9 weeks, were used in the
experiment. Tumor cells, resuspended in 50 µl of PBS were inoculated into the
fourth mammary fat-pad of mice. Nine animals were devided into three groups, in
which they received the following cell injections: first group 2x105, second group
1x105, third group 5x104 cells. On day 14./21./28., we sacrificed one animal from
each group. The primary tumor was surgically removed. Blood (from abdominal
aorte), samples of lungs, liver, and brain were colected. From the isolated organs
microscopic slides were made and reviewed to confirm the presence of metastatic
colonies.
Results
Mean values of primary tumor diameters between the groups of mice that
received 2 x 105 and 1 x 105 cells showed no significant difference. In the group
with 5 x 104 inoculated cells there was noted significantly smaller primary tumor.
The second and third weeks after cell injection, there weren’t apparent metastases
seen in the isolated organs. In the fourth week there were signs of blood metastases
in the lungs amoung the groups that received 2 x 105 and 1 x 105 cells.
Conclusions:The minimum incubation period for primary tumor growth and
detectable metastases colonies were four weeks and the minimum number of cells
needed were 1x105 cells
Page | 40
GLIOMA CELL CYTOTOXICITY
CARRIED BY LIPOSOMES
OF
FULLERENES
C60
Field of medicine: microbiology and immunology
Author(s): DEJAN RADAKOVIC; Stefan Ristic
Supervisor(s): Doc. dr. Vladimir Trajkovic
Country: Serbia
Introduction
Fullerenes are considered to be three-dimensional analogues of benzene,
and represent, besides diamond and graphite, a third carbon allotrope. They show a
range of activities that migth be useful in anticancer or antimicrobial therapy and
cytoprotection. Fullerene C60 has a low water solubility and therefore liposomes
could be filled with fullerene C60, then remain within liposomes until they are
degraded.
Purpose
Cytotoxicity of liposomes filled with fullerenes C60 on rat glioma cells.
Rat glioma cells were incubated with different concentrations of liposomes
filled with fullerenes C60 and different concentrations of liposomes themselves.
MTT test and crystal-violet test were performed to analise cytotoxicity, which was
presented as percent (%) of control value.
Results
Complexes of fullerene C60 and liposomes showed a dose-dependent
citotoxicity, the effect that was not induced by liposomes themselves.
Conclusion
Our results showed the possibility of using these complexes in further
experiments for anticancer therapy, maybe for developing the “active” cancer
targeting by functionalizing the surface of liposomes with ligands such as
antibodies.
Key words
fullerene, liposomes, cytotoxicity, glioma
Page | 41
HEMOLYTIC EFFECT OF FULLEREN C60
Field of medicine: Microbiology and immunology
Author(s): STEFAN RISTIC; Dejan Radakovic
Supervisor(s): Doc. dr. Vladimir Trajkovic
Country: Serbia
Introduction
Fullerenes are large carbon molecules wich are considered to be threedimensional analogues of benzene and they represent third allotrope of carbon. They
are able to convert molecular oxygen in to reactive oxygen species (ROS), causing
cell damage by wich they can express their hemolythic effect.
Purpose
Examine hemolytic effect of water-solubile derivatives of fullerene C60
In experiment we have used water solutions of fullerene C60. Analyses
were made on blood obtained from healthy people, whose number of red blood cells
are in referent range. Hemolysis was examined by hemolytic assay, and also
oxidative stress was determinated by measuring intensity of green fluorescence of
redox sensitive dyes DHR and DCFDA.
Results
Hemolytic assay has shown that higher concentrations of fullerenes causes
higher percentage of hemolysis, but only after 24h. It was shown also that fullerenes
in higher concentrations produce more ROS.
Conclusion
It is necessary to make further researches in order to explore mechanismes
of fullerenes hemolytic activity, or at least find the ways by which it could be
reduced, for sake of potential future application of fullerenes intravenously without
adverse consequences of anemia.
Key words
ulleren, hemolysis, oxidative stress
Page | 42
THE ROLE OF PLATELETS IN CHEMOTAXIS OF DENDRITIC
CELLS
Field of medicine: Basic science
Author(s): WERONIKA BRONIEK, Natalia Wiatr
Supervisor(s): Pawel Wolkow
Country: Poland
Introduction
Dendritic cells (DC) present antigens to T-cells and stimulate immune
response. Taking up antigens by immature DC (iDC) takes place in peripheral
tissues, while T-cells activation by mature DC (mDC) occurs in lymph nodes.
Therefore, chemotaxis of mDC from peripheral tissues to lymph nodes is required.
The most important chemoattractant for mDC is CCL19, acting through CCR7
receptor. Other factors stimulating DC maturation are CD40L and PGE2, abundantly
produced by platelets.
Aims
The aims of study were to determine whether platelets can replace CD40L
in DC maturation and whether it can be inhibited by protein kinase inhibitors (PKI).
Materials And Methods
Peripheral blood monocytes were isolated by immunomagnetic separation,
while platelets by centrifugation. Monocytes matured with IL-4 and GM-CSF to
become iDC, then with CD40L, PGE2 or platelets to become mDC. PKI (PP1 and
SB203580) were added 30 minutes before chemotaxis toward CCL19. Percentage of
cells undergoing chemotaxis was estimated microscopically.
Results
iDC maturing with CD40L or platelets alone did not undergo chemotaxis,
while with PGE2 40±7% of them did. Maturation with PGE2+CD40L or
PGE2+platelets resulted in DC chemotaxis of 51±5% and 47±7%, respectively. PKI
addition to colony maturing with PGE2+platelets reduced percentage of DC
undergoing chemotaxis to 15±5% for PP1 and 31±5% for SB203580. These
numbers are consistent with results obtained for DC maturing with PGE2+CD40L
(16±7 % and 31±6%, respectively).
Conclusions
Platelets can replace CD40L, but not PGE2, in DC maturation process. DC
maturing with platelets show similar sensibility to PKI as do DC maturing with
CD40L.
Page | 43
A NEW IMPORTANT CYTOKINE IN ASTHMA
Field of medicine: imunology
Author(s):FARRAJ MAIN, Greavu Mihai, Farraj Musab
Supervisor(s):Agache Ioana
Country: Romania
Introduction
Immune dysregulation in asthma have a few key elements, such as: mast cells,
T cells, co-stimulatory molecules, eosinophiles, interleukins, cytokines and
autoantibodies. IL-17 is a cytokine secreted by a newly described , special lineage of
CD4 T cells (TH17),IL-17 depends on IL-1, IL-6 and TGF-b for induction and also
depends on nuclear transcription factor RORgT and IL-23 for maintenance.IL-17
promotes inflammation and tissue distruction in both TH1 and TH2 type diseases. IL-17
was found to be increased in many human chronic inflammatory diseases such as
rheumatoid arthritis, SLE, psoriasis or allograft rejection. In rheumatoid arthritis IL-17
was related to disease severity and joint distruction via excessive inflammation. IL-17
expression is increased in asthma but it’s prognostic significance is unknown. Our aim is
to find the prognostic value of increased serum IL-17 in asthma patients.
Methods
Our study has been done on 85 patients with asthma evaluated at inclusion for:
serum IL-17 (ELISA), blood eosinophilia, BMI, FEV1 at baseline < 50% predicted,
aspirin/NSAID
sensitivity,
smoking
status
and
chronic
rhinosinusitis.
As exclusion criteria we had: known associated chronic inflammatory diseases and
symptoms/history suggesting connective tissue diseases. IL-17 serum value > 20 pg/ml
was tested as a risk factor for asthma severity using
multiple regression analysis
Results :From 85 asthma patients the mean age was 49.99 ± 14.1 years, 61% females and
mean asthma duration was 12.64 ± 1.19 years.Also from our group 27% have mild
persistent asthma, 30.6% moderate persistent asthma and 42.4% severe asthma.The
serum IL-17 (medium values) were at mild asthma 14.21 pg/ml, moderate asthma 12.22
pg/ml and severe asthma 24.72 pg/ml.We found IL-17 > 20pg/ml in mild asthma at
3(13%) patients, in moderate asthma at 2(8%) patients and in severe asthma at 11(31%)
patients IL-17 > 20pg/ml was not correlated with other phenotypic features of asthma like
eosinophilia, atopy, NSAID intolerance or Obesity. IL-17 > 20 pg/ml could depict a
special asthma phenotype.
Conclusion :Serum IL-17 is increased in severe asthma compared to mild/moderate
forms of the disease.Valuesof IL-17> 20pg/ml are an independent risk factor for asthma
severity.
Page | 44
EXPRESSION OF INNATE IMMUNE SYSTEM’S MOLECULARS IN
PRETERM BIRTH ASSOCIATED WITH CYTOMEGALOVIRUS
INFECTION
Field of medicine: immunology
Author(s): SKRIPNIK V.V., Akimova E.A.
Supervisor(s): prof. MD Gankovskaya L.V.
Country: Russia
Background: Preterm birth associated with infection is a major clinical problem.
We hypothesized that innate immune system may play an important role in this
condition. Toll-like receptors (TLRs) are critical regulators of the innate immune
response based on their ability to recognize and respond to pathogen-associated
molecular patterns expressed by microbes. TLRs regulate the expression of
cytokines, natural antimicrobial peptides (HBD) and caspases – moleculars caused
apoptosis
Aim: To examine expression of TLRs, HBD-1, caspase 3, caspase 8 genes in human
placenta obtained from women with term and preterm delivery associated with
cytomegalovirus (CMV) infection
Materials And Methods: Placental explants were collected after vaginal delivery
from CMV infected women to provide two groups: group 1 (n=12) with normal
delivery (gestation age 38-39 weeks), group 2 (n=11) with preterm delivery
(gestation age 26-34 weeks). Non-infected women with term delivery (gestation age
38-40 weeks) provide control group (n=12). mRNA for TLR2, TLR4, TLR9, HBD1, caspase 3, caspase 8 genes was detected by real time quantitative PCR
Results: In placentas, collected from CMV infected women with term delivery
expression of TLR2, TLR9 and HBD-1 increased as compared with control group,
whereas expression of TLR4 and caspases didn’t. In group with preterm delivery
gene expression analasise revealed hyperexpression of TLR2, TLR9, caspase 3 and
caspase 8 and no reliable difference in TLR4 and HBD-1 gene expression was
shown compared with control group
Conclusion:The imbalance of innate immune system moleculars expression in
parallel with caspases genes activation play an important role in preterm delivery
pathogenesis.
Page | 45
RAPID SCREENING OF SERUM SAMPLES FOR CHRONIC
OBSTRUCTIVE PULMONARY DISEASE SIGNATURE MOLECULES BY
PROTEIN ARRAY
(Poster presentation )
Field of medicine: immunology
Author(s):CAMERON LAW
Supervisor(s):Dr P Tighe
Country: Zimbabwe
Chronic Obstructive Pulmonary Disease (COPD) is a complex condition with a
progressive underlying pathology. Consequently it was expected that certain
proteins of interest would alter within varying stages of the disease, acting as
detectable biomarkers reflective of the decline of the condition. The objective of this
project was to detect molecular patterns within plasma samples that could aid the
development of a diagnostic microarray system specific to COPD patients.
Fluorescence from dye-labelled proteins, in plasma samples of fifteen patients with
diagnosed COPD, was measured using capture antibodies on a microarray slide.
These samples were compared to plasma from healthy individuals. Binding
immunoglobulin protein, CD40, CD81, Golgin 97, a variety of interleukins,
Perforin, Stabilin 2, Tumour Necrosis Factor (TNF) alpha, TNFalpha MIP1beta and
TNF receptor 1 were all found to be significantly elevated in all COPD patient
samples, though increases were not uniform. Biomarkers suggestive of inflammation
and cellular apoptosis, such as TNF alpha and Perforin, were present, though not
unique to COPD. The identification of specific signature molecules therefore proved
elusive; however the microarray screening system aptly highlighted any elevated
proteins. This study showed that the screening capability is unquestionable, it is the
biomarkers themselves that need further research.
Page | 46
HYPERTENSION AND KIDNEY DISEASE IN THE AREA OF
ENDEMIC NEPHROPATHY – RESULTS OF OUR SCREENING
STUDY
Field of medicine: epidemiology
Author(s):PEJIC BORIS, Sladoje Sladjana, Vuleta Radoslav, Pantovic Marko,
Joksimovic Bojan, Djordje Danicic, Jelena Pavlovic, Sladjan Milanovic,
Kulic Valentina, Stojkovic Mira
Supervisor(s): Assistant Danijela Trifunovic. M.D.
Assistant professor Sinisa Ristic, M.D., Ph.D.
Introduction: Due to long term exposure to elevated blood pressure , in kidney we
can see arteriolosclerosis with progression of renal damage to kidney insufficienty,
eventually. Mechanisam of renal damage in hypertension is multiply and can include
reduced renal blood flow, hypoxia etc.
Material and methods: Our sample included 950 citisens of Donje Crnjelovo
village, which is well-known area od balcanic endemic nephropathy (BEN). For any
of them we got some anamnestic data by questionarry, also we have been measured
blood pressure, by indirect auscultation methods and analysed some laboratory
parametars
in
urin
(proteins,
glucose,
leukocyte,
hemoglobin).
Results: We have found 32 probationers with hypertension, and 43 probationers had
abnormal urine value. Abnormal urine value joined with hypertension we found out
in 14 probationers.
Conclusion: In future investigations it will be interesting to compare these results
with result which will be doing with same methodology in the area which is not
endemic for BEN. On that way we could get some new knowledge in role of
hypertension in ethiology of BEN and others nephropathy. Also in future
investigations it will be intresting to get some detail data which will discriminate
various type of kidney damage in our probationers.
Page | 47
FREQUENCY OF PROTEINURIA AND MICROCHAEMATURIA IN
POPULATION WITH HIGH RISK OF CHRONIC KIDNEY DISEASE
Author(s): BOJAN JOKSIMOVIC, Pejic Boris, Sladoje Sladjana, Vuleta Radoslav,
Pantovic Marko, Djordje Danicic, Jelena Pavlovic, Sladjan Milanovic,
Kulic Valentina, Stojkovic Mira
Supervsor(s):Doc. Dr Sinisa Ristic
Country: Montenegro
Introduction: Chronic kidney disease (CKD) is a worldwide public health problem
and it means looking for early kidney disease in people who are not already known
to have it. Increased risks for CKD were defined as people with: Diabetes, High
blood pressure, older than 60 years, or a family history of CKD. Proteinuria and
asymptomatic microscopic haematuria is a powerful marker of the presence of CKD
and of the risk of progression. Proteinuria is the most important and frequent of
these markers. Proteinuria is therefore important both for the identification of kidney
damage and for guiding future treatment and surveillance. The prognosis for the
combination of proteinuria with haematuria is significantly worse than that for
proteinuria alone.
Aim: The aim of this study has been to fortify frequency of proteinuria and
microhaematuria in population with high risk of CKD.
Material and methods: Our sample included 950 citisen of Donje Crnjelovo
willage, which is well-known endemic area od balcanic endemic nephropatia. For
any of them we got some anamnestic data by questionarry, also we have been
measured blood pressure, by indirect auscultation methods and analysed some
laboratory parametars in urin (proteins, glucose, leukocyte, hemoglobin).
Results: From all examined people 6,3% had high blood pressure. From personal
anamnesis it is shown that 1,7% has diabetes mellitus, 2,6% of all examined people
have some kidney disease, and that 12,6% have someone in family with CKD.
Proteinuria is estimated in 3,9% of all examined people, and microhaematuria is
estimated in 2,7%of people.
Conclusion: Our result suggests that, even study was conducted among population
with high risk of CKD, frequency of proteinuria and microhaematuria aren’t
statistically important.
Page | 48
EPIDEMIOLOGICAL CHARACTERISTICS OF TETANUS IN SERBIA
Author(s):MILJANA DANČETOVIĆ
Supervisor(s):Prof.Svetomir Samardžić ; Prof.Milan Parlić
Country: Serbia
Introduction & Aim: Tetanus is an acute, often-fatal disease of the nervous system that
is caused by nerve toxins produced by the bacterium Clostridium tetani. This infectious
disease - particularly the neonatal form – remains a significant public health problem in
non-industrialized countries. There are about one million cases of tetanus reported
worldwide annually, causing an estimated 300,000 to 500,000 deaths each year.
Epidemiological evaluation of tetanus in Serbia in the five-year period.
Material and methods: The paper used data from the notification of infectious diseases
and epidemics, and periodic reports on the movement of infectious diseases in the period
since 2001. to 2005. years, excluding data for Kosovo and Metohija. The descriptive and
analytical component of epidemiological method was used, that is, retrospect appear
through the observation time, the statistical issues and the application of relative rates and
numbers.
Results: In the period since 2001. to 2005. on the territory of the Republic of Serbia is
registered 56 and 31 patients died of tetanus, with incidence rates of 0.15 / 100,000,
mortality of 0.41 / 100,000 and fatality of 55.35% at the level of the Republic. The
disease was recorded in the 21 district. In the observed period was not reported any case
of patients with tetanus in the Morava, Pčinjski, South Banat and Western Bačka district.
In central Serbia, reported 40 patients, which is (71.4%) in the structure, and in
Vojvodina 16 cases (28.6%). The greatest number of patients (7) and the highest
incidence rate of 0.78 / 100,000 were in the northern Banat district. The greatest number
of patients (14), as well as deaths (9), registered in 2001. year. Female gender was
frequent in getting disease(68%). In age distribution of patients and deaths dominated age
groups (60> years), with the participation of 84% of patients, and 90% of deaths. In the
age of 2 years, reported the case of the youngest child sick and dead. In the observed
period is not registered any case of tetanus infants. The disease was registered in all
months, with the largest number of patients in the period from May to October. All sick
and deads were incomplete vaccinated or revaccinated.
Conclusion: In the Republic of Serbia since 2001. to 2005, reported the 56 patients and
31 died of tetanus, with the registered incidence rate of 0.15
/100,000,mortality,0.41/100.000 and fatality rate of 55.35%. In age distribution of
diseased and dead dominated by age groups (60> years), with the participation of 84% of
patients and 90% of dead. It was not registered any case of tetanus of newborns. Diseased
were incomplete vaccinated or revaccinated. Because of the fall of the vaccinal immunity
over the years, booster shot against tetanus is required for persons older than 30 years,
every 10 years, according to the current Program of the immunisation.
Page | 49
ABORTION AND THE BREAST CANCER; A CASE-CONTROL
STUDY
Author(s):VERA MILOSAVLJEVIC
Supervisor(s):prof.dr Milena Ilic
Country: Serbia
Introduction
Some studies (but not all) have suggested that there may be an increase in the risk of
breast cancer associated with a prior abortion.
Aim
The purpose to address the question of breast cancer risk in relation to abortion.
Matherial and methods:A case-control study, performed in Clinical Centre
Kragujevac, comprised 191 patients with histologically confirmed breast cancer and
191 hospital controls individually matched by age (+/-2 years), hospital admittance
and place of residence (rural or urban). All subjects were asked to complete a selfadministered questionnaire. To aid the women's recall, trained interviewers (medical
doctors) used a calendar on which major life events were identified. For comparison
of 2- , Ficher- , t-test statistical software was the cases and their controls, used to
estimate statistical significance of the differences associated with abortion.
Results: In our study, the women with breast cancer were not more likely than
control women to have the abortion (p=0.029), spontaneous (p=0.350) and induced
(p=0.164). Also, differences concerning the age of first pregnancy and first
childbirth, as well as last pregnancy and childbirth, and oral contraceptives use were
not significant.
Conclusion: The results of the present study give not support to the hypothesis that
there is an increase in breast cancer incidence related to a history of abortion,
induced and spontaneous, among women.
Key words: abortion, breast cancer, case-control study
Page | 50
SUPPLEMENT
TO
OVERLOOKING
OF
THE
EPIDEMIOLOGICAL CHARACTERISTICS OF THE PEOPLE
SUFFERING FROM MYOCARDIAL INFARCTION IN THE
REGION OF NISH IN 2006
Author(s):DANIJELA VELICKOVIC, Sonja Nikolic, Sanja Stefanovic
Supervisor(s):Prof. dr Branislav Tiodorovic
Country: Serbia
Introduction
The myocardial infarction (MI) is ischaemiac illness of heart which arises
in consequence of abrupt and complete intermission of circulation in one of
the coronary artery, which causes the irreversing ischaemia and necrosis myocard.
Aim
Aim of this study was to determinate epidemiological characteristics of MI and
incidence rates in the area of Nish in 2006.
The data on patients were obtained from the municipal population register
of MI in the area of Nish. The resarch included all the registered MI affected
patients in the territory of the area of Nish during the 2006. The descriptive
epidemiological study was applied.
Results
In the area of Nish in 2006 the total registred number was 981 cases ( 620
male and 361 female). The average annual unstandardized incidence rates was
256.96 (330.17 in male and 186.1 in female population). Men suffered 1.7 times
more than women. The lowest rate were register in age of group 20-24, while the
highest rate were register in 80-84, which indicates that with getting older the rate of
incidents increases. The highest rate were register in City of Nish (295.96), while
the lowest rate were register in Doljevac (168.71). Among the patients, most were
retired 63.6%, there were unemployed 18.9% and workers 6.8%. The greatest
number cases were in July (119)
Conclusion
Cardiovaskular disease is the most common cause of illnesses and
dyings and that is way it is neccessary to undertake adequate preventive measures to
decrease the number of ill and dead people.
Page | 51
LEUKEMIA IN THE NORTHWEST OF IRAN :A CROSSSECTIONAL STUDY ON 669 CASES
Field of nedicine: epidemioly ( Cancer Regestration)
Author(s): ATABAK ASVADI, Somaiie Shokrgozar, Mansooreh Taghavinia,
Shahla Fozounkhah,Saeed Dastgiri
Supervisor(s): Saeed Dastgiri
Country: Iran
Introduction: Leukemia is the cancer of the blood or bone marrow, characterized by an
unusual increase in white blood cells. Although different types of leukemia can occur at any
age, adults age 60+ are more likely to develop the disease than younger people. The most
common types in adults are Acute Myelogenous Leukemia (AML) and Chronic Lymphocytic
Leukemia (CLL). Acute Lymphocytic Leukemia (ALL) is the most common form of leukemia
in children. Lifetime probability of developing any leukemia for adults is 1-2 percent.
Hematological cancers are the sixth most common malignancies in Iran, both in males and
females. The aim of this study was to document some epidemiological features of leukemia in
the North-West of Iran.
Materials and Methods: This was a cross-sectional study on the leukemia epidemiology in
Northwest of Iran. The study subjects (n=669, including 377 males and 292 females)
comprised all leukemia cases registered/notified to the clinical and pathology centres of Tabriz
and Ardebil cities, from 2003 to 2006. All patients were classified using the ICD-10 based
coding
system
(
C91-C95,
C77
and
C42).
Results: In observation of 669 leukemia patients, annual incidence of leukemia was 3.7 [95%
CI:3.3-40] and 4.9 [ 95% CI: 4.2-5.6 ] per 100,000 population in Tabriz and Ardebil,
respectively. With appraisal of leukemia type in our patients classified using the ICD-10
coding system, 195 C91 (Lymphoid leukemia), 230 C 92 (Myeloid leukemia), 6 C93
(Monocytic leukemia), 16 C94 (Other leukemia of specified cell type)17 C95 (Leukemia of
unspecified cell type), 83 C77 (Secondary and unspecified, 102 C42 (Hematopoetic and
Reticuloendothelial system ) and 20 Unknown types were found.With an overall fatality r ate
of 13.5 percent [95% CI: 10.8-16.0], the sex ratio(male/female) was 1.23. Over the study
period, the annual occurrence of leukemia In the region increased from 3.9 [95% CI: 3.4-4.5]
to
4.1[95%CL:4.6-3.5]per
100,000
population
(p>0.1).
Discussion and Conclusions:The data from this cross-sectional study of leukemia in the
North-West of IRAN may be used as the baseline information to establish a population-based
registry of hematologic disorders in the area for health care and research purposes. However,
more investigations are needed to develop effective strategies to control the relevant disorders
in high risk groups.
Page | 52
PLENARY Session V
(Dentistry, Otorinolaryngology, Ophtalmology)
Page | 53
FOOD FACTORS AND APPEARANCE OF CARIES IN CHILDREN
OF KOSOVO COUNTRY
Field of medicine: department for dentistry
Author(s):PREDRAG VUČETIĆ
Supervisor(s): Ass. dr Zoraida T. Milosavljević-Milojković
Country: Serbia
Introduction
Dental caries is multicausal, multiphase, reversible infectious disorder.
Aim
To establish existence of inadequate food as a potential risk factor and its
influence in the small child period.
Influence enquiry of inadequate food as etiological factor on appearance
of Caries of early childhood (KRD), covered children that were two, tree, four and
five year old, who were attending kindergarten in the area of north part of Kosovska
Mitrovica, Zvečan, Zubin Potok and Leposavić children, whose parents filled out
questionnaire about the children nourishment and gave Sample was determined in
method of random choice. Dental exam was carried out in 120 accordance for dental
exam. 77 children or 64 % of all that were covered by research had more than 5
meals per day.
Results
Children without caries were fed 5 times a day in 43 % of cases, while
children with caries were fed more than 5 times a day in 75% of cases. In total 50%
of children (15% of children without caries, and 67% of children with caries)
consumes sweet food on daily basis. Sweet food is dominant in nourishment of 61%
of children with caries and 8% without caries.
Conclusion
cases have more than 5 meals per day. Children without KRD have at
most 5 meals per day, while children with KRD in 75% of Frequency of carbon
hydrates consumption in children with KRD increases with age. The biggest number
of enquired children consumes carbon hydrates between the meals. Children without
KRD between the meals more frequently consume juices, fruit, and. vegetable. In
difference of children with KRD who consume sweets between the meals every day.
Key words: food factors, caries
Page | 54
CORRELATION BETWEEN CHRONIC PERIODONTITIS AND
CORONARY HEART DISEASE IN MIDDLE-AGE MEN
Field of medicine: internal medicine,dentistry
Author(s): YURIY ROMAN
Supervisor(s): doc, mu Dr Alexander Kishko, CSc
Country: Ukraine
Chronic periodontitis (CP) is though to be an independent risk factor for
coronary heart disease (CHD). However, no true causal relations between CP and
CHD have been evidenced.
The aim of the study was to assess the incidence of CHD in a cohort of
middle-age males with CP.
We evaluated the incidence of CHD in 120 men under 60 years of age
with significant clinical and radiographic signs of chronic CP in comparison to those
in 120 dentally healthy men of the same age. Both groups were identical to other
risk factors for CHD as smoking, hypertension, cholesterol and glucose levels, body
mass index. At each examination CP was assessed both radiographically and
clinically by a specially trained dentist, comprehensive in oral examination. CHD
was assessed clinically and by the results of ECG, ECHO, stress-tests, myocardial
perfusion scintigraphy or coronary angiography, when needed.
A clinically significant evidence of CHD was found in 48(40.0%) of 120
men with CP under 60 years of age. It significantly differed from the result in
control group, where CHD was found only in 22 (18.2%) of the cases.CP is
associated with higher incidence of CHD among middle-age males, independently of
established cardiovascular risk factors. It should be taken into the account for
accurate definition of CHD risk profile in individual man subject of this age group.
Page | 55
THE EFFICACY OF PROPHYLACTIC USE OF NAPROXEN AND
IBUPROFEN IN CONTROL OF PAINS CAUSED BY ENDODONTIC
Field of medicine: dentistry
Author(s): MARYAM FOROOZIA, Habib Allah Khalil Khani,Fereshteh Ghorban
Sarvi, ,Javaneh Atighi
Supervisor(s):Dr.Habib allah Khalil khani
Country: Iran
Introduction
The most common problems in endodontic treatment is effective pain
management. Naproxen is a Non-Steroidal Anti-Inflammatory Drug (NSAID)
which, is often used for post-endodontic pain management all around the
world,however,it is not the first choice in Iran.
Aim
The purpose of this study was to determine the effectiveness of the
prophylactic prescription of Naproxen, Ibuprofen and placebo in pain management
after endodontic treatment.
Methods
A double-blind, single prophylactic oral dose administration of 400mg
Ibuprofen, 500mg Naproxen or a placebo was performed on a total of 34 patients in
a clinical trial experiment. The endodontic treatments were completed in one visit.
Patients reported their pain levels by use of the VAS (visual analog scale) before the
initiation of treatment, 4, 8, 12 and 24 hours after completion of endodontic
treatment.
Results
Statistical analysis of data showed that both Naproxen and Ibuprofen
demonstrated significantly better pain relief than placebo, however pain reduction
occurred a bit faster with Naproxen (P<0.01).
Conclusion
It could be concluded that prophylactic prescription of Naproxen is useful
in post-endodontic pain control.
Page | 56
A STUDY EFFICACY OF NSAIDS IN CONTROL OF PAINS
CAUSED BY ORTHODONTIC
Field of medicine: dentistry
Author(s): parviz padisar,roya naseeh,zeinab hoseinian,MARYAM FOROOZIA,
javaneh atighi
Supervisor(s): Dr.Parviz Padisar,Dr.Roya Nasseh
Country: Iran
Introduction
Since pain is one of the most important reason that patients do not come
for orthodontic treatments, pain control is important for both clinicians and patients.
Objectives
This double-blind prospective clinical trial was carried-out with the aim of
determining the efficacy of common used Non-Steroidal Anti-Inflammatory Drugs
(NSAIDs)
for
pain
control
after
orthodontic
procedures.
Methods
This study was performed in two stages. In the first stage, separators were
placed on both sides of the first superior molar, in 43 patients (22 females and 21
males) to obtain their pattern of pain plotted on a 100 mm horizontal line (VAS). In
the second stage, 75 patients, after placement of initial arch wire, were randomly
divided into 5 groups receiving 5 different treatments (Ibuprofen, Naproxen,
Mefenamic-Acid, Aspirin and placebo). After receiving 2 doses of drug, they
indicated the severity of their pain during mastication, biting, fitting on anterior and
posterior teeth.
Results
Statistical analysis were carried-out based on ANOVA and t-test. The pain
increased soon after placement of the arch wire and reached its peak in 24 hours. In
all cases, the least pain was reported following consumption of Ibuprofen and the
most after taking placebo.
Conclusion
This study showed that the pattern of pain had no relation with gender and
the pain began immediately after bonding and reached its peak in 24 hours, then
gradually decreased during a period of 7 days. Ibuprofen was relatively the most
effective drug in decreasing the pain.
Page | 57
OTOLARYNGOLOGY AGAINST TOBACCO USE. SMOKEINDUCED OUTCOMES OF ENDOSCOPIC SINUS SURGERY OF
CHRONIC RHINOSINUSITIS
Field of medicine:otolaryngology
Author(s):MARTA KISIEL
Supervisor(s):Rafał Chmielewski
Country: Poland
Introduction
The purpose of this study is to investigate weather smoking influences a
long-term outcomes of endoscopic sinus surgery of chronic rhinosinusitis (CRS).
The study prospectively enrolled 274 patients at the Department of
Otolaryngology of Warsaw Medical University. All patients had diagnosis of CRS
and underwent endoscopic sinus surgery, performed from 1993 to 2000 at a longterm follow up. Patients were divided into two groups: smokers (n=61) and nonsmokers (n=213). Symptoms were compared on the Lund-Kennedy scale and
Rhinosinusitis Task Force Symptom Criteria (RTFSC). If symptoms did not
disappear patient were re-operated (n=27).
Results
In a re-operated group were 22% of non-smokers in comparison to 44% of
smokers (p=...). Before a surgery, 23.2% of smokers (n=61) and 20.5% of nonsmokers (n=213) scored III or IV on the Lund-Kennedy Endoscopic scale (p=).
In the pre and postoperative RTFSC smokers in comparison to non-smokers had
similar improvement (p=, p=).
Conclusions
The study shows that smoking had not influence on preoperative CT scale
score and pre/postoperative symptoms scale. Nevertheless, there were twice more
smokers in the re-operated group then in the one operated. All results recommended
quitting of smoking.
Page | 58
CELL- BASED THERAPY FOR RECOVERY OF NASAL MUCOSA
IN RABBITS
Field of medicine: otorhinolaryngology, regenerative medicine
Author(s): NIKITENKO N., Baranov P.
Supervisor(s): Alexander P. Ettinger, Alexander S. Pavliuk
Country: Russia
Introduction
Certain surgical procedures carried out on the lachrymal apparatus, nasal
chambers and paranasal sinuses include partial or total removal of the mucosal
lining. Its recovery takes 1.5-3 months and usually is complicated by chronic
inflammation. In this case common therapeutic approaches are ineffective.
Aim
We decided to asses the efficiency of the cell therapy method for recovery
of aseptic nasal mucosal defects in the experiment.
On proposed model (surgical injury of nasal mucosa) we assessed the
efficiency of transplantation of human buccal epithelial cells embedded in collagen
gel. The experiment was conducted on 14 New Zealand rabbits. To make a surgical
defect we excised mucosal flaps (1*3 mm) on both sides of cartilaginous nasal
septum. In the treatment arm we performed transplantation of buccal epithelial cells
in the defect region, in the second arm – surgical defect only. The regeneration of
nasal mucosa and the effect of cell therapy was assessed histologically and
morphometrically in 1,2,3,5,7,12,14 days after operation
Results
We observed decrease in size of fibrinous clots, early completion of the
inflammatory infiltration, early initiation and completion of epithelization and more
blood vessels compared with the control.
Conclusion
We proposed and described the biological model of the surgical defect of
nasal mucosa in rabbits. On this model we showed the high efficiency of cell therapy
– transplantation of buccal epithelial cells embedded in collagen gel in the area of
mucosa defect.
Page | 59
NEONATAL HEARING SCREENING
Field of medicine:otorhinolaryngology
Author(s):SLAĐANA PETKOVIĆ
Supervisor(s):Doc.dr Miško Živić
Country:Serbia
Introduction
One-three of one thousand newborns has severe congenital or perinatal
sensorineural hearing defect. Early detection of hearing function defect enables
preventive and proper intervention, habituation and rehabilitation, which enables
ability of speech, language, and in the end intellectual, emotional and psyhosocial
development of children.
Aim
Is to show preliminary results of neonatal screening test of hearing
function, which was carried out in Clinical center in Niš and to determine potential
etiological factors of hearing defect in newborns.
Our paper is based on standards of National program of neonatal hearing
screening and it's based on research of 695 newborns in first three months. We used
two phase screening protocol transiting otoacustic emission with a help of automatic
machine ERO.SCAN, type MAICO. Initional test TEOAE was carried out from
second day after birth. Retest TEOAE was carried out after one month.
Results
After the initional test (TEOAE), on 695 babies, from observation were
eliminated 89,10%, and after repeated test(TEOAE) 99,42%. Four babies(0,58%)
were prosided to further investigation. From 76(10,9%) babies, which had a positive
test, during initial investigation, 37(5,2%) had positive test on both ears and
39(5,7%) on one ear. From the whole 695 babies in seventeen were found risk
factors for acquring hearing defect.
Conclusion
We hope that our results will contribute to development of national
program of neonatal hearing screening and enable publishing exact data about
prevalention and incidention of children with hearing defect in South Serbia.
Key words: neonatal hearing screening, TEOAE, positive test, risk factors
Page | 60
BINAURAL COCHLEAR IMPLANTATION. FUTURE METHOD
OF CHOICE?
Field of medicine:otolaryngology
Author(s):MARTA KISIEL
Supervisor(s):Rafał Chmielewski
Country: Poland
Introduction
Bilateral implantation is an accepted method of cochlear implantation.
Nevertheless, costs of a procedure and a fear of patients have a negative influence on
it wider applications. Therefore, Truy et al. (2003) invention of cochlear implant,
with 24 channels comprises two active electrodes and one internal processor, has
been received enthusiastically.
Material and method
The authors present results of three cases of binaural implantation.
Binaural
implantation
were
performed
in
post-meningitis
patient
(2004),posttraumatic patient (2004) and patient with cochlear otosclerosis (2008).
All underwent a special surgical technique by a cochlea and a subperiosteal passage
to perform an electrode around a skull. The audition of all patients were explored by
the free field threshold evaluation, the audiometry in silence and noise, the speech
perception
evaluation
tests
and
the
sound
localization
tests.
Result and conclusion
Results of the tests showed that bilateral stimulation improved speech
perception in silence and noise and the localization tests what upgraded patients
quality of life. Binaural implantation is an effective solution in cases of bilateral
hearing problems.
Page | 61
MYOPIA- GLOBAL HEALTH PROBLEM
Field of medicine: ophthalmology
Author(s): IVANA JOVANOVIĆ, Gorana Grković, Predrag Jovanović
Supervisor(s): Asist. sci dr Gordana Stanković-Babić
Country: Serbia
Introduction
Due to the fact that myopia is still one of the actual problems in
ophthalmology, the basical research of etiology and pathogenesis is necessary for
it’s prophylaxis and therapy.
Aim
We study retrospectively the children with myopia compared with the sex,
age, height of myopia and the presence of myopia in one or both eyes.
Patients and methods
During the period from 2003-2007, in the Ophthalmology Clinic in
Clinical Center Niš, we realized the first checkup of 650 children, age1to18years.
We examined subjective acuity of sight, the objective refractions of eyes (skiascopy
or refractomerty), biomicroscopy, direct ophthalmoscopia and binocular status.
Results
Of 650 examined children, age 1 to 18years, myopia and myopically
astigmatism were found in 75children (11,69%) of all refraction anomalies (n=131),
in 35 boys and 41 girls. Myopia on one eye as well as myopia on both eyes was
more presented in girls. Compared to age, the majority of school children were age 7
to 9years (n=21;27,63 %) and 10 to 12years (n=17;22,37%). Myopia on both eyes
was found in 55 children (72,37%) and myopia on one eye in 21children(27,63%).
Among 76 children (n=131eyes) with spherical dioptre were 50 eyes(38,17%), with
the myopically astigmatism n=81 eyes(61,83%).
Conclusio:
Accidentally presence of dull sight on one eye or deviations of bought
eyes are the most common reason for child to have an ophthalmological checkup.
The obligatory ophthalmological checkup in preschool period, the latest 3 to 5 years,
will bring the timely detection of refraction anomalies and an adequate therapy.
Key words: myopia, myopically astigmatism, school children
Page | 62
CLINICAL CHARACTERISTICS AND ETIOLOGY OF UVEITISES
Field of medicine:ophtalmology
Author(s):GORDANA ĐUROVIĆ
Supervisor(s):prof. dr Anka Stanojević-Paović
Country: Serbia
Introduction
Uveitises are inflammations of the uveal tract (iris, ciliary body and
choroidea) with chronic relapse course and most often with bilateral localization.
Uveitises most often occur in younger, working population and children and have a
great social and medical importance due to the significant functional damage of the
sight organs.
Aim
The aim of the investigation was to examine etiolology and clinical
characteristics of uveitises.
Material and method
Etiology and clinical characteristics of uveitises were examined in 69
patients hospitalized at Prof. dr Đorđe Nešić, Institute for Eye Diseases, CCS
(retrospective study).
Results
The mean age of patients was 40.32 years. There were 38 (55.1%) female
and 31 (44.9%) male patients. In 30 patients (44%) anterior uveits was diagnosed;
intermediate in 3 (4%), in 12 patients (17%) posterior uveitis, in 15 patients (22%)
total uvetis; neurouveitis was diagnosed in 4 patients (6%) and retinal vasculitis in 5
(7%). Bilateral localization was found in 29% of patients, while unilateral occurred
in 71% of cases. A higher number of unilateral localization was statistically
significant. Certain etiology was diagnosed in 15.7% of patients, possible in 7.2%
and in 77.1% of patients etiology was not proved.
Conclusion
Statistical significance of distribution by sex and age was not proved.The
most represented form of anterior uveitises was fibrinopurulent uveitis. The most
represented form of posterior uveitises was the multifocal type of chorioretinitis.
Etiology was not proved in 2/3 of patients.
Page | 63
PLENARY Session VI
(Biochemistry, Pathophysiology, Dermatovenerology)
Page | 64
IDENTIFYING OF PREDICTING GENES INVOLVED IN ANGIOGENESIS OF THE
BORDERLINE OVARIAN TUMOURS USING MICROARRAY TECHNOLOGY
Field of medicine:molecular biology
Author(s):CRISTINA CIOCANEA, Ioana Berindan Neagoe, R.Chiorean, O.Balacescu,
Oana Tudoran, Loredana Balacescu, Al. Irimie, V.Cristea
Supervisor(s): Ioana Berindan Neagoe
Country: Romania
Introduction: Ovarian cancer is the 5th leading cause of cancer related death in women
being the leading cause of death from gynaecological malignancy, with an estimated
230.000 new cases all over the world and more than 142,000 disease fatalities each year.
Early-stage disease is largely asymptomatic, and most patients are diagnosed when
disease has spread beyond the pelvis with an associated 5-year survival of less than 20%.
Borderline ovarian lesion is an intermediate step in the development of adenocarcinomas.
We looked to identify molecular markers in this pathology. To identify the gene
expression profile in ovarian borderline lesions and to explore its correlation with
angiogenesis mechanisms we used Agilent microarray technology.
Material and Method: Fresh specimens from twelve patients with epithelial ovarian
lesion were collected and stored in liquid nitrogen to be analyzed for microarray
technology. The control group included 4 specimens of normal ovarian tissues.
According with the pathological classification we established three groups of ovarian
tumors:borderline mucinous ovarian tumors, borderline serous ovarian tumors and
malignant serous ovarian tumors. All specimens were processed for RNA extraction,
quality and quantity control, followed by probe hybridization using Gene Expression
Hybridization Kit from Agilent® . The WHG slides were read for Cy3. We used for data
analysis of scanned slides Feature Extraction 9.3 soft. The molecular profiling was
established in accordance with Gene Spring soft for a fold range > 3.
Results: We found differentially expressed genes for borderline tumour compared to
normal tissues and malignant ovarian tissues. From the amount of genes over-expressed
and under-expressed we identified those with relevance in several steps of angiogenic
mechanisms and compared the level of expression between the 4 groups of tumors:
ADAM28, ADAM9, CDH6, TGFα, MMP1, CCND1, TNFRSF, PDGF, PDGFR
.
Conclusions: The results obtained in our study confirm the theory that angiogenesis is
one of the first steps in malignant transformation, early detection of epithelial ovarian
lesions being of vital importance in cancer treatment. The wealth of data obtained by
microarray technology permit the true molecular profiling of a patient competing to his
therapy and response rate. We consider as highly advisable and appropriate microarray
molecular profiling in ovarian early stages as well as in defining new molecules or
mechanisms related to angiogenesis, especially those of malignant potential (borderline).
Page | 65
THE ROLE OF PCR ARRAY ANALYSIS OF MOLECULES INVOLVED IN
ANGIOGENESIS IN PROSTATE CANCER diagnosis
Field of medicine: molecular biology
Author(s): CHIOREAN ROXANA,Ovidiu Balacescu,Cristina Ciocanea,Loredana
Balacescu,Oana Tudoran,Alexandru Irimie
Supervisor(s): Ioana Neagoe-Berindan
Country:Romania
Introduction: Prostate cancer represents a major health problem, being the second cause of
death, after lung cancer, in the population of males over 50, worldwide. Angiogenesis, which is
the formation of new blood vessels, is a highly regulated process, that plays an essential role in
the growth and development of malignant tumours.The modulation of this process depends on
the expression of pro angiogenic factors and angiogenesis inhibitors, through several molecular
mechanisms, involving the over and underexpression of the genes that control the angiogenesis
features.
Aim: The objective of this study was to evaluate in the blood a set of 84 genes transcripts
involved in angiogenesis. Their level expression could bring important data for dignosis in
addition to use of the PSA, abnormal digital rectal examination, and pathological confirmation
for prostate cancer .
Materials and Methods: : Patients: The study was developed on two groups of subjects as it
follows: one, the control group was formed by four healthy subjects with PSA value confirmed
less than 4 ng/ml, normal DRE and abdominal ecography ; the second group contained four
patients with pathologically confirmed prostate adenocarcinoma with PSA value bigger than
4ng/ml, abnormal DRE and abdominal ecography. All patients were free of any associated
diseases. Methods: We used RT² Profiler™ PCR Array technology developed by SA
Bioscience – PAHS -024 kit for Human Angiogenesis ( including angiogenic factors, citokine
and interleukines, growth factors and receptors, transcription factors and adhesion molecules).
The PCR array combine the multi-gene profiling capacity of microarray technology with the
real-time PCR sensitivity. The gene expression normalisation was made on a set of 5
housekeeping genes. The bioinformatic analysis was made using RT² Profiler™
PCR Array Data Analysis.
Results: 1.5. We found 5 overexpressed genes and 32 underexpressed genes in the cancer
group,compared to the normal group.0.05 and fold change From the total number of 84
genes our results revealed a number of 37 with abnormal expression levels.The genes were
selected in accordance with p values The overexpressed genes are involved in adhesion
molecules, cytokines and chemokines mechanisms and the underexpressed genes are involved
in angiogenic, adhesion molecules, transcription factor, cytokines and chemokines mechanisms
.
Conclusion: Our data suggest that PCR Array analysis of angiogenic transcription profile on
blood samples represent an important tool which can improve the prognosis for prostate cancer
in a noninvasive manner.
Page | 66
THE GENETIC POLYMORPHISM OF GSTM1 IN PATIENTS
WITH RENAL CELL CARCINOMA
Author(s): VESNA CORIC, Ivan Ivanovski, Jelena Colic
Supervisor(s): ass. dr Marija Pljesa-Ercegovac
Country: Serbia
Objective
Cytosolic glutathione tranferases (GTSs) are superfamily of enzymes that
protect normal cells by catalyzing conjunction reactions of electrophylic
compounds, including cancerogens, with glutathione. Since differential glutathione
transferase expression significantly influences anti-carcinogenic potential of tissues,
GSTs are currently being investigated as biomarkers of risk for various cancers,
including renal cell carcinoma (RCC). Among polymorphic GST classes, GSTM1,
GSTT1 and GSTP1 polymorphisms have been investigated with regard to
interindividual differences in susceptibility to RCC
Aim
The case control study was designed to test the association between
genetic polymorphism of GSTM1 and susceptibility to RCC.
Materilas and methods
Genomic DNA was isolated from blood of 56 controls and 65 patients
with RCC, who completed a structured interview. Genotypes of GSTM1 were
determined by multiplex PCR. Data obtained on GSTM1 polymorphism were
statisticaly analyzed with respect to known RCC risk factors.
Results
Analysis of demographic data in the group of RCC patients have shown
that older patients had higher risk for RCC and that the number of RCC patients
decerased with increase in body mass index. GSTM1 null genotype (GSTM1*0) was
found in 48,2 % controls and 58,5% in cases. The results have shown that frequency
of GSTM1*0 is not increased in RCC. Frequencies of GSTM1*0 genotype and
smokers were higher in patients with RCC.
Conclusion
Further studies are necessary to clarify the role of GSTM1 polymorphism
as risk factor for RCC, independently or in conjuction with other known risk factors
for this carcinoma.
Page | 67
IDENTIFICATION OF GENETIC MUTATIONS IN A GROUP OF
ROMANIAN PATIENTS SUFFERING FROM β-THALASSEMIA
Field of medicine: genetics
Author(s): FARCAS M., Antonesei M., Csernik F., Trifa A. P., Tania C.
Supervisor(s): Radu Anghel Popp MD
Country:
Introduction: β-thalassemia is caused by mutations that result in the reduced or
non-production of β-globin chains. Around 170 such mutations have so far been
identified. Most homozygotes suffer from a severe syndrome and require regular
blood transfusions to survive. This makes β-thalassemia one of the most significant
single gene disorders globally.
Aim: The aim of this study is to determine which mutation in the β-globin encoding
gene is responsible for the occurrence of β-thalassemia in a group of 31
Romanian patients.
Materials and methods: We studied if 5 of the most common β-globin gene point
mutations reported by other studies done on Romanian patients are responsible for
the occurrence of the clinically and biochemically diagnosed β-thalassemia in our
study group. We performed genetic analysis by means of molecular genetics
techniques, respectively ARMS –PCR (Amplification Refractory Mutation System –
Polymerase Chain Reaction) by amplifying both the mutant and normal allele. We
investigated the following 5 mutations: CD 39 (C>T), Iv 74, Iv -110, IVSI- 1 and
C87G.
Results: We obtained a number of 2 heterozygotes for the Iv 74 mutation and 3
heterozygotes for the Iv-110 mutation. The other patients did not present any of the
mentioned mutant allele variants.
Conclusion: β-thalassemia is a disorder which has a strong degree of genetic
heterogeneity. ARMS-PCR is a fast and reliable molecular genetics technique for
studying common point mutations in the β-globin gene. However, if the responsible
mutation is rare, more powerful methods must be used in order to perform genetic
diagnosis, such as β-globin gene sequencing. The early detection, prevention and
prophylaxis of this form of pathology must be taken into account by all national
health systems.
Page | 68
IDENTIFICATION OF APOPTOSIS IN THE BRAIN OF RATS
PERINATALLY TREATED WITH PHENCYCLIDINE
Field of medicine: Biochemistry
Author(s): ANA ZEKOVIC, Ognjen Bojović
Supervisor(s): dr Nevena Radonjić
Country: Serbia
Introduction
Apoptosis represents genetically controlled proces of cell death.
Neurotransmitter glutamate, acting on NMDA receptors, has a trophic role in brain
in development. Blockade of NMDA receptors in period of development induces
widespread apoptotic neurodegeneration in the brain. Phencyclidine (PCP),
dissociative anesthetic, represents noncompetitive antagonist of NMDA receptors.
Perinatal administration of PCP to rats represents one of the actual animal models of
schizoprenia.
Aim
Verification of animal model and identification of apoptosis 24h after
perinatal phencyclidine treatment in specific brain structures.
Experiments have been conducted on Wistar rats, which were perinatlly
treated on postnatal (PN) day 2., 6., 9. and 12. with either phencyclidine (10 mg/kg)
or saline. Animals were weighed on PN day 13. (24h after the last treatment) and
sacrificed. Isolated brains were weighed and prepared for (immuno)histochemical
analysis. In order to identify apoptosis TUNEL method, propidium iodide staining
and silver method by De Olmos for identification of neurons in process of
neurodegenartion have been used.
Results
Comparison of average values in brain weight showed significant
difference between control and experimental group, while there was no difference in
total body weight. In phencyclidine perinatally treated group widespread apoptotic
process was identified in cortical, subcortical and limbic structures, while in control
group only single, rare apoptotic cells have been detected.
Conclusion
It has been showed that in used animal model blockade of NMDA
receptors in perinatal period leads to widespread apoptosis in specific brain
structures.
SENSITIVITY OF AGING RAT ASTROCYTES IN ENERGY
Page | 69
LIMITED CONDITIONS
Author(s): ALEKSANDAR B. MITROVIC, Mirko Varajic, Nemanja Opacic
Supervisor(s): Doc.Dr Aleksandra Isakovic
Country: Serbia
Introduction: Astrocytes participate in numerous brain functions, in maintaining
homeostasis of CNS, and in reparatory processes of brain tissue after damage.
Morphological changes, together with age-related alteration in functioning and
sensitivity of astrocytes, could affect various brain processes.
Aim: The aim of this study was to investigate how adenosine affects morphology
changes of astrocytes of different age (given that concentration of this nucleoside
significantly increases in various pathological conditions), as well as to determine
the sensitivity of astrocytes of different age in conditions with deprivation of
energetic depots and comparing their sensitivity with C6 cells of glioma.
Material and methods: Primary culture of Wistar rats’ astrocytes and C6 cells of rat
glioma were used in the experiments. Cell viability was assessed by MTT test.
Immunocytochemical dying was used for verification of astrocytes culture (positive
GFAP experession) and distribution of actinic filaments.
Results: The results have demonstrated that adenosine induces arborisation of
astrocytes accompanied by changing cell body shape from polygonal to oval/round,
whereas morphology of C6 cells remained unchanged. Immunocytochemical
analysis of actin distribution on fluorescent microscopy revealed depolimerization of
actin cytoskeleton and consequent lack of stress-fibers and focal adhesions.
Adenosine failed to affect the viability of both, astrocytes and C6 cells. Glycolysis
inhibitors IAA- and NaF-induced deprivation of energy depots led neither to
statistically significant difference in changing viability between young and old
astrocytes nor comparing to C6 cells.
Conclusion: Adenosine takes effect on morphology change in astrocytes of
different age by inducing actin cytoskeleton rearranging and their arborization,
without changing their viability. Different age astrocytes and C6 cells display
similar sensitivity in energy limited conditions.
Page | 70
A BIOCHEMICAL ANALYSIS OF ENDOGENOUS HYDROGEN
SULPHIDE GENERATING ENZYMES
Author(s): MATTHEW JAMES DOE
Supervisor(s): DR. STEPHEN PH ALEXANDER
Country: United Kingdom
Aim
Hydrogen sulphide (H2S), a well known toxic gas, has recently been
defined as a physiologically relevant gasotransmitter. H2S has been found to open
KATP channels and act as a cytoprotective signaller at an endogenous concentration
of 1-300μM. Three enzymes endogenously generate H2S in mammalian tissues via
the desulphydration of cysteine to pyruvate. The present study focused on a
biochemical analysis of cystathioine γ-lyase (CGL), which is thought to synthesise
H2S in the liver, kidney and vasculature.
Methods and Materials
Rat liver cytosol was utilised as a source of CGL. Enzyme activity was
recorded using an adapted form of the spectrophotometric methylene blue method of
H2S determination with 100μM sodium sulphide used for calibration.
Results
L-cysteine was confirmed as the preferred substrate for CGL, with a Km
of 2mM in this assay system. DL-propargylglycine (PPGG), a suicide inhibitor of
CGL, was found to be effective at 10μM, but also to inhibit CBS in rat kidney
cytosol at higher concentrations. ATP (IC50=3.6mM) and ADP (IC50=6.3mM)
were identified as novel CGL inhibitors, while AMP stimulates CGL activity.
Synthetic H2S enzyme activity was in the order liver>kidney>brain in the rat.
Conclusion
CGL activity could transiently increase by removal of tonic ATP
inhibition in conditions such as hypoxia. This would result in ATP generation from
pyruvate and a net increase in H2S levels. This could generate a concentration great
enough for H2S to become physiologically relevant, triggering the appropriate
mechanical effects on vascular beds and cytoprotective properties.
Page | 71
OXIDATIVE STRESS AS A POSSIBLE MECHANIZME OF LIVER
INJURY IN STRESS AND ACUTE ETHANOL INTOXICATION
Field of medicine: Pathophisiology
Author(s):KRISTINA BONDZIC, Ana Andrejevic, Jovana Stekovic
Supervisor(s):Dusan Mladenovic, Tatjana Radosavljevic
Country: Serbia
Stress leads to increased glucocorticoid production, which impairs oxidative status
of the cell. Ethanol, also, induces oxidatuve stress in hepatocytes due to increased
reactive oxygen species production and decreased capacity of antioxidative defense.
The aim of our study was to investigate the role of oxidative stress as a possible
mechanizme of liver injury in stress during acute ethanol intoxication.Male Wistar
rats (n=28) were divided into following groups: 1. control group, 2. ethanol-treated
group, 3. stress-exposed group, 4. ethanol-treated group with stress exposure.
Ethanol was administered in 5 doses of 2 g/kg at 12-hour time intervals. Stress was
induced by 15 minute-lasting exposure of animals to the temperature 4 ˚C during 15
days. After last treatment blood samples from the right side of the heart and liver
samples were collected for determination of oxidative stress parameters. Stress and
ethanol individually induced a significant increase in malondialdehyde, nitrite and
nitrate concentration in liver tissue in comparison with control group (p<0.01). The
most pronounced increase was detected in ethanol-treated group after cold exposure
(p<0.01). Stress exposure induced a significant increase in the activity of total
superoxide dismutase (SOD) and its izoenzymes (p<0.01), while ethanol induced a
significant fall in total and Cu/Zn SOD activity (p<0.01). MnSOD activity was
increased after ethanol treatment (p<0.01). Reduced glutathione level was
significantly lower in ethanol-treated and stress-exposed group in comparison with
control values (p<0.01). Ethanol treatment of cold-exposed group induced the most
extensive reduction in SOD activity and glutathione content. As cold-induced stress
and ethanol have additive effects in inducing prooxidant/antioxidant disbalance in
the liver, stress potentiates ethanol-induced oxidative liver injury caused by acute
ethanol intoxication in rats.
Key words: cold-induced stress, ethanol, oxidative stress, liver injury, rats
Page | 72
THE ROLE OF AGING ON OXIDATIVE LIVER INJURY DURING
BINGE ETHANOL DRINKING IN RATS
Field of medicine:Pathophisiology
Author(s):ANA ANDREJEVIC, Kristina Bondzic, Tamara Sljivancanin
Supervisor(s):Dusan Mladenovic, Tatjana Radosavljevic
Country: Serbia
Aging is a physiological process, that may contribute to increased sensitivity of
various cells, including hepatocytes to oxidative damage. Ethanol, also, increases the
lipid peroxidation in the liver due to increased reactive oxygen species production
and decreased antioxidative capacity. The aim of our study was to investigate the
role of aging on oxidative liver injury during binge ethanol drinking in rats. Adult (3
months) and old (18 months) male Wistar rats (n=28) were divided into following
subgroups: 1. control, 2. ethanol-treated groups. Ethanol was administered in 5 doses
of 2 g/kg at 12-hour time intervals by orogastric tube. After last treatment blood
samples from the right side of the heart and liver samples were collected for
determination of oxidative stress parameters. Aging and ethanol individually
induced a significant increase in malondialdehyde, nitrite and nitrate concentration
in the liver in comparison with adult control rats (p<0.01). The most extensive
increase was detected old ethanol-treated rats. Similarly, aging and ethanol induced
a significant fall in superoxide dismutase (SOD) activity. While MnSOD activity
was significantly higher in adult ethanol-treated animals (p<0.01), the activity of
both izoenzymes was significantly lower in other groups in comparison with adult
control group. Reduced glutathione content was significantly decreased in old and
ethanol-treated animals in comparison with adult control group (p<0.01). The most
pronounced decrease in SOD activity and glutathione content was evident in old
ethanol-treated animals. Aging potentiates ethanol-induced oxidative liver injury due
to increased lipid peroxidation and nitrozative stress and decreased antioxidative
capacity of hepatocytes.
Key words: aging, binge drinking, oxidative stress, liver injury, rats
Page | 73
AGING AS PREDISPOSING FACTOR FOR OXIDATIVE LIVER
INJURY IN RATS DURING COLD-INDUCED STRESS
Field of medicine:pathophysiology
Author(s):TAMARA ŠLJIVANČANIN, Jovana Šteković, Ana Andrejević
Supervisor(s):Prof. dr Tatjana Radosavljević, Ass. dr Dušan Mladenović
Country: Serbia
Introduction
It is known that aging, as physiological process, is followed by decreased
level of antioxidant system and increased free radicals production resulting in cell
damage. Cold induced stress is also characterized by altering the antioxidant status
and oxidative damage as a result of lipid and protein peroxidation and cell
mmembrane injury in rat liver tissue.
Aim
To investigate the effect of aging on oxidative liver injury in rats during
cold-induced stress.
Male Wistar rats (n=28) were divided into two groups: 1. 3 months old
rats and 2. 18 months old rats. Depending on treatment this two groups were divided
into control groups (K3 i K18) and cold-stress groups (S3 i S18) followed by
maintaining them on 4˚C for 15 min/day for 15 days. 24 hours after last exposure to
stress, blood samples from the right side of the heart and liver samples were
collected for determination of corticosterone level in plasma and oxidative stress
parameters.
Results
Corticosterone level , indicator of stress, were significantly increased.
Malondialdehyde concentration was elevated both in plasma and liver in cold stress
group of old rats (p<0.01). Moreover, level of reactive nitrogen species were
increased (p<0.01). Superoxide dismutase activity and its izoenzymes show decrease
in cold-stress group of old rats and their control (p<0.01). Reduced glutathione level
were depleted in liver of old rats and cold-stress groups (p<0.01).
Conclusion
Aging alters stress induced oxidative damage because of the increased
lipid peroxidation and nitrogenic stress and decreased antioxidative cell capacity.
Page | 74
INFLUENCE OF PHYSICAL EXERCISE ON LIPID PEROXIDATION
PROCESS AND OXIDATIVE STRESS
(oral presentation )?
Field of medicine: Pathophysiology
Author(s): VUK ANDRIJASEVIC
Supervisor(s): Prof. Ljiljana Popovic
Country: Serbia
Despite the many health benefits of exercise, there is a plenty of evidence suggesting
that endurance exercise is associated with oxidative stress. Physical exercise is
characterized by an increase in oxygen consumption by the whole body and
particularly by active muscles. This process is accompanied with a rise in the
production of reactive oxygen species (ROS), that may be responsible for a series of
physiological and biochemical changes that occur during exercise.
Measuring free radical production directly is difficult, primarily because of the short
life-spain of the species. The majority of studies investigating the effects of exercise
on oxidative stress have focused on markers of free radicals induced tissue damage.
Malondiadehyde (MDA) is the final product of lipid per oxidation, and increased
concentration of this compound is believed to be an indirect reflection of increased
free radicals concentration.In this paper MDA plasma levels were determinate in 30
students in rest and after treadmill running protocol (Bruce Treadmill Protocol). It
has been found that after the treadmill test, the level of MDA in plasma had
increased
from
3,04
µM/L
to
4,39
µM/L
(p<0,0001).
This results suggest that strenuous exercise increase production of free radicals,
causing increased lipid peroxidation process. The question for further investigation
would be the benefit antioxidant supplements in preventing exercise induced
oxidative stress.
Key words: exercise; oxidative stress; free radicals; lipid peroxidation; MDA
Page | 75
FUNCTION OF NMDA-RECEPTOR IN CALCIUM HOMEOSTASIS
OF HT-168 MELANOMA CELL-LINE
Field of medicine:Basic Science, Melanoma
Author(s):RENÁTA SÜTŐ
Mentor(s):Róza Zákány, Tamás Juhász
Country: Hungary
According to some data, non-selective ionotropic cation channel NMDA-receptors
play important role not just in the function of excitable cells but also in the
migration, proliferation and survival of certain tumor cells. As melanocytes, the
pigment producing cells of the epidermis have neuroectodermal origin, we aimed to
demonstrate the expression and function of NMDA-receptors in melanocyte-derived
malignant cells.HT-168 cell line is established from a liver metastasis of a human
cutaneous melanoma. We investigated the expression of three subunits of NMDAreceptor, NR-1, NR-2A and NR-2B in cells of this cell line. mRNA expression of
the subunits was detected with RT-PCR, protein expression was monitored by
Western blot analysis. Both mRNA and protein expression of all three subunits were
confirmed and we also proved the presence of the NMDA subunits with
immunocytochemical staining. In these experiments, we observed unexpected
localization of the immunopositive signals: they are projected onto the nuclei of HT168 cells using fluorescent microscopy. Colocalization of NR1–NR2A and NR1–
NR2B subunits were also visible. Using the Ca2+ sensitive dye Fluo-4, lowfrequency Ca2+ oscillations were registered mainly in the nuclei of HT-168 cells
under control circumstances. NMDA, a well known agonist of the NMDA-receptor,
DAP5, the general antagonist of the NMDA receptor, and Ifenprodil, the specific
NR2B antagonist were administered to the culture medium at 5 microM
concentrations. Unexpectedly, the nuclear Ca2+ transients were increased due to the
administration of the antagonists, but NMDA abolished these oscillations. None of
the pharmacons used in the physiological characterization of the receptors exerted a
negative effect either on cellular viability or proliferation as revealed by MTT and
thymidine incorporation assays.In summary, our results raise the possibility of the
nuclear membrane-associated localization of NMDA-receptors and their effect on
nuclear Ca2+ signaling pathways in the investigated human melanoma cell line.
This work was supported by the following grants: OTKA K60620, OTKA T49151
Page | 76
PLENARY Session VII
( Psychiatry, Neurology )
Page | 77
ANXIETY AND DEPRESSION IN CHRONIC OBSTRUCTIVE
PULMONARY DISEASE
Field of medicine: psychiatry
Author(s): IVANA ZIVKOVIC
Supervisor(s): Prof. Dr Branislava Milenkovic
Country: Serbia
Introduction
Chronic obstructive pulmonary disease (COPD) is characterized by airway
obstruction and lung function impairment. Dyspnoea is characteristic symptom of
COPD. As anxiety and depression are strongly associated with physical illness, it
can be complex and challenging condition for COPD.
Aim
Primary aim is to evaluate the existance of anxiety and depression.
Secondary aim is to analyze the correlation between anxiety and depression and
forced expiratory volume in first second (FEV1), as well as the degree of dyspnoea.
Thirty patients (mean age was 62.9±9.1) in stable phase of COPD were
examined. The degree of anxiety and depression was measured by Hospital Anxiety
and Depression Scale (HADS), determining scores for anxiety (As) and depression
(Ds). Lung function was measured by forced spirometry. The degree of dyspnoea
was assessed by Medical Research Council (MRC) dyspnoea scale.
Results
According to Global Initiative for COPD criteria, 50.0% patients were in
II, 46.7% in III and 3.3 % in IV stage of COPD. Anxiety and Depression prevalence
was: without anxiety symptoms-51.6%, doubtful anxiety-19.4%, definite anxiety29.0%, without depression symptoms-45.2%, doubtful depression-29.0% and
definite depression-25.8%. Statistically significant correlation between MRC and As
(p=0.017) was found. There is no significant correlation between FEV1 and HADS
scores (p>0.05).
Conclusion
There is significantly higher prevalence of anxiety and depression in
patients with COPD, in comparison to public population. The degree of dyspnoea
affects the presence of depression. The degree of impaired lung function is not the
only parameter that causes anxiety and depression.
Page | 78
POSITIVE EFFECTS OF METHADON THERAPY IN OPIAT ADDICTS ON
MATHADON MAINTENANCE TREATMENT COMPARING AMBULANCE
EXAMINED OPIAT ADDICTS
Author(s): SOVRLIC MIROSLAV, Aleksandra Petrovic
Supervisor(s):Doc. dr Jovanovic Minja
Country: Serbia
Background: Dependence on drugs is a phenomenon that many countries are confronted
with and it is a very expensive problem in the view of cost as well as the sense of
suffering of people. Methadone maintenance treatment (MMT) appeared very efficient
for individuals and the society because it promoted social, psychological and physical
condition of the individual and it reduced public expenses in health-care and juridical
systems.
Aim: Aim of this work is to establish the number of relapses by analyzing the results of
urine tests in the ambulance examined addicts group, who were not included in MMT,
and the group of addicts who were involved in MMT, from 01.01.2008 untill 01.09.2008.
Material and Methods: Research was done in the Clinical center “Kragujevac”, in
psychiatric clinic, and it included 40 opiate addicts who were divided in two groups. First
group included 20 opiate addicts who were not treated with methadone and were
examined in this institution for different reasons, and they satisfy all requirements for
hospitalization and ambulance treatment for opiate addiction. Second group included 20
opiate addicts who were included in MMT. Records were collected from the medical
documentations and then statistical processed.
Results: Results showed that the addicts included in MMT were more frequently tested
for opiate presence in urine (203) than the ambulance examined addicts who were not
treated with methadone (66) in shown period, which showed statistic signification.
Number of relapses in the ambulance examined addicts group (51 or 77,27% of total
number) was bigger then in the group of treated addicts (27 or 13,3% of total number),
which showed highly significant difference. In examined groups, male sex dominates,
medial education level, addicts are usually from city environment, and most is not
married and has no children.
Conclusion: Results from this study show that the number of relapses is significantly
smaller in patients who are involved in MMT, there for the use of opiate, illegal
substances is reduced. Replacement of heroin and morphine with much safer methadone
can, in a positive way, affect many aspects of addict’s life.
Page | 79
THE
RELATIONSHIP
BETWEEN
PHONOSEMANTIC
POTENTIAL AND CLINICAL MANIFESTATIONS OF NEUROTIC
DISORDERS
Field of medicine:psychiatry
Author(s):ALEXANDRA BELOUSOVA
Supervisor(s):Marchenko A.A.
Country: Russia
Introduction: Increased incidence of neurotic disorders, growth of its clinical
polymorphism and little information about the features of neurotic patient’s
perception, make the phonosemantic analysis perspective for diagnostic and
studying this kind of disorders.
Aim: The main aim was to identify the relationship between phonosemantic
potential and clinical symptoms of neurotic disorders.
Materials & Methods: We studied 32 patients with anxiety-depressive disorders.
Controls were 38 age- and gender-matched healthy participants. We used rating
scale methods (Hamilton depression rating scale, Hamilton anxiety rating scale,
Montgomery-Asberg depression rating scale) and the Symptom Checklist – 90-R.
As a stimulus material we used the verbal association test (V.M. Kogan, M.S.
Rogovin, 1961). For the phonosemantic analysis of association words was used the
program «Diaton» (I.U. Cherepanova, 2001 ). For data processing was used
correlation analysis and T-test to detect differences of results between patients with
the prevalence of anxiety
and patients with the prevalence of depression.
Results: We found a significant difference in phonosemantic potential of
association words between patients and controls, and between patients with the
prevalence of anxiety and patients with the prevalence of depression. Also, a reliable
correlation between phonosemantic potential of patient’s association words and the
results of rating scale methods was found.
Conclusions: Our study showed that phonosemantic potential of patient’s
association words had greater amplitude than in control group, reflecting more
intense emotional reactions of patients to most stimuli, in contrast to controls.
Response differences between patients and controls and between anxious and
depressive patients, suggests the possibility of using phonosemantic analysis as an
additional diagnostic and differential diagnostic method.
Page | 80
AN APPLICATION OF STRUCTURAL AND FUNCTIONAL
NEUROIMAGING
IN
DIAGNOSTICS
OF
DIFFERENT
DEPRESSION TYPE
Author(s):ALEXANDER LEBEDEV
Supervisor(s):PhD Korzenev A.V., PhD Abritalin E.J.
Country: Russia
Introduction: Depression is one of the most common mental health problem and it
grows greater every year around the world (Tiganov AS, 1999; Sadock BJ, 2000)
Aim: The main aim was to analyze the possibility of using functional and structural
neuroimaging methods in diagnostics of different depression types.
Materials & Methods: 40 patients with depression syndrome were distributed into 3
groups: 1) Neurotic Depression (Diagnosis: mixed anxiety-depressive disorder,
Adjustment disorders) – ND group; 2) Psychotic Depression (Diagnosis: Recurrent
Depression, Bipolar Affective Disorder – current depressive episode,
Schizoaffective disorder, depressive type) – PD group, 3) Depression due to organic
pathology (Diagnosis: Organic depressive disorder, Organic mixed affective
disorder) – OD group. Controls were 16 age- and gender-matched healthy
participants. We used several methods of functional (positron-emission tomography,
functional magnetic resonance imaging) and structural (voxel-based morphometry,
diffusion-tensorimaging) neuroimaging.
Results: We found several functional and structural abnormalities in limbic
structures within all three groups. Some of them were same, some were different.
Conclusions: We found several functional and structural abnormalities into all three
depressive groups. Almost all of them are parts of so-called frontal-subcortical
circuits (Cummings J.L., 1993), disfunction of which, according to the present
knowledge,
could play crucial
role
in depression pathogenesis.
Summarizing our own results and analyzing the data of our colleagues, we
complement a theory of depression pathogenesis and propose an original point of
view for neurobiological basis of different types of depressive disorders.
Page | 81
RESTORING OF THE REPRODUCTIVE FUNCTION AS AN
IMPORTANT
CONSITUENT
OF
THE
PSYCOLOGICAL
CONDIDTION OF ONCOLOGICAL FEMALE PATIENTS
Field of medicine:psychiatry, psychology, (psycooncology)
Author(s):NATALIA BAKUNINA, Denikina U.V.
Supervisor(s):Kissin M. Y. Tapilskaya N. I.
Country: Russia
Estimation of clinical-and-psychological status was conducted among
female patients with diagnosis of cervical carcinoma and endometrial cancer after
radical treatment. There were 2 sample groups. The first group consisted of 18
patients of early reproductive age from 20 to 35, not having patient parity. Tissue
retrieval of ovary with following criopreservation was carried out among the patients
of this group during the surgery stage. To restore the hormonal function of the ovary
and rehabilitate the reproduction function after finishing of the complex treatment all
patients underwent autotransplantation of the unfrozen ovary tissues into the
abdominolvesical wall. Rehabilitation of the reproductive function consists of
centesis of Graafian follicle, obtaining of the ovule, in vitro fertilization and
transmitting of the embryo of the surrogate mother. 17 patients in the second group
got only standard therapy of the disease.
Methods
Informal clinical interviewing, Minnesota Multiphasic Personality
Inventory (MMPI), The State trait Anxiety Inventory, Personality Questionnaire of
the Bechterev Institution (designed to define peculiarities of the patient’s
attitudestowards his diseases).
Conclusions:
1. The high intensity of anxious reaction and the exceeding rates in the
scales of neurotic triad observed through the MMPI in both groups need adequate
correction.
2. Euphoric, balanced and ergopatic Types of Attitude to the Disease presents the
picture not characteristic for the oncological profile patients.
3. Restoring of the possibility for a woman to enjoy her natural biological function
improves the quality of life of such patients and increases the efficiency of the
antineoplastic treatment.
Page | 82
VISUAL EVOKED POTENTIALS AS AN ADDITIONAL
DIAGNOSTIC PROCEDURE IN MIGRAINE OF CHILDHOOD AND
ADOLESCENCE
Field of medicine:neurology
Author(s):MILOŠ MEANDŽIJA, Milica Mitrović
Mentor(s):MD, PhD Jasna Jancic
Country: Serbia
Introduction
Migraine is the most common primary headache in pediatric population.
Migraineurs often show abnormalities in visual evoked potentials (PR-VEP). Due to
the lack of a specific diagnostic test in establishing the diagnosis of migraine some
authors have decided to use PR-VEP as an additional tool in clarification of both
pathophysiology and diagnosis of migraine.
Aim
Examination of PR-VEP characteristics in patients with migraine.
The observed group consisted of 73 migraineurs (aged 6-22 years). The
diagnosis of migraine was made according to the diagnostic criteria proposed by the
International Headache Society. PR-VEP recordings were performed on all the
patients, both binocularly (BE) and monocularly (LE-left eye,RE-right eye), using
the standardized checkerboard pattern reversal technique, on a Medelec-Sapphire
Premiere apparatus.
Results
Further abnormalities of PR-VEP were detected: BE – prolonged N2
latency in 27 patients (37%), increased N1-P100 amplitude in 53 patients
(72.6%),increased P100-N2 latency in 43 patients (58.9%);LE – increased N1-P100
amplitude in 33 patients (45.2%),increased P100-N2 amplitude in 41 patients
(56.2%);RE – prolonged N2 latency in 37 patients (50.7%),increased N1-P100
amplitude in 40 patients (54.8%),increased P100-N2 amplitude in 40 patients
(54.8%)
Conclusion
The present study found increased amplitudes of PR-VEPs in children and
adolescents suffering of migraine. These results suggest the use of PR-VEP as an
additional diagnostic test for migraine.
Page | 83
RISK FACTORS OF TRANSIENT ISCHEMIC ATTACKS OF
BRAIN
Field of medicine: neurology
Author(s):MARIJA STOJADINOVIĆ, Marija Simić
Supervisor(s):Doc. dr Zagorka Jovanović
Country: Serbia
Introduction
According to a new definition, Transient Ischemic Attack (TIA) presents a
brief episode of neurological dysfunction caused by focal brain or retinal ischemia,
with clinical symptoms lasting less than 60 minutes and without presence of acute
brain infarction.
The aim
The aim of research was to analyze the presence of risk factors of stroke in
patients who had TIA, in purpose to act prevently.
The research included 100 consecutive patients (39 men and 61 women)
who had TIA (in accordance with definition of TIA and with exclusion of other
cerebral diseases after an additional examinations like MRI, CT etc.) and who were
treated during last 3 years. Risk factors were divided in controllable and
uncontrollable.
Results
In group of uncontrollable factors the most important were age, gender
and family history. The average age in patients was 50.60±12.58 years, with
domination of morbidity at women, 61%. 31% of patients had family members that
had stroke. The most frequent gained factors were dyslipidemia (89%), arterial
hypertension (73%) and carotid stenosis (66%). Significantly frequent were
possibilities of paradoxal embolism (especially in women). Harmful habits
(smoking, alcoholism, obesity) were presented in about one third of patients.
Conclusion
Typical profile of risk factors in examined group included dyslipidemia,
high blood pressure, carotid stenosis and smoking . Beside mentioned, an important
role
takes
age,
gender
and
family
history.
Key words: transient ischemic attack, risk factors‚ arterial hypertension,
dyslipidemia
Page | 84
FATIGUE
IN
CORRELATION
DISABILITY
MULTIPLE
SCLEROSIS
WITH
DEPRESSION
AND
PATIENTS,
CLINICAL
Author(s): NEMANJA JOVANOVIC, Ana Jovanovic
Supervisor(s):Doc. Dr Miletic-Drakulic Svetlana
Country: Serbia
Introduction: Fatigue and depression are frequent complaints with multiple
sclerosis (MS) patients, about their correlation there are different thoughts.
Aim: The aim was to determine relation between fatigue and clinical characteristics
of MS (depression, degree of disability), and to assess frequence and degree of
fatigue with MS patients.
Materials and methods: We analyzed 111 patients with definite MS . Mean age of
patients was 38.1±1.2 years. To assess degree of disability we used EDSS
(Expended Disability Status Score). Degree of depression was measured by Beck’s
depression inventory. Fatigue was measured using the Fatigue Descriptive Scale
(FDS, range 0-13) and Fatigue Severity Scale (FSS, range 1-7).
Results: Mean EDSS score was 3,2±1,7 (range 1-8). Mean FSS score was 3,7±2
(range 1-7). Mean FDS score was 3,9±2(range 0-13). Mean BDI score was
10,6±9(range 0-39). FSS score highly correlates with EDSS score (p=0.000), there is
significant correlation between FSS and BDI score (p=0.000).
Conclusion: Our results pay attention to the fact that the fatigue is common
simptom with MS patients, and that the fatigue significantly correlates with degree
of disability and depression.
Key words: Multiple sclerosis, fatigue ,depression.
Page | 85
PROTECTIVE EFFECT OF DEXPANTHENOL ADMINISTRATION
AGAINST CEREBRAL ISCHEMIA/ REPERFUSION INDUCED
INJURY IN RAT
Field of medicine: neurology
Author(s):Mohammad Mehdi Hosseinian Zakaria -Babak Hajipour- Ali Khodadadi
Fatemeh Afshari.
Supervisor(s): Dr Ali Khodadadi
Country: Iran
Introduction: Tissue hypoxia plays a critical role in the primary and secondary
events leading to cell death after cerebral ischemia. Free radicals are generated
during both cerebral ischemia and reperfusion. Dexpanthenol (Dxp) (provitamin B5)
is the biologically active alcohol of pantothenic acid and it is an antioxidant agent
that according to our hypothesis it may attenuate the neuronal damage after cerebral
ischemia.
Materials and Method: Male wistar rats were divided into 4 groups
randomly(n=13): 1- sham group,Group 2 :two hours occlusion of MCA and 24
hours reperfusion.Group 3: two hours occlusion of MCA and 24 hours reperfusion +
Dexpanthenol(250mg/kg) since 3 days before ischemia. Group 4:. two hours
occlusion of MCA and 24 hours reperfusion in which have recieved
Dexpanthenol(500mg/kg) since 3 days before ischemia. Malondialdehyde and
glutathione levels were studied in brain tissue and number of CA1 and CA3
pyramidal
neurons
were
also calculated with light
microscopy.
Result: The glutathione levels were significantly higher in groups III, IV as
compared with the group II. in group III and group IV animals, the malondialdehyde
levels were significantly lower than in group II (P < 0.05). Number of CA1 and CA3
Neurons were completely normal in appearance in the group I. The surviving
neurons in the CA1 and CA3 subfield, were markedly decreased in number, in the
group II. (P < 0.05).
Conclusion: Our pathologic and biochemical study has proven positive effect of
Dxp on protection of cerebral tissue after ischemia reperfusion. The present findings
correlates with previous studies on the protective effects of pantothenic acid against
cell and tissue injury by ischemia reperfusion.
Key words :Dexpanthenol-Brain-Ischemia /Reperfusion-Rat
Page | 86
CORRELATION BETWEEN INTIMI MEDIA THICKNESS (IMT)
OF THE COMMON CAROTI CAROTID ARTERY (CCA) AND
ISCHEMIC STROKE
Author(s):Samia-Nadin Al Khatib, Margarita Malamova, Stoyan Kondov,
Teodora Taneva
Supervisor(s): assoc. prof. Julia Petrova
Country: Bulgaria
Atherosclerosis is a degenerative disease of chronic inflammation with a
predilection for certain arteries. Early detection is important as its first symptom
may result to be an ischemic stroke. Measuring IMT using B-mode ultrasonography
is accepted as a reliable method which can be applied in prediction of future
episodes.
Aim
Evaluation of IMT of the CCA in patients with cerebrovascular disease
(CVD) manifested with an ischemic stroke and proving a relation to age and
duration of the disease.
Method
Investigation was made on 12 subjects divided in groups by criteria of age
(55-66 and 72-80) and duration of the disease(<3 years/>3 years) compared to a
matched control group which consists of 15 volunteers – 55 % female/45% male
(8/7) - at average age of 48+/-9 (from 35 to 70 years old) with no evidence of a
CVD. Examination was made by ultrasound Ultrasonix using a standardized Pignoli
method.
Results
1. No statistically significant difference between IMT of the right and the left
CCA was found.
2. Statistically significant difference between IMT of the 2 groups divided
by age was found.
3. No statistically significant difference between IMT of the 2 groups
divided by duration of the disease was found.
Keywords
IMT, CCA, ischemic stroke, age, duration
Page | 87
BOTULINUM TOXIN TREATMENT OF HEAD TREMOR
Field of medicine: Neurology
Author(s): Tatjana Radeka
Supervisor(s): Prof. dr Marina Svetel
Country: Serbia
Introduction: Head tremor could be the unique feature of essential tremor. Besides
it could be registered in cervical dystonia, sometimes being the sole manifestation of
dystonic disease. Head tremor is mostly resistant to oral medications. There is no
enough studies about botulinum toxin treatment of head tremor, but there are clearly
positive results in cervical dystonia.
Aim: The aim of our study was to explore therapeutic efficiency of botulinum toxin
in head tremor therapy.
Material and methods: In our study we treated 11 patients with local injections of
botulinum toxin A into each m. splenius capitis. We clinically rated and
quantitatively assessed tremor with triaxial accelerometric system, before and two
weeks after the botulinum toxin A injections. Spectral tremor analysis was
performed using tremor analysis software (Viking Select Master Software Version
8.1), the data we analyzed were dominant peak frequency and amplitude (total
power). The subject and examiner performed global assessment using Patients
Global Assessment (PGA) scale on follow-up visit.
Results: We examined five patients with essential tremor and six patients with
dystonic head tremor. In clinical ratings before/after treatment change of head
tremor severity was statistically significant (z=-2.236, p<0.05). Amplitude (total
power) before/after treatment didn’t show any statistical significance, but it’s
median value showed decreasing after the treatment. According to PGA rating scale
8 patients had subjective improvement. There is a very clear trend that the size of
amplitude decrease follows the global assessment ratings after the treatment. Side
effects were mild and resolved spontaneously and were present in five of eleven
patients
Conclusions: Local injections of botulinum toxin A have potential therapeutic
significance in head tremor therapy and may be useful in cases where other tremor
treatments have failed to benefit.
Key words: head tremor, essential tremor, dystonic head tremor, botulinum toxin,
spectral tremor analysis
Page | 88
PLENARY Session VIII
( Pediatrics )
Page | 89
NOSOCOMIAL INFECTIONS IN PREMATURE INFANTS
Field of medicine: pediatrics
Author(s):MARIJA STRUNJAS
Supervisor(s):Prof. dr Aleksandra Doronjski
Country:Serbia
Introduction
Infants born before 37th week of gestation are called premature. They are
in a higher risk for many pathological states, especially infections. Nosocomial
infection is localised or sistemic state, which is consequence of infective agens or its
toxin and which was absent, nor in incubation period during the reception.
Aim
We examined nosocomial infections in premature infants in Neonatal
intensive care unit.
Retrospective study included 95 premature babies, divided into
experimental and control group. Informations about gender, gestational age, birth
weight, invasive procedures, time when infection appeared, duration of
hospitalisation, location and outcome were taken from medical records.
Results
Gender ratio wasn’t statistically different between two groups. Newborns
between 32 and 34 weeks of gestational age had infections most commonly.
Average birthweight in experimental group was below 1500g, and in control above
1700g. Average duration of hospitalisation was 55 in experimental and 35 days in
control group. Most common infection was pneumonia (55,6%) then blood
infections (51,1%), conjunctivitis (13,3%) while other took less then 10%. In
experimental group 11,1%, and in control 6% infants died.
Conclusion
Gender and invasive procedures are not connected with higher risk for
nosocomial infections. Gestational age and birthweight are significant factors for
infection development. Nosocomial infections extended hospitalisation. Most
common infections are pneumonia, blood infections and conjunctivitis. Death
outcome was most frequent in extreme low birthweight infants.
Page | 90
DEEP NASOPHARYNGEAL ASPIRATION AS A METHOD FOR
TERMINATION OF SUPRAVENTRICULAR PAROXISMAL
TACHYCARDIA – FIRST EXPERIENCES
Author(s):BOJANA VUKOVIC, Milena Trandafilovic
Supervisor(s):Ass, Dr med sci. Bojko Bjelakovic
Country: Serbia
Introduction
Supraventricular tachycardias (SVT) are most common paroxysmal
rhythm disorder in childhood. However, due to their nonspecific clinical picture in a
first year of life, a diagnoses of SVT is mainly established with appearance of
clinical signs of cardiogenic shock and/or acute heart failure. Rapid termination of
SVT implies therapeutic imperative for children life in similar cases. In
haemodynamic stable children and according to current pediatric arrhythmia
guidelines, one should always try with vagal maneuver before medicament
conversion.
Aim:
With reference to abundant pharyngeal and hypo pharyngeal innervations
of sensitive vagal and glosopharyngeal afferents which are of vital importance for
triggering reflex efferent vagal activity, the aim of our study was to evaluate the
efficiency of deep nasopharyngeal aspiration as an optional vagal maneuver for SVT
termination.
The study was done at Clinic of Pediatrics - Clinical Centre Nis, in a
period from January 2005 to December 2008. The study included 8 infants ( 5,5 ±
4,4 month old) with first attack of SVT.
Results
After deep nasopharyngeal aspiration, SVT was successfully converted to
sinus rhythm in 3 infants (37,5%) of whom two had clinical signs of low cardiac
output syndrome and acute heart failure before conversion.
Conclusion
Deep nasopharyngeal aspiration represents efficient method for SVT
treatment in the youngest age group children.
Page | 91
EFFECT ATROPINE IN HYPERTROPHIC PYLORIC STENOSIS
Author(s): NEVENA JOCIC, Miloš Sladojević, Ognjen Bojović, Branislav
Rovcanin, Tijana Ralic
Supervisor(s): prof. dr Svjetlana Maglajlić-Djukić
Country: Serbia
Introduction
Hypertrophic pyloric stenosis (HPS) characterized by pyloric smoothmuscle and making stomach empty with difficulty, appeared as the result of
abnormal location of enteric innervation. Atropine is in effect locally when applied
through nasogastric tube.
Aim
Following the effect of atropine given orally during the treatment of HPS.
In retrospective study, we analyzed medical data from retrospective 16
patients who suffered from HPS, hospitalized in Neonatal section of University
Children’S Hospital in Belgrade during the period 2005. to 2008. The history of
illness was used as a source of data. Nasogastric tube was placed and atropine was
applied through it to the newborns with HPS diagnosis.
Results
The treatment with atropine was carried out with 13 patients (81,25%), 10
male (76,92%) and 3 female (23,08%) and 3 patients (18,75%) were operated. The
newborns treated by atropine were 25,77 days old (on the average) with median
body weight 3403 g. on admission. Ultrasonography on admission, pyloric canal
length of those newborns were 13-19 (average 16) mm, pyloric muscle thickness 35,8 (average 3,93) mm, and on release from hospital the pyloric canal length 13,5-17
(average 16,1) mm and pyloric muscle thickness 3,8-5 (average 4,39) mm. There
were no negative reactions. The newborns who had operation were 27 days old with
median body weight 3473 g. on admission. Ultrasonography, pyloric canal length on
admission was 18-21 (average 19,2) mm and pyloric muscle thickness was 4,5-5
(average 4,5) mm. Conservative treated newborns were hospitalized for 11,62 days
on the average but the operated newborns for 8,33 days.
Conclusion
There is no significant statistic difference between the newborns treated by
atropine and the operated ones concerning pyloric canal length (t=2,013; p>0,05),
pyloric muscle thickness (t=0,97; p>0,05), the length of treatment (t=0,8225;
p>0,05) and body weight (t=0, 009; p>0,05) on admission.
Page | 92
DISTRIBUTION OF THE NORMAL VALUES OF NEONATAL TSH
AS AN INDICATOR OF IODINE STATUS IN VOJVODINA
Field of medicine:pediatrics
Author(s):MARIJA VEZILIC
Supervisor(s):PhD Dragan Katanic
Country: Serbia
Introduction: The thyroid controls many very important processes in the human
body by producing thyroid hormones, triiodothyronine (T3) and thyroxin (T4),
which essential component is iodine. Thyroid-stimulating hormone (TSH) is
secreted by the anterior lobe of pituitary gland and induces production and release
thyroid hormones. Neonatal TSH (nTSH) is an important measure because it reflects
iodine status during a period when the developing brain is particularly sensitive
toiodinedeficiency(ID).
Goal: The aim of this study was to examine iodine status of the population of
Vojvodina.
Material and methods: The analyzes was carried out using documents from the
Institute for Children and Youth Health Care in Novi Sad in one year period, during
the year 2008, within the routine neonatal screening on congenital hypothyroidism.
Gathered data were statistically analyzed and classified in accordance with the level
of nTSH on 3 groups: I 0-5 mU/l ; II 5-7.5 mU/l; III 7.5-9 mU/l
As a criterion of the raise TSH was taken level higher than 5 mU/l. Iodine status is,
according to World Health Organization (WHO) recommendations, and due to
percentage of raised nTSH above 5 mU/l, classified as:Mild ID (3-19.9%);
Moderate ID (20-39.9%); Hard ID (> 40%).
Results: The examination included 18112 newborns from Vojvodina. Values of
nTSH 0-5 mU/l were established at 90.92% of the tested sample, 5-7.5 mU/l were
presented
at
8.12%,
and
7.5-9
mU/l
at
0.96%
newborns.
Mild ID was perceived at 9.08% of tested newborn babies.
Conclusion: On the basis of these results, we may conclude that population of
Vojvodina is exposed to mild ID.
Key words: Neonatal TSH (nTSH); Iodine + deficiency; Newborn; Thyroid.
Page | 93
FREGUENCY INFLAMED OF ASTHMA AT HOSPITALIZED
CHILDREN AT PEDIATRICK CLINIC KRAGUJEVAC IN THE
PERIOD OF 1997-2007
Field of medicine:pediatrics
Author(s):ANA SRETENOVIC
Supervisor(s): Acc. Mr. sci. med. Dr Gordana Kostic
Country: Serbia
Introduction
Asthma is a leading chronic disease among children in most number of
industrial countries. Today there are about 10% children who suffer from this
disease in the world and the frequency of growth continues.
Aim
The aim of this work is to examine the frequency of Asthma in relation to
sex, age, time of notification.
All children under diagnosis of Asthma, being hospitalized at the Pediatric
Clinic in Kragujevac in the period of 1997-2007, were included by the retrospective
study. The percentage of relation from the charts and the graphics displays of
achieved results were used from the statistic methods.
Results
With our research work, we established a fact that from 20289
hospitalized children in the given period, 1657 (8%) children were under diagnosis
of Asthma. There were 982 (59%) male children in relation to 675 (41%) female
children. Most number of patients was 385 (23%) the age of 4-7 years. Regarding to
the place of living there was a higher percentage of the sick 1012 (61%) in the urban
surroundings than the sick 645 (39%) in the rural surroundings. Also, the percentage
of pre-school population which was 926 (56%) is higher than in school population
which was 731 (44%). Most number of the sick children in the wintertime in 2007.
was 139 (6%) while the most number of them in the summertime in 2005. was 76
(3%).
Conclusion: According to the research, we can conclude that at the Pediatric Clinic
in the given period, there was a high frequency of the hospitalized patients under
diagnosis of Asthma. The most number of patients were in 2007. at the age of 4-7
years, the male sex in the urban surroundings in the wintertime.
Key words: Asthma, freguency, children.
Page | 94
VANTAGE OF PROCALTITONIN IN RELATION TO OTHER
MARKERS OF INFLAMMINATION OF FEBRIAL CHILDREN
Field of medicine:pediatric
Author(s):JELENA JANKOVIC
Supervisor(s):Prof dr Jasmina Knezevic
Country: Serbia
Introduction
Earlier study indicates that in firs 6h in bacterial infection comes to important
increase level of procaltitonin in blood, which is not case in viruse infections. Level of
procaltitonin is larger in systematic infections and septicaemia.
Aim
To point out on diagnostic and prognostic import of determine value
procaltitonine and also eventual advantages in relation on other parameters of
inflammination which present (golden standard) in diagnostic of bacterial and virusal
infections.
Matherials and methodes
Whit methode of accidentally sample 100 examinees are selected from group
of children which are received on Pediatic clinic in Kragujevac, but which didn’t took
antibiotic therapy before. Examiniees blood sample is defined, diferential leucosite
formula, cedimentation, S-reactive protein (CPT), procaltitonine, and the were bacterial
and virusal examined. The derived values were analysed and compared using objective
matematic-statistic methods descriptive statistics and statistic test: ANOVA, KruscalWallys test and Spirmans rang corellation whit help of software SPSS 11.0.
Resultes
Examinees were separated in seven groups: 1.Examinees with cepticamia(20
patients),2.with
respirators(19),3.with
gastrointectinall(12),
4.with
urinal
infection(9),5.with infection of CNS(11),6.with locall(23) and 7.with virusal
infection(6).There is statisticly important diference in values of procaltitonin in relation
to kind of infection χ2 =14.762,р<0,05. Comparing average values, resulte is that PCT is
lowe, not groving in virusal (0.087±0.053) and local infections (0.946), but important
increase shows in all cases of CHS infections(10.49),gastrointestinall(2.58) and urinal
infections(3.45).There is also high statistic important corelation between values PCT and
SE(Р=0.407,p<0.01), CRP(Р=0.721,p<0.01),number of leucosites(Р=0.362,p<0.01),
neutrofills(Р=0.540, p<0.01) and limfosites(Р=-0.597,p<0.01).
Conclusion:
It's statisticly approved connection of procatitonin with other parameters of
inflammination, as also variability in relation with kind of infection. It's confirmed that
virusal infection values of procaltitonine are staing in normal limits, as also they are
simetrical with weith of bacterial infection.
Page | 95
OUTCOMES OF SURGERY AND BALLOON VALVULOPLASTY
IN CHILDREN WITH CONGENITAL AORTIC VALVE STENOSIS
Author(s):MALGORZATA KOBYLINSKA, Tomasz Makos
Supervisor(s):Radoslaw Pietrzak M.D.
Country: Poland
Introduction: Aortic stenosis is congenital heart malformation. Surgical treatment
and
balloon
valvuloplasty
are
the
methods
of
it
treatment.
The aim of this study was to assess the circulatory system in children with aortic
stenosis with special concern to effectiveness of surgical treatment and balloonvalvuloplasty.
Material: The study group was consisted of 44 patients (f=10, m=34). Children were
divided into groups: 1: Patients (23) in whom surgical treatment was performed.
2: Patients (21) in whom balloon-valvuloplasty was performed.
Results: Group 1: Syncope’s were not observed in this group of patients. In ECHO2D the maximal pressure gradient between left ventricle and aorta (PG) before
procedure ranged from 58 to 91mmHg (mean 77mmHg) and it decreased to 1350mmHg (mean 26mmHg). Left ventricular diastolic diameter (LVDd) before
procedure was 71-140% (mean 94%) and at the end point of follow-up ranged from
73% to 138% (mean 94,7%) of limits. Group 2: Syncope’s were seen in 2 patients.
The PG before procedure ranged from 40 to 85mmHg (mean 67mmHg) after
procedure it decreased to 10-46mmHg (mean 32mmHg). Before procedure LVDd
was 85-96% (mean 90,5%). At the end point of follow-up it ranged from 55% to
135% (mean 96,8%) of limits. Severe and moderate aortic insufficiency in Echo–2D
was diagnosed in all children of the both groups.
Conclusion:
1. The surgical treatment and balloon valvuloplasty are effective methods of
reducing the pressure gradient between left ventricle and aorta in children with
congenital aortic stenosis. 2. Aortic insufficiency is common consequence in
children treated with aortic stenosis.
Page | 96
PLENARY Session IX
( Internal medicine - Cardiology, Pulmology, Nephrology )
Page | 97
PACEMAKER IMPLANTATION IN PATIENTS HOSPITALIZED IN THE
INSTITUTION OF SECUDARY RANG: ANALYSIS OF TYPE,
INDICATIONS AND AFTERPROCEDURE COMPLICATIONS
Field of medicine:internal medicine / cardiology
Author(s):DRAGANA MILOSAVLJEVIC
Mentor(s):ass.dr sci.med Nataša Marković
Country: Serbia
Introduction: Implantation of pacemaker significantly improves survival of patients
as well as quality of their life.
Aim: Aim of the study was to assess the number and the type of all pacemakers
implanted from 1.1.2008. till 31.12.2008., indications and complications of the
procedure in the patients hospitalized at Institut for cardiovascular disease,
University Hospital Zvezdara, Belgrade.
Material and methods: Data from the medical history were assessed. χ2 test was
used as statistical method. Results are shown as tabeles.
Results: The most frequent cardiovascular (CVS) disease were hypertension (HTA)
(80,6%), angina pectoris (50,0%), arrhythmia absoluta (33,9%). The most prevalent
indications for pacemaker implantation were complete AV block and atrial
fibrillation.Among CVS risk factors diabetes mellitus was statistically significantly
more often among men (χ2=4,10; p<s syndrom was more frequent (χ2=4,66; p0,05).
Among women Adam-Stokes<0,05), while arrhythmia absoluta was more frequent
among men (χ2=4,29; p<0,05). Atrial fibrillation was the most frequent indication
for pacemaker implantation among men (χ2=6,66 ; p<0,01). There were 3
complications- dislocation of the electrode, which demanded reimplantation.
Conclusion: Considering that 59 out of 62 patients had all parameters correct at the
regular controls, and that all of them were well, we can conclude that implantation
of adecuate pacemaker improves quality of life and prolongs survival. We must
know all CVS risk factors in our patients in order to perform good secondary
prevention, and that is why good data base is essential in cardiology and inmedicine,
overall.
Key words:pacemaker, risk factors, cardiac rhythm disturbances, secondary
prevention
Page | 98
EPIDEMIOLOGY OF BALKAN ENDEMIC NEPHROPATHY IN
BOSNIA AND HERZEGOVINA
Field of medicine: nephrology
Author(s):MAJA POPOVIC, Renata Zelic
Supervisor(s):Prof. dr. med. sci. Enisa Mesic
Introduction
Balkan Endemic Nephropathy (BEN) is a chronic, irreversible renal
disease of unknown origin, geographically confined to several rural regions of the
Balkan Peninsula.
Aim
The aim of this paper is to analyze epidemiological facts about patients
with BEN diagnosis on chronic dialysis treatment in Bosnia and Herzegovina.
Methods
In this study we used data from The Renal Registry of Society of
Nephrology, Dialysis and Transplantation of Bosnia and Herzegovina for 2003-2006
period. Basic information collected from patients were: sex, age, place of birth and
address, primary renal disease, date of the first dialysis treatment, history of
urothelial tumor and family history of similar kidney disease and RRT.
Results
In 2006, 23 dialysis centres reported totally 2196 patients on chronic
dialysis treatment (duration: more than 90 days). There were 328 (14,94%) patients
with BEN diagnosis in Bosnia and Herzegovina, 310 of them (94,51%) in four DCs
in North-Eastern Bosnia. We found almost the same number of male and female
patients. The youngest reported patients were two women of the age of 43, and the
oldest patient is 87. In 2006, 72,86% of patients were older than 65. Urothelial
tumor was reported in 42 from 328 BEN patients (12,80%). 149 BEN patients
(45,43%) confirmed similar kidney disease in their family, but 79 (24,08%) have
had a family member on RRT. Mortality of the BEN patients was 13,11%.
Conclusion
Based on the presented facts it is evident that BEN prevalence in the 20032006 period shows slow increase, but it is stable. BEN is still a big medical and
social problem in Bosnia and Herzegovina. Therefore it is necessary to make a
detailed study of BEN and take adequate health care of these patients.
Page | 99
CORRELATION BETWEEN RISK FACTORS AND RHYTHM
DISORDERS AS A COMPLICATION IN PATIENTS WITH
CORONARY DISEASE
( poster presentation )
Field of medicine: internal medicine
Author(s): ANA RAZNATOVIC, Mirela Rondic
Supervisor(s): Ljlja Music
Country: Serbia
Introduction: The complications after acute coronary syndrome depend of contributing factors
as age and sex of the patient,heredity,diabetes mellitus,hypertension,cardiovascular
diseases,smoking,consummation
of
alcohol,hyperlipidemia,obesitas,physical
inactivity…Complications may be:angina pectoris,heart failure and rhythm disorders.
Aim: The aim of the examination was to obtain the connection between risk factors for the
acute coronary syndrome and rhythm disorders as one of the complications after.
Material and method: The research was done as a prospective study from 15.1. to
15.08.2008.It obtained 200 patients hospitalized at the department of cardiology in Medical
Center of Montenegro(Podgorica).The data that confirmed acute coronary syndrome and data
about risk factors and complications were taken from examination,anamnesis,laboratory
analysis,analysis of ekg.
Results: As a sample we had 200 patients,145 men(73%) and 55 women(27%).There were
173 patients with complications after acute coronary syndrome or 86,5% of the sample.Among
women were 83,6%(46) and among men 87,5% (127).Rhythm disorders were found in 31
patients or 15,5% of the sample. Most frequent were patients with one of the complications86,7%,with two of them-12,1% and with all three only 1,2%.In the patients with rhythm
disorders heredity was risk factor in 77 of them(44,5%),high glucosis in 53(30,63%),diabetes
in 37(21,38%),smoking in 98(56,64%),hypertriglicidemia in 87(50,28%),hyperclolesteremia in
89(51,44%) and hypertension in 108(62,42%). In the patients without rhythm disorders
heredity was risk factor in 13 patients(48,14%),high glucosis in 6(22,22%),diabetes in
7(25,92%),smoking in 16(59,25%),hypertriglicidemia in 12(44,44%),hypercholesteremia in
11(40,74%)and hypertension in 11(40,74%)
Conclusion: Basing on data we got may conclude that complications after acute coronary
syndrome are more often in men than women.Risk factors more frequent in patients with
rhythm disorders are high glucosis,hyperlipidemia and hypertension.
Page | 100
THE MOST FREQUENTLY INDICATION FOR IMPLANTATION
OF CARDIAC PACEMAKER
( oral presentaion )
Field of medicine: Internal medicine
Author(s): TATJANA STOSIC
Supervisor(s): dr Njegos Petrovic
Country:
Introduction: Cardiac pacemaker is an artefitial implantable electrical heart
stimulator for treating bradycardia which is followed with symptoms.
Aim: The purporse of study is to establish the most frequently indication for
imaplantation of cardiac pacemaker.
Matherial and methods: Retrospectiv study included data abaut 74 patients gathered
from medical history in the period from 01.01.2007. to 31.12.2007 in Clinical centre
of Kragujevac.
Results:
Sick sinus sindrom: 10 (13.5%)
Bradyarrhythmia absoluta: 20 (27.1%)
Arrhythmia absoluta tachy\brady forma: 18 (24.3%)
AV block gradus III: 16 (21.6%)
AV block gradus II: 7 (9.5%)
Trifascikularni blok: 2 (2.7%)
Bifascikularni blok: 1 (1.3%)
-Sex: male: 39(53%)
female : 35(47%)
-Age: 50-54: 2 (2.6%)
55-59: 4 (5.4%)
60-64: 7 ( 9.4%)
65-69: 14 (19%)
70-74: 17 (23%)
75-79: 15 (20.2%)
80-84: 7 (9.4%)
85-89: 8 (11%)
Conclusion: The most frequently indication for imlantntation of pacemaker was
Bradyarrhythmia absoluta (27.1%), at sex of male (53%),and at age of 70-74 (23%).
Key words: pacemaker, arrhythmia, age, sex
Page | 101
CHEST PAIN URGENCY: FROM ACS TO NON-SPECIFIC DISCOMFORTS
( oral presentation )
Field of medicine: Cardiology
Author(s): Marija Kovačević
Mentor(s): Dr Zorica Savović
Country: Serbia
Introduction: Chest pain occurs as the first symptom of a large number of different illnesses of
various urgency levels. The pain may be caused by life-threatening conditions, such as the
acute coronary syndrome (ACS) which may appear in the form of STEMI, NSTEMI or
unstable angina pectoris, or by a lesser urgency level conditions such as stable angina pectoris,
myopathy, hypertension, myocarditis or not heart related illnesses (such as pneumonia, reflux,
muscle and bone related, as well as psychological discomforts) that do not require urgent
treatment.
Aim: This study aims to determine the frequency of specific causes of chest pain, to ascertain
possible relevant statistical difference among them, as well as to identify possible correlation
between the illnesses and age and gender of the patients.
Material and methods: Out of 2134 patients received in the Urgency Ward of the Kragujevac
Clinical Center in the period between 01. 06. 2008. and 15. 07. 2008, this retrospective study
involves 559 patients treated for chest pain. The test group consisted of 270 females (48.3%)
and 289 males (51.7%), mean age 59.5 ± 15.45. This data is based on the patient protocols. The
Hi2 test and the Student’s-t-Test were used in the statistical data processing.
Resulte: Following the examination by an internal medicine specialist, 36.5% of the patients
were assigned a preliminary diagnosis of unstable angina pectoris, 6.4% of the patients were
diagnosed with STEMI, 1.6% with NSTEMI (a total of 44.5% with ACS). A total of 21.5% of
the patients were assigned a preliminary diagnosis of stable angina pectoris; a total of 16.8% of
the patients were admitted due to chest pain of nonischemic origin (myocardiopathy,
hypertension, myocarditis…); a total of 3.2% of the patients were admitted due to chest pain of
pulmonary origin (pneumonia, pleural symphysis, emboly…); a total of 3.9% of the patients
were admitted due to chest pain of gastro-intestinal origin (reflux, gastritis…); a total of 8.6%
of the patients due to muscle pain, and a total of 1.6% due to chest pain of psychogenic origin.
The pain was heart-related in 82.8%, while it was not heart-related in 17.2% of the patients. Of
the total number of the chest pain related group of patients, 53.8% were suspected of suffering
from ACS, 25.9% of suffering from stable angina pectoris, 20.3% of suffering from nonischemic heart diseases, all of which shows a statistical relevance (p=0.000). The difference in
age between heart-related (62.41±13.25) and not heart-related chest pain (45.48±17.54) is
statistically relevant (p=0.000). Patient age had a significant influence on the type of disease
(p=0,000): the oldest patients were those with NSTEMI heart-attack, while the youngest were
those with psychological discomforts. In general, chest pain is equally distributed between
genders (p=0,327). Heart related chest pain is more frequent with females (85.9%) than with
males (79.9%), but the difference is not statistically significant (p=0.327).
Conclusion: One in four patients of the Urgency Ward is admitted due to chest pain. One in
two patients with chest pain are suspected of suffering from ACS, one in four with stable
angina pectoris, while one in five are suspected of suffering from a non-ischemic heart disease.
Page | 102
CORRELATION OF HEMODYNAMIC PARAMETERS AND SUBJECTIVE
EVALUATION OF CONDITION IN PATIENTS WITH ACUTE HEART
FAILURE
Field of medicine: internal medicine,cardiology
Author(s): Milica Matic
Supervisor(s): ass dr Petar Otasevic
Country: Serbia
Introduction
Heart failure presents a clinical condition which is featured with heart
inability to content methabolic demands of the organism. The consequences of this
condition are changes in pulmonary circulation, followed by symptoms of dyspnea
and tiredness.
Aim
To evaluate correlation between pulmonary capillary wedge pressure and
pulmonary artery pressures, with subjective evaluation of condition in patients
hospitalized due to acute heart failure.
Methods:
The study enrolled 11 consecutive patients hospitalized due to acute heart
failure in whom Swan-Ganz catheter was inserted. Hemodynamic parameters have
been measured (pulmonary capillary wedge pressure, pulmonary artery pressuresystolic, diastolic and mean, and also cardiac index and right atrium pressure). These
parameters were compared with subjective physician’s and patient’s evaluation of
condition, using VAS-dyspnea test, euroqol-VAS and Likert scale. For evaluating of
having correlation between hemodynamic parameters and subjective methods
valuation of dyspnea was used statistical method of linear correlation.
Results
There was significant correlation between pulmonary circulation and right
atrium pressures, with subjective methods (VAS-dyspnea and euroqol-VAS), (the
values of correlation are between 0,344 and 0,693, respectively, p<0,05). On the
other hand, no correlation was found between changes in pulmonary capillary wedge
pressure and subjective methods (Likert scale and physician’s evaluation).
Conclusion
Subjective evaluation of condition in patients with acute heart failure
correlates partly with objective hemodynamic parameters, measured by Swan-Ganz
catheter. The physician’s and patients evaluation of changes in patient condition
doesn’t correlate with changes of hemodynamic parameters.
Page | 103
INVESTIGATION OF INFLUENCE OF DISEASE ACTIVITY ON
CARDIOVASCULAR EVENTS IN RHEUMATOID ARTHRITIS
Field of medicine: Internal Medicine
Author(s): OLIVERA JELENKOVIC, Stevan Vujic
Supervisor(s): Ass.dr Bojana Stamenkovic
Country: Serbia
Introduction
Frequency of cardiovascular events is increased in patients with
rheumatoid arthritis (RA).
Aim
To examine whether the disease activity has an influence on
cardiovascular events in RA and also whether the classic risk factors for coronary
disease are connected with the disease activity.
This prospective study enrolled 308 patients with RA (age average 59,67)
who fulfilled ACR criteria and had hospital or ambulant treatment at the Clinic for
Rheumatology at Institute Niska Banja, from January 2007 to January 2009.
Results
Our results showed that frequency of cardiovascular events (coronary
disease, heart insufficiency, death) is significantly higher in a group of patients with
high disease activity (DAS > 5,1) than low (DAS <3,2), 56 (66,7%) as was 7 (8,3%)
patients (p=0,005, p<0,05). Frequency of heart insufficiency is significantly higher
in a group of patients with high disease activity than intermediate,18 (85,7%) as was
3 (14,2%) patients, (p= 0,003, p<0,05). Coronary disease is significantly more
frequent in a group of patients with high disease activity than low, 36 (59%) as was
7(11,5%) patients ( p=0,0001, p< 0,05). Examination also showed that in a group of
patients with high disease activity there is significantly bigger number of patients
with hypertension (p=0,004, p<0,05), diabetes (p=0,005, p<0,05), hyperlipidemia
(p=0,0001, p<0,05) and cigarette smokers (p=0,002, p<0,05).
Conclusion
In patients with RA should be considered strong possibility of
cardiovascular events that are more often in high disease activity. With early
diagnosis and treatment of high activity forms of RA, cardiovascular events can be
controlled and prevented.
Key words: disease activity, arthritis, cardiovascular events
Page | 104
THE MOST COMMON CAUSES OF RESPIRATORY INFECTIONS AT PATIENTS
IN INTENSIVE CARE UNIT AT DEPARTMENT OF PULMOLOGY
Field of medicine:Pulmology
Author(s):MARKO PETROVIC
Supervisor(s):Prof. Dr Zorica Lazic
Country: Serbia
Introduction: Patients who are hospitalised in Intensive care units are under high risk for
getting respiratory infections. The most common factors are absence of patient’s mobility,
immunity deficit and assisted ventilation. Patients with comorbidities are especially
predisposed to acquire these infections, as are patients exposed to respiratory therapy. In this
study, we wanted to analize the most common causes of respiratory infections at patients who
are hospitalised in Intensive care units at pulmology department.
Material and Methods: This study was done in Clinical Center Kragujevac in two years period
(from 2007. to 2008.), and has included 119 patients. Patients have passed clinical
examination, blood tests, radiographic and spirometric examinations. Bacterial analysis of
sputum were performed for detection of infection etiology. Investigation results were laboured
by standard statistical methods.
Results: The most of patients were males (89.08%) and there is significant difference between
genders (p<0.05). Average age of all patients was 61.79 + 12.52 years. For males, average age
was 62.49 + 12.31 years, and for females 56.08 + 13.26 years, so we didn’t find significant
difference (p>0.05). 66.39% of patients are the first time, 15.97% of patients are the second
time and 17.65% of patients are the third or more time in ICU. Average duration of
hospitalisation was 12.28 days. The major reasons for hospitalisation in Intensive care unit
were COPD acutisation, asthma and pulmonary embolism. The most common associated
pulmonary diseases were chronic global respiratory failure (34.45%), bronchopneumonia
(21%) and chronic pulmonary heart (21%). From other system’s, the most frequent associated
diseases were hypertension (12.6%), heart failure (7.56%), ostheoporosis (7.56%), diabetes
mellitus type 2 (7.56%), chronic ischaemic cardiomiopathy (5.04%), anaemia (4.2%) and
paroxismal atrial fibrilation (4.2%). Bacterial sputum analysis was done at 65 (54.62%)
patients and 29 (44.61%) were positive. The most patients have had Candida albicans (34.48%)
than Klebsiella (27.59%), Pseudomonas aeruginosa (24.14%), Acinetobacter (10.34%),
Staphylococcus aureus (6.9%), Esherihia colli (6.9%) and Proteus mirabillis (3.45%).
Conclusion: Candida albicans is the most common microorganism which is isolated from
patients sputum. In the most cases it was colonisation without infection, but also there was
patients with signs of infections and patients who had associated bacterial infection. From
bacteria, Klebsiella, Pseudomonas aeruginosa and Acinetobacter are the most frequent. Our
study shows that Candidial colonisation and infection may predispose bacterial infection,
especially with Klebsiella and Pseudomonas. Also, this respiratory infections are caused by the
most frequent intrahospital microorganisms which are, in big percent, resistent to antibiothic
therapy and it makes more difficult threatment of these patients, especially with comorbidities.
Key words: causes, respiratory infections, intensive care unit
Page | 105
CORRELATION BETWEEN THE RESULTS OF PULMONARY
FUNCTION EXAMINATION AND HEALTH-RELATED QUALITY
OF LIFE IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Author(s):Ivana Zivkovic
Supervisor(s):Prof. Dr Branislava Milenkovic
Country: Serbia
Introduction
Chronic obstructive pulmonary disease (COPD) is characterized by airway
obstruction and lung function impairment. Health-related quality of life, which
refers to subjective and objective patients’ functioning, is considerably impaired in
COPD.
Aim
The aim of this study is to examine correlation between lung function
parameters, health-related quality of life and exercise capacity.
Thirty patients (mean age was 63) in stable phase of COPD were
examined. Health-related quality of life was assessed by St. George’s Respiratory
Questionnaire (SGRQ), calculating scores for symptoms (SGRQs), activity
(SGRQa), impact (SGRQi) and total score (SGRQt), and Short Form Health Survey
(SF-36). Lung function was observed before and after salbutamol inhalation.
Exercise capacity was assessed by walking distance during six-minute walking test
(6-MD).
Results
There is statistically significant negative correlation between basal and
post-bronchodilatatory forced vital capacity (FVCb i FVCpb) and SGRQs (FVCb:
p=0.04 i FVCpb: p=0.02). Difference between FVCb i FVCpb (ΔFVC) was
negatively correlated with all SGRQ scores, except SGRQi (activity: p=0.03,
symptoms: p=0.04, total score: p=0.04, impact: p>0.05). There were no statistically
significant correlation between FEV1 values and health-related quality of life
parameters (p>0.05).
Conclusion
Ventilation parameter FVC correlates better, than FEV1, with subjective
impression and it is the best determinant of lung function influence on entire
patients’ functioning. Improvement of FVC by salbutamol inhalation can
considerably improve health-related quality of life.
Page | 106
METABOLIC SYNDROME IN PATIENTS ON PERITONEAL
DIALYSIS
Field of medicine:nephrology
Author(s):MARIJA ANDJELKOVIC, Branislav Apostolovic, Aneta Jovanovic
Supervsor(s):Ph.D Marina Avramovic Lazic
Country: Serbia
Introduction
According to the definition of NCEP ATP III, metabolic syndrome
represents at least 3 of the folowing elements: central obesity (men>102 cm,
women>88 cm), triglycerides>150 mg/dl, HDL-Cholesterol (men>40 mg/dl 102 cm,
women<50 mg/dl), blood pressure≥130/85 mmHg, glucose>110 mg/dl). Metabolic
syndrome is often present in patients on peritoneal dialysis (PD) because of a burden
of metabolic abnormalities.
Aim
To find out presence and character of metabolic syndrome in patients on
PD, both with and without diabetes mellitus.
Matrial and methods
Our research is done on Clinic of Nephrology, Clinical Center Nis, Serbia.
There were 48 patients, mean age 59.4 ± 12.5 yrs. Lipid profile, glucose, CRP;
anthropometric analysis (body weight and height) and demographic analysis
(consumption of cigarettes and use of antihypertensive therapy, dialysis vintage)
were examined. 63,6% of diabetic patients and 61,5% of nondiabetics have MS.
High blood pressure was the most common feature (100%), then reduced HDL
(56.25%), central obesity (56.25%), elevated Tgl (54.17%), and finally elevated Gly
(45.83%). In diabetic patients the most common feature of MS is hipertension and
hiperglycemia, and in nondiabetic patients beside hipertension the high level of
triglycerides. Statistical analysis show significance for body weight, HDL,
Triglycerides (p<0,05), and BMI (p<0,001).
Conclusion
Our results shows that MS is a substantial problem in this population.
That’s why these patients shoud be registrated at a very beginning of the dialysis
treatment and followed up for the cardiovascular complications to be prevented.
Key words: metabolic syndrome, peritoneal dialysis, diabetes melitus, complications
Page | 107
PLENARY Session X
( Surgery – Abdominal surgery, Urology, Emergency,
Pediaric Surgery )
Page | 108
CORRELATION OF INJURY SEVERITY SCORE (ISS) AND SYSTEMIC
INFLAMMATORY RESPONSE SYNDROME (SIRS) TO CLINICAL AND
EPIDEMIOLOGICAL CHARACTERISTICS OF POLYTRAUMATIZED
PATIENTS ADMITTED TO BELGRADE TRAUMA CENTRE
Field of medicine:surgery
Author(s):MARKO VELIMIROVIC, Sanija Ukic
Supervisor(s):Prof. Ana Sijacki, MD
Country: Serbia
Introduction:Polytrauma is an injury affecting at least two organ systems including
failure of at least one of the vital functions. Trauma is, regardless of age, the third
most frequent cause of death in Serbia, compared to the forth place worldwide. In
order to assess injury severity and possibly predict complication and mortality rates,
many scoring systems are used. Most widely used are the anatomical ISS (Injury
Severity Score), mainly as mortality predictor and SIRS (Systemic Inflammatory
Response Score) - for hospital treatment length and complication rate prediction.
Aim:Predictive ability of ISS and SIRS in determining the outcome of
polytraumatized patients in early stage of treatment (˂24h of admission).
Patients and methods: This prospective study emphesizes 42 polytrauma-suffered
patients who were admitted to Urgent Surgery Center in Belgrade from 10/01/2008
to 01/31/2009. Only patients with ISS>=16 were considered. Gender, age, injury
mechanism, injury type and severity, SIRS parameters, length of stay, complications
and mortality were analysed.
Results: Out of 42 patients, 10 were female (23.8%) and the rest of 32 were male
(76.2%). Traffic accidents were found to be the most frequent cause of injuries
(57.1%). Comparing groups of survived and deceased patients who had ISS<25
(severe injury) to the ones that had ISS>=25 (critical injury) we found ISS to be
statistically highly significant as mortality predictor (p<0.01). SIRS showed similar
predictive abilities; difference in SIRS values for survived and deceased patients
were also statistically significant (p<0.05). ISS is not in correlation with the length
of hospital stay (p>0.05), which directly correlates with SIRS values (p<0.01).
Conclusion:Usability of ISS and SIRS in every polytraumatized patient, due to their
application simplicity and high complication and mortality prediction abilities, is
justified in day-to-day practice.
Page | 109
THE EFFECT OF ETHANOL APPLICATION ON LIVER
PARENCHYMA AFTER INTESTINAL ISCHEMIA-REPERFUSION
INJURY
Author(s):Staško P, Varga J, Pristášová Z, Tóth Š, Pomfy M
Country: Slovakia
The intestinal ischemia-reperfusion (IR) injury is considered to be the
effective experimental model for study of pathophysiology of multiple organ failure.
The liver belongs to among the most functionally and morphologically damaged
organ. The aim of our work was to evaluate the effect of ethanol on the liver
parenchyma after intestinal IR injury. Experimental animals (Wistar rats, n=36)
were divided into two experimental groups – first with ethanol perorally
administration (10% aq, 1g/kg body weight), second without it. Both experimental
groups were subjected to 1 h ischemia by superior mesentery artery occlusion,
followed by 2,4,12 and 24 h of reperfusion. The samples of arterial blood were taken
from abdominal aorta and the levels of ALT and AST were evaluated. The liver
parenchyma of right lateral lobe was removed for histological examination by
hematoxylin-eosin method. The highest levels of AST and ALT were recorded 12 h
of reperfusion in group without ethanol application. In contrast, in the group with
ethanol application 12 h of reperfusion, the levels of liver enzymes were lowered by
approximately 50 % (p<0.001). The histological findings of the liver parenchyma
were not altered in any experimental group. According to our results, the ethanol in
low concentration and dosage may influence the liver enzymes production in
positive way after intestinal IR injury
Page | 110
ETHIOLOGY, DIAGNOSIS AND TREATMENT OF SPLENIC
ABSCESSES
Field of medicine: surgery
Author(s): TIJANA JANJIC
Supervisor(s): Nenad Ivanovic, Stefan Kmezic
Country: Serbia
Introduction
Splenic abscess is a rare disease, followed by high mortality, with a
frequency increasing in the last twenty years.
Aim
The aim of the study was to present the twelve-year experience in the
treatment of splenic abscess in the Institute for Digestive System Diseases, Clinical
Center of Serbia in Belgrade.
13 patients (five women and eight men, mean age 44,69 ± 19,62 years)
with the diagnosis of splenic abscess treated at the Institute for digestive system
diseases from 1.1.1996. to 16.3.2009. were included in the study.
Results: Common symptoms of splenic abscess included fever and weakness
(92,31% of patients) and left-upper-quadrant abdominal pain (46,15%). Majority of
patients had leukocytosis (53,85%). Seven patients were admitted with a previous
diagnosis of endocarditis. Positive microbial cultures were found in 7 patients, with
Enterococcus being the most common pathogenic microorganism isolated from the
splenic abscess. Ultrasonography and CT proved as the most reliable diagnostic
procedures, with CT being superior in the diagnosis of multiple small abscesses.
One patient was treated by combined antibiotic therapy alone; the others underwent
splenectomy followed by postoperative application of antibiotics. One patient died
of endocarditis after a month; another died before splenectomy was performed. The
rest of eleven patients have successfully recovered.
Conclusion
Splenic abscess is an uncommon entity and remains a diagnostic challenge
because of non-specific symptoms that accompany it. Splenic abscess must be
considered in patients with fever, abdominal pain and leukocytosis. Diagnosis
should be established with ultrasonography and abdominal CT. Splenectomy
followed by postoperative application of antibiotics remains the standard treatment.
Key words: spleen, abscess, splenectomy
Page | 111
THE RESULTS
METASTASES
OF
SURGICAL
TREATMENT
OF
LIVER
Field of medicine: Surgery
Author(s):ALEKSANDAR RAGAJI, Dejan Lukic
Supervisor(s):PhD Tomislav Petrovic
Country: Serbia
Introduction
The liver is commonly involved organ by metastases.
Aim
liver
The aim of this study was to analyze the results of surgical treatment of
metastases.
The research is retrospective study of medical records of Oncology
Institute of Vojvodina, surgical department. The analysis included patients with liver
metastases who were surgical treated during the period between 1st of May 2003.
until 1st of May 2007.
Results
The study involved 33 patients (17 males and 16 females). Average age of
patients was 57.8 ± 11 years. Colorectal liver metastases had 23 patients (69.7%)
and 10 patients (30,3%) had noncolorectal liver metastases. Postoperative
complications (which required re-operation) where recorded in 1 patient (3.03%).
Intraoperative mortality was 3.03% (1 patient). Postoperative mortality was 12.12%
(4 patients). Liver re-resections were done in 7 patients (21.21%). One year survival
was 75.76% and three years survival was 43,75%. One year survival of patients with
colorectal metastases was 86.96% and three years survival was 50%, while one year
survival of patients with noncolorectal metastases was 70% and three year survival
was just 25%. Intrahospital mortality in patients with colorectal liver metastases was
8.7% while in patients with noncolorectal metastases was 30%.
Conclusion
One year and three years survival after the surgical treatment of
noncolorectal liver metastases is distinctively less than one and three years survival
after the surgical treatment of colorectal liver metastases. Surgical treatment of liver
metastases gives opportunity of potential curing and decreasing mortality.
Keywords: Liver metastases; Colorectal liver metastases; Noncolorectal liver metastases
Page | 112
SURGICAL TREATMENT OF THE HEMORRHOIDAL DISEASE
WITH STAPLER HEMORRHOIDECTOMY
Author(s):NIKOLIC SONJA
Supervisor(s):Goran Stanojevic
Country: Serbia
Introduction
Hemorrhoidal disease is a very common condition in modern surgical
practice.It is usually defined as a group of symptoms caused by the complications:
bleeding, protrusion, thrombosis, inflammation.
Aim
The paper demonstrates the results of clinical investigations dealing with
the early postoperative complications in patients surgically treated for internal III
and IV grade hemorrhoides with stapler hemorrhoidectomy.
The investigation was conducted on 30 patients aged averagely 39.6 years
(range, 28-53 years), out of which 18 men (60%) and 12 women (40%). In all these,
internal grade III and IV hemorrhoides were confirmed, with a certain degree of
mucosal prolapse.
Results
In the postoperative period in 23 patients (75%) pain value was registered
in the range 2.5-3.5 by the VAS scale, while in 7 examinees the pain intensity was
below 2.5, and 23 examinees (75%) used analgetics in the period of up to 5
postoperative days (average dose of 1 g of metamisole, range, 500 mg to 2 g) and 7
patients (25%) did not use analgetics. Bleeding was not observed postoperatively.In
1 examinee (3%) urine retention was documented and resolved with Foley
catheter.In 3cases (10 %) edema of the perianal region as well as submucous
hematoma were noted.
Conclusion
Stapler application in hemorrhoidal disease is a safe and simple surgical
approach which could resolve hemorrhoidal bleeding,pain,prolapse and represents
minimally invasive surgical procedure.
Key words: hemorrhoides,hemorrhoidal disease,stapler hemorrhoidectomy
Page | 113
INFLUENCE OF PREOPERATIVE CHEMRADIATION ON THE
HISTOLOGICAL REGRESSION OF LOCALY ADVANCED RECTAL
CANCER
Field of medicine:Surgery
Author(s):MILENKO CANKOVIC, Mladen Bjelan
Supervisor(s):phD Tomislav Petrovic
Country: Serbia
Introduction
Determination of the effect of preoperative chemoradiational therapy at
patients with locally advanced rectal cancer. The importance of complete
histological regression as the consequence of chemoradiational therapy and it’s
influence on survival rate of these patients.
Aim
Evaluation of survival rate at patients with complete histological
regression in contrast to the patients with absence of regression.
Method
In the study 53 patients were examined, 35 man and 18 women, with
locally advanced rectal cancer. These patients were put through preoperative
chemoradiational therapy and after 6-10 weeks they were operated. By postoperative
staging they were classified according to ther TNM classification. In order to
evaluate survival rate, all the examined patients were contacted
Results
Average age of diagnosed patients were 65,21 years. The most common
type of radical operation was low anterior (66%) than operation according to Miles
(26,4%) while high anterior (1,9%) and operation according to Hartmann (5,7%)
were not commonly used. According to PH analyses of removed organ, there were
10 (18,9%) patients with complete histological regression. Out of 53 examined
patients, 43 (81,1%) is alive and 10 (18,9%) died. Survival of all the examined
patients was monitored. The survival rate at patients with complete histological
regression was contrasted to the patients with the absence of regression.
Conclusion
The usage of preoperative chemoradiational therapy is justified at locally
advanced rectum carcinoma, because it influences the frequency of sphincter
preserving interventions. Complete histological regression is not what influences
patients survival the most.
Page | 114
COMBINATION
EFFECT
OF
MELATONIN
AND
DEXAMETHASONE ON LIVER ISCHEMIA/REPERFUSION
INJURY IN RAT
Author(s): HOSSEIN ANGOURI, Babak Hajipour-Mohammad Hossein Somi –-Naser
Ahmadi Asl- Rasoul Estakhri- Ali reza Nour Azar- .Mohammad Reza Nasiri zade
Amir Ghorbani Haghjou- Leili Maghbouli, Amir mansour Vatankhah, Farzad
saberifar.
Supervisor(s): Dr Mohammad Hossein Somi
Country: Serbia
Liver failure following ischemia-reperfusion (I/R) injury is a major
concern in liver surgery. The purpose of this study was to evaluate combination
pretreatment of melatonin and dexamethasone on liver I/R model. Male wistar rats
(n=60) were assigned to 5 groups of 12 animals each: 1: Sham; Laparatomy without
I/R 2: I/R; under went hepatic I/R. 3: I/R+MEL; hepatic I/R+ injected
intraperitoneally melatonin (20 mg/kg). 4: I/R+DEX; hepatic I/R+ injected
intravenously dexamethasone (10 mg/kg). 5: I/R+MEL+DEX; hepatic I/R+ injected
intraperitoneally melatonin + injected intravenously dexamethasone. Liver subjected
to ischemia by clamping portal triad for 30 minutes and was reperfused for 6 hours
after ischemia by removing the clamps. Level of glutathione peroxidase (GPx) and
superoxide dismutase (SOD) decreased after hepatic I/R in all groups, level of GPx
and SOD were higher in I/R+MEL+DEX group comparing to I/R, I/R+MEL and
I/R+DEX groups and they were higher in I/R+MEL group comparing to I/R and
I/R+DEX groups significantly (P<0.05). Level of ALT, AST, TNF-α, hepatic tissue
malondialdehyde (MDA) and liver injury index were increased after hepatic I/R.
Level of ALT,AST, tissue MDA and tissue injury index was lower in
I/R+MEL+DEX group comparing to I/R, I/R+MEL and I/R+DEX groups, and in
I/R+MEL was lower than I/R+DEX group significantly (P<0.05). TNF-α level was
lower in I/R+MEL+DEX group comparing to other groups and it was lower in
I/R+DEX group than I/R+MEL and I/R groups significantly (P<0.05). Combination
therapy of melatonin and dexamethasone had better results in decreasing the liver
injury comparing to administering each of them alone.
Key words: Liver-Ischemia/reperfusion-Melatonin-Dexamethasone-Rat.
Page | 115
RETROPERITONEOSCOPY
DISEASE
FOR
POLICYSTIC
KYDNEY
( oral pesentation )
Field of medicine:Urology
Author(s):S.S. STER, A.Tamas-Szora, A.C. Trifan, F.M. Tamasy, S.V. Trifoi, M. Suciu MD
Supervisor(s):Lucan Ciprian, MD
Country: Romania
Autosomal Dominant Polycystic Kidney (ADPKD) disease occurs not infrequently
and is a significant cause for renal failure. The treatment is in general primaly
supportive. It’s estimated that 3-5 millions worldwide are affected by it. In 10 to
15%
of
the
pacients
the
pathology
leads
to renal
failure.
We present an alternative treatment for ADPKD, which could prolong it’s evolution
towards
the
final
stage,
by
laparoscopical
cyst
decortication.
Method and materials
Between March 2007 and December 2008, 40 patients with ADPKD were
included in this study. All the patients had chronic renal failure without needing
dialysis. Clinical assessment was performed by the clinical examination, family
history, abdominal ultrasound, intravenous urography, quantitative renal scan, and
laboratory examinations.From the total, 26 pacients benefited of laparoscopical cyst
decortication. For 15, unilateral and in 11 bilateral, by retroperitoneoscopic
approach.The unroofing of the cyst was performed with the use of the ultrasound
scalpel.
Results
The operative time averaged 45 minutes. Blood loss of 80 ml. The
pressure in the working environment was of 14 mm Hg.Total quantity of CO2 used
per intervention ranged between 75 and 85 litres. Duration of hospitalization, was in
average 3,5 days. None intraoperative complications and 3 renal fistulas were
recorded postoperative.
Discussion
Even though more studies are required to proove the methods’ results, the
use of the laparoscopial approach for this disease, especially the
retroperitoneoscopy, made this method a feasible one. The arguments are, a low-risk
intervention, with short operative and hospitalization time and reduced expences.
Page | 116
CRANIOENCEFALOPAGUS
SURGICAL SEPARATION
TWINS
FINDINGS
OF
THE
Field of medicine: pediatric surgery
Author(s): BUTOLO ANDRA CATALINA, Dobre Veronica
Supervisor(s): MD/Phd Ioan Gherghina, MD Cinteza Eliza
Country: Romania
Introduction
Craniopagus is a rare medical condition of the already uncommon entity of
conjoined twins. We evaluated the possibility of surgery in a case of
multimalformed cranioencefalopagus twins.
B.M.A. and B.M.D. were born prematurely from an unsupervised
pregnancy of a 16-year-old mother. B.M.A. was less developed and had severe
facial and ocular malformations. We made daily measurements for renal function
and blood tests. Further investigations included ophthalmologic examination, skull
radiography, transfontanelar, cardiac and abdominal ultrasound, MRI.
Unfortunately, an anesthetic incident occurred during the MRI-angiography. B.M.A.
suffered an acute respiratory distress.
Results
The first sign for an important shared vascularization was that after we
administrated to B.M.A. Red Cell Concentrate for Anemia of Prematurity
hemoglobin values raised for both. Moreover, B.M.A. was constantly oliguric, but
the renal function values are kept normal through the B.M.D.`s compensatory
poliuria. Ultrasound investigations for BMA reveals hypoplasic cerebellum,
hypoplasic right kidney and disorganized structure of the left one. The
ophthalmological examination assert congenital glaucoma in both of B.M.A.`s eyes
and cataract in the right eye. MRI reveals that their cerebral hemispheres were
separated but had a common meningeal membrane.
Conclusions
The large areas of joint vital anatomical structures and the B.M.A.`s
unexpected response for the small amount of anesthetic substance needed for MRI
exclude any surgical intervention for the moment. Regarding renal function, B.M.A.
is completely dependent on his brother, whose hydronephrosis is a consequence of
the suprastimulation of his kidneys. This makes us believe that B.M.A. is essentially
a parasite for his brother.
Page | 117
PROPHYLACTIC APPLIANCE OF ANTIBIOTICS AT HAERNIA
INGUINALIS OPERATED PATIENTS
Author(s):RAŠA MLADENOVIĆ
Supervisor(s):Ass. dr Nebojša Videnović
Country: Serbia
Inroduction: Antibiotic prophylaxis at surgical patients has been defined like appliance of
antibiotics,to prevent infections of operative field.prophylaxis has been applied in cases when
infection has not been clinically manifested.
Aim: Aim of labour is to show important effect of prophylactic apliance of antibiotics in
hindrance of post-operative infections of haernia inguinalis operated patients.
Material and methods of labour: For making a plan of work we have been used a material of
surgery clinic pristina located in gracanica trough prospective study following 200 of patients.
First group (examination group-group i) had 100 patients with haernia inguinalis,where we
aplied prophylactic apliance of antibiotics. Examination group has been divided into 2 subgroups (group i a), 50 patients with build-in methods. Group i b, 50 patients with haernia
inguinalis where we applied tension therapy methods in medical treatment.at the other group of
patients (control group –(group ii) with the same number of patients in post operative treatment
we had applied therapeutical dose of antibiotics.
Research results: In our research,in prophylactis aims,we used cephalosporine of ii (second)
generation – cephuroxim (nilacef*),wich we gave by i.v. In bolus,by inroducing in
anestesion,in dose of 1.5 grams. At 100 of patients in examinatin group,we used 100 ampules
of different antibiotics.post-operative infection of injury at patients with prophylactic appliance
of antibiotics,we didnt noficed,while at group where we applied therapeutical dose of
antibiotics we noticed infection of injury at 2 (2%) of patients. Average day number of medical
treatment of examined group,in post-operative period,last 2.81 day,while at patient with
therapeutic dose of antibiotics average day number was 5,28.cost of medication with
cephuroxim of 50 patients,at prophylactic applianse was 32460 rsd,while cast of appliance of
antibiotics in postoperative medication of control group,at which we have applied therapeutic
dose of antibiots,was 253961.52 rsd.which is 7.8 time more expensive.
Conclusion: Prophulactic appliance of antibiotic we diminished a non-critical appliance of
antibiotics,incidence of operative field infection,morbidity and mortality cause of postoperative infections,incidence of resistension on antibiotics minimalisation of antibiotics
effects on normal bacteria flore of patient,changes in defend system of patient,and by that
dimenished costs of medical treatment of surgical patients.
Key words: Infection, prophylaxis, antibiotics, costs of medical treatment.
Page | 118
PLENARY Session XI
( Internal medicine – Endocrynology, Gastroenterology,
Haematology )
Page | 119
ANALYSIS OF RENAL FUNCTION AT DIABETIC PATIENTS
Field of medicine: endocrynology
Author(s): MALAKA HULALI, Andreja Vlajankov
Supervisor(s): Dr sci med.Milena Mitrovic
Country: Serbia
Introduction: Diabethic nephropathy is classic microangiopathy complication, at the
same time the most difficult complication at patients with both type of diabetes
mellitus and one of the most common etiological factors of chronic renal
insufficiency.
Aim: The aim of this research was assessment of renal function and stages of renal
insufficiency at patients with diagnosis of diabetes mellitus type 1 and type 2, on the
basis of clinical and laboratory indicators of renal function statement.
Material and Methods: At the Clinic of Endocrinology, diabetes and metabolic
deseases, Clinical Center of Vojvodina, we had done research wich analised 100
patients with the diagnosis of type 1 and type 2 diabetes. During the examination,
were analised the following data related to patients and risk factors: the value of
systolic and dyastolic blood pressure, glycated hemoglobin, lipid status, blood count,
elektrolytes, renal function status , as well as demographic characteristics, duration
of diabetes mellitus and data about smoking.
Results: On the basis of indicators of glucoregulation (glycated hemoglobin) we can
say that patients were metabolically badly regulated in retrograd period at minimum
two months. Further reaserch has shown statisticly significant positive correlation
between the degree of decline of renal function, and creatinine clirens values, with
values of red blood cells and hemoglobin.Corelated with the value of all lipid
parametars, as well as corelation with the values of systolic and dyastolic blood
pressure, values of potassium and 24 our proteinuria were not of statistic
significance.
Conclusion: Analysing the group of patients with diabetes mellitus type 1 and type
2, based on the stage of renal insufficiency found that the largest percentage of
patients (37%) belongs to the second stage of renal insufficiency. Conclusion is that
all patients were badly matabolically regulated, as is found a significant reduction of
red blood cells values and value of hemoglobin. The values of these parametars
significantly retrograde with falling of stage of renal insufficiency.
Key words: Diabetes mellitus, diabetic nephropathy, hyperlipoproteinemia,
hypertension, anemia
Page | 120
THE SIGNIFICANCE OF THE QUOTIENT OF PLATELET NUMBER AND SPLEEN
DIAMETER, AND THE PORTAL VEIN DIAMETER IN ESTABLISHING THE
PRESENCE OF ESOPHAGEAL VARICES
Author(s):MILICA STOJKOVIC
Supervisor(s):Tijana Janjic, Tanja Storebra
Country: Serbia
Introduction
Portal hypertension is a condition of increased pressure in the portal
system, which is followed by increased flow in the portal vein and increased portal
resistance. Bleeding from esophageal varices as a result of portal hypertension is a
serious complication in liver cirrhosis.
Aim
The Aim was to prove that the quotient of platelet number and spleen
diameter greater than 909 has a 100% negative predictive value for the presence of
esophageal varices. Also, to prove that the portal vein diameter less than 15 mm has
a negative predictive value for the presence of portal hypertension.
This retrospective study included 143 patients who were treated hospitaly
in the KCS. In all patients complete clinical examination and laboratory was run:
complete blood picture, hepatogram, coagulation factors, INR, viral markers,
immunological analysis, lipidogram, ultrasound view with color Doppler-based,
esophagogastroduodenoscopy.
Results
the quotient of platelet number and spleen diameter in the group of
patients with esophageal varices was 471, which had 100% positive predictive value
for the presence of varices, while the quotient of the platelet number and spleen
diameter in the group of patients without varices was 976, which had 100% negative
predictive value for the presence of esophageal varices.In the patients with
esophageal varices average portal vein diameter was 15.8 +2.11mm, and in the
group without varices was 12.33 +2.04 (p <0.0002) which was statistically
significant difference.
Conclusion
There is significant correlation between portal vein diameter and
esophageal varices. The quotient of platelet number and spleen diameter greater than
909 has a 100% negative predictive value for the presence of esophageal varices.
Page | 121
EFFECT OF WEIGHT LOSS ON METABOLIC CONTROL IN
OBESE DIABETIC PATIENTS
Field of medicine: endocrinology
Author(s): JELENA DJURDJEVIC,Marijana Stosic
Supevisor(s): Asist.dr Milena Velojić Golubović
Country: Serbia
Introduction
The most important risk factor in development diabetes mellitus type 2 is
obesity.It is well known that obesity has the important role in worsening other risk
factors and at the same time is independant factor.Obesity and related diseases has
become a significant health problem of the modern world,above the rest diabetes
mellitus type 2,hypertension,hyperlipidemia,which all together are a part of
metabolic syndrome and significantly contribute increasing cardiovascular
risk.Weight loss is basic component in treatmant patients with diabetes type 2 and
represent an important item in achieving good metabolic control.
Aim: The aim of study was to evaluate the effect of weight loss on metabolic control
in obese patients(BMI≥30) with diabetes type 2.
The study ivolves 30 patients with diabetes type 2,age from 40 to 65
years.All patientes were submited by the dietary regimen (1200 kcal/day) in the
period of 6 months.Before and at the end of the investigation we measured body
weight and height,determined BMI(body mass index),WHR(waist-to-hip
ratio),glicemia,plasma insulin levels,,HbA1c,total cholesterol,HDL-Ch,LDLCh,triglyceride.
Results
After 6 months of the study,we found significant decrease of BMI(from
35,12±2,12 to 32,03±2,24,p<0,001) and significant decrease of WHR(from
1,40±0,14 to 1,25±0,18,p<0,001).Also,the values HbA1c were significantly
decreased(from 9,73±0,83 to 7,67±0,7,p<0,001) and plasma insulin levels(from
30,26±4,13 to 17,52±3,67,p<0,001).The values of total cholesterol,LDLCh,triglyceride were significant decreased ,and HDL-Ch increased.
Conclusion: Weight loss is in a big procent associated with improved metabolic
control in obese patients with diabetes melitus type 2 and because of that we might
say it is the reason that proper diet remains a fundamental element of therapy in
those patients.
Page | 122
INCIDENCE OF NEUROPATHIC ULCERS IN PATIENTS WITH
DIABETIC FOOT
Field of medicine:endocrinology
Author(s):MIODRAG MILOJEVIĆ
Supervisor(s):asist. Dr Mirijana Dregasevic
Country: Serbia
Editorial
chronic ulcerates of foot occure in 15 % diabetic patients. Diabetic foot
can be neuropathic and ischemic. Neuropathy is almost always seen when there is
ischemia so we call that sort of foot ulcerations neuroischemic. Pure ischemic foot
without neuropathy is rare.
Aim
Purpose of this study is to establish presence of neuropathy in patients
with diabetes mellitus and ulcerates of foot, which is very significant for further
therapeutic approach.
Research involved 33 patients, 7 women and 25 men, all with diabetes
mellitus and ulcerates of foot. In research we used screening method for diagnostic
peripheral neuropathy: analyzing sense of pressure with Semmes-Weinstein
monofilaments (10g) and non-invasive screening method for diagnostic PVD by
measuring Ankle Brachial Index (ABI). Standard descriptive and analytic statistics
methods were used for processing of the facts.
Results
Of 33 patients that were involved in this study 29 had neuropathy , which
represents 87,9%, 19 of them (57,6%) had only neuropathy, 10 of them (30,3%) had
neuropathy associated with PVD. PVD like cause of ulcerates had only 4(12,1%)
patients. This statistic demonstrates that cause of ulcerates is related with gender, but
did not demonstrate that cause of ulcerations is related with age or duration of
diabetes.
Conclusion
Research pointed that neuropathy is the most frequent cause of ulcerations
with patients that have diabetes mellitus and ulcerations of foot, that it is something
we should be aware of in prevention of patients that have risk of developing this
type of ulcerations and in treatment of patients that have already developed ulcers.
Page | 123
HELICOBACTER PYLORY IN DISEASES OF PROXIMAL PART OF THE
GASTROINTESTINAL SYSTEM
Field of medicine: gastroenterology and hepatology-Intern medicine
Author(s): MARIJA TOSIC, Gorana Grkovic, Ivana Jovanovic
Supervisor(s): Ass.mr.sci.dr Daniela Benedeto-Stojanov
Country: Serbia
Background
The isolation of Helicobacter pylori 15 years ago launched a revolution in
gastroenterology and microbiology. Socio-economic status, marriage status and
occupation have the influence on the prevalence of H. pylori infection. H. pylori
carriers have larger risk to develop ulcer and gastric adenocarcinoma. Epidemiology
studies show that H. pylori is more often present in dyspepsia patients than in
asymptomatic patients. The role of H. pylori infection in gastro-oesophageal reflux
disease (GERD) is contrivers.
Aim
To determine statistic significance in the presence of H. pylori between
patients with: chronic gastritis, erosive gastritis, gastric and duodenal ulcer, polypus
ventriculi, gastric cancer and GERD comparing to the control group. Patients and
methods: We prospectively studied 320 patients. According to endoscopic and
histological results all patients were divided in 9 groups.
anamnestic data, proximal endoscopy with the biopsy, urea test, histology
exams. For statistics we used Student’s t-test.
Results
229 patients were H. pylori positive. In all groups of patients we found no
statistical significant difference in H. pylori presence comparing antrum and corpus
of patients in the same group, except in GERD group of patients where we found
statistical significant difference of antrum (p<0.05). Comparing H. pylori presence
in each group with the control group we found statistical significant difference in
every group, except in the group of patients with polypus ventriculi.
Conclusions
The results show that H. pylori eradication may be very useful in these
diseases, as in every symptomatic H. pylori infection, especially if we have positive
pathohistology.
Page | 124
CORRELATION OF VALUE OXIDIZED LDL, METABOLIC
SYNDROME AND PROGRESS OF CORONARY DISEASE IN
PATIENTS WITH TYPE 2 DIABETES
Author(s): SMRZLIC SLADJANA, Smiljkovic Tijana,
Supervisor(s): Doc.dr Lalic Katarina
Country: Serbia
Introduction
It is pointed out that in patients with coronary disease(CD) exists more
frequency of metabolic syndrome(MS) but it is not clear the role of lipid disorders in
beginning(CD) to patients with MS, especially in type 2 diabetes(T2D).
Aim
The aim of study was to examination correlation lipid status , value
oxidized LDL(ozLDL), insulin resistance, MS and appearence CD to patients with
T2D.
The examination includes 51 patients with T2D and we have analyzed
values of total cholesterol(ch), HDL-ch, LDL-ch, trglyceride(enzymatic method),
oxLDL(ELISA method) and parameters of insulin resistance: value of insulin(RIA)
and HOMA index.
Results
In patients with T2D and MS exists significant higher value of oxLDL in
contrary to patients with T2D without MS, until there was no difference between of
values other lipids. Also, levels HOMA and insulin were significant higher in
patients with T2D and MS in compare to patients without MS. Simultaneosus, 81%
patients with T2D and CD have MS, which is significant higher in contrary to
patients with T2D but without CD(61,5%).
Conclusion
Results are suggesting that, in conditions of insulin resistance, MS is in
correlation with structural changes of LDL particles which are more prone to
oxidation
Keywords:
metabolic syndrome, coronary disease, oxLDL, type 2 diabetes
Page | 125
ANALYSIS OF CARDIOVASCULARY FACTORS OF RISIK IN
PATIENT WITH HIGH RISK FOR DEVELOPMENT FOR TYPE 2
DIABETES
Field of medicine:internal medicine
Author(s):SMILJKOVIC TIJANA,Smrzlic Sladjana
Supervisor(s):Doc.dr Lalic Katarina
Country: Serbia
Introduction
Type 2 diabetes is chronic uninfective disease characteristics with increase
of glucoses level in blood, but also means disorder in metabolic of carbonchydrats,
fats and proteins.Prediabetes is first step of development diabetes and characteristic
with increase in glucose blood level but not enought for diagnosis of diabetes.
Aim
Find and analysis risks factors for development cardiovascular risk in
patients with high risk for type 2 diabetes and to show posible ways for prevention
of diabetes.
Our study was done during 2007 and 2008 years, we have had 535
patients. Characteristic of our patients we got from Question-mark for find risks for
diabetes.Question-mark has eight questions with different points and when we sum
that points we get scor who show us risk for diabetes.
Results
When we found scor we devided our patintes in two groups,first with high risk(≥12)
and second without risk(<12).In corelation of our two groups according to clinical
and antropometrics parametars we ca see which is the most important factors for
diabetes and cardiovascular complications.
Conclusion
Type 2 diabetes is disease which can be succesifuly prevented if we
suspecte on in early and use methods of interventio(change lifestyle and use
drugs).This is the the most important way to make better health in our population
and dicrease risk for complications of diabetes.
Page | 126
KLINEFELTERS SYNDROME AND LEG ULCERS – CASE
REPORT AND REVIEW
Field of medicine: hematology
Author(s): MUKHI N.
Supervisor(s): Dube S.
Country: India
Introduction: Klinefelter’s syndrome is the most common sex chromosomal abnormality.
Patients have more than 1 X chromosome and are characterized by eunuchoid body
proportions, scanty facial and body hair, gynecomastia and hypogonadism. These arise from
elevated amounts of estrogen and low amounts of testosterone. About 13% of the patients
develop leg ulcers which are normally clean, red with well defined margins but become
infected. These patients present with normal CBC’s and normal coags(PT/PTT and INR’s).
The reason behind these ulcers remains unknown.
Aim:
To understand the relationship of leg ulcers and klinefleters syndrome.
Case: 58 yo M with klinefelter’s syndrome and h/o chronic lower extremity venous
insufficiency and bilateral draining ulcers since 2005 now presents with recurrence of ulcers
which are painful with excoriation, discoloration of lower extremities, erythema and purulent
discharge. Pt had a similar episode in june 07 s/p debridement and was given testosterone. His
ulcers healed in 10/07 but recurred after discontinuing testosterone. His current WBC, RBC,
Plt counts are normal and his coags are also normal. The patient complains that his older ulcers
were different from the ones now. Biopsy report showed these ulcers were probably due to
arterial insufficiency.
Conclusions: Of the pts with leg ulcers, 41% suffer from venous insufficiency with or w/o
varicosities which can be aggravated by obesity and hence sedentary life style. Other possible
mechanisms include platelet hyperaggregability. Patients show spontaneous Platelet
hyperaggregabilty and aggregability induced in the presence of ADP and arachidonic acid. 2 of
these studies showed normalization of platelet function by giving acetylsalicylic acid. Other
causes of ulcers could be impairment of fibrinolysis with the increase of PAI-1. Studies show
an inverse relationship b/w testosterone and PAI-1. Rare cases also show an isolated elevation
in factor VIIIc with no other serological signs of inflammation which may be due to presence
on the long arm of X chromosome. Other rare causes include positive antinuclear factor,
antiphospholipid Ab, cryglobinemia w/o spontaneous aggregability of platelets/elevated PAI 1,
Factor
V
Leiden
mutation
and
Anti
Thrombin
III
def.
In almost all of the patients irrespective of the cause, the leg ulcers healed completely with the
intake of testosterone titrated to normal level.
Page | 127
THE CHANGES ON
HEPATIC CIRRHOSIS
THE
ELECTROCARDIOGRAPHY
IN
Field of medicine:internal medicine
Author(s): RUXANDRA SFETCU, Adrian Wiener
Supervisor(s): Prof. Dr. Corina Zorila, M.D, PhD, Prof. Dr. Liana Mos, MD,PhD
Country: Romania
Introduction: In hepatic cirrhosis sudden death by arrhythmias is frequent, but
prolonged ventricular repolarization may influence survival in conditions of
biological stress: sepsis, digestive hemorrhage, especially in those treated with
vasopressin, surgery, liver transplantation.
Material and method: We took 35 patients with hepatic cirrhosis in the survey with
various etiologies and different severity categories, under treatment or not with nonselective -blockers (propranolol), admitted in the Municipal Clinical Hospital during
1st ian 2008-31st December 2008. Patients were evaluated clinically, biologically
and imagistic, being in different classes of severity after Child - Pugh score. QT
interval was calculated on the electrocardiogram, then the interval corrected by
cardiac frequency using Framingham formula.
Results: In the study were enlisted patients with compensated and decompensated
liver cirrhosis, with the following distribution: 17 men and 18 women, in ChildPugh class A 10 patients, 11 patients in class B, 14 patients in class C; by etiology:
postviral 19 patients, of alcoholic etiology 9 patients and 7 patients with mixed
etiology, under treatment with beta blockers 20 pacients and without treatment 15.
QTc interval was extended at 10 patients who were not under treatment with bblockers, the extension being proportional to the Child-Pugh score. In patients
treated with b-blockers, QTc was 30 ms lower than in those untreated, independent
of the etiology, but proportional with the initial length of QTc interval.
Conclusions: QTc interval in cirrhosis is sometimes prolonged, the prolongation is
correlated with the severity of the disease but not with its etiology. Non-selective bblocker therapy decrease the QTc interval and this can be used as a surrogate for
assessing the severity of cirrhosis.
Page | 128
ANDROGENS AND PARAMETERS OF ADIPOSITY IN OBESE
WOMEN
Author(s): IVANA IVANISEVIC, Nina Gusic
Supervisor(s): Doc Dr Mira Sumarac Dumanovic
Country: Serbia
Introduction: Obesity is a chronic disease which manifests through excessive
accumulation of body fat and increased body weight. Sex hormone-binding globulin
is the major binding protein of sex hormones in circulation. All factors tend to
decrease SHBG, increase the free fraction of biologicaly active androgens.
Aim: To assess the impact of obesity on androgen levels and SHBG in women with
a body mass index (BMI) over 25 kg/m2.
Materials and Methods: A retrospective study was done in 62 overweight women
(aged 33,24±1.22years) and 18 non-obese women (aged 30,33±1.62years). Patients
were divided into two groups depending on their BMI, where Group I had BMI
<25kg/m2 (n=18), and Group II had BMI >= 25kg/m2 (n=62).The median SHBG in
Group I was 39,2 nmol/L. On this basis, Group II was divided into two subgroups:
women with higher levels (SHBG >= 39,2nmol/L)(n=17) and with lower levels
(SHBG < 39,2nmol/L)(n=45) of SHBG.
Results: The HOMA values are considerably lower and SHBG concentrations
higher in Group I. FAI values are higher in Group II. In Group II, patients with
lower SHBG levels have a significantly higher body mass, greater BMI, greater
waist circumference than patients with higher SHBG. No significant difference was
found between fasting and postprandial glucose, insulin and HOMA between two
subgroups, as well as in lipids whilst HDL-cholestorol levels were considerably
lower in patients with lower SHBG.
Conclusion: Obesity lowers SHBG levels, increases insulin resistance, also that
high FAI levels may significantly impact androgens that lead to many various
diseases in overweight women.
Keywords: SHBG, obesity, androgens, insulin resistance
Page | 129
DIAGNOSING THE HEPATIC ENCEPHALOPHATY IN EARLY
STAGES
Field of medicine: gastroenterology
Author(s): CABA BOGDAN, Al Jaafari Feras
Supervisor(s): Irina Ciortescu, M.d., associate professor
Country: Romania
Hepatic encephalopathy is defined as a spectrum of neuropsychiatric abnormalities
in patients with liver cirrhosis, after exclusion of brain disease or metabolical
disorders.Grading of the symptoms of hepatic encephalopathy is performed
according to the so-called West Haven classification system: from grade 0 - minimal
hepatic encephalopathy (subclinic) to grade 4(coma).
Aim: diagnosing the Hepatic Encephalophaty in the subclinical stage (0) at the
pacients with liver cirrhosis.
Materials: we studied 90 consecutive pacients who periodically came in the
Ambulatory of the Institute of Gastroenterology Iasi.
Methods: by clinical examination we excluded Hepatic Encephalopathy in late
stages (grades 2, 3)- asterixis, hepatic foetor, abnormal reflexes . At the rest of the
pacients we tested the ammonia blood level and we admitted only the patients with
high levels. The psychometric Reitan test, of numeric interconnection, is a specific
method of appreciating the grade of the Hepatic Encephalopathy, but it can also be
influenced by other neurological or somatic disorders.
Results: we have consulted 90 patients, men and women, with ages between 40-70
years old, diagnosed with liver cirrhosis. The etiology of the liver cirrhosis was:
hepatitis C( 22 %) , alcoholic liver disease (28%), Hepatitis C with alcoholic
disease( 38 %), Hepatitis B (12 % ), miscellaneous(8 %). By clinical examination
we excluded 20 patients with clinical Encephalophathy (asterixis, hepatic foetor,
pathological reflexes) and 20 with normal ammonia blood level. The rest of the 50
patients, with high ammonia levels, were evaluated with Reitan test: out of the 50
patients 30 of them were males, 20 of them females.. After applying the Reitan test
17 patients out of 50 (34%) were discovered with subclinical Encephalophaty.
Conclusion : the Hepatic Encephalophaty, eventhough in an early stage, has a
significant negative impact upon the quality of life of the patient and the usage of the
Raitan test has an important role in diagnosing it in a subclinical stage.
It is important to diagnose this neurological problem as soon as possible in order to
adjust the treatment and to make everything it is possible to prevent its evolution.
Page | 130
PLENARY Session XII
(Surgery – Neurosurgery, Vascular & Transplantation surgery,
Plastic surgery)
Page | 131
NEUROLOGICAL DEFICITS IN THE PATIENTS WITH THE
MALIGNANT ASTROCYTOMA OF THE CEREBRUM
Field of medicine:neurosurgery
Author(s):MILAN GLUHOVIC
Mentor(s):Doc dr Zeljko Kojadinovic
Country: Serbia
Introduction
Malignant astrocytomas usually occur in patients older than 45 years.
Clinical picture often has a subacute course and depends on the localization and size
of tumors. Usually, as more malignant tumor is, clinical picture is more difficult and
faster to develop.The signs of elevated intracranial pressure are predominant.
Aim
The aim of this work was to describe a group of patients with malignant
astrocytomas of the cerebrum, and to place particular emphasis on neurological
symptoms and signs. We wanted to name the most common symptoms and signs,
determine their incidence in the developed and the early stages of disease, determine
which deficits influenced the most on the KPS, as one of the most important
prognostic parameters.
Retrospectively, we processed medical documentation of 106 patients
treated for malignant astrocytoma. Statistical data processing was performed in MS
Office Excel 2007. Men were predominant in 70% of the case. Average age was 57,
and average KPS was 70. We found tumor grade III in 63% and grade IV in 37% of
the cases.
Conclusion
We have found that our sample is not significantly different on the age,
sex, localization, neurological deficits, of what is mentioned in the literature. Unlike
most literature data, in our group dominant grade was grade III, and not IV. In the
beginning, the disease was often manifested with headache, epilepsy, hemiparesis of
the lower extremities, and psychoorganic syndrome. We concluded that KPS is good
methods to these patients differ among themselves. KPS was most influenced by
pyramidal deficit level and the existence of psychoorganic syndrome. Epilepsy that
lasts longer than 3 months should be considered as an important prognostic
parameter.
Key words
Malignant astrocytoma; Glioblastoma
anaplasticum; Glioma; Neurological symptoms
multiforme;
Astrocytoma
Page | 132
THORACOSCOPIC APPROACHES VS OPEN APPROACHES IN
TREATMENT OF THORACIC SPINE PATHOLOGY
Field of medicine:neurosurgery (spine surgery)
Author(s):ALEX KASCHEEV
Supervisor(s):Gouscha A.O., MD, Doctor of Medicine; Shevelev I.N., MD, Doctor
of Medicine, Professor; Arestov S.O., MD
Country: Russia
Introduction
Standard open approaches for thoracic spine are invasive and can have
serious complications. However, usage of less-invasive endoscopic methods is widespread in most fields of modern surgery, including neurosurgery. Our aim was to
compare thoracoscopy with open approaches in case of thoracic spine pathology.
In our prospective, non-randomized, comparative trial we studied patients
with disc herniations (N=28) and spine tumors (N=35) on thoracic level. Patients
were divided into 2 groups: thoracoscopy group and open approach group (posterior
and posterolateral approaches). First group consisted of 15 patients with herniations
and 8 patients with tumors; second group included 13 and 27 patients, respectively.
After operation we compared these groups by the following criteria: dynamics of
neurological deficit (modified Frankel scale), quality of life (Euro Quality of Life),
complications rate and time of hospitalization.
Results
In 15 patients with disc herniations from thoracoscopy group Frankel
score improved in 14 (93.3%) cases vs 3 patients (37.5%) from open approach
group. In spine tumors group thoracosopic approach in comparison with
posterolateral approach significantly reduced the complication rate from 18.5% to
12.5% and increased Quality of Life from 0.96±0.014 to 0.83±0.040 in comparison
with posterolateral approach. Time of hospitalization in thoracoscopy group was
also significantly reduced vs open surgery: 6.80 (4-13) vs 10.1 (7-23) days for
tumors, respectively.
Discussion
Usage of thoracoscopic approach is preferred than posterolateral and
posterior approaches in case of T-spine herniations and spine tumors. It improves
neurological restoration after operation, significantly decreases complication rate
and time of hospitalization.
Page | 133
DIAGNOSTIC SIGNS OF CHIARI I MALFORMATION FOR
SURGICAL TREATMENT IN CHILD
Field of medicine: neurosurgery
Author(s):ARKADY A. IVANOV, Andry Zaicev
Supervisor(s):prof. dr. Viktor G. Voronov
Country: Russia
Introduction
Chiari malformation (CM) is a disorder of central nervous system
development which demands a surgical treatment.
Aim
The main purpose of this investigation was improvement of CM diagnosis
in child in case of cerebral tonsil herniation to the level of foramen magnum or
below one.
43 children (15 girls and 28 boys) with CM (from 2 months to 18 years
old) were investigated. 15 child had a clinical manifestation of CM I in combination
with cerebral tonsil herniation only to the foramen magnum level. Magnetic
Resonance Tomography (MRT) in vessel regime, Rentgenophotometry (RPHM),
Emission Computer Tomography (ECT), Acoustic Bulb Induced Potentials
Registration (ABIPR) where used as well as traditional methods of investigation. In
order to define of hydrocephaly degree we marked of ventryculomegaly (VM)
expression using of Evans index (EI) calculation (performed for 23 children).
Results
Type I of CM reviled in 26 (60,5%), type II – in 16 (37,2%) and type III –
in 1 (2,3%) children. Spinal cord hernia diagnosed in 9 cases and fixated spinal cord
syndrome – in 8 (18,6%) cases. Syringomyely presented in 2 (4,7%) child,
hydrocephaly – in 24 (55,8%) child. EI was from 0,27 till 0,77 (in overage – 0,37;
normally – less than 0,25). Degree I of VM presented in 14 (60,9%) cases, II – in 8
(34,8%) and III – in 1 (4,3%) case. Widening of Cavum Verga without VM reviled
in 3 (7%) cases. We performed of surgical operation for 22 children. Multiple stage
combined vice correction carried out for 8 (36,4%) children.
Conclusion
Combination positive results of MRT with RPHM, ECT and ABIPR is an
indication to the surgical treatment of Chiari I malformation.
Page | 134
SURGICAL TREATMENT OF EXTRACRANIAL CEREBROVASCULAR
DISEASE
Field of medicine: vascular surgery
Author(s): MAJA JANJOS,Suzana Jegdic
Supervisor(s): Ass dr sci med Janko Pasternak
Country: Serbia
Introduction: he extracranial cerebro-vascular disease represents a disease of carotid
and vertebral blood-vessels. Occlusive and non-occlusive disease of these arteries is
most frequently caused by the atherosclerotic plaque (of blood vessels). Cerebrovascular disease represents the third- leading cause of death, right behind cardiovascular disease and cancer.
Aim: The aim of this study is to analyse results of surgical treatment of extsacranial
cerebro-vascular disease in relation to the patients' gender and their
symptomatology.
Material and the methods: The material contains the retrospective analysis of all
operatively- treated patients who had the occlusive disease of carotid arteries since
January 1st,2003. to December 31st, 2008.
Results: Our study shows that there are more male operatively treated
patients,according to statistics. It is also interesting that there is no statistically
significant distinction in the frequence of the symptomatic in relation to the
asymptomatic extracranial cerebrovascular disease. Surprisingly interesting a result
among the diseased is that there is no significant difference in the number of
smoking- patients in relation to their suffering from significant contralateral stenosis.
13,2 % of all patients had post-operative comlications. Among them, there were
2,45% of stroke and 10,75% of non-stroke comlications. Among the non-stroke
comlications, there were 7% neurological and 3,75% non-neurological comlications.
Concerning neurological comlications, there were 1,82% of patients who had the
cerebral hiperperfusion syndrome, and 5,18% of patients who had suffered the
injuries of cranial and peripheral nerves. Among non-neurological comlications,
there were 2,19% of patients who suffered from hematoma in lesion, 0,62% of
patients who had peri-operative hemodinamic non-stability and 0,93% of patients
who had other kinds of comlications.
Conclusion: Our study shows low rate of peri-operative mortality, hence, surgical
treatment is the best method of cerebral infarction's secondary prevention , being
important ,as well, as a method of primary prevention.
Page | 135
TREATMENT OF NON-RUPTURED SYMPTOMATIC (IN ACUTE
EXPANSION) ABDOMINAL AORTIC ANEURYSM
Field of medicine: vascular surgery
Author(s): SUZANA JEGDIC,Maja Janjos
Supervisor(s):Ass dr sci med Janko Pasternak
Country: Serbia
Introduction: The non-ruptured symptomatic abdominal aortic aneurysm (AAA) is
a form of clinical manifestation of AAA related to a lot of controversies including
the algorithm of diagnostic and therapeutiical procedures ,especially of those related
to the timing of (endo)surgical eradication of the disease called aneurysm.
Aim: The aim of this study is to define an entity of non-ruptured symptomatic
AAA, to examine the influence of the timing of the surgical treatment and to analyze
the results of its treatment.
Material and methodology: The material contains the retrospective analysis of 390
operatively treated patients during the last five years at the Clinics of Vascular
Surgery in Novi Sad. All of the patients are grouped into four categories: elective
operative surgical treatment, surgical treatment after 24 hours since the reception
through the Ward of Urgent Surgery with the immediate CT diagnostics (within first
2 hours), surgical treatment within first 24 hours, and immediate surgical treatment.
Results: During the last 5 years,390 patients with AAA were operated on. 89
patients had ruptured AAA, 52 were operated on after 24 hours since they were
urgently admitted to hospital, 18 patients were operated on within the first 24 hours,
and 231 patients were planned for the elective surgery. Comparing the groups,rates
of mortality are: elective surgery-5,1%, patients that were operated on after 24 hours
-7,2 %, patients operated on within the first 24 hours -23%, and patients who had
ruptured AAA-34 %.
Conclusions: Considering the results we have got, further conclusion could be
made; the treatment of non-ruptured symptomatic AAA is related to the higher risk
of post-operative mortality in relation to an elective surgery, so we can infer that the
early (semi) elective surgery is a method that should be chosen for the treatment of
non-ruptured symptomatic AAA in acute expansion.
Page | 136
BIOPSY OF SENTINEL NODE IN SKIN MELANOMA –
OVERVIEW OF LITERATURE AND EXPERIENCE OF A CENTER
Field of medicine:plastic surgery
Author(s):MARIJA LAZAREVIC
Supervisor(s):Asist. Prof. dr Predrag Kovacevic
Country:Serbia
Introduction
Melanoma is malignant tumor of melanocites which appears in 1 to 4.5%
of skin malignancies and is defined the cause of death in 70% of patients with skin
malignancies. The aggressiveness of the melanoma and survival rate is determined
by the stage of melanoma. Modern protocols include sentinel node biopsy (SNB) as
diagnostic procedure.
Material, methods & Aim
Using the available literature, the importance of SNB and methodology of
its performing are analyzed together with the radiopharmacy, the particles’ size, time
of lymphoscintigraphy and stage of the disease. The analysis includes the group of
patients with performed SNB over period of 3 years in tertiary clinical centre. The
data of sex, age, histological type, stage, sentinel node positiveness are statistically
analyzed.
Results
Out of 78 treated patients, male are dominant (52), dominant age is 41 to
50 (35.90%). Primary melanoma has equal occurrence rate in body, legs and arms.
The largest percent of patients (43.59%) was in IIA stage of the disease. Forty three
biopsies were performed in axillar region. Patients with one sentinel node are
dominant (62.82%). Micrometastases were found in 22 patients in whom dissections
were performed. Complication of SNB was seroma formation in 3.85%.
Conclusion
SNB is reliable diagnostic method for determing the stage of melanoma in
patients with 1-4mm thick melanoma and in whom clinical examination and
ultrasonography did not show enlarged lymph nodes. The regional lymph node
screening using SNB prolongates the survival rate in these patients.
Key words
melanoma, SNB, complication
Page | 137
LONG-TERM ISCHEMIC PRECONDITIONING (IPC) DURING
INTESTINAL TRANSPLANTATION LOWERS THE RANGE OF
GRAFT DAMAGE
Field of medicine: surgery, transplantation surgery
Author(s): VARGA JÁN, Staško Pavel, Bujdoš Martin
Mentor(s): Tóth Štefan, Oltean Mihai, Pomfy Mikuláš
Country: Slovakia
It is well known that decrease of graft damage range during
intestinaltransplantation (ITx) increases viability of the graft, otherwise resulting in
serious complications. The aim of this study was to observe the impact of ischemic
preconditioning (IPC) on graft damage during ITx. Sprague Dawley rats (n=21)
were randomly divided into 3 groups: control group S (n=7) – graft harvest,
preservation; SIPC (n=7) – short-term IPC following by graft harvest and
preservation; LIPC (n=7) – long-term IPC following by graft harvest and
preservation. The samples were taken during preservation in time 0, 3, 6, 9, 12, 18
and 24h. Following staining by Hematoxylin&Eosin method the histopathological
injury index (HII) was calculated using Park/Chiu scoring system. Bleb cells (BC)
and serotonin positive cells (SPC) were quantified with Alcian blue staining and
anti-serotonin antibody, respectively. Lower values of HII and higher amounts of
BC in comparison to S were detected in all samples of both groups with IPC (SIPC,
LIPC). With increasing range of damage increases the SPC activity. SPC activity
was lower in all samples of group SIPC as well as LIPC comparing to the control
group S. Mutual comparing of all samples of groups with IPC (SIPC, LIPC) showed
lower values of HII, higher amount of BC and lower activity of SPC in group LIPC.
Using of IPC in ITx leads to significantly lower damage of the graft. In conclusion,
long-term IPC (LIPC) shows significantly lower range of graft damage after
intestinal transplantation in rat by comparison with short-term IPC (SIPC).
Page | 138
PLENARY Session XIII
( Pharmacology )
Page | 139
EXPERIMENTAL RESEARCHES ON NEW POSSIBLE ACTION
MECHANISMS OF PROGLUMIDE
Field of medicine:pharmacology
Author(s):OANA TESLARIU
Supervisor(s):Dr. Liliana Tartau
Country: Romania
Introduction
Proglumide (±4-Benzamido-N, N-dipropylglutaramic acid) is an inhibitor
of gastric secretions and a colecistokinin antagonist, which blocks both CCKA and
CCKB receptors. Recent data showed an interrelation between colecistokinin and
opiod system, in nociception mediation, but it is possible that more complex
mechanisms to be implicated.
Aim
We investigated the influence of some Calcium blockers and some
substances with direct action on smooth muscles on the nociceptive effects of
proglumide.
Material and method
The experiment was carried out with white mice (20-25g), divided in
groups of 7 animals each, treated subcutaneous with the same volume of solution as
follows: Group I (Control): distilled water, 0.1 ml; Group II (PGL): Proglumide
20mg/kg; Group III (PGL+NIF): Proglumide 20mg/kg and Nifedipine 0.15 mg/kg;
Group IV (PGL+MEB): Proglumide 20 mg/kg and Mebeverine 0.15 mg/kg; Group
V (PGL+ATR): Proglumide 20 mg/kg and Atropine 0.015 mg/kg. Hot plate and tail
flick tests, as somatic pain model, and writhing test, as visceral pain model, were
used. Data were statistically analyzed with Fischer-Tackey test. Results: The
obtained results showed that Group V (PGL+ATR) presented an insignificant
decreasing of latency time, compared with Group II, in tail flick test and no changes
in hot plate test. In writhing test, Group V (PGL+ATR) determined a significant
increasing of the writhes number (p<0.05), compared with Group II (PGL), after 10
minutes from acetic acid administration.
Conclusions
Proglumide association with nifedipine and mebeverine had no influence
in somatic and visceral pain. Proglumide association with atropine had a significant
influence in visceral pain.
Page | 140
PROTECTIONAL INFLUENCE OF STEVIOSIDE, ROZIGLITAZON AND
PREPARATIONS BASED ON BARLEY AND BARM AT ARTIFICIALLY
INDUCED DIABETES MELLITUS BY ALOKSAN
Field of medicine: Histology
Author(s):SANJA POPIN, Ivan Čapo
Supervisor(s):Prof Dr D. Laloševoić, dr Vlada Cekić
Country: Serbia
Introduction: Diabetes is the most frequent endocrine disorder affecting 246 million
people in the world today. Due to oversensitivity to drugs, increasing number of
people is turning to herbal empirical legacy.
Aim: Look into existance of protectional influence of a preparation called Novodiab
Glut-4-plus, stevioside, oral anti-diabetic Rosiglitazon and a combination of
Novodiab Glut-4-plus and Rosiglitazon on islets of Langerhans in mice’s pancreas
treated with Aloksan.
Material and methods: There were used 18 mice, in this research, divided in 6
groups with 3 animals per a group. They were treated retrospectively with Steviozid,
preparation of Novodiab Glut-4-plus, Rosiglitazon; combination of Novodiab Glut4-plus, Rosiglitazon; and to a negative control group (without a treatment with
Aloksan or researched substances) and to a positive control group (only Aloksan
applied).The animals were treated with these substances during 7-day period and
then given 3 dosages of 100mg/kg of Aloksan by intraperitoneal injunctions (one
dose on the 7th, 8th and 10th day. All tested animals were terminated on the 13th
day of the experiment. The organs are preserved in formalin, cut to 5µm width and
coloured by H&E method.
Results: In the group treated with cariolysis lack of nucleus and residue of damaged
cells in places. Stevioside and preparations based on barley and barm enabled
protection of pancreas.However, in both groups is detected liver deterioration in the
form of leucocyte infiltrates. Rosiglitazon itself did not donate to significant
protectional effect towards pancreas and there is also detected liver deterioration in
the form of leucocyte infiltrates even more than in the first two groups. The
combination of Rosiglitazon with preparations based on barley and barm showed
much better protective influence onto pancreas than with Rosiglitazon only with less
damage to a liver.
Conclusion: By application of stevioside and preparations based on barley and
barm, it is proven their protective effect into pancreas tisue.
Key words: stevioside, Rosiglitazon, barley, barm,diabetes mellitus
Page | 141
TEMPORAL ANALYSIS OF SPONTANEOUS BARORECEPTOR
REFLEX DURING SHAKER AND RESTRAINT STRESS IN
CONSCIOUS NORMOTENSIVE RATS
Field of medicine: pharmacology
Author(s):MARKO JANKOVIC
Supervisor(s):Olivera Šarenac
Country: Serbia
Radiotelemetered male Wistar conscious rats were exposed to acute and chronic
shaker stress (18 times/day 200 cycles/min for 3 days) and acute and chronic
restraint stress (one hour for 9 days) to investigate the effects of stress on the
spontaneous baro-receptor reflex (sBRR). Systolic blood pressure (SBP), pulse
interval (PI) and heart rate (HR) were derived from arterial pulse pressure as
maximum, inter-beat interval and its reverse, respectively. sBRR was evaluated
using the method of sequences and the following parameters: sBRR sensitivity
(BRS, calculated as main linear regression coefficient PI = BRS x BP + const and
the curve fitted in least square sense); sBRR effectiveness index (BEI = n0 of
sequences / n0 of ramps); number of ramps per minute (NR); number of sequences
per minute (N); average sequence length (NB) ; ramp length (NBR); sequence SBP
and PI increment and swing; sBRR operating range (contour coverage area, CCA,
area embedding the sequence points in PI-SBP plain) and sBRR set-point (mass
center of CCA). Exposure of rats to acute shaker stress increased vigilance and SBP,
did not affect BRS and BEI, and rats quickly habituated to stress under chronic
exposure. Acute restraint stress provoked defense reaction, increased SBP and HR,
decrease BRS and BEI. Moreover, SBP and HR of rats increased under chronic
exposure to restraint. However BRS and BEI remained close to basal values. It can
be concluded that stressors differentially affect cardiovascular parameters and the
functioning of spontaneous BRR subservs different behavioral responses.
Page | 142
THE INFLUENCE OF ANTIHYPERTENSIVE DRUGS ON
URINARY
ALBUMIN
EXCRETION
IN
NON-DIABETIC
HYPERTENSIVE PATIENTS
Author(s):DANE KRTINIC, Davor Djukic, Jelena Milosevic, Masa Binic,
Jelena Arandjelovic
Supervisor(s):MD PhD Zorica Jovic
Country:Serbia
Arterial hypertension together with proteinuria is one of the most important factors
associated with the progression of both diabetic and non-diabetic chronic kidney
disease. Reduction of blood pressure is an efficient way of slowing the progression
of this damage. The aim of the present study was to determine the influence of
different antihypertensive drug groups on urinary albumin excretion (UAE) as
related to blood pressure in non-diabetic subjects. Subjects (n=39) with mild-tomoderate hypertension and proteinuria were included in the study. Patients were
divided into four groups and were placed on usual care including
nonpharmacological and/or treatment with an antihypertensive drug regime
(consisting of one or two different antihypertensive drugs-ACE inhibitor or calciumchannel blocker) to achieve target blood pressure ≤ 130/85 mmHg. All patients were
divided into the following 4 groups: 0 – nonpharmacological treatment; 1 – treated
with ACE inhibitors; 2 – treated with calcium channel blockers; 3 –treated with
bowth types of drugs. A statistically significant change in mean UAE values at the
start and end of the study period in patients assigned to drug group 3 was achieved
(p<0.05). Also, a statistically significant difference existed in the average reduction
of proteinuria under varying antihypertensive drug regimens (p<0.05, ANOVA).
Post hoc analyses revealed also a significant difference between groups 0 and 3
(p<0.01) as well as groups 1 and 3 (p<0.01). In patients with hypertension, changes
in UAE depend on the initial UAE values and the type of antihypertensive treatment.
Page | 143
THE INFLUENCE OF 7 – MONOKETOCHOLIC ACID ON
PHARMACOLOGICAL EFFECTS OF ACETYLSALICYLIC ACID
Author(s):BOJAN HRVACANIN, Ljubka Budinski
Supervisor(s): Aleksandar Raskovic, Nebojsa Stilinovic
Country: Serbia
Introduction
Bile acids and their derivates accelerate the transport of drugs through the
biomembranes, and also show a number of therapeutic effects.
Aim
The aim of this study was to investigate the effect of the 7monoketocholic acid on the acetylsalicylic acid crossing the blood-brain barrier. The
influence of the 7-monoketocholic acid on the antipyretic effect of the acetylsalicylic
acid was also examined.
Matherials and Methods
White laboratory rats of Wistar type were used in this experiment. Contact
thermometer was used in the first part of the experiment to measure the body
temperature of rats, who were treated with acetylsalicylic acid, 7-monoketocholic
acid and the combination of acetylsalicylic acid and 7-monoketocholic acid. The
spectrophotofluorometer was used to determine the concentration of salicylates in
the blood as well as in the brain of these rats, treated with acetylsalicylic acid and
the combination of acetylsalicylic acid and 7-monoketocholic acid.
Results
The combination of acetylsalicylic acid and 7-monoketocholic acid has
significantly increased the concentration of salicylates in all compartments of the
brain in contrast to the treatment with acetylsalicylic acid solely. The antipyretic
effect of the salicylates has been considerably increased and prolonged after the use
of the 7-monoketocholic acid in contrast to the effect of the very salicylates
(32,9:34,7 ºC). The use of 7-monoketocholic acid alone has induced significant
antipyretic effect in contrast to the control group (32,7:34,9 ºC).
Conclusion
The 7-monoketocholic acid, a synthetic derivate of cholic acid, promotes
the transport of the salicylates through the blood-brain barrier as well as the
antipyretic effect of the salicylates. The 7-monoketocholic acid itself shows
significant antipyretic effect.
Key words: Acetylsalicylic acid, blood-brain barrier, bile acids.
Page | 144
COMPARISON THERAPEUTIC EFFECT OF “NEBULIZE
CAPTOPRIL” AND “ORAL CAPTOPRIL” ON PARAQUATINDUCED LUNG FIBROSIS IN RATS
Field of medicine: pharmachology
Author(s): SEYED AMIN MIRSADEGHI, M Ghazi-Khansari, M Yesharim,
S G Ghamami
Supervisor(s): M Ghazi-Khansari
Country: Iran
Although different treatment modalities have been implemented for
pulmonary fibrosis, the results have not been promising and these conditions have
been considered untreatable and irreversible. Thus, a plethora of new drugs has been
tried for the control of this condition in recent years. We have studied the
effectiveness of Captopril On protection of rat's lungs against active radicals of
oxygen species induced by paraquat. The optimal dose of Captopril was 70mg/kg in
rats, with considering the side effects of Captopril in human we studied nebulize
Captopril that may be more effective and has fewer side effects.
Male albino Wistar rats were used in the experiment that were divided into
4 groups: group I and the other groups were given a single i.p. dose of 20 mg/kg
paraquat, group II received Captopril (70 mg/kg; po) after injecting paraquat, group
III received nebulize Captopril (70 mg/kg, Inhaln) after injecting paraquat and group
IV received nebulize Captopril (280 mg/kg, Inhaln) after injecting paraquat. After 21
days of treatment, the level of hydroxyproline and the degree of lipid peroxidation
will determine in the lung tissue of the animals and the lungs were examined
histologically for fibrosis.
Paraquat caused a significant increase in hydroxyproline content and
nebulize Captopril significantly decreased the amount hydroxyproline in the lung
tissue of the rats. The histological examination also indicated that nebulize Captopril
can effectively protect the paraquat induced lung fibrosis.
Evaluation the therapeutic effects of nebulize Captopril and its side effects
needs more studies. (Size of nebulize particles, method of administration)
Page | 145
PROTECTIVE EFFECT OF VITAMIN C ON METHOTREXATE
INDUCED RENAL INJURY IN RAT
Author(s): RUHOLLAH HEMMATI -Babak Hajipour, ,Naser Ahmadi Asl
Mohammad Reza Ardalan, Mohammad Reza Hemmati, Amir Mansour Vatankhah.Hossein Angouri-Farzad Saberifar.
Supervisor(s): Dr Mohammad Reza Ardalan
Country: Iran
Introduction
Methotrexate (MTX) is used widely to treat autoimmune diseases and
various neoplastic diseases. Beside MTX therapeutic action its administration causes
nephrotoxicity. Biological compounds with antioxidant properties may contribute to
the protection of cells and tissues against deleterious effects of ROS and other free
radicals induced by MTX. Vitamin C is an antioxidant agent in which can improve
cellular anti-oxidative defense and decrease free radicals.
30 male wistar rats divided into 3 groups: group 1: control group (saline) ,
group 2: received MTX (20 mg/kg) intraperitoneally , group 3: received MTX (20
mg/kg)+Vitamin C 150 mg/kg vitamin C by oral gavage since 3 days before MTX
injection till 6 days after MTX injection for 9 days. After 6 days, all animals were
sacrificed and serum BUN, Cr and TNF-α were meassured, and renal tissue excised
for histophatologic and biochemical assessment.
Results
Data showed that glutathione peroxidase (GPx), and super oxide
dismutase (SOD) levels were higher in MTX+vitamin C group than MTX group
significantly (P<0.05). Tissue injury index , malondealdehyde (MDA) level and
serum TNF-α,BUN and Cr levels were higher in MTX group comparing to
MTX+vitamin C group significantly (P<0.05).
Discussion
This study supported the hypothesis that vitamin C treatment decreases
lipid peroxidation , renal tissue injury and serum TNF-α level in rats receiving MTX
and attenuated reduction of intracellular antioxidants including GPx and SOD. This
agent may be useful for the treatment of people following chemotherapy with MTX.
However, more experimental and clinical studies are needed to explain the exact
mechanism of protective effect.
Page | 146
CHEMOTACTIC EFFECT AND INFLUENCE ON
ADHESION OF DEPRENYL AND ITS DERIVATIVES
CELL
Author(s): LIVIA POLGAR
Supervisor(s): Eszter Lajko Phram. D, Laszlo Kohidai MD PhD
Country: Hungary
Introduction
Cell adhesion and migration play a pivotal role in the development of
neurodegenerative diseases and in the formation of metastases in tumors. Ldeprenyl, an irreversible inhibitor of the enzyme monoamino-oxidase B, has proved
to have positive effect in Parkinson’s disease and tumors.
Aim
In our present work (i) the chemotactic ability; (ii) the effect on the
adhesion of L-deprenyl and its derivatives were evaluated and (iii) the relationship
between the molecular structure and physiological effect of these substances were
studied.
The following ligands were analyzed: L-, D-, racemic deprenyl and parafluoro-deprenyl, methyl-, dimethyl- and N-desmethyl-deprenyl, deprenyl-N-oxide,
L-amphetamine, L-methamphetamine and L-ethyl-amphetamine. The model-cells
were the ciliate Tetrahymena pyriformis and the Mono Mac 6 (humane monocyte).
Chemotactic activity of cells was measured in a two chamber capillary assay
(Tetrahymena) and by NeuroProbe® assay (Mono Mac 6). Adhesion was evaluated
by using an electric impedance based technique (xCELLigence®).
Results
L-deprenyl and L-ethyl-amphetamine had chemoattractant effect both on
Tetrahymena and monocytes while D-deprenyl showed chemorepellent effect on
both model-cells. On monocytes, the attractant effect of L-deprenyl and D-parafluoro-deprenyl was associated with positive effect on adhesion as opposed to Ndesmethyl-deprenyl which proved to be repellent and modified negatively the cell
adhesion.
Conclusion
Deprenyl and its derivatives could elicit chemotactic responses and they
were able to influence adhesion. The model-cells proved to be sensitive to small
structural changes of these molecules. Our molecule/structure specific results call
attention to that deprenyl and its derivatives could change the adhesive ability of
metastasizing tumor cells.
Page | 147
LEGAL LIABILITY IN MEDICAL PRACTICE
Field of medicine: bioethics
Author(s):CORINA ULGUT
Supervisor(s):Conf. Dr. Iuliu Fulga
Country: Romania
Introduction
Under the term of “medical responsibility” are contained numerous
medical values, behaviors and relationships constantly changing, that coming to
strengthen the trust that an individual patients and the public have in the medical
profession. One of the roles of the coroner – according to Louis Roche - “the doctor
coroner” is to make available to the other doctors notions of medical law. Endorse
this view, which is why we propose the study of general and fundamental notions of
law and regulations of the last laws that directly or indirectly related to medical
activity.
Methods
Taking into account the obvious differences between the speed of
evolution of professional medical standards, which are constantly moving, being
exchanged with a variable speed depending on increasing the awareness of society,
on the one hand, and the slow evolution of the rules of law, on the other hand , we
make an update to the notion of medical law.
Results
It followed clarify differences between legal mistake (fault) and the error
of fact, setting limits of liability for failing a medical act, examine the usefulness in
medical work by reducing the risks and maximize benefits for the patient, analyzed
and classified causal chains between the injury and the medical act, College of
Physicians responsability discussed in the analysis of medical activity.
Conclusion
The benefic role of medical responsibility knowledge, controversial
scientific featured in condition of fault and medical liability lead to an increase in
the quality of medical services, the development of an effective barrier against the
development history of the accident, from error. Is incorrect in terms of scientific, to
believe that human errors are avoidable through the application of sanctions. Human
errors are rarely voluntary, and any decision that is taken is a complex process.
Problems do not come from bad people, who work in a good system, but the people
who work in systems that must be improved and made more secure.
Page | 148
PRELIMINARY DATA REGARDING THE EFFECTS OF SOME
ANTIDEPRESSANT DRUGS IN VISCERAL NOCICEPTION IN
MICE
Field of medicine: fundamental sciences
Author(s): ANA NICOLAE, Raluca Samoila, Irina Ibanescu
Supevisor(s): Liliana Tarţău, MD, PhD, Professor assistant
Country:Romania
Aim
Experimental research on
antinociceptive effects in pain models.
some
serotonine
reuptake
inhibitors
Material and method
The experiment was carried out, with white male mice (20-25g), divided
into 5 groups of 7 animals each, treated orally for 7 days, with the same volume of
solution, as follows: Group I: saline solution 0,3ml (control); Group II (IMP):
imipramine 0,3mg/kbw; Group III (CMP): clomipramine 0,15mg/kbw; Group IV
(FLX): fluoxetine 0,15mg/kbw; Group V (FVM): fluvoxamine 0,7mg/kbw. The
model of visceral pain consists of colon inflammation test with capsaicin.
Intracolonic administration of capsaicin induced visceral pain-related nociceptive
behavior manifestations (licking abdomen, stretching, contractions). Data were
statistically analyzed with SPSS for Windows version 10.0.
Results and conclusions
Imipramine and clomipramine determine antinociceptive effect in different
time intervals, in this experimental model. Imipramine administration, resulted in the
most significant antinociceptive effect (p<0,05) in all time intervals of the capsaicin
induced colon inflammation test. Fluoxetine and fluvoxamine did not influence the
nociceptive responses in this visceral pain model in mice. Keywords: SSRIs,
antinociceptive, visceral pain, capsaicin.
Page | 149
MORPHOLOGICAL CHANGES IN THE KIDNEY AND BLOOD
BIOCHEMICAL CHANGES IN RATS TREATED WITH
GENTAMICIN
Field of medicine:physiology
Author(s):SLOBODAN ARANDJELOVIC
Supervisor(s):ass Nenad Stojiljkovic
Country:Serbia
Introduction
The wide spread therapeutic use of the aminoglycoside antibiotic
gentamicin(A) is limited by its nephrotoxic side effect ,which can lead to acute renal
failure.
Aim
This study aimed at examining effects of high, supratherapeutic doses of
gentamicin on morphological, structural and functional alterations of the glomerular
basement membrane in adult rats.
Experiments were done on 30 male Wistar rats, divided in to two
experimental groups. G-group (8 rats) received gentamicin in a dose of
100mg/kg/day intraperitoneally during eight consecutive edays. Controlor K-group
(8rats) received 1ml/day saline intraperitoneally. For histological analysis, 5μm
thick sections were stained with hematoxylin and eosin(HE), periodic acid Schiff
(PAS), and Jones methenamine silver. Biochemical analyses were used to determine
concentrations of blood urea, serum creatinine, sodium and potassium.
Results
In G-group rats, glomeruli were largerand glomerular basement membrane
was diffusely and irregularly thickened with neutrophil cell inltration. In some
capillary glomerula there are neutrophil leucocytes. In epithelial cells proximal
tubules necrosis was present , as well as vacuolization cytoplasm of cells that still
have nuclei. In the cytoplasm of epithelial cells proximal tubule have numerous dark
inclusion. Distal tubule are the usual loock.Founded average values of serum
concentration urea and creatinine in the experimental group of rats treated with
gentamicin were increased compared to the same value in the control group of rats.
Conclusion
Our results clearly showed morphological and structural and biohemical
alterations in blood of adult rats exposed to high doses of gentamicin.
Page | 150
EFFECTS OF MONOSODIUM GLUTAMATE NEONATAL
TREATMENT ON KIDNEY MORPHOLOGY OF RATS
Field of medicine: biology
Author(s):IVAN RANCIC, Stevan Vujic, Marija Mihajlovic
Supervisor(s): prof. dr Stevo Najman
Introduction
Monosodium glutamate (MSG) is a food and pharmaceutical additive.
Studies have shown its toxic effects on organs like liver, kidneys, adrenal glands.
These studies have shown that MSG treatment induces morphological changes in
these organs, but there is little data about these changes in rat kidneys.
Aim
The aim of this study is to gather data about MSG morphological changes
in kidneys of obese rats.
We used 12 Wistar female rats divided in 2 groups. Control (C) group was
given 0, 9% sodium chloride, while the treated (MSG) group was given MSG in
dose of 4 mg/g BW in second, fourth, sixth, eight and tenth day postnatally. Two
months after, animals were sacrificed, after being administered with anesthesia and
organs were taken. Organs were histologicaly processed. Slides were cut and using
histological and histochemical methods stained by HE, PAS, Jones and Van Gieson
methods.
Results
Kidneys of MSG treated rats show cortex hyperemia. Glomeruli are
hypercelluar and undersized, while Bowman’s spaces present hydronephrosis and
dilatation. Proximal tubules have hardly visible lumens and have parenchymatose,
vacuolar and hydropic cell degeneration presentation. Distal tubules and Henle’s
loops are lesser affected by same changes. Blood vessels are hyperemic and have
proliferated surrounding connective tissue. Edematous changes are seen in the
medullar convoluted tubules.
Conclusion
Tested MSG dose induces degenerative kidney changes in proximal
tubules, glomeruli, distal tubules and interstitium. These morphological changes
confirm toxic MSG effects on this organ.
Keywords: monosodium glutamate, kidney, degenerative morphological
changes
Page | 151
PLENARY Session XIV
( Radilogy, Gyneacology & Obstetrics )
Page | 152
THE ROLE OF SCREENING BACTERIAL INFECTION IN A
PREVENTION OF PELVIC INFLAMATORY DISSEASE
Field of medicine: gynecology
Author(s):NATASA ZIVKOVIC
Supervisor(s):prof.dr Mirjana Bogavac
Country: Serbia
Introduction
Pelvic inflammatory disease (PID) is common and can lead to infertility,
ectopic pregnancy or chronic pelvic pain. Last few years an increasing incidence of
genital tract infections, both in women and their partners was observed. Mostly, the way
of spreading is the sexual contact. Symptomatology in all genital infections is similar:
abundant secretion, itching, burning, pain, hyperemia, dysuria, dyspareunia. Bacterial and
chlamidial infections, if left untreated or asymptomatic can lead to long-term infections
with the affection of small pelvis, occurrence of ectopic pregnancy or sterility.
Aim
Determine the presence of bacterial infection of the cervix in patients who
came to the polyclinic due to long-term relapses of cervical infections, adnexitis or
infertility problems; in patients who came to the hospital on regular basis or with
previously treated genital infections.
Material & methods
The research included women who came to the polyclinic of the Clinical center
of Vojvodina – Department of gynecology and obstetrics, with symptoms such as pain in
lower abdomen, increased vaginal secretion, adenxitis or infertility – study group (N 40). Patients without any symptoms made up a controlled group (N – 20). Anamnestic
data like age, occupation, previous genital infections and pregnancies, use of
contraceptives were documented. Vaginal secretion, PAPA and cervical smears were
taken in order to determine the presence of any bacterial infection.
Results
The results proved the presence of bacterial infection in all age groups,
particularly in group of 21 – 30 yrs. Most common diagnosis in study group was:
cervicitis, adnexitis and infertility. Great number of spontaneous abortions in examined
group was also noted. Chlamydia trachomatis was detected in 12 (30%) of the patients
from study group. No one patient from controlled group had Chlamydia trachomatis
infection. Also bacterial infection was found only in patients with symptoms (study
group) in 14 (35%). The most common isolated bacteria were Chlamydia trachomatis,
Enterococcus and E.coli.
Conclusion
Screening of bacterial infections in all patients, particularly taking- up the
cervical smears should be included as a part of regular gynecological examination.
Page | 153
ANTIBIOTICAL PREVENTION AT CEASAREAN SECTION
Field of medicine: obstetrics and gynecology
Author(s):MILANA VLAJANKOV, Milan Ranisavljević
Supervisor(s):Prof Dr Bogavac Mirjana
Country:Serbia
Introduction
Last few years in our, like in other countrys in world high nummber of
cesarean sections is recorded. Cause of that is: lot of pregnant womens are older then
30 years, lots of in vitro fertilisation (IVF), and huge nummber of womens wish
unpainful delivery. Infection is most frequent complication in cesarean section (SC).
Aim
was to show the influence of bacterial infections and antibiotical therapy
at womens and childrens born after cesarean section.
Materials And Methods
In this study was 60 pregnant womens bettwen 36 and 41 weeks of
gestation. Study group (No = 14) was made by womens with infection after SC, and
in control group (No = 46) womens without infection and other complications after
SC. Bacterial infection diagnosis was made by voum, scar and cervical
smear.Antibiotics therapy was give to mothers and babys after antibiogram
verification.
Results
All patients from study group (14) have infection: from cervics E. Colli is
isolated at 1 (7,14 %) and Enterococcus at 3 (21,43%) womens. From voum
Enterococcus was isolated at 5 (35,71 %) patients. Staphylococcus spp. was isolated
from scar at 3 (21,43 %) patients. Positive urin on bacterias (E. Colli) was at 2
(14,29 %) pregnant womens. We use combination of parenteral antibiotics therapy
(proven by antibiogram) for 2-3 days on mothers and babys.
Conclusion
Scrining of bacterial infection in pregnancy is very important. Using
systematic antibiotics therapy proven by antibiogram in combination with local
therapy, could we make prevention of complications before and after delivery
especially at cesarean section.
Keywords:
bacterial
infection,
cesarean
section,
antibiotics
profilaxis.
Page | 154
HYSTEROSCOPIC POLYPECTOMY IN INFERTILE FEMALE
PATIENTS
Field of medicine: gynecology
Author(s):ALEKSANDAR MIHAILOVIĆ, Aleksandar Mitrović, Ognjen Bojović
Supervisor(s):Doc. dr Ana Mitrović
Country:Serbia
Introduction
Infertility is the absence of a pregnancy after a year of frequent sexual
intercource without using any contraceptive measures. Polyps are restricted, usually
focal hyperplasium of endometrium which presence in cavum causes the important
decreasing of possibility of an implantation of the blastocist. The direct visualization
under the control of the hysteroscopic optics we are in the position to remove the
polyp what is very important in the infertility treatment.
Aim
The aim of this research was to show the important role of the
hysteroscopy in the diagnostics and infertility treatment caused by suspicious
assessment in cavum with a special looking-back on the endometrial polyp.
The research was carried on 77 female patients sent to hysteroscopy with
diagnosis of infertility with suspicious change in the cavum of uterus. For the data
analyzing we used the method of descriptive statistics.
Results
The age of the female patients was between 23 and 41 years, average
34,12 years. From 77 patients 48 was with diagnosis of the primary, and 29 with
diagnosis of the secondary infertility. The analysis that was conducted before is
HSG in the case of 45 patients (58,4%), and the interventions that was conducted is
laparoscopy in the case of 8 (10,4%) and hysteroscopy at 3 patients (3,9%). Polyps
as a most frequent cause of infertility were found at 68,83% of patients and
subseptus at 19,5% of them. The most usual location of polyps was on the anterior
wall (36,67%) and on fundus of uteri (26,67%), and the biggest part of them
(43,33%) was in the size of 0,5-1cm.
Conclusion
The researching and the treatment of infertility is a detailed view of the
cavum of uteri where the most important is the assessment of endometrial polyps
and subseptus. Hysteroscopy is a modern, efficient, simple and safe diagnostics and
method of intervention in the case of infertile patients with suspicious assessment in
cavum.
Page | 155
COMPARATIV ANALYSIS OF ABDOMINAL AND VAGINAL
HYSTERECTOMY
–
INDICATIONS,
OPERATIVE
AND
POSTOPERATIVE COMPLICATIONS
Field of medicine:gynecology
Author(s):ALEKSANDAR MITROVIĆ, Aleksandar Mihailović, Ognjen Bojović
Supervisor(s): Doc. dr Ana Mitrović
Country: Serbia
Introduction
Hysterectomy is a surgical procedure by which the uterus is partly or
totally moved out of a woman body. Gynecological surgery have two ways of
intervention: abdominal and vaginal. There are absolute indications for one of the
mentioned interventions, and on the other side those which don t need exactly
vaginal or abdominal intervention.
Aim.
The aim of this research was to show the most common indications,
methods of interventions and complications at hysterectomies in GOC-Narodni
front.
The research was carried on 160 female patients with conducted
hysterectomy. The first group was the patients with already done abdominal
hysterectomy and the second group was the patients with already done vaginal
hysterectomy. For the data processing was used the method of descriptive statistics
Results
The average age of analised patients was 56,86 years. From 160 patients
in the case of 133 was conducted abdominal, and in the case of 27 was conducted
vaginal hysterectomy. The abdominal hysterectomies can be done in tree ways: in 72
(54,2%) cases was used the classical method, in 41 (30,8%) method by Aldridge and
in 20 (15%) method by Wertheim-Meigs. The most common indication for classical
hysterectomy was carcinoma ovarii (33,3%), for method by Aldridge was
polymiomata uteri (43,9%) and the absolute indication for the method by WerthaimMeigs was carcinoma cervicis uteri (100%).
Conclusion
Whenever the indications give you possibility, it is better to stimulate the
vaginal hysterectomy. The percentage of vaginal hysterectomy may rise with the
better trained ginecologists. In the reality this is posible and needed, and everything
in the best interest of our ginecological patients, so the results should come with the
better training of young doctors in this area.
Page | 156
EVALUATION OF SEXUAL HEALTH IN WOMEN OF
REPRODUCTIVE AGE WITH CHRONIC INFLAMMATORY
PROCESSES OF INTERNAL SEXUAL ORGANS
Field of medicine:gynecology
Author(s): VERONIKA ANDRASHKO
Supervisor(s): Oksana Korchynska
Country: Ukraine
Aim
The aim of the study was to assess the prevalence of the indices of
feminine sexual dysfunction (FSD) in women with chronic inflammatory processes
(CIP) of internal sexual organs.
Direct questioning was used in 30 women with CIP of internal sexual
organs aged 18 to 45 years. The results were compared to those in an age-matched
control group of 30 practically healthy women.
Results
Among the women in the study group the overall prevalence of FSD
reached 90%, while in practically healthy women it occured in 53,3%. In the
structure of sexual dysfunction in the study group, weakening or absence of libido
occurred in 43,3% (10% in control group), dyspareunia was discovered in 50%
(16,6%), diminishing or absence of sexual pleasure - 56,6% (6,6%), orgasmic failure
- 66,6% (33,3%). At the same time, 76,6% of women of the study group marked
decrease in the frequency of sexual intercourses due to their disease. The most
frequent reasons of sexual dysfunction among the study group were: disappointment
in one's gynecological health (59,25%), fear of the painful feelings (44,4%) and of
disease complications after the sexual intercourse (33,3%), while among the control
group the prevalence was: expectation of failure or disappointment after failures in
the past (81,25%) or fear of painful feelings (56,25%).
Conclusion
Chronic inflammatory processes of internal sexual organs worsen women's
sexual function, which definitely deserves attention. Thus, collaboration between the
gynecologist, sexologist and psychologist is needed for the improvement of women's
health.
Page | 157
COMPARING EFFECTS OF BERBERIS JUICE AND MEFENAMIC ACID ON
PRIMARY DYSMENORRHEAL SYMPTOMS: A DOUBLE BLIND RANDOMIZED
CONTROLLED TRIAL
Field of medicine: obstetrics and gynecology
Author(s):KARIM DIZANI SETAREH, Kalbasi Anaraki Parnian
Supervisor(s):Musavi Ashrfosadat
Country: Iran
Introduction
Primary dysmenorrhoea is the most frequent gynaecological condition, with a
prevalence of 40 - 90% in women within the reproductive age.1 Dysmenorrhea has been
reported to be one of the most common causes of periodic absenteeism from school or work in
young women.2 Conventional treatment for primary dysmenorrhoea has a failure rate of 20%
to 25% and may be contraindicated or not tolerated by some patients3. One of the treatments of
it is Mefenamic Acid.4 On the other hand, Berberis is an anti inflammation and an anti
coagulation5-8. So we decided to evaluate the effects of Berberis Juice on Primary
Dysmenorrheal symptoms.
Materials & Methods
A prospective double-blind randomized controlled trial. After pilot and calculating
sample size, 80 girls with primary dysmenorrhea were selected from Farzanegan high school
by simple random method. Inclusion criteria for selection were: 1. 17<BMI<25, 2. No
hirsutism, 3. Primary dysmenorrheal symptoms were including nausea and pain in supra
pubical zone, 4. Starting menstuaral least 2 years before and 5. No systemic disease. By
randomization divided two groups. After starting primary dysmenorrheal symptoms, First
group had berberis juice and second group had Mefenamid Acid. We used the validated pain
subscale of a 0-10 pain rating scale to estimate pain severity and when the samples show 0 or 1
was recorded the duration. At the end the information has been analyzed by SPSS v.15
software. Survival analysis was done with Kaplan Meyer and log rank test and compared Ttest. For all tests, P<0.05 was considered significant.
Results
The mean of age and BMI was in first group respectively 16.37(SD=0.66) and
20.4(SD=1.92) and in second group respectively 16.27(SD=0.67) and 20.44(SD=1.9). There
was a significant difference between first group and second group (P<0.001).The survival
analysis showed that the mean curable time was in first and second group respectively 7.15
(SE=0.225) and 27.57 (SE=0.551). Also there was a significant difference in comparing the
mean curable time in two groups by log rank test (P<0.001). The rate of curable dysmenorrheal
symptoms in 5,8,10 minutes was respectively 10, 80 and 100 percent in first group. But
symptoms don't cure until 10 minute in second group. The rate of curable dysmenorrheal
symptoms in 25, 28 and 30 minutes was respectively 30, 60 and 85 percent in second group.
Discussion and Conclusion
Our findings indicate that Berberis Juice cures the primary dysmenorrheal
symptoms sooner than Mefenamic Acid. This study performed with other symptoms of
primary dysmenorrhea is suggested.
Page | 158
SPECIFICITY
AND
SENSITIVITY
OF
ULTRA-SONIC
DIAGNOSTICS IN RELATION TO COMPUTED TOMOGRAPHY
DIAGNOSTICS WITH BLUNT ABDOMEN INJURIES
Author(s):ALEKSANDAR PAVKOVIC
Supervisor(s):Ass. Dr D.Radovanovic
Country: Serbia
Interduction
Two widely spread diagnostic branches ultra-sonic conrol and CT were
observed by retrospective analysis of patients treated becouse of thud injury of
abdomen.
Aim
It is important to see adventages and flaws of certain diagnostics, i.e.
sensitivity and specificity in in defining the final daignosis and all tahet in the goal
of adequate and timely treatment.
Materiles and methodes:
Parallel date of ultra-sonic and CT results were used with group of patients
with thud injury of stomach and the results were later assorted dy patology in four
specific groups,above the rest having in mind sensitivity of these diagnostics,on
parenchyma injuries,liquid collections,retoperitoneum injuries and injuries of
intestinal structures just like others group of 30 injured who dod not have significant
injuries of internal structures.
Results:
Of 30 injured submited to US and CT diagnostics we calculate thet the
sensitivity of US diagnostics is 76%,and the sensitivity of CT diagnostics is 90%.By
calculating the specificites of these two methods on the sample of 30 injured who
did not have serious trauma the US diagnostics showed 90% of specificity and CT
diagnostic showed 93%
Consulusion:
Analysing results we can see high sensitivity of both methods for liquid
collections and parenchyma injuries,low sensitiviti of US diagnostics for
retroperitoneum injures and apsolute irrelevancy of US with intestinal inuriy.High
specificity is proved for both applied metods.
Page | 159
THE IMPLICATIONS OF MULTIPLE MANDIBULAR CHANNELS
IN LOCAL ANESTHESIOLOGY AND IMPLANTOLOGY
Field of medicine: Radiology
Author(s): F.M. TAMASY, A. Tamas-Szora, A.C. Trifan, S.S. Ster, S.V. Trifoi
Supervisor(s): Andreea Seceleanu, MD, PhD
Country: Romania
Introduction
The present paper proposes the study of the importance in indentifying the
double and triple mandibular channel in implantology and oro-maxilo-facial surgery.
The premisses for this study were that in literature the incidence of a double
mandibular channel was of arround 1%.
Means and method
In the first stage 100 panoramic x-rays were evaluated. In the second stage
10 jaw bones were studied, on dry bone, through panoramic, native and then
contrast, x-rays. The contrast dye, iodine based, was injected through the mandibular
foramen.
Results
The extensive examination of the 100 panoramic x-rays revealed a double
transparency with the aspect of double mandibular channel in 5% of the cases. The
x-rays taken of dry bone, jaw-bones revealed only nutritive accessory channels,
without any proof of a double mandibule channel.
Conclusions
In vitro study and literature data prove that the incidence of a double
mandibular channel is much lower than in the panoramic x-rays taken on our
population. The aspect of double mandibular channel can’t be properly assesed on
panoramic x-rays due to confusions determined by the radio-transparency of the
submandibular fossa, or the false radio-transparency induced by the proximity of the
mandibular channel to the lower margin of the mandibule or the mylo-hyoidian line.
Cross-section computer tomograph images, on the dental arch is of first intent in
unconverring double or triple mandibular channels in pre-implant evaluation.
Page | 160
PROSTATE CANCER: ANALYSIS OF DIAGNOSTIC VALUE OF
MAGNETIC RESONANCE AND PROSTATE-SPECIFIC ANTIGEN (PSA)
Field of medicine: Clinical Medicine, Radiology,Oncology
Author(s): IVAN JAMBOR
Mentor(s): Assoc. prof. Viera Lehotská, MD, PhD
Introduction
Prostate cancer is one of the most common malignancies in elderly men.
In the screening of prostate cancer serum level of prostate-specific antigen(PSA) is
commonly used. The diagnosis of prostate cancer is mostly based on the result of
ultrasonography(US) guided biopsy. A random biopsy is usually performed instead
of target biopsy because of low accuracy of US.
Aim
To retrospectively compare the role of PSA, magnetic resonance imaging
(MRI) and combination of basic MRI and diffusion-weighted imaging (DWI) in
diagnostics and monitoring of treatment of prostate cancer.
This study was approved by institution review board and informed consent
was obtained form all patients. All 110 patients underwent standard 1,5-T MR, had
US-guided transrectal biopsy and serum level of PSA was measured. They were
divided into 4 groups:1.group: 20 nontreated patients, DWI performed,2.group: 34
nontreated patients, DWI not performed,3.group: 7 hormone-treated patients, DWI
performed,4.group: 49 hormone-treated patients, DWI not performed.The degree of
diagnostic confidence(C) of tumor presence was recorded on a five-point scale.
Results
There was no significant difference in ability of MRI (C = 4,88) and
combined MRI/DWI (C = 4,91) in localization of tumor in peripheral zone.
Combined MRI/DWI (C = 4,33) had higher degree of diagnostic confidence in
localization of tumor in central and transitional zone than standard MRI alone (C =
3,55). Hormone-treated patients had lover degree of diagnostic confidence than
nontreated patients by using both imaging modalities (CMRI = 3,87 , CMRI/DWI =
4,30). Serum level of PSA did not correlate with TNM classification. Serum level of
PSA (normal < 4 ng/ml) was false positive in 3,6% and false negative in 2,7% of
patients.
Conclusion: Combined MRI/DWI increases sensitivity and specificity of prostate
cancer diagnostic and plays a significant role in diagnosis of patients with elevated
serum level of PSA and monitoring their treatment.
Page | 161
ASSESSMENT OF FOCAL LESIONS IN LIVER USING
MAGNETIC RESONANCE IMAGING - SIGNIFICANCE OF
DIFFUSION WEIGHTED IMAGING
Author(s):NINA GUSIC, Nevena Guduric, Andjelka Isakovic, Natasa Cvetinovic,
Ivana Ivanisevic
Supervisor(s): Associate Professor Ruzica Maksimovic
Country: Serbia
Introduction: The study was design to determine if there is a difference between
apparent diffusion coefficient (ADC) values using magnetic resonance imaging
(MRI) with different b factors and to compare ADC values of hepatic lesions.
Patients and methods: The study included 63 patients with focal hepatic lesions, 52
men (82.5%), age 62.1±9.8 years. Fourteen patients (22.2%) had hepatocellular
carcinoma (HCC) confirmed on surgery, 16 patients (25.4%) were with hepatic
metastatic colorectal tumours confirmed on previous surgery, 17 patients (26.9%)
with cavernous haemangioma and 16 patients (25.4%) with hepatic cysts based on
clinical manifestation, ultrasound/computed tomography/MRI and follow-up results.
MRI was performed with 1.5T scanner, with a body coil using EPI sequence with
tree b values: 0, 400, 800 s/mm2. ADC values were measured in all the lesions, as
well as a ratio between the ADC value of the liver and the lesion.
Results: ADC values were statistically different among the groups (F=70.7, p<0.01),
with the following values: HCC patients 1.11±0.29 s/mm2, metastatic tumours
2.18±0.15 s/mm2, haemangioma 2.22±0.32 s/mm2, cysts 3.08±0.03 s/mm2. Further
comparison revealed statistically significant difference among HCC, haemangioma
and cysts (p<0.05), while there was no significant difference among haemangioma
and secondary tumors (p>0.05). Furthermore, there was a difference between benign
conditions (haemangioma and cysts, 2.36±0.43 s/mm2), and malignant diseases
(HCC and secondary tumors, 1.52±0.58 s/mm2), t=5,6, p<0.01.
Conclusion: ADC values based on three b values offer more homogenous images
and can differentiate focal liver lesions.
Key words: ADC map, liver, focal lesion
Page | 162
ENDOVASCULAR
STENOSIS
TREATMENT
OF
CAROTID
ARTERY
Author(s): MARIJANA STOŠIĆ
Supervisor(s): Doc. dr Dragan Stojanov
Country: Serbia
Introduction
Stroke is the most leading cause of the mortality and morbidity of the
seniors in the world. The revascularization ’gold standard’ treatment is still the
surgical endarterectomy. Nevertheless, with improving the quality of the
catheterization materials, we have today the less invasive alternative methodstenting of the carotids.
Aim
Evaluaton the efficacy of carotid artery stenting (CAS) at patients with
hemodinamic significant carotid artery stenosis.
Over the period from february 2006. to february 2009. at the Institute for
radiology, Clinical centre of Niš, carotid artery stenting has been performed in 49
patients with high percentage carotid artery stenosis (31 male and 18 female) main
age 65 years. 41 patient (83,5%) was with characteristic neurological
simptomatology (st post CVI), 8 patients (16,5%) were after miocardial infarction
without neurological attacks. Main value of stenosis before procedure was 78%
(range:60%-99%). The value of stenosis rate before and after procedure was
evalueted using color Dopler ehosonography.
Resuluts
After carotid artery stenting, revasculariztion of the carotid artery was
achieved at all patients (technical success rate 100%). Average residual stenosis rate
after procedure was 9,5% (range:0%-30%), which is statisticaly significant
difference (p<0,0001). No stent restenosis was defined due to 24 h-36 monts follow
up. It was registered one lethal outcome 48 h after the procedure (2%).
Conclusion
CAS is percutaneous radiology interventional procedure for
revascularization of hemodinamic significant carotid artery stenosis. As a minimaly
invasive technique, it could be considerd as a therapy of choise in treatment of these
patients.
Key words: stenosis, carotid artery, stenting
Page | 163
FREQUENCY AND CHARACTERISTICS OF FOCAL ADRENAL GLANDS
LESIONS INCIDENTALLY DETECTED BY ABDOMINAL COMPUTED
TOMOGRAPHY (INCIDENTALOMAS OF ADRENAL GLANDS)
Field of medicine: radiology
Author(s):MILENA RADOSAVLJEVIC
Supervisor(s):Ass. dr Aleksandra Djuric-Stefanovic
Country: Serbia
Purpose: the aim of this study was to determine the frequency and characteristics of
the focal lesions of the adrenal glands, incidentally detected by abdominal CT.
Materials and methods: We were retrospectively analyzed the 200 abdominal CT
examinations of patients without any clinical or biochemical evidence of adrenal
endocrinopathy (84 women and 116 men, aged 25-81 years, average 57). 169
patients were scanned by the single slice spiral CT, and 31 patient by 64-MDCT,
after intravenous giving the iodinated contrast. In the group of patients in whom
adrenal incidentaloma was detected, the number, location, size and density of lesions
were analyzed.
Results: Incidentaloma was detected in 32 of 200 examined patients (16%). There
was a statistically significant difference in the percentage of detected incidentalomas
related to sex, with higher frequency in women (p <0.01), but in relation to age
difference was not found. Lesions were bilateral in 5 cases, while in the remaining
17, unilateral. Diameter of lesions moves from 7-38 mm (average 18 mm). Most
lesions (25/32) were hypodense, and the remaining 7 cases were heterodense in
relation to the density of preserved adrenal glands parenchyma.
Conclusion: Incidentaloma of the adrenal glands is detected by abdominal CT in a
significant percentage of patients: in the presented series, in every 6th examined
patient. Most of these lesions have CT characteristics of adenomas.
Keywords: Adrenal glands, CT, incidentaloma of adrenal glands
Page | 164
CT PRESENTATION OF NORMAL PANCREAS: COMPARATION
BETWEEN SPIRAL AND MDCT
Field of medicine: radiology
Author(s):MILOS MILINKOVIC
Supervisor(s):Doc. Dr Dragan Masulovic
Country: Serbia
Aim
The aim of this study was to specify the elements of normal CT anatomy
of the pancreas and to analyze the different possibilities of its visualization by spiral
CT and MDCT.
100 CT abdominal scans were retrospectively analyzed, not indicating
sings of pancreatic illness (spiral CT: 69 subjects; 64-MDCT: 31 subjects). Within
the patients group, there were 37 females and 63 males.
Results
Average cephalo-caudal dimension of the entire pancreas, tail and body,
and head were: 68mm, 37mm, and 44mm, respectively. Antero-posterior diameters
of the pancreas were: tail 20mm (10-34mm), body 21mm (8-34mm), neck 12mm (513mm), and head 29mm (11-44mm). No correlation has been found between the
size of the pancreas and the gender, age, constitution and weight of subject.
Lipomatous structure of the pancreas has been found in 26% of subjects, more in
overweight subjects (p<0.01) and in older subjects (p=0,051). Main pancreatic duct
was visualized in the body and in the head of the pancreas in folloving degrees
(MDCT : spiral CT): body 18/31 : 17/69 (p<0,01); head 10/31 : 6/69 (p<0,01).
Visualization of the peripancraetic adipose tissue between the pancreas and the
surrounding anatomical structures achieved to folloving degrees: body/stomach
96%; body/lienal vein 84%; head/D2 duodenum 77%; head/VMS 86%; head/AMS
99%; head/VCI 97%.
Conclusion
Singnificant individual variations hawe been found in the size of a normal
pancreas regardless of the gender, age, constitution or weight. Pancreatic duct is
usually visualized by MDCT, but less often by spiral CT.
Key words: Pancreas, normal anatomy, CT, MDCT.
Page | 165
PLENARY Session XV
( Infectious diseases )
Page | 166
CLINICAL AND LABORATORY CHARACTERISTICS OF
CHRONIC HEPATITIS C AND B IN HAEMODYALISIS PATIENTS
Field of medicine:infectology
Author(s):VUJIĆ STEVAN, Popović Julijana, Tošić Marija, Rančić Ivan
Mentor(s):Prof. dr Velimir T Kostic
Country: Serbia
Introduction
The presence of infection caused by hepatitis B or C viruses complicates
the evolution of chronic renal failure considerably. Untreated patients with chronic
hepatitis may develop liver cirrhosis and hepatocellular carcinoma.
Aim
The aim of this investigation was to determine the presence of some
hepatothropic viral markets, clinical and laboratory characteristics of infection, as
well as therapeutic possibilities for examined patients.GT, LDH and billirubin
levels, as well as clinical course of the disease.
This investigation included 136 patients who are having regular dialysis
treatment. Based on the presence of viral markers all the patients were divided in
three groups: 1. HBV positive patients; 2. HCV positive patients; 3. HBV and HCV
positive patients. Male patients were predominant. All patients were monitored for
their aminotransferase,
Results
Based on clinical findings, all the patients were subdivided into two
groups: those with an acute form and those with a chronic form. Patients with an
acute form were with developed symptoms, followed by appropriate laboratory
analysis. Patients with a chronic form were asymptomatic or showed few symptoms
of the disease, which were followed by normal or slightly elevated aminotransferase
levels.
Conclusion
In significant number of infected patients clinical course and laboratory
analysis did not correlate with the evolution of disease, which frequently leads to
delayed treatment and progression of the disease. Early introduction of modern
antiviral therapy gives a much better perspective to this type of patients.
Key words
Hepatitis B virus, Hepatitis C virus, Chronic renal failure, Chronic
dialysis.
Page | 167
PHARMACOECONOMICS IN TREATING URINARY TRACT
INFECTIONS
Field of medicine:infectious diseases
Author(s): ANDREJA VLAJANKOV, Malaka Hulali, Tijana Vujanic
Supervisor(s): Doc. dr Sandra Stefan-Mikic
Country: Serbia
Background: There are no strict guidelines for treating bacterial infections in our
country. Antibacterial drugs are a personal choice of the physician, which is not
always in accordance with the recommended therapy in the countries with a
developed pharmacoeconomic practice, which is why this study reviews the
difference in implementation of everyday urinary tract infection therapy and the
therapy conducted according to pharmacoeconomic guidelines.
Aim: The aim of this study is to assess the therapeutic efficiency of the antibacterial
drugs used in treating urinary tract infections and to assess the pharmacoeconomic
justification of their use. Efficiency and cost price of the physicians’ therapy of
choice and the therapy according to the pharmacoeconomic guidelines in developed
countries were compared.
Material and methods: A study was conducted at the Infectious Disease Clinic of
the Vojvodina Clinical Center which included 100 patients diagnosed for urinary
tract infections divided into two groups of 50 patients. Control group patients were
treated with the physicians’ antibacterial therapy of choice and the efficiency and
cost price of the therapy was determined. Study group patients were treated
according to the developed countries pharmacologic guidelines and the efficiency
and cost price of the therapy was determined.
Results: Based on the compared efficiency and cost price of urinary tract infection
therapy before and after the introduction of the pharmacoeconomic guidelines, it
was determined that there were no significant differences in the efficiency of the
used therapies, while there were significant savings in cost price (35.67%) after the
guidelines were introduced.
Conclusion: Efficiency of the physicians’ antibacterial therapy of choice for urinary
tract infections and the therapy according to the developed countries pharmacologic
guidelines are equal. In terms of costs, the cost price of the therapy according to the
guidelines used in countries with a developed pharmacological practice was more
favorable.
Keywords: urinary tract infections, therapy, pharmacoeconomics
Page | 168
CLINICAL AND EPIDEMIOLOGICAL CHARACTERISTICS OF
HEPATITIS C AND/OR B COINFECTION IN HIV POSITIVE
PATIENTS IN SERBIA
Field of medicine: infectious diseases
Author(s):URBANCL MAJA,Velimirovic Mrako,Tomic Zoran
Supervisor(s):Ranin Jovan,Assis.Dr.Sci
Country: Serbia
Introduction
In the last few years HCV( hepatitis C virus) and HBV (hepatitis B virus)
co-infections among HIV (human immunodeficiency virus)patients have become
one of the leading public health issues.
Aim
The aim of this study was to determinate incidence of those co-infections
among HIV patients in Serbia and to investigate their influence on immune
reconstitution during HIV infection caused by HAART, as well as, the effect of
HAART( Highly Active AntiRetroviral Therapy)on liver disease progression.
Data used in this research was collected from patients’ medical files in
period of 1986-2008. To assess immune response to HAART, CD4+ cell count was
used and for evaluation of liver disease progression, we used activity of liver
enzymes AST and ALT, before and after application of HAART. Standard statistical
procedures were used.
Results
Out of 877 HIV patients screened for hepatitis viruses, 31.0% were found
to be HCV/HIV co-infected, 9.0% HBV/HIV and 5.7% were found to be triply,
HCV/HBV/HIV, infected. Immune reconstitution (according to CD4 cell count) was
achieved successfully in all patient groups (p < 0,0001). Liver enzyme levels in
HCV/HIV group during HAART, compared to values before therapy, were
significantly increased (p < 0,0001) while in others groups no significant diference
was found.
Conclusion
HCV and/or HBV co-infection did not influence HAART-induced
immune reconstitution ability during HIV infection. Conversely, HAART
contributed to liver damage in patients with HCV/HIV co-infection by either
immune reconstitution or hepatotoxicity.
Page | 169
THE PROGNOSTIC SIGNIFICANCE OF COMPLETE BLOOD
COUNT (CBC) FOR THE MANAGEMENT OF CHRONIC HIVINFECTION
Field of medicine: infectious diseases
Author(s):TOSIC MAJA, Petrovic Branka
Supervisor(s):prof. Djordje Jevtovic, MD/PhD
Country:Serbia
Introduction: Suppression of hematopoesis is related to HIV infection. The most
common cytopenias are anemia, leukopenia (granulocytopenia, lymphopenia and
low number of CD4+ lymphocytes) and thrombocytopenia. Highly active therapy
(HAART) is recommended as earlier and as stronger as possible.
Aim: Identification of correlation between hematological parametars at patients
before and after certain period of HAART treatment and correlation to HIV disease
staging.
Material and methods: Research is provided as retrospective study on sample of
103 patients. Hematological parameters were observed. Immunological and
virological responses to HAART was rated.
Results: The series of 103 HIV-infected patients on HAART consisted of 30.1% of
females and 69.9% of males (mean age of 42.4±10.4years). Clinical AIDS was
present in 45.6% of patients before HAART initiation. Anemia and the CD4 cell
<100/ μL were significantly associated with clinical AIDS (OR 4.0,95% CI 1.79.2,P=0.001,and OR 3.4,95 % CI 1.4-7.9,P=0.004,respectively). Significant
correlation between anemia and CD4 cell count below 200/μL was seen (P=0.039,
Pearson correlation test and OR 2.8,95% CI 1.0-8.0,P=0.043, logistic regression).
Rise in absolute total leukocyte count to ≥7000/ μL and lymphocyte count (TLC) to
≥2500/ during HAART was significantly associated with the achievement of CD4
cell count over 400/μL (OR 2.6,95% CI 1.1-6.2,P=0.022, and OR 3.7,95% CI 1.58.9,P=0.003,respectively).
Conclusion: Together, TLC and haemoglobin concentration provide useful
information for clinicians, even in the absence of CD4 cell count, what would be the
high time to initiate HAART. Rise in lymphocyte count to certain level is a reliable
marker for treatment efficacy.
Page | 170
LYME-BORRELIOSIS,DIFFERENTIAL DIAGNOSTIC
DIFFICULTIES IN INTERPRETATION OF SEROLOGICAL
RESULTS
Field of medicine:infectious deseases
Author(s):MARINA TESIC
Supervisor(s):prof.dr Zoran Todorovic
Country: Serbia
Introduction
Lyme borreliosis is a multisystemic disease caused by spirochete Borrelia
Burgdoferi..Specific response is influed by phenotropic characteristics of
borelia,different antigenic structure,their different geographic distribution and
patient capability to react to infection.Immune response to Borrelia develops
relatively late while in some patients never developes.Immune response in early
phase of Lyme borreliosis is very similar to immune response of helthy population.
- interpretation serological results in diagnoses lyme-borreliosis
30 patient were examined in this research.They all were treated in the
Infectiosus clinic of Clinical center in Kragujevac from 01 01 to 31.12 2008
Results
The majority of patients in late phase of lyme borreliosis have IgG
antibody response,wich could be followed by IgM also throught this period of
time.Specifical borrelia antigens can be detected with western blot test.Our results
show us that:
- 48,48% - have IgM antibody response
- 33,33% -have IgG antibody response
-18,19%-no specific antibody response
Conclusion
There is no positive serologic test,wich solely could be the indicator of
desease activity.Even if it demonstrates high antibody titer If there is no clinical
signs of Lyme borreliosis diagnosis should be primary based on clinical findings..
Page | 171
URINARY INFECTIONS IN INTENSIVE CARE UNIT OF THE
CLINIC FOR INFECTIOUS DISEASES NOVI SAD
Author(s):JELENA RADOSAVLJEVIC
Supervisor(s):Radoslava Doder
Country: Serbia
Introduction
Urinary infection (UI) are the third most frequent type of hospital infection
in intensive care units (ICU). The main risk factor for their development is the
presence of a urinary catheter. 12% of patients may develope urosepsis.
Aim
The aim of this research is to detect the most common causes of UI in the
ICU of the Clinic for infectious diseases of Novi Sad (CIDNS) and to determine the
most effective antibiotics for their prevention and treatment.
A retrospective case history analysis of patients hospitalized in the ICU of
the CIDNS since February 2007 to July 2008 were made. The analysis included 42
patients, divided into two groups on the basis of catheter presence. Biochemical and
microscopical characteristics of urine, as well as urine culture, were analysed.
Results
The first group (patiens with catheter) included 78.6% of the cases. The
second group (patients without catheter) included 21.4% of the cases. Biochemical
and microscopical analysis of urine proved an UI in the majority of patients with
urinary catheter. In the second group, pathological characteristics of urine were
much less represented. In 3% of the patients from the first group and 11.1% from the
second group Candida spp were found. Urine controle prior to patient release
showed a regression or a complete recovery from UI.
Conclusion
Appropriate broad-spectrum antibiotic therapy for treatment of the basic
disease leads to suppression of the UI or possible urosepsis development.
Key words
urinary infection, urinary catheter, risk factors, intensive care unit
Page | 172
CLINICAL FORMS AND DIAGNOSIS OF VIRAL HEPATITIS
Field of medicine:infectous diseases
Author(s):TAMARA NIKOLIC
Supervisor(s):prof.dr Zoran Todorovic
Country: Serbia
Introduction
Viral infection of liver is very complicated disease for diagnosing. It
caused by hepatotropic viruses: A,B,C,D,E.Acute viral hepatic infection have been
classified into the two forms: tipical (with icterus) and atypical (without icterus).
Aim
Researching for:
-the most predominatly viruses of viral hepatitis;
-rapport between numbers of acute and chronic disease of liver;
-the most predominatly clinical form and
-basic diagnostic methods.
Material And Methods
All patients (83) were examined in this research , and were treated since
01.01.2006.-31.12.2008. on the Infectious clinic of Clinical center in Kragujevac.We
used their hystories of disease.
Results
We diagnosed of all patients with viral hepatitis
-38 patients had acute viral infection of which are 21 patient with virus A
infection,15 patients with virus A and virus B infection ,and 2 patients with virus C
infection;
-35 patients had chronic hepatitis C;
-10 patients had chronic hepatitis B.
Based on clinical types of disease,32 patients had anicteric form and 51 patients had
icteric fom of acute hepatitis.
Conclusion
In our study patients with acute clinical form were dominated. For the
beganing of the acute B and C viral infection we don`t find epidemiologic reasons of
disease.Chronic viral hepatitis was diagnosed in the group of very high risk.
Key word:
HAV;HBV;HCV;hepatitis,icterus,acute,chronic form
Page | 173
INCIDENCE OF NEUROLOGICAL SEQUENCES AFTER HEALED
BACTERIAL MENINGITIS ACCORDING TO THE THERAPY
GIVEN
Field of medicine: infective deseases
Author(s):DANIJELA PUSARA
Supervisor(s):doc. dr. Radoslava Doder
Country: Serbia
Introduction
It is believed that an early therapeutic modulation of the imune response
can have favourable effect on the course of severe forms of bacterial meningitis
(BM) and prevention of neurological damages.
Aim
The aim of this study was to determine the most often clinical
manifestation and frequence of neurological sequences after healed BM among two
groups of patients.
The research included 25 patients who were treated from 2006 to 2008 at
the Clinic for Infectious diseases in Novi Sad.Patients were divided into two groups
according to the therapy given.
Results
Severe disorders of general state were present in 22.22% of patients from
the first group and in 75% of patients from the second group.Headache and
vomitting were emphasized in 57.14% cases in the first group and in 68.75% cases
in the second group.All 5 (5%) patients who were in coma on the first day of the
hospitalisation were from the second group.In the control reviews in the first group
were found:50% patients had headaches,damages of periferial nerves and sight had 3
patients and damaged concentration and demention had one patient.In the second
group:42.85% patients had headaches,damaged concentration and demention had 3
patients and damage of hearing had one patient.
Conclusion
Patients from second group have more severe clinical symptoms than the
patients from the first group.Not only that neurological sequences occurs in a lower
percentage,but also better subjective marks of the life quality appears among
patients of the second group.
Key words: bacterial meningitis+therapy, neurological sequences, life quality
Page | 174
CLINIC AND MICROBIOLOGYCAL CHARACTERISTICS OF
PATIENTS WITH SEPSIS
Author(s):ALEKSANDRA JEREMIC, Vida Jeremic
Supervisor(s):ass.dr Stevanovic Goran
Country:Serbia
Introduction
Sepsis is a multisystemic inflammatory response syndrome to
microorganisms. The most frequent causes are Gram - positive and Gram – negative
bacteria. Origins might be infections of any organ.
Aim
Representing the age and gender characteristics of patients, clinical
symptoms; to define the existence of a statistically significant difference of
diagnostic parameters, therapy results, the most frequent causes and sensitivity of
causative microorganisms to tested antibiotics.
Matherial And Methods
This study represents the patients treated at Clinical Pharmacotherapy
Department of the Institute of Infectious and Tropical diseases , Clinical Centre of
Serbia, during the period from November 2004 to December 2005.
Results
The sample includes 66 patients. All of them had high temperature., but
also exhanstion (41%), headache (38%) , myalgia and arthralgia (38%), shivering
and fewer (36%). Chronic diseases as risk factors were present in 35%. All patients
had accelerated sedimentation rate on admission, fibrinogen was increased in 91% ,
85% had increased C-reactive protein. Leukocytosis was present in 45%, leucopenia
in 4.5%. Hemoculture was positive in 27.3% of the patients, major of isolates
consisted of E.coli (22%), Staphilococcus aureus (19.5%) and Enterococcus spp.
(44.6%). The most frequently used initial therapy was the combination of
cephalosporines and aminoglycosides (68.4%).
Conclusions
Age and gender structure of the patients was directly determined by the
population that the Institute treats. The most secure indicator was high temperature.
The indicators of inflammation and leukocyte count were shown as excellent
evaluation parameters of patients’ recovery.
Page | 175
HEMATOLOGICAL MANIFESTATIONS OF HIV-INFECTION IN
CHILDREN
Field of medicine:infections disease
Author(s):VISHNEVSKAYA M. Hermanenko I.
Supervisor(s):Hermanenko I.
Country: Belarus
Background
155 cases of HIV-infection among children from 0 to 14 years were
registered in the Republic of Belarus in 2009.
Aim
We aimed to examine the hematological markers on early stage of HIVinfection in children.
This cross-sectional study involved 41 children with HIV (proved by
imunobloting) (m/f =18/23), mean age 2.87±0.23 years. The physical developments,
viral load, level CD4, CD8 were measured. Hematological data valued by hem
analysis F-800. All the analysis was performed with Excel 2000 p-value < 0.05 was
accept as statistically significant.
Results
The mean Red Blood Cells (RBC) level was 3.92±0.071*1012/l,
haemoglobin contents (111.18±2.37 g/l). Anemia was diagnosed in 41% subjects.
Most of them had microcytic hypochromic anemia (62.5%). By analyzing
hematological indices (MCV, MCH, MCHC) a number of regularities was revealed:
MCV= 77.83±2.03fl (normal rate = 80-99 fl), thus 22.5% of participants had low
MCV counts before developing anemia. Thrombocytopenia was noted about 25.64%
of patients. The correlation analysis were revealed significant (p=0.01) middle
relationship (r=0.57) between thrombocyte and CD4 levels. Biochemical blood
analysis has shows significant (p=0.05) rising of total proteins in 40% of 41 patients,
thymol turbidity test (8.98±0.57), hypergammaglobulinemia (25.8±0.75%). The
other factors were within normal rate.
Conclusions
Our results suggested to exceptions HIV-infection in children with therapy
resistance anemia and thrombocytopenia. Full analysis of the haemogram
(calculation of hematological indices) allows suspecting anemia before its main
clinical manifestations.
Page | 176
Page | 177
Page | 178
Organization Committee of 4th IMSCNS
President of OC
Dunja Glišić
Science and research
Miroslav Petković
Nikola Rokvić
Dajana Lendak
Ivan Čapo
Vladimir Galić
Finance
Siniša Perić
Marketing and international
contacts
Aleksandar Kobilarov
Milan Gluhović
Maja Djurdjević
Hosting
Jasmina Jelić
Jelena Ilić
Dragana Đuričić
Ljiljana Nedić
Technical support
Željko Nađ
IMSCNS is official EMSA European Event organized by
EMSA Novi Sad
Page | 179
FRIENDS & PARTNERS
ISCOMS – International Students Congress
of Medical Sciences
The ISCOMS is an organizing committee consisting of twenty five
medical students from the University Medical Center in Groningen, the
Netherlands. These students organize an annual congress on medical
sciences where 200 presentations will be held in plenary, parallel and poster
sessions. During these four days more than 500 international medical
students meet each other during sessions and social programme activities.
Therefore it is one of the biggest and most important international platforms
for medical students involved and interested in medical sciences
The ISCOMS aims to become the leading forum in worldwide
research exchange between students within all fields of medical sciences. In
the coming years they envision establishing an international network aimed at
collaboration of students with international research institutes, the ISCOMS
serving as the central meeting point. The congress is to be expanded with
pre-congress educational programmes, post-congress master classes and
exchange of research fellowships. The creation of network of top research
institutes and universities will provide the perfect environment for talented
students to flourish.
A worldwide network of institutes and students is advantageous for
both parties. The yearly condensation of knowledge and expertise around
the IS-COMS is a great starting point for creating such a network.
Page | 180
ESC-Berlin – European Students’ Conference
The European Students’ Conference is one of the Worlds’ largest
biomedial student conferences and is held annually in October at the Charité
Univer-sitätsmedizin Berlin, Germany. The ESC was founded in 1989 by
students to students to establish an exchange knowledge between the east
and west of what used to be a divided Europe. Today, the Esc reaches out to
all corners of the continent and beyond.
The ESC serves as a forum for scientific exchange, as well as for
the interaction of:
•
Medical students from different faculties
•
Young scientist in related disciplines
•
Experienced scientist and newcomers
•
Science and the public
•
University and industry
•
Medical students and young scientist, who wish to explore the possibilities of working and researching in Germany
This not only enhances the international, interdisciplinary, scientific exchange, but also strengthens the cooperation and cohesion of a united Europe.
Each year the ESC welcomes over 350 active scientists who
present their work and another 350 passive participants from over 40
countries. Above all competition and cooperation, our aim is to further an
interdisciplinary approach to modern science and to put the results of all our
work into a broader, cultural, social and ethnical context.
Page | 181
EMSA – European Medical Students’ Association
EMSA was founded by medical students, with an idea that it
would benefi t medical students in some way. Over the years, many ideas
were expressed and many of them realized on how to make medical
students, members of EMSA, to benefi t as much as possible from EMSA.
So far, EMSA served and still serves as:
• European network of medical students for communication & exchange
of experiences
• Dissemination point for social, cultural, academic, economic and
ethical aspects of medicine
• Representing body on behalf of European medical students towards
different professional and international institutions
• Source of ideas & projects to be performed at YOUR faculty (Teddy
Bear Hospital, Twinning Project, Working Abroad Database Project)
• Mean of learning medicine-specifi c terminology of a certain country
through EuroTalk
• Publisher and founder of JEMSA – Journal of EMSA on Medical and
Sci-entific Affairs
• Organizer of many congresses throughout Europe
• The organization to be in if you want to participate in cool events such
as EMSA Sailing Week or EMSA Skiing Week
• The best organization to organize a workshop from the fi eld of
medical ethics or medical education at your event!
• The organization that brings you, medical students, even closer to Europe!
Page | 182
ZIMS – Zagreb International Medical Summit
Zagreb International Medical Summit for Medical Students and
Young Doctors is first student summit organised by medical students in
Zagreb, Croatia. ZIMS is intended for medical students and young docotors.
Aim of this summit is to gather medical and adjacent studentsfrom all over
the World. Young doctors are welcome, too. Definition of "young doctor" is
here taken from EMSA Europe congress guidelines as "a person which
graduated in the past year".
ZIMS is one of a few medical summits in Europe that ofers it's
participants to publish their full texts in an cited medical journal (Liječnički
vjesnik).
Page | 183
Authors index
A
Andjelkovic M.
Andrashko V.
Andrejevic A.
Andrijasevic V.
Arandjelovic S.
Asvadi A.
G
107
157
73
75
150
52
B
Bakunina N.
Belousova A.
Bojović O.
Bondzic K.
Broniek W.
Butolo A.. C.
82
80
14, 15
72
43
117
C
Caba B.
Cankovic M.
Chiorean R.M.
Chiorean R.M.
Ciocanea C.
Cismaru A.
Coric V.
130
114
37
66
65
18
67
D
Dančetović M.
Djurdjevic J.
Doe M.J.
DJurović Dj.
49
122
71
63
F
Farcas M.
Farraj M.
Foris V.
Foroozia M.
68
44
32
56, 57
Gligić A.
Gluhovic M.
Greavu M.
Gusic N.
L
33
132
19
162
H
Hemmati R.
Hossein A.
Hrvacanin B.
Hulali M.
146
115
144
120
I
Isakovic A.
Ivanisevic I.
Ivanov A. A.
34
129
134
J
Jakovljev M.
Jambor I.
Jankovic J.
Jankovic M.
Janjic T.
Janjos M.
Jegdic S.
Jelenkovic O.
Jeremic A.
Jocic N.
Joksimovic B.
Jovanovic N.
Jovanović I.
38
161
95
142
111
135
136
104
175
92
48
85
62
K
Kascheev A.
Khatib Al .S.N
Kiselicki D.
Kisiel M.
Kobylinska M.
Kovacevic M.
Krtinic D.
133
87
23
58, 61
96
102
143
Law C.
Lazarevic M.
Lebedev A.
46
137
81
M
Martinova K.
39
Matic M.
103
Meandžija M.
83
Mihailović A.
155
Milinkovic M.
165
Milojević M.
123
Milosavljevic D. 98
Milosavljevic V. 50
Milošević G.
29
Mirsadeghi S.A. 145
Mitrovic A.B.
70
Mitrović A.
156
Mladenović R.
118
Mukhi N.
127
Murzagaliyeva G.Z.21
N
Nadarevic A.
Nicolae A.
Nikitenko N.
Nikolic N.
Nikolic S.
26
149
59
173
113
P
Pavkovic A.
Pejic B.
Petković S.
Petrovic M.
Petrović M.
Pjevac S.
Polgar L.
Popin S.
Popovic J.
Popovic M.
Pusara D.
159
47
60
105
31
27
147
141
22
99
174
Page | 184
R
Radakovic D.
Radeka T.
Radosavljevic J.
Radosavljevic M.
Ragaji R.
Rajsic S
Rakić T.
Rancic I.
Raznatovic A.
Ristic N.
Ristic S.
Rovcanin B.
U
41
88
172
164
112
16
28
151
100
12
42
35
S
Setareh K. D.
Sfetcu R.
Skripnik V.V
Sladjana S.
Smiljkovic T.
Sovrlic M.
Sretenovic A.
Stasko P.
Ster S.S.
Stjepic T.
Stojadinović M.
Stojkovic M.
Stosic T.
Stošić M.
Strunjas M.
Sütő R.
Šljivančanin T.
158
128
45
125
126
79
94
110
116
25
84
121
101
163
90
76
74
Ulgut C.
Urbancl M.
148
169
V
Varga J.
Velickovic D.
Velimirovic M.
Vezilic M.
Vishnevskaya M.
Vlajankov A.
Vlajankov M.
Vlajnic T.
Vučetić P.
Vučinić N.
Vujić S.
Vukovic B.
138
51
109
93
176
168
154
24
54
17
167
91
Y
Yuriy R.
55
Z
Zakaria M.H.M.
Zekovic A.
Zekovic A.
Zivkovic I.
Zivkovic I.
Zivkovic N.
86
36
69
78
106
153
T
Tamasy F.M.
Tesic M.
Teslariu O.
Tosic M.
Tosic M.
Trandafilovic M
Trifan A.C.
Trochim W. M.K.
160
171
140
124
170
13
10
11
Page | 185
About Novi Sad
Novi Sad is capital of Vojvodina, the northern region of Serbia.
Situated on the Danube river, between Budapest and Belgrade, it is
treasured regional and cultural centre.
The city was founded at the end of the 17th century as a vital
bridgehead of the Petrovaradin fortress,one of the most beutiful and biggest
fortresses in Central Europe, which was being built for about 100 years with
the purpose to defend Austria from Turks and known as "The Gibraltar on
the Danube".
Today, Novi Sad is a pleasant city with wide boulevards, modern
buildings and special famous Central Square surrounded by the Old Town
Hall, the Roman catholic church and a similar buildings dating mainly from
the early nineteenth century. The city as well as whole Vojvodina is wellknown multicultural, multinational and multireligious region.Among
cultural-historical monuments, the best known is the Petrovaradin fortress
with its underground corridors, promenades, museums, restaurants and art
studios.There are also many churches, monasteries and other cultural
monuments.
Novi Sad is known by the longest and the most beautiful sand
beach on the Danube, the large marina for river boats and organized water
sports, attractive picnic grounds at Fruska Gora and nearby terrein for
hunting and fishing. As a university town, Novi Sad is known for a lively
bar scene. There are lots of nice bars, cafes and clubs.
Exit Summer Fest, the largest music festival in the South-Eastern
Europe, takes plase on a beautiful fortress in NS. Exit attracts each year
more and more thousands of visitors enjoing performance of world's most
popular rock bands and Djs.
Learn more about Novi Sad, about Serbia and all its beauty:
www.novisad.rs
www.gradnovisad.org.yu
www.srbija.gov.rs
www.vojvodina.com
www.petrovaradinskatvrdjava.rs
www.serbia-tourism.org
www.exitfest.org
www.serbia-visit.com
Page | 186
Legend:
1) IMSCNS 09 (Faculty Of Medicine)
2) HOTEL “ CAR “
3) HOSTEL “ SAJMISTE “
4) BUS & RAILWAY STATION
5) CITY CENTER
6) STRAND BEACH
Page | 187
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Page | 188
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Page | 189
PATRONS
University Of Novi Sad
‘
Faculty of Medicine Novi Sad
Serbian Academy of Sciences and Arts
Republic Of Serbia
Ministry of Science and Environment Protection
Executive Council of Autonomous
Province Of Vojvodina
City Of Novi Sad
Page | 190

09 - imscns

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