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Search Results: 1 - 10 of 1776 matches for " Kosti? Aleksandar "
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FATE OF PATIENTS WITH LATE-DETECTED HEPATITIS C INFECTION - CASE REPORTS
Velimir Kosti,Aleksandar Petrovi?,Jelena Radovi?,Jovana Kosti
Acta Medica Medianae , 2011,
Abstract: Chronic hepatitis C virus infection represents an insidious disease that is often detected with signs of liver cirrhosis or hepatocellular carcinoma. It is practicaly impossible to achieve a significant therapeutic progress in these patients without performing a liver transplantation. However, due to underdeveloped program of organ donations, this kind of intervention, as the last helpful procedure, is often not realized.This study presents three patients (out of 121 treated patients) followed during a two-year period. The patients had been initially registered when the stage of their disease became severe: liver failure with signs of decompensation. Antiviral therapy (pegylated interferon and ribavirin) in these patients have no use, hence only a corrective therapy is administered. Pathohistological findings in two patients revealed hepatocellular carcinoma, and in one case lethal outcome was the result of severe hepatic decompensation, hepatopulmonary and hepatorenal syndromes, as well as developed cardiopulmonary failure. Lethal outcome occurred in the period of 2 to 14 months after the first visit to a doctor. One patient was on the list for liver transplantation; however, surgery was not performed and soon after a fatal outcome ensued.
SEVERE BRAIN INJURIES: CORRELATION BETWEEN SURVIVAL AND INTRACRANIAL HYPERTENSION
Aleksandar Kosti,Ivan Stefanovi?,Vesna Novak,Aleksandar Igi?
Acta Medica Medianae , 2011,
Abstract: There are several reasons of intracranial pressure (ICP) increase in the brain trauma. Brain edema, due to the brain-blood bariere injury, contusion of brain tissue and intracranial hematomas that represent mass lesion, cerebrovascular autoregulation failure which leads to hemodinamic disorder, and traumatic subarchnoid haemorrhagae that is commonly associated with CSF flow disturbances are the main causes. The aim of our study was to examine the survival of patients with severe brain trauma in the presence of different values of ICP. This prospective study included 32 patients with intracranial pressure monitored, and appropriate treatment undertaken. Twenty-two patients (68.75%) had elevated ICP, and in 10 patients (31,25%) there were no criteria of intracranial hypertnesion (ICHTN). The results of our study showed that absolute lethal value of ICHTN is 50mmHg and over – none of the injured survived such ICP if lasted more than two hours, because of inevitable brain and brainstem ischemia and failure of the vital functions. The relatively lethal values of ICP ranged from 40 to 50mmHg, in the case of which we menaged to prevent a fatal outcome in one out of five cases.
Risk of infection after placement of an extraventricular drainage catheter
Novak Vesna,Stefanovi? Ivan,KostiAleksandar,Novak Martin
Srpski Arhiv za Celokupno Lekarstvo , 2012, DOI: 10.2298/sarh1204138n
Abstract: Introduction. The occurrence of infection after the placement of an extraventricular drainage (EVD) catheter can be a very serious problem in neurosurgery. Objective. The aim of this study was to confirm that the use of special catheters with impregnated antibiotics decreased the percentage of infection. Methods. The prospective study conducted at the Clinic of Neurosurgery in Ni in the period 2006-2009 is presented. Group 1 comprised of 43 patients in whom a commonly used system for EVD was applied. Group 2 comprised of 39 patients in whom the Rifampycin and Clindamycin impregnated EVD catheters were applied (Bactiseal catheters). Results. In Group 1 infection occurred in nine patients, mainly caused by bacteria of Staphylococcus genus. In Group 2 only two patients developed infections caused by Acinetobacter. Conclusion. The use of Bactiseal EVD catheters considerably decreased the percentage of infection occurrence with prolonged EVD catheter drainage period.
An alternative approach for endocardial pacemaker lead implantation in patient with persistent left superior vena cava
Mitov Vladimir,Peri?i? Zoran,Kosti? Tomislav,Stojkovi? Aleksandar
Srpski Arhiv za Celokupno Lekarstvo , 2010, DOI: 10.2298/sarh1002085m
Abstract: Introduction. Persistent left superior vena cava represents a congenital vascular defect of the venous system, which often makes standard 58 cm endocardial lead placement impossible. Case Outline. A right chamber approach by the left cephalic vein was tried. This was impossible because standard endocardial lead (SJM Isoflex S 1646T, bipolar lead, 58 cm in length, body diameter 7 French) was too short for this patient. A unipolar lead for coronary sinus (Medtronic ATTEIN 4193-88), 88 cm in length, body diameter 4 French, was placed in the posterior branch of the coronary sinus. With such positioning of the lead, a VVI pacemaker pacing was enabled. The operation lasted for 48 minutes, and the time of total X-ray exposure was 9.6 minutes. The values that were achieved were: threshold 0.3 V, pulse width 0.37 ms, maximum R 22.55 mV. Ten months after the implantation, the values were: thresh- old 0.3 V, maximum R 28.8 mV. Conclusion. Persistent left superior vena cava in some cases makes standard 58 cm endocardial lead placement impossible due to its joining to the right atrium over the dilated coronary sinus. Coronary sinus lead placement in the posterior or lateral coronary sinus branch represents an acceptable alternative approach for pacemaker lead placement in these patients.
Complications after angiogram-negative subarachnoid haemorrhage: Comparative study of pretruncal and nonpretruncal hemorrhage patients
KostiAleksandar,Stojanov Dragan,Stefanovi? Ivan,Novak Vesna
Srpski Arhiv za Celokupno Lekarstvo , 2012, DOI: 10.2298/sarh1202008k
Abstract: Introduction. Subarachnoid haemorrhages (SAH) of unknown aetiology usually have a mild clinical presentation, favourable outcome and low complication rate. Objective. The aim of this study was to analyze the complications in two forms of angiogram-negative spontaneous SAH: pretruncal (PNSAH) and nonpretruncal (NPNSAH). Methods. The study group involved 18 patients with PNSAH and 16 patients with NPNSAH. CT scan was done within 72 hours from bleeding. All patients underwent four-vessel cerebral angiography. Repeat angiography was performed in five PNSAH and all NPNSAH patients. Results. Twenty-nine patients were in grade I or II of the Hunt-Hess Scale (17 PNSAH and 12 NPNSAH). There was one case of rebleeding (NPNSAH patient), 10 cases of transient acute hydrocephalus (4 PNSAH and 6 NPNSAH). Cerebral vasospasm visualized by angiographies in two NPNSAH patients was local and mild, but was not found in PNSAH patients. Acute electrocardiography changes were found in 19 patients (significantly more frequently in NPNSAH than in PNSAH, 12 and 7 patients, respectively; p=0.037). Conclusion. Cardiac problems following these types of SAH are more frequent than expected, and therefore cardiac monitoring is necessary.
INFLUENCE OF PERITUMORAL EDEMA ON THE OUTCOME OF RADIOTHERAPY OF SUPRATENTORIAL NONCYSTIC GLIOBLASTOMA MULTIFORME
Ivan Stefanovi?,Aleksandar Kosti,Mi?a Radisavljevi?,Sla?ana Filipovi?
Acta Medica Medianae , 2011,
Abstract: The lifetime of an OH radical is 10-5 sec., i.e. ten billion times longer than the lifetime of a free electron, and most authors stress its indirect mechanism of DNA destruction as a predominant one in the radiation treatment of glioblastoma multiforme (GBM). Although the concentration of OH radicals in brain edema is increased, the edema remodels the zone of tumor infiltration and prepares the ground for exterritorialization of tumor regions planned for irradiation, influencing the possibility of rapid recurrences.The aim of the paper was to establish the impact of peritumoral edema on the time to recurrence of glioblastoma multiforme, survival, type and incidence of postirradiation complications.Sixty patients with total resection of supratentorial noncystic GBM were treated after a month with 60 Gy of radiation therapy, out of which one half to the therapeutic volume (TV) and the other half to the clinical target volume (CTV), and upon completion all of them were given the BCNU protocol. According to the recommendations by RTOG (Radiation Therapy Oncology Group), surgically treated patients were divided into those with edema below 25 cm3; 25-75 cm3; and finally those over 75 cm3.Patients with peritumoral edema of over 75 cm3 had statistically significantly faster relapse, had poorer Karnofsky score, progression of peritumoral edema, and higher mortality if radiotherapy was delivered only to the CTV. Dispersion of radiation in the TV does not reduce the incidence of cutaneous postirradiation effects and cannot be justified for edemas smaller than 25 cm3.
TEMPORARY PACEMAKER LEAD PLACEMENT IN PATIENT WITH PERSISTENT LEFT SUPERIOR VENA CAVA
Vladimir Mitov,Zoran Peri?i?,Aleksandar Joli?,Tomislav Kosti
Acta Medica Medianae , 2011,
Abstract: Persistent left superior vena cava represents a congenital vascular defect of the venous system, and is usually discovered accidentally. Temporary pacemaker lead placement should be performed under the fluoroscopy control, but also by using the ECG QRS morphology. Echocardiography also represents a reliable noninvasive diagnostic tool for the assessment of temporary pacemaker lead position.
Occlusion of maxillary artery in treatment of trigeminal neuralgia
Novak Vesna,Bo?njakovi? Petar,Risti? Sa?a,KostiAleksandar
Medicinski Pregled , 2012, DOI: 10.2298/mpns1208281n
Abstract: Introduction. This paper deals with a treating method of trigeminal neuralgia classified so far as idiopathic neuralgias and treated conservatively. The study was aimed at proving the compression of peripheral branches of n. trigeminus in those patients by vascular elements of a. maxillaris within the bone-ligament space of the scull and the face base. Material and Methods. The study sample consisted of 76 patients having trigeminal neuralgia. The compression was proved by clinical examination, by angiography and electrophysiological investigations. Endovascular occlusion of a. maxillaris is the original method and it was carried out in selected patients. Results. This method was applied in 76 patients. Embolisation was done in 71 patients by using occlusion spiral and gelfoan was used in 3 patients. Externa carotid artery ligation was done in 2 cases. Conclusion. The effect of absolute improvement has been achieved and verified by electrophysiological method and subjective assessment of the patients.
Prognostic significance of intracranial pressure monitoring and intracranial hypertension in severe brain trauma patients
KostiAleksandar,Stefanovi? Ivan,Novak Vesna,Veselinovi? Dragan
Medicinski Pregled , 2011, DOI: 10.2298/mpns1110461k
Abstract: Since without prospective randomized studies it is not possible to have a clear attitude towards the importance of intracranial pressure monitoring, this study was aimed at examining the prognostic effect of the intracranial pressure monitoring and intracranial pressure oriented therapy in severe brain trauma patients, and at defining optimal intracranial pressure values for starting the treatment. Two groups of patients were treated in the study, one consisted of 32 patients undergoing intracranial pressure monitoring and the second group of 29 patients without intracranial pressure monitoring in the control group. The study was prospective with groups randomized. There were 53% survivals in the intracranial pressure monitored patients and 34% in the control group, with no significant difference in the survival rate between the two groups (χ2=2.11; p=0.15; p>0.05). The average intracranial pressure in the patients with intracranial hypertension who died was 27 mm Hg, while in the patients who survived the average intracranial pressure was significantly lower (Student’s t test: t=2.91; p=0.008; p<0.01) and it was 18 mm Hg. We recommend starting intracranial pressure oriented therapy when the patient’s intracranial pressure exceeds 18 mmHg during 2 hours of monitoring.
The facilitation effect of associative and semantic relatedness in word recognition
Jaki? Milena,Filipovi?-?ur?evi? Du?ica,KostiAleksandar
Psihologija , 2011, DOI: 10.2298/psi1104367j
Abstract: In this study we addressed three issues concerning semantic and associative relatedness between two words and how they prime each other. The first issue is whether there is a priming effect of semantic relatedness over and above the effect of associative relatedness. The second issue is how difference in semantic overlap between two words affects priming. In order to specify the semantic overlap we introduce five relation types that differ in number of common semantic components. Three relation types (synonyms, antonyms and hyponyms) represent semantic relatedness while two relation types represent associative relatedness, with negligible or no semantic relatedness. Finally, the third issue addressed in this study is whether there is a symmetric priming effect if we swap the position of prime and target, i.e. whether the direction of relatedness between two words affects priming. In two lexical decision experiments we presented five types of word pairs. In both experiments we obtained stronger facilitation for pairs that were both semantically and associatively related. Closer inspection showed that larger semantic overlap between words is paralleled by greater facilitation effect. The effects did not change when prime and target swap their position, indicating that the observed facilitation effects are symmetrical. This outcome complies with predictions of distributed models of memory.
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