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Search Results: 1 - 10 of 1884 matches for " Spasovski Milena "
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Historical stages in transition of natural replacement of the Serbian population
Spasovski Milena,?anti? Danica,Radovanovi? Olgica
Glasnik Srpskog Geografskog Dru?tva , 2012, DOI: 10.2298/gsgd1202023s
Abstract: This paper examines the problem of demographic transition of natural replacement of the Serbian population since the mid-nineteenth century to 2010. The special attention is given to analizing trends in birth rate, mortality and population growth through the historical periods in which started and in which the transformation of demographic trends was being done, from the model of extended natural replacement and population expansion to the depopulation model. The specific progress of transitional trends is shown in the natural replacement of population at the macro-regional levels in Serbia (Central Serbia, Vojvodina and Kosovo and Metohija), especially at the meso-regional and local level in the geospace of Serbia (municipalities, districts, regions).[Projekat Ministarstva nauke Republike Srbije, br. 176017]
A Review of Sevelamer Hydrochloride in End-Stage Renal Disease Patients on Dialysis
Goce Spasovski
Clinical Medicine Insights: Therapeutics , 2012, DOI: 10.4137/CMT.S5990
Abstract: It is known that in the presence of even subtle kidney dysfunction an intensive prevention of cardiovascular risk is required. Apart from the conventional factors which contribute to cardiovascular disease (CVD), there are also some specific conditions of the chronic kidney disease (CKD) population such as oxidative stress of uremia and dialysis (D). However, hyperphosphatemia, hypercalcemia, and elevated calcium-phosphorus product remain as major contributors to the development of vascular calcification (VC) in this population, as part of the systemic complication known as mineral and bone disorders (MBD) in CKD patients. Importantly, the retention of phosphate remains as main culprit in the pathogenesis of CKD—MBD. Over the years, various treatment options for phosphate removal and controlling mineral metabolism, bone health, VC and CVD have failed, mainly through an over-suppression of PTH, development of ABD and promotion of VC and mortality. Although KDOQI and KDIGO published CKD—MBD guidelines has clearly stated where calcium-based phosphate binders should not be used in D patients (hypercalcemia and low PTH) and where non calcium-containing phosphate binders are preferred (patients with severe vascular and/or other soft tissue calcifications), the greatest controversy and disagreements within the nephrological community still exists upon the cost-effectiveness of non calcium binder (sevelamer) use. Indeed, despite the evidence and recognised trend towards both a decrease in VC and CVD associated with sevelamer use, it is still an ongoing matter of debate. The magnitude of this controversy is increased when the issue of advanced medical and/or budgetary evaluation related to the implementation of clinical guidelines for CKD—MBD treatment is considered. Despite advocated use of sevelamer across a range of common clinical scenarios in CKD, its widespread utilization is challenged as exceeding what would usually be considered good value for money. If so, it is questionable whether the recommendations and suggestions from the guidelines should be followed, and further, do we need guidelines and innovative drugs for treatment of hyperphosphatemia? While awaiting the answer, as clinicians we should proceed with a treatment to “do no harm”, trying to at least limit the calcium exposure of our dialysis patients.
Journal of Special Education and Rehabilitation , 2010,
Abstract: According to the Salamanca Declaration, inclusive education is understood as a developmental approach aiming to meet the educational needs of all children, youth, and adults, emphasizing those who are subjected to marginalization and exclusion. The approach provides equal opportunities for all to reach their maximum potential and achievement.Through a qualitative approach, the practice of inclusive education is explored in Macedonia: the attainment of universal standards, an analysis of the perception and understanding of inclusive education in relation to teachers, in-school professional staff, teacher educators and student teachers, and teachers’ perceptions in regard to the possession of competencies needed for inclusive education. Lastly, the existing role and responsibilities of teachers and professional staff is discussed and reconsidered.It was found that there is no consensus in the understanding of inclusive education in the circles of academics and practitioners. Further, teachers often perceive themselves as inadequately prepared to teach children with special needs. Namely, many competencies important for efficient practice are not systematically developed. The conclusion considers ways to ensure support for teachers and students. The role and responsibilities of in-school professional staff should be redefined in a way that allows for their on-going presence, availability, and active participation in the classroom teaching process.
On Some Basic Concepts of Genetic Algorithms as a Meta-Heuristic Method for Solving of Optimization Problems  [PDF]
Milena Bogdanovi?
Journal of Software Engineering and Applications (JSEA) , 2011, DOI: 10.4236/jsea.2011.48055
Abstract: The genetic algorithms represent a family of algorithms using some of genetic principles being present in nature, in order to solve particular computational problems. These natural principles are: inheritance, crossover, mutation, survival of the fittest, migrations and so on. The paper describes the most important aspects of a genetic algorithm as a stochastic method for solving various classes of optimization problems. It also describes the basic genetic operator selection, crossover and mutation, serving for a new generation of individuals to achieve an optimal or a good enough solution of an optimization problem being in question.
The Importance of Health Records  [PDF]
Milena Marini?
Health (Health) , 2015, DOI: 10.4236/health.2015.75073
Abstract: Health records have played an increasingly important role throughout history as an important legal document for the exercise of individuals’ rights. However, domestic legislation fails to define health records as a legally important collection of health data and documents. Recording facts and storing legally important documents are therefore the tasks of the operator. Using the prescriptive method we will determine which laws are governing the management of medical records, their safety and accessibility. Based on the descriptive method, we will describe the process of handling health records by the provider of health treatment, focusing on exposed regulatory gaps in the area of the protection of the rights of an individual. Through the analysis of the laws governing the management of health records, even after death and operator terminating the service, we will carry out inductive reasoning and provide conclusions regarding the attitude towards health records. Considering different results we can conclude that health information, especially documents relevant to the protection of individual’s rights, is not transparent. Above all, the documents in the collection are not recorded properly, thus allowing for their removal. Even the transfer of health records by the provider of health treatment is not defined, which could result in the disposal of the entire health documentation.
Triple pelvic osteotomy: Complications and how to avoid them
Vuka?inovi? Zoran,Spasovski Du?ko
Srpski Arhiv za Celokupno Lekarstvo , 2006, DOI: 10.2298/sarh0602049v
Abstract: Authors reviewed their eight-year long experience with triple pelvic osteotomy. They explained the way of introduction of this procedure into everyday clinical practice. Seventy hips were operated using Tonnis-Vladimirov method in fifty nine patients of an average age of 15 years and one month. Treatment results were evaluated, both anatomically and functionally. Anatomic improvement was recorded by measuring the CE angle of Wiberg. Preoperatively, it ranged from -6 to 33 degrees (16.1±10.2 degrees), and at the end of treatment, it ranged from 15 to 68 degrees (43.1±11.1 degrees) - the difference proved to be highly significant (Student test t=-14.27, p<0.01). Functional improvement (absence of waddling gait or limp as well as better range of motion) was noted in almost all cases, although the difference was not statistically significant. In addition, the authors presented some very rare complications - asymptomatic pubic and/or ischial nonunion in seven patients.
Triple pelvic osteotomy in our practice: Eight years later
Vuka?inovi? Zoran,Spasovski ?.,?obelji? Goran
Acta Chirurgica Iugoslavica , 2005, DOI: 10.2298/aci0502055v
Abstract: Authors have reviewed their eight years long experience with triple pelvic osteotomy. They are explaining the way of introduction of this procedure in everyday clinical practice. Sixty six hips were operated using Tonnis-Vladimirov method in fifty five patients of the average age of 15 years and four months. Treatment results were evaluated, both anatomically and functionally. Anatomic improvement was detected by measuring CE angle of Wiberg. Preoperatively it ranged from -6 to 33 degrees (16,4+10,8 degrees), at the end of treatment it ranged from 15 to 68 degrees (43,6+11,8 degrees) - the difference has proven to be statistically highly significant (Student test t=-14,36, p<0,01). Functional improvement (absence of waddling gait or limp, as well as better range of motion) was detected in almost all the cases, although the difference wasn't statistically significant. Also, they are presenting some, very rare, complications - asymptomatic pubic and/or ischial nonunion in seven patients.
Triple pelvic osteotomy in the treatment of hip dysplasia
Vuka?inovi? Zoran,Spasovski Du?ko,?ivkovi? Zorica,Slavkovi? Nemanja
Srpski Arhiv za Celokupno Lekarstvo , 2009, DOI: 10.2298/sarh0906239v
Abstract: Introduction. Insufficient femoral head coverage is found in a variety of diseases, with acetabular dysplasia as the most frequent disorder and triple pelvic osteotomy as the most recently introduced surgical treatment. Objective. This study analyses pre- and postoperative pathoanatomic characteristics of triple in comparison to Salter and Chiari osteotomies, with a logistic regression analysis of outcome predictor and effect explanator factors in relation to the chosen type of operation. Methods. The study involved 136 adolescents treated with Salter and Chiari osteotomies or a triple pelvic osteotomy at the Institute of Orthopaedic Surgery 'Banjica' in Belgrade. The patients were between 10-20 years old at the time of operation. We collected and analyzed data from all the patients: illness history, operative parameters, preoperative and postoperative pathoanatomic data. The data was statistically processed using the statistical software SPSS, defining standard descriptive values, and by using the appropriate tests of analytic statistics: t-test for dependent and independent variables, χ2-test, Fisher's exact test, Wilcoxon's test, parameter correlation, one-way ANOVA, multi-factorial ANOVA and logistic regression, according to the type of the analyzed data and the conditions under which the statistical methods were applied. Results. The average CE angle after triple pelvic osteotomy was 43.5°, more improved than after the Salter osteotomy (33.0°) and Chiari osteotomy (31.4°) (F=16.822; p<0.01). Postoperative spherical congruence was also more frequent after the triple osteotomy than after the other two types of operations, and with a high significance. Preoperative painful discomfort was found to be a valid predictor of indications for the triple osteotomy over both Chiari and Salter osteotomies. The valid explanators of effect for the triple osteotomy are: postoperative joint congruence (compared to the Chiari osteotomy) and increase in joint coverage (compared to Salter osteotomy). Conclusion. Triple pelvic osteotomy is the method of choice in the management of acetabular dysplasia and other disturbances of hip joint containment in adolescent age.
Femoroacetabular impingement related to Legg-Calvé-Perthes disease
Vuka?inovi? Zoran,Spasovski Du?ko,?ivkovi? Zorica
Srpski Arhiv za Celokupno Lekarstvo , 2011, DOI: 10.2298/sarh1112834v
Abstract: Femoroacetabular impingement is an undesirable contact between acetabular rim and femoral neck and presents abnormality of proximal femoral part and acetabulum, as well. Two forms may appear: cam impingement and pincer impingement. Femoroacetabular impingement related to Legg-Calvé-Perthes disease may be caused by various reasons, as the consequence of the disease itself, and as the consequence of its treatment. Coxa magna deformity (large femoral head and neck) and coxa brevis deformity (shortened femoral neck) may produce cam femoroacetabular impingement during hip flexion. After the disease, the flattened femoral head (coxa plana) may persist. Chiari pelvic osteotomy is the only treatment option for such femoral head deformity. Acetabular labrum squeezed continuously between the femoral head and the non-articular part of the cut iliac bone lead to cam femoroacetabular impingement, as well. If Salter or triple pelvic osteotomy is used that may cause a very large iatrogenic acetabular retroversion, we can also refer to radial type pincer femoroacetabular impingement. Treatment of Legg-Calvé-Perthes disease should be conducted according to the natural course of the disease and prognosis. Treatment should start on time, well before a crushed femoral head develops, because it is the easiest way to establish hip spherical congruency at the end of treatment. This is the best option to prevent secondary hip arthrosis caused by femoroacetabular impingement or by insufficient head coverage at the end of remodelling. In each case of delayed hip pain, followed by a limited range of movements, femoroacetabular impingement should be taken into consideration, confirmed, and treated by some of the available therapeutic methods.
Diagnosis and treatment of chondroblastoma: Our experience
Slavkovi? Slobodan,Vuka?inovi? Zoran,Slavkovi? Nemanja,Spasovski Du?ko
Srpski Arhiv za Celokupno Lekarstvo , 2006, DOI: 10.2298/sarh0612526s
Abstract: The paper presented the results of diagnostics and treatment of patients with diagnosis of chondroblastoma, treated at the Institute of Orthopedic Surgery "Banjica", Belgrade. A total of 30 patients were analyzed, involving the period from 1975-2004. All important data were obtained using the complete medical documentation, physical examination, radiographic findings and available additional diagnostic procedures. The proximal part of tibia, the proximal part of humerus and the distal part of femur were the most common sites of tumor, accounting for 63% of cases. Higher incidence of chondroblastoma was found in male patients, especially in the second decade of life. Pathohistological tumor verification was done in all patients. The patients were then treated by different surgical procedures, both on account of primary lesion and recurrence. Curettage and osteoplasty using the auto- and homograft were carried out in 21 patients, wide resection in nine cases, and amputation was performed in three cases. One patient had radiotherapy due to recurrence of lesion, nevertheless malignant transformation of chondroblastoma occurred in time. Seven patients manifested local recurrence, and one of them even had relapse on two occasions and malignant transformation of chondroblastoma. Malignant lesions were found in three cases (10% of patients); one lesion was diagnosed as primary while other two malignancies were detected only after recurrence, and the treatment was completed by lower leg amputation.
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