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Search Results: 1 - 10 of 898 matches for " Stojanovi? Zorica "
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Strategies for endoscopic and surgical management of common bile duct stones
Stojanovi? Drago? Lj.,Stojanovi? Mirjana,Milojevi? Predrag S.,?aparevi? Zorica
Medicinski Pregled , 2003, DOI: 10.2298/mpns0302069s
Abstract: Introduction Common bile duct calculi represent a pathologic entity involving obstructive icterus, cholangitis, hepatic cirrhosis or pancreatitis. Common bile duct calculi mostly have a secondary origin (from gallbladder) in 95% of cases, while primary choledocholithiasis is rare. Classification From surgical aspect, common bile duct calculi can be: 1. Asymptomatic, without manifested symptoms or signs,2. Mobile, with intermittent biliar obstruction and disobstruction, 3. Fixed, with obstruction and signs of hepato-biliary and/or bilio-pancreatic duct, 4. Transitory, microcalculi which pass through Vater's Papilla by propulsion into duodenum with symptoms. Discussion Modern biliary surgery includes diagnosis of common bile duct calculi, and if possible preoperative endoscopic (endoluminal) surgery, which is less invasive for patients. If such approach is not possible, it is necessary to perform stone extraction and cholecystectomy. Conclusion Common bile duct calculi represent a common disease of the digestive system. Endoscopic diagnostic procedure is very important in management of choledocholithiasis Endoscopic treatment of common bile duct calculi prior to cholecystectomy is a method of choice and a strategy for associated cholecysto-choledocholithiasis.
Clinical and radiological manifestations of paraneoplastic syndrome of bronchogenic carcinoma
Goldner Branislav,Milo?evi? Zorica,Sadikovi? Sead,Stojanovi? Milan
Srpski Arhiv za Celokupno Lekarstvo , 2005, DOI: 10.2298/sarh0506248g
Abstract: The objective of this study was to present some clinical and radiological manifestations of PNS in relation to bronchogenic carcinoma (BC) and to evaluate the usefulness of imaging findings in the diagnosis of asymptomatic BC. In the study group of 204 patients (146 male and 58 female) with proven bronchogenic carcinoma, PNS was present in 18 (8.62%) patients. The patients with PNS were divided into two groups. The first one consisted of 13 (72.2%) patients with symptoms related to primary tumours while the second one consisted of 5 (27.7%) patients with symptoms, at initial appearance, indicative of disorders of other organs and systems. The predominant disorder was Lambert-Eaton Syndrome, associated with small-cell carcinoma. Endocrine manifestations included: inappropriate antidiuretic hormone production syndrome (small-cell carcinoma), a gonadotropin effect with gynaecomastia and testicular atrophy (planocellular carcinoma, small-cell carcinoma), a case of Cushing Syndrome (small-cell carcinoma), and hyper-calcaemia, due to the production of the parathyroid hormone-related peptide, which was associated with planocellular carcinoma. A rare case of bilateral exophthalmos was found as PNS at adenocarcinoma. Digital clubbing and hypertrophic osteoarthropathy (HO) were associated with planocellular and adenocarcinoma, while clubbing was much more common than HO, especially among women. The differences between the two groups were related to the time of PNS appearance. In the first group, PNS occurred late on in the illness, while in the second group, PNS preceded the diagnosis of BC. Alternatively, the disappearance of a clinical or a radiological manifestation of PNS after surgery or chemotherapy may be an indicator of an improvement in health or PNS may be the first sign of illness recurrence. Radiological manifestations of PNS in asymptomatic patients may serve as a useful screen for identifying primary BC. In symptomatic patients, it may be an indicator of a higher likelihood of metastatic disease.
News in childhood asthma therapy
?ivkovi? Zorica,Cerovi? Sofija,Vuka?inovi? Zoran,Joci?-Stojanovi? Jasmina
Srpski Arhiv za Celokupno Lekarstvo , 2009, DOI: 10.2298/sarh0910558z
Abstract: Research in the field of pediatric pulmonology, especially asthmology, has been intensified for the last couple of years. A large number of studies describe early wheezing episodes, risk factors, natural course of early childhood asthma. Besides this, literature shows a growing interest in epidemiology, genetics and virusology as predictive factors for development and clinical course of childhood asthma. In this paper, the authors are providing a review of recently published articles on asthma therapy based on phenotypes in terms of better understanding of asthma and asthma-like syndromes. Pediatric respiratory experts worldwide are equally positive in the following statements: real diagnosis leads to real therapy as soon as possible; inhaled corticosteroids are not recommended in very young infants especially if a positive effect is missing; long-term therapy with inhaled corticosteroids has to be scrutinized.
Selective media for the isolation of Actinobacillus pleuropneumoniae from the pig
Vidi? Branka M.,Grgi? ?ivoslav,Novakovi? Zorica,Stojanovi? Dragica
Acta Veterinaria , 2004, DOI: 10.2298/avb0406395v
Abstract: Selective media were developed and evaluated for isolation of A. pleuropneumoniae from pig tonsils. Samples were obtained from four pig herds with a clinical history of pleuropneumonia. For isolation of A. pleuropneumoniae 93 pig tonsils were collected at slaughter. Each sample was streaked on to four different selective media (modified PPLO agar (mPPLO) Brain-Heart agar (BH), Columbia agar (CA), Miller-Hinton chocolate agar (MHCA)) containing different combinations of antibiotics, NAD and nystatin. The selectivity of nutritive media is conditioned by the content of antibiotics, as well as by the type of medium used. Mean isolation rate of A. pleuropneumoniae in the investigated herds, was 17.2%. The best results were obtained using PPLO2 agar, 20.4%. The other media supplemented with the mentioned antibiotics gave satisfactory results.
Lipid abnormalities in elderly patients with subclinical hyperthyroidism
?aparevi? Zorica,Stojanovi? Drago? Lj.,Ili? Vesna,Bojkovi? Gradimir
Medicinski Pregled , 2003, DOI: 10.2298/mpns0312564c
Abstract: Introduction Sensitive thyroid-stimulating hormone (TSH) assays provide identification of many patients with subclinical hyperthyroidism resulting from excessive production or excessive replacement of thyroid hormone. Subclinical hyperthyroidism is defined by a TSH below normal (suppressed) with normal serum T3 and T4 levels. Subclinical hyperthyroidism is the goal of thyroid hormone therapy in patients with thyroid cancer, solitary thyroid nodules, multinodular or diffuse goiters, or a history of head and neck irradiation. Benefits of TSH suppression in these patients, were thought to exceed the risks of subclinical hyperthyroidism. Subclinical hyperthyroidism also occurs in patients with thyroiditis and those with autoimmune thyroid disease. Other causes of TSH suppression, such as use of glucocorticoids, severe illness and pituitary dysfunction should be excluded. Material and methods This investigation included 55 elderly patients with subclical hyperthyroidism in order to establish the type and degree of lipid abnormalities and effects of therapy with antithyroid drugs (methimazole 10 mg/day) during three months. These patients presented with no or minimal symptoms of thyroid hormone excess, but 56% of patients experienced atrial fibrillation and cardiac hypertrophy. Results Levels of serum cholesterol, LDL-cholesterol and HDL-cholesterol were decreased. We found a significant increase of serum cholesterol, LDL-cholesterol and HDL-cholesterol levels after treatment. Discussion and Conclusion Subclinical hyperthyroidism in elderly individuals is difficult to diagnose because it may present only with cardiac manifestations including atrial fibrillation and cardiac hypertrophy. There is general agreement that measurement of serum TSH is the most sensitive indicator of thyroid hormone activity in its target tissues. Patients with subclinical hyperthyroidism tend to have low serum total cholesterol, LDL-cholesterol anf HDL-cholesterol levels. These values increase after treatment. Most patients with subclinical hyperthyroidism should be treated with antithyroid drugs to prevent cardiovascular complications and bone loss, particulary among postmenopausal women.
Celiac disease - case report
Bojkovi? Gradimir,?aparevi? Zorica,Ili? Vesna,Stojanovi? Drago? Lj.
Medicinski Pregled , 2002, DOI: 10.2298/mpns0212532b
Abstract: Introduction Celiac disease (nontropical sprue, gluten-sensitive enteropathy, chronic intestinal malabsorption disorder) is caused by gluten intolerance. This hereditary disorder is caused by sensitivity to gliadin. Because the body's own immune system causes the damage, celiac disease is considered to be an autoimmune disorder. However, it is also classified as a disease of malabsorption because nutrients are not absorbed. When people with celiac disease eat foods containing gluten, their immune system responds by damaging the small intestine. Specifically, tiny finger-like protrusions, called villi, on the lining of the small intestine are lost. The diagnosis is suspected on the basis of symptoms and signs, enhanced by laboratory and x-ray studies, and confirmed by biopsy revealing flat mucosa and subsequent clinical and histologic improvement on a gluten-free diet. Gluten must be excluded from diet. Supplementary vitamins, minerals and hematinics may be given depending on deficiency. Case report This is a case report of a 23-year old female patient with a mineralization defect (osteomalacia) and secondary osteoporosis caused by long-time unrecognized celiac disease. The patient had many symptoms: short stature, steatorrhea, anemia, weight loss and chronic bone pain. Laboratory and x-ray studies and jejunal biopsy revealed a chronic intestinal malabsorption disorder caused by gluten intolerance. Gluten-free diet and supplementary vitamins, minerals and hematinics were included with apparent clinical remission. Discussion and Conclusion Some people with celiac disease may not have symptoms. The undamaged part of their small intestine is able to absorb enough nutrients to prevent symptoms. However, people without symptoms are still at risk for complications of celiac disease. Biopsy of the small intestine is the best way to diagnose celiac disease. Decreased bone density (osteoporosis and osteomalacia) is a serious problem for celiacs. If calcium is not absorbed, due to small intestinal damage caused by untreated celiac disease, bones are not as dense. The only treatment for celiac disease is gluten-free diet, that is, avoiding all foods that contain gluten. For most people, this diet stops symptoms, heals the existing intestinal damage, and prevents further damage.
Psychological evaluation of patients with a thyroid nodule before and after surgical treatment
?aparevi? Zorica,Diligenski Vladimir,Stojanovi? Drago? Lj.,Bojkovi? Gradimir
Medicinski Pregled , 2002, DOI: 10.2298/mpns0210401c
Abstract: Introduction Association between endocrine and mental disorders has been recognized a long time ago, as well as their mutual dependence. The aim of this study was to evaluate the psychological structure of patients with thyroid nodule before and after surgical treatment. Material and methods In order to establish the type and degree of psychological disorders, we have examined 60 patients with thyroid nodule before and after surgical treatment by using DSM-IV classification of mental disorders and psychological instruments: semi structured psychiatric interview, MMPI, Zung Depression Scale and a list of panic symptoms. Patients with nonautonomous ("cold") nodules presented as euthyroid, and those with autonomous ("hot") nodules (after a period of drug therapy if they were hyperthyroid), required surgery. After a period of drug therapy two groups of patients were compared: group 1- euthyroid with "cold" nodules and group 2 - euthyroid with "hot" nodules. Before surgical treatment both groups under went psychological evaluation. Group 2 presented with: anxiety, depression and panic disorder with or without agoraphobia (72%, 46%, 28%) while group 1 presented with following results: 48%, 23%, 14% respectively. After surgical treatment patients from group 1 presented with psychologic disorders in less than 1%. Discussion and conclusion In some physical disorders, psychologic factors contribute directly or indirectly to the etiology, in others, psychologic symptoms are the direct results of a lesion affecting neural or endocrine organs. One of the key etiological factors is often a short-time or long-time stress and its direct consequence is altered functioning of various hormonal systems. Unexpected high percentage of psychological disorders in patients with thyroid disorders suggests that psychological evaluation before and after surgical treatment is unavoidable for good assessment and choice of treatment. These patients need psychotherapeutic and psychopharmacological treatment.
Oxidized LDL and C-reactive protein as markers for detection of accelerated atherosclerosis in type 2 diabetes
?aparevi? Zorica,Kosti? Nada,Ili? Sanja,Stojanovi? Drago?
Medicinski Pregled , 2006, DOI: 10.2298/mpns0604160c
Abstract: Introduction. High levels of inflammatory markers are associated with an increased risk for development of coronary heart disease (CHD). The aim of this study was to estimate relations between oxidized LDL (oxLDL), C-reactive protein (CRP) and conventional lipid risk factors for CHD in type 2 diabetics without coronary heart disease. Material and methods. Three groups of subjects were included in the study. 44 well-controlled type 2 diabetics (25 female/19 male; 54.50±6.54 years); FBG: 5.67+0.69; HbAlc: 6.5±1.6%) without clinical signs of CHD; the second group included 24 hypercholes-terolemic healthy subjects (14 female/28 male; 51.30±5.76 years). The control group included 24 normocholesterolemic healthy subjects (17 female/12 male; 48.1±8.37 years). Lipid profiles were measured by enzymatic methods. OxLDL was measured by a commercially available sandwich ELISA (Mercodia AB, Uppsala, Sweden). Hs-CRP was measured by chemiluminiscence (Immulite-DPC) using Behring Latex hs-CRP assay. Results. Serum oxLDL levels were significantly higher in diabetic patients (p<0.05) and subjects with hypercholesterolemia (p<0.01) compared with control subjects. Levels of CRP were significantly increased in hypercholesterolemic subjects, compared with controls (p<0.01). Levels of CRP in diabetic patients also were significantly increased compared to those of controls (p<0.05). In type 2 diabetes oxLDL significantly correlated with CRP (r=0.657; p=0.0001), TG:HDL-C ratio (r=0.690; p=0.0001). In hypercholesterolemic subjects oxLDL significantly correlated with oxLDL: LDL ratio (r=0.788; p=0.0001) but not with CRP. In controls, oxLDL significantly correlated with oxLDL: LDL ratio (r=0.679; p=0 0001 and CRP (r=0.802; p=0.0001). Conclusion. It is of great importance to identify type 2 diabetics and hyper-cholesterolemic healthy subjects with high levels of oxLDL and CRP, because they are at increased risk for development of accelerated atherosclerosis. .
Dyslipidemia in subclinical hypothyroidism
?aparevi? Zorica,Bojkovi? Gradimir,Stojanovi? Drago? Lj.,Ili? Vesna
Medicinski Pregled , 2003, DOI: 10.2298/mpns0306276c
Abstract: Introduction Subclinical hypothyroidism is defined as an increased serum TSH and normal serum FT4 concentration. In subclinical hypothyroidism, thyroid peroxidase and thyroglobulin antibodies are frequently present. Subclinical hypothyroidism may have endogenous or exogenous causes. The prevalence of subclinical hypothyroidism is rather high. The number of patients progressing to overt hypothyroidism may be higher. These patients may be asymptomatic, or have only mild symptoms or a single symptom. Material and methods We investigated 35 patients with subclinical hypothyroidism in order to establish the type and degree of dyslipidemia and effects of therapy with L-thyroxine (50 micrograms/d) during three months. Results Serum cholesterol LDL-cholesterol and apo B were increased. A significant reduction of serum cholesterol, LDL-cholesterol and apo B concentrations was established during thyroid hormone replacement. Discussion and conclusion Only a few studies reported higher LDL and lower HDL-cholesterol values in subclinical hypothyroidism. Much interest was thus aroused to evaluate whether or not subclinical hypothyroidism is associated with hypercholesterolaemia. Only patients with serum thyrotropin (TSH) concentration above 10 mU/L had a significant reduction of serum cholesterol concentration during thyroid hormone replacement. Most patients with subclinical hypothyroidism should be treated with thyroxine to prevent progression to overt hypothyroidism Thyroid hormone replacement therapy may slow the progression of coronary heart disease, because of its beneficial effects on lipids. These findings and especially high rate of progression towards overt hypothyroidism suggest early thyroxine treatment.
Utilization of psychiatric drugs in Serbia
Divac Nevena,Todorovi? Zoran,Stojanovi? Radan,Ne?i? Zorica
Vojnosanitetski Pregled , 2009, DOI: 10.2298/vsp0903233d
Abstract:
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