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Biomedical subjects

Dusko Spasovski

Publications and source records attributed to Dusko Spasovski.

7 recordsLinked to original sources

[Epidemiological characteristics of hip fractures in Belgrade from 1990 to 2000].

The objective of this study was to estimate the incidence of hip fractures in Belgrade for the period 1990-2000, and to determine distribution of fractures according to sex, age, and causes of injuries. Data based on medical records of the National Health Service in Belgrade were collected from all orthopedic hospitals and departments in Belgrade. A total number of 8904 hip fractures were included in the analysis, out of which 64.7% occurred in women. During the survey period, the estimated average annual incidence rate of hip fractures was 51.7/100 000 (95% CI= 48.1-55.4); 66.2/100 000 (95% CI= 60.8-72.1) in women and 35.3/100 000 (95% CI= 31.4-40.1) in men, respectively. In the age group > or =50 years, the incidence rates standardized by the 1985 US population were 228 and 96 per 100 000 female and male population, respectively. An exponential increase in the incidence of hip fractures with age was observed in both sexes, especially in women. The number of trochanteric fractures was 4718 (53.0%), compared with 4186 (47.0%) cervical fractures. Observation at three time points, in 1990, 1995, 2000, indicated the pronounced increase of trochanteric fractures in women and less distinctive in men. Fall on the flat ground resulted in 70.3% of hip fractures among persons aged 50 years or older, and traffic accidents were recorded as the major cause in 59.7% of patients under 50 years of age.

Adult↗

[Ewing sarcoma--analysis of epidemiological parameters and their relation to clinical characteristics].

The purpose of this investigation was to evaluate epidemiologic features of Ewing sarcoma in children treated in the Institute for Orthopedic Surgery "Banjica: as well as to establish relation of these features to clinical findings. Study involved 78 patients treated over 20-year period (1980-2000). Analysis included standard epidemiologic data (age, sex, tumor localization) and diagnostic clinical features on presentation (major symptoms, time elapsed between presentation and diagnosis, presence of metastases). Most of the patients were in the age group of 15-18 years (50.0%), predominantly males. In general, the results of our study were consistent with data reported in literature. Nevertheless, this investigation revealed slightly higher incidence in patients younger than four years of age (5.1%); localization on the upper extremity was found to be more frequent (upper to lower extremity ratio was nearly 3:1 in our study), and the time lost between presentation and diagnosis was markedly reduced (average time elapsed between presentation and diagnosis was 2.5 months). The results of our study may improve efficiency and success of treatment, thus providing the basis of better prognosis in management of such a serious illness.

Adolescent↗

[Triple pelvic osteotomy--complications and how to avoid them].

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.

Adolescent↗

[Septic arthritis of the hip in infancy--diagnostic and therapeutic possibilities].

Septic arthritis of the hip in infancy is a serious condition which, if left untreated, results in disastrous sequelae and gross invalidity. Treatment is difficult and requires precise perception of characteristic clinical symptoms and signs, application of appropriate diagnostic procedures (laboratory analyses, ultrasound, radiography, joint aspiration, and occasionally additional methods), as well as parenteral administration of adequate antibiotics and obligatory surgical treatment. Differential-diagnostic spectrum of conditions similar to septic hip arthritis is large and diverse. Successful treatment is based on establishing the diagnosis on time, which is only achievable by methodical application of diagnostic protocol for septic hip arthritis in all suspected cases.

Arthritis, Infectious↗

[Sequelae of septic hip arthritis in infancy].

Septic arthritis of the hip represents a serious pathological condition which results in severe sequelae and high invalidity. The most serious sequelae are seen in neonatal and infantile period, when normal growth and development are brutally disturbed, followed by proximal femoral destruction and acetabular dysplasia, which in return result in anatomical limb shortening and functional deficiency. In order to achieve an adequate approach to the treatment of septic hip arthritis sequelae, different classification systems have been developed. Two of them are the most cited in literature: classification according to Hunka, and that according to Choi and associates. In this article, the authors compared both classification systems, presented their similarities and differences, and expanded them in view of treatment options applicable to each category. Although both classifications are based on radiographic findings, it has been shown that they clearly tell between treatment options relevant to particular type of sequelae of the septic hip arthritis, thus representing a useful tool in making decision about adequate treatment.

Arthritis, Infectious↗

[Graf's method in the ultrasound diagnostics of developmental dislocation of the hip].

The authors present the possibilities of ultrasound diagnostics of developmental dislocation of the hip. Special attention has been paid to Graf's method, originally developed in Austria and Germany that has been introduced in many countries all over Europe, including our country. The method in details, normal and pathological anatomy of the infant's hip, all the sonographic types and subtypes with therapeutic implications were described.

Hip Dislocation, Congenital↗

[Ewing sarcoma--current opinion].

Ewing tumor family consists of Ewing tumor of bone, extraosseous Ewing tumor, primitive neurectodermal tumor and Askin tumor. All of them share genetic abnormality, reciprocal translocation (11; 22) (q24; q12), and originate from the same primordial stem cell. Ewing tumor is the most common form, found in 60% of cases. It is the second primary malignant bone tumor. Localized lesion is found in nearly 80% and metastatic disease in 20% of cases. Patients present mostly due to pain and palpable tumefaction, and pathological fracture as the initial problem develops in long bones. Ewing tumor can develop in virtually any bone of the body and in extraosseous localizations as well, while localization in the extremities occurs in 50% of patients. Head or neck localizations are extremely rare. Paraspinal, retroperitoneal or deep pelvic tumor localization is manifested by back pain. Systemic symptoms are also present, commonly fever or weight loss, which often indicates the presence of metastatic disease with predominant invasion of lung, bone and bone marrow. Multimodal chemotherapy with local radiation and/or surgical resection is the best way of modern treatment. Distal parts of extremities and axial skeleton are good prognostic features, while proximal parts, pelvic girdle, metastatic disease and low index of postchemotherapeutic necrosis are associated with poor outcome.

Bone Neoplasms↗