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Biomedical subjects

M Jovanović

Publications and source records attributed to M Jovanović.

At least 19 recordsLinked to original sources

The impact of diabetes mellitus on postoperative morbidity in laryngeal surgery.

The main aim of this study was to analyse risk factors of postoperative morbidity after extended laryngeal surgery comparing patients with diabetes mellitus and non-diabetic patients. In retrospective study 69 patients (63 male and 6 female), who underwent partial laryngo-pharyngectomy and total laryngectomy between 2003 and 2004, were evaluated. 13 % of the total group of examined patients had concurrent diabetes, while 87% were nondiabetic patients. We performed partial laryngopharyngectomy in 39 out of 69 patients (56.5%) and total laryngectomy in 30 patients (43.5%). Secondary wound infections (88.9%) and pharyngocutaneus fistula (44.5%) had a significantly higher rate in diabetic patients (p<0.001). Among diabetics the cases with intraoperative or postoperative blood transfusions were more frequent--44.4%(p<0.001). Diabetic patients with laryngectomy procedures had more frequently prolonged postoperative anemia (55.5%, p<0.001) and electrolitic disbalance (66.6%, p<0.001). Our results have confirmed that diabetes mellitus is an important independent general clinical factor, which increases postoperative morbidity and hospitalization time in laryngeal surgery. Our data indicate the need to make a very serious plan and clinical assesment for laryngeal surgical therapy in diabetic patients.

Adult↗

Transmandibular approach to polycentric recurrent pleomorphic adenoma of the parapharyngeal space.

Surgery for tumors of the parapharyngeal space PPS) requires adequate exposure to identify and protect vital structures. Thus transcervical and transcervical-transparotid approaches to the PPS may be enhanced by mandibulotomy for better visualisation. We have chosen this approach with single mandibulotomy just in front of foramen mentale and without lip incision. We present a 39 years old male who was undergone surgery for policentric recurrency of a pleomorphic adenoma of the parapharyngeal space.

Adenoma, Pleomorphic↗

Occupational accidents in Serbian industries in transition.

Occupational accidents and injuries present a serious social, medical and economical problem in Serbian industries in transition. The purpose of this study is to estimate the number and average annual rate of occupational accidents and traumatic injuries in Serbian industries in transition, between 1992 and 2003, and to estimate the effects of a preventive safety program in the rubber manufacturing industry and in the production of electrical goods and equipment. This paper presents a descriptive analysis of occupational accidents and injuries which occurred in all industries over a twelve years period. In the rubber manufacturing industry and in the production of electrical goods and equipment a surveillance and prevention program has been implemented since 1997. A significant drop after 1997 in average annual accidents rate and severity ratio of injuries in these two industries has been observed, which was not the case in the other industries, and can be explained by the positive effects of the safety training program. The study documents that the safety training program showed significant effects, especially in case of workers with less than ten years of working experience.

Accidents, Occupational↗

Enterococcus durans endocarditis in a patient with transposition of the great vessels.

A case of native valve endocarditis caused by Enterococcus durans in a patient with transposition of the great vessels is reported. The patient was treated initially with gentamicin and ceftriaxone; after isolation of enterococci, ceftriaxone was switched to ampicillin. The only virulence factors established in the strain were haemolytic activity and biofilm formation.

Adult↗

Sesquiterpene lactone mix patch testing supplemented with dandelion extract in patients with allergic contact dermatitis, atopic dermatitis and non-allergic chronic inflammatory skin diseases.

We investigated the value of patch testing with dandelion (Compositae) extract in addition to sesquiterpene lactone (SL) mix in selected patients. After we detected a case of contact erythema multiforme after patch testing with dandelion and common chickweed (Caryophyllaceae), additional testing with common chickweed extract was performed. A total of 235 adults with a mean age of 52.3 years were tested. There were 66 men and 169 women: 53 consecutive patients with allergic contact dermatitis (ACD); 43 with atopic dermatitis (AD); 90 non-atopics suffering from non-allergic chronic inflammatory skin diseases; 49 healthy volunteers. All were tested with SL mix 0.1% petrolatum (pet.) and diethyl ether extracts from Taraxacum officinale (dandelion) 0.1 and 3.0% pet. and from Stellaria media (common chickweed) 0.1 and 3% pet. A total of 14 individuals (5.9%) showed allergic reaction (AR) to at least 1 of the plant allergens, 4 (28.6%) to common chickweed extract, and 11 (78.6%) to Compositae allergens. These 11 persons made the overall prevalence of 4.7%: 8 (3.4%) were SL-positive and 3 (1.3%) reacted to dandelion extract. 5 persons (45.5%) had AD, 2 had ACD, 2 had psoriasis and 2 were healthy controls. The Compositae allergy was relevant in 8 cases (72.7%). The highest frequency of SL mix sensitivity (9.3%) was among those with AD. Half the SL mix-sensitive individuals had AD. ARs to dandelion extract were obtained only among patients with eczema. A total of 9 irritant reactions (IRs) in 9 individuals (3.8%) were recorded, 8 to SL mix and 1 to common chickweed extract 3.0% pet. No IR was recorded to dandelion extract (P = 0.007). Among those with relevant Compositae allergy, 50.0% had AR to fragrance mix and balsam of Peru (Myroxylon pereirae resin) and colophonium. SLs were detected in dandelion but not in common chickweed. Our study confirmed the importance of 1 positive reaction for emerging, not fully established, Compositae allergy. In conclusion, the overall prevalence of 4.7% in our study represents a basal SL mix detection rate of 3.4% reinforced and safely supplemented by testing with the dandelion extract.

Adolescent↗

Influence of dissolution media composition on drug release and in-vitro/in-vivo correlation for paracetamol matrix tablets prepared with novel carbomer polymers.

The influence of dissolution media composition on drug release kinetics and in-vitro/in-vivo correlation (IVIVC) for hydrophilic matrix tablets based on Carbopol 971P and Carbopol 71G was investigated. A number of buffered and unbuffered media differing with respect to their pH value, ionic strength and ionic species was evaluated. The observed in-vitro drug release profiles were compared with the hypothetical drug release profiles in-vivo calculated by numerical deconvolution from the results of an in-vivo study. The obtained IVIVC plots were examined using linear and non-linear (proportional odds, proportional hazards and proportional reversed hazards) mathematical models. Although the studied sustained release agents were chemically identical, they exhibited pronounced differences in drug product behaviour both in-vitro and in-vivo. The use of non-linear modelling resulted in an improved level of correlation, especially in the case of Carbopol 71G matrices. The obtained results indicated the susceptibility of drug release kinetics and hence IVIVC in the case of anionic polymer matrices to media composition, and emphasized the need for thorough evaluation of applied media during the development of biorelevant dissolution methodology. Although the use of non-linear modelling could be advantageous, the need for a simple and meaningful non-linear relationship is pointed out.

Acetaminophen↗

[An acute pancreatitis in a child caused by Na-valproate].

Na-valproat (Apilepsin, Eftil), is is a commonly prescribed medication approved for treatment of epilepsy, trigeminal neuralgy, migraine, and bipolar disorder. Although the common adverse effects associated with Na-valproat are usually benign, more serious and fatal complication like liver failure and acute pancreatitis (AP) can occur. Acute pancreatitis may take place in all ages, regardless of dose and serum levels of the medicine. An acute pancreatitis is relatively common after intravenous administration. The authors presented a case of acute opancreatitis in 13-years girl caused by Na-valproat.

Acute Disease↗

Erythema multiforme due to contact with weeds: a recurrence after patch testing.

Erythema multiforme (EM) as a complication of patch testing (PT) is rare. A 52-year-old woman with a 13-year history of episodes of EM, after contact with weeds during home gardening, had had no recent history of herpes simplex, other infection, drug ingestion or vaccination. On examination, EM lesions were distributed on the exposed skin. 5 weeks after complete resolution, PT and photopatch testing (PPT) were done with fresh plants she brought in. She was PT with a standard series and the Hermal-Trolab plants, woods, tars, balsams and flavors series. Intradermal testing, with a 3 + reaction to mixed weed pollens, was done 3 weeks later. Specific IgE to weed pollens class 1 (CAP-Pharmacia) was detected. Eczematous PT reactions were obtained with fresh leaves: common chickweed (Stellaria media Caryophyllaceae), dandelion (Taraxacum officinale Compositae), field-milk thistle (Sonchus arvensis Compositae) and white clover (Trifolium repens Leguminosae). Photoaggravation was seen to common chickweed and dandelion. Positive PT was also seen with alantolactone. By the 4-day reading, a typical EM had commenced, coming up to quite the same extent as seen on admission. There was no photosensitivity (UV skin tester, K. Waldmann). In the essential oil obtained from common chickweed, thin layer chromatography (TLC) revealed the well-known contact allergens borneol, menthol, linalool, 1,8-cineole, and other terpenes such as epoxy-dehydro-caryophyllene, monoterpene alcohol-ester and caryophyllene. Up to now, no data on essential oil in Stellaria media (common chickweed) have been reported. It can be concluded that EM developed due to contact with weeds, and recurred after patch testing. Neither blistering nor eczematous lesions have been seen on her skin, making this case very unusual. As far as the world literature is concerned, this is only the 4th report of EM developing in association with patch testing.

Dermatitis, Occupational↗

[Treatment of facial nerve paralysis using static suspension methods].

After the injury of facial nerve, facial muscles are subjected to complex series of biochemical and histological changes, which lead to muscular atrophy if reinnervation is not restored. Facial palsy is very difficult to manage completely. Regardless this fact, the plan of correction has to be directed towards the following: restoration of normal function, normal facial appearance at rest, symmetry in voluntary movements as well as symmetry in involuntary and emotional movements. Static suspension methods were used in our study. All patients had unilateral complete facial nerve palsy but one female patient who experienced the palsy of frontal branch of n.facialis. This method was successfully used to lift the eyebrow, the lid and to improve lagophthalmus on the paralytic side, then the angle and paralytic part of the lip, to reinforce buccal wall of oral cavity as well as to reconstruct new nasolabial fold. The results were satisfactory and permanent.

Facial Muscles↗

[Evaluation of the value of local protective methods using latex prosthesis and fibrin glue in colonic anastomoses].

In this experimental study on small animals (Wister rats) performed evaluation of local protective methods--latex prosthesis and fibrine adhesives--on colon anastomosis healing--prevention of dehiscency. Ninety experimental animals in whom segmental left colon resection was done, were divided into three groups of 30 animals. In the control group after segmental resection termino-terminal anastomosis with single-layer continuous suture was performed. In the second and third group with the same animals, anastomosis protection was performed with endoluminal latex prosthesis and extraluminal application of fibrine adhesives. In the postoperative course where the animals were monitored for 21 days in the control group, 3 (10%) died of acute diffuse peritonitis the cause of which was anastomosis dehiscency, in the latex prosthesis 2 animals (6.6%) died, while in the extraluminally applied fibrine glue group all animals survived. The results of this experiment demonstrate that local protective measures for colon anastomoses may produce better results, with fibrine adhesive administration as the best modality.

Anastomosis, Surgical↗

[Treatment of defects of soft tissue and sternum, as postoperative complications of A-C bypass, case report].

Medial sternotomy is optimal approach for great number of heart surgery. Deep infection of sternum and mediastinis are very rear, but very dangerous complications followed by high rate of morbidity and mortality. Factors which can be responsible for these complications are numerous: post operation bleedings, surgery reinterventions, extended mechanical ventilation, liver chronic diseases, older age, diabetes, previous irradiation therapy, respiratory obstructions and use of steroids. Clinical signs for these complications are: red skin around the surgical wound, leaking, dehiscence, increased body temperature and instability of sternum. Early diagnosis, adequate antimicrobial therapy, and aggressive surgical and multidisciplinary approach in initial phase, are base for successful treatment. Surgical treatment most often assumes use of flaps. Our main objective in this work was to present treatment of defect of sternum and soft tissues, after triple aorto-coronary bypass. After the surgery patients got slack of sternum's ficsation and reficsation. With satisfactory respiratory function, corrections of defect was achieved by omentum and bipedicular myocutan flaps. (m. pectoralis major flap). There was no complications.

Aged↗

[Experimental and clinical possibilities of transplantation of the injured and totally devascularized spleen].

The most severe spleen lesions with conquasation and devascularisation of entire organ, when it is practically impossible to do any preservating surgical procedure, are the true indications for the transplantation of this extremely important immunological organ. We have performed the evaluation of the surgical procedure of heterotopic auto transplantation in the 30 dogs with severe spleen lesions. Simulation of totally devascularized spleen with the lesions of V degree was performed by disrupting all segmental blood vessels with deep and long longitudinal transhilar incision. During the 3 months follow-up period, animals were subjected to numerous explorations in order to macroscopically and histologically valuate the implant. In most cases (80-85%) implants had complete vitality with the preservation of normal tissue architecture, while 15-20% of implants had partial or total fibrosis. There were no mortality and no complications after this preservation procedure. The presence of fibrosis in some implants suggests that the implant preparation should be better performed and that transplantation of larger tissue volume is needed. Enriched with this experimental experience we have performed heterotopic auto transplantation in 2 patients with spleen lesion of V degree (car accident and injury at work) with very satisfactory results.

Animals↗

[Cholecystitis associated with milk of calcium] ].

Milk of calcium cholecystitis is a rare disease predominantely of adults. The term designates a pathologic accumulation of calcium carbonate in the gallbladder, much rarer in the common bile duct as well. The patient may be symptom-free. If present the symptoms may be very mild or as an acute biliary pain, transient jaundice and mild attack of pancreatitis. Calcium in the bile may be liquid or it may form a paste-like mass. Both may be seen on a plain X-ray of the abdomen. The stone or stones of calcium carbonate may be formed so that they may cause an obstruction of the gallbladder outflow tract or cystic duct or pass into the common bile duct or into the duodenum. [figure: see text] We present a 71 year old male who was admitted for inguinal hernia repair but in whom a mild hiperbilirubinaemia was found and then on ultrasonography a gallbladder stone was diagnosed. We performed a hernia repair as well as cholecystectomy and operative cholangiography which turn to be normal. Within an almost normal gallbladder a gray-whitesh paste-like mass was found composed of calcium carbonate. The postoperative recovery was uneventful and serum bilirubin become normal. Histology of gallbladder showed chronic nonspecific cholecystitis.

Aged↗

Occupational profile and cardiac risks: mechanisms and implications for professional drivers.

Of the population of 900 drivers, 419 drivers with changes in the circulatory system were enrolled in the study, and the control group consisted of 150 healthy drivers. In both groups there were professional and non-professional drivers. Traffic accidents caused by these drivers were registered over a five-year period. Drivers with cardiovascular diseases and professional drivers were more frequently responsible for accidents than healthy and non-professional drivers. The comparison between the group studied and the controls indicated over a two-fold increase in the number of accidents caused by sick drivers.

Accidents, Traffic↗

[Spongiform encephalopathies in animals and humans].

Spongiform encephalopathies include several diseases of animals and humans: sheep and goat scrapie, bovine spongiform encephalopathy (BSE). Creutzfeldt-Jakob disease (CJD) in humans and its new variant (vCJD). Common characteristics of these diseases are long-term incubation, slow and progressive course, spongiform changes within nerve tissue, neuron loss and astrocytosis. Causative agent responsible for spongiform encephalopathy is prion (PrPsc) and it represents a posttranslationally modified host protein (PrPc) which normally exists and is produced in the cells. Development of certain diseases can be influenced by genetic factors, because of mutations in the PrP gene. Pathogenesis of these diseases is still not clear. In experimental peripheral infection the ineffective agent is first detected in the spleen and lymph nodes, and then it neurally spreads to the CNS. Bearing in mind that etiology, pathogenesis and mutual connection of spongiform encephalopathies have not been completely explained yet, caution and strict veterinary and sanitary measures are of great importance.

Animals↗

The influence of Eudragit type on the dissolution rate of acetylsalicylic acid from matrix tablets.

The effect of four Eudragits used as matrix substances on the physical characteristics of tablets and on the dissolution rate of acetylsalicylic acid has been investigated. The concentration of matrix substance necessary for achieving the appropriate effect of sustained release of acetylsalicylic acid (ASA) depends on the type of Eudragit used. For tablets prepared using Eudragit RS-100, Eudragit L-100-55 and Eudragit S-100, the acceptable dissolution rate of ASA was obtained with only 3% of polymer. In the case of Eudragit RL-100, to obtain the same effect, 10% of polymer was required. The dissolution data were evaluated on the basis of theoretical dissolution equations and by linear transformation of dissolution curves. The following mathematical models were employed: zero order equation, first order kinetics, Hixon-Crowell's cube root kinetics and diffusion model. The results indicated that the fitness of the kinetic model was dependent on the type of Eudragit used.

Acrylic Resins↗

Morphologic characteristics of primary nonperforative intestinal blast injuries in rats and their evolution to secondary perforations.

Five hundred and fifty Wistar rats were investigated to determine the frequency of secondary intestinal perforations after exposure to nonperforating blasts and the evolution of the morphological changes from hematoma through to necrosis and gangrene. The animals were observed at different times for a period of 14 days from the moment that the injury was inflicted. Microscopic findings showed that alterations began in the mucosal layer where they were most extensive, then spread to the submucosal layer, muscular layer, and serosal layer, respectively. Examination of the intestinal wall revealed an evolution of the injury from hematoma to necrosis to gangrene, resulting in secondary intestinal perforation. The secondary wounds had centrifugal patterns, opposite those of the original wound pathways. Based on these observations, the mechanism of evolution of primary nonperforating intestinal blast injury into secondary intestinal perforations is presented.

Animals↗

[Systemic diseases: evaluation of important laboratory parameters in 3 cases with unusual skin changes].

A whole spectrum of various clinical and laboratory disorders in patients with skin changes, may present systemic disease manifestations. Serological parameters correlate with the progression of the disease. Authors present cases with unusual skin lesions and abnormal laboratory findings, that were presumed to be manifestations of the systemic disease progression. The first case is a report of a patient age 44, female with dermatomyositis that started suddenly from full health with generalized linear bluish dark erythematous lesion like excoriations, periocular heliotrope violaceous to dusky erythematous rash with edema in a symmetrical distribution involving periorbital skin with no pruritus, diagnosed on admission as the case of acute urticarica. In the second report, a 17-year old female was referred to us because of a spread up linear sclerodermia followed by high immunological disturbances. Our third case was a 21-year old female with a systemic lupus erythematous--Rowell syndrome, with skin lesions of erythema multiforme type with some similarities to dermatitis herpetiformis on the first examination.

Adolescent↗