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[Liver injuries at the surgical clinic in Novi Sad from 1967-1978].

Experience gained from 80 ceses of liver injuries which have been under treatment at the Clinic of Surgical Diseases in Novi Sad in the period from 1967 to 1978 has been presented in this article. The number of liver injuries has amounted to 0,3% from a total of 23.300 injuried persons who have undergone the treatment at this clinic. The problems of dealing with liver injuries, especially those which can be expected in wartime, have been particularly emphasize.

Humans↗

Extremes in drug utilization patterns. Low prescribing of antihypertensives in the District of Novi Sad, Yugoslavia.

According to data expressed in defined daily doses (DDD), the utilization of antihypertensives is lower in the district of Novi Sad (Yugoslavia) than in other settings studied so far. The number of actually treated persons is even lower than that indicated by the DDD value, which in 1981 was 23.4 DDD/1 000 inhabitants/day. Currently, the participating members in the WHO coordinated MONICA-project are considering the possibility to incorporate the defined daily dose approach to evaluate drug usage in relation to morbidity data. This offers a realistic prospect for identifying the medical consequences of the regional differences in prescribing patterns.

Antihypertensive Agents↗

[Legal abortion during the first trimester of pregnancy at the University Hospital for Women in Novi Sad (1960-1975)].

The authors present the results of their own observations and investigations of legal abortions until the 12th week in the University Department of Gynaecologigy and Obstetrics of Novi Sad for the period 1960 to 1975. The analysis discusses success, failures and complications in 83,121 legal and 23,321 cases of other abortions registered in the Department in the mentioned period. In particular, injuries of the uterus at these interventions, haemorrhage after and during abortion and distinctly low mortality at legal abortions--1 case or 0.0012% are discussed.

Abortion, Therapeutic↗

['A sad and painful heart'--Andreas Vesalius as cardiologist].

One needs courage to dissociate oneself from ideas maintained for ages and put forward by authorities. How laborious this process has been for Vesalius concerning the heart, is obvious when we compare the information of an eye-witness with both editions of the De Humani Corporis Fabrica (1543 and 1555). He must have come hesitantly to the conclusion that the views on the permeability of the septum cordis, as they were supported by Galen, Mondino and Johann Winther, a professor at Louvain, could not be defended. However, they had been essential in the considerations about the blood-flow. Although Vesalius demonstrated by vivisection-experiments that a relation exists between the pulse and the heart contractions, he was not an experimenting cardiophysiologist. In this respect, he stood far behind his contemporary Leonardo da Vinci, who made experiments on heart ntractions and the bloodstream along the heart valves. Vesalius was an anatomist! And a morphologist! But he was also a physician. In this respect, he also was interested in the pathological aspects of anatomy. So he recalled in, his last book, Anatomicarum Gabrielis Fallopii Observationum Examen (1564) some cardiologically interesting patients, a.o. the courtier van Immerseel, with a very unequal pulse and "a sad and painful heart" (tristi in corde, sensu doloreve), by whom a heart abnormality was found post mortem, that in modern terms we could call "an old heart infarction with thrombus formation." According to Schenk von Grafenberg, Vesalius was dreaming of a big book about anatomo-pathology, but alas, he never wrote it. Undoubtedly he would have trusted more his eyes and less Galen: "non solum ex Galenis testimonio, sed etiam oculis ipsis perspexeris".

Anatomy↗

[An unbiased study of the perception of smile and sadness by analysing the integration of emotions].

This article describes a simple and easy-using clinical tool for investigating the visual perception of emotions. The method was validated with healthy persons. On the one hand, the results confirm and sharpen the data of the literature. On the other hand, they enable a precise quantification of the results. Nevertheless, only the perception of the smile and sadness has been studied. Therefore, the extension and validation of this tool to other fundamental emotions is requested. This will enable a simple and easy clinical investigation of troubles of the visual recognition of emotions. On the one hand, for many neurological pathologies: strokes, neurologic disease. On the other hand for psychiatric pathologies: Korsakoff's syndrome, schizophrenia, Alzheimer's disease, other dementias and as on.

Adult↗

[Clinical and epidemiologic aspects of paraneoplastic dermatoses in hospitalized patients treated at the Clinic for Dermatologic and Venereal Diseases in Novi Sad over a 10-year period (1980-1990)].

Authors report results of a retrospective investigation on frequency of paraneoplastic dermatoses, their clinical characteristics, time of onset and course regarding 10 - year material on hospitalized patients at the Clinic for Infectious and Dermatovenerous Diseases in Novi Sad. Out of 9086 hospitalized patients in 14 patients (0.16%) paraneoplastic dermatisis was diagnosed. Out of 14 patients in 5 patients (35.71%) Herpes zoster was diagnosed; in 4 patients (28.57%) bullous dermatosis; in 2 patients (14.29%) paraneoplastic acrokeratosis; in 1 patient (7.14%) exudative multiform erythema in 1 patient (7.14%) erythema figuratum and in one more patient necrotic Herpes labialis was diagnosed. Concerning malignant neoplasms of internal organs together with paraneoplastic dermatosis in most cases (4 - 28.57%) chronic lymphocyte leucosis was found, and in remaining 10 (71.43%) carcinomas were diagnosed at different internal organs. In 7 cases (50%) malignancy proceeded paraneoplastic dermatosis, in 4 cases (28.57%) the malignancy was diagnosed at the same time as paraneoplastic dermatosis and in 3 cases (28.43%) malignancy was established after the onset of paraneoplastic dermatosis. Authors point to the fact that usual skin changes, characteristic for the dermatologic diseases mentioned, in cases when they are associated with visceral malignomas, are characterized by a more serious clinical picture, a longer course of the disease and resistance concerning usual therapy.

Aged↗

[MEDLINE on compact disk as an information source at the Medical School Library in Novi Sad].

The transformation of the Library at the Medical Faculty of Novi Sad into a modern information center necessitated the introduction of an up-to-date technology and enforced the use of the latest information sources among which MEDLINE medical database is the most famous one. In the studied period, January 1993-current, 200 searches have been performed on the basis of which the following parameters were analyzed: institution, occupation, and degree of the user, purpose and accuracy of the order, relevant period, number and format of the references, assessment of the search quality and the quality of the library staff services. The analysis proved the initial belief that MEDLINE is a remarkably valuable data base necessary for medical libraries.

CD-ROM↗

[Basic characteristics of bacterial meningitis in patients treated at the Clinic for Infectious Diseases in Novi Sad during a 2-year period].

Although known for centuries, bacterial meningitis is a disease which still causes death and invalidity no matter there are modern diagnostic methods and therapeutic modalities. Our investigation included 45 patients treated for a purulent meningitis during a two-year period at the Clinic for Infectious Diseases in Novi Sad. Most patients suffered from meningococcal meningitis. The onset of the disease was sporadic, during winter and spring, and there were no contact cases. Most patients were 2-3 and 8-15 years of age. Patients with pneumococcal meningitis had the most serious clinical picture, course of the disease, laboratory results, as well as outcome of the disease.

Adolescent↗

[Characteristics of persons killed by firearms and examined at the Institute of Forensic Medicine in Novi Sad 1989-1993].

Gunshot wounds present an actual medical problem today. This research deals with a group of deceased persons murdered by firearms examined at the Institute of Forensic Medicine Novi Sad during the period 1989 - 1993 (402 persons). The analysis included sex and age structure as well as forensic medical categories connected to characteristics of gunshot wounds and wounds by explosion. Out of the total number of examined persons murdered during the analyzed period 11.92% of cases were deadly injured by firearms. There is an evident increase of those who die by firearms. During the same period of time correlations among homicides, suicides and accidents changed in favor of homicides. The average increase of homicides in 1991, 1992 and 1993 was 61.28% in regard to the average values of the first two years of the 5-year period.

Adolescent↗

[Hygienic aspects of water quality from the Danube River in Novi Sad].

In order to assess the water quality of the Danube river during the bathing season (June, 15. -September, 15.) from 1992-1995, water was examined every day (bacteriologically and chemically) while "big chemistry", hybrid analysis and determination of physiologic groups were performed every other week at the locality of the most beautiful beach called Strand in Novi Sad. Analyses showed that water did not meet criteria of the II class quality in regard to microbiologic requirements in 63.44% of samples (n = 372) and in 6.45% of samples in regard to chemical requirements (n = 372). On the basis of zooplankton and phytoplankton distribution, water of the Danube river belongs to the demanded class of betamesosaprobicity (saprobic index after Pantle-Buck 1.9-2.33). According to Kohl categorization, water belongs to the II and III class. Analyses of the nonspecific bacteriophage point to the most common occurrence of bacteriophage for Shigella sonnei. Salmonella paratyphi B and Shigella flexneri 2-a, which points to earlier fecal contamination. In regard to physiologic groups, water contained heterogenic organic materials. On the basis of occurrence of oligotrophs and heterotrophs, the process of self-purification is mostly satisfactory. The most important causes of chemical contamination were as follows: supersaturation and saturation, decreased oxygen concentration, increased use of BPK5, as well as increased concentrations of iron, barium, arsenic, total dissolving phenols, and occasionally strontium and chloroform. Remains of organochlorine insecticides used to be found in earlier periods.

Water Microbiology↗

[The volume and present methods of legal abortion in children and adolescents at the Gynecology Clinic in Novi Sad 1985-1995].

Legal pregnancy interruptions in juvenile and adolescent age performed at the Department of Obstetrics and Gynaecology in Novi Sad, during the period from 1985 to 1995, have been analyzed and presented. The authors point out the following methods of choice for pregnancy interruptions: interception to 7 weeks of pregnancy, electric vacuum aspiration from 8 to 13 weeks of pregnancy, a combination of parenteral and local application of prostaglandins from 14 to 20 weeks of pregnancy.

Abortion, Induced↗

[The Institute of Surgery in Novi Sad as a trauma center--10 years' experience].

UNLABELLED: Trauma is a surgical disease and a leading cause of death in the population in the age of forties. The Institute for Surgery in Novi Sad (trauma center of the first rank) takes care of all injured people brought to the Institute either directly from the place of accident or from other centers. AIM OF THE STUDY: Retrospective analysis of the injured people treated at the Institute for Surgery in the period 1987-1996. MATERIAL AND METHODS: Multivariate analysis of the traumas from the register of the Institute for Surgery according to the trauma system elements: number of injured individuals, sex and age structure, categorization of injuries, etiology of injuries, distribution of serious injuries by regions, results obtained from the treatment of serious injuries. RESULTS: They show a global representation of all elements involved with injured people: due to moderately serious, serious and critically serious injuries 21.6% of patients were hospitalized; in the age of 29-30 years men with traumas caused on work or in traffic were predominant, while women with injuries caused by falling were predominant in the age of 60-69 years; drastically increased injuries caused by fire-arms in the period 1991-1993 were directly caused by the state of war and these injuries are still numerous; in case of hospitalized patients isolated trauma (80%) was predominant, multiple trauma was under 20% and polytrauma was registered in 5% of patients; after surgical treatment of injuries approximately 17% of patients were indicated for postoperative prolonged treatment and in intensive care unit at the Institute for Surgery; the average mortality of hospitalized patients was 5-7% but with extremely high mortality rate (< 70%) in the group of patients with polytraumas.

Adult↗

[Progress in the treatment of coronary disease at the University Clinic for Cardiovascular Surgery in Novi Sad].

More than 12,000 open heart operations have been performed at the University Clinic of Cardiovascular Surgery in Novi Sad, with the total postoperative mortality rate of 2.6%. Myocardial revascularization has been done in case of 7,944 patients with the operative risk of 2.8%. The advancement in surgical treatment of coronary disease is especially prominent in case of the most severe coronary patients, such as those with left ventricle failure, diffuse and distal coronary disease and associated valvular lesion.

Coronary Disease↗

[Remembering the first successful bone marrow transplantation performed in 1977 in Novi Sad].

The author describes circumstances under which a young man with a severe idiopathic aplastic anemia, pancytopenia and hemorrhagic syndrome had undergone the first successful bone marrow transplantation performed at the Department of Haematology of the Internal Clinic in Novi Sad in 1977. As the patient did not react to the androgenic therapy and he had a healthy twin-brother with the same blood group and HLA system and MCL, differing only in Rh genotype, bone marrow transplantation was suggested. Attempted transplantation without immunosuppression and with a small number of bone marrow cells was performed in 1976 at the Military Medical Academy (MMA) in Belgrade, but it was unsuccessful. The patient suffered from a serious pancytopenia and hemorrhagic syndrome, and survived due to blood transfusions. There were 56 blood transfusions with more than 20 liters of blood. At that time bone marrow transplantations were not performed in Yugoslavia, only MMA started this method. The patient could not be transported, so the author with his associates decided to perform a new transplantation with immunosuppressive therapy with cyclophosphamide and with sufficient number of bone marrow cells, believing that it was the only chance their patient had to get better. Without special equipment, improvising a sterile room, the author performed a new transplantation. Two weeks later first signs of improvement of pancytopenia occurred, whereas after reticulocytic crisis, 45 days later, the number of blood cells reached normal values. On the occasion of examining Rh genotype of our patient it was established that, instead of previous Rh genotype inherited from his father, after retransplantation he had a new Rh phenotype acquired from his brother who inherited it from their mother. It was a proof that the transplantation was a complete success. On the occasion of 20th anniversary of that event in 1977, the whole team, which had performed the retransplantation, met their ex-patient. Today he is healthy, employed and a successful sportsman.

Bone Marrow Transplantation↗

Use of the SADS-RDC in a tri-ethnic community survey.

The Schedule for Affective Disorders and Schizophrenia and the Research Diagnostic Criteria were used to ascertain community-based rates of affective and nonaffective psychiatric disorders. Both current-point and lifetime prevalence rates were reported for a sample of whites, blacks and Mexican-Americans. Rates for whites were compared with those reported for another community sample in which the same diagnostic criteria were applied. Comparison of lifetime rates from the two studies showed good concurrence for most of the affective disorders, particularly depression. This study also examined differences in rates by ethnic status.

Adult↗