Browsing by Author "Durutović, Otaš (6506011266)"

Percutaneous nephrolithotomy (PCNL) is frequently used as the first-line treatment of large and complex stones. The key point for successful complex stone removal with minimal risk of complications is to establish the most appropriate access route. Understanding the three-dimensional (3D) relationship of kidney stones and renal collecting systems is crucial for planning and creating an optimal access route. By using a 3D volume segmentation tool a more accurate approach to the renal collecting system and stone treatment could be planned. The objective of this study was assessing the impact of 3D software in getting the desired access. Copyright © 2022 Durutović, Filipović, Milićević, Somani, Emiliani, Skolarikos and Janković.

Introduction/Objective Infertility is the inability to achieve pregnancy after a year or more of unpro-tected sexual intercourse. It is a clinical and social issue affecting both sexes. Infertility can cause anxiety, depression, and personal distress with long-lasting consequences. Men and women tend to cope with infertility in different ways and reliance on certain coping mechanisms can be harmful. This study aims to examine the correlative effects of infertility, distress and depression among couples, and investigate sex disparities in levels of suffering. Methods The research is a cross-sectional study that included 168 participants (84 couples) divided into two groups, control and infertility group. Beck Depression Inventory Second Edition (BDI-II) and the Brief Symptom Inventory (BSI) were used to identify and assess psychological symptoms. Statistical analysis was performed using SPSS at the 0.05 level of significance. Results The results showed that there was a significant difference in the scores on BDI and BSI scales between the infertile and fertile groups, with participants in the infertile group reporting higher levels of depression and distress (t =-2.724, df = 166, p < 0.01; t =-3.609, df = 166, p < 0.01). Women had significantly higher scores on the depression scale than men (t =-2.079, df = 166, p < 0.05). Conclusion In summary, the study found that couples dealing with infertility experience higher levels of distress and depression compared to the control group. Women in these couples are particularly vulnerable to depression. The study highlights the importance of addressing the mental health needs of individuals and couples dealing with infertility, in addition to treating the underlying medical issues. © 2023, Serbia Medical Society. All rights reserved.

Objective The aim of this study was to estimate interobserver reproducibility of Tc-99m mercaptoacetyltriglycine renography in children and adults by assessing the parameters of the International Atomic Energy Agency (IAEA) software for the analysis of dynamic renal studies. Methods The renograms of 65 children and 65 adults covered a wide age range, different quality of drainage, overall function and differential renal function (DRF). Three observers were processing parameters of the IAEA software. Normalized residual activity at 20 min (NORA20), NORA on the postmicturition acquisition (NORApm), PM to maximum renal count ratio (PM/max), output efficiency at 20 min (OE20), OE 20 min after diuretic stimulation (OEF + 20), whole kidney mean transit time (MTT) and DRF by integral and Rutland-Patlak were calculated by observers. Results The overall agreement between three observers was almost perfect [the average intraclass correlation coefficient (ICC) above 0.99] in children and adults, with no significant difference between the parameters of renal drainage, transit and DRF. ICCs for all parameters were higher than 0.980 in children under 12 months, even slightly greater for PM/max and OEF+20. In children with poor/incomplete drainage and DRF below 40%, ICCs were above 0.98. In the subgroup of adults with impaired overall tubular extraction rate, level of reproducibility was almost perfect. Slightly lower but still insignificant values of ICC were presented in adults with poor/incomplete drainage. Conclusion Our results indicate an excellent interobserver reproducibility for all quantitative parameters of IAEA software in both pediatric and adult patients. © 2020 Lippincott Williams and Wilkins. All rights reserved.

Purpose: Optimal analgesia in ambulatory urology patients still remains a challenge. The aim of this study was to examine if the pre-emptive use of intravenous tramadol can reduce pain after ureteroscopic lithotripsy in patients diagnosed with unilateral ureteral stones. Materials and Methods: This prospective pilot cohort study included 74 patients diagnosed with unilateral ureteral stones who underwent ureteroscopic lithotripsy under general anesthesia in the Urology Clinic at the Clinical Center of Serbia from March to June 2012. All patients were randomly allocated to two groups: one group (38 patients) received intravenous infusion of tramadol 100 mg in 500 mL 0.9%NaCl one hour before the procedure, while the other group (36 patients) received 500 mL 0.9%NaCl at the same time. Visual analogue scale (VAS) scores were recorded once prior to surgery and two times after the surgery (1 h and 6 h, respectively). The patients were prescribed additional postoperative analgesia (diclofenac 75 mg i.m.) when required. Pre-emptive effects of tramadol were assessed measuring pain scores, VAS1 and VAS2, intraoperative fentanyl consumption, and postoperative analgesic requirement. Results: The average VAS1 score in the tramadol group was significantly lower than that in the non-tramadol group. The difference in average VAS2 score values between the two groups was not statistically significant; however, there were more patients who experienced severe pain in the non-tramadol group (p<0.01). The number of patients that required postoperative analgesia was not statistically different between the groups. Conclusion: Pre-emptive tramadol did reduce early postoperative pain. The patients who received pre-emptive tramadol were less likely to experience severe post-operative pain. © Yonsei University College of Medicine 2014.

Background/Aim. The incidence of postoperative delirium (POD) after non-cardiac surgery is a problem not often recognized by many anesthesiologists. The objective of our study was to detect POD and its possible cause, in patients undergoing radical retropubic prostatectomy (RRP) under general anesthesia. Methods. After Ethical Committee approval, we enrolled 80 patients, ASA (the American Society of Anestesiology) status II, scheduled to undergo RRP under general anesthesia, in a prospective study. All patients completed MMSE tests (the Folstein Mini Mental State Exam) the evening before, and 48 hours after the surgery. Assessment for the presence and severity of delirium was performed using CAM (the Confusion Assessment Method), and an assessment of the degree of agitation and sedation using RASS (the Richmond Agitation and Sedation Scale). Results. The average preoperative MMSE score (28.59 ± 1.04) significantly decreased following the surgery (27.74 ± 1.52) (p < 0.0001). The average postoperative MMSE score trend descended in correlation to intraoperative bleeding (p = 0.036). The patients with higher pain scores had significant decline in MMSE after the surgery (28.75 vs. 26.25; p < 0.001). Five patients were considered positive for delirium, and four of them reported regular alcoholic drinks intake (> 1 drink per day) preoperatively (p < 0.0001). Based on RASS score, 13 patients (16.3%) were agitated or sedated, and they had statistically significantly higher intraoperative bleeding (p < 0.001). Conclusion. Results of this study emphasize the importance of proper preoperative evaluation; especially regarding the alcohol consumption since all the patients that developed POD reported moderate alcohol consumption. Furthermore, greater intraoperative bleeding and postoperative pain scores did not influence the occurrence of delirium, but resulted in lower postoperative MMSE scores, which highlights the importance of adequate intraoperative treatment of patients during surgery and anesthesia in order to reduce the risk of developing POD. © 2021 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background/Aim. Urolithiasis is one of the most common urological illnesses with a continual rise in incidence and prevalence in the population. Its pathogenesis is multifactorial; hence, its consequences are serious problems that can significantly impact the quality of life of patients. In the last years, operational modes of urolithiasis treatment had undergone evolution changes towards minimally invasive treatment techniques aimed at improving its efficacy and patients' life quality. The aim of the study was to examine and evaluate the quality of life of the patients with urolithiasis depending on the applied treatment method. Methods. This research was designed as a panel study – a combination of a cross-sectional and cohort study. The sample included patients with urolithiasis treated with extracorporeal shock wave lithotripsy (ESWL) or ureteroscopic lithotripsy (Lithoclast). The research was carried during one year period and 100 respondents met the inclusion criteria. They were divided into two equal groups considering the applied method of the stone disintegration: the Lithoclast group (URSL) and the ESWL group. The instrument used for measuring the quality of life was Short Form (SF) 36 questionnaire. It was administrated to the patients immediately before the operation and one month after the operation. Results. The statistical analysis of the scores obtained preoperationally on the SF 36 questionnaire revealed the decrease in the quality of life of patients with urolithiasis in almost all dimensions of life. The statistically relevant difference in preoperative SF scores between the two groups of patients was not established except in the domain of the role of physical health and the domain of mental health. In the domain of the role of physical health, the Lithoclast group had a statistically significant higher score than the ESWL group, but in the domain of mental health, the ESWL group had a statistically significant higher score than the Lithoclast group. The postoperative statistical analysis of SF questionnaire and the examination of the impact of the treatment mode on the quality of life showed that the use of the Lithoclast method resulted in the much higher, statistically significant score at SF36 questionnaires regarding several life dimensions than the ESWL method. The application of the ESWL method even resulted in the decrease in the postoperational score for some life dimensions. Conclusion. The assessment of the quality of life is an adequate tool for the evaluation of treatment modes in the clinical practice. By using the SF 36 questionnaire in this study, we established that the ureteroscopic lithotripsy (the Lithoclast method) is a method that postoperatively results in much higher and statistically significant improvement of the quality of life of patients with urolithiasis in several health domains than the ESWL method. © 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.