Browsing by Author "Starčević, Ana (49061458600)"

Introduction/Objective The objective of the paper is an analysis of clinical outcomes of non-surgical conservative and operative management of patients with posterior acetabular wall fractures. Methods We investigated 88 fractures of the acetabular joint, 31 of which were treated surgically and 57 non-surgically. Only screws or reconstruction plates and screws were used for surgical treatment and traction in patients who underwent nonsurgical treatment. The study period lasted at least three years. The measures used to assess the outcome of operative, surgical and non-operative, conservative approach were Merle d’Aubigné modified score, Harris hip score, and Matta’s radiometric criteria. Results Matta’s evaluation criteria showed an excellent score of 40.4% in conservatively treated patients; 19.4% in patients who underwent surgery; a good score of 49.1% in conservatively treated patients; and 48.4% in patients who underwent surgery. Comparation between two patient groups differently treated, by Merle d’Aubigné tool, showed excellent results for 56.1% conservatively treated patients and 25.8% in those patients who underwent surgery, and good results in 29.8% conservatively treated patients and 38.7% in patients who underwent surgery. Harris hip score (excellent results were showed in 54.4% for non-operative-treated patients) also showed statistical significance, p < 0.005. Conclusion Proper diagnostics and a proper definitive diagnosis can help avoid surgical treatment if the fracture cannot be treated surgically, making the postoperative period more comfortable for the patient. © 2023, Serbia Medical Society. All rights reserved.

Background: Studies imposing rigorous control over lifetime alcohol intake usually have not found smaller hippocampal volumes in persons with posttraumatic stress disorder (PTSD). Since the majority of negative studies have used adolescent samples, it has been suggested that chronicity is a necessary condition for such findings. We have hypothesized that the volumes of hippocampus, amygdale, prefrontal cortex and the intracranial volume are reduced in the patients with PTSD and excessive alcohol intake. Subjects and methods: Study has been carried out on 54 therapy naive PTSD suffering subjects and healthy controls, divided in two groups: 29 with PTSD and consequent alcoholism, 25 with PTSD but without problems of excessive alcohol intake, and 25 healthy volunteers. All of the patients underwent same magnetic resonance imaging (MRI) protocol and volumetric evaluation of the region of interest. Results: Only hippocampal volume appeared to be significantly reduced in patients with PTSD and alcoholism. Other differences in the volumes obtained remained to be insignificant. Conclusion: Alcohol intake definitely worsens the deterioration of the hippocampal formation in PTSD suffering patients. Nevertheless, other structures of interest for this study did not manifest any kind of statistical differences in volumetric analysis. © Medicinska naklada.

Introduction/Objective During the past 20 years, there have been numerous attempts to design and apply a simple, affordable blood analysis tool for diagnostic and prognostic purposes in psychiatry. In this article we demonstrate that some mathematical parameters of chromatin organization and distribution in blood neutrophil granulocytes are related to stress levels in patients diagnosed with recurrent depressive disorder (RDD). Methods The study was performed on 50 RDD participants who were asked to complete Depression, Anxiety and Stress Scales (DASS-21). Peripheral blood samples were obtained from all the participants, smeared on glass slides and stained using a modification of Giemsa method. A total of 500 representative chromatin structures (10 per patient) of neutrophil granulocytes were evaluated using textural analysis with the application of gray level co-occurrence matrix (GLCM) method. Parameters such as angular second moment (indicator of textural uniformity), inverse difference moment (textural homogeneity), and textural sum variance were calculated. Results The results indicate that there is a statistically highly significant correlation (p < 0.01) between certain chromatin GLCM parameters such as inverse difference moment, and DASS-21 stress score. There was also a significant difference (p < 0.05) in some chromatin GLCM parameters in patients diagnosed with RDD with psychotic features, when compared to the ones without psychosis. Conclusion These findings suggest that in the future, chromatin GLCM features might have a certain predictive value for some clinical features of recurrent depressive disorder. © 2019, Serbia Medical Society. All rights reserved.

Introduction/Objective This research aims to evaluate the impact of chronic stress on behavioral effects of ketamine, which are still not sufficiently clear. Methods Wistar male rats aged five weeks were used in the experiment. The animals were divided into two equal groups: control and experimental. After being exposed to a chronic unpredictable stress paradigm for 42 days, experimental rats received a single injection of ketamine (10 mg/kg; day 45) as did the control group. The impact of ketamine was assessed using behavioral tests, spontaneous coordinate activity, and water maze tests for the evaluation of short-term memory. Results The experimental group rats showed less spontaneous motoric activity than before ketamine application. Statistical significance was shown in gaining weight after time of ketamine application in the control group, as well as in the experimental group, where they showed weight loss during stress paradigm and then increased their weight after ketamine application. There was no statistical significance in speed measurements in either group, showing no effects on short-term memory behavior. Conclusion These findings show that ketamine in a single subanesthetic dose has antidepressant and anxiolytic-like effects in male rats exposed to chronic unpredictable stress paradigm. © 2021, Serbia Medical Society. All rights reserved.

Introduction/Objective The objective was to explore whether there is a difference in headache manifestation and level of its intensity in patients with functional dyspepsia and irritable bowel syndrome. Methods We assessed a cohort of 420 participants out of which 300 satisfied the recruiting criterion of the presence of irritable bowel syndrome (148) or functional dyspepsia (152). Diagnoses of irritable bowel syndrome and functional dyspepsia were made according to Rome IV criteria. Intensity of headaches was estimated in irritable bowel syndrome and functional dyspepsia participants using visual analog scale. All the patients underwent subsequent testing by Hamilton’s Depression Inventory and anxiety scale. Results Our results showed that males with headaches are more susceptible to functional dyspepsia, statistical significance in the group of patients with irritable bowel syndrome with high scores on the visual analog scales, in relation to Hamilton’s anxiety scores in the group of patients with irritable bowel syndrome. Gender and visual analogue scale scores were determinants to show whether the patient falls within the group of functional dyspepsia or irritable bowel syndrome. Scores of visual analogue scale where the patient felt the best was statistically borderline (p = 0.061) and its higher values pinpointed which of those patients fall into irritable bowel syndrome group. Conclusion Gender and level of headache intensity as a extraintestinal manifestation showed to be the main variables to make a difference between patients with functional dyspepsia and irritable bowel syndrome where irritable bowel syndrome had higher scores and greater dominance in differential diagnosis if the headache was determining variable. © 2023, Serbia Medical Society. All rights reserved.

Background/Aim. The key to successful anterior cruciate ligament reconstruction lies in the proper positioning of the femoral tunnel within the anatomical footprint and in pro-viding for an adequate length of this tunnel without perfora-tion to the lateral cortex. The aim of this study was to de-termine the change in the length of the femoral tunnel drilled during anatomic anterior cruciate ligament (ACL) re-construction, depending on: the position of the limb being operated on, the degree of knee flexion, as well as the angle between the drill and the medial aspect of the lateral con-dyle. Methods. This study was performed on 16 cadaveric knees (6 male and 10 female) of the average age of 83. After the subcutaneous tissue was dissected, the femoral insertion of the ACL was identified. Then, 18 tunnels were drilled through the center of the femoral insertion with the help of 2 mm thick Kirschner wires. This was performed in two stages. In the first phase the leg was positioned on an ar-throscopic leg holder, while in the second phase the leg was positioned on the table. In each phase the knee was placed in three different flexion positions (110°, 120° and 130°) and for each position three tunnels were drilled (70°, 60° and 50°) in relation to the medial aspect of the lateral con-dyle. Results. The average length of the femoral tunnel drilled with the leg positioned on the operating table (36.6 ± 4.7 mm) was highly statistically significantly greater (p = 0.000) in comparison with the length of the femoral tunnel obtained by positioning the leg on a fixed arthro-scopic leg holder (35.4±4.3 mm). The greatest lengths of the femoral tunnel were obtain with the leg flexed at 130º and the reamer positioned at 50º angle in relation to the medial aspect of the lateral condyle (43 mm on the operat-ing table and 41 mm on a fixed leg holder), while the short-est tunnel (33 mm on the operating table and 31 mm on a fixed leg holder) was obtained with the lower leg flexed at 110º and the reamer positioned at a 70º angle. Conclusion. The optimal position of the leg on a fixed leg holder for ob-taining a femoral tunnel of sufficient length requires lower leg flexion of 120º and the position of the medial portal which enables the positioning of the reamer at a 60º angle in relation to the medial aspect of the lateral condyle. With the leg positioned on the operating table, it becomes unneces-sary to push the leg into flexion greater than 110º; rather a longer femoral tunnel is achieved by lateralization of the medial portal. © 2018, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.

Background & Aims: Non-alcoholic fatty liver disease (NAFLD) is a metabolic disease with extensive multi-organ involvement, whose extra-hepatic manifestations include diabetes mellitus type 2, cardiovascular disease, obstructive sleep apnea (OSA), chronic kidney disease, and polycystic ovary syndrome. Our hypothesis was that there was a strong psychological component in NAFLD and OSA suffering patients and that psychotherapy would be helpful in the treatment of the mentioned diseases. Methods: Of 144 initially selected patients (with NAFLD, obesity and OSA), 32 patients agreed to undergo psychotherapy, and 31 therapy-naive NAFLD and OSA patients agreed to participate as controls. Results: Psychological evaluation revealed that self-esteem rose significantly after one-year psychotherapy (p=0.005). Body mass index (BMI) was significantly lower after psychotherapy, followed by the changes in laboratory results. Binomial logistic regression revealed that the reduction of BMI in high probability led to self-esteem improvement (p=0.03). Conclusions: Psychotherapy was an efficient supporting method in the treatment of patients with NAFLD, obesity and OSA. It raised self-esteem and stimulated the motivation for further treatment of obesity, as one of the important factors for NAFLD and OSA. Still, it is advisable to use psychotherapy in combination with other clinical methods of treatment. © 2021, Romanian Society of Gastroenterology. All rights reserved.

The concept of diversity, equity, inclusion and belonging is essential for research and academic programs and institutions worldwide, but although women do not lag behind men at entry and graduation from Serbian universities, equitable leadership does and it further hinders outcomes in every way: from translational science via healthcare up to legislative efforts to protect children, women and elderly. Although all these may seem as l’art-pour-l’art issues when compared to mere survival in war zones on two continents and all issues women face under circumstances of displacement and bans on rights to education, healthcare and sounds of their own voices in public, still it is the ongoing fight for rights lost in silence and where one least expects it that has to push every human being to fight for the oppressed and underprivileged. © 2024, Serbia Medical Society. All rights reserved.