Clinical Center Vojvodina

Novi Sad, Serbia

Clinical Center Vojvodina

Novi Sad, Serbia
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Levakov I.,Clinical Center Vojvodina
Medicinski pregled | Year: 2011

The aim of this study was to show whether immunotherapy should be administered in patients with renal cell carcinoma after radical nephrectomy in N0 and N1 stage of disease. The research was conducted in 60 patients with renal adenocarcinoma after radical nephrectomy. The study group included two subgroups of patients: the treatment group consisted of 30 patients receiving immunotherapy, of whom 15 had N1 disease stage and 15 had N0 disease stage; and the observation group consisted of 30 patients who did not receive immunotherapy, of whom 15 had N1 disease stage and 15 had N0 disease stage. It was shown that the administration of immunotherapy in N0 stage neither improved the overall survival nor postponed the appearance of metastases and that immunotherapy in N1 stage even worsened the prognosis in overall survival as compared with the observation group. There is no benefit of administering immunotherapy in patients with N0 and N1 stage of disease after radical nephrectomy.

Eric M.,University of Novi Sad | Krivokuca D.,University of Novi Sad | Savovic S.,Clinical Center Vojvodina | Leksan I.,Josip Juraj Strossmayer University of Osijek | Vucinic N.,University of Novi Sad
Surgical and Radiologic Anatomy | Year: 2010

Purpose Most standard textbooks of hand surgery report on the rate of palmaris longus muscle absence of 15%. The aim of the study was to determine the absence of palmaris longus and to correlate it with age, sex and body side. Methods The study included 800 subjects (400 male and 400 female). They were initially asked to do the standard test for the assessment of the palmaris longus tendon. If the tendon was not visualized or palpable, four additional tests were done to confirm its absence. Results Unilateral absence of the palmaris longus was recorded in 173 (21.6%) and bilateral in 127 (15.9%) study subjects. According to body side, right-sided absence of palmaris longus was found in 69 (8.6%) and left-sided in 104 (13%) subjects, yielding a statistically significant difference. Bilateral absence was slightly more common in men. The prevalence of palmaris longus absence on the right and left side was similar in men, whereas in women it was significantly more common on the left side. Differences between the three age groups (young, middle-aged and old) were not significant; however, the middle-aged and young groups showed a lower rate of palmaris longus presence as compared to old-age group. Conclusions It has been suggested that this tendon is rapidly disappearing in humans. The results of our study show a relatively high incidence of tendon absence and pointed to more pronounced loss of the muscle on the left side. © Springer-Verlag 2009.

Stokic E.,Clinical Center Vojvodina | Brtka V.,Technical Faculty | Srdic B.,University of Novi Sad
Computers in Biology and Medicine | Year: 2010

This paper aims to investigate possible application of the rough set approach to table-organized data in the medical domain, which reveals some relationships among sagittal abdominal diameter, anthropometric parameters and cardiovascular risk factors. When applied to table-organized data, the methodology based on the rough set theory is capable of producing decision rules in the form of If-Then rules. Such rules are suitable for inspection, examination and further analysis. By examination of the selected 30 decision rules, sagittal abdominal diameter could point out a group of obese and preobese patients with high content of visceral fat with different combination and composition of cardiovascular risk factors. These results suggest that sagittal abdominal diameter could be a clinically useful marker for identification of risk factors, combination and structure of total cardiovascular risk by applying different rules in obese and preobese persons. © 2010 Elsevier Ltd.

Veljkovic R.,Clinical Center Vojvodina | Protic M.,Clinical Center Vojvodina | Gluhovic A.,Clinical Center Vojvodina | Potic Z.,Novi Management | And 3 more authors.
Journal of the American College of Surgeons | Year: 2010

Background: Information-based scoring systems predictive of outcomes of midline laparotomy are needed; these systems can support surgical decisions with the aim of improving patient outcomes and quality of life, and reducing the risk of secondary surgical procedures. Study Design: All study subjects were followed for a minimum of 6 months after operation. Numerous demographic, clinical, treatment, and outcomes-related perioperative factors were recorded to determine statistical association with the primary end point: incisional hernia development. The first analysis was designed to establish the statistical model (scoring system) for estimating the risk of incisional hernia within 6 months of midline laparotomy. Univariate and multivariate analyses were performed. A simple additive model was constructed using stepwise logistic and linear regression. The second part of the study analysis was validation of the scoring systems developed initially. Results: A logistic linear minimum regression model was developed based on four covariates independently predictive of incisional hernia: Body mass index (BMI) > 24.4kg/m2; fascial suture to incision ratio (SIR) < 4.2; deep surgical site, deep space, or organ infection (SSI); and time to suture removal or complete epithelialization >16 days (TIME). The hernia risk scoring system equation [p(%) = 32(SIR) + 30(SSI) + 9(TIME) + 2(BMI)] provided accurate estimates of incisional hernia according to stratified risk groups based on total score: low (0 to 5 points), 1.0%; moderate (6 to 15 points), 9.7%; increased (16 to 50 points), 30.2%; and markedly increased (>50 points), 73.1%. Conclusions: A statistically valid, straightforward, and clinically useful predictive model was developed for estimating the risk of incisional hernia within 6 months of midline laparotomy. Prospective independent validation of this model appears indicated.

Knezevic V.,Clinical Center Vojvodina | Nedic A.,Clinical Center Vojvodina
European Review for Medical and Pharmacological Sciences | Year: 2013

BACKGROUND: It is very common that the diagnosis of bipolar disorder comes with several years of delay. This premise is supported by the fact that this diagnosis is almost always set after longitudinal monitoring of symptoms and by the fact that this disorder is often unrecognized or misdiagnosed. AIM: The aim of this study was to determine the incidence of misdiagnosed bipolar disorder and to explore its influence on the further course of the disorder. PATIENTS AND METHODS: The research was provided as a naturalistic study, which included 65 bipolar patients admitted to the Hospital. We examined medical records of the first episode and five-year follow-up of the course of the disease. The average number of episodes was compared between the group with properly diagnosed first episode and the group with wrongly diagnosed first episode in the observed five-year period. T-test was used in this study, in addition to descriptive parameters, mean, median, standard deviation and coefficient of variation. RESULTS: In the sample over which the survey was conducted 52% of the first episodes of bipolar disorder were wrongly diagnosed. We found a statistically significant difference (t = 1.84; p < 0.05) in the number of episodes that followed the first episode between patients whose first episode was appropriately diagnosed and patients whose first episode has not been properly diagnosed. CONCLUSIONS: There is a high number of unrecognized and misdiagnosed bipolar disorders. Inadequate diagnosis leads to inadequate treatment of the disorder. Number of next episodes in period of follow up is statistically significantly connected with the adequacy of diagnose.

Veljko A.,Clinical Center Vojvodina
Medicinski pregled | Year: 2011

The study was aimed at evaluating the efficacy of diode laser trabeculoplsaty in lowering intraocular pressure in patients with both primary open-angle glaucoma and exfoliation glaucoma by using different size of laser spot. This six-month, unmasked, controlled, prospective study included sixty-two patients with the same number of eyes, who were divided into two groups. Trabeculoplasty was performed with 50 micron and 100 micron laser spot size in the group I and group II, respectively. Other laser parameters were the same for both groups: the wave length of 532 nm, 0.1 second single emission with the power of 600-1200 mW was applied on the 180 degrees of the trabeculum. The mean intraocular pressure decrease in the 50 micron group (group 1) on day 7 was 24% from the baseline and after six-month follow-up period the intraocular pressure decrease was 29.8% (p < 0.001). In the 100 micron group (group II), the mean intraocular pressure decrease on day 7 was 26.5% and after six months it was 39% (p < 0.001).

Avulsion fractures of the anterior inferior iliac spine are rare injuries of the pelvic ring and occur during sports activities. Hereby is presented a case of a 22-year-old professional football player who was diagnosed to have an avulsion fracture of the anterior inferior iliac spine on the right side four months after the initial injury and he was treated surgically with the excision of the avulsed fragment. The football player recovered completely and returned to his usual sports activities. Two years later, due to the pain in the hip an x-ray and MR image were made, which established the existence of crescent formation, a heterotopic bone, in the area of the anterior inferior iliac spine, which was surgically removed. Physical and medical therapy was conducted and after four months, the professional athlete was back playing football. Two years after the surgical excision of heterotopic ossification, the patient was completely asymptomatic with the same ROM without any thigh muscle hypotrophy, although isokinetic muscle testing did show some weakness of the thigh extensor muscles. An x-ray did not show any signs of heterotopic ossification.

Dysplastic nevus is a risk factor for developing skin melanoma. The aim was to analyze patients with both skin melanoma and dysplastic nevi. A 10-year retrospective analysis (1999-2009) was conducted at the Department for Plastic and Reconstructive Surgery, Clinical Centre Vojvodina. During the observed time interval, of 482 patients treated for skin melanoma, 165 (34.2%) had also dysplastic nevi. Melanoma developed more often de novo (67.9%) and 32.1% by malignant alteration. The most dominant type of melanoma was nodular one (70.3%), the most frequent depth being 3.1-4mm (40.6%). The highest incidence of melanoma (32.1%) was in patients aged from 51 to 60 years. The 5- and 10-year survival rates were 72.7% and 50.3%, respectively. Our results correspond to those found in literature except for the fact that the majority of diagnosed melanomas were of nodular type with worse prognosis.

Tomic S.,Clinical Center Vojvodina | Brkic S.,Clinical Center Vojvodina | Maric D.,Clinical Center Vojvodina | Mikic A.N.,Clinical Center Vojvodina
Archives of Medical Science | Year: 2012

Introduction: Chronic fatigue syndrome (CFS) is a widely recognized problem, characterized by prolonged, debilitating fatigue and a characteristic group of accompanying symptoms, that occurs four times more frequently in women than in men. The aim of the study was to determine the existence of oxidative stress and its possible consequences in female patients with CFS. Material and methods: Twenty-four women aged 15-45 who fulfilled the diagnostic criteria for CFS with no comorbidities were recruited and were age matched to a control group of 19 healthy women. After conducting the routine laboratory tests, levels of the lipid oxidation product malondialdehyde (MDA) and protein oxidation protein carbonyl (CO) were determined. Results: The CFS group had higher levels of triglycerides (p = 0.03), MDA (p = 0.03) and CO (p = 0.002) and lower levels of HDL cholesterol (p = 0.001) than the control group. There were no significant differences in the levels of total protein, total cholesterol or LDL cholesterol. Conclusions: The CFS group had an unfavorable lipid profile and signs of oxidative stress induced damage to lipids and proteins. These results might be indicative of early proatherogenic processes in this group of patients who are otherwise at low risk for atherosclerosis. Antioxidant treatment and life style changes are indicated for women with CFS, as well as closer observation in order to assess the degree of atherosclerosis. Copyright © 2012 Termedia & Banach.

Vukovic M.,Clinical Center Vojvodina
Medicinski pregled | Year: 2010

Multiple organ procurement is a surgical procedure by which organs of a brain dead donor are taken for transplantation. Cadaveric organ donors must be those who have suffered a sudden structural and irreversible damage of the brain or brainstem. Social and scientific aspects of organ transplantation have been widely discussed so far, whereas the religious factor, which should be also respected, has rarely been analyzed. Considering the fact that Serbia is a multicultural and multi-confessional society, opinions of all confessions practised in the Republic of Serbia should be taken into account. The Orthodox Church permits transplantation from one man to another and transplantation is strongly recommended from the standpoint of Christian morality. These attitudes are accepted and respected by the Roman Catholic Church, Reformers, Judaism and Islam as well. For the future development of organ transplantation it is necessary to have a sufficient number of organ donors. Valid and complete laws must strictly define brain death, organ donation and waiting lists. The public should be fully informed about this issue in order to build mutual confidence between the population and medical staff.

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