BIOMEDICINSKA ISTRAŽIVANJA

Volume 10, No 2, December 2019.


ORIGINAL SCIENTIFIC ARTICLES

Numerical areal density of CD34 and CD117 immunoreactive hematopoietic cells in human fetal and embryonic liver

Jelena Vladičić Mašić, Ivan Nikolić, Vera Todorović, Marko Jović, Vladimir Petrović, Srdjan Mašić, Nikolina Dukić, Snežana Zečević

Biomedicinska istraživanja 2019; 10(2):111-117 doi: 10.7251/BII1902111V

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Numerical areal density of CD34 and CD117 immunoreactive hematopoietic cells in human fetal and embryonic liver

 

Jelena Vladičić Mašić1,2, Ivan Nikolić3, Vera Todorović4, Marko Jović3, Vladimir Petrović3, Srdjan Mašić2, Nikolina Dukić1,3, Snežana Zečević2


1University Hospital Foča, The Republic of Srpska, Bosnia and Herzegovina
2University of East Sarajevo, Faculty of Medicine, Foča, The Republic of Srpska, Bosnia and Herzegovina
3University of Niš, Faculty of Medicine, Department of Histology and Embryology, Niš, Serbia
4University Business Academy, Novi Sad, Faculty of Dentistry, Pančevo, Serbia

Introduction. Hematopoiesis is the process of developing blood cells and the formed elements of blood. This dynamic process occurs postnatally in the bone marrow, while the prenatal hematopoiesis is scattered over multiple localizations. It begins in the yolk sac, in the intra-embryonic islands of hematopoiesis, and continues in the liver, spleen, and bone marrow, as well as, according to new research, in the placenta. The liver, as the largest hematopoietic organ of intrauterine development, is the source of hematopoietic stem cells. The aim of the study was to identify and quantify hematopoietic cells in human fetal and embryonic liver showing the immunoreactivity of CD34 and CD117 molecules.
Methods. 5 human embryonic livers and 25 human fetal livers, 7 to 38 weeks of gestational age, were used in the study. Liver samples were routinely processed to paraffin molds. Tissue sections, 5 µm thick, were stained with hematoxylin and eosin as immunohistochemical detection of CD34 and CD117 antigens. Quantification was performed morphometrically determining numerical areal density. The Chi-square test was used in the statistical analysis.
Results. The numerical areal density of CD34 immunoreactive hematopoietic cells in the liver during the embryonic development was 0.35%: 0.30% in the first trimester (including both the embryonic and fetal period), 0.46% in the second trimester and 0.10% in the third trimester. The numerical areal densities of CD117 immunoreactive hematopoietic cells in the liver during the embryonic period were 0.28%: 0.50% in the first trimester (including both the embryonic and fetal periods), 0.11% in the second trimester and 0.09% in the third trimester.
Conclusion. Fetal and embryonic liver represents a significant source of CD34 and CD117 immunoreactive hematopoietic cells.
Keywords: hematopoiesis, stem cells, fetal liver, CD34 antigen, CD117 antigen.

Diabetic nephropathy in type 2 diabetes: the frequency and risk factors

Marijana Kovačević, Snežana Mališ, Maksim Kovačević, Verica Prodanović, Olivera Čančar, Siniša Ristić, Nenad Petković, Ljubica Djukanović

Biomedicinska istraživanja 2019; 10(2):118-127 doi:10.7251/BII1902118K

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Diabetic nephropathy in type 2 diabetes: the frequency and risk factors

Marijana Kovačević 1,2, Snežana Mališ1,2, Maksim Kovačević1,2, Verica Prodanović1,2, Olivera Čančar1,2 , Siniša Ristić1, Nenad Petković3, Ljubica Djukanović4


1University of East Sarajevo, Faculty of Medicine, Foča, The Republic of Srpska, Bosnia and Herzegovina
2University Hospital Foča, The Republic of Srpska, Bosnia and Herzegovina
3PHI “Fresenius Medical Care”, Center for Dialysis Care, The Republic of Srpska, Bosnia and Herzegovina
4University of Belgrade, Faculty of Medicine, Belgrade, Serbia

Introduction. The aim of the study was to determine the frequency and risk factors for diabetic nephropathy (DN) in patients with type 2 diabetes as well as the factors related to kidney function decrease over a three-year period.
Methods. The study involved 81 patients with type 2 diabetes, initially classified into two groups: the first group was comprised of 41 patients with DN (27 males; 62.03 ± 7.73 years) while the second one included 40 patients without DN (17 males, 61.73 ± 11.55 years). All of them were subjected to history taking, objective examination as well as laboratory examination. Based on the results of the study lasting for three years, the patients of both groups were divided into subgroups with stable kidney function and subgroups with impaired kidney function, defined as an increase in proteinuria level and/or decrease in estimated glomerular filtration rate (eGFR) by more than 25%.
Results. In both groups, high incidence rates of known risk factors for diabetes and DN were recorded at the beginning of the study. The multivariate logistic analysis identified the female sex and the duration of diabetes as significant predictors of DN. After three-year period, kidney function declined in approximately 50% of patients with and without DN. Furthermore, the values of fasting glycemia and HbA1c were statistically higher in the groups with impaired kidney function compared to the ones with stable eGFR. The linear regression analysis revealed that, during three-year period, the change in eGFR was significantly associated with patient age, the duration of diabetes, systolic blood pressure, the difference in diastolic readings and proteinuria. The change in proteinuria was strongly associated with systolic blood pressure, the difference in diastolic readings, as well as with HbA1 and eGFR at the end of the study.
Conclusion. In patients with type 2 diabetes, female sex and longer duration of diabetes were identified as significant risk factors for DN, while patient age, the duration of diabetes, elevated blood pressure and poor glucoregulation were identified as risk factors for kidney function decrease.
Keywords: diabetic nephropathy, proteinuria, glomerular filtration rate, risk factors

Detection of peripheral arterial disease in patients with type 2 diabetes mellitus in family medicine clinic

Biljana Lakić, Saša Turajlić, Verica Petrović

Biomedicinska istraživanja 2019; 10(2):128-135 doi:10.7251/BII1902128L

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Detection of peripheral arterial disease in patients with type 2 diabetes mellitus in family medicine clinic

Biljana Lakić1,2, Saša Turajlić3, Verica Petrović1,2


1Primary Healthcare Center Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
2University of Banja Luka, Faculty of Medicine, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
3Primary Healthcare Center “Dr Mladen Stojanović” Laktaši, The Republic of Srpska, Bosnia and Herzegovina

Introduction. Peripheral arterial disease (PAD) is a progressive, occlusive and atherosclerotic vascular disease and patients with type 2 diabetes mellitus (DM) are at increased risk of developing this disease. The aim of the study was to determine the frequency of PAD in patients with type 2 DM by measuring the ankle-brachial index (ABI) in the family medicine clinic.
Methods. The cross-sectional study included the patients with type 2 DM, registered at the Family Medicine Department of Primary Healthcare Center Laktaši. ABI measurement was carried out by means of the “Boso ABI Mess 100 Oscillometer” apparatus while patients were diagnosed with PAD if the ABI value was <0.9 or >1.3.
Results. The study included 178 respondents with type 2 DM, aged ≥50 years, whereby 90 of them (50.6%) were men. PAD was found in 26 (14.6%) respondents. There was a statistically significant difference in ABI (left/right leg) between the patients with PAD and the ones without it (0.82/0.84 vs. 1.04/1.05; p<0.01). The average duration of DM was longer in patients with PAD compared to those without PAD (12 vs. 8 years; p = 0.097) and the mean values of HbA1c were the same in both groups (7.7% vs. 7.9%; p = 0.634). There was no statistically significant difference in the frequency of hypertension, dyslipidaemia and obesity between the patients with and without PAD, respectively. Furthermore, the number of smokers among the patients with PAD was significantly higher (p <0.01).
Conclusion. In patients with type 2 DM, PAD prevalence was 14.6%. Diabetes lasted a bit longer in patients with PAD, and among them there were significantly more smokers compared to the group without PAD. The Edinburgh Claudication Questionnaire showed positive results in only a third of patients with PAD. Early PAD diagnosis could be established in considerably larger number of patients with type 2 DM by ABI measurement than by the use of the above-mentioned questionnaire.
Keywords: peripheral arterial disease, patient, type 2 diabetes mellitus, ankle-brachial index (ABI)

Impact of elapsed time between first symptoms and diagnosis of celiac disease on psycho-physical functioning and social life of children and adolescents

Biljana Stojanović-Jovanović, Stevan Jovanović, Biljana Vuletić

Biomedicinska istraživanja 2019; 10(2):136–143 doi:10.7251/BII1902136S

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Impact of elapsed time between first symptoms and diagnosis of celiac disease on psycho-physical functioning and social life of children and adolescents

 

Biljana Stojanović-Jovanović1, Stevan Jovanović1, Biljana Vuletić2


1Higher Education School of Professional Health Studies, Belgrade, Serbia
2University of Kragujevac, Faculty of Medical Sciences, Department of Pediatrics, Kragujevac, Serbia

Introduction. Celiac disease is an autoimmune disease resulting from an inadequate immune response to gluten in genetically predisposed individuals as a result of consuming gluten and other related proteins present in wheat, rye, barley and oats. The only cure for this specific disease is a strict, carefully controlled and lifelong gluten-free diet. The aim of the study was to evaluate whether the elapsed time between the onset of the first symptoms and the diagnosis of celiac disease affected the psycho-physical functioning and social life of children and adolescents.
Methods. The study involved 116 respondents (39 of them were males), aged 8−18 years, who were diagnosed with celiac disease. The Documentation Sheet and the Celiac-Specific Pediatric Health-Related Instrument (CDPQOL), measuring the psycho-physical functioning and social life, were used in the study.
Results. 50% of subjects, aged ≤ 2 years, were diagnosed with celiac disease. 48.28% of them were diagnosed with the disease within three months after the symptom onset. In respondents with celiac disease, aged 8−12 years, there was no statistically significant difference between the psycho-physical functioning and social life and the elapsed time between the first symptoms and the established diagnosis. In subjects aged 13−18 years, using CDPQOL, a statistically significant difference was found in the following domains: school functioning, going out and social events, self-confidence. Futhermore, there was a statistically significant difference between total CDPQOL score and the elapsed time between the first symptoms and the established diagnosis.
Conclusion. The elapsed time between the first symptoms and the established diagnosis significantly affects the psycho-physical functioning and social life of subjects aged 13−18 years, but it does not affect the psycho-physical functioning and social life of the younger respodents. This is to confirm the importance of early diagnosis and treatment initiation.
Keywords: celiac disease, children, diagnosis, psycho-physical functioning, social life

Prevalence of anemia among women of reproductive age in Republic of Srpska

Dragana Stojisavljević, Slađana Šiljak, Ljiljana Stanivuk, Jelena Niškanović, Marin Kvaternik

Biomedicinska istraživanja 2019; 10(2):144–151 doi: 10.7251/BII1902144S

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Prevalence of anemia among women of reproductive age in Republic of Srpska

Dragana Stojisavljević1,2, Sladjana Šiljak1, Ljiljana Stanivuk1,2, Jelena Niškanović1, Marin Kvaternik3


1Public Health Institute of the Republic of Srpska, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
2University of Banja Luka, Faculty of Medicine, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
3Public Health Institute of the Republic of Srpska, Regional Center Doboj, Doboj, The Republic of Srpska, Bosnia and Herzegovina

Introduction. Anemia is an important public health problem recognized worldwide either as an isolated problem or associated with other forms of malnutrition. In 2016, the prevalence of anemia in women of reproductive age was 32.0%, that is 613 milions of women, aged 15-49 years. The aim of the present study was to determine the prevalence of anemia among women of reproductive age (>15≤49 years) in the Republic of Srpska as well as to determine the correlation between dietary habits and prevalence of anemia.
Methods. The study was conducted as a cross-sectional study. The sample was designed as a two-stage stratified random sample, with census circles selected during the first stage and households in the second stage. The study included 1539 women, aged 15-49 years. For the assessment of dietary habits and basic socio-demographic characteristics of the sample, two specially created questionnaires were used. Photometer, HemoCue Hb 301/SET was used to determine the hemoglobin level from a capillary sample.
Results. The prevalence of anemia among women in reproductive age in the Republic of Srpska was 11.8%, classifying the Republic of Srpska into countries with low prevalence. There was a statistically significant difference in prevalence of anemia among women (p< 0.001), aged 36-49 years, and within Doboj and East Sarajevo Region (p = 0.002). Analyzing dietary habits, with special emphasis on intake of heme and non-heme iron foods, a statistically significant difference was found in intake of heme iron foods (p=0.009) among the women without anemia. There was a weak but statistically significant correlation between intake of iron supplement and absence of anemia (r = -0.064, p = 0.013).
Conclusion. The Republic of Srpska falls into the category of countries with low anemia prevalence but it is necessary to continue with the activities the aim of which should be dietary habit improvement among all population groups, with the special emphasis on intake of heme iron foods.
Keywords: anemia, women in reproductive age, heme and non-heme iron foods

Investigation of factors associated with symptom severity in patients
with sinonasal polyposis

Aleksandra Aleksić, Siniša Šolaja, Zorica Novaković, Nataša Guzina Golac, Vojin Vojnović, Željko Markić

Biomedicinska istraživanja 2019; 10(2):152–158 doi:10.7251/BII1902152A

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Investigation of factors associated with symptom severity in patients with sinonasal polyposis

Aleksandra Aleksić1, Siniša Šolaja2, Zorica Novaković1
Nataša Guzina Golac1, Vojin Vojnović1, Željko Markić1


1University Clinical Centre of the Republic of Srpska, ENT Clinic, Banja Luka, The Republic of Srpska,
Bosnia and Herzegovina
2The University Hospital in Foča, Department of Otolaryngology, The Republic of Srpska,
Bosnia and Herzegovina

Introduction. Chronic rhinosinusitis with sinonasal polyposis is a chronic inflammatory process of the mucous membranes of the nasal and paranasal sinuses, clinically manifested by the appearance of polyps in the nasal cavity. The presence of polyps in the nose and sinuses is the cause of the characteristic symptoms that affect the quality of life of the patient. The study investigates the correlation between endoscopic, microbiological and radiological findings and symptom severity in patients with chronic rhinosinusitis and sinonasal polyposis.
Methods. The research included 45 patients with chronic rhinosinusitis and sinonasal polyps, for whom surgery treatment was indicated after the failure of conservative therapy, and 25 healthy subjects. Intensity of symptoms in subjects was assessed by A Visual Analogue Scale. The bacteriological examination of secretion of the medial nasal corridor was carried out. Clinical and radiological assessment of the severity of the condition was done by the endoscopy and computerized tomography score (CT score).
Results. A statistically significant difference was found in symptom severity between the experimental and control groups. There was a statistically significant correlation between endoscopy score and the symptom severity (r = 0.315; p = 0.035), CT-score (r = 0.720; p < 0.001) and the presence of asthma (r = 0.335; p = 0.025). Furthermore, there was a statistically significant correlation between CT score and the presence of asthma (r = 0.419; p =0.004). By binary logistic regression, a statistically significant correlation between the endoscopy score and symptom severity (OR = 1.513; p = 0.044) was found.
Conclusion. In comparison with the objective clinical parameters, the severity of symptoms in patients with sinonasal polyposis is in a statistically significant correlation with the endoscopy score.
Keywords: chronic rhinosinusitis, sinonasal polyposis, VAS score, endoscopy score, computerized tomography score.

Measures of prevention of operative field infections caused by
vancomycin-resistant enterococci

Natalija Hadživuković, Biljana Mijović

Biomedicinska istraživanja 2019; 10(2):159–165 doi:10.7251/BII1902159H

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Measures of prevention of operative field infections caused by vancomycin-resistant enterococci

Natalija Hadživuković, Biljana Mijović


University of East Sarajevo, Faculty of Medicine, Foča, The Republic of Srpska, Bosnia and Herzegovina

Introduction. Vancomycin-resistant enterococci (VRE) represent a major healthcare problem all around the world. The most effective methods for the control and prevention of these infections, as well as the methods controlling the growth of hospital-acquired VRE, have not been established yet. The aim of this systematic review of the literature was to investigate the research papers concerned with various preventive measures against the operative field infections caused by VRE, as well as to examine the level of effectiveness of these measures in reducing the infection incidence rate.
Methods. PubMed and EBSCO databases were used in order to find the research papers concerned with the measures for preventing the transmission of VRE. The process of searching for the above-mentioned databases was ended on 8 September 2018.
Results. Using different combinations of the key words, the databases were thoroughly searched for, which led to the identification of 174 appropriate studies on the basis of the title and the abstract. After the detailed examination of the papers, based on the clearly defined criteria, 7 studies were included in the final analysis. The results showed that the VRE contamination was reduced to 70%, using the personal protective equipment such as aprons and gloves in all types of patient-centered interactions. Ecological cleaning, environmental and equipment disinfection as well as the rational use of antibiotics led to reduction in Clostridium difficile infection rates from 12% to 6.6 %, reduction in Staphylococcus aureus infection rates of 25%, while the rate of VRE bacteremia was also significantly lower. The number of patients whose isolation was required due to VRE infection was reduced.
Conclusion. The current measures recommended by the Center for Disease Control and Prevention and used to prevent the spread of VRE are effective if the existing protocols are used adequately.
Keywords: vancomycin-resistant enterococci, operative field infections, preventive measures, active control

Determination of arsenic content in tea samples available on Republic of Srpska market by atomic absorption spectrophotometry

Mirjana Djermanović, Ljubica Bojanić, Relja Suručić, Vesna Antunović

Biomedicinska istraživanja 2019; 10(2):166–171 doi:10.7251/BII1902166DJ

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Determination of arsenic content in tea samples available on Republic of Srpska market by atomic absorption spectrophotometry

Mirjana Djermanović1,2, Ljubica Bojanić1,2, Relja Suručić2, Vesna Antunović2


1Public Health Institute, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
2University of Banja Luka, Faculty of Medicine, Pharmacy Department, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina

Introduction. Arsenic exists in various forms in nature and living organisms. Toxic elements, including arsenic, which are present in some plants, can severely damage haemopoietic, immune, nervous and reproductive systems. For this reason, a content of heavy metals is one of the criteria for the assessment of the safe use of plant material in the production of traditional medicines and herbal infusions. This instigates the need for constant and organized safety control of plants that are used as raw materials in pharmaceutical industry.
The aim of this study is to determine the arsenic content in selected teas which are available on the market of the Republic of Srpska.
Methods. The 10 g samples of 13 herbal and 3 fruit teas were mineralized by dry ashing and arsenic contents were determined by the atomic absorption spectrophotometer Agilent Technologies Series 200 with an air-acetylene burner and D2 background correction.
Results. Mean arsenic concentrations in the herbal tea samples ranged from 0.009 to 0.145 mg/kg. The lowest arsenic concentration in a single sample of 0.007 mg/kg was found in Chamomile tea and Uva ursi collected as a wild plant at elevation above 1200 m. The highest arsenic concentration was found in the sample of Sambucus nigra tea (0.145 mg/kg). In fruit teas, the arsenic concentration ranged from 0.014 mg/kg (Cranberry) to 0.027 mg/kg (Fruit mix).
Conclusion. Arsenic content in all analyzed tea samples is below the value stipulated by the national legislation.
Keywords: arsenic, herbal tea, fruit tea, atomic absorption spectroscopy

 

 

SHORT COMMUNICATION

 

Functional ability of men aged 65 or more

Ilija Stijepić, Tamara Popović, Dragana Sredić Cartes

Biomedicinska istraživanja 2019; 10(2):172–178 doi:10.7251/BII1902172S

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Functional ability of men aged 65 or more

Ilija Stijepić, Tamara Popović, Dragana Sredić Cartes


Medical High School, Prijedor, The Republic of Srpska, Bosnia and Herzegovina

 

Introduction. Aging is a biological process leading to the decrease in functional ability which is defined as an ability to perform activities of daily living in a secure, independent and effective way. The aim of the study was to examine the functional ability of men aged ≥ 65 years as well as to determine the differences in functional ability in relation to the age of respondents.
Methods. The study included 120 men aged ≥ 65 years from Banja Luka and Prijedor region. The patients were divided into four groups depending on their age. The Senior Fitness Test was used for functional ability evaluation.
Results. The Senior Fitness Test showed a statistically significant difference between the group of patients aged 65-69 years and the group of respondents aged ≥80 years in all of the tests except for strength tests. The subjects aged ≥80 years had significantly poorer flexibility of the lower extremities compared to the subjects in the remaining three groups. The smallest statistical difference between the groups of different age structure was found in the parameters of upper extremity strength which progressively but negligibly declined with age. Six-minute walk test showed a statistically significant difference between the group of patients aged 65-69 years (430.42±60.94 m) and the group of respondents aged ≥80 years (370.57±76.727 m; p= 0.003).
Conclusion. Aging leads to the progressive decrease in both upper and lower extremity strength, as well as in flexibility and aerobic ability. Therefore, the lowest functional ability is found in the respondents aged ≥80 years.
Keywords: functional ability, aging, strength, flexibility, aerobic endurance

 

 

REVIEWS

 

Carcinoma of middle ear

Dragoslava Djerić

Biomedicinska istraživanja 2019; 10(2):179–187 doi:10.7251/BII1902179DJ

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Carcinoma of middle ear

Dragoslava Djerić


Academy of Medical Sciences of the Serbian Medical Society, Belgrade, Serbia
Clinical Center of Serbia, Clinic for Otorhinolaryngology and Maxillofacial Surgery, Belgrade
University of Belgrade, Faculty of Medicine, Belgrade, Serbia

Carcinoma of the middle ear is a rare otologic disease. The development of malignancy is most commonly associated with chronic inflammation of the middle ear, although the mechanisms of this development have not been clarified yet. The symptoms of the carcinoma are not always specific and the cancer is frequently diagnosed in its advanced stage. Early evidence-based diagnosis implies a thorough evaluation and identification of cancer signs and symptoms. If ear discharge is followed by an intensive pain, bleeding from the ear, occur­rence of peripheral facial nerve palsy, vertigo and hearing loss, the carcinoma is suspected, although similar clinical symptoms may be recognized in chronic otitis media as well. In addition, the characteristic signs and symptoms of carcinoma are also the following: changes in temporomandibular joint, parotid gland swelling, painless solitary mastoid swelling, neurological disorders, sudden occurrence of polyps and granulation tissue (recurrent polyps and granulation tissues after the removal), signs аnd symptoms of otogenic complications, as well as generalized weakness, weight loss and other biological disturbances. The diagnostic approach may include generally accepted recommendations and treatment protocols.
Keywords: carcinoma of the middle ear, clinical picture, diagnosis

Functional magnetic resonance imaging of kidneys

Siniša Ristić

Biomedicinska istraživanja 2019; 10(2):188–193 doi:10.7251/BII1902188R

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Functional magnetic resonance imaging of kidneys

Siniša Ristić


University of East Sarajevo, Faculty of Medicine, Foča, The Republic of Srpska, Bosnia and Herzegovina

Tendency of modern diagnostic visualization development in biomedicine is focused on the integration of detection and quantification of molecular, functional and morphological events in the biological systems. The increasing number of patients with chronic kidney disease stumulated the development of new diagnostic methods. The development of magnetic resonance technology encouraged the use of functional magnetic resonance imaging of kidneys in both scientific research and clinical practice. The paper presents the basic characteristics of the functional magnetic resonance imagining and the possibilities for its use in the examination of kidney functions.
Keywords: kidneys, magnetic resonance imagining, visualization, function, kidney disease

 

 

FOR PRACTICE

 

Inflammatory heart diseases in children

Biljana Milinković, Dejan Bokonjić, Tatjana Gavrilović Elez, Vladimir Čančar, Nada Avram

Biomedicinska istraživanja 2019; 10(2):194–201 doi:10.7251/BII1902194M

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Inflammatory heart diseases in children

Biljana Milinković1, Dejan Bokonjić2, Tatjana Gavrilović Elez1, Vladimir Čančar1, Nada Avram1


1University Hospital Foča, The Republic of Srpska, Bosnia and Herzegovina
2University of East Sarajevo, Faculty of Medicine, Foča, The Republic of Srpska, Bosnia and Herzegovina

Myocarditis is a limited or diffuse inflammation of the heart muscle, the cause of which might be infectious (viruses, bacteria, fungi, rickettsiae, parasites, protozoas) or non-infectious (systemic diseases, metabolic diseases, toxins). There are types of myocarditis the etiological factor of which cannot be determined and therefore are classified into the group of idiopathic myocarditis. The clinical picture depends on the intensity of the inflammatory process and the lesion topography, varying from a mild form of the disease to severe malignant myocarditis followed by the development of cardiac insufficiency as well as by fatal outcome within a few days. Resting is recommended as the basic method of therapy in all of the patients with suspected myocarditis. If there are signs and symptoms of cardiac insufficiency, an anticongestive therapy must be introduced (diuretics, vasodilators, digitalis). If the conventional therapy does not produce the desired results, it is necessary to introduce continuous intravenous inotropes (dobutamine or hosphodiesterase inhibitors). Rhythm disorders in patients with myocarditis require an appropriate antiarrhythmic drug therapy that should be given as soon as possible. Acute pericarditis is an inflammation of the pericardium characterized by chest pain, pericardial friction rub, and serial electrocardiogram (ECG) changes. Awareness of the disease has increased due to the introduction of noninvasive diagnostic techniques such as echocardiography, CT scanning, and cardiac magnetic resonance imaging (CMRI) . The disease can be severe and even lethal, especially in immunosuppressed children. The disease causative agent can usually be identified from the pericardial fluid by culture or more sensitive tests (e.g. polymerase chain reaction – PCR or from pericardial biopsy samples).
Keywords: myocarditis, pericarditis, cardiac insufficiency

 

Causes, classification, diagnostics and treatment of hydrocephalus

Vjeran Saratlić, Vesna Ivanišević

Biomedicinska istraživanja 2019; 10(2):202–208 doi:10.7251/BII1902202S

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Causes, classification, diagnostics and treatment of hydrocephalus

Vjeran Saratlić1, Vesna Ivanišević2


1University of East Sarajevo, Faculty of Medicine, Foča, The Republic of Srpska, Bosnia and Herzegovina
2University Clinical Center of the Republic of Srpska, Department of Neurosurgery, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina

Hydrocephalus is a hydrodynamic disorder of the cerebrospinal cortex causing an enlargement of the ventricular system and increased pressure around the brain. Hydrocephalus can be divided into congenital and acquired, and, based on occurrence mechanism, into communicative (non-obstructive) and non-communicative (obstructive which can be congenital and acquired). There is also normal-pressure hydrocephalus, hydrocephalus ex vacuo, and external hydrocephalus in newborns. In newborns and infants, the main diagnosis method is the head ultrasound, through fontanels. After fontanel closure, diagnosis is established by means of magnetic resonance imaging (MR) and computed tomography (CT). Significant domination of obstructive hydrocephalus over the other types of it has been established in a sample of patients with hydrocephalus treated at Department of Neurosurgery of the Clinical Center of Banja Luka in a two-year period.
Keywords: cerebrospinal fluid, hydrocephalus, classification, CT and MRI diagnostics, treatment