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Introduction The placement of fixed orthodontic appliances may lead to increased plaque accumulation and changes in subgingival microflora. Objective The aim of this study was to examine the changes in frequency of subgingival microflora that occur after placement and removal of fixed orthodontic appliance using polymerase chain reaction (PCR). Methods This study included 33 orthodontic patients, who were divided into two groups. Subgingival plaque samples were collected from the right upper incisor (U1) and right upper first molar (U6). In group A, the samples were taken three times: before placement appliance (T1), after one month (T2), and after 3 months (T3). In group B the samples were also taken three times: before appliance removal (T1), after one month (T2), and after three months (T3). PCR method was used to determine the presence of P. gingivalis, A. actinomycetemcomitans, T. forsythia, and P. intermedia. Results In group A the frequency of P. gingivalis showed statistically significant decrease at U1 (p=0.049) and U6 (p=0.008), from T1 to T2, and at U1 (p=0.048) from T1 to T3. In group B only the frequency of T. forsythia showed a statistically significant decrease, at U6 (T1 vs. T2, p=0.004; T1 vs. T3, p=0.0003). Regarding other analyzed bacteria, changes in the presence were noticed but no statistical significance was found. Conclusion Placement of fixed appliances may have an impact on subgingival microflora, but in the first months after the placement and removal of the appliance changes were not significant, probably due to good oral hygiene., Uvod Postavka fiksnih ortodontskih aparata može dovesti do povećanog nagomilavanja plaka i promena u subgingivalnoj mikroflori. Cilj rada Cilj ovog rada bio je da se ispitaju promene subgingivalne mikroflore nakon postavke i uklanjanja fiksnih ortodontskih aparata primenom reakcije lančanog umnožavanja molekula DNK (engl. polymerase chain reaction - PCR). Metode rada Studija je obuhvatila 33 pacijenta koja su svrstana u dve grupe (A i B). Uzorci plaka su uzeti iz subgingivalnog prostora desnog gornjeg centralnog sekutića (U1) i desnog gornjeg prvog kutnjaka (U6). U grupi A uzorci su uzimani pre postavke fiksnog aparata (T1), mesec dana posle postavke (T2) i tri meseca od postavke (T3). U grupi B uzorci su uzimani pre uklanjanja aparata (T1), mesec dana posle uklanjanja (T2) i tri meseca nakon uklanjanja (T3). Primenom metode PCR analizirano je postojanje mikroorganizama: Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia i Prevotella intermedia. Rezultati U grupi A učestalost P. gingivalis pokazala je statistički značajno smanjenje na oba zuba (U1: p=0,049; U6: p=0,008) u vremenskom intervalu od T1 do T2. Uočeno je i statistički značajno smanjenje zastupljenosti ove bakterije na zubu U1 u intervalu od T1 do T3 (p=0,048). U grupi B samo se učestalost T. forsythia statistički značajno smanjila na zubu U6 u intervalu od T1 do T2 (p=0,004) i od T1 do T3 (p=0,0003). Učestalosti ostalih bakterija u obe grupe ispitanika nisu pokazale statistički značajne promene. Zaključak Postavka fiksnih aparata može da utiče na sastav subgingivalne mikroflore, ali u prvim mesecima nakon postavke i uklanjanja aparata uglavnom nisu uočene statistički značajne promene, verovatno zbog dobre oralne higijene.

Introduction. In his work the orthopaedic surgeon deals with a large number of peripheral nerve injuries, especially of the upper extremity. Most of these injuries involve the hand (30%). Objective. The aim of the study was to analyze the influence of some factors (age, aetiology, level of injury, associated injuries) on surgical treatment outcome of digital nerve injury of the hand. Methods. At the Department for Microsurgery 72 hospitalized patients were operated on due to the injury of common palmar digital nerves and proper palmar digital nerves. All operations were performed within the first 48h after injury and primary neurosuture was done in all. Beside the evaluation of demographic parameters, we also assessed aetiology of injury, associated injuries, level of injury, as well as the vascular status of the injured finger. Functional recovery was measured by the Medical Research Council (MCR) scale (S0-S4). Results. We found a statistically significant difference in sensory recovery according to age and aetiology of injury (p

Background/Aim. Community acquired pneumonia in elderly has specific clinical aspect and higher mortality in relation to younger patients. According to specific pneumonia severity assessment on admission and its importance in proper prediction of clinical course and outcome, the aim of this study was defining prognostic factors of mortality. Methods. This study included 240 patients aged ? 65 years with community acquired pneumonia. On admission, demographic characteristics, underlying diseases, physical symptoms and findings, laboratory values, chest radiography and oxygen blood saturation (SaO2) were analyzed. Multivariate analysis was used to identify characteristic prognostic factors which showed a statistical significance in relation to mortality. Results. Altered mental status, respiratory frequency ? 23/min and the presence of bilateral pneumonic infiltrates were defined as the most important prognostic factors of mortality (p < 0.001). These factors displayed 57.89% sensitivity, 100% specificity and 93.33% accuracy. Conclusion. The presence of identified characteristic prognostic factors on admission pointed out an adverse clinical course and outcome of community acquired pneumonia in elderly. Age and sex were not significantly associated with mortality.

Introduction. The expression of CD34 antigen is increased in a substantial portion of MDS patients, particularly in high risk patients, which was associated with unfavorable survival in some studies. The aim of this study was to determine the CD34 expression in bone marrow biopsies and its prognostic significance in MDS patients and to analyze it in the context of different clinical, laboratory and prognostic parameters. Material and methods. The study was conducted in 53 MDS patients and 20 controls with normal bone marrow. The CD34 expression was determined by CD34 monoclonal antibody and labelled streptovidin biotin peroxidase method. The positivity was determined by counting the 500 cells and it was expressed as percentage. Results. Among the 53 MDS patients there were 37 males and 16 females with average age of 62. The average CD34 expression in the MDS group was 1.37%, the range being 0-8.8%, and in the control group 0.78%, the range being 0-1.60%. The difference was statistically significant (p

Background: Burnout syndrome (BOS) is caused both by psychological-emotional and physical stress. It is associated with decreased job performance and low career satisfaction. BOS has a significance influence both to physicians' performance in health care system, and in their private life. Until now, there was no data about this aspect of orthopaedic surgeon condition and health in our community. Aim: To assess the level of the burnout syndrome in orthopaedic surgeons and general practitioners (GPs), and the relations of their demographic features, job characteristics to the burnout syndrome Design: Questionnaire-based survey Methods: The sample consisted of 30 orthopaedic surgeons from the University Clinical Centre, and 40 GPs from the primary health care centres. The Burnout syndrome was measured by the Maslach Burnout Inventory (MBI). In addition to the MBI, the demographic data were collected and analyzed (age, age of practicing, gender, marital status) in relation to BOS. Results: Both groups expressed moderate to high rate of emotional exhaustion, depersonalization and low personal accomplishment. However, statistical significance between the groups had not been demonstrated. Neither gender nor years of practice or marital status did express statistically significant impact on the BOS items, i.e. they were not predictors of the BOS. Our results showed that about 70% of the physicians were emotionally exhausted considering both groups. On the other hand, orthopaedics demonstrated slightly higher depersonalisation level (55%) than GPs (38%). While GPs expressed lower personal accomplishment (48%) comparing to orthopaedics (29%). Discussion: The obtained MBI scores in this study were similar to those registered in US among residents, but when comparing to physicians in West Europe, which have similar health care system, our results demonstrated higher rates of BOS items. Conclusion: The Burnout syndrome represents an important problem for actively practicing physicians. The results of this and other similar studies should be used to evaluate medical training, practice, professional relations and introduce necessary changes.

Introduction. Ankylosing spondilitis (AS) is a disease from a group of seronegative spondyloarthropathies with the prevalence of 0.1% affecting mainly young males, which also gives sociomedical significance to the disease. Among all inflammatory arthropathies, AS is the most suitable for balneotherapy. Thermomineral water of the Niska Banja spa is homeothermic, oligomineral, alkaline, low radioactive radon water and also, in conjunction with mineral peloid, is considered to be optimal for this indication. Objective. Our aim was to investigate the effects of natural factors of the Niska Banja spa as a part of complex treatment on the indexes of mobility of the vertebral column in the patients with AS. Methods. The study enrolled 40 patients with the average age of 48.0?14.82 years and the average duration of disease of 16.9?6.42 years. Patients were treated with hydro- and peloid- otherapy during the average of 17.23?2.71 days. At the beginning and at the end of treatment, a number of indexes of spinal mobility were measured. The statistical significance of differences was calculated using the Student's t-test. Results. All of the measured indexes were better after balneotherapy reaching statistically significant differences in regard to the wall-to-occiput distance (p

Introduction Neurogenic bladder can develop as a result of various degrees of neurogenic lesion in spina bifida. The degree of bladder dysfunction depends on the level and type of spina bifida. Due to results upon complete diagnostic protocols, treatment options are applied. Objective Comparison of therapy results of patients with occult spinal dysraphism with neurogenic bladder that under-went medicamentous therapy and medicamentous with electrotherapy treatment. Methods We had 49 patients with neurogenic bladder that were treated at the University Children's Hospital in Belgrade in the period 2003-2008. The first group of children received medicamentous therapy and the second group received medicamentous therapy with transcutaneous electric nerve stimulation. In both groups we evaluated 4 symptoms: daily enuresis, enuresis nocturna, urgency and frequency and 4 urodynamic parameters: lower bladder capacity, unstable contractions and residual urine and detrusor sphincter dyssynergia. Follow-up urodynamic evaluation was done after 3, 6 and 12 months respectively. Results Our findings pointed out a high statistical significance of improvement in all evaluated urodynamic parameters of neurogenic bladder (predominantly in bladder capacity) in the group of children with combined therapy as well in resolution of symptoms (predominantly enuresis nocturna, urgency and frequency). Conclusion Combined therapy is more efficient in treatment of children with neurogenic bladder. Electrotherapy is non-invasive, easily applicable and has had a significant place in treatment of children with dysfunctional voiding.

Introduction. Human aging is characterized by progressive decrease of the homeostatic reserves of every organ system with a possible impairment of cognitive functions. The study was aimed at examing and proving the correlations between cognitive failure and somatic diseases in patients belonging to geriatric population as well as at following the efficiency of treatment of somatic diseases by Mini mental examination test score. Material and methods. A group of 100 geriatric patients did Mini mental examination test at the beginning of hospitalisation and after three weeks of treatment of different somatic diseases. The patients underwent many examination tests-biochemical analyses of blood and urin, ultrasound examination, X-ray examination of lungs and heart, hormons of thyroid gland, concentrations of B12 vitamin, folan acid. Results. The statistical study showed that there was a significant correlation between the recovery of somatic diseases and the score of cognitive functions of patients. MMSE score was significantly increased after three weeks of successful treatment of somatic diseases in hospital. Conclusion. The highest statistical significance in the difference of MMSE score at the beginning and after three weeks of hospital treatment was found in the group of patients with successful results of the treatment of their somatic diseases such as cardiomyopathies and disorders of respiratory system, such as pneumonia. MMSE score did not increase in patients chronic disease with malignant diseases of lungs or liver and chronic disease with frequent exacerbations. It was a group of patients without significant change in their somatic state.

First of all, it was pointed to the specificity of the quality of life of psychiatric patients, primarily to the fact that the very poor mental state significantly reduces the life satisfaction. Then, an overview of results of general research of quality of life among schizophrenic patients was presented, in relation to their conditions of treatment, cultural setting, influence of socio-demographic and other factors. The very research was conducted on the sample of 80 subjects treated under the diagnosis of schizophrenia at the Institute of Mental Health in Belgrade - treated as out-patients in the day-hospital. The controls were 80 healthy subjects employed with a Health-care center in Belgrade. The statistical significance calculations of differences were related to replies to the instrument's questions - the instrument being a combination of Lancashire and Manchester Questionnaire. The questions referred to 15 features, classified according to five dimensions of quality of life (physical and medical; psychological and psychopathological; economic; relational and social; and axiological and transcendental dimension), and we arrived at the following: In terms of statistical significance, schizophrenic patients, in comparison to healthy controls confirmed taking medicaments significantly more often, that is, confirmed feeling as being chronic patients, suffering due to their bad disposition, fear and having hallucinations. The schizophrenic subjects, also confirmed something very interesting - that they were satisfied with their housing conditions and income. On the other hand, healthy controls, statistically speaking, replied significantly more often that they were satisfied with their sexual relations and relations with their friends, as well as that they were significantly more satisfied with their cultural and social activities. The results of our research were also commented on in relation to the social and other factors, and were compared to the results of similar researches.

INTRODUCTION Schizophrenia patients are at greater risk of obesity, diabetes mellitus (DM), lipid abnormalities and cardiovascular disorders. The metabolic complications in patients are associated with several risk factors: family history of DM, lifestyle, smoking, dietary habits, physical inactivity, but also with antipsychotic medication. In literature, most publications have been focused on the effects of the second generation antipsychotics (SGA) on glucose metabolism. However, less attention has been paid to abnormality in glucoregulation, patients with schizophrenia treated with the first generation antipsychotics (FGA). OBJECTIVE The present study evaluated glucose metabolism in normal weight schizophrenia patients treated with FGA. METHOD The cross-sectional study included 18 patients (FGA treated) and 20 healthy controls with neither group differences in sex distribution, age, nor in BMI. Inclusion criteria were normal BMI (20-25 kg/m2). The glucose levels, insulin levels and growth hormone levels during oral glucose tolerance test (OGTT) were measured. RESULTS Fasting glucose and insulin levels did not differ significantly between groups. Groups differed in OGTT glucose and insulin peak and area under curve (AUC), level of significance p < 0.05 (patients vs. controls: glucose peak 8.3 +/- 0.4 vs. 6.9 +/- 0.5 mmol/l, glucose AUC 758 +/- 28 vs. 640 +/- 36 mU/l/120 min; insulin peak in patients 92.7 +/- 15.6 mU/l; insulin AUC 6060 +/- 1016 mU/l/120 min, insulin peak in controls 47.9 +/- 6.5 mU/l; insulin AUC 2597 +/- 256 mU/l/120 min). CONCLUSION Patients with schizophrenia, although with normal body mass index, are at high risk of abnormal glucose regulation. Not only SGA increase the risk of impaired glucoregulation and metabolic syndrome, but this may also be due to FGA or schizophrenia per se.

Background/Aim. Beside many actual groups of classification criteria, uniform classification criteria for Sj?gren?s syndrome (SS) are still missing. The ophtalmic component of SS is well defined. Criteria for classifying its oral component remain controversial. The fifth item of the European Union and the United States of America (EU-US) revised diagnostic classification criteria in 2002, is an objective evidence of xerostomia, diagnosed by one of the tests: unstimulated whole sialometry (UWS), parotid sialography, and dynamic salivary gland scintigraphy (DSGS). The aim of this study was to evaluate senstitivity, specificity, positive and negative predictive value and accuracy of DSGS with ascorbic acid stimulation in detecting xerostomia in SS patients and to compare DSGS findings with UWS values. Methods. Tests DSGS and UWS were done in 20 patients with SS and in 10 of the control subjects. The findings of DSGS were graded from 1 to 4 scintigraphie (SCT) grade 1 - normal finding; SCT grade 2 - moderate function damage; SCT grade 3 - serious function damage, SCT grade 4 - very serious function damage. UWS measured 1.5 hour after the breakfast lasted 15 minutes. UWS bellow 2.5 ml/15min min. considered pathological. Results. All SS patients had pathological SCT findings. Comparing SCT grade between the patients and the control group, high statistical significance was found (p < 0.001). The estimated sensitivity of DSGS was 100%, specificity 80%, positive predictive value 91%, negative predictive value 100% and accuracy 93%. The calculated sensitivity of UWS was 75%. Salivary function damage detected by scintigraphy was in positive correlation with UWS findings. Conclusion. DSGS is a diagnostic test with high sensitivity, specificity, accuracy and positive and negative predictive values in detecting salivary function damage in SS patients. DSGS and UWS are very sensitive diagnostic tests for objective evidence of xerostomia, and have to be ones of the earliest investigations which should be performed in subjects suspected of SS. Test DSGS is more sensitive, and seems to better reflect symptoms of dry mouth than UWS.

The majority of asthmatic patients are atopic - that is to say, they exhibit IgE-mediated sensitivity to common inhalant allergens. Exposure and sensitisation to allergens from the housedust mite has been established as an important risk factor in asthma in most parts of the world. The aim of our study was to assess total IgE and specific IgE on airborne allergens (Dermatophagoides pteronyssinus - DP, Dermatophagoides farinae - DF, mould, and grass pollen) in relation to asthma severity. The study involved 64 children with atopic asthma. Statistical significance was present between groups of intermittent and moderately persistent asthma for IgE and specific IgE on DP and moulds. In mild and moderate asthma, statistically significant differences were present for all parameters except for DF.

Haemorrhage is most important sequelae of brain cavernoma, so the surgical treatment is very important for treatment that complication. There are two types of bleeding - chronic subclinical microhaemorrhage and acute real hemorrhage. Patophisiologycal factors which are reasponsible for bleeding are not still understanding. The reason for this study is understanding of clinical curse of cavernomas and identification of factors of influence. This is retrospective and prospective study. We analyzed 36 patients with symptomatic brain cavernoma, surgically treated in Institute of neurosurgery KCS in 10 years period (1987-1997). Female were dominant but without statistical significance (p>0,05). Male patients were older (32,1:29,8), but without statistical significance (p>0,05). Almost 75% lesions were supratentorial, 25% infratentorial (p0,05). Clinical presentation according the age was not statistically significant (p>0,05). Clinical presentation was very different according the size of lesion (p

Precuneus, a quadrangular gyrus of the medial surface of the human parietal lobe, is bound by three primary brain sulci and by superior hemispheric border. Precise encephalometric data about precuneus are important in the studies of brain lateralization, sex dimorphism, and brain functions in general. In this study, total and visible (exstrasulcal) surface area of the precuneus were measured on 50 brains of the adult persons (31 male, and 29 female), together with the investigation of its relationship to the side (left/right) and gender (sex dimorphism). The average total surface area of the precuneus was 16.07 cm2 on the right (males 16.44 cm2, females 15.27 cm2), and 15.44 cm2 on the left (males 15.67 cm2, females 14.62 cm2). The average visible (extrasulcal) surface area of cortex of precuneus was 9.97 cm2 on the left (males 10.75 cm2, females 8.91 cm2), and 9.38 cm2 on the right (males 10.25 cm2, females 8.19 cm2). Exstrasulcal surface area of the left precuneus was larger, by 0.59 cm on the average, which was not statistically significant. Total surface area of precuneus of males was significantly larger on the right (16.44 cm2) (p