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Acta Medica Academica

Open Access journal
ISSN (Print) 1840-1848 - ISSN (Online) 1840-2879
Published by Academy of Sciences and Arts of Bosnia and Herzegovina

[1 journal]

Očna duplja, anatomija i neurohirurški pristup (The Orbit: Anatomy and Neurosurgical Approaches)
- Authors: Danica Grujičić
  Abstract: With increasing frequency, the orbit and adjacentareas are being exposed to deal with tumors andother lesions involving the orbit as well as intracranialstructures. Difficulties in access to the orbitresult from its relatively small volume, irregularquadrilateral pyramid shape and the fact that it isembedded in the craniofacial structures.
  
  PubDate: 2012-11-26
  Issue No: Vol. 41 (2012)
International publications of authors from Bosnia and Herzegovina in Current Contents indexed publications in 2011
- Authors: Nerma Tanović
  Abstract: International publications of authors from Bosnia andHerzegovina in Current Contents indexed publications in thefirst half of 2012
  
  PubDate: 2012-11-26
  Issue No: Vol. 41 (2012)
Ladislav Ožegović
- Authors: Lidija Lincender-Cvijetić
  Abstract: Academician Ladislav Ožegović(1921-2011)
  
  PubDate: 2012-11-26
  Issue No: Vol. 41 (2012)
Srećko Šimić
- Authors: Lidija Lincender-Cvijetić
  Abstract: Academician Srećko Šimić(1929-2011)
  
  PubDate: 2012-11-26
  Issue No: Vol. 41 (2012)
Trace elements and cell-mediated immunity in gestational and pre-gestational diabetes mellitus at third trimester of pregnancy
- Authors: Fadia Mahmoud|Habib Abul|Ali Dashti|Waleed Al-Jassar|Alexander Omu
  Abstract: Objective. The aim of the study: To evaluate the correlations betweenZn2+, Cu2+, Mg2+, Se2+ and Cr3+ and alteration in T cell subsetsduring diabetic and normal pregnancy. Methods. The study involved63 women with gestational diabetes mellitus (GD) and 16 pregnantwomen with Type 2 diabetes and 48 healthy, non-pregnant womenwere included as controls. Ten ml of whole venous blood from eachparticipant was analyzed for electrolytes by atomic absorption; totalantioxidant activity, individual enzymatic antioxidants by spectrophotometry;and lymphocyte sub-populations by flow cytometry. Results.There were significant changes in lymphocyte sub-populations: NaïveT cells were decreased and memory T-cells and activated T cells(CD4+HLA-DR+, CD4+CD29+) were increased in diabetes in pregnancy.Zn2+ and Cr3+ deficiency were observed in Type 2 diabeticswith an increase in Cu2+ in all pregnant cohorts. In healthy pregnantsubjects, CD4+-HLA-DR+ was increased in direct proportion to serumMg2+ (p<0.05) and Se2+ (p<0.01). In insulin-treated GD patients,CD4+CD29+ cells were increased proportionally to serum Zn2+(p<0.05) while in diet controlled GD cohort CD45RO+/ CD45RA+ Tcells correlated directly with serum Mg (p<0.05) and Zn2+ (p<0.01)while it correlated inversely with serum Cu2+ (p<0.01). Conclusions.The results of the present study show a correlation between trace elementdeficiency and increased lipid peroxidation in diabetes in pregnancyand lymphocyte activation. Dietary manipulation may, therefore,point to improvement in existing approaches to management ofdiabetes mellitus in pregnancy.
  
  PubDate: 2012-11-16
  Issue No: Vol. 41 (2012)
Essential guidance for psychosocial assistance in post-conflict settings: Care providers’ perspectives on suffering, healing and pressing needs in Bosnia and Cambodia
- Authors: Laura McDonald|Richard F. Mollica|Susan Douglas Kelley|Svang Tor|Majda Halilovic
  Abstract: This exploratory study aimed to obtain insight into field-level care providers’views on suffering and healing as well as existing obstacles andneeds related to providing care to their clients. This research providesa “snapshot” for a better understanding of existing care systems in twopost-conflict settings. By identifying existing approaches to care andthe needs of the care provider community, this research might be usefulin guiding psychosocial assistance programming in post-conflictsettings. Utilizing a semi-structured questionnaire, 45 care providerswere interviewed, including local health care practitioners, traditional/spiritual healers, and humanitarian relief workers, in Bosnia andHerzegovina and Cambodia. This study found that the majority ofcare providers in both settings perceived poverty and violence as significantcauses and consequences of human suffering and, at the sametime, felt ill-equipped in addressing these issues and related problems.Other issues that hindered these healers in providing care included:limited government/institutional support; lack of training; materialresources and funding. Study findings point to a new framework fordeveloping effective interventions and the need for further emphasison supporting care providers in their work, and most specifically, inidentifying and responding to poverty and violence.
  
  PubDate: 2012-11-16
  Issue No: Vol. 41 (2012)
Suicide among childhood cancer survivors in Slovenia
- Authors: Mojca Čižek Sajko|Niko Čižek|Berta Jereb
  Abstract: Objective. Suicide is one of the causes of late mortality among childhoodcancer survivors. The aim of our study was to analyse the riskof suicide among childhood cancer survivors compared with that ofthe general population of Slovenia. Patients and methods. This retrospectivestudy included patients with childhood cancer registeredat the Cancer Registry of Slovenia between 1978-2008, with an observationperiod of 1978-2010. Childhood cancer patients and controlsubjects from the general population of Slovenia were matched by sex,year and age at the beginning of follow-up and time of follow-up inyears. Data on the general population of Slovenia were obtained fromthe Statistical Office of the Republic of Slovenia. Results. A total of1647 patients were recorded in the Cancer Registry as having cancerduring childhood, with 3 patients committing suicide. All three weremale. Their age at diagnosis of cancer was 12, 13 and 2 years old; theirage at suicide was 19, 32 and 28 years old. The mechanism of deathwas asphyxiation in all three deaths. The calculation of the expectednumber of suicides in the group of individuals with childhood cancerfrom the general Slovene population revealed the number of 3.16persons. Conclusion. The comparison of the observed and expectedprobability showed that there was no statistically significant differencein the suicide rate between childhood cancer survivors and the generalpopulation of Slovenia.
  
  PubDate: 2012-11-02
  Issue No: Vol. 41 (2012)
Correlation between psychological difficulties in young adulthood and exposure to bullying behavior in childhood and adolescence
- Authors: Kristina Sesar|Marijana Barišić|Maja Pandža|Arta Dodaj
  Abstract: Objective. This study investigates the relationship between involvementin bullying in childhood and adolescence and psychological difficultiesin young adulthood. Materials and method. A total of 249college students completed the Retrospective Bullying Questionnaireand Trauma Symptom Checklist. Results. The results showed significantdifferences in psychological adjustment among respondents whowere exposed to bullying compared to respondents who were not exposedto bullying. Those exposed to bullying had significantly higherlevels of anxiety, depression, sleeping problems, and dissociative andtraumatic symptoms compared to those who were not exposed to bullying.Respondents who were exposed to bullying in all three examinedperiods (the period from the first to fourth grade, the period from thefifth to eighth grade and the high school period) had higher scoreson the subscale of dissociative symptoms and sexual trauma symptomscompared to respondents who were exposed through one or twoperiods. Victims abused in all three periods have more symptoms ofanxiety and sleeping problems compared to the subjects exposed tobullying during one examination period. There were no differences inthe level of depressive symptoms and sexual problems regarding theduration of bullying. Also, there were no differences in psychologicaladjustment between respondents who were bullied during one specificperiod. Conclusion. Bullying experiences in childhood and adolescenceare connected with difficulties in psychological adjustment inyoung adulthood.
  
  PubDate: 2012-10-15
  Issue No: Vol. 41 (2012)
Multiple pyogenic liver abscesses formed after appendectomy: The role of percutaneous drainage in critically ill patient
- Authors: Enver Zerem|Alma Sušić
  Abstract: Multiple pyogenic liver abscesses formed after appendectomy andtheir percutaneous treatment with multiple catheters have been rarelydescribed. We report a case of multiple pyogenic liver abscesses in acritically ill patient, formed after appendectomy and treated successfullyby antibiotics and drainage with six catheters that were introducedsimultaneously under ultrasound control. Even though this wasa case of liver abscess secondary to appendicitis, today very rare inWestern countries, but still a serious complication in developing countries,it was successfully resolved by percutaneous drainage, along withantibiotic therapy. Conclusion. We emphasize the advantages of percutaneoustreatment compared with surgery regarding the avoidanceof perioperative complications and the risks of general anesthesia.
  
  PubDate: 2012-10-15
  Issue No: Vol. 41 (2012)
Combined pergolide-associated valvular heart disease (PAVHD) and Achilles tendon contractures
- Authors: William D. Freeman|Peter T. Dorsher|Robert E. Safford|Jay Van Gerpen|William D. Edwards
  Abstract: A Letter to Editor
  PubDate: 2012-10-11
  Issue No: Vol. 41 (2012)
Diagnosing and treating hemophagocytic lymphohistiocytosis in the tropics: Systematic review from the Indian subcontinent
- Authors: Srinivas Rajagopala|Navneet Singh
  Abstract: Background. Hemophagocytic lymphohistiocytosis (HLH) is a catastrophicsyndrome of unrestrained immune activation. Evaluationand management of HLH in the tropics is challenging. Objectives. Toexamine the reported etiologies and management of HLH reportedfrom the sub-continent. Methods. Systematic review of all publishedcases from the Indian sub-continent. Results. We found only 156 publishedcases of HLH from the sub-continent. HLH was reported fromthe immediate perinatal period to 46 years of age. Infection-associatedHLH (IAHS) constituted 46.8% of all cases of HLH (44% and 51%in children and adults respectively). In adults, tropical infections triggered51% of these cases of IAHS. Steroids were used in 47% of childrenand 10% of adults. Etoposide and/or cyclosporine were used in8% children and 8% of adults only. Intravenous immunoglobulin wasused in another 30% of children and 4% of the adults. HLH-relatedmortality occurred in 31.8% and 28% of children and adults respectively.Conclusions. HLH is under-reported in the sub-continentand has high mortality. Cyclosporine and etoposide are seldom administeredearly despite diagnosis of HLH. Larger cohorts with IAHStriggered by tropical infections are urgently needed to understand itsnatural history and implications of this differing prescription patternon mortality.
  
  PubDate: 2012-10-04
  Issue No: Vol. 41 (2012)
Group analysis training for bosnia-herzegovina mental health professionals in the aftermath of the 1992-1995 war
- Authors: Mevludin Hasanović
  Abstract: A Letter to edito
  PubDate: 2012-09-16
  Issue No: Vol. 41 (2012)
Application of conformal radiotherapy in treatment of non-Hodgkin head and neck lymphoma
- Authors: Goran Marošević|Hasan Osmić|Semir Fazlić|Nermina Obralić
  Abstract: A male patient, aged 33, was treated at the Clinicfor Oncology, Hematology and Radiotherapy atthe University Clinical Center, Tuzla, with thediagnosis of diffuse large B-cell lymphoma. Conformalradiotherapy was conducted on the regionof the epipharynx, oropharynx and lymphnodes of the neck on both sides (1).
  
  PubDate: 2012-08-24
  Issue No: Vol. 41 (2012)
Ichthyosis vulgaris and pycnodysostosis: an unusual occurrence
- Authors: Vinayak Y. Kshirsagar|Minhajuddin Ahmed|Suhel Nagarsenkar|Kulmani Sahoo|Kuldeep B. Shah
  Abstract: Pycnodysostosis is a rare autosomal recessive disorder whose generesponsible for this phenotype (CTSK), mapped to human chromosome1q21, code for the enzyme cathepsin K, a lysosomal cysteineprotease; with an estimated incidence of 1.7 per 1 million births. Thisclinical entity includes micromelic dwarfism, increased radiologicalbone density, dysplasia of the skull, acro-osteolysis, straightening ofthe mandibular angle and in some cases, dysplasia of the acromial endof the clavicle. Oral and maxillo-facial manifestations of this diseaseare very clear. Herein we reported a case of pycnodysostosis, showingshort stature with widening of the sutures, unfused anterior andposterior fontanelles, crowding of teeth with dental caries and typicalradiological features associated with ichthyosis vulgaris and palmoplantarkeratoderma.
  
  PubDate: 2012-08-22
  Issue No: Vol. 41 (2012)
Reliability of transthoracic and transesophageal echocardiography in predicting the size of atrial septal defect
- Authors: Senka Mesihović-Dinarević|Zijo Begić|Mirza Halimić|Almira Kadić|Refet Gojak
  Abstract: Objective. To determine the reliability of transthoracic echocardiography(TTE) and transesophageal echocardiography (TEE) in predictingthe size of an atrial septal defect (ASD). Material and methods.The study included 16 patients who underwent the catheter-basedprocedures to close an atrial septal defect between February 2008 andDecember 2011 at the Paediatrics Clinic, CCU Sarajevo, after clinicaland TTE and TEE evaluation. In order to determine the assumed diameterof the balloon (A-SBD), we used the formula of quantificationA-SBD=TTE defect diameter×1:09 + 3.9 mm and A-SBD=1.1× transesophagealdiameter of ASD+2.0 mm. The ASD was examined usingthe long-axis view, the basal short-axis view, the apical four-chamberview and the subcostal view to observe its position, diameter and relationto neighbouring structures. The largest diameter was selectedas the reference diameter. Results. Of the total number of treatedpatients, 11 were female. Treatment was conducted by a foreign andlocal team of invasive cardiologists. The average age of the patientswas 8.43 years (2 -17 years). Apart from a transient disturbance ofrhythm in the youngest patients, there were no other intra and postproceduralcomplications. The obtained formulas represent “our” defaultsize of the SBD, based on measurements of TTE and TEE: A-SBD(TTE)=6.02+0.86×TTE and A-SBD (TEE)=3.93+0.86×TEE. Conclusion.ASD diameter determined by TTE and TEE can reliably determinethe appropriate size needed Amplatzer Septal Occluder device.
  
  PubDate: 2012-08-13
  Issue No: Vol. 41 (2012)
Radiological imaging of rectal cancer
- Authors: Lidija Lincender-Cvijetić|Maja Banjin-Čardžić|Sandra Vegar-Zubović|Dunja Vrcić
  Abstract: This article discusses the possibilities of diagnosing abdominal imagingin patients with rectal cancer, detecting lesions and assessing thestage of the lesions, in order to select the appropriate therapy. Beforethe introduction of imaging technologies, the diagnosis of colorectalpathology was based on conventional methods of inspecting intestineswith a barium enema, with either a single or double contrast bariumenema. Following the development of endoscopic methods and thewide use of colonoscopy, colonoscopy became the method of choicefor diagnosing colorectal diseases. The improvement of ComputerizedTomography (CT) and Magnetic Resonance Imaging (MRI), gave usnew possibilities for diagnosing colorectal cancer. For rectal cancer,trans-rectal US (TRUS) or endo-anal US (EAUS) have a significantrole. For staging rectal cancer, the Multi Slice Computed Tomography(MSCT) is not the method of choice, but Magnetic Resonance Imaging(MRI) is preferred when it comes to monitoring the rectum. Therole of the MRI in the T staging of rectal cancer is crucial in preoperativeassessment of: thickness – the width of the tumor, the extramuralinvasion, the circumference of resection margin (CRM), andthe assessment of the inclusion of mesorectal fascia. For successful executionof surgical techniques, good diagnostic imaging of the canceris necessary in order to have a low level of recurrence. According tomedical studies, the sensitivity of FDG-PET in diagnosing metastaticnodals is low, but for now it is not recommended in routine diagnosisof metastatic colorectal carcinoma.
  
  PubDate: 2012-06-11
  Issue No: Vol. 41 (2012)
The inframammary dome - a modification of the keyhole pattern for reduction mammaplasty / mastopexy
- Authors: Srdan Babovic|William D. Leighton
  Abstract: A letter
  PubDate: 2012-05-23
  Issue No: Vol. 41 (2012)
The Developmental venous anomaly associated with the cavernous malformation
- Authors: Svjetlana Mujagic|Jasmina Becirovic-Ibrišević
  Abstract: A magnetic resonance imaging (MRI) studywas ordered in a 32-year-old man with a 6month history of double vision and confirmedleft abducens nerve palsy on neurologicalexamination.
  
  PubDate: 2012-04-09
  Issue No: Vol. 41 (2012)
Periodontal disease and dental caries from Krapina neanderthal to contemporery man – skeletal studies
- Authors: Berislav Topić|Hajrija Raščić-Konjhodžić|Mojca Čižek Sajko
  Abstract: Objective. The aim of this study was the quantification of alveolarbone resorption as well as the number and percentage of teeth withdental caries. Materials and Methods. Four samples of jaws and singleteeth were studied from four time periods, i.e. from the KrapinaNeanderthals (KN) who reportedly lived over 130,000 years ago, andgroups of humans from the 1st, 10th and 20th centuries. Resorption ofthe alveolar bone of the jaws was quantified by the tooth-cervicalheight(TCH) index. Diagnosis of dental caries was made by inspectionand with a dental probe. TCH-index was calculated for a totalof 1097 teeth from 135 jaws. Decay was calculated for a total of 3579teeth. Results. Resorptive changes of the alveolar bone in KN and 1stcentury man were more pronounced on the vestibular surface thaninterdentally (p<0.05), while no significant difference could be confirmedfor 10th and 20th century man (p=0.1). The number (percentage)of decayed teeth was 0 (0%, n=281 teeth) in KN, 15 (1.7%; n=860teeth) in 1st century, 24 (3.4%; n=697 teeth) in 10th century, and 207(11.9%, n=1741 teeth) in 20th century. Conclusion. On the basis of ourresults it may be postulated that in contemporary man in relation toKN, the accumulation of plaque pathogens in the interdental space issubstantially greater than on the vestibular side. These findings havepractical, educational and preventive value for oral hygiene improvement, especially of the interdental space, which should help decreasethe prevalence of periodontal disease and dental caries, and improveoral as well as general health.
  
  PubDate: 2012-02-09
  Issue No: Vol. 41 (2012)