Objectives: The aim of our study was to evaluate distribution and influence of selective risk fac... more Objectives: The aim of our study was to evaluate distribution and influence of selective risk factors for a fever onset as an early complication in patients who suffered the acute ischemic stroke. Methods: The study included 106 patients who suffered acute ischemic stroke. Patients were divided into two groups: group with fever and group without fever. Further parameters were evaluated: age, gender, presence of hypertension, presence of previous stroke, systolic and diastolic blood pressures at admission, glycemia levels, hematocrit levels, erythrocyte sedimentation rate, cholesterol and triglycerides levels, distribution of different stroke types according to Bamford classification, and degree of functional disability according to NIH stroke scale –NINDS. Results: There is statistically significant difference in distribution of patients with previous stroke event (p=0.043) and different stroke types according to Bamford clinical classification (p=0.000) between evaluated groups reg...
OBJECTIVES: The present study examined the association between carotid atherosclerosis, coronary ... more OBJECTIVES: The present study examined the association between carotid atherosclerosis, coronary atherosclerosis and common carotid artery intima-media thickness (CCA-IMT) in patients with incident ischemic stroke and its subtypes (75 cases and 21 controls). METHODS: Cases with ischemic brain infarctions (IBIs) were consecutively recruited and classified into subtypes by computed tomography and Bamford's classification (the size and site of the infarct) as one of the following: total anterior circulation infarcts (TACIs); partial anterior circulation infarcts (PACIs); posterior circulation infarcts (POCIs); and lacunar infarcts. Controls were recruited among individuals hospitalized for a reason other than cerebrovascular disease at the same institutions and matched for age and sex. Patients and controls underwent B-mode ultrasonographic measurements of CCA-IMT, and were evaluated by a qualified internist and neurologist for the presence of ischemic coronary disease and a history of previous stroke or transient ischemic attack. RESULTS: Of the 75 patients with an acute ischemic stroke, 10 (14%) were classified as TACIs, 34 (45%) as PACIs, 12 (16%) as POCIs and 19 (25%) as lacunar infarcts. Mean CCA-IMT was higher in patients (1.03±0.18 mm) than in controls (0.85±0.18 mm; P<0.0001). The history of cerebrovascular disease was much lower in the patients with POCI and TACI, and the prevalence of ischemic cardiac disease was in the range of 20% in patients with TACIs to more than 40% in patients with PACIs. CONCLUSIONS: An increased CCA-IMT as a marker of general atherosclerosis was associated with IBI and reflects cardiovascular risk. Carotid and coronary atherosclerosis were positively correlated with IBIs, with significant differences across the subtypes.
Common carotid artery intima-media thickness (CCA-IMT) measurements are widely used to study athe... more Common carotid artery intima-media thickness (CCA-IMT) measurements are widely used to study atherosclerosis. CCA-IMT is a useful outcome measure in clinical studies and intervention trials because it reflects early stages of atherosclerosis and cardiovascular risk. The present study examined the relationship between common carotid artery intima-media thickness and ischemic brain infarction. The present study examined the association between CCA-IMT and incidence of ischemic stroke and its subtypes in 75 cases and 21 controls. Cases with internal borderzone infarction (IBI) were consecutively recruited and classified into subtypes using CT and Bamford&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s classification. It classifies cerebral infarctions regarding vascular territory using clinical features to determine the size and site of infarction. These subtypes included: total anterior circulation infarctions (TACIs), partial anterior circulation infarctions (PACIs), posterior circulation infarctions (POCIs), and lacunar infarctions (LACIs). Controls were recruited among individuals hospitalized at the same institution and matched for age and sex. Patients and control subjects underwent B-mode ultrasonographic measurements of IMT of the far wall of both common carotid arteries. Of 75 patients with acute ischemic stroke, 10 (14%) were classified as TACIs, 34 (45%) had PACIs, 12 (16%) had POCIs and 19 (25%) had LACIs. Mean CCA-IMT was higher in investigation group (1.03+/-0.18 mm) than in controls (0.85+/-0.18 mm; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001). The difference in CCA-IMT between investigation group and controls was significant and the relation between CCA-IMT and IBI remained unchanged after adjustments of main cardiovascular risk factors. Regarding the subtypes of IBI, IMT values were significantly higher in patients with TACIs and PACIs versus those with LACIs and POCIs. An increased CCA-IMT was established in all subtypes of IBI and was significantly higher in those with anterior circulation infarctions versus posterior circulation and lacunar infarctions. This study points to importance of noninvasive measurement of CCA-IMT with ultrasonographic techniques as a diagnostic tool for selecting patients at high risk for IBI and identifying different subtypes of ischemic stroke.
Serbian Journal of Experimental and Clinical Research, 2012
Locked-in syndrome (LIS) is a rare condition characterised by quadriplegia and anarthria and is u... more Locked-in syndrome (LIS) is a rare condition characterised by quadriplegia and anarthria and is usually caused by a bilateral ventral ischemic pontine lesion. Patients are normally fully conscious, but their only mode of communication is with vertical eye movements and/or blinking. Although the mortality rate is high, it has been shown that patients can survive for a significant period of time. Once an LIS patient becomes medically stable, given appropriate medical care, his or her life expectancy may be several decades. LIS patients may suffer appreciably if they are treated by hospital staff as nonresponsive. Medical professionals and lay people often assume that the quality of life of an LIS patient is so poor that it is not worth living. However, the reported overall quality of life of LIS patients is not significantly different from that of healthy subjects. In this case report, we describe a 60-year-old retired man living in a locked-in state due to a brainstem infarct. His personal account vividly reveals his inner thoughts, a great deal of suffering, and his ability to cope with his condition throughout seven years of illness. LIS patients' early referral to specialist rehabilitation services and strong social support from family greatly improves LIS patients'their quality of life. Even limited physical recovery can improve quality of life and enable LIS patients to become active members of society and return to living with family.
Background/Aim. Restless legs syndrome (RLS) is a sensorymotor disorder and the core feature of t... more Background/Aim. Restless legs syndrome (RLS) is a sensorymotor disorder and the core feature of this syndrome is a distressing, irresistible need or urge to move the legs. RLS is one of the most troublesome conditions experienced by endstage renal disease patients treated with regular hemodialysis, and is significantly associated with their increased mortality. The aim of this study was to assess the prevalence of RLS in the patients with end-stage renal failure in the three dialysis centers in central Serbia, and to investigate the association of the syndrome with clinical characteristics and biochemical variables. Methods. A cross-sectional multicentric study in which 166 consecutive hemodialysis patients were evaluated using a standard questionnaire based on diagnostic criteria elaborated by the International Restless Legs Syndrome Study Group was performed. All patients were reinterviewed and clinically examined by a qualified neurologist. The data on the patients with and witho...
Introduction: In the literature the best results for pediatric supracondylar humerus fractures ha... more Introduction: In the literature the best results for pediatric supracondylar humerus fractures have been achieved by closed reduction and wire fixation. However, in these reports the patient group of open reduction and pinning contained the patients who had had previous ineffective closed reduction trials. This retrospective study compared open and closed reduction with pinning, in which the first group of patients was all consecutively treated with open reduction. Materials and methods: The study included 99 children with displaced extension-type supracondylar fractures of humerus who had complete follow-up. Open reduction patients had not had a previous attempted closed reduction. Open reduction and pinning were performed through a posteromedial incision in the first 44 patients and closed reduction and pinning in the subsequent 55 patients. Mean duration surgery was 15 h with open reduction and 17 h with closed reduction. Mean follow up was 35 months with the open reduction and 21 months with closed reduction. Humeral-ulnar angle was compared to the contralateral elbow, clinical flexion deficiency and extension lag, and complications were evaluated. Results: At the latest follow-up the open group had an average of 5.1°valgus change and the closed group 3.6°valgus change in humeral-ulnar angle compared to their uninvolved elbow. Average flexion deficiency was 8.61°in the open and 5.25°in the closed group. Average extension lag was 6.23°in the open and 0.6°in the closed group. Functional results were satisfactory in 71% of patients in the open and 93% of those in the closed reduction group. Cosmetic results were satisfactory in 95% of both groups. Conclusions: Closed reduction and pinning is superior to open reduction and pinning for the treatment of pediatric supracondylar humerus fractures. In the case of technical insufficiencies open reduction and pinning through a posteromedial incision is an alternative treatment for decreasing the surgical time and complications. Complications was not caused in either group by the delayed surgical timing compared to reports in the literature.
Headache is among most frequently encountered neurological symptom during hemodialysis (HD), but ... more Headache is among most frequently encountered neurological symptom during hemodialysis (HD), but still under investigated in peritoneal dialysis (PD) patients. The aim of this study was to assess the incidence and clinical characteristics of dialysis headache (DH) in HD and PD patients. A total of 409 patients (91 on PD and 318 on HD) were interviewed using a structured questionnaire, designed according to the diagnostic criteria of the International Headache Classification of Headache Disorders from 2004. Patients with DH underwent a thorough neurological examination. DH was reported by 21 (6.6%) HD patients and 0 PD patients. PD patients had significantly lower serum sodium, potassium, calcium, phosphate, urea and creatinine, calcium-phosphate product, and diastolic blood pressure than HD patients. HD patients had significantly lower hemoglobin compared to PD patients. Primary renal disease was mostly parenchymal in HD patients, and vascular in PD patients. DH appeared more frequently in men, mostly during the third hour of HD. It lasted less than four hours, was bilateral, non-pulsating and without associated symptoms. Biochemical alterations may be implicated in the pathophysiology of DH. Specific features of DH might contribute to better understanding of this secondary headache disorder.
Connection between oxidative stress and clinical outcome in acute ischemic stroke (AIS) has been ... more Connection between oxidative stress and clinical outcome in acute ischemic stroke (AIS) has been poorly investigated. This study was aimed to assess redox state (through measurement of oxidative stress markers) of patients with acute ischemic stroke during different stages of follow-up period, and to find association between values of mentioned markers and clinical outcome. The investigation was conducted on 60 patients (both sexes, aged 75.90 ± 7.37 years) who were recruited in intensive care units at the Special Hospital for Cerebrovascular Diseases ''Sveti Sava,'' Belgrade. After verification of AIS, patients were followed up in four interval of time: (1) at admission, (2) within 24 h after AIS, (3) within 72 h after AIS, and (4) 7 days after AIS. At these points of time, blood samples were taken for determination of oxidative stress parameters [index of lipid peroxidation (measured as TBARS), nitric oxide (NO) in the form of nitrite (NO À 2 ), superoxide anion radical (O À 2 ), hydrogen peroxide (H 2 O 2 )], and enzymes of antioxidant defense system [superoxide dismutase (SOD) and catalase (CAT)] using spectrophotometer. Present study provides new insights into redox homeostasis during ischemic stroke which may be of interest in elucidation of molecular mechanisms involved in this life-threatening condition. Particular contribution of obtained results could be examination of connection between redox disruption and clinical outcome in these patients. In that sense, our finding have pointed out that O À 2 and NO can serve as the most relevant adjuvant biomarkers to monitor disease progression and evaluate therapies.
The present study examined the association between carotid atherosclerosis, coronary atherosclero... more The present study examined the association between carotid atherosclerosis, coronary atherosclerosis and common carotid artery intima-media thickness (CCA-IMT) in patients with incident ischemic stroke and its subtypes (75 cases and 21 controls). Cases with ischemic brain infarctions (IBIs) were consecutively recruited and classified into subtypes by computed tomography and Bamford's classification (the size and site of the infarct) as one of the following: total anterior circulation infarcts (TACIs); partial anterior circulation infarcts (PACIs); posterior circulation infarcts (POCIs); and lacunar infarcts. Controls were recruited among individuals hospitalized for a reason other than cerebrovascular disease at the same institutions and matched for age and sex. Patients and controls underwent B-mode ultrasonographic measurements of CCA-IMT, and were evaluated by a qualified internist and neurologist for the presence of ischemic coronary disease and a history of previous stroke ...
Coffee drinking is the main source of caffeine intake among adult population in the western world... more Coffee drinking is the main source of caffeine intake among adult population in the western world. It has been reported that low to moderate caffeine intake has beneficial effect on alertness and cognitive functions in healthy subjects. The aim of this study is to evaluate the impact of habitual coffee consumption on cognitive function in hemodialysis patients. In a cross-sectional study, 86 patients from a single-dialysis centre underwent assessment by the Montreal Cognitive Assessment tool and evaluation for symptoms of fatigue, mood, and sleep disorders by well-validated questionnaires. The habitual coffee use and the average daily caffeine intake were estimated by participants&amp;amp;amp;amp;amp;amp;#39; response to a dietary questionnaire. Sixty-seven subjects (78%) consumed black coffee daily, mostly in low to moderate dose. Cognitive impairment was found in three-quarters of tested patients. Normal mental performance was more often in habitual coffee users (25% versus 16%). Regular coffee drinkers achieved higher mean scores on all tested cognitive domains, but a significant positive correlation was found only for items that measure attention and concentration (P = 0.024). Moderate caffeine intake by habitual coffee consumption could have beneficial impact on cognitive function in hemodialysis patients due to selective enhancement of attention and vigilance.
Caffeine is the most widely used psychoactive substance, and caffeinated beverages enjoy immense ... more Caffeine is the most widely used psychoactive substance, and caffeinated beverages enjoy immense popularity around the world. Temporal abstinence from caffeine in habitual users results in the well-characterized withdrawal syndrome, consisting mainly of headache, ...
Headache is among most frequently encountered neurological symptom during hemodialysis (HD), but ... more Headache is among most frequently encountered neurological symptom during hemodialysis (HD), but still under investigated in peritoneal dialysis (PD) patients. The aim of this study was to assess the incidence and clinical characteristics of dialysis headache (DH) in HD and PD patients. A total of 409 patients (91 on PD and 318 on HD) were interviewed using a structured questionnaire, designed according to the diagnostic criteria of the International Headache Classification of Headache Disorders from 2004. Patients with DH underwent a thorough neurological examination. DH was reported by 21 (6.6%) HD patients and 0 PD patients. PD patients had significantly lower serum sodium, potassium, calcium, phosphate, urea and creatinine, calcium-phosphate product, and diastolic blood pressure than HD patients. HD patients had significantly lower hemoglobin compared to PD patients. Primary renal disease was mostly parenchymal in HD patients, and vascular in PD patients. DH appeared more frequently in men, mostly during the third hour of HD. It lasted less than four hours, was bilateral, non-pulsating and without associated symptoms. Biochemical alterations may be implicated in the pathophysiology of DH. Specific features of DH might contribute to better understanding of this secondary headache disorder.
Locked-in syndrome (LIS) is a condition characterized by quadriplegia and anarthria. The most com... more Locked-in syndrome (LIS) is a condition characterized by quadriplegia and anarthria. The most common cause is a ventral pontine lesion due to atherosclerotic basilar artery disease. Cases with LIS were prospectively identified among the patients with acute ischemic stroke over 3 years, between 2009 and 2011. Clinical characteristics, topographic localization of lesions, and outcome were determined during the first 6 months from onset of LIS. Our case series consists of 20 patients (mean age 62 ± 10 years; range 46-82). Initially 16 patients had a reduced level of consciousness (mean 3 days; range 1-15). Respiratory disturbance, mainly as impairment of the breathing pattern, was noted in all cases. Five patients died within the first 10 days due to stroke progression or cardiac arrest. In the remaining cases the most frequent causes of death were pulmonary infections and sepsis. Overall mortality in the acute phase of LIS is 75%, and the median survival time is 42 days. There was a statistically significant association between the more extensive parenchymal brain stem lesions and observed mortality. Ischemic LIS is commonly caused by an acute complete occlusion of the basilar artery due to atherosclerotic lesions in intracranial vertebrobasilar vessels. Mortality remains high in the acute phase of the disease.
... De mo graf ski i kli niè ki na la zi su sliè ni re zul ta ti ma dru gih auto ra u ma lo broj ... more ... De mo graf ski i kli niè ki na la zi su sliè ni re zul ta ti ma dru gih auto ra u ma lo broj nim stu di ja ma. To kom is tra i va wa ni smo us pe li da ot-kri je mo ja san pro vo ka tiv ni fak tor ko ji iza zi va na-sta nak HDG, kao ni zna èaj nu raz li ku u kli niè kim od-li ka ma i bi o he mij ...
Objectives: The aim of our study was to evaluate distribution and influence of selective risk fac... more Objectives: The aim of our study was to evaluate distribution and influence of selective risk factors for a fever onset as an early complication in patients who suffered the acute ischemic stroke. Methods: The study included 106 patients who suffered acute ischemic stroke. Patients were divided into two groups: group with fever and group without fever. Further parameters were evaluated: age, gender, presence of hypertension, presence of previous stroke, systolic and diastolic blood pressures at admission, glycemia levels, hematocrit levels, erythrocyte sedimentation rate, cholesterol and triglycerides levels, distribution of different stroke types according to Bamford classification, and degree of functional disability according to NIH stroke scale –NINDS. Results: There is statistically significant difference in distribution of patients with previous stroke event (p=0.043) and different stroke types according to Bamford clinical classification (p=0.000) between evaluated groups reg...
OBJECTIVES: The present study examined the association between carotid atherosclerosis, coronary ... more OBJECTIVES: The present study examined the association between carotid atherosclerosis, coronary atherosclerosis and common carotid artery intima-media thickness (CCA-IMT) in patients with incident ischemic stroke and its subtypes (75 cases and 21 controls). METHODS: Cases with ischemic brain infarctions (IBIs) were consecutively recruited and classified into subtypes by computed tomography and Bamford's classification (the size and site of the infarct) as one of the following: total anterior circulation infarcts (TACIs); partial anterior circulation infarcts (PACIs); posterior circulation infarcts (POCIs); and lacunar infarcts. Controls were recruited among individuals hospitalized for a reason other than cerebrovascular disease at the same institutions and matched for age and sex. Patients and controls underwent B-mode ultrasonographic measurements of CCA-IMT, and were evaluated by a qualified internist and neurologist for the presence of ischemic coronary disease and a history of previous stroke or transient ischemic attack. RESULTS: Of the 75 patients with an acute ischemic stroke, 10 (14%) were classified as TACIs, 34 (45%) as PACIs, 12 (16%) as POCIs and 19 (25%) as lacunar infarcts. Mean CCA-IMT was higher in patients (1.03±0.18 mm) than in controls (0.85±0.18 mm; P<0.0001). The history of cerebrovascular disease was much lower in the patients with POCI and TACI, and the prevalence of ischemic cardiac disease was in the range of 20% in patients with TACIs to more than 40% in patients with PACIs. CONCLUSIONS: An increased CCA-IMT as a marker of general atherosclerosis was associated with IBI and reflects cardiovascular risk. Carotid and coronary atherosclerosis were positively correlated with IBIs, with significant differences across the subtypes.
Common carotid artery intima-media thickness (CCA-IMT) measurements are widely used to study athe... more Common carotid artery intima-media thickness (CCA-IMT) measurements are widely used to study atherosclerosis. CCA-IMT is a useful outcome measure in clinical studies and intervention trials because it reflects early stages of atherosclerosis and cardiovascular risk. The present study examined the relationship between common carotid artery intima-media thickness and ischemic brain infarction. The present study examined the association between CCA-IMT and incidence of ischemic stroke and its subtypes in 75 cases and 21 controls. Cases with internal borderzone infarction (IBI) were consecutively recruited and classified into subtypes using CT and Bamford&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s classification. It classifies cerebral infarctions regarding vascular territory using clinical features to determine the size and site of infarction. These subtypes included: total anterior circulation infarctions (TACIs), partial anterior circulation infarctions (PACIs), posterior circulation infarctions (POCIs), and lacunar infarctions (LACIs). Controls were recruited among individuals hospitalized at the same institution and matched for age and sex. Patients and control subjects underwent B-mode ultrasonographic measurements of IMT of the far wall of both common carotid arteries. Of 75 patients with acute ischemic stroke, 10 (14%) were classified as TACIs, 34 (45%) had PACIs, 12 (16%) had POCIs and 19 (25%) had LACIs. Mean CCA-IMT was higher in investigation group (1.03+/-0.18 mm) than in controls (0.85+/-0.18 mm; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001). The difference in CCA-IMT between investigation group and controls was significant and the relation between CCA-IMT and IBI remained unchanged after adjustments of main cardiovascular risk factors. Regarding the subtypes of IBI, IMT values were significantly higher in patients with TACIs and PACIs versus those with LACIs and POCIs. An increased CCA-IMT was established in all subtypes of IBI and was significantly higher in those with anterior circulation infarctions versus posterior circulation and lacunar infarctions. This study points to importance of noninvasive measurement of CCA-IMT with ultrasonographic techniques as a diagnostic tool for selecting patients at high risk for IBI and identifying different subtypes of ischemic stroke.
Serbian Journal of Experimental and Clinical Research, 2012
Locked-in syndrome (LIS) is a rare condition characterised by quadriplegia and anarthria and is u... more Locked-in syndrome (LIS) is a rare condition characterised by quadriplegia and anarthria and is usually caused by a bilateral ventral ischemic pontine lesion. Patients are normally fully conscious, but their only mode of communication is with vertical eye movements and/or blinking. Although the mortality rate is high, it has been shown that patients can survive for a significant period of time. Once an LIS patient becomes medically stable, given appropriate medical care, his or her life expectancy may be several decades. LIS patients may suffer appreciably if they are treated by hospital staff as nonresponsive. Medical professionals and lay people often assume that the quality of life of an LIS patient is so poor that it is not worth living. However, the reported overall quality of life of LIS patients is not significantly different from that of healthy subjects. In this case report, we describe a 60-year-old retired man living in a locked-in state due to a brainstem infarct. His personal account vividly reveals his inner thoughts, a great deal of suffering, and his ability to cope with his condition throughout seven years of illness. LIS patients' early referral to specialist rehabilitation services and strong social support from family greatly improves LIS patients'their quality of life. Even limited physical recovery can improve quality of life and enable LIS patients to become active members of society and return to living with family.
Background/Aim. Restless legs syndrome (RLS) is a sensorymotor disorder and the core feature of t... more Background/Aim. Restless legs syndrome (RLS) is a sensorymotor disorder and the core feature of this syndrome is a distressing, irresistible need or urge to move the legs. RLS is one of the most troublesome conditions experienced by endstage renal disease patients treated with regular hemodialysis, and is significantly associated with their increased mortality. The aim of this study was to assess the prevalence of RLS in the patients with end-stage renal failure in the three dialysis centers in central Serbia, and to investigate the association of the syndrome with clinical characteristics and biochemical variables. Methods. A cross-sectional multicentric study in which 166 consecutive hemodialysis patients were evaluated using a standard questionnaire based on diagnostic criteria elaborated by the International Restless Legs Syndrome Study Group was performed. All patients were reinterviewed and clinically examined by a qualified neurologist. The data on the patients with and witho...
Introduction: In the literature the best results for pediatric supracondylar humerus fractures ha... more Introduction: In the literature the best results for pediatric supracondylar humerus fractures have been achieved by closed reduction and wire fixation. However, in these reports the patient group of open reduction and pinning contained the patients who had had previous ineffective closed reduction trials. This retrospective study compared open and closed reduction with pinning, in which the first group of patients was all consecutively treated with open reduction. Materials and methods: The study included 99 children with displaced extension-type supracondylar fractures of humerus who had complete follow-up. Open reduction patients had not had a previous attempted closed reduction. Open reduction and pinning were performed through a posteromedial incision in the first 44 patients and closed reduction and pinning in the subsequent 55 patients. Mean duration surgery was 15 h with open reduction and 17 h with closed reduction. Mean follow up was 35 months with the open reduction and 21 months with closed reduction. Humeral-ulnar angle was compared to the contralateral elbow, clinical flexion deficiency and extension lag, and complications were evaluated. Results: At the latest follow-up the open group had an average of 5.1°valgus change and the closed group 3.6°valgus change in humeral-ulnar angle compared to their uninvolved elbow. Average flexion deficiency was 8.61°in the open and 5.25°in the closed group. Average extension lag was 6.23°in the open and 0.6°in the closed group. Functional results were satisfactory in 71% of patients in the open and 93% of those in the closed reduction group. Cosmetic results were satisfactory in 95% of both groups. Conclusions: Closed reduction and pinning is superior to open reduction and pinning for the treatment of pediatric supracondylar humerus fractures. In the case of technical insufficiencies open reduction and pinning through a posteromedial incision is an alternative treatment for decreasing the surgical time and complications. Complications was not caused in either group by the delayed surgical timing compared to reports in the literature.
Headache is among most frequently encountered neurological symptom during hemodialysis (HD), but ... more Headache is among most frequently encountered neurological symptom during hemodialysis (HD), but still under investigated in peritoneal dialysis (PD) patients. The aim of this study was to assess the incidence and clinical characteristics of dialysis headache (DH) in HD and PD patients. A total of 409 patients (91 on PD and 318 on HD) were interviewed using a structured questionnaire, designed according to the diagnostic criteria of the International Headache Classification of Headache Disorders from 2004. Patients with DH underwent a thorough neurological examination. DH was reported by 21 (6.6%) HD patients and 0 PD patients. PD patients had significantly lower serum sodium, potassium, calcium, phosphate, urea and creatinine, calcium-phosphate product, and diastolic blood pressure than HD patients. HD patients had significantly lower hemoglobin compared to PD patients. Primary renal disease was mostly parenchymal in HD patients, and vascular in PD patients. DH appeared more frequently in men, mostly during the third hour of HD. It lasted less than four hours, was bilateral, non-pulsating and without associated symptoms. Biochemical alterations may be implicated in the pathophysiology of DH. Specific features of DH might contribute to better understanding of this secondary headache disorder.
Connection between oxidative stress and clinical outcome in acute ischemic stroke (AIS) has been ... more Connection between oxidative stress and clinical outcome in acute ischemic stroke (AIS) has been poorly investigated. This study was aimed to assess redox state (through measurement of oxidative stress markers) of patients with acute ischemic stroke during different stages of follow-up period, and to find association between values of mentioned markers and clinical outcome. The investigation was conducted on 60 patients (both sexes, aged 75.90 ± 7.37 years) who were recruited in intensive care units at the Special Hospital for Cerebrovascular Diseases ''Sveti Sava,'' Belgrade. After verification of AIS, patients were followed up in four interval of time: (1) at admission, (2) within 24 h after AIS, (3) within 72 h after AIS, and (4) 7 days after AIS. At these points of time, blood samples were taken for determination of oxidative stress parameters [index of lipid peroxidation (measured as TBARS), nitric oxide (NO) in the form of nitrite (NO À 2 ), superoxide anion radical (O À 2 ), hydrogen peroxide (H 2 O 2 )], and enzymes of antioxidant defense system [superoxide dismutase (SOD) and catalase (CAT)] using spectrophotometer. Present study provides new insights into redox homeostasis during ischemic stroke which may be of interest in elucidation of molecular mechanisms involved in this life-threatening condition. Particular contribution of obtained results could be examination of connection between redox disruption and clinical outcome in these patients. In that sense, our finding have pointed out that O À 2 and NO can serve as the most relevant adjuvant biomarkers to monitor disease progression and evaluate therapies.
The present study examined the association between carotid atherosclerosis, coronary atherosclero... more The present study examined the association between carotid atherosclerosis, coronary atherosclerosis and common carotid artery intima-media thickness (CCA-IMT) in patients with incident ischemic stroke and its subtypes (75 cases and 21 controls). Cases with ischemic brain infarctions (IBIs) were consecutively recruited and classified into subtypes by computed tomography and Bamford's classification (the size and site of the infarct) as one of the following: total anterior circulation infarcts (TACIs); partial anterior circulation infarcts (PACIs); posterior circulation infarcts (POCIs); and lacunar infarcts. Controls were recruited among individuals hospitalized for a reason other than cerebrovascular disease at the same institutions and matched for age and sex. Patients and controls underwent B-mode ultrasonographic measurements of CCA-IMT, and were evaluated by a qualified internist and neurologist for the presence of ischemic coronary disease and a history of previous stroke ...
Coffee drinking is the main source of caffeine intake among adult population in the western world... more Coffee drinking is the main source of caffeine intake among adult population in the western world. It has been reported that low to moderate caffeine intake has beneficial effect on alertness and cognitive functions in healthy subjects. The aim of this study is to evaluate the impact of habitual coffee consumption on cognitive function in hemodialysis patients. In a cross-sectional study, 86 patients from a single-dialysis centre underwent assessment by the Montreal Cognitive Assessment tool and evaluation for symptoms of fatigue, mood, and sleep disorders by well-validated questionnaires. The habitual coffee use and the average daily caffeine intake were estimated by participants&amp;amp;amp;amp;amp;amp;#39; response to a dietary questionnaire. Sixty-seven subjects (78%) consumed black coffee daily, mostly in low to moderate dose. Cognitive impairment was found in three-quarters of tested patients. Normal mental performance was more often in habitual coffee users (25% versus 16%). Regular coffee drinkers achieved higher mean scores on all tested cognitive domains, but a significant positive correlation was found only for items that measure attention and concentration (P = 0.024). Moderate caffeine intake by habitual coffee consumption could have beneficial impact on cognitive function in hemodialysis patients due to selective enhancement of attention and vigilance.
Caffeine is the most widely used psychoactive substance, and caffeinated beverages enjoy immense ... more Caffeine is the most widely used psychoactive substance, and caffeinated beverages enjoy immense popularity around the world. Temporal abstinence from caffeine in habitual users results in the well-characterized withdrawal syndrome, consisting mainly of headache, ...
Headache is among most frequently encountered neurological symptom during hemodialysis (HD), but ... more Headache is among most frequently encountered neurological symptom during hemodialysis (HD), but still under investigated in peritoneal dialysis (PD) patients. The aim of this study was to assess the incidence and clinical characteristics of dialysis headache (DH) in HD and PD patients. A total of 409 patients (91 on PD and 318 on HD) were interviewed using a structured questionnaire, designed according to the diagnostic criteria of the International Headache Classification of Headache Disorders from 2004. Patients with DH underwent a thorough neurological examination. DH was reported by 21 (6.6%) HD patients and 0 PD patients. PD patients had significantly lower serum sodium, potassium, calcium, phosphate, urea and creatinine, calcium-phosphate product, and diastolic blood pressure than HD patients. HD patients had significantly lower hemoglobin compared to PD patients. Primary renal disease was mostly parenchymal in HD patients, and vascular in PD patients. DH appeared more frequently in men, mostly during the third hour of HD. It lasted less than four hours, was bilateral, non-pulsating and without associated symptoms. Biochemical alterations may be implicated in the pathophysiology of DH. Specific features of DH might contribute to better understanding of this secondary headache disorder.
Locked-in syndrome (LIS) is a condition characterized by quadriplegia and anarthria. The most com... more Locked-in syndrome (LIS) is a condition characterized by quadriplegia and anarthria. The most common cause is a ventral pontine lesion due to atherosclerotic basilar artery disease. Cases with LIS were prospectively identified among the patients with acute ischemic stroke over 3 years, between 2009 and 2011. Clinical characteristics, topographic localization of lesions, and outcome were determined during the first 6 months from onset of LIS. Our case series consists of 20 patients (mean age 62 ± 10 years; range 46-82). Initially 16 patients had a reduced level of consciousness (mean 3 days; range 1-15). Respiratory disturbance, mainly as impairment of the breathing pattern, was noted in all cases. Five patients died within the first 10 days due to stroke progression or cardiac arrest. In the remaining cases the most frequent causes of death were pulmonary infections and sepsis. Overall mortality in the acute phase of LIS is 75%, and the median survival time is 42 days. There was a statistically significant association between the more extensive parenchymal brain stem lesions and observed mortality. Ischemic LIS is commonly caused by an acute complete occlusion of the basilar artery due to atherosclerotic lesions in intracranial vertebrobasilar vessels. Mortality remains high in the acute phase of the disease.
... De mo graf ski i kli niè ki na la zi su sliè ni re zul ta ti ma dru gih auto ra u ma lo broj ... more ... De mo graf ski i kli niè ki na la zi su sliè ni re zul ta ti ma dru gih auto ra u ma lo broj nim stu di ja ma. To kom is tra i va wa ni smo us pe li da ot-kri je mo ja san pro vo ka tiv ni fak tor ko ji iza zi va na-sta nak HDG, kao ni zna èaj nu raz li ku u kli niè kim od-li ka ma i bi o he mij ...
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