Introduction: Subarachnoid hemorrhage (SAH)represents hemorrhage in the space between arachnoidea and pia mater, due to aneurysm burst, spontaneously or as a consequence of trauma. It is condition that occurs more common in women than men, and its most common complications are rebleeding and vazospasm. As a result of vasospasm, develops ischemia in the portion of brain tissue that can cause additional neurological deficit. Transcranial Doppler Sonography (TCD) is a noninvasive ultrasound diagnostic method that allows monitoring of the state of intracerebral hemodynamics. Goal: The goal is to follow the occurrence of vasospasm after SAH, by the TCD method. Material and methods: We have analyzed 47 patients with SAH, by analyzing the presence of aneurysm, hypertension and smoking, and by the TCD method monitor the state of intracerebral hemodynamics during the first four days, then in the second and third week. Results: SAH was more common in women (61.7%) than men (38.3%), and in the age range from 22 to 64 years. Aneurism was demonstrated in 61.7% of patients, more common in women, with hypertension 68.1% also more common in women and smoking in 87.2% of patients, also more common in women. By TCD method are recorded milder, elevated blood flow velocities at a quarter of patients in the first measurement, during the second measurement at all and it had significantly greater value, and the third measurement also more increased in about a quarter of patients, so that there is a statistically significant difference in the first and second, second and third measurement for each vessel separately, but not between the first and third measurement. Conclusion: Predilection factors for SAH are aneurysms, hypertension and smoking. By using TCD method were recorded milder elevated blood flow velocity in the first days of SAH, with about a quarter of patients, significantly greater increase in blood flow velocity during the second week in all patients and also milder increase blood flow velocity in the third week of the start of SAH is a quarter of patients. TCD is the method of choice in the evaluation and management of vasospasm after SAH, which allows the prevention of delayed cerebral ischemia.
Summary The Quality of Life Enjoyment and Satisfaction Questionnaire – Short Form is the most often used scale for measuring the quality of life of patients with psychiatric diseases. The aim of this research was to analyze the possibilities for measuring the quality of life in clinical conditions on the sample of patients with schizophrenia by using this scale. The study was conducted on the group including 153 patients with schizophrenia at the Institution for Accommodation of Adults “Male Pčelice”, Kragujevac. The study was observational and cross-sectional. The reliability of questionnaire was examined by using Cronbach’s alpha. The two tests of factor analysis adequacy were used, Spherical Bartlett’s Test and Keiser-Meyer-Olkin test (sampling adequacy). Validation was performed by calculating the correlation (validation by criteria). The Quality of Life Enjoyment and Satisfaction Questionnaire – Short Form was reliable (Cronbach’s alpha coefficient was 0.730) and valid. According to Catell criterion two domains were applied. This two-component solution explained the total of 37.80% variance, whereby the contribution of the first domain was 27.1% and the second 10.7%. The Quality of Life Enjoyment and Satisfaction Questionnaire – Short Form is suitable for everyday clinical evaluation of the patients with schizophrenia.
Summary Anxiety, depression and fear in general are the most common emotional problems in people with cancer and it is necessary to recognize them. The patients’ attitude towards the side effects of chemotherapy has changed significantly in recent years and psychological effects, rather than physiological ones, are becoming increasingly important. The aim of this study was to develop and validate a reliable questionnaire that can measure cancer patients’ fear of the chemotherapy side effects (CheSeFS). A cross-sectional observational study involved 208 oncology and haematology patients at the Clinical Centre of Kragujevac, Serbia and the Institute for Oncology and Radiology of Vojvodina in Sremska Kamenica. The internal reliability of the questionnaire was estimated by calculating Cronbach's alpha coefficient, while the external reliability was calculated by the split-half method with approximately the same number of respondents. In order to test the construct validity of the CheSeFS, all participants filled out the Scale of Depression, Anxiety and Stress-21 (DASS-21) and the Short Subjective Well-being Scale (SSWS), validated in Serbian language. Cronbach’s α coefficient reveals strong internal consistency, with a value of 0.922. The questionnaire demonstrated good structure and uniformity when randomly split into two parts. Exploratory component analysis revealed two factors with the same number of items that explain 61.691% of variance. The components are objective physiological effects of the treatment, and factor that depends on the patient’s psychological and sociological status, with approximately the same percentage of variance. The CheSeFS was positively correlated with the DASS-21 scale (ϱ = 0.595, p = 0.000). CheSeFS is a unique, reliable and valid two-factor 14-item instrument, a clinically useful tool to assess fear of the chemotherapy side effects in cancer patients.
Goal: The goal of this study was the determination of the effects in treatment of early stage (<IIB) and locally advanced stages (≥IIB) of uterine cervical carcinoma by using MRI. Material and Methods: The study was a prospective, comparative, analytical, and observational and included 74 patients with cervical cancer (PH confirmed). All 74 patients have initially gone through the pre-therapeutic MRI to determine the tumour FIGO stage. At a renewal of the initial MRI findings, patients were divided into two study groups: group A and group B. Group A consisted from 39 patients with early-stage cervical carcinoma (<IIB) and group B comprised from 35 patients with locally advanced stage (≥IIB). Postterapeutic MRI control, were perfomed in both group (A and B). Further MRI examinations were set for the patients from both groups. Results: An analysis of treatment outcomes in group A showed that most patients had no local recurrence or residuum disease in 89.7%, while local recurrence was observed in only 10.3% cases. An analysis of treatment outcomes in group B showed that most patients had complete regression after local chemoradiotherapy in 68.8%, while 25.7% of patients had local progression of the disease, while the 5.7% cases recorded partial local tumour regression(p<0.05). It has been shown that a complete local regression was more frequent in the case of squamous cell carcinoma in 74.2% vs 25% in adenocarcinoma cases. Also local and partial regression was observed more frequently in the case of squamous cell carcinoma in 6.5% compared to 0% in adenocarcinoma, while progression was more common in adenocarcinoma at 75% compared to 19.4% for squamous cell (p<0.05). MRI results showed positive outcome of treatment group A and B in our study, showed a statistically significant difference in favour of group A (89.7%) compared to group B 68.8% (p<0.05). Conclusion: The results obtained from our studies show that early stage cervical cancer (<IIB) shows a better outcome in treatment of advanced stages (≥IIB). In the treatment of advanced stages (≥IIB), concomitant radio chemotherapy shows significant results in terms of complete tumour regression, especially in squamous cell type of cervical cancer.
Objective: This study objective was to evaluate interobserver agreement between individual pairs of three nuclear medicine physicians in interpretation of renal cortical scintigraphy in children with respect to the mode of acquisition (planar vs. SPECT), diagnoses and kidney site (left vs. right). Materials and Methods: Thirty children were imaged in planar and SPECT mode per protocol upon the injection of Tc-99m DMSA dose adjusted to their body weight. Patients were classified according to diagnoses into four groups. Three nuclear medicine physicians interpreted the findings blindly and independently. Renal defects were interpreted as focal and diffuse, per three renal segments. For the raters we calculated simple percentage agreement, the Cohen kappa statistic with 95% confidence intervals, and the overall kappa defining the levels of reliability as almost perfect or perfect, substantial, moderate, fair and slight agreement. Results: Interobserver agreement in planar interpretation was 77,2% (kappa=0.59; 95% confidence interval, 0.41 to 0.75) and SPECT 72,9% (kappa= 0,57; 95% confidence interval, 0,41 to 0,72). In planar interpretation, all individual pairs had moderate agreements except one that had a substantial agreement. In SPECT, all the pairs had moderate agreements except one that had an almost perfect agreement. Overall agreement per kidney site was on planar 73,4% for the left (kappa=0,54, moderate agreement), and 81,1% for the right kidney (kappa 0,63, substantial agreement). On SPECT, there was 72,2% agreement for the left (kappa=0,59, mode rate agreement), and 73,7% for the right kidney (kappa=0,54, moderate agreement). Overall agreement per diagnoses ranged from 70-88,9% on planar (kappa= -0,04 to 0,79), and 50-100% on SPECT (kappa=-0,02-1,000) indicating agreements from slight to substantial. Discussion: Our results suggest acceptable levels of interobserver agreement in all individual pairs of raters with respect to the mode of acquisition (planar vs. SPECT), diagnoses and kidney site (left vs. right). For the mode of acquisition, we would recommend hybrid imaging SPECT/CT method to be used whenever possible in the detection of renal cortical defects on Tc-99m-DMSA scintigraphy.
The OG and WC represent the crown of each athlete’s career, so it is the same with gymnasts. The aims of this study it was investigate the historical analysis of the chronological age trend of all participants of men’s artistic gymnastics who have won medals in the period between 1896 and 2016 has been made. The examinees were gymnasts who had won medals at the following competitions: Olympic Games (OG) from 1896 to 2016 (n=1177) and World Championships (WC) from 1903 to 2015 (n=1651). The oldest gymnasts are on the Rings with an average age on (OG: M = 26.48, SD = 3.85) and (WC: M = 40.23, SD = 3.50) years old, and the youngest in the same are contestants (OG: Floor = 23.09, SD = 3.88) and (WC: M = 7.86 SD = 4.02). The results of independent t test were significant difference between OG and WC on Pommel horse (PH), Rings (RI), Paralell bars (PB), All-around individual (AAI) first place and Paralell bars (PB) first place. Changes in the General Rules and Code of Points by the Fédération Internationale de Gymnastique after 1997 years the trend is a significant change only on WC but not on OG. Since artistic gymnastics becomes each Olympic cycle over more demanding in terms of complexity and difficulty value of the elements, it is expected fact that gymnasts need more time to acquire stability, experience and safety when performing such complex exercises in future.
Introduction: Patients with cerebral palsy (CP), besides the basic neurological damage, are also often undernourished. Adequate nutrition for children is very important during the period of intensive growth and development, which is of particular importance in patients with CP. Goal: To evaluate the nutritional status of patients with CP who are treated at the Pediatric Clinic, Clinical Centre of Sarajevo University and causes of malnutrition in these patients. Materials and Methods: Eighty patients with CP underwent anthropometric assessment (body weight, body height, body mass index, head circumference, subscapular skinfold thickness, triceps skinfold thickness and mid upper arm muscle circumference). Severity of CP was classified based on the Gross Motor Function Classification System (GMFCS). We compared the anthropometric parameters of our patients with normal values of healthy children, as well as with degree of motor impairment, oromotor dysfunction, feeding assistance, length of meals and daily feeding time. Results: There were significant differences in all monitored parameters in relation to normal values, with 38 (47.5%) malnourished patients in the total group, out of which 29 (63.0%) with severe motor impairment and with 9 (11.3%) obese patients in the total group. The presence of oromotor dysfunction and other monitored parameters had a significant impact on the nutritional status of these patients. Conclusion: In severely disabled patients with CP there is a risk of profound malnutrition. Early identification and treatment of these patients is very important for their growth, development and health.
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