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1.
J Appl Biomed ; 21(3): 113-120, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37747311

RESUMO

PURPOSE: This study investigated EEG alpha rhythm spectral power in children with Specific Language Impairment (SLI) and compared it to typically developing children to better understand the electrophysiological characteristics of this disorder. Specifically, we explored resting-state EEG, because there are studies that point to it being linked to speech and language development. METHODS: EEG recordings of 30 children diagnosed with specific language impairment and 30 typically developing children, aged 4.0-6.11 years, were carried out under eyes closed and eyes open conditions. Differences in alpha rhythm spectral power in relation to brain topography and experimental conditions were calculated. RESULTS: In the eyes closed condition, alpha rhythm spectral power was statistically significantly lower in children with specific language impairment in the left temporal (T5) and occipital electrodes (O1, O2) than in typically developing children. In the eyes open condition, children with SLI showed significantly lower alpha rhythm spectral power in the left temporal (T3, T5), parietal (P3, Pz), and occipital electrodes (O1, O2). There were no statistically significant differences between the groups in relation to the relative change (the difference between average alpha rhythm spectral power during eyes closed condition and average alpha rhythm spectral power during eyes open condition divided by average alpha rhythm spectral power during eyes closed condition) in the alpha rhythm spectral power between the conditions. CONCLUSION: Lower alpha rhythm spectral power in the left temporal, left, midline parietal, and occipital brain regions could be a valuable electrophysiological marker in children with SLI. Further investigation is needed to examine the connection between EEG alpha spectral power and general processing and memory deficits in patients with SLI.


Assuntos
Ritmo alfa , Transtorno Específico de Linguagem , Humanos , Criança , Ritmo alfa/fisiologia , Estudos Transversais , Eletroencefalografia , Encéfalo/fisiologia
2.
Medicina (Kaunas) ; 58(11)2022 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-36363488

RESUMO

Background and Objectives: The aim of this study was to validate the Serbian version of the Boston Carpal Tunnel Questionnaire (BCTQ) and to evaluate temporal stability for the purpose of its implementation in the evaluation of Serbian patients with carpal tunnel syndrome (CTS). Materials and Methods: For the validation of the Serbian version of the BCTQ (BCTQSR), we tested 69 individuals with diagnosed CTS that were referred for a conservative treatment at the Institute for Rehabilitation. Neurophysiological tests were used for the electrophysiological grading (EG) of CTS severity in the study sample. The final version of the BCTQSR was given to the tested participants from the study on two occasions: test and retest, with a five-day period between the two measurements. Results: The mean value for the symptom severity subscale (SSS) of the BCTQSR was 3.01 ± 0.94; for the functional status subscale (FSS) of the BCTQSR it was 2.85 ± 1.00. Cronbach's α for the SSS was 0.91 and 0.93 for the FSS. The intraclass correlation coefficients (ICCs) concerning the test−retest were significant (p < 0.001) and were 0.949 for the SSS and 0.959 for the FSS. Those with a higher EG grade had higher values of the SSS and FSS but without a statistical significance (p = 0.103 and p = 0.053, respectively). The intercorrelation of the BCTQSR subscales (SSS and FSS) on the test was significant (p < 0.001) with a correlation coefficient equal to 0.777. Conclusion: The Serbian version of the BCTQ (BCTQSR) was successfully culturally adopted. The BCTQSR was a valid and reliable instrument for the measurement of symptom severity and functional status in adults with CTS. Therefore, it can be used in clinical practice for patients with CTS.


Assuntos
Síndrome do Túnel Carpal , Adulto , Humanos , Síndrome do Túnel Carpal/diagnóstico , Reprodutibilidade dos Testes , Sérvia , Inquéritos e Questionários , Extremidade Superior
3.
Medicina (Kaunas) ; 58(6)2022 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-35744070

RESUMO

Background and objectives: Pediatric Outcome Data Collection Instrument (PODCI) is among the most described scales developed to evaluate the physical status of children and adolescents with various musculoskeletal disorders. We aimed to translate PODCI from English to Serbian, culturally adopt items and domains, evaluate the temporal stability, internal consistency and the test−retest reliability of PODCISR in children with obstetrical brachial plexus lesion (OBPL), and finally, to test the construct validity of PODCISR against muscular manual test (MMT) Materials and Methods: The study included 48 eligible participants aged between 2 and 10 years with OBPL. The MMT was used to test the construct validity. Results: There were no significant differences (p > 0.05) between test and retest for all PODCISR domains. Correlations for all tested domains with MMT were statistically significant except for biceps muscle and domains II and IV. Cronbach's alpha value of the Global Functioning Scale was good and equaled 0.838 for test and 0.832 for retest session. Cronbach's α was more than 0.600 for all PODCISR domains except for Domain II and for Domain IV. The observed Test−Retest ICC for all PODCISR domains scores ranged from 0.899 to 0.996. Conclusion: The Serbian version of PODCI (PODCISR) was successfully translated and transculturally adopted. It has satisfactory temporal stability, construct validity and test−retest reliability as well as relevant internal consistency.


Assuntos
Paralisia do Plexo Braquial Neonatal , Adolescente , Criança , Pré-Escolar , Humanos , Psicometria , Reprodutibilidade dos Testes , Sérvia , Inquéritos e Questionários , Tradução
4.
Int J Mol Sci ; 22(9)2021 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-34063061

RESUMO

Diabetic neuropathy (DN), the most common chronic and progressive complication of diabetes mellitus (DM), strongly affects patients' quality of life. DN could be present as peripheral, autonomous or, clinically also relevant, uremic neuropathy. The etiopathogenesis of DN is multifactorial, and genetic components play a role both in its occurrence and clinical course. A number of gene polymorphisms in candidate genes have been assessed as susceptibility factors for DN, and most of them are linked to mechanisms such as reactive oxygen species production, neurovascular impairments and modified protein glycosylation, as well as immunomodulation and inflammation. Different epigenomic mechanisms such as DNA methylation, histone modifications and non-coding RNA action have been studied in DN, which also underline the importance of "metabolic memory" in DN appearance and progression. In this review, we summarize most of the relevant data in the field of genetics and epigenomics of DN, hoping they will become significant for diagnosis, therapy and prevention of DN.


Assuntos
Neuropatias Diabéticas/genética , Epigênese Genética , Epigenômica , Animais , Neuropatias Diabéticas/patologia , Neuropatias Diabéticas/fisiopatologia , Neuropatias Diabéticas/terapia , Predisposição Genética para Doença , Humanos , Inflamação/patologia , Sistema Nervoso Periférico/patologia , Sistema Nervoso Periférico/fisiopatologia
5.
Healthcare (Basel) ; 8(4)2020 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-33327581

RESUMO

Planning and adjusting health capacities to meet the needs of refugees is a constant issue for transit and destination countries following the 2015/2016 Western Balkans refugee crisis. Understanding this crisis is important for taking the right steps in the future. The study informs about the prediction of the refugees' health needs and demands for services in correspondence to political decision-making during 2015/2016 Western Balkan Refugee Crisis. Time series analysis, linear regression, and correlation analyses modelled the weekly flux of arrivals of more than half a million refugees to Serbia and the European Union, changes in the utilization of health care services, and disease diagnoses. With strategic planning, in the event of a recurrence of the refugee crises, the demand for health care services in the transit country could increase by 63 (95% CI: 21-105) for every additional 1000 refugees.

6.
Foods ; 9(11)2020 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-33120944

RESUMO

The aim of this paper was to analyze the main factors that affect green consumers' choice regarding the purchase of organic agriculture products. The data collected through a survey of 559 green consumers were analyzed using explanatory factor analysis, the Relative Importance Index, and logistic regression. The results point out eleven main factors related to the offerings on the organic agriculture market that predominantly drive green consumers' purchasing decisions. The Relative Importance Index identified health benefits that stem from a specific way of production as the main purchasing motive. This was also confirmed by the results of logistic regression, which showed that a respondent who buys organic agricultural products on a daily basis is approximately 71.5% less likely to disagree with the claim that organic products are healthier than non-organic, compared to a consumer who purchases organic products several times a week or month. However, as these benefits cannot be empirically confirmed, green consumers look for official labels on the product packaging. In order to assure the product quality, more than half of them find out very important information about producers: whether they have a product quality certificate (69.5%), how many years they are engaged in production (56.2%), and whether they have specific product packaging (54.9%). The Relative Importance Index also revealed that the main purchasing barriers that consumers face are scarce offerings and an insufficient development of the distribution channel, which were ranked in first and second place. The price as a barrier is of less importance. About 30.8% of the respondents are willing to pay up to 20% higher prices for organic food compared to conventional food, while 39.4% of them would pay even up to 40% higher prices. Based on the given results, there are clear suggestions for creating a sustainable marketing strategy for organic agriculture products as the main prerequisite for an increase of healthy food choices and fostering the future development of organic agriculture businesses at the local and global levels.

7.
Children (Basel) ; 7(3)2020 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-32131387

RESUMO

Our study aimed to analyze the reliability, consistency, and temporal stability of the Alberta Infant Motor Scale (AIMS) in Serbian infants. Additionally, we aimed to present a percentile distribution of AIMS in the tested population. The prospective study included 60 infants that were divided into three age groups: 0-3 months, 4-7 months, and 8-14 months. The Serbian version of AIMS was tested by two raters on two different occasions (test/retest) with a five day period between tests. The observed inter-rater reliability (intraclass correlation coefficient (ICC)) was more than 0.75 for all AIMS scores, except for standing (ICC 0.655 = moderate) in the age group of 4-7 months on retest between raters. The observed intra-rater reliability (ICC) was more than 0.75 for all AIMS scores except standing (ICC 0.655 = moderate) in the age group 4-7 months in test-retest for Rater One, and for sitting (ICC 0.671 = moderate) and standing (ICC 0.725 = moderate) in the age group between 0-3 months on test-retest for Rater Two. The Serbian version of AIMS was shown to have high consistency and high reliability with good to high temporal stability. Thus, it can be used in the evaluation of infants' motor development in Serbia.

8.
Healthcare (Basel) ; 8(1)2020 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-32214024

RESUMO

AIMS: In this study we analyzed the degree of genetic homozygosity among spina bifida patients with different degrees of neurogenic lesion (N = 82), as well as their clinical and neurological characteristics, compared to healthy control individuals (N = 100). METHODS: According to clinical and electromyographic findings, we separately assessed the type of neurogenic lesion (paresis or paralysis). Regarding the degree of neurogenic lesion, patients were classified into three groups: mild, moderate and severe. We analyzed six muscles. For assessing the degree of individual genetic homozygosity, we tested the presence and distribution of 15 homozygous recessive characteristics (HRC). RESULTS: The predominant type of neurogenic lesion was paresis. Every third evaluated muscle was affected in the group with mild neurogenic lesion, while more than half were affected in the group with severe neurogenic lesion. The average values of HRCs among different groups of patients and the control showed the population-genetic differences that exist among them (control HRC/15=3.0±0.2; mild HRC/15=3.6±0.2; moderate HRC/15=4.8±0.3; severe neurogenic lesion HRC/15=5.0±0.3). CONCLUSIONS: Spina bifida patients have a significant increase of recessive homozygosity and a decreased variability compared to the control group. As neurogenic lesions are more severe, more affected muscles are present, as well as the increase of individual recessive homozygosity.

9.
Foods ; 9(3)2020 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-32121318

RESUMO

Considering the benefits of the organic production system, it is recognized as one of the main drivers of future economic development. However, the imbalance between demand and supply at the local market level represents one of the serious obstacles that prevents its future growth. Therefore, this article examines the key factors related to the main elements of the offer that have the strongest impact on consumer preferences and acceptance of organic food products. In that sense, organic product, price, distribution channel, and promotion are considered the main elements of the offer and are analyzed in this paper from the consumer preferences perspective. Further, this article provides insight into some of the sensory properties of the offer that are important to consumers. Finally, it gives recommendations for optimization of the offer on the organic food market based on the analysis of the influence of each of those elements (product, price, distribution, and promotion) on consumer acceptance of organic products and making purchasing decisions. The data were collected using a questionnaire, and analyzed using the structural equation model (SEM). The results revealed that price and promotion have the strongest impact on consumer acceptance and buying decisions. Further analysis revealed that attitudes towards organic food products, price/quality ratio, distribution barriers, and modern media as a promotion instrument are the factors that have the most significant impact on consumer perception and attitudes towards the available market offer. These findings can help producers and other decision makers to better understand what creates added value of the organic food products in consumers' mind and therefore make an offer that is in line with their expectations and preferences, which is recognized as one of the main prerequisites for the acceptance and purchase of organic food products.

10.
Brain Sci ; 9(6)2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31197109

RESUMO

The aim of our study was to evaluate the role of morphogenetic variability in functional outcome of patients with ischemic stroke. The prospective study included 140 patients with acute ischemic stroke, all of whom were tested upon: admission; discharge; one month post-discharge; and three months post-discharge. The age was analyzed, as well. The Functional Independence Measure (FIM) test and the Barthel Index (BI) were used for the evaluation of functional outcomes for the eligible participants. We analyzed the presence of 19 homozygous recessive characteristics (HRC) in the studied individuals. There was a significant change in FIM values at discharge (p = 0.033) and in BI values upon admission (p = 0.012) with regards to the presence of different HRCs. Age significantly negatively correlated for the FIM score and BI values at discharge for the group with 5 HRCs (p < 0.05), while for BI only, negative significant correlation was noticed for the group with 5 HRCs at three months post-discharge (p < 0.05), and for the group with 3 HRCs at one month post-discharge (p < 0.05) and three months post-discharge (p < 0.05). Morphogenetic variability might be one among potentially numerous factors that could have an impact on the response to defined treatment protocols for neurologically-impaired individuals who suffered an ischemic stroke.

11.
Diagnostics (Basel) ; 9(2)2019 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-31035480

RESUMO

OBJECTIVES: The aim of our study was to evaluate the association of health factors with the presence and different degrees of pain in elderly above 65 years of life. METHODS: The population-based study included 3540 individuals above 65 years of age of life from twofold stratified household sample representative for Serbia, during 2013 (the average age 73.9 ± 6.3 years; average Body Mass Index was 26.7 ± 4.4, females 56.8%, living with partner 55.5%, with primary education 55.3%, with poor wealth index 55.8% and from rural settings 46.2%). As health predictors of pain, we analyzed further health parameters: self-perceived general health, long-lasting health problems, diagnosed pulmonary disease, cardiovascular disease, musculoskeletal disease, diabetes, hyperlipidemia, hypertension and other chronic diseases. Pain domain of SF-36 version 2.0 was used for pain assessment. RESULTS: Significant health predictors of pain were: self-perceived general health (OR 2.28), where bad perception of self-perceived general health in our study had greater risk of pain with higher degree of severity; long-lasting health problems (OR 1.60), where elderly with long-lasting health problems had almost twice the risk of moderate degree of pain, and above twice the risk for severe degree of pain; pulmonary disease (OR 1.38); musculoskeletal disease (OR 2.98) and other chronic diseases (OR 1.71). The presence of musculoskeletal disease increases the risk for pain, even more than double in severe versus mild degrees of pain. CONCLUSION: Bad self-perceived general health, long-lasting health problems, pulmonary, musculoskeletal diseases, cardiovascular disease and other chronic disease were significant health-related predictors of various degrees of pain in elderly.

12.
Medicina (Kaunas) ; 55(4)2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30978997

RESUMO

Background and objective: Dysfunctional voiding (DV) presents relatively frequent problem in pediatric urologist practice. The necessity for implementation of DV evaluation in the pediatric population is of particular importance, since there is no clear consensus on the clinical assessment of such condition. The aims of our study were to evaluate the test/retest reliability and reproducibility of dysfunctional voiding and incontinence scoring system: Serbian version (DVISSSR) in patients with voiding and incontinence dysfunctions without structural deformities, and to estimate cut-off value for DVISSSR. Methods: The cross-sectional study included 57 children with voiding and incontinence dysfunctions and 30 healthy pediatric controls. For the evaluation of voiding and incontinence dysfunction we used DVISS. The forward-backward method was applied for translation of the DVISS questionnaire from English into Serbian language. Reproducibility was analyzed by Interclass Correlation Coefficient (ICC). Sensitivity and specificity of DVISSSR scores was done by receiver operating curve (ROC) curve. Results: There was a significant difference in DVISSSR score between patients and controls (p < 0.001). For reliability and reproducibility of the questionnaire, there was no significant difference between repeated measurements (p = 0.141), and strong reliability (ICC = 0.957; p < 0.001). Conclusion: We have demonstrated successful translation and validation of the DVISSSR score. Moreover, a reliable scoring system of children with voiding dysfunctions should include evaluations of symptom scoring systems at the multicentric level.


Assuntos
Projetos de Pesquisa/estatística & dados numéricos , Traduções , Incontinência Urinária/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Idioma , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Sérvia/epidemiologia , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Inquéritos e Questionários
13.
Artigo em Inglês | MEDLINE | ID: mdl-30586888

RESUMO

We aimed to evaluate the prevalence of sociodemographic factors with the presence and different degrees of walking difficulties in elderly above 65 years, and to analyze association between evaluated variables and the presence and degree of waking difficulties. In the population based study, 3540 individuals age above 65 years from Serbia were recruited. Further predictors were analyzed: gender, age, level of education, marital status, body mass index (BMI), index of well-being and place of residence. We assessed difficulty in walking half a km on level ground without the use of any aid (Group-1); and difficulty in walking up or down 12 steps (Group-2). Walking difficulties were categorized as no difficulty, some difficulty, a lot of difficulty and cannot do at all. For present difficulty significant predictors were: age (Group-1 (OR-3.022)/Group-2 (OR-3.825)), gender (Group-1 (OR-0.337)/Group-2 (OR-0.311)), educational level (Group-1 (OR-0.689)/Group-2 (OR-0.556)) and place of residence (Group-2 (OR-1.523)) while for non-performing the task, significant predictors were: age (Group-1 (OR-1.998)/Group-2 (OR-2.096)), gender (Group-1 (OR-0.629)/Group-2 (OR-0.495)), BMI (Group-1 (OR-1.219)/Group-2 (OR-1.305)), marital status (Group-1 (OR 0.764)/Group-2 (OR-0.769)), educational level (Group-1 (OR-0.679)/Group-2 (OR-0.719)) and index of well-being (Group-2 (OR-0.764)). Understanding of predictors, and their role on functional decline in elderly is of great importance for the development of specific population-based health programs to prevent further functional loss and preserve achieved functional gains.


Assuntos
Idoso Fragilizado/estatística & dados numéricos , Inquéritos Epidemiológicos/métodos , Limitação da Mobilidade , Vigilância da População/métodos , Caminhada/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Sérvia , Fatores Socioeconômicos
14.
J Clin Med ; 7(8)2018 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-30110988

RESUMO

OBJECTIVE: The aims of our study were to translate the dysfunctional voiding symptom score (DVSS) from English to Serbian; culturally adopt the items; assess the internal consistency and the test⁻retest reliability of DVSSSR in patients with dysfunctional voiding (DV); evaluate and test the construct and divergent validity of DVSSSR against demographic parameters (gender and education); and examine the level of explained variability for each item of DVSSSR against demographic parameters (gender and education). METHODS: The cross-sectional observational study included 50 patients with dysfunctional voiding aged 5 years and above. The DVSS questionnaire was translated from English into Serbian by the forward⁻backward method. Internal consistency was assessed with Cronbach α and test⁻retest reliability with intraclass correlation coefficient (ICC). For validity testing we performed construct and divergent validity analyses. RESULTS: There was excellent internal consistency for every item except for Item 6 (0.787) and Item 3 (0.864), where internal consistency was good. The observed test/retest ICC for average measures was more than 0.75 (excellent) for all DVSSSR items. Gender and educational level does not correlate significantly with each item of DVSSSR (p > 0.05). For divergent validity, there were no significant differences in mean values of each item of DVSSSR between genders and different levels of education (p > 0.05). Variability that can be explained for gender and educational level was below 10%. CONCLUSION: Translated DVSSSR is of adequate validity and reliability for assessing DV in children.

15.
J Altern Complement Med ; 23(9): 738-744, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28605233

RESUMO

OBJECTIVES: A tribomechanically activated clinoptilolite (natural aluminosilicate mineral) has been used to increase growth in meat-producing animals, as an adjuvant in cancer therapy, and a heavy metal remover in humans. Because of its unique cation exchanging and chelating properties, we hypothesized that clinoptilolite may be beneficial for the treatment of dyslipidemia in the manner similar to bile acid sequestrants. Thus, specific aims of this pilot study were to orally administer clinoptilolite in different doses and granule size combinations to determine magnitude and time profile of changes in blood lipids. DESIGN: A phase I/IIa prospective, open-label, uncontrolled, dose/granule size-ranging study (treatment phase 8 weeks, follow-up 6 weeks). Blood lipids were examined every 2 weeks. SETTINGS: Outpatient clinic of a university-affiliated hospital. SUBJECTS: Forty-one subjects (all white, mean age 57.6 ± 6.8 years, 17 women) with blood lipids above the normative limits divided into three groups. INTERVENTION: A tribomechanically activated clinoptilolite was administered in three dose/grind combinations: 6 g/day of fine grind (6gF), 6 g/day of coarse grind (6gC), and 9 g/day of coarse grind (9gC). OUTCOME MEASURES: Blood concentrations of total cholesterol (TC), low-density lipoprotein cholesterol (LDLc), high-density lipoprotein cholesterol (HDLc), and triglycerides (TG). RESULTS: For the 3 groups combined, all lipid fractions significantly improved after 8 weeks of treatment (20-25%, p < 0.001), which reversed to baseline after 6 weeks of clinoptilolite withdrawal. Early (week 2) and the most pronounced decrease in TC and LDLc was observed in the 6gF group (19% and 23% in week 8, respectively), with no difference in HDLc and TG between the three dose/grind groups. No side effects were reported. CONCLUSIONS: These pilot results suggest that oral administration of clinoptilolite may improve lipid profile in individuals with dyslipidemia, which warrants further investigations.


Assuntos
Colesterol/sangue , Dislipidemias/tratamento farmacológico , Triglicerídeos/sangue , Zeolitas/uso terapêutico , Administração Oral , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Zeolitas/administração & dosagem
16.
Acta Clin Croat ; 56(4): 721-727, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29590728

RESUMO

The aim of the study was to analyze postural stability, walking speed and fear of falling in patients with diabetic polyneuropathy (DPN) in order to determine the risk factors for falls, as well as the effect of DPN characteristics as additional factors. A sample of 48 patients with type 2 diabetes and DPN were enrolled in this non-randomized observational study. The patients were divided into two groups of fallers and non-fallers. All subjects underwent evaluation with the Functional Reach Test (FRT), Tinetti Falls Efficacy Scale (Tinetti FES) and 10-Meter Walk Test (10MWT). Neuropathy was quantified with the Michigan Neuropathy Screening Instrument (MNSI, Questionnaire part) and 5.07/10-g Semmes Weinstein monofilament examination (SW-ME). The 10MWT and SW-ME were significantly different between the faller and non-faller groups (p<0.05). Duration of DPN correlated positively with SW-ME (p=0.005) in the faller group. FES showed significant positive correlation with MNSI and negative correlation with 10MWT in the non-faller group. Logistic regression analysis revealed that SW-ME was significantly associated with the probability of falling (p=0.0076; OR=1.378). Study results suggested that the loss of protective sensitivity of foot could be a risk factor for falls in people suffering from type 2 diabetes.


Assuntos
Acidentes por Quedas , Neuropatias Diabéticas , Medo , Diabetes Mellitus Tipo 2 , Humanos , Fatores de Risco
17.
Ann Ital Chir ; 86: 443-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26567456

RESUMO

INTRODUCTION: An aberrant or accessory crossing renal vessel (CV) leading to the lower pole of the kidney is the most common extrinsic cause of uretero pelvic obstruction(UPJ) obstruction in a child and young adolescent.There is still controversy regarding there functional significance in obstruction Preoperative identification of such vessels may influence surgical management. OBJECTIVE: First aim is to determine the value of magnetic resonance (MR) urography in detecting crossing vessels in children with UPJ obstruction,comparing the data with postoperative findings and the second one is to evaluate morphologic and functional parameters in these hydronephrotic kidneys. MATERIALS AND METHODS: Between June 2009 and December 2012 we retrospectively reviewed MR urography records of one hundred and nine children with unilateral hydronephrosis at the University Children's Hospital. 68 (62.4%) were male and 41 (37.6%) were female,median age was 6.5 ± 5.7. Of the total number of patients, 30 (27%) underwent pyeloplasty, while 79 (72.5%) did not. The age at surgery ranged from 0.3 to 18 years (median 6.6 years). The indication for surgery was based on standard criteria (obstructed renal transit time with or without altered renal function of vDRF < 40%), and did not depend on the presence or absence of a crossing vessel.Consensus reviewes of the MR urography studies were compared with surgical findings. RESULTS: A crossing vessel (CV) was found upon surgery in 9 (33%) of 30 kidneys.On MRU, there was no crossing vessel in 21 kidneys, confirmed at surgery in 18. A crossing vessel was detected with MRU in 9 kidneys and confirmed at surgery in 6. Thus, the sensitivity of MRU was 66.7%, the specificity was 85.7%, the positive predictive value was 66.7%, the negative predictive value was 85.7% and the accuracy was 80%. There was no statistically significant difference in the detection of crossing vessels between MR urography and surgery (p = 0.004 and p < 0.01 respectively). Overall, MRU and surgery showed good agreement (κ = 0.524). CONCLUSION: Based on our results we suggest that MR urography is a reliable and safe diagnostic tool to determine crossing vessels in selected children with UPJ obstruction. Thus, MRU can substitute for other imaging modalities and provide detailed information about the morphology and function of the affected kidney KEY WORDS: Children, Crossing renal vessels, Hydronephrosis, Ureteropelvic function obstruction.


Assuntos
Técnicas de Diagnóstico Urológico , Hidronefrose/diagnóstico por imagem , Pelve Renal/diagnóstico por imagem , Rim/irrigação sanguínea , Imageamento por Ressonância Magnética , Obstrução Ureteral/diagnóstico por imagem , Malformações Vasculares/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Hidronefrose/etiologia , Hidronefrose/cirurgia , Lactente , Pelve Renal/irrigação sanguínea , Pelve Renal/cirurgia , Masculino , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Obstrução Ureteral/etiologia , Obstrução Ureteral/cirurgia , Malformações Vasculares/complicações
18.
Ann Ital Chir ; 85(5): 448-53, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25599711

RESUMO

AIM: We evaluated the influence of ratio between free-to-total prostate specific antigen (F/T PSA) and prostate specific antigen density (PSAD)-(F/T)/PSAD on reduction of unnecessary prostate biopsies in grey zone (prostate specific antigen (psa) value 4.0-10.0 ng/ml). METHODS: The study included 108 patients. For all patients serum total PSA (T PSA), free PSA (F PSA), F/T PSA and PSAD were analyzed. The group was divided due to the prostate volume into: entire group (regardless the prostate VOL-Group 1) and group with prostate VOL<40 (Group 2). RESULTS: Seventy five patients were diagnosed with benign prostatic hyperplasia (BPH) and 33 with prostate cancer (CaP). F/T PSA and (F/T)/PSAD showed significantly lower values in patients with CaP versus those with BPH, while PSAD had significantly higher values. For the cutoff values of 1.12 for (F/T)/PSAD, we found sensitivity to be 67% and specificity 60%, and the (AUC) 0.701. For patients with VOL<40, statistical significance remained with AUC of 0.732 (p=0.003), cutoff was 0.82, and with sensitivity 77% and specificity 68%. CONCLUSIONS: Most significant prostate carcinoma predictors were PSAD and (F/T)/PSAD, where we proposed that patients with (F/T)/PSAD values below 1.49 ± 0.94 and PSAD values above 0.17±0.06 should be included for biopsy.


Assuntos
Biomarcadores Tumorais/sangue , Biópsia , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/patologia , Idoso , Biópsia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Hiperplasia Prostática/patologia , Neoplasias da Próstata/sangue , Neoplasias da Próstata/diagnóstico por imagem , Estudos Retrospectivos , Sensibilidade e Especificidade
19.
Acta Orthop Belg ; 79(1): 60-3, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23547517

RESUMO

We assessed the quality of life of children with developmental dysplasia of the hip (DDH) treated surgically, through analysis of leg length discrepancy, quality of walking and presence of pain in 39 children with DDH between 1991 and 2011 at the University Children's Hospital in Belgrade. Salter's innominate osteotomy combined with derotation and femoral bone shortening was performed. Patients were divided into 3 groups based on their age at operation: the first group included participants operated at age up to 24 months, the second group between 24 and 48 months and the third group above 48 months of life. In the first group, leg length discrepancy was present in 30.76% and mean leg shortening was 0.63cm, versus 27.77% and 1.30 cm in the second group and 37.50% and 1.50 cm in the third group. Children with DDH that were operated earlier in life had less leg shortening and did not display any significant asymmetry of walking.


Assuntos
Luxação Congênita de Quadril/cirurgia , Qualidade de Vida , Caminhada , Adolescente , Criança , Feminino , Humanos , Desigualdade de Membros Inferiores/etiologia , Masculino , Osteotomia
20.
Ann Ital Chir ; 84(1): 117-21, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23445838

RESUMO

OBJECTIVE: The study aim was to evaluate inflammation markers values (C-reactive protein (CRP), Erythrocite sedimentation (ES), White blood cells count (WBC)) in surgically treated pediatric patients with diagnosed developmental displasia of the hip or Perthes disease before and after operation. METHODS: We have evaluated 43 children (20 patients were with diagnosed unilateral developmental displasia of the hip while 23 had Perthes disease). Blood samples were drown at the admission and 5 days after admission, and further inflammatory parameters were analyzed: ES (mm/hour), CRP (mg/L) and WBC (x1000/mm3) count. RESULTS: Elevated erythrocite sedimentation (ESR) was significantly frequent than elevated CRP (p<0.01) and elevated WBC as well (p<0.01). Values of ESR and WBC do not correlate closely with age (FESR= 1.805; FWBC= 0.130; p>0.05) while CRP values correlate significantly with the age of the patients (FCRP= 4.948; p<0.05). The most frequently isolated marker was ESR (34.88%). The most frequent elevated two markers were ESR and CRP (44.19%). CONCLUSION: Surgical procedure could alter the values of inflammatory markers leading to the increasement even though there is no other clinical signs of infection. For estimation of the possible presence of the infection, clinical signs and patients intensive clinical follow-up after the surgery, should be done along with the evaluation of inflammatory markers.


Assuntos
Luxação Congênita de Quadril/cirurgia , Inflamação/sangue , Doença de Legg-Calve-Perthes/cirurgia , Complicações Pós-Operatórias/sangue , Adolescente , Biomarcadores/sangue , Sedimentação Sanguínea , Proteína C-Reativa/análise , Criança , Pré-Escolar , Humanos , Contagem de Leucócitos , Procedimentos Ortopédicos
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