Davorin Kozomara - Academia.edu (original) (raw)
Papers by Davorin Kozomara
Acta Clinica Croatica, Sep 2, 2002
In the beginning, liver cirrhosis was considered a contraindication for laparoscopic cholecystect... more In the beginning, liver cirrhosis was considered a contraindication for laparoscopic cholecystectomy, mostly for the same reasons as for other surgical procedures, i.e. mild to severe bleeding tendency, prolonged wound healing due to hypoproteinemia, and various metabolic disorders. The effect of CO 2 pneumoperitoneum on the cirrhotic liver was also discussed. Results obtained by laparoscopic cholecystectomy in 24 liver cirrhosis patients are presented. The experience acquired since the introduction of laparoscopic procedures at our unit is briefly described. The index of conversion was 4.16% (1/24) and mortality rate 0. The mean length of hospital stay was 2.9 days. The use of laparoscopic cholecystectomy for gallstone disease is proposed in patients with liver cirrhosis as the first choice operative method of treatment.
Psychiatria Danubina, 2017
BACKGROUND Aim of this study was to establish attitudes of medical students on induced abortion a... more BACKGROUND Aim of this study was to establish attitudes of medical students on induced abortion and connection of those attitudes with religiousness, length of their studies, sex and various circumstances of pregnancy. SUBJECTS AND METHODS In total, 148 students of the first, second, fifth and sixth year of medical faculty participated in the research. The study was conducted at the Medical Faculty of the University in Mostar. While collecting the data, we used a survey taken over from literature. The data were tested with adequate statistical methods afterwards. RESULTS 81.1% of students would perform an abortion under certain circumstances (χ2=57.189; P<0.001). Most students answered that they would perform an abortion in case that a fetus had malformations (χ2=3.892; P=0.49) or if the mother's life were endangered (χ2=47.676; P<0.001). By comparison of students' readiness to perform an abortion under various circumstances of pregnancy depending on length of medical ...
Psychiatria Danubina, 2021
Psychiatria Danubina, 2017
BACKGROUND The aim of study was to explore efficiency of the pain rating scales on patients exper... more BACKGROUND The aim of study was to explore efficiency of the pain rating scales on patients experiencing abdominal pain, determine correlation between the scales and their applicability to general population and determine the minimal clinical important difference in mm on the VAS as discriminatory for difference in pain intensity. SUBJECTS AND METHODS The study was performed at the Emergency Department of the University Clinical Hospital of Mostar on patients with abdominal pain which started less than 24 hours before, excluding patients under 16 years old, uncooperative patients and those with altered state of consciousness. The sample data were collected from February to May 2010. Hundred patients completed the questionnaire. Two patients, admitted to the Abdominal Surgery Department, were excluded. The patients were asked to sign the informed consent form and assess the level of pain on three scales (VAS, NRS, VRS). RESULTS The NRS showed a significant difference in assessing the...
SUMMARY The effect of relative bowel rest on the strength of surgical anastomoses in the left c... more SUMMARY The effect of relative bowel rest on the strength of surgical anastomoses in the left colon in the early phase of healing, and correlation between mechanical strength of anastomosis and collagen content in the colonic wall were investigated. The breaking strength of surgical stitches in the left colon after end-to-end anastomosis and collagen content in the colonic wall around the anastomosis were measured and evaluated in rats fed low residue or standard diet. The anastomosis strength decreased by approximately 30% of the immediate postoperative value in the first two days in both groups. After day 2, there was an increase in the anastomosis strength, reaching day 0 strength after 7 days. The strength increase was mainly due to collagen deposition in the anastomosis. From day 0 till day 2, the increase in collagen content was greater in the standard laboratory diet group than in the low residue diet group. Results on anastomotic adhesions and condition of anastomosis sutu...
SUMMARY In the beginning, liver cirrhosis was considered a contraindication for laparoscopic ch... more SUMMARY In the beginning, liver cirrhosis was considered a contraindication for laparoscopic cholecys-tectomy, mostly for the same reasons as for other surgical procedures, i.e. mild to severe bleeding tendency, prolonged wound healing due to hypoproteinemia, and various metabolic disorders. The effect of CO 2 pneumoperitoneum on the cirrhotic liver was also discussed. Results obtained by laparoscopic cholecystec-tomy in 24 liver cirrhosis patients are presented. The experience acquired since the introduction of laparo-scopic procedures at our unit is briefly described. The index of conversion was 4.16% (1/24) and mortality rate 0. The mean length of hospital stay was 2.9 days. The use of laparoscopic cholecystectomy for gallstone disease is proposed in patients with liver cirrhosis as the first choice operative method of treatment.
Psychiatria Danubina, 2019
BACKGROUND Stress at work is a specific type of stress arising from the work environment. Stress ... more BACKGROUND Stress at work is a specific type of stress arising from the work environment. Stress of the medical staff has been investigated in recent years by the medical institutions of different countries. The aim of this study was to examine the stress levels in medical staff of Department of Cardiac Surgery and Center of emergency medicine (CEM) in the Clinical settings, and to compare them. SUBJECTS AND METHODS We conducted a cross-sectional study which included 55 patients between 21 and 50 years of age. The study group consisted of 30 employees from the Department of Cardiac Surgery of Mostar University Clinical Hospital, while the control group comprised 25 employees from the CEM. Research instruments were the Occupational Stress Questionnaire for Hospital Health Care Workers (OSQ-HHCW), General Health Questionnaire (GHQ 28) and a Stress MGMT-TEST A. RESULTS The subjects from the control group had significantly higher stress experience in "bombing" with new informa...
Psychiatria Danubina, 2016
GIANT UNILATERAL BREAST JUVENILE FIBROADENOMA – THE AESTHETIC OUTCOME OF SURGICAL TREATMENT SHOUL... more GIANT UNILATERAL BREAST JUVENILE FIBROADENOMA – THE AESTHETIC OUTCOME OF SURGICAL TREATMENT SHOULD BE CONSIDERED Davorin Kozomara, Nikica Šutalo, Gordan Galić, Sanja Jurišić & Zoran Trninć Department for Plastic and Reconstructive Surgery, Surgery Clinic, Mostar University Hospital, Mostar, Bosnia and Herzegovina Department for Pancreatic-duodenal Surgery, Surgery Clinic, Mostar University Hospital, Mostar, Bosnia and Herzegovina Department for Vascular Surgery, Surgery Clinic, Mostar University Hospital, Mostar, Bosnia and Herzegovina Department for Head and Neck Diseases, School of Medicine, Mostar University, Mostar, Bosnia and Herzegovina Department for Laparoscopic Surgery, Surgery Clinic, Mostar University Hospital, Mostar, Bosnia and Herzegovina
Acta Clinica Croatica, 2002
SUMMARY n In the beginning, liver cirrhosis was considered a contraindication for laparoscopic ch... more SUMMARY n In the beginning, liver cirrhosis was considered a contraindication for laparoscopic cholecystectomy, mostly for the same reasons as for other surgical procedures, i.e. mild to severe bleeding tendency, prolonged wound healing due to hypoproteinemia, and various metabolic disorders. The effect of CO 2 pneumoperitoneum on the cirrhotic liver was also discussed. Results obtained by laparoscopic cholecystectomy in 24 liver cirrhosis patients are presented. The experience acquired since the introduction of laparoscopic procedures at our unit is briefly described. The index of conversion was 4.16% (1/24) and mortality rate 0. The mean length of hospital stay was 2.9 days. The use of laparoscopic cholecystectomy for gallstone disease is proposed in patients with liver cirrhosis as the first choice operative method of treatment.
Psychiatria Danubina, 2015
Unsatisfactory postsurgical end results in the treatment of chronic pilonidal sinus disease cause... more Unsatisfactory postsurgical end results in the treatment of chronic pilonidal sinus disease caused by long term healing, pain, inconvenience and recurrences of the lesion still remain problem after various surgical techniques have been described and used. This study was designed to show results of several aspects of midline closure technique with respect for surgical complications, hospitalization length and recurrence. This study included 90 patients with pilonidal sinus treated by surgery with midline closure at the department of General surgery of Clinical Hospital Mostar between January 2004 and January 2009. The patients were divided in three groups considering the type of drainage used. Data collected retrospectively included demographics, positive diagnosis of chronic pilonidal sinus, operative technique, type of drainage, complications, hospital stay and recurrence of the disease. Mean hospital stay after excision and midline closure technique was 4.68 days Complication rate...
Acta medica Croatica : c̆asopis Hravatske akademije medicinskih znanosti, 2004
The familial adenomatous polyposis syndrome is an autosomal dominant inherited disease characteri... more The familial adenomatous polyposis syndrome is an autosomal dominant inherited disease characterized by progressive development of multiple adenomatous polyps throughout the colon and rectum. Due to the malignant potential of adenomatous polyps, colorectal cancer develops in 100% of cases, approximately 10-15 years after the onset of symptoms. Extracolonic manifestations of the disease including adenomatous polyps of the stomach, duodenum, small intestine and periampullatory region are rare. The etiology of the disease is germline mutation at the site of tumor suppressor gene located on chromosomes 5q21-22. A case is described of a 48-year-old man hospitalized at the Department of Abdominal Surgery, Sveti Duh General Hospital in Zagreb for the treatment of familial adenomatous polyposis syndrome. For some time the patient reported occasional abdominal pain, frequent stools and diarrhea with blood, anemia and body weight loss. Laboratory, radiology and endoscopy examinations verified...
Collegium antropologicum, 2010
The aim of this study was to compare the results of the surgery of inguinal hernias using flat po... more The aim of this study was to compare the results of the surgery of inguinal hernias using flat polypropylene mesh and three-dimensional prolene (PHS) mesh. The study included two groups of 40 male patients, aged 18-50 years, with the diagnosis of inguinal hernia. One group was operated with a flat polypropylene mesh, while the second group was operated with three-dimensional prolene (PHS) mesh. The study has shown that the operation with three-dimensional prolene mesh lasted 15 minutes longer and that the patients had stronger inflammatory response. Statistically, there was no significant difference in post-operative pain intensity, post-operative use of analgesics, length of hospitalization, return to daily activities, early and late post-operative complications. No recurrence was registered in any of the groups. The analysis of results indicates that there is no difference in treatment of inguinal hernia with flat polypropylene and three-dimensional prolene (PHS) mesh.
Acta dermatovenerologica Croatica : ADC, 2021
Primary mucosal malignant melanoma of the small bowel is extremely rare. The small bowel is mostl... more Primary mucosal malignant melanoma of the small bowel is extremely rare. The small bowel is mostly affected by metastases of the primary malignant melanoma of the skin. Bowel obstruction is a rare complication of metastatic melanoma. We present a case of small bowel obstruction in a 49-year-old man with history of skin malignant melanoma. A segmental resection of the ileum with termino-terminal anastomosis was performed. Pathohistological examination showed metastatic melanoma. After 4 years of follow-up, the patient is still free of the disease.
Psychiatria Danubina, Dec 1, 2016
To detect the effect of two different types of brackets (ceramic and stainless steel) and investi... more To detect the effect of two different types of brackets (ceramic and stainless steel) and investigate the effectiveness of two chlorhexidine mouthwashes 0.2% (CHX) on oral hygiene status and incidence of white spot lesions (WSLs) in adolescents wearing fixed orthodontic appliance. One hundred and twenty subjects (aged 11 to 18 years, mean age 14.5 years) were divided into six equal groups according to brackets type and to different mouthwashes: Group 1: metal brackets and conventional CHX, Group 2: metal brackets and CHX with anti-discoloration system (CHX-ADS), Group 3: ceramic brackets and conventional CHX, Group 4: ceramic brackets and CHX-ADS, Group 5: metal brackets and water correction flavors mouthwash (placebo), Group 6: ceramic brackets and placebo. Four weeks after the placement of fixed orthodontic appliance the subjects were provided with three different mouthwashes for use during the next two weeks. Assessment was carried out according to oral hygiene index-simplified (...
Acta Clinica Croatica, Sep 2, 2002
In the beginning, liver cirrhosis was considered a contraindication for laparoscopic cholecystect... more In the beginning, liver cirrhosis was considered a contraindication for laparoscopic cholecystectomy, mostly for the same reasons as for other surgical procedures, i.e. mild to severe bleeding tendency, prolonged wound healing due to hypoproteinemia, and various metabolic disorders. The effect of CO 2 pneumoperitoneum on the cirrhotic liver was also discussed. Results obtained by laparoscopic cholecystectomy in 24 liver cirrhosis patients are presented. The experience acquired since the introduction of laparoscopic procedures at our unit is briefly described. The index of conversion was 4.16% (1/24) and mortality rate 0. The mean length of hospital stay was 2.9 days. The use of laparoscopic cholecystectomy for gallstone disease is proposed in patients with liver cirrhosis as the first choice operative method of treatment.
Collegium Antropologicum, Jun 1, 2009
The main aim of this study was to establish the relationships between several psychosocial charac... more The main aim of this study was to establish the relationships between several psychosocial characteristics in children and adolescents differently treated for isolated long tubular bones' fractures. Examined variables were: self-esteem, basic emotional reactions toward illness or injury including depression and anxiety, as well as perception of quality of life and social support during the treatment. Whole sample comprehends 135 patients, both gender, 10-18 years of age, treated for mentioned fractures in period 2003-2005
Acta Clinica Croatica, Mar 1, 2004
The effect of relative bowel rest on the strength of surgical anastomoses in the left colon in th... more The effect of relative bowel rest on the strength of surgical anastomoses in the left colon in the early phase of healing, and correlation between mechanical strength of anastomosis and collagen content in the colonic wall were investigated. The breaking strength of surgical stitches in the left colon after end-to-end anastomosis and collagen content in the colonic wall around the anastomosis were measured and evaluated in rats fed low residue or standard diet. The anastomosis strength decreased by approximately 30% of the immediate postoperative value in the first two days in both groups. After day 2, there was an increase in the anastomosis strength, reaching day 0 strength after 7 days. The strength increase was mainly due to collagen deposition in the anastomosis. From day 0 till day 2, the increase in collagen content was greater in the standard laboratory diet group than in the low residue diet group. Results on anastomotic adhesions and condition of anastomosis sutures in animals on the standard laboratory diet group and low residue diet group are also presented. Low residue diet did not impair the suture holding capacity or anastomosis strength. Instead, there was evidence for a more uncomplicated healing when the bowel content was diminished.
Collegium Antropologicum, 2010
The purpose of this study was to perform an overall evaluation and comparison of the success rate... more The purpose of this study was to perform an overall evaluation and comparison of the success rate of modified radical mastectomy by harmonic scalpel and monopolar electrocauter The prospective study included all of the patients that were planned for and mastectiomized because of breast carcinoma during July 1st 2008 until December 21st 2008 at the Department of Surgery and Urology, University Hospital Mostar. Duration of the surgical procedure, intraoperative blood loss and operational drain secretion was measured and registered. Leukocyte number (Le), interleukin 6 (IL-6), C-reactive protein (CRP) and erythrocyte sedimentation rate was tested and registered out of peripheral venous blood before the operation, 4 hrs after it, as well as on the first, second and third day after the operation. Every patient was tested for postoperative pain intensity, amount of administered analgesics during hospital stay, number and types of postoperative complications; also the time needed for return to everyday activities was registered. 61 patients were included in the study. 31 patients were operated with the harmonic scalpel, and 30 of them with the monopolar electrocauter. There is no statistically significant difference between the operation time in the two groups: 78.50 +/- 17.50 minutes by harmonic scalpel and 82.50 +/- 18.50 minutes by electrocauter (p = 0.796). The smaller amount of intraoperative blood loss is statistically significant in the group of patients mastectomized by harmonic scalpel 78 +/- 31 ml compared to 256 +/- 112 ml in the group mastectomized by electrocauter (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001); as is the total operational drain secretion: patients mastectomized by harmonic scalpel 540 +/- 390 mL compared to 960 +/- 710 mL in patients mastectomized by electrocauter (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). There is no statistical difference in the number of leukocytes in blood after modified radical mastectomy using the harmonic scalpel or electrocauter (p = 0.957), or in erythrocyte sedimentation rate (p = 0.114), CRP (p = 0.071) and IL-6 (p = 0.082). The duration of postoperative hospital stay does not differ statistically between the two groups, nor does the postoperative pain intensity, amount of administered analgesics, number or types of postoperative complications, as well as the time needed for return to everyday activities. Therefore using the ultrasound harmonic scalpel in comparison to monopolar electrocauter brings certain advantages, which however do not contribute significantly to the total success rate of the operation.
Collegium Antropologicum, Dec 1, 2009
This study evaluate the need for general practitioners referrals and self referrals of acute abdo... more This study evaluate the need for general practitioners referrals and self referrals of acute abdominal pain patients to emergency surgical service, the appropriateness of GP referral diagnosis and their attitudes dealing with abdominal pain. In three months period all acute abdominal pain patient referrals to our hospital emergency surgical service were audited. Data on final diagnosis, surgical treatment, admission to hospital and surgery performance were recorded. Self referral or GP referral, referring GP diagnosis, referral letters indicating presenting complaint or history, axillar and rectal temperature measurement, laboratory checking and abdominal radiography checking by GP were recorded as well. Also, GPs examination details as palpation, auscultation and digit-rectal checking were recorded. We calculated sensitivity, specificity, positive and negative predictive value (PV) for referring diagnosis. Self referrals and GP referrals differences were evaluated. During the study 318 patients were admitted. A total of 163 (51.25%) referrals were deemed inappropriate; 102 (52.6% of GP referrals) and 61 (49.2% of self referred) (p<0.05). There were no differences in general treatment, hospital admission and operative treatment in self referred and GP referred groups (p<0.05 for all three categories). Sensitivity, specificity, positive and negative predictive values for most frequent GP referral diagnoses were: abdominal colic/abdomen in observation 0.
Acta Clinica Croatica, Sep 2, 2002
In the beginning, liver cirrhosis was considered a contraindication for laparoscopic cholecystect... more In the beginning, liver cirrhosis was considered a contraindication for laparoscopic cholecystectomy, mostly for the same reasons as for other surgical procedures, i.e. mild to severe bleeding tendency, prolonged wound healing due to hypoproteinemia, and various metabolic disorders. The effect of CO 2 pneumoperitoneum on the cirrhotic liver was also discussed. Results obtained by laparoscopic cholecystectomy in 24 liver cirrhosis patients are presented. The experience acquired since the introduction of laparoscopic procedures at our unit is briefly described. The index of conversion was 4.16% (1/24) and mortality rate 0. The mean length of hospital stay was 2.9 days. The use of laparoscopic cholecystectomy for gallstone disease is proposed in patients with liver cirrhosis as the first choice operative method of treatment.
Psychiatria Danubina, 2017
BACKGROUND Aim of this study was to establish attitudes of medical students on induced abortion a... more BACKGROUND Aim of this study was to establish attitudes of medical students on induced abortion and connection of those attitudes with religiousness, length of their studies, sex and various circumstances of pregnancy. SUBJECTS AND METHODS In total, 148 students of the first, second, fifth and sixth year of medical faculty participated in the research. The study was conducted at the Medical Faculty of the University in Mostar. While collecting the data, we used a survey taken over from literature. The data were tested with adequate statistical methods afterwards. RESULTS 81.1% of students would perform an abortion under certain circumstances (χ2=57.189; P<0.001). Most students answered that they would perform an abortion in case that a fetus had malformations (χ2=3.892; P=0.49) or if the mother's life were endangered (χ2=47.676; P<0.001). By comparison of students' readiness to perform an abortion under various circumstances of pregnancy depending on length of medical ...
Psychiatria Danubina, 2021
Psychiatria Danubina, 2017
BACKGROUND The aim of study was to explore efficiency of the pain rating scales on patients exper... more BACKGROUND The aim of study was to explore efficiency of the pain rating scales on patients experiencing abdominal pain, determine correlation between the scales and their applicability to general population and determine the minimal clinical important difference in mm on the VAS as discriminatory for difference in pain intensity. SUBJECTS AND METHODS The study was performed at the Emergency Department of the University Clinical Hospital of Mostar on patients with abdominal pain which started less than 24 hours before, excluding patients under 16 years old, uncooperative patients and those with altered state of consciousness. The sample data were collected from February to May 2010. Hundred patients completed the questionnaire. Two patients, admitted to the Abdominal Surgery Department, were excluded. The patients were asked to sign the informed consent form and assess the level of pain on three scales (VAS, NRS, VRS). RESULTS The NRS showed a significant difference in assessing the...
SUMMARY The effect of relative bowel rest on the strength of surgical anastomoses in the left c... more SUMMARY The effect of relative bowel rest on the strength of surgical anastomoses in the left colon in the early phase of healing, and correlation between mechanical strength of anastomosis and collagen content in the colonic wall were investigated. The breaking strength of surgical stitches in the left colon after end-to-end anastomosis and collagen content in the colonic wall around the anastomosis were measured and evaluated in rats fed low residue or standard diet. The anastomosis strength decreased by approximately 30% of the immediate postoperative value in the first two days in both groups. After day 2, there was an increase in the anastomosis strength, reaching day 0 strength after 7 days. The strength increase was mainly due to collagen deposition in the anastomosis. From day 0 till day 2, the increase in collagen content was greater in the standard laboratory diet group than in the low residue diet group. Results on anastomotic adhesions and condition of anastomosis sutu...
SUMMARY In the beginning, liver cirrhosis was considered a contraindication for laparoscopic ch... more SUMMARY In the beginning, liver cirrhosis was considered a contraindication for laparoscopic cholecys-tectomy, mostly for the same reasons as for other surgical procedures, i.e. mild to severe bleeding tendency, prolonged wound healing due to hypoproteinemia, and various metabolic disorders. The effect of CO 2 pneumoperitoneum on the cirrhotic liver was also discussed. Results obtained by laparoscopic cholecystec-tomy in 24 liver cirrhosis patients are presented. The experience acquired since the introduction of laparo-scopic procedures at our unit is briefly described. The index of conversion was 4.16% (1/24) and mortality rate 0. The mean length of hospital stay was 2.9 days. The use of laparoscopic cholecystectomy for gallstone disease is proposed in patients with liver cirrhosis as the first choice operative method of treatment.
Psychiatria Danubina, 2019
BACKGROUND Stress at work is a specific type of stress arising from the work environment. Stress ... more BACKGROUND Stress at work is a specific type of stress arising from the work environment. Stress of the medical staff has been investigated in recent years by the medical institutions of different countries. The aim of this study was to examine the stress levels in medical staff of Department of Cardiac Surgery and Center of emergency medicine (CEM) in the Clinical settings, and to compare them. SUBJECTS AND METHODS We conducted a cross-sectional study which included 55 patients between 21 and 50 years of age. The study group consisted of 30 employees from the Department of Cardiac Surgery of Mostar University Clinical Hospital, while the control group comprised 25 employees from the CEM. Research instruments were the Occupational Stress Questionnaire for Hospital Health Care Workers (OSQ-HHCW), General Health Questionnaire (GHQ 28) and a Stress MGMT-TEST A. RESULTS The subjects from the control group had significantly higher stress experience in "bombing" with new informa...
Psychiatria Danubina, 2016
GIANT UNILATERAL BREAST JUVENILE FIBROADENOMA – THE AESTHETIC OUTCOME OF SURGICAL TREATMENT SHOUL... more GIANT UNILATERAL BREAST JUVENILE FIBROADENOMA – THE AESTHETIC OUTCOME OF SURGICAL TREATMENT SHOULD BE CONSIDERED Davorin Kozomara, Nikica Šutalo, Gordan Galić, Sanja Jurišić & Zoran Trninć Department for Plastic and Reconstructive Surgery, Surgery Clinic, Mostar University Hospital, Mostar, Bosnia and Herzegovina Department for Pancreatic-duodenal Surgery, Surgery Clinic, Mostar University Hospital, Mostar, Bosnia and Herzegovina Department for Vascular Surgery, Surgery Clinic, Mostar University Hospital, Mostar, Bosnia and Herzegovina Department for Head and Neck Diseases, School of Medicine, Mostar University, Mostar, Bosnia and Herzegovina Department for Laparoscopic Surgery, Surgery Clinic, Mostar University Hospital, Mostar, Bosnia and Herzegovina
Acta Clinica Croatica, 2002
SUMMARY n In the beginning, liver cirrhosis was considered a contraindication for laparoscopic ch... more SUMMARY n In the beginning, liver cirrhosis was considered a contraindication for laparoscopic cholecystectomy, mostly for the same reasons as for other surgical procedures, i.e. mild to severe bleeding tendency, prolonged wound healing due to hypoproteinemia, and various metabolic disorders. The effect of CO 2 pneumoperitoneum on the cirrhotic liver was also discussed. Results obtained by laparoscopic cholecystectomy in 24 liver cirrhosis patients are presented. The experience acquired since the introduction of laparoscopic procedures at our unit is briefly described. The index of conversion was 4.16% (1/24) and mortality rate 0. The mean length of hospital stay was 2.9 days. The use of laparoscopic cholecystectomy for gallstone disease is proposed in patients with liver cirrhosis as the first choice operative method of treatment.
Psychiatria Danubina, 2015
Unsatisfactory postsurgical end results in the treatment of chronic pilonidal sinus disease cause... more Unsatisfactory postsurgical end results in the treatment of chronic pilonidal sinus disease caused by long term healing, pain, inconvenience and recurrences of the lesion still remain problem after various surgical techniques have been described and used. This study was designed to show results of several aspects of midline closure technique with respect for surgical complications, hospitalization length and recurrence. This study included 90 patients with pilonidal sinus treated by surgery with midline closure at the department of General surgery of Clinical Hospital Mostar between January 2004 and January 2009. The patients were divided in three groups considering the type of drainage used. Data collected retrospectively included demographics, positive diagnosis of chronic pilonidal sinus, operative technique, type of drainage, complications, hospital stay and recurrence of the disease. Mean hospital stay after excision and midline closure technique was 4.68 days Complication rate...
Acta medica Croatica : c̆asopis Hravatske akademije medicinskih znanosti, 2004
The familial adenomatous polyposis syndrome is an autosomal dominant inherited disease characteri... more The familial adenomatous polyposis syndrome is an autosomal dominant inherited disease characterized by progressive development of multiple adenomatous polyps throughout the colon and rectum. Due to the malignant potential of adenomatous polyps, colorectal cancer develops in 100% of cases, approximately 10-15 years after the onset of symptoms. Extracolonic manifestations of the disease including adenomatous polyps of the stomach, duodenum, small intestine and periampullatory region are rare. The etiology of the disease is germline mutation at the site of tumor suppressor gene located on chromosomes 5q21-22. A case is described of a 48-year-old man hospitalized at the Department of Abdominal Surgery, Sveti Duh General Hospital in Zagreb for the treatment of familial adenomatous polyposis syndrome. For some time the patient reported occasional abdominal pain, frequent stools and diarrhea with blood, anemia and body weight loss. Laboratory, radiology and endoscopy examinations verified...
Collegium antropologicum, 2010
The aim of this study was to compare the results of the surgery of inguinal hernias using flat po... more The aim of this study was to compare the results of the surgery of inguinal hernias using flat polypropylene mesh and three-dimensional prolene (PHS) mesh. The study included two groups of 40 male patients, aged 18-50 years, with the diagnosis of inguinal hernia. One group was operated with a flat polypropylene mesh, while the second group was operated with three-dimensional prolene (PHS) mesh. The study has shown that the operation with three-dimensional prolene mesh lasted 15 minutes longer and that the patients had stronger inflammatory response. Statistically, there was no significant difference in post-operative pain intensity, post-operative use of analgesics, length of hospitalization, return to daily activities, early and late post-operative complications. No recurrence was registered in any of the groups. The analysis of results indicates that there is no difference in treatment of inguinal hernia with flat polypropylene and three-dimensional prolene (PHS) mesh.
Acta dermatovenerologica Croatica : ADC, 2021
Primary mucosal malignant melanoma of the small bowel is extremely rare. The small bowel is mostl... more Primary mucosal malignant melanoma of the small bowel is extremely rare. The small bowel is mostly affected by metastases of the primary malignant melanoma of the skin. Bowel obstruction is a rare complication of metastatic melanoma. We present a case of small bowel obstruction in a 49-year-old man with history of skin malignant melanoma. A segmental resection of the ileum with termino-terminal anastomosis was performed. Pathohistological examination showed metastatic melanoma. After 4 years of follow-up, the patient is still free of the disease.
Psychiatria Danubina, Dec 1, 2016
To detect the effect of two different types of brackets (ceramic and stainless steel) and investi... more To detect the effect of two different types of brackets (ceramic and stainless steel) and investigate the effectiveness of two chlorhexidine mouthwashes 0.2% (CHX) on oral hygiene status and incidence of white spot lesions (WSLs) in adolescents wearing fixed orthodontic appliance. One hundred and twenty subjects (aged 11 to 18 years, mean age 14.5 years) were divided into six equal groups according to brackets type and to different mouthwashes: Group 1: metal brackets and conventional CHX, Group 2: metal brackets and CHX with anti-discoloration system (CHX-ADS), Group 3: ceramic brackets and conventional CHX, Group 4: ceramic brackets and CHX-ADS, Group 5: metal brackets and water correction flavors mouthwash (placebo), Group 6: ceramic brackets and placebo. Four weeks after the placement of fixed orthodontic appliance the subjects were provided with three different mouthwashes for use during the next two weeks. Assessment was carried out according to oral hygiene index-simplified (...
Acta Clinica Croatica, Sep 2, 2002
In the beginning, liver cirrhosis was considered a contraindication for laparoscopic cholecystect... more In the beginning, liver cirrhosis was considered a contraindication for laparoscopic cholecystectomy, mostly for the same reasons as for other surgical procedures, i.e. mild to severe bleeding tendency, prolonged wound healing due to hypoproteinemia, and various metabolic disorders. The effect of CO 2 pneumoperitoneum on the cirrhotic liver was also discussed. Results obtained by laparoscopic cholecystectomy in 24 liver cirrhosis patients are presented. The experience acquired since the introduction of laparoscopic procedures at our unit is briefly described. The index of conversion was 4.16% (1/24) and mortality rate 0. The mean length of hospital stay was 2.9 days. The use of laparoscopic cholecystectomy for gallstone disease is proposed in patients with liver cirrhosis as the first choice operative method of treatment.
Collegium Antropologicum, Jun 1, 2009
The main aim of this study was to establish the relationships between several psychosocial charac... more The main aim of this study was to establish the relationships between several psychosocial characteristics in children and adolescents differently treated for isolated long tubular bones' fractures. Examined variables were: self-esteem, basic emotional reactions toward illness or injury including depression and anxiety, as well as perception of quality of life and social support during the treatment. Whole sample comprehends 135 patients, both gender, 10-18 years of age, treated for mentioned fractures in period 2003-2005
Acta Clinica Croatica, Mar 1, 2004
The effect of relative bowel rest on the strength of surgical anastomoses in the left colon in th... more The effect of relative bowel rest on the strength of surgical anastomoses in the left colon in the early phase of healing, and correlation between mechanical strength of anastomosis and collagen content in the colonic wall were investigated. The breaking strength of surgical stitches in the left colon after end-to-end anastomosis and collagen content in the colonic wall around the anastomosis were measured and evaluated in rats fed low residue or standard diet. The anastomosis strength decreased by approximately 30% of the immediate postoperative value in the first two days in both groups. After day 2, there was an increase in the anastomosis strength, reaching day 0 strength after 7 days. The strength increase was mainly due to collagen deposition in the anastomosis. From day 0 till day 2, the increase in collagen content was greater in the standard laboratory diet group than in the low residue diet group. Results on anastomotic adhesions and condition of anastomosis sutures in animals on the standard laboratory diet group and low residue diet group are also presented. Low residue diet did not impair the suture holding capacity or anastomosis strength. Instead, there was evidence for a more uncomplicated healing when the bowel content was diminished.
Collegium Antropologicum, 2010
The purpose of this study was to perform an overall evaluation and comparison of the success rate... more The purpose of this study was to perform an overall evaluation and comparison of the success rate of modified radical mastectomy by harmonic scalpel and monopolar electrocauter The prospective study included all of the patients that were planned for and mastectiomized because of breast carcinoma during July 1st 2008 until December 21st 2008 at the Department of Surgery and Urology, University Hospital Mostar. Duration of the surgical procedure, intraoperative blood loss and operational drain secretion was measured and registered. Leukocyte number (Le), interleukin 6 (IL-6), C-reactive protein (CRP) and erythrocyte sedimentation rate was tested and registered out of peripheral venous blood before the operation, 4 hrs after it, as well as on the first, second and third day after the operation. Every patient was tested for postoperative pain intensity, amount of administered analgesics during hospital stay, number and types of postoperative complications; also the time needed for return to everyday activities was registered. 61 patients were included in the study. 31 patients were operated with the harmonic scalpel, and 30 of them with the monopolar electrocauter. There is no statistically significant difference between the operation time in the two groups: 78.50 +/- 17.50 minutes by harmonic scalpel and 82.50 +/- 18.50 minutes by electrocauter (p = 0.796). The smaller amount of intraoperative blood loss is statistically significant in the group of patients mastectomized by harmonic scalpel 78 +/- 31 ml compared to 256 +/- 112 ml in the group mastectomized by electrocauter (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001); as is the total operational drain secretion: patients mastectomized by harmonic scalpel 540 +/- 390 mL compared to 960 +/- 710 mL in patients mastectomized by electrocauter (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). There is no statistical difference in the number of leukocytes in blood after modified radical mastectomy using the harmonic scalpel or electrocauter (p = 0.957), or in erythrocyte sedimentation rate (p = 0.114), CRP (p = 0.071) and IL-6 (p = 0.082). The duration of postoperative hospital stay does not differ statistically between the two groups, nor does the postoperative pain intensity, amount of administered analgesics, number or types of postoperative complications, as well as the time needed for return to everyday activities. Therefore using the ultrasound harmonic scalpel in comparison to monopolar electrocauter brings certain advantages, which however do not contribute significantly to the total success rate of the operation.
Collegium Antropologicum, Dec 1, 2009
This study evaluate the need for general practitioners referrals and self referrals of acute abdo... more This study evaluate the need for general practitioners referrals and self referrals of acute abdominal pain patients to emergency surgical service, the appropriateness of GP referral diagnosis and their attitudes dealing with abdominal pain. In three months period all acute abdominal pain patient referrals to our hospital emergency surgical service were audited. Data on final diagnosis, surgical treatment, admission to hospital and surgery performance were recorded. Self referral or GP referral, referring GP diagnosis, referral letters indicating presenting complaint or history, axillar and rectal temperature measurement, laboratory checking and abdominal radiography checking by GP were recorded as well. Also, GPs examination details as palpation, auscultation and digit-rectal checking were recorded. We calculated sensitivity, specificity, positive and negative predictive value (PV) for referring diagnosis. Self referrals and GP referrals differences were evaluated. During the study 318 patients were admitted. A total of 163 (51.25%) referrals were deemed inappropriate; 102 (52.6% of GP referrals) and 61 (49.2% of self referred) (p<0.05). There were no differences in general treatment, hospital admission and operative treatment in self referred and GP referred groups (p<0.05 for all three categories). Sensitivity, specificity, positive and negative predictive values for most frequent GP referral diagnoses were: abdominal colic/abdomen in observation 0.