Slobodanka Lemajic-Komazec - Academia.edu (original) (raw)
Papers by Slobodanka Lemajic-Komazec
The Laryngoscope, 2011
Background Although Chronic rhinosinusitis (CRS) is increasing in prevalence and incidence, its d... more Background Although Chronic rhinosinusitis (CRS) is increasing in prevalence and incidence, its diagnosis and treatment still pose a challenge. The Task Force on rhinosinusitis (TFR) advocates the use of symptom based criteria. However, many otorhinolaryngologists depend on diagnostic nasal endoscopy and computed tomography(CT) of paranasal sinuses for diagnosis of CRS. Computed tomography has been extensively relied upon in confirming the presence of CRS, in assessing severity of disease, surgical planning and management decisions. Despite its widespread use, several studies have failed to correlate findings on CT with symptom severity. Objective To determine the correlations between symptoms described at presentation, radiological findings, endoscopy and extensiveness of surgery. Methods Longitudinal, prospective, analytical study conducted from August 2011 to August 2012 among 87 patients diagnosed as CRS according to the TFR criteria. Symptom, endoscopic, radiological and surgical scoring was done by using Lund and Mackay staging system. Pearson correlation coefficients between scores for symptoms, endoscopy, sinus CT and surgery was determined. Results When overall symptom score was correlated with radiological score and endoscopy score, it was found to be statistically significant (p= <0.01). However, no significant relationship was found between Lund and Mackay symptom and surgery score. Conclusion The symptom criteria used by TFR for CRS diagnosis are not very specific for sinus disease. A detail assessment of the subjective and objective criteria (CT and endoscopy) is necessary for tailoring surgical plan but should not be relied upon for determining the extensiveness of surgical intervention.
Porto Biomedical Journal, 2017
Aim: The purpose of this study was to assess whether patients have changed their physical activit... more Aim: The purpose of this study was to assess whether patients have changed their physical activity habits one year after the bariatric surgery. Introduction: Vast majority of obese patients have developed their condition by overeating and insufficient physical activity. Severe obesity leads to problems with locomotor system and constraint movability, resulting in closure of the vicious circle of gaining weight. Bariatric surgery is an effective weight loss method, but it is still unclear whether this procedure influences modification of physical activity routine. Methods: 54 patients (55.56% females, n = 30) who underwent bariatric surgery at 2nd Department of General Surgery JU MC in Cracow, Poland from November 2015 to June 2016 were enrolled to this prospective study. Mean age, BMI and absolute waist circumference of participants were respectively: 43.6 ± 12.2 y.o., 45.94 ± 6.35 kg/m 2 and 128.39 ± 13.45 cm (female), 146.9 ± 17.21 cm (male). One day before the procedure and one year later participants were asked to complete two standardized questionnaires: Paffenbarger Physical Activity Questionnaire and WHO Global Physical Activity Questionnaire, on the basis of which average physical activity in metabolic energy equivalents (MET-minutes) per week has been estimated Results: One year after surgery MET-minutes has increased over 14 times (Me:299.75, Q1-Q3:225.78-358.38 vs. Me:4339.85, Q1-Q3:1590.6-7827.1, p < 0.00001). Average time sitting or reclining has reduced from 480 to 300 min per day (p = 0.00118). Mean pace of walking has changed from <3.2 km/h to average 3.2-4.8 km/h (p = 0.00406). Participants were also asked to rate on visual analogue scale their level of exertion during normal activities. This parameter has decreased from mean 5 (equivalent of strong effort) to mean 2.5 (equivalent of weak effort) (p = 0.00004). Conclusion: Before the procedure none of participants has achieved recommended by WHO weekly level of 600 MET-minutes and after surgery 81% of them have exceed it. This data have shown significant positive changes in physical activity in patients who underwent bariatric surgery.
Bratislava Medical Journal, 2017
International Journal of Pediatric Otorhinolaryngology, 2021
OBJECTIVE The aim of our study was to contribute to the literature about the prevalence of OME by... more OBJECTIVE The aim of our study was to contribute to the literature about the prevalence of OME by conducting a research in a wide geography examining most of the associating factors together with a questionnaire. Additionally, possible effects of altitudes and latitudes, concordance between the otoscopic examination findings and tympanometric and acoustic reflex test results were evaluated in 4-7 years old children in the same season in different countries. METHODS In the randomly sampled schools from different regions of different cities where people of different scoioecomonic statuses live, 4-7 year-old children were included in the study. The results of the questionnaire covering the potential factors in OME etiology were evaluated together with the results of the otoscopic examination and tympanometry findings, and also the acoustic reflex findings to direct the interpretation in cases of low amplitude - blunted peak tympanograms which can be interpreted as a "Type B" or "Type As". All the results were gathered in the same season. RESULTS Ten centers from nine countries participated in the study. A total of 4768 children were evaluated. The frequency of OME diagnosed by otosopic examination was 22.48% (n=1072) and the diagnosis rate when otoscopic examination plus type B tympanometry were taken into account was found as 11.3% (n=539) in general population. Factors increasing the prevalence of OME were found as; mother's educational level (p=0.02), child's age (p=0.006), history of upper respiratory tract infection (p=0.001), smoking father (p=0.01), mother being a housewife or laborer (p=0.01), history of allergy (p=0.001), asthma (p=0.04), or allergy symptoms (p=0.02). No direct relationship was found between altitudes or latitudes and prevalence of OME. CONCLUSION The important affecting factors found after analyzing all of the potential risk factors in the same model are secondhand smoke exposure, low level of mother's education, mother's occupation, positive history of URTI, and age of the child being less than 7. By paying attention to the factors that increase the prevalence of OME, putting particular emphasis on the preventable ones such as smoking, education, and fighting with allergies could decrease the prevalence of this public health issue.
Nigerian Journal of Clinical Practice, 2021
Objective: The aim of this study was to analyze the complications following secondary voice prost... more Objective: The aim of this study was to analyze the complications following secondary voice prosthesis insertion and impact of previous irradiation on their appearance. Methods: This study included 106 totally laryngectomized patients who underwent secondary Provox 2 voice prosthesis insertion. Among them, 79 (74.5%) were irradiated. Surgery, prosthesis, fistula, and voice-related complications were analyzed and presented. Results: Complications occurred in 23 (22%) patients. Fifteen of them were previously irradiated. There were no surgery-related complications. In the group of prosthesis-related complications, one patient had increased negative pressure during swallowing with extremely short prosthesis life time. There were 17 complications in the group of fistula related ones; 3 patients had excessive granulation tissue around the fistula and 14 patients experienced prosthesis displacement (7 had closed esophageal end of the fistula, 5 had the prosthesis turned sideways in an ope...
Bosnian journal of basic medical sciences, Jan 17, 2017
Progressive multifocal leukoencephalopathy (PML) is a rare, often fatal, opportunistic infection,... more Progressive multifocal leukoencephalopathy (PML) is a rare, often fatal, opportunistic infection, associated with demyelinating process. PML is caused by John Cunningham (JC) polyomavirus, and predominantly involves patients with human immunodeficiency virus (HIV) disease or other immunocompromised conditions. The purpose of this report was to determine the role of magnetic resonance spectroscopy (MRS) in establishing the diagnosis of PML. MRS with long and short echo time was performed in two patients with PML associated with HIV infection and in one PML patient associated with chronic lymphocytic leukemia. The most prominent peak on the obtained spectra was for lactate; it showed 2-3 times higher concentration of lactate compared to choline, almost 4-6 times higher lactate concentration compared to creatine, and 4-11 times higher lactate in comparison to N-acetylaspartate concentration. Similar spectrum pattern was observed in all patients. To the best of our knowledge, this is a ...
Medicinski pregled, 2008
Acute hearing impairment or deafhess may manifest as unilateral or bilateral. The etiopathogeneti... more Acute hearing impairment or deafhess may manifest as unilateral or bilateral. The etiopathogenetic substrate may be organic, functional and of unknown origin, the so-called idiopathic. The functional causes of impaired hearing and deafness also include psychogenic factors, where the essential dysfunction exists between the conscious simulation of hearing impairment and deafness for benefits versus psychogenic hearing impairment in conversion disorders where physical symptoms result as a symbolic expression of long-term psychological problems or conflicts. Acute hearing impairment, pseudohypacusis, as a symptom of conversion disorder, where hearing impairment is without evidence of organic cause, is a rare pseudosensory form of this disease. Numerous literature data indicate that these disorders are most common among children, whereas in adults only individual cases are reported. In otorhinolaryngological practice, other symptoms of conversion disorders are much more common (psychoge...
Medicinski pregled, 2008
As any other medical procedure cochlear implantation could be risky and there are possibilities f... more As any other medical procedure cochlear implantation could be risky and there are possibilities for the development of complications. Serious and adequate diagnostic as well as preoperative preparation is necessary for cochlear implantation. Omissions in the audiological, radiological or psychological diagnostic procedures could provoke far reaching consequences in rehabilitation process. The commonest intraoperative complications may be divided into major and minor complications. Minor complications are those that resolve without surgical intervention: flap infection, change in taste, transitory balance problems, transitory facial palsy, non excessive intraoperative bleeding and other. Major complications required revision surgery because of flap problems, device extrusion or migration and device failure. CSF leak, meningitis as well as facial palsy. Adequate flap design should insure prevention of the flap necrosis, which is a very unpleasant complication. Principles of prevention...
Medicinski pregled, 2008
Inflammation of the middle ear is the most common illness among children. It is commonly recurren... more Inflammation of the middle ear is the most common illness among children. It is commonly recurrent by its nature, causing transient or long-term hearing reduction. From the clinical aspect, the problem of recrudescence and chronicity of childhood otitis media is enormous. There are controversies and nonuniformities in defining the cause, conservative and surgical treatment, prevention, mostly due to morphofunctional specificities and dynamic developmental features of the tubotympanomastoid complex. Some open questions are as follows: is recurrent otitis media in childhood really recurrent, or we are dealing with clinical manifestations of exacerbation of the chronic process (chronic from the very beginning), which are the factors predisposing and/or reflecting inflammatory processes in the middle ear, which are the potentials of real clinical practice, which are the modalities of prevention of inflammatory processes in the middle ear in children, is there a parallelism between the r...
Medical review, 2007
Introduction: Permanent hearing impairment is a significant and relatively common condition in ne... more Introduction: Permanent hearing impairment is a significant and relatively common condition in newborns, affecting at least 1 child per 1000 live births. The early identification of hearing loss is very important in order to begin early rehabilitation and for optimizing normal development of language. Material and methods: We examined 70 children with parental suspicion of a hearing loss. Brainstem Evoked Response Audiometry was performed and the group was divided into three subgroups. The following parameters were analyzed: the average age of hearing loss-identification, the time of parental first suspicion of a hearing loss, as well as risk factors for hearing impairment. Results and discussion: Of 70 children with parental suspicion of a hearing loss, in 17 cases normal hearing or mild hearing loss (up to 40 dB HL) was found (group I), 16 children were suffering from moderate and severe hearing loss (40 to 90 dB HL) (group II), and 37% of children were suffering from profound hea...
Medicinski pregled, 2008
Hearing loss in children will cause cognitive deficits in the central areas which are dependent u... more Hearing loss in children will cause cognitive deficits in the central areas which are dependent upon hearing and is therefore responsible for delay in the speech development, poor language skills and disorders in psychological and mental behavior. An early identification of educationally significant hearing loss in infants and young children is an essential prerequisite for effective aural rehabilitation and educational intervention. Maturation of the auditory path takes place within the first 18 months of life and is dependant on the adequate acoustic stimulation. To ensure the optimal therapy a definite diagnosis of the hearing impairment should be made until the sixth month of life. Current health care standards recommend the confirmation of the neonatal hearing loss before the age of three months and the appropriate intervention before the age of six months. The study consisted of the prospective analysis of data collected for 70 children with suspected hearing loss. According t...
Acta Clinica Croatica, 2019
Current recommendations proposed by pediatric audiologists are to commence with hearing amplifica... more Current recommendations proposed by pediatric audiologists are to commence with hearing amplification in children aged 6 months and above, after previous determination of the type and degree of hearing impairment and audiometric configuration. The goal of this study was to compare results obtained by click-evoked auditory brainstem response (c-ABR) and auditory steady state response (ASSR) in a group of children. This study included 68 children with different degrees of hearing impairment evaluated by c-ABR and ASSR. It is well-known that the c-ABR threshold highly correlates with behavioral hearing level at 2 kHz. In our study, the correlation between the c-ABR and ASSR thresholds in the whole sample was 0.58, 0.73, 0.97, 0.96, 0.95, 0.97; in the group of children with c-ABR thresholds up to 40 dBHL, it was 0.42, 0.73, 0.86, 0.74, 0.81, 0.81; and in the group with c-ABR thresholds worse than 40 dBHL, it was 0.46, 0.56, 0.89, 0.83, 0.85, 0.89 at 0.5, 1, 2, 4, 1-4, 2-4 kHz, respectively. Individual differences between the c-ABR and ASSR thresholds in the whole sample were up to 95, 90, 20, 25 dB at 0.5, 1, 2, 4 kHz, respectively. Study results indicated that there was strong correlation between the c-ABR and ASSR thresholds at 2, 4, 1-4, 2-4 kHz. The ASSR can be used as a valuable clinical tool and an excellent complementary method which, along with other audiologic techniques, provides more accurate hearing threshold estimation at an early age in children.
Central European Journal of Medicine, 2012
Aim: The aim of this paper is to present two case reports of patients with hemangiomas of the ext... more Aim: The aim of this paper is to present two case reports of patients with hemangiomas of the external auditory canal, and to overview all cases published in English language literature so far. Methods: Two patients with hemangiomas of the external auditory canal have undergone clinical and morphofunctional examination, surgical procedures, histopathological examination, and postoperative follow up. Results: In a 38-year-old female patient transmeatal approach was used to remove the cavernous hemangioma of the external auditory canal. The postoperative period was eventless, with normal morphofunctional findings during a 5-month postoperative follow-up period. In the second patient, a 68-year-old female, a capillary-cavernous hemangioma was removed using retroauricular approach. Conclusion: Cavernous hemangiomas are rare lesions of the external auditory canal. In the morphological diagnosis, computed tomography of the temporal bones is the leading diagnostic procedure, along with otoendoscopy and endocranial magnetic resonance imaging which are important in evaluation of the spread of the lesion. Biopsy of vascular lesions is not recommended. Complete surgical excision of hemangioma of the external auditory canal is the therapy of choice with a minor risk of hearing impairment.
Fetal and Pediatric Pathology
Vojnosanitetski pregled, 2010
Background/Aim. A more recent method, the auditory steadystate response (ASSR), has become more a... more Background/Aim. A more recent method, the auditory steadystate response (ASSR), has become more and more important test method due to difference that was found in previous investigations between hearing thresholds determined by the ASSR and the pure-tone audiometry (PTA). The aim of this study was to evaluate the reliability of the ASSR in determining the frequency specific hearing thresholds by establishing a correlation between the thresholds determined by PTA, as well as to evaluate the reliability of ASSR in determining the hearing threshold with respect to the level of hearing loss and the configuration of the PTA findings. Methods. The prospective study included 46 subjects (92 ears) which were assigned to groups based on their level of hearing loss and audiometric configuration. All the subjects underwent determination of hearing thresholds by PTA and ASSR without insight into their previously obtained PTA results. Results. The overall sample differences between the ASSR and ...
Praxis medica, 2014
A prominent ear, so called a protruding or "lop" ear, is the most common congenital deformity of ... more A prominent ear, so called a protruding or "lop" ear, is the most common congenital deformity of the external ear. This deformity persists when the mastoid-helix angle (MHA) is higher than 30 degrees. It is relatively common among the population with the incidence of about 5%. The aim of this study is to present surgical procedure and our results using otoplasty with scoring anterior surface of the auricular cartilage. To analyze objective and subjective surgical procedure effects. Between 2011 and 2014 we treated 28 patients. We found statistically high significance p<0.01 in value mastoid-helix angle (MHA) preoperative and postoperative. In patients with bilateral otoplasty the difference between left and right MHAs after surgical procedure is less than 4 degrees. The difference of head-helix distance (HHD) preoperative and postoperative is statistically important with high significance p<0.05. Preoperative satisfaction by personal appearance was better after surgical procedure p<0.05. Complications occurred in 9 cases (32.4%). Otoplasty by scoring anterior surface of auricular cartilage is safe procedure for correction of prominent ear with excellent results on patient satisfaction by personal appearance. Effect of reducing the MHA and HHD is long lasting.
Signa Vitae - A Journal In Intensive Care And Emergency Medicine
Aim. Sepsis remains the leading cause of mortality in spite of advanced diagnostics. The aim of t... more Aim. Sepsis remains the leading cause of mortality in spite of advanced diagnostics. The aim of the study was to test the diagnostic value of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in the context of a new definition of sepsis. Methods. The study was conducted on 41 patients who were suspected of having sepsis according to SIRS (Systemic Inflammatory Response Syndrome) criteria or sterile SIRS. 20 healthy volunteer blood donors were the control group (adult patients of both sexes). According to the latest sepsis criteria (Sepsis-3), patients were retrospectively divided into three subgroups: septic patients, patients with SIRS plus infection and patients with sterile SIRS (non-infectious SIRS). All subjects had concentrations of sTREM-1 determined by the ELISA method (Abcam commercial test, Cambridge, MA, USA). Samples were collected upon admission to hospital and kept at-20°C until laboratory analysis was performed. Results. Concentrations of sTREM-1 were significantly increased in patients, compared to the healthy population (p=0.021), but there were no significant differences among subgroups of patients (SIRS plus infection vs. sepsis p=0.871, SIRS plus infection vs. sterile SIRS p=0.72, sepsis vs. sterile SIRS p=0.65). The value of 300pg/mL was determined to be the optimal cutoff. Concentrations of sTREM-1 were significantly higher in septic patients who did not develop Multiple Organ Dysfunction Syndrome (MODS) within the first 48 hours after admission than in those who did. Conclusion. According to our results, sTREM-1 failed to express significance as a diagnostic biomarker of sepsis, according to the new definition. Also, it seems not to be a valuable marker in differentiation of sepsis and non-infective SIRS.
Srpski arhiv za celokupno lekarstvo
Introduction/Objective. Chronic rhinosinusitis is one of the most frequent chronic disorders whic... more Introduction/Objective. Chronic rhinosinusitis is one of the most frequent chronic disorders which significantly influences the patients? quality of life. The objectiv? of this paper was to examine which are the most frequent and intensive symptoms in patients with chronic rhinosinusitis, and also to determine whether there is a correlation between a subjective assessment of the disease as a whole and individual symptoms. Methods. The study encircled 90 patients with clinical diagnosis of chronic rhinosinusitis that was endoscopically proven and computer tomography of the nose and paranasal sinuses. Every possible symptom was recorded in every patient (nasal congestion, nasal discharge, facial pain/pressure, reduction or loss of smell, headache, fatigue, cough, halitosis and ear pain/fullness), the intensity of every possible symptom as well as the disorder as a whole. The patients assessed the intensity of their symptoms on the visual analogue scale. Results. Nose congestion is the...
Specijalna edukacija i rehabilitacija
Vojnosanitetski pregled
Background/Aim. Cochlear implantation (CI) is a therapeutic modality that provides a sense of sou... more Background/Aim. Cochlear implantation (CI) is a therapeutic modality that provides a sense of sound to children and adults with profound sensorineural hearing loss or deafness. The aim of this work was to evaluate the lateral semicircular canal function using a high frequency video head impulse test in children after CI. Methods. A prospective descriptive study included 28 children (6?17 years old) with profound sensorineural hearing loss and unilateral CI. The control group included 20 healthy children with normal hearing. The measurement of vestibular function of the lateral semicircular canal was performed using video head impulse test. After cochlear implantation, the children underwent the vestibular testing. Values vestibulo-ocular reflex of lateral semicircular canal were measured using the video head impulse test in the children with cochlear implant and the control group. The values of vestibulo-ocular reflex were compared between the group. Also, in the children with CI va...
The Laryngoscope, 2011
Background Although Chronic rhinosinusitis (CRS) is increasing in prevalence and incidence, its d... more Background Although Chronic rhinosinusitis (CRS) is increasing in prevalence and incidence, its diagnosis and treatment still pose a challenge. The Task Force on rhinosinusitis (TFR) advocates the use of symptom based criteria. However, many otorhinolaryngologists depend on diagnostic nasal endoscopy and computed tomography(CT) of paranasal sinuses for diagnosis of CRS. Computed tomography has been extensively relied upon in confirming the presence of CRS, in assessing severity of disease, surgical planning and management decisions. Despite its widespread use, several studies have failed to correlate findings on CT with symptom severity. Objective To determine the correlations between symptoms described at presentation, radiological findings, endoscopy and extensiveness of surgery. Methods Longitudinal, prospective, analytical study conducted from August 2011 to August 2012 among 87 patients diagnosed as CRS according to the TFR criteria. Symptom, endoscopic, radiological and surgical scoring was done by using Lund and Mackay staging system. Pearson correlation coefficients between scores for symptoms, endoscopy, sinus CT and surgery was determined. Results When overall symptom score was correlated with radiological score and endoscopy score, it was found to be statistically significant (p= <0.01). However, no significant relationship was found between Lund and Mackay symptom and surgery score. Conclusion The symptom criteria used by TFR for CRS diagnosis are not very specific for sinus disease. A detail assessment of the subjective and objective criteria (CT and endoscopy) is necessary for tailoring surgical plan but should not be relied upon for determining the extensiveness of surgical intervention.
Porto Biomedical Journal, 2017
Aim: The purpose of this study was to assess whether patients have changed their physical activit... more Aim: The purpose of this study was to assess whether patients have changed their physical activity habits one year after the bariatric surgery. Introduction: Vast majority of obese patients have developed their condition by overeating and insufficient physical activity. Severe obesity leads to problems with locomotor system and constraint movability, resulting in closure of the vicious circle of gaining weight. Bariatric surgery is an effective weight loss method, but it is still unclear whether this procedure influences modification of physical activity routine. Methods: 54 patients (55.56% females, n = 30) who underwent bariatric surgery at 2nd Department of General Surgery JU MC in Cracow, Poland from November 2015 to June 2016 were enrolled to this prospective study. Mean age, BMI and absolute waist circumference of participants were respectively: 43.6 ± 12.2 y.o., 45.94 ± 6.35 kg/m 2 and 128.39 ± 13.45 cm (female), 146.9 ± 17.21 cm (male). One day before the procedure and one year later participants were asked to complete two standardized questionnaires: Paffenbarger Physical Activity Questionnaire and WHO Global Physical Activity Questionnaire, on the basis of which average physical activity in metabolic energy equivalents (MET-minutes) per week has been estimated Results: One year after surgery MET-minutes has increased over 14 times (Me:299.75, Q1-Q3:225.78-358.38 vs. Me:4339.85, Q1-Q3:1590.6-7827.1, p < 0.00001). Average time sitting or reclining has reduced from 480 to 300 min per day (p = 0.00118). Mean pace of walking has changed from <3.2 km/h to average 3.2-4.8 km/h (p = 0.00406). Participants were also asked to rate on visual analogue scale their level of exertion during normal activities. This parameter has decreased from mean 5 (equivalent of strong effort) to mean 2.5 (equivalent of weak effort) (p = 0.00004). Conclusion: Before the procedure none of participants has achieved recommended by WHO weekly level of 600 MET-minutes and after surgery 81% of them have exceed it. This data have shown significant positive changes in physical activity in patients who underwent bariatric surgery.
Bratislava Medical Journal, 2017
International Journal of Pediatric Otorhinolaryngology, 2021
OBJECTIVE The aim of our study was to contribute to the literature about the prevalence of OME by... more OBJECTIVE The aim of our study was to contribute to the literature about the prevalence of OME by conducting a research in a wide geography examining most of the associating factors together with a questionnaire. Additionally, possible effects of altitudes and latitudes, concordance between the otoscopic examination findings and tympanometric and acoustic reflex test results were evaluated in 4-7 years old children in the same season in different countries. METHODS In the randomly sampled schools from different regions of different cities where people of different scoioecomonic statuses live, 4-7 year-old children were included in the study. The results of the questionnaire covering the potential factors in OME etiology were evaluated together with the results of the otoscopic examination and tympanometry findings, and also the acoustic reflex findings to direct the interpretation in cases of low amplitude - blunted peak tympanograms which can be interpreted as a "Type B" or "Type As". All the results were gathered in the same season. RESULTS Ten centers from nine countries participated in the study. A total of 4768 children were evaluated. The frequency of OME diagnosed by otosopic examination was 22.48% (n=1072) and the diagnosis rate when otoscopic examination plus type B tympanometry were taken into account was found as 11.3% (n=539) in general population. Factors increasing the prevalence of OME were found as; mother's educational level (p=0.02), child's age (p=0.006), history of upper respiratory tract infection (p=0.001), smoking father (p=0.01), mother being a housewife or laborer (p=0.01), history of allergy (p=0.001), asthma (p=0.04), or allergy symptoms (p=0.02). No direct relationship was found between altitudes or latitudes and prevalence of OME. CONCLUSION The important affecting factors found after analyzing all of the potential risk factors in the same model are secondhand smoke exposure, low level of mother's education, mother's occupation, positive history of URTI, and age of the child being less than 7. By paying attention to the factors that increase the prevalence of OME, putting particular emphasis on the preventable ones such as smoking, education, and fighting with allergies could decrease the prevalence of this public health issue.
Nigerian Journal of Clinical Practice, 2021
Objective: The aim of this study was to analyze the complications following secondary voice prost... more Objective: The aim of this study was to analyze the complications following secondary voice prosthesis insertion and impact of previous irradiation on their appearance. Methods: This study included 106 totally laryngectomized patients who underwent secondary Provox 2 voice prosthesis insertion. Among them, 79 (74.5%) were irradiated. Surgery, prosthesis, fistula, and voice-related complications were analyzed and presented. Results: Complications occurred in 23 (22%) patients. Fifteen of them were previously irradiated. There were no surgery-related complications. In the group of prosthesis-related complications, one patient had increased negative pressure during swallowing with extremely short prosthesis life time. There were 17 complications in the group of fistula related ones; 3 patients had excessive granulation tissue around the fistula and 14 patients experienced prosthesis displacement (7 had closed esophageal end of the fistula, 5 had the prosthesis turned sideways in an ope...
Bosnian journal of basic medical sciences, Jan 17, 2017
Progressive multifocal leukoencephalopathy (PML) is a rare, often fatal, opportunistic infection,... more Progressive multifocal leukoencephalopathy (PML) is a rare, often fatal, opportunistic infection, associated with demyelinating process. PML is caused by John Cunningham (JC) polyomavirus, and predominantly involves patients with human immunodeficiency virus (HIV) disease or other immunocompromised conditions. The purpose of this report was to determine the role of magnetic resonance spectroscopy (MRS) in establishing the diagnosis of PML. MRS with long and short echo time was performed in two patients with PML associated with HIV infection and in one PML patient associated with chronic lymphocytic leukemia. The most prominent peak on the obtained spectra was for lactate; it showed 2-3 times higher concentration of lactate compared to choline, almost 4-6 times higher lactate concentration compared to creatine, and 4-11 times higher lactate in comparison to N-acetylaspartate concentration. Similar spectrum pattern was observed in all patients. To the best of our knowledge, this is a ...
Medicinski pregled, 2008
Acute hearing impairment or deafhess may manifest as unilateral or bilateral. The etiopathogeneti... more Acute hearing impairment or deafhess may manifest as unilateral or bilateral. The etiopathogenetic substrate may be organic, functional and of unknown origin, the so-called idiopathic. The functional causes of impaired hearing and deafness also include psychogenic factors, where the essential dysfunction exists between the conscious simulation of hearing impairment and deafness for benefits versus psychogenic hearing impairment in conversion disorders where physical symptoms result as a symbolic expression of long-term psychological problems or conflicts. Acute hearing impairment, pseudohypacusis, as a symptom of conversion disorder, where hearing impairment is without evidence of organic cause, is a rare pseudosensory form of this disease. Numerous literature data indicate that these disorders are most common among children, whereas in adults only individual cases are reported. In otorhinolaryngological practice, other symptoms of conversion disorders are much more common (psychoge...
Medicinski pregled, 2008
As any other medical procedure cochlear implantation could be risky and there are possibilities f... more As any other medical procedure cochlear implantation could be risky and there are possibilities for the development of complications. Serious and adequate diagnostic as well as preoperative preparation is necessary for cochlear implantation. Omissions in the audiological, radiological or psychological diagnostic procedures could provoke far reaching consequences in rehabilitation process. The commonest intraoperative complications may be divided into major and minor complications. Minor complications are those that resolve without surgical intervention: flap infection, change in taste, transitory balance problems, transitory facial palsy, non excessive intraoperative bleeding and other. Major complications required revision surgery because of flap problems, device extrusion or migration and device failure. CSF leak, meningitis as well as facial palsy. Adequate flap design should insure prevention of the flap necrosis, which is a very unpleasant complication. Principles of prevention...
Medicinski pregled, 2008
Inflammation of the middle ear is the most common illness among children. It is commonly recurren... more Inflammation of the middle ear is the most common illness among children. It is commonly recurrent by its nature, causing transient or long-term hearing reduction. From the clinical aspect, the problem of recrudescence and chronicity of childhood otitis media is enormous. There are controversies and nonuniformities in defining the cause, conservative and surgical treatment, prevention, mostly due to morphofunctional specificities and dynamic developmental features of the tubotympanomastoid complex. Some open questions are as follows: is recurrent otitis media in childhood really recurrent, or we are dealing with clinical manifestations of exacerbation of the chronic process (chronic from the very beginning), which are the factors predisposing and/or reflecting inflammatory processes in the middle ear, which are the potentials of real clinical practice, which are the modalities of prevention of inflammatory processes in the middle ear in children, is there a parallelism between the r...
Medical review, 2007
Introduction: Permanent hearing impairment is a significant and relatively common condition in ne... more Introduction: Permanent hearing impairment is a significant and relatively common condition in newborns, affecting at least 1 child per 1000 live births. The early identification of hearing loss is very important in order to begin early rehabilitation and for optimizing normal development of language. Material and methods: We examined 70 children with parental suspicion of a hearing loss. Brainstem Evoked Response Audiometry was performed and the group was divided into three subgroups. The following parameters were analyzed: the average age of hearing loss-identification, the time of parental first suspicion of a hearing loss, as well as risk factors for hearing impairment. Results and discussion: Of 70 children with parental suspicion of a hearing loss, in 17 cases normal hearing or mild hearing loss (up to 40 dB HL) was found (group I), 16 children were suffering from moderate and severe hearing loss (40 to 90 dB HL) (group II), and 37% of children were suffering from profound hea...
Medicinski pregled, 2008
Hearing loss in children will cause cognitive deficits in the central areas which are dependent u... more Hearing loss in children will cause cognitive deficits in the central areas which are dependent upon hearing and is therefore responsible for delay in the speech development, poor language skills and disorders in psychological and mental behavior. An early identification of educationally significant hearing loss in infants and young children is an essential prerequisite for effective aural rehabilitation and educational intervention. Maturation of the auditory path takes place within the first 18 months of life and is dependant on the adequate acoustic stimulation. To ensure the optimal therapy a definite diagnosis of the hearing impairment should be made until the sixth month of life. Current health care standards recommend the confirmation of the neonatal hearing loss before the age of three months and the appropriate intervention before the age of six months. The study consisted of the prospective analysis of data collected for 70 children with suspected hearing loss. According t...
Acta Clinica Croatica, 2019
Current recommendations proposed by pediatric audiologists are to commence with hearing amplifica... more Current recommendations proposed by pediatric audiologists are to commence with hearing amplification in children aged 6 months and above, after previous determination of the type and degree of hearing impairment and audiometric configuration. The goal of this study was to compare results obtained by click-evoked auditory brainstem response (c-ABR) and auditory steady state response (ASSR) in a group of children. This study included 68 children with different degrees of hearing impairment evaluated by c-ABR and ASSR. It is well-known that the c-ABR threshold highly correlates with behavioral hearing level at 2 kHz. In our study, the correlation between the c-ABR and ASSR thresholds in the whole sample was 0.58, 0.73, 0.97, 0.96, 0.95, 0.97; in the group of children with c-ABR thresholds up to 40 dBHL, it was 0.42, 0.73, 0.86, 0.74, 0.81, 0.81; and in the group with c-ABR thresholds worse than 40 dBHL, it was 0.46, 0.56, 0.89, 0.83, 0.85, 0.89 at 0.5, 1, 2, 4, 1-4, 2-4 kHz, respectively. Individual differences between the c-ABR and ASSR thresholds in the whole sample were up to 95, 90, 20, 25 dB at 0.5, 1, 2, 4 kHz, respectively. Study results indicated that there was strong correlation between the c-ABR and ASSR thresholds at 2, 4, 1-4, 2-4 kHz. The ASSR can be used as a valuable clinical tool and an excellent complementary method which, along with other audiologic techniques, provides more accurate hearing threshold estimation at an early age in children.
Central European Journal of Medicine, 2012
Aim: The aim of this paper is to present two case reports of patients with hemangiomas of the ext... more Aim: The aim of this paper is to present two case reports of patients with hemangiomas of the external auditory canal, and to overview all cases published in English language literature so far. Methods: Two patients with hemangiomas of the external auditory canal have undergone clinical and morphofunctional examination, surgical procedures, histopathological examination, and postoperative follow up. Results: In a 38-year-old female patient transmeatal approach was used to remove the cavernous hemangioma of the external auditory canal. The postoperative period was eventless, with normal morphofunctional findings during a 5-month postoperative follow-up period. In the second patient, a 68-year-old female, a capillary-cavernous hemangioma was removed using retroauricular approach. Conclusion: Cavernous hemangiomas are rare lesions of the external auditory canal. In the morphological diagnosis, computed tomography of the temporal bones is the leading diagnostic procedure, along with otoendoscopy and endocranial magnetic resonance imaging which are important in evaluation of the spread of the lesion. Biopsy of vascular lesions is not recommended. Complete surgical excision of hemangioma of the external auditory canal is the therapy of choice with a minor risk of hearing impairment.
Fetal and Pediatric Pathology
Vojnosanitetski pregled, 2010
Background/Aim. A more recent method, the auditory steadystate response (ASSR), has become more a... more Background/Aim. A more recent method, the auditory steadystate response (ASSR), has become more and more important test method due to difference that was found in previous investigations between hearing thresholds determined by the ASSR and the pure-tone audiometry (PTA). The aim of this study was to evaluate the reliability of the ASSR in determining the frequency specific hearing thresholds by establishing a correlation between the thresholds determined by PTA, as well as to evaluate the reliability of ASSR in determining the hearing threshold with respect to the level of hearing loss and the configuration of the PTA findings. Methods. The prospective study included 46 subjects (92 ears) which were assigned to groups based on their level of hearing loss and audiometric configuration. All the subjects underwent determination of hearing thresholds by PTA and ASSR without insight into their previously obtained PTA results. Results. The overall sample differences between the ASSR and ...
Praxis medica, 2014
A prominent ear, so called a protruding or "lop" ear, is the most common congenital deformity of ... more A prominent ear, so called a protruding or "lop" ear, is the most common congenital deformity of the external ear. This deformity persists when the mastoid-helix angle (MHA) is higher than 30 degrees. It is relatively common among the population with the incidence of about 5%. The aim of this study is to present surgical procedure and our results using otoplasty with scoring anterior surface of the auricular cartilage. To analyze objective and subjective surgical procedure effects. Between 2011 and 2014 we treated 28 patients. We found statistically high significance p<0.01 in value mastoid-helix angle (MHA) preoperative and postoperative. In patients with bilateral otoplasty the difference between left and right MHAs after surgical procedure is less than 4 degrees. The difference of head-helix distance (HHD) preoperative and postoperative is statistically important with high significance p<0.05. Preoperative satisfaction by personal appearance was better after surgical procedure p<0.05. Complications occurred in 9 cases (32.4%). Otoplasty by scoring anterior surface of auricular cartilage is safe procedure for correction of prominent ear with excellent results on patient satisfaction by personal appearance. Effect of reducing the MHA and HHD is long lasting.
Signa Vitae - A Journal In Intensive Care And Emergency Medicine
Aim. Sepsis remains the leading cause of mortality in spite of advanced diagnostics. The aim of t... more Aim. Sepsis remains the leading cause of mortality in spite of advanced diagnostics. The aim of the study was to test the diagnostic value of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in the context of a new definition of sepsis. Methods. The study was conducted on 41 patients who were suspected of having sepsis according to SIRS (Systemic Inflammatory Response Syndrome) criteria or sterile SIRS. 20 healthy volunteer blood donors were the control group (adult patients of both sexes). According to the latest sepsis criteria (Sepsis-3), patients were retrospectively divided into three subgroups: septic patients, patients with SIRS plus infection and patients with sterile SIRS (non-infectious SIRS). All subjects had concentrations of sTREM-1 determined by the ELISA method (Abcam commercial test, Cambridge, MA, USA). Samples were collected upon admission to hospital and kept at-20°C until laboratory analysis was performed. Results. Concentrations of sTREM-1 were significantly increased in patients, compared to the healthy population (p=0.021), but there were no significant differences among subgroups of patients (SIRS plus infection vs. sepsis p=0.871, SIRS plus infection vs. sterile SIRS p=0.72, sepsis vs. sterile SIRS p=0.65). The value of 300pg/mL was determined to be the optimal cutoff. Concentrations of sTREM-1 were significantly higher in septic patients who did not develop Multiple Organ Dysfunction Syndrome (MODS) within the first 48 hours after admission than in those who did. Conclusion. According to our results, sTREM-1 failed to express significance as a diagnostic biomarker of sepsis, according to the new definition. Also, it seems not to be a valuable marker in differentiation of sepsis and non-infective SIRS.
Srpski arhiv za celokupno lekarstvo
Introduction/Objective. Chronic rhinosinusitis is one of the most frequent chronic disorders whic... more Introduction/Objective. Chronic rhinosinusitis is one of the most frequent chronic disorders which significantly influences the patients? quality of life. The objectiv? of this paper was to examine which are the most frequent and intensive symptoms in patients with chronic rhinosinusitis, and also to determine whether there is a correlation between a subjective assessment of the disease as a whole and individual symptoms. Methods. The study encircled 90 patients with clinical diagnosis of chronic rhinosinusitis that was endoscopically proven and computer tomography of the nose and paranasal sinuses. Every possible symptom was recorded in every patient (nasal congestion, nasal discharge, facial pain/pressure, reduction or loss of smell, headache, fatigue, cough, halitosis and ear pain/fullness), the intensity of every possible symptom as well as the disorder as a whole. The patients assessed the intensity of their symptoms on the visual analogue scale. Results. Nose congestion is the...
Specijalna edukacija i rehabilitacija
Vojnosanitetski pregled
Background/Aim. Cochlear implantation (CI) is a therapeutic modality that provides a sense of sou... more Background/Aim. Cochlear implantation (CI) is a therapeutic modality that provides a sense of sound to children and adults with profound sensorineural hearing loss or deafness. The aim of this work was to evaluate the lateral semicircular canal function using a high frequency video head impulse test in children after CI. Methods. A prospective descriptive study included 28 children (6?17 years old) with profound sensorineural hearing loss and unilateral CI. The control group included 20 healthy children with normal hearing. The measurement of vestibular function of the lateral semicircular canal was performed using video head impulse test. After cochlear implantation, the children underwent the vestibular testing. Values vestibulo-ocular reflex of lateral semicircular canal were measured using the video head impulse test in the children with cochlear implant and the control group. The values of vestibulo-ocular reflex were compared between the group. Also, in the children with CI va...