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Biomedical subjects

D Miletić

Publications and source records attributed to D Miletić.

At least 19 recordsLinked to original sources

Effect of 6-month athletic training on motor abilities in seven-year-old schoolgirls.

The effects of six-month athletic training on improving motor abilities in 7-year-old schoolgirls were assessed. Analysis of the results of 12 motor tests showed significant improvement in the study group (n = 38) in comparison with control group (n = 140) subjected to conventional physical education classes only. The improvement referred to the variables of aerobic endurance (3-min run), flexibility (forward bow), explosive strength (ball throwing and 20-m run), keeping balance (bench standing), static strength (bent arm hang), and repetitive strength (sit-ups). These are probably adaptive changes brought up by discriminant functions. The varimax factor and discriminative function correlations indicated that all four factors of changes contributed significantly to the explanation of discriminative function. An almost equally high correlation of varimax factors and discriminative function was obtained on the basis of differences in the third factor responsible for changes in the frequency of movements and in the explosive strength of the jump type; in the second factor responsible for changes in coordination with changes in the repetitive strength of the body; and in the fourth factor responsible for changes in the explosive strength of the throw and sprint types with changes and endurance.

Case-Control Studies↗

Ultrasonography in the evaluation of hemoperitoneum in war casualties.

The aim of this study was to evaluate the sensitivity, specificity, accuracy, and positive and negative predictive values of emergent ultrasound examination in the detection of hemoperitoneum among war casualties, and to compare the results of this method in a specific war situation and civil conditions. Ninety-four wounded individuals with suspected blunt or penetrating abdominal trauma were treated at a level I war hospital (group W), and 242 civilians with multiple injuries with suspected blunt abdominal trauma were evaluated at the emergency center of a university hospital (group C). All examinations were performed in less than 5 minutes with a portable ultrasonographic scanner, and typical points were scanned (Morison's pouch, Douglas and perisplenic spaces, paracolic gutter). In group W, hemoperitoneum was identified correctly in 19 patients, with three false-negative and no false-positive findings, whereas group C presented 98 true-positive results, 13 false-negative results, and again no false-positive results. We observed that ultrasonography in specific war conditions showed sensitivity of 86%, specificity of 100%, accuracy as high as 97%, positive predictive value of 100%, and negative predictive value of 96%, whereas in civil conditions the corresponding values were 88%, 100%, 95%, 100%, and 91%, respectively. The sensitivity, specificity, accuracy, and positive and negative predictive values of emergent ultrasound examination in the diagnosis of hemoperitoneum are approximately equal in war and civil conditions.

Abdominal Injuries↗

Resistance and pulsatility indices in acute renal obstruction.

PURPOSE: The aim of this study was to evaluate the reliability of Doppler waveform alterations in diagnosing acute unilateral renal obstruction. METHODS: From December 1993 to January 1996, 54 patients with unilateral renal obstruction were prospectively examined by conventional and duplex Doppler sonography. Seventy-eight patients with nonrenal abdominal problems comprised the control group. Doppler signals were obtained from interlobar arteries and arcuate arteries at the corticomedullary junction. From the waveform analysis, we calculated resistance (RI) and pulsatility (PI) indices. We also used the differences in RI and PI between the 2 kidneys in the same examinee (delta RI and delta PI) for further statistical analysis. RESULTS: The mean RI and PI (+/- standard deviation) in the patients without renal impairment were 0.64 +/- 0.04 and 1.14 +/- 0.14, respectively. The mean delta RI and delta PI were 0.02 +/- 0.01 and 0.07 +/- 0.05, respectively. Both the RI and PI were significantly correlated with age (r = 0.74 and 0.69, respectively; p < 0.01). Acute renal obstruction significantly (p < 0.01) elevated the mean RI (0.72 +/- 0.04), delta RI (0.09 +/- 0.04), PI (1.42 +/- 0.17), and delta PI (0.33 +/- 0.18). Significant decreases in RI and delta RI were noted after relief of the obstruction. The best accuracy in diagnosing acute unilateral renal obstruction was achieved with the combination of delta RI > or = 0.06 and/or delta PI > or = 0.20, which had a sensitivity of 94% and specificity of 99%. CONCLUSIONS: Renal Doppler indices are reliable parameters in the sonographic diagnosis of acute unilateral obstructive uropathy.

Adult↗

Sonographic measurement of absolute and relative renal length in adults.

PURPOSE: The aim of this study was to evaluate sonographically measured absolute and relative lengths of normal kidneys according to subject height, sex, and age. METHODS: Real-time sonography was performed on 202 subjects. Measurements of longitudinal renal diameter represented absolute renal length. Relative renal length was calculated using the kidney length: body height ratio (KBR). RESULTS: Statistical analyses were done on findings in 175 subjects without renal impairment (104 men and 71 women) whose ages ranged from 17 to 85 years (mean +/- SD, 46.3 +/- 17.1). The mean heights of the subjects were 176 +/- 7 cm for men and 167 +/- 6 cm for women. The left kidney was absolutely (mean +/-SD, 112 +/- 9 mm) and relatively (mean KBR +/- SD, 0.655 +/- 0.042) longer than the right kidney (absolute length, 110 +/- 8 mm; KBR, 0.641 +/- 0.038), regardless of sex (p < 0.01). The absolute renal length was significantly greater in men than in women for both kidneys (p < 0.01), but there was no significant difference between KBRs (p > 0.05). Renal length decreased with age, and the rate of decrease seemed to accelerate at 60 years and older. When height and age were included in the multivariate regression analysis, sex was not a significant predictor of kidney length. CONCLUSIONS: Relative renal length better represents kidney size than absolute renal length because it eliminates sex and height differences.

Adolescent↗

Kidney length in postoperative acute renal failure.

PURPOSE: The aim of this study was to evaluate kidney length in patients with postoperative acute renal failure (PARF). METHODS: The effect of PARF on renal size was prospectively studied in 76 patients with PARF and 40 healthy volunteers. Sonographic measurements of kidney length and the level of serum creatinine were obtained each day patients stayed in our surgical intensive care unit. These measurements were done once in volunteers. All study subjects were divided into groups on the basis of age, those younger than 65 years and those 65 years or older. Statistical analyses on the relation of renal size, age, and degree of PARF used the kidney length:body height ratio (KBR) and the peak serum creatinine level. Follow-up kidney length and creatinine measurements were done in 24 patients 1-5 years after they recovered from PARF. RESULTS: Regardless of age, mean KBRs were significantly greater in patients than in healthy volunteers (< 65 years, p < 0.001; > or = 65 years, p = 0.008), with a negative correlation between KBR and patient age (r = -0.664; p < 0.001). A positive correlation was found between the KBR and the peak serum creatinine level in patients younger than 65 years (r = 0.543; p < 0.001); an insignificant negative correlation was found between these factors in patients 65 years or older (r = -0.264; p = 0.1). Follow-up on recovered patients showed that their KBRs were significantly lower than the values when patients had PARF (< 65 years, p < 0.001; > or = 65 years, p = 0.027). CONCLUSIONS: PARF produces a sonographically measurable increase in renal size.

Acute Kidney Injury↗

[Single-layer anastomosis of the colon].

Presented are the analysis of 134 single-layer colon anastomosis done between years 1983 and 1993. Essential parameters of those are compared with two-layer colon anastomosis - 65, done at the same period, as well as with wider series done in the world in a last couple of years. Main task of the analysis is to point to contemporary developments of suture technique in the world and at home, which is being simplified in technical terms, characterized by time and material savings without affecting anastomosis quality. Those characteristics have been attained due to good preparation of intestines, improved materials, antibiotics and due to finding out that submucosis and subserosis are carriers of suture firmness. On processed material when single-layer suture was used (134) we had average of 8.2% clinically evident fistulas - single-layer individual (78) 3.8% a single-layer continuous (58) 14%. With two-layer suture technique (65) we had 14% clinically evident fistula. Average mortality with both techniques was 4%.

Adult↗

[Anastomosis of the rectum].

The anastomosis between rectal remnant and anal canal with other parts of digestive system, remains a big challenge for surgeons till nowadays. In the years period 173 anastomoses has been done with 21 case (12%) of clinical leaks. According to our experience the technique of continuous extramucosal one layer anastomosis is a good one for high colorectal and ileorectal anastomosis. For low colorectal anastomosis the technique of extramucosal interrupted sutures for posterior and Lembert's suture for anterior wall as single layer have had the lowest incidence of clinical leaks. Low and ultra low anastomoses could be best done with double staptechnique acc. to Knight-Griffen. Our figure of 12% of clinical leaks is rather comparable with published data of others.

Anal Canal↗