Biomedical subjects

Dusanka Dobanovacki

Publications and source records attributed to Dusanka Dobanovacki.

4 recordsLinked to original sources

PubMedDate not supplied

[Postoperative nausea and vomiting].

INTRODUCTION: Postoperative nausea and vomiting (PONV) and pain are the most common complaints following anesthesia and surgery, and due to negative emotional impact on patients, they cause prolonged postoperative recovery. The incidence of PONV is 20-30% during the first 24 h after anesthesia. Both peripheral and central mechanisms are involved in control of emesis. FACTORS: Many factors associated with anesthesia and surgery may affect PONV: patient's age and sex, history of PONV after pervious anesthesia, administration of antiemetics prior to operation, type and duration of operation, type of premedication, induction agent, maintenance agent, reversal of muscle relaxation, treatment of postoperative pain and movement of patients. ANTAGONISTS OF 5-HYDROXYTRYPTAMINE-3 (5-HT3) RECEPTORS: Ondansetron is a competitive serotonin type 3 receptor antagonist important in prevention of PONV. However, if 5-HT 3 receptor antagonists are effective against nausea and vomiting after a variety of anesthetic and surgical procedures, then at last we may have the key to the mechanism of PONV. Prophylaxis with a combination of antiemetic drugs is more effective in prevention of PONV.

Antiemetics↗

PubMedDate not supplied

[External genital abnormalities in male schoolchildren: an epidemiological study].

INTRODUCTION: External genital abnormalities represent the most common congenital anomalies. Proper, not delayed diagnosis and treatment of certain abnormalities (undescended testis, hypospadia, varicocele) is of great importance for future fertility potential of children. MATERIAL AND METHODS: An epidemiological study, that consisted of an urological checkup, was performed among school-aged boys in two elementary schools. Prevalence of external genital, and inguinal region was examined. RESULTS: A total of 1229 elementary school boys were examined. The incidence of external genital abnomalities was 27.8%. Certain anomalies were already surgically treated in 7.8% of boys. Phimosis wasfound in 66 patients (5,5%), which represents 26.6% of all abnomalities. DISCUSSION: In this study the incidence of undescended testis was 2.0%. Although it is similar to literature data, the fact that undescended testis was found in 25 boys older than 7 years (two of them 15 years old!) suggests that the primary health care is not satisfactory. The incidence of inguinal hernia and hydrocele varies according to different authors from 0.8-4.4% to 13.44%. In this study the incidence was 2.4%. Varicocele represents a developmental anomaly and the incidence is increasing with age. It is rare in boys up to 10 years of age, but the incidence of varicocele in boys aged 15 years (15.8%) reaches the level of incidence in adults (19.82%). The incidence of phimosis in this study was 5.5%. CONCLUSION: High incidence of external genital abnormalities in school aged boys suggests a need for further education of physicians in primary health care services as well as of parents.

Adolescent↗

PubMedDate not supplied

[Clinical evaluation of fecal continence after posterior sagittal anorectoplasty in anorectal abnormalities].

INTRODUCTION: Posterior sagittal anorectoplasty (PSARP) was introduced in 1982, by Pena and de Vries, as a new surgical procedure for patients with anorectal malformations. It was supposed to provide better chance for normal fecal continence. MATERIAL AND METHODS: Between 1991 and 2000, 50 patients with anorectal abnormalities underwent PSARP. In 43 patients PSARP was primary operation and in 7 it was a secondary procedure. At the time of study patients were not younger than 3, and not older than 13 years. Patients and their parents were interviewed, and fecal continence was graded as follows: voluntary bowel contractions, soiling less than once a week, soiling more than once a week, daily soiling and constipation. RESULTS: Amongst patients who underwent primary surgical correction, 74% had voluntary bowel contractions. Babies with perineal fistula, rectal atresia and stenosis presented with best results in term of voluntary bowel contractions (100%), as with vestibular fistula, ten of eleven patients. Only 18% of patients (atresia without fistula, vestibular fistula and bulbourethral fistula) had soiling. Patients with perineal fistula and rectal atresia and stenosis 40% were totally continent (voluntary bowel movements without soiling). The most frequent sequel was constipation, which appeared in 48%, without coincidence with frequency of soiling. The problem of constipation was surprisingly more frequent in patients with expected better prognosis in fecal continence. CONCLUSION: Although PSARP offers a good esthetic result, only two third of patients have voluntary bowel movements and in about half there exists a problem with constipation, with necessary further treatment.

Anal Canal↗

PubMedDate not supplied

[Constipation--a common problem in childhood].

INTRODUCTION: Constipation in children is defined as the infrequent and difficult passage of hard stool, not necessarily associated with in-frequent stools. All healthy newborns have their first stool within the first 24 to 48 hours after birth. Intestinal transit time increases with age, therapy decreasing the frequency of stooling. ANATOMY AND PHYSIOLOGY OF ANUS AND RECTUM: Acquisition of fecal continence requires: normal internal and external anal sphincters, puborectal muscle as well as intact sensory input from both the rectal vault and anal canal. ETIOLOGY AND DIFFERENTIAL DIAGNOSIS: During the first year of life, failure to have bowel movement every other day warrants evaluation. During infancy, constipation is usually due to dietary manipulations, malnutrition or some other functional abnormalities. Anatomic causes are found only in 5% of patients. DIAGNOSIS AND THERAPY: Diagnosis relies on history and physical examination. Digital rectal examination usually reveals a shorter anal canal with decreased sphincter tone. The rectal ampulla is dilated and filled with stool. Anorectal manometry is helpful in differentiating functional constipation from aganglionosis or other neurologic problems. Treatment varies depending on the underlying cause. Bowel retraining, aimed at establishing regular daily bowel movement, is of utmost importance in children. The response to treatment is usually dramatic. CONCLUSION: Constipation in children causes anxiety in the family and successful treatment requires persistent reassurance and repeted reevaluation.

Child↗