Morphology of the greater palatine foramen: a clinical point of view.

PURPOSE: Anatomical characteristics of the greater palatine foramen (GPF) are essential during the greater palatine nerve block application to anesthetize maxillary teeth, gums, midface, and nasal cavities. The position of GPF is usually described in relation to adjacent anatomical structures. This investigation aims to examine the morphometric relationships of GPF and closely determine its position. METHODS: The study included 87 skulls (174 foramina). They were photographed in a horizontal position with bases facing up. The digital data were processed in the ImageJ 1.53n software. RESULTS: The average distance of the GPF from the median palatine suture was 15.94 mm. In relation to the posterior border of the bony palate, the distance was 2.05 mm. Statistical significance was found in comparing the angle between the GPF, incisive fossa, and the median palatine suture between the sides of the skulls (p = 0.02). Comparing tested parameters between males and females showed significant differences in GPF-MPS (p = 0.003) and GPF-pb (p = 0.012), with lower values in females. The most significant percentage of skulls (77.01%) had the GPF located at the level of the third molar. The most significant number of bony palates had one lesser opening (60.91%) on the left side. CONCLUSION: GPF is located at the level of the maxillary third molar in most of the examined palates. Knowledge of the anatomical position of the greater palatine foramen and its variations is the basis for successfully implementing anesthesia and various surgical interventions.

What Do We Find Attractive about the Face?: Survey Study with Application to Aesthetic Surgery.

The appearance of the face is one of the most important factors influencing our perception of beauty. However, few studies have attempted to quantitate what one perceives as beauty. Therefore, this study was conducted with the goal of providing physicians with anatomical data that demonstrate which facial traits most influence our perception of one's attractiveness. In the first phase of the study, faces of 60 participants (30 males and 30 females) were photographed. Next, the photographs were shown to another group of 120 study members (60 males and 60 females), who evaluated the facial features using a Visual Analogue Scale. The highest rated facial parts were then measured using the ImageJ program. In men, the most attractive parts of the face were Type 1:2 lips, a Type IV nose of medium width, blue eyes, brown hair, and a very narrow face. Among females, the most attractive parts of the face were Type 2:1 lips, Type III and V noses of medium width, dark brown eyes, blonde hair, and a narrow face. This is the first study in which the most aesthetically important facial parts have been comprehensively examined. The results obtained in our study show a higher degree of representativeness compared to other studies due to a different methodological approach and can be used as an aesthetic guide and can help in the planning of aesthetic surgery such as lip augmentation and rhinoplasty. Clin. Anat. 33:214-222, 2020. © 2019 Wiley Periodicals, Inc.

Morphometric analysis and surgical adequacy of palmaris longus as a tendon graft. A systematic review of cadaveric studies.

INTRODUCTION: The tendon of the palmaris longus is commonly used as a tendon graft in many reconstructive surgeries. Easy to access and at proximity to the hand, the palmaris longus tendon is considered as the optimal tendon source for hand reconstructive surgery. However, and besides its inconsistency, the size of the palmaris longus tendon is reported to show variability. The aim of this study is to look for the surgical adequacy of the palmaris longus tendon by conducting a quantitative synthesis on its length and width in human populations and its correlation with the forearm length. METHODS: Twenty-four studies met the inclusion criteria including 1761 cadaveric limbs. RESULTS: The results were as following: (a) the mean palmaris longus tendon length was of 13.9 ± 2.6 cm, (b) the mean ratio palmaris longus tendon length/forearm length was of 0.545 ± 0.06, (c) the weighted correlation value was of 0.686, and (d) the mean palmaris longus tendon width was of 4.0 ± 1.7 mm. Only five studies reported a palmaris longus tendon length of more than 15 cm. The palmaris longus tendon length was shown to vary between ancestries; the Japanese had the shortest while Malaysian the longest palmaris longus tendons. All studies but one reported a palmaris longus tendon mean width of more than 3 mm where the minimal mean palmaris longus tendon width was of 2.5 mm. CONCLUSION: While the requested length depends on the recipient site and/or type of reconstructive surgery, the palmaris longus tendon often met the required diameter for grafting. Our review demonstrated that while palmaris longus length varies between ancestries, its width is often adequate for grafting. In addition, the forearm length could be a good predictor of palmaris longus tendon length; such correlation could assist surgeons when planning to use palmaris longus tendon as a graft source.

Variations and morphometrics of palmaris longus in fetuses: a meta-analysis of cadaveric studies.

The palmaris longus muscle, and its tendon, is one of the most variable muscles in humans. Though it has been extensively researched in the adult population, its variations and development in the fetal period were rarely investigated. The aim of this meta-analysis is to conduct an evidence synthesis on PL variations and the prevalence of its agenesis during intrauterine development. Seven studies met the inclusion criteria comprising 497 fetuses and 1027 fetal limbs. The true and crude weighted prevalence rates were of 81.2% and 77%, respectively. The bilateral and unilateral prevalence estimates were of 62.2% and 15%, respectively. No significant differences were found for side-based and gender-based prevalence values. There were significant frequency differences between the studied populations (p < 0.0001).The Japanese population had the highest prevalence, the Turkish had the lowest and the European value was in between. Out of 494 studied muscles, 67 (13.5%) variations were noted. The weighted proportions of the commonest morphological variations were as follows: (a) bifid tendon in 10 (2%) cases, (b) inverted PL muscle in 9 (1.9%), muscle duplication in 6 (1.36%), and digastric muscle in 25 (5.1%). Prevalence values of the fetal PL were similar to those reported in adults; however, variations seem to be higher than in older populations. The true, crude, and ancestry-based prevalence presence rates of PL in fetuses were found to be similar to those of the adult population.

Prevalence of the Linburg-Comstock variation through clinical evaluation.

INTRODUCTION: Linburg-Comstock variation, the tendinous interconnection between flexor pollicis longus and flexor digitorum profundus, is known to have a wide frequency range. Its prevalence is reported with a range of 13-66%. The aim of the study was to assess this variation in general population and to correlate it with gender and side. MATERIAL AND METHODS: This prospective study included 215 subjects (82 males and 133 females). Two clinical tests were conducted to diagnose the variation and to detect any related symptomatology. The primary outcome was set to be the prevalence of Linburg-Comstock variation. Secondary outcomes were defined as gender-based prevalence, side-based prevalence, and Linburg-Comstock variation prevalence association with gender and side. RESULTS: Linburg-Comstock variation was clinically diagnosed in 130 (60.47%) participants. Unilateral and bilateral prevalence were of 17.21% and 43.26%, respectively, yielding a statistically significant difference. Right-sided and left-sided presence were calculated at 7.44% and 9.77%. Bilateral prevalence was statistically more common in females. Right-sided variation was found to be more frequent in males while left-sided variation was more prevalent in females. The index finger was the most commonly involved with prevalence of 91.03%. Symmetry was noted in 67.74% of subjects. CONCLUSION: The results of our study demonstrated a relatively high prevalence of the Linburg-Comstock variation in Serbian population. We noted a few unusual cases and this finding point to the existence of the broader spectrum of Linburg-Comstock variation, and complexity of the flexor apparatus of the hand, so, further investigations about this topic are needed to improve our knowledge. Due to the possibility of false-positive result during clinical testing we suggest to use expanded clinical method.

Linburg-Comstock variation and syndrome. A meta-analysis.

INTRODUCTION: Linburg-Comstock variation often connecting the flexor pollicis longus and flexor digitorum profundus of the index finger at a different level with significant discrepancy between clinical and cadaveric frequencies reported in the literature. Although this variation is quite prevalent, it is yet frequently unrecognized. The aim of this meta-analysis is to generate more accurate weighted frequency values of the Linburg-Comstock variation and to look for possible association with ethnicity, laterality, gender and side. METHODS: A systematic literature search identified 14 studies, including 4132 forearms/hands, which met the inclusion criteria. RESULTS: While no significant difference was found for laterality, we found significantly higher Linburg-Comstock variation rate in females compared to males. Turkish population demonstrated a significantly higher crude frequency when compared to Europeans (22.2 vs. 15.2%). Hispanic population showed the highest crude frequency (34.5%), whereas the African ancestry showed the least one (8.8%). CONCLUSIONS: Linburg-Comstock variation could cause career-threatening disabilities and could complicate some hand injuries as well. This review invites future researchers to use a single nomenclature; the term "Linburg-Comstock variation" is to be used when no symptoms are present, and the term "Linburg-Comstock syndrome" in cases where the variation is symptomatic.

PALMARIS LONGUS ABSENT IN ONE IDENTICAL TWIN: A CASE REPORT.

- Palmaris longus is a very variable muscle in the human body, but it is often used as an applicable tendon graft. We report on differences between one pair of identical twins regarding the existence of the palmaris longus, which were detected accidentally during examination of the presence/absence of this muscle in Caucasian population. In one of the twins, the palmaris longus was present at both forearms, while the other twin was lacking this muscle at both forearms. On search of the available literature, we found no articles about distinctions in the presence or absence of the palmaris longus in twins.

An anatomical study of the lumbar external foraminal ligaments: appearance at MR imaging.

PURPOSE: The purpose of this study was to examine the MRI appearance of the ligaments within the external space of the lumbar intervertebral foramen by correlating MR images with the corresponding anatomic dissection of the cadaver lumbar spine. METHODS: This was a two part study. Part I of the anatomic study consisted of the dissection of lumbar specimens from one embalmed adult male cadaver. At each lumbar level the external ligamentous structures were identified and their origin, insertion and position were determined. Part II of the study consisted of the anatomical analysis of the external transforaminal ligaments in the 180 lumbar intervertebral foramina on the MR images (1.5 T) in the sagittal plane. The diagnostic procedure was performed on 18 individuals from 18 to 25 years of age. RESULTS: The external transforaminal ligaments were observed at all levels and from both sides in the lumbar intervertebral foramen. The presence of the superior corporotransverse ligament was found in 45.56% intervertebral foramina, while the inferior corporotransverse ligament was found in 61.67% intervertebral foramina in the MRI. CONCLUSION: Our results confirm that external transforaminal ligaments are common structures in the intervertebral foramen. The results of this study show that the external transforaminal ligaments can be clearly visualized in MR images. It is crucial to have previous knowledge of the cadaveric specimens to recognize the transforaminal ligaments in MR images. The presence of these ligaments is clinically important because the ligaments could be the cause of nerve root compression or the low back pain syndrome.

Patient self-reported adherence for the most common chronic medication therapy.

AIMS: The aims of this study was to determine adherence to chronic disease medication measured by self-reported questionnaire. METHODS: The survey was conducted at 106 Zagreb pharmacies, and the questionnaire was filled out by the study subjects. RESULTS: A total 1,357 diagnoses were reported by survey respondents (i.e., an average of 2.1 diagnoses per respondent). The most common diagnoses were diseases of the circulatory system (n = 500; 36.8%). The great majority of study subjects reported forgetfulness ('I just forgot') as the main reason for skipping drug doses. CONCLUSIONS: Among the many reasons people give for not adhering to drug treatment, forgetfulness was the most common. Common barriers to adherence are under the patient's control, so that attention to them is a necessary and important step in improving adherence. The existence of more than one cause of risk considerably increases the non-adherence risk of a patient.

Deep inferior epigastric perforator flap: an anatomical study of the perforators and local vascular differences.

The objective of this study was to determine precise localization and external diameter of the lower abdominal wall perforators as well as to investigate some vascularity differences between the same parts of perfusion zones II and III according to Hartrampf perfusion zones. The study was performed on 10 fresh cadavers (20 hemiabdomens) using the gelatin injection technique. All perforators were identified, and their localization and diameter were noted. Measurements were made at the level of the fascia. We noted localization and diameter of arteries on cross-sectional planes of either part of the flap. The median sum of the external diameter of all arteries in zone I was 17.01 mm. The median sum of the external diameter of all arteries in the medial 1/3 part of zone III was 4.17 mm, and in the medial 1/3 part of zone II, it was 0.96 mm. The median sum of the external diameter of all arteries in the intermediary 1/3 part of zone III was 2.16 mm, whereas in the intermediary 1/3 part of zone II, it was 0.81 mm. Significant differences were recorded between proximal and middle horizontal regions of zones II and III and between medial vertical part of zone III and medial vertical part of zone II. Anastomoses between zones I and II are considerably smaller compared with anastomoses between zones I and III. The best vascularized parts of the lower abdominal wall were perfusion zone I, then the inner 2/3 of zone III and medial 1/3 of zone II.

Effectiveness of the Reverse Sural Flap in Covering Diabetic Foot Ulcers: A Systematic Review and Meta-Analysis.

Background: The reverse sural fasciocutaneous flap (RSFCF) has been used with success to cover noncomplicated foot and ankle soft tissue defects. However, there are some controversies when it is used in patients having chronic diabetic foot ulcers. This aim of this meta-analysis was to evaluate the efficacy of RSFCF in covering diabetic foot and ankle ulcers. Methods: A systematic review was undertaken from MEDLINE, EMBASE, Web of Science, Cochrane Library, and Google Scholar. Only diabetic foot and ankle ulcers were accepted for inclusion and all study designs were included. Proximally based flaps, nondiabetic ulcers, and assisted negative pressure therapy were excluded. Suitability for inclusion was assessed by 2 reviewers. The random-effect estimate was reported for the set outcomes whenever high heterogeneity was present. Metaregression analysis was performed to identify independent risk factors for failure. Results: The search identified 33 relevant studies comprising 187 patients and flap interventions; all but 1 were case-series. The weighted outcomes were as follows: (1) the flap healing rate was 93.3% while 6.6% resulted in total necrosis, (2) the rate of partial flap necrosis was 12%, (3) venous congestion was reported in 6.6% of cases, (4) the infection rate was 8.3%, and (5) the donor site morbidity was 4.6%. No association was found between pedicle width or presence of a subcutaneous pedicle tunnel and the primary outcome of total loss. Conclusions: This review demonstrated excellent results of the flap when covering complicated or large diabetic foot and ankle ulcers. When compared to those published in the literature, our results found RSFCF to be relatively less successful in diabetic wounds than in trauma patients but more successful than in those having associated osteomyelitis and those who were treated with random local flaps.

Historique: Le lambeau fascio-cutané sural inversé (LFCSI) a couvert avec succès des anomalies non compliquées des tissus mous du pied et de la cheville. Cependant, une controverse sévit quant à son utilisation chez les patients ayant des ulcères du pied causés par un diabète chronique. La présente méta-analyse visait à évaluer l'efficacité du LFCSI sur des ulcères du pied et de la cheville causés par un diabète. Méthodologie: Les chercheurs ont réalisé une analyse systématique dans MEDLINE, EMBASE, Web of Science, Bibliothèque Cochrane et Google Scholar. Ils n'ont inclus que les ulcères du pied et de la cheville causés par le diabète, mais accepté toutes les méthodologies d'étude. Ils ont exclu les lambeaux proximaux, les ulcères non diabétiques et la thérapie assistée par pression négative. Deux examinateurs ont évalué la pertinence de l'inclusion. Ils ont précisé l'évaluation à effets aléatoires des résultats cliniques observés dès qu'une forte hétérogénéité était constatée. La méta-analyse de régression a permis d'établir les facteurs de risque d'échec. Résultats: La recherche a permis d'extraire 33 études pertinentes incluant 187 patients et interventions par lambeaux, toutes étant des séries de cas, sauf une. Les résultats pondérés s'établissaient comme suit: a) taux de guérison des lambeaux de 93,3%, et 6,6% de nécrose totale, b) taux de nécrose partielle du lambeau de 12%, c) congestion veineuse dans 6,6% des cas, d) taux d'infection de 8,3% et e) atteinte au siège du donneur de 4,6%. Aucune association n'a été constatée entre la largeur du pédicule ou la présence d'un tunnel pédiculaire sous-cutané et le résultat primaire de perte totale du lambeau. Conclusions: La présente analyse a démontré d'excellents résultats du lambeau pour couvrir des ulcères étendus et complexes du pied et de la cheville causés par le diabète. Par rapport aux résultats figurant dans les publications, les LFCSI étaient relativement moins efficaces pour les plaies causées par le diabète que par un traumatisme, mais plus efficaces que celles également associées à l'ostéomyélite ou que les lambeaux locaux aléatoires.

Prevalence of the palmaris longus in relation to the hand dominance.

PURPOSE: The incidence of left-handedness in the general population is between 8 and 15%. There is a presumption that the prevalence of palmaris longus muscle differ between right-handed and left-handed people. This prospective study was conducted to determine the prevalence of the palmaris longus in relation to the hand dominance. METHODS: The study included 542 subjects (216 male and 326 female). They were initially tested to hand dominance and after that they were asked to do the standard test (Schaeffer's test) for the assessment of the palmaris longus tendon. If the tendon was not visualized or palpable, four additional tests (Thompson's test, Mishra's tests I and II, Pushpakumar's "two-finger sign" method) were done to confirm its absence. RESULTS: Right hand dominance was recorded in 452 (83.4%) subjects while the left hand dominance was recorded in 90 (16.6%) subjects. In right-handed subjects, palmaris longus tendon was absent on the right side in 24 (5.3%) and on the left side in 50 (11.1%) cases. In left-handed subjects, it was absent on the right side in 18 (20%) and on the left side in 2 (2.2%) cases. These differences were statistically significant. Bilateral absence of palmaris longus tendon was similar in both examined groups (25.1% in the overall series, 24.3% in right-handed subjects, 28.9% in left-handed subjects). CONCLUSIONS: The results of our study show that a right-sided absence was more common in left-handed persons while the left-sided absence was more common in right-handed persons. Unilateral tendon absence was more common on the non-dominant hand.

The effects of benzodiazepines in pregnancy.

OBJECTIVES: The objectives of the study were to assess the prevalence of anxiolytic use in pregnancy, the rate of congenital malformations in neonates at in utero exposure to these agents, and the possible association of congenital malformations with the use of these drugs in pregnancy. METHOD: The study was conducted as cross-sectional study. The study was performed at university departments of gynecology and obstetrics in four Zagreb hospitals and included 893 pregnant women. Main outcome measures were pathological defects and congenital malformations. RESULTS: The main anatomic group N drugs (nervous system) was predominated by the use of the benzodiazepine anxiolytic diazepam (FDA group D), which increased with gestational age. Diazepam was used by 74 (8.3%), 127 (14.2%) and 212 (23.7%) women in the first, second and third trimester respectively. Diazepam ranked second among twenty most frequently prescribed drugs in pregnancy. It was taken by 303 (33.9%) pregnant women, while congenital cardiovascular malformations were recorded in three children and genitourinary malformations in three children too. CONCLUSIONS: The high utilization of diazepam in pregnancy that is not supported by professional guidelines is an issue of serious concern. In spite of some study limitations, its results pointed to inappropriate and even potentially harmful use of drugs in pregnant women from Zagreb, thus calling for upgrading the quality of therapy in this vulnerable period of life. In our opinion, other measures appear to be a more appropriate therapeutic modality than medicamentous therapy in many cases.

Prevalence of the palmaris longus through clinical evaluation.

PURPOSE: Most standard textbooks of hand surgery report on the rate of palmaris longus muscle absence of 15%. The aim of the study was to determine the absence of palmaris longus and to correlate it with age, sex and body side. METHODS: The study included 800 subjects (400 male and 400 female). They were initially asked to do the standard test for the assessment of the palmaris longus tendon. If the tendon was not visualized or palpable, four additional tests were done to confirm its absence. RESULTS: Unilateral absence of the palmaris longus was recorded in 173 (21.6%) and bilateral in 127 (15.9%) study subjects. According to body side, right-sided absence of palmaris longus was found in 69 (8.6%) and left-sided in 104 (13%) subjects, yielding a statistically significant difference. Bilateral absence was slightly more common in men. The prevalence of palmaris longus absence on the right and left side was similar in men, whereas in women it was significantly more common on the left side. Differences between the three age groups (young, middle-aged and old) were not significant; however, the middle-aged and young groups showed a lower rate of palmaris longus presence as compared to old-age group. CONCLUSIONS: It has been suggested that this tendon is rapidly disappearing in humans. The results of our study show a relatively high incidence of tendon absence and pointed to more pronounced loss of the muscle on the left side.

Morphometric characteristics of neuropeptide Y immunoreactive neurons in cortex of human inferior parietal lobule.

The aim of this study was to demonstrate and precisely define the morphology of neurons immunoreactive to neuropeptide Y (NPY) in cortex of human inferior parietal lobule (IPL). Five human brains were used for immunohistochemical investigation of the shape and laminar distribution of NPY neurons in serial section in the supramarginal and angular gyrus. Immunoreactivity to NPY was detected in all six layers of the cortex of human IPL. However a great number of NPY immunoreactive neurons were found in the white matter under the IPL cortex. The following types of NPY immunoreactive neurons were found: Cajal-Retzius, pyramidal, inverted pyramidal, "double bouquet" (bitufted), rare type 6, multipolar nonspinous, bipolar, voluminous "basket", and chandelier cells. These informations about morphometric characteristics of NPY immunoreactive neurons in cortical layers, together with morphometric data taken from brains having schizophrenia or Alzheimer's-type dementia may contribute to better understanding patogenesis of these neurological diseases. The finding of Cajal-Retzius neurons immunoreactive to NPY points to the need for further investigations because of great importance of these cells in neurogenesis and involvement in mentioned diseases instead of their rarity.

Survival prediction in patients with cutaneous melanoma by tumour lymphangiogenesis.

Objectives: Melanoma induces lymphangiogenesis by secreting lymphangiogenic growth factors. The aim of this study was to examine the role of tumour lymphangiogenesis in survival of patients with cutaneous melanoma. Methods: Immunostaining of one hundred melanoma specimens was done with lymphatic-specific antibody D2-40. The quantification of tumour lymphangiogenesis - lymphatic vessel density (LVD) and lymphatic vessel area (LVA) - was calculated by computer-assisted morphometric analysis. Results: High intratumoural LVD, high peritumoural LVD, male gender, greater tumour thickness and Clark level IV/V were significantly associated with shorter disease-free survival (p= 0.001, p= 0.004, p= 0.004, p= 0.000 and p= 0.008, respectively) and melanoma-specific survival (p= 0.002, p= 0.002, p= 0.001, p= 0.000 and p= 0.017, respectively), while the trunk melanoma site was significantly associated only with shorter disease-free survival (p= 0.033). No significant association of LVA with survival was found. At multivariate analysis, peritumoural LVD [hazard ratio (HR) = 2.143, 95% confidence interval (CI) 1.097-4.189, p= 0.026)] and melanoma thickness (HR = 1.276, 95%CI 1.106-1.473, p= 0.001) were independent predictors of disease-free survival, while intratumoural LVD (HR = 3.446, 95%CI 1.465-8.109, p= 0.005), peritumoural LVD (HR = 2.742, 95%CI 1.313-5.725, p= 0.007) and gender (HR = 2.880, 95%CI 1.304-6.362, p= 0.009) were independent predictors of melanoma-specific survival. Conclusion: Тhis study shows that LVD enables better prediction of survival than melanoma thickness and other clinical-pathological parameters. Intratumoural LVD is the most significant predictor of melanoma-specific survival, while only peritumoural LVD has a significant impact on both, a disease-free survival and a melanoma-specific survival.

Morphometric analysis of the patterns of calcaneal facets for the talus in Serbian population.

Literature describes different patterns of calcaneal facets for the talus in terms of whether some calcaneal facets are connected or separated from each other or completely absent. The aim of this study was to establish the patterns of calcaneal facets for the talus, to calculate their total area, and to analyse the data with respect to gender. The study involved 59 calcanei which were photographed. The patterns of calcaneal facets noted in this study were compared with the patterns from the literature. ImageJ program was used to measure different parameters on calcanei. The pattern 1 was the most commonly found in the study sample (45.76%), then the pattern 2 (40.68%), and finally the pattern 3 (13.56%). That order of frequencies is the same in both sexes. The patterns 1 and 2 have a larger contact surface for the talus in comparison to the pattern 3. Male bones have a larger contact surface for the talus than female bones. The sum of the pattern 1 and pattern 3 frequencies was high. Knowing the frequency of different patterns of calcaneal facets for the talus in a certain population is important for orthopaedic surgeons when performing foot osteotomy.

Pregnancy and drugs for cardiovascular diseases.

OBJECTIVE: The course of pregnancy is associated with a number of changes in the female body. Literature data indicate that 1-3% of pregnant women develop some cardiac disorder. The aim of the study was to assess the prevalence of using cardiovascular agents in pregnancy, the rate of congenital malformations in neonates at in utero exposure to these agents, and the possible association of congenital malformations with the use of these drugs during pregnancy. METHODS AND RESULTS: One arm of the study (one-month study) was performed at four maternity hospitals in Zagreb, Croatia. The other arm of the study (one-year study) was performed at the University Department of Gynaecology and Obstetrics, Genetic Counselling Unit, and Department of Pathology and Histology in Novi Sad, Serbia. Only pregnant women using drugs for cardiovascular disorders during pregnancy were included in the study. Final analysis included data on 134 (32 from Zagreb and 102 from Novi Sad) pregnant women. Following delivery or abortion, the newborns and foetuses were thoroughly examined and followed-up for the occurrence of minor or major malformations. Malformations were found in 8 (6.0%) foetuses and newborns. CONCLUSION: For most cardiac disorders, the risk posed by the disease itself for both the mother and the foetus generally exceeds the postulated risk of medications used to treat the disease. If a pregnant woman requires such therapy, a respective agent with the best safety profile should definitely be prescribed.

Teratogenicity of antibacterial agents.

The aim of our study was to study the possible correlation between use of antibacterial drugs in pregnancy and occurrence of congenital malformations. Among 6099 investigated pregnant women, 392 (6.43%) used antibacterial drugs. The most frequently used antibacterials belonged to category B (75.77%), while 14.54% antibiotics belonged to category D and 1.02% to category X. The most often used antibiotics were cephalexin (22.19%), amoxicillin (20.66%) and ampicillin (14.29%). In 14 embryos exposed to effects of beta-lactams in utero, malformations were detected. The results of this study show possible teratogenic potential even with those antibacterials which are considered safe, but as those are usually minor malformations, they often pass undetected. Because of that and because of frequent use of antibacterials during pregnancy, detailed examinations concerning their safety should be made.

Application of algometry in patients with cervical and lumbar radiculopathy.

BACKGROUND: Algometry, as a highly sensitive method, provides an objective insight into the degree of pain, while the use of questionnaires can estimate the patient's psychological status in a simple way. OBJECTIVE: This study was conducted in order to measure the pressure pain threshold in patients with cervical and lumbar radiculopathy and to find a possible association of pain with the anxiety and depression. METHODS: The study examined 60 hospitalized patients with cervical radiculopathy and 60 patients with lumbar radiculopathy before starting and after finishing kinesitherapy. The research was conducted using the digital algometry device and Hospital Anxiety and Depression Scale. RESULTS: There was no statistically significant difference in algometric values between the patients with cervical radiculopathy and the patients with lumbar radiculopathy. The program of rehabilitation did not lead to significant improvement in the level of pain. Females have a lower pressure pain threshold than males. Psychological factors greatly affect the pain. CONCLUSIONS: The applied methods will provide the implementation of appropriate therapy and would achieve better verification of the results in a rehabilitation program. Radiculopathy in conservative therapy should be treated in cervical-thoracic and lumbar region together. Rehabilitation period for patients with radiculopathy have to be longer.