Evaluation of the self-assessment knowledge regarding cardiopulmonary resuscitation in medical students at the University of Belgrade.

OBJECTIVE: Cardiopulmonary resuscitation (CPR) is a vital skill that can improve the outcome of patients with sudden cardiac arrest. To raise awareness about CPR some countries have introduced an obligatory First Aid Course (FAC), usually done parallelly to a driver's license (DL). While expected of doctors to know CPR, the curriculum of some medical schools does not seem to have enforced measures to improve that knowledge. The aim was to have students self-evaluate their current knowledge of CPR, comparing it before university and whether it improved during their studies. SUBJECTS AND METHODS: A cross-sectional study was conducted in October 2020 using an anonymous questionnaire among students at the Faculty of Medicine in Belgrade (studies in English). RESULTS: A total of 172 (66.7%) students possessed a DL, of which 39.8% felt they were ready, 45.8% felt neutral, and 14.4% felt unable to perform CPR. The total number of students that completed a FAC during their studies was 165. Analysis was performed on the ability assessment data after the first FAC during studies, comparing it to FAC for DL and assessments at the end of studies. No statistically significant difference was observed in the level of self-reported ability to perform CPR, while a statistically significant difference was found in ability assessments when comparing only the FAC for the DL, and the one after the first FAC during medical studies, with students feeling more prepared after the FAC for DL. Across the sample, 90.2% of the students wished they had more CPR training during their medical studies. CONCLUSIONS: From this study, it may conclude that students wish and need more CPR training in their curriculum.

Predictors of health-related quality of life in Serbian patients with head and neck cancer.

BACKGROUND: The aim of this study was to identify predictors of the Health-Related Quality of Life (HRQoL) in patients with head and neck cancers (HNCs). MATERIAL AND METHODS: In total, 345 patients with HNCs were interviewed. A self-report questionnaire was administered to collect data about demographic characteristics, health status, smoking, alcohol consumption habits, and HRQoL. It were used the EORTC Instruments - Quality of Life Questionnaire-Core 30-questions (QLQ-C30), Quality of Life Questionnaire - Head and Neck Module 35-questions (QLQ-H&N 35) and OHIP-14 instrument for HRQoL assessments. Clinical information and treatment data were collected from medical records. RESULTS: Five groups of HRQoL predictors were identified: demographic, socioeconomic, behavioral, psychophysical, and clinical/treatment. These HRQoL predictors had a strong (i.e., age, level of social support and social contact, level of education, depression, fatigue, presence of gastrostomy, comorbidities, and use of pain medications and supplements), a moderate (i.e., marital status, smoking, sexuality problems, time since diagnosis, presence of tracheostomy, and side effects outcomes of radio and chemotherapy) and a small impact (i.e., employment/financial difficulties, tumor site and stage, and surgical procedure). CONCLUSIONS: Study identified nineteen predictors that had significant, moderate and small impact on the HRQoL of patients with HNCs. Some of the predictors, like levels of social support and social contact, depression, and comorbidities could be targets for innervations to improve HRQoL.

Validation of the oral health impact profile - 14 in patients with head and neck cancer.

BACKGROUND: The Oral Health Impact Profile-14 (OHIP-14) was designed to assess patients' perception of the impact of oral disorders on their quality of life (QoL). Although the OHIP-14 is now frequently used in patients with head and neck cancer, data related to its measurement properties in this population are scarce. The aim of the present study was to evaluate the reliability and validity of the OHIP-14 in a sample of Serbian patients with head and neck cancer. MATERIAL AND METHODS: Data were available for 345 patients (257 [74.5%] males; aged 30-92 years), with head and neck cancer. All patients completed the OHIP-14 and the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-H&N35. Factor analyses, internal consistency reliability (i.e., Cronbach's α coefficient), and construct validity were analyzed. RESULTS: The factor analyses confirmed that 14 OHIP items were measuring a single underlying factor. Cronbach's α coefficient was 0.98 and corrected item-total correlations ranged 0.77-0.93. Lower OHIP-14 scores (i.e., lower impacts on oral health) were more frequently present among patients who had only surgery as a therapeutic procedure compared to those who had surgery accompanied with radio- and chemotherapy (p < 0.01). Patients with a tumor stage 0-II also had lower OHIP-14 scores compared to those who had a tumor stage III-IV (p < 0.01). The OHIP-14 correlated significantly with the QLQ-C30 and QLQ-H&N35 scales. CONCLUSIONS: As a unidimensional instrument, the OHIP-14 provides oral QoL assessments with sound internal consistency reliability and construct validity among patients with head and neck cancer.

Physical characterization of a high-resolution CCD detector for mammography.

The physical characteristics of charge-coupled device (CCD) mammography detector with 16-bit dynamic range and 27 microm detector element size were investigated. The detector, with an active area of 1 cm x 20 cm is suitable for slot-scanning systems. We evaluated the detector resolution by measuring the modulation transfer function (MTF) using a tilted edge. We also measured the noise power spectra (NPS) and detective quantum efficiency (DQE) using tungsten spectra filtered with 3 mm Al. We carried out measurements in two modes of operation: the frame mode where the detector is stationary and the scan mode where the detector operates in a slot-scanning configuration. The specific beam qualities and exposure ranges employed were 30 kVp, HVL 1.4 mm Al, 1.24 microC kg(-1) to 12.44 microC kg(-1), and 40 kVp, HVL 2.1 mm Al and 3.26 microC kg(-1) to 16.64 microC kg(-1). The product of the normalized noise power spectrum and exposure was also computed to evaluate the quantum limited characteristic of the detector. The detector MTF was 12% at 15 lp mm(-1). The product of the noise power spectra and exposure was independent of exposure level, indicating a quantum limited detector. The DQE in the scan and frame modes near zero frequency was 40% and 60%, respectively. Our results show that the slot-scanning configuration was less efficient than the performance capabilities of the detector. This detector is comparable to other digital mammography sensors evaluated in the literature.

Benign and malignant struma ovarii: report of three cases and review of the literature.

Struma ovarii belongs to the group of monodermal and highly specialized teratomas and comprises less than 5% of mature teratomas. Thyroid tissue is present exclusively or predominantly. Malignant transformation in struma ovarii is uncommon, and when present, it exhibits a follicular pattern most of the times. Three patients with the diagnosis of struma ovarii are presented herein. Two of them had a unilateral adnexal mass with ascites in one case. Total abdominal hysterectomy with bilateral salpingo-oophorectomy and omentectomy were carried out in both patients. In both patients thyroid hormonal status was normal pre and postoperatively. The third patient had a histology compatible with follicular carcinoma of the thyroid tissue of struma ovarii; strumal carcinoid was also present. Postoperatively monochemotherapy with etoposide was administered for 6 cycles every 3 weeks. Thyroid hormones and thyroid ultrasonography (US) were also normal in this patient. Surgical management is the treatment of choice for struma ovarii which also represents a preventive measure for possible future malignant transformation.

Full field digital mammography scanner.

We describe the key features of a pre-production, slot-scan digital mammography system. A number of these units have been used in clinical studies over the past year for the purpose of demonstrating their equivalence to the conventional film-screen devices. Since the clinical data has not yet been fully analyzed, it is not possible to make definitive claims. However, with hundreds of patients examined, the results appear to leave very little doubt the SenoScan digital mammography system will prove equivalent to the conventional technology. The detector developed for this system has a sensitive area 1.0 cm wide by 22 cm long. It is constructed by abutting four charge-coupled-device (CCD) chips, which are optically coupled to thallium-doped cesium iodide scintillator by means of a thin fiber optic plate. Scanning is accomplished by attaching the detector to a rigid arm that swings in an arc, with the axis of rotation collinear with the X-ray tube focal spot. The total scan time for the 30 cm image width is less than 6 s, with an effective exposure time of either 0.2 or 0.4 s. Two resolution modes are available: 0.054 mm or 0.027 mm square pixel size; in the latter mode both the image length and width are halved, as is the scan velocity, so that the scan time remains the same. To compensate for the low X-ray utilization efficiency of the slot geometry, a tungsten rhenium target X-ray tube is employed. It is rated at 8 kW on the 0.3 mm focal spot; when used with a heat exchanger, it has been found to provide the patient throughput needed in a busy clinical practice.

[Etiologic factors which affect the development of infrabony periodontal defects]. / Ucestalost etioloskih faktora koji uticu na formiranje infrakostanih parodontalnih defekata.

The aim of the study was to examine frequency and distribution of etiologic factors which, associated with chronic inflammation, can influence the forming of intrabony periodontal defects. The following were studied: occlusal trauma, erosions and concrements on the roots, tooth malposition, the absence of contact point, inadequate interproximal distance of roots and iatrogenic factors. The results revealed that the most frequent etiologic factor in the forming of intrabony periodontal defects was occlusal trauma--55.8%, erosion of the roots--38% and concrements in the roots--34%, as tooth malposition, inadequate interproximal distances of the roots, the absence of contact point and iatrogenic factors. In the forming of 23.5% of intrabony periodontal defects two or more of the studied factors pariticipated. By the analysis of the distribution of etiologic factors by jaw segments, it was concluded that occlusal trauma was the most frequent in upper incisors--61.6%. In upper premolars the most frequent factor was the erosion on the roots--75%, and in the upper molars iatrogenic factors and erosion of the roots--44.4%. In the lower incisors, occlusal trauma was the most frequent--62.5%, in premolars also trauma--35.7%, and concrements of the molars--64.2%. Considering the high incidence the factors associated with chronic inflammation can be extremely significant in the forming of intrabony periodontal defects during parodontopahty.

Pregnancy following treatment of an adolescent with Yolk sac tumour.

The Authors present the case of a patient suffering from a highly malignant tumour, Yolk sac tumour, who received a combined treatment of operation and chemotherapy. The treatment was applied selectively, i.e. surgery was as radical and as conservative as deemed necessary. The patient was cured and after getting married, she gave birth to a baby girl with pes varus. Because of lack of experience with Yolk sac tumours, which up to the cytologic era had had bad prognoses, and of insufficient knowledge with the consequences of chemotherapy on the generative and reproductive functions of the patients cured, we consider our case to be worthy of attention.

Labelling small quantities of monoclonal antibodies and their F(ab')2 fragments with technetium-99m.

Addition of sulfhydryl groups with 2-iminothiolane (2-IT) is an important new method for labelling monoclonal antibodies (mAb) and fragments with 99mTc. F(ab')2 fragments were prepared by digestion of 1B7.11 and BCD-F9 with pepsin. Optimal conditions for labelling 20-100 micrograms mAb or F(ab')2 involved a 2000:1 molar ratio of 2-IT:protein in phosphate buffer pH 7.4 for 30 min followed by addition of 99mTc-pertechnetate and stannous glucoheptonate. Recovered yields were > 70% and radiochemical purities were > 90% with a total preparation time of < 90 min.

[Thrombophlebitis in the minor pelvis in problems with differential diagnosis in gynecologic oncology]. / Tromboflebitis u maloj karlici kao diferencijalno-dijagnosticki problem u ginekoloskoj onkologiji.

The oncologic-gynecology practice shows that vein thrombophlebitis of the pelvis minor causes retroperitonal spreading of malignant tumor of the cervix or growth of the ovarian neoplasm. In cases of unexplained etiology, the existance of malignant tumors as an etiologic factor, should be excluded by the examination performed by an experienced gyneocologist-oncologist, by ultrasonography, computerized tomography and in case of doubt by explorative laparotomy.

[Use of the hybridization in situ method in the detection of human papillomaviruses in female genital tumor tissue]. / Izucavanje mogucnosti primene metode hibridizacije in situ u otkrivanju humanih papilloma virusa (HPV) u tumoroznom tkivu genitalijazena.

We review preliminary results obtained by use of this diagnostic procedure--hybridization in situ for diagnosis of human papilloma virus in bioptic material of anogenital tract in women. Of 11 examined bioptic specimens, we found positive hybridization signal on "test" groups HPV 6, 11 and HPV 16, 18. This is the first report on papilloma virus in women from the territory of Vojvodina.

[Anterior pelvic exenteration with ileocystoplasty in advanced cancer of the uterine cervix]. / Prednja pelvicna egzocentracija sa ileocistoplastikom kod odmaklog raka grlica materice.

A female patient with the IV grade cervical carcinoma without distant metastases is presented. The patient underwent a radical surgical intervention. An anterior pelvic exenteration with ileocystoplasties was successfully performed. The patient is alive 14 months after the initial treatment. No greater complications were observed during the operation and after it, but in spite of a satisfactory general status, the patient has had nocturnal incontinence all the time. It is believed that this complication is the sequel of the newly formed urinary bladder, as the convolution of the ileum is only 30 cm long which has proved insufficient.

A laser-based multiformat camera for medical imaging.

The spatial resolution and contrast resolution required of a multiformat camera (MFC) for medical imaging are discussed. A typical cathode-ray tube (CRT) MFC and a prototype laser MFC are compared based on the following measured quantities: line spread function and associated contrast transfer function, noise characteristics, intensity transfer function (dynamic range), large-area contrast, and film irradiance. The laser MFC is found to provide significantly better performance than the CRT MFC in all of these areas.

Detector for dual-energy digital radiography.

A detection scheme is described that allows one to accomplish dual-energy scanned projection digital radiography without switching the x-ray tube voltage. The method employs a high/low atomic number detector sandwich that simultaneously separates the x-ray beam transmitted by the patient into low and high energy components. To test the method, the response of a scanning linear array of energy-sensitive detectors was simulated, and bone and soft tissue images of an anthropomorphic chest phantom were obtained at 140 kVp. These were compared with similar images obtained by switching the x-ray tube voltage from 80 kVp to a heavily filtered 140 kVp. For comparable entrance skin exposures, the dual-energy detector images required a lower tube load and resulted in higher noise levels. The latter is attributable to the fact that the separation in energy between the high and low energy components is smaller with the dual-energy detector than with the voltage switching technique, and to misregistration problems associated with the simulation methodology. A detector design is also discussed that would result in improved energy separation and lower noise levels. In view of this possibility and the tube loading advantage, the method looks promising for digital scanned projection radiography.

Digital chest radiography: performance evaluation of a prototype unit.

Measurements of the physical performance of a prototype digital chest unit (DCU) are presented. The parameters evaluated were entrance skin exposure, system exposure response and dynamic range, system modulation transfer function (MTF), image noise levels, detective quantum efficiency (DQE) of the detector, and scatter suppression efficiency. Compared with conventional chest imaging systems, the unit has markedly greater exposure latitude, limited spatial resolution, a lower detector DQE, and virtually scatter-free images. Routine clinical exposure levels are comparable with the 1982 national average.

Measured performance characteristics of a solid-state linear detector array.

Experimental studies of a solid-state linear detector array developed for a prototype scanning slit digital chest radiographic unit have been completed. The detector consists of a strip of scintillating material, optically coupled to a linear silicon photodiode array. Measured performance characteristics of the detector, such as sensitivity, modulation transfer function, and detective quantum efficiency, are presented for several different scintillators. Results indicate that direct x-ray absorption events in the silicon photodiode can degrade detective quantum efficiency. Results also indicate that the inexpensive preamplifier circuits used in the digital chest prototype contribute negligible noise at diagnostic x-ray photon fluence rates.

Single-slit digital radiography: some practical considerations.

Clinical evaluation of an experimental digital chest unit using a solid-state linear detector array has provided information regarding the postpatient photon flux required for clinically acceptable images. Results from computer simulation show that energy subtraction imaging of the chest by the method of x-ray-tube voltage switching will be unsuccessful unless it can be demonstrated clinically that a much lower number of photons per pixel is acceptable in energy subtracted images. In addition, x-ray-tube loading limitations preclude imaging of the abdominal and pelvic regions with this technology.

Digital radiography of the chest: design features and considerations for a prototype unit.

The general features of a prototype digital chest unit are described along with the rationale for the choice of design factors employed. It is shown that the scanning-slit, linear-detector-array approach employed can, with available x-ray tube technology, achieve a spatial resolution of 1 cy/mm and detector radiation levels comparable with those obtained with conventional screen-film systems. Also discussed are the unit's exposure latitude and its ability virtually to eliminate scatter.

[Personal experience with ovarian dysgerminoma]. / Nase iskustvo s dizgerminomom jajnika.

The authors present 11 patients with ovarian dysgerminoma treated at the Institute of Oncology and the University Hospital Department of Gynecology and Obstetrics in Novi Sad. The average age of the patients was 33.90 years (the mean value 27). In most of them the disease was in an advanced stage, with considerable local findings at the beginning of the treatment. In only three 3 patients was the disease relatively limited. The results of the treatment were unsatisfactory: three patients have been alive for 8, 11, and 12 years after the beginning of the treatment, three patients after 6 and 26 months and are still under treatment but with suspect clinical or laboratory findings, whereas the remaining five died in the period between 3 and 4 months following the beginning of the treatment. All these patients were treated surgically in the first place, but radiotherapy proved of great help, because this tumour is markedly radiosensitive, and also chemotherapy was useful in some of the women treated. In general, therapy should be strictly adjusted to individual cases, primarily because the disease appears more frequently in younger women.