The Correlation Between the D-Dimer Values and Anatomical Distribution of Pulmonary Embolism.

Background: Pulmonary Embolism (PE) represents a life-threatening medical emergency that, given the serious complications, requires urgent application of anticoagulant therapy. In addition to other factors that are taken into account when choosing a therapy for treatment of PE, the anatomical distribution of thrombi is also considered-whether it is a central, lobar, segmental or subsegmental PE. D-dimer is an intermediate product of degradation of fibrin molecules and its values in the plasma are increased in the case of PE, but also in other diseases. Objective: To determine whether there is a difference in D-dimer values in subjects with different anatomical distribution of PE. Methods: The study included 100 subjects with diagnosed PE by using MSCT and/or V/P SPECT and with measured values of D-dimer. Results: Out of 100 subjects, PE was not diagnosed in 37 subjects, while 63 subjects PE was diagnosed. All subjects with diagnosed PE were divided into 3 groups regarding the anatomical localization of thrombus: lobar, segmental or subsegmental. Average D-dimer values were calculated for all 3 groups. Statistical analysis showed that there was no significant difference in D-dimer values between subjects with different anatomical distribution of PE. Conclusion: There is no significant difference in D-dimer values between subjects with different anatomical distribution od PE-lobar, segmental and subsegmental PE.

Impact of Reduced Acquisition Time on Bone Single-photon Emission Computed Tomography Images in Oncology Patients.

Background: The use of resolution recovery (RR) in bone and myocardial perfusion imaging is becoming increasingly popular in nuclear medicine departments. RR produces reconstructed images that show improved spatial resolution and signal-to-noise ratio compared with conventional single-photon emission computed tomography (SPECT) images. Objective: To evaluate the impact of the ordered subset expectation maximization (OSEM) RR modality on preserving noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) for short SPECT acquisition. Methods: This prospective study was conducted on 80 patients. Full SPECT acquisition was performed as a standardized protocol, while reduced acquisition was achieved with the Poisson resampling method. Noise, SNR, and CNR were measured for different reconstruction parameters for the same image levels. The impact of surface area and body mass index was also measured for the same reconstruction parameters. Results: The results show significantly higher SNR and CNR for the Evolution for Bone protocol compared to the other two reconstruction protocols for full and reduced SPECT acquisition. With the shortening of the SPECT acquisition, an increase in the value of noise was recorded. SNR and CNR decreased with the reduction in SPECT acquisition. Conclusion: The Evolution for Bone protocol for all three analyzed acquisition protocols had the lowest noise values. The highest SNR and CNR were recorded in the Evolution for Bone protocol for the three acquisition protocols and SPECT acquisition time can be reduced from 20 to 10 min for bone SPECT.

The Relationship Between Thyroid Antibodies and Vitamin D Level in Primary Hypothyroidism.

INTRODUCTION: Vitamin D deficiency is a global health problem. Its deficiency has been reported to be associated with different autoimmune diseases. AIM: The aim of this study was to evaluate the relationship between vitamin D level and thyroid antibodies in autoimmune hypothyroidism. METHODS: A total number of 150 individuals were enrolled in this study. They were divided into the fallowing groups: group I included 50 patients with autoimmune thyroid disease (AITD), group II included 50 patients without autoimmune thyroid disease. Group III included 50 apparently healthy participants representing a control group. All participants underwent a detailed clinical examination and laboratory tests including, 25 (OH) vitamin D, thyroid-stimulating hormone (TSH) and thyroid autoantibodies assessment, including anti-thyroid peroxidase antibodies (anti-TPO) and anti-thyroglobulin antibodies (anti-TG). RESULTS: Serum levels of 25 (OH) vitamin D recorded a highly significant difference between the studies groups (20,76±6,31 ng/ml in group I vs. 24,37±9,05ng/ml in group II vs. 24,57±6,45ng/ml in group III, p<0,01). Moreover, there was a highly significant difference between patients with AITD and patients without AITD (20,76±6,31ng/ml vs. 24,37±9,05ng/ml, respectively; p<0,01). The concentration of anti-TPO and anti-TG antibodies were statistically significant higher in patients with vitamin D deficiency (p< 0,001). Serum TSH were significantly higher in group I (p< 0,001). CONCLUSION: Significantly low levels of vitamin D were documented in patients with AITD that were related to the presence of anti-thyroid antibodies and higher level thyroid-stimulation hormone (TSH), suggesting the involvement of vitamin D in the pathogenesis of AITD and the advisability of supplementation.

Influence of thyroid hormones on bone density.

Aim To investigate the relations between hormonal status of the thyroid gland and mineral bone density in women in menopause with or without osteoporosis. Methods The study included 120 postmenopausal women, who were divided into two groups. Group I included postmenopausal patients with osteoporosis, of whom 30 were in the early stages of postmenopause, and 30 of them where in the late postmenopausal phase. The second group included patients with preserved bone mass, of which 30 were in the early stage of postmenopause, and 30 were in the late postmenopausal phase. Bone densitometry (DEXA) was performed for all patients, along with analysis of the level of follicle-stimulating hormone (FSH), thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3). Results A statistically significant correlation between TSH level and mineral bone density in the lumbar spine level (r=0.27) was found in early postmenopausal women (r<0.05), TSH and T-score at the level of the lumbar spine (r=0.31) (p<0.05), as well as between TSH and mineral content of the femur bone (r=0.29; <0.05). There was statistically significant independent association between thyroxine and mineral bone density at the lumbar spine level in the late postmenopausal women (ß=0.29; p=0.025). Conclusion In the early postmenopausal phase, TSH was associated with mineral bone density in the lumbar spine and in the area of the femur.

Evaluation of Congenital Hydronephrosis with Static and Dynamic Magnetic Resonance Urography in Comparation to Dynamic Renal Scintigraphy.

INTRODUCTION: Congenital hydronephrosis (CH) is a condition with dilated renal pelvis with or without dilation of renal calyces. AIM: To examine the role of magnetic resonance urography in the detection of congenital hydronephrosis in comparison to dynamic renal scintigraphy (DRS). PATIENTS AND METHODS: Resarch included 58 (n=58) patients with diagnosis of congenital unilateral or bilateral dilatation of kidney duct system. Each patient had a one-time or multiple hospitalization at the Nephrology Department of the Pediatric Clinic, with performed: ultrasound which confirmed CH, voiding cystourethrography / voiding urosonography was confirmed based on which the vesicoureteral reflux (VUR) was established / excluded, dynamic renal scintigraphy and magnetic urography (analysis was made by CHOP-fMRU software) on the basis of which the uterine anatomy and the relative renal function were evaluated. RESULTS: Male patients were represented in 40 cases (69%). The average age was 4.4 ± 4.3 years with the youngest patient at the age of 2 months, and the oldest was 17 years old. According to diagnostic entities, the most common diagnosis was ureteropelvic junction (UPJ) obstruction in over half of cases (30 or 51.7%), followed by subjects with ureterovesical junction (UVJ) obstruction (11 or 19%), VUR was recorded in 9 (15.5%) cases, and pyelon fissus in 7 (12.1%), and one case (1.7%) was recorded with bilateral megaureter. Comparison of the value of the renal function obtained with DRS and CHOP-fMRU methods shows that there were no statistically significant differences between two methods. In the case of right kidney, the mean DRS value was 53.4 ± 18.4% (range 13-100%), while CHOP-fMRU was 51.8 ± 22.4 (range 0-96.7%). In the case of left kidney, the average value according to the DRS method was 46.9 ± 18.9% (range 0-87%) and according to CHOP-fMRU 47.6 ± 21.5% (range 8.3-100%). The correlation coefficients of both right and left kidneys show a highly statistically significant correlation between these two methods. CONCLUSION: Magnetic resonance urography in the pediatric population in CH based on results should be an integral part of the management of these patients, especially in congenital obstructive uropathy, in complex and associated congenital anomalies, as it provides morphological and functional data on the state of the kidneys and urinary tract.

Evaluation of Thyroid Hormone Status and Bone Density Ratio in Euthyroid Postmenopausal Women in Early and Late Stage of Bone Loss.

INTRODUCTION: Osteoporosis is a consequence of reduction in bone mass and disorders of bone structure, which makes the bones prone to fractures. Physiological variations of thyroid-stimulating hormone (TSH) may be an early indicator of the predisposing basis of the emergence of osteoporosis. AIM: To evaluate the thyroid hormone status and bone density ratio in euthyroid postmenopausal women in early and late stage of bone loss. METHODS: The research is an observational, intersected, controlled study involving postmenopausal women admitted to the Clinic for Nuclear medicine and endocrinology of the Clinical Center University of Sarajevo (CCUS). The study included a total of 120 postmenopausal subjects divided into two groups. First group included 60 postmenopausal patients with osteoporosis, 30 of them were at the early stage of postmenopause, and 30 were in the late postmenopausal phase. The second group consisted of 60 postmenopausal patients with preserved bone mass, 30 of which were in the early stage of postmenopause and 30 in the late postmenopausal phase. For all patients included in the study follicle-stimulating hormone (FSH), TSH, free thyroxine (FT4), free triiodothyronine (FT3) were analyzed. RESULTS: The mean duration of the postmenopausal period was statistically significantly higher in the group of women with osteoporosis (11.4 ± 1.1 years). The mean values of FSH were statistically significantly higher in the group of women with osteoporosis (54.0 ± 2.6 IU / L). The mean level of TSH and FT3 did not statistically significantly differ in the group of women with osteoporosis compared to the control group of women. The mean FT4 level in women with osteoporosis was statistically significantly lower (14.7 ± 0.29 pmol / L) compared to the control group of women (15.95 ± 0.3 pmol / L) (p = 0.004). CONCLUSION: In our examined group, the FT4 patient (mean) was significantly lower in the serum of women with osteoporosis compared to subjects with preserved bone mass. It would be most effective to recognize risk factors in order to influence them on time, and to alleviate and slow down the consequences of osteoporosis. One of these possible factors is the hormonal status of the thyroid gland, that is, TSH whose physiological variations may be an early indicator of the predisposing basis for the emergence of osteoporosis. The frequency and prevalence of these medical problems require additional research, and it is also a great challenge to understand the effects of thyroid hormone on bone tissue.

Vesicoureteral Reflux and Renal Scarring in Infants After the First Febrile Urinary Tract Infection.

INTRODUCTION: The objective of this research was to determine whether vesicoureteral reflux(VUR) was associated with evolution to renal scarring (RS) following a febrile urinary tract infection (UTI) in infants. MATERIALS AND METHODS: Our research included 100 infants, ages up to 1 year with a first febrile UTI. The diagnostic was based on results of: laboratory findings, ultrasonography (USG), voiding cystourethrography (VCUG) and initial and control renal scintigraphy (DMSA renal scan) withtechnetium99mTcsuccimer (dimercaptosuccinic acid), to assess the acute pyelonephritis (APN), VUR and RS. RESULTS: APN was proven with DMSA renal scan in 66 (66%) infants. Twenty-two infants (33.3%) had VUR in-group of patients with APN. On the control DMSA scan, performed 6 months after the first DMSA, the presence of RS was found in 18 (27.27%) infants. In infants with renal scars VUR were discovered in 9 of them (50%). CONCLUSIONS: The pathogenesis of RS after febrile UTI in young children is multifactorial. Children with VUR have an increased risk for APN and RS. However, VUR is not the only precondition for RS. Creating a renal scarring cannot be imagined without the inflammatory process of the upper urinary system. Therefore, early detection and treatment of febrile UTIs in children and identify children at risk for RS are of primary importance.

Secular trend of anthropometric parameters of newborns in municipalities of Tuzla Canton (1976 - 2007).

Aim To determine the acceleration of birth weight and birth length of newborns in the municipalities of Tuzla Canton in the last four decades. Tuzla Canton (TC) as an administrative territorial unit of the FBiH includes 13 municipalities. Methods In this retrospective study data from the Protocol Book of Gynecology and Obstetrics Clinic, University Clinical Center, from 1976 to 2007 were used. The sample of live-born infants by municipalities was divided into four sub-samples: a subsample of infants born in 1976, 1987, 1997 and 2007. During the monitored years there were 19,312 live births in Tuzla Canton (TC), but the study included 17,907 newborns of both sexes. Statistical data processing was performed using standard methods, descriptive and inference statistics. Results Ascertained results of the secular trend for birth weight showed that this parameter had positive values in seven municipalities, but in six municipalities it was negative. The highest values of increasing birth length of newborns, which were statistically significant, were found in the municipalities of Srebrenik and this increase was 0.06 cm per year. Conclusion Different values of the secular trend in the monitored TC are result of different socio-economic and ecological conditions in these municipalities, as well as of violent mass population migration that occurred as a result of the war in BiH in the period from 1992 to 1995.

General Characteristics of Newborn from the Area of Tuzla Canton, Born in the Course of 2007.

The paper examined the basic anthropometric characteristics, birth weight and birth length of newborns, from the Tuzla Canton (TC) born during 2007. The study is a retrospective study in which data from the book of protocol of the Obstetrics and Gynecology Clinic - University Clinical Center Tuzla (OGC UCC). There were 4057 births in which 4125 babies were born in the OGC UCC Tuzla between 01 January and 31 December 2007. Of the total number, there were 29 stillborn (0.7%), of which 16 boys and 13 girls. There was 4,096 (99.3%) live born, of which 2,123 (51.83%) boys and 1973 (48.17%) girls. On every 100 girls 108 boys were born. Average values of the observed parameters in the total sample of infants were the following: birth weight 3387.17g; birth length 52.83cm; age of the mother was X(sr) = 26.49 years, and the average order of birth is 1.61. Birth weight in the total sample of male infants ranged from minimal 1130g to 5150g maximum. The average value of birth weight of male newborns was 3443.47g and female 3326.38g. The birth length of male infants in the total sample ranged from minimal 35 cm to 62 cm maximum and average value of the birth length reached 53.16 cm. Infants with low birth weight, hypotrophic newborns, born 123 or 6.24%. There were 1659 or 84.22% eutrophic infants born. There were 188 or 9.54% of high birth weight infants, hypertrophic infants, born. Male infants were more likely hypertrophic than female.

The Acceleration of Birth Weight and Birth Length of Hypotrophic and Hypertrophic Newborns from Tuzla Canton from 1976 to 2007.

The acceleration or secular changes are long-term systematic changes across a broad spectrum of anthropological variables in successive generations of the population living in the same territory. The phenomenon can be seen in the size of newborns in the period of childhood and early youth, but also at the population level. The research used the data from the book of protocols, from the Departament of Gynecology and Obstetrics, University Clinical Centre in Tuzla. The sample taken from 19312 newborns (10037 boys, or 51.97%, and, 9275 girls, or 48.03%) was composed of four sub-samples of newborns of both sexes, as follows: sub-samples of infants between 01 January and 31 December of the following calendar years: 1976, 1987, 1997 and 2007. The aim of this research paper is to determine the acceleration of birth weight and birth length of hypotrophic (birth weight less than 2500g) and hypertrophic infants (birth weight greater than 4000g) of both sexes in Tuzla Canton, in four time points. On the basis of mathematical-statistical methods, the acceleration of the birth weight of the total sample of hypotrophic neonates with negative values, ranged from -21.39 g / decade and -2.48 g / dec in hypertrophic newborns. The acceleration of birth length of hypotrophic infants in the total sample was 0.14 cm / decade, and in hypertrophic 0.62 cm / decade. Conclusion: it is presumed that this secular change was caused by massive and violent population migrations during the 1992-1996 war in Bosnia and Herzegovina, when there was a change in the genetic composition of the local population.

Impact of ventilation/perfusion single-photon emission computed tomography on treatment duration of pulmonary embolism.

PURPOSE: The aim of the study was to establish whether the duration of anticoagulant (AC) therapy can be tailored, on an objective basis, by using ventilation/perfusion single-photon emission computed tomography (V/P SPECT) and to assess the extent of residual perfusion defects over time. In particular, we addressed the following: (a) is the extent of perfusion recovery at 3 months of initial pulmonary embolism (PE) diagnosis a satisfactory criterion for deciding the duration of oral AC? (b) Is it safe to withdraw AC at 3 months if perfusion recovery is complete? PATIENTS AND METHODS: Of 269 consecutive patients with suspected PE, 100 patients were diagnosed with PE using V/P SPECT. Sixty-seven patients with acute PE were followed up clinically and with V/P SPECT at 3 months. Sixty-four patients were subject to review and examination using V/P SPECT for a period of 6 months and 33 were followed up only clinically. Therapy was terminated after 3 months if perfusion was normalized, and patients were free of symptoms and the risk of hypercoagulability. Initial extension of PE did not have an impact on decision making. RESULTS: PE extension varied from 10 to 70% in the acute stage. After 3 months, complete resolution of PE was found in 48 patients. The treating pulmonologist decided to terminate therapy in 35 (73%) patients and to continue AC in 13 patients because of persistent risk factors. Six months later, at the second control stage, 53 patients had complete recovery of pulmonary perfusion. Eleven patients still had perfusion defects at 6 months. No recurrence was identified at 6 months in the 35 patients whose therapy was terminated after 3 months. No bleeding effects were observed in any of the patients during the 6-month follow-up. CONCLUSION: This study shows that AC therapy can be tailored, on an objective basis, by using V/P SPECT. Normalization of perfusion at 3 months of initial PE diagnosis was a reliable indicator that AC could be safely withdrawn in patients who were without hypercoagulability risk.

Potential Role of Lung Ventilation Scintigraphy in the Assessment of COPD.

OBJECTIVE: To highlight the importance of the lung ventilation scintigraphy (LVS) to study the regional distribution of lung ventilation and to describe most frequent abnormal patterns of lung ventilation distribution obtained by this technique in COPD and to compare the information obtained by LVS with the that obtained by traditional lung function tests. MATERIAL AND METHODS: The research was done in 20 patients with previously diagnosed COPD who were treated in Intensive care unit of Clinic for pulmonary diseases and TB "Podhrastovi" Clinical Center, University of Sarajevo in exacerbation of COPD during first three months of 2014. Each patient was undergone to testing of pulmonary function by body plethysmography and ventilation/perfusion lung scintigraphy with radio pharmaceutics Technegas, 111 MBq Tc -99m-MAA. We compared the results obtained by these two methods. RESULTS: All patients with COPD have a damaged lung function tests examined by body plethysmography implying airflow obstruction, but LVS indicates not only airflow obstruction and reduced ventilation, but also indicates the disorders in distribution in lung ventilation. CONCLUSION: LVS may add further information to the functional evaluation of COPD to that provided by traditional lung function tests and may contribute to characterizing the different phenotypes of COPD.

Comparison between ultrasound, scintigraphy and cytological puncture in diagnostics of thyroid gland nodules.

PURPOSE: The purpose of this study was to compare ultrasound results with results of scintigraphy and targeted cytological puncture of a nodule or nodules of the thyroid. MATERIAL AND METHOD: The study analyzed results of 133 patients, men and women, between age of 16 and 75. The patients had a standard ultrasound of the thyroid, scintigraphy and ultrasound guided cytological puncture. RESULTS: The research showed that nodular diseases of the thyroid are present in 2/3 of women patients, and in 1/3 of men patients. The largest presence of nodules is among the age group of 40-49 years. Nodules are the most common in the lower right lobe of the thyroid. The size increase of nodules also increases probability to be malignant. Furthermore, this research has showed that there is a statistically significant connection between ultrasound results and the cytological puncture test results. CONCLUSION: Ultrasound is a reliable method of diagnosis for selecting patients to have a cytological puncture. If thyroid scintigraphy shows warm nodules, there is no need for ultrasound guided cytological puncture. Scintigraphy, ultrasound and ultrasound guided cytological puncture are complementary methods in reliable diagnostics of nodular disease of the thyroid.

The value of serum thyreoglobulin levels and whole body (I-131) scintigraphy in the follow-up of the thyroid cancer patients after thyroidectomy.

Serum thyreoglobulin (Tg) and whole body scintigraphy (I-131 WBS) have been used to detect recurrent and metastatic thyroid cancers postoperatively. However, discordant results of Tg measurement and 131I WBS have been reported. Negative 131I WBS and a positive Tg test are usually found, but less common occurrence of positive 131I WBS and a negative Tg test has also been demonstrated in a small but significant number of cases. Therefore, the aim of the study was to retrospectively analyse patients with positive 131I WBS after total thyreoidectomy and again 1 year after the radioactive iodine. There were 52 patients included in the study. Four weeks after surgery, during which thyroid hormone treatment was not introduced, each patient received an ablative dose of 131I. The evaluation of the WBS was qualitative and considered positive if thyroid remnant, lymphatic node or metastasis were detected. WBS and serum Tg was measured 12 months after 131I ablation with thyroid hormone suppression. We considered positive any Tg level above the sensitivity values and negative if lower than this level. Tg levels were related to the existence of a positive scan or a negative one. In our 52 WBS positive patients concordant positive Tg levels were observed in 42 patients while in 10 patients we found a negative Tg levels after the surgery. After 1-year follow-up, out of initially 42 concordant patients 8 patients showed remaining concordant positive Tg and WBS values. Discordant results were observed in 13 patients (4 patients were Tg- and WBS+ while 9 patients were Tg+ and WBS-). In the majority of patients (50%) remained with concordant results but changed from Tg+ and WBS+ to Tg- and WBS-. Diagnostic WBS is an additional valuable tool, besides Tg levels, in the follow up of patients after total thyreoidectomy.

Tomographic ventilation/perfusion lung scintigraphy in the monitoring of the effect of treatment in pulmonary embolism: serial follow-up over a 6-month period.

BACKGROUND: Pulmonary embolism (PE) is a severe condition with nonspecific symptoms. Diagnosis relies on medical imaging but follow-up is currently based on clinical symptoms and general risk factors. The duration of anticoagulant treatment after an acute episode of PE is still subject to debate and the best method of identifying the risk of recurrence in individual patients is undefined. Tomographic lung scintigraphy [ventilation/perfusion single photon emission computed tomography (V/P SPECT)] has improved the diagnostic accuracy with regard to PE but has not been evaluated for PE follow-up. AIM: The aim of this prospective study was to quantitatively follow the natural history of treated PE using V/P SPECT, which could prove helpful in defining an anticoagulant treatment regime for individual patients. METHODS: Of 83 consecutive patients with clinically suspected PE examined with V/P SPECT, 23 patients with confirmed PE were followed by serial V/P SPECT examinations over a 6-month period. All patients were also followed clinically. RESULTS: The mean relative decrease in PE extent compared with the time of diagnosis was 54±26% at 2 weeks, 79±30% at 3 months, and 82±30% at 6 months. Significant resolution of mismatched perfusion defects occurred between V/P SPECT controls within the first 3 months of anticoagulation (P<0.001) but not thereafter. V/P SPECT identified four patients with chronic PE, even though all patients were free from symptoms at 3-month follow-up. CONCLUSION: Follow-up of PE with V/P SPECT is feasible to evaluate treatment effectiveness in individual patients and to identify patients that develop chronic PE. This study also confirms that resolution of perfusion defects after PE occurs within the first 3 months of treatment. It is therefore recommended that V/P SPECT follow-up should be considered at 3 months after diagnosis.

Echocardiographic evaluation of cardiac function in female patients with thyroid disorders.

The aim of this study was to assess echocardiographic changes in female patients with untreated dysfunctional thyroid states and whether the therapy aimed to normalize the thyroid dysfunction could lead to improvement in cardiac systolic and diastolic function. The study included 90 female subjects who performed control of thyroid hormonal status at the Institute of Nuclear Medicine at the University of Sarajevo Clinics Centre and who previously were untreated for the thyroid functional disorders. The study sample was divided in three groups based on the thyroid hormones levels: a) hyperthyroid group (n= 30) b) hypothyroid group (n=30) and c) euthyroid (control). Echocardiography measurements were performed on commercially available Toshiba, SSH 140. Before the therapy no statistically significant differences in the peak early and late mitral inflow velocities (E/A) values between the study groups was observed, but the mean left ventricular ejection fraction (LVEF) in hypothyroid group was significantly lower (58.30+/-1.05) compared to control (64.96+/-0.71) and hyperthyroid group (64.69+/-1.31) (p<0.001). In hypothyroid group we found significant increase in mean LVEF (58.30+/-1.05 vs. 64.95+/-0.86, p<0.01) and E/A (1.06+/-0.07 vs. 1.17+/-0.08; p=0.01) values after the normalization of thyroid hormone status.Thyroid dysfunctional states were not associated with impaired diastolic function, probably due to the short duration of thyroid dysfunction and timely and successful conversion therapy. Systolic function however was significantly reduced in hypothyroid patients but subsequently improved after the adequate therapy. Early diagnostic approach in patients with thyroid dysfunctional states is important for avoidance of cardiac complications that accompany these disorders.

Secular changes of anthropometric parameters in newborns from Gracanica area in the period from 1998 to 2008.

INTRODUCTION: Growth and development of children can be observed on individual and population level. Anthropometric measures are main indicators of that development. Secular trend of anthropometric measures increase in BiH and in the world is most often observed during the adolescence period. Changes in anthropometric measures are also investigated in newborns (body length, birth weight, head circumference, upper arm circumference and others) and are correlated with different endogenous and exogenous factors. Purpose of this paper is to analyze birth weight, body length and head circumference in newborns from Gracanica area, which were born in the period from 2007 to 2008, compare them with information's collected in 1998 and 1999, and then determine eventual secular trend. EXAMINEES AND METHODS: Examinees were babies born in period from January 1st to December 31st 1998, and from January 1st 2007 to December 28th 2008. The method was retrospective and used information is from The Book of Protocols at the Department of Gynecology and Obstetrics, Dr M. Beganovic Hospital in Gracanica. In observed period (1998 and 1999, 2007 and 2008) more girls was born than boys (N = 1801). RESULTS: Newborns in Gracanica (2007-2008) weighted 3564 grams and female newborns weighted 3321+/- 333 grams in total sample. Body length in female newborns is 55.37; and male newborns 56.32. CONCLUSIONS: Acceleration of growth of observed anthropometric parameters was established in newborns from Gracanica, in the period from 1998 to 2008 (for birth weight it is 84.96 g/dec; for body length it is 1,13 cm/dec and for head circumference it is 0.34 cm/dec).

Screening of pulmonary embolism by ventilation / perfusion tomography-SPECT and comparation with planar scintigraphy--our experiences.

UNLABELLED: Pulmonary embolism (PE) affects up to 1 per 1000 people every year and is one of the commonest preventable causes of death among hospital inpatients. Laboratory chemical test alone cannot confirm or exclude PE but are used together with the clinical test probability for risk stratification. Ventilation/ perfusion tomographic imaging may be the best practical way to accomplish on this larger scale. The aim of this study was to screen the pulmonary embolism by ventilation/perfusion tomography V/P SPECT. We also compared V/P SPECT with planar scintigraphy. RESULTS: A total of 40 patients with clinically suspected pulmonary embolism were examined. Fifteen patients (37.5%) considered to have perfusion defect with preserved ventilation using ventilation/ perfusion tomography-SPECT. In this group five patients (33%) had multiple perfusion defects (RoPer = 16 poens, RoVent = o poens). Correlation coefficient has been sign among visual analysis and quantitative analysis (C = 0.510). In 25 patients (62.5%) we have found normal ventilation/ perfusion scintigraphy. On the planar scintigraphy PE with high probability was considered in five (26.6%) patients. Intermediate and low probability was considered in seven patients with planar ventilation/ perfusion scintigraphy. Sub-segmental perfusion defect with preserved ventilation we have found in two patients (13%). On the planar scintigraphy the same defect was unclear. CONCLUSIONS: Ventilation/ Perfusion tomography-SPECT is clinically relevant in the diagnosis of pulmonary embolism, and may help reduce the number of non-diagnostic scintigraphy results. On the planar perfusion scintigraphy patients tended to have fewer perfusion defects corresponding pulmonary embolism.

[Perfusion myocardial scintigraphy - SPECT with TC-99m MIBI in detection coronary artery desease in diabetic patients]. / Perfuziona scintigrafija miokarda-SPECT sa TC-99m MIBI u detekciji koronarne bolesti kod pacijenata sa diabetes mellitus-om.

UNLABELLED: Diabetes mellitus is very frequent disease. The prevalence of coronary artery disease is higher in diabetic than in non-diabetic patients. Coronary artery disease (CAD) is the main cause of morbidity and mortalitiy in patients with Diabetes mellitus. The aim of this study was to evaluate usfulnes of myocardial perfusion scintigraphy in diabetic patients for detection of coronary artery disease. PATIENTS AND METHODS: this study included 15 patients with verified diabetes mellitus. All patients were treated with oral hypoglicemic or insulin. Parameters observed for every patients were level of lipemia (cholesterol, triglycerides), family hystory of CAD, hystory of chest pain. All patients underwent sress/rest Tc-99m MIBI study. We have performed one day protocol. Exercise tolerance test were performing in all patients according to the Bruce protocol. 260MBq was injected intravenously at peak exercise. 740MBg was injected for the rest. Myocardial perfusion scintigraphy was clasified as: 1. normal, 2. reversible defect or 3. irreversible defect. RESULTS: reversible perfusion defect we have found in 8 patients. The same patients had elevated glicemia, high level of lipemia; 1 patient had fixed defect, without any previous known history for myocardial infarction. In 6 patients we could not see any significant defect during stress/rest scintigraphy. CONCLUSION: The frequency of abnormal myocardial perfusion scintigraphy suggest that this procedure can be very useful in the detection of high-risk diabetic patients.

Lymphoscintigraphy and radiation--occupational exposure during sentinel node assay.

Ionizing radiation has many practical applications, but it is also, as it is well known, dangerous to human health. The purpose of this study was to estimate the dose and exposure for medical staff involved in sentinel node assay and to determine how safe this assay really is. The theoretical method was used for calculation. Three groups of medical staff were selected: nuclear medicine specialist, nuclear medicine technologist and a surgeon. The results obtained show that the most exposed staff member is nuclear medicine specialist and that dose received by the surgeon is smaller then the dose limit.