External application of seabuckthorn oil (Hippophae rhamnoides L.) is difficult due to its liquid state in spite of its benefits for damaged skin. In order to overcome this inadequacy the semisolid emulsion with seabuckthorn oil was prepared. Previous research showed that this emulsion possessing an enhanced structure with liquid crystals showed a higher wound healing potential than seabuckthorn oil. The aim of this investigation was to characterize suitability of this emulsion for topical use. The emulsion was prepared by combining emulsifiers that form liquid crystals. Two different quantities of seabuckthorn oil were incorporated. Samples were prepared with 10% and 40% of seabuckthorn oil. Organoleptic characteristics were estimated visually and by smearing samples on a thin glass plate. Type of emulsion was determined by a conductometric method, while a pH value of the emulsion was measured by a pH meter. Samples of seabuckthorn emulsion were orange, semisolid, shiny, easily spreadable on skin, and the smear on the glass plate was homogeneous. There was an absence of smell and the emulsion could be rinsed by water after the application on skin, which is a desired characteristic of oil/water emulsions. Results of an electrical conductivity confirmed that an outer phase is water. Samples possesed an acceptable pH value for an external topical use. This research confirmed that constituents and a method used were suitable for preparing semisolid emulsion with seabuckthorn oil. Organoleptic properties, a pH value and a type of obtained emuslion appear to be adequate for topical use.

BACKGROUND Telemedicine could be very useful for patients in remote areas experiencing adverse drug reactions or being in need of sophisticated diagnostic or therapeutic procedures. The aim of this article is to show the experience of our Department of Nuclear Medicine (DNM) in telemonitoring patients with differentiated thyroid carcinomas and neuroendocrine tumors. SUBJECTS AND METHODS The DNM at the Clinical Center Kragujevac, Serbia, uses continuous remote monitoring of patients' vital functions, including heart rate, electrocardiogram, respiration rate, blood pressure, and oxygen saturation, as well as video surveillance of the physical isolation area for patients with neuroendocrine tumors (NETs) and some patients with differentiated thyroid carcinomas (DTCs), during administration of radionuclide therapy and for the days following treatment. RESULTS The DNM used a telemonitoring system for 156 patients with either DTC or NET who received radionuclide therapy during the last 3 years. There were 32 interventions on patients in the physical isolation area based on changes of the patients' vital functions detected by the telemonitoring system. Twenty-five patients (78%) experienced symptoms, whereas the other seven patients (22%) were symptomless. A responsible physician intervened with treatment of tachycardia (18 cases), hypertension (10 cases), hypotension (2 cases), ventricular extrasystoles (1 case), and ST-segment depression (1 case). After administration of the treatment the health status of the patients was normalized. CONCLUSION From our experience gained over the past 3 years, this model of organization and supervision with a telemonitoring system of patients receiving radionuclide therapy ensures a high level of safety for the patient, with significant reduction of staff costs.

1 , Goran Mihajlovic 2 , Slobodan Jankovic 2 , Nela Đonovic 2 ABSTRACT Introduction: Th e current study investigated the prev- alence and characteristics of behavioural and emotional disorders in children with mild intellectual disability, as well as the predictive potential of personal and socio-de- mographic factors. Objective: Th e main objective of this research was to determine the impact of socio-demographic and personal factors on the prevalence and types of emotional and behav- ioural disorders in children with mild intellectual disability. Methods: Non-experimental research was conducted on 311 children with mild intellectual disability, aged 9-18 years, who attended 8 special primary schools in central and south-west Serbia. For the assessment of psychopathol- ogy, we used the Child Behaviour Checklist - Teacher Re- port Form (CBCL-TRF), a checklist of problem behaviours in children aged 6-18 years. To collect data on socio-demo- graphic status, we created a questionnaire about socio-eco- nomic factors and demographic indicators. Th e informants were classroom teachers. Results: An increased incidence of behavioural and emo- tional disorders was found in children with mild intellectual disability, compared to children of average intelligence. Both dimensions of psychopathology were signifi cantly infl uenced by personal and socio-demographic variables, including childs age, gender, academic achievement, placement type, parental educational level and employment, as well as the structure and socio-economic status of the families. Conclusion: Children with intellectual disability are at increased risk of developing psychopathology, mostly within the dimension of adjustment and behavioural disorders. Risk factors include specifi c developmental and psychological characteristics and social learning diffi culties, as well as a number of adverse socio-demographic factors.

Uvod : Sekundarne komplikacije i udružene povrede igraju veliku ulogu u funkcionalnom oporavku, morbiditetu, mortalitetu i dužini boravka kod pacijenata sa povredom kicmene moždine. Cilj: Utvrditi ucestalost sekundarnih komplikacija i urduženih povreda kod pacijenatasa sa povredama kicmene moždine u toku rehabilitacije. Metod: Ovaj rad predstavlja retrospektivnu studija koja je obuhvatila 441 pacijenta sa povredom kicmene moždine koji su rehabilitovani u Klinici za rehabilitaciju "Dr M. Zotovic" u Beogradu u periodu od januara 2000. do decembra 2009. godine. Rezultati:  Komplikacije za vreme rehabilitacije je imalo 368 (83.4%) pacijenata. Od ukupnog broja pacijenata komplikacije je imalo 127 (78.4%) pacijenata sa netraumatskim i 241 (86.4%) pacijenata sa traumatskim povredama kicmene moždine. Najcesce koplikacija kod obe grupe pacijenata su bile: urinarne infekcije (47.5% kod traumatskih i 64.2% kod pacijenata sa netraumatskim povredama kicmene moždine), spasticitet (56.8% kod netraumatskih i 53.8% kod pacijenata sa traumatskim povedama)  i dekubitalni ulkusi (9.9% kod netraumatskih 17.6% kod pacijenata sa traumatskim povredama). Od ukupnog broja pacijenata udružene povrede je imalo 110 (24.9%) pacijenata.  Najcesce udružene povrede su bile: povrede glave (38.5%), povrede rebara (34.4%), povrede gornjih i donjih ekstremiteta (21.9%), povrede unutrasnjih organa (1.4%)  i povrede karlice (1.1%). Udružene povrede su se javljale samo kod pacijenata sa traumatskim povredama kicmene moždine. Zakljucak: Sekundarne komplikacije i udružene povrede su cesto kod pacijenata sa povredom kicmene moždine u toku rehabilitacije. Adekvatna nega u kucnim uslovima može smanjiti procenat komplikacija.

Background. Although online social networking is increasingly used for medical purposes, studies investigating drug use among pregnant females by means of online networks are lacking. Objective. Th e aim of our study was to investigate the extent of inappropriate drug use among pregnant women by creating a Facebook profi le and using it as a tool for interacting with pregnant women. Methods. A Facebook profi le titled “Preserve babies from drugs” was created and maintained by a group of fourth-year pharmacy students for 3 months. Introductory educational material about the principles of drug use in pregnancy, information about health facilities off ering counselling about pregnancy, information about a clinical pharmacology department that off ered counselling and an open-ended questionnaire were posted in the “Notes” section of the Facebook profi le. Results. Of 239 registered pregnant “friends” of the profi le who received the questionnaire from the investigators, 93 responded (39%). Among the respondents, 50 pregnant women (53.8%) reported taking medication(s) during their current pregnancy, and 42 of the respondents reported using one or more drugs improperly. Th e most frequently used drugs were multivitamin and multi-mineral preparations, oral antibiotics, parenteral progesterone and benzodiazepines. Conclusions. Th e Facebook profi le devoted to drug use in pregnancy could be a useful adjunct to eff orts by offi cial health care institutions to identify inappropriate drug use and educate pregnant women appropriately.

1 , Zoran Bukumiric 2 , Aleksandra Karadžov Nikolic 3 , Rade Babovic 1 , Aleksandra Sekulic 1 , Srbislav Stevanovic 1 , Slobodan Jankovic 4 1 Klinika za rehabilitaciju "Dr M. Zotovic", Sokobanjaska 13 Beograd 2 ABSTRACT Introduction: Pressure ulcers (PUs) are often secondary complications in spinal cord injury (SCI) patients. Purpose: To investigate the presence and possible factors associated with pressure ulcers in SCI patients undergoing acute and functional rehabilitation. Methods: Th is was a retrospective study of 453 patients with SCI treated at the Clinic for Rehabilitation "Dr M. Zo- tovic", Belgrade, Serbia, between January 2000 and Decem- ber 2009. Factors that were tested for their infl uence on pres- sure ulcers in spinal cord injury patients included age, sex, mechanism of injury, neurological level of injury, complete- ness of injury, spasticity and length of stay. Th e presence and location of pressure ulcers were recorded on admission, dur- ing acute and functional rehabilitation and at discharge. Th e level of statistical signifi cance in our study was set to 0.05. Results: Th e study included 453 patients: 383 (84.5%) did not have a pressure ulcer during rehabilitation, and 70 (15.5%) patients had a pressure ulcer during rehabilita- tion. Of the total number of patients, 333 (73.5%) were male, and 120 (26.5%) were female. Th e average age of patients enrolled in the study was 51.8 ± 17.2 years. In a multiple lo- gistic regression model, one statistically signifi cant predictor of pressure ulcers during rehabilitation was pressure ulcer before rehabilitation (B = 1420, p <0.001), with an odds ratio (OR) = 4.1. Th is result shows that patients who had pressure ulcers on admission are 4 times more likely to regain pressure ulcers during rehabilitation after controlling for all of the fac- tors in the model. Another statistically signifi cant predictor of pressure ulcers during rehabilitation was FIM score on ad- mission (B = -0036, p = 0.015). Conclusion: Th e prevention of pressure ulcers in acute and functional rehabilitation increases functional outcomes in patients with SCI.

Sideritis scardica Griseb., Lamiaceae (ironwort, mountain tea), an endemic plant of the Balkan Peninsula, has been used in traditional medicine in the treatment of antimicrobial infections, gastrointestinal complaints, inflammation and rheumatic disorders. This study reports a comparison between conventional (hydrodistillation HD and solvent extraction SE) and alternative (supercritical carbon dioxide SC CO2) extraction methods regarding the qualitative and quantitative composition of the obtained extracts as analyzed by GC and GC-MS techniques and their anitimicrobial activity. Different types of extracts were tested, the essential oil EO obtained by HD, EO-CO2 and AO-CO2 obtained by SC CO2 at different preasures 10 and 30 MPa, at 40 °C, respectively, and the fractions A, B, C and D obtained by successive solvent extraction (SE) A: ethanol, B: diethyl ether, C: ethyl acetate and D: n-butanol). While EO was characterized by the presence of the high percentage of oxygenated monoterpenes and sesquiterpenes (30.01 and 25.54%, respectively), the rest of the investigated samples were the most abundant in fatty acids and their esters and diterpenes (from 16.72 to 71.07% for fatty acids and their esters, and from 23.30 to 72.76%, for diterpenes). Microbial susceptibility tests revealed the strong to moderate activity of all investigated extracts against the tested microorganisms (MIC from 40 to 2,560 μg/mL). Although differences in the chemical compositions determined by GC and GC-MS analysis were established, the displayed antimicrobial activity was similar for the all investigated extracts.

The  aim of this study was to compare the sociodemographic and clinical features of odon­togenic infections between hospitalized and non-hospitalized  children and to show what were the risk factors in children that could predict the course of odontogenic infection and indicate the need for hospital treatment. The design of our study was of the case-control type. The two study groups consisted of 70 inpatients and 35 outpatients with odontogenic infections who were treated at Department of Pediatric Dentistry and Department of Maxillofacial Surgery at Clinical Center in Kragujevac, Serbia. Clinical and sociodemographic data were col­lected retrospectively from patients' hospital re­cords. The following characteristics were signifi-cantly associated  with hospital treatment of chil-dren with acute odontogenic infection: li­ving in a village (OR =7.26,[1.43-36.96]), multi-spatial infection (OR =0.04, [0.00-0.91]), and affec­tion of upper face (OR = 0.01, [0.00-0.86]). Tooth extraction was important intervention in the treatment regimen and reduced frequency of hospitalization (OR=0.07, [0.01-0.70]). The dif­ferences between hospitalized and non-hospitali­zed children were not significant in regard to: ethnicity, employment of parents,  anatomical region of infection, side of the facial infection, source of infection (posterior or anterior deci­duous or permanent teeth), and treatment (drai­nage and incision, oral or parenteral antibiotics). In children with acute odontogenic infection it is necessary to do tooth extraction in timely manner, especially if the source of infection is tooth from upper jaw and if it is multi-spatial in­fection.

Objective. Investigation of methyldopa and nifedipine effects on maternal and fetal hemodynamics in women with mild gestational hypertension during the third pregnancy trimester. Methods. A prospective cohort study. Methyldopa effects were followed in 28 patients, and nifedipine effects in another 28 patients. There were also 28 healthy controls. Results. Uterine artery blood velocity waveform indices were improved only by nifedipine. Neither of the drugs affected the indices in umbilical and fetal middle cerebral artery. Both drugs normalized maternal blood pressure and pulse. Conclusions. Methyldopa and nifedipine did not show clinically significant influence on umbilical artery and fetal cerebral blood flow.

Introduction: Antiepileptic drugs are prescribed to patients of all ages and are commonly prescribed to patients over the age of 65. When prescribing these drugs to patients of this age bracket, treatment should be based not only on the diagnosis and seizure type but also on the propensity of the drugs for adverse effects and their drug–drug interactions. Areas covered: This article reviews antiepileptic drugs currently used for treating the elderly and highlights the adverse effects and potential drug–drug interactions for these treatments. The article was complied through literature searches of the Cochrane database of systematic reviews, MEDLINE and SCindeks. Expert opinion: In elderly patients who have hepatic diseases, antiepileptic drugs that are not metabolized in the liver, such as levetiracetam, are preferred; in patients with moderate and severe renal failure, carbamazepine and valproic acid are the preferred antiepileptic drugs. Phenytoin, fosphenytoin, carbamazepine, oxcarbazepine and lamotrigine should not be prescribed in elderly patients with cardiac conduction abnormalities or a history of ventricular arrhythmia. While the majority of antiepileptic drugs interact with other drugs, hepatic enzymes and plasma proteins, a few newer antiepileptic drugs are free from such interactions (e.g., gabapentin, levetiracetam and tiagabine), which make them suitable candidates for elderly patients. However, in order to make further recommendations regarding the choice and dosing regimens of antiepileptic drugs in elderly patients, more extensive clinical research in this specific population is necessary.

Introduction. Early post-operative arrhythmias after general anaesthesia are serious clinical problems for a significant portion of surgical patients. The aim of our study was to investigate the risk factors for the onset of post-operative arrhythmias in general surgery patients undergoing general anaesthesia. Methods. In this case-control study, the cases were patients with at least one episode of arrhythmias in the first 24 hours after general anaesthesia (n=56), and the controls were sex and age matched surgical patients (n=91) without post-operative arrhythmias. ORIGINAL ARTICLE ORIGINALNI NAUČNI RAD ORIGINAL ARTICLE ORIGINALNI NAUČNI RAD

To the Editor: Earlier studies demonstrated unexpected decrease of radioiodine (131I) renal excretion in patients adherent to low-iodine diet before 131I treatment while receiving furosemide [1,2]. This effects seems specific for humans, since it was not confirmed in a study on mice treated with low-iodine diet [3]. Other researchers [4-7] observed increase of 131I uptake to thyroid tissue or thyroid remnants, in patients receiving either furosemide or other diuretics after 131I. However, this increase in 131I uptake could be either due to increased radioctivity in blood, probably a simple diffusion of radioactivity from blood to thyroid, or to increased transport of 131I accross thyroid cell membrane, stimulated by diuretics [8, 9]. Observations on a patient as described below suggested a clue to the above mechanism of increased 131I thyroid uptake. This was a male patient, 34 years old, anuric, suffering from terminal renal failure and hemodialized thrice weekly for four hours per session, from June 2010 till today, November 2011. He was diagnosed as having papillary thyroid cancer metastatic to local and regional lymph nodes (pT3N1aMx). After total thyroidectomy, the patient was submitted to whole-body scintigraphy with 111MBq of 131I (using γ-camera e.cam, dual-head, variable angle, Siemens Medical Solutions, USA), which showed an area of radioiodine accumulation at the left side of thyroid bed (2.4% of the administered 131I was fixed to this area at 24h). In order to achieve complete thyroid ablation, 1.95GBq of 131I were given to the patient after being for 15-days on a low-iodine diet and having plasma TSH 45mIU/L. The patient’s consent for the whole procedure was obtained. With an aim to remove unbound 131I from the patient’s body, the patient was hemodialized twice, 24h and 48h after the administration of 131I with separate and controled collection of radioactive waste solutions. Thus, 73% of the administered 131I dose was eliminated, as calculated after measurements of radioactivity of the dialysis waste solution and in blood and by a survey-meter at 2-meters distance from the patient. Seventy-two hours after administration of 131I, whole-body scintigraphy was made using the same gamma camera. One zone of intense 131I accumulation was found in the thyroid bed, at the projection of right thyroid lobe. About 18h from the radioiodine administration the patient experienced an episode of high blood pressure (160/100mmHg), and was given by accident (considering his anuric state) an intravenous injection of 20mg furosemide, the drug which is routinely used for treatment of hypertensive emergencies, due to its direct vasodilating and diuretic effect [10, 11]. Although the patient’s blood pressure dropped to 130/80mmHg, and no deterioration of patient’s health was noted, this event was reported to the hospital Quality Assurance Committee. In order to follow effects of furosemide on 131I, after obtaining consent from the patient nine 2mL samples of venous blood were drawn from the cubital vein at 15min intervals, till nine samples were collected and simultaneously radioactivity in the neck region was measured by a survey meter with pancake probe, leaning on the thyroid region. Obtained values of radioactivity were expressed as percentage of initial radioactivity of blood and thyroid region, recorded before administration of furosemide (Table 1 and Fig. 1). As early as 15min after the administration of furosemide the drop of radioactivity was recorded in the blood and increase of radioactivity was noted in the thyroid region. All remaining 7 measurements of blood and thyroid region radioactivity showed gradual decrease in blood radioactivity and increase in thyroid region (Table 1 and Fig. 1). Using Pearson’s test, we found high reverse correlation (r=-0.968) radioactivity in between changes in blood and in the thyroid region, with high statistical significance (P<0.001).