2

UVOD: Buka kao naj~e{}i profesionalni rizik ali i iz ‘ivotnog okru‘enja je naj~e{}i uzrok za gubitak sluha. Gornji nivo industrijske buke je 85 dB. CILJ RADA: Cilj na{eg rada je bio da utvrdimo koliki je broj priznatih profesionalnih oboljenja u na{oj dr‘avi kao i da vidimo u kojoj od industrija je najve}a incidenca pojave profesionalnog o{te-}enja sluha bukom. MATERIJAL I METODE: Kori{}ena je kohortna studi-ja za analizu, istorija bolesti, pacijenata hospitalizo-vanih u Institutu za medicinu rada "Dr Dragomir Karajovi} " sa utvrdjenim profesionalnim oboljenjem: o{te}enje slu{nog nerva. Da bi se utvrdilo profesionalno o{te}enje sluha, ispitanici su morali da imaju zadovoljene sve zakonom predvidjene uslove. REZULTATI RADA: Prose~na starost ispitanika koji su imali profesionalno o{te}enje sluha je bila oko 50 godina. Imali su visok radni i ekspozicioni sta‘. 2003 i 2004 g. su godine kada je najve}i broj ispitanika imao priznato i prepoznato profesionalno oboljenje: o{te}enje slu{nog nerva. Vi{e od polovine ispitanika su imali o{te}enje izmedju 30 i 40 % po tablicama F. S. Najvi{e radnika sa lezijom kohlearnig nerva je bilo zaposleno u metalskoj industriji i u rudarstvu. ZAKLJU^AK: Na osnovu rezultata rada mo‘emo da zaklju~imo da je potrebno vr{iti redovne preglede radnika u svim industrijama a naro~ito u metalskim i u rudarstvu. Neophodno je no{enje li~nih sredstava za za{titu i primenjivati zdravstveno prosvetni rad kako medju radnicima tako i u menad‘mentu fabrika radi ve}e prevencije ove vrste profesionalnog oboljenja. Klju~ne re~i: profesionalno oboljenje, o{te}enje slu{nog nerva, vrsta industrije rezime UVOD Buka je verovatno, naj~e{}i profesijski, ali i rizik iz ‘ivotnog okru‘enja. Zbog toga predstavlja i naj~e{}i uzrok za gubitak sluha. Buka koja prouzrokuje gubitak sluha je ireverzibilni atak na zvukoprijemni aparat i rezultira dugotrajnoj ekspozicij

Computerized rhinomanometry: a study of total nasal resistance normal values

Computerized rhinomanomatry with the practical software programmes is used widely as a research tool to evaluate objectively nasal air flow and resistance parametres, while the increase of its clinical application may be facilitated by further standardization of the method. The aim of the study was to determine the total nasal resistance normal values in healthy adult population using a method of computerized rhinomanometry. A randomized sample of 108 white healthy adults (216 nasal cavities), both sexs with a mean age of 32 (20- 45) years comprised the test group. Nasal patency was measured by active anterior rhinomanometry in non-decongested mucosa ("at rest") during 10 repetitive measurements at inspiratory and expiratory reference pressure of 150 Pa. Nasal resistance was measured and calculated accoding to the recommendations of the Committee on objective assessment of the nasal airway, International Rhinologic Society. 1,2 The mean total nasal resistance in the sample was found to be 0.179 Pa/cm 3 /s with the confidant interval from 0,167 to 0,191 Pa/cm 3 /s at the probability level of 95%. Total nasal resistance was very significantly influenced by sex (t =- 4.614), height (F=11.625) and weight (F=11.529) of the examinees. This paper provides additional information on total nasal resistance normal values in healthy adult population important for computirezed rhinomanometry normative parameters standardization

Medicinski fakultet, Univerziteta u Beograd

tomografije (computed tomography-CT) i magnetne rezonance (MR) u vizualizaciji larinksa otvorene su nove mogu}nosti za precizniju dijagnostiku i planiranje terapije bolesti larinksa. Cilj ovog rada je da prika‘e zna‘aj ovih metoda u proceni patolo{kih stanja larinksa kao i da uka‘e na klju~ne anatomske karakteristike ove regije koje su od zna~aja za {irenje tumorskih promena. CT i MR pru‘aju informacije koje doprinose preciznijem odredjivanju stadijuma tumora larinksa s obzirom da prikazuju ne samo endoluminalni prostor, ve} i okolne strukture, zahva}enost submukoznog prostora, propagaciju procesa u kraniokaudalnom i anteroposteriornom pravcu kroz meka tkiva, zahva}enost hrskavica kao i prisustvo metastaza u regionalnim limfnim ~vorovima

externa: preliminary result

Otomycosis is a fungal infection of the ear predominantly caused by Candida and Aspergillus spp. The possible virulence factors of Candida spp. are enzymes, such as proteases, phospholipases, phosphatases and esterase. According to our knowledge, protease production in Candida strains isolated from patients with otomycosis has not been investigated. The present study was aimed at determining in vitro protease activity in 8 strains of Candida spp. (C. parapsilosis, C. famata, C. guilliermondii and C. albicans) isolated from children with otomycosis. A majority of isolated strains 7/8 (87.5%) were protease positive. The protease activity ranged from Pz 0.61 to 0.78. Further investigation is necessary to clarify the contribution of protease production to Candida virulenc

/ PRIKAZ SLU^AJA UDK 616.718.5-001.5-057-089

Profesionalni traumatizam je jedan od naju~estaliji

Composite super-moiré lattices in double-aligned graphene heterostructures

10.1126/sciadv.aay8897Science Advances512eaay889

Comparative risk of major congenital malformations with eight different antiepileptic drugs: a prospective cohort study of the EURAP registry

Background: Evidence for the comparative teratogenic risk of antiepileptic drugs is insufficient, particularly in relation to the dosage used. Therefore, we aimed to compare the occurrence of major congenital malformations following prenatal exposure to the eight most commonly used antiepileptic drugs in monotherapy. Methods: We did a longitudinal, prospective cohort study based on the EURAP international registry. We included data from pregnancies in women who were exposed to antiepileptic drug monotherapy at conception, prospectively identified from 42 countries contributing to EURAP. Follow-up data were obtained after each trimester, at birth, and 1 year after birth. The primary objective was to compare the risk of major congenital malformations assessed at 1 year after birth in offspring exposed prenatally to one of eight commonly used antiepileptic drugs (carbamazepine, lamotrigine, levetiracetam, oxcarbazepine, phenobarbital, phenytoin, topiramate, and valproate) and, whenever a dose dependency was identified, to compare the risks at different dose ranges. Logistic regression was used to make direct comparisons between treatments after adjustment for potential confounders and prognostic factors. Findings: Between June 20, 1999, and May 20, 2016, 7555 prospective pregnancies met the eligibility criteria. Of those eligible, 7355 pregnancies were exposed to one of the eight antiepileptic drugs for which the prevalence of major congenital malformations was 142 (10\ub73%) of 1381 pregnancies for valproate, 19 (6\ub75%) of 294 for phenobarbital, eight (6\ub74%) of 125 for phenytoin, 107 (5\ub75%) of 1957 for carbamazepine, six (3\ub79%) of 152 for topiramate, ten (3\ub70%) of 333 for oxcarbazepine, 74 (2\ub79%) of 2514 for lamotrigine, and 17 (2\ub78%) of 599 for levetiracetam. The prevalence of major congenital malformations increased with the dose at time of conception for carbamazepine (p=0\ub70140), lamotrigine (p=0\ub70145), phenobarbital (p=0\ub70390), and valproate (p<0\ub70001). After adjustment, multivariable analysis showed that the prevalence of major congenital malformations was significantly higher for all doses of carbamazepine and valproate as well as for phenobarbital at doses of more than 80 mg/day than for lamotrigine at doses of 325 mg/day or less. Valproate at doses of 650 mg/day or less was also associated with increased risk of major congenital malformations compared with levetiracetam at doses of 250\u20134000 mg/day (odds ratio [OR] 2\ub743, 95% CI 1\ub730\u20134\ub755; p=0\ub70069). Carbamazepine at doses of more than 700 mg/day was associated with increased risk of major congenital malformations compared with levetiracetam at doses of 250\u20134000 mg/day (OR 2\ub741, 95% CI 1\ub733\u20134\ub738; p=0\ub70055) and oxcarbazepine at doses of 75\u20134500 mg/day (2\ub737, 1\ub717\u20134\ub780; p=0\ub70169). Interpretation: Different antiepileptic drugs and dosages have different teratogenic risks. Risks of major congenital malformation associated with lamotrigine, levetiracetam, and oxcarbazepine were within the range reported in the literature for offspring unexposed to antiepileptic drugs. These findings facilitate rational selection of these drugs, taking into account comparative risks associated with treatment alternatives. Data for topiramate and phenytoin should be interpreted cautiously because of the small number of exposures in this study. Funding: Bial, Eisai, GlaxoSmithKline, Janssen-Cilag, Novartis, Pfizer, Sanofi-Aventis, UCB, the Netherlands Epilepsy Foundation, and Stockholm County Council