Time trend and clinical pattern of extrapulmonary tuberculosis in Serbia, 1993-2007

Background/Aim. Increased incidence of extrapulmonary tuberculosis (XPTB) is reported worldwide. Serbia is a country in socio-economic transition period with lowmiddle HIV prevalence and intermediate-to-low tuberculosis (TB) incidence rate, 100% directly observed treatment (DOT) coverage, and mandatory BCG vaccination at birth. The aim of the study was to examine the incidence trend and clinical features of XPTB in Serbia during a 15-year period. Methods. This retrospective observational study included XPTB cases diagnosed in the period between 1st January 1993 and 31st Decembre 2007, according to the reports of the National Referral Institute of Lung Diseases and Tuberculosis in Belgrade and Central Tuberculosis Register. Population estimates with extrapolations were based on 1991 and 2002 census data. Results. While the overall TB incidence rate showed a slight, not significant decreasing trend (p = 0.535), a significant increase was found for XPTB (y = 1.7996 + 0.089x; R2 = 0.4141; p = 0.01). A total of 2,858 XPTB cases (newly diagnosed and 10% relapses) gave an average age specific incidence rate of 2.51/100,000 population (95% confidence interval, SD = 0.6182) with 8.9% annual increase. The male-to-female ratio was 0.54. Lymph nodes were most frequently affected site (48.5%) followed by genitourinary (20.5%), pleural (12%), and osseo-arthicular (10.3%) TB. Treatment outcome was successful in 88.29% of patients (cured and completed), 3.64% died, 5.18% interrupted, 0.57% displaced, and 2.3% unknown. Conclusion. Increasing trend of XPTB incidence rate may be a result of increased morbidity due to still present risk factors, possible higher detection rate in Serbia and better notification. A high coverage of newborns with BCG vaccination at birth might contribute to a decreased number and rare XPTB cases in children

INFLUENCE OF SPACING SIZE AND SHAPE ON QUALITY COMPONENTS OF CELERIAC CULTIVARS (APIUM GRAVEOLENS VAR. RAPACEUM MILL.)

Celer korjenaš za prodaju u svješem stanju i za preradu mora zadovoljiti potrebne standarde kakvoće. Na svojstva koja određuju kakvoću mogu utjecati klimatski i edafski čimbenici, kultivari i načini uzgoja. Organogena tla u Vranskom bazenu i klimatski uvjeti koji omogućuju dugu vegetaciju povoljni su za rast celera. Kako to utječe na kakvoću korijena u 3 kultivara i 5 načina sadnje cilj je ovog istraživanja. U dvogodišnjem pokusu na lokaciji Jankolovica posađena su 3 kultivara: Nemona, Volltreffer i Praški orijaš uz 2 razmaka redova i 3 razmaka u trakama uz sklop: 8.3, 10.0, 11.1, 12.5 i 13.3 biljke/m2. U vrijeme berbe iz svakog od 5 ponavljanja ustanovljen je udio standardnih korjenova i njihova prosječna masa. Standardni korijeni su zatim klasirani po promjeru u 3 kategorije (6 do 8, 8 do 10 i >10 cm). Korijeni su uzdužno razrezani i ustanovljena je pojava unutrašnjih šupljina za svaku kategoriju te postotak suhe tvari refraktometrom, što je pokazatelj kakvoće za preradu. Prosječna masa tržnog korijena statistički se nije razlikovala. Kultivar Volltreffer bio je nešto krupniji (374 g) od kultivara Nemona (334 g) i Praški orijaš (319 g). Povećanjem broja biljaka po m2 prosječna masa tržnog korijena se lagano smanjivala (od 370 do 259 g) u dvogodišnjem prosjeku za sva tri kultivara. Najmanje sitnog korijena (promjera 6 do 8 cm) u ukupnoj masi bilo je u kultivara Volltreffer 23.5 %, zatim Praškog orijaša 31,0 % i Nemona 40.5 %. Za sva tri kultivara povećanjem sklopa udio sitnih korjenova se povećavao (od 26.5 na 39%). Prosječna masa sitnih (promjera 6-8 cm) bila je 208 do 249 g, srednjih (promjera 8 do 10 cm) 366 do 398 g i krupnih (>10 cm) od 586 do 653 g. Najmanju masu u svim kategorijama imao je Praški orijaš. U svim krupnoćama povećanjem sklopa prosječna masa se malo smanjuje. Pojava šupljina u sredini korijena može biti negativno svojstvo. U prvoj godini bilo je više šupljih korjenova nego u drugoj godini istraživanja, krupni korjenovi imali su više šupljina od sitnih, a u većem sklopu bilo ih je manje. Postotak suhe tvari refraktometrom kretao se u prosjeku od 5 do 7 % a bio je najveći u Praškog orijaša. Na osnovi ovih svojstava ne može se izdvojiti najpovoljniji kultivar, niti sklop koji bi doprinio boljoj kakvoći.Celeriac quality components are influenced by cultivars, growing methods, climatic factors and soil quality. Muck soils of the Vrana area and long growing period as a result of the Mediterranean climate are favorable for celeriac production. Two years experiment was conducted with 3 cultivars: Nemona, Volltreffer and Praški orijaš planted in 2 row distance and 3 bend with 8.3, 10.0, 11.1, 12.5, and 13.3 plants/m2 respectively and 5 replications. During harvest following quality components mean root weight and mean weight were investigated After classification according to diameter (6-8, 8-10 and >10cm), incidence of internal holes (>1 cm) and the dry matter content (Brix) were established. According to ANOVA, mean root weight there were no significant differences between cultivars and spacings (Volltreffer 374 g, Nemona 334 g and Praški orijaš 319 g). With the increase of the number of plants/m2 the root mean weight slightly decreased (370 to 259 g). The lowest percentage of small roots was found in Volltreffer 23.5 %, at Praški orijaš 31.0 % and Nemona 40.5 %. With the increase of the number of plants/m2 the percentage of small roots increased too (from 26.5 to 39 %). Mean weight of small roots was 208 to 249 g, medium 366 to 398 g and large 586 to 653 g. Praški orijaš had the smalest mean weight in all sizes. With spacing decrease mean weight in all sizes slightly decreased. In the first year experiment more internal were was found than in the second year which suggests the influence of climatic factors. More internal holes were found in larger roots than in smaller categories. The same tendency was shown with larger spacings. The dry matter content was from 5 to 7 %. The highest values were found in Praški orijaš cultivar. According to presented experimental results it is not possible to suggest the best cultivar and planting method in respect to quality components

INFLUENCE OF SPACING SIZE AND SHAPE ON QUALITY COMPONENTS OF CELERIAC CULTIVARS (APIUM GRAVEOLENS VAR. RAPACEUM MILL.)

Celer korjenaš za prodaju u svješem stanju i za preradu mora zadovoljiti potrebne standarde kakvoće. Na svojstva koja određuju kakvoću mogu utjecati klimatski i edafski čimbenici, kultivari i načini uzgoja. Organogena tla u Vranskom bazenu i klimatski uvjeti koji omogućuju dugu vegetaciju povoljni su za rast celera. Kako to utječe na kakvoću korijena u 3 kultivara i 5 načina sadnje cilj je ovog istraživanja. U dvogodišnjem pokusu na lokaciji Jankolovica posađena su 3 kultivara: Nemona, Volltreffer i Praški orijaš uz 2 razmaka redova i 3 razmaka u trakama uz sklop: 8.3, 10.0, 11.1, 12.5 i 13.3 biljke/m2. U vrijeme berbe iz svakog od 5 ponavljanja ustanovljen je udio standardnih korjenova i njihova prosječna masa. Standardni korijeni su zatim klasirani po promjeru u 3 kategorije (6 do 8, 8 do 10 i >10 cm). Korijeni su uzdužno razrezani i ustanovljena je pojava unutrašnjih šupljina za svaku kategoriju te postotak suhe tvari refraktometrom, što je pokazatelj kakvoće za preradu. Prosječna masa tržnog korijena statistički se nije razlikovala. Kultivar Volltreffer bio je nešto krupniji (374 g) od kultivara Nemona (334 g) i Praški orijaš (319 g). Povećanjem broja biljaka po m2 prosječna masa tržnog korijena se lagano smanjivala (od 370 do 259 g) u dvogodišnjem prosjeku za sva tri kultivara. Najmanje sitnog korijena (promjera 6 do 8 cm) u ukupnoj masi bilo je u kultivara Volltreffer 23.5 %, zatim Praškog orijaša 31,0 % i Nemona 40.5 %. Za sva tri kultivara povećanjem sklopa udio sitnih korjenova se povećavao (od 26.5 na 39%). Prosječna masa sitnih (promjera 6-8 cm) bila je 208 do 249 g, srednjih (promjera 8 do 10 cm) 366 do 398 g i krupnih (>10 cm) od 586 do 653 g. Najmanju masu u svim kategorijama imao je Praški orijaš. U svim krupnoćama povećanjem sklopa prosječna masa se malo smanjuje. Pojava šupljina u sredini korijena može biti negativno svojstvo. U prvoj godini bilo je više šupljih korjenova nego u drugoj godini istraživanja, krupni korjenovi imali su više šupljina od sitnih, a u većem sklopu bilo ih je manje. Postotak suhe tvari refraktometrom kretao se u prosjeku od 5 do 7 % a bio je najveći u Praškog orijaša. Na osnovi ovih svojstava ne može se izdvojiti najpovoljniji kultivar, niti sklop koji bi doprinio boljoj kakvoći.Celeriac quality components are influenced by cultivars, growing methods, climatic factors and soil quality. Muck soils of the Vrana area and long growing period as a result of the Mediterranean climate are favorable for celeriac production. Two years experiment was conducted with 3 cultivars: Nemona, Volltreffer and Praški orijaš planted in 2 row distance and 3 bend with 8.3, 10.0, 11.1, 12.5, and 13.3 plants/m2 respectively and 5 replications. During harvest following quality components mean root weight and mean weight were investigated After classification according to diameter (6-8, 8-10 and >10cm), incidence of internal holes (>1 cm) and the dry matter content (Brix) were established. According to ANOVA, mean root weight there were no significant differences between cultivars and spacings (Volltreffer 374 g, Nemona 334 g and Praški orijaš 319 g). With the increase of the number of plants/m2 the root mean weight slightly decreased (370 to 259 g). The lowest percentage of small roots was found in Volltreffer 23.5 %, at Praški orijaš 31.0 % and Nemona 40.5 %. With the increase of the number of plants/m2 the percentage of small roots increased too (from 26.5 to 39 %). Mean weight of small roots was 208 to 249 g, medium 366 to 398 g and large 586 to 653 g. Praški orijaš had the smalest mean weight in all sizes. With spacing decrease mean weight in all sizes slightly decreased. In the first year experiment more internal were was found than in the second year which suggests the influence of climatic factors. More internal holes were found in larger roots than in smaller categories. The same tendency was shown with larger spacings. The dry matter content was from 5 to 7 %. The highest values were found in Praški orijaš cultivar. According to presented experimental results it is not possible to suggest the best cultivar and planting method in respect to quality components

Dental caries in primary and permanent teeth in children's worldwide, 1995 to 2019: a systematic review and meta-analysis

Background: Early childhood caries (ECC) is a type of dental caries in the teeth of infants and children that is represented as one of the most prevalent dental problems in this period. Various studies have reported different types of prevalence of dental caries in primary and permanent teeth in children worldwide. However, there has been no comprehensive study to summarize the results of these studies in general, so this study aimed to determine the prevalence of dental caries in primary and permanent teeth in children in different continents of the world during a systematic review and meta-analysis. Methods: In this review study, articles were extracted by searching in the national and international databases of SID, MagIran, IranMedex, IranDoc, Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (ISI) between 1995 and December 2019. Random effects model was used for analysis and heterogeneity of studies was evaluated by using the I2 index. Data were analyzed by using the Comprehensive Meta-Analysis (Version 2) software. Findings: In this study, a total of 164 articles (81 articles on the prevalence of dental caries in primary teeth and 83 articles on the prevalence of dental caries in permanent teeth) were entered the meta-analysis. The prevalence of dental caries in primary teeth in children in the world with a sample size of 80,405 was 46.2% (95% CI: 41.6–50.8%), and the prevalence of dental caries in permanent teeth in children in the world with a sample size of 1,454,871 was 53.8% (95% CI: 50–57.5%). Regarding the heterogeneity on the basis of meta-regression analysis, there was a significant difference in the prevalence of dental caries in primary and permanent teeth in children in different continents of the world. With increasing the sample size and the year of study, dental caries in primary teeth increased and in permanent teeth decreased. Conclusion: The results of this study showed that the prevalence of primary and permanent dental caries in children in the world was found to be high. Therefore, appropriate strategies should be implemented to improve the aforementioned situation and to troubleshoot and monitor at all levels by providing feedback to hospitals

Fractures of the humerus during arm wrestling

Background/Aim. Humeral shaft fractures may occur as a result of arm wrestling. The aim of this study was to present our treatment of humerus fracture sustained during arm wrestling. Methods. A total of six patients, aged 22 to 48, were treated at our department form January 2008 to January 2010 with open reduction and internal fixation and with hanging arm casts. A review of all the relevant literature on the subject was also presented. Results. In all the cases, the fractures healed and function returned to normal. No patient had any neural or vascular compromise. Conclusion. Closed and operative treatments were equally successful in all reported cases. [Projekat Ministarstva nauke Republike Srbije, br. 175-095

“Close–open–close free-flap technique” for the cover of severely injured limbs

The treatment of severely injured extremities still presents a very difficult task for trauma orthopaedic surgeons. Despite improvements in technology and surgical/microsurgical techniques, sometimes a limb must be amputated, otherwise severe and potentially fatal complications may develop. There is a well-established belief that severe open fractures should be left open. However, Godina proved wound coverage in the first 72 h (after an injury) to be safe and to bring good final results. So early wound cover (no later than one week after an injury) with well vascularized free flaps became the gold standard. Yet for many patients (some of whom have serious health problems), operative treatment needs to be postponed when they arrive to specialized microsurgical departments for microsurgical reconstruction much later than one week after incurring an injury. As the definite wound cover period from one week to 3 months seems to be hazardous, especially due to the potential of infection, we developed a safe, original flap technique that prevents infection and covers important structures such as exposed bones, tendons, nerves and vessels. We named this technique the “close–open–close free flap technique”. It enables difficult wound cover in any biological phase of the wound, by combining complete flap cover first, with the removal of stitches from one side of the flap after 6–12 h. This technique works very well for borderline cases as well; where even after a complete debridement, dead tissue still remains in the wound - making wound cover very dangerous. Closing completely severe open fractures with free (or pedicled) flaps and removing the stitches on one side after 6–12 h, enables orthopaedic surgeons to safely cover any kind of wound in any biological phase of the wound. Additional debridements, lavages and reconstructions can easily be performed under the flap and after the danger of a serious infection has disappeared, definitive wound closure can be carried out. © 201