scholarly journals Recurrent hemoptysis caused by arteriovenous malformation

2020 ◽  
Vol 54 (3) ◽  
pp. 120-122
Author(s):  
Ivana Meta-Jevtović ◽  
Romana Suša ◽  
Bojan Đokić

Pulmonary arteriovenous malformation is a rare disorder of pulmonary vascularization. We are going to describe the case of recurring hemoptysis with a patient who was diagnosed late with pulmonary AV malformation. The 68-yearold patient was hospitalized for the fourth time in the Clinic for Pulmonology, Clinical Center of Kragujevac due to recurring hemoptysis. Bronchoscopy was conducted which showed no signs of bleeding nor new changes in the bronchial lumen. MSCT of the chest eliminated the possibility of bronchiectasis as the cause for hemoptysis. Chest MSCT was repeated, and it was without evolutionary aspect when compared to the previous one. In April 2019, at the Military Medical Academy in Belgrade, the patient had bronchoscopy performed, the results were normal, and the examination was completed with exploration, along with selective angiography, where AV shunt could be seen on the left side. Since the diameter of the left bronchial artery was less than 2 mm, it was not possible to place the micro-catheter and do embolization, but hemostasis was done by manual compression, which lasted for 10 minutes. After six months of follow-up examinations, no complications were registered with the patient. The method of choice for diagnosing PAV malformation is bronchial angiography, while other chest radiographic methods are not reliable. Embolization is the method of choice for treating this disorder.

2011 ◽  
Vol 68 (7) ◽  
pp. 602-606 ◽  
Author(s):  
Sasa Mickovic ◽  
Miroslav Mitrovic ◽  
Nebojsa Stankovic ◽  
Mihailo Bezmarevic ◽  
Milan Jovanovic ◽  
...  

Introduction. Pancreatic pseudocyst presented as pseudoaneurysm of the splenic artery is a potential serious complication in patients with chronic pancreatitis. Case report. A 42-year-old male patient with a long-standing evolution of chronic pancreatitis and 8-year long evolution of pancreas pseudocyst was referred to the Military Medical Academy, Belgrade due to worsening of the general condition. At admission, the patient was cachectic, febrile, and had the increased values of amylases in urine and sedimentation (SE). After clinical and diagnostic examination: laboratory assessment, esophagogastroduodenoscopy (EGDS), ultrasonography (US), endoscopic ultrasonography (EUS), multislice computed scanner (MSCT) angiography, pseudoaneurysm was found caused by the conversion of pseudocyst on the basis of chronic pancreatitis. The patient was operated on after founding pancreatic pseudocyst, which caused erosion of the splenic artery and their mutual communication. Postoperative course was duly preceded without complications with one year follow-up. Conclusion. Angiography is the most reliable and the safest method for diagnosing hemorrhagic pseudocysts when they clinically present as pseudoaneurysms. A potentially dangerous complication in the presented case was treated surgically with excellent postoperative results.


2013 ◽  
Vol 5 (1) ◽  
pp. 13-20
Author(s):  
Lidija Kandolf Sekulović ◽  
Kristina Kostić ◽  
Željko Mijušković ◽  
Miroslav Dinić ◽  
Lidija Cvetković Jordanov ◽  
...  

Abstract Atopic dermatitis is most frequently well controlled with topical therapeutic agents, but based on several studies, 10-20% of patients need systemic therapy. The most common systemic treatment for atopic dermatitis in everyday practice includes systemic corticosteroids, although there are insufficient valid data to support this. Cyclosporine is the treatment of choice for severe atopic dermatitis resistant to other commonly used treatment options, since its favorable therapeutic risk/benefit ratio is well documented in randomized placebo controlled trials, and also in uncontrolled trials. However, approximately 10% of patients with atopic dermatitis with indication for cyclosporine treatment are actually treated with this modality in Serbia, and there are no published case series on its use in this region so far. In this article, we evaluated the treatment efficacy and safety of cyclosporine microemulsion in patients with severe atopic dermatitis hospitalized at the Military Medical Academy in Belgrade from 2009 to 2012. This restrospective analysis included patients with severe forms of atopic dermatitis treated at the Department of Dermatology of the Military Medical Academy from 2009 - 2012. The hospital database was used to retrieve patients’ medical records. Approximately 200 patients were treated for atopic dermatitis and 20 patients were admitted to the hospital, 17 due to severe forms of disease. In total, 8 of 17 (47.05%) hospitalized patients with severe forms or erythroderma due to atopic dermatitis were treated with cyclosporine microemulsion with an initial dose of 4-5 mg/kg. Laboratory tests were done before treatment, 7 days later, and/or at the end of hospitalization. Therapeutic efficacy was evaluated based on the percentage of reduction of skin lesions from baseline to the end of hospital treatment (early efficacy), and at the end of follow-up (late efficacy). Duration of therapy, adverse events, treatment efficacy and reasons for treatment cessation were recorded during the follow-up period. There were five male and 3 female patients, with an average age of 36.8 years (15 - 60 years). Previous treatment modalities in all patients included emollients, topical and systemic corticosteroids and PUVA therapy. The average dose of cyclosporine was 4.5±0,5 mg/kg. Median reduction of skin lesions at discharge was 60%. There was no need for further hospitalization after an average of 10±3.2 days. Mean duration of treatment was 16 months (3 - 24), with an average reduction of skin lesions of 75% during follow-up. Arterial blood pressure increased in 3/8 (37.5%) patients, regardless of their age, with and average increase of systolic blood pressure of 11.9±11.6 mm Hg (median 7.5, 0-30 mm Hg) and diastolic blood pressure of 5.6±12.9 mm Hg (median 0, -10-20). Mean increase in urea concentration was 0.3 mmol/L (11.8%) and creatinine increased only in three patients by 4.2% (median increase 4 mmol/L). Hypertension was found in three patients during follow-up, and there were no other adverse events. In conclusion, based on previous studies and this small case series of hospitalized patients with severe forms of atopic dermatitis including erythroderma, cyclosporine can be regarded as a safe and effective treatment modality and it can be recommended as first line therapy in severe forms of atopic dermatitis refractory to topical therapy and phototherapy. Long term therapy, however, should be avoided and a maximum 1-2 year therapy is recommended.


1935 ◽  
Vol 31 (1) ◽  
pp. 150-151
Author(s):  
V. Gruzdev

On 23 November 1934, the Military Medical Academy of the Red Army solemnly honoured one of its most prominent professors, Vyacheslav Mikhailovich Aristovsky, head of the Department of Microbiology, on the occasion of his 25th anniversary of medical, social and scientific and pedagogical activities.


2005 ◽  
Vol 62 (6) ◽  
pp. 429-434 ◽  
Author(s):  
Srboljub Stosic ◽  
Jefta Kozarski ◽  
Tatjana Stosic-Opincal ◽  
Nebojsa Jovic ◽  
Ruzica Kozomara

Background. Vascularized osteoseptocutaneous radial flap is commonly used in the reconstruction of composite bony and soft tissue defects of the lower third of the face due to the outstanding quality of its cutaneous component. The aim was to evaluate the primary and overall success in the reconstruction of mandibular defects, following war injuries, with vascularized osteoseptocutaneous radial flap. Methods. At the Department of Maxillofacial Surgery of the Military Medical Academy Belgrade, there were eight patients with this kind of defect following war injury, and the mandible was reconstructed with a vascularized osteoseptocutaneous radial flap. Bony compartment of the graft was harvested as up to 11 cm long segment of radial circumference. Results. The localization and structure of the defect, features of a harvested compound graft, the procedure of the reestablishment of the mandibular continuity was presented as well as immediate and late complications during the consolidation period, and the primary successful reconstruction in 87.5% of the patients. Conclusion. The primary and overall success in the mandibular defects reconstruction with a vascularized osteoseptocutaneous radial flap was equal or even better than those presented in the literature on the reconstruction of the similar defects after tumor resections.


2021 ◽  
Vol 82 ◽  
pp. 53-78
Author(s):  
Angelina Ilieva ◽  

In February 2020, the Bulgarian government established the National Operational Headquarters for Combating the COVID-19 Pandemic in Bulgaria. General Ventsislav Mutafchiyski, a military doctor, professor at the Military Medical Academy in Sofia, was appointed as its chairman. This paper presents a case study on the public image of Ventsislav Mutafchiyski, its readings and interpretations by the audience, and the specific fan culture that emerged around his media persona during the first wave of the COVID-19 pandemic in Bulgaria. Placed in the spotlight of the media at the very beginning of the crisis, Mutafchiyski became extremely popular as the public figure most strongly associated with the fight against the spread of the disease in the country. Around his media persona, shaped in the public imagination as a wartime leader, a fan culture has grown with all its characteristic features and dimensions: fans and anti-fans, affirmative and transformative fandom. As a fictional character, Mutafchiyski has appeared in numerous forms of vernacular creativity: poems, songs, material objects, jokes, fake news, conspiracy theories, and memes. In this way, the General has become the main character of Bulgarian pandemic folklore and the focal point of a participatory pandemic.


2010 ◽  
Vol 67 (8) ◽  
pp. 634-637 ◽  
Author(s):  
Ljiljana Markovic-Denic ◽  
Vesna Skodric-Trifunovic ◽  
Vladimir Zugic ◽  
Dragana Radojcic ◽  
Goran Stevanovic

Background/Aim. In Serbia brucellosis is a primary disease of the animals in the southern parts of the country. The aim of this study was to describe the first outbreak of human and animal brucellosis in the region of Sabac, Serbia. Methods. An epidemiological investigation was conducted to identify a source of outbreak and the ways of transmission of brucellosis infection in human population. A descriptive and analytical epidemiological methods (cohort study) were used. Additional data included monthly reports of the infectious diseases from the Institutes of Public Health and data from the Veterinary Specialistic Institute in Sabac. The serological tests for human brucellosis cases were performed in the Laboratory of the Military Medical Academy; laboratory confirmation of animal brucellosis cases was obtained from the reference laboratory of the Faculty of Veterinary Medicine, Belgrade. Results. Twelve cases of brucellosis were recorded from February 9 to September 1, 2004. Total attack rate was 8.1% (7.5% of males, 14.2% of females). Relative risk (RR) of milk consumption was 8.9 (95% confidence interval: 1.63-13.38), and RR for direct contact with animals was 14 (95% confidence interval: 3.5-55.6). The prevalence of seropositive animals in 33 villages of the Macva region accounted for 0.8%. Regarding animal species, sheep were predominant - 264 (95.7%). Out of a total number of seropositive animals, ELISA results were positive in 228 (88.7%) of them. Conclusion. As contact epidemics generally last longer, it is probable that the implemented measures of outbreak control did reduce the length of their duration.


2017 ◽  
Vol 10 (2) ◽  
pp. 176
Author(s):  
Alexander Alekseevich Andreev ◽  
Anton Petrovich Ostroushko

Shamov, Vladimir Nikolaevich (1882-1962) – an outstanding Soviet surgeon, neurosurgeon, transfuziolog, academician of the USSR (1945), honored scientist of the RSFSR and the Ukrainian SSR, General-Lieutenant of medical service, laureate of the Lenin prize (1962); awarded the order of Lenin (twice), red banner (twice), red banner, red Star and medals of the USSR. Born may 22, 1882 in Menzelinsk, Ufa governorate (now Tatarstan). In 1908 he graduated from the Military medical Academy. In 1911 he defended his doctoral thesis on the topic: "the importance of physical methods for surgery of malignant tumors". From 1914 to 1923 V. N. Shamov – senior assistant in the Department of Fedorov. In 1919 he received isohemagglutinins serum for the determination of blood groups and for the first time the country produced a blood transfusion given group membership. In 1923, V. N. Shamov was elected as head of the Department of surgery of the Kharkov medical Institute and the surgical clinic of the Ukrainian Institute of experimental medicine. In 1926, he reported he developed a method of complete isolation from neural connections of the small intestine, derived under the skin, and transferring it to the blood supply of the subcutaneous vessels. In 1928, V. N. Shamov proposed and successfully conducted the transfusion of cadaveric blood. In 1930, he organized the second in the USSR and in the world Institute of blood transfusion and emergency surgery, and became its Director. In 1935 he was awarded the title of honored Worker of science. In the years 1939-1958 V. N. Shamov headed the Department of hospital surgery of the Military medical Academy, he was the scientific Director of the Leningrad Institute of blood transfusion (1939-1941). During world war II – General-Lieutenant of medical service, Deputy chief surgeon of the red Army, in 1945 – the chief surgeon of the Supreme command of the far Eastern front. In October 1945, he was elected a full member of the USSR AMS. Since 1947 – was also the Director of the Leningrad research neurosurgical Institute them. A. L. Polenov, surgeon-in-chief of the RSFSR. Since 1958 Professor-consultant of the Military medical Academy. In 1962, V. N. Shamov became a laureate of the Lenin prize for development and introduction in practice of the method of preparation and use fibrinoliticescoy blood. N. Shamov for the first time in the country performed periarterial sympathectomy and surgery choroidal plexuses of the ventricles of the brain; developed method pregrading plasty of the esophagus isolated loop of the small intestine, raised the question of limitation contraindications for surgical interventions in the elderly. He was one of the first applied with the purpose of anesthesia, controlled hypotension and hypothermia anesthesia gas nitrous oxide, etc.; successfully completed one-step pankreatoduodenektomiyu in pancreatic cancer; described the clinical picture of tumors of cortex and medulla of the adrenal glands. V.N. Shamov was a member of the Board of the all-Union society of surgeons and the International Association of surgeons, Chairman of the Surgical society. N.I.Pirogov, the Chairman of the organizing Bureau of the 24th all-Union Congress of surgeons, member of the scientific medical Council of Ministry of health of the USSR. More than 20 of his students became heads of departments of medical Universities. V. N. Shamov awarded the order of Lenin twice red banner (twice); the red banner of Labour, red Star, medals of the USSR. Died V.N. Shamov in Leningrad on 30 March 1962. In memory of academician V. N. The Shamov in St. Petersburg on the building of the Military medical Academy and Neurosurgical Institute. Professor A. L. Polenov installed a memorial plaque, a bust of Lieutenant General of medical service V. N. Shamova installed in the courtyard of the St. Petersburg blood transfusion center, one of the streets of the city of Menzelinsk were named after academician V. N. Shamova.


1935 ◽  
Vol 31 (6) ◽  
pp. 795-796

1) Congress of Dentists in Italy. The scientific director of the Leningrad Dental Institute, professor of the Military Medical Academy D. Entin, who participated in the second world congress of dentists (Bologna), returned to the USSR from Italy.


Author(s):  
Kovalevsky A.M. ◽  
Nikitenko V.V. ◽  
Potockaya A.V.

As an outpatient appointment, 347 patients (185 men and 162 women) who first sought dental care for chronic generalized periodontitis were examined in the therapeutic department of the Dentistry clinic of the Kirov Military Medical Academy. All patients were divided into three age groups: 40-45 years, 46-50 years, 51-55 years. There were no patients younger than 40 years old and older than 55 years old among the examined ones. When analyzing the results of the examination of patients, it was revealed that the largest number of patients belongs to the age group of 40-45 years (49.3±2.7% of all examined), on the second place was the age group of 46-50 years – 127 (36.6±2.6% of all examined) people (p<0.001), the smallest the group of patients was 51-55 years, 49 (14.2±1.9% of all examined) people (p<0.001). There were no large differences in the number of patients by gender between the age groups (p>0.05). Mild chronic generalized periodontitis prevails among the examined patients (65.1±2.6%, p<0.001). The mild severity of chronic generalized periodontitis was recorded in 121 (65.4±3.5%) of the 185 men, among 162 women – in 106 (64.8±3.8%). Chronic generalized periodontitis of moderate severity was detected in 42 (22.7±3.1%) men and 38 (23.5±3.3%) women. Finally, 22 (11.9±2.4%) men and 19 (11.7±2.5%) women went to the therapeutic department of the dental clinic with severe chronic generalized periodontitis. Thus, there were no large differences between the sexes in the number of patients with different degrees of severity of chronic generalized periodontitis (p>0.05).


2015 ◽  
Vol 72 (6) ◽  
pp. 499-504 ◽  
Author(s):  
Srdjan Starcevic ◽  
Stasa Munitlak ◽  
Biljana Mijovic ◽  
Dragan Mikic ◽  
Vesna Suljagic

Background/Aim. Active surveillance is an important component of surgical site infection (SSI) reduction strategy. The aim of this study was to analyze and compare SSI surveillance data in orthopedic patients in the Military Medical Academy (MMA), Belgrade. Methods. A 4-year prospective cohort study was performed to identify the incidence rate and risk factors for SSI in orthopedic patients in the MMA, Belgrade. We collected data regarding patients characteristics, health care and microorganisms isolated in SSI. The National Nosocomial Infection Surveillance (NNIS) risk index was subsequently calculated for each patient. The Centers for Disease Control and Prevention criteria were used for the diagnosis of SSI. Results. Assessment of 3,867 patients after different orthopedic operations revealed SSI in 109 patients. The overall incidence rate of SSI was 2.8% with the decrease from 4.6% in 2007 to 1.6% in 2010. Using NNIS risk index for surgical procedures there were: 53.7% (2,077) patients with risk 0 - the incidence rate of 1.4%; 38.9% (1,506) patients with risk 1 - the incidence rate of 3.1%; 7.3% (281) patients with risk 2 - the incidence rate of 11.7%; 0.1% (3) patients with risk 3 - without infection within the risk. Multivariate logistic regression analysis identified 6 independent risk factors associated with SSI: contaminated or dirty wounds, smoking, preoperative infection, NNIS risk index, body mass index and the length of hospital stay. Conclusion. The results of our study are valuable confirmation of relations between risk factors and SSI in orthopedic patients. A decreasing incidence rate of SSI (from 4.6% to 1.6%) during a 4-year active surveillance approved its implementation as an important component of SSI reduction strategy.


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