Srp Ark Celok Lek
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[Correlation between survival time and severity of injuries in fatal injuries in traffic accidents].
In forensic pathology, only trauma systems based on disintegration of anatomic structure of organs and tissues, could be used for objectivization, comparison and establishing of severity of injuries. Trauma systems based on pathophysiological values are useless. The Abbreviated Injury Scale (AIS) and its derivate Injury Severity Score (ISS) are the most common. AIS coded injuries are divided into six body regions and injuries are assigned a six-digit score in relation to their severity. ISS results the sum of the squares of the highest AIS values from the three most severely injured body regions. In this way, the ISS values are discontinued and vary from 0 (absence of injuries) to 75 (incompatible-with-life injury). ⋯ By anaylzing our sample of fatally injured persons in traffic accidents (unpenetrated blunt trauma), there was a negative weak correlation between the outliving period and severity of injury based on ISS. This correlation was partly direct but mostly depended on other factors (e.g. effective emergency medical system and triage, prompt and correct diagnosis, adequate medical treatment and care, etc.). Establishment of these factors could be possible through state medical projects in big medical trauma centres. Prospect registration, evaluation and scoring of all injuries in hospitals and dissecting rooms, and comparison of the obtained results, can give valid data on mortality of injured people, bad diagnosis, and appropriate medical treatment. The autopsy of injured persons dead on the spot can point out what kind of injuries are incompatible with life, as well as with their severity. The autopsy of injured persons who survived trauma can point to the most frequent injury complications, clinical diagnosis and preventable deaths. According to this paper, the critical injury by ISS is 17. In such cases, the forensic pathologist must answer the following questions: whether the death was due to trauma; whether the precipitated cause of death was the consequence or complication of injury; what were the mechanism and mode of dying; whether the death was preventable; if there were possible malpractice and negligence, etc.
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Hysterosalpingography (HSG) is a radiographic examination of endocervical canals, uterine cavity and Fallopian tube with the use of a radiographic contrast medium [1]. This method is an integral part of gynaecological examination and its value has not been underestimated in the modern gynaecological practice. ⋯ On the basis of the obtained results, the following conclusions can be drawn: 1) HSG is a simple method for examination of female sterility; 2) HSG and laparoscopy are the complementary methods in the examination of tubal sterility; 3) HSG is inferior in relation to laparoscopy in the examination of peritubal adhesion.
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Biography Historical Article
[135 years' since the first medical textbook for higher education in Serbia].
Medical teaching at School in Belgrade started in 1863 when forensic medicine became an oblicatory subject for law students. In 1865 the Serbian physician Joachim Medovitsh (1815-1893) published the first medical textbook "Forensic medicine for lawyers" in Serbia. It appeared more than fifty years before foundation of the School of Medicine in Serbia. ⋯ In his book Medovitsh cited often Johann Casper (1796-1864) one of who published the most used textbook in the second half of the 19th century. Joachim Medovitsh, M. D. contributed very much to the beginnings of High School medical teaching in Belgrade being in the course of events and achievements of European medicine.
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Historical Article
[Centenary of the Nobel Prize for medicine and physiology].
A centenary of the first presentation of the Nobel Prize for Medicine and Physiology has been the reason to make a survey of all those who had been given this prestigious award and their scientific contributions. The Nobel Foundation and the Nobel Museum with their Internet presentations have been the major source of information in this paper, providing a complete survey of anything related to the Nobel Prize. The following Internet address is a very useful source of information about all the laureates of the Nobel Prize for Medicine: www.almaz.comlnobe/medicine/medicine.
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The aorto-enteric fistula (AEF) is a direct communication between aorta and intestinal lumen. There are primary and secondary forms. Primary AEFs are usually due to erosion of an aortic aneurysm (AAA) into the intestine, while secondary forms are caused by reconstructive procedures on the abdominal aorta. The incidence of primary AEF ranges from 0.1 to 0.8%, and secondary from 0.4% to 2.4% [2-4]. The mortality rate after surgical treatment of secondary AEFs is from 14% to 70% [5]. Therefore, they are of great medical importance. The aim of this paper is the presentation of 9 new cases. ⋯ Sir Astley Cooper was the first who described primary AEFs caused by AAA rupture in 1817 [6], and Brock in 1953, first described secondary AEF developed 6 months after aortic homograft implantation [8]. In 1957, Haberer successfully treated primary AEF by suture of the duodenal defect and aneurysmorrhaphy [9]. In our country Stojanovitsh and Vujadinovitsh in 1966, first treated primary AEF [16]. Their patient died due to MOFS. However, in 1984 and 1985, Lotina successfully treated two patients with secondary AEFs [11] (Figure 3, Sheme 1). The authors also analyzed literature data on the aetiology, pathogenesis, clinical manifestations, diagnosis and treatment of AEFs. In conclusion, the authors suggest: 1. "Omega" extra-anatomic bypass from supraceliac artery trough retroperitonely to femoral arteries; 2. "In situ" replacement of the abdominal aorta using cadaveric homografts; 3. Intraoperative control of bleeding with endoluminal balloon occlusive aortic catheter.