Military Medical Academy

About: Military Medical Academy is a healthcare organization based out in Belgrade, Serbia. It is known for research contribution in the topics: Population & Poison control. The organization has 6865 authors who have published 9615 publications receiving 153086 citations. The organization is also known as: Vojnomedicinska Akademija.

A new composite hemiface/mandible/tongue transplantation model in rats.

Abstract: Extensive head and neck deformities, including bone and soft tissue defects, are always challenging for reconstructive surgeons. The purpose of this study was to extend the application of the face/scalp transplantation model in rats by the incorporation of vascularized mandible, masseter and tongue (based on the same vascular pedicle), and to use this as a model to test new reconstructive options for extensive head and neck deformities with involving large soft and bone tissue defects.A total of 10 composite hemiface/mandible/tongue transplantations were performed in Lewis rats (RT1). Hemimandibular bone, masseter muscle, tongue and hemifacial skin flaps were dissected based on the same vascular pedicle of common carotid artery and external jugular vein. The flaps were then transplanted to the recipient inguinal region. Evaluation methods included flap angiography, plain x-ray, computed tomographic scan, and histology.All transplants survived indefinitely and no graft loss was noted. Flap angiography demonstrated intact vascular supply to the bone. Computed tomography scan and bone histology confirmed the viability of the bone components for the composite grafts. Hematoxylin and eosin staining determined the presence of viable bone marrow cells within the transplanted mandible. Viability of the tongue was confirmed by the presence of pink color and bleeding after puncture, as well as by histology.We have introduced a new composite hemiface/mandible/tongue transplant model. The main advantage of this model is the presence of vascularized bone marrow within the mandibular component, which may facilitate future studies on chimerism and tolerance induction. Although this mandible composite allograft is placed heterotopically to the recipient inguinal region, we believe that it may serve as a new reconstructive option for the coverage of combined bone and soft tissue defects within the head and neck region.

Toxic effects of sarin in rats at three months following single or repeated low-level inhalation exposure.

Abstract: Male albino Wistar rats were once or repeatedly exposed to three various low concentrations of sarin for 60 min. in the inhalation chamber. The clinical status of control as well as sarin-poisoned rats was tested 3 months after exposure to sarin using biochemical, haematological, neurophysiological, behavioural and immunotoxicological methods. While biochemical and haematological parameters, including the activities of cholinesterases in erythrocytes, plasma and various organs (brain, diaphragm), did not differ from the control values regardless of the sarin concentration used, few signs of sarin-induced neurotoxicity and immunotoxicity in sarin-poisoned rats were demonstrated. This was especially true when the single exposure of rats to non-convulsive symptomatic concentration and repeated exposure of rats to clinically asymptomatic concentration of sarin was used. In rats repeatedly poisoned with clinically asymptomatic concentrations of sarin, the alteration of the gait characterized by ataxia, the increase in the stereotyped behaviour, the increase in the excitability of the central nervous system following the administration of the convulsive drug pentamethylenetetrazol were observed. In rats poisoned with non-convulsive symptomatic concentration of sarin, the subtle supression of spontaneous, as well as lipopolysaccharides-stimulated, proliferation of spleen lymphocytes and the bactericidal activity of peritoneal macrophages was primarily observed besides the signs of neurotoxicity. Our findings confirm that both non-convulsive symptomatic and clinically asymptomatic concentrations of sarin can only cause very few, subtle long-term signs of neurotoxicity and immunotoxicity in sarin-poisoned rats when the rats were exposed to asymptomatic sarin concentrations repeatedly.

Color Doppler sonographic features of uterine arteriovenous malformations: report of two cases.

Abstract: We describe the color Doppler sonographic features of uterine arteriovenous malformations in two cases. In both cases color Doppler imaging demonstrated hypervascularity throughout the arteriovenous malformation. The dominance of pale shades during both systole and diastole represented low-impedance, high-velocity flow within the lesion and a colored mosaic pattern representing turbulent flow was noted. Spectral analysis of the vessels within the lesion confirmed high-velocity flow during both systole and diastole, and a low resistance index. The spectral waveform trace also showed spectral broadening consistent with turbulence and the spectral envelope was irregular. These findings indicated the presence of numerous arteriovenous shunts and marked turbulence within the arteriovenous malformation. Spectral analysis of the venous flow revealed high flow velocities and systolic velocity peaks similar to an arterial pattern. The uterine artery velocity waveforms were characterized by high flow velocity and a low resistance index. The diagnosis of uterine arteriovenous malformation was confirmed by histological examination in both cases. The findings of these two cases suggest that color Doppler sonography may play an important role in the diagnosis of uterine arteriovenous malformations.

Communication skills training for emergency nurses

Abstract: Objective: To determine the effects of a communication skills training program on emergency nurses and patient satisfaction. Methods: Sixteen emergency nurses attended a 6-week psychoeducation program that was intended to improve their communication skills. The first 3 sessions of the psychoeducation program consisted of theoretical education on empathy and communication. Other sessions covered awareness, active communication, and empathic skills on a cognitive behavioral basis using discussion, role play, and homework within an interactive group. The effects of the program were assessed using a communication skills scale, empathy scale, and patient satisfaction survey and were reflected by the reduction in the number of undesirable events between nurses and patients in the emergency department. Results: The mean communication skill score (177.8±20) increased to 198.8±15 after training (p=0.001). Empathy score also increased from 25.7±7 to 32.6±6 (p=0.001). The patient satisfaction survey of 429 patients demonstrated increased scores on confidence in the nurses (76.4±11.2 to 84.6±8.3; p=0.01); the nurse's respect, kindness, and thoughtfulness (72.2± 8.1 to 82.1 ± 6,5; p=0.01); individualized attention (71.3± 6.2 to 73.2 ± 9.8; p=0.2); devotion of adequate time to listening (84.6± 9.3 to 89.8 ± 7.6; p=0.03); and counseling and information delivery (71.1± 10.2 to 80.2 ± 9.7; p=0.01). The number of undesirable events and complaints during nurse-patient interactions decreased 66 % from 6 to 2. Conclusion: “Communication Skills Training” can improve emergency nurses' communication and empathy skills with a corresponding increase in patient satisfaction and reduction of the undesirable events and complaints during nurse-patient interactions.

Oronasopharyngeal suction versus no suction in normal term and vaginally born infants: a prospective randomised controlled trial.

Abstract: This prospective randomised controlled trial aimed to compare the effects of oronasopharyngeal suction with those of no suction in normal term and vaginally born infants and was performed at a Turkish tertiary hospital from June 2003 to January 2004. A total of 140 newborns were enrolled in the trial (n = 70 per group). The no suction group showed lower mean heart rates through the 3rd and 6th minutes and higher SaO/2 values through the first 6 mins of life (P < 0.001). The maximum time to reach SaO/2 of = 92% (6 vs. 11 min) and = 86% (5 vs. 8 min) were shorter in the no suction group (P < 0.001). (authors)