Introduction/Objective Currently, analysis of the stability of amputees with diabetes is lacking. The aim of this case study was to examine the effects of unilateral transtibial amputation on the stability and balance confidence of patients with below-knee amputation caused by trauma and diabetes. Methods Seventeen subjects, 12 males and five females, with the average age of 51.47 ± 12.12 years, who use a unilateral transtibial prosthesis, were examined. The balance of 10 traumatic amputees (TTA) and seven diabetic amputees (TDA) was assessed by Activities-Specific Balance Confidence (ABC) scale, Timed Up and Go (TUG) test, and One-Legged Stance Test (OLST). Plantar pressure distribution was recorded using Gaitview AFA-50. Results For 10 TTA and one TDA, ABC scores were > 80%, the mean value of the TUG test was 11 (range: 8.08-23 seconds). All the subjects could stand on the healthy leg, two women with diabetes were unable to stand on the prosthetic leg. The distribution of load between the healthy and the prosthetic leg showed higher overload on the healthy leg (average: 56.62%). Conclusion The data from this case series describe stability problems of people with transtibial amputation. Plantar pressure distribution has the potential to provide information about the properties of stability in the amputees who use prosthesis.

The aim of the study was to analyze postural stability, walking speed and fear of falling in patients with diabetic polyneuropathy (DPN) in order to determine the risk factors for falls, as well as the effect of DPN characteristics as additional factors. A sample of 48 patients with type 2 diabetes and DPN were enrolled in this non-randomized observational study. The patients were divided into two groups of fallers and non-fallers. All subjects underwent evaluation with the Functional Reach Test (FRT), Tinetti Falls Efficacy Scale (Tinetti FES) and 10-Meter Walk Test (10MWT). Neuropathy was quantified with the Michigan Neuropathy Screening Instrument (MNSI, Questionnaire part) and 5.07/10-g Semmes Weinstein monofilament examination (SW-ME). The 10MWT and SW-ME were significantly different between the faller and non-faller groups (p<0.05). Duration of DPN correlated positively with SW-ME (p=0.005) in the faller group. FES showed significant positive correlation with MNSI and negative correlation with 10MWT in the non-faller group. Logistic regression analysis revealed that SW-ME was significantly associated with the probability of falling (p=0.0076; OR=1.378). Study results suggested that the loss of protective sensitivity of foot could be a risk factor for falls in people suffering from type 2 diabetes.

Insulin like growth factor 1 (IGF-1) is a regulator of intrauterine growth, and circulating concentrations are reduced in intrauterine growth-restricted fetuses. The aim of our study was to investigate the relationship between IGF-1 levels in newborns and intrauterine growth, expressed as birth weight (BW). The research was designed as a cross-sectional study. The study included 71 premature newborns, gestational age (GA) ≤33 weeks. Quantitative determination of IGF-1 was performed in the 33 rd post-menstrual week (pmw) to make the measurements more comparable. We used an enzyme-bound immunosorbent test for quantitative determination of IGF-1. Our results showed the mean IGF-1 level in premature newborns in 33 rd pmw to be 23.1±4.56 (range 15.44-39.75) μg/L. There was no difference in IGF-1 values between male (23.1±4.98 μg/L) and female (23.1±4.87 μg/L) newborns. There was no significant difference in the average IGF-1 levels between male and female newborns with BW <50 th and BW >50 th percentile for GA either (p>0.50). Only BW <33 rd percentile newborns had a statistically significantly lower IGF-1 level compared to newborns with greater BW. Based on our results, it is concluded that serum IGF-1 level reflects intrauterine growth only in BW <33 rd percentile newborns. This fact could be used for further therapeutic purposes.

Background and objective: Dysfunctional voiding (DV) presents relatively frequent problem in pediatric urologist practice. The necessity for implementation of DV evaluation in the pediatric population is of particular importance, since there is no clear consensus on the clinical assessment of such condition. The aims of our study were to evaluate the test/retest reliability and reproducibility of dysfunctional voiding and incontinence scoring system: Serbian version (DVISSSR) in patients with voiding and incontinence dysfunctions without structural deformities, and to estimate cut-off value for DVISSSR. Methods: The cross-sectional study included 57 children with voiding and incontinence dysfunctions and 30 healthy pediatric controls. For the evaluation of voiding and incontinence dysfunction we used DVISS. The forward–backward method was applied for translation of the DVISS questionnaire from English into Serbian language. Reproducibility was analyzed by Interclass Correlation Coefficient (ICC). Sensitivity and specificity of DVISSSR scores was done by receiver operating curve (ROC) curve. Results: There was a significant difference in DVISSSR score between patients and controls (p < 0.001). For reliability and reproducibility of the questionnaire, there was no significant difference between repeated measurements (p = 0.141), and strong reliability (ICC = 0.957; p < 0.001). Conclusion: We have demonstrated successful translation and validation of the DVISSSR score. Moreover, a reliable scoring system of children with voiding dysfunctions should include evaluations of symptom scoring systems at the multicentric level.

The aim of the study was to evaluate the effects of preoperative respiratory rehabilitation on functional capacity, length of stay in intensive care unit (ICU), duration of mechanical ventilation (MV) and total hospitalization, as well as to estimate arterial blood gas (ABG) values in patients undergoing cardiac surgery. Nineteen patients were included in the randomized observational study, divided into two groups: group A (intervention) and B (control). Preoperative and postoperative rehabilitation was performed in group A, and only postoperative rehabilitation in group B. Rehabilitation was carried out according to a predefined protocol. We used ABG to evaluate respiratory function, two-minute walk test (2MWT) and sit-to-stand test to assess functional capacity. The following data were obtained from medical documentation: duration of MV, length of stay at ICU, occurrence of postoperative pulmonary complications, and length of total hospitalization in both groups. Significant between-group difference was found for the length of total hospitalization and duration of MV (p<0.05 both). Analysis of the mean values of 2MWT on the last day of hospitalization (p=0.005), sit-to-stand test before surgery (p=0.022) and on the last day of hospitalization (p=0.008) showed statistically significant differences. The length of hospital stay significantly correlated with preoperative rehabilitation in group A (r=0.885; p<0.0001). There was no difference in ABG parameters between the groups. The study showed that preoperative respiratory rehabilitation had an effect on reducing duration of MV and length of total hospitalization, and improved functional capacity.

Introduction: Cardiovascular diseases (CVD) are leading factor in global mortality and morbidity. It is the cause of 1/3 of total annual mortality, while coronary heart disease (CHD), as one of the CVD entities, is responsible for 85% of deaths worldwide. The aim of the study is to show the importance of the first phase of cardiac rehabilitation (CR) in patients who are going on cardiac surgery, as well as the impact on respiratory function, the occurrence of pulmonary complications and the length of hospitalization. Methods: A sample of 18 patients was included in the randomized observer study. First phase of CR was carried out according to a predefined protocol. We used arterial blood gases (ABG) to evaluate the respiratory function, "two-minute walk test" (2MWT) to assess the functional capacity Data taken from medical documentation are the duration of mechanical ventilation (MV), the length of stay in the ICU, occurrence of the postoperative pulmonary complications and duration of total hospitalization. Results: The test sample consisted of 12 men (60.58 ± 8.33) and 6 women (66.00 ± 6.51). The mean value of CR was 6.15 ± 3.98 days and MV 19,67±11,23 hours. There were no pulmonary complications in 61,11% patients. Using ABG, a statistically significant difference was found in PO2 after extubating and at the last day in ICU (p = 0.01). 2MWT preoperatively significantly correlated with the examined on the last day of hospitalization (r = 0.648 p-value <0.001) well as the length of postoperative hospitalization and duration of mechanical ventilation (r = 0.708 p-value <0.001). Conclusion: The study showed that first phase of cardiac rehabilitation may positively affect the improvement of functional capacity.

Introduction/Objective The aim of this paper was to examine proportion of patients with arterial abnormalities of feet due to age and severity degree of pes metatarsus varus (PMV), and to evaluate the treatment duration and outcome. Methods The prospective longitudinal study included 240 patients with congenital PMV classified into three age groups: group < 3 months of life (Group 1), group 3-9 months (Group 2), and group 9-12 months (Group 3). Three categories of PMV were analyzed: mild/moderate/severe. Groups with arterial anomalies (Group A) and without (Group B) were analyzed. Clinical outcome was graded as: good/satisfactory/poor. Results There is statistically significant difference in distribution of children regarding age and severity degree on first visit and presence of feet arterial abnormalities (p < 0.01). For Group A, younger children had longer physical therapy, while for Group B, older children had longer duration of physical therapy. Same trend applies as severity degree of foot deformity increase. In Group A, the most frequent treatment outcome was poor (for Group 1-46.7%; Group 2-60%; Group 3-62%), while in Group B for Group 1 and Group 2 it was frequently good (Group 1-90%; Group 2-40%), and for Group 3 frequently satisfactory (Group 3-53.3%). Conclusion In children with PMV it might be advisable to perform ultrasound evaluation of arterial structure of feet, and particularly in cases were such deformity is more severe.