Medicinska istrazivanja最新文献

{"title":"Urban noise and blood pressure of the population: A systematic review of studies in Belgrade","authors":"G. Belojević, K. Paunović, B. Jakovljević, V. Stojanov, Vesna Slepčević, Jelena Ilić-Živojinović","doi":"10.5937/medist1502023b","DOIUrl":"https://doi.org/10.5937/medist1502023b","url":null,"abstract":"The Belgrade team for biological effects of noise, comprising experts in the fields of hygiene and cardiology, has carried out population studies in Belgrade on the sample of 2503 adults, 328 preschool children and 1113 schoolchildren to investigate the effects of urban noise on blood pressure. In the first phase of investigation acoustic measurements were performed on 115 streets of the central municipality \"Stari grad\" as a typical urban environment. Blood pressure measurements were performed using mercury sphygmomanometer in those subjects who did not have a diagnosed hypertension and were not under antihypertensive therapy. Among adults living in the streets with equivalent noise level (Leq) exceeding 45 dB (A) there was a significantly higher number of people with hypertension compared to areas with Leq ≤ 45 dB (A) (23.6% vs.17.5%). After statistical adjustments according to family history of hypertension, age, body mass index (BMI), smoking habits, physical activity and alcohol consumption among males, we found 58% increased odds for obtaining hypertension if they lived in noisy environments for more than 10 years (OR = 1.58; 95 CI = 1.03-2.42; p = 0.038). In females noise exposure and hypertension were not significantly related. In preschool children aged 3-7 and living in areas with night Leq > 45 dB (A) and attending kindergartens in the streets with daytime Leq > 60 dB (A) the prevalence of hypertensive values of blood pressure was higher compared to children from quiet streets (5,7 % vs. 1,5 %; p = 0,054). Systolic blood pressure was significantly higher (5 mmHg on average) in children from noisy streets and kindergartens compared to children from quiet environments (p < 0,01). Multiple regression after adjustments according to age, sex, BMI percentile-forage , family history of hypertension, and socioeconomic status revealed a significant positive correlation between the exposure to urban noise and systolic blood pressure (p = 0,009). In schoolchildren aged 7-11 and attending schools in streets with public transport we found a higher systolic blood pressure (1.3 mmHg on average) compared to children from schools without public transport, after adjustments according to age, sex, BMI, family history of hypertension, living conditions and health related behavioral habits (p < 0.05).","PeriodicalId":167411,"journal":{"name":"Medicinska istrazivanja","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117118163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic low grade inflammation in aging process as a link on a chain of obesity: Related vascular disorders","authors":"D. Vučević, Đ. Radak, Dragoslav Đorđević, M. Miletic, A. Jakovljević, Bojan Jorgačević, Milena Vesković","doi":"10.5937/medist1801032v","DOIUrl":"https://doi.org/10.5937/medist1801032v","url":null,"abstract":"The pathogenesis of obesity-related vascular disorders has not been fully elucidated. The fundamental role of inflammation in aging process is now widely recognized, particularly for atherosclerotic disease which begins before birth. The number of obese individuals worldwide has reached two billion, leading to an explosion of obesity-related vascular disorders associated with increased morbidity and mortality. Obesity, as a chronic low grade inflammatory process, is important risk factor for metabolic and cardiovascular disease. Despite a well-known genetic component, this risk appears to originate from several abnormalities in adipose tissue function associated with a chronic inflammatory state. In particular, obesity as the most common nutritional disorder in industrialized countries, is closely related to impaired endothelial function, a well-known marker of preatherosclerotic disease. These conditions disrupt vascular homeostasis by causing an imbalance between the nitric oxide pathway and the endothelin-1 system, with impaired insulin-stimulated endothelium-dependent vasodilation. Having in mind the growing population of overweight and obese people worldwide, along with an increasingly aging population, understanding the pathophysiology of obesity on cardiovascular system is essential. The mechanisms linking obesity-related vascular disorders and low grade inflammation in aging process are the focus of this paper.","PeriodicalId":167411,"journal":{"name":"Medicinska istrazivanja","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117336266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of early suspicion of non-melanocytic malignant skin cancer (NMSC) in primary and secondary health care","authors":"Spomenka Paurević, D. Lukic, J. Grgic, N. Babić, D. Ivić, P. Lazić","doi":"10.5937/medist1601035p","DOIUrl":"https://doi.org/10.5937/medist1601035p","url":null,"abstract":"The prospective study, which took place from February 2011 to March 2014, included respondents who were sent for computerized dermoscopy because of non-melanocytic skin tumours. Respondents were divided into 2 groups. The first one, group A (45 respondents), consisted of respondents who had expressed concern about the observed changes in the skin and the desire for examination. The second one, group B (50 respondents) were respondents that did not come for examination due to changes on the skin, but for other reasons, so they had indirectly detected suspicious skin lesions. The aim of this study is to analyse the importance of early suspicion of non-melanocytic malignant skin tumours by specialists in primary and secondary health care. Parameters for comparison were respondents' subjective attitude of non-pigment skin lesions and dermoscopy and/or PH findings. It has been shown that changes in the skin that bleed are sometimes highly suspect of NMSC because group A had 5 such cases and NMSC was detected in 4 cases, and group B had 7 respondents with haemorrhage and there were 4 with NMSC. In group B, out of 12 respondents who said that they had found suspicious skin lesions caused by trauma, there were 8 NMSC, while in group A there were 3 cases, which is a statistically significant difference. In group B, out of 16 respondents who claimed that they had had suspicious skin changes dormant for years, NMSC has been proven in 3 cases, and in group A there was not NMSC which is also a statistically significant difference. It was confirmed that the claims of the respondents are unreliable and that all patients should be addressed to computer dermoscopy, in patients with visible changes that arise even a slightest suspicion of NMSC.","PeriodicalId":167411,"journal":{"name":"Medicinska istrazivanja","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125281907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmaceutical therapy of chronic venous disease","authors":"Đ. Radak, V. Sotirović","doi":"10.5937/medist1501033r","DOIUrl":"https://doi.org/10.5937/medist1501033r","url":null,"abstract":"Chronic venous disease (CVD) is a common condition and a global phenomenon that affects a significant part of the population worldwide. The majority of patients with CVD have symptoms that significantly affect their daily activities and deteriorate the quality of their life. Treatment modalities vary from medical and other types of conservative therapies , less invasive endovenous intervention to radical surgical procedures. The purpose of this article is to underline the importance of venoactive drugs in the treatment of patients with CVD.","PeriodicalId":167411,"journal":{"name":"Medicinska istrazivanja","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126198430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory abdominal aortic aneurysm and retroperitoneal fibrosis","authors":"Mihailo Nešković, Nenad Đukić, A. Rakic, Đ. Radak","doi":"10.5937/medist1701001n","DOIUrl":"https://doi.org/10.5937/medist1701001n","url":null,"abstract":"The inflammatory aneurysm of abdominal aorta (IAAA) accounts for 3-11% of all abdominal aortic aneurysms, and occurs predominantly in men. It has similar pathological mechanisms like idiopathic retroperitoneal fibrosis (IRF) and perianeurysmal retroperitoneal fibrosis (PRF), thus presenting the same non-specific systemic inflammatory disorder known as chronic periaortitis (CP). Recognition of CP early in its course is important in order to reduce morbidity due to complications, such as renal failure and mortality from aortic rupture. However, the initial symptoms of CP are non-specific, which makes early clinical diagnosis extremely difficult. Various studies have shown favorable outcomes following corticosteroid treatment in nearly 90% of patients. The positive effects of adding different immunosuppressants to corticoid therapy have established such \"duo-therapy\" as a durable treatment option. Also, cessation of smoking has a positive effect on disease course and it should be an integral part of every treatment regimen. Operative repair of the abdominal aortic aneurysm is considered to be the definitive treatment for IAAA. The effects of both open and endovascular interventions on the inflammatory component however remain unclear. Resolution of periaortic fibrotic tissue after surgery for IAAA is still debated. Some investigators have reported a complete resolution while the others have noted partial regression and even persistence of the inflammatory cuff. Current treatment strategies are based upon \"the best available evidence'', mostly derived from clinical experience obtained by case series involving a small number of patients. Studies of a higher evidence level are very much needed to adjust our approach to such patients and to establish guidelines for treating this complex and serious disorder.","PeriodicalId":167411,"journal":{"name":"Medicinska istrazivanja","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124342436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of radiotherapy in the treatment of Ewing sarcoma of bone","authors":"P. Filipović, Marija Popović-Vuković, M. Nikitović","doi":"10.5937/medi55-40265","DOIUrl":"https://doi.org/10.5937/medi55-40265","url":null,"abstract":"Ewing sarcoma (ES) is the second most common primary bone malignancy after osteosarcoma. The disease most often occurs in adolescence, with peak incidence around the age of fourteen. The most common primary location of the tumor is the bones of the pelvis, followed by the ribs, spine and long bones of the extremities such as the tibia and the fibula. ES shows a tendency towards hematogenous dissemination, primarily in the lungs and bones, much less often lymphogenously. One third of patients have distant metastases present at initial diagnosis, which is why ES is considered a systemic disease. The treatment of Ewing sarcoma is based on a multimodal approach that includes the use of chemotherapy, surgery and/or radiotherapy. The identification of prognostic parameters enabled the individual treatment of patients based on the assessed risk group. With the application of modern therapeutic protocols, five-year survival for patients with localized disease lies between 60% and 68%, while for patients with metastatic disease, five-year survival is still unsatisfactory and is around 17%. ES belongs to the group of radiosensitive tumors, and radiotherapy plays a very important role in the local control of the disease, in combination with surgical treatment or independently, and can be applied as radical, preoperative or postoperative radiation therapy. Also, radiation therapy has a role in the palliative approach to the treatment of lung metastases and other metastatic sites. Considering that the modern multimodal treatment of Ewing sarcoma leads to long-term survival, it is necessary to take into account the expected side effects of the therapy that can reduce the quality of life of treated patients. Modern radiotherapy techniques such as three-dimensional conformal radiation therapy (3D CRT), intensity modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT) enable precise delivery of the prescribed dose of radiation to target volumes with better sparing of surrounding normal tissues and organs, which leads to a lower incidence of late sequelae of radiation therapy and enables the preservation of the quality of life of treated patients.","PeriodicalId":167411,"journal":{"name":"Medicinska istrazivanja","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131576083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of \"Blue toe\" syndrome with Hyperbaric oxygen therapy: Case study","authors":"M. Milačić-Davorka, Tatjana Matković, Anja Lalić, J. Stanimirovic, Z. Gluvić, E. Isenovic","doi":"10.5937/medist1502046m","DOIUrl":"https://doi.org/10.5937/medist1502046m","url":null,"abstract":"\"Blue toe\" syndrome is a relatively rare ischemic disorder produced by occlusion of small blood vessels with fragments of atherosclerotic plaques composed of cholesterol crystals, fatty acids and calcium. It can occur as a complication after endovascular procedures, usually performed on the infra-renal segment of abdominal aorta, as well as in the patients who were under treatment with oral anticoagulant therapy. Hyperbaric oxygen therapy (HBOt) is inhaling 100% oxygen under carefully controlled elevated pressure conditions. In Zemun Clinical Hospital, a patient who presented with \"blue toe\" syndrome, has been treated with HBOt. After the completion of HBOt course, there was an almost complete regression of ischemic changes.","PeriodicalId":167411,"journal":{"name":"Medicinska istrazivanja","volume":"179 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116525810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits and risks of endovascular treatment in patients with proximal vertebral artery stenosis","authors":"S. Babić, Mihajlo Nešković, S. Tanasković, D. Sagic, Ž. Antonić, P. Popov, D. Unić-Stojanović, P. Gajin, P. Matic, Đ. Radak","doi":"10.5937/medist1503038b","DOIUrl":"https://doi.org/10.5937/medist1503038b","url":null,"abstract":"Extracranial vertebral artery stenosis is an important cause of posterior circulation ischemic stroke. There are several therapeutic approaches in patients with vertebral artery (VA) stenosis, including medical, endovascular and surgical treatment. This review should summarize the literature concerning endovascular treatment (EVT) of extracranial VA stenosis. By scanning reference lists of other review articles and by searching electronic database MEDLINE by using major MESH term \"vertebrobasilar insufficiency/therapy\" from January 2010 to April 2015, studies that included patients of any race, age and sex with symptomatic or asymptomatic atherosclerotic stenotic VA disease were identified. Periprocedural transitory ischemic attack (TIA) and stroke, and death within 30 days of the treatment were our primary interest and symptom resolution was secondary outcome measure. We found 12 retrospective studies with prospectively collected data and one additional comparative study of VA angioplasty/stenting and medical treatment was found. Percutaneous luminal angioplasty or stenting alone, or their combinations were performed in 693 patients (726 lesions). Periprocedural TIA or stroke occurred in 14 out of 693 patients (2.0%) and 30 days mortality in 1 (0.15%). A wide range of restenosis rates (3-58%) was reported. The literature shows that EVT of extracranial VA stenosis is safe and efficient. The vast majority of patients remain symptom free after the procedure, despite the restenosis rate.","PeriodicalId":167411,"journal":{"name":"Medicinska istrazivanja","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115822969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of hand-arm vibrations on distal forearm bone mineralization","authors":"Marija Hrković, Tamara Filipović, D. Nikolić, L. Nikcevic, Jovana Kojović-Avramović, A. Filipović, Anđela Milovanović, Aleksandar Milovanović","doi":"10.5937/medi56-43409","DOIUrl":"https://doi.org/10.5937/medi56-43409","url":null,"abstract":"A prolonged, mainly professional, exposure to hand-arm vibration (HAV) may cause a complex chronic disorder of the upper extremities known as Hand-Arm Vibration Syndrome (HAVS). Besides vascular and neurological injuries, such exposure to HAV may cause various bone disorders in the form of cystic changes, exostoses, aseptic necrosis, osteoarthritis, spontaneous fractures and osteoporosis. The objective of this study was to examine whether there were any changes in the bone mineral density in the distal forearm in persons professionally exposed to HAV. In a group of 31 workers professionally exposed to vibrations (29 men and 1 woman) with neurological and/or vascular signs of HAVS, the bone mineral density of the distal part of the radius of both hands was examined by dual X-ray absorptiometry (DXA). The control group consisted of 25 healthy subjects with no history of HAV exposure. Osteopenia was found in 14 subjects (45.16%), which makes a statistically significant difference compared to the control group (p=0.017), where osteopenia was found in 3 subjects (12.0%). Osteoporosis was not found in any of the subjects. Analyzing the value of T score for the dominant (-0.81±0.58 SD) and non-dominant hand (-0.62±0.68SD) in our patients, we found no statistically significant difference in the average T score values of the dominant and non-dominant hand (p=0.269). Changes in bone density at the distal radius are common in persons occupationally exposed to HAV. Distal forearm DXA examination in workers occupationally exposed to HAV can help diagnose HAVS.","PeriodicalId":167411,"journal":{"name":"Medicinska istrazivanja","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127093127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treating refractory chronic spontaneous urticaria with omalizumab: Real life case series","authors":"R. Mišković, Ž. Jovičić, V. Tomić-Spirić, M. Stojanović, A. Plavšić, S. Rašković, Aleksandra Dašić, A. Perić-Popadić","doi":"10.5937/medi55-39584","DOIUrl":"https://doi.org/10.5937/medi55-39584","url":null,"abstract":"Introduction: Patients with refractory chronic spontaneous urticaria (CSU) may pose a significant challenge to the treating physician. Although many studies have investigated the effects of omalizumab in refractory CSU, many issues remain unanswered. Aim: To describe our experience in treating refractory CSU with omalizumab in a real-life setting. Material and methods: We present a series of eight patients with refractory CSU treated with omalizumab during a 2-year period. Results: The average duration of CSU was 49.9 months (3-180). A high average 7-day Urticaria Activity Score (UAS7) of 31.3 (12-42) and a low average Urticaria Control Test (UCT) score of 4.1 (0-8) had been recorded before omalizumab therapy. Prior to omalizumab, all patients required fourfold dose of H1-anihistamines, montelukast and corticosteroids to achieve at least a partial disease control. Antimalarial was given to two patients and dapsone to three, with no response. Adverse effects of corticosteroids were noted in most patients. Patients received 150 mg or 300mg of omalizumab subcutaneously every 4 weeks, for at least 3 months. All patients responded well to omalizumab and discontinued corticosteroid therapy. There were no significant side effects during omalizumab treatment. Conclusion: Omalizumab is an effective corticosteroid sparing treatment, enabling disease control in patients with refractory CSU, even in lower doses (150 mg) and when given for a short period of time. This is especially important when the availability of the drug is determined by economic issues.","PeriodicalId":167411,"journal":{"name":"Medicinska istrazivanja","volume":"256 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133984276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}