Srpski medicinski casopis Lekarske komore最新文献

{"title":"Spontaneous resorption of large thoracic disc herniation: A case report","authors":"R. Ilić, V. Aleksić, A. Paunović, M. Jokovic, Svetlana Mijatović","doi":"10.5937/smclk2001090i","DOIUrl":"https://doi.org/10.5937/smclk2001090i","url":null,"abstract":"Primljen • Received: March 16, 2020; Revidiran • Revised: April 25, 2020; Prihvaćen • Accepted: April 27, 2020; Online first: August 30, 2020. Autor za korespondenciju: Vuk Aleksić Odeljenje neurohirurgije, Kliničko bolnički centar „Zemun” Vukova 9, 11000 Beograd, Srbija Elektronska adresa: aleksicvuk@hotmail.com Corresponding author: Vuk Aleksić Zemun Medical Center, Neurosurgery Department 9 Vukova Street, 11000 Belgrade, Serbia E-mail: aleksicvuk@hotmail.com ABSTRACT","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","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":"131529760","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":"Revising the role of magnesium in epilepsy research and management","authors":"M. Stanojević, M. Parezanović, Aneta Popović, S. Spasić, S. Lopičić, V. Nedeljkov, Z. Jovanović, S. Vučković","doi":"10.5937/smclk4-44498","DOIUrl":"https://doi.org/10.5937/smclk4-44498","url":null,"abstract":"Magnesium is a bioessential mineral with multiple neuroactive effects. Mg2+ ion stabilizes excitable membranes. Epilepsy is the third most frequent chronic neurological condition characterized by spontaneous reappearance of unprovoked epileptic seizures, whose underlying mechanisms are not completely understood yet. A literature review on the role of magnesium in basic and clinical epileptology has been made in order to enlighten the importance of magnesium deficiency in the mechanisms of epileptic brain hyperexcitability, as well as the significance of including magnesium into the management of epilepsy patients. Neuronal magnesium requirements are high. The concentration of magnesium in the cerebrospinal fluid (CSF) is even higher than in the blood. In experimental epilepsy research, perfusing hippocampal slices with artificial CSF containing low concentration of extracellular Mg2+ is a frequently used animal model of spontaneously induced epileptiform activity. Magnesium deficiency is the most frequent clinically unrecognized electrolyte disbalance, often overlooked in epilepsy patients. Serum and CSF Mg2+ concentrations are lower in patients with epilepsy, as compared to healthy controls. Hypomagnesaemia increases seizure frequency and the risk of sudden unexpected death in pharmacoresistant epilepsy. Oral magnesium supplements help achieve better seizure control. Parenterally administered Mg2+ efficiently controls seizures in several epileptic encephalopathies in adults and children (in eclampsia, uremia, porphyria, febrile seizures, infantile spasms), and also helps control status epilepticus. Subclinical magnesium deficiency, very frequent in general population, acts as a factor contributing to seizure generation in epilepsy. It is recommended to assess magnesium status in epilepsy patients. This literature review reveals the therapeutic potential of magnesium as a simple antiepileptic agent, which exceeds its current clinical use.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","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":"128365963","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":"Major vascular surgery in the geriatric population: Cardiac risk stratification","authors":"Velimir Perić, M. Stosic, Dalibor Stojanović, Jelena Lilić, Nemanja Nikolić, Lela Lazović, Dimitrije Spasić, Stefan Stojanović, M. Lazarević","doi":"10.5937/smclk3-40930","DOIUrl":"https://doi.org/10.5937/smclk3-40930","url":null,"abstract":"Reliance on surgery, improvements in surgical techniques, and perioperative management have led to a dramatic increase in the frequency of surgical procedures in the elderly population. According to the European Society of Cardiology and the European Society of Anaesthesiology and Intensive Care, major vascular surgery is defined as high-risk, considering the frequency of myocardial infarction and cardiac arrest, which is higher than 5%. Age is an independent predictor of myocardial infarction and cardiac arrest. Heart function alterations are primary changes that occur with advancing age. Risk stratification represents a set of procedures that include identifying chronic systemic diseases, determining their severity, stability and the need for further evaluation and/or therapy optimization, with the aim of reducing perioperative and postoperative mortality and morbidity. In addition to the application of risk scores, accurate risk stratification requires the combined application of both preoperative and postoperative biomarkers. The main idea of integrating biomarkers with scoring systems is to reveal those patients with clinically unmanifested disease, who carry a mortality risk and remain undetected by scoring systems. Biomarkers, such as NT-proBNP and highly sensitive C-reactive protein, have the greatest predictive influence in geriatric vascular surgery.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"17 2 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":"123725403","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":"Erysipelas in a cat-bite victim caused by 'Pasteurella multocida': Case report","authors":"E. Gvozdenović, J. Malinić, N. Nikolic, Nataša Katanić, M. Jovanović, O. Dulović","doi":"10.5937/smclk3-30991","DOIUrl":"https://doi.org/10.5937/smclk3-30991","url":null,"abstract":"Introduction: Erysipelas is a characteristic form of acute superficial streptococcal cellulitis, usually treated in outpatient service, primarily with penicillin, or erythromycin, in cases where the patient is allergic to penicillin. We are reporting the case of a patient who was preventively treated with erythromycin, after a cat bite, but during treatment developed erysipelas, which, after a swab sample from the wound was analyzed, proved to be caused by Pasteurella multocida, resistant to erythromycin. Case report: A 53-year-old woman came to the outpatient clinic with clinical signs of erysipelas cruris. Seven days before, she had been bitten by her own cat. The wound was surgically treated, and erythromycin, 500 mg qid, was prescribed as prophylaxis of wound infection. There were no signs of infection. On the 5th day following the bite, the patient was running a very high fever (39.2°C), but she was without other symptoms, thus the fever was considered to be a symptom of the flu. On the following day, prominent erythematous swelling appeared around the site of the wound, with localized lymphangitis and regional lymphadenitis, and discharge from the wound. The diagnosis of erysipelas was made. The peripheral blood test results were as follows: WBC = 13.9 x 109 /l; NE = 82%, CRP = 43 IU. A swab sample was collected from the wound and the patient was started on penicillin. On the 7th day of penicillin administration, there were no signs of inflammation, while the blood test results were as follows: WBC = 5.1 x 109 /l; NE = 52%; CRP = 24 IU. Pasteurella multocida, resistant to erythromycin but sensitive to penicillin was isolated from the swab sample. Conclusion: Erysipelas, although an easily recognized clinical entity, can be caused by other microorganisms, besides streptococcus. It is very important to consider this in order to make an accurate diagnosis and prescribe the appropriate therapy.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"22 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":"126521785","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":"COVID-19 mortality in Belgrade","authors":"N. Rosić, Milena Šantrić-Milićević","doi":"10.5937/smclk2-33540","DOIUrl":"https://doi.org/10.5937/smclk2-33540","url":null,"abstract":"Introduction: Mortality data are the most reliable indicators of the number of lives that a community has lost due to COVID-19 and represent the minimum data necessary for public health decision-making. Aim: The aim of the study is to describe the basic characteristics of population mortality from COVID-19 in Belgrade in 2020. Methods: The unit of observation in this cross-sectional study for the description of mortality from COVID-19 in 2020 was the population of Belgrade (total, by sex, and by age intervals). COVID-19 was analyzed as the main cause of death (ICD-10: U071, U072). The number and the structure of deaths (%), the crude death rate (per 1,000 population) and the specific death rate (per 100,000 population) were analyzed. The data sources for the study were official statistics on vital events of the Statistical Office of the Republic of Serbia. Results: In 2020, 10.5% of the total number of deaths were due to COVID-19, and the majority of deaths was from the male contingent of Belgrade residents. The mortality rate due to COVID-19 was 158.78 per 100,000 population (211.7 for males and 111.4 for females). COVID-19 was the second leading cause of death in Belgrade. Conclusion: The results of this study indicate the existence of premature mortality in Belgrade. In 2020, COVID-19 was the second leading cause of death among the male residents of Belgrade, while in female residents, it was the third leading cause of mortality. This research provides evidence that can contribute to the international discussion about societal losses caused by the COVID-19 pandemic.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"30 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":"128141551","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":"SIPOC method of optimizing the clinical process in obstetrics","authors":"Edin Međedović, Lara Spalldi-Barišić, Enida Nevačinović, A. Rama, Anida Kurtović, A. Cerovac","doi":"10.5937/smclk3-38976","DOIUrl":"https://doi.org/10.5937/smclk3-38976","url":null,"abstract":"The promptness of providing services to patients directly affects the success of healthcare organizations. In this regard, the implementation of contemporary concepts in healthcare organizations is synonymous with success. Subject of research: The subject being researched in this paper is the possibility of applying the SIPOC method to the clinical process in obstetrics. A more precise application of the abovementioned method would mean a prompter implementation of activities within the clinical process (pregestational counseling, antenatal care of expectant mothers, deliveries, supervision of women during puerperium). Through the activities of the abovementioned clinical process, an effort is made to meet the health needs of expectant and new mothers. The application of the SIPOC method is not sufficiently present in clinical processes, especially the clinical process in obstetrics, and therefore this paper opens a new research area. Aim: The aim of this paper is to indicate the relevance of the SIPOC method as one of the tools within the Lean methodology, which can be used to improve the clinical process in obstetrics. Materials and methods: The following materials and methods were applied in this study: the method of analysis, the inductive - deductive method, the method of synthesis, the method of description, the method of proof. Case analysis was also used in the application of the SIPOC matrix at a gynecology and obstetrics outpatient clinic. Results: The results of the research showed that there was a positive impact on improving the efficiency of the provision of health services, through the implementation of modern methods. The SIPOC method affected the improvement of the efficiency of the clinical process in obstetrics. The review of the literature and the obtained results revealed that there is no formalized concept with instructions on the implementation of clinical process improvement methods.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","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":"128869136","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":"Communicable diseases incidence and mortality in the Belgrade population, from 2015 to 2019","authors":"M. Pajić, A. Jovic-Vranes","doi":"10.5937/smclk3-39123","DOIUrl":"https://doi.org/10.5937/smclk3-39123","url":null,"abstract":"Introduction: Communicable diseases remain a significant burden to society, both worldwide and in Serbia. This study aims to analyze the trend of the total number of patients and deaths from communicable diseases in the Belgrade population, in the period 2015 to 2019. Method: A descriptive epidemiological method was used in this study. Morbidity and mortality data related to communicable diseases, taken from the Statistical Reviews of Health Activities in Belgrade issued by the City Institute of Public Health of Belgrade, for the period 2015 - 2019, were used in this study. Data on the number of new patients and deaths from communicable diseases were used, as well as data on the number of new patients, by groups of infectious diseases. Linear regression analysis for trends (curve estimation) was used to estimate trends in morbidity and mortality from infectious diseases during the observed period. Results: A total of 144,215 persons suffering from communicable diseases was registered in Belgrade, from 2015 to 2019. Communicable disease morbidity in the observed period decreased in Belgrade, while communicable disease mortality increased. During that period, there was no statistically significant trend in incidence rates and mortality rates related to communicable diseases (incidence: y = 2,158.120 - 134.000 x, p = 0.073; mortality: y = 4.930 + 0.250 x, p = 0.369). Conclusion: Although highly preventable, communicable diseases are still present in underdeveloped and developed countries. In addition to general and personal hygiene measures, wearing protective masks, avoiding risky behavior and using protection against sexually transmitted diseases, it is also necessary to focus public health measures on environmental protection and the prevention of the spread of infectious agents outside their habitats, as well as on the prevention of the emergence of new infectious agents.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"138 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":"124616022","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":"A stem cell overview: From evolving hemobiological concepts to (auto)grafting in clinical practice","authors":"B. Balint, M. Pavlovic, O. Markovic, S. Borović, M. Todorović","doi":"10.5937/smclk3-37014","DOIUrl":"https://doi.org/10.5937/smclk3-37014","url":null,"abstract":"Conventional hematopoietic stem cell transplantation is a well-known treatment method for numerous acquired and congenital hematopoietic disorders, disorders of the immune system, as well as certain metabolic disorders. Stem cells (SCs) can be defined as cells capable of self-renewal with a high proliferative capacity and the potential to differentiate into functionally competent mature cells. Stem cells can be divided into embryonic SCs (ESCs) and tissue-specific or adult SCs - such as bone marrow (BM) stem cells, peripheral blood (PB) stem cells, and SCs derived from umbilical cord blood (UCB), as well as other non-hematopoietic or somatic SCs. SCs in adults are characteristically considered to be restricted in their regenerative and differentiative potential, while embryonic stem cells are 'true' totipotent/pluripotent cells, due to their ability to develop into endoderm, ectoderm, or mesoderm - all three embryonic tissue types in the human body. They are the most promising, but also the most controversial type of potentially transplantable SCs. Immature hematopoietic SCs have the potential of differentiating, not only into all blood cells, but also into some somatic cell types (SC plasticity). In different clinical settings, the transplantation of immature stem cells leads to the repopulation of recipient bone marrow, with subsequent complete, stable, and long-term reconstitution of hematopoiesis. Given that immature stem cells are also capable of homing to different tissues, autologous stem cell implantation into a damaged and/or ischemic area induces their colonizing and consecutive transdifferentiating into cell lineages of the host organ, including neovascularization. Thus, they are clinically applicable in the field of regenerative medicine for the treatment of myocardial, brain, vascular, liver, pancreatic, and other tissue damage. The purpose of this overview is to recapitulate the key developments in the rapidly evolving area of stem cell research, as well as to review the use of SCs in conventional transplantations and in regenerative medicine. Additionally, a brief critical evaluation of our own stem cell research will be summarized.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"46 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":"126348066","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":"Prognostic significance of serum ferritin levels on initial diagnosis in patients with acute myeloid leukemia","authors":"Dejan Dudok, M. Virijević","doi":"10.5937/smclk2-32529","DOIUrl":"https://doi.org/10.5937/smclk2-32529","url":null,"abstract":"Introduction/Aim: Acute myeloid leukemia (AML) is a heterogenous malignant disease whose course and outcome are influenced by a number of prognostic factors. Serum ferritin (SF) is often elevated in oncology patients, and it has been shown that it strongly influences an unfavorable outcome in various malignancies. The aim of this study is to assess the effect of high SF values on overall survival and disease-free survival, as well as to assess the correlation of SF values with other prognostic markers, such as clinical and laboratory parameters. Methods: Retrospective analysis included 108 patients diagnosed with AML at the Clinic for Hematology of the Clinical Center of Serbia (CCS), in Belgrade, in the period 2017 - 2019. Patients with acute promyelocytic leukemia, acute mixed lineage leukemia, secondary AML and patients treated with palliative therapy were excluded from the study. Patients were grouped based on the SF cutoff value of 800 µg/L. Results: Patients with higher SF values had a significantly higher incidence of early death (p = 0.020), sepsis in the induction phase of therapy (p < 0.010), and significantly lower initial hemoglobin levels (p = 0.040), as compared to patients with lower SF values. SF at diagnosis appeared to be a significant independent predictive factor of overall survival (p = 0.019) and of disease-free survival (p = 0.040). Conclusion: Our study showed a significant association of high SF values with sepsis in induction, early death, mean hemoglobin, overall survival, and disease-free survival. Identification of SF as an independent prognostic factor and a potential target site of the action of new drugs could contribute to a better prognosis of AML patients.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","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":"130777319","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":"Impact of the COVID-19 pandemic on chronic pain management","authors":"Andrew Auyeung, H. Wang, I. Pirvulescu, N. Knezevic","doi":"10.5937/smclk2-32971","DOIUrl":"https://doi.org/10.5937/smclk2-32971","url":null,"abstract":"Introduction: The COVID-19 pandemic has generated considerable turmoil in the interventional pain management (IPM) community. Due to IPM being classified as 'elective', numerous pain practices across the United States were forced to close during the pandemic, leaving chronic pain patients untreated for indefinite periods, and IPM physicians with increased stress and burnout. Results: In response to these detrimental effects, various re-opening tools and techniques have been created to facilitate a cautious resumption of in-person interventional pain practice. Due to their ability to minimize person-to-person contact, telehealth and pharmacotherapy played a more significant role in IPM during the pandemic, but their increased utilization has also led to the exacerbation of substance abuse and the opioid epidemic. The interplay between steroid use and its immunosuppressive effects, in relation to the COVID-19 infection and the COVID-19 vaccine, has also arisen as an issue of concern. Conclusion: As practices begin to safely re-open throughout the United States, the effects felt by chronic pain patients during the pandemic must be emphasized and not ignored. This review emphasizes the struggles pain patients have had to face during the pandemic and the need to update and redefine regulations regarding interventional and chronic pain management.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"90 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":"131898893","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}