Srpski medicinski casopis Lekarske komore最新文献

{"title":"New therapeutic agents in neurosarcoidosis treatment","authors":"N. Maric, Aleksandra Golubović, Slobodan Belić, Nataša Đurđević, I. Milivojević, M. Geratović, M. Stjepanović","doi":"10.5937/smclk3-41156","DOIUrl":"https://doi.org/10.5937/smclk3-41156","url":null,"abstract":"Neurosarcoidosis is a relatively common extrapulmonary form of sarcoidosis. It is characterized by variable clinical presentation, low probability of spontaneous remission, and significant impact on the quality of life, as well as potential increase in mortality. In addition to corticosteroids, other drugs are used in the treatment of neurosarcoidosis, such as methotrexate, azathioprine, mycophenolate mofetil, tumor necrosis factor a (TNF-a) inhibitors, infliximab and adalimumab. In this paper, by reviewing the available literature, we have attempted to consolidate the current knowledge and novelties in the treatment of neurosarcoidosis, for the purpose of assisting physicians in their day-to-day clinical work. Previous studies still favor pulsed doses of corticosteroids, while other forms of therapy have proven beneficial only in individual cases. However, it should be noted that additional research is needed in order to successfully develop individual therapy.","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":"130664439","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 COVID-19 infection from the perspective of the gastroenterologist","authors":"M. Branković, I. Jovanovic, T. Radonjić, O. Markovic, Milica Brajkovic, V. Popadić, S. Klašnja, M. Zdravković","doi":"10.5937/smclk2-34920","DOIUrl":"https://doi.org/10.5937/smclk2-34920","url":null,"abstract":"The gastrointestinal tract and liver are not spared, when it comes to the coronavirus disease of 2019 (COVID-19), as it doesn't only affect the respiratory tract, but it is also a systemic disease that causes multiple organ damage. In this review, we have united all information that is clinically significant for physicians dealing with this infection, especially for gastroenterologists. One must bear in mind that gastrointestinal symptoms can be the first and/or only indicators of COVID-19, so this infection needs to be suspected when a patient at risk presents with diarrhea, loss of appetite, abdominal pain, nausea, and/or vomiting. Upper gastrointestinal endoscopy in the COVID-19 pandemic is a major issue, as transmission of this airborne infection happens very easily during this procedure, and it should be performed only in cases of gastrointestinal emergencies. With regard to patients suffering from inflammatory bowel disease (IBD), they are often on immunosuppressive therapy, but recommendations are that no change in therapy should be made, as these patients do not fall under the category of patients who are at increased risk of contracting COVID-19. In addition, liver lesion caused by this infection develops as the result of a multifactorial mechanism and is a definite cause for concern, especially in patients with pre-existing chronic liver conditions, who should be closely monitored.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"18 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":"127617960","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":"Interstitial lung diseases and secondary pulmonary hypertension","authors":"Slobodan Belić, N. Maric, Nataša Đurđević, Aleksandra Golubović, I. Milivojević, M. Geratović, N. Nikolić, Irina Čokrlić, M. Stjepanović","doi":"10.5937/smclk4-41136","DOIUrl":"https://doi.org/10.5937/smclk4-41136","url":null,"abstract":"Interstitial lung disease alone can have a poor prognosis, and when associated with pulmonary hypertension there is a significant reduction in survival rates. Since the incidence of pulmonary hypertension in patients with interstitial lung diseases is very high and the symptoms are similar and often unrecognized, our aim is to point out the significance of both coexisting diseases and to prompt clinicians to suspect pulmonary hypertension. Through a brief review of the pathohistological changes, diagnostic methods, and the clinical presentation of these diseases, the similarities and differences that can help in the management of these patients, are shown. The latest treatment guidelines, with a special focus on the impact of antifibrotic treatment (nintedanib and pirfenidone) on pulmonary hypertension, are presented.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"24 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":"132874237","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":"Hepatitis C: Three decades of the path from discovery to the Nobel prize","authors":"M. Ćupić","doi":"10.5937/SMCLK2002115C","DOIUrl":"https://doi.org/10.5937/SMCLK2002115C","url":null,"abstract":"Ove godine, Nobelova nagrada za medicinu dodeljena je trojici naučnika koji su pre 31 godinu identifikovali novi, krvlju prenosivi primarno-hepatotropni virus (engl. blood born virus-BBV). Bio je to hepatis C virus (HCV), uzročnik istoimene infekcije i globalnog zdravstvenog problema koji se povezuje sa teškim komplikacijama, cirozom jetre i hepatocelularnim karcinomom (HCK). Zbog ovog velikog otktića trojice laureta ovogodišnje Nobelove nagrade – Harvija Altera, Majkla Hotona i Čarlsa Rajsa, kojim su zadužili čitavo čovečanstvo, nezamislivo je da se, u godini kada im je dodeljeno najprestižnije priznanje za otkrića u nauci, ne osvrnemo na njihov rad [1]. Hepatitis C virus je nova paradigma za identifikaciju i kontrolu virusnih infekcija, a njegovo otkriće je postalo prekretnica u borbi protiv virusnih bolesti tokom 20. veka. Od trenutka kada je HCV, kao novi BB hepatotropni virus identifikovan, pokrenuta je era naglog razvoja veoma osetljivih laboratorijskih testova za njegovo dokazivanje, što je uslovilo da posttransfuzijski hepatitis C u velikom delu, posebno razvijenog sveta, bude iskorenjen, a tendencija je da se i u ostatku sveta, prevalencija posttransfuzijske HCV infekcije svede na zanemarljive procente [2]. Takođe, ovo otkriće je dovelo do napretka u lečenju HCV infekcije, dizajniranjem veoma efikasnih antivirusnih lekova, kojima se HCV infekcija u potpunosti stavlja pod kontrolu, daje INTRODUCTION","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"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":"133290125","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 multidetector computed tomography in acute stroke detection, monitoring and selection of therapy","authors":"A. Obreski, Ana Papović, Paskaš Jovo, A. Stanković, Danilo Jeremic, Kristina Davidović","doi":"10.5937/smclk3-31003","DOIUrl":"https://doi.org/10.5937/smclk3-31003","url":null,"abstract":"Introduction: A stroke is a sudden, focal nonconvulsive neurological dysfunction which occurs due to vascular damage. Aim: The aim of the study was monitoring all patients who reported to the Emergency Center due to some neurological deficit, within a particular period of time. Materials and methods: For a period of one month, we monitored 123 patients who were admitted to the Department of Emergency Diagnostics with some form of neurological deficit and who underwent a native computed tomography (CT) scan and/or angiographic examination of the endocranium. All examinations were performed with the GE BrightSpeed 16 Slice CT scanner (USA). After initial native CT diagnostics, depending on the finding, the examination was either stopped, or the contrast dye was administered and postcontrast examination was performed or CT angiography was carried out. Results: Most of the patients with vascular neurological deficit were between 50 and 59 years old, while a smaller number of patients was registered in the age group of persons younger than 40 years. Most of the female patients were in the 50 - 59 age group, while most of the male patients were between 40 and 49 years old. Of the 94 patients who developed stroke, 78 (83%) patients had ischemic stroke, while 16 (17%) patients suffered hemorrhagic stroke. There is no statistically significant difference in the occurrence of intracerebral hemorrhage and subarachnoid hemorrhage between the sexes. The localization of ischemic brain infarction was in the vascular territory of the anterior cerebral artery (ACA) - 3.2% of the cases, the middle cerebral artery (MCA) - in 38.9% of the cases, the internal carotid artery (ICA) - in 8.4% of the patients, the basilar artery (BA) - in 13.7% of the cases, the posterior cerebral artery (PCA) - in 7.4% of the patients, the vertebral artery (VA) - 9.5% of the cases, and the supratentorial watershed areas of arterial irrigation - in 11.7% of the patients. Conclusion: Native CT examination is the golden standard for the triage of patients with acute stroke. The advantages of using a CT scan in the assessment of patients with acute stroke are that it is practical, precise, quick and available. CT imaging has prognostic value as well, as it can predict the response to the administered thrombolytic therapy.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"65 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":"125178603","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":"Uterus-sparing surgical treatment of suture necrosis after caesarean section: Case series report","authors":"R. Cerović-Popović, Ćupić Jovana, Olga Mihaljević, Kosta Pantović, M. Radojevic","doi":"10.5937/smclk4-41703","DOIUrl":"https://doi.org/10.5937/smclk4-41703","url":null,"abstract":"Introduction: Delivery by caesarean section (CS) accounts for approximately 32% of all deliveries worldwide, and it may be associated with early and late complications. Although postpartum uterine suture necrosis is not a common condition, it is associated with high morbidity and mortality in puerperal women, as well as permanent loss of fertility in these patients. In this article, we present seven patients successfully treated conservatively, who were diagnosed with uterine suture necrosis, during puerperium, after caesarean section. Case series report: We present 12 female patients in whom, in the period between February 1, 2019 and November 10, 2022, infection occurred after caesarean section was performed at the Clinic for Gynecology and Obstetrics of the University Clinical Center of Serbia (CGO, UCCS), and clinical suspicion of the presence of uterine suture necrosis arose. Of the total number of patients diagnosed with uterine suture necrosis, seven patients were successfully treated conservatively. Conclusion: The uterus-sparing surgical treatment approach to uterine suture necrosis is a possible alternative to standard treatment, which may allow fertility preservation in patients who have not completed reproduction.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"182 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":"125828887","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":"Frequency of tobacco use and the attitudes of health professions students on tobacco use in Montenegro: Global health professions student survey in Montenegro","authors":"V. Ramčilović, S. Ćatić, Enisa Kujundzic","doi":"10.5937/smclk3-38655","DOIUrl":"https://doi.org/10.5937/smclk3-38655","url":null,"abstract":"Introduction: Health professionals play a significant role in advising patients on the harmful effects of tobacco on human health and on the ways of abandoning this bad habit. However, tobacco consumption is also a challenge for health professionals themselves, as well as for medical students. Aim: The objective of this study was to estimate the prevalence of smoking among students of health sciences in Montenegro, as well as to examine their attitudes related to tobacco control mechanisms. Methods: This is a secondary analysis of the Global Health Professions Student Survey, which was conducted by the Ministry of Health of Montenegro, in the period between October 2010 and March 2011. Results: In the 30 days preceding the survey, 25% of respondents had used tobacco. During the year preceding the survey, 38% smokers had consumed cigarettes on school premises. Of the respondents, 44.6% of smokers and 52.9% of non-smokers had been taught on the subject of the importance of providing educational material to patients, as a form of support to smoking cessation, but only 35% of smokers and 28% of non-smokers had received formal training on how to instruct patients to give up smoking. A total of 63.7% smokers and 81.7% non-smokers (p < 0.001) expressed the belief that health professionals who smoked cigarettes were less suited to advise patients on smoking cessation. There was a 70% lower probability that sixth year students would support the above stated attitude. Also, there was a 40% lower probability that the same attitude would be supported by students who felt that smoking in restaurants should not be banned in restaurants, and a 50% lower probability that this attitude would be supported by those students who believed that health workers do not need special training in smoking cessation techniques. Conclusion: The study showed that it was necessary to improve the curricula at health sciences faculties and improve formal training on the harmful effects of tobacco on human health, as well as to improve the training for acquiring evidence-based smoking cessation skills, which would have an indirect effect of reducing tobacco use among students.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"35 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":"116002543","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":"Sarcopenia: From clinical aspects to therapeutic possibilities","authors":"K. Stefanovic, G. Mihajlović, N. Despotović","doi":"10.5937/smclk3-41007","DOIUrl":"https://doi.org/10.5937/smclk3-41007","url":null,"abstract":"In recent years, with the increase in life expectancy and the increasing number of elderly people, sarcopenia has been recognized as a separate entity and a new field in geriatric medicine. The European Working Group on Sarcopenia in Older People defined sarcopenia as a syndrome characterized by progressive and generalized loss of skeletal muscle mass, strength and consequently muscle function, which carries with it an increased risk of falls, disability, loss of work ability and premature death. Sarcopenia in the elderly is being given major research focus in many countries, due to its great impact on morbidity, mortality and health care costs. Despite its clinical importance, sarcopenia is still underrecognized in daily clinical practice, in part due to the lack of available diagnostic tests and unique diagnostic criteria, as well as the lack of clear treatment guidelines. Diagnosing sarcopenia requires assessment of muscle mass, muscle strength and physical performance. The treatment of sarcopenia includes various non-pharmacological and pharmacological approaches, and is primarily focused on resistance and strength exercises, with simultaneous nutritional support.","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":"116837866","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 hyperbaric oxygen therapy in treating progressive infection of the foot in a newly diagnosed diabetes mellitus patient: Case report","authors":"D. L. S. Danilovic, Jelena Milošević, P. Brkić","doi":"10.5937/smclk3-40756","DOIUrl":"https://doi.org/10.5937/smclk3-40756","url":null,"abstract":"Introduction: Hyperbaric oxygen therapy (HBOT) is a therapeutic and diagnostic method wherein the patient breathes 100% oxygen gas at a pressure of more than one atmosphere absolute (ATA) in a hyperbaric chamber. Diabetes mellitus is a heterogenous group of metabolic disorders which manifest as elevated blood glucose levels resulting from either insufficient insulin secretion or an abnormality in insulin action. Diabetic foot is the most common chronic complication of diabetes mellitus. Case report: We present the case of a fifty-three-year-old patient referred to our hospital for the purpose of receiving hyperbaric oxygen therapy due to wet gangrene and phlegmon of the right foot. The patient was newly diagnosed with diabetes. He was hospitalized at a tertiary healthcare institution where his wound was surgically treated. Appropriate antibiotic, antiaggregation, and insulin therapy was introduced for the purpose of achieving the best possible degree of glucoregulation. An X-ray of the right foot was performed verifying the presence of soft tissue gas. Due to the local finding on the foot, the progression and the propagation of the infection proximally, with the presence of gas, hyperbaric oxygen therapy was introduced immediately, according to the emergency protocol, for the purpose of saving the limb. After 30 hyperbaric oxygen therapy sessions, the local finding was significantly improved, and the limb was no longer in danger. Conclusion: Any abnormality in the continuity of the skin, immunity, and vascularization may be considered a risk factor for the development of phlegmon in patients with diabetes. Diabetic foot is the consequence of neuroischemic changes, which occasionally become complicated with further infection. According to the Tenth European Consensus Conference on Hyperbaric Medicine recommendations, indications for the application of hyperbaric oxygen therapy are classified according to the strength of evidence, and there is a high level of consensus for the above-described pathology. With this case presentation we wanted to demonstrate that it is possible to resolve severe infections in diabetic foot through the application of hyperbaric oxygen therapy, with the implementation of a multidisciplinary approach.","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":"115705088","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":"Health personnel and the reform of primary health care in Montenegro","authors":"L. Šćepanović","doi":"10.5937/smclk4-42596","DOIUrl":"https://doi.org/10.5937/smclk4-42596","url":null,"abstract":"Introduction: Universal health coverage reform activities in primary health care in Montenegro were conducted in the period between 2004 and 2012, with the aim of increasing the efficiency of the health care system by ensuring rational use and availability of resources. Aim: The purpose of this study is to describe the health personnel during and after the reform activities in Montenegro. Materials and methods: We adapted the four-dimensional World Health Organization framework to examine availability, accessibility, acceptability and quality of the health personnel in public primary health care facilities, in Montenegro, during and after the reform. Availability, accessibility, acceptability and quality of health personnel were examined using a defined set of proxies. In addition, the latest available data on density rates of health personnel were presented, in order to examine the sustainability of the implemented reforms. The data used included primary health care information system data, data published by the Institute of Public Health of Montenegro, as well as data from a number of official and expert reports by relevant experts and institutions. Results: The total number of physicians employed in primary health care was reduced during the reform by 5%, while the number of nurses was decreased by 35%. At the same time, the number of GPs (chosen doctors for adults) increased, which improved their availability (54.4 in 2015 vs. 36.3 in 2004, per 100,000). Accessibility showed great variations among municipalities. The utilization of health care services, at the national level, increased by 25% in adult health care services. The reduction of the number of nurses was tailored to meet set norms in health care services for adults, women, and children. Reform activities improved the professional competencies of primary health care teams. Conclusion: Primary health care reform improved the availability and accessibility of health personnel and implemented activities that improved their acceptability and quality. It is recommended to establish a permanent body which would continuously monitor the functioning of the primary health care (PHC) system, as well as the changes that occur in PHC, thus ensuring that reform results are maintained and further improved.","PeriodicalId":286220,"journal":{"name":"Srpski medicinski casopis Lekarske komore","volume":"27 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":"129567263","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}