Medicinski Podmladak最新文献

{"title":"The role of stereotactic body radiation therapy in the treatment of colorectal liver metastases","authors":"M. Marinkovic, S. Stojanovic-Rundic","doi":"10.5937/mp73-34773","DOIUrl":"https://doi.org/10.5937/mp73-34773","url":null,"abstract":"Colorectal cancer is third most common malignant disease and second leading cause of cancer-related deaths worldwide. In 2020, there were 5900 new cases in Serbia and around 3300 number of deaths related to this disease. Metastatic disease is most frequently located in liver. Surgery is first option if complete resection of liver metastases is achievable. Since liver metastases are resectable in 10 - 20% of cases, there is a possibility of implementation of other treatment modality. Alternative for surgery in local treatment of unresectable metastases are stereotactic body radiation therapy (SBRT), interstitial and intraluminal brachytherapy, transarterial chemoembolization, hepatic arterial infusion chemotherapy, selective internal radiation therapy with yttrium-90 resin microspheres, cryoablation, radiofrequency, chemical, and microwave ablation. Candidates for SBRT are patients with unresectable liver metastatic disease and patients with comorbidities which disable surgical treatment, with adequate function of uninvolved liver tissue. Respiration induced motion of target volume can be reduced by introduction of motion management strategies such as infrared markers, deep inspiration breath hold, abdominal compression, respiratory tracking and gating. CyberKnife, TomoTherapy machine and modified linear accelerators are used for delivering SBRT. These units allow us to deliver dose more precisely and to make dose escalation. Different regimes of fractionation are optional, from single fraction to hypo fractionation regimes, and doses are typically around 30 - 60 Gy in 3 fractions. Low toxicity rates in patients with liver metastases treated with SBRT are in relation with precise treatment planning, dose prescription and fractionation. Results of research suggest that delivery of large doses can provide high rate of local response, but on the other hand there is possibility of disease progression out of target volumes. With adequate selection of patients with unresectable liver metastases, the implementation of SBRT, especially in combination with effective systematic treatment modalities, can provide better local control with extension of survival.","PeriodicalId":31558,"journal":{"name":"Medicinski Podmladak","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71006702","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":"Application of shock wave therapy in the treatment of calcific tendinopathies","authors":"I. Topalović, D. Nešić","doi":"10.5937/mp73-35808","DOIUrl":"https://doi.org/10.5937/mp73-35808","url":null,"abstract":"Tendons are the soft tissue that connects muscles to bones. They are made of collagen and elastin, they are strong and solid, and have no possibility of contraction. Their strength helps us to move. Recovery of tendon injuries is long-lasting and can take more than six months. If a tendon is shed during a time injury, calcification occurs at the site of the injury and the disease is called calcifying tendinopathy. The very existence of calcifications is an indication for treatment with a mechanical shock wave (Shock wave). Mechanical shock waves can act in focus or radially. The difference between focused and radial waves is primarily in their physical basis. Focused shock waves differ from radial shock waves in terms of therapeutic depth of penetration into the tissue. The basic biological effect of a mechanical shock wave is stimulating. The energy of the mechanical shock wave acts at the cellular level by stimulating the reduction of inflammation and pain in the tissue. Using mechanical shock wave in the treatment of calcified tendinopathies, a safe method for breaking calcifications was obtained. Shock wave can be applied to using: different frequency, different number of strokes, as well as different strength of strokes in their studies. The choice of parameters for the application depends on whether it is calcified or non-calcified tendinopathy. Indications for the use are: painful shoulder, heel spur, plantar fasciitis, tennis elbow, Achilles tendon tendinopathy, jumping knee, patellar tendinitis, myalgia, myogelosis and muscular tendon overstrain syndrome. Contraindications for the use are: the existence of prostheses, knees and hips, as well as various orthopedic material, pacemaker, as well as the presence of chronic diseases such as multiple sclerosis, amyotrophic lateral sclerosis or tumors. The application of a mechanical shock wave is new, non-invasive method, easy to apply, always reduces pain and practically without side effects. This method has a special role in the treatment of chronic inflammation of diseased tendons, with or without calcification. The only dilemma in the application of a mechanical shock wave can be in the number of applications as well as the time break between the applications of two consecutive mechanical shock waves therapy.","PeriodicalId":31558,"journal":{"name":"Medicinski Podmladak","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71006814","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 analysis of L1 gene variability of Human papilloma virus type 16 in our population","authors":"Filip Milošević, Nina Gatarić, A. Knežević","doi":"10.5937/mp73-35462","DOIUrl":"https://doi.org/10.5937/mp73-35462","url":null,"abstract":"Introduction: Human papilloma viruses (HPV) have been identified as a major etiological factor in the pathogenesis of cervical cancer. High-risk type HPV16 has the greatest medical significance. Based on differences in the nucleotide sequence of the type 16 genome, the existence of 16 variants of this type with different geographical distribution has been shown. Aim: Examination of the nucleotide sequence variability of the L1 gene presented in HPV16 variants in our territory. Material and methods: The paper includes 37 sequences of HPV16 L1 genes taken from the database of the Institute of Microbiology and Immunology of the Faculty of Medicine, University of Belgrade. The sequences were compared with the reference sequences of the HPV16 variants and the construction of the phylogenetic tree was done using the MEGA (Molecular Evolutionary Genetics Analysis, version X) software package. Results: Out of the 37 HPV16 L1 analyzed gene sequences, 23 were grouped with European variants. Other isolates were grouped with non-European HPV16 variants. The nucleotide distance was less than 1%, that is, at the level of subvariants. Conclusion: The results of this study indicate that the European variants of the HPV16 virus are the most common in our population, but they also indicate the presence of non-European variants. Further analysis is necessary in order to monitor the circulation of HPV16 variants in our population.","PeriodicalId":31558,"journal":{"name":"Medicinski Podmladak","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71007105","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":"Productivity and efficiency in the health care system with special focus on hospital performance","authors":"A. Medarević, D. Vuković","doi":"10.5937/mp73-37137","DOIUrl":"https://doi.org/10.5937/mp73-37137","url":null,"abstract":"The principle of efficiency calls on all participants in the provision of health care to seek either better results concerning available financial resources or the highest level of health care with the least resources expenditure. The paper presents a review of theoretical productivity and efficiency concepts and their measuring regarding the health care system and the hospitals' operations. Knowledge of these relationships is essential for the practical implementation of the efficiency principle. The paper also summarizes the results of efficiency studies from comparable, Eastern European systems. Efficiency is a multifactorial phenomenon, for the improvement of which there is a whole range of interventions. The management should implement some of these interventions in the system under their responsibility.","PeriodicalId":31558,"journal":{"name":"Medicinski Podmladak","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71007183","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":"Clinical and laboratory parameter analysis in patients with common Variable Immunodeficiency","authors":"Danka Krtinić, M. Stojanović","doi":"10.5937/mp73-38819","DOIUrl":"https://doi.org/10.5937/mp73-38819","url":null,"abstract":"Introduction: Common Variable Immunodeficiency (CVID) is the most prevalent primary immunodeficiency in adult population. The diagnosis is based on low concentration of at least 2 immunoglobulin classes, mostly IgG, with low IgA and/or IgM. Beside recurrent infections, patients with CVID usually suffer from different respiratory, gastrointestinal, autoimmune and malignant diseases. Leading therapeutic approach to managing CVID is regular intravenous (IVIG) and subcutaneous (SCIG) immunoglobulin replacement therapy. Aim: The aim of the study was to analyze clinical and laboratory parameters in patients with CVID. Material and methods: The present study included 24 patients with CVID who were treated at Clinic of Allergy and Immunology, University Clinical Center of Serbia from 2012 to 2022. Demographic data, clinical and laboratory parameters were obtained from the patients' medical records. The concentrations of IgG, IgM and IgA were measured by nephelometry. Statistical analysis was performed using descriptive methods, Student t test for independent samples and Fisher exact test. Results: Respiratory manifestations were found in 70.8% of patients, gastrointestinal in 45.8%, autoimmune in 29.2% and malignancies in 20.8%. The presence of autoimmune diseases was the most common within the patients aged between 20 to 30 years, and it was statistically significantly higher comparing to other age groups (p = 0.014). Serum IgG concentration of 7.6 ± 2.7 g/l was measured. Statistically significantly higher IgG concentrations were observed in patients receiving SCIG (10.2 ± 1.6), compared to those receiving IVIG (6.7 ± 2.4) (t = -3.3, p = 0.003). Premedication was required in 44.4% of patients receiving IVIG. Conclusion: The most common complication of CVID are chronic lung diseases. Autoimmune diseases are the most frequently diagnosed in patients between the ages of 20 and 30. The use of SCIG is identified as better form of immunoglobulin replacement therapy. Total immunoglobulin serum concentration measuring in patients with recurrent infections and autoimmune diseases can contribute to timely diagnosis.","PeriodicalId":31558,"journal":{"name":"Medicinski Podmladak","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71007667","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":"Correlation between iris color and glaucoma type","authors":"Angelina Kević, Nikola Lisičić, M. Božić","doi":"10.5937/mp73-33349","DOIUrl":"https://doi.org/10.5937/mp73-33349","url":null,"abstract":"Introduction: Glaucoma is a group of diseases, etiologically very different, which is characterized by typical damage to the optic nerve and visual field defects. The most common cause of this disease is higher intraocular pressure (IOP) than the vascular system of the optic nerve head can withstand. Aim: The aim of our study was to examine the correlation between iris color and glaucoma type through a cross-sectional study. Material and methods: Total of 117 patients with glaucoma that were treated at the Clinic for Ophthalmology of the University Clinical Center of Serbia, in the glaucoma clinic, relevant data was recorded, including iris color and the type of glaucoma that was diagnosed and under therapy. The correlation between iris color and sex of patients, age, type of glau-coma, values of IOP of both eyes (IOP OD/OS) and central corneal thickness of both eyes (CCT OD/OS) was examined. Results: The population of our patients consisted of 38.5% men and 61.5% women. Primary open angle glaucoma (POAG) was present in 34.2% and primary angle closure glaucoma (PCAG) in 28.2% of patients. Blue iris was found in 16.2%, green in 6.8%, light brown in 29.9% and dark brown in 47% of patients. The mean IOP is 17.6 ± 6.5mmHg for the right and 16.9 ± 6.1mmHg for the left eye, and for CCT 547.6 ± 69.3mm for the right and 546.6 ± 64.2mm for left eye. Statistically significant correlations were found between glaucoma type and sex (p = 0.001), glaucoma type and iris color (p = 0.031) and CCT and iris color (p = 0.027). Conclusion: A statistically significant correlation of iris color and glaucoma type was confirmed , indicating that people with darker irises develop glaucoma more often than people with lighter irises. The relationship between sex and IOP with iris color was not determined. Results show a higher incidence of glaucoma in females, as well as higher values of CCT in people with darker irises.","PeriodicalId":31558,"journal":{"name":"Medicinski Podmladak","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71006119","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 WBC count on admission on early and longterm mortality in patients treated with primary percutaneous coronary intervention","authors":"J. Starčević, D. Matic","doi":"10.5937/mp73-33781","DOIUrl":"https://doi.org/10.5937/mp73-33781","url":null,"abstract":"Introduction: Inflammation plays a key role in the process of atherosclerosis, its formation, progression and destabilization of plaque. One of the main mediators of inflammation is white blood cells (WBC), whose number increases significantly during inflammation. Aim: The aim of this study was to determine the effect of WBC count at admission on early and long-term mortality in patients with ST segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). Material and methods: A total of 700 consecutive STEMI patients admitted for primary PCI were included in our study. The patients included in the study were divided into two groups: group with normal and group with elevated WBC count. A leukocyte count >11000 / mm3 was considered elevated. Patients were followed-up at 30-days and at 1-year after enrollment. Results: Out off the 700 STEMI patients treated with primary PCI, 665 had WBC count data available at admission and were included in further analysis. From this number, elevated WBC count was registered in 380 patients (57.14%). Patients with increased WBC count were younger and smokers. Observing the characteristics of patients at admission, patients with elevated WBC count had a lower ejection fraction, higher CPK values as well as a higher incidence of heart failure. Thirty-day as well as 1-year mortality were significantly higher in patients with elevated WBC count. Patients with elevated WBC count were at three-fold higher risk for 30day mortality and at two-fold higher risk for 1-year morality. Conclusion: Patients with elevated WBC counts at admission had higher 30-day and 1-year mortality compared with patients with normal WBC counts. The WBC count was an independent predictor of thirty-day and one-year mortality.","PeriodicalId":31558,"journal":{"name":"Medicinski Podmladak","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71007033","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":"Genetic predictors of radiation-induced morbidity in prostate cancer patients","authors":"J. Stanić, V. Stankovic, Snežana Voštinić, M. Nikitović","doi":"10.5937/mp73-32951","DOIUrl":"https://doi.org/10.5937/mp73-32951","url":null,"abstract":"Cancer survivors often face adverse effects of treatment, which have a significant impact on morbidity and mortality. Normal-tissue side effects following radiotherapy (RT), as one of therapeutic modalities, are common and may seriously affect quality of life which is especially important in long-term prostate cancer (PC) survivors. Upgrading in our knowledge in radiation biology have led to the better understanding that genetics plays a significant role in determining a patient's predisposition to developing late RT toxicity, leading to the new field of research called \"radiogenomics\". With the evolution of DNA sequencing technologies and genomic analysis, radiogenomics made an appearance as a state-of-the-art science in the field of personalized medicine with the goal of detection the genetic determinants RT adverse reactions. A single-nucleotide polymorphism (SNPs) - based assay could be used to predict the risk of RT side effects along with clinical features and treatment factors. Several SNPs have been identified that are associated with late radiation-induced morbidity in PC patients. Most importantly, these SNPs make up genes expressed in the tissues that are likely at the root of these symptoms, including the bladder, rectum, and small intestine, which are most exposed in PC RT. Furthermore, genome-wide association studies are likely to lead to an increasing number of genetic polymorphisms that can predict long-term RT complications. Finally, radiogenomics attempts to predict which PC patients will show radiosensitivity, so that radiation oncologists, as well as surgeons, can change treatment accordingly in order to reduce side effects or increase the RT effectiveness.","PeriodicalId":31558,"journal":{"name":"Medicinski Podmladak","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71006040","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 metformin on viability and mitochondrial status of tumor and non-tumor cell line","authors":"Jelena Ljubicic, Andrej Pešić, A. Isaković","doi":"10.5937/mp73-37593","DOIUrl":"https://doi.org/10.5937/mp73-37593","url":null,"abstract":"Introduction: Metformin is a drug of choice in the therapy of type II Diabetes mellitus. There is a growing evidence of metformin's antitumor activity, but the suggested mechanisms of such activity are still not fully elucidated. Aim: To investigate the effect of therapeutic doses of metformin on viability and mitochondrial status of human non-small cell lung carcinoma (NCI-H460) and human immortalized lung fibroblasts (MRC-5) cell lines. Material and methods: Acid phosphatase and Crystal Violet assays were used for the determination of NCI-H460 and MRC-5 cell viability after the treatment with metformin (10-60 µM) for 1-7 days. Mitochondrial membrane potential, production of reactive oxygen species and superoxide anion, as well as mitochondrial mass were measured using flow cytometry after the treatment of the cells for 3, 24 and 120 h, followed by staining with appropriate fluorochromes: JC-1, DHR, DHE and Mitotracker Red. Results: Metformin did not change the viability of both NCI-H460 and MRC-5 cells in all investigated time-points and all used concentrations. Depolarization of mitochondrial membrane was observed 3 h post-treatment in MRC-5 cells. Prolonged treatment (120 h) increased superoxide anion production and mitochondrial mass in NCI-H460 cells. No significant changes in production of reactive oxygen species were observed in both cells lines after short or extended exposure to metformin. Conclusion: : Therapeutic concentrations of metformin do not influence the viability of NCI-H460 and MRC-5 cells, but induce mitochondrial depolarization after short-term exposure in lung fibroblasts and increase production of superoxide anion and mitochondrial mass in lung carcinoma cells after prolonged treatment.","PeriodicalId":31558,"journal":{"name":"Medicinski Podmladak","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71007382","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":"Assessment of the functional significance of borderline stenosis by determining coronary flow reserve, after primary percutaneous infarct artery intervention by stent implantation","authors":"Irena Čolić, V. Vasilev, M. Dobric","doi":"10.5937/mp73-37852","DOIUrl":"https://doi.org/10.5937/mp73-37852","url":null,"abstract":"Introduction: Patients with myocardial infarction who are effectively treated with primary percutaneous coronary intervention (PCI) may have significant coronary artery stenosis that is not responsible for current myocardial infarction. Non-infarction artery stenosis can cause serious adverse cardiac events, which can be avoided by performing PCI. Coronary flow reserve (CFR) is defined as the ratio of the hyperemic mean blood flow velocity to the resting blood flow velocity for a given coronary artery. Coronary flow reserve decreases with increasing severity of the lesion. Aim: Determination of CFR prognostic value in patients with residual intermediate stenosis on non-infarcted artery after PCI. Material and methods: The prospective study included 106 patients treated at the University Clinical Center of Serbia in the period from July 2007 to December 2014. Coronary flow reserve was performed on a non-infarcted coronary artery with intermediate stenosis (40-70%). Adenosine was administered intravenously for two minutes to induce hyperemia at a dose of 140 mcg/kg/min. It was calculated as the ratio of the maximum diastolic flow rate under hyperemia and the maximum flow rate under basal conditions. Patients were invited for follow-up at 6, 12, 18, and 24 months to determine the occurrence of composite adverse events, which included: cardiac death, stroke, myocardial infarction, and myocardial revascularization (non-infarction lesion). Results: In our group of patients, 18 adverse events were reported during follow-up. A statistically highly significant difference (p < 0.001) in CFR values was found in patients with adverse events compared to patients without adverse events. The CFR >2 value had a high negative predictive value (95%) for the absence of adverse events. Conclusion: In patients with CFR > 2, revascularization can be safely delayed with continued optimal drug therapy.","PeriodicalId":31558,"journal":{"name":"Medicinski Podmladak","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71007444","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}