Medicinski Casopis最新文献

{"title":"Diabetic ketoacidosis: Our experiences","authors":"Jelena Miolski, Maja Ješić, S. Kovačević, J. Blagojević, V. Zdravković","doi":"10.5937/mckg55-31440","DOIUrl":"https://doi.org/10.5937/mckg55-31440","url":null,"abstract":"Diabetic ketoacidosis is an acute complication in children with type 1 diabetes mellitus. It is diagnosed if the sugar value is > 11 mmol / l, pH <7.3, HCO3≤ 15 mmol / l, with ketonemia or ketonuria. Based on serum pH and bicarbonate values it could be mild, moderate, and severe. It is manifested by rapid breathing, abdominal pain, nausea, vomiting, altered state of consciousness. Early recognition of symptoms prevents the possibility of serious complications. Treatment includes fluid replacement, rehydration, insulin therapy, electrolyte replacement, glucose correction. This paper presents female patients, aged 2.5 to 15.3 years, with different symptoms. Clinical findings and laboratory test results indicated diabetic ketoacidosis. After starting urgent therapy, they were referred to intensive care units in tertiary centers, where it was concluded that the resulting condition was a newlydiagnosed type 1 diabetes mellitus. Such patients require early recognition of symptoms, urgent care, and treatment in intensive care units, in order to prevent possible complications.","PeriodicalId":39117,"journal":{"name":"Medicinski Casopis","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70986365","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":"Expanded hemodialysis: Basic principles and clinical significance","authors":"M. Nenadović, A. Nikolic, Marijana Stanojević-Pirković, M. Kostović, Branislava Drašković, M. Jovanovic, T. Nikolić, D. Petrovic, J. Trbojevic-Stankovic","doi":"10.5937/mckg55-33909","DOIUrl":"https://doi.org/10.5937/mckg55-33909","url":null,"abstract":"Expanded hemodialysis is a method of treatment to replace kidney function, which effectively removes uremic toxins of middle molecular weight from the blood of the patients with the end stage of chronic kidney disease. Two basic principles of removing uremic toxins during an expanded hemodialysis session are diffusion and convection. The basis of diffusion is the concentration gradient, and the basis of convection is internal filtration (covective transport). Increased MCO membrane sieving capacity and high internal filtration provide high clearance of middle molecular weight uremic toxins. Expanded hemodialysis prevents the development of microinflammation, malnutrition, resistance to the action of erythropoietin, amyloidosis, accelerated atherosclerosis and atherosclerotic cardiovascular diseases in the population of patients treated with regular dialysis. The task of the nephrologist is to evaluate different dialysis modalities that are available and to select the optimal dialysis modality for the treatment of each patient individually, i.e., the individualization of dialysis treatment.","PeriodicalId":39117,"journal":{"name":"Medicinski Casopis","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70986797","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 rare case of melanoma of the rectum hemorrhoid nodule","authors":"V. Selaković, M. Ranisavljevic, Tijana Vasiljevic, B. Stoiljković, B. Kukic","doi":"10.5937/mckg55-31144","DOIUrl":"https://doi.org/10.5937/mckg55-31144","url":null,"abstract":"Anorectal melanoma (AM) is an aggressive and very rare malignancy. The aim of this case report is to present a case of anorectal melanoma that occured in hemorrhoidal node after a colorectal surgery. A patient aged 69 years was treated at the Oncology Institute of Vojvodina for histopathological (HP) verified melanoma of the anorectum (S100, HMB45 and Melan A positive) localized in the hemorrhoidal node. Wide local excision was made. Three months after the operation secondary deposits ocurred at the site of the colorectal anasthomosis, stomach, lung and brain. Polymerase chain reaction analysis of tumor DNA found no mutation in the BRAF V600 gene. Five months after the operation the patient is still alive and on supportive and symptomatic therapy. Despite its rarity, AM should always be considered in unusual anorectal lesions first at all in hemorrhoid nodules.","PeriodicalId":39117,"journal":{"name":"Medicinski Casopis","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70986304","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":"Significance of C-reactive protein determination in patients with metabolic syndrome","authors":"D. Miljkovic̄, S. Todorović","doi":"10.5937/mckg55-30626","DOIUrl":"https://doi.org/10.5937/mckg55-30626","url":null,"abstract":"Objecive. Previous research has shown that CRP is elevated in patients with metabolic syndrome (MS) and that low-intensity inflammation is a characteristic of MS. The aim of this study was to determine the concentration of CRP and to examine the significance of elevated CRP in MS patients. Methods. The study included 149 outpatients, 67 patients with MS (68.9 ± 8.7 years) and 82 subjects who were in the control group of the appropriate age (68.9 ± 8.6 years) (p> 0.05). CRP was determined by turbidimetry and the reference range was up to 5.0 mg / L. Results. The average CRP concentration for MS patients was 5.33 ± 3.60 mg / L, while in the control group the CRP concentration value was 4.60 ± 2.03 mg / L (p <0.001). There was no significant difference in CRP concentrations between men (6.02 ± 4.88 mg / L) and women with MS (4.97 ± 2.87 mg / L) (p> 0.05). Almost a third of patients (29.8%) and only 6.1% of subjects in the control group had a CRP concentration greater than 5 mg / L (p <0.01). Conclusion. A significantly higher frequency of elevated serum CRP concentrations in individuals with MS, compared to those without MS, indicates both the importance of inflammation in the pathogenesis of MS and CRP being biomarkers and mediators of chronic inflammation.","PeriodicalId":39117,"journal":{"name":"Medicinski Casopis","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70985606","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 vitamin a in the nutrition","authors":"Marko Koprivica, J. Bjelanović","doi":"10.5937/mckg55-31633","DOIUrl":"https://doi.org/10.5937/mckg55-31633","url":null,"abstract":"Vitamin A is a group of molecules that are introduced into the body through food. This vitamin is present in food of vegetable and animal origin. Daily vitamin A needs depend on age and reproductive status. The lowest concentrations are required by infants and children up to 14 years of age, while pregnant women and lactating women are more likely to have the highest vitamin A needs. In the human body, vitamin A participates in numerous physiological processes. This vitamin forms the pigment rhodopsin which enables night vision. In addition to this role, vitamin A exerts its function in the immune system, where it participates in maintaining the integrity of the epithelial membranes, as well as in the proper functioning and differentiation of lymphocytes. More recent studies show that vitamin A has a protective role in the process of carcinogenesis and that its regular use prevents gastric cancer from developing. Vitamin A deficiency is a serious public health problem in certain regions of the world, so vitamin supplementation is recommended in some cases in children up to 5 years of age and in pregnant women.","PeriodicalId":39117,"journal":{"name":"Medicinski Casopis","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70986251","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":"Irisin, interleukin-33 and interleukin-37 in patients with ischemic heart disease and obesity","authors":"Y. Kovalova, Nataliia K Sukhonos, Valeriia Brek, Kateryna Smolianyk","doi":"10.5937/mckg55-33926","DOIUrl":"https://doi.org/10.5937/mckg55-33926","url":null,"abstract":"Objective. The aim of this work was to investigate the obesity influence on the levels of irisin and interleukins 33 and 37 in patients with coronary heart disease. Methods. The first group consisted of 36 patients with coronary artery disease (CAD) and obesity. The comparison group consisted of 33 patients with coronary artery disease with normal body weight. The control group included 30 basically healthy persons. The levels of irisin and interleukins were measured by ELISA. Obesity was indicated as increased body mass index (BMI) ≥ 30 kg/m2. Results. The study showed that irisin was reduced to 127.36 (107.52 - 137.88) ng / ml) in the group with stable angina pectoris compared with the controls 147.92 (139.04 - 172.55) ng / ml, p = 0.290. Patients with combined coronary artery disease and obesity had significantly increased IL-33 levels (123.56 ± 32.38 pg / ml, p = 0.004) and IL-37 (131.74 ± 24.17 pg / ml, p = 0.004). Multivariate regression analyses showed that BMI positively correlated with the serum irisin in CAD obese patients (b = 0.255, p = 0.039). Conclusion. The coexistence of obesity in patients with stable angina is suggested to be a significant factor of irisin diminishing and interleukins 33 and 37 levels increasing. Body mass index had direct correlation with irisin concentrations in obese patients with coronary artery disease.","PeriodicalId":39117,"journal":{"name":"Medicinski Casopis","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70986862","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":"Comparison of efficiency of medium molecular weight uremic toxin removal between high-flux hemodialysis and postdilution online hemodiafiltration","authors":"M. Nenadović, A. Nikolic, M. Kostović, Branislava Drašković, M. Jovanovic, T. Nikolić, D. Petrovic","doi":"10.5937/mckg55-31062","DOIUrl":"https://doi.org/10.5937/mckg55-31062","url":null,"abstract":"Introduction. Conventional high-flux hemodialysis effectively removes uremic toxins of medium molecular weight of 0.5-15 (20) kDa, while postdilution online hemodiafiltration effectively removes uremic toxins of medium molecular weight in the range of 0.5-60 kDa. AIM. The aim of the study was to compare the efficacy of b2-microglobulin removal from the patient serum during a single session of conventional high-flux hemodialysis and postdilution online hemodiafiltration. METHOD. Eighty-five patients treated with conventional high-flux hemodialysis and thirty patients treated with postdilution online hemodiafiltration were examined. The main parameter for assessing the removal efficiency of medium molecular weight uremic toxins was serum b2microglobulin concentration before and after a single session of conventional high-flux hemodialysis and postdilution online hemodiafiltration. The following were used for statistical analysis: Kolmogorov-Smirnov test, Student's T test and Mann-Whitney U test. RESULTS. In patients treated with postdilution online hemodiafiltration, the average total convective volume was 21.38 ± 2.97 liters per session. The b2-microglobulin reduction index for the FX CorDiax 600 dialysis membrane was 61.76 ± 7.32%, while for the FX CorDiax 800 dialysis membrane it was 74.69 ± 6.51%. The albumin reduction index for the FX CorDiax 600 membrane was 3.48 ± 1.28%, and for the FX CorDiax 800 dialysis membrane it was 6.01 ± 2.97%. There is a highly statistically significant difference between the reduction index of b2-microglobulin and albumin, for two different dialysis modalities and two different dialysis membranes (p < 0.01). CONCLUSION. Postdilution online hemodiafiltration is more efficient in removing b2-microglobulin from patient serum, compared to conventional high-flux hemodialysis. Albumin loss during a single session of high-flux hemodialysis is lower compared to a single session of postdilution online hemodiafiltration. With both dialysis modalities, albumin loss is less than 4.0 g/4h. High-flux hemodialysis effectively prevents the development of dialysis-related amyloidosis, while postdilution online hemodiafiltration effectively prevents not only the development of dialysis-related amyloidosis, but also the development of resistance to erythropoietin and atherosclerotic cardiovascular diseases in the population treated with regular dialysis.","PeriodicalId":39117,"journal":{"name":"Medicinski Casopis","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70985691","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":"Combination of mifepristone and misoprostol in medical abortion in the first trimester of pregnancy","authors":"J. Georgievska, G. Tofoski, A. Daneva, G. Dimitrov, V. Jovanovska, Eva Sozovska, Sašo Dimitrovski, Adriana Buklioska","doi":"10.5937/mckg55-34879","DOIUrl":"https://doi.org/10.5937/mckg55-34879","url":null,"abstract":"Objective. To determine the effectiveness of the method and patient satisfaction after performing a medical abortion to terminate a pregnancy in the first trimester. Methods. In a retrospective analysis, we present the experiences in performing medical abortion at our clinic in the period from October 1, 2020 to October 1, 2021. Mifepristone tablets and misoprostol tablets were administered according to a scheme, adapted to the protocol of the World Health Organization. Results. In a period of one year at our clinic, we treated 189 patients with the combination of mifepristone and misoprostol in order to terminate a pregnancy in the first trimester. Instrumental revision due to residual masses in the uterus after two weeks was performed in 8 patients (4.23%) while the procedure was repeated successfully in 2 patients (1.06%). The efficiency of the method was 95.8%. We had a small number of complications (prolonged genital bleeding, transient fever, vomiting, etc.). Total of 91.4% of respondents were satisfied with the method. Conclusion. Medical abortion in the first trimester of pregnancy is a safe, effective method and especially useful due to the COVID-19 pandemic, because it can be used without hospitalization, within the ambulatory environment, in consultation with the attending gynecologist.","PeriodicalId":39117,"journal":{"name":"Medicinski Casopis","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70986463","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":"Stress and life satisfaction among alcohol addicts","authors":"Stevan Barać, B. Vukcevic, Medo Gutić, Milan Đorđić, Teodora Safiye","doi":"10.5937/mckg55-35483","DOIUrl":"https://doi.org/10.5937/mckg55-35483","url":null,"abstract":"Objective. The aim of the study was to determine the level of stress and life satisfaction in alcohol addicts, i.e., to examine whether respondents diagnosed with alcohol dependence (F10.2) differ according to the level ofstress and life satisfaction in comparison to respondents from the general population. Methods. The research was designed as a non-experimental, observational cross-sectional study, and was conducted in the period from January to July 2021, at the University Clinical Center Kragujevac. The sample consisted of 80 subjects of both sexes, aged 22 to 36 years, divided into two groups: the clinical group (subjects diagnosed with alcohol dependence - F10.2) and the control group of subjects without psychiatric illness. Results. The study has shown that alcohol addicts have clinically significant and severe symptoms of stress, as well as that stress symptoms were positively correlated with alcoholism, and negatively with life satisfaction. In our sample, the association between stress and life satisfaction in addicts was very negative and very significant (r = - 0.645, p <0.001). In the clinical group of alcohol addicts, a very strong correlation was found (r = - 0.907, p <0.001), while in the control group there was a moderate correlation (r = - 0.315, p <0.05). No statistically significant correlation of stress was found with marital status, as well as with work status, level of education or religious beliefs. Conclusion. In our study, it was found that higher values of stress and lower values of life satisfaction are predictive values for the possibility of alcohol dependence. These findings can be used as an auxiliary tool for orientation assessment as part of establishing the diagnosis of alcohol dependence, as well as for a better understanding of the stress phenomenon in the clinical population of alcohol addicts in our country.","PeriodicalId":39117,"journal":{"name":"Medicinski Casopis","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70986575","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 first confirmed SARS-CoV-2 delta variant in Serbia","authors":"V. Opančina, J. Bohoyo, Christina R. Perez, A. Todorović, Miljan Opančina, R. Radojević-Marjanović, R. Vojinovic","doi":"10.5937/mckg55-33862","DOIUrl":"https://doi.org/10.5937/mckg55-33862","url":null,"abstract":"Severe acute respiratory syndrome coronavirus 2 is a Betacoronavirus of 2B group that belongs to the family of Coronaviridae. Delta variant, which emerged in the Indian State of Maharashtra in December 2020, is nowadays the variant of the most widespread concern and it consists on 3 subtypes, B.1.617.1, B.1.617.2, and B.1.617.3. The transmission rate of Delta variant is 50% - 60% higherthan the Alpha variant and this variant is what currently concerns the world population. In this paper, we present the case of the first registered patient with Delta variant of COVID-19 in Serbia.","PeriodicalId":39117,"journal":{"name":"Medicinski Casopis","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70986915","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}