Medicinska istraživanja最新文献

{"title":"Rare case of pleomorphic adenoma presenting as peritonsilar tumor","authors":"Anđelina Jovanović, Svetlana Valjarević, Milan Jovanović","doi":"10.5937/medi56-40147","DOIUrl":"https://doi.org/10.5937/medi56-40147","url":null,"abstract":"Pleomorphic adenoma, which is considered to be the most common benign neoplasm of small salivary glands, occurs mainly in the region of the hard palate with mild predilection for women and the peak incidence between the third and sixth decades of life. We present the case of a fifty-one-year-old patient with a left peritonsillar region tumor that the patient has been familiar with for several years. Clinical and radiological examination (computed tomography) indicated a clearly limited, encapsulated tumor change in the left peritonsillar region, 2.5 x 2.5 cm in diameter. The change was completely surgically removed transorally and pathohistologically verified as a pleomorphic adenoma of the small salivary gland. Computed tomography and correct pathohistological diagnosis are essential for the decision on surgical treatment in order to completely remove the lesion. Although it is a benign tumor, early detection is important for a timely decision for surgical treatment. Complete excision of tumor is necessary to prevent regrowth and possible malignant transformation.","PeriodicalId":471485,"journal":{"name":"Medicinska istraživanja","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136306173","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 pathohistological characteristics of lupus nephritis in pediatric and adult population","authors":"Gorana Nikolić, Ana Mioljević, Isidora Filipović, Sanja Radojević-Škodrić, Maja Životić","doi":"10.5937/medi56-44204","DOIUrl":"https://doi.org/10.5937/medi56-44204","url":null,"abstract":"Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease, characterized by abundant production of antibodies, deposits of immune complexes, and activation of the complement system, which disrupts the integrity and function of many organs, including the kidney. Although the frequency of SLE is less common in children, affected children develop lupus nephritis (LN) significantly more often, while in adults with SLE, LN occurs in 23% of cases, more often in males. Aim: The aim of this study was to analyze clinical parameters (gender, frequency of LN as the first manifestation of SLE, proteinuria, and serum creatinine values) and pathohistological parameters (frequency of LN classes, activity and chronicity index values, immunoglobulin deposit intensity and complement components at immunofluorescence, and blood vessel lesions) in the pediatric and adult populations of LN patients. Material and methods: The study included 218 biopsy samples of kidney tissue. Patients were divided into two groups: patients under 18 years of age (n=35) and those over 18 years of age (n =183). Results: Mean values of serum creatinine in pediatric population (71.6±16.4 µmol/l) were statistically significantly lower (p<0.001) than in adults (115.5 ±64 µmol/l). Leukocyte interstitial infiltration was statistically significantly higher in the adult group (p=0.003). The average value of the chronicity index (p=0.002), as well as the tubulointerstitial parameters that determine it (tubular atrophy (p <0.001) and interstitial fibrosis (p=0.011)) were significantly higher in adults with LN. Leukocyte infiltration (p=0.003) and myoelastofibrosis (p<0.001) of blood vessels were statistically significantly more common in the adult population. Conclusions: Serum creatinine values are significantly higher in the adult population of LN. Pathohistological findings indicate that glomerular LN lesions do not differ significantly with regard to activity and chronicity index in pediatric and adult populations, but the degrees of tubulointerstitial lesions are significantly higher, both in terms of activity and in terms of chronicity within the adult groups. Myoelastofibrosis and hyalinization of blood vessels as well as leukocyte infiltration of blood vessels, are statistically significantly more common in the adult population.","PeriodicalId":471485,"journal":{"name":"Medicinska istraživanja","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136306216","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":"Dysgerminoma in pregnancy","authors":"Ivana Likić-Lađević, Katarina Stefanović, Branislav Milošević, Igor Pilić, Zoran Vilendečić, Jelena Stojnić, Aleksandra Beleslin, Olga Mihaljević, Jelena Dotlić","doi":"10.5937/medi56-44402","DOIUrl":"https://doi.org/10.5937/medi56-44402","url":null,"abstract":"Introduction: Malignant germ cell tumors (MGCTs), as a subtype of rare non-epithelial ovarian cancers (NOEC), are most commonly found in pregnancy. Of all MGCTs, 38% are dysgerminoma. Considering the rarity of these entities, the aim of this paper is to show a rare case of ovarian dysgerminoma presented in pregnancy and its influence on course and outcome of the pregnancy. Patient Review: Patient aged 26, gravida 2, para 1, with one vaginal delivery five years before, was admitted to the Clinic for Gynecology and obstetrics in term pregnancy because of uterine contractions accompanied by left thigh pain and tingling sensation in the left leg. Solid hypoechogenic mass with regular borders, 125x90 mm in diameter adjacent to the left side of the uterus was seen by ultrasound, without free fluid in pelvic cavity. Since regular uterine contractions started, the decision was made to terminate pregnancy by Caesarean section (CS) because of tumor previa. Histopathological examination confirmed ovarian dysgerminoma, but after staging operation which was performed two months after CS, following imaging diagnostics, ovarian dysgerminoma was confirmed with FIGO stage IA, meaning that patient's specific oncological treatment was finished. Conclusion: Diagnosis of ovarian dysgerminoma is in general challenging since up to 50% are asymptomatic or symptoms are non-specific. The management of ovarian cancer in pregnancy should be multidisciplinary and individualized in the best interest of the mother and the fetus. The overall five-year survival rate for ovarian dysgerminoma is favorable in more than 90% of cases. Women diagnosed with dysgerminoma in pregnancy are young and in general have good feto-maternal outcome.","PeriodicalId":471485,"journal":{"name":"Medicinska istraživanja","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136306321","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":"Tinnitus risk factors and treatment in adolescents","authors":"Milena Tomanić, Goran Belojević, Ljiljana Čvorović, Dušan Mladenović, Jelena Ilić-Živojinović, Dragana Davidović, Ana Jovanović, Katarina Đurđević","doi":"10.5937/medi56-43528","DOIUrl":"https://doi.org/10.5937/medi56-43528","url":null,"abstract":"Introduction: Tinnitus is conscious perception of sound without an external sound stimulus. The origin of the name has its root in the Latin word tinnire (to ring). The sound can be buzzing, ringing, hissing, and is rarely heard as voice, music, or several different sounds simultaneously. Tinnitus occurs in one-third of people at least once in their lifetime and is chronic in 10-15% of the adult population. In children and adolescents aged 5 to 19 years, the range of tinnitus prevalence is quite wide (from 5% to over 40%), depending on how tinnitus is defined in the study. This article aims to provide an up-to-date overview of tinnitus risk factors and treatment in adolescents. Methods: The authors searched PubMed, Embase, and Cochrane Review databases using the following keywords: tinnitus, adolescents, risk behavior, risk factors, and treatment. The inclusion criterion has an article published in Serbian or English without time restriction. Results: Common risk factors for tinnitus among adolescents are female gender, noise exposure, hearing loss, marijuana and tobacco smoking, exposure to second-hand smoke, and sleep deprivation. Recently, some nutritional risk factors have been added: reduced water intake, niacin and protein deficit, and consumption of fizzy drinks, fast food, and white bread. The results of the current tinnitus treatments, including pharmaceutical, surgical, and behavioral ones, are unsatisfactory, causing frustration both in patients and physicians. Currently, there is no registered medicine for tinnitus. Conclusion: Tinnitus is one of the greatest enigmas of modern medicine. As tinnitus is still considered incurable, we point out major risk factors among adolescents that should be targeted in primary prevention.","PeriodicalId":471485,"journal":{"name":"Medicinska istraživanja","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136307737","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":"Hybride imaging in advanced melanoma","authors":"Isidora Grozdić-Milojević, Bogomir Milojević, Dragana Šobić-Šaranović, Nikola Pantić, Jovana Živanović, Vera Artiko","doi":"10.5937/medi56-44557","DOIUrl":"https://doi.org/10.5937/medi56-44557","url":null,"abstract":"Aim: To evaluate the usefulness of 18F-fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG PET/CT) in patients with advanced melanoma. Method: This study included 264 consecutive patients with melanoma who were sent for the 18F-FDG PET/CT. The inclusion criteria were as follows: histopathologically verified melanoma stage III or IV, the absence of other malignancy/infection; glycemia ≤ 11 mmol/l. The final study population consisted of 220 patients. After the first 18F-FDG PET/CT, the follow-up examination was performed after 11.81±7.99 months, for therapy response evaluation. Results: Pathological 18F-FDG PET/CT was present in 154 patients. Sensitivity of 18F-FDG PET/CT was estimated as 99%, specificity as 47%. There was no statistically significant difference between 18F-FDG PET/CT findings and gender (p> 0.05), and MDCT examination (p = 0.678). However, 18F-FDG PET/CT upstaged 45% patients, especially these with widespread disease. SUV max and inguinal disease localization (in patients who had lower extremities as primary localization of disease) were associated with progression free survival (PFS) (p < 0.05). SUV max (HR 1.03, CI 1.00-1.12, p=0.05) and locally advanced disease (HR 12.02, CI 1.13-148.00, p=0.04) were independent predictors of PFS. A follow up 18F-FDG PET/CT revealed active disease in 22/26 patients. Therapy type (immunotherapy or target therapy) did not correlate significantly with the 18F-FDG PET/CT follow up result (p=0.760, r=-0.354). Conclusion: 18F-FDG PET/CT has good sensitivity in the evaluation of advanced melanoma. Small lesions and brain localization reduce specificity of the examination, then MDCT, Mr are advised. Predictive factors SUV max and locally advanced disease, are more important than the timing of follow-up 18F-FDG PET/CT, since they were predictors of PFS. Follow up 18F-FDG PET/CT should be done at least in 6 months, only if there is suspicion of the presence of active disease.","PeriodicalId":471485,"journal":{"name":"Medicinska istraživanja","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136306330","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":"Non-classic form of congenital adrenal hyperplasia","authors":"Jelena Miolski, Maja Ješić, Vladislav Bojić, Smiljka Kovačević, Jelena Blagojević, Nevena Didić, Vera Zdravković","doi":"10.5937/medi56-42715","DOIUrl":"https://doi.org/10.5937/medi56-42715","url":null,"abstract":"Introduction: Congenital adrenal hyperplasia is an autosomal recessive disease caused by gene mutation resulting in 21a-hydroxylase deficiency and a consequent reduction in adrenal steroidogenesis. The disease could present as classic and non-classic form. The frequency of non-classic form is 0.1% in general population, the most common clinical presentation is premature adrenarche, and the diagnosis is made by determining the concentration of 17-hydroxyprogesterone. The recommended treatment is hydrocortisone with close growth monitoring. Case report: A 7.5-year-old girl was admitted due to premature puberty, accelerated bone maturation and tall stature. The clinical exam revealed hypertrichosis, normal blood pressure and normal ultrasound of internal reproductive organs. The karyotype was 46 XX, the basal and stimulated levels of 17-hydroxyprogesterone were elevated. Clinical and laboratory regression with stagnation of bone and body growth after starting treatment with hydrocortisone confirmed the diagnosis of non-classic congenital adrenal hyperplasia. Conclusion: Early diagnosis and therapy provide a better quality of life, reaching the target height in adulthood and avoiding the development of complications.","PeriodicalId":471485,"journal":{"name":"Medicinska istraživanja","volume":"124 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136306331","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":"Risk factors and survival rate for primary thyroid lymphoma: A case-control study","authors":"Nikola Slijepčević, Branislav Oluić, Božidar Odalović, Milan Grujić, Vladan Živaljević","doi":"10.5937/medi56-43866","DOIUrl":"https://doi.org/10.5937/medi56-43866","url":null,"abstract":"Aim. The aim of the study was to evaluate demographic and clinical characteristics of patients with primary thyroid lymphoma (PTL), to identify risk factors associated with PTL and determine overall survival. Methods. We performed a retrospective case-control study of patients operated for PTL from 1995 to 2017. There were 41 patients with PTL who formed the cases group. The control group consisted of 82 patients with Hashimoto thyroiditis without concurrent thyroid disease. In statistical analysis we used standard descriptive statistics, logistic regression analysis, Kaplan-Meier survival curves and log rank test. Results. In the cases group there were 35 patients with non-Hodgkin lymphoma and six patients with Hodgkin lymphoma. The cases group and the control group had a predominantly female population (&gt;90%). In the control group nearly 70% of patients were younger than 55 years, while in the cases group over 60% of patients were older than 55 years. Risk factors for the development of PTL in patients with Hashimoto thyroiditis are older age, long standing Hashimoto thyroiditis, elevated level of TSH and a suspicious FNAB finding. Independent risk factors for PTL are older age (&gt;55 years) and long standing Hashimoto thyroiditis (&gt;10 years). The mean overall survival for patients with PTL is 92.8 months. Patients with longstanding Hashimoto thyroiditis have a shorter survival (84 month). Conclusion. Patients older than 55 years with longstanding Hashimoto thyroiditis have a higher risk of developing PTL. Additionally, patients with longstanding Hashimoto thyroiditis have worse prognosis compared to other patients with PTL.","PeriodicalId":471485,"journal":{"name":"Medicinska istraživanja","volume":"128 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136307735","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":"Antenatal corticosteroids: Between being a useful drug and posing a risk for fetal and adult development","authors":"Ivana Babović, Jelena Dotlić, Radmila Sparić, Mladen Anđić, Jovan Bila, Jelena Micić, Miljana Jovandarić, Vera Plešinac, Jovana Plešinac, Nataša Karadžov-Orlić","doi":"10.5937/medi56-44211","DOIUrl":"https://doi.org/10.5937/medi56-44211","url":null,"abstract":"Antenatal corticosteroid therapy (ACST) is very important in reducing the sequelae of prematurity, respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), and necrotizing enterocolitis (NEC). This therapy has short-term and long-term neonatal consequences that range from reduced neonatal body weight, brain growth, hypertension, hypoglycemia and obesity to delayed neurological development. In addition to undeniable importance this type of therapy has on fetal maturation, it may also impact programming of fetuses future development and health during childhood and adulthood. ACST must be personalized, as a single course, and determined by indications and assessment of the expected time of delivery, so that the exposure time of the fetus to the effects of endogenous and exogenous steroids is shortened.","PeriodicalId":471485,"journal":{"name":"Medicinska istraživanja","volume":"2012 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136306180","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 significance of 18-fluoro-deoxyglucose positron emission tomography with computed tomography in comparison with multi-slice computed tomography in recurrent bladder cancer","authors":"Slobodanka Beatović, Miloš Veljković, Isidora Grozdić-Milojević, Jelena Petrović, Strahinja Odalović, Milica Stojiljković, Vera Artiko, Dragana Šobić-Šaranović","doi":"10.5937/medi56-44169","DOIUrl":"https://doi.org/10.5937/medi56-44169","url":null,"abstract":"Introduction: Positron emission tomography with computed tomography using 18-fluoro-deoxyglucose (18FDG-PET/CT) is still not applied routinely in clinical practice for the evaluation of recurrent bladder cancer. Recent guidelines recognize the importance of 18FDG-PET/CT, but multi-slice computed tomography (MSCT) is still recommended for monitoring these patients. Aim: To determine the agreement between 18FDG-PET/CT and MSCT findings in the categorization of patients into N and M stages of the disease and the agreement of two diagnostic modalities regarding the number of detected lesions. Material and methods: 31 patients (22 men and 9 women), mean age 61.2 ± 9.2 years, were included in our study after surgical treatment and histopathological confirmation of bladder cancer. Zones of pathological uptake of 18FDG were interpreted visually and semi-quantitatively using the maximum standardized uptake value (SUVmax). The agreement of 18FDG-PET/ CT findings was compared to previous MSCT using Cohen's kappa test for interobserver agreement, interpreted based on the Altman's criteria. Results: The overall agreement between 18FDG-PET/CT and MSCT in N stage of the disease was 77% (c = 0.54; moderate agreement); in stage N0 68%, N2 77%, N3 29%. In M stage, total agreement was 53% (c = 0.10; poor agreement); in stage M0 39%, M1a 22%, M1b 44%. 18FDG-PET/CT detected a total of 29 lesions in N stage of the disease, while MSCT detected 16 lesions, with the agreement of 71% (c = 0.41; moderate agreement). In the M stage of the disease, 18FDG-PET/CT detected 42 lesions and MSCT detected 30 lesions, with overall agreement of 52% (c = 0.07; poor agreement). Conclusion: Our results show that there is a moderate agreement between 18FDG-PET/CT and MSCT findings in the categorization of patients and the number of detected lesions in N stage of disease, but that 18FDG-PET/CT detects more lesions. 18FDG-PET/CT also detects a higher number of lesions in M stage, but the agreement with MSCT findings is poor.","PeriodicalId":471485,"journal":{"name":"Medicinska istraživanja","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136306189","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":"Pemphigus vegetans Hallopeau with nail changes and no oral involvement","authors":"Marija Tomanović, Jovan Lalošević, Dušan Škiljević, Dubravka Živanović","doi":"10.5937/medi56-43463","DOIUrl":"https://doi.org/10.5937/medi56-43463","url":null,"abstract":"Introduction: Pemphigus vegetans (PVeg) is the rarest form of autoimmune pemphigus. Lesions are primarily flexural and mucosal, although they may occur at any site. Oral involvement is common. Two subtypes are recognized - the Neumann type and the less common Hallopeau type. Patient review: We present a Hallopeau-type PVeg with no oral lesions and with uncommon nail changes. In the follow-up period of ten years, the patient experienced several flares but no changes in the oral cavity. Conclusion: This case is interesting due to the disease's rarity, atypic clinical presentation, and an association with multiple pregnancies as a possible precipitating factor.","PeriodicalId":471485,"journal":{"name":"Medicinska istraživanja","volume":"88 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136306339","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}