Прегледај по Аутор "Lalović, Nenad"
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- СтавкаAdjuvant application of trastuzumab in HER2 positive breast cancer and impact on time to relapse(Oncology Institute of Vojvodina, Serbia, 2020) Dukić, Nikolina; Gojković, Zdenka; Vladičić-Mašić, Jelena; Mašić, Srđan; Lalović, Nenad; Popović, SlađanaOf all breast cancers 20-25% are HER2 positive. Overexpression of HER2 protein on the surface of the malignant cell leads to excessive cell proliferation through different signaling pathways. Trastuzumab is a human monoclonal antibody that binds to domain IV of HER2 receptor and blocks signaling pathway for proliferation. The result is an improved prognosis for HER 2 positive breast cancer patients, even when compared to patients with other types of breast cancers. Methods: The study presents 74 women patients with early HER2 positive breast cancer who were previously operated (either radicaly or using breast conserving surgery), and received adjuvant chemo- and radiotherapy. Fourty four patients received adjuvant trastuzumab for one year, and 30 patients did not (control group). Observed time to relapse of the disease was 60 months. Results: There was a significant difference in survival in favor of the group that received trastuzumab (p<0.001). Application of trastuzumab also delayed relapse of the disease by 51.7%. No significant difference was observed between estrogen receptor positive and estrogen receptor negative cancers., In the control group there was a significant difference in relapse free survival in favor of estrogen and progesteron receptor positive tumors (p<0.001). Conclusion: Survival of patients with a HER2 positive breast cancer whose prognosis was initially worse compared to HER2 negative patients, significantly improved after administration of trastuzumab.
- СтавкаConsumption of Antibiotics in Primary Care Setting before and during COVID-19 Pandemic in Republic of Srpska, Bosnia and Herzegovina(MDPI, 2022) Sokolović, Dragana; Drakul, Dragana; Joksimović, Bojan; Lalović, Nenad; Avram, Nada; Milić, Marija; Nogo-Živanović, Dajana; Mijović, BiljanaThe pandemic of COVID-19 has brought many changes in health care systems at all levels of health care. The increase in the number of cases of COVID-19 has led to overuse and misuse of antibiotics.The aim of this study was to compare the consumption of antibiotics for systemic use in outpatients in the Republic of Srpska (RS), before and during the first year of the COVID-19 pandemic, as well as the association between antibiotic consumption and the rate of incidence and mortality of COVID-19. The total consumption of the antibiotics for systemic use (J01) in outpatients in the Republic of Srpska during 2019 was 19.40 DDD/TID, with an increase to 30.80 DDD/TID in 2020.Significantly higher use of penicillin (10.58 11.01 DDD/TID in 2019 vs. 17.10 13.63 DDD/TID in 2020), cephalosporins (2.68 1.90 DDD/TID in 2019 vs. 5.93 2.77 DDD/TID in 2020) and macrolides (2.14 2.22 DDD/TID in 2019 vs. 3.40 3.44 DDD/TID in 2020) was observed during the pandemic period. It is necessary to improve the prescribing practice of antibiotics at the primary health care level, public awareness about rational use of antibiotics, as well as the current antibiotic stewardship programs and control their implementation.
- СтавкаFactors Associated with Abnormal Uterine Bleeding in Perimenopausal Women(IMR Press Limited, 2024) Ivanović, Radenko; Joksimović, Bojan; Čančar, Vladimir; Marić, Helena; Matović, Draženka; Lalović, Nenad; Pavlović, Radiša; Milosavljević, Miloš; Milosavljević, Jovana; Janković, SlobodanBackground: Abnormal uterine bleeding (AUB) is one of the most common health problems encountered in women of the perimenopausal age group. The aim of this study was to investigate the characteristics of functional AUB in perimenopausal women, and to identify predictors of the occurrence of functional AUB in perimenopausal women. Methods: This was a cross-sectional study that included 45 women with complaints of AUB admitted to the gynecology ward in the University Hospital in Foča, and 45 women without AUB who underwent a gynecological examination in the Primary Health Center in Foča, Bosnia and Herzegovina. We included women with AUB who had a normal ultrasound finding without obvious genital or cervical lesions, and who were not on hormonal therapy. The existence of AUB was determined on the basis of a clinical examination by a gynecologist and existing medical documentation. A logistic regression model was used to assess the possible relationship between the occurrence of the functional AUB and the risk factors for its occurrence. Results: The mean patient age was 48.38 ± 2.40 years. There was no significant difference in age, frequency of physical activity, or previous use of oral contraceptives between the two groups of patients divided by the presence of the functional AUB in perimenopause. The logistic regression model showed that age (p = 0.008), high values of body mass index (BMI) (p = 0.001), consumption of alcohol and cigarettes on a daily basis (p = 0.001), and hypertension (p = 0.046) represented significant risk factors associated with functional AUB in perimenopausal women. Conclusions: During routine exams of women approaching menopause, gynecologists should emphasize the harms of smoking and alcohol use, as well as the significance of non pharmacological and pharmacological methods for the treatment of obesity and hypertension
- СтавкаOur results in the treatment of tarsal dislocations(Serbian Medical Association, 2020) Kovačević, Maksim; Kovačević, Marijana; Marić, Sanja; Lalović, Nenad; Dostić, Milivoje; Saratlić, VjeranIntroduction/Objective Tarsal dislocations are rare injuries. Usually, they are caused by high-energy trauma. Depending on the type of dislocation, surgical treatment or closed reduction is used. In this study, 13 patients are presented with the aim to analyze the type of feet dislocations, their treatment, and outcome. Methods Tarsal dislocation cases treated in the University Hospital in Foča were analyzed during the period 2009–2016. All the cases were clinically and radiographically examined and monitored on control examinations at least three years. The mobility of joints was measured and pain existence was estimated by visual analogue scale. Results All 13 patients with tarsal dislocation were male. Four patients were treated surgically (two patients with tarsometatarsal and one with cuboid and navicular dislocation) and other patients had non-surgical treatment. In 10 patients, an excellent functional result has been achieved and in two patients with tarsometatarsal dislocation a good functional result. In one patient with cuboidal dislocation satisfactory functional result has been achieved. Conclusion Out of the 13 reviewed patients with tarsal dislocations, functional results were rated as excellent in 10 dislocations, good in two, and satisfactory in one. Diagnosis and treatment of foot dislocations are demanding, but a favorable functional outcome can be expected with an adequate treatment of these injuries.
- СтавкаParaovarian cyst as the cause of uterine prolapse(Institute of Oncology, Sremska Kamenica, 2021) Čančar, Vladimir; Ivanović, Radenko; Lalović, Nenad; Milinković, Biljana; Sladoje, DraganaParaovarian cysts originate from the mesothelium and are presumed to be remnants of Müllerian or Wolffian ducts. In majority of cases they are found to be 10-80 mm in diameter and do not cause any symptoms. Paraovarian cysts can be found unexpectedly during an operation or on ultrasound examination performed for other reasons. They are most freequently discovered on ultrasound examination. However, due to the proximity of the ovary for which cystic formations are not rare, the diagnosis of these lesions can be a challenge. They are mostly asymptomatic and only large lesions (≤20 cm in diameter) become symptomatic. Although these are mostly benign tumors, in rare cases they can become borderline or true malignancies. Most paraovarian cysts are found in the third and fourth decade of life. Paraovarian cyst complications include: compression of the surrounding structures of the pelvis minor and abdomen, pelvic pain, cyst torsion and rupture. Except for the already mensioned complications available literature has so far failed to show cases of uterine prolapse caused by an increase of intra-abdominal pressure due to the expansive growth of giant paraovarian cystic formation.
- СтавкаPublic Knowledge, Attitudes, and Practices towards Antibiotic Use and Antimicrobial Resistance in Eastern Region of Bosnia and Herzegovina in the COVID-19 Pandemic(MDPI, 2023) Drakul, Dragana; Joksimović, Bojan; Milić, Marija; Radanović, Milica; Dukić, Nikolina; Lalović, Nenad; Nischolson, Desmond; Mijović, Biljana; Sokolović, DraganaThe constant worsening of antimicrobial resistance (AMR) imposes the need for an urgent response. Use of antibiotics (AB), both due to irrational prescribing by doctors and irrational use by patients, is recognized as one of the leading causes of this problem. This study aimed to identify knowledge, attitudes, and practices about AB use and AMR within the general population, stratified by age, gender, and urban/rural areas during the COVID-19 pandemic. This questionnaire-based cross-sectional study was conducted in April 2022 among patients who visited three health centers in the eastern region of Bosnia and Herzegovina. A high frequency of AB use was observed during the COVID-19 pandemic (64.2% of respondents were treated with AB). Age and place of residence have not been shown to be factors associated with AB use practices that pose a risk for AMR. However, female gender ( = 0.063; p = 0.041), better knowledge ( = 0.226; p < 0.001), and positive attitudes ( = 0.170; p < 0.001) about use of AB and towards to AMR proved to be factors associated with better practice by respondents. Women, younger respondents, and respondents from urban areas showed better knowledge, attitudes, and behavior about the use of AB and AMR during the COVID-19 pandemic.
- СтавкаSymptomatic isolated thoracic splenosis 11 years after abdominal trauma – Case report(Serbian Medical Association, 2016) Pleša, Tanja; Ždrale, Slavko; Batinić-Škipina, Danijela; Kovačević, Miodrag; Jurišić, Vladimir; Lalović, Nenad; Petković, NenadIntroduction Thoracic splenosis is defined as the autotransplantation of splenic tissue into thorax. It occurs due to splenic rupture in association with a diaphragmatic tear on the left side after a traumatic event. It is a rare disease that most commonly remains undiscovered as it is usually asymptomatic. Case Outline We present a symptomatic case of thoracic splenosis in a 53-year-old smoker male patient with a medical history of abdominal surgery and splenectomy for a thoracoabdominal gunshot. Three years before the medical examination he was suffering from dyspnea, frequent coughing, left pleuritic chest pain and complained about faster fatigue. A chest radiograph obtained during a medical checkup showed a multinodular left pleura-based mass in the upper lobe. Established histopathological diagnosis after surgical removal of the nodule was splenosis. No evidence of malignancy was observed. Conclusion Splenosis should be considered as a differential diagnosis by the undertaken workup of left pulmonary nodules or masses in patients with a history of trauma.
- СтавкаThe Impact of Cytokines on Coagulation Profile in COVID-19 Patients: Controlled for Socio-Demographic, Clinical, and Laboratory Parameters(MDPI, 2024) Milentijević, Milica; Katanić, Nataša; Joksimović, Bojan; Pavlović, Aleksandar; Filimonović, Jelena; Anđelković, Milena; Bojović, Ksenija; Elek, Zlatan; Ristić, Siniša; Vasiljević, Miloš; Stevanović, Jasmina; Radomirović, Danica; Elez-Burnjaković, Nikolina; Lalović, Nenad; Kulić, Milan; Kulić, Jovan; Milić, MarijaSevere coagulation abnormalities are common in patients with COVID-19 infection. We aimed to investigate the relationship between pro-inflammatory cytokines and coagulation parameters concerning socio-demographic, clinical, and laboratory characteristics. Methods: Our study included patients hospitalized during the second wave of COVID-19 in the Republic of Serbia. We collected socio-demographic, clinical, and blood-sample data for all patients. Cytokine levels were measured using flow cytometry. Results: We analyzed data from 113 COVID-19 patients with an average age of 58.15 years, of whom 79 (69.9%) were male. Longer duration of COVID-19 symptoms before hospitalization (B = 69.672; p = 0.002) and use of meropenem (B = 1237.220; p = 0.014) were predictive of higher D-dimer values. Among cytokines, higher IL-5 values significantly predicted higher INR values (B = 0.152; p = 0.040) and longer prothrombin times (B = 0.412; p = 0.043), and higher IL-6 (B = 0.137; p = 0.003) predicted longer prothrombin times. Lower IL-17F concentrations at admission (B = 0.024; p = 0.050) were predictive of higher INR values, and lower IFN-γ values (B = −0.306; p = 0.017) were predictive of higher aPTT values. Conclusions: Our findings indicate a significant correlation between pro-inflammatory cytokines and coagulation-related parameters. Factors such as the patient’s level of education, gender, oxygen-therapy use, symptom duration before hospitalization, meropenem use, and serum concentrations of IL-5, IL-6, IL-17F, and IFN-γ were associated with worse coagulation-related parameters.