Медицински факултет [Научни радови] / Faculty of Medicine [Scientific papers]

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2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases
(BMJ, 2023) Gwinnutt, James M; Wieczorek, Maud; Balanescu, Andra; Bischoff-Ferrari, Heike A; Boonen, Annelies; Cavalli, Giulio; De Souza, Savia; De Thurah, Annette; Dorner, Thomas E; Moe, Rikke Helene; Putrik, Polina; Rodríguez-Carrio, Javier; Silva-Fernández, Lucía; Stamm, Tanja; Walker-Bone, Karen; Welling, Joep; Zlatković-Švenda, Mirjana I; Guillemin, Francis; Verstappen, Suzanne M M
Objectives: A European League Against Rheumatism taskforce was convened to review the literature and develop recommendations on lifestyle behaviours for rheumatic and musculoskeletal diseases (RMDs). Methods: Six lifestyle exposures (exercise, diet, weight, alcohol, smoking, work participation) and seven RMDs (osteoarthritis, rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis, systemic lupus erythematosus, systemic sclerosis, gout) were considered. The taskforce included health professionals in rheumatology, geriatricians, epidemiologists, public health experts, people with RMDs and exposure domain experts. Systematic reviews were conducted to gather available evidence, from which recommendations were developed. Results: Five overarching principles and 18 specific recommendations were defined based on available evidence. The overarching principles define the importance of a healthy lifestyle, how lifestyle modifications should be implemented, and their role in relation to medical treatments. Exercise recommendations highlight the safety and benefits of exercise on pain and disability, particularly among people with osteoarthritis and axial spondyloarthritis. The diet recommendations emphasise the importance of a healthy, balanced diet for people with RMDs. People with RMDs and health professionals should work together to achieve and maintain a healthy weight. Small amounts of alcohol are unlikely to negatively affect the outcomes of people with RMDs, although people with rheumatoid arthritis and gout may be at risk of flares after moderate alcohol consumption. Smokers should be supported to quit. Work participation may have benefits on RMD outcomes and should be discussed in consultations. Conclusions: These recommendations cover a range of lifestyle behaviours and can guide shared decision making between people with RMDs and health professionals when developing and monitoring treatment plans.
A cephalometric analysis of the cranial base and frontal part of the face in patients with mandibular prognathism
(Ministry of Defance, Serbia, 2014) Čutović, Tatjana; Jović, Nebojša; Stojanović, Ljiljana; Radojičić, Julija; Mladenović, Irena; Matijević, Stevo; Kozomara, Ružica
Bacground/Aim. The literature suggests different views on the correlation between the cranial base morphology and size and saggital intermaxillary relationships. The aim of this study was to investigate the cranial base morphology, including the frontal facial part in patients with mandibular prognathism, to clarify a certain ambiguities, in opposing viewspoints in the literature. Methods. Cephalometric radiographies of 60 patients were analyzed at the Dental Clinic of the Military Medical Academy, Belgrade, Serbia. All the patients were male, aged 18–35 years, with no previous orthodontic treatment. On the basis of dental and sceletal relations of jaws and teeth, the patients were divided into two groups: the group P (patients with mandibular prognathism) and the group E (the control group or eugnathic patients). A total of 15 cephalometric parametres related to the cranial base, frontal part of the face and sagittal intermaxillary relationships were measured and analyzed. Results. The results show that cranial base dimensions and the angle do not play a significant role in the development of mandibular prognathism. Interrelationship analysis indicated a statistically significant negative correlation between the cranial base angle (NSAr) and the angles of maxillary (SNA) and mandibular (SNB) prognathism, as well as a positive correlation between the angle of inclination of the ramus to the cranial base (GoArNS) and the angle of sagittal intermaxillary relationships (ANB). Sella turcica dimensions, its width and depth, as well as the nasal bone length were significantly increased in the patients with mandibular prognathism, while the other analyzed frontal part dimensions of the face were not changed by the malocclusion in comparison with the eugnathic patients. Conclusion. This study shows that the impact of the cranial base and the frontal part of the face on the development of profile in patients with mandibular prognathism is much smaller, but certainly more complex, so that morphogenetic tests of the maxillomandibular complex should be included in further assessment of this impact.
A Complex Relationship between Quality of Life, Anxiety, and Depression among General Population during Second Year of COVID-19 Pandemic: A Population-Based Study
(MDPI, 2024) Radulovic, Danijela; Masic, Srdjan; Stanisavljevic, Dejana; Bokonjic, Dejan; Radevic, Svetlana; Rajovic, Nina; Milić, Nikola V.; Simic Vukomanovic, Ivana; Mijovic, Biljana; Vukovic, Maja; Dubravac Tanaskovic, Milena; Jojic, Mirka; Vladicic Masic, Jelena; Spaic, Dragan; Milic, Natasa M.
The COVID-19 pandemic has had a significant impact on the global economy and public health, disrupting various aspects of daily life. Apart from its direct effects on physical health, it has also significantly affected the overall quality of life and mental health. This study employed a path analysis to explore the complex association among multiple factors associated with quality of life, anxiety, and depression in the general population of the Republic of Srpska during the pandemic’s second year. Method: A cross-sectional study was conducted on a nationally representative sample (n = 1382) of the general population (adults aged 20+) during the second year of the COVID-19 pandemic in the Republic of Srpska, Bosnia, and Herzegovina. Assessment tools included the DASS- Quality of Life Scale (QOLS), and Oslo Social Support Scale (OSSS-3). Sociodemographic factors and comorbidities were also assessed. Structural equation modeling was used to identify the direct and indirect links of various characteristics to quality of life, anxiety, and depression. Results: This study revealed a considerable prevalence of anxiety and depression symptoms (27.5% and 20.9%, respectively), with quality of life playing a significant mediating role. The constructed path model accounted for 33.1% of moderate to severe depression and 79.5% of anxiety. Negative coping was directly linked to anxiety and indirectly to depression via anxiety, while the absence of positive coping had both direct and indirect paths (through quality of life) on depression. Among variables that directly affected depression, anxiety had the highest effect. However, the bidirectional paths between anxiety and depression were also suggested by the model. Conclusions: Pandemic response strategies should be modified to effectively reduce the adverse effects on public mental health. Further research is necessary to assess the long-term effects of the pandemic on mental health and to analyze the contributing factors of anxiety and depression in the post-COVID period.
A comprehensive assessment of medical schools in Bosnia and Herzegovina
(Wiley, 2006) Šimunović, Vladimir J.; Sonntag, Hans-Gu¨nther; Hren, Darko; Dørup, Jens; Krivokuća, Zdenka; Bokonjić, Dejan; Verhaaren, Henry; Horsch, Axel; Mimica, Mladen; Vojniković, Benjamin; Selesković, Hajrija; Marz, Richard; Marušić, Ana; Marušić, Matko
OBJECTIVES To perform internal and external evaluations of all 5 medical schools in Bosnia and Herzegovina against international standards. METHODS We carried out a 2-stage survey study using the same 5-point Likert scale for internal and external evaluations of 5 medical schools in Bosnia and Herzegovina (Banja Luka, Foča ⁄East Sarajevo, Mostar, Sarajevo and Tuzla). Participants consisted of managerial staff, teaching staff and students of medical schools, and external expert assessors. Main outcome measures included scores on internal and external evaluation forms for 10 items concerning aspects of school curriculum and functioning: "School mission and objectives"; "Curriculum"; "Management"; "Staff"; "Students"; "Facilities and technology"; "Financial issues"; "International relationships"; "Internal quality assurance", and "Development plans". RESULTS During internal assessment, schools consistently either overrated their overall functioning (Foča ⁄ East Sarajevo, Mostar and Tuzla) or markedly overrated or underrated their performance on individual items on the survey (Banja Luka and Sarajevo). Scores for internal assessment differed from those for external assessment. These differences were not consistent, except for the sections "School mission and objectives", "Curriculum" and "Development plans", which were consistently overrated in the internal assessments. External assessments was more positive than internal assessments on "Students" and "Facilities and technology" in 3 of 5 schools. CONCLUSIONS This assessment exercise in 5 medical schools showed that constructive and structured evaluation of medical education is possible, even in complex and unfavourable conditions. Medical schools in Bosnia and Herzegovina have successfully formed a national consortium for formal collaboration in curriculum development and reform.
A Laser Synthesis Route to Boron-Doped Gold Nanoparticles Designed for X-Ray Radiotherapy and Boron Neutron Capture Therapy Assisted by CT Imaging
(Wiley, 2023) Scaramuzza, Stefano; de Faria, Clara M.G.; Coviello, Vito; Forrer, Daniel; Artiglia, Luca; Badocco, Denis; Pastore, Paolo; Ghigna, Paolo; Postuma, Ian; Cansolino, Laura; Ferrari, Cinzia; Bortolussi, Silva; Vago, Riccardo; Spinelli, Antonello E.; Bekić, Marina; Čolić, Miodrag; Amendola, Vincenzo
New multifunctional theranostic vectors allow the expansion of cancer therapeutic approaches toward scarcely investigated fields. One example is the combination of boron neutron capture therapy (BNCT) and X-ray radiotherapy (XRT) for treating normal and XRT-resistant hypoxic tumor regions and reduce recurrence. Of great relevance for BNCT is also the support of viable, rapid, safe, and reliable techniques for the localization and quantification of the radiosensitizers in the tissues. To address these challenges, polymer-coated Au-B nanoparticles (NPs) are obtained starting from a laser ablation in liquid process. Despite thermodynamic constraints, the two elements coexist by short-range boron segregation in the gold lattice, as demonstrated experimentally and explained with the support of density functional theory calculations. Thus, the Au-B NPs maintain a marked gold character such as biocompatibility, stability, and straightforward surface chemistry with thiolated compounds, desirable for the integration with agents capable of cell targeting and internalization. Overall, the Au-B NPs exhibit the appropriate features for the investigation of combined BNCT and XRT, supported by the localization and quantification with X-ray computed tomography imaging. Besides, the Au-B nanotechnology tool is achievable without renouncing to reproducibility, environmental sustainability, and cost affordability thanks to the laser-assisted synthetic pathway.
A nationwide assessment of the burden of healthcare‑associated infections and antimicrobial use among surgical patients: results from Serbian point prevalence survey, 2017
(Springer, 2021) Šuljagić, Vesna; Bajčetić, Milica; Mioljević, Vesna; Dragovac, Gorana; Mijović, Biljana; Janićijević, Ivana; Đorđević, Zorana; Krtinić, Gordana; Rakić, Violeta; Ćirković, Ivana; Nikolić, Vladimir; Marković‑Denić, Ljiljana
Background: As the only non-European Union (EU) country, Serbia participated in a second point prevalence survey of healthcare-associated infections (HAIs) and antimicrobial use (AMU) organized by the European Centre for Disease Prevention and Control (ECDC) in the EU countries. Here, we aimed to estimate the prevalence of HAI and AMU in patients who had recently undergone a surgery and to compare risk profile, HAI rates, and AMU among surgical patients and non-surgical patients. Methods: A national PPS was performed in 65 Serbian acute-care hospitals, in November 2017. In this paper, the data of 61 hospitals for adult acute-care were analyzed. To ensure the comparability of study design we used the Serbian translation of ECDC case definitions and ECDC PPS protocol. The trained infection control staff, led by a hospital coordinator, reviewed medical records to identify HAI active at the time of the survey and AMU. Only inpatients admitted to the ward before 8 a.m. on the day if the survey were included. Results: A total of 12,478 patients from 61 hospitals for adult acute-care were eligible for inclusion in this study. Significantly higher proportions of surgical patients were female, belonged to the 60-to-79 age group, and were less severely ill. Also, extrinsic factors (invasive devices, hospitalization at the ICU, and prior antibiotics therapy) were more frequent in surgical patients. Prevalence of HAIs was higher among surgical patients (261/3626; 7.2%) than among non-surgical patients (258/8852; 2.9%) (p < 0.0001). The highest prevalence of all HAIs was noted in patients who had kidney transplantation (4/11; 36.4%), while SSIs were the most prevalent among patients who had peripheral vascular bypass surgery (3/15; 20.0%). Non-surgical patients received treatment for community-acquired infections in significantly higher proportion (2664/8852; 64.3) (p < 0.001). Surgical prophylaxis for more than 1 day was applied in 71.4% of surgical patients. Conclusion: We have provided an insight into the burden of HAIs and AMU among Serbia acute-care hospitals, and highlighted several priority areas and targets for quality improvement
A Single-Center Experience on the Treatment Outcomes of Patients with COVID-19-Pleural Disorders: Lessons for the Future
(Academy of Medical Sciences in Bosnia and Herzegovina, 2023) Alihodzic-Pasalic, Alma; Pilav, Ilijaz; Maric, Veljko; Kadic, Kenan; Dapcevic, Meho; Hadzismailovic, Ademir; Pilav, Alen; Ademovic, Enisa; Custovic, Orhan
Background: Pleural disorders in novel coronavirus disease 2019 (COVID-19), responsible for the deaths of more than 6.7 million people worldwide, are relatively uncommon and underappreciated findings. The severity of the pleural disease in these patients correlates with the treatment outcome and overall prognosis. Objective: We aim to review our experience with treatment modalities and prognosis in 45 patients with COVID-19, who were treated at our Clinic between April 2020 and October 2021. Methods: We conducted a retrospective, single-center, cross-sectional study. Demographic data, the type of thoracosurgical intervention(s), and treatment outcome for 45 patients included in this study were recorded for every patient. We analyzed the type and number of treatment modalities according to the pleural disorder, and the outcome of the treatment. Results: Pneumothorax was the most common COVID-19-related pleural disorder, followed by the pleural effusion. Tube thoracostomy was the mainstay of treatment, performed in 84.4% of patients with unilateral pleural complications. In total, 20% of our patients were on mechanical ventilation, and all of them had a fatal outcome. We found statistical significance in comparison to the percentage of fatal outcomes between patients treated with and without mechanical ventilation (p=0.000). Conclusion: COVID-19-related pleural disorders are prognostic markers of disease progression. Mechanically ventilated patients who require tube thoracostomy have an unfavorable prognosis.
A systematic review of the development and application of home cage monitoring in laboratory mice and rats
(Springer, 2023) Kahnau, Pia; Mieske, Paul; Wilzopolski, Jenny; Kalliokoski, Otto; Mandillo, Silvia; Hölter, Sabine M.; Voikar, Vootele; Amfim, Adriana; Badurek, Sylvia; Bartelik, Aleksandra; Caruso, Angela; Čater, Maša; Ey, Elodie; Golin, Elisabetta; Jaap, Anne; Hrncic, Dragan; Kiryk, Anna; Lang, Benjamin; Loncarevic‑Vasiljkovic, Natasa; Meziane, Hamid; Radzevičienė, Aurelija; Rivalan, Marion; Scattoni, Maria Luisa; Torquet, Nicolas; Trifkovic, Julijana; Ulfhake, Brun; Thöne‑Reineke, Christa; Diederich, Kai; Lewejohann, Lars; Hohlbaum, Katharina
Background Traditionally, in biomedical animal research, laboratory rodents are individually examined in test apparatuses outside of their home cages at selected time points. However, the outcome of such tests can be influenced by various factors and valuable information may be missed when the animals are only monitored for short periods. These issues can be overcome by longitudinally monitoring mice and rats in their home cages. To shed light on the development of home cage monitoring (HCM) and the current state-of-the-art, a systematic review was carried out on 521 publications retrieved through PubMed and Web of Science. Results Both the absolute (~ × 26) and relative (~ × 7) number of HCM-related publications increased from 1974 to 2020. There was a clear bias towards males and individually housed animals, but during the past decade (2011–2020), an increasing number of studies used both sexes and group housing. In most studies, animals were kept for short (up to 4 weeks) time periods in the HCM systems; intermediate time periods (4–12 weeks) increased in frequency in the years between 2011 and 2020. Before the 2000s, HCM techniques were predominantly applied for less than 12 h, while 24-h measurements have been more frequent since the 2000s. The systematic review demonstrated that manual monitoring is decreasing in relation to automatic techniques but still relevant. Until (and including) the 1990s, most techniques were applied manually but have been progressively replaced by automation since the 2000s. Independent of the year of publication, the main behavioral parameters measured were locomotor activity, feeding, and social behaviors; the main physiological parameters were heart rate and electrocardiography. External appearance-related parameters were rarely examined in the home cages. Due to technological progress and application of artificial intelligence, more refined and detailed behavioral parameters have been investigated in the home cage more recently. Conclusions Over the period covered in this study, techniques for HCM of mice and rats have improved considerably. This development is ongoing and further progress as well as validation of HCM systems will extend the applications to allow for continuous, longitudinal, non-invasive monitoring of an increasing range of parameters in grouphoused small rodents in their home cages.
Adjuvant 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, Slađana
Of 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.
Adrenal Abscesses: A Systematic Review of the Literature
(MDPI, 2023) Gligorijevic, Nikola; Kaljevic, Marija; Radovanovic, Natasa; Jovanovic, Filip; Joksimovic, Bojan; Singh, Sandra; Dumic, Igor
Objective: To summarize the existing knowledge about adrenal gland abscesses, including etiology, clinical presentation, common laboratory and imaging findings, management and overall morbidity and mortality. Design: Systematic literature review. Methods: We performed a search in the PubMed database using search terms: ‘abscess and adrenal glands’, ‘adrenalitis’, ‘infection and adrenal gland’, ‘adrenal abscess’, ‘adrenal infection’ and ‘infectious adrenalitis’. Articles from 2017 to 2022 were included. We found total of 116 articles, and after applying exclusion criteria, data from 73 articles was included in the final statistical analysis. Results: Of 84 patients included in this review, 68 were male (81%), with a mean age of 55 years (range: 29 to 85 years). Weight loss was the most frequent symptom reported in 58.3% patients, followed by fever in 49%. Mean duration of symptoms was 4.5 months. The most common laboratory findings were low cortisol (51.9%), elevated ACTH (43.2%), hyponatremia (88.2%) and anemia (83.3%). Adrenal cultures were positive in 86.4% cases, with Histoplasma capsulatum (37.3%) being the leading causative agent. Blood cultures were positive in 30% of patients. The majority of the adrenal infections occurred through secondary dissemination from other infectious foci and abscesses were more commonly bilateral (70%). A total of 46.4% of patients developed long-term adrenal insufficiency requiring treatment. Abscess drainage was performed in 7 patients (8.3%) and adrenalectomy was performed in 18 (21.4%) patients. The survival rate was 92.9%. Multivariate analysis showed that the only independent risk factor for mortality was thrombocytopenia (p = 0.048). Conclusion: Our review shows that adrenal abscesses are usually caused by fungal pathogens, and among these, Histoplasma capsulatum is the most common. The adrenal glands are usually involved in a bilateral fashion and become infected through dissemination from other primary sources of infection. Long-term adrenal insufficiency develops in 46% of patients, which is more common than what is observed in non-infectious etiology of adrenal gland disorders. Mortality is about 7%, and the presence of thrombocytopenia is associated with worse prognosis. Further prospective studies are needed to better characterize optimal testing and treatment duration in patients with this relatively rare but challenging disorder.
Age-specific causes of upper gastrointestinal bleeding in children
(Baishideng Publishing Group, 2023) Kocic, Marija; Rasic, Petar; Marusic, Vuk; Prokic, Dragan; Savic, Djordje; Milickovic, Maja; Kitic, Ivana; Mijovic, Tanja; Sarajlija, Adrijan
The etiology of upper gastrointestinal bleeding (UGIB) varies by age, from newborns to adolescents, with some of the causes overlapping between age groups. While particular causes such as vitamin K deficiency and cow’s milk protein allergy are limited to specific age groups, occurring only in neonates and infants, others such as erosive esophagitis and gastritis may be identified at all ages. Furthermore, the incidence of UGIB is variable throughout the world and in different hospital settings. In North America and Europe, most UGIBs are nonvariceal, associated with erosive esophagitis, gastritis, and gastric and duodenal ulcers. In recent years, the most common causes in some Middle Eastern and Far Eastern countries are becoming similar to those in Western countries. However, variceal bleeding still predominates in certain parts of the world, especially in South Asia. The most severe hemorrhage arises from variceal bleeding, peptic ulceration, and disseminated intravascular coagulation. Hematemesis is a credible indicator of a UGI source of bleeding in the majority of patients. Being familiar with the most likely UGIB causes in specific ages and geographic areas is especially important for adequate orientation in clinical settings, the use of proper diagnostic tests, and rapid initiation of the therapy. The fundamental approach to the management of UGIB includes an immediate assessment of severity, detecting possible causes, and providing hemodynamic stability, followed by early endoscopy. Unusual UGIB causes must always be considered when establishing a diagnosis in the pediatric population because some of them are unique to children. Endoscopic techniques are of significant diagnostic value, and combined with medicaments, may be used for the management of acute bleeding. Finally, surgical treatment is reserved for the most severe bleeding.
ALCOHOLIC AND POSTOPERATIVE DELIRIUM: A CASE-CONTROL STUDY
(Medical Publishing House Zagreb, Croatia, 2015) Novakovic, Milan; Đukić Dejanović, Slavica; Marić-Burmazević; Dakić, Zoran; Dimitrijević, Ivan
Background: Delirium is an urgent condition in psychiatry and it occurs after long-lasting alcohol abuse, in surgical procedures and other organic mental syndromes with deprivation of interpersonal and social stimulations. The aim was to evaluate of sociodemographical and psychopathological differences in delirium patients with alcoholand surgical genesis, studied in period from January 1st 2003 to December 31st 2012 in Bosnia and Herzegovina (B&H). Subjects and methods: Subjects were divided into two groups: alcoholics (N=75) and surgical patients (N=75) and multicentric, prospective study was performed in B&H. The following instruments have been used: list of general data (according to MCD-10 criteria), Eysenck Personality Questionnaire (EPQ), Becks test of anxiety (BAI), Hamilton Depressive Rating Scale (HDRS) and Mini Mental State Examination (MMSE). Descriptive and analytical statistical processing of patients has been performed (alpha level: 0.001). Results: Patients from alcohol group showed, with statistical significance p=0.001, the following: unemployment (OR=0.657, CI 0.540-670), ruined marriage (OR=0.570, CI 0.650-710), alcohol abuse (OR=0.179, CI 0.860-0.990), on represented expressed psychoticism, (OR=0.635, CI 0.550-0.715) in EPQ test, HDRS total was more frequent (OR=0.925, CI 0.870-1.120) and on MMSE test, total score was more frequent (OR=0.560, CI 0.570-810). Postoperative patients were older p=0.001 (OR= 1.120, CI 1.082- 1.159) with acutestress: (OR=0.735, CI 0.650-0.910) and showed neuroticism (OR=-0.660, CI 0.575-0.715). Discriminative function confirms the differences between alcohol and surgical groups of delirium patients: Canonical Fcn: r=0.771; Wilkin’s lambda (􀁏nj)=0.773 Student's test=57.551 and significance p=0.001; OR=0.760, CI 0.550-0.870. Conclusion: Delirium lasts longer in alcohol group with higher disalienation, depression of cognitive functions with organic lesions of cerebral functions. In surgical patients, delirium is the consequence of older age, acute stress, multi-morbidity, with neuroticism, vegetative disorders (HDRS) and temporary lesion on MMSE test. Delirium state in both groups requires intensive care and multidisciplinary work.
Anatomical and MRI relations of the cerebral aqueduct to the adjacent parts of the brain and calvaria
(Serbian Medical Association, 2017) Stanković, Gordana; Vitošević, Biljana; Bexheti, Dorentina; Davidović, Kristina; Dožić, Aleksandra; Zekavica, Ana; Ćurčić, Branislava; Vitošević, Zdravko; Milisavljević, Milan
Introducton/Objective Insufficiency of relevant anatomic data and great neurological and neurosurgical significance were the reasons for this study with scientific and practical implications. The purpose was to determine, at the transverse in situ section of the head, the position and relations of the sylvian aqueduct of the mesencephalon by measuring its distances from particular brain and calvaria structures. Also, the aim was to determine the same distances according to axial sections by using MRI. Methods The material consisted of twenty autopsy human heads. The section of the head was made at the level of the tentorial hiatus and the midbrain. After that, we measured the distances between the cerebral aqueduct and a) posterior border of the optic chiasm, b) upper border of the dorsum sellae, c) terminal bifurcation of the basilar artery, d) beginning of the straight sinus, e) internal occipital protuberance, f) tentorial edge (lateral from the aqueduct), and g) internal surface of the calvaria (lateral to the aqueduct). We determined the same distances by the MRI system. The measurements were made in 37 subjects. Results The numerical data obtained by this study will be of benefit to neurosurgeons in choosing a surgical approach to the contents of the incisural space, and to neurologists for the exact localization of the lesion and interpretation of certain signs and symptoms. Conclusion The results of a detailed examination of the sylvian aqueduct position and relations have shown that the use of MRI is the morphometric method of choice, because it is more precise for all the parameters monitored than in situ measurements.
ANEMIA OF INFLAMMATION IN PATIENTS WITH COLORECTAL CANCER: CORRELATION WITH INTERLEUKIN-1, INTERLEUKIN-33 AND GALECTIN-1
(2022) Jocic, Miodrag; Arsenijevic, Nebojsa; Gajovic, Nevena; Jurisevic, Milena; Jovanovic, lvan; Jovanovic, Milan; Zdravkovic, Natasa; Maric, Veljko; Jovanovic, Marina
Background: Patients with colorectal cancer (CRC) have anemia often present as a consequence of chronic bleeding from tumor. The exact role of lL-33, Galectin-l and IL-l in the pathological genesis of anemia in colorectal cancer patients has not been elucidated yet. The main goal of this research was to analyze Gal-l, IL-l and lL-33 systemic values in anemic and non-anemic CRC patients. Methods: Concentrations of IL-33, Galectin-1 and IL-1 have been studied in blood samples of 55 CRC patients (27 without anemia and 28 with anemia). Results: CRC patients with anemia had more severe and local advanced disease compared to CRC non-anemic patients. Anemia positively correlated with higher nuclear grade, lymph and blood vessel invasion, as well as with higher TNM stage, detectable metastatic lesions in lung and liver and peritoneal carcinomatosis. Significantly higher IL-33, Gal-1 and IL-1 concentration have been found in sera of patients with CRC and detected anemia. CRC patients mostly had microcytic anemia, while ferritin values were in normal range. Analysis revealed positive mutual correlation between serum values of galectin-1, IL-1 and IL-33 in CRC patients. Level of hemoglobin negatively correlated with serum IL-33, Gal-1 and IL-1. We have analyzed the Receiver Operating Characteristic (ROC) curves of serum IL-33, Gal-1 and IL-1 showed that these cytokines can be treated as additional markers for anemia of inflammation in CRC patients. Conclusions: Predomination of Galectin-1, IL-1 and IL-33 in anemic CRC patients implicates on their potential role in anemia genesis and further development.
Anterior and middle superior alveolar block is efficient for maxillary premolar teeth extractions regardless of the injection system or anesthetic with adrenaline used
(Serbian Medical Association, 2016) Tomić, Slavoljub; Simić, Ivana; Stanojević, Mihael; Janković, Svetlana; Todorović, Ljubomir
Introduction The anterior and middle superior alveolar nerve block was claimed to be unpredictably efficient for clinical application. Objective The aim of this report was to establish the efficacy of the anterior and middle superior alveolar nerve block, applied with a computer-controlled injection system or a conventional syringe, for upper premolars extraction. Methods Sixty healthy adults were divided into two groups regarding the device used as follows: the first group was injected by a computer-controlled injection system, and the second group by a conventional syringe. Pain ratings were obtained via a visual analog scale (VAS) and a verbal rating scale (VRS). Results Anterior and middle superior alveolar injection enabled a painless extraction in all patients, regardless of the local anesthetic or injection system used. It was slightly less painful when administered by a computer-controlled injection system, but insignificantly when evaluated by VRS. Conclusion The anterior and middle superior alveolar nerve block may be recommended if maxillary permanent premolars have to be extracted
Anti-inflammatory effect of amalgam on periapical lesion cells in culture
(Ministry of Defance, Serbia, 2021) Eraković, Mile; Duka, Miloš; Bekić, Marina; Milanović, Marijana; Tomić, Sergej; Vučević, Dragana; Čolić, Miodrag
Background/Aim. Amalgam h as b een u sed f or y ears in dentistry, but the controversy on its adverse effects, both on local oral/dental tissues and systemic health, still exists. When used for retrograde filling in apical surgery, amalgam comes in close contact with the periapical tissue, and it is sometimes responsible for the induction of periapical lesion (PL) or its exacerbation. Therefore, the aim of the study was to examine the effect of amalgam on cytotoxicity and production of pro-inflammatory cytokine by cells isolated from PL. Methods. Conditioned medium from freshly prepared amalgam (ACM) was performed according to the ISO 10993-12 by incubating the alloy in RPMI medium (0.2 g/mL) for 3 days at 37°C. Cells were isolated from 20 human PLs after apicoectomy by collagenase/DNA-ase digestion and cultured with different dilutions of ACM. Cytotoxicity was determined by MTT assay (n = 7 cultures) and apoptosis/necrosis assays (n = 8 cultures), whereas cytokine production was measured by a Flow Cytomix Microbeads Assay (n = 8 cultures). Results. Undiluted (100%) and 75% ACM was cytotoxic due to induction of apoptosis of PL cells. Non-cytotoxic concentrations of ACM (50% and 25%) inhibited the production of pro-inflammatory cytokines (TNF-α, IL-1β, IL-6, and IL-8), concentrationdependently. Conclusion. For t he f irst t ime, o ur results showed an unexpected anti-inflammatory property of amalgam on PL cells, which could be beneficial for PL healing after apicoectomy
Anti-PD-1 therapy activates tumoricidic properties of NKT cells and contributes to the overall deceleration of tumor progression in a model of murine mammary carcinoma
(University of Defense, Ministry of Defence of the Republic of Serbia, Belgrade, Serbia, 2022) Jovanović, Marina; Gajović, Nevena; Jurišević, Milena; Sekulić, Sofija; Arsenijević, Nebojša; Jocić, Midrag; Jovanović, Milan; Lukić, Ružica; Jovanović, Ivan; Radovanović, Dragče
Background/Aim. Immune checkpoint therapy is a well-established therapeutic approach in the treatment of malig-nant diseases and is thought to be mostly based on facilitat-ing the adaptive immune response. However, the cells of the innate immune response, such as natural killer T (NKT) cells, might also be important for a successful anti-programmed cell death protein-1 (anti-PD-1) therapy, as they initiate the antitumor immune response. The aim of this study was to investigate the influence of anti-PD-1 therapy on the immune response against tumors. Methods. For tumor induction, 4T1 cells synergic to BALB/c back-ground were used, after which mice underwent anti-PD-1 treatment. After the mice were sacrificed, NKT cells, den-dritic cells (DCs), and macrophages derived from spleen and primary tumor tissue were analyzed using flow cytome-try. Results. Anti-PD-1 therapy enhanced the expression of activating molecules CD69, NKp46, and NKG2D in NKT cells of the tumor and spleen. This therapy activated NKT cells directly and indirectly via DCs. Activated NKT cells acquired tumoricidic properties directly, by secreting perfor-in, and indirectly by stimulating M1 macrophages polariza-tion. Conclusion. Anti-PD-1 therapy activates changes in DCs and macrophages of primary tumor tissue towards protumoricidic activity. Since anti-PD-1 therapy induces significant changes in NKT cells, DCs, and macrophages, the efficacy of the overall antitumor response is increased and has significantly decelerated tumor growth.
Antibiotic consumption and antimicrobial resistance in the SARS-CoV-2 pandemic: A single-center experience
(Frontiers Media SA, 2023) Sokolović, Dragana; Drakul, Dragana; Vujić-Aleksić, Vesna; Joksimović, Bojan; Marić, Siniša; Nežić, Lana
Introduction: Antimicrobial resistance and the rapid spread of multiresistant bacteria represent one of the main public health problem in limited resources countries. This issue is significantly worsening since the COVID-19 pandemic due to the unreasonably increased antibiotics prescription to patients with confirmed SARS-CoV-2 infection. The aim of this study was to examine whether COVID-19 pandemic (2020, 2021) was associated with increased antibiotic consumption in inpatient and outpatient settings in the middle size urban region (Republic of Srpska/Bosnia and Herzegovina) in comparison to period before the pandemic (2019). Additionally, we aimed to determine antimicrobial resistance and the presence of multiresistant bacteria in the regional hospital (“Saint Apostol Luka” Hospital Doboj) in 2021. Methodology: The consumption of antibiotics in inpatient was calculated as Defined Daily Dose per one hundred of patient-days. The consumption of antibiotics in outpatient was calculated as Defined Daily Dose per thousand inhabitants per day. Resistance of bacteria to antibiotics is expressed as a rates and density for each observed antibiotic. The rate of resistance was calculated as a percentage in relation to the total number of isolates of individual bacteria. The density of resistance of isolated bacteria against a specific antibiotic was expressed as the number of resistant pathogens/1000 patient days. Results: Antibiotic consumption in hospital setting registered during 2019, 2020 and 2021 was as follows: carbapenems (meropenem: 0.28; 1.91; 2.33 DDD/100 patient-days, respectively), glycopeptides (vancomycin: 0.14; 1.09, 1.54 DDD/100 patient-days, respectively), cephalosporins (ceftriaxone: 6.69; 14.7; 14.0 DDD/100 patient-days, respectively) and polymyxins (colistin: 0.04; 0.25; 0.35 DDD/100 bed-days, respectively). Consumption of azithromycin increased drastically in 2020, and dropped significantly in 2021 (0.48; 5.61; 0.93 DDD/100 patientdays). In outpatient setting, an increase in the consumption of oral forms of azithromycin, levofloxacin and cefixime, as well as parenteral forms of amoxicillinclavulanic acid, ciprofloxacin and ceftriaxone, was recorded. In 2021, antimicrobial resistance to reserve antibiotics in hospital setting was as follows: Acinetobacter baumanii to meropenem 66.0%, Klebsiella spp to cefotaxime 67.14%, Pseudomonas to meropenem 25.7%. Conclusion: Recent COVID-19 pandemic was associated with increased antibiotic consumption in inpatient and outpatient settings, with characteristic change of pattern of azithromycin consumption. Also, high levels of antimicrobial resistance to reserve antibiotics were registered in hospital setting with low prevalence of identified pathogen-directed antimicrobial prescription. Strategies toward combat antimicrobial resistance in the Doboj region are urgently needed.
Antidotal effect of combinations obidoxime/HI-6 and memantine in mice poisoned with soman, dichlorvos or heptenophos
(Ministry of Defance, Serbia, 2011) Antonijević, Biljana; Stojiljković, Miloš P.; Bokonjić, Dubravko; Vučinić, Slavica
In acute organophosphate poisoning the issue of special concern is the appearance of muscle fasciculations and convulsions that cannot be adequately antagonised by the use of atropine and oxime therapy. The aim of this study was to examine atidotal effect of obidoxime or HI-6 combinations with memantine in mice poisoned with soman, dichlorvos or heptenophos. Methods. Male Albino mice were pretreated intravenously (iv) with increasing doses of oximes and/or memantine (10 mg/kg) at various times before poisoning with 1.3 LD-50 of soman, dichlorvos or heptenophos, in order to determine the median effective dose and the efficacy half-time. In a separate experiment, cerebral extravasation of Evans blue dye (40 mg/kg iv) was examined after application of memantine (10 mg/kg iv), midazolam (2.5 mg/kg intraperitonealy – ip) and ketamine (20 mg/kg ip) 5 minutes before soman (1 LD-50 subcutaneously – sc). Results. Coadministration of memantine induced a significant decrease in median effective dose in null time of both HI-6 (7.96 vs 1.79 moL/kg in soman poisoning) and obidoxime (16.80 vs 2.75 moL/kg in dichlorvos poisoning; 21.56 vs 6.63 moL/kg in heptenophos poisoning). Memantine and midazolam succeded to counteract the soman-induced proconvulsive activity. Conclusion. Memantine potentiated the antidotal effect of HI-6 against a lethal dose of soman, as well as the ability of obidoxime to antagonize the toxic effects of dichlorvos and heptenophos probably partly due to its anticonvulsive properties
Antimicrobial properties of viscose yarns ring-spun with integrated amino-functionalized nanocellulose
(Springer, 2021) Kokol, Vanja; Vivod, Vera; Peršin, Zdenka; Čolić, Miodrag; Kolar, Matjaž
Bio-based, renewable and biodegradable products with multifunctional properties are also becoming basic trends in the textile sector. In this frame, cellulose nanofibrils (CNFs) have been surface modified with hexamethylenediamine/HMDA and used as an antimicrobial additive to a ring-spun viscose yarn. The CNF-HMDA suspension was first characterized in relation to its skin irritation potential, antimicrobial properties, and technical performance (dispersability and suspensability in different media) to optimize its sprayability on a viscose fiber sliver with the lowest sticking, thus to enable its spinning without flowing and tearing problems. The impact of CNF-HMDA content has been examined on the yarn‘s fineness, tensile strength, surface chemistry, wettability and antimicrobial properties. The yarn‘s antimicrobial properties were increasing with the content of CNF-HMDA, given a 99% reduction for S. aureus and C. albicans (log 1.6–2.1) in up to 3 h of exposure at minimum 33 mg/g, and for E. coli (log 0.69–2.95) at 100 mg/g of its addition, yielding 45–21% of bactericidal efficacy. Such an effect is related to homogeneously distributed CNF-HMDA when sprayed from a fast-evaporated bi-polar medium and using small (0.4 mm) nozzle opennings, thus giving a high positive charge (0.663 mmol/g) without affecting the yarn‘s tenacity and fineness, but improving its wettability. However, a non-ionic surfactant being used in the durability testing of functionalized yarn to 10-washing cycles, adheres onto it hydrophobically via the methylene chain of the HMDA, thus blocking its amino groups, and, as such, decreasing its antibacterial efficiency, which was slightly affected in the case when the washing was carried out without using it.

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