Прегледај по Аутор "Marić, Radmil"

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    Differences in Risk Factors and Prevalence of Vascular Calcification between Pre-Dialysis and Hemodialysis Balkan Nephropathy Patients
    (MDPI, 2018) Petković, Nenad; Ristić, Siniša; Marinković, Jelena; Marić, Radmil; Kovačević, Marijana; Djukanović, Ljubica
    Aims: The aim of this study was to compare the risk factors and prevalence of vascular calcification (VC) in pre-dialysis and hemodialysis (HD) patients with Balkan endemic nephropathy (BEN) or other kidney diseases (non-BEN). Materials and Methods: The study involved 115 patients, 32 pre-dialysis and 83 HD patients, separated into groups of BEN and non-BEN patients. In addition to interviews, objective examinations and laboratory analyses, VC was assessed using Adragao score. Results: Patients with BEN were significantly older in both groups, while pre-dialysis BEN patients had significantly lower systolic blood pressure, serum cholesterol and phosphorus levels, but higher urinary excretion of phosphorus than non-BEN patients. These differences were lost in HD groups. In pre-dialysis patients, prevalence of VC was lower in BEN than in non-BEN group and mean VC score differed significantly between them (2.8 (1.7) vs. 4.6 (1.8); p = 0.009). No significant difference in VC score was found between BEN and non-BEN patients on HD. Multivariate analysis showed that in pre-dialysis patients VC score >4 was associated with lower iPTH and higher serum cholesterol level, but in the HD group with higher serum triglyceride level and longer HD vintage. Conclusions: Lower prevalence of risk factors for VC in the BEN than non-BEN patients was found in pre-dialysis but not in HD group and this was reflected in the prevalence and severity of VC in the groups. Prevalence of VC and mean VC score were significantly lower in pre-dialysis BEN than in non-BEN patients but not for those on HD.
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    Prevalence and risk factors of vascular calcification in pre-dialysis patients with Balkan endemic nephropathy
    (Serbian Medical Association, 2016) Petković, Nenad; Marić, Radmil; Gajanin, Radoslav; Batinić, Danijela; Ćuk, Mirjana; Ristić, Siniša; Djukanović, Ljubica
    Introduction Vascular calcifications (VC) are common in patients with chronic kidney disease and present one of manifestations of mineral and bone disorders in these patients. Objective The aim of this pilot study was to examine the prevalence and risk factors of VC in pre-dialysis patients with Balkan endemic nephropathy (BEN) and other kidney diseases. Methods The study involved 32 pre-dialysis patients, 15 with BEN and 17 with other kidney diseases. All the patients underwent an interview, objective examination, routine laboratory analyses and measurement of serum concentration of intact parathyroid hormone (iPTH), 25-hydroxyvitamin D3 [25(OH)D3] and osteopontin. VCs in iliac, femoral, radial, and digital arteries were evaluated and Adragao VC score was calculated. The samples of radial artery were collected during the first creation of an arteriovenous fistula, and expression of osteocalcin, bone morphogenic protein-2 osteopontin, and matrix Gla-protein in arterial wall were examined. Results Patients with BEN were significantly older (71.1 ± 6.1 vs. 54.7 ± 11.1 years), but they had significantly lower systolic and mean blood pressure (95.7 ± 13.2 mmHg vs. 104.3 ± 7.4 mmHg) and lower serum concentration of phosphorus (1.32 ± 0.36 mmol/l vs. 1.65 ± 0.35 mmol/l) and cholesterol (4.3 ± 1.1 mmol/l vs. 5.2 ± 0.8 mmol/l) than patients with other kidney diseases. Mean VC score was significantly lower in patients with BEN than in those with other kidney diseases (2.8 ± 1.7 vs. 4.6 ± 1.8; p = 0.009), but expression of four examined proteins in arterial wall differed insignificantly between the two groups. VC score correlated significantly with serum concentrations of cholesterol, triglycerides (positively), and iPTH (negatively). Conclusion Pre-dialysis BEN patients had a significantly lower mean score of VC than patients with other kidney diseases
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    Primary breast angiosarcoma in postmenopausal women with a picture like Kasabach-Merritt syndrome – A case report
    (Ministry of Defance, Serbia, 2021) Ćuk, Mirjana; Gajanin, Radoslav; Marić, Radmil; Marić, Veljko; Todorović, Svjetlana; Vasić Milanović, Milena
    Introduction. Primary angiosarcoma of the breast (PAB) is a very rare tumor and accounts for 0.04% of all breast malignant tumors and most commonly occurs in young women. Kasabach-Merritt syndrome (KMS) is described as consumption coagulopathy with thrombocytopenia, and without adequate therapy almost certainly leads to a very fast lethal outcome. The literature contains only a few cases of PAB associated with thrombocytopenia or with KMS and there are no clear defined protocols for the treatment of these patients, which requires the presentation of as many cases as possible. Case report. We presented a rare case of 60-year-old postmenopausal woman with metastatic PAB grade III associated with a picture like KMS (thrombocytopenia and anemia without the coagulation factor disorder with massive bleeding in the tumor). Mastectomy was performed without the ex-tirpation of the axillary region. After the surgery, im-provement with anemia and thrombocytopenia was no-ticed. One month after the surgery, supportive and symptomatic therapy was administered, as well as bish-osphonate therapy, but with temporary improvement. Deplasmated erythrocytes and methylprednisolone were added during the another hospital stay, but prominent symptoms of general weakness along with the progres-sion od thrombocytopenia were noted. Fibrinogen and coagulation factors were within reference values all the time. The patient died four months after the surgery. Conclusion. PAB in postmenopausal women is a very rare tumor, and may be associated with anemia and thrombocytopenia without other laboratory parameters for KMS. Anemia and thrombocytopenia are refractory to standard treatment protocols, and also significantly reduces the quality of life of these patients