Vol 47, No 1(2019)
Published: 01.01.2019.
Authors in this issue:
Aleksandra Ilić, Dejan Denović, Dragana Stamatović, Mirjana Čukalović, Mirjana Čukalović, Predrag Živković, Ramil Marić, Snežana Filipović-Danić, Tatjana Novaković, Vekoslav Mitrović, Zorica Vujnović Živković, A. Pavlović, A. Sekulić, A. Stojanov, Aleksandra Ilić , B. Radović, B.S. Knežević, F. Juković, J. Jovanović , J. Milošević, J. Stojanov, Jadranka Mitić , Jelena Krdzić , Jovan Živković , L. Brajkovic, Lj. Kulić, M. Galjak, M. Mirković, M.N. Petrović, N. Videnović, Novica Petrović , O. Marinković, Radica Ristić , S. Đurić, S. Matejić, S. Nikolic, S. Trpković, Snežana Marković Jovanović , V. Krstović Spremo, Z.I. Gajović,
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prof. dr Bojana Kisić
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Volume 51, Issue 1, 2022
Volume 50, Issue 3, 2021
01.01.2019.
Original scientific paper
CLINICAL-MORPHOLOGICAL CHARACTERISTICS OF PATHOLOGICAL CHANGES IN THE PROSTATE
The most significant prostate diseases (PD) are benign prostatic hyperplasia (BPH), prostatic intraepithelial neoplasia
(PIN) and prostate cancer (PC). Generally, all PD are rare before the age of 50 with growing number of patients, primarily
with BHP, with each next decade, but about decade later the highest number of PIN and PC began to report. The aim of this
paper is to examine some of clinical, biochemical and histopathological characteristics of BPH, PIN and PC. Our sample
consisted of 169 men. Statisticaly the most common PD was BPH-77.5%, and the rarest PIN-8.3% (p<0.001). The average age of patients was 70.6±7.5 years (51-89) with no significant differences between diagnosis (p=0.415). PIN and PC are more often found in people from urban areas (p=0.004). In the central prostate area BPH is significantly higher in 88.5% (p<0.001). Peripheral parts are significantly more common places of PIN and PC (p<0.001). Median serum PSA values is statistically highest in PC-87.2 ng/ml (12.7-372.5), (p<0,001), especially those with predominantly peripheral parts localization. Gleason score is an important prognostic factor, with average value at PC is 7.32±1.4 (5-10), with a significantly higher values for diffuse PC. BPH is the most common, and PIN rarest PD. All diseases have occurred in people older than 50 years. Usually, BPH is in central and PIN and PC in peripheral prostate parts. PSA values were highest at PC, which is a prove of its importance in malignancy early detection.
Aleksandra Ilić, Dejan Denović
01.01.2019.
Original scientific paper
SERUM VITAMIN D ANALYSIS IN ACUTE VIRAL BRONCHIOLITIS
Bronchiolitis is an acute viral disease of lower respitatory pathways in children under 2 years of age. It is manifested by coughing, whistling and refusing food intake. The most common cause of bronchiolitis is a respiratory syncytial virus. Vitamin D is a steroid hormone which is synthesized in the skin after sun exposure or food intake. With discovery of Vitamin D receptors and hydroxylated enzymes in immune cells, a potential role for Vitamin D in maintaining immune homeostasis was seen. It has been established that Vitamin D induces a change of the antimicrobial polypeptide, cathelicidin, which has both antibacterial and antiviral roles.
Zorica Vujnović Živković, Snežana Marković Jovanović, Jovan Živković, Mirjana Čukalović, Mirjana Čukalović, Tatjana Novaković, Dragana Stamatović, Jelena Krdzić, Jadranka Mitić, Radica Ristić, Aleksandra Ilić, Predrag Živković
01.01.2019.
Original scientific paper
EXTRACRANIAL CAROTID ATHEROSCLEROSIS IN GENESIS INFARCTION BRAIN IN THE BORDER ZONES SUPRATENTORIAL LOCALIZATION
The emergence of brain infarction depends to a great extent on the status of collateral blood circulation and is associated with hemodynamic instability. This kind of brain infarction is usually found in border vascular zones. Infarction of borderline fields arises between vascular territories ACA and ACM or between ACM and ACP, deep paraventricular infarcts in internal border zones, wound or triangular cortical infarcts, as well as major infarctions involving the entire irrigated territory of ACM.
Vekoslav Mitrović, Ramil Marić, Snežana Filipović-Danić, Novica Petrović
01.01.2019.
Professional paper
OXIDATIVE STRES PARAMETERS IN PATIENTS WITH MENIERE DISEASE
Introduction: The role of oxidative stres in patients with Meniere disease (MD), is still unresearched.
The aim: The aim was to compare serum levels of total and direct bilirubin, albumins, uric acid and creatinine as antioxidative status parameters in patients with MD with healthy controls, and patients with multiple sclerosis (MS).
Methods: We divided patients in three groups - 85 MD patients, 75 healthy controls (HC) and 72 MS patients. Patients with
MD were divided into groups according to sex, age at the time of the disease onset, and number of attacs per year. Severity
of clinical presentation during the attack was assessed by Vertigo Symptom Scale.
Results: The serum levels of all parameters were significantly lower in MD and MS group compared to the healthy control
group (p<0.05). Regarding severity of clinical presentation we found strong correlation (p<0.001) which indicates lower
antioxidant status in patients with severe clinical presentation.
Conclusion: The results of our research showed significantly lower values of all investigated parameters in MD group
related to the healthy controls, which could suggest a potential role of oxidative process in MD patophysiology.
A. Stojanov, J. Stojanov
01.01.2019.
Professional paper
THE IMPACT OF OCCUPATIONAL STRESS ON WORK ABILITY OF ELECTRICIANS
Introduction The testing of stressors and the impact of stress on health and work ability of electricians working in workplaces with a special health risk is very important.
OBJECTIVE is to examine the impact of occupational stress on the ability of electricians to work.
METHODS The research was designed as a cross sectional study and covered 108 respondents, classified into two groups: electricians (52) and control group (56) made up of administrative workers. The survey included the following: Questionnaire on basic sociodemographic indicators of respondents, IRS Questionnaire, Work Ability Index (WAI) Questionnaire, General Health Questionnsire (GHQ), Copenhagen Burnout Inventory (CBI) and Occupational Stress Assessment Questionnaire. Data analysis was performed with SPSS.
RESULTS The frequency of different categories of WAI score is uniform between the tested groups (p = 0.155). Work ability is poor in 11.5%, moderate in 25%, good in 26.90% and excellent in 36.5% of electricians. The frequency of different categories of WAI score is aligned between the tested groups (p = 0.155). By analyzing all components of IRS score, it was found that there is a statistically significant difference in the components between the electricians and the control group: requirements (p <0.001) and work role (p <0.001); GHQ is higher in electricians, but no statistically significant difference was found (p = 0.082); CBI is statistically significantly higher in electricians (p <0.001) and WAI score is statistically significantly higher in electricians (p = 0.039). In the overall population, the 10 strongest stressors were ranked and statistically significant difference in all stressors (p <0.001) between the electrician and the control group was shown. The values of the stressors are equal in relation to WAI score categories. In the electricians, the strongest stressors are: night work (4.60), hazards (4.58), shift work (4.54), working overtime (4.46), time limit for individual tasks (4.44), fear of injuries (4.42), pressure of time limits for execution of tasks (4.23), work overload (4.22), inadequate work space (4.18) and daily unforeseen situations (4.10). Average value of all stressors among electricians is 2.87 ± 1.10 (Min 1.10, Max 4.60). In the tested population, 14 different stressors have higher values than the average value of all stressors. In the control group, the average value of all stressors is 1.84 ± 0.33 (Min. 1.17, Max 2.69). Correlation analysis has shown that there is a correlation of age with shift work (r = 0.130, p = 0.013) and working overtime (r = -0.220, p <0.001). URS is statistically significantly related to the time limit for individual tasks (r = 0.149, p = 0.005) and pressure of time limits for execution of tasks (r = 0.125, p = 0.017). ERS is statistically significantly related to night work (r = 0.169, p = 0.001), shift work (r = 0.160, p = 0.002), time limit for execution of tasks (r = 0.203, p <0.001) pressure of time limits for execution of tasks (r = 0.194, p <0.001), work overload (r = 0.128, p = 0.017) and inadequate work space (r = 0.122, p = 0.022). The subjective assessment of work ability in relation to physical (p = 0.010) and psychological requirements (p <0.001) is statistically significantly lower in electricians compared to control group. DISCUSSION By analyzing all components of IRS score, it is found that there is a statistically significant difference between the electricians and the control group in the requirements and the working role components. In the overall population, the top 10 stressors were ranked and it was shown that there was a statistically significant difference in all stressors between the electricians and the control group. The average value of all stressors in the electricians is high and a large number (14) of different stressors have higher values than the average value of all the stressors. The subjective assessment of work ability in relation to physical and mental requirements is statistically significantly worse in electricians than in control group. More than half of electricians went on sick leave (mostly short leaves) during the previous year.
CONCLUSION Occupational stress significantly affects work ability of electricians. Values of WAI score are statistically significantly higher in electricians, and values of stressors are equal in relation to WAI score categories. Correlation analysis has shown there is a correlation between age, URS and ERS with individual stressors.
Lj. Kulić, J. Jovanović, M. Galjak, V. Krstović Spremo, S. Đurić, M. Mirković, J. Milošević, J. Jovanović
01.01.2019.
Professional reviews
PRINCIPLES OF OXYGEN ADMINISTRATION AND VENTILTORY SUPPORT IN PATIENTS WITH ACUTE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Chronic obstructive pulmonary disease (COPD) significantly reduces quality of life and is one of the main causes of chronic morbidity and mortality worldwide. Acute exacerbation of COPD (AECOPD) is a life-threatening condition that causes rapid deterioration of respiratory symptoms (worsening of dyspnea, cough and/or abundant sputum production) requiring urgent treatment. This review article examines the evidence underlying supplemental oxygen therapy and ventilator support during exacerbations of COPD. In the introduction, we discuss the epidemiology and pathophysiology of hypercapnic respiratory failure, and then we explain that the key to achieving appropriate levels of oxygenation is using controlled low-flow oxygen therapy. In patients with risk of hypercapnia a target oxygen saturation (SaO ) range of 88%–92% 2 is now generally accepted unless hypercapnia is disproved by gas analysis of arterial blood. However, if the partial pressure of carbon dioxide in arterial blood (PaCO ) is normal, oxygen therapy may target the usual saturation range of 94%–98%. 2 Many COPD patients may have a lower stable SaO , such that chasing this target (94%-98%) is not usually necessary unless 2 the patient is unwell. Further, we review current recommendations for ventilatory support in patients with AEHOBP. Noninvasive ventilation has assumed an important role in managing patients with acute respiratory failure. The use of invasive ventilation is the last remaining option, associated with a poor outcome.
S. Trpković, A. Pavlović, N. Videnović, O. Marinković, A. Sekulić
01.01.2019.
Case Reports
SPECIFIC PATTERN OF F-2-FLUORO-2-DEOXY-D-GLUCOSE POSITRON EMISSION TOMOGRAPHY IN DIFFERENTIAL DIAGNOSIS OF ALZHEIMER DISEASE: CASE REPORT
Introduction: Dementia is a clinical diagnosis based on deficits of intellectual function, usually memory. Primarily neurodegenerative diseases are characterized by progressive neuronal damages and its synapsis. Early-onset Alzheimer disease 18 occurs in someone younger than 65. FDG-PET/CTis a quantitative tomographic technique also calleda biomarker of neuronal activity.
Case outline: A female of 54, mother, 12 years of education, an accountant, was sent to FDG-PET/CT brain scan because of loss of memory, social withdrawal, apathy, behavior changes, troubles with paying bills, speaking difficulties with no structural imaging abnormalities. PET scan reviled glucose hypometabolism in parietal lobes, left posterior cingulum, parietotemporal regions, the left parietooccipital region, left insula and temporal lobes. A male of 43, father, army corporal, 12 years of education, was sent to metabolic hybrid imaging because suspected dementia. He expressed progressive behavior decline, in a year time. The patient wasn't cooperative, could not concentrate and confabulated a lot. Forgetfulness, decline in voluntary dynamics and apathy dominated the clinical presentation. Structural imaging showed supratentorial, right precentral gyri solitary lesion and cortical bilateral hypocampal atrophy. FDG scan reviled distinctively diminished glucose metabolism posteriorly in parietal and temporal lobes, both posterior cingulum. SPM analysis confirmed the visually observed pattern of hypometabolism in both patients.
Conclusion: Depression is an important consideration in the differential diagnosis of AD. Early detection of AD through molecular imaging techniques will assist the choice of medications to slow the progression of the disease and optimize patient care.
B. Radović, L. Brajkovic, S. Nikolic
01.01.2019.
Case Reports
FATAL ASPIRATION OF GRAIN CORN - CASE REPORT
Introduction: Asphyxiation by aspiration- inhalation of foreign bodies is a form of violent mechanical asphyxia and can occur at any age, most commonly in children and the elderly. In children up to third age choking is a significant cause of morbidity and mortality. Mortality due to aspiration of foreign bodies is higher in children because of the relatively narrow airways and less developed protective mechanisms. The size, type, shape and place of obstruction with foreign body leads to the diversity of clinical picture.
Case report. We present the case of a 15 month-old girl, who was found by her mother in her house in a village, lying down, cyanotic, collapsed, without breathing. Autopsy showed that the cause of death was acute respiratory obstruction with impacted grains of corn in two places, on the larynx entrance and in the right bronchus.
Conclusion. The diagnosis of death by asphyxiation due to aspiration of foreign bodies is set at autopsy, when the place of airway occlusion is found. If a foreign body was removed during providing assistance, the diagnosis would be made based on medical records or history data of persons who were provided assistance. In cases of sudden deaths of young children, in order to clarify pathophysiological mechanism and mode of death in each case, a pathologist should always keep in mind the possibility of aspiration of foreign bodies, and in accordance with this, carefully apply appropriate autopsy techniques to locate the place of obstruction, with special regard to local finding in airways.
F. Juković, S. Matejić
01.01.2019.
Case Reports
PRIMARY MEDIASTINAL LARGE B-CELL LYMPHOMA
Introduction: Primary mediastinal large B cell lymphoma is a rare highly aggressive form of non-Hodgkin lymphoma and occurs in 5-7% of all diffuse large B lymphoma and 2% of all non-Hodgkin lymphomas. Originates from thymic medullary cells and has its own histogenesis. Typically affects young women in the third and fourth decade of life. Superior vena cava syndrome is present in more than 50% of cases, with swelling of face, hands, deep venous thrombosis, dyspnea, dysphagia, chest pain, headache and cough. Diagnosis is made by histopathological analysis and immunohistochemical surgical biopsy specimens obtained mediastinoscopy. Timely treatment with cycles of monoclonal antibody and chemotherapy is requirement to relapse and stable state.
Case outline: Patient, 37 years old, came for the first time for review at General practice because she has been repeatedly visited emergency service due to coughing, feeling that something is strangling, the lack of air pressure and pain in the head and swelling of face and neck. Started detailed diagnostics. Radiologically determined mediastinal tumor, computed tomography confirmed it and sent to the referral Institute where video-assisted thoracic surgery and patho histology diagnosed PMBCL CSII AM +. Administered six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone therapy protocols submitted by the expected side effects. Control positron emission tomography found that the tumor mass completely withdrawn. In remission for two years, have a good feeling and occurs at regular checkups.
Conclusion: General practice has a big responsibility in recognizing early symptoms of malignant disease that accelerates
the diagnosis and timely start of treatment.
B.S. Knežević, Z.I. Gajović, M.N. Petrović