: Atherosclerosis is a chronic, long-term process in which the walls of the arteries become hardened and abnormally narrowed by atherosclerotic plaques. Hardening of the arteries and the development of atherosclerotic plaques compromise the vascular system. Atherosclerosis develops due to fat and cholesterol accumulation, inflammation, and calcification. Preventative measures that stop or slow atherosclerosis is considered the best approach to good vascular health. While some risk factors for vascular disease are nonmodifiable, such as inherited characteristics, other risk factors may be controlled, such as blood lipid levels, obesity, a sedentary lifestyle, and smoking, to reduce the risk of vascular disorders. Lifestyle changes are very effective at lowering blood pressure and risk associated with vascular disease but they are a lifelong commitment that many people find difficult. Half of the people who know they have hypertension and vascular disease are not receiving treatment, or not being adequately treated. All health clinicians and health care professionals have a valuable role to assist patients in a health prevention plan to control the development of vascular disease.
{"title":"[Sudden cardiac death].","authors":"V. Topalov, B. Radišić, D. Kovacević","doi":"10.32388/y2mapl","DOIUrl":"https://doi.org/10.32388/y2mapl","url":null,"abstract":": Atherosclerosis is a chronic, long-term process in which the walls of the arteries become hardened and abnormally narrowed by atherosclerotic plaques. Hardening of the arteries and the development of atherosclerotic plaques compromise the vascular system. Atherosclerosis develops due to fat and cholesterol accumulation, inflammation, and calcification. Preventative measures that stop or slow atherosclerosis is considered the best approach to good vascular health. While some risk factors for vascular disease are nonmodifiable, such as inherited characteristics, other risk factors may be controlled, such as blood lipid levels, obesity, a sedentary lifestyle, and smoking, to reduce the risk of vascular disorders. Lifestyle changes are very effective at lowering blood pressure and risk associated with vascular disease but they are a lifelong commitment that many people find difficult. Half of the people who know they have hypertension and vascular disease are not receiving treatment, or not being adequately treated. All health clinicians and health care professionals have a valuable role to assist patients in a health prevention plan to control the development of vascular disease.","PeriodicalId":18511,"journal":{"name":"Medicinski pregled","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77954319","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}
Introduction. The occurrence of more than one primary cancer in the same patient is not very common. Multiple cancer prevalence is about 7.9% and the percentage is lower as the number of multiple primary cancers is higher. The incidence of four or more primary cancers in one patient is very rare and its prevalence is around 0.07%. Case Report. We report a rare case of a female with four histopathologically confirmed primary malignant neoplasms. The first tumor was endometrial carcinoma diagnosed at the age of 52. Three additional metachronous tumors were diagnosed as follows: left breast cancer, melanoma, and contralateral breast cancer. Extensive genetic testing was performed and 19 genes were sequenced using the next generation sequencing (BRCA1, BRCA2, ATM, BRIP1, CDH1, CHEK2, MSH2, MLH1, MSH6, PMS2, EPCAM, NBN, NF1, PALB2, PTEN, RAD51C, RAD51D, STK11 and TP53). Even with the existing indicators of genetic etiology, this case showed no pathogenic mutations in any of these genes. This indicates the existence of other underlying mechanisms such as hormonal factors, previous treatment of the primary and subsequent tumors, environmental factors, gene-gene and gene-environment interactions, as well as immunosuppression that could increase the risk for the second and subsequent malignancies. Conclusion. Detailed information on the biology of multiple primary tumors is important for both clinicians and cancer patients during medical management following primary treatment. In addition, genetic information is very important because it has future implications for both patients and their family members.
{"title":"Genetic analysis of multiple primary cancers: A case report","authors":"M. Jevrić, E. Filipović, A. Krivokuca","doi":"10.2298/mpns2006170j","DOIUrl":"https://doi.org/10.2298/mpns2006170j","url":null,"abstract":"Introduction. The occurrence of more than one primary cancer in the same patient is not very common. Multiple cancer prevalence is about 7.9% and the percentage is lower as the number of multiple primary cancers is higher. The incidence of four or more primary cancers in one patient is very rare and its prevalence is around 0.07%. Case Report. We report a rare case of a female with four histopathologically confirmed primary malignant neoplasms. The first tumor was endometrial carcinoma diagnosed at the age of 52. Three additional metachronous tumors were diagnosed as follows: left breast cancer, melanoma, and contralateral breast cancer. Extensive genetic testing was performed and 19 genes were sequenced using the next generation sequencing (BRCA1, BRCA2, ATM, BRIP1, CDH1, CHEK2, MSH2, MLH1, MSH6, PMS2, EPCAM, NBN, NF1, PALB2, PTEN, RAD51C, RAD51D, STK11 and TP53). Even with the existing indicators of genetic etiology, this case showed no pathogenic mutations in any of these genes. This indicates the existence of other underlying mechanisms such as hormonal factors, previous treatment of the primary and subsequent tumors, environmental factors, gene-gene and gene-environment interactions, as well as immunosuppression that could increase the risk for the second and subsequent malignancies. Conclusion. Detailed information on the biology of multiple primary tumors is important for both clinicians and cancer patients during medical management following primary treatment. In addition, genetic information is very important because it has future implications for both patients and their family members.","PeriodicalId":18511,"journal":{"name":"Medicinski pregled","volume":"53 1","pages":"170-174"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75187893","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}
A. Krsman, Branislava Baturan, D. Petrovic, D. Ilić, B. Gutic, D. Panic
Introduction. Extensive use of assisted reproduction has resulted in an increased incidence of triplet pregnancies, which are associated with higher risk of complications in mothers and newborns. Material and Methods. A retrospective study reviewed a total of 85 triplet pregnancies delivered at the Department of Obstetrics and Gynecology, Clinical Center of Vojvodina, Novi Sad, from January 1, 2010 to December 31, 2017. Results. The average maternal age was 32 years and the average body mass index was 30.56 kg/m2. The average gestational age at birth was 32 weeks. One patient (1.18%) had vaginal delivery, while 84 (98.82%) pregnancies were completed by cesarean section. The average blood loss was 1294 ml and there was one postpartum hysterectomy. The most common maternal pregnancy-induced complications were sideropenic anemia (70.58%), hypertensive syndrome (40%) and obstetric cholestasis (35.29%). Preterm premature rupture of membranes was observed in 17 (20%) patients. Prophylactic cerclage was performed in 57 patients (67.05%) and 12 patients (14.11%) received tocolytic therapy. The average birth weight of the first newborn was 1838 g, 1755 g of the second, and 1695 g of the third. Body weight ? 1500 g was observed in 61 newborns (24.01%). The mean Apgar score in the first minute was 7, while in the fifth minute it was 8. Respiratory distress syndrome was found in 64 newborns (25.19%). Conclusion. Monitoring and treatment of triplet pregnancies remains a complex task for obstetricians due to the increased incidence of prematurity and perinatal morbidity.
介绍。辅助生殖的广泛使用导致三胞胎妊娠的发生率增加，这与母亲和新生儿并发症的风险增加有关。材料和方法。一项回顾性研究回顾了2010年1月1日至2017年12月31日在诺维萨德伏伊伏丁那临床中心妇产科分娩的85例三胞胎妊娠。结果。产妇平均年龄32岁，平均体重指数30.56 kg/m2。出生时的平均胎龄为32周。阴道分娩1例(1.18%)，剖宫产84例(98.82%)。平均失血量1294 ml，产后子宫切除1例。最常见的妊娠并发症是缺铁性贫血(70.58%)、高血压综合征(40%)和产科胆汁淤积(35.29%)。17例(20%)患者出现胎膜早破。预防性结扎57例(67.05%)，溶胎治疗12例(14.11%)。第一胎平均出生体重1838 g，第二胎平均出生体重1755 g，第三胎平均出生体重1695 g。体重?新生儿1500 g 61例(24.01%)。第一分钟的平均阿普加评分为7分，而第五分钟为8分。新生儿出现呼吸窘迫综合征64例(25.19%)。结论。由于早产和围产期发病率的增加，三胞胎妊娠的监测和治疗仍然是产科医生的一项复杂任务。
{"title":"The outcomes of triplet pregnancies","authors":"A. Krsman, Branislava Baturan, D. Petrovic, D. Ilić, B. Gutic, D. Panic","doi":"10.2298/mpns2006153k","DOIUrl":"https://doi.org/10.2298/mpns2006153k","url":null,"abstract":"Introduction. Extensive use of assisted reproduction has resulted in an increased incidence of triplet pregnancies, which are associated with higher risk of complications in mothers and newborns. Material and Methods. A retrospective study reviewed a total of 85 triplet pregnancies delivered at the Department of Obstetrics and Gynecology, Clinical Center of Vojvodina, Novi Sad, from January 1, 2010 to December 31, 2017. Results. The average maternal age was 32 years and the average body mass index was 30.56 kg/m2. The average gestational age at birth was 32 weeks. One patient (1.18%) had vaginal delivery, while 84 (98.82%) pregnancies were completed by cesarean section. The average blood loss was 1294 ml and there was one postpartum hysterectomy. The most common maternal pregnancy-induced complications were sideropenic anemia (70.58%), hypertensive syndrome (40%) and obstetric cholestasis (35.29%). Preterm premature rupture of membranes was observed in 17 (20%) patients. Prophylactic cerclage was performed in 57 patients (67.05%) and 12 patients (14.11%) received tocolytic therapy. The average birth weight of the first newborn was 1838 g, 1755 g of the second, and 1695 g of the third. Body weight ? 1500 g was observed in 61 newborns (24.01%). The mean Apgar score in the first minute was 7, while in the fifth minute it was 8. Respiratory distress syndrome was found in 64 newborns (25.19%). Conclusion. Monitoring and treatment of triplet pregnancies remains a complex task for obstetricians due to the increased incidence of prematurity and perinatal morbidity.","PeriodicalId":18511,"journal":{"name":"Medicinski pregled","volume":"200 1","pages":"153-157"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80120146","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}
Introduction. Adrenal cavernous hemangiomas are extremely rare non-functioning benign tumors. The majority of adrenal cavernous hemangiomas are diagnosed incidentally after surgery by histopathological examination. Case Report. We report a clinical case of a 57-year-old woman with adrenal cavernous hemangioma. On admission, the patient?s adrenal-related hormones were in the reference range, so adrenal endocrine dysfunction was ruled out. The computed tomography scan revealed a well-circumscribed, round, heterogeneous right adrenal mass (32.3 x 55.4 mm). Iodinated contrast enhanced abdominal computed tomography showed a slight inhomogeneity. In this case, preoperative radiologic findings and absence of signs of local invasion indicated laparoscopic adrenalectomy. The patient underwent right transperitoneal adrenalectomy. Microscopic evaluation showed a sinusoidal dilatation and fibrotic septa, so postoperative diagnosis of adrenal cavernous hemangioma was made. Conclusion. In summary, we reported a case of an incidentally discovered non-functioning adrenal cavernous hemangioma treated by laparoscopic surgery. The diagnosis of adrenal cavernous hemangioma may be challenging, and it is commonly made after surgery, since it is frequently confirmed by histopathological examination.
介绍。肾上腺海绵状血管瘤是极为罕见的无功能良性肿瘤。大多数肾上腺海绵状血管瘤是在手术后通过组织病理学检查偶然诊断出来的。病例报告。我们报告一位57岁女性肾上腺海绵状血管瘤的临床病例。入院时，病人呢?肾上腺相关激素均在参考范围内，排除肾上腺内分泌功能障碍。计算机断层扫描显示一个边界清晰、圆形、不均匀的右侧肾上腺肿块(32.3 x 55.4 mm)。碘化增强腹部计算机断层扫描显示轻度不均匀。在这个病例中，术前的放射学检查结果和没有局部侵犯的迹象表明腹腔镜肾上腺切除术。患者行右侧经腹膜肾上腺切除术。镜检显示窦状窦扩张及纤维性间隔，术后诊断为肾上腺海绵状血管瘤。结论。总之，我们报告了一例偶然发现的无功能肾上腺海绵状血管瘤的腹腔镜手术治疗。肾上腺海绵状血管瘤的诊断可能具有挑战性，通常是在手术后做出的，因为它经常通过组织病理学检查得到证实。
{"title":"A rare case of adrenal cavernous hemangioma","authors":"Ivo Vujicik","doi":"10.2298/mpns2004101v","DOIUrl":"https://doi.org/10.2298/mpns2004101v","url":null,"abstract":"Introduction. Adrenal cavernous hemangiomas are extremely rare non-functioning benign tumors. The majority of adrenal cavernous hemangiomas are diagnosed incidentally after surgery by histopathological examination. Case Report. We report a clinical case of a 57-year-old woman with adrenal cavernous hemangioma. On admission, the patient?s adrenal-related hormones were in the reference range, so adrenal endocrine dysfunction was ruled out. The computed tomography scan revealed a well-circumscribed, round, heterogeneous right adrenal mass (32.3 x 55.4 mm). Iodinated contrast enhanced abdominal computed tomography showed a slight inhomogeneity. In this case, preoperative radiologic findings and absence of signs of local invasion indicated laparoscopic adrenalectomy. The patient underwent right transperitoneal adrenalectomy. Microscopic evaluation showed a sinusoidal dilatation and fibrotic septa, so postoperative diagnosis of adrenal cavernous hemangioma was made. Conclusion. In summary, we reported a case of an incidentally discovered non-functioning adrenal cavernous hemangioma treated by laparoscopic surgery. The diagnosis of adrenal cavernous hemangioma may be challenging, and it is commonly made after surgery, since it is frequently confirmed by histopathological examination.","PeriodicalId":18511,"journal":{"name":"Medicinski pregled","volume":"28 1","pages":"101-103"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81447092","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}
Aleksandra Lučić-Prokin, P. Slankamenac, P. Kovačević
Introduction. Transcranial Doppler is the only non-invasive neuroimaging modality in the diagnosis and monitoring of various neurovascular diseases. Apart from assessing cerebral hemodynamics of blood flow in the basal brain arteries, transcranial Doppler provides physiological data and anatomical images. Quantification analysis of vasomotor reactivity. Various transcranial Doppler methods evaluate cerebral vasomotor reactivity, providing important information on the properties of arterioles under induced hemodynamic conditions. Exogenous and endogenous vasoactive stimuli of different potency (apnea, acetazolamide, carbon dioxide, L-arginine) are most commonly used, making transcranial Doppler a prognostic indicator of future ischemic events. This article reviews principles of various transcranial Doppler methods in the evaluation of vasomotor reactivity, emphasizing their advantages and disadvantages. Transcranial Doppler in the field of reduced vasomotor reactivity. Evaluation of vasomotor reactivity has a role in the prediction of future ischemic events, evaluation of revascularization effect after carotid endarterectomy, but also in the increasingly significant choice of the right time to perform it. In recent years, transcranial Doppler methods have found application in other areas of dysfunctional cerebral hemodynamics: dementia, hypertension, migraines, and sepsis. Conclusion. Due to an excellent temporal resolution, non-invasive approach, good cost-benefit ratio, bedside monitoring, relative simplicity in terms of interpretation and performance, and portability, transcranial Doppler in vasomotor reactivity may be the ideal tool in the evaluation of cerebral hemodynamics, arterial perfusion integrity and collateral capacity.
{"title":"Transcranial doppler methods in the assessment of cerebral vasomotor reactivity","authors":"Aleksandra Lučić-Prokin, P. Slankamenac, P. Kovačević","doi":"10.2298/mpns2002021l","DOIUrl":"https://doi.org/10.2298/mpns2002021l","url":null,"abstract":"Introduction. Transcranial Doppler is the only non-invasive neuroimaging modality in the diagnosis and monitoring of various neurovascular diseases. Apart from assessing cerebral hemodynamics of blood flow in the basal brain arteries, transcranial Doppler provides physiological data and anatomical images. Quantification analysis of vasomotor reactivity. Various transcranial Doppler methods evaluate cerebral vasomotor reactivity, providing important information on the properties of arterioles under induced hemodynamic conditions. Exogenous and endogenous vasoactive stimuli of different potency (apnea, acetazolamide, carbon dioxide, L-arginine) are most commonly used, making transcranial Doppler a prognostic indicator of future ischemic events. This article reviews principles of various transcranial Doppler methods in the evaluation of vasomotor reactivity, emphasizing their advantages and disadvantages. Transcranial Doppler in the field of reduced vasomotor reactivity. Evaluation of vasomotor reactivity has a role in the prediction of future ischemic events, evaluation of revascularization effect after carotid endarterectomy, but also in the increasingly significant choice of the right time to perform it. In recent years, transcranial Doppler methods have found application in other areas of dysfunctional cerebral hemodynamics: dementia, hypertension, migraines, and sepsis. Conclusion. Due to an excellent temporal resolution, non-invasive approach, good cost-benefit ratio, bedside monitoring, relative simplicity in terms of interpretation and performance, and portability, transcranial Doppler in vasomotor reactivity may be the ideal tool in the evaluation of cerebral hemodynamics, arterial perfusion integrity and collateral capacity.","PeriodicalId":18511,"journal":{"name":"Medicinski pregled","volume":"11 1","pages":"21-28"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78143550","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}
Džemail Detanac, Mehmed Mujdragić, Dzenana A. Detanac, D. Bihorac, Mersudin Mulić
Abdominal injuries caused by blunt trauma are in the 3rd place, right after head and chest traumas, blunt abdominal traumas (BAT) being the leading cause of mortality and morbidity in all age groups. Isolated injuries of the small intestine and mesentery, as a part of BATs, are rare and occur in about 1–5% of cases, and high morbidity and mortality is often due to late diagnosis [1, 2]. Intestinal injuries in BAT may be caused by various forms of blunt traumas, but the main causes of BAT are direct traumas, motor vehicle accidents, and falls from height [3]. The authors present a case of a 58-year-old male with traumatic jejunal perforation caused by an accidental hammer blow to the abdomen. Case Report
{"title":"Small bowel perforation following blunt abdominal trauma caused by an accidental hammer blow: A case report","authors":"Džemail Detanac, Mehmed Mujdragić, Dzenana A. Detanac, D. Bihorac, Mersudin Mulić","doi":"10.2298/mpns2004108d","DOIUrl":"https://doi.org/10.2298/mpns2004108d","url":null,"abstract":"Abdominal injuries caused by blunt trauma are in the 3rd place, right after head and chest traumas, blunt abdominal traumas (BAT) being the leading cause of mortality and morbidity in all age groups. Isolated injuries of the small intestine and mesentery, as a part of BATs, are rare and occur in about 1–5% of cases, and high morbidity and mortality is often due to late diagnosis [1, 2]. Intestinal injuries in BAT may be caused by various forms of blunt traumas, but the main causes of BAT are direct traumas, motor vehicle accidents, and falls from height [3]. The authors present a case of a 58-year-old male with traumatic jejunal perforation caused by an accidental hammer blow to the abdomen. Case Report","PeriodicalId":18511,"journal":{"name":"Medicinski pregled","volume":"277 1","pages":"108-111"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79028291","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}
Introduction. Aortoenteric fistula is a communication between the aorta and segments of the gastrointestinal tract. Primary aortoduodenal fistula is an extremely rare cause of gastrointestinal bleeding associated with a high mortality rate. Case Report. We report a case of a 63-year-old man admitted due to abdominal pain lasting for a week. Abdominal ultrasound and computed tomography angiography revealed an aortoduodenal fistula without an aortic aneurysm. Conclusion. This case is an example of a rare cause of gastrointestinal bleeding, as well as presentation of aortoduodenal fistula that was not caused by an abdominal aortic aneurysm.
{"title":"Primary aortoduodenal fistula without an abdominal aortic aneurysm: A case report","authors":"Slobodan Torbica","doi":"10.2298/mpns2006180t","DOIUrl":"https://doi.org/10.2298/mpns2006180t","url":null,"abstract":"Introduction. Aortoenteric fistula is a communication between the aorta and segments of the gastrointestinal tract. Primary aortoduodenal fistula is an extremely rare cause of gastrointestinal bleeding associated with a high mortality rate. Case Report. We report a case of a 63-year-old man admitted due to abdominal pain lasting for a week. Abdominal ultrasound and computed tomography angiography revealed an aortoduodenal fistula without an aortic aneurysm. Conclusion. This case is an example of a rare cause of gastrointestinal bleeding, as well as presentation of aortoduodenal fistula that was not caused by an abdominal aortic aneurysm.","PeriodicalId":18511,"journal":{"name":"Medicinski pregled","volume":"119 1","pages":"180-182"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80395170","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}
Jelena Samac, R. Žeravica, B. Ilinčić, Marija Vukmirovic-Papuga, D. Burić, T. Ostojic
Introduction. Radionuclide methods are used in the evaluation of different aspects of renal function. The aim of this study was to define and implement an index derived from scintigraphic image and to compare it with ortho-iodohippurate clearance values, an indicator of effective renal plasma flow. Material and Methods. A retrospective analysis included 67 adult patients, who underwent static renal scintigraphy and ortho-iodohippurate clearance. We computed the background-to-renal index that represents the ratio of average values of counts per pixel in the background regions and in the regions of kidneys. Patients were divided into three groups according to the values of measured effective renal plasma flow: group 1 - patients with mild renal dysfunction (reduction of effective renal plasma flow ? 20%, 17 patients), group 2 - moderate dysfunction (reduction of effective renal plasma flow 20-50%, 25), and group 3 - severe dysfunction (reduction of effective renal plasma flow 50-70%, 25 patients). Results. Subjects with mild effective renal plasma flow reduction had significantly lower background-to-renal index values compared to those with moderate and severe reduction [(0.105 ? 0.05) vs. (0.134 ? 0.056) vs. (0.275 ? 0.154), p < 0,001]. A significant linear correlation was found between background-to-renal index and effective renal plasma flow (r = 0.60, p < 0.0001). Sensitivity and specificity of the calculated cut-off value of 0.1335, for the differentiation between the patients with renal reduction higher and lower than 20%, were 62% and 100%, respectively (area under curve 0.85). Conclusion. The background-to-renal index is a simple method for semiquantitative estimation of global tubular renal function that can be a useful tool when determining patients for further in vitro assessment of global renal function.
介绍。放射性核素法用于评价肾功能的不同方面。本研究的目的是定义和实现一个从扫描图像衍生的指数，并将其与正碘酸盐清除率进行比较，正碘酸盐清除率是有效肾血浆流量的指标。材料和方法。回顾性分析包括67例成人患者，他们接受了静态肾显像检查和正碘尿酸清除。我们计算了背景-肾脏指数，该指数表示背景区域和肾脏区域中每像素计数的平均值之比。根据有效肾血浆流量的测量值将患者分为三组:1组-轻度肾功能不全患者(有效肾血浆流量减少?2组-中度功能障碍(有效肾血浆流量减少20-50%，25例)，3组-重度功能障碍(有效肾血浆流量减少50-70%，25例)。结果。轻度有效肾血浆流量减少的受试者与中度和重度减少的受试者相比，其本底肾指数显著降低[(0.105 ?0.05) vs (0.134 ?0.056) vs. (0.275 ?0.154)， p < 0.001]。背景-肾指数与有效肾血浆流量之间存在显著的线性相关(r = 0.60, p < 0.0001)。计算截断值为0.1335，对肾缩小高于20%和低于20%的患者进行区分的敏感性为62%，特异性为100%(曲线下面积0.85)。结论。背景-肾指数是一种半定量估计全肾小管功能的简单方法，可作为确定患者进一步进行体外全肾功能评估的有用工具。
{"title":"Image-derived index - as a paramether for the semi-quantitative assessment of global tubular renal function","authors":"Jelena Samac, R. Žeravica, B. Ilinčić, Marija Vukmirovic-Papuga, D. Burić, T. Ostojic","doi":"10.2298/mpns2006139s","DOIUrl":"https://doi.org/10.2298/mpns2006139s","url":null,"abstract":"Introduction. Radionuclide methods are used in the evaluation of different aspects of renal function. The aim of this study was to define and implement an index derived from scintigraphic image and to compare it with ortho-iodohippurate clearance values, an indicator of effective renal plasma flow. Material and Methods. A retrospective analysis included 67 adult patients, who underwent static renal scintigraphy and ortho-iodohippurate clearance. We computed the background-to-renal index that represents the ratio of average values of counts per pixel in the background regions and in the regions of kidneys. Patients were divided into three groups according to the values of measured effective renal plasma flow: group 1 - patients with mild renal dysfunction (reduction of effective renal plasma flow ? 20%, 17 patients), group 2 - moderate dysfunction (reduction of effective renal plasma flow 20-50%, 25), and group 3 - severe dysfunction (reduction of effective renal plasma flow 50-70%, 25 patients). Results. Subjects with mild effective renal plasma flow reduction had significantly lower background-to-renal index values compared to those with moderate and severe reduction [(0.105 ? 0.05) vs. (0.134 ? 0.056) vs. (0.275 ? 0.154), p < 0,001]. A significant linear correlation was found between background-to-renal index and effective renal plasma flow (r = 0.60, p < 0.0001). Sensitivity and specificity of the calculated cut-off value of 0.1335, for the differentiation between the patients with renal reduction higher and lower than 20%, were 62% and 100%, respectively (area under curve 0.85). Conclusion. The background-to-renal index is a simple method for semiquantitative estimation of global tubular renal function that can be a useful tool when determining patients for further in vitro assessment of global renal function.","PeriodicalId":18511,"journal":{"name":"Medicinski pregled","volume":"169 1","pages":"139-144"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80615060","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}
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