Milena Milanovic, Zoran Mandinic, Jelena Juloski, Biljana Milicic, Biljana Andjelski-Radicevic, Vladimir Pavlovic, Milos Beloica
Introduction/Objective. Artificial enamel caries lesions are commonly created to simulate in vivo caries development and to examine the effect of non-invasive and microinvasive approaches in treatment of initial caries lesions. The objective of the present study was to compare three different demineralizing solutions and exposing times in terms of the formation of artificial white spot lesions and to evaluate their demineralization effect through Scanning Electron Microscopy observations. Methods. Twenty intact human premolars, extracted for orthodontic reasons, were thoroughly cleaned, stored in 0.1% thymol solution at room temperature and cut at the cementoenamel junction before demineralizing process. The specimens were randomly divided into three experimental groups, according to the used demineralization agent and the time of exposure: Group I (Acetic acid; pH = 4.4; 96 hours); Group II (Lactic acid; pH = 4.5; 120 hours); Group III (Lactic acid; pH = 4.3; 504 hours) and one control group (saline). After demineralisation, macroscopic appearance was checked and all specimens were observed under Scanning Electron Microscope to evaluate the enamel characteristics and caries lesion depths. Results. In Group I and II enamel subsurface porosity with dissolution of enamel crystals is detected and the mean depths of white spot lesions were 48.55 ?m (SD = 1.11) and 43.23 ?m (SD = 6.74), respectively. In Group III structural integrity of enamel surface was not preserved. Conclusion. Demineralizing solutions used in experimental groups I and II resulted in artificial initial caries lesions with satisfactory characteristics and similar appearance on Scanning Electron Microscopy. The outcome of demineralizing process which lasted 504 hours were cavitated enamel lesions.
介绍/目标。人工牙釉质龋齿通常用于模拟体内龋齿的发展，并研究非侵入性和微创方法在治疗初始龋齿病变中的效果。本研究的目的是比较三种不同的脱矿溶液和暴露时间对人工白斑病变形成的影响，并通过扫描电镜观察其脱矿效果。方法。20颗完整的人前磨牙，因正畸原因拔出，彻底清洁，室温下保存在0.1%百里酚溶液中，在牙髓-牙釉质交界处切割，然后进行脱矿处理。根据所使用的脱矿剂及暴露时间，将标本随机分为3个实验组:1组(醋酸;pH = 4.4;96小时);第二组(乳酸;pH = 4.5;120小时);第三组(乳酸;pH = 4.3;504小时)和1个对照组(生理盐水)。脱矿后检查肉眼外观，并在扫描电镜下观察所有标本的牙釉质特征和龋损深度。结果。ⅰ组和ⅱ组牙釉质表面下有孔隙，牙釉质晶体溶解，白斑病变平均深度分别为48.55 μ m (SD = 1.11)和43.23 μ m (SD = 6.74)。ⅲ组牙釉质表面结构完整性不完整。结论。实验1组和实验2组使用脱矿液，人工形成初始龋损，扫描电镜特征满意，外观相似。脱矿过程持续504小时，结果为牙釉质空化损伤。
{"title":"Effect of different demineralizing solutions and different exposing times on artificial initial caries lesion formation - an in vitro study","authors":"Milena Milanovic, Zoran Mandinic, Jelena Juloski, Biljana Milicic, Biljana Andjelski-Radicevic, Vladimir Pavlovic, Milos Beloica","doi":"10.2298/sarh221228095m","DOIUrl":"https://doi.org/10.2298/sarh221228095m","url":null,"abstract":"Introduction/Objective. Artificial enamel caries lesions are commonly created to simulate in vivo caries development and to examine the effect of non-invasive and microinvasive approaches in treatment of initial caries lesions. The objective of the present study was to compare three different demineralizing solutions and exposing times in terms of the formation of artificial white spot lesions and to evaluate their demineralization effect through Scanning Electron Microscopy observations. Methods. Twenty intact human premolars, extracted for orthodontic reasons, were thoroughly cleaned, stored in 0.1% thymol solution at room temperature and cut at the cementoenamel junction before demineralizing process. The specimens were randomly divided into three experimental groups, according to the used demineralization agent and the time of exposure: Group I (Acetic acid; pH = 4.4; 96 hours); Group II (Lactic acid; pH = 4.5; 120 hours); Group III (Lactic acid; pH = 4.3; 504 hours) and one control group (saline). After demineralisation, macroscopic appearance was checked and all specimens were observed under Scanning Electron Microscope to evaluate the enamel characteristics and caries lesion depths. Results. In Group I and II enamel subsurface porosity with dissolution of enamel crystals is detected and the mean depths of white spot lesions were 48.55 ?m (SD = 1.11) and 43.23 ?m (SD = 6.74), respectively. In Group III structural integrity of enamel surface was not preserved. Conclusion. Demineralizing solutions used in experimental groups I and II resulted in artificial initial caries lesions with satisfactory characteristics and similar appearance on Scanning Electron Microscopy. The outcome of demineralizing process which lasted 504 hours were cavitated enamel lesions.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135505600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Biljana Certic, Andjela Dimkic-Milenkovic, Milan Jovanovic
Introduction. Full thickness burns pose a significant challenge in terms of surgical management, particularly when concurrent trauma of other organs is involved. Traditional treatment of deep burns includes early excision or debridement of necrotic tissue, followed by skin grafting or flap reconstruction. There are numerous challenges such as poor overall general condition, polytrauma, questionable wound bed viability, limited donor sites. Thus, we have to consider skin substitutes. INTEGRAR is a acellular dermal substitute which create a native dermis. The aim of this case was to share our experience of the treatment by skin substitutes in the polytraumatized burn patient. Case outline. We present the case report of a 46-year-old man with the severe work-related contact burn wounds associated with multiple rib and vertebral fractures as well as lungs contusion with localized bilateral hemothorax. Patient suffered from third-degree burns to the lower extremities, extending to scrotal and gluteal area, which included 15% of total body surface area. Patient underwent early excision of necrotic tissues with subsequently skin autografting on right leg, however, due to partial failure of autografts we had to perform allografting followed by autografting because of limited local donor sites and poor general condition. Successive debridement and partial osteotomy resulted in left knee defect with exposed patella. Therefore, in order to reconstruct consequent defect and prevention of joint contracture, defect was finally covered by INTEGRAR. Conclusion. Our experience has highlighted that INTEGRAR prevents functional disability and furthermore, it leads to optimal aesthetic results.
{"title":"Challenges in surgery of deep burns","authors":"Biljana Certic, Andjela Dimkic-Milenkovic, Milan Jovanovic","doi":"10.2298/sarh221230108c","DOIUrl":"https://doi.org/10.2298/sarh221230108c","url":null,"abstract":"Introduction. Full thickness burns pose a significant challenge in terms of surgical management, particularly when concurrent trauma of other organs is involved. Traditional treatment of deep burns includes early excision or debridement of necrotic tissue, followed by skin grafting or flap reconstruction. There are numerous challenges such as poor overall general condition, polytrauma, questionable wound bed viability, limited donor sites. Thus, we have to consider skin substitutes. INTEGRAR is a acellular dermal substitute which create a native dermis. The aim of this case was to share our experience of the treatment by skin substitutes in the polytraumatized burn patient. Case outline. We present the case report of a 46-year-old man with the severe work-related contact burn wounds associated with multiple rib and vertebral fractures as well as lungs contusion with localized bilateral hemothorax. Patient suffered from third-degree burns to the lower extremities, extending to scrotal and gluteal area, which included 15% of total body surface area. Patient underwent early excision of necrotic tissues with subsequently skin autografting on right leg, however, due to partial failure of autografts we had to perform allografting followed by autografting because of limited local donor sites and poor general condition. Successive debridement and partial osteotomy resulted in left knee defect with exposed patella. Therefore, in order to reconstruct consequent defect and prevention of joint contracture, defect was finally covered by INTEGRAR. Conclusion. Our experience has highlighted that INTEGRAR prevents functional disability and furthermore, it leads to optimal aesthetic results.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135759417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Polovina, Z. Terzić-Šupić, D. Mićić, J. Todorović, B. Parapid, Jelena Milin-Lazovic, Jelena Vasilijevic, Ana Mladenovic-Markovic, Milos Bjelovic
Introduction/Objective. Diabetes mellitus and its chronic complications impair quality of life when compared to the one of the general population. The objective of this study was to determine the prevalence of > 14 unhealthy days per month among the patients with diabetes in Serbia and to determine the association of the socio-demographic characteristics and health characteristics with the total of > 14 unhealthy days. Methods. Serbian version of a generic self-administered questionnaire from Centers for Disease Control and Prevention (CDC-HRQOL-4) was used for data collection in all three levels of care. Results. The study involved 4898 patients with diabetes, 2283 (46.6%) men and 2611 (53.4%) women. Overall mean age was 57.3 ? 12.2 years with over one fifth (23.2 %) were younger than 50 years. Multivariate logistic regression analyses indicated that age > 65 (OR:1.575, 95%CI 1.100-2.256), being a woman (OR: 1.287, 95% CI 1.042-1.588), lower education (OR: 1.383, 95%CI 1.091-1.754), felt depressed ? 14 days (OR: 3.689, 95% CI 2.221-6.128), felt anxious ? 14 days (OR: 1.749, 95% CI 1.113-2.749), poor sleep ? 14 days (OR:2.161, 95%CI 1.569-2.988), fair or poor self-rated health ? 14 days (OR: 4.322, 95%CI 3.474-5.376) were associated with unhealthy days ? 14 days. The strongest negative association was observed between limited physical activity ? 14 days and a decrease in the quality of life of people with diabetes (OR: 22.176, 95%CI 10.971-44.824). Conclusion. This study highlights association between impaired quality of life in patients with diabetes and physical activity limitations. Limited physical activity is the factor with the greatest negative impact on the quality of life particularly in older, less educated women with diabetes.
{"title":"Quality of life in patients with diabetes - limited activity hinders women more","authors":"S. Polovina, Z. Terzić-Šupić, D. Mićić, J. Todorović, B. Parapid, Jelena Milin-Lazovic, Jelena Vasilijevic, Ana Mladenovic-Markovic, Milos Bjelovic","doi":"10.2298/sarh211230080p","DOIUrl":"https://doi.org/10.2298/sarh211230080p","url":null,"abstract":"Introduction/Objective. Diabetes mellitus and its chronic complications impair quality of life when compared to the one of the general population. The objective of this study was to determine the prevalence of > 14 unhealthy days per month among the patients with diabetes in Serbia and to determine the association of the socio-demographic characteristics and health characteristics with the total of > 14 unhealthy days. Methods. Serbian version of a generic self-administered questionnaire from Centers for Disease Control and Prevention (CDC-HRQOL-4) was used for data collection in all three levels of care. Results. The study involved 4898 patients with diabetes, 2283 (46.6%) men and 2611 (53.4%) women. Overall mean age was 57.3 ? 12.2 years with over one fifth (23.2 %) were younger than 50 years. Multivariate logistic regression analyses indicated that age > 65 (OR:1.575, 95%CI 1.100-2.256), being a woman (OR: 1.287, 95% CI 1.042-1.588), lower education (OR: 1.383, 95%CI 1.091-1.754), felt depressed ? 14 days (OR: 3.689, 95% CI 2.221-6.128), felt anxious ? 14 days (OR: 1.749, 95% CI 1.113-2.749), poor sleep ? 14 days (OR:2.161, 95%CI 1.569-2.988), fair or poor self-rated health ? 14 days (OR: 4.322, 95%CI 3.474-5.376) were associated with unhealthy days ? 14 days. The strongest negative association was observed between limited physical activity ? 14 days and a decrease in the quality of life of people with diabetes (OR: 22.176, 95%CI 10.971-44.824). Conclusion. This study highlights association between impaired quality of life in patients with diabetes and physical activity limitations. Limited physical activity is the factor with the greatest negative impact on the quality of life particularly in older, less educated women with diabetes.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68727106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dejan Djokanovic, Bojana Lazic, Z. Gojković, Željka Cvijetić, E. Sokolović, T. Cerić, S. Jungić
Introduction/Objective. The purpose of this study was to assess the effectiveness of different approaches in the treatment of metastatic melanoma in daily clinical practice in a situation with limited and late availability of new drugs in a resource-limited country and to compare these parameters with those reported in clinical studies and from other real-world data. Methods. Main methods included assessment of overall survival (OS) and progression-free survival (PFS). Patients were included in the study if they were treated with first or second-line systemic therapy for radiologically/pathologically confirmed metastatic melanoma. Patients were divided into four groups based on the type of therapy they received: chemotherapy (dacarbazin), BRAF inhibitor (vemurafenib), BRAF/MEK inhibitors (vemurafenib/cobimetinib and trametinib/dabrafenib) and anti PD-1 therapy with pembrolizumab. Results. Regardless of the line of therapy, the calculated median OS in chemotherapy and vemurafenib group was nine months. The median OS in the BRAF/MEK inhibitor group was 14 months and 15 months in the pembrolizumab group. Median PFS in the chemotherapy group was four months, seven months for vemurafenib, in the BRAF/MEK inhibitor group nine months and in the pembrolizumab group six months. There was a statistically significant difference in survival between first and second-line therapy in the pembrolizumab group. Conclusion. Our results showed lower median OS and PFS in comparison to reported data from clinical trials. Compared to other real-world data from countries with similar problems related to the late reimbursement of new drugs, our research has shown similar results.
{"title":"Real-world treatment patterns and outcomes in patients with metastatic melanoma","authors":"Dejan Djokanovic, Bojana Lazic, Z. Gojković, Željka Cvijetić, E. Sokolović, T. Cerić, S. Jungić","doi":"10.2298/sarh220207006d","DOIUrl":"https://doi.org/10.2298/sarh220207006d","url":null,"abstract":"Introduction/Objective. The purpose of this study was to assess the effectiveness of different approaches in the treatment of metastatic melanoma in daily clinical practice in a situation with limited and late availability of new drugs in a resource-limited country and to compare these parameters with those reported in clinical studies and from other real-world data. Methods. Main methods included assessment of overall survival (OS) and progression-free survival (PFS). Patients were included in the study if they were treated with first or second-line systemic therapy for radiologically/pathologically confirmed metastatic melanoma. Patients were divided into four groups based on the type of therapy they received: chemotherapy (dacarbazin), BRAF inhibitor (vemurafenib), BRAF/MEK inhibitors (vemurafenib/cobimetinib and trametinib/dabrafenib) and anti PD-1 therapy with pembrolizumab. Results. Regardless of the line of therapy, the calculated median OS in chemotherapy and vemurafenib group was nine months. The median OS in the BRAF/MEK inhibitor group was 14 months and 15 months in the pembrolizumab group. Median PFS in the chemotherapy group was four months, seven months for vemurafenib, in the BRAF/MEK inhibitor group nine months and in the pembrolizumab group six months. There was a statistically significant difference in survival between first and second-line therapy in the pembrolizumab group. Conclusion. Our results showed lower median OS and PFS in comparison to reported data from clinical trials. Compared to other real-world data from countries with similar problems related to the late reimbursement of new drugs, our research has shown similar results.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68727698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Stajevic, Slobodan Ilic, V. Parezanovic, S. Prijic, V. Milovanović, M. Kuzmanović, S. Djuricic, I. Dizdarević, Saša Popović, D. Bisenic
Introduction/Objective. Although cardiac tumors in the pediatric population are seldom findings, their occurrence is constant and with occasional variations. The purpose of this study is to show our experience with surgical options of these masses in two leading national university-level pediatric centers over four decades. Methods. This retrospective study is presenting a total number of 24 surgically treated pediatric patients who have been operated from 1988 to 2020. There were 16 children with primary masses and eight children with metastatic cardiac tumors. Two patients with tumor-like intracardiac masses were not included in the series but had been mentioned as diagnostic challenges. Our patients did not have cardiac transplantation options. Results. The average age of our patients was five and a half years and the most frequent operated tumor was the cardiac myxoma. Four children had neurological symptoms. There were two deaths, one in the primary tumor group and one metastatic patient misdiagnosed as a primary tumor in the early ages of our department. We had two recurrent cases, a girl with Carney complex and an infant with an extremely rare form of cardiac malignancy after a myxoma extraction. One child required a permanent pacemaker insertion. Conclusion. Although rare, the pediatric cardiac tumors can be a source of different life-threatening conditions and lifelong sequelae. Therefore, special considerations should be paid to the diagnostic and surgical modalities of their treatment.
{"title":"Cardiac tumors in the pediatric population - surgical experience of four decades","authors":"M. Stajevic, Slobodan Ilic, V. Parezanovic, S. Prijic, V. Milovanović, M. Kuzmanović, S. Djuricic, I. Dizdarević, Saša Popović, D. Bisenic","doi":"10.2298/sarh220607005s","DOIUrl":"https://doi.org/10.2298/sarh220607005s","url":null,"abstract":"Introduction/Objective. Although cardiac tumors in the pediatric population are seldom findings, their occurrence is constant and with occasional variations. The purpose of this study is to show our experience with surgical options of these masses in two leading national university-level pediatric centers over four decades. Methods. This retrospective study is presenting a total number of 24 surgically treated pediatric patients who have been operated from 1988 to 2020. There were 16 children with primary masses and eight children with metastatic cardiac tumors. Two patients with tumor-like intracardiac masses were not included in the series but had been mentioned as diagnostic challenges. Our patients did not have cardiac transplantation options. Results. The average age of our patients was five and a half years and the most frequent operated tumor was the cardiac myxoma. Four children had neurological symptoms. There were two deaths, one in the primary tumor group and one metastatic patient misdiagnosed as a primary tumor in the early ages of our department. We had two recurrent cases, a girl with Carney complex and an infant with an extremely rare form of cardiac malignancy after a myxoma extraction. One child required a permanent pacemaker insertion. Conclusion. Although rare, the pediatric cardiac tumors can be a source of different life-threatening conditions and lifelong sequelae. Therefore, special considerations should be paid to the diagnostic and surgical modalities of their treatment.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68729012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction. Acute myocarditis is a serious inflammatory condition of the myocardium. Clinically, symptoms may differ from case to case, and as such can pose a significant diagnostic dilemma. Here we present a case of acute focal myocarditis with markedly elevated troponins, in which diagnosis was finally made using cardiac magnetic resonance (CMR). Case outline. A male patient, 26-year-old, without cardiovascular risk factors presented with severe chest pain, diaphoresis, pallor, and dyspnea. Blood pressure was 160/110 mmHg, and ECG showed ST-segment elevation in inferior leads. In laboratory there was an extreme elevation of Troponin. Inferior-posterior-lateral STEMI was suspected, and initial treatment was given according to that suspicion. The patient was then sent to catheterization laboratory for further evaluation, which showed absence of coronary artery disease. A working diagnosis of myocardial infarction with non-obstructive coronary arteries (MINOCA) was established. To distinguish MINOCA from other causes of myocardial injury with elevated troponins, a CMR was done, and its finding was consistent with focal myocarditis of inferolateral localization. Further treatment consisted of beta blockers, ACE inhibitors and avoidance of strenuous activity for the next six months. The patient fully recovered and had no further complications with ECG only showing flat T-wave in D3 lead. Conclusion. Focal myocarditis is an unusual manifestation of myocardial disease and can confuse physicians, especially if it occurs along with elevated cardiac markers and ST-elevation, but in a young patient, without any known comorbidity, this diagnosis must be considered. Here, a cardiovascular magnetic resonance may be a useful tool.
{"title":"Focal myocarditis, an unusual imitator: Case report and short literature review","authors":"N. Jovanovic, N. Jovanovic","doi":"10.2298/sarh221014067j","DOIUrl":"https://doi.org/10.2298/sarh221014067j","url":null,"abstract":"Introduction. Acute myocarditis is a serious inflammatory condition of the myocardium. Clinically, symptoms may differ from case to case, and as such can pose a significant diagnostic dilemma. Here we present a case of acute focal myocarditis with markedly elevated troponins, in which diagnosis was finally made using cardiac magnetic resonance (CMR). Case outline. A male patient, 26-year-old, without cardiovascular risk factors presented with severe chest pain, diaphoresis, pallor, and dyspnea. Blood pressure was 160/110 mmHg, and ECG showed ST-segment elevation in inferior leads. In laboratory there was an extreme elevation of Troponin. Inferior-posterior-lateral STEMI was suspected, and initial treatment was given according to that suspicion. The patient was then sent to catheterization laboratory for further evaluation, which showed absence of coronary artery disease. A working diagnosis of myocardial infarction with non-obstructive coronary arteries (MINOCA) was established. To distinguish MINOCA from other causes of myocardial injury with elevated troponins, a CMR was done, and its finding was consistent with focal myocarditis of inferolateral localization. Further treatment consisted of beta blockers, ACE inhibitors and avoidance of strenuous activity for the next six months. The patient fully recovered and had no further complications with ECG only showing flat T-wave in D3 lead. Conclusion. Focal myocarditis is an unusual manifestation of myocardial disease and can confuse physicians, especially if it occurs along with elevated cardiac markers and ST-elevation, but in a young patient, without any known comorbidity, this diagnosis must be considered. Here, a cardiovascular magnetic resonance may be a useful tool.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68729765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Mitrovic, D. Stevanović, Damir Jašarović, A. Lazić, B. Lukic
Introduction/Objective. More than three years have passed since the discovery of the new virus strain SARS-CoV-2, and the virus is still a challenge for all medical specialties. One of the most important characteristics is the tendency to develop thromboembolic complications, which are often lethal. The aim of this paper is to present the experience of the General Surgery Department of the Zemun Clinical Hospital Centar in the surgical treatment of patients with thromboembolic complications. Methods. The research was conceived as a retrospective study conducted in the period from March 2020 to March 2021. A total of 42 patients participated in the study and were divided into a group diagnosed with small and large bowel ischemia and a group diagnosed with acute limb ischemia. Results. In both groups, males were predominantly represented. The first group consisted of nine patients, all of whom had a clinical finding of acute abdomen and ileus, while seven of them also had a severe computed tomography image of bilateral pneumonia. In the second group, a smaller number of patients were initially candidates for thrombectomy, while in others, primary amputation treatment was approached. Mortality from the underlying disease in both groups was high. Conclusion. Moderate and severe forms of SARS-CoV-2 infection are associated with an inflammatory response leading to endothelial dysfunction accompanied by a high incidence of thromboembolic complications despite pharmacological prophylaxis. The current consensus supports the use of anticoagulants in all hospitalized patients with moderate to severe disease, as well as in critically ill patients.
{"title":"Thromboembolic complications in patients with COVID-19 - experiences of the General Surgery Department of Zemun Clinical Hospital Center","authors":"N. Mitrovic, D. Stevanović, Damir Jašarović, A. Lazić, B. Lukic","doi":"10.2298/sarh211231046m","DOIUrl":"https://doi.org/10.2298/sarh211231046m","url":null,"abstract":"Introduction/Objective. More than three years have passed since the discovery of the new virus strain SARS-CoV-2, and the virus is still a challenge for all medical specialties. One of the most important characteristics is the tendency to develop thromboembolic complications, which are often lethal. The aim of this paper is to present the experience of the General Surgery Department of the Zemun Clinical Hospital Centar in the surgical treatment of patients with thromboembolic complications. Methods. The research was conceived as a retrospective study conducted in the period from March 2020 to March 2021. A total of 42 patients participated in the study and were divided into a group diagnosed with small and large bowel ischemia and a group diagnosed with acute limb ischemia. Results. In both groups, males were predominantly represented. The first group consisted of nine patients, all of whom had a clinical finding of acute abdomen and ileus, while seven of them also had a severe computed tomography image of bilateral pneumonia. In the second group, a smaller number of patients were initially candidates for thrombectomy, while in others, primary amputation treatment was approached. Mortality from the underlying disease in both groups was high. Conclusion. Moderate and severe forms of SARS-CoV-2 infection are associated with an inflammatory response leading to endothelial dysfunction accompanied by a high incidence of thromboembolic complications despite pharmacological prophylaxis. The current consensus supports the use of anticoagulants in all hospitalized patients with moderate to severe disease, as well as in critically ill patients.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"23 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68727172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kristina Rebić, Bojan Janjic, V. Danilovic, V. Djordjevic, B. Ilić
Introduction. Oroantral communication (OAC) closure may be accompanied with hard and soft tissue defects. Platelet-rich fibrin (PRF) is the second-generation platelet concentrate that can be an effective therapeutic option for the closure of defects up to 5mm. The aim of this investigation was to evaluate whether the PRF could be a viable therapeutic option for OAC closure and provide sufficient bone quality/quantity for the forthcoming implant placement. Outlines of cases. The case series included 8 patients treated with PRF due to the presence of OAC less than 3mm in diameter. Three months after the surgery, at the time of implant placement, bone samples were harvested and taken for histological analysis. The results demonstrated success in all eight cases, obtaining the hard and soft tissue healing. Histological analysis showed that newly formed bone was present on all histological samples, without visible signs of inflammation and necrosis. Conclusion. PRF could be a viable therapeutic option for OAC closure in specific clinical cases, but future randomized, controlled, clinical studies are required for more conclusive results.
{"title":"Histological analysis of bone three months after the treatment of oroantral communication with autologous platelet-rich fibrin - a case series","authors":"Kristina Rebić, Bojan Janjic, V. Danilovic, V. Djordjevic, B. Ilić","doi":"10.2298/sarh220704043r","DOIUrl":"https://doi.org/10.2298/sarh220704043r","url":null,"abstract":"Introduction. Oroantral communication (OAC) closure may be accompanied with hard and soft tissue defects. Platelet-rich fibrin (PRF) is the second-generation platelet concentrate that can be an effective therapeutic option for the closure of defects up to 5mm. The aim of this investigation was to evaluate whether the PRF could be a viable therapeutic option for OAC closure and provide sufficient bone quality/quantity for the forthcoming implant placement. Outlines of cases. The case series included 8 patients treated with PRF due to the presence of OAC less than 3mm in diameter. Three months after the surgery, at the time of implant placement, bone samples were harvested and taken for histological analysis. The results demonstrated success in all eight cases, obtaining the hard and soft tissue healing. Histological analysis showed that newly formed bone was present on all histological samples, without visible signs of inflammation and necrosis. Conclusion. PRF could be a viable therapeutic option for OAC closure in specific clinical cases, but future randomized, controlled, clinical studies are required for more conclusive results.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68728904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marija Tomanović, D. Živanović, Novica Boricic, O. Andonovic
Introduction. Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer in Caucasians and one of the most frequent malignancies in general, especially in older adults. Squamous cell carcinoma is the most frequent tumor developing on chronic leg ulceration, while BCC rarely occurs and is often misdiagnosed. In addition, since older adults commonly have coexisting chronic vein insufficiency, the ulcerated BCC is frequently mistaken as being of venous origin. Outlines of cases. We present five cases of BCC presenting as chronic venous ulcers. Conclusion. Long-lasting ulcers with no healing tendency must be considered malignant until proven otherwise. Knowing the characteristics of malignant ulceration may help in early detection and treatment.
{"title":"Basal cell carcinoma presented and mistreated as chronic venous ulcers - report of five cases","authors":"Marija Tomanović, D. Živanović, Novica Boricic, O. Andonovic","doi":"10.2298/sarh220710034t","DOIUrl":"https://doi.org/10.2298/sarh220710034t","url":null,"abstract":"Introduction. Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer in Caucasians and one of the most frequent malignancies in general, especially in older adults. Squamous cell carcinoma is the most frequent tumor developing on chronic leg ulceration, while BCC rarely occurs and is often misdiagnosed. In addition, since older adults commonly have coexisting chronic vein insufficiency, the ulcerated BCC is frequently mistaken as being of venous origin. Outlines of cases. We present five cases of BCC presenting as chronic venous ulcers. Conclusion. Long-lasting ulcers with no healing tendency must be considered malignant until proven otherwise. Knowing the characteristics of malignant ulceration may help in early detection and treatment.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68729054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Dimitrijević, D. Brasanac, Nikola Todorović, Masa Petrovic, Ana Dimitrijevic
Basal cell carcinoma (BCC) is one of the most common malignant tumors in human medicine and the most common skin malignancy, with the largest number of lesions found on exposed parts of the skin, on the face, head, and neck. The average age of the patients is 60 years, with an increasing incidence in younger ages and an increased incidence in males. The incidence of BCC is increasing and doubles every 25 years. Annually, there are approximately 1,000,000 newly diagnosed cases worldwide. The frequency of malignant skin tumors depends on the influence of external factors such as UV radiation and other biological properties of the skin with a higher incidence in fair-skinned people (Fitzpatrick type I and type II skin types). BCC is a slow growing malignant tumor that arises from the basal layer of the epidermis, the outer layer of hair follicles, or the sebaceous glands. BCC can be locally invasive and, if neglected, can infiltrate surrounding structures (muscles and cartilage) and vital structures, which can ultimately lead to death. The clinical presentation is very diverse and dependent on the histological subtype. Prevention is the most important and effective approach towards reducing the burden of BCC. The best treatment for BCC is surgical excision with confirmation and verification of surgical margins. The therapeutic goal is oncologic radical resection of the tumor, followed by reconstruction of the affected area for structure and optimal aesthetic result.
{"title":"Basal cell carcinoma - principles of treatment","authors":"M. Dimitrijević, D. Brasanac, Nikola Todorović, Masa Petrovic, Ana Dimitrijevic","doi":"10.2298/sarh220830010d","DOIUrl":"https://doi.org/10.2298/sarh220830010d","url":null,"abstract":"Basal cell carcinoma (BCC) is one of the most common malignant tumors in human medicine and the most common skin malignancy, with the largest number of lesions found on exposed parts of the skin, on the face, head, and neck. The average age of the patients is 60 years, with an increasing incidence in younger ages and an increased incidence in males. The incidence of BCC is increasing and doubles every 25 years. Annually, there are approximately 1,000,000 newly diagnosed cases worldwide. The frequency of malignant skin tumors depends on the influence of external factors such as UV radiation and other biological properties of the skin with a higher incidence in fair-skinned people (Fitzpatrick type I and type II skin types). BCC is a slow growing malignant tumor that arises from the basal layer of the epidermis, the outer layer of hair follicles, or the sebaceous glands. BCC can be locally invasive and, if neglected, can infiltrate surrounding structures (muscles and cartilage) and vital structures, which can ultimately lead to death. The clinical presentation is very diverse and dependent on the histological subtype. Prevention is the most important and effective approach towards reducing the burden of BCC. The best treatment for BCC is surgical excision with confirmation and verification of surgical margins. The therapeutic goal is oncologic radical resection of the tumor, followed by reconstruction of the affected area for structure and optimal aesthetic result.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68729491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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