Introduction/Objective. Ovarian carcinomas are the deadliest gynecological tumors. Despite advances in treatment options, survival rates are still not at the desired level. Since clinical signs are not typical in early-stage disease, 2/3rd of patients are diagnosed late. Carbohydrate Antigen 125 (CA125) does not have sufficient sensitivity and specificity in early-stage disease and early post-relapse progression. There is a need for a simple and cost-effective marker that correlates with CA125. For this purpose, we aimed to evaluate the potential of systemic inflammatory markers? as diagnostic aids. Methods. Patients with platinum-sensitive recurrent ovarian carcinomas were preferred because the treatment options were more diverse than the resistant group. Using retrospective data collection, 105 patients with platinum-sensitive recurrent ovarian carcinoma, admitted in the last four years were included in the study. Complete blood count data was recorded based on recurrence and progression periods. Results. When the systemic immune inflammatory index (SII) values were evaluated in combination with CA125 in terms of progression during the control visits after platinum-sensitive disease recurrence treatment, progression detection proportions increased to 97.5%, which was 82.9% when only CA125 was used. On the other hand, false positivity, which was 18.5% for CA125 alone, decreased to 2.5% when combined with SII. Furthermore, neutrophil lymphocyte ratio, WBC, and neutrophil values showed correlations with high CA125 values. Conclusion. The SII value could be used together with CA125 because it is easy to use, accessible, and has low cost in clinical practice, as well as to increase the accuracy rate and make precise corrections in the false positivity rate.
{"title":"Novel inflammatory markers and prognostic importance of platinum-sensitive ovarian carcinoma relapse","authors":"Fatih Tay, Mustafa Büyükkör, Öztürk Ateş","doi":"10.2298/sarh221122057t","DOIUrl":"https://doi.org/10.2298/sarh221122057t","url":null,"abstract":"Introduction/Objective. Ovarian carcinomas are the deadliest gynecological tumors. Despite advances in treatment options, survival rates are still not at the desired level. Since clinical signs are not typical in early-stage disease, 2/3rd of patients are diagnosed late. Carbohydrate Antigen 125 (CA125) does not have sufficient sensitivity and specificity in early-stage disease and early post-relapse progression. There is a need for a simple and cost-effective marker that correlates with CA125. For this purpose, we aimed to evaluate the potential of systemic inflammatory markers? as diagnostic aids. Methods. Patients with platinum-sensitive recurrent ovarian carcinomas were preferred because the treatment options were more diverse than the resistant group. Using retrospective data collection, 105 patients with platinum-sensitive recurrent ovarian carcinoma, admitted in the last four years were included in the study. Complete blood count data was recorded based on recurrence and progression periods. Results. When the systemic immune inflammatory index (SII) values were evaluated in combination with CA125 in terms of progression during the control visits after platinum-sensitive disease recurrence treatment, progression detection proportions increased to 97.5%, which was 82.9% when only CA125 was used. On the other hand, false positivity, which was 18.5% for CA125 alone, decreased to 2.5% when combined with SII. Furthermore, neutrophil lymphocyte ratio, WBC, and neutrophil values showed correlations with high CA125 values. Conclusion. The SII value could be used together with CA125 because it is easy to use, accessible, and has low cost in clinical practice, as well as to increase the accuracy rate and make precise corrections in the false positivity rate.","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":"68730935","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. Implantation in irradiated bone is very challenging due to many factors: implant therapy parameters, irradiated tissue, and the patient's general health. Implantologists have to consider all of these aspects when planning implant therapy and during the postsurgical recovery period. Case outline. A case presented in this paper is a 54-year old male, who was admitted to the Clinic for maxillofacial surgery, School of dental medicine in Belgrade, for implant anchored orbital prosthesis. One year previously, the patient had orbital exenteration and postoperatively received radiotherapy with an overall dose of 60 Gy. After planning, three disk implants - two double and one triple disk were placed (Ihde Dental, Switzerland). Implant stability was clinically satisfactory with immediate ISQ of 37, 46, and 51, respectively. After osseointegration implant retained prosthesis was manufactured. After six years due to osteoradionecrosis (ORN) implant stability was compromised. The patient received conservative and hyperbaric chamber treatment. The implants regained stability, and the patient was in remission for four years. Afterwards due to ORN two implants were explanted, and the third implant was stable enough to anchor the prosthesis. The prosthetic plan had to be modified for one implant anchorage, afterwards successful prosthetic rehabilitation was achieved. Conclusion. Implantation in irradiated bone is very delicate, and careful planning of implant insertion and prosthetic rehabilitation is essential. The possible occurrence of osteoradionecrosis should also be taken into account, as a result of which the implant may be lost, which compromises the retention of the prosthesis.
{"title":"Challenges in irradiated bone implantation","authors":"Filip Ivanjac, V. Konstantinovic","doi":"10.2298/sarh230105026i","DOIUrl":"https://doi.org/10.2298/sarh230105026i","url":null,"abstract":"Introduction. Implantation in irradiated bone is very challenging due to many factors: implant therapy parameters, irradiated tissue, and the patient's general health. Implantologists have to consider all of these aspects when planning implant therapy and during the postsurgical recovery period. Case outline. A case presented in this paper is a 54-year old male, who was admitted to the Clinic for maxillofacial surgery, School of dental medicine in Belgrade, for implant anchored orbital prosthesis. One year previously, the patient had orbital exenteration and postoperatively received radiotherapy with an overall dose of 60 Gy. After planning, three disk implants - two double and one triple disk were placed (Ihde Dental, Switzerland). Implant stability was clinically satisfactory with immediate ISQ of 37, 46, and 51, respectively. After osseointegration implant retained prosthesis was manufactured. After six years due to osteoradionecrosis (ORN) implant stability was compromised. The patient received conservative and hyperbaric chamber treatment. The implants regained stability, and the patient was in remission for four years. Afterwards due to ORN two implants were explanted, and the third implant was stable enough to anchor the prosthesis. The prosthetic plan had to be modified for one implant anchorage, afterwards successful prosthetic rehabilitation was achieved. Conclusion. Implantation in irradiated bone is very delicate, and careful planning of implant insertion and prosthetic rehabilitation is essential. The possible occurrence of osteoradionecrosis should also be taken into account, as a result of which the implant may be lost, which compromises the retention of the prosthesis.","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":"68731668","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}
Andrea Raicevic, Vladimir Stevanovic, Marta Vukotic-Lazar, Dejan Tubic
Urban positioning, architectural concept and construction of health facilities are parts of a complex process with a number of actors from fields of engineering, but also political and management structures on whose decisions the success of project implementation depends. In general, throughout history, the involvement of representatives of the medical profession in such endeavors has proven to be fruitful because in such a way they directly participate in the functional and formal design of their own work environment. In that sense, it can be stated that the collaboration of engineers, specifically architects, with medical doctors is all the more valuable for scientific research in the field of both the history of medicine and the history of architecture. This text deals with the implications of the collaboration between Primarius Dr. Svetozar Zivojnovic (1899-1981) and academician architect Nikola Dobrovic (1897-1967) on the design and construction of several health facilities as well as the planning of urban zones in Igalo during the sixth and seventh decades of the 20th century. The paper emphasizes their respective contributions, which are considered crucial for the socio-economic development that has turned Igalo into a modern international health center, and one of the main centers of health tourism in the Mediterranean region.
{"title":"Collaboration of Primarius Dr. Svetozar Zivojnovic and academician architect Nikola Dobrovic in the development of medical infrastructure in Igalo","authors":"Andrea Raicevic, Vladimir Stevanovic, Marta Vukotic-Lazar, Dejan Tubic","doi":"10.2298/sarh220531091r","DOIUrl":"https://doi.org/10.2298/sarh220531091r","url":null,"abstract":"Urban positioning, architectural concept and construction of health facilities are parts of a complex process with a number of actors from fields of engineering, but also political and management structures on whose decisions the success of project implementation depends. In general, throughout history, the involvement of representatives of the medical profession in such endeavors has proven to be fruitful because in such a way they directly participate in the functional and formal design of their own work environment. In that sense, it can be stated that the collaboration of engineers, specifically architects, with medical doctors is all the more valuable for scientific research in the field of both the history of medicine and the history of architecture. This text deals with the implications of the collaboration between Primarius Dr. Svetozar Zivojnovic (1899-1981) and academician architect Nikola Dobrovic (1897-1967) on the design and construction of several health facilities as well as the planning of urban zones in Igalo during the sixth and seventh decades of the 20th century. The paper emphasizes their respective contributions, which are considered crucial for the socio-economic development that has turned Igalo into a modern international health center, and one of the main centers of health tourism in the Mediterranean region.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"220 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":"135450882","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}
T. Zenginkinet, E. Okay, A. T. Toksoz Yildirim, A. Çelik, Y. Turhan, K. Ozkan, M. Akyurek
Introduction/Objective. Chordomas are rare tumors of a notochordal origin. Wide surgical resection is recommended for treatment. However, it is associated with a high risk of morbidity and mortality. Additionally, these tumors are resistant to chemotherapy. Thus, targeted therapy is needed for the treatment of chordomas. Programmed death ligand 1 (PD-L1) is a promising target for cancer treatment. Here, we investigated PD-L1 expression in patients with chordoma in a single-center study. Methods. Formalin-fixed paraffin-embedded blocks were evaluated for immunohistochemical analysis to evaluate PD-L1 expression. Clinicopathological variables, such as sex, age, and follow-up data (recurrence and outcome), were retrospectively collected from the patients? medical records. Results. Ten patients diagnosed with sacral chordoma in a single institution between December 2015 and November 2021 were included in this study. The median patient age was 57 years and the median follow-up period was 40 months. The surgical margins were negative in all cases, without any preoperative medical treatment. Four of the ten patients showed PD-L1 positivity on immune cells. These patients showed local recurrence, without metastasis. In these cases, the median time to local recurrence was 15 months. All the patients with the disease were alive. Conclusion. This study demonstrated that PD-L1 positivity in immune cells can be used as a predictive marker for local recurrence at the time of surgical treatment. This can potentially be used to determine the necessity to administer immunotherapy.
{"title":"Evaluation of PD-L1 expression in recurrent nonmetastatic sacral chordomas - a retrospective study","authors":"T. Zenginkinet, E. Okay, A. T. Toksoz Yildirim, A. Çelik, Y. Turhan, K. Ozkan, M. Akyurek","doi":"10.2298/sarh220524009z","DOIUrl":"https://doi.org/10.2298/sarh220524009z","url":null,"abstract":"Introduction/Objective. Chordomas are rare tumors of a notochordal origin. Wide surgical resection is recommended for treatment. However, it is associated with a high risk of morbidity and mortality. Additionally, these tumors are resistant to chemotherapy. Thus, targeted therapy is needed for the treatment of chordomas. Programmed death ligand 1 (PD-L1) is a promising target for cancer treatment. Here, we investigated PD-L1 expression in patients with chordoma in a single-center study. Methods. Formalin-fixed paraffin-embedded blocks were evaluated for immunohistochemical analysis to evaluate PD-L1 expression. Clinicopathological variables, such as sex, age, and follow-up data (recurrence and outcome), were retrospectively collected from the patients? medical records. Results. Ten patients diagnosed with sacral chordoma in a single institution between December 2015 and November 2021 were included in this study. The median patient age was 57 years and the median follow-up period was 40 months. The surgical margins were negative in all cases, without any preoperative medical treatment. Four of the ten patients showed PD-L1 positivity on immune cells. These patients showed local recurrence, without metastasis. In these cases, the median time to local recurrence was 15 months. All the patients with the disease were alive. Conclusion. This study demonstrated that PD-L1 positivity in immune cells can be used as a predictive marker for local recurrence at the time of surgical treatment. This can potentially be used to determine the necessity to administer immunotherapy.","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":"68729271","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}
Igor Vasković, I. Udovicic, Mihailo Stojić, Ljiljana Arsenovic, V. Nešković
Introduction. Coronavirus disease 2019 (COVID-19) is associated with high inflammatory response, hemostatic disturbances, and high thrombotic risk. Despite thromboprophylaxis, a high incidence of thromboembolic events has been reported with a consequent increase in anticoagulant therapy from standard to intermediate or even therapeutic doses. However, published evidence on the incidence and outcome of the hemorrhagic complications of applied therapy is still limited. Case report. We present two female COVID-19 patients, treated with anticoagulant therapy and suffering from major spontaneous bleeding and retroperitoneal hematoma. The first, 64-year-old patient, treated with non-invasive ventilation protocol in the Intensive Care Unit (ICU) due to respiratory failure received a therapeutic dose of anticoagulant therapy adjusted to the anti-Xa assay. The cumulative dose of Nadroparin was 150 IU/kg BW/day. The second, 60-year-old patient with the moderate clinical presentation on low flow oxygen support was treated with therapeutic doses of anticoagulant therapy calculated according to the body weight. Emergency open surgery was performed due to massive bleeding. No active surgical bleeding was detected, and retroperitoneal hematomas were assumed to be complications of the applied anticoagulant therapy. Both patients were discharged and fully recovered. Conclusion. Although rare, severe hemorrhage requires attention when considering anticoagulant therapy in COVID-19. Uncommon sites of spontaneous bleeding suggest additional evaluation on a case-by-case basis, given that a diagnosis is often delayed due to a lack of specific presenting symptoms. Further studies are needed to verify the risk-benefit ratio of different regiments of anticoagulant therapy in patients with COVID-19.
{"title":"Retroperitoneal hematoma: An unexpected complication of anticoagulant therapy in COVID-19 patients","authors":"Igor Vasković, I. Udovicic, Mihailo Stojić, Ljiljana Arsenovic, V. Nešković","doi":"10.2298/sarh220824023v","DOIUrl":"https://doi.org/10.2298/sarh220824023v","url":null,"abstract":"Introduction. Coronavirus disease 2019 (COVID-19) is associated with high inflammatory response, hemostatic disturbances, and high thrombotic risk. Despite thromboprophylaxis, a high incidence of thromboembolic events has been reported with a consequent increase in anticoagulant therapy from standard to intermediate or even therapeutic doses. However, published evidence on the incidence and outcome of the hemorrhagic complications of applied therapy is still limited. Case report. We present two female COVID-19 patients, treated with anticoagulant therapy and suffering from major spontaneous bleeding and retroperitoneal hematoma. The first, 64-year-old patient, treated with non-invasive ventilation protocol in the Intensive Care Unit (ICU) due to respiratory failure received a therapeutic dose of anticoagulant therapy adjusted to the anti-Xa assay. The cumulative dose of Nadroparin was 150 IU/kg BW/day. The second, 60-year-old patient with the moderate clinical presentation on low flow oxygen support was treated with therapeutic doses of anticoagulant therapy calculated according to the body weight. Emergency open surgery was performed due to massive bleeding. No active surgical bleeding was detected, and retroperitoneal hematomas were assumed to be complications of the applied anticoagulant therapy. Both patients were discharged and fully recovered. Conclusion. Although rare, severe hemorrhage requires attention when considering anticoagulant therapy in COVID-19. Uncommon sites of spontaneous bleeding suggest additional evaluation on a case-by-case basis, given that a diagnosis is often delayed due to a lack of specific presenting symptoms. Further studies are needed to verify the risk-benefit ratio of different regiments of anticoagulant therapy in patients with COVID-19.","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":"68729477","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}
A. Vulin, I. Popov, M. Stefanovic, D. Zivkov-Saponja, A. Stojsic-Milosavljevic
Introduction. Pulmonary artery hypertension and right ventricular failure are potentially fatal complications that can develop in patients with portal hypertension. The objective of this case report was to report a patient with end stage liver disease, and portal and pulmonary artery hypertension and right heart failure. Case outline A 57-year-old man was admitted to the Cardiology Department of tertiary hospital due to signs of right sided heart failure, ascites, pleural effusions, and pretibial edema. The patient had the history of alcohol abuse, arterial hypertension and gout. Just prior to the admission, abdominal ultrasound revealed granular liver structure, as well as ascites. Laboratory tests showed microcytic anemia, values of transaminases below referent, hypoalbuminemia, low creatinine clearance. Echocardiography revealed pulmonary hypertension (PH) and right ventricle failure. Right heart catheterization unraveled precapillary PH, but thoracic CT scan and thoracocentesis excluded underlying pulmonary illness. Treatment continued at Gastroenterology department of tertiary hospital. Abdominal CT scan diagnosed cirrhotic liver, and signs of portal hypertension. The patient was treated with symptomatic therapy, but develop acute on chronic renal failure and eventually died. Conclusion. Multidisciplinary approach is very important to distinguish portopulmonary hypertension early in the course of liver disease, because evolution of right sided heart failure precludes these patients from adequate lifesaving therapy.
{"title":"Right-sided heart failure as a first presentation of portopulmonary hypertension","authors":"A. Vulin, I. Popov, M. Stefanovic, D. Zivkov-Saponja, A. Stojsic-Milosavljevic","doi":"10.2298/sarh221120021v","DOIUrl":"https://doi.org/10.2298/sarh221120021v","url":null,"abstract":"Introduction. Pulmonary artery hypertension and right ventricular failure are potentially fatal complications that can develop in patients with portal hypertension. The objective of this case report was to report a patient with end stage liver disease, and portal and pulmonary artery hypertension and right heart failure. Case outline A 57-year-old man was admitted to the Cardiology Department of tertiary hospital due to signs of right sided heart failure, ascites, pleural effusions, and pretibial edema. The patient had the history of alcohol abuse, arterial hypertension and gout. Just prior to the admission, abdominal ultrasound revealed granular liver structure, as well as ascites. Laboratory tests showed microcytic anemia, values of transaminases below referent, hypoalbuminemia, low creatinine clearance. Echocardiography revealed pulmonary hypertension (PH) and right ventricle failure. Right heart catheterization unraveled precapillary PH, but thoracic CT scan and thoracocentesis excluded underlying pulmonary illness. Treatment continued at Gastroenterology department of tertiary hospital. Abdominal CT scan diagnosed cirrhotic liver, and signs of portal hypertension. The patient was treated with symptomatic therapy, but develop acute on chronic renal failure and eventually died. Conclusion. Multidisciplinary approach is very important to distinguish portopulmonary hypertension early in the course of liver disease, because evolution of right sided heart failure precludes these patients from adequate lifesaving therapy.","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":"68730626","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. Prijović, V. Šantrić, U. Babić, Danica Stanić, B. Stankovic, L. Kovačević, P. Nikic
The COVID-19 pandemic affected the functioning of health care systems, including emergency services worldwide. The aim of this study was to examine the impact of the pandemic and lockdown on the care of urgent urological patients in daily practice. Methods. Data were retrospectively collected from patients urgently hospitalized at Emergency Department of Clinic of Urology, University Clinical Center of Serbia, during the first three months of lockdown between Mar 15, 2020 and Jun 15, 2020, and compared to the same period in 2019. The collected data included demographic and clinical characteristics, as well as treatment characteristics and treatment outcomes. Results. This study included 80 patients who were hospitalized during the lockdown in 2020 and 68 patients who were hospitalized in the same period in 2019. There was no difference in total number of hospitalized patients, age and gender comparing these two periods. Among patients with urinary tract infection, the number of patients with urosepsis was significantly higher in 2020 (p = 0.028). The median time from symptoms onset to hospitalization was significantly longer in patients who were hospitalized in 2020 (p=0.049). No difference was found in duration of hospitalization and characteristics of treatment between two periods. The number of deaths was significantly higher in 2020 (p = 0.034). Conclusion. During lockdown in Serbia, patients applied to the emergency urology service significantly later. Furthermore, a higher number of patients with urosepsis and a higher number of deaths among hospitalized patients were found during lockdown compared to the previous year.
{"title":"The impact of the covid-19 pandemic on the treatment of emergency urological patients during lockdown - Serbian tertiary center experience","authors":"N. Prijović, V. Šantrić, U. Babić, Danica Stanić, B. Stankovic, L. Kovačević, P. Nikic","doi":"10.2298/sarh221221077p","DOIUrl":"https://doi.org/10.2298/sarh221221077p","url":null,"abstract":"The COVID-19 pandemic affected the functioning of health care systems, including emergency services worldwide. The aim of this study was to examine the impact of the pandemic and lockdown on the care of urgent urological patients in daily practice. Methods. Data were retrospectively collected from patients urgently hospitalized at Emergency Department of Clinic of Urology, University Clinical Center of Serbia, during the first three months of lockdown between Mar 15, 2020 and Jun 15, 2020, and compared to the same period in 2019. The collected data included demographic and clinical characteristics, as well as treatment characteristics and treatment outcomes. Results. This study included 80 patients who were hospitalized during the lockdown in 2020 and 68 patients who were hospitalized in the same period in 2019. There was no difference in total number of hospitalized patients, age and gender comparing these two periods. Among patients with urinary tract infection, the number of patients with urosepsis was significantly higher in 2020 (p = 0.028). The median time from symptoms onset to hospitalization was significantly longer in patients who were hospitalized in 2020 (p=0.049). No difference was found in duration of hospitalization and characteristics of treatment between two periods. The number of deaths was significantly higher in 2020 (p = 0.034). Conclusion. During lockdown in Serbia, patients applied to the emergency urology service significantly later. Furthermore, a higher number of patients with urosepsis and a higher number of deaths among hospitalized patients were found during lockdown compared to the previous year.","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":"68731454","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}
V. Milosavljević, Bogdan Crnokrak, Aleksandar Gluhović, B. Tošković
Introduction. Spigelian hernia is a type of lateral ventral hernia, localized between the rectus abdominis muscle and the semilunar line. Current literary data indicate that the prevalence of Spigelian hernia is 1-2% of all hernias of the abdominal wall. Patients are most commonly asymptomatic. Case outline. We present a 63-year-old male patient, who was admitted to our hospital as an emergency case due to lower abdominal pain. Upon hospital admission, radiological diagnostics, and a physical examination, the presence of a Spigelian hernia was verified, which, at the moment of the examination, was incarcerated. It was established that surgical treatment was indicated. We performed laparoscopic intraperitoneal onlay mesh plastic in the standard way. The patient was discharged from hospital on the following day with normal values of vital and laboratory parameters. Conclusion. The Spigelian hernia, although first described many years ago, remains a diagnostic challenge, which is why its occurrence requires a multidisciplinary approach for the purpose of establishing a timely and accurate diagnosis. Within the surgical treatment of this state, there are several surgical techniques, and special focus is placed on the minimally invasive surgical approach. Also, within the minimally invasive surgical approach, there are several operating techniques.
{"title":"Intraperitoneal onlay mesh laparoscopic repair of an incarcerated Spigelian hernia - case report and literature review","authors":"V. Milosavljević, Bogdan Crnokrak, Aleksandar Gluhović, B. Tošković","doi":"10.2298/sarh221230019m","DOIUrl":"https://doi.org/10.2298/sarh221230019m","url":null,"abstract":"Introduction. Spigelian hernia is a type of lateral ventral hernia, localized between the rectus abdominis muscle and the semilunar line. Current literary data indicate that the prevalence of Spigelian hernia is 1-2% of all hernias of the abdominal wall. Patients are most commonly asymptomatic. Case outline. We present a 63-year-old male patient, who was admitted to our hospital as an emergency case due to lower abdominal pain. Upon hospital admission, radiological diagnostics, and a physical examination, the presence of a Spigelian hernia was verified, which, at the moment of the examination, was incarcerated. It was established that surgical treatment was indicated. We performed laparoscopic intraperitoneal onlay mesh plastic in the standard way. The patient was discharged from hospital on the following day with normal values of vital and laboratory parameters. Conclusion. The Spigelian hernia, although first described many years ago, remains a diagnostic challenge, which is why its occurrence requires a multidisciplinary approach for the purpose of establishing a timely and accurate diagnosis. Within the surgical treatment of this state, there are several surgical techniques, and special focus is placed on the minimally invasive surgical approach. Also, within the minimally invasive surgical approach, there are several operating techniques.","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":"68731545","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. Pejcic, R. Mitic, Slobodan Gavrilovic, Marija Jović, S. Krusic, B. Pujic, I. Velickovic, N. Sadana
Introduction/Objective. ?o ensure that all patients receive the best possible anesthetic care, it is essential to continuously evaluate our practices and strive for improvement. The objective of this study is to internally assess the anesthesia services provided during the peripartum period. Methods. The Anesthesiology Department of Leskovac General Hospital, Serbia (LGH) aimed to evaluate patient satisfaction with spinal anesthesia (SA) for Cesarean delivery (CD) using a questionnaire consisting of four open-ended questions. Following Institutional Review Board approval, an institutional-based survey was conducted from August 2021 to July 2022. During the study period, 624 (40.6%) of the total 1,535 deliveries in LGH were CDs, with 311 (49.8%) of them performed under SA. Of the patients who underwent CD under SA, 87 agreed to anonymously complete the questionnaire. Results. Although patients had sufficient space to provide detailed responses, the majority of participants opted for brief answers, often limited to ?yes? or ?no?. Of the surveyed participants, 78% were informed about SA for CD before delivery, and 96.6% expressed satisfaction with the information provided during the preoperative anesthesiologist's visit. Additionally, the majority of participants (94.3%) reported satisfaction with the postoperative analgesia they received. Conclusion. Our patients expressed high levels of satisfaction with the preoperative anesthesiologist's visit and the SA provided for CD. However, there is a need to improve antenatal education for expectant mothers in the field of anesthesia. Conducting a new and more detailed survey would be necessary to further explore the influence of patient education and socioeconomic status on patient satisfaction.
{"title":"Evaluation of patient satisfaction with provided spinal anesthesia for cesarean delivery - a survey in leskovac general hospital, serbia","authors":"N. Pejcic, R. Mitic, Slobodan Gavrilovic, Marija Jović, S. Krusic, B. Pujic, I. Velickovic, N. Sadana","doi":"10.2298/sarh230110078p","DOIUrl":"https://doi.org/10.2298/sarh230110078p","url":null,"abstract":"Introduction/Objective. ?o ensure that all patients receive the best possible anesthetic care, it is essential to continuously evaluate our practices and strive for improvement. The objective of this study is to internally assess the anesthesia services provided during the peripartum period. Methods. The Anesthesiology Department of Leskovac General Hospital, Serbia (LGH) aimed to evaluate patient satisfaction with spinal anesthesia (SA) for Cesarean delivery (CD) using a questionnaire consisting of four open-ended questions. Following Institutional Review Board approval, an institutional-based survey was conducted from August 2021 to July 2022. During the study period, 624 (40.6%) of the total 1,535 deliveries in LGH were CDs, with 311 (49.8%) of them performed under SA. Of the patients who underwent CD under SA, 87 agreed to anonymously complete the questionnaire. Results. Although patients had sufficient space to provide detailed responses, the majority of participants opted for brief answers, often limited to ?yes? or ?no?. Of the surveyed participants, 78% were informed about SA for CD before delivery, and 96.6% expressed satisfaction with the information provided during the preoperative anesthesiologist's visit. Additionally, the majority of participants (94.3%) reported satisfaction with the postoperative analgesia they received. Conclusion. Our patients expressed high levels of satisfaction with the preoperative anesthesiologist's visit and the SA provided for CD. However, there is a need to improve antenatal education for expectant mothers in the field of anesthesia. Conducting a new and more detailed survey would be necessary to further explore the influence of patient education and socioeconomic status on patient satisfaction.","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":"68731698","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}
Higher prevalence of chronic kidney disease (CKD) in women than in men was reported all over the world. This difference could be partly explained by longer life expectancy and slower CKD progression rate in women. Potential factors associated with sex difference in CKD progression are: difference in glomerular hemodynamic and the response to angiotensin II; sex hormones - estrogen has protective but testosterone deleterious effects on CKD progression; lifestyle. In most countries, the percentage of men is higher than women among incident and prevalent patients on hemodialysis (HD). In HD patients the index Kt/V overestimates HD adequacy, secondary hyperparathyroidism is more common in women, and women require higher doses of erythropoiesis stimulating agents for achieving and maintaining the hemoglobin target level. The survival of HD patients is equal for both sexes. In earlier years, an equal percentage of women and men started peritoneal dialysis (PD), but in recent years, a higher percentage of women, especially at younger ages, start PD. Initial peritoneal transport properties differ between men and women. A smaller percentage of women than men receive deceased donor kidneys but women are more likely to be living kidney donors. Kidney allograft outcome depends on the sex and age of both the recipient and the donor. Cardiovascular diseases are the most common cause of death for renal replacement therapy patients of both sexes. Although sex-specific differences have been described in CKD patients, the inequality of patients in access to medical care has not been found in most regions of the world.
{"title":"Sex-specific differences in the epidemiology, progression, and outcomes of chronic kidney disease","authors":"L. Djukanović, N. Dimkovic, V. Ležaić","doi":"10.2298/sarh230321071d","DOIUrl":"https://doi.org/10.2298/sarh230321071d","url":null,"abstract":"Higher prevalence of chronic kidney disease (CKD) in women than in men was reported all over the world. This difference could be partly explained by longer life expectancy and slower CKD progression rate in women. Potential factors associated with sex difference in CKD progression are: difference in glomerular hemodynamic and the response to angiotensin II; sex hormones - estrogen has protective but testosterone deleterious effects on CKD progression; lifestyle. In most countries, the percentage of men is higher than women among incident and prevalent patients on hemodialysis (HD). In HD patients the index Kt/V overestimates HD adequacy, secondary hyperparathyroidism is more common in women, and women require higher doses of erythropoiesis stimulating agents for achieving and maintaining the hemoglobin target level. The survival of HD patients is equal for both sexes. In earlier years, an equal percentage of women and men started peritoneal dialysis (PD), but in recent years, a higher percentage of women, especially at younger ages, start PD. Initial peritoneal transport properties differ between men and women. A smaller percentage of women than men receive deceased donor kidneys but women are more likely to be living kidney donors. Kidney allograft outcome depends on the sex and age of both the recipient and the donor. Cardiovascular diseases are the most common cause of death for renal replacement therapy patients of both sexes. Although sex-specific differences have been described in CKD patients, the inequality of patients in access to medical care has not been found in most regions of the world.","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":"68732797","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：