Enes Zogic, Dzenana A. Detanac, Kemal Brnicanin, Džemail Detanac, Sead Marovac
Introduction. Neuroendocrine neoplasms (NENs) of the gastrointestinal tract (GIT) are slow-growing and rare tumors with different clinical, histological, and biological characteristics with an increased incidence in recent years. Most of them are indolent and colonic NENs are rare among all GIT-NENs. Compared to colorectal adenocarcinoma neuroendocrine tumors of the colon and sigmoid colon are uncommon. Case outline. We present a 25-year-old female patient, who was admitted to our department in hemorrhagic shock due to life-threatening bleeding from a tumor on the sigmoid colon, and after unsuccessful endoscopic hemostasis during colonoscopy. The complaints started the day before admission to the ward with hematochezia. The patient had no complaints before that. Emergency operation and colon resection with terminal colostomy were performed. Pathohistological and immunohistochemical analysis of the tumor showed unclear histogenetic origin from the group of neuroendocrine tumors. Conclusion. Regardless of the asymptomatic period of the disease, these tumors can cause severe bleeding as the first symptom, which can be life-threatening.
{"title":"Large Bowel's tumor of unclear histogenetic origin from the group of neuroendocrine tumors with life-threatening hemorrhage and hemorrhagic shock","authors":"Enes Zogic, Dzenana A. Detanac, Kemal Brnicanin, Džemail Detanac, Sead Marovac","doi":"10.2298/sarh221212042z","DOIUrl":"https://doi.org/10.2298/sarh221212042z","url":null,"abstract":"Introduction. Neuroendocrine neoplasms (NENs) of the gastrointestinal tract (GIT) are slow-growing and rare tumors with different clinical, histological, and biological characteristics with an increased incidence in recent years. Most of them are indolent and colonic NENs are rare among all GIT-NENs. Compared to colorectal adenocarcinoma neuroendocrine tumors of the colon and sigmoid colon are uncommon. Case outline. We present a 25-year-old female patient, who was admitted to our department in hemorrhagic shock due to life-threatening bleeding from a tumor on the sigmoid colon, and after unsuccessful endoscopic hemostasis during colonoscopy. The complaints started the day before admission to the ward with hematochezia. The patient had no complaints before that. Emergency operation and colon resection with terminal colostomy were performed. Pathohistological and immunohistochemical analysis of the tumor showed unclear histogenetic origin from the group of neuroendocrine tumors. Conclusion. Regardless of the asymptomatic period of the disease, these tumors can cause severe bleeding as the first symptom, which can be life-threatening.","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":"68730951","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}
Natasa Djordjevic, Sanja Matic, Dragan Milovanovic, Srdjan Stefanovic, S. Popovic, D. Todorović, P. Djurdjevic, P. Sazdanovic, Vasilije Antic, Slavica Loncar, Slavica Bukumira, Marko Radenkovic, T. Šušteršič, Nenad Filipović, D. Baskić
Introduction/Objective. The duration of vaccine-induced protection against SARS-CoV-2 is shown to be limited. The aim of this study was to assess vaccine effectiveness (VE) of a third dose of four different COVID-19 vaccines during Delta variant predominance in Serbia. Methods. The data for the period from Aug 18th to Oct 1st 2021, were used to estimate the incidence rates of the SARS-CoV-2 infection, COVID-19-related hospitalization, and intensive care unit (ICU) admission. The study included 41,186 fully vaccinated subjects, of which 13,589 had received the third dose. VE was estimated based on the incidence rate ratio following vaccination with three versus two doses. Results. We found that a third dose of all investigated vaccines reduces the incidence of both SARS-CoV-2 infection and severe illness that requires hospitalization or ICU admission. The highest VE against infection demonstrated BNT162b2, followed by Gam-COVID-Vac and BBIBP-CorV. Third dose vaccination reduced the risk of hospitalization (incidence rate IR = 0 for Gam-COVID-Vac and BBIBP-CorV), and ICU admission (IR = 0 for all vaccines). The hazard distributions for SARS-CoV-2 infection and hospitalization following vaccination with three versus two doses were significantly different. Conclusion. These findings indicate that an additional, third dose of studied vaccine boosters protection against all investigated outcomes.
{"title":"Effectiveness of a third dose of COVID-19 vaccines against delta variant of SARS-COV-2: A Serbian cohort study","authors":"Natasa Djordjevic, Sanja Matic, Dragan Milovanovic, Srdjan Stefanovic, S. Popovic, D. Todorović, P. Djurdjevic, P. Sazdanovic, Vasilije Antic, Slavica Loncar, Slavica Bukumira, Marko Radenkovic, T. Šušteršič, Nenad Filipović, D. Baskić","doi":"10.2298/sarh221217082d","DOIUrl":"https://doi.org/10.2298/sarh221217082d","url":null,"abstract":"Introduction/Objective. The duration of vaccine-induced protection against SARS-CoV-2 is shown to be limited. The aim of this study was to assess vaccine effectiveness (VE) of a third dose of four different COVID-19 vaccines during Delta variant predominance in Serbia. Methods. The data for the period from Aug 18th to Oct 1st 2021, were used to estimate the incidence rates of the SARS-CoV-2 infection, COVID-19-related hospitalization, and intensive care unit (ICU) admission. The study included 41,186 fully vaccinated subjects, of which 13,589 had received the third dose. VE was estimated based on the incidence rate ratio following vaccination with three versus two doses. Results. We found that a third dose of all investigated vaccines reduces the incidence of both SARS-CoV-2 infection and severe illness that requires hospitalization or ICU admission. The highest VE against infection demonstrated BNT162b2, followed by Gam-COVID-Vac and BBIBP-CorV. Third dose vaccination reduced the risk of hospitalization (incidence rate IR = 0 for Gam-COVID-Vac and BBIBP-CorV), and ICU admission (IR = 0 for all vaccines). The hazard distributions for SARS-CoV-2 infection and hospitalization following vaccination with three versus two doses were significantly different. Conclusion. These findings indicate that an additional, third dose of studied vaccine boosters protection against all investigated outcomes.","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":"68731192","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}
D. Prokić, S. Djuricic, I. Kitić, M. Kocic, S. Pašić, Biljana Vuletić
Introduction/Objective. To assess the applicability of serum anti-tissue transglutaminase (tTG) antibodies IgA and IgG concentration and HLA DQ2/DQ8 typing as a non-invasive alternative to duodenal biopsy in diagnosing celiac disease in pediatric population. Methods. A prospective cohort study included a total of 179 pediatric patients aged 1- 18 years. Determination of tTG IgA and tTG IgG antibodies and human leukocyte antigen (HLA) DQ2/DQ8 typing was performed for all patients. Histology of duodenal biopsies was interpreted by modified Marsh scoring system. Results. Diagnosis of coeliac disease (CD) was confirmed in 101 (56%) of the studied population. In cases of CD, HLA DQ2/DQ8 was positive in 100 patients (99%). The tTG IgA antibodies in concentration higher than 100 U/ml were detected in 77 (76.2%) of the CD patients and in significantly smaller number for tTG IgG 29 (28.7%) (p<0.001). Statistically highly significant association of duodenal lesions Marsh grade 3 with concentration of tTG IgA 10-fold higher than upper level of normal (ULN) was established (p< 0.001) Conclusion. Concentration of tTG IgA 10-fold higher than ULN is in significantly positively correlated with Marsh grade 3 histopathology findings. Specific antibodies determination in in combination with HLA DQ2/DQ8 typing proves to be sufficient for a diagnosis of CD, supporting the fact that duodenal biopsy may be avoided in significant majority of patients - 75%.
{"title":"Assessment of diagnostic value of HLA DQ2/DQ8 typing and anti-tissue transglutaminase antibodies as an alternative to duodenal biopsy in pediatric celiac disease","authors":"D. Prokić, S. Djuricic, I. Kitić, M. Kocic, S. Pašić, Biljana Vuletić","doi":"10.2298/sarh230113064p","DOIUrl":"https://doi.org/10.2298/sarh230113064p","url":null,"abstract":"Introduction/Objective. To assess the applicability of serum anti-tissue transglutaminase (tTG) antibodies IgA and IgG concentration and HLA DQ2/DQ8 typing as a non-invasive alternative to duodenal biopsy in diagnosing celiac disease in pediatric population. Methods. A prospective cohort study included a total of 179 pediatric patients aged 1- 18 years. Determination of tTG IgA and tTG IgG antibodies and human leukocyte antigen (HLA) DQ2/DQ8 typing was performed for all patients. Histology of duodenal biopsies was interpreted by modified Marsh scoring system. Results. Diagnosis of coeliac disease (CD) was confirmed in 101 (56%) of the studied population. In cases of CD, HLA DQ2/DQ8 was positive in 100 patients (99%). The tTG IgA antibodies in concentration higher than 100 U/ml were detected in 77 (76.2%) of the CD patients and in significantly smaller number for tTG IgG 29 (28.7%) (p<0.001). Statistically highly significant association of duodenal lesions Marsh grade 3 with concentration of tTG IgA 10-fold higher than upper level of normal (ULN) was established (p< 0.001) Conclusion. Concentration of tTG IgA 10-fold higher than ULN is in significantly positively correlated with Marsh grade 3 histopathology findings. Specific antibodies determination in in combination with HLA DQ2/DQ8 typing proves to be sufficient for a diagnosis of CD, supporting the fact that duodenal biopsy may be avoided in significant majority of patients - 75%.","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":"68731791","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}
{"title":"Physicians are humans and replaceable - the current millennium approach","authors":"G. Teofilovski-Parapid","doi":"10.2298/sarh230222020t","DOIUrl":"https://doi.org/10.2298/sarh230222020t","url":null,"abstract":"<jats:p>nema</jats:p>","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":"68732587","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/Objective. Glaucoma diagnosis often induces fear of vision loss and blindness, as well as concerns related to the lifelong use of eye drops and financial expenses, which can lead to certain emotional disorders, depression and anxiety in particular. As these psychological disturbances usually coexist with physical disorders, the aim of the present study was to assess the risk factors for depression in patients with glaucoma. Methods. This cross-sectional study involved 132 consecutive glaucoma patients that were seen between September 2018 and December 2019 at the Glaucoma Department of Clinic for Eye Diseases, University Clinical Centre of Serbia in Belgrade. All participants completed the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale to assess depression and anxiety, respectively. Results. The mean age of glaucoma patients was 65.67 ? 8.63 years, whereby the mean age in the group with depression/anxiety was 65.74 ? 7.6/64.67 ? 5.51. Prevalence of cardiovascular diseases and previous surgery was statistically significantly greater among glaucoma patients exhibiting depression relative to those that did not report any depressive symptoms (42.6% vs. 15.4%, 66.7% vs. 34.6 %, respectively). On the other hand, these two groups were indistinguishable with respect to the evaluated ophthalmological parameters and the number of eye drops used to treat glaucoma. Conclusion. Our analyses revealed that low economic status, poor health, prevalence of cardiovascular diseases, history of surgeries, and non-beneficial lifestyle habits such as coffee consumption are the main risk factors for depression. However, none of the investigated clinical ophthalmological characteristics emerged as the risk factors for depression.
{"title":"Risk factors for depression in glaucoma patients","authors":"V. Marić, M. Božić, I. Marjanović, M. Stamenkovic","doi":"10.2298/sarh230301047m","DOIUrl":"https://doi.org/10.2298/sarh230301047m","url":null,"abstract":"Introduction/Objective. Glaucoma diagnosis often induces fear of vision loss and blindness, as well as concerns related to the lifelong use of eye drops and financial expenses, which can lead to certain emotional disorders, depression and anxiety in particular. As these psychological disturbances usually coexist with physical disorders, the aim of the present study was to assess the risk factors for depression in patients with glaucoma. Methods. This cross-sectional study involved 132 consecutive glaucoma patients that were seen between September 2018 and December 2019 at the Glaucoma Department of Clinic for Eye Diseases, University Clinical Centre of Serbia in Belgrade. All participants completed the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale to assess depression and anxiety, respectively. Results. The mean age of glaucoma patients was 65.67 ? 8.63 years, whereby the mean age in the group with depression/anxiety was 65.74 ? 7.6/64.67 ? 5.51. Prevalence of cardiovascular diseases and previous surgery was statistically significantly greater among glaucoma patients exhibiting depression relative to those that did not report any depressive symptoms (42.6% vs. 15.4%, 66.7% vs. 34.6 %, respectively). On the other hand, these two groups were indistinguishable with respect to the evaluated ophthalmological parameters and the number of eye drops used to treat glaucoma. Conclusion. Our analyses revealed that low economic status, poor health, prevalence of cardiovascular diseases, history of surgeries, and non-beneficial lifestyle habits such as coffee consumption are the main risk factors for depression. However, none of the investigated clinical ophthalmological characteristics emerged as the risk factors for depression.","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":"68732641","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. Short bowel syndrome in children is a rare disease. One of the most common etiological factors for the development of short bowel syndrome in children is atresia of the small intestine. After surgical correction of the congenital anomaly, the remaining intestine attempts to increase absorption to restore homeostasis, and the process of intestinal adaptation begins. This process of adaptation can be assisted with analogues of endogenous growth factors of the intestine, such as teduglutide. Case outline. A girl, aged two years and eight months, who had an estimated 20 cm of small intestine after surgical correction of congenital small bowel atresia and clinical signs of short bowel syndrome. She was repeatedly hospitalized due to frequent need for parenteral correction of fluid, electrolyte, and nutrient imbalances. Stagnation in body weight and slow growth in body height were accompanied by weakened gross motor strength and slowed psychophysical development. After exploit conservative treatment measures, stimulation of intestinal adaptation was initiated with the drug teduglutide. After 6 months of drug therapy, progress was observed in body parameters, as well as an increase in intelligence quotient and motor abilities. Conclusion. Short bowel syndrome is a challenging entity for every clinician, and its previous therapy has mainly consisted of parenteral substitution of nutrients, fluids, and electrolytes. Surgical treatment carries the risk of loss of the remaining bowel and lifelong immunosuppression. The pharmacological possibilities of promoting intestinal adaptation using drugs such as teduglutide represent a light at the end of the tunnel for patients with short bowel syndrome.
{"title":"Teduglutide therapy in a child with short bowel syndrome","authors":"M. Stojsic, T. Redzek-Mudrinic, A. Mikov","doi":"10.2298/sarh230316048s","DOIUrl":"https://doi.org/10.2298/sarh230316048s","url":null,"abstract":"Introduction. Short bowel syndrome in children is a rare disease. One of the most common etiological factors for the development of short bowel syndrome in children is atresia of the small intestine. After surgical correction of the congenital anomaly, the remaining intestine attempts to increase absorption to restore homeostasis, and the process of intestinal adaptation begins. This process of adaptation can be assisted with analogues of endogenous growth factors of the intestine, such as teduglutide. Case outline. A girl, aged two years and eight months, who had an estimated 20 cm of small intestine after surgical correction of congenital small bowel atresia and clinical signs of short bowel syndrome. She was repeatedly hospitalized due to frequent need for parenteral correction of fluid, electrolyte, and nutrient imbalances. Stagnation in body weight and slow growth in body height were accompanied by weakened gross motor strength and slowed psychophysical development. After exploit conservative treatment measures, stimulation of intestinal adaptation was initiated with the drug teduglutide. After 6 months of drug therapy, progress was observed in body parameters, as well as an increase in intelligence quotient and motor abilities. Conclusion. Short bowel syndrome is a challenging entity for every clinician, and its previous therapy has mainly consisted of parenteral substitution of nutrients, fluids, and electrolytes. Surgical treatment carries the risk of loss of the remaining bowel and lifelong immunosuppression. The pharmacological possibilities of promoting intestinal adaptation using drugs such as teduglutide represent a light at the end of the tunnel for patients with short bowel syndrome.","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":"68732755","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}
Stefan Brunet, Nikola Babic, Sofija Davidovic, Aleksandar Miljkovic, Nikola Knezi, Vladimir Canadanovic
Introduction/Objective. Age-related cataract is a significant cause of visual impairment worldwide. Oxidative damage and the effects of free radical species are considered important in the etiopathogenesis of cataracts. The aim of this study was to evaluate the antioxidative capacity and oxidative stress in the aqueous humor according to age and cataracts maturity. Methods. Clinical and biochemical researches were carried out in 55 patients with age-related cataract. According to the cataract maturity patients were classified into incipient (cortical-group C, 18 pts, nuclear-group N, 20 pts) and mature (group M, 17 pts). In order to evaluate the impact of age patients within each group were divided in: Group I (65-69 years) and Group II (70 ? years). The antioxidant activity of aqueous humor was measured by the reduction power (RP) method and the activity of glutathione peroxidase (GPx) spectrophotometrically. Changes in the concentrations of hydroxyl and ascorbyl radicals were detected by electron spin resonance spectroscopy. Results. Both RP and GPx activitiy were significantly (p < 0.001) reduced in group N compared to group C and in group M compared to group N. Concentrations of hydroxyl (29.45 ? 1.01% in group C, 38.12 ? 1.29% in group N and 74.14 ? 2.52% in group M) and ascorbyl radicals (26.12 ? 0.89% in group C, 41.15 ? 1.39% in group N and 83.56 ? 2.84% in group M) increased significantly (p < 0.05) with progression of age-related cataract. Significant negative correlation (r = -0.759, p < 0.05) was determined between concentrations of hydroxyl radicals and content of GPx. Conclusion. Our research proved that the level of oxidative stress in the aqueous humor is significantly affected during aging and cataract progression, The obtained data support the hypothesis that during aging, depending on the maturity of the cataract, the antioxidant capacity in the aqueous humor decreases due to an increase in the concentration of reactive hydroxyl radicals.
{"title":"Antioxidant and free radicals species in the aqueous humor of patients with age-related cataract","authors":"Stefan Brunet, Nikola Babic, Sofija Davidovic, Aleksandar Miljkovic, Nikola Knezi, Vladimir Canadanovic","doi":"10.2298/sarh230619092b","DOIUrl":"https://doi.org/10.2298/sarh230619092b","url":null,"abstract":"Introduction/Objective. Age-related cataract is a significant cause of visual impairment worldwide. Oxidative damage and the effects of free radical species are considered important in the etiopathogenesis of cataracts. The aim of this study was to evaluate the antioxidative capacity and oxidative stress in the aqueous humor according to age and cataracts maturity. Methods. Clinical and biochemical researches were carried out in 55 patients with age-related cataract. According to the cataract maturity patients were classified into incipient (cortical-group C, 18 pts, nuclear-group N, 20 pts) and mature (group M, 17 pts). In order to evaluate the impact of age patients within each group were divided in: Group I (65-69 years) and Group II (70 ? years). The antioxidant activity of aqueous humor was measured by the reduction power (RP) method and the activity of glutathione peroxidase (GPx) spectrophotometrically. Changes in the concentrations of hydroxyl and ascorbyl radicals were detected by electron spin resonance spectroscopy. Results. Both RP and GPx activitiy were significantly (p < 0.001) reduced in group N compared to group C and in group M compared to group N. Concentrations of hydroxyl (29.45 ? 1.01% in group C, 38.12 ? 1.29% in group N and 74.14 ? 2.52% in group M) and ascorbyl radicals (26.12 ? 0.89% in group C, 41.15 ? 1.39% in group N and 83.56 ? 2.84% in group M) increased significantly (p < 0.05) with progression of age-related cataract. Significant negative correlation (r = -0.759, p < 0.05) was determined between concentrations of hydroxyl radicals and content of GPx. Conclusion. Our research proved that the level of oxidative stress in the aqueous humor is significantly affected during aging and cataract progression, The obtained data support the hypothesis that during aging, depending on the maturity of the cataract, the antioxidant capacity in the aqueous humor decreases due to an increase in the concentration of reactive hydroxyl radicals.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"13 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":"135449827","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. Calcaneus fractures are rare but potentially debilitating injuries. Most of them are displaced intraarticular fractures, which management represents one of the controversial issues. There is no consensus on whether to operate or not. The most often chosen surgical treatment is open reduction and internal fixation as the primary method. Failure of this surgery often needs secondary subtalar arthrodesis as definitive management, so primary subtalar arthrodesis in cases with severe comminution represents definitive treatment in one stage with good functional results. Case outline. We present the case of a 54-year-old male patient with a severely comminuted (Sanders type IV) bilateral calcaneus fracture. After the withdrawal of local swelling and disappearance of fracture blisters patient was operated on using one-stage bilateral subtalar arthrodesis with percutaneous screw fixation and bone grafting performed through a mini-open sinus tarsi approach. The early postoperative period went unremarkably. The patient did not walk for the first seven postoperative weeks, after which rehabilitation was continued with partial weight bearing with a gradual increase of weight-bearing to full through the next five weeks, after which walking aids were completely phased out. Three years after surgery patient has no symptoms and has a close-to-normal gait. Conclusion. Although this type of injury has traditionally been treated with open reduction and internal fixation, we believe that primary subtalar arthrodesis with bone grafting through a mini-open sinus tarsi approach can benefit patients with severe comminution of calcaneus, allowing good functional results and patient satisfaction, with fewer postoperative complications and faster definitive recovery.
{"title":"Primary subtalar arthrodesis with percutaneous screw fixation and bone grafting through mini-open sinus tarsi approach for sanders type iv bilateral calcaneal fracture - three-year follow-up case report","authors":"Zelimir Jovanovic, Lazar Miceta, Nemanja Jovanovic, Danilo Jeremic, Nemanja Slavkovic","doi":"10.2298/sarh230206107j","DOIUrl":"https://doi.org/10.2298/sarh230206107j","url":null,"abstract":"Introduction. Calcaneus fractures are rare but potentially debilitating injuries. Most of them are displaced intraarticular fractures, which management represents one of the controversial issues. There is no consensus on whether to operate or not. The most often chosen surgical treatment is open reduction and internal fixation as the primary method. Failure of this surgery often needs secondary subtalar arthrodesis as definitive management, so primary subtalar arthrodesis in cases with severe comminution represents definitive treatment in one stage with good functional results. Case outline. We present the case of a 54-year-old male patient with a severely comminuted (Sanders type IV) bilateral calcaneus fracture. After the withdrawal of local swelling and disappearance of fracture blisters patient was operated on using one-stage bilateral subtalar arthrodesis with percutaneous screw fixation and bone grafting performed through a mini-open sinus tarsi approach. The early postoperative period went unremarkably. The patient did not walk for the first seven postoperative weeks, after which rehabilitation was continued with partial weight bearing with a gradual increase of weight-bearing to full through the next five weeks, after which walking aids were completely phased out. Three years after surgery patient has no symptoms and has a close-to-normal gait. Conclusion. Although this type of injury has traditionally been treated with open reduction and internal fixation, we believe that primary subtalar arthrodesis with bone grafting through a mini-open sinus tarsi approach can benefit patients with severe comminution of calcaneus, allowing good functional results and patient satisfaction, with fewer postoperative complications and faster definitive recovery.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"59 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":"135759424","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 Medjo, Olivera Calovic, Marija Karlicic, Misela Raus, Vladimir Radlovic, Dejan Nikolic
Introduction/Objective. Physical therapy aims to improve airway clearance, breathing and enhance gas exchange. It is widely used as an additional therapy in children with pneumonia. The aim of this study was to assess the effects of complications and comorbidities on physical therapy duration in children with pneumonia. Methods. We conducted a retrospective descriptive study including 40 children with pneumonia admitted to a tertiary children hospital. Study participants were divided into two groups, group with and without complications and group with and without comorbidities. All children received physical therapy one time daily five days a week plus standard treatment for pneumonia. Physical therapy procedures that were applied were chest physical therapy and kinesiotherapy. Results. Chest physical therapy (p < 0.001) and kinesiotherapy (p = 0.024) were applied significantly longer in group with complications versus those without complications. Chest physical therapy was applied significantly longer in group with comorbidities versus group without comorbidities (p < 0.001), while there was no difference regarding duration of kinesiotherapy in group with and without comorbidities (p = 0.239). Conclusion. Our results show that the presence of complications and/or comorbidities significantly prolongs the duration of chest physical therapy in children with pneumonia.
{"title":"The effects of complications and comorbidities on physical therapy duration in children with pneumonia","authors":"Biljana Medjo, Olivera Calovic, Marija Karlicic, Misela Raus, Vladimir Radlovic, Dejan Nikolic","doi":"10.2298/sarh230627097m","DOIUrl":"https://doi.org/10.2298/sarh230627097m","url":null,"abstract":"Introduction/Objective. Physical therapy aims to improve airway clearance, breathing and enhance gas exchange. It is widely used as an additional therapy in children with pneumonia. The aim of this study was to assess the effects of complications and comorbidities on physical therapy duration in children with pneumonia. Methods. We conducted a retrospective descriptive study including 40 children with pneumonia admitted to a tertiary children hospital. Study participants were divided into two groups, group with and without complications and group with and without comorbidities. All children received physical therapy one time daily five days a week plus standard treatment for pneumonia. Physical therapy procedures that were applied were chest physical therapy and kinesiotherapy. Results. Chest physical therapy (p < 0.001) and kinesiotherapy (p = 0.024) were applied significantly longer in group with complications versus those without complications. Chest physical therapy was applied significantly longer in group with comorbidities versus group without comorbidities (p < 0.001), while there was no difference regarding duration of kinesiotherapy in group with and without comorbidities (p = 0.239). Conclusion. Our results show that the presence of complications and/or comorbidities significantly prolongs the duration of chest physical therapy in children with pneumonia.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"144 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":"135505594","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. Chromosomal numerical aberrations are very common in hematological malignancies, but near-tetraploidy (80-104 chromosomes) is rare in myeloid lineage malignancies, with only a few cases reported in myelodysplastic syndrome (MDS). Due to a small number of cases with this rare cytogenetic abnormality, clinicopathological significance of near-tetraploidy in MDS is still unknown. In this case report we present a case of de novo MDS patient with near-tetraploidy in association with TP53 mutation, and we aimed to elucidate the prognostic significance of this rare genetic feature. Case Outline. In August of 2018 a 71-year-old male presented with severe anemia, thrombocytopenia, and leucopenia and enlarged spleen. Laboratory data were as follows: hemoglobin (Hb) 93 g/L, white blood cells (WBC) 2.8?109/L and platelets 23x109/L. The bone marrow aspirate was hypercellular, megakaryocytes were not found, granulocytic cells were 15% with signs of dysplasia, with 16% of blast cells without Auer rods. The finding was in correlation with diagnosis of MDS, type RAEB2 which was also confirmed by immunophenotyping. Cytogenetic finding was near-tetraploidy (48,XY+mar[10]/92,XXYY[10]), and TP53 mutational analysis showed the presence of mutation in exon 8 (p.D281A; c.842 A>C). The patient received from time-to-time packed red blood cells and platelets, and died four months after initial diagnosis. Conclusion. Near-tetraploidy associated with TP53 mutation has been described only in few MDS cases. Results of these reports including ours suggest that the association of TP53 mutation and near-tetra polyploidy is a poor prognostic factor.
{"title":"Rare case of myelodysplastic syndrome with near-tetraploidy and TP53 mutation","authors":"Natasa Colovic, Vesna Djordjevic, Milica Radojkovic, Teodora Karan-Djurasevic, Natasa Tosic","doi":"10.2298/sarh230728100c","DOIUrl":"https://doi.org/10.2298/sarh230728100c","url":null,"abstract":"Introduction. Chromosomal numerical aberrations are very common in hematological malignancies, but near-tetraploidy (80-104 chromosomes) is rare in myeloid lineage malignancies, with only a few cases reported in myelodysplastic syndrome (MDS). Due to a small number of cases with this rare cytogenetic abnormality, clinicopathological significance of near-tetraploidy in MDS is still unknown. In this case report we present a case of de novo MDS patient with near-tetraploidy in association with TP53 mutation, and we aimed to elucidate the prognostic significance of this rare genetic feature. Case Outline. In August of 2018 a 71-year-old male presented with severe anemia, thrombocytopenia, and leucopenia and enlarged spleen. Laboratory data were as follows: hemoglobin (Hb) 93 g/L, white blood cells (WBC) 2.8?109/L and platelets 23x109/L. The bone marrow aspirate was hypercellular, megakaryocytes were not found, granulocytic cells were 15% with signs of dysplasia, with 16% of blast cells without Auer rods. The finding was in correlation with diagnosis of MDS, type RAEB2 which was also confirmed by immunophenotyping. Cytogenetic finding was near-tetraploidy (48,XY+mar[10]/92,XXYY[10]), and TP53 mutational analysis showed the presence of mutation in exon 8 (p.D281A; c.842 A>C). The patient received from time-to-time packed red blood cells and platelets, and died four months after initial diagnosis. Conclusion. Near-tetraploidy associated with TP53 mutation has been described only in few MDS cases. Results of these reports including ours suggest that the association of TP53 mutation and near-tetra polyploidy is a poor prognostic factor.","PeriodicalId":22263,"journal":{"name":"Srpski arhiv za celokupno lekarstvo","volume":"64 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":"135561032","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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