Introduction. Sustained monomorphic ventricular tachycardia (SMVT) is a rare, underdiagnosed pathology, with a very poor prognosis. Along with ventricular fibrillation, SMVT is responsible for nearly all of the arrhythmic sudden cardiac death (SCD). The most common cause of ventricular tachycardia is ischemic heart disease, but there are many other reasons, among which are: arrhythmogenic right ventricular cardiomyopathy (ARVD) and myocardial bridging phenomenon. Treatment options include a hybrid approach consisting of antiarrhythmic drugs, catheter ablation and implantable cardioverter defibrillators (ICD). Case report. We present a case of 46-year old man, military officer, who experienced chest pain, palpitations and nausea during regularly physical activity at home. Due to the symptoms described, he examined immediately and diagnosed sustained monomorphic ventricular tachycardia. Shortly after the diagnosis, he lost consciousness, and successfully resuscitated. A complete non-invasive and invasive cardiology examination performed and it revealed that the patient had stable coronary disease, a muscle bridge on the LAD, and arrhythmogenic right ventricular cardiomyopathy suspected after transthoracic echocardiography and heart MRI. Genetic testing for ARVD was negative, but according to the Heart Rhythm Society (HRS) expert consensus criteria, we had enough for a definitive diagnosis. Conclusion. SMVT is the most common cause of sudden cardiac death. It is of inestimable importance to carry out a detailed examination and determine the immediate cause of the arrhythmia and the right therapy, which for these patients is a life-saving form of treatment. Therapy includes medications, electrophysiology, or ICD, or a combination of these treatment approaches.
{"title":"Sudden sustained monomorphic ventricular tachycardia in a previously healthy adult with many causes for it, but which one is the correct? A case report","authors":"Zoran Jovic, Miljan Opancina, Zorica Mladenovic, Predrag Djuric, Ivica Djuric, Jelena Maric-Kocijacic, Nemanja Djenic, Valentina Opancina, Slobodan Obradovic","doi":"10.2298/vsp230619065j","DOIUrl":"https://doi.org/10.2298/vsp230619065j","url":null,"abstract":"Introduction. Sustained monomorphic ventricular tachycardia (SMVT) is a rare, underdiagnosed pathology, with a very poor prognosis. Along with ventricular fibrillation, SMVT is responsible for nearly all of the arrhythmic sudden cardiac death (SCD). The most common cause of ventricular tachycardia is ischemic heart disease, but there are many other reasons, among which are: arrhythmogenic right ventricular cardiomyopathy (ARVD) and myocardial bridging phenomenon. Treatment options include a hybrid approach consisting of antiarrhythmic drugs, catheter ablation and implantable cardioverter defibrillators (ICD). Case report. We present a case of 46-year old man, military officer, who experienced chest pain, palpitations and nausea during regularly physical activity at home. Due to the symptoms described, he examined immediately and diagnosed sustained monomorphic ventricular tachycardia. Shortly after the diagnosis, he lost consciousness, and successfully resuscitated. A complete non-invasive and invasive cardiology examination performed and it revealed that the patient had stable coronary disease, a muscle bridge on the LAD, and arrhythmogenic right ventricular cardiomyopathy suspected after transthoracic echocardiography and heart MRI. Genetic testing for ARVD was negative, but according to the Heart Rhythm Society (HRS) expert consensus criteria, we had enough for a definitive diagnosis. Conclusion. SMVT is the most common cause of sudden cardiac death. It is of inestimable importance to carry out a detailed examination and determine the immediate cause of the arrhythmia and the right therapy, which for these patients is a life-saving form of treatment. Therapy includes medications, electrophysiology, or ICD, or a combination of these treatment approaches.","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","volume":"45 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":"135448043","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}
Vidna Karadzic-Ristanovic, Selena Gajic, Ana Bontic, Jelena Pavlovic, Aleksandra Kezic, Jovana Radovanovic, Milan Radovic
Background/Aim. Chronic kidney disease (CKD) is a global health concern associated with increased cardiovascular risks and premature mortality. Proteinuria is a vital prognostic indicator for CKD outcomes. Sodium-glucose cotransporter 2 (SGLT2) inhibitors show promise in reducing proteinuria and slowing CKD progression. The aim of the study was to investigate the impact of SGLT2 inhibitor therapy on CKD patients over one year, evaluating serum creatinine (sCr), 24-hour urine protein (24hPiU), estimated glomerular filtration rate (eGFR), and blood pressure changes. Methods. This prospective study monitored 79 CKD patients on therapy with SGLT2 inhibitors. Patients received an SGLT2 inhibitor (dapagliflozin) once daily (10 mg), and assessments were conducted at baseline, 6 months and 1 year. The study evaluated sCr, 24hPiU, eGFR, systolic blood pressure (BPs), diastolic blood pressure (BPd), uric acid (UA), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL), sodium (Na+), and potassium (K+). Results. Over the one-year follow-up, significant changes were seen in UA levels (5.36 ? 4.99 ? 4.94 mg/dL; p=0.032), 24hPiU (662.60 ? 574.11 ? 507.72 mg/dL; p=0.026), as well as BPs (128.44 ? 125.64 ? 126.12 mmHg ; p=0.028). No significant variations were observed in BPd, sCr, TC, TG, LDL, K levels. Na+ levels displayed anotable decrease (148.21 ? 147.57 ? 146.41 mmol/L; p=0.021). Conclusion. The study suggests potential benefits of SGLT2 inhibitors in managing CKD.
{"title":"Evaluating the renoprotective effectiveness of SGLT2 inhibitor therapy in patients with chronic kidney disease: A prospective study","authors":"Vidna Karadzic-Ristanovic, Selena Gajic, Ana Bontic, Jelena Pavlovic, Aleksandra Kezic, Jovana Radovanovic, Milan Radovic","doi":"10.2298/vsp230805061k","DOIUrl":"https://doi.org/10.2298/vsp230805061k","url":null,"abstract":"Background/Aim. Chronic kidney disease (CKD) is a global health concern associated with increased cardiovascular risks and premature mortality. Proteinuria is a vital prognostic indicator for CKD outcomes. Sodium-glucose cotransporter 2 (SGLT2) inhibitors show promise in reducing proteinuria and slowing CKD progression. The aim of the study was to investigate the impact of SGLT2 inhibitor therapy on CKD patients over one year, evaluating serum creatinine (sCr), 24-hour urine protein (24hPiU), estimated glomerular filtration rate (eGFR), and blood pressure changes. Methods. This prospective study monitored 79 CKD patients on therapy with SGLT2 inhibitors. Patients received an SGLT2 inhibitor (dapagliflozin) once daily (10 mg), and assessments were conducted at baseline, 6 months and 1 year. The study evaluated sCr, 24hPiU, eGFR, systolic blood pressure (BPs), diastolic blood pressure (BPd), uric acid (UA), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL), sodium (Na+), and potassium (K+). Results. Over the one-year follow-up, significant changes were seen in UA levels (5.36 ? 4.99 ? 4.94 mg/dL; p=0.032), 24hPiU (662.60 ? 574.11 ? 507.72 mg/dL; p=0.026), as well as BPs (128.44 ? 125.64 ? 126.12 mmHg ; p=0.028). No significant variations were observed in BPd, sCr, TC, TG, LDL, K levels. Na+ levels displayed anotable decrease (148.21 ? 147.57 ? 146.41 mmol/L; p=0.021). Conclusion. The study suggests potential benefits of SGLT2 inhibitors in managing CKD.","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","volume":"5 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":"134979762","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}
Sanja Ostojic-Zeljkovic, Mina Nikolic, Sanja Djokovic
Introduction. Treacher Collins syndrome (TCS) is a rare genetic condition characterized by typical head and neck malformations occurring in 1:50,000 newborns. Permanent conductive or mixed hearing loss of various degrees is diagnosed in 50% of individuals with TCS. Adequate amplification of conductive or mixed hearing loss is the prerequisite for speech and language development in those children. The degree of hearing loss and type of ear malformation implies the choice of hearing aids. Case report. We present a patient with multiple genetic malformations due to TCS. The patient (girl) was immediately after birth referred for audiological evaluation because of considerable ear and face malformations. Permanent mixed, predominantly conductive, bilateral hearing loss severe degree was diagnosed using a hearing test battery. The use of bone conduction hearing aids, including the Vibrant Soundbridge middle ear implant did not provide sufficient amplification for adequate speech and language development, and the cochlear implantation performed at the age of nine has finally provided sufficient stimulation for the adequate development of communication and academic achievements. Conclusion. Even though cochlear implantation is rarely considered as a solution for the amplification of hearing impairment in TCS patients, the case of the presented patient has proved that a middle ear implant was insufficient for adequate amplification, so cochlear implantation was necessary to obtain an adequate aided threshold for the full development of communication skills. Cochlear implantation should be considered a plausible solution for permanent severe mixed hearing loss in patients with TCS, when other amplification solutions do not provide adequate aided threshold.
{"title":"Cochlear implantation for severe mixed hearing loss caused by Treacher Collins syndrome: Case report","authors":"Sanja Ostojic-Zeljkovic, Mina Nikolic, Sanja Djokovic","doi":"10.2298/vsp221026066o","DOIUrl":"https://doi.org/10.2298/vsp221026066o","url":null,"abstract":"Introduction. Treacher Collins syndrome (TCS) is a rare genetic condition characterized by typical head and neck malformations occurring in 1:50,000 newborns. Permanent conductive or mixed hearing loss of various degrees is diagnosed in 50% of individuals with TCS. Adequate amplification of conductive or mixed hearing loss is the prerequisite for speech and language development in those children. The degree of hearing loss and type of ear malformation implies the choice of hearing aids. Case report. We present a patient with multiple genetic malformations due to TCS. The patient (girl) was immediately after birth referred for audiological evaluation because of considerable ear and face malformations. Permanent mixed, predominantly conductive, bilateral hearing loss severe degree was diagnosed using a hearing test battery. The use of bone conduction hearing aids, including the Vibrant Soundbridge middle ear implant did not provide sufficient amplification for adequate speech and language development, and the cochlear implantation performed at the age of nine has finally provided sufficient stimulation for the adequate development of communication and academic achievements. Conclusion. Even though cochlear implantation is rarely considered as a solution for the amplification of hearing impairment in TCS patients, the case of the presented patient has proved that a middle ear implant was insufficient for adequate amplification, so cochlear implantation was necessary to obtain an adequate aided threshold for the full development of communication skills. Cochlear implantation should be considered a plausible solution for permanent severe mixed hearing loss in patients with TCS, when other amplification solutions do not provide adequate aided threshold.","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","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":"135560409","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}
Radoslav Romanovic, Boris Dzudovic, Nemanja Djenic, Zoran Jovic, Marjan Spasic, Obrad Djuric, Andjelko Hladis, Dragana Malovic, Slobodan Obradovic
Background/Aim. Patients treated with primary percutaneous coronary intervention (pPCI) and survive ventricular tachycardia (VT) and ventricular fibrillation (VF) in the first 48 hrs of ST-elevation myocardial infarction (STEMI), in most investigations had similar outcome of long-term prognosis compared to those patients not having VT and VF during the first 48 hrs of STEMI. The aim of the study was to determine association of myocardial infarction marker creatine kinase-MB fraction (CK MB), heart failure marker - brain natriuretic peptide and systemic inflammation factor - C reactive protein (CRP) with early VT and VF onset, with regard to 6 months mortality in patients with STEMI. Methods. The study included consecutive patients with STEMI treated with primary PCI during a 10-year period. VF and sustained VT were detected out of hospital and during the first 48 hrs of hospitalization. Results. In this study 971 consecutive patients with STEMI treated with primary PCI. During the first 48 hours from admission 108 (11.1%) patients had life-threatened arrhythmia of which 75 (69.4%) patients had VF and (33 patients, 30.6%) had sustained VT, treated with DC shock and intravenous amiodarone. Intrahospital mortality was significantly higher in patient with VF/sVT at 48 hrs compared to patients without VF/VT - 14.8% vs. 5.7% (p = 0.001). Brain natriuretic peptide (BNP) level had higher accuracy in the prediction of 6-month death than maximum C-reactive protein (CRP) blood level in patients without VF/sVT at 48 hrs, however, in patients with early onset malignant arrhythmias BNP had lower accuracy for the prediction of 6-month death and CRP values had almost the same accuracy. Admission glycaemia had much modest predictive value in both groups of patients compare to BNP and CRP [0.705 (0.628-0.781], p < 0.001 and 0.662 (0.521-0.803), p = 0.046. Maximum CK-MB levels were not predictive for 6-months all-cause mortality in neither groups. Conclusion. Our study indicates that STEMI patients with early onset VT and VF treated with primary PCI with a high BNP level have a statistically significantly higher mortality rate compared to patients with a lower BNP level.
{"title":"The significance of early-onset malignant arrhythmias in STEMI patients treated with primary percutaneous coronary intervention and their relationship with biomarkers","authors":"Radoslav Romanovic, Boris Dzudovic, Nemanja Djenic, Zoran Jovic, Marjan Spasic, Obrad Djuric, Andjelko Hladis, Dragana Malovic, Slobodan Obradovic","doi":"10.2298/vsp230927068r","DOIUrl":"https://doi.org/10.2298/vsp230927068r","url":null,"abstract":"Background/Aim. Patients treated with primary percutaneous coronary intervention (pPCI) and survive ventricular tachycardia (VT) and ventricular fibrillation (VF) in the first 48 hrs of ST-elevation myocardial infarction (STEMI), in most investigations had similar outcome of long-term prognosis compared to those patients not having VT and VF during the first 48 hrs of STEMI. The aim of the study was to determine association of myocardial infarction marker creatine kinase-MB fraction (CK MB), heart failure marker - brain natriuretic peptide and systemic inflammation factor - C reactive protein (CRP) with early VT and VF onset, with regard to 6 months mortality in patients with STEMI. Methods. The study included consecutive patients with STEMI treated with primary PCI during a 10-year period. VF and sustained VT were detected out of hospital and during the first 48 hrs of hospitalization. Results. In this study 971 consecutive patients with STEMI treated with primary PCI. During the first 48 hours from admission 108 (11.1%) patients had life-threatened arrhythmia of which 75 (69.4%) patients had VF and (33 patients, 30.6%) had sustained VT, treated with DC shock and intravenous amiodarone. Intrahospital mortality was significantly higher in patient with VF/sVT at 48 hrs compared to patients without VF/VT - 14.8% vs. 5.7% (p = 0.001). Brain natriuretic peptide (BNP) level had higher accuracy in the prediction of 6-month death than maximum C-reactive protein (CRP) blood level in patients without VF/sVT at 48 hrs, however, in patients with early onset malignant arrhythmias BNP had lower accuracy for the prediction of 6-month death and CRP values had almost the same accuracy. Admission glycaemia had much modest predictive value in both groups of patients compare to BNP and CRP [0.705 (0.628-0.781], p < 0.001 and 0.662 (0.521-0.803), p = 0.046. Maximum CK-MB levels were not predictive for 6-months all-cause mortality in neither groups. Conclusion. Our study indicates that STEMI patients with early onset VT and VF treated with primary PCI with a high BNP level have a statistically significantly higher mortality rate compared to patients with a lower BNP level.","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","volume":"183 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":"135560413","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}
Jovana Lovric, Milisav Markovic, Marko Bulajic, Sasa Zeljkovic, Jana Ilic, Olivera Dolic
Background/Aim. Dental varnishes are effective in preventing caries in children. This study aims to compare the effect of varnishes containing fluoride and casein phosphopeptide-amorphous calcium phosphate on the microhardness and roughness of three specific restorative materials in pediatric dental practice. Methods. The study included 60 discs and 60 bars, made from three commonly used dental restorative materials. After preparation and incubation, and subsequent basic measurement, the samples were divided into two subgroups, each of which was treated with fluoride varnish and casein phosphopeptide-amorphous calcium phosphate according to a precisely established protocol. After treatment, all samples were retested for microhardness and roughness. Results. The application of fluoride varnish and casein phosphopeptideamorphous calcium phosphate varnish increased the microhardness of the hybrid composite and resin-modified GIC but reduced the microhardness of high-viscosity GIC. The roughness was more pronounced with the composite material, as well as with the resinmodified glass ionomer cement. Conclusion. Prophylactic varnishes containing fluoride and calcium have the potential to alter the microhardness and roughness of dental restorations. It is important to carefully select the appropriate varnish, as it can influence the microhardness and roughness properties of the material.
{"title":"The impact of dental varnishes on the immediate surface microhardness and roughness of restorative dental materials: An in vitro study","authors":"Jovana Lovric, Milisav Markovic, Marko Bulajic, Sasa Zeljkovic, Jana Ilic, Olivera Dolic","doi":"10.2298/vsp230530049l","DOIUrl":"https://doi.org/10.2298/vsp230530049l","url":null,"abstract":"Background/Aim. Dental varnishes are effective in preventing caries in children. This study aims to compare the effect of varnishes containing fluoride and casein phosphopeptide-amorphous calcium phosphate on the microhardness and roughness of three specific restorative materials in pediatric dental practice. Methods. The study included 60 discs and 60 bars, made from three commonly used dental restorative materials. After preparation and incubation, and subsequent basic measurement, the samples were divided into two subgroups, each of which was treated with fluoride varnish and casein phosphopeptide-amorphous calcium phosphate according to a precisely established protocol. After treatment, all samples were retested for microhardness and roughness. Results. The application of fluoride varnish and casein phosphopeptideamorphous calcium phosphate varnish increased the microhardness of the hybrid composite and resin-modified GIC but reduced the microhardness of high-viscosity GIC. The roughness was more pronounced with the composite material, as well as with the resinmodified glass ionomer cement. Conclusion. Prophylactic varnishes containing fluoride and calcium have the potential to alter the microhardness and roughness of dental restorations. It is important to carefully select the appropriate varnish, as it can influence the microhardness and roughness properties of the material.","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","volume":"12 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":"135599952","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 Todorovic, Boban Bisevac, Stevo Lukic, Jovan Ilic, Dejan Aleksic
Introduction. Periventricular nodular heterotopia (PNH) is a malformation of cortical development which is characterized by abnormal migration of neurons to the cortical plate and is very often linked to drug -resistant focal epilepsy. Case report. A 33-year-old woman with a severe drug-resistant epilepsy is presented. She suffered from focal epilepsy predominantly characterized by focal seizures and occasionally focal to bilateral tonic-clonic seizures. Magnetic resonance imaging showed bilateral heterotopic nodules in the occipital horns of the lateral ventricles. 18-Fluoro-deoxyglucose positron emission tomography (FDG-PET) scan demonstrated a zone of reduced glucose metabolism on the right temporal region. Electroencephalogram suggested focal electrocortical activity on the temporo-parieto-occipital regions, predominantly on the temporal right. The woman was treated with polytherapy (valproic acid, lamotrigine, levetiracetam, oxcarbazepine, pregabalin, clobazam, lacosamide) but it did not affect the seizure frequency. Surgical treatment was not recommended due to bilateral localization of the heterotopic nodules. We decided on vagus nerve stimulation (VNS) and achieved satisfying seizure control. Conclusion. Patients with PNH require multidisciplinary assessment and treatment, while this report represents a case of a patient with satisfying seizure control after the VNS implantation.
{"title":"Satisfying outcome in a patient with drug-resistant epilepsy due to periventricular nodular heterotopia treated with vagus nerve stimulation","authors":"Stefan Todorovic, Boban Bisevac, Stevo Lukic, Jovan Ilic, Dejan Aleksic","doi":"10.2298/vsp230217046t","DOIUrl":"https://doi.org/10.2298/vsp230217046t","url":null,"abstract":"Introduction. Periventricular nodular heterotopia (PNH) is a malformation of cortical development which is characterized by abnormal migration of neurons to the cortical plate and is very often linked to drug -resistant focal epilepsy. Case report. A 33-year-old woman with a severe drug-resistant epilepsy is presented. She suffered from focal epilepsy predominantly characterized by focal seizures and occasionally focal to bilateral tonic-clonic seizures. Magnetic resonance imaging showed bilateral heterotopic nodules in the occipital horns of the lateral ventricles. 18-Fluoro-deoxyglucose positron emission tomography (FDG-PET) scan demonstrated a zone of reduced glucose metabolism on the right temporal region. Electroencephalogram suggested focal electrocortical activity on the temporo-parieto-occipital regions, predominantly on the temporal right. The woman was treated with polytherapy (valproic acid, lamotrigine, levetiracetam, oxcarbazepine, pregabalin, clobazam, lacosamide) but it did not affect the seizure frequency. Surgical treatment was not recommended due to bilateral localization of the heterotopic nodules. We decided on vagus nerve stimulation (VNS) and achieved satisfying seizure control. Conclusion. Patients with PNH require multidisciplinary assessment and treatment, while this report represents a case of a patient with satisfying seizure control after the VNS implantation.","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","volume":"42 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":"135400709","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}
Lora Novaković-Lacković, Ljilja Latinovic-Tadic, M. Stanetić, Marko Lacković
Background/Aim. The fact that lung carcinomas, like other solid tumours, can be immunogenic, may have a substantial prognostic value in non-small cell lung cancer. Specific cytotoxic T-lymphocytes can be demonstrated in most patients with primary tumours of different histological types. Two main groups of T-lymphocytes participate in the coupled recognition of tumour-specific antigens - cytotoxic T-lymphocytes (CD8+, cluster of differentiation 8) and helper T-lymphocytes (CD4+, cluster of differentiation 4). The main goal of this research was to assess the relationship between the tumour infiltration of T-lymphocytes and the therapeutic response to initial chemotherapy. Methods. Data were obtained from patients with non-small cell lung cancer whose therapeutic response after four cycles of initial platinum chemotherapy was observed in relation to the density of tumour-infiltrating T-lymphocytes (CD4+ and CD8+) in small tumour biopsy samples. The therapeutic response was assessed in line with RECIST 1.1. therapeutic response evaluation system. Based on the expected therapeutic response, the patients were divided into three following groups: favourable therapeutic response patients (complete and partial regression), stable disease patients and disease progression patients. To assess the density of CD4+ and CD8+ T-lymphocytes, the number of lymphocytes was determined at x200 (1.1mm2) magnification. Three visual fields with the most dense lymphocyte infiltrate were selected for counting, and the values of all individual fields were added up. Based on the mean value, the samples were classified into the following groups: score 0, 1, 2 and 3. During statistical processing of the data, low infiltration density combined score 0 and score 1 group, and high infiltration density combined score 2 and score 3 group. Based on the collected data, a database was created in SPSS 22.0 software and used for further statistical analysis. The statistical analysis of the data included the method of descriptive and analytical statistics. Results. The results did not show any difference in distribution of CD4+ T-lymphocytes in epithelial components between patients with a different therapeutical response (?2=2,977; p= 0.226). Also, there was not any significant difference in the distribution of CD8+ T-lymphocytes in epithelial component between patients with a different therapeutical response (?2=1,329; p=0.515). There was no significant influence of the infiltration density of CD4+ T-lymphocytes in the stromal component on the therapeutic response (?2=0,606; p=0.739) and also, there was no significant influence of the infiltration density of CD8+ T-lymphocytes in stromal component on the therapeutic response (?2=5,167; p=0.076). Conclusion. The research did not prove that patients with a high level of tumour-infiltrating CD4+ and CD8+ T-lymphocytes in the epithelial and stromal component of the tumour (non-small cell lung cancer)
{"title":"Prognostic value of tumor-infiltrating T-lymphocytes density in the therapeutic response to initial platinum-based chemotherapy in patients with non-small cell lung cancer","authors":"Lora Novaković-Lacković, Ljilja Latinovic-Tadic, M. Stanetić, Marko Lacković","doi":"10.2298/vsp220627019n","DOIUrl":"https://doi.org/10.2298/vsp220627019n","url":null,"abstract":"Background/Aim. The fact that lung carcinomas, like other solid tumours, can be immunogenic, may have a substantial prognostic value in non-small cell lung cancer. Specific cytotoxic T-lymphocytes can be demonstrated in most patients with primary tumours of different histological types. Two main groups of T-lymphocytes participate in the coupled recognition of tumour-specific antigens - cytotoxic T-lymphocytes (CD8+, cluster of differentiation 8) and helper T-lymphocytes (CD4+, cluster of differentiation 4). The main goal of this research was to assess the relationship between the tumour infiltration of T-lymphocytes and the therapeutic response to initial chemotherapy. Methods. Data were obtained from patients with non-small cell lung cancer whose therapeutic response after four cycles of initial platinum chemotherapy was observed in relation to the density of tumour-infiltrating T-lymphocytes (CD4+ and CD8+) in small tumour biopsy samples. The therapeutic response was assessed in line with RECIST 1.1. therapeutic response evaluation system. Based on the expected therapeutic response, the patients were divided into three following groups: favourable therapeutic response patients (complete and partial regression), stable disease patients and disease progression patients. To assess the density of CD4+ and CD8+ T-lymphocytes, the number of lymphocytes was determined at x200 (1.1mm2) magnification. Three visual fields with the most dense lymphocyte infiltrate were selected for counting, and the values of all individual fields were added up. Based on the mean value, the samples were classified into the following groups: score 0, 1, 2 and 3. During statistical processing of the data, low infiltration density combined score 0 and score 1 group, and high infiltration density combined score 2 and score 3 group. Based on the collected data, a database was created in SPSS 22.0 software and used for further statistical analysis. The statistical analysis of the data included the method of descriptive and analytical statistics. Results. The results did not show any difference in distribution of CD4+ T-lymphocytes in epithelial components between patients with a different therapeutical response (?2=2,977; p= 0.226). Also, there was not any significant difference in the distribution of CD8+ T-lymphocytes in epithelial component between patients with a different therapeutical response (?2=1,329; p=0.515). There was no significant influence of the infiltration density of CD4+ T-lymphocytes in the stromal component on the therapeutic response (?2=0,606; p=0.739) and also, there was no significant influence of the infiltration density of CD8+ T-lymphocytes in stromal component on the therapeutic response (?2=5,167; p=0.076). Conclusion. The research did not prove that patients with a high level of tumour-infiltrating CD4+ and CD8+ T-lymphocytes in the epithelial and stromal component of the tumour (non-small cell lung cancer)","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","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":"68338965","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. Vojvodić, Aleksandar Matic, J. Mihailović, P. Bjelogrlic, L. Puškaš, L. Stijak, Dubravka Aleksic, B. Filipović, Biserka Vukomanović-Djurdjević, Slobodan Kapor
Background/Aim. The iliopsoas muscle originates from the Greek word ?psoa? meaning ?loin? and represents the only muscle in body that has anatomical preconditions for stability and movement of the trunk, pelvic and legs at the same time. The iliopsoas belongs to the inner thigh muscle group and forms part of the posterior abdominal wall. This muscle is the major flexor of the hip joint, and he is functionally essential for proper posture, walking, running and other physical activities. The aim of this study is to investigate the relationship between the anatomical parameters of the pelvis and femoral nerve, as well as the relationship of the same pelvic parameters and psoas major muscle. Methods. The study was conducted at the Faculty of Medicine, University of Belgrade. Our research was conducted on the cadaveric material on the Institute of Anatomy ?Niko Miljanic?, using 14 cadavers, of which they were 7. cadavers male and 7. cadavers female, aged 67-79 years. The measuring instruments used in this study were a ruler and an electronic digital caliper (measuring range 0-500 mm, 0.01 mm resolution). Statistical data processing was performed in SPSS 11.0 using Mann-Whitney U test. Results. Results of this study indicate that there is a significant statistical difference in pelvic width between male and female cadavers, which is observed in the reduction of the bituberal line in females, while the parameters of the bispinal line does not make significant difference between the two sexes. The decrease of the bituberal line in females was followed by an increase in the width of the proximal origin with a statistically significant decrease in the length of the proximal origin.of the psoas major muscle. Also the vertically distance of femoral nerve from the exit point of the muscle to the bispinal line was significantly reduced in the male group. Conclusion. Based on our results, we can assume that in most cases, due to the smaller bituberal and bispinal line, or narrower pelvis, a shorter proximal attachment of the psoas major muscle will occur with greater width (L2-L5 level) in female than in the male gender, resulting with a longer vertically distance of the femoral nerve. Such results indicate that there is a close correlation between the anatomical parameters of the psoas major muscle, wich may affect the distance of the femoral nerve exit from the muscle.
{"title":"Anatomical and functional study of the psoas major muscle and femoral nerve in correlation with pelvic diameters","authors":"A. Vojvodić, Aleksandar Matic, J. Mihailović, P. Bjelogrlic, L. Puškaš, L. Stijak, Dubravka Aleksic, B. Filipović, Biserka Vukomanović-Djurdjević, Slobodan Kapor","doi":"10.2298/vsp221129025v","DOIUrl":"https://doi.org/10.2298/vsp221129025v","url":null,"abstract":"Background/Aim. The iliopsoas muscle originates from the Greek word ?psoa? meaning ?loin? and represents the only muscle in body that has anatomical preconditions for stability and movement of the trunk, pelvic and legs at the same time. The iliopsoas belongs to the inner thigh muscle group and forms part of the posterior abdominal wall. This muscle is the major flexor of the hip joint, and he is functionally essential for proper posture, walking, running and other physical activities. The aim of this study is to investigate the relationship between the anatomical parameters of the pelvis and femoral nerve, as well as the relationship of the same pelvic parameters and psoas major muscle. Methods. The study was conducted at the Faculty of Medicine, University of Belgrade. Our research was conducted on the cadaveric material on the Institute of Anatomy ?Niko Miljanic?, using 14 cadavers, of which they were 7. cadavers male and 7. cadavers female, aged 67-79 years. The measuring instruments used in this study were a ruler and an electronic digital caliper (measuring range 0-500 mm, 0.01 mm resolution). Statistical data processing was performed in SPSS 11.0 using Mann-Whitney U test. Results. Results of this study indicate that there is a significant statistical difference in pelvic width between male and female cadavers, which is observed in the reduction of the bituberal line in females, while the parameters of the bispinal line does not make significant difference between the two sexes. The decrease of the bituberal line in females was followed by an increase in the width of the proximal origin with a statistically significant decrease in the length of the proximal origin.of the psoas major muscle. Also the vertically distance of femoral nerve from the exit point of the muscle to the bispinal line was significantly reduced in the male group. Conclusion. Based on our results, we can assume that in most cases, due to the smaller bituberal and bispinal line, or narrower pelvis, a shorter proximal attachment of the psoas major muscle will occur with greater width (L2-L5 level) in female than in the male gender, resulting with a longer vertically distance of the femoral nerve. Such results indicate that there is a close correlation between the anatomical parameters of the psoas major muscle, wich may affect the distance of the femoral nerve exit from the muscle.","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","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":"68339965","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}
Background/Aim. Chronic total coronary artery occlusions (CTOs) are still one of the most complex procedures in the treatment of coronary arteries. If there is a bifurcation lesion within the CTO, it is certainly one of the biggest challenges for interventional cardiologists. Methods. We present a retrospective analysis of patients from our center who underwent percutaneous coronary intervention (PCI) with a bifurcation lesion within the CTO and a side branch with a diameter of 2 mm or more, in the period from January 2017 to December 2020. Results. Out of a total of 216 patients in the four-year period, 38 (18%) of them had a bifurcation lesion within the CTO. The most common bifurcation lesions were on the left anterior descending (LAD) artery (50%), and the least frequent on the circumflex coronary artery (21%). CTO recanalization was successful in 35 patients (92%). One stent technique was used in 27 patients (77%), while the two stent technique was used in 8 patients (23%). Conclusion. Bifurcation lesions in the context of PCI CTO are a relatively common finding on coronary angiography and represent a special challenge for CTO operators. Provisional technique (one stent technique) is the most common strategy for the treatment of bifurcation lesions in patients with CTO.
{"title":"Bifurcation lesions in the context of a PCI CTO - insight from Belgrade single center CTO registry","authors":"S. Juricic, M. Tesic, M. Dobric, S. Stojkovic","doi":"10.2298/vsp230116013j","DOIUrl":"https://doi.org/10.2298/vsp230116013j","url":null,"abstract":"Background/Aim. Chronic total coronary artery occlusions (CTOs) are still one of the most complex procedures in the treatment of coronary arteries. If there is a bifurcation lesion within the CTO, it is certainly one of the biggest challenges for interventional cardiologists. Methods. We present a retrospective analysis of patients from our center who underwent percutaneous coronary intervention (PCI) with a bifurcation lesion within the CTO and a side branch with a diameter of 2 mm or more, in the period from January 2017 to December 2020. Results. Out of a total of 216 patients in the four-year period, 38 (18%) of them had a bifurcation lesion within the CTO. The most common bifurcation lesions were on the left anterior descending (LAD) artery (50%), and the least frequent on the circumflex coronary artery (21%). CTO recanalization was successful in 35 patients (92%). One stent technique was used in 27 patients (77%), while the two stent technique was used in 8 patients (23%). Conclusion. Bifurcation lesions in the context of PCI CTO are a relatively common finding on coronary angiography and represent a special challenge for CTO operators. Provisional technique (one stent technique) is the most common strategy for the treatment of bifurcation lesions in patients with CTO.","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","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":"68340161","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. Stojiljković, Aleksandar Kamenov, M. Lazarević, M. Golubovic, Velimir Perić, M. Stosic, S. Živić, D. Milic
Background/Aim. Coronary artery bypass grafting (CABG) is the treatment of choice for significant number of the patients with ischemic heart disease. Some of the postoperative complications are closely linked with the preoperative antiplatelet therapy (APT). The aim of this study was to compare the early clinical outcomes of CABG in patients with preserved platelet (PLT) function and patients with platelet function impaired by the residual therapeutic effect of APT. Methods. A total of 181 patients with isolated CABG were enrolled in this prospective, nonrandomized, observational study. Subjects were divided in four groups: Control (arachidonic acid-dependent PLT aggregation - ASPI) ? 790 AU/min, adenosine diphosphate (ADP) ? 406 AU/min, Mild acetylsalicylic acid - ASA (ASPI 410-789 AU/min), Pronounced ASA (ASPI ? 409 AU/min) and dual APT (DAPT) (ASPI ? 789 AU/min; ADP ? 405 AU/min). Preoperative data, intraoperative characteristics and postoperative outcomes were obtained and compared between groups. Results. A significant difference was found regarding the average time of APT cessation between groups (p < 0.001). DAPT group had significantly higher drainage compared to Control group (p = 0.004), Mild ASA group (p = 0.001) and compared to Pronounced ASA group (p = 0.006). Pronounced ASA group had significantly higher rate of chest reexploration compared to Mild ASA group (p = 0.032). DAPT group required significantly more packed red blood cells (PRBC) compared to Control group (p < 0.001) and Mild ASA group (p = 0.009). Pronounced ASA group received significantly more PRBC compared to Control group (p < 0.001) and Mild ASA group (p = 0.019). DAPT group required higher amounts of PLT compared to Control group (p < 0.001), Mild ASA group (p = 0.002) and Pronounced ASA group (p < 0.001). DAPT group received higher amounts of cryoprecipitate compared to Control group (p = 0.002), Mild ASA group (p = 0.009) and Pronounced ASA group (p = 0.016). Conclusion. Patients with a residual effect of DAPT as well as patients with a pronounced residual effect of ASA have a higher risk of postoperative bleeding and chest reexploration, and increased transfusions demands.
{"title":"Early clinical outcomes of surgical myocardial revascularization in patients with preoperative platelet dysfunction","authors":"V. Stojiljković, Aleksandar Kamenov, M. Lazarević, M. Golubovic, Velimir Perić, M. Stosic, S. Živić, D. Milic","doi":"10.2298/vsp230306036s","DOIUrl":"https://doi.org/10.2298/vsp230306036s","url":null,"abstract":"Background/Aim. Coronary artery bypass grafting (CABG) is the treatment of choice for significant number of the patients with ischemic heart disease. Some of the postoperative complications are closely linked with the preoperative antiplatelet therapy (APT). The aim of this study was to compare the early clinical outcomes of CABG in patients with preserved platelet (PLT) function and patients with platelet function impaired by the residual therapeutic effect of APT. Methods. A total of 181 patients with isolated CABG were enrolled in this prospective, nonrandomized, observational study. Subjects were divided in four groups: Control (arachidonic acid-dependent PLT aggregation - ASPI) ? 790 AU/min, adenosine diphosphate (ADP) ? 406 AU/min, Mild acetylsalicylic acid - ASA (ASPI 410-789 AU/min), Pronounced ASA (ASPI ? 409 AU/min) and dual APT (DAPT) (ASPI ? 789 AU/min; ADP ? 405 AU/min). Preoperative data, intraoperative characteristics and postoperative outcomes were obtained and compared between groups. Results. A significant difference was found regarding the average time of APT cessation between groups (p < 0.001). DAPT group had significantly higher drainage compared to Control group (p = 0.004), Mild ASA group (p = 0.001) and compared to Pronounced ASA group (p = 0.006). Pronounced ASA group had significantly higher rate of chest reexploration compared to Mild ASA group (p = 0.032). DAPT group required significantly more packed red blood cells (PRBC) compared to Control group (p < 0.001) and Mild ASA group (p = 0.009). Pronounced ASA group received significantly more PRBC compared to Control group (p < 0.001) and Mild ASA group (p = 0.019). DAPT group required higher amounts of PLT compared to Control group (p < 0.001), Mild ASA group (p = 0.002) and Pronounced ASA group (p < 0.001). DAPT group received higher amounts of cryoprecipitate compared to Control group (p = 0.002), Mild ASA group (p = 0.009) and Pronounced ASA group (p = 0.016). Conclusion. Patients with a residual effect of DAPT as well as patients with a pronounced residual effect of ASA have a higher risk of postoperative bleeding and chest reexploration, and increased transfusions demands.","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","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":"68341058","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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