Background. Diabetes is one of the most common diseases among hospitalized patients due to COVID-19. Therefore, this study aimed to identify the clinical characteristics of diabetic and non-diabetic patients with COVID-19 that may lead to death. Methods. A multicenter cross-sectional study was conducted among patients admitted to hospitals due to COVID-19. The data, including demographic data, symptoms and signs, underlying diseases, patient progress, and outcomes were obtained from 38 hospitals in the registry system of Khuzestan province (the southwest of Iran) between January 19, 2020 and March 8, 2021. The Cox proportional hazards regression was used to analyze the data. Results. Data from 23,447 hospitalized patients due to COVID-19 were included in the study. Four thousand three hundred and forty participants (18.5%) with a mean age of 62 years had diabetes and 14.72% of them died. A multivariable Cox regression showed that the variables of age (Hazard Ratio (HR) = 2.65; 95% CI: 1.78-3.95; P < 0.001), sex (HR = 1.16; 95% CI: 1.001 - 1.35; P = 0.049) and comorbidities such as cancer (HR = 1.89; 95% CI: 1.24 - 2.89; P = 0.003) and cardiovascular disease (HR = 1.2; 95% CI: 1.24 - 2.89; P = 0.032) were associated with mortality in diabetic patients with COVID-19. Conclusion. This study showed that COVID-19 mortality was higher in men, the elderly, and people with cardiovascular disease and cancer. Therefore, the management and prevention of COVID-19 in diabetic patients with these characteristics are vital.
{"title":"Clinical characteristics and outcomes in diabetic and non-diabetic patients hospitalized for COVID-19: A multicenter cross-sectional study in Southwestern Iran","authors":"M. Ahmadi, J. Zarei, A. Hadianfard, T. Moghadam","doi":"10.5937/afmnai40-39949","DOIUrl":"https://doi.org/10.5937/afmnai40-39949","url":null,"abstract":"Background. Diabetes is one of the most common diseases among hospitalized patients due to COVID-19. Therefore, this study aimed to identify the clinical characteristics of diabetic and non-diabetic patients with COVID-19 that may lead to death. Methods. A multicenter cross-sectional study was conducted among patients admitted to hospitals due to COVID-19. The data, including demographic data, symptoms and signs, underlying diseases, patient progress, and outcomes were obtained from 38 hospitals in the registry system of Khuzestan province (the southwest of Iran) between January 19, 2020 and March 8, 2021. The Cox proportional hazards regression was used to analyze the data. Results. Data from 23,447 hospitalized patients due to COVID-19 were included in the study. Four thousand three hundred and forty participants (18.5%) with a mean age of 62 years had diabetes and 14.72% of them died. A multivariable Cox regression showed that the variables of age (Hazard Ratio (HR) = 2.65; 95% CI: 1.78-3.95; P < 0.001), sex (HR = 1.16; 95% CI: 1.001 - 1.35; P = 0.049) and comorbidities such as cancer (HR = 1.89; 95% CI: 1.24 - 2.89; P = 0.003) and cardiovascular disease (HR = 1.2; 95% CI: 1.24 - 2.89; P = 0.032) were associated with mortality in diabetic patients with COVID-19. Conclusion. This study showed that COVID-19 mortality was higher in men, the elderly, and people with cardiovascular disease and cancer. Therefore, the management and prevention of COVID-19 in diabetic patients with these characteristics are vital.","PeriodicalId":7132,"journal":{"name":"Acta Facultatis Medicae Naissensis","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71196270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Sabzi, Aghigh Heydari, M. Rouzbahani, Atefeh Asadmobini
Introduction. Congenital hypoplasia of the left atrial appendage (LAA) with stenotic ostium in an abnormal position is an extremely rare entity. We report an exceptional case of hypoplastic LAA with ostial stenosis in an abnormal location in the patient with mitral valve stenosis that was mistaken in the transesophageal echocardiography (TEE) for an intraluminal thrombus. Case report. A 43-year-old woman was admitted to our center with dyspnea on exertion. TEE revealed the presence of severe mitral stenosis and clot in the LAA. The patient underwent open cardiac surgery by cardiopulmonary bypass. Intraoperative inspection of the left atrium revealed hypoplasia of the LAA with stenotic and slit-like ostium. There was also a malposition of the LAA that was placed in a paravalvular location. The ostium of the LAA was not round and wide but narrowed and slit-like. Conclusion. The authors believe that this anomaly may have some physiologic consequences in patients with mild structural failure. Indeed, this anomaly may aggravate the severity of structural failure by pressure burden on the atrial wall and valve.
{"title":"Incidental finding of a rare left atrial appendage anomaly: A case report","authors":"F. Sabzi, Aghigh Heydari, M. Rouzbahani, Atefeh Asadmobini","doi":"10.5937/afmnai40-37783","DOIUrl":"https://doi.org/10.5937/afmnai40-37783","url":null,"abstract":"Introduction. Congenital hypoplasia of the left atrial appendage (LAA) with stenotic ostium in an abnormal position is an extremely rare entity. We report an exceptional case of hypoplastic LAA with ostial stenosis in an abnormal location in the patient with mitral valve stenosis that was mistaken in the transesophageal echocardiography (TEE) for an intraluminal thrombus. Case report. A 43-year-old woman was admitted to our center with dyspnea on exertion. TEE revealed the presence of severe mitral stenosis and clot in the LAA. The patient underwent open cardiac surgery by cardiopulmonary bypass. Intraoperative inspection of the left atrium revealed hypoplasia of the LAA with stenotic and slit-like ostium. There was also a malposition of the LAA that was placed in a paravalvular location. The ostium of the LAA was not round and wide but narrowed and slit-like. Conclusion. The authors believe that this anomaly may have some physiologic consequences in patients with mild structural failure. Indeed, this anomaly may aggravate the severity of structural failure by pressure burden on the atrial wall and valve.","PeriodicalId":7132,"journal":{"name":"Acta Facultatis Medicae Naissensis","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71196037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dragana M. Đurić, Snežana B. Ilić, Alameri Shaima, Almenhali Ameera, Alqutub A. Tariq
Aims. The aim of the study was to assess the effectiveness of robotic-assisted gait treadmill training (Lokomat) as an adjunct to traditional physiotherapy in improving the range of motion, muscle strength and decreasing spasticity in lower extremities in children with cerebral palsy. Materials and Methods. Twenty-six participants, with mean 7.69 ± 2.90 years, levels I-IV on Gross Motor Classification System (38.5% level I-II and 61.5% level III-IV) with a bilateral and unilateral form of cerebral palsy underwent intensive 20 Lokomat and 20 traditional physiotherapy sessions, each training session lasting 40 minutes. Preand post-testing was done using goniometer measure, manual muscle testing and modified Ashworth scale. Results. Positive effects were seen in participant who underwent a combination of Lokomat training and traditional therapy. An increase in the range of motion was minimal (2 - 4 degrees) in hip flexion, extension, and abduction. A significant improvement was achieved in ankle dorsiflexion on the right (p = 0.003) and left side (p = 0.006), while the values of knee extension for the left and right extremity were p = 0.062 left and p = 0.075, respectively. An increase in muscle strength of the lower limb was seen in 30.8% - 80% of participants. Reduction of spasticity in adductors, hamstrings and gastrocnemius were seen in 26.9% of participants. Conclusion. Lokomat training is an adjunct to conventional physiotherapy treatment. It has a negligible effect on the increase in the range of motion and muscle strength of the lower limb and reduction of spasticity in children with cerebral palsy.
{"title":"Effect of robotic-assisted gait training as adjunct to traditional therapy on motor impairments in children with cerebral palsy","authors":"Dragana M. Đurić, Snežana B. Ilić, Alameri Shaima, Almenhali Ameera, Alqutub A. Tariq","doi":"10.5937/afmnai40-39301","DOIUrl":"https://doi.org/10.5937/afmnai40-39301","url":null,"abstract":"Aims. The aim of the study was to assess the effectiveness of robotic-assisted gait treadmill training (Lokomat) as an adjunct to traditional physiotherapy in improving the range of motion, muscle strength and decreasing spasticity in lower extremities in children with cerebral palsy. Materials and Methods. Twenty-six participants, with mean 7.69 ± 2.90 years, levels I-IV on Gross Motor Classification System (38.5% level I-II and 61.5% level III-IV) with a bilateral and unilateral form of cerebral palsy underwent intensive 20 Lokomat and 20 traditional physiotherapy sessions, each training session lasting 40 minutes. Preand post-testing was done using goniometer measure, manual muscle testing and modified Ashworth scale. Results. Positive effects were seen in participant who underwent a combination of Lokomat training and traditional therapy. An increase in the range of motion was minimal (2 - 4 degrees) in hip flexion, extension, and abduction. A significant improvement was achieved in ankle dorsiflexion on the right (p = 0.003) and left side (p = 0.006), while the values of knee extension for the left and right extremity were p = 0.062 left and p = 0.075, respectively. An increase in muscle strength of the lower limb was seen in 30.8% - 80% of participants. Reduction of spasticity in adductors, hamstrings and gastrocnemius were seen in 26.9% of participants. Conclusion. Lokomat training is an adjunct to conventional physiotherapy treatment. It has a negligible effect on the increase in the range of motion and muscle strength of the lower limb and reduction of spasticity in children with cerebral palsy.","PeriodicalId":7132,"journal":{"name":"Acta Facultatis Medicae Naissensis","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71196224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction. Neuroendocrine tumors (NETs) have increased expression of somatostatin receptors (SSTR), where subtype 2 and 5 are the most common. Overexpression of the SSTR is an outstanding molecular target for inoperable and metastatic NETs that enables a unique approach of targeted diagnosis and treatment. In addition to SSTRs, neuroendocrine tumors also express other receptors that can be suitable targets for visualization by nuclear medicine methods. Aim. This review paper is focused on the most common radiopharmaceuticals and their molecular targets that are used today based on theranostic approach in NETs. Results. In conventional nuclear medicine, the most important diagnostic radiopharmaceuticals are somatostatin analogs (SSA) labeled with 111 In and 99m Tc, however 99m Tc has advantages over 111 In based on better physical characteristics and better performance. In recent years, highly potent theranostic pairs have been created for the imaging and treatment of NETs, which can strongly bind SSTR. Derivatives of 68 Ga-labeled octreotide are recommended for diagnostics and follow-up of NENs. The great advantage of 68 Ga radiopharmaceuticals is that identical compounds can be labeled with therapeutic radionuclides 90 Y and 177 Lu. Conclusion. Peptide receptor radionuclide therapy is a systemic molecular target therapy that has proven to be safe and very effective in controlling the disease and prolonging the survival of patients with advanced and inoperable NETs. With a negligible number of adverse events, this therapy is safe and should be administered to all patients who meet the necessary criterias, primarily overexpression of the somatostatin receptor type 2.
{"title":"Theranostics and precision medicine In neuroendocrine tumors","authors":"Filip Veličković, Marina Vlajković, Miloš Stević, Nina Topić, Tamara Anđelković, Đuro Macut","doi":"10.5937/afmnai40-40887","DOIUrl":"https://doi.org/10.5937/afmnai40-40887","url":null,"abstract":"Introduction. Neuroendocrine tumors (NETs) have increased expression of somatostatin receptors (SSTR), where subtype 2 and 5 are the most common. Overexpression of the SSTR is an outstanding molecular target for inoperable and metastatic NETs that enables a unique approach of targeted diagnosis and treatment. In addition to SSTRs, neuroendocrine tumors also express other receptors that can be suitable targets for visualization by nuclear medicine methods. Aim. This review paper is focused on the most common radiopharmaceuticals and their molecular targets that are used today based on theranostic approach in NETs. Results. In conventional nuclear medicine, the most important diagnostic radiopharmaceuticals are somatostatin analogs (SSA) labeled with 111 In and 99m Tc, however 99m Tc has advantages over 111 In based on better physical characteristics and better performance. In recent years, highly potent theranostic pairs have been created for the imaging and treatment of NETs, which can strongly bind SSTR. Derivatives of 68 Ga-labeled octreotide are recommended for diagnostics and follow-up of NENs. The great advantage of 68 Ga radiopharmaceuticals is that identical compounds can be labeled with therapeutic radionuclides 90 Y and 177 Lu. Conclusion. Peptide receptor radionuclide therapy is a systemic molecular target therapy that has proven to be safe and very effective in controlling the disease and prolonging the survival of patients with advanced and inoperable NETs. With a negligible number of adverse events, this therapy is safe and should be administered to all patients who meet the necessary criterias, primarily overexpression of the somatostatin receptor type 2.","PeriodicalId":7132,"journal":{"name":"Acta Facultatis Medicae Naissensis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135611045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction. Colorectal cancer is the third most common cancer and metastatic disease is an important and frequent clinical problem. Metastases in the oral and maxillofacial region are rare, comprising 1-2% of all malignant lesions, and clinically resemble common benign conditions. Case report. A 59-year-old woman diagnosed with rectal cancer developed perimandibular lesion as a first sign of metastatic process. Metastasis manifested clinically during the curative intent treatment of rectal cancer (preoperative chemo-irradiation) as a rapidly growing tumefaction close to the mandible angle. After the biopsy and histopathological examination of the lesion that clinically resembled abscess, metastasis of rectal cancer was diagnosed. Incidentally, a cerebral metastasis was diagnosed as well. Although it was oligometastatic rectal cancer, surgical treatment was not indicated due to extensive infiltrative characteristics of the perimandibular lesion. The patient was treated with chemotherapy, with good clinical response. Biological therapy was not available at that moment. Cerebral metastasis was treated with stereotactic neuroradiosurgery with gamma knife. Unfortunately, the patient died from cerebrovascular insult. Conclusion. Lesions in the oral and maxillofacial region may be the first manifestation of metastatic disease. Since early diagnosis of metastatic process has prognostic implications, any new formation in the oral and maxillofacial region in a patient with colorectal cancer requires cautious observation and histological examination.
{"title":"Perimandibular metastasis of rectal cancer: A case report","authors":"Miljana Džunić, Ana Cvetanović, Ivan Petković","doi":"10.5937/afmnai40-38706","DOIUrl":"https://doi.org/10.5937/afmnai40-38706","url":null,"abstract":"Introduction. Colorectal cancer is the third most common cancer and metastatic disease is an important and frequent clinical problem. Metastases in the oral and maxillofacial region are rare, comprising 1-2% of all malignant lesions, and clinically resemble common benign conditions. Case report. A 59-year-old woman diagnosed with rectal cancer developed perimandibular lesion as a first sign of metastatic process. Metastasis manifested clinically during the curative intent treatment of rectal cancer (preoperative chemo-irradiation) as a rapidly growing tumefaction close to the mandible angle. After the biopsy and histopathological examination of the lesion that clinically resembled abscess, metastasis of rectal cancer was diagnosed. Incidentally, a cerebral metastasis was diagnosed as well. Although it was oligometastatic rectal cancer, surgical treatment was not indicated due to extensive infiltrative characteristics of the perimandibular lesion. The patient was treated with chemotherapy, with good clinical response. Biological therapy was not available at that moment. Cerebral metastasis was treated with stereotactic neuroradiosurgery with gamma knife. Unfortunately, the patient died from cerebrovascular insult. Conclusion. Lesions in the oral and maxillofacial region may be the first manifestation of metastatic disease. Since early diagnosis of metastatic process has prognostic implications, any new formation in the oral and maxillofacial region in a patient with colorectal cancer requires cautious observation and histological examination.","PeriodicalId":7132,"journal":{"name":"Acta Facultatis Medicae Naissensis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135612080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Osadchuk, Inna Vasilieva, E. Mironova, N. Korzhenkov, M. Trushin
Introduction. Sleep disturbance is a frequent complaint of patients suffering from arterial hypertension (AH) for a long time. A hidden and uncontrolled increase in blood pressure (BP) makes the course of physiological processes more difficult, disrupts the regulation of biological rhythms, and increases the risk of cardiovascular complications even with a short duration of AH. At the same time, chronic sleep disorders contribute to the development of hypertension, defining the role of a new socially significant risk factor. An important role in the pathogenesis of insomnia is played by a deficiency in melatonin (MT) synthesis, which negatively affects the cardiovascular system (CVS). Aim. The aim of the paper was to study the features of central and vascular hemodynamics in patients with the 1st degree AH and to evaluate the clinical effectiveness of antihypertensive therapy with synthetic analog of prolonged-release MT at the onset of the disease. Methods. Instrumental examination included registration of an electrocardiogram, office measurement of blood pressure with an automatic tonometer, non-invasive automatic blood pressure monitoring for 24 hours. The severity of insomnia was assessed by somnological questionnaires. Representatives of the 1st group (n = 34) took monotherapy with the ACE inhibitor ramipril, participants of the 2nd group (n = 33) took the ACE inhibitor ramipril in combination with a synthetic analogue of melatonin. Results. The results of a randomized open prospective study including 78 participants reveal the activity of the renin-angiotensin-aldosterone system (RAAS), hypersympathicotonia at night and desynchronosis due to a possible deficiency in the MT secretion. Pharmacological antihypertensive therapy with the addition of prolonged release MT analog was accompanied by a significant improvement in the clinical condition of hypertensive patients. Positive dynamics of indicators of systemic hemodynamics and functional arterial parameters of stiffness was noted. Conclusion. The article describes the probable benefits of melatonin as part of combination antihypertensive therapy in patients with early-stage hypertension and insomnia. Additional introduction of MT at the onset of the AN as a physiological regulator of circadian biological rhythms is substantiated.
{"title":"N-[2-(5-methoxy-1h-indole-3-yl)ethyl]acetamide may correct arterial hypertension in people with sleep problems","authors":"M. Osadchuk, Inna Vasilieva, E. Mironova, N. Korzhenkov, M. Trushin","doi":"10.5937/afmnai40-37183","DOIUrl":"https://doi.org/10.5937/afmnai40-37183","url":null,"abstract":"Introduction. Sleep disturbance is a frequent complaint of patients suffering from arterial hypertension (AH) for a long time. A hidden and uncontrolled increase in blood pressure (BP) makes the course of physiological processes more difficult, disrupts the regulation of biological rhythms, and increases the risk of cardiovascular complications even with a short duration of AH. At the same time, chronic sleep disorders contribute to the development of hypertension, defining the role of a new socially significant risk factor. An important role in the pathogenesis of insomnia is played by a deficiency in melatonin (MT) synthesis, which negatively affects the cardiovascular system (CVS). Aim. The aim of the paper was to study the features of central and vascular hemodynamics in patients with the 1st degree AH and to evaluate the clinical effectiveness of antihypertensive therapy with synthetic analog of prolonged-release MT at the onset of the disease. Methods. Instrumental examination included registration of an electrocardiogram, office measurement of blood pressure with an automatic tonometer, non-invasive automatic blood pressure monitoring for 24 hours. The severity of insomnia was assessed by somnological questionnaires. Representatives of the 1st group (n = 34) took monotherapy with the ACE inhibitor ramipril, participants of the 2nd group (n = 33) took the ACE inhibitor ramipril in combination with a synthetic analogue of melatonin. Results. The results of a randomized open prospective study including 78 participants reveal the activity of the renin-angiotensin-aldosterone system (RAAS), hypersympathicotonia at night and desynchronosis due to a possible deficiency in the MT secretion. Pharmacological antihypertensive therapy with the addition of prolonged release MT analog was accompanied by a significant improvement in the clinical condition of hypertensive patients. Positive dynamics of indicators of systemic hemodynamics and functional arterial parameters of stiffness was noted. Conclusion. The article describes the probable benefits of melatonin as part of combination antihypertensive therapy in patients with early-stage hypertension and insomnia. Additional introduction of MT at the onset of the AN as a physiological regulator of circadian biological rhythms is substantiated.","PeriodicalId":7132,"journal":{"name":"Acta Facultatis Medicae Naissensis","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71195947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: This present study focuses on the findings of clinical trials that have revealed unsatisfactory results and mortality escalation rates of patients suffering from serious traumatic brain injuries (TBI). Aim: The main objective of this research was to investigate whether hyperglycaemia is a significant indicator of mortality in patients with the diagnosis of severe TBI. Methods: The research was performed using meta-analysis. The research material was collected throughout PubMed, Cochrane, NCBI, and Google Scholar from 2010 to 2020. Results: The research subjects were patients with TBI, proven to have hyperglycaemia on admission (random blood sugar evaluation > 200 mg/dl on arrival at the emergency department), with or without a history of DM (HbA1C evaluation ≥ 6.5%), a Glasgow Coma Scale score ≤ 8, and aged 0 - 100 years. The pooled risk ratio (RR) for mortality in severe TBI with hyperglycaemia on admission was 2.39. The evidence of mortality appeared significantly greater in patients with TBI with hyperglycaemia on admission than in those with normal blood glucose levels (RR = 2.39, p < 0.00001). The pooled RR had wide heterogeneity (I2 = 0.87), so the random-effect model was used. Conclusion: Hyperglycaemia on admission is often associated with unsatisfactory clinical outcomes and greater mortality.
{"title":"Hyperglycaemia on admission-related mortality in patients with severe traumatic brain injury: A systematic review and meta-analysis","authors":"A. Danta, Thirza Quila","doi":"10.5937/afmnai40-34751","DOIUrl":"https://doi.org/10.5937/afmnai40-34751","url":null,"abstract":"Introduction: This present study focuses on the findings of clinical trials that have revealed unsatisfactory results and mortality escalation rates of patients suffering from serious traumatic brain injuries (TBI). Aim: The main objective of this research was to investigate whether hyperglycaemia is a significant indicator of mortality in patients with the diagnosis of severe TBI. Methods: The research was performed using meta-analysis. The research material was collected throughout PubMed, Cochrane, NCBI, and Google Scholar from 2010 to 2020. Results: The research subjects were patients with TBI, proven to have hyperglycaemia on admission (random blood sugar evaluation > 200 mg/dl on arrival at the emergency department), with or without a history of DM (HbA1C evaluation ≥ 6.5%), a Glasgow Coma Scale score ≤ 8, and aged 0 - 100 years. The pooled risk ratio (RR) for mortality in severe TBI with hyperglycaemia on admission was 2.39. The evidence of mortality appeared significantly greater in patients with TBI with hyperglycaemia on admission than in those with normal blood glucose levels (RR = 2.39, p < 0.00001). The pooled RR had wide heterogeneity (I2 = 0.87), so the random-effect model was used. Conclusion: Hyperglycaemia on admission is often associated with unsatisfactory clinical outcomes and greater mortality.","PeriodicalId":7132,"journal":{"name":"Acta Facultatis Medicae Naissensis","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71196069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Koksal, S. Doğan, R. Eroz, F. Ozturk, A. Ozturk, N. Cucer
Aim. The aim of the paper was to evaluate the AgNOR parameters for the discrimination of benign from malignant breast tumors via a new approach - the total AgNOR area/nuclear area (TAA/NA). Material and methods. Three groups, consisting of control (n = 14), benign (n = 18) and malignant (n = 28) participants were included in the study. The AgNOR staining technique was performed and both mean AgNOR number and TAA/NA ratio were evaluated. Results. While the differences between the control and patient groups were statistically significant for AgNOR number (p < 0.001), it was not significant between the malignant group and the benign group for mean AgNOR number (p > 0.05). For the ratio of TAA/NA, the differences between the control and benign group (p < 0.001), control and malignant group (p < 0.001), and malignant and benign patient groups were significant. (p < 0.05). Conclusion. We consider that the evaluation of the TAA/NA rate, when compared with the AgNOR number, can be more sensitive and useful tool for distinguishing benign from the malignant breast lesions.
{"title":"Comparative evaluation of argyrophilic nucleolar organizer regions parameters in benign and malignant breast tumors","authors":"M. Koksal, S. Doğan, R. Eroz, F. Ozturk, A. Ozturk, N. Cucer","doi":"10.5937/afmnai40-35516","DOIUrl":"https://doi.org/10.5937/afmnai40-35516","url":null,"abstract":"Aim. The aim of the paper was to evaluate the AgNOR parameters for the discrimination of benign from malignant breast tumors via a new approach - the total AgNOR area/nuclear area (TAA/NA). Material and methods. Three groups, consisting of control (n = 14), benign (n = 18) and malignant (n = 28) participants were included in the study. The AgNOR staining technique was performed and both mean AgNOR number and TAA/NA ratio were evaluated. Results. While the differences between the control and patient groups were statistically significant for AgNOR number (p < 0.001), it was not significant between the malignant group and the benign group for mean AgNOR number (p > 0.05). For the ratio of TAA/NA, the differences between the control and benign group (p < 0.001), control and malignant group (p < 0.001), and malignant and benign patient groups were significant. (p < 0.05). Conclusion. We consider that the evaluation of the TAA/NA rate, when compared with the AgNOR number, can be more sensitive and useful tool for distinguishing benign from the malignant breast lesions.","PeriodicalId":7132,"journal":{"name":"Acta Facultatis Medicae Naissensis","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71196105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction. Alexithymia is manifested by limited abilities to identify and express emotions and is a possible risk factor for the onset and treatment of the disease. Objective. To determine the dependence of the presence of alexithymia in patients with chronic lung and heart diseases. Methodology and results. One hundred respondents aged 35 to 75 participated in the research, 50% of whom were being treated for chronic lung diseases, and 50% for chronic heart diseases. After filling out the Toronto Twenty-Point Scale (TAS-20) questionnaire, the degree of alexithymia was determined. Using the Chi-square test for independence, it was determined that the presence of alexithymia and chronic heart and lung diseases were dependent characteristics (p > 0.0005), and a significantly larger number of respondents with established alexithymia were treated for chronic lung diseases. Using the Chi-square test, it was shown that the presence of alexithymia and the gender of the subject were not dependent characteristics, while the non-parametric Mann-Whitney U test of significance was used to analyze the dependence of alexithymia and the age of the subject. It demonstrated that there was a statistically significant difference in the age of the subjects with and without alexithymia (p < 0.05). Conclusion. In this paper, we found that alexithymia is a more significant risk factor for the occurrence of chronic impairment of lung function in relation to heart disease.
{"title":"Connection between alexithymia and chronic diseases of the hearth and lungs","authors":"Marija Lazarević","doi":"10.5937/afmnai40-41356","DOIUrl":"https://doi.org/10.5937/afmnai40-41356","url":null,"abstract":"Introduction. Alexithymia is manifested by limited abilities to identify and express emotions and is a possible risk factor for the onset and treatment of the disease. Objective. To determine the dependence of the presence of alexithymia in patients with chronic lung and heart diseases. Methodology and results. One hundred respondents aged 35 to 75 participated in the research, 50% of whom were being treated for chronic lung diseases, and 50% for chronic heart diseases. After filling out the Toronto Twenty-Point Scale (TAS-20) questionnaire, the degree of alexithymia was determined. Using the Chi-square test for independence, it was determined that the presence of alexithymia and chronic heart and lung diseases were dependent characteristics (p > 0.0005), and a significantly larger number of respondents with established alexithymia were treated for chronic lung diseases. Using the Chi-square test, it was shown that the presence of alexithymia and the gender of the subject were not dependent characteristics, while the non-parametric Mann-Whitney U test of significance was used to analyze the dependence of alexithymia and the age of the subject. It demonstrated that there was a statistically significant difference in the age of the subjects with and without alexithymia (p < 0.05). Conclusion. In this paper, we found that alexithymia is a more significant risk factor for the occurrence of chronic impairment of lung function in relation to heart disease.","PeriodicalId":7132,"journal":{"name":"Acta Facultatis Medicae Naissensis","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71196816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ivica Lalić, Vladimir Harhaji, Oliver Dulić, Mile Bjelobrk, Nataša Janjić, Nensi Lalić, Marko Bojović, Marko Mladenović
Introduction. High-energy distal tibia fractures are characterized by great comminution and extensive lesions of the surrounding soft tissues. The risk of developing complications during treatment is high. The application of the Ilizarov's technique reduces the risk of complications significantly, and provides good final treatment results. Methods. In our prospective observational study 41 patients were included. Clinical characteristics were evaluated by Gustillo-Anderson, Checketts-Otterburns and AO/OTA classification. The ASAMI protocol was used to assess bone union. Functional treatment results were represented using the modified Karlström-Ollerud scoring system. Analysis and monitoring time (follow up) was 18 months. Results. Using radiographic and clinical parameters, we recorded complete healing in all fractures. In the group of 43B intra-articular fractures, circular fixator was removed after 16 weeks (range 13 -31), while in the 43C fracture type group, it was removed after 18 weeks (range 13 -29). The ASAMI evaluation of bone healing showed 31 (75%) excellent, 76 (15%) good, 3 (8%) satisfactory, and 1 (2%) poor result. Functional recovery results obtained after 6 months showed the mean value of 24.7 using the modified Karlström-Ollerud scoring system in three follow-up periods, which represents recovery. The results present 12 months after surgery showed the mean value of 27.6, representing satisfactory recovery, while during the last parameter measurement performed after 18 months, the value was 29.5, which indicates good functional recovery. Conclusion. Transosseous osteosynthesis Ilizarov treatment applied in closed and open comminuted distal tibia fractures showed good final bone and functional results with minimal complications, and contributed to better patient's quality of life.
{"title":"The application of llizarov technique in the treatment of comminuted distal tibia fractures","authors":"Ivica Lalić, Vladimir Harhaji, Oliver Dulić, Mile Bjelobrk, Nataša Janjić, Nensi Lalić, Marko Bojović, Marko Mladenović","doi":"10.5937/afmnai40-41694","DOIUrl":"https://doi.org/10.5937/afmnai40-41694","url":null,"abstract":"Introduction. High-energy distal tibia fractures are characterized by great comminution and extensive lesions of the surrounding soft tissues. The risk of developing complications during treatment is high. The application of the Ilizarov's technique reduces the risk of complications significantly, and provides good final treatment results. Methods. In our prospective observational study 41 patients were included. Clinical characteristics were evaluated by Gustillo-Anderson, Checketts-Otterburns and AO/OTA classification. The ASAMI protocol was used to assess bone union. Functional treatment results were represented using the modified Karlström-Ollerud scoring system. Analysis and monitoring time (follow up) was 18 months. Results. Using radiographic and clinical parameters, we recorded complete healing in all fractures. In the group of 43B intra-articular fractures, circular fixator was removed after 16 weeks (range 13 -31), while in the 43C fracture type group, it was removed after 18 weeks (range 13 -29). The ASAMI evaluation of bone healing showed 31 (75%) excellent, 76 (15%) good, 3 (8%) satisfactory, and 1 (2%) poor result. Functional recovery results obtained after 6 months showed the mean value of 24.7 using the modified Karlström-Ollerud scoring system in three follow-up periods, which represents recovery. The results present 12 months after surgery showed the mean value of 27.6, representing satisfactory recovery, while during the last parameter measurement performed after 18 months, the value was 29.5, which indicates good functional recovery. Conclusion. Transosseous osteosynthesis Ilizarov treatment applied in closed and open comminuted distal tibia fractures showed good final bone and functional results with minimal complications, and contributed to better patient's quality of life.","PeriodicalId":7132,"journal":{"name":"Acta Facultatis Medicae Naissensis","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135612082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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