Introduction. Diffuse large B-cell lymphoma represents a group of entities characterized by pathological and biological heterogeneity and different clinical outcomes. Due to pronounced heterogeneity, prognostic biomarkers are of great importance in identifying high-risk patients who might benefit from more aggressive approaches or new therapeutic modalities. Several prognostic score systems have been established and applied to predict the survival of patients with diffuse B-large cell lymphoma. The first established prognostic system for NHL patients is the International Prognostic Index, its variations Revised International Prognostic Index and National Comprehensive Cancer Network- International Prognostic Index were subsequently introduced in the era of immunochemotherapy. As the discriminative power of clinical scores is suboptimal, other strategies have been explored in order to improve risk stratification, especially in the high-risk group of patients who have the highest risk of treatment failure. In this regard, there is a tendency to integrate genetic and molecular biomarkers and prognostic somatic mutations into standardized and personalized models for risk stratification that would have a wide application in routine clinical practice. The results of recent studies based on machine learning methods have shown that the best risk stratification is achieved by a combination of clinical, genetic and molecular parameters, as well as a combination of clinical parameters with new quantitative Positron Emission Tomography parameters, such as Metabolic Tumor Volume and dissemination features and analysis of circulating tumor DNA levels. This paper provides an overview of studies in which these new risk stratification models were analyzed.
{"title":"Risk-stratification in diffuse large B-cell lymphoma in the rituximab era","authors":"O. Markovic","doi":"10.2298/mpns22s1082m","DOIUrl":"https://doi.org/10.2298/mpns22s1082m","url":null,"abstract":"Introduction. Diffuse large B-cell lymphoma represents a group of entities characterized by pathological and biological heterogeneity and different clinical outcomes. Due to pronounced heterogeneity, prognostic biomarkers are of great importance in identifying high-risk patients who might benefit from more aggressive approaches or new therapeutic modalities. Several prognostic score systems have been established and applied to predict the survival of patients with diffuse B-large cell lymphoma. The first established prognostic system for NHL patients is the International Prognostic Index, its variations Revised International Prognostic Index and National Comprehensive Cancer Network- International Prognostic Index were subsequently introduced in the era of immunochemotherapy. As the discriminative power of clinical scores is suboptimal, other strategies have been explored in order to improve risk stratification, especially in the high-risk group of patients who have the highest risk of treatment failure. In this regard, there is a tendency to integrate genetic and molecular biomarkers and prognostic somatic mutations into standardized and personalized models for risk stratification that would have a wide application in routine clinical practice. The results of recent studies based on machine learning methods have shown that the best risk stratification is achieved by a combination of clinical, genetic and molecular parameters, as well as a combination of clinical parameters with new quantitative Positron Emission Tomography parameters, such as Metabolic Tumor Volume and dissemination features and analysis of circulating tumor DNA levels. This paper provides an overview of studies in which these new risk stratification models were analyzed.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78733438","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}
A. Milenkovic, J. Javorac, D. Živanović, S. Kasikovic-Lecic, Vanja Tovilovic, M. Ilic
Introduction. Among infectious diseases, tuberculosis ranks first in terms of morbidity and mortality. It mainly affects the lungs, but it can affect any organ in the body. Case Report. A 29-year old female patient, bacillus Calmette-Guerin vaccinated, human immunodeficiency virus-negative, non-smoker, active athlete, presented with magnetic resonance imaging of the spine indicating vertebral body collapse of Th10 with signs of intraosseous infiltration, extraosseous prevertebral, and extracorporeal spread into the spinal canal. Corpectomy of Th10 and Th11 with an anterior fusion of Th9-12 was performed by neurosurgical intervention. Histopathological examination of the vertebral body confirmed a necrotic granulomatous inflammation. No acid-fast bacilli were seen by Ziehl-Neelsen staining, while Mycobacterium tuberculosis culture was positive. Chest X-ray and computed tomography were normal, induced sputum smear microscopy was negative for Mycobacterium tuberculosis. The antituberculosis therapy lasted for 12 months. Conclusion. Spinal tuberculosis is a differential diagnostic problem in relation to pyogenic infections and metastatic bone tumors.
{"title":"A spinal tumor or tuberculosis - a case report and short literature review","authors":"A. Milenkovic, J. Javorac, D. Živanović, S. Kasikovic-Lecic, Vanja Tovilovic, M. Ilic","doi":"10.2298/mpns2208250m","DOIUrl":"https://doi.org/10.2298/mpns2208250m","url":null,"abstract":"Introduction. Among infectious diseases, tuberculosis ranks first in terms of morbidity and mortality. It mainly affects the lungs, but it can affect any organ in the body. Case Report. A 29-year old female patient, bacillus Calmette-Guerin vaccinated, human immunodeficiency virus-negative, non-smoker, active athlete, presented with magnetic resonance imaging of the spine indicating vertebral body collapse of Th10 with signs of intraosseous infiltration, extraosseous prevertebral, and extracorporeal spread into the spinal canal. Corpectomy of Th10 and Th11 with an anterior fusion of Th9-12 was performed by neurosurgical intervention. Histopathological examination of the vertebral body confirmed a necrotic granulomatous inflammation. No acid-fast bacilli were seen by Ziehl-Neelsen staining, while Mycobacterium tuberculosis culture was positive. Chest X-ray and computed tomography were normal, induced sputum smear microscopy was negative for Mycobacterium tuberculosis. The antituberculosis therapy lasted for 12 months. Conclusion. Spinal tuberculosis is a differential diagnostic problem in relation to pyogenic infections and metastatic bone tumors.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78038796","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. The role of tracheotomy in the treatment of patients with prolonged intubation in intensive care units is known and confirmed. In light of the global pandemic of severe acute respiratory syndrome coronavirus-2 infection and consequent coronavirus disease 2019, we present our experiences with tracheotomy in infected patients. Material and Methods. A retrospective observational study of patients treated in intensive care units at the Clinical Hospital Center ?Dr. Dragisa Misovic Dedinje? was carried out in the period from March 21, 2020 to May 14, 2020. Results. A total of 970 coronavirus disease 2019-positive patients were treated and out of that number, 116 patients were treated in intensive care units (12%), of which 49 patients (42%) were on non-invasive mechanical ventilation and 67 patients (58%) on intensive mechanical ventilation. The average age of the patients was 59.3 years; the youngest patient was 46, and the oldest 73 years old. Tracheotomy was performed in 24 patients (21%), in 13 males (54.1%) and 11 females (45.9%). The mean time from intubation to tracheotomy was 11.6 days. Of the 24 tracheotomized patients, 12 had a successful decannulation (50%) and were discharged from intensive care units, 6 had a lethal outcome, and 6 patients were in treatment. Discussion. All the patients underwent tracheotomy in the hospital room, because we considered that any transfer and manipulation of these severe patients may lead to worsening of the generally serious condition. Although some guidelines recommend that it would be ideal to know the coronavirus disease 2019 status before any invasive procedure, we believe that this is not necessary, especially considering the clinical picture of patients during the pandemic, as well as computed tomography findings in the lungs. Conclusion. Tracheotomy has an important place in the treatment of patients with severe coronavirus disease 2019 infection since it provides easier maintenance of the airway, and in the recovery phase leads to easier transition of patients from mechanical ventilation to spontaneous breathing. The decision on the day when the tracheotomy will be performed is strictly individual and depends on the general condition of the patient, and the use of thermocautery does not affect the course of treatment and the final outcome.
{"title":"Role and significance of tracheotomy in intensive care units in coronavirus disease 2019-positive patients","authors":"I. Djordjevic, D. Stojakov","doi":"10.2298/mpns2202050d","DOIUrl":"https://doi.org/10.2298/mpns2202050d","url":null,"abstract":"Introduction. The role of tracheotomy in the treatment of patients with prolonged intubation in intensive care units is known and confirmed. In light of the global pandemic of severe acute respiratory syndrome coronavirus-2 infection and consequent coronavirus disease 2019, we present our experiences with tracheotomy in infected patients. Material and Methods. A retrospective observational study of patients treated in intensive care units at the Clinical Hospital Center ?Dr. Dragisa Misovic Dedinje? was carried out in the period from March 21, 2020 to May 14, 2020. Results. A total of 970 coronavirus disease 2019-positive patients were treated and out of that number, 116 patients were treated in intensive care units (12%), of which 49 patients (42%) were on non-invasive mechanical ventilation and 67 patients (58%) on intensive mechanical ventilation. The average age of the patients was 59.3 years; the youngest patient was 46, and the oldest 73 years old. Tracheotomy was performed in 24 patients (21%), in 13 males (54.1%) and 11 females (45.9%). The mean time from intubation to tracheotomy was 11.6 days. Of the 24 tracheotomized patients, 12 had a successful decannulation (50%) and were discharged from intensive care units, 6 had a lethal outcome, and 6 patients were in treatment. Discussion. All the patients underwent tracheotomy in the hospital room, because we considered that any transfer and manipulation of these severe patients may lead to worsening of the generally serious condition. Although some guidelines recommend that it would be ideal to know the coronavirus disease 2019 status before any invasive procedure, we believe that this is not necessary, especially considering the clinical picture of patients during the pandemic, as well as computed tomography findings in the lungs. Conclusion. Tracheotomy has an important place in the treatment of patients with severe coronavirus disease 2019 infection since it provides easier maintenance of the airway, and in the recovery phase leads to easier transition of patients from mechanical ventilation to spontaneous breathing. The decision on the day when the tracheotomy will be performed is strictly individual and depends on the general condition of the patient, and the use of thermocautery does not affect the course of treatment and the final outcome.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84188381","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}
Osteoporosis is defined as a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. The definition of osteoporosis is based on the T-score for bone mineral density in women and is defined as a value for bone mineral density of 2.5 standard deviation or more below the young female adult mean (T-score less than or equal to ? 2.5). The clinical significance of osteoporosis lies in the fractures, which are usually the first clinical sign. Approximately one in two adult women and one in five men will sustain one or more fragility fractures (defined as a low trauma fracture sustained from a fall from standing height or less) in their lifetime. More than 9 million osteoporotic or fragility fractures occur annually across the globe, more than a third of which happen in Europe. It was estimated that 10.6 out of the 18.4 million women in Europe who exceeded the threshold risk for osteoporotic fractures were not treated, representing a treatment gap of 57%. The treatment gap is considered such a major concern that multiple global health organizations have issued global calls to tackle this crisis. The increase in the treatment gap could be accredited to several factors such as misbelief about osteoporosis, absence of perceived benefits of therapy, concern about side effects and medication costs, low motivation, and shortfall of patient education. Several methods have been explored to enable fracture risk assessment and initiation of appropriate therapy. The multi-disciplinary Fracture Liaison Service is one of the most successful of these systems.
{"title":"Osteoporosis - treatment gap","authors":"R. Matijević","doi":"10.2298/mpns22s2019m","DOIUrl":"https://doi.org/10.2298/mpns22s2019m","url":null,"abstract":"Osteoporosis is defined as a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. The definition of osteoporosis is based on the T-score for bone mineral density in women and is defined as a value for bone mineral density of 2.5 standard deviation or more below the young female adult mean (T-score less than or equal to ? 2.5). The clinical significance of osteoporosis lies in the fractures, which are usually the first clinical sign. Approximately one in two adult women and one in five men will sustain one or more fragility fractures (defined as a low trauma fracture sustained from a fall from standing height or less) in their lifetime. More than 9 million osteoporotic or fragility fractures occur annually across the globe, more than a third of which happen in Europe. It was estimated that 10.6 out of the 18.4 million women in Europe who exceeded the threshold risk for osteoporotic fractures were not treated, representing a treatment gap of 57%. The treatment gap is considered such a major concern that multiple global health organizations have issued global calls to tackle this crisis. The increase in the treatment gap could be accredited to several factors such as misbelief about osteoporosis, absence of perceived benefits of therapy, concern about side effects and medication costs, low motivation, and shortfall of patient education. Several methods have been explored to enable fracture risk assessment and initiation of appropriate therapy. The multi-disciplinary Fracture Liaison Service is one of the most successful of these systems.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91312728","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}
Bojan Mihajlović, A. Redžek, M. Jarakovic, T. Popov, Dejan Aleksandric, L. Velicki
Introduction. The aim of this study was to evaluate the predictive value of the European System for Cardiac Operative Risk Evaluation II in adult patients with acquired heart diseases. Material and Methods. The research included a consecutive series of 6,031 patients who underwent coronary, valvular and combined cardiac surgical interventions in the period from January 15, 2015 to December 31, 2020. Model calibration was assessed by comparing the ratio of actual to expected postoperative mortality and using the Hosmer-Lemeshow test. The discriminative power was examined using the area under the receiver operating characteristic curve. Results. A total of 2,883 patients underwent isolated coronary surgery, 1,841 underwent valvular procedures, while a combined procedure was performed in 1,307 patients. The operative risk was moderately underestimated in the entire group, as well as in the group of patients who underwent surgical revascularization of the coronary arteries. In patients who underwent valvular surgery, the actual mortality rate was slightly overestimated, while in patients with combined procedures it was moderately underestimated. The European System for Cardiac Operative Risk Evaluation II showed excellent discriminative power in the whole group of patients undergoing surgery (area under the curve = 0.825, p < 0.0005). The cut-off value was 2.60, sensitivity 0.757 and specificity 0.750. The discriminative power of the model was excellent in the group of coronary patients (area under the curve = 0.810) as well as in the group with isolated valvular surgery (area under the curve = 0.815). In patients with combined procedures, the discriminatory power was very good (area under the curve = 0.775). Conclusion. The results of our single centre study show that European System for Cardiac Operative Risk Evaluation II predicts hospital mortality with satisfactory results in the entire group, but underestimates it when it comes to combined cardiac surgical procedures. The discriminative power of the model is excellent.
{"title":"Ten years after the introduction of the European system for cardiac operative risk evaluation 2: A single center validation","authors":"Bojan Mihajlović, A. Redžek, M. Jarakovic, T. Popov, Dejan Aleksandric, L. Velicki","doi":"10.2298/mpns2204083m","DOIUrl":"https://doi.org/10.2298/mpns2204083m","url":null,"abstract":"Introduction. The aim of this study was to evaluate the predictive value of the European System for Cardiac Operative Risk Evaluation II in adult patients with acquired heart diseases. Material and Methods. The research included a consecutive series of 6,031 patients who underwent coronary, valvular and combined cardiac surgical interventions in the period from January 15, 2015 to December 31, 2020. Model calibration was assessed by comparing the ratio of actual to expected postoperative mortality and using the Hosmer-Lemeshow test. The discriminative power was examined using the area under the receiver operating characteristic curve. Results. A total of 2,883 patients underwent isolated coronary surgery, 1,841 underwent valvular procedures, while a combined procedure was performed in 1,307 patients. The operative risk was moderately underestimated in the entire group, as well as in the group of patients who underwent surgical revascularization of the coronary arteries. In patients who underwent valvular surgery, the actual mortality rate was slightly overestimated, while in patients with combined procedures it was moderately underestimated. The European System for Cardiac Operative Risk Evaluation II showed excellent discriminative power in the whole group of patients undergoing surgery (area under the curve = 0.825, p < 0.0005). The cut-off value was 2.60, sensitivity 0.757 and specificity 0.750. The discriminative power of the model was excellent in the group of coronary patients (area under the curve = 0.810) as well as in the group with isolated valvular surgery (area under the curve = 0.815). In patients with combined procedures, the discriminatory power was very good (area under the curve = 0.775). Conclusion. The results of our single centre study show that European System for Cardiac Operative Risk Evaluation II predicts hospital mortality with satisfactory results in the entire group, but underestimates it when it comes to combined cardiac surgical procedures. The discriminative power of the model is excellent.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84544726","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}
I. Isakov, V. Čabarkapa, Branislava Srdjenovic-Conic, N. Kladar, B. Ilinčić, D. Burić
Introduction. Modification of tryptophan metabolism during the progression of chronic kidney disease may have significant pathophysiological consequences. The aim of this study was to investigate the status of metabolic products of tryptophan, indoxyl sulfate and kynurenine in different stages of chronic kidney disease. Material and Methods. In all participants included in the cross-sectional study (n = 66) with previously diagnosed chronic kidney disease, the parameters of renal function were measured: glomerular filtration rate using radionuclide plasma clearance with 99mTc-labelled diethylene triamine penta-acetate and effective renal plasma flow using 131Ilabeled orthoiodohippuric acid. Plasma concentrations of indoxyl sulfate and kynurenine were measured by high-performance liquid chromatography. Results. A significant difference was observed in the concentrations of both metabolites between the observed groups (Group II - measured glomerular filtration rate - 15 - 60 ml/min/1.73 m?; n = 36 vs. Group I measured glomerular filtration rate > 60 l/ min/1.73 m?; n = 26): indoxyl sulfate 1.07 ? 0.89 vs. 2.44 ? 4.05 ?g/ ml, p < 0.001; kynurenine 3.15 ? 0.22 vs. 3.21 ? 0.17 ?g/ml, p < 0.05. The correlation was statistically significant between glomerular filtration rate and kynurenine - r = -0.38, p = 0.001 and indoxyl sulfate - r = 0.56, p ? 0.001; effective plasma renal flow and kynurenine - r = -0.33, p < 0.05 and indoxyl sulfate - r = 0.46, p ? 0.001. Conclusion. There is a significant difference in the plasma concentrations of indoxyl sulfate and kynurenine in the group of patients with glomerular filtration rate of 15 - 60 ml/min/1.73 m? compared to patients with glomerular filtration rate > 60 ml/min/1.73 m?. In patients with chronic kidney disease, plasma concentrations of both metabolites of tryptophan are inversely correlated with the glomerular filtration rate and effective plasma renal flow.
介绍。慢性肾脏疾病进展过程中色氨酸代谢的改变可能具有显著的病理生理后果。本研究旨在探讨色氨酸、硫酸吲哚酚和犬尿氨酸在慢性肾脏疾病不同阶段的代谢产物状态。材料和方法。在横断研究中纳入的所有先前诊断为慢性肾脏疾病的参与者(n = 66)中，测量了肾功能参数:使用99mtc标记的放射性核素血浆清除率(肾小球滤过率)和使用131il标记的正碘马尿酸测量有效肾血浆流量。采用高效液相色谱法测定硫酸吲哚酚和犬尿氨酸的血药浓度。结果。观察组之间两种代谢物的浓度有显著差异(II组-测量肾小球滤过率- 15 - 60 ml/min/1.73 m?;n = 36 vs. I组肾小球滤过率> 60 l/ min/1.73 m?N = 26):硫酸吲哚酚1.07 ?0.89 vs 2.44 ?4.05 g/ ml, p < 0.001;犬尿素3.15 ?0.22 vs. 3.21 ?0.17 g/ml, p < 0.05。肾小球滤过率与犬尿氨酸- r = -0.38, p = 0.001，硫酸吲哚酚- r = 0.56, p ?0.001;有效血浆肾流量和犬尿氨酸- r = -0.33, p < 0.05，硫酸吲哚酚- r = 0.46, p ?0.001. 结论。在肾小球滤过率为15 ~ 60ml /min/1.73 m?与肾小球滤过率> 60 ml/min/1.73 m?在慢性肾病患者中，色氨酸两种代谢物的血浆浓度与肾小球滤过率和有效血浆肾流量呈负相关。
{"title":"Status of tryptophan metabolites in different stages of chronic kidney disease of non-diabetc etiology","authors":"I. Isakov, V. Čabarkapa, Branislava Srdjenovic-Conic, N. Kladar, B. Ilinčić, D. Burić","doi":"10.2298/mpns2202005i","DOIUrl":"https://doi.org/10.2298/mpns2202005i","url":null,"abstract":"Introduction. Modification of tryptophan metabolism during the progression of chronic kidney disease may have significant pathophysiological consequences. The aim of this study was to investigate the status of metabolic products of tryptophan, indoxyl sulfate and kynurenine in different stages of chronic kidney disease. Material and Methods. In all participants included in the cross-sectional study (n = 66) with previously diagnosed chronic kidney disease, the parameters of renal function were measured: glomerular filtration rate using radionuclide plasma clearance with 99mTc-labelled diethylene triamine penta-acetate and effective renal plasma flow using 131Ilabeled orthoiodohippuric acid. Plasma concentrations of indoxyl sulfate and kynurenine were measured by high-performance liquid chromatography. Results. A significant difference was observed in the concentrations of both metabolites between the observed groups (Group II - measured glomerular filtration rate - 15 - 60 ml/min/1.73 m?; n = 36 vs. Group I measured glomerular filtration rate > 60 l/ min/1.73 m?; n = 26): indoxyl sulfate 1.07 ? 0.89 vs. 2.44 ? 4.05 ?g/ ml, p < 0.001; kynurenine 3.15 ? 0.22 vs. 3.21 ? 0.17 ?g/ml, p < 0.05. The correlation was statistically significant between glomerular filtration rate and kynurenine - r = -0.38, p = 0.001 and indoxyl sulfate - r = 0.56, p ? 0.001; effective plasma renal flow and kynurenine - r = -0.33, p < 0.05 and indoxyl sulfate - r = 0.46, p ? 0.001. Conclusion. There is a significant difference in the plasma concentrations of indoxyl sulfate and kynurenine in the group of patients with glomerular filtration rate of 15 - 60 ml/min/1.73 m? compared to patients with glomerular filtration rate > 60 ml/min/1.73 m?. In patients with chronic kidney disease, plasma concentrations of both metabolites of tryptophan are inversely correlated with the glomerular filtration rate and effective plasma renal flow.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89078302","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. The Myeloproliferative Neoplasms are a heterogeneous group of clonal hematopoietic stem cell disorders characterized by increased proliferation of the myeloid lineages in the bone marrow. A particular clinical challenge is presented by certain situations in patients with myeloproliferative Neoplasms, which we do not encounter daily. For this reason, in this paper, we will emphasize the approach to overcoming obstacles in patients with Myeloproliferative Neoplasms in specific settings, like pregnancy. Pregnancy with Philadelphia chromosome-negative Myeloproliferative Neoplasms has been reported to be associated with maternal thrombosis, hemorrhage, and placental dysfunction leading to fetal growth restriction or loss. Thrombocytosis, leucocytosis, high level of hematocrit, activation of Platelets, leucocytes, and circulating pro-thrombotic are connected with the pathogenesis of thrombosis in MPNs With survival expectations similar to age-matched controls and excellent response and worldwide access to tyrosine kinase inhibitors, family planning is increasingly important for many patients with chronic myeloid leukemia. All patients were managed by a multidisciplinary team of physicians with obligatory hematological and gynecologistsobstetrician consultations.
{"title":"Myeloproliferative neoplasms and pregnancy","authors":"I. Urosevic, A. Bogdanović, D. Leković","doi":"10.2298/mpns22s1121u","DOIUrl":"https://doi.org/10.2298/mpns22s1121u","url":null,"abstract":"Introduction. The Myeloproliferative Neoplasms are a heterogeneous group of clonal hematopoietic stem cell disorders characterized by increased proliferation of the myeloid lineages in the bone marrow. A particular clinical challenge is presented by certain situations in patients with myeloproliferative Neoplasms, which we do not encounter daily. For this reason, in this paper, we will emphasize the approach to overcoming obstacles in patients with Myeloproliferative Neoplasms in specific settings, like pregnancy. Pregnancy with Philadelphia chromosome-negative Myeloproliferative Neoplasms has been reported to be associated with maternal thrombosis, hemorrhage, and placental dysfunction leading to fetal growth restriction or loss. Thrombocytosis, leucocytosis, high level of hematocrit, activation of Platelets, leucocytes, and circulating pro-thrombotic are connected with the pathogenesis of thrombosis in MPNs With survival expectations similar to age-matched controls and excellent response and worldwide access to tyrosine kinase inhibitors, family planning is increasingly important for many patients with chronic myeloid leukemia. All patients were managed by a multidisciplinary team of physicians with obligatory hematological and gynecologistsobstetrician consultations.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89522617","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. Cannabis use in adolescence has a major impact on the individual, family and community, whereas the effects are cumulative and contribute to social, physical and mental problems. Socializing with peers who use psychoactive substances can significantly increase the likelihood of adolescent cannabis use. The aim of this study was to determine the prevalence of cannabis use among adolescents in Novi Sad, as well as the differences in prevalence depending on the risky behavior of their friends depending on the relationships between them. Material and Methods. The research was conducted as a cross-sectional study in 2017 and included 1,067 first-grade students from 19 high schools in Novi Sad. The research instrument was a questionnaire of the European School Survey Project on Alcohol and Other Drugs. Results. The prevalence of marijuana abuse in Novi Sad was 12% and it was twice higher among students from the city (13.1%) or suburban areas (13.6%) than in students from villages (5.8%) (p < 0.05). Marijuana use was significantly more prevalent among students whose most/all friends smoked (23.1%) than among those whose friends did not smoke (10.1%) or only a few smoked (5.5%) (p < 0.001). Respondents whose friends use alcohol were significantly more likely to use marijuana (15.2%) than those who have only a few such friends (6.4%) or none (10.5%) (p < 0.001). More than half of students whose friends use marijuana have tried it (54%), while among those who do not have such friends, only 3% have used marijuana (p < 0.001). Conclusion. The prevalence of marijuana use in adolescents in Novi Sad is high. Peer risk behaviors influence adolescent cannabis use.
{"title":"Peer influence on marijuana use among adolescents in Novi Sad","authors":"Bojana Jovančević, I. Radić, S. Ukropina","doi":"10.2298/mpns2206182j","DOIUrl":"https://doi.org/10.2298/mpns2206182j","url":null,"abstract":"Introduction. Cannabis use in adolescence has a major impact on the individual, family and community, whereas the effects are cumulative and contribute to social, physical and mental problems. Socializing with peers who use psychoactive substances can significantly increase the likelihood of adolescent cannabis use. The aim of this study was to determine the prevalence of cannabis use among adolescents in Novi Sad, as well as the differences in prevalence depending on the risky behavior of their friends depending on the relationships between them. Material and Methods. The research was conducted as a cross-sectional study in 2017 and included 1,067 first-grade students from 19 high schools in Novi Sad. The research instrument was a questionnaire of the European School Survey Project on Alcohol and Other Drugs. Results. The prevalence of marijuana abuse in Novi Sad was 12% and it was twice higher among students from the city (13.1%) or suburban areas (13.6%) than in students from villages (5.8%) (p < 0.05). Marijuana use was significantly more prevalent among students whose most/all friends smoked (23.1%) than among those whose friends did not smoke (10.1%) or only a few smoked (5.5%) (p < 0.001). Respondents whose friends use alcohol were significantly more likely to use marijuana (15.2%) than those who have only a few such friends (6.4%) or none (10.5%) (p < 0.001). More than half of students whose friends use marijuana have tried it (54%), while among those who do not have such friends, only 3% have used marijuana (p < 0.001). Conclusion. The prevalence of marijuana use in adolescents in Novi Sad is high. Peer risk behaviors influence adolescent cannabis use.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"26 5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82949338","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}
D. Andric, T. Miljković, S. Andric, A. Milovančev, M. Tomic, S. Šušak
Introduction. If young women with congenital heart disease need heart valve surgery, it is necessary to thoroughly consider the choice of the valve and the risks of serious complications during pregnancy. Case Report. We report a case of a woman who presented with a pregnancy complicated by mechanical aortic valve thrombosis at the end of the first trimester. After a thorough evaluation by a multidisciplinary team, the patient underwent surgical thrombectomy and normal mechanical valve function was restored. At 36 weeks of gestation, planned cesarean section was performed. The mother and the child remained well during the 5-year follow-up. Conclusion. Mechanical heart valves in pregnancy carry a very high risk of complications. An individualized approach is needed in the management of women with mechanical valves, as well as uniform antenatal care in centers that provide complete care from pregnancy planning to delivery.
{"title":"Mechanical valve thrombosis during pregnancy: A case report","authors":"D. Andric, T. Miljković, S. Andric, A. Milovančev, M. Tomic, S. Šušak","doi":"10.2298/mpns2210308a","DOIUrl":"https://doi.org/10.2298/mpns2210308a","url":null,"abstract":"Introduction. If young women with congenital heart disease need heart valve surgery, it is necessary to thoroughly consider the choice of the valve and the risks of serious complications during pregnancy. Case Report. We report a case of a woman who presented with a pregnancy complicated by mechanical aortic valve thrombosis at the end of the first trimester. After a thorough evaluation by a multidisciplinary team, the patient underwent surgical thrombectomy and normal mechanical valve function was restored. At 36 weeks of gestation, planned cesarean section was performed. The mother and the child remained well during the 5-year follow-up. Conclusion. Mechanical heart valves in pregnancy carry a very high risk of complications. An individualized approach is needed in the management of women with mechanical valves, as well as uniform antenatal care in centers that provide complete care from pregnancy planning to delivery.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82017354","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}
Maja M Drljača, Maja Ružić, D. Marić, N. Rajić, Jelena Djurica, S. Ilić
Introduction. Hepatitis A virus is the most common cause of acute viral hepatitis, and in people over 25 years of age the disease may have different degrees of severity. Even though hepatitis A virus infection was long believed to be transmitted strictly by fecal-oral route, now this virus is classified among sexually transmitted diseases. Homosexual population, especially those positive for human immunodeficiency virus, is at the greatest risk of hepatitis A virus infection. Case 1. A twenty-six-year-old male homosexual was admitted with clinical and laboratory findings of acute hepatitis. The patient tested positive for enzyme-linked immunosorbent assay immunoglobulin M antibodies to hepatitis A virus and human immunodeficiency virus antibodies, and later on human immunodeficiency virus infection was confirmed by polymerase chain reaction test. After the discharge, the antiretroviral therapy was initiated. Case 2. A twenty-seven-year-old male homosexual was transferred to our clinic from the Regional Hospital, where he was hospitalized due to acute hepatitis A virus infection, after a positive serological test for anti-human immunodeficiency virus antibodies. Human immunodeficiency virus infection was confirmed by polymerase chain reaction test, and upon discharge, antiretroviral therapy was initiated. Conclusion. In order to take the most effective preventive measures, it is very important to identify individuals and groups at high risk of coinfection with human immunodeficiency virus and hepatitis A virus. Timely vaccination against hepatitis A virus among people living with human immunodeficiency virus is recommended and therefore it is necessary to design effective strategies for education of groups at risk.
{"title":"First reported cases of hepatitis A virus and human immunodeficiency virus coinfection in Vojvodina, Serbia: A case report","authors":"Maja M Drljača, Maja Ružić, D. Marić, N. Rajić, Jelena Djurica, S. Ilić","doi":"10.2298/mpns2208263d","DOIUrl":"https://doi.org/10.2298/mpns2208263d","url":null,"abstract":"Introduction. Hepatitis A virus is the most common cause of acute viral hepatitis, and in people over 25 years of age the disease may have different degrees of severity. Even though hepatitis A virus infection was long believed to be transmitted strictly by fecal-oral route, now this virus is classified among sexually transmitted diseases. Homosexual population, especially those positive for human immunodeficiency virus, is at the greatest risk of hepatitis A virus infection. Case 1. A twenty-six-year-old male homosexual was admitted with clinical and laboratory findings of acute hepatitis. The patient tested positive for enzyme-linked immunosorbent assay immunoglobulin M antibodies to hepatitis A virus and human immunodeficiency virus antibodies, and later on human immunodeficiency virus infection was confirmed by polymerase chain reaction test. After the discharge, the antiretroviral therapy was initiated. Case 2. A twenty-seven-year-old male homosexual was transferred to our clinic from the Regional Hospital, where he was hospitalized due to acute hepatitis A virus infection, after a positive serological test for anti-human immunodeficiency virus antibodies. Human immunodeficiency virus infection was confirmed by polymerase chain reaction test, and upon discharge, antiretroviral therapy was initiated. Conclusion. In order to take the most effective preventive measures, it is very important to identify individuals and groups at high risk of coinfection with human immunodeficiency virus and hepatitis A virus. Timely vaccination against hepatitis A virus among people living with human immunodeficiency virus is recommended and therefore it is necessary to design effective strategies for education of groups at risk.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87172085","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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