Introduction. Tumor lysis syndrome is an emergency condition requiring prompt recognition and treatment. It?s a consequence of spontaneous or therapy-induced cellular death leading to the release of intracellular ions and metabolic products of purine bases into the bloodstream. Pathophysiology. The characteristic metabolic derangement comprises hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia. These metabolic changes can lead to kidney failure, arrhythmia, and seizures. Epidemiology, classification and risk assessment. The incidence of tumor lysis syndrome varies between different types of tumors, but it is most common in hematologic malignancies. According to Cairo - Bishop Classification, tumor lysis syndrome can be defined as laboratory tumor lysis syndrome and clinical tumor lysis syndrome. Preventive measures and treatment of tumor lysis syndrome. Frequent laboratory monitoring is obligatory in patients with intermediate and high risk of tumor lysis syndrome. Preventive measures are based on vigorous hydration and administration of medication to control serum uric acid levels. When clinical tumor lysis syndrome develops, additional treatment, including renal replacement therapy, is needed for the correction of metabolic disturbances. Conclusion. Tumor lysis syndrome is a potentially fatal complication in patients with suffering from malignancies. Early recognition of patients at risk and administration of prophylactic and therapeutic measures improves outcomes for these patients.
{"title":"Tumor lysis syndrome","authors":"Ivanka Perčić","doi":"10.2298/mpns22s1157p","DOIUrl":"https://doi.org/10.2298/mpns22s1157p","url":null,"abstract":"Introduction. Tumor lysis syndrome is an emergency condition requiring prompt recognition and treatment. It?s a consequence of spontaneous or therapy-induced cellular death leading to the release of intracellular ions and metabolic products of purine bases into the bloodstream. Pathophysiology. The characteristic metabolic derangement comprises hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia. These metabolic changes can lead to kidney failure, arrhythmia, and seizures. Epidemiology, classification and risk assessment. The incidence of tumor lysis syndrome varies between different types of tumors, but it is most common in hematologic malignancies. According to Cairo - Bishop Classification, tumor lysis syndrome can be defined as laboratory tumor lysis syndrome and clinical tumor lysis syndrome. Preventive measures and treatment of tumor lysis syndrome. Frequent laboratory monitoring is obligatory in patients with intermediate and high risk of tumor lysis syndrome. Preventive measures are based on vigorous hydration and administration of medication to control serum uric acid levels. When clinical tumor lysis syndrome develops, additional treatment, including renal replacement therapy, is needed for the correction of metabolic disturbances. Conclusion. Tumor lysis syndrome is a potentially fatal complication in patients with suffering from malignancies. Early recognition of patients at risk and administration of prophylactic and therapeutic measures improves outcomes for these patients.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"107 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77450116","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}
Marko Atanaskovic, Marko Nemet, Borislav Tapavički, Milica Vasilić, Ivona Stanic-Hadzalic, Enis Garipi
Introduction. Heart rate variability is the leading non-invasive method used for assessing the activity of the autonomic nervous system. Investigation of the changes in the autonomic nervous system activity under the influence of circadian rhythm and daily physical activity can be beneficial to exercise at the best time of the day and at regular time intervals. Furthermore, it can be used to determine the optimal level of total daily physical activity. This study aimed to demonstrate the effects of circadian rhythm and daily physical activity on the autonomic nervous system at rest through short-term measurements of heart rate variability. Material and Methods. Fifteen young healthy adults participated in the study. Heart rate variability was measured on three separate occasions. During these visits, heart rate variability measurements were made in the morning, in the afternoon hours following a physically active day, and in the afternoon hours after a physically inactive day. Results. Our study showed no significant differences in the parameters of heart rate variability measured at different times of the day. A comparison of heart rate variability values after a physically inactive day and heart rate variability values after a physically active day did not show a significant difference in any of the heart rate variability parameters. Conclusion. Short-term measurements of heart rate variability showed no impact of circadian rhythm and daily physical activity on heart rate variability at rest.
{"title":"Effects of circadian rhythm and daily physical activity on short-term heart rate variability in young healthy adults: A pilot study","authors":"Marko Atanaskovic, Marko Nemet, Borislav Tapavički, Milica Vasilić, Ivona Stanic-Hadzalic, Enis Garipi","doi":"10.2298/mpns2210295a","DOIUrl":"https://doi.org/10.2298/mpns2210295a","url":null,"abstract":"Introduction. Heart rate variability is the leading non-invasive method used for assessing the activity of the autonomic nervous system. Investigation of the changes in the autonomic nervous system activity under the influence of circadian rhythm and daily physical activity can be beneficial to exercise at the best time of the day and at regular time intervals. Furthermore, it can be used to determine the optimal level of total daily physical activity. This study aimed to demonstrate the effects of circadian rhythm and daily physical activity on the autonomic nervous system at rest through short-term measurements of heart rate variability. Material and Methods. Fifteen young healthy adults participated in the study. Heart rate variability was measured on three separate occasions. During these visits, heart rate variability measurements were made in the morning, in the afternoon hours following a physically active day, and in the afternoon hours after a physically inactive day. Results. Our study showed no significant differences in the parameters of heart rate variability measured at different times of the day. A comparison of heart rate variability values after a physically inactive day and heart rate variability values after a physically active day did not show a significant difference in any of the heart rate variability parameters. Conclusion. Short-term measurements of heart rate variability showed no impact of circadian rhythm and daily physical activity on heart rate variability at rest.","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":"75868001","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. Tosic, Nikola Vukosav, Milan Majkić, Branko Baljak, Milan Milinkov, S. Ninkovic
Introduction. The purpose of this paper is to present and analyze the results of treatment of anterior soft-tissue shoulder instability using an open surgical technique with a minimally invasive anterior approach, as well as to emphasize the benefits of using an open surgical procedure in high-risk patients. Material and Methods. All patients underwent surgery at the Clinic of Orthopedic Surgery and Traumatology in Novi Sad in the period between January 2013 and September 2017. Out of 138 patients undergoing surgery for anterior shoulder instability, 40 patients came for follow-up examination. The average age of subjects was 27 ? 6. Medical history was taken from each patient and the range of motion and muscle strength of the operated shoulder was examined. The subjects filled out a questionnaire regarding the functional status of the operated shoulder, their experience in resuming sports activities, and their subjective feeling of pain. The Constant-Murley score was used to assess the postoperative results. Results. Postoperatively, the mean Constant-Murley score was 90.3 ? 11.5, while 87.5% patients had excellent and good results. Compared to the contralateral uninjured shoulder, there was a statistically significant difference (p < 0.05) in the Constant-Murley score, in external rotation of the abducted shoulder (13.2? ? 10.4?), as well as in shoulder adduction (10.25? ? 9.7?). Out of 35 patients who were athletes, 27 continued to actively engage in sports following the surgical treatment. Four patients had a re-dislocation (10%). Conclusion. Open surgical treatment of the anterior shoulder joint instability using a minimally invasive anterior approach is a reliable, time-tested procedure that provides favorable clinical results in young high-risk contact and overhead athletes with timely diagnosis and surgical care.
{"title":"Functional outcomes after surgical treatment of anterior soft-tissue shoulder instability using a minimally invasive anterior approach","authors":"M. Tosic, Nikola Vukosav, Milan Majkić, Branko Baljak, Milan Milinkov, S. Ninkovic","doi":"10.2298/mpns2206177t","DOIUrl":"https://doi.org/10.2298/mpns2206177t","url":null,"abstract":"Introduction. The purpose of this paper is to present and analyze the results of treatment of anterior soft-tissue shoulder instability using an open surgical technique with a minimally invasive anterior approach, as well as to emphasize the benefits of using an open surgical procedure in high-risk patients. Material and Methods. All patients underwent surgery at the Clinic of Orthopedic Surgery and Traumatology in Novi Sad in the period between January 2013 and September 2017. Out of 138 patients undergoing surgery for anterior shoulder instability, 40 patients came for follow-up examination. The average age of subjects was 27 ? 6. Medical history was taken from each patient and the range of motion and muscle strength of the operated shoulder was examined. The subjects filled out a questionnaire regarding the functional status of the operated shoulder, their experience in resuming sports activities, and their subjective feeling of pain. The Constant-Murley score was used to assess the postoperative results. Results. Postoperatively, the mean Constant-Murley score was 90.3 ? 11.5, while 87.5% patients had excellent and good results. Compared to the contralateral uninjured shoulder, there was a statistically significant difference (p < 0.05) in the Constant-Murley score, in external rotation of the abducted shoulder (13.2? ? 10.4?), as well as in shoulder adduction (10.25? ? 9.7?). Out of 35 patients who were athletes, 27 continued to actively engage in sports following the surgical treatment. Four patients had a re-dislocation (10%). Conclusion. Open surgical treatment of the anterior shoulder joint instability using a minimally invasive anterior approach is a reliable, time-tested procedure that provides favorable clinical results in young high-risk contact and overhead athletes with timely diagnosis and surgical care.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81562248","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}
von Willebrand disease is the most common inherited bleeding disorder, with mucocutaneous bleeding and menorrhagia as leading clinical manifestations. Cause of the bleeding diathesis is deficit or dysfunction of the vonWillebrand factor, plasma protein with important roles in adhesion of platelets to the site of vascular injury and transport and protection of coagulation factor VIII. Prevalance of the disease, according to different registries, is between 1 von Willebrand disease on 100 persons to 1 von Willebrand disease on 10000 persons. These data shows that detection of the disorder is not easy and that many cases are undiagnosed. That why bleeding assessment tools are developed and they are widely used for many years. Confirmation of the diagnosis is through laboratory testing. Some of tests are not easily accessible. Therapy of the disorder depends on goals of the treatment (stopping bleeding, prophylaxis or preoperative management). Last year, new guideline for diagnostics and treatment of von Willebrand disease was published by experts of World Federation of Haemophilia, International Society of Thrombosis and Haemostasis, American Society of Hematology and National Hemophilia Foundation. In this paper, new recommendations for detection, diagnostics and treatment of the von Willebrand disease, are presented.
{"title":"Von Willebrand disease - detection, diagnostics and treatment","authors":"N. Rajić","doi":"10.2298/mpns22s1147r","DOIUrl":"https://doi.org/10.2298/mpns22s1147r","url":null,"abstract":"von Willebrand disease is the most common inherited bleeding disorder, with mucocutaneous bleeding and menorrhagia as leading clinical manifestations. Cause of the bleeding diathesis is deficit or dysfunction of the vonWillebrand factor, plasma protein with important roles in adhesion of platelets to the site of vascular injury and transport and protection of coagulation factor VIII. Prevalance of the disease, according to different registries, is between 1 von Willebrand disease on 100 persons to 1 von Willebrand disease on 10000 persons. These data shows that detection of the disorder is not easy and that many cases are undiagnosed. That why bleeding assessment tools are developed and they are widely used for many years. Confirmation of the diagnosis is through laboratory testing. Some of tests are not easily accessible. Therapy of the disorder depends on goals of the treatment (stopping bleeding, prophylaxis or preoperative management). Last year, new guideline for diagnostics and treatment of von Willebrand disease was published by experts of World Federation of Haemophilia, International Society of Thrombosis and Haemostasis, American Society of Hematology and National Hemophilia Foundation. In this paper, new recommendations for detection, diagnostics and treatment of the von Willebrand disease, are presented.","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":"91120670","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}
Marija Lazarević, D. Milovanović, Dejana Ružić-Zečević
Introduction. The aim of our research is to determine the breakdown value of vitamin B12 in the blood that causes mild cognitive impairment. Material and Methods. Two hundred respondents participated in this research. Using screening tests, mild cognitive impairment was found in 50 patients, while in 150 patients the cognitive function was preserved. Borderline values and units of vitamin B12 concentration were determined according to the standards of the local laboratory and their reference values ranged from 138.00 to 652.00 pmol/l. Results. Using the t-test for independent samples, it was determined that there was a statistically significant difference in the values of vitamin B12 in relation to whether or not the respondents had mild cognitive impairment (? = 0.000), i.e. that respondents with mild cognitive impairment - 225.66 had significantly lower values of vitamin B12 than those without mild cognitive impairment - 421.06. The statistic analysis revealed that the area under the receiver operating characteristic curve was significantly above 0,5 (0.968) and this result was statistically significant (? < 0.0005). The breakdown value of vitamin B12 was determined as the maximum product between sensitivity and specificity. Conclusion. In this research, we determined that there was a statistically significant difference in the values of vitamin B12 in relation to whether or not the respondents had mild cognitive impairment. Being a significant risk factor for mild cognitive impairment, we defined the breakdown value of vitamin B12 which induces mild cognitive impairment of 300.5 pmol/l.
{"title":"Defining the breakdown value of vitamin B12 as an important factor in the development of mild cognitive impairment","authors":"Marija Lazarević, D. Milovanović, Dejana Ružić-Zečević","doi":"10.2298/mpns2210284l","DOIUrl":"https://doi.org/10.2298/mpns2210284l","url":null,"abstract":"Introduction. The aim of our research is to determine the breakdown value of vitamin B12 in the blood that causes mild cognitive impairment. Material and Methods. Two hundred respondents participated in this research. Using screening tests, mild cognitive impairment was found in 50 patients, while in 150 patients the cognitive function was preserved. Borderline values and units of vitamin B12 concentration were determined according to the standards of the local laboratory and their reference values ranged from 138.00 to 652.00 pmol/l. Results. Using the t-test for independent samples, it was determined that there was a statistically significant difference in the values of vitamin B12 in relation to whether or not the respondents had mild cognitive impairment (? = 0.000), i.e. that respondents with mild cognitive impairment - 225.66 had significantly lower values of vitamin B12 than those without mild cognitive impairment - 421.06. The statistic analysis revealed that the area under the receiver operating characteristic curve was significantly above 0,5 (0.968) and this result was statistically significant (? < 0.0005). The breakdown value of vitamin B12 was determined as the maximum product between sensitivity and specificity. Conclusion. In this research, we determined that there was a statistically significant difference in the values of vitamin B12 in relation to whether or not the respondents had mild cognitive impairment. Being a significant risk factor for mild cognitive impairment, we defined the breakdown value of vitamin B12 which induces mild cognitive impairment of 300.5 pmol/l.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79208860","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 elderly are at high risk of developing osteosarcopenia, which is characterized by the coexistence of osteoporosis and sarcopenia. There are many factors that affect the interaction between bones and muscles: genetics, hormones, nervous system, aging, cardiac rhythm, nutrition. Pathophysiology of osteosarcopenia. Risk factors include: age of 50 years and over, sex, Caucasian race, genetic predisposition, short stature, malnutrition, physical inactivity, amenorrhea, late menarche, early menopause, estrogen and androgen deficiency, alcohol consumption, cigarette smoking, calcium deficiency in the diet, use of some drugs. Complications of osteosarcopenia include frequent bone fractures, physical disability, and mortality in the elderly population. Diagnostics. The gold standard is magnetic resonance imaging and computed tomography to assess muscle tissue. Bioelectric impedance analyzes the composition of the body, based on the speed at which electricity moves through tissues. Drug treatment of osteosarcopenia. Modern treatment of osteosarcopenia includes application of bisphosphonates, selective estrogen-receptor modulators, monoclonal antibodies, hormonal therapy, estrogens, and supplementation with calcium preparations and vitamin D. Prevention. Lifestyle changes and non-pharmacological measures are most important for healthy bones and muscles. Physical activity, nutrition rich in calcium and vitamin D, smoking and alcohol consumption are of crucial importance for people of all ages, especially for the elderly. The therapy should be reevaluated at least annually, and the quality of life should be assessed.
{"title":"Contemporary approach to osteosarcopenia","authors":"S. Tomasevic-Todorovic, N. Ilić","doi":"10.2298/mpns22s2068t","DOIUrl":"https://doi.org/10.2298/mpns22s2068t","url":null,"abstract":"Introduction. The elderly are at high risk of developing osteosarcopenia, which is characterized by the coexistence of osteoporosis and sarcopenia. There are many factors that affect the interaction between bones and muscles: genetics, hormones, nervous system, aging, cardiac rhythm, nutrition. Pathophysiology of osteosarcopenia. Risk factors include: age of 50 years and over, sex, Caucasian race, genetic predisposition, short stature, malnutrition, physical inactivity, amenorrhea, late menarche, early menopause, estrogen and androgen deficiency, alcohol consumption, cigarette smoking, calcium deficiency in the diet, use of some drugs. Complications of osteosarcopenia include frequent bone fractures, physical disability, and mortality in the elderly population. Diagnostics. The gold standard is magnetic resonance imaging and computed tomography to assess muscle tissue. Bioelectric impedance analyzes the composition of the body, based on the speed at which electricity moves through tissues. Drug treatment of osteosarcopenia. Modern treatment of osteosarcopenia includes application of bisphosphonates, selective estrogen-receptor modulators, monoclonal antibodies, hormonal therapy, estrogens, and supplementation with calcium preparations and vitamin D. Prevention. Lifestyle changes and non-pharmacological measures are most important for healthy bones and muscles. Physical activity, nutrition rich in calcium and vitamin D, smoking and alcohol consumption are of crucial importance for people of all ages, especially for the elderly. The therapy should be reevaluated at least annually, and the quality of life should be assessed.","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":"74183869","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. Todorovic-Balint, B. Balint, I. Djunić, Nevena Besevic, Andrej Pešić, O. Stojković
Introduction. Poor graft function is one of the most severe complications after allogeneic hematopoietic stem cell transplantation, which manifests as pancytopenia/cytopenia in the blood count, with the presence of complete or incomplete donor chimerism. There are three entities of graft weakness: 1. poor graft function: pancytopenia with complete donor chimerism, 2. graft failure: pancytopenia with incomplete, i.e., mixed donor chimerism and 3. graft rejection: progressive decline of donor chimerism. Definition. Poor graft function is diagnosed as pancytopenia (hemoglobin < 70 g/L, absolute neutrophil count < 0.5 x 109/L, platelets < 20 x 109/L) for 3 consecutive days from D+28, excluding the presence of severe graft versus host disease and relapse, with complete donor chimerism in poor graft function, and incomplete in graft failure. Risk factors and therapeutic principles. The most common risk factors for poor graft function are a small dose of CD34+ hematopoietic stem cells in the transplant, graft versus host disease, cytomegalovirus infection, the presence of donor-specific antibodies, high serum ferritin, i.e., iron overload, as well as splenomegaly. Pathogenetic mechanisms in the development of poor graft function are still not fully elucidated. The role of the microenvironment of the patient?s bone marrow is also important, as well as disorders of the immune system Therapeutic options for overcoming this complication include using selected ?stem cell boost?, mesenchymal stem cells, and newer medical agents (N-acetyl cysteine, atorvastatin, thrombopoietin receptor agonists). Conclusion. The type of poor function of the graft is defined in relation to the percentage of donor chimerism, and is necessary for planning further treatment strategy.
介绍。移植物功能差是同种异体造血干细胞移植后最严重的并发症之一，表现为血细胞计数全减少/细胞减少，存在完全或不完全的供体嵌合。存在三种类型的嫁接弱点:1。移植物功能差:全血细胞减少伴完全供体嵌合;移植物失败:全血细胞减少伴不完全，即混合供体嵌合和3。移植物排斥反应:供体嵌合性逐渐下降。定义。移植物功能差的诊断为从D+28开始连续3天全血细胞减少(血红蛋白< 70 g/L，绝对中性粒细胞计数< 0.5 x 109/L，血小板< 20 x 109/L)，排除严重移植物抗宿主病和复发，移植物功能差的供体嵌合完全，移植物功能不全。危险因素和治疗原则。移植物功能差最常见的危险因素是移植中CD34+造血干细胞的剂量小、移植物抗宿主病、巨细胞病毒感染、供体特异性抗体的存在、血清铁蛋白高(即铁超载)以及脾肿大。移植物功能不良的发病机制尚未完全阐明。患者微环境的作用?骨髓也很重要，免疫系统紊乱也是如此。克服这种并发症的治疗方法包括使用选择性的干细胞增强疗法。、间充质干细胞和较新的药物(n -乙酰半胱氨酸、阿托伐他汀、血小板生成素受体激动剂)。结论。移植物功能不良的类型与供体嵌合的百分比有关，这对于规划进一步的治疗策略是必要的。
{"title":"Poor graft function - causes and potential solutions","authors":"M. Todorovic-Balint, B. Balint, I. Djunić, Nevena Besevic, Andrej Pešić, O. Stojković","doi":"10.2298/mpns22s1045t","DOIUrl":"https://doi.org/10.2298/mpns22s1045t","url":null,"abstract":"Introduction. Poor graft function is one of the most severe complications after allogeneic hematopoietic stem cell transplantation, which manifests as pancytopenia/cytopenia in the blood count, with the presence of complete or incomplete donor chimerism. There are three entities of graft weakness: 1. poor graft function: pancytopenia with complete donor chimerism, 2. graft failure: pancytopenia with incomplete, i.e., mixed donor chimerism and 3. graft rejection: progressive decline of donor chimerism. Definition. Poor graft function is diagnosed as pancytopenia (hemoglobin < 70 g/L, absolute neutrophil count < 0.5 x 109/L, platelets < 20 x 109/L) for 3 consecutive days from D+28, excluding the presence of severe graft versus host disease and relapse, with complete donor chimerism in poor graft function, and incomplete in graft failure. Risk factors and therapeutic principles. The most common risk factors for poor graft function are a small dose of CD34+ hematopoietic stem cells in the transplant, graft versus host disease, cytomegalovirus infection, the presence of donor-specific antibodies, high serum ferritin, i.e., iron overload, as well as splenomegaly. Pathogenetic mechanisms in the development of poor graft function are still not fully elucidated. The role of the microenvironment of the patient?s bone marrow is also important, as well as disorders of the immune system Therapeutic options for overcoming this complication include using selected ?stem cell boost?, mesenchymal stem cells, and newer medical agents (N-acetyl cysteine, atorvastatin, thrombopoietin receptor agonists). Conclusion. The type of poor function of the graft is defined in relation to the percentage of donor chimerism, and is necessary for planning further treatment strategy.","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":"88646102","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}
Jelena Grgur, Djurdja Cvjetkovic-Nikoletic, D. Simić, N. Eić, Sonja Lukac, R. Jokić
Introduction. Iliopsoas abscess is a rare condition, which may be categorized as primary or secondary. Primary iliopsoas abscess is caused by lymphohematogenous spread of infectious agents from a distant site, unlike secondary iliopsoas abscess that is a result of direct spread of a nearby infectious or inflammatory process. The diagnosis and treatment of primary iliopsoas abscess are often prolonged, due to the rarity of the disease and the nonspecific signs and symptoms. Case Report. This study presents a case of a onemonth old infant with a left-sided iliopsoas abscess. The physical examination revealed a swelling with a pronounced vascular pattern in the area of the left groin. Laboratory findings showed leukocytosis and increased inflammatory markers. An abscess within the left hemiabdomen and inguinofemoral region was diagnosed by ultrasonography and computerized tomography. The main therapeutic approach included antibiotic therapy, as well as surgical drainage of the abscess. Staphylococcus aureus was isolated from a 100 ml sample of the drained abscess. The treatment outcome was good. Conclusion. Given the frequency of iliopsoas abscess in infants, which is far less common than other primary diseases, greater attention must be paid to symptoms and signs during clinical examination, along with the appropriate choice of diagnostic procedures. Timely diagnosis, as well as adequate treatment of iliopsoas muscle abscess, is imperative in order to prevent the development of complications, such as systemic inflammation and sepsis.
{"title":"Iliopsoas abscess in infants: A case report","authors":"Jelena Grgur, Djurdja Cvjetkovic-Nikoletic, D. Simić, N. Eić, Sonja Lukac, R. Jokić","doi":"10.2298/mpns2204119g","DOIUrl":"https://doi.org/10.2298/mpns2204119g","url":null,"abstract":"Introduction. Iliopsoas abscess is a rare condition, which may be categorized as primary or secondary. Primary iliopsoas abscess is caused by lymphohematogenous spread of infectious agents from a distant site, unlike secondary iliopsoas abscess that is a result of direct spread of a nearby infectious or inflammatory process. The diagnosis and treatment of primary iliopsoas abscess are often prolonged, due to the rarity of the disease and the nonspecific signs and symptoms. Case Report. This study presents a case of a onemonth old infant with a left-sided iliopsoas abscess. The physical examination revealed a swelling with a pronounced vascular pattern in the area of the left groin. Laboratory findings showed leukocytosis and increased inflammatory markers. An abscess within the left hemiabdomen and inguinofemoral region was diagnosed by ultrasonography and computerized tomography. The main therapeutic approach included antibiotic therapy, as well as surgical drainage of the abscess. Staphylococcus aureus was isolated from a 100 ml sample of the drained abscess. The treatment outcome was good. Conclusion. Given the frequency of iliopsoas abscess in infants, which is far less common than other primary diseases, greater attention must be paid to symptoms and signs during clinical examination, along with the appropriate choice of diagnostic procedures. Timely diagnosis, as well as adequate treatment of iliopsoas muscle abscess, is imperative in order to prevent the development of complications, such as systemic inflammation and sepsis.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"217 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73234916","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}
Emir Bisevac, E. Mahmutovic, Medo Gutić, Armin Zećirović, Raid Mekic, Z. Dolicanin
Introduction. Musculoskeletal pain is one of the most common types of pain affecting muscles, bones, joints, ligaments and tendons. The aim of this study was to determine the differences in the prevalence of musculoskeletal pain between students of sports and physical education and health care students. Material and Methods. The cross-sectional study included a total of 50 students, of whom 25 (50%) were students of sports and physical education, and 25 (50%) were students of health care. Data on the musculoskeletal system of students were collected through a questionnaire for the analysis of musculoskeletal symptoms. Results. The results showed that the neck and upper back pain was not negligible (14 respondents, 28%) as well as the lower back pain (27, 54%). Based on the Chi-square test, it was concluded that low back pain was significantly more common in students of health care (c2 = 3.945; p = 0.047 < 0.05) than in students of sports and physical education. Also, neck pain was significantly more common in health care students (c2 = 6.349; p = 0.012 < 0.05). Conclusion. Based on the obtained results, it can be concluded that students mostly presented with low back pain, followed by the neck and upper back pain. Engaging in proper exercises on weekly basis and excess weight reduction can prevent low back pain.
{"title":"Differences in the prevalence of musculoskeletal pain between health care students and students of sports and physical education","authors":"Emir Bisevac, E. Mahmutovic, Medo Gutić, Armin Zećirović, Raid Mekic, Z. Dolicanin","doi":"10.2298/mpns2204109b","DOIUrl":"https://doi.org/10.2298/mpns2204109b","url":null,"abstract":"Introduction. Musculoskeletal pain is one of the most common types of pain affecting muscles, bones, joints, ligaments and tendons. The aim of this study was to determine the differences in the prevalence of musculoskeletal pain between students of sports and physical education and health care students. Material and Methods. The cross-sectional study included a total of 50 students, of whom 25 (50%) were students of sports and physical education, and 25 (50%) were students of health care. Data on the musculoskeletal system of students were collected through a questionnaire for the analysis of musculoskeletal symptoms. Results. The results showed that the neck and upper back pain was not negligible (14 respondents, 28%) as well as the lower back pain (27, 54%). Based on the Chi-square test, it was concluded that low back pain was significantly more common in students of health care (c2 = 3.945; p = 0.047 < 0.05) than in students of sports and physical education. Also, neck pain was significantly more common in health care students (c2 = 6.349; p = 0.012 < 0.05). Conclusion. Based on the obtained results, it can be concluded that students mostly presented with low back pain, followed by the neck and upper back pain. Engaging in proper exercises on weekly basis and excess weight reduction can prevent low back pain.","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":"79784255","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}
Milijana Rakin, Natasa Anicic, O. Ivanov, Sanja Jaric, Nemanja Novakovic, Ivan Korpivica
Introduction. In locally advanced cancers of the cervix, endometrium and vulva, radiotherapy is the primary treatment modality. In recent years, new modern techniques of external radiation have been developed in radiation oncology, with the goal of dose escalation to the target volume, while sparing healthy tissues. The aim of this study is to determine the impact of volumetric modulated arc therapy on clinical outcomes of patients with gynecological malignancies. Material and Methods. Data were retrospectively collected from 60 patients treated for International Federation of Gynecology and Obstetrics stage I - III cervical, endometrial and vulvar cancers, using definitive (n = 35) or adjuvant (n = 25) radiotherapy/ chemoradiotherapy. Thirty patients underwent three-dimensional conformal radiation therapy (definitive in 22 and adjuvant in 8) and the other 30 patients were treated with volumetric modulated arc therapy (definitive in 13 and adjuvant in 17). The following clinical outcome parameters were compared between the two groups: complete clinical response, disease free survival, progression free survival, and 4-year overall survival. Results. Progression free survival of patients treated with definitive radiotherapy/ chemoradiotherapy using volumetric modulated arc therapy was 17.2 months, while in the group treated with three-dimensional conformal radiation therapy it was 7.9 months (p = 0.300). Four-year overall survival in patients who were treated with definitive radiotherapy/ chemoradiotherapy using three-dimensional conformal radiation therapy was 50%, and 61.5% in the group treated with definitive volumetric modulated arc therapy (p = 0.200), while in patients treated using adjuvant radiotherapy/chemoradiotherapy it was 75% vs. 88.2%, respectively (p = 0.400). Conclusion. Although without statistical significance, volumetric modulated arc therapy showed better results with respect to progression free survival and 4-year overall survival in previously unoperated patients who underwent definitive radiotherapy/chemoradiotherapy.
{"title":"The impact of volumetric modulated arc radiotherapy on clinical outcomes of patients with gynecological malignancies","authors":"Milijana Rakin, Natasa Anicic, O. Ivanov, Sanja Jaric, Nemanja Novakovic, Ivan Korpivica","doi":"10.2298/mpns2208224r","DOIUrl":"https://doi.org/10.2298/mpns2208224r","url":null,"abstract":"Introduction. In locally advanced cancers of the cervix, endometrium and vulva, radiotherapy is the primary treatment modality. In recent years, new modern techniques of external radiation have been developed in radiation oncology, with the goal of dose escalation to the target volume, while sparing healthy tissues. The aim of this study is to determine the impact of volumetric modulated arc therapy on clinical outcomes of patients with gynecological malignancies. Material and Methods. Data were retrospectively collected from 60 patients treated for International Federation of Gynecology and Obstetrics stage I - III cervical, endometrial and vulvar cancers, using definitive (n = 35) or adjuvant (n = 25) radiotherapy/ chemoradiotherapy. Thirty patients underwent three-dimensional conformal radiation therapy (definitive in 22 and adjuvant in 8) and the other 30 patients were treated with volumetric modulated arc therapy (definitive in 13 and adjuvant in 17). The following clinical outcome parameters were compared between the two groups: complete clinical response, disease free survival, progression free survival, and 4-year overall survival. Results. Progression free survival of patients treated with definitive radiotherapy/ chemoradiotherapy using volumetric modulated arc therapy was 17.2 months, while in the group treated with three-dimensional conformal radiation therapy it was 7.9 months (p = 0.300). Four-year overall survival in patients who were treated with definitive radiotherapy/ chemoradiotherapy using three-dimensional conformal radiation therapy was 50%, and 61.5% in the group treated with definitive volumetric modulated arc therapy (p = 0.200), while in patients treated using adjuvant radiotherapy/chemoradiotherapy it was 75% vs. 88.2%, respectively (p = 0.400). Conclusion. Although without statistical significance, volumetric modulated arc therapy showed better results with respect to progression free survival and 4-year overall survival in previously unoperated patients who underwent definitive radiotherapy/chemoradiotherapy.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"123 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77482394","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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