Srp Arh Celok Lek [JOURNAL]
Sun
200 papers
Iris melanocytoma.
Radovanović AB, Krnjaja BD, Jaksić V
Srp Arh Celok Lek · 2016 · PMID 27276862 · Publisher ↗
INTRODUCTION: Iris melanocytoma (IM) is a rare benign tumor, but unavoidable in differential diagnosis of pigmented iris lesions. According to the best knowledge of the authors it is for the first time in Serbia that a w...
INTRODUCTION: Iris melanocytoma (IM) is a rare benign tumor, but unavoidable in differential diagnosis of pigmented iris lesions. According to the best knowledge of the authors it is for the first time in Serbia that a well-documented case of IM is presented and that the problem of this tumor is discussed. CASE OUTLINE: In the left eye of a 47-year-old white female at the iris in a six o'clock position, a highly pigmented, dome shaped lesion with a crater-like cavity in the center and with feathery margins was noticed. There were no signs of infiltration of surrounding tissue or intrinsic vessels and the lens was clear. Visual acuity and intraocular pressure were normal. An ultrasound biomicroscopy (UBM) revealed a well-defined lesion with high internal reflectivity, with a base diameter of 1.25 mm and a thickness of 0.80 mm in the periphery, and 0.53 mm in the central part.The diagnosis of IM of the left eye was established and regular checkups were performed for ten years. No changes in clinical or UBM presentation were established. CONCLUSION: Awareness of clinical presentation of IM is most important for correct diagnosis. Ultrasound biomicroscopy is a useful diagnostic procedure in the following up of IM.
Doppler changes as the earliest parameter in fetal surveillance to detect fetal compromise in intrauterine growth-restricted fetuses.
Bansal S, Deka D, Dhadwal V … +1 more , Mahendru R
Srp Arh Celok Lek · 2016 · PMID 27276861 · Publisher ↗
INTRODUCTION: It is estimated that 3-10% of infants are growth restricted. Growth disturbances may have long-term issues. Doppler allows insight into the fetal response to intrauterine stress. OBJECTIVE: The aim of this...
INTRODUCTION: It is estimated that 3-10% of infants are growth restricted. Growth disturbances may have long-term issues. Doppler allows insight into the fetal response to intrauterine stress. OBJECTIVE: The aim of this study was to detect fetal compromise in intrauterine growth-restricted (IUGR) fetuses by means of biophysical profile (BPP) vis-à-vis Doppler velocimetry studies of the fetal umbilical artery, and to find out which of the two is a better and earlier predictor of fetal compromise. METHODS: A prospective study was conducted on a total of 50 singleton pregnancies with IUGR between 28 and 42 weeks of gestation. Study patients were managed expectantly with nonstress testing and amniotic fluid assessment, BPP and Doppler velocimetry studies of the fetal umbilical artery. RESULTS: Fetal outcome was poor in 5/50 (10%) of the fetuses, defined as presence of all of the following: poor Apgar test score, neonatal intensive care unit stay, necrotizing enterocolitis, and low birth weight. Of the four with abnormal BPP, 50% had poor fetal outcomes. Out of 46 with normal BPP, 6.5% had poor fetal outcomes. CONCLUSION: Inference drawn from the study is that the Doppler technology provides us the opportunity for repetitive noninvasive hemodynamic monitoring in IUGR pregnancies.
Epidemiological characteristics and clinical manifestations of hepatitis E virus infection in Bulgaria: A report on 20 patients.
Baymakova M, Sakem B, Plochev K … +4 more , Popov GT, Mihaylova-Garnizova R, Kovaleva V, Kundurdjiev T
Srp Arh Celok Lek · 2016 · PMID 27276860 · Publisher ↗
INTRODUCTION: Hepatitis E is one of the leading clinical manifestations of acute viral hepatitis in developing countries. In industrialized countries, during the past several years, sporadic "autochthonous" cases of HEV...
INTRODUCTION: Hepatitis E is one of the leading clinical manifestations of acute viral hepatitis in developing countries. In industrialized countries, during the past several years, sporadic "autochthonous" cases of HEV infection have been increased. OBJECTIVE: The aim of this study was to analyze the epidemiological, clinical and laboratory features of HEV infection among patients hospitalized at the Department of Infectious Diseases in Military Medical Academy, Sofia, Bulgaria. METHODS: A retrospective study of 806 cases of acute viral hepatitis was performed at the Department of Infectious Diseases in Military Medical Academy, Sofia, Bulgaria, between December 2004 and September 2012.The etiological diagnosis was established by ELISA. The statistical analysis was performed using Excel 2007 (Microsoft, Redmond, Washington, USA) and SPSS Statistics 19.0 (IBM Corp., Armonk, NewYork, USA). RESULTS: Specific reaction to anti-HEV-IgM and anti-HEV-IgG antibodies were detected in 20 (2.48%) of 806 patients. The most observed clinical presentations were jaundice (85%), fatigue (85%), anorexia (65%), abdominal discomfort (55%) and fever (40%). The mean values of aspartate transaminase and alanine transaminase were 521 IU/l and 881 IU/l, respectively. The cholestasis was slight, marked with mean values of gamma-glutamyl transferase and alkaline phosphatase, respectively 418 IU/I and 486 IU/I. CONCLUSION: We report twenty autochthonous sporadic cases of acute infection with HEV. The zoonotic etiology of the virus as well as the foodborne transmission of the infection is discussed. We found that aging and pre-existing underlying diseases are risk factors for a severe course of the HEV infection.
Clinical and laboratory differences between Epstein-Barr and cytomegalovirus infectious mononucleosis in children.
Medović R, Igrutinović Z, Radojević-Marjanović R … +6 more , Marković S, Rasković Z, Simović A, Tanasković-Nestorović J, Radovanović M, VuIetić B
Srp Arh Celok Lek · 2016 · PMID 27276859 · Publisher ↗
INTRODUCTION: Infective mononucleosis is most commonly caused by Epstein-Barr virus (EBV), and in smaller percentage by cytomegalovirus (CMV). OBJECTIVE: The aim of this paper was to determine the clinical and laboratory...
INTRODUCTION: Infective mononucleosis is most commonly caused by Epstein-Barr virus (EBV), and in smaller percentage by cytomegalovirus (CMV). OBJECTIVE: The aim of this paper was to determine the clinical and laboratory differences between EBV and CMV infectious mononucleosis in children. METHODS: Cohort retrospective analytical research was conducted. We used data from medical history in six years period and monitored anamnestic data, frequency of inspection and palpation obtained data during physical examination, several laboratory tests, abdomen ultrasonography examination finding and emergence of disease complications. Statistical processing of data has been performed using SPSS 20. RESULTS: Total number of examined children was 137, out of which 85.4% were with EBV and 14.6% with CMV infection. Affected children were most commonly younger than eight years. Boys were affected more often. There was no difference in frequency of high temperature, sore throat, bad breath, and respiratory symptomatology between examined children. Differences were discovered in frequency of stomachaches, eyelid swelling, skin rash and fatigue. Differences were not proven in the frequency of angina, lymphadenopathy and splenohepatomegaly between the groups. Values of transaminases and lactic dehydrogenases significantly decreased after seven days of hospitalization in both groups. In children with EBV, values of transaminases declined faster than in children with CMV. Anemia and bacterial superinfection of pharynx were most common disease complications. Thrombocytopenia was more common in children with CMV infection. Average duration of hospitalization was 6.7 days. CONCLUSION: In children with CMV abdominal pain, eyelid swelling, skin rash, fatigue and thrombocytopenia were more common. In children with EBV values of transaminases declined significantly faster.
Fungal infections in corn picker hand injury.
Obradović-Tomasev M, Jovanović M, Vucković N … +1 more , Popović A
Srp Arh Celok Lek · 2016 · PMID 27276858 · Publisher ↗
INTRODUCTION: Hand injuries caused by corn pickers are relatively rare but in most cases extensive, with massive tissue destruction. Severe wounds sustained during agricultural work are contaminated, with high incidence...
INTRODUCTION: Hand injuries caused by corn pickers are relatively rare but in most cases extensive, with massive tissue destruction. Severe wounds sustained during agricultural work are contaminated, with high incidence of infection. OBJECTIVE: The aim of the study was to determine the frequency and type of fungal infection in corn picker injuries and their impact on the course and outcome of treatment. METHODS: Corn picker hand injuries for the period 2006-2012 were analyzed. After setting up clinical suspicion, direct examination of repeated swabs and histopathological analysis of biopsy material were done in order to detect fungi. RESULTS: From the total number of 60 patients, there was a fungal infection in nine of them (which makes 15% of the total number of patients). Aspergillus spp. was isolated in seven patients, Candida spp. in three, and Mucor spp. in one patient. None of the patients had increased risk factors for developing a fungal infection. In most cases, there was loss of graft and tissue necrosis in previously normally look- ing wound, after seven or more days. All patients were treated with repeated surgical debridement and concomitant parenteral and topical application of appropriate antifungal agents. There was no need for reamputation in any patient. CONCLUSION: A high degree of suspicion and a multidisciplinary approach are needed for early diagnosis of fungal infection. Confirmation of diagnosis and the initiation of surgical and appropriate antifungal therapy are essential for a successful outcome.
Displaced supracondylar humeral fractures in children: Comparison of three treatment approaches.
Ducić S, Bumbasirević M, Radlović V … +7 more , Nikić P, Bukumirić Z, Brdar R, Radojicić Z, Bukva B, Abramović D, Ducić TJ
Srp Arh Celok Lek · 2016 · PMID 27276857 · Publisher ↗
INTRODUCTION: Closed reduction and percutaneous pinning are the most widely used treatment options for displaced supracondylar humerus fractures in children, but there is still no consensus concerning the most preferred...
INTRODUCTION: Closed reduction and percutaneous pinning are the most widely used treatment options for displaced supracondylar humerus fractures in children, but there is still no consensus concerning the most preferred technique in injuries of the extension type. OBJECTIVE: The aim of this study was to compare three common orthopaedic procedures in the treatment of displaced extension type supracondylar humerus fractures in children. METHODS: Total of 93 consecutive patients (66 boys and 27 girls) referred to our hospital with Gartland type II or III extension supracondylar humeral fractures were prospectively included in the study over a six-year period. At initial presentation 48 patients were classified as Gartland type II and 45 as Gartland type III fractures. The patients were subdivided into three groups based on the following treatment modality: closed reduction with percutaneous pinning, open reduction with Kirschner wires (K-wires) fixation, and closed reduction with cast immobilisation. The treatment outcome and clinical characteristics were compared among groups, as well as evaluated using Flynn's criteria. RESULTS: Excellent clinical outcome was reported in 70.3% of patients treated with closed reduction with percutaneous pinning and in 64.7% of patients treated with open reduction with K-wire fixation. The outcome was significantly worse in children treated with closed reduction and cast immobilisation alone, as excellent outcome is achieved in just 36.4% of cases (p = 0.011). CONCLUSION: Closed reduction with percutaneous pinning is the method of choice in the treatment of displaced pediatric supracondylar humeral fracture, while open reduction with K-wire fixation is as a good alternative in cases with clear indications.
Clinical trial/experimental study (consort compliant): Optimal time period to achieve the effects on synbiotic-controlled wheezing and respiratory infections in young children.
Stojković A, Simović A, Bogdanović Z … +2 more , Banković D, Poskurica M
Srp Arh Celok Lek · 2016 · PMID 27276856 · Publisher ↗
INTRODUCTION: Urban life is often followed by immune dysfunction and loss of immune tolerance in the youngest children. OBJECTIVE: The study aimed to determine optimal time efficiency of a synbiotic (5 x 10⁹ Lactobacillu...
INTRODUCTION: Urban life is often followed by immune dysfunction and loss of immune tolerance in the youngest children. OBJECTIVE: The study aimed to determine optimal time efficiency of a synbiotic (5 x 10⁹ Lactobacillus acidophilus Rosell-52, Bifidobacterium infantis Rosell-33, Bifidobacterium bifidum Rosell-71) in controlling respiratory infections and wheezing disease. METHODS: We randomly selected a group of children younger than five years, hospitalized earlier, and classified them into three groups. RESULTS: The incidence of respiratory infection before the study was once a month, while after a three-month supplementation with the synbiotic children rarely suffered from respiratory infections, and the state was maintained after six-month and nine-month supplementations with the synbiotic. The decreased incidence of respiratory infections was followed by a falling incidence of concomitant wheezing. A significant increase in tIgA serum was observed in all groups for only three months, the increase being the highest in children with recurrent respiratory infections accompanied by wheezing. After a nine-month administration of the synbiotic, total IgE serum was lower in all groups of patients. CONCLUSION: The optimal duration of administration of the synbiotic containing three probiotic cultures to provide effective control of the frequency of respiratory infections was three months, and six months were required to establish control of the frequency of wheezing. This synbiotic is useful for immunomodulation in children and is well-tolerated in young children.
Correlation between demographic characteristics, cognitive functioning and functional independence in stroke patients.
Arsić S, Konstantinović L, Eminović F … +1 more , Pavlović D
Srp Arh Celok Lek · 2016 · PMID 27276855 · Publisher ↗
INTRODUCTION: It has been assumed that there is causality of the achieved level of functional independence with the degree of preservation of cognitive function in stroke patients. Demographic characteristics may be impo...
INTRODUCTION: It has been assumed that there is causality of the achieved level of functional independence with the degree of preservation of cognitive function in stroke patients. Demographic characteristics may be important for monitoring the achieved level of functional independence. OBJECTIVE: The aim of this study was to examine the relationship of demographic characteristics and functional independence in regard to the level of cognitive impairment in stroke patients. METHODS: The study included 50 stroke patients after rehabilitation, as well as age- and gender-matched 50 subjects selected randomly, according to the demographic characteristics of the studied sample, who in their medical history had no neurological disorders. For the assessment of functional independence, the Functional Independence Measure (FIM) test was used.The general cognition was estimated by the Mini-Mental State Examination (MMSE) test. The statistical analyses included the Mann-Whitney test, for two independent samples, measures of canonical correlation, and χ2 test. RESULTS: There was a statistically significant difference between the groups in relation to risk factors, hypertension and diabetes mellitus type II (p < 0.001); There was a statistically significant difference within the groups in relation to the cognitive impairment in all the examined demographic characteristics (p<0.001); the differences within the groups in relation to the cognitive impairment are present on all subscales of the FIM test (p < 0.05); the differences within the groups in relation to handedness, hemiparesis, show that mild cognitive impairment is more common among left hemiparesis, while a more severe one is more common among right-sided hemiparesis (p < 0.05); More severe cognitive impairment is common among women, the elderly and in persons with lower education (p < 0.05). CONCLUSION: By prevention of risk factors, and prevention of possible cognitive impairment, consequences of stroke can be reduced, the recovery can be made more successful, and quality of life can be improved.
Influence of manual thrombus aspiration on left ventricular diastolic function in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention.
Ilić I, Stanković I, Vidaković R … +11 more , Janićijević A, Cerović M, Jovanović V, Aleksić A, Obradović G, Nikolajević I, Kafedzić S, Milicević D, Kusić J, Putniković B, Nesković AN
Srp Arh Celok Lek · 2016 · PMID 27276854 · Publisher ↗
INTRODUCTION: Data on effects of thrombus aspiration on left ventricular diastolic function in ST-elevation myocardial infarction (STEMI) population are scarce. OBJECTIVE: We sought to compare echocardiographic indices o...
INTRODUCTION: Data on effects of thrombus aspiration on left ventricular diastolic function in ST-elevation myocardial infarction (STEMI) population are scarce. OBJECTIVE: We sought to compare echocardiographic indices of the diastolic function and outcomes in STEMI patients treated with and without manual thrombus aspiration, in an academic, high-volume percutaneous coronary intervention (PCI) center. METHODS: A total of 433 consecutive patients who underwent primary PCI in 2011-2012 were enrolled in the study. Patients were not eligible for the study if they already suffered a myocardial infarction, had been previously revascularized, received thrombolytics, presented with cardiogenic shock, had significant valvular disease, atrial fibrillation or had previously implanted pacemaker. Comprehensive echocardiogram was performed within 48 hours. During follow-up patients'status was assessed by an office visit or telephone interview. RESULTS: Patients treated with thrombus aspiration (TA+, n=216) had similar baseline characteristics as those without thrombus aspiration (TA-, n = 217). Groups had similar total ischemic time (319 ± 276 vs. 333 ± 372 min; p = 0.665), but TA+ group had higher maximum values of troponin I (39.5 ± 30.5 vs. 27.6 ± 26.9 ng/ml; p < 0.001). The echocardiography revealed similar left ventricular volumes and systolic function, but TA+ group had significantly higher incidence of E/e' > 15, as a marker of severe diastolic dysfunction' (TA+ 23.1% vs. TA- 15.2%; p = 0.050). During average follow-up of 14 ± 5 months, major adverse cardiac/cerebral events occurred at the similar rate (log rank p = 0.867). CONCLUSION: Thrombus aspiration is associated with a greater incidence of severe diastolic dysfunction in unselected STEMI patients treated with primary PCI, but it doesn't influence the incidence of major adverse cardiovascular events.
Relationship between the vertical craniofacial disproportions and the cervicovertebral morphology in adult subjects.
Trajković M, Lazić E, Nedeljković N … +2 more , Stamenković Z, Glisić B
Srp Arh Celok Lek · 2016 · PMID 27276853 · Publisher ↗
INTRODUCTION: Orthodontic diagnosis includes the interpretation of the relations between the craniofacial and cervical system, given the potential impact of the irregularities from one system to another. OBJECTIVE: The a...
INTRODUCTION: Orthodontic diagnosis includes the interpretation of the relations between the craniofacial and cervical system, given the potential impact of the irregularities from one system to another. OBJECTIVE: The aim of this study was to examine morphological characteristics of the cervical spine, depending on the parameters of the vertical craniofacial growth and gender in adult subjects. METHODS: The sample comprised lateral cephalograms of 120 subjects with different vertical facial growth, aged 17.5-35 years. Measured parameters were the following: anterior and posterior vertebral body height (ABHC2-C5, PBHC2-C5), anterior and posterior intervertebral space (AISC2-C5, PISC2-C5), distance between vertebrae and point sella (SC2, SC3, SC4), pterygomaxillare (PmC2), gonion (GoC2) and basion (BaC4); cervical spine angulation (OPT/CVT) and inclination (OPT/HOR, CVT/HOR). RESULTS: Results showed that subjects with anterior facial growth rotation have greater values for BaC4, OPT/HOR, CVT/HOR, OPT/CVT, anterior and posterior vertebral body heights and intervertebral spaces, and lower values for GoC2 and PmC2. Higher values in males were found for anterior and posterior vertebral body heights, distances SC2, SC3, SC4, and BaC4. In females, the greater values were found for GoC2 and OPT/CVT. CONCLUSION: Subjects with anterior facial growth rotation have greater cervical spine inclination and angulation, higher cervical vertebrae and intervertebral spaces, longer upper cervical spines and shorter distances GoC2 and PmC2. Males show smaller cervical column curvature, but higher cervical vertebrae and greater length of the upper cervical spine.
Estimation of total bacteria by real-time PCR in patients with periodontal disease.
Brajović G, Popović B, Puletić M … +2 more , Kostić M, Milasin J
Srp Arh Celok Lek · 2016 · PMID 27276852 · Publisher ↗
INTRODUCTION: Periodontal diseases are associated with the presence of elevated levels of bacteria within the gingival crevice. OBJECTIVE: The aim of this study was to evaluate a total amount of bacteria in subgingival p...
INTRODUCTION: Periodontal diseases are associated with the presence of elevated levels of bacteria within the gingival crevice. OBJECTIVE: The aim of this study was to evaluate a total amount of bacteria in subgingival plaque samples in patients with a periodontal disease. METHODS: A quantitative evaluation of total bacteria amount using quantitative real-time polymerase chain reaction (qRT-PCR) was performed on 20 samples of patients with ulceronecrotic periodontitis and on 10 samples of healthy subjects. The estimation of total bacterial amount was based on gene copy number for 16S rRNA that was determined by comparing to Ct values/gene copy number of the standard curve. RESULTS: A statistically significant difference between average gene copy number of total bacteria in periodontal patients (2.55 x 10⁷) and healthy control (2.37 x 10⁶) was found (p = 0.01). Also, a trend of higher numbers of the gene copy in deeper periodontal lesions (> 7 mm) was confirmed by a positive value of coefficient of correlation (r = 0.073). CONCLUSION: The quantitative estimation of total bacteria based on gene copy number could be an important additional tool in diagnosing periodontitis.
Carotid artery wall stiffness is increased in patients with small vessel disease: A case-control study.
Hajdarević DS, Pavlović AM, Smajlović D … +4 more , Podgorac A, Jovanović Z, Medjedović TS, Sternić NC
Srp Arh Celok Lek · 2016 · PMID 27276851
INTRODUCTION: Cerebral ischemic small-vessel disease (SVD), causing lacunar infarcts and white matter hyperintensities on brain magnetic resonance imaging (MRI), is a progressive disease associated with an increased risk...
INTRODUCTION: Cerebral ischemic small-vessel disease (SVD), causing lacunar infarcts and white matter hyperintensities on brain magnetic resonance imaging (MRI), is a progressive disease associated with an increased risk of stroke, dementia and death. Increased arterial stiffness has been associated with ischemic stroke and cerebral SVD independently of common vascular risk factors. OBJECTIVE: The aim of the study was to analyze arterial stiffness in our patients with symptomatic SVD. METHODS: In a cross-sectional study design we included 30 patients with clinical and MRI evidence of cerebral SVD and 30 age-, gender- and risk factor-matched control subjects with no neurological diseases. Patients were evaluated at the Ultrasound Laboratory at the Neurology Clinic, Clinical Center of Serbia in Belgrade, during a three-month period (from September 1st to December 1st 2012). Baseline demographic and vascular risk factors were recorded. All patients underwent standard carotid ultrasound scans with measuring of intima-media thickness (IMT) and analysis of atheromatous plaques. Internal carotid artery stiffness was evaluated with the use of e-tracking option as beta stiffness index (BSI) value. RESULTS: There were no differences between study groups in regard to degree of carotid stenosis and type of carotid plaques (p > 0.05). Patients in SVD group had significantly higher mean IMT (p = 0.0093) and mean BSI (p < 0.0001) than subjects in the control group. No significant correlation was detected between IMT and BSI in SVD group (r = 0.168; p = 0.376). Brain lesions severity correlated with BSI (r = 0.733; p < 0.0001). CONCLUSION: Arterial stiffness is increased in symptomatic patients with SVD, independently of vascular risk factors and IMT.
Sudden cardiac death and guidelines for pre-participation examination in athletes.
Georgijević L, Andrić L, Klašnja A
Srp Arh Celok Lek · 2016 · PMID 29648763
Incidence of sudden cardiac death (SCD) in athletes under 35 years of age is between 0.4 and 4.4 in 100,000. The highest mortality is seen in older athletes (≥35 years) who engage in running, mostly because of complicati...
Incidence of sudden cardiac death (SCD) in athletes under 35 years of age is between 0.4 and 4.4 in 100,000. The highest mortality is seen in older athletes (≥35 years) who engage in running, mostly because of complications of atherosclerotic coronary ischemic disease. Majority of European countries are guided by European Society of Cardiology’s (ESC) pre-participation screening (PPS) recommendations that include electrocardiography (ECG), while in the United States of America the ECG is not a routine part of the PPS examination. In Serbia, the ESC guidelines are being used, but there are no references prescribed by the Ministry of Health. The authors of this study believe that the national strategy for sport improvement should be accompanied with clear and well defined PPS recommendations that could be tenable in our health system.
[Recommendation for gastroprotection in gastrointestinal bleeding prevention].
Damjanov N, Vukčević V, Krstić M … +3 more , Milosavljević T, Jeremić I, Sokić-Milutinović A
Srp Arh Celok Lek · 2016 · PMID 29648762
Incidence of gastrointestinal bleeding in most populations is about 1 per 1,000 inhabitants. More than 65% of all bleeding episodes are associated with drug use. The most often involved are non-steroidal antiinflammatory...
Incidence of gastrointestinal bleeding in most populations is about 1 per 1,000 inhabitants. More than 65% of all bleeding episodes are associated with drug use. The most often involved are non-steroidal antiinflammatory drugs and low doses of acetyl-salicylic acid. The mortality within the first month after the bleeding episode is about 10–12%, and has not significantly changed in the last decade. Therefore, bleeding prevention is of major importance. Appropriate selection of patients, proper drug choice, application of lowest efficient doses of potentially ulcerogenic drugs, and use of drugs that inhibit gastric acid secretion remain cornerstone preventive measures of gastrointestinal bleeding.
Current issues on sublingual allergen-specific immunotherapy in children with asthma and allergic rhinitis.
Živković Z, Djurić-Filipović I, Živanović S
Srp Arh Celok Lek · 2016 · PMID 29648760
In 1993 the European Academy of Allergy and Clinical Immunology was the first official organization to recognize that sublingual administration could be “promising route” for allergic desensitization. A few years later,...
In 1993 the European Academy of Allergy and Clinical Immunology was the first official organization to recognize that sublingual administration could be “promising route” for allergic desensitization. A few years later, the World Health Organization recommended this therapy as “a viable alternative to the injection route in adults.” The first meta-analysis showed sublingual allergen specific immunotherapy (SLIT) effectiveness for allergic rhinitis and another study showed SLIT can actually help prevent the development of asthma both in adults and in children. The main goal of this review article is to present insight into the most up-to-date understanding of the clinical efficacy and safety of immunotherapy in the treatment of pediatric patients with allergic rhinitis and asthma. A literature review was performed on PubMed from 1990 to 2015 using the terms “asthma,” “allergic rhinitis,” “children,” “allergen specific immune therapy.” Evaluating data from double-blind placebo-controlled randomized clinical trials (DB-PC-RCTs), the clinical efficacy (assessed as the reduction of symptom score and the need of rescue medicament) of SLIT for allergic rhinitis and allergic asthma, has been confirmed in various meta-analysis Outcomes such as rhinoconjunctivitis score and medication scores, combined scores, quality of life, days with severe symptoms, immunological endpoints, and safety parameters were all improved in the SLIT-tablet compared with placebo group. SLIT safety has been already proven in many DB-PC-RCTs and real-life settings. In accordance with all of the above mentioned, the goals for future trials and studies are the development of comprehensive guidelines for clinical practice on immunotherapy, embracing all the different potential participants. The importance of allergen immunotherapy is of special relevance in the pediatric age, when the plasticity and modulability of the immune system are maximal, and when preventative effects can be reasonably expected.
Laterality in living beings, hand dominance, and cerebral lateralization.
Milenković S, Paunović K, Kocijančić D
Srp Arh Celok Lek · 2016 · PMID 29648759
To date, lateralization in living beings is a phenomenon almost mythologically unexplored. Scientists have proved that lateralization is not exclusively a human feature. Investigations in molecular biology, protein struc...
To date, lateralization in living beings is a phenomenon almost mythologically unexplored. Scientists have proved that lateralization is not exclusively a human feature. Investigations in molecular biology, protein structure, mobility of bacteria, and intracellular lateralization in ciliates, shows important and universal nature of lateralization in living systems. Dominant lateralization implies the appearance of a dominant extremity, or a dominant sense during the performance of complex psychomotor activities. Hand dominance is usually defined as a tendency to use one hand rather than another to perform most activities and this is considered to be the most obvious example of cerebral lateralization and exclusive characteristic of humans. However, there are some exceptions in other species. The dominant hand is able to perform more complex and subtle manual tasks than the non-dominant hand, and this behavioral superiority is the absolute result of additional cerebral support. The asymmetry of brain organization was confirmed in rats, chimpanzees, dogs and birds, some fishes and lizards. The relationships between hand dominance with brain structure and function remain far from clear. For a long time, lateralization was considered unique to humans, but recently it has become clear that lateralization is a fundamental characteristic of the organization of brain and behavior in all vertebrates. It has been questioned to what extent lateralization in humans and other vertebrates may be comparable.
Anorectal melanoma and seborrheic dermatitis – A case report.
Vekić B, Živić R, Kalezić M … +2 more , Otašević S, Arsić-Arsenijević V
Srp Arh Celok Lek · 2016 · PMID 29648758
INTRODUCTION: Anorectal melanoma (ARM) is a rare and aggressive neoplasm with predisposition for early infiltration, distant spread, and unfavorable prognosis. It has been speculated that Malassezia yeasts could possibly...
INTRODUCTION: Anorectal melanoma (ARM) is a rare and aggressive neoplasm with predisposition for early infiltration, distant spread, and unfavorable prognosis. It has been speculated that Malassezia yeasts could possibly have an impact on skin carcinogenesis and development of melanoma, especially in patients with seborrheic dermatitis (SD), due to production of aryl hydrocarbon receptor (AhR) agonists. CASE OUTLINE: A 52-year-old man with intensive SD complained of a four-month-long rectal bleeding, tenesmus, pain, and difficulty during defecation. On examination, a rectal tumor was detected and histopathology of tumor tissue revealed ARM with positive protein S100, melanoma antigen HMB45 and melan-A expression. After the diagnosis was established, abdominoperineal resection of the anus and rectum was performed, since the tumor was large, obstructive, and the anal sphincter was invaded. CONCLUSION: Because of the possible impact of intensive SD to the cross-link between Malassezia yeasts AhR agonists and skin carcinogenesis, we discussed on this matter and reviewed the literature data regarding ARM. In addition to “pathogenic” and “non-pathogenic” Malassezia subtypes based on AhR agonist production, future studies on Malassezia metabolites, their carcinogenic effect in the skin and development of melanoma are needed. If the cross-link between Malassezia AhR agonists and skin carcinogenesis exists, timely prevention of ARM could be done with Malassezia eradication, especially in patients with severe SD.
Metastatic malignant melanoma of the uterus diagnosed by colposcopy.
Živadinović R, Mijović Ž, Petrić A … +4 more , Popović J, Vukomanović P, Trenkić M, Krtinić D
Srp Arh Celok Lek · 2016 · PMID 29648757
INTRODUCTION: Primary and metastatic malignant melanomas represent a rare diagnosis with a small number of described cases. The aggressive nature of the tumor, non-specific symptoms, difficult diagnosis, and no official...
INTRODUCTION: Primary and metastatic malignant melanomas represent a rare diagnosis with a small number of described cases. The aggressive nature of the tumor, non-specific symptoms, difficult diagnosis, and no official protocol about the treatment result in poor disease prognosis. CASE OUTLINE: The authors presented a 41-year-old multigravida patient. She had an operation of malignant melanoma in the occipital area of the head. She went to her gynecologist because of increased pale pink vaginal secretion. Gynecological examination didn’t show any significant abnormalities apart from a slightly enlarged uterus. Papanicolaou test and vaginal secretion examination were normal. Colposcopically, a significant dark brown hyperpigmented area around 1 cm in size was observed on the posterior lip of the cervix, near the orifice and cervical canal, suspicious of melanoma, which was proven on targeted biopsy of the hyperpigmented change on the cervix, and by magnetic resonance imaging of the lesser pelvis. Classic hysterectomy with adnexectomy and regional pelvic lymphadenectomy were performed. CONCLUSION: This case report pointed out the significance of applying colposcopy in diagnosing suspected metastatic melanoma of the uterine cervix, along with other diagnostic methods and anamnestic data.
Early post-transplant lymphoproliferative disorder – Case of fatal lymphoma after kidney transplantation.
Laušević M, Markovic-Lipkovski J, Terzić T … +3 more , Jovanović N, Milinković M, Naumović R
Srp Arh Celok Lek · 2016 · PMID 29648755
INTRODUCTION: Post-transplant lymphoproliferative disorder (PTLD) is a common malignancy following organ transplantation. Risk for PTLD is associated with the use of anti-thymocyte globulin in the prevention and treatmen...
INTRODUCTION: Post-transplant lymphoproliferative disorder (PTLD) is a common malignancy following organ transplantation. Risk for PTLD is associated with the use of anti-thymocyte globulin in the prevention and treatment of acute rejection following kidney transplantation. CASE OUTLINE: We report a case of fatal PTLD presented with sudden onset of fever. A 33-year-old male patient with primary diagnosis of left kidney agenesia underwent kidney transplantation six years following hemodialysis treatment initiation. Deceased donor was a 66-year-old female whose cause of death was cerebrovascular accident. Immunosuppressive regimen consisted of basiliximab, corticosteroids, tacrolimus, and mycophenolate mofetil. Six months upon transplantation the patient was hospitalized due to fever of unknown origin. All microbiological samples were negative, but abdominal ultrasound revealed round solid mass in the right native kidney. Right nephrectomy was performed showing tumor 35 × 35 × 20 mm in size within the 70 × 40 × 35 mm kidney. Pathohistological analysis confirmed very rare monomorphic B-cell PTLD – B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma. CONCLUSION: We consider this case of PTLD following kidney transplantation particular because of the tumor mass in native kidney after basiliximab induction and rare pathohistology. In a transplanted patient with fever, PTLD must always be considered, irrespective of immunosuppressive regimen.
Acute renal failure and hepatocellular damage as presenting symptoms of type II aortic dissection.
Jovanović I, Tešić M, Antonijević N … +5 more , Menković N, Paunović I, Ristić A, Vučićević V, Vujisić-Tešić B
Srp Arh Celok Lek · 2016 · PMID 29648754
INTRODUCTION: Pericardial effusion can be a consequence of a number of pathological conditions, and as such it can cause impaired left ventricular filling followed by decreased cardiac output and blood pressure. This kin...
INTRODUCTION: Pericardial effusion can be a consequence of a number of pathological conditions, and as such it can cause impaired left ventricular filling followed by decreased cardiac output and blood pressure. This kind of hemodynamic compromise and its consequences are extremely uncommon unless pericardial effusion causes tamponade. CASE OUTLINE: We describe a very rare case of a 30-year old male patient, with an acute aortic dissection type II causing pericardial effusion without clinical nor echocardiographic signs of tamponade, while presenting with an acute renal and hepatic failure. After initial diagnostic uncertainties, and following final diagnosis of an acute aortic dissection, this patient underwent surgical aortic valve replacement with a satisfactory outcome. CONCLUSION: It is important to underscore the significance of clinical situation of simultaneously existing acute renal and hepatic failures in the setting of a “non-tamponade” pericardial effusion, following a type II aortic dissection. Although most commonly aortic dissection presents itself with typical clinical symptoms or patient history data, it is not that unusual for it to be hidden in an entirely atypical clinical milieu as the one described in this case.
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