Srpski Arhiv Za Celokupno Lekarstvo[JOURNAL]
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200 papers
A case of severe type of cerebro-costo-mandibular syndrome.
Matić A, Velisavljev-Filipović G, Lovrenski J … +1 more , Gajdobranski D
Srp Arh Celok Lek · 2016 · PMID 29652453 · Publisher ↗
INTRODUCTION: Cerebro-costo-mandibular syndrome (CCMS) is a rare disorder, with only 75 cases described in the literature to date. CCMS is characterized by association of micrognathia and specific multiple rib defects. I...
INTRODUCTION: Cerebro-costo-mandibular syndrome (CCMS) is a rare disorder, with only 75 cases described in the literature to date. CCMS is characterized by association of micrognathia and specific multiple rib defects. It is accompanied by mental deficiency in considerable number of cases. Sometimes, there are associated anomalies and problems, such as spine deformities, brain, heart, kidney or ear anomalies, feeding difficulties, delayed psychomotor development, and growth impairment. Depending on severity of deformities and consecutive respiratory insufficiency, in about 35–50% of CCMS cases, death occurs during the first year of life. These cases are referred to as severe types of CCMS. CASE OUTLINE: In this paper we present a female infant with severe type of CCMS. Diagnosis was established in the first day of life, based on micrognathia and findings of posterior rib-gap defects on the chest X-ray, accompanied by dyspnea. Progressive severe respiratory insufficiency caused by chest and air-way deformities and exacerbated by episodes of pneumonia, led to respiratory failure and death at the age of 7.5 months. CONCLUSION: CCMS should be considered in every infant with micrognathia and rib-gap defects on chest X-ray.
Factors associated with inconsistent condom use with clients among female sex workers in Podgorica, Montenegro.
Laušević D, Begić S, Terzić N … +3 more , Vratnica Z, Čičić A, Mugoša B
Srp Arh Celok Lek · 2016 · PMID 29652452
INTRODUCTION: Female sex workers (FSWs) are a group at increased risk for human immunodeficiency virus (HIV) infection, and inconsistent condom use with clients is a known risk factor for infection in this group. OBJECTI...
INTRODUCTION: Female sex workers (FSWs) are a group at increased risk for human immunodeficiency virus (HIV) infection, and inconsistent condom use with clients is a known risk factor for infection in this group. OBJECTIVE: The aim of the study was to determine factors associated with inconsistent condom use with clients among female sex workers in Podgorica, Montenegro. METHODS: We conducted an HIV bio-behavioral cross-sectional study in a sample of female sex workers recruited by snowball sampling. RESULTS: A total of 142 FSWs were recruited. Eighty-one (57.0%) of them used condoms consistently with clients. HIV prevalence was 0.0%. In the multivariate analysis inconsistent condom use with clients in the previous month was associated with clients’ negative personal attitude [age-adjusted odds ratio (AOR) = 22.7, 95% confidence interval (CI) = 2.3–228.0] or client’s indifference (AOR = 13.0, 95% CI = 1.4–118.9) towards using condom during sex with sexual workers, decision making by clients or by mutual agreement with client about using a condom (AOR = 10.2, 95% CI = 3.7–28.0), and early age of first sex (AOR = 5.4, 95% CI = 1.6–18.5). CONCLUSION: Our results suggest not only the need for further promotion of condom use, information and education for FSW but also the need to strengthen negotiation skills of FSWs with clients on regular use of condoms, as well as the need to extend prevention programs to clients of FSWs.
Search for the presence of occult hepatitis C in patients with treatment-induced viral clearance using an ultrasensitive assay.
Dzekova-Vidimliski P, Nikolov IG, Matevska-Geshkovska N … +7 more , Boyanova Y, Nikolova N, Antonov K, Mateva L, Dimovski A, Rostaing L, Šikole A
Srp Arh Celok Lek · 2016 · PMID 29652451 · Publisher ↗
INTRODUCTION: Occult hepatitis C is defined by the presence of virus in the peripheral blood mononuclear cells (PBMCs) and/or liver cells, in the absence of serum viremia. OBJECTIVE: To detect the persistence of occult h...
INTRODUCTION: Occult hepatitis C is defined by the presence of virus in the peripheral blood mononuclear cells (PBMCs) and/or liver cells, in the absence of serum viremia. OBJECTIVE: To detect the persistence of occult hepatitis C in hemodialysis (HD) patients and patients without renal disease (non-renal) with treatment-induced clearance of hepatitis C virus (HCV) infection, using assays with a very low detection limit of viremia. METHODS: A group of 13 HD patients and a group of 43 non-renal patients, with treatment-induced HCV infection clearance were investigated in the study. The HD patients were treated with pegylated interferon alpha (PEG-IFN-α) only, while the non-renal patients were treated with a combination therapy of PEGIFN- α and ribavirin. Detection of a possible persistence of HCV RNA in the PBMCs and plasma samples was assessed by an ultrasensitive reverse transcription polymerase chain reaction (RT-PCR) assay (2 IU/ml). RESULTS: HCV RNA was not detected in the PBMCs and plasma samples of HD patients and of non-renal patients, when assessed by the ultrasensitive RT-PCR assay. CONCLUSION: When a sensitive RT-PCR assay was applied, to determine if treatment induced clearance of HCV infection had been successful, occult hepatitis C could not be detected by an ultrasensitive assay, neither in HD nor in non-renal patients.
Lymphoblastic lymphomas in children – A single-center experience from Serbia.
Lazić J, Janić D, Krstovski N … +5 more , Rodić P, Milošević G, Janković S, Brašanac D, Dokmanović L
Srp Arh Celok Lek · 2016 · PMID 29652450
INTRODUCTION: Intensive treatment protocols used for non-Hodgkin lymphoma in children lead to eventfree survival rates ranging from 80% to 90%. However, the results are less successful in developing countries. Lymphoblas...
INTRODUCTION: Intensive treatment protocols used for non-Hodgkin lymphoma in children lead to eventfree survival rates ranging from 80% to 90%. However, the results are less successful in developing countries. Lymphoblastic lymphoma (LBL) is the second most frequent type of lymphoma in children, contributing with about one third to all non-Hodgkin lymphoma in childhood. OBJECTIVE: The aim of the study was to evaluate the results of LBL treatment in University Children’s Hospital (UCH), Belgrade. METHODS: A retrospective analysis of patient records at UCH from 1997 to 2015 was carried out in patients aged 0–18 years, in whom the diagnosis of LBL had been established. Twenty-two children were included in the analysis. RESULTS: Mean age at diagnosis was 10 years, with preponderance of male patients. All patients were treated according to Berlin-Frankfurt-Münster-based chemotherapy protocols. With median follow-up of 91.5 months, five-year probability of event-free survival was 79.5% for all patients, while overall survival was 81.8%. CONCLUSION: Our results, although slightly inferior to those of leading international groups, reflect a good treatment outcome in our patients.
Rising incidence of childhood type 1 diabetes in Montenegro.
Samardžić M, Popović N, Terzić N … +2 more , Popović-Samardžić M, Nedović-Vuković M
Srp Arh Celok Lek · 2016 · PMID 29652449
INTRODUCTION: The incidence rate of childhood type1 diabetes continues to rise across Europe by an average of approximately 3–4% per annum. OBJECTIVE: The aim of this study was to examine incidence and trends of type 1 d...
INTRODUCTION: The incidence rate of childhood type1 diabetes continues to rise across Europe by an average of approximately 3–4% per annum. OBJECTIVE: The aim of this study was to examine incidence and trends of type 1 diabetes in children aged 0–14 years in Montenegro from 1997 to 2011. METHODS: This was a prospective study. Primary case ascertainment was from a diabetes register, and a secondary independent data source was from hospital notifications. Case ascertainment was 100% complete using the capture-recapture method. Standardized incidence rates were calculated and trends estimated using the Poisson regression. RESULTS: A total of 298 children (157 boys and 141 girls) were diagnosed with type 1 diabetes before 15 years of age during 1997–2011. The mean age-standardized incidence was 15.0/100,000 persons (95% CI: 12.3–17.6) during this period, increasing from 11.7/100,000 in 1997 to 18.8/100,000 in 2011. The agespecific rates per 100,000 persons per year were 10.7, 17.2, and 18.2 at ages 0–4 years, 5–9 years, and 10–14 years, respectively. A significant linear trend in incidence (p = 0.002) has been observed over time, with an average annual increase of 4.2%. The increase in incidence was present in both genders, with the largest relative increase in the 0–4 years age group for boys (11.0%; p = 0.006). CONCLUSION: The incidence of type 1 diabetes in Montenegro children continues to increase. We need further monitoring and additional research in order to explain the cause.
Correlation between the season, temperature and atmospheric pressure with incidence and pathogenesis of acute appendicitis.
Karanikolić A, Karanikolić V, Djordjević L … +1 more , Pešić I
Srp Arh Celok Lek · 2016 · PMID 29652448
INTRODUCTION: There is very little literature data on the correlation between the seasons, temperature and atmospheric pressure, and pathogenesis of acute appendicitis (AA). OBJECTIVE: The aim of this research is to inve...
INTRODUCTION: There is very little literature data on the correlation between the seasons, temperature and atmospheric pressure, and pathogenesis of acute appendicitis (AA). OBJECTIVE: The aim of this research is to investigate the association between the seasons, changes in atmospheric temperature and pressure, and patients’ age and severity of the clinical form of AA in the city of Niš METHODS: This study included 395 patients diagnosed with AA, who, during the two-year period, from July 1st 2011 to June 30th 2013, were hospitalized and operated on at the Department of General Surgery, Clinical Center in Niš, Serbia. RESULTS: The increased average daily values of barometric pressure by 1 millibar on the day when the event took place was associated (p < 0.05) with the decrease of total risk of the occurrence of appendicitis by 2.2% (0.2–4.1%). In all observed patients, each increase of the mean daily temperature by 1°C three days before the event took place (Lag 3) was associated (p < 0.05) with the increase of total risk of the occurrence of appendicitis by 1.3% (0.1–2.5%). CONCLUSION: According to the results of this research, we can conclude that patients’ sex, age and severity of the clinical form of AA are not in connection with the seasons, while there are certain connections between appendicitis occurrence and atmospheric temperature and pressure.
Thyroglobulin value in patients surgically treated for differentiated thyroid carcinoma.
Mikač G, Stanković S
Srp Arh Celok Lek · 2016 · PMID 29652447
INTRODUCTION: Thyroglobulin is composed glycoprotein, and it is synthesized by follicular cells of the thyroid gland. Treatment of differentiated thyroid carcinomas involves total thyroidectomy followed by radioiodine ab...
INTRODUCTION: Thyroglobulin is composed glycoprotein, and it is synthesized by follicular cells of the thyroid gland. Treatment of differentiated thyroid carcinomas involves total thyroidectomy followed by radioiodine ablation of a potential remaining tissue. The measurement of thyroglobulin in the postoperative follow-up can serve as an indicator of tumor growth or recurrence of the disease. OBJECTIVE: The aim of this paper is to examine the value of thyroglobulin in patients surgically treated for differentiated thyroid cancer who had metastases in the lymph nodes of the neck, as well as in operated on patients without any evident metastasis. METHODS: Thyroglobulin values in the serum of 58 patients were analyzed. Two groups were formed. The thyroglobulin value was established with the use of IRMA-hTg (125I) system. Normal levels of thyroglobulin were from 2 ng/ml to 65 ng/ml. For all of 58 patients, thyroglobulin was determined three times. The first, so-called pre-ablation thyroglobulin was determined immediately before the application of 131I ablation dose. The second and the third measurements were conducted six to eight months and one year, respectively, after the application of the ablation dose respectively. RESULTS: The first group consisted of 14 patients with histologically proven metastases in the lymph nodes of the neck, while the second group consisted of 44 patients without any evident metastases. The average thyroglobulin value of pre-ablation in the patients from the first group was 43.45 ng/ml, while in the second was 7.57 ng/ml. Levene’s test (with p = 0.00, i.e p < 0.05), demonstrated a statistically significant difference. Furthermore, in both groups, there was statistically significant difference between pre-ablation and post-ablation thyroglobulin values (Student’s t-test with p < 0.05). CONCLUSION: It can be concluded that the average value of thyroglobulin was significantly higher in patients with lymph node metastases in the neck. We are of the opinion that the determination of thyroglobulin, despite individual variations, may serve as a good indicator to assist in monitoring of patients surgically treated for differentiated thyroid cancer.
Modified Risdon approach using periangular incision in surgical treatment of subcondylar mandibular fractures.
Nikolić ŽS, Jelovac DB, Šabani M … +1 more , Jeremić JV
Srp Arh Celok Lek · 2016 · PMID 29652446
INTRODUCTION: No consensus has been reached yet on the surgical approach for treatment of condylar fractures. OBJECTIVE: The aim of this study was to present modified Risdon approach (without facial nerve identification)...
INTRODUCTION: No consensus has been reached yet on the surgical approach for treatment of condylar fractures. OBJECTIVE: The aim of this study was to present modified Risdon approach (without facial nerve identification) in the treatment of subcondylar mandibular fractures. METHOD: This is a retrospective study of a period 2005–2012. During this seven-year period, 25 condylar mandibular fractures in 22 men and three women (19–68 years old) were treated by modified Risdon approach without identifying the facial nerve. The main inclusion criterion was subcondylar fracture according to Lindahl classification. RESULTS: No additional morbidity related to postoperative complications, such as infection or salivary fistula, was observed in this series. Only two (8%) patients developed temporary weakness of the marginal branch of the facial nerve, which resolved six weeks postoperatively. Each patient achieved good mouth opening postoperatively. Scar was camouflaged in the first cervical wrinkle. Two patients developed temporomandibular joint dysfunction. No patient had postoperative occlusal disturbance. In all of the patients good aesthetic result was achieved in a two-year follow-up. CONCLUSION: In comparison with techniques described in the literature, the main advantages of the modified Risdon approach are the following: no need for facial vessels identification; direct, fast, and safe approach to mandibular angle and subcondylar region; relatively simple surgical technique and good cosmetic result – due to aesthetically placed incision. This approach could be recommended for subcondylar fracture as a simplified and safe procedure.
Useful histological findings in incisional biopsies of oral squamous cell carcinoma.
Ismerim AB, Xavier FCA, Cangussu MCT … +3 more , Ramalho LMP, Agra IMG, dos Santos JN
Srp Arh Celok Lek · 2016 · PMID 29652445 · Publisher ↗
INTRODUCTION: Oral squamous cell carcinoma (OSCC) is one of the most common head and neck cancers. OBJECTIVE: The aim of this study was to investigate the histopathological features of OSCC specimens obtained from incisi...
INTRODUCTION: Oral squamous cell carcinoma (OSCC) is one of the most common head and neck cancers. OBJECTIVE: The aim of this study was to investigate the histopathological features of OSCC specimens obtained from incisional biopsies and to alert clinicians to the importance of more representative biopsies. METHODS: Forty-eight OSCC samples were obtained from incisional biopsies and classified by Bryne’s score. The following morphological features were analyzed: invasive front, invasiveness, apoptotic cells, atypical mitosis, giant cells, acantholysis, ulceration, necrosis, calcification, surface epithelium, granulation tissue, desmoplasia, tissue invasions, inflammatory infiltrate and tumor thickness. RESULTS: Ten (21%) cases were classified as high grade malignancies and 38 (79%) as low grade. Apoptotic cells (n = 26), atypical mitosis (1–2/20×; n = 38), giant cells (n = 8), acantholysis (n = 5), necrosis (n = 5), calcification (n = 1), granulation tissue (n = 32), desmoplasia (n = 4), perineural invasion (n = 2), muscular invasion (n = 8), invasion of salivary gland tissue (n = 3), vascular invasion (n = 10), and chronic inflammation (n = 33) were observed. Vascular invasion (p = 0.04, Pearson’s χ2 test) and necrosis (p = 0.04, Pearson’s χ2 test) were significantly associated with cases of high-grade malignant tumors. Atypical mitosis was associated with a greatest tumor thickness (p = 0.04, Fischer’s exact test). CONCLUSION: This study suggests that incisional biopsies may be useful and significant as they can show histopathological variables that are important to classify oral squamous cell carcinomas into low grade and high grade according to Bryne’s score, which was used in this study. Thus, more representative biopsies might be useful to achieve this and allow a more accurate planning.
Ocular surface disease incidence in patients with open-angle glaucoma.
Radenković M, Stanković-Babić G, Jovanović P … +2 more , Djordjević-Jocić J, Trenkić-Božinović M
Srp Arh Celok Lek · 2016 · PMID 29652117
INTRODUCTION: Ocular surface disease (OSD) is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbances, tear film instability with potential damage to the ocula...
INTRODUCTION: Ocular surface disease (OSD) is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbances, tear film instability with potential damage to the ocular surface, accompanied by increased tear film osmolarity and inflammation of the ocular surface. It is a consequence of disrupted homeostasis of lacrimal functional unit. The main pathogenetic mechanism stems from tear hyperosmolarity and tear film instability. The etiological classification is hyposecretory (Sy-Sjögren and non-Sjögren) and evaporative (extrinsic and intrinsic) form. Delphi panel classification grades disease stages. Antiglaucoma topical therapy causes exacerbation or occurrence of symptoms of dry eye due to main ingredients or preservatives (benzalkonium chloride – BAK), which are dose- and time-dependent. BAK reduces the stability of the lipid layer of tears, the number of goblet cells, induces apoptosis and inflammatory infiltration. OBJECTIVE: The aim of this study was the analysis of the OSD incidence in open-angle glaucoma patients caused by topical medicamentous therapy. METHODS: Retrospective analysis of examined patients with open-angle glaucoma was used. RESULTS: Increased incidence of moderate and advanced OSD Index degrees in the group of primary open-angle glaucoma (POAG) and pseudoexfoliative glaucoma. According to the Delphi Panel Scale the most common grade is IIb (POAG and pseudoexfoliative glaucoma). Evaporative form of OSD prevailed in all treatment groups. High percentage of dry eye in patients with higher concentrations of preservatives applied was noticed. CONCLUSION: OSD should be timely diagnosed and treated. Dry eye has an impact on surgical outcome and postoperative visual acuity, and in order to improve patient compliance and quality of life, symptoms of dry eye should be addressed and medications with lower concentrations of preservatives should be applied.
Double trouble: accessory spleen mimicking renal carcinoma recurrence identified by scintigraphy.
Cvetković Z, Suvajdzić-Vuković N, Todorović-Tirnanić M
Srp Arh Celok Lek · 2016 · PMID 27276872 · Publisher ↗
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How can eHealth enhance adherence to cancer therapy and supportive care?
Bateman EH, Keef DM
Srp Arh Celok Lek · 2016 · PMID 27276871 · Publisher ↗
eHealth is currently a hot topic, but is certainly not a new one. The use of communications technology to relay health-related information or provide medical services has been around since the advent of this technology....
eHealth is currently a hot topic, but is certainly not a new one. The use of communications technology to relay health-related information or provide medical services has been around since the advent of this technology. It has been primarily over the last decade that eHealth has seen a global expansion, due to the far-reaching capabilities of the Internet and the widespread use of wireless technology. This paper will outline what eHealth is, what adherence is, and how eHealth can help with adherence, in cancer and supportive care particularly. It will discuss the current state of the art, and project into the future. Keywords: telemedicine; compliance; use of electronic media for health
Foreign scientists on the contribution of Serbian physician and scientist Dr. Lazar K. Lazarević to medical science.
Draca S
Srp Arh Celok Lek · 2016 · PMID 27276870 · Publisher ↗
Dr. Lazar K. Lazarević (1851-1890, Julian calendar/1891, Gregorian calendar) was an exceptional Serbian physician, scientist, writer and translator. During his short life and his close to 11-year-long professional career...
Dr. Lazar K. Lazarević (1851-1890, Julian calendar/1891, Gregorian calendar) was an exceptional Serbian physician, scientist, writer and translator. During his short life and his close to 11-year-long professional career (1879-1890), Dr. Lazarević authored 78 scientific papers and presentations in various branches of medicine. His greatest contribution to the field of neurology and to medical science in general is his description of the straight leg raising test.The article titled"Ischiac postica Cotunnii--One contribution to its differential diagnosis"was published in the Serbian language (in Cyrillic alphabet) in the Serbian Archives of Medicine in 1880.The article was translated to German and republished in Vienna in 1884 in Allgemeine Wiener medizinische Zeitung. The straight leg raising test is usually called Lasegue's test/sign, after the French clinician Charles Lasègue, although he never described it. However, there are numerous authors who admit that Lasègue never published the description of the straight leg raising test, and instead give full credits for its discovery to Dr. Lazarević. Our objective in this article is to highlight the major literature written by foreign scientists who give credit to Dr. Lazarević for his contribution to medical science.
Electrocardiography in pre-participation screening and current guidelines for participation in competitive sports.
Georgijević L, Andrić L
Srp Arh Celok Lek · 2016 · PMID 27276869 · Publisher ↗
Electrocardiography (ECG) is especially significant in pre-participation screening due to its ability to discover or to rise a suspicion for certain cardiovascular diseases and conditions that represent a serious health...
Electrocardiography (ECG) is especially significant in pre-participation screening due to its ability to discover or to rise a suspicion for certain cardiovascular diseases and conditions that represent a serious health risk in athletes. Common, conditionally benign and training related ECG changes are sinus bradycardia and sinus arrhythmia, first degree atrioventricular block, incomplete right bundle branch block, benign early repolarization, and isolated QRS voltage criteria for left ventricular enlargement. Uncommon ECG changes, unrelated to training, and some specific syndromes are ST segment depression and/or ≥ 2 mm T wave inversion in two or more adjacent leads, intraventricular conduction disorder, Wolf-Parkinson-White syndrome, long QT interval syndrome, short QT interval syndrome, catecholaminergic polymorphic ventricular tachycardia, monomorphic ventricular extrasystole and benign ventricular tachycardia. Keywords: examination; athletes; recommendations
Food allergy in children.
Radlović N, Leković Z, Radlović V … +3 more , Simić D, Ristić D, Vuletić B
Srp Arh Celok Lek · 2016 · PMID 27276868 · Publisher ↗
Food allergy represents a highly up-to-date and continually increasing problem of modern man. Although being present in all ages, it most often occures in children aged up to three years. Sensitization most often occurs...
Food allergy represents a highly up-to-date and continually increasing problem of modern man. Although being present in all ages, it most often occures in children aged up to three years. Sensitization most often occurs by a direct way, but it is also possible to be caused by mother's milk, and even transplacentally. Predisposition of inadequate immune response to antigen stimulation, reaginic or nonreaginic, is of non-selective character so that food allergy is often multiple and to a high rate associated with inhalation and/or contact hypersensitivity. Also, due to antigen closeness of some kinds of food, cross-reactive allergic reaction is also frequent, as is the case with peanuts, legumes and tree nuts or cow's, sheep's and goat's milk. Most frequent nutritive allergens responsible for over 90% of adverse reactions of this type are proteins of cow's milk, eggs, peanuts, tree nuts, wheat, soy, fish, shellfish, crustaceans, and cephalopods. Allergy intolerance of food antigens is characterized by a very wide spectrum of clinical manifestations. Highly severe systemic reactions, sometimes fatal, are also possible.The diagnosis of food allergy is based on a detailed personal and family medical history, complete clinical examination, and corresponding laboratory and other examinations adapted to the type of hypersensitivity and the character of patient's complaints, and therapy on the elimination diet. A positive effect of elimination diet also significantly contributes to the diagnosis. Although most children "outgrow" their allergies, allergy to peanuts, tree nuts, fish, shellfish, crustaceans, and cephalopods are generally life-long allergies.
Recent advances in research on non-auditory effects of community noise.
Belojević G, Paunović K
Srp Arh Celok Lek · 2016 · PMID 27276867 · Publisher ↗
Non-auditory effects of noise on humans have been intensively studied in the last four decades. The International Commission on Biological Effects of Noise has been following scientific advances in this field by organizi...
Non-auditory effects of noise on humans have been intensively studied in the last four decades. The International Commission on Biological Effects of Noise has been following scientific advances in this field by organizing international congresses from the first one in 1968 in Washington, DC, to the 11th congress in Nara, Japan, in 2014. There is already a large scientific body of evidence on the effects of noise on annoyance, communication, performance and behavior, mental health, sleep, and cardiovascular functions including relationship with hypertension and ischemic heart disease. In the last five years new issues in this field have been tackled. Large epidemiological studies on community noise have reported its relationship with breast cancer, stroke, type 2 diabetes, and obesity. It seems that noise-induced sleep disturbance may be one of the mediating factors in these effects. Given a large public health importance of the above-mentioned diseases, future studies should more thoroughly address the mechanisms underlying the reported association with community noise exposure. Keywords: noise; cancer; stroke; diabetes mellitus type 2; obesity
Case report of an infant with severe vitamin D deficiency rickets manifested as hypocalcemic seizures.
Vuletić B, Marković S, Igrutinović Z … +3 more , Vladimir R, Rasković Z, Simović A
Srp Arh Celok Lek · 2016 · PMID 27276866 · Publisher ↗
INTRODUCTION: Hypocalcemic seizures are uncommon in the post-neonatal period. We report an infant with hypocalcemic seizures caused by severe deficiency of vitamin D. CASE OUTLINE: A five-month-old male infant was admitt...
INTRODUCTION: Hypocalcemic seizures are uncommon in the post-neonatal period. We report an infant with hypocalcemic seizures caused by severe deficiency of vitamin D. CASE OUTLINE: A five-month-old male infant was admitted to hospital in March 2013 with recurrent generalized afebrile seizures resistant to clonazepam therapy. At the clinical examination, the infant showed characteristic rachitic signs, so that after a blood sample was taken for laboratory testing, the infant was given infusion of 2 ml/kg of 10% of calcium gluconate at a rate of 0.5 ml/min.The treatment resulted in immediate termination of seizures and normalization of the consciousness of the infant. Blood sample analysis showed extremely low levels of free and total calcium (0.36/1.24 mmol/) and 25(OH)D (<3 ng/ml), elevated alkaline phosphatase (878 U/) and parathyroid hormone (283 pg/ml), and low calcium/creatinine ratio (mg/mg) in a portion of urine (0.03), while the levels of serum phosphorus, pH, total protein, albumin and creatinine were within the reference range. Wrist X-ray showed typical signs of rickets. In order to fully stabilize calcium homeostasis, along with 2,000 IU of vitamin D3 daily and standard cow's milk formula, calcium gluconate (80 mg/kg daily) was given orally over a period of two weeks.The treatment resulted in complete stabilization of the infant's condition and rapid improvement in laboratory, radiological and clinical findings of rickets. CONCLUSION: Generalized convulsions in the afebrile infant represent a serious and etiopathogenically very heterogeneous problem. Extremely rare, as in the case of our patient, it may be due to severe hypocalcemia caused by a deficiency of vitamin D.
"Stray" achalasia: From gastroenterologist to pulmonologist and back.
Obradović D, Sević BJ, Stojanović M … +2 more , Ilić M, Ivanov I
Srp Arh Celok Lek · 2016 · PMID 27276865 · Publisher ↗
INTRODUCTION: Achalasia is a rare esophageal disorder which, due to frequent presence of both respiratory and gastrointestinal symptoms, can initially be referred either to pulmonologist or gastroenterologist. CASE OUTLI...
INTRODUCTION: Achalasia is a rare esophageal disorder which, due to frequent presence of both respiratory and gastrointestinal symptoms, can initially be referred either to pulmonologist or gastroenterologist. CASE OUTLINE: A 50-year-old patient was initially referred to gastroenterologist with the following symptoms: nausea, vomiting, occasional hiccups, weight loss, chest pain, dysphonia, and dry cough. After chest X-ray, the patient was referred to pulmonologist with differential diagnosis for pulmonary infiltration and thoracic aortic aneurysm. Pulmonologist interpreted chest X-ray as showing paratracheal mediastinal enlargement with air-fluid levels, thus suspecting achalasia. Computed tomography scan of the thorax with per os contrast showed extremely dilated esophagus with food stasis. The patient was then referred to thoracic surgeon, who ordered additional diagnostics (esophageal passage with contrast, esophagomanometry, esophagogastroduodenoscopy), and finally performed Heller myotomy. Postoperatively there were no complications, and the patient was symptom free during the follow-up. CONCLUSION: Although achalasia can also result in respiratory symptoms, fastidious anamnesis and accurate radiological interpretation are essential for the correct diagnosis.
A case of essential thrombocythemia and ankylosing spondylitis treated with a combination of anagrelide, disease-modifying antirheumatic drugs, and etanercept.
Zeremski V, Savić A, Ilić T … +3 more , Milosević I, Maksimović M, Vucković B
Srp Arh Celok Lek · 2016 · PMID 27276864 · Publisher ↗
INTRODUCTION: A high platelet count, or thrombocytosis, is either a reactive process or a result of a myeloproliferative disorder. Ankylosing spondylitis is a chronic inflammatory rheumatic disease affecting the spine an...
INTRODUCTION: A high platelet count, or thrombocytosis, is either a reactive process or a result of a myeloproliferative disorder. Ankylosing spondylitis is a chronic inflammatory rheumatic disease affecting the spine and sometimes peripheral joints in which reactive mild to moderate thrombocytosis is a common finding. There have been no previously reported cases of essential thrombocythemia associated with ankylosing spondylitis. CASE OUTLINE: We report a case of a 32-year-old man with human leukocyte antigen B27-positive ankylosing spondylitis and Janus kinase 2-positive essential thrombocythemia who was treated first with a combination of anagrelide and disease-modifying antirheumatic drugs and, after liver toxicity, with a combination of anagrelide and etanercept (TNF-α antagonist). Both diseases were gradually brought under control. CONCLUSION: Our case of ankylosing spondylitis and essential thrombocythemia suggests that concomitant etanercept and anagrelide therapy is safe, as well as effective.
Peripartum cardiomyopathy in a patient treated for acute myeloid leukemia.
Colović N, Seferović P, Plećić M … +3 more , Vidović A, Suvajdzić N, Tomin D
Srp Arh Celok Lek · 2016 · PMID 27276863 · Publisher ↗
INTRODUCTION: Peripartum cardiomyopathy usually presents with systolic heart failure during the last months of pregnancy and up to five months postpartum. The disease is rare and can be fatal. CASE OUTLINE: We report a 3...
INTRODUCTION: Peripartum cardiomyopathy usually presents with systolic heart failure during the last months of pregnancy and up to five months postpartum. The disease is rare and can be fatal. CASE OUTLINE: We report a 30-year-old female who was diagnosed with acute myeloid leukemia, with maturation and cytogenetic finding of t(8;21)(q22;q22),del(9)(q22) in January 2004. She was treated with chemotherapy and achieved complete remission that lasts to date. She became pregnant and delivered a healthy newborn with caesarean section in 2009. Seven months later, she again became pregnant and delivered the second child with caesarean section in January 2011. Seven days after delivery she developed symptoms and signs of heart failure. Electrocardiogram showed sinus rhythm, low voltage and negative T-waves in inferior and lateral leads. Echocardiography revealed global left ventricular dysfunction with ejection fraction of 15%, with mobile thrombotic mass of 12 mm attached to the left ventricle wall. She was treated with both unfractionated and low-molecular heparin, diuretics, cardiotonics, and beta-blockers. Within six following weeks left ventricle systolic function improved up to 25-30%. The full clinical recovery was achieved in September 2013, resulting in absence of heart failure and left ventricular ejection fraction of 54%. CONCLUSION: Peripartum cardiomyopathy is a rare condition. The cause of cardiomyopathy is unknown, but it is believed that it could be triggered by various conditions and risk factors. Although the patient was treated with cardiotoxic drugs (doxorubicin and mitoxantrone) in permitted doses, they could have been contributory factors of myocardial damage. Close monitoring of cardiac function in the peripartal period might be beneficial in patients treated with cardiotoxic drugs.
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