Browsing by Author "Bokonjić, Dubravko (35516999100)"

Background/Aim. Factors determining the risk of Lyme disease (LD) may be followed in terms of the type of habitat. The evaluation of the risk of Borrelia burgdorferi (B. burgdorferi) transmission in humans on Ixodes ricinus (I. ricinus) tick habitats is done by means of the ecological risk index, which determines the tick habitat, abundance and infection rate. The aim of this paper was to determine the value of ecological risk index (potential and actual risk – PR and AR) on green areas in 9 pаrks in Belgrade and establish the correlation of this index with tick bites in humans. Methods. Ticks were collected in parks by means of the flag hour method and examined for the presence of LD cause in dark-field microscopic analysis. Point values were assigned to certain parameters and potential and actual risk index evaluated for each habitat. The data on tick bites from the surveyed habitats were obtained from the Protocol of patients bitten by ticks of the Sector for Preventive Medicine, Institute of Epidemiology, Military Medical Academy in Belgrade. Analysis of variance (ANOVA), Tukey test and Pearson ´s coefficient were used in statistical analysis of data. Results. In Belgrade´s park habitats a high PR of B. burgdorferi transmission was determined, while AR for 4 habitats was categorized as PR, and limited for other 5 habitats. Statistically, in terms of AR values the following habitats were significantly different (p < 0.05): Hаjd Pаrk and Tаšmаjdаn; Hаjd Pаrk and Kаlemegdаn; Hаjd Pаrk and Pionirski Pаrk; Hаjd Pаrk and Bаnovo Brdo; Topčider and Tаšmаjdаn; Topčider and Kаlemegdаn; Topčider and Pionirski Pаrk; Topčider and Bаnovo Brdo Park. A statistically significant correlation (p < 0.05) between bites of adults and the number of bites of infected adults with the AR value was established. Conclusion. In parks of Belgrade, there is a limited AR of B. burgdorferi transmission on the average. The AR values vary from limited to the potential, depending on the ecological features of habitat, the number of collected ticks and their infection rate. In view of the correlation of AR with the bites in humans, this index is significant for assessing LD risk. © 2017, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.

Background/Aim. Patients with chronic renal failure (CRF) have increased cardiovascular morbidity and mortality. It is unknown which biomarkers best describe the degree of diastolic dysfunction in patients with CRF. The aim of this study was to determine the correlation between B-type natriuretic peptide (BNP), N-terminal prohormone brain natriuretic peptide (NTproBNP) and left ventricular diastolic dysfunction (DD-LV) with the degree of CRF. Methods. The study included 100 adult patients with CRF without major cardiac and cerebral incidents who did not start actively treating CRF. According to the degree of CRF, the patients were divided into two groups: G1 (moderate degree), glomerular filtration rate (GFR) ≥ 30 mL/min/1.73 m2, and G2 (more severe degree), GFR < 30 mL/min/1.73 m2. Blood concentrations of BNP and NTproBNP were measured and Doppler echocardiographic measurement performed to estimate diastolic dysfunction (DD-LV). According to the degree of DD-LV, all the patients were divided into two groups: DD-LV1 (mild diastolic dysfunction) and DD-LV2 (severe diastolic dysfunction). According to the degree of CRF and DD-LV, the patients were divided into four groups: I (G1, DD-LV1), II (G1, DD-LV2), III (G2, DD-LV1) and IV (G2, DD-LV2). Results. There was a highly significant statistical correlation between BNP and NTproBNP with GFR (p < 0.001), and DD-LV with BNP (p < 0.023) and NTproBNP (p = 0.035). In patients with DD-LV2, a statistically significantly higher BNP concentrations were registered in patients with G2 (p < 0.001). Unlike BNP in the patients with diastolic dysfunction DD-LV1 and those with diastolic dysfunction DD-LV2, significantly higher concentrations of NTproBNP were registered in the patients with G2 (DD- LV1: p = 0.006; DD-LV2: p < 0.001). Conclusion. Biomarkers BNP and NTproBNP are not the best predictors in the assessment of diastolic dysfunction because they are correlated with the degree of renal insufficiency. © 2017, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.

Background/Aim. The integrity of outer retinal structures, primarily the photoreceptor layer, is important because of its direct correlation with visual acuity. The aim of this study was to investigate the correlation between best-corrected visual acuity (BCVA), the foveal photoreceptor-inner seg-ment/outer segment (IS/OS) junction and external limiting membrane (ELM) in patients with neovascular age-related macular degeneration (NVAMD) after the treatment with bevacizumab, as well as the correlation between the above-mentioned parameters and different types of neovascular membrane, classified by fluorescein angiography (FA). Me-thods. The study included 82 patients with NVAMD, treated with intravitreal bevacizumab. All patients under-went a basic ophthalmological examination, FA and optical coherence tomography (OCT). Based on the results of FA, all the patients were divided into two main groups - type I (the occult and minimally classic) and type II (classic and predominantly classic) of the choroidal neovascular mem-brane (CNV). The OCT images revealed either the presence or the absence of IS/OS and ELM. Results. After the treatment, the mean best corrected visual acuity improved significantly in both groups (p < 0.01). Preserved IS/OS and ELM were registered in a smaller number of patients as compared to the condition before the treatment (p < 0.01). After the treatment, the mean BCVA was significantly bet-ter in patients with preserved IS/OS and ELM (p < 0.01). In addition, we registered a higher number of patients with preserved ELM in the first group than in the second group (p < 0.01), whereas there was no significant difference in the integrity of IS/OS between the groups (p > 0.05). Conclu-sion. The patients with preserved IS/OS and ELM achieved better final visual acuity as compared to the pa-tients without preserved IS/OS and ELM. In our patients, the absence of IS/OS and ELM were more frequent in type II (classic and predominantly classic) CNV than in type I (the occult and minimally classic) CNV. © 2017, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.

Background/Aim. Hyperbaric oxygen therapy (HBOT) is a method which increases oxygen solubility in plasma up to 20 times. This effect is very important in the treatment of circulatory disorders, which reduces oxygenation and leads to increased production of inflammatory mediators and free oxygen radicals. The aim of this study was to examine the impact of HBOT on the oxidative stress parameters in the patients with systemic lupus erythematosus (SLE). Methods. This prospective study included 18 females with SLE [American College of Rheumatology (ACR) criteria], average age 52.2 ± 8.82 years, treated with HBOT for 60 min/day, with average partial oxygen pressure of 2.2 atmospheres absolute (ATA), during 10 days, in combination with appropriate medication therapy for SLE. The following parameters were determined in the serum: C-reactive protein (CRP), hemoglobin, creatinine, albumin, complement 3 (C3), antinuclear antibodies (ANA), glomerular filtration rate (GFR) using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. In the urine, parameters of oxidative stress were spectrofotometrically determined: Levels of superoxide anion radical (O2(Formula Presented)), hydrogen peroxide (H2O2), nitrites (NO2 -) and concentration of thiobarbituric acid reactive substances (TBARS). In hemolysate, the pa rameters of antioxidant protection: Superoxide dismutase (SOD), catalase (CAT) and reduced gluthatione (GSH), were measured. The samples for the analysis were collected three times: Before HBOT (initial values), after 10 days of HBOT and 1 month after beginning the treatment in relation to the initial value. Results. We noticed a statistically significant (p < 0.05) decrease in a level of O2(Formula Presented), both after 10 days and after 1 month of HBOT (8.26 ± 13.62; 8.39 ± 4.94; 11.92 ± 6.86 nmol/mL, respectively). Values of other parameters of oxidative stress such as NO2 -, TBARS and H2O2-showed no significant difference during the monitored period. Regarding the parameters of antioxidant the protection, we revealed slightly higher value of GSH after treatment (initial value: 66.34 ± 16.31; after 10 days of HBOT 79.43 ± 36.77; after 1 month of HBOT69.72 ± 22.32 μmol/mL red blood cells) which was held after a month, but it was not statistically significant. Activity of SOD and CAT, before and after HBOT, did not change significantly. Conclusion. Our results suggested the potential beneficial effects of HBOT on redox status in the patients with SLE by decreasing the levels of O2(Formula Presented). © 2019, Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background/Aim. Hospital-acquired pneumonia (HAP) in a surgical population significantly increases morbidity and mortality, prolongs hospitalization and increases total treatment costs. In the present study, we aimed to determine incidence, in-hospital mortality and risk factors (RFs) of HAP in patients with intra-abdominal surgical procedures hospitalized in a tertiary hospital in Belgrade (Serbia). Methods. Through regular hospital surveillance of patients who underwent intra-abdominal surgical procedures, we prospectively identified postoperative HAP during five years. In the matched case-control study, every surgical patient with HAP was compared with four control patients without HAP. In the group of patients with HAP, those who died were compared with those who survived. Results. Overall 1.4% of all intra-abdominal surgical patients developed HAP in the postoperative period. The incidence of HAP (per 1,000 operative procedures) was greatest in patients undergoing exploratory laparotomy (102.6), followed by small bowel surgery (36.6), and gastric surgery (22.7). Multivariate logistic regression analysis (MLRA) identified three independent risk factors (RF) associated with HAP: multiple transfusion [p = 0.011; odds ratio (OR): 4.26; 95% confidence interval (CI): 1.59-11.33], length of hospital stay (p = 0.024; OR: 1.02; 95%CI: 1.00-1.03) and hospitalization in the Intensive care unit (ICU) (p = 0.043; OR: 2.83; 95%CI: 1.03-7.71). MLRA identified only surgical site infection as an independent RF associated with the poor outcome of HAP (p = 0.017; OR: 5.929; CI95%: 1.37-25.67). Conclusion. The results of the present study are valuable in documenting the relations between RFs and HAP in patients undergoing intra- abdominal surgical procedures. © 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background/Aim. Dialysis and kidney transplantation are treatments that can be applied to patients with the end-stage renal disease. There is a lack of information on the quality of life (QOL) among hemodialysis (HD) patients on the waiting list for a kidney transplant, a group that is increasing all over the world. The aim of this study was to investigate the quality of life of patients on HD waiting for a kidney transplant. Methods. In the clinical comparative 12-month study, QOL level was compared between consecutively recruited patients waiting for a kidney transplant (WT patients) (N = 24) and patients not waiting for a kidney transplant (non-WT patients) (N = 52). All patients were older than 18 years and were on HD at least three months. To measure QOL, the short Form Health Survey (SD-36) was used. Results. WT patients were younger (43.50 ± 12.64 vs 63.58 ± 13.88 years; p < 0.001), they had started dialysis in the younger age (32.38 ± 14.50 vs 57.12 ± 15.79 years; p < 0.001) and spent more time on dialysis (112.04 ± 82.48 vs 72.40 ± 81.31 months; p < 0.05) than non-WT patients. Non-WT patients had more comorbidities than WT patients (p < 0.01). In laboratory parameters, there were statistically significant differences in values of serum creatinine (p < 0.01), phosphorus (p < 0.05) and number used to quantyfy hemodialysis treatment adequacy (Kt/V index: K dialyzer clearance of urea; t dialysis time; V volume of distribution of urea approx equal to patients’ total body water) (p < 0.05). Mean scores were higher among WT patients compared to non-WT patients in four dimensions of QOL: Physical Function (PF) (83.33 ± 10.59 vs 66.53 ± 27.87; respectively p > 0.05), Role Physical (RP) (58.66 ± 21.39 vs 46.90 ± 23.73; respectively p > 0.05), General health (GH) (45.00 ± 14.81 vs 37.98 ± 12.88; respectively p > 0.05); Social Functioning (SF) (93.66 ± 16.10 vs 78.30 ± 29.80; respectively p > 0.05) including Physical Component Summary (PCS) scores (64.16 ± 13.77 vs 52.38 ± 19.53; respectively p > 0.05). Conclusion. Patients waiting for a kidney transplant were younger, had started dialysis in the younger age and spent longer on dialysis compared with patients not eligible for transplantation. Low comorbidity, better laboratory parameters interferes in all domains with higher values of QOL in patients waiting for a kidney transplant, especially in general health, physical conditions and social functioning. © 2017, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.

Background/Aim. Tacrolimus concentration-dose ratio as a potential therapeutic drug monitoring strategy was suggested to be used for the patients subjected to renal trans-plantation. The aim of this study was examining the relationship between tacrolimus concentration-dose ratio, suggested to be used as a therapeutic drug monitoring strategy and the polymorphisms of genes encoding the most important enzymes, such as CYP3A5 and CYP3A4, as well as the transporter P-glycoprotein, for its metabolism and elimination. Methods. The study was designed as a prospective case series study, in which the unit of monitoring was the outpatient examination of 54 patients subjected to renal transplantation. Genotyping was performed by 7500 Real-Time PCR System by assessing allelic discrimination based on TaqMan® methodology. Results. Patients (n = 13) who were treated with less than 2 mg of tacrolimus/day (0.024 ± 0.006 mg/kg/day) had the tacrolimus concentration-dose ratio larger than 150 ng/mL/mg/kg. In this group, 84.62% patients had CYP3А5 *3*3 allele. All of these patients had CYP3А4 *1*1/*1*1B allele. Regarding ABCB1 C3435T gene, 30.77% of patients had the TT gene variant, while 69.23% of our patients had CC and CT gene variants. Conclusion. Tacrolimus concentration-dose ratio greater than 150 ng/mL/mg/kg is cut-off value in patients subjected to renal transplantation which might point to patients who are poor CYP3A5 metabolizers and/or with dysfunctional P-glycoprotein. © 2018, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.