Browsing by Author "Micić, Dušan (37861889200)"

Polytrauma is a term describing patients with injuries involving multiple body regions that compromises function of the body and/or organ involved. The aim of the study was to evaluate the potential role of erythropoietin in predicting poorer outcome in trauma patients. This prospective study included 86 patients admitted to the Emergency Center of Serbia due to polytrauma assigned according to Injury Severity Score (ISS). The patients were further evaluated using the Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores and erythropoietin levels. There was a significant difference among erythropoietin levels at admission, after 48 and 72 hours, and on day 7 of hospital stay, with significantly higher levels in patients with ISS values 49-75. Based on the results, ROC curves were used to identify cut-offlevels to predict ISS score with critical clinical course. It was concluded that erythropoietin could be a good marker of injury severity. Further research has to be performed to determine the cut-offvalues of erythropoietin that are significant for injury severity.

[No abstract available]

Introduction Gastrointestinal stromal tumor (GIST) is relatively rare neoplasm and according to data in the literature, makes up less than 1% of all tumors of the gastrointestinal tract with the most frequent incidence in the sixth decade of life. The development and discovery of new molecular, biochemical and immunohistochemical methods contributed significantly to the successful identification and better understanding of this type of neoplasm. The most common localization of GIST is stomach, causing merely discomfort and occasional pain in the abdomen as the only complaint. Case Outline Our patient, a 71-year-old male, came for an outpatient surgical examination due to gastrointestinal bleeding and low hemoglobin values in laboratory findings. We conducted the endoscopic examination of the upper parts of the digestive tract; there were neither active nor old signs of gastrointestinal bleeding. The patient underwent an ultrasound examination and then a computed tomography (CT) of the abdomen. CT scan showed tumor mass in the lower parts of abdominal cavity, highly suspicious for GIST of small intestine (ileum). The patient underwent emergency surgery, with the resection of bleeding tumor and creation of primary anastomosis. The patient recovered well from the surgery and was discharged home in good general condition. Conclusion The goal of surgery is to achieve an optimal resection line R0 with an intact pseudocapsule of the tumor. Postoperative adjuvant therapy with imatinib is indicated in certain cases, in order to ensure the most favorable clinical and oncological outcome. © 2024, Serbia Medical Society. All rights reserved.

[No abstract available]

Background: The predictive value of preoperative neutrophil-to-lymphocyte ratio (NLR) in patients with cholecystitis has not been established. The aim of this study was to investigate preoperative NLR in patients with cholecystitis and to identify a relevant NLR value that discriminates between simple and severe cholecystitis. Methods: This study included 136 patients who under went laparoscopic cholecystectomy due to cholecystitis. The Receiver Operating Characteristic (ROC) analysis was performed to identify the most useful NLR cut-off value in relation to the severity of cholecystitis. The patients were di vided into two groups according to the cut-off NLR value: high NLR group (≥4.18, n=23) and low NLR group (<4.18, n=113). Severe cholecystitis was defined as a state which includes inflammation, empyema, gangrene, perforation of gallbladder, adhesions or difficulty in dissecting Calot's triangle. Results: In the high NLR group, severe cholecystitis (p<0.0001) and higher C-reactive protein level (CRP) and white blood cells count (WBC) (p<0.0001) were significantly more frequent. There was no difference in homeostatic model assessment-insulin resistance index (HOMA-IR) between both groups before the operation (p<0.634). The incidence of severe cholecystitis was 16.9%. The NLR of 4.18 could predict severe cholecystitis with 78.3% sensitivity and 74.3% specificity. Spearman's correlation revealed significant association between the preoperative NLR and HOMA-IR on day 1, (r=0.254, p=0.030) and between preoperative NLR and CRP on day 1 (ρ=0.355; p<0.0001). Conclusions: NLR ≥4.18 was significantly associated with severe cholecystitis. The preoperative NLR in patients under going cholecystectomy due to cholecystitis could be a useful surrogate marker of severe cholecystitis. © 2017 Dušan Micić et al.

Background: The predictive value of preoperative neutrophil-to-lymphocyte ratio (NLR) in patients with cholecystitis has not been established. The aim of this study was to investigate preoperative NLR in patients with cholecystitis and to identify a relevant NLR value that discriminates between simple and severe cholecystitis. Methods: This study included 136 patients who under went laparoscopic cholecystectomy due to cholecystitis. The Receiver Operating Characteristic (ROC) analysis was performed to identify the most useful NLR cut-off value in relation to the severity of cholecystitis. The patients were di vided into two groups according to the cut-off NLR value: high NLR group (≥4.18, n=23) and low NLR group (<4.18, n=113). Severe cholecystitis was defined as a state which includes inflammation, empyema, gangrene, perforation of gallbladder, adhesions or difficulty in dissecting Calot's triangle. Results: In the high NLR group, severe cholecystitis (p<0.0001) and higher C-reactive protein level (CRP) and white blood cells count (WBC) (p<0.0001) were significantly more frequent. There was no difference in homeostatic model assessment-insulin resistance index (HOMA-IR) between both groups before the operation (p<0.634). The incidence of severe cholecystitis was 16.9%. The NLR of 4.18 could predict severe cholecystitis with 78.3% sensitivity and 74.3% specificity. Spearman's correlation revealed significant association between the preoperative NLR and HOMA-IR on day 1, (r=0.254, p=0.030) and between preoperative NLR and CRP on day 1 (ρ=0.355; p<0.0001). Conclusions: NLR ≥4.18 was significantly associated with severe cholecystitis. The preoperative NLR in patients under going cholecystectomy due to cholecystitis could be a useful surrogate marker of severe cholecystitis. © 2017 Dušan Micić et al.

Introduction/Objective Diabetes mellitus and its chronic complications impair quality of life (QoL) when compared to the one of the general population. The objective of this study was to determine the prevalence of > 14 unhealthy days per month among the patients with diabetes in Serbia and to determine the association of the socio-demographic characteristics and health characteristics with the total of > 14 unhealthy days. Methods Serbian version of a generic self-administered questionnaire from Centers for Disease Control and Prevention (CDC-HRQOL-4) was used for data collection in all three levels of care. Results The study involved 4898 patients with diabetes, 2283 (46.6%) men and 2611 (53.4%) women. Overall mean age was 57.3 ± 12.2 years with over one fifth (23.2 %) were younger than 50 years. Multivariate logistic regression analyses indicated that age > 65 (OR:1.575, 95%CI 1.100–2.256), being a woman (OR: 1.287, 95% CI 1.042–1.588), lower education (OR: 1.383, 95%CI 1.091–1.754), felt depressed ≥ 14 days (OR: 3.689, 95% CI 2.221–6.128), felt anxious ≥ 14 days (OR: 1.749, 95% CI 1.113–2.749), poor sleep ≥ 14 days (OR:2.161, 95%CI 1.569–2.988), fair or poor self-rated health ≥ 14 days (OR: 4.322, 95%CI 3.474–5.376) were associated with unhealthy days ≥ 14 days. The strongest negative association was observed between limited physical activity ≥ 14 days and a decrease in the QoL of people with diabetes (OR: 22.176, 95%CI 10.971–44.824). Conclusion This study highlights association between impaired QoL in patients with diabetes and physical activity limitations. Limited physical activity is the factor with the greatest negative impact on the QoL particularly in older, less educated, and women with diabetes. © 2023, Serbia Medical Society. All rights reserved.

Introduction/Objective Acute pancreatitis (AP) is a relatively common disease which in most patients has favorable course. However, in approximately 20% patients, the course of the disease is more severe with high mortality (40–50%). The evaluation of disease severity is now primarily based on protocols that includes clinical, laboratory, and radiographic diagnostic procedures, APACHE II score, Ranson score, CT index, and CT necrosis score. Key cells in the immunopathogenesis of AP are T-lymphocytes, and recent studies indicate the role of Th2 and their effector cytokines: interleukin (IL)-4 and interleukin (IL)-5. The purpose of our study was to determine the potential clinical value of IL-4 and IL-5 as biochemical markers for predicting development of severe, necrotizing form of acute pancreatitis with systemic complication such as systemic inflammatory response syndrome (SIRS). Methods This prospective study included 240 patients hospitalized at The Clinic for Emergency Surgery of Clinical Center of Serbia as AP. Levels of IL-4 and IL-5 in serum were detected using commercial Bender Med Systems (BMS716FF) kits. Results IL-4 and IL-5 were statistically significant increased on the second day of hospitalization with maximum values on the third day. In patients with severe AP complicated with necrosis and/or sepsis values were rising all through the seventh day. Conclusion Levels of IL-4 and IL-5 in peripheral blood correlate with SIRS, Ranson score and clinical outcome in AP patients, therefore these cytokines are potential early biomarkers of disease progression and related complications. © 2021, Serbia Medical Society. All rights reserved.