Browsing by Author "Milovanovic, Andjela (57213394852)"

Purpose: The purpose of this article was to analyse the impact of low-dose ionizing radiation to nuclear medicine professionals of the Nuclear Medicine Centre of Serbia (NMCRS). Methods: Data from the previous/initial and the last medical check-ups, obtained from the medical records of 65 employees from NMCRS, were analysed. A typical checkup, haematological parameters analysis, as well as special cytogenetical analyses, such as unstable chromosomal aberrations and micronucleus test, were carried out. For analyses of chromosomal aberrations the modified Moorhead's micro method was applied to the culture of peripheral blood lymphocytes and conventional cytogenetic technique of chromosomal aberrations was applied. The received cumulative 5-year dose was measured by personal inactive thermoluminescent dosimeters (TLD) calibrated into personal doses equivalent Hp(10). Results: An increased frequency of all unstable chromo-somal aberration forms, such as acentric chromosomes and isochromatid lesions, was noticed in the last periodical check-up as compared to the previous/initial checkups (p<0.05). As for haematological parameters, a higher erythrocytes and monocytes count in the periodical checkups was noticed (p<0.01). There was a negative correlation between reticulocytes and received 5-year cumulative dose (p<0.01). The duration of exposure had significant influence on higher level of leucocytes in the last periodical check-up (p<0.05). Conclusions: Nuclear medicine employees have increased health risks and there is a need to monitor their health condition by periodical check-ups for prevention from occupational diseases (carcinoma).

Purpose: The purpose of this article was to analyse the impact of low-dose ionizing radiation to nuclear medicine professionals of the Nuclear Medicine Centre of Serbia (NMCRS). Methods: Data from the previous/initial and the last medical check-ups, obtained from the medical records of 65 employees from NMCRS, were analysed. A typical checkup, haematological parameters analysis, as well as special cytogenetical analyses, such as unstable chromosomal aberrations and micronucleus test, were carried out. For analyses of chromosomal aberrations the modified Moorhead's micro method was applied to the culture of peripheral blood lymphocytes and conventional cytogenetic technique of chromosomal aberrations was applied. The received cumulative 5-year dose was measured by personal inactive thermoluminescent dosimeters (TLD) calibrated into personal doses equivalent Hp(10). Results: An increased frequency of all unstable chromo-somal aberration forms, such as acentric chromosomes and isochromatid lesions, was noticed in the last periodical check-up as compared to the previous/initial checkups (p<0.05). As for haematological parameters, a higher erythrocytes and monocytes count in the periodical checkups was noticed (p<0.01). There was a negative correlation between reticulocytes and received 5-year cumulative dose (p<0.01). The duration of exposure had significant influence on higher level of leucocytes in the last periodical check-up (p<0.05). Conclusions: Nuclear medicine employees have increased health risks and there is a need to monitor their health condition by periodical check-ups for prevention from occupational diseases (carcinoma).

Aim: To develop a specific rehabilitation protocol for patients who have undergone surgical repair of acute aneurysmal subarachnoid hemorrhage (aSAH), and to determine the time at which verticalization should be initiated after aSAH. Material and Methods: Sixty-five patients who underwent acute-term surgery for aSAH and early rehabilitation were evaluated in groups: Group 1 (n=34) started verticalization on days 2-5 post-bleeding whereas Group 2 (n=31) started verticalization approximately day 12 post-bleeding. All patients were monitored for early complications, vasospasm and ischemia. Assessments of motor status, depression and anxiety (using Zung scales), and cognitive status (using the Mini-Mental State Examination (MMSE)) were conducted at discharge and at 1 and 3 months post-surgery. Results: At discharge, Group 1 had a significantly higher proportion of patients with ischemia than Group 2 (p=0.004). Group 1 had a higher proportion of patients with hemiparesis than Group 2 three months post-surgery (p=0.015). Group 1 patients scored significantly higher on the Zung depression scale than Group 2 patients at 1 month (p=0.005) and 3 months post-surgery (p=0.001; the same applies to the Zung anxiety scale (p=0.006 and p=0.000, respectively). Group 2 patients scored significantly higher on the MMSE than those in Group 1 at discharge (p=0.040) and 1 month post-surgery (p=0.025). ConclusIon: Early verticalization had no effect with respect to preventing early postoperative complications in this patient group. Once a patient has undergone acute surgical repair of aSAH, it is safe and preferred that rehabilitation be initiated immediately postsurgery. However, verticalization should not start prior to day 12 post-bleeding.

Influence of physiotherapy on the outcome of the lung resection is still controversial. Study aim was to assess the influence of physiotherapy program on postoperative lung function and effort tolerance in lung cancer patients with chronic obstructive pulmonary disease (COPD) that are undergoing lobectomy or pneumonectomy. The prospective study included 56 COPD patients who underwent lung resection for primary non small-cell lung cancer after previous physiotherapy (Group A) and 47 COPD patients (Group B) without physiotherapy before lung cancer surgery. In Group A, lung function and effort tolerance on admission were compared with the same parameters after preoperative physiotherapy. Both groups were compared in relation to lung function, effort tolerance and symptoms change after resection. In patients with tumors requiring a lobectomy, after preoperative physiotherapy, a highly significant increase in FEV1, VC, FEF50 and FEF25 of 20%, 17%, 18% and 16% respectively was registered with respect to baseline values. After physiotherapy, a significant improvement in 6-minute walking distance was achieved. After lung resection, the significant loss of FEV1 and VC occurred, together with significant worsening of the small airways function, effort tolerance and symptomatic status. After the surgery, a clear tendency existed towards smaller FEV1 loss in patients with moderate to severe, when compared to patients with mild baseline lung function impairment. A better FEV1 improvement was associated with more significant loss in FEV1. Physiotherapy represents an important part of preoperative and postoperative treatment in COPD patients undergoing a lung resection for primary lung cancer.

Influence of physiotherapy on the outcome of the lung resection is still controversial. Study aim was to assess the influence of physiotherapy program on postoperative lung function and effort tolerance in lung cancer patients with chronic obstructive pulmonary disease (COPD) that are undergoing lobectomy or pneumonectomy. The prospective study included 56 COPD patients who underwent lung resection for primary non small-cell lung cancer after previous physiotherapy (Group A) and 47 COPD patients (Group B) without physiotherapy before lung cancer surgery. In Group A, lung function and effort tolerance on admission were compared with the same parameters after preoperative physiotherapy. Both groups were compared in relation to lung function, effort tolerance and symptoms change after resection. In patients with tumors requiring a lobectomy, after preoperative physiotherapy, a highly significant increase in FEV1, VC, FEF50 and FEF25 of 20%, 17%, 18% and 16% respectively was registered with respect to baseline values. After physiotherapy, a significant improvement in 6-minute walking distance was achieved. After lung resection, the significant loss of FEV1 and VC occurred, together with significant worsening of the small airways function, effort tolerance and symptomatic status. After the surgery, a clear tendency existed towards smaller FEV1 loss in patients with moderate to severe, when compared to patients with mild baseline lung function impairment. A better FEV1 improvement was associated with more significant loss in FEV1. Physiotherapy represents an important part of preoperative and postoperative treatment in COPD patients undergoing a lung resection for primary lung cancer.

Introduction: The aim of this study was to assess the effects of preoperative pulmonary rehabilitation (PPR) on preoperative clinical status changes in patients with chronic obstructive pulmonary disease (COPD) and non-small cell lung cancer (NSCLC), and net effects of PPR and cancer resection on residual pulmonary function and functional capacity. Material and methods: This prospective single group study included 83 COPD patients (62 ±8 years, 85% males, FEV1 = 1844 ±618 ml, Tiffeneau index = 54 ±9%) with NSCLC, on 2-4-week PPR, before resection. Pulmonary function, and functional and symptom status were evaluated by spirometry, 6-minute walking distance (6MWD) and Borg scale, on admission, after PPR and after surgery. Results: Following PPR significant improvement was registered in the majority of spirometry parameters (FEV1 by 374 ml, p < 0.001; VLC by 407 ml, p < 0.001; FEF50 by 3%, p = 0.003), 6MWD (for 56 m, p < 0.001) and dyspnoeal symptoms (by 1.0 Borg unit, p < 0.001). A positive correlation was identified between preoperative increments of FEV1 and 6MWD (rs = 0.503, p = 0.001). Negative correlations were found between basal FEV1 and its percentage increment (rs = -0.479, p = 0.001) and between basal 6MWD and its percentage change (rs = -0.603, p < 0.001) during PPR. Compared to basal values, after resection a significant reduction of most spirometry parameters and 6MWD were recorded, while Tiffeneau index, FEF25 and dyspnoea severity remained stable (p = NS). Conclusions: Preoperative pulmonary rehabilitation significantly enhances clinical status of COPD patients before NSCLC resection. Preoperative increase of exercise tolerance was the result of pulmonary function improvement during PPR. The beneficial effects of PPR were most emphasized in patients with initially the worst pulmonary function and the weakest functional capacity.

Background/Aim. Laryngeal carcinomas make 1%-3% of all head and neck malignancies.Treatment outcome and survival rates depend greatly on established stage of the disease. The purpose of this study was to examine the survival of the patients with advanced laryngeal carcinoma depending on gender, age, common risk factors (tobacco and alcohol use), primary tumor localization, histopathological tumor grade, clinical TNM (tumor, node and metastasis) stage and surgical treatment of the disease. Methods. Retrospective study included 252 patients treated surgically for advanced squamocellular carcinoma of the larynx in a threeyear period with five-year follow-up. Patients included in the study were treated primary with surgery, with postoperative radiotherapy and chemotherapy depending on the stage of the disease, intraoperative findings and tumor resection borders. Overall survival and disease-specific five-year survival of patients was calculated for demographical and clinical characteristics of the patients. Results. Overall 5-year survival of patients with operable advanced laryngeal cancer included in the study was 86.14% and disease-specific survival 86.51%. Lower overall and the disease-specific survival was associated with age, higher histological tumor grade and more extensive neck dissections. Conclusion. Primary total laryngectomy results in higher survival outcomes in cases of transglottic T3 and T4a laryngeal tumors. Patients should be informed of the likely increased mortality risks tied to the choice of surgical resection and treatment modality before their decision. © 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.