Browsing by Author "Radovanovic, Dragan (36087908200)"

Purpose: In contrast to other thyroid carcinomas it is diffi cult to establish a correct preoperative diagnosis for oxyphile carcinoma of the thyroid. In this study we looked for predic tive malignancy factors in order to enable surgeons to choose operative treatment and to perform an adequate operation for each patient with an oxyphile neoplasm of the thyroid. Methods: In this retrospective study we have analyzed the medical files of all patients with oxyphile tumors of the thy roid operated between 1999 and 2008 in our institution. A total of 256 patients were included and divided into oxy phile adenomas (142) and carcinomas (114) on the basis of their definite histopathological diagnosis. The most import ant demographic and clinical characteristics were analyzed by univariate and multivariate logistic regression analysis. Results: Univariate analysis showed that male gender, thyroglobulin concentrations ≥300 ng/ml and tumor diam eter >30 mm were significantly more frequent in patients with oxyphile carcinoma compared to patients with oxy phile adenoma, while coexisting Hashimoto thyreoiditis and positive AntiTPO antibodies appeared significantly less frequent in the carcinoma group. All variables with a p value <0.1 in the univariate test were subjected to multi variate regression analysis in which elevated preoperative thyroglobulin concentrations (≥ 300 ng/ml) was shown as the only independent predictive factor for oxyphile thyroid carcinomas (OR=5.88, 95%Ci 2.78-12.05, p=0.001). Conclusions: Preoperative thyroglobulin concentration is an independent predictor of malignancy for oxyphile thy roid carcinomas.

Purpose: In contrast to other thyroid carcinomas it is diffi cult to establish a correct preoperative diagnosis for oxyphile carcinoma of the thyroid. In this study we looked for predic tive malignancy factors in order to enable surgeons to choose operative treatment and to perform an adequate operation for each patient with an oxyphile neoplasm of the thyroid. Methods: In this retrospective study we have analyzed the medical files of all patients with oxyphile tumors of the thy roid operated between 1999 and 2008 in our institution. A total of 256 patients were included and divided into oxy phile adenomas (142) and carcinomas (114) on the basis of their definite histopathological diagnosis. The most import ant demographic and clinical characteristics were analyzed by univariate and multivariate logistic regression analysis. Results: Univariate analysis showed that male gender, thyroglobulin concentrations ≥300 ng/ml and tumor diam eter >30 mm were significantly more frequent in patients with oxyphile carcinoma compared to patients with oxy phile adenoma, while coexisting Hashimoto thyreoiditis and positive AntiTPO antibodies appeared significantly less frequent in the carcinoma group. All variables with a p value <0.1 in the univariate test were subjected to multi variate regression analysis in which elevated preoperative thyroglobulin concentrations (≥ 300 ng/ml) was shown as the only independent predictive factor for oxyphile thyroid carcinomas (OR=5.88, 95%Ci 2.78-12.05, p=0.001). Conclusions: Preoperative thyroglobulin concentration is an independent predictor of malignancy for oxyphile thy roid carcinomas.

Background: The aim of this study was to evaluate the effects of pneumoperitoneum on liver function during and after laparoscopic cholecystectomy. Methods: This prospective study comprised a total of 165 patients, who were divided into two groups: The first group had low-pressure pneumoperitoneum (12 mm Hg; N = 78) and the second group had high-pressure pneumoperitoneum (14 mm Hg; N = 87). A detailed statistical analysis included sex, age, operation time, and liver function tests including total bilirubin, gamma-glutamyl transferase (GGT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin, fibrinogen, and lactate dehydrogenase (LDH), which were obtained preoperatively and 24 h, 7 days, and 30 days postoperatively. The statistical hypotheses were tested with a t test, Mann–Whitney test, chi-square test, Friedman test, and Wilcoxon’s test. Results: There was no statistical difference between the two groups considering age, gender, and operation time (p = 0.740, p = 0.255, and p = 0.480, respectively). There was also no statistical difference in the median values of bilirubin, AST, GGT, LDH, albumin, and fibrinogen between the two groups. There was a significant statistical difference between the two groups in the median values of ALT on the 30th postoperative day (p = 0.045). There was a statistical difference for all hematochemical parameters as a function of time, independent of the level of intra-abdominal pressure (IAP). Conclusion: There were no statistically significant differences in the values of parameters of structural damage to the liver between the two groups, but within the groups themselves. From this we conclude that both values of elevated IAP cause microstructural and functional damage to the liver. © 2019, Springer-Verlag GmbH Austria, part of Springer Nature.

There is compelling evidence that postexercise heart rate recovery (HRR) is a valid indicator of sympaticovagal balance. It is also used in prescription and monitoring of athletic training. The purpose of our study was to determine HRR after maximal exercise among elite athletes with respect to age. A total of 274 elite male Caucasian athletes were randomly selected from the larger sample and divided into two groups: adolescent (group Y) and adult athletes (≥18 years; group A). They performed maximal cardiopulmonary exercise testing on a treadmill. Heart rate recovery was calculated as the rate of decline of HR from peak exercise to rates 1, 2 and 3 min after cessation of exercise (HRR1, HRR2 and HRR3). A significantly higher HRR1 was found in group A (29·5 ± 15·6 versus 22·4 ± 10·8, P<0·001), but HRR3 was higher in group Y (82·7 ± 10·2 versus 79·9 ± 12·25; P = 0·04). Stepwise multivariate linear regression analysis showed that, among all subjects, the HRR1 alone was independently associated with age (P<0·001). The maximal oxygen consumption (VO2 max) was in a negative relationship with HRR1 and in a positive one with HRR3 (P<0·05) with respect to all athletes. The HRR during 3 min postexercise should be reported for the purpose of better assessing functional adaptation to exercise among elite athletes as well as the age-associated differences in recovery. Higher values of HRR1 should be expected in older athletes, and HRR3 could be used as an index of aerobic capacity, irrespective of age. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd

There is compelling evidence that postexercise heart rate recovery (HRR) is a valid indicator of sympaticovagal balance. It is also used in prescription and monitoring of athletic training. The purpose of our study was to determine HRR after maximal exercise among elite athletes with respect to age. A total of 274 elite male Caucasian athletes were randomly selected from the larger sample and divided into two groups: adolescent (group Y) and adult athletes (≥18 years; group A). They performed maximal cardiopulmonary exercise testing on a treadmill. Heart rate recovery was calculated as the rate of decline of HR from peak exercise to rates 1, 2 and 3 min after cessation of exercise (HRR1, HRR2 and HRR3). A significantly higher HRR1 was found in group A (29·5 ± 15·6 versus 22·4 ± 10·8, P<0·001), but HRR3 was higher in group Y (82·7 ± 10·2 versus 79·9 ± 12·25; P = 0·04). Stepwise multivariate linear regression analysis showed that, among all subjects, the HRR1 alone was independently associated with age (P<0·001). The maximal oxygen consumption (VO2 max) was in a negative relationship with HRR1 and in a positive one with HRR3 (P<0·05) with respect to all athletes. The HRR during 3 min postexercise should be reported for the purpose of better assessing functional adaptation to exercise among elite athletes as well as the age-associated differences in recovery. Higher values of HRR1 should be expected in older athletes, and HRR3 could be used as an index of aerobic capacity, irrespective of age. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd

We report a case of successful transcatheter arterial embolization of a pancreaticoduodenal artery pseudoaneurysm (PSA) caused by erosion of the pancreatic pseudocyst content near pancreaticoduodenal arteries. A 55-year-old man was admitted to a local hospital for investigation of severe, stabbing epigastric pain confined to the upper abdomen. He had a history of previous alcohol abuse, chronic pancreatitis, and a duodenal ulcer. Upper gastrointestinal endoscopy revealed narrowing in the pyloric channel along with an ulcer located at the first and second portions of the duodenum with oozing beneath an adherent cloth and duodenal distortion. Computed tomography additionally revealed an enlarged head of the pancreas with numerous spot calcifications and round cystic formation inside, with a diameter of 30 x 25 mm. Following two surgical procedures for duodenal ulcers, selective angiography revealed a PSA located inside the pancreas head and high-grade stenosis > 90% of the celiac trunk and hepatic artery that rose separately from the aorta. Fiber coil embolization was used to occlude the PSA sac successfully. There was no complication after completion of the last embolic procedure. The patient was doing well after 26 months. © BC Decker Inc. All rights reserved.

We sought to investigate right heart remodeling and function in elite athlees, as well as the relationship between parameters of right ventricular (RV) and right atrial (RA) remodeling and indices of aerobic capacity. Elite male athletes (n = 352) underwent echocardiographic examination including the evaluation of RV and RA parameters. Maximal cardiopulmonary exercise testing was performed to measure maximal oxygen consumption (VO2max), ventilatory anaerobic threshold (VAT) and heart rate reserve (HRR). The right heart remodeling was different between groups. Soccer players had significantly higher RV and RA diameters indexed for BSA. RV filling pressure assessed by tricuspid E/e’ ratio was the lowest in soccer players, suggesting somewhat better RV diastolic function. Functional capacity also varies between groups of athletes. VO2max was the highest among soccer players, somewhat lower in basketball players and and the lowest among water polo players (55.3 ± 5.6 vs. 52.1 ± 5.9 vs. 53.5 ± 4.8 ml/kg/min, p < 0.001). Age, average weekly duration of training, percentage of body fat, as well as parameters of cardiopulmonary fitness (VO2max, O2 pulse, HRR), correlated well with parameters of RV and RA structure and function in the whole study population. However, systolic blood pressure at rest, VO2max and LV mass index are independently associated with RV and RA structure, whereas duration of training shows the best association with parameters of RV systolic and diastolic function. Even though soccer, water polo and basketball belong to the same group of sports, there is a significant difference in RV and RA remodeling between these three groups. It seems that right heart adaptation is the most pronounced in soccer players, who also have the highest maximal oxygen consumption. Further studies are necessary to investigate the mechanisms of these differences. © Springer Nature B.V. 2019.

Purpose: A multidisciplinary approach to the treatment of patients with malignant diseases requires adequate venous access in order to safely administer chemotherapy, blood transfusion and blood products, antibiotics, rehy-dratation and total parenteral nutrition. The insertion of the central venous catheter (CVC), its use and its maintenance can be accompanied by multiple complications.; Methods: Fifty cancer patients were retrospectively enrolled in this study. The obligatory inclusion criterion was an implanted CVC of the port-a-cath type, inserted for chemotherapy administration. This study included patients who had their catheters inserted in the period from 2001 to 2012.; Results: The median patient age was 44 years (range 28-68). Thirty five patients (70%) were female and 15 (30%) male. The port-a-cath had been used from Ito 40 months (16.8±9 months on average). Breast cancer was the most frequent malignancy (18 patients, 36%). The overall incidence of reported complications was 38%. The most common complications were infections and thromboembolic events, each with an incidence of 10 %. The malposition and disconnection of the port-a-cath were in second place, each with an incidence of 6%.; Conclusion: Insertion of the CVC carries the possibility of serious complications (thrombosis, infections, occlusions). However, correct implantation and handling performed by experienced and trained surgical and other medical staff significantly decrease the incidence of these complications. The use of the CVC has greatly improved the quality of life and also decreased the morbidity and mortality of the cancer patients in our study.

Purpose: A multidisciplinary approach to the treatment of patients with malignant diseases requires adequate venous access in order to safely administer chemotherapy, blood transfusion and blood products, antibiotics, rehy-dratation and total parenteral nutrition. The insertion of the central venous catheter (CVC), its use and its maintenance can be accompanied by multiple complications.; Methods: Fifty cancer patients were retrospectively enrolled in this study. The obligatory inclusion criterion was an implanted CVC of the port-a-cath type, inserted for chemotherapy administration. This study included patients who had their catheters inserted in the period from 2001 to 2012.; Results: The median patient age was 44 years (range 28-68). Thirty five patients (70%) were female and 15 (30%) male. The port-a-cath had been used from Ito 40 months (16.8±9 months on average). Breast cancer was the most frequent malignancy (18 patients, 36%). The overall incidence of reported complications was 38%. The most common complications were infections and thromboembolic events, each with an incidence of 10 %. The malposition and disconnection of the port-a-cath were in second place, each with an incidence of 6%.; Conclusion: Insertion of the CVC carries the possibility of serious complications (thrombosis, infections, occlusions). However, correct implantation and handling performed by experienced and trained surgical and other medical staff significantly decrease the incidence of these complications. The use of the CVC has greatly improved the quality of life and also decreased the morbidity and mortality of the cancer patients in our study.