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Browsing by Author "Stankovic, Sanja (7005216636)"

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    Acute insulin resistance in ST-segment elevation myocardial infarction in non-diabetic patients is associated with incomplete myocardial reperfusion and impaired coronary microcirculatory function
    (2014)
    Trifunovic, Danijela (9241771000)
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    Stankovic, Sanja (7005216636)
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    Sobic-Saranovic, Dragana (57202567582)
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    Marinkovic, Jelena (7004611210)
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    Petrovic, Marija (57207720679)
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    Orlic, Dejan (7006351319)
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    Beleslin, Branko (6701355424)
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    Banovic, Marko (33467553500)
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    Vujisic-Tesic, Bosiljka (6508177183)
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    Petrovic, Milan (56595474600)
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    Nedeljkovic, Ivana (55927577700)
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    Stepanovic, Jelena (6603897710)
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    Djordjevic-Dikic, Ana (57003143600)
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    Tesic, Milorad (36197477200)
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    Djukanovic, Nina (24722840600)
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    Petrovic, Olga (33467955000)
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    Vasovic, Olga (15059749900)
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    Nestorovic, Emilija (56090978800)
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    Kostic, Jelena (57159483500)
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    Ristic, Arsen (7003835406)
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    Ostojic, Miodrag (34572650500)
    Background: Insulin resistance (IR) assessed by the Homeostatic Model Assessment (HOMA) index in the acute phase of myocardial infarction in non-diabetic patients was recently established as an independent predictor of intrahospital mortality. In this study we postulated that acute IR is a dynamic phenomenon associated with the development of myocardial and microvascular injury and larger final infarct size in patients with ST-segment elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (pPCI).Methods: In 104 consecutive patients with the first anterior STEMI without diabetes, the HOMA index was determined on the 2nd and 7th day after pPCI. Worst-lead residual ST-segment elevation (ST-E) on postprocedural ECG, coronary flow reserve (CFR) determined by transthoracic Doppler echocardiography on the 2nd day after pPCI and fixed perfusion defect on single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) determined six weeks after pPCI were analyzed according to HOMA indices.Results: IR was present in 55 % and 58 % of patients on day 2 and day 7, respectively. Incomplete post-procedural ST-E resolution was more frequent in patients with IR compared to patients without IR, both on day 2 (p = 0.001) and day 7 (p < 0.001). The HOMA index on day 7 correlated with SPECT-MPI perfusion defect (r = 0.331), whereas both HOMA indices correlated well with CFR (r = -0.331 to -0.386) (p < 0.01 for all). In multivariable backward logistic regression analysis adjusted for significant univariate predictors and potential confounding variables, IR on day 2 was an independent predictor of residual ST-E ≥ 2 mm (OR 11.70, 95% CI 2.46-55.51, p = 0.002) and CFR < 2 (OR = 5.98, 95% CI 1.88-19.03, p = 0.002), whereas IR on day 7 was an independent predictor of SPECT-MPI perfusion defect > 20% (OR 11.37, 95% CI 1.34-96.21, p = 0.026).Conclusion: IR assessed by the HOMA index during the acute phase of the first anterior STEMI in patients without diabetes treated by pPCI is independently associated with poorer myocardial reperfusion, impaired coronary microcirculatory function and potentially with larger final infarct size. © 2014 Trifunovic et al.; licensee BioMed Central Ltd.
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    Acylcarnitines' Level in the Dried Blood Spot Samples of Healthy Newborns in Serbia-The Pilot Study
    (2023)
    Beletic, Andjelo (16318445800)
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    Tijanic, Aleksandra (57490147000)
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    Nikolic, Tatjana (57193994432)
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    Chrastina, Petr (57411056600)
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    Stefanovic, Aleksandar (8613866900)
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    Stankovic, Sanja (7005216636)
    Analysis of the acylcarnitines' (ACs) is the mainstay for screening for fatty acid oxidation disorders (FAOD). Data about the ACs profile in the dried blood spot samples of healthy newborns in Serbia are not at disposal. Therefore, we determined the ACs levels and established the cut-offs. Between August 2018 and August 2019 a total of 1771 samples had been analysed. Cut-offs, established using a non-parametric approach, were verified in comparison with the worldwide target ranges and the data for several Caucasian populations. The majority of ACs had comparable distribution in Serbian and the worldwide population. In case of discrepancy, the individual alterations had a frequency of less than 10%. Seventeen out of 25 established cutoffs were in the worldwide target range. Reliability of the cut-offs positioning out of the target ranges is not jeopardized, since alterations are negligible or similar findings were reported for other Caucasian populations. The established and verified set of cut-offs can be used in the future screening for carnitine uptake/transport defect, medium-chain acyl-CoA dehydrogenase deficiency, very long-chain acyl-CoA dehydrogenase deficiency, long-chain L-3 hydroxyacyl-CoA dehydrogenase deficiency, trifunctional protein deficiency, carnitine palmitoyltransferase deficiency Ia and II, as well as carnitine:acylcarnitine translocase deficiency. © 2023 Andjelo Beletic et al., published by Sciendo.
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    Acylcarnitines' Level in the Dried Blood Spot Samples of Healthy Newborns in Serbia-The Pilot Study
    (2023)
    Beletic, Andjelo (16318445800)
    ;
    Tijanic, Aleksandra (57490147000)
    ;
    Nikolic, Tatjana (57193994432)
    ;
    Chrastina, Petr (57411056600)
    ;
    Stefanovic, Aleksandar (8613866900)
    ;
    Stankovic, Sanja (7005216636)
    Analysis of the acylcarnitines' (ACs) is the mainstay for screening for fatty acid oxidation disorders (FAOD). Data about the ACs profile in the dried blood spot samples of healthy newborns in Serbia are not at disposal. Therefore, we determined the ACs levels and established the cut-offs. Between August 2018 and August 2019 a total of 1771 samples had been analysed. Cut-offs, established using a non-parametric approach, were verified in comparison with the worldwide target ranges and the data for several Caucasian populations. The majority of ACs had comparable distribution in Serbian and the worldwide population. In case of discrepancy, the individual alterations had a frequency of less than 10%. Seventeen out of 25 established cutoffs were in the worldwide target range. Reliability of the cut-offs positioning out of the target ranges is not jeopardized, since alterations are negligible or similar findings were reported for other Caucasian populations. The established and verified set of cut-offs can be used in the future screening for carnitine uptake/transport defect, medium-chain acyl-CoA dehydrogenase deficiency, very long-chain acyl-CoA dehydrogenase deficiency, long-chain L-3 hydroxyacyl-CoA dehydrogenase deficiency, trifunctional protein deficiency, carnitine palmitoyltransferase deficiency Ia and II, as well as carnitine:acylcarnitine translocase deficiency. © 2023 Andjelo Beletic et al., published by Sciendo.
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    Autoimmune and immunoserological markers of COVID-19 pneumonia: Can they help in the assessment of disease severity
    (2022)
    Stjepanovic, Mihailo I. (55052044500)
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    Stojanovic, Maja R. (57201074079)
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    Stankovic, Sanja (7005216636)
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    Cvejic, Jelena (58810863700)
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    Dimic-Janjic, Sanja (57208444020)
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    Popevic, Spasoje (54420874900)
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    Buha, Ivana (44460972900)
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    Belic, Slobodan (57222640039)
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    Djurdjevic, Natasa (57202011285)
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    Stjepanovic, Mirjana M. (56716026000)
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    Jovanovic, Dragana (7102247807)
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    Stojkovic-Laloševic, Milica (57218133245)
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    Soldatovic, Ivan (35389846900)
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    Bonaci-Nikolic, Branka (10839652200)
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    Miskovic, Rada (56394650000)
    Background: Immune dysregulation and associated inefficient anti-viral immunity during Coronavirus Disease 2019 (COVID-19) can cause tissue and organ damage which shares many similarities with pathogenetic processes in systemic autoimmune diseases. In this study, we investigate wide range autoimmune and immunoserological markers in hospitalized patients with COVID-19. Methods: Study included 51 patients with confirmed Severe Acute Respiratory Syndrome Coronavirus 2 infection and hospitalized due to COVID-19 pneumonia. Wide spectrum autoantibodies associated with different autoimmune inflammatory rheumatic diseases were analyzed and correlated with clinical and laboratory features and pneumonia severity. Results: Antinuclear antibodies (ANA) positivity was found in 19.6%, anti-cardiolipin IgG antibodies (aCL IgG) in 15.7%, and anti-cardiolipin IgM antibodies (aCL IgM) in 7.8% of patients. Positive atypical x anti-neutrophil cytoplasmic antibodies (xANCA) were detected in 10.0% (all negative for Proteinase 3 and Myeloperoxidase) and rheumatoid factor was found in 8.2% of patients. None of tested autoantibodies were associated with disease or pneumonia severity, except for aCL IgG being significantly associated with higher pneumonia severity index (p = 0.036). Patients with reduced total serum IgG were more likely to require non-invasive mechanical ventilation (NIMV) (p < 0.0001). Serum concentrations of IgG (p = 0.003) and IgA (p = 0.032) were significantly lower in this group of patients. Higher total serum IgA (p = 0.009) was associated with mortality, with no difference in serum IgG (p = 0.115) or IgM (p = 0.175). Lethal outcome was associated with lower complement C4 (p = 0.013), while there was no difference in complement C3 concentration (p = 0.135). Conclusion: Increased autoimmune responses are present in moderate and severe COVID-19. Severe pneumonia is associated with the presence of aCL IgG, suggesting their role in disease pathogenesis. Evaluation of serum immunoglobulins and complement concentration could help assess the risk of non-invasive mechanical ventilation NIMV and poor outcome. Copyright © 2022 Stjepanovic, Stojanovic, Stankovic, Cvejic, Dimic-Janjic, Popevic, Buha, Belic, Djurdjevic, Stjepanovic, Jovanovic, Stojkovic-Laloševic, Soldatovic, Bonaci-Nikolic and Miskovic.
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    Can preoperative CEA and CA19-9 serum concentrations suggest metastatic disease in colorectal cancer patients?
    (2017)
    Lalosevic, Milica Stojkovic (57218133245)
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    Stankovic, Sanja (7005216636)
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    Stojkovic, Mirjana (58776160500)
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    Markovic, Velimir (57206490091)
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    Dimitrijevic, Ivan (59595303500)
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    Lalosevic, Jovan (57190969635)
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    Petrovic, Jelena (57207943674)
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    Brankovic, Marija (57217208566)
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    Markovic, Aleksandra Pavlovic (24438035400)
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    Krivokapic, Zoran (55503352000)
    Objective: This study was designed to investigate the efficiency of preoperative serum carcinoembryonic antigen (CEA) and carbohydrate cancer antigen (CA19-9) levels for diagnosing synchronous liver metastases and lymph node in colorectal carcinoma (CRC) patients. Subjects and Methods: A total of 300 patients with histologically diagnosed CRC were included in this study between May 2014 and March 2015. The data were obtained from patient's medical records: medical history, demographics, tumor location, differentiation (grade), depth of the tumor (T), lymph node metastases (N), distant metastases (M), lymphatics, venous and perineural invasion, and disease stage. Tumor markers were measured with an electrochemilu-minescent assay and the reference value was 5ng/ml for CEA and for Ca 19-9, 37u/ml. Results: There was A high statistically significant difference in the levels of serum CEA and CA19-9 between different disease stages of CRC (P<0.001). Regarding different T stages of CRC, We noticed a significant statistical difference in CEA (stage I 3.76±8.73; II 5.68±17.27, III 7.56±14.81, and IV 70.90±253.23) and CA 19-9 levels (stage I 9.65 ±11.03, II 9.83±11.09; III 19.58±36.91, and IV 228.9±985.38, respectively). The mean CEA and CA19-9 serum levels were significantly higher in patients with regional lymph nodes involvement (CEA 37.21 ±177.85 vs 4.79±9.90, CA19-9 119.51 ±687.71 VS 12.24±17.69, respectively, P<0.05) and in liver metastases (CEA 86.56± 277.65 vs. 5.98± 12.98, and CA19-9 273.27±1073.46 vs. 4.98± 3142, respectively, with P<0.001) in comparison to patients without lymph node involvement and liver metastases. We noticed a cut-off value for lymph nodes involvement, for CEA and CA 19-9, 3.5 ng/mL and 7.5 U/mL, respectively. While, a cut-off value for the presence of synchronous liver metastases of these two markers was 3.5 ng/mL AND 5.5 U/mL. Conclusion: Our study showed that tumor makers, CEA and CA19-9, can be used as diagnostic factors regarding the severity of CRC specifically to suggest metastatic disease in CRC.
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    Combined Diagnostic Efficacy of Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Mean Platelet Volume (MPV) as Biomarkers of Systemic Inflammation in the Diagnosis of Colorectal Cancer
    (2019)
    Stojkovic Lalosevic, Milica (57218133245)
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    Pavlovic Markovic, Aleksandra (55110483700)
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    Stankovic, Sanja (7005216636)
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    Stojkovic, Mirjana (58776160500)
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    Dimitrijevic, Ivan (59595303500)
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    Radoman Vujacic, Irena (57206897292)
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    Lalic, Daria (57206903158)
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    Milovanovic, Tamara (55695651200)
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    Dumic, Igor (57200701725)
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    Krivokapic, Zoran (55503352000)
    Background: Systemic inflammation in colorectal cancer (CRC) may be reflected by neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV). This study was designed to investigate the efficiency of preoperative NLR, PLR, and MVP as a tool for the assessment of tumor characteristics in newly diagnosed patients with CRC. Patients and Methods: For 300 patients and 300 healthy volunteers, complete blood counts with automated differential counts were performed. The NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count; PLR was calculated by dividing the absolute platelet count by the absolute lymphocyte count. The diagnostic performance of NLR, PLR, and MVP was estimated by ROC curve. Results: ROC curve analysis showed high diagnostic efficacy of NLR and PLR in CRC patients with cut-off values of 2.15 (AUC = 0.790, 95% CI 0.736-0.884, Se = 74.1%, and Sp = 73%) and 123 (AUC = 0.846, 95% CI 0.801-0.891, Se = 73.5%, and Sp = 80%) compared to healthy controls, respectively. The diagnostic efficacy of three combined markers was superior compared with individual markers (AUC = 0.904, 95% CI 0.812-0.989, Se = 96%, and Sp = 70%). Conclusion: NRL, PLR, and MPV may be useful markers in diagnostic and early recognition of different stages of CRC; additionally combined all together have stronger diagnostic efficacy.
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    Combined diagnostic efficacy of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) as biomarkers of systemic inflammation in the diagnosis of colorectal cancer
    (2019)
    Lalosevic, Milica Stojkovic (57218133245)
    ;
    Markovic, Aleksandra Pavlovic (24438035400)
    ;
    Stankovic, Sanja (7005216636)
    ;
    Stojkovic, Mirjana (58776160500)
    ;
    Dimitrijevic, Ivan (59595303500)
    ;
    Vujacic, Irena Radoman (57208718001)
    ;
    Lalic, Daria (57206903158)
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    Milovanovic, Tamara (55695651200)
    ;
    Dumic, Igor (57212525843)
    ;
    Krivokapic, Zoran (55503352000)
    Background. Systemic inflammation in colorectal cancer (CRC) may be reflected by neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV). This study was designed to investigate the efficiency of preoperative NLR, PLR, and MVP as a tool for the assessment of tumor characteristics in newly diagnosed patients with CRC. Patients and Methods. For 300 patients and 300 healthy volunteers, complete blood counts with automated differential counts were performed. The NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count; PLR was calculated by dividing the absolute platelet count by the absolute lymphocyte count. The diagnostic performance of NLR, PLR, and MVP was estimated by ROC curve. Results. ROC curve analysis showed high diagnostic efficacy of NLR and PLR in CRC patients with cut-off values of 2.15 (AUC = 0 790, 95% CI 0.736-0.884, Se = 74 1%, and Sp = 73%) and 123 (AUC = 0 846, 95% CI 0.801-0.891, Se = 73 5%, and Sp = 80%) compared to healthy controls, respectively. The diagnostic efficacy of three combined markers was superior compared with individual markers (AUC = 0 904, 95% CI 0.812-0.989, Se = 96%, and Sp = 70%). Conclusion. NRL, PLR, and MPV may be useful markers in diagnostic and early recognition of different stages of CRC; additionally combined all together have stronger diagnostic efficacy. © 2019 Milica Stojkovic Lalosevic et al.
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    Combined diagnostic efficacy of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) as biomarkers of systemic inflammation in the diagnosis of colorectal cancer
    (2019)
    Lalosevic, Milica Stojkovic (57218133245)
    ;
    Markovic, Aleksandra Pavlovic (24438035400)
    ;
    Stankovic, Sanja (7005216636)
    ;
    Stojkovic, Mirjana (58776160500)
    ;
    Dimitrijevic, Ivan (59595303500)
    ;
    Vujacic, Irena Radoman (57208718001)
    ;
    Lalic, Daria (57206903158)
    ;
    Milovanovic, Tamara (55695651200)
    ;
    Dumic, Igor (57212525843)
    ;
    Krivokapic, Zoran (55503352000)
    Background. Systemic inflammation in colorectal cancer (CRC) may be reflected by neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV). This study was designed to investigate the efficiency of preoperative NLR, PLR, and MVP as a tool for the assessment of tumor characteristics in newly diagnosed patients with CRC. Patients and Methods. For 300 patients and 300 healthy volunteers, complete blood counts with automated differential counts were performed. The NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count; PLR was calculated by dividing the absolute platelet count by the absolute lymphocyte count. The diagnostic performance of NLR, PLR, and MVP was estimated by ROC curve. Results. ROC curve analysis showed high diagnostic efficacy of NLR and PLR in CRC patients with cut-off values of 2.15 (AUC = 0 790, 95% CI 0.736-0.884, Se = 74 1%, and Sp = 73%) and 123 (AUC = 0 846, 95% CI 0.801-0.891, Se = 73 5%, and Sp = 80%) compared to healthy controls, respectively. The diagnostic efficacy of three combined markers was superior compared with individual markers (AUC = 0 904, 95% CI 0.812-0.989, Se = 96%, and Sp = 70%). Conclusion. NRL, PLR, and MPV may be useful markers in diagnostic and early recognition of different stages of CRC; additionally combined all together have stronger diagnostic efficacy. © 2019 Milica Stojkovic Lalosevic et al.
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    Combined Diagnostic Efficacy of Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Mean Platelet Volume (MPV) as Biomarkers of Systemic Inflammation in the Diagnosis of Colorectal Cancer
    (2019)
    Stojkovic Lalosevic, Milica (57218133245)
    ;
    Pavlovic Markovic, Aleksandra (55110483700)
    ;
    Stankovic, Sanja (7005216636)
    ;
    Stojkovic, Mirjana (58776160500)
    ;
    Dimitrijevic, Ivan (59595303500)
    ;
    Radoman Vujacic, Irena (57206897292)
    ;
    Lalic, Daria (57206903158)
    ;
    Milovanovic, Tamara (55695651200)
    ;
    Dumic, Igor (57200701725)
    ;
    Krivokapic, Zoran (55503352000)
    Background: Systemic inflammation in colorectal cancer (CRC) may be reflected by neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV). This study was designed to investigate the efficiency of preoperative NLR, PLR, and MVP as a tool for the assessment of tumor characteristics in newly diagnosed patients with CRC. Patients and Methods: For 300 patients and 300 healthy volunteers, complete blood counts with automated differential counts were performed. The NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count; PLR was calculated by dividing the absolute platelet count by the absolute lymphocyte count. The diagnostic performance of NLR, PLR, and MVP was estimated by ROC curve. Results: ROC curve analysis showed high diagnostic efficacy of NLR and PLR in CRC patients with cut-off values of 2.15 (AUC = 0.790, 95% CI 0.736-0.884, Se = 74.1%, and Sp = 73%) and 123 (AUC = 0.846, 95% CI 0.801-0.891, Se = 73.5%, and Sp = 80%) compared to healthy controls, respectively. The diagnostic efficacy of three combined markers was superior compared with individual markers (AUC = 0.904, 95% CI 0.812-0.989, Se = 96%, and Sp = 70%). Conclusion: NRL, PLR, and MPV may be useful markers in diagnostic and early recognition of different stages of CRC; additionally combined all together have stronger diagnostic efficacy.
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    Comparison of high glucose concentration blood and crystalloid cardioplegia in paediatric cardiac surgery: A randomized clinical trial
    (2016)
    Mimic, Branko (55891059600)
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    Ilic, Slobodan (57212487618)
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    Vulicevic, Irena (55588791200)
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    Milovanovic, Vladimir (36935585800)
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    Tomic, Danijela (57189057673)
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    Mimic, Ana (55865595300)
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    Stankovic, Sanja (7005216636)
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    Zecevic, Tatjana (57189059739)
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    Davies, Ben (7402928198)
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    Djordjevic, Miroslav (7102319341)
    OBJECTIVES This study investigates the effects of high glucose content on patients undergoing cold crystalloid versus cold blood cardioplegia in terms of early clinical results, functional myocardial recovery and ischaemia-reperfusion injury in patients undergoing repair of acyanotic cardiac lesions. METHODS Patients were randomly assigned to receive either crystalloid (n = 31) or blood cardioplegia (n = 31). Early clinical results were assessed. Changes in left ventricular fractional shortening, arterial blood lactate levels, central venous saturation, cardiac Troponin I release and blood glucose concentration were measured during the first 24 h after ischaemia. RESULTS There was no significant difference in clinical outcomes and postoperative complication rates between groups. The postoperative changes in left ventricular function, lactate levels, central venous saturation and Troponin I were not significantly different between groups. The use of crystalloid cardioplegia was associated with significant increases in serum glucose compared with blood cardioplegia. CONCLUSIONS A high glucose content blood cardioplegia does not show any advantage compared with crystalloid cardioplegia in terms of clinical outcomes, functional recovery and the degree of ischaemic injury in infants and children undergoing repair of acyanotic heart lesions. High glucose concentration of the cardioplegic solution might potentiate ischaemia-reperfusion injury and diminish the beneficial effects of blood cardioplegia. © 2016 The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.
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    Coronary flow of the infarct artery assessed by transthoracic Doppler after primary percutaneous coronary intervention predicts final infarct size
    (2014)
    Trifunovic, Danijela (9241771000)
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    Sobic-Saranovic, Dragana (57202567582)
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    Beleslin, Branko (6701355424)
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    Stankovic, Sanja (7005216636)
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    Marinkovic, Jelena (7004611210)
    ;
    Orlic, Dejan (7006351319)
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    Vujisic-Tesic, Bosiljka (6508177183)
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    Petrovic, Milan (56595474600)
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    Nedeljkovic, Ivana (55927577700)
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    Banovic, Marko (33467553500)
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    Djukanovic, Nina (24722840600)
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    Petrovic, Olga (33467955000)
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    Petrovic, Marija (57207720679)
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    Stepanovic, Jelena (6603897710)
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    Djordjevic-Dikic, Ana (57003143600)
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    Tesic, Milorad (36197477200)
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    Ostojic, Miodrag (34572650500)
    Coronary microcirculatory function after primary percutaneous coronary intervention (pPCI) in patients with acute myocardial infarction is important determinant of infarct size (IS). Our aim was to investigate the utility of coronary flow reserve (CFR) and diastolic deceleration time (DDT) of the infarct artery (IRA) assessed by transthoracic Doppler echocardiography after pPCI for final IS prediction. In 59 patients, on the 2nd day after pPCI for acute anterior myocardial infarction, transthoracic Doppler analysis of IRA blood flow was done including measurements of CFR, baseline DDT and DDT during adenosine infusion (DDT adeno). Killip class, myocardial blush grade, resolution of ST segment elevation, peak creatine kinase-myocardial band and conventional echocardiographic parameters were determined. Single-photon emission computed tomography myocardial perfusion imaging was done 6 weeks later to define final IS (percentage of myocardium with fixed perfusion abnormality). IS significantly correlated with CFR (r = −0.686, p < 0.01), DDT (r = −0.727, p < 0.01), and DDT adeno (r = −0.780, p < 0.01). CFR and DDT adeno in multivariate analysis remained independent IS predictors after adjustment for other covariates and offered incremental prognostic value in models based on conventional clinical, angiographic, electrocardiographic and enzymatic variables. In predicting large infarction (IS > 20 %), the best cut-off for CFR was <1.73 (sensitivity 65 %, specificity 96 %) and for DDT adeno ≤720 ms (sensitivity 81 %, specificity 96 %). CFR and DDT during adenosine are independent and powerful early predictors of final IS offering incremental prognostic information over conventional parameters of myocardial and microvascular damage and tissue reperfusion. © 2014, Springer Science+Business Media Dordrecht.
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    Coronary Microcirculation: The Next Frontier in the Management of STEMI
    (2023)
    Milasinovic, Dejan (24823024500)
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    Nedeljkovic, Olga (56958449900)
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    Maksimovic, Ruzica (55921156500)
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    Sobic-Saranovic, Dragana (57202567582)
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    Dukic, Djordje (57919369500)
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    Zobenica, Vladimir (58118595100)
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    Jelic, Dario (57201640680)
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    Zivkovic, Milorad (55959530600)
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    Dedovic, Vladimir (55959310400)
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    Stankovic, Sanja (7005216636)
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    Asanin, Milika (8603366900)
    ;
    Vukcevic, Vladan (15741934700)
    Although the widespread adoption of timely invasive reperfusion strategies over the last two decades has significantly improved the prognosis of patients with ST-segment elevation myocardial infarction (STEMI), up to half of patients after angiographically successful primary percutaneous coronary intervention (PCI) still have signs of inadequate reperfusion at the level of coronary microcirculation. This phenomenon, termed coronary microvascular dysfunction (CMD), has been associated with impaired prognosis. The aim of the present review is to describe the collected evidence on the occurrence of CMD following primary PCI, means of assessment and its association with the infarct size and clinical outcomes. Therefore, the practical role of invasive assessment of CMD in the catheterization laboratory, at the end of primary PCI, is emphasized, with an overview of available technologies including thermodilution- and Doppler-based methods, as well as recently developing functional coronary angiography. In this regard, we review the conceptual background and the prognostic value of coronary flow reserve (CFR), index of microcirculatory resistance (IMR), hyperemic microvascular resistance (HMR), pressure at zero flow (PzF) and angiography-derived IMR. Finally, the so-far investigated therapeutic strategies targeting coronary microcirculation after STEMI are revisited. © 2023 by the authors.
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    Enhanced liver fibrosis score as a biomarker for vascular damage assessment in patients with takayasu arteritis—a pilot study
    (2021)
    Stojanovic, Maja (57201074079)
    ;
    Raskovic, Sanvila (6602461528)
    ;
    Milivojevic, Vladimir (57192082297)
    ;
    Miskovic, Rada (56394650000)
    ;
    Soldatovic, Ivan (35389846900)
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    Stankovic, Sanja (7005216636)
    ;
    Rankovic, Ivan (57192091879)
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    Stanojevic, Marija Stankovic (57386467100)
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    Dragasevic, Sanja (56505490700)
    ;
    Krstic, Miodrag (35341982900)
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    Diamantopoulos, Andreas P. (41261479100)
    Takayasu Arteritis (TA) is characterized by granulomatous panarteritis, vessel wall fibrosis, and irreversible vascular impairment. The aim of this study is to explore the usefulness of the Enhanced Liver Fibrosis score (ELF), procollagen-III aminoterminal propeptide (PIIINP), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), and hyaluronic acid (HA) in assessing vascular damage in TA patients. ELF, PIIINP, TIMP-1, and HA were measured in 24 TA patients, and the results were correlated with the clinical damage indexes (VDI and TADS), an imaging damage score (CARDS), and disease activity scores (NIH and ITAS2010). A mean ELF score 8.42 (±1.12) and values higher than 7.7 (cut-off for liver fibrosis) in 21/24 (87.5%) of patients were detected. The VDI and TADS correlated significantly to ELF (p < 0.01). Additionally, a strong association across ELF and CARDS (p < 0.0001), PIIINP and CARDS (p < 0.001), and HA and CARDS (p < 0.001) was observed. No correlations of the tested biomarkers with inflammatory parameters, NIH, and ITAS2010 scores were found. To our knowledge, this is the first study that suggests the association of the serum biomarkers PIIINP, HA, and ELF score with damage but not with disease activity in TA patients. The ELF score and PIIINP may be useful biomarkers reflecting an ongoing fibrotic process and quantifying vascular damage. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
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    Enhanced liver fibrosis score as a biomarker for vascular damage assessment in patients with takayasu arteritis—a pilot study
    (2021)
    Stojanovic, Maja (57201074079)
    ;
    Raskovic, Sanvila (6602461528)
    ;
    Milivojevic, Vladimir (57192082297)
    ;
    Miskovic, Rada (56394650000)
    ;
    Soldatovic, Ivan (35389846900)
    ;
    Stankovic, Sanja (7005216636)
    ;
    Rankovic, Ivan (57192091879)
    ;
    Stanojevic, Marija Stankovic (57386467100)
    ;
    Dragasevic, Sanja (56505490700)
    ;
    Krstic, Miodrag (35341982900)
    ;
    Diamantopoulos, Andreas P. (41261479100)
    Takayasu Arteritis (TA) is characterized by granulomatous panarteritis, vessel wall fibrosis, and irreversible vascular impairment. The aim of this study is to explore the usefulness of the Enhanced Liver Fibrosis score (ELF), procollagen-III aminoterminal propeptide (PIIINP), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), and hyaluronic acid (HA) in assessing vascular damage in TA patients. ELF, PIIINP, TIMP-1, and HA were measured in 24 TA patients, and the results were correlated with the clinical damage indexes (VDI and TADS), an imaging damage score (CARDS), and disease activity scores (NIH and ITAS2010). A mean ELF score 8.42 (±1.12) and values higher than 7.7 (cut-off for liver fibrosis) in 21/24 (87.5%) of patients were detected. The VDI and TADS correlated significantly to ELF (p < 0.01). Additionally, a strong association across ELF and CARDS (p < 0.0001), PIIINP and CARDS (p < 0.001), and HA and CARDS (p < 0.001) was observed. No correlations of the tested biomarkers with inflammatory parameters, NIH, and ITAS2010 scores were found. To our knowledge, this is the first study that suggests the association of the serum biomarkers PIIINP, HA, and ELF score with damage but not with disease activity in TA patients. The ELF score and PIIINP may be useful biomarkers reflecting an ongoing fibrotic process and quantifying vascular damage. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
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    Erythropoietin in predicting prognosis in patients with acute-on-chronic liver failure
    (2016)
    Alempijevic, Tamara (15126707900)
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    Zec, Simon (57193857395)
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    Nikolic, Vladimir (57192426202)
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    Veljkovic, Aleksandar (57192430563)
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    Milivojevic, Vladimir (57192082297)
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    Dopsaj, Violeta (6507795892)
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    Stankovic, Sanja (7005216636)
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    Milosavljevic, Tomica (7003788952)
    Background & Aims: Acute-on-chronic liver failure (ACLF) is characterized by a rapid progression to multiple organ failure and is associated with a very high mortality rate of 50-90%. Novel therapies are being investigated such as Erythropoietin (EPO). The aim of this prospective cohort study was to analyse the value of EPO in predicting prognosis and determine which patients may benefit most from EPO therapy. Methods: According to the EASL-CLIF criteria, 104 consecutive patients were diagnosed with ACLF, and separated into two groups based on the type of insult: bleeding (Group A=31) or non-bleeding (Group B=73). In addition to a complete biochemical work-up and calculation of relevant prognostic scores, levels of EPO were measured on admission and correlated to the type of insult and final outcome. Results: Fifteen patients from Group A (mean age 60.32±9.29 years) had a lethal outcome and higher values of EPO on admission (319.26±326.58 mIU/ml) (p<0.005), compared to the 37 patients from Group B (mean age 59.9±10.19 years) with EPO levels at admission of 29.88±34.6 mIU/mL. In Group B, a cut-off EPO value of 30.65 mIU/mL had a sensitivity of 87.5% and a specificity 57.4% in predicting lethal outcome with an AUROC of 0.823. In Group A, a cut-off value of 229.95 mlU/mL had a sensitivity and specificity of 53.3% and 92.7%, respectively. The AUROC for this cut-off was 0.847. Conclusions: Erythropoietin is superior to the standard prognostic scores in predicting 28-day mortality. Lower levels of EPO were detected in patients without bleeding as an insult indicating a possible therapeutic benefit in these patients. © 2016, Romanian Society of Gastroenterology. All rights reserved.
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    External Validation of the Simple NULL-PLEASE Clinical Score in Predicting Outcome of Out-of-Hospital Cardiac Arrest
    (2017)
    Potpara, Tatjana S. (57216792589)
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    Mihajlovic, Miroslav (57207498211)
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    Stankovic, Sanja (7005216636)
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    Jozic, Tanja (6504760115)
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    Jozic, Irena (57195197364)
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    Asanin, Milika R. (8603366900)
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    Ahmad, Rajai (23990255500)
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    Lip, Gregory Y.H. (57216675273)
    Background Rapid clinical decision-making on further management of patients with out-of-hospital cardiac arrest may be challenging. Recently, a “futility” score (NULL-PLEASE) incorporating multiple adverse resuscitation features (Nonshockable rhythm, Unwitnessed arrest, Long no-flow or Long low-flow period, blood PH <7.2, Lactate >7.0 mmol/L, End-stage chronic kidney disease on dialysis, Age ≥85 years, Still resuscitation, and Extracardiac cause) has been proposed to help identify patients with out-of-hospital cardiac arrest unlikely to survive; however, external independent score validation is lacking. Methods We retrospectively validated the NULL-PLEASE predictive ability for early in-hospital outcome of out-of-hospital cardiac arrest in a single-center cohort of 547 consecutive patients with out-of-hospital cardiac arrest who were admitted from April 2013 to October 2016 (mean age, 66.3 ± 13.2 years); 227 patients (41.5%) died. Because pH and lactate were inconsistently measured, a modified NULL-PLEASE score excluding both variables was calculated as the principal analysis. A sensitivity analysis included the subgroup with pH data available (n = 177). Results Long low-flow period and age ≥85 years were independently associated with fatal outcome (both P <.001). Patients with a modified NULL-PLEASE score of ≥5 had a 3.3-fold greater risk of fatal outcome compared with a score of 0 to 4 (odds ratio, 3.34; 95% confidence interval [CI], 2.29-4.89; P <.001); 77% of nonsurvivors had a score ≥5; NULL-PLEASE showed a modest predictive ability for fatal outcome (c-statistic 0.658; 95% CI, 0.613-0.704; P <.001). Sensitivity analysis yielded similar results, with 88% of nonsurvivors having a score ≥5. Conclusions The NULL-PLEASE score was predictive for early in-hospital outcome of out-of-hospital cardiac arrest, with a 3.3-fold greater odds for fatal outcome at the score values of ≥5. © 2017 Elsevier Inc.
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    Folic acid affects cardiometabolic, oxidative stress, and immunohistochemical parameters in monocrotaline-induced rat heart failure
    (2020)
    Uzelac, Jovana Jakovljevic (57210212812)
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    Djukic, Tatjana (36193753800)
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    Radic, Tanja (35275858300)
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    Mutavdzin, Slavica (56678656800)
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    Stankovic, Sanja (7005216636)
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    Rakocevic, Jelena Kostic (55251810400)
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    Borovic, Milica Labudovic (36826154300)
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    Milic, Natasa (7003460927)
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    Simic, Tatjana (6602094386)
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    Savic-Radojevic, Ana (16246037100)
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    Djuric, Dragan (36016317400)
    Heart failure (HF) is one of the major cardiovascular causes of death worldwide. In this study, we explored the Effects of folic acid (FA) on cardiometabolic, oxidative stress biomarker changes, and the activity of proliferation marker Ki67 in monocrotaline-induced HF. The research was conducted during a 4 week period using five experimental groups (eight animals per group): Blank solution exposed controls (C1: 1 mL/kg physiological saline, 1 day; C2: 1 mL/kg physiological saline, 28 days), monocrotaline (MCT) induced HF (50 mg/kg MCT), FA (5 mg·kg−1·day−1 FA), and MCT+FA (50 mg/kg MCT, 5 mg·kg−1·day−1 FA). Superoxide dismutase and glutathione peroxidase activities together with total glutathione and parameters of oxidative damage of proteins were determined in cardiac tissue as well as cardiometabolic parameters in plasma or serum. The total glutathionylation was determined by Western blot and proliferation marker Ki67 was assessed by immunohistochemistry. The right ventricular (RV) wall hypertrophy and Ki67 positivity, accompanied by a significant increase of troponin T, has been shown in MCT-induced HF. The antioxidant effect of FA was reflected through superoxide dismutase activity, reduced Ki67 positivity in the RV wall, and a slightly decreased total glutathionylation level. © 2020, Canadian Science Publishing. All rights reserved.
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    Folic acid affects cardiometabolic, oxidative stress, and immunohistochemical parameters in monocrotaline-induced rat heart failure
    (2020)
    Uzelac, Jovana Jakovljevic (57210212812)
    ;
    Djukic, Tatjana (36193753800)
    ;
    Radic, Tanja (35275858300)
    ;
    Mutavdzin, Slavica (56678656800)
    ;
    Stankovic, Sanja (7005216636)
    ;
    Rakocevic, Jelena Kostic (55251810400)
    ;
    Borovic, Milica Labudovic (36826154300)
    ;
    Milic, Natasa (7003460927)
    ;
    Simic, Tatjana (6602094386)
    ;
    Savic-Radojevic, Ana (16246037100)
    ;
    Djuric, Dragan (36016317400)
    Heart failure (HF) is one of the major cardiovascular causes of death worldwide. In this study, we explored the Effects of folic acid (FA) on cardiometabolic, oxidative stress biomarker changes, and the activity of proliferation marker Ki67 in monocrotaline-induced HF. The research was conducted during a 4 week period using five experimental groups (eight animals per group): Blank solution exposed controls (C1: 1 mL/kg physiological saline, 1 day; C2: 1 mL/kg physiological saline, 28 days), monocrotaline (MCT) induced HF (50 mg/kg MCT), FA (5 mg·kg−1·day−1 FA), and MCT+FA (50 mg/kg MCT, 5 mg·kg−1·day−1 FA). Superoxide dismutase and glutathione peroxidase activities together with total glutathione and parameters of oxidative damage of proteins were determined in cardiac tissue as well as cardiometabolic parameters in plasma or serum. The total glutathionylation was determined by Western blot and proliferation marker Ki67 was assessed by immunohistochemistry. The right ventricular (RV) wall hypertrophy and Ki67 positivity, accompanied by a significant increase of troponin T, has been shown in MCT-induced HF. The antioxidant effect of FA was reflected through superoxide dismutase activity, reduced Ki67 positivity in the RV wall, and a slightly decreased total glutathionylation level. © 2020, Canadian Science Publishing. All rights reserved.
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    Genes and metabolic pathway of sarcoidosis: Identification of key players and risk modifiers
    (2019)
    Stjepanovic, Mihailo I. (55052044500)
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    Mihailovic-Vucinic, Violeta (13410407800)
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    Spasovski, Vesna (26655022200)
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    Milin-Lazovic, Jelena (57023980700)
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    Skodric-Trifunovic, Vesna (23499690800)
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    Stankovic, Sanja (7005216636)
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    Andjelkovic, Marina (57197728167)
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    Komazec, Jovana (57196477706)
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    Momcilovic, Ana (57222582752)
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    Santric-Milicevic, Milena (57211144346)
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    Pavlovic, Sonja (7006514877)
    Introduction: Sarcoidosis is a rare multisystem granulomatous disease with unknown etiology. The interplay of vitamin D deficiency and genetic polymorphisms in genes coding for the proteins relevant for metabolism of vitamin D is an important, but unexplored area. The aim of this study was to investigate the association between single nucleotide polymorphisms (SNPs) in CYP2R1 (rs10741657), CYP27B1 (rs10877012), DBP (rs7041; rs4588), and VDR (rs2228570) genes and sarcoidosis, as well as the association between these SNPs and 25(OH)D levels in sarcoidosis patients. Material and methods: For that purpose we genotyped 86 sarcoidosis patients and 50 healthy controls using the PCR-RFLP method. Results: Subjects carrying the CC genotype of CYP27B1 rs10877012 have 10 times lower odds of suffering from sarcoidosis. Moreover, DBP rs4588 AA genotype was shown to be a susceptibility factor, where carriers of this genotype had eight times higher odds for developing sarcoidosis. In addition, the A allele of the DBP gene (rs4588) was associated with lower levels of 25(OH)D in sarcoidosis patients. Conclusions: These results suggest that patients with vitamin D deficiency should be regularly tested for genetic modifiers that are related to sarcoidosis in order to prevent development of serious forms of sarcoidosis. Copyright © 2018 Termedia & Banach
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    Genetics of suspected thrombophilia in Serbian females with infertility, including three cases, homozygous for FII 20210A or FV 1691A mutations
    (2017)
    Djurovic, Jelena (24778181900)
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    Stojkovic, Oliver (35618950700)
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    Todorovic, Jelena (56641105000)
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    Brajic, Aleksandra (56578623500)
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    Stankovic, Sanja (7005216636)
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    Obradovic, Svetlana (57191970242)
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    Stamenkovic, Gorana (6508293958)
    Reproductive failure (recurrent foetal loss, unexplained infertility and IVF implantation failure) may be, in a number of cases, explained by thrombophilia, either acquired or inherited. Several genes contribute to thrombophilia, some with major effect (Factor V, Factor II), and some with minor effect (MTHFR, PAI-1, ATIII, etc.). The aim of this study was to estimate frequency of thrombophilia-associated genotypes (FII20210G > A, FV1691G > A, MTHFR677C > T and PAI-1 -675 4G/5G) in a group of 1631 Serbian women experiencing reproductive failure, and compare it with a healthy, female control group. Our results showed marginally significant (p = 0.050) differences in allele frequencies between patients and controls for the FV1691 mutations. For the FII20210G > A, although the statistical significance was not achieved (p = 0.076), we found higher frequency of variant allele in patients compared to controls (1.87% vs. 0.38%, respectively) which may point to a possible role of this polymorphism in thrombotic events. For the MTHFR677C > T and PAI-1 -675 4G/5G, we found no difference in distributions of genotype or allele frequencies between these two groups (p > 0.05). For three subjects with very rare genotypes (two patients homozygous for FV1691G > A and one patient homozygous for FII20210G > A) we performed additional biochemical analyses for haemostasis, as well as genotyping of two polymorphisms (MTHFR1298A > C and ATIII786G > A). © 2016 The British Fertility Society.
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