Browsing by Author "Vekic, Berislav (8253989200)"

Colorectal cancer (CRC) is one of the most commonly diagnosed malignant neoplasms. The aim of the study was to evaluate and correlate most important epidemiological and economic indicators of CRC in 11 selected Balkan countries. The number of new CRC cases was 56,960, and the highest 5-year CRC prevalence was in Slovenia, Croatia, and Greece. Age-standardized CRC incidence rates were highest in Slovenia, Serbia, and Croatia, and age-standardized mortality rates were highest in Croatia, Serbia, and Bulgaria. Current Health Expenditure as % of Gross Domestic Product was the highest in Bosnia and Herzegovina and Serbia. The GDP per capita levels have shown positive correlation with the CRC incidence rate and prevalence. Absolute numbers of new and death-related CRC cases and 5-year prevalence in absolute numbers have shown strong positive correlation with GDP in million current US$. It has been shown that various economic indicators can be linked to the rate of incidence and prevalence of the CRC patients in the selected Balkan countries. Therefore, economic factors can influence the epidemiology of CRC, and heavy CRC burden in the Balkan region may be one of the indexes of the economic development. © Copyright © 2020 Vekic, Dragojevic-Simic, Jakovljevic, Kalezic, Zagorac, Dragovic, Zivic, Pilipovic, Simic, Jovanovic, Milovanovic and Rancic.

Background: Seborrheic dermatitis (SD) and Parkinson's disease (PD) are frequently associated conditions. Aims of this study were: to determine severity of SD, presence of different species and density of Malassezia yeasts; to assess yeast lipases and phosphatases production in vitro and to compare these results between SD patients with and without PD.Methods: This case-control prospective study was conducted at the Dermatology and Neurology Units, Clinical Centre of Serbia and at the National Medical Mycology Reference Laboratory, University of Belgrade Medical School, Serbia. A total of 90 patients and 70 healthy controls (HC) were investigated: 60 patients with SD (SDN) and 30 patients with SD and PD (SDP). Culture-based mycological examination was carried out on lesional skin (LS) and non-lesional skin (NLS). A yeasts density was determined by counting the Malassezia colony forming units per tape (CFU/tape). Enzymes production by isolated Malassezia was investigated.Results: The most patients with SD were male (76.7%; SDP and 63.3%; SDN) and the intensity of SD was dominantly severe or moderate (76.7%; SDP and 75%; SDN). The presence of Malassezia{cyrillic} was high on LS in both groups (87.3%; SDP and 86.7%; SDN) (p=0.667).The highest yeasts density (mean CFU/tape=67.8) was detected on LS in 53% of SDP group and in 21.7% of SDN group (mean CFU/tape=31.9) (p < 0.01). The presence of negative cultures was lower in SDP group (13.3%) in comparison to HC and SDN groups (37% and 31.7%, respectively). Malassezia density on NLS in SDP group (mean CFU/tape=44.3) was significantly higher in comparison to SDN and HC (p=0.018). M. globosa was the most abundant species identified amongst isolates from the SDP group (42.3%) and exhibited high production of phosphatase and lipase in vitro.Conclusion: From this laboratory-based study a positive correlation between SD, PD, M. globosa incidence, high yeast density and high phosphatase and lipase activity was established. Our data lead to conclusion that local skin performance of PD patient's characterized with increased sebum excretion ratio play a role in SD by stimulation of yeasts replication and enzyme production. © 2014 Arsic Arsenijevic et al.; licensee BioMed Central Ltd.

Anaplastic thyroid cancer (ATC) is one of the tumors with the shortest survival in human medicine. Aim. The aim was to determine the importance of age in survival of patients with ATC. Material and Methods. We analyzed the data on 150 patients diagnosed with ATC in the period from 1995 to 2006. The Kaplan-Meier method and log-rank test were used to determine overall survival. Prognostic factors were identified by univariate and multivariate Cox regression analysis. Results. The youngest patient was 35 years old and the oldest was 89 years old. According to univariate regression analysis, age was significantly associated with longer survival in patients with ATC. In multivariate regression analysis, patients age, presence of longstanding goiter, whether surgical treatment is carried out or not, type of surgery, tumor multicentricity, presence of distant metastases, histologically proven preexistent papillary carcinoma, radioiodine therapy, and postoperative radiotherapy were included. According to multivariate analysis, besides surgery (P = 0.000, OR = 0.43, 95% CI = 0.29-0.63), only patients age (P = 0.023, OR = 0.68, 95% CI = 0.49-0.95) was independent prognostic factor of favorable survival in patients with ATC. Conclusion. Age is a factor that was independently associated with survival time in ATC. Anaplastic thyroid cancer has the best prognosis in patients younger than 50 years. © 2014 Vladan Zivaljevic et al.

Anaplastic thyroid cancer (ATC) is one of the tumors with the shortest survival in human medicine. Aim. The aim was to determine the importance of age in survival of patients with ATC. Material and Methods. We analyzed the data on 150 patients diagnosed with ATC in the period from 1995 to 2006. The Kaplan-Meier method and log-rank test were used to determine overall survival. Prognostic factors were identified by univariate and multivariate Cox regression analysis. Results. The youngest patient was 35 years old and the oldest was 89 years old. According to univariate regression analysis, age was significantly associated with longer survival in patients with ATC. In multivariate regression analysis, patients age, presence of longstanding goiter, whether surgical treatment is carried out or not, type of surgery, tumor multicentricity, presence of distant metastases, histologically proven preexistent papillary carcinoma, radioiodine therapy, and postoperative radiotherapy were included. According to multivariate analysis, besides surgery (P = 0.000, OR = 0.43, 95% CI = 0.29-0.63), only patients age (P = 0.023, OR = 0.68, 95% CI = 0.49-0.95) was independent prognostic factor of favorable survival in patients with ATC. Conclusion. Age is a factor that was independently associated with survival time in ATC. Anaplastic thyroid cancer has the best prognosis in patients younger than 50 years. © 2014 Vladan Zivaljevic et al.

At present, neither specific antiviral drugs, nor vaccine is recommended for coronavirus disease 2019 (COVID-19) treatment. In this review we discuss the drugs suggested as therapy for COVID-19 infection, with a focus on chloroquine and hydroxychloroquine. The list of drugs used for COVID-19 treatment includes a combination of lopinavir and ritonavir, remdesivir, favipiravir, alpha-interferon, ribavirin, atazanavir, umifenovir, and tocilizumab. As their efficacy and safety are under investigation, none of the regulatory agencies approved them for the treatment of COVID-19 infection. Although chloroquine and hydroxychloroquine possess antiviral and immunomodulatory effects, in practice benefit of their use for COVID-19 treatment is controversial. Several studies investigating hydroxychloroquine were stopped and the French national medicines regulator suspended its use in clinical trials because of safety concerns. The results from the double-blind, randomised clinical trials, including large number of participants, will add better insight into the role of these two drugs as already available and affordable, antimalarial therapy. The ethical issue on emergency use of chloroquine and hydroxychloroquine in the settings of COVID-19 should be carefully managed, with adherence to the “monitored emergency use of unregistered and experimental interventions” (MEURI) framework or be ethically approved as a trial, as stated by the WHO. Potential shortage of chloroquine/hydroxychloroquine on the market can be overbridged with regular prescriptions by medical doctors and national drug agency should ensure sufficient quantities of these drugs for standard indications. © 2020 John Wiley & Sons Ltd

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: Burnout syndrome is under-researched within caregivers (CGs) of children with cerebral palsy. The primary aim was to determine the burnout level of formal CGs of children with cerebral palsy (G1) and to compare it with a control group (G2) of professional pediatric nurses, and second, to correlate the level of depression and anxiety with the burnout level. Method: In a total sample of 60 CGs, the Maslach Burnout Inventory Human Services Survey (MBI-HSS), consisting of three structural units - emotional exhaustion (MBIEE) subscale, depersonalization (MBI-DP) subscale and personal accomplishment (MBI-PA) subscale - was used to measure burnout. The Beck Anxiety Inventory (BAI) was used for the assessment of anxiety, and the Beck Depression Inventory (BDI) for depression. Results: A significant difference was shown on the MBI-EE subscale and on the BDI test (p-0.05), in both cases higher scores were obtained by G1. High burnout was observed in all subscales, on the MBI-EE subscale registered 50% of CGs in G1, and 17% in control G2. Correlation of the MBI-EE subscale with BDI and BAI tests was highly significant (p-0.01). Conclusions: These findings indicate the need for future research aimed at formulating preventive strategies for caregivers’ mental health. Better care for caregivers would provide them with better professional satisfaction, and consequently would lead to better care for patients. © 2016, Mediafarm Group. All right reserved.

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.

Implementation of the e-Health or EHR systems at national level is a major challenge for any country in the world. There are numerous examples of projects for implementation of such systems that did not complete successfully. Funds spent for this purpose are also very significant. This paper provides a detailed description of the platform Pinga and comparison of two implementations of national e-health and EHR systems carried out in Macedonia (MK) and in Serbia (RS). It also provides a detailed description of the approach for the development and implementation applied, in terms of architecture and the development of technical solution and in terms of project management. Numerous challenges and difficulties are discussed that had to be overcome to achieve successful implementation of these systems. A review of some of the benefits and results of the implementation of the systems is presented. These results show that the platform enables rapid implementation of national e-health systems with positive effects on health systems visible as early as the final stages of the implementation.

Implementation of the e-Health or EHR systems at national level is a major challenge for any country in the world. There are numerous examples of projects for implementation of such systems that did not complete successfully. Funds spent for this purpose are also very significant. This paper provides a detailed description of the platform Pinga and comparison of two implementations of national e-health and EHR systems carried out in Macedonia (MK) and in Serbia (RS). It also provides a detailed description of the approach for the development and implementation applied, in terms of architecture and the development of technical solution and in terms of project management. Numerous challenges and difficulties are discussed that had to be overcome to achieve successful implementation of these systems. A review of some of the benefits and results of the implementation of the systems is presented. These results show that the platform enables rapid implementation of national e-health systems with positive effects on health systems visible as early as the final stages of the implementation.

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