https://aseestant.ceon.rs/index.php/medi/issue/feed Medicinska istraživanja 2024-11-20T08:29:37+01:00 Prof. dr Olivera Stanojlović ostanoj@gmail.com SCIndeks Assistant <p>Medicinska istraživanja&ldquo; je recenzirani naučni časopis Medicinskog fakulteta Univerziteta u Beogradu, koji je prvi put objavljen 1971 godine, dakle, pre pola veka. Časopis &bdquo;Medicinska istraživanja&ldquo; je prvenstveno posvećen publikovanju rezultata naučno-istraživačkog rada nastavnika i saradnika Medicinskog fakulteta, kao i drugih naučnika u oblasti biomedicinskih istraživanja. Časopis &bdquo;Medicinska istraživanja&ldquo; objavljuje naučne radove na engleskom jeziku uz sažetak na srpskom jeziku i ima usvojenu politiku otvorenog pristupa (open access). Izlazi tri puta godi&scaron;nje, dok se u četvrtoj svesci objavljuju i sažeci izlaganja na simpozijumu &bdquo;Stremljenja i novine u medicini&ldquo;. U časopisu &bdquo;Medicinska istraživanja&ldquo; se objavljuju originalni i prethodno neobjavljeni radovi: a. originalni radovi u kojima se prvi put objavljuju rezultati sopstvenih istraživanja; b. pregledni radovi (Review), kritički i originalno prikazani (sa autocitatima); c. prikazi bolesnika i slučajeva (Case report). Radovi koji se objavljuju u časopisu &bdquo;Medicinska istraživanja&ldquo; pripadaju oblastima: bazičnih biomedicinskih istraživanja, kliničkih istraživanja i preventivne medicine. U cilju stručne recenzije prispelih radova, Uređivački odbor časopisa je podeljen u tri sekcije: bazične, kliničke i preventivne nauke, a njihovim radom koordiniraju Urednici sekcija. Sekcija za statističku analizu podataka će biti uključena u evaluaciju statističkih podataka prispelih radova.</p> https://aseestant.ceon.rs/index.php/medi/article/view/53710 Hirurška zamena aortne valvule istog dana nakon stentiranja karotidne arterije- manje invazivna procedura za visoko-rizične pacijente 2024-11-20T08:29:30+01:00 Slobodan Mićović bobanmic@gmail.com Zoran Tabaković zokitaba@gmail.com Ivan Soldatović soldatovicivan@gmail.com Petar Vuković petarvuk02@gmail.com Petar Milačić petar_milacic@yahoo.com Ivana Petrović petrovicivana4@gmail.com Miloš Matković dr.matko@hotmail.com Stefan Grujić drstefangrujic@gmail.com Igor Živkovic igor88zivkovic@gmail.com <p class="MsoNormal" style="text-align: justify; text-indent: 36.0pt; line-height: 200%;"><a name="_Hlk149509019"></a><strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1; mso-ansi-language: SR-LATN-RS;">Uvod:</span></strong><span style="mso-bookmark: _Hlk149509019;"><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1; mso-ansi-language: SR-LATN-RS;"> Etiologija stenoze aortne valvule (SOAS) je multifaktorijalna; hipertenzija, hiperlipidemija i dijabetes melitus su najče&scaron;ći faktori rizika za nastanak ovog oboljenja. Ovi faktori rizika povećavaju i učestalost ateroskleroze u perifernim arterijskim krvnim sudovima. Hemodinamski poremećaj kod oba oboljenja povećava rizik od cerebrovaskularnih događaja. Zbog preklapanja simptoma kod pacijenata sa udruženom stenozom aortne valvule i karotidnom bole&scaron;ću, nije lako doneti odluku o indikaciji za adekvatnim tretmanom. Postoji nekoliko strategija lečenja: hibridna procedura, simultana hirurgija, etapna procedura, transkateterska tehnika ili medikamentozno lečenje.</span></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 36.0pt; line-height: 200%;"><span style="mso-bookmark: _Hlk149509019;"><strong><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Cilj:</span></strong></span><span style="mso-bookmark: _Hlk149509019;"><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;"> Cilj studije je ispitivanje izvodljivosti i sigurnosti hibridne procedure SAVR i CAS kod pacijenata sa udruženom aortnom stenozom i stenozom karotidnih arterija. </span></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 36.0pt; line-height: 200%;"><span style="mso-bookmark: _Hlk149509019;"><strong><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Materijal i metode:</span></strong></span><span style="mso-bookmark: _Hlk149509019;"><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;"> Prospektivna nerandomizovana studija je izvedena na na&scaron;em Institutu od avgusta 2015. do avgusta 2023. godine i pacijenti su bili podvrgnuti hibridnoj procedure (istog dana je urađena hirurgija aortne valvule i implantacija stenta u karotidnoj arteriji).</span></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 36.0pt; line-height: 200%;"><span style="mso-bookmark: _Hlk149509019;"><strong><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Rezultati: </span></strong></span><span style="mso-bookmark: _Hlk149509019;"><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Studijom je obuhvaćeno 34 pacijenta sa udruženom karotidnom bole&scaron;ću i stenozom aortne valvule. Osim <span style="mso-spacerun: yes;">&nbsp;</span>same hirurgije aortne valvule, u najvećem broju slučajeva pacijentima je rađena i konkomitantna hirur&scaron;ka revaskularizacija miokarda. Ukupno su evidentirana 3 neželjenja kardiovaskularna događaja. </span></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 36.0pt; line-height: 200%;"><span style="mso-bookmark: _Hlk149509019;"><strong><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;">Zaključak:</span></strong></span><span style="mso-bookmark: _Hlk149509019;"><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; color: black; mso-themecolor: text1;"> Nema mnogo istraživanja na ovu temu, te nema jasnih preporuka o strategiji lečenja. Simultano hirur&scaron;ko lečenje aortne valvule i karotidne arterije se izvodi uz prihvatljivo dobre rezultate, ali može biti previse invazivno za visoko-rizične pacijente. U tom slučaju treba razmotriti hirur&scaron;ku zamenu aortnog zaliska <span style="mso-spacerun: yes;">&nbsp;</span>i CAS kao manje invazivnu opciju lečenja. </span></span></p> 2024-10-10T00:00:00+02:00 Sva prava zadržana (c) 2024 Medicinska istraživanja https://aseestant.ceon.rs/index.php/medi/article/view/51138 Zapaljenske manifestacije infekcije virusima Herpesviridae na prednjem segmentu oka 2024-11-20T08:29:31+01:00 Aleksandra Radosavljevic alexandra.radosavljevic@gmail.com <p><!-- [if gte mso 9]><xml> <o:OfficeDocumentSettings> <o:RelyOnVML/> <o:AllowPNG/> </o:OfficeDocumentSettings> </xml><![endif]--><!-- [if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:TrackMoves/> <w:TrackFormatting/> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:DoNotPromoteQF/> 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font-size:11.0pt; font-family:"Calibri",sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} </style> <![endif]--></p> <p class="MsoNormal" style="margin-bottom: .0001pt; text-align: justify; text-justify: inter-ideograph; line-height: 150%;"><strong><span style="font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;">Uvod: </span></strong><em style="mso-bidi-font-style: normal;"><span style="font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; mso-bidi-font-weight: bold;">Herpesviridae</span></em><span style="font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; mso-bidi-font-weight: bold;"> predstvaljaju veliku familiju dvolančanih DNK virusa od kojih osam tipova </span><span style="font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;">inficira ljude: Herpes simplex virus (HSV) tip 1 i 2, Varicella zoster virus (VZV), Cytomegalovirus (CMV), Epstein Barr virus (EBV), Human herpesvirus (HHV) 6, 7 i 8. <span style="mso-bidi-font-weight: bold;">Herpetična bolest oka može zahvatiti prednji i/ili zadnji segment oka. U ovom radu biće prikazane manifestacije na prednjem segment oka.</span></span></p> <p class="MsoNormal" style="margin-bottom: .0001pt; text-align: justify; text-justify: inter-ideograph; line-height: 150%;"><strong><span style="font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;">Metodologija: </span></strong><span style="font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; mso-bidi-font-weight: bold;">U revijskom radu su analizirani naučni radovi publikovanim u PubMed databazi do 30.4.2024. sa ključnim rečima: scleritis, keratitis, anterior uveitis, herpetic, HSV, VZV, CMV, EBV. </span></p> <p class="MsoNormal" style="margin-bottom: .0001pt; text-align: justify; text-justify: inter-ideograph; line-height: 150%;"><strong><span style="font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;">Rezultati: </span></strong><span style="font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; mso-bidi-font-weight: bold;">Dobro je poznato da HSV1, VZV i CMV uzrokuju inflamaciju prednjeg segmenta oka<strong>, </strong>i to skleritis, keratitis i prednji uveitis ili njihovu kombinaciju. Ipak, postoje prikazi slučajeva uzrokovanih EBV, HSV2 ili HHV6. Bolest obično ima hronični ili recidivirajući tok i dugotrajna inflamacija može uzrokovati ozbiljna o&scaron;tećenja tkiva oka, koja mogu značajno o&scaron;tetiti vid. Iako neki tipovi zapaljenja oka se mogu efikasno lečiti antivirusnim lekovima tokom aktivne faze bolesti (npr. HSV1, HSV2, VZV, CMV), za sada nema finalnog re&scaron;enja koje bi trajno sprečilo recidive bolesti. Glavne komplikacije uključuju ožiljke rožnjače, istanjenje sklere, glaukom, sinehije, atrofiju dužice i katarakta.</span></p> <p class="MsoNormal" style="margin-bottom: .0001pt; text-align: justify; text-justify: inter-ideograph; line-height: 150%;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;">Zaključak</span></strong><span style="font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;">: Usled hroničnog i recidivirajućeg toka bolesti, herpetične zapajenske manifestacije prednjeg segmenta oka jo&scaron; uvek predstavljaju izazov za kliničara. Iako u nekim slučajevima postoje tipični klinički znaci koji vode oftalmologa da posumnja na herpetični izrok zapaljenja, finalna dijagnoza (posebno u atipičnim slučajevima) se može doneti jedino potvrdom virusne DNK iz tkiva oka pomoću PCR metode ili u slučajevima uveitisa detekcijom lokalne produkcije specifičnih antivirusnih antitela u očnoj vodici pomoću Goldmann-Witmer-ovog koeficijenta </span></p> 2024-10-14T10:04:41+02:00 Sva prava zadržana (c) 2024 Medicinska istraživanja https://aseestant.ceon.rs/index.php/medi/article/view/51060 Stres kod trudnica tokom pandemije COVID-19 pandemije 2024-11-20T08:29:31+01:00 Konstantin Kostić k.ginekos@gmail.com Aleksandra Kostić a.ginekos@gmail.com Nikolina Banjanin nikolina.banjanin85@gmail.com Jelena Milin-Lazović milinjelena@gmail.com <p class="MsoNormal" style="margin-bottom: .0001pt; line-height: 200%;"><strong><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">Uvod:</span></strong><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 200%; font-family: 'Times New Roman',serif;"> Trudnoća je osetljiv period u životu žene kada psiholo&scaron;ki distres može imati negativne posledice po majku i plod. Trudnice i porodilje su pod povećanim rizikom za oboljevanje težom kliničkom slikom od COVID-19 infekcije u poređenju sa ženama koje nisu trudne.</span></p> <p class="MsoNormal" style="margin-bottom: .0001pt; line-height: 200%;"><strong><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">Cilj rada:</span></strong><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 200%; font-family: 'Times New Roman',serif;"> Ispitivanje stresa kod trudnica u Srbiji tokom COVID-19 pandemije.</span></p> <p class="MsoNormal" style="margin-bottom: .0001pt; line-height: 200%;"><strong><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">Materijal i metode:</span></strong><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 200%; font-family: 'Times New Roman',serif;"> Anonimni upitnik dat je na popunjavanje trudnicama prilikom ambulantnog pregleda. Ispitivane su socijalno-demografske karakteristike, aku&scaron;erski faktori, COVID-19 istorija, DASS-21 upitnik i PREPS upitnik.</span></p> <p class="MsoNormal" style="margin-bottom: .0001pt; line-height: 200%;"><strong><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">Rezultati:</span></strong><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 200%; font-family: 'Times New Roman',serif;"> U okviru PREPS upitnika, prosečna ocena za domen ,,pripremljenosti za porođaj&ldquo; je 2,4&plusmn;0,9, za domen ,,infekcija&ldquo; 2,9&plusmn;1,0, a za domen ,,pozitivno vrednovanje trudnoće&ldquo; 3,7&plusmn;0,8. Pozitivna, slaba statistički značajna povezanost je registrovana između domena pripremljenost za porođaj sa domenima depresija i anksioznost na DASS-21 upitniku.&nbsp; Pozitivna, umerena statistički značajna povezanost je registrovana između domena pripremeljenost za porođaj sa domenom stres na DASS-21 upitniku. Pozitivna, slaba statistički značajna povezanost je registrovana između domena infekcija i stres na DASS-21 upitniku.</span></p> <p class="MsoNormal" style="margin-bottom: .0001pt; line-height: 200%;"><strong><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">Zaključak:</span></strong><span lang="EN-US" style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 200%; font-family: 'Times New Roman',serif;"> Dve godine od početka pandemije trudnice su preležale COVID-19 infekciju ili su vakcinisane, pa su dobijeni skorovi domena ,,pripremljenosti za porođaj&ldquo; i ,,infekcija&ldquo;&nbsp; očekivano niži, dok je skor za domen ,,pozitivno vrednovanje trudnoće&ldquo; vi&scaron;i u poređenju sa studijama koje su sprvedene na početku pandemije. Dobijeni rezultati osnažuju buduća istraživanja o povezanosti depresije, stresa i anksioznosti sa stresom u trudnoći prouzrokovanog COVID-19 pandemijom.</span></p> <p>&nbsp;</p> <p class="MsoNormal" style="margin-bottom: .0001pt; line-height: 200%;"><strong><span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">Ključne reči:</span></strong><span lang="EN-US" style="font-size: 10.0pt; mso-bidi-font-size: 11.0pt; line-height: 200%; font-family: 'Times New Roman',serif;"> <em>trudnoća, stres, COVID-19</em></span></p> 2024-10-14T10:07:17+02:00 Sva prava zadržana (c) 2024 Medicinska istraživanja https://aseestant.ceon.rs/index.php/medi/article/view/51761 Grejvsova orbitopatija 2024-11-20T08:29:32+01:00 Biljana Beleslin biljana_beleslin@yahoo.com <p class="MsoNormal"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 115%; font-family: 'Times New Roman',serif;">Sa</span></strong><strong style="mso-bidi-font-weight: normal;"><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">žetak</span></strong></p> <p class="MsoNormal"><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">Grejvsova orbitopatija (GO) je autoimino oboljenje orbite i glavna ekstratiroidna manifestacija Grejvsove bolesti. Oko 30% pacijenata sa <span style="mso-spacerun: yes;">&nbsp;</span>Grejvsovom bole&scaron;ću ima GO, dok manje od 10% razvije težu formu koja zahteva lečenje. Lečenje GO je multidisciplinarno. Izbor terapije se zasniva na proceni aktivnosti i težine bolesti Aktivnost predstavlja stepen inflamacije. Težina predstavlja stepen kozmetičkih i funkcionalnih poremećaja. Za blage i aktivne GO se savetuje kontrola faktora rizika, lokalna oftalmolo&scaron;ka terapija i selen (posebno u oblastima deficitarnim selenom). Lečenje aktivnih srednje do te&scaron;kih formi GO u većini slučajeva se zasniva na primeni visokih doza<span style="mso-spacerun: yes;">&nbsp; </span>intravenski primenjenih glukokortikoida kao monoterapijja ili u kombinaciji sa mikofenolatom. Druga linija lečenja obuhvata ponovljeni ciklus glukokortikoida intravenski, oralne glukokortikoide u kombinaciji sa ciklosporinom ili azatioprinn, radioterapiju u kombinaciji sa intravenskim glukokortikoidima, teprotumumab, rituksimab ili tocilizumab. U slučaju veoma te&scaron;kih, po vid ugrožavajućih GO se primenjuje vi&scaron;e visokih, pojedinačnih<span style="mso-spacerun: yes;">&nbsp; </span>doza metilprednizolona tokom nedelju dana. U slučaju da ne postoji povoljan odgovor na terapiju sprovodi se hitna hirur&scaron;ka dekompresija. Rekonstruktivna hirurgija (dekompresija, strabolo&scaron;ka operacija ili operacija kapaka) je indikovana za neaktivne, posle medikamentne terapije zaostale, manifestacije GO. </span></p> <p class="MsoNormal"><strong style="mso-bidi-font-weight: normal;"><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">Ključne reči: </span></strong><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 115%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">Grejvsova orbitopatija, Grejvsova bolest, glukokortikoidi, mofetil, orbitalna dekompresija</span></p> 2024-10-14T10:18:23+02:00 Sva prava zadržana (c) 2024 Medicinska istraživanja https://aseestant.ceon.rs/index.php/medi/article/view/52237 AKUTNA RADIJACIONA TOKSIČNOST KOD PACIJENATA SA GLIOBLASTOMOM KOJI SU LEČENI HIPOFRAKCIONISANOM RADIOTERAPIJOM 2024-11-20T08:29:32+01:00 Aleksandar Stepanović a.stepanovic@ncrc.ac.rs Tatjana Arsenijević tatjanaarsenijevic96@gmail.com Aleksandar Tomašević alektom@gmail.com Ivan Bogdanović ivanbg83@gmail.com Katarina Kopčalić kaca.obradovic83@gmail.com Bojana Poparić-Banđur bojanapoparic@yahoo.com Marina Nikitović marina.nikitovic@ncrc.ac.rs <p><!-- [if gte mso 9]><xml> <o:OfficeDocumentSettings> <o:AllowPNG/> </o:OfficeDocumentSettings> </xml><![endif]--><!-- [if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:TrackMoves/> <w:TrackFormatting/> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:DoNotPromoteQF/> <w:LidThemeOther>EN-GB</w:LidThemeOther> <w:LidThemeAsian>X-NONE</w:LidThemeAsian> <w:LidThemeComplexScript>X-NONE</w:LidThemeComplexScript> <w:Compatibility> <w:BreakWrappedTables/> <w:SnapToGridInCell/> <w:WrapTextWithPunct/> <w:UseAsianBreakRules/> <w:DontGrowAutofit/> 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5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:8.0pt; mso-para-margin-left:0cm; line-height:107%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Aptos",sans-serif; mso-ascii-font-family:Aptos; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Aptos; mso-hansi-theme-font:minor-latin; mso-font-kerning:1.0pt; mso-ligatures:standardcontextual; mso-fareast-language:EN-US;} </style> <![endif]--></p> <p class="MsoNormal" style="line-height: 250%;"><strong><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 250%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">Uvod.</span></strong><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 250%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;"> Hipofrakcionisana radioterapija je preporučeni režim radioterapije za starije pacijente sa glioblastomom, kao i pacijente sa nepovoljnim prognostičkim faktorima. Pojava akutna radijacione toksičnosti je jedna od dilema kod primene hipofrakcionisanog režima radioterapije.</span></p> <p class="MsoNormal" style="line-height: 250%;"><strong><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 250%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">Cilj</span></strong><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 250%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">. Sproveli smo ovu retrospektivnu studiju sa ciljem da prikažemo profil akutne toksičnosti kod pacijenata sa glioblastomom lečenih hipofrakcionisanim režimom radioterapije, sa ili bez primene temozolomida. </span></p> <p class="MsoNormal" style="line-height: 250%;"><strong><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 250%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">Materijal i metode</span></strong><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 250%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">. Ova studija je obuhvatila 25 pacijenata sa dijagnostikovanim glioblastomom koji su bili lečeni hipofrakcionisanom radioterapijom, sa ukupnom dozom od 40 Gy u 15 frakcija ili 34 Gy u 10 frakcija. Akutna radijaciona toksičnost koja je zabeležena tokom tretmana, gradirana je prema <em>Common Terminology Criteria for Adverse Events, version 5.0.</em></span></p> <p class="MsoNormal" style="line-height: 250%;"><strong><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 250%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">Rezultati</span></strong><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 250%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">. Akutna radijaciona toksičnost je zabeležena kod 60% pacijenata. Većina pacijenata sa toksično&scaron;ću (80%) imala je gradus 1 toksičnosti. Jedan pacijent (6,7%) je imao radijacionu toksičnost gradusa 3. Nije zabeležena radijaciona toksičnost gradusa 4. Statistički značajno veći broj pacijenata koji su imali radiotoksičnost bili su raspoređeni u grupi pacijenata koji su imali tumor u vi&scaron;e od jednog moždanog režnja, multifokalni ili multicentrični tumor, u poređenju sa pacijentima koji su imali tumor u jednom moždanom režnju (p &lt; 0.01). </span></p> <p class="MsoNormal" style="line-height: 250%;"><strong><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 250%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">Zaključci</span></strong><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 250%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">. Hipofrakcionisani režim radioterapije predstavlja povoljnu opciju za lečenje starijih pacijenata sa glioblastomom ili onih pacijenata sa lo&scaron;om prognozom, sa prihvatljivim profilom akutne radijacione toksičnosti. </span></p> 2024-10-14T10:20:37+02:00 Sva prava zadržana (c) 2024 Medicinska istraživanja https://aseestant.ceon.rs/index.php/medi/article/view/52338 CAR indeks u predikciji mortaliteta hospitalizovanih pacijenata sa Kovid-19 pneumonijom 2024-11-20T08:29:32+01:00 Nataša Milić silly_stat@yahoo.com <p class="MsoNormal" style="text-align: justify; line-height: 200%;"><strong style="mso-bidi-font-weight: normal;"><span lang="EN-CA">Uvod/Cilj rada: </span></strong><span lang="EN-CA" style="mso-no-proof: yes;">Kovid-19 pneumonija je ozbiljan oblik bolesti koji može dovesti do te&scaron;kih komplikacija koje ugrožavaju život. Ova studija ima za cilj da proceni prognostičku vrednost CAR indeksa kod hospitalizovanih pacijenata sa kovid-19 pneumonijom. </span></p> <p class="MsoNormal" style="text-align: justify; line-height: 200%;"><strong style="mso-bidi-font-weight: normal;"><span lang="EN-CA">Metod: </span></strong><span lang="EN-CA">Istraživanje je sprovedeno kao prospektivna kohortna studija u Univerzitetskom kliničkom centru Zvezdara tokom aprila 2020. Godine. U studiju su uključeni pacijenati hospitalizovani zbog dijagnostikovane umerene do te&scaron;ke kovid-19 pneumonije. Kovid-19 infekcija je potvrđena reakcijom lančane polimeraze reverznom transkripcijom u realnom vremenu (RT-PCR) iz brisa nazofarinksa. CAR indeks je izračunat kao količnik CRP-a i albumina. </span></p> <p class="MsoNormal" style="text-align: justify; line-height: 200%;"><strong style="mso-bidi-font-weight: normal;"><span lang="EN-CA">Rezultati:</span></strong><span lang="EN-CA"> U studiju je uključeno 208 hospitalizovanih pacijenata sa Kovid-19 pneumonijom, prosečne starosti 54,5&plusmn;14,6 godina, pretežno mu&scaron;kog pola (64,4%). Komorbiditeti su bili prisutni kod 67,3% pacijenata. Ukupan bolnički mortalitet iznosio je 14,4%. Vrednost CAR indeksa od 2,0 identifikovana je kao tačka preseka za predikciju mortaliteta, uz senzitivnost od 86% i specifičnost od 72% (AUC=0,844). U univarijantnoj regresionoj analizi, starost, komorbiditeti, otežano disanje i CAR indeks identifikovani su kao značajni prediktori mortaliteta (p&lt;0,050, za sve analize). U multivarijantnoj analizi, starost (RR=1,06; 95% CI: 1,02-1,09; p=0,001) i CAR indeks (RR=1,12; 95% CI: 1,02-1,23; p=0,019) bili su nezavisni prediktori mortaliteta kod hospitalizovanih pacijenata sa Kovid-19 pneumonijom.</span></p> <p class="MsoNormal" style="text-align: justify; line-height: 200%;"><strong style="mso-bidi-font-weight: normal;"><span lang="EN-CA">Zaključak: </span></strong><span lang="EN-CA">Rutinska analiza krvi može biti korisna u identifikaciji pacijenata sa Kovid-19 pneumonijom koji su pod povećanim rizikom od letalnog ishoda. CAR indeks je &scaron;iroko dostupan, jednostavan inflamatorni marker koji može biti indikator za ranu diferencijaciju težine bolesti pacijenata sa Kovid-19 pneumonijom.</span></p> 2024-10-14T10:22:41+02:00 Sva prava zadržana (c) 2024 Medicinska istraživanja https://aseestant.ceon.rs/index.php/medi/article/view/52718 KLINIČKE MANIFESTACIJE SINDROMA POLICISTIČNIH JAJNIKA 2024-11-20T08:29:33+01:00 Radmila M Sparic radmila@rcub.bg.ac.rs Jelena Zlatar zlatarjelenamed@gmail.com Luka Nikolić luka.nikolic.med@gmail.com Milica Opalić Palibrk opalicmilica@gmail.com Lena Radić lena_radic@outlook.com Jelica Bjekić Macut jbjekic@yahoo.com Sanja Ognjanović ognjanovicsanja1@gmail.com Djuro Macut djmacut@gmail.com <p class="MsoNormal" style="mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; line-height: 200%;"><span style="font-family: 'Times New Roman',serif;">Sindrom policističnih jajnika, odnosno PCOS, kao najče&scaron;će endokrino oboljenje kod žena u reproduktivnom periodu predstavlja kompleksno oboljenje koje se karakteri</span><span lang="SR-LATN-RS" style="font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">&scaron;e različitim hormonskim poremećajima i brojnim varijacijama u kliničkoj slici.</span><span style="font-family: 'Times New Roman',serif;"> Dijagnoza i lečenje PCOS-a otežani su izrazito varijabilnom kliničkom slikom </span><span lang="SR-LATN-RS" style="font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">i </span><span style="font-family: 'Times New Roman',serif;">nedovoljno poznatom etiologijom i patogenezom ovog poremećaja. Primarni klinički znaci PCOS-a obuhvataju hiperandrogenizam, ovlatornu disfunkciju i policističnu morfologiju jajnika, iako sva tri ne moraju biti prisutna kod svih pacijentkinja sa PCOS.</span></p> <p class="MsoNormal" style="mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; line-height: 200%;"><span style="font-family: 'Times New Roman',serif;">Hiperandrogenizam, koji se manifestuje kao hirzutizam, akne ili androgena alopecija, </span><span lang="SR-LATN-RS" style="font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">značajno </span><span style="font-family: 'Times New Roman',serif;">utiče kako na fizičko, tako i na psihičko stanje ovih pacijentkinja. Ovulatorna disfunkcija, koja se manifestuje iregularnim menstruacionim ciklusima kao posledica oligo/anovulacije, predstavlja zna</span><span lang="SR-LATN-RS" style="font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">čajan element kliničke prezentacije PCOS-a i uzrokuje infertilitet koji se sreće kod pojedinih </span><span style="font-family: 'Times New Roman',serif;">pacjentkinja. Takođe, insulinska rezistencija koja je karakteristična za PCOS dovodi do hiperinsulinemije i metaboličkih poremećaja koji se sreću kod ovih pacijentkinja. Posledično, </span><span lang="SR-LATN-RS" style="font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">ž</span><span style="font-family: 'Times New Roman',serif;">ene sa PCOS imaju povećan rizik gojaznosti, displipidemije, dijabetesa, i kardiovaskularnih bolesti, naročito u kasnijoj životnoj dobi. Učestalost poremećaja raspoloženja, pre svega depresije i anksioznosti takođe je značajno povećana u ovoj populaciji. </span></p> <p class="MsoNormal" style="mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; line-height: 200%;"><span style="font-family: 'Times New Roman',serif;">Kompleksnost sindroma otežava brigu o pacijentkinjama, a njegova hronična priroda ističe potrebu za proaktivnim pristupom lečenju i pažljivom procenom svih elemenata oboljenja.</span></p> 2024-10-14T10:26:25+02:00 Sva prava zadržana (c) 2024 Medicinska istraživanja https://aseestant.ceon.rs/index.php/medi/article/view/50984 Primarni lejomiosarkom donje šuplje vene - radikalna resekcija i vaskularna rekonstrukcija - prikaz slučaja 2024-11-20T08:29:33+01:00 Ognjen Petrovic ognjenpetrovic54@gmail.com Srdjan Nikolic onkosurge1@yahoo.com Igor Djurisic drigordjurisic@gmail.com Milan Kocic kocic011@gmail.com Andjela Babic andjela.ug@gmail.com Vladimir Jokic vladimir.jokic90@gmail.com Luka Pejnovic lpejnovic14@gmail.com Nikola Vucic nikola.vucic91@gmail.com Stefan Gacic stefan.gacic@yahoo.com Lila Rajacic lilaa.rajacic@gmail.com <p class="MsoNormal" style="text-indent: 0in;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman','serif';">Uvod:</span></strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman','serif';"> Sarkomi su retki tumori koji čine manje od 1% malignih tumora kod odraslih. Primarni lejomiosarkom donje &scaron;uplje vene je veoma redak tumor čija je incidencija<span style="mso-spacerun: yes;">&nbsp; </span>&lt;1/100 000 svih malignih bolesti kod odraslih. U ovom radu predstavljen je slučaj žene, upravo, sa lejomiosarkomom donje &scaron;uplje vene kojoj je urađena radikalna resekcija tumora uz vaskularnu rekonstrukciju.</span></p> <p class="MsoNormal" style="text-indent: 0in;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman','serif';">Prikaz bolesnika:</span></strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman','serif';"> Žena stara 71 godinu, javila se lekaru zbog bezbolne hematurije. U sklopu dijagnostičke evaluacije pored UZ i CT pregleda abdomena učinjena je i CT angiografija sa 3D rekonstrukcijom. Zaključak radiologa je bio da opisana tumorska masa najpre odgovara primarnom lejomiosarkomu donje &scaron;uplje vene koji se lateralno levo propagirao u lumen leve bubrežne vene, dok je desna bubrežna arterija bila infiltrisana tumorom. Pacijentkinja je prikazana konzilijumu na Institutu za onkologiju i radiologiju Srbije koji je doneo odluku o operativnom lečenju. Tumor je u celosti odstranjen u bloku sa desnim bubregom, desnom nadbubrežnom žlezdom i u&scaron;ćem leve bubrežne vene u donju &scaron;uplju venu. Donja &scaron;uplja vena je rekonstruisana uz pomoć grafta termino-terminalnom anastomozom, dok je leva bubrežna vena implantirana u graft termino-lateralnom anastomozom. Postoperativni tok kod pacijentkinje je uredno protekao i ona je VIII postoperativnog dana otpu&scaron;tena iz bolnice.</span></p> <p class="MsoNormal" style="text-indent: 0in;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman','serif';">Zaključak:</span></strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman','serif';"> <span style="color: black;">Lejomiosarkom donje &scaron;uplje vene je ekstremno redak tumor. Hirur&scaron;ka resekcija tumora I zahvaćenog krvnog suda sa negativnim ivicama resekcije je jedina terapijska opcija koja pobolj&scaron;ava preživljavanje. Vrlo često uz komplikovane vaskularne rekonstrukcije, hirurgija uključuje i multivisceralne resekcije, kako bi se postigao najbolji mogući terapijski efekat.</span></span></p> 2024-10-21T10:28:21+02:00 Sva prava zadržana (c) 2024 Medicinska istraživanja https://aseestant.ceon.rs/index.php/medi/article/view/52532 Хистопатолошки алати у дијагнози Хиршпрунгове болести и сродних обољења 2024-11-20T08:29:33+01:00 Radmila Janković radmila.jankovic@med.bg.ac.rs Miloš Đuknić milos.djuknic@med.bg.ac.rs Jovan Jevtić jovan.jevtic@med.bg.ac.rs Milica Labudović Borović milica.labudovic-borovic@med.bg.ac.rs Dragana Vujović dr.v.dragana@gmail.com Sanja Sinđić-Antunović sanja.sindjic.antunovic@gmail.com Đorđe Topličić drdjordjetoplicic@gmail.com Milena Backović mimab1997@gmail.com Dunja Putniković putnikovicc@gmail.com Jelena Jovanović mmjeka@hotmail.com <p>&nbsp;</p> <p class="MsoNormal" style="margin-bottom: 0cm; line-height: 150%;"><span lang="SR-CYRL-RS" style="font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-CYRL-RS;">Дијагностика Хиршпрунгове болести</span> <span lang="SR-CYRL-RS" style="font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-CYRL-RS;">(ХБ) и сродних поремећаја може бити сложена и захтева добро познавање механизама који регулишу цревни мотилитет, као што су ентерички нервни систем (ЕНС), интерстицијске Кахалове ћелије (ИКЋ) и мишићни омотач црева. Лондонска класификација идентификује три групе гастроинтестиналних неуромускуларних поремећаја: неуропатије, миопатије и абнормалности ИКЋ. Хирсчспрунгова болест коју одликује одсуство ганглијских ћелија, је најчешћа цревна неуропатија и резултат је поремећене миграције ћелија нервног гребена током развоја. Погађа око 1 од 5 000 живорођене деце и укључује више гена, међу којима је најзначајнији </span><em><span style="font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif;">RET</span></em><span lang="SR-CYRL-RS" style="font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-CYRL-RS;"> ген. ХБ обично погађа ректум и део колона, са различитим степенима аганглионозе. Дијагноза се заснива на хистопатолошкој анализи сукционих биопсија - одсуству ганглијских ћелија и присуству дебелих субмукозних нерава на стандардном хематоксилин и еозин бојеном препарату, допуњеном ензимохистохемијским бојењем (метода ацетилхолинестеразе) или имунохистохемијским (калретинин и друга антитела) бојењем. Лечење ХБ подразумева хируршку ресекцију аганглионарног сегмента црева. Тачна интраоперативна процена ткивних маргина је кључна за превенцију постоперативних компликација условљених псеудообструкцијом. Комуникација између хирурга и патолога је од суштинског значаја за постизање успешног терапијског исхода.</span></p> <p class="MsoNormal" style="margin-bottom: 0cm; line-height: 150%;"><span lang="SR-CYRL-RS" style="font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-CYRL-RS;">Остале цревне неуропатије укључују интестиналну хипоганглионозу, хиперганглионозу, одложено сазревање ганглијских ћелија и глиопатије. Интестиналне миопатије су изузетно ретка стања, са типичним морфолошким променама као што су атрофија мишићног омотача црева, интрацелуларна вакуолизација глатких мишићних ћелија и интерстицијална фиброза. Поремећај у мрежи и распореду ИКЋ чини морфолошку основу за констипацију спорог пролаза. Сваки од поменутих поремећаја има јединствене карактеристике и дијагностичке изазове. Дијагностиковање ових стања често захтева комбинацију хистолошких, хистохемијских, имунохистохемијских и понекад генетских анализа. Интеграција ових метода је од виталног значаја за тачну дијагнозу и ефикасно планирање лечења.</span></p> <p class="MsoNormal" style="margin-bottom: 0cm; line-height: 150%;"><span lang="SR-CYRL-RS" style="font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-CYRL-RS;">Укратко, сложеност поремећаја цревног дисмотилитета захтева детаљно разумевање цревног мотилитета и коришћење напредних дијагностичких метода како би се пружиле тачне дијагнозе и ефикасни третмани.</span></p> <p>&nbsp;</p> 2024-10-21T10:30:45+02:00 Sva prava zadržana (c) 2024 Medicinska istraživanja https://aseestant.ceon.rs/index.php/medi/article/view/53019 Age, Glasgow Coma Scale and vasopressors can predict mortality in traumatized patients treated in the ICU 2024-11-20T08:29:34+01:00 Sofija Mirosavljević mala.sof.5@gmail.com <p><!-- [if gte mso 9]><xml> <o:OfficeDocumentSettings> <o:AllowPNG/> </o:OfficeDocumentSettings> </xml><![endif]--><!-- [if gte mso 9]><xml> 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mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:8.0pt; mso-para-margin-left:0in; line-height:107%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri",sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi; mso-font-kerning:1.0pt; mso-ligatures:standardcontextual;} </style> <![endif]--></p> <p class="MsoNormal" style="margin-bottom: .0001pt; line-height: 200%;"><strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">Uvod </span></strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">&ndash; Trauma predstavlja jedan od najznačajnijih javnozdravstvenih problema &scaron;irom sveta. Ona je jedan od vodećih uzroka smrtnosti, posebno u populaciji mladih, ali sa značajno većim udelom nefatalnih povreda koje rezultiraju doživotnim invaliditetom i zdravstvenim posledicama. Pravilna i blagovremena identifikacija pacijenata sa većim rizikom od mortaliteta je ključna za bolje ishode. </span><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-fareast-font-family: Calibri;">Cilj ove studije je da ispita potencijalne prediktor smrtnog ishoda kod pacijenata koji su preživeli traumu, a leče se u jedinici intenzivnog lečenja.</span></p> <p class="MsoNormal" style="margin-bottom: .0001pt; line-height: 200%;"><strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">Metode</span></strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;"> - Retrospektivna kohortna studija je sprovedena u traumatolo&scaron;koj, 12-krevetnoj intenzivnoj intenzivnoj pomoći Univerzitetskog urgentnog centra Kliničkog centra Srbije, Beograd. Svi uzastopni pacijenti sa tupim traumama primljeni su u intenzivnu intenzivnu terapiju između avgusta 2021. i avgusta 2022. Primarni ishodi od interesa bili su bolnička smrtnost od svih uzroka. Vrednost p &lt; 0,05 smatrana je statistički značajnom.</span></p> <p class="MsoNormal" style="margin-bottom: .0001pt; line-height: 200%;"><strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">Rezultati</span></strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">- <em>GCS</em> (koeficijent opasnosti 0,924 95%CI 0,873 &ndash; 0,979), vazopresori (koeficijent opasnosti 3,47 95%CI 1,373 &ndash; 8,787) i starost (odnos opasnosti 1,030 95%CI 1,030 95%CI 1,0147 individualno) predikt.</span></p> <p class="MsoNormal" style="margin-bottom: .0001pt; line-height: 200%;"><strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">Zaključak</span></strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;"> &ndash; Ova studija ukazuje na faktore rizika za nepovoljne kliničke ishode nakon te&scaron;ke traume.To može biti od izuzetnog značaja da bi se na vreme izdvojili pojedinci sa lo&scaron;om prognozom, kako bi se &scaron;to pre započela adekvatna intenzivna terapija i time smanjila smrtnost. Starost, vazopresori i mehanička ventilacija, nezavisno mogu biti prediktori letalnog ishoda kod pacijenata koji su preživeli traumu, a leče se u jedinici intenzivnog lečenja.</span></p> 2024-10-21T10:32:40+02:00 Sva prava zadržana (c) 2024 Medicinska istraživanja https://aseestant.ceon.rs/index.php/medi/article/view/53024 MEDIKAMENTOZNA TERAPIJA POSTOPERATIVNOG BOLA 2024-11-20T08:29:34+01:00 Katarina R Savić Vujović katarinasavicvujovic@gmail.com Sonja Vučković vuckovicsonja1@gmail.com Branislava Medić brankicamedic@gmail.com Dragana Srebro srebrodragana1@gmail.com Ana Jotić anajotic@yahoo.com <p class="MsoNormal" style="mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; line-height: 150%;"><span style="font-size: 12.0pt; line-height: 150%; font-family: 'Times New Roman','serif'; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-weight: bold;">Postoperativni bol je i dalje veoma rasprostranjen i jo&scaron; uvek potcenjen problem kako u na&scaron;oj zemlji, tako i u svetu. Brojne studije koje su sprovedene u zemljama s razvijenim sistemom zdravstvene za&scaron;tite pokazale su da čak ni u 21. veku postoperativni bol nije adekvatno tretiran. Vi&scaron;e od 80% pacijenata koji se podvrgavaju hirur&scaron;kim procedurama iskuse akutni postoperativni bol, a 75% pacijenata opisuju akutni bol kao srednje težak, težak ili ekstreman. Postoperativni oporavak zavisi od karakteristika pacijenta, ali i od faktora koji omogućavaju postoperativni oporavak, odnosno od prisustva ili odsustva komplikacija posle operacije. Farmakologija postoperativnog bola je usmerena prema patofiziolo&scaron;kim mehanizmima kao &scaron;to su: nocicepcija, periferna senzitizacija, ektopična aktivnost, centralna senzitizacija. Savremeno medikamentno lečenje postoperativnog bola podrazumeva balansiranu multimodalnu analgeziju. Princip multimodalne analgezije je baziran na multifaktorijalnoj prirodi i kompleksnosti puteva preno&scaron;enja bola, a defini&scaron;e se kao upotreba različitih lekova ili tehnika sa različitim mehanizmom dejstva na perifernom ili centralnom nervnom sistemu, koje mogu imati aditivan ili sinergistički efekat. Nekoliko grupa lekova je uključeno u multimodalni princip, i svaki od njih ima specifičan patofiziolo&scaron;ki mehanizam dejstva. Efikasnost opioidnih analgetika u terapiji umerenog do te&scaron;kog postoperativnog bola se ostvaruje zbog nedostatka plato efekta. Međutim, povećanjem doze dolazi do povećanja neželjenih efekata. Nesteroidni anti-inflamatorni lekovi (NSAIL), ciklooksigenaza-2 inhibitori (COX-2) i sistemski steroidi smanjuju inflamatornu komponentu hirur&scaron;kog bola. Sistemski i lokalni anestetici redukuju oslobađanje inflamatornih medijatora (IL-6, Il-1&beta;, i IL-1RA). Gabapentinoidi, vezujući se za alfa-2-delta-1 subjedinicu voltažnih kalcijumskih kanala u centralnom nervnom sistemu, redukuju oslobađanje važnih ekscitatornih neurotransmitera uključenih u nocicepciju. Alfa-2-agonisti, kao &scaron;to su klonidin i deksmedetomidin, aktiviranjem presinaptičkih i postsinaptičkih &alpha;2 receptora u kičmenoj moždini moduli&scaron;u transmisiju bolnih impulsa. Lokalni anestetici (lidokain) blokiraju neuralnu transmisiju blokirajući natrijumske kanale, pa preveniraju transmisiju bolnih stimulusa sa periferije u centralni nervni sistem. NMDA antagonisti, ketamin i magnezijum, smanjuju mehanizam cetralne senzitizacije.</span></p> 2024-10-21T11:28:36+02:00 Sva prava zadržana (c) 2024 Medicinska istraživanja https://aseestant.ceon.rs/index.php/medi/article/view/52586 UTICAJ PERIFERNIH NERVNIH BLOKOVA NA INFLAMATORNI ODGOVOR POSLE ARTROPLASTIKE KOLENA 2024-11-20T08:29:35+01:00 prof. dr Svetlana Sreckovic svetlanasreckovic@yahoo.com Radmila Klacar radmilaklacar@gmail.com Ana Odalovic anaodalovic@gmail.com Dragana Vracevic draganatejovic@gmail.com Jovan Vesic jovandvesic@gmail.com Nikola Ladjevic nikola.ladjevic@yahoo.com Marko Kadija kadija.marko@gmail.com <p><!-- [if gte mso 9]><xml> <o:OfficeDocumentSettings> <o:AllowPNG/> </o:OfficeDocumentSettings> </xml><![endif]--><!-- [if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:TrackMoves/> <w:TrackFormatting/> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> 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mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;} </style> <![endif]--></p> <p class="MsoNormal" style="line-height: 200%;"><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman','serif'; color: #1d2228; background: white;">Pojačan inflamatorni odgovor nakon artroplastike kolena (TKA) rezultat je traume kosti i mekih tkiva, a njegova ekstenzivna reakcija doprinosi postoperativnom morbiditetu i mortalitetu. <strong>Metode: </strong>200 pacijenata uključeno je u ovu prospektivnu kohortnu studiju nakon elektivne TKA. U prvoj grupi pacijenata primenjeni su aduktor kanal blok i IPACK blok, a u drugoj ne. <strong>Rezultati: </strong>Bol u mirovanju imalo je manje pacijenata u grupi sa blokom i bio je manjeg intenziteta (1,18&plusmn;0,76 vs. 3,35&plusmn;1,18 p˂0,001). U grupi bez blokova bol je bio intenzivniji tokom ka&scaron;lja (1,7&plusmn;0,52 vs. 3,72&plusmn;1,61 p˂0,001) i pri aktivnim pokretima operisane noge (1,67&plusmn;0,83 vs. 3,78&plusmn;1,94 p˂0,001). U prva 24 sata nakon operacije, u grupi sa blokovima, 22% pacijenata je koristilo opioide u dozi od 9,64&plusmn;3,21 mg, dok u grupi bez bloka svi pacijenti su koristili u dozi od 30,94&plusmn;11,47. Statistički značajna razlika između grupa je postojala u WBC, CRP, ESR i albuminima 1,3. i 5. dana postoperativno. Tri meseca nakon TKA, KOOS skor je bio statistički vi&scaron;i u grupi sa blokovima (92,6&plusmn;11,73 vs 85,65&plusmn;17,49 p˂0,001). <strong>Zaključak: </strong>Kombinacijom nervnih blokova obezbeđuje se adekvatna postoperativna analgeziju koja omogućava ranu rehabilitaciju, smanjuje potro&scaron;nju morfijuma, smanjuje broj WBC, CRP, ESR i albumina (1., 3. i 5. dan posle operacije) i pozitivno utiče na funkcionalni status tri meseca nakon operacije. Identifikacija i uticaj na faktore koji smanjuju lokalni i sistemski inflamatorni odgovor je od vitalnog značaja za pobolj&scaron;anje oporavka nakon TKA.</span></p> 2024-10-29T08:39:04+01:00 Sva prava zadržana (c) 2024 Medicinska istraživanja https://aseestant.ceon.rs/index.php/medi/article/view/52852 OVARIAN STIMULATION WITH FOLLITROPIN-δ REDUCES RISK OF OVARIAN HYPERSTIMULATION SYNDROME 2024-11-20T08:29:35+01:00 Milan Perovic perovic.milan@gakfront.org Nebojsa Zecevic nebojsa.zecevic1@gmail.com Dragana Bojovic Jovic drbojovicjovic@gmail.com Tatjana Nozic Zecevic nozictanja@gmail.com Aleksandar Stojsavljević aleksandars@chem.bg.ac.rs Gorana Nikolic gorana.nikolic03@gmail.com Ana Nikolic dr.ana.nikolic11@gmail.com <p class="MsoNormal" style="line-height: 200%;"><strong><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">UVOD</span></strong></p> <p class="MsoNormal" style="line-height: 200%;"><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">Stimulacija jajnika (OS) u sklopu vantelesne oplodnje (VTO) nosi rizik sindroma ovarijalne hiperstimulacije (OHSS). Rizik je naročito izražen kod žena sa sindromom policističnih jajnika (PCOS). Rekombinantnim DNK tehnologijama stvorene su nove generacije gonadotropina, kao &scaron;to je Follitropin-</span><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">&delta;</span><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">, koje individualizovanim doziranjem na osnovu vrednosti antimilerijan hormona (AMH) i telesne mase (tm) pacijenta smanjuju rizik OHSS-a. </span></p> <p class="MsoNormal" style="line-height: 200%;"><strong><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">CILJ</span></strong></p> <p class="MsoNormal" style="line-height: 200%;"><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">Uporediti prevalencu OHSS-a i efikasnost OS individualizovanim doziranjem Follitropinom-</span><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">&delta;</span><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;"> <span lang="SR-LATN-RS">i standardnim doziranjem starijim generacijama gonadotropina u populaciji žena sa PCOS-om.</span></span></p> <p class="MsoNormal" style="line-height: 200%;"><strong><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">METODE</span></strong></p> <p class="MsoNormal" style="line-height: 200%;"><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">U studiji kontrole slučajeva radnu grupu činile su 24 žene stimulisane individualizovanim doziranjem Follitropinom-</span><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">&delta;</span><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">, a kontrolnu 48 žena standardnim doziranjem starijim generacijama gonadotropina. Studijski kriterijumi za uključivanje: PCOS, odnosno isključivanje: ostali uzroci infertiliteta. Ispitanice radne grupe uparene su sa ispitanicama kontrolne grupe na osnovu AMH, tm, godina starosti i pu&scaron;ačkog statusa.</span></p> <p class="MsoNormal" style="line-height: 200%;"><strong><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">REZULTATI</span></strong></p> <p class="MsoNormal" style="line-height: 200%;"><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">U radnoj grupi prevalenca umerenih (0% vs. 5.9%) i težih (0% vs. 17.6%) formi OHSS-a značano je manja (p=0.009) u odnosu na kontrolnu grupu. Trajanje OS (9.06&plusmn;1.53 dana vs. 10.00&plusmn;1.13 dana, p=0.01) i primenjena doza gonadotropina (1,117.95&plusmn;234.90 vs. 1,940.33&plusmn;501.20 IU, p&lt;0.001) značajno su manji u radnoj grupi. Broj dobijenih embriona visokog kvaliteta veći je u radnoj grupi (3.33&plusmn;1.13 vs. 2.20&plusmn;0.96, p&lt;0.001).</span></p> <p class="MsoNormal" style="line-height: 200%;"><strong><span lang="ES" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ansi-language: ES;">ZAKLJUČAK</span></strong></p> <p class="MsoNormal" style="line-height: 200%;"><span lang="ES" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ansi-language: ES;">Prevalenca umerenih i težih formi OHSS-a manja je kod OS </span><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">individualizovanim doziranjem Follitropinom-</span><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">&delta;</span><span lang="ES" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ansi-language: ES;"> u odnosu na OS</span><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;"> standardnim doziranjem starijim generacijama gonadotropina. Efikasnost OS u studijskim grupama nije se značajno razlikovala, osim kraćeg trajanja OS, manje primenjene ukupne doze gonadotropina i znatno većeg broja dobijenih visoko kvalitetnih embriona, a koji su zabeleženi kod OS individualizovanim doziranjem Follitropinom-</span><span style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">&delta;</span><span lang="SR-LATN-RS" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif; mso-ansi-language: SR-LATN-RS;">.</span></p> 2024-10-29T09:05:02+01:00 Sva prava zadržana (c) 2024 Medicinska istraživanja https://aseestant.ceon.rs/index.php/medi/article/view/53338 UNAPREĐIVANJE FUNKCIONALNOG OPORAVKA BALNEOTERAPIJOM NAKON ARTROPLASTIKE KUKA 2024-11-20T08:29:35+01:00 Attila Klimó petik@stcable.net Rada Jeremić rada.jeremic@med.bg.ac.rs Predrag Brkić predrag.brkic@med.bg.ac.rs Mina Bogetić mina.bogetic@med.bg.ac.rs Marija Babić marijabb222@gmail.com <p class="MsoNoSpacing" style="line-height: 200%;"><span class="MsoHyperlink"><strong style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">Uvod:</span></strong></span><span class="MsoHyperlink"><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;"> Balneoterapija je terapijski pristup koji koristi prirodne elemente kao sredstvo lečenja. Artroplastika kuka je hirur&scaron;ka procedura koja pomaže u re&scaron;avanju disfunkcije zgloba kuka i pokazala se efikasnom. Ova studija ima za cilj da istraži da li upotreba termomineralne vode može pobolj&scaron;ati oporavak funkcionalnih sposobnosti i pobolj&scaron;ati kvalitet života pacijenata koji su bili podvrgnuti artroplastici kuka.</span></span></p> <p class="MsoNoSpacing" style="line-height: 200%;"><span class="MsoHyperlink"><strong style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">Materijal i metode:</span></strong></span><span class="MsoHyperlink"><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;"> U studiju su uključeni pacijenti (n=100) koji su bili podvrgnuti artroplastici kuka i učestvovali u vežbama hidrokineze u bazenima sa termomineralnom vodom, pored konvencionalnog programa terapijske rehabilitacije na suvom. Evaluacija je uključivala procene opsega pokreta zgloba kuka i snage ključnih mi&scaron;ića pokretača zgloba kuka. Ispitanici su takođe ocenili uspeh protokola na osnovu parametra pobolj&scaron;anja kvaliteta života.</span></span></p> <p class="MsoNoSpacing" style="line-height: 200%;"><span class="MsoHyperlink"><strong style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">Rezultati:</span></strong></span><span class="MsoHyperlink"><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;"> Rezultati istraživanja su pokazali da je primena balneolo&scaron;kih sredstava sa specifičnog izvora termomineralne vode &bdquo;Banja Kanjiža&rdquo; značajno ubrzala oporavak funkcionalnih sposobnosti i pobolj&scaron;ala kvalitet života pacijenata koji su bili podvrgnuti operaciji artroplastike kuka.</span></span></p> <p class="MsoNoSpacing" style="line-height: 200%;"><span class="MsoHyperlink"><strong style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">Zaključak:</span></strong></span><span class="MsoHyperlink"><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;"> Da bi se dalje proverila efikasnost balneoterapije, neophodna su koordinirana multicentrična klinička ispitivanja i fundamentalna istraživanja. Takođe su važni uporni napori da se pro&scaron;ire prednosti prirodnih lekovitih sredstava, stručnost kvalifikovanih zdravstvenih stručnjaka i infrastruktura razvijenih spa centara za stanovnike i svetsko stanovni&scaron;tvo.</span></span></p> <p class="MsoNoSpacing" style="line-height: 200%;"><span class="MsoHyperlink"><strong style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">Ključne reči</span></strong></span><span class="MsoHyperlink"><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">: balneoterapija, artroplastika kuka, rehabilitacija</span></span></p> 2024-10-29T09:35:58+01:00 Sva prava zadržana (c) 2024 Medicinska istraživanja https://aseestant.ceon.rs/index.php/medi/article/view/54347 100 GODINA INSTITUTA ZA HEMIJU U MEDICINI MEDICINSKOG FAKULTETA UNIVERZITETA U BEOGRADU 2024-11-20T08:29:36+01:00 Kristina Gopčević kristinagopcevic@yahoo.com Vesna Vujić vesna.vujic@med.bg.ac.rs Nataša Avramović natasa.avramovic@med.bg.ac.rs Lidija Izrael Živković lidija.izrael-zivkovic@med.bg.ac.rs Ana Medić ana.medic@med.bg.ac.rs Teodora Đukić teodora.djukic@med.bg.ac.rs Zorana Lopandić zorana.lopandic@med.bg.ac.rs Danijela Krstić danijela.krstic@med.bg.ac.rs <p class="MsoNormal" style="margin-bottom: 0cm; line-height: 200%;"><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; font-family: 'Times New Roman',serif;">Institut za hemiju u medicini <a name="_Hlk180604462"></a>&ldquo;Prof. dr Petar Matavulj&rdquo;, jedan od najstarijih instituta Medicinskog fakulteta Univerziteta u Beogradu, osnovan je 1923. godine. Sagledavajući ulogu hemije u razumevanju medicinskih nauka, osnivači Medicinskog fakulteta angažovali su vodeće autoritete toga doba u oblasti hemije: Simu Lozanića, Milivoja Lozanića i Petra Matavulja, postaviv&scaron;i čvrste temelje za kvalitetnu edukaciju budućih lekara. Tokom vi&scaron;e od jednog veka, nastavnici i saradnici instituta uspe&scaron;no odgovaraju na specifične izazove u medicinskoj edukaciji, prilagođavajući se savremenim trendovima u nauci i obrazovanju.</span></p> <p class="MsoNormal" style="margin-bottom: 0cm; line-height: 200%;">&nbsp;</p> 2024-10-29T09:38:48+01:00 Sva prava zadržana (c) 2024 Medicinska istraživanja https://aseestant.ceon.rs/index.php/medi/article/view/54466 Appendix Vol. 57 Br. 4- Simpozijum ,,Stremljenja i novine u medicini“ 2024-11-20T08:29:36+01:00 Dragana Popović dragana.popovic@med.bg.ac.rs <p><!-- [if gte mso 9]><xml> <o:OfficeDocumentSettings> <o:AllowPNG/> </o:OfficeDocumentSettings> </xml><![endif]--><!-- [if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:TrackMoves/> <w:TrackFormatting/> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> 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Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Smart Link"/> </w:LatentStyles> </xml><![endif]--><!-- [if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:8.0pt; mso-para-margin-left:0cm; line-height:107%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri",sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} </style> <![endif]--></p> <p class="MsoNormal">Apstrakti radova sa tradicionalnog simpozijuma ,,Stremljenja i novine u medicini&rdquo; Medicinskog fakulteta u Beogradu koji se održava povodom Dana fakulteta 9. decembra.</p> <p class="MsoNormal">&nbsp;</p> 2024-10-30T12:22:49+01:00 Sva prava zadržana (c) 2024 Medicinska istraživanja https://aseestant.ceon.rs/index.php/medi/article/view/53290 OKSIDATIVNI STRESS I OPSTETRIČKE KOMPLIKACIJE KOD TRUDNICA SA NASLEDNOM TROMBOFILIJOM, SA I BEZ TERAPIJE HEPARINOM NISKE MOLEKULSKE TEŽINE 2024-11-20T08:29:36+01:00 Dragana Maglic dragana.maglic@gmail.com Vesna Mandic Markovic vesna.m.mandic@gmail.com Jelena Bogdanovic Pristov jelenabog@gmail.com Rastko Maglic rastko.maglic@gmail.com Olivera Dzatic Smiljkovic lola.dzatic.smiljkovic@gmail.com Radomir Anicic radomir.anicic@gmail.com Milica Mandic milica96mandic@gmail.com Jelena Mitrovic jelenavugdelic@gmail.com Sabrina Skrijelj skrijelj.sabrina@outlook.com <p class="MsoNormal" style="line-height: 200%;"><strong><span lang="EN-US">Uvod:</span></strong><span lang="EN-US"> Urođena trombofilija (UT) predstavlja stanje&nbsp; udruženo sa rizikom od duboke vaskularne tromboze (DVT) i obstetričkih komplikacija (OK) kao &scaron;to su preeklampsija (PE), zastoj u rastu ploda&nbsp; (IUZR), mrtvorođenost i abrupcija placente (PA). </span></p> <p class="MsoNormal" style="line-height: 200%;"><strong><span lang="EN-US">Cilj studije</span></strong><span lang="EN-US">: da se proceni učestalost OC i oksidativnog stresa (OS) kod žena sa IT tokom trudnoće sa i bez terapije niske molekulske težine (LMVH), u poređenju sa ženama sa zdravim trudnoćama.</span></p> <p class="MsoNormal" style="line-height: 200%;"><strong><span lang="EN-US">Metodologija</span></strong><span lang="EN-US">: U studiju je uključeno 60 trudnica sa UT dijagnostikovanom pre aktuelne trudnoće na osnovu prethodne DVT ili OK (ispitivana grupa) i 60 zdravih trudnica (kontrolna grupa). Kod svih ispitanica uzet je uzorak krvi pre porođaja, kao i uzorak placentnog tkiva I određena je aktivnost CAT, GPX, GH, SH, </span><span lang="EN-US">GR, CuZnSOD i MnSOD. </span></p> <p class="MsoNormal" style="line-height: 200%;"><strong><span lang="EN-US">Rezultati:</span></strong><span lang="EN-US"> Nakon uvođenja NMH u terapiju žena sa UT značajno je smanjen broj OK. Analizom povezanosti OK i različitih tipova UT, nađena je značajna povezanost samo </span><span lang="EN-US">između mutacije faktora <span style="background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;">V Leiden i deficit proteina C sa gestacijskom hipertenzijom/preeklampsijom. Nivo S</span>H je povi&scaron;en kod UT; CAT, GPH i GR pokazuju tri puta povi&scaron;enu aktivnost kod žena sa UT na terapiji NMH u poređenju sa kontrolnim grupom.</span></p> <p>&nbsp;</p> <p class="MsoNormal" style="line-height: 200%;"><strong><span lang="EN-US">Zaključak </span></strong><span lang="EN-US">Vrednosti parametara OS kod trudnica sa UT tokom porođaja mogu da potvrde prisustvo OS i ukažu na opravdanost primene antioksidativne terapije.&nbsp;</span></p> 2024-10-31T08:42:58+01:00 Sva prava zadržana (c) 2024 Medicinska istraživanja https://aseestant.ceon.rs/index.php/medi/article/view/52347 ERECTOR SPINAE PLANE BLOK KAO TRETMAN AKUTNOG BOLA NAKON MASTEKTOMIJE - ISKUSTVO JEDNOG CENTRA INSTITUTA ZA ONKOLOGIJU I RADIOLOGIJU SRBIJE 2024-11-20T08:29:36+01:00 Ana Cvetković anadjurdjic@yahoo.com <p><!-- [if gte mso 9]><xml> <o:OfficeDocumentSettings> <o:AllowPNG/> </o:OfficeDocumentSettings> </xml><![endif]--><!-- [if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> 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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="envelope return"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="footnote reference"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="annotation reference"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="line number"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="page number"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="endnote reference"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="endnote text"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="table of authorities"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="macro"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="toa heading"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Bullet"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Number"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List 5"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Bullet 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Bullet 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Bullet 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Bullet 5"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Number 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Number 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Number 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Number 5"/> <w:LsdException Locked="false" Priority="10" QFormat="true" Name="Title"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Closing"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Signature"/> <w:LsdException Locked="false" Priority="1" SemiHidden="true" UnhideWhenUsed="true" Name="Default Paragraph Font"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Body Text"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Body Text Indent"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="List Continue"/> <w:LsdException 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Name="Note Heading"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Body Text 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Body Text 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Body Text Indent 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Body Text Indent 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Block Text"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Hyperlink"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="FollowedHyperlink"/> <w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/> <w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Document Map"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Plain Text"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="E-mail Signature"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Top of Form"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Bottom of Form"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Normal (Web)"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Acronym"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Address"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Cite"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Code"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Definition"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Keyboard"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Preformatted"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Sample"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Typewriter"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="HTML Variable"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Normal Table"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="annotation subject"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="No List"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Outline List 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Outline List 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Outline List 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table 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Name="Table Grid 7"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 8"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table List 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table List 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table List 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table List 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table List 5"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table List 6"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table List 7"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table List 8"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table 3D effects 1"/> <w:LsdException Locked="false" 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Name="Balloon Text"/> <w:LsdException Locked="false" Priority="39" Name="Table Grid"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Theme"/> <w:LsdException Locked="false" SemiHidden="true" Name="Placeholder Text"/> <w:LsdException Locked="false" Priority="1" QFormat="true" Name="No Spacing"/> <w:LsdException Locked="false" Priority="60" Name="Light Shading"/> <w:LsdException Locked="false" Priority="61" Name="Light List"/> <w:LsdException Locked="false" Priority="62" Name="Light Grid"/> <w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/> <w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/> <w:LsdException Locked="false" Priority="65" Name="Medium List 1"/> <w:LsdException Locked="false" Priority="66" Name="Medium List 2"/> <w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/> <w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/> <w:LsdException Locked="false" Priority="70" Name="Dark List"/> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/> <w:LsdException Locked="false" Priority="72" Name="Colorful List"/> <w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/> <w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/> <w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/> <w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 1"/> <w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 1"/> <w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 1"/> <w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/> <w:LsdException Locked="false" SemiHidden="true" Name="Revision"/> <w:LsdException Locked="false" QFormat="true" Name="List Paragraph"/> <w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/> <w:LsdException Locked="false" Priority="30" QFormat="true" Name="Intense Quote"/> <w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/> <w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 1"/> <w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 1"/> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 1"/> <w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 1"/> <w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/> <w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 1"/> <w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 2"/> <w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/> <w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 2"/> <w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 2"/> <w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 2"/> <w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 2"/> <w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 2"/> <w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 2"/> <w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 2"/> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 2"/> <w:LsdException Locked="false" Priority="70" Name="Dark List Accent 2"/> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 2"/> <w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 2"/> <w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/> <w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/> <w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/> <w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/> <w:LsdException 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Name="Grid Table 5 Dark Accent 1"/> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful Accent 1"/> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful Accent 1"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 2"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful Accent 2"/> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful Accent 2"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 3"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/> 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mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi; mso-font-kerning:1.0pt; mso-ligatures:standardcontextual; mso-fareast-language:EN-US;} </style> <![endif]--></p> <p class="MsoNormal" style="line-height: 250%;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 250%; font-family: 'Times New Roman',serif; mso-fareast-font-family: Calibri;">Uvod</span></strong><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 250%; font-family: 'Times New Roman',serif; mso-fareast-font-family: Calibri;">: Najče&scaron;ća onkolo&scaron;ka operacija u ženskoj populaciji je operacija raka dojke, u skladu sa visokom inidencom istog.<span style="mso-spacerun: yes;">&nbsp; </span>Različiti intenziteti postoperativnog bola obično prate mastektomiju sa disekcijom aksile. <em style="mso-bidi-font-style: normal;">Erector spinae plane</em> (ESP) kao alternativni blok, je interfascijalni blok, novodefinisana tehnika regionalne anestezije za analgeziju zida grudnog ko&scaron;a. </span></p> <p class="MsoNormal" style="line-height: 250%;"><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 250%; font-family: 'Times New Roman',serif; mso-fareast-font-family: Calibri;">U ovoj retrospektivnoj studiji, koja uključuje žene predložene za mastektomiju sa disekijom aksile na Institutu za onkologiju i radiologiju Srbije, ispitujemo efekte ESP bloka na neposredan postoperativni bol.</span></p> <p class="MsoNormal" style="line-height: 250%;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 250%; font-family: 'Times New Roman',serif; mso-fareast-font-family: Calibri;">Metodologija</span></strong><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 250%; font-family: 'Times New Roman',serif; mso-fareast-font-family: Calibri;">:<span style="mso-spacerun: yes;">&nbsp; </span>Ovom studijom obuhvaćeno je 25 pacijentkinja sa karcinomom dojke indikovanih za unilateralnu mastektomiju sa disekcijom aksile, koje su primile ESP blok uz op&scaron;tu anesteziju u na&scaron;em centru u periodu od 18.01.2023. do 01.05.2023.</span></p> <p class="MsoNormal" style="line-height: 250%;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 250%; font-family: 'Times New Roman',serif; mso-fareast-font-family: Calibri;">Rezultati:</span></strong><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 250%; font-family: 'Times New Roman',serif; mso-fareast-font-family: Calibri;"> Prosečna starost pacijentkinja bila je 56,8 godina. Kod svih pacijentkinja ASA skor bio je 2. Prosečna srčana frekvencija bila je 72,08 otkucaja / minuti i do&scaron;lo je do pada vrednosti na 65,32 otkucaja / minuti u intraoperativnom periodu. Incidencija bola bila je najvi&scaron;a u dvanaestom satu, bol je bio prisutan kod 64% pacijentkinja sa srednjim skorom Numeričke skale bola (NSB) od 2,36. Potreba za <span style="mso-bidi-font-style: italic;">dodatnom</span> analgezijom bila je značajno veća do dvanaestog sata, dok smo u dvadesetčetvrtom satu registrovali da je značajno manji broj pacijentkinja primio dodatnu analgeziju.</span></p> <p class="MsoNormal" style="line-height: 250%;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 250%; font-family: 'Times New Roman',serif; mso-fareast-font-family: Calibri;">Zaključak:</span></strong><span style="font-size: 12.0pt; mso-bidi-font-size: 11.0pt; line-height: 250%; font-family: 'Times New Roman',serif; mso-fareast-font-family: Calibri;"> Na&scaron;i rezultati su pokazali da su pacijentkinje iz ispitivane grupe,<span style="mso-spacerun: yes;">&nbsp; </span>koje su primile ESP blok uz standardni protokol, <span style="mso-spacerun: yes;">&nbsp;</span>imale dobru kontrolu postoperativnog bola, na &scaron;ta ukazuju niži NSB skorovi i niže stope incidencije postoperativne mučnine i povraćanja.</span></p> <p class="MsoNormal" style="line-height: 250%;">&nbsp;</p> 2024-11-05T08:33:25+01:00 Sva prava zadržana (c) 2024 Medicinska istraživanja