Medical Journal of Montenegro

Inflammation in pathogenesis of abdominal aortic aneurysm

Janja Raonić, Vesna Lačković, Božina Radević, Nikola Fatić, Nemanja Radojević — Sat, 12 Dec 2015 10:15:45 +0100

INTRODUCTION: Abdominal aortic aneurysm (AAA) is one of the most significant vascular diseases. The most frequent are atherosclerotic AAAs. Atherosclerosis has traditionally been considered a central process in the AAA pathogenesis. Contemporary researchs point to the disadvantages of the traditional theory.

OBJECTIVE: To determine the presence of inflammation and evaluate its significance in AAA pathogenesis.

METHODS: In this retrospective histopathological case-control study, 30 atherosclerotic AAAs and 30 tissue samples of the atherosclerotic abdominal aorta were examined. Routine H/E and immunohistochemical (CD45 and CD68) stainings were performed. The morphometric analysis was performed on 10 microscopic fields at the 400 times magnification. The result is expressed as cell density (number of cells/mm2).

RESULTS: Extensive inflammatory infiltrate is present in the entire AAA wall. The inflammatory infiltrate consists predominantly of CD45 immunoreactive cells, that sometimes form tertiary lymphoid organs. Density of inflammatory cells is significantly higher in AAA samples.

DISCUSSION: Far extensive inflammation in AAA wall and the fact that only 9-16% of people with aortic atherosclerosis develop AAA are some of the arguments which confirm that traditional theory is untrue.Inflammatory infiltrate mostly constitute T and B lymphocytes, but also plasmocytes, dendritic and NK cells.Inflammatory infiltrate produces different types of leukotrienes, cytokines, imunoglobline and proteases, causing degradation of the vascular wall. The trigger of inflammation remains unknown.

CONCLUSION: Significantly higher density of the inflammatory infiltrate in the AAA samples, proves that atherosclerosis is not the only process that damages the vascular wall and leads to the formation of the aneurysms.

Keywords: AAA, inflammation

The influences of antipsychotics therapy at cognitive impairments in schizophrenia spectrum disorders

Jovo Đedović — Sat, 05 Dec 2015 14:20:16 +0100

Significant degree of cognitive impairment represents one of the basic cornerstones among clinical manifestations of the schizophrenia spectrum psychotic disorders and accordingly to some authors it is present in up to 75% patients with these psychopathological syndromes.

The aim of this study was to exam degree of cognitive impairment, firstly among patients on first generation antipsychotics therapy (FGA) compared to the patients on second generation antipsychotics therapy (SGA), and secondly to compare both groups of patients with healthy controls.

Material and methods: Prospective, parallel research was conducted, in which the sample of patients and employees of Specialized Psychiatric Hospital Kotor was tested with Montreal Cognition Scale (MoCA). There were 66 participants in the sample and they were divided on four subgroups: 1. Patients with FGA therapy; 2. Patients with SGA therapy; 3 Patients with combined FGA and SGA therapy; 4 Healthy controls.

Results: All three groups of patients had statistically significantly lower mean MoCA scores in the comparison with healthy controls. The fact that among 83.7% of patients was diagnosed significant degree of cognitive decline (MoCA score bellow 26) strongly speaks in favor of high sensitivity of MoCA test in detection of cognitive impairment among patients with schizophrenia spectrum psychotic disorders. In addition, the group of patients with FGA therapy also had statistically significantly lower mean MoCA score compared to patients with SGA therapy

Discussion: The mechanisms of explanation of these results can be additionally enlightened with further studies on larger samples of patients, which would investigate the correlation between extrapyramidal symptomatology, anticholinergic therapy and cognitive deficit.

Key words: Schizophrenia, cognitive impairments, antipsychotics therapy.

Impact of atrial fibrillation on the prognosis of patients with ischemic stroke

Mirha S Hasanbegović — Thu, 10 Dec 2015 18:41:50 +0100

Introduction: Atrial fibrillation is among main risk factors for ischemic stroke. Its prevalence increases progressively with age.

Material and methods: Retrospective study was conducted on 778 patients hospitalized for stroke in period from January 2004 to January 2014 on Internal medicine Department of General hospital Pljevlja.

RESULTS: During ten years opservational period, 637 (81,9%) out of 778 patients had ischemic stroke. Average age in this patient group was 72,68 ± 9,075, range from 38 to 101. Patients above than 65 years had stroke in higher percent (84%) in comparison to younger group (74,4%). Chi square test showed statistical significant correlation between age and ischemic stroke (p꞊0,004; p˂0,05). Strength of influence was Fi꞊0,103.

Patients older than 65 years had AF in higher rate (23,3%) compared to those younger than 65 (12,8%). Mean age of patients with AF was statistically higher compared to those without AF (p꞊0,003; p˂0,05; Fi꞊-0,107). Total 174 patients died before discharge. Chi square test of independance showed statistically significant correlation between AF and lethal outcome (p꞊0,015; p˂0,05). Lethal outcome of patients with AF was of higher rate (29,4%) compared to those without AF (20,5%), strength of influence was Fi꞊ -0,088.

Conclusion: Patients with stroke associated with AF are at high risk of having lethal outcome. Primary prevention regarding AF recognition and adecquate treatment play key role in inhibiting stroke occurrence as its complication.

The importance of oral health behavior of children for their oral health

Ivana Andjelic, Snezana Matijevic, Jasminka Andjelic — Sun, 06 Dec 2015 13:26:47 +0100

Introduction. Health culture is an integral part of generalculture and health education plays an important role in maintaining health of individuals.

Aim.The main objective of this study is to determine the influence of oral health behavior of schoolchildren aged 12 to 14 on their oral health.

Method.The survey was conducted during the period from the end of January to April 2015 at Drago Milovic Elementary School in Tivat. The survey instrument was a questionnaire and it consisted of 36 closed-ended questions. Assessment of oral health was carried out under natural light with dental mirror and probe according to WHO recommendations. The parameter used to assess the state of oral health was DMFTindex. In addition, the assessment of oral hygiene was conducted using soft debris index according to Green-Vermillion.

Results.The majority of students stated that they lack knowledge regarding the effectiveness of fluoride toothpaste (69.4%).It was found that the lowest incidence of caries occurred among those students who think that teeth should be brushed after every meal, and the highest incidence of this diagnosis occurred in respondents who think that teeth should be brushed once a day. DMFTindex for study population was 1.87 while Green-Vermillion soft debris score of oral hygiene was 2 in largest number of students(49.5%).Conclusion.Looking at the results it can be concluded that dental care in this area does not significantly affect the improvement of oral health in children.

Key words: students, oral health, health education, DMFTindex, Green-Vermillion index

Low dose CT in detection of lung cancer –preliminary raport

Dijana Račeta-Mašić, Goran Nikolić — Mon, 07 Dec 2015 17:12:52 +0100

Lung cancer is the most common cause of cancer death worldwide. Every year in the world more people dies from lung cancer. Approximately 300 people in the Montenegro are diagnosed with lung cancer each year . Success in the treatment can be achieved by implementing screening programs.

From November 2013 through November 2014, a total of 120 asymptomatic men and women older than 50 with at least a 20 pack-year history of smoking were randomly assigned to undergo LDCT lung cancer screening. In 26% (32 individuals), one or more pulmonary nodules were detected. In our study low dose CT found asymptomatic lung cancer in 3.3% of scanned patients at one year into our study. We ordered biopsy for four nodules with malignant characteristic The rest of the nodules showed no enlargement during a follow-up period of 24 months and were presumed non-malignant.

In conclusion, in the current study, low-dose spiral CT was feasible for depicting small lung cancers by using a simple algorithm based on the size and attenuation of detected nodules to guide invasive procedures.

Prevalence and determinants of tobacco use among youth

Maja Raičević — Thu, 10 Dec 2015 18:49:26 +0100

Introduction: The beginning of tobacco use is connected with adolescense and it presents the way how young people try to be accepted by their peers and to demonstrate their autonomy.

Aim: This study was designed to determine the frequency of tobacco use among youth, but also the impact of their knowledge and attitudes about smoking, as well as the determinants that affect individual smoking status.

Materials and Methods: The study was conducted between December 2014 and March 2015 and 601 first grade students of two high schools in Podgorica were included.

Results: The study showed that among respondents 9,2% are current cigarette smokers. To smoke cigarettes once in life, even a puff, has tried 37,9% of respondents. That they will certainly or probably try tobacco product if their friends offer them in future, said 7,9% of adolescents that are current non-smokers who took part in this study. The association between smoking status of students and the education based on the harmful effects of tobacco use is statistically significant, as is the case with smoking status of parents or friends, and smoking status of a young person.

Conclusion: Among the first grade students of secondary schools in Podgorica almost every tenth student is a smoker, while almost two out of five students at one time in their life tried to smoke a cigarette and pulled at least one smoke. Factors identified as those affecting the smoking status of the individual are the level of knowledge about the harmful effects of tobacco use, smoking status of parents but also the number of smokers among the closest friends of an adolescent.

Key words: smoking, adolescents, Montenegro, social factors