Sanamed

RISK FACTORS FOR POTENTIAL DRUG-DRUG INTERACTIONS OF ANALGESICS IN HOSPITALIZED UROLOGICAL PATIENTS

Ivan Milovanović, Ana Pejčić, Zoran Kovačević, Katarina Janićijević — Mon, 26 Jan 2026 11:22:13 +0100

Objective: To evaluate potential drug–drug interactions (pDDIs) involving analgesics in hospitalized urological patients and identify risk factors influencing their number.

Methods: This study involved a post hoc analysis based on data obtained from a retrospective observational cohort clinical study conducted at the Clinic of Urology, University Clinical Centre Kragujevac, Serbia. Of the original 220 patients, 191 who received analgesics were included. Daily pharmacotherapy data, along with demographic and clinical characteristics, were collected, while pDDIs were identified and classified using the Lexicomp Interaction Checker. Descriptive statistics were used to summarize the data. Multiple linear regression with backward elimination was used to identify independent predictors of the number of pDDIs.

Results: Analgesic-related pDDIs were detected in 175 patients (91.6%). Non-steroidal anti-inflammatory drugs (NSAIDs) were prescribed to 173 patients (90.6%), opioids to 53 (27.7%), and paracetamol to 54 (28.3%). The mean number of pDDIs per patient was 5.5 ± 5.5 (range 0–30). Category X interactions most frequently included NSAID combinations (diclofenac + ketorolac, ketorolac + metamizole), while category D interactions frequently involved enoxaparin + ketorolac and opioid–benzodiazepine pairs. Category C interactions were dominated by NSAID + potassium chloride and tramadol + ondansetron or atropine combinations. Multiple regression analysis identified diabetes, a higher number of prescribed drugs, and the use of NSAIDs or opioids as positive predictors of the number of pDDIs, whereas a cancer diagnosis was associated with a lower number.

Conclusion: Analgesic-related pDDIs affect the majority of hospitalized urological patients. Avoiding high-risk combinations, close monitoring, and multidisciplinary medication review in patients with risk factors may help reduce preventable harm.

HÜRTHLE-CELL CARCINOMA OF THE THYROID: CLINICOPATHOLOGIC FEATURES AND SURGICAL OUTCOMES AT A SINGLE INSTITUTION

Muhammad Memon — Mon, 16 Feb 2026 14:38:24 +0100

Background: Hürthle cell carcinoma (HCC) is a rare differentiated thyroid malignancy with variable biological behavior. This study evaluates clinicopathologic features, treatment patterns, and long-term outcomes in patients managed at a single tertiary institution.

Methods: We retrospectively reviewed medical records of patients with histologically confirmed HCC between January 2005 and December 2020. Demographics, tumor characteristics, surgical treatment, adjuvant radioactive iodine (RAI) therapy, recurrence, and survival were analyzed. Outcomes were compared with reported retrospective series and discussed in the context of current ATA guidelines.

Results: Forty-eight patients were identified (mean age, 58.7 ± 11.4 years; female-to-male ratio, 2.2:1). Mean tumor size was 38.5 ± 14.2 mm. Minimally invasive disease was present in 29 patients (60.4%), and widely invasive disease in 19 (39.6%). Total thyroidectomy was performed in 36 patients (75%), and lobectomy in 12 (25%). RAI therapy was administered to 30 patients (62.5%), predominantly in widely invasive cases. Median follow-up was 104 months (range, 24–192 months). Recurrence occurred in 8 patients (16.7%), with a median time to relapse of 78 months. Five- and ten-year overall survival (OS) rates were 91.3% and 81.5%, respectively. Disease-specific survival (DSS) was 95.6% at 5 years and 90.2% at 10 years. Ten-year disease-free survival (DFS) was 82.1%.

Conclusions: Our results support existing evidence that minimally invasive HCC carries an excellent prognosis, while widely invasive tumors have a higher risk of recurrence. Long-term follow-up is essential, given the potential for late recurrence. These findings are consistent with current ATA guidelines recommending risk-tailored treatment and surveillance strategies.

ASSOCIATION OF THE TP53 PIN3 16-BP DUPLICATION POLYMORPHISM WITH ORAL SQUAMOUS CELL CARCINOMA RISK AND PROGNOSIS

Marija Antunović — Fri, 20 Feb 2026 17:10:11 +0100

Background/Aim: Oral squamous cell carcinoma (OSCC) is associated with multiple risk factors, including genetic variations such as the TP53 PIN3 16-bp duplication polymorphism. This study aimed to assess the association between this polymorphism and susceptibility to OSCC in the Montenegrin population and to evaluate its influence on OSCC prognosis and progression.

Materials and Methods: Genomic DNA extracted from 60 patients with OSCC and 71 cancer-free controls was analyzed using the polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) technique to identify TP53 PIN3 genotypes and allele frequencies. Clinical and pathological data, along with three-year follow-up outcomes, were also analyzed.

Results: During the follow-up period, 12 patients (20%) experienced local recurrence of disease and 6 patients (10%) developed regional metastases, with no distant metastases detected. No significant associations were observed between the PIN3 16-bp duplication polymorphism and patient age, tumor site, grade, disease recurrence, or metastasis (p > 0.05). A significant association between TP53 genotypes and advanced stage of disease was found (p = 0.006). There were no significant differences in disease-free survival among genotypes: A1A1 (28.26 ± 1.70 months), A1A2 (35.00 ± 0.94 months), and A2A2 (30.00 ± 5.20 months) (p = 0.38). Additionally, no significant differences in allele or genotype frequencies between patients and controls were observed (p > 0.05).

Conclusion. The TP53 PIN3 16-bp duplication polymorphism cannot be considered a risk factor for OSCC development in the Montenegrin population. Furthermore, this polymorphism does not modulate susceptibility to OSCC progression.

POST-LAPAROSCOPIC SHOULDER PAIN: A NARRATIVE REVIEW OF A FREQUENT POSTOPERATIVE SEQUELA

Sajad Ahmad Salati, Saleh AlSuwaydani — Fri, 20 Feb 2026 17:09:09 +0100

While the adoption of laparoscopic surgery has enhanced patient safety, comfort, and satisfaction, a considerable number of patients experience post-laparoscopic shoulder pain (PLSP), which can slow recovery. The English-language literature was reviewed after searching major academic databases and engines, including PubMed, Google Scholar, ResearchGate, and Web of Science, to summarize the current understanding of the etiopathogenesis, associated risk factors, and management strategies for post-laparoscopic shoulder pain. The precise etiology remains undefined, and several theories have been proposed to explain PLSP. The most widely accepted theory suggests that PLSP is a form of referred pain caused by diaphragmatic irritation due to stretching from pneumoperitoneum or the presence of residual gases and fluids. Currently, there are no universally accepted protocols for either the prevention or treatment of PLSP; consequently, a wide range of modalities are applied based on the surgeon’s expertise and preference. There is a clear need to improve awareness of this condition to enable the standardization of management options, thereby optimizing patient outcomes.