Vojnosanitetski pregled

Characteristics of human immunodeficiency virus-1 influencing the development and efficacy of anti-HIV-1 vaccines

2024-12-26T11:48:41+01:00

Changing panorama in risk factors of cerebral palsy

2024-12-26T11:48:41+01:00

Background/Aim. The etiology of cerebral palsy (CP) is multifactorial and not yet fully understood. The aim of this study was to determine the changes in CP etiological factors over the past 30 years. Methods. A retrospective study analyzed a database of 296 individuals with CP. Risk factors (RFs) were divided into preconception, antenatal, intrapartum, and neonatal. Patients on the register were divided into three cohorts: those born before 2000, the ones born between 2000 and 2010, and those born after 2010. The changes in CP RFs were investigated at ten-year intervals. Results. The five RFs with the highest total frequency were low birth weight (46.62%), prematurity (44.25%), advanced maternal age – over 35 years (37.16%), emergency cesarean section (33.78%), and birth asphyxia (25.33%). The consanguineous marriage rate was 22.29%. Conclusion. Low birth weight and prematurity rates, which are the most frequently identified RFs, are gradually increasing. The rate of birth asphyxia has decreased in the last ten years. The rate of advanced maternal age is increasing, and consanguineous marriage is still an important RF in Turkey.

Risk factors and preventive measures for abnormal blood pressure during hemodialysis filtration for patients with sepsis

2024-12-26T11:48:42+01:00

Background/Aim. Hemodialysis filtration (HDF) plays an extremely important role in treating patients with sepsis and subsequent acute renal failure. However, abnormal blood pressure (ABP) during HDF badly influences the prognosis and increases all-cause mortality in patients with sepsis. The aim of the study was to investigate risk factors and preventive measures of ABP during HDF for patients with sepsis. Methods. A total of 145 patients with sepsis undergoing HDF were included in this study, and they were divided into two groups: the normal blood pressure (NBP) group (n = 89) and the ABP group (n = 56). Their clinical data were collected, and the independent influencing factors for ABP during HDF were assessed by univariate and multivariate logistic regression analyses. A nomogram model for prediction was constructed based on the results of multivariate analysis, and its discrimination and consistency were assessed using receiver operating characteristic and calibration curves. The Kaplan-Meier method was used to plot the survival curve to evaluate the prognosis 28 days after HDF. Results. Multivariate logistic regression analysis revealed that age, blood calcium, fasting plasma glucose, intact parathyroid hormone, ultrafiltration volume, and ultrafiltration rate were independent risk factors, whereas albumin was a protective factor for ABP during HDF (p < 0.05). The nomogram model exhibited a good fitting effect, with high discrimination and accuracy. Kaplan-Meier survival analysis showed that the NBP group had a significantly higher 28-day survival rate than that of ABP (88.76% vs. 73.21%) (p < 0.05). Conclusion. The constructed risk model is suitable for identifying high-risk groups and provides a reference for effective prevention and treatment, to lower the incidence rate of ABP and improve the prognosis.

A multidisciplinary collaborative care model involving family members in the treatment of type 2 diabetes mellitus and associated diabetes distress in young and middle-aged patients

2024-12-26T11:48:42+01:00

Background/Aim. Diabetes mellitus (DM) represents a significant and enduring health concern and, due to various complications arising from inadequate management, leads to disability and mortality. The aim of this study was to examine the impact of the family-engaged multidisciplinary collaborative care (FEC) model on the management of type 2 DM (T2DM) in young and middle-aged patients, considering the presence of DM distress. Methods. The study included 98 patients aged 18 to 59 diagnosed with T2DM and experiencing DM distress. The patients were admitted to the Department of Endocrinology of The First People’s Hospital of Jingzhou, in Hubei province, China, between February and December 2023. Using the random number table method, the patients were randomly assigned to either the intervention group (IG) or control group (CG), each consisting of 49 patients. While both groups received standard care, IG additionally received FEC. We assessed and compared glycated hemoglobin (HbA1c) levels, Diabetes Distress Scale (DDS) scores, Summary of Diabetes Self-care Activities (SDSCA) scores, and body mass index (BMI) between the two groups before the intervention and three months after. Results. Three months post-intervention, IG exhibited lower HbA1c levels (6.02 ± 0.63 vs. 6.81 ± 0.85) and DDS scores (25.27 ± 2.70 vs. 34.24 ± 4.46) while demonstrating higher SDSCA scores (30.69 ± 1.91 vs. 25.03 ± 2.13) compared to CG. Additionally, the BMI of patients in IG measured 23.83 ± 2.51 kg/m², which, compared to the BMI of CG (25.64 ± 3.68 kg/m²), was statistically significant (p < 0.05). Conclusion. The FEC model demonstrated efficacy in lowering HbA1c levels and BMI, mitigating DM distress, and enhancing self-care capabilities among young and middle-aged patients with T2DM experiencing DM-related distress.

Risk factors for ischemic osteonecrosis of the femoral head after internal fixation with multiple cannulated screws for Pauwels type III femoral neck fracture

2024-12-26T11:48:43+01:00

Background/Aim. Numerous factors lead to hip fractures that are common and often devastating in the geriatric population. The aim of the study was to determine the risk factors for ischemic osteonecrosis of the femoral head (ONFH) in patients after internal fixation with multiple cannulated screws for Pauwels type III femoral neck fracture (FNF). Methods. A total of 212 patients with Pauwels type III FNF, who underwent internal fixation with multiple cannulated screws from January 2019 to September 2022 and received one-year follow-up after surgery, were selected. Based on their clinical data and the incidence of ONFH, they were divided into two groups: the group with ischemic ONFH occurrence (n = 30) and the ischemic ONFH non-occurrence group (n = 182). Logistic regression analysis was conducted to analyze the risk factors for postoperative ischemic ONFH. Results. Age, body mass index (BMI), time from injury to surgery, partial weight bearing (PWB) time after surgery, and preoperative diabetes mellitus (DM) were significantly different between the ischemic ONFH occurrence and ischemic ONFH non-occurrence groups (p < 0.05), while other clinical data showed no significant differences (p > 0.05). The results of logistic regression analysis revealed that age (> 55 years), PWB time after surgery (≤ 3 months), BMI (≥ 24 kg/m²), time from injury to surgery (> 2 days), and preoperative DM were independent risk factors for postoperative ischemic ONFH (p < 0.05). Conclusion. The incidence of postoperative ischemic ONFH can be prevented by effectively controlling the following factors: age, BMI, PWB after surgery, and preoperative DM.

COVID-19 pandemic and vaccination rate in patients with psoriasis treated with biologics: a single center experience

2024-12-26T11:48:43+01:00

Introduction: Psoriasis is a chronic, immune-mediated, genetically determined disease, presented with erythematous scaly plaques. Treatment includes conventional therapies and biologics. Coronavirus disease 2019 (COVID-19) raised widespread concern about the treatment of psoriasis, with immunosuppressive drugs, especially biologics. Even though there was no data on the efficacy and safety of COVID-19 vaccines in patients with psoriasis treated with biologics, the National Psoriasis Foundation recommends their use in these patients.
Aim: The aim of this study was to evaluate the effect of vaccination and COVID-19 infection in patients with psoriasis treated by biologics and disease state.
Materials and methods: A retrospective cohort study was conducted at the Clinic of Dermatovenereology, University Clinical Center of Serbia (UCCS) during the COVID-19 pandemic. Data was collected from medical documentation, all stored in the computer database – Heliant during the consecutive hospitalization of patients with psoriasis who received biologics. Results: A total of 181 patients with psoriasis were treated with two biologics (ustekinumab 61% and secukinumab 37%) and achieved significant improvement of psoriasis severity (PASI before 14.1 (0-50.5) and after 1.2 (0-49.7), p<0.001) and quality of life (DLQI before 15.0 (0-34) and after 0 (0-28)). Vaccine against COVID-19 infection received 53%, but only 20.4% received three doses. COVID-19 infection was reported in 34.5% of all patients, but 68% of them got infected before getting vaccinated. Therapy with biologics was delayed due to COVID-19 infection in 29% and 21% of them had exacerbation of psoriasis.
Conclusion: Vaccination rate in patients with psoriasis receiving biologics was hardly 50%, and about a third of the patients had milder form of COVID-19 infection. The therapy with biologics was successful in patients with psoriasis, regardless of the interruption and worsening of the main disease in some patients due to COVID-19 infection for a short period.

Re-evaluation of the psychometric properties of the Serbian version of the Primary Sjögren’s Syndrome Quality of Life questionnaire

2024-12-26T11:48:44+01:00