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Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]-->Uvod/Cilj. Aneurizme visceralnih arterija (visceral artery aneurysms – VAAs) su retka, ali po život potencijalno opasna stanja. Sa porastom dostupnih dijagnostičkih i terapijskih mogućnosti, raste potreba za određivanjem optimalnog terapijskog pristupa–endovaskularna (EV) rekonstrukcija vs. otvorena hirurška (open surgery – OS) rekonstrukcija. Cilj rada bio je da se analiziraju ishodi lečenja obolelih od VAA u jednom centru i uporedi efikasnost EV i OS pristupa. Metode. Istraživanjem je obuhvaćeno 27 OS (OS grupa) ili EV (EV grupa) intervencija za VAA, sprovedenih u našoj ustanovi od januara 2010. do novembra 2023. godine, kod 27 bolesnika, 13 muškog i 14 ženskog pola prosečne starosti 57 ± 13 godina. Odluke o lečenju donosio je multidisciplinarni tim, koji su činili vaskularni hirurg, anesteziolog i interventni radiolog. Rezultati. Od ukupno 27 bolesnika, 9 je zbrinuto kao hitni slučajevi, od kojih je 6 imalo rupturu aneurizme. Najčešća je bila aneurizma slezinske arterije, 50,0% svih VAAs. Trinaest bolesnika podvrgnuto je EV rekonstrukciji, hibridnom pristupu 1 bolesnik, a OS rekonstrukciji 13 bolesnika. Tehnički uspeh bio je 24/27 ili 88,9%. Embolizacijom spiralama lečeno je 11 bolesnika, dok su 2 bolesnika lečena ugradnjom pokrivenog stenta. U grupi bolesnika lečenih EV putem nije bilo smrntih ishoda. Kod 14 bolesnika urađeno je OS hirurško lečenje sa 9 VAA resekcija i arterijskih rekonstrukcija (7 Dacron graftom, 1 politetrafluoroetilen graftom i 1 autovenskim graftom), uz 2 splenektomije i 3 isključenja aneurizme. Usled jakog krvarenja, 2 bolesnika su preminula tokom operacije, a jedan posle zahvata zbog crevnih ishemijskih komplikacija. Prosečno trajanje hospitalizacije posle OS ili EV procedure iznosilo je 7,43 i 4,92 dana, redom. Zaključak. Lečenje EV pristupom je bezbedno, sa manje invazivnosti i kraćim boravkom u bolnici i pogodno je za elektivne i hitne slučajeve, kada je to tehnički izvodljivo. Primena OS pristupa ostaje pouzdana mogućnost u centrima sa velikim brojem operacija, posebno za složene slučajeve koji nisu pogodni za EV pristup ili kod bolesnika sa niskim rizikom. Odluka o lečenju treba da bude vođena karakteristikama VAA (veličina, simptomi, lokacija, morfologija), komorbiditetima bolesnika i specifičnim kliničkim kontekstom, poput prethodnih abdominalnih operacija.
Aktinomikoza pluća – dijagnostička dilema
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Name="List Table 3 Accent 3"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 3"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 3"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 4"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 4"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 4"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 4"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 4"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 5"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 6"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]-->Uvod. Aktinomikoza pluća je hronična zapaljenska infektivna bolest koju izaziva anaerobna i/ili mikroaerofilna bakterija iz roda Actinomyces spp. Izaziva nespecifične simptome kod bolesnika i daje atipičnu kliničku i radiografsku sliku. Veoma je retka i karakteriše je stvaranje apscesa i fistula u plućima, ili lokalna fibroza. U diferencijalnoj dijagnozi moraju se razmotriti bolesti i patološka stanja od tuberkuloze pluća do neoplastičnog procesa u plućima. Prikaz bolesnika. Predstavljamo 39-godišnjeg bolesnika sa infiltrativnom promenom u gornjem delu desnog plućnog krila i nespecifičnim simptomima. Kod ovog bolesnika, aktinomikoza je patohistološki dokazana posle hirurške intervencije. U periodu od nešto više od mesec dana, dva puta su urađene multidetektorska kompjuterizovana tomografija grudnog koša i bronhoskopija sa transbronhijalnom biopsijom i bronhijalnim brisom. U početku se nije sumnjalo na aktinomikozu pluća. Nakon atipične resekcije tumorske mase u gornjem delu desnog plućnog krila i histopatološki dokazane infekcije, bolesnik je lečen antibiotskom terapijom u trajanju od 6 meseci. Sprovedena su dalja ispitivanja da bi se potvrdila moguća primarna ili sekundarna imunodeficijencija. Zaključak. Kod bolesnika sa nespecifičnim promenama u plućnom parenhimu treba sumnjati i na aktinomikozu, a nakon dijagnoze potrebno je dopuniti ispitivanje kako bi se potvrdila ili isključila imunodeficijencija.
Komparativna studija efikasnosti Isobar TTL i Isobar EVO sistema u lečenju lumbalnih degenerativnih bolesti i njihovog uticaja na degeneraciju susednih segmenata
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<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 6"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]--> Uvod/Cilj. Lumbalne degenerativne bolesti (lumbar degenerative diseases – LDD) su bolesti koje nastaju usled normalnog starenja i degeneracije lumbalne kičme. Pored konzervativnih terapija, hirurške procedure postaju neophodne da bi se postigli zadovoljavajući klinički ishodi. Cilj rada bio je da se proceni efikasnost Isobar TTL i Isobar Evolution (EVO) sistema dinamičke unutrašnje stabilizacije u lečenju LDD, kao i njihov uticaj na degeneraciju susednog segmenta. Metode. Istraživanje je obuhvatilo 78 obolelih od LDD, lečenih primenom sistema unutrašnje dinamičke stabilizacije Isobar TTL ili Isobar EVO. Bolesnici su bili podeljeni u dve grupe: TTL (n = 40) i EVO (n = 38). Procena bola pomoću skorova vizuelne analogne skale (VAS) i Oswestry Disability Index (ODI), kao i procena efikasnosti prema modifikovanim MacNab kriterijumima sprovedeni su preoperativno, 1 i 3 meseca postoperativno, kao i na završnom kontrolnom pregledu. Preoperativno i nakon poslednjeg kontrolnog pregleda mereni su obim pokreta (range of motion – ROM) i odnos intervertebralnog prostora (intervertebral space ratio – IVSR). Rezultati. Za skoro dve godine 37 bolesnika iz TTL grupe i 33 iz EVO grupe završila su sve kontrolne preglede. Nakon operacije, skorovi VAS i ODI u obe grupe značajno su se poboljšali u poređenju sa preoperativnim vrednostima (p < 0,05). Hirurška efikasnost u TTL i EVO grupama ocenjena je korišćenjem modifikovanih MacNab kriterijuma kao odlična ili dobra (91,89% i 93,94%, redom). Preoperativne vrednosti ROM i IVSR nisu se razlikovale između grupa (p > 0,05). Na poslednjem kontrolnom pregledu EVO grupa imala je značajno veći ROM nego TTL grupa (4,46 ± 1,19° vs. 2,58 ± 0,71°; p < 0,05), a ROM susednih segmenata u TTL grupi bio je značajno veći nego u EVO grupi (6,74 ± 1,55° vs. 5,83 ± 1,32°; p < 0,05). IVSR operisanih i okolnih segmenata nije se značajno promenio od preoperativnog do poslednjeg kontrolnog pregleda (p > 0,05). Takođe, nije bilo značajne razlike u IVSR između dve grupe za operisane i susedne segmente na poslednjem kontrolnom pregledu (p > 0,05). Zaključak. Sistemi dinamičke stabilizacije Isobar TTL i Isobar EVO pokazali su dobar klinički učinak. Sposobnost Isobar EVO sistema da ograniči pokretljivost susednih segmenata može doprineti sprečavanju njihove degeneracije.
Kvalitet života žena u reproduktivnom dobu koje imaju sindrom policističnih jajnika
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Name="List Table 3 Accent 3"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 3"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 3"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 4"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 4"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 4"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 4"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 4"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 5"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 6"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]-->Uvod/Cilj. Sindrom policističnih jajnika (polycystic ovary syndrome – PCOS) je najčešći endokrini poremećaj žena u reproduktivnom dobu i utiče na njihovo fizičko i mentalno zdravlje i na kvalitet života (quality of life – QoL). Cilj rada bio je da se proceni QoL žena u reproduktivnom periodu koje imaju PCOS. Metode. Istraživanjem je obuhvaćeno 100 žena starijih od 18 godina, kojima je dijagnostikovan PCOS. Kao instrument istraživanja korišćen je upitnik Short Form Health Survey-36 (SF-36). Za ispitivanje mogućih razlika u QoL u odnosu na ispitivane varijable, korišćeni su Mann-Whitney U test, Kruskal-Wallis test i Spearman-ov koeficijent korelacije. Rezultati. Žene koje imaju PCOS i žive u ruralnim sredinama imale su značajno viši prosečni rezultat u domenu vitalnosti. Statistički značajna, jaka pozitivna korelacija sa ukupnim rezultatom QoL utvrđena je za podskale Mental Component Summary (MCS) (p < 0,001) i Physical Component Summary (PCS) (p < 0,001). Utvrđena je statistički značajna, ali slaba negativna korelacija između samoprocene zdravlja i PCS (p = 0,021), MCS (p = 0,004) i ukupnog skora QoL (p = 0,002), kao i između životnog doba i PCS (p = 0,023) i ukupnog skora QoL (p = 0,032). Zaključak. Žene u ruralnim područjima koje imaju PCOS bile su vitalnije i imale su bolji QoL. Niže samopouzdanje u vezi sa zdravljem povezano je sa lošijim QoL, posebno u psihološkom domenu. Kod žena sa ispoljenim PCOS se, uz ranu dijagnozu i odgovarajuću edukaciju, mogu ublažiti pojedini simptomi i sprečiti teške komplikacije.
Lipokalin udružen sa neutrofilnom gelatinazom kao prediktor ishoda lečenja primarnog glomerulonefritisa
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<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 6"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]-->Uvod/Cilj. Biomarkeri za predviđanje toka bolesti mogli bi da olakšaju izbor terapije primarnog glomerulonefritisa (PGN). Podaci o ulozi lipokalina udruženog sa neutrofilnom gelatinazom (neutrophil gelatinase-associated lipocalin – NGAL) u PGN su oskudni. Cilj rada bio je da se proceni značaj NGAL u predviđanju ishoda lečenja PGN. Metode. Istraživanjem je obuhvaćeno ukupno 60 obolelih od PGN, praćenih od 2012. do 2024. godine. Pri postavljanju dijagnoze određivani su serumski NGAL (sNGAL) i urinarni NGAL (uNGAL). Parametri bubrežne funkcije (serumski kreatinin, proteinurija) i ishod bolesti–razvoj terminalnog stadijuma bubrežne slabosti (end-stage renal disease – ESRD)–procenjivani su na početku praćenja, posle 5 godina i posle kompletnog perioda praćenja. Povezanost NGAL-a i kliničkih ishoda analizirana je korišćenjem odgovarajućih statističkih testova. Rezultati. Na početku, medijane nivoa za sNGAL i uNGAL iznosile su 154,71 ng/mL i 13,94 ng/mL, redom. Tokom medijane praćenja od 112 meseci, 8,33% bolesnika je izgubljeno iz praćenja, a 20% je razvilo ESRD. Bolesnici koji su razvili ESRD imali su više nivoe sNGAL (p = 0,027). Korišćenjem sNGAL, razvoj ESRD bio je solidno predvidljiv (AUC = 0,709; p = 0,036), a sNGAL je bio značajno povezan sa vremenskim periodom do razvoja ESRD (Kaplan-Meier analiza, p < 0,001). U grupi sa najvišim sNGAL petogodišnje preživljavanje bubrega bilo je najniže. Bolesnici sa stabilnom ili poboljšanom procenjenom stopom glomerularne filtracije (estimated glomerular filtration rate – eGFR) imali su više vrednosti odnosa uNGAL/kreatinin (p = 0,049). Promene u vrednostima proteinurije bile su u negativnoj korelaciji sa koncentracijama sNGAL (p < 0,001) i uNGAL (p = 0,005). Zaključak. Kod obolelih od PGN, sNGAL može biti prediktor razvoja ESRD, potencijalno odražavajući njegovu profibroznu aktivnost. Nasuprot tome, korelacija između nivoa NGAL i promene vrednosti proteinurije, kao i povezanost između viših vrednosti odnosa uNGAL/kreatinin i poboljšane eGFR, ukazuju na složenu i potencijalno protektivnu ulogu NGAL u progresiji bolesti.
Zdravstveni radnici i osteoartritis kolena: april kao podsetnik na zanemareni rizik
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<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 6"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]-->Iako se često posmatra kao oboljenje opšte populacije, klinička zapažanja ukazuju na to da značajan deo pregleda zbog bola u kolenu usled osteoartritisa obuhvata upravo zaposlene u zdravstvu, što upućuje na moguće opterećenje koje prevazilazi očekivani nivo za odrasle osobe istog životnog doba. U postojećim istraživanjima navodi se visoka učestalost simptoma oboljenja kolena kod zdravstvenih radnika, uključujući prevalenciju od 47% za mišićno‑skeletne poremećaje kolena povezanih sa poslom kod perioperativnih medicinskih sestara. Međutim, ova istraživanja se bave simptomima, a ne dijagnostikovanim osteoartritisom, ostavljajući nedovoljno ispitan stvarni teret strukturnog oboljenja u toj populaciji. Radne obaveze koje uključuju dugotrajno stajanje, intenzivno hodanje, često okretanje, klečanje, čučanje i fizički zahtevno zbrinjavanje bolesnika, nameću trajno opterećenje koje može ubrzati degeneraciju zgloba. Povećanje starosne granice za penzionisanje dodatno produžava godine izloženosti, povećavajući rizik od hroničnih mišićno‑skeletnih oboljenja. Uprkos tome, osteoartritis kolena ostaje uglavnom odsutan iz politika zaštite na radu. Intervencije na radnom mestu čiji troškovi nisu veliki, poput struktuiranih pauza za kretanje, kratkih vežbi snage i dosledne upotrebe pomagala, predstavljaju obećavajuće pristupe, iako su trenutni dokazi ograničeni i potrebna su dalja istraživanja radi potvrde njihovog preventivnog efekta. Zakonom regulisane mere, poput skraćenog radnog vremena za starije radnike, mogu dodatno smanjiti kumulativno opterećenje. Nova tehnološka rešenja, uključujući pomoć robota u zbrinjavanju bolesnika, pokazuju potencijal za smanjenje izloženosti velikim silama. Prepoznavanje osteoartritisa kolena kao problema profesionalnog rizika koji se može sprečiti, ključno je za očuvanje pokretljivosti, dobrobiti i dugoročne radne sposobnosti zdravstvenog kadra.
Analiza uticaja visokofrekventnog elektromagnetnog zračenja na frekvenciju talasa na elektroencefalografiji
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Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]--> Uvod/Cilj. Interesovanje za uticaje elektromagnetnih polja na ljudski organizam značajno je poraslo sa pojavom digitalnih mobilnih komunikacionih sistema, koji koriste pulsirajuća visokofrekventna elektromagnetna polja. U stanju mirovanja mobilni telefon ne emituje značajnu snagu signala, dok tokom aktivne komunikacije intenzitet elektromagnetnog polja može dostići vrednosti do 250 mW. Cilj rada bio je da se ispita da li izlaganje visokofrekventnim elektromagnetnim poljima utiče na frekvenciju talasa na elektroencefalografiji (EEG). Metode. Istraživanje je obuhvatilo ukupno 60 ispitanika (30 osoba muškog pola i 30 osoba ženskog pola). Svakom ispitaniku su urađena dva uzastopna EEG snimanja u trajanju od oko 20 min. Prvo EEG snimanje obavljeno je u stanju mirovanja bez upotrebe generatora elektromagnetnog polja. Nakon toga je usledilo drugo EEG snimanje tokom korišćenja mobilnog telefona u trajanju od 10 min na jednom uvu, potom je načinjena pauza od oko 2 min i snimanje je ponovljeno na suprotnom uvu, takođe u trajanju od 10 min. Kao izvor visokofrekventnog elektromagnetnog polja korišćen je standardni mobilni telefon. Rezultati. Analiza frekvencija talasa na EEG nije pokazala statistički značajne razlike kod oba pola pre i posle izlaganja mobilnom telefonu u alfa, beta i delta frekventnim opsezima. Promena u teta frekventnom opsegu kod ženskih ispitanica nakon izlaganja mobilnom telefonu bila je lokalizovana u desnoj hemisferi. Zaključak. Metodološka ograničenja su najverovatniji razlog za odsustvo zabeleženih promena kod većine ispitanika. Uočeni efekti mogu biti toliko suptilni ili sporadični da standardna EEG snimanja ne uspevaju da ih detektuju. Iz tog razloga, izostanak uočenih promena ne može se tumačiti kao dokaz da visokofrekventna elektromagnetna polja ne utiču na EEG aktivnost.
Trodelni i četvorodelni bubrežni sinus: retka anatomska varijacija prisutna kod pedijatrijskog pacijenta
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Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]--> Uvod. Anatomske varijacije bubrežnog sinusa se na ultrazvuku pojavljuju kao hiperehogena područja koja se mogu pogrešno protumačiti kao prave hiperehogene mase, poput bubrežnih angiomiolipoma. Prikaz bolesnika. Desetogodišnja devojčica upućena je u dečiju bolnicu tercijarnog nivoa zbog sumnje na bilateralne angiomiolipome bubrega. Prilikom prijema, rezultati laboratorijskih analiza bili su u granicama normalnih vrednosti. Ultrazvučnim pregledom utvrđeno je da su oba bubrega imala normalan položaj i veličinu. Na sagitalnom ultrazvučnom snimku desnog bubrega uočene su tri cilindrične mase koje se pružaju kroz sinus i daju izgled tri hiperehogene zone što ukazuje na trodelni bubrežni sinus. Na sagitalnom snimku levog bubrega prikazano je prisustvo višestrukih cilindričnih masa koje se pružaju kroz sinus i stvaraju izgled četiri hiperehogene zone identifikovane kao četvorodelni bubrežni sinus. Nalaz je protumačen kao retka benigna anatomska varijacija bez znakova patologije, te dodatna radiološka snimanja nisu bila potrebna. Zaključak. Precizna identifikacija ovih varijacija je važna kako bi se sprečilo da bolesnici budu podvrgnuti nepotrebnoj biopsiji i dodatnom snimanju.
Kvantitativna analiza kapsularne mikrovaskularizacije u odnosu na debljinu hroničnog subduralnog hematoma
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<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 6"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]--> Uvod/Cilj. Hronični subduralni hematom (chronic subdural hematoma – CSDH) je ekstraaksijalna, inkapsulirana, sporo rastuća kolekcija krvi, praćena lokalnom koagulopatijom. Ovo doprinosi kontinuiranom ponovnom krvarenju iz novoformirane kapsule hematoma, što dovodi do sporog, ali progresivnog uvećanja hematoma sa potencijalom da se razvije u kompresivnu intrakranijalnu leziju. Cilj rada bio je da se ispita odnos između proliferacije sinusoidnih krvnih sudova i rasta i prečnika CSDH. Metode. U ovoj studiji, analizirana su 33 slučaja CSDH koja su operativno lečena. Uzet je uzorak biopsije iz parijetalne kapsule hematoma (prosečne veličine 3 × 3 mm). Uzorci tkiva dobijeni biopsijom fiksirani su u 4% vodenom rastvoru formaldehida, rutinski su pripremljeni parafinski preseci na pločicama i obojeni imunohistohemijskim metodama u cilju detekcije prisutva CD34 antigena. Profili krvnih sudova mikrovaskularne mreže koji su ispoljavali CD34 su kvantifikovani, a broj CD34 pozitivnih kapilara i sinusoida izražen je po jednom mm2. Rezultati. Varijable starost i broj krvnih sudova pokazale su statistički značajnu povezanost sa povećanjem zapremine hematoma (β = 0,422; p = 0,007; β = 0,486; p = 0,022, redom). Stariji bolesnici imali su veći rizik od uvećanja zapremine hematoma, kao i bolesnici sa većim brojem sinusoidnih krvnih sudova. Zaključak. Broj sinusoida u parijetalnoj kapsuli CSDH po jedinici površine od 1 mm2 pozitivno korelira sa debljinom hematoma, što naglašava značaj vaskularne teorije u razvoju hematoma. Iako je CSDH jedno od najčešćih neurohirurških oboljenja, njegova patogeneza još uvek nije potpuno razjašnjena. Dalja istraživanja u ovoj oblasti neophodna su kako bi se razvile potencijalno nove terapijske opcije koje bi pružile sveobuhvatnije modalitete lečenja.
Kliničko lečenje rana primenom nano plazme obogaćene tombocitima
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Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]--> Uvod/Cilj. Hronične refraktorne rane su teško zarastajuće lezije koje su podložne infekcijama uzrokovanim bakterijama i drugim patogenima, što dovodi do dodatnog oštećenja tkiva i značajnog smanjenja kvaliteta života bolesnika. Cilj rada bio je da se ispita efikasnost nano plazme obogaćene tombocitima (platelet-rich plasma – PRP) – nano-PRP u poređenju sa konvencionalnom PRP u kliničkom lečenju rana. Metode. U studiju je bilo uključeno ukupno 96 bolesnika sa hroničnim refraktornim ranama, uključujući rane izazvane traumom i dekubitalne ulkuse, primljenih u periodu od juna 2021. do juna 2023. godine. U skladu sa primenjenim tretmanom, bolesnici su bili podeljeni u dve grupe: opservacionu grupu (OG) (n = 47) tretiranu nano-PRP i kontrolnu grupu (KG) (n = 49) tretiranu konvencionalnom PRP. Razlike između grupa analizirane su korišćenjem t-testa za nezavisne uzorke za kontinuirane varijable i Hi-kvadrat testa za kategorijske varijable. Rezultati. Ukupna efikasnost lečenja u OG bila je značajno veća nego u KG (p < 0,05). Nakon tretmana, vrednost skora na vizuelnoj analognoj skali se smanjila u obe grupe u poređenju sa početnim vrednostima, pri čemu je OG pokazala značajno niže rezultate od KG (p < 0,05). Brzina zarastanja rana je takođe bila značajno veća u OG (p < 0,05). Takodje, bolesnici tretirani nano-PRP pokazali su bolje ishode hiperplazije ožiljaka i kraće vreme zarastanja rane u odnosu na grupu tretiranu konvencionalnom PRP (p < 0,05). Zaključak. U poređenju sa konvencionalnom PRP, nano-PRP pokazuje bolju efikasnost u zarastanju rana kod pacijenata sa hroničnim refraktornim ranama, povezan je sa većim ublažavanjem bola i dovodi do boljih estetskih ishoda. Ovi nalazi ukazuju na to da nano-PRP može predstavljati efikasniju terapijsku opciju od konvencionalne PRP za kliničko lečenje teško zarastajućih rana.
Genetički polimorfizam i farmakokinetika/toksikokinetika karbamazepina: opšti pregled
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Name="List Table 3 Accent 3"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 3"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 3"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 4"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 4"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 4"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 4"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 4"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 5"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 6"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]-->Karbamazepin (KBZ) je široko korišćen lek u terapiji epilepsije, bipolarnog poremećaja i neuropatskog bola. Njegov farmakokinetički profil je veoma varijabilan zbog spore resorpcije, ekstenzivnog metabolizma i autoindukcije. Genetički polimorfizmi utiču na transportere i metaboličke enzime, dodatno modifikujući terapijski odgovor i dovode do nelinearne i nepredvidive toksikokinetike u slučaju predoziranja. KBZ se prvenstveno metaboliše putem citohrom P450 (CYP) enzima CYP3A4, CYP3A5 i CYP2C8 do aktivnog metabolita KBZ-10, 11-epoksida (KBZ-E), nakon čega sledi hidroliza pomoću epoksid hidrolaze 1 (EPHX1) i glukuronidacija pomoću uridin difosfat glukuronil transferaze 2B7 (UGT2B7). Drugi CYP enzimi dodatno doprinose stvaranju reaktivnih intermedijera i neaktivnih metabolita KBZ. Polimorfizmi u genima koji kodiraju enzime (EPHX1, CYP3A4/5 i UGT2B7) i transportere (ABCB1, ABCC2, RALBP1) mogu uticati na izloženost organizma KBZ i KBZ-E, dozu održavanja i rizik od neželjenih reakcija na lek. U slučajevima predoziranja lekom dolazi do zasićenja procesa epoksidacije, što dovodi do akumulacije leka i njegovog aktivnog metabolita, produžene eliminacije i neurotoksičnosti, dok serumske koncentracije slabo koreliraju sa kliničkim nalazima. Praćenje koncentracije leka i njegovog aktivnog metabolita u krvi bolesnika, zajedno sa farmakogenetičkim testiranjem, moglo bi poboljšati i individualizaciju terapije i lečenje predoziranja.
Retrospektivna kohortna studija preživljavanja bolesnika sa bolničkom infekcijom izazvanom bakterijom Klebsiella pneumoniae – klinički, fenotipski i genotipski prediktori u tercijarnoj zdravstvenoj ustanovi u Srbiji (2022–2023)
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Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]--> Uvod/Cilj. Klebsiella (K.) pneumoniae je čest uzročnik bolničkih infekcija (healthcare-associated infections – HAI), naročito u jedinicama intenzivne nege. Karbapenem-rezistentni sojevi predstavljaju ozbiljnu pretnju zbog visoke smrtnosti i ograničenih terapijskih mogućnosti. Cilj rada bio je da se identifikuju klinički prediktori 30-dnevne smrtnosti i da se utvrdi prisustvo gena za karbapenemaze kod izolata K. pneumoniae. Metode. Retrospektivna kohortna studija sprovedena je na Vojnomedicinskoj akademiji u Beogradu, Srbija. Studija je obuhvatila 121 bolesnika sa HAI izazvanim K. Pneumoniae od januara 2022. do decembra 2023. godine. Klinički podaci prikupljeni su aktivnim nadzorom nad HAI. Izolacija i ispitivanje osetljivosti na antimikrobne lekove urađeni su standardnim mikrobiološkim procedurama, a detekcija gena za karbapenemaze urađena je metodom multipleks lančane reakcije polimeraze. Preživljavanje je analizirano Kaplan-Majerovom metodom, a prediktori smrtnosti Koksovom regresionom analizom. Rezultati. Tridesetodnevna smrtnost iznosila je 59,5%. Zabeležene su visoke stope rezistencije na aminoglikozide (84,3%), fluorohinolone (94,2%) i karbapeneme (95,9%), dok je 67,8% izolata bilo multirezistentno. Najčešći gen bio je blaOXA-48-like (45,5% u 2022. i 65,9% u 2023. godini), zatim blaNDM (22,7% u 2022. i 4,5% u 2023. godini), dok je blaKPC (23,9%) detektovan samo u 2023. godini. Najčešće otkrivena kombinacija gena za karbapenemaze bila je blaNDM + blaOXA-48-like (31,8% u 2022. i 5,7% u 2023. godini). Detektovani geni nisu imali značajan uticaj na preživljavanje. Starost ≥ 70 godina, infekcija krvotoka i boravak u jedinicama intenzivne nege identifikovani su kao nezavisni prediktori 30-dnevne smrtnosti. Zaključak. Visoka smrtnost kod bolesnika sa HAI izazvanom karbapenem-rezistentnim sojevima K. pneumoniae pre svega je bila povezana sa karakteristikama bolesnika i težinom osnovnog oboljenja, a ne sa prisustvom gena za karbapenemaze.
Corrigendum: Clinical and laboratory status in Parkinson’s disease patients with and without polyneuropathy (vol. 81, no. 10, p. 613-8, 2024, https://doi.org/10.2298/VSP240528061P)
Nikolaj Sergejevič Korotkov: 120 godina njegove metode merenja arterijskog krvnog pritiska
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Name="List Table 3 Accent 3"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 3"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 3"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 4"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 4"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 4"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 4"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 4"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 5"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 6"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]-->Nikolaj Sergejevič Korotkov (1874–1920) bio je ruski vojni lekar, hirurg, koji je otkrio tehniku neinvazivnog merenja arterijskog krvnog pritiska. Merenje arterijskog krvnog pritiska je moguće na osnovu tonova registrovanih stetoskopom, danas poznatih kao Korotkovljevi, uz korišenje sfingomanometra. Tonovi nestaju kada je pritisak vazduha u manžetni postavljenoj oko nadlaktice veći od sistolnog pritiska. Pojava prvog od ukupno pet tonova javlja se posle postepenog ispuštana vazduha i označava sistolni pritisak. On je za nekoliko milimetara živinog stuba viši od onog dobijenog palpacijom radijalne arterije, kako se do tada određivalo. Nestanak poslednjeg, petog, tona uz dalje smanjenje vazdušnog pritiska u manžetni, označava dijastolni pritisak. Njega do tog momenta nije bilo moguće meriti ovako bezbolnim i jednostavim načinom. Upravo se navršilo 120 godina od kada je Korotkov, sa svega 31 godinom života, svoje otkriće prvi put saopštio 1905. godine u Petrogradu. Metoda je prepoznata od stručne javnosti 1939. godine. Od tada su u svetu prihvaćeni Korotkovljevi tonovi za merenje arterijskog krvnog pritiska. Ova metoda je do danas ostala neprevaziđena.
Uticaj težine sindroma opstruktivne apneje-hipopneje u snu na kvalitet života i toleranciju napora kod obolelih od hipertenzije
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Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]-->Uvod/Cilj. Sindrom opstruktivne apneje-hipopneje u snu (obstructive sleep apnea-hypopnea syndrome – OSAHS) povezan je sa smanjenim kvalitetom života (quality of life – QoL) i smanjenom tolerancijom fizičkog napora. Cilj rada bio je da se utvrdi da li težina OSAHS-a utiče na QoL i toleranciju napora kod bolesnika sa umerenim do teškim OSAHS-om i arterijskom hipertenzijom. Metode. Studija je obuhvatila 115 konsekutivnih bolesnika sa arterijskom hipertentijom koji su imali srednje tažak [40 (34,78%)] ili težak [75 (65,22%)] OSAHS. Tolerancija fizičkog napora procenjivana je korišćenjem testa fizičkim opterećenjem, dok je QoL procenjivan korišćenjem upitnika Short-Form 36 (SF-36). Rezultati. Ispitivane grupe se nisu statistički značajno razlikovale prema starosti (54,80 ± 8,91 vs. 53,55 ± 9,53, p = 0,494) i polu [ženska populacija: 11 (27,50%) vs. 13 (17,33%), p = 0,201]. Uočena je visoka prevalencija kardiovaskularnih faktora rizika. Bolesnici sa teškim OSAHS-om imali su značajno višu vrednost indeksa telesne mase i veći obim vrata. Isto tako, kod bolesnika sa teškim OSAHS-om gojaznost je bila zastupljenija. Pored toga, ova grupa bolesnika imala je značajno više vrednosti indeksa apneje-hipopneje, indeksa desaturacije i trajanje perioda u kome je zabeležena sautracija kiseonika ispod 90%. Nije bilo statistički značajne razlike ni u toleranciji fizičkog napora, niti u parametrima upitnika SF-36 između grupa. Takođe, nije utvrđena značajna korelacija između indeksa apneje-hipopneje, tolerancije fizičkog napora i parametara QoL. Kod dvoje asimptomatskih bolesnika registrovano je postojanje višesudovne koronarne bolesti. Zaključak. Oboleli od OSAHS-a generalno imaju brojne kardiovaskularne faktore rizika, niži QoL i smanjenu toleranciju fizičkog napora. Nije dokazano postojanje značajne korelacije između težine OSAHS-a, tolerancije fizičkog napora i QoL. Otkrivanje višesudovne koronarne bolesti kod asimptomatskih bolesnika u istraživanju naglašava klinički značaj skrininga na koronarnu bolest srca kod obolelih od OSAHS-a.
Procena kvaliteta neurohirurških usluga primenom SERVQUAL metode
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Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]-->Uvod/Cilj. U eri brzih tehnoloških inovacija i rastućih očekivanja bolesnika, zdravstveni sistemi širom sveta suočavaju se sa potrebom za kontinuiranim unapređenjem kvaliteta usluga. Model Service Quality – SERVQUAL je validirani instrument za merenje kvaliteta usluge, koji se zasniva na poređenju očekivanja bolesnika sa njihovom percepcijom pružene usluge. Razlika (jaz) između ove dve mere procenjuje se primenom petostepene Likertove skale u okviru pet dimenzija: opipljivost, pouzdanost, odgovornost, sigurnost i empatiju. Cilj rada bio je da se izmere i uporede očekivanja i percepcije bolesnika podvrgnutih neurohirurškim uslugama, kao i da se ispita da li se veličina jaza razlikuje između SERVQUAL dimenzija. Metode. Studija je obuhvatila 60 bolesnika koji su operisani zbog degenerativnih bolesti lumbalne i cervikalne kičme na Klinici za neurohirurgiju Univerzitetskog kliničkog centra Vojvodine, Novi Sad, Srbija, u periodu od juna do septembra 2024. godine. Za prikupljanje podataka korišćen je modifikovani upitnik SERVQUAL. Podaci su prikupljani na prijemu i pre otpusta bolesnika. Podaci su analizirani primenom deskriptivne statistike, uparenog t-testa za poređenje očekivanja i percepcija, i analize varijanse za ispitivanje razlika između sociodemografskih grupa. Rezultati. Bolesnici su imali pozitivne percepcije o pruženim uslugama. Rezultati ukazuju na postojanje jaza između očekivanja bolesnika i njihove percepcije primljenih usluga. Prosečna očekivanja bila su visoka u svim dimenzijama (ukupno 4,85; raspon 4,79–4,88), kao i percepcije (ukupno 4,90; raspon 4,85–4,94). U svim dimenzijama utvrđen je pozitivan jaz (percepcije > očekivanja). Jazovi specifični za pojedine dimenzije iznosili su: opipljivost 0.06 (p = 0,196), pouzdanost 0.05 (p = 0,132), odgovornost 0.04 (p = 0,249), sigurnost 0.06 (p = 0,107), empatija 0.06 (p = 0,039). Jedino je dimenzija empatije dostigla statističku značajnost. Nisu utvrđene statistički značajne razlike između sociodemografskih podgrupa. Zaključak. Metoda SERVQUAL omogućila je jasan uvid u percepciju bolesnika o kvalitetu neurohirurških usluga. Rezultati ove studije mogu doprineti unapređenju kvaliteta usluga i povećanju zadovoljstva bolesnika, čime se pozitivno utiče na kliničke ishode i zdravstveni sistem u celini.
Istovremena procena nivoa TNF-α, TIM-1 i TLR4 u plazmi kao prediktora težine alergijskog rinitisa
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Name="List Table 3 Accent 3"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 3"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 3"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 4"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 4"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 4"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 4"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 4"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 5"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 6"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]-->Uvod/Cilj. Alergijski rinitis (AR) je hronično zapaljenje nosne sluznice izazvano dejstvom alergena. Do sada se pokazalo da su pojedini biomarkeri, kao što je ukupni imunoglobulin E (IgE), mogući pokazatelji za procenu težine AR. Cilj rada bio je da se proceni vrednost istovremenog određivanja nivoa faktora nekroze tumora (tumor necrosis factor-TNF)-α, T-cell immunoglobulin and mucin domain (TIM)-1 i toll-like receptora 4 (TLR4) kao prediktora težine AR. Metode. U studiju su uključene dve grupe ispitanika: AR grupa – ARG (n = 96), koju su činili bolesnici lečeni od marta 2021. do maja 2023. godine, i kontrolna grupa – KG (n = 60), koju su činile zdrave osobe koje su tokom istog perioda bile pregledane od strane lekara. Nivoi TNF-α, TIM-1 i TLR4 upoređivani su između ARG i KG i analizirana je njihova povezanost sa težinom bolesti. Rezultati. Logistička regresiona analiza pokazala je da su povišen broj eozinofila i povišeni nivoi IgE, TNF-α, TIM-1 i TLR4 nezavisni faktori rizika od pojave umerenog do teškog AR (odds ratio > 1, p < 0,05). Površine ispod receiver operating characteristic krive za nivoe TNF-α, TIM-1 i TLR4 u plazmi u predviđanju težine bolesti iznosile su 0,889, 0,831 i 0,842, redom, dok je prediktivna vrednost kombinacije markera dostigla 0,932, što ukazuje na odličan dijagnostički učinak. Zaključak. Istovremeno merenje nivoa TNF-α, TIM-1 i TLR4 u plazmi pruža nov i pouzdan pristup za predviđanje težine AR. Procena njihove kombinacije pokazuje veću prognostičku tačnost od procene pojedinačnih markera, nudeći potencijalnu vrednost za stratifikaciju bolesti i donošenje kliničkih odluka.
Invazivna oboljenja izazvana pneumokokom i hemofilusom influence tipa b u Autonomnoj Pokrajini Vojvodini, Srbija (2003–2024): trendovi, uticaj vakcinacije i dinamika serotipova pneumokoka
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Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]-->Uvod/Cilj. Invazivna pneumokokna bolest (invasive pneumococcal disease – IPD) i invazivna bolest izazvana bakterijom Haemophilus influenzae tipa b (Hib) i dalje su povezane sa značajnim morbiditetom i mortalitetom. Cilj rada bio je da se analiziraju dugoročni trendovi, obrasci specifični za uzrast i sezonski obrasci bolesti, klinički ishodi, distribucija serotipova IPD i uticaj programa imunizacije na ta oboljenja u Autonomnoj Pokrajini (AP) Vojvodini, Srbija, u periodu od 2003. do 2024. godine. Metode. Sprovedena je deskriptivna epidemiološka studija korišćenjem podataka iz regionalnog sistema nadzora nad zaraznim bolestima, kojim koordinira Institut za javno zdravlje Vojvodine. U analizu su uključeni svi prijavljeni slučajevi IPD i Hib-izazvane invazivne bolesti. Rezultati. Program imunizacije protiv infekcija izazvanih Hib, uveden 2006. godine, doveo je do trajnog sniženja učestalosti Hib-izazvane invazivne bolesti, sa sporadičnim slučajevima oboljenja prijavljenim posle 2009. godine. Incidencija IPD varirala je tokom posmatranog perioda i porasla je u poslednjim godinama, uprkos visokom obuhvatu (≥ 90%) primarnom serijom pneumokokne konjugovane vakcine (pneumococcal conjugate vaccine – PCV) od 2019. godine. Uvođenje PCV značajno je smanjilo učestalost serotipova obuhvaćenih PCV10. Serotip 3 i nevakcinalni serotipovi opstali su, naročito među odraslima i odojčadima starosti < 1 godine. Odrasle osobe starosti ≥ 40 godina pretežno su bile pogođene IPD, dok se Hib-izazvana invazivna bolest javljala uglavnom kod dece uzrasta 1–4 godine. Nijedan od obolelih nije prethodno bio vakcinisan protiv IPD ili Hib-izazvane invazivne bolesti. Stopa smrtnosti bila je značajno viša kod IPD (9,6%) nego kod Hib-izazvane bolesti (3,5%) (p = 0,0361). U ukupnoj populaciji, učestalost serotipova PCV10 naglo je opala posle uvođenja vakcine (sa 55% na 22%), dok su serotipovi PCV13-ne-PCV10 ostali stabilni (~40%), a prisustvo nevakcinalnih serotipova se povećalo (sa 11% na 28%), uz dodatnu pojavu serotipova PCV20-ne-PCV15. Zaključak. Program imunizacije protiv Hib-izazvanih oboljenja obezbedio je zadovoljavajuću kontrolu bolesti u AP Vojvodini, dok, zbog perzistentnog serotipa 3 i novih serotipova koji nisu obuhvaćeni vakcinom, IPD i dalje predstavlja značajan javnozdravstveni problem. Kontinuirani nadzor i razmatranje primene viševalentnih pneumokoknih vakcina (najmanje PCV13) ili strategije vakcinacije usmerene na odrasle osobe su od ključnog značaja za dalje smanjenje tereta bolesti.
Procena uticaja nintedaniba i pirfenidona na funkciju pluća kod idiopatske plućne fibroze: sveobuhvatna meta-analiza
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SemiHidden="true" UnhideWhenUsed="true" Name="Outline List 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Simple 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Simple 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Simple 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Classic 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Classic 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Classic 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Classic 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Colorful 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Colorful 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Colorful 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 5"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 5"/> <w:LsdException 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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" Priority="34" 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 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<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/> <w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/> <w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 3"/> <w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 3"/> <w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 3"/> <w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 3"/> <w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 3"/> <w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 3"/> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/> <w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/> <w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/> <w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/> 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Name="Plain Table 2"/> <w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/> <w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/> <w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/> <w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 1"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/> <w:LsdException Locked="false" Priority="50" 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"/> 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Name="Grid Table 7 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 5"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 6"/> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 1"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 1"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 1"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 1"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 1"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 1"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 1"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 2"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 2"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 2"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 2"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 2"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 2"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 2"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 3"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 3"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 3"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 3"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 3"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 4"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 4"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 4"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 4"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 4"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 5"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 6"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]--> Uvod/Cilj. Učestalost idiopatske plućne fibroze (IPF) je u porastu iz godine u godinu. Iako su pirfenidon i nintedanib odobreni 2014. godine, dobili su samo uslovne preporuke, a nijedan od ta dva leka još uvek nema snažnu preporuku za lečenje IPF. Cilj rada bio je da se uporede bezbednost i efikasnost pirfenidona i nintedaniba. Metode. Sve randomizovane i nerandomizovane kliničke studije identifikovane su pretraživanjem baza podataka objavljenih studija, uključujući Medline, Embase, Scopus, Google Scholar i ClinicalTrials.gov. Sprovedena je meta-analiza kako bi se procenio uticaj pirfenidona i nintedaniba na kliničke ishode i bezbednost. Poređeni su bolesnici lečeni pirfenidonom i bolesnici lečeni nintedanibom. Rezultati. Studijom je obuhvaćeno 12 radova. Utvrđeno je da su i pirfenidon i nintedanib značajno smanjivali pad srednje vrednosti forsiranog vitalnog kapaciteta (forced vital capacity – FVC) pluća i srednje vrednosti difuzionog kapaciteta pluća za ugljen-monoksid (diffusion capacity of the lungs for carbon monoxide – DLco) nakon 6 i 12 meseci. Nije uočena statistički značajna razlika između pirfenidona i nintedaniba u pogledu poboljšanja FVC ili DLco. Takođe, oba agensa protiv fibroze pluća imala su slične bezbednosne profile. Međutim, kod bolesnika lečenih nintedanibom zabeleženo je značajno manje epizoda dijareje (p < 0,00001) u poređenju sa bolesnicima lečenim pirfenidonom, dok su bolesnici lečeni pirfenidonom imali značajno manje epizoda kožnog osipa (p < 0,00001) u poređenju sa bolesnicima lečenim nintedanibom. Zaključak. O mogućim razlikama između pirfenidona i nintedaniba može se zaključiti na osnovu rangiranja njihove efikasnosti dobijenog ovom meta-analizom. Neophodne su dodatne direktne uporedne studije kako bi se ovo pitanje detaljnije istražilo, što će omogućiti bolje razumevanje potencijala kombinovanih, sekvencijalnih ili dodatnih režima lečenja, u kojima oba agensa protiv fibroze mogu igrati ključnu ulogu za određenu grupu obolelih od IPF.
Farmakokinetika i farmakogenetika – principi, primene i izazovi
Otpornost na prelom pet različitih barijera koje se postavljaju na ulazu u kanal endodontski lečenih premolara u donjoj vilici: in vitro studija
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6"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]--> Uvod/Cilj. Endodontski lečeni zubi (endodontically treated teeth – ETT) skloniji su prelomima od vitalnih zuba, a umetanje barijera koje se postavljaju na ulazu u kanal (intra-orifice barriers – IOB) može povećati njihovu otpornost na prelom (fracture resistance – FR). Cilj rada bio je da se uporedi i proceni FR ETT korišćenjem „pametne“ zamene dentina (smart dentin replacement – SDR), everX Flow (EXF), smolom modifikovanog stakleno-jonomernog cementa (resin-modified glass-ionomer cements – RMGIC), kalcijum silikatnog cementa (calcium-enriched mixture – CEM) i univerzalnog tečnog kompozita (universal flowable composite – UFC) kao IOB. Metode. Nakon lečenja korena kanala 70 humanih jednokanalnih mandibularnih premolara, zagrejanim instrumentima su uklonjena koronarna 3 mm korenskih punjenja, osim kod kontrolnih uzoraka. Na osnovu IOB iznad opturacije korenskog kanala, uzorci pripremljeni za punjenje podeljeni su u šest grupa : RMGIC (n = 13), UFC (n = 13), SDR (n = 13), CEM (n = 13), EXF (n = 13) i kontrolna grupa (KG; n = 5). U testu čvrstoće univerzalnom mašinom za ispitivanje korišćen je sferični čelični umetak prečnika 2 mm. Za analizu podataka korišćeni su Shapiro-Wilk test, analiza varijanse i test najmanje značajne razlike. Vrednost p < 0,05 smatrana je statistički značajnom. Rezultati. Grupa EXF pokazala je najvišu srednju FR od 759,9 ± 177,9 Njutna. Grupe RMGIC, UFC i EXF pokazale su statistički značajnu razliku u odnosu na KG. CEM je imao nižu vrednost FR od svih grupa osim SDR i KG. Međutim, FR SDR bio je niži nego kod UFC i EXF grupa. Nije bilo značajnih razlika između grupa EXF, UFC i RMGIC. Zaključak. Osim SDR i CEM, sve ostale grupe pokazale su povećanje FR u poređenju sa KG. Rezultati ukazuju da korišćenje EXF, UFC ili RMGIC kao IOB može značajno poboljšati otpornost na prelom ETT u poređenju sa netretiranim kontrolama. Klinički, izbor ovih IOB može pomoći u sprečavanju preloma korena zuba i poboljšanju dugoročne prognoze ETT.
Moguća povezanost krvnih grupa i impaktiranih donjih trećih molara kategorisanih prema Pell i Gregory i Winter klasifikacijama
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Priority="46" Name="List Table 1 Light Accent 5"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 6"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]--> Uvod/Cilj. Zubi koji ne dostignu svoj normalan položaj u vilicama smatraju se impaktiranim, a etiologija impaktiranih zuba ima više uzroka. Cilj rada bio je da se ispita moguća povezanost između krvnih grupa i impaktiranih donjih trećih molara (lower third molars – LTM) kategorisanih prema Pell i Gregory i Winter klasifikacijama. Metode. Ova retrospektivna, studija preseka obuhvatila je 534 pacijenta (274 muškarca i 260 žena) sa najmanje jednim impaktiranim LTM. Ukupno je analizirano 890 impaktiranih LTM pomoću panoramske radiografije. Zubi su klasifikovani prema Pell i Gregory i Winter klasifikacijama, a krvne grupe su zabeležene za svakog pacijenta. Statistička analiza sprovedena je korišćenjem Fisher-Freeman-Halton-ovog testa i Fisher-ovog egzaktnog testa, uz Bonferroni-jevu korekciju Z testa za višestruka poređenja. Rezultati. Utvrđena je značajna povezanost između krvnih grupa i Pell i Gregory klasifikacije (p = 0,008), ali ne i povezanost sa Winter klasifikacijom. Posebno je uočeno da su žene sa krvnim grupama A Rh-negativnom (Rh-), AB Rh- i B Rh- pokazale višu prevalenciju za pozicije I/B, I/C i III/C, redom. Takođe, žene sa krvnim grupama A Rh-pozitivnom (Rh+) i O Rh+ imale su više stope učestalosti za poziciju II/A, dok su muškarci sa A Rh+ krvnom grupom imali višu stopu učestalosti za poziciju II/C. Polno specifične razlike u obrsacima impakcije primećene su kod krvnih grupa A Rh+ i O Rh+ (p = 0,006, p = 0,038, redom). Zaključak. Antigeni krvnih grupa mogu uticati na obrasce impakcije LTM, posebno u odnosu na Pell i Gregory klasifikaciju.
Poređenje antimikrobnih i trombolitičkih rastvora za zatvaranje centralnih venskih katetera u prevenciji komplikacija povezanih sa kateterima kod bolesnika na hemodijalizi: randomizovano kontrolisano ispitivanje
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6"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]-->Uvod/Cilj. Centralni venski kateteri (CVK) kod bolesnika na hemodijalizi (HD) povezani su sa ozbiljnim komplikacijama, posebno bakterijemijom povezanom sa kateterom (BPSK) i trombozom, što dovodi do povećanog morbiditeta i mortaliteta. Cilj rada bio je da se proceni efikasnost tri različita rastvora za zatvaranje katetera u sprečavanju većih komplikacija povezanih sa kateterom. Metode. Ova prospektivna, randomizovana, kontrolisana studija sprovedena u jednom centru, od juna 2018. do juna 2023. godine, obuhvatila je 96 odraslih bolesnika na HD. U zavisnosti od rastvora koji su primali, bolesnici su bili ravnomerno podeljeni u tri različite grupe: gentamicin–citrat dva puta nedeljno uz taurolidin/urokinazu nakon treće nedeljne dijalize (TAURO); gentamicin–citrat tri puta nedeljno (GENTAM); nefrakcionisani heparin 5 000 internacionalnih jedinica/mL tri puta nedeljno (HEPARIN). Rastvori za zatvaranje katetera su primenjivani najmanje tri meseca nakon plasiranja CVK i njihova primena je nastavljena do uklanjanja katetera. Praćeni ishodi obuhvatali su incidenciju BPSK, trombozu katetera i neželjene događaje. Rezultati. Tokom 10 770 „kateter-dana“ registrovano je osam epizoda BPSK, a najčešći uzročnik bio je Staphylococcus aureus (50%). Incidencija BPSK (na 1 000 „kateter-dana“) bila je 0,27 u TAURO grupi, 0,83 u GENTAM grupi i 1,15 u HEPARIN grupi, bez statističke značajnosti (p = 0,526). Incidencija tromboze katetera bila je slična u svim grupama (1,09–1,15; p = 0,990). Koksova analiza proporcionalnih rizika nije pokazala značajne razlike, iako je TAURO grupa pokazala trend ka manjem riziku od BPSK u poređenju sa HEPARIN grupom (hazard ratio = 0,236; 95% interval poverenja 0,026–2,116). Zaključak. Nijedan ispitivani režim rastvora za zatvaranje katetera nije značajno smanjio rizik od BPSK ili tromboze. Ipak, najniža incidencija BPSK zabeležena je u TAURO grupi, što ukazuje na potencijalnu korist koju treba potvrditi u većim, multicentričnim studijama.
Multiparametrijski strukturni slikovni biomarkeri ranih promena mikrostrukture bele mase tokom i nakon hemoradioterapije glioblastoma: difuziono tenzorsko snimanje i difuziono snimanje kurtoze
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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 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SemiHidden="true" UnhideWhenUsed="true" Name="Outline List 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Simple 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Simple 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Simple 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Classic 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Classic 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Classic 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Classic 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Colorful 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Colorful 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Colorful 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 5"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 5"/> <w:LsdException 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Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Web 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" 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" Priority="34" 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 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Name="Grid Table 7 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 5"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 6"/> 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Locked="false" Priority="50" Name="List Table 5 Dark Accent 1"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 1"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 1"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 2"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 2"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 2"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 2"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 2"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 2"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 2"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 3"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 3"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 3"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 3"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 3"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 4"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 4"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 4"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 4"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 4"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 5"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 6"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]-->Uvod/Cilj. Prepoznavanje ranih promena izazvanih zračenjem u beloj masi je od velike važnosti. Cilj rada bio je da se ispita moguća primena parametara difuzionog tenzorskog snimanja (diffusion tensor imaging - DTI) i difuzionog snimanja kurtoze (diffusion kurtosis imaging - DKI) kao biomarkera ranih promena mikrostrukture moždanog tkiva, tokom lečenja novodijagnostikovanog glioblastoma hemioradioterapijom (HRT). Metode. Ukupno 42 bolesnika obolela od glioblastoma, koji su posle hirurške resekcije/biopsije podvrgnuti HRT, snimljena su tri puta magnetnom rezonancom (MR): pre terapije, posle 16 frakcija i posle 33 frakcije. Regioni od interesa (ROI), sa ukupnim dozama zračenja od 59,4 Gy (ROI 1), 39,6 Gy (ROI 2) i 19,8 Gy (ROI 3), identifikovani su korišćenjem koregistrovanih aksijalnih planova raspodele doze/histograma zapremine doze i snimaka MR. Za svaki ROI izračunati su, izmereni i analizirani sledeći DTI parametri: frakciona anizotropija (FA), radijalna difuzivnost (RD), aksijalna difuzivnost (AD) i srednja difuzivnost (SD). Odgovarajući DKI parametri uključivali su: radijalnu kurtozu (RK), aksijalnu kurtozu (AK) i srednju kurtozu (SK). Rezultati. Značajno smanjenje vrednosti FA utvrđeno je u ROI 1 (ukupna isporučena doza 59,4 Gy) posle isporučenih 16 i 33 frakcija, dok su ostali parametri DTI i SK pokazali značajno povećanje. U ROI 1 utvrđen je opadajući trend RK i AK, koji je potvrđen statistički i posle 16 i posle 33 isporučene frakcije. U ROI 2 (ukupna isporučena doza 39,6 Gy), vrednost FA bila je značajno smanjena i posle 16 i posle 33 frakcije, dok su RD, AD, SD i SK bili povećani posle 16 frakcija, a potom smanjeni posle 33 frakcije. Vrednost RK u ROI 2 pokazala je značajno smanjenje nakon 16 i 33 frakcije, a u vrednostima AK nisu ustanovljene promene. U ROI 3 (ukupna isporučena doza 19,8 Gy) nisu primećene značajne promene ni u jednom od izmerenih DTI ili DKI parametara. Zaključak. Metrički parametri DTI i DKI mogu poslužiti kao biomarkeri ranih promena tokom i posle HRT, obezbeđujući informacije koje pružaju bolje razumevanje složene dinamike ranih promena mikrostrukture bele mase, kao odgovor na HRT glioblastoma.
Transplantacija matičnih ćelija – pregled podataka iz kliničke prakse u eri novih lekova
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<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 3"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 3"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 3"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 4"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 4"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 4"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 4"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 4"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 5"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 6"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]--> Transplantacija hematopoetskih matičnih ćelija (hematopoietic stem cell transplantion – HSCT) već decenijama predstavlja terapiju izbora u lečenju pojedinih hematoloških maligniteta i nekih nemalignih poremećaja. Uvođenjem novih imunoterapijskih i ćelijama-posredovanih pristupa trebalo bi da bude redefinisana uloga autologne HSCT (auto-HSCT) i alogene HSCT (alo-HSCT). Auto-HSCT i dalje ostaje standard u lečenju multiplog mijeloma, Hočkinovog limfoma i ne-Hočkinovog limfoma. Primena novih medikamenata, uključujući inhibitore proteazoma, imunomodulacijske lekove, monoklonska i bispecifična antitela, povećava intenzitet i efikasnost terapijskog odgovora na HSCT i otvara raspravu o optimalnom vremenu za primenu HSCT. Alo-HSCT predstavlja najefikasniji oblik adoptivne imunoterapije, obezbeđujući kompletnu i dugotrajnu hematopoetsku rekonstituciju, neretko praćenu efektom “kalem protiv leukemije” (graft-versus-leukemia). Ona ostaje primarni kurativni vid lečenja akutnih leukemija, visoko-rizičnih mijelodisplastičnih i mijeloproliferativnih sindroma, kao i teške aplastične anemije. Poboljšanja u izboru donora matičnih ćelija (stem cell – SC), ex vivo manipulaciji prikupljenih ćelija, kao i inženjering grafta uz napredni imunski monitoring, proširila su i unapredila primenljivost ove terapije uz istovremeno povećanje bezbednosti i poboljšanje kliničkog ishoda. Uprkos brzom napretku u oblasti ćelijama posredovane i drugim agensima posredovane imunoterapije, HSCT i dalje ima ključnu ulogu u lečenju pojedinih hematoloških poremećaja. Kombinacija HSCT sa novim lekovima i drugim vidovima imunoterapije pruža mogućnost personalizovanog i bezbednijeg lečenja sa dugotrajnim povoljnim kliničkim ishodima, i obezbeđuje da HSCT ostane visoko relevantan metod u savremenoj medicini. Cilj ovog rada bio je da se sumiraju trenutni biološki koncepti SC, kao i bitna dostignuća na istraživačkim poljima u oblasti SC koja se brzo razvijaju, i da se odredi mesto i efikasnost HSCT danas, u eri novih terapijskih pristupa i agenasa.
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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" 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Locked="false" Priority="50" Name="List Table 5 Dark Accent 1"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 1"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 1"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 2"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 2"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 2"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 2"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 2"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 2"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 2"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 3"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 3"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 3"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 3"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 3"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 4"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 4"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 4"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 4"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 4"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 5"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 6"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]-->Uvod/Cilj. Bazocelularni karcinom (basal cell carcinoma – BCC) je najčešći maligni tumor kože kod ljudi svetle puti. Iako ima nizak metastatski potencijal, lokalno može biti visoko invazivan, te pored funkcije dela tela na kome se nalazi može ugroziti i sam život. Većina BCC-a se može uspešno lečiti klasičnom hirurškom ekscizijom uz odgovarajuće sigurnosne margine. Cilj rada bio je da se proceni korelacija između kliničke i patohistološke širine kod ekscidiranih BCC-a. Metode. Prospektivna klinička i histopatološka studija obuhvatila je 45 bolesnika pregledanih na Odeljenju za dermatohirurgiju i tumore kože, Univerzitetskog kliničkog centra Vojvodine, Novi Sad, Srbija, gde je analizirano ukupno 60 uzoraka primarnih BCC-a dobijenih klasičnom hirurškom ekscizijom. Uzeti su anamnestički podaci i obavljen je dermatološki pregled. Pre ekscizione biopsije, načinjen je rez duž ivice klinički vidljivog tumora do nivoa papilarnog dermisa, i dodata standardno preporučena sigurnosna margina. Histopatološka obrada uključila je mikroskopsku analizu na različitim uveličanjima. Histopatološka širina tumora merena je milimetarskim okularom. Ukupna klinički procenjena širina tumora određena je kao razdaljina između dva navedena reza na koži, a zabeležena je i razdaljina između reza i histopatološke margine tumora. Rezultati. Utvrđena je statistički značajna korelacija između klinički određene i mikroskopski izmerene ukupne širine tumora (p < 0,05). Prosečna klinički procenjena širina bila je 9,55 ± 5,13 mm, dok je histopatološka širina bila 7,98 ± 4,75 mm. Statistički utvrđena razlika između klinički obeležene i mikroskopski izmerene širine tumora bila je u 96,7% slučajeva manja od 2,0 mm, tj. u 88,4% slučaja ova razlika u proceni bila je 1,0 mm ili manja. Zaključak. Postoji pozitivna korelacija između klinički procenjene i histopatološki verifikovane širine BCC-a.
Sva prava zadržana (c) 2025 Vojnosanitetski pregled
Razvoj personalizovanog sistema zvučne terapije i njegov terapijski efekat na pacijente sa subjektivnim tinitusom
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Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]-->Uvod/Cilj. Tinitus je rasprostranjeno auditivno stanje koje značajno utiče na kvalitet života. Uprkos nizu dostupnih tretmana, njihova delotvornost je varijabilna. Cilj rada bio je da se proceni uticaj novorazvijenog sistema zvučne terapije na pacijente sa tinitusom, posebno u smislu promena u audiologiji, testova povezanih sa tinitusom i psihoakustičkih karakteristika tinitusa. Metode. U studiju je bilo uključeno 100 pacijenata sa tinitusom. Podeljeni su u dve grupe, kontrolnu grupu (KG) (n = 48) i terapijsku grupu (TG) (n = 52). Zabeležene su različite demografske karakteristike pacijenata. Svi pacijenti imali su temeljnu audiološku procenu, koja je obuhvatila audiometriju čistih tonova i testiranje akustičke imitanse, kao i procene specifične za tinitus, kao što su određivanje frekvencije tinitusa, određivanje jačine tinitusa, ispitavanja minimalnog maskirajućeg nivoa (minimum masked level – MML) i rezidualne inhibicije (RI). Pored toga, procenjene su psihoakustičke karakteristike tinitusa, uključujući rezultate Upitnika umenjenja sposobnosti zbog tinitusa (Tinnitus Handicap Inventory – THI), Bolničke skale za anksioznost i depresiju (Hospital Anxiety and Depression Scale – HADS), Pitsburškog indeksa kvaliteta sna (Pittsburgh Sleep Quality Index – PSQI) i Vizuelne analogne skale (Visual Analog Scale – VAS). Rezultati. Nije bilo značajnih razlika u različitim demografskim karakteristikama između KG i TG pre akustičke terapije. Dodatno, nije bilo značajnih razlika između grupa u audiometrijskim procenama, testovima povezanim sa tinitusom, psihoakustičkim karakteristikama tinitusa pre tretmana, niti u distribuciji frekvencija tinitusa. Prag sluha u TG bio je znatno niži nego u KG (p = 0,0238). Jačina tinitusa značajno se smanjila u TG (p = 0,0256). MML u TG imao je tendenciju poboljšanja (p = 0,0532), iako ova razlika nije dostigla statističku značajnost i pokazala je pozitivan trend. Među podskalama THI, u grupi TG je pokazano značajno poboljšanje. Takođe, rezultati PSQI pokazali su da su skorovi u TG bili značajno niži nego u KG (p = 0,0238). Ukupni rezultati na skalama HADS (16,58 ± 2,89 vs. 16,67 ± 2,76; p = 0,8730) i VAS (4,19 ± 1,48 vs. 4,22 ± 1,37; p = 0,9160), nisu pokazali značajnu razliku. Zaključak. Akustička terapija značajno poboljšava sluh pacijenata, smanjuje jačinu tinitusa i poboljšava kvalitet sna. Naš sistem akustičke terapije je efikasna strategija za ublažavanje hroničnog subjektivnog tinitusa.
Otvorena radikalna prostatektomija sa i bez poštede neurovaskularnog snopa: korelacije između Internacionalnog indeksa erektilne funkcije i elektromiografije kavernoznih tela
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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 Simple 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Simple 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Simple 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Classic 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Classic 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Classic 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Classic 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Colorful 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Colorful 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Colorful 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Columns 5"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 4"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 5"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Grid 6"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" 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" SemiHidden="true" UnhideWhenUsed="true" Name="Table 3D effects 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table 3D effects 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Contemporary"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Elegant"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Professional"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Subtle 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Subtle 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Web 1"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Web 2"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" Name="Table Web 3"/> <w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true" 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" Priority="34" 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 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<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/> <w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/> <w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 3"/> <w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 3"/> <w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 3"/> <w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 3"/> <w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 3"/> <w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 3"/> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/> <w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/> <w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/> <w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/> <w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/> <w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/> <w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/> <w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/> <w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/> <w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/> <w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 4"/> <w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 4"/> <w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 4"/> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 4"/> <w:LsdException Locked="false" Priority="70" Name="Dark List Accent 4"/> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 4"/> <w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/> <w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/> <w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/> <w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/> <w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 5"/> <w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 5"/> <w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/> <w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 5"/> <w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/> <w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/> <w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 5"/> <w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/> <w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5"/> <w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/> 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<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/> <w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/> <w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/> <w:LsdException Locked="false" Priority="19" QFormat="true" Name="Subtle Emphasis"/> <w:LsdException Locked="false" Priority="21" QFormat="true" Name="Intense Emphasis"/> <w:LsdException Locked="false" Priority="31" QFormat="true" Name="Subtle Reference"/> <w:LsdException Locked="false" Priority="32" QFormat="true" Name="Intense Reference"/> <w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/> <w:LsdException Locked="false" Priority="37" SemiHidden="true" UnhideWhenUsed="true" Name="Bibliography"/> <w:LsdException Locked="false" Priority="39" SemiHidden="true" UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/> <w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/> <w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/> <w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/> <w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/> <w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/> <w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 1"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/> <w:LsdException Locked="false" Priority="50" 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"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 4"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 4"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 4"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 4"/> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 4"/> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 5"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 6"/> <w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 1"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 1"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 1"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 1"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 1"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 1"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 1"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 2"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 2"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 2"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 2"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 2"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 2"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 2"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 3"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 3"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 3"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 3"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 3"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 3"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 4"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 4"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 4"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 4"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 4"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 4"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 5"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 5"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 5"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 5"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 5"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 5"/> <w:LsdException Locked="false" Priority="46" Name="List Table 1 Light Accent 6"/> <w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 6"/> <w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 6"/> <w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 6"/> <w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 6"/> <w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful Accent 6"/> <w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful Accent 6"/> </w:LatentStyles> <![endif]--><!-- [if gte mso 10]> <![endif]-->Uvod/Cilj. Erektilna disfunkcija (ED) se povećava sa godinama, a značaj seksualnog zdravlja postao je sve rasprostranjeniji u terapeutskoj praksi. Cilj rada bio je da se proceni korelacija između subjektivnih i objektivnih parametara ED kod bolesnika koji su podvrgnuti otvorenoj radikalnoj prostatektomiji, sa i bez poštede neurovaskularnog snopa, zbog lokalizovanog karcinoma prostate. Metode. Prospektivna kontrolisana studija obuhvatila je 50 bolesnika sa dijagnostikovanim karcinomom prostate i normalnom preoperativnom erektilnom funkcijom (EF). Bolesnici su podeljeni u grupu sa poštedom neurovaskularnog snopa (n = 25) i grupu bez poštede neurovaskularnog snopa (n = 25). EF je procenjivana preoperativno i nakon šest meseci korišćenjem upitnika za procenu Internacionalnog indeksa eretkilne funkcije (IIEF), dok je elektromiografija kavernoznih tela registrovala spontanu aktivnost glatkih mišića. Statistička analiza uključivala je upareni t-test i Spearmanove korelacije. Rezultati. Postoperativni rezultati IIEF su se značajno smanjili u obe grupe (poštedna tehnika: 22,04 ± 2,10 na 17,87 ± 3,83, p < 0,001; nepoštedna tehnika: 21,67 ± 2,64 na 6,42 ± 1,51, p < 0,001). Bilateralna pošteda neurovaskularnog snopa očuvala je superiorniju EF u poređenju sa unilateralnom tehnikom (19,87 ± 2,80 vs.14,13 ± 2,42, p < 0,001). Nije nađena značajna korelacija između parametara elektromiografije kavernoznog tela (amplituda, srednji talas, fazni preokreti i rezultata IIEF (p > 0,05). Zaključak. Otvorena radikalna prostatektomija sa poštedom neurovaskularnog snopa, naročito bilateralna tehnika, značajno smanjuje težinu ED. Međutim, elektromiografija kavernoznih tela nije korelirala sa ishodima koje su prijavili bolesnici, što ukazuje na njenu ograničenu samostalnu primenljivost u postoperativnoj proceni ED.