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The study aimed to assess the oncologic and reproductive outcome of fertility-sparing treatment of stage I borderline ovarian tumors (BOTs). A retrospective study of patients aged 18-40 years with stage I BOTs surgically treated during a 10-year period was conducted. In total, 52 patients (average age 32.7+/-5.9) were followed for 16 to 137 months after BOT diagnosis (mean 73.4 months). The overall survival rate was 100%. Recurrence was registered in 4 patients (7.7%). All patients underwent a unilateral salpingo-oophorectomy and all histologic findings corresponded with primary BOTs (3 serous; 1 endometrioid). Higher parity increased while the histological type and stage did not impact recurrence. Average recurrence-free survival was 36.2+/-23.6 months regardless of histological type and stage. Recurrence occurred during the first 3 postoperative years in 75% of cases. Out of 45 women treated with fertility-sparing surgery, 64.4% attempted pregnancy and the pregnancy success rate was 44.8%. Only one pregnancy was conceived by assisted reproduction, while all others were spontaneous. The fertility-sparing treatment in stage I borderline ovarian tumors can be a safe and successful option both in terms of oncologic and reproductive outcomes, regardless of patient and treatment characteristics. Pregnancies after BOT surgery can be achieved with satisfactory rates and adequate outcomes.

Objectives The aim of this study was to assess the validity and reliability of the Serbian versions of the Copenhagen Burnout Inventory (CBI) and the Study Burnout Inventory (SBI) among fifth-year medical students at 5 universities in Serbia. Material and methods The study included 573 fifthyear medical students at 5 universities in Serbia. The research instrument consisted of SBI and CBI. The reliability of these instruments was assessed using an internal consistency measure (Cronbach's α), an intra-class coefficient (ICC) and factor analysis. Results Cronbach's α for SBI was 0.83, including for exhaustion 0.73, for cynicism 0.70, and for inadequacy 0.48. The test-retest reliability (ICC) was 0.75. Cronbach's α for personal burnout on CBI was 0.89, for the faculty-related burnout 0.86, and for the faculty-members-related burnout 0.92. Cronbach's α for CBI was 0.93. The factor analysis for SBI showed 2 factors and for CBI 3 factors. Conclusions This study revealed that the Serbian versions of both SBI and CBI could be used for the assessment of burnout in this population.

Methods based on the evaluation of textural patterns in microscopy, such as the “gray-level co-occurrence matrix” (GLCM) analysis are modern and innovative computer and mathematical algorithms that can be used to quantify subtle structural changes in cells and their organelles. Potential application of GLCM method in the fields of psychophysiology and psychiatry to this date has not been systematically investigated. The main objective of our study was to test the existence and strength of the association between chromatin structural organization of peripheral blood neutrophils and levels of self-perceived mental stress. The research was done on a sample of 100 healthy student athletes, and the Depression, Anxiety, and Stress Scales (DASS-21) were used for the estimation of psychological distress. Chromatin textural homogeneity and uniformity were negatively correlated (p < 0.01) with mental distress and had relatively good discriminatory power in differentiating participants with normal and elevated stress levels. As an addition, we propose the creation of a machine learning model based on binomial logistic regression that uses these and other GLCM features to predict stress elevation. To the best of our knowledge, these results are one of the first to establish the link between neutrophil chromatin structural organization quantified by the GLCM method and indicators of normal psychological functioning.

Cardiovascular manifestations are common (35–100%) in the multisystem inflammatory syndrome in children. Our study aimed to analyze treatment impact and cardiovascular involvement in patients with multisystem inflammatory syndrome in children. The retrospective cohort included 81 patients treated between April 2020 and December 2021 (9.3±4.6 years). Elevated cardiac troponin I and pro-B-type natriuretic peptide were observed in 34.2% and 88.5% of patients, respectively. Myocardial dysfunction was observed in 50.6%. Children older than 10 years had a 4-fold increased risk of myocardial dysfunction (odds ratio [OR] 3.6, 95% confidence interval [CI] 1.4-8.9; p=0.006). A moderate negative correlation was proved between left ventricle ejection fraction and C-reactive protein (rr = - 0.48; p < 0.001). More than one-fifth of the patients presented with shock. Coronary artery dilatation was observed in 6.2% of patients. Mild pericardial effusion was detected in 27.1% of children. On standard electrocardiogram, 52.6% of children had negative T waves in the inferior and/or precordial leads; transient QTc prolongation was registered in 43% of patients. Treatment failure was observed in 19 patients. Patients initially treated with intravenous immunoglobulins had 10-fold higher chances for treatment failure than patients treated with corticosteroids (OR 10.6, 95% CI 3,18 – 35.35; p < 0.001). Cardiovascular manifestations were observed in more than half of the patients, with acute myocardial dysfunction being the most common, especially in children older than 10 years. We established a negative association between the degree of elevation of inflammatory markers and left ventricular ejection fraction. Patients treated with intravenous immunoglobulins who had cardiovascular manifestations had treatment failures more frequently than patients treated with corticosteroids.

Perinatal asphyxia (PA) is a condition characterized by a gas exchange disorder due to a lack of blood flow or gas exchange, with potential multiorgan dysfunction. Our study aimed to determine the correlation between biochemical markers and echocardiography findings in a group of asphyxiated newborns. The prospective cohort study included 120 neonates (52/120 with PA) treated at a tertial referral pediatric center, from 2012 to 2014. A moderate-strong positive correlation was recorded between the transtricuspid pressure gradient (TRPG) and serum lactate, and between TRPG and NT-proBNP in the PA group (P

Urosepsis is defined as sepsis caused by urinary tract infection (UTI). Urosepsis represents a quarter of all cases of sepsis in adults. Complications of UTIs are the most common risk factor for urosepsis development. These infections, especially pyelonephritis, often occur in patients with structural or functional malformations that interfere with normal urine flow. The problem of a significant increase in UTIs with multiresistant bacteria should be emphasized, especially in patients with recurrent UTI and their frequent treatments. As the urogenital tract is one of the most common sources of infection in sepsis in general, a detailed assessment of the tract should be carried out in all septic patients. Even though urosepsis is associated with a relatively good prognosis and lower mortality than sepsis of another etiology, it occurs rapidly and progresses at a significant speed. Since urosepsis is mainly the result of obstruction of the urinary tract, the development of septic shock can most often be prevented by implementing early deobstruction. Knowledge of the most common causes of urosepsis and the category of high-risk patients will provide clinicians with the tools with which to prevent its occurrence.

Introduction/Objective. Continuing Medical Education (CME) is a crucial element to keep the level of professionalism in the three key fields of medical education: pre-clinical, clinical, and public health. The profile of CME in Serbia has been analyzed for the 2011?2017 period. Methods. Between 2011 and 2017, 11,557 courses of CME have been submitted for accreditation, described by 26 variables. Due to the predominance of nominal data, we employed a principal component analysis (PCA) using the nonlinear iterative partial least squares algorithm (PCA/PLS) to arrange the 16 variables with complete information in such a way that most influential factors could be displayed and ranked. The analysis was done with TIBCO Statistical Software. Results. The Faculty of Medicine of Belgrade takes the top position among the medical faculties in Serbia with 569 courses or 47.9% (n = 1187; 2011?2017), whereas non-educational institutions with 86.2% of all courses (n = 11,514) are the most dominant providers. Clinical topics dominate the thematic spectrum with 59.7%. Between 2012 and 2017, the total number of courses offered diminished by 16.9%. A PCA of 16 potential determinants of CME reveals that the most relevant ones are duration, credit points, price, and number of lecturers. Conclusion. For the last decade, a standstill or even a regression in the development can be observed. Especially the faculties of medicine in Serbia, as well as other major providers, should reconsider the entire structure of their administrative organization and initiate innovative development.

Paper description: The growth hormone secretagogue receptor R1a, the receptor for ghrelin, is expressed in immune cells. The influence of intracerebroventricularly administered ghrelin (1 μg/day/rat for 5 days) to rats of different ages (peripubertal (5 weeks), young (2 months) and middle-aged (6 months; n=10 per group), on thymus mass and thymic architecture was examined. Intracerebroventricular application of ghrelin postponed thymic atrophy: the average weights of the thymuses were significantly higher in the ghrelin groups; ghrelin positively influenced the number of thymocytes and thymic structure. Our results point to a stimulatory effect of ghrelin on thymic size and function. Abstract: Ghrelin positively influences the total number of thymocytes and size of the thymus in 14-, 20- and 24-month-old rats. We examined the effect of centrally-applied ghrelin on thymus weight and structure in Wistar rats of different ages. The study included 30 male Wistar rats of three age groups: peripubertal (5-week-old rats), young (2 months) and adult (6 months). The animals of each age group were divided into control and experimental groups that were administered intracerebroventricularly (ICV) 1 μg ghrelin/5 μL saline daily for five consecutive days. Following treatment, the thymuses were isolated, weighed and processed for stereological analysis by the point-counting method. The average weights of the thymuses were significantly higher in the ghrelin groups with respect to control rats (5 weeks: 444.90±18.03 vs 365.00±18.63; 2 months: 354.30±13.77 vs 257.00±9.60; 6 months: 365.00±15.90 vs 225.00±7.03, p

Background and Objectives: Smartphone use has been rapidly increasing worldwide, which has brought possible smartphone addiction into the focus of research. In order to identify potential smartphone addicts, several scales were developed to assess smartphone addiction. Among them, the Smartphone Addiction Scale was frequently used. The study aimed to test the reliability and validity of the Serbian version of the SAS-SV and estimate smartphone addiction prevalence among medical students. Materials and Methods: The study was conducted in December 2018 on a convenience sample of 323 third-year medical students. The cross-cultural adaptation was performed following the well-established guidelines for cross-cultural adaptation of self-reported measures. Exploratory factor analysis was used to examine the structure of the questionnaire. Factor extraction was performed by principal component analysis with Varimax rotation. For test–retest reliability, students completed the questionnaire twice within seven days. Results: The Serbian version of the SAS-SV showed good internal consistency (Cronbach’s alpha = 0.89) and excellent reliability for test–retest scores (ICC = 0.94, 95% CI = 0.92–0.96). Factor analysis supported the extraction of one factor, which explained 51.538% of the variance. To explore convergent validity furthermore, the SAS-SV was correlated with time indicators of smartphone use. According to cut-off values for the SAS-SV score, 19.5% of students could be regarded as “addicted”, and often spent more time on smartphones and social networks on working days and weekends than “not addicted” students. Conclusions: The Serbian version of the SAS-SV is a reliable and valid instrument for detecting smartphone addiction among university students. Further research on this issue is encouraged to enable a better understanding of this ever-increasing public health issue.

Supplemental Digital Content is available in the text., Background: Cardiovascular complications with myocarditis in multisystem inflammatory syndrome in children (MIS-C) associated with severe acute respiratory syndrome coronavirus 2 infection have been reported, but the optimal therapeutic strategy remains unknown. Methods: A retrospective cohort study included 19 patients with acute left ventricular systolic dysfunction associated with MIS-C, average years of age 13.2 ± 3.8, treated from April 2020 to April 2021. Results: Treatment failure (TF) was observed in 8 patients (in the intravenous immunoglobulin [IVIG] group 7/10; in the corticosteroid [CS] group 1/9). The independent risk factor for TF was IVIG treatment (odds ratio [OR] 18.6, 95% confidence interval [CI] 1.6–222.93, P = 0.02). Patients initially treated with CS became afebrile during in-hospital day 1 (1.5, interquartile range [IQR] 1–2), while IVIG-treated patients became afebrile on in-hospital day 4 (IQR 2–4.25), after CS was added. The C-reactive protein (CRP) significantly declined in CS-treated patients on day 2 (P = 0.01), while in the IVIG group, CRP decreased significantly on the fourth day (P = 0.04). Sodium and albumin levels were higher on third in-hospital day in the CS group than in the IVIG group (P = 0.015, P = 0.03). A significant improvement and normalization of ejection fraction (EF) during the first 3 days was observed only in the CS group (P = 0.005). ICU stays were shorter in the CS group (4, IQR 2–5.5) than in the IVIG group (IVIG group 7, IQR 6–8.5) (P = 0.002). Conclusions: Among children with MIS-C with cardiovascular involvement, treatment with CS was associated with faster normalization of LV EF, fever, laboratory analysis, and shorter ICU than IVIG-treated patients.

Background: In recent years, the need for validated and reliable questionnaires for different applications could be observed throughout scientific literature. To add to this trend, we translated into Serbian the Smartphone Addiction Scale-Short Version (SAS-SV) and tested it for its psychometric properties. This study's main aims were to test the Serbian version of the SAS-SV's internal consistency and reliability and estimate smartphone addiction prevalence among medical students. Methods: The study was conducted in December 2018 on a representative sample of third-year medical students. The cross-cultural adaptation was performed following the well-established guidelines for cross-cultural adaptation of self-reported measures. For test-retest reliability, students filled the questionnaire twice, within seven days. Results: The Serbian version of SAS-SV showed good internal consistency (Cronbach's alpha = 0.89) and excellent reliability for test-retest scores (ICC = 0.94, 95% CI = 0.92-0.96). Factor analysis supported the extraction of one factor, which explained 51,5% of the variance. To explore construct validity furthermore, SAS-SV was correlated with time indicators of smartphone use. According to cut-off values for the SAS-SV score, 19.5% of students could be regarded as “addicted” and often spent more time on smartphones and social networks on working days and weekends than “not addicted” students. Conclusion: The SAS-SV in the Serbian version is a reliable and valid instrument for detecting smartphone addiction among university students. Further research on this issue is encouraged to enable a better understanding of this ever-increasing public health issue.

Paper description: Chronic exposure to glucose-based peritoneal dialysis (PD) solutions causes peritoneal injury as a result of upregulation of vascular endothelial growth factor (VEGF) with proinflammatory and proangiogenetic activities. Few studies have examined the in vivo effects of VEGF on the peritoneal membrane in humans. Observed significant inverse correlations between drained dialysate VEGF concentrations, residual diuresis and residual renal function at chronic PD onset point to the importance of preserved residual renal function in achieving VEGF clearance. The predictive value of drained dialysate VEGF in identifying patients with preserved transport characteristics of peritoneal membrane and efficacious long term PD maintenance is emphasized. Abstract: Vascular endothelial growth factor (VEGF), a powerful angiogenetic agent crucial for microvascular hyperpermeability and neoangiogenesis in the peritoneum, is associated with increased solute transport rates in chronic peritoneal dialysis (PD) patients. We investigated the correlation between serum and drained dialysate (dd) concentrations of VEGF and the transport characteristics of peritoneal membrane and dialysis quality in 20 patients with end-stage renal failure at the beginning and after six months of PD. The serum VEGF (sVEGF) concentration rose significantly (149.33±116.71 pg/mL vs 239.36±102.23 pg/mL; p=0.012) and ddVEGF concentration increased slightly (38.44±50.47 pg/mL vs 43.55±51.10 pg/mL) during the first 6 months of PD. At the beginning of chronic PD, ddVEGF concentrations correlated inversely with the peritoneal equilibrium test (PET) glucose (R=-0.565; p=0.009) and creatinine (R=-0.506; p=0.023) and residual renal function (RRF) (R=-0.691; p=0.001); sVEGF concentrations inversely correlated with PET creatinine (R=-0.457; p=0.043) and residual diuresis (RD) (R=-0.691; p=0.001). After 6 months of treatment, ddVEGF concentrations correlated directly with PET creatinine (R=0.450; p=0.047), and inversely with RRF (R=-0.552; p=0.012) and residual renal weekly Kt/V (R=-0.488; p=0.029). The sVEGF concentration inversely correlated with RD (R=-0.589; p=0.006). High ddVEGF at the beginning of PD is predictive of adverse alterations of the peritoneal membrane, i.e. increased transport rate of glucose and creatinine. ddVEGF values may help to identify patients who will preserve adequate transport characteristics of the peritoneal membrane and maintain successful long-term PD. https://doi.org/10.2298/ABS181120061J Received: November 20, 2018; Revised: December 19, 2018; Accepted: December 22 2018; Published online: December 27, 2018 How to cite this article: Jovanovic NŽ, Žunic SS, Trbojevic-Stankovic JB, Lausevic ŽD, Nesic DM, Stojimirovic BB. The relationship between vascular endothelial growth factor (VRGF) in the serum and drained dialysate with the quality of peritoneal dialysis and peritoneal membrane transport rates. Arch Biol Sci. 2018;71(1):187-94.

Paper description: Tumor markers are significant for early detection of (pre)malignant lesions, local recurrence and distant metastasis, prevention of secondary tumors, appropriate therapeutic protocol choice, and as a prognostic factor for disease progression. In this prospective case, immunohistochemical expression of the tumor markers PCNA, HER-2 and CD-31 in patients with oral squamous cell carcinoma undergoing the same surgical treatment during a ten years period was determined. Increased expression of PCNA during advanced stage of the disease may be a useful biomarker in determining further disease progression. PCNA can be useful in routine clinical practice. Abstract: Several studies have investigated the expression of tumor markers, including p53, HER-2, PCNA, EGFR, VEGFR CD-31 and Bcl-2 in patients with oral squamous carcinoma (OSC). This study aimed to determine the expression of proliferating cell nuclear antigen (PCNA), endothelial functions of platelet/endothelial cell adhesion molecule-1 (CD31) and human epidermal growth factor receptor-2 (HER-2) according to OSC stage. The prospective study included 62 patients diagnosed with OSC stages II and III. Surgical specimens were obtained from tumor and peritumoral tissues. We determined the pathohistological degree of tumor differentiation and the immunohistochemical expression of PCNA, CD-31 and HER-2 for each specimen. Immunohistochemical analysis of the expression of PCNA in tumor cells demonstrated poor staining of immunoreactive tumor cells in 23 patients (10 in stage II, 7 in stage IIIa and 6 in stage IIIb). Moderately expressed PCNA-immunoreactivity in the tumor cells in 17 patients (7 in stage II, 6 in stage IIIa and 4 in stage III), and extremely strong PCNA-immunoreactive staining in tumor cells of 10 patients with IIIb stage, was observed. These results suggest that PCNA expression combined with pathohistological findings could possess a prognostic value in determining the survival rates for patients with oral squamous cell carcinoma. https://doi.org/10.2298/ABS190705053L Received: July 5, 2019; Revised: August 4, 2019; Accepted: August 6, 2019; Published online: August 30, 2019 How to cite this article: Loncarevic SA, Brajkovic DO, Gardasevic MF, Loncarevic OLj, Lađevic NG, Nesic DM, Stamenkovic DM, Likic-Lađevic IS, Lađevic NN, Rancic NK. Expression of PCNA, CD-31 and HER-2 in Serbian patients with oral squamous cell carcinoma. Arch Biol Sci. 2019;71(4):703-10.

The aim of this study was to assess the validity and reliability of the Serbian versions of theThe study included 573 fifthyear medical students at 5 universities in Serbia. The research instrument consisted of SBI and CBI. The reliability of these instruments was assessed using an internal consistency measure (Cronbach's α), an intra-class coefficient (ICC) and factor analysis.Cronbach's α for SBI was 0.83, including for exhaustion 0.73, for cynicism 0.70, and for inadequacy 0.48. The test-retest reliability (ICC) was 0.75. Cronbach's α for personal burnout on CBI was 0.89, for the faculty-related burnout 0.86, and for the faculty-members-related burnout 0.92. Cronbach's α for CBI was 0.93. The factor analysis for SBI showed 2 factors and for CBI 3 factors.This study revealed that the Serbian versions of both SBI and CBI could be used for the assessment of burnout in this population. Int J Occup Med Environ Health. 2021;34(6):737-45.

BACKGROUND: Acute myocarditis (AM) is defined as inflammation of the myocardium. The aim of our study is a comparative analysis of the differences between AM related and unrelated to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: The retrospective study included children with AM treated from January 2018 to November 2020. RESULTS: The study included 24 patients; 7 of 24 had AM related to SARS-CoV-2 and they were older than 7. They were more likely to have abdominal pain (P = 0.014), headache (P = 0.003), cutaneous rash (P = 0.003), and conjunctivitis (P = 0.003), while fulminant myocarditis was commonly registered in AM unrelated to SARS-CoV-2 (P = 0.04). A multisystem inflammatory syndrome in children associated with COVID-19 was diagnosed in six adolescents. Patients with AM related SARS-CoV-2 had lower serum cardiac troponin I (cTnI) (P = 0.012), and platelets (P < 0.001), but had a higher C-reactive protein (CRP) value (P = 0.04), and N-terminal-pro hormone BNP in comparison to patients with AM unrelated to SARS-CoV-2. The patients with AM related to SARS-CoV-2 had significant reduction of CRP (P = 0.007). Inotropic drug support was used for shorter durations in patients with AM related to SARS-CoV-2, than in others (P = 0.02). Children with AM related to SARS-CoV-2 had significant improvement of left ventricle systolic function on the third day in hospital (P = 0.001). Patients with AM unrelated to SARS-CoV-2 AM had more frequent adverse outcomes (P = 0.04; three died and four dilated cardiomyopathy). CONCLUSIONS: In contrast to patients with AM unrelated to SARS-CoV-2, patients with AM related to SARS-CoV-2 had a higher CRP value, polymorphic clinical presentation, shorter durations of inotropic drugs use as well as prompt recovery of left ventricle systolic function.

Background: In multisystem inflammatory syndrome in children (MIS-C) temporarily associated with coronavirus disease-19 (COVID-19), myocardial damage has been reported. Materials and Methods: A retrospective observational cohort study included children under 18 who had a myocardial injury related to COVID-19 treated in mother and child health institute from April 2020 to August 2020. Myocardial injury related to COVID-19 was manifested by elevated serum cardiac troponin and NT-proBNP with LV dysfunction, arrhythmias, and coronary arteries (CAs) dilatation or aneurysms. During the short-term follow-up, cardiac testing (electrocardiography, laboratory analysis, echocardiography, 24-h Holter monitoring, exercise stress test, and cardiac magnetic resonance) was performed. Results: Six male adolescents (14.7 ± 2.4 years) were included in the analysis (2/6 had MIS-C shock syndrome). All patients had elevated acute-phase reactants and NT-proBNP, whereas troponins were elevated in 5/6 patients. Echocardiography revealed left ventricular (LV) systolic dysfunction (EF 45.2 ± 6.9%); 2/6 had dilated CAs. IVIG was prescribed to all patients with MIS-C. Four patients required inotropic drug support. During hospitalization, a significant reduction of CRP, LDH, NT-proBNP, and D-dimer (P < 0.05) was registered. LV systolic function recovery was registered 3 days after applied therapy (P < 0.001). None of the patients developed dilated cardiomyopathy or CA aneurysms. Conclusions: With early recognition and adequate MIS-C therapy, children recovered entirely, maintained in the short-term follow-up period.

The novel coronavirus disease (COVID-19) may induce multisystem inflammatory syndrome in children, which may be associated with Kawasaki-like disease, and cardiac injury. In this study, we presented three male adolescents with multisystem inflammatory syndrome and myocardial injury admitted to the hospital during the peak of COVID-19 pandemic. All of the three patients had a history of fever, gastrointestinal symptoms, polymorph rash, non-exudative conjunctivitis, and signs of acute myocarditis. One of them had renal failure. Previously, they did not have an acute infection. Upon admission, they were hypotensive and tachycardic. A nasopharyngeal swab for SARS-CoV-2 on reverse transcription-polymerase chain reaction (PCR) assay was negative, but neutralizing viral antibodies were positive. In combination with blood tests, ECG, echocardiography and computerized tomography (CT), a multisystem inflammatory syndrome associated with acute myocarditis with mild to moderate systolic dysfunction and dilated coronary arteries were diagnosed. Two of three patients had shock syndrome and required inotropic support. All patients were treated with intravenous immunoglobulins. The second patient had a fever up to 102.2°F (39°C) three days after intravenous immunoglobulins. Further, he was treated according to protocols for refractory Kawasaki disease, with an intravenous methylprednisolone pulse therapy and aspirin. After a few hours, he became afebrile and the clinical signs disappeared. The favorable short-term outcome may reflect the early recognition and adequate therapy; however, the long-term outcomes are currently unknown.

Objective The predisposing factors for pericarditis recurrence in the pediatric population have not yet been established. This study aimed to define the risk factors for the unfavorable prognosis of pediatric acute pericarditis. Methods This was a retrospective study that included all patients with acute pericarditis treated from 2011 to 2019 at a tertiary referent pediatric center. Results The study included 72 children. Recurrence was observed in 22.2% patients. Independent risk factors for recurrence were: erythrocyte sedimentation rate ≥ 50 mm/h (p = 0.003, OR 186.3), absence of myocarditis (p = 0.05, OR 15.2), C-reactive protein ≥ 125 mg/L (p = 0.04, OR 1.5), and non-idiopathic etiology pericarditis (p = 0.003, OR 1.3). Corticosteroid treatment in acute pericarditis was associated with a higher recurrence rate than treatment with non-steroid anti-inflammatory therapy (p = 0.04). Furthermore, patients treated with colchicine in the primary recurrence had lower recurrence rate and median number of repeated infections than those treated without colchicine (p = 0.04; p = 0.007, respectively). Conclusion Independent risk factors for recurrence are absence of myocarditis, non-idiopathic etiology pericarditis, C-reactive protein ≥ 125 mg/L, and erythrocyte sedimentation rate ≥ 50 mm/h. Acute pericarditis should be treated with non-steroid anti-inflammatory therapy. A combination of colchicine and non-steroid anti-inflammatory drugs could be recommended as the treatment of choice in recurrent pericarditis.

Recent findings have suggested that iron oxide nanoparticles (IONPs) have some exceptional chemical characteristics which make them useful in both experimental physiology and cell biology research. These nanoparticles might be applied as drug delivery systems for anti-cancer and other medications. Also, IONPs might be a valuable part of many novel bioassays in various fundamental medical fields. In recent years, several studies have indicated that IONPs may have certain cytotoxic and genotoxic potential in living systems. During in vitro conditions, IONPs might induce generation of reactive oxygen species and cause oxidative stress in some cell populations. The toxicity of IONPs is not yet fully understood, and additional research is needed to confirm if IONPs have detrimental effects on human health. This short article focuses on the recent developments and trends in the fields of nanomedicine and nanobiology regarding iron oxide nanomaterials and their application in fundamental medical disciplines such as experimental physiology. We discuss our previously published works on structural effects of IONPs and other metallic nanoparticles on cell nucleus in in vitro conditions. We also describe our recent findings regarding the impact of IONPs on certain biophysical properties of subcellular components.

The aim of this study was to evaluate longitudinal changes in drained dialysate cancer antigen 125 (dCA-125) levels and to assess relationships between dCA-125 and dialysis quality, peritoneal membrane transport rates, dialysate glucose load, peritonitis and use of erythropoiesis stimulating agents (ESA), angiotensin-converting-enzyme inhibitors (ACEi) and statins in patients with end-stage renal failure during the first 6 months of peritoneal dialysis (PD) treatment. This prospective study included 20 patients (11 males and 9 females; mean age 62.90±12.69 years) who were followed-up during the first 6 months of PD using conventional low pH glucose-based dialysis fluids. The concentration of dCA-125 was measured in all patients, and the peritoneal equilibration test (PET), peritoneal dialysis treatment adequacy (Kt/V), normalized protein catabolic rate (nPCR), and total, peritoneal and residual clearances of urea and creatinine were calculated. Information on peritonitis occurrence, the use of ESA, ACEi and statins were collected. Data were analyzed by the Mann-Whitney test, Wilcoxon matched pairs test and Spearman’s rank correlation. The concentration of dCA-125 significantly decreased during the follow-up (p=0.016). After 6 months of PD treatment, the concentration of dCA-125 decreased significantly (p=0.016) in all patients. The decrease was present in all patients, but was statistically significant in patients on ACEi therapy (p=0.006) and in patients not using statins (p=0.005) or ESA (p=0.012). No correlation was found between dCA-125 and glucose load, but a statistically significant negative correlation between dCA-125 and the PET for creatinine was observed (p=0.013). These findings challenge the role of dCA-125 in predicting mesothelial cell integrity in PD patients. https://doi.org/10.2298/ABS170324021J Received: March 24, 2017; Revised: May 7, 2017; Accepted: May 9, 2017; Published onlione: June 12, 2017 How to cite this article: Jovanovic NŽ, Trbojevic-Stankovic JB, Nesic DM, Obrenovic RŽ, Boricic NI, Stojimirovic BB. Cancer antigen 125 concentrations in patients on chronic peritoneal dialysis: Relationship with dialysis quality and membrane transport properties. Arch Biol Sci. 2018;70(1):13-20.

Both pregnancy, as physiological, and polycystic ovary syndrome (PCOS), as a pathological condition, carry the risk for developing glucose metabolism abnormalities. In this retrospective cross-sectional study, we hypothesized that pregnancy as a physiological condition carries a higher likelihood for abnormal oral glucose tolerance test (OGTT) results than PCOS as a pathological condition. We have compared the prevalence and likelihood ratios for abnormal OGTT results between non-pregnant women with PCOS (Group A) and pregnant women at 24 to 28 weeks of gestation (Group B). Participants of both study groups underwent glucose tolerance testing with 75 g glucose OGTT. During the study period, 7411 women were tested, 3932 women encompassed Group A, and 3479 women comprised Group B. The numbers of yearly tested pregnant women and the corresponding proportion of tested women among all study participants have decreased during the study period, from 766 to 131 and 89.1% to 20.5%, respectively. Group A had a significantly lower prevalence (4.4%) of pathological OGTT results compared to Group B (8.1%). This has resulted in a 45.427 likelihood ratio (P

Internet addiction is a novel and relatively uninvestigated form of dependence that is fairly common in adolescent population. Previous research has indicated that it may be associated with other mental health problems, such as dysthymic mood and narcissistic behavior. In our study, we tested the existence and strength of relationship between Internet addiction, self-esteem and narcissism in a student population. On a sample of 244 students, we also investigated social networking activities, such as number of self-portrait photographs ("selfies"), and their potential connection with self-esteem and narcissism. Each participant completed a questionnaire consisting of Young Internet Addiction Test, Rosenberg Self-Esteem scale, and Narcissistic Personality Inventory. There was a statistically significant negative correlation between internet addiction score and self-esteem. Internet addiction increased as self-esteem decreased and vice versa. On the other hand, there was a positive correlation between internet addiction and narcissism. NPI score and number of self-portrait photographs (selfies) on Facebook were also in a positive relationship. Conversely, NPI score increased as the self-esteem decreased. The results of the study are in accordance with our previous findings on Internet use and mental health, confirming that Internet addiction is a potentially a serious public health problem.

Nutritional support of surgical patients is a necessary part of the treatment. It alone cannot cure the disease but it significantly affects the recovery of patients and supports surgical interventions. Patients in malnutrition have shown to have significantly more postoperative infectious and non-infectious complications. This significantly prolongs treatment time and increases costs. However, there is one fact that cannot be expressed in money, which is the patient's impression of the surgical intervention. Adequate preoperative patient support, based on the intake of liquid nutritive solutions, reduces preoperative stress and deflects the metabolic response. Now, it is recommended for adults and children older than one year to drink clear liquid up to 2 hours before induction in anesthesia. Appropriate enteral nutrition has a significant place in the postoperative recovery of patients. Enteral nutrition is reducing complications, mainly infectious complications because the function of the digestive system as one large immune system is preserved. Perioperative enteral nutrition is a necessary part of the modern treatment of surgical patients. In addition to the significant effect on the occurrence of postoperative complications, it is also important that this type of diet improves the psychological status of patients.

In this study we investigated the relationship between the calcium channel blockers (CCBs), amlodipine, felodipine, isradipine, nicardipine, nifedipine, nimodipine, nisoldipine, verapamil and diltiazem, and their calculated molecular descriptors: polar surface area (PSA), molecular weight (Mw), volume value (Vol), aqueous solubility data (logS), lipophilicity (logP), acidity (pKa values) and plasma protein binding (PPB) data, obtained from relevant literature. The relationships between the computed molecular properties of selected CCBs and their PPB data were investigated by simple linear regression analysis that revealed very low correlations (R2

The plasma protein binding (PPB) data of twelve antipsychotics (aripiprazole, clozapine, olanzapine, quetiapine, risperidone, sertindole, ziprasidone, chlorpromazine, flupentixol, fluphenazine, haloperidol, zuclopenthixol) were estimated using computed molecular descriptors, which included the electronic descriptor – polar surface area (PSA), the constitutional parameter – molecular weight (Mw), the geometric descriptor – volume value (Vol), the lipophilicity descriptor (log P ) and aqueous solubility data (log S ), and the acidity descriptor (pK a ). The relationships between computed molecular properties of the selected antipsychotics and their PPB data were investigated by simple linear regression analysis. Low correlations were obtained between the PPB data of the antipsychotics and PSA, Mw, Vol, pKa, log S ( R

Target dialysis dose to ensure the best patient outcome is still a matter of debate. Traditional models have a number of limitations and do not comprehensively reflect all factors involved. In this study we present a new complex model of dialysis adequacy, the hemodialysis adequacy score (HAS), and evaluate its prognostic value, as well as its relationship with the malnutrition-inflammation score (MIS). The components of HAS included paradigms of the 6 major factors known to influence the outcome of hemodialysis (HD) patients: the modified Karnofsky index (KI), the Charlson comorbidity index (CCI), Kt/V and URR measures of dialysis dose, body mass index (BMI) and serum albumin level, serum levels of hemoglobin and ferritin, intact parathyroid hormone (iPTH) and calcium-phosphorus solubility product. The score was evaluated in a 24-month prospective study on 147 HD patients. Odds ratio analysis showed that hospitalized patients had twice the chance to have HAS >13 compared to those who were not hospitalized during the study period (OR=2.152, CI 95% (1.0024-4.619). Mortality rate was significantly higher in patients with a HAS >13 at the 12-month follow-up (χ2=16.416, p 13 had significantly higher probability of death (log-rank Cox-Mantel=17.920, df=1, p

Background and Objectives: Recurrence of pericarditis (ROP) is an important complication of the acute pericarditis. The aim of this study was to analyse the influence of aetiology, clinical findings and treatment on the outcome of acute pericarditis. Methods: Data were retrospectively collected from medical records of patients treated from 2011 to 2019 at a tertiary referent heart paediatric center. Results: Our investigation included 56 children with idiopathic and viral pericarditis. Relapse was registered in 8/56 patients, 2/29 (7.41%) treated with nonsteroidal anti-inflammatory drugs (NSAID) and 6/27 (28.57%) treated with corticosteroids (CS) and NSAID. Independent risk factors for ROP were viral pericarditis (p = 0.01, OR 31.46), lack of myocardial affection (p = 0.03, OR 29.15), CS use (p = 0.02, OR 29.02) and ESR &ge, 50 mm/h (p = 0.03, OR 25.23). In 4/8 patients the first recurrence was treated with NSAID and colchicine, while treatment of 4/8 patients included CS. Children with ROP treated with CS had higher median number of recurrence (5, IQR: 2&ndash, 15) than those treated with colchicine (0, IQR: 0&ndash, 0.75). Conclusions: Independent risk factors for recurrence are CS treatment, viral aetiology, pericarditis only and ESR &ge, 50 mm/h. Acute pericarditis should be treated with NSAID. Colchicine and NSAID might be recommended in children with the first ROP.

Objectives Physical activity level decreases during young adulthood. As social media are nowadays widely used and are included into many people's daily routines, the interventions on these websites have the possibilities to be integrated into those routines without becoming a burden. The aim of this study was to assess physical activity level among first- and fifth-year medical students and social media intervention with the aim to improve physical activity among them. Study design Prospective longitudinal study was conducted during October of 2016 at the Faculty of Medicine, University of Belgrade, Serbia. The study included 375 first- and fifth-year students. Methods At the baseline, students filled in the questionnaire and were asked to join a Facebook discussion group. The intervention consisted of motivation for physical activity through motivational pictures, texts, and discussions. The second assessment was carried out after one month. Based on the reported physical activity level, students were divided into groups: sufficient (>600 metabolic equivalent [MET]-minutes/week) and insufficient physical activity (≤600 MET-minutes/week). Results Total of 85.4% of students were sufficiently active at the baseline, whereas 90.4% were sufficiently active after one month. Multivariate logistic regression analysis showed that students who were part of the Facebook group (odds ratio [OR]: 3.51, 95% confidence interval [CI]: 1.46–8.43) and students who had sufficient physical activity at the baseline (OR: 5.44, 95% CI: 2.44–12.13) had a higher likelihood to be sufficiently active after one month. Conclusion Social media are shown to be valuable in health-promoting interventions and can be used for interventions targeting lifestyle change among young adults.

We sought to investigate right heart remodeling and function in elite athlees, as well as the relationship between parameters of right ventricular (RV) and right atrial (RA) remodeling and indices of aerobic capacity. Elite male athletes (n = 352) underwent echocardiographic examination including the evaluation of RV and RA parameters. Maximal cardiopulmonary exercise testing was performed to measure maximal oxygen consumption (VO2max), ventilatory anaerobic threshold (VAT) and heart rate reserve (HRR). The right heart remodeling was different between groups. Soccer players had significantly higher RV and RA diameters indexed for BSA. RV filling pressure assessed by tricuspid E/e’ ratio was the lowest in soccer players, suggesting somewhat better RV diastolic function. Functional capacity also varies between groups of athletes. VO2max was the highest among soccer players, somewhat lower in basketball players and and the lowest among water polo players (55.3 ± 5.6 vs. 52.1 ± 5.9 vs. 53.5 ± 4.8 ml/kg/min, p

Introduction: Tramadol and metamizol are very commonly used postoperatively for acute pain (bolus doses). Combined iv infusion tramadol/metamizol provide safe and effective acute pain relief and there is no evidence for pharmacokinetic and pharmacodynamic side effects in clinical practice. Morphine sulfate seems to be the best rescue analgesic for patients receiving this infusion. Methods: After approval of local ethic committee and written ICF, the prospective cohort pilot study included all patients undergoing surgery (radical nephrectomy with lumbotomy approach). ASA physical status I to III and normal minimental score patients were included. Patients suffered from diabetes melitus, depressive disorders, advanced renal failure, hematology disease, peptic ulcer, drug abuse or chronic opioid use, medicament allergic reaction were excluded. All patients who underwent surgery under general anesthesia recieved the same premedication. Anaesthesia induction was made with propofol in dose 2 mg/ kg followed by sevoflurane (1MAC), fentanyl (0,005 mg/ kg) and rocuronium 0,6 mg/kg for intubation. Complications of surgical procedures have not occurred. Postoperatively, patients were randomized into two groups. Group I received iv infusion of tramadol 100 mg qd and metamizol -Na 2500 mg bid in bolus doses. Analgesia started with tramadol 100 mg followed by metamizol 2500 mg after 120 minutes. Group II received the solution tramadol 400 mg (0,8 mg/ml) and metamizol 5000 mg (10 mg/ml) in 500 ml normal saline. Infusion rate was 200 ml/h first 30 minutes followed with 17 ml/h infusion rate for maintenance until end of infusion. For both group of patients administration of analgesia started 15 minutes after awakeing. Patient related data were compared between two groups as well as pain scores, analgesic consumption and rescue medication if it was necessary. If pain intensity score was above 7/10 by VAS, patients in both groups received rescue dose of 0,025 mg/kg morphine sulfate. Prophylactic doses of metoclopramide 10 mg tid were administered to prevent nausea. Vital signs, body temperature, sedation scores, emetic episodes, therapy side effects and volume loss were recorded. Results: In Group I, 11 patients were randomized, mean age 59 ± 8,95. Regarding gender there were 6 male and 5 female patients. In Group II, 12 patients were randomized, mean age 62,2± 9,51. Regarding gender there were 7 male and 5 female. There was no difference in demographic caracteristics, duration of surgery and intraoperative blood loss between two groups. We found difference in group II patients (p = 3.42, p < 0,01) regarding weight. In group I no difference was found. Average VAS was similar in both groups. Male patients reported higher initial pain score but also higher pain reduction with no age difference in both groups. Patients in group I reached good pain control (VAS ≤ 3) in 8th, while patients in group II reached it in 2nd hour postoperatively. We administered higher doses of analgesics in group I (tramadol 2.58 mg/kg, metamizol 32.28 mg/kg) than in group II (tramadol 1.24 mg/kg, metamizol 15.72 mg/kg). In group I, 45% of patients required rescue analgesia. There was no patients in group II that required rescue analgesia. In patients with significant intraoperative blood loss, additional consumption of rescue analgesia did not occurred. There was no therapy side effects. Conclusion: Administration of combined lower dose tramadol/metamizol in continual infusion provides faster onset and better postoperative analgesia with no consumption of rescue analgesics compared to tramadol/metamizol given individually (in bolus doses).

Erythropoietin is a hormone that promotes the formation of red blood cells by the bone marrow. In adults it is mainly produced by the kidneys as a response to hypoxia. Besides its main role, it also acts as antiapoptotic, anti-inflammatory and cytoprotective agent. Furthermore, it is produced in many non-hematopoietic tissues where it acts locally, stimulating angiogenesis. Erythropoietin binds cytokine receptors on target cells, such as erythrocyte precursor cells, neurons, glial and endothelial cells, cardiomyocytes, myocytes etc. The discovery of synthetic erythropoietin forms, in the late eighties of the last century, has significantly improved treatment outcome of patients with anaemia related to chronic diseases, especially chronic renal failure. Renal anaemia is multifactorial, but predominantly a consequence of erythropoietin deficiency. Today, three generations of erythropoiesis stimulating agents are available, differing in glycosylation pattern, molecular size, half-life and modes of administration and dosage. In anaemic patients this therapy significantly improves their quality of life, but may also have serious, potentially dangerous adverse effects. Synthesis of recombinant human erythropoietin, on the other hand, has improved possibilities for manipulations in sport, in the field of blood doping. Erythropoietin administration in athletes increases their maximum oxygen consumption capacity, improves endurance and performance, especially in aerobic exercise. This seriously undermines the spirit of sport, and also endangers athletes' health. Different anti-doping tests have been developed and used, still with limited success. At the same time, new illicit ways of malpractice are developing, such as variuos models of gene doping. Therefore, providing new models of anti-doping tests and strategies, together with better health control of athletes, still remains a considerable challenge.

Adipose tissue is an endocrine organ which releases biologically active adipokines. Adiponectin, an adipocyte-derived protein structurally similar to complement 1q, plays a significant role in metabolic disorders, due to its insulin sensitizing, anti-inflammatory and anti-atherogenic properties. AdipoR1 and AdipoR2, mediate the metabolic actions of adiponectin by activating adenosine monophosphate-activated protein kinase (AMPK) and peroxisome proliferator-activated receptors- alpha (PPAR-α) which leads to an increase in fatty acid combustion and energy consumption, fatty acid oxidation and glucose uptake in myocytes and reduces gluconeogenesis and thus leads to increased insulin sensitivity. Plasma adiponectin level is affected by multiple factors: gender (females have higher plasma adiponectin levels), obesity-linked diseases (metabolic syndrome, diabetes mellitus type 2 and atherosclerosis are associated with lower adiponectin levels), lifestyle -including exercise. Yet, to date, little is known about the response of adiponectin concentrations to exercise and, in particular, the response of this hormone to training in population of athletes. The aim of this review is to overview the published evidence for the effects of exercise on adiponectin levels in athletes. Adiponectin concentration presents a delayed increase (30 min) after short-term intense performance, by athletes, both male and female. It seems that adiponectin concentrations do not change in response to long-term exercise. No significant difference was found in total adiponectin and/or high-molecular weight (HMW) oligomers in long-term effects of high physical training in athletes. Adiponectin can serve to monitor training loads and the establishment of individual limit values of training loads. Further studies are needed to clarify possible mechanisms by which adiponectin might influence energy homeostasis during heavy training in elite athletes.

The article's abstract is no available.

Obstructive sleep apnea (OSA) can lead to severe health consequences. Drivers of motor vehicles with untreated or undiagnosed OSA have a greater risk of traffic accidents. Use of self-reported questionnaires is the first step in OSA diagnosis. The main aim of this study was to perform the translation and validation of Berlin Questionnaire in a sample of commercial drivers. After formal translation, validation was performed on a sample of commercial drivers and included evaluation of internal consistency, test–retest reliability, construct and criterion validity. Full-night attended polysomnography or cardiorespiratory polygraphy was used for OSA diagnosis. One hundred male participants, 24–62 years old, were included. Berlin Questionnaire classified 35 % subjects as potential OSA patients. Polysomnography confirmed OSA in 58 % of the subjects. Berlin Questionnaire showed good internal consistency (Cronbach’s alpha 0.82—first category, 0.73–0.95—second category). Test–retest reliability (Cohen’s kappa 0.78) was adequate. Berlin score was significantly correlated with OSA category and apnea–hypopnea index (AHI). Sensitivity of Berlin Questionnaire was from 50.9 (AHI ≥ 5) to 75 % (AHI ≥ 30), while specificity ranged from 86 to 70.5 %. Berlin Questionnaire (Serbian version) showed good measurement properties, creating basis for further research of its usefulness as OSA screening tool in populations of interest.

Transforming-growth factor β1 (TGF-β1) is a powerful cytokine involved in physiological processes of growth, differentiation, gene expression, embryogenesis, tissue remodelling, wound healing as well as tumorigenesis, immunosuppression and fibrosis, like peritoneal membrane fibrosis on long-term peritoneal dialysis (PD) treatment. The aims of this study were to determine TGF-β1 levels in serum (s) and drained dialysate (dd), to assess their relations to sex, age, diabetes, dialysis modality, peritonitis and use of erythropoiesis stimulating agents (ESAs), inhibitors of angiotensin-converting enzyme (ACEi) and/or statins in 20 patients, 11 men and 9 women, mean age 62.90 ± 12.69 years, free of peritonitis during the first 6 months of PD treatment. There was no statistically significant difference in TGF-β1 concentrations in serum and drained dialysate at the beginning and after first 6 months of chronic PD, in patients of different sex, age and diabetic patients versus non-diabetic. The significant positive correlations between sTGF-β1 levels and glycemia at the beginning and cholesterolemia after 6 months of PD treatment suggest higher TGF-β1 concentrations in patients with unfavorable metabolic profile. Expression of TGF-β1 in effluent dialysate was significantly lower in patients on chronic PD using ACEi therapy, suggesting ACEi to have a protective effect on peritoneal membrane. Patients on ESA had slightly lower sTGF-β1 concentrations after the first 6 months of PD treatment.

Calcium channel blockers (CCBs) are among the most widely used drugs in cardiovascular medicine. In this study, nine CCBs (amlodipine, felodipine, isradipine, nicardipine, nifedipine, nimodipine, nisoldipine, verapamil and diltiazem) were investigated to assess the relationship between their molecular properties and elimination data obtained from literature. The descriptors of the molecular properties of CCBs were calculated using three software packages. The relationship between computed molecular properties and elimination data collected from relevant literature, initially investigated with simple linear regression analysis, showed poor correlation (R2

Angiotensin II receptor antagonists (ARBs) modulate the function of the renin-angiotensin-aldosterone system and are commonly prescribed antihypertensive drugs, especially in patients with renal failure. In this study, the relationship between several molecular properties of seven ARBs (candesartan, eprosartan, irbesartan, losartan, olmesartan, telmisartan, valsartan) and their fecal elimination data obtained from the literature were investigated. The ARB molecular descriptors were calculated using three software packages. Simple linear regression analysis showed the best 2 correlation between fecal elimination data and lipophilicity descriptor, ClogP values (R2 = 0.725). Multiple linear regression was applied to examine the correlation of ARBs’ fecal elimination data with their lipophilicity and one additional, calculated descriptor. The best correlation (R2 = 0.909 with an acceptable probability value, P