SAŽETAK
Totalna laringektomija kao metoda kirurškog liječenja tumora područja glave i vrata nosi doživotne posljedice koje su funkcionalnog, psihološkog i socijalnog karaktera, a jedna od najtežih ...jest gubitak sposobnosti glasnog govora. Zbog toga rehabilitacija glasa/govora poslije totalne laringektomije predstavlja važan aspekt funkcionalne rehabilitacije laringektomirane osobe. Dvije najčešće korištene metode usvajanja alaringealnog govora jesu ezofagealni (EF) i traheoezofagealni (TEF) glas/govor. Cilj istraživanja bio je utvrditi razlike u akustičkim vrijednostima ezofagealnog i traheoezofagealnog glasa te na osnovi objektivnih akustičkih parametara prikazati i obrazložiti koji od ova dva modaliteta alaringealnog glasa posjeduje akustičke vrijednosti bliže vrijednostima laringealnih glasova. Materijali i metode: Proveli smo retrospektivno istraživanje na 75 ispitanika u Klinici za bolesti uha, nosa i grla i kirurgiju glave i vrata Kliničkoga bolničkog centra Zagreb. Akustičke vrijednosti mjerene su programom za akustičku analizu glasa LingWAVES SLP Suite Pro VPR (WEVOSYS medical technology GmbH – Germany) te su analizirani slijedeći parametri: fundamentalna frekvencija, intenzitet, varijacije u osnovnoj frekvenciji (jitter), varijacije u intenzitetu glasa (shimmer). Rezultati statističke analize pokazali su da postoji statistički značajna razlika (p<0,05) između dvije skupine alaringealnih govornika na svim mjerenim parametrima osim na vrijednosti varijacija u intenzitetu glasa. Zaključak: Traheoezofagealni glas/govor postiže bolje rezultate od ezofagealnog glasa/govora na svim mjerenim akustičkim parametrima. Vrijednosti TEF govora značajno odstupaju od vrijednosti urednoga laringealnog glasa.
Introduction/Aim. Reproductive health and cervical cancer screeaning are public health priorities. The aim of the study was to asses the sexual behavior and prevalence of cervical cancer screening ...use in the Šumadija District, Serbia. Methods. The research was conducted as a cross-sectional study. The study population consisted of 510 females aged 18 -49 years, living on the territory of the Šumadija District. An anonymous standardised questionnaire was used as a research tool based on the research protocol entitled "The World Health organization, STEPwise Approach to Noncommunicable Disease Risk Factor Surveillance (STEPS)". Results. During the first sexual intercourse, 60.1% of the surveyed population used some of the contraceptives, whereas during the last sexual intercourse, 72.5% of the female respondents reported not having used any of these. Out of the total number of female respondents, every fifth respondent reported not having had a single Pap smear in her lifetime performed (22.8%), i. e. 85.0% of the female respondents aged 19 -29 years (p < 0.001), every third female respondent who had completed elementary school (28.4%) p = 0.009, and every third respondent who was not married (33.3%) (p = 0.01). Conclusion. All the activities should be directed towards increasing the levels of accessibility and availability of the institutions and cervical cancer screening services provided there. In addition, resource capacities should be enhanced as well (medical staff, rooms, equipment).
Peptide receptor radionuclide therapy (PRRT) is a treatment option for well-differentiated, somatostatin receptor positive, unresectable or/and metastatic neuroendocrine tumors (NETs). Although high ...disease control rates seen with PRRT a significant number NET patients have a short progression-free interval, and currently, there is a deficiency of effective biomarkers to pre-identify these patients. This study is aimed at determining the prognostic significance of biomarkers on survival of patients with NETs in initial PRRT treatment.
We retrospectively analyzed 51 patients with NETs treated with PRRT at the Department for nuclear medicine, University Clinical Center Kragujevac, Serbia, with a five-year follow-up. Eligible patients with confirmed inoperable NETs, were retrospectively evaluated hematological, blood-based inflammatory markers, biochemical markers and clinical characteristics on disease progression. In accordance with the progression og the disease, the patients were divided into two groups: progression group (n=18) and a non-progression group (n=33). Clinical data were compared between the two groups.
A total of 51 patients (Md=60, age 25-75 years) were treated with PRRT, of whom 29 (56.86%) demonstrated stable disease, 4 (7.84%) demonstrated a partial response, and 14 (27.46%) demonstrated progressive disease and death was recorded in 4 (7.84%) patients. The mean PFS was a 36.22 months (95% CI 30.14-42.29) and the mean OS was 44.68 months (95% CI 37.40-51.97). Univariate logistic regression analysis displayed that age (p<0.05), functional tumors (p<0.05), absolute neutrophil count (p<0.05), neutrophil-lymphocyte ratio-NLR (p<0.05), C-reactive protein-CRP (p<0.05), CRP/Albumin (p<0.05), alanine aminotransferase-ALT (p<0.05), were risk factors for disease progression. Multivariate logistic regression analysis exhibited that functional tumors (p<0.001), age (p<0.05), CRP (p<0.05), and ALT (p<0.05), were independent risk factors for the disease progression in patients with NETs. Tumor functionality was the most powerful prognostic factor. The median PFS (11.86 ± 1.41 vs. 43.38 ± 3.16 months; p=0.001) and OS (21.81 ± 2.70 vs 53.86 ± 3.70, p=0.001) were significantly shorter in patients with functional than non-functional NETs respectively.
The study's results suggest that tumor functionality, and certain biomarkers may serve as prognostic survival indicators for patients with NETs undergoing PRRT. The findings can potentially help to identify patients who are at higher risk of disease progression and tailor treatment strategies accordingly.
Objectives
To evaluate local effect of gaseous ozone on bacteria in deep carious lesions after incomplete caries removal, using chlorhexidine as control, and to investigate its effect on pulp ...vascular endothelial growth factor (VEGF), neuronal nitric oxide synthase (nNOS), and superoxide dismutase (SOD).
Materials and methods
Antibacterial effect was evaluated in 48 teeth with diagnosed deep carious lesion. After incomplete caries removal, teeth were randomly allocated into two groups regarding the cavity disinfectant used: ozone (open system) or 2% chlorhexidine. Dentin samples were analyzed for the presence of total bacteria and
Lactobacillus
spp. by real-time quantitative polymerase chain reaction. For evaluation of ozone effect on dental pulp, 38 intact permanent teeth indicated for pulp removal/tooth extraction were included. After cavity preparation, teeth were randomly allocated into two groups: ozone group and control group. VEGF/nNOS level and SOD activity in dental pulp were determined by enzyme-linked immunosorbent assay and spectrophotometric method, respectively.
Results
Ozone application decreased number of total bacteria (
p
= 0.001) and
Lactobacillus
spp. (
p
< 0.001), similarly to chlorhexidine. The VEGF (
p
< 0.001) and nNOS (
p
= 0.012) levels in dental pulp after ozone application were higher, while SOD activity was lower (
p
= 0.001) comparing to those in control pulp.
Conclusions
Antibacterial effect of ozone on residual bacteria after incomplete caries removal was similar to that of 2% chlorhexidine. Effect of ozone on pulp VEGF, nNOS, and SOD indicated its biocompatibility.
Clinical relevance
Ozone appears as effective and biocompatible cavity disinfectant in treatment of deep carious lesions by incomplete caries removal technique.
The objective of this research was to analyze the correlation of the neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), soluble programmed cell death ligand 1 (sPD-L1), and Schlafen 11 ...(SLFN11) with the response to first-line chemotherapy in a cohort of small cell lung cancer (SCLC) patients, and to determine their potential as predictive serum biomarkers.
A total of 60 SCLC patients were included. Blood samples were taken to determine CRP, sPD-L1, and SLFN11 levels. The first sampling was performed before the start of chemotherapy, the second after two cycles, and the third after four cycles of chemotherapy.
The patients who died earlier during the study had NLR and SLFN11 concentrations significantly higher compared to the survivor group. In the group of survivors, after two cycles of chemotherapy, the NLR ratio decreased significantly (
< 0.01), but after four cycles, the NLR ratio increased (
< 0.05). Their serum SLFN11 concentration increased significantly (
< 0.001) after two cycles of chemotherapy, but after four cycles, the level of SLFN11 fell significantly (
< 0.01). CRP, NLR, and SLFN11 were significant predictors of patient survival according to Kaplan-Meier analysis. The combination of inflammatory parameters and SLFN11 with a cutoff value above the 75th percentile of the predicted probability was associated with significantly lower overall survival in SCLC patients (average survival of 3.6 months vs. 4.8 months).
The combination of inflammatory markers and the levels of two specific proteins (sPD-L1, SLFN11) could potentially serve as a non-invasive biomarker for predicting responses to DNA-damaging therapeutic agents in SCLC.
Social support as a complex construct has a positive influence not only on a patient's condition but also on the process of the patient's emotional adjustment to cancer. The goal of this study is to ...investigate aspects of the level of social support in oncology patients and its interconnection with sociodemographic and medical variables.
The study was conducted as a prospective observational study in 2020, including 250 patients aged 19 and over, both sexes, with a diagnosis of oncological disease. The research was conducted in the Department of General Medicine of the Health Center Trstenik, Central Serbia, after approval by the Ethics Committee of the Health Center Trstenik, Central Serbia. A social support assessment questionnaire (Oslo-3 Social Support Scale) was used as a research instrument.
Data collected from the entire study population showed that bad social support was present in almost 90% of cases. Univariate and multivariate regression analysis showed a statistically significant influence of the following variables on the bad social support: education level, activity limitation, difficulties in performing daily activities, the impact of pain on the performance of activities, the need for additional help with activity, the need for help at home, unfulfilled needs for health care, means of information, anxiety score and depression score.
Interventions to increase social support may be important for enhancing mental health and quality of life in cancer patients.
Background/Aim. Depression is the most prevalent mental disorder which affects approximately 7% of the world?s older population. This study aimed at examining the prevalence of depression among older ...adults and its relations to chronic illnesses. Methods. Study was con-ducted within the National Health Survey of the Serbian population in 2013. The questionnaires used as instruments in this study were created in accordance with the questionnaires of the European Health Interview Survey ? Second Wave. The Patient Health Questionnaire-8 (PHQ-8) was used to evaluate the presence of depressive symptoms. The relations between depression symptoms (a de-pendent variable) and a set of independent variables were examined with univariate and multivariate logistic regression analyses. Results. The study showed that there was a 10.0% prevalence of depression within this population with statistically significant differences between the genders ? 12.6% of women and 6.5% of men. The multivariate analysis revealed that multimorbidity odds ratio (OR) = 1.89, chronic pain (OR = 2.35) and self-evaluations of poor health (OR = 8.37) were strongly associated to depression. In terms of individual chronic illnesses, the study showed that strokes double the odds of developing depression (OR = 1.82) while the deformities of lower spine increased this odds by 27%. Conclusion. Depression is very frequent in older persons who suffer from chronic diseases and medical conditions. It is crucial to enable ad-equate screening in primary healthcare institutions in order to diagnose depression in its early stages and start its treatment as soon as possible.
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