1
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Pérez EM, Montero HP, Viguera JG, Peñacoba MA, Fernández MN, Stefanovic M, Torres ML, Fernández MDA, Borràs SMI, Montells S, Garau MMI. Increase in the number of adjuvant radiotherapy treatments in breast cancer patients in 2022: effect of COVID-19 pandemic? Clin Transl Oncol 2023; 25:3565-3566. [PMID: 37160572 PMCID: PMC10169108 DOI: 10.1007/s12094-023-03201-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 04/12/2023] [Indexed: 05/11/2023]
Affiliation(s)
- E Martínez Pérez
- Radiation Oncology Department, Catalan Institute of Oncology, Hospital Duran i Reynals. Avinguda de la Granvía de l'Hospitalet 199, l'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - H Pérez Montero
- Radiation Oncology Department, Catalan Institute of Oncology, Hospital Duran i Reynals. Avinguda de la Granvía de l'Hospitalet 199, l'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - J González Viguera
- Radiation Oncology Department, Catalan Institute of Oncology, Hospital Duran i Reynals. Avinguda de la Granvía de l'Hospitalet 199, l'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - M Arangüena Peñacoba
- Radiation Oncology Department, Catalan Institute of Oncology, Hospital Duran i Reynals. Avinguda de la Granvía de l'Hospitalet 199, l'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - M Nuñez Fernández
- Radiation Oncology Department, Catalan Institute of Oncology, Hospital Duran i Reynals. Avinguda de la Granvía de l'Hospitalet 199, l'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - M Stefanovic
- Radiation Oncology Department, Catalan Institute of Oncology, Hospital Duran i Reynals. Avinguda de la Granvía de l'Hospitalet 199, l'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - M Laplana Torres
- Radiation Oncology Department, Catalan Institute of Oncology, Hospital Duran i Reynals. Avinguda de la Granvía de l'Hospitalet 199, l'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - M D Arnáiz Fernández
- Radiation Oncology Department, Catalan Institute of Oncology, Hospital Duran i Reynals. Avinguda de la Granvía de l'Hospitalet 199, l'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - S Marín I Borràs
- Radiation Oncology Department, Catalan Institute of Oncology, Hospital Duran i Reynals. Avinguda de la Granvía de l'Hospitalet 199, l'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - S Montells
- Radiation Oncology Department, Catalan Institute of Oncology, Hospital Duran i Reynals. Avinguda de la Granvía de l'Hospitalet 199, l'Hospitalet de Llobregat, 08908, Barcelona, Spain
| | - M Macià I Garau
- Radiation Oncology Department, Catalan Institute of Oncology, Hospital Duran i Reynals. Avinguda de la Granvía de l'Hospitalet 199, l'Hospitalet de Llobregat, 08908, Barcelona, Spain.
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Ghorbanpour SM, Richards C, Pienaar D, Sesperez K, Aboulkheyr Es H, Nikolic VN, Karadzov Orlic N, Mikovic Z, Stefanovic M, Cakic Z, Alqudah A, Cole L, Gorrie C, McGrath K, Kavurma MM, Ebrahimi Warkiani M, McClements L. A placenta-on-a-chip model to determine the regulation of FKBPL and galectin-3 in preeclampsia. Cell Mol Life Sci 2023; 80:44. [PMID: 36652019 PMCID: PMC9849194 DOI: 10.1007/s00018-022-04648-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 11/03/2022] [Accepted: 11/24/2022] [Indexed: 01/19/2023]
Abstract
Preeclampsia is a pregnancy-specific cardiovascular disorder, involving significant maternal endothelial dysfunction. Although inappropriate placentation due to aberrant angiogenesis, inflammation and shallow trophoblast invasion are the root causes of preeclampsia, pathogenic mechanisms are poorly understood, particularly in early pregnancy. Here, we first confirm the abnormal expression of important vascular and inflammatory proteins, FK506-binding protein-like (FKBPL) and galectin-3 (Gal-3), in human plasma and placental tissues from women with preeclampsia and normotensive controls. We then employ a three-dimensional microfluidic placental model incorporating human umbilical vein endothelial cells (HUVECs) and a first trimester trophoblast cell line (ACH-3P) to investigate FKBPL and Gal-3 signaling in inflammatory conditions. In human samples, both circulating (n = 17 controls; n = 30 preeclampsia) and placental (n ≥ 6) FKBPL and Gal-3 levels were increased in preeclampsia compared to controls (plasma: FKBPL, p < 0.0001; Gal-3, p < 0.01; placenta: FKBPL, p < 0.05; Gal-3, p < 0.01), indicative of vascular dysfunction in preeclampsia. In our placenta-on-a-chip model, we show that endothelial cells are critical for trophoblast-mediated migration and that trophoblasts effectively remodel endothelial vascular networks. Inflammatory cytokine tumour necrosis factor-α (10 ng/mL) modulates both FKBPL and Gal-3 signaling in conjunction with trophoblast migration and impairs vascular network formation (p < 0.005). Our placenta-on-a-chip recapitulates aspects of inappropriate placental development and vascular dysfunction in preeclampsia.
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Affiliation(s)
- Sahar Masoumeh Ghorbanpour
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia.,Institute for Biomedical Materials and Devices, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia.,Heart Research Institute, Sydney, NSW, Australia
| | - Claire Richards
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia.,Institute for Biomedical Materials and Devices, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Dillan Pienaar
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Kimberly Sesperez
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Hamidreza Aboulkheyr Es
- School of Biomedical Engineering, Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, NSW, Australia
| | - Valentina N Nikolic
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Nis, Niš, Serbia
| | - Natasa Karadzov Orlic
- Department of Gynaecology and Obstetrics, Narodni Front, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Zeljko Mikovic
- Department of Gynaecology and Obstetrics, Narodni Front, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milan Stefanovic
- Department of Internal Medicine-Gynaecology, Faculty of Medicine, University of Nis, Niš, Serbia.,Department of Gynaecology and Obstetrics, Clinical Centre Nis, Niš, Serbia
| | - Zoran Cakic
- Department of Gynaecology and Obstetrics, General Hospital of Leskovac, Leskovac, Serbia
| | - Abdelrahim Alqudah
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, The Hashemite University, Zarqa, Jordan
| | - Louise Cole
- Australian Institute of Microbiology and Infection, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Catherine Gorrie
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Kristine McGrath
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Mary M Kavurma
- Heart Research Institute,The University of Sydney, Sydney, NSW, Australia
| | - Majid Ebrahimi Warkiani
- Institute for Biomedical Materials and Devices, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia.,School of Biomedical Engineering, Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, NSW, Australia
| | - Lana McClements
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia. .,Institute for Biomedical Materials and Devices, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia.
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3
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Chen H, Aneman I, Nikolic V, Karadzov Orlic N, Mikovic Z, Stefanovic M, Cakic Z, Jovanovic H, Town SEL, Padula MP, McClements L. Maternal plasma proteome profiling of biomarkers and pathogenic mechanisms of early-onset and late-onset preeclampsia. Sci Rep 2022; 12:19099. [PMID: 36351970 PMCID: PMC9646706 DOI: 10.1038/s41598-022-20658-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 09/16/2022] [Indexed: 11/10/2022] Open
Abstract
Preeclampsia is still the leading cause of morbidity and mortality in pregnancy without a cure. There are two phenotypes of preeclampsia, early-onset (EOPE) and late-onset (LOPE) with poorly defined pathogenic differences. This study aimed to facilitate better understanding of the mechanisms of pathophysiology of EOPE and LOPE, and identify specific biomarkers or therapeutic targets. In this study, we conducted an untargeted, label-free quantitative proteomic analyses of plasma samples from pregnant women with EOPE (n = 17) and LOPE (n = 11), and age, BMI-matched normotensive controls (n = 18). Targeted proteomics approach was also employed to validate a subset of proteins (n = 17). In total, there were 26 and 20 differentially abundant proteins between EOPE or LOPE, and normotensive controls, respectively. A series of angiogenic and inflammatory proteins, including insulin-like growth factor-binding protein 4 (IGFBP4; EOPE: FDR = 0.0030 and LOPE: FDR = 0.00396) and inter-alpha-trypsin inhibitor heavy chain H2-4 (ITIH2-4), were significantly altered in abundance in both phenotypes. Through validation we confirmed that ITIH2 was perturbed only in LOPE (p = 0.005) whereas ITIH3 and ITIH4 were perturbed in both phenotypes (p < 0.05). Overall, lipid metabolism/transport proteins associated with atherosclerosis were highly abundant in LOPE, however, ECM proteins had a more pronounced role in EOPE. The complement cascade and binding and uptake of ligands by scavenger receptors, pathways, were associated with both EOPE and LOPE.
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Affiliation(s)
- Hao Chen
- grid.117476.20000 0004 1936 7611School of Life Sciences, Faculty of Science, University of Technology Sydney, Ultimo, NSW Australia
| | - Ingrid Aneman
- grid.117476.20000 0004 1936 7611School of Life Sciences, Faculty of Science, University of Technology Sydney, Ultimo, NSW Australia
| | - Valentina Nikolic
- grid.11374.300000 0001 0942 1176Department of Pharmacology and Toxicology, Faculty of Medicine, University of Nis, Nis, Serbia
| | - Natasa Karadzov Orlic
- Department of Gynaecology and Obstetrics, Narodni Front, Belgrade, Serbia ,grid.7149.b0000 0001 2166 9385Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Zeljko Mikovic
- Department of Gynaecology and Obstetrics, Narodni Front, Belgrade, Serbia ,grid.7149.b0000 0001 2166 9385Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milan Stefanovic
- grid.11374.300000 0001 0942 1176Department of Gynaecology and Obstetrics, Faculty of Medicine, University of Nis, Nis, Serbia ,grid.418653.d0000 0004 0517 2741Gynaecology and Obstetrics Clinic, Clinical Centre Nis, Nis, Serbia
| | - Zoran Cakic
- Department of Gynaecology and Obstetrics, General Hospital of Leskovac, Leskovac, Serbia
| | - Hristina Jovanovic
- grid.11374.300000 0001 0942 1176Department of Pharmacology and Toxicology, Faculty of Medicine, University of Nis, Nis, Serbia
| | - Stephanie E. L. Town
- grid.117476.20000 0004 1936 7611School of Life Sciences, Faculty of Science, University of Technology Sydney, Ultimo, NSW Australia
| | - Matthew P. Padula
- grid.117476.20000 0004 1936 7611School of Life Sciences, Faculty of Science, University of Technology Sydney, Ultimo, NSW Australia
| | - Lana McClements
- grid.117476.20000 0004 1936 7611School of Life Sciences, Faculty of Science, University of Technology Sydney, Ultimo, NSW Australia ,grid.117476.20000 0004 1936 7611Institute for Biomedical Materials and Devices, Faculty of Science, University of Technology Sydney, Ultimo, NSW Australia
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Vukomanovic P, Kutlesic R, Milosevic Stevanovic J, Djordjevic I, Stefanovic M. Cervical molar pregnancy, profuse bleeding and urgent surgical treatment. Ginekol Pol 2022:VM/OJS/J/88510. [DOI: 10.5603/gp.a2022.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/22/2022] [Accepted: 03/28/2022] [Indexed: 11/25/2022] Open
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van der Zander QEW, Schreuder RM, Fonollà R, Scheeve T, van der Sommen F, Winkens B, Aepli P, Hayee B, Pischel AB, Stefanovic M, Subramaniam S, Bhandari P, de With PHN, Masclee AAM, Schoon EJ. Optical diagnosis of colorectal polyp images using a newly developed computer-aided diagnosis system (CADx) compared with intuitive optical diagnosis. Endoscopy 2021; 53:1219-1226. [PMID: 33368056 DOI: 10.1055/a-1343-1597] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Optical diagnosis of colorectal polyps remains challenging. Image-enhancement techniques such as narrow-band imaging and blue-light imaging (BLI) can improve optical diagnosis. We developed and prospectively validated a computer-aided diagnosis system (CADx) using high-definition white-light (HDWL) and BLI images, and compared the system with the optical diagnosis of expert and novice endoscopists. METHODS CADx characterized colorectal polyps by exploiting artificial neural networks. Six experts and 13 novices optically diagnosed 60 colorectal polyps based on intuition. After 4 weeks, the same set of images was permuted and optically diagnosed using the BLI Adenoma Serrated International Classification (BASIC). RESULTS CADx had a diagnostic accuracy of 88.3 % using HDWL images and 86.7 % using BLI images. The overall diagnostic accuracy combining HDWL and BLI (multimodal imaging) was 95.0 %, which was significantly higher than that of experts (81.7 %, P = 0.03) and novices (66.7 %, P < 0.001). Sensitivity was also higher for CADx (95.6 % vs. 61.1 % and 55.4 %), whereas specificity was higher for experts compared with CADx and novices (95.6 % vs. 93.3 % and 93.2 %). For endoscopists, diagnostic accuracy did not increase when using BASIC, either for experts (intuition 79.5 % vs. BASIC 81.7 %, P = 0.14) or for novices (intuition 66.7 % vs. BASIC 66.5 %, P = 0.95). CONCLUSION CADx had a significantly higher diagnostic accuracy than experts and novices for the optical diagnosis of colorectal polyps. Multimodal imaging, incorporating both HDWL and BLI, improved the diagnostic accuracy of CADx. BASIC did not increase the diagnostic accuracy of endoscopists compared with intuitive optical diagnosis.
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Affiliation(s)
- Quirine E W van der Zander
- Division of Gastroenterology and Hepatology, Maastricht University Medical Center + Maastricht, the Netherlands.,GROW, School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Ramon M Schreuder
- Division of Gastroenterology and Hepatology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands
| | - Roger Fonollà
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Thom Scheeve
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Fons van der Sommen
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Bjorn Winkens
- Department of Methodology and Statistics, CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Patrick Aepli
- Division of Gastroenterology and Hepatology, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Bu'Hussain Hayee
- Division of Gastroenterology and Hepatology, King's College Hospital, London, United Kingdom
| | - Andreas B Pischel
- Division of Gastroenterology and Hepatology, University Hospital Gothenburg, Gothenburg, Sweden
| | - Milan Stefanovic
- Division of Gastroenterology and Hepatology, Diagnostični Center Bled, Ljubljana, Slovenia
| | - Sharmila Subramaniam
- Division of Gastroenterology and Hepatology, Queen Alexandra Hospital, Portsmouth, United Kingdom
| | - Pradeep Bhandari
- Division of Gastroenterology and Hepatology, Queen Alexandra Hospital, Portsmouth, United Kingdom
| | - Peter H N de With
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Ad A M Masclee
- Division of Gastroenterology and Hepatology, Maastricht University Medical Center + Maastricht, the Netherlands
| | - Erik J Schoon
- GROW, School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands.,Division of Gastroenterology and Hepatology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands
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Andric D, Tesic D, Andric S, Tomic MD, Petrovic M, Miljkovic T, Stefanovic M, Popov T, Tomic MT. Obesity and decreased vibration perception associated with premature cardiovascular mortality in a single center prospective study of people with diabetes. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and aims
The aim of this prospective, single center study was to define factors associated with early cardiovascular mortality in diabetes.
Materials and methods
1345 patients under age 75 were included who were undergoing assessment of their diabetes between January 2008 and May 2010 as part of standard practice in a specialist clinic at a regional teaching hospital in Serbia. Peripheral artery disease (PAD) was assessed by audible Doppler waveform and ABPI with cut-offs >1.4 and <0.9. Peripheral neuropathy was assessed by vibration perception threshold (VPT, using a semi-quantitative tuning fork: abnormal if ≤5), ankle reflexes (AR) and sudomotor function of the foot. Diabetic retinopathy (DR) was assessed by fundoscopy. Evidence of vascular disease: thromboendarterectomy and/or cerebrovascular insult (TEA/CVI), myocardial infarction (MI), heart failure (HF), diabetic foot ulcer (DFU), minor amputations (sAMP) and major amputations (mAMP) was also collected. Outcome was determined in 2021 and baseline characteristics were compared between those who had and had not suffered cardiovascular death under age 75 years within 10 years of review in two casually selected cohorts.
Results
Those who died (n2=70) were more frequently male (60 vs. 45.3%, p=0.08), younger (66.4±7.4 vs. 79.9±3.4, p<0.000), had a shorter period of follow-up (3.6±2.3 vs. 11.2±1.7 years, p<0.000) when compared to those still alive (n1=75). Those who died were also significantly (p<0.01) more likely to have had TEA/CVI (34.3 vs. 10.7%), HF (21.4 vs. 1.3%), MI (44.3 vs. 20%), PAD (48.6 vs. 9.3%), DFU (25.7 vs. 9.3%), mAMP (17.1 vs. 1.3%) at baseline. There were no differences in proliferative DR (17.1 vs. 8%, p=0.10) and laser photocoagulation (25.7 vs. 13.3%, p=0.06) Following multivariable logistic regression analysis significant differences between groups remained for only creatinine (123±45 vs. 88.9±16.9 mmol/L, p<0.003) and VPT <5 (7.8 [95% CI: 3.7–16.4)], p=0.008), estimated maximum lifetime BMI (3.4 [95% CI: 1.7–6.8)], p<0.000), alcohol usage (4.7 [95% CI: 1.5–14.7)], p=0.005), smoking habit (2.2 [95% CI: 1.1–4.3)], p<0.03) and earlier age of diabetes onset (43.4±12.5 vs. 49.2±9.9, p=0.0029). When the 72 patients with impaired vibration sense were compared with 73 with VPT>6, there were significant differences in TEA/CVI (4.2 [95% CI: 1.6–10.9)], p=0.003), PAD (3.9 [95% CI: 1.8–8.8)], p<0.001) and estimated maximum lifetime BMI (9.4 [95% CI: 3.4–25.7), p<0.000). Finally, when those who had had a previous MI at baseline (n=46) were compared with those who hadn't (n=99), MI was associated with increased death rate (3.2 [95% CI: 1.5–6.6)], p=0.002), as was PAD (2.9 [(1.3–6.1)], p=0.007).
Conclusion
Decreased VPT, the presence of PAD on clinical testing and higher maximum estimated lifetime BMI are strongly associated with premature cardiovascular death. These measures may be independent markers of greater risk of reduced life expectancy.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Andric
- Institute for Cardiovascular Diseases of Vojvodina, Novi Sad, Serbia
| | - D Tesic
- Clinical Center of Vojvodina, Novi Sad, Serbia
| | - S Andric
- Institute for Cardiovascular Diseases of Vojvodina, Novi Sad, Serbia
| | - M D Tomic
- Clinical Center of Vojvodina, Novi Sad, Serbia
| | - M Petrovic
- Institute for Cardiovascular Diseases of Vojvodina, Novi Sad, Serbia
| | - T Miljkovic
- Institute for Cardiovascular Diseases of Vojvodina, Novi Sad, Serbia
| | - M Stefanovic
- Institute for Cardiovascular Diseases of Vojvodina, Novi Sad, Serbia
| | - T Popov
- Institute for Cardiovascular Diseases of Vojvodina, Novi Sad, Serbia
| | - M T Tomic
- Clinical Center of Vojvodina, Novi Sad, Serbia
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Pérez-Montero H, Godino O, Lozano A, Asiáin L, Martínez I, Sánchez JJ, de BlasFernández R, Fernández E, Stefanovic M, García N, Martínez J, Guedea F, Navarro-Martin A. Long-term outcomes of spinal SBRT. Is it important to select the treatment time? Clin Transl Oncol 2021; 24:276-287. [PMID: 34342817 DOI: 10.1007/s12094-021-02684-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 07/08/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE SBRT (stereotactic body radiation therapy) is widely used as a curative treatment in tumoral lesions and has become a fundamental tool for the treatment of spine metastasis. In this study, we present survival and toxicity outcomes of spine SBRT after a 2-year follow-up. METHODS/PATIENTS Data from spine SBRT treatments performed at our institution between March 2012 and February 2020 was collected. Medical records, including demographic, primary tumor, and treatment characteristics were reviewed. Patient follow-up included clinical evaluation, imaging, and blood tests. Toxicity was recorded according to CTCAE v4.0. RESULTS We analyzed 73 consecutive spine SBRT treatments in 60 patients. 39.7% of the cases had primary breast cancer and 23.3% had prostate cancer. Most cases (87.7%) were treated with a single SBRT fraction of 16 Gy. Median follow-up was 26.1 months (range 1.7-78.6), and 1- and 2-year overall survival (OS) rates were 96.9% and 84.2%, respectively. Local control (LC) rates at 1- and 2-years were 76.3% and 70.6%, respectively. Multivariate analysis identified histology as a prognostic factor for both OS and LC. Patients who underwent spine SBRT 6 months after the spinal lesion diagnosis had LC at 2 years of 88%, vs 61.7% for those who underwent SBRT before this period. No grade III or higher toxicity was reported. The vertebral compression fracture (VCF) rate was 4.1%. CONCLUSION Spine SBRT at our institution showed a 2-year LC of 70.6%, without G3 toxicities. Delaying SBRT at least 6 months to administer systemic treatment was related to an improvement in local control.
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Affiliation(s)
- H Pérez-Montero
- Radiation Oncology Department, Institut Català D'Oncologia, Barcelona, Spain
| | - O Godino
- Neurosurgery Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - A Lozano
- Radiation Oncology Department, Institut Català D'Oncologia, Barcelona, Spain
| | - L Asiáin
- Radiation Oncology Department, Institut Català D'Oncologia, Barcelona, Spain
| | - I Martínez
- Radiation Oncology Department, Institut Català D'Oncologia, Barcelona, Spain
| | - J J Sánchez
- Radiodiagnostic Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - R de BlasFernández
- Medical Physics and Radiation Protection Department, Institut Català D'Oncologia, Barcelona, Spain
| | - E Fernández
- Physical Medicine and Rehabilitation Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - M Stefanovic
- Radiation Oncology Department, Institut Català D'Oncologia, Barcelona, Spain
| | - N García
- Radiation Oncology Department, Institut Català D'Oncologia, Barcelona, Spain
| | - J Martínez
- Radiation Oncology Department, Institut Català D'Oncologia, Barcelona, Spain
| | - F Guedea
- Radiation Oncology Department, Institut Català D'Oncologia, Barcelona, Spain
| | - A Navarro-Martin
- Radiation Oncology Department, Institut Català D'Oncologia, Barcelona, Spain.
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8
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Tepes B, Stefanovic M, Stabuc B, Mlakar DN, Grazio SF, Zakotnik JM. Quality Control in the Slovenian National Colorectal Cancer Screening Program. Dig Dis 2021; 40:187-197. [PMID: 33965953 DOI: 10.1159/000516978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/01/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The objective of the study was to assess the impact of an internal quality indicator (QI) audit on the quality level of colonoscopies in the National Colorectal Cancer Screening Program (NCCSP). DESIGN Sixty-eight colonoscopists from 29 endoscopic centres participated in the NCCSP from April 2009 to January 2015. Controlled QIs were the percentage of total colonoscopies, adenoma detection rate (ADR), mean adenoma per procedure (MAP), mean adenoma per positive procedure (MAP+), right-sided ADR, sessile serrated lesion (SSL) detection rate, and patient responses to post-procedural questionnaires. A group of 3 expert endoscopists from the NCCSP Council performed 91 inspections and provided education. RESULTS A total of 891.364 (58.2%) Slovenian citizens participated in the first 3 screening rounds of the NCCSP. Among 46.552 (6%) positive individuals, 42.866 (92.1%) underwent first colonoscopies. Total colonoscopies were performed in 98% of endoscopies (p = 0.459 between cycles), mean ADR was 51.8% (p = 0.872 between cycles), mean percentage of adenoma in the right colon was 37.5% (p = 0.227 between cycles), mean MAP was 1.1 (p = 0.981 between cycles), mean MAP+ was 2.0 (p = 0.824 between cycles), and mean SSL detection rate was 3% (p < 0.001). We observed great difference in QIs between endoscopists and a significant increase in MAP, ADR in the right colon, and SSL per endoscopist during the 6-year period. Due to quality underperformance, 3 endoscopic centres (10.3%) and 13 endoscopists (19.1%) were excluded from the program. CONCLUSIONS The success of the NCCSP is related to the quality of colonoscopies performed. To ensure the proper quality level, regular audit and permanent education are needed.
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Affiliation(s)
| | | | - Borut Stabuc
- University Medical Center Ljubljana, Ljubljana, Slovenia
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9
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Richards C, Sesperez K, Chhor M, Ghorbanpour S, Rennie C, Ming CLC, Evenhuis C, Nikolic V, Orlic NK, Mikovic Z, Stefanovic M, Cakic Z, McGrath K, Gentile C, Bubb K, McClements L. Characterisation of cardiac health in the reduced uterine perfusion pressure model and a 3D cardiac spheroid model, of preeclampsia. Biol Sex Differ 2021; 12:31. [PMID: 33879252 PMCID: PMC8056582 DOI: 10.1186/s13293-021-00376-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/07/2021] [Indexed: 12/15/2022] Open
Abstract
Background Preeclampsia is a dangerous cardiovascular disorder of pregnancy that leads to an increased risk of future cardiovascular and metabolic disorders. Much of the pathogenesis and mechanisms involved in cardiac health in preeclampsia are unknown. A novel anti-angiogenic protein, FKBPL, is emerging as having a potential role in both preeclampsia and cardiovascular disease (CVD). Therefore, in this study we aimed to characterise cardiac health and FKBPL regulation in the rat reduced uterine perfusion pressure (RUPP) and a 3D cardiac spheroid model of preeclampsia. Methods The RUPP model was induced in pregnant rats and histological analysis performed on the heart, kidney, liver and placenta (n ≥ 6). Picrosirius red staining was performed to quantify collagen I and III deposition in rat hearts, placentae and livers as an indicator of fibrosis. RT-qPCR was used to determine changes in Fkbpl, Icam1, Vcam1, Flt1 and Vegfa mRNA in hearts and/or placentae and ELISA to evaluate cardiac brain natriuretic peptide (BNP45) and FKBPL secretion. Immunofluorescent staining was also conducted to analyse the expression of cardiac FKBPL. Cardiac spheroids were generated using human cardiac fibroblasts and human coronary artery endothelial cells and treated with patient plasma from normotensive controls, early-onset preeclampsia (EOPE) and late-onset preeclampsia (LOPE); n = 3. FKBPL and CD31 expression was quantified by immunofluorescent labelling. Results The RUPP procedure induced significant increases in blood pressure (p < 0.001), collagen deposition (p < 0.001) and cardiac BNP45 (p < 0.05). It also induced a significant increase in cardiac FKBPL mRNA (p < 0.05) and protein expression (p < 0.01). RUPP placentae also exhibited increased collagen deposition and decreased Flt1 mRNA expression (p < 0.05). RUPP kidneys revealed an increase in average glomerular size (p < 0.05). Cardiac spheroids showed a significant increase in FKBPL expression when treated with LOPE plasma (p < 0.05) and a trend towards increased FKBPL expression following treatment with EOPE plasma (p = 0.06). Conclusions The rat RUPP model induced cardiac, renal and placental features reflective of preeclampsia. FKBPL was increased in the hearts of RUPP rats and cardiac spheroids treated with plasma from women with preeclampsia, perhaps reflective of restricted angiogenesis and inflammation in this disorder. Elucidation of these novel FKBPL mechanisms in cardiac health in preeclampsia could be key in preventing future CVD. Supplementary Information The online version contains supplementary material available at 10.1186/s13293-021-00376-1.
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Affiliation(s)
- Claire Richards
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Kimberly Sesperez
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Michael Chhor
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Sahar Ghorbanpour
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Claire Rennie
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Clara Liu Chung Ming
- School of Biomedical Engineering, Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, NSW, Australia
| | - Chris Evenhuis
- The iThree Institute, University of Technology Sydney, Sydney, NSW, Australia
| | - Valentina Nikolic
- Department of Pharmacology and Toxicology & Department of Internal Medicine - Gynaecology, Medical Faculty, University of Nis, Nis, Serbia
| | - Natasa Karadzov Orlic
- Department of Gynaecology and Obstetrics, Narodni Front, Belgrade, Serbia.,Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Zeljko Mikovic
- Department of Gynaecology and Obstetrics, Narodni Front, Belgrade, Serbia.,Medical Faculty, University of Belgrade, Belgrade, Serbia
| | - Milan Stefanovic
- Department of Pharmacology and Toxicology & Department of Internal Medicine - Gynaecology, Medical Faculty, University of Nis, Nis, Serbia.,Department of Gynaecology and Obstetrics, Clinical Centre Nis, Nis, Serbia
| | - Zoran Cakic
- Department of Gynaecology and Obstetrics, General Hospital of Leskovac, Leskovac, Serbia
| | - Kristine McGrath
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Carmine Gentile
- School of Biomedical Engineering, Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, NSW, Australia.,The Kolling Institute, University of Sydney, Sydney, NSW, Australia
| | - Kristen Bubb
- The Kolling Institute, University of Sydney, Sydney, NSW, Australia.,Biomedical Discovery Institute, Monash University, Melbourne, Australia
| | - Lana McClements
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia.
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10
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Pop-Trajkovic Dinic S, Zivadinovic R, Stefanovic M, Trenkic M, Milosevic J, Mitic D. Predictors of poor neonatal outcomes in fetuses diagnosed with congenital urinary tract anomalie. Ginekol Pol 2021:VM/OJS/J/72174. [PMID: 33844244 DOI: 10.5603/gp.a2021.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/28/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Urinary tract anomalies account for approximately one-quarter of all antenatally detected anomalies. The aim of this study was to identify factors associated with severe adverse neonatal outcomes of a prenatally diagnosed urinary tract anomaly. MATERIAL AND METHODS A retrospective-prospective study included 101 pregnant women with prenatally diagnosed fetal urinary tract anomalies presented to the Council for Fetal Anomalies. Prenatal diagnoses were compared with autopsy findings in cases of terminated pregnancy or with clinical and operative findings of the infants. RESULTS The mortality rate in the group of patients with fetal obstructive uropathy (60 patients) was 10% and in the group of patients with fetal multicystic dysplastic kidney (38 patients) 15.7%. Surgery was performed on 53.4% of the children, whereas more than half of the operations involved resolving associated urinary tract anomalies. Postoperative renal function deterioration occurred in 19% of the children. CONCLUSIONS The prognosis of renal function in obstructive uropathies is excellent if oligoamnios does not develop prenatally and in case of timely provided surgical care is provided postnatally. The finding of the bilateral multicystic dysplastic kidney is associated with poor prognosis. The prognosis in fetal unilateral multicystic dysplastic kidney depends primarily on the condition of the contralateral kidney and the existence of associated anomalies.
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Affiliation(s)
| | | | - Milan Stefanovic
- Clinic for Gynecology and Obstetrics, Clinical Center of Niš, Serbia
| | - Milan Trenkic
- Clinic for Gynecology and Obstetrics, Clinical Center of Niš, Serbia
| | - Jelena Milosevic
- Clinic for Gynecology and Obstetrics, Clinical Center of Niš, Serbia
| | - Dejan Mitic
- Clinic for Gynecology and Obstetrics, Clinical Center of Niš, Serbia
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11
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Stefanovic M, Stankovic I, Jemcov T, Janicijevic A, Zec N, Kusic Milicevic J, Markovic M, Vidakovic R, Neskovic AN. Mechanical dispersion is associated with clinical and subclinical coronary artery disease in patients on chronic renal replacement therapy with normal left ventricular ejection fraction. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Since coronary artery disease (CAD) is the leading cause of mortality in patients with end-stage renal failure, early detection of CAD in these patients presenting with still normal left ventricular (LV) systolic function is of clinical importance.
Aim
To investigate the correlation between electrical and mechanical dispersion and CAD in dialysis patients with normal LV systolic function.
Material and methods: This prospective study included 78 dialysis patients who underwent a 12-channel electrocardiogram and echocardiographic examination to determine electrical and mechanical myocardial dispersion. A coronary calcium score using cardiac computed tomography was also assessed in a group of 20 patients without known CAD. Electrical dispersion was defined as the difference between the longest and shortest corrected QT interval (QTc). Mechanical dispersion (MD) was defined as either standard deviation of mechanical contraction duration of all LV segments (MD_SD) or the difference between the longest and shortest duration of mechanical contraction (MD_delta). The duration of mechanical contraction was determined by myocardial strain analysis.
Results
Previously known CAD was present in 11 (14%) patients, while pathologic Q wave was absent in all patients. No significant correlation was observed between QTc dispersion and both MD parameters (p > 0.05 for both). Both MD parameters (p = 0.007 for MD_SD; p = 0.026 for MD_delta), but not electrical dispersion (p = 0.584), showed a discriminative power for detecting previously known CAD (Figure). In patients without known CAD, neither QTc dispersion nor MD_SD showed a correlation with coronary calcium score (p > 0.05 for both). MD_delta showed a strong correlation with both total and coronary calcium score in the territory of the left anterior descending coronary artery (r = 0.62; p = 0.004) in patients without previously known CAD.
Conclusion
Mechanical dispersion is associated with known CAD in dialysis patients with normal LV systolic function. The range of mechanical myocardial contraction duration (MD_delta) correlates with subclinical coronary atherosclerosis.
Figure. Discriminative power of mechanical and electrical dispersion for the detection of coronary artery disease
Abstract Figure.
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Affiliation(s)
- M Stefanovic
- Clinical Hospital Center Zemun, Belgrade, Serbia
| | - I Stankovic
- Clinical Hospital Center Zemun, Belgrade, Serbia
| | - T Jemcov
- Clinical Hospital Center Zemun, Belgrade, Serbia
| | | | - N Zec
- Clinical Hospital Center Zemun, Belgrade, Serbia
| | | | - M Markovic
- Clinical Hospital Center Zemun, Belgrade, Serbia
| | - R Vidakovic
- Clinical Hospital Center Zemun, Belgrade, Serbia
| | - AN Neskovic
- Clinical Hospital Center Zemun, Belgrade, Serbia
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12
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Kutlesic R, Kutlesic M, Vukomanovic P, Stefanovic M, Mostic-Stanisic D. Cesarean Scar Pregnancy Successfully Managed to Term: When the Patient Is Determined to Keep the Pregnancy. ACTA ACUST UNITED AC 2020; 56:medicina56100496. [PMID: 32987706 PMCID: PMC7598584 DOI: 10.3390/medicina56100496] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/18/2020] [Accepted: 09/22/2020] [Indexed: 02/06/2023]
Abstract
Cesarean scar pregnancy (CSP) is a rare form of ectopic pregnancy, defined as the implantation of the gestational sac at the uterine incision scar of the previous cesarean section. This condition is associated with severe maternal and fetal/neonatal complications, including severe bleeding, rupture of the uterus, fetal demise, or preterm delivery. In view of these, early diagnosis allows the option of termination of pregnancy. In this case report, we present a patient with a cesarean scar pregnancy who was diagnosed at the sixth week of gestation but declined early termination of the pregnancy and was managed to the 38th week. Placenta previa was confirmed in the second trimester. A planned cesarean section was performed that resulted in the birth of a live full-term neonate. Intraoperatively, placenta percreta was diagnosed, and due to uncontrollable bleeding, a hysterectomy was performed. The postoperative course was uneventful. In cases where an early diagnosis of CSP is made, women should be counseled that this will almost certainly evolve to placenta previa, and the associated risks should be explained. Close follow-up of CSP is mandatory if expectant management is selected. Further studies are needed for definitive conclusions and to determine the risks of expectant management.
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Affiliation(s)
- Ranko Kutlesic
- Clinic of Gynaecology and Obstetrics, University Clinical Centre Nis, 18000 Nis, Serbia; (P.V.); (M.S.)
- Faculty of Medicine, University of Nis, 18000 Nis, Serbia
- Correspondence:
| | - Marija Kutlesic
- Department of Anaesthesia, Clinic of Gynaecology and Obstetrics, University Clinical Centre Nis, 18000 Nis, Serbia;
| | - Predrag Vukomanovic
- Clinic of Gynaecology and Obstetrics, University Clinical Centre Nis, 18000 Nis, Serbia; (P.V.); (M.S.)
- Faculty of Medicine, University of Nis, 18000 Nis, Serbia
| | - Milan Stefanovic
- Clinic of Gynaecology and Obstetrics, University Clinical Centre Nis, 18000 Nis, Serbia; (P.V.); (M.S.)
- Faculty of Medicine, University of Nis, 18000 Nis, Serbia
| | - Danka Mostic-Stanisic
- Institute of Gynaecology and Obstetrics Belgrade, Clinical centre of Serbia, 11000 Belgrade, Serbia;
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13
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Subramaniam S, Kandiah K, Schoon E, Aepli P, Hayee B, Pischel A, Stefanovic M, Alkandari A, Coron E, Omae M, Baldaque-Silva F, Maselli R, Bisschops R, Sharma P, Repici A, Bhandari P. Development and validation of the international Blue Light Imaging for Barrett's Neoplasia Classification. Gastrointest Endosc 2020; 91:310-320. [PMID: 31586576 DOI: 10.1016/j.gie.2019.09.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 09/21/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Detecting subtle Barrett's neoplasia during surveillance endoscopy can be challenging. Blue-light imaging (BLI) is a novel advanced endoscopic technology with high-intensity contrast imaging that may improve the identification of Barrett's neoplasia. The aim of this study was to develop and validate the first classification to enable characterization of neoplastic and non-neoplastic Barrett's esophagus using BLI. METHODS In phase 1, descriptors pertaining to neoplastic and non-neoplastic Barrett's esophagus were identified to form the classification, named the Blue Light Imaging for Barrett's Neoplasia Classification (BLINC). Phase 2 involved validation of these component criteria by 10 expert endoscopists assessing 50 BLI images. In phase 3, a web-based training module was developed to enable 15 general (nonexpert) endoscopists to use BLINC. They then validated the classification with an image assessment exercise in phase 4, and their pre- and post-training results were compared. RESULTS In phase 1 the descriptors were grouped into color, pit, and vessel pattern categories to form the classification. In phase 2 the sensitivity of neoplasia identification was 96.0% with a very good level of agreement among the experts (κ = .83). In phase 3, 15 general endoscopists completed the training module. In phase 4 their pretraining sensitivity (85.3%) improved significantly to 95.7% post-training with a good level of agreement (κ = .67). CONCLUSIONS We developed and validated a new classification system (BLINC) for the optical diagnosis of Barrett's neoplasia using BLI. Despite the limitations of this image-based study with a high prevalence of neoplasia, we believe it has the potential to improve the optical diagnosis of Barrett's neoplasia given the high degree of sensitivity (96%) noted. It is also a promising tool for training in Barrett's esophagus optical diagnosis using BLI.
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Affiliation(s)
- Sharmila Subramaniam
- Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, United Kingdom
| | - Kesavan Kandiah
- Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, United Kingdom
| | - Erik Schoon
- Department of Gastroenterology, Catharina Hospital, Eindhoven, Netherlands
| | - Patrick Aepli
- Department of Gastroenterology & Hepatology, Luzerner Kantonsspital, Luzerne, Switzerland
| | - Bu' Hayee
- Department of Gastroenterology, King's College Hospital NHS Foundation Trust, London, United Kingdom
| | - Andreas Pischel
- Department of Gastroenterology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Asma Alkandari
- Department of Gastroenterology & Hepatology, Aljahra Hospital, Kuwait
| | - Emmanuel Coron
- Centre Hospitalier Universitaire & Faculté de Médecine de Nantes, Institut des Maladies de l'Appareil Digestif, France
| | - Masami Omae
- Centre for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | - Roberta Maselli
- Digestive Endoscopy Unit, Humanitas Research Hospital, Milan, Italy
| | - Raf Bisschops
- Department of Gastroenterology & Hepatology, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - Prateek Sharma
- Department of Gastroenterology & Hepatology, Kansas University Medical Center, Kansas, USA
| | | | - Pradeep Bhandari
- Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, United Kingdom
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14
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Tadic S, Ilic A, Stefanovic M, Stojsic-Milosavljevic A, Stojsic S, Popov T. P929 Routine Left Atrium Strain in acute STEMI: to do or not to do. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction and purpose
Left atrium strain (LAS) is a very useful, modern method of establish left atrium (LA) function and rarely use in predicting adverse events (AE) in acute anterior ST-elevated myocardial infarction (STEMI). The purpose of our study was to compare LAS among other echocardiographic parameters of LA and left ventricle (LV) function, in patients that developed AE (heart failure, all cause mortality, reinfarction and rehospitalization) after acute anterior STEMI during one year follow up.
Methods
All 101 patients with a first acute anterior STEMI treated by primary PCI had early echocardiography in first 24 hours. After one year follow up, patients were divided in two groups: AE group (27 patients; 27%) and non-AE group (74 patients; 73%). We compared: LA size, LA maximal volume index, LAS, systolic and diastolic left ventricle parameters, between groups for the purpose of identifying early AE predictors.
Results
Among all left atrium parameters, LA strain was most prognostic for AE between groups (AE group vs. non-AE group): LA diameter (3,7cm vs. 3,5cm, p = 0,03), LA maximal volume index (27 ml/m2 vs. 24,5 ml/m2, p = 0,03), LAS (30% vs.37%, p < 0,0001)
Statistically significant differences in systolic and diastolic LV function between AE and non-AE groups were: ejection fraction (p < 0.0001), stroke volume index (p < 0.0001), fractional shortening (p < 0.0001), cardiac index (p < 0.0001), LV systolic work (p < 0,0001), WMSI- wall motion score index (p < 0,0001), average LV peak systolic longitudinal global strain- LGSav (p < 0,001), mitral inflow peak early velocity/average mitral annular peak early velocity- E/e"av (p < 0,001).
After adjustment for all echocardiographic parameters, LA strain (OR 0,91 95% CI, p = 0,04), WMSI ≥ 2 (OR 6.1 95% CI, p < 0.001), average peak systolic left ventricle LGS (OR = 15.1 95% CI, p < 0.0001) and cardiac index (OR 2.6 95% CI, p = 0.01) were independently associated with adverse outcomes.
Conclusion
Routine left atrium strain is very prognostic parameter of high-risk STEMI patients for adverse events and could possibly be considered as an important component of the new predictive score system for MACE and mortality of STEMI patients in the near future.
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Affiliation(s)
- S Tadic
- Faculty of Medicine, University of Novi Sad, Serbia, Novi Sad, Serbia
| | - A Ilic
- Faculty of Medicine, University of Novi Sad, Serbia, Novi Sad, Serbia
| | - M Stefanovic
- Faculty of Medicine, University of Novi Sad, Serbia, Novi Sad, Serbia
| | | | - S Stojsic
- Institute of CVD Vojvodina, Sremska Kamenica, Serbia
| | - T Popov
- Faculty of Medicine, University of Novi Sad, Serbia, Novi Sad, Serbia
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15
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Stojanovic S, Deljanin-Ilic M, Ilic S, Stefanovic M, Petrovic D, Petrovic V, Stojanovic M. Adiponectin resistance parameter as a marker for high normal blood pres-sure and hypertension in patients with metabolic syndrome. Hippokratia 2020; 24:3-7. [PMID: 33364732 PMCID: PMC7733364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The different degrees of adiponectin/insulin sensitivity and dysfunctional adipose tissue lead to the development of hypertension (HT). This study aimed to determine adiponectin (AD) concentration in patients with metabolic syndrome (MetS) and high-normal blood pressure or hypertension and to investigate the importance of Homeostatic Model Assessment-AD (HOMA-AD) index in assessing adiponectin/insulin resistance in hypertension. METHODS This cross-sectional study involved 150 subjects divided into two groups: with MetS (and high-normal blood pressure, n =50; and HT, n =50), and controls without MetS (n =50). In all subjects, serum adiponectin concentration was measured by enzyme-linked immunosorbent assay method. Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and HOMA-AD index were calculated. RESULTS The results showed that, compared to the control group, serum AD concentrations were significantly lower in patients with MetS and high-normal blood pressure (p =0.008), and the lowest in group MetS and HT (p =0.001). High AD levels and low HOMA-AD were significantly associated with decreased blood pressure values. In patients with MetS, the value of HOMA-AD≥1.13 was associated with a higher risk of developing high-normal blood pressure. Furthermore, the value of HOMA-AD≥2.63 was associated with a higher risk of developing hypertension. CONCLUSIONS Hypoadiponectinemia is associated with hypertension, especially in the early stages of the disease. The serum AD levels and HOMA-AD index may be useful markers for identifying patients at risk for high-normal blood pressure and hypertension. HIPPOKRATIA 2020, 24(1): 3-7.
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Affiliation(s)
- S Stojanovic
- The Clinic for Cardiovascular Diseases, Institute for Treatment and Rehabilitation "Niska Banja", Nis, Serbia
| | - M Deljanin-Ilic
- The Clinic for Cardiovascular Diseases, Institute for Treatment and Rehabilitation "Niska Banja", Nis, Serbia
| | - S Ilic
- The Clinic for Cardiovascular Diseases, Institute for Treatment and Rehabilitation "Niska Banja", Nis, Serbia
| | | | - D Petrovic
- Department of Histology and Embryology, Faculty of Medicine, University of Nis, Nis, Serbia
| | - V Petrovic
- Fresenius Medical Care, Belgrade, Serbia
| | - M Stojanovic
- The Clinic for Cardiovascular Diseases, Institute for Treatment and Rehabilitation "Niska Banja", Nis, Serbia
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16
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Janicijevic A, Stankovic I, Zivanic A, Stefanovic M, Putnikovic B, Neskovic AN. 1026 Prognostic implications of global and regional RV strain in patients with heart failure and conduction delays. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Right ventricular (RV) dysfunction is present in a substantial proportion of candidates for cardiac resynchronization therapy (CRT) but its prognostic implication has not been fully determined. We investigated the association of different echocardiographic indices of RV function and survival in patients with heart failure (HF) and conduction delays.
Methods
A total of 122 HF patients with bundle branch blocks (BBB), not treated with device therapy, were included in this retrospective observational study. RV function was assessed by measuring the tricuspid annular plane systolic excursion (TAPSE) and RV free wall longitudinal strain (RVFWSL). Patients were followed for cardiac mortality during a median period of 33 months.
Results
Both TAPSE ≤ 18 mm and RVFWSL≥-25% were associated with unfavorable long-term survival (log rank p < 0.05 for both, Figure A and B). Importantly, in patients with normal TAPSE, RVFWSL remained predictive of long-term outcome (HR 1.15, 95% CI 1.003-1.327; p = 0.045). In the multivariate regression analysis, only NYHA class (HR 2.21, 95%CI (1.122 – 4.357; p = 0.022) and RVFWSL (HR 1.11, 95%CI 1.029 – 1.204; p = 0.008) were independently associated with cardiac mortality. Significant differences among segmental RVFWLS values were observed, including a basal-to-apical gradient with the highest strain values in the base and the lowest in the apex (Figure C).
Conclusions
RV dysfunction is associated with unfavorable survival in HF patients with BBB. RVFWSL appears to be stronger predictor of mortality than TAPSE. Different segments of the RV may contribute differently to RV dysfunction in patients with conduction delays.
Abstract 1026 Figure.
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Affiliation(s)
| | - I Stankovic
- Clinical Hospital Center Zemun, Belgrade, Serbia
| | - A Zivanic
- Clinical Hospital Center Zemun, Belgrade, Serbia
| | - M Stefanovic
- Clinical Hospital Center Zemun, Belgrade, Serbia
| | - B Putnikovic
- Clinical Hospital Center Zemun, Belgrade, Serbia
| | - A N Neskovic
- Clinical Hospital Center Zemun, Belgrade, Serbia
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17
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Stankovic I, Stefanovic M, Janicijevic A, Milicevic P, Panic M, Kalezic-Radmili T, Putnikovic B, Neskovic AN. P943 Added value of quantification of dobutamine stress echocardiography in patients with suspected coronary artery disease. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Patients with chest pain and suspected coronary artery disease (CAD) frequently undergo dobutamine stress echocardiography (DSE) which is based on visual wall motion analysis.
Purpose
In this prospective study, we investigated accuracy and clinical utility of quantification of DSE.
Methods
In 81 consecutive patients scheduled for DSE, standard test was performed in 35 patients, while in the remaining 46 DSE was quantified. Visual assessment of wall motion abnormalities (WMA) was compared to speckle tracking–derived longitudinal strain parameters – global longitudinal strain (GLS) and mechanical dispersion (MD) at different stages of DSE. Reliable tracking was impossible at high-dose DSE in most patients.
Results
In most patients, it was impossible to obtain reliable speckle tracking analysis at high-dose DSE due to high heart rates. New WMA were observed in 23 patients (28%). Patients with dobutamine-induced WMA had similar values of GLS and MD at rest and during low-dose DSE as those without WMA (p > 0.05 for both). However, during the recovery phase, patients with new WMA at high dose DSE showed a greater amount of MD than those without (52 ± 16 vs. 40 ± 14 ms, p < 0.05). Both MD ≥60 ms and GLS ≤-16% during recovery phase had a low sensitivity (20% for both) but high specificity (90% for GLS and 92% for MD) for the detection of WMA during DSE. (Table).
Conclusions
Patients with WMA during DSE exhibit a lower GLS and a greater extent of mechanical dispersion («ischemic memory») during recovery phase. Clinical utility of strain-based quantification of DSE is limited due to inability to define effective cutoff values of strain parameters.
Abstract P943 Figure.
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Affiliation(s)
- I Stankovic
- Clinical Hospital Center Zemun, Department of Cardiology, Belgrade, Serbia
| | - M Stefanovic
- Clinical Hospital Center Zemun, Department of Cardiology, Belgrade, Serbia
| | - A Janicijevic
- Clinical Hospital Center Zemun, Department of Cardiology, Belgrade, Serbia
| | - P Milicevic
- Clinical Hospital Center Zemun, Department of Cardiology, Belgrade, Serbia
| | - M Panic
- Clinical Hospital Center Zemun, Department of Cardiology, Belgrade, Serbia
| | - T Kalezic-Radmili
- Clinical Hospital Center Zemun, Department of Cardiology, Belgrade, Serbia
| | - B Putnikovic
- Clinical Hospital Center Zemun, Department of Cardiology, Belgrade, Serbia
| | - A N Neskovic
- Clinical Hospital Center Zemun, Department of Cardiology, Belgrade, Serbia
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Ilic A, Stojsic S, Papovic J, Stefanovic M, Grkovic D, Miljkovic T, Bjelobrk M, Tadic S, Ilic DJ, Radisic B, Milovancev A, Bjelic S, Bogdanovic D, Stojsic-Milosavljevic A. P948 Assessment of maternal cardiac remodeling and systolic function by 3D echocardiography in gestational hypertension and preeclampsia. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
It was recently showed that there is a difference between 3D and 2D evaluation of the left ventricular (LV) myocardial mass and cardiac function in gestational hypertension (GH) probably due to more pronounced heart shape changes in hypertensive pregnant women. It is also known that preeclampsia (PE) is associated with a deterioration in maternal cardiac function. Purpose: We were interested whether there was a difference in 3D morphological and functional parameters of the LV in relation to the blood pressure (BP) profile in GH, but also between GH and PE. Methods: 22 women and 55 with GH (28 with dipping pattern of BP, and 27 non-dippers) underwent 3D echocardiography and ambulatory blood pressure monitoring in the third trimester. LV mass index, LV volumes, SV index and parameters of systolic function of the LV: CO index, EF, longitudinal strain (LS), circumferential strain (CS), radial strain (RS) and area strain (AS) were estimated using 3D software. These three groups (PE, dippers and non-dippers) were each other"s control. Results: Groups did not differ in age and LV massi. SVi was significantly lower in non-dippers (p = 0,045) and PE (p = 0,031) compared with dippers, without significant difference between non-dippers and PE (p = 0,59). Similar results were obtained when we analyzed the EF in these three groups. COi was the lowest in PE (2,76 ± 0,3), compared with dippers (3,43 ± 0,5; p< 0,0005), with significant difference between non-dippers (2,97 ± 0,4; p< 0,0005) and dippers, and with a small difference between PE and non-dippers (p = 0,045). Evaluation of the systolic function by 3D strain, also showed that the systolic function was significantly lower in PE, but also in non-dippers compared to dippers (Table 1). Multivariate regression analysis revealed that nocturnal BP (p = 0,001; OR 1,106; 95% CI 1,029 - 1,142) and presence of proteinuria (p< 0,0005; OR 7,2; 95% CI 1,896 – 36,5) strongly predict preterm delivery. Conclusions: Deterioration of 3D systolic function is more pronaunced in PE, but also in non-dipping pattern of BP in GH compared with dippers, without significant difference in 3D LV massi between groups.
Values od 3D strain in groups Dippers Non-dippers PE p1 p2 p3 LS -18,62 -16,99 -16,91 p< 0,0005 p< 0,0005 ns CS -18,22 -16,22 -16,21 p< 0,0005 p< 0,0005 ns RS 52,85 48,3 48,1 p< 0,0005 p< 0,0005 ns AS -31,77 -27,67 -27,98 p< 0,0005 p< 0,0005 ns p1 - difference between dippers and non-dippers; p2 - difference between dippers and PE; p3 - difference between non-dippers and PE
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Affiliation(s)
- A Ilic
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
| | - S Stojsic
- Institute of CVD Vojvodina, Sremska Kamenica, Serbia
| | - J Papovic
- Institute of pulmology Vojvodina, Sremska Kamenica, Serbia
| | - M Stefanovic
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
| | - D Grkovic
- Institute of CVD Vojvodina, Sremska Kamenica, Serbia
| | - T Miljkovic
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
| | - M Bjelobrk
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
| | - S Tadic
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
| | - D J Ilic
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
| | - B Radisic
- Institute of CVD Vojvodina, Sremska Kamenica, Serbia
| | - A Milovancev
- Institute of CVD Vojvodina, Sremska Kamenica, Serbia
| | - S Bjelic
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
| | - D Bogdanovic
- Institute of CVD Vojvodina, Sremska Kamenica, Serbia
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Ilic A, Stojsic S, Papovic J, Grkovic D, Miljkovic T, Bjelobrk M, Tadic S, Stefanovic M, Ilic DJ, Radisic B, Bjelic S, Dimic S, Puskar S, Stojsic - Milosavljevic A. P2639The influence of non-dipping pattern of blood pressure in gestational hypertension on early onset of hypertension later in life. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
It is known that gestational hypertension (GH) and preeclampsia have been associated with the onset of hypertension later in life. We wondered if the blood pressure (BP) pattern affects the incidence of hypertension in the future.
Purpose
The aim of this study was to determine whether hypertension occurs more frequently if a non-dipping pattern was registered during GH, but also if non-dipping pattern in GH afects deterioration of systolic function of the left ventricle (LV) later in life.
Methods
This longitudinal study included 56 pregnant women with gestational hypertension (of which 28 met criteria for non-dipping pattern of BP, according to the values registrated by the ambulatory blood pressure monitoring (ABPM) – non-dippers, while other 28 were classified in dippers) and 27 normotensive pregnant women, as control. All of women became normotensive after delivery, but they continued to be periodically controlled in term of values of blood pressure. The function and morphology of the left ventricle (LV) were analyzed by echocardiography exam in the third trimester of pregnancy and 5 years after delivery, as well as ABPM, while 2D longitudinal strain (LS) was performed only after delivery in order to evaluate systolic function of the LV. All echo and ABPM parameters recorded during pregnancy, also as parameters of pregnancy outcome – intrauterine growth restriction (IUGR) and preterm delivery, were analyzed, in order to relate them with later onset of hypertension.
Results
After, average 5 years, diagnosis of hypertension was determined in 8 women (2 from dipper group – during pregnancy – 7,1%, and 6 from non-dipper group 21,4%). Those 8 hypertensive women had significantly reduced LS: −18,12±1,3 compared to normotensive −19,9±1,4 (p=0,001). It is very interesting that, 5 years after delivery, values of 2D LS were, although in reference values, significantly reduced in women who were non-dippers (−19,32±1,38) during GH, compared with both, normotensive (−20,69±1,18; p<0,0005) and dippers (−20,10±1,29; p=0,026). Univariate regression analysis revealed that higher values of day and night BP, the mean arterial BP, LV mass index, preterm delivery and IUGR were associated with onset of hypertension later in life, while parameters of systolic and diastolic function of the LV during pregnancy, didn't affect occurrence of it. As revealed by multivariate regression analysis, the peak value of night-time diastolic blood pressure during pregnancy (p=0,016; OR=1,127; 95% CI: 1,022–1,242) and the LV mass index, also during pregnancy (p=0,041; OR=1,099; 95% CI: 1,004–1,203) had strong relation with hypertension in future life.
Conclusion
The non-dipping pattern of blood pressure in gestationl hypertension is significant associate with onset of hypertension later in life, but also with decreased systolic function of the left ventricle.
Acknowledgement/Funding
Provincial Secretariat for Health of the Autonomous Province of Vojvodina
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Affiliation(s)
- A Ilic
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
| | - S Stojsic
- Institute of CVD Vojvodina, Sremska Kamenica, Serbia
| | - J Papovic
- Institute of pulmology Vojvodina, Sremska Kamenica, Serbia
| | - D Grkovic
- Institute of CVD Vojvodina, Sremska Kamenica, Serbia
| | - T Miljkovic
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
| | - M Bjelobrk
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
| | - S Tadic
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
| | - M Stefanovic
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
| | - D J Ilic
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
| | - B Radisic
- Institute of CVD Vojvodina, Sremska Kamenica, Serbia
| | - S Bjelic
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
| | - S Dimic
- Institute of CVD Vojvodina, Sremska Kamenica, Serbia
| | - S Puskar
- Institute of CVD Vojvodina, Sremska Kamenica, Serbia
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Milosevic-Stevanovic J, Krstic M, Stefanovic M, Zivadinovic R, Vukomanovic P, Trajkovic-Dinic SP, Stojnev S. T lymphocytes in the third trimester decidua in preeclampsia. Hypertens Pregnancy 2019; 38:52-57. [PMID: 30744453 DOI: 10.1080/10641955.2019.1575393] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aim of study was to conduct immunohistochemical quantification of CD3+ and CD8+ decidual lymphocytes in preeclampsia. METHODS A study group included 30 cases of preeclampsia and a control group included 20 healthy pregnant women, all delivered by Cesarean section. Samples of placental bed were analyzed after immunohistochemical staining of CD45+, CD3+ and CD8+ cells. RESULTS The group with preeclampsia included a significantly higher number of CD3+ (p < 0.01) and CD8+ (p < 0.05) T lymphocytes. CONCLUSION It is certain that thebalance dysregulation of T cell of the immune milieu of deciduais of importance in etiopathogenesis and manifestations of preeclampsia.
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Affiliation(s)
- Jelena Milosevic-Stevanovic
- a Department of Gynecology and Obstetrics, Faculty of Medicine , University of Nis , Nis , Serbia.,b Clinic of Gynecology and Obstetrics , Clinical Center Nis , Nis , Serbia
| | - Miljan Krstic
- c Department of Pathology, Faculty of Medicine , University of Nis , Nis , Serbia.,d Center for Pathology and Pathological Anatomy , Clinical Center Nis , Nis , Serbia
| | - Milan Stefanovic
- a Department of Gynecology and Obstetrics, Faculty of Medicine , University of Nis , Nis , Serbia.,b Clinic of Gynecology and Obstetrics , Clinical Center Nis , Nis , Serbia
| | - Radomir Zivadinovic
- a Department of Gynecology and Obstetrics, Faculty of Medicine , University of Nis , Nis , Serbia.,b Clinic of Gynecology and Obstetrics , Clinical Center Nis , Nis , Serbia
| | - Predrag Vukomanovic
- a Department of Gynecology and Obstetrics, Faculty of Medicine , University of Nis , Nis , Serbia.,b Clinic of Gynecology and Obstetrics , Clinical Center Nis , Nis , Serbia
| | - Sonja Pop Trajkovic-Dinic
- a Department of Gynecology and Obstetrics, Faculty of Medicine , University of Nis , Nis , Serbia.,b Clinic of Gynecology and Obstetrics , Clinical Center Nis , Nis , Serbia
| | - Slavica Stojnev
- c Department of Pathology, Faculty of Medicine , University of Nis , Nis , Serbia
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Subramaniam S, Hayee B, Aepli P, Schoon E, Stefanovic M, Kandiah K, Thayalasekaran S, Alkandari A, Bassett P, Coron E, Pech O, Hassan C, Neumann H, Bisschops R, Repici A, Bhandari P. Optical diagnosis of colorectal polyps with Blue Light Imaging using a new international classification. United European Gastroenterol J 2019; 7:316-325. [PMID: 31080616 DOI: 10.1177/2050640618822402] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 11/21/2018] [Indexed: 12/27/2022] Open
Abstract
Background Blue Light Imaging (BLI) is a new imaging technology that enhances mucosal surface and vessel patterns. A specific BLI classification was recently developed to enable better characterisation of colorectal polyps (BLI Adenoma Serrated International Classification (BASIC)). The aim of this study was to validate the diagnostic performance of BASIC in predicting polyp histology in experienced and trainee endoscopists. Methods Five experienced and five trainee endoscopists evaluated high-definition white light (HDWL) and BLI images from 45 small polyps to assess baseline accuracy, sensitivity, specificity, and positive and negative predictive values (NPVs) of polyp histology. Each endoscopist was trained with the BLI classification before repeating the exercise. Results were compared pre- and post-training. Results The overall pre-training accuracy improved from 87% to 94%. The sensitivity and NPV of adenoma diagnosis also improved significantly from 79% to 96% and 81% to 95% with BASIC training. This improvement was noted in both groups. The interobserver level of agreement was very good (K = 0.90) in the experienced cohort and good (K = 0.66) in the trainee group post-training. Conclusions BLI is a useful tool for optical diagnosis, and the use of BASIC with adequate training can significantly improve the accuracy, sensitivity and NPV of adenoma diagnosis.
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Affiliation(s)
- Sharmila Subramaniam
- Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, Hampshire, UK
| | - Bu Hayee
- Department of Gastroenterology, King's College Hospital NHS Foundation Trust, London, UK
| | - Patrick Aepli
- Department of Gastroenterology, Luzerner Kantonspittal, Lucerne, Switzerland
| | - Erik Schoon
- Department of Gastroenterology, Catharina Hospital, Eindhoven, the Netherlands
| | - Milan Stefanovic
- Department of Gastroenterology, Diagnostični center Bled, Ljubljana, Slovenia
| | - Kesavan Kandiah
- Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, Hampshire, UK
| | | | - Asma Alkandari
- Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, Hampshire, UK
| | | | - Emmanuel Coron
- Centre Hospitalier Universitaire and Faculté de Médecine de Nantes, Institut des Maladies de l'Appareil Digestif, Nantes, France
| | - Oliver Pech
- Department of Gastroenterology and Interventional Endoscopy, St John of God Hospital, Regensburg, Bavaria, Germany
| | - Cesare Hassan
- Department of Gastroenterology, Nuovo Regina Margherita Hospital, Rome, Italy
| | - Helmut Neumann
- Department of Medicine, University Hospital Erlangen, Germany
| | - Raf Bisschops
- Department of Gastroenterology and Hepatology, Universitaire Ziekenhuizen Leuven, Belgium
| | | | - Pradeep Bhandari
- Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, Hampshire, UK
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Bjelic S, Srdanovic I, Stefanovic M, Milovancev A, Radin A, Sakac D, Pavic Poljak J, Vulin A, Popov T, Kovacevic M, Ilic A, Grkovic D. P696Etiology and outcome of patients undergoing pericardiocentesis due to cardiac tamponade. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- S Bjelic
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - I Srdanovic
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - M Stefanovic
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - A Milovancev
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - A Radin
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - D Sakac
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - J Pavic Poljak
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - A Vulin
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - T Popov
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - M Kovacevic
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - A Ilic
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
| | - D Grkovic
- Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia
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Popovic J, Stefanovic M, Dinic ST, Antic V, Trenkic M. Recurrent endometriosis and IVF: is it still an enigma? CLIN EXP OBSTET GYN 2018. [DOI: 10.12891/ceog4173.2018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Stojanovic S, Arsenijevic N, Djukic A, Djukic S, Zivancevic Simonovic S, Jovanovic M, Pejnovic N, Nikolic V, Zivanovic S, Stefanovic M, Petrovic D. ADIPONECTIN AS A POTENTIAL BIOMARKER OF LOW BONE MINERAL DENSITY IN POSTMENOPAUSAL WOMEN WITH METABOLIC SYNDROME. Acta Endocrinol (Buchar) 2018; 14:201-207. [PMID: 31149258 PMCID: PMC6516524 DOI: 10.4183/aeb.2018.201] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
CONTEXT Adiponectin is an abundant adipokine, which has antiinflammatory, anti-atherosclerotic and vasoprotective actions, and potential antiresorptive effects on bone metabolism. It seems to be directly involved in the improvement and control of energy homeostasis, protecting bone health and predicting osteoporotic fracture risk. OBJECTIVE To examine the relationship between adiponectin level and bone mineral density (BMD) in post-menopausal women with metabolic syndrome (MetS) and low BMD, and to estimate the prognostic significance of adiponectin in osteoporosis. DESIGN Clinical-laboratory cross-sectional study including 120 middle-aged and elder women (average 69.18±7.56 years). SUBJECTS AND METHODS The anthropometric parameters were measured for all examinees. Lumbar spine and hip BMD, as well as body fat percentage, were measured using a Hologic DEXA scanner. In all subjects serum adiponectin concentration was measured by ELISA method. RESULTS The level of adiponectin was significantly positively correlated with BMD-total, BMD of the lumbar spine and BMD of the femoral neck (r=0.618, r=0.521, r=0.567; p<0.01). Levels of adiponectin and BMD are significantly lower in post-menopausal women with MetS and osteoporosis compared to patients with osteopenia (856.87±453.43 vs. 1287.32±405.21 pg/mL, p<0.01; BMD, p<0.05), and the highest values in healthy examinees. A cut-off value of adiponectin level for osteoporosis/osteopenia was 1076.22/1392.74 pg/mL. CONCLUSIONS Post-menopausal women with MetS have significantly lower adiponectin level and low BMD compared to healthy examinees. Adiponectin may be an early, significant and independent predictor of developing osteoporosis in women with MetS, especially in post-menopausal period.
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Affiliation(s)
- S.S. Stojanovic
- “Niska Banja” Institute for Treatment and Rehabilitation, Nis, Serbia
| | - N.A. Arsenijevic
- University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Nis, Serbia
| | - A. Djukic
- University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Nis, Serbia
| | - S. Djukic
- University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Nis, Serbia
| | | | - M. Jovanovic
- University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Nis, Serbia
| | - N. Pejnovic
- University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Nis, Serbia
| | - V. Nikolic
- University of Nis, Faculty of Medicine, Nis, Serbia
| | - S. Zivanovic
- University of Nis, Faculty of Medicine, Nis, Serbia
| | | | - D. Petrovic
- “Niska Banja” Institute for Treatment and Rehabilitation, Nis, Serbia
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Ilic I, Vidakovic R, Janicijevic A, Stefanovic M, Kafedzic S, Cerovic M, Milicevic D, Obradovic G, Jovanovic V, Stankovic I, Putnikovic B, Neskovic A. P2342Plaque characterization by MSCT coronary angiography in native, “true” non-left main coronary bifurcation may be useful for guiding PCI procedures. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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26
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Ilic A, Papovic J, Milovancev A, Stojsic S, Grkovic D, Bjelobrk M, Miljkovic T, Stojsic-Milosavljevic A, Tadic S, Stefanovic M, Ilic D. P3257The impact of maternal hemodynamics on preterm delivery and intrauterine growth restriction in gestational hypertension. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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27
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Stankovic I, Janicijevic A, Dimic A, Stefanovic M, Vidakovic R, Putnikovic B, Neskovic A. P1440Mechanical dispersion but not dyssynchrony is associated with poor outcome in heart failure with a severely depressed left ventricular function and bundle branch blocks. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tepeš B, Bracko M, Novak Mlakar D, Stefanovic M, Stabuc B, Frkovic Grazio S, Maucec Zakotnik J. Results of the FIT-based National Colorectal Cancer Screening Program in Slovenia. J Clin Gastroenterol 2017; 51:e52-e59. [PMID: 27552327 DOI: 10.1097/mcg.0000000000000662] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Colorectal cancer (CRC) is one of the most common malignancies in the western world. OBJECTIVE We aimed to assess the first round of fecal immunochemical test (FIT)-based National CRC screening program (NCSP). METHODS In the NCSP conducted in Slovenia, a FIT and colonoscopy for those tested positive was used. The NCSP central unit sent 536,709 invitations to Slovenian residents age 50 to 69 years old between 2009 and 2011. The adherence rate was 56.9% (303,343 participants). FIT was positive in 6.2% (15,310) of the participants (men, 7.8%; women, 5.0%; P<0.01). A total of 13,919 unsedated colonoscopies were performed with the cecal intubation rate of 97.8%. RESULTS The overall adenoma detection rate was 51.3% [95% confidence interval (CI), 50.5%-52.1%] of which 61.0% (95% CI, 59.9%-62.1%) was in men, and 39.1% (95% CI, 37.8%-40.3%) in women (P<0.01). The mean number of adenoma per positive colonoscopy was 1.94 (95% CI, 1.90-1.97). Adenoma, advanced adenoma, or cancer were found in 7732 (55.5%) colonoscopies. A total of 862 (6.2%) CRC cases were found. Only 161 (18.7%) carcinomas were situated in the right colon. A total of 597 (70.2%) patients with cancer were in the early clinical stages (N, negative; 194 22.8%) of all cancers were cured with only endoscopic resection. CONCLUSIONS In the NCSP, CRC was found in 6.2% of those participants attending colonoscopy, with 81.3% of carcinomas found in the left colon. A localized clinical stage was found in 70.2% participants. In 22.8% of CRC patients, cancer was cured with endoscopic resection only.
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Affiliation(s)
- Bojan Tepeš
- *AM DC Rogaška, Rogaška Slatina †University Clinical Center ‡National Institute for Public Health, Ljubljana §DC Bled, Bled, Slovenia
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Brand M, Stefanidis A, Morbach C, Fan YT, Elremisy DRA, Kuznetsov VA, Carrero C, Almodares Q, Abdulrahim H, Galli E, Galli E, Moreno J, Lerena Saenz P, Ikonomidis I, Galuszka OM, Bonapace S, Clerc OF, Kuznetsov VA, Tadic S, Kataoka A, Abdul Rahman E, Calin A, Antonini-Canterin F, Schwartzenberg SS, Christ M, Roeing J, Amirie S, Grett M, Beko M, Breker I, Wennemann R, Trappe HJ, Lagoudakou S, Vintzilaios K, Mokadem N, Vlachou J, Komatanou E, Korlou P, Kakkavas A, Komninos K, Kranidis A, Gelbrich G, Simon J, Cramer M, Knobeloch F, Tiffe T, Wagner M, Heuschmann PU, Stoerk S, Yang D, Wang X, Chan AK, Cheung SH, Lee AP, Salim FF, Bakhoum SW, Ashour ZA, Soldatova AM, Krinochkin DV, Enina TN, Altamirano C, Pipkin M, Constantin I, Fava A, Diaz Babio G, Masson Juarez G, San Miguel J, Vera Janavel G, Stutzbach P, Wallentin Guron C, Thurin A, Fu M, Kontogeorgos S, Thunstrom E, Johansson MC, Da Silva C, Venkateshvaran A, Nagy AI, Lund LH, Manouras A, Leclercq C, Fournet M, Bernard A, Mabo P, Samset E, Hernandez A, Donal E, Leclercq C, Fournet M, Bernard A, Mabo P, Samset E, Hernandez A, Donal E, Martinez Lugo CML, Zuniga Sedano JZD, Alexanderson EAR, Camilletti JC, Ahmed Abdelrahman M, Raslan H, Ruisanchez Villar C, Cuesta Cosgalla JM, Zarauza Navarro J, Veiga Fernandez G, Rifaie O, Omar AMS, Vlastos D, Frogoudaki A, Vrettou AR, Vlachos S, Varoudi M, Triantafyllidi H, Parissis J, Tsivgoulis G, Lekakis J, Steffens D, Friebel J, Rauch-Krohnert U, Landmesser U, Kasner M, Adamo E, Valbusa F, Ciccio' C, Rossi A, Lanzoni L, Chiampan A, Cecchetto A, Canali G, Barbieri E, Fuchs TA, Stehli J, Benz DC, Graeni C, Buechel RR, Kaufmann PA, Gaemperli O, Yaroslavskaya EI, Krinochkin DV, Kolunin GV, Gorbatenko EA, Dyachkov SM, Jung R, Ilic A, Stojsic-Milosavljevic A, Dejanovic J, Stefanovic M, Stojsic S, Sladojevic M, Watanabe Y, Kozuma K, Yamamoto M, Takagi K, Araki M, Tada N, Shirai S, Tamanaka F, Hayashida K, Ewe SH, Fadzil MA, Najme Khir R, Ismail JR, Lim CW, Chua N, Ibrahim ZO, Kasim SS, Ding ZP, Mateescu AD, Beladan CC, Rosca M, Enache R, Calin C, Cosei I, Botezatu S, Simion M, Ginghina C, Popescu BA, Di Nora C, Poli S, Vriz O, Zito C, Carerj S, Pavan D, Vaturi M, Kazum S, Monakier D, Sagie A, Kornowski R, Shapira Y. Poster Session 2The imaging examination and quality assessmentP520Benefit of early basic transthoracic echocardiography (TTE) in emergency patients performed by physicians with low to intermediate TTE experienceP521Appropriateness criteria in echocardiography. A contemporary necessity in clinical practiceP522Interobserver variability in 2d transthoracic echocardiography impact of scanning and reading on total variability results from the STAAB cohort study quality controlP5233D printing for personalised planning of catheter-based left atrial appendage occlusionP524Central obesity: an independent role or synergistic effect to metabolic syndrome on right atrial structure?P525Dynamics of left ventricular volumes and mortality in patients with early and late effect of cardiac resynchronization therapyP526Variability of thoracic aortic diameters according to gender, age and body surface area. Time to forget absolute cut-off values?P527The association of left ventricular outflow tract velocity time integral to all-cause mortality in elderly patients with heart failureP528Left ventricular myocardial performance and atrioventricular coupling in patients with primary arterial hypertensionP529Interest of a combinatory approach based on traditional left ventricular dyssynchrony parameters and cardiac work estimated by pressure-strain loop curves for the prediction of cardiac resynchronizatP530The evaluation of cardiac performance by pressure-strain loops: a useful tool for the identification of cardiac resynchronization therapy respondersP531Left ventricle cardiac function by 2D-speckle tracking echocardiography in diabetes mellitus population: sub-clinical systolic disfunction studyP532Biphasic tissue doppler mitral annular isovolumic contraction velocities are associated with left ventricular function, isovolumic relaxation, and pulmonary wedge pressure in heart failure patientsP533Abnormal left atrial volumes and strains are associated with increased arterial stiffnes in patients with cryptogenic stroke: a novel pathophysiological pathP534Detection of coronary microvascular disease using two-dimensional speckle-tracking echocardiographyP535Predictive value of a bi-dimensional transthoracic echocardiographic sign of " binary image" to identify the anomalous origin of the left circumflex coronary artery from the right coronary sinusP536Systematic review and meta-analysis of screening for coronary artery disease in asymptomatic diabetic patientsP537Noninvasive screening test for diagnosis of nonobstructive coronary artery disease using echocardiographic criteriaP538Early echocardiography after primary angioplasty, important role in predicting left ventricular remodelingP539Prognostic impact of low-flow severe aortic stenosis in Japanese patients undergoing transcatheter aortic valve implantation: the ocean-tavi registryP540Left ventricular outflow tract geometry and its impact on aortic valve area calculations in aortic stenosis using 3D transoesophageal echocardiography and 2D transthoracic echocardiographyP541Impaired left atrial myocardial deformation predicts postoperative atrial fibrillation after aortic valve replacement in patients with aortic stenosisP542Ejection fraction-velocity ratio in predicting symptoms in severe aortic stenosisP543Incremental value of transesophageal echocardiography in conjunction with transthoracic echocardiography in the assessment of aortic stenosis severity. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Milosevic-Stevanovic J, Krstic M, Radovic-Janosevic D, Stefanovic M, Antic V, Djordjevic I. Preeclampsia with and without intrauterine growth restriction–Two pathogenetically different entities? Hypertens Pregnancy 2016; 35:573-582. [DOI: 10.1080/10641955.2016.1212872] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Hadži-Lega MHL, Markova AD, Stefanovic M, Tanturovski M. Combination of selected biochemical markers and cervical length in the prediction of impending preterm delivery in symptomatic patients. CLIN EXP OBSTET GYN 2016. [DOI: 10.12891/ceog2046.2016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Hadži-Legal M, Markova AD, Stefanovic M, Tanturovski M. Combination of selected biochemical markers and cervical length in the prediction of impending preterm delivery in symptomatic patients. CLIN EXP OBSTET GYN 2016; 43:154-160. [PMID: 27048042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The pathophysiology of preterm delivery (PTD) is complex and multifactorial.It occurs in 8-12% of all deliveries, and the rate of PTD has increased during the past years in spite of intensive efforts towards early detection and prompt treatment. Fifty-eight pregnant women were eligible to join the study if they attended the University Clinic for Gynecology and Obstetrics, Skopje and were admitted to Department of High Risk pregnancy Unit with symptoms of preterm labor (PTL) (symptoms of uterine activity judged by the assessing physician to be indicative of PTL) at 24.0 to 36.6 weeks gestation.Test specimens for fetal fibronectin (fFN), phosphorylated insulin like growth factor binding protein 1 (phIGFBP-1), IL-6, and IL-2R and measuring the cervical length via transvaginal ultrasound were performed for each patient. The best statistical model for predicting PTL in the present study was to use a combination of the phIGFBP-1 test, a positive fFN test, cervical length less than 21.5 mm, levels of IL-6 higher than 1,305 pg/ml in the cervico-vaginal fluid (CVF), and serum levels of C-reactive protein (CRP) higher than 6.1 mg/L which was excellent at identifying the patients that were to deliver within 14 days of admittance.
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Daneva AM, Hadži-Lega M, Stefanovic M. Correlation of the system of cytokines in moderate and severe preeclampsia. CLIN EXP OBSTET GYN 2016; 43:220-224. [PMID: 27132414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE OF THE STUDY To study the production of pro-inflammatory (IL-1β, IL- 2, IL-6, IL-8) and anti-inflammatory (IL-4, IL-10) cytokines in pregnancy complicated by preeclampsia in the third trimester. Institution: University Clinic of Gynecology and Obstetrics, Skopje, Republic of Macedonia. MATERIAL AND METHODS Fifty women with pregnancies complicated by preeclampsia in the third trimester and 50 women with physiological pregnancy. Levels of IL-1β, IL-2, IL-6, IL-8, IL-4, and IL-10 were measured by using a solid-phase enzyme immunoassay. Statistical data processing was done using the application program SPSS for Windows 13.0. To describe the distribution of analyzed variables, descriptive methods (mean, median, minim and max) were used . RESULTS In pregnancies complicated by preeclampsia, there are increased levels of proinflammatory cytokines and a change in the behaviour of opposing pools. Most pronounced changes in the levels of proinflammatory cytokines were observed in mild preeclampsia. In severe preeclampsia there was reduction of the concentration of anti-inflammatory cytokines IL-4 and IL-10. CONCLUSION The use of assessment cytokine profile monitoring of health status of women with preeclampsia is expedient.
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Hadži-Lega M, Markova AD, Stefanovic M, Tanturovski M. Correlation of cervical length, fetal fibronectin, phIGFBP-1, and cytokines in spontaneous preterm birth up to 14 days from sampling. J Perinat Med 2015; 43:545-51. [PMID: 25503663 DOI: 10.1515/jpm-2014-0275] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 10/23/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this study was to determine the relationship between sonographic cervical length, fetal fibronectin (fFN), phIGFBP-1 (actim partus test), cytokines (IL-6, IL-2R, and TNF-α), and spontaneous preterm birth (SPTB) up to 14 days from sampling. METHODS Fifty-eight patients were recruited in a period of 6 months from September 2013 until March 2014 with symptoms or complaints suggestive of preterm labor. Consenting women were treated according to usual hospital protocol, with addition of vaginal swabs taken for fetal fibronectin, phIGFBP-1 (actim partus test) and cervical IL6, IL2R, and TNF-α. The outcome variable was occurrence of preterm delivery within 14 days from the day of hospital admission. RESULTS Thirty-six patients (62.07%) were delivered within 14 days from admission. Our results indicated that the cervical length significantly inversely correlates with the concentration of IL-6 in the CVF (Spearman's coefficient R=-0.382, P<0.05). Cervical length also correlated with a positive phIGFBP-1 test, i.e., patients with a positive test had an average cervical length of 18.5±4.63 mm, which is significantly lower than patients with a negative test -23.43±7.39 mm (P=0.003). CONCLUSIONS The studied biochemical markers were only moderately successful in the prediction of preterm delivery.
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Hadzi Lega M, Daneva Markova A, Stefanovic M, Tanturovski M. Interleukin 6 and fetal fibronectin as a predictors of preterm delivery in symptomatic patients. Bosn J Basic Med Sci 2015; 15:51-6. [PMID: 25725144 DOI: 10.17305/bjbms.2015.1.93] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 10/05/2014] [Accepted: 10/05/2014] [Indexed: 11/16/2022] Open
Abstract
Preterm delivery is the leading cause of neonatal mortality and morbidity. The rate of preterm births has been estimated to be about 15 million, which accounts for 11.1% of all live births worldwide. The purpose of this study was to evaluate the cervico-vaginal (CVF) cytokine IL-6 and fetal fibronectin (fFN) status as predictors of preterm delivery in patients with symptoms of preterm labor. Patients with symptoms suggestive of preterm labor were recruited from September 2013 to March 2014. Vaginal swabs were taken for fetal fibronectin test (fFN) and CVF IL-6. Antibiotics, steroids and tocolytics were administered, where appropriate. The outcome was measured by the occurrence of preterm delivery within 14 days from the day of hospital admission. Cut-off value of 1305 pg/mL for the concentration of IL-6 in the CVF was the best predictor of preterm delivery, with the sensitivity of 69.4% and specificity of 68.2%. Patients with positive fFN test had the OR of 6.429 (95%CI 1.991-20.758) to deliver prematurely. The multivariate analysis of combined fFN and CVF IL-6 tests resulted in risk of 86.7% to deliver prematurely, if both tests were positive. The combination of both tests performed better than the individual tests and decreased the false positive rate, which in turn reduced the chances for inappropriate patient treatment, bringing down the costs.
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Affiliation(s)
- Marija Hadzi Lega
- Clinic of Obstetrics and Gynecology, Medical Faculty, Ss. Cyril and Methodius University, Skopje, Macedonia.
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Tubic-Pavlovic A, Radovic-Janosevic D, Petric A, Stefanovic M. Are there any association between polycistic ovary syndrome and congenital abnormalities of Müllerian ducts. VOJNOSANIT PREGL 2014. [DOI: 10.2298/vsp1406576t] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background/Aim. There are many specificities of merital infertility and
sometimes surprising connections between some thinks with no connections at
first sight. Examinations of these patients imply diagnostic actions such as
the blood basal hormone sample, doing hysterosalpingography,
ultrahysterosonography, ultrasound examinations, and sometimes laparoscopy
and hysteroscopy if there are necessary. The aim of the study was to
determine the characteristics of the connection between policystic ovary
(PCO) syndrome (Sy) and congenital M?llerian ducts abnormalities. Methods.
This study included 356 patients treated in the period from January 1, to
December 31, 2009, in the Department of Infertility of the Clinic for
Obstetrics and Gynecology in Nis, Serbia. Exclusion criteria were no myoma,
ovary cysts, tubal and male factors of infertility. Results. A total of 180
patients were divided into 3 groups: the group I with PCO sy, the group II
with uterine congenital malformation and the group III with a combination of
these disorders. The middle age of patients was 29.6 ? 4.8, body mass index
(BMI) was 26.1 ? 4,8 kg/m2 the middle thicknes of endometrium was 5.2 + 2.7
mm, and there were no significant differences between the examined groups.
There were no significant among in a number of miscarriages in the examined
groups. We found that PCO Sy and congenital abnormalities of M?llerian ducts
were conjoint in 30% of examined patients. Conclusion. Conjoined PCO Sy and
congenital abnormalities of M?llerian ducts do not result in a higher number
of misscarriages than only either PCO Sy or abnormalities of M?llerian ducts.
It is important to check BMI, basal level of follicle stimulating hormone and
number of antral follicles because the induction protocol and concentracion
of inductors depends on these characteristics, thus, the successful cycles
and pregnancy.
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Hadzi-Lega M, Daneva-Markova A, Stefanovic M. Cervical length and phosphorilated insulin like growth factor binding protein-1 as the predictors of spontaneus preterm delivery in symptomatic women. SANAMED 2014. [DOI: 10.5937/sanamed1402143h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Radovic-Janosevic D, Lilic V, Basic H, Tubic-Pavlovic A, Stefanovic M, Milosevic J. Decidual natural killer cells in recurrent spontaneous abortions. VOJNOSANIT PREGL 2011; 68:41-5. [DOI: 10.2298/vsp1101041r] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background/Aim. A repeated or habitual miscarriage (PSP) is defined as three
or more consecutive losses of pregnancy. In the first three months of
pregnancy, habitual miscarriages occur in about 1% of pregnant women, out of
which 50% are of an unknown etiology. It is believed that among them, the
greatest number is the consequence of an inadequate alloimmune response of a
women to the pregnancy. The endocrine and immune systems are in a close
interaction during the implantation and maintaining of pregnancy. This
communication is the most obvious on endometrium of pregnancy decidua. The
aim of the study was to identify the number and the subpopulation
distribution of the decidual NK cells in the decidua by using an
immunohistochemical method. Methods. The research included a group of 30
women who had had two spontaneous miscarriages consecutively in the first
three months of their pregnancy, while the curettage after the third
spontaneous abortion was histopathologically and immunohistochemically
analyzed. The control group consisted of 20 women without a problematic
reproductive anamnesis, who had had their pregnancy terminated for social
reasons. The criteria for the eliminating from the research were the
diagnosed uterus anomalies, positive screening on thrombophilia, as well as
women suffering from diabetes melitus and the ones with the thyroid gland
function disorder. Results. The number and the phenotype structure of the
uterus NK cells were significantly different between the decidua of a normal
pregnancy and that in PSP. In the decidua in PSP, there were much more NK
cells with the phenotype of the peripheral circulation CD57 and CD56dim,
while in the decidua of the control group the dominant cells were the typical
uNK cell subpopulation CD56bright. Conclusion. The above mentioned results
show that the disregulation of the immunocompetent cells of the decidua, by
creating an inadequate cytokine milieu, is one of the mechanism of rejecting
the semiallogeneic blastocyst.
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Affiliation(s)
| | - Vekoslav Lilic
- Klinički Centar Niš, Klinika za ginekologiju i akušerstvo, Niš
| | - Hakija Basic
- Klinički Centar Niš, Institut za patologiju, Niš
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Jonckheere E, Lohsoonthorn P, Musuvathy S, Mahajan V, Stefanovic M. On a standing wave Central Pattern Generator and the coherence problem. Biomed Signal Process Control 2010. [DOI: 10.1016/j.bspc.2010.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Sljivic S, Kamenov B, Maglajlic S, Djordjevic V, Stojkovic-Eferica I, Stojanovic M, Stefanovic M, Mihailovic D, Mrkaic L, Tasic G. Possible interactions of genetic and immuno-neuro-endocrine regulatory mechanisms in pathogenesis of congenital anomalies. Med Hypotheses 2006; 67:57-64. [PMID: 16574341 DOI: 10.1016/j.mehy.2005.07.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2005] [Accepted: 07/14/2005] [Indexed: 11/29/2022]
Abstract
The process of organogenesis depends on genetic and environmental factors. Besides genetic background, congenital anomalies can also be influenced by micro environmental changes, which are related to maternal-foetal interactions followed by the production of cytokines, hormones, neurotransmitters, growth factors and biochemical mediators, and stress proteins. Pre-natal maternal stress, including infections, psychological stress and other teratogens, can influence a disregulation of maternal immune, endocrine and nervous systems, during pregnancy. This is a crucial condition for the abnormal growth and development of the foetus. Activated maternal immune system can alter the cytokine network and make it inadequate for normal embryogenesis and organogenesis. Heat-shock proteins play an important role in stress physiology repairing DNA errors or activating pro-inflammatory response. Regarded from this aspect, the altered cytokine network suggests aetiopathogenetic basis of congenital anomalies in neonates. It is our wish to point out our potentially harmful conditions in the development of congenital anomalies, as well as their control by using pre-natal and pre-conceptional diagnostics and treatment.
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Affiliation(s)
- Sofija Sljivic
- Gynaecology and Obstetrics Clinic, Department of Neonatology, Clinical Centre, Nis Bulevar Nemanjica 7/12, 18 000 Nis, and University Clinic of Pediatrics, Belgrade, Serbia and Montenegro.
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Hiebert A, Jonckheere E, Lohsoonthorn P, Mahajan V, Musuvathy S, Stefanovic M. Visualization of a stationary CPG-revealing spinal wave. Stud Health Technol Inform 2006; 119:198-200. [PMID: 16404044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Central Pattern Generator (CPG) is still an elusive concept that has a visual manifestation as a rhythmic oscillation commanded from the spine, but that also has another manifestation as a train of bursts in the surface electromyographic (sEMG) signals recorded on the para-spinal muscles. This leads to the challenging problem of correlating the visually observed spinal wave with the sEMG signals recorded during the session. This paper develops a mathematical model of the spinal wave phenomenon, which, when driven by the sEMG data, yields such visually observable features as wave nodes.
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Affiliation(s)
- A Hiebert
- University of Southern California, Los Angeles, CA, USA
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Volavka J, Mohammad Y, Vitrai J, Connolly M, Stefanovic M, Ford M. Characteristics of state hospital patients arrested for offenses committed during hospitalization. Psychiatr Serv 1995; 46:796-800. [PMID: 7583480 DOI: 10.1176/ps.46.8.796] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The study was a preliminary exploration of the relatively new phenomenon of arresting psychiatric inpatients for offenses committed in the hospital. METHODS A retrospective record review at two New York state hospitals identified all 73 inpatients arrested over a 30-month period for an offense committed while they were hospitalized. Logistic regression was used to compare arrestees with a control group of 1,438 non-arrested inpatients. RESULTS The number of arrests at the two hospitals significantly increased over the study period. Seventy-nine percent of arrests resulted from a violent incident. At least 68 percent of arrestees had been arrested previously. Compared with the control group, arrestees were more likely to be young, male, and black and to have a shorter length of stay. Axis I diagnoses did not differentiate arrestees from control patients. Ninety percent of arrestees had a diagnosis of substance use or personality disorder or both. The sample more closely resembled the population of criminal offenders in the community than the psychiatric inpatient population. Prosecution resulted in jail or prison terms for 11 percent of arrestees. CONCLUSIONS This descriptive preliminary study was limited by its retrospective nature and reliance on records of varying quality. Although the increase in arrests is clear, the cause of the increase and the impact of arrests on arrestees and hospitals remain to be clarified.
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Affiliation(s)
- J Volavka
- Clinical Research Division, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York 10962, USA
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Stefanovic M, Janjatovic T, Zivkovic D, Jovanovic M. [Buccopharyngitis caused by mold fungi]. Dermatol Monatsschr 1973; 159:412-3. [PMID: 4726627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Tavciovski I, Cvetkovic N, Stefanovic M. [Dry caries]. Stomatol Glas Srb 1972; 19:103-5. [PMID: 4509945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Stefanovic M, Walker BL. Effect of stationary phase-support ratio on the gas chromatographic separation of trifluoroacetylamino acid butyl esters. Anal Chem 1967; 39:710-3. [PMID: 6042629 DOI: 10.1021/ac60251a007] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Micovic V, Stojcic S, Mladenovic S, Stefanovic M. Oxydation of polymethylene α,ω - glycols by means of lead tetraacetate. Preparation of ditetrahydrofuran derivatives. Tetrahedron Lett 1965. [DOI: 10.1016/s0040-4039(01)84091-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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