Blood and urine cadmium and bioelements profile in nickel-cadmium battery workers in Serbia.

Although cadmium (Cd) is extensively used for nickel-cadmium battery production, few recent reports are available on the effect of this toxic metal on the imbalance of biometals in occupational exposure. The current study was carried out to determine the Cd level and its effect on the content of bioelements: zinc, cooper, magnesium, and iron in blood and urine of workers exposed to Cd during nickel-cadmium battery production. beta(2)-microglobulins (beta(2)-MG), as indicators of kidney damage, were determined in urine.The study group comprised 32 male nickel-cadmium battery workers, and the control group had 15 male construction workers with no history of Cd exposure. Levels of Cd and bioelements were determined in blood and urine by atomic absorption spectrophotometry.Cd concentration in blood of exposed workers was around 10 microg/L and in urine ranged from 1.93 to 8.76 microg/g creatinine (cr). Urine Cd concentration was significantly higher in exposed workers than in the controls, although no statistical difference in beta(2)-MG content was observed in urine between the two groups. Blood Zn and Mg level were significantly reduced and urine Zn level was increased in Cd-exposed group when compared with controls.The mean Cd concentrations in blood and urine did not exceed the recommended reference values of 10 microg/L in blood and 10 microg/g cr in urine. Cd exposure resulted in disturbances of Zn in blood and urine and Mg in blood but had no effect on Cu and Fe content in biological fluids.

Diet and bladder cancer: a case-control study.

To investigate possible relationships between diet and risk for bladder cancer in Serbia, the hospital-based case-control study was carried out. This study included 130 newly diagnosed bladder cancer patients and the same number of controls matched by sex, age (%+/-%2 years) and type of residence (rural or urban). Dietary information was obtained by using a food frequency questionnaire. Initial case-control comparisons were based on tertiles of average daily intake of control group. The odds ratios (ORs) were computed for each tertile, with the lowest tertile defined as the referent category. All variables (food items) significantly related to bladder cancer were included in multivariable logistic regression analysis. According to this analysis, risk factors for bladder cancer appeared to be consumption of liver (OR=6.60, 95%CI=1.89-23.03), eggs (OR=3.12, 95%CI=1.10-8.80), pork (OR=2.99, 95%CI=1.16-7.72), and pickled vegetable (OR=3.25, 95%CI=1.36-7.71). A protective effect was found for dietary intake of kale (OR=0.21, 95%CI=0.06-0.73), cereals (OR=0.19, 95%CI=0.06-0.62), tangerines (OR=0.21, 95%CI=0.07-0.68), cabbage (OR=0.27, 95% CI=0.11-0.68), and carrots (OR=0.15, 95%CI=0.05-0.41). The study indicated a potentially important role for dietary fat and pickled vegetables in bladder carcinogenesis. An inverse association was recorded between consumption of fruits, vegetables and cereals, and the development of bladder cancer.

Immature ovarian teratoma in a young girl: very short course and lethal outcome. A case report.

Immature teratomas of the ovary represent less than 1% of all ovarian teratomas. They contain several tissues that derive from the three embryologic layers: ectoderm, mesoderm, and endoderm. We report the case of a 17-year-old girl who presented with an immature teratoma of the left ovary that recurred 3 months later as an inoperable malignant neuroepithelial peritoneal tumor resembling a glioblastoma. She died 3 weeks after the second explorative operation. The very aggressive course and fast lethal outcome could be explained by the patient's refusal to receive chemotherapy after the initial operation.

[Acute hemolytic transfusion reaction]. / Akutna transfuziona hemolizna reakcija.

Alloogenous blood and/or corresponding haemoproduct transfusion is an efficient and relatively safe supportive treatment. Despite the fact that pre transfusion investigation of both patients and donors ensure high degree of safety of this type of treatment, occurrence of adverse haemotherapy effects is possible and often unpredictable. Acute haemolytic transfusion reaction occur as a consequence of immune conflict between red blood cell membrane agents and specific antibodies present in plasma. Since it is impossible to completely avoid the occurrence of transfusion reactions, wherein acute transfusion haemolytic reaction present a serious, possibly life threatening complication, it is an imperative to continue to improve the knowledge on pathogenesis mechanisms leading to complications associated with these reaction and to define the most efficient therapeutical modalities.

The significance of immunoglobulins in the treatment of patients with sepsis and septic shock.

Inappropriate body response is, besides the infectious agent, responsible for the genesis of sepsis and septic shock. It is non-specific and in cascade of events it can hardly be controlled. The results of immunoglobulins administration compared to the disease course and outcome have been compared and analyzed in 135 patients with sepsis and septic shock. A hundred and four patients were treated for sepsis. Immunoglobulins were administered to 18, of whom 17 patients (94.55%) were cured, while one (5.55%) developed septic shock with lethal outcome. Out of the other 86 patients who did not receive immunoglobulins, 82 (95.35%) were cured, while in 4 (4.65%) patients the outcome was lethal. No difference was observed between studied groups. Among 31 patients with septic shock, 13 received immunoglobulins. Seven (53.85%) patients were cured, and 6 (46.15%) died. In relation to the favorable disease outcome the difference was observed (statistically non-significant) in the group that received immunoglobulins, compared to the group that did not (53.85% vs. 44.45%). The importance of immunoglobulins administration, in sepsis and septic shock should be emphasized.

[Viral hepatitis C. Personal experience with diagnostic, monitoring and epidemiologic studies]. / Virusni hepatitis C. Nasa iskustva u dijagnostici, pracenju i epidemioloskim ispitivanjima.

In the period from 1991 to 1993, 18 patients with the acute viral hepatitis type C were treated and followed up--13 men and 5 women, the average age of 42 years. The group of 6 patients (4 men and two women) with the "old" proven liver cirrhosis, whose etiology was unknown for 20 years, was analyzed. The investigations showed that the acute viral hepatitis type C usually began with the mild subjective disorders. The half of the patients did not have either jaundice or hepatomegaly, only half of them recover, and the first cases of cirrhosis could have been expected almost as early as a year after the beginning of illness. The developed liver cirrhoses remained compensated for years. About 58% of patients got infected parenterally, and the rest of them could have gotten infected in other manner. ELISA test showed great reliability in proving the antibodies against the viral hepatitis type C in the confirming the diagnosis of illness.

[Clinical manifestations of infectious erythema in adults]. / Klinicko ispoljavanje infektivnog eritema kod odraslih.

The infectious erythema is usually childhood disease associated with rash and caused by parvovirus B19. At the beginning of 1993., at the Clinic for infectious and tropical diseases of the Military Medical Academy 36 patients were treated for this disease, the average age 21 years. The prodromal phase of illness lasted approximately 2.9 days, the elevated temperature 5.2 days, and 17 patients had temperature above 39 degrees C. The rash was usually maculo-papullous and lasted about 6 days. Four patients had the recurrence of rash. The polyarthralgia appeared for short in six patients and in one patient lasted longer than 4 months. The mild anemia during infectious erythema was observed in 18 patients. IgM antiparvo B19 antibodies were proven in serum in 91.7%, and IgG antibodies in 58.3% of patients.

[Personal experience in the treatment of chronic viral hepatitis B with recombinant interferon B alfa-2]. / Nasa iskustva u lecenju hronicnog virusnog hepatitisa B alfa-2 rekombinantnim interferonom.

Twelve patients were treated with alpha-2 recombinant interferon during 4 months. Patients were given daily dose of 3 million units three times a week. Therapeutic effect expressed as the percentage of HBeAG seroconversion or by the loss of antibodies for the core antigen in IgM fraction and by the core antigen loss from hepatic tissue, was achieved in 41.6% of patients. Corticosteroids, administered before interferon, could improve therapeutic effect. Better response to therapy was observed in patients with higher serum transaminase levels and with histopathologically confirmed chronic hepatitis. Predictive value of each immunological parameter of therapeutic effect requires further study.

[Endotoxemia in patients with food poisoning]. / Endotoksemija u bolesnika sa alimentarnom toksiinfekcijom.

In 22 patients with alimentary toxoinfection caused by salmonella and other gram-negative bacteria, endotoxemia was proved in 8 (36%) patients. The causative agent of the disease was proved in 11 (50%) of cases. In 6 (54%) patients the causative agent were from salmonella species: S. enteritidis, S. typhimurioum, S. hadar and S. heidelberg. Endotoxemia and positive coprocultures, that is, hemocultures were found in two patients respectively. In two patients with positive coprocultures and hemocultures, endotoxemia was found as well as in two patients with unknown causative agent. In patients with alimentary toxoinfection caused by salmonella and other gram-negative bacteria, endotoxemia occurred relatively often. Early detection of endotoxemia is important for application of urgent therapeutic measures and procedures, especially in immunocompromised patients.

[Clinical characteristics of Lyme disease]. / Klinicke karakteristike lajmske bolesti.

Clinical characteristics of Lyme disease were analysed in 22 patients. Erythema migrans was found in 20 (91%), arthralgia in 18 (81%), neuralgia in 8 (36%), encephalitis in 3 (13%), carditis in 2 (9%) and arthritis in 2 (9%) patients. The positive antibody titer was found in 14 (63%) patients. Favourable effects of antibiotic therapy was achieved in all patients. Erythema migrans has been manifested up to 12 days after tick sting and arthralgia, arthritis, neuralgia, hepatitis and chronic dermatitis within a year. Carditis and encephalitis have been developing from a month to ten years after tick sting. Lyme borreliosis is commonly manifested as a systemic disease. Together with the skin, most commonly have been involved ankle joints, heart and nervous system. The time from tick sting to the onset of first signs of the diseases varies by the involved organs.

[Changes in thyroid hormone levels in patients with acute viral hepatitis]. / Promene nivoa hormona stitaste zlezde u bolesnika sa akutnim virusnim hepatitisom.

In 10 patients with acute viral hepatitis A or B the dynamics of the concentrations of the thyroid hormones thyroxine (T4), triiodothyroxine (T3) and their coefficient T3/T4, and thyroid stimulating hormone (TSH) in all phases of hepatitis have been studied. In acute phase and in the fully developed clinical picture of the diseases, the increased T4 values and decreased values of T3, T3/T4 coefficient and TSH were found. These changes are explained by the slowed down deiodinization of T3 and T4 in hepatocytes as well as by the disturbed secretion of the thyroid hormone in hepatitis and they could be of some value in diagnosis and prognosis.

[Epidemiologic characteristics of hemorrhagic fever with renal syndrome in a military population]. / Epidemioloske karakteristike hemoragicne groznice sa bubreznim sindromom u vojnickom kolektivu.

In the period 1952-1990 there have been recorded 84 patients with hemorrhagic fever with renal syndrome (HFRS): 81 soldiers and 3 officers of the Y.P.A. The largest number of cases was recorded in three epidemics, 61 or 72.6%. In 94% of cases the infection occurred during camping of units. The disease appeared in all months, but 57.2% of cases occurred in June and July. The mean lethality was 2.4%, in epidemics 1.6% and as sporadic cases 4.3%. In an army unit staying for six months in HFRS focus, 9.8% of soldiers were infected by the causative agent of this infection and only in one case the clinical picture of HFRS was manifested. Serologic tests (IIF and ELISA) confirmed the diagnosis of HFRS. Virus strains of Hantaan, Puumala and Seoul groups were used as antigens.

[Allogenic transplantation of bone marrow in hematologic diseases. Preparation and completion of transplantation at the Hematology Clinic in Novi Sad]. / Alogena transplantacija kostne srzi u hematoloskim oboljenjima. Pripreme i izvodenje transplantacije na Klinici za hematologiju u Novom Sadu.

The paper deals with the results of clinical preparations for the application of allogenic bone marrow transplantation at the Clinic of Hematology in Novi Sad. The obligation of the definite treatment of patients below 45 years by allogenic and autologous bone marrow transplantation results from the acceptance of the Yugoslav protocols for acute leukaemia treatment. Thus immunogenotypical analyses, so far performed in patients with severe aplastic anaemia have been extended to patients with acute leukaemia as well and then to patients with chronic myelogenous leukaemia, high risk lymphocYtic lymphoma and myeloma multiplex with resistance to standard chemotherapy and their potential sibling donors. The bone marrow transplantation Unit has been set up, the team of specialists has been formed and educated and the protocol for allogenic transplantation with Busulfan and cyclophosphamide combination for pretransplant conditioning has been adopted. In research work concerning the field of bone marrow transplantation a particular emphasis has been put on the working out of a mathematical model for optimal timing of bone marrow transplantation in patients with acute myelogenous leukaemia.