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1.
Sci Rep ; 13(1): 14058, 2023 08 28.
Article in English | MEDLINE | ID: mdl-37640927

ABSTRACT

People resort to various questionable health practices to preserve or regain health - they intentionally do not adhere to medical recommendations (e.g. self-medicate or modify the prescribed therapies; iNAR), or use traditional/complementary/alternative (TCAM) medicine. As retrospective reports overestimate adherence and suffer from recall and desirability bias, we tracked the variations in daily questionable health behaviors and compared them to their retrospectively reported lifetime use. We also preregistered and explored their relations to a wide set of psychological predictors - distal (personality traits and basic thinking dispositions) and proximal (different unfounded beliefs and biases grouped under the term irrational mindset). A community sample (N = 224) tracked daily engagement in iNAR and TCAM use for 14 days, resulting in 3136 data points. We observed a high rate of questionable health practices over the 14 days; daily engagement rates roughly corresponded to lifetime ones. Both iNAR and TCAM were weakly, but robustly positively related. Independent of the assessment method, an irrational mindset was the most important predictor of TCAM use. For iNAR, however, psychological predictors emerged as relevant only when assessed retrospectively. Our study offers insight into questionable health behaviors from both a within and between-person perspective and highlights the importance of their psychological roots.


Subject(s)
Anxiety , Ecological Momentary Assessment , Humans , Retrospective Studies , Health Behavior , Mental Recall
2.
BMJ Open ; 13(6): e069978, 2023 06 27.
Article in English | MEDLINE | ID: mdl-37369402

ABSTRACT

OBJECTIVES: We aimed to (1) develop a novel instrument, suitable for the general population, capturing intentional non-adherence (iNAR), consisting of non-adherence to prescribed therapy, self-medication and avoidance of seeking medical treatment; (2) differentiate it from other forms of non-adherence, for example, smoking; and (3) relate iNAR to patient-related factors, such as sociodemographics, health status and endorsement of irrational beliefs (conspiratorial thinking and superstitions) and to healthcare-related beliefs and experiences ((mis)trust and negative experiences with the healthcare system, normalisation of patient passivity). DESIGN: То generate iNAR items, we employed a focus group with medical doctors, supplemented it with a literature search and invited a public health expert to refine it further. We examined the internal structure and predictors of iNAR in an observational study. SETTING: Data were collected online using snowball sampling and social networks. PARTICIPANTS: After excluding those who failed one or more out of three attention checks, the final sample size was n=583 adult Serbian citizens, 74.4% female, mean age 39.01 years (SD=12.10). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary, planned outcome is the iNAR Questionnaire, while smoking was used for comparison purposes. RESULTS: Factor analysis yielded a one-factor solution, and the final 12-item iNAR Questionnaire had satisfactory internal reliability (alpha=0.72). Health condition and healthcare-related variables accounted for 14% of the variance of iNAR behaviours, whereas sociodemographics and irrational beliefs did not additionally contribute. CONCLUSIONS: We constructed a brief yet comprehensive measure of iNAR behaviours and related them to health and sociodemographic variables and irrational beliefs. The findings suggest that public health interventions should attempt to improve patients' experiences with the system and build trust with their healthcare practitioners rather than aim at specific demographic groups or at correcting patients' unfounded beliefs. STUDY REGISTRATION: The design and confirmatory analyses plan were preregistered (https://osf.io/pnugm).


Subject(s)
Delivery of Health Care , Health Status , Adult , Humans , Female , Male , Serbia , Reproducibility of Results , Surveys and Questionnaires
3.
Hernia ; 26(5): 1369-1379, 2022 Oct.
Article in English | MEDLINE | ID: mdl-35575863

ABSTRACT

PURPOSE: The purpose of this study is to present a concept combining three modifications of the component separation technique (CST) in one procedure as an original solution for the management of complex subcostal abdominal wall hernia. METHODS: Between January 2010 and January 2020, seven patients presenting at the high-volume academic center with complex subcostal hernia underwent surgery in which three modifications of CST were combined into one procedure. Major complex subcostal hernia was defined by either width or length of the defect being greater than 10 cm. The following were the stages of the operative technique: (a) the "method of wide myofascial release" at the side of the hernia defect; (b) "open-book variation" of the component separation technique at the opposite side of the hernia defect; (c) a modified component separation technique for closure of midline abdominal wall hernias in the presence of enterostomies; (d) suturing of the myofascial flaps to each other to cover the defect; and (e) repair augmentation with an absorbable mesh in the onlay position. RESULTS: The median length and width of the complex subcostal hernias were 15 cm (10-19) and 15 cm (8-24), respectively. The overall morbidity rate was 57.1% (wound infection occurred in three patients, seroma in two patients, and skin necrosis in one patient). There was no hernia recurrence during the median follow-up period of 19 months. CONCLUSION: The operative technique integrating three modifications of CST in one procedure with onlay absorbable mesh reinforcement is a feasible solution for the management of complex subcostal abdominal wall hernia.


Subject(s)
Abdominal Wall , Hernia, Ventral , Abdominal Wall/surgery , Hernia, Ventral/surgery , Herniorrhaphy/adverse effects , Herniorrhaphy/methods , Humans , Recurrence , Seroma , Surgical Flaps , Surgical Mesh
4.
Hernia ; 25(4): 1095-1101, 2021 08.
Article in English | MEDLINE | ID: mdl-34165648

ABSTRACT

PURPOSE: To investigate short and long-term outcome after the open preperitoneal flat mesh technique (OPFMT) for umbilical, epigastric, spigelian, small incisional and "port-site" hernia performed as a day case procedure. METHODS: We retrospectively analyzed records of patients who underwent OPFMT for umbilical, epigastric, Spigelian, small incisional and "port-site" hernia in ambulatory settings between 2004 and 2020 at Clinical Center of Serbia. Demographic and clinical characteristics, operative data and postoperative complications were compared between the groups. Univariate and multivariate analyses were performed to identify predictive factors for mesh infection and recurrence. RESULTS: Overall, 476 patients were divided according to the type of hernia. Early postoperative complications were similar in all study groups. Mesh infection, chronic pain and recurrence were different between groups (p = 0.013, p = 0.019 and p = 0.011, respectively). Overall recurrence rate after OPFMT was 2.5%. Hernia defect, hematoma and length of postoperative stay at the Day Surgery Unit were identified as potential predictors of mesh infection (Odds ratio 6.449, 22.143 and 1.546, respectively; p = 0.027, p = 0.011 and p = 0.038, respectively) while mesh infection was the only potential predictor of recurrence in univariate analysis. Hematoma was an independent predictor of recurrence (Odds ratio 27.068; 95% Confidence interval 2.355-311.073; p = 0.008). CONCLUSION: The OPFMT performed under local anesthesia as a day case procedure is a safe technique associated with favorable long-term outcome. Hematoma is an independent predictor of mesh infection occurrence.


Subject(s)
Hernia, Umbilical , Hernia, Ventral , Incisional Hernia , Follow-Up Studies , Hernia, Umbilical/surgery , Hernia, Ventral/surgery , Herniorrhaphy/adverse effects , Humans , Incisional Hernia/etiology , Incisional Hernia/surgery , Recurrence , Retrospective Studies , Surgical Mesh/adverse effects
5.
Sci Rep ; 11(1): 4493, 2021 02 24.
Article in English | MEDLINE | ID: mdl-33627697

ABSTRACT

To date, it is unclear which treatment modality, liver resection (LR) or transarterial chemoembolization (TACE) is the more appropriate for patients with huge (≥ 10 cm) hepatocellular carcinoma (HCC). The study aim was to compare, using propensity score matching, short- and long-term outcomes of patients with huge HCC who underwent potentially curative LR or TACE. Patients with huge HCC who had been managed at the Clinical Center by curative-intent LR or by palliative TACE between November 2001 and December 2018 were retrospectively identified. The morbidity and mortality rates and overall survival were compared between the groups before and after the propensity score matching. Independent predictors of long-term survival were determined by multivariate analysis. A total of 103 patients with huge HCC were included; 68 were assigned to the LR group and 35 to the TACE group. The overall morbidity rate was higher in the LR group than in the TACE group before matching (64.7% vs. 37.1%, p = 0.012), while there was no difference after matching (60% vs. 30%, p = 0.055). The major morbidity and 30-days mortality were similar between the groups before and after matching. The LR group was associated with longer overall survival than the TACE group before matching (p = 0.032) and after matching (p = 0.023). Total bilirubin and TACE treatment were independent prognostic factors associated with long-term survival. In patients with huge HCC, liver resection provides better long-term survival than TACE and should be considered as the initial treatment whenever possible.


Subject(s)
Carcinoma, Hepatocellular/pathology , Liver Neoplasms/pathology , Liver/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Chemoembolization, Therapeutic/methods , Female , Hepatectomy/methods , Humans , Male , Middle Aged , Multivariate Analysis , Prognosis , Propensity Score , Retrospective Studies , Treatment Outcome , Young Adult
6.
Radiat Prot Dosimetry ; 178(2): 138-142, 2018 Jan 01.
Article in English | MEDLINE | ID: mdl-28985374

ABSTRACT

It is indicated that the exposure to radon originating from the building materials is not negligible and the radon exhalation measurement should get more attention in the future. The experience with four different methods of the exhalation measurement, established in our laboratory for the purpose of the intercomparison is reported. Additionally, a comparison of advantages and disadvantages of used methods is discussed.


Subject(s)
Air Pollutants, Radioactive/analysis , Air Pollution, Indoor/analysis , Construction Materials , Radiation Monitoring/methods , Radon/analysis
7.
Phytopathology ; 107(1): 29-35, 2017 01.
Article in English | MEDLINE | ID: mdl-27618192

ABSTRACT

Bacterial fruit blotch of cucurbits (BFB) is caused by the gram-negative bacterium Acidovorax citrulli, whose populations can be distinguished into two genetically distinct groups, I and II. Based on visual assessment of BFB severity on cucurbit seedlings and fruit after inoculation under greenhouse conditions, group I A. citrulli strains have been reported to be moderately to highly virulent on several cucurbit hosts, whereas group II strains have exhibited high virulence on watermelon but low virulence on other cucurbits. Additionally, group I strains are recovered from a range of cucurbit hosts, while group II strains are predominantly found on watermelon. The goal of this research was to develop tools to characterize and rapidly distinguish group I and II A. citrulli strains. We first sought to determine whether quantification of A. citrulli colonization of cucurbit seedling tissue reflects the differences between group I and II strains established by visual assessment of BFB symptom severity. Spray inoculation of melon seedlings with cell suspensions containing approximately 1 × 104 CFU/ml resulted in significantly higher (P = 0.01) population growth of M6 (group I; mean area under population growth curve [AUPGC] = 43.73) than that of AAC00-1 (group II; mean AUPGC = 39.33) by 10 days after inoculation. We also investigated the natural spread of bacterial cells and the resulting BFB incidence on watermelon and melon seedlings exposed to three group I and three group II A. citrulli strains under mist chamber conditions. After 5 days of exposure, the mean BFB incidence on melon seedlings exposed to representative group II A. citrulli strains was significantly lower (25 and 3.98% in experiments 1 and 2, respectively) than on melon seedlings exposed to representative group I strains (94.44 and 76.11% in experiments 1 and 2, respectively), and on watermelon seedlings exposed to representative group I and II strains (70 to 93.33%). Finally, we developed a polymerase chain reaction assay based on the putative type III secretion effector gene, Aave_2166, to rapidly distinguish group I and II A. citrulli strains. This assay will be important for future epidemiological studies on BFB.


Subject(s)
Citrullus/microbiology , Comamonadaceae/classification , Cucurbitaceae/microbiology , Plant Diseases/microbiology , Bacterial Proteins/genetics , Base Sequence , Comamonadaceae/genetics , Comamonadaceae/pathogenicity , DNA Primers/genetics , Fruit/microbiology , Polymerase Chain Reaction , Seedlings/microbiology , Virulence
8.
Radiat Prot Dosimetry ; 162(1-2): 47-51, 2014 Nov.
Article in English | MEDLINE | ID: mdl-25377751

ABSTRACT

The charcoal canister method of radon measurement according to US Environment Protection Agency protocol 520/5-87-005 is widely used for screening. This method is based on radon adsorption on coal and measurement of gamma radiation of radon daughters. For the purpose of gamma spectrometry, appropriate efficiency calibration of the measuring system must be performed. The most usual method of calibration is using standard canister, a sealed canister with the same matrix and geometry as the canisters used for measurements, but with the known activity of radon. In the absence of standard canister, a different method of efficiency calibration has to be implemented. This study presents the results of efficiency calibration using the EFFTRAN efficiency transfer software. Efficiency was calculated using a soil matrix cylindrical secondary reference material as a starting point. Calculated efficiency is then compared with the one obtained using standard canister and applied to a realistic measurement in order to evaluate the results of the efficiency transfer.


Subject(s)
Air Pollution, Radioactive/analysis , Charcoal/chemistry , Germanium/chemistry , Radiation Monitoring/instrumentation , Radiation Monitoring/methods , Radon/analysis , Calibration
9.
Appl Radiat Isot ; 87: 452-5, 2014 May.
Article in English | MEDLINE | ID: mdl-24444699

ABSTRACT

Active charcoal detectors are used for testing the concentration of radon in dwellings. The method of measurement is based on radon adsorption on coal and measurement of gamma radiation of radon daughters. The contributions to the final measurement uncertainty are identified, based on the equation for radon activity concentration calculation. Different methods for setting the region of interest for gamma spectrometry of canisters were discussed and evaluated. The obtained radon activity concentration and uncertainties do not depend on peak area determination method.

10.
Hippokratia ; 17(4): 307-12, 2013 Oct.
Article in English | MEDLINE | ID: mdl-25031507

ABSTRACT

BACKGROUND: Although anemia and renal dysfunction are related to increased natriuretic peptides levels in heart failure patients, less is known about this relationship in asymptomatic predialysis patients with chronic kidney disease (CKD). The aim of this study was to investigate relationship between hemoglobin (Hb) concentration, N-terminal proBNP (NT-proBNP) levels and echocardiographic findings in these patients. METHODS: The study included 61 patients with CKD stage IV-V (34 male, mean age 62.6 ± 13.6 years) and 22 age- and sex -matched healthy persons as control group. All participants underwent clinical, laboratory and echocardiographic examination, including Tissue Doppler Imaging and colour M-mode Doppler. RESULTS: Patients with CKD had lower Hb levels (p<0.001), and higher levels of NT-proBNP (p<0.001) than healthy controls. Patients were divided into two groups according to their mean Hb levels: group A, Hb<10.3 g/dL and group B, Hb≥10.3 g/dL. Patients from group A was significantly older (p<0.001), left ventricular mass index was significantly higher (LVMI, p<0.001), LV diastolic function was worse (septal and lateral E'/A' ratio: p<0.05 and p<0.01, respectively), and the level NT-proBNP was higher (p<0.001) compared to patients from group B. The natural logarithm of NT-proBNP (lnNT-proBNP) showed highly significant correlation with Hb (p<0.001) and significant correlation with estimated glomerular filtration rate (p=0.035) in CKD patients. Multiple regression analysis revealed Hb levels (p<0.01), cholesterol (p<0.001), LV ejection fraction (p<0.001) and septal E/E' ratio (p<0.01) as the independent variables predicting as much as 54% variability of lnNTpro-BNP. CONCLUSIONS: The increased NT-proBNP levels in asymptomatic patients with advanced CKD were independently associated with echocardiographic parameters of LV function, but anemia may represent one of the important confounder of the relationship between NT-proBNP and cardiovascular abnormalities.

11.
Clin Radiol ; 65(9): 720-8, 2010 Sep.
Article in English | MEDLINE | ID: mdl-20696299

ABSTRACT

AIM: To evaluate the efficacy and safety of selective internal radiation therapy (SIRT). MATERIALS AND METHODS: A retrospective analysis was undertaken of all patients who underwent SIRT at a single institution. Diagnostic and therapeutic angiograms, computed tomography (CT) images, positron-emission tomography (PET) images, and planar isotope images were analysed. The response to SIRT was analysed using radiological data and tumour markers. Overall survival, complications, and side effects of SIRT were also analysed. RESULTS: The initial 12 patients were included on an intention-to-treat basis, between 21/09/2005 and 07/05/2008. All patients had advanced disease and multiple prior courses of chemotherapy. One patient did not receive yttrium-90 due to complex vascular anatomy; the remaining 11 patients underwent 13 SIRT treatment episodes following work-up angiography. A response was seen using PET in 80% of patients. Using CT, the response of the tumour to therapy in the treated hepatic segments demonstrated a 20% partial response, stable disease in 50%, and progressive disease in 30%. Estimated median survival was 229 days, with 64% of patients still alive at the time of writing. No major complications were observed, although 82% of patients experienced side-effects following SIRT, mainly nausea, vomiting, and abdominal pain. CONCLUSIONS: There have been no complications in the 12 SIRT patients. Tumour response was seen in four out of five patients who underwent PET. Objective CT response rates were mixed and are perhaps partially explained by advanced disease and limitations of using measurements to assess response. This complex and potentially hazardous service has been successfully and safely established.


Subject(s)
Carcinoma, Hepatocellular/radiotherapy , Colorectal Neoplasms , Liver Neoplasms/radiotherapy , Yttrium Radioisotopes/administration & dosage , Adult , Aged , Biomarkers, Tumor , Carcinoma, Hepatocellular/diagnostic imaging , Carcinoma, Hepatocellular/pathology , Colorectal Neoplasms/diagnostic imaging , Colorectal Neoplasms/pathology , Dose-Response Relationship, Radiation , Female , Humans , Infusions, Intra-Arterial , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/pathology , Male , Microspheres , Middle Aged , Positron-Emission Tomography/methods , Retrospective Studies , Tomography, X-Ray Computed/methods , Treatment Outcome
12.
J Neurol Neurosurg Psychiatry ; 74(11): 1567-70, 2003 Nov.
Article in English | MEDLINE | ID: mdl-14617718

ABSTRACT

OBJECTIVE: To determine the effects of cholinergic treatment on the muscarinic receptor in patients with Alzheimer's disease. METHODS: 12 patients with mild to moderate Alzheimer's disease and six controls were studied. The patients underwent ADAS-COG psychometric assessment and SPECT brain imaging with (123)I quinuclidinyl benzilate (QNB), to demonstrate the postsynaptic muscarinic M1 receptor, before being randomised in a double blind study to receive either an acetylcholinesterase inhibitor (donepezil) or placebo for four months. Following this, the ADAS-COG and the (123)I-QNB receptor scan were repeated. The controls were imaged on one occasion only. All image analyses were undertaken using SPM99. RESULTS: (123)I-QNB imaging showed a significant relation between baseline psychometric impairment and deficits on scanning. Both placebo and actively treated groups had reductions in (123)I-QNB uptake. Greater reductions in receptor binding were demonstrated in the placebo group than in those receiving active treatment. Intraindividual reproducibility of the (123)I-QNB imaging technique appeared highly robust. CONCLUSIONS: The results suggest that (123)I-QNB uptake is better preserved in Alzheimer's disease patients on cholinergic treatment than on placebo. Cholinergic treatment may play a neuroprotective role. Sequential (123)I-QNB imaging seems to be a powerful tool in monitoring the response of these receptors to disease modifying treatments.


Subject(s)
Alzheimer Disease/drug therapy , Alzheimer Disease/physiopathology , Cholinesterase Inhibitors/therapeutic use , Indans/therapeutic use , Muscarinic Antagonists/pharmacokinetics , Piperidines/therapeutic use , Quinuclidinyl Benzilate/pharmacokinetics , Aged , Aged, 80 and over , Cholinesterase Inhibitors/pharmacology , Donepezil , Double-Blind Method , Female , Humans , Indans/pharmacology , Iodine Radioisotopes , Male , Middle Aged , Piperidines/pharmacology , Placebos , Psychometrics , Sensitivity and Specificity , Severity of Illness Index , Tomography, Emission-Computed, Single-Photon , Treatment Outcome
13.
Med Pregl ; 52(1-2): 5-11, 1999.
Article in English, Croatian | MEDLINE | ID: mdl-10352497

ABSTRACT

Dynamics and distribution of ulcer disease in population in the period 1987-1996 were analyzed on the basis of morbidity and mortality rate registered at clinics and institutes in Novi Sad. During the analyzed period 4.111 cases of ulcer disease were hospitalized and 47 with lethal outcome. Duodenal ulcer (2,739) is twice as frequent as gastric ulcer (1,372). Both localisations of ulcer disease are more frequent in males, and specific morbidity shows constant rise towards the older age groups. Duodenal ulcer shows sudden increase in the age group of over 20, and gastric ulcer in the age group of over 60. Gastric ulcer mortality (1.6%) is higher in comparison to duodenal ulcer mortality (0.9%) and it increases constantly towards the older age groups. Unfavourable result is statistically significantly higher in persons over 60. During the monitored period the increasing trend in duodenal ulcer is sharp, while figures in gastric ulcer are without significant changes. Both localisations have become a frequent health problem in population over 40 years of age.


Subject(s)
Duodenal Ulcer/epidemiology , Stomach Ulcer/epidemiology , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Prevalence , Yugoslavia/epidemiology
14.
Med Pregl ; 51(7-8): 343-5, 1998.
Article in Croatian | MEDLINE | ID: mdl-9769669

ABSTRACT

INTRODUCTION: In vitro experiments with Lactobacillus acidophilus have revealed its inhibitory effect on Helicobacter pylori and its application in treatment of Helicobacter pylori positive gastritis was examined. MATERIAL AND METHODS: 15 patients have undergone gastroscopy with biopsy and by histopathological examination. Helicobacter pylori positive gastritis was detected. During a two-month period these patients took acidophilus milk (3 x 250 ml a day) prepared according to a special protocol and which contained 4 x 10(9)-1 x 10(10) live cells of Lactobacillus acidophilus at the moment of preparation. Lactobacillus acidophilus strain NAS, gained from lyophilized preparation Bio-Nate (Natren Inc. USA) was used as a test organism. Control gastroscopy was performed 2 months later. RESULTS: 14 patients have completed the examination. All of them were satisfied with the taste of acidophilus milk and could stand it well, whereas in 6 out of 14 Helicobacter pylori was eradicated. DISCUSSION: Helicobacter pylori eradication therapy is recommended in all cases of Helicobacter pylori positive gastritis associated with peptic ulcer, as well as in absence of ulcer when subjective difficulties occur. Antibiotic therapy is often unsuccessful and most often associated with risks of significant adverse effects, being the consequence of intestinal microflora disorders. The aim of using Lactobacillus acidophilus in the therapy is to reduce risks of adverse effects. In our study, by using acidophilus milk only, without other therapy, eradication of Helicobacter pylori was achieved in 6 out of 14 patients. All patients could stand the therapy well and were satisfied with the taste of the preparation. The number of examinees was small in regard to making conclusions, but the results are encouraging and show that apart from established in vitro effect. Lactobacillus acidophilus has a potential in vivo effect.


Subject(s)
Gastritis/therapy , Helicobacter Infections/therapy , Helicobacter pylori , Lactobacillus acidophilus , Adult , Animals , Female , Gastritis/microbiology , Humans , Male , Middle Aged , Milk/microbiology
15.
Med Pregl ; 50(11-12): 465-8, 1997.
Article in Croatian | MEDLINE | ID: mdl-9471504

ABSTRACT

Helicobacter pylori infection is the most frequent infection in humans. It is assumed that over 50% of total world population suffer from this infection. Chronic gastritis is the most usual consequence of this infection. Development of peptic ulcer appears in case of 10 to 20 percent of infected people with the increased risk of malignancy. In the group of 819 examined patients at the Clinic for gastroenterology and hepatology of the Institute for internal diseases, the presence of helicobacter pylori was confirmed in case of 69.18% of patients. The infection was equally observed in both sexes and its frequency was higher with the increase of age, reaching its peak in the sixth decade of life (75.24%). The highest frequency was found in patients with duodenal ulcer (84.85%) and hyperplastic stomach polyp (81.82%) and lowest in case of resected stomach (56.52%). We also establish the dependence of the type and degree of pathohistological changes and the Helicobacter pylori infection.


Subject(s)
Duodenal Diseases/microbiology , Helicobacter Infections/complications , Helicobacter pylori , Stomach Diseases/microbiology , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged
16.
J Nucl Med ; 37(6): 1058-63, 1996 Jun.
Article in English | MEDLINE | ID: mdl-8683301

ABSTRACT

UNLABELLED: In the treatment of neural crest tumors, such as pheochromocytoma, with[131I]MIBG, bone marrow toxicity limits the amount of administered activity and, thus, a therapeutically useful tumor dose. METHODS: We calculated tumor doses in a series of diagnostic studies with [123I]MIBG using accurate quantification of SPECT and planar scintigraphy. By extrapolating diagnostic results to therapeutic activities of [131I]MIBG, we could compare the results with whole-body doses from a series of therapies. RESULTS: The tumor dose was DT = 2.2 mGy MBq(-1) (median value of 27 measurements, range 0.04 < or = DT < or = 20 mGy MBq(-1) and the whole-body dose in a series of 16 patients undergoing 50 therapies was DWB = 0.12 +/- 0.04 mGy MBq(-1) (mean +/- s.d.). The therapeutic ratio varied between 130 to below 10 in some patients. CONCLUSION: The results were compared with published data. We found clearly skewed distribution of tumor doses, with a majority of tumors receiving only a few mGy per MBq administered activity. In some patients, however, doses did reach 20 mGy MBq(-1).


Subject(s)
Antineoplastic Agents/administration & dosage , Iodine Radioisotopes/administration & dosage , Iodobenzenes/administration & dosage , Neuroblastoma/radiotherapy , Pheochromocytoma/radiotherapy , 3-Iodobenzylguanidine , Adolescent , Adult , Antineoplastic Agents/adverse effects , Antineoplastic Agents/therapeutic use , Child , Humans , Iodine Radioisotopes/adverse effects , Iodine Radioisotopes/therapeutic use , Iodobenzenes/adverse effects , Iodobenzenes/therapeutic use , Neuroblastoma/diagnostic imaging , Pheochromocytoma/diagnostic imaging , Radiotherapy Dosage , Risk , Tomography, Emission-Computed, Single-Photon
17.
Med Pregl ; 46 Suppl 1: 58-9, 1993.
Article in English | MEDLINE | ID: mdl-8569609

ABSTRACT

In purpose of early diagnosis of gallbladder carcinoma, the serum levels of tumor markers CA 72-4, CA 19-9, CEA, AFP, Ferritin and beta HCG were determined in 124 patients with benign and malign diseases of gallbladder, before and 10 days after the operation. The most important clinical significance have CA 72-4 and CA 19-9, which are increased in Ca in situ and carcinoma of the first stage. These early stages of carcinoma cannot be diagnostified by preoperative echotomography, but radical operation is possible with recover by all means. These two tumor markers should be attended in risk group of patients for rising gallbladder carcinoma: calculosis and polyposis. The rest of tumor markers are increased in progressive carcinoma with infiltration of surrounding tissue and metastases.


Subject(s)
Biomarkers, Tumor/analysis , Gallbladder Neoplasms/surgery , Antigens, Tumor-Associated, Carbohydrate/analysis , Carcinoembryonic Antigen/analysis , Chorionic Gonadotropin, beta Subunit, Human/analysis , Ferritins/analysis , Gallbladder Neoplasms/diagnosis , Humans , alpha-Fetoproteins/analysis
18.
Med Pregl ; 46(3-4): 117-9, 1993.
Article in Croatian | MEDLINE | ID: mdl-7862044

ABSTRACT

Among the patients subjected to esophoagogastroduodenoscopy because of different clinical indications, 108 were examined for the presence of Helicobacter pylori in the antral gastric mucosa. Microbiological analysis of the antral gastric mucosa biopsies were conducted by direct microscopy, the urease test and by growing in nutritious media. Positive findings were recorded in 38 (86.36%) patients with endoscopically diagnosed chronic gastritis, 29 (80.56%) patients with duodenal ulcer and 19 (67.86%) patients with ventricular ulcer. The majority of the positive findings were recorded by direct microscopy--86 (79.63%) while the bacterial culture was positive in 66 (61.11%) cases.


Subject(s)
Gastritis/microbiology , Helicobacter Infections , Helicobacter pylori , Peptic Ulcer/microbiology , Adolescent , Adult , Aged , Chronic Disease , Female , Helicobacter Infections/diagnosis , Humans , Male , Middle Aged
19.
Med Pregl ; 46(5-6): 213-7, 1993.
Article in Croatian | MEDLINE | ID: mdl-7869980

ABSTRACT

In 72 patients operated on for gastric ulcer, hospitalized at the Clinic of Gastroenterology and Hepatology in Novi Sad within two years (1989, 1990) we analyzed clinical disorders, biochemical status and endoscopic findings. 75% of the patients were males and 25% females, mean age being 49 years. In 70.83% the two-thirds Billroth II resection was performed, in 15.28% the two thirds Billroth I resection, in 9.72% truncal vagotomy with pyloroplasty, while in 4.17% supraselective vagotomy was carried out. The mean period of time after the operation was 12 years. The majority of patients complained about gastrointestinal disorders, and manifest hemorrhage was detected in 4.17% of the patients. The symptoms of the afferent loop syndrome and early dumping syndrome were verified in one patient from each group. The endoscopic finding was normal in only 2.78%, reflux esophagitis in 6.94%, chronic gastritis with and without erosions in 86.11%, chronic anastomositis in 69.44%, recurrent ulcer in 29.16% out of which hemorrhagic ulcer was found in 4.17%. Malignant neoplasm of the stomach stump was endoscopically evidenced and histologically proved in 2.78%. Multiple associated endoscopic changes were found in 58.33%. The analysis indicates the diversity of postoperative disorders after one of the operations on gastroduodenum, requiring postoperative follow ups of the patients with subjective discomfort, appropriately set diagnosis and individual therapeutical approach to prevent more serious complications.


Subject(s)
Endoscopy, Gastrointestinal , Peptic Ulcer/surgery , Postoperative Complications/diagnosis , Adult , Aged , Duodenal Diseases/diagnosis , Female , Humans , Male , Middle Aged , Peptic Ulcer/diagnosis , Recurrence , Stomach Diseases/diagnosis
20.
Clin Oncol (R Coll Radiol) ; 4(2): 101-7, 1992 Mar.
Article in English | MEDLINE | ID: mdl-1372817

ABSTRACT

The palliation of bone pain is a common clinical problem once metastatic prostate cancer has escaped from hormonal control. This retrospective study compares the results of treatment using hemibody irradiation (HBI) at the Royal Marsden Hospital (27 cases) with isotope therapy using the bone-seeking isotope strontium-89 (89Sr) at Southampton General Hospital (51 cases). Prior to analysis patients were matched for potential prognostic factors (performance status, bone scan extent of disease, age, histology and duration of hormone response) to minimize the effect of treatment selection bias. Pain control assessed at 3 months was similar for HBI and matched 89Sr cases, with 63% and 52% respectively showing some benefit. Median survival was similar for these groups at 20 and 21 weeks respectively. The unmatched 89Sr group, which had more favourable prognostic factors, had a better outcome with 96% showing improvement in pain and with a median survival of 59 weeks. Subsequent univariate analysis demonstrated that performance status and extent of disease on bone scan were of overriding importance in determining outcome. Transfusion requirements were higher for the HBI group than for the matched 89Sr group (50% and 25% respectively) but other bone marrow toxicity was similar. Despite routine anti-emetic therapy 37% of patients treated with HBI had some nausea or vomiting. Although expensive, 89Sr appears as effective a treatment option as HBI. Response is most likely with either approach when patients have a good performance status and a limited extent of disease.


Subject(s)
Bone Neoplasms/radiotherapy , Bone Neoplasms/secondary , Palliative Care/methods , Prostatic Neoplasms/radiotherapy , Strontium Radioisotopes/therapeutic use , Actuarial Analysis , Blood Cells/radiation effects , Bone Neoplasms/blood , Bone Neoplasms/mortality , Cobalt Radioisotopes/adverse effects , Cobalt Radioisotopes/therapeutic use , Humans , Male , Particle Accelerators , Prognosis , Prostatic Neoplasms/blood , Prostatic Neoplasms/mortality , Radiotherapy/methods , Radiotherapy Dosage , Remission Induction , Retrospective Studies , Strontium Radioisotopes/adverse effects , Time Factors
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