The importance of Myd88 L265P mutation, clinical and immunohistochemical prognostic factors for the survival of patients with diffuse large B-cell non-Hodgkin lymphoma treated by immunochemotherapy in southeast Serbia.

PURPOSE: Immunochemotherapy used in the treatment of non-Hodgkin diffuse large B-cell lymphoma (DLBCL) modifies the course of disease and has a positive effect on overall survival (OS). The purpose of this study was to verify the existence of the important Myd 88 mutation and other immunohistochemical factors on disease prognosis in patients with DLBCL in southeast Serbia. METHODS: Immunohistochemical expression of CD10, Bcl- 2, Bcl-6, Ki-67 and MUM 1 was performed using paraffin blocks of DLBCL. Molecular-genetic study of MyD88 L265P gene polymorphism was done by isolation of genomic DNA from paraffin embedded tissue by means of polymerase chain reaction (PCR). RESULTS: Immunochemotherapy (rituximab+CHOP/R-CHOP) significantly improved the overall survival (OS) of patients with DLBCL compared with patients treated with CHOP alone (p<0.0001). OS in the R-CHOP group was longest in patients with International Prognostic Index (IPI) 2 score (p=0.012) and IPI 4 score (p=0.024). Patients with Bcl-2 +, and MUM 1+ benefited from R-CHOP and their expression had no effect on OS. Analysis of restriction fragment length on the genomic DNA showed a homozygous normal TT genotype. CONCLUSION: Addition of rituximab to CHOP standard protocol improved the OS rate in patients with DLBCL and altered the character and significance of previously recognized prognostic factors. IPI score in the immunochemotherapy era could not reveal possible predictive factors of poor prognosis which would help identify a high-risk subgroup of newly diagnosed DLBCL. In the patient population from Southeast Serbia pathological signaling pathway achieved by Myd 88 L265 mutation was not responsible for the development of DLBCL.

Household environmental tobacco smoke and respiratory diseases among children in Nis (Serbia).

The authors investigated the relationship between household environmental tobacco smoke (ETS) exposure and prevalence of respiratory symptoms and diseases as well as absenteeism related to respiratory illness in schoolchildren. The study sample consisted of 1,074 children aged 7-11 years from three primary schools in Nis (Serbia). ETS exposure was associated with wheezing (OR-1.48; 1.09-2.01), bronchitis (OR-1.66; 1.23-2.23), headache (OR-1.45; 1.08-1.95), and fatigue (OR-1.38; 1.02-1.85) in exposed children. The other risk factors with possible influences weren't assessed. There was no statistically significant difference in the number of physicians' visits as well as in absenteeism from school due to illness in children exposed to ETS in comparison to non exposed children. The tobacco smoke effect on children is an essential and urgent problem with life lasting negative health effects which are preventable.

Radiation therapy with or without concurrent low-dose daily chemotherapy in locally advanced, nonmetastatic squamous cell carcinoma of the head and neck.

PURPOSE: To retrospectively investigate the difference between conventionally fractionated (CF) and hyperfractionated (Hfx) radiation therapy (RT), with and without either daily cisplatin (CDDP) or carboplatin (CBDCA), in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) enrolled onto two consecutive prospective randomized studies. PATIENTS AND METHODS: Treatment consisted of CF RT (70 Gy, group 1), CF RT and either daily CDDP (6 mg/m2) or daily CBDCA (25 mg/m2; group 2), Hfx RT (77 Gy, 1.1 Gy bid; group 3), or Hfx RT and daily CDDP (group 4). RESULTS: Hfx RT plus CDDP achieved better overall survival (OS) and local recurrence-free survival (LRFS) than any other group. There was an insignificant difference favoring Hfx RT over CF RT, either alone or in combination with CDDP or CBDCA, regarding both OS (P =.058 and P =.051, respectively) and LRFS (P =.088 and P =.091, respectively). No difference was seen between CF RT plus chemotherapy (CHT) and Hfx RT alone regarding either OS (P =.32) or LRFS (P =.48). Regional recurrence-free survival was similar in the four treatment groups. CF RT plus CHT and Hfx RT plus CDDP achieved better distant metastasis-free survival than CF RT and Hfx RT. High-grade toxicity was significantly more frequent in Hfx RT plus CDDP than in any other group, except in the Hfx RT group. Hfx RT led to significantly more acute toxicity and xerostomia than CF RT plus CHT. Hfx RT was more toxic than CF RT, either alone or with concurrent CHT. CONCLUSION: Results of this study show that there may be a therapeutic benefit for CF RT plus CHT over Hfx RT plus CDDP in patients with SCCHN, but this cannot be firmly established without a larger and well-planned controlled trial.

[Relation between size of the nasopharynx and occurrence of chronic otitis media]. / Odnos izmedju velicine nazofarinksa i pojave hronicnog zapaljenja srednjeg uva.

Aetiopathogenesis of chronic middle ear inflammation has not yet been sufficiently elucidated. Eustachian tube infection, causative organism virulence, immune status and biologically predisposed middle ear mucosa play the major role. The study was aimed at evaluation of the correlation between nasopharyngeal size and development of chronic middle ear inflammations. The studies were performed in 60 adults. Group A comprised the patients affected with chronic middle ear inflammation. Group B was the control group composed of healthy individuals matched with respect to their sex and age. The studies included clinical examination, audiological findings, radiological studies and craniometrical X-ray measurements. The type of chronic middle ear inflammation was defined as well as normal findings in the control group. X-ray nasopharyngeal area in the mediosagittal head plane was calculated. The results of the studies indicate that skeletal dimensions of nasopharynx were smaller in patients with chronic middle ear inflammation in comparison to those found in the control group. Nasopharyngeal morphological differences have certain influence on the shape, position and dimensions of the tube and its function. Determination of nasopharyngeal dimensions may be predictive of development of chronic middle ear inflammation.

[Cytology in the diagnosis of diseases of the nose and maxilary sinuses]. / Citologija u dijagnostici oboljenja nosa i maksilarnih sinusa.

The aim of this work is to evaluate cytologic examination of secretions of nose and maxillary sinuses in patients with naso-sinusal disorders. The material for cytologic examination is taken from 128 nasal cavities of 101 patients with inflammation or tumour diseases of nose and maxillary sinuses, and from 114 maxillary sinuses, intraoperatively, of 89 patients. The results of cytological examinations were classified in five groups: acute bacterial inflammations, chronic bacterial inflammations, allergic processes, viral infections and positive findings for malignancy. With cytological examination of secretions of the nose and maxillary sinuses we can, with great accuracy, diagnose chronic bacterial inflammation, and with some less accuracy determine allergic process, when for documentation of malignancy, cytology is not a reliable diagnostic method. Cytologic examination of secretions of the nose and maxillary sinuses are an additional method, whose goal is to indicate possible aetiologic factors and to direct further diagnostic steps.