Introduction: Hyperhomocysteinemia has a role in the pathogenesis of various pathological states,... more Introduction: Hyperhomocysteinemia has a role in the pathogenesis of various pathological states, such as cardiovascular and neurodegenerative disease and cancer. Acetylcholinesterase (AChE) is an enzyme that catalyzes the breakdown of acetylcholine. Carbon monoxide (CO) belongs to the gas transmitter family, and it has vasodilatory, anti-inflammatory, antiapoptotic and antioxidant effects. Considering these facts, the research of the relations between homocysteine and CO on AChE activity in rat cardia tissue should be relevant. Aim: The objective of this study is to examine and compare the effects of homocysteine and Zn PPR IX on acetylcholinesterase activity in rat cardiac tissue, separately and simultaneously applied. Material and methods: AChE activity in the rat cardiac homogenate tissue was examined after acute homocysteine application, in a dose of 8 mmol/kg b.m i.p., as well as Zn PPR IX application in a dose of 30 µmol/kg b.m. i.p., separately and simultaneously. AChE activity was determined by Ellman method, 60 minutes after application. Results: AChE activity was expressed as ΔA/min mg tissue, and it was (0.039±0.003) in the control group; (0.023±0.002) in the group where homocysteine was applied; (0.024±0.002) in the group where Zn PPR IX was applied; and (0.051±0.004) in the group where tested compounds were applied simultaneously. Homocysteine caused a statistically significant reduction of AChE activity compared to the control group (p = 0.007), Zn PPR IX also caused a statistically significant reduction of AChE activity, compared to the control group (p = 0.006). There was statistically relevant difference between AChE activity caused by homocysteine and Zn PPR IX. Simultaneously applied compounds caused statistically significant increase of AChE activity, compared to control group (p = 0.009). Conclusion: Examined compounds caused statistically significant decrease of AChE activity in the rat cardiac homogenate tissue compared to control group, but there is not statistically significant difference between homocysteine and Zn PPR IX. Surprisingly, there is a statistically significant increase of AChE activity after homocysteine application and Zn PPR IX, simultaneously compared to control group, which is opposite to effects of these two compounds applied separately. Hadžibegović A. et al. The effects of homocysteine and nitric oxide inhibitor, applied separately and simultaneously, on acetylcholinesterase activity in the rat heart tissue, MedPodml 2016, 67(4):30-35 Medicinski podmladak / Medical Youth
The athlete's heart is a set of morphological and functional characteristics that develop over ti... more The athlete's heart is a set of morphological and functional characteristics that develop over time due to sports training. These adaptive changes result in increase in cardiac work efficiency and economy. They are manidested as cardiac muscle hypertrophy and dilation, with accompanying angiogenesis and slower heart rate, that are influenced by variable regulatory systems and genetic predisposition. The problem of sudden cardiac death in athletes, which persists despite numerous activities aimed at prevention, creates the need for a better definition of the athlete`s heart, especially in terms of its differentiation from certain pathological conditions. This is of particular importance in the context of cardiac electrical activity. Right heart adaptations, hormonal regulatory mechanisms and the effects of nonphysiological adaptations during training, that may lead to pathologic alterations direction, are all relevant in the investigation of adverse cardiac events in athletes. In order to prevent sudden cardiac death in athletes, it is necessary to examine competitive athletes as well as apparently health individsuals who recreationally exercise at a high volume. There are guidelines for mass screening and individual examinations, for all age groups and both genders, as well as for public service staff who require intense physical activity during their occupation. Both American and European recommendations require a detailed anamnesis and physical examination, whereas European, apart from that, require initial electrocardiography. The implementation of additional tests is necessary if the existence of any underlying pathophysiologic process is suspected. Checks should be performed before engaging in sports activities, as well as during training and competition periods.
The athlete's heart is an exercise-induced cardiac remodelling phenomenon, which is individual an... more The athlete's heart is an exercise-induced cardiac remodelling phenomenon, which is individual and depends on the intesity, duration and frequency of training, as well as genetic factors. Cardiovascular screening prior to participation in sports activities, is a systematic practice of medical evaluation in the athlete population. The current US recommendations for the screening of cardiovascular abnormalities in high school and university athletes at all levels of performance were initially put forther by the American Heart Association in 2007. These recommendations consist of 12 points, factoring personal and family history data, as well as physical examination. On the other hand, European recommendations suggest the importance of non-invasive diagnostic methods, such as the 12-lead ECG, which should be carried out in combination with a history and physical examination. According to the European Association for Cardiovascular Imaging, standard echocardiography is the first line approach to differentiate an athlete`s heart from pathological left ventricular hypertrophy. Updated ,,Seattle criteria''from 2017. include criteria for assessing abnormalities in the electrocardiogram of athletes and their differentiation from the adaptive electrophysiological changes, which do not require further evaluation. Since sudden cardiac death during sport activities remains a major concern and, as such, it is imperative for the physician to diagnose unrecognized pathological conditions in athletes. Following current expert consensus recommendations on this topic helps to prevent untoward events during physical activity in those who are found to be at elevated risk.
Huntington's disease (HD) is an autosomal dominant neurodegenerative disease which is characteriz... more Huntington's disease (HD) is an autosomal dominant neurodegenerative disease which is characterized by the presence of involuntary choreatic movements, cognitive impoverishment and behavioral disorders. The objectives of this research were: analysis of the clinical specifics of people with HD and definition of chronology in the occurrence of milestone disease progression. 56 patients with HD were interviewed by telephone about their age, family history, age at onset of the disease, first symptoms, current symptoms and their beginning. Also, the number of trinucleotide (CAG) repeats was determined by PCR method. In group of 50 alive patients the average age was 54.5 years, age at the beginning of disease 46.7 years, disease duration 7.8 years and latency to diagnosis 2 years, approximately. Family history was positive for 22 patients. Most frequently first symptoms were involuntary movements as isolated symptom (24 patients). In a progression of the disease swallowing difficulty and choking were first problem in everyday life for patients and they occurred 4.5 years after the first symptoms. Talking difficulty, falls, dependence on the assistance of another person during bathing and eating and walking difficulty happened after 4.6, 5.2, 6.2, 7.5 and 7.5 years, respectively. The average number of trinucleotide repeats was 43.8, in range from 40 to 51 repeats. HD in short term leads to significant disability with the emergence of problems with swallowing, speaking and walking, leading thus to complete depending on the physical assistance of another person.
Uvod: Aniridija je retka kongenitalna anomalija oka, praćena različitim oftalmološkim tegobama. U... more Uvod: Aniridija je retka kongenitalna anomalija oka, praćena različitim oftalmološkim tegobama. Uzroci ovog oboljenja su mutacije u PAX6 genu (engl. paired box 6, gen sa blokom koji kodira parni domen) ili delecija lokusa na kratkom kraku jedanaestog hromozoma koja može da bude parcijalna ili kompletna. U ovoj studiji je ispitivana sekvenca PAX6 gena kod četiri nesrodna bolesnika sa aniridijom. Cilj: Ispitavanje celokupne kodirajuće sekvence PAX6 gena kod naših bolesnika u cilju otkrivanja mutacija u ovom genu. Materijal i metode: Iz uzoraka periferne krvi izolovana je DNK bolesnika. Nakon toga je metodom polimerazne lančane reakcije (PCR metodom) izvršena amplifikacija kodirajućih PAX6 egzona i graničnih regiona i dati uzorci su direktno sekvencirani metodom po Sangeru. Rezultat: Kod jednog bolesnika je nađena mutacija po tipu insercije (c.342-2insC) u drugom intronu PAX6 gena. Kod preostala tri bolesnika nije nađeno odstupanje u sekvenci PAX6 gena. Zaključak: Ovo su prvi rezultati analize PAX6 gena u Srbiji. Osim najčešćih mutacija, delecija različitog obima u kodirajućem regionu ovog gena, mogući uzroci aniridije su i druge vrste mutacija. Insercija pronađena u ovoj studiji nije prijavljena ranije. Moguće je i da su mutacije u drugim genima povezane sa malformacijama dužice, što može da objasni nalaz normalne sekvence kod tri bolesnika sa aniridijom.
The athlete's heart is an exercise-induced cardiac remodelling phenomenon, which is individual an... more The athlete's heart is an exercise-induced cardiac remodelling phenomenon, which is individual and depends on the intesity, duration and frequency of training, as well as genetic factors. Cardiovascular screening prior to participation in sports activities, is a systematic practice of medical evaluation in the athlete population. The current US recommendations for the screening of cardiovascular abnormalities in high school and university athletes at all levels of performance were initially put forther by the American Heart Association in 2007. These recommendations consist of 12 points, factoring personal and family history data, as well as physical examination. On the other hand, European recommendations suggest the importance of non-invasive diagnostic methods, such as the 12-lead ECG, which should be carried out in combination with a history and physical examination. According to the European Association for Cardiovascular Imaging, standard echocardiography is the first line approach to differentiate an athlete`s heart from pathological left ventricular hypertrophy. Updated ,,Seattle criteria''from 2017. include criteria for assessing abnormalities in the electrocardiogram of athletes and their differentiation from the adaptive electrophysiological changes, which do not require further evaluation. Since sudden cardiac death during sport activities remains a major concern and, as such, it is imperative for the physician to diagnose unrecognized pathological conditions in athletes. Following current expert consensus recommendations on this topic helps to prevent untoward events during physical activity in those who are found to be at elevated risk.
Uvod: Aniridija je retka kongenitalna anomalija oka, praćena različitim oftalmološkim tegobama. U... more Uvod: Aniridija je retka kongenitalna anomalija oka, praćena različitim oftalmološkim tegobama. Uzroci ovog oboljenja su mutacije u PAX6 genu (engl. paired box 6, gen sa blokom koji kodira parni domen) ili delecija lokusa na kratkom kraku jedanaestog hromozoma koja može da bude parcijalna ili kompletna. U ovoj studiji je ispitivana sekvenca PAX6 gena kod četiri nesrodna bolesnika sa aniridijom. Cilj: Ispitavanje celokupne kodirajuće sekvence PAX6 gena kod naših bolesnika u cilju otkrivanja mutacija u ovom genu. Materijal i metode: Iz uzoraka periferne krvi izolovana je DNK bolesnika. Nakon toga je metodom polimerazne lančane reakcije (PCR metodom) izvršena amplifikacija kodirajućih PAX6 egzona i graničnih regiona i dati uzorci su direktno sekvencirani metodom po Sangeru. Rezultat: Kod jednog bolesnika je nađena mutacija po tipu insercije (c.342-2insC) u drugom intronu PAX6 gena. Kod preostala tri bolesnika nije nađeno odstupanje u sekvenci PAX6 gena. Zaključak: Ovo su prvi rezultati analize PAX6 gena u Srbiji. Osim najčešćih mutacija, delecija različitog obima u kodirajućem regionu ovog gena, mogući uzroci aniridije su i druge vrste mutacija. Insercija pronađena u ovoj studiji nije prijavljena ranije. Moguće je i da su mutacije u drugim genima povezane sa malformacijama dužice, što može da objasni nalaz normalne sekvence kod tri bolesnika sa aniridijom.
Introduction: Diabetic Retinopathy (DR) is a common microvascular complication of diabetes mellit... more Introduction: Diabetic Retinopathy (DR) is a common microvascular complication of diabetes mellitus. Optical Coherence Tomography Angiography (OCTA) is a new method for visualizing the microvasculature of the retina and choroid, which is based on detecting the movement of circulating erythrocytes. Objective: To present OCTA findings in patients with diabetes mellitus with different microvascular changes to diagnose diabetic retinopathy before the onset of clinical signs of the disease, as well as to monitor changes in clinically visible retinopathy, with or without Diabetic Macular Edema (DME). Methods: In this study, OCTA findings were compared in three groups of selected subjects - 5 patients with Non-Proliferative Diabetic Retinopathy (NPDR) without DME, 5 patients with NPDR and DME, and 5 patients with diabetes but without NPDR and DME. Results: Patients in all three groups showed decreased vessel diameter (VD) in the foveal, parafoveal, and perifoveal segments of the Superficia...
Background and Objectives: The main cause of the vision loss in diabetics is the development of d... more Background and Objectives: The main cause of the vision loss in diabetics is the development of diabetic macular edema, regardless of the stage of diabetic retinopathy. The paper aimed to examine whether the additional intravitreal application of triamcinolone acetonide to continuous anti-vascular endothelial growth factor therapy could improve therapeutic outcomes for pseudophakic eyes with persistent diabetic macular edema. Materials and Methods: twenty-four pseudophakic eyes with refractory diabetic macular edema, that had appeared despite three previously administered intravitreal injections of aflibercept, were divided into two groups (twelve eyes in each group). The first group continued to have aflibercept administered according to a fixed dosing regimen (once in two months). Triamcinolone acetonide 10 mg/0.1 mL (administered once per four months) was included for the second group, i.e., their treatment continued with a combination of aflibercept + triamcinolone acetonide. Re...
Integration is the process of enabling a communication between disparate software components. Int... more Integration is the process of enabling a communication between disparate software components. Integration has been the burning issue for large enterprises in the last twenty years, due to the fact that 70% of the development and deployment budget is spent on integrating complex and heterogeneous back-end and front-end IT systems. The need to integrate existing applications is to support newer, faster, more accurate business processes and to provide meaningful, consistent management information. Historically, integration started with the introduction of point-to-point approaches evolving into simpler hub-and spoke topologies. These topologies were combined with custom remote procedure calls, distributed object technologies and message-oriented middleware (MOM), continued with enterprise application integration (EAI) and used an application server as a primary vehicle for integration. The current phase of the evolution is service-oriented architecture (SOA) combined with an enterprise...
Background and Objectives: To evaluate possible changes in macular thickness parameters during an... more Background and Objectives: To evaluate possible changes in macular thickness parameters during and after silicon oil tamponade and in pars plana rhegmatogenous retinal detachment surgery. Materials and Methods: Our retrospective study included 34 consecutive patients who underwent 23-gauge retinal detachment surgery with silicon oil tamponade. Central macular thickness (CMT), central macular volume cube (CMV) and average macular thickness cube (AVG) were measured by optical coherence tomography (OCT) before rhegmatogenous retinal detachment surgery with silicon oil tamponade during tamponade (seven days, one month and three months after surgery), and one month after silicon oil removal. Results: In our sample, macular parameters CMT, CMV and AVG in patients who underwent retinal detachment surgery were statistically reduced during silicon oil tamponade (p < 0.05). After silicon oil removal, all parameters recovered, reaching numeric values which were not statistically significant...
Introduction: Diabetic retinopathy is one of the major complications of diabetes mellitus. It is ... more Introduction: Diabetic retinopathy is one of the major complications of diabetes mellitus. It is a progressive disease that includes following stages: no apparent DR, nonproliferative DR and proliferative DR. Contrast sensitivity is defined as the ability to distinguish details at low contrast levels. Numerous studies have shown that in patients with DR, in stages when visual acuity is normal or only mildly reduced, CS function is significantly affected. Aim: The aim of our study was to examine whether CS is reduced in patients with diabetes, and whether is it significantly lower in diabetic patients compared to healthy subjects. Material and methods: 20 patients with diabetes treated at Hospital for Eye Diseases, Clinical Center of Serbia and 20 healthy subjects from general population participated in the study. We have conducted case-contol study. We used low-contrast ETDRS chart to measure CS. Results: CS in diabetic patients was compared with CS in healthy subjects. We also examined CS in diabetics with and without retinopathy. A statistically significant difference was observed between the patients and the control group, both at monocular and binocular vision and the diseased persons had significantly impaired CS function. Regarding the stage of retinopathy, statistical significance existed only in monocular vision, in terms of decreased CS in patients with nonproliferative DR. Our study shows that there was no statistically significant difference in CS in diabetics with hemoglobin A1c lower than 7 and in those with hemoglobin A1c equal or higher than 7. Conclusion: Our research found that CS in diabetic patients can be greatly impaired, even in early stages of desease, while there were still no retinal abnormalities. In view of the fact that in all of our respondents visual acuity was normal, we conclude that measuring CS, could be good indicator of early vision disorders in diabetic patients.
Introduction/Objective. World Health Organization in January 2020 declared a pandemic of the coro... more Introduction/Objective. World Health Organization in January 2020 declared a pandemic of the coronavirus disease named COVID-19. The state of emergency in the Republic of Serbia began on March 15 2020, which greatly influenced the treatment of those patients who were not affected by COVID-19. The aim of this paper is to compare the most common ophthalmic surgeries during quarantine with those performed in 2019 in the same period. Methods. This study is a retrospective. We collected data from the operating protocol of the main ophthalmic operating room. We have followed the changes related to surgical procedures during these two years. Results. During the state of emergency, significantly more operations were performed on male patients than on female patients compared to the same period in 2019 (p=0.043). In the observed period, in 2019 significantly more patients older than 65 were surgically treated (p ?0.001). During 2019, there were 397 (64.3%) elective and 220 (35.7%) urgent pro...
Introduction/Objective Dry eye is a multifactorial disease with incidence up to 50% in the genera... more Introduction/Objective Dry eye is a multifactorial disease with incidence up to 50% in the general population. It is characterized by a loss of homeostasis of the tear film and accompanied by ocular symptoms. Ocular Surface Disease Index (OSDI) questionnaire is designed to provide a rapid assessment of the symptoms. The aim of this study was to evaluate the diagnostic capacity of OSDI. Methods A prospective, randomized and observational study was conducted at the Clinic for Eye Disease, University Clinical Center of Serbia, between December 2018 and February 2019. The OSDI questionnaire was used to rate the severity of dry eye disease. Schirmer I test, tear break-up time test (TBUT), Rose Bengal test and lid-parallel conjunctival folds (LIPCOF) test were performed as a clinical proof of the symptoms. Results A total of 27 patients, 15 male (55.4%) and 12 female (44.6%), with mean age of 60 ± 15 years were included in the study. The average value of OSDI score was 26.37 ± 23.98 (0-80). Schirmer I test and Rose Bengal test for the right and the left eye, as well as the TBUT test for the left eye were positively correlated with OSDI score (Spearman correlation coefficient). Conclusion OSDI questionnaire is a fast, reliable, and inexpensive test. In our study we have found a correlation between the OSDI score and other clinical tests, except with LIPCOF test. At this moment, the questionnaire that could be the gold standard for dry eye disease diagnosis does not exist, therefore further studies concerning this topic are needed.
Background. The accumulation of risk factors for central retinal artery occlusion can be seen in ... more Background. The accumulation of risk factors for central retinal artery occlusion can be seen in a single person and might be explained by the metabolic syndrome. Case report. We presented the case of a 52-year-old man with no light perception in his right eye. The visual loss was monocular and painless, fundoscopy showed central retinal artery occlusion and the laboratory investigation showed the raised erythrocyte sedimentation rate of 105 mm/h and the raised C-reactive protein of 22 mg/l. Specific laboratory investigations and fluorescein angiography excluded the presence of vasculitis, collagen vascular diseases, hypercoagulable state and antiphospholipid syndrome. Conclusion. The patient met all the five of the National Cholesterol Education Program (NCEP) criteria for the metabolic syndrome: hypertension, abnormal lipid profile, abnormal glucose metabolism, obesity and hyperuricemia. Measurement of C-reactive protein is useful for the assessment of therapeutic systemic effect ...
ceral involvement (kidneys, lungs, digestive tract, heart) so the disease can be fatal (progressi... more ceral involvement (kidneys, lungs, digestive tract, heart) so the disease can be fatal (progressive fibrosis in multiple organs) [1]. Localized fibrosing disorder-morphea-is a rare condition that frequently begins in childhood, and is characterized by various fibrotic areas of the dermis, subcutis or underlying tissue and bone, similar to the skin involvement of systemic sclerosis, but without systemic features. The clinical course of the disease is usually benign at first, but sometimes significant complications occur, especially in disseminated morphea [3]. Case Report A 63-year-old man was referred to us due to decreased vision in the only functional, left eye, which lasted more than several months. The other eye was not functional and irrelevant for observation due to the retinal detachment surgery that had been performed 10 years ago after a severe injury. An examination showed that visual acuity in the left eye was 6/12 (with +3.50 Dsph) and intraocular pressure was 16 mm Hg. The patient had localized scleroderma-morphea en plaque type-according to Mayo Clinic classification system of morphea [3] from early childhood. Raynaud's phenomenon was present. The skin on the forearms and feet was taut, thickened and hidebound with scattered telangiectatic changes (fig. 1). His mouth aperture was slightly narrower than normal. Clinical findings and investigations on lungs, heart, kidneys, digestive tract, etc. were within normal limits. As it was reported in the recent publications, neurologic involvement is one of the most frequent ex-Key Words Morphea ؒ Morphea en plaque ؒ Localized scleroderma ؒ Choroidal sclerosis
Introduction: Hyperhomocysteinemia has a role in the pathogenesis of various pathological states,... more Introduction: Hyperhomocysteinemia has a role in the pathogenesis of various pathological states, such as cardiovascular and neurodegenerative disease and cancer. Acetylcholinesterase (AChE) is an enzyme that catalyzes the breakdown of acetylcholine. Carbon monoxide (CO) belongs to the gas transmitter family, and it has vasodilatory, anti-inflammatory, antiapoptotic and antioxidant effects. Considering these facts, the research of the relations between homocysteine and CO on AChE activity in rat cardia tissue should be relevant. Aim: The objective of this study is to examine and compare the effects of homocysteine and Zn PPR IX on acetylcholinesterase activity in rat cardiac tissue, separately and simultaneously applied. Material and methods: AChE activity in the rat cardiac homogenate tissue was examined after acute homocysteine application, in a dose of 8 mmol/kg b.m i.p., as well as Zn PPR IX application in a dose of 30 µmol/kg b.m. i.p., separately and simultaneously. AChE activity was determined by Ellman method, 60 minutes after application. Results: AChE activity was expressed as ΔA/min mg tissue, and it was (0.039±0.003) in the control group; (0.023±0.002) in the group where homocysteine was applied; (0.024±0.002) in the group where Zn PPR IX was applied; and (0.051±0.004) in the group where tested compounds were applied simultaneously. Homocysteine caused a statistically significant reduction of AChE activity compared to the control group (p = 0.007), Zn PPR IX also caused a statistically significant reduction of AChE activity, compared to the control group (p = 0.006). There was statistically relevant difference between AChE activity caused by homocysteine and Zn PPR IX. Simultaneously applied compounds caused statistically significant increase of AChE activity, compared to control group (p = 0.009). Conclusion: Examined compounds caused statistically significant decrease of AChE activity in the rat cardiac homogenate tissue compared to control group, but there is not statistically significant difference between homocysteine and Zn PPR IX. Surprisingly, there is a statistically significant increase of AChE activity after homocysteine application and Zn PPR IX, simultaneously compared to control group, which is opposite to effects of these two compounds applied separately. Hadžibegović A. et al. The effects of homocysteine and nitric oxide inhibitor, applied separately and simultaneously, on acetylcholinesterase activity in the rat heart tissue, MedPodml 2016, 67(4):30-35 Medicinski podmladak / Medical Youth
The athlete's heart is a set of morphological and functional characteristics that develop over ti... more The athlete's heart is a set of morphological and functional characteristics that develop over time due to sports training. These adaptive changes result in increase in cardiac work efficiency and economy. They are manidested as cardiac muscle hypertrophy and dilation, with accompanying angiogenesis and slower heart rate, that are influenced by variable regulatory systems and genetic predisposition. The problem of sudden cardiac death in athletes, which persists despite numerous activities aimed at prevention, creates the need for a better definition of the athlete`s heart, especially in terms of its differentiation from certain pathological conditions. This is of particular importance in the context of cardiac electrical activity. Right heart adaptations, hormonal regulatory mechanisms and the effects of nonphysiological adaptations during training, that may lead to pathologic alterations direction, are all relevant in the investigation of adverse cardiac events in athletes. In order to prevent sudden cardiac death in athletes, it is necessary to examine competitive athletes as well as apparently health individsuals who recreationally exercise at a high volume. There are guidelines for mass screening and individual examinations, for all age groups and both genders, as well as for public service staff who require intense physical activity during their occupation. Both American and European recommendations require a detailed anamnesis and physical examination, whereas European, apart from that, require initial electrocardiography. The implementation of additional tests is necessary if the existence of any underlying pathophysiologic process is suspected. Checks should be performed before engaging in sports activities, as well as during training and competition periods.
The athlete's heart is an exercise-induced cardiac remodelling phenomenon, which is individual an... more The athlete's heart is an exercise-induced cardiac remodelling phenomenon, which is individual and depends on the intesity, duration and frequency of training, as well as genetic factors. Cardiovascular screening prior to participation in sports activities, is a systematic practice of medical evaluation in the athlete population. The current US recommendations for the screening of cardiovascular abnormalities in high school and university athletes at all levels of performance were initially put forther by the American Heart Association in 2007. These recommendations consist of 12 points, factoring personal and family history data, as well as physical examination. On the other hand, European recommendations suggest the importance of non-invasive diagnostic methods, such as the 12-lead ECG, which should be carried out in combination with a history and physical examination. According to the European Association for Cardiovascular Imaging, standard echocardiography is the first line approach to differentiate an athlete`s heart from pathological left ventricular hypertrophy. Updated ,,Seattle criteria''from 2017. include criteria for assessing abnormalities in the electrocardiogram of athletes and their differentiation from the adaptive electrophysiological changes, which do not require further evaluation. Since sudden cardiac death during sport activities remains a major concern and, as such, it is imperative for the physician to diagnose unrecognized pathological conditions in athletes. Following current expert consensus recommendations on this topic helps to prevent untoward events during physical activity in those who are found to be at elevated risk.
Huntington's disease (HD) is an autosomal dominant neurodegenerative disease which is characteriz... more Huntington's disease (HD) is an autosomal dominant neurodegenerative disease which is characterized by the presence of involuntary choreatic movements, cognitive impoverishment and behavioral disorders. The objectives of this research were: analysis of the clinical specifics of people with HD and definition of chronology in the occurrence of milestone disease progression. 56 patients with HD were interviewed by telephone about their age, family history, age at onset of the disease, first symptoms, current symptoms and their beginning. Also, the number of trinucleotide (CAG) repeats was determined by PCR method. In group of 50 alive patients the average age was 54.5 years, age at the beginning of disease 46.7 years, disease duration 7.8 years and latency to diagnosis 2 years, approximately. Family history was positive for 22 patients. Most frequently first symptoms were involuntary movements as isolated symptom (24 patients). In a progression of the disease swallowing difficulty and choking were first problem in everyday life for patients and they occurred 4.5 years after the first symptoms. Talking difficulty, falls, dependence on the assistance of another person during bathing and eating and walking difficulty happened after 4.6, 5.2, 6.2, 7.5 and 7.5 years, respectively. The average number of trinucleotide repeats was 43.8, in range from 40 to 51 repeats. HD in short term leads to significant disability with the emergence of problems with swallowing, speaking and walking, leading thus to complete depending on the physical assistance of another person.
Uvod: Aniridija je retka kongenitalna anomalija oka, praćena različitim oftalmološkim tegobama. U... more Uvod: Aniridija je retka kongenitalna anomalija oka, praćena različitim oftalmološkim tegobama. Uzroci ovog oboljenja su mutacije u PAX6 genu (engl. paired box 6, gen sa blokom koji kodira parni domen) ili delecija lokusa na kratkom kraku jedanaestog hromozoma koja može da bude parcijalna ili kompletna. U ovoj studiji je ispitivana sekvenca PAX6 gena kod četiri nesrodna bolesnika sa aniridijom. Cilj: Ispitavanje celokupne kodirajuće sekvence PAX6 gena kod naših bolesnika u cilju otkrivanja mutacija u ovom genu. Materijal i metode: Iz uzoraka periferne krvi izolovana je DNK bolesnika. Nakon toga je metodom polimerazne lančane reakcije (PCR metodom) izvršena amplifikacija kodirajućih PAX6 egzona i graničnih regiona i dati uzorci su direktno sekvencirani metodom po Sangeru. Rezultat: Kod jednog bolesnika je nađena mutacija po tipu insercije (c.342-2insC) u drugom intronu PAX6 gena. Kod preostala tri bolesnika nije nađeno odstupanje u sekvenci PAX6 gena. Zaključak: Ovo su prvi rezultati analize PAX6 gena u Srbiji. Osim najčešćih mutacija, delecija različitog obima u kodirajućem regionu ovog gena, mogući uzroci aniridije su i druge vrste mutacija. Insercija pronađena u ovoj studiji nije prijavljena ranije. Moguće je i da su mutacije u drugim genima povezane sa malformacijama dužice, što može da objasni nalaz normalne sekvence kod tri bolesnika sa aniridijom.
The athlete's heart is an exercise-induced cardiac remodelling phenomenon, which is individual an... more The athlete's heart is an exercise-induced cardiac remodelling phenomenon, which is individual and depends on the intesity, duration and frequency of training, as well as genetic factors. Cardiovascular screening prior to participation in sports activities, is a systematic practice of medical evaluation in the athlete population. The current US recommendations for the screening of cardiovascular abnormalities in high school and university athletes at all levels of performance were initially put forther by the American Heart Association in 2007. These recommendations consist of 12 points, factoring personal and family history data, as well as physical examination. On the other hand, European recommendations suggest the importance of non-invasive diagnostic methods, such as the 12-lead ECG, which should be carried out in combination with a history and physical examination. According to the European Association for Cardiovascular Imaging, standard echocardiography is the first line approach to differentiate an athlete`s heart from pathological left ventricular hypertrophy. Updated ,,Seattle criteria''from 2017. include criteria for assessing abnormalities in the electrocardiogram of athletes and their differentiation from the adaptive electrophysiological changes, which do not require further evaluation. Since sudden cardiac death during sport activities remains a major concern and, as such, it is imperative for the physician to diagnose unrecognized pathological conditions in athletes. Following current expert consensus recommendations on this topic helps to prevent untoward events during physical activity in those who are found to be at elevated risk.
Uvod: Aniridija je retka kongenitalna anomalija oka, praćena različitim oftalmološkim tegobama. U... more Uvod: Aniridija je retka kongenitalna anomalija oka, praćena različitim oftalmološkim tegobama. Uzroci ovog oboljenja su mutacije u PAX6 genu (engl. paired box 6, gen sa blokom koji kodira parni domen) ili delecija lokusa na kratkom kraku jedanaestog hromozoma koja može da bude parcijalna ili kompletna. U ovoj studiji je ispitivana sekvenca PAX6 gena kod četiri nesrodna bolesnika sa aniridijom. Cilj: Ispitavanje celokupne kodirajuće sekvence PAX6 gena kod naših bolesnika u cilju otkrivanja mutacija u ovom genu. Materijal i metode: Iz uzoraka periferne krvi izolovana je DNK bolesnika. Nakon toga je metodom polimerazne lančane reakcije (PCR metodom) izvršena amplifikacija kodirajućih PAX6 egzona i graničnih regiona i dati uzorci su direktno sekvencirani metodom po Sangeru. Rezultat: Kod jednog bolesnika je nađena mutacija po tipu insercije (c.342-2insC) u drugom intronu PAX6 gena. Kod preostala tri bolesnika nije nađeno odstupanje u sekvenci PAX6 gena. Zaključak: Ovo su prvi rezultati analize PAX6 gena u Srbiji. Osim najčešćih mutacija, delecija različitog obima u kodirajućem regionu ovog gena, mogući uzroci aniridije su i druge vrste mutacija. Insercija pronađena u ovoj studiji nije prijavljena ranije. Moguće je i da su mutacije u drugim genima povezane sa malformacijama dužice, što može da objasni nalaz normalne sekvence kod tri bolesnika sa aniridijom.
Introduction: Diabetic Retinopathy (DR) is a common microvascular complication of diabetes mellit... more Introduction: Diabetic Retinopathy (DR) is a common microvascular complication of diabetes mellitus. Optical Coherence Tomography Angiography (OCTA) is a new method for visualizing the microvasculature of the retina and choroid, which is based on detecting the movement of circulating erythrocytes. Objective: To present OCTA findings in patients with diabetes mellitus with different microvascular changes to diagnose diabetic retinopathy before the onset of clinical signs of the disease, as well as to monitor changes in clinically visible retinopathy, with or without Diabetic Macular Edema (DME). Methods: In this study, OCTA findings were compared in three groups of selected subjects - 5 patients with Non-Proliferative Diabetic Retinopathy (NPDR) without DME, 5 patients with NPDR and DME, and 5 patients with diabetes but without NPDR and DME. Results: Patients in all three groups showed decreased vessel diameter (VD) in the foveal, parafoveal, and perifoveal segments of the Superficia...
Background and Objectives: The main cause of the vision loss in diabetics is the development of d... more Background and Objectives: The main cause of the vision loss in diabetics is the development of diabetic macular edema, regardless of the stage of diabetic retinopathy. The paper aimed to examine whether the additional intravitreal application of triamcinolone acetonide to continuous anti-vascular endothelial growth factor therapy could improve therapeutic outcomes for pseudophakic eyes with persistent diabetic macular edema. Materials and Methods: twenty-four pseudophakic eyes with refractory diabetic macular edema, that had appeared despite three previously administered intravitreal injections of aflibercept, were divided into two groups (twelve eyes in each group). The first group continued to have aflibercept administered according to a fixed dosing regimen (once in two months). Triamcinolone acetonide 10 mg/0.1 mL (administered once per four months) was included for the second group, i.e., their treatment continued with a combination of aflibercept + triamcinolone acetonide. Re...
Integration is the process of enabling a communication between disparate software components. Int... more Integration is the process of enabling a communication between disparate software components. Integration has been the burning issue for large enterprises in the last twenty years, due to the fact that 70% of the development and deployment budget is spent on integrating complex and heterogeneous back-end and front-end IT systems. The need to integrate existing applications is to support newer, faster, more accurate business processes and to provide meaningful, consistent management information. Historically, integration started with the introduction of point-to-point approaches evolving into simpler hub-and spoke topologies. These topologies were combined with custom remote procedure calls, distributed object technologies and message-oriented middleware (MOM), continued with enterprise application integration (EAI) and used an application server as a primary vehicle for integration. The current phase of the evolution is service-oriented architecture (SOA) combined with an enterprise...
Background and Objectives: To evaluate possible changes in macular thickness parameters during an... more Background and Objectives: To evaluate possible changes in macular thickness parameters during and after silicon oil tamponade and in pars plana rhegmatogenous retinal detachment surgery. Materials and Methods: Our retrospective study included 34 consecutive patients who underwent 23-gauge retinal detachment surgery with silicon oil tamponade. Central macular thickness (CMT), central macular volume cube (CMV) and average macular thickness cube (AVG) were measured by optical coherence tomography (OCT) before rhegmatogenous retinal detachment surgery with silicon oil tamponade during tamponade (seven days, one month and three months after surgery), and one month after silicon oil removal. Results: In our sample, macular parameters CMT, CMV and AVG in patients who underwent retinal detachment surgery were statistically reduced during silicon oil tamponade (p < 0.05). After silicon oil removal, all parameters recovered, reaching numeric values which were not statistically significant...
Introduction: Diabetic retinopathy is one of the major complications of diabetes mellitus. It is ... more Introduction: Diabetic retinopathy is one of the major complications of diabetes mellitus. It is a progressive disease that includes following stages: no apparent DR, nonproliferative DR and proliferative DR. Contrast sensitivity is defined as the ability to distinguish details at low contrast levels. Numerous studies have shown that in patients with DR, in stages when visual acuity is normal or only mildly reduced, CS function is significantly affected. Aim: The aim of our study was to examine whether CS is reduced in patients with diabetes, and whether is it significantly lower in diabetic patients compared to healthy subjects. Material and methods: 20 patients with diabetes treated at Hospital for Eye Diseases, Clinical Center of Serbia and 20 healthy subjects from general population participated in the study. We have conducted case-contol study. We used low-contrast ETDRS chart to measure CS. Results: CS in diabetic patients was compared with CS in healthy subjects. We also examined CS in diabetics with and without retinopathy. A statistically significant difference was observed between the patients and the control group, both at monocular and binocular vision and the diseased persons had significantly impaired CS function. Regarding the stage of retinopathy, statistical significance existed only in monocular vision, in terms of decreased CS in patients with nonproliferative DR. Our study shows that there was no statistically significant difference in CS in diabetics with hemoglobin A1c lower than 7 and in those with hemoglobin A1c equal or higher than 7. Conclusion: Our research found that CS in diabetic patients can be greatly impaired, even in early stages of desease, while there were still no retinal abnormalities. In view of the fact that in all of our respondents visual acuity was normal, we conclude that measuring CS, could be good indicator of early vision disorders in diabetic patients.
Introduction/Objective. World Health Organization in January 2020 declared a pandemic of the coro... more Introduction/Objective. World Health Organization in January 2020 declared a pandemic of the coronavirus disease named COVID-19. The state of emergency in the Republic of Serbia began on March 15 2020, which greatly influenced the treatment of those patients who were not affected by COVID-19. The aim of this paper is to compare the most common ophthalmic surgeries during quarantine with those performed in 2019 in the same period. Methods. This study is a retrospective. We collected data from the operating protocol of the main ophthalmic operating room. We have followed the changes related to surgical procedures during these two years. Results. During the state of emergency, significantly more operations were performed on male patients than on female patients compared to the same period in 2019 (p=0.043). In the observed period, in 2019 significantly more patients older than 65 were surgically treated (p ?0.001). During 2019, there were 397 (64.3%) elective and 220 (35.7%) urgent pro...
Introduction/Objective Dry eye is a multifactorial disease with incidence up to 50% in the genera... more Introduction/Objective Dry eye is a multifactorial disease with incidence up to 50% in the general population. It is characterized by a loss of homeostasis of the tear film and accompanied by ocular symptoms. Ocular Surface Disease Index (OSDI) questionnaire is designed to provide a rapid assessment of the symptoms. The aim of this study was to evaluate the diagnostic capacity of OSDI. Methods A prospective, randomized and observational study was conducted at the Clinic for Eye Disease, University Clinical Center of Serbia, between December 2018 and February 2019. The OSDI questionnaire was used to rate the severity of dry eye disease. Schirmer I test, tear break-up time test (TBUT), Rose Bengal test and lid-parallel conjunctival folds (LIPCOF) test were performed as a clinical proof of the symptoms. Results A total of 27 patients, 15 male (55.4%) and 12 female (44.6%), with mean age of 60 ± 15 years were included in the study. The average value of OSDI score was 26.37 ± 23.98 (0-80). Schirmer I test and Rose Bengal test for the right and the left eye, as well as the TBUT test for the left eye were positively correlated with OSDI score (Spearman correlation coefficient). Conclusion OSDI questionnaire is a fast, reliable, and inexpensive test. In our study we have found a correlation between the OSDI score and other clinical tests, except with LIPCOF test. At this moment, the questionnaire that could be the gold standard for dry eye disease diagnosis does not exist, therefore further studies concerning this topic are needed.
Background. The accumulation of risk factors for central retinal artery occlusion can be seen in ... more Background. The accumulation of risk factors for central retinal artery occlusion can be seen in a single person and might be explained by the metabolic syndrome. Case report. We presented the case of a 52-year-old man with no light perception in his right eye. The visual loss was monocular and painless, fundoscopy showed central retinal artery occlusion and the laboratory investigation showed the raised erythrocyte sedimentation rate of 105 mm/h and the raised C-reactive protein of 22 mg/l. Specific laboratory investigations and fluorescein angiography excluded the presence of vasculitis, collagen vascular diseases, hypercoagulable state and antiphospholipid syndrome. Conclusion. The patient met all the five of the National Cholesterol Education Program (NCEP) criteria for the metabolic syndrome: hypertension, abnormal lipid profile, abnormal glucose metabolism, obesity and hyperuricemia. Measurement of C-reactive protein is useful for the assessment of therapeutic systemic effect ...
ceral involvement (kidneys, lungs, digestive tract, heart) so the disease can be fatal (progressi... more ceral involvement (kidneys, lungs, digestive tract, heart) so the disease can be fatal (progressive fibrosis in multiple organs) [1]. Localized fibrosing disorder-morphea-is a rare condition that frequently begins in childhood, and is characterized by various fibrotic areas of the dermis, subcutis or underlying tissue and bone, similar to the skin involvement of systemic sclerosis, but without systemic features. The clinical course of the disease is usually benign at first, but sometimes significant complications occur, especially in disseminated morphea [3]. Case Report A 63-year-old man was referred to us due to decreased vision in the only functional, left eye, which lasted more than several months. The other eye was not functional and irrelevant for observation due to the retinal detachment surgery that had been performed 10 years ago after a severe injury. An examination showed that visual acuity in the left eye was 6/12 (with +3.50 Dsph) and intraocular pressure was 16 mm Hg. The patient had localized scleroderma-morphea en plaque type-according to Mayo Clinic classification system of morphea [3] from early childhood. Raynaud's phenomenon was present. The skin on the forearms and feet was taut, thickened and hidebound with scattered telangiectatic changes (fig. 1). His mouth aperture was slightly narrower than normal. Clinical findings and investigations on lungs, heart, kidneys, digestive tract, etc. were within normal limits. As it was reported in the recent publications, neurologic involvement is one of the most frequent ex-Key Words Morphea ؒ Morphea en plaque ؒ Localized scleroderma ؒ Choroidal sclerosis
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