Introduction/Objective. Kidney transplant recipients were at higher risk for COVID-19-associated complications and mortality. The goal was to examine the frequency and outcomes of COVID-19 infection among patients under our center's control, as well as the effects of tocilizumab and anti-SARS-CoV-2 antibodies. Methods. We analyzed a cohort of 220 kidney transplant patients monitored at our center who experienced COVID-19 infection between March 2020 and March 2022. Results. In the period of two years, 55 pts contracted COVID-19 (25%). The average age of the infected was 48.38 years old. In 24% of patients during COVID-19 infection the immunosuppressive therapy did not change. Because of pneumonia development 33% of patients have been hospitalized. Of all infected patients, tocilizumab was used in 7% of patients, of whom three died. AntiSARS-COV-2 mAb was used in 24% of patients, no fatalities were reported. Antivirotic (favipiravir) was used in 4% of patients, in one case fatal. CRRT/HD was applied in 5.5% of patients. Out of all infected, death occurred in 14.5% of patients. The cause of death was severe acute respiratory syndrome (50%), cardiac arrest (25%), or multiorgan failure (25%). All of these patients had serious comorbidities, or were late admitted to the transplant center. Conclusions. The therapeutic use of mAb was reliable, with a significant positive effect on achieving a milder clinical form and shorter duration of the disease. The main risk factors of adverse outcomes of COVID-19 infection in kidney transplant recipients were serious comorbidities and late admission to the transplant center.
Introduction. Neuroleptic malignant syndrome (NMS) is a potentially fatal complication of neuroleptic drugs. Over the past few decades, it has been mostly considered as idiosyncratic reaction. The aim of this report is to present the case of an atypical NMS associated with clozapine treatment. Case outline. We describe a case of a young male patient treated with clozapine (400 mg), who developed NMS for the first time during the third relapse of schizoaffective disorder. The patient rapidly developed hyperthermia (40°C), tachycardia, labile blood pressure, confusion, elevated creatine phosphokinase, leukocytosis, and rhabdomyolysis, without muscle rigidity or other extrapyramidal signs. Extensive investigations excluded infectious, neurological, endocrine, and metabolic causes. Antipsychotics were discontinued, and treatment with lorazepam, intravenous hydration, and supportive care resulted in complete somatic recovery. Olanzapine was successfully reintroduced after stabilization. Conclusion. Specific pharmacodynamic profile of clozapine hampers early detection of NMS, since muscular rigidity is rare. Therefore, the presentation of NMS in this case is atypical. Atypical development of NMS during clozapine therapy imposes increased clinical attention.
Introduction/Objective. This study aimed to examine job satisfaction among healthcare professionals in public hospitals in Belgrade, Serbia, and to identify its underlying dimensions using exploratory factor analysis. Methods. A cross-sectional study was conducted using a standardized job satisfaction questionnaire developed according to the methodology of the Institute of Public Health of Serbia. The analysis included 6899 healthcare professionals, categorized into two groups according to educational level: those with a university degree and those with secondary school or college education. Descriptive statistics, Student’s t-test, χ2 test, and exploratory factor analysis were applied. Results. Healthcare professionals with a university degree reported significantly higher satisfaction than those with secondary school or college education across the analyzed domains. The highest satisfaction scores were observed for collaboration with colleagues and superiors, whereas salary was the lowest-rated item in both groups. Exploratory factor analysis identified three dimensions of job satisfaction: “Organizational Culture and Personal Development”, “Working Conditions,” and “Workplace Change Intention.” Conclusion. Job satisfaction among healthcare professionals in Belgrade public hospitals was multidimensional and differed according to educational background. The findings indicate that interpersonal collaboration was among the most positively evaluated aspects of work, whereas salary and other working conditions represented important sources of dissatisfaction. The identified factor structure provides exploratory evidence for further research and more detailed organizational assessment of job satisfaction in healthcare settings.
Introduction/Objective. The aim was to analyze the evolution of modern combat casualty care from the Golden Hour and Tactical Combat Casualty Care (TCCC) to Prolonged Field Care (PFC) and Prolonged Casualty Care (PCC), and to construct an Echelon P model for situations in which casualty evacuation is delayed or interrupted. Methods. A structured literature analysis, conceptual differentiation, and model-construction approach was used. Foreign military guidelines, position statements, operational reports, and peer-reviewed studies on PCC were reviewed, with priority given to literature from 2022 to 2026. PFC and PCC were compared by origin, target users, operational scenario, capability requirements, time frame, and interface with traditional echelons of care. Results. The evidence indicates a shift from evacuation-dependent care toward sustained forward care under contested conditions. PFC is primarily a clinical continuation of TCCC by advanced-trained personnel, whereas PCC is a system-level framework for all Role 1 responders when timely evacuation is limited or denied. The proposed Echelon P model includes activation triggers, P0-P3 capability tiers, and medical, blood/resuscitation, data, and command interfaces. Conclusion. Institutionalizing prolonged care as an independent capability layer may improve medical resilience in future high-intensity operations. Implementation should focus on doctrine, training, equipment modularization, telemedicine-enabled support, documentation, and quality assessment.
Introduction/Objective. This study aimed to assess the diagnostic value and explore the potential role of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immuneinflammation index (SII) in distinguishing benign from malignant parotid gland tumors. Methods. Clinical data from 129 patients who underwent parotid surgery between 2014 and 2024 were evaluated retrospectively. Demographic characteristics, preoperative complete blood count parameters, and histopathological findings were compared. Patients were categorized into benign and malignant tumor groups based on histopathological diagnosis. Results. No significant difference was found in sex distribution between the groups (p > 0.05). Patients with malignant tumors were significantly older than those with benign tumors (p = 0.038). Lymphocyte and platelet counts were significantly higher in the benign tumor group (p = 0.008 and p = 0.029, respectively). In contrast, mean NLR values were significantly higher in patients with malignant tumors (p = 0.016). Although PLR and SII values were also higher in the malignant tumor group, the differences were not statistically significant (p > 0.05). Conclusion. NLR may serve as a supportive and adjunctive marker rather than a standalone diagnostic tool for differentiating between benign and malignant parotid gland tumors. This study should be considered a pilot study, and larger, controlled studies are required.
Introduction/Objective. Breast cancer in women shows more aggressive biological characteristics, while the status of axillary lymph nodes remains the most important prognostic factor. The aim of this study was to determine the prevalence of axillary lymph node metastases and to identify histological and immunohistochemical predictors in patients under 40 years of age with breast cancer. Methods. A retrospective cohort study that included patients under 40 years of age with histopathologically confirmed breast cancer who underwent surgical treatment at the Department of Oncological Surgery, Clinical Hospital Center “Bezanijska kosa”, between 2014 and 2024. Results. The study included 97 patients under 40 years of age (mean age 34.75 ± 3.74 years). Axillary lymph node metastases were identified in 48.5% of patients, while sentinel lymph node biopsy was positive in 26.8%. The most common molecular subtype was Luminal B (53.6%). Luminal B tumors were associated with younger age (p = 0.031) and higher body mass index (p = 0.007). HER2-positive and triple-negative tumors were more often of high histological grade (p = 0.003) and larger tumor size (p = 0.025), with a higher Ki-67 proliferation index (p = 0.001). Positive axillary lymph node status was significantly associated with Rh-positive blood type (p = 0.004), tumor size (p = 0.001), and mastectomy (p = 0.004). Conclusion. Breast cancer in women under 40 years of age is characterized by marked biological heterogeneity, with axillary lymph node metastases significantly associated with larger tumor size and more aggressive biological characteristics.
Introduction/Objective. The aim was to investigate the effects of combined Chinese medicine acupoint moxibustion and psychological nursing on the gastrointestinal function and quality of life (QoL) of patients with lung cancer undergoing chemotherapy. Methods. A total of 120 lung cancer patients were randomly divided into two groups. The control group received conventional care, while the observation group was administered combined traditional Chinese medicine acupoint moxibustion and emotional nursing. The observation indicators included serum acetylcholinesterase activity, plasma inhibin B, gastrin, motilin, dopamine, 5-hydroxytryptamine levels, incidence and duration of nausea/vomiting, Self-rating anxiety scale and Self-rating depression scale scores, and World Health Organization QoL-BREF scores. Results. Before intervention, no significant differences were observed between groups (p > 0.05). Post-intervention, the observation group showed significantly higher acetylcholinesterase activity (7.64 ± 1.17 U/mL vs. 6.96 ± 1.11 U/mL, p < 0.001) and inhibin B levels (193.52 ± 15.72 pg/mL vs. 166.77 ± 20.36 pg/mL, p < 0.001), lower gastrin (146.7 ± 13.02 ng/L vs. 157.35 ± 14.4 ng/L, p < 0.001) and motilin levels (151.55 ± 9.99 pmol/L vs. 158.22 ± 8.37 pmol/L, p < 0.001), reduced incidence (2.83 ± 0.64 times/day vs. 3.12 ± 0.67 times/day, p < 0.001) and duration (1.7 ± 0.5 d vs. 2.97 ± 0.64 d, p < 0.001) of nausea/vomiting, lower Self-rating anxiety scale (40.55 ± 2.79 vs. 47.06 ± 4.12, p < 0.001) and Self-rating depression scale (39.82 ± 2.81 vs. 47.25 ± 4.5, p < 0.001) scores, and higher QoL total scores (309.44 ± 9.11 vs. 294.56 ± 8.45, p < 0.001) than the control group. Conclusion. The combined use of Chinese medicine acupoint moxibustion and traditional Chinese medicine emotional care for patients with lung cancer undergoing chemotherapy has significant effects, which can significantly improve their gastrointestinal function and effectively improve their anxiety and depression symptoms, and improve their QoL.
Introduction/Objective. Burnout is a multidimensional syndrome that disproportionately affects healthcare professionals. While organizational and occupational factors have been extensively studied, the role of individual traits, such as personality, remains underexplored. This study aimed to examine the relationship between specific personality traits, sociodemographic variables, and occupational burnout among medical doctors in the Republic of Serbia. Methods. A cross-sectional, correlational study was conducted in 2024 using an online survey completed by 304 medical doctors. The instruments included a sociodemographic questionnaire, a shortened Big Five Plus Two personality inventory, and the Copenhagen Burnout Inventory (work-related scale). Data were analyzed using descriptive statistics, t-tests, and linear regression. Results. There were no significant gender differences in burnout levels (p = 0.958), nor differences based on communication skills training (p = 0.214). However, participants who reported insufficient time for patient care had significantly higher burnout levels (p < 0.001). Linear regression analysis indicated that extraversion negatively predicted burnout (β = -0.24, p = 0.003), while conscientiousness (β = 0.21, p = 0.002) and openness (β = 0.12, p = 0.024) were positive predictors. The model was significant (R = 0.307, F(5, 298) = 6.18, p < 0.001), explaining 9.4% of the variance in burnout. Conclusion. Extraversion appears to serve as a protective factor against burnout, whereas higher levels of conscientiousness and openness are associated with increased burnout. These findings highlight the relevance of personality traits in burnout susceptibility and suggest the potential for targeted interventions in physician support programs.
Introduction. Alveolar soft part sarcoma (ASPS) is an exceptionally rare soft tissue sarcoma, accounting for less than 1% of all cases. It typically presents as an indolent, slow-growing, painless mass. Superior vena cava (SVC) syndrome is usually caused by extraluminal compression from intrathoracic malignancies. Case outline. We report the case of a 53-year-old male who developed acute symptoms of SVC thrombosis. Imaging revealed extensive venous thrombosis without significant extrinsic venous compression. The clinical findings mimicked classic SVC syndrome, yet the underlying mechanism was intraluminal obstruction caused by thrombus formation. Histopathological evaluation confirmed the diagnosis of ASPS. Conclusion. To our knowledge, this is the first reported case of ASPS presenting with SVC syndrome secondary to extensive thrombosis rather than compression. Although the underlying mechanism remains uncertain, this case raises the possibility of a paraneoplastic mechanism. Awareness of this atypical manifestation may facilitate earlier recognition and timely management in similar presentations.
Multidisciplinary health support for young children with multiple disabilities remains a critical need. This paper aims to analyze the need for a multidisciplinary approach to early intervention in local health centers, where a team of professionals is supporting children's growth and development. The study employed a desk research approach, the descriptive method, and content analysis. The content of relevant literature was analyzed, and a functional analysis was applied in the research phase of the study. The frameworks for effective multidisciplinary work by different specialists in a local health center include the structure, roles, approaches, and methods that make them an important factor in working with children in the field of early intervention. Children with multiple disabilities require monitoring and support in a healthcare setting until the age when early intervention shows its effects in all areas of development. A team-based, multidisciplinary approach and working with children with multiple disabilities at an early age is invaluable for children's well-being and health. The roles of different specialists and therapists on the team are significant. All multidisciplinary team members possess the necessary knowledge and competencies and are valuable team members who care for the youngest children. All local health centers should employ various specialists то work in teams treating multiple disorders in young children, ensuring comprehensive and timely early childhood care.
Introduction/Objective. Intertrochanteric fractures of the femur are one of the biggest public health problems. This paper aims to determine the functional results and features of operative treatment of unstable intertrochanteric femoral fractures. Methods. This retrospective study included 67 patients who were treated surgically for AO/OTA A2 pertrochanteric fracture at Department for Orthopedic Surgery and Traumatology of CHC Kosovska Mitrovica and at Clinic for Orthopedic Surgery and Traumatology „Academician Prof. Dr. Milorad Mitkovic“ of University Clinical Center Nis. There were two groups of patients regarding the fixation method used - Dynamic Hip Screw (DHS) group and TRIGEN INTERTAN group. Results. Patients treated by DHS method had a statistically confirmed longer operation time, greater intraoperative blood loss, and longer hospitalization in relation to patients treated by TRIGEN INTERTAN method (p<0.001). In contrast, patients from the TRIGEN INTERTAN group spend less time in the intensive care unit, but had more favorable radiological findings regarding fracture healing, as well as better functional outcomes assessed by Harris hip score and Barthel index, which was also statistically significant. The peak-to-peak tip-apex distance (TAD) was greater in the DHS group, with a significant difference between the techniques (p = 0.019). According to the Charlson comorbidity index, patients who were treated by DHS method had more pronounced comorbidities (p = 0.022). Conclusion. Surgical treatment of unstable pertrochanteric fractures using intramedullary fixation with TRIGEN INTERTAN is very safe and effective in all patients, especially in elderly patients with comorbidities.
Introduction/Objective. Knee osteoarthritis is a progressive, degenerative disease of the knee joint that can eventually lead to disability. Clinical mesotherapy is an intradermal therapy used for injecting diluted pharmacological substances into the superficial layer of the skin at multiple points. The objectives of this study were to determine the therapeutic effect of mesotherapy on pain in patients with knee osteoarthritis treated with a mixture of Zodol (Zodol, 30 mg/mL, Hemofarm, Vršac, Serbia) and lidocaine, compared to patients with knee osteoarthritis treated with lidocaine alone. Methods. Participants were randomly assigned into two groups. The experimental group, in which patients were treated with an injection containing a mixture of lidocaine without adrenaline (Lidocainechlorid 1%, 35 mg / 3.5 mL, Galenika, Belgrade, Serbia) and of Zodol (Hemofarm). The control group was treated with lidocaine solution without adrenaline. Results. There is a statistically significant difference in pain intensity after the second dose of mesotherapy and one month after the fourth dose of mesotherapy. Western Ontario and McMaster Universities Osteoarthritis Index scale values were significantly higher in patients in the control group. The frequency of patients experiencing moderate and severe pain was significantly higher in the control group, while the frequency of patients reporting no pain or only mild pain was significantly higher in the experimental group. Conclusion. The therapeutic effect of mesotherapy on pain in patients with knee osteoarthritis in experimental group is more effective and longer-lasting compared to patients treated with lidocaine alone.
Introduction. Small lymphocytic lymphoma (SLL) / chronic lymphocytic leukemia (CLL) is an indolent lymphoproliferative disorder characterized by accumulation of mature but dysfunctional B lymphocytes. Aortic complications have been occasionally reported in lymphoma, most often in aggressive subtypes, while they are extremely rare in SLL/CLL. The aim of this report was to present a case of recently developed ruptured abdominal aortic aneurysm in a patient with SLL and its successful hybrid endovascular management. Case outline. A 58-year-old male with SLL/CLL presented with lower back and right flank pain. Initial computed tomography scan (CT) demonstrated marked progression of lymphadenopathy and interval enlargement of the infrarenal aortic diameter compared to prior imaging, remaining below the aneurysmal threshold. Due to persistent symptoms and elevated inflammatory markers, further imaging was performed. Magnetic resonance imaging of the lumbosacral spine and subsequent CT angiography revealed a newly developed saccular aneurysm of the infrarenal abdominal aorta with retroperitoneal hematoma and surrounding lymph node conglomerates. The patient underwent urgent endovascular repair using an aorto-uniiliac stent graft with contralateral iliac occlusion, combined with femoro-femoral crossover bypass. Postprocedural imaging confirmed successful exclusion of the lesion without endoleak. Conclusion. This case highlights a rare vascular complication of SLL/CLL and suggests a possible role of lymphomatous infiltration and inflammation in aortic wall weakening. Hybrid endovascular treatment represents an effective therapeutic option.
Introduction/Objective. This study compared the pharmacodynamics of butylphthalide and sodium chloride (BSC) with those of edaravone dexborneol (ED) in middle-aged and elderly patients with acute cerebral infarction (ACI), focusing on etiology and culprit vessel stratification. Methods. A total of 138 middle-aged and elderly patients with ACI admitted to our hospital from January 2023 to June 2025 were enrolled and randomly assigned to the BSC group (n = 69) and the ED group (n = 69). Both groups received standard ACI treatment; the BSC group received BSC injection (25 mg twice daily), and the ED group received ED injection (30 mg twice daily). The main outcome measures were the National Institutes of Health Stroke Scale (NIHSS) score, modified Rankin Scale (mRS) score, and mean flow velocity (Vm) of the middle cerebral artery before and after treatment. The secondary indices included coagulation-related parameters [platelet count (PLT) and white blood cell (WBC) count] and safety evaluation. Subgroup analyses were based on culprit vessel type (large-vessel / small-vessel disease) and etiologic category (atherosclerotic infarction / cardioembolism). Results. Findings revealed that, compared with the ED group, the BSC group had a significantly lower NIHSS score (p < 0.05) and a significantly higher Vm in the middle cerebral artery, especially in the largevessel disease subgroup (p < 0.05). Coagulation profiles showed that after seven days of treatment, platelet counts were lower in the BSC group compared with the ED group (p < 0.05). In the atherosclerotic infarction subgroup, BSC resulted in lower PLT counts than in the ED group (p < 0.05). Safety assessments indicated comparable adverse event rates and liver/kidney function between the groups (p > 0.05), with no cases of serious bleeding or organ damage. Conclusion. BSC exerts a pathology type-dependent therapeutic effect via its multi-target mechanism (vascular endothelial growth factor-mediated collateral augmentation and platelet-activating factordependent platelet inhibition), demonstrating significant etiology-specific efficacy and supporting its prioritization in large-vessel or atherosclerotic ACI subtypes.
Introduction/Objective. The mandibular foramen (MF) and lingula (ML) are key landmarks on the medial surface of the mandibular ramus. Their position relative to the ramus borders, dentition, and lingula morphology is clinically important for anesthesia and surgical procedures. The study aimed to assess the morphological and morphometric characteristics of MF and ML in relation to ramus borders, alveolar presence, and lingula shape in a Serbian population sample. Methods. The material comprised 50 human dry hemimandibles from the bone collection of the Department of Anatomy, Faculty of Medicine, University of Niš. Distances from MF and ML to the superior, anterior, and posterior ramus borders, temporal crest, and gonion were measured, along with MF diameter and ML height. Hemimandibles were classified by the number of alveoli present (0, 1–4, or 5–8). Lingulae were classified by shape. Measurements were obtained using a digital vernier caliper, and mean values with standard deviations were analyzed by ANOVA. Statistical significance was defined as p < 0.05. Results. The MF–posterior border and ML–posterior border distances (14.49 and 16.03, respectively) were significantly larger in partially edentulous hemimandibles, compared with the dentulous subjects (11.97 and 13.95 mm, respectively). The triangular lingula was most prevalent (48%), followed by truncated (32%), nodular (16%), and assimilated (4%) forms. The ML–gonion distance was significantly greater in mandibles with a truncated vs. triangular lingula (33.37 vs. 27.99 mm). Conclusion. This study suggests considering the posterior ramus distance in partially edentulous patients and the shape of the ML to optimize MF localization for anesthesia and surgery.
Introduction/Objective. The aim of this paper was to evaluate the incremental predictive value of 24- hour serum occludin beyond clinical features and to develop and internally validate a clinically applicable risk prediction model. Methods. This was a single-center prospective cohort study. Patients with spontaneous intracerebral hemorrhage (ICH) presenting within 24 hours of symptom onset were enrolled. The primary outcome, early neurological deterioration (END), was assessed at 72 hours post-admission. Variables for model development were selected using least absolute shrinkage and selection operator regression. A logistic regression model was constructed incorporating clinical and imaging factors and serum occludin levels measured at 24 hours post-admission. Model performance was evaluated using the area under the curve (AUC). Decision curve analysis was used to assess net clinical benefit across different risk thresholds. Results. Among the 600 enrolled patients, 210 (35%) developed END. The base model incorporating age, admission Glasgow Coma Scale score, ICH volume, intraventricular hemorrhage, location, surgical intervention, and systolic blood pressure achieved an optimism-corrected AUC of 0.78 (95% CI: 0.74–0.82). The extended model with added 24-hour serum occludin significantly improved discrimination (AUC = 0.84, 95% CI: 0.81–0.87; ΔAUC = 0.06, p < 0.001), with greater clinical net benefit across threshold probabilities of 10%–40%. Category-free net reclassification improvement was 0.42 (95% CI: 0.28–0.56), and integrated discrimination improvement was 0.08 (95% CI: 0.05–0.11). Risk stratification at 10% and 20% thresholds demonstrated high sensitivity (87%) and specificity (79%) for the identification of the high-risk group. Conclusion. Twenty-four-hour serum occludin significantly enhances predictive performance for END and holds potential as an improved biomarker. However, external validation is necessary before widespread implementation.
Atopic dermatitis is an inflammatory skin disease that is characterized by a chronic-relapsing course and a pronounced feeling of itching. Altered production of structural proteins, lipids and antimicrobial peptides results in epidermal impairment, leading to the early onset of disease, more severe lesions and numerous comorbidities. Atopic dermatitis has recently been recognized as a systemic type 2 inflammation and emerging novel therapeutic modalities reflect sophisticated molecular and immunopathological pathways. The aim of this article is to provide a thorough review of the existing knowledge regarding the most significant immunological aspects of the development and progression of atopic dermatitis.
Introduction/Objective. Health workers are five times more likely to be exposed to workplace violence than other workers are. The goal of this paper is to present an overview of the situation related to violence against health workers and other employees in health institutions, before amendments to the Criminal Code of the Republic of Serbia by the end of 2024. Methods. This cross-sectional study was carried out over a three-month period, from July 10, 2024, to October 10, 2024, in the form of a purpose-designed online survey, voluntarily completed by 125 respondents. Results. The survey showed that 74.4% of participants had experienced violence. Psychological abuse dominated. Verbal abuse was experienced by 68.8% of workers, psychological-nonverbal by 64.4%, and physical violence by 12.8% of participants in the survey. There was no statistically significant difference in experienced workplace violence in relation to sex, place of residence, nationality, marital status, number of children, or level of education, type of specialization, type of institution, presence of security staff, activity on social networks, number of their workplaces, and trade union membership. Workplace violence decreased as the length of service increased. Managers experienced less violence. The dominant cause of violence in general hospitals is communication problems and a patient’s psychological disorder, while in health centers it is the non-acceptance of organizational limitations. Conclusion. We provide proposals that would contribute to the overall prevention of violence at workplaces and to the protection of healthcare workers.
Introduction/Objective. The normal postmenopausal endometrium typically appears thin, homogeneous, and echogenic on transvaginal ultrasonography. In contrast, endometrial carcinoma is often associated with increased thickness, heterogeneous echogenicity, irregular endometrial–myometrial interface, and enhanced Doppler vascularization. The objective of this study was to evaluate the association between heterogeneous endometrial echogenicity and the risk of endometrial malignancy in postmenopausal women. Methods. This prospective clinical study included 120 postmenopausal women treated at the University Clinic for Gynecology and Obstetrics in Skopje. Participants were divided into a control group (n = 40) and an examined group (n = 80). The examined group was further stratified according to uterine bleeding status and endometrial thickness (5–8 mm, > 8–11 mm, and > 11 mm). Endometrial echogenicity was assessed by transvaginal ultrasonography and classified as homogeneous or heterogeneous. Binary logistic regression analysis was performed to determine independent predictors of malignancy. Results. Heterogeneous endometrial echogenicity was significantly more frequent in the examined group compared with controls (p < 0.001). It was identified as an independent predictor of endometrial malignancy (OR = 4.938; 95% CI: 1.24–19.62; p = 0.023). No statistically significant association was observed between echogenicity and endometrial thickness subgroups (p = 0.49) or uterine bleeding status (p = 0.82). Conclusion. Heterogeneous endometrial echogenicity represents a significant independent sonographic predictor of endometrial malignancy in postmenopausal women and should be incorporated into routine ultrasound risk assessment.
Introduction/Objective. Platelet transfusion refractoriness represents a common issue in the treatment course of acute myeloid leukemia (AML) patients who require chronic transfusion support. Antibodies to human platelet antigens could cause immune-mediated transfusion refractoriness. The main goal of this study was to examine the presence and quantity of antibodies to GP IIb/IIIa, GP Ib/IX, and GP Ia/IIa in AML patients refractory to platelet transfusion in comparison to healthy male subjects. Methods. This prospective study involved 22 adult AML patients who demonstrated resistance to platelet transfusion. Antibody titers for the following platelet antigens: GP IIb/IIIa, GP Ib/IX, and GP Ia/IIa were measured in these patients before and two hours after platelet transfusion as well as in healthy male controls. Results. The antibodies to platelet antigens taken before the platelet transfusion were significantly increased in all patients compared with healthy untransfused controls (p = 0.001). In all three groups of antibodies, the titers were significantly higher after platelet transfusion (p = 0.001) than before. There was no statistically significant difference between males and females, platelet sources (buffy-coat vs. apheresis-derived) in the examined initial antibody levels, as well as in the antibody titer increments after the transfusion. No significant correlation between platelet count increment (absolute numbers) and initial levels of antiplatelet antibodies was found. Conclusion. Platelet transfusion refractoriness in AML patients could be caused by the antibodies to platelet antigens, since their levels are significantly higher in the examined patients than in healthy male untransfused controls.
