Background/Aim. Older adults with oropharyngeal dysphagia (OD) residing in nursing homes without clinical guidance may spontaneously adopt compensatory strategies through adjustments in eating and swallowing. However, evidence regarding the spontaneous emergence of head flexion (HF) and postural adaptations remains limited. The aim of the study was to investigate adaptive head posture and trunk sway (TS) during swallowing in older adults screening positive for OD (spOD). Methods. Based on the presence of a swallowing disorder determined by the 100 mL water swallow test, a total of 45 older adults were classified into two groups: a group with spOD (spOD group) and a group without spOD (non-spOD group). Head posture was assessed using a smartphone-based accelerometer, and TS was evaluated with a Swaymeter. Data were analyzed using image processing techniques. Group comparisons were performed using multivariate analysis of covariance – MANCOVA with Bonferroni correction, followed by a confirmatory multivariable linear regression. Semi-structured interviews were conducted with the spOD group to explore their recognition of spontaneous strategies. Results. The spOD group (n = 21) showed significantly greater maximum HF during swallowing compared to the non spOD group (n = 24) (p = 0.0002). No significant group differences were observed in TS parameters (p > 0.00625). Linear regression indicated a positive association between spOD and maximum HF: B = 13.46, 95% confidence interval: 6.50–20.41, p < 0.001. In interviews, the participants reported various conscious strategies (e.g., small bites, water use, breath holding), but none mentioned HF or trunk sway. Conclusion. Despite the HF and TS results obtained in older individuals, this cross sectional study cannot determine whether HF serves a compensatory function or is merely associated with OD. Therefore, no clinical recommendations can be drawn from these findings.
Hashimoto’s thyroiditis (HT) and human papillomavirus (HPV)-induced cervical cancer (CC) are distinct clinical entities; however, their etiologies share several pathogenetic mechanisms related to immune dysregulation, endocrine disturbances, and chronic inflammation. HT is an autoimmune disease characterized by lymphocytic infiltration of the thyroid gland, autoantibody production, and progressive tissue damage resulting from a persistent inflammatory response. In contrast, the development of HPV-induced CC depends on the virus’s ability to evade host immune surveil-lance, thereby enabling long-term persistence of the infection. Increasing evidence suggests a potential role of other viral infections, particularly Epstein-Barr virus and hepatitis C virus, in the development of autoimmune thyroid diseases. The underlying mechanisms include chronic inflammation, molecular mimicry, and impaired immune tolerance. Furthermore, thyroid hormones and the sex hormones estrogen and progesterone play a significant role in modulating innate and adaptive immune responses and may influence the persistence of viral infections. Although there is an overlap in the immunological and endocrine mechanisms involved in these conditions, current evidence remains in-sufficient to confirm a direct association between HT and an increased risk of developing CC. Further experimental and epidemiological studies are required to elucidate the potential relationship between HT and HPV-induced CC.
Introduction. Congenital cholesteatoma (CC) is a rare pathological condition of the middle ear characterized by keratinizing squamous epithelium located behind an in-tact tympanic membrane. Bilateral involvement is exceptionally uncommon and may present a significant diagnostic challenge, particularly in the absence of inflammatory symptoms. Case report. We present the case of a 19-year-old male with a 4-year history of gradually progressive bilateral hearing loss accompanied by tinnitus and otalgia, without otorrhea or prior otologic disease. Otomicroscopy revealed a pearly white mass visible through intact tympanic membranes bilaterally. Pure-tone audiometry identified severe bilateral conductive hearing loss. Multislice computed tomography of the temporal bones revealed bilateral soft-tissue masses within the middle ear cavities, along with associated ossicular erosion. Bilateral tympanomastoidectomy with ossiculoplasty was performed, and CC occupying the mesotympanum and epitympanum was confirmed intraoperatively. Postoperative follow-up with non-echo-planar diffusion-weighted magnetic resonance imaging, performed 2 years after surgery, showed no evidence of residual or recurrent disease. Conclusion. This case emphasizes the importance of considering CC in adolescents and young adults presenting with bilateral severe conductive hearing loss and intact tympanic membranes. Advanced imaging is essential for accurate diagnosis and timely surgical management, even in the absence of classic inflammatory signs.
Background/Aim. Posterior tibial tendon (PTT) entrapment is a rare, often underdiagnosed, but severe complication of complex ankle fractures. The aim of the study was to determine the characteristics of PTT entrapment in elderly patients with ankle fractures, and to establish a predictive model based on preoperative available clinical and imaging data. Methods. The study enrolled a total of 130 elderly patients treated between 2019 and 2024. Data were retrospectively analyzed, and all patients completed a minimum follow-up period of 12 months. Using intraoperative confirmation as the gold standard, a basic clinical logistic regression (LR) model was compared with an imaging-enhanced LR model (incorporating fracture fragment count and PTT sheath involvement), a random forest (RF) model, and a support vector machine (SVM). Performance was validated via 5-fold cross-validation, area under the receiver operating characteristic (ROC) curve (AUC), calibration, and decision curve analysis (DCA). Results. PTT entrapment occurred in 29.2% (38/130) of patients, primarily located in the posterior fracture gap (68.4%) or medial malleolus (31.6%). Morphological findings included simple mechanical incarceration (50.0%), soft tissue adhesion (36.8%), and tendon surface injury (13.1%). The imaging-enhanced LR model significantly outperformed the basic model (AUC 0.89 vs. 0.72) and exceeded RF (0.85) and SVM (0.88) models. DCA demonstrated high net benefit across risk levels, and intraoperative findings showed high consistency with imaging-based predictions. Conclusion. PTT entrapment is common in elderly ankle fractures. An imaging-enhanced predictive model based on preoperative computed tomography fracture morphology and local anatomy enables effective risk assessment, providing a reliable reference for targeted intraoperative exploration and surgical management strategies.
Antituberculosis drug-induced liver injury (ATB-DILI) is one of the most significant adverse effects of first-line tuberculosis therapy and a leading cause of treatment discontinuation. Hepatotoxicity associated with isoniazid, rifampicin, and pyrazinamide may substantially impair treatment adherence, prolong treatment duration, and, in severe cases, lead to acute liver failure. This paper provides an overview of contemporary trends in the epidemiology, pathogenesis, diagnosis, and management of ATB-DILI, with particular emphasis on clinically relevant aspects and ongoing controversies. The underlying mechanisms of ATB-DILI origin involve complex interactions between drug metabolism, genetic susceptibility, oxidative stress, mitochondrial dysfunction, and immune-mediated injury, with emerging evidence suggesting a potential role of ferroptosis. Diagnosis relies on biochemical and clinical criteria, the exclusion of alternative causes, and causality assessment tools, such as the Roussel Uclaf Causality Assessment Method – RUCAM scale. Early recognition and timely discontinuation of hepatotoxic agents are of paramount importance, while optimal strategies for treatment reintroduction and the role of hepatoprotective agents are still not fully defined. A better understanding of risk factors and mechanisms, alongside the development of predictive biomarkers and pharmacogenetic approaches, may enable more individualized and safer tuberculosis treatment.
Background/Aim. Discovering rapid and efficient biomarkers to predict the occurrence of acute respiratory distress syndrome (ARDS) is crucial for guiding subsequent treatment in patients with severe pneumonia (SP). The aim of this study was to determine the predictive value of the combination of the lung ultrasound score (LUS), the extravascular lung water index (EVLWI), and the C-reactive protein (CRP)/procalcitonin (PCT) ratio for predicting ARDS in patients with SP. Methods. The study included a total of 240 patients treated from January 2023 to January 2025, divided into two groups: a control group (n = 120) comprising patients with mild pneumonia and a research group (n = 120) comprising patients with SP. Comparisons of LUS, EVLWI, and CRP/PCT ratio were performed between the groups. The research group was further divided into an ARDS group (AG) and a non-ARDS group (N-AG). Results. Out of the 120 patients with SP, ARDS was registered in 20 (16.67%). The patients in AG exhibited significantly higher values of LUS, EVLWI, and CRP/PCT ratio in comparison to the N-AG patients (p < 0.05). In patients with SP, LUS, EVLWI, and CRP/PCT ratio positively correlated with the occurrence of ARDS (r > 0, p < 0.05) and were identified as independent risk factors for ARDS development (odds ratio > 1, p < 0.05). The areas under the receiver operating characteristic curve of LUS, EVLWI, CRP/PCT ratio, and their combination for predicting the occurrence of ARDS in patients with SP were 0.713, 0.739, 0.731, and 0.925 respectively (95% confidence interval: 0.867–0.983), with the combined model incorporating all three parameters showing the highest predictive performance. Conclusion. In patients with SP, LUS, EVLWI, and CRP/PCT ratio were elevated and were closely associated with the occurrence of ARDS.
Background/Aim. Measuring psychological safety in the workplace is essential for creating an environment where individuals feel safe expressing themselves, thereby promoting optimal patient care. The aim of the study was to develop a reliable and concise scale with preliminary psychometric properties to measure psychological safety in community pharmacies. Methods. After scale development through content and face validity, a cross-sectional study was conducted in which data were collected from 216 community pharmacists. A test-retest component was subsequently performed on 32 pharmacists at baseline and after three months to assess the temporal stability of the scale. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), the Wilcoxon signed-rank test, and Spearman’s correlation coefficient (ρ) were used to evaluate the scale’s reliability, construct validity, and stability. Results. The scale was developed through multiple iterations: Version 1 (32 items), Version 2 (26 items), and Version 3 (15 items), all of which demonstrated high content and face validity (indices > 0.80) and internal consistency (Cronbach’s alpha = 0.92). Version 4 (10 items) was established through CFA, which suggested excluding certain items, resulting in excellent reliability (Cronbach’s alpha = 0.89) and fit parameters: χ2(35) = 65.81; p < 0.001; goodness of fit index – GFI = 0.94; comparative fit index – CFI = 0.97; Tucker-Lewis index – TLI = 0.96; root mean square error of approximation – RMSEA = 0.064; standardized root mean square residual – SRMR = 0.040. During psychometric evaluation, EFA revealed a one-factor structure, with the primary component explaining nearly 50% of the variance. The Wilcoxon signed-rank test indicated no significant difference in mean scores between baseline [mean = 50.72, standard deviation (SD) = 12.93] and retest after three months (mean = 50.69, SD = 12.59). Additionally, Spearman’s correlation coefficients showed strong correlations between baseline and three-month scores (ρ = 0.994; p < 0.001). Conclusion. The findings indicate promising preliminary psychometric properties, supporting the use of the developed scale to assess psychological safety perceptions in community pharmacies. However, further validation, including criterion, convergent, and discriminant validity testing, is required.
Background/Aim. Polycystic ovary syndrome (PCOS) is a common gynecological disorder in women of reproductive age. Depression is a common PCOS-related comorbidity that affects women’s mental state. Although vitamin D deficiency (VDD) has been associated with affective dysregulation through immuno-inflammatory and neuroendocrine pathways, evidence in PCOS remains limited. The aim of this study was to determine the relationship between serum 25-hydroxyvitamin D [25(OH)D] deficiency and Beck Depression Inventory (BDI) scores in women with PCOS. Methods. This cross-sectional study included 80 women with PCOS who completed the BDI on the same day when their fasting serum 25(OH)D levels were measured. Multivariable models were prespecified to compare depressive symptom (DS) severity across vitamin D status, adjusting for key confounders such as age, body mass index, sea-son, and insulin resistance. Results. Women with VDD experienced a greater burden of DSs than women without VDD (p < 0.05). This association persisted after adjusting for covariates in sensitivity analyses. Conclusion. Among women with PCOS, VDD was associated with greater DS severity. However, causal relationships cannot be established, and further longitudinal and interventional studies are needed.
Background/Aim. Although the global prevalence of smoking has been steadily declining, aggregate trends conceal substantial regional differences across Europe, as well as socioeconomic and education-level inequalities. The aim of this study was to assess the widening regional and educational inequalities in smoking prevalence in Europe and de-lineate structural barriers to tobacco control against the backdrop of aggregate trends. Methods. Using European Statistical Office (Eurostat) data from 32 countries (2014–2019), daily smoking rates, indoor environmental tobacco smoke exposure, and smoking intensity were analyzed. To account for demographic differences, European averages were calculated using population-weighted means. Pearson correlations and multivariate regression models were utilized to examine country-level associations between educational attainment indices and smoking outcomes. Results. While the weighted European Union (EU) average for daily smoking declined slightly, regional divergence intensified. Nordic countries maintained the lowest prevalence (~12%), whereas Eastern European nations and Türkiye (~27–29%) exhibited stagnation or increases. A strong country-level educational gradient persisted; nations with higher tertiary attainment rates exhibited significantly lower aggregate smoking prevalence. Marked cross-country differences in indoor secondhand smoke exposure were observed; daily indoor tobacco smoke exposure exceeded 19% in countries such as Greece and Croatia but remained below 3% in Finland. Conclusion. The decline in smoking has stalled in structurally disadvantaged regions, supporting the “hardening hypothesis” (the phenomenon where the remaining smoker population becomes more resistant to quitting) at the macro level. Generic tobacco control measures are losing efficacy. To bridge the widening health equity gap, future interventions must target high levels of heavy smoking and the enforcement of smoke-free environments in lagging regions.
Background/Aim. Center-involved diabetic macular edema (CI-DME) is a major cause of vision loss in diabetes mellitus, characterized by retinal thickening (1 mm) in the central foveal zone. Intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents, such as aflibercept, are widely used to treat retinal edema and improve visual outcomes. The aim of the study was to evaluate anatomical and functional changes of the retina following intravitreal administration of aflibercept in patients with CI-DME. Methods. This retrospective longitudinal cohort study included 70 eyes in 50 patients with optical coherence tomography (OCT)- confirmed CI-DME [with central foveal thickness (CFT) ≥ 350 μm and best-corrected visual acuity (BCVA) ≥ 0.6 Snellen], treated with three monthly aflibercept injections. BCVA, CFT, and macular volume (MV) were measured using the Optovue RTVue XR OCT device at baseline and after 1, 3, and 6 months of treatment. Results. Mean patient age was 64.63 ± 7.79 years. Hypertension was the most prevalent comorbidity (72.0%). Over the six-month follow-up period, significant reductions were observed in mean CFT (459.00 μm to 379.92 μm, p < 0.001) and MV (9.05 mm³ to 8.44 mm³, p < 0.001) values. Although BCVA showed modest improvement, it did not reach statistical significance. Anatomical improvements align with aflibercept’s inhibition of VEGF-A and placental growth factor, which reduced vascular permeability. Conclusion. Intravitreal aflibercept significantly decreases retinal thickness and MV in patients with CI-DME, confirming its anatomical efficacy. Functional visual improvement was limited, possibly due to chronic retinal damage. In order to clarify the effect of intravitreal aflibercept on visual outcomes, longer-term studies with larger patient cohorts are required.
Background/Aim. Exacerbation of Mycoplasma pneumoniae pneumonia (MPP) in children commonly manifests as severe or refractory disease. The aim of this study was to evaluate the predictive value of the dynamic percentage change in C-reactive protein – CRP (ΔCRP%) and immunoglobulin (Ig) G1 subclass for the exacerbation of MPP in children, and to determine whether their incorporation into the basic prediction model improves the prediction of disease exacerbation. Methods. This retrospective study included hospitalized pediatric patients diagnosed with MPP between 2020 and 2023, who were enrolled and stratified according to the occurrence of MPP exacerbation. Baseline clinical characteristics, laboratory parameters, serial CRP measurements (at 0 and 72 hrs), and IgG1–IgG4 subclass levels were collected. According to the predicted probabilities generated by the enhanced model, patients were categorized into three risk groups: low-risk (< 0.20), medium-risk (0.20–0.35), and high-risk (≥ 0.35). Results. Among the 512 pediatric patients, 110 (21.5%) experienced MPP exacerbation. Multivariate analysis identified fever duration, bilateral lung involvement, decreased lymphocyte percentage, elevated lactate dehydrogenase, increased D-dimer, higher ΔCRP% (per 10 percent-age-point increase), and low IgG1 levels as independent predictors (p < 0.05). The enhanced model demonstrated superior discriminative performance, with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.873, significantly higher than that of the basic model (0.792; p = 0.004). Risk stratification analysis showed a progressive increase in the observed exacerbation rate across the low-, medium-, and high-risk groups (approximately 10%, 30%, and 50%, respectively). Conclusion. Both ΔCRP% and low IgG1 levels are independent predictors of MPP exacerbation in children. The incorporation of these markers significantly improves the model’s discrimination, calibration, and clinical utility for predicting the risk of disease progression.
Background/Aim. Although prosthodontic rehabilitation restores the structural integrity of the stomatognathic system, its impact on patients’ oral health–related quality of life (OHRQoL) remains insufficiently explored, particularly within the military population. The aim of this study was to evaluate the association between the type of prosthetic rehabilitation and OHRQoL, with a specific focus on functional, esthetic, and psychosocial dimensions, as well as to investigate the relationship between these findings and objective oral health indicators. Methods. A cross-sectional study was conducted to assess patient-reported outcomes using the Oral Health Impact Profile-14 (OHIP-14) questionnaire. The study included active duty personnel of the Serbian Armed Forces with natural dentition, as well as personnel with fixed or removable prostheses. Dental status was evaluated through comprehensive clinical examinations conducted by two experienced examiners. Biological parameters included the Caries Activity Factor (CAF) index, the Community Periodontal Index of Treatment Needs (CPITN), the plaque index (PI), and the gingival index (GI). Chronic systemic disease was recorded and included as a covariate in the analyses. Nonparametric statistical tests and multivariable regression analyses were employed to identify independent predictors of OHRQoL. Results. Participants with prostheses reported significantly higher OHIP-14 scores than those with natural dentition (p < 0.0001). No significant differences were observed between fixed and removable prostheses in overall OHIP-14 scores, except within the functional limitation domain, in which fixed prostheses demonstrated a measurable advantage. Multivariable analysis identified oral status, CAF and CPITN indices, and the presence of chronic systemic diseases as independent predictors of OHRQoL, whereas PI, GI, and age were not statistically significant after adjustment. Conclusion. According to the results of this study, prosthetic rehabilitation is associated with improved functional outcomes, but it did not fully alleviate the psychosocial burden associated with tooth loss. The severity of biological oral diseases and general health status were significant predictors of OHRQoL, suggesting that these factors may influence overall quality of life.
Introduction. Hydatid cysts are most often found in the liver and lungs, while other locations are rarely involved. Pleural hydatidosis, whether primary or secondary, is rarely seen in clinical practice. Case report. In this article, we present a case of a 33-year-old woman who presented with cough and dyspnea. Initial chest X-ray showed a large right-sided pleural effusion. Pleural hydatidosis was suspected based on the findings of the computed tomography scan of the chest. Right thoracotomy and cystectomy were performed. Albendazole was administered postoperatively for 6 months, and during this period, liver function tests and abdominal ultrasonography showed no abnormalities. Conclusion. This case emphasizes that pleural hydatidosis should be suspected in patients with pleural effusions and large cystic formations found on imaging, especially in endemic areas.
Background/Aim. Bone-anchored hearing aids (BAHA®) are implantable devices that transmit sound through bone conduction directly to the inner ear. They are indicated for patients with conductive or mixed hearing loss who cannot benefit from conventional hearing aids. The aim of this study was to evaluate surgical outcomes, post-operative complications, and audiological improvements following percutaneous and transcutaneous BAHA® implantation in a pediatric cohort. Methods. A retrospective cohort study was carried out on 20 children who underwent BAHA® implantation between 2011 and 2024. Demographic data, clinical indications, syndromic associations, audiological findings, and postoperative complications were analyzed. Statistical analyses included Fisher’s exact test and the Wilcoxon signed-rank test, with significance set at p < 0.05. Results. Out of the total of 20 patients (60% male; mean age 6.3 years), 11 received perctaneous and 9 transcutaneous BAHA® devices. The primary indications were congenital anomalies (50%), notably Treacher-Collins syndrome and isolated atresia. In patients with a percutaneous BAHA® device, skin infections were recorded in 3 (27%) of 11 patients, and they were accompanied by skin overgrowth, which required revision surgery in 2 (18%) patients. In the group implanted with the transcutaneous BAHA® Attract device, paresthesia and skin erythema were observed in one case each. The mean hearing improvement was 36.6 dB with percutaneous BAHA® devices and 31.7 dB with BAHA® Attract devices at 0.5 kHz, 1 kHz, 2 kHz, and 4 kHz. Significant postoperative hearing improvement was achieved in all patients (p = 0.0002). Conclusion. BAHA® implantation provides significant hearing rehabilitation in children with conductive or mixed hearing loss. The transcutaneous system demonstrates comparable audiological outcomes with fewer complications and superior cosmetic acceptability compared to the percutaneous system.
I. Тhe article “Clinical and laboratory status in Parkinson’s disease patients with and without polyneuropathy“ published in the October 2024 print issue of the Vojnosanitetski pregled (Vojnosanit Pregl 2024; 81(10): 613-8; https://doi.org/10.2298/VSP240528061P) by Sanela Popović, Nemanja Popović, Dragica Hajder, Smiljana Kostić, Aleksandra Lučić Prokin, contains error with respect to the e-mail address of the corresponding author Sanela Popović. Instead of the existing e-mail address sanela_bozic@yahoo.com, it should be sanela.popovic@mf.uns.ac.rs. This article was corrected Online 1. 1. Popović S, Popović N, Hajder D, Kostić S, Lučić Prokin A. Clinical and laboratory status in Parkinson’s disease patients with and without polyneuropathy. Vojnosanit Pregl 2024; 81(10):613-8. (https://doi.org/10.2298/VSP240528061P). Available at the web-site: https://www.vsp.mod.gov.rs/eng/clanak/1644 Link to the corrected article 10.2298/VSP240528061P
Hematopoietic stem cell transplantation (HSCT) has been the therapy of choice for treating some hematologic malignancies and selected non-malignant disorders for decades. With the introduction of novel immunotherapeutic and cell-mediated approaches, the role of autologous HSCT (auto-HSCT) and allogeneic HSCT (allo-HSCT) should be redefined. Auto-HSCT remains the standard of treatment for multiple myeloma, Hodgkin’s lymphoma, and non- Hodgkin’s lymphoma. The use of novel agents, including proteasome inhibitors, immunomodulatory drugs, mono-clonal and bispecific antibodies, enhances the intensity and efficacy of the therapeutic response and opens debate on an optimized timing for HSCT. Allo-HSCT represents the most effective type of adoptive immunotherapy, ensuring complete and long-term hematopoietic reconstitution, often accompanied by the graft-versus-leukemia effect. It remains the main curative treatment for acute leukemias, high-risk myelodysplastic and myeloproliferative syndromes, and severe aplastic anemia. Improvements in stem cell (SC) donor selection, ex vivo manipulations of harvested cells, and graft engineering with superior immune monitoring have broadened and expanded their applicability, while improving safety and clinical outcome. Despite rapid progress in cellular and other immunotherapies, HSCT continues to play an essential role in the treatment of numerous hematologic disorders. A combination of HSCT with novel drugs and other immunotherapies offers the potential for personalized and safer treatment with long-term positive clinical outcomes, ensuring that HSCT remains a highly relevant method in modern medicine. The aim of this re-view was to summarize current biological concepts of SCs, as well as important advances in the rapidly developing fields of SC research, and to determine the place and efficacy of HSCT nowadays, in the era of new therapeutic approaches and agents.
Introduction. Pulmonary actinomycosis is a chronic inflammatory infectious disease caused by anaerobic and/or microaerophilic bacteria of the genus Actinomyces spp. It causes non-specific symptoms in the patient and gives an atypical clinical and radiographic presentation. It is extremely rare and is characterized by the formation of abscesses and fistulas in the lungs or local fibrosis. In the differential diagnosis, diseases and pathological conditions from tuberculosis to neoplastic processes in the lungs must be considered. Case report. We present a 39-year-old patient with an infiltrative lesion in the apex of the right lung and non-specific symptoms. In this patient, actinomycosis was pathohistologically proven after surgical intervention. Within a period of just over a month, a multi-detector computed tomography of the chest and bronchoscopy with transbronchial biopsy and bronchial swab were performed twice. Initially, pulmonary actinomycosis was not suspected. After an atypical resection of the tumor mass in the apex of the right lung and histopathologically proven infection, the patient was treated with antibiotic therapy for 6 months. Further examination was carried out to prove a potential primary or secondary immunodeficiency. Conclusion. Patients with non-specific changes in the lung parenchyma should also be suspected of having actinomycosis, and after diagnosis, it is necessary to supplement the examination to confirm or exclude immunodeficiency.
Background/Aim. Visceral artery aneurysms (VAAs) are rare but potentially life-threatening conditions. With the increasing availability of diagnostic and therapeutic options, there is a growing need to determine the optimal treatment approach–endovascular (EV) vs. open surgical (OS) reconstruction. The aim of this study was to analyze treatment outcomes in patients with VAA at a single center and compare the efficacy of EV and OS approaches. Methods. The study included 27 OS (the OS group) or EV (the EV group) interventions for VAA, performed at our institution from January 2010 to November 2023, on 27 patients, 13 males and 14 females, with a mean age of 57 ± 13 years. Treatment decisions were reached by a multidisciplinary team of a vascular surgeon, an anesthesiologist, and an interventional radiologist. Results. Out of the 27 patients, 9 were treated in the emergency setting, with 6 of them having ruptured aneurysms. The most common was a splenic artery aneurysm, 50.0% of all VAAs. Thirteen patients underwent EV reconstruction, one patient underwent a hybrid approach, and 13 patients had OS reconstruction. Technical success was 24/27 or 88.9%. Eleven patients were treated by coil embolization, while two were treated with the implantation of a covered stent. In the EV group, mortality was nil. In 14 patients, OS treatment was performed with 9 VAA resections and arterial reconstructions (7 with Dacron graft, 1 with polytetrafluoroethylene graft, and 1 with autovenous graft), with 2 splenectomies and 3 aneurysm exclusions. Two patients died intraoperatively due to severe bleeding, and one after the procedure because of intestinal ischemic complications. Mean duration of hospitalization after OS or EV procedure was 7.43 and 4.92 days, respectively. Conclusion. Treating patients using the EV approach is safe, with less invasiveness and shorter hospital stays, suitable for elective and emergency cases when technically feasible. OS remains a reliable option at high-volume centers, particularly for complex cases unsuitable for EV approaches or in low-risk patients. Treatment decision should be guided by VAA characteristics (size, symptoms, location, morphology), patient comorbidities, and specific clinical context, such as prior abdominal surgeries.
Background/Aim. Interest in the effects of electromagnetic fields on the human organism has grown significantly with the advent of digital mobile communication systems, which employ pulsed high-frequency electromagnetic fields. In standby mode, a mobile phone does not emit significant signal power, while during active communication, the intensity of the electromagnetic field may reach values of up to 250 mW. The aim of this study was to examine whether exposure to high-frequency electromagnetic fields affects the frequency of electroencephalography (EEG) waves. Methods. The study included 60 participants (30 males and 30 females). Each participant underwent two consecutive EEG recordings, each lasting approximately 20 min. The first EEG recording was performed at rest, without exposure to an electromagnetic field generator. This was followed by a second EEG recording while using a mobile phone for 10 minutes on one ear, then a break of about 2 minutes was made and the recording was repeated on the opposite ear, also for 10 minutes. A standard mobile phone was used as the source of the high-frequency electromagnetic field. Results. The analysis of EEG wave frequencies revealed no statistically significant differences in either sex before and after mobile phone exposure in the alpha, beta, or delta frequency bands. A change in the theta frequency band in female participants following mobile phone exposure was localized to the right hemisphere. Conclusion. Methodological limitations are the most likely reason for the absence of recorded changes in the majority of participants. The observed effects may be sufficiently subtle or infrequent to evade detection by standard EEG recordings. Therefore, the lack of observed changes cannot be interpreted as evidence that high-frequency electromagnetic fields have no effect on EEG activity.
