Clinical Hospital Center Dr Dragisa Misovic Dedinje

Belgrade, Serbia

Clinical Hospital Center Dr Dragisa Misovic Dedinje

Belgrade, Serbia
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Grdinic A.,Clinical Hospital Center Dr Dragisa Misovic Dedinje | Vojvodic D.,Military Medical Academy | Djukanovic N.,Institute for Cardiovascular Diseases | Colic M.,Institute for Cardiovascular Diseases Dedinje | And 7 more authors.
Acta Cardiologica | Year: 2011

Objective This study on responsiveness to clopidogrel and aspirin evaluates its interaction with: (i) patient characteristics; (ii) procedure characteristics; (iii) antiplatelet dose. Methods and results After elective PCI, 60 patients receiving aspirin 100 mg daily, and clopidogrel 75mg daily were monitored with the PFA 100 test and VASP assay. Non-responsiveness to aspirin and clopidogrel was found in 23 (38%) and 18 (30%) of 60 patients, respectively. Seven (12%) patients were dual non- responders. Non-responders to both aspirin and clopidogrel were more often smokers. Non-responders to clopidogrel, in addition had elevated inflammatory markers (P < 0.05). Dual non-responders had (i) a higher platelet count, LDL, and CRP; (ii) a lower HDL (P < 0.05). Clopidogrel non-responders were receiving 150 mg clopidogrel, with a positive response in 72%. Eighty % of non-responders to 150 mg clopidogrel were also non-responders to aspirin. Conclusion Baseline patient characteristics and clopidogrel dose modify the antiplatelet response. Also, patients resistant to both aspirin and clopidogrel do no benefit from an increased clopidogrel dose.


Novakovic M.,University of East Sarajevo | Dejanovic S.D.,University of Kragujevac | Maric-Burmazevic J.,Clinical Hospital Center dr Dragisa Misovic Dedinje | Dakic Z.,Health Center Bijeljina | Dimitrijevic I.,University of Belgrade
Psychiatria Danubina | Year: 2015

Background: Delirium is an urgent condition in psychiatry and it occurs after long-lasting alcohol abuse, in surgical procedures and other organic mental syndromes with deprivation of interpersonal and social stimulations. The aim was to evaluate of sociodemographical and psychopathological differences in delirium patients with alcoholand surgical genesis, studied in period from January 1st 2003 to December 31st 2012 in Bosnia and Herzegovina (B&H). Subjects and methods: Subjects were divided into two groups: alcoholics (N=75) and surgical patients (N=75) and multicentric, prospective study was performed in B&H. The following instruments have been used: list of general data (according to MCD-10 criteria), Eysenck Personality Questionnaire (EPQ), Becks test of anxiety (BAI), Hamilton Depressive Rating Scale (HDRS) and Mini Mental State Examination (MMSE). Descriptive and analytical statistical processing of patients has been performed (alpha level: 0.001). Results: Patients from alcohol group showed, with statistical significance p=0.001, the following: unemployment (OR=0.657, CI 0.540-670), ruined marriage (OR=0.570, CI 0.650-710), alcohol abuse (OR=0.179, CI 0.860-0.990), on represented expressed psychoticism, (OR=0.635, CI 0.550-0.715) in EPQ test, HDRS total was more frequent (OR=0.925, CI 0.870-1.120) and on MMSE test, total score was more frequent (OR=0.560, CI 0.570-810). Postoperative patients were older p=0.001 (OR= 1.120, CI 1.082-1.159) with acutestress: (OR=0.735, CI 0.650-0.910) and showed neuroticism (OR=-0.660, CI 0.575-0.715). Discriminative function confirms the differences between alcohol and surgical groups of delirium patients: Canonical Fcn: r=0.771; Wilkin's lambda (λnj)=0.773 Student's test=57.551 and significance p=0.001; OR=0.760, CI 0.550-0.870. Conclusion: Delirium lasts longer in alcohol group with higher disalienation, depression of cognitive functions with organic lesions of cerebral functions. In surgical patients, delirium is the consequence of older age, acute stress, multi-morbidity, with neuroticism, vegetative disorders (HDRS) and temporary lesion on MMSE test. Delirium state in both groups requires intensive care and multidisciplinary work. © Medicinska naklada.


Sjerobabin N.,Clinical Hospital Center Dr Dragisa Misovic Dedinje | Colovic B.,Vinča Institute of Nuclear Sciences | Petrovic M.,University of Belgrade | Markovic D.,University of Belgrade | And 2 more authors.
Srpski Arhiv za Celokupno Lekarstvo | Year: 2016

Introduction Biodegradable porous scaffolds are found to be very promising bone substitutes, acting as a temporary physical support to guide new tissue regeneration, until the entire scaffold is totally degraded and replaced by the new tissue. Objective The aim of this study was to investigate cytotoxicity of a synthesized calcium hydroxyapatitebased scaffold, named ALBO-OS, with high porosity and optimal topology. Methods The ALBO-OS scaffold was synthesized by the method of polymer foam template. The analysis of pore geometry and scaffold walls’ topography was made by scanning electron microscope (SEM). The biological investigations assumed the examinations of ALBO-OS cytotoxicity to mouse L929 fibroblasts, using 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromidefor (MTT) and lactate dehydrogenase (LDH) tests and inverse phase microscopy. Results The SEM analysis showed high porosity with fair pore distribution and interesting morphology from the biological standpoint. The biological investigations showed that the material is not cytotoxic to L929 cells. Comparison of ALBO-OS with Bio-Oss, as the global gold standard as a bone substitute, showed similar results in MTT test, while LDH test showed significantly higher rate of cell multiplication with ALBO-OS. Conclusion The scaffold design from the aspect of pore size, distribution, and topology seems to be very convenient for cell adhesion and occupation, which makes it a promising material as a bone substitute. The results of biological assays proved that ALBO-OS is not cytotoxic for L929 fibroblasts. In comparison with Bio-Oss, similar or even better results were obtained. © 2016. Srpski Arhiv za Celokupno Lekarstvo. All right reserved.


Dekleva M.,University of Belgrade | Lazic J.S.,Clinical Hospital Center Dr Dragisa Misovic Dedinje | Pavlovic-Kleut M.,Clinical Hospital Center Dr Dragisa Misovic Dedinje | Mazic S.,University of Belgrade | And 4 more authors.
Hypertension Research | Year: 2012

An increase in reactive oxygen species has been implicated in the pathologies of hypertension. This study was designed to evaluate antioxidant activity in hypertensive patients and to assess the relationship between oxidative stress and exercise tolerance in hypertensive patients with mild left ventricular diastolic dysfunction (LVDD). A total of 42 patients, aged 51±9 years, with a long history of hypertension and mild LVDD (mitral flow velocities-E/A 1, deceleration time of E >220 ms, and preserved ejection fraction-EF >50%), and 30 controls without cardiovascular disease, aged 50±7 years, underwent cardiopulmonary exercise testing (CPET). Peak oxygen uptake (peak VO2 ), oxygen pulse (VO2/heart rate (HR)) and ventilatory anaerobic threshold (VAT) were obtained during CPET. Antioxidant activity of superoxide dismutase (SOD) and glutathione peroxidase in the blood was measured before and after exercise. Reduced peak VO2 (1715±426 vs. 2083±465 ml min -1, P(0.001), VO 2/HR (12.0±2.8 vs. 14.6±3.3 ml per beat, P(0.001) and percentage of peak VO2 at VAT (55.5±15.8% vs. 64.5±14.7%, P 0.007) were observed in hypertensive patients, compared with controls. Antioxidant protection was significantly attenuated in hypertensive patients, compared with controls, before (945 vs. 1006, P=0.012) and after exercise (954 vs. 1051, P=0.001). The level of SOD before and after exercise was significantly associated with LVDD in hypertensive patients (P=0.012 and 0.02, respectively). In addition, the degree of LVDD before exercise (E/A) influenced the degree of exercise capability (peak VO2 ) (P0.016). Asymptomatic hypertensive patients with mild LVDD had reduced cardiopulmonary capacity, accurately identified by CPET. The redox state in hypertensive patients was significantly related to LVDD and exercise tolerance. Attenuated antioxidant protection was associated with long-term hypertension. © 2012 The Japanese Society of Hypertension All rights reserved.


Kojic D.,Clinical Hospital Center Dr Dragisa Misovic Dedinje | Vukotic V.,Clinical Hospital Center Dr Dragisa Misovic Dedinje | Boricic I.,University of Belgrade | Babic U.,Clinical Hospital Center Dr Dragisa Misovic Dedinje | And 2 more authors.
Archives of Biological Sciences | Year: 2014

Adenomatoid tumor of the epididymis is a rare benign neoplasm of mesothelial origin, mostly localized in the epididymis. It is usually presented as an indolent, painless scrotal enlargement. Immunohistochemically it is characterized by strong positivity for calretinin and epithelial markers, while tumor marker values are within the reference ranges. In this paper, two cases of 28- and 37-year-old men with adenomatoid tumors of the epididymis are described. In both, the tumor was presented as an indolent, slowly growing palpable mass in the epididymis. Tumor markers were in the normal range, digital examination found painless scrotal enlargement, while ultrasound showed a nonhomogeneous tumor. Immunohistochemically, they were characterized by strong positivity for calretinin and epithelial markers. If a localized epididymal mass is found, it is necessary to conduct an adequate diagnostic examination to differentiate inflammatory process from the neoplasm. An excision of the lesion is the most recommended option that also preserves testicular function and fertility. Histological and immunohistochemical evaluation are mandatory for a definitive diagnosis.


Samardzic J.,University of Belgrade | Jadzic D.,University of Belgrade | Radovanovic M.,University of Belgrade | Jancic J.,University of Belgrade | And 3 more authors.
Srpski Arhiv za Celokupno Lekarstvo | Year: 2013

Introduction The trans-isomer of resveratrol is the active ingredient of Poligonum cuspidatum, known for its medicinal properties and traditionally used in the treatment of neuropsychiatric disorders. It is also found abundantly in the skin of red grapes and red wine. Previous studies have suggested that trans-resveratrol demonstrates a variety of pharmacological activities including antioxidant, anti-inflammatory, as well as neuroprotective properties and procognitive effects. Objective The goal of the present study was to examine the influence of trans-resveratrol on behavior in rats and its antidepressant properties. Methods Male Wistar rats were treated intraperitoneally (i.p.) with the increasing doses of trans-resveratrol (5, 10 and 20 mg/kg) or vehicle (dimethyl sulfoxide - DMSO), 30 minutes before testing of the spontaneous locomotor activity or forced swimming. For the experiments, the behavior of the animals was recorded by a digital camera, and the data were analyzed by one-way ANOVA, followed by Tukey post-hoc test. Results Testing of spontaneous locomotor activity, after the application of vehicle or increasing doses of trans-resveratrol, showed no statistically significant difference between groups (p>0.05). In the forced swim test, one-way ANOVA indicated statistically significant effects of trans-resveratrol (p<0.001). Tukey post-hoc test showed that resveratrol significantly decreased immobility time at the doses of 10 mg/kg and 20 mg/kg, manifesting the acute antidepressant-like effects. There were no statistically significant differences between the resveratrol treatment of 5 mg/kg and vehicle (p>0.05). Conclusion The results from our study suggest that transresveratrol produces significant effects in the central nervous system. After single application, it has acute antidepressant effects, but without influence on locomotor activity.


Ignjatovic V.S.,Clinical Center Kragujevac | Petrovic N.,Clinical Center Kragujevac | Miloradovic V.,Clinical Center Kragujevac | Ignjatovic S.,Medical Faculty Kragujevac | And 8 more authors.
Coronary Artery Disease | Year: 2010

Purpose: Dual antiplatelet therapy is recommended after acute coronary syndrome or after percutaneous coronary intervention with coronary stent implantation. Many of the patients on dual antiplatelet therapy receive β-blockers; some of them could have antiaggregatory effect. Bisoprolol is a highly selective adrenoceptor-blocker, which is often used in the settings of percutaneous coronary intervention or acute coronary syndrome in patients on dual antiplatelet therapy. Its antiaggregative effect has not been extensively studied. Therefore, the aim of this study is to investigate the effect of bisoprolol on ADP-induced platelet aggregation in patients on dual antiplatelet therapy. Methods: Platelet aggregability has been measured in 100 patients on dual antiplatelet therapy with multiplate analyzer using ADP test in blood samples anticoagulated with heparin. ADP test values have been expressed by arbitrary units/minute. In univariate and multivariate regression analyses, we have investigated the influence of bisoprolol and its dose and also different factors, such as risk factors, concomitant drugs and their dosage, laboratory findings, on ADP test values. Results: Univariate regression analysis showed significant correlation between the bisoprolol dose and the ADP test value (P=0.046, B=52.55, 95% confidence interval 0.87-104.23), which was also shown in the multivariate regression analysis (P=0.018; B=57.011; 95% confidence interval 10.455-103.567). Conclusion: We have identified a positive correlation between bisoprolol dose and ADP-induced platelet aggregability in patients on dual antiplatelet therapy. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Zeljkovic V.,Prince Mohammad Bin Fahd University | Bojic M.,Clinical Hospital Center Dr Dragisa Misovic Dedinje
2011 1st Middle East Conference on Biomedical Engineering, MECBME 2011 | Year: 2011

We propose in this paper automatic algorithm for early planocellular lung cancer detection in lung X ray images. Considering the fact that lung cancer is one of the most lethal cancers and that it is usually diagnosed too late, the solution is to attempt early diagnosis at general practitioners level, using cheapest diagnostic tools, chest radiography. The proposed algorithm determines and segments the suspected area in lung X ray images. It consists of two steps: comparison between extracted planocellular lung cancer structure and the analyzed lung X ray image by calculating similarity coefficients and finding the maximum similarity coefficient which will indicate the suspected cancer affected area in the lung image. The obtained results are promising and confirm that the proposed algorithm should serve as the foundation for future research in this area. © 2011 IEEE.


Zeljkovic V.,New York Institute of Technology | Druzgalski C.,California State University, Long Beach | Yequn L.,New York Institute of Technology | Jian C.,New York Institute of Technology | And 3 more authors.
Pan American Health Care Exchanges, PAHCE | Year: 2013

Epilepsy poses a significant burden to society due to associated healthcare costs to treat and control the unpredictable and spontaneous occurrence of seizures. There is a need for a quick screening process that could help neurologists diagnose and determine the patient's treatment. Electroencephalogram has been traditionally used to diagnose patients by evaluating brain functions that might correspond to epilepsy. This research focuses on developing a new classification technique and the prediction of pre-ictal states that announce epileptic seizures, from the direct EEG data analysis. The approach involves the placement of electrodes on critical regions on the patient's head as a part of a telemetry system which communicates with the EEG recorder and the DSP unit that performs automated pre-ictal state detection based on the obtained EEG signal. Studying potential preconditions and alerting the patient about a possible seizure attack so that s/he can take safety precautions has a potential to improve patient care management. © 2013 IEEE.


PubMed | Clinical Hospital Center Dr Dragisa Misovic Dedinje
Type: Journal Article | Journal: Acta cardiologica | Year: 2011

This study on responsiveness to clopidogrel and aspirin evaluates its interaction with: (i) patient characteristics; (ii) procedure characteristics; (iii) antiplatelet dose.After elective PCI, 60 patients receiving aspirin 100 mg daily, and clopidogrel 75 mg daily were monitored with the PFA 100 test and VASP assay. Non-responsiveness to aspirin and clopidogrel was found in 23 (38%) and 18 (30%) of 60 patients, respectively. Seven (12%) patients were dual nonresponders. Non-responders to both aspirin and clopidogrel were more often smokers. Non-responders to clopidogrel, in addition had elevated inflammatory markers (P < 0.05). Dual non-responders had (i) a higher platelet count, LDL, and CRP; (ii) a lower HDL (P < 0.05). Clopidogrel non-responders were receiving 150 mg clopidogrel, with a positive response in 72%. Eighty % of non-responders to 150 mg clopidogrel were also non-responders to aspirin.Baseline patient characteristics and clopidogrel dose modify the antiplatelet response. Also, patients resistant to both aspirin and clopidogrel do no benefit from an increased clopidogrel dose.

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