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Milutinovic D.,University of Novi Sad | Andrijevic I.,University of Novi Sad | Andrijevic I.,The Institute for Pulmonary Diseases of Vojvodina | Licina M.,University of Novi Sad | And 2 more authors.
Biochemia Medica

Introduction: This study aimed to assess confidence level of healthcare professionals in venipuncture and their knowledge on the possible causes of in vitro hemolysis. Materials and methods: A sample of 94 healthcare professionals (nurses and laboratory technicians) participated in this survey study. A four-section questionnaire was used as a research instrument comprising general information for research participants, knowledge on possible causes of in vitro hemolysis due to type of material used and venipuncture technique and specimen handling, as well as assessment of healthcare professionals’ confidence level in their own ability to perform first and last venipuncture. Results: The average score on the knowledge test was higher in nurses’ than in laboratory technicians (8.11 ± 1.7, and 7.4 ± 1.5, respectively). The difference in average scores was statistically significant (P = 0.035) and Cohen’s d in the range of 0.4 indicates that there is a moderate difference on the knowledge test among the health care workers. Only 11/94 of healthcare professionals recognized that blood sample collection from cannula and evacuated tube is method which contributes most to the occurrence of in vitro hemolysis, whereas most risk factors affecting occurrence of in vitro hemolysis during venipuncture were recognized. There were no significant differences in mean score on the knowledge test in relation to the confidence level in venipuncture (P = 0.551). Conclusion: Confidence level at last venipuncture among both profiles of healthcare staff was very high, but they showed insufficient knowledge about possible factors affecting hemolysis due to materials used in venipuncture compared with factors due to venipuncture technique and handling of blood sample. © Croatian Society of Medical Biochemistry and Laboratory Medicine. Source

Kojicic M.,Rochester College | Kojicic M.,The Institute for Pulmonary Diseases of Vojvodina | Li G.,Rochester College | Li G.,Chinese Academy of Sciences | And 9 more authors.
Critical Care

Introduction: Although pneumonia has been identified as the single most common risk factor for acute lung injury (ALI), we have a limited knowledge as to why ALI develops in some patients with pneumonia and not in others. The objective of this study was to determine frequency, risk factors, and outcome of ALI in patients with infectious pneumonia.Methods: A retrospective cohort study of adult patients with microbiologically positive pneumonia, hospitalized at two Mayo Clinic Rochester hospitals between January 1, 2005, and December 31, 2007. In a subsequent nested case-control analysis, we evaluated the differences in prehospital and intrahospital exposures between patients with and without ALI/acute respiratory distress syndrome (ARDS) matched by specific pathogen, isolation site, gender, and closest age in a 1:1 manner.Results: The study included 596 patients; 365 (61.2%) were men. The median age was 65 (IQR, 53 to 75) years. In total, 171 patients (28.7%) were diagnosed with ALI. The occurrence of ALI was less frequent in bacterial (n = 99 of 412, 24%) compared with viral (n = 19 of 55, 35%), fungal (n = 39 of 95, 41%), and mixed isolates pneumonias (n = 14 of 34, 41%; P = 0.002). After adjusting for baseline severity of illness and comorbidities, patients in whom ALI developed had a markedly increased risk of hospital death (OR adj9.7; 95% CI, 6.0 to 15.9). In a nested case-control study, presence of shock (OR, 8.9; 95% CI, 2.8 to 45.9), inappropriate initial antimicrobial treatment (OR, 3.2; 95% CI, 1.3 to 8.5), and transfusions (OR, 4.8; 95% CI, 1.5 to 19.6) independently predicted ALI development.Conclusions: The development of ALI among patients hospitalized with infectious pneumonia varied among pulmonary pathogens and was associated with increased mortality. Inappropriate initial antimicrobial treatment and transfusion predict the development of ALI independent of pathogen. © 2012 Kojicic et al.; licensee BioMed Central Ltd. Source

Bijelovic S.,Institute of Public Health of Vojvodina | Novakovic B.,University of Novi Sad | Trajkovic-Pavlovic L.,Institute of Public Health of Vojvodina | Bijelovic M.,The Institute for Pulmonary Diseases of Vojvodina

Introduction: In terms of global impact assessment of air quality on human health the WHO recommends the unique method of reporting health status dependent of the concentration of suspended particles (TSP, PM 10 and PM 2.5) in air, which is not applicable in the Republic of Serbia. Aim: The aim of our study was to determine the concentration of TSP, PM 10 and PM 2.5 in the environment and to determine whether registered concentrations affect health of the population applying the international approved "DPSEEA" methodology. Methodology: The study was carried out in the City of Novi Sad on the basis of data collected during 2006. Determination of hazards presented in the air of environment was done by air sampling to define the average annual concetrations of TSP and further calculation of annual PM 10 and PM 2.5 concentration. In environmental impact assessment were used data of total mortality, cardiopulmonary mortality of persons aged above 30 and respiratory mortality of children under five years. The expected number of deaths was calculated on the basis of estimated concentration of PM 10 and PM 2.5, as well as in relation to changed concentrations of PM 10 of 10 μg/m 3. The significance of differences was tested by t-test and test of proportions. Results: Daily average value of TSP per year was 174.13 μg/m 3. The estimated average daily concentration of PM 10 and PM 2.5 were 95.77 μg/ m 3, i.e. 47.88 μg/m 3, per year. The expected total number of deaths dependent on short-term presence and concentration of PM 10 was 131 (95% CI, 114-148). Expected number of deaths from cardiopulmonary disease people aged above 30, dependent on long-term presence and concentration of PM 2.5, was 42 (95% CI, 36-75). Expected number of deaths from respiratory disease of children under five years, dependent on short-term presence and concentration of PM 10, was 0.036 (95% CI; 0.031 - 0.040). Decrease of the average population exposure to suspended particles PM 10 in 10 μg/m 3 induced reduction of the expected total number of deaths in 16 cases and decrease of the expected number of deaths from cardiopulmonary disease people aged above 30 in 5 cases. Conclusion: The research, which should be seen as the first in this area, has shown that the elevated concentrations of TSP, PM 10 and PM 2.5 contribute to the overall mortality rate and respiratory mortality in children under five by 3.6% and to cardiopulmonary mortality in persons aged above 30 with 1.81%. Source

Tegeltija D.,The Institute for Pulmonary Diseases of Vojvodina | Lovrenski A.,The Institute for Pulmonary Diseases of Vojvodina | Panjkovic M.,The Institute for Pulmonary Diseases of Vojvodina | Knezevic-Usaj S.,Oncology Institute of Vojvodina | And 2 more authors.
Archive of Oncology

Clear cell sarcoma/malignant melanoma of soft parts is a rare malignant tumor that originates from the neural crest. It is most common in young men in the lower limbs, grows slowly in the form of deep localized nodes around the tendons, fascia, and aponeurosis. Prognosis is poor, local recurrences and metastases are common. We present a case of a 53-year-old patient who sought medical attention due to the presence of a tumefaction in the nuchal neck region, followed by pain, heightened sensitivity, and numbness in his right hand. After excision, histological examination, and application of immunohistochemical and histochemical methods, malignant melanoma of soft tissues was diagnosed. Fourteen months after the excision of the neck tumor, a metastatic stomach disease was diagnosed. Larger tumors with necrosis, expressed pleomorphisam, and increased mitotic activity give metastases before local recurrence. Diagnosis is set using immunohistochemical methods after surgical excision of the tumor and the prognosis of the disease depends on the size of tumor and complete surgical excision. © 2011, Oncology Institute of Vojvodina, Sremska Kamenica. Source

Djuric M.,The Institute for Pulmonary Diseases of Vojvodina | Povazan D.,The Institute for Pulmonary Diseases of Vojvodina | Djuric D.,The Institute for Pulmonary Diseases of Vojvodina | Eri Z.,The Institute for Pulmonary Diseases of Vojvodina | Trudic A.,The Institute for Pulmonary Diseases of Vojvodina
Vojnosanitetski Pregled

Introduction. Localised organising pneumonia, radiologically presented with oval or round shadows mimicing lung cancer or metastases, is a major issue in differential diagnosis. Case report. A female patient was hospitalized to clarified the etiology of multiple nodular lung lesions. The chest X-ray and the chest computed tomography (CT) revealed bilateral patchy and nodular shadows, and round lung lesions, respectively. Neither sputum analyses, nor histology of bronchoscopy samples clarified the etiology of these lung lesions. As secondary deposits in the lungs were suspected, video-assisted thoracoscopy and anterolateral right minithoracotomy with atypical upper and lower lobe resection were performed. The frozen-section analysis suggested the benign nature of the lesion, and the definite histopathological finding of localised organising pneumonia was established. Due to bilateral lung lesions, corticosteroids were applied. Seven weeks later, the chest CT finding revealed a total regression of the lesions. Conclusion. A surgical re-section was necessary to diagnose the localised organising pneumonia which mimiced secondary malignant lesions, thus establishing the definite etiology of lung lesions. Bronchoscopic cryobiopsy, recently introduced in order to obtain peripheral lung biopsy samples, has provided new possibilities in the diagnosis and treatment of neoplastic and nonneoplastic lung diseases. © 2015, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved. Source

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