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Biomedical subjects

M Gajić

Publications and source records attributed to M Gajić.

17 recordsLinked to original sources
PubMed2003

[Prognostic factors in resectable non-small-cell bronchial carcinoma].

This study represents the univariate and multivariate analysis of prognostic factors of resectable non small cell-lung cancer (NSCLC) that included 360 patients who underwent a surgical treatment because of primary (NSCLC) in the aforementioned institution in a period between 1985 and 1992. Patients with incomplete resection were rejected, perioperative deaths were not included in the analysis. In the analysed group there were 2931 (81.38%) males and 67(18.62%) females--M:F ratio 4.37:1. Age of the operated patients was 36-75 years with the mean age of 55.15 years. Right-sided tumours existed in 197(54.72%) patients, left-sided tumours in 163(45.28%) patients. Based on pTNM, 157, 65, 114, 18 and 6 patients were classified into stages I, II, IIIA, IIIB and IV respectively. In the univariate analysis, survival curves were obtained using the life table method, with the statistical analysis of the obtained data using the Gehan-Wilcoxon method. In the multivariate analysis--Cox regression analysis was performed. Multivariate analysis found only T-stage, N-stage and the stage of the disease as significant independent prognostic factors. Mode of influence of factors that were found significant in the univariate analysis (age 60 years, tumour diameter 60 mm, involvement of the visceral pleura, indirect tumour signs) is discussed and compared with literature data. Survival differences depending on other factors (tumour location, bronchoscopic aspect, extent of the resection), although without statistical significance, can be useful for the clinician, in the same time contributing to the better comprehension of informations obtained by basical investigations, especially of lymphatic spread of the disease and tumour pathology.

Adult↗
PubMed2000

Long-term results after low anterior stapled anastomosis.

In the period 01.01.1991-12.31.1996, 286 low anterior stapled resections of the rectum due to rectal carcinoma were performed at the First Surgical Clinic, the Third Department for Colorectal Surgery, Belgrade. There were 57% males and 43% females, median age 59.6 years. The most common localization of tumor was in the distal third of the rectum 181 (63%). In the middle third, there were 89 (31%) and in the upper, intraperitoneal third 16 (6%). Histopathological examination revealed adenocarcinoma in all cases. All operative specimens were examined by one pathologist and classified according to the Gunderson-Sosin modification of Dukes classification. There were 14 (4.9%) in stage A, 167 (58.4%) in stage B (B1,B2,B3), 89 (31.1%) stage C (C1,C2,C3) and 16 (5.6%) stage D. According to Broders classification, there were 129 (45%) well differentiated, 142 (50%) moderately and 15 (5%) poorly differentiated tumors. Anastomotic dehiscence was found in 17 patients (5.95%), mostly conservatively treated, except in 6 cases where spreading peritonitis developed requiring operative treatment. There were 9 (3.1%) postoperative deaths, a half of them with specifically operation related mortality. Recurrence of the disease was registered in 47 (18%) patients, out of 260 who were regularly followed up (26 were lost). Local recurrence alone was found in 21 (8.0%) patients, while distant spread was registered in 22 (8.46%) patients. Local and distant spread was found in 4 (1.5%) cases. At present, the median follow-up is at 54 months. Analysis by the Kaplan-Meier's test shows cumulative survival of 66% at 71 months of the follow-up. Seventy four percent of patients with curative operations exhibit no signs of recurrence at 5 years.

Adenocarcinoma↗
PubMed1990

[Scanning electron microscopic study of fluorotic permanent teeth enamel].

The materia comprised 8 caries-free fluorotic permanent teeth (4 with severe and 4 with very mild fluorosis) and 4 caries-free non-fluorotic permanent teeth. The surface of teeth with severe fluorosis was mainly rought with discrete pitting and small parts of relative sound enamel. The subsurface enamel of teeth with severe fluorosis was with irregular cross-sectional shape of rod and more extensive inter-rod enamel spaces in comparison with other parts of enamel. The surface enamel of teeth with very mild fluorosis was mainly smooth, similar to the sound enamel, with small parts of rough enamel. In subsurface enamel of teeth with very mild fluorosis no difference was found between cross-sectional shape of rod and dimension of inter-rod enamel spaces in comparison with other parts of enamel.

Adolescent↗
PubMed1989

[Effective revaccination against tetanus in adults].

Immunologic response in persons revaccinated against tetanus was dealt with in this paper. Out of 35 examined patients with the mean age of 47.4 years on the day of revaccination 20% of them had titres of antitetanus antibodies on the lower limit which guaranteed antitetanus protection (0.01-0.02 i.j./m.). Values of titre were below 1.00 i.j./m. in one third of patients. A high degree of negative correlation was statistically established between the age of patients and the height of titre (p less than 0.001). Mean geometric titre (GMT) of the patients amounted to 1.32 i.j./ml on the day of revaccination. Seven days following revaccination GMT was 10.41 i.j./ml and it was the best illustration of immunity "eruption" induced by one dose of Te Al vaccine a 0.5 ml. Optimal values of the titre (over 1.00 i.j./ml) occurred in all examined patients. Dependence of revaccinated titre upon age was of less significance (P = 0.01). A high degree of dependence of revaccinated titre upon the values on the day of revaccination was statistically established (p less than 0.001). It was concluded that by revaccination of persons with the lowest protective titre as well a safe antitetanus protection was provided in a 7-day period. This conclusion also necessitated obligatory immunization against tetanus at an older age too whereby a more expensive active-passive treatment of injured persons would de avoided.

Antibodies, Bacterial↗
PubMed1989

[Risk factors for breast cancer in Belgrade].

Reproductive history, contraceptive use, family history of breast cancer, health behaviour and socioeconomic variables of 60 women with breast cancer were compared to those of 71 age and place of living matched hospital controls. Besides nulliparity, all known risk factors for breast cancer were more frequently present in the cases observed, although the statistical significance was not attained (age at first delivery, early menarche, positive family history of breast cancer, positive history of benign breast disease, obesity). Oral contraceptives ever used were reported for 16.7% of cases and 15.5% of controls (RR = 1.09; 95% confidence interval 0.42-2.77). Although the study is small and the difference in the risk factor distribution insignificant, it is clearly consistent with many published studies on the same subject.

Adult↗
PubMedDate not supplied

[Relation between body mass, body height and the blood picture to vital capacity in students exposed to air pollution].

The authors examined the relationship between body mass, body height, haemogram and vital capacity in two groups of pupils exposed to long aeropollution. The first group consisted of children with low vital capacity. In the second group the spirometric test was normal. The authors found differences between these two groups in relation to body mass and hemoglobin concentration.

Adolescent↗
PubMedDate not supplied

[Prenatal caries prophylaxis with fluoride tablets].

The attitude towards the use of fluoride tablets during pregnancy differs considerably: from absolute denying to assertion of obligate fluoride intake, even in higher doses than recommended. On the basis of our shides as well as of studies of other authors of pathohistologic, chemical and epidemiologic placental permeability of fluorides and of the influence of fluorides on the hard teeth tissues formed during the pregnancy, it can be concluded that: Fluoride application during pregnancy is a positive method since the effect of caries reduction in deciduous and permanent dentition has been confirmed; Tablets should be used from the 10the or 12the week of pregnancy; Tablets should be taken 30 minutes before the meal and an hour and a half before the intake of calcium tablets; The optimal daily dose for a pregnant woman is 1 mg of fluoride.

Dental Caries↗
PubMedDate not supplied

[The status of the respiratory organs in students in Sabac exposed to increased air pollution].

The authors followed up the health of 322 elementary-school pupils at Sabac who were exposed to increased air pollution with chemical agents (ammonia, fluor hydrogen, chloracetic acid, sulfur dioxide, soot). The mean annual concentration of these gases were above or insignificantly under maximally permitted values. The results of the examination were as follows: recurrent cough in 12.4 per cent of cases and clinical signs of chronic or obstructive bronchitis in 8.4 per cent of children. Values of vital capacity were under normal in 27.6 per cent of cases and almost in the half of children vital capacity was at the lower normal limit. FEV1/FVC was under normal in 15 per cent of cases and at the lower normal limit in about 18.6 per cent of children. In spite of a great number of children with positive cutaneous tests to inhalation allergens with Prick's method IgE was within normal limits in these children. Thus, a significant noxious effect of allergic components on respiratory organs should be excluded. This was also confirmed by spirometric measurements of the two subsequent maximal expiriums when differences of +/- 3% were registered. However, in children with allergic bronchitis the value dispersion was by 2-3 times greater. Consequently, the authors concluded that damaged respiratory organs in children at Sabac appeared in a greater number of cases than in other places and that these damages were due to increased concentrations of different chemical air pollution agents.

Adolescent↗
PubMedDate not supplied

[Renal tubular function in children with hypercalciuria].

INTRODUCTION: Renal stone disease is commonly due to hypercalciuria [1, 2], which may be assessed either from a 24-hour urinary collection or from the fasting first morning urine. Hypercalciuria during childhood has been defined by a 24-hour calcium excretion greater than 3.5 mg/kg per day and/or calcium to creatinine ratio greater than 0.20 [3]. The alteration in the calcium transporting systems plays a pathogenetic role in promoting hypercalciuria [4, 5]. Since calcium reabsorption along the nephron is intimately related to that of other electrolytes and substances, it can be hypothesized that patients with hypercalciuria may have other renal tubular defects. The aim of the study was to investigate proximal tubular function (tubular reabsorption of sodium, potassium, phosphate and glucose) and distal tubular function (urinary concentrating capacity and acidifying capacity) in children with hypercalciuria. PATIENTS AND METHODS: Two groups of children were studied: hypercalciuric group included 23 children with hypercalciuria (10 males, aged 11.9 +/- 4.1 years), of whom 6 with nephrolithiasis, and control group included 42 healthy children (20 males, aged 11.2 +/- 3.8 years). All subjects had normal serum values for calcium, sodium, potassium, phosphate and glucose, as well as normal renal function. The urinary excretion of calcium, sodium, potassium, phosphate, glucose and creatinine was measured in a 24-hour urine specimen by standard laboratory methods. Urine osmolality and urinary specific gravity were measured following 12-hour water-deprivation test. A short ammonium chloride loading test was performed in 3 patients with urinary pH above 5.5. The fractional excretion of sodium, tubular phosphate reabsorption and renal threshold phosphate concentration were calculated according to standard formula. Statistical analysis was performed using the t-test and analysis of variance (ANOVA). Kruskal-Wallis method was used to compare urinary phosphate excretion between two groups. RESULTS: Table 1 summarizes urinary excretion of electrolytes in children with hypercalciuria compared with healthy controls. We found that urinary sodium excretion was significantly increased in patients with hypercalciuria when compared with controls (p < 0.05). Urinary phosphate excretion was significantly higher in patients with hypercalciuria in comparison to controls, and this was accompanied by a significant lowering of the tubular phosphate reabsorptive threshold (p < 0.05). Urinary potassium excretion tended to be lower, although not significantly, in the hypercalciuric children than in normal subjects. Table 2 shows the mean values +/- standard deviation of urinary specific gravity, urinary osmolality and urinary pH. Urinary specific gravity mean value was significantly lower in patients with hypercalciuria in comparison to controls (p < 0.05). Urinary pH was found below 5.5 in all patients. Glycosuria was detected in 3 patients (13.3%). As shown in Graph. 1, a significant correlation between the urinary excretion of calcium and sodium was demonstrated in both groups of children (r = 0.29; p < 0.01). DISCUSSION: The present study shows that children with hypercalciuria have significantly higher urinary sodium and urinary phosphate excretion in comparison to controls, while urinary potassium excretion is normal in both groups of children. According to some recent reports [6-9], these findings may indicated defects of the renal tubular transport of sodium and phosphate which may be interpreted as a cause or a consequence of the alteration of the calcium transporting system. Defects in both proximal and distal renal tubular functions have been demonstrated in patients with nephrolithiasis, particularly those with hypercalciuria. Proximal renal tubular defects include defects in sodium, fluid, phosphate and glucose reabsorption, which were evident also in our patients. (ABSTRACT TRUNCATED)

Calcium↗
PubMedDate not supplied

[Sodium excretion in children with lithogenic disorders].

INTRODUCTION: The causes of nephrolithisis are multifactorial and have not yet been enough investigated [1]. Hypercalciuria is the most common cause of metabolic nephrolithiasis [2-4]. Close relationship between urinary calcium and urinary sodium has been a subject of reported observations in the past, showing that high urinary sodium is associated with high urinary calcium [5-7]. Hyperoxaluria, hyperuricosuria and cystinuria are also metabolic disorders that can lead to nephrolithiasis. Recent studies have indicated that urinary elimination of cystine is influenced by urinary sodium excretion. Based on these observations it has been hypothesised that patients with high urinary sodium excretion are at high risk of urinary stone disease. The purpose of the study was to investigate sodium excretion in a 24-hour urine and first morning urine collected from children with lithogenic metabolic abnormalities (hypercalciuria, hyperoxaluria, hyperuricosuria, cystinuria), both with nephrolithiasis and without it, in order to determine its significance in urinary calculi formation. PATIENTS AND METHODS: Urinary sodium excretion was investigated in 2 groups of children: patients with lithogenic metabolic abnormalities, but without urinary stone disease (L group) and patients with nephrolithiasis (C group). Both groups were divided into 2 subgroups: patients with hypercalciuria and without it. There were 22 patients in group L (mean age 11.97 +/- 4.13 years), of whom 17 formed a hypercalciuric subgroup and 5 formed a non-hypercalciuric subgroup (3 patients with hyperuricosuria and 2 patients with hyperoxaluria). Group C consisted of 21 patients with nephrolithiasis (mean age 12.67 +/- 3.44 years), of whom 6 formed a hypercalciuric subgroup and 15 formed a non-hypercalciuric group (2 patients with cystinuria and 13 patients without lithogenic metabolic abnormalities). Control group consisted of 42 healthy age-matched children. All subjects had a normal renal function. A detailed history and clinical examination were done, and ultrasonography was performed in all patients. A 24-hour urine, first morning urine and serum specimen were analysed for sodium, potassium, calcium, uric acid, urea and creatinine. Fractional excretion of sodium, as well as urinary sodium to creatinin ratio and urinary sodium to potassium ratio, were calculated from the findings. Sodium and potassium levels were determined by flame photometry, calcium was measured by atomic absorption technique (Beckman Atomic Spectrophotometer, Synchron CX-5 model, USA), uric acid by carbonate method and creatinine by Jaffe technique. Cystine and dibasic amino acids were quantified by ion chromatography. Urinary oxalate excretion was determined by enzyme spectrophotometry. Hypercalciuria was defined by 24-hour calcium excretion greater than 3.5 mg/kg per day and/or calcium to creatinine ratio greater than 0.20 [8]. Uric acid excretion was expressed as uric acid excretion factored for glomerular filtration, according to Stapleton's and Nash's formula [9]. Normal values were lower than 0.57 mg/dl of glomerular filtration rate in 24-hour samples. Mean values were statistically analyzed by Pearson's linear correlation and analysis of variance (ANOVA). RESULTS: Urinary sodium concentration values including urinary sodium to potassium ratios, are shown in Table 1. We found that urinary sodium excretion was significantly increased in patients of both L and C groups when compared with controls (p < 0.05). Further analysis of the subgroups showed that urinary sodium excretion was significantly higher only in patients with hypercalciuria of both L and C groups in comparison to controls (p < 0.05) (Table 2). A significant positive correlation was found between 24-hour urinary sodium to creatinine ratio and urinary calcium to creatinine ratio (r = 0.31; p < 0.001) (Graph 1), as well as between urinary sodium to potassium ratio in 24-hour and first morning urine (r = 0.69; p < 0.001) (Graph 2). (A

Calcium↗