Predikcija i prevencija femicida u nasilnim partnerskim odnosima - forenzička studija

The current study was carried out in order to determine the predictive potential for the earlier recognized risk factors of intimate partner femicide. The research was conducted on cadaveric material of 74 autopsied victims of femicide committed by their intimate partners during the period from 2000 to 2014 and 303 interviewed women as a control group. Logistic regression was used to estimate the independent associations for each of the hypothesized risk factors and the risk of intimate partner femicide. Identified risk factors were graded according to their predictive capacity as the factors of low, moderate and high-risk potential. Empirical validation of the most informative risk factors was performed by adding numerical value of each of them, in order to make a proper risk assessment tool, for identification of victims at the greatest risk for intimate partner femicide. Using this measuring instruments in everyday clinical practice, at the first meeting with a woman - a victim of partner violence allows the rapid identification of potential victim of femicide and preventive actions in order to impede adverse outcomes

Increased Expression of Extracellular Vesicles Is Associated With the Procoagulant State in Patients With Established Rheumatoid Arthritis

This study sought to identify different subpopulations of extracellular vesicles (EVs) in plasma from female patients with established rheumatoid arthritis (RA) in relation to the activation of coagulation and fibrin formation in these patients. Forty women were included in the study, 20 patients and 20 age-matched healthy controls. The mean disease duration in patients was 13.0 (5.0-25.0) years, with medium to high disease activity despite ongoing treatment with low-dose prednisolone and methotrexate. There were no differences between the investigated groups regarding the presence of traditional cardiovascular risk factors. The concentration of phosphatidylserine-positive (PS+) EVs; platelet (CD42a(+)), leucocyte (CD45(+)), monocyte (CD14(+)), and endothelial (CD144(+))-derived EVs; and EVs-expressing tissue factor (CD142(+)), P-selectin (CD62P(+)), and E-selectin (CD62E(+)) were determined by flow cytometry analysis. Overall hemostasis potential (OHP) was assessed to follow the hemostatic disturbances, including the parameters for overall coagulation potential (OCP) and overall fibrinolytic potential (OFP). Fibrin clot turbidity was measured together with clot lysis time, and scanning electron microscopy was performed. Increased concentrations of PS+, CD42a(+), CD142(+), CD45(+), CD14(+), and CD62P(+) EVs were found in plasma from patients with RA compared to healthy controls, and the concentrations of PS+, CD42a(+), CD14(+), and CD62P(+) EVs were positively correlated with the inflammatory parameters in RA patients. Positive correlations were also found between the levels of PS+ and CD42a(+) EVs and OCP as well as between the levels of PS+, CD42a(+), and CD62P(+)EVs and OHP. The levels of PS+, CD42a(+), CD14(+), CD62P(+), and CD62E(+) EVs were negatively correlated with OFP. Elevated levels of circulating EVs of different cell origins were found in patients with established RA, in relation to the inflammatory burden and coagulation activation in the disease

Assessment of hemostatic disturbances in women with established rheumatoid arthritis

Objectives This study was aimed to assess hemostatic disturbances in female patients with established rheumatoid arthritis (RA) in relation to menopausal status and disease activity. Method Ninety women were included in the study, 42 patients and 48 age-matched healthy controls. There were no differences between the investigated groups regarding the presence of traditional cardiovascular risk factors. Two global hemostatic assays were employed, namely endogenous thrombin potential (ETP) and overall hemostasis potential (OHP). The parameters of the ETP assay (ETP, C-max, t-lag, t-max) and OHP assay (overall coagulation potential (OCP) and overall fibrinolytic potential (OFP)) were assessed. Moreover, the parameters of the fibrin clot (lag time, Max Abs, and slope) were measured by clot turbidity and scanning electron microscopy (SEM). Both patients and controls were divided into four subgroups according to menopause status. Results The premenopausal controls differed significantly from all other subgroups in terms of diminished levels of ETP (p = 0.02), C-max (p = 0.01), OCP (p = 0.02), OHP (p = 0.001), and Max Abs (p = 0.008), while OFP (p = 0.0001) was increased. This tendency was not seen in the premenopausal RA patients compared with the postmenopausal RA patients. SEM images showed denser clots composed of thinner fibers in samples from RA patients. The disease activity measured by DAS28 correlated with OCP and OHP (r = 0.54; p = 0.001 and r = 0.44; p = 0.003, respectively) indicating persistent hypercoagulable condition in the whole group of RA patients. Conclusions Our results point towards coagulation activation in premenopausal women with established RA. The patients were well characterized, which enabled assessment in a real-life setting

Impaired Fibrinolysis Is Linked With Digital Vasculopathy and Onset of New Digital Ulcers in Systemic Sclerosis (vol 49, pg 598, 2022)

J Rheumatol 2022; doi: 10.3899/jrheum.210931 In the Methods section, under the subheading “Follow-up and study outcome,” the last sentence should be as follows: “All new DUs were recorded by contacting all 39 patients once every 1–3 months during follow-up.” The error does not affect the results or conclusions of the study. This correction only applies to the April 1 First Release. The correct text appears in the print and online issues

Phosphatidylserine positive microparticles improve hemostasis in in-vitro hemophilia A plasma models

Circulating microparticles (MPs) are procoagulant due to the surface containing phosphatidylserine (PS), which facilitates coagulation. We investigated if MPs improve hemostasis in HA plasma models. MPs isolated from pooled normal human plasma were added to severe, moderate and mild HA plasma models (0%, 2.5%, 20% FVIII). The MPs' effect on hemostasis was evaluated by calibrated automated thrombogram (CAT) and overall hemostasis potential (OHP) assays, while fibrin structure was imaged by standard confocal, stimulated emission depletion (STED) microscopy and scanning electron microscopy (SEM). MPs partially restored thrombin generation and fibrin formation in all HA plasma models. The procoagulant effect of MPs requires PS exposure, to a less extent of contact pathway activation, but not tissue factor exposure or in vitro stimulation of MPs. MPs partially normalized the fibrin structure, and using super-resolution STED, MPs attached to fibrin were clearly resolved. In summary, our results demonstrate that PS positive MPs could improve hemostasis in HA plasma models

MORPHOLOGICAL AND MORPHOMETRIC ANALYSIS OF FASCICULAR STRUCTURE OF TIBIAL AND COMMON PERONEAL NERVES

In clinical practice, the common peroneal nerve palsy is more frequent compared to the tibial nerve, although both are part of the sciatic nerve. The aim of our study was to analyze and compare the fascicular structure of the tibial and common peroneal nerve. For the study we used tissue samples of the sciatic nerve, 19 subjects aged 8–86 years. The samples were processed by standard histological procedures, after which were made transverse sections of 5 microns and stained with hematoxylin-eosin staining. First, we analyzed the number, size and arrangement of fascicle. After that we made photographs of each common peroneal and tibial nerve fascicules and to each the area and maximum diameter were determined. In all studied cases, a connective tissue septum that separates the fascicular groups, tibial and common peroneal nerve was detected. The tibial nerve fascicular group was numerous and medially localized while the common peroneal nerve fascicular group was less numerous and placed laterally. Morphometric analysis showed that the common peroneal nerve has statistically significantly lower number of fascicles (16.28 ± 4.39) and the total fascicular area (2.13 × 106 ± 8.91 × 106 μm2) compared to the tibial nerve (average 35 fascicles ± 13.29 and mean fascicular area 5.05 × 106 ± 2.46 × 106 μm2). The average value of the maximum diameter and the average area of the investigated fascicle, tibial and common peroneal nerves showed no statistically significant differences. Correlation analysis of the studied parameters with the age of subjects also did not reach statistical significance. Fascicular structure with a smaller number of larger fascicles and sparse epineurial connective tissue sheath may increase susceptibility of the common peroneal nerve injury

UNSUCCESSFUL PRIMARY PCI FOR POSTPARTAL DISSECTION OF ALL THREE MAJOR CORONARY ARTERIES

Coronary artery dissection is rare but very dangerous condition which can result in myocardial infarction. It mostly occurs in young postpartum women. The left anterior descending artery is affected in 75% of cases and in some extremely rare cases dissection may include all three coronary arteries. Treatment guides are still not consistent. While some authors recommend medical treatment other recommend surgical one. Case report. We present a 36-year-old female patient who was admitted to our hospital with intermittent chest pain and dyspnea that occurred two hours before admission. After premedication with Aspirin 300 mg per os, Clopidogrel 300 mg per os and Enoxaparin 30 mg iv, the pain disappeared. Chest pain was repeated after five days. Coronary angiography revealed spiral dissection in medial segment of LAD. After PCI attempt, dissection progressed and ended fatal. Pathological finding was intimal dissection of the coronary arteries with loss of some parts of internal elastic lamina. It is interesting that in the literature there is no consistent opinion about therapeutic approach to SDCA and we hope that this case report will contribute to elucidating the problem

Primary pericardial mesothelioma presenting as constrictive pericarditis

Primary pericardial mesothelioma is an extremely rare and lethal cardiac tumor. We report an autopsy case of a primary pericardial mesothelioma in a 52-year-old man. He developed dyspnea, cough, low-grade fever and night sweats approximately 3 months before last admission. Initially, he was evaluated at a hospital in another city, without a firm diagnosis. Due to progressive symptoms and the development of lower-extremity edema, he presented at our hospital in September 2005. The physical examination at admission demonstrated signs of pericardial tamponade. Chest radiography revealed marked enlargement of the cardiac silhouette. Specimens of bloody pericardial fluid were positive for pericardial mesothelioma by cytologic examination. The general condition of the patient worsened very rapidly and he was transferred to the intensive care unit where he later died. Postmortem examination confirmed primary pericardial mesothelioma of the mixed/biphasic type with lymphatic metastasis in the right lung. By using immunohistochemical analysis for specific markers of mesothelioma and for differentiation of the mesothelioma from the lung adenocarcinoma, definitive diagnosis was established: primary pericardial mesothelioma

Categorization of Marijuana Suspected Policies’ Seizures in Southeast Serbia According to Cannabinoids Content

Background: The cannabis plant or marijuana has been used since ancient times for different purposes. An increase in the content of THC in cannabis has been observed worldwide, whereas the CBD content is dropping. This study’s main goal was to categorize marijuana suspected policies’ seizures (MSPS) based on the cannabinoid component concentrations concerning their potency and age. Methods: The samples were MSPS seized in southeast Serbia from April 2019 to April 2020. The cannabinoid content was determined using gas chromatography with mass spectrometry. Descriptive statistics were performed using Linux LibreOffice Calc. Results: All of the samples had a THC content higher than 0.3%, thus classifying the samples as marijuana according to the Serbian Law on Psychoactive Controlled Substances. The highest concentration of THC was 16.10%, while the lowest was 4.90%. The highest average concentration of THC (12.39%) was found in the buds. Only 11.81% of the samples had a CBD concentration higher than 1%, making all other marijuana samples extremely psychoactive. Most of the samples were older than 2 years, according to the calculated CBN/THC ratio. Conclusion: Our results confirm trends regarding the dominance of THC content in contemporary cannabis worldwide. It is necessary to monitor trends of cannabis potency in Serbia continuously because of its location