Tumor necrosis factor-alpha as differential diagnostic marker for patients with fever of unknown origin

© 2019, University of Kragujevac, Faculty of Science. All rights reserved. Febrile conditions of unidentified origin are still unknown in modern medicine despite the development of diagnostic procedures. There are various agents of long-term temperature encompassing numerous infectious or non-infectious diseases. The aim of this study was to determine if there was a statistically significant difference in the values of proinfl ammatory cytokines (IL-1, TNFa, IL-6) in patients who meet the criteria for febrile conditions of unidentified origin, between the group of infectious, malignant, rheumatic, “other” diseases and undiagnosed patients. The study was conducted in the Immunology laboratory of the Center for Molecular Medicine and Stem Cells Research of the Faculty of Medical Sciences in Kragujevac. Blood samples were taken from patients tested at the Clinic for Infectious Diseases, of the Clinical Center of Kragujevac, in the period from 2014 to 2016. The study included 70 patients. The measured values of the level of TNFa showed significantly higher values in a group of malignant diseases than in the group of infectious diseases, while the values of IL-1 and IL-6 did not show statistical significance. TNFa can improve diagnosing in case of patients with an unknown febrile condition, which can shorten the length of the hospital stay and reduce the volume of performance of diagnostic procedures

Synthesis, Characterization and Biological Studies of Organoselenium trans-Palladium(II) Complexes

Background: Over the years, transition metal complexes have exhibited significant antimicrobial and antitumor activity. It all started with cisplatin discovery, but due to the large number of side effects it shows, there is a growing need to find a new metal-based compound with higher selectivity and activity on more tumors. Objectives: Two novel trans-palladium(II) complexes with organoselenium compounds as ligands, [Pd(L1)2Cl2] (L1 = 5-(phenylselanylmethyl)-dihydrofuran-2(3H)-one) and [Pd(L2)2Cl2] (L2 = 2- methyl-5-(phenylselanylmethyl)- tetrahydrofuran) were synthesized, in the text referred to as Pd-Se1 and Pd-Se2. Also, a structurally similar trans-palladium(II) complex, [Pd(L3)2Cl2] (L3= 2,2- dimethyl-3-(phenylselanylmethyl)-tetrahydro-2H-pyran ) was synthesized according to an already published work and is referred to as Pd-Se3. The interaction of synthesized complexes with DNA and bovine serum albumin was observed. Also, antimicrobial activity and in vitro testing, cell viability, and cytotoxic effects of synthesized ligands and complexes on human epithelial colorectal cancer cell line HCT-116 were studied. Molecular docking simulations were performed to understand better the binding modes of the complexes reported in this paper with DNA and BSA, as well as to comprehend their antimicrobial activity. Methods: The interactions of the synthesized complexes with DNA and bovine serum albumin were done using UV-Vis and emission spectral studies as well as docking studies. Antimicrobial activity was tested by determining the minimum inhibitory concentrations (MIC) and minimum microbicidal concentration (MMC) using the resazurin microdilution plate method. Cytotoxic activity on cancer cells was studied by MTT test. Results: The Pd(II) complexes showed a significant binding affinity for calf thymus DNA and bovine serum albumin by UV-Vis and emission spectral studies. The intensity of antimicrobial activity varied with the complexes Pd-Se1 and Pd-Se3, showing significantly higher activity than the corresponding ligand. The most significant activity was shown on Pseudomonas aeruginosa. Under standardized laboratory conditions for in vitro testing, cell viability and cytotoxic effects of synthesized ligands and complexes were studied on human epithelial colorectal cancer cell line HCT-116, where Pd-Se2 showed some significant cytotoxic effects. Conclusion: The newly synthesized complexes have the potential to be further investigated as metallodrugs.Publishe

The pressure of Aphids (Aphididae, Hemiptera), vectors of potato viruses

Plant viruses and aphids as their vectors, are limiting factors in the production of healthy seed potato. Potato Virus Y (PVY) and Potato Leafroll Virus (PLRV) are the two most significant potato viruses in Europe, and seed quality depends directly on the infection level. In order to determine the possibilities for healthy seed potato production in Serbia, aphid flight activities have been monitored for four years in four localities. Over 6400 specimens of aphids have been collected. The number of aphids and vector pressure index varies depending on the localities' altitude. In localities at altitudes under 1000 m, they were high. The highest index was in locality Kotraža in 2007, when the PVY index exceeded the value of 180, while for PLRV it was 60. At high altitudes, above 1100 m, the number of aphids was low, as was the vector pressure index. The lowest index values were recorded in localities on Mt. Golija at 1300 m a.s.l. where the indexes for both viruses never exceeded value 6

LEAN THINKING IN HEALTHCARE: REVIEW OF IMPLEMENTATION RESULTS

For over decade, automotive industry originated lean concept has been successfully implemented in healthcare systems as a management method and philosophy with main focus on elimination of all types of wastes and looses in all tasks and processes so that time, materials, resources and medical procedures could be realized as effectively as it is possible. As main result lean concept implementation ensured to healthcare organizations to focus on their main core function and dedicate more time and efforts to patients without additional costs for them or healthcare system. However, lean implementation in healthcare could be much more difficult than in standard industrial environment and there are significant number of examples of lean in healthcare projects that failed to gain any measurable results and sustainable benefits from it. This paper presents review of some of the most successful implementations of lean tools and principles in healthcare organizations

Infections caused by clostridium difficile bacterium

© 2015, Serbian Medical Society. All rights reserved. Toxigenic strains of Clostridium difficile are the major cause of intestinal tract diseases of hospitalized patients. For a long time, Clostridium difficile was considered to produce both types of toxins (A+/B+ strain). However, the investigations conducted in the last ten years point to the existence of clinically significant isolates which produce only toxin B, i.e. toxin A negative. Toxigenic strains Clostridium difficile are present in our country so this bacterium sort has to be considered in differential causal diagnosis of diarrhea syndrome. Considering that it can cause a difficult form of the disease, it is an obligation to establish the presence of some toxins in stool samples of patients and/or production of some toxins in liquid culture of isolates

Toxic megacolon associated with clostridium difficile infection - A case study

© 2017, Serbian Medical Society. All rights reserved. Hyper virulent bacterial strain and irrational antibiotics use are among main causes of incidence increase in Clostridium difficile infection. The most difficult complication of clostridia infection is toxic megacolon with the incidence of 0.4 - 3 % of cases. The study shows a female 56-year-old patient hospitalized at Infectious Disease Clinic in Kragujevac, on the fourth day of the disease, with stomach ache, nausea, vomiting and diarrhea. The patient was previously hospitalized at Pulmonary Clinic for twenty-two days where she had been treated for pneumonia with combined antibiotic therapy. Laboratory analyses showed increased levels of leucocytes (WBC 50.4×109/L), nitrates (urea: 15.4 mmol/l, creatinine: 328 mmol/L) and C-reactive proteins (CRP: 221.2 mg/L), while albumin levels were decreased (16 g/L). Stool was positive on Clostridium difficilyэ. Computerized tomography (CT) was used to visualize diffuse thickening of colon’s wall, especially ascendant, with peritoneum density increase and the presence of free liquid. Despite eradication antibiotic (amp. Vankomycin 125mg/6h per os, amp. Orvagyl 500mg/8h iv), substitution and symptomatic therapy, as well as multidisciplinary approach, the patient passed away on the third day of hospitalization. Recognizing risk factors for clostridia infection onset, monitoring clinical course of the disease, adequate medicament therapy, and early surgical intervention due to complications can lead to lower morbidity and mortality infection rates

Analysis of clinical, haematological and biochemical parameters in patients with infectious mononucleosis

© 2015, University of Kragujevac, Faculty of Science. All rights reserved. Primary infection with Epstein-Barr virus (EBV) usually occurs in early childhood and often does not present clinical symptoms. More than 90% of adults are infected with this virus. A primary infection that occurs in adolescence or adulthood is usually clinically presented as infectious mononucleosis with a triad of symptoms: fever, lymphadenopathy and pharyngitis. Our retrospective study included 51 patients with a median age of 17 (9-23) years and serologically confirmed infectious mononucleosis. All patients with infectious mononucleosis were treated at the Clinic for Infectious Diseases at the Clinical Center in Kragujevac during 2013. We analysed the clinical, haematological and laboratory parameters of patients. The aspartate-aminotransferase levels were increased in 40 patients, with a mean value of 116.24 (±93.22); the alanine-aminotransferase levels were increased in 44 patients, with a mean value of 189.24 (±196.69). Lymphadenopathy was the most common clinical feature upon admission in 49 patients (96%); 38 patients (74.5%) had splenomegaly, and 20 (39%) had hepatomegaly. Twenty-six patients (51%) had leukocytosis with lymphocytosis, while 15 (75%) of the 20 who had a normal leukocyte count also had lymphocytosis. In the present study, we updated the clinical, haematological and laboratory parameters, which may lead to the establishment of an accurate diagnosis and promote further treatment of the patients

Encephalopathy during H1N1 influenza a virus infection

© 2016, University of Kragujevac, Faculty of Science. All Rights Reserved. Influenza virus type A is known for its capacity to transform its antigenic structure and create new viral subtypes. The clinical picture varies from non-febrile, mild upper respiratory tract infection to severe or fatal pneumonia. Neurological complications include encephalitis, encephalopathy, Reye’s syndrome and other neurological diseases. Patients with encephalopathy exhibit a disturbed state of consciousness lasting more than 24 hours, and patients with encephalitis exhibit high temperature, focal neurological signs and pathological CSF results in addition to disturbed state of consciousness. A 54-year old, previously healthy male farmer was hospitalized at the Clinic for Infectious Diseases of the Clinical Centre Kragujevac on the fifth day of disease. In addition to general symptoms of the disease, the clinical picture was dominated by a disturbed state of consciousness (Glasgow Coma Scale score <8). The aetiological agent was an H1N1 influenza A virus, which was isolated from nasopharyngeal secretions. No other causes of infection were demonstrated from both serum and cerebrospinal fluid specimens. Interstitial pneumonia was detected by radiographic examination of the chest. There were also some changes present in the EEG. The patient was cured without consequences. Because our country is in a whirlwind of pandemic H1N1 virus activity, we should think of all the possible complications that this virus can produce regardless of the epidemiological data and the clinical picture

The analysis of risk factors and clinical-demographic characteristics of patients with clostridium dificille infection as well as the outcome of their treatment

© 2016, University of Kragujevac, Faculty of Science, All rights reserved. Pseudomembranous colitis is a frequent nosocomial infection associated with significant morbidity and mortality. Clostridium difficile infection incidence most frequently increases due to unreasonable antibiotic use and the appearance of new hypervirulent bacterial strains, which leads to prolonged hospitalization and an increase in the total cost of hospital treatment. This is a retrospective design study conducted at Clinical Centre Kragujevac from January to December 2014. The patient data were obtained from the protocol of the Virological Laboratory and from medical documentation. All statistical analyses were performed using the computer program SPSS. The descriptive statistical data are expressed as percentage values. Continuous variables are expressed as the arithmetic mean with the standard deviation. Clostridium difficile infection occurred more frequently with elderly patients (123 patients were over 65 years old). Out of 154 patients on antibiotic treatment, 110 patients were treated with a combination of two or more antibiotics from different pharmacological groups. The most represented antibiotics were from the cephalosporin (71.4%) and quinolone (46.3%) groups. A total of 85.8% of the patients used proton pump inhibitors and H2 blockers. Our results describe the clinical and demographic characteristics of patients with diagnosed Clostridium difficile infection. The most prevalent characteristics (age, antibiotic therapy, PPI and H2 blocker use), which other researchers have also mentioned as risk factors, were present in our study as well

Analysis Of Clinical, Haematological And Biochemical Parameters In Patients With Infectious Mononucleosis

Primary infection with Epstein-Barr virus (EBV) usually occurs in early childhood and often does not present clinical symptoms. More than 90% of adults are infected with this virus. A primary infection that occurs in adolescence or adulthood is usually clinically presented as infectious mononucleosis with a triad of symptoms: fever, lymphadenopathy and pharyngitis. Our retrospective study included 51 patients with a median age of 17 (9-23) years and serologically confirmed infectious mononucleosis. All patients with infectious mononucleosis were treated at the Clinic for Infectious Diseases at the Clinical Center in Kragujevac during 2013. We analysed the clinical, haematological and laboratory parameters of patients. The aspartate-aminotransferase levels were increased in 40 patients, with a mean value of 116.24 (±93.22); the alanine-aminotransferase levels were increased in 44 patients, with a mean value of 189.24 (±196.69). Lymphadenopathy was the most common clinical feature upon admission in 49 patients (96%); 38 patients (74.5%) had splenomegaly, and 20 (39%) had hepatomegaly. Twenty-six patients (51%) had leukocytosis with lymphocytosis, while 15 (75%) of the 20 who had a normal leukocyte count also had lymphocytosis. In the present study, we updated the clinical, haematological and laboratory parameters, which may lead to the establishment of an accurate diagnosis and promote further treatment of the patients