Increased il-33 and il-17 in colorectal carcinoma patients with severe disease

© 2020, University of Kragujevac, Faculty of Science. All rights reserved. Colorectal cancer (CRC) represents one of the most common cancers. It is frequently diagnosed at advanced stages, indicating on need for new diagnostic markers. The aim of this study was to determine systemic and fecal values of IL-17 and IL-33 in patients with CRC and the relationship with clinicopathological aspects of disease. The blood samples and feces liquid fraction of 50 patients with CRC were analyzed. Serum and fecal levels of IL-33 and IL-17 were measured using sensitive enzyme-linked immu-nosorbent assay (ELISA) kits. Fecal levels of Il-33 and IL-17 were increased in CRC patients with poor tumor tissue differentiation. Serum IL-33 and fecal IL-17 were increased in patients with presence of lung/liver metastasis or peritoneal carcinomatosis, respec-tively, while enhanced fecal IL-33 was detected only in patients with peritoneal carcinomatosis. Positive correlation between IL-33 and IL-17 values in sera and feces, respectively was also observed. We believe that increased local values of IL-33 and IL-17, reflected trough higher fecal concentration, in CRC patients with poor tumor tissue differentiation and with presence of lung/liver metastasis or peritoneal carcinomatosis may be considered as a sign of the tumor’s malignant progression and, consequently, of a poor prognosis for patients

Parenting Style, Involvement of Parents in School Activities and Adolescents’ Academic Achievement

AbstractThis paper deals with problems of correlations between a parenting style, involvement of parents in school activities and academic achievements of adolescents. The theoretical concepts of Baumrind (1991) and Epstein (2002) were used as theoretical framework. The research was conducted with the aim to determine a correlation between a parenting style, involvement of parents in school activities and success of adolescents in schools. There were 400 parents and 200 adolescents who were examined. A PSDQ questionnaire of parenting styles and dimensions was used (Parenting Styles & Dimensions Questionnaire, Robinson, Mandleco, Olsen, & Hart, 2001) for examining parenting styles. A scale was designed according to the Epstein concept for examining the involvement of parents. The results of the research showed that an authoritative parenting style was characteristic for mothers, which was correlated with a higher involvement in school activities and a greater success of adolescents. An authoritarian parenting style is dominant for fathers and it is correlated with a lack of time necessary for involvement in school activities. The given results indicate a problem concerning involvement of fathers in school activities of children and the indifference of school to establish a partner relationship with parents. School should offer relevant information about effects of various parenting styles on achievements of students within collaborating between school and a family and establishing a partnership between school and a family

Cost-effectiveness analysis of tocilizumab in combination with methotrexate for rheumatoid arthritis: A Markov model based on data from Serbia, country in socioeconomic transition

Background/Aim. Recent studies have shown that biological treatments for rheumatoid arthritis can change the course of rheumatoid arthritis and improve functional ability of patients with rheumatoid arthritis. In spite of this fact, use of biological therapy is still limited by high prices of these medicines, especially in countries in socioeconomic transition. The aim of our study was to compare costeffectiveness of a combination of tocilizumab and methotrexate with methotrexate alone for rheumatoid arthritis in Serbia, a country in socioeconomic transition. Methods. For the purpose of our study we designed a Markov model using data on therapy efficacy from the available literature, and data on the costs of health states calculated from records of actual patients treated in the Clinical Center Kragujevac, Serbia. The duration of one cycle in our model was set at one month, and the time horizon was 480 months (40 years). The study was done from the social perspective, and all the costs and outcomes were discounted for 3% per year. Results. Treating rheumatoid arthritis with diseasemodifying antirheumatic drugs (DMARDs) alone was more cost-effective in comparison with a combination of biologic treatment with tocilizumab and DMARDs. The total costs for treating a patient with DMARDs for one year were on average 261,945.42 RSD, or 2,497.70 Euro and the total costs for treatment with tocilizimab plus DMARDs were on average 1,959,217.44 RSD, or 18,659.20 Euro. However, these results are susceptible to changes in costs and treatment effects of tocilizumab in patients with more severe forms of rheumatoid arthritis. Conclusion. Our results show that the use of tocilizumab for rheumatoid arthrits in economic environment of Serbia is not cost-effective. Use of tocilizumab for treating rheumatoid arthritis can become affordable, if costs of its use become lower. In order to start using expensive biologic medicines in patients in transitional countries, special strategy and pricing policy of international pharmaceutical companies are necessary, which would include calculation of prices of biologic medicines on the basis of local pharmacoeconomic studies

Atención en un centro de parto según las recomendaciones de la Organización Mundial de la Salud

Centros de parto constituem modelo que\ud adota tecnologia apropriada na assistência\ud à parturiente. O objetivo foi caracterizar\ud a assistência intraparto em um centro de\ud parto extra-hospitalar quanto às práticas\ud recomendadas pela Organização Mundial\ud da Saúde (OMS). Estudo descritivo sobre\ud 1.079 partos assistidos de 2006 a 2009 na\ud Casa do Parto de Sapopemba, São Paulo,\ud Brasil. Os resultados mostraram ausculta\ud intermitente (média=7 controles); posição\ud materna no expulsivo semissentada\ud (82,3%), lateral (16,0%), outras (1,7%);\ud aceitação da dieta (95,6%); acompanhante\ud (93,3%); até três exames vaginais (85,4%);\ud banho de aspersão (84,0%), deambulação\ud (68,0%), massagem (60,1%), exercícios\ud com bola suíça (51,7%); amniotomia\ud (53,4%); ocitocina na dilatação (31,0%),\ud banho de imersão (29,3%), ocitocina no\ud expulsivo (25,8%) e episiotomia (14,1%).\ud Concluiu-se que os profissionais do centro\ud de parto utilizam práticas recomendadas\ud pela OMS, contudo existem práticas cujo\ud uso pode ser reduzido, tais como amniotomia,\ud administração de ocitocina, episiotomia\ud e posição semissentada no expulsivoBirth centers are maternal care models\ud that use appropriate technology when\ud providing care to birthing women. This\ud descriptive study aimed to characterize intrapartum\ud care in a freestanding birth center,\ud in light of the practices recommended\ud by the World Health Organization (WHO),\ud with 1,079 assisted births from 2006 to\ud 2009 in the Sapopemba Birth Center, São\ud Paulo, Brazil. Results included the use of\ud intermittent auscultation (mean=7 controls);\ud maternal positions during delivery:\ud semi-sitting (82.3%), side-lying (16.0%),\ud other positions (1.7%), oral intake (95.6%);\ud companionship (93.3%); exposure to up\ud to three vaginal examinations (85.4%),\ud shower bathing (84.0%), walking (68.0%),\ud massage (60.1%), exercising with a Swiss\ud ball (51.7%); amniotomy (53.4%), oxytocin\ud use during the first (31.0%) and second\ud stages of labor (25.8%), bath immersion\ud (29.3%) and episiotomy (14.1%). In this\ud birth center, care providers used practices\ud recommended by the WHO, although\ud some practices might have been applied\ud less frequentlyCentros de parto constituyen un modelo\ud que adopta la tecnología apropiada en la\ud atención a la parturienta. El objetivo fue caracterizar\ud la atención intraparto en un centro\ud de parto extra-hospitalario en relación a las\ud prácticas recomendadas por la Organización\ud Mundial de la Salud (OMS). Estudio descriptivo\ud sobre 1.079 partos atendidos del 2006 al\ud 2009 en la Casa de Parto de Sapopemba, São\ud Paulo, Brasil. Los resultados mostraron: auscultación\ud intermitente (media=7 controles);\ud posición materna en el expulsivo - semisentada\ud (82,3%), lateral (16,0%), otras (1,7%);\ud aceptación de dieta (95,6%); acompañante\ud (93,3%); hasta tres exámenes vaginales\ud (85,4%); baño en ducha (84,0%), deambulación\ud (68,0%), masaje (60,1%), ejercicios con\ud pelota suiza (51,7%); amniotomía (53,4%);\ud oxitocina durante la dilatación (31,0%), baño\ud de inmersión (29,3%), oxitocina durante el\ud expulsivo (25,8%) y episiotomía (14,1%). Se\ud concluyó que los profesionales del centro de\ud parto utilizan prácticas recomendadas por\ud la OMS, pero existen algunas prácticas cuyo\ud uso puede reducirse, tales como la amniotomía,\ud administración de oxitocina, episiotomía\ud y posición semisentada en el período\ud expulsivoCNPqPIBIC 115521/2008-

COVID-19 effects on mental health of children and adolescents with intellectual disabilities in North Kosovo

Background. People with intellectual disabilities (ID) are susceptible to physical, mental and social implications of the COVID-19 pandemic. Aim. Learning the way young individuals with disabilities dealt with the COVID-19 pandemic and how it affected their lives. Materials and Methods. An epidemiological questionnaire including information on the person’s health, mental state, behavior, educational capabilities, and epidemiological and clinical features of the COVID-19 infection was completed by 41 children/young adults and their family members. Results. During the two-year period of the pandemic, we monitored the frequency of COVID-19 infection in children and adolescents with intellectual disorders, children’s mental condition, and the occurrence of post-COVID symptoms. We also discussed the role of society regarding economic stability and support for families with a disabled member. Conclusions. The severity of COVID-19 symptoms was the independent predictor of mental status deterioration. Children and adolescents with ID experienced a greater prevalence of COVID-19 infection as well as post-COVID sequelae

Impaired olfactory performance and anxiety-like behavior in a rat model of multiple sclerosis are associated with enhanced adenosine signaling in the olfactory bulb via A1R, A2BR, and A3R

The present study shows that animals with experimental autoimmune encephalomyelitis (EAE) exhibit olfactory dysfunction and impaired general cognitive abilities, as well as anxiety-like behavior. Olfactory dysfunction occurs on average at 2 dpi, well before the onset of the first motor signs of EAE (8–10 dpi). After the initial olfactory dysfunction, the EAE animals show a fluctuation in olfactory performance that resembles the relapsing–remitting course of human MS. The study also shows severe neuroinflammation in the olfactory bulb (OB), with numerous infiltrated CD4+ T cells and peripheral macrophages in the superficial OB layers, marked microgliosis, and massive induction of TNF-α, IL-1β, and IL-6. Reduced tyrosine hydroxylase activity in the glomerular layer, pronounced granule cell atrophy, and reduced numbers of type B neuroblasts in the rostral migratory stream also indicate altered plasticity of the neuronal network in the OB. Considering the exceptionally high purinome expression in the OB, the possible involvement of purinergic signaling was also investigated. The study shows that macrophages infiltrating the OB overexpress A3R, while highly reactive microglia overexpress the adenosine-producing enzyme eN/ CD73 as well as A2BR, A3R, and P2X4R. Given the simultaneous induction of complement component C3, the results suggest that the microglial cells develop a functional phenotype of phagocytizing microglia. The study also demonstrates transcriptional and translational upregulation of A1R in mitral and tufted cells, which likely influence resting network activity in OB and likely contribute to olfactory dysfunction in EAE. Overall, our study shows that olfactory dysfunction and altered social and cognitive behavior in EAE are associated with increased adenosine signaling via A1R, A2BR, and A3R

MONITORING OF IMMUNE RESPONSE IN VIROLOGIC SUCCESSFULLY TREATED HIV-INFECTED PATIENTS IN SOUTHEASTERN SERBIA

The number of CD4 lymphocytes defines the evolutional stage of HIV-infection and is the most important for a reliable estimation of the individual risk of developing AIDS. However, it is difficult to predict the degree of immune reconstitution during antiretroviral therapy, as it varies significantly from one person to another. Further investigations to better understand the limitations of immunological success are necessary to improve the response to treatment and regimen durability. The current study includes HIV-infected patients in Southeastern Serbia with achieved virologic suppression of HIV infection. The CD4 count was determined by flow cytometry, and was correlated with the duration of treatment, initial number of CD4 cells, type of antiretroviral therapy, mode of transmission of infection, age and gender of examinees. The resulting arithmetic mean and standard deviation of CD4 number was 473±259 cells/µl (range, 1130 cells/µl). There was no statistically significant correlation between the values of CD4 count and length of treatment, stage of the infection at which the therapy was started, treatment profile, method of infection, age or gender. The obtained results are comparable with the existing studies that follow immunological response to antiretroviral therapy and primarily point out the issue of substantial individual response variability, which has not yet been fully elucidated

Intracerebral hemorrhage as a first sign of pheochromocytoma: case report and review of the literature

Pheochromocytomas and sympathetic paragangliomas are rare catecholamine-secreting tumours that represent very rare causes of intracerebral haemorrhage in the young, with only a few cases reported. A 32-year-old man presented to our emergency department because of sudden onset of severe headache. He had a six-month history of paroxysmal headache, palpitations, and sweating. During examination he became somnolent and developed left-sided hemiplegia. A computed tomographic (CT) scan of the brain showed a right temporoparietal haematoma. He was admitted to the Clinic for Neurosurgery and the haematoma was evacuated. The patient was comatose, on assisted respiration, with frequent hypertensive crises. An examination for possible secondary causes of hypertension was undertaken. Plasma metanephrine value was elevated (414 pg/mL, reference values < 90 pg/mL). Abdominal CT scans revealed a large mass (6 cm) in the right adrenal gland. After adequate control of the hypertension was achieved with nonselective alpha- and beta-adrenergic blockers the tumour was excised. The histopathologic findings confirmed the diagnosis of pheochromocytoma. The genetic analysis demonstrated a duplication in exon 1 of the VHL gene. We reported a rare, potentially fatal complication of pheochromocytoma — an intracerebral haemorrhage. This case and review of similar rare cases in the literature illustrate the importance of early recognition of the characteristic symptoms of catecholamine excess in young patients with hypertension

Discussing Challenges in Diagnosis of Tuberculous Meningitis and Neurosarcoidosis.

Isolated chronic granulomatous meningitis remains a diagnostic challenge for the physician. Symptoms are often nonspecific and ancillary tests have low-sensitivity rates, which may delay targeted treatment and lead to increased morbidity and mortality. Here, we discuss the challenges in diagnosing and treating patients with chronic meningitis by reporting two cases of previously healthy patients who presented with granulomatous meningitis on brain biopsy