Numerička arealna gustina CD34 i CD117 imunoreaktivnih hematopoetskih ćelija u jetri humanog embriona i fetusa

Uvod. Hematopoeza je proces stvaranja krvnih ćelija i uobličenih elemenatakrvi. Ovaj dinamičan proces se postnatalno odvija u koštanoj srži, dok jeprenatalna hematopoeza raspršena na više lokalizacija. Počinje u žumančanojkesi, u intraembrionalnim ostrvcima hematopoeze, nastavlja se ujetri, slezini i koštanoj srži, a prema novim saznanjima i u placenti. Jetra jekao najveći hematopoetski organ intrauterinog razvoja izvor matičnih ćelijahematopoeze. Cilj rada je identifikacija i kvantifikovanje CD34 i CD117imunoreaktivnih hematopoetskih ćelija u jetri humanog embriona i fetusa.Metode. Korišćeno je 5 jetri humanih embriona i 25 jetri humanog fetusastarosti od 7 do 38 nedelja gestacije. Uzorci jetre podvrgnuti su rutinskojobradi do parafinskih kalupa. Tkivni presjeci, debljine 5 μm bojeni su hematoksilinomi eozinom, kao i imunohistohemijskim dokazivanjem CD34i CD117 antigena. Kvantifikacija je urađena morfometrijski određivanjemnumeričke arealne gustine. U statističkoj analizi korišćen je Hi-kvadrat test.Rezultati. Numerička arealna gustina CD34 imunoreaktivnih hematopoetskihćelija u jetri u embrionalnom periodu razvića je iznosila 0,35%, 0,30%u prvom trimestru (koji obuhvata i embrionalni i fetalni period), 0,46% udrugom trimestru i 0,10% u trećem trimestru. Numerička vrijednost arealnegustine CD117 imunoreaktivnih hematopoetskih ćelija u jetri za embrionalniperiod je iznosila 0,28%, 0,50% u prvom trimestru (koji obuhvata i embrionalnii fetalni period), 0,11% u drugom trimestru i 0,09% u trećem trimestru.Zaključak. Jetra embriona i fetusa predstavlja značajan izvor CD34 i CD117imunoreaktivnih hematopoetskih ćelija

The importance of medical students' attitudes towards statistics for acquiring competence in biostatistics: multi-site study and meta-analysis

Nakon saznanja da osnovne greške u analizi podataka doprinose neponovljivosti rezultata istraživanja mnogih publikovanih studija, u naučnoj zajednici prepoznata je potreba za boljim razumevanjem statističkih analitičkih metoda. Cilj ove studije je da se ispitaju stavovi studenata prema statistici u različitim edukativnim okruženjima, prate njihove promene i uticaj na postignuća iz biostatistike. Takođe, sproveden je sistematski pregled literature u cilju pronalaženja naučnih dokaza radi pružanja podrške pedagoškim odlukama koje se odnose na podučavanje studenata medicine iz oblasti primenjene statistike. Metod Upitnik za procenu stavova studenata prema statistici (eng. Survey of Attitudes Towards Statistics – SATS – 36) je korišćen za anketiranje studenata medicine na tri fakulteta Zapadnog Balkana, koji su pohađali obavezni predmet iz biostatistike. Prethodno je urađena validacija i kulturološka adaptacija upitnika na srpski jezik. Sistematski pregled literature sproveden je pretraživanjem publikacija objavljenih od 1994. godine u sledećim bazama podataka: Scopus, Web of Science, Science Direct, Medline i APA. Urađena je i meta-analiza koeficijenata korelacije skorova SATS komponenti i postignutih rezultata iz statistike. Zbirne procene su izračunate korišćenjem modela slučajnih efekata...The scientific community increasingly is recognizing the need to bolster standards of data analysis given the widespread concern that basic mistakes in data analysis are contributing to the irreproducibility of many published research findings. The aim of this study was to investigate students’ attitudes towards statistics within a multi-site medical educational context, monitor their changes and impact on student achievement. In addition, we performed a systematic review to better support our future pedagogical decisions in teaching applied statistics to medical students. Methods A validated Serbian Survey of Attitudes Towards Statistics (SATS-36) questionnaire was administered to medical students attending obligatory introductory courses in biostatistics from three medical faculties. A systematic review of peer-reviewed publications was performed through searches of Scopus, Web of Science, Science Direct, Medline, and APA databases through 1994. A meta-analysis was performed for the correlation coefficients between SATS component scores and statistics achievement. Pooled estimates were calculated using random effects models..

The importance of medical students' attitudes towards statistics for acquiring competence in biostatistics: multi-site study and meta-analysis

Nakon saznanja da osnovne greške u analizi podataka doprinose neponovljivosti rezultata istraživanja mnogih publikovanih studija, u naučnoj zajednici prepoznata je potreba za boljim razumevanjem statističkih analitičkih metoda. Cilj ove studije je da se ispitaju stavovi studenata prema statistici u različitim edukativnim okruženjima, prate njihove promene i uticaj na postignuća iz biostatistike. Takođe, sproveden je sistematski pregled literature u cilju pronalaženja naučnih dokaza radi pružanja podrške pedagoškim odlukama koje se odnose na podučavanje studenata medicine iz oblasti primenjene statistike. Metod Upitnik za procenu stavova studenata prema statistici (eng. Survey of Attitudes Towards Statistics – SATS – 36) je korišćen za anketiranje studenata medicine na tri fakulteta Zapadnog Balkana, koji su pohađali obavezni predmet iz biostatistike. Prethodno je urađena validacija i kulturološka adaptacija upitnika na srpski jezik. Sistematski pregled literature sproveden je pretraživanjem publikacija objavljenih od 1994. godine u sledećim bazama podataka: Scopus, Web of Science, Science Direct, Medline i APA. Urađena je i meta-analiza koeficijenata korelacije skorova SATS komponenti i postignutih rezultata iz statistike. Zbirne procene su izračunate korišćenjem modela slučajnih efekata...The scientific community increasingly is recognizing the need to bolster standards of data analysis given the widespread concern that basic mistakes in data analysis are contributing to the irreproducibility of many published research findings. The aim of this study was to investigate students’ attitudes towards statistics within a multi-site medical educational context, monitor their changes and impact on student achievement. In addition, we performed a systematic review to better support our future pedagogical decisions in teaching applied statistics to medical students. Methods A validated Serbian Survey of Attitudes Towards Statistics (SATS-36) questionnaire was administered to medical students attending obligatory introductory courses in biostatistics from three medical faculties. A systematic review of peer-reviewed publications was performed through searches of Scopus, Web of Science, Science Direct, Medline, and APA databases through 1994. A meta-analysis was performed for the correlation coefficients between SATS component scores and statistics achievement. Pooled estimates were calculated using random effects models..

Quality of osteoarthritis care in family medicine - a cross-sectional study

Introduction. Effective treatments for osteoarthritis are available, yet little is known about the quality of primary care in the Republic of Srpska for this disabling condition. Objective. The main objective of this study was to analyze the overall quality of osteoarthritis treatment in a family medicine setting, as well as to explore whether the achievement of quality indicators was associated with particular patient characteristics and severity of osteoarthritis. Methods. The cross-sectional study included 120 patients with confirmed hand, knee, and hip osteoarthritis, recruited at seven family practices in the town of Ugljevik, Republic of Srpska, Bosnia and Herzegovina. Data were extracted from a patient questionnaire on quality indicators, as well as from their electronic and paper records, to assess care against 14 indicators. The included quality indicators were based on the Arthritis Foundation’s Quality Indicator set for Osteoarthritis. Summary achievement rates for hip, knee, or hand osteoarthritis, as well as for the total sample, were calculated. Results. The mean achievement rate for all 14 quality indicators obtained from medical records was 74%, and 77% obtained from patient interview. The quality indicators concerning referral for weight reduction (23%) and pharmacological treatment (24%) had the lowest achievement rates, whereas the highest achievement rates were related to physical examination (100%), pain and functional assessment (100%), and education (90.8%). Patients physical functioning was significantly associated with the quality indicator achievement rate (p = 0.001). Conclusion. Pharmacological therapy and the referral of osteoarthritis patients in need of weight reduction seem to have the greatest potential for improvement in primary health care

Ispitivanje znanja studenata medicine o faktorima rizika za metabolički sindrom

Uvod. U poslednje dve decenije neprekidno raste učestalost metaboličkogsindroma kao skupa faktora rizika za kardiovaskularne bolesti i dijabetes.Edukacija studenata o metaboličkom sindromu je od posebnog značaja zanjihov kasniji rad na njegovoj prevenciji. Cilj istraživanja je bio da ispita znanjestudenata na završnoj godini studija medicine u Foči o faktorima rizika zametabolički sindrom i proveri njihove stavove o sopstvenom zdravstvenomstanju i pojedinim zdravstvenim navikama.Metode. U istraživanju koje je sprovedeno na Medicinskom fakultetu u Fočije učestvovalo 30 studenata VI godine (stopa odgovora 96,8%). Korišćen jespecifični upitnik namenjen ovom istraživanju koji su studenti popunjavali,a na osnovu kojih su dobijeni podaci o znanju i stavovima studenata, i pojedinimzdravstvenim navikama. Procena stanja uhranjenosti je vršena naosnovu izjava o telesnoj masi i telesnoj visini, na osnovu čega je određivanostanje uhranjenosti prema kriterijumima Svetske zdravstvene organizacije.Rezultati. Oko polovine studenata zna definiciju gojaznosti po kriterijumimaInternational Diabetes Federation (IDF). Pojedine faktore rizika koji definišumetabolički sindrom poznaje 10-47% studenata. Ne postoji razlika po polu uodnosu na znanje studenata o sopstvenim vrednostima arterijskog pritiska ikoncentraciji ukupnog holesterola u serumu. Utvrđena je visoka učestalostpušenja kod studenata oba pola (45,5% studenata i 31,6% studentkinja), astudenti muškog pola su značajno češće gojazni od studentkinja (18% vs. 0%).Zaključak. Studenti imaju određeni nivo znanja o faktorima rizika kojidefinišu metabolički sindrom, ali je to znanje neophodno poboljšati. Učestalostgojaznosti i pušenja je veća kod studenata muškog nego ženskog pola,te je neophodno implementirati stečena znanja o značaju faktora rizika zakardiovaskularne bolesti

Impact of the physician-patient relationship on the treatment outcomes of arterial hypertension

Objective: The primary objective is to analyze the impact of the physicianpatient relationship on the outcomes of hypertension treatment. Method: The study included 8 family physicians and 240 patients with arterial hypertension, selected according to specific criteria. Physicians were divided into two groups. Group 1 consisted of physicians who have had completed training in communications, while group 2 was comprised of those with no training in medical communications. Each physician was accompanied by a group of thirty patients with hypertension. The interaction between physician and patient was evaluated using the Bales interaction process analysis. During the 12 months, the functional parameters, blood pressure, patient compliance and patient satisfaction were monitored. Results: Statistically significant differences were found between two groups of physicians in all 12 categories of Bales Interaction Analysis. Physicians from group 1 were showing more empathy, humor, understanding, interest for patient background and their opinion compared to group 2 physicians. The mean systolic blood pressure level of the patients treated by physicians which belonged to group 1 decreased from 155.25 to 137.16 mmHg and diastolic from 94.20 to 79.3 mmHg. Statistically significant improvements in work performance, activities of daily living, psychological function, social activity, compliance and patient's satisfaction were also found in group 1 after 12 months. Conclusion: The study showed that physician-patient relationship significantly affects treatment outcomes in patients with arterial hypertension. Communication with patients can be improved by introducing interaction elements that are not exclusively related to the causes and characteristics of diseases, giving the relevant information and increasing intelligibility of this information during the encounter

Neoadjuvantna terapija HER2 pozitivnog karcinoma dojke

Receptor humanog epidermalnog faktora rasta 2 – HER2 (c-erb-B2) je prisutankod 15-20% karcinoma dojke u trenutku postavljanja dijagnoze. Prekomjernaekspresija HER2 receptora povezana je sa agresivnijom formomkarcinoma dojke. Trastuzumab je humano monoklonsko antitijelo kojevezujući se za HER2 receptor blokira signalne puteve ćelijske proliferacije.S obzirom na moguću pojavu rezistenzije na trastuzumab (vezuje se zapoddomenuII HER2 receptora te ostvaruje ligand nezavisnu inhibiciju ćelijskeproliferacije), tokom godina kreirano je drugo monoklonsko antitijelopertuzumab (vezuje se poddomenu IV HER 2 receptora i ostvaruje ligandzavisnu inhibiciju ćelijske proliferacije) te zajedno čine temelj dualne blokadeHER2 receptora. Brojne studije su pokazale korist od primjene trastuzumabai pertuzumaba, prvobitno u metastatskom, a potom i u adjuvantnomi neoadjuvantnom režimu. Neoadjuvantna (preoperativna) terapijase ordinira kod inoperabilnih tumora, kod bolesnika sa visokim rizikom odlošeg ishoda (HER2 pozitivni tumori, nodus pozitivni tumori, inflamatornikracinom dojke, veliki tumori), kao i kad postoje dodatni faktori rizika - HRnegativni tumori kod kojih se ne očekuje korist od hormonalne terapije uadjuvantnom miljeu. Neoadjuvantna terapija, takođe, omogućava in vivouvid u odgovor tumora na neoadjuvantnu terapiju. Kompletan patološkiodgovor (pCR – pathological complete response) je rani parametar efikasnostineoadjuvantnog tretmana koji takođe omogućava da se “na vrijeme”sazna senzitivost tumora i donese odluku o adjuvantnom tretmanu. pCRima prediktivnu i prognostičku vrijednost. Naime, stopa pCR u korelaciji jesa vremenom do progresije bolesti i ukupnim preživljenjem. Brojne studijesu na osnovu stope pCR pokazale da postoje podgrupe HER2 pozitivnihkarcinoma dojke: podgrupa hormon negativnih tumora koji imaju dobarodgovor na postojeću antiHER2 terapiju i HER2 pozitivni karcinomi dojke,podgrupa hormon zavisnih tumora, kod kojih se postojećim terapijskim opcijamajoš uvijek ne postiže adekvatna stopa pCR što predstavlja područjeza nova istraživanja i pronalaženje novih strategija liječenja