Assessment of the reliability of the serbian version of the sickness impact profile questionnaire in patients with chronic viral hepatitis

© 2015, Serbia Medical Society. All rights reserved. SUMMARY Introduction Health-related quality of life (HRQL) of chronic patients has been researched as the ultimate goal of modern treatment of chronic diseases to improve patients’ quality of life. Objective The objective was to assess the reliability of the Serbian version of the Sickness Impact Profile (SIP) questionnaire on the sample of patients with chronic viral hepatitis. Methods The research covered 102 patients with chronic hepatitis (47 type B and 55 type C). The assessment of the reliability of the SIP questionnaire was performed by testing the internal consistency of the questions by calculating the Cronbach’s alpha coefficient. The factor analysis was used to assess whether the grouping of the questions within dimensions matches the distribution of the questions in the original English version of the questionnaire administered to U.S. patient population. Results The Cronbach’s alpha coefficient for the entire questionnaire is 0.925, 0.869 for the physical dimension, and 0.857 for the psychosocial dimension. After running a factor analysis of the psychosocial dimension, “emotional instability” was extracted as the key factor, confirming the results of previous research. Compared with the English version of the questionnaire, the Cronbach’s alpha coefficient of the Serbian version does not diverge significantly, whereas the factor analysis confirms the classification of the questionnaire into two dimensions. Conclusion Our study has shown that the Serbian version of the SIP questionnaire is a reliable tool for assessing the HRQL of patients with chronic hepatitis B and C before starting treatment

Association between risk factors, basal viral load, virus genotype and the degree of liver fibrosis with the response to the therapy in patients with chronic hepatitis C virus infection

© 2015, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved. Background/Aim. Hepatitis C is an important sociomedical problem worldwide due to frequent progression to chronic dis-ease, occurrence of liver cirrhosis and hepatocellular carcinoma. Standard pegylated interferon alfa 2a plus ribavirin therapy results in resolution of infection only in 50% of patients. The aim of this study was to determine the association of various factors with re-sponse to the therapy in patients with chronic heptitis C virus (HCV) infection. Age and sex of patients, inoculation risk factors, histopathological changes in the liver, viral load and HCV geno-type were analyzed. Methods. The study included a group of 121 patients with chronic HCV infection. The treatment was carried out 24 weeks for virus genotype 2 and 3, and 48 weeks for geno-type 1 and 4. The degree of histopathological changes in the liver was determined by hematoxylin and eosin staining, whereas polimerase chain reaction was used for HCV genotyping. Results. In the group of non-responding patients genotype 1 was repre-sented with 100%, while in the other groups, although predomi-nantly present, its percentage was lower. Unresponsiveness to therapy and relapse of disease were associated with higher viral load and advanced fibrosis. Intravenous use of psychoactive sub-stances, as a risk factor, was present in a high percentage in the group of patients with sustained response, while blood transfusion and dialysis were leading risk factors in the group of relapse re-sponders and non-responders. Conclusion. The results of our study showed that the treatment outcome of chronic HCV infec-tion was associated with baseline HCV ribonucleic acid, HCV genotype, route of infection and the degree of histopathological changes in the liver

Effects of host defense peptides B2RP, Brevinin-2GU, D-Lys-Temporin, Lys-XT-7 and D-Lys-Ascaphin-8 on peripheral blood mononuclear cells: Preliminary study

Background and purpose: Host defense peptides have considerable therapeutic potential. One of the limitations for their therapeutic use is insufficient selectivity of some peptides, i.e. toxicity for eukaryotic cells. In this study, we have investigated effect of two naturally occurring and three analogs of frog skin-derived peptides on viability/proliferation of resting peripheral blood mononuclear cells and activated lymphocytes.Materials and Methods: Effect of tested peptides was assessed using MTT colorimetric assay. Concanavalin A was used as lymphocyte mitogen.Results: Brevinin-2GU induced cell death only in the highest tested concentration, whereas other peptides were not cytotoxic to resting peripheral blood mononuclear cells. Moreover, high concentrations of B2RP, D-Lys-Ascaphin-8  and Lys-XT-7 induced cell proliferation and this effect was more prominent in lymphocytes (pConclusions: Tested peptides (with exception of Brevinin-2GU) didn’t show cytotoxicity toward peripheral blood mononuclear cells. Moreover, they have potential to modulate immune response by inducing proliferation of resting peripheral blood mononuclear cells and limiting proliferative response to the activation stimulus. Regarding their potent antimicrobial and low hemolytic activity this makes them good candidates for therapeutic use.Key words: host defence peptides; cytotoxicity; immunomodulation </p

Lečenje koronavirusne boLesti (CoviD-19)

Coronavirus disease (COVID-19) is caused by RNA virus of severe acute respiratory syndrome 2 (SARS-CoV-2) which is highly contagious to humans. The primary receptor for the virus is probably angiotensin-converting enzyme 2. COVID-19 is a respiratory infection, primarily transmitted by droplets and close contact with a diseased person. Estimated reproductive number (R0) is 2-2.5 and the mean incubation time is 5.2 days, ranging 1-14 days (95% confidence interval 4.1-7.0 days). The most common symptoms are: fever, dry cough, malaise, productive sputum and dyspnea, followed, sore throat, headache, myalgia, arthralgia, fever and dizziness and, occasionally, confusion, rhinorrhea, nasal congestion, gastrointestinal symptoms, hemoptysis and conjunctival injection. Initial atypical manifestations are also known. Real-time reverse transcriptase polymerase chain reaction (rRT-PCR) assay is the "gold" diagnostic standard, but its specificity and sensitivity have not been established. The most common complications are: acute respiratory distress syndrome, acute liver damage, acute heart damage and arrhythmia, followed by secondary infections, acute respiratory failure, acute renal impairment, sepsis and/or septic shock, pneumothorax, disseminated intravascular coagulation, acute heart failure and occasionally, rhabdomyolysis. Disease duration varies and in hospitalized patients it is estimated to be 16-26 days (interquartile range 12-29 days), while the global mortality rate is still unknown with certainty. Drugs against SARS-CoV-2 prescribed by empirical protocols (off-label use) are lopinavir/ritonavir, chloroquine and hydroxychloroquine, nitazoxanide, umifenovir, ribavirin, inhaled interferon Alpha while the new drugs of clinical trial stages are remdesivir, nafamostat i favipiravir. Proven drug prophylaxis of COVID-19 does not yet exist and vaccine against SARS-CoV-2 has not yet been developed.Publishe

Hepatitis C Therapy – Related Haematological Side Effects are Associated with Treatment Outcome / Hematološka Neželjena Dejstva Terapije Hepatitisa C Su Povezana Sa Ishodom Lecenja

Treatment of patients suffering from chronic hepatitis C with standard pegylated interferon alpha 2a plus ribavirin has limited efficacy. Therapy outcome is dependent on several factors of both the host and virus, including age, sex, stage of fibrosis, viral genotype, viral load, and occurrence of haematological adverse events during chronic hepatitis C treatment. The aim of this study was to determine the relationship between the viral and host factors and the haematological side effects of therapy with sustained virological response

Risk factors of nosocomial infections caused by piperacillin-tazobactam resistant Pseudomonas aeruginosa

Introduction Pseudomonas aeruginosa is a common cause of serious infections in hospitalized patients and is associated with high rates of hospital morbidity and mortality. Objective The aim of this study was to identify the risk factors of nosocomial infections caused by piperacillin-tazobactam-resistant P. aeruginosa (PT-RPA). Methods A case-control study was conducted in the Clinical Centre Kragujevac from January 2010 to December 2011. Results In the observed period, 79 (38.16%) patients had PTRPA infections, while 128 (61.84%) patients had infections caused by piperacillin-tazobactam-sensitive P. aeruginosa (PT-SPA). Pneumonia was more frequently found in the PT-RPA group (55.70%) (p<0.05), whereas urinary tract infections were more frequent in the group of patients with PT-SPA infections (26.56%) (p<0.01). Multivariate analysis was used to identify an injury on admission (OR=3.089; 95%CI=1.438-6.635; p=0.004), administration of imipenem (OR=15.027; 95%CI=1.778-127.021; p=0.013), meropenem (OR=2.618; 95%CI=1.030-6.653; p=0.043), ciprofloxacin (OR=3.380; 95%CI=1.412-8.090; p=0.006), vancomycin (OR=4.294; 95%CI=1.477-12.479; p=0.007), piperacillin-tazobactam (OR=4.047; 95%CI=1.395-11.742; p=0. 010) as independent risk factors associated with PT-RPA infection. Conclusion In hospitalized patients, the risk of PT-RPA infec tions is associated with previous administration of imipenem, meropenem, ciprofloxacin, vancomycin, piperacillin-tazobac tam, and the presence of injury on admission

CD4/CD8 ratio as a predictor for the occurrence of metabolic syndrome in HIV / AIDS patients during 6 months of cART therapy

© 2019 Refet Gojak, Vesna Hadžiosmanović, Rusmir Baljić, Lamija Zečević, Jozo Ćorić, Željko Mijailović published by Sciendo. HIV infection is characterized by progressive depletion of CD4+ T cells due to their reduced synthesis and increased destruction followed by marked activation and expansion of CD8+ T lymphocytes. CD4/CD8 ratio was traditionally described as a marker of immune system ageing in the general population, but it increasingly appears as a marker of different outcomes in the HIV-infected population. The main objective of this study is to examine the power of CD4/CD8 ratio in predicting the occurrence of metabolic syndrome (MetS) in HIV-positive patients receiving cART therapy. 80 HIV/AIDS subjects were included in a retrospective case-control study. Flow cytometry was used to determine the percentage of CD4+ and CD8+ cells in peripheral blood of these patients. The values of biochemical parameters (triglycerides, HDL, blood sugar, blood counts), immunological parameters (CD4/CD8, PCR), anthropometric measurements and type of cART therapy were evaluated in this study. After six months of cART therapy 19 (23.8%) subjects had all the elements necessary for making the diagnosis of MetS. Using multivariate analysis CD4/CD8 ratio was statistically significant (p 0.05. CD4/CD8 ratio proved to be a significant marker for prediction of metabolic syndrome in HIV/AIDS patients

Applying the Molecular Adsorbent Recirculating System (MARS) in the Treatment of Acute Liver Failure (ALF) Case Report

Acute liver failure (ALF) is a rare but life-threatening illness with multiple organ failure. The short-term mortality rate exceeded 80 % despite modern approaches in treatment. Drugs, infections by hepatic viruses and toxins are the most common causes of ALF. Progressive jaundice, coagulation disorder and hepatic encephalopathy are dominated as a clinical signs of the illness. We present a case of a 36-year-old Caucasian woman hospitalized in ICU due to yellow discoloration of the skin and sclera, severe disseminated coagulopathy and hemodynamic instability. ALF is developed due to Hepatitis B Virus infection, resulting in hepatic toxicity as well as coma. General condition rapidly improved after applying of Molecular Adsorbent Recirculating System (MARS), an extracorporeal liver support system based on albumin dialysis. It is relatively expensive treatment that is used for the patient with hepatic encephalopathy grade 3 or 4 in our institution. In conclusion, an early administration of MARS significantly reveals subjective and objective clinical improvement in the case we presented