USE OF BLOOD PRODUCTS IN ONCOLOGICAL PATIENTS TREATED WITH RADIO AND CHEMOTHERAPY

Retrospectively, we analyzed the use of blood products in Oncological Clinic of Clinical Center Nis in the period November 1st 2007-November 1st 2008, and also the influence of the treatment on degree of anemia and thrombocytopenia and use of blood products. None of the patients received the whole blood. In this period, 324 patients received the transfusion of blood components, 302 patients received 983 units of red cells (red blood cell concentrate, resuspended, washed, filtered), 17 patients received 5050 ml of platelets (single-donor concentrate or pooled platelet concentrate) and 5 patients received 2200 ml of fresh frozen plasma. An average use of red cell transfusion is 3,26 units, platelet concentrate 5,54, fresh frozen plasma 2 units per oncological patient who receives transfusion. The use of red cell units and platelet concentrate transfusion was adequate (91,85% of patients received transfusion of red cells when Hgb<70g/l, 89,2% of patients received platelet concentrate transfusion when platelet count was less than 20 x109/l). During radio and chemotherapy we noticed a decrease of hematological parameter values, whereas the experimental group patients were dependent on blood product transfusion. Statistically, a significant decrease of hemoglobin level and platelet count was observed in the patients treated only with radiotherapy, who are the greatest consumers of blood products

THE ROLE OF CANDIDA ALBICANS ON THE DEVELOPMENT OF STOMATITIS IN PATIENTS WEARING DENTURES

Denture stomatitis is the most common inflammatory reaction that occurs in people who wear dentures. It is believed that in 60-65% of cases the cause of this inflammation is infections by yeasts from the genus Candida (C.), primarily Candida albicans infection. C.albicans is a part of the normal microflora of the respiratory and digestive tract. This yeast has the ability to adhere to the oral mucosa and to the base of the denture, as well as to form a biofilm. Its virulence is especially supported by the state of weakened resistance of the organism, when C.albicans expresses its pathological effect. This paper presents the pathogenesis of C. albicans-associated denture stomatitis, as well as the most common diagnostic and therapeutic procedures used to diagnose and successful therapy

Factors associated with fetal growth restriction and small for gestational age newborns

Objectives: To identify risk factors that contribute to the occurrence of fetal growth restriction (FGR) and small for gestational age (SGA) and quantify the strength of their impact. Material and methods: This study was designed as a retrospective-prospective observational cohort study conducted on pregnant women at the Clinic for Gynecology and Obstetrics at the University Clinical Centre Kragujevac, Serbia. We measured the intrauterine degree of fetal development through the estimated fetal weight (EFW) on ultrasound examination, which was calculated using Hadlock’s formula 3. Fetuses whose EFW was below the 10th percentile on the World Health Organization (WHO) fetal growth charts adjusted for gender and gestational age were classified as FGR fetuses, while newborns weighing less than the 10th percentile were considered SGA. Results: The study included 320 pregnant women with an average age of 30.3 ± 5.5 years who gave birth to 332 newborns. The results of univariate and multivariate stepwise backward conditional binary logistic regression showed that the occurrence of FGR during the second trimester was more likely in pregnant women with lower body height and proteinuria. The risk factors for the occurrence of FGR during the third trimester were lower body height and proteinuria, while iron supplementation had a protective effect. SGA newborns were more common in pregnant women who were shorter, had proteinuria, used corticosteroids, or smoked during pregnancy. Conclusions: Clinicians should pay special attention to pregnant women with lower body height, proteinuria, who smoke and use corticosteroids in order to prevent FGR and SGA

Analysis of inpatient costs in patients with knee osteoarthritis treated by implantation of total condylar knee endoprosthesis

© 2018, Routledge. All rights reserved. Background/Aim. Total knee replacement is an elective and high cost surgical procedure which is performed more frequently as a result of increasing prevalence of knee osteoarthritis. The aim of this study was to provide insight into the value and structure of inpatient costs associated with total knee replacement in Serbia. Methods. This study was conducted as an in-depth, bottom-up, retrospective, case series analysis of services consumption patterns and costs associated with inpatient treatment of patients with knee osteoarthritis by implantation of primary total condylar knee endoprosthesis from perspective of the national Republic Health Insurance Fund. We obtained data on 97 patients treated with primary unilateral or bilateral total knee replacement in 2014 at the Clinic for Orthopaedic Surgery and Traumatology of the Military Medical Academy in Belgrade, a tertiary health care university hospital. Results. Mean age of entire study sample was 67.89 years. Majority of patients (60 patients; 61.9%) had unilateral implantation of total condylar knee endoprosthesis. Bilateral implantation was performed in 37 (38.1%) patients. Mean total inpatient cost per patient for both unilateral and bilateral implantation of total condylar knee endoprosthesis was EUR 2,709.1, ranging from EUR 1,685.2 to EUR 5,356.6. Mean total inpatient cost per patient was EUR 2,093.8 for unilateral implantation and EUR 3,706.8 for bilateral implantation. Two major cost drivers were surgery specific material and surgery. Cost of implants was the highest single cost driver in all observed groups of patients. Conclusion. Our findings imply that inpatient costs associated with implantation of primary total condylar knee endoprosthesis are substantial. It seems that the most important cost drivers are surgery and surgery specific material, with implants being the highest single cost driver. Further research should be focused on analyzing factors that influence these costs in order to develop effective strategies which could contribute to substantial savings in the future

Growth of Global Publishing Output of Health Economics in the Twenty-First Century: A Bibliographic Insight

BackgroundStrong growth of interdisciplinary sciences might find exceptional example in academic health economics. We decided to observe the quantitative output in this science since the beginning of the twenty-first century.MethodsElectronic search of the published literature was conducted in four different databases: one medical database—MEDLINE/PubMed, two general databases—Scopus/Elsevier and Web of Science (WoS), and one specialized health economic database—NHS Economic Evaluation Database (EED). The applied combination of key words was carefully chosen to cover the most commonly used terms in titles of publications dealing with conceptual areas of health economics. All bibliographic units were taken into account.ResultsWithin the time horizon from January 1, 2000 to December 31, 2016, without language or limitations on bibliographic unit types, we identified an output ranging approximately from 60,345 to 88,246 records with applied search strategy in MEDLINE/PubMed, Scopus/Elsevier, and WoS. In NHS EED, we detected 14,761 records of economic evaluations of health interventions during the period in which database was maintained and regularly updated. With slightly more than one-third of the identified records, USA clearly dominates in this field. United Kingdom takes a strong second place with about 12% of identified records. Consistently, USA and UK universities are the most frequent among the top 15 affiliations/organizations of the authors of the identified records. Authors from Harvard University contributed to the largest number of the identified records.ConclusionThere is a clear evidence of both the upward stream of blossoming in health economics publications and its acceleration. Based on this bibliographic data set, it is difficult to distinguish the actual impact growth of this output provided dominantly by academia with modest contribution by pharmaceutical/medicinal device industry and diverse national government-based agencies. Further insight into the citation track record of these individual publications could provide helpful upgrade and a perspective on ongoing development