The impact of ultrasound-guided erector spinae plane block on hemodynamic stability and postoperative pain in patients undergoing modified radical mastectomy for breast cancer.

OBJECTIVE: Breast cancer, a prevalent global malignancy in women, necessitates a comprehensive treatment approach, with surgery playing a crucial role. Severe acute pain is common post-radical breast cancer surgery, emphasizing the significance of hemodynamic stability and postoperative pain control for optimal outcomes. This study evaluates the impact of ultrasound-guided erector spinae plane block (ESPB) on these parameters in ASA scores 1-2 patients undergoing modified radical breast cancer surgery with general anesthesia. PATIENTS AND METHODS: Forty-eight patients were divided into two groups: a general anesthesia group, with erector spinae plane block (GA+ESPB), and a control group receiving only general anesthesia (GA). Hemodynamic parameters were continuously monitored, and postoperative pain was assessed using the visual analog scale (VAS) at various time points. RESULTS: Ultrasound-guided ESPB effectively maintained hemodynamic stability and reduced postoperative pain in breast cancer surgery patients. Statistically significant differences were observed in heart rate, systolic and diastolic blood pressure, and mean arterial pressure between the GA and GA+ESPB groups at multiple time points (p < 0.05). VAS scores showed a significant interaction time*group (p < 0.001), with consistent differences between the groups at all time points (p ≤ 0.001). CONCLUSIONS: Ultrasound-guided ESPB application proved effective in preserving hemodynamic stability and managing postoperative pain in modified radical breast cancer surgery. The technique demonstrates promise in minimizing complications related to hemodynamic variations and postoperative pain, contributing to a comprehensive approach to breast cancer surgical treatment.

CUSHING'S SYNDROME, A RISK FACTOR FOR VENOUS THROMBOEMBOLISM IS A CANDIDATE FOR GUIDELINES.

OBJECTIVES: The present paper aims to review important contemporary information about VTE risk in endogenous and exogenous CS, as a substantial discrepancy exists between the results of a recent meta-analysis confirming the increased risk for VTE and the absence of CS in VTE guidelines. METHODS: An extensive search of relevant databases (e.g. PubMed, Google Scholar, and Scopus) was performed in order to establish the interconnectedness of the following terms: Cushing's syndrome, venous thromboembolism, deep vein thrombosis, pulmonary embolism. RESULTS: The analysis demonstrated that patients with CS have about ten times the risk for VTE, particularly during the first year following the diagnosis of CS. Oral glucocorticoid users (with iatrogenic CS) have a 3-fold increase in risk of VTE in comparison with non-users. The most recent 2019 meta-analysis encompassed 7142 patients with endogenous CS (including Cushing's disease) undergoing transsphenoidal surgery or adrenalectomy, and their risk of unprovoked VTE was almost 18 times higher in comparison with a healthy population. CONCLUSION: Over the past 50 years considerable evidence of increased VTE risk in CS has been accumulated. It pertains to both endogenous and exogenous type of CS and has been confirmed in the vast majority, if not all the available studies, including meta-analyses. Nevertheless, official CS guidelines make no mention of CS as a VTE risk factor, even though it is important that not only physicians who treat CS, but also physicians who manage patients with suspected VTE be aware of increased VTE risk.

Abdominal rectus muscle endometriosis after Cesarean section. Extrapelvic localization of endometriosis.

INTRODUCTION: Endometriosis is defined by the presence of functional endometrial tissue outside the uterus, where it is normally located. Endometriosis could has intra and extra pelvic localization. Abdominal endometriosis is the most common localization of extrapelvic endometriosis and is usually developed in the connective tissue surrounding the operation. Very rarely this could be found in the muscle tissue. The mechanical transplantation theory is responsible for the development of scar endometriosis. CASE REPORT: The patient, 35 years old, three years after caesarian section had an operation because of the assumption for the presence of front abdominal hernia, located at the place of previous section. The egg-sized tumor was removed from the abdominal rectus muscle and sent for PH and immunohistochemical analyses. The results showed endometriosis of the muscle with positive estrogen and progesterone receptors. One year after the operation, due to the repeated pains in the scar area, the treatment continued by GNRH analogues and control was performed by serial ultrasound and biochemical markers CA 125. CONCLUSION: Clinical diagnoses of scar endometriosis could be provided by an accurate anamnesis and physical, ultrasound and biochemical examinations. Scar endometriosis should always be considered when the symptoms are present in cyclic manner, hormone depending, mostly after gynecological operations and worsening during menstruation. The problem was diagnosed by pathohistological analyses (Fig. 4, Ref. 20).

Long-term outcome in Serbian patients with Wilson disease.

BACKGROUND AND PURPOSE: To investigate survival rates, prognostic factors, and causes of death in Wilson disease (WD). METHODS: In the years 1980-2007, a cohort of 142 patients with WD was prospectively registered (54 presented with neurologic symptoms, 49 with hepatic symptoms, 33 had mixed form, and data were missing for six patients). The duration of follow-up for patients alive was 11.1 +/- 8.8 years. RESULTS: After initiation of treatment (d-penicillamine and zinc salts), 79% of patients had a stable or improved course of disease. Despite early diagnosis and appropriate therapy, 15 patients still had a relentlessly progressive course. Thirty patients died. The cumulative probability of survival in a 15-year period for the whole group was 76.7 +/- 4.9%. Better prognosis of WD was associated with male sex, younger age at onset, neurologic form of the disease, and treatment continuity. Causes of death were predominantly related to hepatic failure (16 patients), but also suicide (four patients) and cancer (three patients). CONCLUSION: Despite the relatively early diagnosis and treatment of our patients with WD, mortality was still considerably high.

A comparison of sevoflurane-fentanyl and neuroleptic anaesthesia for laparoscopic cholecystectomy of mildly obese patients.

The current study was formulated to evaluate the advantages and disadvantages of sevoflurane-fentanyl and neuroleptic anaesthesia for laparoscopic cholecystectomy surgery of mildly obese patients. Laparoscopic cholecystectomy was performed using either sevoflurane-fentanyl or neuroleptic anaesthesia. Intra-operative haemodynamic stability, surgical duration, awakening time, severity of post-operative pain and hormonal stress parameters (serum and urinary cortisol, serum insulinlike growth factor and serum insulin) were determined. The duration of both surgery and patient hospitalisation were similar in both study groups. Patients that received sevoflurane-fentanyl exhibited a significantly shorter awakening time compared to neuroleptic anaesthesia. In addition, the same group of patients had less post-operative complications (nausea, vomiting, urinary retention and respiratory insufficiency) despite more abdominal pain. The severity of postoperative pain and the requirement of additional analgesia (up to 12 hours post-surgery) were greater in patients that received sevoflurane-fentanyl. The serum and urinary cortisol concentrations were significantly increased in post-operative patients that received neuroleptic anaesthesia whereas the insulin-like growth factor-I concentration in both study groups significantly decreased post-operatively. Our results clearly show that neuroleptic anaesthesia attenuates the stress response to laparoscopic cholecystectomy to a lesser extent than sevoflurane-fentanyl. The latter anaesthesia is recommended for laparoscopic cholecystectomy of mildly obese patients.

[Clinical and diagnostic approaches to neurocysticercosis]. / Klinicki i dijagnosticki pristup neurocisticerkozi.

ETIOLOGY: Cysticercosis is a tissue infection caused by larvae of the cestode Taenia solium. Neurocysticercosis is a central nervous system form of this infection. Taenia solium invades tissues in a form of a cyst with a thin, semitransparent wall. It can reach 1-2 cm in diameter in muscles and brain tissue and up to 3-6 cm in brain chambers. EPIDEMIOLOGY: Pigs are the most common intermediate hosts. The infection occurs when the parasite eggs or proglottids are ingested. It is most common in regions where human feces is used as a fertilizer, or regions with poor sanitary conditions. The man is infected with contaminated food or water, or by autoinoculation. PATHOGENESIS: The Taenia solium eggs are hatched in the duodenum. Embryos invade the intestinal mucosa, and reach various parts of the body, disseminated by the blood circulatory system. The most common localizations of cysticerci are skeleton, muscles and brain. While alive, these cysts produce a minimal reaction in hosts. Inflammation occurs when they die, often a few years after infection. CLINICAL FEATURES: While presence of adult worms of Taenia solium in the gastrointestinal tract causes unspecific symptoms, clinical features of neurocysticercosis depend on the number, size and localization of cysts, as well as on the degree of granulomatous response. The most common manifestations of this infection are epileptic seizures, whereas intracranial pressure increase can be the earliest sign of the disease. Hydrocephalus, meningitis and spinal cord compression syndrome are the most usual complications. PROGNOSIS: The death rate is low in neurocysticercosis with parenchymal cysts and calcification without hydrocephalus. However, fatal outcome occurs in hydrocephalic patients, cases with huge supratentorial cysts, multiple granuloma, brain edema or cerebral infarctions. DIAGNOSIS: Informations about travels to endemic regions are valuable in diagnosing neurocysticercosis. Cytobiochemical finding of the cerebrospinal fluid is often normal. However, in 50% of patients, lymphocytic or eosinophilic pleocytosis is found, low glucose (in 25%) and elevated protein (in 40% of cases). Further testing includes serologic examination of blood and cerebrospinal fluid. Finding of specific antibodies in the sera or cerebrospinal fluid confirms the diagnosis, although false positive reaction may occur in patients with other helminths, especially other cestode. The enzyme-linked immunotransfer blot assay is proven to be sensitive and specific in patients with multiple cysticerci. Computerized tomography and magnetic resonance imagining are techniques mostly used in establishing neurocysticercosis. They reveal the localization of cysticerci, identify the atrophic or edematous fields and assess the degree of ventricular dilatation.

[Clinico-epidemiologic characteristics of Lyme disease treated at the Infectious Disease in Novy Sad 1993-1998]. / Klinicko-epidemioloske karakteristike lajmske bolesti lecenih na Klinici za infektivne bolesti u Novom Sadu u periodu 1993-1998. godine.

INTRODUCTION: Borrelia burgdorferi, the etiological agent of Lyme disease, is transmitted by the bite of Ixodes ricinus, registered in all parts of Yugoslavia. Vectors are very active in spring and early summer and the disease has a seasonal distribution. Generally speaking, there are three defined stages of the disease, but some of them can be misdiagnosed or really absent. Serological analysis of Lyme disease is very difficult to interpret, especially in later stages, so confirmation by immunoblot assays is recommended. The aim of this study was to present some epidemiologic and clinical characteristics of Lyme disease in Vojvodina in the period from 1993-1998. Throughout this period, 1.659 persons with tick bite were registered, whereas 560 with diagnosed Lyme disease have been treated at the Clinic for Infectious Diseases in Novi Sad. RESULTS: In 511 patients (91.25%) we registered the first stage of the disease, in 42 (7.50%) the second stage and in 7 (1.25%) the third stage of the disease. The mean age of patients with erythema migranes was 38.67 years, mean incubation period was 9.37 days, and tick was removed from the skin after 2.29 days on average. Most of the identified tick bites originated from suburban areas (50.29%), they predominantly occurred in May and June (63.01%), and most of the ticks were removed improperly (57.67%). Dominant clinical manifestations of the second stage were acute meningitis (9.52%), Bannwarth's syndrome (9.52%), arthralgia and arthritis (50%), skin lesions (14.28%), cardiac disorders (11.90%) and mild liver lesions (2.38%) and generalized lymphadenopathy (2.38%). Chronic neuroborreliosis (42.85%), acrodermatitis chronica atrophicans (28.57%) and chronic arthritis were dominant clinical manifestations of the third stage. Up to 81.63% of patients with late stage of disease had a history of previous tick bite. One third of patients were asymptomatic in the first stage of the disease. Improper treatment of the first stage resulted in development of late stage disease in 57.14% of patients. CONCLUSIONS: Morbidity of Lyme disease in Vojvodina is about 1.98-9.8 cases on 100.000 inhabitants, and it belongs to regions with low incidence. Majority of bites are registered during summer months arround cities. Longer persistence of vector on the skin is a risk factor for manifested diseases. Inappropriately treated or completely untreated persons have higher risk for disseminated infection. In our country, most common manifestations of the second stage are neurological and articular manifestations as in the third stage. Leading symptoms and epidemiology aren't enough for diagnosis of Lyme disease, and more specific and sensitive serologic assays are necessary.

[Effect of prolactin on the regulation of osmotic processes across the fetoplacental membranes in vitro]. / Uticaj prolaktina na regulaciju osmotskih procesa kroz fetoplacentarnu membranu in vitro.

INTRODUCTION: The aim of this investigation was to point to the influence of minerals and total osmolality on regulation and secretion of prolactin in decidual tissue of the placenta and the role of prolactin in regulation of osmotic processes across the fetoplacental membrane. MATERIAL AND METHODS: Explants for the tissue culture have been obtained from pregnant women with normal pregnancy and delivery, between the 277 and 282 days of gestation. The investigation consisted of 4 repeated experiments. The parietal decidua and the corresponding chorion were separated from the amnion, rinsed in salt solution and cut into explants 0.2 g of weight. After a 2-hour period of preincubation in the control medium, 12 explants were incubated in the media of altered mineral and osmotic properties, whereas the 13-th in the control medium. Concentrations of prolactin following the 3-hour incubation in the medium was estimated by immunoenzymologic procedures. RESULTS: During the 3-hour incubation, the control explants secreted on average 75.4 +/- 5.23 micrograms/l of prolactin in the experiment repeated 4 times. The changes of Na+, Cl-, K+, Mg++, P- and HCO3- concentrations and of the total osmolality have not significantly influenced the synthesis of prolactin. In the medium with no Ca++, the value of secreted prolactin was 26.7 +/- 3.34 micrograms/l (p < 0.001); increase of the Ca++ concentration has not influenced the synthesis of prolactin. In the medium with increased concentration of H+ (pH = 7.00), the prolactin concentration was 50.9 +/- 2.9 micrograms/l (p < 0.001). CONCLUSION: The minerals--Na+, Cl-, K+, Mg++, P-, HCO3- and the total osmolality do not significantly influence the synthesis of prolactin in decidual-chorionic tissue. Certain quantities of Ca++ and optimal concentration of H+ are necessary for the synthesis of prolactin (PRL).

[Agranulocytosis as a complication of acute infectious mononucleosis]. / Agranulocitoza kao komplikacija akutne infektivne mononukleoze.

INTRODUCTION: Acute infections mononucleosis is the most common clinical manifestation of primary Epstein-Barr virus (EBV) infection occurring during adolescence. It is a benign lymphoproliferative, usually self-limiting disease. Complications are relatively rare, but they may occur, especially hematological. Most common are autoimmune hematolytic anemia and thrombocytopenia, and they respond to corticoid therapy. Deuteration of white blood cells is rather rare, whereas mild neutropenia is a normal finding during the course of acute disease. On the other hand, agranulocytosis is extremely rate, and almost every case has been reported in the literature. Filgrastim--the recombinant human granulocyte colony-stimulating factor (G-CSF) stimulates the activation, proliferation and maturation of progenitor granulocyte cells. This drug is usually applied in treatment of iatrogenic neutropenia, during chemotherapy of malignancies and in some idiopathic and cyclic neutopenias. CASE REPORT: A female patient, 18 years of age, has been hospitalized at the Clinic of Infectious Diseases in Novi Sad on two occasions. First because of severe acute infectious mononucleosis with acute hepatitis and jaundice 10 days after onset of symptoms. Physical examination revealed severe intoxication, dehydration, icteric skin, mucosis and massive hepatosplenomegaly. The diagnosis was confirmed by ELISA IgM, EBV VCA positive and ELISA IgG EBV VCA and IgG EBVNA negative results. The patient was discharged from hospital after 24 days without complaints and with normal physical and laboratory findings. For several days she felt well, but gradually severe fatigue and malaise occurred and she became febrile again. That was the reason why she was hospitalized again, two weeks later. This time she was febrile, extremely intoxicated with general lymphadenopathy, catarrhal gingivostomatitis and massive splenomegaly. The first laboratory findings showed severe neutropenia (absolute count of granulocytes was 0.156 x 10/l, with only 12% segmented neutrophils). Mild anemia--3.05 x 10/l was also registered, while the platelet count was normal. Other biochemical analyses were normal, the Coombs' test negative, while the serological response was also normal. Bone marrow puncture was performed and normocellular bone marrow was registered, somewhere hypercellular due to hyperplasia of granulocyte progenitor cells from promyelocytes to normal maturated cells. Anemia showed megaloblastoid proliferation, while megakaryocytes were normal. High doses of corticosteroids were applied (dexamethasone 160 mg daily) and filgrastim 5 micrograms every other day. From the very beginning of therapy the patient felt better, whereas granulocytes responded with elevation as soon as 48 hours after initiation of therapy. On the sixth day the treatment was stopped because the level of granulocytes was normal and the patient has completely recovered. She was discharged from hospital 4 weeks later with mild meteorism, but normal physical and laboratory findings and mild splenomegaly registered only by ultrasonography. DISCUSSION: During the last 10 years only several cases of severe leukopenia with acute infectious mononucleosis had been reported in literature. In all cases it was associated with some other hematological complications and it occurred in young adults without previously registered immunodeficiency. We have no knowledge about application of filgrastim in treatment of EBV-induced agranulocytosis, but the International Association for Studying Agranulocytosis and Aplastic Anemia reported that in 4% of patients Epstein-Barr virus can cause agranulocytosis even a year after the occurrence of acute disease.

[Modern aspects in the diagnosis and treatment of gynecologic diseases in childhood and adolescence]. / Savremeni stavovi u dijagnostici i lecenju ginekoloskih oboljenja u decijem i adolescentnom uzrastu.

Gynecological problems in juvenile and adolescent age deserve a special attention. Disorders appearing at this age are not identical with those developing in adults. Diagnostics and therapy of gynecological diseases in juvenile and adolescent age are far more complicated than the same procedures with adult women, while instruments and examination protocols have to be adjusted to the age of patients. To maintain the purpose of preserving the generative function and sexuality of an adult woman early detection and treatment of gynecological diseases of juvenile age are essential. The paper focuses at the analysis of the most frequently appearing disorders in juvenile and adolescent age: vulvovaginitis, foreign parts in vagina, development anomalies, synechia vulvae and injuries. It is essential to recognize certain diseases in order to prevent possible consequences in older age. Following diseases appearing in adolescents have also been analyzed: menstruation disorders (with an emphasis on menstruation disorder influenced by body weight), sexually transmitted diseases, pregnancy detection and complications.

[Leptospirosis at the Clinic for Infectious Diseases in Novi Sad 1984-1993]. / Leptospiroze na Klinici za infektivne bolesti u Novom Sadu u periodu 1984-1993. godine.

We examined the clinical picture and course of leptospiral infections in 50 patients treated at the Clinic during the period 1984-1993. Most patients were 11-20 years of age (9 years the youngest and 77 years the oldest, mean age being 25.16). The disease more often occurred in male patients, 44 (88%). There were 30 (60%) patients with gastrointestinal symptoms, while 21 (42%) had liver and kidney infections. Meningeal syndrome was established in 25 (50%) and serous meningitis in 13 (26%). Leptospiral infections represented average and serious infections with complications in 8 (16%) patients, successful treatment in 47 (94%) patients while 3 (6%) patients died due to hematorenal insufficiency.

[The effect of hypertension on prolactin levels in pregnant women at term]. / Uticaj hipertenzivne bolesti na nivo prolaktina kod trudnica u terminu.

In 79 women with regular menstrual cycle and giving birth to children on the 274th to 287th day of gestational age, prolactin was determined in mother's serum, umbilical artery serum and in the amniotic fluid, by using radioimmunity method in mg/l. Two groups of women and their newborn infants were examined. In the first group (n - 36) were women with hypertension, in the second (n - 43) healthy women. The average values of prolactin (X +/- SD) in mother's serum (214.3 +/- 98.6 micrograms/l and 189.4 +/- 94.7 micrograms/l) in examined women do not differ significantly (p > 0.05). The level of prolactin in the serum of embryo is much higher (p < 0.01) in women with hypertension (338.2 +/- 106.5 micrograms/l) than it is the case in normal pregnancies (251.6 +/- 99.2 micrograms/l). The values of prolactin are significantly higher (p < 0.01) in the amniotic fluid in women from the examined group (527.3 +/- 188.6 micrograms/l) than in the control group (398.1 +/- 156.3 micrograms/l). The difference between the level of prolactin in the amniotic fluid of women with meconium and clear amniotic fluid in both examined groups is not significant (p > 0.05). Values of correlation coefficient are small (r < 0.317) and point that the mutual dependence among the prolactin in mother's serum, umbilical artery serum and serum of the amniotic fluid is not significant.

Detection of Trichinella by various methods in Yugoslavia.

From studies performed on experimentally infected pigs, it was possible to conclude that enzymatic digestion methods are superior to trichinoscopy for inspection of pork for the presence of Trichinella spiralis. The analyses included comparative examination of samples taken from five different parts of diaphragm tissue.

[Malignant ovarian tumors in childhood and adolescence in Novi Sad (1946-1989)]. / Maligni tumori ovarijuma u decijoj i adolescentnoj dobi u Novom Sadu (1946-1989).

In the period from 1946-1989, at the Department of Gynecology and Obstetrics University of Novi Sad, 79 ovarian tumors in children and adolescents were registered. There were 10 (12.6%) malignant tumours. The most common were dysgerminoma and carcinoma (total 6-7.6%). The treatment depended on the extent of the disease at the time of diagnosis (surgery, irradiation, chemotherapy or combination).

[Injuries of the genital organs in young girls and adolescents (1959-1988)]. / Povrede genitalnih organa zenske dece i maloletnica (1959-1988).

In the 30-year period from 1959 to 1988, there were 112 young and adolescent girls admitted and treated at the Department of Obstetrics and Gynecology in Novi Sad, i.e. 3-4 per year. Young girls most often suffered from accidental injuries (41-36.6%) while older girls suffered from intracoital injuries (71-63.4%). The most frequent accidental injuries were the injuries of the vulva, perineum, hymen, vagina and sphincter ani, as well as one case of a severe injury of Douglas pouch followed by intestine injury. Colporrhexis was the most frequent intracoital injury.

[Dr. Lazar Nenadovic, gynecologist-obstetrician and founder of balneology and physical medicine in Serbia]. / Prof. Dr Lazar Nenadovic, ginekolog-akuser osnivac balneologije i fizikalne medicine u Srbiji.

Prof. Dr. Lazar-Laza Nenadovic specialist in obstetrics and gynaecology (Modos, 1870--Beograd, 1939), the founder of advanced physical medicine and balneo-climatology in Serbia. Prof. Nenadovic, besides a series of papers on obstetrics and gynaecology, is the author of a monograph on obstetrics and gynaecology published in Novi Sad in 1912, being the first of this kind in Serbia. Its title is Diseases of the female, their origin, causes and treatment. He was also one of the pioneers of gynecologic balneology in Yugoslavia and one of the founders of the Belgrade School of Obstetrics and Gynaecology, as well as a close collaborator and friend of Prof. Dr Milos Bogdanovic, the first head and professor of the Department of Obstetrics and Gynaecology of the School of Medicine in Belgrade.

[Determination of nutritional levels in patients on chronic hemodialysis programs using anthropometric methods]. / Odredivanje stepena ishranjenosti bolesnika na hronicnom programu hemodijalize antropometrijskim metodama.

The results of a number of methods used in the cross-sectional nutritional assessment differ markedly in patients on regular hemodialysis (RHD). Correlations of nutritional parameters were investigated in 31 patients on RHD and in 31 control subjects with similar sex and age structure without any considerable difference in any of the examined nutritional parameters. In the patient group on RHD, beside a high mutual correlation of general nutritional parameters and a high correlation of general parameters with fat compartment parameters and the fat free compartment (protein) parameter, there is also a high correlation of fat parameters with the protein parameter which does not occur in the control group. This can possibly explain the difficulties in the nutritional assessment of patients on RHD. Out of this reason we suggest the usage of the RBM/F classification which is a combination of relative body mass values (RBM) and the body fat content (F) percentage.

[Occupational damage and risk of occupational damage in personnel working with "Amerika" and IGK "Polet" drying kilns in Novi Becej]. / Profesionalne stetnosti i rizik od profesionalnih ostecenja radnika zaposlenih u susari tipa "Amerika" IGK "Polet" Novi Becej.

The paper briefly presents the technological process and professional noxiousness in the working environment, exposed to which are the workers employed in the smoke house type "America" IGK "Polet" in Novi Becej. Described is a case of accidental poisoning of 28 working women with carbon-monoxide, which happened because of a malfunctioning valve, and the letting through of gases into the air for the smoke house. A presentation is given of all the undertaken preventive measures for preventing the possibility of the exiting of gases into the smoke house air by introducing a system for the continuous measurement of carbon-monoxide concentrations in the working environment with sound and light signalization; the necessity of conducting periodical medical examinations of employees and examining of working environment conditions.

[Nutritional levels and in vitro tests of thyroid function in patients on a chronic hemodialysis program]. / Stepen ishranjenosti i in vitro testovi tireoidne funkcije kod bolesnika na hronicnom programu hemodijalize.

The nutritional status of 31 patients on regular hemodialysis (RHD) and of 32 control subjects was assessed by the Simic RTM/M classification, and in vitro thyroid function tests were determined in each subgroup. There were 13 malnourished, 13 normally nourished and 5 obese patients on RHD and 9 malnourished and 23 normally nourished control subjects. Differences between subgroups were considered in the light of their sex and age structure, duration of regular hemodialysis, proportion of patients with concomitant chronic illness, and the proportion of patients which received transfusion within the last 7 days. TT4, FT4 and rT3 were influenced by the nutritional status of the patients on RHD, while TBG, TT3 and FT3 were not. The statistical significance between RHD patient subgroups and the subgroups of control subjects was altered only in the case of TT4.

[Increase in body weight and levels of organochlorine insecticide and polychlorinated biphenyl residues in the blood during pregnancy]. / Prirast telesne mase i koncentracije rezidua organohlornih insekticida i polihlorovanih bifenila u serumu trudnica.

Concentrations of organochlorine residues, viz., p,p'DDE, p,p'DDT, total DDT, gamma-HCH and polychlorinated biphenyl (PHB) were determined in the serum of both pregnant and unpregnant women. It appeared that concentrations of these residues were statistically significantly lower in the pregnant women. Besides, some variations in these concentrations, observed at three stages of pregnancy (the third month, the sixth month and at the delivery), were not statistically significant. With the body weight increase during the pregnancy, an increase, instead of the expected decrease, in concentration of organochlorine residues was observed. The increase in organochlorine residue content which is statistically significant may be of clinical significance. Those pregnant women that had a greater body mass increase had also higher concentrations of organochlorine contaminants in the serum. This means that the fetus was exposed more strongly to their action. An explanation of this phenomenon should be sought in the numerous physiological changes occurring in the pregnancy. In is necessary to continue the study of the correlation between the body mass increase and the concentration of organochlorine residues in the serum of pregnant women and their milk after the delivery.