Serum leptin levels in children and adolescents with spinal muscular atrophy types 2 and 3✰.

AIM: It has been reported that in patients with spinal muscular atrophy (SMA), lower levels of motor function are associated with hyperleptinemia. Additionally, hyperleptinemia has been found to be more frequent in underweight SMA patients. Therefore, we aimed to analyze serum leptin levels in patients with SMA. METHOD: This was a cross-sectional study of pediatric patients (2-19 years old) with SMA types 2 and 3. The investigations included anthropometric measurements, assessment of pubertal status, motor function evaluation using the Hammersmith Functional Motor Scale - Expanded (HFMSE), and serum leptin levels. RESULTS: In total, 37 patients (22 with type 2 and 15 with type 3 SMA) were included in the study. The male-to-female ratio was 1:1.3 and 62.2% of patients were prepubertal. No statistically significant correlation was found between the HFMSE score and leptin levels, rs(35) = 0.24, p = 0.15. There was, however, a strong positive relationship between the body mass index (BMI) z-score and leptin levels, rs(35) = 0.87, p < 0.001. CONCLUSION: Serum leptin levels do not seem to be a useful marker of disease severity in children and adolescents with types 2 and 3 SMA. As in the general pediatric population, leptin levels are strongly correlated with BMI, which is a surrogate measure of body fat.

[Incidence of surgical site infection after open heart surgery].

INTRODUCTION: Despite modem surgical techniques, preoperative preventive use of antibiotics and optimal treatment of operative site, surgical site infections (SSI) are significant medical problem in the countries worldwide. OBJECTIVE: The aim of this paper was to estimate the frequency of SSI after open heart surgery and to identify the most frequent causes of these infections. MATERIAL AND METHODS: A prospective cohort study was performed during the period from January 2008 to December 2009 at the Clinic of Cardiovascular Surgery of the Institute of Cardiovascular Diseases, Vojvodina. The surveillance was consistent throughout the study period. During hospitalization, patients were evaluated daily by the infection control nurse. Isolation, identification and sensitivity tests of causative agents to antimicrobial drugs, obtained from patients' material, were carried out by standard microbiological methods. The descriptive epidemio-logical method was used. The incidence rates of hospital infections were calculated. RESULTS: During the study period, among 23 patients, 24 SSIs were registered. The average incidence rate of patients with SSI was 0.98% and SSI rate was 1.02% (ranged from 0% to 3.7%). There was no difference in the incidence rates according to gender (p = 0.65).The mean age of patients with SSI was 64.7 years. Except one, all patients had the ASA score higher than 2. The patients with SSIs were hospitalized approximately 3.8 times longer than the patient without SSI (p = 0.03). The most common causes of SSI were: Staphylococcus aureus (30%), coagulasa-negative Staphylococcus spp, Acinetobacter spp (8%), Enterococcus spp and Klebsiella pneumoniae. CONCLUSION: Although the incidence rate of hospital infections is low, it is necessary to maintain continuous surveillance of surgical site infections and to implement the preventive measures.

[Risk factors for urinary bladder cancer]. / Faktori rizika za nastanak raka mokracne besike.

A matched case control study was conducted in order to assess possible relationships between some habits and risk of bladder cancer. The study included 130 newly diagnosed bladder cancer patients and the same number of controls matched with respect to sex, age (+/- 2 years) and type of residence (rural-urban). According to multivariate logistic regression analysis, risk factors of bladder cancer were smoking habits (OR = 3.15), consumption of animal fats (RR = 2.10) and pickled food (RR = 21.28). Higher level of educational (RR = 0.51), frequent urination (RR = 0.21), consumption of greens (RR = 0.10), cherry (RR = 0.03) and tangerines (RR = 0.02) had a protective effect.

[Descriptive and epidemiologic characteristics of patients with malignant upper urothelial tumors in the endemic area of Lazarevac]. / Neke deskriptivno-epidemioloske odlike osoba obolelih od malignih tumora gornjeg urotelijuma i endemskom regionu Lazarevca.

Although there is permanent increase in incidence of malignant upper urothelial tumours [1, 2], these malignancies are rare neoplasms in relation to both all malignant tumours and urotract tumours. Upper urothelial tumours, i.e. tumours of the renal pelvis and ureter are more frequent in the regions affected by endemic nephropathy [3-5]. The aim of this paper was to describe the main epidemiological characteristics in patients with upper urothelial tumours (UUT) in endemic nephropathic (EN) foci in Lazarevac. We analyzed 73 patients treated at the Institute of Endemic Nephropathy, Lazarevac and the Institute of Urology and Nephrology, Belgrade, from January 1, 1992 to December 31, 1994. The descriptive-epidemiological methods was used. The characteristics in patients with histopathologically confirmed upper urothelial tumours were examined. The diagnosis was made on the basis of the clinical picture, echo-sonographic and radioscopic examinations, intravenous and infusion urography and retrograde pielography. With genealogic analysis, a genealogical tree as far as the fourth degree of kinship for each patient, was made both for urothelial tumours and endemic nephropathy. The average age of the patients at the time of diagnosis was 64.2 years, and the majority of the patients (59%) was in the seventh decade of life (Figure 1). Our results are in accordance with the results of other authors who examined the patients with upper urothelial tumours in the regions with endemic nephropathy and out of them [7, 8, 12, 14]. Females were more affected than males (1.4:1). These results are in accordance with the results of other authors who studied the endemic regions [7, 11, 13]. Foreign authors found that males were more affected by upper urothelial tumours [9, 10]. In view of anatomic localization of tumours (Table 2) our results are in accordance with results of the studies carried out in endemic [11, 12, 15, 19] and non-endemic regions [8]. The majority of patients were rural population and lived in villages known as endemic foci (89%) (Table 1). Agriculture was their main or additional occupation. A large number of UUT patients (67%) had endemic nephropathy as well. The other authors from our country found that farmers were most affected [17, 18]. In foreign studies, there are no data on the fact that farming is risk for the appearance of upper urothelial tumours. The family agglomeration of UUT and EN in UUT patients has been observed in all degrees of relation, especially in the second and third generations (Table 3). The obtained results are comparable with hypotheses on a possible mutual or the same aetiological factor for both diseases, which is in accordance with the results of other authors who studied the endemic regions [6, 7, 12, 13].

[Organization of the program for prevention and control of nosocomial infections in France]. / Organizacija rada na sprecevanju i suzbijanju nozokomijalnih infekcija u Francuskoj.

Nosocomial infections (NI) are infections acquired in hospitals. The aim of this paper is to describe the organization of NI control program in France. The organization of this program started in 1988 by the formation of the Infection Control Committees in hospitals. Their role has been to organize the surveillance of NI, to verify basic measures of hygiene, safety of invasive procedures, disinfection and sterilization procedures, occupational safety, and to organize the continued education of health staff members. Operational teams have also been established in hospitals. At the national and regional levels, the National and Regional Infection Control Committees were established in 1992 in order to define the national policy for the treatment of actual infection problems in hospitals and to organize the co-operation between hospitals. In addition, many research projects concerning NI have been conducted and a number of international scientific meetings regarding this subject have taken place in France. According to the two surveys conducted at the national level, in 1990 and 1996, the prevalence rate of NI was found to be 7.4 and 7.6%, respectively. The infection control program could probably be integrated, in the future, into the Hospital Risk Management Program.