Academic Medical Journal

THE SIGNIFICANCE OF PLACENTAL CHROMOSOMAL COMPOSITION IN THE OCCURRENCE OF FALSE POSITIVE RESULT IN NON- INVASIVE PRENATAL TESTING: A CASE REPORT HIGHLIGHTING POSITIVE RESULT FOR TRISOMY 21

2025-01-20T12:21:42+00:00

Introductioion: The article presents a case report of a false-positive result (FPR) for Trisomy 21 (T21) identified through a non-invasive prenatal test (NIPT) during pregnancy, which may arise from biological factors that lead to discrepancies between NIPT outcomes and the actual condition of the fetus.

T21 is the most frequently detected chromosomal anomaly, constituting 30% of findings obtained through NIPT. This study investigated the clinical application of NIPT following a positive T21 result.

Material and methods: Two distinct prenatal tests were conducted for the same pregnancy. The initial NIPT employed Harmony reagents with Ariosa cell-free DNA System, and was followed with confirmatory amniocentesis which involved quantitative florescent PCR analysis. Second NIPT utilized the VeriSeq NIPT Solution V2 from Illumina and was followed with confirmatory amniocentesis analysis and placental tissue analysis post-delivery both using quantitative fluorescent PCR and an oligonucleotide array.

Results: This study demonstrated that both NIPT tests produced consistent results, thereby clarifying the notion of a ‘false positive’ result attributed to Confined Placental Mosaicism (CPM).

Conclusion: Understanding the implications of FPR for T21 regardless of the lowest risk of CPM is essential when considering diagnostic options.

VERTEBRAL ARTERY DISSECTION: CASE REPORT

2025-02-28T07:10:27+00:00

Case report: A 36-year-old female patient with no cardiovascular risk factors was admitted as an emergency due to a disturbance in the gait and balance, dizziness, headache, which started suddenly approximately one day before admission to the neurology department. Nuclear magnetic resonance imaging studies showed an ischemic event in the left segment of the medulla oblongata, associated with a history of neck injury. NMR of the brain with FS sequence found a dissection of the left vertebral artery in proximal intracranial segment, approximately 1 cm in length. After conservative treatment with antiplatelet and antilipemic therapy, neurological improvement was observed. After one and a half years of follow-up, there was no recurrence of the same or similar neurological symptomatology. Conclusion: This paper highlights the importance of neck trauma, even after some time latency following the initial injury, as a cause of vertebral artery dissection and subsequent ischemic brain damage. This enables timely diagnostic and therapeutic actions, which certainly contribute to a better final outcome, which is a basic goal in our daily work.

MANAGEMENT OF FROZEN ABDOMEN AFTER HYSTERECTOMY - CASE REPORT

2025-03-23T19:31:48+00:00

Introduction: Frozen abdomen is characterized by the persistent loss of natural free spaces between intra-abdominal organs and compartmental structures, as well as pathological changes that are outof normal anatomical proportion. These pathological changes are brought on by a severe adhesive syndrome, followed by fibrotic and scar tissue formation.

Case report: A 56-year-old patient was admitted to the Intensive Care Unit with clinical signs of ileus. The patient had undergone a hysterectomy 28 days ago. The patient presented with abdominal pain, vomiting, and nausea. Laboratory tests and CT scans were obtained. After the performed tests, an indication for surgical treatment was set.

Under general anesthesia, a median laparotomy was performed which revealed an extremely difficult entry into the abdominal cavity due to the presence of abundant adhesions from a previous operation. The wound was left open and a vacuum-assisted closure (VAC) device was applied for continuous wound drainage, while broad-spectrum antibiotics were empirically initiated. Following this intervention, during the patient’s hospital stay, five additional interventions were performed to change the vacuum pack until complete closure of the abdominal cavity and establishment of full continuity of the surgical wound, followed by an improvement in the patient's general condition.

Conclusion: For a patient who has undergone surgery revealing a hostile abdomen, open abdominal management should be considered based on the origin of the illness. This allows for sufficient control of the abdominal cavity, as well as the identification and treatment of the disease.

FRACTURE OF THE MEDIAL TIBIAL PLATEAU WITH CONCOMITANT AVULSION FRACTURE OF THE FIBULAR HEAD

2025-02-13T08:52:47+00:00

Fractures of the medial tibial plateau accompanied by avulsion fracture of the head of the fibula are complex injuries that require careful evaluation and management. This type of injury is commonly observed in high-energy trauma, such as motor vehicle accidents or sports-related incidents. A common injury mechanism for this type of injury is axial compression with varus loading stress, which causes axial loading on the medial tibial plateau and at the same time strain stress in the lateral structures of the knee. Herein, we present a case of a 51-year-old male patient with medial tibial plateau fracture associated with avulsion fracture of the fibular head. This case presents our approach to the diagnosis and treatment of this particularly complex injury. Fractures of the medial tibial plateau with concomitant avulsion fracture of the fibular head are complex injuries that require meticulous approach. The key to success is accurate diagnostics, recognizing the problem and treating each problem accordingly. The goal is anatomical reduction and absolute stability which will allow early motion and mobilization.

INTEGRATIVE MANAGEMENT OF TIBIAL PLATEAU FRACTURE AND MEDIAL GONARTHROSIS WITH HIGH TIBIAL OPEN WEDGE OSTEOTOMY: A COMPREHENSIVE CASE STUDY

2025-02-25T20:33:44+00:00

Post-traumatic knee osteoarthritis (PTOA) is a significant long-term complication of tibial plateau fractures (TPFs), leading to joint degeneration and impairment. This study presents a comprehensive case analysis of a 72-year-old male diagnosed with a Schatzker Type VI tibial plateau fracture after a high-energy trauma, managed through a staged surgical approach. Initial open reduction and internal fixation (ORIF), achieved fracture alignment, leaving a residual varus deformity, accelerating medial compartment degeneration. The patient developed progressive pain (VAS score: 7/10), restricted mobility (KSS score: 45), and radiographic signs of osteoarthritis within six months post-ORIF.

A high tibial open wedge osteotomy (OWHTO) was performed to correct varus malalignment, redistribute mechanical loads, and delay the need for total knee arthroplasty (TKA). Preoperative radiographs determined a correction angle for biomechanical restoration. The osteotomy was stabilized using a TomoFix locking plate, and rehabilitation followed a structured weight-bearing protocol. At the three-year follow-up, the patient demonstrated pain relief (VAS: 2/10), functional recovery (KSS: 82), and joint stability, returning to daily activities with minimal limitations.

This study shows the critical role of OWHTO in managing post-traumatic gonarthrosis, as a joint-preserving alternative to early TKA. It explores biomechanical principles, surgical considerations, and rehabilitation strategies advocating for staged interventions in complex knee trauma to optimize long-term function.

FACTORS ASSOCIATED WITH RELAPSE AND DURATION OF ORTHODONTIC RETENTION

2025-01-17T09:32:00+00:00

Introduction: The main aim of orthodontic therapy is not only to correct malocclusions but also to maintain the results achieved over time. Retention after orthodontic therapy plays a critical role in this process, preventing relapses and ensuring long-term stability.

The aim of this systematic literature review was to analyze the factors influencing the relapses after orthodontic treatment and duration of the retention.

Material and methods: A literature search was conducted covering publications between the period from 1990 to 2024, using electronic databases such as PubMed, Scopus and Web of Science. Data were systematically organized regarding the principles of retention, factors affecting retention success, duration of retention and future research directions.

Results: Literature reviews indicate that the most common causes of relapses after orthodontic therapy are the following: (1) Aging process; (2) Periodontal ligament and gingival fibers; (3) Soft-tissue maturation; (4) Occlusal factors; (5) Limits of the dentition; (6) Presence of third molars and (7) Maxillary and mandibular expansion. Also, there are many factors influencing on the duration of the retention after orthodontic therapy.

Conclusion: Retention in orthodontics is a process influenced by various factors: patient compliance, retention modalities, and retention duration. Although many retention strategies have been proposed and implemented, challenges such as relapse and negative effects of long-term retention remain significant. To optimize stability post-therapy and enhance patient satisfaction in orthodontic practice, focus should be on personalized retention protocols, digital monitoring systems and the effects of long-term retention.

BRAF MUTATION IN COLORECTAL CARCINOMA IS ASSOCIATED WITH TUMOR DEPTH, LOCATION, GRADE AND PD-L1 EXPRESSION: SINGLE CENTER EXPERIENCE

2025-01-21T22:36:19+00:00

Introduction: BRAF mutations in colorectal carcinoma (CRC) are a known marker of poor prognosis and aggressive tumor behavior.

Aim: This study aimed to evaluate the correlation of BRAF mutations with tumor depth, anatomical location, histological grade, and programmed death-ligand 1 (PD-L1) expression in colorectal carcinoma.

Material and methods: A retrospective prospective analysis was conducted on 152 cases of CRC diagnosed at the Clinical Hospital Acibadem - Sistina. Tumor samples were tested for BRAF mutations and immunohistochemically stained for PD-L1 expression (clone SP263). Tumor depth and location were documented, and histological grades were determined. PD-L1 expression was assessed at cut-offs of 1-10%, 10-50%, and 50-100% of positive tumor cells.

Results: BRAF mutations were identified in 7.24% of cases, predominantly in right-sided colon tumors. Mutated cases exhibited greater tumor depth and higher histological grade (G3) compared to BRAF wild-type tumors. PD-L1 expression (50-100%) was significantly associated with BRAF-mutated tumors, particularly in advanced stages (IIIC and IVA). These tumors showed a higher likelihood of being located in the right colon and were linked to poorer differentiation and increased immune checkpoint expression.

Conclusion: BRAF mutations in CRC are associated with aggressive tumor characteristics, including greater depth, high grade, and right-sided location. The strong correlation with PD-L1 expression suggests potential therapeutic benefits of immune checkpoint inhibitors in BRAF-mutated CRC cases. Early identification of these mutations is crucial for optimizing patient outcomes.

DISTINCT SUBGROUP OF PATIENTS WITH UNMUTATED IGHV1-69 CHRONIC LYMPHOCYTIC LEUKEMIA AFFECTED WITH COVID‑19 INFECTION - SINGLE CENTER EXPERIENCE

2025-03-23T18:14:40+00:00

Introduction: With the onset of infection with COVID-19, complications of this disease among vulnerable populations have been a primary alarm for health systems. Chronic lymphocytic leukemia (CLL) is characterized by variable clinical courses among patients with distinct genetic background, often leading to a compromised immune system, and, hence, these patients were seriously affected by this pandemic.

Aim of the study: Evaluation of COVID-19 infection outcome in a subgroup of patients with unmutated IGHV1-69 CLL.

Materials and methods: This was a retrospective study comprising 35 patients with CLL, diagnosed and followed in the period between January 2012 and January 2022. Traditional laboratory, clinical and biological prognostic factors were evaluated at first patient visit to the University Clinic for Hematology – Skopje, Macedonia. Mutational status and genetics were analyzed using reverse transcriptase-polymerase chain reaction (RT-PCR) and sequencing methodology.

Results: In our study, there was a male predominance, with 65.7% of patients being male. Majority of patients had Binet B stage (57.1%). According to genetic structure, the most frequently expressed D gene was 3-16 in 42.8% of patients, and J gene 3-15 and 6-15 present in 42.8% of patients. Most of the patients were treated with Obinutuzumab (Ob)-based therapy, and 68.5% of patients received Ob + chlorambucil. Infection with Covid 19 was registered in 69% of patients; 44.8% of patients were vaccinated but with fatal outcome, and the overall fatal outcome rate was 42.8%.

Conclusion: In this retrospective study on COVID-19 comprising patients with unmutated IGHV1-69 CLL, 42.8% had a fatal outcome.

SERUM IMMUNOGLOBULIN LEVEL FOLLOWING THE TREATMENT IN CHILDREN WITH ACUTE LYMPHOBLASTIC LEUKEMIA

2025-03-25T11:10:40+00:00

Introduction: Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy, requiring intensive chemotherapy that can lead to immune suppression and secondary immunodeficiency. This study evaluates serum immunoglobulin (Ig) levels before and after intensive therapy in children with ALL.

Methods: Serum levels of IgA, IgG, and IgM were analyzed in children with ALL before chemotherapy initiation and after completing intensive treatment. Results were compared with a healthy control group. Statistical analysis was performed using the t-test, with significance set at p < 0.05.

Results: Before treatment, Ig levels in children with ALL did not differ significantly from those in the healthy control group (p > 0.05). However, after intensive therapy, IgA, IgG, and IgM levels showed a significant decline (p < 0.05). The decrease was more pronounced in children aged 6 to 12 years.

Conclusion: Intensive chemotherapy leads to a significant reduction in serum immunoglobulin levels, increasing the risk of infections. The results highlight the need for further research on intravenous immunoglobulin (IVIG) supplementation as a potential strategy to improve immune function in pediatric ALL patients undergoing treatment

PRENATAL AND POSTNATAL RISK FACTORS IN OVERWEIGHT CHILDREN WITH ASTHMA

2025-03-23T19:01:49+00:00

There is undoubtedly an increased risk of asthma in overweight children. The aim of this study was to evaluate the relationship between prenatal exposure and postnatal events and the development of asthma in overweight children. A total of 112 children aged 7-17 years were included in this prospective study. Thirty-eight had asthma and a normal body mass index (BMI), 33 were overweight with asthma, and 41 were overweight children. A medical history was taken from every child’s parent. No significant association between premature birth, gestational age, birth wight, delivery mode, maternal smoking status during pregnancy within the groups was found. Mothers of overweight children with asthma were most likely using antibiotics (12.1%) in the first 3 months of pregnancy. Familial atopy was significantly more associated with asthma as well overweight and asthma compared to overweight [OR=3.937 (1.46-10.61) 95%CI] vs. [OR=5.880 (1.89-18.23) 99%CI], respectively. According to the analysis, most children born as small for gestational age (SGA) 7(17.1%) were in the overweight group. For p<0.05, a significant difference in the number of older siblings was determined between overweight/asthma/overweight + asthma groups for consecutive Mann-Whitney U Test: Z=-2.619; p=0.009. Breastfeeding, vaccination, attendance at kindergarten, having pats and annual frequency of antibiotic treatment in the first 3 years, have no statistical significance.

Conclusion: Familial atopy was confirmed as one of the prenatal risk factors for asthma in childhood, independent of BMI. We did not confirm the "hygiene hypothesis" probably due to the small number of subjects for epidemiological analysis.

RADIOTHERAPY- INDUCED THYROID DYSFUNCTION

2025-02-18T09:35:44+00:00

Aim:The aim of this paper was to evaluate the effects of radiotherapy on thyroid function in breast cancer patients, comparing those treated only on the chest wall with those who also received supraclavicular (SCV) nodal irradiation.

Material and Methods: A total of 100 women with breast cancer treated with radiotherapy were analyzed. Blood samples were taken before radiotherapy and evaluated by measuring serum thyroid stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4) levels. None of the women were on thyroid substitution therapy. Thyroid function, including TSH, fT3 and fT4 levels, was monitored in patients every 6 months after the completion of radiation.

Results: The results revealed a significant impact on thyroid function, particularly an increased incidence of hypothyroidism in the SCV irradiation group. The study reported that after six months of radiotherapy, 35% of patients developed hypothyroidism, and this percentage decreased to 27% after twelve months. This suggests that while many patients may experience immediate thyroid dysfunction following radiotherapy, some may recover over time, though a substantial portion remains affected.

Conclusions: The data presented highlight a concerning trend of increased hypothyroidism among breast cancer patients undergoing radiotherapy, particularly those receiving SCV irradiation. The study's findings indicate that a substantial proportion of patients may experience lasting thyroid dysfunction, necessitating vigilant monitoring and management.

INITIAL CLINICAL SYMPTOMS IN CORRELATION WITH DURATION OF HOSPITALIZATION IN PATIENTS WITH ODONTOGENIC INFECTIONS

2025-01-28T12:52:17+00:00

Introduction: Odontogenic cervicofacial phlegmons are severe infections of the superficial and deep anatomical spaces of the head and neck. Early diagnosis and appropriate treatment are crucial for faster recovery, shortening the hospitalization period, and reducing the risk of severe systemic complications. Therefore, this study was performed to analyze the role of CRP, white blood cell count (WBC), and clinical symptoms in predicting the prolonged duration of hospitalization in adult patients with maxillofacial infections.

Material and methods: This retrospective study was based on diagnosed cases of odontogenic cervicofacial phlegmons, admitted to the University Clinic for Maxillofacial Surgery in Skopje, RN. Macedonia between January 2019 and December 2024. The Symptom Severity score (SS) was assessed in this study for all patients. Routine blood sample analysis on admission to hospital was performed: complete blood count, C-reactive protein, WBC, erythrocyte sedimentation rate (ESR), blood glucose level.

Results: In our investigation, CRP level on admission, WBC level on admission, and SS, were shown to have a positive correlation with the length of hospitalization.

Conclusion: The results indicated that serum WBC count and CRP levels in combination with SS score on admission should be used as biological and clinical parameters for the prediction of the duration of hospitalization in adult patients with maxillofacial infections.

TREATMENT CHALLENGES OF BIPOLAR DISORDER DURING THE PERINATAL PERIOD

2025-03-25T09:58:48+00:00

Introduction: The perinatal period presents significant challenges for women with bipolar disorder (BD), who face heightened risks of affective episodes and postpartum psychosis.

This study aims to examine the course of BD during the perinatal period, assess associated risk factors, and evaluate therapeutic interventions.

Material and methods: This prospective cohort study included 23 women, diagnosed with BD (ICD-10), over the course of six months. Assessments included the Edinburgh Postnatal Depression Scale (EPDS), Young Mania Rating Scale (YMRS), clinical interviews, and a questionnaire on sociodemographic and risk factors. Patients received combined pharmacological and psychotherapeutic treatment.

Results: The EPDS scores showed a low likelihood of depression at baseline, 3, and 6 months (56.5%, 69.6%, 69.6%), with mean scores decreasing from baseline to three months and slightly increasing at six months (p = 0.81). The YMRS scale indicated a significant reduction in mania from baseline to six months (p = 0.038).

All participants reported risk factors, including history of affective episodes (95.6%), traumatic events, intimate-partner violence (34.8%), substance abuse (26.1%), and unplanned pregnancy (21.7%). There was no significant correlation between risk factors and depression (p >0.05).

Conclusion: The findings of the study confirm the increased risk of mood episodes in women with (BD) during the perinatal period. Continuous treatment and long- term monitoring play a vital role in reducing the incidence and severity of affective episodes. Identifying and managing risk factors is crucial for providing effective individualized care during this vulnerable period.

INTENSITY OF PERSONALITY DISORDER AND BORDERLINE SPECIFICITIES IN PERSONS WITH NEUROTIC AND DEPRESSIVE DISORDERS

2025-04-01T10:24:37+00:00

Introduction: The intensity of personality disorders conditioned by the degree of self and/or interpersonal functionality is the basic diagnostic criterion for personality disorders according to ICD 11. There is a high prevalence and association of personality disorders with other psychiatric entities, as well as with neurotic and depressive disorders. The aims of this study were to determine the prevalence of personality disorder in neurotic and depressive patients, as well as the correlation with the borderline pattern.

Materials and methods: The study was designed as a monocentric, analytical observational cross-sectional study. It included 108 participants divided in three groups – people with neurotic and/or depressive disorders according to ICD 10 (60 participants), a control group (30 participants), and a group of people with personality disorders according to ICD 10 (18 participants). Scales were used to assess anxiety, depression, severity of personality disorders according to ICD 11 and the borderline pattern scale.

Results: A high prevalence of personality disorders was found in individuals with neurotic and/or depressive disorders; a high correlation of anxiety and depression with the severity of personality disorder, as well as a high correlation between the borderline pattern and the intensity of personality dysfunction.

Conclusion: The study demonstrated a significant difference in personality functionality among the examined groups, which had clinical implications.

THE RELATIONSHIP OF PERSISTENT HUMAN PAPILLOMAVIRUS INFECTION AND STRESS AT THE WORKPLACE

2024-12-25T07:42:59+00:00

Introduction: Human papillomavirus (HPV) is one of the most common sexually transmitted infections. While most genital HPV infections regress spontaneously, some persist and can progress to cervical cancer. The biological susceptibility to acquire HPV and the immunological capacity to eliminate the infection are influenced by various factors, including occupational roles, work-related stress, and burnout syndrome.

Materials and methods: In our study, relevant data were collected from 71 patients, 38 of whom had documented persistent HPV infections, while 33 patients were included in the study as a control group. Among those with persistent HPV infections, HPV 16 was the most common type, followed by HPV 31 and HPV 52.

Results: Job demands were assessed using the Job Demands Questionnaire. The burnout syndrome was evaluated with the Maslach Burnout Inventory. Job resources were investigated using the Hospital Survey on Patient Safety Culture Questionnaire and the English version of the Questionnaire sur les Ressources et Contraintes Professionnelles.

Conclusion: Preliminary data analysis revealed significantly higher levels of stress factors in the group of patients with persistent HPV infections compared to the control group. The insights gained from assessing the impact of workplace stress on HPV infection progression will help formulate recommendations to promote the health of the working population.

COPD PREVALENCE AND CHARACTERISTICS AMONG RETIRED WORKERS

2025-03-23T18:48:30+00:00

Introduction: Age and exposure to noxious particles and gases are considered as important risk factors for the development of COPD.

Aim of the study: To assess the prevalence of COPD in a sample of retired persons from the Skopje region.

Material and methods: We performed a cross-sectional study (prevalence study) in a sample of 392 randomly selected retired persons, 207 males and 185 females, aged 56 to 84 years. Study protocol included completion of a questionnaire and pre- and post-bronchodilator spirometry.

Results: The prevalence of COPD in the whole sample was 8.7% (34/392), being non-significantly higher in men (9.1%) than in women (8.1%). The difference in COPD prevalence between smoking and non-smoking retired persons was within the borders of statistical significance (10.7% vs. 7.5; P=0.084). The difference in COPD prevalence between retired persons exposed to vapors, gases, dusts, and fumes (VGDF) at their workplace during their active period and retired persons with no such exposure just missed statistical significance (9.5% vs. 7.4%; P=0.073). COPD prevalence in the smoking retired persons occupationally exposed to VGDF during their active period was significantly higher than its prevalence in the smoking retired persons occupationally unexposed to VGDF during their active period (12.6% vs. 8.2%; P=0.036).

Conclusion: Our results confirm the role of age and exposure to noxious particles and gases in the COPD development.

THE IMPACT OF AGE AS RISK FACTOR IN THE DEVELOPMENT OF SYMPTOMS OF MUSCULOSKELETAL DISORDERS RELATED TO WORK OF A DEFINED GROUP OF NURSES

2025-02-04T08:01:48+00:00

Introduction: If musculoskeletal disorders are caused or aggravated by work and/or the effects of the immediate work environment, they are called work-related musculoskeletal disorders (MSD). The physical capabilities that enable people to cope with the physical demands of work are naturally subject to decline with age.

Aim: The aim of the paper was to assess the influence of age as a risk factor in the development of symptoms of musculoskeletal disorders related to work in a defined group of nurses.

Material and method: The study included 160 nurses divided into two groups. The first group consisted of nurses under 45 years of age, and the second group nurses over 45 years. The used instrument was the medical history questionnaire and checklist for work-related MSD symptoms from the Canadian Centre for Occupational Health and Safety

Results: Musculoskeletal pain was registered in a total of 136 (85%) nurses, of which 71 (100%) nurses were over 45 years of age, and 65 (73.0%) nurses under 45 years of age. 20.2% of nurses under 45 years of age and more than half (57.7%) of nurses over 45 years of age were absent from work due to musculoskeletal disease. 33.8% of nurses over 45 years of age were hospitalized due to musculoskeletal disorder.

Conclusion: The results of our study and literature data indicate a significant influence of age on the development of symptoms of work-related musculoskeletal disorders in nurses. Therefore, timely ergonomic intervention and regular health monitoring is necessary.

INCREASE IN SERUM CYTOKINE CONCENTRATION FOLLOWING GERIATRIC HIP FRACTURE – CLINICAL RELEVANCE

2025-02-13T09:16:26+00:00

Introduction: Hip fractures are the most common operatively treated skeletal injuries, predominantly affecting individuals over 65 years of age who often have multiple comorbidities. A global increase in hip fracture incidence has been observed, accompanied by unfavorable outcomes, including reduced life expectancy. This study aimed to analyze the inflammatory response after hip fracture and surgery in patients aged over 65 years, and its association with functional outcomes.

Methods: This prospective, non-randomized study included patients with AO type 31A and 31B hip fractures admitted for surgical treatment. Eligible participants had demographic and clinical parameters recorded, including ASA scores, pharmacological therapy, and Katz Index scores. Blood samples were collected at four time points: within 10 hours post-injury, 48-60 hours post-surgery, on postoperative day seven, and day 30. Laboratory analyses included IL-1β, IL-6, and IL-10 levels. Follow-up data, including survival, mobility, pain, and quality of life (SF-12), were collected at 12 months.

Results: The study included 40 patients (median age: 78 years; 60% female). By the 12-month follow-up, 32 participants survived, while 8 died within 4-9 months. Deceased patients had significantly higher serum levels of IL-1β, IL-6, and IL-10 at all time-points. IL-6 was identified as an independent predictor of reduced mobility (p=0.013) and quality of life (p=0.009).

Conclusion: Elevated serum inflammatory markers were associated with poorer quality of life, mobility, and survival. These findings suggest potential for targeted rehabilitation programs and preventive strategies to improve outcomes in geriatric hip fracture patients.

TREATMENT OF KNEE OSTEOARTHRITIS WITH MESENCHYMAL STEM CELLS ARTHROSCOPY AND PHYSIOTHERAPY: EVALUATION WITH SF-36

2025-01-28T13:13:50+00:00

Introduction: Osteoarthritis (OA), a chronic degenerative joint disease, significantly impacts quality of life (QoL) and poses economic burdens, especially as aging populations grow. While no therapy fully regenerates cartilage, mesenchymal stem cells (MSC) offer a promising treatment for the condition.

Aim: This study aimed to evaluate effects of arthroscopically administered MSC therapy in conjunction with an 8-week standard physiotherapy regimen for patients with knee OA.

Material and methods: This monocentric clinical study involved 35 patients with knee OA (aged 45-65 years, of both genders), who treated with arthroscopy and MSC. Health status was assessed pre- and post-treatment using the 36-Item Short Form Health Survey (SF-36). Additionally, the influence of age and gender on treatment efficacy was analyzed to understand demographic impacts on therapeutic response.

Results: The average SF-36 score after treatment among male patients demonstrated better condition compared to female patients across individual concepts or domains, and overall SF-36 score.

The best condition of 100% according to the SF-36 score after treatment was found among males for the role limitations due to physical health and role limitations due to emotional problems. Among females, these domains also represented best post-treatment condition, with half of them achieving SF-36 scores of 100%. Younger age was significantly associated with better outcomes across all SF-36 concepts.

Conclusion: The results of the study highlight the potential of MSC arthroscopy in combination with physiotherapy, in managing knee OA in this group of subjects. To better understand long-term effects and optimize treatment, larger-scale randomized controlled trials are necessary.

DETECTION AND DETERMINATION OF RADIOACTIVE SURFACE CONTAMINATION WITH THE USE OF GAMMA CAMERA

2025-01-17T08:43:12+00:00

Introduction: In the nuclear medicine departments, the risk of radioactive contamination is significantly higher compared to other medical facilities. Although the gamma camera is used to scan patients who have been administered certain amounts of radioactive materials for medical purposes, this paper presents the possibility of using the gamma camera to detect and determine radioactive surface contamination.

Material and methods: For the purposes of this paper, an indirect method was used to determine the surface contamination, by taking wipe tests. These wipe tests were taken from a room where patients who are treated with I-131 therapy stay. The wipes were then measured using Gamma Camera – SoloMobile (DDD-Diagnostic) and an instrument for detection and measurement of radiation from the wipe tests FHZ 732 GM – Pancake (Thermo Electron).

Results and Conclusion: After the readings, the values of surface contamination (S_c) were calculated for both the gamma camera and the standardized instrument for determining surface contamination. After comparing the obtained results, the conclusion is that the gamma camera - SoloMobile can be used to detect surface contamination caused by gamma emitters. Notably, for S_c values greater than 1Bq/cm², satisfactory results were obtained, while for S_c values below 1Bq/cm², significant deviations were observed compared to those obtained with the standard instrument for detection of surface contamination.