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Volume 39, Issue 2, 2025

Online ISSN: 3042-3511

ISSN: 3042-3503

Volume 39 , Issue 2, (2025)

Published: 12.11.2025.

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01.12.2011.

Review Article

Impact of medical therapy for sympthomatic benign prostatic hyperplasia on transurethral resection of the prostate

The aim of this study is to examine how the introduction of medical therapy for symptomatic benign prostatic hyperplasia (BPH) might have changed the indications, patient characteristics and outcome in men undergoing transurethral resection of the prostate (TURP) over two decades (1991.- 2011.). All patients who underwent TURP for symptomatic BPH at our institutions in 1991. (before the introduction of medical therapy for BPH), 2001. (when medical therapy was becoming an important therapy for BPH) and 2011. (when medical therapy was the first line therapy for BPH), were reviewed. We assessed the total number of TURPs, indications for surgery, patient age, health status, weight of resected tissue, and pre and post-operative events/ complications. Our institutions provided primary urological care for 989, 1815 and 2162 men > 50 years of age in 1991., 2001. and 2011., respectively. There was a 60% decrease of TURPs from 1991. to 2011. with a slight increase in number in 2001. Failure of medical therapy was not an indication in 37% and 88% of patients in 2001. and 2011., respectively. There was a substantial rise in the percentage of men at risk presenting with acute or chronic retention (AUR and CUR) at the time of their TURPs ( from 23% in 1991. to 55% in 2001. and from 14% in 1991. to 38% in 2011. for AUR and CUR, respectively) (P<0.05). There was also rise in the percentage of patients presenting with preoperative hydronephrosis (2% in 1991., 13% in 2001. and 6% in 2011.) (P<0.05) and gradual decrease of UTI before TURP overtime (14%, 10% and 12%, respectively).The mean operative time was lower in 2011., compared with either of the two previous cohorts (P<0.05), postoperative stays decreased (from 4.1 days in 1991. to 2.7 days in 2001. and 2.1 days in 2011.)(P<0.05), but the number of patients discharged with catheter increase over two decades (from 3.5% in 1991 to 4.8% in 2001., and to 8.8% in 2011.)(P<0.05). The postoperative complications of our three cohorts differed significantly (14% in 1991., 6.4% in 2001. and 20.6% in 2011.)(P<0.05). The increasing use of medical therapy as a first line treatment for BPH has resulted in a dramatic decrease in TURPs which, in turn, has been associated with an apparent increase in risk of poor pre- and postoperative outcomes seems to be related to earlier catheter removal and hospital discharge, although a causal relationship cannot be established. The present study covering the last two decades would suggest that we are not delaying surgery for patients who will eventually require it. We are now selecting the appropriate patients for TURP, rather than using TURP as our only means of BPH therapy as we did two decades ago.

Aleksandar Argirovic, Djordje Argirovic

01.12.2011.

Review Article

Analiza stope morbiditeta i mortaliteta od akutnog infarkta miokarda stanovništva Kosovske Mitrovice za period 2001-2011

U radu je obrađen jedanaestogodišnji period obolelih i umrlih pacijenata od akutnog infarkta miokarda (AIM) u populaciji Kosovske Mitrovice od 2001-2011 godine. Retrospektivno su obrađeni podaci o pacijentima koji su hospitalizovani na internom odeljenju Zdravstvenog centra u Kosovskoj Mitrovici tačnije u koronarnoj jedinici za period od 2001-2011 godine.Obrađeni su pacijenti uzrasnih grupa od 20- 70 godine.Za napred navedeni period hospitalizovano je ukupno 1380 pacijenta koji su lečeni od akutnog infarkta miokarda. Od ukupnog broja obolelih 894 ili 64,7% su muškarci a 486 ili 35,3% su žene. Stopa obolelih od akutnog infarkta miokarda je 1,9:1 u korist muškaraca. Registrovano je 142 fatalna ishoda 10,3% dok je 1238 bilo nefatalnih infarkta ili 89,7%.

Kristina Bulatovic, Milan Jakovljevic

01.12.2011.

Review Article

Deset godina posle -Izazovi u identifikaciji eshumiranih posmrtnih ostataka na teritoriji Kosova i Metohije

Nakon oružanih sukoba koji su se devedesetih godina XX veka odvijali na teritoriji bivše SFR Jugoslavije, poseban izazov predstavlja identifikacija žrtava rata. U radu je dat detaljan opis procesa identifikacije ekshumiranih posmrtnih ostataka. Jedan od ciljeva rada predstavlja i poređenje rezultata analize DNK i klasičnih forenzičkih metoda identifikacije. Ovaj rad se odnosi na identifikaciju posmrtnih ostataka koji su ekshumirani na Kosovu i Metohiji u periodu od 2001-2011. godine, a koji pripadaju Srbima i drugim nealbanskim nacionalnim zajednicama (Crnogorci, Bošnjaci, Romi, Goranci i dr.) i u znatno manjem broju Albancima, koji su takođe stradali u ratnom i posleratnom periodu. Ekshumacija i identifikacija posmrtnih ostataka otpočela je još tokom oružanog sukoba, nastavljena je velikim intenzitetom neposredno po uspostavljanju UN administracije u pokrajini, a od kraja 2001. godine među identifikovanim žrtvama dominiraju osobe nealbanskog porekla – Srbi, Crnogorci, Romi i dr. Iskustva ovog procesa kao i iskustva drugih država pokazuju da postoji potreba za organizovanjem odgovarajuće službe za identifikaciju posmrtnih ostataka nepoznatog identiteta u Srbiji, da bi se na efikasan način moglo reagovati u slučaju velikih nesreća.

Suzana Matejic, Milanka Miletic, Branko Mihajlovic, Nebojsa Deletic, Vesna Boskovic, Danijela Todorovic, Zivana Minic, Sefcet Hajrovic, Milos Todorovic

01.12.2011.

Review Article

Dementia: Screening and early detection in General Practice -a Pilot Study

The millions of patients at risk of developing dementia may be identified at an early stage of disease at the primary health care. The aim of our study was to perform screening for dementia in patients older than 65 years.Clinical instrument that we used in the screening of dementia patients was the Montreal cognitive assessment: Serbian version. The investigation involved forty patients older than 65 years who were tested for the existence of cognitive impairment. The results were processed by a computer program for statistical analysis (SPSS, version 20), using the Student’s t-test and linear correlation. Of all respondents, in 80% causes was registered cognitive disorder and with age were deteriorated test results. Our results suggest the efficiency and simplicity of screening programs on dementia, which could be implemented in daily practice.

Mirjana Makevic-Djuric, Milivoje Djuric

01.12.2011.

Review Article

Delivery after assisted reproduction

The aim of the paper was to describe and compare means of deliveries after assisted conception and after spontaneous conception. The rapid spread of assisted reproductive technology (ART) is part of development of modern society. Study is retrospective, descriptive and analytical. Data were collected out of medical charts of patients of Hospital for gynecology and obstetrics CHC Zvezdara, who have delivered babies in this institution after using methods of ART during the years 2001 till 2011. There were 190 ART patients, age ranging from 21 to 56 years, on average 35.6 (± 4.7) years. Majority (94.6%) of women were primiparous, without previous miscarriages. The most frequently used method of ART is IVF/ET (94.8%, of which ICSI was performed in 6.53%). 42.1% of pregnancies were achieved after second attempt of IVF/ET. Pregnancies delivered vaginally lasted on average 38,7±1,2 week of gestation. Majority of premature infants (overall incidence of preamaturety was 20,2%) were born by urgent cesarean section. There were 5 extremely premature infants (2,17%). There was 17,4% of twin pregnancies, and almost all of them (92,5%) we delivered by cesarean section. Average birth weight was 3160g (± 600), and average body length on birth was 51cm (± 3). The most vital infants were born spontaneously (wirh mean Apgar score in the 5th minute of 9,08). During our first ART pregnancy experiences we performed no vaginal deliveries. Further on, evident decreasing trend of cesarean section made place for vaginal deliveries. This ratio in study population slowely approaches to the general population ratio, and for now it is 40:60 (vaginal:cesarean delivery). Current experiencies encourage us to deal with ART pregnanices, as if they were spontaniously achieved, and to deliver them respecting obsteric indications.

Predrag Mitrovic, Nikola Matavulj, Aleksandra Mladenovic-Mihailovic

01.12.2011.

Review Article

Diffuse large B cell lymphoma: variants, subgroups and subtypes/entities

Diffuse large B-cell lymphoma (DLBCL) is the most common type of lymphoma worldwide, and represents a clinically, pathologically and biologicaly very heterogeneous group of tumours. Recent studies have subdivided diffuse large B cell lymphomas into morphological variants, molecular and immunophenotypical subgroups and distinct entities. An immunophenotypical subdivision of DLBCL, into germinal centre-like (GCB) and non-germinal centre-like (non-GCB) subgroups, using a combination of antibodies to CD10, BCL6 and MUM1, does not correlate exactly with gene expresion profile of GCB and activated peripheral B-cells (ABC). Some studies reported that combination of CD10, BCL6 and MUM1 expression could subdivide DLBCL patients into long- and short-time survivors.The WHO classification of 2008. recognizes a group of aggressive B-cell lymphomas that are not readily classified as either Burkitt lymphoma (BL) or DLBCL, and provisional category of B-cell neoplasms with features intermidiate between DLBCL and classical Hodgkin lymphoma. Furthermore, the new classification recognizes the patient age, site-specific categories, and clinical factors in defining variants of DLBCL.The WHO classification of 2008. is the result of successful international collaboration among pathologists, biologists and clinicians, but heterogeneous group of DLBCL will be the subject of further investigation.

Maja Perunicic-Jovanovic

01.12.2011.

Review Article

Classical Hodgkin lymphoma: Differential diagnosis and tumour microenvironment

Hodgkin lymphoma (HL) accounts for approximately 15% to 30% of all malignant lymphomas. According to current diagnostic criteria, approximately 90% to 95% of HLs fall into the Classical Hodgkin lymphoma (CHL) category; the remaining cases are nodular lymphocyte-predominant subtype of Hodgkin’s lymphoma (NLPHL) which is recognized as a separate entity in the World Health Organization (WHO) classification1. WHO classification is based on the fact that there are clear and consistent histologic, epidemiologic, immunologic, and genetic differences between NLPHL and CHL. NLPHL is an indolent germinal center (GC) B-cell malignancy, that represents a nodular proliferation comprised of a minority of large neoplastic centroblasts with multilobated nuclei, the so-called popcorn or lymphocyte-predominant (LP) cells. Immunohistochemically LP cells are CD20+, PAX5+, BCL6+, EBV-LMP1-, CD30- and CD15-. Background inflammatory infiltrate represent mixture of small B and T lymphocytes1. This type of tumour is characterised clinically by a relatively indolent course and a very good response to standard therapy in cases with low stage disease. Unfortunately, the prognosis is unfavourable for advanced stages2. CHL is also a clonal, malignant lymphoproliferation originating from germinal center B cells3. CHL has a bimodal age curve in western countries, showing a peak at 15-35 years of age and a second peak later in life at 45-60 years1. A histopathologic diagnosis of CHL is based on the identification of diagnostic Reed-Sternberg (RS) cells in an appropriate inflammatory background of mixed infiltrate by histiocytes, small lymphocytes, eosinophils, neutrophils, plasma cells, fibroblasts and colagen. Based on characteristics of the reactive infiltrate and the specific features of neoplastic cells, cases may be subclassified into one of four subtypes: nodular sclerosis (NSCHL), lymphocyte-rich (LRCHL), mixed cellularity (MCCHL) and lymphocyte-depleted classical Hodgkin lymphoma (LDCHL)1,4. Although most cases can be diagnosed on the basis of morphology alone, diagnostic criteria include the characteristic immunophenotype of the neoplastic population. RS cells and variants express the CD30 and CD15 antigens in the majority of cases and lack the common leukocyte antigen CD455,6. The LMP-1 protein of EBV is expressed in approximately 25% to 50% of CHLs depending on the histologic subtype and patient age7. The staining is membranous and cytoplasmic, and usually most neoplastic cells are positive. Etiology of CHL is still questionable, but due to the unique epidemiologic and clinical features of the disease, an infectious cause has long been suspected. Currently, immunohistochemistry for the EBV latent membrane protein-1 (LMP-1) and nonradioactive in situ hybridization for EBV-encoded early RNAs (EBERs) are the methods of choice for the detection of EBV in routinely fixed, paraffin-embedded tissues8. Recent data suggest that the EBV status of tumour cells in classical HL could have prognostic significance for patients with this heterogenous disease9.

Slavko Gasparov

01.12.2011.

Review Article

Problematic 'low grade' lesions in lymphoproliferative pathology

Pathological diagnosis of lymphoproliferative processes has been associated with a high error rate of 17- 35%, compared to a low diagnostic error incidence of 1-3% in general histopathology. In lymphoma diagnosis, one half of the diagnostic errors result in significant clinical consequences such as delayed or inappropriate therapy, unnecessary treatment, avoidable morbidity and compromised survival.1 Inherent pathological ambiguity of lymphoproliferative processes, interpretational subjectivity, unfamiliarity with diagnostic criteria and novel entities, lack of expert opinion, inappropriate laboratory support and poor clinico-pathological correlation are the main reasons behind most pitfalls in this subspecialty.

Stefan Dojcinov

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