fourth global students' conference of biomedical sciences...

Fourth Global Students' Conference of Biomedical Sciences

Abstract bookBelgrade, 19th - 21st October 2017, Republic of Serbia

Conference organiser:

Faculty of Medicine, University of Belgrade

4th Global Students’ Conference of Biomedical Sciences

2 Belgrade, Serbia2017

ADVISORY BOARD

Vladimir Bumbaširević, Full Prof. MSASA, Rector of University of Belgrade; Nebojša Lalić, Full Prof. MSASA, Dean of the Faculty of Medicine; Tatjana Simić, Full Prof. Vice-Dean of the Faculty of Medicine; Predrag Peško, Full Prof. MSASA, Vice-Dean of the Faculty of Medicine; Dragan Micić, Full Prof. MSASA, Vice-Dean of the Faculty of Medicine; Petar Bulat, Full Prof. Vice-Dean of the Faculty of Medicine; Tanja Jovanović, Full Prof. Vice-Dean of the Faculty of Medicine; Vesna Bjegović Mikanović, Full Prof. Vice-Dean of the Faculty of Medicine; Tatjana Pekmezović, Full Prof; Marija Plješa Ercegovac, Assoc. Prof.;

SCIENTIFIC BOARD

Maja Ćupić, Full Prof; Jelena Milašin, Full Prof; Branislava Milenković, Full Prof; Tatjana Pekmezović, Full Prof; Gordana Dragović-Lukić, Assoc. Prof; Srđan Lopičić, Assoc. Prof; Nađa Marić-Bojović, Assoc. Prof; Miloš Marković, Assoc. Prof; Dejan Nešić, Assoc. Prof; Jelena Nešović-Ostojić, Assoc. Prof; Sanja Sinđić-Antunović, Assoc. Prof; Mila Todorović-Tirnanić, Assoc. Prof; Nebojša Antonijević, Assist. Prof; Ksenija Bojović, Assist. Prof; Martina Bo-sić, Assist. Prof; Marina Đelić, Assist. Prof; Svetlana Đogo-Mračević, Assist. Prof; Dragan Hrnčić, Assist. Prof; Vesna Jakšić, Assist. Prof; Milica Labudović-Borović, Assist. Prof; Maja Lozić, Assist. Prof; Nela Maksimović, Assist. Prof; Petar Milovano-vić, Assist. Prof; Maja Miletić, Assist. Prof; Sonja Misirlić-Denčić, Assist. Prof; Milica Pejović-Milovančević, Assist. Prof; Janko Samardžić, Assist. Prof; Željka Stanojević, Assist. Prof; Jovica Šaponjski, Assist. Prof; Nikola Vojvodić, Assist. Prof; Jasna Zidverc-

Trajković, Assist. Prof; Darko Antić, TA; Voin Brković, TA; Vesna Ćorić, TA; Jelena Dotlić, TA; Eleonora Dubljanin, TA; Ina Gajić, TA;Anđelka Isaković, TA; Ana Jotić, TA; Igor Končar, TA; Sanjin Kovačević, TA; Marko Krstić, Mr. Ph. PhD; Vesna Mandić-Marković, TA; Ljiljana Marina, TA; Jelena Stojković Filipović, TA; Jasna Trboje-vić-Stanković, TA; Ivan Zaletel, TA

EDITOR-IN-CHIEFNikola Pantić

ASSOCIATE EDITORSSmiljana Mihailović, MDAleksandra Beleslin

EDITORSDanica NikolićDobroslav PureševićRadovan AnđićMilica PrpićStefan MaksimovićAna PetronijevićAleksa Leković

TECHNICAL EDITORNikola Pantić


3Belgrade, Serbia2017

PRESIDENT OF ORGANISING COMITEE Dimitrije Cvetković, MD

VICE-PRESIDENT OF ORGANISING COMITEEAdi Hadžibegović, MD

TREASURER OF ORGANISING COMITEEMarija Jeremić, MD

SECRETARY OF ORGANISING COMITEEPetar Simić

EDITOR IN CHIEF OF ABSTRACT BOOKNikola Pantić

ORGANISING COMMITTEE ASSOCIATESAmalija StojanovićDario Potkonjak

LOGISTICSLidija Aleksić, MDMiloš LazićSiniša PetkovićKatarina IvanovićSrđan Pandurević

WORKSHOPS Bogdan Bjelica, MDIvo Božović, MDStefan StankovićSuzana SredićVanja Radišić

PUBLIC RELATIONSJovan IlićJelena Ćuk, MDArsenijević Mirjana, MDJovana Ilkić

HOSTINGJelena MarićĐurđa RafailovićDaniela Čule

FUNDRAISINGAlesandra TrajkovićNatasa AtlijaBojana PotparaSara Milovanović

SOCIAL PROGRAMMEMiloš Banjanac, MDDavid ObućinaPetar Đurković

OUR TEAM:



CONFERENCE TIMETABLE

Thursday, 19.10.2017.11:00-15:30 REGISTRATION12:00-12:45 OPENING CEREMONY12:45-13:30 LECTURE 1 - Jason Payne-James13:30-14:15 LECTURE 2 - Vladan Vukčević, MD PhD14:15-15:30 COKCKTAIL15:30-21:00 FREE TIME

21:00 SOCIAL PROGRAMME

Friday, 20.10.2017.9:00-10:15 PRESENTATIONS 1

10:15-10:30 COFFEE BREAK/SNACK10:30-11:30 LECTURE 3 - Dimitrije Brašanac, MD PhD11:30-12:00 COFFEE BREAK/SNACK12:00-14:00 WORKSHOPS 114:00-15:00 LUNCH15:00-22:00 WALKING TOURS, FREE TIME

22:00 SOCIAL PROGRAMME

Saturday, 21.10.2017.9:00-10:15 PRESENTATIONS 2

10:15-10:30 COFFEE BREAK/SNACK10:30-12:15 PhD SESSION12:15-12:30 COFFEE BREAK/SNACK12:30-14:00 WORKSHOPS 214:00-15:00 LUNCH15:00-17:00 FREE TIME17:00-18:00 CLOSING CEREMONY18:00-19:00 GROUP PHOTO AND CERTIFICATE PICKUP



Dear Professors, colleagues and guests,

Working with GSC community for 2 years now, has really been a rewarding experience. I had the opportunity to meet, work and become friend with some really great people. This is the essence of the GSC. Building a platform that allows young researchers to present their work, share experiences and ideas and make connections with people from all parts of the world and hopefully create long lasting friendships and partnerships.

I really hope you will enjoy our stay, and I wish you all the best with your presentation.

Sincerely, Dimitrije Cvetković

President of Global Students’ Conference of Biomedical Sciences in Belgrade 2017

FOREWORD



1. TRANSCRANIAL PARENCHYMAL SONOGRAPHY

TA Milija Mijajlović

Transcranial parenchymal sonography is a highly sensitive noninvasive ultrasound method for detection of early and specific basal ganglia echogenic changes in patients with some neurodegenerative diseases. Transcranial sonography showed substantia nigra hypere-chogenicity as a typical echo feature in idiopathic Parkinson disease and lenticular nuclei hy-perechogenicity as a characteristic finding in atypical parkinsonian syndromes. Brain stem ra-phe hypoechogenicity or interruption has been shown to be highly prevalent in patients with unipolar depression as well as depression associated with certain neurodegenerative diseases. Transcranial ultrasonography also revealed basal ganglia hyperechoic changes in movement disorders with trace metal accumulation such as Wilson disease, some entities of neurode-generation with brain iron accumulation, as well as several forms of spinocerebellar ataxia.

During the workshop, we will present basic examination principles and will demon-strate normal ultrasound anatomy of the brain parenchyma, as well as typical pathological findings.

2. DERMATOLOGY IN EVERYDAY PRACTICE – TEST YOURSELF

Assoc. Prof. Mirjana Milinković

Skin is the largest organ in our body and one of the great advantages is that it is acces-sible for the examination. Can we read from the skin? What are other associated disorders? Could we use the skin as a window to internal organs?

How much does the general practitioner (GP) know about the most common skin dis-eases? Are any of them life threatening?

If we have a (young) person with acne, eczema or psoriasis, are we aware of the patients’ psychological suffering, as the cutaneous disorders are easily seen by everybody? How do we deal with fear that people have, thinking that most of the skin diseases are contagious?

The participants of the workshop will learn to find the answers to those questions. At the end, we will have the quiz: Test yourself in skin disorders in GP’s office.

3. FIRST AID IN SPORT

Full Prof. Dragan Radovanović, Red cross of Serbia

How to respond e ectively in the sport emergencies with an injured athlete on the eld?Sport injuries can vary in severity, from minor laceration and hematomas to spinal

injuries and head trauma.First aid intervention on the spot of accident can potentially save athletes’ life, can help

to speed recovery process and limit potential complications.Let’s join workshop “First Aid in sport” and develop your rst aid knowledge and prac-

tical skills, and learn how to deal with sport emergencies.

4. ADVANCED LIFE SUPPORT

TA Jelena Veličković, Assist. Prof. Ivan Palibrk

Advanced Life Support (ALS) Workshop will prepare you to respond to life-threatening emergencies in the adult population with advanced interventions. This ALS course is based on the latest guidelines which focus on doing several tasks simultaneously with a group pro-

WORKSHOPS



cess that enables efficiency and minimization of error.This course will teach participants how to perform advanced emergency interventions

as well as review foundation issues including Basic Life Support, the Resuscitation Team, Life-Threatening Issues, Medical Devices, Bradycardia, Tachycardia, and much more.

This workshop teaches the knowledge and skills required to:1. Recognise and treat the deteriorating patient using a structured A B C D E approach.2. Treat cardiac arrest in special circumstances, including starting CPR, manual defibrilla-

tion, life threatening arrhythmias, and post resuscitation care.3. Lead a team, work as a team member, and use structured communication skills includ-

ing giving an effective handover.The program will emphasise the practical aspects of resuscitation and provide partic-

ipants with the theory underpinning such aspects. The students will have an opportunity to practice the airway management (endotracheal intubation, laryngeal mask placement, mask ventilation) and to take part in solving different CPCR scenarios guided and monitored by experienced instructors.

5. FORENSIC MYSTERIES SOLVED

TA Danica Cvetković, TA Milenko Bogdanović, TA Tijana Durmić, TA Bojana Radnić

Are you interested in another round of mysteries, blood traces and possibly some bullet holes? Did you know that as a future clinician, you can be a milestone in crime inves-tigation and prosecution? And what happens when doctors have to make their statement in court? After introducing you with basic forensic concepts, we will discuss how deaths from natural causes can make a “crime” scene look very suspicious… And for those of you thirsty for intriguing cases of violent deaths and having gut for photos with interesting autopsy find-ings – we will not disappoint you. Everyone with good medical knowledge and a curious mind are welcome!

6. FISH (FLUORESCENT IN SITU HYBRIDIZATION) ANALYSIS IN ROUTINE PATHOLOGY AND RESEARCH

Sanja Ćirović, PhD

The aim of this workshop is to familiarize students with basic princepes of “in situ” hybridization. As well as analysis of slides from tissue embedded in paraffin blocks, than to show the practical importance of FISH analysis in everyday pathology diagnostic and in re-search. FISH technique is elegant and fast method to search and detect changes on DNA molecules such as deletions, translocations, amplifications etc. The work will be organized in Molecular pathology lab (practical part of workshop) and in library in the form of video-dis-play (theoretical part of workshop) at the Institute of Pathology, Medical Faculty, Belgrade University.

7. MODERN THERAPY OF CLL - ROCHE

Organiser: ROCHE

Chronic lymphocytic leukemia (CLL) is an indolent malignancy of B lymphocytes and is the most common leukemia in adults in Western countries, accounting for approxi-mately 25 to 30 % of all leukemias in the USA. CLL is a disease of marked clinical heterogene-ity, and while some patients have a normal life expectancy, others develop rapidly progressive disease shortly after diagnosis.



8. CLINICAL APPLICATIONS OF PCR TECHNIQUES

TA Vesna Ćorić

Did you know that the storage space required for analyzing a whole genome is ~200 Gb? In this sense, a single computer with a 1 terabyte hard drive could store fewer than ten individual genomes!!!

Today, there is an extraordinary wealth of different techniques available for acquir-ing genomic data coming from a whole genome or just the exome, subset of genes, or even a single gene.

But first, we will need some DNA…and then a molecular photocopier, which ‘am-plifies’ or makes multiple copies of small segments of DNA you wish to analyze.

Join us in the Lab for functional genomics and proteomics at the Institute of Medi-cal and Clinical biochemistry, Medical Faculty, Belgrade University as we isolate DNA from patients’ samples and explore different PCR techniques!

9. BASICS OF SURGICAL SUTURING

Marko Todorović

The mission of this educational course is to provide an intensive education and training for medical students during their studies in order to improve the standards of surgical prac-tice. Project aims to introduce participants to safe, basic surgical techniques that are common to all surgical practices in medicine. It is important to stress work in smaller groups and the use of peer-learning. The modules are delivered using the series of tutor demonstrations and presentations, followed by workshops with hands-on sessions where participants work and practice on animal tissue models.

10. FORENSIC AUTOPSY TECHNIQUES

Full Prof. Slobodan Savić, Assist. Prof. Vladimir Živković

The aim of this workshop is to familiarize students with the objectives and modalities of general and special forensic autopsies, as well as the practical importance of the autopsy findings, both for legal and for medical science and practice. It will be displayed and discussed what is true , and especially which misapprehensions are shown in numerous films and series in relation to the opportunities provided by forensic autopsy. The work will be organized in autopsy hall, as a demonstration of the autopsy and the amphitheater in the form of vid-eo-display the most interesting cases from the archives of the Institute of Forensic Medicine.

11. ERASMUS +

Assist. Prof. Janko Samardžić

The ERASMUS+ Promo Workshop, for all colleagues who are interested in studying abroad, will be organized during the GSC 2017 at the Medical Faculty, University of Belgrade. The goal of the workshop is to present the benefits of academic mobility and encourage stu-dents and teachers to be active in Eramsus+ programme. Doc. dr Janko Samardzic, Erasmus+ Ambassador for Higher Education, will share his experience about the programme and give some practical information for completing successful application. Participants will have the opportunity to get first-hand information and ask questions. Moreover, participants will be introduced to the world of professional network and get to know more about the Erasmus+ programme. After the first part of the official presentation, attendees will have occasion to exchange questions in an informal way during the networking cocktail.



12. THE IMPORTANCE OF ULTRASONOGRAPHY DIAGNOSTICS OF PERIPHERAL NERVES

Stojan Perić, MD, PhD

Ultrasonography is a relatively new technique used in diagnosis of the lesions of periph-eral nervous system that has been rapidly developing during last few years. This technique is most commonly used in diagnosis of compressive neuropathy, traumatic and iatrogenic nerve injury, tumors of peripheral nerve and neurocutaneous syndromes, but its importance in di-agnosis of inflammatory and hereditary neuropathy is growing. US in noninvasive, easily applied, fast and economic technique. Advantages of US compared to electroneurography (ENG) are: painless and atraumatic medical examination, insight into nerve anatomy and ability to determine etiology of neuropathy in some cases. On the other hand, ENG can better determine nerve functionality and possibility of recovery, depending on the existence of le-sions in myelin or axon degeneration. That is why US and ENG are complementary methods. US has some advantages over MRI because it allows whole nerve examination in one take during its static and dynamic phase and has better planar resolution. Furthermore, there are no contraindications for implementing US compared to MRI. It is very important to point out certain restrictions in nerve US such as inadequate penetration into deeper structures and limitations when it comes to over-weight people. US, ENG and MRI are complementary methods in diagnosis injuries and diseases of peripheral nervous system.

13. NOBODY WANTS TO BE A COPYCAT

Organiser: Medicinski podmladak/Medical Youth

Are you a copy-cat? Have you ever done cherry-picking? Do you recycle from time to time? Do you know what all these phrases mean? Join us on our workshop and find out ev-erything you ever wanted to know about plagiarism, how to avoid it and what is the best way to properly write your scientific paper.

14. NEUROPHYSIOLOGY TOOLS

Full Prof. Olivera Stanojlović, Assoc. Prof. Aleksandra Rašić Marković, Assist. Prof. Dragan Hrnčić

Participants of this workshop will have opportunity to gain experience in wide-range of contemporary neurophysiology techniques and methods. Tips and tricks on assessment of convulsive, anxiety and depressive-related behaviors, pain thresholds as well as learning and memory in experimental conditions will be covered. We’ll discuss how to design, analyze and interpret experiments in the field of behavioral, electrophysiological, cognitive and pain stud-ies with special focus on their translational aspects. Hands-on experience in light-dark, open-field, forced swimming, radial maze, elevated plus maze, von Frey tests, EEG and many others will be provided. Instructions will be individually tailored according to participant’s attitudes.

15. ROLE AND POTENTIAL OF MODERN ULTRASOUND

TA Polina Pavićević

Children and especially infants are not small adults – they suffer from specific diseases, present different imaging demands and have increased radiation sensitivity. Ultrasound (US) has gained its place as the preferred first-line imaging modality in children.Especially in in-fants US has advantages – the small amount of tissue and fat creating restrictions to CT and



MRI allows for application of high-resolution (especially linear) transducers, offering excel-lent imaging capabilities; in addition, US is applicable at the bedside and can be performed without sedation. As radiation protection has become a key issue for imaging children, ex-ploiting US to the utmost using all its possibilities and applying modern methods that have significantly widened US potential is an increasingly important approach. This review illus-trates standard US techniques, basic and new applications throughout the entire abdomen and its different organ systems, trying to point out the enormous potential of US in different clinical scenarios, focusing on gastrointestinal and urogenital issues. Future perspectives pro-vided by new modalities such as contrast-enhanced and 3D US will further strengthen the di-agnostic value of this powerful imaging tool, hopefully contributing to continuing reduction of diagnostic radiation burden to children, by diminishing the need for CT.

16. TORTURE IN WAR REHABILITATION OF VICTIMS

Jović V., Alempijević Đ, Homel D.

Wars in former Yugoslavia (1991-1999) brought destruction and su ering on a large scale. One of characteristics of this con ict was aggression and brutality toward civilian population, which resulted in massive displacement, ethnic cleansing, massive killings and phys- ical and psychological abuse, torture and trauma. Large number of individuals exposed to extreme violence needed treatment and support a er the wars. Our workshop aims at presenting work and experiences of experts from non-governmental organization International Aid Network (IAN), Belgrade, which organized Center for Rehabilitation of Torture Victims from 2000, and is active today, currently providing help to refugees from Middle East.

We will present a movie „Is My Story Hurting You“, written and directed by David Homel, which closely follows Dr Vladimir Jović, psychiatrist and psychoanalyst, one of the founders of IAN, as he and his team are providing a psycho-social treatment for refugees and torture victims in a post-war societies of Serbia and Bosnia and Herzegovina. A er the movie, participants will be able to discuss all issues relevant to the medical, psychological and sociological aspects of rehabilitation of torture victims with the movie director, Mr David Homel, Canadian author, Dr Đorđe Alempijević, professor of forensic medicine at the Bel- grade University and a long-time consultant of IAN, and Dr Vladimir Jović, professor of the psychopathology at the University of Pristina (Kosovska Mitrovica).

17. CHALLENGES OF LAPARASCOPIC SURGERY

Full Prof. Dragan Radovanović

Laparoscopic surgery is a modern surgical technique in which operations are performed far from their location through small incisions (usually 0.5–1.5 cm) elsewhere in the body. Participants of this workshop will have an opportunity to see some of the most common laparoscopic procedures.



FORENSIC & LEGAL MEDICINE: ROLE AND FUNCTION IN THE UK

Jason Payne-JamesForensic Healthcare Services Ltd

• Definition of forensic & legal medicine;• Range of roles of forensic & legal medicine practitioner;• Duties of doctors;• Structure of forensic & legal medicine within UK;• Examples of nature and setting of different roles:

1. human rights;2. care of detainees;3. sexual offence examination;4. child safeguarding;

• Future of forensic & legal medicine in UK.

LECTURE 1

LECTURE 2

40 YEARS ANNIVERSARY OF INTERVENTIONAL CARDIOLOGY AND CURRENT DEVICES IN USE

Assist. prof. Vladan VukčevićFaculty of Medicine, University of Belgrade

This year we are celebrating 40 th anniversary of interventional cardiology. On September 17th 1977 Andreas Gruentzig performed in Zurich first coronary angioplasty. The new method who offered the possibility to treat coronary artery disease on beating heart and in local anesthesia, without opening of chest wall, was accepted with huge excitement worldwide. Over the course of these 40 years, numerous innovations have made this technique simple, easily feasible and reliable and have extended indications for its use. Today, over 2 million of these interventions are made in Europe.



HISTOPATHOLOGICAL PARAMETERS OF CUTANEOUS MELANOMA IN SERBIA: ANALYSIS FROM THE INSTITUTE OF

PATHOLOGY (2001-2015)

Full Prof. Dimitrije BrašanacFaculty of Medicine, University of Belgrade

Histopathological characteristics of cutaneous melanoma allow prognostic stratification and determine further diagnostic and therapeutic procedures.

Analysis of main histopathological parameters in relation to clinical characteristics (like body location, patients’ age and gender) could reveal specific features of melanoma in defined population over certain time span.

Histopathological data on melanoma in Serbia, analyzed on Institute of Pathology, Faculty of Medicine in Belgrade over the fifteen-years period, will be presented and compared with similar analyses of cutaneous melanoma in Europe and USA, and possible explanations for the observed differences will be provided.

LECTURE 3



PhD SESSION

THE ASSOCIATION OF GLUTATHIONE TRANSFERASE A1, M1, P1 AND T1 GENE POLYMORPHISMS WITH THE RISK OF RENAL CELL

CARCINOMA DEVELOPMENT AND PROGRESSION

Vesna M. Ćorić, MD, PhDFaculty of Medicine, University of Belgrade

Background: Cytosolic glutathione S-transferases (GSTs) might affect both the development and the progression of renal cell carcinoma (RCC) due to their dual functionality. Aim: The aim of this study was to evaluate specific role of GST gene variants as determinants of risk in patients with RCC, independently or simultaneously with recognized RCC risk factors. Furthermore, we evaluated the effect of GST gene variants on postoperative prognosis in RCC patients. Material and Methods: GST genotypes were determined in 305 RCC patients and 326 matched-controls in whom overall survival was evaluated as well. The levels of benzo(a)pyrene diolepoxide (BPDE)-DNA adducts were determined by ELISA method. The expression of GSTM1 and GSTP1 protein level, as well as the level of regulatory (ASK1, JNK1/2) and executor (Caspase-3) apoptotic molecules in ccRCC tissue samples were analyzed by method of immunoblot. The presence of GSTM1:ASK1/ GSTP1:JNK1/2 protein:protein interactions was determined by means of immunoprecipitation.Results: Significant association between GST genotype and risk of overall RCC and ccRCC development was found for GSTM1-null and GSTP1-variant genotypes (p<0.05). Furthermore, ccRCC smokers with GSTM1-null genotype had significantly higher concentration of BPDE-DNA adducts in comparison with GSTM1-active cRCC smokers (p= 0.050). Survival analysis indicated shorter overall survival for the whole group of RCC and ccRCC patients with GSTM1-active genotype (p<0.05). Furthermore, overall RCC and ccRCC patients with GSTM1-active genotype had a significantly higher hazard ratio (p<0.05), compared to the carriers of GSTM1-null genotype. Finally, the presence of GSTM1:ASK1, as well as GSTP1:JNK1/2 protein:protein interactions was found in all ccRCC tissue samples studied.Conclusions: Certain GST polymorphisms might be associated with the risk of RCC, with special emphasis on GSTM1-null and GSTP1-variant genotypes. On the other hand, GSTM1-null genotype is associated with favorable postoperative prognosis in RCC. The possible molecular mechanism underlying the role of GST proteins in RCC progression might be the presence of GSTM1:ASK1 and GSTP1:JNK1 protein:protein interactions.

Key words: GST, RCC, risk, prognosis, survival, BPDE, MAPK, protein expression



FREQUENCY AND SPECIFICITY OF PARKINSON’S DISEASE AMONG HOMOZYGOUS AND HETEROZYGOUS CARRIERS OF

MUTATIONS IN GLUCOCEREBROSIDASE GENE

Nikola Kresojević, MD, PhDFaculty of Medicine, University of Belgrade

Background: It was found recently that homozygous carriers of mutations in the gene encoding for glucocerebrosidase (GBA)- Gaucher’s disease (GD) patients, and heterozygous carriers of GBA mutations, are in greater risk to develop Parkinson’s disease (PD). According to literature, clinical presentation of such PD is similar to that in sporadic PD. Aim: To estimate GBA mutation frequency among PD patients in Serbia and to determine GBA genotype. To determine clinical presentation of PD patienets who are heterozygous or homozygous carriers od GBA mutations and to determine genotype-phenotype correlation. To determine neuro-imaging characteristics of PD patients with GBA mutations, GD patients and healthy carriers of GBA mutations. Material and methods: Sequencing of exons 8-11 of GBA gene was performed on 644 PD patients and 368 healthy controls. Also, 18 GD patients and 14 of their first-degree relatives, who are obligate carriers of GBA mutation, were included. After determining GBA status and the presence of PD signs, adequate groups were formed for further analysis. Cross-sectional study was used to determine odds ratio for presence of GBA mutations among PD patients and their basic clinical characteristics comparing to healthy controls. Case control study design was used for analysis of non-motor characteristics and imaging differences in between PD groups with and without GBA mutations. Motor, non-motor, cognitive and behavioural characteristics were assessed using Unified Parkinson Disease Rating Scale, Hoehn and Yahr scale, Mini Mental State Examination, Hamilton depression scale, Hamilton anxiety scale, Beck depression inventory, Apathy scale, Non-motor symptoms questionnaire, Addenbrooks cognitive examination and Boston naming test. Imaging examination was performed on 1.5 T MRI. Images were used for analysis of the white matter hyperintense lesions load, grey matter volume using voxel-based morphometry (VBM) and assessment of white matter tracts with diffusion tensor imaging (DTI). Transcranial sonography (TCS) was used for analysis of the brainstem midline structures. DaT-SPECT was performed in healthy GBA carriers without definite parkinsonism in order to detect premotor phase of PD. Results: GBA mutations are more frequent among PD patients (6.52%) than among controls (1.36%) (OR=5.07; CI=1.99-12.92; p=0.00017). Seventeen different changes were detected in exons 8-11 of GBA gene in homozygous, heterozygous or compound heterozygous state, including mutations, recombinant allels, polymorphisms and silent variants. N370S, D409H and RecNciI were the three most frequent and together represented ¾ of all detected mutations (72%). Mean PD onset was at 53 years, regardless of GBA status. Those carrying severe GBA mutations had earlier PD onset comparing to carriers of mild GBA mutations. Groups of PD patients with and without GBA mutations did not differ regarding sex, age at examination, disease duration, family history for PD and L-dopa therapeutic response. First PD symptom was one of cardinal PD symptoms, regardless of the GBA status. Pain was more frequent finding as an initial symptom among GBA carriers. Most of the patients had asymmetric parkinsonism with similar motor phenotype regardless of the GBA status. L-dopa induced dyskinesias and freezing of gait were more frequent among patients with GBA mutations. PD patients with GBA mutations had cognitive decline more frequently comparing to those PD patients without GBA mutations, however, without statistical significance. The GBA



carriers had a statistical trend for lesser subscore for language of Addenbrooke’s cognitive examination and had significantly lower score on the Boston naming test. The GBA mutations did not have an influence on hallucinations and apathy frequency. Results of depression and anxiety analysis remain inconclusive. Profile of non-motor symptoms did not differ among PD patients with and without GBA mutations, with an exception for loss of interest and difficulties to stay awake during daily activities that were more frequent among GBA carriers. The most important TCS finding was that aSNmax value was almost identical when comparing homozygous carriers with PD, heterozygous carriers with PD and sporadic PD group. MRI examination showed altered pattern in white matter, including interhemispheric and frontal cortico-cortical connections, while gray matter atrophy was not detected. Conclusions: GBA mutations are a genetic risk factor for PD among the Serbian population. Clinical characteristics of GBA related PD is very similar to sporadic PD and includes asymmetric parkinsonism with a good response to L-dopa therapy. Dyskinesias, freezing of gait and nomination abnormalities are more frequent among PD patients with GBA mutations then those without GBA mutations. TCS revealed that GBA related PD patients have typical TCS findings while MRI showed white matter abnormalities.

Key words: Parkinson’s disease (PD), glucocerebrosidase (GC-ase), Gaucher’s disease (GD), behaviour, cognitive impairment, non-motor symptoms, magnetic resonance imaging (MRI), voxel-based morphometry (VBM), diffusion tensor imaging (DTI), transcranial sonography (TCS)



ANATOMY OF BONE FRAGILITY: FROM NANO- TO MICRO-SCALE INDICATORS OF REDUCED BONE STRENGTH

Petar Milovanović, MD, PhDFaculty of Medicine, University of Belgrade

Hip fractures are an important and growing health problem in elderly population worldwide, particularly in women. They occur even after low-intensity trauma due to increased fragility of aged bone. However, the exact causes of increased bone fragility are not yet clear. We hypothesized that age-related bone fragility originates from multiple alterations to bone structural organization at nano- and micro-levels. To test this hypothesis, bone specimens from the femoral neck were obtained at autopsy from young (20 y. – 40 y.) and elderly women (>60 y.) with and without a fracture. A variety of advanced research methods were applied to examine microstructural features (micro-computed tomography) and nanostructural or compositional characteristics (atomic force microscopy, quantitative backscatter electron microscopy, nanoindentation) of the bone matrix. There was particularly strong deterioration in trabecular microstructure in aged individuals with hip fracture, as evidenced in decreased bone volume fraction, lower trabecular thickness and reduced trabecular connectivity. The observed bone deterioration was more pronounced in the superolateral region of the femoral neck, which explains why that region is a typical fracture-initiating site. Several indicators of higher bone fragility in aged individuals were revealed at nano-scale: increased size of mineral crystals, decreased surface roughness, lower fractal dimension, as well as altered mineralization level. These nano-indicators denote decreased energy dissipation during loading and consequent increase in brittleness and bone fragility in aged individuals. Assessment of nano-level mechanical behavior (combined with nanostructural evaluation) offered experimental evidence for particular mechanical consequences of bone matrix aging, separately from age-related effects at other hierarchical levels of bone structure. In summary, our multi-level analytical approach with application of advanced research techniques revealed various nano- and micro-structural indicators of increased bone fragility in the elderly population. This is essential for understanding why age-related hip fractures occur and will contribute to developing new strategies for their prevention and treatment.

Key words: bone, aging, hip fracture, nanostructure, microstructure



ACUTE ISCHEMIC STROKE IN PATIENTS WITH ATRIAL FIBRILLATION: CLINICAL CHARACTERISTICS AND OUTCOME

Višnja Pađen, MD, PhDFaculty of Medicine, University of Belgrade

Purpose: Atrial fibrillation (AF) is an independent risk factor for acute ischemic stroke which increases the stroke risk by five-fold. In addition, it is also a significant predictor of stroke’s poor outcome. The question of whether intravenous thrombolytic therapy (IVT) is beneficial in patients with ischaemic stroke and atrial fibrillation (AF) remains unresolved. Methodology: The objective was to evaluate the outcome of patients with AF who received IVT for stroke in the registries of Belgrade (Serbia) and Lille (France), in a 3-year period. End-points were poor outcome (modified Rankin Scale [mRS] 3 to 6), and symptomatic hae-morrhagic transformation (sHT) according to ECASS3. Results: Of 734 consecutive patients, 155 (21.2%) had AF. The unadjusted comparison found patients with AF to be 12 years older, more likely to be women, to have hypertension, and baseline INR>1.2, and less likely to be smokers. They had higher baseline NIHSS scores, dia-stolic blood pressure, and serum glucose concentrations, and lower platelet counts. They did not differ for sHT (5.8% vs. 5.5%; p=0.893), but they had more frequently poor outcomes (52.3% vs. 35.2%; p<0.001) and death (21.9% vs. 9.0%; p<0.001). The only independent pre-dictor of sHT was baseline NIHSS (adjOR 1.05 per 1 point increase; 95% CI: 1.01-1.10). In-dependent variables associated with poor outcome were age (adjOR 1.04 for 1 year increase; 95% CI: 1.03-1.06), baseline NIHSS (adjOR 1.17 per 1 point increase; 95% CI: 1.13-1.21), and sHT (adjOR 47.6; 95% CI: 10.2-250) but not AF.

Conclusion: In patients treated with IVT for cerebral ischaemia, those with AF have worse outcomes because they are older and have more severe strokes. This result suggesting that we should focus on prevention and research on more aggressive strategies at the acute stage.



BRAIN INVOLVEMENT IN PATIENTS WITH MYOTONIC DYSTROPHY TYPE 1Stojan Perić, MD, PhD

Faculty of Medicine, University of BelgradeBackground: Myotonic dystrophy type 1 (DM1) is an autosomal dominant disease, that besides muscle affects many other tissues and organs, including the central nervous system. Brain manifestations in DM1 include neuropsychological and behavioral impairment. Development of modern neuroimaging and molecular medicine enables better insight in possible causes of the central nervous system involvement in DM1. Aim: Assessment of neuropsychological and behavioral profile of DM1 patients, structural analysis of their brain and investigation of cerebrospinal fluid biomarkers of neurodegeneration. Material and methods: Study comprised 66 genetically confirmed DM1 patients. Severity of muscle weakness was assessed using the Muscular Impairment Rating Scale (MIRS). Extensive battery of classic pen and pencil tests and Cambridge Neuropsychological Test Automated Battery (CANTAB) were used. Following measures were also administered: Hamilton depression and anxiety scales, Millon Multiaxial Clinical Inventory (MMCI) for personality pattern, Daytime Sleepiness Scale (DSS) and Krupp’s Fatigue Severity Scale (FSS). Magnetic resonance imaging on 1.5 T equipment was performed in patients and 38 healthy controls (HCs). Images were used for analysis of the white matter hyperintense lesions (WMHL) load, grey matter volume using voxel-based morphometry (VBM) and assessment of white matter tracts with diffusion tensor imaging (DTI). Transcranial sonography (TCS) was used for analysis of the brainstem midline structures in patients and 55 HCs. Cerebrospinal fluid levels of total and phosphorylated tau protein (T-tau and P-tau) as well as beta amyloid 42 (Aβ42) were analyzed in patients and 26 HCs using sandwich ELISA.Results: Visuospatial dysfunction was observed in 80 % of DM1 patients, executive dysfunction in 67 % and naming was impaired in 62 %. Significant depressiveness was registered in 15 % and anxiety in 11 % of patients, excessive daytime sleepiness in 44 % and fatigue in 52 %. Clinically significant personality impairment was registered in 60 % of patients (dependent personality in 52 % and paranoid in 39 %). Worse results on certain neuropsychological and behavioral tests correlated with longer CTG expansion (p<0.05). DM1 patients had higher WMHL load compared to HCs (0.30 ± 0.80 vs. 0.04 ± 0.10; p<0.01). VBM showed decrease in grey matter volume in almost all parts of the brain, including cerebral cortex, cerebellum, basal ganglia and thalami (p<0.05). DTI showed decrease of fractional anisotropy in almost all white matter association fibers, callosal body, both internal and external capsules and in the brainstem (p<0.05). In DM1 patients, more extensive white matter changes in the left hemisphere were in correlation with worse results on the attention and orientation subscore of the Addenbrooke’s cognitive examination test (p<0.05). TCS showed increased frequency of hypoechogenicity of the substantia nigra in DM1 patients compared to HCs (26 % vs. 11 %; p<0.01), and also of the raphe nucleus (38 % vs. 8 %; p<0.01). Presence of depressiveness and fatigue was in significant association with decreased echogenicity of the raphe (p<0.01 and p<0.05). We observed decreased level of Aβ42 in patients with juvenile DM1 (jDM1) compared to HCs (781.3 ± 226.4 ng/l vs. 947.3 ± 233.8 ng/l; p<0.05), and decreased Aβ42/P-tau ratio in patients with adult DM1 (aDM1) (18.2 ± 5.3 vs. 23.2 ± 9.2; p<0.05). Lower level of Aβ42 correlated with higher number of CTG repeats in jDM1 (rho=-0.53; p<0.05), while decrease of Aβ42/P-tau ratio correlated with patients age in aDM1 (rho=-0.30; p<0.05). Positive correlation between T-tau, P-tau and Aβ42 was observed in our cohort of DM1 patients (p<0.01).



Conclusions: Significant cognitive and behavioral impairment was observed in our DM1 patients. Modern neuroimaging revelaed diffuse abnormalities of the grey and white brain matters underlying functional changes. At least a part of the central manifestations in DM1 was associated with tau protein and Aβ42 pathology. Positive correlation between cerebrospinal fluid T-tau and Aβ42 is specific for DM1 and it might be a potential biomarker in this disease.

Key words: myotonic dystrophy type 1 (DM1); neuropsychology; behavior; magnetic resonance imaging (MRI); white matter hyperintense lesions (WMHL); voxel-based morphometry (VBM); diffusion tensor imaging (DTI); transcranial sonography (TCS); tau protein; beta amyloid



ATTITUDES OF DENTAL STUDENTS TOWARDS PSYCHIATRIC PATIENTS

Author(s): Dejan Mihajlović, Danijela Mihajloviće-mail: [email protected] Mentor(s): TA Mirjana Stojanović-TasićFaculty of Medicine, University of PristinaGSC ID: 20

Background: Аttitudes towards mental disorders were not significantly changed throughout history, although the possibility of their diagnosis and treatment has sig-nificantly improved. Still, they are associated with fear, contempt and stigmatization.Aim: The aim of this study was to determine dental students' attitudes towards psy-chiatric patients and to examine whether there has been a change in attitudes after bi-monthly lectures in psychiatry and encounters with mentally ill patients.Material and Methods: The sample consisted of 102 third-year students of dentist-ry. The attitudes toward mental illness were assessed using Opinions about mental illness questionnaire (OMI) before and after training program. Statistical analysis was performed using descriptive statistics and Student t-test. Results: Our findings showed that dental students had negative attitudes and stig-mas about mental illness. The highest score was in the authoritarianism sub-scale (M=38.27), which means that they consider psychiatric patients to be inferior and dangerous. The next subscales with high scores were social restrictiveness (M = 35.34), than interpersonal etiology (M = 24.61), followed by the sub-scale of mental illness ideology (M = 23.56). The lowest scores were in the benevolence sub-scale which means that our subjects did not have a benevolent attitude toward the mentally ill. The current study showed that lectures in psychiatry and encounters with mental-ly ill patients did not change students’ attitudes, except for students from rural area who did change their attitudes considering mental illness ideology sub-scale after the training program with statistical significance (p=0.02).Conclusion: Our results suggest that bi-monthly training program is too short to bring changes in students’ attitudes and to contribute to their destigmatization. More education about patient-centered medicine is more than necessary for students of humanistic professions.

Key words: attitudes stigmatization, OMI questionnaire, psychological test



ANALYSIS OF POLYMORPHISM -174G/C IN THE PROMOTER REGION OF THE INTERLEUKIN 6 GENE IN CERVICAL CANCER

Author(s): Katarina Ivanović, Stefan Ivanoviće-mail: [email protected](s): Assoc. Prof. Momčilo RistanovićFaculty of Medicine, University of BelgradeGSC ID: 36

Background: Cervical cancer is one of the most common causes of mortality in women. According to rate it takes the sixth place in more developed countries and the second place in less developed ones. The occurrence of cervical cancer is multi-factorial, with well known risk factors such as early initiation of sexual practice, large number of sexual partners, low socio-economic conditions, the use of oral contra-ceptives, lifestyle. Genetic factors play an important role also. Within genetic and im-munological factors, one more closely examined is IL6, a cytokine which has an im-portant role in the development of inflammation and tumorigenesis. Polymorphism in the promoter region of IL6 -174G/C affects the intensity of the transcription and the expression of the gene.Aim: The aim of study was to analyze the frequencies of genotypes and alleles at the locus IL6 -174G/C in patients with cervical cancer, and to compare data with the control group, in order to determine whether one of the variants predisposes for the occurrence of disease.Material and Methods: The study included 80 women, of whom 30 were affected with invasive cervical cancer, while 50 women had a normal gynecological exam. Testing methodology included DNA isolation, allele-specific PCR for amplification of the polymorphic region (-174 G/C) and analysis of PCR products by gel electro-phoresis.Results: In the healthy group GG genotype dominated (43%), while in the group of patients CG genotype was the most common (43.33%). There is no significant difference between the frequencies of the genotypes. In the group of patients the more frequent was allele C, and in the control group the allele G (in both cases the frequency is 0.52). In examining the differences in alleles frequencies without Yates correction the difference is significant (p = 0.045304), and with Yates correction it is not significant ( p = 0.066).Conclusion: The polymorphism in the promoter region -174 G/C of IL6 gene was not associated with cervical cancer in our patients, but further extensive studies are needed to evaluate the role of this polymorphism in the development of cervical cancer.

Key words: cervical cancer; IL6; polymorphism; risk



VESICOURETERAL REFLUX: PREDICTOR FACTORS FOR SURGICAL TREATMENT

Author(s): Dimitrije Cvetković, Tatjana Dejanoviće-mail: [email protected](s): Full Prof. Miroslav ĐorđevićFaculty of Medicine, University of BelgradeGSC ID: 41

Background: Vesicoureteral reflux (VUR) is the most common uropathy in children and it represents retrograde flow of urine from the bladder to the kidney. The impor-tance of this disease lies in its complications such as recurrent urinary tract infec-tions, reflux nephropathy and chronic renal insufficiency.Aim: Analysis of the demographic characteristics of the patients, time of diagnosis and radiological characteristics as potential predictors in the choice of methods of treatment.Material and Methods: The study included 99 patients who were treated at the Uni-versity Children's Hospital over a three year period. The data on sex, age, indication testing for VUR, diagnostic methods and therapeutic method were collected by a retrospective analysis from electronic medical records. The results were statistically analyzed using descriptive statistics and the chi-square test. Results: The study included 99 patients aged one month to 4 years (median 42 months) with approximately equal distribution between the sexes (52.5% male and 47.5% female). Surgical approach was chosen in 82.8% of the cases (51.5% endoscop-ic, open surgery in 25.3%, 6.1% both methods) while the conservative treatment was chosen for 17.1%. In patients with grade I VUR treatment of choice was conservative therapy (57.1%). Endoscopic surgery was the method of choice in patients with II (81.3%), III (76%) and IV (50%) level, while in patients with V level, open surgery was applied in 61.5% of patients. Patients with prenatal hydronephrosis were treat-ed surgically in 91% of cases. Comparing the severity of the disease and treatment methods obtained very significant statistical association between moderate and se-vere forms of the disease and the choice of surgical methods of treatment respectively p = 0.0021 and p = 0.0001.Conclusion: By analyzing our data we conclude that the possible predictors for sur-gical treatment of VUR may be older age, prenatal diagnosed hydronephrosis and severe form of the disease.

Key words: urinary infection; hydronephrosis; vesicoureteral reflux



THE DISTRIBUTION OF GENOTYPES JC VIRUS AMONG HEALTHY INDIVIDUALS

Author(s): Miloš Lazić, Maja Maksimović, Radovan Anđiće-mail: [email protected](s): TA Danijela KaralićFaculty of Medicine, University of BelgradeGSC ID: 45

Background: The JC virus (JCV) is ubiquitous in the human population. After pri-mary usually asymptomatic infection, JCV establish latency in the cells of the kid-neys. Based on single nucleotide polymorphism within the VP1 gene, JCV isolates can be classified into eight different genotypes and several subgenotypes. Due to its wide distribution and association with particular ethnic group, JCV genotypes are frequently used as a genetic marker for human evolution and migration. Aim: The aims of this study were to determine the frequency of JCV urinary shed-ding and distribution of JCV genotypes among healthy individuals. Material and Methods: The urine samples collected from 50 healthy individuals were tested for the presence of JCV DNA by PCR. A seminested-PCR was used for amplification of 495-nt fragment within the VP1 gene, and amplified fragments were directly sequenced. The genotypes of JCV isolates were determined by manual in-spection in BioEdit software.Results: The frequency of JCV DNA in healthy individuals was 30%. Males had a higher excretion rate than did the females (60% vs. 40%) but statistically significant difference was not found. The most dominant genotype was genotype 1 (46.7%), fol-lowed by genotype 2 (26.7%) and genotype 4 (26.7%).Conclusion: This study showed that European, Eurasian and Indian types of JCV circulating among the population of Serbia and such distribution is in accordance with the origin and history of the Serbian people.

Key words: JC virus; PCR; VP1 gene; genotypes; population



INFLUENCE OF THE BRAIN LESION LOCALIZATION ON COGNITIVE POTENTIAL P300

Author(s): Stefan Stojkoviće-mail: [email protected](s): Assistant professor Mirjana DejanovićFaculty of Medicine, University of PrištinaGSC ID: 77

Background: P300 component of cognitive evoked potentials is a response to endog-enous information transmitted via interneurons through active brain synapses. The occurrence of cognitive impairment after a stroke may affect various factors such as localization and extensiveness of the lesion, age and gender of respondents.Aim: The aim of this study was to examine the impact of the stroke lesion on the cognitive status of patients using the P300 component of cognitive potentials.Material and Methods: A prospective study that includes 60 patients, 30 of whom patients with the first clinically verified acute stroke and 30 healthy volunteers, with no statistically significant differences of both groups in terms of age and gender. CT was performed on all patients while the 5 patients underwent MRI. Measuring laten-cy and amplitude of the P300 cognitive potential was done on all patients in the acute phase of stroke and 3 months after stroke.Results: The values of P300 latency were significantly longer in supratentorial lesions over all three large brain areals (p <0.01). There was a trend of larger amplitude in the group with infratentorial lesions at Cz and Pz electrodes but the difference was not statistically significant. P300 latency was significantly longer in the group of patients with lesions of corti-cal-subcortical structures on Cz electrode (p <0.01). There was not statistically signif-icant difference in the amplitudes in both groups. Patients with left-sided lesions had significantly longer latencies P300 to Cz electrodes(p <0.01), while the difference in the amplitudes did not occur.Conclusion: Patients with supratentorial lesions, multiple lesions in cortical-subcor-tical structures and patients with lesions of the dominant left hemisphere have great-er cognitive impairment and significantly extended latency of P300. It was concluded that the localization of acute ischemic stroke has an impact on cognitive potential P300. P300 has an importance in monitoring the recovery of brain function.

Key words: P300; endogenous evoked potentials; stroke; localization; latency; amplitude; cognitive dysfunction



EPIDEMIOLOGICAL ANALYSIS AND ROLE OF TP53 GENE IN BIOLOGICAL BEHAVIOR OF ODONTOGENIC TUMORS

Author(s): Ivan Staniće-mail: [email protected](s): Full Prof. Zvezdana TepavčevićFaculty of Dental Medicine, University of BelgradeGSC ID: 78

Background: Odontogenic tumors make 2% of all tumors in human population. De-pending on type of tumor epidemiology is different. The impact on the supression of tumor tissue, among the others, has a tumor supressor gene TP53, and its product, protein p53. It functions by binding to DNA and stopping the cell cycle by starting the process of apoptosis, as a protective mechanism.Aim: The aim of this study was to determine frequency of odontogenic tumors in terms of their location, gender and age in period from 2011 to 2015 (5 years). In the second part of the study by genetic and immunohistochemical methods we examined expression levels of TP53 gene and its product from samples of odontogenic tumors.Material and Methods: The study involved patients who were operated in the last 5 years at the Clinic for Maxillofacial Surgery, with a confirmed diagnosis of odonto-genic tumors at the Institute of Pathology, Faculty of Dental Medicine University of Belgrade. Data of location, gender and age of the patient were taken from referrals for histopathologic analysis about. In order to clarify the role of protein and its product in the pathogenesis of odontogenic tumors were performed appropriate immunohis-tochemical studies.Results: Total number of patients is 193. The most comon odontogenic tumor is keratocystic odontogenic tumor (78.8%). With exeption of odontoma, all other tu-mors showed a significantly higher percentage of manifestation in male population and lower jaw. Immunohistochemical analysis showed that the most pronounced expression of p53 protein in nucleus of cells of the basal and parabasal layers of the epithelium was in 30% of samples.Conclusion: Results of study showed that there are significant deviations from the allegations in the literature when the epidemiology of odontogenic tumors is viewed in the last 5 years. There is a balance between proapoptotic and antiapoptotic mecha-nisms, which is in accordance with the benign nature of the examined tumors.

Key words: TP53 gene; p53 protein; odontogenic tumor



MORPHOMETRIC ANALYSIS OF THE AORTIC ARCH BRANCHES IN FETUSES

Author(s): Milan Sibinović, Jelena Grujović, Radomir Stankoviće-mail: [email protected] Mentor(s): TA MD Milena TrandafilovićInstitute of Anatomy, Medical faculty, University of Niš GSC ID: 82

Background: The branch anatomy of the aortic arch varies widely between individu-als. These are likely due to alterations in the development of aortic arch arteries dur-ing the embryonic period. These variations in each population are very important to intervention radiologists, thoracic and neck surgeons. There is still insufficient data about fetal developmental changes of the aortic arch branches.Aim: The aim of this research was to analyze the morphological characteristics of the aortic arch branches in fetuses.Material and Methods: The study was performed on 51 dissected fetal hearts with aorta, obtained from the collection of the Institute of Anatomy, Faculty of Medicine, University of Niš. Fetal age varied from the 4th to 8th lunar month. Preparations were photographed and 11 linear and 3 angular parameters of the aortic arch branch-es were measured using ImageJ program. Results: There was a moderate positive correlation between values of the outer di-ameter of the second aortic branch and fetal age in weeks. This parameter was signif-icantly higher in the 7th than in the 6th lunar month (p<0.05). For the other linear parameters, statistical significant changes between lunar months were not noted. The values of the angles and the distances (measured outside) between adjacent branches of the aortic arch, correlated with fetal age with negligible positive correlation. Dis-tance of the first aortic branch from the beginning of the fetal aorta showed a weak positive correlation with fetal age. Distance between the first and the second aortic branch, measured inside of the aortic arch, showed a weak positive correlation with the age of the fetus. The 4th aortic arch branch is noted in one case (1.96%). Conclusion: This research pointed out a relative stability in the relations between the fetal aortic arch branches during the period from the 4th to 8th lunar month.

Key words: aortic arch; fetus; variations; morphometry



THE INVOLVEMENT OF ADRENERGIC RECEPTORS IN THE ANTINOCICEPTIVE EFFECT OF ESLICARBAZEPINE ACETATE

Author(s): Katarina Popović, Veljko Cvetkoviće-mail: [email protected](s): full prof Radica Stepanović Petrović, TA Uroš PecikozaFaculty of Pharmacy, University of BelgradeGSC ID: 83

Background: Eslicarbazepine acetate is an antiepileptic drug with known antinoci-ceptive effects in orofacial formalin test a trigeminal pain model in mice. It inhibits not only hyperactivity of neurons which leads to convulsions but also the genesis of hyperexcitable neuron network responsible for trigeminal neuralgia. Activation of adrenergic receptors can generate analgesic effect or contribute to hyperalgesia and chronic pain. Aim: To assess the role of adrenergic neurotransmission via β-adrenergic receptors in the antinociceptive effect of eslicarbazepine acetate in orofacial formalin test in mice.Material and Methods: Pain hypersensitivity of orofacial region in male Swiss Web-ster mice was caused by subcutaneous injection of formalin (2%, 20 μL). The time that mice spent in nociceptive behaviour - rubbing of perinasal area with ipsilateral front and/or hind paw was measured. Eslicarbazepine acetate (60 mg/kg), alone or combined with β-antagonists propranolol (1 mg/kg or 3 mg/kg) or metoprolol tarta-rate (1 mg/kg or 2 mg/kg) was administrated 60 minutes before formalin injection.Results: Eslicarbazepine acetate significantly reduced the time spent in nociceptive behaviour in the second phase of the orofacial formalin test, comparing to control (vehicle-treated) group (p<0.05). Propranolol and metoprolol significantly reduced the antinociceptive effect of eslicarbazepine acetate in the second phase of the test (P < 0.001 for propranolol, P = 0.004 for metoprolol). The level of inhibition for pro-pranolol dose 1 mg/kg was 63% and for 3 mg/kg was 100%. The level of inhibition for metoprolol dose 1 mg/kg was 58.6% and for dose 2 mg/kg was 100%. Data was analyzed by t-test or one-way ANOVA and Tukey post hoc test. Conclusion: Experimental results suggest a possible role of adrenergic neurotrans-mission by β-receptors in antinociceptive effect of eslicarbazepine acetate in trigem-inal pain model, most probably β1-adrenergic receptor type.

Key words: eslicarbazepine acetate; trigeminal nociception; orofacial formalin test; propranolol; metoprolol



PRURITUS PREVALENCE AND ITS ASSOCIATION WITH CLINICAL DATA, LABORATORY PARAMETERS AND PSYCHIATRIC DISTUR-

BANCES IN HEMODIALYSIS PATIENTS

Author(s): Nikola Pantić e-mail: [email protected](s): TA Jasna Trbojević-Stanković Faculty of Medicine, University of Belgrade GSC ID: 89

Introduction: Uremic pruritus is an undesirable and very bothersome complication of end stage renal disease (ESRD). Despite its prevalence, its etiopathogenesis is still unclear, albeit complex and most likely multifactorial. The challenge remains to de-termine if this symptom is related solels to ESRD, or the effect of comorbidites or dialstic treatment.Aim: The aim of this study was to investigate the prevalence and intensity of uremic pruritus and to evaluate its association with hemodialysis characteristics and labora-tory data, as well as its impact on sleep quality and depression. Material and Methods: A total of 76 chronic hemodialysis patients (37 males, age range 20 – 83 years) were investigated. The presence and intensity of pruritus were assessed using the visual-analogue scale (VAS). The demographic data, presence of comorbidities (diabetes, hyperparathyroidism and dyslipidemia), hemodialysis char-acteristics (dialysis vintage, heparin doses, adequacy), routine laboratory investiga-tions (leukocytes, eosinophils, neutrophil/lymphocyte ratio, haemoglobin, calcium, phosphate, total bilirubin, creatinine, urea, urates, ALT, AST, γGT, AP, cholesterol, HDL, LDL, triglycerides, ferritin, PTH, CRP, IgE, TSAT) were collected. Sleep quality and depression were assessed using the Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Inventory (BDI). Results were analyzed with T, Mann-Whitney U and χ2 test. Results: The prevalence of pruritus was 45.2%, represented as mild (24%), moderate (52%) or severe (24%). Pruritus intensity was not significantly associated with neither demographic data, presence of comorbities, hemodialyisis characteristics, laboratory parameters, sleep quality or depression. The single statistically significant finding was lower serum triglycerides (p = 0.01) in patients suffering from pruritus.Conclusion: The prevalence of uremic pruritus within the range reported in previous studies. Pruritus was more common among patients with lower level of triglycerides.

Key words: hemodialysis; uremic pruritus; pruritus; sleep quality; depression; triglycerides



THE DIABETIC FOOT AT THE WORKING PLACE

Author(s): Christos Papageorgiou, Christos Samaras, Vasileios Stamatopoulos, Dimitrios Samaras e-mail: [email protected] Mentor(s): Elli PapageorgiouFaculty of Medicine, Sofia University “St. Kliment Ohridski”GSC ID: 95

Background: Diabetic foot (D.F) is a major complication of diabetes mellitus (D.M). Compromise of the blood supply from microvascular disease, often in association with lack of sensation because of neuropathy, predisposes persons with diabetes mel-litus to foot infections. Three mechanisms are involved in the pathogenesis of D.F: neuropathy, peripheral vascular diseases and infection. Aim: The purpose of our study was to highlight how the exposure to occupational hazards, when workers’ health and safety rules are not applied, can aggravate existing serious illnesses such as D.M.Material and Methods: The study group consisted from 70 patients with D.M and D.F, that were recruited from the outpatient’s diabetic clinic of St. Kliment Ohridski University Hospital. The stage of their D.F condition was decided according to ob-jective measurements, by clinical examination and specific tests. The majority of the sample was farmers, active or retired, while the other, of different occupations.Results: The main difference between farmers and the rest of the subjects, were the lower educational level, the higher body weight, and the more frequent use of in-appropriate shoes. As a result, several factors in combination, contribute to more unfavorable effects of D.M, such as D.F, in the groups of agricultural occupation. It seems that farmers do not control their D.M, because of rare medical checkups and the long distance from health providers. Finally, working outdoors increases the risk for injuries, burns and infections.Conclusion: The research shows that in all groups of workers the etiopathogenet-ic factors of peripheral angiopathy and peripheral neuropathy are necessary for the development of the diabetic foot. Additional factors such as age, literacy, weight, un-controlled and chronic DM, kidney failure, hypertension, dyslipidemia, smoking, in-fections and unsuitable footwear, increase the risk of ulcers and differentiate working groups, such as farmers, to high-risk groups, in the appearance of diabetic foot.

Key words: Diabetic foot(DF); diabetes mellitus(DM); farmers; inappropriate footwear; occupational hazards



MORPHOMETRIC ANALYSIS OF NEUROSECRETORY GRANULES IN PERIPHERAL NEUROBLASTIC TUMORS OF PEDIATRIC PATIENTS

Author(s): Sofija Jovanović, Henrique Hora, Murilo Carvalhoe-mail: [email protected](s): Assoc. Prof. Tamara Kravić Stevović, ТА Darko Ćirić, TA Tamara Martinović Faculty of Medicine, University of Belgrade GSC ID: 97

Background: Peripheral neuroblastic tumors (pNTs) are tumors arising from the embryonic remnants of the sympathetic nervous system. On the basis of histology and outcome, these tumors can be classified into two groups: favorable (FH) and unfavorable (UH). Aim: The aim of this study was to analyze the morphological characteristics of neu-rosecretory granules (NSG) found in pNTs with the use of transmission electron mi-croscopy, and to compare their size, number and distribution between the FH and UH tumor groups. Material and Methods: The tumor biopsies analysed were obtained from 11 pre-viously untreated pediatric patients with pNTs, 5 of which were FH and 6 of which were UH, diagnosed at the Health Care Institute for Mother and Child, in Belgrade. Tumor sections and micrographs for the ultrastructural analysis were selected by way of the Systematic Uniform Random Sampling procedure, and the NSGs determined in 60 cell bodies and/or processes per tumor sample. Results: More NSGs were found in UH (p < 0.01) than in FH tumors. The number of NSGs found in cell bodies of UH tumors was significantly higher (p <0.01), whereas there was no difference in the total of NSGs counted in the processes of tumor cells across the UH/FH categories. No difference was noted in the average diameter of the NSGs between FH and UH tumors, either. However, the number of autolysosomes with NSGs (crinophagy) was notably higher in UH (p < 0.01) tumors. Conclusion: A higher number of NSGs found in the cell bodies of UH tumors sug-gests the connection between a dysregulated biosynthesis of these granules and the process of tumorigenesis of peripheral neuroblastic tumors.

Key words: neurosecretory granules; transmission electron microscopy; morphometry; SY; tumors



THE EFFECT OF HYPERGLYCEMIA ON PLASMA MARKERS OF OXIDATIVE STRESS AND GLUTATHIONE PEROXIDASE ACTIVITY

IN ADOLESCENTS WITH POLYCYSTIC OVARY SYNDROME

Author(s): Ivana Ilić, Valerie Lupie-mail: [email protected] Mentor(s): TA Tatjana ĐukićFaculty of Medicine, University of BelgradeGSC ID: 111

Background: Polycystic ovary syndrome (PCOS), a frequent disorder of reproductive-aged women, is accompanied by oxidative stress (OS) in which increased production of free radicals is followed by decreased serum total antioxidant levels. Previous stud-ies have shown that hyperglycemia induces increased free radicals production. Aim: To determine in which way hyperglycemia, induced during the oral glucose tolerance test (OGTT), affects the levels of plasma markers of OS and antioxidant glutathione-peroxidase (GPX) activity. Furthermore, the aim was to establish wheth-er there is any correlation between plasma markers of OS and testosterone, during the oral glucose tolerance test (OGTT). Material and Methods: Plasma nitrotyrosine, thiol groups, testosterone and glu-tathione peroxidase (GPX) activity were measured during OGTT in 35 PCOS pa-tients, non-obese female adolescents, and 17 healthy controls. Waist circumference and body mass index were measured in both groups. Plasma nitrotyrosine was de-termined by enzyme-linked immunosorbent assay (ELISA), while thiol groups and GPX were measured spectrophotometrically. Testosterone levels were assessed by radioimmunoassay.Results: Acute hyperglycemia during OGTT induced alteration in OS markers and GPX, in both group of patients and healthy controls. Statistically significant percent of change of thiol groups and nitrotyrosine was found between the patients and healthy controls when fasting samples were compared with the samples collected 2 h after OGTT (p=0.044, p=0.044, respectively). At the same time, the change in nitro-tyrosine during OGTT correlated with testosterone levels (r=0.493, p=0.020).Conclusions: Our results indicate that PCOS women are susceptible to oxidative stress induced by hyperglycemia. Protein oxidative stress marker, nitrotyrosine, correlated with circulating testosterone.

Key words: glutathione peroxidase; nitrotyrosine; thiol groups; oxidative stress; polycystic ovary syndrome



OPERATIVE APPROACH COMPARISON OF OVARIAN DERMOID CYST TREATMENT AT THE OBSTETRICS AND GYNAECOLOGY

CLINIC NARODNI FRONTIN 2016

Author(s): Tatjana Dejanović, Ana Ristanoviće-mail: [email protected] Mentor(s): TA Rastko MaglićFaculty of Medicine, University of BelgradeGSC ID: 128

Background: Ovarian dermoid cyst or mature cystic teratoma is one of the most common benign ovarian neoplasm. Most often occurs in women between 25 and 45 years. Teratomas are formed from primordial germ cells. They are often discovered incidentally during routine gynecological exam. Torsion of dermoid cysts is the most common complication. In treatment we use two approaches: laparotomy and lapa-roscopy.Aim: The aim of this study is comparison of two main methods, laparotomy and laparoscopy, in the treatment of ovarian dermoid cysts.Material and Methods: This study involved 74 patients who were treated at the OGC "Narodni front" during the 2016. Information about patients were taken retrospec-tively from the Health Information System. The inclusion criteria was histopatho-logical confirmation of a dermoid cyst. Data were analyzed in statistical programme SPSS.Results: Frequency of laparoscopic surgery was 60.8% and 39.2% for laparotomy. The average age of patients operated with laparotomy was 32.8 ± 6.1 years and with lapa-roscopy was 29.3 ± 7.9 years (p = 0.043). Median length of recovery after laparotomy was 5 days and after laparoscopy was 2 days (p < 0.001).The frequency of bilateral cysts was 6.8%. Two methods were used for cyst removal: cystectomy (83.8%) and adnexectomy (16.2%). The average cost for laparotomy was 96610 ± 21457 RSD, and for patients operated with laparoscopy was 124870 ± 14184 RSD (p < 0.001). Torsion occurred in 6.8% cases. Conclusion: In this study we had compared two methods for treatment of ovarian dermoid cysts, laparotomy and laparoscopy, and concluded that both methods are safe for practice. Laparoscopic method should be the first choice in the treatment of these patients not only because of the shorter hospital stay and shorter recovery, but also because of cosmetic reasons such as smaller incision and consequently smaller scar.

Key words: mature cystic teratoma; laparoscopy; laparotomy



ANTIBIOTIC-ASSOCIATED DIARRHEA: AN EMERGING PROBLEM

Author(s): Marija Livajić, Marko Mikolčević, Martin Lacković e-mail: [email protected](s): Full professor Ivica PavićFaculty of Medicine, University of RijekaGSC ID: 136

Background: Antibiotic-associated diarrhea (AAD) is caused by C. difficile which is replicated in the colon after use of antibiotics. They are considered as a main pre-cipitating factor for developing disease by disrupting normal gut flora together with others as age, recent hospitalization, use of proton pump inhibitors (IPP) and previ-ous recurrent disease.Aim: Our aim was to show sociodemographic characteristics, laboratory parameters of patients and risk factors for developing antibiotic-associated diarrhea. We wanted to make a review of the most often clinical presentations of AAD and to determine which group of patients was the most affected and had a risk of developing the dis-ease.Material and Methods: We used the data from medical documentation of 24 pa-tients, treated in the Clinic of Infectious Disease CHC Rijeka which were hospitalized during the period 2010.-2015. Every patient with this condition in our clinic was included in this study. The statistic was made by descriptive analysis in the program Microsoft Excel 2016.Results: The share of women was 58 %. Average age of examinees was 73 years (±16,5). All patients had at least one risk factor for developing AAD. The most im-portant risk factor was the previous use of antibiotics. Before the onset of AAD symp-toms 79 % of patients used at least one antibiotic. Aminoglycosides are mentioned for the first time as a causative agent of AAD. Serious AAD was seen in 46 % (11) patients, while one had a fulminant form and all the rest had mild/moderate form. Laboratory parameters which show heavier forms of AAD were hypoalbuminemia (<30 g/L), leukocytosis (>35x109/L) or leukopenia (<2x109/L) and creatinine level (>133 μmol/L) which were considered equally important. Metronidazole was applied as a therapy in 75 % patients and vancomycin in 25 %. Recurrent disease was found in 29 % patients and most common cause was reuse of antibiotics. We treated 75 % of those patients with metronidazole again and 25 % with vancomycin.Conclusion: This study gives insight about AAD in CHC Rijeka. It points towards the education about sanitary measures necessary to stop the spreading of C. difficile and emphasizes the necessity of rational prescribing of antibiotics.

Key words: antibiotic-associated diarrhea; C. difficile; antibiotics



POSTOPERATIVE COMPLICATIONS DUE TO DIFFERENT INCISION TYPES FOR APICOECTOMY IN AESTHETIC REGION

Author(s): Jovana Bakaloviće-mail: [email protected](s): Assoc. Prof. Bojan GačićFaculty of Dental Medicine, University of BelgradeGSC ID: 145

Background: Surgical treatment of periapical lesions in the aesthetic region is a great challenge. In addition to the complete removal of the lesion, a lot of attention should be given to the election of the right incision in order to avoid postoperative compli-cations and consequences and to ensure proper healing. Aim: The aim of this research was to determine the most suitable incision, compar-ing modified vertical (Eskici) and gingival angular (Reinmuller) incision.Materials and Methods: Five patients with bilateral periapical lesions in maxillary front region were included. Concerning indications for each incision, on one side we used modified Eskici vertical incision, and on contra lateral side gingival angular – Reinmuller incision. All procedures were performed by the same surgeon. Patients were followed up to 30 days after intervention. The healing process was evaluated clinically, after 1, 2, 7 and 30 days post operatively. Parameters for evaluation were pain, swelling, aesthetic aspect, suture dehiscence and bleeding.Results: In all cases, pain was negligible, and there was no bleeding recorded. Verti-cal incision showed slightly smaller swelling (~0.355) comparing to gingival angular incision (~0.479), although statistical analysis showed no significant difference. Con-cerning aesthetic acceptance, patients evaluated vertical incision as more acceptable (average grade : 8.05) than the gingival angular (4.74). In one case Reinmuller flap was indicated for revision of the intervention, due to the dehiscence of sutures. All other patients had no complications during the healing process.Conclusion: Due to the short period of time and complex inclusion criteria, this was just a pilot study. So far, the results have shown that vertical incison is slightly better than the gingival angular. The study will be expanded further, in the future.

Key words: oral surgery; apicoectomy; incision; aesthetic region; Eskici



INDICATIONS FOR ORAL-SURGICAL INTERVENTIONS UNDER GENERAL ANESTHESIA ON FACULTY OF DENTAL MEDICINE IN

BELGRADE

Author(s): Ognjan Pavlović, Tamara Zdravkoviće-mail: [email protected](s): Full Prof. Miroslav AndrićFaculty of Dental Medicine University of BelgradeGSC ID: 153

Background: Oral-surgical interventions, depending on patients’ age, general health condition and type of intervention, can be performed under local anesthesia, seda-tion or general anesthesia.Aim: In our study, indications for interventions under general anesthesia in Clinic for oral surgery of Faculty of Dental Medicine in Belgrade were analyzed.Material and Methods: On Clinic for oral surgery, two-year retrospective study (Jan-uary 2015-January 2017) was conducted. The study included 56 patients (38 men and 18 women) who have undergone intervention under general anesthesia. From the protocol book of oral-surgical interventions in general anesthesia and patients’ history of illnesses, data was collected, afterwards put in tables and analyzed, using student T-test and χ2 test. Based on this data, three groups were formed: patients with special needs (29), younger than 13 (17) and adults (10).Results: According to collected data, indications for oral surgery under general an-esthesia differ between the groups. In the first group there were significantly more extractions (114) than in the second (28), while in the third were mostly enucleations of cysts (8). However, indications for extractions were different. In the first group the most common was caries and its complications (87/114), while in the second those were supernumerary and impacted teeth (22/28). It was shown that patients with special needs were significantly younger (average value of years 26.03±8.84) com-pared to adults (42.1±12.09), and the duration of interventions for these patients was significantly shorter (40±23.41 as opposed to 82±30.93 minutes).Conclusion: The results of this study show that people with special needs are most often operated in the conditions of general anesthesia, especially when radical oral surgery procedures of caries are needed. Given that there are no standardized crite-ria determining which patients should be operated in general anesthesia and which should not, the possible definition would be of great importance for the prevention of irrational use of general anesthesia.

Key words: oral-surgery interventions; general anesthesia; patients with special needs



MEAN PLATELET VOLUME AS PROGNOSTIC AND DIAGNOSTIC BIOMARKER IN LARYNGEAL CANCER

Author(s): Damir Vučinić, Ivan Vuksan, Gordana Žauhar PhD, Gordana Zamolo PhD MD e-mail: [email protected](s): TA Blažen Marijić, Assist. Prof. Milodar Kujundžić, Assist. Prof. Tamara BrautFaculty of Medicine, University of Rijeka GSC ID: 151

Background: Laryngeal squamous cell carcinoma (LSCC) is the most frequently oc-curring malignant head and neck tumor. According to clinical TNM classification, cancer can be classified into two groups: early stage (Tis, T1a, T1b, T2) and advanced (T3, T4) tumors. Mean platelet volume (MPV) is a marker that shows the activation and function of the platelets. Altered MPV has been reported in several malignancies.Aim: In our study, we wanted to investigate the diagnostic and prognostic signifi-cance of easily available markers, such as platelet and MPV values, in LSCC.Material and Methods: Laboratory and clinical data were analysed from 67 patients with LSCC under active follow-up over 5 years. Patients were divided into two groups based on TNM classification: 32 patients with early stage and 35 with advanced LSCC. MPV and platelet values were compared between groups. The correlation of MPV values with 5-year survival were investigated. For this correlation, patients were divided into two groups by taking MPV laboratory reference values.Results: Mean MPV value in early stage group was 7,51 fL, while mean MPV value in advanced group was 6,89 fL. Comparison was performed by a Student’s t-test that showed a statistically significant lower MPV values in patients with advanced LSCC (t =2,601; P = 0,011). Platelet values were significantly higher in advanced group (t = -2,701; P = 0.009). The correlation between MPV and platelet values in both groups were not statistically significant. The survival difference between group 1 (MPV < 6,8 fL) and group 2 (MPV 6,8 – 10,4 fL) is also not statistically significant.Conclusion: Our research proves the diagnostic importance of MPV in advanced LSCC. Lower MPV values can be a prognostic factor because they are closely related to the advanced LSCC. However, our research has not proved the correlation of these values with survival.

Key words: mean platelet volume; laryngeal cancer; platelet count; diagnostic marker; prognostic marker



NEUROPSYCHIATRIC CORRELATIONS OF COGNITIVE DISORDERS IN PARKINSON’S DISEASE

Author(s): Nevena Koponja, Staša Krasiće-mail: [email protected](s): TA Tanja StojkovićFaculty of Medicine, University of BelgradeGSC ID: 155

Background: In Parkinson’s disease (PD), besides usual motor disorders, we find also neuropsychiatric symptoms and cognitive disorders.Aim: To examine the difference in frequency of the neuropsychiatric symptoms in PD patients, PD with and without cognitive disorders.Material and Methods: The study includes 122 patients in the various stages of PD (according to the Hoehn-Yahr scale). Demographic and clinical data are collected by using a semi-structural questionnaire and Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS UPDRS). Mini Mental State Test (MMS) and revised Addenbrooke’s Scale (ACE-R) has been used to evaluate global cognitive functioning. For a more detailed evaluation of the cognitive functioning in five fun-damental cognitive domains (memory, executive functioning, language, attention, visual-spatial perception) a neuropsychological battery has been used. In accordance with Criteria of the Society for Involuntary Movement patients are classified as, ac-cording to the grade of cognitive impairment, on cognitively unimpaired patients (PDCN), patients suffering from mild cognitive impairment (PDMCI) and those suf-fering from dementia (PDD). Psychiatric symptoms are examined using Hamilton Anxiety Scale (HARS), Hamilton Depression Rating Scale (HDRS), Scale of Apathy (SA) and Neuropsychiatric Inventory scale (NPI).Results: In our group, there were 56,9 % patients with mild cognitive impairment and 21,6% patients suffering from dementia. PDCN, PDMCI patients didn’t differ regarded to HDRS, HARS and SA (p>0,05 for each). PDD patients had higher scores on SA compared to PDMCI and PDCN patients (p<0,01). On the sub-scores of the NPI scale, we have noticed differences between PDMCI and PDD groups in form of grade of paranoid ideas and apathy. On the NPI scale, the most frequent occurrenc-es in PDMCI patients are anxiety (55,3%) and depression (48,9%), in PDD apathy (64,3%), and in PDCN anxiety (60,0%) and depression (50,0%). By comparing all of three groups of patients mutually, there were obtained differences in domains: delu-sions, hallucinations, agitation, depression and apathy (p<0,01 for each). Taking in concern only the clinically significant symptoms, a variation was noticed in halluci-nation and agitation (p<0,01) when we have compared all the groups together. Apa-thy, paranoid ideas and hallucinations are identified as predictors of dementia in PD.Conclusion: Our study has confirmed that psychiatric symptoms are more common in patients with PD and a cognitive damage than in patients without any cognitive damage.

Key words: Parkinson’s disease; mild cognitive impairment; dementia; neuropsychiatric symptoms



EVALUATION OF ANTIGENOTOXIC AND ANTIOXIDANT POTENTIAL OF AGARICUS BLAZEI

Author(s): Ivana Đorđević, Nataša Atlijae-mail: [email protected](s): Full Prof Lada Živković, TA Dijana TopalovićFaculty of Pharmacy, University of BelgradeGSC ID: 158

Background: Agaricus blazei Murrill is a fungus used in traditional medicine as a treatment for a vast of chronic diseases, such as hepatitis, diabetes, infectious diseas-es, and it is confirmed that it has immunomodulatory and antitumor activity. Some in vitro studies suggest antigenotoxic and antioxidant effect. Main components with biological activity are polysaccharides β-(1,6)-glucans and β-(1,3)-glucans.Aim: In vitro evaluation of antigenotoxic and antioxidant effect of A. blazei, on the hydrogen-peroxide induced DNA damage of human peripheral blood leukocytes, using alkaline comet assay.Material and Methods: Selected concentrations of dried and powdered mycelium A. blazei (250 μg/ml, 500 μg/ml, 1000 μg/ml) were tested for antigenotoxic effect in pre-treatment and post-treatment, as well as repair kinetics, using in vitro alkaline comet assay. DNA damage was induced with hydrogen-peroxide in concentration of 50 μM. Antioxidant properties were tested using its •OH scavenging properties in concentrations from 0.01 to 2 mg/ml.Results: Antigenotoxic activity was confirmed in both pre-treatment, with maxi-mum of 47.42% improvement over the control, and post-treatment, with maximum of 45.95% improvement over the control. Evaluation of repair kinetics showed that the concentration of 250 μg/ml in post-treatment decreased induced DNA damage during the first 15 minutes, with a maximum result after 45 minutes. Analysis of the antioxidant properties showed concentration dependant trend with strong •OH scavenging properties. Concentration of 0.196 μg/ml showed to be IC50, and con-centrations of 250 μg/ml, 500 μg/ml and 1000 μg/ml showed 55%, 62% and 68% inhibition of •OH radical respectively.Conclusion: It is confirmed that A. blazei has an antigenotoxic and antioxidant effect against H2O2 induced DNA damage in human peripheral blood leukocytes. Test of the antioxidant power showed that A. blazei has strong •OH scavenging properties. These in vitro studies confirm existing results and it is a justification to investigate effects in vivo.

Key words: Agaricus blazei; antigenotoxic; genoprotective; Comet test; oxidative stress



DIFFERENCE IN AUTONOMIC NERVOUS RESPONSE BETWEEN TWO ACUTE ACOUSTIC STRESS ASSESSED BY HEART RATE

VARIABILITY (HRV) METHOD IN GROUP OF STUDENTS

Author(s): Michał Jurczyk, Andrzej Boryczkoe-mail: [email protected](s): Dr Agata Furgała, Dr hab. Krzysztof GillFaculty of Medicine, Jagiellonian University Collegium Medicum, KrakówGSC ID: 191

Background: Stress became one of the major risk factors for cardiovascular disease. In real life unexpected stress we can meet everywhere: construction projects, the loud phone, household appliances and road traffic. Aim: The aim of our study was to evaluate the differences in response to acoustic stress stimuli on autonomic system (AUN) activity assessed by heart rate variability (HRV), blood pressure variability (BPV) and cardiovascular hemodynamic param-eters.Material and Methods: 25 healthy volunteers - medical and non-medical students - 9 women and 16 men (21.96±0.79yrs.) were included into the study. The stress level among students was tested using a simple questionnaire. AUN activity was assessed by HRV and BPV . Signal recordings were conducted for 10 min at rest and 10 min after a sound signal used during the anatomy practical exam named “pins” (frequen-cy 1100 Hz, duration 4.0 sec, sound intensity 95 dB) or for 10 min after the standard sound signal from a generator (1100 Hz, 0.5 sec, 95 dB).Results: Both acoustic impulses caused the increase of HR, systolic and diastolic BP immediately after signal release during the first 30 seconds and compensatory de-crease of such parameters in the next 30 seconds. The sound of anatomy exam caused stronger increase of HR than acoustic startle in medical students (69±10 vs. 73±13 p<0.005) than in non-medical students(69±6 vs. 70±10, p=0.748). The dBP in 15 sec-onds after stresses (“pins” sound vs. acoustic startle) increased in comparison to base level in medical student and non-medical students (3.1% and 1.5% vs. 3% and 4.4%), respectively. This correlation was observed in LF-dBPV (6.2±1.6 vs. 4.0±0.8ms2, p=0.04) in medical students’group and (6.1±4.3 vs. 4.1±2.6 p=0.06) in non-medical.Conclusions: Both acoustic stimuli activated the sympathetic AUN. The anatomy practical exam sound, which students remembered from the past, more strongly stimulates sympathetic autonomic nervous system in medical students group than in non-medical.

Key words: Stress; HRV; blood pressure variability; students; autonomic system activity



THE CHANGES OF THE HYALURONIC ACID ORGANIZATION IN LAMINA PROPRIA OF UNINVOLVED RECTAL MUCOSA IN PA-

TIENTS WITH RECTAL ADENOCARCINOMA

Author(s): Aleksa Jovanović e-mail: [email protected] Mentor(s): Assist. Prof. Mila Ćetković Milisavljević, ТА Sanja Despotović, TA Tamara Martinović Faculty of Medicine, University of Belgrade GSC ID: 161

Background: The interactions between tumor cells and tumor stromal elements are very complex. It has been shown that changes are not only present between those, but also in uninvolved mucosa nearby the tumor (transitional mucosa). It is believed that genetic, epigenetic and biochemical changes happen in transitional mucosa. The changes in morphometric parameters, number of blood vessels and distribution and presence of collagen and reticular fibers have been reported in recent study of unin-volved rectal mucosa 10 cm and 20 cm away from adenocarcinoma.Aim: The aim of this paper was to establish changes in the hyaluronic acid (HA) organization as an important extracellular component of uninvolved rectal mucosa 10 cm and 20 cm away from adenocarcinoma using exact morphometric methods. Material and Methods: Tissue samples of healthy rectal mucosa and mucosa 10 cm and 20 cm away from adenocarcinoma were stained immunohistochemically using Anti-Hyaluronic Acid Binding Protein (HABP) antibody. The presence of HA in lamina propria was inspected using software Icy. It recognizes the color of HA and calculates the percentage of lamina propria it occupies. Software Fiji was used for investigating spacing between HA molecules. Plugin Bone J measures the greatest possible radius of the circle that can be drawn between two HA molecules.Results: The presence of HA (%) in lamina propria 10 cm and 20 cm away from ad-enocarcinoma (45.42±13.35 and 42.71±11.81, p<0.01) compared to healthy samples (60.41±9.31) is significantly lower. The spacing between HA “chains” (µm) in lamina propria away from tumor (3.92±2.48 and 3.44±1.35, p<0.01) is significantly bigger compared to healthy mucosa (1.6±0.5).Conclusion: The morphometric analysis confirmed that the presence of hyaluronic acid in lamina propria 10 cm and 20 cm away from adenocarcinoma is decreased and that diameter of spacing between the hyaluronic acid “chains” is significantly increased compared to normal tissue samples.

Key words: rectal adenocarcinoma; lamina propria; hyaluronic acid; image analysis



CHANGES IN MYOFIBROBLASTS CONTENT IN LAMINA PROPRIA OF MUCOSA 10 cm AND 20 cm AWAY FROM RECTAL

ADENOCARCINOMA

Author(s): Valentina Balint, Jelena Bukarace-mail: [email protected] Mentor(s): TA Sanja DespotovićFaculty of Medicine University of BelgradeGSC ID: 162

Background: It is known that fibroblasts and myofibroblasts play an important role in all stages of malignant progression, including initiation, growth and formation of the metastases. Distribution and number of myofibroblast changes, not just in tumor, but also in immediate surroundings of tumor (transitional mucosa). However, the literature lacks information whether distribution and number of myofi-broblasts changes at greater distance from tumor.Aim: The aim of this paper was to determine whether there are some changes in the distribution of myofibroblasts in lamina propria of rectal mucosa within 10 cm and 20 cm away from rectal adenocarcinoma by using exact morphometric methods. Material and Methods: Tissue samples were examined by immunohistochemistry with anti-alpha-SMA antibody.Using computer-assisted image analysing software Icy, we determined distribution of myofibroblasts in lamina propria 10 cm and 20 cm away from primary tumor lesion. Results: In comparison to lamina propria of healthy examinees: there is decreased distribution of myofibroblasts in whole lamina propria of colon 10 cm and 20 cm away from tumor (p<0.01), but also in 10 cm compared to 20 cm away from tumor. When observed by regions, similar to previous observations, when compared with healthy examinees, there is significantly lower distribution of myofibroblasts in lam-ina propria along lamina muscularis mucosae 10 cm away from tumor (p<0.01). In lamina propria between crypts there is significantly lower distribution of myofibro-blasts 10 cm (p<0.01) and 20 cm (p<0.05) away from tumor. In subepithelial region of lamina propria there is not any statistically significant difference in distribution of myofibroblasts 10 cm and 20 cm away from tumor.Conclusion: We showed that, analog to the transitional mucosa, distribution of my-ofibroblast is decreased in seemingly healthy lamina propria 10 cm and 20 cm away from tumor, compared to lamina propria of patients without malignant tumor.

Key words: rectal adenocarcinoma; lamina propria; myofibroblast; image analysis



RELATIONSHIP BETWEEN TYPE OF FERTILISATION TO THE COURSE OF PREGNANCY, THE LABOR AND THE HEALTH OF THE

MOTHER AND CHILD

Author(s): Ewelina Preizner-Rzucidlo, Magdalena Górecka, Klaudia Walochae-mail: [email protected](s): TA Malgorzata Radon-Pokracka, Assoc. Prof. Hubert HurasFaculty of Medicine, Jagiellonian University Medical CollegeGSC ID: 165

Background: In-vitro fertilisation (IVF) is an effective treatment for infertility, but there is concern about the health of children. There is a deficiency of population long-term studies in children born after IVF.Aim: The study aim was to investigate how many children conceived by in-vitro fer-tilisation were born in our Clinic and analyse their obstetrical outcomes.Material and Methods: The study group (n = 263) included patients admitted to the Obstetrics and Perinatology Department in Cracow between Jan 2002 and Jan 2016 with the in-vitro induced pregnancies. Control subjects (n = 306) were randomly chosen from a regional birth register and were matched for maternal age, parity, fetal sex, plurality and the date of delivery. The main outcome measures were duration of gestation, birth weight, perinatal death, perinatal morbidity, incidence of congenital malformations and incidence of cesarean delivery.Results: Multiple births occurred in 28% of pregnancies compared with 3% in the control group. In the IVF group, more babies were born preterm (< 37 weeks) than controls (22% vs 7%) and more had low birth weights (< 2500g, 23% vs 5%). The perinatal mortality was respectively 3.8% to 0.3% in the control. We observed 0.75% congenital defects in IVF group, in comparison to controls 0.3%. More patients in the study group were delivered by cesarean section. (76% vs 18%).Conclusion: Children born after IVF had poorer obstetric outcome compared with children born after spontaneous conception, mainly because of the increased rate of preterm birth. There was no significantly increase incidence of fetal chromosomal abnormalities in the IVF group. For both singleton and twin pregnancies obtained with in-vitro fertilisation, the incidence of cesarean delivery is increased.

Key words: in vitro fertilization; obstetric outcome; pregnancies; IVF



MAXILLOFACIAL FRACTURES: A FOUR YEAR LONG STUDY

Author(s): Marko Mikolčeviće-mail: [email protected](s): Assist. Prof. Margita Belušić-GobićFaculty of Medicine, University of RijekaGSC ID: 166

Background: The maxillofacial region entails the face, the upper and lower jaw and the oral cavity. Given its exposure, the face is constantly at risk for trauma in all age groups. Considering the fact that it consists of many bones that vary in their anato-my and position, various mechanisms of injury cause certain types of fractures and associated injuries which, therefore, further determine the therapy, it being surgical or conservative.Aim: The purpose of this retrospective study was to determine the occurrence of maxillofacial fractures in a four year long period depending on the age and sex of the examinees, as well as the mechanism of injury, associated injuries and the way they were treated.Material and Methods: For this study we used data from patients admitted to the Clinic for Maxillofacial Surgery at the University Hospital Rijeka, Croatia in the pe-riod from January 1st 2013 until December 31st 2016. There were 287 patients with 391 maxillofacial fractures. Statistics from the acquired data was made in Microsoft Excel 2010.Results: Men were 3 times more often impacted with maxillofacial trauma and the most common age group were young men (age 21 – 25). The most common etiolog-ical factor in both sexes was falls (44% of all cases). The most common associated injuries were soft tissue injuries (50% of all cases), whereas the most frequently frac-tured bone was the mandible (25% of all fractures), followed closely by the zygomatic bone (23% of all fractures). Approximately 60% of all the examinees were surgically treated, whereas the rest was treated conservatively.Conclusion: Considering the fact that a yearly increase in maxillofacial fractures was detected with peak incidence being in young and working age population, the re-sults of this study can help better understand under what circumstances maxillofacial fractures mostly occur and, therefore, help prevent them.

Key words: maxillofacial; trauma; fractures



MICROSCOPIC IMAGES OF BORDER NEURONS FROM THE HUMAN DENTATE NUCLEUS: PARAMETERS OF NONLINEAR QUANTITATIVE ANALYSIS AND INVESTIGATION OF THEIR

DISTRIBUTION WITH AGE

Author(s): Sara Milovanović, Jelena Stevanović e-mail: [email protected] Mentor(s): Assoc. Prof. Nebojša Milošević Faculty of Medicine, University of Belgrade GSC ID: 171

Background: Dentate nucleus represents a cluster of neurons located deep in white matter of cerebellum. Neurons from dentate nucleus, as the biggest and the most lat-eral from deep cerebellar nuclei are classified into two groups by its morphology and function. The group of big neurons are further classified into four subgroups and one of them are border neurons.Aim: This study investigates possibility to discriminate inner and outer neurons from small sample of human border neurons, using quantitative and nonlinear pa-rameters of the image analysis. In addition, this study investigates relations between nonlinear parameters and the age of neurons.Material and Methods: In our study we used brains of nine adult men obtained from department of forensic medicine. Age of our respondents varied from 23 to 75 years. The small sample of 2D images of dentate nucleus border neurons have been used for this study: 16 images of inner and 12 images of outer neurons. Their morphology was quantified by 7 parameters which investigate the neuron area, dendritic length, number of primary dendrites, space-filling property, shape, dendritic complexity/tortuosity and neurons inhomogeneity/rotational invariance.Results: The results have showed that means of neuron area, dendritic length, num-ber of primary dendrites and neurons inhomogeneity/rotational invariance are sta-tistically equal for inner and outer border neurons. In contrast to this, space-filling property, shape and dendritic complexity/tortuosity are statistically different between two types of border neurons. In addition, means of four nonlinear parameters does not change when the age of neurons increases.Conclusion: Our results corroborate previous findings and conclusions: border neu-rons of the dentate nuclei can be classified into inner and outer type. Moreover, our study promotes hypothesis that morphology of neurons from the human dentate nu-cleus does not change with the age.

Key words: age; border neurons; classification; dentate nucleus; nonlinear analysis



EFFECTS OF AGING ON HEMATOLOGICAL PARAMETERS, CELLULARITY OF SPLEEN AND BONE MARROW IN RATS

Author(s): Radovan Anđić, Aleksandra Vranić, Miloš Lazić, Jovan Ismae-mail: [email protected](s): Assoc. Prof. Silvio De LukaFaculty of Medicine, University of BelgradeGSC ID: 173

Background: Aging is a process common to all living beings that leads to the physi-ological deterioration of organ systems, including hematopoietic system. Changes in hematopoietic stem cells during aging result in changes in bone marrow cellularity and number of myeloid and lymphoid cell lines, and thus may hinder correct inter-pretation of routinely used laboratory analyzes.Aim: Examination how aging affects standard hematological parameters, cellularity of spleen and bone marrow in rats.Material and Methods: Fourteen male Wistar rats were divided into 2 groups: young and old. After achieving 10 weeks (young) and 3 years (old), rats were sacrificed and samples of blood, spleen and tibial bone marrow were treated in order to determine blood parameters, spleen and bone marrow cellularity.Results: The aging process hasn’t led to a statistically significant difference in the number of erythrocytes, Hgb, Hct, MCV, MCH, MCHC and RDW between these two groups. Number of platelets was significantly lower in the group of young rats (p < 0.01). Leukocyte count showed statistically significant lower number of monocytes (p < 0.01) in the group of young rats. Differential blood count showed statistically significant higher number of lymphocytes (p < 0.01) and statistically significant low-er values of monocytes and neutrophils (p < 0.01) in the group of young rats.Spleen cellularity was significantly higher in the group of young rats (p < 0.01). It also showed that percentage of red blood cells (p < 0.01) and granulocytes (p < 0.05) were significantly lower, but percentage of lymphocytes was significantly (p < 0.01) higher than the group of old rats. Bone marrow cellularity was significantly higher in the group of young rats (p < 0.01).Conclusion: The deterioration of hematopoietic system in aging is reflected through the decrease of hematopoietic tissue cellularity and tendency towards shifting from lymphoid to myeloid line.

Key words: aging; hematopoiesis; blood; spleen; bone marrow



INCIDENCE AND SURVIVAL OF PATIENTS WITH CHROMOPHOBE RENAL CELL CARCINOMA

Author(s): Nikolina Perić, Matea Verlić, Šime Medić, Mihovil Mandiće-mail: [email protected](s): Assist. Prof. Dean MarkićFaculty of Medicine, University of RijekaGSC ID: 174

Background: Renal cell carcinoma (RCC) accounts for approximately 3% of all adult malignancies, 5% of which is chromophobe renal cell carcinoma (crRCC). 30% of patients already have metastatic disease in the time of diagnosis.Aim: This study aimed at reviewing the incidence and survival of patients diagnosed with crRCC over a 10-year interval at the Clinical Hospital Center of Rijeka, Clinic of Urology.Material and Methods: A retrospective review was conducted and the total of 29 pa-tients who were diagnosed with crRCC and treated between May 2005 and October 2014 were included in this study. Clinical evaluation of patients included gender, age in the time of diagnosis, affected kidney (left or right), symptoms, type of surgery, ECOG performance status, size of carcinoma, TNM classification, Fuhrman grade and patient’s survival. Data was gathered from the patient’s medical records.Results: The incidence of crRCC was higher in male patients (69%, n=20). One male patient was diagnosed and treated three times in the period of research. Average age in the time of diagnosis was 59,87. The average size of the carcinoma was 5,3cm (ranged 1,5cm – 12,5cm). The most common Fuhrman grades were II (64,52%, n=20) and III (29,03%, n=9). Only one patient was reported with metastases (crRCC 6,8cm, Fuhrman grade IV). 7 patients (24,14%) developed symptoms like macrohae-maturia, pain, bloating and weight loss (average crRCC size 7,1cm, most common Fuhrman grade II (57,14%, n=4). Radical nephrectomy was performed in 83,87% of cases (n=26) which shows it is still the basic surgical procedure in the treatment of crRCC.Conclusion: This study gave an insight into the current incidence of crRCC, whichis mostly asymptomatic and usually detected incidentally. Findings from this study reaffirm common knowledge about crRCC.

Key words: chromophobe renal cell carcinoma; radical nephrectomy; partial nephrectomy; ECOG performance status; fuhrman grade



PROSTATE IMAGING REPORTING AND DATA SYSTEM ROLE IN PROSTATE CANCER SCREEENING

Author(s): Tadas Letauta , Rūta Briedienė , Ieva Naruševičiūtė, Simona Le-tautienėe-mail: [email protected](s): Faculty of Medicine, Vilnius UniversityGSC ID: 182

Background: Standardised Prostate Imaging Reporting and Data System (PI-RADS) guidelines for the assessment of prostate alterations were designed for the assessment of prostate pathology. Published by the ESUR in 2012, PI-RADS v1 was based on the total score of different MRI sequences with subsequent calculation. PI-RADS v2 was published by the American College of Radiology in 2015 and featured different assessment criteria for prostate peripheral and transitory zones. Aim: The aim of our study was to assess the correlations of PI-RADS v1 and PI-RADS v2 with Gleason score values and to done their predictive values of the diag-nosis of prostate cancer. Material and Methods: A retrospective analysis of 66 patients. Prostate specific an-tigen (PSA) value and the Gleason score (GS) were assessed. One of the most malig-nant focal lesion was selected in the peripheral zone of each lobe of the prostate (91 in total). Statistical analysis was carried out applying SPSS so ware, v.23, p < 0.05. Results: Focal lesions assessed by PI-RADS v1 score: 10% – 1, 12% – 2, 41% – 3, 23% – 4, 14% – 5. Assessment applying PI-RADS v.2: 20% – 1, 7.5% – 2, 26%, 29.5%, and 17% were assessed by 3, 4, and 5 scores. Statistically relevant correlation was found only between GS and PI-RADS (p = 0.033). The positive predictive value of both versions of PI-RADS – 75%, negative predictive value of PI-RADS v1 – 46%, PI-RADS v2 – 43%. Conclusion: PI-RADS v1 was more statistically relevant in assessing the grade of tumour. Prediction values were similar in both versions.

Key words: PI-RADS v1; prostate; cancer; Gleason; screening



POSSIBILITIES OF COMPUTED TOMOGRAPHY WITH RESPIRATORY CONTROL

Author(s): Greta Letautaite e-mail: [email protected] Mentor(s): Simona Rūta Letautienė, Rita Steponavičienė, Donatas Vajauskas Faculty of Medicine, Vilnius UniversityGSC ID: 183

Background: 4D CT (computed tomography) is advanced imaging method which scans much faster and more accurate. It uses a new technology that captures the lo-cation and movement of tumor and body’s organs over time.Aim: The aim of the work was to determine the difference between 3D and 4D CT models for irradiated volumes in lung cancer radiation.Material and Methods: Prospectively analyzed the anonimyze data of 9 patients with non-small cell lung cancer in the National Cancer Institute 2016-2017. For all pa-tients was done computer tomography of the chest. Sections were made every 2.5 mm. The above six patients were additionally subjected to a four-dimensional (4D) protocol using the MIP (maximum intensity projection) protocol. During the study, breathing movements are recorded. The data were correlated with 3D CT imaging kits for the same patients, evaluating 5 respiratory phases. The precise dosage calcu-lation uses the Radiation Therapy Planning System (TPS), the Dose Count Algorithm - Anisotropic Analytical Algorythm (Version 10.0.28). Results: The mean age of patients was 65 ± 10.3 years. These patients have stage I-III non-small cell lung cancer (adenocarcinoma, platelet carcinoma of the lungs (G2-G3), 3D KT CTV median - 356.71 cm2, median CTV equivalent spherical level - 7.27 cm, 4D KT CTV median - 165,70 cm2, the median plane of the equivalent plane of the CTV is 5.75 cm. The median of the 3D CT PTV is 536.83 cm2, the median of the PTV equivalent spherical level is 10.07 cm, the median of the 4D KT PTV is 369.21 cm2, the PTV equivalent spherical level Median - 8.03.Conclusions: By applying 4D CT, a significantly lower volume of irradiated target is calculated. The planned lower volume of irradiated target can have a significant effect on the damage to the healthy lung tissue and critical organs.

Key words: 4D CT; non-small cell lung cancer; radiation; volume; 3D CT



CONSEQUENCES OF BAD SLEEPING: EXPERIMENTAL INVESTIGATION OF OPEN FIELD BEHAVIORAL ALTERATIONS

UPON SLEEP ARCHITECTURE DISRUPTION

Author(s): Anida Ademović, Željko Grubač, Aleksa Leković, Nikola Šutuloviće-mail: [email protected](s): Assist. Prof. Dragan Hrnčić, Full Prof. Olivera StanojilovićFaculty of Medicine, University of Belgrade GSC ID: 184

Background: Sleep duration, but also sleep architecture has to remain intact in order to preserve mutual restorative effects of sleeping and to prevent numerous disorders in all organ systems. Sleep fragmentation is a form of sleep architecture disruption, where a set of frequent arousals excel 1/min. Inbred strains of rats provide a good model for examining psychiatric spectrum of alterations that follow this kind of sleep modulation. Aim: of this study was to examine the relation between sleep fragmentation in dura-tion of 6h and anxiety-related behavior in male rats using the open field test. Material and Methods: 24 Wistar albino male rats were randomly assigned to: sleep fragmentation group (EXP, n=8), where the treadmill was programmed to alternately work 30 s ON and 90 s OFF every 2min during entire period of 6 h; activity group (ACONT, n=8), where treadmill program was set to working mode of 10 min ON and 30 min OFF; treadmill control group (CCONT, n=8), where rats stayed in the treadmill at moving speed of 0 m/s and conditions equivalent to those in cages. Im-mediately upon the completion of the treadmill regime open field test took place, where index of thigmotaxis, number of rearings and time spent in a central area were measured. One-way ANOVA with Fisher’s LSD post hoc test was used to estimate the difference between groups.Results: of this study showed anxiety-related behavior in EXP group of rats. This was corroborated by the significant increase in index of thigmotaxis compared to both ACON and CCON group. On the contrary, the significant decrease was noticed in time spent in a central area of open field arena, as well as a decrease in number of rearings in EXP group compared to ACON and CCON group. Conclusion: Sleep fragmentation in a duration of 6h leads to noteworthy anxiety-re-lated changes in behavior. These findings pave road to further translational research of this phenomenon.

Key words: sleep modulation; anxiety-related behavior; open field test; rats



EARLY AND LONG-TERM RESULTS AFTER SURGICAL REPAIR OF ANOMALOUS ORIGIN OF THE LEFT CORONARY ARTERY FROM

THE PULMONARY ARTERY

Author(s): Staša Krasić, Nikola Momčilović, Zorana Kovačević, Igor Živkoviće-mail: [email protected](s): TA Sergej Prijić, Assoc. prof. Mila Stajević, Assoc. prof. Vladislav VukomanovićFaculty of Medicine, University of BelgradeGSC ID: 190

Introduction: The anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is rare congenital heart anomaly, which produces postnatal myocardial ischemia and subsequent heart failure in infants.Aim: The evaluation of systolic function and cardiac remodeling during the both early and long-term follow up after surgical repair of ALCAPA.Material and Methods: Investigation was retrospective and included analysis of the medical records from patients with ALCAPA who had operation in the period between 2009 and 2017 at the Mother and Child Health Institute of Serbia „Dr Vukan Čupić“.Results: Five patients with coronary anomaly were included in the study (four girls and one boy). Diagnosis was established at the average age of 4.8 ± 3.0 months. All patients had significant dilatation of left ventricle preoperatively with end diastolic diameter (EDD) of 42.0 ± 7.6 mm (z-score = 6.42 ± 1.10), along with moderate to severe mitral regurgitation. In addition, decreased systolic function was revealed with ejection fraction (EF) of 34.8 ± 3.3% and fractional shortening (FS) of 19.8 ± 4.4%. Early effects of the operative treatment had trend toward to statistical significance. Partial reduction of the left ventricle EDD (37.4 ± 4.1 mm; z-score = 3.23 ± 0.78; p = 0.064) and contractility improvement (EF = 53.2 ± 6.7%; p = 0.072; FS = 31.3 ± 2.8%; p = 0.075) was registered. Average follow up period was 4.25 years (2 to 8 years). Statistical significant improvement of all mentioned parameters related to preoperative findings was recorded during the long-term follow up (pEDD = 0.008; pEF <0.0001; pFS = 0.029), with complete normalization of the left ventricle EDD (34.4 ± 2.5mm; z-score = 0.83 ± 0.29), EF (67.2 ± 3.60%) and FS (38.8 ± 1.1%).Conclusion: Excellent results with good long-term outcome can be achieved in infants with ALCAPA using reimplantation techniques. Operative treatment is related with favorable prognosis and normalization of systolic function and size of the left ventricle.

Key words: ALCAPA; echocardiography; cardiomyopathy



PSEUDOEXFOLIATION GLAUCOMA FREQUENCY AND PRESENTING FEATURES IN PATIENTS REFERRED TO A TERTIARY

OPHTHALMOLOGY CLINIC IN SERBIA

Author(s): Dolika Vasoviće-mail: [email protected](s): Full Prof. Vujica MarkovićFaculty of Medicine, University of BelgradeGSC ID: 200

Background: Pseudoexfoliation (PEX) syndrome is not only an ocular disease but also a general disorder that involves the abnormal production and disposal of extracellular matrix material in intra- and extraocular tissues. Intraocular pressure (IOP) of the pseudoexfoliative eyes is higher than IOP of the non-pseudoexfoliative eyes which leads to more severe eye damage during longer period of time. Glaucoma in the pseudoexfoliation syndrome has been shown to have a more serious clinical course than in primary open-angle glaucoma.Aim: The aim of our study was to determine the presence and frequency of pseudoexfoliation (capsular) glaucoma compared to other types of glaucoma among patients examined in one month period and in total number of glaucoma operated patients during last year.Material and methods: Our study involved 105 patients examined and diagnosed in November 2016 and 346 glaucoma patients operated between January and October 2016 at Clinic for eye diseases, Clinical Centre of Serbia. Methods used in examination and monitoring of patients were: biomicroscopy, applanation tonometry, computerized perimetry, ophthalmoscopy, gonioscopy and Heidelberg Retinal Tomography II (HRT II).Results: Although the frequency of capsular glaucoma in our sample was more common in women 14 (13.4%) compared to men 11 (10.4%), statistically significant difference related to sex was not observed. Binocular expression was 3.7 times more often than monocular in women and 1.7 times in men. Among glaucoma operated patients, capsular glaucoma was found in 94 (27.2%) cases, which indicates that every fourth patient operated last year had this type of glaucoma.Conclusion: Based on the results of our study, it can be concluded that in patients with capsular glaucoma, early detection and monitoring of pseudoexfoliation in the eye is extremely important for undertaking an adequate therapeutic procedure on time and better long-term prognosis.

Key words: PEX syndrome; glaucoma; frequency; diagnosis



INVESTIGATION OF ASSOCIATION BETWEEN BDNF GENE VAL66MET POLYMORPHISM AND OBESITY IN ADOLESCENT

POPULATION

Author(s): Veljko Banduka, Mario Baloe-mail: [email protected](s): Assist. Prof. Nela MaksimovićFaculty of Medicine, University of BelgradeGSC ID: 201

Introduction: Brain derived neurotrophic factor (BDNF) plays a very important role in the regulation of synaptic activity, transmission of signals between neurons, and in the processes of learning and memory. Recent studies have shown that BDNF also exists outside of the central nervous system in systemic circulation. It has been shown that BDNF is necessary for the control of body weight and energetic homeostasis. Low levels of circulating BDNF were found in obese individuals (children and adults) and individuals with diabetes type II. Aim: The aim of this study was to investigate the association of Val66Met polymor-phism of BDNF gene with lipid status (triglyceride, HDL, LDL and total cholesterol levels), body mass index (BMI), glycemia and blood pressure in adolescents. Material and Methods: Our study included 129 adolescents, mean age 15 years. An-thropometric demographic and medical data including age, gender, height, weight, lipid profile (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides) and fasting glucose were recorded. The analysis of Val66Met polymorphism was per-formed by PCR-RFLPs method. Results: There was no statistically significant difference in allele (p=0.876) and gen-otype (p=0.724) frequencies between normal weight children and overweight and obese children. Also, there was no statistically significant difference in the mean val-ues of analyzed variables (BMI, systolic, diastolic blood pressure, glycemia, level of triglycerides, total cholesterol, LDL and HDL cholesterol) depending on the BDNF genotype. When we performed the analysis separately for boys and girls our results have shown that there is a trend in the group of boys. Boys with GA genotype had low-er systolic blood pressure (p=0.070) and higher level of HDL cholesterol (p=0.066). Conclusion: Our results show that there is a possible association of Val66Met poly-morphism of BDNF gene with lower systolic blood pressure and higher total choles-terol in a group of adolescent boys.

Key words: BDNF gene; Val66Met polymorphism; obesity; adolescents; lipid status



THE IMPACT OF RISK ON COMPLICATIONS AND LENGTH OF HOSPITAL STAY AFTER GASTROINTESTINAL SURGERY

Author(s): Maša Žnidaršiče-mail: [email protected](s): TA Jelena VeličkovićFaculty of Medicine, University of BelgradeGSC ID: 202

Background: Malnutrition is a well recognised risk factor for poor outcome in hospitalized patients. It can be assessed by numerous tools across different populations of patients. European Society for Parenteral and Enteral Nutri-tion (ESPEN) proposed the NRS 2002 score, as one of the means of detecting malnourished patients, those at risk, and those who might benefit from nutri-tional support.Aim: The aim of our study was to determine the prevalence of nutritional risk and its impact on postoperative complications (POC) and length of hospital stay (LOS) after gastrointestinal surgery.Material and Methods: We evaluated 132 unselected patients in a cross-sectional study during the Nutrition Day (ND) 2016. Nutritional intake and health status data were collected by interviewing patients the ND organisation questionnaires. Patients NRS 2002 scores were calculated and they were followed for possible complications until discharge or readmission.Results: The overall prevalence of nutritional risk (NRS 2002 ≥ 3) was 37.1%. The type of surgery was insignificant in terms of nutritional risk(p>0.05). Patients with NRS ≥ 3 had much higher complication rate of 57.1% (28/49) compared to 13.3% (11/83) in patients with a normal score (p<0.001). Postoperative morbidity was in-creased 8.73 times for the NRS 2002 ≥ 3(OR 8.73; 95% CI 3.73-20.42). Positive an-swer to the question regarding weight loss in the last 3 months increased the risk for POC by 88.21 (95% CI 11.53-674.42). Conclusion: Nutritional risk found to be of the high prevalence amongst patients undergoing gastrointestinal surgery. The NRS 2002 score was a strong predictor of POC and LOS and should therefore, in such patients, be implemented in screening programs for evaluating the risk of malnutrition.The unintentional weight loss in the last three months was the strongest predictor of poor outcome.

Key words: nutritional support, malnutrition, surgery outcome, gastrointestinal surgery, weight loss



LUTEINIZING HORMONE AND INSULIN RESISTANCE IN MENO-PAUSAL WOMEN

Author(s): Srđan Pandureviće-mail: [email protected] Mentor(s): TA Ljiljana Marina Faculty of Medicine, University of Belgrade GSC ID: 204

Introduction: Levels of luteinizing hormone (LH) in menopausal women with adre-nal incidentalomas are in a direct correlation with insulin resistance (IR). The same correlation was established in women with polycystic ovary syndrome (PCOS). In-terestingly, very few data exist on effect of LH on IR in healthy menopausal women.Aim: The aim of our study was to investigate the possible relationship between LH and IR in healthy menopausal women.Material and Methods: Study group consisted of 35 healthy menopausal women ad-mitted to the Clinic for endocrinology, diabetes and metabolic diseases, Belgrade, Serbia. Measurements were taken for: LH, follicle-stimulating hormone (FSH), es-tradiol, testosterone, dihydroepiandrosterone, morning serum cortisol. Oral glucose tolerance test (OGTT) was performed, and levels of glucose and insulin were meas-ured at 0, 30, 60, 90, and 120 minutes. Insulin resistance was evaluated by HOMA-IR (Homeostasis Model Assessment index for insulin resistance) and Matsuda compos-ite insulin sensitivity index.Results: No significant correlation was found in levels of LH and IR (p > 0.05), nor in levels of FSH and IR. There was significant negative correlation between LH/FSH ratio and menopause duration (r = -0.352, p = 0.044), as well as LH/FSH and cortisol (r = -0.387, p = 0.035). No significant correlation was found between LH and cortisol, nor between FSH and cortisol. Significant positive correlation was found between testosterone and Matsuda index (r = 0.381, p = 0.05).Conclusion: Our results showed no correlation between LH and IR in healthy men-opausal women. However, we found a significant positive correlation between tes-tosterone and IR, which implies a direct relation between IR onset and lowered sex hormones in menopause.

Key words: LH; insulin resistance; menopause; testosterone; LH/FSH



IMMUNOHISTOCHEMICAL EXPRESION OF PARVALBUMIN- POSITIVE INTERNEURONS IN THE HIPPOCAMPUS OF AN

ANIMAL MODEL OF ALZHEIMER’S DISEASE DURING AGING

Author(s): Mario Balo, Veljko Bandukae-mail: [email protected](s): TA Ivan Zaletel, Assoc. Prof. Nela PuškašFaculty of Medicine, University of BelgradeGSC ID: 205

Background: Alzheimer’s disease (AD) is a neurodegenerative disease that leads to progessive memory loss, behavioral alterations and cognitive impairments. Litera-ture data suggests that the homeostasis of calcium ions may play a major role in the pathogenesis of AD. Parvalbumin (PV) is one of the Ca2+ binding proteins expressed in hippocampal GABAergic interneurons.Aim: The aim of this study was to quantify the PV immunoreactive interneurons in the hippocampus of an animal model of AD and of control mice and to determine the effect of aging on the expression of this protein.Material and Methods: The 5xFAD model of AD was used, which expresses mutant amyloid precursor protein and presenilin-1. These proteins play a fundamental role in the pathophysiology of AD. Transgenic and corresponding control mice were sac-rificed at 8 and 24 weeks of age, after which their brains were removed and processed for immunohistochemical analysis of PV protein in the hippocampus. Results: Statistically significant difference was found in expression of PV between transgenic and control mice aged 8 weeks, in CA1/2 region of the hippocampus while there was no statistical significance in mice aged 24 weeks.Conclusion: The obtained results show initial decrease in the expression of PV in 5xFAD model at 8 weeks of age, and normalisation of PV expression by 24th week compared to the control group of mice. These results support the data about early functional disruption of Ca2+ binding proteins in the hippocampus and provide new evidence for their potential role in the pathophysiology of AD.

Key words: Alzheimer’s disease; parvalbumin; 5xFAD; hippocampus



THE INFLUENCE OF PREVIOUS TRANSFUSIONS ON APPEARANCE OF ANTI-HLA ANTIBODIES IN PATIENTS ON KIDNEY

TRANSPLANT WAITING LIST

Author(s): Tamara Periće-mail: [email protected](s): Full Prof. Svetlana VojvodićFaculty of Medicine, University of Novi SadGSC ID: 208

Introduction: Sensibilization is defined as the occurrence of antibodies to different antigens in the serum. Correlation between the number of blood units and the du-ration of transfusion with the degree of sensitization of the patient has been proved. The presence of anti HLA antibodies in the serum of the recipient before transplan-tation proces is an important risk factor for transplant rejection. Sensibilization may be caused by exposure HLA during blood transfusions, previous transplantation or pregnancy.Aim: To evaluate the effect of the number, type and volume of transfused blood prod-ucts on the appearance of anti HLA antibodies in patients on kidney transplant wait-ing list.Material and methods: We investigated 69 patients with end stage renal disease from South Backa, on the waiting list for kidney transplant. Anti-HLA antibodies were detected by three methods: CDC–Complement Dependent Cytotoxicity test, ELI-SA-Enzyme-Linked Immunosorbent Assay, Luminex technology.Results: Out of 69 patients, 44 were sensitized (63.8%). The average PRA value was 8.04%. Most patients (53.6%) received 2-5 liters of blood, followed by those who received up to 10 liters (17.4%). A statistically significant correlation was found be-tween the volume of blood received and the occurrence of PRA (p <0.001), as well as between the effects of fresh frozen plasma without cryoprecipitate and the occurrence of PRA (p = 0.038). The influence of the number of products received (p = 0.204), the number of blood units received (p = 0.425) and the time since the last blood transfu-sion (p = 0.171) on the occurrence of PRA was not statistically significant.Conclusion: The volume and type of previous blood transfusions showed significant impact on the appearance of anti-HLA antibodies.

Key words: anti HLA antibodies; blood transfusion; kidney transplantation; sensibilization



CHARACTERISTICS AND OUTCOME OF PATIENTS WITH MASSIVE PULMONARY EMBOLISM TREATED WITH

THROMBOLYTIC THERAPY

Author(s): Bogdana Petrović, Marko Stijoviće-mail: [email protected](s): assist. prof. Dušanka ObradovićFaculty of Medicine, University of Novi SadGSC ID: 209

Introduction: Pulmonary embolism (PE) is, after myocardial infarction and cere-brovascular insult, the most common cardiovascular disorder. Massive (hemody-namically unstable) pulmonary embolism is characterized by systolic blood pressure <90 mmHg, poor tissue perfusion or multisystem failure and thrombolytic therapy is indicated in these patients. According to the literature, there are only a few studies devoted to risk factors that contribute to negative outcome these patients.Aim: The aim of our study was to determine how demographic parameters, comor-bidities, risc factors, echocardiographic findings, vasopressors and dobutamine af-fects on outcome of patients threated with thrombolytics therapy.Material and Methods: The study included 43 patients with hemodynamically un-stable PE who were treated with thrombolytic therapy at the Institute for Pulmonary Diseases of Vojvodina, in the period of 2013-2016. Demographic parameters (gen-der, age), comorbidities, risk factors, Well’s scoring system and the echocardiograph-ic findings upon admission, the use of vasopressors, dobutamine, rapid application or standard therapeutic protocol of thrombolytic therapy and intubation were analyzed. The statistical significance was determined by Pearson chi –square test and compar-ison of secondary value with Student t-test. They was used with the standard cutoff level of statistical significance: p<0.05.Results: The statistical significance relative to the death outcome had: age (t=2,419; p=0,020), intubation (χ2=25,899; p<0,01), use of vasopressors (χ2=14,532; p<0,01), dobutamine (χ2=5,250; p=0,022), and rapid therapeutic protocol of thrombolytic therapy (χ2=5,999; p=0,014).Conclusion: Risk factors of the greatest impact on mortality were age, intubation, use of vasopressors, dobutamine and rapid therapeutic protocol. According to data available from the literature, our results agree with the results of other surveys except in terms of applying rapid therapeutic protocol as risk factors for the occurrence of death.

Key words: hemodynamically unstable pulmonary embolism; outcome; risk factors



ASSESSMENT OF COMORBIDITIES IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Author(s): Marko Stijović, Bogdana Petrović, Marija Radoševiće-mail: [email protected] Mentor(s): TA Violeta KolarovFaculty of Medicine University of Novi Sad GSC ID: 210

Introduction: Chronic obstructive pulmonary disease (COPD) is one of the most common respiratory diseases in the working-ability population and represents seri-ous public health problem both in developed and developing countries. It has been found that the presence of comorbidities significantly increases mortality of patients with COPD and leads to frequent deteriorations. Comorbidities are present more often in serious illness, but it is not rare that they exist in all stages of COPD. The most common comorbidities that are present in patients with COPD are: cardio-vascular comorbidities, metabolic syndrome, lung cancer, depression and anxiety, gastroesophageal reflux.Aim: To determine frequency of comorbidities in patients with COPD, to determine whether there is relation between the stages of COPD and the number of comor-bidities, between duration of COPD and the number of comorbidities, between the frequency of COPD exacerbations and the number of comorbidities and between the outcome of the disease and number of comorbidities.Material and Methods: The study included 134 patients who were hospitalized at Institute for Pulmonary Diseases of Vojvodina because of deteriroration of COPD. The number of comorbidities were evaluated in all patients.Results: In total 60.4% of patients had 1-2 comorbidities, 34.4% of patients 3-5 co-morbidities, while 5.2% of patients had more than 5 comorbidities. The most com-mon comorbidity was cardiovascular disease in (68%) patients, while haematological comorbidities was in the lowest percentage (1%) of patients. There was not the re-lation between stages of COPD and the number of comorbidities (p=0.116). There was not the relation between duration of COPD and the number of comorbidities (p=0.591). There was the relation between the frequency of COPD exacerbations and the number of comorbidities (p=0.016). There was not the relation between the out-come of the disease and number of comorbidities (p=0,233).Conclusion: Comorbidities are present in all stages of COPD but usually cardiac comorbidity is the most present.

Key words: chronic obstructive pulmonary disease; comorbidities; exacerbations



ANALYSIS OF RS4696480 POLYMORPHISM IN THE REGULATORY REGION OF TLR2 IN PATIENTS WITH TRAUMA

Author(s): Dario Potkonjak, Ilija Radosavljević, Ivo Božović, Milena Papoviće-mail: [email protected](s): Full Prof. Ivana NovakovićFaculty of Medicine, University of BelgradeGSC ID: 212

Introduction: Sepsis is the most common, most serious posttraumatic and postop-erative complication. The incidence ofsepsis is getting smaller, but the prognosis re-mains poor, despite the introduction of new principles of intensive care. The average mortality rate of patients with sepsis is 40%, but it can be as high as 80% for older patients. Sepsis is a systemic response of the innate immune system to the presence of pathogens in the blood. It is characterized with multiorgan disfunction.Clinical picture of sepsis varies, elevated body temperature, (39-41 ° C), hypersensitivity of nerves and most important, high riskof septic shock development, the most common cause of death. TLR2 is a gene, whose polymorphisms are related to higher morbidity of sepsis in literature. TLR2 is localised on the 4. chromosome, it encodes a protein from the TLR family, a crucial receptor in response of the imune system to Gram positive bacteria. Aim: Study the association between SNP rs4696480 TLR 2 A/G and the susceptibility and outcome of sepsis.Material and Methods: The study group included 79 patients from the Clinical Center of Serbia from intensive care after trauma / surgery. As the main criteria for classification of patients was taken whether they developed sepsis after surgery, as well as its outcome (exitus and discharge). Rs4696480 polymorphism was detected by the method of Real-Time Polymerase Chain Reaction RT-PCR. Results: Study showed a statistically significant association between rs4696480 pol-ymorphism and morbidity from sepsis after trauma. There was a statistically signif-icant association between the polymorphism mentioned above and the outcome of sepsis. Conclusion: A larger number of complex studies is needed to conclude the associ-ation between genetic polymorphisms and the development of sepsis. With the dis-covery of a clear connection, we come one step closer to a better understanding sepsis and significant improvement of its prognosis with the use ofgenotyping.

Key words: Sepsis; TLR2; rs4696480; polymorphism



THE IMPACT OF PRENATAL CORTICOSTEROID THERAPY ON FETAL OXYGENATION, FETOPLACENTAL CIRCULATION AND

CEREBRAL CIRCULATION OF THE HUMAN FETUS

Author(s): Alisa Đorđeviće-mail: [email protected] Mentor(s): TA Ivana BabovićFaculty of Medicine, University of BelgradeGSC ID: 213

Background: Prematurity is the major cause of infant deaths. The introduction of antenatal corticosteroid therapy for prevention of preterm delivery has led to a large increase in survival of premature infants, but the effects and consequences of the therapy are not fully understood.Aim: The aim of this study was to determine the effect of prenatal corticosteroid therapy on biophysical profile parameters of the fetus and on the parameters of feto-placental and cerebral circulation of the fetus.Material and Methods: This retrospective study (2001-2011) included 72 women who were at risk of premature birth. These women received prenatal corticosteroid therapy between 29th and 35th week of gestation. The subjects were divided into two equal groups: one group received direct fetal intramuscular therapy and the other group received indirect transplacental therapy. We analysed biophysical pro-file of the fetus (BPP) and resistance index (RI) of the umbilical artery and middle cerebral artery just before and 4 hours after the treatment.Results: The mean gestational age at the time of therapy was 31,28±1,80. Statisti-cal analysis showed that there is a statistically significant correlation between fetal breathing movements (p<0,0001) and BPP (p=0,0003) before and after transplacen-tal therapy. Also, statistically significant correlation was found between umbilical artery RI before and after intramuscular (p<0,00001) and transplacental therapy (p=0,000), as well as between middle cerebral artery RI before and after intramus-cular (p<0,00001) and transplacental therapy (p=0,0006). However, the results of the non stress test and basal heart rate before intramuscular and transplacental ther-apy were not significantly correlated with the results after these therapies.Conclusion: Results of this research showed that indirect transplacental prenatal corticosteroid therapy had a significant influence on BPP, as well as on fetoplacental and cerebral circulation of the fetus.

Key words: prenatal corticosteroid therapy, biophysical profile of the fetus, resistance index, non stress test.



GREEN CHEMISTRY - AGRICULTURAL WASTE AS A SOURCE OF PHARMACEUTICALLY EXCIPIENTS: MICROCRYSTALLINE

CELLULOSE FROM CORN

Author(s): Tamara Bakić, Jovana Petroviće-mail: [email protected], [email protected] Menthor(s): PhD Marko Krstić, Full Prof. Slavica Razic, Assoc. Prof. Zoran Maksimovic Faculty of Pharmacy, University of Belgrade GSC ID: 214

Background: Agricultural waste is cheap and easily accessible renewable source of lignocellulosic biomass. Serbia’s annual production is about 12.5 million tons of bi-omass, where over 50% lie in corn biomass. Invention of a new source for micro-crystalline cellulose preparation would be very significant for the pharmaceutical industry.Aim: Research interest is focused on extraction and characterization of microcrys-talline cellulose, as excipients in the pharmaceutical industry, from agricultural bio-mass.Materials and Methods: The first phase included extraction and degradation of ag-ricultural biomass with hexane and methanol. In the sеcond one, the samples were subjected to delignification, bleaching, hydrolysis, rinsing and drying. The confirma-tion of structure of obtained product was carried out using FT-IR spectroscopy, the morphology of microcrystalline cellulose particles was determined by using SEM. In the obtained samples metals, metalloids and anions were analysed too. Pharmaceuti-cal-technological tests (flow, bulk, taped density, simulation of material compaction, disintegration and tablet’s dissolution rate) were performed. The results were com-pared with commercially available microcrystalline cellulose (Vivapur®).Results: The obtained yield of microcrystalline cellulose was 40.05%. Characteristic stripes of MCC were evident in FT-IR spectra of the sample. Using SEM, conclusion was that fibers of microcrystalline cellulose from corn (MMCC) were longer and unsettled than spherical fibers of commercial microcrystalline cellulose (MCC). Ac-cording to Ph Eur 9.0 microcrystalline cellulose monograph for heavy metals, can be concluded that corn-based sample is safe for use. MCC tablets disintegrated within 1 min and MMCC within 3 min. During the compaction simulation the obtained material showed good compactibility and it exhibits plastic deformation with also fragmentation during compression. Dissolution rate and drug release test with model drug (ibuprofen) proved that the faster dissolution rate and drug release was achieved from the tablets with MCC than tablets with MMCC. Conclusion: The results of these analyzes indicate that corn has a high potential as a source of microcrystalline cellulose, with satisfactory technological properties.

Key words: microcrystalline cellulose; corn; biomass; excipient



THE INFLUENCE OF DIABETES MELLITUS ON THE EFFICACY OF INTRAVENOUS THROMBOLYTIC THERAPY IN PATIENTS WITH

ACUTE ISCHEMIC STROKE

Author(s): Mirjana Arsenijević e-mail: [email protected](s): Assoc. Prof. Dejana JovanovićFaculty of Medicine, University of BelgradeGSC ID: 215

Introduction: Diabetes mellitus is a well-established major modifiable risk factor for acute ischemic stroke (AIS). It is associated with an increase in overall stroke mortality.Aim: The aim of our study was to investigate the efficacy of intravenous thrombolysis in the diabetic patients with AIS compared to patients without diabetes.Material and methods: A total of 458 AIS patients treated with intravenous throm-bolysis, were divided by the presence of diabetes into two groups, patients with dia-betes (n=76) and without it (n=382). The functional outcome using modified Rankin scale (mRS) was used as a measure of treatment efficacy. The follow-up period was 3 months after stroke onset.Results: The univariate analysis showed that there is no difference between two groups of patients in excellent (mRS≤1) (p=0,333) and good functional outcome (mRS≤2) (p=0,859), while the rate of death was higher in the group of patients with diabe-tes (21% vs. 12.8%), but this difference was not statistically significant (p=0,064). After adjustment for: years, hypertension, hyperlipidemia, smoking, initial glycemia, treatment beginning time > 180 minutes, the multivariate analysis also did not show difference in the excellent and good functional outcome neither in the rate of death between this 2 groups.Conclusion: There is no significant difference in good and excellent functional out-come, as well as the rate of death in patients with diabetes suffering from AIS, treated with intravenous thrombolysis, compared to the group without diabetes.

Key words:



INFLUENCE OF SMEAR LAYER PRESENCE ON THE PUSH-OUT BOND STRENGTH OF CALCIUM SILICATE-BASED ROOT CANAL

SEALERS

Authors: Anica Pavlović, Luka Tovaroviće-mail: [email protected]: TA Ivana Milanović, TA Bojan DželetovićFaculty of Dental Medicine, University of BelgradeGSC ID: 216

Introduction: Smear layer is produced during root canal instrumentation. Calcium silicate - based sealers form an apatite-like layer on sealer/dentin interface and may exhibit higher push-out bond strengths. Aim: The aim of this study was to investigate the influence of smear layer presence on the push-out bond strength of BioRoot RCS (Septodont, France), MTA Fillapex (Angelus, Brasil) and AH plus (Dentsply, Germany) root canal sealers.Material and Methods: Twenty dentin disks were obtained from the middle thirds of twenty extracted third maxillary molars with fused roots. Three 1.2 mm large holes were drilled in each dentin disk. Group 1 (n=10) was rinsed with 10% citric acid followed by 0.5% NaOCl. Group 2 (n=10) was rinsed with 0.5% NaOCl. All slices were for 30 s immersed in the selected solutions and then rinsed with distilled water and dried with absorbent paper. Then, the three holes of the same dentine slice were filled with three different sealers. Following setting, the push-out test was performed using a universal testing machine at a cross-head speed of 1mm/min. Bond strength values (MPa) were calculated as force (N) divided by 2 area (mm). Data were compared using two- way and one-way ANOVA with Turkey’s post-hoc test (α=0.05).Results: Regarding the smear layer presence, there were no significant differences in bond strengths values of sealers (p>0.05). In group 1, AH Plus showed significantly higher values of bond strength than calcium silicate-based root canal sealers (p< 0.05). There were no significant differences in bond strength values between BioRoot RCS and MTA Fillapex (p>0.05). Group 2 showed similar results; again, AH Plus exhibited higher values of bond strength than calcium silicate-based root canal sealers (p< 0.05).Conclusions: The smear layer presence did not affect the adhesion of the sealers. AH Plus presented higher dislocation resistance than calcium silicate-based sealers.

Кеy words: smear layer; bond strength; calcium silicate based sealers



THE FREQUENCY OF TRANSPLACENTAL VARICELLA-ZOSTER VIRUS TRANSMISSION AFTER PRIMARY MATERNAL INFECTION

Аuthor(s): Vuk Isakoviće-mail: [email protected](s): Full Prof. Aleksandra KneževićFaculty of Medicine, University of Belgrade GSC ID: 222

Background: Varicella Zoster virus (VZV) is a very important cause of perinatal infections. The greatest risk for perinatal infection is a primary infection during pregnancy with possible transplacental transmission of the virus and the onset of congenital varicella syndrome or neonatal varicella.Aim: The objective of this study was to evaluate the frequency of transplacental VZV transmission in pregnant women in our population. Material and Methods: The study included 50 samples of amniotic fluid of pregnant women with suspected fetal varicella or VZV vertical transmission. The presence of the virus was determined by PCR method with primers for DNA VZV gene 71. The procedure involved the extraction of DNA, PCR and gel electrophoresis for visualization of specific PCR products.Results: The presence of VZV was demonstrated in 13% (7/50) of the amniotic fluid samples. Transmission of the virus was detected in all three trimesters of pregnancy. Statistical significance was not shown between the referral diagnosis, age of pregnant women and gestational age of pregnancy and VZV positivity. Conclusion: Although the results of this study showed low prevalence of VZV vertical transmission during the eight year period, the use of VZV immunoglobulin is very important for the prevention of congenital VZV syndrome and neonatal varicella.

Key words: VZV infections; fetal varicella; vertical transmission



THE IMPORTANCE OF CURRENT PROGNOSTIC INDICES IN PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA

Author(s): Nikola Spremic, Nikola Momcilovice-mail: [email protected] Mentor(s): Full Prof. Milena Todorovic BalintFaculty of Medicine, University of Belgrade GSC ID: 225

Background: Diffuse large B-cell lymphoma - DLBCL is the most common subtype of Non Hodgkin lymphomas accounting for about a third of all cases. In order to assess the prognosis of these patients several indices are in use.Aim: The aim is to analyze the prognostic importance of the International Prognostic Index (IPI), the revised IPI (R-IPI) and NCCN (National Comprehensive Cancer Network) - IPI in patients with DLBCL treated by immunochemotherapy.Material and Methods: In this retrospective analysis 148 patients were analyzed (50.7% of men, 49.3% of women) who where diagnosed and treated in a period from 2003 to 2015 at the Clinic of Hematology, Clinical Center of Serbia.Results: 43.2% of the patients had low IPI score, 18.9% had medium-low, 24.3% had medium-high and 13.5% had a high score. 10.8% of the patients had low R-IPI score, 52.0% had medium and 37.2% had a high. According to the NCCN-IPI distribution was: 18.2% of the patients had low-risk, 37.2% had medium-low, 36.5% had medium-high and 8.1% had a high risk. According to the IPI, the favorable treatment response was achieved in 95.3% of patients with low-risk, in 85.7% with medium-low, in 86.1% with medium-high and in 70.0% with high-risk (p=0.023). According to the R-IPI, the favorable treatment response was achieved in 100.0% of patients with low-risk, in 90.9% with medium and in 80.0% with high-risk (p=0.048). According to the NCCN-IPI, the favorable treatment response was achieved in 96.3% patients with low-risk, in 92.7% with medium-low, in 79.6% with medium and in 83.3% with a high risk (p=0.074). The analysis of survival has determined the importance of IPI, R-IPI and NCCN-IPI in assessing the prognosis of patients with DLBCL (p<0,0001).Conclusion: IPI, R-IPI and NCCN-IPI have a significant role in assessing the prognosis of patients with DLBCL who are treated by immunochemotherapy.

Key words: Non-Hodgkin’s lymphoma; DLBCL; IPI; R-IPI; NCCN-IPI



ULTRASTRUCTURAL ANALYSIS OF MORPHOLOGIC CHARACTERISTICS OF LYMPHOCYTES IN PATIENTS WITH TYPE 2

DIABETES

Author(s): Nađa Vukašinoviće-mail: [email protected](s): Full Prof. Miljana Obradović, Assist. Prof Tamara Kravić Stevović, TA Tamara MartinovićFaculty of Medicine, University of BelgradeGSC ID: 236

Background: Type 2 diabetes (T2D) is a chronic metabolic disorder accompanied by immune response. As one of the most important components of the immune system, lymphocytes are expected to transform from resting to activated state as the development of T2D progresses.Aim: Aim of this research is evaluation of ultrastructural morphologic characteristics of peripheral blood lymphocytes obtained from patients with T2D that would indicate lymphocyte activation. Material and Methods: Peripheral blood samples were collected from 5 patients with T2D and 5 healthy individuals. Mononuclear cells were isolated from these peripheral blood samples and then fixed in glutaraldehyde and embedded in EPON. Ultrathin sections were made and observed using transmission electron microscope. Volume fraction of cytoplasm in lymphocytes, heterochromatin and euchromatin ratio, circularity and roundness of the nucleus were determined by processing ultramicrographs. Double point grid in Adobe Photoshop was used for morphometric analysis of cytoplasm and nuclear shape and chromatin analysis were done by ImageJ software with area measurement and shape descriptors. Statistical analysis of data was done using Student t test.Results: Nuclei of mononuclear cells of T2D patients had irregular shape, decreased circularity and roundness, compared to the mononuclear cells of healthy individuals, which was found to be highly statistically significant. Increased share of euchromatin in the nuclei of mononuclear cells in patients with T2D was found to be of high statistical significance in regard to the healthy control. No changes in the volume fraction of the cytoplasm were observed, however plasmocytes were identified in peripheral blood of patients only.Conclusion: Characteristics of nuclei that were examined showed evidence of cell activation in T2D patients despite the absence of quantitative changes in cytoplasm volume fraction of examined lymphocytes.

Key words: lymphocytes; type 2 diabetes; cell activation



THE ASSOCIATION BETWEEN GST GENOTYPE AND MARKERS OF OXIDATIVE DAMAGE IN PATIENTS WITH ADVANCED CORONARY

ARTERY DISEASE

Author(s): Petar Simić, Marko Todoroviće-mail: [email protected](s): Teaching Ass Vesna ĆorićFaculty of Medicine, University of Belgrade GSC ID: 241

Introduction: Oxidative stress seems to play a role in the development and progression of coronary artery disease (CAD). 8-hydroxy-2'-deoxyguanosine (8-OHdG) is a marker of oxidative DNA damage. Genes encoding for glutathione transferases (GST) contain several polymorphic variants that may affect their role in protecting cellular DNA against oxidative damage, through altered protein levels or function.Aim: The aim of this study was to investigate the role of certain GST polymorphisms in the risk of CAD development, as well as the association of different GST variants with the level of 8-OHdG among those patients.Material and Methods: GSTM1, GSTT1 and GSTP1 genotypes were determined in 100 male patients with severe three-vessels CAD documented by coronary angiography. GST genetic polymorphisms were determined by multiplex PCR or qPCR. Byproducts of DNA oxidative damage (8-OHdG) were determined by ELISA method.Results: The GSTT1-null genotype enhanced the risk of CAD compared to the GSTT1-active genotype (OR:3,08; 95%CI: 1,23-7,73). Moreover, the carriers of GSTM1-null/GSTP1-variant genotype exhibited 3-fold increased risk for CAD development, however, without reaching statistical significance (p>0.05.) The GSTM1-active genotype was significantly associated with higher level of 8-OHdG (p=0.013). Additionally, CAD patients with combined GSTM1-active/GSTP1-referent genotype had statistically higher level of 8-OHdG compared to the carriers of GSTM1-null/GSTP1-variant genotype (p=0.011).Conclusion: GST genotype seems to modify the risk for CAD development and was shown to affect the level of 8-OHdG.

Key words: gluthaione transferases; polymorphism; coronary artery disease; 8-OHdG



PROSPECTIVE MONITORING OF THE FIRST TREATMENT LINE IN HIV / AIDS PATIENTS IN THE REPUBLIC OF SERBIA

Author(s): Siniša Petković, Mladen Anđić.Mentor(s): Prof. dr Gordana Dragović LukićFaculty of Medicine, University of BelgradeGSC ID: 249

Introduction: In the treatment of human immunodeficiency virus (HIV) infection combined antiretroviral therapy (cART) is proscribed. It usually involves the usage of two drugs from the group of nucleoside reverse transcriptase inhibitors (NIRT) in combination with a drug from the group of non-nucleoside reverse transcriptase inhibitors (NNIRT) or a protease inhibitor (PI). There is a little published data on initial cART (icART) in Serbia, combinations of drugs that make it, and the outcome of the treatment of first-line therapy. Aim: The aim of this study is to determine the reasons for the termination of the first line therapy in patients with HIV / AIDS treated with combined antiretroviral therapy in Serbia. Material and Methods: The study included 410 HIV-infected patients who started icART in the period from 01.01.2008.-31.12.2014. at the Clinic for Infectious Diseases in Belgrade. We used methods of descriptive statistics, Kaplan-Meier method, Poisson method and Multivariate regression analysis. Results: In this study shown that the duration of icART was 3 ± 1.5 years. The average age of patients was 35 ± 9 years. 186 (45.4%) patients had AIDS. Change of icART was observed in 177 (43%) patients. Reasons for changes of icART were: the decision of the treating physician about changing therapy 68 (17%), failure to treat 53 (13%), shortage of drugs in 45 (11%), toxicity in 44 (11%) and 30 patients personal decision (7%). Conclusion: In the Republic of Serbia duration of icART is short, there are frequent crossings to other treatment options due to frequent shortages and the many side effects of outdated treatment regimens.

Key words: initial cART; HIV / AIDS patients; reasons for treatment interruption



INFLUENCE OF ACTIVATED AMPK ON VIABILITY AND EXPRESSION OF PP2A AND PGC-1α IN SH SY5Y CELLS IN

NEUROTOXICITY INDUCED BY EXTRACELLULAR α-SYNUCLEIN

Author(s): Ana Petronijević, Marija Jeremić, Vanja Radišiće-mail: [email protected] Mentor(s): Full Professor Ivanka Marković Faculty of Medicine, University of Belgrade GSC ID: 250

Introduction: Parkinson’s disease (PD) is a progressive neurodegenerative disease, characterized by the loss of dopaminergic neurons in pars compacta substantiae ni-grae in mesencephalon and formation of intracellular inclusions – Lewy bodies. The main component of Lewy bodies is a protein called α-synuclein (ASYN). There are many causes of accumulation of ASYN: mutations of amplifications of ASYN gene, errors in protein clearance or generation of phosphorylated ASYN forms. AMP-acti-vated protein kinase (AMPK) is an enzyme, that is a master regulator of energetic ho-meostasis of the cell. AMPK activation is regulated by several enzymes, but its main inhibitor is PP2A (protein phosphatase 2A). PP2A has important roles in various processes in the cell. Furthermore, the modification of its expression has been shown in PD. Additionally, AMPK activates PGC-1α (peroxisome proliferator-activated re-ceptor-c coactivator-1α) which is an important factor in mitochondrial biogenesis. Aim: The aim of our research was to assess the viability of SH SY5Y neuroblastoma cells, exposed to extracellular ASYN and pharmacological AMPK activators (AICAR and metformin), as well as the expression of PP2A i PGC-1α in this experimental model.Material and Methods: All experiments were done on SH SY5Y neuroblastoma cells, exposed to extracellular ASYN, present in conditioned medium (CM), and phar-macological AMPK activators (AICAR and metformin). Crystal violet test was per-formed to assess cell viability. Expression of PP2A and PGC-1α was determined by immunoblotting. Results: Our results show that AICAR and metformin, as AMPK activators, signif-icantly increase the viability of SH SY5Y cells, exposed to extracellular ASYN. Fur-thermore, no change in PP2A expression was detected in these conditions, while there was an increase in PGC-1α expression, compared to cell treated only with CM.Conclusion: The increase in SH SY5Y cell viability and PGC-1α expression high-lights the neuroprotective effect of AMPK. The absence of change in PP2A expres-sion points the complexity of the molecular baseline of PD and that further research is necessary.

Keywords: Parkinson’s disease, α-synuclein, AMPK, viability, PP2A, PGC-1α, SH SY5Y cells.



1. 12th BIALYSTOK INTERNATIONAL MEDICAL CONGRESS FOR YOUNG SCIENTISTS

We have a great pleasure to invite you to the12th Bialystok International Medical Congress, which will be held on 20-22nd

April 2017 at the Educational-Scientific Center, The Faculty of Health Sciences at Medical University of Bialystok, Poland. Every year our Congress brings together hundreds of participants from Poland and abroad, giving them the possibility to present their scientific achievements. Over 300 participants took part in last year’s edition, which makes it one of the largest students’ conferences in Poland. It’s a great opportunity to show the results of your research and practice your presentation skills. Best presentations will be awarded with valuable prizes at the Great Gala. The conference’s programme includes numerous thematic sessions, expert lectures and workshops, during which participants have a possibility to expand their practical skills. It is also a chance to make new acquaintances with students from all over the world.

The official language of the 12th BIMC is English. Deadline for sending abstracts is 19.02.2017.

For more information visit our website: www.bimc.umb.edu.pl, follow our Facebook fanpage: www.facebook.com/bimcfys/ or contact us at [email protected]

2. 16th INTERNATIONAL CONGRESS OF MEDICAL SCIENCES

16th International Congress of Medical Sciences will be held at the Medical University of Sofia on May 11th-14th, 2017. Abstract submission deadline is February 20th.

As our slogan says “Breaking the Barriers of Science, Transforming Medcine ! “

We believe in encouraging and motivating medical students Young doctors and everyone in the medical fields We provide an opportunity to present your research works or to take part in workshops which you were longing to do in med school to experience something different . Therefore, we would like to invite you to ICMS 2017, Students from all over the world are welcome to register and present their research, attend workshops, keynote lectures, Poster and oral sessions.

Please visit our website and facebook profile for more details: https://www.facebook.com/ICMSBulgaria/ and http://icmsbg.org/

ICMS video: https://www.youtube.com/watch?v=yIQhiQoomfs Registration: http://icmsbg.org/registration-form/

3. CROSS 13 - CROATIAN STUDENT SUMMIT

The Croatian Student Summit (CROSS) is an international scientific congress of students and young scientists in the field of biomedicine, which found its place as one of the leading congresses in its field, not only in Croatia, but in the entire region.

This project was started by the Student Council of School of Medicine at the University of Zagreb in the academic year 2004/2005, in collaboration with the School of Dental Medicine, the Faculty of Veterinary Medicine and the Faculty of Pharmacy and Biochemistry of the University of Zagreb.

The thirteenth CROSS in a row, which will be held from April 18 to April 21, 2017 at the University of Zagreb, School of Medicine, Šalata 3, is, once again, organized by the Student Council of School of Medicine. The congress' main topic is "Innovations in health".

PARTNERS



4. ISC GRAZ

We are proud to announce that from the 25th to the 27th June 2017 the fifth inter-national student congress (ISC) in Graz, Austria is going to take place. So save the date and join us celebrating our anniversary with an extraordinary congress!

We take on the challenge of bring together researchers and students from many disciplines of biological sciences to talk about their most recent findings, share experiences and make new connections.

The core components of the Medical University of Graz are high standard training and education, research at an international level and continuous improvement of top quality medicine.

A group of medical students therefore had the idea to organize a three day long congress for students and young scientists.

Seize the chance to present and discuss your first research study on a poster, plenary or oral presentation. There is the possibillity to take an active part in different workshops and attend keynote lectures. Moreover, you can start networking with colleagues from all over the World and enjoy the evenings with different social programs.

5. JUVENES PRO MEDICINA

Polish & International Training & Scientific Conference of Students’ Scientific Societies and Junior Doctors. Medical University of Łódź.

19-20.05.2017.

6. IMSC CRACOW

25th International Medical Students’ Conference (IMSC 2017) will take place within the buildings of the Jagiellonian University Medical College in Cracow between 27th and 29th of April 2017. By now this annual event has become one of the biggest medical students’ gatherings in Europe. Last year we hosted over 500 participants from 32 countries and this year as we celebrate it’s 25th edition we would be honored if you’d like to join us be a part of it.

Students’ Scientific Society of Jagiellonian University Medical College is a students’ organisation that supports the scientific development of students of the Medical College by the coordination of the work of Students’ Scientific Groups. Participation in workshops, lectures and competitions we organise during each academic year let our student improve their qualifications. The most important happen in the year is International Medical Students’ Conference, when students have the possibility to present the results of their hard work.

We believe, that “together we can more” so we cooperate with other students’ organization, mainly with the Council of Self-governing Students’ Union of the Jagiellonian University Medical College in Kraków College and IFMSA Poland Local Committee in Cracow and Polish Society of Dental Students. We hope you will join us and together we will make the International Medical Students’ Conference in Cracow medical students



7. MEDICS 2017 - YOUR CONGRESS

30 March - 2 April Bucharest, RomaniaWe have some exciting news: MEDICS - Medical International

Conference for Students - is here for its second edition! You can count on us for another unforgettable scientific experience - and we mean it!

Go ahead and submit your Abstract before the Abstract Submission Deadline (27 February 2017)! Not only will you have the chance to become a Presenting Author, but also to win one of our spectacular Prizes!

8. MEDIS TIMISOARA 2017

It is an honor for us to welcome you to the 20th International Congress for Medical Students and Young Doctors - "MEDIS Timisoara 2017".

The congress "Medis " has been a tradition for the University of Medicine and Pharmacy "Victor Babes" - Timisoara till 1989, being resumed in 1997 by Timisoara Medical Students Society thus becoming known and appreciated both at national and at universities of neighbour countries.

The Congress is organized by Timisoara Medical Students Society with the support of the University of Medicine and Pharmacy "Victor Babes" from Timisoa-

Contact: fb page : https://www.facebook.com/medistimisoara/?fref=ts web page : http://www.ssmt.ro/medis/index.htm e-mail adress : [email protected]

9. NEURI 2017 - 21. – 23. 04. 2017.

You can register through an on-line form, bearing in mind that active participants should send their abstracts by e- mail at: [email protected] by no later than 17th February 2017, after which they will be notified of acceptance.

Your participation at NeuRi 2017 can be active or passive. Active participants can present the results of their research as an oral or poster presentation.

10. ACIBAS BIOMEDICAL CONGRESS

fourth global students' conference of biomedical sciences...

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