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Article ; Online: Acute lymphoblastic leukemia

Toljić Branka G. / Stojanović-Ristić Snežana P.

Opšta Medicina, Vol 29, Iss 1-2, Pp 27-

2023 Volume 32

Abstract: Introduction. Acute lymphoblastic leukemia (ALL) is a heterogeneous disease distinguished by clonal replication and piling of immature lymphoid cells in the bone marrow and lymph organs. The etiology is unknown but radiation and some chemical exposure, ... ...

Abstract	Introduction. Acute lymphoblastic leukemia (ALL) is a heterogeneous disease distinguished by clonal replication and piling of immature lymphoid cells in the bone marrow and lymph organs. The etiology is unknown but radiation and some chemical exposure, as well as genetics, might play a role. The disease onset is abrupt. Clinical presentation is characterized by a variety of general symptoms: fatigue, malaise, night sweats, weight loss, fever. The diagnosis is based on a patient's history, physical examination, blood tests, bone marrow biopsy, cytogenetic, and immunohistochemical tests. Core treatments are poly-chemotherapy, radiation therapy, hematopoietic stem cell transplantation. Case report. We presented a 20-year-old patient. On his first visit, he complained of neck pain. He was treated by a physiotherapist. After he finished with physical therapy we noticed pancytopenia in his lab work. His general practitioner (GP) referred him to a hematologist where further medical examinations were performed and ALL diagnosis was made. The treatment started with a chemotherapy regimen. An allogeneic hematopoietic stem cell transplantation was performed afterward. In the follow-up, regular haematologic assessments were done, as well as, the assessment of MRD (Minimal Residual Disease). Complete morphologic remission was maintained the whole time but with positive MRD findings. He received an antiCD22 monoclonal antibody therapy and the therapeutic response was good. Eight months later B-ALL relapse was confirmed. The patient's general condition got worse and in spite of an intensive therapy the patient died. Conclusion. Acute lymphoblastic leukemia is a disease whose outcome depends on many a factor. Due to atypical symptoms, it should be taken into consideration to shorten the time to diagnosis, provide timely treatment and thus influence the disease outcome.
Keywords	leukemia ; young person ; early diagnosis ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Serbian Medical Society, Belgrade
Document type	Article ; Online
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Article ; Online: Analysis of cardiac manifestation and treatment of multisystem inflammatory syndrome in children related to SARS-CoV-2.

Krasic, Stasa / Ninic, Sanja / Prijic, Sergej / Popovic, Sasa / Pasic, Srdjan / Petrovic, Gordana / Zec, Boris / Ristic, Snezana / Nesic, Dejan / Nikolic, Luka / Vukomanovic, Vladislav

Biomolecules and biomedicine

2023 Volume 23, Issue 2, Page(s) 335–343

Abstract: Cardiovascular manifestations are common (35-100%) in the multisystem inflammatory syndrome in children. Our study aimed to analyze treatment impact and cardiovascular involvement in patients with multisystem inflammatory syndrome in children. The ... ...

Abstract	Cardiovascular manifestations are common (35-100%) in the multisystem inflammatory syndrome in children. Our study aimed to analyze treatment impact and cardiovascular involvement in patients with multisystem inflammatory syndrome in children. The retrospective cohort included 81 patients treated between April 2020 and December 2021 (9.3±4.6 years). Elevated cardiac troponin I and pro-B-type natriuretic peptide were observed in 34.2% and 88.5% of patients, respectively. Myocardial dysfunction was observed in 50.6%. Children older than 10 years had a 4-fold increased risk of myocardial dysfunction (odds ratio [OR] 3.6, 95% confidence interval [CI] 1.4-8.9; p=0.006). A moderate negative correlation was proved between left ventricle ejection fraction and C-reactive protein (rr = - 0.48; p < 0.001). More than one-fifth of the patients presented with shock. Coronary artery dilatation was observed in 6.2% of patients. Mild pericardial effusion was detected in 27.1% of children. On standard electrocardiogram, 52.6% of children had negative T waves in the inferior and/or precordial leads; transient QTc prolongation was registered in 43% of patients. Treatment failure was observed in 19 patients. Patients initially treated with intravenous immunoglobulins had 10-fold higher chances for treatment failure than patients treated with corticosteroids (OR 10.6, 95% CI 3,18 - 35.35; p < 0.001). Cardiovascular manifestations were observed in more than half of the patients, with acute myocardial dysfunction being the most common, especially in children older than 10 years. We established a negative association between the degree of elevation of inflammatory markers and left ventricular ejection fraction. Patients treated with intravenous immunoglobulins who had cardiovascular manifestations had treatment failures more frequently than patients treated with corticosteroids.
MeSH term(s)	Child ; Humans ; COVID-19/complications ; Immunoglobulins, Intravenous/therapeutic use ; Retrospective Studies ; SARS-CoV-2 ; Stroke Volume ; Ventricular Function, Left ; Child, Preschool
Chemical Substances	Immunoglobulins, Intravenous
Language	English
Publishing date	2023-03-16
Publishing country	Bosnia and Herzegovina
Document type	Journal Article
ISSN	2831-090X
ISSN (online)	2831-090X
DOI	10.17305/bjbms.2022.7820
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Article ; Online: Recent Experience: Corticosteroids as a First-line Therapy in Children With Multisystem Inflammatory Syndrome and COVID-19-related Myocardial Damage.

Vukomanovic, Vladislav / Krasic, Stasa / Prijic, Sergej / Ninic, Sanja / Popovic, Sasa / Petrovic, Gordana / Ristic, Snezana / Simic, Radoje / Cerovic, Ivana / Nesic, Dejan

The Pediatric infectious disease journal

2021 Volume 40, Issue 11, Page(s) e390–e394

Abstract: Background: Cardiovascular complications with myocarditis in multisystem inflammatory syndrome in children (MIS-C) associated with severe acute respiratory syndrome coronavirus 2 infection have been reported, but the optimal therapeutic strategy remains ...

Abstract	Background: Cardiovascular complications with myocarditis in multisystem inflammatory syndrome in children (MIS-C) associated with severe acute respiratory syndrome coronavirus 2 infection have been reported, but the optimal therapeutic strategy remains unknown. Methods: A retrospective cohort study included 19 patients with acute left ventricular systolic dysfunction associated with MIS-C, average years of age 13.2 ± 3.8, treated from April 2020 to April 2021. Results: Treatment failure (TF) was observed in 8 patients (in the intravenous immunoglobulin [IVIG] group 7/10; in the corticosteroid [CS] group 1/9). The independent risk factor for TF was IVIG treatment (odds ratio [OR] 18.6, 95% confidence interval [CI] 1.6-222.93, P = 0.02). Patients initially treated with CS became afebrile during in-hospital day 1 (1.5, interquartile range [IQR] 1-2), while IVIG-treated patients became afebrile on in-hospital day 4 (IQR 2-4.25), after CS was added. The C-reactive protein (CRP) significantly declined in CS-treated patients on day 2 (P = 0.01), while in the IVIG group, CRP decreased significantly on the fourth day (P = 0.04). Sodium and albumin levels were higher on third in-hospital day in the CS group than in the IVIG group (P = 0.015, P = 0.03). A significant improvement and normalization of ejection fraction (EF) during the first 3 days was observed only in the CS group (P = 0.005). ICU stays were shorter in the CS group (4, IQR 2-5.5) than in the IVIG group (IVIG group 7, IQR 6-8.5) (P = 0.002). Conclusions: Among children with MIS-C with cardiovascular involvement, treatment with CS was associated with faster normalization of LV EF, fever, laboratory analysis, and shorter ICU than IVIG-treated patients.
MeSH term(s)	Adolescent ; Adrenal Cortex Hormones/therapeutic use ; Biomarkers ; COVID-19/complications ; COVID-19/etiology ; COVID-19/virology ; Child ; Disease Management ; Disease Susceptibility ; Female ; Humans ; Immunoglobulins, Intravenous/therapeutic use ; Inflammation Mediators/metabolism ; Male ; Myocarditis/drug therapy ; Myocarditis/etiology ; Odds Ratio ; Retrospective Studies ; SARS-CoV-2 ; Systemic Inflammatory Response Syndrome/drug therapy ; Systemic Inflammatory Response Syndrome/etiology ; Treatment Outcome ; COVID-19 Drug Treatment
Chemical Substances	Adrenal Cortex Hormones ; Biomarkers ; Immunoglobulins, Intravenous ; Inflammation Mediators
Language	English
Publishing date	2021-07-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	392481-6
ISSN	1532-0987 ; 0891-3668
ISSN (online)	1532-0987
ISSN	0891-3668
DOI	10.1097/INF.0000000000003260
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Article: Myocardial damage in multisystem inflammatory syndrome associated with COVID-19 in children and adolescents.

Vukomanovic, Vladislav / Krasic, Stasa / Prijic, Sergej / Petrovic, Gordana / Ninic, Sanja / Popovic, Sasa / Cerovic, Ivana / Ristic, Snezana / Nesic, Dejan

Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences

2021 Volume 26, Page(s) 113

Abstract: Background: In multisystem inflammatory syndrome in children (MIS-C) temporarily associated with coronavirus disease-19 (COVID-19), myocardial damage has been reported.: Materials and methods: A retrospective observational cohort study included ... ...

Abstract	Background: In multisystem inflammatory syndrome in children (MIS-C) temporarily associated with coronavirus disease-19 (COVID-19), myocardial damage has been reported. Materials and methods: A retrospective observational cohort study included children under 18 who had a myocardial injury related to COVID-19 treated in mother and child health institute from April 2020 to August 2020. Myocardial injury related to COVID-19 was manifested by elevated serum cardiac troponin and NT-proBNP with LV dysfunction, arrhythmias, and coronary arteries (CAs) dilatation or aneurysms. During the short-term follow-up, cardiac testing (electrocardiography, laboratory analysis, echocardiography, 24-h Holter monitoring, exercise stress test, and cardiac magnetic resonance) was performed. Results: Six male adolescents (14.7 ± 2.4 years) were included in the analysis (2/6 had MIS-C shock syndrome). All patients had elevated acute-phase reactants and NT-proBNP, whereas troponins were elevated in 5/6 patients. Echocardiography revealed left ventricular (LV) systolic dysfunction (EF 45.2 ± 6.9%); 2/6 had dilated CAs. IVIG was prescribed to all patients with MIS-C. Four patients required inotropic drug support. During hospitalization, a significant reduction of CRP, LDH, NT-proBNP, and D-dimer ( Conclusions: With early recognition and adequate MIS-C therapy, children recovered entirely, maintained in the short-term follow-up period.
Language	English
Publishing date	2021-11-29
Publishing country	India
Document type	Journal Article
ZDB-ID	2513029-8
ISSN	1735-7136 ; 1735-1995
ISSN (online)	1735-7136
ISSN	1735-1995
DOI	10.4103/jrms.JRMS_1195_20
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Article ; Online: Biology teachers’ attitudes toward computer assisted learning

Županec Vera / Miljanović Tomka / Parezanović-Ristić Snežana

Archives of Biological Sciences, Vol 66, Iss 3, Pp 1281-

2014 Volume 1289

Abstract: Based on the new technology initiative in Serbian education, we explored primary school teachers’ attitudes toward Computer Assisted Learning (CAL) in biology teaching, as well as the relationships between the teachers’ attitudes and four independent ... ...

Abstract	Based on the new technology initiative in Serbian education, we explored primary school teachers’ attitudes toward Computer Assisted Learning (CAL) in biology teaching, as well as the relationships between the teachers’ attitudes and four independent variables: age, teaching experience, teachers’ competence to use modern teaching aids and their professional advanced training in the field of computer applied learning. Fifty-four elementary school biology teachers from Novi Sad participated in the study. The findings suggested that the teachers generally had positive attitudes toward CAL in biology teaching. Correlation analyses revealed significant relationships between age, teaching experience, teachers’ competence to use modern teaching aids in the teaching process, professional advanced training in the field of computer applied learning, and the teachers’ attitudes toward CAL. We offer suggestions for further research in this field. [Projekat Ministarstva nauke Republike Srbije, br. 179010]
Keywords	Computer Assisted Learning ; attitudes ; biology teachers ; elementary education ; Biology (General) ; QH301-705.5
Subject code	370 ; 420
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	University of Belgrade, University of Novi Sad
Document type	Article ; Online
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Article ; Online: Validation of the Serbian version of the Asthma Control Test

Milenković Branislava / Ristić Snežana / Mirović Danijela / Dimić-Janjić Sanja / Janković Jelena / Đurđević Nataša / Davičević-Elez Žaklina / Lukić Tamara

Vojnosanitetski Pregled, Vol 76, Iss 10, Pp 1029-

2019 Volume 1036

Abstract: Background/Aim. Asthma still remains poorly controlled in the majority of patients. The Asthma Control Test (ACT) is a short and useful patient-administered questionnaire for identification of patients with poor asthma control in clinical settings. The ... ...

Abstract	Background/Aim. Asthma still remains poorly controlled in the majority of patients. The Asthma Control Test (ACT) is a short and useful patient-administered questionnaire for identification of patients with poor asthma control in clinical settings. The aim of this study was to validate a Serbian version of the ACT in the adults with asthma. Methods. A total of 250 consecutive adult asthmatic patients were recruited in a prospective observational study. The exclusion criteria were chronic respiratory disease and acute respiratory tract infection in preceding 4 weeks. Results. The spirometry and ACT questionnaire were performed on the baseline visit and 6 months later. The ACT test was completed by 98.8% of patients with the mean time of completion of 4.5 minutes. The correlation of ACT score and lung function parameters (forced expiratory volume in 1 second – FEV1 and forced vital capacity – FVC) was significant (p = 0.016 and p = 0.002, respectively). A change in the ACT scores between baseline and 6- months visit was not associated with a change in FVC and FEV1. The ACT score had excellent diagnostic accuracy according to the physicians asthma control classification and even outstanding accuracy according to the patients’ classification. Conclusion. The results of this study confirm the reliability, validity and accuracy of Serbian version of the ACT, contributing to established value of original ACT test and with consistent findings as the previously reported validity of ACT in other languages. Therefore, it should be utilized more in everyday clinical practice as a useful and reliable tool of asthma control assessment.
Keywords	asthma ; surveys and questionnaires ; serbia ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Military Health Department, Ministry of Defance, Serbia
Document type	Article ; Online
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Article ; Online: The effect of parental attitudes on habilitation of hearing impaired children

Ristić Snežana / Kocić Biljana / Milošević Zoran

Vojnosanitetski Pregled, Vol 70, Iss 4, Pp 363-

2013 Volume 367

Abstract: Background/Aim. Habilitation of children with hearing loss is a very complex process and requires a team work. Habilitation period length, as well as the effects themselves are individual and depend on many factors. The goal of any habilitation process ... ...

Abstract	Background/Aim. Habilitation of children with hearing loss is a very complex process and requires a team work. Habilitation period length, as well as the effects themselves are individual and depend on many factors. The goal of any habilitation process is to improve the quality of life of each individual to the maximal extent possible, regardless of whether embedded cochlear implant, or other forms of amplification applied. A long-standing practice has shown that the influence of parents and their attitudes in the habilitation process is great. The aim of this study was to examine the extent of this influence in order to educate the parents so to help their children maximize their potential. Methods. The instruments used in this study were: semi-structured interview, the Parental Attitudes Scale (PAD), Package Nottingham Early Estimates (NEAP). The participants in this study were the parents with children aged 4-15 years. The extent of hearing loss in the children was recorded at the beginning and during the habilitation process and all were actively involved at least three months. For statistical analysis of this study the descriptive and inferential statistical techniques were applied. Results. The results of our study show significant differences in certain parental attitudes. A close cooperation of the parents and quality experts interactions with the parents are a prerequisite for a successful habilitation. Conclusion. The result of this research show that the process of habilitation of children with hearing and speech disorders is significantly affected by the parent attitudes. Parental attitudes were proved to be especially important for children with greater hearing loss. It was also noted that in our society mainly mothers are concerned with hearing-damaged children, which indicates that the educational process should be extend to both parents.
Keywords	rehabilitation ; attitude ; parents ; child ; child preschool ; adolescent ; quolity of life ; Medicine (General) ; R5-920
Subject code	370
Language	English
Publishing date	2013-01-01T00:00:00Z
Publisher	Military Health Department, Ministry of Defance, Serbia
Document type	Article ; Online
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Article ; Online: Validation of Serbian version of chronic obstructive pulmonary disease assessment test

Milenković Branislava / Dimić-Janjić Sanja / Kotur-Stevuljević Jelena / Kopitović Ivan / Janković Jelena / Stjepanović Mihailo / Vukoja Marija / Ristić Snežana / Davičević-Elez Žaklina

Vojnosanitetski Pregled, Vol 77, Iss 3, Pp 294-

2020 Volume 299

Abstract: Background/Aim. The Chronic obstructive pulmonary disease (COPD) Assessment Test (CAT) is a simple and reliable tool designed to measure overall COPD related health status and complement physician assessment in routine clinical practice. Objective of ... ...

Abstract	Background/Aim. The Chronic obstructive pulmonary disease (COPD) Assessment Test (CAT) is a simple and reliable tool designed to measure overall COPD related health status and complement physician assessment in routine clinical practice. Objective of this study was to evaluate the validity of the Serbian version of CAT. Methods. Study included 140 outpatients in the stable COPD, recruited from two centres: Clinic for Pulmonology, Clinical Center of Serbia, Belgrade, and Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica. All patients completed pulmonary function testing – spirometry, the CAT and the modified Medical Research Council (mMRC) dyspnea scale at baseline visit. The CAT test-retest reliability was tested in 20 patients by the same investigator (physician). Results. We demonstrated that Serbian version of CAT had high internal consistency with Cronbach’s alpha 0.88. Test-retest analysis showed good correlation between CAT scores in two time points (Spearman’s ρ = 0.681, p < 0.01). In our study the CAT correlated moderately to mMRC scale (ρ = +0.57), weakly to FEV1 (ρ -0.214), was positively related to number of exacerbations, but did not showed exact regularity with change in the Global Initiative for Chronic Obstructive lung disease (GOLD) stage. Conclusion. The Serbian version of CAT is a reliable, simple and easy-to-use tool that can be used in everyday clinical practice to assess the health status of COPD patients in Serbia.
Keywords	pulmonary disease ; chronic obstructive ; surveys and questionnaires ; serbia ; comorbidity ; forced expiratory volume ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Military Health Department, Ministry of Defance, Serbia
Document type	Article ; Online
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Article: Uticaj stavova roditelja na habilitaciju dece sa ostećenim sluhom.

Ristić, Snezana / Kocić, Biljana / Milosević, Zoran

Vojnosanitetski pregled

2013 Volume 70, Issue 4, Page(s) 363–367

Abstract: Background/aim: Habilitation of children with hearing loss is a very complex process and requires a team work. Habilitation period length, as well as the effects themselves are individual and depend on many factors. The goal of any habilitation process ... ...

Title translation	The effect of parental attitudes on habilitation of hearing impaired children.
Abstract	Background/aim: Habilitation of children with hearing loss is a very complex process and requires a team work. Habilitation period length, as well as the effects themselves are individual and depend on many factors. The goal of any habilitation process is to improve the quality of life of each individual to the maximal extent possible, regardless of whether embedded cochlear implant, or other forms of am plification applied. A long-standing practice has shown that the influence of parents and their attitudes in the habilita tion process is great. The aim of this study was to examine the extent of this influence in order to educate the parents so to help their children maximize their potential. Methods: The instruments used in this study were: semi-structured interview, the Parental Attitudes Scale (PAD), Package Nottingham Early Estimates (NEAP). The participants in this study were the parents with children aged 4-15 years. The extent of hearing loss in the children was recorded at the beginning and during the habilitation process and all were actively involved at least three months. For statistical analysis of this study the descriptive and inferential statisti cal techniques were applied. Results: The results of our study show significant differences in certain parental atti tudes. A close cooperation of the parents and quality ex perts interactions with the parents are a prerequisite for a successful habilitation. Conclusion: The result of this re search show that the process of habilitation of children with hearing and speech disorders is significantly affected by the parent attitudes. Parental attitudes were proved to be espe cially important for children with greater hearing loss. It was also noted that in our society mainly mothers are concerned with hearing-damaged children, which indicates that the educational process should be extend to both parents.
MeSH term(s)	Adolescent ; Attitude ; Child ; Child, Preschool ; Correction of Hearing Impairment/psychology ; Deafness/rehabilitation ; Humans ; Parents/psychology ; Quality of Life ; Surveys and Questionnaires
Language	Croatian
Publishing date	2013-05-22
Publishing country	Serbia
Document type	English Abstract ; Journal Article
ZDB-ID	123795-0
ISSN	0042-8450
ISSN	0042-8450
DOI	10.2298/vsp111007034r
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Article ; Online: Biology contents in curricula of compulsory education in Serbia, Finland and England

Đokić-Ostojić Ana / Miljanović Tomka / Pribićević Tijana / Parezanović-Ristić Snežana / Topuzović Marina

Archives of Biological Sciences, Vol 66, Iss 2, Pp 859-

2014 Volume 866

Abstract: At this moment in time, which is marked by extremely negative human influences on the environment, and when a sustainable development of nature is needed, school has a significant role in developing students’ knowledge, skills and attitudes towards ... ...

Abstract	At this moment in time, which is marked by extremely negative human influences on the environment, and when a sustainable development of nature is needed, school has a significant role in developing students’ knowledge, skills and attitudes towards natural sciences. In European countries, students gain biological knowledge during primary school either through integrated or specific subjects. This paper contains the results of a comparative analysis of the biological content in teaching programs and curricula in three European countries - Serbia, Finland and England. In Serbia, biological contents are included in two integrated subjects (The World Around Us and Nature and Society) during the first cycle of compulsory education, while during the second cycle they are included in a separate subject - biology - and are linearly arranged. Throughout compulsory education in Finland and England, biological contents are concentrically arranged and are realized through the students’ research work in their surroundings in several school subjects.
Keywords	Compulsory education ; biological contents ; Serbia ; Finland ; England ; Biology (General) ; QH301-705.5 ; Science ; Q
Subject code	370
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Serbian Biological Society
Document type	Article ; Online
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