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  • Author: Milan Kostić x
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Immunoglobulin Heavy Chain Gene Rearrangements in Patients with Gaucher Disease

Summary

Several studies support the evidence of increased incidence of hematological complications in Gaucher disease including monoclonal and polyclonal gammopathies and blood malignancies, especially multiple myeloma. Serum concentrations of immunoglobulins and PCR analysis of the IGH gene rearrangements were performed. The clonal PCR products were directly sequenced and analyzed with the appropriate database and tools. Serum monoclonal proteins were detected and identified by electrophoresis. Among 27 Gaucher patients, clonal IGH rearrangement was discovered in eight, with 5/8 having also serum monoclonal protein. Elevated immunoglobulins were detected in 9/27 patients. Follow-up data for 17 patients showed that the clonal rearrangement remained the same in four of them, however, in one patient it disappeared after the follow-up period. The remaining 12/17 patients were without previous IGH clonal rearrangement and remained so after the follow-up. Although clonal expansion may occur relatively early in the disease course, at least judging by the IGH gene rearrangements in Gaucher patients, the detected clones may be transient. A careful clinical follow-up in these patients is mandatory, including monitoring for lymphoid neoplasms, especially multiple myeloma.

Open access
Key Policy Rate as the Main or Additional Instrument of Inflation Targeting Strategy in Serbia

Abstract

In achieving price stability as the primary objective of monetary policy, the National Bank of Serbia uses the key policy rate as the main instrument of monetary policy, while other instruments have a supporting role - contribute to a smooth transmission of the key policy rate on the market, as well as the development of financial markets. However, because the conditions in which economic and financial system of the Republic of Serbia works, transmission mechanism of monetary policy is conducted mainly through the exchange rate channel, while the channel of interest rates almost did not work. The great impact the exchange rate channel is determined by the great influence of the single currency euro and the ECB on our country. Therefore, the aim of this paper is to analyse the efficiency of the key policy rate as a monetary policy instrument, because in recent years the primary instrument receives a secondary character in the monetary regulation.

Open access
Gender Differences in Prosodic Characteristics of Speech in the Task of Serial Subtracting of Sevens

Summary

Significant differences in speech between genders are contained in nonsegmental correlates, i.e. in the prosody and paralinguistics. Pronunciation differences between genders are more numerous than those in grammatical form. This study aims to detect temporal prosodic patterns and investigate gender differences in performing serial sevens subtraction (SSS). One hundred students of medicine (equal number of males and females) voluntarily participated in the investigation. SSS was performed by asking the participant to perform mental arithmetic consisting of repeatedly subtractions of sevens, beginning from one thousand. The students had to pronounce aloud and simultaneously write the results for five minutes. The original program for the analysis of digital signals (ADS) converted the speech signal samples into digital data. MANOVA showed significant gender differences for a group of characteristics of the SSS test: F (11, 75)=4.06, p=0.000. The number of samples per each minute and the total number of samples during five minutes was higher in males compared to females. The average length of articulation of three-digit numbers, average length of articulation and length of pauses between the linguistic units, as well as between the samples, was shorter in males for each of these five minutes and for the „average“ minute. The maximum intensity of speech was higher in males for each of the five minutes. Average duration of mispronunciations, with end results being correct, was longer in women in the first, second, and fourth minute, as well as for the „average“ minute. A conclusion may be drawn that shorter utterances and pauses in men suggest the advantage on the part of men in SSS task, and not greater verbal fluency in general in men.

Open access
Dermoscopy of the Month
Azithromycin-Induced Longitudinal Melanonychia in a Child-a Case Report

Abstract

Melanonychia refers to a brown or black coloration of the nail plate caused by numerous factors. Regarding the arrangement of pigmentation, we can differentiate between total melanonychia, when pigmentation involves the whole nail plate, or transverse or longitudinal melanonychia, when pigmentation involves the nail in a form of transverse or longitudinal band of pigmentation, respectively. Since longitudinal melanonychia can be a sign of numerous benign and malignant lesions, it often poses a diagnostic challenge for a dermatologist. Herein, we report a case of a 13-year-old girl who developed longitudinal melanonychia on multiple nails after receiving a therapy with azithromycin.

Open access
Application of the New Self-dynamisable Internal Fixator in the Treatment of Femoral Shaft Fractures

Summary

The aim of this study was to present the results of one original method application in internal fixation of long bones.

The series of 27 patients with unilateral fractures of femoral shaft was analyzed. According to AO classification, 21 fractures were classified as 32A, five as 32B, and one as 32C type. Original diaphyseal self-dynamisable internal fixator (model 1) was used as a fixation implant, consisting of three components: specially designed extramedullary bar, clamps and screws. The main feature of this implant is a possibility to become dynamic in the axial direction spontaneously if there is no sufficient fracture healing. Because of that, this implant is known as an „intelligent implant“. Surgical method included a standard surgical approach and minimally invasive surgical approach.

Minimally invasive technique of application required less blood transfusion and shorter surgery time when compared to the standard surgical approach. The duration of used intraoperative fluoroscopy control was 7(3-18) seconds. The average healing time was 4.3 (3.5-9.5) months. There were neither intra operative nor postoperative complications.

In comparison to intramedullary nails, self-dynamisable internal fixator provides a similar treatment results, while in comparison to plates it provides fewer mechanical complications. Self-dynamisable internal fixator method preserves periosteal and intramedullary blood circulation, and it is the first fixation implant with a possibility of spontaneous axial dynamising activation when needed.

This implant has been proven as suitable for routine use in the treatment of femoral shaft fractures.

Open access
Wandering Spleen - A Possible Cause of Adrenal “Mass” - Case Report

Abstract

Wandering spleen is a very rare clinical condition characterized by spleen absence in the normal anatomical location in the upper left quadrant of the abdomen and its presence at another location in the abdomen or pelvis. The ectopic spleen is extremely rare in children, where its increased mobility is the result of a congenital disturbance of the fixation for the anterior wall due to the absence or weakness of the supporting ligaments. Wandering spleen is usually asymptomatic, but its torsion is possible, as well as infarction or rupture which demand an urgent diagnosis and surgical treatment. The diagnosis of wandering spleen can easily be overlooked due to low incidence and insufficient clinical experience, which multiplies patient’s risk from life-threatening conditions. We present a case of wandering spleen in an 11-year-old girl with acute abdominal pain, which after ultrasound examination raised suspicion on the right adrenal gland tumor. Additional diagnostics verified an ectopic spleen in the right adrenal box, after which the recommended preventive splenopexy was seriously considered. Due to the fixation of the vital spleen in the new position, but also the negative attitude of the parents towards the surgical intervention, clinical monitoring was selected, with exclusion of intense physical activity that carries the risk of traumatization of the spleen. As the girl has been in good health for over 3 years and without symptoms, we consider that the selection of conservative access although difficult, was correct. We hope that our experience in treating wandering spleen in girls will increase the number of valid facts about this rare condition.

Open access