Tatjana Roš, Branislava Gajić, Milana Ivkov-Simić and Zorica Gajinov
Basal cell carcinoma is a slow-growing, malignant epidermal tumor predominantly affecting sun exposed areas in Caucasians, accounting for up to 80% of all diagnosed skin cancers, with a rising incidence. Chronic UV radiation, in association with constitutional factors, plays the main role in its etiology. Inappropriate activation of the hedgehog signaling pathway seems to be a key pathogenesis mechanism. Basal cell carcinoma metastases are extremely rare, but it is a locally invasive tumor that can cause significant destruction of the surrounding tissues, with their functional and esthetic impairment. There are four main clinical types of basal cell carcinoma, although clinical classification is of poor prognostic significance. Preselection of suspicious lesions and treatment planning include noninvasive diagnostic techniques: dermoscopy, confocal microscopy and ultrasoud imaging, yet histopathology remains the “gold standard” of basal cell carcinoma diagnosis. In terms of the histological growth pattern, which is essential for the prognosis, basal cell carcinoma may be divided into circumscribed or diffuse types. Surgical excision is considered to be a first line treatment option, but there are numerous less invasive treatment modalities for low-risk basal cell carcinoma. Prevention strategies are focused on behavioral modifications, regular follow up and use of chemopreventive agents in high-risk patients.
Khair Fadel Merei Al Junidi, Mirjana Paravina, Vuka Katić and Pasxalina Mitsa
Basal cell carcinoma (BCC) is the most common malignant tumor of the skin. This study was conducted to analyze patients with BCC, their age and sex distribution, occupation, site distribution of tumors, clinical types, and histopathological characteristics of lesions. Based on the data obtained from the Histopathological Registry, a clinical and histopathological analysis of the surgically excised BCCs was performed.
The study included 100 randomly selected patients out of 263 consecutive patients with histopathologically diagnosed BCC at the Institute of Pathology of the Clinical Center in Niš in the period of 15 months. The sex ratio was 1.4:1 in favor of men (p<0.05). Two thirds of patients were over the age of 60 (p<0.0001). The average age of patients was 66.6 ± 12.2 years (range 23 - 90). In agreement with the age distribution, 53 patients were retired (mostly retired farmers), 12 were workers, 14 farmers, 12 without permanent employment, 5 were housewives, and 4 clerks. A substantial majority of 61% of examinees lived in the country (p<0.001). The employment status was related to the age of examinees, but also with the altered demographic structure in the country: many workers lived in the country, or returned to the country after retirement.
BCC was commonly found on the face (77%), and rarely on the trunk (11%) and extremities (2%).
There were no data about exposition to X-rays or chemicals (except for pesticides and insecticides), scars resulting from burns or genodermatoses. In 87% of cases, BCC was significantly most often found at sites continually exposed to the sun (head including face and scalp, and neck). The most commonly diagnosed was the nodular type (57%), then the superficial (7%), ulcerative (5%), ulcero-sclerotic (4%), pigmented (1%), and morpheaform (1%). In 27% of cases, there were no data about the histopathological type of BCC in the Histopathological Registry, based on which accurate histological type of BCC could have been established. Based on histopathological analysis, apart from the nodular (40%), other types were rarely diagnosed, like the adenoid (12%) (p<0.0001), mixed types (nodular-adenoid, nodular-adenoid-fibroblastic and mixed) (9%), superficial (7%), fibroblastic (2%), infiltrative (1%), pigmented (1%), and morpheaform (1%). Surgical excision is the gold standard in the treatment of BCC: conventional, conducted in our patients, and Mohs micrographic surgery, which takes an important place in the treatment of high-risk BCCs. In 6% of cases, the tumor process was found in the margins of the excision.
In conclusion: Basal cell carcinoma was more common in males than in females. Significantly more patients with excised basal cell carcinoma lived in the country. An age-related increase in the number of patients with BCC has been established, and most patients with excised basal cell carcinomas belonged to the age group of 61 to 81 years of age. In most patients the tumor site was on the face, whereas clinically and histopathologically, nodular type was the most common.
Vladica Čudić, Dragica Kisić, Dragoslava Stojiljković and Aleksandar Jovović
Ash From Thermal Power Plants as Secondary Raw Material
The basic characteristic of thermal power plants in the Republic of Serbia is that they use low-grade brown coal (lignite) as a fuel. Depending on the location of coal mines, lignite may have different properties such as heating value, moisture, and mineral content, resulting in different residue upon combustion. Because of several million tonnes of ash and slag generated every year, their granularmetric particle size distribution, and transport and disposal methods, these plants have a negative impact on the environment. According to the waste classification system in the Republic of Serbia, ash and slag from thermal power plants are classified as hazardous waste, but with an option of usability. The proposed revision of waste legislation in Serbia brings a number of simple and modern solutions. A procedure is introduced which allows for end-of-waste criteria to be set, clarifying the point where waste ceases to be waste, and thereby introducing regulatory relief for recycled products or materials that represent low risk for the environment. The new proposal refocuses waste legislation on the environmental impacts of the generation and management of waste, taking into account the life cycle of resources, and develops new waste prevention programmes. Stakeholders, as well as the general public, should have the opportunity to participate in the drawing up of the programmes, and should have access to them.
Cheilitis is an inflammatory condition of the vermilion border of the lips, which is the junction between the skin and the mucosa. Cheilitis may arise as a primary disorder of the vermilion zone; the inflammation may extend from the nearby skin, or less often from the oral mucosa. Primary cheilitis lesions are either superficial or deep. Deep types include cheilitis glandularis (inflammatory changes and lip gland swelling), and granulomatous cheilitis (chronic swelling of the lip due to granulomatous inflammation mostly of unknown origin). Cheilitis glandularis is a rare condition that mostly affects the lower lip and it is characterized by nodular enlargement, reduced mobility and lip erosion. Based on clinical presentation, cheilitis glandularis may be classified into three subtypes: simplex (described as Puente and Acevedo), superficial suppurative (described by Baelz-Unna), and the most severe type - deep suppurative, also known as cheilitis glandularis apostematosa (Volkmann’s cheilitis) characterized by deep-seated inflammation forming abscesses and fistulous tracts. This is a case report of a female patient with a deep suppurative type of cheilitis affecting both lips. Treatment with systemic antibiotics (using antibiogram tests), corticosteroids and topical therapy resulted in significant improvement.
Zoran Golušin, Olivera Levakov and Biljana Jeremić
Urethritis is a clinical syndrome which is characterized by mucopurulent or purulent urethral discharge with or without dysuria, due to an increased number of polymorphonuclear leukocytes in the anterior urethra. Antimicrobial therapy and preventive measures are essential in the management of bacterial urethritis. However, these drugs may cause antimicrobial resistance, resulting in unsuccessful treatment and complications of urethritis. Resistance of Neisseria gonorrhoeae to antibiotics is well known for decades, and in recent years there are more cases of resistance of Chlamydia trachomatis and Mycoplasma genitalium to different antibiotics. There is a danger that in the future certain strains of N. gonorrhoeae will be resistant to all available antimicrobial agents, unless new antibiotics to which resistance will not develop rapidly or an effective vaccine are developed.
Zsolt Becskei, Mila Savić, András Gáspárdy, Branko Petrujkić, Blagoje Dimitrijević, Ružica Trailović and Vladimir Dimitrijević
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2. Sanson A: Traité de Zootechnie en 5 volumes, Tomes II et V. Librarie agricole de la Masion Rustique 1888, Paris.
3. Pavlović S: Le Mouton Yugoslave de Lipe, (These de doctorat) Paris Vigot Freres, Editeurs. 1935.
4. Becskei Zs: Application of in situ programme for conservation of the animal genetic resources. Specialistic Thesis (Serbian language), Faculty of Veterinary Medicine University of Belgrade, 2012.
5. Savić M, Trailović R, Petrujkić B, Becskei Zs
Nevenka Kopjar, Davor Želježić, Vilena Kašuba and Ružica Rozgaj
Antineoplastični Lijekovi Kao Čimbenik Rizika u Radnom Okolišu: Mehanizmi Djelovanja na Razini Stanice i Pregled Metoda za Otkrivanje Njihovih Genotoksičnih Učinaka
U članku je prikazana osnovna podjela antineoplastičnih lijekova prema mehanizmima djelovanja na razini stanice. Objašnjeni su mehanizmi genotoksičnosti najvažnijih vrsta lijekova koji se primjenjuju u okviru uobičajenih protokola za liječenje zloćudnih novotvorina. Navedena je važeća klasifikacija antineoplastika prema kancerogenom potencijalu, podaci o mutagenom potencijalu te je prikazana njihova podjela u skladu s anatomsko-terapijsko-kemijskim sustavom klasifikacije. Sustavno su prikazani najvažniji rezultati svjetskih i hrvatskih istraživanja na populacijama radnika izloženih antineoplasticima, provedenih u razdoblju 1980.-2009. s pomoću četiri najčešće primjenjivane metode: analize izmjena sestrinskih kromatida, analize kromosomskih aberacija, mikronukleus-testa i komet-testa. Objašnjena su osnovna načela navedenih metoda te raspravljene njihove prednosti i nedostaci. Biološki pokazatelji daju važne podatke o individualnoj osjetljivosti profesionalno izloženih ispitanika koji mogu poslužiti unaprjeđenju postojećih uvjeta rada i upravljanju rizicima pri izloženosti genotoksičnim agensima. Na osnovi prednosti i nedostataka citogenetičkih metoda zaključeno je da je mikronukleus-test, koji podjednako uspješno dokazuje klastogene i aneugene učinke, jedna od najboljih metoda dostupnih za otkrivanje štetnih djelovanja antineoplastičnih lijekova koji su u aktivnoj primjeni.
Predrag Grubor, Milorad Mitković, Milan Grubor and Milan Mitković
A war wound to the proximal humerus is characterised by profuse bleeding, multifragmentary fracture-dislocations, defects of the muscle tissue, capsule, skin and by primary contamination with polymorphic bacterial flora, and it is rarely isolated.
Out of 27 injured people, subluxation/dislocation of the humeral head occured in the first four patients who suffered a proximal humeral fracture resulting from a warrelated trauma stabilized with an external fixator. Two pins were inserted into the humeral head, and the other two into the diaphysis. In the other wounded people, there was no subluxation/dislocation of the humerus because the pins were placed into the clavicle, into the acromion or spinous process of the scapula.
Out of the 27 patients treated for proximal humeral injuries, the contact was established with 11. Out of these 11 patients, only in one patient we did not use the clavicle, the acromion or spinous process of the scapula to stabilize the fracture. The result of the treatment was poor due to avascular necrosis of the head and ankylosis of the shoulder. In the ten remaining patients we used 'temporary' placement of a pin into the clavicle or into the acromion or spinous process of the scapula. The final outcome of the treatment was satisfactory. The average Constant score was 59 points.
There is little data in professional literature about injuries to the proximal humerus caused by war-related trauma. The most commonly used system of classification of peacetime traumas is the Neer or AO classification system as there are balanced algorythms in the protocol for treating the trauma.
Proximal humeral fractures should be stabilized with an external fixator, inserting one pin into the clavicle or into the acromion or scapular spine. This prevents the subluxation/dislocation of the humeroscapular joint and facilitates early mobilisation, and thus improves the clinical result and reduces complications.
An Experiment to Develop Conversion Factors to Standardise Measurements of Airborne Asbestos
Various researchers and agencies recommend different conversion factors for different asbestos exposures. The aim of this study was to develop conversion factors from particles per cm3 (p cm-3) to fibres per cm3 (f cm-3) and from mg m-3 to f cm-3.
More than 1000 exposure measurements were available in the Slovenian asbestos-cement factory Salonit Anhovo. Three types of measurement of asbestos concentrations in the air were used: a konimeter measuring p cm-3, a gravimetric method measuring mg m-3 and a membrane filter method measuring f cm-3. Operation-specific conversion factors among these methods were developed. One conversion factor was obtained for asbestos-pipe-dry jobs (4.7) and one for asbestos-sheet-dry jobs (1.6). Only one conversion factor (0.8) was used for asbestos-cement-pipe-wet and asbestos-cement-pipe-dry jobs. For asbestos cement sheets, two conversion factors were obtained (0.3 and 1.2).
The development of five different conversion factors made it possible to calculate cumulative exposure to asbestos from historical data and to decrease exposure misclassification.