Introduction/Objective. The objective of the paper was to explore the risk factors and prediction models of digestive system complications in patients with rheumatic diseases. Methods. This case-control retrospective study enrolled 326 patients with rheumatic diseases (163 with digestive system involvement and 163 without), collecting demographic data, laboratory parameters (liver enzymes, lipid profiles, etc.) and disease types (rheumatoid arthritis, connective tissue diseases, gout, etc.). Potential variables were screened through univariate analysis, with independent risk factors subsequently identified using multivariate logistic regression analysis. Results. Univariate analysis revealed significantly higher proportions of males (35% vs. 20.2%, p = 0.003), alcohol consumption history (23.9% vs. 14.7%, p = 0.035), triglyceride (TG) (1.59 vs. 1.13 mmol/L, p < 0.001) and aspartate aminotransferase (AST) (21 vs. 19 U/L, p = 0.005) in the digestive system involvement group compared with controls. Multivariate logistic regression con-firmed male gender (odds ratio [OR] = 2.276, 95% confidence interval [CI]:1.184-4.376), elevated AST (OR = 1.039/U/L, 95% CI:1.005-1.074) and hypertriglyceridemia (OR = 5.456, 95% CI:3.217-9.252) as independent risk factors (all p < 0.05). Conclusion. Male gender, elevated AST and hypertriglyceridemia constituted core predictive factors for digestive complications in rheumatic diseases, with a 445.6% increased risk observed at TG levels >1.6 mmol/L, necessitating targeted intensive monitoring and clinical intervention.

Introduction/Objective. There is an increasing number of children requiring magnetic resonance imaging (MRI) of the brain as a diagnostic procedure. During the scan, it is necessary for the child to remain still for an extended period. This is often challenging due to the patient's age, the nature of the illness. The aim of this study was to evaluate the quality and safety of procedural sedation in children undergoing MRI of the brain by comparing two different sedation protocols. Methods. The study included 60 participants, aged 1 to 18 years, who required sedation during MRI of the brain. Using simple randomization, they were divided into two groups: the dexmedetomidine group (DEX group) was sedated with dexmedetomidine, and the dexmedetomidine/S-ketamine (DEX/KES group) received a combination of dexmedetomidine and S-ketamine. Results. Our results showed that the time to achieve adequate sedation was significantly shorter in the DEX/KES group (6.37 ? 3.62 min) compared to the DEX group (9.03 ? 3.48 min) (p = 0.005). During the initial 10 minutes, the average dexmedetomidine dose was identical in both groups (1.59 mcg/kg). However, during the continuous infusion phase until the end of sedation, the average dexmedetomidine dose was 1.47 mcg/kg in the DEX/KES group versus 1.60 mcg/kg in the DEX group. Analysis of hemodynamic parameters showed better stability in the DEX/KES group. Complications occurred more frequently in the DEX group. Conclusion. The dexmedetomidine/S-ketamine group provides a faster onset of sedation, better hemodynamic stability, lower total doses of sedatives, and fewer complications compared to dexmedetomidine alone.

Introduction/Aim. The aim was to investigate the effects of dexmedetomidine (DEX) on hemodynamics and stress responses during tracheal intubation under general anesthesia in patients with poorly controlled hypertension. Methods. This study is a prospective, randomized, controlled clinical study, it included 43 patients divided into an experimental group (n = 28) and a control group (n = 15). The experimental group received an intravenous infusion of 0.5 ?g/kg DEX before anesthesia induction, while the control group was given an equal volume of normal saline. Heart rate (HR) and arterial blood pressure were recorded at multiple time points after induction and intubation, and the rate-pressure product (RPP) was calculated. Statistical analysis was performed using independent sample t-test, Mann-Whitney U-test or chi-square test. Results. At 1 and 3 minutes after intubation, significant increases in HR, systolic blood pressure, diastolic blood pressure and mean arterial pressure were observed in the control group (p < 0.01), whereas the experimental group showed no significant changes. All post-intubation hemodynamic parameters were significantly lower in the experimental group (p < 0.001), with no difference in RPP. No adverse events or serious complications within seven days post-surgery occurred in either group. Conclusion. Dexmedetomidine effectively inhibits the sympathetic activation response induced by tracheal intubation, maintains hemodynamic stability, and demonstrates a favorable safety profile.

Introduction/Objective. Common internalizing symptoms, such as anxiety and depression, in school-age children with new-onset epilepsy, may not be immediately evident and can be misinterpreted by parents. This study compares how school-age children with epilepsy and their parents view the children's anxiety and depression, following previous findings that internalizing symptoms are common six months after diagnosis. Methods. The study was conducted at the University Children's Hospital in Belgrade, Serbia, with assessments performed after diagnosis and again six months later. After obtaining informed consent, children and their parents independently filled out the RCADS questionnaire. Paired t-tests assessed changes in scores from baseline to six months, with p < 0.05 considered significant. Results. Throughout the entire group over the six-month follow-up period, all RCADS scores, as well as self-report and parent ratings, showed significant increases. The most notable increases are seen in the subscales of social phobia from self-assessment and panic disorder from parent assessments (p < 0.01). Conclusion. Six-month follow-up of internalizing symptoms in our cohort of school-age patients with new-onset, uncomplicated epilepsy has shown that their parents are not sufficiently aware of the symptoms of social phobia, separation, and generalized anxiety, as well as OCD, although their symptoms become significant after six months. Parents need to be taught to recognize their children's emotions and to seek psychological help when necessary.

Introduction/Objective. was to evaluate the push-out bond strength to root canal dentine and radiopacity of three different sealers: Adseal (Meta Biomed, South Korea), CeraSeal (Meta Biomed, South Korea) and control AH Plus (Dentsply, Germany). Methods. In nine dentin discs, 1 mm thickness, three holes, 1.2 mm diameter, were drilled in with a fissure carbide bur. Discs were immersed in 0.5% NaOCl and 10% citric acid respectively, for 60 seconds rinsed and dried. Every hole was filled with different sealer. Specimens were wrapped in gauze previously immersed in Hank?s balanced salt solution at 37?C / seven days. The push-out test was performed using universal testing machine at a cross-head speed of 1mm/min. The radiopacity was tested (ISO 6876/2012 standard). Three sealer specimens, 5 mm in diameter and 2 mm thick were prepared and radiographed using radiovisiography system (CCD sensor, Trophy, France) with graded aluminum step-wedge. Gray-scale value was assessed using Adobe Photoshop CS7 (San Jose, USA). Results. Mean values of push-out bond strength were 5.21 ? 0.87 MPa (Adseal), 0.06 ? 0.02 MPa (CeraSeal), and 3.13 ? 0.38 MPa (AH Plus). A statistically significant difference in push-out bond strength was observed among all three sealer groups (p < 0.05). Adseal exhibited the strongest bond strength to root canal dentine. All sealers achieved radiopacity over 3 mm, with statistically significant difference among the groups (p < 0.05). Conclusion. The epoxy-based sealer Adseal showed higher bond strength compared to AH Plus and calcium silicate-based sealer CeraSeal, which, expectedly, showed the weakest dislocation resistance. All three sealers fulfilled the ISO standard to be distinguished on dental radiogram.

Introduction/Objective. Asthma is the most common chronic disease in children. Asthmatic status is a severe exacerbation of asthma that can lead to hypoxemia and respiratory failure. Diagnosing asthma in preschool-aged children is often challenging as wheezing episodes at this age are mostly caused by viral infections. The objective was to assess this health issue in our population and improve clinical practice in diagnosing and treating asthmatic status in preschool children. Methods. A retrospective study included 200 children, aged up to 5 years, who were hospitalized due to asthmatic status from January 2019 to December 2023. Data on patients, diagnostic procedures, therapy, and clinical courses were analyzed. Results. The majority of patients were one year old (31.5%) with a predominance of males (60.5%). Patients were most commonly hospitalized during the autumn months with an average length of hospital stay of 6.4 days. Allergy was confirmed in 50% of children. Family history of atopy was present in 56% of children. Previously diagnosed asthma was present in 13.5% of children. Upon discharge, asthma preventive therapy was introduced in 91.5% of children. All children had a favorable outcome and were discharged from the hospital. Conclusion. Status asthmaticus most commonly occurs in children in the first year of life, often presenting as the initial manifestation of asthma. More than half of the children have a family history of atopy and confirmed allergies. Timely therapy according to current protocols is crucial for a good outcome.

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Introduction/Aim. The escalating resistance of numerous pathogens to currently available therapeutic agents has sparked a renewed interest in the search of novel antimicrobial compounds. Plants have become a potentially valuable source of these compounds. This study aimed to assess the direct and indirect antimicrobial effects of Onosma visianii Clem root extract on reference and clinical bacterial strains using broth microdilution and a modified ethidium bromide/acridine orange (EB/AO) fluorescence assay. Methods. The ethanolic extract obtained from the dried root of Onosma visianii Clem was used to determine the minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) by broth microdilution, as well as the half maximal inhibitory concentration (IC50) values for reference and clinical bacterial strains. The EB/AO fluorescence method was employed to assess the effect on efflux pumps in methicillin-resistant Staphylococcus aureus MRSA and vancomycin-resistant Enterococcus faecalis VRE, using 50% of the MIC value of the extract. Results. The MIC, MBC, and IC50 values for Gram-positive bacteria were all below 15 ?g/mL. The extract demonstrated strong antibacterial activity against VRE and, in particularly, against MRSA isolates (MIC = 7.81 ?g/mL and MBC = 7.81 ?g/mL, respectively). Furthermore, treatment with 50% of the MIC concentration produced a significant inhibitory effect on efflux pumps in Gram-positive bacteria, ranging from 18% to 26% compared with untreated cells. Conclusion. The root extract of Onosma visianii Clem exhibited antimicrobial activity against both Gram-positive and Gram-negative bacteria, with practiculary strong effects against VRE and MRSA. In addition, the observed inhibition of bacterial efflux pumps underscores its promise as a candidate for pharmacological evaluation of the antibiotic properties of the Onosma visianii Clem root extract.

Long-term statistical data on lung cancer (LC) show an overall 34% reduction in mortality compared to 1991. The primary reasons for this decline include a reduced smoking rate, earlier diagnosis, advancements in invasive diagnostic methods, and the introduction of low-dose computed tomography (LDCT) screening. These factors have contributed to detecting LC at earlier stages of the disease and improving timely treatment. The diagnostic sensitivity of conventional bronchoscopy for peripheral pulmonary lesions (PPL), representing early-stage LC, has historically been relatively low, ranging from 30% to 60%. Over the past two decades, diagnostic sensitivity for PPL has improved with the development of advanced navigational techniques, such as virtual bronchoscopic navigation, electromagnetic navigation bronchoscopy, radial endobronchial ultrasound, cone-beam computed tomography, and ultrathin bronchoscopy. In the past two to three years, robotic-assisted bronchoscopy has further enhanced diagnostic navigation capabilities to their current maximum potential.

Introduction/Objective. Crohn?s disease was traditionally managed by gastroenterologists, but in the past decade the surgeon?s role has expanded, with specialized inflammatory bowel disease surgeons now integral to multidisciplinary decision-making. Evidence indicates that early ileocecal resection for localized terminal ileitis with a predominantly fibrotic component, performed before complications arise, may improve outcomes and reduce disease-related morbidity. The aim of this study is to evaluate the impact of early ileocecal resection with Kono-S anastomosis on postoperative disease control in patients with localized Crohn?s disease, by assessing changes in inflammatory biomarkers, clinical symptoms, and endoscopic recurrence over a two-year follow-up period. Methods. From 2021 to 2023, all patients in this study were assessed by the Inflammatory Bowel Disease Multidisciplinary Team of the University Clinical Center of Vojvodina, which determined indications for surgery. Postoperative recurrence was monitored clinically and endoscopically using colonoscopy and the Rutgeerts score. Sixty patients underwent laparoscopic ileocecal resection with Kono-S anastomosis. Results. Statistical analyses (IBM SPSS 26) used repeated-measures ANOVA at three time points: preoperatively, one year postoperatively, and two years postoperatively. Fecal calprotectin showed a strong time effect (F(1.77, 104.51) = 300.13, p < .001, ??? = .84), demon-strating substantial reduction in intestinal inflammation. Defecation difficulty scores also decreased significantly (F(1.43, 84.28) = 136.36, p < .001, ??? = .70). Rutgeerts scores showed no significant change between years one and two (F(1, 56) = 3.11, p > .05), indicating stable endoscopic findings. Conclusion. Endoscopic monitoring with the Rutgeerts score, supported by fecal calprotectin, proved most reliable for postoperative surveillance. With careful multi-disciplinary selection-especially in patients with localized, fibrotic disease-early ileocecal resection using the Kono-S technique can effectively control Crohn?s disease, decrease rehospitalizations and reoperations, and improve quality of life.