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Phthalates are ubiquitous environmental contaminants, massively used in industry as plasticizers and additives in cosmetics, which may impair the human endocrine system inducing fertility problems, respiratory diseases, obesity, and neuropsychological disorders. The aim of this study was to examine the influence of the monoethyl phthalate (MEP) and mono-(2-ethylhexyl) phthalate (MEHP) on the liver function and cardiometabolic risk factors in males. In this research, 102 male participants (51 normal weight and 51 overweight/obese) were enrolled and examined for phthalate metabolites exposure in urine samples after 12 h of fasting. MEP was found in 28.43% (29/102) volunteers, while MEHP was detected among 20.59% (21/102) participants. Statistically significant increment in transaminase serum levels was observed in MEP-positive normal weight subgroup. Linear correlation was obtained between MEP concentration in urine samples and triglyceride (TG) serum levels (r = 0.33; p< 0.01), visceral adiposity index (VAI) (r = 0.41; p< 0.01), lipid accumulation product (LAP) (r = 0.32; p< 0.01), and TG to high-density lipoprotein (HDL) ratio (r = 0.40, p< 0.01) among the obese. The MEHP-positive normal weight volunteers had statistically significant increment of body mass index (p = 0.03) compared to MEHP-negative participants. Urine MEHP concentrations were negatively correlated with HDL serum levels (r = 0.31; p< 0.05) in the normal weight subgroup. The phthalates exposure may be related to statistically significant ALT and AST serum levels increment as well as with increased BMI, while the phthalate levels in the urine may be correlated with increased TG and decreased HDL cholesterol serum levels and associated with indicators of cardiometabolic risk and insulin resistance as LAP and VAI.

Hepatitis-associated aplastic anemia occurs in up to 10% of all aplastic anemia cases. Syngeneic bone marrow transplantation is rare in patients with severe aplastic anemia and usually requires pre-transplant conditioning to provide engraftment. We report on a 29-year-old male patient with hepatitis-associated severe aplastic anemia who had a series of severe infectious conditions before transplantation, including tracheal inflammation. Life-threatening bleeding, which developed after bronchoscopy, was successfully treated with activated recombinant factor VII and platelet transfusions. Syngeneic peripheral blood stem cell transplantation using immunosuppressive treatment with antithymocyte globulin and cyclosporin A without high-dose pre-transplant conditioning was performed, followed by complete hematologic and hepatic recovery.

Objective: To present a case with 4 different potential causes of hyponatremia. Clinical Presentation and Intervention: The patient presented with the following symptoms: nausea, vomiting, diarrhea, and dark urine after drinking large amounts of fluids that included alcohol and caffeine. Laboratory, microbiological, and morphological examinations revealed the existence of severe hyponatremia and acute poststreptococcal glomerulonephritis. The patient developed acute symptomatic seizures and coma. Gradual normalization of the sodium level led to a recovery of consciousness. Conclusion: Treatment with hypertonic sodium, fluid restriction, and antibiotics led to a complete recovery. In the case of multiple causes of hyponatremia, it is necessary to treat all causes.

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Introduction. Ecthyma gangrenosum is a rare skin disorder which commonly affects immunocompromised patients. Case Report. We report two hematological patients suffering from ecthyma gangrenosum. Pseudomonas aeruginosa was isolated from skin lesions of both patients, but bacteremia was present only in the first case. These two cases had different pathogenic mechanisms and outcomes. Conclusion. Early diagnosis and prompt combination antibiotic therapy are of utmost importance in the treatment of this condition. On the other hand, the underlying disease has a great impact on the outcome as well.

Background / Aim. The treatment of chronic myeloid leukemia (CML) has changed dramatically with the advent of targeted therapies. The study aimed to assess the efficacy of generic imatinib in CML patients treated in our center. Methods The study was retrospective. It included 101 patients with the diagnosis of CMLchronic phase (CP). There were two study groups. Group 1 included 55 patients initially treated with branded imatinib and then switched to generic imatinib. Group 2 consisted of 46 newly diagnosed patients who received only generic imatinib from the start of therapy. Results. The patients were treated with branded imatinib for the mean of 42 months (range 6-132 months) before switching to generic imatinib. Treatment with generic imatinib lasted for 25 months in average (range 3-66 months). A quarter of the patients from Group 1 lost their cytogenetic response after being switched to generic imatinib but without signs of transformation to acute leukemia. Patients treated with branded imatinib had a significantly longer event-free survival (EFS) and failure-free survival (FFS) (log-rank p=0.01 and p=0.03). These results could have been influenced by frequent changes of the brand and dosage formulation of generic imatinib. Conclusions. Our study showed a significantly longer EFS nad FFS on treatment with initially branded imatinib due to cross over study design, but provide some informative data of these two group of patients Key words: branded imatinib mesylate; generic imatinib mesylate; chronic myeloid leukemia. Apstrakt Uvod / Cilj. Ciljna terapija je značajno izmenila uspeh lečenje bolesnika sa hroničnom mijeloidnom leukemijom. Cilj rada je bio da se proceni efikasnost lečenja obolelih od hronične mijeloidne leukemije generičkim imatinibom u našem centru. Metode: Istraživanje je bilo retrospektivno. Obuhvatilo je 101 obolelog od hronične mijeloidne leukemije u hroničnj fazi. Bolesnici su bili podeljeni u dve grupe. Prvu grupu je činilo 55 bolesnika koji su inicijalno lečenji originalnim imatinibom i koji su kasnije tokom lečenja prevedeni na terapiju gneričkim imatinibom. Drugu grupu je činilo 46 novodijagnostikovanih bolesnika koji su od početka lečeni generičkim imatinibom. Rezultati. Bolesnici su originalnim imatinibom lečeni u proseku 42 meseca (od 6 do 132 4 meseca) nakon čega su prevedeni na generički imatinib. Lečenje generičkim imatinibom je u proseku trajalo 25 meseci (od 3 do 66 meseci). Četvrtina bolesnika prve grupe je izgubila citogenetski odgovor nakon prevoĎenja na generički imatinib. Nije bilo znakova za transformaciju u akutnu leukemiju. Bolesnici lečeni originalnim imatinibom su imali statistički značajno duže preživljavanje bez dogaĎaja koje podrazumeva smrtni ishod i preživljavanje bez neuspeha terapije (log-rank p=0.01 and p=0.03). Na ovakve rezultate je mogla imati uticaj učestala promena dozne formulacije i poizvoĎača generičkog imatiniba. Zaključak. Naše istraživanje je ukazalo na značajno duže preživljavanje bez dogaĎaja koje podrazumeva smrtni ishod i preživljavanje bez neuspe...

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