Publications by authors named "Sekulic A"

Acute kidney injury (AKI) incidence after neurosurgical operations has been reported as 10-14%. The literature regarding the incidence of nosocomial acute kidney disease (AKD) following neurosurgery is scarce. This retrospective, single-center, observational study aimed to assess the impact of different anaesthetics on development of postoperative AKI and persistent AKD in neurosurgical patients.

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Objective: To execute a large-scale, decentralized, clinical-grade whole exome sequencing study, coined Tapestry, for clinical practice, research discovery, and genomic education.

Patients And Methods: Between July 1, 2020, and May 31, 2024, we invited 1,287,608 adult Mayo Clinic patients to participate in Tapestry. Of those contacted, 114,673 patients were consented and 98,222 (65.

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: Pectus excavatum (PEx) is considered, at least partially, a familial disorder. A variety of inheritance patterns, associations with genetic syndromes, and pathogenic variants have been reported. However, the etiology of this condition is still not completely understood, and no known genes have been identified as definitive contributors.

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  • Drug repurposing offers a cost-effective strategy for developing therapies for rare diseases, which often face challenges in traditional drug development.
  • This study used a new drug identification and repurposing pipeline to discover molecular drivers and potential therapies for psoriasis, leading to the identification of both known and novel disease mechanisms.
  • The approach was further applied to necrobiosis lipoidica, revealing important disease drivers and potential treatments, demonstrating a high success rate in matching drugs to identified molecular targets.
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  • The study assessed health-related quality of life (HRQoL) in 84 patients with locally advanced basal cell carcinoma (laBCC) treated with cemiplimab.
  • Patients received cemiplimab every 3 weeks for up to 9 cycles, and HRQoL was evaluated using the QLQ-C30 and Skindex-16 questionnaires at various points.
  • Results showed that 62-90% of patients experienced improvement or maintenance in HRQoL, except for fatigue, which remained a concern throughout the treatment.
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  • A phase 2 study of cemiplimab showed a 24.1% objective response rate in patients with metastatic basal cell carcinoma who couldn't continue hedgehog inhibitor therapy due to side effects, disease progression, or stable disease after nine months.
  • Patients were given intravenous cemiplimab and their health-related quality of life was assessed using questionnaires at various treatment cycles.
  • Results indicated most patients experienced low symptom burden and moderate-to-high functioning, with significant improvements or maintenance in quality of life and functioning scales reported throughout treatment cycles.
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  • - The study aimed to determine if exome sequencing could help efficiently identify individuals with hereditary breast and ovarian cancer (HBOC) and Lynch syndrome (LS), which are genetic conditions linked to increased cancer risk.
  • - Over 44,000 participants were recruited across diverse regions in the U.S., resulting in the identification of 550 carriers of HBOC and LS, with 52.1% being newly diagnosed and 39.2% not meeting current genetic evaluation criteria.
  • - The findings suggest a need for broader use of germline genetic screening to improve the screening and detection of those predisposed to these cancer syndromes, particularly among underrepresented populations.
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: Spinal cord injuries are debilitating conditions with significant impacts on physical function and patient quality of life. The high incidence of urinary tract infections in these patients can be attributed to neurogenic bladder-a major complication of spinal cord injuries. The aim of this study is to investigate the incidence of urinary tract infections in patients with spinal cord injuries and their relation to the method of bladder emptying.

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  • Necrobiosis lipoidica (NL) is a rare skin disease with limited treatment options, and this study aimed to evaluate the effectiveness of ruxolitinib, a Jak1/2 inhibitor, for managing NL.
  • The phase 2 study involved 12 patients and found that, after 12 weeks of treatment, NL lesions significantly improved, showing a 58.2% decrease in severity.
  • Additionally, genetic analysis indicated that ruxolitinib affects specific immune pathways linked to NL, although the study's small size and restricted patient criteria were notable limitations.
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  • Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD), involves long-term liver inflammation that causes damage and can lead to serious conditions like cirrhosis.
  • Patients with MASLD are at higher risk for cardiovascular diseases due to shared issues in lipid metabolism and the harmful effects of lipotoxicity.
  • Currently, there is no specific medication for MASLD, but lifestyle changes are recommended, and recent trials are exploring existing drugs that might also benefit MASLD patients.
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The NCCN Guidelines for Merkel Cell Carcinoma (MCC) provide recommendations for diagnostic workup, clinical stage, and treatment options for patients. The panel meets annually to discuss updates to the guidelines based on comments from expert review from panel members, institutional review, as well as submissions from within NCCN and external organizations. These NCCN Guidelines Insights focus on the introduction of a new page for locally advanced disease in the setting of clinical node negative status, entitled "Clinical N0 Disease, Locally Advanced MCC.

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  • Metastatic basal cell carcinoma (mBCC) is challenging to treat, and cemiplimab, an immune checkpoint inhibitor, has been evaluated after previous hedgehog pathway inhibitor (HHI) treatment.
  • In a phase II study with 54 patients, cemiplimab showed a 22% objective response rate, including complete and partial responses, and a disease control rate of 63%.
  • The treatment was relatively well-tolerated with common side effects like fatigue and diarrhea, and the median overall survival was 50 months without treatment-related deaths.
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Basal cell carcinoma (BCC) is the most common form of skin cancer in the United States. Due to the high frequency, BCC occurrences are not typically recorded, and annual rates of incidence can only be estimated. Current estimated rates are 2 million Americans affected annually, and this continues to rise.

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Objective: We aimed to compare mortality and complication rates in patients treated for obstructive jaundice before and during the COVID-19 pandemic in a tertiary care center in Serbia.

Methods: We conducted a retrospective cohort study among a first group of patients treated between 1 January 2017 and 1 January 2019. The second group was treated between 1 March 2020 and 1 March 2022.

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  • Risk stratification for COVID-19 patients using Early Warning Scores (EWSs) is complex, and their effectiveness in predicting outcomes is not yet fully understood.
  • This study evaluated the predictive power of five EWSs (MEWS, NEWS, NEWS2, REMS, and qSOFA) on ICU admissions and mortality among 3608 COVID-19 patients at a Serbian hospital.
  • The REMS score was found to be the most effective predictor of mortality and ICU admission, with significant factors including age, CT score, urea levels, and bacterial superinfection.
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Purpose: Polymorphisms in complement genes are risk-associated for age-related macular degeneration (AMD). Functional analysis revealed a common deficiency to control the alternative complement pathway by risk-associated gene polymorphisms. Thus, we investigated the levels of terminal complement complex (TCC) in the plasma of wet AMD patients with defined genotypes and the impact of the complement activation of their plasma on second-messenger signaling, gene expression, and cytokine/chemokine secretion in retinal pigment epithelium (RPE) cells.

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  • Genome-wide fragmentation patterns of cell-free DNA (cfDNA) in plasma are influenced by the cellular origin, which varies between healthy and cancerous cells, presenting an opportunity for new cancer diagnostics.
  • The study analyzed cfDNA from 2,668 samples, including those from healthy individuals and patients with 11 different cancer types, using a novel metric called information-weighted fraction of aberrant fragments (iwFAF) to identify tumor-derived DNA in blood samples.
  • A machine learning model was developed using iwFAF and specific nucleotide frequencies, achieving a high accuracy in distinguishing between healthy and cancer patients, with an AUC of 0.91 for any cancer stage and 0.87 for early-stage detection, while requiring only
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Introduction: Videolaryngoscopy (VL) is the recommended strategy for airway management in COVID-19 patients and guidelines recommends that all anesthesiologists should be trained to use and have immediate access to the device. However, the availability of VL in hospitals and its use may vary, as well as the choice of the device and necessary training. Our primary aim was to investigate data on availability of VL in Croatia, its use, the choice of the device and its implementation, with special consideration of COVID-19 management.

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Introduction: There are still no definite curative or preventive strategies for COVID-19 disease. It is crucial to fully comprehend the pathogenesis of COVID-19 infection so that we can develop expedient pharmacological protocols. While the impact of cytokine storm on COVID-19 severity has been one of the most tested hypotheses, the role of bradykinin and various other oxidative stress markers has been relatively under-researched.

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Obstructive sleep apnea (OSA) is a serious condition linked with various metabolic disorders and associated with increased all-cause and cardiovascular mortality. Although the potential mechanisms of pathophysiological processes related to OSA are relatively well known, the data regarding the correlation between obstructive sleep apnea, dyslipidemia, and systemic inflammation are still inconclusive. The study was conducted as a retrospective cohort study including 328 patients with newly diagnosed obstructive sleep apnea during the period between April 2018, and May 2020, in University Clinical Hospital Center "Bezanijska kosa", Belgrade, Serbia.

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Background: Limited information is available regarding real-world treatment patterns and their effectiveness and safety in patients with locally advanced basal cell carcinoma, including patients not typically represented in clinical trials. The purpose of the current study was to describe how clinicians diagnose and treat locally advanced basal cell carcinoma in the United States.

Methods: This prospective, multicenter, observational registry study included patients with newly diagnosed, Hedgehog pathway inhibitor-naive locally advanced basal cell carcinoma without basal cell carcinoma nevus syndrome (n = 433) treated at 75 US academic and community practices, including dermatology, Mohs surgery, and medical oncology sites.

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The NCCN Guidelines for Squamous Cell Skin Cancer provide recommendations for diagnostic workup, clinical stage, and treatment options for patients with cutaneous squamous cell carcinoma. The NCCN panel meets annually to discuss updates to the guidelines based on comments from panel members and the Institutional Review, as well as submissions from within NCCN and external organizations. These NCCN Guidelines Insights focus on the introduction of a new surgical recommendation terminology (peripheral and deep en face margin assessment), as well as recent updates on topical prophylaxis, immunotherapy for regional and metastatic disease, and radiation therapy.

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The Quality of Recovery-40 (QoR-40) questionnaire is a psychometric instrument designed to quantify postoperative recovery. It has been translated and validated in several countries but not in Croatia. The aim was to translate, cross-culturally adapt, and validate Croatian version of the QoR-40.

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Aim: To compare the effect of adjunctive lidocaine-based scalp block and laryngotracheal local anesthesia vs general anesthesia only on pro-inflammatory cytokine concentrations in patients with non-ruptured brain aneurysms undergoing elective open surgery.

Methods: This parallel, randomized, controlled, open-label trial was conducted at Clinical Hospital Center Zagreb between March 2019 and March 2020. At the beginning of anesthesia, lidocaine group received 40 mg of 2% lidocaine for laryngotracheal topical anesthesia and 4 mg/kg for the scalp block.

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