In adult organisms, deregulation of the sonic hedgehog (SHH) signaling pathway is significantly correlated with different malignancies. Currently, data associating genetic polymorphisms in the SHH pathway with melanoma are scarce and largely unknown. The objective of our study was to elucidate an association between gene polymorphisms in the SHH pathway and prognosis of melanoma skin cancer patients. The current study investigated the association of PTCH1 (rs357564), SMO (rs2228617) and GLI1 (rs2228224, rs2228226), polymorphisms with melanoma predisposition and prognosis. Single-nucleotide polymorphisms were assessed by TaqMan SNP Genotyping Assays. The study involved 93 melanoma patients and 97 individuals in the control group. Melanoma patients with the variant mutant genotype GG of GLI1 rs2228226 polymorphism had poorer overall survival and recurrence-free survival (P = 0.0001 and P = 0.037, respectively). The multivariate analysis revealed that disease progression [hazard ratio (HR) = 14.434, P = 0.0001] and the GLI1 rs2228226 polymorphism (HR = 4.161, P = 0.006) persisted as independent prognostic factors. Mutated allele carriers (combined heterozygous and mutated genotypes) for GLI1 rs2228224 G and GLI1 rs2228226 G allele significantly increased melanoma risk [odds ratio (OR) = 2.261, P = 0.007; OR = 2.176, P = 0.010]. Our study demonstrated that genetic variants in GLI1, downstream member of the HH signaling pathway, are the risk factors for melanoma susceptibility and it can be a novel marker for melanoma prognosis. As a crucial SHH signaling member, GLI1 can also be regarded as a novel drug target for anti-cancer treatment in melanoma.

Gradski zavod za Hitnu medicinsku pomoć Beograd EKG artefakati u urgentnoj medicini Sažetak: Artefakti su tehničke greške na elektrokardiogramu (EKG-u), koje mogu biti prisutne u svim odvodima, u nekoliko njih, ili u samo jednom odvodu. Mogu biti suptilni i ne ometati bitno interpretaciju, ali i toliko izraženi da učine EKG zapis potpuno neupotrebljivim, što može dovesti do odlaganja dijagnoze i pravovremene terapije. Potpuno suprotno, artefakti na EKG-u mogu biti pogrešno protumačeni i pacijenta izložiti nepotrebnim ili rizičnim terapijskim procedurama. EKG artefakti se dele na one koji su poreklom iz spoljne sredine i na one koje vode poreklo od tela pacijenta. Prva grupa može biti uzrokovana elektromagnetnom intereferencijom (sa naizmeničnom strujom iz električnih instalacija; električnim uređajima u/na pacijentu svetlom), ili malfunkcijom kablova ili/ i elektroda (oštećeni kablovi i elektrode, njihovo pomeranje prilikom transporta, pogrešno povezani odvodi, "offset" signali, odlepljene eleкtrode, nedovoljno gela ili neodgovarajući filteri). U drugu grupu spadaju artefakti poreklom iz mišića, kože i adneksa. Mišići su čest izvor artefakata, bilo da se radi o voljnim, ili nevoljnim pokretima. Koža i adneksa mogu biti dvojaki izvor EKG artefakata: loš kontakt sa elektrodom, ili samo rastezanje epidermisa koje generiše stvaranje električnog potencijala (okretanje pacijenta u krevetu, npr.). Opisan je i redak artefakt izazvan pulsacijama radijalne arterije neposredno ispod elektroda, tzv. elektromehanička asocijacija. Artefakti mogu imati različite prezentacije na EKG-u. Linija EKG zapisa može biti: debela, nepravilna, prekinuta, "šetajuća", ili (pseudo) izoelektrična. Artefakti mogu imitirati bilo koji talas ili zubac na EKG-u; ekstrasistole; tahikardije uskih ili širokih kompleksa; produženje QT intervala; elevacije/depresije ST segmenta, ili promene T talasa. Načini njihovog uklanjanja se odnose na manipulacije sa pacijentom, pomoćnom opremom, ili samim EKG aparatom.

Osnovna tema rada je rekonstrukcija i revitalizacija objekta Studija M. - kulturnog nasleđa Novog Sada, koje je zaboravljeno i preti mu nestnak sa mape grada. Metodologija rada se sastoji od generisanja osnov­ne teze - teza o procesu Translacije ideje, koja pro­ističe iz prethodne analize pojma ideologije, kao podteme rada, a zatim i ilustrovanja teze kroz primer Studija M pre i posle intervencije, kroz prizmu ideologije. U istraživanju se ideo­logija posmatra kao sistem namera čijim oprostorenjem se stvara arhitektura. Pored programske i formalne razrade ovog projekta, razvijaju se i apstraktni programski seg­menti, odnosno funkcije koje nisu čisto utilitarne i odnose se na utiskivanje novih značenja u telo i duh objekta.

Introduction: Severe thoracic trauma is a potentially lifethreatening injury, leading to immediate impairment of cardiorespiratory functions or bleeding; but also consequential fatal infections, damage of: heart, large blood vessels, mediastinal organs or pleura with pneumothorax/hematothorax. Objective: To present a case of penetrating chest injuries with forks, caused by traffic. Methodology: Case report from medical documentation. Case report: The EMS team was called for a car accident including vehicle and a tractor. At the passenger seat of the car, a female person was found stabbed with a pitchfork through the torso and fixed to the seat. Firefighters cut a part of the metal forks, while medics stabilized foreign body and made emporary hemostasis. The entrance and exit wounds were verified. Vitals were: TA: 130/60mmHg, heart rate 100/min, SaO2 90%. The peripheral venous line was opened and O2 10L/min was applied through an oxygen mask. The patient was transported in a sitting position, with medical manual stabilization, to the ER. The surgeon was immediately consulted and the patient, due to vital indications, was urgently admitted to the operating room. In the abdomen, 8 cm laceration of the III segment of the liver, cleft omentum and deserosion of the small curve of the stomach were verified. A foreign body passed between the aorta and the esophagus, without injuring them. Conclusion: Thanks to the prompt EMS reaction and the proper pre-hospital care, as well as early inpatient surgical treatment, the patient's outcome was good.

Wide complex tachycardia (WCT) presents on an ECG with a rate higher than 100 beats per minute and the QRS complex width of over 120ms. The usual classification of wide complex tachycardia includes ventricular tachycardia and supraventricular tachycardia with aberration, but they can also be the result of the effects of metabolic and/or toxic agents. A xenobiotic is a chemical substance that is present in an organism but is not produced within the organism or expected to be there. That also includes substances that are present within the organism in much higher concentrations than usual. For people, various drugs are also considered to be xenobiotics. One type of irregularity caused by xenobiotic poisoning is based on cardiomyocyte sodium channel blockade, responsible for the phase 0 rapid depolarization of action potentials. Certain groups of drugs can cause the WCT as a result of a repolarization disorder and prolonging of the QTc interval. Treating WCT as a result of xenobiotic poisoning depends primarily on the type of tachycardia and the disorder that caused it. Early recognition and adequate treatment are of the utmost importance for a favourable outcome.