Miroslav Radenkovic

By Miroslav Radenković

Part of the book: Gestational Diabetes

By Miroslav Radenković and Ana Jakovljević

The incidence of gestational diabetes mellitus (GDM) is still rising, and this pathological condition is strongly associated with some serious adverse pregnancy outcomes. Therefore, GDM must be timely recognized and adequately managed. Treatment of GDM is aimed to maintain normal glycemia and it should involve regular glucose monitoring, dietary modification, lifestyle changes, moderate physical activity, and pharmacotherapy, when necessary. As for the pharmacotherapy, needed in approximately one-third of GDM women, insulin administration is the first choice of pharmacological treatment, although oral hypoglycemic drugs, for example, metformin (a biguanide agent) or glyburide (a second-generation sulfonylurea drug), could be indicated, too. Metformin is considered as a reasonable and safe first-line alternative to insulin. If comparing two oral agents, metformin seems to be safer than glyburide, since glyburide was found to be linked to neonatal hypoglycemia and higher birth weight, which can for example increase the hazard for shoulder dystocia and a necessity for Cesarean delivery. Finally, it should be underlined that many pregnant women turn to complementary and alternative medicine for health maintenance or symptom relief, including traditional herbal medicine and the use of supplements. Given the previous facts, this chapter will address current pharmacotherapy options and challenges related to GDM treatment.

Part of the book: Gestational Diabetes Mellitus

By Miroslav Radenković and Ivana Milićević

Ever since their discovery in the fifties of the last century, as an anti-inflammatory drugs for the treatment of rheumatoid arthritis, corticosteroids have found a significant place and wide application in various fields of medicine. Their effects are known to be diverse. The most significant ones are the anti-inflammatory, anti-allergic, and immunosuppressive effects. Furthermore, they affect the hematopoietic system. Corticosteroids produce complex metabolic effects by stimulating glyconeogenesis, increasing the uptake of amino acids in the liver and kidneys, and enhancing lipolysis. Given that natural adrenocortical hormones are synthesized under the influence of stress, it is expected that in the emergency situations, where we face vitally endangered patients whose body is under the stress due to respiratory insufficiency or impaired hemodynamics, corticosteroids do have significant place in the treatment. Thus, these drugs are used in the treatment of acute exacerbation of chronic obstructive pulmonary disease and asthma, in anaphylactic reactions, spinal shock, Addisonian crisis, and sepsis. During the COVID-19 pandemic, corticosteroids found their place in certain stages of treatment, as well as in many national protocols for the treatment of COVID-19 patients. Hence, the use of corticosteroids in the emergency pathologies will be reviewed in this chapter.

Part of the book: Updates on Corticosteroids

By Jelena Roganović and Miroslav Radenković

Artificial intelligence (AI) is a technology that aims to create a machine (algorithm-software) that can mimic intelligent human behavior. In order to respect human-technology interaction in a clinical environment, AI in medicine and dentistry should have a complementary role in the work of clinical practitioners. In dentistry, various software-type algorithms are used as the basic application of AI, which is expected to improve the accuracy of dental diagnosis, provide visualization of anatomical guidelines during treatment, and, due to the possibility of analyzing large amounts of data, predict the occurrence and prognosis of oral diseases. Conscientious and ethical AI use in dentistry has to consider: (1) when to apply AI and (2) how to use AI appropriately and responsibly. Patients should be notified about how their data is used, also about the involvement of AI-based decision-making, especially if there is a lack of regulatory policy if AI is utilized to diminish costs rather than improve the health of patients or if the dentist has a conflict of interest. As many dentists are speeding in the direction of integrating AI systems into diagnostics, prognostics, and dental treatment, the legal and ethical questions are becoming even more pertinent.

Part of the book: Ethics