Pub Date : 2024-06-15DOI: 10.3889/oamjms.2024.11917
Zaim Gashi, Astrit Hamza, Blerina Ukimeri, Valon Hamza, Marigona Zubaku-Rakovic
BACKGROUND: Malignant melanoma (MM) is the deadliest form of skin cancer and the most common carcinoma to metastasize into the gastrointestinal tract (GI). While the jejunum, ileum, colon, and rectum are common gastrointestinal sites of metastasis, metastatic melanoma in the stomach is rare and usually not detected until late in the disease. CASE PRESENTATION: We report a patient who presented with hematemesis, epigastric pain, and weight loss. In the second esophagogastroduodenoscopy, after 8 months from the first endoscopic assessment, a double ulcerative gastric mass was found, and histopathology confirmed metastatic malignant melanoma. The complete surgical resection of GI metastatic MM in carefully selected patients not only provides symptom control but has also been associated with an increase in overall survival in the absence of other metastatic sites. At present, the overall survival of patients with advanced metastatic MM who have been treated with a combination of immunotherapeutic agents reaches 52% at 5 years. CONCLUSION: The role of surgery for patients with metastatic involvement of the GI tract with MM is evolving in the era of effective systemic treatments.
背景：恶性黑色素瘤（MM）是最致命的皮肤癌，也是最常见的胃肠道转移癌。空肠、回肠、结肠和直肠是常见的胃肠道转移部位，而转移到胃部的黑色素瘤却很少见，而且通常在疾病晚期才被发现。在距离第一次内镜评估 8 个月后的第二次食管胃十二指肠镜检查中，发现了一个双溃疡性胃肿块，组织病理学证实为转移性恶性黑色素瘤。对经过严格筛选的消化道转移性黑色素瘤患者进行完全手术切除，不仅能控制症状，而且在没有其他转移部位的情况下，还能提高总生存率。目前，接受免疫治疗药物联合治疗的晚期转移性 MM 患者的 5 年总生存率达到 52%。
{"title":"A Rare Case of Gastric Metastasis from a Rare Case of Mucosal Malignant Melanoma","authors":"Zaim Gashi, Astrit Hamza, Blerina Ukimeri, Valon Hamza, Marigona Zubaku-Rakovic","doi":"10.3889/oamjms.2024.11917","DOIUrl":"https://doi.org/10.3889/oamjms.2024.11917","url":null,"abstract":"BACKGROUND: Malignant melanoma (MM) is the deadliest form of skin cancer and the most common carcinoma to metastasize into the gastrointestinal tract (GI). While the jejunum, ileum, colon, and rectum are common gastrointestinal sites of metastasis, metastatic melanoma in the stomach is rare and usually not detected until late in the disease.\u0000CASE PRESENTATION: We report a patient who presented with hematemesis, epigastric pain, and weight loss. In the second esophagogastroduodenoscopy, after 8 months from the first endoscopic assessment, a double ulcerative gastric mass was found, and histopathology confirmed metastatic malignant melanoma. The complete surgical resection of GI metastatic MM in carefully selected patients not only provides symptom control but has also been associated with an increase in overall survival in the absence of other metastatic sites. At present, the overall survival of patients with advanced metastatic MM who have been treated with a combination of immunotherapeutic agents reaches 52% at 5 years.\u0000CONCLUSION: The role of surgery for patients with metastatic involvement of the GI tract with MM is evolving in the era of effective systemic treatments.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"82 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-15DOI: 10.3889/oamjms.2024.11906
B. Tuleuov, S. M.KozhanovaB., Temirgaziyev Kairtay, Z. AlmagambetovM., B. ShaidarovR., B. SeidakhmetovaP., M. DrašarS., Adekenov, Ksenija Bogoeva-Kostovska, I. Tuleuov, A. Kozhanova, B. S. Temirgaziyev, K. Kh
BACKGROUND: A supramolecular complex of ecdysterone triacetate with β-cyclodextrin (β-CD) was synthesized to obtain new potentially bioactive substances and study the effect of bulky pharmacophore-functional groups on the preservation of the specific activity of 20-hydroxyecdysone. The adaptogenic and anabolic activities of the resulting water-soluble inclusion complex were studied. It was established that with the introduction of 3 acyl-pharmacophore groups in the form of encapsulated and hydrophilic supramolecular forms to experimental animals at a dose of 10 mg/kg, the studied complex has anabolic and adaptogenic effects, including increased stress resistance, increased physical endurance, as well as slightly increased weight of the heart and gonads compared to the control. AIM: Study of the specific activity of the supramolecular complex of ecdysterone 3-acetate with β-CD. METHODS: During the experimental study of the adaptogenic and anabolic effects of the supramolecular complex of ecdysterone 3-acetate with β-CD, the “open field” and “free swimming” tests were used. Statistical processing of the results was carried out using the Statistica 8 software package. Intergroup differences were assessed using the non-parametric Mann–Whitney U-test. For unpaired related groups, the non-parametric Wilcoxon test was used. CONCLUSIONS: It has been established that physical activity (swimming) simultaneously has a significant stressor effect on animals and is characterized by an increased supply of glucose into the blood and the breakdown of blood proteins. It was revealed that the supramolecular complex of ecdysterone 3-acetate with β-CD at a dose of 10 mg/kg has anabolic and adaptogenic effects, in particular increased stress resistance and physical endurance of animals, as well as a slightly increased weight of the heart and gonads compared to the control.
{"title":"Studying the Specific (Adaptogenic and Anabolic) Activity of the Supramolecular Complex of 20-Hydroxyecdysone Triacetate with β-Cyclodextrin","authors":"B. Tuleuov, S. M.KozhanovaB., Temirgaziyev Kairtay, Z. AlmagambetovM., B. ShaidarovR., B. SeidakhmetovaP., M. DrašarS., Adekenov, Ksenija Bogoeva-Kostovska, I. Tuleuov, A. Kozhanova, B. S. Temirgaziyev, K. Kh","doi":"10.3889/oamjms.2024.11906","DOIUrl":"https://doi.org/10.3889/oamjms.2024.11906","url":null,"abstract":"BACKGROUND: A supramolecular complex of ecdysterone triacetate with β-cyclodextrin (β-CD) was synthesized to obtain new potentially bioactive substances and study the effect of bulky pharmacophore-functional groups on the preservation of the specific activity of 20-hydroxyecdysone. The adaptogenic and anabolic activities of the resulting water-soluble inclusion complex were studied. It was established that with the introduction of 3 acyl-pharmacophore groups in the form of encapsulated and hydrophilic supramolecular forms to experimental animals at a dose of 10 mg/kg, the studied complex has anabolic and adaptogenic effects, including increased stress resistance, increased physical endurance, as well as slightly increased weight of the heart and gonads compared to the control.\u0000AIM: Study of the specific activity of the supramolecular complex of ecdysterone 3-acetate with β-CD.\u0000METHODS: During the experimental study of the adaptogenic and anabolic effects of the supramolecular complex of ecdysterone 3-acetate with β-CD, the “open field” and “free swimming” tests were used. Statistical processing of the results was carried out using the Statistica 8 software package. Intergroup differences were assessed using the non-parametric Mann–Whitney U-test. For unpaired related groups, the non-parametric Wilcoxon test was used.\u0000CONCLUSIONS: It has been established that physical activity (swimming) simultaneously has a significant stressor effect on animals and is characterized by an increased supply of glucose into the blood and the breakdown of blood proteins. It was revealed that the supramolecular complex of ecdysterone 3-acetate with β-CD at a dose of 10 mg/kg has anabolic and adaptogenic effects, in particular increased stress resistance and physical endurance of animals, as well as a slightly increased weight of the heart and gonads compared to the control.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"79 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-15DOI: 10.3889/oamjms.2024.11900
Petra Kotnik, Nataša Koprivnik
BACKGROUND: Since musculoskeletal disorders at work (MSDW) are very common among physiotherapists, we must introduce strategies that could help reduce their prevalence. The main objective of this study was to determine the prevalence of MSDW among physiotherapists, which parts of the body are most often affected, what are the ergonomic risk factors for MSDW among physiotherapists and what are strategies to reduce them. METHODS: In the systematic literature review, involving a total of 2127 physiotherapists, search terms such as occupational musculoskeletal disorders, physiotherapists, and occupational risk factors were used in the SCOPUS (n = 24), MEDLINE (n = 2), ScienceDirect (n = 103), PEDro (n = 0), Cumulative index of the nursing and allied health literature (n = 3), and PubMed (n = 30) databases in February 2024. The search included only original studies published in English, cross-sectional studies published in thepast 10 years, studies that included the prevalence of MSDW, and studies that included risk factors for MSDW. In the end, we included eight studies in the systematic review. RESULTS: A systematic review of eight studies highlighted the prevalence and risk factors associated with MSDW among physiotherapists. The studies were conducted on samples ranging in size from 75 to 501 individuals and focused on determining the prevalence of MSDW and identifying the associated risk factors. The prevalence rates differ, with the lower back region being the most affected region in all studies (38–68.8%), followed by the neck (10–59.2%) and the shoulder girdle (7–51.7%). Risk factors included back strain, awkward posture, prolonged posture, frequent bending/turning of the trunk, performing manual therapy techniques, patient lifting, repetitive tasks, work environment, and psychosocial issues. Reported coping strategies included changing one’s working posture, improving one’s body mechanics, and taking more breaks during the workday. CONCLUSION: Our systematic review of the literature revealed a high prevalence of MSDW among physical therapists (up to 92%) and highlighted the urgent need for strategies to mitigate this widespread problem. These findings highlight the multifaceted nature of the etiology of MSDW and point to the interplay of physical demands, ergonomic challenges, and psychological stressors that characterize the profession of a physical therapist.
{"title":"Musculoskeletal Disorders in the Workplace of Physiotherapists: Occupational Risk Factors and Their Role in Prevention and Management: A Systematic Review","authors":"Petra Kotnik, Nataša Koprivnik","doi":"10.3889/oamjms.2024.11900","DOIUrl":"https://doi.org/10.3889/oamjms.2024.11900","url":null,"abstract":"BACKGROUND: Since musculoskeletal disorders at work (MSDW) are very common among physiotherapists, we must introduce strategies that could help reduce their prevalence. The main objective of this study was to determine the prevalence of MSDW among physiotherapists, which parts of the body are most often affected, what are the ergonomic risk factors for MSDW among physiotherapists and what are strategies to reduce them.\u0000METHODS: In the systematic literature review, involving a total of 2127 physiotherapists, search terms such as occupational musculoskeletal disorders, physiotherapists, and occupational risk factors were used in the SCOPUS (n = 24), MEDLINE (n = 2), ScienceDirect (n = 103), PEDro (n = 0), Cumulative index of the nursing and allied health literature (n = 3), and PubMed (n = 30) databases in February 2024. The search included only original studies published in English, cross-sectional studies published in thepast 10 years, studies that included the prevalence of MSDW, and studies that included risk factors for MSDW. In the end, we included eight studies in the systematic review.\u0000RESULTS: A systematic review of eight studies highlighted the prevalence and risk factors associated with MSDW among physiotherapists. The studies were conducted on samples ranging in size from 75 to 501 individuals and focused on determining the prevalence of MSDW and identifying the associated risk factors. The prevalence rates differ, with the lower back region being the most affected region in all studies (38–68.8%), followed by the neck (10–59.2%) and the shoulder girdle (7–51.7%). Risk factors included back strain, awkward posture, prolonged posture, frequent bending/turning of the trunk, performing manual therapy techniques, patient lifting, repetitive tasks, work environment, and psychosocial issues. Reported coping strategies included changing one’s working posture, improving one’s body mechanics, and taking more breaks during the workday.\u0000CONCLUSION: Our systematic review of the literature revealed a high prevalence of MSDW among physical therapists (up to 92%) and highlighted the urgent need for strategies to mitigate this widespread problem. These findings highlight the multifaceted nature of the etiology of MSDW and point to the interplay of physical demands, ergonomic challenges, and psychological stressors that characterize the profession of a physical therapist.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"6 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-05DOI: 10.3889/oamjms.2024.11888
M. Tirant, Heather Tirant, Uwe Wollina
Skin microbiota is an integral part of the human immune system. Staphylococcus aureus is one of the essential components of the normal flora. Approximately 20–30% of healthy individuals are persistently colonized with S. aureus, whereas the remainders are considered low-level intermittent carriers. Despite these natural aspects of existence, S. aureus can be a major opportunistic human pathogen. This versatile microorganism can infect a variety of anatomical sites, causing a broad spectrum of pathologies ranging from superficial to invasive infections. It developed a variety of strategies to adopt to a changing microenvironment. This attributed to the emergence of resistance to antibiotics of different classes during the past six decades. Methicillin-resistant S. aureus (MRSA) was originally confined to health-care settings (health-care-associated MRSA). Later on, community-acquired MRSA was identified as another source of infections. Recent figures indicate that MRSA strains have been associated with approximately 75% of all S. aureus infections worldwide. Several guidelines have been published to establish an adequate treatment of skin and soft tissue infections (SSTIs) caused by MRSA strains. In the first part of this review, we focus on current treatment guidelines with a focus on medical drug therapy, but drug therapy has its own limitations. Recently, the interest in herbal remedies has greatly increased. There is growing evidence of antimicrobial activity of medicinal plants and their extracts. The second part of this review is dedicated to herbal compounds to circumvent antibiotic resistance. Herbal compounds may potentiate the action of antibiotics and restore the activities of antibacterial agents against which S. aureus has developed a drug resistance. Part 2 focuses on the role of S. aureus in pathology of the two major inflammatory skin diseases, i.e., atopic dermatitis (AD) and psoriasis. Finally, Part 3 provides an overview on natural compounds with antimicrobial activity against S. aureus and possible use in the treatment of SSTIs,
{"title":"Herbal Bioactive Compounds for Skin Infections and Inflammatory Conditions","authors":"M. Tirant, Heather Tirant, Uwe Wollina","doi":"10.3889/oamjms.2024.11888","DOIUrl":"https://doi.org/10.3889/oamjms.2024.11888","url":null,"abstract":"Skin microbiota is an integral part of the human immune system. Staphylococcus aureus is one of the essential components of the normal flora. Approximately 20–30% of healthy individuals are persistently colonized with S. aureus, whereas the remainders are considered low-level intermittent carriers. Despite these natural aspects of existence, S. aureus can be a major opportunistic human pathogen. This versatile microorganism can infect a variety of anatomical sites, causing a broad spectrum of pathologies ranging from superficial to invasive infections. It developed a variety of strategies to adopt to a changing microenvironment. This attributed to the emergence of resistance to antibiotics of different classes during the past six decades. Methicillin-resistant S. aureus (MRSA) was originally confined to health-care settings (health-care-associated MRSA). Later on, community-acquired MRSA was identified as another source of infections. Recent figures indicate that MRSA strains have been associated with approximately 75% of all S. aureus infections worldwide. Several guidelines have been published to establish an adequate treatment of skin and soft tissue infections (SSTIs) caused by MRSA strains. In the first part of this review, we focus on current treatment guidelines with a focus on medical drug therapy, but drug therapy has its own limitations. Recently, the interest in herbal remedies has greatly increased. There is growing evidence of antimicrobial activity of medicinal plants and their extracts. The second part of this review is dedicated to herbal compounds to circumvent antibiotic resistance. Herbal compounds may potentiate the action of antibiotics and restore the activities of antibacterial agents against which S. aureus has developed a drug resistance. Part 2 focuses on the role of S. aureus in pathology of the two major inflammatory skin diseases, i.e., atopic dermatitis (AD) and psoriasis. Finally, Part 3 provides an overview on natural compounds with antimicrobial activity against S. aureus and possible use in the treatment of SSTIs,","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"25 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140736843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-06DOI: 10.3889/oamjms.2024.10105
Opeyemi M. Folorunso, C. Frazzoli, O. Orisakwe
Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although both COVID-19 and HIV infections have been declared as pandemic at different times and both are known to cause lung injury, very few research has been done to determine the possibility of worsened lung injury in HIV patients infected with COVID-19. This systematic review attempts to determine the oxidative and inflammatory biomarkers associated with acute lung injury in HIV-positive population co-infected with COVID-19. Published studies in three databases were searched from January 1, 2019, to October 27, 2020. The search identified eight studies (with a total of 76 patients) that met the inclusion criteria and were included in the qualitative analysis of the systematic review. Among the eight studies, three were case reports describing 1–3 patients, four case series including 4–31 patients, and one was a cohort study. The Joanna Briggs Institute critical appraisal tools were used to assess the included studies. Qualitative analysis was used due to the heterogeneity of the study designs and the biomarkers measured. At present, C-reactive protein, Interleukin-6, D-dimer, and Lactate dehydrogenase have been found associated with the severity of disease, prognosis, and lung injury in HIV-positive patients coinfected with COVID-19. The causal association between elevated levels of these biomarkers and acute lung injury is still unknown; therefore, prospective studies are needed to determine biomarkers of lung injury useful for the prognosis and outcome of COVID-19 infection in the HIV population.
{"title":"PathophysiologyOxidative and Inflammatory Biomarkers of Lung injury in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) patients living with HIV","authors":"Opeyemi M. Folorunso, C. Frazzoli, O. Orisakwe","doi":"10.3889/oamjms.2024.10105","DOIUrl":"https://doi.org/10.3889/oamjms.2024.10105","url":null,"abstract":"Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although both COVID-19 and HIV infections have been declared as pandemic at different times and both are known to cause lung injury, very few research has been done to determine the possibility of worsened lung injury in HIV patients infected with COVID-19. This systematic review attempts to determine the oxidative and inflammatory biomarkers associated with acute lung injury in HIV-positive population co-infected with COVID-19. Published studies in three databases were searched from January 1, 2019, to October 27, 2020. The search identified eight studies (with a total of 76 patients) that met the inclusion criteria and were included in the qualitative analysis of the systematic review. Among the eight studies, three were case reports describing 1–3 patients, four case series including 4–31 patients, and one was a cohort study. The Joanna Briggs Institute critical appraisal tools were used to assess the included studies. Qualitative analysis was used due to the heterogeneity of the study designs and the biomarkers measured. At present, C-reactive protein, Interleukin-6, D-dimer, and Lactate dehydrogenase have been found associated with the severity of disease, prognosis, and lung injury in HIV-positive patients coinfected with COVID-19. The causal association between elevated levels of these biomarkers and acute lung injury is still unknown; therefore, prospective studies are needed to determine biomarkers of lung injury useful for the prognosis and outcome of COVID-19 infection in the HIV population.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"31 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140262497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-06DOI: 10.3889/oamjms.2024.11862
Neda Faraj, Manal AlHawiti, Sarah AlGosi
BACKGROUND: Pediatric acute transverse myelitis (ATM) is a potentially devastating condition with variable outcomes and presents significant demands on health and social care resources. CASE PRESENTATION: The patient in the present study was a 9-year-old boy, unknown to have chronic diseases. He was presented to Maternity and Children Hospital, Tabuk, with a history of acute progressive onset of unsteady gait and imbalance with pictures of encephalopathy. “Change level of consciousness” for >1 week, preceded by fever and upper respiratory tract infection symptoms. Physical findings were very suggestive and consistent with ATM. Diagnosis was confirmed by blood investigations, lumbar puncture analysis, and magnetic resonance imaging (MRI) brain, and spine. The analysis of lumbar puncture (cerebrospinal fluid) showed high white blood cells count and high protein level “more than 500.” The findings of MRI brain and spine were consistent with TM. The treatment was done initially with intravenous immunoglobulin (IVIG) by a dose of 2 g/kg divided over 2–4 days; followed by a dose of IV pulse steroid, 30 mg/kg/dose of methylprednisolone once a day for 3 days, with close monitor. The patient had a full physical and radiological recovery within less than one month. In conclusion, IVIG showed a significant role in the management of ATM together with steroid. CONCLUSION: IVIG showed a significant role in the management of ATM and could be used as a supportive treatment together with IV pulse steroid. IVIG showed a good efficacy with no serious complications.
{"title":"Case Report: Is Intravenous Immunoglobulin Important when Used Together with Pulse Steroid! Complete recovery within 1 Month of Pediatric Patient Diagnosed with Transverse Myelitis","authors":"Neda Faraj, Manal AlHawiti, Sarah AlGosi","doi":"10.3889/oamjms.2024.11862","DOIUrl":"https://doi.org/10.3889/oamjms.2024.11862","url":null,"abstract":"BACKGROUND: Pediatric acute transverse myelitis (ATM) is a potentially devastating condition with variable outcomes and presents significant demands on health and social care resources.\u0000CASE PRESENTATION: The patient in the present study was a 9-year-old boy, unknown to have chronic diseases. He was presented to Maternity and Children Hospital, Tabuk, with a history of acute progressive onset of unsteady gait and imbalance with pictures of encephalopathy. “Change level of consciousness” for >1 week, preceded by fever and upper respiratory tract infection symptoms. Physical findings were very suggestive and consistent with ATM. Diagnosis was confirmed by blood investigations, lumbar puncture analysis, and magnetic resonance imaging (MRI) brain, and spine. The analysis of lumbar puncture (cerebrospinal fluid) showed high white blood cells count and high protein level “more than 500.” The findings of MRI brain and spine were consistent with TM. The treatment was done initially with intravenous immunoglobulin (IVIG) by a dose of 2 g/kg divided over 2–4 days; followed by a dose of IV pulse steroid, 30 mg/kg/dose of methylprednisolone once a day for 3 days, with close monitor. The patient had a full physical and radiological recovery within less than one month. In conclusion, IVIG showed a significant role in the management of ATM together with steroid.\u0000CONCLUSION: IVIG showed a significant role in the management of ATM and could be used as a supportive treatment together with IV pulse steroid. IVIG showed a good efficacy with no serious complications.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"9 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140261902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-21DOI: 10.3889/oamjms.2024.11860
Gian Ivander, Albert Riantho, Yovita Anggono
AIM:This study aimed to perform a systematic review (SR) of SR to elucidate prior findings regarding favorable outcomes between platelet-rich plasma (PRP) and hyaluronic acid (HA) injections for early knee osteoarthritis (KOA). MATERIALS AND METHODS: We conducted a thorough literature search adhering to the Preferred Reporting Items for SR and Meta-analyses only for SRs from PubMed, ScienceDirect, and Google Scholar from 2020 to 2023. The inclusion and exclusion criteria were determined using the population, intervention, comparison, outcome, and study design model. A measurement tool to assess SR-2 was used to grade the included SRs. Two researchers independently searched, extracted, and assessed the risk of bias in the included studies. Cohen’s kappa coefficient was used to calculate the inter-observer disparities in study eligibility and risk of bias. The corrected covered area (CCA) metric addressed the overlap issue with the original studies. RESULTS: One SR yielded high methodological quality whereas three SRs yielded moderate methodological quality. The overall CCA among the four SRs was 30.77%, and all SRs used the Western Ontario and McMaster Universities Osteoarthritis Index score as a patient-reported outcome (PRO) and revealed that the PRP group improved more than the HA group. One SR used the Tegner score as a PRO and found no distinction between the PRP and HA groups. The incidence of substantial pain was lower in the PRP group than in the HA group. One SR reported considerably lower local pain post-injection in the HA groups. Overall, three SRs showed that PRP yielded better outcomes than the HA, and one showed that PRP showed advantages over HA injections for knee pain at 6 and 12 months; however, the clinical outcomes were not different. CONCLUSION: Our findings supported the superiority of PRP over HA as a long-term alternative therapy for early-stage KOA.
目的：本研究旨在对SR进行系统性综述（SR），以阐明先前关于富血小板血浆（PRP）和透明质酸（HA）注射治疗早期膝骨关节炎（KOA）的有利结果的研究结果。材料与方法：我们在2020年至2023年期间对PubMed、ScienceDirect和Google Scholar上的SR和Meta分析进行了全面的文献检索，并遵守SR和Meta分析的首选报告项目。采用人群、干预、比较、结果和研究设计模式确定纳入和排除标准。使用SR-2评估工具对纳入的SR进行分级。两名研究人员独立搜索、提取并评估了纳入研究的偏倚风险。科恩卡帕系数（Cohen's kappa coefficient）用于计算研究资格和偏倚风险的观察者间差异。结果：一项研究的方法学质量较高，三项研究的方法学质量中等。四项SR的总体CCA为30.77%，所有SR均使用西安大略和麦克马斯特大学骨关节炎指数评分作为患者报告结果（PRO），结果显示PRP组的改善程度高于HA组。一位研究人员使用 Tegner 评分作为患者报告结果，结果发现 PRP 组和 HA 组之间没有区别。PRP 组的剧烈疼痛发生率低于 HA 组。一份研究报告称，HA 组注射后局部疼痛明显减轻。结论：我们的研究结果支持 PRP 作为早期 KOA 的长期替代疗法优于 HA。
{"title":"Platelet-rich Plasma Superiority over Hyaluronic Acid as a Conservative Treatment for Early Knee Osteoarthritis: A Systematic Review","authors":"Gian Ivander, Albert Riantho, Yovita Anggono","doi":"10.3889/oamjms.2024.11860","DOIUrl":"https://doi.org/10.3889/oamjms.2024.11860","url":null,"abstract":"AIM:This study aimed to perform a systematic review (SR) of SR to elucidate prior findings regarding favorable outcomes between platelet-rich plasma (PRP) and hyaluronic acid (HA) injections for early knee osteoarthritis (KOA).\u0000MATERIALS AND METHODS: We conducted a thorough literature search adhering to the Preferred Reporting Items for SR and Meta-analyses only for SRs from PubMed, ScienceDirect, and Google Scholar from 2020 to 2023. The inclusion and exclusion criteria were determined using the population, intervention, comparison, outcome, and study design model. A measurement tool to assess SR-2 was used to grade the included SRs. Two researchers independently searched, extracted, and assessed the risk of bias in the included studies. Cohen’s kappa coefficient was used to calculate the inter-observer disparities in study eligibility and risk of bias. The corrected covered area (CCA) metric addressed the overlap issue with the original studies.\u0000RESULTS: One SR yielded high methodological quality whereas three SRs yielded moderate methodological quality. The overall CCA among the four SRs was 30.77%, and all SRs used the Western Ontario and McMaster Universities Osteoarthritis Index score as a patient-reported outcome (PRO) and revealed that the PRP group improved more than the HA group. One SR used the Tegner score as a PRO and found no distinction between the PRP and HA groups. The incidence of substantial pain was lower in the PRP group than in the HA group. One SR reported considerably lower local pain post-injection in the HA groups. Overall, three SRs showed that PRP yielded better outcomes than the HA, and one showed that PRP showed advantages over HA injections for knee pain at 6 and 12 months; however, the clinical outcomes were not different.\u0000CONCLUSION: Our findings supported the superiority of PRP over HA as a long-term alternative therapy for early-stage KOA.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"25 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140442490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Perivascular epithelioid cell tumor (PEComa) is a type of mesenchymal tumor composed of histologically and immunohistochemically distinctive perivascular epithelioid cells. Benign mesenteric PEComa is a rare entity as there has been only one case reported so far. We are presenting a case of benign mesenteric PEComa in a 30-year-old female that presented with abdominal pain and was diagnosed by microscopic morphological examination and immunohistochemical staining. The aim of this case report is to make health-care professionals aware of the diagnostic criteria in similar presentations, treatment modalities offered for this patient, and others reported over the years for malignant as well as benign PEComas and also shedding the light on a new presentation and diagnosis. CASE REPORT: We reported a case of a 30-year-old female who presented with abdominal pain radiating to the back and rectum. After a thorough physical examination which was unremarkable, a CT scan was done which showed a mesenteric mass. This mass was then resected and sent for histopathology which revealed a PEComa. We report the history, clinical findings, laboratory reports, and gross imaging of a 30-year-old female who presented to our clinic and was diagnosed with a very rare benign mesenteric PEComa. CONCLUSION: PEComa is a rare tumor, and as PEComas arising from the mesentery being one of the rarer kinds with only 10 cases reported and this case being the 11th, out of those ten cases, only two of them were found to be benign which makes the case we are reporting the second benign mesenteric PEComa reported in English Literature.
{"title":"Benign Perivascular Epithelioid Cell Tumor of the Mesentery Misdiagnosed as a Uterine Fibroid: A Case Report and Review of Literature","authors":"Omar Al-Nahhas, Aysha Simran Haris, Yousif Basim Raad, Khaled Alaboud Alkheder, Kenichi Miyata","doi":"10.3889/oamjms.2024.11842","DOIUrl":"https://doi.org/10.3889/oamjms.2024.11842","url":null,"abstract":"BACKGROUND: Perivascular epithelioid cell tumor (PEComa) is a type of mesenchymal tumor composed of histologically and immunohistochemically distinctive perivascular epithelioid cells. Benign mesenteric PEComa is a rare entity as there has been only one case reported so far. We are presenting a case of benign mesenteric PEComa in a 30-year-old female that presented with abdominal pain and was diagnosed by microscopic morphological examination and immunohistochemical staining. The aim of this case report is to make health-care professionals aware of the diagnostic criteria in similar presentations, treatment modalities offered for this patient, and others reported over the years for malignant as well as benign PEComas and also shedding the light on a new presentation and diagnosis.\u0000CASE REPORT: We reported a case of a 30-year-old female who presented with abdominal pain radiating to the back and rectum. After a thorough physical examination which was unremarkable, a CT scan was done which showed a mesenteric mass. This mass was then resected and sent for histopathology which revealed a PEComa. We report the history, clinical findings, laboratory reports, and gross imaging of a 30-year-old female who presented to our clinic and was diagnosed with a very rare benign mesenteric PEComa.\u0000CONCLUSION: PEComa is a rare tumor, and as PEComas arising from the mesentery being one of the rarer kinds with only 10 cases reported and this case being the 11th, out of those ten cases, only two of them were found to be benign which makes the case we are reporting the second benign mesenteric PEComa reported in English Literature.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"229 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140456029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-14DOI: 10.3889/oamjms.2024.11840
Andrej Petrov, Djengis Jashar, Deva Petrova
BACKGROUND: Melanoma in situ (MIS) is the very early stage of a skin tumor called melanoma. In recent decades, the incidence rate for melanoma has increased by 2.6%/year and MIS is the main diagnosis responsible for this increase. It is important to recognize MIS since in this phase (called the intraepidermal phase), cancer cells do not have the opportunity to spread anywhere in the body. The use of dermoscopy has contributed to the early diagnosis of melanoma. The most common dermoscopic features of melanoma are multiple structures and colors (multicomponent pattern), an atypical reticular pattern (with wide, irregular meshes), and an absence of distinguishing features (nonspecific pattern) associated with the presence of vascular structures. The clinical decision about the excision of the lesion should always be in correlation with the dermoscopic picture of the pigmented lesion. If dermoscopy is unclear and there is suspicion for MIS, surgical excision with a wide margin of more than 5 mm should be performed. AIM: In this work, we are presenting four cases of diagnosis of MIS and their clinical, dermoscopic, and histopathological findings. METHODS: In this work, we present four cases of diagnosis of MIS, their clinical, dermoscopic and histopathological findings. RESULTS: The invasive melanoma cohort, compared with the MIS cohort, had an elevated risk for subsequent invasive melanoma in the first 10 years. However, the MIS cohort was more likely to develop subsequent MIS during the entire follow-up period than the invasive melanoma cohort. In our work, none of the four patients that we presented had relapsed during the first 2 years of follow-up, which is consistent with these results. CONCLUSION: With the presentation of these cases, we want to stress and help clinicians that the main focus in dermoscopy assessment of MIS is on the asymmetry of the pigmented network and a two-color sign because many other marks of melanoma are missing.
背景：原位黑色素瘤（MIS）是皮肤肿瘤黑色素瘤的早期阶段。近几十年来，黑色素瘤的发病率以每年 2.6% 的速度增长，而原位黑色素瘤是导致这一增长的主要诊断依据。识别 MIS 非常重要，因为在这一阶段（称为表皮内阶段），癌细胞没有机会扩散到身体的任何地方。皮肤镜的使用有助于黑色素瘤的早期诊断。黑色素瘤最常见的皮肤镜特征是多结构、多颜色（多成分模式）、非典型网状模式（网眼宽而不规则），以及缺乏与血管结构相关的特征（非特异性模式）。临床决定是否切除病变时，应始终结合皮肤镜下色素病变的图像。如果皮肤镜检查结果不明确，并怀疑是 MIS，则应进行手术切除，切除范围应大于 5 毫米。目的：本文将介绍四例 MIS 诊断病例及其临床、皮肤镜检查和组织病理学检查结果。结果：侵袭性黑色素瘤队列与 MIS 队列相比，在最初 10 年内罹患后续侵袭性黑色素瘤的风险较高。然而，在整个随访期间，MIS 组群比浸润性黑色素瘤组群更有可能继发 MIS。结论：通过这些病例的介绍，我们希望强调并帮助临床医生在皮肤镜下评估 MIS 时主要关注色素网的不对称性和双色征，因为黑色素瘤的许多其他标志都会缺失。
{"title":"DermatologyClinical and Dermatoscopic Characteristics of Melanoma in situ - Institutional Experience","authors":"Andrej Petrov, Djengis Jashar, Deva Petrova","doi":"10.3889/oamjms.2024.11840","DOIUrl":"https://doi.org/10.3889/oamjms.2024.11840","url":null,"abstract":"BACKGROUND: Melanoma in situ (MIS) is the very early stage of a skin tumor called melanoma. In recent decades, the incidence rate for melanoma has increased by 2.6%/year and MIS is the main diagnosis responsible for this increase. It is important to recognize MIS since in this phase (called the intraepidermal phase), cancer cells do not have the opportunity to spread anywhere in the body. The use of dermoscopy has contributed to the early diagnosis of melanoma. The most common dermoscopic features of melanoma are multiple structures and colors (multicomponent pattern), an atypical reticular pattern (with wide, irregular meshes), and an absence of distinguishing features (nonspecific pattern) associated with the presence of vascular structures. The clinical decision about the excision of the lesion should always be in correlation with the dermoscopic picture of the pigmented lesion. If dermoscopy is unclear and there is suspicion for MIS, surgical excision with a wide margin of more than 5 mm should be performed.\u0000AIM: In this work, we are presenting four cases of diagnosis of MIS and their clinical, dermoscopic, and histopathological findings.\u0000METHODS: In this work, we present four cases of diagnosis of MIS, their clinical, dermoscopic and histopathological findings.\u0000RESULTS: The invasive melanoma cohort, compared with the MIS cohort, had an elevated risk for subsequent invasive melanoma in the first 10 years. However, the MIS cohort was more likely to develop subsequent MIS during the entire follow-up period than the invasive melanoma cohort. In our work, none of the four patients that we presented had relapsed during the first 2 years of follow-up, which is consistent with these results.\u0000CONCLUSION: With the presentation of these cases, we want to stress and help clinicians that the main focus in dermoscopy assessment of MIS is on the asymmetry of the pigmented network and a two-color sign because many other marks of melanoma are missing.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"260 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140456934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-13DOI: 10.3889/oamjms.2024.11838
Sandra Atanasova, Sofija Carceva Salja, B. Dzipunova
BACKGROUND: Improving smile aesthetics is the main reason patients seek different treatments. AIM: This study aimed to evaluate some of the smile characteristics in patients with completed orthodontic treatment and patients with different types of dentoalveolar malocclusion using the method of photogrammetric analysis. MATERIALS AND METHODS: The sample consisted of 52 young adults aged 16–35 years. A standardized smile analysis was used to evaluate ten smile characteristics. Two frontal digital photographs were taken for each individual, one at rest and the other with a posed smile. RESULTS: A student’s t-test was used to evaluate the differences between the mean values of the smile characteristics of each type of malocclusion in untreated and treated patients. Comparing the characteristics of the smile in the study groups of treated and untreated patients with a subgroup of Class I and Class III malocclusion, no significant difference was observed in the mean values of the studied parameters. A statistically significant difference was observed only in the mean values of upper incisor exposure and left buccal corridor between untreated and treated patients with class II malocclusion. CONCLUSION: Knowledge of the correlation between hard and soft-tissue anatomy and smile esthetics has important clinical significance; therefore, the components of the smile should be considered as a guide to assist in orthodontic diagnosis and treatment planning.
背景：改善微笑美观是患者寻求不同治疗的主要原因。目的：本研究旨在使用摄影测量分析方法，评估已完成正畸治疗的患者和不同类型牙槽骨错合畸形患者的一些微笑特征。采用标准化微笑分析法评估十种微笑特征。结果：采用学生 t 检验来评估未治疗和已治疗患者每种错颌畸形的微笑特征平均值之间的差异。比较研究组中接受治疗和未接受治疗的 I 类和 III 类错牙合畸形患者的微笑特征，未发现研究参数的平均值有显著差异。结论：了解软硬组织解剖与微笑美学之间的相关性具有重要的临床意义；因此，微笑的组成部分应被视为辅助正畸诊断和治疗计划的指南。
{"title":"Analysis of Different Vertical and Horizontal Smile Characteristics","authors":"Sandra Atanasova, Sofija Carceva Salja, B. Dzipunova","doi":"10.3889/oamjms.2024.11838","DOIUrl":"https://doi.org/10.3889/oamjms.2024.11838","url":null,"abstract":"BACKGROUND: Improving smile aesthetics is the main reason patients seek different treatments.\u0000AIM: This study aimed to evaluate some of the smile characteristics in patients with completed orthodontic treatment and patients with different types of dentoalveolar malocclusion using the method of photogrammetric analysis.\u0000MATERIALS AND METHODS: The sample consisted of 52 young adults aged 16–35 years. A standardized smile analysis was used to evaluate ten smile characteristics. Two frontal digital photographs were taken for each individual, one at rest and the other with a posed smile.\u0000RESULTS: A student’s t-test was used to evaluate the differences between the mean values of the smile characteristics of each type of malocclusion in untreated and treated patients. Comparing the characteristics of the smile in the study groups of treated and untreated patients with a subgroup of Class I and Class III malocclusion, no significant difference was observed in the mean values of the studied parameters. A statistically significant difference was observed only in the mean values of upper incisor exposure and left buccal corridor between untreated and treated patients with class II malocclusion.\u0000CONCLUSION: Knowledge of the correlation between hard and soft-tissue anatomy and smile esthetics has important clinical significance; therefore, the components of the smile should be considered as a guide to assist in orthodontic diagnosis and treatment planning.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"172 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140457355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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