Liver cancer is the sixth most common cancer worldwide in terms of the number of cases (626,000 or 5.7% of new cancer cases) but due to the very poor prognosis, the number of deaths is nearly similar (598,000). The survival rate is 3% to 5% in cancer registries for the United States and developing countries. The modality of treatment in hepatocellular carcinoma (HCC) patients depends on the stage of the disease. The Barcelona Clinic Liver Cancer Classification (BCLC) is the favorite staging system. There are many patients who initially present with the intermediate-stage disease, and in this setting transarterial chemoembolization (TACE) is the treatment of choice. The purpose of this article is to highlight and discuss the role of chemoembolization in the treatment of hepatocellular carcinoma, including the results of recent large studies, and the concept of combined therapies, illustrating our case. The differences in individual factors that are not captured by the BCLC framework, such as the tumor growth pattern, degree of hypervascularity, and vascular supply, complicate the further evaluation of these patients. Because of these differences, not all patients benefit equally from TACE. Several tools have been devised to aid the decision-making process which have shown promising initial results but have failed external evaluation and have not been translated to the clinical aspects. Criteria for treatment decisions in daily clinical practice are needed in all stages of the disease. Conclusion: TACE is a safe method for prolonging patients' survival with unresectable HCC. The correct treatment of HCC is concentrated in cancer centers, and cooperation between multiple specialists is necessary.
{"title":"Transarterial Chemoembolization in Hepatocellular Carcinoma, Albanian Experience.","authors":"I. Laçi, A. Spahiu","doi":"10.32391/ajtes.v6i2.291","DOIUrl":"https://doi.org/10.32391/ajtes.v6i2.291","url":null,"abstract":"Liver cancer is the sixth most common cancer worldwide in terms of the number of cases (626,000 or 5.7% of new cancer cases) but due to the very poor prognosis, the number of deaths is nearly similar (598,000). The survival rate is 3% to 5% in cancer registries for the United States and developing countries. The modality of treatment in hepatocellular carcinoma (HCC) patients depends on the stage of the disease. The Barcelona Clinic Liver Cancer Classification (BCLC) is the favorite staging system. There are many patients who initially present with the intermediate-stage disease, and in this setting transarterial chemoembolization (TACE) is the treatment of choice. \u0000The purpose of this article is to highlight and discuss the role of chemoembolization in the treatment of hepatocellular carcinoma, including the results of recent large studies, and the concept of combined therapies, illustrating our case. \u0000The differences in individual factors that are not captured by the BCLC framework, such as the tumor growth pattern, degree of hypervascularity, and vascular supply, complicate the further evaluation of these patients. Because of these differences, not all patients benefit equally from TACE. Several tools have been devised to aid the decision-making process which have shown promising initial results but have failed external evaluation and have not been translated to the clinical aspects. Criteria for treatment decisions in daily clinical practice are needed in all stages of the disease. \u0000Conclusion: TACE is a safe method for prolonging patients' survival with unresectable HCC. The correct treatment of HCC is concentrated in cancer centers, and cooperation between multiple specialists is necessary.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48818671","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}
E. Muço, Astrit Xhemali, A. Hasa, Deniona Nurci, N. Çomo
Background; Coronavirus disease-19 (COVID-19) is an infectious respiratory disease. The first confirmed case of 2019-nCoV infection in Albania was reported in Tirana on 08 March 2020, when a patient and his adult son who had come from Florence, Italy tested positive. Patients with COVID-19 can be presented with a series of signs and symptoms. Acute abdomen as a presentation of COVID-19 is rare. The diagnosis of COVID-19 should be suspected and investigated in every case of acute abdomen. Case presentation: We report a case of a 42-year-old male who presented with features of acute appendicitis. SARS-CoV-2 polymerase chain reaction test result was positive for COVID-19. Abdominal ultrasonography and his computed tomography of the chest and abdomen showed a perforated appendix and no infiltrates or abnormalities of COVID-19. The diagnosis of our case was appendicitis with COVID-19 without pneumonia. He was admitted and treated with antibiotic therapy and supportive care. He had an improvement in his health condition which made it possible to leave the hospital on the third day of hospitalization. Conclusion: Based on our clinical case and literature data, we suggest that clinicians should suspect the diagnosis of acute appendicitis in patients with COVID 19. So the case of acute abdomen pain must be completed with a SARS-CoV-2 test. Therefore we recommend additional studies to reinforce the idea of linking SARS COV 2 infection with acute appendicitis.
{"title":"Is acute Appendicitis as an extra Pulmonary Manifestation of Covid-19 infection?","authors":"E. Muço, Astrit Xhemali, A. Hasa, Deniona Nurci, N. Çomo","doi":"10.32391/ajtes.v6i2.278","DOIUrl":"https://doi.org/10.32391/ajtes.v6i2.278","url":null,"abstract":"Background; Coronavirus disease-19 (COVID-19) is an infectious respiratory disease. The first confirmed case of 2019-nCoV infection in Albania was reported in Tirana on 08 March 2020, when a patient and his adult son who had come from Florence, Italy tested positive. Patients with COVID-19 can be presented with a series of signs and symptoms. Acute abdomen as a presentation of COVID-19 is rare. The diagnosis of COVID-19 should be suspected and investigated in every case of acute abdomen. \u0000Case presentation: We report a case of a 42-year-old male who presented with features of acute appendicitis. SARS-CoV-2 polymerase chain reaction test result was positive for COVID-19. Abdominal ultrasonography and his computed tomography of the chest and abdomen showed a perforated appendix and no infiltrates or abnormalities of COVID-19. The diagnosis of our case was appendicitis with COVID-19 without pneumonia. He was admitted and treated with antibiotic therapy and supportive care. He had an improvement in his health condition which made it possible to leave the hospital on the third day of hospitalization. \u0000Conclusion: Based on our clinical case and literature data, we suggest that clinicians should suspect the diagnosis of acute appendicitis in patients with COVID 19. So the case of acute abdomen pain must be completed with a SARS-CoV-2 test. Therefore we recommend additional studies to reinforce the idea of linking SARS COV 2 infection with acute appendicitis.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44840153","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}
With all the measures taken, the trend of liver cancer cases has increased worldwide, as a consequence, this is accompanied by an increase in mortality by 43% (10.3 per 100,000 in 2016 (USA)) [1, 2]. Liver cancer is also associated with the lowest 5-year survival rate among all types of cancer (19%) [1]. Liver cancer (including intrahepatic bile duct cancer) was the ninth leading cause of cancer death in 2000 and rose to sixth in 2016 [3]. This shows that the identification of safe and effective treatments for liver cancer is urgent now. Microwave ablation is a thermal ablation modality that has particular applicability in treating hepatic malignancies primary tumors or metastases. Microwaves can generate very high temperatures in short time periods, potentially leading to improved treatment efficiency in larger ablation zones. We will show a patient male 55 years old. Post-surgery of colon cancer 6 months ago. Normal exam. There is e liver metastasis in the right lobe subcapsular 22mm. The patient was a good candidate for MWA. Conclusions MWA is an effective and safe alternative in patients/tumors that are not suitable for resection. Survival and recurrence outcomes after MWA are significantly improved with significantly shorter hospital stays and operative times, with little or no intraoperative blood loss and minor complications. Its use should be extended more and more in the field of treatment of these patients depending on the therapeutic indications
{"title":"Non-surgical Treatment of Metastatic Liver Tumors with Microwave Ablation.","authors":"I. Laçi, A. Spahiu","doi":"10.32391/ajtes.v6i2.289","DOIUrl":"https://doi.org/10.32391/ajtes.v6i2.289","url":null,"abstract":"With all the measures taken, the trend of liver cancer cases has increased worldwide, as a consequence, this is accompanied by an increase in mortality by 43% (10.3 per 100,000 in 2016 (USA)) [1, 2]. \u0000Liver cancer is also associated with the lowest 5-year survival rate among all types of cancer (19%) [1]. \u0000Liver cancer (including intrahepatic bile duct cancer) was the ninth leading cause of cancer death in 2000 and rose to sixth in 2016 [3]. \u0000This shows that the identification of safe and effective treatments for liver cancer is urgent now. \u0000Microwave ablation is a thermal ablation modality that has particular applicability in treating hepatic malignancies primary tumors or metastases. Microwaves can generate very high temperatures in short time periods, potentially leading to improved treatment efficiency in larger ablation zones. \u0000We will show a patient male 55 years old. Post-surgery of colon cancer 6 months ago. Normal exam. There is e liver metastasis in the right lobe subcapsular 22mm. The patient was a good candidate for MWA. \u0000Conclusions \u0000MWA is an effective and safe alternative in patients/tumors that are not suitable for resection. Survival and recurrence outcomes after MWA are significantly improved with significantly shorter hospital stays and operative times, with little or no intraoperative blood loss and minor complications. Its use should be extended more and more in the field of treatment of these patients depending on the therapeutic indications","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44814461","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}
R. Alimehmeti, Florian Dashi, Arba Cecia, G. Braçe, M. Demneri
Background; Pain at the surgical site is an important concern, especially in locations of main joints which may resolve important limitations of movement. Materials and Methods; We present the case of painful dysesthesia after knee surgery for traumatic meniscal rupture in a young lady. She presented with painful dysesthesia, limitation of knee flexion, and severe pain in light touch and pressure on the mid-patellar area of the left knee. Tinel’s sign at the site of surgical scar, dysesthetic area (abnormal sensation) corresponded with the medial reticular nerve at surgical exploration under a microscope. Results; Microsurgical exploration of the three nerves of medial subcutaneous nerves revealed the branch stack in the scar. The distal end was internalized subfascial inside the muscle fibers of the medial vastus of quadriceps femoris muscle according to Dellon. The other two were released from adherences and found to be in anatomical continuity were left in place. Immediate resolution of dysesthesia was referred by the patient and the amplitude of motion was complete at one-month postoperative control. She remains pain-free 4 months from surgery and the area of dysesthesia remains anesthetic at the center. Conclusions; Surgical identification and rerouting of the distal end of sensitive nerves is an efficient treatment after peripheral nerve injury.
{"title":"Surgical Treatment of Painful Nerve Injury after Knee Arthroscopy.","authors":"R. Alimehmeti, Florian Dashi, Arba Cecia, G. Braçe, M. Demneri","doi":"10.32391/ajtes.v6i2.275","DOIUrl":"https://doi.org/10.32391/ajtes.v6i2.275","url":null,"abstract":"Background; Pain at the surgical site is an important concern, especially in locations of main joints which may resolve important limitations of movement. \u0000Materials and Methods; We present the case of painful dysesthesia after knee surgery for traumatic meniscal rupture in a young lady. She presented with painful dysesthesia, limitation of knee flexion, and severe pain in light touch and pressure on the mid-patellar area of the left knee. \u0000Tinel’s sign at the site of surgical scar, dysesthetic area (abnormal sensation) corresponded with the medial reticular nerve at surgical exploration under a microscope. \u0000Results; Microsurgical exploration of the three nerves of medial subcutaneous nerves revealed the branch stack in the scar. The distal end was internalized subfascial inside the muscle fibers of the medial vastus of quadriceps femoris muscle according to Dellon. The other two were released from adherences and found to be in anatomical continuity were left in place. Immediate resolution of dysesthesia was referred by the patient and the amplitude of motion was complete at one-month postoperative control. She remains pain-free 4 months from surgery and the area of dysesthesia remains anesthetic at the center. \u0000Conclusions; Surgical identification and rerouting of the distal end of sensitive nerves is an efficient treatment after peripheral nerve injury.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42131534","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}
Nefise Büşra Çelik, A. U. Seyhan, Semih Korkut, E. Yılmaz, Nurhayat Başkaya, N. Şahin
Background: The aim of this study is to evaluate the sociodemographic characteristics, clinical conditions, and results of patients who were admitted to the emergency department (ED) due to suicide attempts by self-poisoning intentionally. Methods: This retrospective study was conducted between January 1 and December 31, 2017, in the ED of Istanbul Lutfi Kırdar City Hospital, University of Health Sciences. Patients of only attempted suicide through taking overdose drugs with the intent of self-poisoning and over 12 ages were included in the study, which included 391 cases. Patients who attempted suicide in any different ways than self-poisoning were excluded. Results: Our study is consisted 69.8% (n=273) of female and 30.2% (n=18) of male patients. The mean age of the total cases was 31.01±12.064, which the youngest case being 14 years old and the oldest being 73 years old. The marital status of the cases is as follows: 140 (35.8%) married, 205 (52.4%) unmarried, 42 (10.7%) divorced, and 4 (1%) widow/widower. Istanbul is covering a major population of patients (93.1%) as a living place. The study has resulted in 58.3% ED discharge, 27.1% hospital leaving, and 10.5% Psychiatry unit admission. It can be stated that elderly people aim for death more than young people via their suicide attempts. The reasons for the suicide of the patients included in the study were grouped as a secondary gain, anger, and death. We found that secondary gain was the reason for teens mostly. We divided into categories clinical results as ED discharge, psychiatrist hospitalization, Intensive care unit (ICU) admission, and discharge against medical advice (DAMA). The patients who attempted suicide with the aim of death were hospitalized in the psychiatry unit, and the attempts caused by secondary gain were discharged from the ED. Patients who had taken paracetamol for suicide, which is contain 70.10% of the total cases, were discharged from the ED, after the examination. It was detected that 39.29% of the cases who had Suicidal ideations again, had a psychiatric disease in their medical history. Conclusions: Suicidal behavior is a very comprehensive topic when considering its etiology and risk factors, there are many variables as well. Since it is one of the serious public health issues and causes of death, the risk factors must be identified and preventions to be taken should be determined. In addition, when elderly people attempt suicide, more medical care should be taken during ED, since they are more focused to die and fall into the category of severe cases.
{"title":"Characteristics of Patients who Visited the Emergency Department due to self-poisoning Suicide Attempt: A Retrospective Study.","authors":"Nefise Büşra Çelik, A. U. Seyhan, Semih Korkut, E. Yılmaz, Nurhayat Başkaya, N. Şahin","doi":"10.32391/ajtes.v6i2.290","DOIUrl":"https://doi.org/10.32391/ajtes.v6i2.290","url":null,"abstract":"Background: The aim of this study is to evaluate the sociodemographic characteristics, clinical conditions, and results of patients who were admitted to the emergency department (ED) due to suicide attempts by self-poisoning intentionally. \u0000Methods: This retrospective study was conducted between January 1 and December 31, 2017, in the ED of Istanbul Lutfi Kırdar City Hospital, University of Health Sciences. Patients of only attempted suicide through taking overdose drugs with the intent of self-poisoning and over 12 ages were included in the study, which included 391 cases. Patients who attempted suicide in any different ways than self-poisoning were excluded. \u0000Results: Our study is consisted 69.8% (n=273) of female and 30.2% (n=18) of male patients. The mean age of the total cases was 31.01±12.064, which the youngest case being 14 years old and the oldest being 73 years old. The marital status of the cases is as follows: 140 (35.8%) married, 205 (52.4%) unmarried, 42 (10.7%) divorced, and 4 (1%) widow/widower. Istanbul is covering a major population of patients (93.1%) as a living place. The study has resulted in 58.3% ED discharge, 27.1% hospital leaving, and 10.5% Psychiatry unit admission. It can be stated that elderly people aim for death more than young people via their suicide attempts. The reasons for the suicide of the patients included in the study were grouped as a secondary gain, anger, and death. We found that secondary gain was the reason for teens mostly. We divided into categories clinical results as ED discharge, psychiatrist hospitalization, Intensive care unit (ICU) admission, and discharge against medical advice (DAMA). The patients who attempted suicide with the aim of death were hospitalized in the psychiatry unit, and the attempts caused by secondary gain were discharged from the ED. Patients who had taken paracetamol for suicide, which is contain 70.10% of the total cases, were discharged from the ED, after the examination. It was detected that 39.29% of the cases who had Suicidal ideations again, had a psychiatric disease in their medical history. \u0000Conclusions: Suicidal behavior is a very comprehensive topic when considering its etiology and risk factors, there are many variables as well. Since it is one of the serious public health issues and causes of death, the risk factors must be identified and preventions to be taken should be determined. In addition, when elderly people attempt suicide, more medical care should be taken during ED, since they are more focused to die and fall into the category of severe cases.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48159884","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}
Blunt renal artery injuries are rare, and no single trauma center has accumulated sufficient experience to draw meaningful conclusions or recommendations about optimal therapeutic strategies.[1] The increased use of CT scans to evaluate blunt abdominal trauma identifies more acute renal artery injuries that may have gone undetected.[2] Patients with renal injury have limited options such as open surgical repair or anticoagulation.[3] The use of endovascular stents to treat trauma is a good option treatment. [4] But not every case is successful. The purpose of this case report is to describe the importance of accurate diagnosis and successful repair in emergency traumatic conditions by means of interventional radiology in cases of intimal damage to the renal arteries. We will present a 38-year-old man who shows on the emergency room because of an accident with abdominal and thoracic trauma. The patient complained of pain in the right side of the abdomen… Through Angiography, an intimal dissection localized in the upper pole of the right kidney was confirmed. We inserted an expandable balloon stent using a transfemoral approach to successfully repair the dissection. Conclusion: Blunt renal artery injury is rare. Nonoperative management should be considered an acceptable therapeutic option. Management of blunt renal injuries includes timely evaluation to maximize the preservation of renal function. Recent management trends support the consideration of endoluminal intervention for traumatic renal artery dissections.
{"title":"Endovascular Treatment of post-traumatic Renal Artery Dissection.","authors":"I. Laçi, A. Spahiu","doi":"10.32391/ajtes.v6i2.288","DOIUrl":"https://doi.org/10.32391/ajtes.v6i2.288","url":null,"abstract":"Blunt renal artery injuries are rare, and no single trauma center has accumulated sufficient experience to draw meaningful conclusions or recommendations about optimal therapeutic strategies.[1] \u0000The increased use of CT scans to evaluate blunt abdominal trauma identifies more acute renal artery injuries that may have gone undetected.[2] \u0000Patients with renal injury have limited options such as open surgical repair or anticoagulation.[3] The use of endovascular stents to treat trauma is a good option treatment. [4] But not every case is successful. \u0000The purpose of this case report is to describe the importance of accurate diagnosis and successful repair in emergency traumatic conditions by means of interventional radiology in cases of intimal damage to the renal arteries. \u0000We will present a 38-year-old man who shows on the emergency room because of an accident with abdominal and thoracic trauma. The patient complained of pain in the right side of the abdomen… \u0000Through Angiography, an intimal dissection localized in the upper pole of the right kidney was confirmed. We inserted an expandable balloon stent using a transfemoral approach to successfully repair the dissection. \u0000Conclusion: Blunt renal artery injury is rare. Nonoperative management should be considered an acceptable therapeutic option. Management of blunt renal injuries includes timely evaluation to maximize the preservation of renal function. Recent management trends support the consideration of endoluminal intervention for traumatic renal artery dissections.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43621028","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}
Nusret Xhaferi, A. Gavrilovski, M. Jakimova, Fatime Ukaj, Dea Dyla, Skender Ukaj
Abstract: A parasitic disease called actinomycosis occurs when bacteria spread through body tissues, causing abscesses, inflammation, and pain. It affects the skin or deeper parts of the body and can sometimes affect the blood.[1] The symptoms of actinomycosis may mimic those of other diseases or even neoplasms. Remission and exacerbation of symptoms occurring in parallel sequence with the initiation and cessation of therapy is a phenomenon that should increase suspicion of actinomycosis in any of its manifestations. [2] Microbiology, histopathology, and MRI revealed the presence of an unusual infectious agent, Actinomyces spp., which is also known as Madura foot [3] This implies a serious difficulty in getting a bactericidal concentration of the effective drug into areas of active infection and seriously questions the possibility of restoring the involved tissues [4, 8] The diagnosis was confirmed by isolation of the organisms by anaerobic culture giving typical molar tooth colonies. Final confirmation was done by histopathological examination. Case report; The patient's condition dates back 5 years before the operative treatment when for the first time the patient reported that she was stabbed with a foreign body in the area of the left foot. The patient was treated at home and in the beginning, did not go to the doctor. She occasionally complained of pain and swelling but the pain was not distressing, with no fever and no swelling of the foot…
{"title":"Primary Actinomycosis of the Foot in a 37-year-old female Patient: A Case Study and Review of the Literature.","authors":"Nusret Xhaferi, A. Gavrilovski, M. Jakimova, Fatime Ukaj, Dea Dyla, Skender Ukaj","doi":"10.32391/ajtes.v6i2.270","DOIUrl":"https://doi.org/10.32391/ajtes.v6i2.270","url":null,"abstract":"Abstract: \u0000A parasitic disease called actinomycosis occurs when bacteria spread through body tissues, causing abscesses, inflammation, and pain. It affects the skin or deeper parts of the body and can sometimes affect the blood.[1] The symptoms of actinomycosis may mimic those of other diseases or even neoplasms. Remission and exacerbation of symptoms occurring in parallel sequence with the initiation and cessation of therapy is a phenomenon that should increase suspicion of actinomycosis in any of its manifestations. [2] \u0000Microbiology, histopathology, and MRI revealed the presence of an unusual infectious agent, Actinomyces spp., which is also known as Madura foot [3] This implies a serious difficulty in getting a bactericidal concentration of the effective drug into areas of active infection and seriously questions the possibility of restoring the involved tissues [4, 8] \u0000The diagnosis was confirmed by isolation of the organisms by anaerobic culture giving typical molar tooth colonies. Final confirmation was done by histopathological examination. \u0000Case report; The patient's condition dates back 5 years before the operative treatment when for the first time the patient reported that she was stabbed with a foreign body in the area of the left foot. \u0000The patient was treated at home and in the beginning, did not go to the doctor. She occasionally complained of pain and swelling but the pain was not distressing, with no fever and no swelling of the foot…","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47409155","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}
Anila Pema (Kristo), D. Tarifa, M. Ikonomi, F. Proko, Alketa Ymeri, Lindita Shehu, Besiana Poga
Introduction; There are data on an increase in cancer cases in Albania in recent decades, this growing trend of cancer in the Albanian population is due to the rapid increase of habits or unhealthy behaviours such as; smoking, excessive alcohol consumption, unhealthy diet, high levels of obesity, and physical inactivity. However, Albanian men and women show one of the lowest values (in terms of age) in the region of Southeast Europe. In Albania still, we do not have official data regarding the number of breast cancer diagnosed patients either their characteristics, or pathological profile. Our purpose is to conduct retrospective study of number of Breast Cancer patients treated and diagnosed in Albania during 2018. Material and Methods; We have recorded and recorded all breast cancer data from the registry of the Oncology Service at University Hospital Center “Mother Teresa “and private clinics in Tirana and from the registries of the district hospitals, during 2018. Results; Total number of breast cancer patients treated and diagnosed in 2018, from them 506 patients were diagnosed and treated with breast cancer of all stages in our hospital. Since the registry of cancer is still not untirely functioning the data represents only our hospital not. Conclusions; Breast cancer remains a major public health concern worldwide. Trends in the incidence, mortality, and regulated life years of the disabled are varied across regions and countries, suggesting the allocation of appropriate health care resources for breast cancer, which should have the highest level of evaluation.
{"title":"Breast Cancer Disease Burden in Albania","authors":"Anila Pema (Kristo), D. Tarifa, M. Ikonomi, F. Proko, Alketa Ymeri, Lindita Shehu, Besiana Poga","doi":"10.32391/ajtes.v6i2.281","DOIUrl":"https://doi.org/10.32391/ajtes.v6i2.281","url":null,"abstract":"Introduction; There are data on an increase in cancer cases in Albania in recent decades, this growing trend of cancer in the Albanian population is due to the rapid increase of habits or unhealthy behaviours such as; smoking, excessive alcohol consumption, unhealthy diet, high levels of obesity, and physical inactivity. However, Albanian men and women show one of the lowest values (in terms of age) in the region of Southeast Europe. In Albania still, we do not have official data regarding the number of breast cancer diagnosed patients either their characteristics, or pathological profile. \u0000Our purpose is to conduct retrospective study of number of Breast Cancer patients treated and diagnosed in Albania during 2018. \u0000Material and Methods; We have recorded and recorded all breast cancer data from the registry of the Oncology Service at University Hospital Center “Mother Teresa “and private clinics in Tirana and from the registries of the district hospitals, during 2018. \u0000Results; Total number of breast cancer patients treated and diagnosed in 2018, from them 506 patients were diagnosed and treated with breast cancer of all stages in our hospital. Since the registry of cancer is still not untirely functioning the data represents only our hospital not. \u0000Conclusions; Breast cancer remains a major public health concern worldwide. Trends in the incidence, mortality, and regulated life years of the disabled are varied across regions and countries, suggesting the allocation of appropriate health care resources for breast cancer, which should have the highest level of evaluation.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44566391","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}
K. Haxhirexha, A. Dogjani, Aulona Haxhirexha, Labeat Haxhirexha, Blerim Fejzuli, A. Ademi
Introduction: Port site hernias continue to be a major problem in laparoscopic surgery. The causes of this type of hernia are numerous. The main ones are operative wound infection, obesity, male gender, diabetes, BPH, etc. However, in addition to these factors it seems that in the etiology of post laparoscopic port - site hernias are at least two other factors that have an impact on these complications. Aim of the article is to assess the role of different factors in the occurrence of port site incisional hernias according to our experience. Material and Methods: the 187 patients who were operated on at the General Surgery Department of the Clinical Hospital of Tetovo between January, 2017 and June, 2019 on whom the surgical intervention was performed through laparoscopic techniques were included in this study. The reason for the surgical interventions has been various surgical pathologies of the abdomen such as cholecystolithiasis, acute appendicitis, cysts of the liver, ovaries and kidneys, etc. Postoperative complications in these patients, especially port site hernia will be in the focus of our study. Results: Out of the total of 187 patients included in this study the occurrence of incisional hernia was recorded in six of them. In five patients the hernia was localized at the site of insertion of the supra-umbilical trocar, while in the other, the trocar was inserted below the xiphoid process. From our records it happened that in all these patients, with postoperative hernia, the insertion of the cannula was done with the cutting trocar. At the same time in all six patients with post laparoscopic hernia the surgical intervention performed was cholecystectomy or appendectomy. Thus, the removal of the gallbladder and appendix, without the use of an Endo-bag, was performed at the site of the hernia presentation. In all these patients the entrance porta infection in which the hernia has occurred, was registered in the early post operative period. Conclusion: Of the many factors that increase the risk of incisional hernias, at the site of cannula insertion during laparoscopic interventions, it seems that the type of trocar and the place from which the extruded organ is removed, if it is done without the use of an Endo-bag, are very important.
{"title":"Some Consideration about Port Site Hernia after Laparoscopic Surgery.","authors":"K. Haxhirexha, A. Dogjani, Aulona Haxhirexha, Labeat Haxhirexha, Blerim Fejzuli, A. Ademi","doi":"10.32391/ajtes.v6i2.284","DOIUrl":"https://doi.org/10.32391/ajtes.v6i2.284","url":null,"abstract":"Introduction: Port site hernias continue to be a major problem in laparoscopic surgery. The causes of this type of hernia are numerous. The main ones are operative wound infection, obesity, male gender, diabetes, BPH, etc. However, in addition to these factors it seems that in the etiology of post laparoscopic port - site hernias are at least two other factors that have an impact on these complications. \u0000Aim of the article is to assess the role of different factors in the occurrence of port site incisional hernias according to our experience. \u0000Material and Methods: the 187 patients who were operated on at the General Surgery Department of the Clinical Hospital of Tetovo between January, 2017 and June, 2019 on whom the surgical intervention was performed through laparoscopic techniques were included in this study. The reason for the surgical interventions has been various surgical pathologies of the abdomen such as cholecystolithiasis, acute appendicitis, cysts of the liver, ovaries and kidneys, etc. Postoperative complications in these patients, especially port site hernia will be in the focus of our study. \u0000Results: Out of the total of 187 patients included in this study the occurrence of incisional hernia was recorded in six of them. In five patients the hernia was localized at the site of insertion of the supra-umbilical trocar, while in the other, the trocar was inserted below the xiphoid process. From our records it happened that in all these patients, with postoperative hernia, the insertion of the cannula was done with the cutting trocar. At the same time in all six patients with post laparoscopic hernia the surgical intervention performed was cholecystectomy or appendectomy. Thus, the removal of the gallbladder and appendix, without the use of an Endo-bag, was performed at the site of the hernia presentation. In all these patients the entrance porta infection in which the hernia has occurred, was registered in the early post operative period. \u0000Conclusion: Of the many factors that increase the risk of incisional hernias, at the site of cannula insertion during laparoscopic interventions, it seems that the type of trocar and the place from which the extruded organ is removed, if it is done without the use of an Endo-bag, are very important.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49381147","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; Clinical outcome is the most measurable of the critical care activity. Although every burn center has its own particular limitations, it is clear that exists a minimum standard of survival after burn injury which is LA50 (Lethal Area 50). The aim of this study is to present demographic and epidemiologic features of severe burns in Albania in the period 2009-2019 and to analyze burn mortality as an important outcome measure analyzing LA 50. Material and Methods; The study is retrospective clinical and analytical. Since our burn center is the only one in the country it encompasses all the cases with moderate burns from the capital and severe burns. The data used are obtained by the analysis of the medical records of 1684 patients hospitalized in Burns Service ICU near University Hospital Center in Tirana, Albania during 2009-2019. Results; While comparing the decade (2009-2019) with the previous one (1998-2008) there is a progressive decrease of mortality (6.89% versus 10.5%) of our burn patient population although mean BSA (%) burned increased to 25.6±19.1 % (versus 22.8±14.7%). LA 50 for all patients was 80.04%, for children was 77.7%, for adults was 87% and for elderly was 52.28%. The mortality rate of all ICU burns as an average for 2009-2019 was 0.35 cases per 100000 population/year. Conclusions; The long-term studies and the comparison of our results with the ones of other burn centers have allowed us to determine the actual level of care and as well as to build up contemporary protocols in order to improve the treatment with the objection decreasing the mortality. Improvements in overall mortality expressed by LA 50 noticed it as an important outcome measure.
{"title":"Analyzing Mortality in Burned Patients with Lethal Area 50.","authors":"Bajram Abdullahu, M. Belba","doi":"10.32391/ajtes.v6i2.272","DOIUrl":"https://doi.org/10.32391/ajtes.v6i2.272","url":null,"abstract":"Background; Clinical outcome is the most measurable of the critical care activity. Although every burn center has its own particular limitations, it is clear that exists a minimum standard of survival after burn injury which is LA50 (Lethal Area 50). \u0000The aim of this study is to present demographic and epidemiologic features of severe burns in Albania in the period 2009-2019 and to analyze burn mortality as an important outcome measure analyzing LA 50. \u0000Material and Methods; The study is retrospective clinical and analytical. Since our burn center is the only one in the country it encompasses all the cases with moderate burns from the capital and severe burns. The data used are obtained by the analysis of the medical records of 1684 patients hospitalized in Burns Service ICU near University Hospital Center in Tirana, Albania during 2009-2019. \u0000Results; While comparing the decade (2009-2019) with the previous one (1998-2008) there is a progressive decrease of mortality (6.89% versus 10.5%) of our burn patient population although mean BSA (%) burned increased to 25.6±19.1 % (versus 22.8±14.7%). LA 50 for all patients was 80.04%, for children was 77.7%, for adults was 87% and for elderly was 52.28%. The mortality rate of all ICU burns as an average for 2009-2019 was 0.35 cases per 100000 population/year. \u0000Conclusions; The long-term studies and the comparison of our results with the ones of other burn centers have allowed us to determine the actual level of care and as well as to build up contemporary protocols in order to improve the treatment with the objection decreasing the mortality. Improvements in overall mortality expressed by LA 50 noticed it as an important outcome measure.","PeriodicalId":32905,"journal":{"name":"Albanian Journal of Trauma and Emergency Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46620505","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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