A. Yordanov, S. Strashilov, M. Karcheva, M. Karamanliev, S. Slavchev, P. Vasileva
Background Warty carcinoma of the cervix is a rare subtype of squamous cell carcinoma. In general, it is not as aggressive as the other subtypes, and has a better prognosis. Aims The aim of this study was to investigate overall and recurrence-free survival rate in patients with Warty carcinoma of the cervix. Methods During the ten year period (2008–2017) in the Clinic of Gynaecologic oncology at the UMHAT Pleven, Bulgaria were operated 714 cases with cervical cancer, 14 of which were histologically confirmed as a Warty carcinoma. Patients were investigated by retroand prospective analysis for overall and recurrence-free survival rate. Results Warty carcinoma accounts for 1.94 per cent of all cervical carcinomas, operated in the clinic. The mean age of the patients was 48 years, ranging from 29–72 years. According to the FIGO staging systems for cervix, patients were staged as follows: in stage IB1 – 43 per cent and in stage IB2 – 57 per cent. Despite the high percentage of locally advanced process, only in one case out of all the patients there was local spreading of the lesion towards the uterine cavity and in one case there were metastases in the pelvic lymph nodes. Lymphovascular space invasion was not seen in any patient, and neither were perineural or perivascular invasion. Conclusion This report highlights a favourable course and good prognosis of Warty carcinoma of the cervix. It is necessary to reconsider the aggressive surgical treatment and subsequent chemotherapy in women with Warty carcinoma of the cervix.
{"title":"Contemporary challenges of warty carcinoma of cervix - Our experience and review of literature","authors":"A. Yordanov, S. Strashilov, M. Karcheva, M. Karamanliev, S. Slavchev, P. Vasileva","doi":"10.21767/AMJ.2018.3503","DOIUrl":"https://doi.org/10.21767/AMJ.2018.3503","url":null,"abstract":"Background Warty carcinoma of the cervix is a rare subtype of squamous cell carcinoma. In general, it is not as aggressive as the other subtypes, and has a better prognosis. Aims The aim of this study was to investigate overall and recurrence-free survival rate in patients with Warty carcinoma of the cervix. Methods During the ten year period (2008–2017) in the Clinic of Gynaecologic oncology at the UMHAT Pleven, Bulgaria were operated 714 cases with cervical cancer, 14 of which were histologically confirmed as a Warty carcinoma. Patients were investigated by retroand prospective analysis for overall and recurrence-free survival rate. Results Warty carcinoma accounts for 1.94 per cent of all cervical carcinomas, operated in the clinic. The mean age of the patients was 48 years, ranging from 29–72 years. According to the FIGO staging systems for cervix, patients were staged as follows: in stage IB1 – 43 per cent and in stage IB2 – 57 per cent. Despite the high percentage of locally advanced process, only in one case out of all the patients there was local spreading of the lesion towards the uterine cavity and in one case there were metastases in the pelvic lymph nodes. Lymphovascular space invasion was not seen in any patient, and neither were perineural or perivascular invasion. Conclusion This report highlights a favourable course and good prognosis of Warty carcinoma of the cervix. It is necessary to reconsider the aggressive surgical treatment and subsequent chemotherapy in women with Warty carcinoma of the cervix.","PeriodicalId":46823,"journal":{"name":"Australasian Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68186716","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 Malignant melanoma (MM) of the skin is a rare, highly malignant tumour, affecting younger age. Its incidence rate has been rising as compared to all malignant neoplasms – 5 per cent of all newly diagnosed cancers in men, and 6 per cent of those in women. Aims The aim of the literature review is to present the contemporary tendencies in the surgical treatment and monitoring of patients with malignant melanoma of the
{"title":"Modern surgical treatment of malignant skin melanoma: A brief literature overview","authors":"S. Strashilov, A. Yordanov","doi":"10.21767/amj.2018.3504","DOIUrl":"https://doi.org/10.21767/amj.2018.3504","url":null,"abstract":"Background Malignant melanoma (MM) of the skin is a rare, highly malignant tumour, affecting younger age. Its incidence rate has been rising as compared to all malignant neoplasms – 5 per cent of all newly diagnosed cancers in men, and 6 per cent of those in women. Aims The aim of the literature review is to present the contemporary tendencies in the surgical treatment and monitoring of patients with malignant melanoma of the","PeriodicalId":46823,"journal":{"name":"Australasian Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68186736","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}
{"title":"Arthroscopic treatment of synovial chondromatosis of the proximal tibiofibular joint: A case report","authors":"Sang Jin Lee","doi":"10.21767/AMJ.2018.3547","DOIUrl":"https://doi.org/10.21767/AMJ.2018.3547","url":null,"abstract":"","PeriodicalId":46823,"journal":{"name":"Australasian Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68187643","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}
We present the case of 60-year-old man (twin) with ileus cause by intussusception of the caecum adenocarcinoma and coexistence of intestinal malrotation (IM) and agenesis of one kidney. Intestinal malrotation with colon carcinoma is very rare in adult patients (only 14 cases have been described in the literature). Ileus cause by tumour intussusception has been previously reported in only one patient and the additional coexistence of agenesis of one kidney has not been reported in the available medical literature. However, coexistence of other anomalies was observed in 46 per cent of patients with IM. Therefore, in patients with ileus and coexisting congenital anomalies in other organs, the existence of intestinal malrotation should be considered. Furthermore, because of the unusual anatomy of the mesenteric vessels, right colon resection in patients with IM should be performed with special caution and the preoperative work-up should be extended to include visceral angiography.
{"title":"Intussuscepted caecal cancer in a patient with intestinal malrotation and agenesis of one kidney","authors":"J. Andrzej","doi":"10.21767/AMJ.2017.3287","DOIUrl":"https://doi.org/10.21767/AMJ.2017.3287","url":null,"abstract":"We present the case of 60-year-old man (twin) with ileus cause by intussusception of the caecum adenocarcinoma and coexistence of intestinal malrotation (IM) and agenesis of one kidney. Intestinal malrotation with colon carcinoma is very rare in adult patients (only 14 cases have been described in the literature). Ileus cause by tumour intussusception has been previously reported in only one patient and the additional coexistence of agenesis of one kidney has not been reported in the available medical literature. However, coexistence of other anomalies was observed in 46 per cent of patients with IM. Therefore, in patients with ileus and coexisting congenital anomalies in other organs, the existence of intestinal malrotation should be considered. Furthermore, because of the unusual anatomy of the mesenteric vessels, right colon resection in patients with IM should be performed with special caution and the preoperative work-up should be extended to include visceral angiography.","PeriodicalId":46823,"journal":{"name":"Australasian Medical Journal","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68183198","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}
{"title":"Porphyria Cutanea Tarda (PCT) experience in Victoria, Australia","authors":"Quynh Lê, R. Fullinfaw, M. McGuinness, G. Ross","doi":"10.21767/AMJ.2018.3316","DOIUrl":"https://doi.org/10.21767/AMJ.2018.3316","url":null,"abstract":"","PeriodicalId":46823,"journal":{"name":"Australasian Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68183940","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}
{"title":"Groin pain secondary to Femoral Acetabular Impingement- A case of mistaken identity","authors":"Elizabeth Tan, P. Durgakeri","doi":"10.21767/amj.2018.3317","DOIUrl":"https://doi.org/10.21767/amj.2018.3317","url":null,"abstract":"","PeriodicalId":46823,"journal":{"name":"Australasian Medical Journal","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68184080","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}
J. Song, Kathryn A Breidenbach, A. Duong, Shan Zhang, V. Joseph
Background Migraine headaches, anxiety disorder and depression have not been studied to determine if parturients are at risk for developing a PDPH. Aims This retrospective analysis is to identify and assess the risk of developing a post-dural puncture headache (PDPH) in parturients with a documented history of primary migraines and anxiety/depression. Methods The parturients who had accidental dural puncture (ADP) during labour epidural placement were included and further analysed for the development of a post-dural puncture headache (PDPH). We compared patient demographics and the history of depression/anxiety, as well as evaluated the patient for a history of migraine headaches and depression/anxiety. Results One hundred seventy-five parturients met our criteria for ADP, from which 92 (52.6 per cent) developed PDPH. A history of migraines was present in 7 of 10 (70 per cent) of patients with a PDPH, from which 4 of 7 (57.1 per cent) required an epidural blood patch treatment. A history of depression/anxiety was found in 7 of 12 (58.3 per cent) with a PDPH of which 2 of 7 (28.6 per cent) required an epidural blood patch treatment. Data analysis showed no significant difference between a history of migraines or depression/anxiety and the incidence of dural puncture headache (P=0.26 and P=0.68, respectively), nor was there an association between a history of migraines or depression/anxiety and the intensity of dural puncture headache (P=0.25 and P=0.63, respectively). Conclusion The results of this study indicate that in postpartum patients neither the presence of a history of migraines nor a history of depression/anxiety was associated with an increased risk of the development of PDPH or an increase in its intensity.
{"title":"Impact of migraine headaches and depression/anxiety on the incidence of post-dural puncture headache during postpartum course","authors":"J. Song, Kathryn A Breidenbach, A. Duong, Shan Zhang, V. Joseph","doi":"10.21767/AMJ.2018.3346","DOIUrl":"https://doi.org/10.21767/AMJ.2018.3346","url":null,"abstract":"Background Migraine headaches, anxiety disorder and depression have not been studied to determine if parturients are at risk for developing a PDPH. Aims This retrospective analysis is to identify and assess the risk of developing a post-dural puncture headache (PDPH) in parturients with a documented history of primary migraines and anxiety/depression. Methods The parturients who had accidental dural puncture (ADP) during labour epidural placement were included and further analysed for the development of a post-dural puncture headache (PDPH). We compared patient demographics and the history of depression/anxiety, as well as evaluated the patient for a history of migraine headaches and depression/anxiety. Results One hundred seventy-five parturients met our criteria for ADP, from which 92 (52.6 per cent) developed PDPH. A history of migraines was present in 7 of 10 (70 per cent) of patients with a PDPH, from which 4 of 7 (57.1 per cent) required an epidural blood patch treatment. A history of depression/anxiety was found in 7 of 12 (58.3 per cent) with a PDPH of which 2 of 7 (28.6 per cent) required an epidural blood patch treatment. Data analysis showed no significant difference between a history of migraines or depression/anxiety and the incidence of dural puncture headache (P=0.26 and P=0.68, respectively), nor was there an association between a history of migraines or depression/anxiety and the intensity of dural puncture headache (P=0.25 and P=0.63, respectively). Conclusion The results of this study indicate that in postpartum patients neither the presence of a history of migraines nor a history of depression/anxiety was associated with an increased risk of the development of PDPH or an increase in its intensity.","PeriodicalId":46823,"journal":{"name":"Australasian Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68184529","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}
V. Boras, Božana Lončar-Brzak, D. Juras, I. Jukić, S. L. HadžavdiĆ, D. Vranić, I. Pelivan
We report a case of 29-year-old woman who was admitted to our Department with red eyes and two bullae located on the right buccal mucosa. Otherwise she is healthy but one day before she finished azithromycin (Sumamed, Tewa, Croatia) intake as she had pneumonia. Direct and indirect immunofluorescence did not reveal presence of vesicullobulous disorders. During the period of nine days she was given 40mg of prednisone (Decortin, Merck, Germany) orally as well as betamethasone (Beloderm, Belupo, Croatia) in orabase locally and after that the lesions subsided.
{"title":"Oral bullous lesions due to the azithromycin intake","authors":"V. Boras, Božana Lončar-Brzak, D. Juras, I. Jukić, S. L. HadžavdiĆ, D. Vranić, I. Pelivan","doi":"10.21767/AMJ.2018.3388","DOIUrl":"https://doi.org/10.21767/AMJ.2018.3388","url":null,"abstract":"We report a case of 29-year-old woman who was admitted to our Department with red eyes and two bullae located on the right buccal mucosa. Otherwise she is healthy but one day before she finished azithromycin (Sumamed, Tewa, Croatia) intake as she had pneumonia. Direct and indirect immunofluorescence did not reveal presence of vesicullobulous disorders. During the period of nine days she was given 40mg of prednisone (Decortin, Merck, Germany) orally as well as betamethasone (Beloderm, Belupo, Croatia) in orabase locally and after that the lesions subsided.","PeriodicalId":46823,"journal":{"name":"Australasian Medical Journal","volume":"11 1","pages":"237-239"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68185106","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}
A. Bokov, A. Bulkin, S. Mlyavykh, A. Dydykin, A. Aleynik
Background It is reported that expandable pedicle screws are effective and a safer alternative to pedicle screws with cement augmentation application in patients with poor bone quality. Aims To study implant related complications associated with expandable pedicle screws application and to propose revision options in case of implant failure. Methods A retrospective analysis of a heterogeneous cohort of patients operated on because of traumatic injuries and degenerative diseases of the lumbar spine and thoracolumbar junction was performed. 42 patients with osteopeny or osteoporosis were enrolled, the duration of the follow-up accounted for 18 months. Cases with implant failure (loosening and screw breakage) were registered and revision pedicle screws fixation was performed. Results Out of 42 enrolled patients 3 were presented with implant failure (a screw loosening in one case and a screw rupture and loosening in 2 cases). The attempts to remove retained fractured fragments were unsuccessful, therefore, alternative bypass creation and a direct screw placement into a retained fractured fragment were carried out and suggested as an alternative strategy to osteotomy with a fractured screw fragment removal. Conclusion In case of rupture, expandable screws have a poor feasibility for a revision pedicle screw fixation because of fractured fragments strong anchorage in bone. The alternative bypass for a revision screw without fractured fragment removal or tapping and direct screw placement into retained expanded fragment of a screw are less invasive alternatives to osteotomy that can help overcome the discussed issue.
{"title":"Implant related complications in patients operated on with expandable pedicle screws and technical solutions for revision surgery","authors":"A. Bokov, A. Bulkin, S. Mlyavykh, A. Dydykin, A. Aleynik","doi":"10.21767/AMJ.2018.3489","DOIUrl":"https://doi.org/10.21767/AMJ.2018.3489","url":null,"abstract":"Background It is reported that expandable pedicle screws are effective and a safer alternative to pedicle screws with cement augmentation application in patients with poor bone quality. Aims To study implant related complications associated with expandable pedicle screws application and to propose revision options in case of implant failure. Methods A retrospective analysis of a heterogeneous cohort of patients operated on because of traumatic injuries and degenerative diseases of the lumbar spine and thoracolumbar junction was performed. 42 patients with osteopeny or osteoporosis were enrolled, the duration of the follow-up accounted for 18 months. Cases with implant failure (loosening and screw breakage) were registered and revision pedicle screws fixation was performed. Results Out of 42 enrolled patients 3 were presented with implant failure (a screw loosening in one case and a screw rupture and loosening in 2 cases). The attempts to remove retained fractured fragments were unsuccessful, therefore, alternative bypass creation and a direct screw placement into a retained fractured fragment were carried out and suggested as an alternative strategy to osteotomy with a fractured screw fragment removal. Conclusion In case of rupture, expandable screws have a poor feasibility for a revision pedicle screw fixation because of fractured fragments strong anchorage in bone. The alternative bypass for a revision screw without fractured fragment removal or tapping and direct screw placement into retained expanded fragment of a screw are less invasive alternatives to osteotomy that can help overcome the discussed issue.","PeriodicalId":46823,"journal":{"name":"Australasian Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68186516","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}
We describe an unusual and misleading manifestation of stromal graft rejection after uneventful deep anterior lamellar keratoplasty (DALK). A 25-year-old healthy man with advanced keratoconus underwent uneventful DALK. After a few months, developed recurrent graft oedema, acute and diffuse epithelial and stromal oedema, few very fine keratic precipitates (KPs) in the allograft and not seen in the recipient bed, anterior chamber (AC) inflammation with cells and flair, without any vascularization in the graft and recipient bed, and without any infiltration or loosening of the sutures. Polymerase chain reaction (PCR) analysis was performed on an aqueous sample, which was negative for herpes simplex virus (HSV) and cytomegalovirus (CMV). Management with topical and systemic steroids led to complete resolution of the problem. Although there is no endothelial immune reaction after uneventful DALK, stromal graft rejection after DALK can present with the same features as endothelial graft rejection and should be differentiated from other similar demonstrations such as viral induced endotheliitis.
{"title":"Stromal graft rejection after uneventful deep anterior lamellar keratoplasty with a misleading manifestation similar to viral endotheliitis","authors":"R. S. Moghadam, M. Akbari","doi":"10.21767/AMJ.2017.3250","DOIUrl":"https://doi.org/10.21767/AMJ.2017.3250","url":null,"abstract":"We describe an unusual and misleading manifestation of stromal graft rejection after uneventful deep anterior lamellar keratoplasty (DALK). A 25-year-old healthy man with advanced keratoconus underwent uneventful DALK. After a few months, developed recurrent graft oedema, acute and diffuse epithelial and stromal oedema, few very fine keratic precipitates (KPs) in the allograft and not seen in the recipient bed, anterior chamber (AC) inflammation with cells and flair, without any vascularization in the graft and recipient bed, and without any infiltration or loosening of the sutures. Polymerase chain reaction (PCR) analysis was performed on an aqueous sample, which was negative for herpes simplex virus (HSV) and cytomegalovirus (CMV). Management with topical and systemic steroids led to complete resolution of the problem. Although there is no endothelial immune reaction after uneventful DALK, stromal graft rejection after DALK can present with the same features as endothelial graft rejection and should be differentiated from other similar demonstrations such as viral induced endotheliitis.","PeriodicalId":46823,"journal":{"name":"Australasian Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68182731","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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