D. Donat, Sonja Lukac, I. Bajkin, Ivana Vorgučin, V. Till, Sladjana Zagorac
Introduction. Kallmann syndrome is a genetic disorder marked by hypogonadotropic hypogonadism and anosmia. Patients with Kallmann syndrome have low circulating testosterone levels and low gonadotropin levels, whereas other pituitary hormones are normal. The treatment is based on sex steroid replacement with the aim to restore normal pubertal development and includes attempts to restore fertility by using gonadotropin-releasing hormones. Ultrasound examination of the testicles is a very useful complement to determine and monitor the precise testicular volume, which is an important prognostic factor for future fertility. Case Report. At the age of 18, the patient was suspected of having Kallmann syndrome and was referred to an endocrinologist. After three months of testosterone therapy, the patient was sent for an ultrasound of the testicles. The right testicle measured 16 x 6 mm, the left testicle 10 x 5 mm, both with a discrete marginal circular dichroism signal. One year after the first testicular ultrasound, the patient came for a checkup. The right testicle measured 14 x 5 mm, the left testicle 11 x 5 mm, stationary structure. Conclusion. The diagnosis of Kallmann syndrome is often delayed, because hypogonadotropic hypogonadism is usually not apparent until puberty, and individuals with anosmia are often unaware of this sensory deficit. In this case, late recognition of the syndrome, as well as late initiation of therapy, did not give satisfactory results.
{"title":"Testicular ultrasound in a patient with Kallmann syndrome: A case report","authors":"D. Donat, Sonja Lukac, I. Bajkin, Ivana Vorgučin, V. Till, Sladjana Zagorac","doi":"10.2298/mpns2208247d","DOIUrl":"https://doi.org/10.2298/mpns2208247d","url":null,"abstract":"Introduction. Kallmann syndrome is a genetic disorder marked by hypogonadotropic hypogonadism and anosmia. Patients with Kallmann syndrome have low circulating testosterone levels and low gonadotropin levels, whereas other pituitary hormones are normal. The treatment is based on sex steroid replacement with the aim to restore normal pubertal development and includes attempts to restore fertility by using gonadotropin-releasing hormones. Ultrasound examination of the testicles is a very useful complement to determine and monitor the precise testicular volume, which is an important prognostic factor for future fertility. Case Report. At the age of 18, the patient was suspected of having Kallmann syndrome and was referred to an endocrinologist. After three months of testosterone therapy, the patient was sent for an ultrasound of the testicles. The right testicle measured 16 x 6 mm, the left testicle 10 x 5 mm, both with a discrete marginal circular dichroism signal. One year after the first testicular ultrasound, the patient came for a checkup. The right testicle measured 14 x 5 mm, the left testicle 11 x 5 mm, stationary structure. Conclusion. The diagnosis of Kallmann syndrome is often delayed, because hypogonadotropic hypogonadism is usually not apparent until puberty, and individuals with anosmia are often unaware of this sensory deficit. In this case, late recognition of the syndrome, as well as late initiation of therapy, did not give satisfactory results.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79501255","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. Bila, A. Sretenović, O. Markovic, N. Stanisavljevic, Nada Vlaisavljević, I. Savić
Introduction. Multiple myeloma is the second most common malignant hemopathy. The average incidence of this disease in our country is 4.2-6.7/100,000 inhabitants per year. Despite significant progress in the overall survival over the past 20 years, only 10-15% of patients achieve long-term remission and an average survival that corresponds to the average life expectancy of the general human population. The current recommendations for the treatment of multiple myeloma are globally based on the results of randomized clinical trials in which only 10-40% of patients are treated, which is why the analysis of the results of the patients treated outside of randomized clinical trials, the so-called ?Real-World Evidence? data, is very important. Diagnosis and treatment of multiple myeloma - Real-World Evidence. Through presentations of the cases from routine clinical practice, multiple myeloma treatment modalities are presented in accordance with modern recommendations for diagnosis and treatment, as well as the multiple myeloma phase of the disease: treatment approach in newly diagnosed patients; treatment of the first relapse; and treatment of the second and subsequent relapses. Conclusion. The analysis of Real-World Evidence data indicates significant differences between clinical and laboratory characteristics of patients treated outside randomized clinical trials in comparison to the randomized clinical trials participants, with an significant impact to the therapeutic approach, course and outcome of the disease, consequently leading to the necessity of further Real- World Evidence analyzes and their inclusion in the current recommendations for multiple myeloma diagnosis and treatment
{"title":"Real-world evidence in diagnostics and treatment of patients with multiple myeloma","authors":"J. Bila, A. Sretenović, O. Markovic, N. Stanisavljevic, Nada Vlaisavljević, I. Savić","doi":"10.2298/mpns22s1115b","DOIUrl":"https://doi.org/10.2298/mpns22s1115b","url":null,"abstract":"Introduction. Multiple myeloma is the second most common malignant hemopathy. The average incidence of this disease in our country is 4.2-6.7/100,000 inhabitants per year. Despite significant progress in the overall survival over the past 20 years, only 10-15% of patients achieve long-term remission and an average survival that corresponds to the average life expectancy of the general human population. The current recommendations for the treatment of multiple myeloma are globally based on the results of randomized clinical trials in which only 10-40% of patients are treated, which is why the analysis of the results of the patients treated outside of randomized clinical trials, the so-called ?Real-World Evidence? data, is very important. Diagnosis and treatment of multiple myeloma - Real-World Evidence. Through presentations of the cases from routine clinical practice, multiple myeloma treatment modalities are presented in accordance with modern recommendations for diagnosis and treatment, as well as the multiple myeloma phase of the disease: treatment approach in newly diagnosed patients; treatment of the first relapse; and treatment of the second and subsequent relapses. Conclusion. The analysis of Real-World Evidence data indicates significant differences between clinical and laboratory characteristics of patients treated outside randomized clinical trials in comparison to the randomized clinical trials participants, with an significant impact to the therapeutic approach, course and outcome of the disease, consequently leading to the necessity of further Real- World Evidence analyzes and their inclusion in the current recommendations for multiple myeloma diagnosis and treatment","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84286705","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}
Tijana Koković, Nikola Batinic, Z. Zivanovic, V. Till
Introduction. Embolization into the systemic circulation through the persistent foramen ovale is known as paradoxical embolization. Coexistence of paradoxical embolism with pulmonary thromboembolism is rare and it requires detailed examination. The objective of this study was to present an unusual case of stroke that was complicated by the occurrence of pulmonary thromboembolism, with thrombosis of the superior mesenteric artery, and arterial infarction of numerous visceral organs, a few days after its onset. Case Report. A 60-year-old female patient was admitted to the Emergency Center with clinical symptoms of acute ischemic stroke, with sudden left hemiparesis. Computed tomography showed a fresh ischemia in the basin of the right anterior cerebral artery. The initial clinical course was favorable, with gradual regression of neurological symptoms. On the seventh day of hospitalization, the patient presented with a sudden worsening of symptoms. Computed tomography confirmed multiple infarctions of the liver, spleen and both kidneys, partial thrombosis of the superior mesenteric artery, as well as thrombosis of both pulmonary arteries and two fresh ischemic zones, namely right temporal and parieto-occipital, cortico- subcortical. A persistent foramen ovale was found by transesophageal echocardiography, which also confirmed the existence of an atrial septal aneurysm. In the further course, there was an improvement of symtoms. The patient was referred for further rehabilitation therapy. A surgical closure of persistent foramen ovale was indicated. Conclusion. Paradoxical embolism remains a pathology rarely mentioned by clinicians, although it can affect the functional and vital status and prognosis of the patient. Good cardiac evaluation and detection of persistent foramen ovale in every patient with embolic ischemia is of great importance.
{"title":"Systemic embolic events associated with persistent foramen ovale: A case report","authors":"Tijana Koković, Nikola Batinic, Z. Zivanovic, V. Till","doi":"10.2298/mpns2208254k","DOIUrl":"https://doi.org/10.2298/mpns2208254k","url":null,"abstract":"Introduction. Embolization into the systemic circulation through the persistent foramen ovale is known as paradoxical embolization. Coexistence of paradoxical embolism with pulmonary thromboembolism is rare and it requires detailed examination. The objective of this study was to present an unusual case of stroke that was complicated by the occurrence of pulmonary thromboembolism, with thrombosis of the superior mesenteric artery, and arterial infarction of numerous visceral organs, a few days after its onset. Case Report. A 60-year-old female patient was admitted to the Emergency Center with clinical symptoms of acute ischemic stroke, with sudden left hemiparesis. Computed tomography showed a fresh ischemia in the basin of the right anterior cerebral artery. The initial clinical course was favorable, with gradual regression of neurological symptoms. On the seventh day of hospitalization, the patient presented with a sudden worsening of symptoms. Computed tomography confirmed multiple infarctions of the liver, spleen and both kidneys, partial thrombosis of the superior mesenteric artery, as well as thrombosis of both pulmonary arteries and two fresh ischemic zones, namely right temporal and parieto-occipital, cortico- subcortical. A persistent foramen ovale was found by transesophageal echocardiography, which also confirmed the existence of an atrial septal aneurysm. In the further course, there was an improvement of symtoms. The patient was referred for further rehabilitation therapy. A surgical closure of persistent foramen ovale was indicated. Conclusion. Paradoxical embolism remains a pathology rarely mentioned by clinicians, although it can affect the functional and vital status and prognosis of the patient. Good cardiac evaluation and detection of persistent foramen ovale in every patient with embolic ischemia is of great importance.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81762732","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}
N. Milenovic, Marijana Hornjak, Sonja Lukac, Ana Simundja, M. Veselinović, Gordan Bajić
Introduction. Osteoarthritis is a degenerative rheumatic disease of the peripheral joints. It mostly affects one joint, usually the hip and knee joints, as well as the distal interphalangeal joints of the wrist and thumb carpometacarpal joint. The clinical symptoms include pain, swelling, stiffness, crepitus, muscle atrophy, subluxation, as well as reduced joint mobility, greatly affecting the quality of life of patients. The aim of this study was to assess the quality of life of patients with knee osteoarthritis and determine whether there is a difference in the quality of life of patients with unilateral and patients with bilateral knee osteoarthritis. Material and Methods. The study was designed as a retrospective study including 60 patients, 30 patients with unilateral gonarthrosis and 30 patients with bilateral gonarthrosis. The EuroQoL five dimensions questionnaire was used to assess the quality of life. Results. There is no statistically significant difference in the quality of life between individuals with unilateral and bilateral knee osteoarthritis, but there is a significant positive correlation between the pain intensity and difficulties in the domains of quality of life. Conclusion. People with osteoarthritis of the knee mostly take painkillers and have a good or excellent response to therapy. There is no statistically significant difference in the quality of life among people with unilateral and bilateral knee osteoarthritis. There is a significant positive correlation between the pain intensity and difficulties in the domains of quality of life. There is a significant negative correlation between the perception of general health and all five domains of quality of life.
{"title":"Assessment of the quality of life in patients with knee osteoarthritis","authors":"N. Milenovic, Marijana Hornjak, Sonja Lukac, Ana Simundja, M. Veselinović, Gordan Bajić","doi":"10.2298/mpns2204103m","DOIUrl":"https://doi.org/10.2298/mpns2204103m","url":null,"abstract":"Introduction. Osteoarthritis is a degenerative rheumatic disease of the peripheral joints. It mostly affects one joint, usually the hip and knee joints, as well as the distal interphalangeal joints of the wrist and thumb carpometacarpal joint. The clinical symptoms include pain, swelling, stiffness, crepitus, muscle atrophy, subluxation, as well as reduced joint mobility, greatly affecting the quality of life of patients. The aim of this study was to assess the quality of life of patients with knee osteoarthritis and determine whether there is a difference in the quality of life of patients with unilateral and patients with bilateral knee osteoarthritis. Material and Methods. The study was designed as a retrospective study including 60 patients, 30 patients with unilateral gonarthrosis and 30 patients with bilateral gonarthrosis. The EuroQoL five dimensions questionnaire was used to assess the quality of life. Results. There is no statistically significant difference in the quality of life between individuals with unilateral and bilateral knee osteoarthritis, but there is a significant positive correlation between the pain intensity and difficulties in the domains of quality of life. Conclusion. People with osteoarthritis of the knee mostly take painkillers and have a good or excellent response to therapy. There is no statistically significant difference in the quality of life among people with unilateral and bilateral knee osteoarthritis. There is a significant positive correlation between the pain intensity and difficulties in the domains of quality of life. There is a significant negative correlation between the perception of general health and all five domains of quality of life.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87930633","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}
Introduction. Vitamin D is known to regulate calcium and phosphate metabolism. It plays an essential role in maintaining a healthy mineralized skeleton and it is also an immunomodulatory hormone. Experimental studies have shown that vitamin D has significant biologic activities on the innate and adaptive immune systems. Animal studies have demonstrated that administration of vitamin D or its metabolites leads to changes in the occurrence and progression of various immune-related diseases. This supports the clinical and epidemiological data that link vitamin D with the incidence and severity of many disorders, such as psoriasis, multiple sclerosis, rheumatoid arthritis, type 1 diabetes, and infectious diseases. In recent decades, interest in vitamin D has increased exponentially, particularly as a vitamin D deficit has been associated with multiple diseases, and globally, there appears to be a high vitamin D deficiency. Osteoporosis prevention. Recent literature states that for the prevention of hypovitaminosis D in children, a daily recommended dose of 400-800 international units (IU) from 0 months to 3 years is required. For ages up to 18, the dose increases to 1000 IU, and from 19 to 70+ the dose is up to 1500 IU. In treating hypovitaminosis D, higher doses than preventive doses are recommended. For ages 0 to 12 months, they vary from 1000 to 1500 IU, while after the age of 9, therapeutic doses increase to 4000 IU. Osteoporosis therapy. In osteoporosis therapy, two groups of drugs are most often used - antiresorptive and anabolic. Of the antiresorptive preparations, bisphosphonates are the most important - the gold standard in treating osteoporosis, the first drug of choice. Conclusion. Circulating vitamin D has an important physiological role. It is necessary to provide enough vitamin D daily to ensure stable concentrations in the circulation and ensure optimal benefits of vitamin D. Recommendations for vitamin D supplementation differ in terms of preventive versus therapeutic doses. If a person is diagnosed with osteoporosis, before the introduction of antiresorptive or anabolic therapy, it is necessary to determine the method of administration of the appropriate dose of vitamin D. In the treatment of osteoporosis bisphosphonates are the gold standard; in addition to vitamin D.
{"title":"The importance of supplementation with vitamin D and minerals for achieving maximum effects in the treatment of osteoporosis","authors":"N. Milenovic","doi":"10.2298/mpns22s2028m","DOIUrl":"https://doi.org/10.2298/mpns22s2028m","url":null,"abstract":"Introduction. Vitamin D is known to regulate calcium and phosphate metabolism. It plays an essential role in maintaining a healthy mineralized skeleton and it is also an immunomodulatory hormone. Experimental studies have shown that vitamin D has significant biologic activities on the innate and adaptive immune systems. Animal studies have demonstrated that administration of vitamin D or its metabolites leads to changes in the occurrence and progression of various immune-related diseases. This supports the clinical and epidemiological data that link vitamin D with the incidence and severity of many disorders, such as psoriasis, multiple sclerosis, rheumatoid arthritis, type 1 diabetes, and infectious diseases. In recent decades, interest in vitamin D has increased exponentially, particularly as a vitamin D deficit has been associated with multiple diseases, and globally, there appears to be a high vitamin D deficiency. Osteoporosis prevention. Recent literature states that for the prevention of hypovitaminosis D in children, a daily recommended dose of 400-800 international units (IU) from 0 months to 3 years is required. For ages up to 18, the dose increases to 1000 IU, and from 19 to 70+ the dose is up to 1500 IU. In treating hypovitaminosis D, higher doses than preventive doses are recommended. For ages 0 to 12 months, they vary from 1000 to 1500 IU, while after the age of 9, therapeutic doses increase to 4000 IU. Osteoporosis therapy. In osteoporosis therapy, two groups of drugs are most often used - antiresorptive and anabolic. Of the antiresorptive preparations, bisphosphonates are the most important - the gold standard in treating osteoporosis, the first drug of choice. Conclusion. Circulating vitamin D has an important physiological role. It is necessary to provide enough vitamin D daily to ensure stable concentrations in the circulation and ensure optimal benefits of vitamin D. Recommendations for vitamin D supplementation differ in terms of preventive versus therapeutic doses. If a person is diagnosed with osteoporosis, before the introduction of antiresorptive or anabolic therapy, it is necessary to determine the method of administration of the appropriate dose of vitamin D. In the treatment of osteoporosis bisphosphonates are the gold standard; in addition to vitamin D.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86449728","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}
Over the last 10-15 years, the prognosis of patients with follicular lymphoma has improved, and for the majority of patients, follicular lymphoma is a chronic disease with ten years of overall survival of around 80%. Nevertheless, a certain subset of patients belongs to high-risk follicular lymphoma with early relapses and progressive disease, poor outcomes, and much shorter survival, and there is still no standard approach in the treatment of high-risk follicular lymphoma. Treatment of follicular lymphoma is highly heterogeneous, ranging from a ?watch and wait? strategy to intensive immunochemotherapy, and needs to be individualized to each patient. An early stage of the disease can be treated with involved-field radiotherapy, which has curative potential. Follicular lymphoma in the advanced stage is still an incurable disease. Standard first-line treatment is a combination of an anti-CD20 antibody (rituximab) and chemotherapy, followed by antibody maintenance. In relapse, treatment with novel anti-CD20 monoclonal antibody-obinutuzumab in combination with chemotherapy. The combination of lenalidomide and rituximab shows good results in patients with relapses and refractory follicular lymphoma, but also as a first-line treatment. An option for elderly patients with comorbidities is rituximab monotherapy. Autologous or allogeneic stem cell transplantation may be an option for a small group of selected patients. In the past decade development of novel targeted agents such as phosphoinositide three kinase inhibitors and immunotherapies (CD20/CD3 bispecific antibody, chimeric antigen receptor T cell therapy) demonstrate the efficiency of chemotherapy-free approach not only for relapsed/refractory patients but also in first-line treatment. A better understanding of the clinical and biological features of follicular lymphoma patients is necessary to improve treatment outcomes in the future.
{"title":"Current principles of follicular lymphoma treatment","authors":"M. Radojković","doi":"10.2298/mpns22s1062r","DOIUrl":"https://doi.org/10.2298/mpns22s1062r","url":null,"abstract":"Over the last 10-15 years, the prognosis of patients with follicular lymphoma has improved, and for the majority of patients, follicular lymphoma is a chronic disease with ten years of overall survival of around 80%. Nevertheless, a certain subset of patients belongs to high-risk follicular lymphoma with early relapses and progressive disease, poor outcomes, and much shorter survival, and there is still no standard approach in the treatment of high-risk follicular lymphoma. Treatment of follicular lymphoma is highly heterogeneous, ranging from a ?watch and wait? strategy to intensive immunochemotherapy, and needs to be individualized to each patient. An early stage of the disease can be treated with involved-field radiotherapy, which has curative potential. Follicular lymphoma in the advanced stage is still an incurable disease. Standard first-line treatment is a combination of an anti-CD20 antibody (rituximab) and chemotherapy, followed by antibody maintenance. In relapse, treatment with novel anti-CD20 monoclonal antibody-obinutuzumab in combination with chemotherapy. The combination of lenalidomide and rituximab shows good results in patients with relapses and refractory follicular lymphoma, but also as a first-line treatment. An option for elderly patients with comorbidities is rituximab monotherapy. Autologous or allogeneic stem cell transplantation may be an option for a small group of selected patients. In the past decade development of novel targeted agents such as phosphoinositide three kinase inhibitors and immunotherapies (CD20/CD3 bispecific antibody, chimeric antigen receptor T cell therapy) demonstrate the efficiency of chemotherapy-free approach not only for relapsed/refractory patients but also in first-line treatment. A better understanding of the clinical and biological features of follicular lymphoma patients is necessary to improve treatment outcomes in the future.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88709971","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}
N. Suvajdžić-Vuković, N. Pantić, Z. Pravdic, M. Cvetković, N. Sabljić, M. Mitrović
Introduction. Primary immune thrombocytopenia is a chronic acquired autoimmune disorder that is characterized by isolated thrombocytopenia (<100 x109/L) and the absence of any underlying cause. Treatment of primary immune thrombocytopenia. While splenectomy has a curable potential, it carries long-term risk of infection and thromboembolic complications. Therefore, the use of splenectomy has declined with the advent of rituximab and agonists of thrombopoietin receptors. The efficacy of rituximab is good for the short-term outcome, and the majority of patients will relapse. On the other hand, agonists of thrombopoietin receptors induce remission in only 10-30% of patients after treatment discontinuation, and long-term treatment is often required. Health - related quality of life. Immune thrombocytopenia and its treatments may affect the entire spectrum of patients? lives, encompassing daily activities, emotional health, energy level, fatigue, and work productivity. Primary immune thrombocytopenia World Impact Survey was conducted to discern how immune thrombocytopenia and associated treatments affect patient lives. Concerns about unstable platelet count, low energy levels, inability to exercise, and reduced participation in hobbies and work had the greatest negative impact. While most patients reported ?good health?, nonetheless half of patients reported a negative impact on their emotional well-being that worsened with increasing burden of disease and was often substantial. Conclusion. Although several important improvements have been made in immune thrombocytopenia treatment algorithms, there is still room for improvement. One of the possible options could be early, intensive treatment of immune thrombocytopenia, which might reduce the risk of disease progression and consequently improve patients? quality of life.
{"title":"Primary immune thrombocytopenia in adults - disease considerations","authors":"N. Suvajdžić-Vuković, N. Pantić, Z. Pravdic, M. Cvetković, N. Sabljić, M. Mitrović","doi":"10.2298/mpns22s1153s","DOIUrl":"https://doi.org/10.2298/mpns22s1153s","url":null,"abstract":"Introduction. Primary immune thrombocytopenia is a chronic acquired autoimmune disorder that is characterized by isolated thrombocytopenia (<100 x109/L) and the absence of any underlying cause. Treatment of primary immune thrombocytopenia. While splenectomy has a curable potential, it carries long-term risk of infection and thromboembolic complications. Therefore, the use of splenectomy has declined with the advent of rituximab and agonists of thrombopoietin receptors. The efficacy of rituximab is good for the short-term outcome, and the majority of patients will relapse. On the other hand, agonists of thrombopoietin receptors induce remission in only 10-30% of patients after treatment discontinuation, and long-term treatment is often required. Health - related quality of life. Immune thrombocytopenia and its treatments may affect the entire spectrum of patients? lives, encompassing daily activities, emotional health, energy level, fatigue, and work productivity. Primary immune thrombocytopenia World Impact Survey was conducted to discern how immune thrombocytopenia and associated treatments affect patient lives. Concerns about unstable platelet count, low energy levels, inability to exercise, and reduced participation in hobbies and work had the greatest negative impact. While most patients reported ?good health?, nonetheless half of patients reported a negative impact on their emotional well-being that worsened with increasing burden of disease and was often substantial. Conclusion. Although several important improvements have been made in immune thrombocytopenia treatment algorithms, there is still room for improvement. One of the possible options could be early, intensive treatment of immune thrombocytopenia, which might reduce the risk of disease progression and consequently improve patients? quality of life.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90883339","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}
Introduction. Myelodysplastic syndromes represent clonal neoplastic disorders characterized by hematological dysplasia, ineffective hematopoiesis, cytopenia, and increased risk of transformation to acute myeloid leukemia. Material and Methods. A literature review was conducted using the following bibliographic databases: Google Scholar, MEDLINE, and Kobson. The recommendations for diagnosis, classification, and prognosis are based on expert opinions grounded on a review of the literature and contemporary recommendations for diagnosis and prognosis in myelodysplastic syndrome. Diagnosis and classification. Diagnosis of myelodysplastic syndrome should be based on detailed patient and family history, physical examination, and comprehensive blood examinations in to exclude all other causes of cytopenia and dysplasia. Mandatory for myelodysplastic syndrome diagnosis is cytology of blood and bone marrow, bone marrow biopsy with immunohistology and cytogenetics. 2016 World Health Organization classification should be used for myelodysplastic syndrome diagnosis. SF1B3 genetic analysis is recommended in patients with suspected myelodysplastic syndrome with ringed sideroblasts and p53 mutation status. Prognosis. Revised International Prognostic Scoring System for myelodysplastic syndrome (IPSS-R) risk score should be defined for every patient in order to determine prognosis. The next-generation sequencing could provide additional diagnostic and prognostic information, particularly in young transplant candidates. Conclusion. Myelodysplastic syndrome diagnosis is based on the 2016 World Health Organization classification. The prognosis should be based on the Revised International Prognostic Scoring System with the possible addition of genetic analysis.
{"title":"Diagnosis, classification, and prognosis of myelodysplastic syndromes","authors":"A. Bogdanović, D. Marisavljević, A. Savic","doi":"10.2298/mpns22s1025b","DOIUrl":"https://doi.org/10.2298/mpns22s1025b","url":null,"abstract":"Introduction. Myelodysplastic syndromes represent clonal neoplastic disorders characterized by hematological dysplasia, ineffective hematopoiesis, cytopenia, and increased risk of transformation to acute myeloid leukemia. Material and Methods. A literature review was conducted using the following bibliographic databases: Google Scholar, MEDLINE, and Kobson. The recommendations for diagnosis, classification, and prognosis are based on expert opinions grounded on a review of the literature and contemporary recommendations for diagnosis and prognosis in myelodysplastic syndrome. Diagnosis and classification. Diagnosis of myelodysplastic syndrome should be based on detailed patient and family history, physical examination, and comprehensive blood examinations in to exclude all other causes of cytopenia and dysplasia. Mandatory for myelodysplastic syndrome diagnosis is cytology of blood and bone marrow, bone marrow biopsy with immunohistology and cytogenetics. 2016 World Health Organization classification should be used for myelodysplastic syndrome diagnosis. SF1B3 genetic analysis is recommended in patients with suspected myelodysplastic syndrome with ringed sideroblasts and p53 mutation status. Prognosis. Revised International Prognostic Scoring System for myelodysplastic syndrome (IPSS-R) risk score should be defined for every patient in order to determine prognosis. The next-generation sequencing could provide additional diagnostic and prognostic information, particularly in young transplant candidates. Conclusion. Myelodysplastic syndrome diagnosis is based on the 2016 World Health Organization classification. The prognosis should be based on the Revised International Prognostic Scoring System with the possible addition of genetic analysis.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89647544","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}
Sonja Lukac, Maja Stankov, D. Nićiforović, Jelena Pilipovic-Grubor, D. Donat, Tijana Mrdjanin
Introduction. Calcifications and microcalcifications are mineral deposits in the breast tissue. Breast calcifications are a common mammographic finding, present on over 80% of images, and they are usually benign. Characteristics such as size, shape, number, distribution pattern, location, density, and other findings help determine the pathology. Dermal calcifications of the breast are superficial and benign calcifications that are usually found on the sebaceous glands of the skin. In some cases, calcifications can be the first marker of underlying cancer development. They may be associated with the presence of ductal carcinoma in situ or even invasive ductal carcinoma that has spread to the surrounding breast tissue. By correct identification of benign calcifications as such, unnecessary interventions and use of limited resources can be avoided. Case Report. A 66-year-old female patient presented for a regular mammography check-up. On the previous mammographic examination, she was categorized as bilateral breast imaging reporting and data system 1. The new mammography images showed numerous newly formed grouped microcalcifications at the junction of the lower quadrants of the right breast, and a stereotactic vacuum-assisted biopsy was indicated. During the biopsy attempt, the image guided biopsy program did not detect any calcifications in the parenchyma or in any projection and therefore it did not allow the biopsy procedure to continue after several attempts. Examination of the right breast skin revealed lesions treated by the patient for a few weeks; a repeat mammogram was performed and it was observed that the calcifications were of dermal origin. Conclusion. Dermal calcifications are mostly tiny, about the size of skin pores, single or clustered, and often have a calcified rim surrounding a lucent center. However, dermal calcifications deserve a special attention, because they sometimes lack a lucent center and simulate grouped intraparenchymal calcifications that require careful monitoring or biopsy.
{"title":"Unusual presentation of dermal microcalcifications on mammography images: A case report","authors":"Sonja Lukac, Maja Stankov, D. Nićiforović, Jelena Pilipovic-Grubor, D. Donat, Tijana Mrdjanin","doi":"10.2298/mpns2210305l","DOIUrl":"https://doi.org/10.2298/mpns2210305l","url":null,"abstract":"Introduction. Calcifications and microcalcifications are mineral deposits in the breast tissue. Breast calcifications are a common mammographic finding, present on over 80% of images, and they are usually benign. Characteristics such as size, shape, number, distribution pattern, location, density, and other findings help determine the pathology. Dermal calcifications of the breast are superficial and benign calcifications that are usually found on the sebaceous glands of the skin. In some cases, calcifications can be the first marker of underlying cancer development. They may be associated with the presence of ductal carcinoma in situ or even invasive ductal carcinoma that has spread to the surrounding breast tissue. By correct identification of benign calcifications as such, unnecessary interventions and use of limited resources can be avoided. Case Report. A 66-year-old female patient presented for a regular mammography check-up. On the previous mammographic examination, she was categorized as bilateral breast imaging reporting and data system 1. The new mammography images showed numerous newly formed grouped microcalcifications at the junction of the lower quadrants of the right breast, and a stereotactic vacuum-assisted biopsy was indicated. During the biopsy attempt, the image guided biopsy program did not detect any calcifications in the parenchyma or in any projection and therefore it did not allow the biopsy procedure to continue after several attempts. Examination of the right breast skin revealed lesions treated by the patient for a few weeks; a repeat mammogram was performed and it was observed that the calcifications were of dermal origin. Conclusion. Dermal calcifications are mostly tiny, about the size of skin pores, single or clustered, and often have a calcified rim surrounding a lucent center. However, dermal calcifications deserve a special attention, because they sometimes lack a lucent center and simulate grouped intraparenchymal calcifications that require careful monitoring or biopsy.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76833153","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}
Nikola Batinic, Tijana Koković, N. Budakov, D. Nikolić
Introduction. Upper extremity venous aneurysms and aneurysms of the neck are rare, unlike the lower extremity venous aneurysms. Only a few cases of upper extremity venous aneurysms have been described in the literature. The aim of the study was to find the best way to treat upper extremity venous aneurysms and the aneurysms of the neck region. Case Report. A 40-year-old female patient reported to the Emergency Center due to the swelling in the supraclavicular region. Color Doppler ultrasonography was performed and a saccular subclavian aneurysm was found, at the junction with the internal jugular vein, with signs of rupture presenting with locoregional hematoma spillage measuring 19 x 13 mm. Complete laboratory tests were performed, followed by computed tomography phlebography, where a partially thrombosed aneurysm was described in the angle between the internal jugular vein and subclavian vein, with a maximum diameter of 25 mm. The patient was hospitalized and treated conservatively. Six days after the onset of symptoms, magnetic resonance phlebography was performed, which did not show the previously described aneurysm of the left venous angle. Three months after the onset of symptoms, a control magnetic resonance phlebography was performed, which showed an aneurysm in the region of the junction of the left internal jugular vein and subclavian vein again, with a maximum diameter of 20 x 13 mm. Conclusion. Clinical examination and color Doppler ultrasound should certainly be the first-line of diagnosis, while magnetic resonance phlebography and computed tomography phlebography are the gold standard for aneurysm monitoring. Asymptomatic aneurysms and aneurysms with mild symptoms are best treated conservatively.
介绍。上肢静脉动脉瘤和颈部动脉瘤是罕见的，不像下肢静脉动脉瘤。文献中只有少数上肢静脉动脉瘤的病例被报道过。本研究的目的是寻找治疗上肢静脉动脉瘤和颈部动脉瘤的最佳方法。病例报告。一名40岁女性患者因锁骨上区域肿胀而向急救中心报告。彩色多普勒超声检查发现一囊状锁骨下动脉瘤，位于颈内静脉交界处，有破裂迹象，局部血肿溢出，尺寸为19 x 13 mm。进行了完整的实验室检查，随后进行了计算机断层摄影静脉摄影，在颈内静脉和锁骨下静脉之间的角度处描述了部分血栓形成的动脉瘤，最大直径为25毫米。患者住院并接受保守治疗。症状出现6天后，进行了磁共振静脉造影，没有显示先前描述的左静脉角动脉瘤。症状出现3个月后行对照磁共振静脉造影，再次在左侧颈内静脉与锁骨下静脉交界处发现动脉瘤，最大直径为20 x 13 mm。结论。临床检查和彩色多普勒超声当然是诊断的第一线，而磁共振血管造影和计算机断层血管造影是动脉瘤监测的金标准。无症状和症状轻微的动脉瘤最好保守治疗。
{"title":"Spontaneus rupture of the left venous angle aneurysm - a case report","authors":"Nikola Batinic, Tijana Koković, N. Budakov, D. Nikolić","doi":"10.2298/mpns2206189b","DOIUrl":"https://doi.org/10.2298/mpns2206189b","url":null,"abstract":"Introduction. Upper extremity venous aneurysms and aneurysms of the neck are rare, unlike the lower extremity venous aneurysms. Only a few cases of upper extremity venous aneurysms have been described in the literature. The aim of the study was to find the best way to treat upper extremity venous aneurysms and the aneurysms of the neck region. Case Report. A 40-year-old female patient reported to the Emergency Center due to the swelling in the supraclavicular region. Color Doppler ultrasonography was performed and a saccular subclavian aneurysm was found, at the junction with the internal jugular vein, with signs of rupture presenting with locoregional hematoma spillage measuring 19 x 13 mm. Complete laboratory tests were performed, followed by computed tomography phlebography, where a partially thrombosed aneurysm was described in the angle between the internal jugular vein and subclavian vein, with a maximum diameter of 25 mm. The patient was hospitalized and treated conservatively. Six days after the onset of symptoms, magnetic resonance phlebography was performed, which did not show the previously described aneurysm of the left venous angle. Three months after the onset of symptoms, a control magnetic resonance phlebography was performed, which showed an aneurysm in the region of the junction of the left internal jugular vein and subclavian vein again, with a maximum diameter of 20 x 13 mm. Conclusion. Clinical examination and color Doppler ultrasound should certainly be the first-line of diagnosis, while magnetic resonance phlebography and computed tomography phlebography are the gold standard for aneurysm monitoring. Asymptomatic aneurysms and aneurysms with mild symptoms are best treated conservatively.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76852860","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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