Danilo Kuzman, L. Vujanović, Dunja Veskovic, Dejan Ogorelica, Aleksandra Fejsa-Levakov
Introduction. Pityriasis lichenoides et varioliformis acuta is a rare inflammatory skin disease of unknown etiology and its diagnosis is sometimes established by eliminating diseases that are considered in the differential diagnosis. Given the lack of randomized clinical trials, recommendations for therapy remain based on case reports and case series. Case Report. We present a 63-year-old female patient with generalized skin lesions including, papules, papulonecrotic lesions, and atrophic scars accompanied by a subjective feeling of itching that occurred 2 months before admission. The histopathological findings showed a mixed perivascular inflammatory cellular infiltrate and capillary blood vessels with thickened walls in the superficial part of the dermis as signs of vasculitis. The infiltrate was dominated by lymphocytes, neutrophils were admixed, but there were no signs of cellular atypia, which supported the clinical diagnosis of pityriasis lichenoides et varioliformis acuta. Therapy with systemic corticosteroids and doxycycline was applied, which led to the resolution of lesions. Conclusion. The authors would like to bring to the readers? attention a rare skin disease, pityriasis lichenoides et varioliformis acuta, point to papulonecrotic tuberculids in differential diagnosis due to similar clinical presentation, remind them of the dilemmas that may arise in case of the described lymphocytic vasculitis based on the findings of histopathological analysis, and highlight the effectiveness of doxycycline and prednisone in the therapy.
{"title":"Pityriasis lichenoides et varioliformis acuta - dilemmas in diagnosis and choice of therapy: A case report","authors":"Danilo Kuzman, L. Vujanović, Dunja Veskovic, Dejan Ogorelica, Aleksandra Fejsa-Levakov","doi":"10.2298/mpns2210321k","DOIUrl":"https://doi.org/10.2298/mpns2210321k","url":null,"abstract":"Introduction. Pityriasis lichenoides et varioliformis acuta is a rare inflammatory skin disease of unknown etiology and its diagnosis is sometimes established by eliminating diseases that are considered in the differential diagnosis. Given the lack of randomized clinical trials, recommendations for therapy remain based on case reports and case series. Case Report. We present a 63-year-old female patient with generalized skin lesions including, papules, papulonecrotic lesions, and atrophic scars accompanied by a subjective feeling of itching that occurred 2 months before admission. The histopathological findings showed a mixed perivascular inflammatory cellular infiltrate and capillary blood vessels with thickened walls in the superficial part of the dermis as signs of vasculitis. The infiltrate was dominated by lymphocytes, neutrophils were admixed, but there were no signs of cellular atypia, which supported the clinical diagnosis of pityriasis lichenoides et varioliformis acuta. Therapy with systemic corticosteroids and doxycycline was applied, which led to the resolution of lesions. Conclusion. The authors would like to bring to the readers? attention a rare skin disease, pityriasis lichenoides et varioliformis acuta, point to papulonecrotic tuberculids in differential diagnosis due to similar clinical presentation, remind them of the dilemmas that may arise in case of the described lymphocytic vasculitis based on the findings of histopathological analysis, and highlight the effectiveness of doxycycline and prednisone in the therapy.","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":"87122848","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}
M. Veselinović, S. Mitrović, Renata Škrbić, Vesela Milankov, Daniela Tamas
Inroduction. Pathological characteristics of voice and speech in persons with benign and malignant vocal fold tumors present as different variations in the voice pitch, intensity and quality. The aim of the study was to determine the speech capacity of persons with malignant and benign vocal fold tumors before and after surgical treatment and to establish if there are differences in the speech capacity in relation to the type of tumor. Material and Methods. The sample included 67 subjects who were divided into two groups: group I - subjects with benign tumors, vocal cord lesions (polyps, cysts) and Reinke?s edema and group II - subjects with malignant tumors, aged 23 to 74 years (mean age 55.43; standard deviation 11.95). Acoustic voice analysis, maximum phonation time of the vowel /a/, analysis of temporal speech organization, and sentence melody analysis were used for measuring the speech capacity. Results. Before surgery, the speech capacity in both groups of patients was almost equal, without statistical significance between the compared groups. After surgery, there was a statistically significant difference between the speech capacity in the examined groups, with better speech capacity observed in group I (t = -3.807, p < 0.001). The study did not show an isolated effect of time or tumor type on the speech capacity, but showed a combined effect (F = 10.079, p = 0.002). Conclusion. The proposed method for the assessment of the speech capacity before and after surgical treatment of vocal fold tumors is a useful tool for the prediction of the voice outcome and in planning rehabilitation procedures.
Inroduction。良性和恶性声带肿瘤患者的声音和言语病理特征表现为音高、强度和音质的不同变化。这项研究的目的是确定患有恶性和良性声带肿瘤的人在手术治疗前后的语言能力，并确定语言能力是否与肿瘤类型有关。材料和方法。样本包括67名受试者，他们被分为两组:I组-患有良性肿瘤、声带病变(息肉、囊肿)和Reinke?ⅱ组:伴有恶性肿瘤的患者，年龄23 ~ 74岁，平均年龄55.43岁;标准偏差11.95)。通过语音分析、元音/a/最大发声时间、时态语音组织分析和句子旋律分析来测量语音容量。结果。术前两组患者言语能力基本持平，两组间差异无统计学意义。术后各组患者言语能力差异有统计学意义，其中ⅰ组患儿言语能力较好(t = -3.807, p < 0.001)。该研究没有显示时间或肿瘤类型对语言能力的单独影响，而是显示了一种综合影响(F = 10.079, p = 0.002)。结论。本文提出的评估声带肿瘤手术前后言语能力的方法是预测声带预后和规划康复治疗的有用工具。
{"title":"Speech capacity in patients with voice disorders before and after surgical treatment of vocal fold tumors","authors":"M. Veselinović, S. Mitrović, Renata Škrbić, Vesela Milankov, Daniela Tamas","doi":"10.2298/mpns2202019v","DOIUrl":"https://doi.org/10.2298/mpns2202019v","url":null,"abstract":"Inroduction. Pathological characteristics of voice and speech in persons with benign and malignant vocal fold tumors present as different variations in the voice pitch, intensity and quality. The aim of the study was to determine the speech capacity of persons with malignant and benign vocal fold tumors before and after surgical treatment and to establish if there are differences in the speech capacity in relation to the type of tumor. Material and Methods. The sample included 67 subjects who were divided into two groups: group I - subjects with benign tumors, vocal cord lesions (polyps, cysts) and Reinke?s edema and group II - subjects with malignant tumors, aged 23 to 74 years (mean age 55.43; standard deviation 11.95). Acoustic voice analysis, maximum phonation time of the vowel /a/, analysis of temporal speech organization, and sentence melody analysis were used for measuring the speech capacity. Results. Before surgery, the speech capacity in both groups of patients was almost equal, without statistical significance between the compared groups. After surgery, there was a statistically significant difference between the speech capacity in the examined groups, with better speech capacity observed in group I (t = -3.807, p < 0.001). The study did not show an isolated effect of time or tumor type on the speech capacity, but showed a combined effect (F = 10.079, p = 0.002). Conclusion. The proposed method for the assessment of the speech capacity before and after surgical treatment of vocal fold tumors is a useful tool for the prediction of the voice outcome and in planning rehabilitation procedures.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90140145","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. Knežević, Larisa Vojnovic, D. Popović, T. Spasojevic, Enis Garipi
Introduction. Osteoarthritis is the most common form of arthritis which affects millions of people worldwide and represents the leading cause of disability among the elderly. There is a substantial number of guidelines available for the treatment of knee osteoarthritis. The primary aim of this paper is to explore the distinctions and similarities between knee osteoarthritis treatment guidelines. The treatment is divided into core treatment and additional steps. Core treatment of knee osteoarthritis involves education of the patient, weight loss in the case of overweight patients and establishing an exercise program. First step of additional treatment of knee osteoarthritis consists of non-pharmacological (application of orthoses, lateral wedge insoles, assistive walking devices, therapeutic modalities, manual therapy, aquatic exercise, Tai chi) and pharmacological therapy (topical nonsteroidal anti-inflammatory drugs, topical capsaicin, paracetamol). Second step of additional treatment of knee osteoarthritis - pharmacological therapy should be considered if the first step didn?t show any significant results. It involves the use of oral nonsteroidal antiinflammatory drugs, intra-articular corticosteroid injections and viscosupplementation. Third step of additional treatment of knee osteoarthritis - last resort pharmacological therapy Pain occurring in knee osteoarthritis. can be partially caused by central sensitization. Because of that, use of duloxetine and tramadol may be considered. Fourth step of additional treatment of knee osteoarthritis-end stage treatment of knee osteoarthritis is reserved for the most severe patients. It includes total knee replacement surgery, and if it is not possible, treatment with strong opioids could be considered. Conclusion There are many possibilities in treatment of knee osteoarthritis. Unfortunately, there is often a lack of concordance between different guidelines. In these circumstances, treatment plans should be personalized, while comprehending potential risks and benefits.
{"title":"Knee osteoarthritis treatment","authors":"A. Knežević, Larisa Vojnovic, D. Popović, T. Spasojevic, Enis Garipi","doi":"10.2298/mpns22s2057k","DOIUrl":"https://doi.org/10.2298/mpns22s2057k","url":null,"abstract":"Introduction. Osteoarthritis is the most common form of arthritis which affects millions of people worldwide and represents the leading cause of disability among the elderly. There is a substantial number of guidelines available for the treatment of knee osteoarthritis. The primary aim of this paper is to explore the distinctions and similarities between knee osteoarthritis treatment guidelines. The treatment is divided into core treatment and additional steps. Core treatment of knee osteoarthritis involves education of the patient, weight loss in the case of overweight patients and establishing an exercise program. First step of additional treatment of knee osteoarthritis consists of non-pharmacological (application of orthoses, lateral wedge insoles, assistive walking devices, therapeutic modalities, manual therapy, aquatic exercise, Tai chi) and pharmacological therapy (topical nonsteroidal anti-inflammatory drugs, topical capsaicin, paracetamol). Second step of additional treatment of knee osteoarthritis - pharmacological therapy should be considered if the first step didn?t show any significant results. It involves the use of oral nonsteroidal antiinflammatory drugs, intra-articular corticosteroid injections and viscosupplementation. Third step of additional treatment of knee osteoarthritis - last resort pharmacological therapy Pain occurring in knee osteoarthritis. can be partially caused by central sensitization. Because of that, use of duloxetine and tramadol may be considered. Fourth step of additional treatment of knee osteoarthritis-end stage treatment of knee osteoarthritis is reserved for the most severe patients. It includes total knee replacement surgery, and if it is not possible, treatment with strong opioids could be considered. Conclusion There are many possibilities in treatment of knee osteoarthritis. Unfortunately, there is often a lack of concordance between different guidelines. In these circumstances, treatment plans should be personalized, while comprehending potential risks and benefits.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"20 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":"90413150","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}
M. Peruničić-Jovanović, Sofija Šarac, V. Vukovic, V. Otašević, K. Tomic, B. Mihaljević, D. Antić
Nodular lymphocyte predominant Hodgkin lymphoma appears in 5% of Hodgkin lymphoma. Because of major biological and clinical differences with classical Hodgkin lymphoma and close relationship to T-cell/histiocyte-rich large B-cell lymphoma, lately the term nodular lymphocyte predominant B-cell lymphoma is accepted. The presence of lymphocyte predominant cells with preserved B-cell phenotype and a lack of CD30 is the prerequisite for the diagnosis of nodular lymphocyte predominant Hodgkin lymphoma. Lymphocyte predominant cells are typically embedded in large nodules of B lymphocytes (growth patterns A and B), but variants that are characterized by lymphocyte predominant cells located outside the nodules, a Tcell- rich nodular growth pattern and T-cell-rich or B-cell-rich diffuse growth patterns, respectively, have also been described (growth patterns C, D, E, and F). Variant growth patterns are associated with the recurrence and progression of disease and should be recognized and specified in pathology reports. Broad B-cell immunohistochemical panel, including PAX5, CD79a, Bob.1, and Oct-2 is indicated in these cases to distinguish between nodular lymphocyte predominant Hodgkin lymphoma, classical Hodgkin lymphoma and T-cell/histiocyte-rich large B-cell lymphoma, which have significant differences in clinical behavior and treatment. There are different treatment approaches in patients with nodular lymphocyte predominant Hodgkin lymphoma depending on pathohistological type, clinical presentation and stage of the disease. Treatment may include active surveillance, radiation therapy, immunotherapy or chemotherapy. A multidisciplinary approach is beneficial to optimize the diagnosis and management of patients with nodular lymphocyte predominant Hodgkin lymphoma.
{"title":"Nodular lymphocyte predominant Hodgkin lymphoma with T-cell/histiocyte - rich large B-cell lymphoma pathohistological characteristics and extranodal presentation: Case report and literature review","authors":"M. Peruničić-Jovanović, Sofija Šarac, V. Vukovic, V. Otašević, K. Tomic, B. Mihaljević, D. Antić","doi":"10.2298/mpns22s1111p","DOIUrl":"https://doi.org/10.2298/mpns22s1111p","url":null,"abstract":"Nodular lymphocyte predominant Hodgkin lymphoma appears in 5% of Hodgkin lymphoma. Because of major biological and clinical differences with classical Hodgkin lymphoma and close relationship to T-cell/histiocyte-rich large B-cell lymphoma, lately the term nodular lymphocyte predominant B-cell lymphoma is accepted. The presence of lymphocyte predominant cells with preserved B-cell phenotype and a lack of CD30 is the prerequisite for the diagnosis of nodular lymphocyte predominant Hodgkin lymphoma. Lymphocyte predominant cells are typically embedded in large nodules of B lymphocytes (growth patterns A and B), but variants that are characterized by lymphocyte predominant cells located outside the nodules, a Tcell- rich nodular growth pattern and T-cell-rich or B-cell-rich diffuse growth patterns, respectively, have also been described (growth patterns C, D, E, and F). Variant growth patterns are associated with the recurrence and progression of disease and should be recognized and specified in pathology reports. Broad B-cell immunohistochemical panel, including PAX5, CD79a, Bob.1, and Oct-2 is indicated in these cases to distinguish between nodular lymphocyte predominant Hodgkin lymphoma, classical Hodgkin lymphoma and T-cell/histiocyte-rich large B-cell lymphoma, which have significant differences in clinical behavior and treatment. There are different treatment approaches in patients with nodular lymphocyte predominant Hodgkin lymphoma depending on pathohistological type, clinical presentation and stage of the disease. Treatment may include active surveillance, radiation therapy, immunotherapy or chemotherapy. A multidisciplinary approach is beneficial to optimize the diagnosis and management of patients with nodular lymphocyte predominant Hodgkin lymphoma.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"44 7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75675456","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}
S. Pantelinac, D. Simic-Panic, Natasa Janjic, T. Spasojevic, S. Tomasevic-Todorovic
Introduction. A multidisciplinary and therapeutic approach is used for patients with osteoporotic bone fractures. Falls, leading to injuries, including bone fractures, are a common occurrence in the elderly suffering from osteoporosis. Multifactorial risk assessment is of great importance in identifying risk factors for the occurrence of falls, their removal and implementing preventive measures. The issue of risk assessment is very current and treated by related professional recommendations and national and international guidelines. The latter point out the following fall risks: previous falls, use of psychotropic substances, vision impairment, mobility, gait, muscle strength and balance and impairment of cognitive functions. Fear of falling, psychological passivity, urinary incontinence, inadequate footwear and certain neurologic and cardiovascular conditions are also considered additional risks. Fall risks may also be environmental (within the dwelling and outside), such as low lighting, inadequate furniture and its disposition, difficulty in accessing the bed, chair, toilet, bathroom, stairs and other. For a realistic fall risk estimate, besides using adequate questionnaires, several static and dynamic tests may be used to assess balance and mobility. Depending on the type of risk factors present, actions for their removal through information, education and participation of the elderly in preventive measures are also recommended. Conclusion. Multifactorial risk assessment of fall occurrence and bone fracture, as of recovery, are of great importance within certain population groups, especially the elderly.
{"title":"Physical activity and fall prevention - solving clinical problems","authors":"S. Pantelinac, D. Simic-Panic, Natasa Janjic, T. Spasojevic, S. Tomasevic-Todorovic","doi":"10.2298/mpns22s2032p","DOIUrl":"https://doi.org/10.2298/mpns22s2032p","url":null,"abstract":"Introduction. A multidisciplinary and therapeutic approach is used for patients with osteoporotic bone fractures. Falls, leading to injuries, including bone fractures, are a common occurrence in the elderly suffering from osteoporosis. Multifactorial risk assessment is of great importance in identifying risk factors for the occurrence of falls, their removal and implementing preventive measures. The issue of risk assessment is very current and treated by related professional recommendations and national and international guidelines. The latter point out the following fall risks: previous falls, use of psychotropic substances, vision impairment, mobility, gait, muscle strength and balance and impairment of cognitive functions. Fear of falling, psychological passivity, urinary incontinence, inadequate footwear and certain neurologic and cardiovascular conditions are also considered additional risks. Fall risks may also be environmental (within the dwelling and outside), such as low lighting, inadequate furniture and its disposition, difficulty in accessing the bed, chair, toilet, bathroom, stairs and other. For a realistic fall risk estimate, besides using adequate questionnaires, several static and dynamic tests may be used to assess balance and mobility. Depending on the type of risk factors present, actions for their removal through information, education and participation of the elderly in preventive measures are also recommended. Conclusion. Multifactorial risk assessment of fall occurrence and bone fracture, as of recovery, are of great importance within certain population groups, especially the elderly.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87490806","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}
About 40% of patients with diffuse large B-cell lymphoma will develop disease relapse or refractory disease to first-line rituximabcyclophosphamide, doxorubicin, vincristine and prednisone chemotherapy, necessitating second-line therapy. Historically, this consisted of platinum-based chemotherapy followed by autologous stem cell transplantation for patients who were transplant-eligible. But not all patients are eligible for autologous stem cell transplantation and curative treatment options for these patients were limited. The lack of effective treatment options in the relapsed/refractory diffuse large B-cell lymphoma had made the prognosis of these patients poor. In recent years there have been several new therapeutic agents approved or pending approval for the treatment of relapsed/refractory diffuse large B-cell lymphoma. These treatments include antibody- drug conjugates, novel anti CD19 monoclonal antibodies, chimeric antigen receptor T-cell therapy, bispecific antibodies, and selinexor. This paper reviews current strategies and novel therapies for relapsed/refractory diffuse large B cell lymphoma.
{"title":"Relapsed/refractory diffuse large B-cell lymphoma - advancements in treatment","authors":"O. Tarabar","doi":"10.2298/mpns22s1096t","DOIUrl":"https://doi.org/10.2298/mpns22s1096t","url":null,"abstract":"About 40% of patients with diffuse large B-cell lymphoma will develop disease relapse or refractory disease to first-line rituximabcyclophosphamide, doxorubicin, vincristine and prednisone chemotherapy, necessitating second-line therapy. Historically, this consisted of platinum-based chemotherapy followed by autologous stem cell transplantation for patients who were transplant-eligible. But not all patients are eligible for autologous stem cell transplantation and curative treatment options for these patients were limited. The lack of effective treatment options in the relapsed/refractory diffuse large B-cell lymphoma had made the prognosis of these patients poor. In recent years there have been several new therapeutic agents approved or pending approval for the treatment of relapsed/refractory diffuse large B-cell lymphoma. These treatments include antibody- drug conjugates, novel anti CD19 monoclonal antibodies, chimeric antigen receptor T-cell therapy, bispecific antibodies, and selinexor. This paper reviews current strategies and novel therapies for relapsed/refractory diffuse large B cell lymphoma.","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":"72879124","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. We present the recommendations for treatment of the lower-risk myelodysplastic syndromes on behalf of the Serbian myelodysplastic syndromes group. Material and Methods. A literature review was conducted using the following bibliographic databases: Google Scholar, MEDLINE and Kobson. The recommendations for treatment of lower-risk myelodysplastic syndromes are based on expert opinion based on review of the literature and contemporary recommendations for treatment of lower risk myelodysplastic syndromes. Recommendations. Anemia is the most relevant cytopenia in terms of frequency and symptoms in lower-risk myelodysplastic syndromes, and may be treated successfully with erythropoietic stimulating agents, with or without granulocyte growth factor, provided a careful selection is performed on the basis of Revised International Prognostic Scoring System, endogenous erythropoietin levels, and transfusion independence. In case a patient fails erythropoietic stimulating agents treatment, the available options may include lenalidomide, hypomethylating agents, and a rather large number of experimental agents. Chelation therapy is recommended in patients who have received or are anticipated to receive > 20 red blood cell transfusions and those with serum ferritin levels > 2500 ng/mL. Specific therapy for thrombocytopenia has been proposed in experimental clinical trials with thrombomimetic agents that have shown good efficacy, but raised some safety concern. Severe neutropenia is targeted symptomatically with growth factor supportive care. The immunosuppressive treatments are indicated mainly for pancytopenia, hypoplastic lowerrisk myelodysplastic syndromes. Finally, hematopoietic stem cell transplantation is the curative option for younger, good performance (fit) lower-risk patient with poor risk features, according to European Blood and Marrow Transplantation/European Leukemia Net International expert panel and myelodysplastic syndrome-RIGHT group. Conclusion. Treatment of myelodysplastic syndromes is mainly based on resolution of symptoms due to particular cytopenia(s).
{"title":"Treatment of lower-risk myelodysplastic syndrome","authors":"D. Marisavljević, A. Savic, A. Bogdanović","doi":"10.2298/mpns22s1032m","DOIUrl":"https://doi.org/10.2298/mpns22s1032m","url":null,"abstract":"Introduction. We present the recommendations for treatment of the lower-risk myelodysplastic syndromes on behalf of the Serbian myelodysplastic syndromes group. Material and Methods. A literature review was conducted using the following bibliographic databases: Google Scholar, MEDLINE and Kobson. The recommendations for treatment of lower-risk myelodysplastic syndromes are based on expert opinion based on review of the literature and contemporary recommendations for treatment of lower risk myelodysplastic syndromes. Recommendations. Anemia is the most relevant cytopenia in terms of frequency and symptoms in lower-risk myelodysplastic syndromes, and may be treated successfully with erythropoietic stimulating agents, with or without granulocyte growth factor, provided a careful selection is performed on the basis of Revised International Prognostic Scoring System, endogenous erythropoietin levels, and transfusion independence. In case a patient fails erythropoietic stimulating agents treatment, the available options may include lenalidomide, hypomethylating agents, and a rather large number of experimental agents. Chelation therapy is recommended in patients who have received or are anticipated to receive > 20 red blood cell transfusions and those with serum ferritin levels > 2500 ng/mL. Specific therapy for thrombocytopenia has been proposed in experimental clinical trials with thrombomimetic agents that have shown good efficacy, but raised some safety concern. Severe neutropenia is targeted symptomatically with growth factor supportive care. The immunosuppressive treatments are indicated mainly for pancytopenia, hypoplastic lowerrisk myelodysplastic syndromes. Finally, hematopoietic stem cell transplantation is the curative option for younger, good performance (fit) lower-risk patient with poor risk features, according to European Blood and Marrow Transplantation/European Leukemia Net International expert panel and myelodysplastic syndrome-RIGHT group. Conclusion. Treatment of myelodysplastic syndromes is mainly based on resolution of symptoms due to particular cytopenia(s).","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"438 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76674505","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. The ABO blood group antigens are determined by genes located at three separate genetic loci. Loss or weakening of ABO antigens is often associated with hematological malignant diseases, but also solid tumors in the body. A change in the expression of ABO antigens leads to discrepancies when determining the patient?s blood group and carries the risk of incompatible transfusions. Case Report. During the blood typing of a 27-year-old female patient with a diagnosis of acute myeloid leukemia, there were discrepancies in the interpretation of the ABO blood group. Since the confirmation blood group indicated that it was blood group O, when determining the reverse blood group, the reading showed the absence of the expected agglutination of group A1 and B red blood cells. By examination of the patient?s records, as well as confirmation genotyping, the blood group A was established. After the patient entered the remission phase of the disease, the A Rhesus D positive blood group was determined, without discrepancies during testing. Conclusion. Changes in blood groups can occur even before the diagnosis of hematological malignant disease is established. For this reason, it is extremely important to thoroughly examine any discrepancy during blood typing in order to provide patients with safe blood.
{"title":"Resolving blood group discrepancy in a patient with acute myeloid leukemia: A case report","authors":"Jasmina Grujić, Nevenka Bujandrić, G. Malenković","doi":"10.2298/mpns2210314g","DOIUrl":"https://doi.org/10.2298/mpns2210314g","url":null,"abstract":"Introduction. The ABO blood group antigens are determined by genes located at three separate genetic loci. Loss or weakening of ABO antigens is often associated with hematological malignant diseases, but also solid tumors in the body. A change in the expression of ABO antigens leads to discrepancies when determining the patient?s blood group and carries the risk of incompatible transfusions. Case Report. During the blood typing of a 27-year-old female patient with a diagnosis of acute myeloid leukemia, there were discrepancies in the interpretation of the ABO blood group. Since the confirmation blood group indicated that it was blood group O, when determining the reverse blood group, the reading showed the absence of the expected agglutination of group A1 and B red blood cells. By examination of the patient?s records, as well as confirmation genotyping, the blood group A was established. After the patient entered the remission phase of the disease, the A Rhesus D positive blood group was determined, without discrepancies during testing. Conclusion. Changes in blood groups can occur even before the diagnosis of hematological malignant disease is established. For this reason, it is extremely important to thoroughly examine any discrepancy during blood typing in order to provide patients with safe blood.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"148 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77923297","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. Deep vein thrombosis and pulmonary thromboembolism are among the most important causes of morbidity and mortality in cancer patients. They are common and serious complications that are affected by various risk factors. The aim of this study was to determine the incidence of thromboembolic complications and their association with risk factors in patients with newly diagnosed multiple myeloma. Material and Methods. A retrospective study included 32 patients and the following variables were collected: age, C-reactive protein, beta-2 microglobulin, hemoglobin, platelets, total proteins, nephrotic syndrome, fibrinogen, D-dimer, albumin, lactate dehydrogenase, creatinine, calcium, gender, performance status, type of multiple myeloma, clinical stage, and applied therapy. All variables were compared between two groups of patients: group with thromboembolic complications (deep venous thrombosis and pulmonary thromboembolism), and the group without these complications. Results. The study sample included 18 men and 14 women. The patients? age ranged from 36 to 73 years. Of the 32 patients, 6 had deep venous thrombosis of the lower extremities, and 2 patients had deep venous thrombosis and pulmonary thromboembolism. The only two biomarkers that showed an association with venous thromboembolism in our patients with myeloma were elevated levels of C-reactive protein and D-dimer. Conclusion. The incidence of thromboembolic complications in patients with newly diagnosed multiple myeloma was 25%. When making the diagnosis of myeloma, risk factors that were significantly associated with venous thromboembolism were elevated levels of C-reactive protein and D-dimer. The occurrence of venous thromboembolism in patients with multiple myeloma was not associated with significantly higher mortality compared to patients without venous thromboembolism.
{"title":"Multiple myeloma and deep vein thrombosis/pulmonary thromboembolism - incidence and risk factors","authors":"Jovana Marinkovic, O. Tarabar","doi":"10.2298/mpns2208230m","DOIUrl":"https://doi.org/10.2298/mpns2208230m","url":null,"abstract":"Introduction. Deep vein thrombosis and pulmonary thromboembolism are among the most important causes of morbidity and mortality in cancer patients. They are common and serious complications that are affected by various risk factors. The aim of this study was to determine the incidence of thromboembolic complications and their association with risk factors in patients with newly diagnosed multiple myeloma. Material and Methods. A retrospective study included 32 patients and the following variables were collected: age, C-reactive protein, beta-2 microglobulin, hemoglobin, platelets, total proteins, nephrotic syndrome, fibrinogen, D-dimer, albumin, lactate dehydrogenase, creatinine, calcium, gender, performance status, type of multiple myeloma, clinical stage, and applied therapy. All variables were compared between two groups of patients: group with thromboembolic complications (deep venous thrombosis and pulmonary thromboembolism), and the group without these complications. Results. The study sample included 18 men and 14 women. The patients? age ranged from 36 to 73 years. Of the 32 patients, 6 had deep venous thrombosis of the lower extremities, and 2 patients had deep venous thrombosis and pulmonary thromboembolism. The only two biomarkers that showed an association with venous thromboembolism in our patients with myeloma were elevated levels of C-reactive protein and D-dimer. Conclusion. The incidence of thromboembolic complications in patients with newly diagnosed multiple myeloma was 25%. When making the diagnosis of myeloma, risk factors that were significantly associated with venous thromboembolism were elevated levels of C-reactive protein and D-dimer. The occurrence of venous thromboembolism in patients with multiple myeloma was not associated with significantly higher mortality compared to patients without venous thromboembolism.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85732519","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. Systemic sclerosis is a rare autoimmune disorder of the connective tissue, gastrointestinal tract, lungs, kidneys, and musculoskeletal tissue. It predominantly affects women. The localized variant is limited scleroderma. Case Report. We present a 64-year-old female patient with the diagnosis of limited scleroderma that has lasted for thirteen years. She had hyperpigmentation, telangiectasias, and progressive skin tightening of the face and fingers. Her blood test was positive for antinuclear antibodies. Sclerodactyly began in the distal phalanx. Tender and painful calcium deposits appeared subcutaneously on the surface of palms and knees, radiographically confirmed. The patient was treated with surgical debridement, vasodilating agents, corticosteroids, diltiazem, sildenafil, nitro paste, antiplatelet drugs, and physical therapy. Conclusion. It is necessary to control numerous factors that affect daily functioning, including nutrition, pain therapy, musculoskeletal dysfunctions, and emotional and social aspects caused by deformities. Targeted therapy in the early stages of the disease, before irreversible damage occurs, improves the overall quality of life.
{"title":"Limited scleroderma - a case report","authors":"S. Knežević, S. Djordjevic","doi":"10.2298/mpns2212377k","DOIUrl":"https://doi.org/10.2298/mpns2212377k","url":null,"abstract":"Introduction. Systemic sclerosis is a rare autoimmune disorder of the connective tissue, gastrointestinal tract, lungs, kidneys, and musculoskeletal tissue. It predominantly affects women. The localized variant is limited scleroderma. Case Report. We present a 64-year-old female patient with the diagnosis of limited scleroderma that has lasted for thirteen years. She had hyperpigmentation, telangiectasias, and progressive skin tightening of the face and fingers. Her blood test was positive for antinuclear antibodies. Sclerodactyly began in the distal phalanx. Tender and painful calcium deposits appeared subcutaneously on the surface of palms and knees, radiographically confirmed. The patient was treated with surgical debridement, vasodilating agents, corticosteroids, diltiazem, sildenafil, nitro paste, antiplatelet drugs, and physical therapy. Conclusion. It is necessary to control numerous factors that affect daily functioning, including nutrition, pain therapy, musculoskeletal dysfunctions, and emotional and social aspects caused by deformities. Targeted therapy in the early stages of the disease, before irreversible damage occurs, improves the overall quality of life.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"2674 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75234109","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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