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Malignant pleural effusion in patients with ovarian cancer 恶性胸腔积液在卵巢癌患者中的应用
Pub Date : 2022-01-01 DOI: 10.2298/mpns2202045m
Tamara Maksimovic, A. Mandić, S. Maksimovic, Ivan Kuhajda, Milorad Bijelović, N. Stevanovic
Introduction. Ovarian cancer is the most lethal gynecological cancer. The most common manifestation of thoracic metastasis is pleural effusion. Pleural effusion with positive cytology is regarded as stage IVa of the International Federation of Gynecology and Obstetrics classification, and the overall five-year survival in these patients is less than 20%. We analyzed the data of patients with ovarian cancer who were treated at the Oncology Institue of Vojvodina, in order to establish the incidence of malignant pleural effusions, laterality of pleural effusions, and clinical manifestations. Material and Methods. The study included 731 patients with ovarian cancer who were treated at the Oncology Institue of Vojvodina from January 2012 to May 2020. The obtained data were compared with data found in the literature in the same period. Results. The incidence of malignant pleural effusion in our study was 5.75%; right-sided pleural effusion was found in 57.15% of patients, 33.33% of patients had effusion on the left side, and 9.52% had bilateral effusions. Thus, unilateral effusion was found in 90.48% of cases, and bilateral in only 9.52%. The most common symptom was dyspnea, reported in 33 patients (78.6%). Conclusion. The incidence of malignant pleural effusion in our study was most similar to data found by Zamboni et al. published in 2015; the right side was the dominant side of pleural effusions. The most common symptoms were dyspnea, shortnes of breath and chest pain.
介绍。卵巢癌是最致命的妇科癌症。胸部转移最常见的表现是胸腔积液。细胞学阳性的胸腔积液被国际妇产联合会(International Federation of Gynecology and Obstetrics)分类为IVa期,这类患者的总5年生存率低于20%。我们分析了在伏伊伏丁那肿瘤研究所接受治疗的卵巢癌患者的资料,以确定恶性胸腔积液的发生率、胸腔积液的侧边性和临床表现。材料和方法。该研究包括2012年1月至2020年5月期间在伏伊伏丁那肿瘤研究所接受治疗的731名卵巢癌患者。将获得的数据与同期文献中的数据进行比较。结果。恶性胸腔积液的发生率为5.75%;右侧胸腔积液占57.15%,左侧胸腔积液占33.33%,双侧胸腔积液占9.52%。单侧积液占90.48%,双侧仅占9.52%。最常见的症状是呼吸困难,33例(78.6%)。结论。我们研究中恶性胸腔积液的发生率与Zamboni等人在2015年发表的数据最为相似;胸腔积液以右侧为主。最常见的症状是呼吸困难、呼吸短促和胸痛。
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引用次数: 0
Effects of cataract surgery on short-term intraocular pressure fluctuations in patients with primary angle-closure and primary angle-closure glaucoma 白内障手术对原发性闭角型和原发性闭角型青光眼患者短期眼压波动的影响
Pub Date : 2022-01-01 DOI: 10.2298/mpns2208217m
Bojana Markić, Milka Mavija, Sasa Smoljanovic-Skocic, S. Burgic
Introduction. Cataract surgery results in a reduction of intraocular pressure, but it has not been sufficiently investigated how it affects short-term intraocular pressure fluctuations. The aim of this study was to evaluate the effects of cataract surgery on short-term intraocular pressure fluctuations in patients with primary angle-closure, with or without glaucoma. Material and Methods. A prospective interventional clinical study included 31 patients (eyes) with primary angle-closure/primary angle-closure glaucoma (study group) and 31 patients (eyes) with cataract only (control group). All subjects underwent cataract surgery. Preoperatively, and at the first, third and sixth postoperative months, diurnal tension curves for the assessment of intraocular pressure was performed and the mean intraocular pressure and short-term intraocular pressure fluctuations were evaluated. Results. Postoperatively, the mean intraocular pressure and short-term intraocular pressure fluctuations were significantly reduced in both groups. In the study group, the highest mean intraocular pressure reduction was - 4.14 ? 2.50 mmHg, and in the control group it was - 2.44 ? 1.76 mmHg. The highest reduction of short-term fluctuations was - 1.61 ? 3.55 mmHg in the study group, and - 0.55 ? 1.72 mmHg in the control group. In both groups, a significant negative correlation was found between the preoperative and postoperative mean intraocular pressure and short-term intraocular pressure fluctuations. At the end of the research, the number of medications was reduced by 18.4% compared to the preoperative period. Conclusion. Cataract surgery in patients with primary angle-closure/primary angle-closure glaucoma results in a significant reduction of intraocular pressure, short-term intraocular pressure fluctuations, and a reduction in the number of medications.
介绍。白内障手术可降低眼压,但对其如何影响短期眼压波动的研究还不够充分。本研究的目的是评估白内障手术对伴有或不伴有青光眼的原发性闭角术患者短期眼压波动的影响。材料和方法。前瞻性介入临床研究纳入31例(眼)原发性闭角型/原发性闭角型青光眼(研究组)和31例(眼)单纯白内障(对照组)。所有受试者都接受了白内障手术。术前、术后第1、3、6个月测眼压日张力曲线,评估平均眼压和短期眼压波动。结果。术后两组平均眼压和短期眼压波动均明显降低。在研究组中,最高平均眼压降低为- 4.14 ?2.50 mmHg,对照组为- 2.44 ?1.76毫米汞柱。短期波动的最大降幅为- 1.61 ?研究组为3.55 mmHg, - 0.55 ?1.72 mmHg。两组患者术前、术后平均眼压与短期眼压波动呈显著负相关。研究结束时,与术前相比,用药数量减少了18.4%。结论。原发性闭角型/原发性闭角型青光眼患者行白内障手术可显著降低眼压、短期眼压波动和减少药物用量。
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引用次数: 0
Electrocardiographic features of patients with hypertrophic cardiomyopathy 肥厚性心肌病患者的心电图特征
Pub Date : 2022-01-01 DOI: 10.2298/mpns2202056p
Andrej Preveden, Mirna Usorac, M. Todić, M. Preveden, M. Golubović, L. Velicki
Introduction. Hypertrophic cardiomyopathy is a disorder of the myocardium characterized by asymmetric or symmetric left ventricular hypertrophy. It is often an inherited disorder with an autosomal dominant pattern. The aim of this study was to evaluate the electrocardiographic characteristics of patients with hypertrophic cardiomyopathy, as well as to assess the accuracy of current electrocardiographic criteria for left ventricular hypertrophy used as indicators of hypertrophic cardiomyopathy. Material and Methods. This retrospective study was conducted using hospital medical records of 42 patients with the diagnosis of hypertrophic cardiomyopathy. Detailed electrocardiography analysis, apart from all the usual parameters, included the calculation of indices used to diagnose left ventricular hypertrophy including Sokolow augmented vector left, Cornell voltage, Cornell product, and Sokolow-Lyon index. Results. Sinus rhythm was present in 95.2% of patients, while atrial fibrillation was found in 4.8%. The majority of patients presented with left axis deviation. A slight positive correlation was found between the Sokolow augmented vector left index and posterolateral wall thickness (r = 0.475; p < 0.05), and also between the Cornell voltage index and posterolateral wall thickness (r = 0.368; p < 0.05). A borderline positive correlation was found between the Cornell product index and posterolateral wall thickness (r = 0.290; p = 0.063). Interventricular septum thickness showed no significant correlation with any of the electrocardiographic indices of left ventricular hypertrophy. Conclusion. In patients with hypertrophic cardiomyopathy, the Sokolow augmented vector left and Cornell voltage indices were the best indicators of posterolateral wall hypertrophy, whereas none of the examined indices correlated well with the interventricular septum thickness.
介绍。肥厚性心肌病是一种以不对称或对称左心室肥厚为特征的心肌疾病。它通常是一种遗传疾病与常染色体显性模式。本研究的目的是评估肥厚性心肌病患者的心电图特征,以及评估当前左室肥厚心电图标准作为肥厚性心肌病指标的准确性。材料和方法。本回顾性研究利用42例诊断为肥厚性心肌病的医院病历进行。详细的心电图分析除常用参数外,还计算了诊断左室肥厚的指标,包括Sokolow增广向量左、Cornell电压、Cornell积、Sokolow- lyon指数。结果。95.2%的患者存在窦性心律,4.8%的患者存在心房颤动。多数患者表现为左轴偏曲。Sokolow增广向量左指数与后外侧壁厚度呈轻微正相关(r = 0.475;p < 0.05),康奈尔电压指数与后侧壁厚度之间也存在差异(r = 0.368;P < 0.05)。康奈尔产物指数与后外侧壁厚度呈临界正相关(r = 0.290;P = 0.063)。室间隔厚度与左室肥厚的心电图指标均无显著相关性。结论。在肥厚型心肌病患者中,Sokolow增强向量左和Cornell电压指数是后外侧壁肥厚的最佳指标,而这些指标与室间隔厚度的相关性都不太好。
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引用次数: 0
Self-assessment of the risk of sexually transmitted diseases 性传播疾病风险的自我评估
Pub Date : 2022-01-01 DOI: 10.2298/mpns2206171b
Aleksandra Bulovic, Jelena Djurica, Milos Nisavic, Vanja Andric
Introduction. Sexually transmitted diseases can be prevented, but it is necessary to know how the infection is transmitted and be aware of the possibility of infection that will lead to change in behavior. Regular testing for sexually transmitted infections is also of crucial importance to prevent its further spread and the development of complications of the infection. The aim of this study was to examine the incidence of risky behaviors in the population of men who have sex with men, their self-assessment of the risk of sexually transmitted diseases, as well as the incidence of testing for these infections. Material and Methods. The study was conducted in the territory of the City of Novi Sad in the population of 185 men who have sex with men. The research method was an anonymous online survey that respondents filled out on a voluntary basis, with previously provided information about the research. Results. Of the total number of respondents, 39% claimed that they had unprotected sex with at least one partner in the previous year. Among the respondents who had unprotected sex in the past year, only 12% believe that they are at high risk of sexually transmitted diseases, and 42% of them have not been tested for sexually transmitted diseases in the past year. Conclusion. In conclusion, a large number of untested people practice risky sex and have a poor perception of the risk of sexually transmitted diseases. The common reason for not getting tested is fear or lack of information about testing.
介绍。性传播疾病是可以预防的,但有必要知道感染是如何传播的,并意识到感染的可能性会导致行为的改变。定期检测性传播感染对于防止其进一步传播和感染并发症的发展也至关重要。这项研究的目的是调查与男性发生性关系的男性人群中危险行为的发生率,他们对性传播疾病风险的自我评估,以及对这些感染进行检测的发生率。材料和方法。这项研究是在诺维萨德市的185名男男性行为者中进行的。研究方法是一项匿名在线调查,受访者在自愿的基础上填写,并提供之前提供的有关研究的信息。结果。在所有受访者中,39%的人声称他们在前一年至少与一名伴侣发生过无保护措施的性行为。在过去一年中有过无保护性行为的答复者中,只有12%的人认为他们患性传播疾病的风险很高,其中42%的人在过去一年中没有接受过性传播疾病的检测。结论。总之,大量未经检验的人从事危险性行为,对性传播疾病的风险认识不足。不接受检测的常见原因是害怕或缺乏有关检测的信息。
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引用次数: 0
Perineal stapled prolapse resection: A csse report 会阴钉状脱垂切除术:一例病例报告
Pub Date : 2022-01-01 DOI: 10.2298/mpns2210317v
D. Vasic, Valentina Isakovic, M. Sekulić, D. Ivanov
Introduction. Over 100 different surgical procedures for the treatment of rectal prolapse have been described. Since these patients commonly have associated comorbidities, methods of choice include surgical techniques with a perineal approach, such as perineal stapled rectal resection. Case Report. A 77-year-old female patient presented with a complete rectal prolapse measuring 12 cm in length. Considering the associated comorbidities and the patient?s age, perineal stapled rectal resection was chosen as the surgical modality. She underwent surgery under general anesthesia in the dorsal decubitus and slightly reverse-Trendelenburg position. The surgery lasted 35 minutes. The surgery and the immediate postoperative course were uneventful. At the follow-up examination, six months after surgery, the findings were normal, without local recurrence. There was a slight deterioration of fecal incontinence, with a Vaizey score 10/20, but the patient tolerated it well. Discussion. The perineal stapled rectal resection technique has fewer intraoperative complications and 6.3% fewer postoperative complications compared to classic perineal procedures (staple line bleeding, anastomotic stenosis, pelvic hematoma, sigmoid colon perforation, perirectal abscesses and rectovaginal fistulas), which were reported in many studies. However, patients with longer postoperative followup demonstrated a higher recurrence rate compared to patients who underwent other surgical techniques with an abdominal approach. Conclusion. The perineal stapled rectal resection procedure is easy to perform and acceptable for the elderly patients with associated comorbidities, who are not candidates for other surgical techniques with abdominal approach.
介绍。超过100种不同的手术程序治疗直肠脱垂已被描述。由于这些患者通常有相关的合并症,选择的方法包括手术技术与会阴入路,如会阴钉直肠切除术。病例报告。一个77岁的女性病人提出了一个完整的直肠脱垂测量长度12厘米。考虑到相关的合并症和患者?50岁时选择会阴直肠吻合术作为手术方式。患者在全身麻醉下采用背卧位和稍反的trendelenburg位进行手术。手术持续了35分钟。手术和术后的过程都很顺利。术后6个月随访检查结果正常,无局部复发。大便失禁轻微恶化,Vaizey评分为10/20,但患者耐受性良好。讨论。会阴吻合器直肠切除术术中并发症少,术后并发症(吻合器线出血、吻合口狭窄、盆腔血肿、乙状结肠穿孔、直肠周围脓肿、直肠阴道瘘)比传统会阴手术少6.3%,相关研究较多报道。然而,术后随访时间较长的患者与接受其他腹部入路手术技术的患者相比,复发率更高。结论。会阴直肠吻合术对于有相关合并症的老年患者容易操作且可接受,这些患者不适合其他腹部入路手术技术。
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引用次数: 0
Grey zone lymphoma - diagnostic and therapeutic challenge 灰色地带淋巴瘤——诊断和治疗的挑战
Pub Date : 2022-01-01 DOI: 10.2298/mpns22s1101a
Danijela Agić, Tanja Lakic, Z. Nikin
Introduction. ?Grey zone Lymphoma?? is associated with various entities. The last published classification of lymphoproliferative neoplasms includes mediastinal grey zone lymphoma. Precise diagnostic criteria are insufficient and establishing a diagnosis is as complex as deciding on treatment options. In this article pathologist and hematologist discuss issues on this topic through case presentation and literature review. Clinical characteristics. It presents in the younger population usually with a mediastinal mass, sometimes large, with compressive symptoms. Pathologic characteristics. Some cases can?t be classified neither as Hodgkin nor Primary mediastinal B-cell lymphoma. Morphology resembles Hodgkin, but with a positive immunophenotype for primary mediastinal or diffuse large B-cell lymphoma, and vice versa. Case report. We presented a case of a 33-year-old male with cervical lymphadenomegaly, B symptoms and clinical deterioration during the diagnostic period. After the first biopsy, differential diagnosis was Epstein-Barr virus-associated lymphoproliferative disorder or classical Hodgkin lymphoma. The second biopsy confirms Epstein-Barr virus-positive diffuse large B-cell lymphoma. The World Health Organization Classification of lymphoproliferative neoplasms - clinical perspective. The term ?grey zone lymphoma? is associated with overlapping diagnosis or uncertainty in diagnosis in more clinical settings than the ones provided in the 5th World Health Organization Classification. Discussion. For now, chemotherapeutic regimen (rituximab-cyclophos phamide, doxorubicin, vincristine, prednisone) stays the standard first line therapy for diffuse large B-cell lymphoma regardless of the Epstein- Barr virus status. Mediastinal grey zone lymphoma treatment varies: chemotherapeutic regimen (rituximab-cyclophos phamide, doxorubicin, vincristine, prednisone) was linked with better outcomes than chemotherapeutic regimen (adriablastin, bleomycin, vinblastine, dacarbazine) +/-R, but for some patients chemotherapeutic regimen (dose adjusted-etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin) might be beneficial. Conclusion. Grey zone lymphoma is a rare hematologic malignancy that needs extensive sampling for correct diagnosis and is still subject to inter-observer variability.
介绍。灰色地带淋巴瘤?与各种实体相关联。最近发表的淋巴增生性肿瘤分类包括纵隔灰色区淋巴瘤。精确的诊断标准是不够的,建立诊断和决定治疗方案一样复杂。在这篇文章中,病理学家和血液学家通过病例报告和文献回顾来讨论这个话题。临床特点。它在年轻人群中表现为纵隔肿块,有时较大,有压迫症状。病理特点。有些情况下可以?既不能归类为霍奇金淋巴瘤,也不能归类为原发性纵隔b细胞淋巴瘤。形态学类似霍奇金淋巴瘤,但原发性纵隔或弥漫性大b细胞淋巴瘤免疫表型阳性,反之亦然。病例报告。我们报告了一例33岁男性,在诊断期间出现颈部淋巴结肿大,B型症状和临床恶化。第一次活检后,鉴别诊断为爱泼斯坦-巴尔病毒相关淋巴细胞增生性疾病或经典霍奇金淋巴瘤。第二次活检证实eb病毒阳性弥漫性大b细胞淋巴瘤。世界卫生组织淋巴增生性肿瘤分类-临床观点。“灰色地带淋巴瘤”这个术语?与世界卫生组织第五次分类中提供的诊断相比,在更多的临床环境中与重叠诊断或诊断不确定有关。讨论。目前,化疗方案(利妥昔单抗-环磷酰胺、阿霉素、长春新碱、强的松)仍然是弥漫性大b细胞淋巴瘤的标准一线治疗方案,无论爱泼斯坦-巴尔病毒是否存在。纵隔灰色地带淋巴瘤的治疗方法各不相同:化疗方案(利妥昔单抗-环磷酰胺、阿霉素、长春新碱、泼尼松)的预后优于化疗方案(阿德里亚布拉西丁、博来霉素、长春新碱、达卡巴嗪)+/-R,但对某些患者而言,化疗方案(剂量调整-依托泊苷、泼尼松、长春新碱、环磷酰胺、阿霉素)可能有益。结论。灰色地带淋巴瘤是一种罕见的血液恶性肿瘤,需要广泛的采样才能正确诊断,并且仍然受到观察者之间的差异。
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引用次数: 0
Correlation between the perceived pain intensity and psychophysical tests in patients with chronic pain 慢性疼痛患者感知疼痛强度与心理物理测试的相关性
Pub Date : 2022-01-01 DOI: 10.2298/mpns2212356a
Tijana Aleksandric, Ivana Radicevic, V. Pejcic, A. Savić, Dajana Dedic, A. Knežević
Introduction. Pain perception varies due to many factors. Quantitative sensory testing is a panel of diagnostic tests used to assess somatosensory function. The aim of the study was to determine how psychophysical variables are related to the perceived pain intensity in patients with chronic pain. Material and Methods. The cross-sectional study included 88 subjects (average age 51.3 ? 9.4 years, 76 (86.4%) women) diagnosed with chronic pain syndrome and fibromyalgia or chronic neuropathic pain associated with lumbosacral radiculopathy. Current and average pain intensities in the past 4 weeks were rated on a numerical rating scale. Quantitative sensory testing included pressure pain thresholds, heat pain thresholds, and cold pain thresholds. Patients filled out the Fear Avoidance Component Scale, a questionnaire that examines the fear avoidance phenomenon. Results. The highest correlations were found between the Fear Avoidance Component Scale scores and current and average pain intensity (r = 0.438 and r = 0.253, respectively); between pain duration and current and average pain intensity in the past 4 weeks (r = 0.340 and r = 0.308, respectively). Moderate and negative correlations were found between pressure pain thresholds and current and average pain intensity (r = - 0.233 and r = -0.300, respectively). Conclusion. Low to moderate, significant positive correlations were found between fear-avoidance and pain intensity. Significant but low negative correlations were found between pressure pain threshold and current pain intensity, as well as between pressure pain threshold and average pain intensity.
介绍。痛觉受多种因素影响。定量感觉测试是一组用于评估体感觉功能的诊断测试。该研究的目的是确定心理物理变量如何与慢性疼痛患者的感知疼痛强度相关。材料和方法。横断面研究包括88名受试者(平均年龄51.3 ?9.4年,76名(86.4%)女性)被诊断为慢性疼痛综合征和纤维肌痛或腰骶神经根病相关的慢性神经性疼痛。在过去4周内对当前和平均疼痛强度进行数值评定。定量感官测试包括压力痛阈、热痛阈和冷痛阈。患者填写了恐惧回避成分量表,这是一份调查恐惧回避现象的问卷。结果。恐惧回避成分量表得分与当前和平均疼痛强度的相关性最高(r = 0.438和r = 0.253);疼痛持续时间与当前及过去4周的平均疼痛强度之间(r = 0.340和r = 0.308)。压力疼痛阈值与当前和平均疼痛强度之间存在中度和负相关(r = - 0.233和r = -0.300)。结论。在恐惧回避和疼痛强度之间发现了低到中等的显著正相关。压痛阈值与当前疼痛强度之间,以及压痛阈值与平均疼痛强度之间存在显著但较低的负相关。
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引用次数: 0
Perioperative bevacizumab in the treatment of colorectal cancer in patients with liver metastases 贝伐单抗在结直肠癌肝转移患者围手术期治疗中的应用
Pub Date : 2022-01-01 DOI: 10.2298/mpns2202012n
I. Nikolic, N. Manojlovic, Z. Andrić, D. Radosavljević, M. Ristic, V. Kovcin
Introduction. Patients with colorectal cancer with metastases in the liver parenchyma may benefit from perioperative chemotherapy with biological agents and operative liver resection. Material and Methods. This prospective, multicenter, non-interventional study included 191 previously untreated patients with metastatic colorectal cancer and potentially resectable or initially unresectable liver metastases who received bevacizumab plus chemotherapy. The safety profile, as well as progression-free-survival, response rate and conversion rate of initially unresectable metastases to resectable were assessed. Results. A total of 40 adverse events were reported in 29/191 patients (15.2%), of which 31 were serious adverse events. Among the serious adverse events, 14 were related to the use of bevacizumab therapy, of which 4 were fatal due to serious adverse events, but only one could be related to bevacizumab therapy. The median progression-free period was 9 months (1 - 28). A high rate of response to the applied therapy, 34.5% and 49%, was recorded in both groups of patients: with initially unresectable and potentially resectable metastases in the liver parenchyma. A significant part of patients with metastatic colorectal cancer and metastases only in the liver parenchyma had a clinical benefit from intensive chemotherapy with bevacizumab (disease control rate of 70%). Conclusion. This study confirmed a favourable safety profile and tolerability in terms of the incidence and severity of adverse and serious adverse events. High rates of resectability in both groups of patients, initially unresectable and potentially resectable, reflect the heterogeneity of criteria in decision making about liver resection and emphasize the need for establishing multisciplinary oncology teams and following the generally accepted criteria.
介绍。结直肠癌肝实质转移患者可能受益于围手术期生物制剂化疗和手术肝切除术。材料和方法。这项前瞻性、多中心、非介入性研究纳入了191例既往未接受治疗的转移性结直肠癌和潜在可切除或最初不可切除的肝转移患者,这些患者接受了贝伐单抗加化疗。评估了安全性、无进展生存期、缓解率和最初不可切除转移到可切除转移的转换率。结果。191例患者中29例(15.2%)共报告40例不良事件,其中31例为严重不良事件。在严重不良事件中,14例与使用贝伐单抗治疗有关,其中4例因严重不良事件致死性,但只有1例可能与贝伐单抗治疗有关。中位无进展期为9个月(1 - 28)。两组患者对应用治疗的高反应率分别为34.5%和49%:最初不可切除和潜在可切除的肝实质转移。相当一部分转移性结直肠癌和仅肝实质转移的患者从贝伐单抗强化化疗中获得临床获益(疾病控制率为70%)。结论。该研究在不良和严重不良事件的发生率和严重程度方面证实了良好的安全性和耐受性。两组患者的高可切除率,最初不可切除和潜在可切除,反映了肝脏切除术决策标准的异质性,并强调需要建立多学科肿瘤团队并遵循普遍接受的标准。
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引用次数: 0
Minipuberty in extremely premature female infants: A report of two cases 极早产女婴青春期缩短:附两例报告
Pub Date : 2022-01-01 DOI: 10.2298/mpns2202067s
Djurdjina Stankovic, Ivana Vorgučin
Introduction. Minipuberty occurs during the first months of life after the activation of the hypothalamic-pituitary-gonadal axis which causes an increase in gonadotropic and sex hormones. Usually, it does not induce clinically evident physical changes. Studies have shown that minipuberty in extremely premature infants is more pronounced and lasts longer, leading to higher levels of sex hormones induce climically evident in physical changes. Case Report. We present two extremely premature female infants, born at 25 weeks of gestation, with clinically evident physical changes during minipuberty. The first infant presented with vaginal bleeding at the age of 4 months, corrected age of 2 weeks. The vaginal bleeding lasted for two days and stopped spontaneously. The infant also had small glandular breast buds of 1 cm bilaterally, swelling in the pubic region, swollen vulva and clitoris. The second infant presented with swelling in the genital region, suprapubic area and the anterior part of thighs, at the age of 4 months, corrected age of 2 weeks. Both infants had ovarian cysts. In both cases, laboratory tests were consistent with minipuberty. The described changes disappeared gradually and spontaneously. Conclusion. In order to avoid unnecessary testing, clinicians should be aware of possible physical changes during minipuberty in extremely premature infants. Clinical monitoring of these infants is recommended until regression of newly developed physical characteristics.
介绍。小青春期发生在生命的最初几个月,在下丘脑-垂体-性腺轴激活后,引起促性腺激素和性激素的增加。通常,它不会引起临床上明显的生理变化。研究表明,极度早产儿的青春期缩短更明显,持续时间更长,导致性激素水平升高,诱发生理变化,这在临床上是明显的。病例报告。我们报告了两个极度早产的女婴,在怀孕25周出生,在青春期轻度有明显的临床生理变化。第一个婴儿在4个月时出现阴道出血,矫正后2周。阴道出血持续了两天,然后自然停止了。婴儿双侧乳腺小腺芽约1cm,阴部肿胀,外阴和阴蒂肿胀。第2例患儿在4个月时出现生殖器区、耻骨上区和大腿前部肿胀,矫正后2周。两个婴儿都有卵巢囊肿。在这两起案件中,实验室检测结果都与轻度青春期相符。所描述的变化逐渐自发地消失。结论。为了避免不必要的测试,临床医生应该意识到在极早产儿青春期可能发生的身体变化。建议对这些婴儿进行临床监测,直到新发育的身体特征消退。
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引用次数: 0
Current strategies for the treatment of acute myeloid leukemia 急性髓性白血病的当前治疗策略
Pub Date : 2022-01-01 DOI: 10.2298/mpns22s1011s
N. Suvajdžić-Vuković, M. Mitrović, M. Virijević, A. Vidović, Z. Cvetković
Introduction. Acute myeloid leukemia is a rare malignancy with an average age of 70 years at diagnosis. Until recently, five-year survival of younger patients with this disease, despite being treated with allogenic hematopoietic stem cell transplantation, was < 30%, while in patients older than 60 years it was < 10%. Treatment overview. Due to the heterogeneity of acute myeloid leukemia no new drugs for treating this disease have been introduced for decades. The introduction of new drugs began from 2017: midostaurin, gilteritinib, CPX351, enasidenib, ivosidenib, venetoclax, glasdegib, while gemtuzumab ozogamicin has been reintroduced. Modern treatment strategies require an individual approach, based on prognostic parameters such as cytogenetical and molecular profile of acute myeloid leukemia at diagnosis and the assessment of minimal residual disease evaluated after two cycles of chemotherapy. Moreover, determining the eligibility of patients for ??intensive?? treatment, based on functional status, comorbidities and geriatric assessment of older patients, is necessary. Regarding the treatment of acute promyelocytic leukemia, the combination of arsenic trioxide and all-trans retinoic acid is universally accepted as the standard of care for non-high risk patients (WBC < 10x109/L), while standard chemotherapy combined with all-trans retinoic acid is still used for high-risk patients (WBC >10x109/L). Conclusion. Novel therapeutic modalities, along with allo-HSCT have changed the outcome of AML patients. However, treating patients unfit for intensive chemotherapy, as well as patients with relapse/refractory disease, is still challenging.
介绍。急性髓性白血病是一种罕见的恶性肿瘤,诊断时平均年龄为70岁。直到最近,尽管接受同种异体造血干细胞移植治疗,患有这种疾病的年轻患者的5年生存率< 30%,而60岁以上患者的5年生存率< 10%。治疗概述。由于急性髓系白血病的异质性,几十年来一直没有新的药物用于治疗这种疾病。2017年开始引入新药:midoshuin、gilteritinib、CPX351、enasidenib、ivosidenib、venetoclax、glasdegib,同时重新引入了吉妥珠单抗ozogamicin。现代治疗策略需要个性化的方法,基于预后参数,如诊断时急性髓系白血病的细胞遗传学和分子谱,以及两个化疗周期后评估的最小残留疾病。此外,确定患者是否有资格接受“强化”治疗。根据老年患者的功能状态、合并症和老年评估进行治疗是必要的。对于急性早幼粒细胞白血病的治疗,三氧化二砷联合全反式维甲酸是公认的非高危患者(WBC为10x109/L)的治疗标准。结论。新的治疗方式以及同种异体造血干细胞移植已经改变了AML患者的预后。然而,治疗不适合强化化疗的患者,以及复发/难治性疾病的患者,仍然具有挑战性。
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Calcutta medical review
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