I. Ergelašev, A. Milenkovic, A. Lovrenski, Milorad Bijelović, Ivan Kuhajda, Sanja Ergelašev
Introduction. Two-thirds of patients with congenital pulmonary airway malformation are asymptomatic at birth, but during life they may develop symptoms such as recurrent respiratory infections. The purpose of this paper is to present three cases of adult patients in whom congenital pulmonary airway malformation was diagnosed and treated at the Institute for Lung Diseases of Vojvodina, along with the clinical course of the disease and the therapeutic procedure. Case Report 1. A 24-year-old female with a medical history of asthma and recurrent signs of lower respiratory tract infections was referred to a thoracic surgeon. Computed tomography of the chest and clinical features were consistent with a congenital lung disease. A left lower video-assisted thoracoscopic lobectomy was performed. Histopathological analysis confirmed type II congenital pulmonary airway malformation with pulmonary sequestration. Case Report 2. A 41-year-old male with a history of left-sided spontaneous pneumothorax at the age of 16 was referred to a thoracic surgeon due to moderate hemoptysis, one month after hospital treatment of left-sided bronchopneumonia. On chest computed tomography, multiple cystic lesions were found in the left lower lung lobe. Thoracotomy and left lower lobectomy were performed. Histopathological analysis confirmed type I congenital pulmonary airway malformation. Case Report 3. The third patient was a 16-year-old male with a history of juvenile asthma and recurrent right-sided bronchopneumonia. Sings of necrotizing pneumonia, lung abscess, and mediastinal lymphadenomegaly were found in the affected lobe. Thoracotomy and right lower lobectomy were performed. Histopathological analysis confirmed type II congenital pulmonary airway malformation. Conclusion. In children and young adults with recurrent small airway inflammation, congenital lung malformation should be considered in the differential diagnosis.
{"title":"Congenital pulmonary airway malformation in adults: A case series","authors":"I. Ergelašev, A. Milenkovic, A. Lovrenski, Milorad Bijelović, Ivan Kuhajda, Sanja Ergelašev","doi":"10.2298/mpns2204128e","DOIUrl":"https://doi.org/10.2298/mpns2204128e","url":null,"abstract":"Introduction. Two-thirds of patients with congenital pulmonary airway malformation are asymptomatic at birth, but during life they may develop symptoms such as recurrent respiratory infections. The purpose of this paper is to present three cases of adult patients in whom congenital pulmonary airway malformation was diagnosed and treated at the Institute for Lung Diseases of Vojvodina, along with the clinical course of the disease and the therapeutic procedure. Case Report 1. A 24-year-old female with a medical history of asthma and recurrent signs of lower respiratory tract infections was referred to a thoracic surgeon. Computed tomography of the chest and clinical features were consistent with a congenital lung disease. A left lower video-assisted thoracoscopic lobectomy was performed. Histopathological analysis confirmed type II congenital pulmonary airway malformation with pulmonary sequestration. Case Report 2. A 41-year-old male with a history of left-sided spontaneous pneumothorax at the age of 16 was referred to a thoracic surgeon due to moderate hemoptysis, one month after hospital treatment of left-sided bronchopneumonia. On chest computed tomography, multiple cystic lesions were found in the left lower lung lobe. Thoracotomy and left lower lobectomy were performed. Histopathological analysis confirmed type I congenital pulmonary airway malformation. Case Report 3. The third patient was a 16-year-old male with a history of juvenile asthma and recurrent right-sided bronchopneumonia. Sings of necrotizing pneumonia, lung abscess, and mediastinal lymphadenomegaly were found in the affected lobe. Thoracotomy and right lower lobectomy were performed. Histopathological analysis confirmed type II congenital pulmonary airway malformation. Conclusion. In children and young adults with recurrent small airway inflammation, congenital lung malformation should be considered in the differential diagnosis.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83325573","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, M. Veselinović, Sonja Lukac, Ana Simundja, Gordan Bajić
Introduction. The coronavirus pandemic has affected various aspects of human life around the world and, among other things, the quality and level of physical activity, which is one of the main preventive mechanisms for many chronic diseases, for both young and adults. It has been shown that physical activity improves mental health and quality of life. Due to the strict measures during the pandemic, people spent more time at home, inactive, sitting or lying for long periods of time. The aim of this study is to assess the level of physical activity of students during the coronavirus disease 2019 epidemic and to determine the impact of these measures on its level. Material and Methods. The study was conducted as a retrospective study including a total of 60 students, aged 22 to 30 years, of which 30 students were final year students of the Faculty of Medicine in Novi Sad and 30 students of the Faculty of Agriculture in Novi Sad. The International Physical Activity Questionnaire was used to assess the level of physical activity. Results. The strictest epidemiological measures affected the level of physical activity of students, mostly reducing the level of light-intensity physical activity. Students of the Faculty of Agriculture were more physically active during the quarantine, especially regarding moderate physical activities. There is no statistically significant association between gender, body mass index, and length of study with the level of physical activity during the epidemic. Conclusion. Students of the Faculty of Medicine showed a lower level of physical activity during the strict epidemiological measures compared to the following period. Students of the Faculty of Agriculture were more physically active during the quarantine compared to the following period and compared to the students of the Faculty of Medicine; they were more active both during and after the strict measures during the coronavirus disease 2019 epidemic.
{"title":"Assessment of the level of physical activity in the final year students of the faculty of medicine in relation to the students of the faculty of agriculture during the covid-19 epidemic","authors":"N. Milenovic, M. Veselinović, Sonja Lukac, Ana Simundja, Gordan Bajić","doi":"10.2298/mpns2202031m","DOIUrl":"https://doi.org/10.2298/mpns2202031m","url":null,"abstract":"Introduction. The coronavirus pandemic has affected various aspects of human life around the world and, among other things, the quality and level of physical activity, which is one of the main preventive mechanisms for many chronic diseases, for both young and adults. It has been shown that physical activity improves mental health and quality of life. Due to the strict measures during the pandemic, people spent more time at home, inactive, sitting or lying for long periods of time. The aim of this study is to assess the level of physical activity of students during the coronavirus disease 2019 epidemic and to determine the impact of these measures on its level. Material and Methods. The study was conducted as a retrospective study including a total of 60 students, aged 22 to 30 years, of which 30 students were final year students of the Faculty of Medicine in Novi Sad and 30 students of the Faculty of Agriculture in Novi Sad. The International Physical Activity Questionnaire was used to assess the level of physical activity. Results. The strictest epidemiological measures affected the level of physical activity of students, mostly reducing the level of light-intensity physical activity. Students of the Faculty of Agriculture were more physically active during the quarantine, especially regarding moderate physical activities. There is no statistically significant association between gender, body mass index, and length of study with the level of physical activity during the epidemic. Conclusion. Students of the Faculty of Medicine showed a lower level of physical activity during the strict epidemiological measures compared to the following period. Students of the Faculty of Agriculture were more physically active during the quarantine compared to the following period and compared to the students of the Faculty of Medicine; they were more active both during and after the strict measures during the coronavirus disease 2019 epidemic.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85945628","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}
T. Terzić, V. Otašević, V. Vukovic, Sofija Šarac, K. Tomic, B. Mihaljević, D. Antić
Diffuse large B-cell lymphoma, not otherwise specified, is the most common type of non-Hodgkin lymphoma worldwide, accounting for 30-40% of all lymphomas. It represents a collection of morphologically, genetically and clinically different diseases. Therefore, it can be subdivided into morphological variants, phenotypic subtypes, and molecular or genetic categories. More recently, diffuse large B-cell lymphoma has witnessed advances in molecular profiling and treatment of patients with refractory and relapsed disease. The optimal management requires integrated morphological and immunophenotypic analysis of cell and tissue, along with chromosome and molecular analyses. Double-expressor lymphoma, defined as overexpression of MYC and BCL2 proteins not related to underlying chromosomal rearrangements, accounts for 20% to 30% of Diffuse large B-cell lymphoma cases. In the latest, 5th edition of the World Health Organization Classification of Hematolymphoid Tumors-lymphoid neoplasms, double-expressor lymphoma is not defined as an independent entity, but it has been proven to be a marker for poor outcome in diffuse large B-cell lymphoma. However, the degree of adverse prognosis is lesser than in double-hit lymphomas. Although double-expressor lymphoma feature is confirmed as adverse prognostic marker for diffuse large B-cell lymphoma patients, currently no sufficient data is available to support treatment intensification over standard rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone regimen. Well-designed randomized clinical trials are mandatory in order to properly respond to this substantial clinical dispute.
{"title":"“Double expressor” diffuse large B-cell lymphoma: A case report and literature review","authors":"T. Terzić, V. Otašević, V. Vukovic, Sofija Šarac, K. Tomic, B. Mihaljević, D. Antić","doi":"10.2298/mpns22s1106t","DOIUrl":"https://doi.org/10.2298/mpns22s1106t","url":null,"abstract":"Diffuse large B-cell lymphoma, not otherwise specified, is the most common type of non-Hodgkin lymphoma worldwide, accounting for 30-40% of all lymphomas. It represents a collection of morphologically, genetically and clinically different diseases. Therefore, it can be subdivided into morphological variants, phenotypic subtypes, and molecular or genetic categories. More recently, diffuse large B-cell lymphoma has witnessed advances in molecular profiling and treatment of patients with refractory and relapsed disease. The optimal management requires integrated morphological and immunophenotypic analysis of cell and tissue, along with chromosome and molecular analyses. Double-expressor lymphoma, defined as overexpression of MYC and BCL2 proteins not related to underlying chromosomal rearrangements, accounts for 20% to 30% of Diffuse large B-cell lymphoma cases. In the latest, 5th edition of the World Health Organization Classification of Hematolymphoid Tumors-lymphoid neoplasms, double-expressor lymphoma is not defined as an independent entity, but it has been proven to be a marker for poor outcome in diffuse large B-cell lymphoma. However, the degree of adverse prognosis is lesser than in double-hit lymphomas. Although double-expressor lymphoma feature is confirmed as adverse prognostic marker for diffuse large B-cell lymphoma patients, currently no sufficient data is available to support treatment intensification over standard rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone regimen. Well-designed randomized clinical trials are mandatory in order to properly respond to this substantial clinical dispute.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"107 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73547002","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. Pharmacotherapy and physical therapy in patients with osteoporosis are aimed at increasing bone density and reducing the risk of fall in order to prevent fractures. Medications approved for the treatment of osteoporosis reduce the risk of fracture, either by reducing bone resorption or by stimulating bone formation. Bisphosphonates are most widely used antiresorptive agents that lower bone turnover markers to premenopausal levels and reduce fracture rates. Bisphosphonates bind to bone minerals and have a long-lasting effect. Long-term, continuous use of oral bisphosphonates is usually interspersed with drug breaks of 1-2 years to reduce the risk of atypical femoral fractures. Denosumab is a monoclonal antibody that also acts as an antiresorptive and it targets receptor activators of nuclear factor-?B ligand thus inhibiting the formation and function of osteoclasts. Denosumab is administered as a subcutaneous injection every 6 months. Anti-fracture effects of denosumab are similar to those of bisphosphonates, but there is a marked loss of antiresorptive effect 7 months after the last dose, which may lead to recurrent vertebral fractures. Anabolic drugs work by stimulating bone formation. Teriparatide and abaloparatide bind to the parathyroid hormone-1 receptor and are given as daily subcutaneous injection for up to 2 years. Romosozumab is a monoclonal antibody that targets sclerostin, stimulates bone formation and inhibits resorption. The effects of anabolics are transient, so it is necessary to switch to antiresorptive medications. Conclusion. It is a matter of great importance to determine the optimal strategy for cycles of anabolics, antiresorptive drugs and therapy-free periods.
{"title":"Indications for initiation of drug therapy and modern therapy protocols in patients with osteoporosis","authors":"K. Boskovic","doi":"10.2298/mpns22s2007b","DOIUrl":"https://doi.org/10.2298/mpns22s2007b","url":null,"abstract":"Introduction. Pharmacotherapy and physical therapy in patients with osteoporosis are aimed at increasing bone density and reducing the risk of fall in order to prevent fractures. Medications approved for the treatment of osteoporosis reduce the risk of fracture, either by reducing bone resorption or by stimulating bone formation. Bisphosphonates are most widely used antiresorptive agents that lower bone turnover markers to premenopausal levels and reduce fracture rates. Bisphosphonates bind to bone minerals and have a long-lasting effect. Long-term, continuous use of oral bisphosphonates is usually interspersed with drug breaks of 1-2 years to reduce the risk of atypical femoral fractures. Denosumab is a monoclonal antibody that also acts as an antiresorptive and it targets receptor activators of nuclear factor-?B ligand thus inhibiting the formation and function of osteoclasts. Denosumab is administered as a subcutaneous injection every 6 months. Anti-fracture effects of denosumab are similar to those of bisphosphonates, but there is a marked loss of antiresorptive effect 7 months after the last dose, which may lead to recurrent vertebral fractures. Anabolic drugs work by stimulating bone formation. Teriparatide and abaloparatide bind to the parathyroid hormone-1 receptor and are given as daily subcutaneous injection for up to 2 years. Romosozumab is a monoclonal antibody that targets sclerostin, stimulates bone formation and inhibits resorption. The effects of anabolics are transient, so it is necessary to switch to antiresorptive medications. Conclusion. It is a matter of great importance to determine the optimal strategy for cycles of anabolics, antiresorptive drugs and therapy-free periods.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"429 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74388689","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. Zvekic-Svorcan, I. Minaković, K. Boskovic, D. Simic-Panic, J. Mikov, Natasa Igic
Introduction. The purpose of treating osteoarthritis is to relieve pain, improve the function of the osteoarthritic joint, and arrest further development of osteoarthritis through non-pharmacological and pharmacological treatment modalities. Pharmacological osteoarthritis therapy. In the treatment of osteoarthritis, guidelines and recommendations are often consulted, but they do not dictate the treatment mode, which is tailored to the individual needs of the patient. These guidelines promote desired and positive treatment outcomes, but cannot predict a specific outcome. They are also valuable when analyzing the use of topical and oral non-steroidal anti-inflammatory drugs, keeping dosage as low as possible for the shortest time. For example, monitoring hepatotoxicity is advised when administering paracetamol, while caution is needed when prescribing drugs with a central effect due to the possible development of addiction and appearance of toxic effects. A significant body of research on the use of chondroprotectors exists, but there is a large discrepancy across studies. Nonetheless, their findings indicate benefits of intra-articular administration of glucocorticoids. However, their more frequent administration can lead to accelerated cartilage loss, while guidelines differ concerning intra-articular administration of hyaluronic acid, the administration of plasma enriched with platelets, and the administration of stem cells due to the heterogeneity of the preparations and the lack of standardization in their administration. Conclusion. Non-surgical therapy is a growing field of research, especially from a pharmacological point of view, intending to find the best treatment to slow down or completely stop further development of osteoarthritis.
{"title":"Pharmacological osteoarthritis therapy and modern therapeutic principles","authors":"J. Zvekic-Svorcan, I. Minaković, K. Boskovic, D. Simic-Panic, J. Mikov, Natasa Igic","doi":"10.2298/mpns22s2047z","DOIUrl":"https://doi.org/10.2298/mpns22s2047z","url":null,"abstract":"Introduction. The purpose of treating osteoarthritis is to relieve pain, improve the function of the osteoarthritic joint, and arrest further development of osteoarthritis through non-pharmacological and pharmacological treatment modalities. Pharmacological osteoarthritis therapy. In the treatment of osteoarthritis, guidelines and recommendations are often consulted, but they do not dictate the treatment mode, which is tailored to the individual needs of the patient. These guidelines promote desired and positive treatment outcomes, but cannot predict a specific outcome. They are also valuable when analyzing the use of topical and oral non-steroidal anti-inflammatory drugs, keeping dosage as low as possible for the shortest time. For example, monitoring hepatotoxicity is advised when administering paracetamol, while caution is needed when prescribing drugs with a central effect due to the possible development of addiction and appearance of toxic effects. A significant body of research on the use of chondroprotectors exists, but there is a large discrepancy across studies. Nonetheless, their findings indicate benefits of intra-articular administration of glucocorticoids. However, their more frequent administration can lead to accelerated cartilage loss, while guidelines differ concerning intra-articular administration of hyaluronic acid, the administration of plasma enriched with platelets, and the administration of stem cells due to the heterogeneity of the preparations and the lack of standardization in their administration. Conclusion. Non-surgical therapy is a growing field of research, especially from a pharmacological point of view, intending to find the best treatment to slow down or completely stop further development of osteoarthritis.","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":"78778623","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. Cvjetković-Bošnjak, Željko Bibić, A. Nedić, O. Zivanovic, V. Vasic, Dusan Kujancic
Introduction. There is a lot of evidence that coronavirus disease 2019 has various manifestations. This paper presents a report of two cases with the aim to indicate the multifactorial etiology of confusional states in patients with mental disorders at the time coronavirus disease 2019 pandemic. The severe acute respiratory syndrome coronavirus-2 affects not only the respiratory and cardiovascular systems, but also the brain, kidneys and other organ systems. One of the first manifestations of this infection can be mental confusion. Case Study. The first patient, a woman diagnosed with schizoaffective psychosis, suddenly presented with confusion, followed by hypersedation which was at first attributed to overmedication. In another patient, with the diagnosis of bipolar affective disorder, sudden confusion (delirium) was initially recognized as an element of mental disorder deterioration. A more detailed observation revealed that the confused state in both patients was caused by severe acute respiratory syndrome coronavirus-2 infection. Discussion. It is common for the manifestations of severe acute respiratory syndrome coronavirus-2 infection to include respiratory and cardiovascular syimptoms. However, symptoms related to other organs and organ systems, including changes in neurological and psychological status, should not be ignored. Conclusion. It was noticed that confusion and delirium-like states are quite common early symptoms of coronavirus disease 2019. In psychiatric patients, it is always necessary to rule out the organic etiology of the consciousness disorder and immediately proceed with the diagnostic procedures. One should certainly keep in mind that diagnostic errors are possible, not only due to various manifestations of the infection, but also due to the stigmatization of mental illness, which must be overcome in order to provide the best possible treatment effects.
{"title":"Understanding the state of confusion in patients with psychosis during COVID-2019 pandemic: A report of two cases","authors":"M. Cvjetković-Bošnjak, Željko Bibić, A. Nedić, O. Zivanovic, V. Vasic, Dusan Kujancic","doi":"10.2298/mpns2204115c","DOIUrl":"https://doi.org/10.2298/mpns2204115c","url":null,"abstract":"Introduction. There is a lot of evidence that coronavirus disease 2019 has various manifestations. This paper presents a report of two cases with the aim to indicate the multifactorial etiology of confusional states in patients with mental disorders at the time coronavirus disease 2019 pandemic. The severe acute respiratory syndrome coronavirus-2 affects not only the respiratory and cardiovascular systems, but also the brain, kidneys and other organ systems. One of the first manifestations of this infection can be mental confusion. Case Study. The first patient, a woman diagnosed with schizoaffective psychosis, suddenly presented with confusion, followed by hypersedation which was at first attributed to overmedication. In another patient, with the diagnosis of bipolar affective disorder, sudden confusion (delirium) was initially recognized as an element of mental disorder deterioration. A more detailed observation revealed that the confused state in both patients was caused by severe acute respiratory syndrome coronavirus-2 infection. Discussion. It is common for the manifestations of severe acute respiratory syndrome coronavirus-2 infection to include respiratory and cardiovascular syimptoms. However, symptoms related to other organs and organ systems, including changes in neurological and psychological status, should not be ignored. Conclusion. It was noticed that confusion and delirium-like states are quite common early symptoms of coronavirus disease 2019. In psychiatric patients, it is always necessary to rule out the organic etiology of the consciousness disorder and immediately proceed with the diagnostic procedures. One should certainly keep in mind that diagnostic errors are possible, not only due to various manifestations of the infection, but also due to the stigmatization of mental illness, which must be overcome in order to provide the best possible treatment effects.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"130 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79611326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Ivanovic, D. Dabović, M. Stefanovic, M. Bjelobrk, G. Samardzija, B. Crnomarković
Introduction. Myxoma is the most common intracardiac tumor accounting for about 50% of all heart tumors. The symptoms depend on the size of the tumor, its location and mobility. Embolic manifestations of coronary arteries are extremely rare, occurring in about 0.06% of cases, and they are caused by tumor fragments. Case Report. A 54-year-old female patient was admitted for an acute myocardial infarction with ST segment elevation in the inferior leads. Urgent coronary angiography was performed showing no coronary vessel stenosis. In the projection of the left atrium, a mobile mass with partial calcification was registered, which was stained to a lesser extent with a contrast agent. These were nutrient vessels with a typical ?tumor blush? sign. An echocardiographic examination showed a round, inhomogeneous mass in the left atrium, which was fixed to the interatrial septum. The findings were presented to the cardiology team and urgent surgical extirpation was performed. During the follow-up period of two years, the patient was doing well and echocardiographic examination showed a normal finding, without recurrence of the tumor. Conclusion. Acute myocardial infarction in people without risk factors for ischemic heart disease is very rare. The most common cause of this type of acute coronary syndrome is spontaneous coronary artery dissection. Acute myocardial infarction caused by embolization of the coronary artery by myxoma fragments is a rare phenomenon. Echocardiographic examination is the method of choice in the diagnosis of myxoma. The most effective treatment for these patients is surgical resection of the tumor with low operative mortality.
{"title":"A rare cause of myocardial infarction - coronary artery embolization by myxoma fragments","authors":"V. Ivanovic, D. Dabović, M. Stefanovic, M. Bjelobrk, G. Samardzija, B. Crnomarković","doi":"10.2298/mpns2208243i","DOIUrl":"https://doi.org/10.2298/mpns2208243i","url":null,"abstract":"Introduction. Myxoma is the most common intracardiac tumor accounting for about 50% of all heart tumors. The symptoms depend on the size of the tumor, its location and mobility. Embolic manifestations of coronary arteries are extremely rare, occurring in about 0.06% of cases, and they are caused by tumor fragments. Case Report. A 54-year-old female patient was admitted for an acute myocardial infarction with ST segment elevation in the inferior leads. Urgent coronary angiography was performed showing no coronary vessel stenosis. In the projection of the left atrium, a mobile mass with partial calcification was registered, which was stained to a lesser extent with a contrast agent. These were nutrient vessels with a typical ?tumor blush? sign. An echocardiographic examination showed a round, inhomogeneous mass in the left atrium, which was fixed to the interatrial septum. The findings were presented to the cardiology team and urgent surgical extirpation was performed. During the follow-up period of two years, the patient was doing well and echocardiographic examination showed a normal finding, without recurrence of the tumor. Conclusion. Acute myocardial infarction in people without risk factors for ischemic heart disease is very rare. The most common cause of this type of acute coronary syndrome is spontaneous coronary artery dissection. Acute myocardial infarction caused by embolization of the coronary artery by myxoma fragments is a rare phenomenon. Echocardiographic examination is the method of choice in the diagnosis of myxoma. The most effective treatment for these patients is surgical resection of the tumor with low operative mortality.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86002495","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. Peripheral joint osteoarthritis is the leading cause of musculoskeletal pain and functional limitation. Osteoarthritis has a high prevalence and incidence and, therefore great socioeconomic importance. Clinical presentation. Pain in osteoarthritis results from a complex interaction of sensory, affective, and cognitive processes that include numerous abnormal cellular mechanisms at the affected joints and different levels of the nervous system involved in the pathophysiological mechanisms of chronic pain (spinal and supraspinal). In chronic pain states, central nervous system factors are particularly prominent. Although there are several ways to determine pain sensitivity, data suggest that assessing pressure pain threshold (i.e., tenderness to palpation) is the most reliable and reproducible method for identifying individuals with a centralized pain state. Conclusion. Significant advances in our understanding of pain pathophysiology and pain biomarkers are finally making the vision of ?personalized analgesia?. Clinicians can identify the sub-sets of individuals with what were once considered purely ?peripheral? pain syndromes and treat these patients with approaches directed more centrally than peripherally.
{"title":"Pain in focus in patients with osteoarthritis","authors":"S. Tomasevic-Todorovic, T. Spasojevic","doi":"10.2298/mpns22s2043t","DOIUrl":"https://doi.org/10.2298/mpns22s2043t","url":null,"abstract":"Introduction. Peripheral joint osteoarthritis is the leading cause of musculoskeletal pain and functional limitation. Osteoarthritis has a high prevalence and incidence and, therefore great socioeconomic importance. Clinical presentation. Pain in osteoarthritis results from a complex interaction of sensory, affective, and cognitive processes that include numerous abnormal cellular mechanisms at the affected joints and different levels of the nervous system involved in the pathophysiological mechanisms of chronic pain (spinal and supraspinal). In chronic pain states, central nervous system factors are particularly prominent. Although there are several ways to determine pain sensitivity, data suggest that assessing pressure pain threshold (i.e., tenderness to palpation) is the most reliable and reproducible method for identifying individuals with a centralized pain state. Conclusion. Significant advances in our understanding of pain pathophysiology and pain biomarkers are finally making the vision of ?personalized analgesia?. Clinicians can identify the sub-sets of individuals with what were once considered purely ?peripheral? pain syndromes and treat these patients with approaches directed more centrally than peripherally.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88516447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Knežević, Minja Abazović, A. Dickov, Dragana M. Ratković, Masa Comic, P. Savic
Introduction. Atypical antipsychotics are the gold standard in the treatment of psychotic and other mental disorders due to their efficacy and tolerability. However, the relatively frequent occurrence of antipsychotic-induced metabolic syndrome has encouraged research into possible solutions to this problem, including the adjunctive use of metformin. The aim of this review article is to present a concise, comprehensive and critical overview of the aforementioned issue based on the analysis of available experimental research. Material and Methods. PubMed and Google Scholar databases were searched for relevant literature published in a fifteen-year period between 2008 and 2022. The following terms were used in the search: atypical antipsychotics, metformin, and weight gain. Only double-blind, placebo-controlled, randomized, and cohort studies were taken into consideration. Results. A total of 145 papers were analyzed, of which 10 papers with 852 subjects met the inclusion criteria. All the reviewed studies concluded that the adjunctive administration of metformin at a daily dose of 500 mg to 2,000 mg has significantly reduced atypical antipsychotic-induced weight gain, with a favorable effect on other metabolic parameters that were examined in the analyzed papers. Conclusion. Taking into account the increased cardiovascular morbidity and the consequent mortality among those who have been using atypical antipsychotics in the long term, it is necessary to assess the risks and benefits of introducing adjunctive metformin in every patient who is at risk of developing metabolic syndrome. In order to recommend the routine use of metformin in such indications, studies that would include a larger sample and a longer period of treatment are needed.
{"title":"Adjunctive use of metformin in the treatment of atypical antipsychotic-induced weight gain","authors":"V. Knežević, Minja Abazović, A. Dickov, Dragana M. Ratković, Masa Comic, P. Savic","doi":"10.2298/mpns2206151k","DOIUrl":"https://doi.org/10.2298/mpns2206151k","url":null,"abstract":"Introduction. Atypical antipsychotics are the gold standard in the treatment of psychotic and other mental disorders due to their efficacy and tolerability. However, the relatively frequent occurrence of antipsychotic-induced metabolic syndrome has encouraged research into possible solutions to this problem, including the adjunctive use of metformin. The aim of this review article is to present a concise, comprehensive and critical overview of the aforementioned issue based on the analysis of available experimental research. Material and Methods. PubMed and Google Scholar databases were searched for relevant literature published in a fifteen-year period between 2008 and 2022. The following terms were used in the search: atypical antipsychotics, metformin, and weight gain. Only double-blind, placebo-controlled, randomized, and cohort studies were taken into consideration. Results. A total of 145 papers were analyzed, of which 10 papers with 852 subjects met the inclusion criteria. All the reviewed studies concluded that the adjunctive administration of metformin at a daily dose of 500 mg to 2,000 mg has significantly reduced atypical antipsychotic-induced weight gain, with a favorable effect on other metabolic parameters that were examined in the analyzed papers. Conclusion. Taking into account the increased cardiovascular morbidity and the consequent mortality among those who have been using atypical antipsychotics in the long term, it is necessary to assess the risks and benefits of introducing adjunctive metformin in every patient who is at risk of developing metabolic syndrome. In order to recommend the routine use of metformin in such indications, studies that would include a larger sample and a longer period of treatment are needed.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73334889","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. Zvekic-Svorcan, I. Minaković, M. Vojnović, A. Miljković, J. Mikov, K. Boskovic
Introduction. Knee osteoarthritis is a progressive degenerative disease of the entire joint that leads to functional limitations and reduced quality of life. The end-stage of the disease is associated with disability and a significant burden both for the patient and the society. Osteoarthritis and metabolic syndrome. Metabolic syndrome is a group of cardiovascular risk factors including diabetes and hyperglycemia, abdominal obesity, hypercholesterolemia, and hypertension. The adverse effects of the metabolic syndrome are associated with worsening of the clinical manifestations and disease prognosis through the combined effects of metabolic disorders. It has also been suggested that individual components of the metabolic syndrome may be an independent risk factor for knee osteoarthritis. Osteoarthritis and diabetes mellitus. Experimental and epidemiological evidence supports the role of type II diabetes mellitus in the pathogenesis of osteoarthritis. Chronic hyperglycemia leads to oxidative stress and excessive production of proinflammatory cytokines, while insulin resistance can act locally and systemically through chronic low-grade inflammation. Osteoarthritis and hypertension. The mechanism that explains the relationship between osteoarthritis and hypertension is unclear. Several potential pathways for subchondral bone damage due to hypertension have been described. Osteoarthritis and dyslipidemia. Experimental studies suggest that dyslipidemia may be involved in the pathophysiological process of osteoarthritis, while epidemiological studies show heterogeneous results. Conclusion. Patients with knee osteoarthritis require a holistic approach in which the emphasis is not only on symptomatic pain relief, but also on the treatment of metabolic disorders.
{"title":"The role of metabolic syndrome in the development of osteoarthritis","authors":"J. Zvekic-Svorcan, I. Minaković, M. Vojnović, A. Miljković, J. Mikov, K. Boskovic","doi":"10.2298/mpns2202039z","DOIUrl":"https://doi.org/10.2298/mpns2202039z","url":null,"abstract":"Introduction. Knee osteoarthritis is a progressive degenerative disease of the entire joint that leads to functional limitations and reduced quality of life. The end-stage of the disease is associated with disability and a significant burden both for the patient and the society. Osteoarthritis and metabolic syndrome. Metabolic syndrome is a group of cardiovascular risk factors including diabetes and hyperglycemia, abdominal obesity, hypercholesterolemia, and hypertension. The adverse effects of the metabolic syndrome are associated with worsening of the clinical manifestations and disease prognosis through the combined effects of metabolic disorders. It has also been suggested that individual components of the metabolic syndrome may be an independent risk factor for knee osteoarthritis. Osteoarthritis and diabetes mellitus. Experimental and epidemiological evidence supports the role of type II diabetes mellitus in the pathogenesis of osteoarthritis. Chronic hyperglycemia leads to oxidative stress and excessive production of proinflammatory cytokines, while insulin resistance can act locally and systemically through chronic low-grade inflammation. Osteoarthritis and hypertension. The mechanism that explains the relationship between osteoarthritis and hypertension is unclear. Several potential pathways for subchondral bone damage due to hypertension have been described. Osteoarthritis and dyslipidemia. Experimental studies suggest that dyslipidemia may be involved in the pathophysiological process of osteoarthritis, while epidemiological studies show heterogeneous results. Conclusion. Patients with knee osteoarthritis require a holistic approach in which the emphasis is not only on symptomatic pain relief, but also on the treatment of metabolic disorders.","PeriodicalId":87940,"journal":{"name":"Calcutta medical review","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80034068","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：