Medical archives (Sarajevo, Bosnia and Herzegovina)最新文献

Background: Patients with COVID-19 are at greater risk of pulmonary embolism.

Objective: The aim of the present study was to evaluate the monthly prevalence of pulmonary embolism diagnosed by angiotomography and mortality between March 2020 and May 2021 in more than 6000 patients hospitalized with COVID-19 at a single institution.

Methods: A clinical trial was conducted with evaluated medical records the patients hospitalized at the institution who developed pulmonary embolism determined by angiotomography. Monthly and overall mortality rates between March 2020 and May 2021 in this population were evaluated.

Results: A total of 6040 patients were hospitalized in this period, 203 of whom (3.36%) had an angiotomographic diagnosis of pulmonary embolism and 119 of these patients (58.62%) died. The largest number of patients with pulmonary embolism occurred in the periods from July to September 2020 and March to May 2021. No significant difference was found between mortality and the two peaks of the pandemic (p = 0.9, Fisher's exact test).

Conclusion: Pulmonary embolism is associated a higher mortality rate among patients with COVID-19. Therefore, one of the strategies is an emphasis on the prevention of thrombotic and embolic events.

Background: Familial non-autoimmune hyperthyroidism is a rare disorder characterized by the absence of thyroid autoimmunity, particularly TSH receptor antibody [TRAb].

Objective: The aim of this study was to describe a novel TSHR mutation identified in a family of two siblings and their father.

Methods: Two siblings presented for endocrine assessment at ages 7 and 14 years with mild T3 toxicosis, and the father presented at 30 years of age with non-autoimmune thyrotoxicosis. Both siblings were treated with oral antithyroid therapy to achieve reasonable symptom control and thyroid function normalization. The father was treated with oral antithyroid therapy, radioactive iodine, thyroidectomy, and thyroid replacement therapy. Peripheral blood DNA was extracted from both affected siblings and father. Mutation analysis of TSHR was carried out by PCR and Sanger sequencing of both strands of the extracted DNA.

Results: Both siblings and their father were heterozygous for the missense TSHR variant c.1855G>C, p.[Asp619His], in exon 10.

Conclusions: This novel TSHR variant is associated with T3 toxicosis during childhood. Therefore, early identification and treatment may improve patient outcomes.

Background: Malignant triton tumors (MTT) are subtype of malignant peripheral nerve sheath tumor (MPNST) which develop from Schwan cells of peripheral nerves or within neurofibromas, and shows rhabdomyoblastic differentiation. It is a rare soft tissue tumor with poor prognosis.

Objective: We report a case of Malignant Triton Tumor (MTT) arising in the right shoulder in a 46 year old male patient presented to our Musculoskeletal Oncology Clinic at Royal Rehabilitation center at King Hussein Medical Center during June 2018.

Case presentation: The patient was complaining of an 8 months long progressive right shoulder pain and swelling at the posterior lateral area of the shoulder. As accurate diagnosis is crucial in such case, investigations that included x-rays and magnetic resonance imaging (MRI) demonstrated an soft tissue tumor involving the right shoulder area leading to the differential diagnosis of aggressive soft tissue tumor which laid down the plan of an open incisional biopsy to be reported histopathological as a case of Malignant Triton Tumor which is a very rare and aggressive sarcoma originates from the peripheral nerve sheaths as it is subtype of malignant peripheral nerve sheath tumors after which excision of the entire tumor with safety margin was performed and referred for adjuvant chemotherapy.

Conclusion: The treatment of choice is radical tumor excision with wide margins followed by chemotherapy and /or radiotherapy to improve the 5 years survival rates.

Background: Juvenile papillomatosis (JP) of the breast is a rare and benign proliferative disorder affecting young women. The affected patients tend to have an increased risk of breast cancer development during follow-up.

Objective: This article aims to highlight a rare entity of breast disease, that harbor risk of breast cancer.

Case presentation: Here, we present 2 cases of JP in young females; the first case is a 13 year-old presented with spontaneous nipple discharge, while the other patient is a 24 year-old presented with a right breast lump. Both patients had a total excision of the breast lesions, revealing JP at histology. Discussion: Juvenile Papillomatosis is considered a clinicopathological entity and is usually misdiagnosed as fibroadenoma clinically and radiologically, which requires histological correlation. The histologic findings are well-defined (hyperplasia, papillomatosis, and multiple cysts with foamy histiocytes).The controversy in management between surgery and observation is because of insufficient knowledge about the direct relationship between JP and subsequent cancer.

Conclusion: Considering the risk of developing breast cancer in JP, enrolling patients and their families in a close follow-up and surveillance program is crucial.

Background: Chordoma is a rare malignant neoplasm that predominantly arises from the axial skeleton, but can also develop in unusual locations. However, there are also rare cases of "NOS" chordoma involving the oropharyx and epithelial-myoepithelial carcinoma of the parotid gland in the same patient. According to contemporary research, chordoma is a rare malignant neoplasm that arises from the embryonic remnants of the notochord. and typically involves the clivus, sacrococcygeal bones or vertebrae. Studies have shown that the incidence of chordoma has been estimated to be one per one million people per year. Chordoma can occur at any age, but most commonly it is diagnosed in the 40-60 year old age group with the male predominance.

Objective: The aim of this article was to review the case of a 74-year-old female patient with epithelial-myoepithelial carcinoma of the parotid gland and a case of "NOS" chordoma involving the oropharyx.

Methods: Diagnostic methods were used to examine a female patient with two primary malignant tumors: CT neck scan, CT of paranasal sinuses, ultrasound examination, scintigraphy and operative finding.

Case presentzation: Due to the anatomy complexity, complete resection of the tumor through a transoral-transpharyngeal approach was not possible. Intraoperative palpation of the mass revealed well defined submucosal lesion 20x43x46mm beginning at the level of the oro- and hypopharynx and extending superiorly to the nasopharynx, and posteriorly into the spinal canal and intervertebral foramen causing near complete occlusion of the oro and hypopharynx. The patient also underwent extracapsular dissection of the parotid tumor. Postoperative palliative radiotherapy was performed.

Conclusion: Surgical treatment remains the mainstay of treatment for EMC and radiation is imperative for patients who refuse surgery and for those with advanced or inoperable diseases.

Background: Informed Consent (IC) is crucial in pediatric research, aligning with the National Research Act of 1974 and the Belmont Report's principles. Current regulations, particularly 45 CFR 46, provide additional safeguards for children in research.

Objective: This article explores ethical challenges in pediatric research IC, drawing from PubMed literature and regulatory guidelines to understand historical context, legislative milestones, and contemporary issues.

Methods: A literature review, primarily sourced from PubMed, informed the examination of pediatric research and IC, referencing guidelines from the American Academy of Pediatrics and regulations from the FDA and HHS.

Results: The study underscores the need for increased pediatric research due to the prevalence of drugs studied on adults. Despite legislative efforts like the FDAMA and Pediatric Research Equity Act, ethical challenges persist in obtaining IC in pediatric studies.

Conclusion: Pediatric research necessitates nuanced IC approaches, involving parents, guardians, and children. Ethical challenges such as coercion and compensation require attention, with recommendations emphasizing guideline adherence and increased public engagement for trust-building and pediatric health advancement.

Background: HIV is still a global health concern worldwide and in 2021, a total of 27,000 newly infected cases were detected in the Indonesian population, specifically among adults. However, there is no available data found about serotonin levels in newly infected cases of HIV.

Objective: This study aimed to preliminary investigate serotonin levels in newly-infected HIV-positive cases in the Indonesian population.

Methods: A quantitative cross-sectional analytic design was used with a total of 54 newly-infected HIV-positive participants who were enrolled using the purposive sampling technique. The questionnaire, blood sampling, and ELISA methods for measuring serotonin were applied. Furthermore, the serotonin distribution was compared based on participants' characteristics using the Mann-Whitney U test. The main effect of characteristics was also tested by the generalized linear model.

Results: The mean serotonin level was low and did not differ based on participants' characteristics.

Conclusion: Low serotonin level is characteristic of people newly infected with HIV in Indonesia. This might be a manifestation of the depression stage, a consequence of infection, or the involvement in provoking HIV infection progression.

Background: Herpes Zoster (HZ), also known as Shingles, is a commonly occurring infection especially among the elderly. It is due to the reactivation of the dormant virus in the sensory ends that were present since the primary infection with the virus.

Objective: Our study aims at assessing the knowledge, attitudes practices beliefs and current barriers towards the Shingrix vaccine to fully understand where we stand and come up with proper recommendations to services these at-risk individuals and ultimately have a positive impact on the healthcare system.

Methods: Questionnaire based cross sectional study using a translated version of a previously developed and tested questionnaire.

Results: more than 8000 participants responded to the survey. The vast majority had chicken pox before and did hear about the vaccine from different sources. Most of the participants had minimal knowledge regarding the vaccine and were willing to take it regardless of some safety concerns.

Conclusion: more efforts need to be conducted to enhance vaccine uptake in at risk populations in Saudi Arabia.

Background: Dark chocolate and carrot juice may positively decline the pain. However, there is a lack evidence the impact of combination dark chocolate and carrot juice on labor pain during stage 1 of birth delivery among primigravida.

Objective: This study aimed to examine the effectiveness of dark chocolate and carrot juice on perceived labor pain during stage 1 of birth delivery among primigravida.

Methods: This was a quasi-experimental study with participants who received dark chocolate (n=30), carrot juice (n=30), and control group (n=30). Pain level was assessed by using the Numeric Pain Rating Scale (NPRS) before the intervention and at 30 hours after intervention. The Chi-square and one-way analysis of variance tests and general equational model were used.

Results: Data were collected and analyzed before and after 60 minutes of intervention. Our results showed a significant interaction between the group and time, with both groups independently ameliorating labor pain.

Conclusion: Dark chocolate and carrot juice therapies independently lowered pain labor in primigravida mothers, making them a viable treatment for advanced pain labor.

Background: Prostate cancer remains a significant global health concern, necessitating the exploration of novel therapeutic avenues to enhance treatment efficacy and mitigate adverse effects. Objective This study delves into the potential anticancer properties of Pasak Bumi (Eurycoma longifolia Jack) root extract, a traditional Southeast Asian medicinal plant, against prostate cancer.

Methods: The research employs a multifaceted approach, encompassing molecular and cellular analyses to unravel the intricate mechanisms underlying Pasak Bumi's effects on prostate cancer cells. Primary focus is given to the PTEN/P13k/Akt pathway, a critical regulator of cell survival and apoptosis. Various concentrations of Pasak Bumi root extract are applied to prostate cancer cell lines, and the impact on apoptosis, cell proliferation, and key molecular targets is assessed.

Results: Preliminary findings reveal that Pasak Bumi root extract induces apoptosis in prostate cancer cells, evidenced by downstream molecular events associated with programmed cell death. The extract demonstrates concentration-dependent effects, with higher concentrations exhibiting more pronounced anticancer activity. Moreover, Pasak Bumi root extract appears to modulate the PTEN/P13k/Akt pathway, providing a potential mechanistic link to its anticancer effects. Discussion: The study's significance lies in its contribution to the evolving landscape of natural compounds as anticancer agents, particularly in the context of prostate cancer. Pasak Bumi's traditional use as a medicinal plant, coupled with emerging scientific evidence, underscores its potential translational value. The observed modulation of the PTEN/P13k/Akt pathway aligns with the current understanding of prostate cancer pathogenesis, offering a plausible explanation for Pasak Bumi's anticancer effects.

Conclusion: This research sheds light on the promising anticancer potential of Pasak Bumi root extract against prostate cancer. Further exploration of its molecular interactions, synergy with conventional therapies, and efficacy at different stages of cancer progression is warranted. The findings present Pasak Bumi as a nature-inspired candidate for prostate cancer treatment, warranting continued investigation into its therapeutic applications. As the scientific community endeavors to enhance cancer treatment modalities, Pasak Bumi emerges as a captivating subject in the pursuit of effective and minimally invasive prostate cancer therapies.