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Minimally invasive surgical treatment of carcinoma of the papilla of Vater: A case report
Get PDFAmpullary cancer is a rare neoplasm of the pancreaticobiliary tract. Most of the ampullary neoplasms require surgical resection. Cephalic pancreaticoduodenectomy (CPD) has been performed laparoscopically at high-volume institutions worldwide. In this paper, we present a 63-year-old patient with painless jaundice, subjected to proximal endoscopy and biopsy of the lesion located in the papilla of Vater, which resulted in a diagnosis of the adenocarcinoma of the papilla of Vater. We performed laparoscopic CPD with appropriate lymphadenectomy. To the best of our knowledge, this complex and technically challenging surgical procedure is the first of this kind in our country and the region
Quality of the life of people with a bilateral tear of the anterior cruciate ligament of the knee
Get PDFIntroduction: A number of people with facial injuries after surgical treatment one knee time comes and a violation of the opposite knee. These injuries have a major impact on quality of life if they are not treated properly, but also have consequences and after surgery. The aim of this paper is to analyze the questionnaires used to assess the quality of life after mutual ruptured anterior cruciate ligament, and to make recommendations for optimal use of the same. Our goal is to establish a correlation between the results obtained from questionnaires used descriptive answers to questions descriptive questions about aspects of everyday life, aspects of physical activity as well as aspects of personal perception of the current health and satisfaction with it.
Methods: We analyzed questionnaires used to evaluate the quality of life after a bilateral rupture of the anterior cruciate ligament, which are listed in the attached work. In accordance with the subject of research, in this paper were used the following scientific research methods: a method of deduction, analysis, classification, comparison, analysis methods of written documents.
Results: By searching the PubMed database for the purpose of this master\u27s thesis under the terms "unilateral rupture ACL" we came across a 2792 articles, while the term "bilateral rupture of the ACL," retrieved only 73 articles, "contralateral ACL rupture" 192 articles, "Quality of life ACL " 41 articles. The most important dates in our study are certainly "Quality of life after bilateral rupture of the anterior cruciate ligament," where we all find only two articles on this topic.
Conclusion: The most commonly used questionnaires to be used in assessing the success of treatment and quality of life after a bilateral rupture of the anterior cruciate ligament are: QOL, IKDC, KOOS, HSS, ADL, SF-36, WOMAC. IKDC proved to be most suitable for patients with ACL rupture in this study
Routine careful histopathological examination should be performed in sleeve gastrectomy specimens
Get PDFIntroduction: The presence of increased ratio of obesity caused a rapid increase of bariatric surgery practice. In this study, our purpose is to clarify the histopathologic findings of the patients who have experienced this type of bariatric surgery and to learn more about the distinguishable features of laparoscopic sleeve gastrectomy (LSG) specimens and to contribute to the related literature.
Methods: A retrospective study was designed with the histopathologic findings from pathology specimens of 109 patients who experienced LSG between April 2014 and May 2016. To collect essential data, we used the database system of our institution that contains all of the selected patients for our study.
Results: Overall, the average age was 36.2 years, and 85 were female while 24 were male. The principal histopathologic features were active chronic gastritis in 9, chronic gastritis in 68, atrophy in 5, and intestinal metaplasia in 8 patients. In two patients, gastrointestinal stromal tumor was found and in another patient, neuroendocrine cell hyperplasia was found. In addition to the dominant histopathologic features including chronic and active chronic gastritis, a small percent of patients had clinically significant pathologic findings in the sleeve gastrectomy specimens and this may have an effect on postoperative management and morbidity.
Conclusion: Considering these results, having histopathologic examination of the sleeve gastrectomy specimens as a standard procedure is strongly recommended
The effect of temperature and chlorine residual on the presence of Legionella spp. in water systems of public and tourist facilities
Get PDFIntroduction: Legionella bacteria are ubiquitous microorganisms mostly found in artificial water environments, especially those which produce aerosol, such as swimming pools, saunas, and spas. Development of Legionella depends on several factors, including water temperature and chlorine. The aim of this study was to evaluate the occurrence of Legionella spp. to the temperature and free residual chlorine in tap water, water from fountains, swimming pools, cooling and heating systems.
Methods: We collected 238 samples of water taken from different places and analyzed the presence of Legionella spp. by BAS EN ISO 11731-2:2009 - Water quality – Detection and enumeration of Legionella - Part 2: A direct membrane filtration method for waters with low bacterial counts, as samples were the waters with low expectancy of bacterial contamination compared to the temperature and free residual chlorine. The X2 test was used to show statistical significance.
Results: Legionella spp. was detected in 18.62% of tap water and in 8.82% samples of water taken from fountains, swimming pools, and cooling and heating systems. The highest number of positive samples were detected in waters with the temperature higher than 20°C and lower than 50°C. The highest number of positive samples were reported by the concentration of free residual chlorine lower than 0.2 mg/l. The X2 test showed a statistically significant difference between positive and negative results for the presence of Legionella spp. among three groups of water samples.
Conclusion: The research has shown a connection between environmental factors and the presence of Legionella spp. in the water systems of public and tourist facilities
Physical ability in bariatric patients - improvement needed by supervised and individual approach
No full textIntroduction: Physical activity (PA), exercise, and lifestyle intervention are basic interventions to reduce short- and long-term surgical and non-surgical complications in bariatric patients. The purpose of our study was, first, to evaluate the importance of individualized, professionally guided training, encouraging PA, and subsequent positive effects of physical ability and body composition following a structured and supervised exercise program.
Methods: A total of 11 morbidly obese male (n = 4) and female (n = 7), aged 30–54 years, previously subjected to bariatric surgery, were recruited and subjected to 10-weeks structured and supervised exercise protocol with nutritional counseling and motivational support, consisting of twice weekly aquatic and outdoors training sessions. The same protocol was applied to the control group but without supervision, counseling and support. Blood analyses, basic anthropometric measures, body composition analyses, and physical fitness tests were performed before and after the exercise protocol.
Results: The weight, body fat, BMI, systolic and diastolic pressures were mildly decreased after the exercise program, while sit-to-stand, handgrip, and one leg stance scores showed mild increase after the exercise program.
Conclusion: Obese bariatric surgery patients may benefit from structured, supervised exercise program with nutritional counseling and motivational support. Further studies with larger number of participants are needed to confirm the results
External auditory canal osteoma: a case report
Get PDFOsteoma is benign tumor composed of well- differentiated matured osseous tissue. Its presence in mandible and paranasal sinuses is common, yet appearance in external auditory canal is rare. We present a case of a 26- year- old male complaining of hearing loss and pain in the affected ear. Pathohistological analysis of surgically removed tissue revealed tumor consisted of mature trabecular bone, which represents benign lesion without tendency of metastasis
Surgical treatment of lumbar disc herniation in Aceh, Indonesia: description in 28 patients
Get PDFIntroduction: Several studies have reported the incidence of herniated nucleus pulposus (HNP) in some hospitals. Surgery is one of the options in HNP management. HNP surgery results in Aceh have not been reported yet. Therefore, this study reported the HNP surgery in Zainoel Abidin General Hospital, Banda Aceh period 2010-2012.
Methods: This was a descriptive retrospective survey conducted in Zainoel Abidin General Hospital Banda Aceh at August-September 2012.
Results: The incidence of HNP who underwent surgery was 28 patients. There was no HNP case in the age group I (0-18 years), seven patients (25%) were age group II (19-40 years), and 21 patients (75%) were age group III (over 40 years). Based on HNP location, no HNP located in the L1-L2 and L3-L4, one patient (3.57%) was L2-L3, 20 patients (71.42%) were L4-L5, three patients (10.71%) were L5-S1, and there were four HNP patients in multiple lumbar (14.28%). Laminectomy was the most common type of surgery performed (27 patients or 96.42%), followed by laminotomy (one patients or 3.57%).
Conclusion: There was significant association between the incidence of HNP with age, but not with gender. In summary, the most common lumbar disc herniation was in L4-L5. Laminectomy was the most common procedure performed in HNP patient in Aceh
A novel and widely accessible HPLC method for determination content of homosalate in sunscreen products on the market
Get PDFIntroduction: Considering that the research has shown that homosalate act as endocrine-active substance, it is very important to develop quick and sensitive method for tracking its concentrations in sunscreen products. The aim of this paper is to develop and validate the method for determining homosalate in sunscreen preparations and controlling the content of the products found on the market of Bosnia and Herzegovina.
Methods: A high pressure liquid chromatography (HPLC) method for determination homosalate in sunscreen products has been developed and validated. Samples of six different manufacturers have been analyzed. HPLC method is method of choice for this type of investigation.
Results: According to the calibration curve it has been found that the proposed analytical method in a given range of concentration is linear and that the correlation coefficient is R2=0.9998. Accuracy of the method is in range 94.26% -121.53%.The results have shown that the homosalate concentration in the tested samples did not exceed the maximally permissible concentration (10%). In the sample AV50 homosalate was not declared as an active ingredient, but it was identified and quantified at a concentration of 0.143%.
Conclusion: Results of investigation of cosmetic products that are widely present on the market show the need of developing a sufficiently sensitive, easily accessible, analytical method for controlling the content of organic UV filters since the exceeding of the maximally permissible concentration can have a harmful effect on people who use these kinds of products. The results show that developed method meets conditions and is suitable for wide application
Evaluation of quality of life in patients treated for colorectal cancer at the University Hospital Trnava
Get PDFIntroduction: The aim of the study was to evaluate quality of life (QoL) in patients with colorectal cancer (CRC) during complex treatment using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-CR29 questionnaires and to implement routine QoL assessment into our practice.
Methods: 30 patients diagnosed with CRC at the Department of Surgery, Faculty Hospital Trnava, Slovakia were included in the study between May 2014 and April 2015. QoL was assessed using EORTC QLQ-C30 and QLQ-CR29 questionnaires before surgery and 1 month after surgery. Data are presented as means, and a paired t-test and independent t-test were used for statistical analysis.
Results: A significant correlation between the type of treatment and QoL was identified in the cohort. A trend to lower QoL was observed in patients with completed neoadjuvant chemoradiotherapy (CRT) and after surgery with stoma formation. The QoL was also affected by the age and gender of the patients.
Conclusion: QoL assessment provides important outcomes reflecting the consequences of particular therapeutic modality in patients with CRC. The worse effect of neoadjuvant CRT and stoma formation was shown in our study in comparison to radical resection with adjuvant chemotherapy
The impact of organizational culture on patient satisfaction
Get PDFIntroduction: Managing organizational culture has been increasingly viewed as a lever for health care improvement. The aim of this study was to investigate the correlation between the type of organizational culture and patient satisfaction in the selected health care centers in the Federation of Bosnia and Herzegovina (FBIH).
Methods: We conducted a cross-sectional survey in two municipal primary health care (PHC) centers in the FBIH, referred as Primary health care (PHC) center A and Primary health care (PHC) center B. A validated questionnaire, known as the Organizational Culture Assessment Instrument (OCAI), was used for the assessment of organizational culture. The questionnaire was distributed among the family health care teams at the two PHCs. Simultaneously, we carried out a survey about patient satisfaction among patients during their visits to the family health care teams.
Results: We observed the differences in the type of the organizational culture between the health care centers. The hierarchical culture was found the dominant culture in PHC center A, whereas the market culture was the dominant culture in PHC center B. Also, the statistical significance (t test) was recorded in the overall patient satisfaction in the health care center with the dominated hierarchical culture followed by the clan culture (PHC center A).
Conclusions: Considering the lack of similar surveys in Bosnia and Herzegovina, we believe that this study might be a good starting point for education of human resource managers in health care