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Correlation between hypertrophic osteoarthropathy and malignancies in patients hospitalized in the Department of rheumatology, physical medicine and rehabilitation, University hospital center Sestre milosrdnice in 1998-2015 period
No full textRizik hiperkoagulabilnosti kod sindromahiperstimulacije jajnika
No full textOvarian hyperstimulation syndrome (OHSS) is a rare and potentially life-threatening complication of infertility treatment occurring during either the luteal phase or early pregnancy. An increasing number of thromboembolic complications associated with the increased use of assisted reproductive techniques have been reported in the literature. Identification of the risk factors is crucial for prevention of thromboembolic events in OHSS patients. Alterations in the hemostatic system cause hypercoagulability in women affected by severe OHSS. Coexistence of inherited hypercoagulable conditions increases the risk of thromboembolism. The role of clinical parameters that can help predict development of thrombosis is controversial. Patients with a personal or family history of thrombosis undergoing infertility treatment should be considered for thrombophilia screening, while routine examination of inherited thrombophilic mutations is not indicated in infertile patients. Antithrombotic primary prevention is not indicated in healthy women undergoing assisted reproductive procedures or in women with thrombophilia. Anticoagulant therapy is indicted if there is clinical evidence of thrombosis or laboratory evidence of hypercoagulability. In this review, the risks of hypercoagulability in the OHSS are discussed.Sindrom hiperstimulacije jajnika je rijetka i za život opasna komplikacija liječenja neplodnosti koja se javlja u lutealnoj fazi menstruacijskog ciklusa ili tijekom rane trudnoće. Povećanjem zastupljenosti tehnika potpomognute oplodnje povećava se broj prijavljenih slučajeva tromboembolijskih komplikacija. U prevenciji tromboembolijskih događaja kod bolesnica sa sindromom hiperstimulacije jajnika ključno je određivanje rizičnih čimbenika. Promjene u sustavu hemostaze uzrokuju hipekoagulabilnost, a nasljedne trombofilije dodatno povećavaju rizik tromboembolije. Sporna je uloga kliničkih parametara koji mogu pomoći u predviđanju razvoja tromboze. Žene podvrgnute liječenju neplodnosti koje su preboljele tromboembolijsku bolest ili u obitelji imaju slučajeve tromboembolijske bolesti treba testirati na nasljedne trombofilije, dok se rutinsko testiranje kod neplodnih žena ne provodi. Antitrombotska terapija je indicirana samo ako su prisutni klinički znakovi tromboze ili laboratorijski dokazana hiperkoagulabilnost, a nije indicirana kod žena s nasljednom trombofilijom u postupku medicinski potpomognute oplodnje bez kliničkih i/ili laboratorijskih znakova tromboze. U ovom preglednom članku opisani su rizici hiperkoagulabilnosti u sindromu hiperstimulacije jajnika
Solitary pulmonary amyloidoma mimicking lung cancer on 18 F-FDG PET-CT scan in systemic lupus erythematosus patient
No full textLocalized amyloid deposits (tumoral amyloidosis or amyloidoma) are uncommon form of amyloidosis and nodular pulmonary amyloidomas are rarely found. This incidental finding can mimic a bronchopulmonary neoplasm and may occur secondarily to an infectious, inflammatory or lymphoproliferative disease. We report a case of a 62-year-old female with long-standing systemic lupus erythematosus (SLE) with low compliance who presented with radiologically-verified solitary pulmonary nodule. Work-up included positron emission tomography–computed tomography (PET-CT) scan, which revealed hypermetabolic uptake of 18 F-fluorodeoxyglucose, and lobectomy was performed. Staining of the tissue was positive for Congo red and was green birefringent under polarized light. Immunohistochemical methods excluded lymphoproliferative disease and confirmed amyloidoma. SLE was controlled with antimalarials and glucocorticoids. Pulmonary amyloidoma should be considered in the differential diagnosis of solitary lung nodules
Cystic Shape Cemento-Ossifying Fibroma of Ethmoid Sinus
No full textCementofibromi skupina su rijetkih dobroćudnih tumora koji nastaju iz peridontalne membrane. Njihov izgled i klinička slika variraju. Zajednička im je veća ili manja produkcija cementnoga tkiva. U većini slučajeva tumori su mali jer im cementomi brzo dozrijevaju i postaju neaktivni, pa novotvorina prestaje rasti. Najčešće se razvijaju u mandibuli, a zatim slijedi maksila. Ostale lokacije, poput paranazalnih šupljina te mekih tkiva kostiju i glave, iznimno su rijetke. Opisan je slučaj devetogodišnje djevojčice koja je imala cementni fibrozirajući tumor sa psamomskim uklopinama, a nastao je u etmoidnom sinusu. Zbog frontalnih glavobolja i smetnji s vidom desno učinjen je NMR koji je pokazao mukocelu prednjega i stražnjega etmoida s destrukcijom orbitalne stijenke i probojem u orbitu. U desnom maksilarnom sinusu uočena je retencija i zadebljana sluznica. Rinoskopski vidjela se kuglasta tvorba u srednjem nosnom hodniku koja je imponirala kao konha buloza. Endoskopski je ustanovljeno da je tumor prominirao ispred srednje nosne školjke u desni kavum nosa, razmekšao krov etmoida, prodirao prema bazi lubanje te adherirao i potiskivao orbitu. Uklonjen je FESS tehnikom, a PHD je naknadno pokazao da nije bila riječ o mukokeli, nego o cementofibromu.Cemento-ossifying fibromas are a group of rarely occurring benign tumours, developing from the periodontal membrane and varying considerably in appearance and in the progress of the disease. Their common feature is higher or lower production of cemental tissue. In most cases the tumours are small because their cementoma mature quickly and become inactive, which causes the tumour to stop growing. They develop most frequently in the mandible and also in the maxilla. Other sites, such as paranasal cavities, soft tissues and bones of the head, are extremely rare. The case of a cemento-fibrosing tumour with psammoma infiltrations, developing from the ethmoid sinus in a nine-year-old girl is reported. Due to frontal headaches and sight defects as well as impaired vision on the right side, NMR was done, which showed a mucocele of the front and rear ethmoid with destruction of the orbital wall and a breakthrough into the orbit. The right maxillary sinus showed a visible retention and a thickened mucous membrane. A rhinoscopy revealed a ball-shaped spherical mass in the medial nasal meatus, which was defined as concha bullosa. An endoscopic examination showed that the tumour protruded in front of the medium nasal concha into the right nasal cavity, softened the ethmoid roof, penetrated toward the base of the skull, adhered and pushed the orbit. It was removed by FESS technique, and PHD revealed subsequently that it was not a mucocele but a cemento-ossifying fibroma
Ultrazvuk kod transplantacije jetre
No full textKod transplantacije jetre dopler ultrazvuk je prva metoda u preoperativnoj obradi bolesnika, intraoperativnoj potvrdi prohodnosti vaskularnih anastomoza, te postoperativnom praćenju s naglaskom na detekciju komplikacija
Ruptura maternice u trećem trimestru nakon prethodne miomektomije
No full textRupture of gravid uterus is surgical emergency causing maternal and fetal morbidity and mortality. The risk of uterine rupture is associated with uterine scars caused by previous cesarean section, myomectomy, hysteroscopic procedures, and curettage. We report a case of a 40-year-old woman in 31st week of gestation with spontaneous uterine rupture. It was her third pregnancy. She had two healthy children from previous pregnancies. Her symptoms were abdominal pain, vomiting and pain in the right shoulder lasting for 12 hours prior to admission. Ultrasound examination at admission revealed a dead fetus in the abdomen and free fluid in the abdominal cavity. She had previously undergone laparoscopic myomectomy. After myomectomy, she had one successful vaginal delivery. Every abdominal pain in pregnant woman with uterine scar should be carefully and promptly examined to exclude uterine rupture before further diagnostic procedures. This early time frame is essential for survival of the fetus and sometimes even of the mother. Uterine rupture represents indication for immediate cesarean section and it should be performed within 25 minutes of the first signs of uterine rupture. As shown in the case presented, one successful vaginal delivery after myomectomy is no guarantee for future pregnancies.Ruptura maternice je akutno stanje u porodništvu koje može voditi do majčine i/ili fetalne smrti. Rizik za rupturu maternice povezan je s ožiljkom na maternici uzrokovanim prethodnim carskim rezom, miomektomijom, histeroskopskim zahvatom ili kiretažom. Prikazuje se 40-godišnja trudnica u 31. tjednu trudnoće koja je imala spontanu rupturu maternice. Ovo je bila treća trudnoća ove bolesnice koja je iz ranijih trudnoća rodila dvoje zdrave djece. Simptomi su bili praćeni bolovima u trbuhu, povraćanjem i bolovima u desnom ramenu koji su trajali 12 sati. Ultrazvučnim pregledom kod prijma je nađen mrtav plod u trbušnoj šupljini uz slobodnu tekućinu u abdomenu. Prethodno je bolesnica jedanput imala laparoskopsku miomektomiju. Nakon miomektomije je vaginalno rodila. Svakoj boli u trbuhu kod trudnice s ožiljkom na maternici treba pristupiti pažljivo i hitno pregledati te obraditi kako bi se isključila ruptura maternice prije daljnjih dijagnostičkih postupaka. Ovo rano vrijeme prepoznavanja je ključno za preživljavanje fetusa, a ponekad i majke. Ruptura maternice je indikacija za hitni carski rez koji treba učiniti unutar 25 minuta od prvih znakova rupture maternice. Čak niti jedan uspješan porod nakon stanja poslije miomektomije ne jamči da će ožiljak izdržati drugu trudnoću
Ultrasonography monitoring of patients with recurrence and neck metastases of medullary thyroid carcinoma
No full textThe aim of the study was to evaluate the usefulness of ultrasonography (US) in follow-up of patients (pts) with medullary thyroid carcinoma (MTC)
UZV prostate
No full textDijagnostičke radiološke metode su transabdominalni ultrazvuk koji orjentaciono određuje volumen prostate, endokavitalni transrektalni ultrazvuk prostate (TRUS) koji je svakako bolji pristup u dijagnostici bolesti prostate, CT koji insuficijentno prikazuje prostatu, te MR odlična radiološka metoda za staging
Sphenoid sinus aspergilloma in trans-sphenoidal surgery for pituitary adenomas
No full textBackground: Simultaneous appearance of sphenoid sinus aspergilloma and pituitary adenoma is a very rare finding.
Methods: Retrospective analysis of patients with sellar and sphenoid sinus mass lesions who underwent trans-sphenoidal surgery was performed. Demographic data, medical history, predisposing factors, clinical picture, neurological status and radiological findings were reviewed. All patients underwent a trans-sphenoidal microsurgical treatment, and acquired specimens underwent both histopathological and microbiological analysis.
Results: Sphenoid sinus aspergilloma was encountered in seven patients. Three patients had an isolated sphenoid sinus aspergilloma and four patients with pituitary macroadenoma had a sphenoid aspergilloma as an incidental finding.
Conclusions: Sphenoid sinus aspergilloma can be found during trans-sphenoidal surgery for pituitary adenomas. Sphenoid sinus extirpation followed by adenomectomy is the treatment of choice unless invasive aspergilloma is encountered requiring additional antifungal therapy
Mogućnosti ultrazvuka u dijagnostici lezija perifernih živaca
No full textPrimjenom sonde visoke frekvencije prikazati mogućnosti ultrazvuka u evaluaciji kontinuiteta, ehostrukture, pokretljivosti i vaskularizacije živca