The study examined the influence of phototherapy with light-emitting diodes (LEDs) on chronic diabetic wound healing.
Chronic diabetic wounds are very difficult to treat due to underlying conditions ...such as angiopathy and neuropathy, resulting in slow healing rates. Conventional treatment options are often insufficient and do not provide satisfactory outcomes. Phototherapy with LED enhances the healing processes through mechanisms of energy exchange between incoming photons and their target, the main one being cytochrome-c oxidase in mitochondria.
A double-blind, randomized study included 60 patients with a chronic diabetic wound treated at the University Medical Center Ljubljana between October 1, 2012 and December 1, 2014. Patients were randomized into either an active group (LED group) or a control group (Co-group). The active group was treated with LED 2.4 J/cm
(wavelengths 625, 660, 850 nm) three times a week for 8 weeks. The Co-group was treated with light that simulated LED. Healing was evaluated using the Falanga wound bed score and wound surface area.
The average baseline wound surface before treatment was 1315 mm
in the LED group and 1584 mm
in the Co-group (p = 0.80). After 8 weeks, the mean surface in the LED group was 56% of the baseline surface and 65% in the Co-group (p > 0.05). Falanga score evaluation showed significantly faster wound bed healing in the LED group compared with the Co-group (p < 0.05).
According to our results, LED significantly improves healing of chronic diabetic wounds and prepares the wound bed for further coverage options.
The aim of the prospective clinical study was to evaluate the reasons for refusing kidney transplantation among chronic dialysis patients. A total of 164 adult chronic dialysis patients participated ...in the study. They were asked to complete a detailed questionnaire on specific issues regarding transplantation. The mean age was 60.9 ± 16.0 (20–89) years, 61.6% were male, 11.6% had had a previous transplant. The majority, that is, 72.0%, of the patients believed that transplantation improved the quality of life, and 55.5% believed that transplantation prolonged life. Nevertheless, 45.0% of the patients wanted to be transplanted, 35.0% refused transplantation, and 20.0% were undecided. Patients refusing transplantation were significantly older compared to the patients wanting to be transplanted (67 ± 16 vs. 57 ± 16 years; P < 0.001). The main reasons for refusing transplantation (57 patients) were the side‐effects of immunosuppressive therapy (31.6%), unpredictability of transplant outcome (29.8%), and unfavorable outcomes in fellow patients (28.1%). The side‐effects of immunosuppressive therapy that patients were most concerned about included mobility problems (29.8%), new‐onset diabetes (26.3%), increased risk of severe infections (26.3%), problems with vision (22.8%), and increased risk of cancer (21.1%). Many patients did not want to accept organs from expanded criteria donors (ECD) (44.6% of the patients wanting and 64.9% of those refusing transplantation). The majority believed that patients should be informed if an organ from an ECD donor is being offered (64.9% of patients wanting and 63.2% of those refusing transplantation). The main reasons for refusing kidney transplantation were the side‐effects of immunosuppressive therapy, unpredictability of transplant outcome, and unfavorable outcomes in fellow patients.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Introduction. A ganglion cyst is a common benign tumor, mainly found in the wrist and ankle. The ones originating from a tendon, such as in our case, are the most rare. The ganglion cyst presents ...with a variety of symptoms, offering a wide range of possible differential diagnoses. Physical examination is crucial to make an accurate diagnosis, but magnetic resonance imaging (MRI) can help in identifying the ganglion cyst. The treatment is mostly conservative, but in cases when the ganglion cyst disables the patient?s ability for normal life functioning, due to pain and decreased mobility, surgery is necessary. Case report. A 38-year-old female with persistent ankle pain and edema was clinically diagnosed with luxation of peroneal tendons. Further investigation with MRI showed tenosynovitis of peroneal ten-dons and rupture of the superior peroneal retinaculum with an intratendinous ganglion cyst of peroneus brevis tendon. Surgical treatment with the reconstruction of peroneus brevis and peroneal retinaculum was performed with semitendinosus graft and anchor sutures. Histology confirmed the diagnosis of the intratendinous ganglion. After four months of rehabilitation, the patient returned to normal daily and sports activities and was pain-free on the follow-up. No recurrence of the ganglion cyst was acknowledged. Conclusion. Surgery is crucial for patients with intratendinous ganglion cyst and symptomatic instability of the peroneal tendons with chronic subluxation.
nema
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DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Background: Thrombotic microangiopathy (TMA) is a rare syndrome that leads to excessive formation of blood clots, microthrombosis and is accompanied by non-autoimune haemolytic anemia and ...thrombocytopenia. Only few cases describing secondary TMA, thrombotic thrombocytopenic purpura (TTP) caused by cancer have been reported in the literature. Patient: A 42-year old male patient with meta-static carcinoma of the descending colon and several accompanying diagnoses had later developed clinical and laboratory signs of TMA. Secondary, cancer-related TTP, was unresponsive to therapy with plasmapheresis, which was discontinued and the rst cycle of chemotherapy was applied. The patient died soon aer. The autopsy did not provide any additional information about the disease. There were no signs of malignant bone marrow inltration. Conclusion: The diagnosis of secondary TMA, caused by cancer, is difficult. Patients with cancer do not respond to plasmapheresis, which oen delays the application of chemotherapy, which is the only eective treatment for such cases.
Debelost je kronična bolezen, za katero je značilno čezmerno kopičenje maščevja v telesu. Debeli bolniki imajo pogosto številne pridružene bolezni ter anatomske in presnovne spremembe, ki so povezane ...z večjim tveganjem za zaplete v perioperativnem obdobju. Debelost tako pomembno vpliva na izbiro anestezijske tehnike in zahteva multidisciplinarni pristop. V prispevku predstavljamo primer 60-letne bolnice z rakom na debelem črevesu in indeksom telesne mase (ITM) 48,1 kg/m2. Perioperativno smo jo obravnavali v skladu s protokolom za hitro okrevanje po kirurškem posegu (angl. Enhanced Recovery After Surgery, ERAS). Pred kirurškim posegom smo ocenili morebitna tveganja in jih upoštevali pri vodenju anestezije med kirurškim posegom. Po posegu smo bolnico obravnavali v enoti intenzivne terapije (EIT). V prispevku se osredotočamo na anesteziološke vidike perioperativnega vodenja. Čeprav je debelost nedvomno pomemben dejavnik tveganja kirurškega zdravljenja, pa v novejših raziskavah poročajo tudi o ugodnih vplivih debelosti z manjšo perioperativno obolevnostjo in smrtnostjo. Gre za t. i. paradoks debelosti, saj čezmerna telesna masa velja za zaščitni dejavnik, ki varuje pred zapleti kirurškega zdravljenja, kar smo potrdili tudi v našem primeru. Hkrati smo opredelili kritične točke pri anesteziji morbidno debelega bolnika in tista področja, na katerih lahko anesteziologi – ob upoštevanju protokola ERAS – pomembno prispevamo k bolnikovemu čim hitrejšemu okrevanju.
Debelost je kronična bolezen, za katero je značilno čezmerno kopičenje maščevja v telesu. Debeli bolniki imajo pogosto številne pridružene bolezni ter anatomske in presnovne spremembe, ki so povezane ...z večjim tveganjem za zaplete v perioperativnem obdobju. Debelost tako pomembno vpliva na izbiro anestezijske tehnike in zahteva multidisciplinarni pristop. V prispevku predstavljamo primer 60-letne bolnice z rakom na debelem črevesu in indeksom telesne mase (ITM) 48,1 kg/m2. Perioperativno smo jo obravnavali v skladu s protokolom za hitro okrevanje po kirurškem posegu (angl. Enhanced Recovery After Surgery, ERAS). Pred kirurškim posegom smo ocenili morebitna tveganja in jih upoštevali pri vodenju anestezije med kirurškim posegom. Po posegu smo bolnico obravnavali v enoti intenzivne terapije (EIT). V prispevku se osredotočamo na anesteziološke vidike perioperativnega vodenja. Čeprav je debelost nedvomno pomemben dejavnik tveganja kirurškega zdravljenja, pa v novejših raziskavah poročajo tudi o ugodnih vplivih debelosti z manjšo perioperativno obolevnostjo in smrtnostjo. Gre za t. i. paradoks debelosti, saj čezmerna telesna masa velja za zaščitni dejavnik, ki varuje pred zapleti kirurškega zdravljenja, kar smo potrdili tudi v našem primeru. Hkrati smo opredelili kritične točke pri anesteziji morbidno debelega bolnika in tista področja, na katerih lahko anesteziologi – ob upoštevanju protokola ERAS – pomembno prispevamo k bolnikovemu čim hitrejšemu okrevanju.
Background
Currently, data on pathogenic variants in the
CHEK2
gene and their impact on cancer risk are lacking. This study aimed to explore the characteristics of breast cancer (BC) patients from ...families with
CHEK2
pathogenic variants in Slovenia.
Methods
In the years 2014 to 2019,
CHEK2
pathogenic variants/likely pathogenic variants (PV/LPVs) were found in probands from 50 different families who underwent genetic counseling and testing using a multigene panel at the authors’ institution. Altogether, the study enrolled 75 individuals from 50
CHEK2
families who were carriers of a
CHEK2
PV/LPV. The clinical data on 41 BC patients with
CHEK2
PV/LPV and other carriers of
CHEK2
PV/LPV from Slovenia were collected and analyzed.
Results
Breast cancer was diagnosed in 41 of 75
CHEK2
PV/LPV carriers (40 females, 1 male). The mean age at BC diagnosis was 42.8 years (range, 21–63 years), and 27 (65.8%) of the 41 of patients with BC had a positive family history for BC. Contralateral BC (CBC) was observed in 8 (19.5%) of the 41 patients (mean age, 55.6 years). Of 12 patients with human epidermal growth factor receptor 2 (HER2)-positive tumor type, a c.444+1G > A PV/LPV was detected in 4 patients, c.349A > G in 3 patients, deletion of exons 9–10 in 3 patients, deletion of exon 8 in 1 patient, and c.1427C > T PV/LPV in 1 patient.
Conclusion
Bilateral BC was diagnosed in as many as 19.5% of the Slovenian BC patients with
CHEK2
PV/LPVs. Breast cancer associated with a germline
CHEK2
PV/LPV occurs in younger patients compared with sporadic BC.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
AbstractBackground: Thrombotic microangiopathy (TMA) is a rare syndrome that leads to excessive formation of blood clots, microthrombosis and is accompanied by non-autoimune haemolytic anemia and ...thrombocytopenia. Only few cases describing TMA caused by cancer are being reported in the literature.Patient: A 42-year old male patient with metastatic carcinoma of sigma and several accompanying diagnoses (pulmonary embolism, deep vein thrombosis, cerebrovascular insult) had later developed clinical and laboratory signs of TMA. TMA was unresponsive to plasmapheresis, which was discontinued and first cycle of chemotherapy was applied. The patient died soon after. The autopsy did not provide any additional information about the disease, there were no signs of malignant bone marrow infiltration.Conclusion: The diagnosis of secondary TMA remains a diagnostic and therapeutic challenge. It appears as a rare complication in patients with cancer. Treatment is difficult because the cause of TMA (malignancy) is hard to remove. Patients with cancer do not respond to plasmapheresis, which often delays the application of chemotherapy, the only effective treatment for TMA. Consequently this condition has poor prognosis.
Abstract
Background: Thrombotic microangiopathy (TMA) is a rare syndrome that leads to excessive formation of blood clots, microthrombosis and is accompanied by non-autoimune haemolytic anemia and ...thrombocytopenia. Only few cases describing TMA caused by cancer are being reported in the literature.
Patient: A 42-year old male patient with metastatic carcinoma of sigma and several accompanying diagnoses (pulmonary embolism, deep vein thrombosis, cerebrovascular insult) had later developed clinical and laboratory signs of TMA. TMA was unresponsive to plasmapheresis, which was discontinued and first cycle of chemotherapy was applied. The patient died soon after. The autopsy did not provide any additional information about the disease, there were no signs of malignant bone marrow infiltration.
Conclusion: The diagnosis of secondary TMA remains a diagnostic and therapeutic challenge. It appears as a rare complication in patients with cancer. Treatment is difficult because the cause of TMA (malignancy) is hard to remove. Patients with cancer do not respond to plasmapheresis, which often delays the application of chemotherapy, the only effective treatment for TMA. Consequently this condition has poor prognosis.
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