To identify malnourishment of surgical and oncologic patients or those at risk of becoming malnourished at four hospital centers in Croatia by use of nutritional screening questionnaire developed ...specifically for the purpose of this study.
The study included 1639 adult patients: 1475 scheduled for various surgical treatments and 164 oncologic patients receiving primary or adjuvant radio- and/or chemotherapy. The nutritional screening questionnaire consisted of data on recently reduced food intake and weight loss, body mass index (BMI), estimated period of perioperative fasting or oncologic disease status, categorization of surgical procedure, and additional stress expected. Each component was rated on a 0-2 or 0-3 scale. A score of seven points was chosen as the borderline between patients at risk of malnutrition (score <or=7) and those at no such risk (score 8-11). The questionnaire also included data on blood albumin, blood urea, blood lymphocyte count, blood creatinine, and overall patient evaluation by the physician.
Reduced food intake and weight loss were reported by 20% and 33% of the patients, respectively. Median BMI was 26 (range, 23.2-28.9) and underweight BMI values (<20) were found in 7% of the patients. Screening questionnaire score of <or=7, indicating the risk of malnutrition, was obtained in 23% of 1639 patients. Decreased albumin and lymphocytes were found in 10% and 17% of the patients, respectively. Increased urea and creatinine were found in 13% and 7% of the patients, respectively. Of the 288 patients examined by the physician, 41% were assessed as at risk of malnutrition and 9% as malnourished.
Nutritional screening questionnaire could be used for the identification of patients being at risk of malnutrition. An adequate prospective study is required for its final validation.
The report covers the first case of insular thyroid cancer recorded in Croatian medical literature. A 71-year old female patient presented to our hospital with symptoms of inspiratory stridor. ...Clinical examination disclosed an expansive tumor mass. US guided FNA indicated anaplastic cancer and total thyroidectomy was accordingly indicated. Pathohistological analysis of H/E biopsies disclosed a tumor mass with a characteristic insular growth pattern of monomorphic tumor cells. Immunohistochemical analysis confirmed diagnosis by a diffuse positive reaction to thyreoglobulin, focally to TTF-1, and scant to cytokeratin, while calcitonin, FVIII, CD34 and LCA were clearly negative. P53 and bcl-2 were expressed in 35.9% and 85% of tumor cells, respectively. The proliferation index for Ki-67 was 4.19. According to our survey we suggest a panel of immunohistochemistry for diagnosing insular cancer. Even if partly present, insular cancer should be mentioned in the pathohistological description because of its prognostic meaning.
Prikazana je bolesnica s tumorom male žlijezde slinovnice mekog nepca. Citološki se radilo o pleomorfnom adenomu. Učinjena je transoralna ekstirpacija. Patohistološka dijagnoza potvrdila je citološki ...nalaz. Na redovitim kontrolama bolesnica je više od 4 godine bez recidivnog tumora.
Tumori žlijezda slinovnica čine oko 3% svih lokalizacija tumora. Češći su tumori velikih žlijezda slinovnica, tumori lokalizirani u malim žlijezdama slinovnicama češće su maligni. Pleomorfni adenomi čine 10% tumora malih žlijezda slinovnica.
Dijagnostička obrada intraoralnih tumora uključuje metode vizualizacije tumora, kao i aspiracijsku citodijagnostiku. Rezultati učinjenih pretraga utječu na odluku o kirurškom pristupu.
Pilomatriksom je benigni tumor porijekla stanica dlačnog folikula. On je rijetki, benigni, sporo rastući kožni tumor kojeg su prvi puta opisali Malhebre i Chenantais 1880. godine. Pojavljuje se ...obično kao pojedinačna lezija, najčešće na glavi i vratu kao tvrdi, dublje smješten čvor prekriven normalnom kožom.
Naša studija retrospektivno evaluira kliničke i citomorfološke značajke sedam slučajeva pilomatriksoma.
U razmazima koji su bili bojeni MGGom isključen je malignitet. Dijagnoza pilomatriksoma potvrđena je histološki. Upotrebljena je semikvantitativna metoda u analizi sljedećih karakteristika: bazaloidne stanice, anuklerane stanice, upalne stanice, divovske stanice, gole jezgre, i detritus (O negativno, 1+ mala zastupljenost, 2+ srednja zastupljenost, 3+ obilno).
Maksimalan rezultat dobiven aspiracijskom citodijagnostikom iznosio je za bazaloidne stanice 13/21, anuklearne stanice 14/21 i divovske stanice 11/21, dok su histološkom analizom dobiveni rezultati za bazaloidne stanice 20/21 i za anuklearne stanice 17/21.
Prisutnost bazaloidnih stanica, anuklearnih stanica i divovskih stanica u citološkim razmazima kao i kliničke informacije o lokalizaciji u području glave i vrata, te o sporo rastućem tumoru kože i potkožnog tkiva upućivat će u citodijagnostici na zaključnu dijagnozu pilomatriksoma.
