Limited scientific evidence shows that alpha lipoic acid (ALA) can induce regression rates of low-grade squamous intraepithelial lesions (LSILs), but the mechanisms of these effects have not been ...elucidated. To gain a broader insight into its therapeutic potential and mechanisms of action, the effects of 3 months of supplementation with 600 mg of ALA on antioxidant and lipid status parameters in 100 patients with LSILs were investigated in a randomized, placebo-controlled study. The obtained results are discussed in terms of patients’ initial metabolic status and diet quality (particularly nutritional intake of antioxidants). The obtained results showed that oxidative status biomarkers were not significantly affected by ALA supplementation. However, serum superoxide dismutase (SOD) activity was positively affected in the subgroup of patients with higher dietary antioxidant intake. Surprisingly, ALA supplementation resulted in a small but statistically significant increase in serum low density lipoprotein (LDL), and the observed effect was significantly affected by the initial lipid status of the participants. Larger studies are necessary to gain additional insights on the clinical significance of ALA as an antioxidant and hypolipemic agent and to optimize its potential application in LSIL treatment.
Low-grade squamous intraepithelial lesion (SIL) is a cytologic diagnosis etiologically related to human papilloma virus (HPV) infection that leads to the release of inflammation mediators, the ...formation of reactive oxygen species (ROS) and decreased levels of antioxidants in tissues, which is why antioxidants might be considered effective against SIL progression. This randomized double-blind placebo-controlled study aimed to investigate the effectiveness of alpha-lipoic acid (ALA) supplementation (600 mg/day) on the regression of low-grade SIL in 100 patients. Low-grade SIL was determined after the cytological screening, colposcopic examination and targeted biopsy and histological confirmation of cytological−colposcopic diagnosis. Inflammation parameters and the presence of HPV were determined by standard laboratory methods. Dietary and lifestyle habits were investigated using a standardized and validated semi-quantitative food questionnaire (FFQ). ALA supplementation significantly reduced the proportion of patients with low-grade cytological abnormalities, in comparison to placebo. Given the obtained level of significance (p < 0.001), the presented results indicate that short-term ALA supplementation shows a clinically significant effect on cervical cytology. Future studies should focus on the use of innovative formulations of ALA that might induce bioavailability and therapeutic efficiency against HPV infection and the investigation of synergistic effects of concurrent dietary/lifestyle modification and ALA supplementation in both low-grade and high-grade SIL.
Aim
Neuroendocrine neoplasms (NENs) are a heterogeneous group of tumours with varying clinical expression and behaviour. Because of indolent behaviour of NENs, reviewing and evaluation of ...epidemiological characteristics is a challenge. The aim of this study was to assess prevalence of NENs at tertiary hospitals considering age, gender, location, and grade.
Methods
Electronic files were used for a retrospective assessment of the patients with NENs of the gastroenteropancreatic tract and
bronchopulmonary system in tertiary hospitals in Bosnia and Herzegovina over the past 15 years (2005-2020).
Results
Among 438 patients, 291(66.4%) were males and 147 (33.6%) females; the median age was 62 years. The lungs were
the most frequent site, 304 (69.4%), followed by the pancreas, 22 (5.0%), colon, 14 (3.2%), stomach, 13 (2.9%), appendix,
13 (2.9%), rectum,11 (2.5%), small intestine, eight (1.8%) and gallbladder, one (0.2%). Metastases were most frequently found in the liver, 35 (8%) and lymph nodes, 15 (3.42%).
Conclusion
The results were largely consistent with those in literature, including age, gender, location, and the degree of differentiation. Most metastases originated from high-grade tumours and greater impairment of the liver.
Sarcomas of the female genital tract in general are rare and ovarian sarcomas comprise less than 1% of ovarian malignancies. In the literature there are 15 reported angiosarcomas of patients 21 year ...old and younger with no one originated in the ovary. We report a case of ovarian angiosarcoma in an 11 year old girl, presented with left side hip pain. MRI of abdomen and pelvis confirmed expansive solid and cystic mass occupied both ovaries. Imunohistochemistry staining was performed, CD34, Factor VIII, CD31, in order to confirm the diagnosis. Final diagnosis was angiosarcoma. The patient received 6 cycles of chemotherapy, according to the CWS-2002P protocol. 8 months after the diagnosis was established, there were no signs of any tumors according to the ultrasound, CT scan, and MRI. Although, extremely rare, angiosarcoma can also affect children and this diagnosis should be considered carefully in tumor with rich vascular network, necrosis and brisk mitotic activity.
The exact incidence and mortality rate in Bosnia and Herzegovina are unknown as there are no National Cancer Register. The available data are mostly based on the estimation from neighboring ...countries. Therefore, the aim of this study was to present the preliminary but more accurate estimates of cervical cancer incidence and mortality rates in Bosnia and Herzegovina. The data on cervical cancer cases in Bosnia and Herzegovina were collected from different sources and varies depending on the size of the city or region. To calculate the crude rates for the period from 2000 to 2008, we used the Bosnian and Herzegovinian population census for 1991. Thus, the crude incidence rate in Sarajevo region is more equable (app. 30.4/100,000 women-year), while in Tuzla Canton it varied from 18.5 in 2005 to 4.8/100,000 in 2000. In Tuzla Canton, in the period 1993-2006, 27.1% of all women with cervical cancer were younger than 30. However, the exact crude incidence in Bosnia and Herzegovina could be even higher. Data from Tuzla Canton showed slight increase in mortality rate in the last 5years (4.9/100,000), with the peak in 2007 (7.0/100,000). The presented data reflects the situation throughout Bosnia and Herzegovina and underline the necessity of the implementation of cervical cancer register and organized screening program.
The exact incidence and mortality rate in Bosnia and Herzegovina are unknown as there are no National Cancer Register. The available data are mostly based on the estimation from neighboring ...countries. Therefore, the aim of this study was to present the preliminary but more accurate estimates of cervical cancer incidence and mortality rates in Bosnia and Herzegovina. The data on cervical cancer cases in Bosnia and Herzegovina were collected from different sources and varies depending on the size of the city or region. To calculate the crude rates for the period from 2000 to 2008, we used the Bosnian and Herzegovinian population census for 1991. Thus, the crude incidence rate in Sarajevo region is more equable (app. 30.4/100,000 women-year), while in Tuzla Canton it varied from 18.5 in 2005 to 4.8/100,000 in 2000. In Tuzla Canton, in the period 1993-2006, 27.1% of all women with cervical cancer were younger than 30. However, the exact crude incidence in Bosnia and Herzegovina could be even higher. Data from Tuzla Canton showed slight increase in mortality rate in the last 5years (4.9/100,000), with the peak in 2007 (7.0/100,000). The presented data reflects the situation throughout Bosnia and Herzegovina and underline the necessity of the implementation of cervical cancer register and organized screening program.
Myopericytoma is a benign tumor with the most common presentation as a well-circumscribed, slow-growing mass. It is frequently misdiagnosed as a sarcoma. We presented a 23-year-old patient with a ...history of a sciatic pain of the right leg. A careful physical examination discovered tumor-like mass in the posterior part of the thigh. Neurological finding showed a reduction of myotatic reflexes on the right leg with a weaker muscle strength on the right leg. The right leg musculature was slightly hypotrophic in the range of 2-3 cm comparing to left leg. Initially electrophysiological and radiological diagnostic with magnetic resonance imaging (MRI) of the lumbar spine, pelvis and thighs were normal. Magnetic resonance imaging of the right thigh discovered a slow growing 2.1 × 3.8 cm sized mass that was initially described by radiologist as a neurinoma. Patient was admitted to department of neurosurgery and operated on for a tumor removal. Tumor was located intimately to femur and sciatic nerve and after careful dissection completely removed. Patient was doing well after surgery and discharge after three days from the hospital. In the postoperative period the symptoms disappeared. Histopathology showed a myopericitoma. Postoperative MRI after three months of follow up showed no tumor residues, and after 6 and 12 months there was no tumor recurrence. Myopericytoma behave in a benign fashion, but, because local recurrences and rarely metastases may occur in atypical and malignant neoplasms, a careful follow-up after radical resection is recommended.
The needle biopsies from 60 transplanted and native kidneys have been processed and a prospective analysis of pattern, intensity and distribution of immunoglobulin deposits (IgA, IgG and IgM) and ...complement components (C3c and C1q) identified in these lesions has been carried out by immunohistochemistry with three step immunoperoxidase, in the period from 2000 to 2004. Those deposits were previously detected and analyzed by immunofluorescence. The samples consisted of 30 renal biopsies, previously diagnosed with glomerulonephritis and positive immunofluorescence and 30 renal biopsies without morphologic changes and deposits on immunofluorescence. 78,7% of the analyzed samples showed the identical results of the deposits of immunoglobulin and components of the complement with both, immunohistochemistry and immunofluorescence method. Sensitivity of the immunohistochemistry method with three step immunoperoxidase for all analyzed immunoglobulin and complement components is high (0,93), while specificity for the same method is 0,79. Standardized method of the three step immunoperoxidase on the paraffin embedded, formalin fixed needle renal biopsies could successfully replace the immunofluorescence method in diagnostic of GN, with the emphasis on a follow up and control of each single step in the procedure of the method.
Nephrotic syndrome (NS) is one of the most frequent glomerular diseases among children. While most of the children with primary NS respond to steroid treatment, 10 to 20% of the patients are ...steroid-resistant, and the best therapy for such cases has never been defined.
The present study aimed to evaluate steroid-resistant nephrotic syndrome (SRNS) patients.
Our research included 50 children (56% female and 44% male) with NS. NS was defined as the presence of edema, massive proteinuria, hypoalbuminemia and hyperlipidemia. Patients with NS were treated according to international protocol. SRNS was diagnosed in patients with idiopathic NS based on lack of complete remission despite treatment with steroids. Renal biopsy was performed in 22 patients with SRNS at the Pediatric Clinic II of the University Clinical Center in Sarajevo (UCCS). Histopathologic analyzes of renal biopsy were performed at the Department of Pathology, University Clinical Center in Tuzla (UCCT). Patients with SRNS, after kidney biopsy were treated with nonsteroidal immunosuppressant's.
Eight (36.4%) of the 22 patients who had undergone renal biopsies had minimal change disease (MCNS) and seven (31.8%) had focal segmental glomerulosclerosis (FSGS). The immunosuppressive drugs used in SRNS were Cyclosporine (CsA), Cyclophosphamide (CYC), Mycophenolat mofetil (MMF) and Rituximab (RTX). Three patients (13.6%) did not respond to any treatment and had developed end - stage renal disease (ESRD).
With current treatments, some children will ultimately achieve a sustained remission with one of the second line or third line of the proposed drugs. Patients with refractory NS will go to progression towards ESRD. The rapid development of molecular genetics will give a new contribution to the pathogenesis and treatment of this disease.
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