To assess what was the cause of weight loss in children in early postoperative period after tonsilloadenoidectomy.
Prospective study conducted at Department of ENT, Head and Neck Surgery, General ...Hospital „Dr. Josip Benčević“ Slavonski Brod, Croatia.
In total 31 patients aged 6–22 years that underwent tonsilloadenoidectomy.
The study was performed using specially designed questionnaires from January 2017 until August 2017. Results of pain assessment and administrated analgesic therapy, postoperative complications and inception of eating were completed through the questionnaire. During the study, children were weighed before tonsilloadenoidectomy, 24 h after tonsilloadenoidectomy and the seventh postoperative day where age, height, weight, body fat, body mass index (BMI), muscle mass and body water were recorded. Weighing was performed by the "Body Structure Analyzer BC-420MA" TANITA.
Data analysis revealed a significant reduction in mass, body fat, body mass index (BMI) and muscle mass in the children up to 10 years of age, as well as in the children that were 11 years and older. In children up to 10 years of age, there was no significant change in body water (%), while body water in the group of patients aged 11 and over was significantly higher on the seventh postoperative day (Friedman test, P = 0.02). In the total sample, there was a significant decrease in body weight, body fat (%), body mass index and muscle mass (Friedman test, P < 0.001), while there was a significant increase in body water (Friedman test, P = 0.003). There is no significant correlation between pain intensity and individual parameter change in all subjects, nor in age groups.
Water is an important factor of muscle mass. It plays an essential role in musle repair and growth, since it's crucial for protein synthesis. Poorly hydrated muscle loses it's weight, since musle cells don't have enough water in themselves. Good hydratation, especially among children up to 10 years old in early post tonsilloadenoidectomy period is important to keep muscular mass and power.
Rare Laryngeal Hamartoma: A Case Report Veselski Krajinović, Karolina; Stojadinović, Tomislav; Pajić Matić, Ivana ...
Acta clinica Croatica,
01/2022, Letnik:
61, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Hamartoma (from the Greek language, where
hamartia
means defect or an error and
-oma
denoting a tumor or neoplasm) is a benign tumor-like mass composed of mature tissue or cells that are present in ...abnormal proportions or show a disorganized arrangement. Hamartomas are rarely seen in the head and neck area and especially rare in the larynx. Only few cases of laryngeal hamartoma have been reported in the literature so far. They are usually manifested by stridor, dysphonia and symptoms associated with airway obstruction. The diagnosis must be confirmed histologically and the method of choice in treatment is complete excision of the lesion. The authors present a case of laryngeal hamartoma of a 43-year-old woman treated for hoarseness and paralysis of the left vocal cord.
Background
The purpose of this study was to investigate the pathohistological status of mucous lining infected with
Helicobacte pylori
as the possible cause of chronic laryngitis and laryngeal ...carcinoma.
Materials and methods
The prospective examination included 51 patients suffering from planocellular laryngeal cancer and 26 examinees suffering from chronic laryngitis. The examinees and the control group were subjected to esophagogastroduodenoscopy which described the local status of the esophagus and stomach. Two biopsy samplings are taken from the stomach antrum and corpus. One part of the biopsies was colored using the histological technique used in the pathohistological detection of
H. pylori
, while the other part was incorporated in paraffin cubes where the
H. Pylori
gene expression was determined using the deparaffinization and PCR method DNA isolation.
Results
In the group of examinees suffering from laryngeal tumor, there were a higher number of patients suffering also from chronic gastritis (32/51) than in the other group, suffering from chronic laryngitis (9/26). In the chronic laryngitis group, there were more examinees with acute gastritis (12/26) than in the examined group (11/51). The difference is statistically significant (
p
= 0.0457).
Conclusion
Chronic gastritis and
H. pylori
infection are risk factors for laryngeal carcinoma formation; therefore, acute gastritis with helicobacter pylori infection must be immediately treated to not let infection to become chronic.
Uvod: S prevalencijom od 0,005% svih karcinoma, karcinom paratireoidne žlijezde jedna je od najrjeđih malignih bolesti koja zahvaća oko 1% bolesnika s primarnim hiperparatireoidizmom. Pojavljuje se ...sporadično ili u sklopu genetskog sindroma. Više od 90% karcinoma paratireoidne žlijezde su hormonski funkcionalni i dovode do hipersekrecije parathormona, što uzrokuje izrazitu hiperkalcijemiju. Zbog sličnih simptoma s benignim uzrocima hiperparatireoze otežano je preoperativno dijagnosticiranje karcinoma paratireoidne žlijezde. Ultrazvuk vrata i scintigrafija s Tc-99m MIBI mogu pomoći u lokalizaciji bolesti, dok se citopunkcija prije primarne operacije ne preporučuje. Primarni modalitet liječenja je potpuna kirurška resekcija s mikroskopski negativnim rubovima i nudi najbolju šansu za izlječenje. Do sada ne postoje dokazi o učinkovitosti kemoterapijskog ili radioterapijskog pristupa. U više od 50% bolesnika dolazi do razvoja recidiva bolesti, kada je ponovna kirurška resekcija najbolji način liječenja koje tada, rijetko kurativno, služi u svrhu ublažavanja metaboličkih poremećaja i komplikacija hiperkalcijemije koje su glavni uzrok letaliteta. Prikaz bolesnice: Šezdesetogodišnja žena s nizom komorbiditeta upućena je od strane nefrologa sa sumnjom na adenom paratireoidne žlijezde. Po učinjenoj ultrazvučnoj i citološkoj obradi ekstirpira se desna donja paratireoidna žlijezda, te se patohistološkom analizom postavi dijagnoza karcinoma paratireoidne žlijezde, što posljedično indicira reoperaciju. Prije reoperacije učinjena je scintigrafija koja ukazuje na hiperfunkcijsko paratireoidno tkivo, te se u sklopu reoperacije učini desnostrana lobektomija štitnjače i ekstirpacija desne gornje uvećane paratireoidne žlijezde s disekcijom regije VI. Patohistološkom obradom izolira se uredno tkivo štitnjače, adenom paratireoidne žlijezde i jedan hormonski aktivni metastatski limfni čvor iz regije VI. Karcinom paratireoidne žlijezde je izrazito rijedak entitet koji zahtijeva operativnu intervenciju i cjeloživotno praćenje vrijednosti serumskog kalcija i parathormona. Kako bi se unaprijedilo i standardiziralo liječenje bolesnika s karcinomom paratireoidne žlijezde, potrebne su daljnje multicentrične studije.
Introduction: With a prevalence of 0.005% of all cancers, parathyroid carcinoma is one of the rarest malignancies affecting approximately 1% of patients with primary hyperparathyroidism. It can occur sporadically or as part of a genetic syndrome. More than 90% of parathyroid carcinomas are hormonally functional and lead to hyper secretion of parathyroid hormone, which causes marked hypercalcemia. Due to similar symptoms with benign causes of hyperparathyroidism, preoperative diagnosis of parathyroid gland cancer is difficult. Neck ultrasound and Tc-99m MIBI scintigraphy can help localize the disease,while fine needle aspiration before primary surgery is not recommended. The primary treatment modality is complete surgical resection with microscopically negative margins and offers the best chance for recovery. So far, there is no evidence of the effectiveness of chemotherapy or radiotherapy. In more than 50% of cases the disease relapses and surgical resection is the best way of treatment, which is then rarely curative and serves the purpose of mitigating metabolic disorders and complications of hypercalcemia, which are the main cause of mortality. Case report: A 60-year-old woman with a number of comorbidities was referred by a nephrologist with suspicion of parathyroid adenoma. After ultrasound and cytological processing, the right lower parathyroid gland was extirpated, and the pathohistological analysis established the diagnosis of carcinoma of the parathyroid gland, which consequently indicated reoperation. Before the reoperation, a scintigraphy was performed, which indicated hyperfunctioning parathyroid tissue, and as part of the reoperation, a rightsided thyroid lobectomy and extirpation of the right upper enlarged parathyroid gland with dissection of region VI were performed. Pathohistological processing isolated normal thyroid tissue, adenoma of the parathyroid gland and one hormonally active metastatic lymph node from region VI. Carcinoma of the parathyroid gland is an extremely rare entity that requires operative intervention and lifelong monitoring of serum calcium and PTH values. Further multicenter studies are needed to improve and standardize the treatment of patients with parathyroid carcinoma.
Postaviti dijagnozu zloćudne bolesti tijekom prvog pregleda bolesnika u hitnoj ambulanti nije jednostavno. Ako tijekom obrade proširenosti bolesti posumnjamo na inoperabilnost karcinoma, ...metastaziranje ili drugu zloćudnu novotvorinu, zadatak postaje još teži. Nedostatak protokola za aktivno liječenje bolesnika s dva sinkrona karcinoma udaljenih regija predstavlja veliki problem kod rijetkih bolesnika. Bolesnica u dobi od 64 godine javila se u hitnu ambulantu zbog promuklosti i razvoja obostrane otekline na vratu. Postavili smo dijagnozu karcinoma epiglotisa s obostranim metastazama u vratu. U sklopu obrade bolesnice uočili smo neočekivanu hipovaskularnu leziju jetrenog parenhima te smo dijagnosticirali kolangiokarcinom jetre. S obzirom na dva sinkrona karcinoma, bolesnicu smo uputili multidisciplinarnom onkološkom timu koji je indicirao konkomitantnu kemoradioterapiju, a liječenje je još uvijek u tijeku. Dva sinkrona karcinoma udaljenih regija izrazito su rijetka. Pretraživanjem baza podataka Pubmed i Google Scholar opisan je još samo jedan slučaj istovremenog karcinoma grkljana i kolangiokarcinoma u kojem nije provedeno aktivno liječenje, već samo palijativna skrb. Slučaj naše bolesnice pokazuje kako postoje terapijske opcije koje mogu produljiti život i poboljšati kvalitetu života takvih bolesnika.
Diagnosing a malignant disease during the first examination of a patient in an emergency room is very challenging. If the cancer is metastatic or inoperable; or another malignancy is suspected, the task becomes even more difficult. The lack of a protocol for the active treatment of patients with two synchronous cancers in distant regions is a major problem for rare patients. A 64-year-old patient presented to the emergency department with hoarseness and bilateral neck swelling. We diagnosed an epiglottic carcinoma with bilateral neck metastases. As part of the cancer staging, an irregular hypovascular lesion in the liver parenchyma was observed. Diagnosis of an intra hepatic cholangiocarcinoma was set. Due to synchronous malignancies, the patient was referred to a multidisciplinary oncology team, indicating concomitant chemoradiotherapy with ongoing treatment. Two synchronous carcinomas of distant regions are extremely rare. By searching the Pubmed and Google Scholar databases, only one case of synchronous laryngeal carcinoma and cholangiocarcinoma was described in the literature in which no active treatment was performed, only palliative care. This case shows that there are therapeutic options that can prolong life and improve the quality of a life in such patients.
Uvod: Vrtoglavica je iluzija rotacije prostora koja se javlja zbog oštećenja vestibularnog sustava. S obzirom na mjesto oštećenja razlikujemo periferne i centralne vrtoglavice. Među najčešće ...periferne vrtoglavice ubrajamo benigni paroksizmalni pozicijski vertigo (BPPV) i vestibularni neuronitis. Hipofunkcija labirinta uslijed vestibularnog neuronitisa nastaje zbog senzorineuralnog oštećenja, dok je BPPV uzrokovan mehaničkim promjenama u polukružnim kanalićima, tj. migriranjem kristala kalcijevog karbonata. Osim spomenute razlike, vestibularni neuronitis i BPPV razlikuju se po duljini trajanja simptoma i vrsti nistagmusa koji stvaraju. Dijagnozu oba poremećaja postavljamo kliničkim pregledom, uz pomoć dobro definiranih testova, a laboratorijska ispitivanja ravnoteže mogu nam poslužiti kao koristan alat u potvrdi dijagnoze, lokalizaciji oštećenja i praćenju oporavka. Iako su oba poremećaja česta, simultana pojava BPPV-a bočnog kanala i vestibularnog neuronitisa rijedak je entitet, te pretraživanjem literature pronalazimo dva opisana slučaja. Prikaz slučaja: Ovaj rad opisuje 49-godišnju bolesnicu s vrtoglavicom kojoj smo dijagnosticirali benigni paroksizmalni pozicijski vertigo bočnog kanala i istostranu perifernu vestibulopatiju. Bolesnica je dobro reagirala na repozicijski postupak i vestibularnu rehabilitaciju, što je dovelo do oporavka vestibularne funkcije kroz nekoliko mjeseci. Zaključak: Položavajuće probe potrebno je raditi kod svih bolesnika s vrtoglavicom, a u slučaju dijagnoze BPPV-a bočnog kanalića, pseudonistagmus se ne smije zamijeniti spontanim nistagmusom. Laboratorijski testovi vestibularne funkcije indicirani su kod nejasnih slučajeva.
Postaviti dijagnozu zloćudne bolesti tijekom prvog pregleda bolesnika u hitnoj ambulanti nije
jednostavno. Ako tijekom obrade proširenosti bolesti posumnjamo na inoperabilnost karcinoma,
...metastaziranje ili drugu zloćudnu novotvorinu, zadatak postaje još teži. Nedostatak protokola za aktivno
liječenje bolesnika s dva sinkrona karcinoma udaljenih regija predstavlja veliki problem kod rijetkih
bolesnika.
Bolesnica u dobi od 64 godine javila se u hitnu ambulantu zbog promuklosti i razvoja obostrane otekline
na vratu. Postavili smo dijagnozu karcinoma epiglotisa s obostranim metastazama u vratu. U sklopu obrade
bolesnice uočili smo neočekivanu hipovaskularnu leziju jetrenog parenhima te smo dijagnosticirali
kolangiokarcinom jetre. S obzirom na dva sinkrona karcinoma, bolesnicu smo uputili multidisciplinarnom
onkološkom timu koji je indicirao konkomitantnu kemoradioterapiju, a liječenje je još uvijek u tijeku.
Dva sinkrona karcinoma udaljenih regija izrazito su rijetka. Pretraživanjem baza podataka Pubmed i
Google Scholar opisan je još samo jedan slučaj istovremenog karcinoma grkljana i kolangiokarcinoma u
kojem nije provedeno aktivno liječenje, već samo palijativna skrb. Slučaj naše bolesnice pokazuje kako
postoje terapijske opcije koje mogu produljiti život i poboljšati kvalitetu života takvih bolesnika.
Primary cutaneus apocrine carcinoma is a rare malignancy with about 50 cases reported in the literature. Axilla is the most common site of occurrence, but locations like scalp, anogenital region, ear ...canal, chest, wrist, finger and eyelid have been described. The neoplasm presents itself as an asymptomatic, slow-growing, solid or cystic mass that varies in color. Most patients have a history of a long-standing neoplasm before the diagnosis is made. The disease is considered to have an indolent clinical course with favorable outcome although more than half of reported patients had regional lymph node metastases at the time of diagnosis. Systemic dissemination to lung, bones, liver and brain is extremely rare with only 14 cases documented in the literature. Wide surgical excision with lymph node dissection upon confirmation of the lymph node metastases remains the only curable treatment. Care and management of the disseminated disease is still challenging. We report a case of a 65-year-old woman with a very aggressive apocrine carcinoma of the scalp prone to local recurrence and distant metastases to lung and bones.
Eosinophilic granuloma is a rare, benign, lesion characterized by uncontrolled proliferation of Langerhan's cells. It is commonly found in a bone and has been described in almost every bone in the ...body. It usually affects children and is seldom found in adults. A case of 60-year-old adult male with an eosinophilic granuloma of the right temporal bone with infiltration of the temporal and infratemporal fossa and osteolysis of the squama of the temporal bone is presented. Diagnostic procedure and course of treatment are described. Controversies in the management and different approaches in therapy of such lesion are discussed because there is no agreed treatment protocol established.
Angioleiomyoma is benign soft tissue tumor composed of smooth muscle cells and vascular endothelium, characterized with slow growth, unspecific symptoms and rare malignant transformation. It is very ...rare in the head and neck region and complete surgical excision is the gold standard for diagnosis and treatment. We present a very rare case of angoleomyoma of the tounge base treated with partial glosectomy with harmonic scalpel which shortened surgical procedure, reduced bleeding and postoperative complications.
