Srp Ark Celok Lek
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Case Reports
[Diffuse large cell lymphoma and colon adenocarcinoma in patient with Waldenström's macroglobulinaemia].
Waldenström's macroglobulinaemia is a rare B cell lymphoproliferative disorder characterized by lymphoplasmocyte bone marrow infiltration and monoclonal IgM gammopathy. In the majority of cases, Waldenström's macroglobulinaemia is a chronic disease with variable course. Therapy consists of alkylating agents, purine analogs and antiCD20 monoclonal antibody. In the literature, there have been descriptions of rare cases of progression of Waldenström's macroglobulinaemia to aggressive lymphoma, as well as secondary carcinoma in the patients after treatment of macroglobulinaemia. ⋯ The patient was diagnosed with a rare occurrence of three neoplastic diseases: Waldenstrom's macroglobulinaemia, colon adenocarcinoma and diffuse large B cell lymphoma. The possible mechanisms of the combined appearance of lymphoproliferative and other malignant diseases include the previous treatment with alkylating agents, genetic, immunomodulatory and environmental factors.
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Otoplasty or correction of prominent ears, is one of most commonly performed surgeries in plastic surgery both in children and adults. Until nowadays, there have been more than 150 techniques described, but all with certain percentage of recurrence which varies from just a few up to 24.4%. ⋯ All patients showed a high satisfaction rate with the final result and there was no necessity for further surgeries. The technique described in this paper is easy to reproduce even for young surgeons.
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Congenital coarctation of the thoracic aorta at the ligamentum arteriosum or the aortic arch is well recognized. But a much less common variety (0.5-2.0%) of aortic coarctation is located in the distal thoracic aorta or abdominal aorta or both and is often called "middle aortic syndrome" or "mid-aortic dysplastic syndrome". This represents serious pathological condition and indicates multidisciplinary therapy approach. ⋯ Abdominal coarctation is a pathological disease which is seldom found in vascular surgery. Angiography is of major importance for setting the diagnosis and for the control of the results of surgical and nonsurgical treatment. The combination of surgical and endovascular treatment in our patients showed very good results in the studied period.
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As a systemic disease, diabetes mellitus may lead to several complications affecting both the quality and the length of life. While periodontal disease is one of the major oral health problems in patients with diabetes, reports of an increased risk of dental caries among diabetics are controversial. ⋯ The study indicates that there is a relationship between poor control of diabetes and caries, and periodontal disease.
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Comparative Study
[The impact of cognitive impairment at admission on short-term functional outcome of elderly hip fracture patients].
The number of patents with dementia increases among hip fracture patients. Cognitive dysfunction is defined as a premorbid state which is potentionally negatively related to short-term functional outcome. ⋯ The systematic use of MMSE identifies cognitively impaired hip fracture patients, and effectively predicts their short-term functional outcome. A higher admission cognitive status is related to a more favourable short-term rehabilitation outcome. In spite of cognitive impairment, elderly patients with hip fracture can benefit from participation in rehabilitation programmes. The systematic identification of cognitively impaired hip fracture patients at admission facilitates optimal treatment and rehabilitation, and thus enables the best achievable outcome to be reached.