Acta medica academica最新文献

{"title":"Toxic Cardiomyopathy in a Young Patient Treated for Her2-Positive Early Breast Cancer: Case Report and Literature Review.","authors":"Amina Hadžibeganović, Dijana Koprić","doi":"10.5644/ama2006-124.417","DOIUrl":"10.5644/ama2006-124.417","url":null,"abstract":"<p><strong>Objective: </strong>We present the case of toxic cardiomyopathy in a healthy thirty-eight-year-old female patient treated for Her2-positive early breast cancer.</p><p><strong>Case report: </strong>During the neoadjuvant treatment, the patient received four cycles of AC regimen and four cycles of docetaxel in combination with trastuzumab biosimilar. Two days after she received the ninth dose of trastuzumab biosimilar, she reported feebleness, palpitation, and dyspnoea. A heart ultrasound was performed and was normal without changes in the ejection fraction (EF) compared to previous checks. Three days later she reports worsening of her symptoms that were highly suggestive of heart failure. A cardiologist was consulted who insisted that the patient's symptoms were the consequence of the disease progression. A CT scan showed signs of heart failure. A heart ultrasound was done and the EF dropped to 30%. Drainage of the right pleural cavity was performed and pharmacotherapy for heart failure was started. The treatment led to clinical improvement, but eighteen months later EF is still not back to normal.</p><p><strong>Conclusion: </strong>This is a rare case of toxic cardiomyopathy in a young, previously healthy, patient who received anthracyclines followed by trastuzumab biosimilar in combination with taxanes. All the medications this patient received are potentially cardiotoxic. However, the overall presentation is not typical for any of these medications since the patient presented with symptoms and signs of heart failure with significant dilatation of the right atrium, which persists eighteen months after its onset, with only a small increase in the EF. There is also a possibility that the antineoplastic therapy the patient received only facilitated dilatative cardiomyopathy, while the main causative factor was intrinsic or extrinsic.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":"225-230"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10945316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138795620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inherited Thrombophilia and Risk of Thrombosis in Children with Cancer: a Single-center Experience.","authors":"Ana Đordević, Blaženka Grahovac, Silvije Šegulja, Lidija Bilić Zulle, Jelena Roganović","doi":"10.5644/ama2006-124.430","DOIUrl":"10.5644/ama2006-124.430","url":null,"abstract":"<p><strong>Objectives: </strong>Thrombosis is an increasingly recognized complication of childhood malignancy and its treatment. The incidence and etiology of pediatric cancer-related thrombosis is still not well understood. The aim of this study was to evaluate the prevalence of common prothrombotic genetic conditions in children with cancer, the frequency of thrombosis, and the role of inherited thrombophilia in the development of thrombosis in a pediatric oncology population.</p><p><strong>Patients and methods: </strong>Forty-seven children (36 treated for hematological malignancies and 11 for solid tumors) with a median age of 8.8. years (range 0.4 - 19.3 years) were included in the study. Genetic polymorphisms of Factor V Leiden (G1691A), prothrombin G20210A, and methylenetetrahydrofolate reductase (MTHFR) C677T were determined by real-time polymerase chain reaction-based DNA analysis.</p><p><strong>Results: </strong>Four (8.5%) patients were heterozygous for Factor V Leiden, 3 (6.4%) were heterozygous for prothrombin G20210A mutation, and 3 (6.4%) were homozygous for MTHFR C677T mutation. All patients had implanted central venous catheters. Four (8.5%) children had documented thrombosis, three of which were in the upper venous system. Two of the four patients with thrombosis had Factor V Leiden heterozygosity.</p><p><strong>Conclusions: </strong>Thrombosis is an important complication of childhood cancer. The risk of thrombosis may be increased in patients with Factor V Leiden. In the absence of consensus guidelines, our results support the recommendation for thrombophilia screening in children with cancer.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":"52 3","pages":"161-168"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10945322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coccygeal Disc Disease as a Possible Cause of Coccygodynia.","authors":"Spyridon P Galanakos, Nikolaos D Karakousis, George Bablekos, Sophia Fontara","doi":"10.5644/ama2006-124.418","DOIUrl":"10.5644/ama2006-124.418","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the present study was to describe the causes involved in the pathophysiology of coccydynia, emerging from the coccyx or the anatomical tailbone region.</p><p><strong>Case report: </strong>We present the case of a 64-year-old man with pain in the coccyx and numbness in the perianal area. After clinical examination and imaging evaluation, including plain X-rays and magnetic resonance, coccygeal disc disease was identified. Other findings, such as tumor and fracture were excluded. We decided to undertake conservative management and the pain was eventually relieved. This is the first case report of coccygodynia and perianal numbness attributed to coccygeal disc disease.</p><p><strong>Conlcusion: </strong>Although there is no standard treatment, coexisting coccygeal disc disease should be always taken into account, with clinical and imaging examinations being considered of major importance to establish both medical diagnosis and treatment.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":"231-235"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10945321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138795617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Endoscopic Measurements of the Anterior and Posterior Ethmoidal Arteries with CT Measurements: A Cadaveric Study.","authors":"Rukiye Ozcelik Erdem, Mehmet Akif Dundar, Muzaffer Seker, Hamdi Arbag","doi":"10.5644/ama2006-124.410","DOIUrl":"10.5644/ama2006-124.410","url":null,"abstract":"<p><strong>Objective: </strong>To reveal the reliability of radiological measurements of the ethmoid arteries.</p><p><strong>Method: </strong>Five fresh frozen cadaveric heads underwent computed tomography and endoscopic sinus surgery. The lateromedial length of the anterior ethmoidal artery (AEA) and its distance to the axilla of the middle turbinate (MTA), the sphenoethmoidal recess (SR) and the posterior ethmoidal artery were measured. The posterior ethmoidal artery (PEA) was referenced to the SR. These anatomical parameters were measured both radiologically and endoscopically, and the compatibility of the two was examined.</p><p><strong>Results: </strong>Ten nasal cavities were dissected. We found that the distance of MTA to the AEA was 16±8 mm in dissection, 21±4 mm radiologically in the sagittal section, the distance of SR to the AEA was 14±3 mm in dissection, 19±4 mm radiologically in the sagittal section, and the distance of the AEA to the PEA was 10±3 mm in dissection, 12±3 mm radiologically in the axial section. The distance of the PEA to SR was 6±3 mm in dissection, 8±2 mm radiologically in the sagittal section.</p><p><strong>Conclusions: </strong>The distance of the AEA to the MTA, the distance of the AEA to the PEA and the distance of the PEA to the SR were compatible with each other in the dissection and in the radiologically evaluation, whereas the distance of the AEA to the SR was not compatible.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":"52 2","pages":"105-111"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71486980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress Response Assessment between First and Second Elective Caesarean Sections by Comparing Cortisol Levels.","authors":"Dionysios Galatis, Christos Benekos, Panagiotis-Konstantinos Karachalios, Antonios Strongylos, Foteini Anifantaki, Ioannis Dalivigkas, Argyrios Monastiriotis, Nikolaos Kiriakopoulos","doi":"10.5644/ama2006-124.411","DOIUrl":"10.5644/ama2006-124.411","url":null,"abstract":"Objectives. The aim of this study was to compare the stress response produced during elective CS for the first and second time. For that goal, cortisol blood levels before, during and after childbirth were measured. Materials and Methods. We performed this prospective observational study during the period of September 2020 to September 2021. Blood samples were taken from all participants at three different stages. A statistical analysis was performed to compare the CS1 (first elective Caesarean) and CS2 (second elective Caesarean) groups. Results. At every stage, the levels of cortisol were statistically higher in the CS1 group than in the CS2 group. Therefore, CS2 generates a significantly less stressful response than CS1. Between stages, in CS2 cortisol was lowered at a faster rate than in CS1, meaning the stress response initiated was present for a longer time period in the CS1 group. Conclusion. A second elective caesarean section is a safe procedure that does not place an unnecessary burden upon the mother. This is an important fact that practitioners can rely upon while designing the ideal management of a pregnant woman for the stressful environment of birth.","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":"52 2","pages":"112-118"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71486984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Erlenmeyer Flask Deformity on Computed Tomography.","authors":"Chrysovalantis Stylianou, Savas Deftereos","doi":"10.5644/ama2006-124.415","DOIUrl":"10.5644/ama2006-124.415","url":null,"abstract":"","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":"52 2","pages":"146-147"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71486986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Review of the Typical Course of the Musculocutaneous Nerve into the Coracobrachialis Muscle: Its Variability and Possible Clinical Implications.","authors":"Ioannis Pantekidis, Maria Piagkou, Christos Koutserimpas, Alexandros Samolis, George Tsakotos, Michael Kostares, Theodore Troupis","doi":"10.5644/ama2006-124.409","DOIUrl":"10.5644/ama2006-124.409","url":null,"abstract":"<p><strong>Objective: </strong>This literature review highlights the prevalence of the typical course of the musculocutaneous nerve (MCN) through the coracobrachialis muscle (CB), and evaluates the distance from the entrance point of the MCN to the CB, taking the coracoid process (CP) as a landmark.</p><p><strong>Methods: </strong>PubMed (MEDLINE), Scopus, and CINAHL online databases were searched in December 2022 for studies reporting the prevalence of the MCN's typical course and the distance between the CP and the MCN entrance point to the CB.</p><p><strong>Results: </strong>Twenty-eight studies were included (including 2846 subjects) investigating the MCN's typical course, and eliciting a prevalence of 93.4%. The mean distance of the CP to the entrance point of the MCN's main trunk into the CB was 5.6±2cm (median 6.1cm, in 550 subjects). In 76.12% of cases the MCN's accessory branches entered the CB proximally to the MCN's main trunk. The mean distance from the CP to the entrance point of the MCN's proximal branches to the CB was 3.8±1.2cm (median 3.7cm, in 140 subjects).</p><p><strong>Conlcusion: </strong>In the vast majority of cases, the MCN had a typical course through the CB. In cases of altered anatomy, the MCN was either absent or passed medially to the CB (without piercing it). The average entrance point of the MCN into the CB from the CP is 5.6 cm. Proximal motor branches of the MCN to the CB are common and usually arise at a mean distance of 3.8cm from the inferior border of the tip of the CP. Surgeons should be aware of both the MCN's typical and its atypical course and these distances to avoid possible complications when operating in the area.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":"52 2","pages":"95-104"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71486978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-renal Arteries in Nephrectomy from a Historical Aspect, a Quest Originated by Medical Illustrations to Reach Modern Angiography.","authors":"Vassiliki Kyriakou, Georgia Chondrou, Panagiotis Georgakopoulos, Evaggelos Mavrommatis","doi":"10.5644/ama2006-124.416","DOIUrl":"10.5644/ama2006-124.416","url":null,"abstract":"<p><p>The aim of the present paper is to contribute to the understanding of the history of the anatomical study of the intra-renal arteries. The vasculature and especially the intra-renal arteries of the kidneys are an intriguing field which was first studied through art and then perfected by medicine. Angiography and microsurgery have resulted in partial nephrectomy techniques for surviving kidneys with adequate functional results. Graves' categorization dating from 1954 opened the way for innovative approaches that have resulted in modern topographical anatomy. CONCLUSION: Our understanding of the anatomy of intra-renal arteries has played a significant role in surgical anatomy and internal medicine.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":"52 2","pages":"148-151"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71486981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Clinical and Radiological Evaluation of Impacted Third Molar Position, Crown and Root Morphology.","authors":"Naida Hadziabdic, Aida Dzankovic, Madzda Maktouf, Irmina Tahmiscija, Lajla Hasic-Brankovic, Samra Korac, Amila Haskic","doi":"10.5644/ama2006-124.407","DOIUrl":"10.5644/ama2006-124.407","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyze the crown and root morphology of maxillary and mandibular third molars, and assess their position in relation to adjacent anatomical structures using clinical examination and radiographic images.</p><p><strong>Materials and methods: </strong>A total of 176 extracted impacted or partially impacted third molars were included in this study. Orthopantomogram images (OPG) were used to evaluate the number of roots, position, depth of impaction relative to the occlusal plane of the second molar, and angulation of maxillary and mandibular third molars. The extracted teeth were examined to determine the actual number of roots. The root morphology was classified using the Alavi classification system for maxillary third molars and the Machado classification for mandibular third molars. Additionally, the number of cusps, crown dimensions, and morphology were analyzed using digital and dental calipers.</p><p><strong>Results: </strong>The extracted samples exhibited a significantly higher number of roots compared to the number assessed on OPG images (P<0.001). The majority of mandibular third molars had two fused roots (37.39%) and a five-cuspid crown (48.70%), while maxillary third molars had three fused roots (26.23%) and four cusps (42.62%). Both maxillary (60.66%) and mandibular third molars (61.74%) were predominantly vertically positioned. Regarding the depth of impaction, maxillary third molars were primarily classified as Class C (65.57%), while mandibular third molars were classified as Class B (47.83%). Differences in crown shape were observed, with maxillary crowns being mostly triangular (36.07%) and mandibular crowns being oval (38.26%). Maxillary third molars had shorter crowns compared to mandibular third molars (P<0.05).</p><p><strong>Conclusion: </strong>The root morphology of maxillary and mandibular third molars in the population of Bosnia and Herzegovina displays variability. Orthopantomogram imaging was found to be inadequate for accurate determination of the number of roots in third molars. The number of cusps on third molars cannot be relied upon as a predictor of the number of roots. The study's findings will have implications for dental practice, particularly for oral surgeons and restorative dentists.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":"52 2","pages":"77-87"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71486985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Activity Level Alterations Due to the Lockdowns: A Multi-Center Greek University-Based Study.","authors":"Konstantinos Natsis, Michael Kostares, George Tsakotos, Christos Koutserimpas, Evangelos Kostares, George Triantafyllou, Trifon Totlis, Vasilios Karampelias, Dimitrios Chytas, Nikos Pantazis, Nikos Otountzidis, Anastasia Triantafyllou, Vlassis Achlatis, Vasilios Ediaroglou, Maria Piagkou","doi":"10.5644/ama2006-124.412","DOIUrl":"10.5644/ama2006-124.412","url":null,"abstract":"<p><strong>Objective: </strong>This cross-sectional study determines the impact of the pandemic lockdowns on physical activity, and evaluates the factors associated with physical activity cessation on students and personnel of eight Greek Higher Education Institutions.</p><p><strong>Materials and methods: </strong>A total of 6,380 volunteer participants completed a survey reporting their physical activity levels and perceptions during the COVID-19 pandemic. The survey was made available through an online platform.</p><p><strong>Results: </strong>Both the conduct and intensity of physical activity were significantly reduced from the pre-pandemic era to the second lockdown (P<0.001). Walking was the most frequently selected type of physical activity, in all periods except for the second lockdown. Loss of interest (52.4%) was the main, self-reported factor for cessation of physical activity. Females had a 31% lower probability of ceasing physical activity during lockdowns.</p><p><strong>Conclusion: </strong>The conduct and intensity of physical activity decreased significantly during the pandemic. Female gender, annual checkup attendance, and specific physical activity types during the pre-pandemic era were associated with a reduction in the risk of pausing physical activity during lockdowns. Lockdowns may be implemented in future health crises, hence measures for maintaining the physical activity of the general population, such as online group sessions and support from healthcare professionals, should be prepared.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":"52 2","pages":"119-133"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71486982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}