Medical archives (Sarajevo, Bosnia and Herzegovina)最新文献

{"title":"Isolated Subtalar Dislocations: Insights from a Case Study and Literature Review.","authors":"Alzahid Abdullah, Alghamdi Mohannad, Alkhadra Faisal, Almulihi Qasem, Assiri Mohammed, Almulhim Mohammed, Alhawas Abdulaziz","doi":"10.5455/medarh.2024.78.71-74","DOIUrl":"10.5455/medarh.2024.78.71-74","url":null,"abstract":"<p><strong>Background: </strong>Isolated subtalar joint dislocations without associated fractures are rare in the medical literature. They occur when the talus bone remains in place while the calcaneus and navicular bones shift out of place. These dislocations account for about 15% of talus bone injuries and 1 to 2% of all joint dislocations. They are more common in young men following inversion trauma.</p><p><strong>Objective: </strong>This study aims to improve the understanding of diagnosis, treatment, and management of these rare injuries for better patient care.</p><p><strong>Case presentation: </strong>17-year-old male patient with type 1 diabetes mellitus presented to the emergency department with severe ankle pain and swelling following an inversion injury, which rendered him unable to walk or stand. Despite his chronic condition, he was hemodynamically stable, with no neurovascular deficits but an apparent deformity in the left ankle. Treatment involved pain management with morphine, successful closed reduction under ketamine sedation, and immobilization. Follow-up radiographs and a CT scan revealed no fractures but indicated soft tissue edema, joint effusion, and subsequent osteopenia. At a three-month follow-up, the patient experienced ongoing pain and weight-bearing difficulties, diagnosed as complicated pain syndrome requiring further physiotherapy and rehabilitation.</p><p><strong>Conclusion: </strong>This case highlights the clinical challenges and complications in managing isolated subtalar joint dislocations, particularly in patients with systemic health issues, and contributes valuable insights to the sparse literature on this topic.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"78 1","pages":"71-74"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10928679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121702","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":"Metaplastic Breast Cancer with Squamous Differentiation: Beyond the Recognized Statistics.","authors":"Rania Zaki Fallatah, Dhuha N Boumarah, Ghadeer Hajjaj, Abdullah Ahmed Alkhars, Mohammed AlDuhileb","doi":"10.5455/medarh.2024.78.75-77","DOIUrl":"10.5455/medarh.2024.78.75-77","url":null,"abstract":"<p><strong>Background: </strong>Metaplastic breast cancer is a clinically rare subtype of breast carcinomas, accounting for less than 1% of all breast neoplasms, and was not officially recognized till the end of the 20th century as an independent pathological diagnosis.</p><p><strong>Objective: </strong>In this paper, we report a case of metaplastic breast cancer with squamous differentiation in a 51-year-old female, with a succinct review of the literature.</p><p><strong>Case report: </strong>The patient presented to our outpatient department with a complaint of left breast mass for 2 months duration with a diagnostic workup found to be grade three metaplastic carcinoma with squamous differentiation. The management decision was to proceed with neoadjuvant chemotherapy, followed by surgical intervention based on the tumor cell response to neoadjuvant therapy.</p><p><strong>Conclusion: </strong>Metaplastic breast cancer represents a rare clinical entity, encountered in a minority of patients. The clinical presentation of metaplastic carcinomas in general is similar to other breast cancers, however, metaplastic breast cancer tend to present in later stages as a rapidly growing mass with poor prognosis. The recognized poor prognosis along with rarity necessities having a high index of suspicion for early detection and appropriate management of metaplastic breast cancer.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"78 1","pages":"75-77"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10928677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121704","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 Highly Rare Complication: Right Obturator Artery Pseudoaneurysm in a Crohn's Disease Patient Due to Multiple Perianal Abscesses and Drainages.","authors":"Mohammed M Al-Ghamdi, Ahmed Albaqshi, Khwaja Junaid Saeed, Tarig Adlan, Zakaria AlSafran, Hassan Alsayegh","doi":"10.5455/medarh.2024.78.241-243","DOIUrl":"10.5455/medarh.2024.78.241-243","url":null,"abstract":"<p><strong>Background: </strong>Obturator artery pseudoaneurysm is a rare entity, typically caused by trauma or iatrogenic injury during pelvic procedures. It is associated with symptoms such as pain, swelling if the aneurysm is large, and anemia.</p><p><strong>Objective: </strong>To report the first documented case of obturator artery pseudoaneurysm as a complication of perianal involvement in a patient with Crohn's disease, detailing the diagnostic approach and therapeutic interventions to highlight the importance of considering vascular complications in patients with complex perianal diseases.</p><p><strong>Case presentation: </strong>A 39-year-old male with long-standing Crohn's disease affecting the perianal region, and a history of multiple surgical drainages for perianal abscesses, presented to the emergency room with minimal bloody discharge from a perianal fistula. He was vitally stable and thus, perianal MRI was booked on routine bases, revealing a large cystic lesion near the perineum, showing intense enhancement post IV contrast administration. Subsequent imaging confirmed the diagnosis of an obturator artery pseudoaneurysm. The patient underwent successful management via percutaneous trans-arterial embolization, recognized as a safe and effective treatment for such cases.</p><p><strong>Conclusion: </strong>This case is the first in the literature reporting an obturator artery pseudoaneurysm in a patient with Crohn's disease. It underscores the necessity of vigilance for vascular complications in patients with extensive perianal Crohn's disease, offering significant educational value for improving outcomes in similar clinical scenarios.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"78 3","pages":"241-243"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411845","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 Patterns and Quality of Acute Trauma Care in A University Hospital - A 5-year Analysis.","authors":"Omar A Bamalan, Ahmed A Alshaikhi, Nader M Alosaimi, Mamoun A Nabri, Adel J Osman, Humood A Alsadery, Ayman O Nasr","doi":"10.5455/medarh.2024.78.226-231","DOIUrl":"10.5455/medarh.2024.78.226-231","url":null,"abstract":"<p><strong>Background: </strong>Traumatic injuries contribute to over 5 million fatalities each year and cause a significant burden on healthcare systems' resources and availability. Traumatic injury patterns and a healthcare system's efficiency are critical to predicting patients' outcomes and should be regularly evaluated to deliver optimum care.</p><p><strong>Objective: </strong>The study will present and discuss trauma qualty indicators (TQI's) to display the local practices' opportunities for improvement and analyze patterns of traumatic injuries and outcomes.</p><p><strong>Methods: </strong>The study retrospectively analyzed trauma cases from January 2016 to December 2020, in which patients hospitalized and treated under the trauma unit were included. The collected data included several variables (e.g., demographics, mechanism of injury), and the patients were divided into early/late phase and severe/non-severe cases.</p><p><strong>Results: </strong>In total, there were 2024 cases, 70% were polytraumas with a mean age of 29 years and a male-to-female ratio of 3.8:1. The most common mechanism of injury was motor vehicle collision (55%) while the most common injuries were pneumothorax (18%) and lung contusions (17%). Notably, there was a 3.5-hour reduction in both the time to the operating room and the time to normotension when comparing the early to late phase. The 30-day outcomes for the patients were 90.5% recovery, 2.2% disability, 2.2% transfer, and 5.1% mortality rates.</p><p><strong>Conclusion: </strong>This study emphasizes how crucial trauma quality indicators are to achieve the best outcomes for patients. The results point to improvements in terms of trauma quality indicators and offer insightful information on patterns of traumatic injuries, aiding in the enhancement of trauma care. Thus, the continuous assessment of trauma quality indicators and the implementation of preventive measures are mandatory for the future advancement of trauma care.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"78 3","pages":"226-231"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412129","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":"Thirty Years of Editorial Experience of the Oldest Bosnia and Herzegovina Medical Journal \"Medicinski Arhiv/Medical Archives\".","authors":"Izet Masic","doi":"10.5455/medarh.2024.78.266-273","DOIUrl":"10.5455/medarh.2024.78.266-273","url":null,"abstract":"","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"78 4","pages":"266-273"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470334","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 use of Tranexamic Acid in Case of Patient with Intracerebral Hemorrhage After a Coronary Procedure-Case Report.","authors":"Amra Salkic, Amel Amidzic, Stoja Eric, Nermina Gorana-Polimac, Naida Tiro, Merita Tiric-Campara","doi":"10.5455/medarh.2024.78.317-321","DOIUrl":"10.5455/medarh.2024.78.317-321","url":null,"abstract":"<p><strong>Background: </strong>Tranexamic acid can prevent death from bleeding after trauma and postpartum hemorrhage.</p><p><strong>Objective: </strong>The aim of the paper was to assess whether tranexamic acid reduces hematoma expansion and improves outcome in adults with stroke caused by intracerebral hemorrhage.</p><p><strong>Case presentation: </strong>Administration of Tranexamic acid in a patient after a diagnosis of intracerebral hematoma, which occurred after coronary stent implantation. Intracerebral hematoma, or neurological deficit, occurs one day after cardiac surgery in the patient. The case report will present the radiological resolution of the intracerebral hematoma, as well as the improvement of the clinical picture, neurological deficit, in the patient during a one-month follow-up, after the administration of Tranexamic acid.</p><p><strong>Conclusion: </strong>Tranexemic acid is affordable, easy to administer, appears to be safe, and is widely available, so even a modest treatment effect can have an important global impact, and it is necessary to consider its more frequent use, as well as to initiate larger randomized trials.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"78 4","pages":"317-321"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470332","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":"Characteristics of Patients With Acute Coronary Syndrome and Normal Electrocardiogram.","authors":"Aleksandra Ljubojevic, Sofija Aleksandra Neskovic, Ivona Vranic, Ivan Stankovic","doi":"10.5455/medarh.2024.78.100-104","DOIUrl":"https://doi.org/10.5455/medarh.2024.78.100-104","url":null,"abstract":"<p><strong>Background: </strong>Patients with acute coronary syndrome (ACS) and normal electrocardiogram (ECG) may have an increased risk of late diagnosis and complications of the disease.</p><p><strong>Objective: </strong>To study the demographic, angiographic and echocardiographic characteristics of patients hospitalized for ACS in whom the ECG was normal on admission to the hospital.</p><p><strong>Methods: </strong>This retrospective study included patients who were hospitalized for ACS without ST-elevation between 2015 and 2023 and who had coronary artery disease (CAD) confirmed by coronary angiography. By further inspection of the electronic databases, patients with ACS who had a normal ECG on admission were filtered out and analyzed separately.</p><p><strong>Results: </strong>Of the total 3137 patients with suspected ACS without ST-elevation, 129 patients (4.1%) were diagnosed as having ACS with a normal ECG. In three patients a non-atherosclerotic cause for the ACS was found. A significantly higher proportion of patients had single-vessel (54.3%) compared to two-vessel (29.5%) and three-vessel (14%) CAD. In addition to a normal ECG, 5.7% of patients with single-vessel CAD and 3.5% of patients with multi-vessel CAD had normal troponin levels and normal regional LV systolic function on echocardiography.</p><p><strong>Conclusion: </strong>Less than 5% of hospitalized patients with ACS without ST-elevation had a normal ECG on admission. The majority of these patients have single-vessel CAD. In about 5% of patients with single-vessel CAD, neither elevated troponin levels nor LV asynergy are detected.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"78 2","pages":"100-104"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10983090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862194","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":"Less Invasive Surfactant Administration (LISA) Versus INSURE Method in Preterm Infants: a Retrospective Study.","authors":"Gianluca Dini, Maria Grazia Santini, Federica Celi","doi":"10.5455/medarh.2024.78.112-116","DOIUrl":"https://doi.org/10.5455/medarh.2024.78.112-116","url":null,"abstract":"<p><strong>Background: </strong>Respiratory distress syndrome (RDS) is a major cause of morbidity and mortality in preterm infants. Early nasal CPAP and selective administration of surfactant via the endotracheal tube are widely used in the treatment of RDS in preterm infants.</p><p><strong>Objective: </strong>The aim of this study was to compare the need for intubation and mechanical ventilation after surfactant delivery between LISA-treated and INSURE-treated premature infants with respiratory distress syndrome (RDS).</p><p><strong>Methods: </strong>Retrospective registry-based cohort study enrolled 36 newborns admitted to the neonatal intensive care unit of the \"Santa Maria\" Hospital of Terni between 2016 and 2023. As a primary outcome, we followed the need for intubation and mechanical ventilation within 72 hours of life, while the secondary outcomes were major neonatal morbidities and death before discharge.</p><p><strong>Results: </strong>The LISA group and the INSURE group included 13 and 23 newborns respectively. Demographic features showed no significant differences between the two groups. The need for mechanical ventilation in the first 72 hours of life was similar in both groups (p >0.99). There were no significant differences in morbidities.</p><p><strong>Conclusion: </strong>LISA and INSURE are equally effective modalities for surfactant administration for the treatment of RDS in preterm infants.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"78 2","pages":"112-116"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10983101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873072","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 Relationship Between KI67 Expression and Grading with Chemotherapy Response in Triple-Negative Breast Cancer Patients at Haji Adam Malik General Hospital, Medan.","authors":"Edy Anugrah Putra, Dedy Hermansyah, Endi Taris Pasaribu, Putri Chairani Eyanoer","doi":"10.5455/medarh.2024.78.285-289","DOIUrl":"10.5455/medarh.2024.78.285-289","url":null,"abstract":"<p><strong>Background: </strong>The response to chemotherapy in TNBC varies greatly, highlighting the need for predictive factors to estimate the success of the therapy.</p><p><strong>Objective: </strong>The primary aim of this study is to analyze the relationship between Ki67 expression and clinicopathological features with chemotherapy response in locally advanced TNBC.</p><p><strong>Methods: </strong>This retrospective study utilized secondary data from the medical records of locally advanced TNBC patients at Haji Adam Malik General Hospital, Medan. Out of an initial sample of 50 patients, 35 met the inclusion criteria, which required a confirmed TNBC diagnosis through histopathological and immunohistochemical examination, as well as complete clinical data. Chemotherapy response was assessed based on the World Health Organization (WHO) criteria, ensuring a standardized evaluation of treatment outcomes.</p><p><strong>Results: </strong>The majority of patients were aged ≥50 years (54.5%), with a dominant tumor size of 2-5 cm (69.7%) and high histological grading (Grade 3: 60.6%). A total of 45.5% of patients exhibited high Ki67 expression (≥30%). Chemotherapy response was categorized as complete response (12.1%), partial response (45.5%), stable disease (30.3%), and progressive disease (12.1%). Statistical analysis revealed a significant relationship between Ki67 expression and chemotherapy response (p=0.02), with patients exhibiting high Ki67 expression more frequently achieving complete or partial response.</p><p><strong>Conclusion: </strong>High Ki67 expression is a critical indicator for predicting chemotherapy response in TNBC. Integrating Ki67 assessment with other clinicopathological factors is highly recommended to enhance predictive accuracy and optimize therapeutic planning for more effective treatment outcomes.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"78 4","pages":"285-289"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470330","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":"Esophageal Injury After Anterior Cervical Spine Fixation: What Can Thoracic Surgeons Offer?","authors":"Humood A Alsadery, Yesser Aljehani, Farouk Alreshaid, Yasser Elghoneimy, Omar A Bamalan, Abdulrahman Alblowi, Jumana Alhelal, Ayman Elbaz, Moustafa Aboollo","doi":"10.5455/medarh.2024.78.290-295","DOIUrl":"10.5455/medarh.2024.78.290-295","url":null,"abstract":"<p><strong>Background: </strong>The anterior approach for cervical spine surgery was introduced in the late 1950's and was then extensively used with a known considered risk for an esophageal injury.</p><p><strong>Objective: </strong>Therefore, we designed this study to look into our institution's experience in the treatment of esophageal injury post cervical spine fixation looking at possible causes, presentation and risk factors.</p><p><strong>Methods: </strong>A retrospective analysis of esophageal perforation cases secondary to cervical spine fixation, encountered in King Fahad hospital of the University (Eastern province, Dammam, Saudi Arabia) in between (2008-2019) were studied.</p><p><strong>Results: </strong>The patients included were 11, in which the most common presenting symptoms were dysphagia, neck pain, persistent discharge from the cervical wound with or without food particles and odynophagia, while the mean period for presentation was 358.9 days (ranging from 4 to 2555 days). The pharyngo-esophageal perforation repair was done in 9 patients, while 2 patients were treated conservatively. In addition, supportive measures (i.e., frequent wound care, broad spectrum intravenous antibiotics, non per oral and adequate feeding via alternative routes) were done for all patients.</p><p><strong>Conclusion: </strong>Esophageal injury, although uncommon in anterior spinal approach, still considered a life-threatening complication and need a low threshold of suspicion.</p>","PeriodicalId":94135,"journal":{"name":"Medical archives (Sarajevo, Bosnia and Herzegovina)","volume":"78 4","pages":"290-295"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470340","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}