93 research outputs found

    Liječenje prijeloma potkoljenice u dječjoj dobi

    Get PDF

    The influence of size, depth and histologic characteristics of invasive ductal breast carcinoma on thermographic properties of the breast

    Get PDF
    Invasive breast carcinoma is the most common oncologic disease worldwide. The existing diagnostic methods use morphologic changes in the breast to diagnose a carcinoma when it has reached a certain size. Therefore, it is important to augment the morphologic diagnostic examinations with a new method that focuses on characteristics other than morphology such as electromagnetic changes produced by cancer. 50 adult female patients with confirmed ductal carcinoma following a core biopsy due to a suspicious breast mass were included in the study. They underwent breast thermography us ing a specially designed infrared camera. The data collected was statistically analyzed to determine how the presence of a tumor and its histologic characteristics influence breast thermographic properties. Twenty eight [56 %] patients in the study had an abnormal thermogram. Following statistical analysis, it was found that temperature of the diseased breast was directly correlated to tumor volume [p=0.009] and negatively correlated to depth of tumor [p=0.042]. Tumors that were ER+ and PR+ tumors produced warmer temperatures [p=0.017 and p=0.038 respectively] than tumors without these receptors. HER2 status and Ki-67 index had no statistical correlation with breast temperature. Tumor size, distance from the skin surface and receptor status cause changes in breast thermographic properties. Despite technical advances in the field of thermography, there are still contradictory results associated with thermography. Its diagnostic abilities are generally poorer than conventional methods and its use in breast cancer screening or as an adjunctive tool for diagnostic purposes is not recommended

    Mechanical properties of stainless steel orthopaedic implants in simulated biological conditions

    Get PDF
    Brojna su propitivanja potrebe rutinskog odstranjenja metalnog implantata nakon saniranja prijeloma kosti. Pretežita indikacija za odstranjenje jest slabljenje mehaničkih svojstava i pucanje implantata prije cijeljenja kosti. Cilj ovog istraživanja bio je ispitati mehanička svojstva osteosintetske pločice izrađene od standardnoga kirurÅ”kog čelika u simuliranim bioloÅ”kim uvjetima. U istraživanju smo koristili implantate nehrđajućeg čelika 316L i pohranili ih kroz godinu dana u simuliranome bioloÅ”kom mediju (engl. SBF ā€“ simulated body fluid). Analizirano je 48 pločica standardnoga kirurÅ”kog čelika podijeljeno u četiri skupine. Jedna je kontrolna. Ostale su bile uronjene u otopine različitih pH vrijednosti. Uronjene pločice testirane su nakon godinu dana, a kontrolna odmah na početku istraživanja. Tijekom godinu dana analizirala se promjena mikrostrukture uronjenih pločica skenirajući elektronskim mikroskopom (SEM) u pet navrata, a kontrolna grupa samo jednom. Na pločicama koje su bile u bioloÅ”kim simuliranim uvjetima, bez obzira na pH medija, značajno je veći broj jamičastih korozija kod mjerenja nakon Å”est mjeseci i godinu dana. Nakon godinu dana pohrane u medijima različite pH mjerene su vrijednosti mehaničkog, statičkog i dinamičkog opterećenja pločica. Niti jedno načinjeno mehaničko testiranje nije pokazalo statistički značajnu razliku između kontrolne skupine pločica i onih koje su bile u bioloÅ”ki simuliranim uvjetima kroz godinu dana. Nepromijenjena mehanička svojstava istraživanih implantata, unatoč značajnim promjenama mikrostrukture nastale kao posljedica jamičaste korozije u bioloÅ”ki simuliranim uvjetima, otklanjaju vjerojatnost slabljenja pločice kao i indikaciju za njezino odstranjenje u tom vremenskom razdoblju.Questioning the routine metal implant removal after bone fracture healing has increased. One of the main indications for removal is metal weakening in biological bone healing conditions, in addition to reports about its breakage even prior to bone healing. The aim of this study is to investigate the mechanical properties of osteosynthesis plates made out of standard surgical stainless steel in simulated biological conditions. Implants made out of 316L stainless steel were kept for one year in simulated body fluid (SBF). We analysed 48 plates made out of standard surgical stainless steel that were divided in four groups. One was the control group and the remaining were immersed in solutions with various pH values according to pH changes during bone fracture healing. The immersed plates were tested mechanically through one year, and those in the control group at the beginning of the study. During one year microstructural changes of the immersed plates were examined five times using a scanning electron microscope (SEM), and only once in the control group. There were significant microstructural pitting corrosion changes after six months and after one year in all plates that were in simulated biological conditions, regardless of the group pH value. Static and dynamic mechanical plate loading tests were performed one year after storage in solutions with various pH values. Following the complete mechanical testing no statistically significant changes were found between groups kept in simulated biological conditions for one year and the control group. The study showed no changes in the mechanical properties of the investigated implants regardless of significant microstructural changes as a consequence of pitting corrosion in simulated biological conditions, which precludes the probability of implant weakening and indication for its removal one year after fracture fixation

    Trigger thumb in children

    Get PDF
    Prirodan tijek bolesti kod Å”kljocavog palca u djece joÅ” je predmet neslaganja, a sukladno tomu i preporuke za liječenje znatno se razlikuju te ne postoje jasne i Å”iroko prihvaćene smjernice. Ovim radom pokuÅ”ali smo dati trenutačni literaturni pregled spoznaja o tijeku bolesti te dijagnostičkim i terapijskim mogućnostima s naglaskom na konačnom ishodu liječenja. Å kljocavi palac jedna je od najčeŔćih anomalija dječje Å”ake i uglavnom se vidi u djece predÅ”kolske dobi. Karakteristično je otežano klizanje tetive fleksora policisa longusa kroz njezinu ovojnicu, Å”to je posljedica anatomskog nesklada njihovih veličina. Tipičan klinički nalaz jest palac fiksiran u fleksijskoj kontrakturi, na razini interfalangealnog zgloba. Prvi opis dao je Notta, čije ime i danas nosi palpabilna masa tetive fleksora policisa longusa u području A1 pulleya. Dijagnoza se obično postavlja temeljem anamneze i fizikalnog pregleda, uz ultrazvuk kao korisno rano dijagnostičko sredstvo. Å kljocavi palac dijagnostički treba razlučiti od dislokacije, frakture ili anomalije poznate kao deformacija palca u dlanu. Klinička istraživanja poboljÅ”ala su razumijevanje i benignost prirodnog tijeka bolesti. Terapijski postupak ovisi o izboru roditelja i liječnika. On može biti konzervativan, s pomoću udlage i izvođenjem vježba pasivne ekstenzije, ili kirurÅ”ki, presijecanjem A1 pulleya, Å”to pouzdano vraća pokretljivost interfalangealnog zgloba palca. Spontani oporavak može trajati godinama, no on pruža obiteljima voljnim čekanja mogućnost izbjegavanja stresa hospitalizacije i operacijskog liječenja.The natural course of the condition in pediatric trigger thumb is still controversial, and accordingly, the recommendations for treatment vary considerably and there are no clear and broadly accepted guidelines. In this paper, we tried to provide a current literary overview of the disease progression and diagnostic and therapeutic abilities with an emphasis on the ultimate outcome of the treatment. Trigger thumb represents one of the most common pediatric hand conditions, mostly seen in preschool children. As a result of anatomic size mismatch between the flexor pollicis longus tendon and its sheath, disrupted tendon gliding is characteristic. The interphalangeal joint of the affected thumb fixed in a flexion contracture presents typical clinical finding. The first description of trigger thumb is attributed to Notta, and the palpable nodule at the volar aspect of the interphalangeal joint flexion crease still bears his name. Medical history and physical examination are used to diagnose this deformity with ultrasound as a potential early diagnostic tool. It is possible to misdiagnose a fracture, dislocation of the thumb or thumb-in-palm deformity. Clinical investigation has improved our understanding of the natural history and its benignancy. Therapeutic treatment depends on parent and physician preference. It can be either conservative, consisting of splint therapy and passive stretching exercises, or surgical, releasing of the A1 pulley that reliably restores thumb interphalangeal joint motion. Although it may take several years for spontaneous resolution, families willing to wait are given an opportunity to avoid hospitalization stress and surgical intervention
    • ā€¦
    corecore