39 research outputs found
Kalcificirani fibrozni tumor rektuma: prikaz slučaja
A calcifying fibrous tumor (CFT) is a benign tumor of unknown etiology. A calcifying fibrous tumor is rare in the intestinal tract. A calcifying fibrous tumor is characterized by hyalinized collagenous fibrous tissue, psammomatous or dystrophic calcification, and focal lymphoplasmacytic infiltrates on histology. Magnetic resonance imaging is the standard method for evaluating the lesions of the rectum, and CFTs should be considered in differentiating the rectal wall tumors. Herein, we report a case of a 68-year-old man with a rectal wall CFT.Kalcificirani fibrozni tumor (CFT) je benigni tumor nepoznate etiologije. CFT u crijevnom traktu je vrlo rijedak. CFT karakterizira prisutnost hijaliniziranog kolagenskog vlaknastog tkiva, psamomatoznih ili distrofičnih kalcifikacija i fokalnih limfoplazmocitnih infiltrata. Prikazujemo slučaj 68-godišnjeg muškaraca s CFT-om u stijenci rektuma. Magnetska rezonancija je korisna metoda za procjenu procesa stijenke rektuma, CFT treba uzeti u obzir u diferencijalnoj dijagnozi tumorskih procesa stijenke rektuma
The Importance of P-glycoprotein Multidrug Transporter Activity Measurement in Patients with Helicobacter pylori Infection
P-glycoprotein is important in local antibiotic resistance. Aim was to evaluate the role of P-glycoprotein in local antibiotic resistance in patients with antral gastritis during antibiotic therapy to Helicobacter pylori infection. In the group of 53 patients with pathohistologically verified gastritis and microbiologically confirmed H. pylori infection (no signs of antimicrobial resistance) we have determined P-glycoprotein activity in gastric mucosa biopsy specimens, and compared them with the P-glycoprotein activity in 12 control subjects with normal endoscopic findings. The H. pylori positive patients were treated according to Maastricht protocol with short-term 7-day therapy consisting of two antibiotics (amoxicillin and azithromycin/metronidazole and clarithromycin) and a proton pump inhibitor. P-glycoprotein activity was determined in rhodamine dye efflux test and quantified by ratio of the mean fluorescence (RMF) in flow cytometry analysis. H. pylori was successfully eradicated in the first cycle in 20 patients, whereas therapy was continued in 33 patients. The mean pre-treatment RMF values were higher in patients with H. pylori infection then in control subjects (p<0.0046). RMF was also higher in patients with multiple therapeutic failure than in those with successful H. pylori eradication (p<0.0001). RMF increased significantly during the antibiotic therapy (p<0.05). P-glycoprotein might be one of the causes of therapy failure in patients with H. pylori. Our study confirms the importance of quantitative evaluation of P-glycoprotein expression during antibiotic treatment response
HOW TO DISTINGUISH IDIOPATHIC ACHALASIA FROM PSEUDOACHALASIA?
Achalasia is a disorder characterized by insufficient relaxation of the lower esophageal sphincter and absent peristalsis. It is
usually primary (idiopathic) achalasia, but it can also be secondary achalasia (pseudoachalasia). With a review of the literature,
epidemiological data was gathered on achalasia in this paper, and followed up with presented etiopathogenetic mechanisms of
achalasia. An optimal diagnostic algorithm along with the therapeutic possibilities in achalasia, from endoscopic to surgical
methods of therapy, was analyzed.
The most common causes of pseudoachalasia and the mechanisms of this disorder are reported. In patients with dysphagia and
suspected achalasia, it is important to distinguish idiopathic achalasia from pseudoachalasia, since pseudoachalasia most often
occurs due to tumor infiltrations of the lower esophageal sphincter. In this paper, the importance of a timely and accurate diagnosis
of pseudoachalasia in relation to idiopathic achalasia was shown
Prognostic Value of Venoarterial Carbon Dioxide Gradient in Patients with Severe Sepsis and Septic Shock
Aim To investigate the changes in the venoarterial carbondioxide
gradient (V-a Pco2) and its prognostic value for survival
of patients with severe sepsis and septic shock.
Methods The study was conducted in General Hospital
Holy Spirit from January 2004 to December 2007 and included
71 conveniently sampled adult patients (25 women
and 46 men), who fulfilled the severe sepsis and septic
shock criteria and were followed for a median of 8 days
(interquartile range, 12 days). The patients were divided in
two groups depending on whether or not they had been
mechanically ventilated. Both groups of patients underwent
interventions with an aim to achieve hemodynamic
stability. Mechanical ventilation was applied in respiratory
failure. Venoarterial carbon dioxide gradient was calculated
from the difference between the partial pressure of arterial
CO2 and the partial pressure of mixed venous CO2, which
was measured with a pulmonary arterial Swan-Ganz catheter.
The data were analyzed using Kaplan-Meier survival
analysis, along with a calculation of the hazard ratios.
Results There was a significant difference between nonventilated
and ventilated patients, with almost 4-fold
greater hazard ratio for lethal outcome in ventilated patients
(3.85; 95% confidence interval, 1.64-9.03). Furthermore,
the pattern of changes of many other variables was
also different in these two groups (carbon dioxide-related
variables, variables related to acid-base status, mean arterial
pressure, systemic vascular resistance, lactate, body mass
index, Acute Physiology and Chronic Health Evaluation II,
Simplified Acute Physiology II Score, and Sepsis-related Organ
Failure Assessment score). Pco2 values (with a cut-off
of 0.8 kPa) were a significant predictor of lethal outcome
in non-ventilated patients (P = 0.015) but not in ventilated
ones (P = 0.270).
Conclusion V-a Pco2 was a significant predictor of fatal
outcome only in the non-ventilated group of patients. Ventilated
patients are more likely to be admitted with a less
favorable clinical status, and other variables seem to have a
more important role in their outcome
HOW TO DISTINGUISH IDIOPATHIC ACHALASIA FROM PSEUDOACHALASIA?
Achalasia is a disorder characterized by insufficient relaxation of the lower esophageal sphincter and absent peristalsis. It is
usually primary (idiopathic) achalasia, but it can also be secondary achalasia (pseudoachalasia). With a review of the literature,
epidemiological data was gathered on achalasia in this paper, and followed up with presented etiopathogenetic mechanisms of
achalasia. An optimal diagnostic algorithm along with the therapeutic possibilities in achalasia, from endoscopic to surgical
methods of therapy, was analyzed.
The most common causes of pseudoachalasia and the mechanisms of this disorder are reported. In patients with dysphagia and
suspected achalasia, it is important to distinguish idiopathic achalasia from pseudoachalasia, since pseudoachalasia most often
occurs due to tumor infiltrations of the lower esophageal sphincter. In this paper, the importance of a timely and accurate diagnosis
of pseudoachalasia in relation to idiopathic achalasia was shown
Clinical and Anorectal Motility Features in Chronically Constipated Children
Constipation is a common problem in children. It can be a symptom of functional disorder in majority of cases, but
sometimes a serious organic disease is a cause of constipation. Anorectal manometry plays an important role in the diagnostic
procedure. It can be presumed that some values of manometric parameters could be very useful in treatment plan.
The aim of this study was to confirm or exclude such limits in manometric finding, to make a plan of the therapy more
accurate. Therefore the group of 81 constipated children was investigated. There were 58 patients suffering from functional
constipation and 23 with organic disorders. The age of the patients was 3 to 15 years. Scoring system was applied
to estimate severity of constipation and anorectal manometry was performed. Our results did not show significant correlation
between clinical symptoms and signs and the values that we obtained using anorectal manometry. But, we recommend
anorectal manometry because it is a safe method and contributes to clarify the diagnosis, which is very important
for treatment plan
Clinical and Anorectal Motility Features in Chronically Constipated Children
Constipation is a common problem in children. It can be a symptom of functional disorder in majority of cases, but
sometimes a serious organic disease is a cause of constipation. Anorectal manometry plays an important role in the diagnostic
procedure. It can be presumed that some values of manometric parameters could be very useful in treatment plan.
The aim of this study was to confirm or exclude such limits in manometric finding, to make a plan of the therapy more
accurate. Therefore the group of 81 constipated children was investigated. There were 58 patients suffering from functional
constipation and 23 with organic disorders. The age of the patients was 3 to 15 years. Scoring system was applied
to estimate severity of constipation and anorectal manometry was performed. Our results did not show significant correlation
between clinical symptoms and signs and the values that we obtained using anorectal manometry. But, we recommend
anorectal manometry because it is a safe method and contributes to clarify the diagnosis, which is very important
for treatment plan