Malignant melanoma of the liver

Autori prikazuju slučaj četrdeset-trogodišnje bolesnice, obrađivane zbog bolova desnog hemiabdomena, u trajanju dva mjeseca, i hepatomegalije. Glavni anamnestički podatak bila je dijagnoza malignog melanoma lijevog oka i enukleacije tog oka prije jedanaest godina. Patološki testovi jetrene funkcije, posebno povećane vrijednosti AST, ALT, gama GT, alkalne fosfataze; te scintigrafija, ultrazvuk i CT nisu bili dovoljni za postavljanje dijagnoze. Perkutornom biopsijom jetre, pod kontrolom CT-a, postavljena je definitivna dijagnoza: metastaza malignog melanoma.The case of a 43-year-old woman with two-month history of right hemiabdominal pain and hepatomegaly is presented. The main anamnestic data were the diagnosed left eye malignant melanoma and the enucleation of that eye 11 years ago. Abnormal results of the liver function tests, particularly elevated AST, ALT, gamma GT and alkaline phosphatase levels as well as scintiscan, ultrasound and CT could not provide a presumptive diagnosis. Percutaneous needle biopsy of the liver under CT control enabled the diagnosis of malignant melanoma metastases

Comparison of epidemiological characteristics of duodenal erosions and duopdenal ulcer

Na Internoj klinici Medicinskog fakulteta Sveučilišta u Zagrebu, Opće bolnice Osijek u razdoblju od 01. siječnja 1987. do 31. prosinca 1989. godine napravljeno je 10209 ezofagogastroduodenoskopija i u 27,9% bolesnika nađene su erozije, a peptički ulkus u 48,9% bolesnika. Erozije su najčešće bile locirane u duodenumu (38%), a 18% bolesnika imalo je erozije i u duodenumu i u antrumu. Erozije su nađene u 24,9% bolesnika s peptičkim ulkusom. Duodenalne erozije nađene su u 56% bolesnika s erozivnom bolešću. Oko 40% bolesnika s duodenalnim erozijama imalo je i peptički ulkus (duodenalni 37%, a želučani 3% bolesnika). Pojava ulkusne i/ili erozivne duodenalne bolesti najčešća je u jesen (40%), a najrjeđa ljeti (16%). Iz epidemiološke analize 360 bolesnika, koji su bili podijeljeni u tri grupe s obzirom na to imaju li nezavisne duodenalne erozije, erozije i ulkus ili nezavisni duodenalni ulkus, proizlazi da prioritetan štetan utjecaj na nezavisne duodenalne erozije ima neredovita, loša prehrana i pretjerana uporaba mirodija, dok brzo jedenje i/ili nedovoljno žvakanje hrane ima utjecaj na pojavu ulkusne bolesti. Postoji i mala povezanost između slobodnih zanimanja i ulkusne bolesti, te između erozivne bolesti i prekida radnog odnosa. Određen utjecaj na udruženu erozivnu i ulkusnu patologiju imaju i psihoemocionalne komponente u obitelji, mjestu stanovanja i na radnom mjestu. Konzumiranje alkohola (125 g/dan i više) ima više utjecaja na pojavu erozija, a pušenje cigareta (25/dan i više) i pijenje crne kave (5 šalica/dan i više) na pojavu duodenalne ulkusne bolesti. Uočena je i veza između uporabe lijekova koji oštećuju sluznicu i nezavisne erozivne bolesti.In the period from January the 1st 1987, till December the 31st 1989, it was done 10209 endoscopy examinations on the Internal Clinic of General Hospital Osijek. In 27,9% of the patients erosions and in 48,9% of the patients peptic ulcer has been found. Erosive lesions were localized mainly in duodenum (38%) and in 18% of the cases erosive lesions were localized both in duodenum and in antrum. In 24,9% of the cases duodenal erosions coexist with ulcerative peptic disease (duodenal 37%, gasrtic 3%). The appearance of ulcer and/or erosive duodenal disease was mainly in autumn (40%) and less often in summer (16%). From an epidemiological study on 360 cases, which were divided into 3 groups: cases with autonomus duodenal erosive disease, those with erosions and ulcer and those with autonomous duodenal ulcer, we can see that in duodenal erosive disease predisposing factors are irregular, poor nutrition and excessive use of flavours, while fast eating and/or insufficiently chewing of the food are predisposing factors for ulcerative disease. Besides, there is a slight association between free-lance activity and ulcerative disease and between erosive disease and temporary or permanent interruption of work. The psycho-emotional component in family and work situations does have a determining effect on the erosive and ulcerative associated pathology. It is interesting to notice the relationship between erosive disease and abuse of alcohol (125 g/day or more) and between duodenal ulcerative disease and abuse of nicotine (25 cigarettes/day or more) and coffee (5 cups/day or more). Besides, it is notice the relationship between mucosa- damaging drugs and autonomous erosive disease

Epidemiological characteristic of duodenal erosions

Na Internoj klinici Opće bolnice Osijek učinjena je prospektivna studija gdje je napravljeno 3950 ezofagogastroduodenoskopija i u 238 bolesnika nađene su duodenalne erozije. U 99 bolesnika one su bile udružene s peptičkim ulkusom. Bolesnici s duodenalnim erozijama (u obje grupe) bili su uglavnom u dobi od 30 do 59 godina. Omjer muškaraca prema ženama u bolesnika s nezavisnim erozijama bio je 4,8:1, a u bolesnika koji su imali erozije udružene s peptičkim ulkusom 6,1:1. Duodenalne erozije su u 143 bolesnika diseminirane, a u 81 bolesnika zonalno raspoređene (uglavnom na prednjoj i stražnjoj stijenci). Pojedinačne erozije nađene su u 14 bolesnika. Pojava duodenalnih erozija u obje grupe bila je najčešća u jesen, a najrjeđa ljeti. Pojava konzumiranja alkoholnih pića, crne kave i pušenja cigareta slični su u bolesnika s duodenalnim erozijama i u općoj populaciji podvrgnutoj ezofagogastrođuodenoskopiji. Ti rezultati pokazuju da su epidemiološke karakteristike duodenalnih erozija dosta slične onima kod duodenalnog ulkusa i zbog toga ova patologija treba biti uključena u široko poglavlje peptičke bolesti.In the prospective investigation on the Internal Clinic of General Hospital Osijek 3950 endoscopic examinations has been done and in 238 patients duodenal erosions has been found. In 99 patients duodenal erosions coexist with ulcerative peptic disease. The patients with duodenal erosions (in both groups) were predominantly between 30 and 59 years old. The ratio of men to woman in patients with autonomous erosions was 4,8:1, and in patients with erosions connected with ulcerative peptic disease was 6,1:1. In 143 patients duodenal erosions werde disseminated and in 81 patients were zonally disributed (mainly in the anterior and posterior walls). In 14 patients single erosions have been found. In both groups duodenal erosions were mainly observed in autumn, and rarely in summer. The intake of alcohol, coffe and cigarettes were quite similar in patients with duodenal erosions and in the general population submitted to endoscopic examinations. In conclusion, the analysis of our data presen epidemiological characteristics of duodenal erosions very similar to those pertaining to duodenal ulcer and therefore this pathology has to be included in the wide chapter of the peptic diseases

Anti-Citrullinated Antibodies, Radiological Joint Damages and Their Correlations with Disease Activity Score (DAS28)

Determination of anti-citrullinated peptides (anti-CCP) specificity as a predictor of joint erosive changes, correlation between their serum level and radiological damages as well as disease activity score (DAS28). A trial has been conducted on a 211 patient sample fulfilling ACR criteria for rheumatoid arthritis (RA). There was assigned anti-CCP serum level, disease activity score by the formula for DAS28(3)-CRP and assessed radiological changes degree after Steinbrocker score. In 132 patient (62,559%) the serum anti-CCP concentration was positive for RA. Specificity of the test was 100% and sensitivity 65% (Z=0,731, p=0,465). There is a medium intensity correlation between variables representing anti- -CCP and Steinbrocker score. Pearson’s coefficient was 0,479 and Spearman’s rank correlation coefficient was 0,614, i.e. statistically significant (p=0,000). There is no statistically significant correlation between variables representing anti- -CCP and DAS28(3)-CRP. Anti-CCP are good RA predictor and their concentration correlate with radiological damages degree

Antibody Profile of Pregnant Women with Antiphospholipid Syndrome and Pregnancy Outcome After Treatment with Low Dose Aspirin and Low-Weight-Molecular Heparin

The aim of the research was to show our diagnostic and therapeutic experience with antiphospholipid syndrome (APS) in pregnant women. 36 pregnant women suspect on APS were included in the study: 32 with primary antiphospholipd syndrome (PAPS) and 4 with secondary antiphospholipid syndrome (SAPS). All pregnant women received low-molecular-weight-heparin (LMWH) and low dose aspirin (LDA) therapy. Control group represented 26 women with SAPS and previous bad reproductive anamnesis. Average pregnancy lasted 37.060.707 weeks. LMWH and LDA therapy was successful in 97.22%. Lupus anticoagulant (LA) was found to be more frequent in PAPS group (71,87%). Anticardiolipin antibodies (aCL) were found to be more frequent in SAPS (26,66%). For three patients (3.37%), PAPS was diagnosed due to a fact that they had positive antibeta2-glycoprotein1 (anti-GP1). To make APS diagnosis, it is of great importance to search for all antiphospholipid antibodies. LMWH and low dose of acetylsalicylic acid should be the first choice therapy

Comparison between famotidine (20 mg at bed time) and ranitidine (150 mg at bed time) in the prevention of duodenal ulcer relapse

Famotidin u dozi od 20 mg navečer uspoređivanje s ranitidinom u dozi od 150 mg navečer u prevenciji recidiva duodenalnog ulkusa u tijeku 6 mjeseci. Ispitivanjem je obuhvaćen 71 bolesnik. Bolesnici su bili podijeljeni vi dvije skupine. Prva skupina od 40 bolesnika poslije zalječenja akutnog napada bolesti liječena je ranitidinom vi dozi 150 mg navečer, a druga skupina od 31 bolesnika famotidinom od 20 mg navečer. Bolesnici iz obje skupine uz ove su lijekove uzimali i antacid. Nakon tri mjeseca u prvoj skupini zabilježen je jedan recidiv a u drugoj skupini nije bilo recidiva. U prvoj skuipini poslije šest mjeseci bila svi tri recidiva, a u drugoj bila su dva recidiva dvanaesničnog vrijeda. Dva od tri bolesnika u prvoj skupini i oba bolesnika u drugoj skupini s recidivom dvanaesničnog vrijeđa bili su pušači. Statistički značajnih odstupanja vi CKS, koncentraciji ureje, kreatinina i transaminaza vi krvi poslije 3 i 6 mjeseci nije bilo ni u jednoj skupini bolesnika. Nisvi zabilježene ni značajne popratne pojave pri uzimanju oba lijeka.Famotidine given in a 20-mg dose at bed-time was compared to ranitidine administered in a dose of 150 mg at bed-time in the prevention of duodenal ulcer relapse during a six-month period. Seventy-one patients were included in the study. Patients were divided into two groups. Group 1 consisting 40 patients, after curing of acute illness, were treated with ranitidine, 150 mg at bed time, whereas group 2 consisting of 31 patients were treated with famotidine 20 mg at bed-time. Patients from both groups were additionally treated with antacide. After 3 months, one and no cases of relapse were recorded in groups 1 and 2, respectively. After 6 months, three cases of duodenal ulcer relapse were recorded in group 1 and two cases in group 2. Two out of three patients in group 1 and both patients in group 2 with duodenal ulcer relapse were smokers. There were no statistically significant differences between the two groups of patients in RBC, urea concentrations, creatinine and transaminases in blood after 3 and 6 months. No adverse side-effects were observed during the administration of either drug studied

Esomeprazole versus pantoprazole for healing erosive oesophagitis

The aim of this study was to compare the efficacy of esomeprazole and pantoprazole with regard to healing and relief from gastroesophageal reflux disease-related symptoms. I this multicentre, randomized, single-blind study 180 patients (ITT population) diagnosed with endoscopically proven GERD grade A,B,C received esomeprazole (40 mg once daily (o.d.), n = 90) orpantoprazole (40 mg o.d., n = 90). Healing and relief from GERD-related symptoms were assessed at first and final visit (after 4 or 8 weeks of treatment). Esomeprazole 40 mg provided significantly greater healing than pantoprazole 40 mg after 4 weeks of treatment in patients with EE (77.8% vs. 72.2%). Esomeprazole-treated patients were healed after up to 8 weeks of treatment similar those treated with pantoprazole (92.2% vs. 91.1%). The proportion of heartburn-free days was similar in patients treated with esomeprazole and to those treated with pantoprazole