Middle ear tuberculosis: Diagnostic criteria

Introduction. Tuberculous otitis is a diagnostic problem due to the difficulty to obtain microbiological, histomorphological and cytological confirmation of the disease. Objective. Our objective was to compare clinical and radiological characteristic and development of otogenic complications in patients with tuberculous otitis and otitis with cholesteatoma as the most destructive form of chronic nonspecific otitis in the purpose of establishing the diagnostic criteria for tuberculous otitis. Methods. Medical records of 12 patients with tuberculous otitis and 163 patients with cholesteatoma treated at the Institute of Otorhinolaryngology and Maxillofacial Surgery in Belgrade during the eight-year period were analyzed. All of the patients underwent otomicroscopic, audiological and radiological examination of the thorax and temporal bone, microbiological examination of the secretion and histomorphological examination of the tissue taken during middle ear surgery. Statistical analysis was done using χ2 test with Yates correction. Results. Otogenic complication as facial palsy and sensorineural hearing loss were more frequent in tuberculous otitis patients, than in cholesteatoma. Also, fistulas of the labyrinth and facial canal bone destruction were also more frequent in tuberculous otitis than in cholesteatoma. A larger extent of temporal bone destruction was noticed on CT scans of the temporal bone in half of the patents with tuberculous otitis. Coexistence with miliary pulmonary tuberculosis was detected in one third of the patients. There were no microbiological or histomorphological confirmations of the disease, except in one case with positive Ziehl-Neelsen staining. Conclusion. Tuberculous otitis media should be considered in patients with serious otogenic complications and with shorter duration of ear discharge, and in association with diagnosed miliary pulmonary tuberculosis and extensive temporal bone destruction. Polymerase chain reaction still is not reliable for diagnosis

Incidence and risk factors for thyroid microcarcinoma

Papilarni mikrokarcinom štitaste žlezde(PTMC) se definiše kao tumor štitaste žlezde manji od 10 mm, koji se obično otkriva slučajno...Papillary thyroid microcarcinoma (PTMC) is defined as a thyroid tumour that measures less than 10 mm, and is usualy discovered incidentally..

Incidence and risk factors for thyroid microcarcinoma

Papilarni mikrokarcinom štitaste žlezde(PTMC) se definiše kao tumor štitaste žlezde manji od 10 mm, koji se obično otkriva slučajno...Papillary thyroid microcarcinoma (PTMC) is defined as a thyroid tumour that measures less than 10 mm, and is usualy discovered incidentally..

Surgical anatomy of thyroid and parathyroid glands and basic principles of operative technique

The thyroid gland is the largest endocrine organ with the highest frequency of disorders of all the endocrine organs. A successful treatment of both benign and malignant diseases of the thyroid is connected with adequate pre-operative evaluation, a precise operative technique and the knowledge of surgical anatomy. Complications that may occur due to the insufficient knowledge of the surgical anatomy of the thyroid and parathyroid glands permanently damage the health of the patient and cause his lifelong disability. Therefore it is necessary that the surgeon performing a thyroid and/or parathyroid glands operation should have sufficient knowledge of the surgical anatomy of these endocrine organs despite the wide availability of instruments which enable better visualization of the operative field, coagulation of blood vessels and intraoperative neuromonitoring

Vision-Related Quality of Life and Treatment Satisfaction Following Panretinal Photocoagulation in Diabetic Retinopathy—A Panel Study

Background and Objectives: The aim of the study was to evaluate vision-related quality of life (VR-QOL) and treatment satisfaction (TS) in patients with diabetic retinopathy treated with panretinal photocoagulation (PRP). Material and Methods: The panel study included 95 patients who underwent PRP for diabetic retinopathy. Eligible patients with no history of previous PRP were interviewer-administered the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and Retinopathy Treatment Satisfaction Questionnaire (RetTSQ) beforehandand one month after the last session of laser application. The study was conducted between June 2017 and June 2019 at tertiary care center in Serbia, Belgrade. We assessed pre- to post-PRP values of the composite score and subscale scores of VFQ-25 and RetTSQ, using a paired samples t-test. Univariate logistic regression was used to analyze the relationship between binary outcomes and potential predictors. Multivariate regression included predictors from univariate analyses that were statistically significant. Results: The mean VFQ-25 composite score was 65.4 ± 17.4 before and 63.3 ± 19.5 after PRP (p = 0.045). Subscale analysis showed that two of the 11 items achieved a significant decrease after laser application (general vision and dependency). The mean RetTSQ score at baseline was 60.0 ± 11.8 and at the exit visit was 60.3 ± 12.3 (p = 0.858). Sub-scale analysis showed significant deterioration for five of the 13 items. Multivariate logistic regression found that significant predictor of VFQ-25 composite score reduction was fewer laser burns (p = 0.002) while significant predictor of RetTSQ total score reduction was presence of hyperlipidaemia (p = 0.021). Conclusion: The use of vision-related quality of life and treatment satisfaction questionnaires in conjunction with clinical examination, appears to provide a more comprehensive overview of an individual’s daily well-being following PRP. Laser treatment for diabetic retinopathy leads to deterioration of some of the patients’ perceived VR-QOL and TS. Health-care providers should inform patients about their treatment options and together decide which therapeutic method is best for them

Adrenocortical carcinoma’s incidence and mortality in central Serbia

Introduction/Objective. Adrenocortical carcinomas (ACCs) are very rare tumors with grave prognosis despite multimodal treatment. The aim of our study was to determine the incidence and mortality of ACCs in Central Serbia. Methods. The study period was from 1999 to 2012. We used data from the Cancer Registry of Central Serbia. Incidence and mortality rates were sex- and age-standardized according to Segi’s world population. Results. In the defined period of the study, 128 patients with a diagnosis of ACC were registered and the female-to-male ratio was 1.3:1. The median age of affected individuals was 42.3 years. There were two main age peaks – one in childhood (0–9 years), and the other in the fifth and sixth decade of life. In this period, the average standardized incidence rate of ACC amounted to two per million people with slightly increasing trend. The largest number of male patients with ACC (22; 39.2%) was registered in the age group of 0–9 years, while the largest number of patients in females was shown to be in the age group of 40–49 years (29; 40.3%). During the study period, there were 35 deaths registered in patients with ACC (mean age of 61.2 years). The average mortality rate of ACC was 0.3 per million people. The male-to-female ratio was 1.5:1. Most fatal outcomes were registered in the age groups of 50–59 and 60–69 years, so 91.4% of all deaths took place in the age groups 50+. Conclusion. ACC is an extremely rare tumor that occurs more often in women than in men. However, fatal outcomes occur more frequently in males. [Project of the Ministry of Education, Science and Technological Development of the Republic of Serbia, Grant no. 175042

ОРИГИНАЛНИ РАД / ORIGINAL ARTICLE � UDC: 616.284-002.5-07 Middle Ear Tuberculosis: Diagnostic Criteria

Introduction Tuberculous otitis is a diagnostic problem due to the difficulty to obtain microbiological, histomorphological and cytological confirmation of the disease. Objective Our objective was to compare clinical and radiological characteristic and development of otogenic complications in patients with tuberculous otitis and otitis with cholesteatoma as the most destructive form of chronic nonspecific otitis in the purpose of establishing the diagnostic criteria for tuberculous otitis