Acta clinica Croatica
-
Acta clinica Croatica · Jun 2020
ReviewTotal Thyroidectomy with Central Node Dissection is a Valuable Option in Papillary Thyroid Cancer Treatment.
Papillary thyroid cancer is one of the cancers with favorable prognosis, although the long-term recurrence rate in the paratracheal region is reported to be as high as 30%. The use of 131I is considered to be a reliable treatment option for lymph node metastases in the paratracheal region. According to the majority of internationally accepted guidelines, it is not recommended to perform central node dissection (CND) routinely. Total thyroidectomy (TT) remains an adequate treatment for these patients. According to many studies, CND is associated with higher rates of hypoparathyroidism. However, CND improves staging. ⋯ In our hands, CND was a safe and effective surgical procedure. It improved staging and postsurgical management. Efforts should be made to improve the preoperative work-up in order to more accurately identify high-risk patients.
-
Acta clinica Croatica · Jun 2020
ReviewThyroidectomy-related Swallowing Difficulties: Review of the Literature.
This study aims to provide insight into the etiology and frequency of swallowing complications that arise after thyroidectomy and to outline the available diagnostic procedures by revising the existing literature on this topic. We conducted a bibliographic search using the electronic database MEDLINE/PubMed to identify all relevant articles and 44 studies were included in the review out of a total of 218 published articles. Dysphagia after thyroid surgery is a common postoperative complication which, in the short- or long-term, significantly affects patient life quality. ⋯ Fiberoptic endoscopy is a standard diagnostic tool performed prior and after thyroid surgery, primarily to identify changes in vocal fold mobility. Although instrumental findings usually reveal non-specific alterations of swallowing; swallowing videofluoroscopy and esophageal manometry can be the most helpful tools in further management of thyroidectomy dysphagia. In patients with thyroidectomy-related swallowing difficulties and suspected laryngopharyngeal reflux, 24-hour MII-pH metry should be performed.
-
Acta clinica Croatica · Jun 2020
Review Case ReportsBrucellosis in pregnancy: case reports with different outcomes in an endemic region.
Different outcomes of brucellosis in pregnancy regarding the fetus/neonate and the mother are described. Medical records of five pregnant women with brucellosis were retrospectively analyzed. Patients were treated in several departments of infectious diseases in the Republic of Macedonia between 1995 and 2009. ⋯ Brucellosis, especially if acquired in early pregnancy, can have an impact on pregnancy outcome. In endemic regions, in pregnant women with persisting fever and unspecific manifestations one should always have in mind brucellosis. In these areas, cases with unexplained spontaneous abortion, intrauterine fetal death and premature delivery should also be investigated for brucellosis.
-
Acta clinica Croatica · Jun 2020
Review Case ReportsTHE RISK OF MULTIPLE INTRACRANIAL ANEURYSM FORMATION IN PATIENTS WITH MALIGNANT DISEASE UNDERGOING RADIATION THERAPY: A CASE REPORT AND LITERATURE REVIEW.
Neoplastic etiology of intracranial cerebral aneurysm is rare. Yet, the risk of its development is higher in malignant tumor patients receiving radiation therapy. Due to the possible negative effects of irradiation on intracranial vessel walls, the risk of aneurysm formation after radiation therapy, which is crucial for some types of breast cancer patients, continues to be a matter of debate. ⋯ Due to the bilateral aneurysm multiplicity, tumor characteristics and prognosis, comorbidity and relatively advanced age, the patient was not selected for active endovascular or microsurgical aneurysm treatment but only periodical clinical, oncologic and radiological follow-up was advised. In conclusion, the risk of multiple intracranial aneurysm formation in patients with breast cancer undergoing radiation therapy is low, but still possible. Long-term follow-up and regular cerebral angiographic check-up studies are necessary in selected malignant patients to decrease such a risk and to evade the worst outcome associated with aneurysm rupture.
-
Acta clinica Croatica · Jun 2020
CALCIFIC TENDINOPATHY: CALCIUM DEPOSIT MORPHOLOGY DIRECTLY AFFECTS PAIN AND FUNCTION OF THE SHOULDER.
The aim of this study was to determine conventional ultrasonography characteristics of calcium deposits in patients diagnosed with calcific tendinopathy, to determine vascularization around deposits by power Doppler, and to compare morphological and power Doppler findings with clinical findings by use of two questionnaires. Pain and function were evaluated using the visual analog scale and two questionnaires, Constant Shoulder Score and Oxford Shoulder Score. All subjects underwent ultrasonography examination and evaluation of vascularization (flow) along calcium deposit using power Doppler. ⋯ This study showed the patients with fragmented, cloudy calcification to have statistically significantly worse results on functional questionnaires and more positive power Doppler findings (grades II and III) and to experience stronger pain (visual analog scale 8-10). Upon defining the stage of calcific tendinopathy, the method of treatment can be determined and further course of the disease predicted. Defining the stage of calcification precisely helps avoid unnecessary and long-lasting physical therapy while introducing an effective treatment option, depending on the stage of the disease.