Acta medica Croatica : c̆asopis Hravatske akademije medicinskih znanosti
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The aim of the study was to identify the clinical and laboratory (hematologic, biochemical and morphological) prognostic parameters of chronic leukemic lymphoproliferative diseases (CLLPD). ⋯ Careful clinical examination is an important step on assessing the extent and progression of the disease, and a major chain on tailoring individualized therapeutic approach, along with clinical stages according to Rai and Binet, CLLPD subtype and progression factors (DTM and DTL). Laboratory parameters (hematologic and biochemical) as objective quantitative parameters obtained by simple venipuncture, in contrast to the 'researcher-dependent' ones, increase the utilization of some of these parameters as risk factors in CLL.
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The aim of this review is to highlight the continuing role of fine needle aspiration cytology (FNAC) in the diagnosis of breast lesions, against a background of its diminishing use in some centres, particularly those involved in breast screening, because of its controversial inadequate rate and suboptimal accuracy. This review explores the current practice and confirms the continuing role of FNAC in the diagnosis and management of breast lesions. The three main areas where FNAC still plays a major role are the following: (a) diagnosis of benign disease in symptomatic palpable lumps as part of triple assessment; (b) staging of breast carcinoma, in particular preoperative axillary lymph node FNAC and intraoperative sentinel node imprints; and (c) diagnosis of metastatic disease at distant sites following treatment for carcinoma. ⋯ Hormone receptor status, but not HER 2, can be reliably assessed from cytological material. Cells carry a promise of molecular diagnosis and targeted treatment in the future. The future of breast FNAC is bright.
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Acute rhabdomyolysis is a syndrome characterized by the lesion of skeletal muscle resulting in subsequent release of intracellular contents into the circulatory system, which can cause potentially lethal complications. These contents include myoglobin, creatine phosphokinase, potassium, aldolase, lactate dehydrogenase and glutamic-oxaloacetic transaminase. There are numerous causes that can lead to acute rhabdomyolysis and many of patients present with multiple causes. ⋯ Acute rhabdomyolysis should be considered as a possibility in any patient with prolonged imobilization while in coma as well as in any intoxicated patient. Of course, creatine phosphokinase is the most sensitive indicator of muscle injury and the degree of creatine phosphokinase elevation correlates with the amount of muscle injury and disease severity. Other laboratory findings can help identify common complications of rhabdomyolysis such as acute renal failure, metabolic derangements and disseminated intravascular coagulopathy.
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The percentage of elderly people increases in societies today and so does the number of specific conditions, illnesses and injuries, with hip fracture as the most important one. The aim of the study was to point to hip fracture as a medical and social problem by objectively quantifying functional abilities of geriatric patients after hip fracture. ⋯ The patient's functionality before injury, the duration and quality of rehabilitation after surgery, and the patient's motivation and cooperation during rehabilitation are the key factors of patient recovery to the pre-injury state. In spite of numerous concomitant diseases, reduced psychophysical abilities of the elderly and medical difficulties in the management of these injuries, such treatment of hip fractures is necessary and human for patients and time-consuming for medical staff, yet being the most profitable option for the society. Hip fracture and consequential disablement cause a double problem. On the one hand, it entails dependence on other person, family or social institution, or society in general, and on the other hand there is mental frustration, especially if he/she is psychically instable. Quite frequently, disabled persons have psychical traumas that have unfavorable impact on their families. It is additionally complicated in societies that tend to stigmatization of disabled persons. Therefore, it is very important how the society will behave toward disabled elderly who are generally more vulnerable.
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A relationship between migraine with aura and patent foramen ovale (PFO) has been established in clinical studies, and is now related to previous observation that migraine and stroke are connected. Studies have shown that the prevalence of PFO in patients with migraine is about 2.5-fold than in patients without migraine. ⋯ Most nonrandomized studies (and 1 randomized placebo-controlled study) have shown that migraine attacks are reduced after PFO closure; however, recent studies show that a new onset or worsening of migraine headaches may occur after closure of PFO or atrial septal defects. Therefore, no definite conclusions can be made on the treatment of migraines by PFO closure.