Fetus in fetu (FIF) is a rare entity, with a difficult preoperative diagnosis, frequently being an intraoperative surprise. In recent literature, theories pertaining to its development either assimilate the tumor with a monochorionic twin that halted its evolution, or with a highly differentiated mature teratoma. We present the case of a 27-year-old patient, with a cystic tumor in the anterior mediastinum, which intraoperatively proved to be a rare case of intrathoracic FIF. The clinical presentation lacked any specific clues that would infer such a diagnosis; imaging was partially useful as it shown the possible existence of bone structures, heterogeneously mixed with fatty inclusions and other types of tissue. Upon surgery, the nature of said tumor was clear, and pathology confirmed the FIF diagnosis, showing different types of epithelia and tissue of several organ-like structures that halted in evolution at an early stage. Concluding our presentation, we can say that the presence of an axial skeleton as well as differentiated tissue types of several organs could confirm our case of FIF.
Background and Objectives: Malignant neoplasms are common causes of acute pleuropericardial effusion. Pleuropericarditis denotes poor patient prognosis, is associated with shortened average survival time, and represents a surgical emergency. Materials and Methods: We analyzed the impact of two minimally invasive surgical approaches, the type of cancer, and other clinical variables on the mortality of 338 patients with pleuropericarditis admitted to an emergency hospital in Romania between 2009 and 2020. All patients underwent minimally invasive surgeries to prevent the recurrence of the disease and to increase their life expectancy. Log-rank tests were used to check for survival probability differences by surgical approach. We also applied univariate and multivariate Cox proportional hazard models to assess the effect of each covariate. Results: No significant differences were found in the 2-year overall survival rate between patients who underwent the two types of surgery. The multivariate Cox proportional regression model adjusted for relevant covariates showed that age, having lung cancer, and a diagnosis of pericarditis and right pleural effusion increased the mortality risk. The surgical approach was not associated with mortality in these patients. Conclusion: These findings open up avenues for future research to advance the understanding of survival among patients with pleuropericarditis.
Aim. The paper represents a review of the current state of knowledge regarding lenticulostriate vasculopathy (LSV) in premature and term neonates. Material and method. There are reviewed the definition, the history of this diagnosis, the epidemiology, the anatomy of the vessels the etiology and the methods of diagnosis. Results. LSV is defined as the bright hyperechoic blood vessels in the region of the thalamus and basal ganglia. It was first described in 1960. The incidence is 0.3-2% of live births. The etiology is infectious (congenital rubella, cytomegalovirus, toxoplasma, or other chronic intrauterine infections), hypoxic-ischemic, and in many cases idiopathic (without a clear cause). The diagnosis is mainly done by ultrasonography – the are also proposed classification systems based on the number of vessels affected and/or the echogenicity of the vessels involved. Conclusion. LSV represents a pathology recognized for a long time, in the past, it was considered mainly associated with chronic intrauterine infections, at present, it is more and more seen as a consequence of perinatal hypoxic events. Further large follow-up studies are needed in order to better characterize the etiology and prognosis of this pathologic condition.
Bevezetés: A krónikus obstruktív tüdőbetegség (COPD) gyakori krónikus gyulladásos betegség, nagy mortalitással. Célkitűzés: A vizsgálat célja a COPD-ben szenvedő betegek paraméterei – életkor, nemi megoszlás, kockázati tényezők (dohányzás, foglalkozási expozíció), a COPD súlyossága, testtömegindex, tüdőfunkció, társbetegségek és szövődmények – közötti összefüggések feltárása volt dohányzó és foglalkozási ártalomnak kitett betegeknél. Módszer: 209 beteg adatait elemeztük, akiket 2019-ben a marosvásárhelyi Tüdőgyógyászati Klinikára COPD-exacerbatio miatt vettek fel. Eredmények: A tápláltsági állapot alapján 4 csoportba soroltuk a betegeket: 50 alultáplált, 53 normál testsúlyú, 53 túlsúlyos, valamint 53 elhízott páciens. A férfi : nő arány 2,48 volt. Az esetek 67%-a aktív, keresőkorban levő páciens, 55,98%-a 55–65 év közötti volt. A betegek 10,5%-a volt 75 év feletti. A páciensek jelentős része (76,55%) dohányzott, a férfiak 91,9%-a és a nők 33,8%-a. A foglalkozási ártalom az esetek 30,62%-ában a dohányzással társult. A nem dohányzóknál a foglalkozási expozíció volt a fő tényező a COPD patogenezisében (81,6%). A „biomassza-tüzelőanyagoknak” vagy a passzív dohányzásnak való expozíció is főleg a nem dohányzó nőknél volt megfigyelhető (78,9%). A FEV1 átlagértékei alacsonyabbak voltak a túlsúlyos, elhízott és alultáplált betegekben, mint a normál testsúlyúaknál. Az elhízott és túlsúlyos COPD-s betegek körében gyakrabban fordult elő ischaemiás szívbetegség (41,5%, illetve 43,4%), mint a normál súlyú, illetve sovány betegeknél (24%, illetve 20%). Megbeszélés: Adataink rávilágítanak a károsodott tüdőfunkció súlyosságára mind a cachexiás, mind az elhízott betegeknél, és alátámasztják a testmozgás, a táplálkozás-ellenőrzés, a légzőfunkciók szűrése és az általános rehabilitáció szükségességét a COPD-s betegek tüdőkapacitásának javítása érdekében. Következtetés: A COPD multidiszciplináris megközelítése mind diagnosztikai módszerként, mind a COPD-társbetegségek helyes kezeléséhez szükséges. Orv Hetil. 2022; 163(40): 1597–1605.
Cancer is the second leading cause of death in Romania and worldwide. Cancer patients are at increasing risk of acquiring bacterial infection with multi-resistant germs, including multidrug-resistant (MDR) strains of Gram-negative bacteria involved in nosocomial infection. Romania is one of the South-Eastern European countries with one of the highest prevalence rates of MDR pathogens. To determine the resistance pattern of bacterial profile and antibiotic resistance pattern in cancer patients admitted at the County Emergency Clinical Hospital Craiova, Romania. A retrospective study of bacterial pathogens was carried out on 90 adult cancer patients admitted from January to December 2018. The analysis of the resistance patterns for the action of the appropriate antibiotics was performed using Vitek 2 Compact system and diffusion method. In this study there were analysed 92 samples from 90 oncological patients (37-86 years). A total of 157 bacterial isolates were obtained, of which 37 strains of Staphylococcus aureus (23.56%), followed by Streptococcus pneumoniae (23- 14.64%), Klebsiella spp. and Escherichia coli (22 - 14,01%). The most common isolates were from respiratory tract (86 isolates - 54.77%). High rates of MDR were found for E. coli (63.63%), MRSA (61,11%) and Klebsiella spp. (54,54%), while one third of the isolated strains of Pseudomonas aeruginosa, Acinetobacter spp. and Proteus spp. were MDR. The findings of this study may be the basis for further more extensive studies highlighting the germs involved in the infectious pathology of cancer patients, in order to determine the antimicrobial resistance and to improve the methods of prophylaxis and treatment. Keywords: multidrug resistance (MDR), cancer patients, bacterial pathogen
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