: The prevalence of depression among women with breast cancer (BC) is extremely variable in research studies. The aim of this study was to determine the prevalence of depressive disorder in women suffering from BC as well as to examine its relationship with clinical–pathological and immunophenotypic characteristics of BC. The study included 194 patients with BC who were diagnosed with the disease between 2009 and 2015 in the Clinical Center Kragujevac, Serbia. Pathohistological and immunohistochemical analyses was used on the material obtained after the surgical removal of breast tumors, determining all significant clinical and morphological parameters. The level of depression among the examinees confirmed that the differences in the level of depression between the histological grades were statistically significant. According to the univariate binary logistic regression, the depression of a patient correlates with the category of molecular tumor subtype / Luminal A (p <0.0005), PR expression (p = 0.050) and lymphatic invasion (p = 0.025). Multivariate binary logistic regression showed that the onset of depression associated with the present molecular subtype of the tumor of a worse prognostic character (p = 0.019). Depression is a common disorder in women with breast cancer. The level of depression is correlates with some of the clinicоmorphological and immunophenotypic characteristics of BC.
Background/Aim. Most surgeons, at the end of corrective rhinoplasty, use endonasal tamponade and external splinting, primarily because of hemostasis and immobilization. Possible complications of this surgery are various. Pain, nose edema, palpebral swelling and ecchymosis, are the most common and usual. The aim of our study was to evaluate the incidence of nonaesthetic complications and the efficiency of corrective rhinoplasty without the use of tamponade and external splint. Methods. One hundred and fiftyone patients, who underwent primary corrective rhinoplasty without endonasal tamponade and without an external splint, were analyzed at the Clinical Centre "Kragujevac" in Kragujevac, Serbia, in the period 1999-May 2016. The surgeries were done by the same surgeon. Instead of a splint, sterile skin adhesive tapes were used. Study was prospective, consecutive case-series type. We analyzed the possible complications and subjective estimates of the patients who underwent primary corrective rhinoplasty in described fashion. In assessing postoparative pain, the visual analogue scale (VAS) in a range of 1 to 5 was used. Palpebral swelling and ecchymosis, were estimated 24h after surgery, by the Surgeon Periorbital Rating of Edema and Ecchymosis (SPREE) scale ranging from 0 to 5. The degree of restriction of nasal respiration was evaluated by the scale 1-4. The overall comfort of patients in the postoperative period was evaluated according to a scale: good, no opinion, bad.
Introduction. The umbilicus (omphalos; the navel; belly button; tummy button) is important in a medical and psychosocial context. Umbilical tumors are rare and can be benign or malignant, primary or secondary. The most common are malignant metastatic tumors, especially The Sister Mary Joseph Nodule, an eponym for the umbilical metastasis of intra-abdominal malignant tumors. Primary melanoma of the umbilicus is very rare, there is few literature data about it and its incidence is not well known. Therefore, the aim of this study was to present a patient with a rare localization of the primary skin melanoma, that was, also, of atypical form, large and involved the whole umbilicus and surrounding skin. Case Report. In this report, the patient had nodular red tumor which involved the whole umbilicus. Tumor had rapid growth. In the differential diagnosis, the tumor most by resembled a pyogenic granuloma. After the surgery, the histopathological finding showed the primary nodular skin melanoma (Clark V, Breslow 10 mm, positive for: vimentim S-100 protein, melan-A and HMB-45, and negative for EMA, with moderately high proliferative activity). Conclussion. According to literature data, this is 27th case of the primary melanoma of the umbilicus since 1916 when it was first reported. By presenting this rare clinical case, we emphasize that any skin lesion that is removed, must be sent to a histopathologic analysis.
Introduction: A lipoma is a benign tumor of the adipose tissue and the most common tumor of the subcutaneous tissue which is most commonly found on the trunk. It appears as a round or oval subcutaneous mass of soft consistency, which is not attached to the skin or to the deeper tissues. Its growth can cause compressive symptoms, the most common being pain and paresthesia. Case report: Considering the fact that lipomas very rarely occur in the hand and foot, in this paper we present a case of a large lipoma in the hand of a 70-year-old female patient, with a subcutaneous tumor, in the area of the ulnar side of the left palm, and the pain and tingling in the fourth and fifth finger. Longitudinal incision on the medial side of the palm and transversal incision up to the proximal palmar crease were performed under general endotracheal anesthesia. The extirpated tumor was, due to its dimensions (5.6 x 3.4 x 2.5 cm), categorized as a giant hand lipoma. A histopathological analysis confirmed the diagnosis of lipoma. Conclusion: A hand lipoma requires surgical treatment exclusively, involving a qualified hand surgeon, which is important because of the high functional and aesthetic importance of the hand.
The accessory navicular (AN) is a bony formation located on the medial side of the foot, proximal to the navicular and continuous with the posterior tibialis tendon. It emerges as a developmental variant due to the presence of the secondary ossification center adjacent to the primary center of the navicular. It is regarded as a physiological and anatomical variant. In most instances, this is an incidental finding. Radiographic values are used to define three types of AN based on its relationship with the navicular. The symptomatic AN causes pain in the medial portion of the bone, a decreased range of motion and discomfort with shoe wearing. In case of recurrent symptoms, following an inadequate diagnosis and treatment, it can result in acquired flatfoot. Our case study examined the condition of asymptomatic AN in a young man with both flatfeet, who was initially treated conservatively, and then, after the failed response to the therapy, surgically. Following the Kidner procedure (excision with the reattachment of the insertion in the posterior tibialis tendon) and rehabilitation, the patient reports no subjective symptoms in the period of 12- month monitoring. An objective examination was conducted with the use of FE analysis during weight-bearing. We determined a reduction in total weight-bearing and the pressure distribution to the lateral side of the foot, metatarsal, and the heel region.
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