The analysis of limbs acute ischemia during seasons on the territory of South Serbia.

The aim of this study was to examine the seasons variations in incidence of limbs acute ischemia (LAI) as well as the connection between seasons with location of LAI, old age and gender. During the three year period between January 2009 and December 2011, at the Clinic for Vascular Surgery, Clinical Center of Nis, Serbia, 167 patients were hospitalized diagnosed with limbs acute ischemia. There was no statistically significant difference in patients distribution with LAI compared with seasons (p=0.726) and months of the year (p=0.0741). There was no statistically significant difference in patients age (p=0.066), sex (p=0.923) and LAI localization (p=0.219 ) in different seasons. The absence of seasonal and monthly patterns for the AIE creation as well as its localization is followed by the absence of a connection between the age and the sex..

A unique case of hereditary bilateral segmental neurofibromatosis on the face.

Segmental neurofibromatosis is a rare clinical finding generally with no family history and facial involvement. There are four subtypes of segmental neurofibromatosis: true segmental, localized cases with deep involvement, hereditary segmental and bilateral segmental neurofibromatosis. Here we report three patients from the same family (father, son and granddaughter) with segmental bilateral neurofibromatosis on the face. This form has not been noticed in the literature.

A unique case of hereditary bilateral segmental neurofibromatosis on the face / Neurofibromatose segmentar bilateral hereditária da face: caso único

Segmental neurofibromatosis is a rare clinical finding generally with no family history and facial involvement. There are four subtypes of segmental neurofibromatosis: true segmental, localized cases with deep involvement, hereditary segmental and bilateral segmental neurofibromatosis. Here we report three patients from the same family (father, son and granddaughter) with segmental bilateral neurofibromatosis on the face. This form hasn't noticed in the literature.

A neurofibromatose segmentar é um achado clínico raro, geralmente com história familiar negativa e raro envolvimento facial. Existem quatro subtipos de neurofibromatose segmentar: segmentar verdadeira, segmentar com envolvimento visceral profundo, segmentar com história familiar e segmentar cutânea bilateral. Aqui nós reportamos três pacientes de uma mesma família (pai, filho e neta) com neurofibromatose segmentar bilateral na face. Esta forma ainda não foi relatada na literatura.

Application of sentinel lymph node biopsy in cutaneous basosquamous carcinoma.

Basosquamous carcinoma of the skin is a relatively rare cutaneous neoplasm that has significant metastatic potential and a metastatic rate greater than that of basal cell and squamous cell carcinoma. We describe the use of lymphatic mapping and sentinel lymph node biopsy in a 63-year-old man after identification of basosquamous carcinoma. Sentinel lymph node biopsy, which is a standard tool to detect regional lymphatic metastasis in cutaneous melanoma, has been rarely employed to detect lymphatic metastasis of basosquamous carcinoma. The approach was successful in detecting a regional lymphatic metastasis of two nodal basins with minor morbidity. Sentinel lymph node biopsy may be useful for certain high-risk lesions of basosquamous carcinoma.

Does incomplete excision of basal cell carcinoma of the eyelid mean tumor recurrence? / A excisão incompleta de carcinoma basocelular da pálpebra implica

INTRODUCTION: Basal cell carcinoma is the most common tumor of the eyelid. In this region, reconstruction is complex and damage to healthy tissue should be minimal. Objective: To define the relationship between margin clearance at excision and the recurrence rate of basal cell carcinoma of the eyelid. METHODS: This prospective study was conducted with 111 patients submitted to surgery for basal cell carcinoma of the eyelid between 2001 and 2003 and followed up for a period of five years. The patients were evaluated according to age, tumor site, recurrence rate and margin clearance at excision. RESULTS: No significant association was found between incomplete tumor excision and recurrence except in patients under 56 years of age, female patients and in the case of tumors of the medial canthus. CONCLUSION: A risk of recurrence in incompletely excised basal cell carcinomas of the eyelid was only confirmed in younger patients, females and for tumors of the medial canthus.

INTRODUÇÃO: O carcinoma basocelular é o tumor mais comum entre os tumores das pálpebras. Nesta região, a reconstrução é complexa e recomenda-se que haja perda mínima de tecido saudável. OBJETIVO: Para definir a relação entre margem livre de tumor na excisão e taxa de recidiva do carcinoma basocelular das pálpebras. MÉTODOS: Este estudo prospectivo incluiu 111 pacientes operados para remoção de carcinoma basocelular das pálpebras no período de 2001 a 2003, com acompanhamento subsequente de 5 anos. Os pacientes foram avaliados de acordo com a idade, localização do tumor, taxa de recidiva, e margem livre de tumor na excisão. RESULTADOS: Não se encontrou associação significativa entre a excisão incompleta do tumor e casos de recidiva, exceto em pacientes com idade inferior a 56 anos, pacientes do sexo feminino e em tumores do canto medial. CONCLUSÃO: Um risco maior de recidiva de carcinoma basocelular das pálpebras com excisão incompleta foi confirmado estatisticamente apenas em pacientes mais jovens, em mulheres, e nos tumores do canto interno.

Can you combine herbal therapy with physical agents in the treatment of venous leg ulcers? Evaluation of healing and antimicrobiological effects: a pilot study.

INTRODUCTION: Venous leg ulcers are an important and common health problem. The aim of this study was to determine the effects of herbal therapies alone or in combination with physical therapy in the treatment of venous ulcers, as well as their antibacterial effects. PATIENTS AND METHODS: Our study included 60 patients (3 groups, 20 patients each) with non-infected venous leg ulcers. The patients were treated with herbal therapy alone (group HTC), with a combination of electro-ionizing radiation and herbal therapy (group ERHT) or with a combination of polarized light and herbal therapy (group PLHT). RESULTS: Surface area and score of venous leg ulcers were followed clinically at baseline and at the end of 1, 3, 5, and 7 weeks of treatment. Comparing the results within the HTC, PLHT, and ERHT groups we found that the physical agents and herbal therapy significantly accelerated the healing of venous leg ulcers and reduced bacterial flora (p < 0.05). Comparing the results between the tested groups revealed no statistically significant difference (p > 0.05). CONCLUSIONS: Our results demonstrate healing and antibacterial effects of combined physical and herbal therapies, but no superiority of the combined treatment for venous leg ulcers as compared to treatment by herbal therapy alone.

Does incomplete excision of basal cell carcinoma of the eyelid mean tumor recurrence?

INTRODUCTION: Basal cell carcinoma is the most common tumor of the eyelid. In this region, reconstruction is complex and damage to healthy tissue should be minimal. OBJECTIVE: To define the relationship between margin clearance at excision and the recurrence rate of basal cell carcinoma of the eyelid. METHODS: This prospective study was conducted with 111 patients submitted to surgery for basal cell carcinoma of the eyelid between 2001 and 2003 and followed up for a period of five years. The patients were evaluated according to age, tumor site, recurrence rate and margin clearance at excision. RESULTS: No significant association was found between incomplete tumor excision and recurrence except in patients under 56 years of age, female patients and in the case of tumors of the medial canthus. CONCLUSION: A risk of recurrence in incompletely excised basal cell carcinomas of the eyelid was only confirmed in younger patients, females and for tumors of the medial canthus.

Evaluation of healing and antimicrobiological effects of herbal therapy on venous leg ulcer: pilot study.

Venous leg ulcers represent a significant public health problem that will increase as the population ages. Numerous herbs and their extracts are potentially conducive to wound healing, including the ability to serve as an antimicrobial, antifungal, astringent, etc. A total of 32 patients with venous leg ulcers were randomized into two groups: a group with herbal therapy treatment (PT) (17 patients) and a control group (C) (15 patients). The investigation focused on five controls of parameter changes important for ulcer healing and the control of microbiological flora. Within-treatment analysis of the PT group showed that, following herbal therapy treatment, there was a significant decrease in the scores of surface leg ulcer and venous leg ulcer after week 7 of treatment (p < 0.05). In group C following topical antibiotic treatment there was no significant decrease in the surface leg ulcer. Comparing the results of decreased venous leg ulcer surface of the) PT group with the C group showed a significant difference at p < 0.05 after week 7 of treatment. The number of different types of isolated bacterial species decreased significantly (p < 0.05) after the use of herbal preparations. The results of this pilot study demonstrate the healing and antimicrobiological effects of herbal therapy on non-infected venous leg ulcer.

[Overview of the scoring system for cardiovascular risk estimation: role and significance of lipids].

Practical recommendations for the regulation of hyperlipoproteinemia and the prevention of coronary disease and scoring systems for coronary disease risk estimation are based on the results of epidemiologic studies and international consensus guidelines. According to the Framingham point score the risk was defined as an absolute 10 year probability of myocardial infarction and coronary death, while the PROCAM function of risk was based on cardiovascular events: fatal and non-fatal myocardial infarction and sudden coronary death. The Third European Joint Task Force and other societies for the prevention of cardiovascular diseases revise the joint European guidelines and the recommendations for national population strategies. Global coronary disease risk is nowadays in Europe based on the SCORE system. The risk is defined as an absolute 10 year probability of afatal cardiovascular event, and high risk cut-off is at 5%.

[Effect of fosinopril on progression of the asymptomatic carotid atherosclerosis and left ventricular hypertrophy in hypertensive patients].

INTRODUCTION: The cardiovascular changes (vascular structure changes, hypertrophy of the left ventricle) contribute to both the increased cardiovascular morbidity and the mortality of essential hypertension. Therefore, modern treatment strategies should not only target blood pressure (BP) reduction but also normalize cardiovascular structure and function. OBJECTIVE: Aim of the study was to determine the effect of the ACE inhibitor Fosinopril on the intima-media thickness of the common carotid artery and on the left ventricle mass after 9-month treatment of hypertensive patients. METHOD: The study included 40 patients with the arterial hypertension and the left ventricle hypertrophy verified by echocardiography. The patients were randomized on A) ACE-inhibitor--Fosinopril and B) without ACE inhibitor--atenolol, and they were followed up 9 months. The groups were not different by age, sex, and metabolic status. Color Duplex ultrasonography of the carotid arteries was performed by Acuson Sequia C236 with high-frequency linear probe of 8 MHz. The intima-media thickness of the common carotids on the left and the right was measured in diastole at 1.5 cm from the highest point of bifurcation under maximal magnification. Using the same device, the left ventricle mass and other parameters of the left ventricle were determined in M-mode and by means of 2D image. RESULTS: After 9 months, BP in both groups was reduced in similar range (group A: systolic BP from 158 to 137 mmHg, and diastolic BP from 94 to 85 mmHg, and group B: systolic BP from 164 to 137 mmHg, and diastolic BP from 87 to 84 mmHg). The thickness of the intimomedial complex in patients using Fosinopril was decreased by 0.0278 +/- 0.03 mm, while in the group of patients that did not use the ACE-inhibitor, it was increased by 0.078 +/- 0.13 mm. The left ventricle mass in patients using Fosinopril was decreased by 5 grams (312 +/- 72 g vs. 307 +/- 77 g), while in group B patients, it was increased by 15 grams (323 +/- 79 g vs. 328 +/- 58 g. Diastolic function expressed through relation E/A was improved minimally in the group A, while it worsened by 0.1 in the group B. After 9 months, serious cardiovascular events were recorded (one infarction of myocardium and one hospitalization due to the unstable angina pectoris) in two patients of the group A, while four patients of the group B had serious CV events (1 cerebrovascular stroke and 3 hospitalizations due to unstable angina pectoris). CONCLUSION: The results of our study showed that the application of Fosinopril in patients with the arterial hypertension and the left ventricle hypertrophy could efficiently block further progression of the intima-medial thickness of the common carotid artery, reduce the left ventricle mass, and improve diastolic function of the left ventricle.