Search Results

1 - 10 of 45 items :

  • Internal Medicine x
Clear All
KRAS, NRAS, BRAF, HER2 and microsatellite instability in metastatic colorectal cancer – practical implications for the clinician

control processes like cell proliferation, cell differentiation, cell adhesion, apoptosis and cell migration. When they are mutated, the cell will have an increased potential of invasion and metastasis. The main members of the RAS family are KRAS and NRAS mutations. 5 , 6 , 7 These are point mutations in which a single nucleotide base is changed, inserted or deleted from a DNA sequence. Moreover, these are frequently somatic mutations (acquired during lifetime). 8 In the metastatic setting, KRAS mutations occur in approximately 40% of the cases, especially in exon 2

Open access
Atomoxetine in the Treatment of the Most Common Comorbid Disorders of Attention-Deficit/Hyperactivity Disorder, Oppositional Defiant Disorder and Anxiety Disorders

Abstract

Attention-deficit/hyperactivity disorder (ADHD) in childhood or adolescence is associated with a significantly higher lifetime risk of oppositional defiant disorder, anxiety disorder, conduct disorder, among others. Reports of co-morbidity rates are variable and influenced by assesment methodology and refferal bias, and may reflect lifetime rates within clinical groups. Up-to date studies revealed that as many as 85% of patients with ADHD have at least one psychiatric comorbidity and approximately 60% have at least two. Research and clinical practice has shown that having multiple co-existing psychiatric problems increase the severity of ADHD and behavioural problems, and is associated with incereased psychosocial impairment. The high rate of psychiatric problems co-occuring with ADHD has strong implications for the management of these patients. The presence of co-existing psychiatric conditions may moderate the response to treatment of ADHD and ADHD treatments may adversely affect and exacerbate the symptoms of the co-morbit condition. The aim of this article was to summarize the use of atomoxetine in the most frequent co-morbid disorders accompaining ADHD, ODD (oppositional defiant disorder) and anxiety, and to emphazise decrease of co-morbid symptoms with treatment of atomoxetine what exhort us to think about them as about possible subtypes of ADHD.

Open access
Modern approach to the identification and elimination of periodontal infection

Abstract

In global terms, periodontitis is the leading cause of tooth loss, and causes serious aesthetic and functional problems. There are numerous scientific evidence that power periopathogenic microorganisms may have influence on some systemic conditions and diseases. If we add the fact that periimplantitis are caused by identical periopathogenes, management or effective identification and elimination of periodontal inflammation set as imperative in successful periodontal treatment and possible complications locally or systemic, as well as resistance and lifetime of the implants. As a method for quantifying and classification of bacterial species are recommended monitoring of the bacterial micro flora through PCR (polymerase chain reaction) technique. Laser therapy as a supplementary method to classic treatment is strongly emphasized as a new therapeutic option that uses the photo-thermal effect to fight bacterial infection. Air flow - an original method that uses water, air and powder help to destroy the biofilm and remove plaque. Oral application of LAD (Light activated disinfection) therapy influence nascent oxygen breaks down the interaction in biofilm and makes the microorganisms more sensitive to further damage. Finally, the role and use of probiotics as a link between the beneficial oral bacteria species and inflammation

Open access
Polymialgia Rheumatica, Giant Cell Arteritis or Both?

References 1. Salvarani C, Gabriel SE, O’Fallon WM, Hunder GG. Epidemiology of polymyalgia rheumatica in Olmsted County, Minnesota, 1970-1971, Arthritis Rheum 1995; 38:369 2. Crowson CS, Matteson EL, Myasoedova E, et al. The lifetime risk of adult-onset rheumatoid arthritis and other inflammatory autoimmune rheumatic diseases. Arthris Rheum 2011;63:633 3. Liozon E, Ouattara B, Rhaiem K, et al. Familial aggregation in giant cell arteritis and polymyalgia rheumatic: a comprehensive literature review including 4 new families. Clin Exp Rheumatol

Open access
Coincidence of Malignancy and Congenital Thrombophilia as the Cause of Deep Venous Thrombosis - Case Report and Review of the Literature

Abstract

Introduction: Deep venous thrombosis (DVT, phlebothrombosis) is a very important clinical problem with its resultant fatal pulmonary embolism (PE) as one of the possible consequences. Factor V Leiden (FV Leiden) is a genetic disorder characterized by a poor anticoagulant response to activated protein C (APC) and an increased risk of venous thromboembolism (VTE). Homozygous carriers of the FV Leiden mutation are estimated to have an 80-fold increased lifetime relative risk of VTE. Most homozygous carriers present with VTE before 40 years of age, but some can live thrombosis-free until the sixth or seventh decade of life or even remain asymptomatic for life. Case-controlled studies of patients with cancer revealed a four-fold increase in thromboembolic occurrence in acute leukaemia, with the risk of thrombosis persisting even after remission of the disease.

Case Report: The authors present a case report of the 61-year-old patient with leukaemic transformation of myelodysplastic syndrome (MDS) to acute myeloid leukaemia (AML) and development of DVT of the left leg (LL) as the first clinical manifestation of homozygous FV Leiden carrier. Due to his diagnosis it was not possible to indicate surgical treatment of DVT. After initial treatment with subcutaneous low molecular weight heparin (LMWH) and continuous intravenous application of unfractionated heparin (UFH) the deficiency of antithrombin III (AT III) potentiating the persistence of his hypercoagulable state developed. Treatment with the new oral anticoagulant - rivaroxaban, vasoprotective and antithrombotic drugs in the combination with mechanical methods of VTE prophylaxis led to a reduction in edema of left thigh and calf by 3.5 cm and 4 cm, respectively. Son of the patient experienced DVT at the age of 27 years, too.

Conclusion: In this report, we describe a case of the patient with DVT during the leukaemic transformation of MDS to AML as a relatively late first clinical manifestation of homozygous FV Leiden mutation. At the same time the article deals with the clinical aspects of discussed thrombophilia in the relatives of the patient, as well as with the etiopathogenesis, pharmacologic treatment options and possible complications of DVT (PE, pulmonary hypertension and post-thrombotic syndrome).

Open access
Functional Analysis of Mutahassaneen Area during Hajj 1427 Hijra

;4:290-292. Yousaf M, Zafar MO, Maqbool M. Medical problems of Pakistani pilgrims in Saudi Arabia. Pak J Med Res. 1993;32:172-175. Gazzaz ZJ, Dhaffar KO, Shahbaz J. Hajj (1422H) In-patient Characteristics in Al-Noor Specialist. Kuwait Med J. 2004;36(4):279-80. Gallagher EB, Searle CM. Health services and political culture of Saudi Arabia. Soc Sci Med. 1985;21(3):251-62. doi:10.1016/0277-9536(85)90099-1 PMID:4035414. A comprehensive account of all aspects of the Hajj and Umrah, the journey of a lifetime

Open access
The Most Common New Cases of Breast Cancer among the Housewives: The Some Carcinogenic Determinants

-8. 10. Chang SC, Ziegler RG, Dunn B, Stolzenberg- Solomon R, et al. Association of energy intake and energy balance with postmenopausal breast cancer in the prostate, lung, colorectal, and ovarian cancer screening trial. Cancer Epidemiol Biomarkers Prev. 2006; 15(2): 334-41. 11. Sprague BL, Trentham- Dietz A, Newcomb PA, at al. Lifetime recreational and occupational physical activity and risk of in situ and invasive breast cancer. Cancer Epidemiol Biomarkers Prev. 2007; 16(2): 236-243. 12. Tirona MT, Sehgal R, Ballester O. Prevention of

Open access
Efficacy of the Carotid Endarterectomy in Asymptomatic and Symptomatic Carotid Stenosis and in Patients with Multifocal Atherosclerosis

. Predictors of Acute Hospital Costs for Treatment of Ischemic Stroke in an Academic Center. Stroke. 1999; 30(4):724-728. PMID:10187869 Taylor T, Davis P, Torner J, at al. Lifetime Cost of Stroke in the United States. Stroke. 1996;27(9):1459-1466. PMID:8784113 Oddone E, Waters K. Endarterectomy for asymptomatic carotid artery stenosis. JAMA. 1995;273:1421-8. doi:10.1001/jama.273.18.1421 PMID:7723155 Barnett HJM, Haines SJ. Carotid endarterectomy for asymptomatic carotid stenosis. N Engl J

Open access
A hypothetical approach on gender differences in cancer diagnosis

In parallel to the continual increase in cancer diagnosis all over the world, the number of studies on tumorigenesis is constantly rising. However, there are still no curative treatment options available for patients, particularly for those suffering from advanced metastatic malignancies, and many aspects related to carcinogenesis process have remained mysterious even in the 21 st century. Based on the global cancer statistics, one in two men and one in three women will be diagnosed with some type of invasive cancer during their lifetime [ 1 , 2 , 3

Open access
Schizophrenia and Oral Health - Review of the Literature

functioning in schizophrenia among new enrolees in the NIMH CATIE study. Psychiatr Serv, 2006; 57(8):1110-1116. 89. Fowler IL, Carr VJ, Carter NJ, Levin TJ. Patterns of current and lifetime substance use in schizophrenia. Shizophr Bull, 1998; 24(3):443-455. 90. McGrath J, Welham J, Scott J, Varghese D, Degenhardt L, Hayatbakhsh MR, Alati R, Williams GR, Bor W, Najman JM. Association between cannabis use and psychosis-related outcomes using sibling pair analysis in a cohort of young adults. Archives of General Psychiatry, 2010; 67

Open access