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Nikola Besic and Milena Kerin Povsic

) physical status classification, which accurately predicts morbidity and mortality. 10 Bioelectric impedance analysis (BIA) measurement was performed on the day before the surgery using a portable bioelectrical impedance analyzer BodyStat QuadScan 4000 (Douglas, Great Britain), as already described by Kerin-Povsic et al . 7 Phase angle is the ratio between the reactance and resistance. 11 The illness marker is the ratio between the impedance measurement at 200kHz and 5kHz. A ratio closer to 1.00 indicates poor cellular health or extreme fluid overload. DM was found

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Monica Jurcău, Mariana Floria, Bogdan Mazilu, Anca Ouatu and Daniela Maria Tanase

Abstract

Introduction: We present the case of a young man with multiple atherosclerotic risk factors and a rare cause of angina and supraventricular ectopic beats.

Case presentation: A 35-year-old man with one-year history of stable angina pectoris and supraventricular ectopic beats, without any medication, presented to the emergency room complaining of anterior chest pain that occurs at moderate physical exertion. The rest electrocardiogram, transthoracic echocardiography, and chest X-ray were normal; the exertion stress test was also normal, except for supraventricular ectopic beats (trigeminal rhythm). Due to the intermediate pre-test probability of coronary artery disease, he was evaluated using coronary computed tomography angiography. An anomalous origin of the right coronary artery from the left coronary sinus, with an inter-arterial course and without any atheroma plaques, was observed. During hospitalization the evolution was stable, without complications. The patient was further referred to a cardiac surgery clinic to evaluate the possibility of surgical treatment of this anomaly.

Conclusions: Coronary artery anomalies are very rare; however, they present multiple implications in current practice. The most severe complication of this condition is represented by sudden death in young patients due to malignant ventricular arrhythmias. Imaging diagnostic techniques allow for a rapid, noninvasive diagnosis of this rare cause of angina.

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Ali Coskun and Nazif Erkan

Giant Brunner's gland adenoma as an unusual cause of anaemia: report of a case

Background. Brunner's gland adenoma (BGA) is a rare benign duodenal tumour proliferating from Brunner's glands. Here, we present a giant BGA leading to anaemia, with its clinical, endoscopic, radiological, surgical and pathological findings.

Case report. A 48-year-old Turkish man complained of a six months history of vague epigastric discomfort, loss of appetite and nausea after meals without vomiting. The physical examination had no unremarkable finding. Laboratory findings, including liver function tests, were within normal limits except a hypochromic, microcytic anaemia. The upper gastrointestinal endoscopic examination revealed a lobulated, red, polypoid tumour with a smooth surface covered with normal mucosa. The tumour was located on the anterior surface of duodenal bulb and had a wide base measuring 3.5 × 4 cm in size. Endoscopic ultrasonography revealed a submucosal polypoid mass located at the anterior surface of duodenal bulb. The endoscopic excision was tried but was not successful. The patient was operated and transduodenal polypectomy was done. The postoperative period was uneventful and the pathologic diagnosis was assessed as Brunner's gland adenoma. During the follow-up period, the endoscopic examination was normal at 12th month postoperatively.

Conclusions. BGA is a rare benign cause of anaemia that can be treated with excellent results.

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Matjaz Vrtovec, Ajda Anzic, Irena Preloznik Zupan, Katja Zaletel and Ales Blinc

617F positive myeloproliferative disease. Our aim was to test whether patients with JAK2 V617F positive MPNs, without clinically manifest atherosclerosis, have more prevalent asymptomatic carotid plaques, greater carotid artery stiffness, greater coronary calcium burden and worse digital endothelial function than apparently healthy control subjects, matched for classical risk factors for atherosclerosis. Patients and methods Patients were recruited from University Medical Centre Ljubljana, Department of Haematology among JAK2 V617F positive patients with

Open access

Rodica Togănel

.10.969. 12. Abu-Harb M, Wyllie J, Hey E, et al. Presentation of obstructive left heart malformations in infancy. Arch Dis Child Fetal Neonatal Ed. 1994;71:F179. doi:10.1136/fn.71.3.F179. 13. Ewer AK, Furmston AT, Middleton LJ, et al. Pulse oximetry as a screening test for congenital heart defects in newborn infants: a test accuracy study with evaluation of acceptability and costeffectiveness. Health Technol Assess. 2012;16(2):v-xiii,1-184. doi: 10.3310/hta16020. 14. Duff FD, McNamara DG. History and physical examination of the cardiovascular

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Vaneja Velenik, Ajra Secerov-Ermenc, Jasna But-Hadzic and Vesna Zadnik

much with age. TABLE 2 Mean scores (MS) with standard deviations (SD) for all scales and items by gender Total Men Women p (t-test) MS SD MS SD MS SD Global health status/quality of life 71.1 21.4 72.5 21.4 69.7 21.3 0.882 Physical functioning 91.8 14.0 93.3 12.6 90.3 15.1 <0.000 Role functioning 88.7 20.1 90.0 19.3 87.5 20.9 0.056 Emotional functioning 82.0 18.5 83.6 18.4 80.4 18.5 0.686 Cognitive functioning 90.2 16.0 90.2 16

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Natasa Kos, Boris Kos and Mitja Benedicic

fatigue significantly correlate with poor functional status and poorer quality of life due to impaired physical functioning and sleep disturbances. 13 Patients with fatigue have problems with routine tasks - these tasks require greater concentration and effort as usually. These problems need to be considered when deciding upon the intensity of activity during the rehabilitation program. Therefore, we plan short periods of rest during the program and assure that the patients stop with the activity before becoming overtired. Besides fatigue, cognitive functions such as

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Dimitrij Kuhelj, Anita Dobrovolec and Igor Jozef Kocijancic

’ request ( Figure 3 ). Figure 3 MR control 27 months after application of DiscoGel ® showing marked reduction of herniation on level L5–S1. Statistical analysis Analysis was performed on the data collected before the treatment and in five designated periods for VAS and up to 12 months for mean physical activity. Descriptive statistics such as mean and range were calculated and displayed. Statistical significance of VAS reduction 1, 6 and 36 months after the treatment were evaluated by pooled variance t-test. P values < 0.05 were considered as

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Jan Grosek, Jerica Novak, Katja Kitek, Alta Bajric, Ana Majdic, Jurij Ales Kosir and Ales Tomazic

outcomes. For the linear transformation, the following formulas were applied: – For functional scoring scales: S = ; – For symptom scoring scales: S = ; – For global health-status: S. The numerical variables were represented by means and standard deviations. The differences between numerical variables were tested using Student’s t -test. For the purpose of the statistical analysis, patients were divided into two age groups according to the reported median age of 73 years. First group included patients from 39 to 73 years and the second group patients from 74

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Giulia Schillani, Daniel Era, Tania Cristante, Giorgio Mustacchi, Martina Richiardi, Luigi Grassi and Tullio Giraldi

References 1. Stanton AL, Danoff-Burg S, Huggins M. The first year after breast cancer diagnosis: hope and coping strategies as predictors of adjustment. Psychooncology 2002; 11: 93-102. 2. Ozalp E, Soygu H, Cankurtaran E, Turhan L, Akbyk D, Geyik P. Psychiatric morbidity and its screening in Turkish women with breast cancer: a comparison between the HADS and SCID tests. Psychooncology 2008; 17: 668-75. Lueboonthavatchai P. Prevalence and psychosocial factors of anxiety and depression in breast cancer patients