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Case Reports 2018; 39(3): 156-159 PubMed PMID: 30431737 Citation  Keywords:  Adult, Female, Humans, Laparoscopy, Laparotomy, Pregnancy, Pregnancy, Abdominal:diagnostic imaging, Retroperitoneal Space:diagnostic imaging, Ultrasonography,.   

: Ectopic pregnancy is a condition when fertilized egg implants outside the uterine cavity. The reported incidence is about 0.5-1% of all pregnancies. Retroperitoneal ectopic pregnancies (REP) are extremely rare and early diagnosis and treatment is very difficult. For the adequate management and elimination of risks of maternal morbidity and even mortality, timely diagnosis is of a key importance. A 38-year-old woman was referred to our department for RCUI due to missed abortion/anembryonic pregnancy. Re-RCUI was later indicated due to suspicion of residua post RCUI. Histological examination didn't confirm intrauterine pregnancy, β-hCG blood levels were flat. Further ultrasonographic examination identified retroperitoneal ectopic pregnancy, most likely in the precaval lymph node. The surgical and subsequently histological examination confirmed this diagnosis. Our case describes successful management of rare retroperitoneal ectopic pregnancy. When common sites of ectopic pregnancy do not have any positive finding, then the presence of REP should be taken into consideration....

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Journal Article 2018; 39(4): 321-324 PubMed PMID: 30531707 Citation  Keywords:  Adult, Female, Gestational Age, Humans, Laser Coagulation, Myopia:epidemiology, Ophthalmoscopy, Pregnancy, Pregnancy Complications:diagnosis, Puerperal Disorders:diagnosis, Retinal Degeneration:diagnosis, Retinal Diseases:diagnosis, Risk Factors, Young Ad.   

OBJECTIVES: Myopia is associated with increased frequency of retinal degenerative changes which are the risk factors of intra- and postpartal ophthalmological complications. Aim of this study was to analyze the degenerative lesions detected in opthalmological examination (including peripheral retinal lesions) as a potential risk factors for eyes' status in terms of delivery in myopic women. MATERIAL AND METHODS: 254 pregnant women affected with myopia underwent opthalmological examination as a screening method to examine retina. In case of any degenerative lesions, the qualification for laser photocoagulation treatment was performed. Furthermore, study group was divided into two subgroups due to presence or absence of the retinal lesions and opthalmological outcomes compared. Follow up examination was performed in every patient from the study group between 3 and 6 months after the delivery. RESULTS: Among 508 eyes, retinal lesions were revealed in 69 women (121 eyes) what constituted for 23.8%. In remaining 185 patients results of the opthalmological examination were normal. Average maternal age was higher in group affected with degenerative lesions (p<0.001). Myopia in women with retinal lesions ranged between -0.25 and -12 dioptries (D), while in 43 cases of degenerative lesions qualified for laser photocoagulation this value ranged between -0.5 and -12.0 D (p=ns). Postpartal follow-up examination did not reveal any abnormalities in this group, as well. CONCLUSION: Degenerative retinal lesions are present in one fourth of pregnant women. Both the severity and type of the lesions are not associated with severity of myopia. Among pregnant patients, retinal lesions occur in patients with more advanced maternal age. opthalmological examination remains an important prophylactic modality in retinal disorders, especially in primary retinal detachment due degenerative disorders....

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Journal Article 2018; 39(4): 281-287 PubMed PMID: 30531701 Citation  Keywords:  Adolescent, Adult, Aged, Aged, 80 and over, Brain Neoplasms:radiotherapy, Female, Glioblastoma:radiotherapy, Humans, Male, Middle Aged, Neoplasm Recurrence, Local:radiotherapy, Palliative Care, Radiosurgery, Retrospective Studies, Survival Rate, Treatment.   

OBJECTIVE: Local recurrence of glioblastoma is observed in most patients after standard oncologic treatment (surgery, chemotherapy and radiotherapy). Stereotactic radiosurgery with the Leksell Gamma Knife (SRS with LGK) was used to treat recurrent tumors in selected cases, and retrospective analysis of treatment outcome was performed. METHODS: Altogether 126 patients were treated for glioblastoma at our center from 1992-2014. Sixty-nine patients (55%) were male and 57 (45%) female, with a median age of 56 years (range 17-80 years). Prior to LGK radiosurgery, 123 (98%) underwent surgery, 126 (100%) radiotherapy and 116 (92%) chemotherapy. The median Karnofsky score before LGK radiosurgery was 90% (range 50-100), and the median time from GBM diagnosis to LGK radiosurgery was 12 months (range 1-96 months). The median tumor volume was 3.75 cm3 (range 0.04-37.10 cm3). LGK radiosurgery was performed in a single fraction with a median minimal tumor dose of 12 Gy (range 10-25 Gy) on a median 50% (range 40-86%) isodose line. Two and more LGK radiosurgeries were performed in 19 (15%) cases, a median interval of 9.6 months (range 2-45 months) from the initial LGK radiosurgery. The median prescribed dose in these patients was 12.6 Gy (range 10-15 Gy), and the median volume 5.8 cm3 (range 0.1-13.7 cm3). RESULTS: The median survival from GBM diagnosis was 20 months (range 6-237 months). The median survival after LGK radiosurgery was 7 months (range 1-223 months). The one year survival after LGK radiosurgery was 27%, 2 years 8%, and more than 3 years 4%. Tumor regression on MR images was observed in 17% of patients at a median interval of 7 months. The median interval to tumor progression on MR images after LGK treatment was 8.5 months. No treatment-related radionecrosis with expansive behaviour was detected after radiosurgery. CONCLUSION: We show that LGK radiosurgery is a safe palliative treatment modality in patients with recurrent GBM....

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Journal Article 2019; 39(7): 496-500 PubMed PMID: 30860681 Citation  Keywords:  Acute Pain:drug therapy, Analgesics, Opioid:therapeutic use, Animals, Central Amygdaloid Nucleus:physiology, Dose-Response Relationship, Drug, Facial Pain:drug therapy, Naloxone:pharmacology, Pain Measurement:methods, Pilot Projects, Rats, Tapentadol:anta.   

OBJECTIVE: Tapentadol exhibits a synergistic dual effect effect (MOR / NRI) -agonist effect on noradrena-line reuptake inhibition (NRI). Tapentadol is effective on pain with neuropathic characteristics, therefore we decided to use it in an experimental model of acute orofacial pain. METHODS: The Orofacial Stimulation Test, developed by Ugo Basile, measures hypersensitivity to thermal or mechanical stimulation of the trigeminal area. In the experiment, rats had to voluntarily contact a thermal or mechanical stimulator with their unshaved vibrissal pad in order to access a food reward. Twenty adult laboratory rats (average weight 345 grams) were tested. Intraperitoneal tapentadol was used in doses of 1 mg/kg and 2 mg/kg. RESULTS: The results of the pilot study indicate that intraperitoneal administration of tapentadol (2 mg/kg) increased mechanical anti-nociception in rats....

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