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1.
Int J Nephrol Renovasc Dis ; 17: 47-58, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38370010

RESUMO

Background: End-stage kidney disease (ESKD) is associated with a tremendous financial burden. Data in Indonesia shows an increasing number of patients with ESKD taking hemodialysis as a routine procedure every year. Establishment and maintenance of vascular access are important in the management of ESKD. Vascular complications that often arise due to hemodialysis are common and one of the main reasons for hospitalization. Cannulation complications ranged from minor hematomas to acute bleeding from pseudoaneurysms that required emergency surgical procedures. This study aims to assess the different clinicopathological characteristics of ESKD patients with vascular access cannulation complications and the surgical management related to the complications. Materials and Methods: This research is a retrospective observational study. The research subjects in this study were ESKD patients in the vascular and endovascular surgery division of the tertiary hospital in West Java, Indonesia. There were 121 study subjects. Clinicopathological characteristics of vascular cannulation complications and surgical management are extracted from the medical record. Results: Three major vascular complications were ruptured pseudoaneurysms 64/121 (52.9%), impending rupture pseudoaneurysms 28/121 (23.1%), and pseudoaneurysms 21/121 (17.4%). Common surgical procedures were ligation of the draining vein 47/121 (38.8%), arterial primary repair 28/121 (23.1%), and arterial patch repair 18/121 (14.9%). There was a significant relationship between symptoms of bleeding in ruptured pseudoaneurysms and bulging masses in pseudoaneurysms (p = 0.001). There was a significant relationship between the diameter of the vascular mass, vascular defect size, and hematoma and the type of surgical procedure taken (p < 0.010). Conclusion: Ruptured, impending rupture, and pseudoaneurysms are major complications of vascular access in ESKD patients, and there was a significant relationship between the carried-out surgical procedure and the size of the vascular mass, defect, and hematoma.

2.
Artigo em Inglês | MEDLINE | ID: mdl-38090282

RESUMO

Objective: Breast cancer is the most prevalent cancer in women and can spread to the lymph nodes in the axilla. The sentinel lymph node is the first lymph node to be targeted for the spread or metastasis of cancer cells involving the lymph nodes. The aim of this study is to compare the accuracy rate of methylene blue injection into sentinel lymph nodes in early-stage breast cancer patients who have undergone incisional and excisional biopsies. Methods: This is a prospective observational study conducted in two general hospitals in West Java, Indonesia. The research subjects in this study were early-stage breast cancer patients with no lymph node metastasis (N0) who had undergone a biopsy. There were 83 study subjects included in this study. The sentinel lymph node biopsy was taken after injection of methylene blue into the peritumoral area. Blue nodes in the axilla were marked as positive lymph node biopsy results and sent for histopathology examination. Results: Patients who underwent excisional biopsy surgery had a sensitivity rate of 85.3% and a specificity of 93.3%, while the accuracy rate in patients who underwent incisional biopsy surgery had a sensitivity rate of 79.2% and a specificity of 80%. Conclusion: There was no difference in the accuracy of SLNB using methylene blue in patients with early-stage breast cancer with N0 who had a history of incisional and excisional biopsy.

3.
J. coloproctol. (Rio J., Impr.) ; 43(4): 300-309, Oct.-Dec. 2023. tab, ilus
Artigo em Inglês | LILACS | ID: biblio-1528946

RESUMO

Introduction: Chemotherapy response in early age-onset colorectal cancer patients is still controversial, and the results of chemotherapy response are unknown. Therefore, the purpose of this study is to determine the relationship between the age of colorectal cancer patients and histopathological features and chemotherapy response. Methods: This is a prospective observational study. The subjects in this study were colorectal cancer patients in the Digestive Surgery division at Tertiary Hospital in West Java from September 2021 to September 2022. Results: There were 86 subjects who underwent chemotherapy in accordance with the inclusion and exclusion criteria. Consisting of 39 patients of early age onset and 44 female patients. The most common histopathological feature in early age onset (EAO) and late age onset (LAO) was adenocarcinoma (25% and 46%, respectively). Stage III colorectal cancer affected 38 patients, while stage IV affected 48 patients. There was a significant relationship between early age onset and late age onset with histological features (p < 0.001). The patients with the highest chemotherapy response had stable diseases in EAO (17 patients) and LAO (20 patients). There was no statistically significant relationship between age, histological features, and stage of colorectal cancer and chemotherapy response (p > 0.05). The results of the ordinal logistic regression test showed no systematic relationship between chemotherapy response and age, histopathological features, gender, or cancer stage (p > 0.05). Conclusion: There was no association between age and histopathologic features with chemotherapy response and there is no difference in chemotherapy response between early and late age onset. (AU)


Assuntos
Neoplasias Colorretais/tratamento farmacológico , Fatores de Risco , Fatores Etários , Neoplasias Colorretais/patologia , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/diagnóstico por imagem , Estadiamento de Neoplasias
4.
Heliyon ; 9(10): e21051, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37876424

RESUMO

Introduction: COX-2 is overexpressed in colorectal tumour tissue relative to the healthy colonic mucosa, thus we investigated the prognostic significance of COX-2 in determining the metastasis of patients with colorectal cancer. Methods: PubMed, EMBASE, and Cochrane Library were searched using the following terms colorectal cancer, colon cancer, rectal cancer, colorectal carcinoma, Cyclooxygenase-2, and prognosis to identify articles providing information on the prognostic importance of COX-2 in adult patients with metastatic colorectal cancer. Review papers, non-research letters, comments, case reports, animal studies, original research with sample sizes of fewer than 20, case reports and series, non-English language articles, and pediatric studies (those under the age of 17) were excluded. The Newcastle Ottawa Scale (NOS) was used to assess the credibility of the included studies. The full texts were evaluated and this study complied with the terms of the local protocol and the Helsinki Declaration. Results: Eight relevant studies were included in this review involving 937 patients. The meta-analysis revealed that COX-2 expression is associated with lymph node invasion (RR 1.85 [1.21, 2.83], P = 0.005, I2 = 88 %) and liver metastasis (RR 4.90 [1.12, 21.57], P = 0.04, I2 = 42 %), but not with venous dissemination (RR 1.48 [0.72, 3.03], P = 0.28, I2 = 87 %). Conclusion: COX-2 expression is associated with lymph node invasion in colorectal cancer but further studies are required to determine the prognostic significance of COX-2 expression in determining metastasis status for colorectal cancer patients.

5.
Int J Surg Case Rep ; 110: 108673, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37598485

RESUMO

INTRODUCTION AND IMPORTANCE: Penile sclerosis lipogranuloma, a disease that occurs as a result of the body's reaction to lipid-based foreign substances, is a rare case with manifestations that can occur years after injection. Reactions that emerge can be disturbing to the point of causing functional impairment, so proper therapy needs to be done to restore and maintain penis function and prevent complications. Here, we present a case of penile sclerosis lipogranuloma that was treated surgically with a scrotal flap and VY plasty, including circumcision. CASE PRESENTATION: We report here the case of a 19-year-old Asian male who came in with multiple, irregular, nodular masses in his penis after a candlenut oil injection that had been performed a year before presentation. An extensive excision and extraction of the penile lipogranuloma, including all areas invaded by oil injection, were performed. Then a scrotal flap and VY plasty were used to reconstruct the exposed penile shaft. The operative procedure was successful, and the patient experienced positive functional and aesthetic outcomes. CLINICAL DISCUSSION: Determining therapy for penile sclerosis granuloma becomes important to improve or restore normal penile function and for performance function. Therapy includes the complete removal of the substance and the affected part. The recommended reconstruction for the penile shaft is a scrotal flap with penile scrotal invagination and VY plasty. CONCLUSION: Proper treatment of the penis and its surroundings in cases of penile lipogranuloma is important to prevent further complications and maintain penile function.

6.
Ann Med Surg (Lond) ; 85(5): 1761-1768, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37228916

RESUMO

In Indonesia, colorectal cancer is the third most common type. In 2008, Indonesia ranked fourth in the Association of Southeast Asian Nations (ASEAN) countries, with an incidence rate of 17.2 per 100 000 population. This figure is predicted to continue to increase from year to year. In 30% of colorectal cancer patients diagnosed after metastases, some patients will develop metastases after undergoing surgical resection of the primary tumor. The survival of metastatic colorectal cancer patients has improved significantly in the last 20 years with the introduction of target-oriented drugs, anti-epidermal growth factor receptor (EGFR), and anti-human epidermal growth factor receptor-2 (HER2). This study aims to assess the relationship between Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation and HER2 expression for targeted therapy implementation. Patients and methods: This research is a cross-sectional study. The research subjects in this study were colorectal cancer patients in the digestive surgery division. There were 58 study subjects. Examination of KRAS mutations was carried out by PCR on fresh tumor tissue obtained from surgery or colonoscopy. Meanwhile, the HER2 examination used the immunohistochemistry method of paraffin blocks for anatomical pathology examination. Results: Examination of KRAS mutations showed 28/58 (43.8%) patients with colorectal cancer, while HER2 overexpression was found in 6/58 (10.3%) patients with colorectal cancer. Univariate analysis of KRAS mutations and HER2 expression showed that four subjects with KRAS mutations had excess HER2 expression (P=0.341). Conclusion: There is no association between KRAS mutations and HER2 overexpression in colorectal cancer patients.

7.
Ann Med Surg (Lond) ; 85(5): 2115-2118, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37229084

RESUMO

Primary internal hernias are rare in adults. Internal hernias present clinically as a sign of small intestinal obstruction. If left untreated, internal hernias might lead to high morbidity and mortality due to strangulation. Internal hernias are usually diagnosed intraoperatively. Here, we present an internal hernia diagnosed with an abdominal computed tomography (CT) scan. The importance of preoperative diagnosis for internal hernias leads to early surgery and keeps the patient from suffering intestinal strangulation. Case presentation: We report here the case of a 67-year-old male who presented with acute intestinal obstruction and underwent an abdominal CT scan. The patient was diagnosed with an internal hernia from the imaging of the abdominal CT scan and scheduled for an exploratory laparotomy. An internal hernia was found in the mesocolon of the sigmoid colon; one loop of jejunum was trapped in the hernia defect. After reduction, the hernial defect was closed; no resections were done, and the patient was discharged after 5 days without complication. Clinical discussion: Our finding represents a transmesosigmoid hernia, a rare variant of sigmoid mesocolon hernias. The clinical sign and the judgment of the surgeon for the diagnosis of an internal hernia became important factors related to the patient's outcome. Conclusion: The proper adjunct imaging, correct diagnosis, and timing of surgery for internal hernias save the patient from morbidity or intestinal death.

8.
Asian Pac J Cancer Prev ; 24(4): 1373-1377, 2023 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-37116161

RESUMO

OBJECTIVE: This study aims to assess the association of subject characteristics and NRAS mutations with HER2 expression in CRC. METHODS: This research is a cross-sectional study. The research subjects in this study were colorectal cancer patients in the Digestive Surgery division at Dr. Hasan Sadikin Hospital. There were 58 study subjects. Examination of NRAS mutations was carried out by Polymerase Chain Reaction (PCR) from fresh tumour tissue obtained from surgery or colonoscopy. Meanwhile, HER2 examination used the Immunohistochemistry (IHC) method of paraffin blocks for anatomical pathology examination of the same patients. RESULT: HER2 overexpression was found in 6/58 (10.3%) patients with CRC, and from 8 subjects with NRAS mutations, only 1 subject (1.7%) showed overexpression of HER2. Univariate analysis of HER2 expression showed no significant associations to age, sex, histologic feature, tumor location, and NRAS mutations. A significant association was found between HER2 expression and stage of the CRC with p=0.001. CONCLUSION: There is no association between NRAS mutations and HER2 overexpression in colorectal cancer patients.


Assuntos
Neoplasias Colorretais , Humanos , Estudos Transversais , Indonésia , Mutação , Reação em Cadeia da Polimerase , Neoplasias Colorretais/patologia , Receptor ErbB-2/genética , Proteínas de Membrana/genética , GTP Fosfo-Hidrolases/genética
9.
Int J Surg Case Rep ; 106: 108263, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37116278

RESUMO

INTRODUCTION AND IMPORTANCE: Splenic cyst is a rare disease, with reported incidences ranging from 0.07 to 0.3 %. A splenic cyst is typically discovered inadvertently and may not cause any symptoms until it grows to a significant size. In some cases, complications such as acute abdomen may be brought on by an intracystic hemorrhage, rupture, or infection. As a rare disease, diagnosing a splenic cyst is still precarious because only a few cases have been reported. CASE PRESENTATION: The first case is a 23-year-old Asian man without a significant history of illness who complains of a left upper quadrant mass that he discovered 10 years prior. Since then, the mass had been gradually growing and had been accompanied by severe pain. Walking made the pain worse; lying down made it lessen. A computed tomography (CT) scan of the abdomen showed a 20.05 × 15.95 × 26.71 cm splenic cyst. Surgery for a peri-cystic splenectomy was done. A primary splenic cyst was identified in the specimen after microscopic and macroscopic examination. After 10 days, the patient was released from the hospital without complications. The second case is that of a 28-year-old Asian man who complained of a mass in their abdomen that was getting bigger in size. Four years prior to the complaint, the patient had fallen while driving a motorcycle, and the left side of his abdomen collided with the sidewalk. In this patient, a splenectomy-the complete removal of all spleen parts-was done. The specimen's macroscopic and microscopic examination revealed a splenic pseudocyst. The patient was discharged after three days without complications. CLINICAL DISCUSSION: Splenic cysts are considered rare and challenging to diagnose, as there have been only a limited number of reports. Nevertheless, proper management is still needed, as it carries the risk of rupturing and causing complications such as peritonitis and anaphylactic reactions. Considering the risk of overwhelming post-splenectomy infection (OPSI), conservative treatment can be the gold standard for splenic cysts. However, considering the risk from the size of the cyst, splenectomy or peri-cystic splenectomy is an appropriate surgery option for a splenic cyst. CONCLUSION: Splenectomy, or peri-cystic splenectomy, is a surgery option for a splenic cyst with significant size and rupture risk.

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