391. Bleomycin electrosclerotherapy (BEST) for the treatment of vascular malformations : an International Network for Sharing Practices on Electrochemotherapy (InspECT) study group reportTobian Muir, Giulia Bertino, Aleš Grošelj, Lakshmi Ratnam, Erika Kis, Joy Odili, Ian McCafferty, Walter A Wohlgemuth, Maja Čemažar, Aljoša Krt, Maša Omerzel, Alessandro Zanasi, Michela Battista, Francesca De Terlizzi, Luca Giovanni Campana, Gregor Serša, 2023, review article Abstract: Biomedical applications of electroporation are expanding out of the field of oncology into vaccination, treatment of arrhythmias and now in the treatment of vascular malformations. Bleomycin is a widely used sclerosing agent in the treatment of various vascular malformations. The application of electric pulses in addition to bleomycin enhances the effectiveness of the drug, as demonstrated by electrochemotherapy, which utilizes bleomycin in the treatment of tumors. The same principle is used in bleomycin electrosclerotherapy (BEST). The approach seems to be effective in the treatment of low-flow (venous and lymphatic) and, potentially, even high-flow (arteriovenous) malformations. Although there are only a few published reports to date, the surgical community is interested, and an increasing number of centers are applying BEST in the treatment of vascular malformations. Within the International Network for Sharing Practices on Electrochemotherapy (InspECT) consortium, a dedicated working group has been constituted to develop standard operating procedures for BEST and foster clinical trials. By treatment standardization and successful completion of clinical trials demonstrating the effectiveness and safety of the approach, higher quality data and better clinical outcomes may be achieved. Keywords: vascular malformations, electrosclerotherapy, bleomycin Published in DiRROS: 25.07.2024; Views: 188; Downloads: 68
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392. Two-stage hepatectomy in resection of colorectal liver metastases - a single-institution experience with case-control matching and review of the literatureŠpela Turk, Irena Plahuta, Tomislav Magdalenić, Tajda Španring, Kevin Laufer, Žan Mavc, Stojan Potrč, Arpad Ivanecz, 2023, original scientific article Keywords: colorectal cancer, liver metastasis, future liver remnant, posthepatectomy liver failure Published in DiRROS: 25.07.2024; Views: 173; Downloads: 104
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393. Moss biomonitoring of the distribution of chemical elements in the air in the Prespa region, North MacedoniaBiljana Dimkova, Robert Šajn, Trajče Stafilov, 2024, original scientific article Abstract: A study was conducted to investigate atmospheric deposition and to explore the natural distribution and possible contamination with potentially toxic elements (PTEs) in the Prespa region, North Macedonia, using moss samples as biomonitors for air pollution. The distribution of 19 chemical elements (Ag, Al, Ba, Ca, Cr, Cu, Fe, K, Li, Mg, Mn, Mo, Na, Ni, P, Pb, Sr, V, and Zn) was detected in 11 moss samples from this area. The moss samples were analysed after microwave digestion using inductively coupled plasma – atomic emission spectrometry (ICP-AES). R-mode factor analysis was used to identify and characterise the elemental associations, and four associations of elements were identified. Four factors were separated from the group of elements: Factor 1 (Fe-Al-Cr-V-Ni), Factor 2 (Sr-Ba-Mg), Factor 3 (K-P-Zn) and Factor 4 (Pb-Cu). All element factors were found to be typical geochemical associations, with the exception of the distribution of K and P in the agricultural areas of the study area where fertilisers are used over a long period of time. Keywords: moss biomonitoring, air pollution, potentially toxic elements, Prespa region, North Macedonia Published in DiRROS: 25.07.2024; Views: 157; Downloads: 135
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394. Monitoring the effect of perioperative nutritional care on body composition and functional status in patients with carcinoma of gastrointestinal and hepatobiliary system and pancreasAndrej Gyergyek, Nada Rotovnik-Kozjek, Jasna Klen, 2023, original scientific article Abstract: Background. The significance of nutritional care in the management of cancer, particularly in the surgical treatment of abdominal cancer, is increasingly acknowledged. Body composition analysis, such as the Bioelectric impedance assay (BIA), and functional tests, e.g., handgrip strength, are used when assessing nutritional status alongside general and nutritional history, clinical examination, and laboratory tests. The primary approach in nutritional care is individually adjusted nutritional counselling and the use of medical nutrition, especially oral nutritional supplements. The aim of the study was to investigate the effects of perioperative nutritional care on body composition and functional status in patients with carcinoma of the gastrointestinal tract, hepatobiliary system, and pancreas. Patients and methods. 47 patients were included, 27 received preoperative and postoperative nutritional counselling and oral nutritional supplements (Group 1), while 20, due to surgical or organisational reasons, received nutritional care only postoperatively (Group 2). The effect of nutritional therapy was measured with bioimpedance body composition and handgrip measurements. Results. Group 2 had a higher average Nutritional Risk Screening (NRS) 2002 score upon enrolment (3 vs. 2 points); however, there was no difference when malnutrition was assessed using Global Leadership in Malnutrition (GLIM) criteria. There was a relative increase in lean body mass and fat-free mass index (FFMI) 7 days after surgery in group 1 (+4,2% vs. -2,1% in group 2). There was no difference in handgrip strength. Conclusions. Our results indicate that combined preoperative and postoperative nutritional care is superior to only postoperative nutritional care. It seems to prevent statistically significant lean mass loss 7 days after surgery but not after 14 days or 4 weeks. Keywords: abdominal cancer, nutritional status, body composition Published in DiRROS: 25.07.2024; Views: 163; Downloads: 72
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395. CD56-positive diffuse large B-cell lymphoma : comprehensive analysis of clinical, pathological, and molecular characteristics with literature reviewGorana Gašljević, Lučka Boltežar, Srdjan Novaković, Vita Šetrajčič Dragoš, Barbara Jezeršek Novaković, Veronika Kloboves-Prevodnik, 2023, original scientific article Abstract: Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma. The expression of CD56 in DLBCL is highly unusual. Little is known about its incidence and clinical importance. So far, no genetic profiling was performed in CD56 positive DLBCL.Patients and methods. Tissue microarrays have been constructed, sectioned, and stained by H&E and immuno-histochemistry for 229 patients with DLBCL diagnosed 2008–2017. For CD56 positive cases, clinical data was collected including age at diagnosis, stage of the disease, International Prognostic Index (IPI) score, treatment scheme and number of chemotherapy cycles, radiation therapy, treatment outcome, and possible relapse of the disease. Overall survival (OS) and progression-free survival (PFS) were calculated. For four patients, RNA was extracted and targeted RNA (cDNA) sequencing of 125 genes was performed with the Archer FusionPlex Lymphoma kit.Results. CD56 expression was found in 7 cases (3%). The intensity of expression varied from weak to moderate focal, to very intensive and diffuse. All patients had de novo DLBCL. The median age at the time of diagnosis was 54.5 years. Five of them were women and 2 males. According to the Hans algorithm, 6 patients had the germinal centre B cells (GBC) type and one non-GBC (activated B-cell [ABC]) type, double expressor. Genetic profiling of four patients ac-cording to Schmitz’s classification showed that 1 case was of the BN2 subtype, 1 of EZB subtype, 2 were unclassified. The six treated patients reached a complete response and did not experience progression of the disease during the median follow-up period of 80.5 months.Conclusions. We report on one of the largest series of CD56+DLBCL with detailed clinicopathological data and for the first time described genetical findings in a limited number of patients. Our results show that CD56 expression is rare, but seems to be present in prognostic favourable subtypes of DLBCL not otherwise specified (NOS) as tested by immunohistochemical or genetic profiling Keywords: diffuse large B-cell lymphoma, immunohistochemistry, lymphomas, CD56 Published in DiRROS: 25.07.2024; Views: 172; Downloads: 63
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397. Association of OPRM1, MIR23B, and MIR107 genetic variability with acute pain, chronic pain and adverse effects after postoperative tramadol and paracetamol treatment in breast cancerZala Vidic, Katja Goričar, Branka Stražišar, Nikola Bešić, Vita Dolžan, 2023, original scientific article Abstract: Background. Tramadol is an opioid analgesic often used for pain management after breast cancer surgery. Its anal-gesic activity is due to the activation of the μ-opioid receptor, encoded by the OPRM1 gene. This study investigated the association of genetic variability in OPRM1 and its regulatory miRNA genes with outcomes of tramadol/paraceta-mol treatment after breast cancer surgery with axillary lymphadenectomy.Patients and methods. The study included 113 breast cancer patients after breast cancer surgery with axillary lymphadenectomy treated with either 75/650 mg or 37.5/325 mg of tramadol with paracetamol for pain relief within the randomized clinical trial KCT 04/2015-DORETAonko/si at the Institute of Oncology Ljubljana. All patients were geno-typed for OPRM1 rs1799971 and rs677830, MIR23B rs1011784, and MIR107 rs2296616 using competitive allele-specific PCR. The association of genetic factors with acute and chronic pain as well as adverse effects of tramadol treatment was evaluated using logistic regression, Fisher’s exact test, and Mann-Whitney test.Results.The investigated OPRM1 related polymorphisms were not associated with acute pain assessed with the VAS scale within four weeks after surgery (all P > 0.05). Carriers of at least one polymorphic OPRM1 rs1799971 allele had a higher risk of constipation in the first four weeks after surgery compared to non-carriers (OR = 4.5, 95% CI = 1.6–12.64, P = 0.004). Carriers of at least one polymorphic OPRM1 rs677830 allele had a higher risk of constipation after third week of tramadol treatment (OR = 3.11, 95% CI = 1.08–8.89, P = 0.035). Furthermore, carriers of two polymorphic MIR23Brs1011784 alleles had a higher risk of nausea after 28 days of tramadol treatment (OR = 7.35, 95% CI = 1.27–42.6, P = 0.026), while heterozygotes for MIR107 rs2296616 allele had a lower risk of nausea after 21 days of tramadol treatment (OR = 0.21, 95% CI = 0.05–0.87, P = 0.031). In carriers of two polymorphic MIR107 rs2296616 alleles, chronic pain was significantly more common than in carriers of two wild-type alleles (P = 0.004). Carriers of at least one polymorphic MIR23B rs1011784 allele experienced more neuropathic pain after adjustment for tramadol dose (OR = 2.85, 95% CI = 1.07–7.59, P = 0.036), while carriers of at least one polymorphic OPRM1 rs677830 allele experienced less neuropathic pain compared to carriers of two wild-type alleles (OR = 0.38, 95% CI = 0.15–0.99, P = 0.047).Conclusions.Genetic variability of OPRM1 and genes coding for miRNAs that could affect OPRM1 expression may be associated with adverse effects of tramadol/paracetamol treatment as well as with chronic and neuropathic pain after breast cancer surgery with axillary lymphadenectomy. Keywords: operacija raka na dojki, zdravljenje bolečine, tramadol Published in DiRROS: 25.07.2024; Views: 691; Downloads: 162
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398. Does concurrent gynaecological surgery affect infectious complications rate after mastectomy with implant-based reconstruction?Nina Pišlar, Barbara Perić, Uroš Ahčan, Romi Cencelj-Arnež, Janez Žgajnar, Andraž Perhavec, 2023, original scientific article Abstract: Background. Women who undergo breast cancer surgery often have an indication for gynaecological procedure. The aim of our study was to compare infectious complications rate after mastectomy with implant-based reconstruc-tion in patients with and without concurrent gynaecological procedure.Patients and methods. We retrospectively reviewed clinical records of 159 consecutively operated patients after mastectomy with implant-based reconstruction. The patients were divided in 2 groups: 102 patients without (Group 1) and 57 with (Group 2) concurrent gynaecological procedure. Infectious complications rates between the groups were compared using χ2-test. Logistic regression was performed to test for association of different variables with infec-tious complications.Results. There were240 breast reconstructions performed. Median follow-up time was 297 days (10–1061 days). Mean patient age was 47.2 years (95% CI 32.8–65.9); 48.2 years (95% CI 46.1–50.3) in Group 1 and 45.8 years (95% CI 43.2–48.3) in Group 2; p = 0.002). Infectious complications rate was 17.6% (17.6% vs. 17.5%, p = 0.987), implant loss occurred in 5.7% (4.9% vs. 7.0%, p = 0.58). Obesity (body mass index[BMI] > 30 kg/m2), age, previous breast conserv-ing treatment (BCT) with radiotherapy (RT) were identified as risk factors for infectious complications in univariate analysis. Obesity (adjusted odds ratio [aOR] 3.319, 95% CI 1.085–10.157, p = 0.036) and BCT with RT (aOR 7.481, 95% CI 2.230–25.101, p = 0.001) were independently associated with infectious complications in multivariate model.Conclusions. Concurrent gynaecological procedure for patients undergoing mastectomy with implant-based re-construction did not carry an increased risk for infectious complications. Keywords: rak na dojki, infekcijski zapleti, rekonstrukcija z vsadki Published in DiRROS: 25.07.2024; Views: 161; Downloads: 102
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399. Ultrasonography of peripheral nerve tumours : a case seriesSimon Podnar, 2023, original scientific article Abstract: Background. Peripheral nerve tumours (PNTs) are rare, but important cause of peripheral nerve dysfunction. The aim of the study was to present a series of consecutive patients with PNTs evaluated in authors’ ultrasonography (US) practice.Patients and methods. The electronic medical records of patients with PNTs examined at our US laboratory from February 2013 to May 2020 were retrospectively reviewed. Data on gender, age, clinical features, PNT location, elec-trodiagnostic (EDx) features and US findings were collected.Results. In the analyzed period 2845 patients were examined in our US laboratory. From these 15 patients (0.5%) with PNTs were identified. Four of them (3 with confirmed neurofibromatosis) had multiple PNTs. Half of patients (53%) presented with features of peripheral nerve damage, and others with palpable mass or pain. The most often involved nerve was ulnar (36%). PNT cross sectional areas varied from 24 mm2 to 1250 mm2 (median, 61 mm2). Based in 5 pa-tients on histological and in remaining patients on US features, schwannoma was diagnosed in 40%, neurofibroma in 27%, and perineurioma in 27% of patients.Conclusions. As in previous reports,PNTs in our series presented with neurological symptoms, palpable mass or pain. In contrast to other focal neuropathies, particularly nerves with schwannomas, in spite of their large thickening, often demonstrated well preserved function. Adding US to our clinical practice, enabled us to diagnose these rare periph-eral nerve lesions that we missed before. Keywords: elektrodiagnostika, površina preseka živca, periferni živci Published in DiRROS: 25.07.2024; Views: 182; Downloads: 95
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400. Oral verrucous carcinoma : a diagnostic and therapeutic challengeNejc Krištofelc, Nina Zidar, Primož Strojan, 2023, review article Abstract: Background. Verrucous carcinoma is a low-grade variant of squamous cell carcinoma with specific morphologic, cytokinetic and clinical features. Despite low mitotic activity and slow growth, it can infiltrate adjacent tissues in advanced stages but does not metastasize. The most frequently affected site is the oral cavity. The following article provides latest updates in the etiology, clinical presentation, diagnostics and treatment options in oral verrucous car-cinoma and discusses the existing dilemmas linked to this unique malignancy.Conclusions. Oral verrucous carcinoma must be differentiated from conventional squamous cell carcinoma due to its less aggressive behaviour with a more favourable prognosis. Close communication between clinician and patholo-gist is mandatory for making a correct diagnosis. Primary surgery with negative surgical margins seems to be the most successful treatment. However, management recommendations are not uniform since they are mostly based on case reports and small retrospective case series. Prospective and pooled multi-institutional studies are therefore needed. Keywords: verrucous carcinoma, oral verrucous carcinoma, squamous cell carcinoma Published in DiRROS: 25.07.2024; Views: 148; Downloads: 141
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