Malignant Disease In Patients Research Articles

Predictive factors in the differential diagnosis of benign and malignant causes in patients undergoing endoscopic retrograde cholangiopancreatography for extrahepatic cholestasis.

Diagnosing benign vs. malignant extrahepatic cholestasis is challenging despite the currently available advanced imaging and endoscopic techniques. This study aims to determine the predictive accuracy of initial biochemical data and bile duct dilatation findings in transabdominal ultrasound (US) to differentiate between benign and malignant disease in patients with extrahepatic cholestasis. We reviewed the case records of 814 patients who had undergone endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (in cases of unsuccessful ERCP) for extrahepatic cholestasis. The etiology of biliary obstruction was determined based on ERCP, endoscopic ultrasonography, radiology, cytology, biopsy, and/or clinical follow-up at one year. The patients were divided into benign and malignant groups according to the underlying etiology of biliary obstruction. A complete biochemical profile, transabdominal ultrasonography at presentation, and other demographic data were recorded. Alkaline phosphatase (p = 0.002), aspartate aminotransferase (p = 0.038), and bilirubin levels were significantly higher in malignant patients. The mean age of patients with malignancy was 69.5 years, vs. 60.6 years in benign patients (p < 0.001). The likelihood of malignancy increased with the increased bilirubin levels (> 200 µmol/l: 30.0% sensitivity, 97.6% specificity). The total bilirubin level predicting malignancy as the best cut-off value was 111 mmol/L with optimum sensitivity and specificity (61.8% and 83.8%, respectively) and area under the curve = 0.756, (p < 0.001). Intrahepatic bile duct (IHBD) dilatation was significantly higher in malignant patients (p < 0.001). A serum bilirubin level of 111 µmol/L or higher and the detection of IHBD dilatation on abdominal ultrasonography are important predictors in the differential diagnosis of benign and malignant causes of extrahepatic cholestasis.

Prognostic Significance of Pre-Treatment Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio in Head and Neck Malignancies.

Carcinoma is the second most common cause of death worldwide. The neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) are essential markers of inflammation and tumorigenesis in various cancers including head and neck cancers. Pretreatment platelet- lymphocytic ratio can be used as an independent predictor of mortality whereas neutrophil- lymphocytic ratio is an independent predictor of recurrence. The main aim of this study is to compare the pre-treatment neutrophil lymphocyte ratio and platelet-lymphocyte ratio in the patients of head and neck malignancies with those of the control group. 100 patients with histologically diagnosed cases of head and neck malignancies. Age and sex matched healthy subjects attending Otorhinolaryngology out-patient department for any other complaints (100 control subjects). Complete blood count had been done to calculate absolute neutrophil count and absolute lymphocyte count. The mean age of the subjects in the study group was 55.73 ± 11.56years. In control group, the mean age group was 54.11 ± 10.46years. NLR and PLR significantly increased in cases than controls. NLR associated with T stage, histological type and histological grade but not with site and nodal involvement. PLR associated with T stage, metastasis but not with the histological grade, histological type, site and nodal involvement. From this study, we conclude that pre-treatment NLR and PLR were closely associated both with the size of primary tumor and also with the stage of malignant disease in patients of head and neck malignancies.

Occurrence of malignant diseases in patients with multiple sclerosis: population-based MS Registry data

Among different comorbidities occurring in multiple sclerosis (MS), the presence of malignant diseases in these patients is of the particular importance. The aim of this study was to determine the malignant diseases burden in a whole cohort of patients with MS in the Belgrade region, based on the Belgrade population registry data. This study comprises 2725 MS patients from the MS Registry, which represents a source for all necessary demographic and clinical data. Firstly, the Registry was searched for all persons with MS who had cancer comorbidity, during the period 1996-2019. Diagnosis of cancer was validated by the patients' medical documentation. In order to investigate factors associated with the occurrence of any type of the cancer and/ or breast cancer only, in persons with MS, different logistic regression analyses were performed. A total of 64 persons with 69 malignant diseases were observed (prevalence 2.53%). The most frequent malignancies in males were skin cancer (50.0%) and in females, breast cancer (23.2%). The cumulative incidence of cancer comorbidity in persons with MS was 324.9 new cases per 100,000 person-years for the total population (137.6/100,000 in males and 403.6 per 100,000 in females). Comparison of cancer incidence rate between MS and general Belgrade population revealed lower risk for malignancy occurrence in the MS population in total (standardized incidence ratio, SIR = 0.58, 95% CI 0.16-1.49). Our findings demonstrate that MS patients in the Belgrade region have lower risk for the development of malignancy than age- and sex-matched general population.

Nötrofil lenfosit oranı: Papiller tiroit kanserini multinodüler guatrdan gerçekten ayırt eder mi?

Aim: The aim of this study is to reveal the value of preoperative neutrophil lymphocyte ratio in differential diagnosis between papillary thyroid carcinoma, papillary thyroid microcarcinoma and benign multinodular goiter. Materials and methods: Patients with papillary thyroid carcinoma, papillary thyroid microcarcinoma, and multinodular goiter whose histopathological diagnosis was confirmed by postoperative pathology reports were included in the study. Results: The TSH levels were statistically significantly different among the groups (p &amp;lt; 0.001). The intergroup comparison revealed that the TSH levels were significantly lower in the multinodular goiter group compared to the papillary thyroid carcinoma and papillary thyroid microcarcinoma groups (p &amp;lt; 0.001, p0.001). The mean neutrophil count was 4.98 ± 1.19 in the papillary thyroid carcinoma group, 4.68 ± 1.33 in the papillary thyroid microcarcinoma group, and 4.59 ± 1.40 in the multinodular goiter group. The neutrophil counts of the groups were found to be significantly different (p = 0.013). The papillary thyroid carcinoma group had a significantly higher neutrophil count than the multinodular goiter group. The mean Neutrophil lymphocyte ratio value was 2.20 ± 0.71 in the papillary thyroid carcinoma group and 2.02 ± 0.92 in the multinodular goiter group. Neutrophil lymphocyte ratio values were significantly higher in the the papillary thyroid carcinoma group (p = 0.006). Conclucion: We believe that increased neutrophil lymphocyte ratio may be an indicator of underlying malignant disease in patients with thyroid nodules in the preoperative period.

Atypical vessels in hysteroscopy: Usefulness in prediction of malignant diseases in patients treated with tamoxifen.

Tamoxifen (TAM) is widely used in adjuvant endocrine therapy for invasive breast cancer as a selective estrogen modulator, but this treatment has a risk of developing endometrial malignancy. However, hysteroscopic findings during or after TAM treatment are unclear. The aim of this study is to examine the association between hysteroscopic patterns and malignant histological findings during or after treatment with TAM. The subjects were patients who received TAM after surgery for breast cancer and underwent hysteroscopy at our institution from January 2016 to December 2019. Clinicopathological factors and hysteroscopic findings were collected from medical records and investigated retrospectively. Histologically, atypical endometrial hyperplasia, endometrial cancer, and carcinosarcoma were classified as malignant diseases. A total of 26 patients were eligible for the study. Hysteroscopic findings included an irregular surface of the endometrium (n = 3, 11.5%), atypical vessels (n = 10, 38.5%), papillary structure (n = 3, 11.5%), and polypoid structure (n = 18, 69.2%). Histological examination revealed malignancy in six patients (23.0%). The percentage of atypical vessels in patients with malignancies was significantly higher than that in patients with a normal endometrium or benign lesion (100% vs. 20%, p = 0.0009). The sensitivity and specificity of atypical vessels in hysteroscopy for diagnosis of malignant diseases were 100% and 80%, respectively. Hysteroscopic findings of atypical vessels may be useful for prediction of malignant diseases in patients treated with TAM.

Incidence of Malignant Diseases in Punjab: A Retrospective Study in a Tertiary Level Government Hospital in Punjab

Introduction: Cancer is a grave problem with increase in incidence of various malignancies at an alarming rate in Punjab. Crude annual incidence rate of all cancers in Punjab has increased from 58.0 in 1990 to 85.5 in 2016 while crude mortality incidence ratio of all cancers in Punjab is 0.61 in females and 0.81 in males. Not only it is increasing mortality and morbidity, but it is also increasing the economic burden on a state already facing financial crisis. The exact burden of malignancies is not well known, although many local surveys have been done. Aim: To know the accurate burden of malignant diseases in patients presenting to a tertiary level government hospital in Punjab. Materials and Methods: A retrospective observational study in which data of all cases diagnosed to have malignant disease on histopathology at Government Medical College and Rajindra Hospital, Patiala, Punjab, from January, 2006 to December, 2015. The data was retrieved on yearly basis and total of each malignant disease was done to know the exact incidence of various malignancies over the decade by the measure of relative frequency. Results: A total of 4270 patients (41.65% in age group 41 to 70 years) were diagnosed to have malignant disease on histopathology out of which 2341 (54.82%) were females and 1929 (45.18%) were males. Leading causes of malignancy were the cancers of the f emale genital organs i.e., 20.05%, followed by breast cancer i.e., 1 8.17% and cancers of lip, oral cavity and pharynx i.e., 15.36%. Conclusions: Maximum incidence was seen in Carcinoma Breast followed by carcinoma cervix and carcinoma larynx. Early screening, timely diagnosis and management along with regular scrutiny of records should be done in routine to know the actual burden of cancer in the society.

Venous Thromboembolism: A First Sign of Malignant Disease

Venous thromboembolism (VTE) is commonly known to be associated with malignant disease; however, there is limited analysis of VTE as a first presenting indicator. The aim of our study was to evaluate the incidence and predictors of unrecognized malignant disease in patients presenting with VTE.

Opportunities for ovarian reserve preservation in the treatment of oncological diseases

This article presents the data of multi-year research on the problem of ovarian reserve preservation in cancer patients. The review includes 64 literary sources. The review provides the main methods for ovarian function preservation during the treatment of malignant diseases in patients of reproductive age. Given the increasing number of cancer patients in the group of patients of reproductive age, modern medicine is faced with the task not only to provide effective anticancer treatment, but also to try to preserve ovarian function in order to maintain hormonal levels and fertility. Unfortunately, most cancer treatment methods inhibit ovarian function. Thanks to modern approaches, there are medicinal methods for protecting against ovarian inhibition, which allows to maintain hormonal function and come back to solve reproductive problems after recovering from cancer.

Comparison of serum cancer antigen 125, human epididymis protein 4, ROMA, and CPH-I for diagnosis of ovarian cancer in Chinese patients with ovarian mass

To compare the performance of serum cancer antigen 125 (CA125), human epididymis protein 4 (HE4), Risk of Ovarian Malignancy Algorithm (ROMA) and Copenhagen index (CPH-I) for differential diagnosis of benign and malignant diseases in patients with ovarian mass. We retrospectively analyzed the data of 719 women with pelvic mass, and the performance of preoperative serum levels of CA125 and HE4, ROMA and CPH-I for differential diagnosis of the masses was compared. Of the 710 women analyzed, 531 were diagnosed with benign ovarian lesions, 44 with borderline ovarian tumors (BOTs), 119 with epithelial ovarian cancers (EOCs), and 25 with non-EOCs. In differentiating ovarian cancer (OC) and BOT from benign lesions, the area under the receiver-operator characteristic (ROC) curve (AUC) was 0.854 for HE4, 0.856 for ROMA, 0.854 for CPH-I, and 0.792 for CA125, demonstrating better diagnostic performance of HE4, ROMA, and CPH-I than CA125 alone; the diagnostic sensitivity was 56.9% for HE4, 70.2% for CA125, 69.1% for ROMA, and 63.8% for CPH-I; the specificity was the best with HE4 (94.4%) and CPH-I (94.7%). In sub-analysis of EOC vs benign lesions, the AUCs of HE4, ROMA, and CPH-I increased to 0.946, 0.947, and 0.943, respectively, all greater than that of CA125 (0.888). In other sub-analyses, HE4, ROMA, and CPH-I all showed greater AUCs than CA125 alone. This study confirms the accuracy of HE4, ROMA, and CPH-I for differentiating malignant from benign ovarian mass, and all these 3 tests show better performance than CA125. Furthermore, HE4 and CPH-I is superior to ROMA and CA125 in terms of specificity, while CA125 and ROMA have better diagnostic sensitivities.

Colonic Wall Thickening Reported in Abdominal CT: Does It Always Imply Malignancy?

Aim/Background Early diagnosis of patients with colon cancer is one of the most important parameters affecting the survival of patients. In this study, we aimed to examine the effect of the age, hemoglobin (Hb), albumin, neutrophil lymphocyte ratio (NLR), thrombocyte lymphocyte ratio (PLR), and mean platelet values (MPV) on the separation of benign and malignant diseases in patients with suspected colon wall thickness (CWT) observed in abdominal computed tomography (CT) examination. Method The study included 116 patients between the ages of 18 and 95 who had CT examination where the colon wall could be evaluated and who also had colonoscopy. Patients suspected for CWT in CT with difficulties in differential diagnosis were divided into two groups according to colonoscopic-histopathological evaluations. Normal or benign pathological causes were included in the first group, while malignant causes constituted the second group. Whether the two groups differed in terms of CWT, Hb, age, albumin, NLR, PLR, and MPV values was investigated with descriptive statistics. Results One hundred and sixteen patients (74 males, 42 females) with CT examinations and colonoscopic sampling were included in the study. After colonoscopic and histopathological evaluations, there were 64 cases in the first group and 52 in the second group. According to the results of the univariate analysis and multivariate logistic regression, CWT, Hb, NLR, and MPV were identified to be independent variables for determining colon cancer. Conclusion A combined evaluation of Hb, NLR, and MPV values in patients with CWT in abdominal CT examination may contribute to the separation of benign and malignant pathologies.

Prospective Study of the Utility of Computed Tomography Triage of Pleural Biopsy Strategies in Patients With Pleural Diseases.

This study aimed to prospectively evaluate the efficacy and reliability of a diagnostic workup, triaging pleural biopsy method according to baseline computerized tomography (CT) findings in the diagnosis of pleural diseases. Patients with pleural pathology were divided into 3 arms according to findings on CT scan images. Arm A: patients with pleural thickening/lesion in addition to pleural effusion. These patients underwent CT scan-guided Abrams' needle pleural biopsy. Arm B: patients with pleural effusion alone or suspected benign asbestos pleurisy. This group underwent medical thoracoscopy (MT). Arm C: patients with only pleural thickening. This group underwent ultrasonography-guided cutting needle pleural biopsy. MT was planned in patients who did not have a specific diagnosis in the CT scan-guided Abrams' needle pleural biopsy group. When patients with a histopathologic diagnosis of fibrinous pleuritis after MT were assessed in terms of the risk factors for malignant pleural diseases, we offered a further invasive procedure. A total of 164 patients were enrolled in the study. Diagnostic sensitivity after the initial procedure was 90.2% in Arm A, 93.3% in Arm B, 95.2% in Arm C, and 92.4% in the entire workup. The negative predictive value of the entire workup was 90.4% for malignant pleural mesothelioma, 97.1% for metastatic malignant pleural diseases, and 100% for tuberculous pleurisy. Five cases who had a diagnosis of fibrinous pleuritis after MT were detected to have risk factors, 4 of which (80%) indicated malignant disease. Complication rates were low and acceptable. Use of CT scans to triage an appropriate pleural biopsy method is associated with high diagnostic success. We recommend that the proposed diagnostic workup in this study may be used as a diagnostic algorithm for pleural diseases that require a histopathologic analysis. Determination of risk factors predicting malignant disease in patients where fibrinous pleuritis is reported after MT would be useful for clinical practice.

Bladder cancer stage-associated hub genes revealed by WGCNA co-expression network analysis

BackgroundBladder cancer was a malignant disease in patients, our research aimed at discovering the possible biomarkers for the diseases.ResultsThe gene chip GSE31684, including 93samples, was downloaded from the GEO datasets and co-expression network was constructed by the data. Molecular complex detection(MCODE) was used to identify hub genes. The most significant cluster including 16 genes: CDH11, COL3A1, COL6A3, COL5A1, AEBP1, COL1A2, NTM, COL11A1, THBS2, COL8A1, COL1A1, BGN, MMP2, PXDN, THY1, and TGFB1I1 was identified. After annotated by BiNGO, they were suggested associated with collagen fibril organization and blood vessel development. In addition, the Kaplan Meier curves were obtained by UALCAN. The high expression of THY1, AEBP1, CDH11, COL1A1, COL1A2, COL11A1, MMP2, PXDN, BGN, COL5A1, COL8A1, and TGFB1I1 indicated poor prognosis of the patients(P < 0.05). Finally, we examined genes’ expression between low and high tumor stage by the Wilcoxon test(P < 0.05), TGFB1I1 was excluded.ConclusionTHY1, AEBP1, CDH11, COL1A1, COL1A2, COL11A1, MMP2, PXDN, BGN, COL5A1, COL8A1 associated with the tumor stage as well as tumor patients’ prognosis. COL5A1, COL8A1(P < 0.01) may serve as therapeutic targets for the disease.

Distribution of malignant neoplasms among patients with endometriosis: an epidemiological study

Hypothesis/aims of study. The current analysis was undertaken to assess the incidence of malignant diseases in patients with endometriosis.&#x0D; Study design, materials and methods. This is a cohort study of women with surgically verified endometriosis retrieved from the Saint Petersburg 122 Clinical Hospital Discharge Register 1996–2006 (n = 1551). Data were linked to the Saint Petersburg Cancer Agency to identify cases of malignancy.&#x0D; Results. Malignant diseases were identified in 6.3% (n = 98) of cases. The median follow-up was 12.2 (7.5) years. Breast cancer (n = 29), ovarian cancer (n = 7), endometrial cancer (n = 7), thyroid cancer (n = 7), colorectal cancer (n = 6), melanoma (n = 6), non-Hodgkin’s lymphoma (n = 4), and glioblastoma (n = 3) were prevalent.&#x0D; Conclusion. The incidence of cancer in patients with endometriosis is low. Women with endometriosis have an increased risk of some malignancies, particularly ovarian cancer.

P271 Malignant diseases in patients treated at the CF Centre Innsbruck

P271 Malignant diseases in patients treated at the CF Centre Innsbruck

Comparison of ultrasound and fine needle aspiration biopsy in terms of determining of preoperative malignancy in thyroid nodules

To reveal the diagnostic efficacy and accuracy, compared with postoperative histopathological diagnosis, preoperative ultrasonography (US) and fine needle aspiration biopsy (FNAB) in determining benign and malignant disease in patients undergoing thyroidectomy in our clinic. Materials and methods: The research was designed with records of 95 patients who were examined thyroidectomy at our hospital Ear, Nose and Throat Clinic for five years. Preoperative ultrasound findings, FNAB results, postoperative histopathological findings, blood groups, age and sex were recorded. These data were each compared with the histopathological results in order to determine which technique was superior in distinguishing malignant from benign thyroid nodules. Ninety-five patients, aged between 21 and 76, 27 male and 68 female, were included. Mean age of male patients was 51.11±13.54 and mean age of female patients 49.18±11.92. Total thyroidectomy was performed in 82 (86.3%) cases, left lobectomy in 3 (3.2%), right lobectomy in 4 (4.2%) and total thyroidectomy plus neck dissection in 6 (6.3%). Of the cases thought to be benign at US, 76.4% were actually benign, and 83.33% of the cases thought to be malignant were actually malignant. The level of cases incorrectly identified as benign or malignant was 23.16%. Validity (test power) of US on the basis of postoperative diagnosis was 76.84%. In terms of FNAB findings, 27.78% of cases suspected of being malignant were malignant, and 72.73% of the group assessed as having benign cytology was actually benign. The level of cases incorrectly identified as being malignant or benign was 35.79%. FNAB test reliability (test power) on the basis of postoperative diagnosis was 56.1%. In addition, only US findings were significant when compared with histopathological findings in preoperative determination of malignant or benign disease (p=0.001), all other data being not significant (p˃0.05). The use of US findings in differentiating malignant from benign thyroid nodules and in accordingly planning treatment is more effective than use of FNAB.

Extensive screening for occult malignancy in unprovoked venous thromboembolism: A meta-analysis

BackgroundThe present meta-analysis aimed to evaluate the efficacy and sensitivity of an extensive screening strategy for occult malignant diseases in patients with unprovoked venous thromboembolism (VTE). MethodsWe conducted a systematic search of PubMed, Cochrane, EMBASE, and relevant article references. Meta-analysis was used to pool weighted relative risks (RR) for the rate of missed diagnosis, all-cause mortality, and cancer-related mortality. Heterogeneity test was performed using the inconsistency index. Furthermore, pooled analysis of the sensitivity and the proportion of false-positive findings of PET/CT were conducted. ResultsA total of 5 controlled studies were included with 1,115 and 1,159 unprovoked VTE patients receiving limited or extensive screening strategy, respectively. The risk of missed diagnosis (RR, 0.51; 95% CI, 0.20–1.28; P=0.15) was not significantly different between the limited and extensive screening group. Moreover, there was no statistically significant difference in all-cause mortality (RR, 0.86; 95% CI, 0.58–1.27; P=0.44) and cancer-related mortality (RR, 0.86; 95% CI, 0.46–1.62; P=0.65) between the two groups. The pooled sensitivity and proportion of false-positive findings of PET/CT as a screening tool for occult malignancy in patients with unprovoked VTE was 95% (95% CI, 38%–100%) and 33% (95% CI, 20%–47%), respectively. ConclusionsExtensive screening strategy did not show a clinically significant benefit over limited screening strategy. Considering the high cost and the additional physical and emotional harm, current evidence did not support extensive screening for each patient in the setting.

Risk of Cancer in Patients with Autoimmune Pancreatitis: A Single-Center Experience from Germany

Background/Aims: Autoimmune pancreatitis (AIP) has been associated with an increased risk of malignant diseases. We aimed to describe the incidence of malignant diseases in patients with AIP compared to the general population and to characterize the clinical presentation of these patients. Methods: We retrospectively analyzed data from 28 patients with AIP presenting to the clinic (periods 1998 until 2010, 2012 until September 2015). We retrieved the expected cancer incidence of the general population from the German cancer registry. We determined the ratio of patients with malignant disease, characterized the clinical presentation of these patients, and calculated standardized incidence ratios (SIR). Results: We observed 6 malignant diseases in 5 patients with AIP (non-Hodgkin lymphoma, colon cancer, breast cancer and ovarian carcinoma, breast cancer, bladder cancer, n = 5/28, 17.9%) during an overall observation period of 223 person-years (2,675 months). The overall SIR of cancer in patients with AIP was 17.3 (95% CI 5.9-35.8), and the overall incidence rate of malignant diseases in these patients was significantly increased compared to the expected incidence in the German population (Fisher's exact test, p < 0.001). Conclusion: The incidence of malignant diseases in patients with AIP is significantly increased compared to the general population. Careful clinical monitoring is required in individuals with AIP to exclude the occurrence of malignancy.

A prospective study on the characteristics and subjects of pediatric palliative care case management provided by a hospital based palliative care team

BackgroundCase management is a subject of interest within pediatric palliative care. Detailed descriptions of the content of this type of case management are lacking. We aim to describe the contents of care provided, utilization of different disciplines, and times of usage of a pediatric palliative care case management program compared for patients with malignant disease (MD) and non-malignant disease (NMD).MethodsA three-month prospective study, with questionnaires filled in by members of a pediatric palliative care team (PPCT) for each contact with parents.ResultsFour hundred fifty-five contacts took place with parents of 70 patients (27MD, 43NMD). Sixty-two percent of all contacts were with the specialized nurse. The child life specialists, psychologist and social worker were also regularly consulted, the chaplain was not consulted. Ninety-five percent of all contacts took place between 8 am and 6 pm during weekdays, a limited number between 6 pm and 9 pm. Twenty-five percent of all contacts were proactively initiated by the PPCT, 25 % were initiated by parents. In these care characteristics, no differences were seen for MD and NMD patients. Psychosocial topics were addressed most frequently. MD patients consulted the PPCT more often about school and NMD patients about socio-economic issues.ConclusionsAll different disciplines of the PPCT were regularly consulted, except for the chaplain. With an easy accessible team with a highly pro-active approach, availability from 8 am to 9 pm seems sufficient to accommodate patient’s and parent’s needs. More anticipation seems required for socio-economic topics. This insight in pediatric palliative case management can provide guidance in the development of a new PPCT.

Laparoscopic heminephrectomy for benign and malignant diseases of the horseshoe kidney.

In the current study, we present our pure laparoscopic heminephrectomy experience in 13 patients with horseshoe kidney (HK). A total of 13 patients with HK underwent pure laparoscopic heminephrectomy (Transperitoneal= 7, Retroperitoneal = 6) due to benign and malign renal conditions (non-functional hydronephrotic and/or infected kidney = 12, kidney mass = 1). The mean age of the patients was 45.8 years. The mean operating time was 140 minutes, and estimated blood loss was 131 ml. The mean hospital stay was 2.3 days. Division of istmus was performed with stapler in 5 patients, ultrasonic scalpel in 3, 15 mm Hem-o-lok clip in 3, 10 mm LigaSure vessel seal system in one and endoscopic suture by 0 polyglactin in one patient without bleeding. Twelve patients underwent pure laparoscopic heminephrectomy due to nonfunctional hydronephrotic and or infected kidney. One patient underwent transperitoneal laparoscopic right heminephrectomy due to kidney mass. According to modifies Clavien classification, Grade I complication (wound infection) occurred in one patient (7.7%) who underwent heminephrectomy due to non-functional kidney. Laparoscopic heminephrectomy seems to be technically feasible and safe for benign and malignant diseases in patients with HK.

Oral pathology in inflammatory bowel disease

The incidence of inflammatory bowel diseases (IBD) - Crohn's disease (CD) and ulcerative colitis (UC) - has been increasing on a global scale, and progressively, more gastroenterologists will be included in the diagnosis and treatment of IBD. Although IBD primarily affects the intestinal tract, extraintestinal manifestations of the disease are often apparent, including in the oral cavity, especially in CD. Specific oral manifestations in patients with CD are as follows: indurate mucosal tags, cobblestoning and mucogingivitis, deep linear ulcerations and lip swelling with vertical fissures. The most common non-specific manifestations, such as aphthous stomatitis and angular cheilitis, occur in both diseases, while pyostomatitis vegetans is more pronounced in patients with UC. Non-specific lesions in the oral cavity can also be the result of malnutrition and drugs. Malnutrition, followed by anemia and mineral and vitamin deficiency, affects the oral cavity and teeth. Furthermore, all of the drug classes that are applied to the treatment of inflammatory bowel diseases can lead to alterations in the oral cavity due to the direct toxic effects of the drugs on oral tissues, as well as indirect immunosuppressive effects with a risk of developing opportunistic infections or bone marrow suppression. There is a higher occurrence of malignant diseases in patients with IBD, which is related to the disease itself and to the IBD-related therapy with a possible oral pathology. Treatment of oral lesions includes treatment of the alterations in the oral cavity according to the etiology together with treatment of the primary intestinal disease, which requires adequate knowledge and a strong cooperation between gastroenterologists and specialists in oral medicine.