PubMed Health⌕ Search

Biomedical subjects

J Fortuna

Publications and source records attributed to J Fortuna.

4 recordsLinked to original sources
PubMed2001

[Should cervical lymph nodes be electively removed in differentiated thyroid carcinoma?].

Differentiated thyroid carcinomas (DTC; papillary and follicular) constitute merely 0.5-1% of all malignancies in the world. The proper extent of their surgical resection has been discussed for many years. Two different approaches predominate in the literature. One group claims, that elective, modified radical neck dissection (MRND) should be performed. That strategy is supported by high frequency (80%) of observed "occult", clinically not evident, micrometastases in regional lymph nodes on the neck. On the other hand, there have been no studies so far which would unquestionably confirm the prognostic value of neck lymph node involvement in DTC, or the favorable influence of elective lymph node dissection on long-term survival. Therefore, other authors do not recommend prophylactic lateral neck dissection. MRND, apart from its doubtful influence on prognosis, is connected with a higher complication rate and longer hospitalization. The authors of this review also share this opinion.

Adenocarcinoma, Follicular↗
PubMed2000

Male breast cancer. Does the prognosis differ compared to female?

Due to the low incidence of breast cancer in males there are not many reports in the literature. In this study we analyzed results of treatment in 65 breast cancer males, who had been treated in one institution. Radical surgery was performed in 45 patients. Lymph node metastases were found in 25 patients (55.5%), the tumor was usually moderately differentiated (21 pts - 46.7%). Median survival after radical surgery was 73 months compared to 38 months for nonsurgical patients (p < 0.0001). In the group of males after radical surgery the results of 5-, 10- and 15-year survival rates were 69.8, 59.7 and 31.3% respectively. Comparable analysis of two subgroups of patients with favorable (T1 or T2, N0, grade I or II) and unfavorable (T3 or N+ or grade III) prognostic factors was also performed. In the first subgroup the 5-, 10- and 15-year survival rates were 90, 77.4 and 62%, compared to 61.8, 23.1 and 23. 1% for the second subgroup. The multivariate analysis showed grading and node status as the strongest parameters influencing survival. Relative risk of death was over 3 times higher for nodal metastases and near 3 times higher for high grade carcinomas (p < 0.01), compared to patients without metastases and low grade of tumor. Similar analysis was performed when 45 males were compared to 500 selected women, with similar clinical parameters (age, node status, grading). Again, data indicated grading and lymph node status as the strongest prognostic factors. It was not unlikely, that gender had some influence on prognosis, when relative risk of death for males was over 1.5 times higher than for females, but this result was not clearly significant (p < 0.1 ). The question, whether male breast cancer prognosis is worse then in female remains open. Multiinstitutional prospective studies are needed in this area.

Adult↗
PubMed1995

[Muscular diseases in hyperthyroidism].

Hyperthyroidism may present various muscular diseases, namely thyrotoxic chronic myopathy, myasthenia gravis, disthyroid ophthalmopathy and thyrotoxic periodic paralysis. Although infrequent, it is possible to find some of these clinical situations in a medical ward of a general hospital. Differential diagnosis must be made with chronic idiopathic polymyositis and certain congenital myopathies. We describe three patients with hyperthyroidism; one of these patients had chronic thyrotoxic myopathy and another had myasthenia gravis. The third had a thymolipoma and ocular changes probably corresponding to myasthenia gravis.

Adult↗