Apocrine Carcinoma of the Scalp with Aggressive Clinical Course – A Case Report and Review of the Literature

Primary cutaneus apocrine carcinoma is a rare malignancy with about 50 cases reported in the literature. Axilla is the most common site of occurrence, but locations like scalp, anogenital region, ear canal, chest, wrist, finger and eyelid have been described. The neoplasm presents itself as an asymptomatic, slow-growing, solid or cystic mass that varies in color. Most patients have a history of a long-standing neoplasm before the diagnosis is made. The disease is considered to have an indolent clinical course with favorable outcome although more than half of reported patients had regional lymph node metastases at the time of diagnosis. Systemic dissemination to lung, bones, liver and brain is extremely rare with only 14 cases documented in the literature. Wide surgical excision with lymph node dissection upon confirmation of the lymph node metastases remains the only curable treatment. Care and management of the disseminated disease is still challenging. We report a case of a 65-year-old woman with a very aggressive apocrine carcinoma of the scalp prone to local recurrence and distant metastases to lung and bones

Retrospective study of the incidence and outcomes of sepsis in a Center

Background: sepsis is the common cause of death in immunocompromised patients and those suffering from malignant diseases. The mortality can be significantly reduced when early and correct diagnosis is given and the appropriate therapy is administered. Here we set to determine the incidence, sources and outcomes of sepsis and to resolve which bacteria, based on Gram staining, are more often the cause of sepsis. Patients and methods: we conducted a retrospective study of medical history in a two-year period, from April 2014 to April 2016. Diagnosis was given based on patients’ blood culture findings or their clinical presentation. Results: during a two-year period 1663 patients were treated. Sepsis was diagnosed in 35 patients (2.10%). The median age was 73 years and 22 patients (63%) were male. Sepsis was the primary cause of death in 10 patients (29%). Gram-positive bacteria were isolated in 21 patients (60%), and Gram-negative bacteria in 10 patients (31%). Conclusion: in our retrospective study, the gastrointestinal tract had the highest frequency of identified sepsis source. The incidence of sepsis caused by Gram-positive bacteria found in blood cultures was higher than by Gram-negative bacteria. However, due to small sample size, no difference in mortality was found based on Gram status

Mjesto i važnost nekliničkih bolničkih centara u liječenju bolesnika sa zloćudnim bolestima u Republici Hrvatskoj

Onkologija predstavlja važan segment sveukupnoga hrvatskoga zdravstvenog sustava. Sama onkologija jedna je od trenutačno najpropulzivnijih medicinskih struka te smo svakodnevno svjedoci ekspanzivnog rasta novih modaliteta onkološkog liječenja. Ove činjenice nameću imperativ stvaranja onkološke mreže koja bi kao zadatak imala standardiziranje onkološkog liječenja i osiguravanje dostupnosti novih modaliteta liječenja za sve oboljele od zloćudnih bolesti, neovisno o njihovom mjestu boravka.¹ Hrvatska već ima prepoznate i definirane regionalne onkološke centre u sklopu kliničkih bolničkih centara u Zagrebu, Rijeci, Osijeku i Splitu. Nasreću, u Hrvatskoj postoji tradicija, stara nekoliko desetljeća, razvoja onkoloških centara u općim i županijskim bolnicama. Poimence, to su neklinički onkološki centri u Županijskoj bolnici Čakovec, Općoj bolnici Dubrovnik, Općoj bolnici Karlovac, Općoj bolnici Koprivnica, Općoj bolnici Pula, Općoj bolnici Slavonski Brod, Općoj bolnici Šibenik, Općoj bolnici Varaždin i Općoj bolnici Zadar. Svrha ovoga istraživanja, provedenog u svim nekliničkim onkološkim centrima Hrvatske te korištenjem podataka Državnog zavoda za statistiku i Hrvatskog zavoda za zdravstveno osiguranje, bila je uvidjeti kako je trenutno organizirana onkološka skrb u Republici Hrvatskoj i koja je uloga nekliničkih onkoloških centara u liječenju bolesnika sa zloćudnim bolestima u Republici Hrvatskoj

Impact of the coronavirus disease pandemic on cancer care in Croatia: a multicentre cross-sectional study

Purpose: The coronavirus disease (COVID-19) pandemic has greatly affected the oncology community worldwide. Lockdowns, an epidemiological measure, have made it difficult for oncologists to provide care. In this study, we analysed the impact of the COVID-19 pandemic on Croatian cancer care. ----- Methods: This was a multicentre cross-sectional observational study of 422 patients who received systemic oncology therapy during the pandemic. The patients completed a survey to capture their views on the impact of the COVID-19 pandemic on their cancer care. Univariate descriptive and bivariate analyses were performed to analyse the relationship between the patients' perspective on the impact of the COVID-19 pandemic on cancer care and the quality of Croatian cancer care and their clinical and sociodemographic data. ----- Results: Discontinuation or change in cancer treatment during the COVID-19 pandemic was observed in 10.2% of cases. Most did not change their place of treatment owing to the lockdown (97.6%). 14.7% of the patients felt that the quality of cancer care received had changed during the pandemic. ----- Conclusions: In the first few months of the pandemic, Croatia had a favourable epidemiological situation. However, 25% of patients with cancer reported that the pandemic affected cancer treatment and the quality of cancer care