Ovarian Cancer: PCD and Brain Metastases

Paraneoplastic cerebellar degeneration (PCD), the one of the most common paraneoplastic syndromes, refer to clinical disorders associated mostly with lung, ovarian and breast cancer, but not directly caused by the cancer or its metastases. Pathologic finding is an extensive loss of Purkinje cells in the cerebellum. Immunohistocemicaly, the auto-antibodies on the Purkinje cells had been detected. Clinically, PCD is characterized by sub-acutely evolving pancerebellar symptoms. Neurological dysfunction may appear before the detection of the underlying cancer. Therefore, the surgical exploration is necessary for the final diagnosis. The patient undergoes specific therapy. Soon, neurological status of the patient gets irreparable worse. Death come usually 2–3 years after the first symptoms of the PCD occurs. Case of a 63-years old woman with PCD as the first evidence of her cancer is reported. The patient developed brain metastases and died almost 3 years after the first symptoms of PCD occur

CYFRA 21-1 Protein - a Potential Marker of Endometriosis

Endometrioza je kronična upalna bolest karakterizirana pojavom i rastom endometrija izvan maternice. Etiopatogeneza nije razjašnjena, a postoji više teorija nastanka endometrioze. Patološki procesi prisutni u endometriozi jesu adhezija, invazija, proliferacija, angiogeneza i promijenjena imunost. Moguće je da procesi invazije i proliferacije uzrokuju povećanu sintezu određenih proteina koji se zatim izlučuju urinom. Protein citokeratin 19-9 (CYFRA 21-1) pojačano se izlučuje u urinu pacijentica s endometriozom te je potencijalni marker u ranim stadijima ove bolesti kada nije moguće slikovnim metodama postaviti sumnju na bolest ili ciljanu dijagnozu.Endometriosis is a chronic gynaecological inflammatory disease characterized by the appearance and flourishing of endometrium outside the uterine cavity. The etiopathogenesis is not yet clearly understood. The ongoing pathologic processes are invasion, adhesion, proliferation, angiogenesis, and immune dysfunction. There is a possibility of increased production of proteins caused by proliferation and invasion, that are excreted in the urine. The protein CYFRA 21-1 shows increased production in endometriosis and is a potential marker in the early stages of this disease when it is not possible to suspect the disease or diagnose it with imaging techniques

CLINICAL RECOMMENDATIONS FOR DIAGNOSING, TREATMENT AND MONITORING OF PATIENTS WITH OVARIAN CANCER – CROATIAN ONCOLOGY SOCIETY AND CROATIAN SOCIETY FOR GYNECOLOGY AND OBSTETRICS AS CROATIAN MEDICAL ASSOCIATION UNITS AND CROATIAN SOCIETY OF GYNECOLOGICAL ONCOLOGY

Rak jajnika i jajovoda po učestalosti je peta zloćudna bolest žena u Hrvatskoj. Histološki je rak jajnika najčešće epitelnog podrijetla, i to seroznog podtipa. Rjeđi su različiti neepitelni malignomi jajnika, a posebnu skupinu čine epitelni karcinomi niskoga zloćudnog potencijala karakterizirani neinvazivnošću, klinički indolentnim tijekom i dobrom prognozom te primarni rak potrbušnice i rak jajovoda. Klinički su ovi zloćudni tumori u ranim stadijima razvoja uglavnom asimptomatski, zbog čega se najčešće dijagnosticiraju u kasnijim stadijima bolesti. Dijagnoza se potvrđuje patohistološkim nalazom, a iznimno citološkim nalazom nakon provedene dijagnostičke obrade. O liječenju odlučuje multidisciplinarni tim uzimajući u obzir dob, opće stanje i komorbiditete bolesnice, kao i obilježja samog tumora uključujući stadij bolesti, histološki tip i gradus tumora. Principi liječenja primarnog raka potrbušnice i jajovoda temelje se na principima liječenja epitelnog raka jajnika koji obuhvaćaju primjenu kirurških zahvata, kemoterapije, imunoterapije i hormonske terapije, kao i suportivno-simptomatskih mjera tijekom cijelog liječenja. Razlikuje se terapijski pristup rjeđim, neepitelnim histološkim tipovima tumora koji se češće dijagnosticiraju u ranim stadijima bolesti, imaju indolentniji tijek pa se kod ovih bolesnica češće primjenjuju poštedni kirurški zahvati s ciljem očuvanja plodnosti. U tekstu koji slijedi predstavljene su kliničke upute s ciljem standardizacije postupaka i kriterija postavljanja dijagnoze, liječenja te praćenja bolesnica s rakom jajnika, jajovoda i potrbušnice u Republici Hrvatskoj.Ovarian cancer together with fallopian tube represents the fifth most common female cancer in the Republic of Croatia. Epithelial ovarian cancer, serous subtype, encompasses most of malignant ovarian neoplasms. Less common are various non-epithelial ovarian malignancies. A special group consists of epithelial carcinomas of low malignant potential with clinically indolent flow, good prognosis and no invasion, and primary cancer of the peritoneum and fallopian tube cancer. Clinically, these malignant tumors are generally asymptomatic in early stages, and usually diagnosed in advanced stages. The diagnosis is confirmed by pathological examination, and occasionally, cytological findings after completing diagnostic procedures. Multidisciplinary team makes treatment decisions, taking into account age, general condition and comorbidities of the patient and characteristics of the tumor itself, including disease stage, histological type and grade of the tumor. The principles of treatment of primary peritoneal and fallopian tube cancer are based on the principles of treatment of epithelial ovarian cancer involving surgery, chemotherapy, immune and hormone therapy, and symptomatic-supportive care throughout the treatment. Less common histological types have a different treatment approach being more frequently diagnosed in the early stages of the disease, have more indolent flow, so in these patients conservative surgeries with the goal of preserving fertility are more often employed. The following text presents the clinical guidelines in order to standardize the procedures and criteria for the diagnosis, management, treatment and monitoring of patients with ovarian carcinoma, fallopian tube and primary peritoneal cancer in the Republic of Croatia

CLINICAL RECOMMENDATIONS FOR DIAGNOSING, TREATMENT AND MONITORING OF PATIENTS WITH UTERINE CERVICAL CANCER – CROATIAN ONCOLOGY SOCIETY AND CROATIAN SOCIETY FOR GYNECOLOGY AND OBSTETRICS AS CROATIAN MEDICAL ASSOCIATION UNITS AND CROATIAN SOCIETY OF GYNECOLOGICAL ONCOLOGY

Rak vrata maternice, u odnosu na malignome drugih ginekoloških sijela, jest bolest mlađih žena koja se može redovitim kontrolama i zdravstvenim odgojem prevenirati, a u slučaju pojave bolesti učinkovito liječiti. Metode liječenja uključuju kirurgiju, radioterapiju i kemoterapiju, ovisno o stadiju bolesti i općem stanju bolesnica. Odluku o liječenju donosi multidisciplinarni tim. S obzirom na važnost ove bolesti, potrebno je definirati i provoditi standardizirani pristup u dijagnostici, liječenju i praćenju ovih bolesnica. U tekstu koji slijedi iznesene su kliničke smjernice s ciljem implementacije standardiziranih postupaka u radu s bolesnicama s rakom vrata maternice u Republici Hrvatskoj.Cervical cancer, in comparison with other gynecological malignancies, mainly affects younger women. It can be prevented trough educational programs, screening and early detection. It also can be efficiently treated when it appears. Treatment modalities include surgery, chemotherapy and radiotherapy, according to the stage of the disease and patient condition. Treatment decisions should be made after multidisciplinary team discussion. Due to the significance of this disease it is important to define and implement standardized approach for diagnostic, treatment and monitoring algorithm as well. The following text presents the clinical guidelines in order to standardize the procedures and criteria for the diagnosis, management, treatment and monitoring of patients with uterine cervical cancer in the Republic of Croatia

CLINICAL RECOMMENDATIONS FOR DIAGNOSING, TREATMENT AND MONITORING OF PATIENTS WITH ENDOMETRIAL CANCER – CROATIAN ONCOLOGY SOCIETY AND CROATIAN SOCIETY FOR GYNECOLOGY AND OBSTETRICS AS CROATIAN MEDICAL ASSOCIATION UNITS AND CROATIAN SOCIETY OF GYNECOLOGICAL ONCOLOGY

Rak trupa maternice javlja se u većini slučajeva u poslijemenopauzalnih žena, a najčešće se očituje ginekološkim krvarenjem. Nakon raka jajnika i vrata maternice treći je uzrok smrti žena od raka spolnog sustava. Dijagnoza se postavlja patohistološkim pregledom kiretmana ili bioptata, a definitivni stadij bolesti utvrđuje se analizom uzoraka dobivenih histerektomijom i obostranom salpingoovariektomijom sa zdjeličnom i paraaortalnom limfadenektomijom. U tekstu koji slijedi sadržane su kliničke upute s ciljem standardizacije postupaka i kriterija postavljanja dijagnoze, liječenja i praćenja bolesnica s rakom trupa maternice u Republici Hrvatskoj.Uterine cancer occurs mainly in postmenopausal women, usually as vaginal bleeding. Following ovarian and cervical cancer it is the third most common cause of female reproductive system cancer death. Diagnosis is set by analyzing samples obtained via hysterectomy with salpingo-oophorectomy and pelvic / paraaortal lymphadenectomy. The following text presents the clinical guidelines in order to standardize the procedures and criteria for the diagnosis, treatment and monitoring of patients with uterine cancer in the Republic of Croatia

Laporovaginal surgery in cervical cancer: a Croatian experience

With correct staging a large number of patients with cervical cancer FIGO stages IA2 and IB can be spared of unnecessary radiation therapy by laparoscopic assisted vaginal radical hysterectomy (LAVRH) as an option of radical surgical treatment in such patients. The development of laparovaginal surgery, indication and contraindication were presented. Also, the surgical technique was described in detail. Fifty-two patients were followed up in 2003 after LAVRH or open surgery, performed in our single center. Only 5 (14%) patients died from cervical cancer within 3 years following the treatment. They were all clinical stage IB treated with open surgery. There were 4 (11%) complications following treatment and they were all in patients with clinical stage IB, also treated with open surgery. There was no complication in LAVRH treated patients. The results and complications of the sole Croatian center performing LAVRH or open surgery in patients with cervical cancer FIGO stages IA and IB were similar to those in centers across the world

Proteins in urine – Possible biomarkers of endometriosis

In the pathogenesis of endometriosis, a number of pathological reactions occur. Proteins secreted in the urine are thought to interact with each other and stimulate the pathological processes in endometriosis. Identifying one or more proteins that are specific enough and could serve as biomarkers for endometriosis is both a challenge and a necessity that would facilitate diagnosis. The urine of patients treated in a tertiary university hospital between July 1, 2020 and June 30, 2021 was analyzed. The studied group consists of patients who were treated surgically for endometriosis and in whom the diagnosis was confirmed by pathohistological analysis. The control group consists of patients who were operated for functional ovarian cysts. Urinary proteins were analyzed by chromatography and mass spectrometry (LC-MS/MS). We identified 17 proteins in urine whose concentrations were statistically significantly different in the group with endometriosis (N = 16) compared with the control groups (N = 16). The detected proteins were classified into groups according to their function in invasion, migration and proliferation, proteolysis, immune system, cell adhesion and vascular system. For all mentioned proteins the difference in concentration is statistically significant p < 0.005. Proteins are secreted in the urine of patients with endometriosis that may be involved in the pathogenesis of the disease and are possible biomarkers for endometriosis

Kliničke upute za dijagnostiku, liječenje i praćenje bolesnica oboljelih od raka jajnika Hrvatskoga onkološkog društva i Hrvatskog društva za ginekologiju i opstetriciju Hrvatskoga liječničkog zbora te Hrvatskoga ginekološkoonkološkog društva [Clinical recommendations for diagnosing, treatment and monitoring of patients with ovarian cancer - Croatian Oncology Society and Croatian Society for Gynecology and Obstetrics as Croatian Medical Association units and Croatian Society of Gynecological Oncology]

Ovarian cancer together with fallopian tube represents the fifth most common female cancer in the Republic of Croatia. Epithelial ovarian cancer, serous subtype, encompasses most of malignant ovarian neoplasms. Less common are various non-epithelial ovarian malignancies. A special group consists of epithelial carcinomas of low malignant potential with clinically indolent flow, good prognosis and no invasion, and primary cancer of the peritoneum and fallopian tube cancer. Clinically, these malignant tumors are generally asymptomatic in early stages, and usually diagnosed in advanced stages. The diagnosis is confirmed by pathological examination, and occasionally, cytological findings after completing diagnostic procedures. Multidisciplinary team makes treatment decisions, taking into account age, general condition and comorbidities of the patient and characteristics of the tumor itself, including disease stage, histological type and grade of the tumor. The principles of treatment of primary peritoneal and fallopian tube cancer are based on the principles of treatment of epithelial ovarian cancer involving surgery, chemotherapy, immune and hormone therapy, and symptomatic-supportive care throughout the treatment. Less common histological types have a different treatment approach being more frequently diagnosed in the early stages of the disease, have more indolent flow, so in these patients conservative surgeries with the goal of preserving fertility are more often employed. The following text presents the clinical guidelines in order to standardize the procedures and criteria for the diagnosis, management, treatment and monitoring of patients with ovarian carcinoma, fallopian tube and primary peritoneal cancer in the Republic of Croatia

Suor Angelica et autres sœurs (komorni ansambl i solisti Muzičke akademije u Zagrebu, 12.2.2021.)

Snimka izvedbe održane na Muzičkoj akademiji u Koncertnoj dvorani "Blagoje Bersa" 12.2.2021. Na projektu postavljanja opere sudjelovale su četiri sastavnice Sveučilišta u Zagrebu: Muzička akademija, Akademija dramske umjetnosti, Akademija likovnih umjetnosti i Fakultet strojarstva i brodogradnje. Izvođači: studenti solo pjevanja: Nela Katalenić Klinar, Lucija Ercegovac, Emilija Rukavina, Tea Zec, Maja Sremec, Neža Vasle, Martina Barišić, Stefani Pijetlović, Darija Auguštan, Laura Marincel Haller, Josipa Bilić, Barbara Pijetlović, Marija Jurić; komorni ansambl: Barbara Tomić (flauta, piccolo), Andrea Pedron (udaraljke), Petra Barišić (harfa), Ellen Široka (harfa), Dubravko Ćepulić Polgar (orgulje), Ivana Hrkać (pozitiv), Marko Glogović (violina), Edita Kolovrat (violina), Filip Kojundžić (viola), Lana-Lucija Horvatić (violončelo); umjetničko vodstvo: Mladen Tarbuk; dirigent: Mateo Narančić; redatelj: Matthias Behrends. Program: Suor Angelica et autres sœurs, pasticcio-opera sastavljena od glazbe skladatelja različitih stilskih razdoblja (Puccini, Poulenc, Mozart, Barber, Klose, Hindemith, Hildegard von Bingen, Caplet, Tarbuk, Ravel) prema romanu Veronike Peters "Što sve stane u dva kofera"

Suor Angelica et autres sœurs (komorni ansambl i solisti Muzičke akademije Sveučilišta u Zagrebu, 10. 2. 2021.)

Snimka premijere pasticcio-opere održane na Muzičkoj akademiji u Koncertnoj dvorani "Blagoje Bersa" 10. 2. 2021. Na projektu postavljanja opere sudjelovale su četiri sastavnice Sveučilišta u Zagrebu: Muzička akademija, Akademija dramske umjetnosti, Akademija likovnih umjetnosti i Fakultet strojarstva i brodogradnje. Izvođači: studenti solo pjevanja (Nela Katalenić Klinar, Lucija Ercegovac, Emilia Rukavina, Tea Zec, Maja Sremec, Neža Vasle, Martina Barišić, Stefani Pijetlović, Darija Auguštan, Laura Marincel Haller, Josipa Bilić, Barbara Pijetlović, Marija Jurić), komorni ansambl (Barbara Tomić (flauta, piccolo), Andrea Pedron (udaraljke), Petra Barišić (harfa), Ellen Široka (harfa), Dubravko Ćepulić Polgar (orgulje), Ivana Hrkać (pozitiv), Marko Glogović (violina), Edita Kolovrat (violina), Filip Kojundžić (viola), Lana-Lucija Horvatić (violončelo)). Umjetničko vodstvo: red. prof. art. Mladen Tarbuk. Dirigent: Pavle Zajcev. Redatelj: Matthias Behrends. Program: Suor Angelica et autres sœurs, pasticcio-opera sastavljena od glazbe skladatelja različitih stilskih razdoblja (Puccini, Poulenc, Mozart, Barber, Klose, Hindemith, Hildegard von Bingen, Caplet, Tarbuk, Ravel) prema romanu Veronike Peters "Što sve stane u dva kofera"