Važnost rekonstrukcijske kirurgije kod bolesnica s rakom dojke

Breast cancer is the most common cancer in women in Croatia. Thanks to modern diagnostics and national program of early detection of breast cancer, tumors today are diagnosed in earlier stage, which has favorable effect on the prognosis of disease, but also on the possibilities of surgical treatment. Surgical treatment of breast cancer is progressing rapidly, from breast conserving surgical procedures to skin sparing mastectomies and primary reconstruction of removed breast which became the standard of modern surgical treatment. Apart from the primary reconstruction, patients are offered the opportunity of secondary reconstruction. In patients with early breast cancer (T1 and T2 stage), skin sparing mastectomy followed with breast reconstruction is a safe method from oncologic viewpoint and from the aspect of patient, it reduces psychological trauma that is associated with removal of the entire breast (feeling of mutilation, depression, decreased sexuality). This method also gives plastic surgeons ability to achieve excellent aesthetic appearance of new breast.Rak dojke najčešći je rak u žena u Hrvatskoj. Zahvaljujući suvremenoj dijagnostici i nacionalnom probiru u mogućnosti smo otkrivati rak dojke u ranijoj fazi. Važnost rane dijagnostike povoljno utječe ne samo na prognozu bolesti, već i na mogućnost odabira optimalnog kirurškog zahvata s kojim i počinje liječenje u žena s rakom dojke. Od kirurških zahvata u obzir dolaze poštedni zahvati na dojci, od mastektomije s poštedom kože i primarnom rekonstrukcijom do sekundarnih rekonstrukcija. U svih bolesnica s T1 i T2 tumorom, mastektomija s poštedom kože i primarnom rekonstrukcijom kirurški je postupak koji nudi jednaku onkološku sigurnost kao i standardna mastektomija, a nakon primarne rekonstrukcije u bolesnica se umanjuje psihološka trauma, koje tim zahvatom ne gube osjećaj ženstvenosti. ženama se također vraća povjerenje u vlastito tijelo, a samim time i odnos prema partneru te drugima u zajednici

Važnost ranog otkrivanja raka dojke u očuvanju psihičkog i tjelesnog integriteta žene

Breast cancer remains a major public health problem in the entire developed world. The first and the biggest reason is an ever increasing number of breast cancer diagnoses and consistently high mortality from this disease. Due to the continuous improvement of standard methods and introduction of new diagnostic tests breast cancer can be detected at an early stage, when a high percentage of cases are likely to be successfully treated and/or cured. One of many different types of surgery is usually the first step in treating breast cancer. Each in their own way affects woman’s quality of life. Efforts should be made to detect breast cancer as early as possible to entirely avoid some of the treatment modalities and thus significantly improve woman’s quality of life in all its aspects.Rak dojke i dalje ostaje velik javnozdravstveni problem u cijelom razvijenom svijetu. Prvi i najveći razlog svakako je sve veći broj oboljelih žena i konstantno visoka smrtnost od ove bolesti. Zahvaljujući stalnom usavršavanju standardnih te uvo|enju novih dijagnostičkih metoda rak dojke moguće je otkriti u najranijoj fazi kada je bolest u visokom postotku uspješno liječiva i/ili izlječiva. Prvi korak u liječenju raka dojke najčešće je jedan od više tipova operativnih zahvata. Svaki od njih na svoj način utječe na kvalitetu života žene. Rak dojke treba nastojati što ranije otkriti kako bi se neki od modaliteta liječenja u cijelosti izbjegli što značajno podiže kvalitetu života žene u svim njegovim aspektima

Važnost rekonstrukcijske kirurgije kod bolesnica s rakom dojke

Breast cancer is the most common cancer in women in Croatia. Thanks to modern diagnostics and national program of early detection of breast cancer, tumors today are diagnosed in earlier stage, which has favorable effect on the prognosis of disease, but also on the possibilities of surgical treatment. Surgical treatment of breast cancer is progressing rapidly, from breast conserving surgical procedures to skin sparing mastectomies and primary reconstruction of removed breast which became the standard of modern surgical treatment. Apart from the primary reconstruction, patients are offered the opportunity of secondary reconstruction. In patients with early breast cancer (T1 and T2 stage), skin sparing mastectomy followed with breast reconstruction is a safe method from oncologic viewpoint and from the aspect of patient, it reduces psychological trauma that is associated with removal of the entire breast (feeling of mutilation, depression, decreased sexuality). This method also gives plastic surgeons ability to achieve excellent aesthetic appearance of new breast.Rak dojke najčešći je rak u žena u Hrvatskoj. Zahvaljujući suvremenoj dijagnostici i nacionalnom probiru u mogućnosti smo otkrivati rak dojke u ranijoj fazi. Važnost rane dijagnostike povoljno utječe ne samo na prognozu bolesti, već i na mogućnost odabira optimalnog kirurškog zahvata s kojim i počinje liječenje u žena s rakom dojke. Od kirurških zahvata u obzir dolaze poštedni zahvati na dojci, od mastektomije s poštedom kože i primarnom rekonstrukcijom do sekundarnih rekonstrukcija. U svih bolesnica s T1 i T2 tumorom, mastektomija s poštedom kože i primarnom rekonstrukcijom kirurški je postupak koji nudi jednaku onkološku sigurnost kao i standardna mastektomija, a nakon primarne rekonstrukcije u bolesnica se umanjuje psihološka trauma, koje tim zahvatom ne gube osjećaj ženstvenosti. ženama se također vraća povjerenje u vlastito tijelo, a samim time i odnos prema partneru te drugima u zajednici

Psihosocijalna onkologija, sofrologija i komplementarne suportivne terapije

Modern approaches to psychosocial oncology and sophrology are shown through reflections on sickness and health, body and spirituality, and existential issues faced by patients and medical and other professionals engaged in different areas of treatment, rehabilitation and palliative care. Modern complementary methods that can be implemented in education, treatment and rehabilitation of cancer patients are discussed in the framework of the deep ecological and holistic approach to health care, based on the principles of complementarity and interdisciplinarity.Kroz promišljanja o bolesti i zdravlju; o tijelu i duhovnosti; o egzistencijalnim pitanjima s kojima se suočavaju i pacijenti i stručnjaci iz medicinskih i drugih disciplina koji se bave različitim područjima liječenja; rehabilitacije i palijativne skrbi; prikazani su suvremeni pristupi u području psihosocijalne onkologije i sofrologije. U okviru dubinsko-ekološkog i holističkog pristupa u zdravstvenoj skrbi; na načelima interdisciplinarnosti i komplementarnosti; prikazan je i pregled nekih suvremenih komplementarnih metoda koje mogu biti primijenjene u edukaciji; liječenju i rehabilitaciji oboljelih od raka

Vrijednosti pojedinih dijagnostičkih metoda u otkrivanju patoloških promjena u dojci

For diagnosing pathologic changes in the breast, depending on age, clinical examination combined with ultrasound, mammography and cytology are most commonly used. Any positive finding requires a biopsy for a final diagnosis. The biopsy precedes surgical treatment usually performed during the same operative session. To assess the value of some diagnostic methods for detection of pathologic breast changes a retrospective study was carried out on a sample of 78 patients diagnosed and treated at the Eljuga Polyclinic from March 1999 to March 2003. In diagnosing for pathohistologic changes, the aforementioned methods were applied in all of the 78 studied patients (aged 23-77). The patients were assigned to two age groups including patients over 35 (mean age 49) and under 35 yrs of age (mean age 29), respectively. The first group was further divided into 6 subgroups, depending on the correlation between a particular diagnostic method and final pathohistologic finding. The correspondence between pathohistologic finding and all other diagnostic procedures was as follows: clinical examination, US, mammography and cytological analysis showed accuracy in 92.30% (72/78), 96.15% (75/78), 92.53% (62/67, excluding 11 patients <35 yrs not requiring mammography – benign changes), and 84.62 % (64/73, technically failed samples excluded) of the cases, respectively. Ultrasound breast imaging demonstrated superior accuracy over mammography, clinical examination and cytologic puncture. The results lead to the conclusion that in the majority of breast patients, a combination of several diagnostic methods should be used to get an accurate diagnosis.U dijagnosticiranju patoloških promjena u dojci, ovisno o dobi, najčešće se primjenjuju klinički i ultrazvučni pregled, mamografija i citološka analiza. Pozitivan nalaz bilo koje od tih metoda pretrage indicira biopsiju kao konačnu dijagnostičku metodu. Ona prethodi kirurškom liječenju i najčešće se vrši u istom aktu s operacijom. U svrhu procjene vrijednosti pojedinih dijagnostičkih metoda u otkrivanju patoloških promjena u dojci, provedena je retrospektivna studija na uzorku od 78 bolesnica, podvrgnutih dijagnosticiranju i liječenju promjena u dojci u Poliklinici "Eljuga" u razdoblju između ožujka 1999. i ožujka 2003. U svih 78 bolesnica (u dobi između 23 i 77 godina) u postupku dijagnosticiranja patoloških promjena u dojci primjenjivane su sve navedene dijagnostičke metode. Bolesnice su podijeljene u dvije dobne skupine: one starije od 35g. (prosječne dobi od 49 godina) i one mlađe od 35g. (prosječne dobi od 29 godina). Prva skupina bolesnica podijeljena je u daljnjih 6 podskupina, ovisno o korelaciji između pojedinih dijagnostičkih metoda i konačnog patohistološkog nalaza. Podudarnost patohistološkog nalaza i svih drugih dijagnostičkih postupaka bila je sljedeća: klinički pregled pokazao se točnim u 92,30 % ( 72/78 ) bolesnica, UZV u 96,15 % ( 75/78 ), mamografija u 92,53 % ( 62/ 67, izuzeto 11 bolesnica <35 god. kojima nije bila potrebna mamografija-benigne promjene), a citološka analiza u 84,62 % bolesnica ( 64/73, s izuzetkom tehnički neuspjelih uzoraka). Najtočnijom metodom pokazao se UZV pregled dojki, kojeg slijede mamografija, klinički pregled, te citološka punkcija. Rezultati nameću zaključak, da kod većine bolesnica samo kombinacija više dijagnostičkih metoda može dovesti do ispravne dijagnoze

Psihosocijalna onkologija, sofrologija i komplementarne suportivne terapije

Modern approaches to psychosocial oncology and sophrology are shown through reflections on sickness and health, body and spirituality, and existential issues faced by patients and medical and other professionals engaged in different areas of treatment, rehabilitation and palliative care. Modern complementary methods that can be implemented in education, treatment and rehabilitation of cancer patients are discussed in the framework of the deep ecological and holistic approach to health care, based on the principles of complementarity and interdisciplinarity.Kroz promišljanja o bolesti i zdravlju; o tijelu i duhovnosti; o egzistencijalnim pitanjima s kojima se suočavaju i pacijenti i stručnjaci iz medicinskih i drugih disciplina koji se bave različitim područjima liječenja; rehabilitacije i palijativne skrbi; prikazani su suvremeni pristupi u području psihosocijalne onkologije i sofrologije. U okviru dubinsko-ekološkog i holističkog pristupa u zdravstvenoj skrbi; na načelima interdisciplinarnosti i komplementarnosti; prikazan je i pregled nekih suvremenih komplementarnih metoda koje mogu biti primijenjene u edukaciji; liječenju i rehabilitaciji oboljelih od raka

Intake of carbohydrates and incidence of gestotis in pregnant women in the Osijek city area

Trudnoća je najvažniji period u životu svake žene praćen brojnim fiziološkim promjenama, tijekom kojeg treba posebnu pozornost posvetiti prehrani koja utječe kako na zdravlje majke tako i na zdravlje djeteta. Unatoč općem uvjerenju da je prehrana tijekom trudnoće adekvatna i okarakterizirana boljim prehrambenim navikama, brojna su istraživanja dokazala suprotno. Uz neadekvatnu prehranu, rizični čimbenici koji mogu dovesti do komplikacija i preranog poroda su visoka dob majke, visok indeks tjelesne mase (BMI) i visok dobitak na masi u trudnoći. Na trudnicama iz Osijeka (Istočna Hrvatska) provedena je randomizirana, obzervacijska, prospektivna longitudinalna studija. Metodom 24-satnog prisjećanja prikupljeni su podaci o kvaliteti prehrane. Žene su podijeljene u dvije skupine: prva skupina su bile žene s normalnim BMI-jem prije trudnoće i visokim dobitkom na masi u trudnoći, a druga skupina žene sa BMI ≥ 25 kg/m2 prije trudnoće i visokim dobitkom na masi u trudnoći. Rezultati su pokazali da je prehrana energetski slaba, a unos masti i ugljikohidrata neuravnotežen. Za žene koje su počele trudnoću sa normalnim BMI-jem, veći utjecaj na ishod imala je ravnoteža u unosu specifičnih ugljikohidrata, posebno u prvom tromjesečju. Na ishod trudnoće u žena koje su na početku imale visok BMI, veći utjecaj imao je ukupan unos masti i specifičnih masnih kiselina, posebno u trećem tromjesečju.Pregnancy presents the most important period in every woman's life, partially for the number of physiological adaptations she is going through, partially for the expectance of new life. Diet during pregnancy is considered as one of the most important external factors affecting health of a child further in life. Despite of general belief that nutrition through pregnancy is adequate and is characterized with better nutritional habits, number of research are showing this is not the case. Additionally, unfavourable diet is together with advanced maternal age, high pre-pregnancy body mass index (BMI), and excessive pregnancy weight gain considered as significant risk factor for adverse pregnancy complications and outcomes, especially in terms of newborn. Randomized, observational, prospective, long-term study encompassed pregnant women from the area of city Osijek, Eastern Croatia. Based on 24-hour dietary record quality of nutrition was assessed for two subgroups of women: the first group of normal pre-pregnancy BMI and excessive pregnancy weight gain, and the second with overweight/obese BMI (BMI ≥ 25 kg/m2) and excessive weight gain. The results have shown energy deficient diet throughout gestation, characterized with unbalance between intake of fats and carbohydrates. For women starting pregnancy with normal BMI, from the aspect of pregnancy outcomes higher importance has the balance in specific carbohydrates. This is especially emphasized in the first trimester. On the other hand, for women at-risk, who start their pregnancy with overweight/obese BMI, from the aspect of pregnancy outcomes higher importance has the total intake of fats and specific fatty acids, especially during the third trimester

Prikaz slučaja bolesnice s pojavom lokalnog recidiva na prsnom košu pet uzastopnih godina nakon radikalne mastektomije

Breast cancer is most common cancer in women. After surgical treatment and adjuvant therapy, locoregional recurrences do occur in certain number of patients. Herein we report a breast cancer patient who developed isolated chest wall local recurrence 3 years after mastectomy which was reappearing in next fi ve consecutive years. Multimodal treatment which includes surgical excision and adjuvant chemoradiotherapy can achieve a signifi cant degree of palliation when locoregional recurrences are diagnosed. In our case, inclusion of adjuvant treatment did not provide satisfactory local control of disease therefore repetitive surgical excision was the only modality which off ered our patient 7 years of overall survival after fi rst excision of local recurrence.Rak dojke je najčešći rak u žena. Unatoč kirurškom liječenju i adjuvantnoj terapiji, lokalni recidivi se javljaju u određenom broju pacijenata. Prikazan je slučaj bolesnice s pojavama lokalnog recidiva na prsnom košu u razdoblju od pet uzastopnih godina nakon radikalne mastektomije. Koristeći se multimodalnim tretmanom koji uključuje kirurški zahvat i kemoradioterapiju, načelno se postižu dobri rezultati u liječenju lokoregionalnog recidiva. Unatoč danoj terapiji, uzastopne kirurške ekscizije su se pokazale kao jedini modalitet liječenja koji je bolesnici omogućio sedmogodišnje preživljenje nakon pojave prvog lokalnog recidiva