95 research outputs found
Prostate specific antigen: blessing or curse?
PSA je poznat kao najkorisniji tumorski biljeg do sada u medicinskoj dijagnozi. Niti jedan drugi marker ili metoda probira ne postižu takvu specifičnost i osjetljivost. S druge strane, PSA također daje kako lažno pozitivne tako i lažno negativne rezultate. U članku se raspravlja o prednostima i nedostatcima u određivanju PSA. Pravilno praćenje nalaza te korektna evaluacija rezultata trebale bi umanjiti moguća razočarenja koja donosi PSA.The PSA has been the most useful tumour marker in the medical diagnosis so far. No other markers or screening methods reach the specificity and sensitivity of PSA. On the other hand the PSA has also false positive and negative results as well. The advantages and disadvantages of the PSA determination are discussed in our paper. The proper counselling with the papers and right evaluation of results should be diminished the disappointments in PSA
Fournier-gangréna = Fournier’s gangrene
A hĂmvesszĹ‘ fulmináns gangrĂ©náját Fournier több mint 200 Ă©ve leĂrta, kezelĂ©sĂ©t illetĹ‘en azonban fennállnak bizonyos ellentmondások. A betegsĂ©get ma már nem tekintjĂĽk idiopathiásnak, mert a legtöbb esetben urolĂłgiai, colorectalis vagy bĹ‘reredetű forrás kimutathatĂł. A halálozási arány továbbra is magas, kĂĽlönöskĂ©ppen kiterjedt folyamatok esetĂ©n. HajlamosĂtĂł tĂ©nyezĹ‘nek tekintjĂĽk a cukorbetegsĂ©get, az alkoholizmust Ă©s az immunszuppressziĂłs állapotokat, kĂĽlönös tekintettel a HIV-fertĹ‘zĂ©sre. A Fournier-gangrĂ©na kĂłrismĂ©je alapvetĹ‘en a klinikai kĂ©pen nyugszik, a genitoanális tájĂ©kon jelentkezĹ‘ sĂşlyos, heveny gyulladásos folyamatokat indokolt a Fournier-gangrĂ©na kiindulási helyzetĂ©nek tekinteni. SĂĽrgĹ‘s kezelĂ©s szĂĽksĂ©ges, amely az aerob Ă©s anaerob kĂłrokozĂłk ellen egyaránt hatĂ©kony, szĂ©les spektrumĂş antibiotikum-kezelĂ©st Ă©s a szeptikus állapotban lĂ©vĹ‘ betegek intenzĂv osztályos ellátását igĂ©nyli. Az azonnali sebĂ©szi beavatkozás elengedhetetlen: az elhalt szövetek kimetszĂ©se Ă©s az elĂ©gsĂ©ges drenázs biztosĂtása. A sebĂ©szi kezelĂ©s rendszerint ismĂ©tlendĹ‘, majd a vĂ©gleges szövethiány pĂłtlása esetenkĂ©nt már speciális helyreállĂtĂł, plasztikai műtĂ©ttel lehetsĂ©ges.
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Fulminant gangrene of the penis was described by Fournier more than two hundred years ago, however, to this day there are a number of contraversies regarding its management. The diagnosis of Fournier’s gangrene is essentially clinical, and although laboratory and various imaging techniques can be used, every acute and severe subcutaneous inflammatory process must be considered as the onset of Fournier’s gangrene. Immediate treatment is essential and includes the use of combined broad spectrum antibiotics effective against both aerobic and anaerobic bacteria. Intensive supportive care is required for septicaemic patients. Immediate surgical debridement must be performed, this includes excision of necrotic tissue and drainage. Repeated surgery is usually required. To achieve better cosmetic results, special plastic surgery methods must be applied for reconstruction
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