Foundationone - precizna dijagnostika za precizno liječenje Foundationone - precision diagnostics for precision treatment

Precizna medicina u onkologiji pristup je u liječenju onkoloških bolesnika kojemu je cilj povezati nova znanja vezana za patogenezu tumora uz preciznu ciljanu terapiju. Da bi se omogućilo precizno liječenje, nužna je precizna dijagnostika. Određivanje genskog profila tumora pomaže liječnicima da točnije dijagnosticiraju subtipove tumora, predvide njihovo ponašanje, te im olakšava izbor ciljane terapije. Točno određivanje promijenjenih gena u nekom tipu tumora osigurava optimalnu primjenu ciljanih lijekova koji specifično blokiraju posljedice genskih promjena što dovodi do boljih krajnjih ishoda liječenja uz izbjegavanje nastanka neželjenih nuspojava. U izvješću FoundationOne (tvrtke za usluge molekulske analize, koja liječnike i bolesnike upoznaje s recentnim terapijskim postupcima i implementira individualiziranu medicinu u svakodnevnu praksu), nalazi se popis komercijalnih lijekova dostupnih bolesnicima koje je odobrila američka Agencija za hranu i lijekove (engl. Food and Drug Administration-FDA), a koji su učinkoviti za svrhe liječenja bolesnika kod kojih je pronađena specifična genska promjena te popis ciljanih lijekova koji baš zbog utvrđene genske promjene neće biti učinkoviti ili su čak potencijalno štetni. Navedeni su i lijekovi koji su učinkoviti u liječenju bolesnika s istovjetnom genskom promjenom u drugim histološkim tipovima tumora, a čija učinkovitost još nije potvrđena provedenim uobičajenim kliničkim studijama o tipu tumora koji ima bolesnik. Izvještaj sadrži i podatke o postojećim ili pokrenutim kliničkim studijama u kojima bi bolesnik bio prihvatljiv kandidat za uključivanja u iste na osnovu genomskog profila tumora. Preporukama u navedenom izvješču omogućuje se da liječnik odabere najbolji dostupan oblik liječenja za bolesnika. Bolesnici koji bi mogli imati najviše koristi od uporabe preporuka liječenja prema FoundationOne:jes • sa stadijem IV. raka pluća ne malih stanica (engl. non-small cell lung cancer-NSCLC); • s tumorima nepoznatoga primarnog podrijetla; • s vrlo agresivnim solidnim tumorima stadija IV.; • sa stadijem IV. solidnih tumora koji su iscrpili sve terapijske mogućnosti temeljene na kliničkim smjernicama; • sa solidnim tumorima čiji su biopsijski uzorci nedovoljni za provedbu svih potrebnih uobičajenih testiranja

Craniofacial characteristics of Croatian and Syrian populations

Craniofacial area is apart of the human body which undergoes the greatest changes during development and is characterized by uneven growth. External and internal factors affect the growth and development of craniofacial structures. They are responsible for the occurrence of specific craniofacial characteristics in different races or populations within the same race. The present study investigates the possible differences of the basic head and face shapes between the Croatian and Syrian populations. The sample included 400 subjects of both sexes aged 18-24 years and was divided into a Croatian and a Syrian group with 200 subjects each. Six variables defined according to Martin and Saller were measured by standard anthropometric instruments. The results of the study demonstrated statistically significant differences between our subjects in all variables except face width. The dolichocephalic head type and the mesoprosopic face type were predominant in the Croatian population, while the brachycephalic head type and the euryprosopic face type dominated in the Syrian population

Do Parathyroid Glands from Individuals of Different Age and Gender Contain Lymph Vessels?

Whereas lymph vessels in some endocrine glands have been thoroughly investigated, data on these vessels in human parathyroid glands are often contradictory and deficient in available literature. Therefore, the aim of this study was to histomorphologically investigate whether lymph vessels could be found in human parathyroid glands postnatally and, if so, whether their presence was age- and gender-dependent. A total of 44 parathyroid glands from subjects of both genders, aged 4–90 years, were studied. The glands were divided into three groups. Those from the 1st and the 2nd age group demonstrated similar morphological structure of parenchyma with predominant chief cells with pale-staining cytoplasm, while the frequency of lymph vessels was lower in the 2nd group. Unlike in these groups, chief cells with dark- staining cytoplasm predominated in the glandular parenchyma of the 3rd age group where lymph vessels were not found in any of the examined glands. The frequency of lymph vessels in parathyroid glands was almost the same for both genders. Histomorphologic occurrence of lymph vessels coincided with the presence of endocrine cells with pale-staining cytoplasm, which allowed the assumption that lymph vessels were also one of the signs of functional activity of human parathyroid glands

Craniofacial Characteristics of Croatian and Syrian Populations

Craniofacial area is a part of the human body which undergoes the greatest changes during development and is characterized by uneven growth. External and internal factors affect the growth and development of craniofacial structures. They are responsible for the occurrence of specific craniofacial characteristics in different races or populations within the same race. The present study investigates the possible differences of the basic head and face shapes between the Croatian and Syrian populations. The sample included 400 subjects of both sexes aged 18–24 years and was divided into a Croatian and a Syrian group with 200 subjects each. Six variables defined according to Martin and Saller were measured by standard anthropometric instruments19. The results of the study demonstrated statistically significant differences between our subjects in all variables except face width. The dolichocephalic head type and the mesoprosopic face type were predominant in the Croatian population, while the brachycephalic head type and the euryprosopic face type dominated in the Syrian population

Smjernice za provođenje dijagnostičkih pretraga prije početka liječenja onkološkog bolesnika – kliničke preporuke Hrvatskog društva za internističku onkologiju HLZ-a I. dio: tumori urogenitalnog sustava (rak bubrega, rak mokraćnog mjehura, rak prostate, rak testisa), tumori probavnog sustava (rak jednjaka, rak želuca, rak debelog i završnog crijeva, rak gušterače, rak žučnih vodova, hepatocelularni rak, neuroendokrine novotvorine) [Guidelines for usage of diagnostic procedures prior to initiation of antineoplastic treatment – Croatian society for medical oncology clinical recommendations Part I. tumors of urogenital system (renal cell cancer, urinary bladder cancer, prostatic cancer, testicular cancer), tumors of gastrointestinal system (oesophageal cancer, gastric cancer, colorectal cancer, pancreatic cancer, biliary ducts cancer, hepatocellular cancer, neuroendocrine neoplasms)]

Cancer is the second most important cause of death in our country, immediately after cardiovascular diseases. With the assumption that cancer incidence and mortality will increase in the next years, projections show that the costs of diagnosis and treatment of cancer will be significantly increased, both due to the introduction of new diagnostic techniques and innovative medicines and treatment methods. Consequently, the imperative of making optimal use of financial resources, available personnel and techniques is all the more necessary in or-der to ensure the continuity of adequate diagnosis and treatment. Optimal use of diagnostic methods can pre-vent unnecessary processing delay, waste of financial resources and unnecessary burden on healthcare work-ers, and shorten waiting lists. HDIO has made these guidelines with the aim of overcoming these problems, rationalizing and standardizing diagnostic procedures in everyday clinical practice. Guidelines should help us to select, from the entire range of diagnostic procedures available, those which are most relevant to a particular localization and clinical extension of the disease

Do parathyroid glands from individuals of different age and gender contain lymph vessels?

Whereas lymph vessels in some endocrine glands have been thoroughly investigated, data on these vessels in human parathyroid glands are often contradictory and deficient in available literature. Therefore, the aim of this study was to histomorphologically investigate whether lymph vessels could be found in human parathyroid glands postnatally and, if so, whether their presence was age- and gender-dependent. A total of 44 parathyroid glands from subjects of both genders, aged 4-90 years, were studied. The glands were divided into three groups. Those from the 1st and the 2nd age group demonstrated similar morphological structure of parenchyma with predominant chief cells with pale-staining cytoplasm, while the frequency of lymph vessels was lower in the 2nd group. Unlike in these groups, chief cells with dark- staining cytoplasm predominated in the glandular parenchyma of the 3rd age group where lymph vessels were not found in any of the examined glands. The frequency of lymph vessels in parathyroid glands was almost the same for both genders. Histomorphologic occurrence of lymph vessels coincided with the presence of endocrine cells with pale-staining cytoplasm, which allowed the assumption that lymph vessels were also one of the signs of functional activity of human parathyroid glands

The effectiveness of nab-paclitaxel plus gemcitabine and gemcitabine monotherapy in first-line metastatic pancreatic cancer treatment: A real-world evidence

Pancreatic cancer is one of the most lethal malignancies with a rise in mortality rates. FOLFIRINOX and nab-paclitaxel plus gemcitabine demonstrated a survival benefit compared to gemcitabine alone. Both protocols are now considered the standard of first-line treatment with no significant difference between them, primarily based on observational studies. Although new therapeutic options have emerged recently, the prognosis remains poor. We conducted a retrospective single-center study on 139 patients treated for metastatic pancreatic adenocarcinoma (mPDAC) with gemcitabine monotherapy (Gem) or nab-paclitaxel + gemcitabine (Nab-P/Gem) in the first line. The aim of our study was to evaluate the effectiveness in terms of overall survival (OS) and progression-free survival (PFS) as well as the influence of patient and disease characteristics on outcomes. Nab-P/Gem resulted in OS of 13.87 months compared to 8.5 months in patients receiving Gem. The same trend was achieved in PFS, 5.37 versus 2.80 months, respectively, but without reaching statistical significance. Furthermore, the 6-month survival in the Nab-P/Gem group was also higher, 78.1% versus 47.8%. In terms of survival, the group of elderly patients, patients of poorer performance, with higher metastatic burden and liver involvement, benefited the most from combination therapy. In our analysis ECOG performance status (p.s.), previous primary tumor surgery, and liver involvement were found to be independent prognostic factors. The addition of nab-paclitaxel to gemcitabine resulted in a significant improvement in the OS of patients with mPDAC. Subgroup analysis demonstrated that patients with some unfavorable prognostic factors benefited the most