Suvremeni pristup kirurškom liječenju melanoma – iskustva Opće bolnice Dubrovnik

Incidencija je melanoma među pet najčešćih malignih bolesti. Cilj je istraživanja utvrđivanje pojave melanoma u općoj populaciji Dubrovačko-neretvanske županije [DNŽ], posebice odnos oboljenja prema spolu, dobi, debljini zahvaćenosti kože, kliničkom stadiju te stupnju preživljavanja. Opisuju se metode i postupci liječenja u odnosu na kliničke stadije oboljenja. Prikazuju se rezultati dijagnostičko- terapeutskih postupaka i metoda/postupaka liječenja melanoma u populaciji bolesnika liječenih u Općoj bolnici [OB] Dubrovnik, i to u petogodišnjem razdoblju, od 1. 1. 2006. do 31. 12. 2010. godine

Antropometrijske karakteristike šake – pregledni članak

Antropometrija je dio antropologije koji upotrebljava metode mjerenja radi kvantitativnog određivanja morfoloških osobina i funkcionalnih sposobnosti čovječjeg tijela. Važnost antropometrije danas je posebice prepoznatljiva u industrijskom dizajniranju i ergonometriji. Uporaba u arhitekturi važna je za svrhe prikupljanja statističkih podataka o distribuciji tjelesnih dimenzija unutar određene populacije, a koristi se za stalno poboljšanje novih proizvoda. U članku autori opisuju razvoj i vrste antropometrije, povijesni prikaz proučavanja dimenzija ljudskog tijela i šake, metode koje su u uporabi za funkcionalno mjerenje šake i radiografske metode za mjerenje šake, a čiji rezultati mogu poslužiti kao dopuna učinjenim antropometrijskim mjerenjima

Antropometrijske karakteristike šake odraslih osoba na uzorku populacije Dubrovačko-neretvanske županije Anthropometric characteristics of the hand in adults of Dubrovnik County population

Cilj/svrha: Cilj je istraživanja trostruki, i to: ad 1] uporabom antropoloških metoda mjerenja utvrditii postojanje tzv. antropološkog „fenomena akceleracije“ šake; ad 2] usporedba vrijednosti četiriju osnovnih čimbenika mjerenja šake; ad 3] povezanost dimenzija šake u odnosu na vrstu zanimanja, spol, mjesto boravka u dvije populacije različite starosne dobi, i to od 20 do 30 godina u odnosu na populaciju starosne dobi od 50 do 60 godina u Dubrovačko-neretvanskoj županiji [DNŽ]. Metoda i ispitanici: U istraživanje je uključeno 117 ispitanika, i to 52 ispitanika [30 muškaraca] starosne dobi od 20 do 30 godina, te 65 ispitanika starosne dobi od 50 do 60 godina [33 muškarca]. Svi uključeni ispitanici liječeni su u Općoj bolnici [OB] Dubrovnik tijekom 6 mjeseci [od 1. studenoga 2012. do 1. svibnja 2013.]. Kriteriji za uključivanje bili su ispitanici prosječnog osteomuskularnog statusa, bez neuroloških poremećaja, tjelesne visine od 160 do 170 cm za žensku, te od 180 do 190 cm za mušku populaciju, nepostojanje degenerativnih i kongenitalnih bolesti šake. Kriterij za isključivanje bila je tjelesna težina veća od 75 kg za žensku te veća od 100 kg za mušku populaciju. U uporabi su 4 standardne antropometrijske metode mjerenja šake, i to: dužina šake, dužina dlana, širina dlana u projekciji metakarpofalangealnih zglobova, opseg cirkumferencije ručnog zgloba. Statistička obrada učinjena je uporabom pearmanova korelacijskog testa. Rezultati: Iznalazi se statistička značajnost za 4 antropometrijska čimbenika kod populacije mlađe u odnosu na stariju životnu dob, kod ženske populacije koja živi u urbanoj sredini, u komparaciji sa ženama koje žive u ruralnim područjima. Iznalazi se statistička značajnost za 3 antropometrijska čimbenika kod ženskih ispitanica koje svakodnevno obavljaju fizičku aktivnost, i to za čimbenike dužine šake i dlana te posebno cirkumferencije ručnog zgloba, dok se kod muških ispitanika iznalazi značajnost u čimbeniku dužine šake. Kod ispitanika oba spola iznalazi se značajnost vrste obavljanja svakodnevnih poslova u odnosu na dužinu šake i cirkumferenciju ručnog zgloba. Diskusija: Rezultati provedenog istraživanja upućuju na postojanje pozitivnog fenomena akceleracije šake u populaciji mlađe u odnosu na populaciju starije životne dobi u DNŽ. Nadalje, iznalazi se znatna povezanost ispitanika oba spola s vrstom zanimanja i većim dimenzijama šake. Veće dimenzije šake verificiraju se kod ženske populacije koja provodi ruralne vrste svakodnevnih radnih aktivnosti života, dok se kod muškaraca ta povezanost nije verificirala. Dobiveni rezultati istovjetni su objavljenim rezultatima studija koje opisuju istovjetnu problematiku. Nedostaci provedenog istraživanja jesu premalen uzorak ispitanika te kratak vremenski tijek provedenog istraživanja, ali mogu poslužiti kao polazište za daljnja istraživanja antropometrijskih čimbenika stanovništva DNŽ-a

CLINICAL GUIDELINES FOR DIAGNOSIS, TREATMENT AND MONITORING OF PATIENTS WITH NON-INVASIVE BREAST CANCER

Rak dojke najčešća je maligna bolest u žena. Ranom dijagnostikom i sve uspješnijim liječenjem invazivnog raka dojke postignut je značajan pad mortaliteta, produljenje preživljenja i poboljšanje kvalitete života bolesnica. Postupak s neinvazivnim rakom dojke međutim povezan je s nekim dvojbama i sviješću o problemu predijagnosticiranja i pretjeranog liječenja nekih bolesnica. U tekstu koji slijedi multidisciplinarni tim stručnjaka donosi prve hrvatske smjernice čija je svrha standardizacija i optimalizacija kriterija i postupaka dijagnostike, liječenja i praćenja bolesnica s neinvazivnim rakom dojke u Republici Hrvatskoj.Breast cancer is the most common malignancy in women. Early diagnosis and more effective treatment of invasive breast cancer resulted in significant mortality reduction, improvement of survival and the quality of life of the patients. The management od non-invasive breast cancer, on the contrary, is still controversial and the problem of overdiagnosis and overtreatment of patients come to evidence. In the following text a multidisciplinary team of experts brings the first consensus guidelines aimed to standardize and optimize the criteria and management in diagnosis, treatment and monitoring of non-invasive breast cancer patients in the Republic of Croatia

Modern approach in surgical treatment of melanoma – experiences in General

Incidencija je melanoma među pet najčešćih malignih bolesti. Cilj je istraživanja utvrđivanje pojave melanoma u općoj populaciji Dubrovačko-neretvanske županije [DNŽ], posebice odnos oboljenja prema spolu, dobi, debljini zahvaćenosti kože, kliničkom stadiju te stupnju preživljavanja. Opisuju se metode i postupci liječenja u odnosu na kliničke stadije oboljenja. Prikazuju se rezultati dijagnostičko- terapeutskih postupaka i metoda/postupaka liječenja melanoma u populaciji bolesnika liječenih u Općoj bolnici [OB] Dubrovnik, i to u petogodišnjem razdoblju, od 1. 1. 2006. do 31. 12. 2010. godine

Kliničke smjernice za dijagnostiku, liječenje i praćenje bolesnika s neinvazivnim rakom dojke [Clinical guidelines for diagnosis, treatment and monitoring of patients with non-invasive breast cancer]

Breast cancer is the most common malignancy in women. Early diagnosis and more effective treatment of invasive breast cancer resulted in significant mortality reduction, improvement of survival and the quality of life of the patients. The management od non-invasive breast cancer, on the contrary, is still controversial and the problem of overdiagnosis and overtreatment of patients come to evidence. In the following text a multidisciplinary team of experts brings the first consensus guidelines aimed to standardize and optimize the criteria and management in diagnosis, treatment and monitoring of non-invasive breast cancer patients in the Republic of Croatia

Growth suppression of human breast carcinoma stem cells by lipid peroxidation product 4-hydroxy-2-nonenal and hydroxyl radical-modified collagen

Breast cancer is a leading cause of mortality and morbidity in women, mostly due to high metastatic capacity of mammary carcinoma cells. It has been revealed recently that metastases of breast cancer comprise a fraction of specific stem-like cells, denoted as cancer stem cells (CSCs). Breast CSCs, expressing specific surface markers CD44+CD24-/lowESA+ usually disseminate in the bone marrow, being able to spread further and cause late metastases. The fundamental factor influencing the growth of CSCs is the microenvironment, especially the interaction of CSCs with extracellular matrix (ECM). The structure and function of ECM proteins, such as the dominating ECM protein collagen, is influenced not only by cancer cells but also by various cancer treatments. Since surgery, radio and chemotherapy are associated with oxidative stress we analyzed the growth of breast cancer CD44+CD24-/lowESA+ cell line SUM159 cultured on collagen matrix in vitro, using either native collagen or the one modified by hydroxyl radical. While native collagen supported the growth of CSCs, oxidatively modified one was not supportive. The SUM159 cell cultures were further exposed to a supraphysiological (35 µM) dose of the major bioactive lipid peroxidation product 4-hydroxynonenal (HNE), a well known as 'second messenger of free radicals', which has a strong affinity to bind to proteins and acts as a cytotoxic or as growth regulating signaling molecule. Native collagen, but not oxidised, abolished cytotoxicity of HNE, while oxidized collagen did not reduce cytotoxicity of HNE at all. These preliminary findings indicate that beside direct cytotoxic effects of anticancer therapies consequential oxidative stress and lipid peroxidation modify the microenvironment of CSCs influencing oxidative homeostasis that could additionally act against cancer

Oncoplastic Breast Surgery: A Global Perspective on Practice, Availability, and Training

Based on a BSI symposium, ISW 2007, Montreal, Canada.Oncoplastic surgery is the seamless joining of the extirpative and reconstructive aspects of breast surgery that is performed by a single surgeon. A symposium was held at ISW 2007 in Montreal with a prearranged aim to publish an article on the current and historical record of the developing specialty of oncoplastic breast surgery. The presenters and authors are well-known breast surgeons from Australia, Croatia, India, Sweden, and South Africa.Peter L. Malycha, Ian R. Gough, Marko Margaritoni, S. V. S. Deo, Kerstin Sandelin, Ines Buccimazza, Gaurav Agarwa

Breast Cancer Management During the COVID-19 Pandemic: The Senologic International Society Survey

Objective: In early 2020, the spread of coronavirus disease-2019 (COVID-19) led the World Health Organization to declare this disease a pandemic. Initial epidemiological data showed that patients with cancer were at high risk of developing severe forms of COVID-19. National scientific societies published recommendations modifying the patients' breast cancer (BC) management to preserve, in theory, quality oncologic care, avoiding the increased risk of contamination. The Senology International Society (SIS) decided to take an inventory of the actions taken worldwide. This study investigates COVID-19-related changes concerning BC management and analyzes the will to maintain them after the pandemic, evaluating their oncological safety consequences. Materials and Methods: SIS network members participated in an online survey using a questionnaire (Microsoft® Forms) from June 15th to July 31st, 2020. Results: Forty-five responses from 24 countries showed that screening programs had been suspended (68%); magnetic resonance imagines were postponed (73%); telemedicine was preferred when possible (71%). Surgeries were postponed: reconstructive (77%), for benign diseases (84%), and in patients with significant comorbidities (66%). Chemotherapy and radiotherapy protocols had been adapted in 28% of patients in both. Exception for telemedicine (34%), these changes in practice should not be continued. Conclusion: The SIS survey showed significant changes in BC's diagnosis and treatment during the first wave of the COVID-19 pandemic, but most of these changes should not be maintained. Indeed, women have fewer severe forms of COVID-19 and are less likely to die than men. The risk of dying from COVID-19 is more related to the presence of comorbidities and age than to BC. Stopping screening and delaying treatment leads to more advanced stages of BC. Only women aged over 65 with BC under treatment and comorbidities require adaptation of their cancer management