74 research outputs found
Genitourinarni karcinomi: potencijalna uloga oslikavanja
Imaging is an essential part of the management of patients with genitourinary cancers. Imaging is necessary for diagnosis, treatment selection and planning, applying minimally invasive image-guided techniques, assessment of response to treatment, and post-treatment follow-up. With advances in technology, imaging now comprises far more than descriptive anatomy. In the next decade anatomic, functional and molecular imaging information will increasingly be combined to achieve more accurate disease characterization and better patient care. In this review we present standard as well as some new imaging methods used in patients with kidney and prostate cancer.Oslikavanje je sastavni dio lijeÄenja bolesnika s genitourinarnim karcinomima. Oslikavanje je nužno za dijagnozu bolesti, izbor i planiranje terapije, te voÄenje minimalno invazivnih tehnika lijeÄenja, procjenu odgovora na terapiju, te praÄenje bolesnika nakon lijeÄenja. S napretkom tehnologije oslikavanje je danas puno viÅ”e od deskriptivne anatomije. U sljedeÄoj dekadi kombinirat Äe se informacije anatomskog, funkcionalnog i molekularnog oslikavanja s ciljem postizanja Å”to bolje karakterizacije bolesti, a samim time i boljeg lijeÄenja bolesnika. U ovom Älanku prikazat Äemo standardne i neke nove
metode oslikavanja koje se primjenjuju kod bolesnika s karcinomom bubrega i karcinomom prostat
Analiza prijava sumnji na nuspojave lijekova za lijeÄenje benigne hiperplazije prostate prijavljene HALMED-U
Benign prostatic hyperplasia is one of the most common diseases in men, with a
prevalence rate of 50% in their 50s to 80% in their 80s, and is mostly treated with chronic drug therapy.
The aim of this study was to analyze adverse drug reactions (ADR) to drugs used in benign prostate
hyperplasia (BPH) treatment reported to HALMED from 2008 to 2021. Data on ADR reports in
Croatia were obtained from the VigiFlow national database and on the use of drugs for BPH in Croatia
from Drug Utilization Reports from HALMED. In the observed period, the number of reports on each
BPH drug, total number of reports, seriousness of reported ADR, patient age and sex, type of reporter,
and most reported ADRs were analyzed. Results showed that 438 ADR reports were received, of which
45.95% on tamsulosin as the most frequently used drug for BPH. Of all reports, 84% were non-serious,
96% were reported in men and 82% in patients older than 45 years. The most frequently reported ADRs
were consistent with the known safety profile of BPH drugs. Pharmacists were the most common (47%)
reporters of ADRs for BPH drugs, while 33% were reported by physicians. Analysis of the reported
ADRs showed that most frequently reported ones were in line with the known safety profile of BPH
drugs. However, given the prevalence of the disease and the extent of the use of BPH drugs, it could be
argued that the number of reports could be higher (i.e., 34 reports/year). Reporting on ADRs is necessary
to better understand the safety profile of drugs in the post-authorization period, and more information
on the safe use of medicines could be collected by raising awareness of healthcare professionals.Benigna hiperplazija prostate (BHP) jedna je od najÄeÅ”Äih bolesti u muÅ”karaca dobi od 50 godina i viÅ”e, s uÄestaloÅ”Äu od
50% do 80% u muÅ”karaca starijih od 80 godina. Danas se najÄeÅ”Äe lijeÄi kroniÄnom terapijom lijekovima. Cilj ovoga rada bio
je analizirati prijave sumnji na nuspojave lijekova za lijeÄenje BHP prijavljene Agenciji za lijekove i medicinske proizvode
(HALMED) od 2008. do 2021. godine. Podaci o prijavama izdvojeni su iz nacionalne baze nuspojava VigiFlow. Analiziran
je ukupan broj prijava za lijekove za BHP, broj prijava za svaki lijek za BHP, ozbiljnost prijavljenih nuspojava, dob i spol bolesnika,
vrsta prijavitelja i najÄeÅ”Äe prijavljene nuspojave. Podaci o potroÅ”nji lijekova izdvojeni su iz HALMED-ovih IzvjeÅ”Äa o
potroŔnji lijekova u Republici Hrvatskoj. U promatranom razdoblju zaprimljeno je 438 prijava sumnji na nuspojave lijekova
koji se primjenjuju u lijeÄenju BHP-a, od Äega je najviÅ”e prijavljeno za tamsulozin (45,95%), koji je i najÄeÅ”Äe primjenjivani
lijek za BHP. Od ukupnog broja prijava 83,5% prijava je bilo ne-ozbiljne naravi, 95,9% je prijavljeno u muŔkaraca, a 81,5%
prijava prijavljeno je u bolesnika u dobi od 45 godina i viÅ”e. NajÄeÅ”Äi prijavitelji bili su farmaceuti (u 46,7% prijava). LijeÄnici
su prijavili 32,9% prijava. NajÄeÅ”Äe prijavljivane nuspojave u skladu su s poznatim sigurnosnim profilom lijekova za BHP.
MeÄutim, uzimajuÄi u obzir uÄestalost BPH i Äestu primjenu farmakoterapije u lijeÄenju BPH moglo bi se zakljuÄiti da bi
broj prijava mogao biti veÄi od sadaÅ”nje 34 prijave godiÅ”nje. Prijavljivanje sumnji na nuspojave nužno je za bolje razumijevanje
sigurnosnog profila lijekova nakon stavljanja u promet. Podizanjem svjesnosti svih zdravstveni djelatnika o važnosti prijavljivanja
nuspojava može se doprinijeti prikupljanju veÄe koliÄine informacija i ukupnom znanju o sigurnoj primjeni lijekova
TUMORSKI ANTIGENI U KARCINOMU PROSTATE, STRESNI KOMUNIKATIVNI PROBLEMI SUVREMENOG ÄOVJEKA
This study investigated the immunohistochemical expression of the cancer testis antigen SSX in prostate cancer. SSX expression, with varying staining intensities, was observed in 83% of cancer samples. Substantial heterogeneity of expression was observed within individual samples. SSX expression was significantly higher in Gleason score 7 than in Gleason score 6 cancer (p=0.008). Tumours demonstrating capsular invasion had higher SSX expression than did tumours without capsular invasion (p=0.005). SSX expression did not correlate significantly with prostate-specific antigen level or tumour size. Further studies are needed to investigate SSX expression in prostate cancer and its potential implications for diagnosis and immunotherapy.U ovom radu istraživali smo imunohistokemijsku ekspresiju karcinom testis antigena SSX u karcinomu prostate. SSX ekspresija razliÄitog intenziteta je pokazana u 83% uzoraka karcinoma. Pokazana je takoÄer i znaÄajna heterogenost ekspresije unutar individaulnih uzoraka. SSX ekspresija je bila znaÄajno viÅ”e u Gleason zbroju 7, nego u Gleason zbroju 6 karcinoma prostate (p=0.008). Tumori koji su zahvatili kapsulu prostate imali su takoÄer znaÄajniju SSX ekspresiju nego tumori koji nisu zahvatili kapsulu (p=0.005). SSX ekspresija nije korelirala znaÄajno s vrijednostima prostata-specifiÄnog antigena ili veliÄinom tumora. Daljnje studije su potrebna da bi se istražila ekpresija SSX antigena u karcinomu prostate s potencijalnim implikacijama i na dijagnostiku i na imunoterapiju karcinoma prostate
TUMORSKI ANTIGENI U KARCINOMU PROSTATE, STRESNI KOMUNIKATIVNI PROBLEMI SUVREMENOG ÄOVJEKA
This study investigated the immunohistochemical expression of the cancer testis antigen SSX in prostate cancer. SSX expression, with varying staining intensities, was observed in 83% of cancer samples. Substantial heterogeneity of expression was observed within individual samples. SSX expression was significantly higher in Gleason score 7 than in Gleason score 6 cancer (p=0.008). Tumours demonstrating capsular invasion had higher SSX expression than did tumours without capsular invasion (p=0.005). SSX expression did not correlate significantly with prostate-specific antigen level or tumour size. Further studies are needed to investigate SSX expression in prostate cancer and its potential implications for diagnosis and immunotherapy.U ovom radu istraživali smo imunohistokemijsku ekspresiju karcinom testis antigena SSX u karcinomu prostate. SSX ekspresija razliÄitog intenziteta je pokazana u 83% uzoraka karcinoma. Pokazana je takoÄer i znaÄajna heterogenost ekspresije unutar individaulnih uzoraka. SSX ekspresija je bila znaÄajno viÅ”e u Gleason zbroju 7, nego u Gleason zbroju 6 karcinoma prostate (p=0.008). Tumori koji su zahvatili kapsulu prostate imali su takoÄer znaÄajniju SSX ekspresiju nego tumori koji nisu zahvatili kapsulu (p=0.005). SSX ekspresija nije korelirala znaÄajno s vrijednostima prostata-specifiÄnog antigena ili veliÄinom tumora. Daljnje studije su potrebna da bi se istražila ekpresija SSX antigena u karcinomu prostate s potencijalnim implikacijama i na dijagnostiku i na imunoterapiju karcinoma prostate
Promjene u usnoj Ŕupljini nakon transplantacije bubrega
Permanent immunosuppression is necessary to prevent rejection after kidney transplantation. However, it may predispose patients to different conditions and diseases including oral lesions. The most common benign oral lesions in kidney transplant recipients are gingival hyperplasia, oral candidiasis, hairy leukoplakia and saburral tongue. Oral form of Kaposi sarcoma, although rarely, can also be seen in kidney transplant patients. In this review, we present the incidence, etiology, clinical findings, diagnosis and treatment options for these lesions. For kidney transplant recipients, it is important to maintain good oral hygiene and care, as well as regular professional control by the dentist. This approach can reduce the number and severity of oral lesions.Nakon transplantacije bubrega bolesnici moraju biti na trajnoj imunosupresiji, Å”to ih Äini osjetljivima za razliÄita stanja i bolesti ukljuÄujuÄi oralne lezije. NajÄeÅ”Äe dobroÄudne oralne lezije kod bolesnika s transplantiranim bubregom su hiperplazija gingive, oralna kandidijaza, vlasasta leukoplakija i obloženi jezik. Oralna forma Kaposijevog sarkoma takoÄer se, iako rijetko, može vidjeti kod bolesnika s transplantiranim bubregom. Donosimo pregled incidencije, etiologije, kliniÄke slike, dijagnoze i lijeÄenja ovih lezija. Kod bolesnika s transplantiranim bubregom važna je redovita skrb za oralno zdravlje uz održavanje oralne higijene te redovite posjete lijeÄnicima dentalne medicine, Å”to sve može smanjiti broj i ozbiljnost oralnih lezija
ZdjeliÄna i retroperitonealna lipomatoza : prikaz sluÄaja
A rare case of pelvic and retroperitoneal lipomatosis lasting for more then three decades is presented. Although the disease is benign, it is usually progressive and may lead to renal insufficiency. On the other hand, treatment options are limited and with questionable effects. The clinical features, intravenous urography, computed tomography and magnetic resonance images, differential diagnosis and therapeutic aspects of this rare disease are presented.Prikazan je rijedak sluÄaj zdjeliÄne i retroperitonealne lipomatoze koji traje viÅ”e od tri desetljeÄa. Iako je ova bolest u svojoj naravi dobroÄudna ona uglavnom s vremenom napreduje te može dovesti do bubrežne insuficijencije, a moguÄnosti lijeÄenja su ograniÄene s upitnim rezultatima. Opisuju se kliniÄke znaÄajke, slike intravenske urografije te kompjutorizirane tomografije i magnetske rezonance, kao i diferencijalna dijagnoza te terapijske moguÄnosti lijeÄenja zdjeliÄne i retroperitonealne lipomatoze
Expression of MAGE-A1, MAGE-A3/4 and NY-ESO-1 Cancer-Testis Antigens in Fetal Testis
SUMMARY Immunohistochemical expression of MAGE-A1, MAGE-A3/4 and NY-ESO-1/LAGE-1 cancer testis antigens (CTA) was assessed in 24 fetal testes from 15 th to 36 th week of gestation. Three monoclonal antibodies were used for immunohistochemical staining: 77B recognizing MAGE-A1, 57B recognizing multiple MAGE-A CTA, and D8.38 recognizing NY-ESO-1/ LAGE-1. Expression of MAGE-A1 was not observed in fetal testis samples, whereas multi-MAGE-A and NY-ESO-1/LAGE-1 specific reagents stained pro-spermatogonia in all samples with different expression levels during the period of fetal development observed. Significant expression of MAGE-A3/4 and almost continuous expression of NY-ESO-1 in fetal testes after 22 nd week of gestation suggested their important role in the development of sex cords and pro-spermatogonia in particular
Laparoskopska radikalna prostatektomija: serija sluÄajeva jednog centra
Laparoscopic radical prostatectomy (LRP) is traditionally characterized as a technically
difficult procedure with a long learning curve but it is successfully performed worldwide. The
aim of this paper was to assess the initial learning curve and clinical outcomes for LRP in our center.
We performed a retrospective study including 63 LRP cases, in the course of 22 months, performed
by 2 urologists, with no previous LRP experience. All patients were previously assessed by a multidisciplinary
team and were selected on the basis of low and intermediate risk disease attributes according
to the classification of prostate cancer risk groups of the European Association of Urology. The main
outcomes of follow-up are procedure duration, estimated blood loss, complications, positive surgical
margins, biochemical relapse and urinary continence. The median follow-up was 19.6 months. The
median procedure duration was 196.8 minutes and median blood loss 257.1 mL. Significant decrease
in both outcomes was observed when comparing first and last cases in the series. There were 5 (7.9%)
Clavien Dindo grade II complications. Undetectable prostate specific antigen (PSA) was observed in
59 (93.6%) patients, and fifty-five patients (87.3%) were continent. Following a methodical learning
approach, LRP can be safely mastered with favorable outcomes.Laparoskopska radikalna prostatektomija (LRP) tradicionalno se smatra tehniÄki zahtjevnom operacijom s dugom krivuljom
uÄenja, ali se uspjeÅ”no primjenjuje u cijelome svijetu. Cilj rada je prikazati krivulju uÄenja i ishode lijeÄenja za LRP
u naÅ”em centru. Proveli smo retrospektivnu studiju koja je ukljuÄila 63 pacijenta tijekom 22 mjeseca. Sve zahvate izvela su
2 specijalista urologa bez iskustva u LRP. UkljuÄene pacijente prethodno je procijenio multidisciplinarni tim te su imali
karakteristike nisko i srednje riziÄnog bolesti prema klasifikaciji karcinoma prostate Europskog uroloÅ”kog udruženja. Glavni
ishodi praÄenja bili su trajanje operacije, procijenjen gubitak krvi, uÄestalost komplikacija, prisutnost pozitivnog kirurÅ”kog
ruba, biokemijski povrat bolesti i kontinencija mokraÄe. Medijan praÄenja bio je 19.6 mjeseci. Medijani trajanja operacije i
procijenjenog gubitka krvi bili su 196.8 minuta i 257.1 mL. ZnaÄajno smanjenje oba parametra zabilježeno je usporeÄujuÄi
zadnje s prvim sluÄajevima u seriji. Zabilježeno je 5 (7.9%) Clavien Dindo stupanj II komplikacija. Nemjerljiv post-operacijski
prostata specifiÄni antigen (PSA) imalo je 59 (93.6%) pacijenata, a pedeset i pet pacijenata (87.3%) bilo je kontinentno.
PrateÄi metodiÄan sustav uÄenja, moguÄe je na siguran naÄin savladati LRP u zadovoljavajuÄe ishode lijeÄenja
Usporedba kratkoroÄnih ishoda perkutane radiofrekventne i mikrovalne ablacije u lijeÄenju malih tumora bubrega
Although the gold standard in the management of kidney tumors is surgical treatment,
thermal ablation methods are a viable therapeutic option for patients with small (<4 cm) renal
masses who are poor surgical candidates. The aim of this study was to compare the technical success,
primary efficacy and complication rate of percutaneous radiofrequency and microwave ablation in the
treatment of small renal masses. A retrospective analysis of consecutive patients with small renal masses
treated with radiofrequency or microwave ablation between December 2017 and January 2022 was conducted.
Response to the ablative therapy was assessed on contrast-enhanced computed tomography examination
after 3 months. Ablations of 44 kidney lesions were performed in 43 patients. Sixteen lesions
were treated with radiofrequency and 28 with microwave ablation. Both methods were associated with
high technical success (100%). Primary efficacy rates of radiofrequency and microwave ablation were
81.3% and 89.3%, respectively. Ablation-related complications were noted only in the patients treated
with microwave ablation (18.5%), all of them being low grade (Clavien-Dindo 1 and 2). Radiofrequency
and microwave ablation exhibited comparable efficacy in the treatment of small renal masses. Microwave
ablation was associated with a comparatively higher number of complications.Iako je zlatni standard u lijeÄenju tumora bubrega kirurÅ”ko lijeÄenje, metode termalne ablacije dobar su izbor za bolesnike
s malim (<4 cm) tumorima bubrega koji nisu kandidati za operativni zahvat. Cilj ovoga rada je usporediti tehniÄki uspjeh,
odgovor na terapiju i uÄestalost komplikacija perkutane radiofrekventne i mikrovalne ablacije u lijeÄenju malih tumora
bubrega. UÄinjena je retrospektivna analiza uzastopnih bolesnika s malim tumorima bubrega lijeÄenih radiofrekventnom ili
mikrovalnom ablacijom izmeÄu prosinca 2017. i sijeÄnja 2022. godine. Odgovor na terapiju procijenjen je na temelju pregleda
kompjutoriziranom tomografijom 3 mjeseca nakon zahvata. Ablacijom su lijeÄene 44 lezije kod 43 bolesnika, pri Äemu je
16 lezija lijeÄeno radiofrekventnom, a 28 mikrovalnom ablacijom. Kod obje metode postignuta je visoka razina tehniÄkog
uspjeha (100%). Potpun odgovor na terapiju zabilježen je kod 81,3% lezija lijeÄenih radiofrekventnom i 89,3% lezija lijeÄenih
mikrovalnom ablacijom. Komplikacije vezane uz ablaciju zabilježene su samo kod bolesnika lijeÄenih mikrovalnom ablacijom
(18,5%), no sve su bile niskog gradusa (Clavien-Dindo 1 i 2). Radiofrekventna i mikrovalna ablacija podjednako su uspjeŔne
u lijeÄenju malih tumora bubrega, pri Äemu je mikrovalna ablacija povezana s usporedbeno veÄim brojem komplikacija
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