Influence of Insolation on Osteoporosis Progression in Androgen Deprived Nonmetastatic Prostate Cancer Patients

Prostate cancer is a major public health problem in all the developed countries. Increasing numbers of men with nonmetastatic prostate cancer are receiving long-term androgen deprivation therapy (ADT). ADT is associated the loss of bone mineral density and a increased risk of bone fractures. The standard recommendations for male bone health include above all optimizing calcium and vitamin D intake, and exercise. Vitamin D3 is an essential factor in the maintenance of bone health and calcium homeostasis. The main supply of vitamin D3 is obtained through photosynthesis in the skin. The aim of this study was to investigate the influence of insolation on osteoporosis progression in androgen deprived nonmetastatic prostate cancer patients. We divided our androgen deprived prostate cancer patients in 2 groups. The first group (A) consists of 224 patients with insolation rate less then 3h per week. The second group (B) consists of 174 patients with insolation rate greater then 10h per week. With a questionnaire we determined, that patients from both groups were 70 to 80 years old, body mass index was 25–30 kg/m2, androgen deprivation was 4–6 years and received no vitamin D supplements. In the group A 21.86% suffered pathologic fractures do to osteoporosis. In the group B 10.92% patients suffered from osteoporotic bone fractures. The risk for pathological bone fractures is significantly greater in the group A. In conclusion higher insolation in androgen deprived nonmetastatic prostate cancer patients significantly decreases the osteoporosis progression and the risk of pathologic bone fractures

Kidney transplantation from non-heart-beating donor using perfusion in situ

Cilj - Najveći problem u daljem razvoju transplantacije bubrega je nedovoljan broj umrlih davatelja. Retrospektivno smo obradili grupu bolesnika koji su primili bubreg od umrle osobe uz primjenu perfuzije in situ. Materijal i metode - U razdoblju od 1989. do 2002. izvršili smo 21 transplantaciju bubrega uzetih od 11 davatelja nakon zastoja srca uz primjenu perfuzije in situ. Topla ishemija kretala se uz primjenu kardiopulmonalne reanimacije od 12 do 85 min. (srednja 50 ± 24 min.). Hladna ishemija trajala je od 7 h 30 min. do 26 h (srednja 19,42 ± 3,88 h). Rezultati - Sedam je bolesnika imalo ranu funkciju bubrega, a 11 odgođenu. Primarna afunkcija transplantata nije zabilježena. Rasprava - Primjenom perfuzije in situ izbjegnuta je primarna afunkcija transplantata. To u našim uvjetima pruža osnovu za masovniju transplantaciju bubrega od davatelja s nekucajuæim srcem.Aim - The main obstacle in further development of kidney transplantation is a shortage of cadaveric donors. A group of patients with kidney transplant from non-heart-beating donor using a perfusion in situ was being retrospectively studied. Patients and methods - From 1989 to 2002 we performed 21 kidney transplantations from 11 NHBD using perfusion in situ. Warm ischemia with cardiopulmonary resuscitation ranged from 12 to 85 min (mean 50 ± 24 min). Cold ischemia time ranged from 7 hrs 30 min to 26 hrs (mean 19.42 ± 3.88 hrs). Results - Seven patients had an immediate and 11 of them delayed function of the transplant. A primary non-function of transplant was not observed. Discussion - The use of perfusion in situ contributed to the avoidance of a primary non-function after kidney transplantation. In our terms, it provides the foundation for kidney harvesting from non-heart-beating donor in greater numbers

Clinical Recommendation for Diagnostics, Treatment and Monitoring of Patients with Prostate Cancer

Adenokarcinom prostate najčešća je zloćudna neoplazma u muškaraca u Republici Hrvatskoj. Klinički je često asimptomatski, a najčešće se otkriva na osnovi povišenih vrijednosti PSA u serumu. Odluka o liječenju donosi se na temelju TNM-klasifikacije, gradusne skupine i vrijednosti PSA. Klinički lokalizirana bolest vrlo se uspješno liječi radikalnom prostatektomijom ili radikalnom radioterapijom s hormonskom terapijom ili bez nje. Klinički lokalno uznapredovala bolest najčešće se liječi združenom primjenom radikalne radioterapije i hormonske terapije. Metastatska bolest godinama se može kontrolirati androgenom deprivacijom, a nakon razvoja kastracijski rezistentne bolesti opravdani su kemoterapija ili dodatni oblici hormonske terapije. U radu su prikazane kliničke upute radi ujednačenja postupaka i kriterija postavljanja dijagnoze, liječenja i praćenja bolesnika s rakom prostate u Republici Hrvatskoj.Prostate adenocarcinoma is the most common solid neoplasm in male population in Croatia. It is often asymptomatic. The finding of PSA rise is the most common reason for diagnostic workout. Treatment plan is based on TNM classification, grade group and PSA. Clinically localized disease is successfully treated by radical prostatectomy or radiotherapy with or without hormonal therapy. Locally advanced disease is treated with radiotherapy and hormonal therapy. Metastatic disease can be controlled for many years by androgen deprivation. For castration resistant metastatic disease appropriate treatment is chemotherapy or secondary hormonal therapy. The following paper presents the clinical guidelines to standardize procedures for the diagnosis, treatment and follow-up of patients with prostate cancer in the Republic of Croatia