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Acta Clinica Croatica

Josip Šojat, Bernardica Jurić, Šoip Šoipi, Monika Ulamec, Božo Krušlin
Prostate adenocarcinoma with Paneth cell-like neuroendocrine differentiation is a rare entity. Foci of scattered cells and small clusters are found in the majority of described cases, although cases with predominant Paneth cell-like features have also been recorded. These cells contain eosinophilic cytoplasmic inclusions and lack androgen receptors, and are consequently immune to hormone therapy. It is, therefore, important for pathologists to recognize them. According to literature, clinical outcome depends on the standard grading of the conventional prostate cancer component...
October 2018: Acta Clinica Croatica
Matea Pirša, Ivan Pezelj, Matej Knežević, Borislav Spajić, Igor Tomašković, Ante Reljić, Boris Ružić
The aim of this study was to determine the incidence of incidental prostate cancer and its clinical significance among patients who underwent transurethral prostate resection or transvesical adenomectomy for benign prostate hyperplasia at the Department of Urology in Sestre milosrdnice University Hospital Center from January 1997 to December 2017. A total of 277/4,372 (6.34%) patients from our cohort were diagnosed with incidental prostate cancer (mean age 74.5 years). Due to incomplete data, 12 patents were excluded from further analysis...
October 2018: Acta Clinica Croatica
Luka Novosel, Ivan Pezelj, Igor Tomašković, Dijana Zadravec, Boris Ružić
Prostatic artery embolization is a minimally invasive endovascular treatment that improves lower urinary tract symptoms in men with benign prostatic hyperplasia. Although further randomized studies and long-term evidence is still needed for this method to be fully incorporated into treatment guidelines for benign prostatic hyperplasia, current studies show that this method can be an effective and safe alternative in patients with a significantly enlarged prostate gland who are not good surgical candidates. Therefore, we present the theory, technical details and potential benefits of this method as we review the current evidence on prostatic artery embolization...
October 2018: Acta Clinica Croatica
Igor Tomašković, Sven Nikles, Miroslav Tomić, Ivan Pezelj, Ivan Svaguša, Matea Pirša, Boris Ružić
Pelvic lymph node dissection (PLND) during radical prostatectomy (RP) is the most accurate staging modality for lymph node assessment in patients with prostate cancer. It is recommended in all patients with intermediate or high-risk disease undergoing radical prostatectomy. The goal of our study was to assess unfavorable clinicopathological characteristics in patients with omitted lymphadenectomy (PLND) during radical prostatectomy based on the nomogram proposed by Briganti and colleagues. In 2011, 200 patients undertook radical prostatectomy in our institution...
October 2018: Acta Clinica Croatica
Božo Krušlin, Majda Vučić, Silvija Mašić, Ivan Kruljac, Cvjetko Lež, Boris Ružić, Borislav Spajić, Monika Ulamec
LMO2 (LIM domain only) is a member of transcription factor family of proteins characterized by their cysteine-rich, zinc-binding LIM domains. Its expression in prostate cancer cells, as well as in adjacent stroma, is described in a study in a cohort of 83 patients treated with radical prostatectomy for clinically localized prostate adenocarcinoma. Authors found that LMO2 overexpression in prostate cancer was strongly associated with features indicative of worse prognosis (higher preoperative PSA, higher Gleason score, positive surgical margins, and extraprostatic extension of disease)...
October 2018: Acta Clinica Croatica
Borislav Spajić, Sven Nikles, Igor Grubišić, Matej Knežević, Shoip Shoipi, Monika Ulamec, Goran Štimac, Igor Tomašković, Boris Ružić
One of the main reasons for the introduction of a new grading system was Gleason sum 7, which differed significantly in the prognosis of the disease depending on the primary Gleason. The aim of this study was to compare grade group 2 and grade group 3, and the impact of cancer percentages in final pathology reports after radical prostatectomy on the occurrence of T3 stage of the disease after radical prostatectomy of clinically localized prostate cancer. The study covered 365 patients with clinically localized prostate cancer who underwent radical retropubic prostatectomy (RRP) over the period of two years...
October 2018: Acta Clinica Croatica
Ivan Pezelj, Igor Tomašković, Karolina Bolanča Čulo, Luka Novosel, Miroslav Tomić, Ante Reljić, Josip Katušić, Matej Knežević, Sven Nikles, Matea Pirša, Danijel Justinic, Diana Zadravec, Boris Ružić
The objective of this study was to determine differential expression of TFF1, TFF2 and TFF3 genes and proteins in breast tumor subtypes. In addition, we investigated the correlation between TFF genes within tumor subgroups, and TFF genes with clinical and pathologic characteristics of the tumor. Study group included 122 patients with surgically removed breast tumors. Samples were investigated using qRT-PCR and immunohistochemistry. TFF1 and TFF3 genes and proteins were expressed in breast tumors, while the levels of TFF2 gene and protein expression were very low or undetectable...
October 2018: Acta Clinica Croatica
Igor Tomašković, Ivan Pezelj, Karolina Bolanča Čulo, Luka Novosel, Sven Nikles, Miroslav Tomić, Ante Reljić, Josip Katušić, Matej Knežević, Matea Pirša, Božo Kruslin, Monika Ulamec, Boris Ružić
The aim of this prospective clinical study was to determine the detection rate of prostate cancers by multiparametric magnetic resonance and transrectal ultrasound (mpMRI-TRUS) cognitive fusion biopsies in patients with a previously negative TRUS-guided biopsy. Between 1 October 2016 and 1 July 2017, in 101 consecutive patients with elevated antigen (PSA) and/or positive digital rectal examination and after a negative first TRUS biopsy, a second, repeated prostate biopsy was performed. In 24 patients, cognitive fusion mpMRI-TRUS biopsy of the prostate with 8-10 system cores and 1-3 target biopsies was performed, in line with the European Association of Urology guidelines...
October 2018: Acta Clinica Croatica
Igor Tomašković, Matej Knežević, Ivan Pezelj, Karolina Bolanča Čulo, Luka Novosel, Sven Nikles, Miroslav Tomić, Danijel Justinić, Josip Ninčević, Matea Pirša, Boris Ružić
Multiparametric magnetic resonance is assuming an increasingly important role in the diagnosis, initial assessment and monitoring of patients with prostate cancer. This paper offers a more complex insight into the application of magnetic resonance imaging with prostate cancer, with a current literature overview. The focus is on the problem of initial prostate cancer evaluation which strongly affects further decision-making and therapeutic interventions. Clinical suggestions based on the current guidelines are also offered...
October 2018: Acta Clinica Croatica
Ante Reljić, Petra Čukelj, Igor Tomašković, Boris Ružić, Mario Šekerija
Prostate cancer represents a significant public health burden in Croatia, as well as in other developed countries. The aim of this paper was to present the current epidemiological situation in Croatia in comparison to other similar countries, using basic indicators such as incidence, mortality, prevalence and survival, and to discuss future possibilities in this field. The incidence of prostate cancer in Croatia has been rapidly increasing since the mid-nineties; recent data indicates that the trend is levelling off...
October 2018: Acta Clinica Croatica
Igor Tomašković, Sven Nikles, Ivan Pezelj, Miroslav Tomić, Ivan Svaguša, Matea Pirša, Danijel Justinić, Igor Grubišić, Matej Knežević, Borna Vrhovec, Alek Popović, Ante Reljić, Borislav Spajić, Josip Katušić, Boris Ružić
The Department of Urology at the Sestre milosrdnice University Hospital Center is the oldest urological institution in the Republic of Croatia and this part of Europe. Today, the Department is a modern tertiary healthcare institution, where the most complex methods of urological practice are performed using modern medical devices and highly sophisticated technology. In 2011, our urology specialist education program was certified by the European Board of Urology (EBU) as the only one of its kind in Croatia. The program was recertified in 2017...
October 2018: Acta Clinica Croatica
Boris Ružić, Josip Katušić, Borislav Spajić, Ante Reljić, Alek Popović, Goran Štimac, Igor Tomašković, Šoip Šoipi, Danijel Justinić, Igor Grubišić, Miroslav Tomić, Matej Knežević, Ivan Svaguša, Ivan Pezelj, Sven Nikles, Matea Pirša, Borna Vrhovec
The history of Croatian urology clearly shows its affiliation to the medical and civilizational circle of the Western world. The Department of Urology at the Sestre milosrdnice University Hospital Center is the oldest urology institution in the Republic of Croatia. The Department was established in 1894, when the new Sestre milosrdnice Hospital was open in Vinogradska cesta in Zagreb. It was then that doctor Dragutin Mašek founded the so-called III Department, which, in addition to treating urology patients, also treated patients with conditions of the ear, nose and throat, eye diseases and dermatologic conditions...
October 2018: Acta Clinica Croatica
Goran Štimac, Borislav Spajić, Alek Popović, Danijel Justinić, Igor Grubišić, Šoip Šoipi, Ivan Svaguša, Matea Pirša, Boris Ružić
Stress urinary incontinence (SUI) continues to present a major complication after radical prostatectomy. Suburethral slings represent one of the less invasive options for postprostatectomy SUI, and a more recent addition is a transobturator sling, the AdVance®. We report our results with the AdVance® sling for the management of postoperative SUI. The evaluation was conducted on 47 patients with AdVance® implant for SUI in our institution (November 2010 - June 2017). Measurements included age, etiology of SUI, duration of SUI, follow-up and pad use per day (PPD) pre- and postoperatively...
June 2018: Acta Clinica Croatica
Nikola Pavlović, Šime Manola, Hrvoje Vražić, Marinko Vučić, Sandro Brusich, Vjekoslav Radeljić, Ivan Zeljković, Richard Matasić, Ante Anić, Ivica Benko, Željka Gavranović, Milana Zlatić Glogoški
Four thousand cardiac implantable electronic devices (CIED) are implanted yearly in Croatia with constant increase. General anesthesia and surgery carry some specific risk for the patients with implanted CIEDs. Since most of the surgical procedures are performed in institutions without reprogramming devices available, or in the periods when they are unavailable, these guidelines aim to standardize the protocol for perioperative management of these patients. With this protocol, most of the procedures can be performed easily and, more importantly, safely in the majority of surgical patients...
June 2018: Acta Clinica Croatica
Andrija Jurina, Valentina Delimar, Damjan Dimnjaković, Ivan Bojanić
Lateral inverted osteochondral fracture of the talus (LIFT) is a rare variant of stage IV osteochondral lesion of the talus (OLT), where the fragment is inverted in situ by 180°. The management of LIFT lesion is very challenging and early recognition crucial, given that treatment options depend on the articular cartilage condition and sufficiency of the adjacent bone of the displaced fragment. We describe two LIFT cases referred from other institutions after unsuccessful conservative treatment of OLT. They presented with pain, swelling and tenderness over the anterolateral aspect of the right ankle...
June 2018: Acta Clinica Croatica
Ivan Blažeković, Tomislav Jukić, Roko Granić, Marija Punda, Maja Franceschi
Papillary thyroid carcinoma (PTC) is considered one of the most favorable tumors, indolent, with rare distant dissemination. Lungs and bones are the most common metastatic sites. Unusual sites of PTC distant metastases are extremely rare. Brain, liver, skin, kidney, pancreas, and adrenal gland PTC metastases have been sporadically reported in the literature. An 86-year-old female patient underwent total thyroidectomy and neck dissection due to PTC. Postoperative whole body iodine-131 scintigraphy with I-131 SPECT/CT of the abdomen revealed radioiodne avid left adrenal gland metastasis together with high postoperative serum thyroglobulin (Tg) value of more than 5000 µg/L and high serum Tg antibodies...
June 2018: Acta Clinica Croatica
Luka Vučemilo, Zoran Lajtman, Josip Mihalj, Jasmina Plašćak, Darija Mahović Lakušić, Darija Mužinić
Schwannoma as an extracranial nerve sheath tumor rarely affects brachial plexus. Due to the fact that brachial plexus schwannomas are a rare entity and due to the brachial plexus anatomic complexity, schwannomas in this region present a challenge for surgeons. We present a case of a 49-year-old female patient with a slow growing painless mass in the right supraclavicular region that was diagnosed as schwannoma and operated at our department. The case is described to remind that in case of supraclavicular tumors, differential diagnosis should take brachial plexus tumors, i...
June 2018: Acta Clinica Croatica
Sandra Kojić Katović, Ankica Vasilj, Goran Rinčić
T-cell large granular lymphocytic leukemia (T-LGLL) is an uncommon but probably underdiagnosed disease caused by clonal proliferation of large granular lymphocytes. Diagnosis is typically based on the high number of morphologically characteristic lymphoid cells and finding of an abnormal immunophenotype by flow cytometry. Because of its relatively indolent clinical behavior, observation is often an appropriate therapy. Here we present a case of a 53-year-old male admitted to the hospital because of abdominal pain...
June 2018: Acta Clinica Croatica
Ines Lazibat, Maja Rubinić Majdak, Sven Županić
Multiple sclerosis (MS) is a multicomponent disease characterized by inflammation, neurodegeneration, and cancellation of the central nervous system recovery mechanisms. The cause of MS is still unknown, but it is undeniable that genetic, environmental and immune factors are involved in the etiopathogenesis of this complex and heterogeneous disease. From the aspect of immunopathogenesis, until recently the opinion prevailed that autoreactive T lymphocytes played a major role, the activation of which is a key step in MS...
June 2018: Acta Clinica Croatica
Liborija Lugović-Mihić, Kristina Pilipović, Iva Crnarić, Mirna Šitum, Tomislav Duvančić
Although cheilitis as a term describing lip inflammation has been identified and recognized for a long time, until now there have been no clear recommendations for its work-up and classification. The disease may appear as an isolated condition or as part of certain systemic diseases/conditions (such as anemia due to vitamin B12 or iron deficiency) or local infections (e.g., herpes and oral candidiasis). Cheilitis can also be a symptom of a contact reaction to an irritant or allergen, or may be provoked by sun exposure (actinic cheilitis) or drug intake, especially retinoids...
June 2018: Acta Clinica Croatica
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