The aim of this study was to determine the association between total triiodothyronine (T3), free fraction of thyroxin (FT4), and thyrotropin (TSH) levels with prostate cancer histopathological ...features.
Blood samples from 140 patients with prostate cancer were analyzed preoperatively and stratified according to postoperative histopathological differentiation. The first group (N=62) included patients with prostate cancer Grade Groups (GG) 1-2, while the second group (N=63) included patients with prostate cancer GG 3-5.
T3 levels were significantly higher in patients with prostate cancer GG 3-5 (p=0.047). There was no significant difference in the FT4 and TSH levels between the two groups (p=0.680 and 0.801, respectively). T3 levels were positively correlated with tumor percentage involvement (TPI) (p=0.002), and pT stage (p=0.047) on definitive pathology.
Higher T3 levels are associated with several indicators of prostate cancer histopathological aggressiveness.
Background
A case of simultaneous adrenocortical and renal cell carcinoma due to long-term lead exposure from residual gun pellets is a rare and relatively unknown topic in the literature.
Case ...presentation
We present a 43-year-old male patient with a giant retroperitoneal tumor. Thirteen years before he had a shotgun injury of the left upper side of the abdomen and residual gun pellets are present in the abdominal wall. Extirpation of the tumor and the left kidney was performed. Histopathological examination described adrenocortical and renal cell carcinoma.
Conclusion
Continuous and long-term exposure to toxic lead effects from residual gun pellets and traumatic injury represent likely carcinogenic factors in the presented patient.
Background
This study aims to present long-term results, preoperative classification, and surgical approach in the therapy of vesicovaginal fistulas (VVF) and neovesicovaginal fistulas (NVVF). Unlike ...developing countries, where fistulas are mainly the result of delivery trauma, in the modern world, the main causes are urogynecological surgery and irradiation therapy.
Methods
Data of 36 woman who underwent surgical treatment of VVF and NVVF were collected retrospectively. After clinical assessment, fistulas were categorized by the Goh classification system, which led to the choice of surgical approach: transvaginal or transabdominal. Follow-up period was 60 to 108 months.
Results
Out of 36 patients evaluated, 23 were operated transabdominal, and 13 were operated transvaginal. Patients selected for the transabdominal approach were mainly categorized as Goh 1 and 2, including patients after radiotherapy and patients with large fistulas. Patients selected for the transvaginal approach were mainly Goh 3 and 4. There were no statistical differences between groups regarding the success of the operation (83.3%) and complication rate. Complications included fistula recurrence (16.6%), stress urinary incontinence (22.2%), urinary tract infections (11.1%), overactive bladder (13.9%), and urosepsis (2.8%). There was a statistical difference in the duration of the hospital stay in favor of the transvaginal approach (12.00 ± 5.8 vs 16.27 ± 4.65).
Conclusions
Success in the surgical treatment of VVF and NVVF can be achieved by careful preoperative classification, selection of surgical approach, assessment of local tissue status, taking into consideration the characteristics of the fistulas, and adhering to the basic surgical principles. Regardless of the surgical approach, conducting such a preoperative stratification can achieve similar long-term outcomes. Most fistula recurrence (83.3%) appeared within 6 months after the surgery.
- Infections are well-known complications of radical prostatectomy. In the United States and Europe, the rates of surgical site infections are generally less than 1% and of other infections up to 3%. ...We report a case of a 62-year-old man who developed severe sepsis with renal insufficiency, paralytic ileus and polyserositis after radical prostatectomy, as a consequence of probable quinolone-resistant bacterial infection. Computed tomography of the abdomen and chest showed polyserositis with bilateral pleural and peritoneal effusions. Treatment with meropenem and other supportive measures resulted in good clinical outcome. This case suggested that severe sepsis with exudative polyserositis was probably caused by mobilization of an infective agent (bacterium) during bladder neck dissection as part of open radical prostatectomy.
Rak mokraćnog mjehura (RMM) jest, u skladu s podatcima hrvatskog Registra za rak iz 2015. godine, drugi prema učestalosti tumor urinarnog sustava, odmah nakon raka prostate. U 90% slučajeva radi se o ...urotelnom karcinomu, a razlika u preživljenju kod bolesnika s mišićnoinvazivnim RMM-om (MIRMM) i nemišićnoinvazivnim RMM-om (NMIRMM) znatna je. Liječenje NMIRMM-a usmjereno je na smanjenje recidiva i sprječavanje napredovanja bolesti, a sastoji se od transuretralne resekcije (TUR) tumora i primjene intravezikalne terapije ovisno o procjeni rizika od povrata bolesti. Temelj liječenja bolesnika s MIRMM-om jest radikalno kirurško liječenje, tj. cistektomija kojoj u bolesnika koji su sposobni primiti cisplatinu prethodi neoadjuvantna kemoterapija (NKT). U trenutku postavljanja dijagnoze bolest je kod 4 – 6% bolesnika proširena, dok će se u 50% bolesnika razviti povrat bolesti nakon cistektomije. Metode liječenja proširenje bolesti uključuju: kemoterapiju temeljenu na cisplatini, imunoterapiju, palijativnu radioterapiju te simptomatsko i potporno liječenje. Važno obilježje RMM-a jest prisutnost visoke stope somatskih mutacija koje su omogućile promjenu paradigme u liječenju proširenog RMM-a i dovele do odobravanja niza novih lijekova koji pripadaju inhibitorima PD-1 i PD-L1, tj. inhibitorima nadzornih točaka imunosnog odgovora posredovanog T-stanicama .
We report a rare case of spontaneous intraperitoneal bladder rupture following normal vaginal delivery without concomitant uterine rupture. Key diagnostic clinical features were acute renal failure, ...new-onset ascites and bowel ileus with urosepsis. Laparotomy and bladder repair with omentum patch were performed with no adverse outcome reported.
Infekcije su dobro znane komplikacije radikalne prostatektomije. Učestalost infekcija kirurških rana je općenito manja od 1%, a ostalih infekcija je do 3%. Prikazujemo slučaj bolesnika u dobi od 62 ...godine kod kojega se nakon provedene radikalne prostatektomije tijek liječenja komplicirao razvojem teške sepse s renalnom insuficijencijom, paralitičkim ileusom i poliserozitisom, što je bilo vjerojatno uzrokovano bakterijom rezistentnom na kinolone. Kompjutorizirana tomografija abdomena i toraksa pokazala je poliserozitis s obostranim pleuralnim i peritonejskim efuzijama. Liječenje meropenemom i drugim potpornim mjerama rezultiralo je dobrim kliničkim oporavkom i ishodom. Naš slučaj upućuje na to da je teška sepsa s eksudativnim poliserozitisom vjerojatno bila posljedica mobilizacije infektivnog agensa (bakterije) tijekom disekcije vrata mokraćnog mjehura za vrijeme otvorene radikalne prostatektomije.
Zadaća je studije bila procijeniti efikasnost augmetacijsk cistoplastike u liječenju bolesnika s jasno definiranim neurološkim lezijama i posljedičnim neurogenim mjehurom. Kod 22 bolesnika (21 ...muškarac i 1 žena) učinjena je augmentacijska cistoplastika zbog neurogene disfunkcije mjehura (14 ratnih ozljeda kralježnice, 7 prometnih ozljeda kralježnice, 1 transverzalni mijelitis). Temeljna indikacija za operaciju bila je neuspješna farmakoterapija, uz intermitentnu kateterizaciju i persistentnu urinarnu inkontinenciju, s kontinuiranim oštećenjem funkcije gornjeg urinarnog trakta. U 20 bolesnika učinjena je clam ileocistoplastika, dok je u dva bolesnika učinjena augmentacija ileocekoascendensom uz kontinentnu apendikostomiju. (Mainz 1). Rezultati su procjenjivani klinički i urodinamski nakon tri mjeseca i na zadnjem followupu (9 do 18 mjeseci). Gornji urinarni trakt i renalna funkcija bili su poboljšani ili ostali stabilni u svih bolesnika, kao što je u svih acidibazni status bio normalan. Tri mjeseca postoperativno svi su bolesnici bili kontinentni po danu, dok je 9 bolesnika imalo povremene epizode noćne enureze. Na zadnjem followupu svi su bolesnici bili kontinentni dan i noć, uz povremenu samokateterizaciju svakih 4 do 6 sati. Na urodinamskom ispitivanju (3 mjeseca) funkcionalni kapacitet mjehura iznosio je 310.0±78.31 ml, što je značajno povećanje u odnosu na prijeoperativnu vrijednost od 129.55±56.01 (p<0.0001; t=8,790 unpaired t test). Na zadnjem folowupu funkcionalni je kapacitet mjehura iznosio 502.73±107.14 ml, što je značajno povećanje, kako u odnosu na prijeoperativnu vrijednost, tako i u odnosu na vrijednost kapaciteta nakon tri mjeseca (p<0.0001; t=14.478; odnosno p<0.0001; t=6.812, unpaired t test). Ovaj bi nalaz sugerirao da je potrebno određeno vrijeme (duže od tri mjeseca) da se postigne definitivni uzorak ponašanja augmentiranog mjehura. Augmentacijska je cistoplastika terapijski modalitet kojim se može postići niskotlačni rezervoar, uz veliki kapacitet mjehura, te kontinencija pomoću povremene samokateterizacije.
In the frame of measles elimination activities, sera from 1205 Croatian citizens from all parts of the country and of all ages were tested, using Gull Laboratories ELISA, for measles IgG. Equivocal ...results were found in 50 subjects. Of the remaining 1155 participants, 118 or 10.2% were negative and 1037 or 89.8% positive. The proportion of seronegatives ranged from zero (age groups 41-50, 51 and more) up to 21.4% (1 year of age). As for their distribution into age groups suggested by the European Regional Office of WHO, there were 12.7, 8.9, 9.5 and 8.8% negatives in age groups 1-4, 5-9, 10-14 and 15+ years, respectively. According to these results, only the first two age groups meet WHO criteria, indicating that vaccination coverage higher than the reported 90-94% should be attained if one is to expect measles elimination.
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