Erectile dysfunction (ED) is a highly prevalent disorder among renal transplant recipients. Vitamin D deficiency (VDD) has been associated with several ED risk factors but only recently directly ...linked to ED. We conducted a study to investigate whether vitamin D serum levels were associated with the presence and severity of ED in 40 male patients that underwent deceased donor kidney transplantation (TX) from 2001 to 2013. Blood samples were collected on two seasonally distinct occasions and 25(OH)D concentration was assessed by radioimmunoassay. A 5-item version of the International Index of Erectile Function (IIEF-5) was used for ED evaluation and group stratification. We found comparable rates of ED (75%) and VDD (42.5%-62.5%) as in previously published studies. Serum levels of 25(OH)D did not differ between patients with and those without ED on both measurements (p=0.656 and p=0.914, respectively), or when comparing different ED severity groups. Duration of renal replacement therapy before TX and graft duration until analysis were longer in patients with ED (p=0.022 and p=0.05, respectively), but with the results being nonsignificant on logistic regression. In conclusion, we found no association of 25(OH)D concentration with the presence and severity of ED in renal transplant recipients. So far, there are no similar published data.
Extracorporeal shock wave lithotripsy (ESWL) treatment has been used at Department of Urology, University Hospital "Osijek", Croatia, since July 1988. Until December 2001 seven thousand and eight ...hundred patients underwent ESWL for urinary stones, 68 of them were children (0.87%). Sixty-eight children aged 4 to 15 years (average 10.14 years) underwent ESWL. They were treated for the total of 91 stones: 35 (38.46%) caliceal, 23 (25.27%) in pyelon, 7 (7.69%) in pyeloureteric segment and 14 (15.38%) ureteral. Staghorn calculi were found in 6 (6.59%) patients and multiple stones (four or more stones in the same kidney) in 6 (6.59%). There was total of 95 ESWL sessions performed in 68 patients (1.39 session per patient). Fifty-six patients (82.35%) without residual stones found at the control plain film and sonography of urinary tract were considered "stone free". Addition of 5 patients with clinically insignificant residual fragments (less than 4 mm) increases overall success rate to 89.70%. ESWL is a simple, safe and effective procedure in the management of urolithiasis in childhood. Clinical experience of our institution confirms ESWL as the first line treatment for kidney stones in the pediatric age patients.
CILJ: Metode neinvazivnoga odstranjivanja mokraćnih kamenaca uvedene su na Klinici za urologiju Kliničke bolnice Osijek u razdoblju 1986.-88. godine. Od 1.07.1988. do 31.12.2009. godine ...ekstrakorporalnom udarno-valnom litotripsijom (ESWL), perkutanom nefrolitotripsijom (PCNL), ureterolitolapaksijom (URS) liječeno je 10570 bolesnika s urolitijazom. Cilj je ove studije analiza iskustava stečenih njihovom primjenom u Klinici za urologiju Kliničke bolnice Osijek od 1988. godine do danas.
ISPITANICI I METODE: U promatranom razdoblju liječeno je 5831 muškaraca, 4976 žena i 98 djece starih 2 do 79 godina (prosječna dob 42,23 godine). Urađeno je ukupno 11305 ESWL-a, 262 PCNL-a i 623 URS-a. Rezultat tretmana je procijenjen na osnovi nativnih snimaka urotrakta, UZV pregleda bubrega i laboratorijskih nalaza najmanje tri mjeseca nakon posljednje hospitalizacije.
REZULTATI: Retrogradnim uvidom u medicinsku dokumentaciju 5542 redovito kontrolirana bolesnika, 73,83% ESWLom tretiranih bolesnika ocijenjeno je kao “stone free”. Odljevni kamenci uspješno su tretirani monoterapijim ESWLorn u 59,02%) bolesnika. Ukupno 132 odljevna kamenca tretirana su isključivo PCNL-om s uspjehom od 75,28%), a u 130 bolesnika kombiniran je ESWL i PCNL s uspjehom od 82,61%). URS je primijenjen u 381 (61,16%) bolesnika s ureteralnim kamencima nakon neuspjeha ESWL-a, dok je u 242 (38,84%) bolesnika URS bio metoda prvoga izbora.
ZAKLJUČCI: Još od samoga osnutka civilne Zakladne bolnice u Osijeku 1874. godine možemo pratiti pisane izvještaje osječkih liječnika, kirurga i konačno urologa o odstranjivanju kamenaca mokraćnoga sustava. Konačna potvrda o suvremenosti osječke urologije bila je uspješno usvajanje poštednih metoda ESWL-a, PCNL a i URS-a samo nekoliko godina nakon uvođenja u kliničku praksu tih metoda u vodećim zemljama svjetske urologije.
Trends in testicular germ cell cancer incidence in Eastern Croatia Sudarević, Bojan; Radoja, Ivan; Šimunović, Dalibor ...
Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
11, Številka:
1
Journal Article
To investigate a possible association between radioactive and toxic elements contamination, mainly depleted uranium (DU) from the Chernobyl accident, Croatian War of Independence and Bosnian War and ...the increasing incidence of testicular germ cell cancers (TGCC) in the population of Eastern Croatia.
From 1969 to 2012, 258 testicular cancer (TC) patients were treated at the Department of Urology, University Hospital Centre Osijek. Incomplete data were found in 32 patients who were excluded from the analysis and 10 patients had non-TGCC TC. Seminoma and non-seminoma groups were included out of 216 TGCC patients. The patients were assigned to one of the time periods: 1969-1995 (distant prewar and war period) and 1996- 2012 (postwar period).
In the postwar period 3.5 times higher incidence rate for non-seminomas (4.5 patients yearly vs. 1.3), seminomas (4.2 vs. 1.2) and TGCC overall (8.7 vs. 2.5) was found compared to the prewar period, with non-seminoma presenting in more advanced stage III (35.5% vs. 13.9%, p=0.013).
Usage of depleted uranium in armed conflicts could lead to the development of TGCC after unknown time of latency. Exposure assessment is mandatory to determine a possible causative correlation between the depleted uranium exposure and testicular germ cell cancer.
Cystine lithiasis is a diagnostic and therapeutic challenge. This consensus document has outgrown of discussion of experts in nephrology and urology. It is our hope that this document will be of use ...for all physicians who are facing this disturbing type of urolithiasis. So far, in our national literature there have been no comprehensive documents dealing with this entity and we believe that not only nephrologists and urologists will benefit, but also specialists in internal medicine and general practitioners.
Erektilna disfunkcija (ED) je poremećaj visoke učestalosti u bolesnika nakon transplantacije bubrega. Deficijencija vitamina D (VDD) je već ranije povezana s nekoliko rizičnih čimbenika za ED, ali je ...tek nedavno dovedena u izravnu vezu s ED. U predmetnom smo istraživanju ispitali je li serumska vrijednost vitamina D povezana s prisutnošću i jačinom izraženosti ED u 40 muških ispitanika u kojih je kadaverična transplantacija bubrega (TX) učinjena od 2001. do 2013. godine. Serumsko uzorkovanje je učinjeno u dva sezonski različita razdoblja, uz mjerenje koncentracije vitamina D radioimuno testom. Upitnik International Index of Erectile Function(IIEF-5) korišten je za stratifikaciju bolesnika s obzirom na jačinu ED. Pronašli smo usporedivu učestalost ED (75%) i VDD (42,5%-62,5%) kao u dosad objavljenim istraživanjima. Ni u jednom mjerenju nije utvrđena razlika u serumskim vrijednostima 25(OH)D između ispitanika s ED i bez nje (p=0,656 i p=0,914), kao ni među ispitanicima s različito izraženom ED. Trajanje bubrežne nadomjesne terapije (RRT) prije TX i “trajanje” transplantata do analize bilo je duže za ispitanike s ED (p=0,022 odnosno p=0,05), no samo u univarijatnoj analizi. Zaključno, nismo pronašli povezanost između serumske razine 25(OH)D i prisutnosti te jačine izraženosti ED. Prema našim spoznajama, dosad nema sličnih objavljenih rezultata za navedenu populaciju bolesnika.
Urothelial cancer is the most common bladder cancer. Hematuria is the most common presenting symptom in patients with bladder cancer. The most common diagnostics of bladder cancer is performed by ...transurethral resection of bladder after which pathohistological diagnosis is set. It is necessary to determine whether the cancer penetrated in muscle layer (muscle-invasive cancer) or not (muscle-noninvasive cancer). Decision on therapeutic modality depends on the clinical stage of disease and on prognostic and risk factors. For muscle non-invasive bladder cancer transurethral resection is preferred with or without intravesical instillation of Bacillus Calmette-Guérin (BCG). For invasive cancer the method of choice is radical cystectomy. Radiotherapy is used in radical and palliative purposes. Metastatic disease is most frequently treated by chemotherapy metotrexate/vinblastine/doxorubicine/cisplatin (MVAC) or gemcitabine/cisplatin (GC). The purpose of this article is to present clinical recommendations to set standards of procedures and criteria in diagnostics, treatment and follow up of patients with bladder cancer in the Republic of Croatia.
Cistinska litijaza dijagnostički je i terapijski izazov, a u našoj literaturi do sada nije bilo ujedinjenih prikaza kako valja postupati s ovakvim bolesnicima. Ovaj dokument rezultat je rasprava na ...tom sastanku uz nadogradnju nakon simpozija putem elektroničkih sjednica i ekspertno je mišljenje stručnjaka. Nadamo se da će članak biti od praktične koristi brojnim kolegama koji se susreću s problemom litijaze, a one koji to rjeđe imaju prilike, podsjetit će na ovaj oblik kamenaca mokraćnog sustava. Ovaj dokument namijenjen je primarno urolozima i nefrolozima, ali i svim općim internistima te liječnicima obiteljske medicine jer će svima, vjerujemo, olakšati razmišljanja kada se suoče s takvim bolesnikom.
U Stanici hitne medicinske pomoći (SHMP) Osijek, koja pokriva područje od 180.000 stanovnika, liječeno je u dvogodišnjem razdoblju, od 01. 09. 1985. do 01. 09. 1987. godine, ukupno 33.080 bolesnika. ...Izdvojeno je i analizirano 886 bolesnika s ureteralnom kolikom. 510 bolesnika (57,6%) pregledano je i liječeno u ambulanti SHMP, a u 376 slučajeva (42,7%) pomoć je ukazana u kući bolesnika. Ureteralna kolika javljala se u dobnim skupinama od 10 do 70 i više godina života, a najzastupljeniji su bolesnici u dobnoj skupini od 31. do 40. godine života. Raspodjela po spolu je 1,2 : 1 u korist muških. Pomoć zbog ureteralne kolike tražilo je 27 do 49 bolesnika mjesečno, ali nije utvrđena veća učestalost ureteralnih kolika u ljetnim mjesecima. U 868 (97,8%) bolesnika bol je savladana jednom injekcijom spazmoanalgetika ili spazmoanalgetika u kombinaciji s analgetikom. U 18 (2,2%) bolesnika doza je ponovljena nakon 15—30 minuta. 93 bolesnika (5,3 posto) hitno je upućeno u Urološki odjel Opće bolnice Osijek zbog nerazjašnjene dijagnoze, simptoma akutnog zastoja mokraće, popratnog akutnog pijelonefritisa, anurije ili uremije. U ostalih bolesnika preporučena je kompletna urološka obrada u specijalističkoj urološkoj ambulanti.
Točna i pouzdana analiza kemijskoga sastava bubrežnih kamenca s definiranjem kristalnih komponenti koje se nalaze u sastavu kamenca preduvjet je za djelotvorno medicinsko praćenje osoba koje stvaraju ...bubrežne kamence. Ona može značajno olakšati procjenu i tretman u takvim slučajevima. Za utvrđivanje sastava kamenaca koriste se brojne fizikalno kemijske tehnike. FTIR spektroskopija fizikalna je metoda za analizu kamenaca koja koristi sofisticiranu instrumentaciju, a zahtijeva usporedbu uzorka s poznatim standardima. U radu je prikazano dvadestogodišnje iskustvo kliničkoga laboratorija u IR analizi sastava bubrežnih kamenaca. Glavne kristalne supstance koje se mogu naći u kamencima podijeljene su u šest glavnih grupa: kalcij oksalat, kalcij fosfat, infektivni kamenci, uratni kamenci, cistin i ostali.
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