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[Medical oncology].

Patients are more and more often coming to see the physician with reprints from the Oracle of modem times, (the Internet). Facing the rapid development of new anticancer drugs, even the expert can have difficulties in knowing which ones have already rigorous comparative trials and which results are really clinically significant, leading to important improvements in the treatment of patients with solid tumors. In past years we had already noticed that in some cancer types, these progresses unfortunately sometimes remain of marginal importance. Survival benefits are not always well established and, confronted with the exploding costs of medicine, the physician may not always want to use some promising drugs. This review summarizes results of some of the most important randomized clinical trials, but does not attempt to solve the cost-benefit question.

Humans↗

[Regional anaesthesia--whether or not?].

Regional anesthesia is very popular in "Dr. Ivo Pedisić" General hospital Sisak. All the staff know the techniques, surgeons and patients accept it very well, despite still existing prejudice. The aim of the study was to explore the use of regional anesthesia during one year period, in 2003, the reasons for not performing it, as well as the prevalence of complications, also its impact on the number of patients who postoperatively required the surveillance in the intensive care unit (ICU), and finally to compare the costs of the surgery in regional vs. general anesthesia. Regional anesthesia was performed very often (69%), for different operations, without any serious complication. Regional anesthesia showed good impact on the need for postoperative surveillance in the ICU that was significantly lower (p < 0.0001, Chi square test), as well as three times lower costs, realizing the savings of one modem anesthetic machine during one-year period (228.202,72 kn). The results of the study confirm all the benefits of regional anesthesia.

Adolescent↗

[Male infertility caused by pituitary adenoma].

Pituitary adenoma is one of the important etiologies of male infertility. The early diagnosis of pituitary adenoma that caused infertility is not difficult with the help of modem incretion examination and imaging technique. The treatment focused on pituitary adenoma is no doubt the optimal choice of this kind of male infertility.

Growth Hormone-Secreting Pituitary Adenoma↗

[Batching of low-concentration anesthetics with evaporators used in apparatuses for inhalation anesthesia].

The accuracy of the anesthetic vaporizers with modern vaporizing devices is complicated by necessity of providing small anesthetic vapor concentration for a wide range of gas flows, especially at small flows, and at use of a combination of inhalation anesthesia with intravenous one. Compliance with the requirements of the international standards concerning the accuracy of low-concentration anesthetic vapor batching also does not provide management of anesthesia depth at various stages of surgical operations. The problem is solved well by replacement traditional vaporizers with so-called barbotage ones equipped by adjustment of vapor concentration by modem electronic methods. It is even more promising to use direct injection of the liquid anesthetics into the respiratory contour of infusion pump. However, because individual sensitivity of patients to anesthetics is rather variable, these devices do not provide regulation of the depth of anesthesia. Therefore, stability rather than accuracy of batching of low-concentration anesthetics with evaporators used in apparatuses for inhalation anesthesia is of cardinal importance, Methods of objective instrumental evaluation of the depth of anesthesia require further research and implementation.

Anesthesia, Inhalation↗

[Modern pharmacotherapy of benign prostatic hyperplasia].

Benign prostatic hyperplasia is the most common medical problem affecting elderly men throughout the world. With increasing awareness of health issues amongst males, the morbidity caused by this disease is not longer being accepted as just part of growing old. Until about 10 years ago, surgery was the only effective treatment for symptomatic benign prostatic hyperplasia. Now, many men suffering from this disorder may be effectively treated with a medical therapy. This article provides an overview of the efficacy and safety of 5alpha-reductase inhibitors, alpha1-adrenoceptor antagonists and herbal remedies, putting special emphasis on the current place of these agents in the modem therapy of benign prostatic hyperplasia. Wherever possible, our opinion is based on the detailed analysis of the results of available clinical trials.

Adrenergic alpha-1 Receptor Antagonists↗

[Abdominal gunshot wound: description of 86 cases in Cameroon].

Abdominal gunshot wound (AGSW) is a trauma emergency. The purpose of this report is to describe our experience with managing AGSW largely without modem investigational modalities. Data was collected retrospectively by reviewing the surgical reports and clinical charts of patients admitted to live hospitals dealing with AGSW over a 5-year period. Incomplete files and wounds not involving the abdomen were not included. A total of 86 files were analyzed. Patients ranged in age from 10 to 63 years ivith mean age of 32 years and a sex ratio of 5.5. Most patients (87%) underwent surgical exploration. Laboratory revealed no lesions in 22.5% of cases, minor lesions in 9.5% and major lesions justifying surgical repair in 68%. A total of 86 visceral lesions were found in the patients who underwent surgical exploration. The lesion involved the small intestine in 31.5% of case, colon in 24.5%, liver in 23.5%, spleen in 7%, stomach in 6%, and uterus in 2%. The kidney, pancreas, mesenteries, large momentum, and transverse mescaline each accounted for 1% of lesions. Conventional operative techniques were used with a mortality of 5.5% and morbidity of 4%. Based on our findings we conclude that when investigational tools (CT-scan, peritoneal lavage and laparoscopy) are unavailable prolonged watchful waiting increases the risk of mortality and morbidity in patients presenting AGSW associated with suspicious clinical signs. Prompt surgical treatment improves prognosis but is associated with a high rate of cases showing no lesions.

Abdominal Injuries↗

Satisfaction with the oral health services. A qualitative study among Non-Commissioned Officers in the Malaysian Armed Forces.

INTRODUCTION: Patient satisfaction is critical for the growth and prosperity of any oral health service or practice. The success of any oral health service can be assessed by an evaluation of the degree of satisfaction/dissatisfaction of its patients. OBJECTIVE: The aim of this study is to assess satisfaction/dissatisfaction with the oral health services among Non-Commissioned Officers (NCOs) in the Malaysian Armed Forces (MAF). METHOD: A qualitative study using the Nominal Group Technique was undertaken. Eighty subjects from the Rasah Camp, Seremban were randomly selected from four lists, namely privates, male and female corporals and sergeants and were grouped into 10 discussion groups of eight participants each. Of the 10 groups, four groups comprised male corporals, three groups of privates, two groups of sergeants and one group of female corporals. Two separate discussion sessions were conducted to elicit factors/items causing dissatisfaction and satisfaction expressed by the participants. Every participant then scored all the factors perceived as important by members of the group. The score ranged from 0-9 i.e., the least to the most important. Scores were weighted, and the weighted score of every participant for each item was added. The ratings of the factors were determined by comparing the sum of the weighted scores. RESULTS: The six most important factors/items rated in the satisfaction discussion were modem equipment (9.07), friendly dentist (8.27), pleasant surgery (8.23), good quality treatment (7.93), friendly staff (7.18) and pain alleviation (6.07). These factors were further regrouped into three broad categories i.e. (1) Clinic set-up, (2) Patient-personnel interaction (PPI) and (3) Technical competency (TC). In the dissatisfaction discussion six factors/items were rated i.e. long waiting time (10.39), sequence of treatment not followed (7.18), non-availability of dentist (7.16), unfriendly staff (7.05), poor quality treatment (6.80) and restricted time for treatment (5.98). The three most important categories in the dissatisfaction discussion were (1) Administrative efficiency, (2) PPI and (3) TC. CONCLUSION: A conceptual model was developed to explain the factors affecting patients' satisfaction/dissatisfaction with the oral health services. It is recommended that a questionnaire survey be undertaken to validate and reflect the entire population of the MAF. Remedial measures highlighted in the areas of dissatisfaction should be addressed accordingly based on the quantitative study.

Adolescent↗

[Research progress on chemical constituents of Laggera plants in China].

Laggera plants are traditionally used as folk medicine to treat bacterial infection, inflammation and fever in China. Three species, Laggera alata, L. intermedia and L. pterodonta, grow in China. Modem clinical studies show that L. pterodonta is a good medicine against inflammation. More than 100 compounds were obtained from these plants. In order to assist in medicinal application of this species of plants, progresses made in this field are systemically reviewed in this article.

Asteraceae↗

[Analysis of phospholipids in bifidobacteria].

Methods of preparative chromatography on silica gel columns were used for obtaining preparations of polar lipids of bifidobacteria. Studies of the preparations by one-dimensional and two-dimensional TLC demonstrated that diphosphatidylglycerol (DPG), phosphatidylglycerol (PG), phosphatidylethanolamine (PE), and phosphatidylcholine (PC) were the predominant phospholipids; minor phospholipids (phosphorus-containing components present in considerably lower amounts) included phosphatidylinositol (PI) and lyso-phosphatidylcholine (lyso-PC). Parameters of qualitative composition of phospholipids and glycolipids may serve as a set of chemotaxonomic markers in modem procedures for identifying Bifidobacterium species.

Bacterial Typing Techniques↗

Mitochondrial DNA of ancient Cumanians: culturally Asian steppe nomadic immigrants with substantially more western Eurasian mitochondrial DNA lineages.

The Cumanians were originally Asian pastoral nomads who in the 13th century migrated to Hungary. We have examined mitochondrial DNA from members of the earliest Cumanian population in Hungary from two archeologically well-documented excavations and from 74 modern Hungarians from different rural locations in Hungary. Haplogroups were defined based on HVS I sequences and examinations of haplogroup-associated polymorphic sites of the protein coding region and of HVS II. To exclude contamination, some ancient DNA samples were cloned. A database was created from previously published mtDNA HVS I sequences (representing 2,615 individuals from different Asian and European populations) and 74 modem Hungarian sequences from the present study. This database was used to determine the relationships between the ancient Cumanians, modern Hungarians, and Eurasian populations and to estimate the genetic distances between these populations. We attempted to deduce the genetic trace of the migration of Cumanians. This study is the first ancient DNA characterization of an eastern pastoral nomad population that migrated into Europe. The results indicate that, while still possessing a Central Asian steppe culture, the Cumanians received a large admixture of maternal genes from more westerly populations before arriving in Hungary. A similar dilution of genetic, but not cultural, factors may have accompanied the settlement of other Asian nomads in Europe.

Asian People↗

[Brain diseases and modern-day society].

Brain diseases represent one of the largest strains in the developed societies of the modem world. The major lost is in the indirect expenses caused by psychical disorders. Psychiatric diseases start frequently in childhood, affect from the life lasting view one half of the population and frequently result in disablement. Administrative of the World Health Organization and of European Union consider these problems highly important and require emancipation of psychically disabled, including the financial support for the care. Only 4% of the National Budget is directed to that sector in Czech Republic, which is the second lowest share (after Slovakia).

Czech Republic↗

Haptens as drugs: contact allergens are powerful topical immunomodulators.

For the past 40 years, dermatologists have safely used contact sensitizers such as dinitrochlorobenzene (DNCB), diphenylcyclopropenone (DPCP), and squaric acid dibutylester (SADBE) for the treatment of warts, alopecia areata, and even skin cancers. Most of these studies have utilized these powerful topical immunomodulators in acetone, a volatile solvent that precludes development of contact sensitizers as products. We have overcome these problems and stabilized these topical immunomodulators in a non-volatile, nonirritating GRAS (generally regarded as safe) vehicle. The current review article covers the traditional use of contact sensitizers for a variety of benign and malignant conditions and discusses possible mechanisms in relation to developments in modem molecular immunodermatology.

Administration, Topical↗

[Survey of study on the extraction, purification and determination methods of glycyrrhizic acid in Licorice].

Extraction, purification and determination methods of glycyrrhizic acid in Licorice are surveyed in this paper. The extracting efficiency of dilute ethanol solvent for glycyrrhizic acid is higher than water extraction, and ammonia appended to ethanol solution can increase the effect of extraction. Ultrasound method, microwave-assisted method and supercritical CO2 fluid extraction are more effective than the conventional techniques, due to the short extraction time, low consumption of solution and energy. The modem analytical methods such as TLCs, HPLC and CE can determine the content of glycyrrhizic acid rapidly and exactly.

Ammonia↗

[CSF leaks--diagnostic and therapeutic approach].

The paper presents the classification of the CSF leaks and their etiology. The authors insist on the post surgical causes and on the modem diagnostic procedures such as 2 transferrin and trace protein determination and high resolution CT. They also present their own experience in repairing defects from the anterior skull base under endoscopic control. A lot of 20 patients with CSF leak is presented and the types of approach are discussed. If the defect is in the sphenoid sinus the obliterative techniques are preferred. The ethmoidal roof defects are covered with onlay or underlay procedures depending on their dimensions. The results are compared with those from the literature. The authors conclude that the CSF leaks in the anterior and middle skull base are mainly due to trauma or iatrogenic. A clear diagnostic algorithms and a correct selection of the cases suitable for endoscopic approach are required.

Adult↗

[Generation of vaccine strains of gram-negative bacteria with reduced adverse reactions].

The main shortcoming of the modem live and killed vaccines based on gram-negative bacterial strains is their ability to cause adverse reactions. The majority of the adverse reactions are associated with the effect of biological activity of lipopolysaccharide. The report covers the problems concerned with biogenesis of the lipid A, lipopolysaccharide structural component, responsible for its endotoxic activity, as well as with genes determining lipid A synthesis. The special attention is paid to gene-engineering technique for reduction of adverse reactions of vaccine strains that are based on the knock-out mutagenesis of genes waaM and/or waaN responsible for addition of lauroyl and myristoyl residues to the distal glucosamine unit lipid A, generating acyloxyacyl moieties.

Acyltransferases↗

[Radical perineal prostatectomy].

The authors have compared results of the first 9 perineal prostatectomies to a similar group of patients who underwent radical retropubic prostatectomy. In the group of patients after perineal prostatectomies the time of operation was at the average two hours less and the volume of blood loss was also two times less. Perineal radical prostatectomy is an effective modem method of treatment of localized prostate cancer. For many patients it will be a valuable alternative of the retropubic radical prostatectomy.

Aged↗

[Photodynamic therapy of urinary bladder cancer using a chlorin based photosensitizer].

Photodynamic therapy (PDT) is a modem, low-invasive method of urinary bladder (UB) cancer treatment. PDT can induce complete or partial destruction of the tumor, reduce recurrence rate, provide assistance to elderly patients with compromised somatic status who are not radically operable. A combined technique improves the results of photodynamic therapy in patients with surface and invasive UB cancer of stage T2 because photodynamic impact affects not only the tumor but also all UB mucosa by light fiber with cylindric diffusor introduced in a silicon balloon with water. This leads to tumor destruction and a recurrence rate decrease.

Aged↗