TGF-BETA IN THE NATURAL HISTORY OF PROSTATE CANCER.

All transforming growth factors beta (TGFß) are cytokines that regulate several cellular functions such as cell growth, differentiation and motility. They may also have a role in immunosuppression. Their role is important for normal prostate development. TGFß is active in the regulation of balance between epithelial cell proliferation and apoptosis through stromal epithelia via the androgen receptor action. TGFß protects and maintains prostate stem cells, an important population necessary for prostate tissue regeneration. However, TGFß is shown to have a contrasting role in prostate tumor genesis. In the early stages of tumor development, TGFß acts as a tumor suppressor, whereas in the later stages, TGFß becomes a tumor promoter by inducing proliferation, invasion and metastasis. In this review, we outline complex interactions that TGFß-mediated signaling has on prostate tumor genesis, focusing on the role of these interactions during the course of prostate cancer and, in particular, during disease progression.

Introducing Scientific Writing as Mandatory Topic in Bachelor Nursing Program - Experience of the University of Dubrovnik, Croatia.

One of the methods that have been used to encourage student reflection skills is scientific writing. The purpose of this article is to discuss implementation of obligatory study topic with the main objective to increase the skills of scientific writing among students of Bachelor Nursing Curriculum and its relation to scientific publishing volume of Bachelor degree students from the University of Dubrovnik. By searching the local rank database called HRCAK, data were collected on publication volume of the Bachelor course students at the University of Dubrovnik from 2010 to 2014. Articles published in the Croatian medical journals in Croatian language were identified. Sixty-six students published 35 articles, alone or with co-authors. Two (6%) articles were written by a single author. Among co-authors from the nursing profession, those with associate degree in nursing (20%) predominated, followed by medical doctors and anthropologists (25%). The total number of authors was 95, and the share of papers published in Croatian language was 100%. The body of published articles increased from 2012 to 2013 by 14%, and then from 2013 to 2014 by 113%. For future investigations, closer insight into novel approaches is needed to encourage nursing students to increase their scientific productivity, especially in English language. In order to enhance international visibility of Croatian nursing authors, academic members of the Croatian scientific nursing community should find additional tools to upgrade scientific productivity of the Croatian nursing authors.

Treatment of Postherpetic Neuralgia with 5% Topical Lidocaine Plaster ­ Experience from a Small County Hospital: Case Report

Postherpetic neuralgia (PHN) characterized by chronic neuropathic pain is a common complication of herpes zoster. We investigated the efficacy, safety and cost of treating refractory chronic neuropathic pain with 5% topical lidocaine plaster (TLP) in a female patient attending pain unit at a small county hospital. An 80-year-old female diagnosed with PHN presented with severe left intercostal allodynia and hyperalgesia up to the root of the fourth to tenth thoracic dermatome. We administered the well established first- and second-line specific medications for PHN, but treatment regimens were not efficient. Then we introduced TLP and analyzed data from initial assessment and throughout follow up of 1313 days. The efficacy of treatment was based on pain severity that was assessed using the Short-Form McGill Pain Questionnaire and the related visual analog scale. In the last two years of observation, significant reduction was recorded in healthcare resource utilization (changes correlated with substantial reduction in direct cost (2012-2013: -425.90 €; and 2013-2014: -1,435 €) and clinically relevant reduction in pain severity. No unusual side effects were observed. In conclusion, treatment of PHN with 5% lidocaine plaster demonstrated efficacy in reducing pain severity and cost of medical care with a satisfactory safety profile. A starting point for future studies should be comparison of different treatment protocols and upgrading the knowledge, especially related to the cost of PHN treatment.

Renal replacement therapies after abdominal aortic aneurysm repair--a review.

The objective of this review is to assess the incidence of postoperative acute renal failure that necessitates the application of hemofiltration and to determine the factors that influence the outcome in patients undergoing surgical repair of abdominal aortic aneurysm. In addition, the review aims to assess the outcomes of postoperative early hemofiltration as compared to late intensive hemofiltration. Different forms of renal replacement therapies for use in abdominal aortic aneurysm surgery patients are discussed. Electronic literature searches were performed using Pubmed, Medline, Embase, Sumsearch, Cinahil, The Cochrane Central Register of Controlled Trials and Excerpta Medica. The search identified 419 potentially eligible studies, of which 119 were excluded based on the title and abstract. Of the remaining 300 studies, full articles were collected and re-evaluated. Forty-five articles satisfied our inclusion criteria, of which only 12 were of the IA Level of evidence. The search results indicated that the underlying disease, its severity and stage, the etiology of acute renal failure, clinical and hemodynamic status of the patient, the resources available, and different costs of therapy might all influence the choice of the renal replacement therapy strategy. However, clear guidelines on renal replacement therapy duration are still lacking. Moreover, it is not known whether in acute renal failure patients undergoing abdominal aortic aneurysm surgery, renal replacement therapy modalities can eliminate significant amounts of clinically relevant inflammatory mediators. This review gives current information available in the literature on the possible mechanisms underlying acute renal failure and recent developments in continuous renal replacement treatment modalities.