- Professor Piotr L. Chlosta, MD, PhD, DSci, FEBU:Professor of Urology and Chairman Department of Urology Jagiellonian ... moreProfessor Piotr L. Chlosta, MD, PhD, DSci, FEBU:Professor of Urology and Chairman Department of Urology Jagiellonian University Medical College in Krakow.President of Polish Urological Association. Doctor honoris causa of Semmelweis University in Budapest. Piotr Chlosta is member of several scientific associations, including the European Association of Urology, the American Urological Association (AUA), Academic Association of European Urologists (AAEU) and the Societé Internationale d’Urologie. He is also a Board Member of ESOU. In addition, he is member of the National Examination in Urology Committee and former (2002 - 2014) delegate of the European Board of Urology. Honorary Member of Videosurgery Section Polish Surgeons Association, Hungarian Urological Association New York Section of AUA ,Slovak Urological Association, Czech Urological Association and external assesor of the Athenian Medical University, Greece. His main professional and scientific interests are urological oncology, robotic surgery and laparoscopy. P. Chlosta is author of several original and peer-reviewed articles, books, and book chapters.edit
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Research Interests: Medicine and Hyperplasia
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Research Interests: Medicine and Laparoscopy
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Badanie PROSPER to badanie 3 fazy z randomizacją, w ktorym oceniano wyniki terapii enzalutamidem w polączeniu z hormonoterapią w porownaniu z hormonoterapią i placebo u chorych z rakiem stercza opornym na kastracje (CRPC,... more
Badanie PROSPER to badanie 3 fazy z randomizacją, w ktorym oceniano wyniki terapii enzalutamidem w polączeniu z hormonoterapią w porownaniu z hormonoterapią i placebo u chorych z rakiem stercza opornym na kastracje (CRPC, castration-resistant prostate cancer ) bez przerzutow z czasem podwojenia swoistego antygenu sterczowego (PSA, prostate specific antigen ) (PSADT, prostate specific antigen doubling time ) wynoszącym maksymalnie 10 miesiecy. Artykul podsumowuje kluczowe wyniki badania PROSPER. Do badania PROSPER wlączono 1401 mezczyzn z CRPC z utrzymaną deprywacją androgenową, u ktorych wykluczono obecnośc przerzutow w scyntygrafii koścca i tomografii komputerowej lub rezonansie magnetycznym. Chorych poddano randomizacji w stosunku 2:1 do grupy otrzymującej enzalutamid lub do grupy otrzymującej placebo. Pierwszorzedowym punktem koncowym bylo przezycie wolne od przerzutow zdefiniowane jako czas od randomizacji do progresji radiologicznej lub jako czas do zgonu bez stwierdzenia progresji radiologicznej. Drugorzedowe punkty koncowe obejmowaly czas do progresji PSA, odsetek odpowiedzi PSA, czas do pierwszej kolejnej terapii przeciwnowotworowej, ocene jakości zycia, przezycie calkowite oraz bezpieczenstwo. Mediana przezycia bez przerzutow wyniosla 36,6 miesiąca w grupie enzalutamidu, a 14,7 miesiąca w grupie placebo (HR 0,29; 95% CI 0,24–0,35; p < 0,001). Leczenie enzalutamidem wiązalo sie z lepszymi wynikami w porownaniu z placebo w odniesieniu do drugorzedowych punktow koncowych czasu do progresji PSA i czasu do pierwszego zastosowania kolejnej terapii przeciwnowotworowej. Profil bezpieczenstwa enzalutamidu byl zgodny z odnotowywanym w poprzednich badaniach dotyczących enzalutamidu. W maju 2020 roku opublikowane zostaly wyniki ostatecznej analizy przezycia calkowitego w badaniu PROSPER. Stwierdzono 288 (31%) zgonow w grupie enzalutamidu i 178 (38%) w grupie placebo. Mediana przezycia calkowitego wyniosla 67 miesiecy w grupie enzalutamidu (95% CI 64,0 — nieosiągniete), natomiast w grupie placebo wyniosla 56,3 miesiąca (95% CI 54,4–63,0) (HR 0,73; 95% CI 0,61–0,89; p = 0,001). Podsumowując, w badaniu PROSPER wykazano, ze stosowanie enzalutamidu wiąze sie z wydluzeniem czasu do wystąpienia przerzutow oraz wydluzeniem przezycia calkowitego u chorych z CRPC z PSADT wynoszącym maksymalnie 10 miesiecy w porownaniu z placebo. Aktualnie enzalutamid jest zalecany przez wytyczne urologiczne i onkologiczne u mezczyzn z CRPC bez przerzutow z wysokim ryzykiem ich wystąpienia.
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Background and objective: Urological diseases represent a significant health issue worldwide. Presented study aimed at assessing current urological knowledge and confidence in performing urological diagnostic and therapeutic procedures... more
Background and objective: Urological diseases represent a significant health issue worldwide. Presented study aimed at assessing current urological knowledge and confidence in performing urological diagnostic and therapeutic procedures among medical students at Jagiellonian University Medical College in Poland and compare it on different stages of the undergraduate medical education. Material and methods: We designed an anonymous survey distributed among Polish students from 1st to 6th year of medical studies, before and after clinical urology course. Questions concerned general urological knowledge, prostate diseases, erectile dysfunction, and self-reported practical urological skills. Results: Overall, 437 respondents participated in the survey. Mean total test score in our study group was 50.08%, mean general urological knowledge score was 53.44%, mean prostate diseases knowledge score was 55.43%, mean erectile dysfunction score was 36% and mean practical skills score was 45.83%. Mean total test score increased with consecutive years of studies (R = 0.58; p <0.001). The risk of an above average total test score was significantly influenced by the urology course (OR = 7.95, 95%CI = 1.81-34.84, p = 0.006) and the year of medical studies (4th-6th vs. 1st-3rd) (OR = 5.16, 95%CI = 3.41-7.81, p <0.001). Practical skills score above average was significantly more frequent in the group after the urology course (OR = 6.75, 95%CI = 1.54-29.58, p = 0.011). Conclusions: Results of this study reveal low mean scores obtained by students, even after completing the urology course, which implies that curriculum requires further development. Urological knowledge and self-assessed practical skills increased with years of medical education. The urology course improved the score obtained in our survey, both in terms of total test score and practical skills.
Research Interests: Urology, Medicine, Erectile dysfunction, Curriculum, Knowledge, and 3 moreSurvey, Medical Students, and Pubmed
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Purpose: The α1-adrenoreceptor antagonists, such as terazosin and doxazosin, induce prostate programmed cell death (apoptosis) within prostate epithelial and stromal cells in vitro. This treatment should cause prostate volume decrease,... more
Purpose: The α1-adrenoreceptor antagonists, such as terazosin and doxazosin, induce prostate programmed cell death (apoptosis) within prostate epithelial and stromal cells in vitro. This treatment should cause prostate volume decrease, However, this has never been observed in clinical conditions. The aim of this paper is to review the disconnect between these two processes. Methods: PubMed and DOAJ were searched for papers related to prostate, apoptosis, and stem cell death. The following key words were used: prostate, benign prostate hyperplasia, programmed cell death, apoptosis, cell death, α1-adrenoreceptor antagonist, α-blockade, prostate epithelium, prostate stroma, stem cells, progenitors, and in vitro models. Results: We have shown how discoveries related to stem cells can influence our understanding of α-blockade treatment for BPH patients. Prostate epithelial and mesenchymal compartments have stem (progenitors) and differentiating cells. These compartments are described in relation to experimental in vitro and in vivo settings. Conclusions: Apoptosis is observed within prostate tissue, but this effect has no clinical significance and cannot lead to prostate shrinkage. In part, this is due to stem cells that are responsible for prostate tissue regeneration and are resistant to apoptosis triggered by α1-receptor antagonists.
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Research Interests: Psychiatry, Mental Health, Medicine, Distress, Insomnia, and 4 moreAnxiety, Delirium, ANXIETY, and Pandemic
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5019 Background: In prostate cancer, expression of survivin, a protein that inhibits apoptosis, is associated with resistance to taxanes and poor outcome. LY2181308 reduces survivin expression and consequently is expected to improve... more
5019 Background: In prostate cancer, expression of survivin, a protein that inhibits apoptosis, is associated with resistance to taxanes and poor outcome. LY2181308 reduces survivin expression and consequently is expected to improve activity of taxanes, such as docetaxel. A randomized phase II study was conducted to assess the activity of the combination. Methods: Adult patients (pts) with CRPC, ECOG performance status &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;2, and no bone or CNSmetastases were randomized 1:2 to standard docetaxel/prednisone every 21 days (Arm A) or standard therapy combined with LY2181308 given as a 3-hr IV infusion (Arm B). Analysis was planned and performed after 130 pts progressed or died. This assessment provided a 70% chance of detecting a difference in progression-free survival (PFS) at the 10% significance level. Initially, LY2181308 was given as a loading dose (3 consecutive days) and then as a weekly 3-hr IV maintenance dose. Arm B also included a window treatment with LY2181308 monotherapy equivalent to a 21-day cycle of docetaxel before starting combined treatment. The primary endpoint was PFS. Results: This study enrolled 154 pts. The median PFS for Arm B was 8.64 (90% CI, 7.39–10.45) months vs. 9.00 (90% CI, 7.00–10.09) months in Arm A, showing no statistical difference (log rank p=0.755). The median overall survival (OS) for Arm B was 27.04 (90% CI, 19.94–33.41) months vs. 29.04 (90% CI, 20.11–39.26) months for Arm A (log-rank p= 0.838). The PSA responses (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;50% reduction in PSA) were similar: 56.9% for Arm A and 56.1% in Arm B (p=0.856). Most pts had no pain or mild pain at baseline and during the active period. Pts treated in Arm B had a higher frequency of serious and nonserious adverse events (AEs) than those in Arm A. The observed AE and pharmacokinetic (PK) profiles were consistent with the known safety and PK profiles of LY2181308 and docetaxel. Conclusions: The addition of LY2181308 to a standard docetaxel/prednisone regimen showed no improvement in PFS, PSA response, and OS in first line CRPC pts. The safety profile of docetaxel and LY2181308 is predictable and consistent with the known safety profiles. Clinical trial information: NCT00642018.
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AimsNo specific questionnaire to date has been available in Polish for evaluating health‐related quality of life for urinary dysfunctions associated with multiple sclerosis (MS). The aim of this study was to translate, culturally adapt,... more
AimsNo specific questionnaire to date has been available in Polish for evaluating health‐related quality of life for urinary dysfunctions associated with multiple sclerosis (MS). The aim of this study was to translate, culturally adapt, and validate Polish versions of the Qualiveen and SF‐Qualiveen for use in patients with MS.MethodsCross‐cultural adaptation of the original English Qualiveen and SF‐Qualiveen into Polish was performed according to international recommended and standard procedures. Adult patients with MS of the Department of Urology at the Jagiellonian University, Krakow, Poland, completed the Qualiveen, SF‐Qualiveen, and International Consultation on Incontinence Questionnaire‐Short Form (ICIQ‐SF) twice: at baseline and 2 weeks later.ResultsOne hundred eighty‐nine Polish‐speaking patients with MS completed the questionnaires. An intercorrelation study revealed that internal consistency was good for the total Qualiveen and SF‐Qualiveen (Cronbach's α &gt;0.8). Test‐retest reliability (reproducibility) demonstrated strong stability (intraclass correlation coefficient &gt;0.8). Content validities were optimal. Significant relationships between the Qualiveen and the ICIQ‐SF, as well as the SF‐Qualiveen and the ICIQ‐SF, confirmed good construct/criterion validity.ConclusionThe Polish Qualiveen and SF‐Qualiveen are reliable, valid, and consistent measures of urinary disorder‐specific quality of life in patients with MS. After years of no appropriate Polish instrument being available for healthcare professionals to evaluate patients with MS, we provide these versions and recommend their use in research and clinical practice in Poland.
