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Vol.21 No.1

Date: January 2012.

CONTENT:

SIGNIFICANCE OF HISTOLOGICAL TYPE OF CERVICAL CANCER PATIENTSSTAGE IB1-IIB TREATED WITH RADICAL HYSTERECTOMY AND PELVIC LYMPHADENECTOMY (Vol.21 No.1, str.1-7)

Authors:

Herman Haller,1 Maja Kraljević,2 Stanislav Rupčić,1 Ozren Mamula,1 Miroslav Stamatovi},1 Ružica Karnjuš-Begonja,3 Alemka Brnčić-Fischer,1 Senija Eminović,2 Ana Mihaljević-Ferari,3 Danko Perović,1 Miljenko Manestar1

Original paper

Summary:
Objective. To analyze the survival and prognostic factors related to the histology type of cervical cancer patients FIGO stage IB1-IIB treated with radical hysterectomy and lymphadenectomy. Methods. The patients who underwent surgery with or without adjuvant therapy between 1990 and 2005 at Department of Obstetrics and Gynecology, Clinical Hospital Center Rijeka, Medical Faculty University of Rijeka were evaluated. There were totally 239 patients, 184 (77.4%) with squamous cervical cancer, 35 (14.2%) adenocarcinoma and 20 (8.4%) adenosquamous carcinoma of the uterine cervix. Results. There is no difference in survival between squamous cervical carcinoma, adenocarcinoma and adenosquamous carcinoma of the uterine cervix within each group: age, FIGO stages, parametrial radicality, tumor diameter, depth of tumor invasion, tumor differentiation, the use of adjuvant treatment, presence of lymph vascular space invasion and the involvement of parametria. Cox regression hazard model identifies three independent factors: lymph node status, parametrial invasion and dimension of primary cervical tumor while histological type has no significance. Conclusion. There is no difference in prognostic significance of cervical cancer histological type among patients treated with radical hysterectomy and pelvic lymphadenectomy stage IB1-IIB.

Key words:
squamous cervical cancer, adenocarcinoma, adenosquamous carcinoma of the uterine cervix, survival, FIGO stage, radical hysterectomy, lymphadenectomy


UTERINE THERMAL ABLATION BY A SIMPLE TECHNIQUE USING FOLEY’S CATHETER (Vol.21 No.1, str.8-13)

Authors:

Tejal Patel, Bakul Leuva

Original papers

Summary:
Objectives. To introduce a simple and cost-effective ablative technique to treat excessive menstrual flow. Design. Prospective study from Oct 2005 to May 2007. Total 50 patients were studied. Methods. The endometrium was treated with boiling normal saline for 9 minutes with the use of Foley’s catheter. Side effects, complications and outcome of the operative procedure were studied. Results. The success rate according to reduction in blood flow was 92% at 3 months, 93.75% at 6 months, 89.58% at 9 months and 91.3% at 12 months post-operatively. Over all satisfaction rate of the procedure was 88%. 70% patients had mild cramps or lower abdominal pain and 80% patients had pink or watery vaginal discharge in the immediate post-operative period. No patient had complaint of pain or discharge at the end of 12 months. 10% patients required hysterectomy due to persistence of symptoms. Conclusion. Thermal ablation with Foley’s catheter is a simple, effective, less invasive and inexpensive technique to treat excessive menstrual flow. Hysterectomies can be avoided with this simple technique and it is also useful in patients in whom anesthesia is contraindicated.

Key words:
uterine thermal ablation, Foley’s catheter, menorrhagia


JUSTIFIABILITY OF MICROBIOLOGICAL ANALYSIS OF CERVICAL SAMPLES DURING THE THIRD TRIMESTER AT ASIMPTOMATIC PREGNANT WOMEN (Vol.21 No.1, str.14-16)

Authors:

Sonja Pejković,* Damir Roje,** Lidija Pejkovič,*** Vanja Kaliterna****

Original paper

Summary:
Objective. To test justifiability of microbiological analysis of cervical samples during the third trimester, to improve neonatal outcome. Examines and methods. Examined group consists of 210 asimptomatic pregnant women, all supervised by the same gynaecologist. Their cervical samples were analysed with standard microbiological procedures between 33 and 36 weeks of pregnancy. The pregnant women who were positive, were treated with corresponding antibiotic. Equal number of women whose delivery, according to protocol, set inimmediately after individual delivery, represents this control group. Data on microbiological analysis of cervical samples are unknown for this group. Results. 29 pregnant women were positive (13,8%) for microbiological isolates: Streptococcus agalactiae 12 (5,71%), Escherichia coli 15 (7,14%), Proteus mirabilis 2 (0,95%). Among those two groups there is no statistically significant difference in age or parity. 14,76% of pregnant women were delivered by Caesaren section, while 12,85% of those in control group (x2=0,32;p=0,56). 61 (29,04%) of newborns from examined and 53 (25,23%) from control group were received in Neonatal intensive care unit (x2=0,77; p=0,38) . Duration of NICU supervision in examined group was 9 days (min – max: 7–14) and in control group 8,5 days (min – max: 7–9), (z= –1,4; p=0,14). Six newborns from control group were hospitalized because of perinatal infection. Conclusion. Statistical justifiabelness of microbiological analysis of cervical samples in asimptomatic pregnant women in third trimester has not been proved yet. These results point out necessity of further research with the aim of final calculation of medical and economical justifiability of procedure.

Key words:
cervical smears, neonatal sepsis, perinatal infection


PERINATAL OUTCOME OF TWINS AFTER ASSISTED REPRODUCTION – OUR EXPERIENCES (Vol.21 No.1, str.17-21)

Authors:

Marko Vulić,* Edita Runjić,** Damir Roje,* Zoran Meštrović,* Mirjana Vukinović*

Original paper

Summary:
Objective. To compare perinatal outcome of twins conceived spontaneusly and after assisted reproductive technologies (ART). Material and methods. We conducted a retrospective study that included twin pregnancies in period 01.01.2007. – 31.12.2008. Investigated varaibles were maternal age (years), parity, body mass index – BMI (kg/m2), week (£366/7 and ³37) and mode of delivery (vaginal and SC), birth weight (grams), way of conceiving pregnancy (ART and spontaneously) and Apgar score (0–3, 4–7, 8–10). Results. We found no difference in the preterm delivery rate (c2=0,0596, P=0,822), mode of delivery, (c2=2,8368, P=0,062), prevalence of small for gestational age (SGA) babies (c2=0,9664, P=0,664) and Apgar score (c2=2,61926, P=0,27) between twin pregnancies following ART and spontaneously conceived. Conclusion. Twin pregnancies after ART compared to spontaneusly conceived, does not have a negative impact on perinatal outcome in terms of preterm delivery, birth weight, SGA babies, mode of delivery and Apgar score.

Key words:
twin pregnancy, perinatal outcome, assisted reproduction


NEW COLPOSCOPIC CLASSIFICATION RIO DE JANEIRO 2011 (Vol.21 No.1, str.22-30)

Authors:

Goran Grubišić

Review

Summary:
The new colposcopic classification was accepted after three years Study group efforts (2008–2010). Having in the mind that lot of time elapsed from colposcopic terminology »Barcelona (2002–2008)« it was reasonable to bear in mind that certain practical problems have arrised to be solved. The first was subdivision of transformation zone in three types, the second was pointing out the minor and major changes in squamous epithelium of the uterine cervix and upper third of vagina, the third was precise mapping of cervical coloposcopic change surface areas subdivided in four quadrants, the fourth one was that keratosis again is included in abnormal changes.

Key words:
colposcopy, classification, transformation zone


PREPORUKE ZA CIJEPLJENJE PROTIV ROTAVIRUSNE INFEKCIJE (Vol.21 No.1, str.30-30)

Authors:

*

Guideline

Summary
*

Key words:
*


FUNCTIONAL VISION IN CHILDREN WITH PERINATAL BRAIN DAMAGE (Vol.21 No.1, str.31-34)

Authors:

Sonja Alimović

Review

Summary:
Sense of sight is most important for overall development of a child. So it is necessary, for children in risk of visual impairment, to assess how they are using their vision, as early as possible. Beside ophthalmologic procedures, we need to assess functional vision. Functional vision is the one that can be used for planning and performance of tasks. It depends on numerous factors related to child and environment. By using unstandardized materials and standardized tests, trough play and observing child’s reactions, visual functions and functional vision is being assessed. It is possible even in newborns to assess development of some visual functions that gives us a clue about child’s visual abilities. Children with perinatal brain damage develop different kinds of problems in visual functioning. The cerebral visual impairment (CVI) is defined as loss of vision caused by disorder of posterior visual pathways and/or occipital lobe. We can say that it is every kind of visual problem not caused by problems on eye. It is most important to assess functional vision in children with perinatal brain damage as early as possible, because using therapeutic-habilitation procedures process of brain plasticity can be stimulated, that will contribute to the recovery of damaged functions. Sensory experience from environment can influence to »connecting« of visual pathways after birth. It is necessary to do early habilitation of vision using techniques of visual stimulation that are individually planed according to functional vision assessment. Habilitating the vision, we facilitate overall child’s development (motor, emotional, communication, learning by imitation etc).

Key words:
perinatal brain damage, functional visus


PERINATAL MORTALITY – A PROSPECTIVE VIEW (Vol.21 No.1, str.35-37)

Authors:

Ahmed Khalid Yassin, Atif Fazari, Elhadi Miskeen

Professional paper

Summary:
Objective. To study the perinatal mortality rate in King Abdulah hospital, the various factors contributing to perinatal mortality rate and to draw strategies to reduce it. Method. A prospective study from January 2003 to January 2006 (total period of 36 months) was done in the labor and delivery unit in King Abdullah hospital, Bisha, Kingdom of Saudi Arabia. All stillbirths and all live births that died within one week of birth were recorded. Results. Out of a total of 9412 deliveries, the perinatal mortality rate (PMR) was calculated to be 24.3 per 1000 livebirths and stillbirths. It was also studied that PMR was greater in the male fetuses than in the females. The common cause of PMR was unknown 26.2%, followed by prematurity, congenital malformations, maternal diseases, antepartum haemorrhage, cord accidents, twin – twin transfusion syndrome, perinatal asphyxia, hydrops fetalis and infection. In the absence of postmortem study in this country, all perinatal deaths where the cause was unidentified were listed as unknown cause and that constituted the majority. Conclusion. In general the PMR was found to be higher in male fetuses, birthweight below 1000gms, increasing maternal age ~ 46 years, and grandmultigravida G~10. A strategy to reduce PMR is highly recommended.

Key words:
perinatal mortality


GENERAL ANAESTHESIA IN A PATIENT WITH HEREDITARY ANGIOEDEMA (Vol.21 No.1, str.38-40)

Authors:

Marija Matas, Dunja Anzulović, Slobodan Mihaljević, Ljiljana Mihaljević

Case report

Summary:
Hereditary angioedema (HAE) is a rare condition characterised by episodic attacks of oedema most often affecting the extremities, face, neck or the mucosal tissues of the gastrointestinal and respiratory tracts which can, when it affect airway, also be life threatening. This disorder is a result of an inherited deficiency or dysfunction of C1-esterase inhibitor. We describe here the peri-operative management of a woman with hereditary angioedema undergoing conisatio following CIN III.

Key words:
hereditary angioedema, C1-esterase inhibitor deficiency, anaesthesia


Dr. DRAGAN METZGER (Vol.21 No.1, str.41-42)

Authors:

Dubravko Habek

In memoriam


Mjesto održavanja kongresa: Hotel President****, Split, Starčevićeva 1, www.hotelpresident.hr/split
Vrijeme održavanja kongresa: 22.- 24. listopad 2015.