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Vol.21 No.2

Date: April 2012.

CONTENT:

DELIVERY OF HYPOTROPHIC NEWBORNS IN MATERNITY HOSPITAL OF SPLIT (Vol.21 No.2, str.45-49)

Authors:

Nina Medić,* Damir Roje,** Milka Jerić,* Ajana Löw,*** Zoran Meštrović,** Marko Vulić**

Original paper

Summary:
Objective. To investigate the characteristics of deliveries with fetal hypotrophy at the Department of Gynecology and Obstetrics, University Hospital Split. Methods. All mothers of hypotrophic infant pairs born after 28th week of gestation in the two-year period (2008. – 2009.) were included in this retrospective study (n=603). The control group combined two eutrophic infant births which appeared immediately after the every one from the study group (n=1206). Multiple pregnancies, stillborns and malformed ones were excluded from the investigation. Results. Fetal hypotrophy rate was larger in nulliparous subgroup then in multiparous one (c2=5.088; P=0.024). Proportion of fetal hypotrophy in each gestational week was higher as the gestation was lower. Caesarean section was performed more often in the study group (c2=37.457; P<0.001). Hypotrophic newborns had lower birth weight (t=43.816; p<0.001), length (t=27.241; P<0.001) and ponderal index (t=22.398; P<0.001). First minute Apgar score lower or equal to 7 had 7.5% of hypotrophic and 1.7% of eutrophic newborns (c2=31.601; P<0.001). Preeclampsia (c2=9.983; P=0.002) and olygohydramnios (c2=4.582; P=0.032) were more related to fetal hypotrophy. Conclusion. Fetal hypotrophy is associated with worse perinatal outcome which especially applies to higher preeclampsia, olygohidramnios, low ponderal index, cesarean section and low Apgar score rates.

Key words:
fetal growth, fetal weight, Caesarean section, Apgar score, preeclampsia


RESPONSIBILITY OF DOCTORS (Vol.21 No.2, str.50-54)

Authors:

Jadranka Šanjug, Rajko Fureš, Nikša Knezović, Mladen Zadro, Marin Šimić

Review

Summary:
In this paper the authors call attention to the crisis which in the healthcare challenge the doctor’s responsibility because of great number of juridical indicts for financial compensation especially regarding its amount. The paper has intention closely to demonstrate the one of momentally the most actual question of medical law i.e. the responsibility of doctor that may be moral-ethical, disciplinary, civilian-law, and penal. In the paper the views to civil law responsibility are presented and they play the central place in doctor’s respondibility. A special attention is devoted to the malpractice. The knowledge of a justice is absolutely necessary for the doctor’activity. The knowledge of justice fulfils the difference between successful and unsuccessful physician and increases the level of professionalism.

Key words:
civil law responsibility, criminal responsibility, malpractice

 


TREATMENT OF VULVAR CANCER (Vol.21 No.2, str.55-61)

Authors:

Herman Haller1, Maja Krašević2, Stanislav Rupčić1, Miroslav Stamatović1, Alemka Brnčić-Fischer1, Danko Perović1, Senija Eminović2, Marko Klarić1

Review

Summary:
Objective. Treatment modalities for vulvar cancer includes: surgical, radio- and chemo-therapeutical options. In this paper we discuss the impact of new staging classification (2009) on the treatment modalities. Methods. We reviewed the available literature on treatment of invasive vulvar cancer and compared with own results on 114 squamous vulvar cancer patients. Results. The cornerstone of primary treatment remains surgery. There is a trend to introduce less radical surgery, especially in early disease (wide excision). In patients with advanced primary disease, treatment criteria for the use of chemo/radiotherapy are still not completely defined. Conclusions. Less radical approach in surgical management of early stages with implementation of sentinel node identification techniques, the use of triple incision in radical vulvectomy decrease treatment associated morbidity with similar outcome results. Advanced disease requires individualized approach including combination of chemoradiation option and surgery associated with increased complication rate and undefined benefit in final outcome. The centralization of cases will facilitate the use of optimal treatment and patient recruitment for clinical studies. Finally, a new staging system adopted in 2009 whould be applied in all cases with invasive vulvar cancer.

Key words:
chemoradiation, inguino-femoral lymphadenectomy, radical vulvectomy, sentinel lymph node biopsy, vulvar cancer

 


TREATMENT OF MENOPAUSAL SYMPTOMS IN WOMEN WITH BREAST CANCER (Vol.21 No.2, str.62-67)

Authors:

Marina Šprem Goldštajn, Dinka Pavičić Baldani, Hrvoje Vrčić, Tomislav Čanić,Mihajlo Strelec, Velimir Šimunić

Review

Summary:
Breast cancer is the most common malignancy in women. Despite significant improvement in early detection, according to Croatian National Cancer Registry, in the last twenty years permanent increase of new breast cancer cases was detected. In 2009 there were 2390 new cases of breast cancer patients. The improvement in early detection and treatment of breast cancer has led to longer survival of these patients. As a result of early detection and targeted therapies, many of women with breast cancer will survive, resulting in the need to educate patients and providers about the late and long-term effects of cancer in order to improve different aspects of life quality. Beside the most frequent vasomotor symptoms, the lack of estrogen is manifested by cardiovascular, pshychological, genitourinary symptoms as well as symptoms of bone destruction. Reccomendations for treatment of symptoms and signs of estrogen deficit in women with breast cancer are not consistent. The treatment choice depends on patients age, possible disturbances and consequences of treatment. In the paper we present treatment modalities for menopausal symptoms in women with breast cancer.

Key words:
menopausal symptoms, breast cancer, treatment


HYPOTHYREOSIS IN PREGNANT WOMEN (Vol.21 No.2, str.68-72)

Authors:

Marina Ivanišević, Slavko Orešković, Josip Juras, Josip Đelmiš

Review

Summary:
Thyroid function physiologically changes with the progress of pregnancy and it is considered as response to metabolic challenge of pregnancy. During pregnancy basal metabolism increases, iodine accumulates in thyroid gland and thyroid gland itself enlarges due to hyperplasia and hypervascularisation. As the result of physiologic thyroid changes in healthy pregnant women, referent values of TSH and T4 during pregnancy are established. The upper limit value for serum TSH for the first trimester is 2.5 mIU/L, and 3.0 mIU/L for the second and the third trimester. The incidence of hypothyroidism in pregnancy is 2–3%. Hypothyroidism causes frequent perinatal complications during pregnancy and delivery and the offspring often suffers because of impairment of neurological development. Croatian thyroid society recommends screening for all pregnant women at the first visit of pregnancy.

Key words:
hypothyroidism, thyrotropin, pregnancy complications, diagnose, screening and guidelines.


RETROSPECTION ON THE EUROPEAN ASSOCIATION OF PERINATAL MEDICINE REPORT: THE NEWS FOR DIAGNOSIS OF PRETERM RUPTURE OF MEMBRANES (Vol.21 No.2, str.73-77)

Authors:

Marina Ivanišević, Slavko Orešković, Josip Juras, Josip Đelmiš

Review:

Summary:
This review offers short comment on European Association of Perinatal Medicine Guidelines from the year 2011.for the identification of preterm rupture of fetal membranes. The goal is to show the news for diagnosis of premature rupture of fetal membranes and new biochemical diagnostic tests in comparrison with standard diagnostic procedure.

Key words:
preterm rupture, amniotic membranes


Prof. dr. FRANE MIKULANDRA (Vol.21 No.2, str.78-78)

Authors:

Ante Dražančić

In memorian


Dr. VJERA VALJIN (Vol.21 No.2, str.79-79)

Authors:

Josip Franičević, Linda Pavić

In memorian

 

 

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