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Vol.22 No.3

Date: July–September 2013.

CONTENT:

TREATMENT OF ENDOMETRIAL CANCER DURING 2011 IN CROATIA: RESULTS OF A NATIONAL SURVEY (Vol.22 No.3, p.133-133)

Authors:

Herman Haller, Marko Klarić, Ante Ćorušić, Vlastimir Kukura, Krunoslav Kuna, Deni Karelović, Tomislav Strinić, Zlatko Topolovec, Berivoj Mišković, Branko Dukić, Davor Zoričić, Branko Denona

Original paper 

Summary:

Objective. We investigated the status of endometrial cancer patients treatment in Croatia during 2011. Methods. An anonymous survey containing questions regarding the examinee experience, number of procedures per institution, preoperative analysis, surgical procedures, indications for lymphadenenctomy and adjuvant therapy was sent to 27 hospital institutions in Croatia which participates in treatment of this disease. Results. A total of 70 gynaecologists from 18 institutions responded to the survey. Abdominal total hysterectomy (TAH) was utilized in 481 (85.0%) cases. Laparoscopic assisted vaginal hysterectomy (LAVH) or total laparoscopic hysterectomy (TLH) were used in 64 cases(11.3%). In 334 (59.0%) cases at least pelvic lymphadenectomy was performed while in 197 (34.8%) cases no lymphadenectomy was performed. We separatly examinated results from clinical and general hospitals and find out that a statistically significant greater number of lymphadenectomies was performed in clinical institutions. Furthermore, gynaecologists from clinical institutions more often requested an intraoperative frozen section analysis to assess the depth of myometrial invasion. There was no difference in indications for adiuvant therapy between gynaecologists from general and clinical hospitals. In cases where lymphadenectomy was performed responders were more accurate in indications for adjuvant radiotherapy, as well as responders who participates actively in indication meetings. Conclusion. Surgical treatment of endometrial cancer in Croatia isn’t standardized. However, abdominal hysterectomy with bilateral adnexectomy is the most performed surgical procedure. Results of the present suvey showed that lymhadenectomy was used significantly more often in clincal institutions. There were no significant difference in indications for adiuvant radiotherapy between general and clinical institutions. On the other hand our results emphasizes the importance of lymphadenctomy for setting the indications for radiotherapy. These results represent the present status in treatment of endometrial cancer patients in Croatia and this research should be the base for future similar investigations with the intention to determinate the standard surgical procedures to be used for the treatment of endometrial cancer.

Key words:

endometrial cancer, lymphadenectomy, survey


THE FREQUENCY AND DISTRIBUTION OF HPV DNA OF HIGH AND LOW ONCOGENIC RISK IN CERVICAL SMEAR IN RELATION TO THE CYTOLOGICAL FINDING OF RESPONDENTS (Vol.22 No.3, p.141-141)

Authors:

Miodrag Milojković, Mićo Rosso, Dimitrije Milojković

Original paper

Summary:

Objective. To determine the frequency and distribution of HPV types of high and low oncogenic risk in therelation to the cytological findings of the patients. Methods. The retrospective study included 146 women who were sent to colposcopy clinic for HPV DNA testing from 01.01. till 31.12.2006.. During the study, a total of 217 cervical smears were obtained (1–5 per women) and only the strongest findings were analyzed. In 14 (9.6%) of women HPV type (six without HPV DNA and six with unidentified type because of the small number of cells) or Pap results (N=2) were unknown. They were excluded from further processing and the remaining 132 (90.4%) were analyzed. The Roche PCR-ELISA method was used for HPV DNA detection. HPV types were identified using the PCR ELISA DIG detection kit (Roche Diagnostics GmbH, Mannheim, Germany). Results. HPV DNA was typified from cervical smears in 58 (43.9%) of 132 women. High oncogenic risk HPV types were found in 46 (34.8%) women and 12 (9.1%) had low risk types. Abnormal cytological finding had 94 (71.2%) women: low-grade squamous intraepithelial lesion (LSIL) had 48 (36.4%) women, high-grade squamous intraepithelial lesion (HSIL) 40 (30.3%) and atypical squamous cells of undetermined significance/atypical glandular cells (ASCUS/AGC) six (4.5%). HPV DNA was not typified in 30 (62.5%) of 48 women with LSIL. In 12 (25%) of them high oncogenic risk types were found and six (12.5%) had low risk types. HPV DNA was not typified in 13 (32.5%) of 40 women with HSIL. In 23 (57.5%) of them high oncogenic risk types were found and four (10.0%) had low risk types. In 28 (73.7%) of 38 women with normal cytology HPV DNA was not typified while nine (23.7%) of them had high oncogenic risk types and one (2.6%) had low risk types. Conclusion. The frequency of HPV DNA detection in cytological smear increases with the severity of intraepithelial lesions. The same pattern is seen with frequency of high oncogenic risk HPV types. However, high oncogenic risk types were not found in up to 27.5% of women who have had HSIL shortly before taking smears for HPV testing.

Key words:

HPV DNA type, oncogenic risk, cytological finding, distribution, frequency

 


VALUES OF THE CEPHALIZATION INDEX IN EVALUATION OF CHILDREN BORN AFTER ASYMMETRIC INTRAUTERINE GROWTH RESTRICTION (Vol.22 No.3, p.145-145)

Authors:

Andrea Šimić Klarić, Zdravko Kolundžić, Slavka Galić, Ljerka Banožić, Želimir Šimić, *Vlatka Mejaški Bošnjak

Original paper

Summary:

Objective: The aim of this study is to show the value of the cephalization index in the assessment of children born after asymmetrical intrauterine growth restriction (IUGR). Methods: Examinees are term children born after asym- metrical IUGR (birth weight below 10.centile for gestational age, parity and gender) in General County Hospital Po`ega from 2002. to 2004. aged five to seven and a half. Exclusion criteria were congenital malformations, chromosomopa- thies, conatal viral infections, severe perinatal infections, central nervous system infections and hearing impairment. Control group consisted of children matched to IUGR children according to chronological and gestational age, gender and maternal educational level. Touwen neurological examination was performed for the motor development assess- ment. For cognitive development assessment, Developmental Test ^uturi}, Imitative Hand Positions and Test of Visual Attention from a Developmental Neuropsychological Assessment were performed. For the assessment of language de- velopment Reynell Developmental Language Scale, the Naming test, Articulation test and Mottier test were performed. Cephalization index presenting the ratio between head circumference at birth and birth weight was analysed. There were 50 children in each group. Results: Cephalization index is statistically significant correlated to fine motor skills, muscle power, structure of language and time needed for the naming test. Conclusion: Cephalization index can be useful in neurodevelopment assessment of some higher cortical functions in children born after asymmetrical IUGR.

Key words:

cephalization index, intrauterine growth restriction, neurological development

 


CELL-FREE FETAL NUCLEIC ACIDS IN MATERNAL BLOOD – DIAGNOSTIC POSSIBILITIES, PERSPECTIVES AND CHALLENGES (Vol.22 No.3, p.150-150)

Authors:

Jasenka Grujić Koračin, Željka Modrić

Review 

Summary:

The technique of fetal DNA/RNA isolation is a routine procedure today, particularly in sex determination and RhD immunization in high-risk pregnancies. The field of prenatal testing for the most common aneuploidies /trisomy 21, trisomy 18 and trisomy 13/ has seen an intensive development in the last few years thanks to new technologies that use maternal blood for the analysis of fetal genetic material (the massive parallel sequencing method – MPS) but also thanks to biostatistics’ algorithms. Noninvasive prenatal testing –NIPT is based on a molecular genetic method, which can examine cell free DNA fragments circulating in maternal blood: the method is able to clarify the origin of these fragments and to asses their amount. These tests /noninvasive prenatal tests – NIPT/ are still used as screening methods but with the development of the technology and biostatistics analysis it is possible that they become diagnostic tests due to their specificity and sensitivity /for trisomy 21 99–100%/ which is today already considerable. It is for this reason that many international professional societies have implemented NIPT into their protocols for detection of the most common aneuploidies. Genetic counseling is unavoidable in all protocols. This review article lists physiological preconditions for the techniques of isolation of fetal DNA/RNA from maternal blood, necessary to perform noninvasive prenatal tests – NIPT. It also discusses clinical trials which were conducted and the implications which implementing this expensive (and therefore to most of our patients unavailable) but valuable method, that could in its future find a place in the national protocol of prenatal screening for aneuploidies in Croatia.

Key words:

Cell-free fetal nucleic acid testing, cell-free DNA (cfDNA), non-invasive prenatal testing (NIPT)


THE OVERVIEW OF FOUR PATIENTS WITH POSTPARTAL HEMOLYTIC-UREMIC SYNDROME (Vol.22 No.3, p.157-157)

Authors:

Tanja Vukušić Pušić,* Damir Roje,* Milenka Šain,** Sandra Benzon,* Zdeslav Benzon,* Josipa Radić**

Case report 

Summary:

Postpartum hemolytic-uremic syndrome (HUS) is an extremely rare complication of pregnancy, and it appears together with thrombotic thrombocytopenic purpura (TTP) in one out of hundred thousand pregnancies. It is described mostly in the postpartum period, for most part from 48 hours to ten weeks after the delivery. During 2012, in University Hospital in Split we have had as much as four patients with postpartum HUS, who were treated at Department of Gynecology and Obstetrics, Intensive Treatment Unit, and Department of Internal Medicine. About the generally bad prognosis of this severe and serious disease, a right-timed diagnosis and treatment, accompanied with multidisciplinary approach is of crucial importance to curing HUS. HUS is characterized by thrombocytopenia, damage of renal functions, hemolytic and microangiopathic anemia, and presence of shistocytes in peripheral blood smears. A plasmapheresis treatment has been done on all four patients, with a 100% rate of response to the therapy.

Key words:

hemolytic-uremic syndrome, plasmapheresis


 

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Vrijeme održavanja kongresa: 22.- 24. listopad 2015.