Purpose
Most site-specific cancer incidence is increased with the decrease of glomerular filtration rate (GFR). We analyzed endometrial cancers depending on different type, staging, and histology ...grades. We hypothesized that patients with lower GFR levels have an increased risk for higher staging and histology grades of endometrial cancers.
Methods
Patients were divided into two subgroups regarding GFR; the first group with GFR < 60 ml/min and the second group with GFR > 60 ml/min and regarding different histology grades and cancer stages. Cancers were also divided by stages (1–4). Patients were followed up during 1 year through regular controls in the outpatient clinic and during that time cancer recurrence was recorded.
Results
GFR was the strongest predictor for higher cancer histology grade and higher cancer staging. Patients with reduced GFR had OR for higher histology grade and higher staging of 1.06 and 1.06. Traditional risk factors for endometrial cancer development were not associated with higher histology grade or higher cancer staging.
Conclusion
Higher staging and histology grades in patients with endometrial cancers are associated with reduced GFR. Patients with mild-to-moderate CKD had significantly higher number of cancers with higher histology grades and higher stages than patients with mild or normal GFR category. Decline in GFR was independently associated with more aggressive cancers without other well-known risk factors for endometrial cancer development like age, menopause, diabetes, and obesity.
Dugotrajna infekcija visokorizičnim tipovima humanog papiloma virusa (HPV-a) glavni je čimbenik nastajanja premalignih i malignih lezija vrata maternice. Učinkovita prevencija i kontrola bolesti ...zahtijeva poznavanje epidemioloških karakteristika populacije, provođenje metoda probira te otkrivanja bolesti u što ranijem stadiju odnosno predstadiju invazivne bolesti. Dijagnostičke metode koje se koriste u cilju probira uključuju citološke metode – PAPA test, mikrobiološka testiranja, HPV testiranje, HPV genotipizaciju i kolposkopiju. Korištenje novih dijagnostičkih testova zahtijeva preispitivanje uloge svih razina probira odnosno dijagnosticiranja. Usporedom smjernica različitih stručnih društava za probir i dijagnosticiranje premalignih i malignih lezija vrata maternice, kolposkopija je metoda koja određuje daljnji smjer. Cilj je ovog rada propitati važnost i ulogu kolposkopije u dijagnostici i praćenju premalignih i malignih promjena vrata maternice u sinergiji s drugim dijagnostičkim metodama.
A 32-year-old pregnant woman presented to the hospital with abdominal pain and minimal vaginal bleeding. Transvaginal ultrasound revealed visible fluid in pelvic region with suspected tubal rupture, ...and subsequently laparoscopy was performed. During laparoscopy, additional gynecologic pathologies were noticed. Histopathologic finding showed dermoid and endometriotic cyst, as well as tubo-ovarian abscess in the same adnexa. This case report highlights the necessity of considering multiple diagnoses in the same organic system, which may be encountered by surgeon and histopathologist.
Cilj: Cilj istraživanja bila je usporedba djelovanja tramadola i petidina tijekom porođaja na opstetričke ishode (njihov analgetski učinak, trajanje porođaja, pojavnost nuspojava u rodilja i ...neonatalni status). Metode:
Djelovanje analgetika ispitano je prospektivnim usporedbenim (engl. head-to-head) randomiziranim dvostruko slijepim intervencijskim istraživanjem na uzorku od 60 rodilja tijekom ročnog porođaja. U istraživanju su upotrijebljene doze tramadola i petidina od 50 mg primijenjene intravenski. Pri analizi podataka služili smo se testom razlike u proporcijama dvaju nezavisnih skupova i Studentovim t-testom. Prije provedbe t-testa normalnost je ispitana Kolmogorov-Smirnovljevim testom.
Rezultati: Primjena tramadola povezana je s manje prijavljenih nuspojava te kraćim trajanjem porođaja u odnosu prema skupini rodilja liječenih petidinom. Analizom analgetskog učinka statistički značajno niža vrijednost boli nakon 10 minuta i 30 minuta utvrđena je u pacijentica kojima je primijenjen petidin u odnosu prema onima na tramadolu, uz negativnu razliku osjeta boli u obje promatrane točke mjerenja. Efekt primjene tramadola iščeznuo je nakon 30 minuta. Nisu utvrđene statistički značajne razlike u karakteristikama CTG zapisa, Apgarina zbroja, vrijednosti pH iz pupkovine.
Zaključak: Prema rezultatima istraživanja, tramadol skraćuje trajanje porođaja, a petidin ima jači analgetski učinak, ali i više neugodnih nuspojava za majku. Neonatalni je ishod neovisan o vrsti opioida.
Number of reported cases of human dirofilariasis in the last couple of decades has been increasing. Dogs are the main reservoir hosts, while various mosquito species represent/serve as vectors. Human ...infections are caused by two different parasites: Dirofilaria immitis and Dirofilaria repens. Dirofilaria repens is currently considered to be one of the most rapidly-spreading human and animal parasite species in Europe. Clinical features are characterised by subcutaneous or ocular lesions which can persist for months without any symptoms. The disease is considered to be endemic in Mediterranean countries, central Asia, Israel, and Sri Lanka with increased incidence in Central and East Europe. Apart from the local population, tourists are also susceptible to this disease. Export of domestic animals can transfer parasites between different countries. This disease is rare in Croatia.
We are presenting a case of a 58-year-old female patient with dirofilariasis of the genital region caused by Dirofilaria repens, confirmed with PCR and sequencing.
From the clinician point of view, subcutaneous dirofilariasis should be considered as a differential diagnosis in cases of long-lasting subcutaneous swellings.
Rak tijela maternice, prema zadnjim podatcima Registra za rak iz 2017. godine u Republici Hrvatskoj, nalazi se na četvrtom mjestu po učestalosti, a na osmom mjestu po smrtnosti. Najčešće se ...dijagnosticira u postmenopauzalnih žena, većinom u dobi od 50. do 79. godine života. Dijagnoza karcinoma endometrija utvrđuje se patohistološkom analizom kiretmana ili bioptata sluznice maternice, a stupanj proširenosti bolesti primjenom slikovnih metoda. U većine bolesnica bolest se otkriva u lokaliziranom stadiju te se uspješno liječi operativno, a ovisno o patohistološkom nalazu i primjenom odgovarajuće adjuvantne terapije. Lokalno uznapredovala bolest najčešće se liječi operativno uz adjuvantnu terapiju, a metastatska primjenom kemoterapije ili hormonske terapije. Mezenhimalni tumori tijela maternice liječe se operativno uz dodatak sistemske terapije adjuvantno ili samo sistemskom terapijom u slučaju diseminirane bolesti. Ove kliničke upute pisane su u cilju postizanja najviših standarda i ujednačenja postupaka u dijagnosticiranju, liječenju i praćenju bolesnica sa zloćudnim tumorima tijela maternice u Republici Hrvatskoj.
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