The aim of the study is to investigate the efficiency of the second-trimester biochemical screening, with maternal serum alpha-fetoprotein (MS-AFP) and free beta-subunit of human chorionic ...gonadotropin (free beta-hCG), during the ten-year period. The study included 11,292 of pregnant women between the 15th and 18th gestational week, who underwent screening from November 1996 to December 2006. The risk for trisomy 21 and trisomy 18 were calculated by computer software, based on a model which generated the final risk for fetal aneuploidies from the pregnant woman's a priori age risk and the likelihood ratio of the distribution of the biochemical markers, according to the second-trimester gestation. With the cut-off value of the final risk > or = 1:250, the detection rate for trisomy 21 was 75% (21/28). In women less than or equal to 35, the detection was 57.1% (8/14) and 92.9% (13/14) in those over 35 years, respectively. The detection rate of trisomy 18 was 50% (2/4). The results confirmed that the implementation of double-test, as non-invasive screening for fetal aneuploidies, should be accepted as a complementary method of antenatal care.
The 20-year experience with large loop excision of the transformation zone (LLETZ) at Gynecologic Oncology Unit, Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Centre ...from Zagreb is presented. This retrospective observational study included 1407 women with cervical dysplasia treated by LLETZ technique during the 1995-2016 period. LLETZ was most commonly performed in the 25-35 age group (51%), followed by the 36-45 age group (22%), and least frequently in the >65 age group (2%). Histopathologic results lower than high-grade squamous intraepithelial lesion were found in 23% and high grade squamous intraepithelial lesion or worse findings in 77% of patients. Positive margin as a sign of possible residual dysplasia was found in 25% of cones, 80% of which included endocervical positive margin. Cervical canal biopsy result was positive in 18% of cases. Accurate colposcopy and its findings can help avoid overtreatment, the rate of which was higher than expected in our retrospective study. Long-term follow up is an imperative for proper assessment of the procedure success. This method is the best choice for complete disease removal without unnecessary overtreatment, but it requires continuous education and training of the whole team. Keywords: Conization; Cervical intraepithelial neoplasia; Uterine cervical dysplasia; Colposcopy; Croatia Prikazuje se 20-godisnje iskustvo u primjeni tehnike large loop excision of the transformation zone (LLETZ) na Zavodu za opcu i onkolosku ginekologiju Klinike za zenske bolesti i porodnistvo, KBC Sestre milosrdnice. Ova retrospektivna studija obuhvatila je 1407 bolesnica s cervikalnom displazijom lijecenih ovom tehnikom u razdoblju od 1995. do 2016. godine. Metoda LLETZ najcesce se izvodila u dobnoj skupini od 25 do 35 godina (51%), zatim u dobnoj skupini od 36 do 45 godina (22%), dok je najmanje zastupljena skupina bila ona iznad 65 godina (2%). Histopatoloski nalaz skvamozne intraepitelne lezije niskog stupnja naden je u 23%, a skvamozna intraepitelna lezija visokog stupnja ili losiji nalaz u 77% bolesnica. Pozitivni rubovi kao znak moguce rezidualne displazije nadeni su u 25% konusa, od kojih je 80% ukljucivalo pozitivan endocervikalni rub. U 18% slucajeva biopsija cervikalnog kanala je bila pozitivna. U zakljucku, tocno izvodenje kolposkopskog pregleda pomaze da se izbjegne prekomjerno lijecenje koje je u nasoj studiji bilo vise od ocekivanog. Dugorocno pracenje nuzno je za pravilnu procjenu uspjesnosti zahvata. Ova metoda je najbolji izbor za potpuno uklanjanje bolesti bez nepotrebnog prekomjernog lijecenja, ali zahtijeva trajnu izobrazbu i obuku cijeloga tima. Kljucne rijeci: Konizacija; Cervikalna intraepitelna neoplazija; Cerviks uterusa, displazija; Kolposkopija; Hrvatska
Provider: - Institution: - Data provided by Europeana Collections- Paraoksonaza 1 (PON1) je enzim koji sudjeluje u uklanjanju karcinogenih radikala lipidne peroksidacije. Cilj istraživanja je ...odrediti paraoksonaznu i arilesteraznu aktivnost PON1, razdiobu fenotipova PON1, učestalost polimorfizama gena pon1 koji utječu na enzimsku aktivnost i koncentraciju te parametre lipidnog statusa i oksidacijskoga stresa u ispitanica s premalignim promjenama vrata maternice. Bazalna i NaCl-stimulirana paraoksonazna aktivnost PON1, kao i ove aktivnosti standardizirane na koncentraciju HDL-a i apoAI, ne razlikuju se znatno između kontrolne skupine ispitanica i skupine ispitanica s cervikalnom intraepitelnom neoplazijom (CIN). Arilesterazna aktivnost PON1 te aktivnost standardizirana na koncentraciju HDL-a i apoAI znatno su niže u ispitanica s CIN-om i u ispitanica podijeljenih u podskupine s CIN-om niskog rizika i s CIN-om visokog rizika. Razdioba fenotipova PON1 ne razlikuje se značajno između ispitivanih skupina kao ni razdioba genotipova i alela polimorfizama Q192R, L55M i -108C>T gena pon1. Koncentracija se tiolnih skupina ne razlikuje, dok je koncentracija malondialdehida mnogo niža, a koncentracija glutationa značajno viša u skupini ispitanica s CIN-om. Dobiveni rezultati upućuju na oksidacijsko-antioksidacijsku neravnotežu u žena s CIN-om. Uočeno sniženje arilesterazne aktivnosti PON1 ukazuje na sniženu koncentraciju ovog enzima u serumu žena s CIN-om što može biti posljedica smanjene genske ekspresije uslijed poremećaja redoks homeostaze.- Paraoxonase 1 (PON1) is the enzyme that removes carcinogenic radicals of lipid peroxidation. The aim of this study was to determine the paraoxonase and arylesterase activity of PON1, phenotype distribution and polymorphisms of pon1 gene, and parameters of lipid status as well as oxidation stress in patients with premalignant lesion of the cervix. Basal and NaCl-stimulated paraoxonase activity of PON1 as well as those activities standardized on the concentration of HDL and apoAI did not differ significantly between control group and group of patients with cervical intraepithelial neoplasia (CIN). On the other hand, arylesterase activity of PON1 as well as activity standardized on the concentration of HDL and apoAI was significantly reduced in CIN group, and in the subgroups with low grade and high grade changes. Distribution of PON1 phenotypes was similar in the study groups. In addition distribution of genotypes and alleles of Q192R, L55M and -108C>T polymorphisms of pon1 gene did not differ between the study groups. Concentration of thiol groups was similar, of malondialdehide was lower and of glutathione was significantly higher in the CIN groups. Observed results indicated an oxidation-antioxidation disbalance in women with CIN. Decreased arilesterase PON1 activity might reflect reduced enzyme concentration which could be the consequence of down-regulated gene expression due to redox homeostasis disturbances.- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
Henoch-Schönlein purpura (HSP) is an IgA-mediated small vessels' vasculitis that affects the skin, intestines and kidneys. Pregnancy has been reported as an exacerbating factor. We present the case ...of a 24-year-old
with HSP that occurred in the third trimester and lasted up to the end of the successful delivery. She had pruritic maculopapular exanthema on her legs. Biopsy of a cutaneous lesion was performed for histopathologic features and direct immunofluorescence (DIF) for the presence of perivascular IgA deposition. Histopathology of the cutaneous lesion confirmed leukocytoclastic vasculitis. A DIF examination of the skin lesion confirmed deposits of fibrinogen in the small blood vessel walls. Six weeks following delivery, the skin lesions almost completely disappeared. Control laboratory findings were normal. This case of HSP might have been primarily associated with a preceding respiratory infection but this should first be carefully investigated due to a possible severe immunological disease in the patient's background requiring special attention since nephrotic symptoms may occur.
Anomalija trostrukog uretera je iznimno rijetka anomalija gornjeg urotrakta. Također može biti povezana s povećanom
incidencijom kongenitalnih anomalija, kao i s predispozicijom za češće mokraćne ...infekcije, no nije nužno klinički značajna.
Kod postojanja simptoma koji smanjuju kvalitetu života svakako treba razmišljati o operativnom zahvatu koji se planira
ovisno o vrsti tegoba koje trpi bolesnik. Kirurško liječenje bolesnika s utrostručenjem uretera obično je indicirano ako postoji
rizik bubrežnog zatajenja. Ta stanja su najčešće vezikoureteralni refluks, opstrukcija, ureteralna ektopija i ponavljajuće infekcije.
Kirurški zahvat može uključiti istodobni tretman gornjih i donjih mokraćnih putova. Prikazuje se slučaj 38-godišnje
bolesnice kojoj je tijekom radikalne operacije raka vrata maternice pronađen slučajan nalaz trostrukog lijevog uretera.
Ruptura maternice u trudnoći teška je opstetrička komplikacija povezana sa značajnom maternalnom i fetalnom smrtnošću.
Rizik raste kod žena s prethodnom uterotomijom koja uključuje carski rez, ...miomektomiju, salpingektomiju, ali i različite
anomalije posteljice i maternice, polihidramnij, a u rijetkim slučajevima može nastati i spontano. Prikazujemo slučaj
rupture maternice u ranom trećem trimestru trudnice koja je prethodno imala lijevostranu salpingektomiju zbog saktosalpinksa
učinjenu laparoskopskim putem i resekciju lijevog roga kao terapiju ektopične trudnoće laparotomijom.
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