Autor u radu nastoji afirmirati komedektomiju kao jedan od najpoštednijih operativnih zahvata u k... more Autor u radu nastoji afirmirati komedektomiju kao jedan od najpoštednijih operativnih zahvata u ki rurgiji dojke. Prema vlastitim rezultatima koji se te melje na 46 operiranih bolesnica u dobi od 22 do 79 godina, u proteklom desetgodišnjem periodu otkrive no je 5 (10,8 %) intraduktalnih karcinoma, što bez dvojbe opravdava ovakav postupak. Prema konzultiranoj literaturi istaknuti su mini malni postoperativni nuzefekti u smislu naknadne po jave karcinoma nakon transsekcije vodova, što komedektomiji, među svim poštednim zahvatima na dojci, osigurava važno mjesto u programu kirurškog liječe nja najranijih intraepitelijalnih, intraduktalnih pro mjena.
Purpose: To assess differences between patients with breast cancer before, during and after the 1... more Purpose: To assess differences between patients with breast cancer before, during and after the 1991-1995 war in Croatia. Material and Methods: We analyzed 660 patients of Pozesko-Slavonska County, during the three periods. Relative predictive values of patient's characteristics and stage of tumor were assessed using the X 2-test, and survival with Kaplan-Meier analysis. Results: Tumors were significantly more often of higher stages (IIA and IIB) and with axillary lymph node metastases (N1) during the war, than in prewar and postwar period. Breast cancer was significantly more frequent in patients who previously experienced death in the family (35,3%). The Kaplan-Meier analysis showed correlation between survival, T and N stages of tumor and clinical stage of tumor. Conclusion: The war aggression towards Croatia with its impact on our patients, contributed to modification of characteristics of breast cancer in the analyzed period.
Purpose: In spite of the general consensus on the issue, to point to major dilemmas which appear ... more Purpose: In spite of the general consensus on the issue, to point to major dilemmas which appear in this matter of multidisciplinary interest, and to review current concepts on how to achieve optimal diagnostic and therapeutic outcome. Results: Recent literature data show that the rate of gestational breast cancer, according to most protocols, range from 0.2% to 3.8%. By definition, the clinical manifestation of this type of carcinoma is expected to occur during pregnancy or within one year after delivery. The mode of treatment and prognosis is identical to those of women with breast carcinoma beyond pregnancy, except for radiotherapy that is not indicated during pregnancy and selective use of cytostatics in polychemotherapy during the first trimester. The only exceptions to this practice are women with any advanced stage of the disease due to delayed diagnosis. Results of large studies indicate that the therapy for breast cancer has no adversarial effect on the prognosis of subsequent pregnancy. Conclusion: The evaluation and management of women with gestational breast cancer requires a multidisciplinary approach. A chemotherapeutic regimen should be individualised to a maximum reduction of risk, if applied in the second and third trimester. Surgical therapy may include mastectomy and sparing operative procedures. Sentinel node biopsy should be considered in node negative patients. Radiotherapy should be postponed to the postpartum period.
Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : časopis Društva za medicinsku informatiku BiH, 2013
Poster: "ECR 2011 / C-2258 / Feasibility of calcium scoring of intracranial arteries as a me... more Poster: "ECR 2011 / C-2258 / Feasibility of calcium scoring of intracranial arteries as a measure of arteriosclerosis in stroke patients" by: "N. Gotovac1, I. Isgum2, B. Velthuis2, M. A. Viergever2, J. Fajdic1, M. Prokop3; 1Pozega/HR, 2Utrecht/NL, 3Nijmegen/NL"
U ovom radu analizirali smo podatke o stanju 564 bolesnika, operiranih na Kirurškom odjelu Opće ž... more U ovom radu analizirali smo podatke o stanju 564 bolesnika, operiranih na Kirurškom odjelu Opće županijske bolnice u Požegi, zbog uraslog nokta, u razdoblju od 1982. do 1994. godine. Bilo je 424 (75,2%) muških i 140 (24,8%) ženskih bolesnika, u dobi od 18 do 77 (prosječno 47) godina. Promjene su bile nađene na palcu samo jednog stopala u 512 (90,8%) bolesnika, a obostrano u 52 (9,2%) operiranih. Svi bolesnici operirani su ambulantno, u lokalnoj anesteziji, metodom klinaste resekcije matriksa nokta, a nakon preoperacijskog suzbijanja infekcije, kupkama u antiseptičkim otopinama. Ovisno o opsežnosti procesa, ekscidirana je 1/4 do 1/3 nokta. Postoperacijski bilježimo 148 (26,2%) upala i 2 (0,4%) osteomijelitisa, a zbog recidiva je reoperirano 55 (9,8%) bolesnika. Valja spomenuti da je statistički znakovit (X2 = 9 , 078; p<0,01) udio dijabetičara u skupini recidiva (21,8%) u odnosu prema skupini infekcija (6,1%). Zaključno ističemo da za naše prilike opisanu metodu ocjenjujemo vrlo u...
Poster: "ECR 2011 / C-2259 / Positive calcium scores in the carotid arteries indicate caroti... more Poster: "ECR 2011 / C-2259 / Positive calcium scores in the carotid arteries indicate carotid bifurcation stenosis" by: "N. Gotovac1, I. Isgum2, B. Velthuis2, M. A. Viergever2, J. Fajdic1, M. Prokop3; 1Pozega/HR, 2Utrecht/NL, 3Nijmegen/NL"
Požeška Bolnica djelovala je u ratnim uvjetima od sredine kolovoza 1991. godine, a do sada je jed... more Požeška Bolnica djelovala je u ratnim uvjetima od sredine kolovoza 1991. godine, a do sada je jedna od vrlo rijetkih u Slavoniji koja nije pretrpjela izravna ratna razaranja. Veliki podrumski prostori omogu ćili su relativno siguran rad i smještaj oko 150 ležaje va. Tijekom rata zbrinuto je 589 ranjenika s požeške i drugih bojišnica. Većina ranjenika ozlijeđena je ek splozivnim oružjima (50%) što je ijedno od značajki ovoga rata. Na hrvatskim bojišnicama 49 Požežana izgubilo je život, od čega je 10 umrlo nakon prijema u bolnicu, šest u prvom satu po prijemu a četiri u prva tri dana. U većine se ranjenika radilo o politraumi, a najčešće su bili ozlijeđeni udovi (73,9%) potom prsni koš, glava i trbuh. Postupnim gašenjem većine hrvatskih bojnišnica, po žeška Bolnica postala je oslonac susjednim općina ma, prije svega Slavonskom Brodu i Novoj Gradišci, u zbrinjavanju ranjenika s preostalih posavskih bo jišta, kao i oboljelih koji još uvijek ne mogu zdrav stvenu zaštitu ostvariti u svojim bolnicama. Ključne riječi: rat, bolnica, organizacija, liječenje ...»jer mi koji nismo naoružani nismo ništa manje hrabri, nismo ništa manje ponosni, nismo ništa manje zaljubljeni u svoju domovinu. Ako nemamo oružje ima mo snagu ovoga što je tu, snagu svoje ljubavi, snagu svog dostojanstva, snagu svoje spremnosti da umremo ako ne možemo kao ljudi živjeti. I to je ono što ne damo!«
The work of the Pozega Medical Center Surgical Unit during the two war years (from July 16, 1991,... more The work of the Pozega Medical Center Surgical Unit during the two war years (from July 16, 1991, to October 1, 1993) in Croatia is described. Since the war operations did not affect the town directly, the work was mostly characterized by treatment of wounds inflicted by explosive devices (51.2%) and localized mostly on the extremities (62.9%). Apart from these wounds, there were 0.7% burns, 26.6% gunshot wounds, and 19.6% injuries caused by blunt and hard objects. Of the total of 959 treated wounded persons, only 18 (1.9%) died, illustrating the success of the therapy administered according to the war surgery doctrine criteria.
Radial scar is a confusing lesion of the breast which represent a premalignant lesion. It looks l... more Radial scar is a confusing lesion of the breast which represent a premalignant lesion. It looks like a tubular carcinoma but histologically we can see two rows of cells in tubules. Mammographically there are some typical but not specific signs: (1) the presence of the central radiolucency, (2) the presence of radial long thin spicules, (3) varying appearance in different projection, (4) radiolucent linear structures parallel to spicules, and (5) abscence of palpable lesion or skin changes. All these signs make the "black star" appearance. Authors reanalyzed 21 from 26 woman with the radial scar diagnosis. Aim of our study was to investigate the different morphologic changes in view of differential diagnosis, frequency and potential prognostic importance of the different lesions. According to our findings we can conclude that the radial scar is unpalpable, subclinical lesion which can be seen on mammography but the final diagnosis is histological.
AIM: In spite of the general consensus on the issue, to point to major dilemmas encountered in th... more AIM: In spite of the general consensus on the issue, to point to major dilemmas encountered in this entity of multidisciplinary interest, and to review current concepts on how to achieve optimal diagnostic and therapeutic outcome. RESULTS: Recent literature data show the rate of gestational breast cancer according to most protocols to range from 0.2 to 3.8 %. By definition, clinical manifestation of this type of carcinoma is expected to occur during pregnancy or within one year of delivery. The mode of treatment and prognosis are identical to those in women with breast carcinoma beyond pregnancy, except for radiotherapy which is not indicated during pregnancy and selective use of cytostatics in polychemotherapy during the first trimester. The only exception to this practice are women with advanced stage of the disease due to delayed diagnosis. Results of large studies indicate that therapy for breast cancer has no adverse effect on the prognosis of subsequent pregnancy. METHODS: Recent and older published work available to authors has been reviewed by having in mind common and acceptable methods of treatment used today as well as opinions and data published by more cited authors having in mind institutions with biggest experience in treatment of gestational breast cancer. Public databases and other relevant published literature were used. CONCLUSION: The evaluation and management of women with gestational breast cancer require a multidisciplinary approach. Chemotherapeutic regimen should be individualized to maximally reduce the risk if administered in the second and third trimester. Surgical therapy may include mastectomy and sparing operative procedures. Sentinel node biopsy should be considered in node negative patients. Radiotherapy should be postponed to the postpartum period.
a im: To point out the dangers, side effects and risks of medical assisted fertilization, in vitr... more a im: To point out the dangers, side effects and risks of medical assisted fertilization, in vitro fertilization, embryo transfer and injection on sperm in ovum for mother and the child. Results: On the one hand the negative side effects for women of an abrupt rising risk for the development of neoplasm under pharmaceutical therapy are mentioned. Especially under a therapy which has the purpose to stimulate the ovulation of the ovary it lies around 100%. An increased level of certain hormones, as for example HCG, which influences the ovulation, is closely related with the risk of developing ovarian cancer. Clinical studies at more than 12000 infertile women (primary and secondary acyesis), with an average age of 30 years, show an elevated risk for the development of a malignant tumor of 98%. Also the application of Gonadotrophin is connected with a risk of 146% for the occurrence of cancer after a period of 15 years. FDT involves a risk of about 12% for the occurrence of breast cancer and shows also an aggravation for the risk of cancer of the endometrium from 79% up to 1152%. On the other hand the risk of spontaneous miscarriages under MAF, which is near 20%, and serious illness of the children, including 47% with need of intensive care unit support after birth, need to be realized. Furthermore the investigation of naturally obtained twins and through ART obtained twins shows in the arrangement a slower and poorer development of the children in the ART group with also great differences in physical development. In total the number of inherent malformation of newborns under the use of ART rises from 47 to 177 %. With an installment of 9% we notice that children who came into being by IVF and ICS also fall more frequently ill. (Teething troubles, more hospitalizations and operations, higher frequency of major inherent malformations). Conclusion: All women who want to undergo a medical assisted fertilization should be informed about the side effects and risks for mother and child.
Aim: This retrospective analysis presents our experience in treating Fournier gangrene (FG) and a... more Aim: This retrospective analysis presents our experience in treating Fournier gangrene (FG) and aims to bring in focus diagnostic and therapeutic problems as well as early and aggressive treatment. Patients and Methods: A total of 16 male patients were included in the study. The gastrointestinal form was seen in 5 and the urogenital form in 11 patients. The subjects ranged in age from 39 to 74 years (average 61) for the urogenital, and from 48 to 72 (average 58) for the gastrointestinal form. Other conditions were seen in 9 patients (diabetes mellitus was most common). Most patients were infected with several bacteria. We performed colostomy in 1 patient, orchidectomy in 2 patients, cystostomy in 2 patients and penis amputation in 1 patient. Ultrasound-guided biopsy or aspiration, and CT was also used. Aggressive surgical necrectomy and aggressive antimicrobial therapy was used. Results: Treatment was successful in 14 of 16 patients (87.5%). The length of hospitalization was 19–58 d...
... Level of harm induced by radiation is proportional to distance from source, intensity, as wel... more ... Level of harm induced by radiation is proportional to distance from source, intensity, as well as wavelength of the radiation and age of the fetus [22][28][29][30]. ... Bull Cancer 1996; 83: 266-175 6 Haagensen CD, Stout AP. Carcinoma of the breast. Criteria for operability. ...
Chorangioma of the placenta is a rare tumor with a frequency of about 1%, which usually presents ... more Chorangioma of the placenta is a rare tumor with a frequency of about 1%, which usually presents as a solitary nodule or, less frequently, as multiple nodules. It is found on the fetal surface of the placenta or in placental parenchyma. Most chorangiomas are small and possess no clinical significance. On the contrary, clinically significant chorangiomas, greater then 5 cm or multiple, may be associated with pregnancy complications. The case presented is one of the uncommon presentations of chorangioma, in which its presence and size were not related to a pregnancy disorders or developmental anomalies of the fetus.
Purpose: In spite of the general consensus on the issue, to point to major dilemmas which appear ... more Purpose: In spite of the general consensus on the issue, to point to major dilemmas which appear in this matter of multidisciplinary interest, and to review current concepts on how to achieve optimal diagnostic and therapeutic outcome. Results: Recent literature data show that the rate of gestational breast cancer, according to most protocols, range from 0.2% to 3.8%. By definition, the clinical manifestation of this type of carcinoma is expected to occur during pregnancy or within one year after delivery. The mode of treatment and prognosis is identical to those of women with breast carcinoma beyond pregnancy, except for radiotherapy that is not indicated during pregnancy and selective use of cytostatics in polychemotherapy during the first trimester. The only exceptions to this practice are women with any advanced stage of the disease due to delayed diagnosis. Results of large studies indicate that the therapy for breast cancer has no adversarial effect on the prognosis of subsequent pregnancy. Conclusion: The evaluation and management of women with gestational breast cancer requires a multidisciplinary approach. A chemotherapeutic regimen should be individualised to a maximum reduction of risk, if applied in the second and third trimester. Surgical therapy may include mastectomy and sparing operative procedures. Sentinel node biopsy should be considered in node negative patients. Radiotherapy should be postponed to the postpartum period.
Autor u radu nastoji afirmirati komedektomiju kao jedan od najpoštednijih operativnih zahvata u k... more Autor u radu nastoji afirmirati komedektomiju kao jedan od najpoštednijih operativnih zahvata u ki rurgiji dojke. Prema vlastitim rezultatima koji se te melje na 46 operiranih bolesnica u dobi od 22 do 79 godina, u proteklom desetgodišnjem periodu otkrive no je 5 (10,8 %) intraduktalnih karcinoma, što bez dvojbe opravdava ovakav postupak. Prema konzultiranoj literaturi istaknuti su mini malni postoperativni nuzefekti u smislu naknadne po jave karcinoma nakon transsekcije vodova, što komedektomiji, među svim poštednim zahvatima na dojci, osigurava važno mjesto u programu kirurškog liječe nja najranijih intraepitelijalnih, intraduktalnih pro mjena.
Purpose: To assess differences between patients with breast cancer before, during and after the 1... more Purpose: To assess differences between patients with breast cancer before, during and after the 1991-1995 war in Croatia. Material and Methods: We analyzed 660 patients of Pozesko-Slavonska County, during the three periods. Relative predictive values of patient's characteristics and stage of tumor were assessed using the X 2-test, and survival with Kaplan-Meier analysis. Results: Tumors were significantly more often of higher stages (IIA and IIB) and with axillary lymph node metastases (N1) during the war, than in prewar and postwar period. Breast cancer was significantly more frequent in patients who previously experienced death in the family (35,3%). The Kaplan-Meier analysis showed correlation between survival, T and N stages of tumor and clinical stage of tumor. Conclusion: The war aggression towards Croatia with its impact on our patients, contributed to modification of characteristics of breast cancer in the analyzed period.
Purpose: In spite of the general consensus on the issue, to point to major dilemmas which appear ... more Purpose: In spite of the general consensus on the issue, to point to major dilemmas which appear in this matter of multidisciplinary interest, and to review current concepts on how to achieve optimal diagnostic and therapeutic outcome. Results: Recent literature data show that the rate of gestational breast cancer, according to most protocols, range from 0.2% to 3.8%. By definition, the clinical manifestation of this type of carcinoma is expected to occur during pregnancy or within one year after delivery. The mode of treatment and prognosis is identical to those of women with breast carcinoma beyond pregnancy, except for radiotherapy that is not indicated during pregnancy and selective use of cytostatics in polychemotherapy during the first trimester. The only exceptions to this practice are women with any advanced stage of the disease due to delayed diagnosis. Results of large studies indicate that the therapy for breast cancer has no adversarial effect on the prognosis of subsequent pregnancy. Conclusion: The evaluation and management of women with gestational breast cancer requires a multidisciplinary approach. A chemotherapeutic regimen should be individualised to a maximum reduction of risk, if applied in the second and third trimester. Surgical therapy may include mastectomy and sparing operative procedures. Sentinel node biopsy should be considered in node negative patients. Radiotherapy should be postponed to the postpartum period.
Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : časopis Društva za medicinsku informatiku BiH, 2013
Poster: "ECR 2011 / C-2258 / Feasibility of calcium scoring of intracranial arteries as a me... more Poster: "ECR 2011 / C-2258 / Feasibility of calcium scoring of intracranial arteries as a measure of arteriosclerosis in stroke patients" by: "N. Gotovac1, I. Isgum2, B. Velthuis2, M. A. Viergever2, J. Fajdic1, M. Prokop3; 1Pozega/HR, 2Utrecht/NL, 3Nijmegen/NL"
U ovom radu analizirali smo podatke o stanju 564 bolesnika, operiranih na Kirurškom odjelu Opće ž... more U ovom radu analizirali smo podatke o stanju 564 bolesnika, operiranih na Kirurškom odjelu Opće županijske bolnice u Požegi, zbog uraslog nokta, u razdoblju od 1982. do 1994. godine. Bilo je 424 (75,2%) muških i 140 (24,8%) ženskih bolesnika, u dobi od 18 do 77 (prosječno 47) godina. Promjene su bile nađene na palcu samo jednog stopala u 512 (90,8%) bolesnika, a obostrano u 52 (9,2%) operiranih. Svi bolesnici operirani su ambulantno, u lokalnoj anesteziji, metodom klinaste resekcije matriksa nokta, a nakon preoperacijskog suzbijanja infekcije, kupkama u antiseptičkim otopinama. Ovisno o opsežnosti procesa, ekscidirana je 1/4 do 1/3 nokta. Postoperacijski bilježimo 148 (26,2%) upala i 2 (0,4%) osteomijelitisa, a zbog recidiva je reoperirano 55 (9,8%) bolesnika. Valja spomenuti da je statistički znakovit (X2 = 9 , 078; p<0,01) udio dijabetičara u skupini recidiva (21,8%) u odnosu prema skupini infekcija (6,1%). Zaključno ističemo da za naše prilike opisanu metodu ocjenjujemo vrlo u...
Poster: "ECR 2011 / C-2259 / Positive calcium scores in the carotid arteries indicate caroti... more Poster: "ECR 2011 / C-2259 / Positive calcium scores in the carotid arteries indicate carotid bifurcation stenosis" by: "N. Gotovac1, I. Isgum2, B. Velthuis2, M. A. Viergever2, J. Fajdic1, M. Prokop3; 1Pozega/HR, 2Utrecht/NL, 3Nijmegen/NL"
Požeška Bolnica djelovala je u ratnim uvjetima od sredine kolovoza 1991. godine, a do sada je jed... more Požeška Bolnica djelovala je u ratnim uvjetima od sredine kolovoza 1991. godine, a do sada je jedna od vrlo rijetkih u Slavoniji koja nije pretrpjela izravna ratna razaranja. Veliki podrumski prostori omogu ćili su relativno siguran rad i smještaj oko 150 ležaje va. Tijekom rata zbrinuto je 589 ranjenika s požeške i drugih bojišnica. Većina ranjenika ozlijeđena je ek splozivnim oružjima (50%) što je ijedno od značajki ovoga rata. Na hrvatskim bojišnicama 49 Požežana izgubilo je život, od čega je 10 umrlo nakon prijema u bolnicu, šest u prvom satu po prijemu a četiri u prva tri dana. U većine se ranjenika radilo o politraumi, a najčešće su bili ozlijeđeni udovi (73,9%) potom prsni koš, glava i trbuh. Postupnim gašenjem većine hrvatskih bojnišnica, po žeška Bolnica postala je oslonac susjednim općina ma, prije svega Slavonskom Brodu i Novoj Gradišci, u zbrinjavanju ranjenika s preostalih posavskih bo jišta, kao i oboljelih koji još uvijek ne mogu zdrav stvenu zaštitu ostvariti u svojim bolnicama. Ključne riječi: rat, bolnica, organizacija, liječenje ...»jer mi koji nismo naoružani nismo ništa manje hrabri, nismo ništa manje ponosni, nismo ništa manje zaljubljeni u svoju domovinu. Ako nemamo oružje ima mo snagu ovoga što je tu, snagu svoje ljubavi, snagu svog dostojanstva, snagu svoje spremnosti da umremo ako ne možemo kao ljudi živjeti. I to je ono što ne damo!«
The work of the Pozega Medical Center Surgical Unit during the two war years (from July 16, 1991,... more The work of the Pozega Medical Center Surgical Unit during the two war years (from July 16, 1991, to October 1, 1993) in Croatia is described. Since the war operations did not affect the town directly, the work was mostly characterized by treatment of wounds inflicted by explosive devices (51.2%) and localized mostly on the extremities (62.9%). Apart from these wounds, there were 0.7% burns, 26.6% gunshot wounds, and 19.6% injuries caused by blunt and hard objects. Of the total of 959 treated wounded persons, only 18 (1.9%) died, illustrating the success of the therapy administered according to the war surgery doctrine criteria.
Radial scar is a confusing lesion of the breast which represent a premalignant lesion. It looks l... more Radial scar is a confusing lesion of the breast which represent a premalignant lesion. It looks like a tubular carcinoma but histologically we can see two rows of cells in tubules. Mammographically there are some typical but not specific signs: (1) the presence of the central radiolucency, (2) the presence of radial long thin spicules, (3) varying appearance in different projection, (4) radiolucent linear structures parallel to spicules, and (5) abscence of palpable lesion or skin changes. All these signs make the "black star" appearance. Authors reanalyzed 21 from 26 woman with the radial scar diagnosis. Aim of our study was to investigate the different morphologic changes in view of differential diagnosis, frequency and potential prognostic importance of the different lesions. According to our findings we can conclude that the radial scar is unpalpable, subclinical lesion which can be seen on mammography but the final diagnosis is histological.
AIM: In spite of the general consensus on the issue, to point to major dilemmas encountered in th... more AIM: In spite of the general consensus on the issue, to point to major dilemmas encountered in this entity of multidisciplinary interest, and to review current concepts on how to achieve optimal diagnostic and therapeutic outcome. RESULTS: Recent literature data show the rate of gestational breast cancer according to most protocols to range from 0.2 to 3.8 %. By definition, clinical manifestation of this type of carcinoma is expected to occur during pregnancy or within one year of delivery. The mode of treatment and prognosis are identical to those in women with breast carcinoma beyond pregnancy, except for radiotherapy which is not indicated during pregnancy and selective use of cytostatics in polychemotherapy during the first trimester. The only exception to this practice are women with advanced stage of the disease due to delayed diagnosis. Results of large studies indicate that therapy for breast cancer has no adverse effect on the prognosis of subsequent pregnancy. METHODS: Recent and older published work available to authors has been reviewed by having in mind common and acceptable methods of treatment used today as well as opinions and data published by more cited authors having in mind institutions with biggest experience in treatment of gestational breast cancer. Public databases and other relevant published literature were used. CONCLUSION: The evaluation and management of women with gestational breast cancer require a multidisciplinary approach. Chemotherapeutic regimen should be individualized to maximally reduce the risk if administered in the second and third trimester. Surgical therapy may include mastectomy and sparing operative procedures. Sentinel node biopsy should be considered in node negative patients. Radiotherapy should be postponed to the postpartum period.
a im: To point out the dangers, side effects and risks of medical assisted fertilization, in vitr... more a im: To point out the dangers, side effects and risks of medical assisted fertilization, in vitro fertilization, embryo transfer and injection on sperm in ovum for mother and the child. Results: On the one hand the negative side effects for women of an abrupt rising risk for the development of neoplasm under pharmaceutical therapy are mentioned. Especially under a therapy which has the purpose to stimulate the ovulation of the ovary it lies around 100%. An increased level of certain hormones, as for example HCG, which influences the ovulation, is closely related with the risk of developing ovarian cancer. Clinical studies at more than 12000 infertile women (primary and secondary acyesis), with an average age of 30 years, show an elevated risk for the development of a malignant tumor of 98%. Also the application of Gonadotrophin is connected with a risk of 146% for the occurrence of cancer after a period of 15 years. FDT involves a risk of about 12% for the occurrence of breast cancer and shows also an aggravation for the risk of cancer of the endometrium from 79% up to 1152%. On the other hand the risk of spontaneous miscarriages under MAF, which is near 20%, and serious illness of the children, including 47% with need of intensive care unit support after birth, need to be realized. Furthermore the investigation of naturally obtained twins and through ART obtained twins shows in the arrangement a slower and poorer development of the children in the ART group with also great differences in physical development. In total the number of inherent malformation of newborns under the use of ART rises from 47 to 177 %. With an installment of 9% we notice that children who came into being by IVF and ICS also fall more frequently ill. (Teething troubles, more hospitalizations and operations, higher frequency of major inherent malformations). Conclusion: All women who want to undergo a medical assisted fertilization should be informed about the side effects and risks for mother and child.
Aim: This retrospective analysis presents our experience in treating Fournier gangrene (FG) and a... more Aim: This retrospective analysis presents our experience in treating Fournier gangrene (FG) and aims to bring in focus diagnostic and therapeutic problems as well as early and aggressive treatment. Patients and Methods: A total of 16 male patients were included in the study. The gastrointestinal form was seen in 5 and the urogenital form in 11 patients. The subjects ranged in age from 39 to 74 years (average 61) for the urogenital, and from 48 to 72 (average 58) for the gastrointestinal form. Other conditions were seen in 9 patients (diabetes mellitus was most common). Most patients were infected with several bacteria. We performed colostomy in 1 patient, orchidectomy in 2 patients, cystostomy in 2 patients and penis amputation in 1 patient. Ultrasound-guided biopsy or aspiration, and CT was also used. Aggressive surgical necrectomy and aggressive antimicrobial therapy was used. Results: Treatment was successful in 14 of 16 patients (87.5%). The length of hospitalization was 19–58 d...
... Level of harm induced by radiation is proportional to distance from source, intensity, as wel... more ... Level of harm induced by radiation is proportional to distance from source, intensity, as well as wavelength of the radiation and age of the fetus [22][28][29][30]. ... Bull Cancer 1996; 83: 266-175 6 Haagensen CD, Stout AP. Carcinoma of the breast. Criteria for operability. ...
Chorangioma of the placenta is a rare tumor with a frequency of about 1%, which usually presents ... more Chorangioma of the placenta is a rare tumor with a frequency of about 1%, which usually presents as a solitary nodule or, less frequently, as multiple nodules. It is found on the fetal surface of the placenta or in placental parenchyma. Most chorangiomas are small and possess no clinical significance. On the contrary, clinically significant chorangiomas, greater then 5 cm or multiple, may be associated with pregnancy complications. The case presented is one of the uncommon presentations of chorangioma, in which its presence and size were not related to a pregnancy disorders or developmental anomalies of the fetus.
Purpose: In spite of the general consensus on the issue, to point to major dilemmas which appear ... more Purpose: In spite of the general consensus on the issue, to point to major dilemmas which appear in this matter of multidisciplinary interest, and to review current concepts on how to achieve optimal diagnostic and therapeutic outcome. Results: Recent literature data show that the rate of gestational breast cancer, according to most protocols, range from 0.2% to 3.8%. By definition, the clinical manifestation of this type of carcinoma is expected to occur during pregnancy or within one year after delivery. The mode of treatment and prognosis is identical to those of women with breast carcinoma beyond pregnancy, except for radiotherapy that is not indicated during pregnancy and selective use of cytostatics in polychemotherapy during the first trimester. The only exceptions to this practice are women with any advanced stage of the disease due to delayed diagnosis. Results of large studies indicate that the therapy for breast cancer has no adversarial effect on the prognosis of subsequent pregnancy. Conclusion: The evaluation and management of women with gestational breast cancer requires a multidisciplinary approach. A chemotherapeutic regimen should be individualised to a maximum reduction of risk, if applied in the second and third trimester. Surgical therapy may include mastectomy and sparing operative procedures. Sentinel node biopsy should be considered in node negative patients. Radiotherapy should be postponed to the postpartum period.
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