The degree of agreement between HPV testing, pap smear and colposcopy in cervical dysplasia diagnosis.

MATERIAL AND METHODS: The current study analyzed the degree of agreement between HPV testing, Pap smear, and colposcopic directed cervical biopsies. The study was performed on a group of 332 patients diagnosed and treated for cervical dysplasia at Cuza-Voda Obstetrics-Gynecology Clinic Hospital and Suceava County Hospital between 2006 and 2011. RESULTS: 190 patients (57.23%) were positive for HPV, 56 (35%) were positive for two HPV types and 42 (22.10%) for three or more HPV types. High grade cervical squamous intraepithelial lesion (HSIL) accounted for 88 (26.5%), low grade cervical squamous intraepithelial lesion (LSIL) for 92 (27.71%), atypical squamous cells of undetermined significance (ASC-US) for 69 (20.78%) and squamous cell carcinoma accounted for 5 (1.5%) of referral Pap smears. Colposcopic directed cervical biopsies reported no pathological abnormality (negative) in 64 (19.28%), HSIL in 105 (31.62%), LSIL in 83 (25%) and other lesions in 80 (24.1%) women. Exact degree of agreement between Pap smear and cervical biopsy was fair (k = 0.5) when analyzing for high grade cervical squamous intraepithelial lesion. The high-risk HPV types 16, 18, 66 and 68 and the low-risk HPV types 11, 54, 83, and 61 were the most frequently detected HPV types. CONCLUSIONS: The current study showed the fair agreement between Pap smear and colposcopic biopsy. Incorporation of HPV testing into the present Pap screening program has the potential to make screening for cervical cancer more effective, and a necessary prelude to assessing this is determining the prevalence of the high-risk types.

[Incidence of congenital malformations in the Iasi "Cuza Voda" Maternity Hospital]. / Cercetari privind incidenta malformatiilor congenitale în Spitalul Clinic "Cuza Voda" Iasi.

AIM: To update the data on the incidence of congenital malformations in our area and emphasize the importance of prenatal diagnosis. MATERIAL AND METHODS: The study was conducted over a period of ten years and included 2211 cases with congenital malformations. Such parameters as the incidence of malformations over these years, gestational age at the moment of diagnosis, and mortality from congenital malformations were followed. Statistical and graphical data were processed with the help of SPSS 16.0 and MS Excel software. RESULTS: The total prevalence of malformations was 3.52%, comparable with the data in the literature. Over this period a number of 262 cases (11.8%) ended in spontaneous miscarriage or termination of pregnancy for fetal abnormalities. A significant percentage of these pregnant women gave birth to their child, many of them dying shortafter. CONCLUSIONS: Congenital malformations remain the leading cause of mortality in neonates. In Romania, the advanced techniques of prenatal diagnosis being used only in specialized centers, and a large number of cases may escape early diagnosis. This study underlines the importance of a correct assessment of fetuses so that the discovery of fetal abnormalities at birth not to be a surprise.

[Breast cancer in women over 60 years of age]. / Cancerul mamar la femeile cu vârsta peste 60 de ani.

UNLABELLED: The breast cancer is the most frequent malignancy in women over 60 years of age in the developed countries and it represents the second frequent cause of death through malignancies in women. MATERIAL AND METHOD: The study was performed on 63 women over 60 years old diagnosed with breast cancer in an one year period (2006) in our service. The aim of the study is to establish the clinical particularities and the optimal therapeutically management of this disease on elderly women. RESULTS: The incidence of the malignancy is high (78% of all cases) in women of 60 to 69 years of age. The most common risk factor revealed in this study is obesity (33%). Cardiovascular diseases (70%) and atrophic cervico-vaginitis (43%) are the most frequent associated conditions. The incidence of the early stages of the malignancy is low (14%) and usually the tumors are well differentiated ductal invasive carcinomas (63%). The modified Madden radical mastectomy was performed in most of the cases (75%). CONCLUSIONS: Breast cancer in elderly women has an incidence peak at the age of 60 to 69 years. Despite numerous associated conditions the surgical treatment remains the most effective therapy.

[The prevention of urinary tract injuries in obstetrics]. / Prevenirea traumatismelor aparatului urinar in obstetrica.

The aim of this study was to warn young obstetricians of the traumatic injuries to the urinary tract in their daily practice. After a short description of the changes that occur in pregnancy and puerperium at the urinary tract, we present "details" of some methods in order to avoid the urethral, bladder and ureteral injuries during vaginal delivery and some obstetric procedures (caesarean section, hysterectomy). This article represents a small and useful guide for young obstetricians in order to avoid unpleasant situations that can occur in their obstetric practice.

[Cervugid ovules in cervico-vaginal infections and cervix uteri precancerous conditions treatment]. / Tratamentul infectiilor cervico-vaginale si a starilor precanceroase ale colului uterin cu Cervugid-ovule.

UNLABELLED: This medicine was authorized by the National Drug Agency (ANM, Bucuresti) in 2001. PURPOSE: To evaluate the effectiveness and the tolerance to Cervugid-ovules, a preparation that combines the polyvalent local antiinflammatory action of chloramphenicol, metronidazole and nystatin with the effect of hydrocortisone acetate, an unspecific anti-inflammatory agent; they all are embedded in a Lipex-403, semisynthetic fat. MATERIALS AND METHODS: The evaluation of 500 patients ages between 15 and 85 years with genital infections, registered in the files of "Cl. II Obst. and Gynecology" of the Cuza-Voda Hospital from Iasi has been studied. We studied the subjective manifestations (local discomfort and pelvic pains, local burning and dryness,vulvovaginal itching and dyspareunia) and objective manifestations (vaginal and cervical secretion, the cytotest performed and colored though the Papanicolaou method and reported in the Bethesda system). RESULTS AND DISCUSSION: Healing of the subjective symptoms in 98%, healing of the leukorrhea--as a main objective symptom--in 95%; The Bethesda system cytotest was one of the inflammatory type in the most of the cases and there wew found in 85 cases: 6 ASCUS, 41 LSIL, and 37 HSIL. The use of Cervugid had a healing response in most of the cases when used in acute and chronic cervico-vaginal inflammatory processes. Cervugid may be considered as an important agent in the treatment of the precancerous affections af the cervix uteri on the following reasons: zhe cure of the infections caused by chlamydia, involved in the etiology of cervical neoplasms, the cure of the HPV infection under episome form, classified in the Bethesda system within the ASCUS, AGUS or LSIL classes. When the cytotest was in the HSIL class, a conization in the LLETZ method was performed. CONCLUSIONS: Cervugid is conceived for those three main categories of pathogenic factors related to the etiology of cervico-vaginitis: microbia germs, protozoa and mycosis. In addition, it is active on chlamydia and mycoplasms, always sensitive to chloramphenicol therapy. That is why Cervugid with in local administration is indicated in the microbial, trichomoniasis and mycotic vaginitis caused by one category of pathogenic agents or by associated forms, in cervicitis, in the pelvic inflammatory processes (pelvic congestion, metritis, adnexitis, and inflammatory processes associated with benign or malignant tumors of the genital apparatus). The results obtained proved that Cervugid is highly effective medicine.

[CA 15-3 and CEA markers - prognostic factors in breast cancer]. / Determinarea markerilor CA 15-3 si CEA--factori prognostici si predictivi în cancerul glandei mamare.

For the increasing of sensibility and specificity in the monitoring of the diagnosis and treatment of breast cancer it is used the simultaneous determination of two tumoral markers: CA 15-3 and CEA. This study try to demonstrate the grade of involvement in diagnostic and screening. We have determinate CA 15-3 and CEA in 73 serum samples. The correlation between the stage of malignancies and CA 15-3 levels was relieved in the second section of this study. The third section follow up the dynamic evolution of CA 15-3 marker in pre- and postoperator (14 days) stages obtaining a decreasing of CA 15-3 level. The obtained results for CEA does not establish any clinical rules in order to compare with the CA 15-3 level and disease stages. The easy-used and non-invasive determination, the early increasing of it's level and it's preservation recommend glycoprotein CA 15-3 like an current clinical instrument.

[Cervical pregnancy]. / Sarcina cervicala.

The authors report a case of cervical pregnancy in a nulliparous woman (after treatment for secondary infertility) treated systemically and locally with methotrexate. Related to the case, they make some considerations concerning early diagnosis and conservative treatment of ectopic cervical pregnancies, in order to maintain the patients' fertility. The woman presented in this case report is now 5-weeks intrauterine pregnant.

[The heart: a spectator or participant in neoplasms? Neoplastic subacute cor pulmonale]. / Cordul: spectator sau participant în neoplazii? Cordul pulmonar subacut neoplazic.

Neoplastic subacute cor pulmonale is a distinct clinical syndrome that is often not too easily diagnosed. Such rapid development of cor pulmonale is observed in a patient with lymphangitis carcinomatosa of the lung consecutive to a cancer of the stomach with splenic, pancreatic and lymph nodes invasion. Diagnosis was established on transition of the normal ECG to a typical pattern of cor pulmonale and was revealed by chest roentgenographic examination (interstitial syndrome finding) and fatal evolution of severe respiratory failure. Necroptic and pathological studies confirmed histologic lung involvement by tumoral emboli and lymphangitic carcinoma the tosis and documented neoplasm in the stomach.

[Thyroid cancers]. / Les cancers thyroidiens.

We have analysed factors that influenced on the patient survival in 195 cases of thyroid cancer. The survival is essentially influenced by the histology, the papillary forms (survival after 15 years: 83.1-93%) and follicular cancers (survival after 15 years: 84-94%) having an excellent evolution. The non-differentiated and mixed cancers have a very severe prognosis that is independent of the complex therapy that have been used (survival after 5 years: 17.1% in non-differentiated forms and 32.5% in mixed ones). The prognosis is better in subjects under the age of 45 and in female subjects. The cancers in the 1-st and 2-nd stage of tumor extension have a better evolution that those in the 3-rd stage. In differentiated cancers, the total or subtotal thyroidectomy followed by radioiodine administration determine the best survival.