The experience with colorectal cancer screening in the Czech Republic: the detection at earlier stages and improved clinical outcomes.

OBJECTIVES: Colorectal cancer (CRC) remains a major health burden. Although screening is recommended and considered beneficial, further data on its positive effects are needed for worldwide implementation. STUDY DESIGN: The aim of our national multicentre prospective observational study was to reveal and document clinicopathological differences in CRC diagnosed by screening and presented by disease symptoms as well as assess the efficiency of the screening programme in the Czech Republic. METHODS: Between March 2013 and September 2015, a total of 265 patients were enrolled in 12 gastroenterology centres across the Czech Republic. Patients were divided into screening and symptomatic groups and compared for pathology status and clinical characteristics. Screening was defined as a primary screening colonoscopy or a colonoscopy after a positive faecal occult blood test in an average-risk population. RESULTS: The distribution of CRC stages was significantly (statistically and clinically) favourable in the screening group (predominance of stages 0, I and II) compared with the non-screening group (P < 0.001). The presence of distant and local metastases was significantly less frequent in the screening group than in the symptomatic group (P < 0.001). Patients in the screening group had a higher probability of radical surgery (R0) than those diagnosed based on symptoms (P < 0.001). Systemic palliative treatment was indicated in two patients in the screening group compared with 23 patients in the non-screening group (P = 0.018). CONCLUSION: CRC diagnosed by screening disclosed less advanced clinicopathological characteristics and results in patients with a higher probability of radical surgery (R0) than diagnoses established based on symptoms, with subsequent management differing accordingly between both groups. These results advocate the implementation of a suitable worldwide screening programme.

Operative vaginal deliveries and their impact on maternal and neonatal outcomes - prospective analysis.

OBJECTIVE: Evaluation of maternal and neonatal outcomes in operative vaginal deliveries in prospective study analysis. DESIGN: Prospective case-control study analysis. SETTING: Prospective analysis of 292 operative vaginal deliveries (VEX, forceps) for the period June 2016 - August 2017 from overall 6056 vaginal deliveries. Type and frequency of maternal and neonatal trauma occurence was observed in connection with using vacuum-assisted delivery and forceps delivery, mainly the cephalohematomas and their complications. Collected data were statistically analysed. RESULTS: In the reported period from overall 6056 deliveries there were 216 vacuumextractions (3.6%) and 72 forceps deliveries (1.2%) performed. Both methods were used in four patients (VEX and forceps). The most frequent trauma in newborns were cephalohematomas. Remarkable cephalohematoma, requiring further observation has occured in 40 newborns (18.5%) after vacuum-assisted delivery and in 5 newborns (6.9%), (p = 0,017) after forceps delivery. Consequential punction of cephalohematoma occured only after vacuumextraction delivery and in 6 newborns (15.0 %). The third degree perineal rupture occured after vacuumextraction in 20 patients (9.3%) and after forceps delivery in 12 patients (16.7%), (p = 0,091). The fourth degree perineal rupture occured only after vacuumextraction and in 1 case (0.5%). CONCLUSION: The vacuumextraction compared with forceps is more likely to be associated with the statistically significant incidence of cephalohematomas and their further treatment. Forceps deliveries compared with vacuumextraction are more likely to be associated with the maternal perineal trauma, but the diference was not statistically significant.

[Structural changes in platelets in alloxan diabetes as parameters of their activation in the vascular bed and morphologic features]. / Strukturnye izmeneniia trombotsitov pri alloksanovom diabete kak pokazateli ikh aktivizatsii v sosudistom rusle i osobennostei morfoobrazovaniia.

The present study shows that a stable level of blood platelet number persists in diabetic rats (following 15 and 60 days after experimental alloxan injection) Unusual platelet megaforms are seen accumulating (up to 36%), having no size analogs in control animals. A quantitative electron-microscopic analysis demonstrated that the enlargements of diabetic platelets was accompanied by their rounding in shape and by a more frequent (by 2.0-2.6 times) generation of surface pseudopodia. The share of platelets increased in two independent fractions, with considerable deflexion over the normal range limit variations in the number, size and general volume of their alpha-granules (cutting down) or dense (increase) bodies. At the same time a common decrease in these indexes for different types of grains in platelets of various dimensions occurred. The integral picture of the platelet granular apparatus (image of granular apparatus), that demonstrates quantitative proportions between the number and size indexes of different grain types, is found distorted in diabetic rats.

[The characteristics of breathing regulation in animals after sympathectomy procedures during alpine adaptation]. / Osobennosti reguliatsii dykhaniia u zhivotnykh na fone desimpatiziruiushchikh vozdeistvii v protsesse gornoi adaptatsii.

Physiological parameters were studied at the 760 and 3200-metres altitudes in chemically desympathised (25 mg guanethidine per kg during 30 days) albino rats. Changes in external respiratory function were found to be less obvious at the higher altitude.

[Risk factors and prognosis in premature labor]. / Faktory riska i prognozirovanie prezhdevremennykh rodov.

In order to find a relationship between risk factors and the incidence of premature delivery, 3014 delivery histories, including 323 protocols of premature deliveries, have been surveyed. Study results depicted the magnitude of risk associated with determinants like maternal growth, deficient body weight, occupation, parity, a history of reproductive dysfunction. Sixteen percent of women with term and 35% with preterm deliveries were a high-risk population. The incidence of premature delivery in it was 24%, suggesting an adequate predictive value of the risk scoring system.

[Mechanism of the formation of micronuclei in PHA-stimulated lymphocytes from human peripheral blood]. / K mekhanizmu obrazovaniia mikroiader v FGA-stimulirovannykh limfotsitakh perifericheskoi krovi cheloveka.

The micronuclei of PHA-stimulated human lymphocytes were assayed by comparison of electron microscopy and light microscopy data. The length of the cell cycle was checked by the flow cytofluorimetry method. Both the variability of the apoptosis stages and the increase in (G2+M) period in gamma-irradiated cultures were found. It is concluded that at least part of the micronuclei results from the cell nucleus "partition" during the apoptosis type cell death.

[Viability of the R, S and M variants of Mycobacterium lacticolum under various preservation conditions]. / Vyzhivaemost' R-, S- i M-variantov Mycobacterium lacticolum pri razlichnykh usloviiakh khraneniia.

The survival rate of Mycobacterium lacticolum and the proportion between its R, S and M variants were studied in the course of 12 months under different conditions of storage (freeze-drying, under vaseline oil, in 0.85% NaCl solution and in distilled water). A high survival rate of the variants was found in cells freeze-dried in a protective medium containing 10% of sucrose +1% of gelatin as well as in a 0.85% solution of NaCl.The survival rate of te variants differed by 2--3 orders of magnitude in cells freeze-dried with sodium glutamate or suspended in distilled water. The proportion between the R, S and M variants in the population noticeable changed after storage under these conditions.

[Comparative study of the chemical composition and properties of the capsule polysaccharides in M-, S- and R-variants of Mycobacterium lacticolum]. / Sravnitel'noe izuchenie khimicheskogo sostava i nekotorykh svoistv polisakharidov kapsul M-, S- i R-variantov Mycobacterium lacticolum.

Polysaccharides from the capsules of Mycobacterium lacticolum M, S and R variants were comparatively studied for the first time. The polysaccharides from M and S cells contained galactose, glucose and mannose; however, the polysaccharides must be different since they vary in specific rotation. The capsule polysaccharide from R cells contained also arabinose. Its specific rotation differed considerably from those of M and S cells. The polysaccharides are involved in phage adsorption on mycobacterial cells, and the three variants show differences in this respect. The free exopolysaccharides of M, S and R variants are identical with the corresponding capsule exoglycans, and their proportions differ among the variants.

[DNA content and the endometrial cellular mitotic activity in the phase of menstrual bleeding]. / Soderzhanie DNK i mitoticheskaia aktivnost' kletok éndometriia v faze menstrual'nogo krovotecheniia.

Endometrium obtained during menses from 46 healthy women in reproductive age was investigated morphologically and cytospectrophotometrically in order to solve the problem on the source of the cells reepithelizing the uterine mucous membrane after desquamation. It was stated that desquamation takes place not in the whole functional layer of endometrium, some mucous fragments, covered with persisting luminal epithelium, are always preserved. During endometrial regeneration the cells of the luminal and glandular epithelia and those of endometrial stroma are predominantly diploid. The amount of premitotic cells in population is so small that they cannot secure any intensive cellular proliferation. Mitogenesis in endometrium is stimulated only after a complete restoration of the epithelial layer. It is suggested that persisting luminal epithelium is the source of cells for reepithelization; they migrate towards endometrial "wounds" and repair defects in the uterine mucosa during the regeneration phase.

[DNA concentration in cells of the glandular epithelium of the endometrium during the menstrual bleeding phase]. / Soderzhanie DNK v kletkakh zhelistogo épiteliia éndometriia v fazu menstrual'nogo krovotecheniia.

DNA content in the endometrial gland cells (9 women of fertile age) was studied during menstruation by microspectrophotometry. It was shown that DNA content (mainly 2n) remained unchanged during different days of menstruation, both during the desquamation (the 1st--2nd days of the cycle), and during the regeneration stage (the 3rd--4th days). Along with this the mitotic activity in the glandular epithelium was absent completely (36 samples of endometrium).