[ENDOMETRIOSIS FERTILITY INDEX].

In women suffering from endometriosis and infertility, the decision as to when and how to perform surgical excision and/or fertility treatment is mainly based on clinical guidelines and expert opinions. However, so far data from randomized controlled trials or meta-analyses to answer the question whether surgical treatment of moderate to severe endometriosis can indeed enhance pregnancy rates compared with expectant management are lacking, as not all studies report fertility outcome or supply sufficiently detailed information. The most frequently used staging system for endometriosis is the revised American Fertility Society (rAFS) score (ASRM, 1997). Unfortunately, this classification system has some serious limitations, including not effectively predicting clinical outcomes of treatment, especially pregnancy rates in infertile patients. For this reason, Adamson and Pasta (2010) developed the endometriosis fertility index (EFI). EFI is a scoring system which includes assessment of historical factors at the time of surgery (age, duration of infertility and pregnancy history), of adnexal function at conclusion of surgery (functional score of Fallopian tubes, fimbriae and ovaries bilaterally), and of the extensiveness of endometriosis (rAFS endometriosis lesion score and total rAFS score). The EFI is intended as a clinical tool to counsel patients on the approach towards fertility after surgery.

[Diagnostic value of TruScreen, cytology and colposcopy].

UNLABELLED: The aim of this study was to compare the diagnostic value of TruScreen with that of already approved in practice methods for detection of precancerous conditions of the cervix. This study reviewed 301 patients; for analysis were included 260 women aged from 16 to 69 years, mean 35.82 years. They were divided into three groups. RESULTS: After statistical analysis of the results we found sensitivity of conventional Pap smear, colposcopy and TruScreen respectively 67.44%, 96.55% and 53.85%, and specificity respectively 83.93%, 45.90% and 78.79%. CONCLUSION: TruScreen is a representative of real time methods for cervical screening. Our results are close to the obtained in other studies: medium value sensitivity and high specificity of the method, which shows that there is a possibility for its use as a primary screening, and also in addition to cytology. TruScreen is especially suitable in places where no cytology laboratories and specialists are available. It is a quick method (result at the moment), does not require special qualification and long training of the operator (as opposed to colposcopy) and is well received by women. Sufficient number of cases remains to be collected for more accurate assessment of the potential of TruScreen. It is appropriate to identify if TruScreen has different diagnostic value in mild and severe cervical changes, and also its efficacy as a primary screening method and in combination with other already approved in practice screening methods.

[Fracture of clavicle in newborns, an attempt to make prognostic factors].

UNLABELLED: The most common bone fracture of the newborn is that of the clavicle - frequency 0.2-3.5% of all births, according to various literature sources. The most common cause of this complication perinatally determining the weight of the newborn and the skills of those who manage second stage of labour Purpose of the study was the establishment of prognostic factors for fracture of the clavicle regardless of the way of delivery. MATERIAL AND METHODS: The study was retrospective for the period January 2005 to June 2010 and includes 38 infants with fracture of the clavicle in spontaneous and operative vaginal deliveries, as well as caesarean sections. There were examined the following factors: age, parity and maternal weight, fetal weigh and length duration of pregnancy, experience of managing labour. RESULTS: The incidence of fracture of the clavicle during the study was 0.26%, calculated to the total number of births. Eight fractures are of newborn delivered by caesarean section, 6 by vacuum extractor and 24 by normal vaginal deliveries with episiotomy mostly. The average weight of infants with fractures was 3767 gr 3 fractures are accompanied by brachial plexus paresis, and 2 were complicated with shoulder dystocia. CONCLUSIONS: It was not found statistically significant prognostic value of most of the indicators studied. Fracture of the clavicle most often dependent on the weight of the newborn and the technique of managing labour without the consequence of shoulder dystocia.