Fertility sparing approach in young women with endometrial cancer.

The incidence of endometrial cancer in young women is increasing, especially in developed countries. Although it is predominantly a disease of peri- and postmenopausal women, there is an absolute increase in younger women of childbearing age who, with today's lifestyle and pushing back maternal needs, do not have fulfilled reproductive plans. About 67% of cancers are diagnosed in the early stages. For these women, fertility-preserving procedures can be considered until reproductive plans are fulfilled. Subsequently, however, definitive management is appropriate even in the absence of carcinoma. This article discusses the most common gynecologic pelvic cancer, endometrial adenocarcinoma, and the possibility of fertility-preserving procedures.

Trends in blood pressure levels, prevalence, awareness, treatment, and control of hypertension in the Czech population from 1985 to 2000/01.

OBJECTIVE: To assess trends in blood pressure (BP) levels, prevalence, awareness, and control of hypertension in the Czech population from 1985 to 2000/01. DESIGN: Five independent cross-sectional population surveys conducted in 1985, 1988, 1992, 1997/98, and 2000/01. SETTING: Six, mostly rural, districts of the Czech Republic (Praha-východ, Benesov, Pardubice, Chrudim, Cheb, and Jindrichuv Hradec). PARTICIPANTS: Men and women aged 25-64 years randomly selected from six districts using the National Population Register/General Health Insurance Company Register (covering, by law, all citizens). The total number of participants was 11 726. MAIN OUTCOME MEASURES: We assessed the mean systolic BP, diastolic BP and pulse pressure, prevalence of hypertension (systolic BP > or = 140 mmHg and/or diastolic BP > or = 90 mmHg, or current treatment with antihypertensive drugs), awareness, treatment, and control of hypertension. RESULTS: Mean systolic BP, diastolic BP, and pulse pressure decreased significantly over a period of 15/16 years. This was associated with a significant decrease in the prevalence of hypertension (from 47.1 to 39.1%, P < 0.001) and with an increase in its awareness (from 49.5 to 67.2%, P < 0.001), use of antihypertensive medication (from 29.3 to 49.3%, P < 0.001), and hypertension control (from 3.9 to 17.0%, P < 0.001). Despite having lower BP values and prevalence of hypertension, females showed higher awareness of the disease, and were more frequently taking antihypertensive medication, and their hypertension was better controlled. CONCLUSION: The reduction in population BP and improved control of hypertension may have contributed to the decrease in cerebrovascular and coronary heart disease mortality in the Czech Republic. The positive longitudinal changes seen in the MONICA regions need not necessarily reflect the situation in the country as a whole. The situation is far from being optimal; a major problem is inadequate treatment of hypertension