Local recurrence rate in patients with DCIS.

UNLABELLED: The aim of this observational retrospective study was to evaluate the local recurrence rate of ductal carcinoma in situ of the breast (DCIS) and/or invasive breast cancer in patients with DCIS or microinvasive carcinoma of the breast after breast conserving or radical surgery. Secondary aim of the study was comprehensive assessment of the whole management of DCIS and its comparison with European guidelines. METHODS: The study was performed in a group of 41 women with DCIS or microinvasive cancer, who underwent surgical treatment (breast conserving or radical modified mastectomy) at the IInd Department of Gynaecology and Obstetrics, University Hospital Bratislava (UNB), during the period 2001-2009. Documentation and pathological examination data from paraffin embedded tissue sections were used as data source. We sent out questionnaires regarding data about additional postoperative treatment and course of the disease up to year 2010 with focus on recurrence or tumour de novo incidence. RESULTS: Breast conserving surgery was performed in 28 cases - 68 %, modified radical mastectomy in 13 cases. All cases of mastectomy were due to multicentricity and/or extensive tumour >4 cm. Additional surgery due to unsatisfactory marginal status was performed in 8 patients (3.28 %). Additional treatment such as radiotherapy and/or hormonal therapy received 19 patients. Van Nuyss Prognostic Index was reported in 17 patients on the basis of histopathological data. 27 patients completed and returned questionnaire. No DCIS recurrence nor infiltrating cancer or tumour de novo was reported in this group. CONCLUSION: We consider surgical management as adequate. Further material analysis is needed (Tab. 5, Fig. 1, Ref. 28).

Correlation between fetal blood oxygen saturation and umbilical blood pH values.

AIM: The aim of the study was to find out whether there is correlation between the fetal blood oxygen saturation values detected by intrapartum fetal pulse oximetry and the umbilical blood pH values taken postpartum, and what is the effect of intrapartum fetal pulse oximetry on the mode of delivery. BACKGROUND: Seventy six women were examined in the study. METHODS: Intrauterine fetal well-being was monitored with cardiotocography equipment (FC 700), intrapartum fetal pulse oximetry (Nellcor OxiFirst, TYCO Inc, Pleasanton, CA), and the neonatal umbilical blood pH values were taken postpartum using an acid-base analyzer (AVL Compact 3). Descriptive statistics, Shapiro-Wilk normality test, Spearman rank correlation test and Mann-Whitney test were used for statistical data processing. RESULTS: The study results showed a highly significant correlation between the fetal blood oxygen saturation values and the neonatal umbilical blood pH values (rS = 0.54; p < 0.0001), and between the fetal blood oxygen saturation values and Caesarean section rate (rS = -0.68; p < 0.0001). CONCLUSION: In the light of the results of the study the authors recommend monitoring the fetal status using intrapartum fetal pulse oximetry in cases of non-reassuring or pathological cardiotocography, which allows a significant reduction in the Caesarean section rate for an imminent fetal hypoxia (Tab. 5, Fig. 1, Ref. 17). Full Text (Free, PDF) www.bmj.sk.

["Nested" PCR for human papillomavirus detection and typing in samples from cervical lesions of gynecological patients]. / "Nested" PCR a jej vyuzitie pri detekcii a typizácii papilomavírusovej infekcie vo vzorkách z cervikálnych lézií gynekologických pacientok.

OBJECTIVE: The authors tested PCR--so called nested (N-PCR) for the detection of HPV in cervical lesions of uterus. This method is based on repeated amplification of specific viral DNA fragments. The sensitivity of N-PCR was compared to the sensitivity of the hybridization method. In the second part of the experiment positive samples underwent HPV typing by PCR. BACKGROUND: The effectiveness of N-PCR for HPV detection was verified on 30 samples from cytologically/histologically suspected cervical lesions. In these cases, previous detection by hybridization method was unsuccessful. The second group consisted of 21 samples acquired by conisation, in which HPV presence was confirmed by hybridization method. Post surgery HPV detection using hybridization technique was negative in this group of patients. RESULTS: By means of N-PCR the presence of HPV DNA was confirmed in all 30 samples from the first group (100%) and in 8 (38%) cases from the group of samples obtained after conisation. Type-specific PCR detection indicated HPV type 16 in 20 cases, HPV type 18 in 6 cases (from the first series). In the remaining 4 cases typing for HPV 16, 18, 31 and 33 was negative. In the second series all 8 samples were HR-HPV type 16. CONCLUSION: At the present time, N-PCR is probably the most sensitive HPV detection method. The only real disadvantages of the given technique are relatively high costs of diagnostics equipment and the requirement of highly qualified personel.

[Screening for hemolytic streptococcus group B in pregnancy and prevention of infection in neonates]. / Skríning hemolytického streptokoka skupiny B v tehotnosti a prevencia infekcie novorodencov.

OBJECTIVE: The aim of this study was to evaluate the influence of Group B streptococcus (GBS) screening and intrapartum antibiotic prophylaxis to the incidence of GBS disease in newborns. DESIGN: Prospective non-randomised study. SETTING: IInd Clinic of Obstetric and Gynaecology LFUK and FNsP Ruzinov, Bratislava, Slovakia. METHODS: We enrolled 3023 newborns (754 in the study group, 2269 in the control group), which were born between 1.9.2000 and 31.3.2003. In both groups we compared following variables: total number of infectious diseases in newborns, number and forms of GBS neonatal disease, number of perinatal death due to GBS disease. RESULTS: There was no GBS disease in the study group of 754 newborns. Mothers of these newborns had one screening culture in 35-36th week of gestation. One swab was taken from vagina and anus. GBS carriers (161-21.4%) were administered i.v. intrapartum antibiotic prophylaxis with Penicillin G i.v., or, when allergy to penicillin was in history, with Clindamycin i.v. In the control group of 2269 newborns, whose mothers had no prevention, the incidence of GBS neonatal disease reached 7.5/1000 newborns (17 cases). The incidence of invasive GBS neonatal disease was 2.6/1000 newborns. CONCLUSION: The authors have noticed a significant decrease in incidence of GBS neonatal disease after implication of GBS screening and intrapartum antibiotic prophylaxis.

[Changes in serum levels of lipid peroxidation products during labor and in the puerperium]. / Zmeny sérových hladín produktov lipoperoxidácie pocas pôrodu a v sestonedelí.

OBJECTIVE: To determine the activity of reactive oxygen species (ROS) during labour by characterizing changes in maternal serum levels of lipid peroxidation end-products--MDA and lipofuscin during labour and the early post-partum period. We also tried to evaluate the relationship between levels of lipid peroxides and some clinical characteristics of labour. DESIGN: Prospective study. SETTING: Department of Obstetrics and Gynaecology LFUK, Bratislava; Department of clinical laboratories, Ministry of defense SR, Bratislava. METHODS: Blood samples were obtained from 66 pregnant women with uncomplicated pregnancy at the end of labour and during the early post-partum period. The control group consisted of 19 pregnant women delivering by primary Cesarean section. Blood samples were examined for MDA and lipofuscin by HPLC method. We used paired and unpaired Student's t-test to statistically evaluate our results. RESULTS: MDA and lipofuscin levels in pregnant women delivering spontaneously compared to those delivering by C-section were significantly elevated (P < 0.05). MDA and lipofuscin levels in pregnant women during spontaneous labour or during by C-section compared to the levels in early post-partum period were not significantly increased. We have not found any correlation between the length of the labour and lipoperoxides concentration.

[Phospholipids in the human myometrium in various stages of contraction before and during labor]. / Fosfolipidy humánneho myometria pri rôznych stavoch kontrakcnej cinnosti pred termínom a v termíne pôrodu.

A detailed analysis of the myometrium showed that the physical state of phospholipids--fluidity--depends on the ratio of their individual components and changes in relation to the state of contractile activity. The results indicate that before term of labor changes in the fluidity of myometrial phospholipids as well as increased availability of arachidonic acid for prostaglandin synthesis can induce preterm onset of contractile activity. Possibilities of affecting these mechanisms, which belong to the many potential factors inducing preterm labor, are discussed.

[Lipid composition of the myometrium during labor]. / Lipidické zlozky myometria pocas pôrodnej cinnosti.

Lipids represent one of the basic components of each cellular and subcellular membrane of the myometrium and their fluidity has a strong influence upon membrane function. Human myometrium was obtained at cesarean sections. Lipids were separated by one-dimensional thin layer chromatography. The chromatoplates were determined on the densitometer Shimadzu CS 930. Lipid profile of the myometrium was studied before the 37th week of pregnancy, at term without contractile activity, further during at term labor with normal contractile activity and at failure of myometrial contractility. Analysis of the obtained data showed changes in lipid fluidity, namely a decrease before the 37th week of pregnancy and at failure of myometrial contractions during at term labor. The decrease of fluidity was caused by a higher content of total cholesterol and a lower content of total phospholipids in the myometrium.

Premature delivery and placenta. A morphological study.

A complex morphological examination of the placentas of the prematurely delivered newborns revealed that in a part of them there was a complex of changes detectable either by a naked eye immediately after delivery or by the use of light and electron microscope, respectively. The changes observed were characteristic of premature maturation of placenta, some changes, however, were similar to those present in the placentas of the term delivered intrauterine growth retarded newborns. The most important were the following changes: underweight of placenta, placental infarctions, capillary haemangioma, increased amount of fibrinoid, small and focal circulatory defects, reduction of the microvillous border and of the pinocytic activity of the syncytiotrophoblast, focal to diffuse thickening of the basal membrane with an increased number of collagen fibrils and fibroblasts in the stroma of terminal villi. These changes resulted in deterioration of the intrauterine state of the foetus and in premature delivery of frequently intrauterine growth retarded newborn. Such changes did not occur in all placentas under study. They indicate, however, the possibility of the occurrence of chronic placental insufficiency in a part of the pregnant women treated for the imminent premature delivery. From this follows the necessity of monitoring the placental functions and the state of the foetus with a subsequent differential approach to the therapy of such patients.

[Incidence of macroscopic changes in the placenta in intrauterine growth retardation in neonates]. / Výskyt makroskopických zmien placent u intrauterinne rastovo retardovaných novorodencov.

Advances in noninvasive imaging techniques allow to visualize the placenta and changes of its structure in the course of gestation. Macroscopic examination of the placenta in newborns with intrauterine growth retardation reveals changes responsible for reduced placental functions. These can then be diagnosed in utero, e.g. by ultrasonographic examination. The most serious defects include reduced weight an insertion area of the placenta and infarcts covering more than 6% of the placental area. Extrachorial placentas also have adverse effects. Other macroscopic changes do not appear to be causally associated with intrauterine growth retardation and have been recorded to a comparable extent also in placentas of eutrophic newborns.