Clinic for Gynecology and Obstetrics

Serbia

Clinic for Gynecology and Obstetrics

Serbia
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Zeller T.,Goethe University Frankfurt | Muenstedt K.,Justus Liebig University | Stoll C.,Klinik Herzoghohe | Schweder J.,Goethe University Frankfurt | And 5 more authors.
Journal of Cancer Research and Clinical Oncology | Year: 2013

Purpose: About 40-50 % of cancer patients use complementary and alternative medicine (CAM). Women, and especially those with gynecological cancers, are more active in this field than men. The goal of our study was to estimate the likelihood of CAM use and the likelihood of interactions of CAM with cancer therapy in the setting of a gynecological outpatient clinic at a German Comprehensive Cancer Center (CCC). Methods: One hundred consecutive gynecological outdoor patients of the CCC in Frankfurt am Main in Germany were interviewed with a standardized questionnaire on CAM use. An investigation on potential interactions was done by matching a scientific database systematically. Results: Sixty-nine of the interviewed 100 women received chemotherapy, 23 endocrine therapy and 41 monoclonal antibodies. In total, 64 % used CAM, 48 % used at least one substance-bound CAM. In 17 out of those 48 cases (35 %), interactions were unlikely, whereas they were probable in 14 patients (29 %). Thus, a third of all patients in this study were in danger of interactions. More than half of all CAM users and three quarters of users of substance-bound CAM are at risk of interactions. This number is independent of whether the patient is taking chemotherapy, endocrine therapy or antibodies. Conclusions: The frequency of CAM use we found is in line with international data from CCCs in the USA. To our knowledge, this is the first study publishing data on the frequency of potential interactions. Thus, an initiative to protect women from the dangers of uncontrolled CAM use is urgently needed. In the discussion, we propose a concept of how to achieve this aim. © 2012 Springer-Verlag Berlin Heidelberg.


PubMed | University of Belgrade, Clinical Center Zemun and Clinic for Gynecology and Obstetrics
Type: | Journal: TheScientificWorldJournal | Year: 2015

The objective of this study was to cross-culturally adapt and validate ICS male SF questionnaire to Serbian language.This study included 91 male patients with lower urinary tract symptoms and 24 men with similar age and with confirmed absence of LUTS. ICS male SF questionnaire was translated from English to Serbian language and then back-translated to English.Internal consistency was high in both dimensions, voiding (Cronbachs alpha = 0.916) and incontinence (Cronbachs alpha = 0.763). Comparison of the average scores between patients and controls revealed significant differences in both dimensions: voiding (med = 8 versus med = 0; P < 0.001) and incontinence (med = 3 versus med = 0; P < 0.001). Interclass correlation revealed high testretest validity in both dimensions, voiding ICC = 0.992 (P < 0.001) and incontinece ICC = 0.989 (P < 0.001). Correlation analysis revealed high agreement between ICS male SF voiding dimension and IPSS questionnaire ( = 0.943; P < 0.001).The Serbian version of male ICS SF questionnaire showed acceptable reliability and validity. The ICS male SF questionnaire could be used in routine practice as an easy and comprehensive tool for assessment of LUTS.


Selimovic A.,Clinic for Gynecology and Obstetrics | Skokic F.,Clinic for Gynecology and Obstetrics | Bazardzanovic M.,University of Tuzla | Selimovic Z.,University of Tuzla
Turkish Journal of Pediatrics | Year: 2010

The aim of the present study was to analyze complete blood count (CBC) and C-reactive protein (CRP) levels to create the predictive score for diagnosis of early-onset neonatal sepsis (EONS). All neonates treated for suspected EONS between January 2004 and December 2006 were evaluated from their case record. A diagnosis of EONS was made if either clinical findings consistent with sepsis developed within 72 hours of life, or if positive cultures were obtained. Evaluations for EONS were preformed in 341 neonates, and 199/341 (58.4%) developed EONS. Total white blood count, immature/total ratio, immature/ mature ratio, and CRP levels were found to be independent predictors of EONS, and the predictive score for EONS was created. An increase in the predictive score for EONS was directly correlated with possibility of EONS. Receiver operating characteristic (ROC) curve analysis determined a cut-off value of a predictive score for EONS >0.503, with sensitivity of 73% and specificity of 89%. Correct prediction of EONS was found in 78% of all neonates, 80% for positive and 75% for negative outcome (p<0.0001). In conclusion, for its high sensitivity and prediction rates, the predictive score for EONS is useful in diagnostic evaluation of neonates suspected for EONS.


Stoss O.C.,Targos Molecular Pathology GmbH | Scheel A.,University of Cologne | Nagelmeier I.,Institute of Pathology Nordhessen | Schildhaus H.-U.,University of Gottingen | And 6 more authors.
Modern Pathology | Year: 2015

Recently the American Society of Clinical Oncology and the College of American Pathologists have updated their clinical practice guidelines for HER2 testing in breast cancer. In order to evaluate these new recommendations, we have re-assessed the HER2 status of 6018 breast cancer cases of the screening population for the HERceptin adjuvant (HERA) trial that were originally centrally tested by fluorescence in situ hybridization based on the FDA-released test guidelines. According to the most recent 2013 ASCO/CAP recommendations, 3380 (56.2%) cases were classified as HER2 positive compared with 3359 (55.8%) applying the HERA/FDA scheme and 3339 (55.5%) applying the 2007 ASCO/CAP guidelines. Twenty-one cases switched from negative (HERA/FDA scheme) to positive (2013 ASCO/CAP guidelines). This group is characterized by a mean HER2 gene copy number of ≥6.0, polysomy or co-amplification of CEP17 with an average CEP17 count of 5, and with HER2 receptor overexpression in 75% of cases. On the basis of the HER2 gene copy number alone, we observe 494 cases (8.2%) that are in the equivocal range. Most of these cases (>80%) were also nondecisive by immunohistochemistry (score 2+) irrespective of whether ratio was <2.0>. The number of equivocal cases that would require HER2 reflex testing decreases to 113 (1.9%) if in addition to the HER2 gene copy number also the ratio of HER2 and CEP17 copy numbers is considered via dual-color in situ hybridization. The combination of applying the HER2 mean gene copy number as well as the HER2/CEP17 ratio to define equivocal test decisions by fluorescence in situ hybridization as proposed by the current ASCO/CAP guidelines appears to be a more optimum approach to adopt in order to avoid or minimize reporting of false negative results. Using the mean HER2 gene copy number alone for decision making results in a significant increase of equivocal cases. © 2015 USCAP, Inc.


PubMed | Targos Molecular Pathology GmbH, University of Cologne, Nazarbayev University, University of Milan and 3 more.
Type: Journal Article | Journal: Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc | Year: 2015

Recently the American Society of Clinical Oncology and the College of American Pathologists have updated their clinical practice guidelines for HER2 testing in breast cancer. In order to evaluate these new recommendations, we have re-assessed the HER2 status of 6018 breast cancer cases of the screening population for the HERceptin adjuvant (HERA) trial that were originally centrally tested by fluorescence in situ hybridization based on the FDA-released test guidelines. According to the most recent 2013 ASCO/CAP recommendations, 3380 (56.2%) cases were classified as HER2 positive compared with 3359 (55.8%) applying the HERA/FDA scheme and 3339 (55.5%) applying the 2007 ASCO/CAP guidelines. Twenty-one cases switched from negative (HERA/FDA scheme) to positive (2013 ASCO/CAP guidelines). This group is characterized by a mean HER2 gene copy number of 6.0, polysomy or co-amplification of CEP17 with an average CEP17 count of 5, and with HER2 receptor overexpression in 75% of cases. On the basis of the HER2 gene copy number alone, we observe 494 cases (8.2%) that are in the equivocal range. Most of these cases (>80%) were also nondecisive by immunohistochemistry (score 2+) irrespective of whether ratio was <2.0>. The number of equivocal cases that would require HER2 reflex testing decreases to 113 (1.9%) if in addition to the HER2 gene copy number also the ratio of HER2 and CEP17 copy numbers is considered via dual-color in situ hybridization. The combination of applying the HER2 mean gene copy number as well as the HER2/CEP17 ratio to define equivocal test decisions by fluorescence in situ hybridization as proposed by the current ASCO/CAP guidelines appears to be a more optimum approach to adopt in order to avoid or minimize reporting of false negative results. Using the mean HER2 gene copy number alone for decision making results in a significant increase of equivocal cases.


Zisovska E.,Clinic for Gynecology and Obstetrics | Lazarevska L.,Institution for Public Health | Pehcevska N.,Clinic for Gynecology and Obstetrics | Tavcioska G.,General Hospital
Italian Journal of Public Health | Year: 2010

Background: Cigarette smoking, active or passive, is related to adverse perinatal outcomes, increased risk of spontaneous abortions, preterm delivery, low birth weight, malformations, placenta previa, and abruption. It is also known to have adverse effects on the fetus and newborn, as well as affecting breastfeeding. The literature data gave the initial idea to identify some possibly smoking-influenced conditions on perinatal/ neonatal outcome indicators. Patients and Methods: Newborns and their mothers admitted to Gynecology& Obstetric Clinic, Skopje, Macedonia were selected to participate in the study. The patients were divided into 3 groups: the first group consisted of newborns unexposed to tobacco smoke, the second group were newborns born to mothers who smoked more than 20 cigarettes per day, who did not try to quit smoking during the pregnancy, and the third group were newborns born to the mothers who don't smoke, but were in close contact with other smokers (intensively exposed to the tobacco smoke).Methods used: epidemiological, clinical examinations, biochemical analysis and statistical analysis of the results. Our results clearly demonstrated that maternal smoking had a significant effect (p<0.01) on indictors for perinatal/neonatal outcomes such as: prematurity combined with low birth weight (3,3% vs 12% for the first and second group respectively, and 3,3% vs 9,7% for the first and third group respectively), Apgar scores <6 in the 5-th minute (5,3% vs 13,7% for the first and second group respectively, and 5,3% vs 12,7% for the first and third group respectively), elevated NRBC (2,3% vs 14,7% for the first and second group respectively, and 2,3% vs 12,7% for the first and third group respectively), and for pregnancy outcomes, anemia and premature rupture of the amniotic sac membranes. The following indicators were also significantly affected (p<0.05) by maternal smoking: respiratory distress, cord blood gases, prematurity rate, and for the pregnancy outcome placental abruption and anemia of pregnancy. There was also a statistically significant difference between the results in the unexposed group and both exposed groups. Although smoking and tobacco cannot be considered unique factors influencing the worse perinatal/neonatal outcomes, our study suggests that cigarette smoking is the most frequent, and completely preventable risk factor for adverse neonatal outcomes.


Maksimovic J.,Serbian Medical Society | Maksimovic M.,Clinic for Gynecology and Obstetrics
Archive of Oncology | Year: 2013

The authors of this paper presented the key moments in the development of proctology, a medical discipline which is an integral part of surgery, whose development path was inseparable from the historical development of operational medicine. Even in the ancient Egypt, proctology was an important branch of medicine. Out of eight of so far known medical papyri in the history of proctology, the most important one is the Beatty's (Chester Beatty) papyrus from the 13th century BC, which is actually a short monograph on diseases of the anus and their treatment. In the ancient period, operative proctology reached the highest level in the time of Hippocrates. In detail, and with special care, the operative procedures of the large intestine, primarily perianal fistula and hemorrhoids were described in the Hippocratic writings. One of the most famous Roman medical writers, Celsus (Cornelius Celsus Asullus) described the surgery of hemorrhoids by their ligature and the surgery of anorectal fistula in two ways: ligation of the fistula channel by string of raw flax and fistula incision through the probe placed through the fistula channel. Doctors of the 18th and the 19th century introduced into practice some more complicated surgical procedures in the treatment of anorectal diseases. The French surgeons were the leaders. In 1710, Littré performed, for the first time, anus praeter naturalis and Jacques Lisfranc (1790-1847) pioneered the method of perineal resection of the rectum for cancer. The first rectoscope was constructed in 1895 and in 1903 it was introduced into practice by Kelly (Kelly Howard Atwood). A sudden progress in the diagnosis and treatment of anorectal diseases occurred after the Second World War and the trend has continued to this day. © 2013, Oncology Institute of Vojvodina, Sremska Kamenica.


Stadler J.,Hannover Medical School | Le T.P.,Clinic for Gynecology and Obstetrics | Haas P.,Hannover Medical School | Nave H.,Martin Luther University of Halle Wittenberg
Annals of Anatomy | Year: 2011

Even now, sepsis remains a major problem in modern clinical medicine, leading to systemic inflammatory response including altered leukocyte subset distribution and increased cytokine release. As immune cells are known to express NPY receptors, we investigated the effects of a specific NPY Y2 receptor agonist (NPY13-36) and/or the corresponding Y2 receptor antagonist BIIE0246 treatment on blood (by FACS analyses) and tissue (by immunohistochemistry) leukocyte subsets as well as on levels of IL-4, IL-6, IL-10, TNF-α, INF-γ (by Cytometric Bead Array) in healthy and acutely endotoxemic rats. Results show a significant decrease in blood monocytes after LPS challenge in endotoxemic control animals (by 93%), in endotoxemic NPY13-36 treated animals (by 83%) and in endotoxemic BIIE0246 treated animals (by 88%) as compared to the corresponding healthy controls. Endotoxemic control animals showed a significant increase of TNF-α (by 98%) as compared to the healthy control group. A treatment with NPY13-36 significantly stabilized TNF-α level in endotoxemic animals. This study indicates distinct subset- and cytokine-specific in vivo effects induced by an NPY Y2 receptor specific treatment after a short-term LPS challenge. © 2011.


Likic-Ladjevic I.,Clinic for Gynecology and Obstetrics
Acta chirurgica Iugoslavica | Year: 2011

All the elective surgeries are to be avoided during pregnancy and pregnant women should undergo only emergency surgical interventions. Pregnancy is associated with different physiological changes in the organism, which should be taken into account in preparative preparation of the pregnant women. Expanded body fluid volume leads to dilutional anemia, however other hematological disorders may be present as well. Extreme obesity is a frequent comorbidity, while hypertension is associated with the highest risks since it may lead to a life-threatening complication--eclampsia. As for other coexisting diseases, urinary tract infections and gestational diabetes are the most common as well as hyperthyroidism and other diseases that may also develop. The type and severity of the acute surgical disease, extensiveness of the planned surgery as well as the type of planned anesthesia to be applied, occasionally necessitate, depending on the gestational age, termination of pregnancy to be considered. Gynecological-obstetric consultations are mandatory in all surgical interventions planned in pregnant women.


PubMed | Clinic for Gynecology and Obstetrics
Type: Journal Article | Journal: Acta chirurgica Iugoslavica | Year: 2011

All the elective surgeries are to be avoided during pregnancy and pregnant women should undergo only emergency surgical interventions. Pregnancy is associated with different physiological changes in the organism, which should be taken into account in preparative preparation of the pregnant women. Expanded body fluid volume leads to dilutional anemia, however other hematological disorders may be present as well. Extreme obesity is a frequent comorbidity, while hypertension is associated with the highest risks since it may lead to a life-threatening complication--eclampsia. As for other coexisting diseases, urinary tract infections and gestational diabetes are the most common as well as hyperthyroidism and other diseases that may also develop. The type and severity of the acute surgical disease, extensiveness of the planned surgery as well as the type of planned anesthesia to be applied, occasionally necessitate, depending on the gestational age, termination of pregnancy to be considered. Gynecological-obstetric consultations are mandatory in all surgical interventions planned in pregnant women.

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