Quality of life and ability to work in ovarian cancer patients in Slovakia.

The aim of this paper was to find out the association of relevant factors on health-related quality of life (HRQOL) among ovarian cancer patients and their ability to work. Analyzed data were prospectively collected on 123 ovarian cancer patients enrolled across multiple oncology practices in Slovakia. We examined knowledge about the disease, negative perceptions related to health care, ability to work and social and economic ranking. HRQOL measurements included quality of life based on a numeric scale (1-worst, 10-best) and selected aspects from QoL-Ov28 questionnaire. We have used non-parametric Friedman and Dunne pairwise comparison tests to detect differences in HRQOL and the ability to work. Spearman correlation was used to measure the strength of association between variables. With hindsight, patients identified first signs of disease 3.6 months prior to diagnosis, with median duration of disease being 3.1 years. HRQOL was significantly different at various points during cancer journey; between current state and at diagnosis (4.19), between current state and at time without cancer or at time in full health (8.94, 9.52 respectively). Similarly, significant differences were noted in patients' current work ability (WA) compared to WA at diagnosis, or at time without cancer or in full health (4.2, 9.07, 9.58). The highest correlation of HRQOL was found in relation to current ability to work (r = 0.87) and in impact of cancer treatment (r = 0.66). Medium correlation was noted with visits to oncology clinics, knowledge about cancer, salary, future expectations or perceived quality of life of relatives (r < 0.51). Low correlation (r < 0.3) was found with other aspects related to healthcare (nursing care, general practitioner appointments) or demographics (age, number of children) and others. Patients were willing to pay monthly for curative treatment €191.84 from an average monthly salary €470.84 (41%). Ovarian cancer diagnosis has a significant impact on HRQOL and WA and both are positively highly correlated. Ovarian cancer patients are willing to give significant share of their monthly salary for treatment leading to cure.

[Diagnosis of thyreopatic diseases by laboratory examinations--possibility for rational economy]. / Laboratórne vysetrovacie metódy v diagnostike tyreopatií--moznosti racionálnej ekonomizácie.

This paper is oriented on the possibility of racional economy of laboratory diagnostical process of thyreopathies. The study was based on analysis of 29,683 examinations made at biochemical department in hospital Trencín. The overuse--mostly of antibodies and also, but less of thyreoidal hormones was discovered, mostly in the group of physicians in general practise and less in hospital and internal practise. The absence of initial algoritmus in thyreoidology is documented. The followed approach was formulated as new proposal: the first step is the examination of TSH (by ultrasensitive method) with possibility for all groups of physicians. Clinical and biochemical department should have responsibility to add fT4 in the case of pathological TSH. The endokerinologist should have responsibility for all other thyreoidal examinations, but in reasonable case also the internists in ambulatory and hospital care, and other relevant hospital physicians could order these examinations. Probability of cost saving was about 34% of expanditures on thyreoidology. To make the recount for Slovak republic the saving cost could be about 42,500,000 Sk.

[Asymptomatic cholecystolithiasis in an ultrasonography study from Trencín]. / Asymptomatická cholecystolitiáza v ultrasonografickej stúdii z Trencína.

The author examined 1952 girls and women aged 15 to 92 years by ultrasonography. The incidence of cholecystolithiasis in the group without complaints was 8.19% in the group with atypical complaints it was 17.67% and in the group with typical complaints it was 75.0%. The ratio of asymptomatic cholecystolithiasis of the first two groups combined was 67.0% of the total. The ratio of cholecystectomies in the total number of cases with cholecystolithiasis was 30.9%. The clinical manifestation of cholecystolithiasis is influenced greatly by genetic factors, i.e. symptomatic lithiasis in the mother. Prophylactic cholecystectomy in case of asymptomatic cholecystolithiasis should not be recommended.

[An ultrasonographic picture of a growing pseudotumor in the abdominal cavity]. / Neobvyklý ultrasonografický obraz rastúceho pseudotumoru v brusnej dutine.

The case history of patient is presented who was diagnosed a tumor in abdominal cavity in an ultrasonographic examination. In the following surgery the tumour was extirpated and histology verified a liposarcoma. The control ultrasonographic examination revealed a growing solid formation in the region of resection. For presumed relapse of liposarcoma the patient underwent laparotomy again. In the region of the original tumour there was a conglomerate of adhesions in a size of tangerine. The histological examination revealed fibrous and fatty tissue without the sign of malignity.

[Cholecystolithiasis and ultrasonography. Is "technologism" possible in medicine?]. / Cholecystolitiáza a ultrasonografia. Je mozný "technologizmus" v medicíne?

The term "technologism" is used for a phenomenon where inadequate evaluation of the patient's condition may lead to an excessive number of auxiliary examinations, with a possible incorrect interpretation of their results and a possible inadequate final solution. On analysis of ultrasonographic examinations of the gallbladder the author considered as inadequate evaluation of biliary dyspepsia on account of the high incidence of cholecystolithiasis - 55.6% in men and 48.7% in women, biliary colic in men because of the low incidence of cholecystolithiasis - 32.0% and abdominal colic in women on account of the high incidence of cholecystolithiasis - 52.4%. In the final surgical treatment this phenomenon was not observed. The author wants to draw attention to the fact that a similar phenomenon may occur not only in biliary-disease and in ultrasonography, but also in other medical disciplines.