The Use of Photodynamic Therapy in the Treatment of Endometrial Cancer-A Review of the Literature.

Endometrial cancer is the most common malignant tumor of the female reproductive system. It develops in the mucous membrane lining the inside of the uterine body-the endometrium, through the abnormal and continuous growth of cancer cells originating from the uterine mucosa. In recent years, there has been a significant increase in the number of cases in European countries. Photodynamic therapy (PDT) is an innovative and dynamically developing medical procedure, useful in the treatment of cancer and non-cancer tissue conditions. The PDT reaction involves the activation of a photosensitizing substance with visible light, which in turn leads to the formation of free oxygen radicals, which contribute to the destruction of the cell. PDT is minimally invasive, has few side effects, and preserves organ anatomy and function. Both diagnostics and photodynamic therapy as modern methods of treatment are becoming more and more popular in many research units around the world. They are most often practiced and tested in in vitro experimental conditions. In clinical practice, the use of PDT is rare. Comprehensive cooperation between scientists contributes to taking steps towards obtaining new, synthetic photosensitizers, directing their physicochemical properties, and showing the impact on a given organism. This review examines the evidence for the potential and usefulness of PDT in the treatment of endometrial cancer. This review highlights that PDT is gaining popularity and is becoming a promising field of medical research.

Google Trends Analysis Reflecting Internet Users' Interest in Selected Terms of Sexual and Reproductive Health in Ukraine.

INTRODUCTION: The war in Ukraine has had adverse impacts on all areas of life, including health-related issues. Limited access to medical care increases the need to look for alternative sources of medical information. AIM: To analyze trends of Internet users' interest in sexual and reproductive health in Ukraine based on Google Trends. MATERIALS AND METHODS: The retrospective study was based on the analysis of terms related to sexual and reproductive health searched by Ukrainian Internet users. The tool used was Google Trends. The period from 1 January 2021 to 1 January 2023 was analyzed. The time variability in search growths and peaks was assessed from the perspective of two time intervals (before the war and during the war) using the chi-square test. RESULTS: Significant changes have been demonstrated in the interests of Internet users from Ukraine regarding selected issues of sexual and reproductive health during the ongoing war. Compared to the pre-war period, a marked increase was observed in active searches for terms such as "condoms" (p = 0.0081), "rape" (p = 0.0008), "syphilis" (p = 0.0136), "ovulation" (p = 0.0002) and "pregnancy test" (p = 0.0008). CONCLUSIONS: The conducted analysis clearly indicates an increased need for information regarding sexual and reproductive health among Ukrainian citizens during the ongoing armed conflict. The analysis of trends among Internet users interests can be a valuable source of knowledge for decision makers, including human rights organizations, regarding the scope and coordination of activities aimed at protecting the sexual and reproductive health of the inhabitants of Ukraine.

Two oncomiRs, miR-182-5p and miR-103a-3p, Involved in Intravenous Leiomyomatosis.

Leiomyomas, also referred to as fibroids, belong to the most common type of benign tumors developing in the myometrium of the uterus. Intravenous leiomyomatosis (IVL) tends to be regarded as a rare type of uterine leiomyoma. IVL tumors are characterized by muscle cell masses developing within the uterine and extrauterine venous system. The underlying mechanism responsible for the proliferation of these lesions is still unknown. The aim of the study was to investigate the expression of the two epigenetic factors, oncomiRs miR-182-5p and miR-103a-3p, in intravenous leiomyomatosis. This study was divided into two stages: initially, miR-182-5p and miR-103a-3p expression was assessed in samples coming from intravenous leiomyomatosis localized in myometrium (group I, n = 6), intravenous leiomyomatosis beyond the uterus (group II; n = 5), and the control group, i.e., intramural leiomyomas (group III; n = 9). The expression level of miR-182-5p was significantly higher in samples coming from intravenous leiomyomatosis (group I and group II) as compared to the control group (p = 0.029 and p = 0.024, respectively). In the second part of the study, the expression levels of the studied oncomiRs were compared between seven samples delivered from one woman during a four-year observation. The long-term follow-up of one patient demonstrated significantly elevated levels of both studied oncomiRs in intravenous leiomyomatosis in comparison to intramural leiomyoma samples.

Selected environmental factors in mothers of newborns subjected to the therapeutic hypothermia - a case control study.

OBJECTIVES: Hypothermia is an established method of treating severe forms of perinatal hypoxia in newborns. Some of them develop neonatal encephalopathy, which is associated with high morbidity and mortality. Therefore, prophylaxis of this pathology is important as well as determining environmental factors in mothers of newborns affected by this pathology. The aim of the study was to assess of selected environmental factors in mothers of newborns qualified for hypothermia. MATERIAL AND METHODS: The material consisted of 102 subjects, including 51 mothers of newborns with hypoxic-ischemic encephalopathy referred for hypothermia treatment (group I) and 51 mothers of newborns without signs of hypoxia (group II). The case-control study was carried out in the third level reference centre. It is 1 of 20 centers of therapeutic hypothermia for newborn in Poland. Data was collected based on a data collection sheet. Study groups were compared in terms of demographic and environmental data. The odds ratio (OR) was determined and the logistic regression analysis of univariate and multivariate regression was used to determine the probability of the need for hypothermia in the study group. RESULTS: The groups did not differ in terms of age, BMI and place of living. The need to use hypothermia increased in pregnant women living together with their parents (OR = 6.8, 95% CI: 2.4-19.6) also in case of exposure to factors at the workplace, i.e., noise (OR = 4.1, 95% CI: 1.1-15.5). CONCLUSIONS: Based on the results of our case-control study we postulate to pay attention during preconception care to proper preparation for pregnancy especially in younger women exposed to nuisance in the work environment and at home. In this area postulated activities should include education programs, in close cooperation occupational medicine practitioners and obstetricians even before the conception as a part of pre-conception counseling. Int J Occup Med Environ Health. 2023;36(1):59-68.

The Use of Photodynamic Therapy in the Treatment of Brain Tumors-A Review of the Literature.

The treatment of neoplastic disease of the brain is still a challenge for modern medicine. Therefore, advanced methodologies are needed that can rationally and successfully contribute to the early diagnosis of primary and metastatic tumors growing within the brain. Photodynamic therapy (PDT) seems to be a valuable method of treatment for precancerous and cancerous lesions including brain tumors. The main advantage of PDT is its high efficiency, minimal invasiveness and no serious side effects, compared with chemotherapy and radiotherapy. This review was conducted through a comprehensive search of articles, scientific information databases and the websites of organizations dealing with cancer treatment. Key points from clinical trials conducted by other researchers are also discussed. The common databases such as PubMed, Google Scholar, EBSCO, Scopus, and Elsevier were used. Articles in the English language of reliable credibility were mainly analyzed. The type of publications considered included clinical and preclinical studies, systematic reviews, and case reports. Based on these collected materials, we see that scientists have already demonstrated the potential of PDT application in the field of brain tumors. Therefore, in this review, the treatment of neoplasm of the Central Nervous System (CNS) and the most common tumor, glioblastoma multiforme (GBM), have been explored. In addition, an overview of the general principles of PDT, as well as the mechanism of action of the therapy as a therapeutic platform for brain tumors, is described. The research was carried out in June 2022.

Histopathological Analysis of the Effect of Photodynamic Action on Post-Chemotherapy Excised Breast Cancer Tissue.

Background and objectives: Breast cancer is the most commonly diagnosed cancer in women and its mortality is increasing. Therefore, research to improve treatment is of paramount importance. One method of treatment is photodynamic therapy. Photodynamic therapy selectively stimulates apoptosis in photosensitizer-treated neoplastic breast cells as a result of cytotoxic singlet oxygen generation via collisions between triplet excited state photosensitizer and triplet ground state oxygen upon tissue irradiation. The aim of this study was to evaluate the effects of photodynamic action on cancerous breast tissue samples as a model of photodynamic therapy. Materials and Methods: Breast cancer tissue samples were obtained from post-operative material and the patterns of histopathological changes in breast cancer tissue before and after photodynamic action on post-chemotherapy tissue were evaluated. Excised tissue samples were obtained from 48 female breast cancer patients who had previously undergone chemotherapy. Breast cancer tissues for this study were taken from macroscopically visible tumors larger than 10 mm. Histopathological analysis was performed to evaluate any morphological changes prior to and after photodynamic action on the post-chemotherapy tissue samples. Eighteen breast cancer tissue samples were analyzed before chemotherapy, fifteen after chemotherapy, and fifteen samples were analyzed after chemotherapy and application of photodynamic action. The photosensitizer Rose Bengal was applied to the samples subjected to photodynamic action. Results: Photodynamic action on post-chemotherapy neoplastic tissue showed histological changes under a light microscope. The results showed that morphological changes in breast cancer tissues after chemotherapy and photodynamic action were dependent on the concentration of Rose Bengal. In all cases, follow-up imaging showed tumor shrinkage of an average of 35% from baseline size. Conclusions: Histopathological examination revealed photosensitizer-concentration-dependent changes after photodynamic action in excised post-chemotherapy tissue. The effects of photodynamic action observed in this study suggest that the application of photodynamic therapy after chemotherapy can aid in breast cancer cell eradication.

Effects of SARS-CoV-2 Inflammation on Selected Organ Systems of the Human Body.

INTRODUCTION AND PURPOSE OF THE STUDY: SARS-CoV-2 virus does not only affect the respiratory system. It may cause damage to many organ systems with long-term effects. The latest scientific reports inform that this virus leaves a long-term trace in the nervous, circulatory, respiratory, urinary and reproductive systems. It manifests itself in disturbances in the functioning of the organs of these systems, causing serious health problems. The aim of the study was to review the latest research into the long-term effects of COVID-19 and determine how common these symptoms are and who is most at risk. Based on a literature review using the electronic scientific databases of PubMed and Web of Science on the long-term effects of SARS-CoV-2 infection, 88 studies were included in the analysis. The information contained in the analyzed literature shows that the SARS-CoV-2 virus can cause multi-organ damage, causing a number of long-term negative health complications. CONCLUSIONS: There is evidence that the virus can cause long-term complications lasting more than six months. They mainly concern disturbances in the functioning of the nervous, circulatory and respiratory systems. However, these studies are small or short-lasting, and many are speculative.

Assessment of the Postpartum Emotional Wellbeing among Women Participating and Not Participating in Antenatal Classes.

The perinatal period is associated with an increased risk of emotional disorders. Exposure to stress impacts the functioning of the maternal brain, also shaping the developmental processes of the child's brain. To assess the emotional wellbeing of women participating and not participating in antenatal classes. The study involved a group of 200 women divided into two groups: the study group, participants of the antenatal classes (N = 100), and the control group, not participating in the antenatal classes (N = 100). The Edinburgh Postnatal Depression Scale (EPDS) and Mini-COPE inventory were used. EPDS was administered at two time points: on the 2nd day of puerperium and 6 weeks after the delivery, while Mini-COPE inventory was applied once during pregnancy. Severe symptoms of depression on the 2nd day after childbirth concerned 16.0% of the women (N = 15) participating in the antenatal classes and 11.0% of the controls (N = 11). Intensification of depressive symptoms 6 weeks after the delivery occurred in 19.5% of the females attending antenatal classes (N = 17) and 18.8% of the controls (N = 18). Severe symptoms of depression 6 weeks after the delivery in the group of women participating in antenatal classes were significantly related to adopting helplessness to cope with stress and a sense of being accepted by the husband/partner, family, and society. In the case of women not participating in antenatal classes, the severity of symptoms of depression 6 weeks after the delivery was slightly related to the sense of acceptance by the husband/partner, family, and society. Apart from identifying risk factors for emotional disorders in pregnancy, it is worth taking into account whether a woman participated in antenatal classes when planning the care in the perinatal period. This factor can be a potential protective factor in preventing emotional problems after childbirth.

Application of Personalized Education in the Mobile Medical App for Breast Self-Examination.

Introduction. Mobile apps are considered intelligent tools useful in various areas of public health. The social dimension of breast cancer and the current epidemic situation require tools that may increase knowledge and improve the skills in the field of breast self-examination. The study aims to assess the use of personalized education based on algorithms with conditions in the mobile medical app for breast self-examination. Materials and methods. In total, 500 women from the Podkarpackie Province were enrolled in the study, which was a representative group for the inhabitants of this province. The subjects were randomly divided into two groups (group I: the study group including 250 people; group II: the controls of 250 people). The study group was subjected to intervention, which was personalized education on breast cancer. The method was a proprietary mobile medical app based on algorithms with conditions. The study was carried out from March 2018 to February 2019. Results. The majority of women, 77.8% (N = 389), were under 30 years of age. Only a small amount of the breast area was marked in the tactile test in both groups. In the study group, the average number of selected points was 14.86 (7.43% of the area to be examined), while in the control group it amounted to 9.14 (4.57%). The area most commonly examined in Test I in both groups was the central area of the mammary gland with the nipple. After the intervention in Test II, women from the study group marked a significantly greater area in the tactile test than women from the control group (χ2 = 99.733; df = 6; p < 0.0001). The mean result in the study group was 22.10, while in the control group it amounted to 9.10. It was found that the breast area marked in both tests depended solely on the women's knowledge about breast cancer (p < 0.001). It was also found that the higher the risk of developing breast cancer, the more points in Test I were indicated by the women in the tactile test (p = 0.0122). Conclusions. Educational mobile medical apps for breast cancer prevention may help to deal with breast cancer, which is an important public health issue. It is also important to broaden the possibilities of medical apps for breast self-examination with elements verifying the skills of the three-stage compression of the examined breast.

Characterisation of breast cancer molecular signature and treatment assessment with vibrational spectroscopy and chemometric approach.

Triple negative breast cancer (TNBC) is regarded as the most aggressive breast cancer subtype with poor overall survival and lack of targeted therapies, resulting in many patients with recurrent. The insight into the detailed biochemical composition of TNBC would help develop dedicated treatments. Thus, in this study Fourier Transform Infrared microspectroscopy combined with chemometrics and absorbance ratios investigation was employed to compare healthy controls with TNBC tissue before and after chemotherapy within the same patient. The primary spectral differences between control and cancer tissues were found in proteins, polysaccharides, and nucleic acids. Amide I/Amide II ratio decrease before and increase after chemotherapy, whereas DNA, RNA, and glycogen contents increase before and decrease after the treatment. The chemometric results revealed discriminatory features reflecting a clinical response scheme and proved the chemotherapy efficacy assessment with infrared spectroscopy is possible.

Approach of Pregnant Women from Poland and the Ukraine to COVID-19 Vaccination-The Role of Medical Consultation.

There are many arguments for the safety and efficacy of COVID-19 vaccines in pregnancy. The aim of this study is to describe the level of vaccination acceptance, to find the factors that most influence the decision to vaccinate, and to describe the scale of changes in vaccination acceptance influenced by medical information on the safety, efficacy, and benefits of vaccination among pregnant women. A total of 300 patients completed the questionnaire, including 150 in Poland and 150 in the Ukraine. The level of vaccination acceptance was assessed before and after medical consultation. There were 53 (35.3%) patients with the intention to get vaccinated in Poland and 25 (16.7%) in the Ukraine. After consultation with a physician, this increased to 109 (72.6%) in Poland and 69 (46%) in the Ukraine. The main factors influencing the acceptance of vaccinations were the fear of harming the foetus (OR-0.119, CI-0.039-0.324 p < 0.001), complications in pregnancy (OR-0.073 CI-0.023-0.197 p < 0.001), and limitations in the vaccination programme (OR-0.026 CI-0.001-0.207 p < 0.001). Medical information about the safety, effectiveness and benefits of vaccinations among pregnant women, provided during a medical visit, may increase the acceptance of vaccinations by 105.6%, as among Polish patients, and by 176%, as among pregnant women from the Ukraine.

Synchronous occurrence of HPV-associated cervical squamous cell carcinoma (FIGO IIA) in prolapsed uterus and adenocarcinoma of the anal canal cT1N0M0: Case report.

RATIONALE: Guidelines of rare synchronous tumours treatment are often unavailable due to lack of wide prospective studies. Additionally, their management is not just a simple sum of coexisting tumours management and has to regard many circumstances like symptoms, age, comorbidities, advancement. PATIENT CONCERNS: Herein, we report a case of an 81-year-old woman who presented with bleeding from the prolapsed uterus. DIAGNOSES: Based on physical examination, that is, speculum examination, bimanual, and per rectum, followed by rectoscopy and histopathology, the diagnosis of cervical squamous cell carcinoma FIGO IIA2 in prolapsed uterus with anal canal adenocarcinoma cT1N0M0 was made. INTERVENTIONS: Dominating complaint of bleeding from prolapsed cervix was managed with radical vaginal hysterectomy in conjunction with wide colpectomy preceded by laparoscopic pelvic and paraaortic lymphadenectomy. Due to the lack of consent for removal of the anus, only radiotherapy was applied instead. OUTCOMES: The patient underwent magnetic resonance image follow-up. No recurrence was found at 18 months. LESSONS: Imaging is useful method of synchronous cancers diagnostics. These cancers may vary in aetiology and stage. Cervical cancer may be co-existing with another anogenital cancer. Therapy of synchronous cancers should be individualized taking into account patient's consent, age, physical condition, and comorbidities.

The Approach of Pregnant Women to Vaccination Based on a COVID-19 Systematic Review.

Background and Objectives: Pregnant women are more likely to develop a more severe course of COVID-19 than their non-pregnant peers. There are many arguments for the safety and efficacy of COVID-19 vaccines in pregnant women. The aim of this study is to conduct a systematic review concerning the approach of pregnant women towards vaccination against COVID-19, with particular regard to determinants of vaccination acceptance. Materials and Methods: Articles were reviewed in which the aim was to evaluate-via a survey or questionnaire-the acceptance and decision to undergo vaccination against COVID-19. The articles were subjected to review according to recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). Results: In various studies, the percentage of pregnant women accepting the COVID-19 vaccine was between 29.7% and 77.4%. The strongest factors co-existing with the acceptance of the COVID-19 vaccination in pregnancy were trust in the importance and effectiveness of the vaccine, explicit communication about the safety of COVID-19 vaccines for pregnant women, acceptance of other vaccinations such as those for influenza, belief in the importance of vaccines/mass vaccination in one's own country, anxiety about COVID-19, trust in public health agencies/health science, as well as compliance to mask guidelines. The remaining factors were older age, higher education, and socioeconomic status. Conclusions: This review allowed us to show that geographic factors (Asian, South American countries) and pandemic factors (different threats and risks from infection) significantly influence the acceptance of vaccines. The most significant factors affecting acceptance are those related to public awareness of the risk of infection, vaccine safety, and the way in which reliable information about the need and safety of vaccines is provided. Professional and reliable patient information by obstetricians and qualified medical personnel would significantly increase the level of confidence in vaccination against COVID-19.

The Diagnosis of Perineural Invasion: A Crucial Factor in Novel Algorithm of Coexistence of Conventional and Nerve-Sparing Radical Hysterectomy.

Nerve-sparing radical hysterectomy (NSRH) was introduced to mitigate adverse effects associated with conventional radical hysterectomy (CRH) in cervical cancer. However, the introduction of NSRH was compromised by possible existence of perineural invasion (PNI). Additionally, the coexistence of NSRH and CRH is currently the fact. The aim of the study was to review the literature and attempt to construct a novel and preliminary PNI diagnostic algorithm that would establish the coexistence of NSRH and CRH in one system of early-stage cervical cancer (ESCC) surgical treatment. This algorithm takes into account the PNI risk factors and current and future diagnostic methods such as imaging and biopsy.

Spectroscopic evaluation of carcinogenesis in endometrial cancer.

Carcinogenesis is a multifaceted process of cancer formation. The transformation of normal cells into cancerous ones may be difficult to determine at a very early stage. Therefore, methods enabling identification of initial changes caused by cancer require novel approaches. Although physical spectroscopic methods such as FT-Raman and Fourier Transform InfraRed (FTIR) are used to detect chemical changes in cancer tissues, their potential has not been investigated with respect to carcinogenesis. The study aimed to evaluate the usefulness of FT-Raman and FTIR spectroscopy as diagnostic methods of endometrial cancer carcinogenesis. The results indicated development of endometrial cancer was accompanied with chemical changes in nucleic acid, amide I and lipids in Raman spectra. FTIR spectra showed that tissues with development of carcinogenesis were characterized by changes in carbohydrates and amides vibrations. Principal component analysis and hierarchical cluster analysis of Raman spectra demonstrated similarity of tissues with cancer cells and lesions considered precursor of cancer (complex atypical hyperplasia), however they differed from the control samples. Pearson correlation test showed correlation between cancer and complex atypical hyperplasia tissues and between non-cancerous tissue samples. The results of the study indicate that Raman spectroscopy is more effective in assessing the development of carcinogenesis in endometrial cancer than FTIR.

Obesity as a risk factor of in-hospital outcomes in patients with endometrial cancer treated with laparoscopic surgical mode.

OBJECTIVES: Obesity has been suggested to have a negative influence on procedural outcomes of endometrial cancer laparoscopic treatment. Obesity and other possible risk factors of laparoscopic endometrial cancer treatment has not been precisely described in the literature. The aim of the study is to determine the factors that have the greatest influence on the course of laparoscopic surgery for endometrial cancer, with particular emphasis on the influence of obesity. MATERIAL AND METHODS: The study included 75 females who were treated for endometrial cancer by laparoscopic surgery. Preoperative body-mass index (BMI), waist circumference(WC), waist to hip ratio(WHR), and selected anatomical indices were measured. The duration of surgery and hospitalization stay, loss of hemoglobin, and procedural-related complications served as parameters of in-hospital outcomes. RESULTS: Multiple linear regression analysis indicate the body mass as most sensitive parameter of obesity which influence in-hospital outcomes in patients treated with laparoscopic procedure. Procedural-related complications occurred in the group of patients with significantly greater WC and BMI. Multiple linear regression indicates also histological grading (G1-G3), external conjugate, intertrochanteric distance as significant risk factors. The multiple linear regression analysis confirmed also that implementation of sentinel lymph node procedure is related with decreased hemoglobin loss in patients with cancer of endometrium compare to lymphadenectomy without sentinel node biopsy(Est.: 0.488; 95% CI: 0.083-0.892, p = 0.018). CONCLUSIONS: The most sensitive risk factor of in-hospital outcomes in laparoscopic treatment of endometrial cancer is body mass. The implementation of the sentinel node procedure is associated with reduced surgery time and reduced hemoglobin loss.

Simultaneous FTIR and Raman Spectroscopy in Endometrial Atypical Hyperplasia and Cancer.

Currently, endometrial carcinoma (EC) is the most common genital cancer in high-income countries. Some types of endometrial hyperplasia (EH) may be progressing to this malignancy. The diagnosis of EC and EH is based on time consuming histopathology evaluation, which is subjective and causes discrepancies in reassessment. Therefore, there is a need to create methods of objective evaluation allowing the diagnosis of early changes. The study aimed to simultaneously asses Fourier Transform Infrared (FTIR) and Raman spectroscopy combined with multidimensional analysis to identify the tissues of endometrial cancer, atypical hyperplasia and the normal control group, and differentiate them. The results of FTIR and Raman spectroscopy revealed quantitative and qualitative changes in the nucleic acid and protein in the groups of cancer and atypical hyperplasia, in comparison with the control group. Changes in the lipid region were also observed in Raman spectra. Pearson correlation coefficient demonstrated a statistically significant correlation between Raman spectra for the cancer and atypical hyperplasia groups (0.747, p < 0.05) and for atypical hyperplasia and the controls (0.507, p < 0.05), while FTIR spectra demonstrated a statistically significant positive correlation for the same group as in Raman data and for the control and cancer groups (0.966, p < 0.05). To summarize, the method of spectroscopy enables differentiation of atypical hyperplasia and endometrial cancer tissues from the physiological endometrial tissue.

Obesity as a risk factor of in-hospital outcomes in patients with endometrial cancer treated with traditional surgical mode.

OBJECTIVES: Abdominal obesity is a risk factor for endometrial cancer. The negative impact of individual parameters of obesity on the procedural effects of endometrial cancer surgical treatment has been suggested. The aim of the current study was to estimate the relationship of particular parameters of obesity and in-hospital outcomes in patients treated surgically due to endometrial cancer. MATERIAL AND METHODS: The study included 70 women treated surgically for endometrial cancer. Pre-operatively, mass, body mass index (BMI), waist circumference, waist-hip ratio and selected anatomical indices were measured. The duration of surgery, hospitalisation, and the loss of haemoglobin served as parameters of in-hospital procedure success. Also, procedural-related complications were estimated. RESULTS: There were 37 (52.8%) obese females in the current study. They were obese patients presenting more advanced clinical stages of endometrial cancer before operation. The duration of operation (94.9 ± 21.6 min. vs. 76.1 ± 13.5 min., p < 0.0001), hospitalisation (12.4 ± 3.4 days vs. 10 ± 2.3 days, p = 0.0009) and haemoglobin loss (2.5 ± 0.9 g/dL vs. 1.9 ± 0.8 g/dL, p = 0.004) were significantly greater in obese patients. Multivariate analysis, among the independent predictors of the duration of operation, has confirmed the correlation between BMI, waist circumference and weight and the duration of hospitalisation. Waist and hip circumference and BMI coupled with external conjugate dimension and intertrochanteric distance have been linked with haemoglobin loss. The strongest correlation for the duration of operation, hospitalisation and haemoglobin loss was noticed for waist circumference (r = 0.7, r = 0.57 and r = 0.59). CONCLUSIONS: Waist circumference and BMI are strong predictors of in-hospital outcomes among patients with endometrial cancer treated via traditional surgical operation.

Natural history of leiomyomas beyond the uterus.

RATIONALE: Most leiomyomas are located in the uterus. Leiomyomas are rarely found outside the uterus and classified as leiomyoma beyond the uterus (LBU). This group consists of disseminated peritoneal leiomyomatosis, benign metastasizing leiomyoma, intravenous leiomyomatosis, parasite leiomyoma located in the broad ligament and retroperitoneal space. The descriptions of the patients who suffer from these types of leiomyomas are presented mainly in case reports. PATIENT CONCERNS: A 34-year-old multiparous woman was operated on multiple recurrent uterine leiomyoma in parametrium. At one time, 32 leiomyomas were removed. Thirteen months following it, in next laparotomy, 132 leiomyomas were excised. Histologically, both were intravenous leiomyomas (IVLs). DIAGNOSIS AND INTERVENTIONS: In follow-up, computed tomography (CT) and magnetic resonance imaging scans were performed to look for next recurrent leiomyoma. Accidentally, the mass was found in inferior vena cava which was diagnosed as intravenous vena cava leiomyoma. The mass was removed and the final diagnosis of intravenous myoma was confirmed in histopathology. OUTCOMES: CT scan performed 3 months after the surgery for leiomyoma in vena cava revealed no pathology. Next 10 months' follow-up was uneventful. LESSONS: The recurrent multiple uterine leiomyoma precede LBU. The uterine leiomyoma spreads intravenously route to parametria as parasite leiomyoma, then to vena cava. It has to be taken into account in follow-up.

Preoperative colonoscopy in patients with a supposed primary ovarian cancer.

The final diagnosis of ovarian cancer is based on surgery and pathological verification. Therefore patients who are presented to surgery may be described only as supposed ovarian cancer. According to the literature the diagnosis of ovarian cancer is confirmed only in 2/3 of them. The rest are that which mimic ovarian cancer. One of them is colorectal cancer. Colonoscopy is a gold standard in its diagnostics. On the other hand, ovarian cancer may disturb the bowel patency and makes the bowel resection or stoma necessary.The main aim was to find out the distribution of bowel patency disturbances in ovarian cancer patients during preoperative colonoscopy and to assess their predictive value with respect to the bowel resection or stoma and the additional aim to identify the pathologies which mimic the ovarian cancer.In a prospective study among 104 patients with supposed ovarian cancer, primary ovarian cancer was diagnosed in 68 patients. The rest of them suffered from colorectal cancer found at colonoscopy (N = 6), ovarian benign pathology (N = 8), ovarian borderline tumor (N = 5), and other nonandexal malignant diseases (N = 17). In ovarian cancer group dominated serous carcinoma and fedération international de gynécologie et d'obstétrique stage 3 (N = 33).During preoperative colonoscopy in ovarian cancer patients, the complete obstruction was found in 27.9%, and relative risk of bowel resection or stoma was in them 4.29 and 4.38, respectively. Another colonoscopic finding was limited patency caused by extrinsic compression (29%) which is connected with relative risk of bowel resection or stoma 3.16 and 3.21 accordingly. The last colonoscopy finding was described as moderate limited patency of unknown origin (20.6%) and the relative risk of bowel resection or stoma was 5.14 and 4.17, respectively.Colonoscopy enables the diagnoses of colorectal cancer one of the diseases which mimic ovarian cancer in patients supposed to have this diseases.Bowel patency disturbances found at colonoscopy are a potential risk factor to intestine resection or ostomy.Colonoscopy is not fully noninvasive procedure and its obligatory use in patients supposed to have ovarian cancer should be limited to the cases with specific symptoms, and tumor marker pattern. Preoperative computed tomography, dedicated to bowel examination, candidates as an alternative to colonoscopy, but not completely.