Obstetric neuraxial analgesia - is it a matter of ethnic disparity?

OBJECTIVE: Pain is an essential element of humane childbirth. Neuraxial analgesia is the most effective method for relieving pain during childbirth. More and more women are using this type of analgesia in childbirth. The aim of the study was to identify ethnic differences in the application of neuraxial analgesia. SUBJECTS AND METHODS: The research was conducted through a face-to-face survey. The respondents are patients after vaginal delivery. The experimental group consists of patients of the ethnic minority, the Romani group (32 women), and the control group consists of patients of the majority, the Serb group (99 women). We investigated the quality and quantity of prenatal care, information about regional anesthesia, and its application in these two groups. RESULTS: There is a significant ethnic disparity between the Serb and Romani ethnic groups. Patients of the Romani ethnic group have qualitatively and quantitatively poorer antenatal care, less information regarding the use of neuraxial analgesia, and use it significantly less often. CONCLUSIONS: Neuraxial analgesia must be available to all patients regardless of ethnicity or social status.

Intra-amnial methotrexate in cervical pregnancy treatment.

Cervical pregnancy is an extremely rare condition with potential devastating consequences if not diagnosed and treated early enough. The authors present a case with ultrasound images of early cervical ectopic pregnancy in a woman with a history of previous cesarean section who was successfully treated with intra-amnial methotrexate (MTX).

Current approach to epithelial ovarian cancer based on the concept of cancer stem cells.

Epithelial ovarian cancer (EOC) is the most common ovarian malignancy. EOCs comprise a diverse group of neoplasms, exhibiting a wide range of morphological characteristics, genetic alterations, and biological behaviors. Currently, there is no effective screening for early detection of EOCs and more than two-thirds of EOC patients are diagnosed with advanced stage disease. The major limiting factors in the treatment of EOC patients are recurrence and chemoresistance. Recent studies suggest that EOCs, like other solid tumors, contain distinct populations of cells that are responsible for tumor initiation, maintenance and growth. These cells, termed cancer stem cells (CSCs), display some of the features of normal stem cells and are thought to evade current chemotherapeutic strategies for the treatment of EOCs. Distinguishing CSC-associated antigen profiles may elucidate novel, more sensitive biomarkers for early detection of EOCs and provide molecular targets for the development of new treatment modalities. This review summarizes the current approaches to EOCs based on the concept of CSCs and evaluates their clinical relevance.

Late recurrence of malignant melanoma mimicking ovarian malignancy.

BACKGROUND: Malignant melanoma (MM) is an extremely malignant tumor with an unpredictable profile of spread and variable periods of remission. CASE: We describe an unusual case of malignant melanoma metastatic to the omentum occurring seven years after diagnosis and treatment of cutaneous malignant melanoma in the patient's arm. She received surgery and chemoimmunotherapy. To date, nine months after detection of malignant melanoma metastatic to the omentum, the patient is alive with no clinical and radiological metastatic disease. CONCLUSIONS: The diagnosis of omentum malignant melanoma in a living patient is uncommon, thus very few individuals and referral centers can build up an adequate experience of handling this disease. Optimal management has been a challenge and a subject of debate and has not yet been established.