Treatment of endometrial cancer in patient with malignant obesity.

Our 60-year-old patient menarche in 13-year, two delivery, last menstruation in 53-year, without uterine bleeding or any kind of symptomatology. The gynecological transvaginal ultrasound examination showed hyperplasio endometrii (20 mm). After curettage, pathological examination was diagnostic polypus carcinomatoides. The patient with HTA and obesity was admitted to and operated on at the Gynecological Department due to endometrial carcinoma (FIGO stage IA1). Because of her giant obesity, BMI - 71.50 kg/m2, weight 219 kg and height 175 cm, surgery by the abdominal approach was very difficult to perform, so vaginal hysterectomy was carried out. The procedure was completed within 127 minutes without any intraoperative complications. Blood loss was less than 100 ml. The patient was discharged on postoperative day 7. The patient was followed up for 6 months after surgery. No complications or recurrence were reported during the 6-month follow up.

Primary gastric mucosa associated lymphoid tissue lymphoma: clinical data predicted treatment outcome.

AIM: To determine clinical characteristics and treatment outcome of gastric lymphoma after chemotherapy and immuno-chemotherapy. METHODS: Thirty four patients with primary gastric mucosa associated lymphoid tissue (MALT) lymphoma (Ann Arbor stages I to IV) were enrolled. All had upper gastric endoscopy, abdominal ultrasonography, CT and H pylori status assessment (histology and serology). After anti-H pylori treatment and initial chemotherapy, patients were re-examined every 4 mo. RESULTS: Histological regression of the lymphoma was complete in 22/34 (64.7%) and partial in 9 (26.5%) patients. Median follow up time for these 31 responders was 60 mo (range 48-120). No regression was noted in 3 patients. Among the 25 (73.5%) H pylori positive patients, the eradication rate was 100%. CONCLUSION: Using univariate analysis, predictive factors for overall survival were international prognostic index (IPI) score, hemoglobin level, erythrocyte sedimentation rate (ESR), and platelet numbers (P < 0.005). In addition to this, Cox proportion hazard model differentiate IPI score, ESR, and platelets as predictors of survival.

Cervical length measured by transvaginal ultrasonography and cervicovaginal infection as predictor of preterm birth risk.

INTRODUCTION: The study shows possibilities of transvaginal sonographic measurement of the cervix in prediction of premature birth risk. GOALS: The aim of the study was to follow up the cervical length in the pregnant from 16(th) to 37(th) week, as well as to do a microbiological analysis of the vaginal and cervical flora and to identify relation between the cervical shortening and microbiological flora as well as with a premature birth. MATERIAL AND METHODS: The investigation was conducted as a prospective study on two groups of female patients in Clinical Centre of Banja Luka. In the high risk group we had 8% of patients with cervical length bellow than 15mm, 30% of patients with cervical length from 15 to 25m and 62% of patients with cervical length bigger than 25mm. In the low risk group we had no patients with cervical length bellow 15mm, 95% of patients had cervical length bigger than 25mm and 5% of patients had cervical length from 15 do 25mm. RESULTS: The regression coefficient of the cervical length in the high risk group was 0.44mm, while in the low risk group it was 0.26mm. In the high risk group 67.56% patients had a positive cervical smear finding, while in the low risk group it was 4%. A high premature birth (defined as birth before 36.6 weeks) incidence of 50% was presented in patients with cervical length bellow 15mm. In the group of patients with cervical length up to 25mm the premature risk incidence was 10.52±0.05. In the high risk group of patients with a positive cervical smear finding, regarding the cervical length the percentage was as follows; in the subgroup of 15mm length 88,89±11,87, in subgroup from 15 to 25mm was 62,07±11,43 and in the subgroup bigger than 25mm, 60.06±8.05. CONCLUSION: By the analysis of the first and second goal of our study we can conclude that ultrasound assessment of cervical length is simple and feasible in the 16(th) week of pregnancy in both groups, with high and low risk. The length of the cervix in this period is shorter in the high risk group compared with the low-risk group. This difference was not statistically significant, however, it clearly demonstrated connection between shorten length of the cervix with the preterm birth. A regression analysis shows that the shortening of the cervix length is more frequent in high risk group which is to be expected, bearing in mind that in this group, the risk of preterm delivery was significantly higher.