Browsing by Author "Pervulov, M. (6602872337)"

Keeping in mind the frequency of preterm deliveries as well as the morbidity and mortality of the newborn population, many ways of bringing about faster maturation of the fetus have been. Today, we can say that after the 24th week of gestation, when the pneumocites time 2 are anatomically formatted, medical treatment of the fetus for maturation not only of the lungs but all the vulnerable organs is available. By stimulating the pneumocites to make surfactant and sphingomyeline and phosphatidilinositol and phosphatidilglycerol, we can reduce respiratory distress syndrome. Moreover, the frequency of intracranial haemorage is lowered. We have performed many studies with all of their positive and negative effects, including: use of corticosteroids, thyroxine, aminophilline, surfactant, inositole and beta adrenergic agonist.

Within diagnostic procedures protocols in preterm delivery, the objective of the study was to examine bacterial causes of preterm deliveries in relation to term deliveries. The study included 106 patients delivered before term (24 to 37 weeks of gestation) and 126 patients with term delivery after 37 to 42 weeks of gestation. Bacterial analysis included hospital material: cervix smear in patients before the delivery and protective and functional fetal elements.

Cystosarcoma phyloides is a breast cancer with deterrent features because of its size and fast growth. Borderline ovarian tumors comprise 10% to 15% of all epithelial tumors of the ovary. Regardless of the tumor type (serous, mucinous, clear cell, Brenner, mixed) they can be benign, borderline or malignant. There is a close physiological relation between the breasts and genital tract. By routine examination of girls in secondary schools, suspected ultrasonography findings were found in two out of 180 examinees.

Objective. We have studied 37 women with all forms of cerebrovascular diseases. Our aim was to study the etiology, clinical manifestations and prognosis of such conditions during pregnancy or puerperium. Methods. We analyzed the most common causes of cerebrovascular diseases during the given period. Results. The most common causes of cerebrovascular diseases during pregnancy or puerperium are hematological coagulation disorders, cardio embolism and eclampsia, whereas other causes ara rarer. Conclusions. The incidence of cerebrovascular diseases during pregnancy or puerperium is 11%. Cerebrovascular diseases are more frequent in puerperium than during pregnancy, being 1.8:1. Etiology remains undetermined in 35% of the cases. © 2009 Informa Healthcare USA, Inc.

During routine examination of a 32-year-old patient, a cervical polyp was found and CIN III was confirmed by biopsy. After performing colposcopy, biopsy and establishing CIN III as well as performing gastroscopy where a duodenal polyp was found, thorough diagnostic exams and therapy were carried out. Complete duodenal resection and conization were performed. The medical board decided that neither further radiation nor chemotherapy was needed.

Cervical carcinoma is the fourth most common malignant disease in women, after breast, lung and colon cancer. It is present in two-thirds of all malignant diseases of the genital tract. Although in most of Europe patients are subjected to regular health screening, diagnoses of severe life-threatening alterations are often made when they are already in late stages.

With the acceptance of new ideas in medicine and modernization of life styles, it is necessary to conduct delivery as a beautiful act of giving life with the least amount of pain possible using epidural anesthesia. Thus, not only is the physical aspect of delivery improved but also benefits from anesthesia are seen in obstetrics. To conduct epidural anesthesia successfully during delivery, certain conditions are necessary regarding the fetus and mother. Such conditions include an adequate Bishop score, fetal head presentation, the presence of amnion, adequate term of delivery and Doppler flows that do not compromise vaginal delivery. Primiparas in term pregnancies without pathological conditions related to mother or fetus were examined. The duration of delivery was observed in a group of primiparas that did not receive epidural anesthesia (group A) and a group of primiparas that received epidural anesthesia (group B). The study lasted one year.

The cause of stomach carcinoma is still unclear but a variety of possible factors are presently under investigation. The clinical signs of stomach carcinoma are deceitful, and the disease is mainly asymptomatic. The first symptoms are dyspeptic disturbances, the feeling of satiety after meals, belching, and loss of appetite. This interesting and educative case starts with an almost classical story of a patient admitted with hyperemesis during pregnancy. She was a primipara, 18 years old, with a significantly low body mass index and electrolyte imbalance and at the 23 rd week of gestation.

Hydatidiform mole is a degenerative chorion disturbance of unknown etiology. It is characterized by a permanent whitish enlargement of the chorionic villi with a grape-like appearance and poor vascularization. The symptoms of a molar pregnancy are nausea and vomiting which are present in more than one-third of the patients. Other symptoms include an enlarged uterus and vaginal bleeding. Our patient was a 19-year-old primipara with a twin pregnancy where one embryo was molar. Diagnosis was confirmed by beta-hCG levels.

AIM: The aim of the study was to analyze the effectiveness of the application of DDAVP (desmopressin) and Hemate P with cryoprecipitate pre- and postpartum in patients with von Willebrand disease. METHODS: We monitored 32 patients with von Willebrand disease during the study period 1993-2003. DDAVP was applied in the 36th/37th week of gestation and cryoprecipitate and fresh frozen plasma were applied 1 day before and 3 days after delivery. DDAVP treatment continued for 4 weeks. Factor VIII (Hemate P) at the day of delivery RESULTS: No complications occurred in the studied population. CONCLUSION: Precipitation of DDAVP, Hemate P, and cryoprecipitate may help in the treatment of pregnant women with von Willebrand disease.

We have analyzed a case of pancreatic carcinoma in a pregnant woman, 37 years old, in the second trimester of the pregnancy. She had a positive family history of digestive tract carcinoma. The delivery ended surgically and hysterectomy was performed at the same time.

The purpose of this investigation was to determine if twin pregnancies induced by in vitro fertilization (IVF) are under greater risk of negative perinatal outcome than "spontaneous" twin pregnancies. The study included 240 patients with gemellar pregnancies. Each patient with a gemellar IVF pregnancy (120) was assigned to a pregnant woman with appropriate age, education and parity from the "spontaneous" group as a control. Pregnancies were followed clinically, with laboratory analyses and ultrasonography.

Backround: Pregnant woman with fetal tachycardia have a risk of chorioamnionitis as cause of tachycardia. Different studies have supported or refuted the use of C-reactive protein (CRP) to diagnose chorioamnionitis. The goal of this study was to evaluate serial serum CRP levels for diagnosis of chorioamnionitis. Methods: The study included 60 woman with chorioamnionitis confirmed after measuring the levels of CRP. Patients were monitored by CRP determination, white blood cell (WBC) count, maternal temperature, maternal and fetal heart rate. Results: Elevated CRP level was present in 93.33% of cases. Fetal tachycardia was present in 91,67 cases, all associated with elevated CRP level. Increased WBC count was present in 63.33%. A statistically significant difference was found in the level of CRP in pregnant women with increased WBC count compared with those without (p < 0.01). Conclusion: Elevated C-reactive protein levels were more sensitive than other standard laboratory or clinical tests in predicting chorioamnionitis. Also, recent reports indicate that serial CRP levels during this interval may be useful for monitoring antibiotic treatment.

In the population of pregnant women in Serbia and Montenegro, hemorrhoids are present in 85% of the cases during the second and third pregnancy. Urged by the complications of non-treated hemorrhoids, we carried out a routine diagnostic procedure to examine hemorrhoids during pregnancy, i.e. a differential diagnosis with other possible complications was performed. Fifty patients, aged between 36 and 38, were examined by anoscope and rectoscope during the second trimester. Rectal carcinoma was found in three cases, which is a disturbing number. The patient with the most serious clinical picture was subjected to urgent artificial fetal lung maturation and surgical delivery. One of the patients had clinical cachexia, and in view of the fact that the magnetic resonance imaging during pregnancy showed infiltration and that the patient was 38 years old, with the patient's consent, surgery was performed together with hysterectomy and salpingo-oophorectomy and immediate removal of the rectum and anus. In the other two cases, the delivery ended vaginally between the 35th and 38th week of gestation, after which the patients were moved to the surgery ward. Besides a positive family history for digestive tract carcinoma (95%), smoking and increased body mass index, there were no significant parameters distinguishing these three patients from others with hemorrhoids. Interesting data were obtained from the fact that there was no increase in body mass during pregnancy which patients correlated with their already present obesity. Moreover, pain was correlated with the fact that the patients did not follow a healthy dietary regime. In all 50 patients, the following procedures were performed: anoscope, rectoscope and digestive tract tumor markers. Observing the results of the biopsies, we found rectal carcinoma Stage C according to Dukes staging (tumor included serosa) in one case. In the other two cases, Stage B1 carcinomas were found (which included all layers except serosa). Magnetic resonance imaging was performed and confirmed progression of the disease. The delivery ended per vias naturalis in two cases in view of the fact that it was the third pregnancy for both patients. Surgery was performed 40 days after delivery. Postoperative recovery was unremarkable in all described cases.

By following Doppler flow of the small pelvis with laboratory parameters and anamnesis data, we obtained more precise diagnostic possibilities for timely discovering of malignant processes in adnexal region and fallopian tube. By following patients who had come for routine check ups, prompted by a positive family history for malignant processes, resistant indexes of blood vessels in the adnexal region and vascularisation pattern were determined. Out of 78 women observed in the postmenopausal period with diagnosed adnexal masses, we found two cases of fallopian tube cancer. Resistance indexes ranged between 0.20 and 0.30 during a one-month period. Hystopathological analysis pointed to fallopian tube cancer. Besides Doppler flow, only patient history of amber extract use was significant. By CA 125 marker analysis, we found an increased value but not signifiant enough. Both patients had a positive family history according to the female hereditary line.

During a four-year period we analyzed the significance, sensitivity and sensibility of myoma Doppler flow during pregnancy in relation to the course and outcome of the pregnancy and to later histopathological findings. By following 36 older primigravidas with determined myomas, we observed the course of the pregnancies in all trimesters and analyzed myoma Doppler flow. In conditions where the resistance index showed the possibility of uterine sarcoma, the pregnancy was ended by surgery; not only was myomectomy performed but also complete uterine hysterectomy with the previous consent of the patient. Doppler flow was accepted as the authoritative parameter for non-invasive detection of a malignant process. Considering the obstetrical findings, other patients were delivered vaginally or operatively, but after puerperium they were subjected to control examinations and myomectomy because Doppler flow findings did not show any indications of sarcoma. By histopathological analysis, we received benign results in 31 cases, while in four cases where we decided on hysterectomy and surgical delivery, we received malignant results, i.e. leiomyosarcoma. In four cases of performed hysterectomy immediately after cesarean section, the resistance index (RI) of revascularization within the myoma was in the range between RI 0.30 ± 0.02. Flows within the uterine artery were 0.54 ± 0.03.

Gall bladder carcinoma is the most common carcinoma of the biliary tract and the fifth most common malignant tumor of the gastrointestinal tract. The patients usually have no symptoms at all or non-specific symptoms are present. The therapy for gall bladder carcinoma is complete removal. Unfortunately, in 80% of the cases the survival period is less than one year.