Browsing by Author "Rakić, Snežana (11639224800)"

Introduction. Ovarian endometriosis has been identified as a risk factor for occurrence of endometriosis-associated ovarian carcinoma. We presented a rare case of simultaneous clear cell/ endometrioid ovarian carcinoma and endometriosis of the ipsilateral ovary. Case report. A 47-year- old patient underwent surgery for right ovarian endometriotic cyst. A total hysterectomy with bilateral salpingooophorectomy, lymphadenectomy in the right psoas muscle region and omentectomy were performed as well as multiple peritoneal biopsies. Six cycles of chemotherapy were instituted postoperatively using the Taxol-CBDCA protocol. Abdominal and pelvic CT did not demonstrate recurrence of the disease postoperatively and after completed chemotherapy treatment. Six months after the completion of treatment, the patient felt well without the disease recurrence. Conclusion. Clear cell and endometrioid subtypes of ovarian carcinoma have good prognosis if they are diagnosed and treated at an early stage of the disease. In our patient, the carcinoma was detected in the first stage and successfully treated with combination therapy, i.e., surgical and chemotherapy. Apstrakt Uvod. Endometrioza jajnika je identifikovana kao faktor rizika od nastanka karcinoma jajnika udruženog sa endometriozom. Prikazali smo bolesnicu sa istovremenom pojavom svetloćelijskog/endometrioidnog tipa karcinoma jajnika i endometrioze u istom jajniku. Prikaz bolesnika. Bolesnica, stara 47 godina, podvrgnuta je operativnom zahvatu zbog endometriotične ciste na desnom jajniku. Urađena je histerektomija sa obostranom adneksektomijom, limfadenektomija regije desnog slabinskog mišića, omentektomija i višestruke biopsije peritoneuma. Posle operacije primenjena je hemioterapija u toku šest ciklusa po protokolu Taxol-CBDCA. Nakon hiruškog zahvata i sprovedenog lečenja hemioterapijom urađen je kontrolni CT abdomena i male karlice i kod bolesnice nisu nađeni znakovi recidiva bolesti. Šest meseci posle završenog lečenja bolesnica se dobro osećala i nije imala recidiv bolesti. Zaključak. Svetloćelijski i endometrioidni podtip karcinoma jajnika imaju dobru prognozu ako se otkriju i leče u ranom stadijumu bolesti. Kod prikazane bolesnice karcinom je otkriven u prvom stadijumu i uspešno je lečen kombinovanom terapijom tj. hiruški i hemioterapijom. © 2019, Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Introduction. Infectious diseases caused by Streptococcus pyogenes, a member of the group A Streptococci (GAS) are among the most common life threatening ones. Patients with GAS infections have a poor survival rate. Cellulitis is a severe invasive GAS infection and the most common clinical presentation of the disease associated with more deaths than it can be seen in other GAS infections. According to the literature data, most cases of GAS toxic shock syndrome are developed in the puerperium. However, there are two main problems with GAS infection in early puerperium and this case report is aimed at reminding on them. The first problem is an absence of awareness that it can be postpartal invasive GAS infection before the microbiology laboratory confirms it, and the second one is that we have little knowledge about GAS infection, in general. Case report. A 32-year-old healthy woman, gravida 1, para 1, was hospitalized three days after vaginal delivery with a 38-hour history of fever, pain in the left leg (under the knee), and head injury after short period of conscious lost. Clinical picture of GAS infection was cellulites. Group A Streptoccocus pyogenes was isolated in vaginal culture. Rapid antibiotic and supportive treatment stopped development of streptococcal toxic shock syndrome (STSS) and potential multiorganic failure. Signs and symptoms of the infection lasted 25 days, and complete recovery of the patient almost 50 days. Conclusion. In all women in childbed with a history of fever early after delivery, vaginal and cervical culture specimens should be taken as soon as possible. Early recognition of GAS infection in early puerperium and prompt initiation of antimicrobial drug and supportive therapy can prevent development of STSS and lethal outcome.

Hysteroscopy is the gold standard for diagnosing and managing endocervical and endometrial pathology. The development of today’s hysteroscopy begins in the early 19th century. Initially, hysteroscopy was used solely for diagnostics. Operative hysteroscopy surfaced with the development of distension media, the hysteroscope, and its associated instruments. Operative hysteroscopy underwent the most significant development in the early 1970s, when new hysteroscopes were introduced, and the distension media became more widely used. A multitude of hysteroscopic procedures are performed with the common goal of removing pathological changes in the endometrial cavity. In the 1980s, small cameras, also known as “chip” cameras, were developed, leading to the transition of endoscopy into videoendoscopy. Bettocchi revolutionized modern hysteroscopy in 1996 when he used the first operative office hysteroscope. Operative resectoscopes, containing monopolar and bipolar energy, were also constructed. Hysteroscopic morcellators have been in use since the beginning of the 21st century. Today’s modern hysteroscopy represents a safe diagnostic and operative endoscopy. © 2019, Serbia Medical Society. All rights reserved.

Patient with malignant Gestational Trophoblastic Neoplasm (GTN) was treated by mean of MTX-FA, MAC, EMA-CO and EMA-EP. Changes in serum human chorionic gonadotropine (beta hCG) levels and changes in ultrasonographic findings were checked weekly. Finally transabdominal hysterectomy with ovaries conservation was done and polychemotherapy administrated after the operation until three consecutive serum chorionic gonadotropine values were negative. This is a case report of Invasive mole in 32 years old patient without possibillity to preserve reproductive health. GTN developed two months after spontaneous abortion in 13th week gestation. No changes in uterine structure were found during the first ultrasonographic examination. Th ree months after abortion and one month after GTN confirmed, massive destruction of lateral uterine wall was detected during transvaginal Doppler ultrasound examination. Resistance index of 0,366 was significantly lower than normal, with hypervascularisation in affected tissue. Serum beta hCG confirmed poor effect of polychemotherapy treatment and decision for operative treatment was made. Hystological findings after the operation confirmed malignant GTN-invasive mole. Specific changes in ultrasonographic picture could have an impact in therapy making decision and could not be refereed without the most relevant parameter such is serum human chorionic gonadotropine.

Introduction. Fetomaternal hemorrhage (FMH) is a transfusion of fetal blood into the maternal circulation. A volume of transfused fetal blood required to cause severe, life-threatening fetal anemia, is not clearly defined. Some authors suggest volumes of 80 mL and 150 mL as a threshold which defines massive FMH. Therefore, a rate of massive FMH is 1: 1,000 and 1: 5,000 births, respectively. Fetal and neonatal anemia is one of the most serious complications of the FMH. Clinical manifestations of FMH are nonspecific, and mostly it presented as reduced fetal movements and changes in cardiotocography (CTG). The standard for diagnosing FMH is Kleihaurer-Betke test. Case report. A 34-year-old gravida (G) 1, para (P) 1 was hospitalized due to uterine contractions at 39 weeks of gestation. CTG monitoring revealed sinusoidal fetal heart rate and clinical examination showed complete cervical dilatation. Immediately after admission, the women delivered vaginally. Apgar scores were 1 and 2 at the first and fifth minute, respectively. Immediately baby was intubated and mechanical ventilation started. Initial analysis revealed pronounced acidosis and severe anemia. The patient received intravenous fluid therapy with sodium-bicarbonate as well as red cell transfusion. With all measures, the condition of the baby improved with normalization of hemoglobin level and blood pH. Kleihaurer-Betke test revealed the presence of fetal red cells in maternal circulation, equivalent to 531 mL blood loss. The level of maternal fetal hemoglobin (HbF) and elevated alpha fetoprotein also con-firmed the diagnosis of massive FMH. Conclusion. For the successful diagnosis and management of FMH direct communication between the obstetrician and the pediatrician is necessary as presented in this report. © 2016, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.

[No abstract available]

Hypogonadotropic hypogonadism is one of the causes of infertility. In women with hypogonadotropic hypogonadism both follicle-stimulating hormone and luteinizing hormone are required to induce optimal follicular growth and steroidogenesis. We described a case of singleton pregnancy in a 38-year-old patient, presenting with primary hypogonadotropic amenorrhea and empty sella syndrome, treated with human menopausal gonadotropins and performing intrauterine insemination in first attempt. This therapy led to maturation of two follicles and one of them was fertilized. A singleton pregnancy ensued and a normal infant was delivered by cesarean section. © 2006 Blackwell Munksgaard.

Hypogonadotropic hypogonadism is one of the causes of infertility. In women with hypogonadotropic hypogonadism both follicle-stimulating hormone and luteinizing hormone are required to induce optimal follicular growth and steroidogenesis. We described a case of singleton pregnancy in a 38-year-old patient, presenting with primary hypogonadotropic amenorrhea and empty sella syndrome, treated with human menopausal gonadotropins and performing intrauterine insemination in first attempt. This therapy led to maturation of two follicles and one of them was fertilized. A singleton pregnancy ensued and a normal infant was delivered by cesarean section. © 2006 Blackwell Munksgaard.

Introduction: Uterus didelphys results when Mullerian duct fusion is completely arrested during development. We presented a rare case of nonobstructive uterus didelphys occurring simultaneously with an endometriotic cyst of the ovary. Case report: A twenty-nine-year-old, nulliparous patient was admitted to our Clinic for laparoscopic treatment of an endometriotic ovarian cyst. Diagnoses of right ovarian endometriotic cyst and nonobstructed uterus didelphys were established with bimanual pelvic exam and two-dimensional transvaginal ultrasound. Diagnoses were subsequently confirmed by laparoscopy and magnetic resonance imaging. Laparoscopic incision and drainage of the endometriotic cyst were performed, followed by biopsy and coagulation of endometriotic lesions. Histopathology confirmed ovarian endometriosis. Gonadotropin-releasing hormone analogue (GnRHa) was prescribed post-operatively, for a total of 3 months. Ten months after completion of treatment, the patients was without disease recurence. Conclusion: Nonobstructive uterus didelphys is rarely associated with ovarian endometriosis. © 2019 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Cardiovascular and reproductive health of women have been going hand in hand since the dawn of time, however, their links have been poorly studied and once the basis of their connections started to be established in late 20th century, it depended on local regional abilities and the level of progressive thinking to afford comprehensive women’s care beyond the “bikini medicine”. Further research identified different associations rendering more conditions sex-specific and launching therefore a slow, yet initial turn around in clinical trials’ concept as the majority of global cardiovascular guidelines rely on the results of research conducted on a very modest percentage of women and even less on the women of color. Currently, the concept of women’s heart centers varies depending on the local demographics’ guided needs, available logistics driven by budgeting and societal support of a broad-minded thinking environment, free of bias for everyone: from young adults questioning their gender identity, via women of reproductive age both struggling to conceive or keep working part time when healthy and line of work permits it during pregnancy, up to aging and the elderly. Using “Investigate-Educate-Advocate-Legislate” as the four pillars of advancing cardiovascular care of women, we aimed to sum-marize standing of women’s health in Serbia, present ongoing projects and propose actionable solutions for the future. © 2021, Serbia Medical Society. All rights reserved.