Browsing by Author "Sparic, R. (23487159800)"

Purpose: The study aim was to report an unusual case of a misplaced IUD in isthmico-cervical region causing partial uterine perforation and discuss literature data regarding such a condition. Case Report: A 50-year-old women was referred to the present institution for IUD extraction. She was diagnosed with spontaneously misplaced IUD located in isthmico-cervical region of the uterus causing partial perforation. The time of dislocation was unknown, as she was completely asymptomatic for ten years after IUD application. Moreover, she had no risk factors for device misplacement. The removal of IUD was uneventful. Conclusion: Isthmico-cervical misplacement of IUD, although rare, can occur at any time and can be asymptomatic. Thus, women with IUD should be annually checked-up in order to prevent possible IUD complications.

Objective. To investigate the effect of trans-resveratrol from Polygonum cuspidatum/magnesium hydroxide complex, trademark Revifast®, plus D-chiro-inositol (DCI) and Myo-inositol (MI) during spontaneous pregnancies in overweight patients in a pilot study. Study design. A one-year, prospective, randomized, doubleblinded, placebo-controlled single center clinical study was carried out on overweight pregnant women. 110 patients were randomized in 3 groups to receive: Revifast® with DCI/MI (group I), DCI/MI alone (group II) or control group (group III) for 30 and 60 days. The main outcomes were to explore the lipid profile (total cholesterol, LDL, HDL, TG) and glucose levels, after 30 and 60 days of therapy. Results. No difference in systolic and diastolic parameters among 3 groups during study. All blood chemistry parameters improved compared to placebo at 30 days already, but significantly to 60 days, respect placebo. By comparing the two treatment groups, group I demonstrates significantly improved lipid and glucose parameters than group II, which are at 30 to 60 days of treatment. Conclusion. The supplementation of Trans-resveratrol, Revifast® in addition to DCI/MI in overweight pregnant woman with an elevated fasting glucose improves glucose levels, Total Cholesterol, LDL and TG. © Società Editrice Universo (SEU).

Objective: The objective of the present study was to evaluate the accuracy of the sentinel lymph node (SLN) detection procedure in Serbian sample of women with early-stage endometrial cancer (EC). Materials and Methods: In the period from March, 2015 to May 2016, all consecutive patients with histologically confirmed EC, were considered for enrolment in the study. Exclusion criteria included preoperative FIGO Stages II-IV, previous surgery that could influence the uterine lymphatic drainage, history of congenital uterus anomalies, duplex malignancies or deep vein thrombosis on lower extremities, and allergies to the contrast agent. Finally, 27 patients underwent SLN detection, followed by systematic pelvic lymphadenectomy. Demographic, surgical, and pathologic data on all patients were evaluated. Results: The SLNs were identified in 25 patients, with overall detection rate of 92.6%. Twenty-two (81.5%) patients had bilateral, while 11.15% had unilateral intraoperative visualization of SLNs. Of the seven females with positive SLNs, at definitive histology evaluation, pelvic non-SLNs were metastatic in four (57.1%) cases and negative in three (42.9%) cases. The false-negative rate of sentinel procedure was 0%. The evaluation of prognostic values of SLN status, for prediction of presence of metastases in non-SLNs showed the negative predicive value of 100%, and the positive predictive value of 57.1%. Additionally, the sensitivity of SLN method in sample of women with early-stage EC was 100%, while the specificity was 86.9%. Conclusions: SLN procedure has good diagnostic performance and is reliable in prediction of the metastatic status of the regional pelvic lymph nodes in women with early-stage EC.

Purpose: The study aim was to report diagnostic and therapeutic challenges in treatment of a patient with cervical dysplasia and congenital uterine anomaly. Case Report: A 53-year-old women with Mullerian anomaly - uterus duplex (bicorporal septate uterus) and Yshaped endocervical canal was referred due to repeated abnormal Pap smears. She underwent endocervical curettage of both canals and the endocervical septum biopsy which revealed presence of cervical intraepithelial neoplasia (CIN) III. Cervical conization was considered technically unfeasible because of abnormal cervical anatomy (lesions deep in the cervical canal on the cervical bifurcation where the cervical wall is the thickest). Classical open abdominal hysterectomy was performed. Patient had two almost equally-sized, symmetrical uterine bodies connected in the isthmico-cervical region, with normal left and obstructed right hemi-vagina. Postoperative histopathological findings confirmed that dysplasia was located in the region where two endocervical canals conjoined. Conclusion: Diagnostic and therapeutic approach to patients with uterine anomalies has to be individualized, based on anomaly type, patient's age, reproductive history, and patient's preferences.

Spindle-cell epithelioma or "mixed tumor" of the vagina is an unusual and intriguing vaginal tumor consisting of both epithelial and mesenchymal components. A case of spindle-cell epithelioma of the vagina diagnosed at delivery of a 31-year-old primiparous woman is described. The excision of the mass was performed immediately after the delivery, which was uneventful. The patient was regularly followed up and no evidence of local recurrence or dissemination was found 40 months after surgery. The presentation and the diagnosis of this kind of tumor in pregnancy, and its effect on the pregnancy and delivery are still largely unknown. Since it is unlikely that any institution will have a large number of patients with this rare disease, case reports add further information to this entity. As the number of cases studied is small, close follow-up is recommended although there has been no report in the literature of metastasis so far.

A primigravid woman at 29th gestational week with placental abruption causing fetal death, that underwent instant cesarean section, developed a disseminated intravascular coagulation (DIC), revealed by hemoperitoneum and hematoma of the abdominal wall. After re-laparotomy and transfusion of blood, fresh plasma, and platelets, the patient was discharged from hospital on the 14th postoperative day completely recovered. To conclude, conservative surgical approach for DIC treatment is possible and safe. Novel antifibrinolitic drugs are recommended for obstetrical patients with DIC to enable a healthy subsequent pregnancy.

Objectives: We aimed to describe the first cases of human trichinellosis due to Trichinella britovi in Serbia. A large trichinellosis outbreak due to the consumption of wild boar meat products took place during the 2015–2016 winter. Patients and methods: In January 2016, the Department of Infectious Diseases in Uzice examined 111 individuals with clinical and biological signs of trichinellosis, of whom 19 were hospitalized. Trichinella species identification was performed by multiplex PCR. Serodiagnosis was performed using immunofluorescence antibody assay, indirect ELISA, and Western Blot as confirmatory tests. Results: The main symptoms included myalgia (83%), weakness (82%), joint pain (80%), fever (77%), facial edema (74%), and diarrhea (23%). Eosinophil levels >500/μl were observed in 98% of patients. Elevated CPK levels were detected in 71% of patients and elevated LDH levels in 75%. Three patients had cardiac complications. Treatment included mebendazole, nonsteroidal anti-inflammatory drugs, and corticosteroids. Anti-Trichinella antibodies were observed in 89.7% of patients two months after disease onset, including all hospital-treated patients. Among them, serum positivity detected one year later was 100%. Conclusions: This outbreak highlighted communication failures, from hunters to consumers. Awareness should be raised on the relation between trichinellosis and game meat. Trichinella species detection is important for adequate outbreak recording and could contribute to better understanding the clinical and serological signs of T. britovi infection. © 2019 Elsevier Masson SAS