Razlika histološkog gradusa karcinoma endometrija u kiretaži i histerektomiji – presječna studija

Objectives: To determine the compatibility rate between histological grades of endometrial carcinoma in curettage and hysterectomy and to determine how quantity of material, given by the method of fractional hysterectomy, affects the compatibility between histological grades in the two methods. Material and methods: The study included 102 patients with endometrioid endometrial cancer who underwent methods of fractional curettage and hysterectomy. Data regardingthepathohistological status of uterine tissue was obtained from the available medical records. Information on age andclinical diagnoses were obtained from referrals for pathohistologicaltissue examination. The age of the subjects was determined at the time when the tissue samples were taken for analysis. Data on the amount of material was obtained from the description of macroscopic evaluation of the given material. Results: Most subjects had grade II endometrioid endometrial cancer (47.1 % and 50 %). Most of the respondents had a medium deficient material obtained by fractional curettage (40.2 %). There was no statistically significant difference between the histological grade determined after the fractional curettage and hysterectomy. There were no statistically significant differences in histological grade in the sample obtained by fractional curettage and hysterectomy depending on the amount of material in fractional curettage. Conclusions: There was no statistically significant differences in the grade of endometrial cancer in samples obtained by the fractional curettage and hysterectomy. The correspondence is higher in higher tumor grade (III), and lower in lower tumor grades (I, II). The amount of material did not affect the grade deviation in the sample obtained by fractional curettage and hysterectomy.Cilj: Ispitati podudarnost histološkog gradusa endometrioidnog karcinoma endometrija u uzorcima dobivenim frakcioniranom kiretažom i histerektomijom te ispitati utječe li količina materijala dobivenog frakcioniranom kiretažom na podudarnost histoloških gradusa. Materijal i metode: U istraživanje su bile uključene 102 pacijentice oboljele od endometrioidnog karcinoma endometrija. Iz dostupne medicinske dokumentacije prikupljeni su arhivski podatci o patohistološkom nalazu tkiva maternice dobivenog metodom frakcionirane kiretaže i histerektomijom. Iz uputnice za patohistološki pregled tkiva dobiveni su podatci o dobi i uputnim kliničkim dijagnozama. Podatci o količini materijala dobiveni su iz opisa makroskopske procjene prikupljenog materijala. Rezultati: Najveći broj ispitanica imao je gradus II endometrioidnog karcinoma endometrija (47,1 % i 50 %). Najveći dio ispitanica imao je srednje obilan materijal dobiven frakcioniranom kiretažom (40,2 %). Nije uočena statistički značajna razlika između histološkog gradusa utvrđenog nakon frakcionirane kiretaže i nakon histerektomije, kao ni u histološkom gradusu između uzoraka dobivenih frakcioniranom kiretažom i histerektomijom s obzirom na količinu kiretiranog materijala. Zaključci: Nije bilo statistički značajne razlike u određenim gradusima karcinoma endometrija u uzorcima dobivenima metodom frakcionirane kiretaže i histerektomije. Podudarnost je veća u višem gradusu tumora (III), a manja u nižem gradusu tumora (I, II). Količina materijala nije utjecala na odstupanje gradusa u uzorku dobivenom frakcioniranom kiretažom i histerektomijom

PROGINS Mutation of Progesterone Receptors and Its Role in Premature Birth – An Overview

Premature ( or preterm ) birth ( birth prior 37 weeks of gestation ) is big worldwide medical and socioeconomic problem. It percentage is 8-12% of total number of births, and apart from the increased mortality of newborns, it is also cause of increased morbidity in for it. worldwide, as far as some statistical reviewes say, 15 million of babies per year are preterm born. Despite the frequency, consequences and costs of premature delivery, very little has been done for preventing it, especially for preventing early premature deliveries. Etiology of premature labor is multifactorial, and includes pathophysiology, genetics and enviromental factors. Resent scientific researches, particulary in the field of human genomics, show that genetic factors, mostly present in genome of mother, contribute up to 40% variation in delivery time. It is belived that premature birth has same cascade of events like normal birth; just in this case it starts sooner. This process is controlled by series of hormonal effects between fetus, placenta and mother. One of the key signaling pathways in this series is progesterone one. PROGINS allele is progesterone receptor gene modification. It is built of 3 variants : V660L,H770H and alu insertion. Progesterone receptors with PROGINS mutation are less susceptible to progesteron activity, and it looks as the withdrawal of progesterone causes the beggining of birth cascade. +331G/A progesterone receptor mutation is newly discovered mutation. It is belived that this mutation leads to PR-a an PR-B receptor quantity disorder before delivery term. The aim of this review is to resume all recent aknowledgements about PROGINS and +331G/A mutation of progesterone receptor and see if there is the value of these genetic mutations in modulation of risk for preterm birth

PREGLED ŽENSKE SPOLNE FUNKCIJE S PRIKAZOM HRVATSKOG PRIJEVODA INDEKSA ŽENSKE SPOLNE FUNKCIJE

Introduction: The Female Sexual Function Index (FSFI) is a questionnaire used to assess female sexual function and diagnose sexual dysfunction (SD). Aim: to provide a Croatian translation of the FSFI. Methods: The translation procedure consisted of creating two independent forward translations, merging them into a single forward translation, creating a back translation, comparing the back translation with the original, and deciding on a fi nal translation. Results: no semantic differences were found when comparing the back translation with the original. Therefore, minimal changes were made to the earlier translation when the fi nal translation was created. Conclusions: The Croatian translation of the FSFI is now available for assessing the widespread problem of female SD in the Croatian-speaking population.Uvod: Indeks ženske seksualne funkcije (engl. Female Sexual Function Index, FSFI) je upitnik koji se rabi za procjenu ženske seksualne funkcije i dijagnosticiranje seksualne disfunkcije (SD). Cilj: prikazati prijevod upitnika FSFI na hrvatski jezik. Postupci: Postupak prevođenja sastojao se od stvaranja dvaju neovisnih prijevoda upitnika s engleskog na hrvatski jezik, njihovog spajanja u jedan prijevod, ponovnog prevođenja stvorene hrvatske inačice upitnika na engleski jezik te usporedbe konačne inačice prijevoda s originalnim upitnikom i konačnih prilagodba fi nalne verzije prijevoda. Rezultati: Nisu pronađene semantičke razlike pri usporedbi hrvatskog prijevoda s originalnom verzijom upitnika. Stoga su napravljene minimalne promjene u prvoj verziji prijevoda pri stvaranju konačnog prijevoda. Zaključak: Hrvatski prijevod upitnika FSFI je sada na raspolaganju za ispitivanje raširenog problema SD u ženskoj populaciji hrvatskog govornog područja

PREGLED ŽENSKE SPOLNE FUNKCIJE S PRIKAZOM HRVATSKOG PRIJEVODA INDEKSA ŽENSKE SPOLNE FUNKCIJE

Introduction: The Female Sexual Function Index (FSFI) is a questionnaire used to assess female sexual function and diagnose sexual dysfunction (SD). Aim: to provide a Croatian translation of the FSFI. Methods: The translation procedure consisted of creating two independent forward translations, merging them into a single forward translation, creating a back translation, comparing the back translation with the original, and deciding on a fi nal translation. Results: no semantic differences were found when comparing the back translation with the original. Therefore, minimal changes were made to the earlier translation when the fi nal translation was created. Conclusions: The Croatian translation of the FSFI is now available for assessing the widespread problem of female SD in the Croatian-speaking population.Uvod: Indeks ženske seksualne funkcije (engl. Female Sexual Function Index, FSFI) je upitnik koji se rabi za procjenu ženske seksualne funkcije i dijagnosticiranje seksualne disfunkcije (SD). Cilj: prikazati prijevod upitnika FSFI na hrvatski jezik. Postupci: Postupak prevođenja sastojao se od stvaranja dvaju neovisnih prijevoda upitnika s engleskog na hrvatski jezik, njihovog spajanja u jedan prijevod, ponovnog prevođenja stvorene hrvatske inačice upitnika na engleski jezik te usporedbe konačne inačice prijevoda s originalnim upitnikom i konačnih prilagodba fi nalne verzije prijevoda. Rezultati: Nisu pronađene semantičke razlike pri usporedbi hrvatskog prijevoda s originalnom verzijom upitnika. Stoga su napravljene minimalne promjene u prvoj verziji prijevoda pri stvaranju konačnog prijevoda. Zaključak: Hrvatski prijevod upitnika FSFI je sada na raspolaganju za ispitivanje raširenog problema SD u ženskoj populaciji hrvatskog govornog područja

Utjecaj majčinih i fetalnih faktora na uspješnost medikamentozne indukcije poroda

Labour induction is the process in which labour is induced mechanically or pharmacologically. The percentage of induced labours is between 1.4% and 32% of the total number of births in the world. The aim of this research is to present the number of medically induced labours from 2012 to 2019 at the Clinic for Gynaecology and Obstetrics of the Clinical Hospital Center in Osijek and to present the success rate of medically induced labour and factors, both maternal and/or foetal which may affect it. Materials and methods: In the study 2361 subjects were included whose births were induced by medication regardless of the indication for medically induced labour, gestational age or mother’s age. χ2 test, Mann Whitney U test, Fisher’s exact test, Kruskal Wallis test (Pot Hoc Conover), and the univariate and multivariate logistic regression model were used. Results: The percentage of inductions was 13.8%. 81% of the child births was completed vaginally , while 19% was completed by the caesarean section. The univariate regression analysis found that meconium amniotic fluid increases the risk of the caesarean section after the labour has been induced. Factors decreasing the possibility of the caesarean section after induced labour include multiparity, women age between 25 and 35 years and women bearing female children. The multivariate statistical regression model found that women over the age of 36 are 1.58 times more likely to have the caesarean section. Women with meconium amniotic fluid are 1.47 times more likely to have the caesarean section. Multiparity in the mother and the female sex of the child reduce the probability of the caesarean section after induced labour (odds ratio (OR) 0.20, P=0.02 and OR 0.84, P=0.09, respectively). Conclusion: The study indicates that multiparity and female gender of child increase the probability of the vaginal birth after the induction, while the mother’s age over 36 and meconium amniotic fluid after the induction increase the risk of the caesarean section.Indukcija poroda postupak je kojim mehaničkim ili farmakološkim putem pokušavamo potaknuti porod. Postotak induciranih porođaja u svijetu mjeri se od 1,4 do čak 32 % od ukupnog broja poroda. Cilj je ovog preglednog rada prikazati broj medikamentozno induciranih poroda u razdoblju od 2012. do 2019. godine na Klinici za ginekologiju Kliničkog bolničkog centra u Osijeku, prikazati uspješnost medikamentozne indukcije poroda te koji od materničnih i/ili fetalnih faktora mogu utjecati na uspjeh indukcije poroda. Materijali i metode: Koristili smo podatke iz rađaonskog protokola Klinike za ginekologiju i porodništvo Kliničkog bolničkog centra u Osijeku. U istraživanje smo uključili 2361 ispitanicu čiji su porodi inducirani medikamentozno. Statistički smo obradili podatke o vrsti indukcije poroda, indikacijama za indukciju poroda te načinu poroda nakon indukcije. Koristili smo χ2 test, Mann Whitney U test, Fisherov egzaktni test, Kruskal Wallis test (Pot Hoc Conover) te model univarijantne i multivarijantne logističke regresije. Rezultati: Postotak indukcija bio je 13,8 %. U 81 % slučajeva porod je dovršen vaginalnim putem, dok je u 19 % slučajeva dovršen carskim rezom. Utvrdili smo da je čimbenik rizika za carski rez nakon indukcije poroda dijagnoza mekonijske plodove vode, dok su čimbenici koji smanjuju vjerojatnost carskog reza – dob majke od 25 do 35 godina, trudnice koje su rodile žensko dijete te trudnice koje su do sada već rađale. Modelom multivarijantne statističke regresije utvrdilo se da žene u dobi iznad 36 godina imaju 1,58 puta veću šansu za carski rez u odnosu na mlađe, a one s prisutnom dijagnozom mekonijske plodove vode 1,47 puta veću šansu za carski rez u odnosu na one koje nemaju navedenu dijagnozu. Multiparitet u majke te ženski spol djeteta smanjuju vjerojatnost carskog reza nakon indukcije poroda (redom OR 0.20, P = 0.02 te OR 0.84, P = 0.09). Zaključak: Studija je pokazala da su multiparitet i ženski spol djeteta protektivni faktori za vaginalni porod, dok su dob majke iznad 36 godina te zelena plodna voda nakon indukcije poroda rizični faktori za carski rez

SEXUAL FUNCTION AND BODY IMAGE OF WOMEN TREATED FOR KIDNEY DISEASE

Cilj: Utvrditi prevalenciju spolne disfunkcije (SD) u populaciji žena s nadomještanjem bubrežne funkcije (NBF) i u ovisnosti o vrsti NBF-a kroničnom hemodijalizom (CHD, od engl. chronic hemodialysis) ili bubrežnom presadbom (TX, od engl. transplantation), SD u ovisnosti o slici o sebi, razini depresivnosti i tjeskobe i o komorbiditetu. Ispitanici i postupci: Ispitane su 54 bolesnice liječene CHD-om, 53 liječene TX-om i 90 zdravih kontrola. Ispitanice su ispunjavale sociodemografski upitnik; upitnik o depresivnosti, PHQ9, od engl. The Patient Health Questionnaire; upitnik o tjeskobi, GAD7, od engl. Generalized Anxiety Disorder-7; upitnik -indeks ženske spolne funkcije, FSFI, od engl. Female Sexual Function Indeks; upitnik slike o svome tijelu, BIS, od engl. Body Image Scale te indeks Ifudu o komorbiditetima. Statistička raščlamba učinjena je pomoću programa IBM SPSS Statistics, razina značajnosti P < 0,05. Rezultati: SD je nađena u 90 % bolesnica na CHD-u, postotak u podskupini koje su u vezi u više od 50 %. Prevalencija je bila značajno niža za kontrole (12,5 %) i skupinu TX (44,44 %). Ispitanice skupine CHD pokazale su više razine depresivnosti od ostalih skupina. Nije bilo značajnih razlika u tjeskobi među skupinama. Lošija slika o sebi nađena je u skupini CHD u odnosu na zdrave kontrole. SD je bila češća u žena starije dobi, onih s većim brojem djece, postojanjem depresivnosti i niskim stupnjem obrazovanja. Isti čimbenici utjecali su na lošiju sliku o sebi. Pronađene su statistički značajne razlike u obilježjima SD-a u ispitanica na dijalizi u odnosu na kontrole, nije bilo značajne razlike između skupine TX i kontrola. Komorbiditeti su pozitivno korelirali s FSFI-jem u skupini CHD. Zaključak: Velik udio bolesnica s NBF-om ima SD, one liječene CHD-om češće nego dobno prilagođene kontrole i bolesnice skupine TX. Skupina TX imala je bolju spolnu funkciju od CHD skupine, dok nije bilo značajnih razlika između zdravih kontrola i skupine TX. Slika o sebi bila je niža u skupini CHD u odnosu na kontrole. Razine depresivnosti bile su više u skupini CHD u odnosu na druge skupine. Potrebne su daljnje analize ove populacije radi razvijanja dijagnostike i liječenja SD-a.Aim: To determine the prevalence of sexual dysfunction (SD) in the population of women with renal replacement therapy (RRT) and in relation to the type of therapy: CHD (chronic hemodialysis) or TX (transplantation) and SD in relation to body image, levels of depression, anxiety and comorbidities. Methods: A total of 54 CHD and 53 TX patients as well as 90 healthy controls were questionned using a sociodemographic questionnaire, PHQ9 (The Patient Health Questionnaire), GAD7 (Generalized Anxiety Disorder - 7), FSFI (Female Sexual Function Index), BIS (Body Image Scale) and Ifudu Index (about comorbidities). Statistical analysis was performed using the software program a IBM SPSS Statistics. P < 0.05 was considered statistically significant. Results: Out of the dialysis patients, 90 % filled the criteria for SD, or 50 % of those women who were in a relationship. The prevalence was lower for healthy controls (12.5 %) and TX patients (44.44 %). CHD patients showed higher levels of depression than the other two groups. No significant differences in anxiety were observed. Lower Body Image was found in the CHD group when compared to controls. SD was more prevalent in older women, those with more children, depression, and lower levels of education. The same parameters were associated with a lower body image. Significant differences in SD were noticed between the dialysis and healhy control group, while no differences were observed between the transplant and healthy control group. Comorbidies correlated positively with FSFI in CHD group. Conclusion: A large proportion of patients with RRT had SD, which was more prominent in CHD group when compared to the TX and control groups. TX patients had better sexual function than those on dialysis, while no significant differences were observed between healthy controls and TX. Body image was lower in the CHD group when compared to controls, while levels of depression were more pronounced in the CHD group when compared to the other groups. More research is needed in this population in order to develop proper diagnostic and therapeutic measures for treating SD

SEXUAL FUNCTION AND BODY IMAGE OF WOMEN TREATED FOR KIDNEY DISEASE

Cilj: Utvrditi prevalenciju spolne disfunkcije (SD) u populaciji žena s nadomještanjem bubrežne funkcije (NBF) i u ovisnosti o vrsti NBF-a kroničnom hemodijalizom (CHD, od engl. chronic hemodialysis) ili bubrežnom presadbom (TX, od engl. transplantation), SD u ovisnosti o slici o sebi, razini depresivnosti i tjeskobe i o komorbiditetu. Ispitanici i postupci: Ispitane su 54 bolesnice liječene CHD-om, 53 liječene TX-om i 90 zdravih kontrola. Ispitanice su ispunjavale sociodemografski upitnik; upitnik o depresivnosti, PHQ9, od engl. The Patient Health Questionnaire; upitnik o tjeskobi, GAD7, od engl. Generalized Anxiety Disorder-7; upitnik -indeks ženske spolne funkcije, FSFI, od engl. Female Sexual Function Indeks; upitnik slike o svome tijelu, BIS, od engl. Body Image Scale te indeks Ifudu o komorbiditetima. Statistička raščlamba učinjena je pomoću programa IBM SPSS Statistics, razina značajnosti P < 0,05. Rezultati: SD je nađena u 90 % bolesnica na CHD-u, postotak u podskupini koje su u vezi u više od 50 %. Prevalencija je bila značajno niža za kontrole (12,5 %) i skupinu TX (44,44 %). Ispitanice skupine CHD pokazale su više razine depresivnosti od ostalih skupina. Nije bilo značajnih razlika u tjeskobi među skupinama. Lošija slika o sebi nađena je u skupini CHD u odnosu na zdrave kontrole. SD je bila češća u žena starije dobi, onih s većim brojem djece, postojanjem depresivnosti i niskim stupnjem obrazovanja. Isti čimbenici utjecali su na lošiju sliku o sebi. Pronađene su statistički značajne razlike u obilježjima SD-a u ispitanica na dijalizi u odnosu na kontrole, nije bilo značajne razlike između skupine TX i kontrola. Komorbiditeti su pozitivno korelirali s FSFI-jem u skupini CHD. Zaključak: Velik udio bolesnica s NBF-om ima SD, one liječene CHD-om češće nego dobno prilagođene kontrole i bolesnice skupine TX. Skupina TX imala je bolju spolnu funkciju od CHD skupine, dok nije bilo značajnih razlika između zdravih kontrola i skupine TX. Slika o sebi bila je niža u skupini CHD u odnosu na kontrole. Razine depresivnosti bile su više u skupini CHD u odnosu na druge skupine. Potrebne su daljnje analize ove populacije radi razvijanja dijagnostike i liječenja SD-a.Aim: To determine the prevalence of sexual dysfunction (SD) in the population of women with renal replacement therapy (RRT) and in relation to the type of therapy: CHD (chronic hemodialysis) or TX (transplantation) and SD in relation to body image, levels of depression, anxiety and comorbidities. Methods: A total of 54 CHD and 53 TX patients as well as 90 healthy controls were questionned using a sociodemographic questionnaire, PHQ9 (The Patient Health Questionnaire), GAD7 (Generalized Anxiety Disorder - 7), FSFI (Female Sexual Function Index), BIS (Body Image Scale) and Ifudu Index (about comorbidities). Statistical analysis was performed using the software program a IBM SPSS Statistics. P < 0.05 was considered statistically significant. Results: Out of the dialysis patients, 90 % filled the criteria for SD, or 50 % of those women who were in a relationship. The prevalence was lower for healthy controls (12.5 %) and TX patients (44.44 %). CHD patients showed higher levels of depression than the other two groups. No significant differences in anxiety were observed. Lower Body Image was found in the CHD group when compared to controls. SD was more prevalent in older women, those with more children, depression, and lower levels of education. The same parameters were associated with a lower body image. Significant differences in SD were noticed between the dialysis and healhy control group, while no differences were observed between the transplant and healthy control group. Comorbidies correlated positively with FSFI in CHD group. Conclusion: A large proportion of patients with RRT had SD, which was more prominent in CHD group when compared to the TX and control groups. TX patients had better sexual function than those on dialysis, while no significant differences were observed between healthy controls and TX. Body image was lower in the CHD group when compared to controls, while levels of depression were more pronounced in the CHD group when compared to the other groups. More research is needed in this population in order to develop proper diagnostic and therapeutic measures for treating SD

Circadian Typology and Personality Dimensions of Croatian Students of Health-Related University Majors

The aim of this study was to determine the relationship between circadian preferences and personality dimensions among 712 students of three different majors from the Faculty of Medicine, Osijek: medical students (MD), nursing students (RN) and medical laboratory diagnostics students (MLD). For the measurement of personality dimensions, the IPIP50 Big-Five questionnaire was used. The circadian preference of students was assessed using the reduced morningness-eveningness questionnaire (rMEQ). Several significant results were observed and there was a significant difference in circadian preference among the three tested groups, with RN students scoring highest on the morningness scale and MLD students scoring the lowest. RN students scored significantly higher on agreeableness and conscientiousness than the other two groups. On the other hand, MD students scored higher on intellect than the MLD students. MLD students scored the lowest on emotional stability scales. Morning type students had higher conscientiousness and emotional stability scores. These results imply that circadian preference and personality traits are crucial elements of medical professionals&rsquo; wellbeing. With this paper, we would like to raise awareness about common personality traits and adherence to certain circadian orientations in medical professionals as a motivation to introduce a more flexible view towards strict time and task divisions in everyday practice

The Croatian Translation of the Horne and Östberg Morningness-Eveningness Questionnaire With a Brief Review of Circadian Typology

Introduction: Horne and Östberg Morningness-Eveningness Questionnaire (MEQ) is a questionnaire widely used to assess the circadian typology. The aim of this study was to translate the MEQ from English into Croatian. Methods: The translation process included two independent forward translations, integration of the forward translation into a single translation, back-translation, back translation review and drafting of the final translation. Results: No semantic differences were observed when comparing the original and the back-translation; thus, only minimal alterations were done to the final translation, compared to the first one. Conclusions: The Croatian version of the MEQ is a reliable translation ready to be tested in a Croatian sample

Seksualna funkcija zdravih žena u istočnoj Hrvatskoj

The aim was to evaluate sexual function of healthy women in Croatia and the possible impact of depression, anxiety, and sociodemographic factors. A total of 204 healthy women filled in a basic sociodemographic questionnaire, the Patient Health Questionnaire-9, Anxiety Disorder-7, and Female Sexual Function Index (FSFI). Almost half of study subjects (47.1%) reported at least some degree of sexual dysfunction defined as an FSFI score lower than 26.55. Study results suggest sexual dysfunction of women in Croatia as a still unrecognized problem. More room in research and in the public must be given to this issue.Cilj je bio procijeniti seksualnu funkciju zdravih žena u Hrvatskoj i mogući utjecaj depresije, anksioznosti i sociodemografskih čimbenika. Ukupno 204 zdrave žene ispunile su sociodemografski upitnik, Upitnik o zdravlju pacijenata-9, ljestvicu anksioznosti GAD-7 i Indeks ženske seksualne funkcije (FSFI). Gotovo polovica naših ispitanica (47,1%) postigla je rezultat FSFI niži od 26,55, što označava određeni stupanj seksualne disfunkcije. Naši rezultati ukazuju na problem koji još uvijek nije prepoznat, a to je seksualna disfunkcija žena u Hrvatskoj. Ovom pitanju mora se dati više prostora u istraživanju i javnosti