Survival of Advanced Stage High-Grade Serous Ovarian Cancer Patients in the Republic of Macedonia

AIM: The primary objective of the study was to evaluate the overall survival of women with advanced stage (Stage IIIA-IV) high-grade serous ovarian cancer in MacedoniaMATERIALS AND METHODS: The study was a cross-sectional medical record review of patients diagnosed with advanced stage HGSC. Patients were deemed eligible for inclusion if they were diagnosed with an advanced stage (Stage IIIA-IV) HGSC of the ovary, fallopian tube or peritoneum between 2009 and 2015.  The data were analyzed in a descriptive fashion and summary statistics were provided, as appropriate. Survival was calculated using the Kaplan-Meier method.RESULTS: A total of 81 eligible patients were identified and included in the study. The average overall survival in the studied cohort was 46.59 months (95%CI = 39.11-54.06). Patients that were optimally debulked and patients that had a platinum-free interval larger than 12 months had significantly longer survival in the current series (p < 0.001).CONCLUSION: the average overall survival of advanced stage HGSC patients in the studied series was 46.59 months (95%CI = 39.11-54.06). Patients aged 65 years or younger tended to live approximately ten months longer than patients older than 65 years, but this difference was not statistically significant. There was no difference in HGSC survival in the groups of patients with grade 2 and grade 3 disease. However, optimal surgical debulking and platinum sensitivity were associated with significantly better overall survival

Correlation of Immunohistochemistry and Fluorescence in Situ Hybridization for HER-2 Assessment in Breast Cancer Patients: Single Centre Experience

BACKGROUND: Accurate assessment of HER-2 is imperative in selecting patients for targeted therapy. Most commonly used test methods for HER-2 are immunohistochemistry (IHC) and fluorescence in situ hybridisation (FISH). We evaluated the concordance between FISH and IHC for HER-2 in breast cancer samples using Food and Drug Administration approved tests.MATERIAL AND METHODS: Archived paraffin tissue blocks from 73 breast cancer patients were used. HER-2 immunostaining was performed using Ventana anti–HER-2 monoclonal antibody. The FISH assay was performed using PathVysion™ HER-2 DNA Probe Kit.RESULTS: Of the 73 cases 68.5% were IHC 0/1+, 15.07% were IHC 2+ and 16.44% were IHC 3+. Successful hybridisation was achieved in 72 cases. HER-2 FISH amplification was determined in 16.67% cases. Ten IHC 3+ and two IHC 2+ cases were FISH positive. Two of the IHC 3+ cases were FISH negative. Concordance rate was 100%, 18.18% and 83.33% for IHC 0/1+, 2+ and 3+ group, respectively. Total concordance was 84.72%, kappa 0.598 (p < 0.0001). The sensitivity of IHC in detecting IHC 2+ and IHC 3+ cases was 16.7% and 83.3%, and the specificity was 85% and 96.67%, respectively.CONCLUSION: The consistency between the methods was highest for IHC negative and lowest for IHC equivocal cases. The immunohistochemistry showed high sensitivity for IHC 2+/3+ cases and high specificity for IHC 3+ cases. Our results support the view that false-positive rather than false-negative IHC results are a problem with HER-2/IHC testing, and that IHC should be used as an initial screening test, but IHC 2+/ 3+ results should be confirmed by FISH

Endometrioid Adenocarcinoma Arising in Adenomyoma in a Woman with a Genital Prolapse - Case Report

BACKGROUND: Endometrial cancer is the third-ranked genital malignancy in women and includes 3% of cancer deaths. There is a 2.8% chance of a woman developing endometrial cancer during her lifetime. Low-grade endometrioid adenocarcinomas are often seen along with endometrial hyperplasia, but high-grade endometrioid adenocarcinomas have more solid sheets of less-differentiated tumour cells, which are no longer organised into glands, often associated with surrounded atrophic endometrium.CASE REPORT: We present an unusual case of endometrial adenocarcinoma arising in adenomyoma in 74-year old woman presented with genital prolapse, without other clinical symptoms. Ultrasound evaluation revealed endometrium with 4 mm-thickness and atrophic ovaries. The cervical smear was normal. The patient underwent a total vaginal hysterectomy. The histopathology of the anterior uterine wall revealed an intramural adenomyoma of 4 mm in which some endometrial glands with malignant transformation of well-differentiated endometrioid adenocarcinoma without infiltration in surrounding myometrium and lymphovascular invasion were present. The endometrium lining the uterine cavity was predominantly atrophic, and only one focus of simplex and complex hyperplasia was found, with cell-atypia. According to AJCC/FIGO 2010, the tumour was classified: pTNM = pT1B pNX pMX G1 R0 L0 V0 NG1, Stage I. On dismiss, the near-future oncological consultation was recommended.CONCLUSION: We would like to point out the rare occurrence of such type of malignancy and the importance of meticulous histopathology evaluation, even after reconstructive surgery for genital prolapse

A Rare Case of Soft Tissue Erdheim Chester Disease: Diagnostic Dilemma and Management

BACKGROUND: Erdheim Chester disease (ECD) is a rare form of non-Langerhans histiocytosis that still presents a diagnostic and clinical dilemma. CASE PRESENTATION: We present a rare case of ECD, young 31 male with atypical localisation and soft tissue presentation and no bone involvement. He started clinical investigations due to subcutaneous tumour mass in the lumbar spine that caused severe back pain. Skin biopsy revealed ECD with Immunohistochemistry CD68+, CD10+, CD11c+, vimentin+, S100A4+. Activating BRAFV600E mutation was positive from the tumour tissue. The patient was referred to the haematology department. PET CT was performed for initial disease staging. Treatment was started with corticosteroids (methylprednisolone 0.5 mg/kg per day), and after 7 days, a significant clinical improvement was noticed in terms of pain disappearance with no need for pain killers. After two weeks, treatment with interferon Alfa (IFN-α) was started in a dose of 3 million units 3 times per week. After 4 months of interim treatment PET, CT revealed a significant reduction of the tumour mass. Therapy with IFN-α was continued, and the patient is still clinically in good condition. CONCLUSION: It can be concluded that shortening the time of diagnosis of ECD is essential in treatment outcome of this disease. Still, large studies have to confirm the best treatment of this rare condition

Оптимизација на погонските трошоци кај водоснабдителните системи преку зголемување на енергетската ефикасност

Сведоци сме на брзиот раст на цените на енергенсите, а постојат и реални очекувања дека тие и во иднина ќе растат, така што се јавува потреба од користење на енергетско ефикасни објекти. Примената на енергетско ефикасни објекти ќе придонесе за намалување на загубите и трошоците за топлинска и електрична енергија. Секаде каде што се користи енергија постојат можности за зголемување на нејзината ефикасност. Во најголем број случаи, мерките за енергетска ефикасност самите се отплаќаат преку намалување на трошоците при работа, односно преку плаќање на пониските сметки за потрошената електрична енергија и моќност. Водоснабдителните системи по правило се големи потрошувачи на електрична енергија и моќност. Инвестициите во зголемување на нивната енергетската ефикасност не само што имаат економска димензија, туку овозможуваат и заштита на животната средина. Намалувањето на потрошувачката на енергијата има позитивен ефект врз животната средина, пред сѐ затоа што со намалената потрошувачка на фосилни горива, паралелно се намалува и емисијата на штетни гасови. Токму затоа, предмет и основна цел на истражување во овој труд е зголемувањето на енергетската ефикасност кај водоснабдителните системи, односно дефинирање на методи и начини за модернизација на енергетскиот систем со цел намалување на неговите погонски трошоци и обезбедување на висок квалитет и сигурност во процесот на испорака и снабдување со комунална вода до сите крајни потрошувачи. „Она што треба да се направи е, подобрување на стандардите за енергетска ефикасност, развој на обновлива и алтернативна енергија и примена на еден ресурс кој постои во изобилство, кретаивноста" Луис Капс Клучни зборови: водоснабдување, електрична енергија, моќност, трошоци, анализа, оптимизација

Зголемување на енергетската ефикасност кај водоснабдителните системи

Сведоци сме на брзиот и постојан раст на цените на енергенсите, а и сите очекувања се дека тие и во иднина ќе растат така што се јавува потреба од зголемување на енергетската ефикасност при нивното користење. Со зголемувањето на енергетската ефикасност значително може да се постигне намалување на загубите и трошоците како за топлинска така и за електрична енергија. Водоснабдителните системи спаѓаат во редот на релативно големи потрошувачи на електрична енергија, а особено на ангажирана моќност. Инвестициите во зголемување на енергетската ефикасност кај овие системи не само што имаат економска димензија, туку обезбедува и дополнителни позитивни ефекти особено во делот на заштитата на животната средина. Во овој труд, на прво место дадена е анализата на степенот на ефикасно користење на електрична енергија како и изработката на соодветна техно-економска анализа за енергетската потрошувачка за еден реален водоснабдителен систем, а потоа се презентирани предлог методи за подобрување на енергетската ефикасност на водоснабдителниот систем, заедно со економската анализа на придобивките од реализацијата на овие методи

Some Optimization Methods for Increasing the Energy Efficiency of the Water Supply Systems

We are witnessing the rapid growth of the energy prices and there are expectations that they will continue to grow in the future. Consequently, there is a constant need of energy efficiency improvements that could be achieved by decreasing of energy losses, smart and efficient energy utilization and conservation of energy resources. The water supply systems are large energy consumers. So, the investments in the increasing of their energy efficiency will not only have an economic dimension, but also they could have large positive effect on the environment protection. In this paper, an analysis of the degree of efficient usage of the energy and the appropriate techno-economic analysis of the energy consumption for a real water supply system is presented. Few methods for increasing the energy efficiency of water supply pump stations and an analysis of the potential benefits of this method are proposed and discussed too

Increasing Energy Efficiency of Water Supply Systems with Pump Systems Power Factor Improvement

Wherever the energy is used, there are the opportunities for increasing its effectiveness. In most cases, the energy efficiency solutions are repaid through the lower energy bills (expenses). There is large electrical energy consumption in the water supply systems. Investments in the increasing of their energy efficiency will not only have an economic dimension, but also they could have large positive effect on environment because along with reduced consumption of fossil fuels, there will be reduction of the greenhouse gases. This paper proposes one modern method for increasing energy efficiency of water supply pump stations and an analysis of the potential benefits of this method