PROGNOSIS FACTORS AND TREATMENT TACTICS OF PATIENTS WITH UTERINE LEIOMYOSARCOMA

Surgery is the main method of treatment of the patients with the uterine leiomyosarcoma. A standard extent of surgery is extirpation of the uterus without its appendages in the reproductive period or with uterine appendages in the postmenopause. The comparative analysis of the remote results of the treatment of the patients depending on the radicality of the performed surgery let to find out that the presence of the resid- ual tumor in the minor pelvis significantly worsens the course and the prognosis of the disease in the patients with the uterine leiomyosarco- ma. The adjuvant therapy is worth using for the prophylaxis of the distant metastasizing in the patients with the uterine leiomyosarcoma in the presence the poor prognosis factors. The postoperative radiotherapy of the patients is ineffective due to the low radio sensitivity of the tumor. The poor prognosis factors are: postmenopause, age over 60 years, the presence of the residual tumor, invasion depth more than half of the myometrium, invasion of the tumor up to the tunica serosa uteri, tumor size more than 5 cm, tumor necroses, low grade of the tumor differ- entiation, mitoses rate more than 10 in 10 view fields. The vital prognosis of the patients with the distant metastases depends on their charac- ter. In case of solitary metastases — the prognosis is favorable, in patients with the multiple metastases the prognosis worsens essentially

დუშეთის ობსერვატორიაზე დაფიქსირებული გეომაგნიტური ველის ვარიაციები (იანვარი - ივნისი 2013)

Georgia is a part of the far-extending seismically active region, which includes the whole Caucasus, Northern parts of Turkey, Bulgaria, etc. These territories witnessed several intense destructive earthquakes. Thus carrying out possible short-term prognosis of earthquakes is very important for the country. The statistic evidence for reliability of the geomagnetic precursor is based on the distributions of the time difference between occurred and predicted earthquakes for the period January-June of 2013 for Dusheti region. Before strong earthquake magnetic precursors denoted by many authors, but must to say, that more of them don’t satisfy stern criterions. For estimation of the geomagnetic variations as reliable precursor it was discovered the specific time analysis for digital definition of Geomagnetic Quake and proposed way for interval defined from the extremum of local tide variations. The method of earthquake’s predictions are based on the correlation between geomagnetic quakes and the incoming minimum (or maximum) of tidal gravitational potential. The geomagnetic quake is defined as a jump of day mean value of geomagnetic field one minute standard deviation measured at least 2.5 times per second. The probability time window for the incoming earthquake or earthquakes is approximately ± 1 day for the tidal minimum and for the maximum- ± 2 days

Subspecialty training in Europe: A report by the European Network of Young Gynaecological Oncologists

Background ESGO (European Society of Gynaecological Oncology) and partners are continually improving the developmental opportunities for gynaecological oncology fellows. The objectives of this survey were to evaluate the progress in the infrastructure of the training systems in Europe over the past decade. We also evaluated training and assessment techniques, the perceived relevance of ENYGO (European Network of Young Gynaecological Oncologists) initiatives, and unmet needs of trainees. Methodology National representatives of ENYGO from 39 countries were contacted with an electronic survey. A graduation in well/moderately/loosely-structured training systems was performed. Descriptive statistical analysis and frequency tables, as well as two-sided Fisher's exact test, were used. Results National representatives from 33 countries answered our survey questionnaire, yielding a response rate of 85%. A national fellowship is offered in 22 countries (66.7%). A logbook to document progress during training is mandatory in 24 (72.7%) countries. A logbook of experience is only utilized in a minority of nations (18%) for assessment purposes. In 42.4% of countries, objective assessments are recognized. Trainees in most countries (22 (66.7%)) requested additional training in advanced laparoscopic surgery. 13 (39.4%) countries have a loosely-structured training system, 11 (33.3%) a moderately-structured training system, and 9 (27.3%) a well-structured training system. Conclusion Since the last publication in 2011, ENYGO was able to implement new activities, workshops, and online education to support training of gynaecological oncology fellows, which were all rated by the respondents as highly useful. This survey also reveals the limitations in establishing more accredited centers, centralized cancer care, and the lack of laparoscopic training. © 2021 BMJ Publishing Group. All rights reserved