Limatthiesen3435

Nowadays, we can confidently state that systematic lymphadenectomy in patients with advanced ovarian cancer without clinically apparent nodal disease is not necessary, and the presence of macroscopic retroperitoneal lymph node disease should be resected as part of cytoreductive surgery since it will be this and the residual disease that determine the prognosis of the patients.The high mortality rate for hepatocellular carcinoma (HCC) relative to its prevalence underscores the need for curative-intent therapies. Multidisciplinary treatment decisions are required to craft optimal treatment strategies considering tumor size, location and underlying liver cirrhosis. selleck kinase inhibitor Surgical resection of anatomically limited tumors with adequate hepatic reserve provides long-term survival in more than half of patients and remains a standard first-line therapy. Eligibility for resection among newly diagnosed patients is low and recurrences in the remaining cirrhotic liver are common. Transplantation offers a higher chance of cure. Long wait times for the limited door pool require neoadjuvant loco-regional therapies to maintain transplant eligibility. Image-guided therapies such as ablation and embolization have an established role as primary or neoadjuvant preparing patients for curative treatment. Percutaneous ablation in appropriately selected patients offers long-term survival similar to resection. New and evolving techniques such as stereotactic body radiotherapy (SBRT), radiation segmentectomy and lobectomy, and combination therapies employing both trans-arterial and ablative approaches show promise for curative-intent treatment but require further prospective data before they can be integrated into treatment algorithms. For palliativeintent therapy, conventional trans-arterial chemoembolization with lipiodol-based emulsions remains the only technique supported by clinical trials. Newer platforms such as drug-eluting embolics failed to improve survival over bland embolization in randomized trials and showed increased hepatobiliary toxicity. Transarterial radioembolization offers similar overall survival (OS) to transarterial chemoembolization (TACE) and non-inferiority to sorafenib in meta-analyses. The more favorable clinical toxicity profile makes it an appealing technique for patients willing to accept the longer time to response.Objective To bring actual summary of pre and perinatal care of women with Crohn's disease and ulcerative colitis. Design Review. Setting Department of Gynaecology and Obstetrics, General Faculty Hospital and 1st Faculty of Medicine, Prague. Methods Review of articles. Conclusion Care of women with inflammatory bowel diseases should be placed in a specialised centre and management of pregnancy should be discussed by a multidisciplinary team included obstetrician, gastroenterologist, surgeon and nutritional specialist. All the possibilities in treatment of these women (except a few of them) are safe during the pregnancy and in the puerperium both for mother and fetus.Objective To informed about international surveillance network severe maternal morbidity and mortality - INOSS. Design Literature review. Settings 1st Department of Gynaecology and Obstetrics Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic. Methods Literate review of articles published till august 2019. Results The International Network of Obstetric Survey Systems (INOSS) is an international network that connects countries with the same or similar system of surveillance of acute severe maternal morbidity and mortality. The INOSS was established in year 2010 by twelve countries. Nowadays 19 countries are involved in the INOSS. The cooperation between member countries is focused on the acquisition of relevant data about rare severe acute maternal morbidities. INOSS in 2017 year unified definitions of 8 severe acute maternal morbidities according Delphi method eclampsia, amniotic fluid embolism, peripartum hysterectomy, severe primary postpartum haemorrhage, uterine rupture, abnormally invasive placenta, spontaneous hemoperitoneum in pregnancy, and cardiac arrest in pregnancy. Conclusion The international cooperation allows the acquisition of relevant epidemiologic data and the optimalization of the treatment according the evidence-based medicine.Objective The aim of this study is to clarify the news and to summarize recommended methods in the quantification of female pelvic organ prolapse (POP). Design Summarizing study. Setting Department of Obstetrics and Gynecology, Masaryk University, University Hospital Brno. Methods The terminology of POP was significantly reworked in last decades. It is important to use common classification system for mutual communication of specialists and for exact interpretationof research. Results The older classifications of POP are not exact enough for interpretation of research. International classification system Pelvic organ prolapse quantification (POP-Q) brought necessary consensus in the terminology, encompassing many parameters that exactly define individual anatomy of each female patient. This detailed terminology could be replaced with simplified but also satisfactorily detailed version called Simplified POP-Q for the regular clinical practice. Modern classification of POP is still developing and new concepts of vaginal and perineal measurements for description of operation techniques effectiveness are waiting for further validation. Conclusion Modern terminology and classification of POP meets the requirements of current science and research and also is usable for regular clinical practice.Objective The aim of this article is to present a summary of the actual diagnostic possibilities and differentiation of MODY (Maturity-Onset Diabetes of the Young) from gestational diabetes (GDM) found during routine screening, and specific aspects of care and treatment of MODY during pregnancy and early postpartum period. Design Rewiev. Settings Centre for Research of Diabetes, Metabolism and Nutrition; Second Department of Internal Medicine University Hospital Královské Vinohrady and Third Faculty of Medicine, Prague. Department of Internal Medicine, Second Faculty of Medicine, Charles University, Prague. Methods Recent publications selected in PubMed with the key words MODY, gestational diabetes. Results Many patients with MODY, especially the glucokinase MODY, can be first diagnosed during pregnancy. It is estimated that MODY patients account for up to 5% of GDM cases found in routine screening of GDM. MODY should be considered in lean women around 25 years of age, with a positive family history of diabetes in one of the parents.