Ceská gynekologie / Ceská lékarská spolecnost J. Ev. Purkyne
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Randomized Controlled Trial
[Effect of GnRH analogues pre-treatment on myomectomy outcomes in reproductive age women].
To evaluate the role of three-monthly pre-treatment with gonadothropin releasing hormone (GnRH) analogues prior to myomectomy for women in comparison with control group of patients with no application. Analysis is focused on peroperative and postoperative results of surgery treatment for women with clinically symptomatic uterine fibroids in reproductive age with interest in getting pregnant. ⋯ Application of GnRH analogues in observed group of patients before LM and OM have not lead to improvement of peroperative results in comparison with control group. Pre-treatment of GnRh analogues before OM have lead to significant drop in recidives of uterine fibroids observed by SLL (p = 0.0025) compared with control group.
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The axillary reverse mapping (ARM) technique has been developed to map and preserve arm lymphatic drainage during axillary lymph node dissection (ALND) and/or sentinel lymph node (SLN) biopsy, thereby minimizing arm lymphedema. However, several problems remain to be resolved in the practical application of this technique. This article presents a review of current knowledge regarding ARM and discusses the practical applicability and relevance of this technique. ⋯ The axillary reverse mapping (ARM) procedure is based on the hypothesis that the lymphatic drainage from the upper arm is different from that of the breast and offers the opportunity to prevent lymphedema in breast cancer patients. However, the oncologic safety of the procedure has not yet been determined.
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Case Reports
[Spontaneous preterm birth in mother in an artificial sleep on ECMO with severe form of H1N1 infection].
The authors demonstrate a premature birth of a pregnant woman, who was for heavy Respiratory Distress Syndrome (ARDS), on the basis of pulmonary infection H1N1, connected to venovenous extracorporeal membrane oxygenation (ECMO). Patient spontaneously delivered after being connected to the ECMO for 30 hours. ⋯ Preterm birth at 24 week of pregnancy. During pregnancy, the labor and postpartum was the pregnant woman connected to extracorporeal membrane oxygen therapy.
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Uterine fibroids are the most common benign disease of women. They occur in women under 30 years of 20-30% for women over 30 years in 50%. The most frequent indication for hysterectomy, uterine fibroids are just. ⋯ Treatment of uterine fibroids include monitoring, administration of medications and surgical techniques that preserve either the uterus or not. In recent years the conservatives have extended performance of minimally invasive surgery, which is a common feature of the endoscopic approach, or uterine fibroid devascularization. Gynecologist surgeon must be familiar with the history of the patient and based on history and examination to consider which procedure is best for the patient.
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Work summarises current data ideas of problems of ethical thinking and decision making in neonatology. Primary objective ethical questions of administration resuscitative and intensive care are outlined, as well as administration of care for babies, delivered on limit of viability, in the same way for children with high probability of serious damage in case of survival. ⋯ Findings of extensive european study named EURONIC are shortly mentioned, study concerns problems of ethical dilemmas in neonatology in 8 European countries. Finally the categorization of newborns in ethical thinking is mentioned and present circumstances in Czech republic are remarked.