1. Vpliv barvanja p16/Ki67 citološkega brisa materničnega vratu pri spremembah žleznih celicSaša Jeromel, 2024, final research report Abstract: Rak materničnega vratu (RMV) velja za četrto najpogostejše maligno obolenje žensk in kar prvo najpogostejše med ženskami, starimi od 20 do 34 let. S pravočasnim odkrivanjem predrakavih in rakavih sprememb na materničnem vratu (MV) jih lahko uspešno zdravimo in zmanjšamo umrljivost zaradi RMV.
Že več desetletij citološka preiskava brisa materničnega vratu (BMV) predstavlja osnovno metodo v presejanju za predrakave spremembe. Zaradi nezadovoljive zanesljivosti negativnega izvida presejanje s citološkim pregledom brisa zahteva pogoste ponovitve. Nastanek RMV je v večini primerov posledica okužbe z visokorizičnimi humanimi papilomavirusi (HPV), zato je v številnih državah test HPV postal del presejalnih protokolov. Ker je okužba s HPV pogosto prehodna in nam test ne omogoča ločevanja med ženskami z velikim in majhnim tveganjem za razvoj RMV, potrebujemo dodatno triažno metodo.
Imunocitokemično dvojno barvanje p16/Ki67 je metoda, ki temelji na določanju bioloških označevalcev p16 in Ki67 v celicah iz BMV. V številnih raziskavah ugotavljajo, da je dvojno barvanje učinkovita metoda za triažo žensk s spremembami ploščatih celic, vendar je količina informacij o vplivu barvanja p16/Ki67 citološkega BMV pri spremembah žleznih celic zelo omejena.
Tako relativna kot absolutna incidenca cervikalnega adenokarcinoma narašča. Odkrivanje žleznih predrakavih sprememb s cervikalno citologijo je zaradi njihove multifokalne narave in lokacije v bazi kript oteženo, test HPV pa ne omogoča odkritja nekaterih tipov adenokarcinoma, ki so navadno HPV-negativni. Po drugi strani pa zaradi porasta precepljenosti proti najpogostejšim različicam virusa HPV pričakujemo upad specifičnosti testa HPV.
Namen raziskave je bil opredeliti vpliv barvanja p16/Ki67 citološkega BMV pri spremembah žleznih celic. Želeli smo oceniti, ali je dvojno barvanje primerno orodje za dopolnitev trenutnega presejalnega programa za predrakave in rakave spremembe MV, ki bi omogočilo lažje odkrivanje predrakavih in rakavih sprememb tudi žleznega epitelija.
Keywords: dvojno barvanje p16/Ki67, atipične žlezne celice, HPV, adenokarcinom in situ, cervikalni adenokarcinom
Published in DKUM: 20.01.2025; Views: 0; Downloads: 5
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2. The role of methylation of host and/or human papillomavirus (HPV) DNA in management of cervical intraepithelial neoplasia grade 2 (CIN2) lesionsAndraž Dovnik, Mario Poljak, 2023, review article Abstract: Cervical intraepithelial neoplasia grade 2 (CIN2) is an intermediate stage between CIN 1, which is a low-grade lesion, and CIN3, which is the immediate precursor of cervical cancer (CC). Traditionally, CIN2 was regarded as a high-grade lesion and was treated with conization or ablative methods. In recent years, there has been a shift in the management of younger patients, who are now more often being managed conservatively due to frequent spontaneous CIN2 regression and possible adverse effects of treatment on future pregnancies. Because the risk of progression to CC still exists with conservative management, a personalized approach is needed to identify patients with a higher probability of progression. In this regard, research has focused on the role of host and human papillomavirus (HPV) gene methylation. This systematic review summarizes the current knowledge regarding conservative CIN2 management focusing on the main methylation markers and its implementation in conservative CIN2 management, and it describes major ongoing longitudinal studies on the subject. The review showed that DNA methylation is an accurate predictor of disease progression and a valid triage tool for HPV-positive women, with CIN2 performing better than triage cytology. Because virtually all CCs are methylation-positive, methylation-negative women at baseline have an extremely low risk of CC.
Keywords: cervical intraepithelial lesion, human papillomavirus, gene methylation
Published in DKUM: 19.07.2024; Views: 169; Downloads: 10
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3. Treatment of uterine sarcomas at the Maribor University Clinical Centre between 1996 and 2011Darja Arko, Andraž Dovnik, Iztok Takač, 2013, original scientific article Abstract: Purpose: Uterine sarcomas are rare malignant tumours with a worse prognosis than endometrial carcinomas.This retrospective study was performed to determine the clinical and histologic characteristics, treatment, and outcomes in uterine sarcoma patients treated at our hospital over a 16-year period. Methods: Twenty-two patients (median age, 60.5 years) with uterine sarcomas were treated at our facility between 1996 and 2011. Information was collected from hospital and follow-up records and from the Cancer Registry of Slovenia. All tumours were classified according to the new FIGO classification for uterine sarcomas. Results: The majority of the patients presented with postmenopausal bleeding. The most common histologic subtype was leiomyosarcoma (50%), followed by carcinosarcoma (40.9%), and endometrial stromal sarcoma (9.1%). All of the patients were initially treated surgically, 21 by laparotomy and 1 laparoscopically. Eight patients were treated with postoperativeradiotherapy and 4 patients received postoperativechemotherapy. Disease progression was observed in 8 of17 patients who had sufficient followup information forthis analysis. The 5-year overall survival was 44 %.Conclusion: The overall survival of patients treated for uterine sarcomas in our study was comparatively good. Due to the small number and heterogeneity of the patients, larger multicentre trials are needed for a reliable analysis of factors influencing patient survival.
Keywords: maternični sarkom, histološke značilnosti, kirurško zdravljenje, dopolnilno zdravljenje, celokupno preživetje
Published in DKUM: 12.04.2024; Views: 211; Downloads: 8
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4. Surgical treatment of acute patellar dislocation associated with bony avulsion in childrenSamo K. Fokter, Andraž Dovnik, Nina Fokter Dovnik, 2013, original scientific article Abstract: Purpose: The management of acute patellar dislocation in children and adolescents is controversial. Traditionally,most first time traumatic patellar dislocations have been treated nonoperatively. However, due to new knowledge about medial patellar stabilizers some authors have advocated for surgical repair. The present report describes the midterm subjective and functional results of operative treatment of acute patellar dislocation in children less than eighteen years of age with concomitant osteochondral fracture. Methods: Data on a cohort of sixteen patients (eight girls and eight boys) aged 14.9 years (mean, range12-17 years) with acute patellar dislocation were retrospectively collected. Intraarticular fragments were detected in all patients in conventional radiographs. Operative treatment consisted of arthroscopic removal (12cases) or refixation (4 cases) of the osteochondral fragments and direct repair of the damaged medial patellofemoral ligament (MPFL) if that was still feasible (13 cases). All patients were seen at six months, and a telephone interview with twelve patients (75%) was conductedat four years (mean, range 27 years). Results: Of the sixteen patients, two (12.5%) had a recurrent patellar luxation. The subjective IKDC score at the time of the most recent follow up was 86 (mean, range 63-100), and the Marx Activity Rating Scale score was 9.2 (mean, range 216).Conclusions: Direct surgical repair of the injured MPFLmay be considered an option to prevent subsequent dislocation and subluxation in first time traumatic dislocation of the patella in children and adolescents with osteochondral fractures and substantial disruption of medial patellar stabilizers.
Keywords: akutni izpah pogačice, patelofemoralna kostna avulzija, izpah pri otrocih, pediatrične poškodbe, kirurško zdravljenje
Published in DKUM: 12.04.2024; Views: 162; Downloads: 10
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5. Cesarean scar pregnancy : case report and review of the literatureAndraž Dovnik, Polona Kores Testen, Lea Mlakar, Milan Reljič, Darja Arko, Iztok Takač, 2014, professional article Keywords: zapleti po carskem rezu, nosečnost v brazgotini, vaginalni ultrazvok, histerotomija
Published in DKUM: 11.04.2024; Views: 211; Downloads: 8
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6. Gastric cancer in pregnancy - diagnostic and therapeutic dilemma : case reportLucija Kuder, Andraž Dovnik, Matjaž Horvat, Iztok Takač, 2016, professional article Keywords: rak želodca, nosečnost, carski rez, gastrektomija, limfadenektomija
Published in DKUM: 11.04.2024; Views: 195; Downloads: 14
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7. Early detection of neck lymph node metastases in breast cancer patients : the role of ultrasound and fine needle biopsyJanez Rebol, Peter Balon, Peter Kokol, Boštjan Lanišnik, Iztok Takač, Andraž Dovnik, Nina Fokter Dovnik, Monika Sobočan, Darja Arko, 2019, original scientific article Keywords: metastases, neck lymph, ultrasound, fine needle biopsy, breast canser
Published in DKUM: 27.03.2024; Views: 225; Downloads: 6
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8. Contemporary approach to diagnostics in women with suspected pelvic endometriosisJure Knez, Andraž Dovnik, Maja Pakiž, Igor But, Milan Reljič, Vida Gavrić-Lovrec, Maja Banović, Iztok Takač, 2019, review article Keywords: endometriosis, endometrioma, ovarian cysts, deep pelvic endometriosis, ultrasound, pelvic pain
Published in DKUM: 27.03.2024; Views: 258; Downloads: 13
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9. Primerjava prednosti in slabosti takojšnje ter odložene prekinitve popkovnice pri novorojenčkuTamara Serdinšek, Andraž Dovnik, Iztok Takač, 2015, review article Abstract: Izhodišča: Prekinitev popkovnice pri novorojenčku je v porodništvu še vedno predmet raz- prav. Tako ločimo takojšnjo prekinitev popkovnice, ki se običajno izvede v prvih 10, 15, 30 ali celo 60 sekundah po rojstvu, in odloženo prekinitev popkovnice, ki običajno pomeni prekinitev popkovnice več kot 60 sekund ali 2–5 minut po rojstvu, ob prenehanju pulzacij popkovnice ali ob pojavu posteljice v porodnem kanalu. Takojšnja prekinitev popkovnice je ena od treh komponent aktivnega vodenja tretje porodne dobe, ki se je v modernem porodništvu uveljavilo v zadnjem stoletju, medtem ko je v nekaterih severnoevropskih državah ponekod v ZDA in Kanadi ter v razvijajočih se državah bolj aktualen fiziološki pristop.
Zaključki: V zadnjih letih se takojšnja prekinitev popkovnice v številnih smernicah vse bolj zamenjuje z odloženo prekinitvijo, saj so raziskave potrdile številne prednosti slednje. Med najpomembnejšimi prednostmi odložene prekinitve popkovnice omenjajo višjo raven hemoglobina in feritina, večje zaloge železa, zmanjšano pojavnost anemije zaradi pomanjkanja železa, boljšo kardiopulmonalno prilagoditev in daljše trajanje zgodnjega dojenja pri donošenem novorojenčku ob nespremenjeni pojavnosti poporodne krvavitve pri materi. Prednosti odložene prekinitve popkovnice se kažejo tudi pri nedonošenčkih. Kljub vsemu je potrebna previdnost zaradi možnega pojava policitemije s hiperviskoznostjo, hiperbilirubinemije in dihalne stiske.
Keywords: prekinitev popkovnice, tretja porodna doba, anemija, pomanjkanje železa, poporodna krvavitev
Published in DKUM: 10.05.2017; Views: 1694; Downloads: 396
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10. Incidence of positive peritoneal cytology in patients with endometrial carcinoma after hysteroscopy vs. dilatation and curettageAndraž Dovnik, Bojana Crnobrnja, Branka Žegura Andrić, Iztok Takač, Maja Pakiž, 2017, original scientific article Abstract: Background: The aim of the study was to compare the frequency of positive peritoneal washings in endometrial cancer patients after either hysteroscopy (HSC) or dilatation and curettage (D&C).
Patients and methods: We performed a retrospective analysis of 227 patients who underwent either HSC (N = 144) or D&C (N = 83) and were diagnosed with endometrial carcinoma at the University Medical Centre Maribor between January 2008 and December 2014. The incidence of positive peritoneal cytology was evaluated in each group.
Results: There was no overall difference in the incidence of positive peritoneal washings after HSC or D&C (HSC = 13.2%; D&C = 12.0%; p = 0.803). However, a detailed analysis of stage I disease revealed significantly higher rates of positive peritoneal washings in the HSC group (HSC = 12.8%; D&C = 3.4%; p = 0.046). Among these patients, there was no difference between both groups considering histologic type (chi-square = 0.059; p = 0.807), tumour differentiation (chi-square = 3.709; p = 0.156), the time between diagnosis and operation (t = 0.930; p = 0.357), and myometrial invasion (chi-square = 5.073; p = 0.079).
Conclusions: Although the diagnostic procedure did not influence the overall incidence of positive peritoneal washings, HSC was associated with a significantly higher rate of positive peritoneal cytology in stage I endometrial carcinoma compared to D&C.
Keywords: endometrial carcinoma, peritoneal cytology, FIGO staging, hysteroscopy, dilatation and curettage
Published in DKUM: 10.05.2017; Views: 1168; Downloads: 359
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