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K Dókus

Publications and source records attributed to K Dókus.

4 recordsLinked to original sources

HER-2 [Ile655Val] polymorphism in association with breast cancer risk: a population-based case-control study in Slovakia.

Breast cancer belongs to the most frequent types of cancer affecting women and it occurs at any age. Around 1600-1800 women are getting ill annually in the Slovak republic. One of the most important factors in connection with cancer genesis refers to changes in specific genes. HER-2 proto-oncogene belongs to low penetrating genes, which increase susceptibility to breast cancer genesis. Clinical studies demonstrated an association between polymorphism at codon 655 of this gene and increased risk for breast cancer development. The aim of this case-control based prospective study was to determine the distribution of HER-2 genotype and its association with risk factors of breast cancer in the population of women in Slovak republic. HER-2 genotypes were determined with PCR-RFLP method. The DNA was isolated from white blood cell nuclei. The frequency of Val allele in the cancer group was 29.79% and was higher than in the control group 15.84% (p<0.05). The presence of the heterozygote (Ile/Val) genotype was identified in 46.81% of patients in the case group and in 28.33% in healthy individuals, and the homozygote (Val/Val) genotype in 6.38% and 1.67, respectively (p<0.01). The risk of breast cancer development for carriers of one valine (Val) allele in genotype was two-times lower (OR=2.47) than for carriers of two Val alleles (OR=5.73) (p<0.05). Risk of cancer genesis for Val allele carriers was higher in multiparas (OR=2.90), among women with positive family history of breast cancer (OR=5.0), BMI>24 (kg/m2), and late menopause (OR=1.5). Contraceptives in anamnesis contrariwise showed tend to decrease the risk in Val allele carriers (OR=0.3). In conclusion, this study revealed relatively high frequency of the Val allele among the women population of the Slovak republic. Ile655Val polymorphism of HER-2 gene was associated with a statistically significantly increased risk of breast cancer all above in homozygotes for Val allele.

Adult↗

[Laparoscopy in chronic pelvic pain--a prospective clinical study].

OBJECTIVE: The aim of this study was to analyze the incidence, causes and management in women with chronic pelvic pain and to evaluate the role of laparoscopy. DESIGN: A prospective non-randomized clinical trial on 86 women with chronic pelvic pain. SETTING: Clinic of Gynecology and Obstetrics, JMF CU Martin, Slovak Republic. METHODS: A prospective clinical trial was performed on 86 patients with chronic pelvic pain, who have undergone laparoscopy from March 2003 to March 2004. Only patients with a pain history of at least 6 month were enrolled into this trial. Specific patient's history characteristics, laparoscopic and cytologic findings were reviewed and analyzed (pain interval, organic findings, preoperative ultrasound examination, previous surgical intervention, oral contraceptive usage, patient's medical history, menstrual cycle regularity, age, presence of dysmenorrhea). In all women, laparoscopy was performed under general anesthesia. RESULTS: During the study we have performed 309 diagnostic laparoscopic examinations, from which 86 (27.8%) were done due to chronic pelvic pain. The mean patient's age was 35.8 years (19-56). The mean parity was 1.6, ranging from 0-5. Pelvic organ pathology was present in 88.4% of the patients. The most frequent finding was endometriosis (31.4%). According to revised criteria of the American Fertility Society the presence of first, second, third and fourth stage of endometriosis was 55.6, 25.9, 11.1 and 7.4%, respectively. The most frequent occurrence of endometriotic lesions were on ligamenta sacrouterina (21.4%) and plica vesicouterina (19.0%). Pelvic adhesions, myomas, pelvic varicosities and chronic inflammatory process were present in 25.6, 15.1, 9.3 and 3.5% of the cases, respectively. No somatic origin of pain was identified at laparoscopy in 11.6% of patients. Preoperative ultrasonic examination with pelvic pathology findings were performed in 36 patients, and laparoscopy correlated with ultrasonographic findings in 31 (86.1%) cases. The average pain duration was 11.5 months (6-28) with the majority among women with history of previous surgical intervention (48.8%) and parturated women. Presence of pain was most common among women after 31 years of age. Predominantly, cytology examination of biological materials (peritoneal fluid, cyst fluid) revealed an increased histiocytic reaction in coincidence with chronic inflammation process in 31.6%. CONCLUSION: Invasive laparoscopy in chronic pelvic pain pertains to one of the most important examination procedures for its high specificity and sensitivity. Laparoscopy can reveal organic causes of pelvic pathology in 60% of cases with the possibility of following treatment. Our combined effort should stop the progression of such pathology leading to possible morphologic, functional and psychological alteration, especially among young women in fertile age. Today, endometriosis still remains the main cause of chronic pelvic pain in high percentage rate.

Adult↗

[Morbidity after cesarean section].

OBJECTIVE: To determine the frequency, spectrum of indications and complications and maternal morbidity rate connected with Caesarean sections as the most frequent mode of operative delivery. DESIGN: Retrospective, epidemiologic and comparative clinical study. SETTING: Department of Obstetrics and Gynecology, Jessenius Medical Faculty, Comenius University, Martin, Slovak Republic. METHODS: The authors retrospectively analyzed clinical data during a ten-years period. The number of deliveries, premature deliveries, frequency of Caesarean section, indications and maternal morbidity rate were determined. Further, a special attention was paid to premature deliveries and the related frequency of Caesarean sections and maternal morbidity rate in this group. In addition, the effectiveness of a complex pre-operative management was evaluated. RESULTS: The evidence shows that the natality rate is decreasing and the incidence of premature deliveries is increasing. The frequency of Caesarean sections is relatively stable with lower morbidity rate in the group of premature Caesarean deliveries. The positive effect of antibiotics, heparin and anti-aspiration medication within a complex pre-operative management was proved to decrease the frequency and severity of complications. CONCLUSIONS: The maternal morbidity rate following Caesarean delivery is relatively low, owing to the use of prophylaxis. However, it is vital to keep to the indications for Caesarean termination of the pregnancy, because there is still substantial mortality rate connected with it.

Cesarean Section↗

[Epidural obstetrical analgesia and cardiotocography].

OBJECTIVE: The increase of cardiotocographic abnormalities, such as late decelerations, bradycardia and reduced variability have been reported with epidural analgesia (EDA) in some studies. The aim of our study was to assess the influence of epidural analgesia on the incidence of the pathological cardiotocographic patterns. DESIGN: A clinical study. SETTING: Department of Obstetrics and Gynaecology, Jessenius Medical Faculty of Comenius University, Martin, Slovak Republic. METHODS: Clinical group consists of 200 parturients, who borne in our department from 1997 to 2000. The epidural group of parturients (n = 100) borne under epidural analgesia, the control group of (n = 100) borne under other resp. no analgesic method. We compared BFHR, variability and the incidence of accelerations and decelerations in CTG between both groups. All cardiotocographic patterns were evaluated by Fischer score. For statistic evaluation was used Student t-test. RESULTS: We did not find any statistically significant differences in Fischer score between epidural and control group. CONCLUSION: The epidural labour analgesia is safe method of ease pain during labour. In our study we confirmed, that EDA is not responsible for the increase of pathological cardiotocographic patterns.

Analgesia, Epidural↗