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The concept of identification of goods implies establishment of its consumer qualities related to purpose, material of production, origin and other characteristics The specificity of customs identification is establishment of correspondence of moving good to data in accompanying documentation and to declared classification code according to Unified Commodity Nomenclature of the Eurasian Economic Union If category of good is complicated from point of view of customs classification then problems can occur related to custom control of reliability of declared data The negative legal practice of customs authorities related to passed classification decisions indicates on insufficiently investigated issue of identification of goods in customs purpose Within the framework of analysis of customs classifier it was established that pharmaceutical production is complicated category from point of view of customs identification as pharmaceutical production The neglect of such characteristics of good as material, purpose, area of application often originates conditions for inconsistent identification of pharmaceutical production in customs purpose The material characteristics of good established separately indicating to application with medical purposes and presence of good in pharmacopoeia doesnt prove labeling of production as pharmaceutical one The development of separate document establishing order of identification of pharmaceutical production is proposed. В целом понятие идентификации товаров подразумевает установление его потребительских свойств, связанных с назначением, материалом изготовления, происхождением и прочими характеристиками Особенностью таможенной идентификации является установление соответствия перемещаемого товара сведениям в сопроводительной документации, а также заявленному классификационному коду в соответствии с Единой Товарной номенклатурой Евразийского экономического союза Следовательно, если категория товара является сложной с точки зрения таможенной классификации, то могут возникать проблемы таможенного контроля достоверности заявленного кода на этапе установления должностным лицом таможенных органов соответствия между подсубпозицией, отраженной в графе 33 подаваемой декларации на товар, и сведениями, указанными в графе 31 в части словесного описания товара Негативная судебная практика таможенных органов в области выносимых классификационных решений указывает на недостаточность изучения вопроса идентификации товаров в таможенных целях, что обусловливает необходимость разработки установленного порядка идентификации перемещаемых товаров при помещении их под различные таможенные процедуры В рамках изучения таможенного классификатора было выявлено, что фармацевтическая продукция является сложной категорией с точки зрения таможенной идентификации, поскольку применение товара в терапевтических, медицинских и лечебных целях не всегда является основным критерием отнесения к рассматриваемой группе 30 «Фармацевтическая продукция» К недостоверной идентификации лекарственных препаратов и аналогичных медицинских средств может привести использование недостаточной информации о товаре, непонимание ключевых признаков систематизации и распределения товаров по классификационным группировкам Правильное выделение ключевых классификационных признаков в идентифицируемой фармацевтической продукции может быть выстроено только на глубоком изучении структуры и концепции построения номенклатурной части Игнорирование такой характеристики товара, как материал, назначение, сфера применения, состояние или глубина переработки, зачастую создает условия для проведения некорректной идентификации фармацевтической продукции в таможенных целях Отдельно выявленные вещественные свойства товара, указывающие на применение в медицинских целях, как и нахождение товара в фармакопее, не подтверждают однозначного отнесения продукции к числу фармацевтической Для разъяснения выявленных особенностей идентификации лекарственных средств и медицинских изделий предлагается разработка отдельного документа, устанавливающего порядок проведения идентификации фармацевтической продукции в таможенных целях с обязательным уточнением средств идентификации и составлением перечня товаров, детализирующего наименования, соответствующие им классификационные коды, взаимосвязанные с обязательными дополнительными сведениями, определяющими особенности идентификации.

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The aim of this multicentric observational study was to explore the impact of the timing of cesarean section (SC) on levator (MLA - levator ani musle) avulsion at the first subsequent vaginal birth. All women after term vaginal birth following a cesarean section (VBAC) for their second delivery at the Departments of Gynecology and Obstetrics, Faculty of Medicine, Charles University and University Hospital in Pilsen and the 1st Faculty of Medicine, Charles University and General Hospital in Prague, between 2012 and 2016 were identified. Hospital database and surgical notes were used to collect basic characteristics of the patients including the indication and course of their previous delivery. These women were divided into two groups according to indication of prior SC in the previous delivery to women with elective SC and acute SC. All participants were invited for a 4D pelvic floor ultrasound to assess levator trauma. Levator avulsion and the levator hiatus area were assessed off-line from the stored pelvic floor volumes. Data were statistically assessed. A total of 356 women had a VBAC for their second delivery during the study period. Of these, 152 (42.7%) attended the ultrasound examination and full data were available for 141 women for statistical analyses. These were further divided into 80 women after acute SC and 61 women after elective SC. The levator avulsion rate was higher in the elective SC subgroup, but the difference was not significant (26.3 vs. 41.0%, P = 0.0645). No statistical differences in urogenital hiatus enlargement and ballooning were observed. VBAC is associated with a significantly higher rate of levator ani avulsion compared to the first vaginal birth in nulliparous women. However, it seems that risk of levator ani avulsion doesnt depend on the timing of SC in previous labor. More studies are needed to confirm the results of this pilot study.

Our aim in this study was to prove influence of chromagen filter on color vision quality. Further we wanted to compare quality of color vision in groups of young healthy persons with persons with maculopathy. In our study we had in total 39 subjects. First group contained 13 subjects with average age 23 years without important eye pathology. In the second group we had 13 patients (average age 68 years) with maculopathy. Third group contained subjects with average age 64 years without important eye pathology. While examination we used sorting tests for color vision: Farnsworth-Munsell test and Lanthony test. Results were evaluated according the Vingryse and King-Smith technique. We found that average total error score (TES) in young healthy subjects with color chromagen filter doesnt differ from TES value gained from patients with disease of macula (p = 0.86). Further we found that chromagen filter changes color vision in group of young subjects on statistical significant level (p = 0.01). But in clinical view this is not important color vision defect (TES = 107.46 and CI = 1.42). Next study result showed statistically not important difference between the color vision in young healthy patient (average age 23 years) and older healthy patients with average age 64 years (p = 0.58). Finally we can conclude that green color chromagen filter doesnt have negative influence for dyslectic patients who will use this filter all day. Further we proved that color vision deterioration of patients with macular disease is not important for practical distinguishing of colors but is important clinically for diagnostic purposes. Last but not least we brought result which shows not important difference between young healthy subjects and older subjects (23 versus 64 years).Key words: Color vision, chromagen lens, total error score, maculopathy.

Glycine max root cells developing into syncytia through the parasitic activities of the pathogenic nematode Heterodera glycines underwent isolation by laser microdissection (LM). Microarray analyses have identified the expression of a G. max DOESN'T MAKE INFECTIONS3 (DMI3) homolog in syncytia undergoing parasitism but during a defense response. DMI3 encodes part of the common symbiosis pathway (CSP) involving DMI1, DMI2, and other CSP genes. The identified DMI gene expression, and symbiosis role, suggests the possible existence of commonalities between symbiosis and defense. G. max has 3 DMI1, 12 DMI2, and 2 DMI3 paralogs. LM-assisted gene expression experiments of isolated syncytia under further examination here show G. max DMI1-3, DMI2-7, and DMI3-2 expression occurring during the defense response in the H. glycines-resistant genotypes G.max [Peking/PI548402] and G.max [PI88788] indicating a broad and consistent level of expression of the genes. Transgenic overexpression (OE) of G. max DMI1-3, DMI2-7, and DMI3-2 impairs H. glycines parasitism. RNA interference (RNAi) of G. max DMI1-3, DMI2-7, and DMI3-2 increases H. glycines parasitism. The combined opposite outcomes reveal a defense function for these genes. Prior functional transgenic analyses of the 32-member G. max mitogen activated protein kinase (MAPK) gene family has determined that 9 of them act in the defense response to H. glycines parasitism, referred to as defense MAPKs. RNA-seq analyses of root RNA isolated from the 9 G. max defense MAPKs undergoing OE or RNAi reveal they alter the relative transcript abundances (RTAs) of specific DMI1, DMI2, and DMI3 paralogs. In contrast, transgenically-manipulated DMI1-3, DMI2-7, and DMI3-2 expression influences MAPK3-1 and MAPK3-2 RTAs under certain circumstances. The results show G. max homologs of the CSP, and defense pathway are linked, apparently involving co-regulated gene expression.

Little attention is given to the process and impact of poor communicaton on the doctor-patent relationship. The paper aims to employ Theory of Conditionals to help shed light on the experience from a patient perspective. Doesnt really apply as this was inductive research i.e. based on other research in the area. Doesnt really apply except that The Theory of Conditionals enables us to understand the points of mis-communication as well as reasons behind misunderstandings across the medical consultation. A number of recommmednations are made to support GPs to reduce the impact of this problem on the medical consultation.

In this work, the antioxidant effect of pumpkin flower powder was evaluated in chicken patties. For this purpose, three drying methods were proposed to obtain the pumpkin flower powder and preserve its properties (antioxidants, color, odor): foam-mat drying, freeze drying, and oven drying. The drying process of the powder plays an important role in the conservation of bioactive compounds. The foam-mat drying method would allow the preservation of these compounds after cooking and after cold storage due to encapsulation like mechanism of the added proteins. Thus, these powders were selected as the most adequate vehicle to incorporate in the formulation, since patties with these additives presented the better antioxidant scores for DPPH, ABTS, and FRAP even after 7 days of storage. In addition, total polyphenolic content and the presence or thiobarbituric acid reactive substances (TBARS) were better scored in samples with the pumpkin flowers. The incorporation of the pumpkin flower additives in the patty formulation improved sensorial attributes of the chicken patties and consumers acceptance after cold storage.

The studyFOCUS Trial Collaboration. Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial. Lancet 2019;393:256-74.The study was funded by the UK Stroke Association and the NIHR Health Technology Assessment Programme project number 13/04/30.To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000729/a-commonly-used-antidepressant-doesnt-improve-recovery-after-stroke.

This paper reports a description of the characteristics of the Nephrology and Dialysis department of the Yangzhou Northern Peoples Hospital (Jiangsu province - China) observed by the Author in a two weeks stay. The most outstanding remark is that, in spite of the modern and highly developed structure and information technology of the hospital, the Chinese Health System, an insurance based system, doesnt cover all the care expenses, leaving the remaining cost to be payed by the patients (about 30%). This often induces an empirical method of treatment of nephropathy, because of the lack of a histologic diagnosis and a minimalistic approach for choosing drugs. Another important point is the discontinuity in the follow-up of the disease and the frequent development of uremic complications, especially hyperparathyroidism.

Some ideas emphazied by RENARD and his collaborators were rediscovered.--Anastomosis doesnt always signify compensation and it is often difficult to appreciate the functional importance of the anastomoses shown by arteriographies.--The most valuable compensations are made by short ways. Long ways only come into action when the shorter are obliterated. Finally a certain number of arteries play an important role in the compensatory circulation, that is:--the system of lumbar arteries--the hypogastric artery--the origin of the deep femoral artery.

Caridina ravisankarani sp. nov. is a cave-adapted species, collected during June and November 2018 and January 2019 from a limestone cave (CN2) on Interview Island, Andaman and Nicobar Islands. The shrimps were collected from a stream, sourced through the percolation of rainwater, which reduces during the post-monsoon months. The species is closely related to Caridina typus H. Milne Edwards, 1837, Caridina villadolidi Blanco, 1939 and Caridina jeani Cai, 2010. A detailed comparison of characters and a key for identification are given in the text. The present species can be diagnosed by the presence of: short rostum with edentulous upper margin and ventral margin with 2 minute teeth situated at the distal part; outer antennular flagellum with 16 segments at the basal part swollen; highly atrophied propodus and dactylus of endopod of 2nd maxilliped; bushy long setae on fingers of 2nd chelate legs; dactylus of 5th pereopod with 4243 comb-like bristles; dieresis with 18 spines; dorsal surface of telson with 45 pairs of spines and disto-median region doesnt end in a point, outer lateral pair of spines absent and eyes with cornea pigmentation variable, from totally absent to a small black spot. Fecundity is 1300 eggs with an average length 0.710.03 mm and width 0.420.03 mm (MeanSD).

The aim of this study was to compare the relation between the quality of life, level of depression and some other psychological characteristics of women and the method (pharmacological or instrumental) they chose to terminate their pregnancy up to 49 days of amenorrhoea. From Jan 1st, 2019 to Aug 31st, 2020 we prospectively analyzed data obtained by evaluating questionnaires from 106 women with a choice of pharmacological (faUUT) and 105 women with a choice of surgical (iUUT) termination of pregnancy. The questionnaires focused on their quality of life and other characteristics. Women undergoing faUUT have a statistically significantly higher quality of life (P = 0.001), they are physically (P = 0.003) and mentally (P = 0.027) healthier, they have a higher socioeconomic status, and they are more satisfied with their environment (P = 0.022). Women with a differently chosen method of termination of pregnancy had a statistically significantly different quality of life as a whole. This difference is statistically significant in the sub-areas of the quality of life: feeling of physical health and mental well-being, satisfaction with the environment, and subjective perception of the quality of life. The result doesnt confirm a statistically significant difference between both groups on the level of depression and their cohabitation.

Department of Obsterics and Gynecology 1st Faculty of Medicine, Charles University and General Faculty Hospital in Prague. Predicting both the course of childbirth and the intensity of pain felt during childbirth is difficult, especially with first-time mothers. Some women tolerate birthing pains well, others require effective pain relief. Sometimes simple methods are enough, such as the presence of a partner, a relaxing atmosphere, massages, or walking, while other times the services of a birthing assistant or physician or even an anaesthesiologist are required. Choosing the right approach or methods should always be dependent on the actual situation and the individual choices and preferences of the mother. In line with this, the INKA Program was initiated in the Czech Republic in 2013. The name is an acronym derived from the Czech words for informed (as in the expectant mother), choice (of services), quality (of services offered) and analysis (of the system of care offered). The aim of this program is to distribute information about current possibilities for decreasing the pain of childbirth to the widest possible population of expectant mothers. The information must be objective and clearly explain the benefits and risks of each analgesic method, and must not encourage or discourage any particular method. As part of this program, a brochure titled "Birth doesnt have to be that painful" was distributed at the end of 2013, to inform the lay public about all available methods of analgesia for childbirth in the Czech Republic. The contents of the brochure were approved by the Czech Gynecological and Obstetrical Society and the Czech Society of Anaesthesiology and Intensive Care Medicine. The INKA program encourages the personnel of birthing centres to arrange the most individual approaches possible for the needs of each expectant mother. Even women that originally had negative attitudes toward obstetric analgesics should have the opportunity for adequate and effective help at any time, if the birth does not proceed according to their original expectations.

As part of an observational multicenter prospective study European Registry on the management of Helicobacter pylori infection, conducted on the initiative of the European H. pylori and Microbiota Study Group, the compliance of clinical practice in the management of patients with Helicobacter pylori infection in Kazan with clinical guidelines was assessed. The data of 437 patients included into the register by clinical sites in Kazan in 20132019 were analyzed. The methods used for the initial diagnosis of H. pylori infection and eradication control were evaluated. The frequency of various eradication therapy regimens prescription was analyzed in 379 cases. Data regarding the effectiveness of eradication therapy was analyzed in 173 patients. The rapid urease test (44.2% of cases) and cytology/histology (60% of cases) were most often used for the initial diagnosis of H. pylori infection; however non-invasive methods such as 13C-urea breath (9.2%), serology (6.2%), H. pylori stool antigen test (2.3%) were less common. In 21.7% of patients two methods of H. pylori detection were used for primary diagnosis. The control test to evaluate the effectiveness of eradication therapy at the recommended timepoint was performed in 46.2% of patients. 13C-urea breath test (31.7%), stool PCR/stool antigen test (28.7%), rapid urease test (22.3%), cytology/histology (26.2% of cases) prevailed in the assessment of eradication rate. Standard triple therapy, including proton pump inhibitor, clarithromycin and amoxicillin was most commonly prescribed as first-line therapy (64.6% of cases). The duration of eradication therapy was 14 days in the majority of cases with pantoprazole as the most common proton pump inhibitor in standard triple therapy regimens (84.8%). The efficacy of 14-day standard triple therapy (mITT) was 87.0%. The results indicate a high frequency of non-invasive methods use for assessing the effectiveness of eradication therapy; however, the overall rate of eradication efficacy assessment is low, limiting the possibility of analyzing the eradication results. The effectiveness of the most common 14-day standard triple first-line therapy in Kazan doesnt reach the recommended 90% eradication level. This could be explained by high rate of pantoprazole use, which is not an optimal proton pump inhibitor in eradication therapy regimens. Цель. Оценка соответствия реальной клинической практики ведения пациентов с инфекцией H. pylori в Казани клиническим рекомендациям. Материалы и методы. В рамках наблюдательного многоцентрового проспективного исследования Европейский регистр ведения инфекции Helicobacter pylori, проводимого по инициативе Европейской группы по изучению H. pylori и микробиоты, проведен анализ данных 437 пациентов, внесенных в регистр клиническими центрами Казани в период с 2013 по 2019 г. Оценены методы, использованные для первичной диагностики инфекции H. pylori и контроля эрадикации. В 379 случаях проанализирована частота назначения разных схем эрадикационной терапии. В анализ эффективности эрадикационной терапии вошли данные 173 пациентов. Результаты. Для первичной диагностики инфекции H. pylori наиболее часто использованы быстрый уреазный тест (44,2% случаев) и цитологический/гистологический метод (60% случаев); реже применялись неинвазивные методы 13С-уреазный дыхательный тест (9,2%), серологический метод (6,2%), тест на определение антигена H. pylori в стуле (2,3%); у 21,7% пациентов определение H. pylori проведено двумя методами. Контрольный тест для оценки эффективности эрадикационной терапии в рекомендованные сроки проведен у 46,2% пациентов. При оценке эффективности эрадикационной терапии доминировали 13С-уреазный дыхательный тест (31,7%), полимеразная цепная реакция в кале/моноклональный тест определения антигена H. pylori в кале (28,7%), быстрый уреазный тест (22,3%), цитологическое/гистологическое исследование (26,2% случаев). Наиболее часто в качестве терапии первой линии назначалась стандартная тройная терапия, включающая ингибитор протонной помпы (ИПП), кларитромицин и амоксициллин (64,6% случаев). В преобладающем большинстве случаев длительность эрадикационной терапии составила 14 дней. В качестве ИПП в схемах стандартной тройной терапии первой линии преобладало назначение пантопразола (84,8%). Эффективность 14-дневного курса стандартной тройной терапии (mITT) составила 87,0%. Заключение. Полученные результаты свидетельствуют о высокой частоте применения неинвазивных методов для оценки эффективности эрадикационнной терапии, вместе с тем следует отметить низкую частоту проведения контрольных тестов, что ограничивает возможности анализа успеха терапии. Эффективность наиболее часто назначаемой в Казани 14-дневной стандартной тройной терапии первой линии не достигает рекомендованного уровня в 90%, что можно объяснить частым использованием пантопразола, не оптимального ИПП в схемах эрадикационной терапии.

to evaluate the efficacy of ART methods to treat infertility in men with obstructive azoospermia. The results of treatment of infertile couples using ART methods during the period from 2009 to 2017 were analyzed. A total of 18 married couples with obstructive azoospermia in men were included in the main group. The control group consisted of 59 married couples in which men had spermatozoa in the ejaculate. Both groups were comparable in age, concomitant gynecological pathology in female partner, protocols of superovulation, fertilization method, days of transfer and the number of transferred embryos into the uterine cavity. The results were evaluated by pregnancy rate (according to the results of determining the level of the -subunit of human chorionic gonadotropin), clinical pregnancy rate (according to the results of the first ultrasound), the number of birth and the number of living children. Pregnancy rate in the main group was 55.6%, compared to 35.6% in the control group (2 with Yeats correction = 1531, p=0.217), while clinical pregnancy rate was 44.4% and 32.2%, respectively (2with Yeats correction = 0.450, p=0.503). In the main group, there were 6 births and 8 children were born (4 with one fetus and 2 twin). In the control group, there were 14 births (2 with Yeats correction=0.168, p=0.683 in comparison with the main group) and 19 children were born (12 one fetus, 2 twins, 1 triplets). The high rates obtained in the main group can be explained by the fact that the obstructive azoospermia doesnt have such a pronounced negative influence on spermatozoa as a non-obstructive azoospermia, and, possibly, as severe oligozoospermia. Our data have convincingly established the efficiency of testicular biopsy for the treatment of infertility in men with azoospermia. In addition, spermatozoa obtained from these patients, are suitable for fertilization.

Cancer anorexia-cachexia syndrome( CACS) occurs in 30-80% of patients with cancer. CACS is connected with poor prognosis and higher risk of treatment complications. CACS belongs to the common cause of death in cancer patients. Main role in the development of this syndrome play cytokines like TNF, interleukin 1 and 6 and interferon alpha and gamma. The importance of a lot of other substances is still unknown. VEGF promotes new vessels development,enhance vascular permeability and plays a role in inflammatory reaction. The aim of this study was comparison of VEGF levels in patients with lung cancer with and without CACS and in control group. The serum levels of VEGF were measured by ELISA method. The VEGF was significatly higher in patients with lung cancer then in control group (p = 0.004). There were no correlations between VEGF and weight lost, histological type and stage of disease. This suggest that VEGF doesnt play a role in development of CACS.

The objective of this study was to retrospectively compare imaging techniques with histopathological findings from bone biopsy. Imaging techniques such as X-Ray, CT scan and MRI where compared with the histopathological findings from bone biopsy, in a population of 64 patients with bone tumors, with 64.1% of males and an age range of 5 to 79 years. Histologically, 39.1% were malignant bone tumors, while 60.9% were benign. The X-ray showed 90% of diagnostic accuracy, with sensitivity of 92.9%, specificity of 87.5%, positive predictive value of 86.7% and negative predictive value of 93.3%. CT scan presented 75.9% of diagnostic accuracy, with 84.6, 68.8, and 84.6% of sensitivity, specificity, positive predictive value and negative predictive value, respectively. The MRI documented a diagnostic accuracy of 95.1%, with 94.4% os sensitivity, 95.7% of specificity, 94.4% of positive predictive value and 95.7% for negative predictive value. This showed a great agreement between the histology findings and those within the X-Ray and MRI (K = 0.8 and 0.9, respectively), but doesnt depreciate the value of bone biopsy in diagnosis of bone tumors. This data showed good correlation between imagenological and histopatologic techniques. El objetivo de este estudio fue comparar retrospectivamente las técnicas de imagen con los hallazgos histopatológicos de la biopsia ósea. Las técnicas de diagnóstico por imágenes como rayos X, tomografía computarizada y resonancia magnética fueron comparadas con los hallazgos histopatológicos de la biopsia ósea, en una población de 64 pacientes con tumores óseos, con 64.1% de los varones y un rango de edad de cinco a 79 años. Histológicamente, 39.1% eran tumores óseos malignos, mientras que 60.9% eran benignos. Los rayos X mostraron un 90% de precisión diagnóstica, con una sensibilidad de 92.9%, especificidad de 87.5%, valor predictivo positivo de 86.7% y un valor predictivo negativo de 93.3%. La tomografía computarizada presentó 75.9% de la precisión diagnóstica, con 84.6, 68.8, y 84.6% de sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo, respectivamente. La resonancia magnética documentó una precisión diagnóstica de 95.1%, con 94.4% de sensibilidad, 95.7% de especificidad, 94.4% de valor predictivo positivo y 95.7% para valor predictivo negativo. Esto mostró un gran acuerdo entre los hallazgos de histología y los que están dentro de la radiografía y la RMN (K=0.8 y 0.9, respectivamente), pero no deprecia el valor de la biopsia ósea en el diagnóstico de tumores óseos. Estos datos mostraron una buena correlación entre técnicas imagenológicas e histopatológicas.

In 2018 three European societies have joined to create clinically relevant guidelines on the diagnosis and management of cervical cancer. The European Society of Gynaecological Oncology (ESGO), the European Society for Radiotherapy and Oncology (ESTRO), and the European Society of Pathology (ESP) agreed on diagnostic approaches in cervical cancer staging. Review article. Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital in Prague. A literature review of published data on cervical cancer staging. Physical examination with biopsy still has its place in histological confirmation of malignancy but doesnt offer much information on the extent of the disease. It is historically the first time when transvaginal/transrectal ultrasound (TVS/TRS) is recommended as an alternative to the magnetic resonance (MRI) in a primary workup. Both imaging modalities offer excellent soft tissue contrast resolution, which is crucial in tumour detection and evaluation of local extent of tumour, including the depth of tumour infiltration in the bladder and rectal wall. These new advances in imaging rendered the use of cystoscopy and rectoscopy redundant. Similarly, with the implementation of modern imaging in pretreatment staging, intravenous urography has lost its role in the staging. Apart from the local extent of the disease, it is necessary to accurately evaluate the lymph node status in order to plan optimal treatment. The detection rate of imaging reflects the prevalence of lymph node metastases depending on tumor stage and size of metastasis. In the early stage disease (T1a, T1b1, T2a1) with negative lymph nodes on TVS/TRS or MRI, surgicopathological staging of pelvic lymph nodes is a method of choice for detection of small volume metastases. Both imaging modalities might not detect small metastatic lesions within non-enlarged lymph nodes, but by identifying the characteristic changes of the infiltrated lymph nodes they have very low rate of false positives. In locally advanced cervical cancer (T1b2 and higher, except T2a1) or early stages with positive lymph nodes detected on ultrasound or MRI, computed tomography (CT) or CT in combination with positron emission tomography (PET-CT) are recommended to assess distant spread including paraaortic lymph nodes and chest. PET-CT is the preferred option in cases indicated for primary chemoradiation. Unfortunatelly no imaging method is accurate enough to exclude small volume metastasis in paraaortic nodes. In the cases with negative paraaortic lymph nodes on CT or PET-CT, surgicopathological staging with dissection of the paraaortic lymph nodes may be considered. In order to reduce false positive findings by imaging methods, it is recomended to obtain an ultrasound or CT-guided tru-cut biopsy from any equivocal extrauterine lesion to avoid inappropriate treatment. This review offers scientific evidence that led to the recent changes in the cervical cancer staging.

Although horseshoe kidney (HSK) is the most common congenital anomaly of the upper urinary tract, renal cell cancer (RCC) in HSK develops extremely rarely. Until 2012 y. there were less than 200 cases of RCC in HSK published in PubMed. Only five cases of laparoscopic partial nephrectomies and some cases of heminephrectomies have been described in PubMed. To conduct a multicenter retrospective analysis of laparoscopic surgery for tumors in HSK. From January 2013 to December 2018 a total of 19 conventional laparoscopic interventions were performed in patients with RCC in HSK, including 1 isthmusectomy, 5 partial nephrectomies and 13 heminefrectomies. In addition, 16 divisions of isthmus were done in 15 patients. The video describing our operation technique is available on: http://youtu.be/nk-WlbjNtIs . There were no conversions to open surgery and mortality as well as intra- and postoperative complications of Clavien grade 3 or higher. Warm ischemia time during partial nephrectomy didnt exceed 19 minutes. Operative time ranged from 110 to 270 min, while max estimated blood loss was 400 ml. All patients were followed for 6 month and no case of disease recurrence or progression was noted. The small number of laparoscopic interventions in patients with RCC in HSK doesnt allow to carry out a proper statistical analysis and draw certain conclusions. We presented the largest experience available in the literature and our results demonstrate the efficacy and safety of conventional laparoscopic technologies in the treatment of RCC in HSK.