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TitleStatement on combined hormonal contraceptives containing third-or fourth-generation progestogens or cyproterone acetate, and the associated risk of thromboembolism. Permalinkhttps://escholarship.org/uc/item/2g26x0v0 JournalThe journal of family planning and reproductive health care, 39(3)

Objective: To investigate the importance of morphological scoring systems in differentiation of ovarian tumors in childhood. Methods: Morphological assessment using DePriest's index was performed for all patients with histopathological confirmation of ovarian tumor, with evaluation of tumor markers, from January 1997. Results: Fifty-three girls (age range 13 months to 19 years) were surgically treated for 59 ovarian tumors, including six bilateral. All lesions with cystic appearance on ultrasonography were benign, 23 of 35 semisolid, and four of ten solid tumors were also benign. Stage of malignant disease was as follows: stage I, ten; stage II, two; stage III, six. Sensitivity, positive predictive value and accuracy by DePriest's and Ueland's indexes for benign tumors (score <7) were: 0.88, 0.79; 0.89; and 0.94, 0.84; 0.93; respectively. Elevated levels of tumor markers were observed in 17 patients, including four patients with endocrine manifestations. In 24 patients ovaries were successfully preserved, including two patients with foci of immature teratoma in a dermoid cyst. Conclusion: Ultrasonographic assessment with morphological analysis recommended by DePriest and Ueland is a very useful procedure for differentiating benign from malignant ovarian tumors in children. Tumor markers and endo-crinological investigation are also useful for preoperative evaluation. KEY WORDSovarian tumor, ultrasonography, childhood, tumor marker, ovarian surgery

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The problem of a large number of abortions in our country was first pointed out as far back as 1935 at the 17th Congress of Yugoslav Physicians. The abortion problem in Serbia is still present today, even though modern science has provided new methods and means which are a logical solution to the dilemma on birth control methods from the health and social aspect. Namely, total abortion rate in Serbia was estimated at 2.76 in the year 2007. It is very high; double the number of the total fertility rate and among the highest in Europe and the world. The term abortion culture was first used, as far as we know, by Henry David in the introduction of the book From Abortion to Contraception - A Resource to Public Policies and Reproductive Behavior in Central and Eastern Europe from 1917 to the Present in 1999, without specifically determining it. The aim of this paper is to identify the most important factors of the deterministic basis of endemic induced abortions in Serbia together with indirectly estimating their connection with the existence, namely nonexistence, of the abortion culture in our country. In that sense, potential factors of abortion incidence in Serbia which emerge from the social system and those connected to the individual level have been considered. In other words, a series of laws and other legal and political documents have been analyzed which are significant for perceiving the abortion matter, as well as institutional frameworks for family planning, health services, educating the youth regarding reproductive health, including findings of numerous researches carried out among women of various age and doctors from 1990 till present day in Serbia. The following most significant factors for the long duration of the abortion problem have been singled out: insufficient knowledge of modern contraception, a belief that modern contraceptive methods are harmful to health and a number of psychological barriers as well as those arising from relationships with partners. Gynecological attitudes about modern contraception and behavior do not differ significantly from the rest of the population. Additionally, there are few organized efforts to promote sex education, as well as limitations in the family planning programme. Distinguished macro and micro factors of traditional birth control in Serbia confirm the existence of the abortion culture. The nature of these factors though, indicate to the presence of the abortion culture in our country on the political, educational, health and individual level. The abortion culture obstructs the adoption of a modern concept of family planning and points out to the persistence of the abortion problem in our country in the years to come