Tooltip
.tooltip {
position: relative;
cursor: pointer;
text-decoration: none;
border-bottom: 1px dashed rgba(0, 0, 0, 0.6);
}
.tooltip::before {
content: attr(data-tooltip);
position: absolute;
top: -40px; /* Trochę niżej nad słowem */
left: 50%; /* Wyśrodkowanie */
transform: translateX(-50%);
background-color: rgba(255, 255, 255, 0.9);
color: #333;
padding: 6px 12px;
border-radius: 8px;
white-space: nowrap;
opacity: 0;
visibility: hidden;
transition: opacity 0.3s ease, visibility 0.3s ease;
font-family: ‘Arial’, sans-serif;
font-size: 14px;
box-shadow: 0px 4px 8px rgba(0, 0, 0, 0.1);
z-index: 10;
}
.tooltip:hover::before {
opacity: 1;
visibility: visible;
}
document.addEventListener(‘DOMContentLoaded’, function () {
const wordsToTooltip = {
“Bacterial Vaginosis”: “Bakteryjna waginoza”,
“vaginal discharge”: “wydzielina z pochwy”,
“imbalance of normal vaginal bacteria”: “zaburzenie równowagi naturalnej flory bakteryjnej pochwy”,
“overgrowth”: “nadmierny rozwój”,
“sexually transmitted infection”: “infekcja przenoszona drogą płciową”,
“increase the risk”: “zwiększenie ryzyka”,
“complications during pregnancy”: “powikłania w czasie ciąży”,
“Etiology and Risk Factors”: “Etiologia i czynniki ryzyka”,
“Bacterial Imbalance”: “Zaburzenie równowagi bakteryjnej”,
“lactobacilli”: “pałeczki kwasu mlekowego”,
“beneficial bacteria”: “pożyteczne bakterie”,
“gardnerella vaginalis”: “Gardnerella vaginalis”,
“Mobiluncus”: “Mobiluncus”,
“Sexual Activity”: “Aktywność seksualna”,
“disrupt normal vaginal flora”: “zakłócenie naturalnej flory pochwy”,
“increase risk of bacterial overgrowth”: “zwiększenie ryzyka nadmiernego rozwoju bakterii”,
“Antibiotic Use”: “Stosowanie antybiotyków”,
“alter vaginal microbiome”: “zmiana mikrobiomu pochwy”,
“Hormonal Changes”: “Zmiany hormonalne”,
“menstruation, pregnancy, menopause”: “miesiączka, ciąża, menopauza”,
“influence vaginal environment”: “wpływ na środowisko pochwy”,
“protective lactobacilli”: “ochronne pałeczki kwasu mlekowego”,
“reduced lactobacilli”: “zmniejszona liczba pałeczek kwasu mlekowego”,
“vaginal pH”: “pH pochwy”,
“less acidic”: “mniej kwaśne”,
“proliferation of harmful bacteria”: “rozrost szkodliwych bakterii”,
“produce metabolites”: “produkcja metabolitów”,
“inflammation”: “stan zapalny”,
“characteristic symptoms”: “charakterystyczne objawy”,
“Clinical Manifestations”: “Objawy kliniczne”,
“Vaginal Discharge”: “Wydzielina z pochwy”,
“thin, grayish-white”: “rzadka, szarawo-biała”,
“Itching or Irritation”: “Swędzenie lub podrażnienie”,
“mild itching”: “łagodne swędzenie”,
“vaginal area”: “okolice pochwy”,
“Burning Sensation”: “Pieczenie”,
“burning during urination”: “pieczenie podczas oddawania moczu”,
“Asymptomatic Cases”: “Przypadki bezobjawowe”,
“absence of noticeable symptoms”: “brak zauważalnych objawów”,
“Diagnostic Approach”: “Podejście diagnostyczne”,
“Clinical Evaluation”: “Ocena kliniczna”,
“associated symptoms”: “objawy towarzyszące”,
“thin, grayish-white discharge”: “rzadka, szarawo-biała wydzielina”,
“fishy odor”: “rybi zapach”,
“clue cells”: “komórki wskazujące”,
“Whiff Test”: “Test zapachowy”,
“adding KOH to discharge”: “dodanie KOH do wydzieliny”,
“Nucleic Acid Amplification Tests”: “Testy amplifikacji kwasów nukleinowych”,
“definitive diagnosis”: “ostateczna diagnoza”,
“Treatment”: “Leczenie”,
“Antibiotics”: “Antybiotyki”,
“metronidazole”: “metronidazol”,
“oral or topical gel”: “doustnie lub w postaci żelu miejscowego”,
“clindamycin”: “klindamycyna”,
“oral or topical cream”: “doustnie lub w postaci kremu miejscowego”,
“Avoiding Irritants”: “Unikanie drażniących substancji”,
“douching”: “irygacje pochwy”,
“sexual partners”: “partnerzy seksualni”,
“Complications”: “Powikłania”,
“Increased Risk of STIs”: “Zwiększone ryzyko infekcji przenoszonych drogą płciową”,
“susceptibility”: “podatność”,
“Pregnancy Complications”: “Powikłania w ciąży”,
“preterm labor”: “przedwczesny poród”,
“low birth weight”: “niska masa urodzeniowa”,
“pelvic inflammatory disease”: “zapalenie narządów miednicy mniejszej”,
“Recurrence”: “Nawrót”,
“high recurrence rate”: “wysoka częstotliwość nawrotów”,
“multiple episodes”: “wielokrotne epizody”,
“after initial treatment”: “po początkowym leczeniu”,
“respond to antibiotics”: “odpowiada na antybiotyki”,
“symptoms resolve within days”: “objawy ustępują w ciągu kilku dni”,
“lifestyle modifications”: “zmiany stylu życia”,
“Menstrual Disorders”: “Zaburzenia menstruacyjne”,
“dysmenorrhea”: “bolesne miesiączkowanie”,
“menorrhagia”: “obfite krwawienia miesiączkowe”,
“heavy menstrual bleeding”: “obfite krwawienia miesiączkowe”,
“painful cramps during menstruation”: “bolesne skurcze podczas miesiączki”,
“Primary and Secondary Dysmenorrhea”: “Pierwotne i wtórne bolesne miesiączkowanie”,
“Primary Dysmenorrhea”: “Pierwotne bolesne miesiączkowanie”,
“release of prostaglandins”: “uwalnianie prostaglandyn”,
“uterine contractions”: “skurcze macicy”,
“adolescence”: “okres dojrzewania”,
“Secondary Dysmenorrhea”: “Wtórne bolesne miesiączkowanie”,
“underlying conditions”: “choroby podstawowe”,
“endometriosis”: “endometrioza”,
“fibroids”: “mięśniaki”,
“Variable Outcomes”: “Zróżnicowane wyniki”,
“hormonal therapy”: “terapia hormonalna”,
“NSAIDs”: “niesteroidowe leki przeciwzapalne”
};
// Normalize keys in the dictionary
const normalizedWordsToTooltip = {};
for (const [key, value] of Object.entries(wordsToTooltip)) {
const cleanedKey = key.replace(/(.*?)/g, ”).trim(); // Remove anything in parentheses
normalizedWordsToTooltip[cleanedKey.toLowerCase()] = value;
}
function processNode(node) {
if (node.nodeType === Node.TEXT_NODE && node.nodeValue.trim()) {
let content = node.nodeValue;
// Regex to match only the main words (ignores parentheses)
const regex = new RegExp(
`\b(${Object.keys(normalizedWordsToTooltip).join(‘|’)})\b`,
‘gi’
);
if (regex.test(content)) {
const wrapper = document.createElement(‘span’);
wrapper.innerHTML = content.replace(regex, (match) => {
const tooltip = normalizedWordsToTooltip[match.toLowerCase().trim()];
return `
${match}`;
});
node.replaceWith(wrapper);
}
} else if (node.nodeType === Node.ELEMENT_NODE) {
Array.from(node.childNodes).forEach(processNode);
}
}
document.querySelectorAll(‘body *:not(script):not(style)’).forEach((element) => {
Array.from(element.childNodes).forEach(processNode);
});
});
Podświetlanie tekstu z notatkami
body {
margin: 0;
padding: 0;
font-family: Arial, sans-serif;
}
.highlight {
background-color: #cce7ff; /* Highlight color without notes */
position: relative;
display: inline;
}
.highlight.with-note {
background-color: #ffeb3b; /* Highlight color with notes */
}
.note-box {
position: absolute;
background-color: #f9f9f9;
color: #333;
font-size: 14px;
line-height: 1.6;
padding: 10px 15px;
border: 1px solid #ddd;
border-radius: 5px;
box-shadow: 0 2px 5px rgba(0, 0, 0, 0.2);
max-width: 250px;
z-index: 1000;
white-space: normal;
text-align: left;
display: none; /* Hidden by default */
}
.note-controls {
position: absolute;
top: -30px;
right: -30px;
display: flex;
gap: 10px;
z-index: 10;
opacity: 0;
pointer-events: none;
transition: opacity 0.3s;
}
.note-controls.visible {
opacity: 1;
pointer-events: all;
}
.note-controls span {
cursor: pointer;
background-color: gray;
color: white;
padding: 5px 10px;
border-radius: 5px;
font-size: 16px;
font-weight: bold;
}
.note-controls span:hover {
background-color: darkgray;
}
document.addEventListener(“DOMContentLoaded”, () => {
/**
* Checks if an element is a header.
*/
const isHeaderElement = (node) => {
while (node) {
if (node.nodeType === 1 && node.tagName.match(/^H[1-5]$/)) {
return true;
}
node = node.parentNode;
}
return false;
};
/**
* Checks if an element is inside a table cell.
*/
const isInsideTable = (node) => {
while (node) {
if (node.tagName === “TD” || node.tagName === “TH”) {
return node;
}
node = node.parentNode;
}
return null;
};
/**
* Checks if an element belongs to the same list item.
*/
const isWithinSameListItem = (selection) => {
if (selection.rangeCount === 0) return false;
const range = selection.getRangeAt(0);
const startContainer = range.startContainer;
const endContainer = range.endContainer;
const getClosestListItem = (node) => {
while (node) {
if (node.nodeType === 1 && node.tagName === “LI”) {
return node;
}
node = node.parentNode;
}
return null;
};
const startListItem = getClosestListItem(startContainer);
const endListItem = getClosestListItem(endContainer);
// Ensure selection is within the same list item
return startListItem === endListItem;
};
/**
* Validates the selection.
* Ensures the selection is within a single header, table cell, or list item.
*/
const isSelectionValid = (selection) => {
if (selection.rangeCount === 0) return false;
const range = selection.getRangeAt(0);
const startContainer = range.startContainer;
const endContainer = range.endContainer;
const startInHeader = isHeaderElement(startContainer);
const endInHeader = isHeaderElement(endContainer);
// Block selection spanning headers
if (startInHeader !== endInHeader) {
return false;
}
const startCell = isInsideTable(startContainer);
const endCell = isInsideTable(endContainer);
// Block selection spanning table cells
if (startCell && endCell && startCell !== endCell) {
return false;
}
// Block selection spanning multiple list items
if (!isWithinSameListItem(selection)) {
return false;
}
return true;
};
/**
* Highlights the selected text.
*/
const wrapTextWithHighlight = (range) => {
const fragment = range.extractContents();
const highlight = document.createElement(“span”);
highlight.className = “highlight”;
highlight.appendChild(fragment);
range.insertNode(highlight);
const noteControls = document.createElement(“div”);
noteControls.className = “note-controls visible”;
const editNote = document.createElement(“span”);
editNote.textContent = “✎”;
editNote.title = “Edit note”;
noteControls.appendChild(editNote);
const removeHighlight = document.createElement(“span”);
removeHighlight.textContent = “x”;
removeHighlight.title = “Remove highlight”;
noteControls.appendChild(removeHighlight);
highlight.style.position = “relative”;
highlight.appendChild(noteControls);
let noteBox = null;
const updateNotePosition = () => {
const rect = highlight.getBoundingClientRect();
if (noteBox) {
noteBox.style.top = `${rect.height}px`;
noteBox.style.left = `${rect.width / 2}px`;
}
};
const hideControlsAndNoteAfterDelay = () => {
setTimeout(() => {
noteControls.classList.remove(“visible”);
if (noteBox) noteBox.style.display = “none”;
}, 3000);
};
// Show controls for 3 seconds after highlighting
hideControlsAndNoteAfterDelay();
highlight.addEventListener(“click”, () => {
noteControls.classList.add(“visible”);
if (noteBox) noteBox.style.display = “block”;
hideControlsAndNoteAfterDelay();
});
editNote.addEventListener(“click”, () => {
const noteText = prompt(“Add or edit a note:”, noteBox?.textContent || “”);
if (noteText) {
if (!noteBox) {
noteBox = document.createElement(“div”);
noteBox.className = “note-box”;
highlight.appendChild(noteBox);
}
noteBox.textContent = noteText;
noteBox.style.display = “block”;
highlight.classList.add(“with-note”);
updateNotePosition();
hideControlsAndNoteAfterDelay();
}
});
removeHighlight.addEventListener(“click”, () => {
const parent = highlight.parentNode;
while (highlight.firstChild) {
parent.insertBefore(highlight.firstChild, highlight);
}
parent.removeChild(highlight);
if (noteBox) noteBox.remove();
});
};
/**
* Handles the mouseup event to validate and apply highlighting.
*/
document.body.addEventListener(“mouseup”, () => {
const selection = window.getSelection();
if (selection.rangeCount > 0 && selection.toString().trim()) {
if (!isSelectionValid(selection)) {
alert(“Zaznaczenie musi być w obrębie jednego akapitu, komórki tabeli lub punktu listy!”);
selection.removeAllRanges();
return;
}
const range = selection.getRangeAt(0);
wrapTextWithHighlight(range);
selection.removeAllRanges();
}
});
});
Bacterial Vaginosis (BV)
Bacterial Vaginosis (BV) is the most common cause of vaginal discharge in women of reproductive age. It is characterized by an imbalance of normal vaginal bacteria, leading to an overgrowth of certain types of bacteria. BV is not classified as a sexually transmitted infection (STI), but it is associated with sexual activity and can increase the risk of STIs and other complications during pregnancy.
Etiology and Risk Factors
- Bacterial Imbalance: BV results from a decrease in lactobacilli (the beneficial bacteria) and an increase in anaerobic bacteria such as Gardnerella vaginalis and Mobiluncus.
- Sexual Activity: New or multiple sexual partners may increase the risk of developing BV, although it can also occur in women who are not sexually active.
- Douching: This practice can disrupt the normal vaginal flora, increasing the risk of bacterial overgrowth.
- Antibiotic Use: Recent use of antibiotics can alter the vaginal microbiome and promote BV.
- Hormonal Changes: Fluctuations in hormones during menstruation, pregnancy, or menopause can influence the vaginal environment.
Pathophysiology
In BV, the protective lactobacilli in the vagina are reduced, leading to an overgrowth of other bacteria. This shift in the microbiome alters the vaginal pH, making it less acidic. The resulting environment favors the proliferation of harmful bacteria, which can produce various metabolites and lead to inflammation and characteristic symptoms.
Clinical Manifestations
- Vaginal Discharge: The most common symptom, typically thin, grayish-white, and has a fishy odor, especially after sexual intercourse.
- Itching or Irritation: Some women may experience mild itching or irritation in the vaginal area.
- Burning Sensation: A burning feeling during urination may occur in some cases.
- Asymptomatic Cases: Many women with BV may be asymptomatic and not experience noticeable symptoms.
Diagnostic Approach
- Clinical Evaluation: A thorough history and physical examination, focusing on vaginal discharge and associated symptoms.
- Amsel Criteria: Diagnosis can be made based on at least three of the following: thin, grayish-white discharge; a fishy odor; vaginal pH greater than 4.5; and the presence of clue cells on microscopic examination.
- Whiff Test: Adding KOH to vaginal discharge may produce a fishy odor, indicating the presence of BV.
- Nucleic Acid Amplification Tests: Can be used for a more definitive diagnosis but are less commonly required.
Treatment
- Antibiotics: The first-line treatment includes metronidazole (oral or topical gel) or clindamycin (oral or topical cream).
- Avoiding Irritants: Patients are advised to avoid douching, scented soaps, and other irritants that may exacerbate symptoms.
- Partner Treatment: Typically, sexual partners do not require treatment unless symptoms are present; however, discussing sexual health and practices can be beneficial.
Complications
- Increased Risk of STIs: BV is associated with an increased susceptibility to sexually transmitted infections, including HIV.
- Pregnancy Complications: Women with untreated BV during pregnancy may face complications such as preterm labor, low birth weight, and pelvic inflammatory disease.
- Recurrence: BV has a high recurrence rate, with many women experiencing multiple episodes after initial treatment.
Prognosis
- Generally Favorable: Most women respond well to antibiotic treatment, and symptoms typically resolve within a few days. However, recurrence is common, and approximately 30-50% of women may experience BV again within three months of treatment. Regular follow-ups and lifestyle modifications can help manage and reduce recurrence.managing recurrent BV may involve prolonged antibiotic therapy or the use of probiotics, although this remains an area of ongoing research.
Menstrual Disorders: Dysmenorrhea and Menorrhagia
Menstrual disorders, including dysmenorrhea and menorrhagia, are common issues that can significantly affect a woman’s quality of life. These conditions are characterized by pain and heavy menstrual bleeding, respectively, and can have various underlying causes.
Dysmenorrhea
Dysmenorrhea refers to the painful cramps that occur during menstruation. It is classified into two types: primary and secondary.
Etiology and Risk Factors
- Primary Dysmenorrhea: Often related to the release of prostaglandins, which cause uterine contractions. It typically begins in adolescence and can improve with age or after childbirth.
- Secondary Dysmenorrhea: Caused by underlying conditions such as endometriosis, fibroids, or pelvic inflammatory disease (PID). It often starts later in life and can last longer than primary dysmenorrhea.
- Risk Factors: Young age, family history of dysmenorrhea, smoking, obesity, and a history of sexual or physical abuse may increase the likelihood of experiencing dysmenorrhea.
Pathophysiology
In primary dysmenorrhea, elevated levels of prostaglandins lead to increased uterine contractions, which can cause ischemia and pain. In secondary dysmenorrhea, pain arises from underlying pelvic pathology that triggers inflammation and muscle contractions.
Clinical Manifestations
- Cramping Pain: Typically begins one to two days before menstruation and lasts for 2-3 days. The pain is often described as a dull, throbbing, or cramping sensation in the lower abdomen.
- Associated Symptoms: Nausea, vomiting, diarrhea, headache, and fatigue may accompany the pain.
Diagnostic Approach
- Clinical Evaluation: A thorough history and physical examination to assess the nature and severity of pain.
- Pelvic Examination: To rule out any underlying abnormalities such as cysts or fibroids.
- Imaging Studies: Ultrasound or MRI may be used to identify conditions like endometriosis or fibroids.
Treatment
- Pain Management: NSAIDs such as ibuprofen or naproxen can help reduce pain by decreasing prostaglandin production.
- Hormonal Therapy: Birth control pills or hormonal IUDs may help regulate menstrual cycles and reduce dysmenorrhea.
- Alternative Therapies: Heat therapy, acupuncture, and lifestyle modifications, including exercise and dietary changes, may provide relief.
Complications
- Chronic Pain: Untreated dysmenorrhea can lead to chronic pelvic pain and impact daily activities.
- Emotional Distress: Anxiety and depression can develop due to persistent pain.
Prognosis for Dysmenorrhea
- Generally Favorable: Most cases of dysmenorrhea, particularly primary dysmenorrhea, respond well to over-the-counter pain relief and lifestyle modifications, with many women experiencing symptom relief over time. Secondary dysmenorrhea may require treatment of the underlying condition, but effective management can significantly improve quality of life for those affected.
Menorrhagia
Menorrhagia refers to abnormally heavy or prolonged menstrual bleeding. It is defined as bleeding that soaks through one or more sanitary pads or tampons every hour for several consecutive hours, or menstrual bleeding that lasts longer than seven days.
Etiology and Risk Factors
- Hormonal Imbalance: Anovulation leads to unopposed estrogen stimulation of the endometrium, resulting in excessive growth and subsequent heavy bleeding.
- Uterine Pathology: Conditions such as uterine fibroids, polyps, adenomyosis, and endometrial hyperplasia can contribute to menorrhagia.
- Coagulation Disorders: Conditions like von Willebrand disease or platelet dysfunction can lead to heavy bleeding.
- Risk Factors: Obesity, older age, certain medications (e.g., anticoagulants), and a history of menstrual disorders can increase the risk.
Pathophysiology
Menorrhagia may result from excessive endometrial growth due to hormonal imbalances or structural abnormalities within the uterus. Inadequate response to hormonal signals leads to prolonged bleeding during menstruation.
Clinical Manifestations
- Heavy Bleeding: Soaking through sanitary products every hour or passing large clots.
- Prolonged Menstrual Periods: Lasting more than seven days.
- Fatigue: Resulting from anemia due to chronic blood loss, which may present as weakness or shortness of breath.
Diagnostic Approach
- Clinical Evaluation: A detailed menstrual history and physical examination to assess bleeding patterns.
- Blood Tests: Complete blood count (CBC) to check for anemia and tests to evaluate clotting function.
- Imaging Studies: Ultrasound or hysteroscopy may be employed to visualize the uterus and identify any structural abnormalities.
Treatment
- Medications:
- Hormonal Therapy: Birth control pills or progestins to regulate the menstrual cycle and reduce bleeding.
- NSAIDs: To reduce menstrual bleeding and alleviate pain.
- Surgical Interventions:
- Endometrial Ablation: A procedure to destroy the uterine lining to reduce bleeding.
- Myomectomy or Hysterectomy: Surgical options for fibroids or severe cases.
- Iron Supplementation: For women experiencing anemia due to heavy menstrual loss.
Complications
- Anemia: Chronic blood loss can lead to iron deficiency anemia, resulting in fatigue and decreased quality of life.
- Impact on Daily Life: Heavy menstrual bleeding can interfere with work, social activities, and overall well-being.
Prognosis for Menorrhagia
- Variable Outcomes: The prognosis for menorrhagia largely depends on the underlying cause. Many cases can be effectively managed with medications such as hormonal therapy or nonsteroidal anti-inflammatory drugs (NSAIDs). For women with structural abnormalities, such as fibroids or polyps, surgical options can provide significant relief, and the prognosis is generally good with appropriate treatment.
