Maternal hemodynamic influence on uteroplacental oxygen distribution during cesarean section.

This study investigated maternal hemodynamic influence on uteroplacental oxygen distribution and neonatal outcome during cesarean section (CS). CS was performed on 80 parturients using two anaesthetic techniques: spinal anaesthesia (SA) and general balanced anaesthesia (GBA). Indications for CS were exclusively obstetric related. Monitored maternal parameters were: ECG, heart rate (HR), non-invasive blood pressure (NIBP), saturation (SaO2). Gas parameters in umbilical artery, vein, and neonatal capillary blood were sampled. Vitality was assessed by the Apgar scoring, first breath-taking time and the first breastfeeding attempt. Hypotension was the most common finding after SA induction. GBA group presented changes such as QT inversion (12.5%), tachycardia (55%), and bradycardia (2.5%). SA group experienced higher rates of sinus tachycardia (45%) and ventricular dysrhythmias (2.5%). Neonatal oxygenation was significantly higher in SA group. Higher quality of early neonatal adaptation in the SA group confirms it as the technique with the least neonatal risk during CS.

Multiorgan thrombotic disorder in a young patient with primary antiphospholipid syndrome (APS) and ovarian tumor.

Catastrophic antiphospholipid syndrome (CAPS) is a life-threatening condition with high mortality rate besides aggressive multimodal treatment. Underlying triggers of "thrombotic and cytokine storm" include pregnancy, inflammation, trauma, surgery, and infection. The authors present a case of a young female patient with primary antiphospholipid syndrome (APS) who was admitted to the hospital due to abdominal pain caused by ovarian tumor with elevated tumor markers. After the prophylactic anticoagulants and antibiotic treatment, surgery was performed. Suddenly after treatment, her clinical status deteriorated and she died regardless of intensive immunosupresive and anticoagulant therapy attempts. This condition requires all clinical awareness, timely diagnosis, and therapeutical approach, including a better understanding of the pathophysiology that leads to CAPS.

Malignant fibrous histiocytoma of the ovary: a case report.

Malignant fibrous histiocytoma (MFH) is the most common soft-tissue sarcoma of late adult life occurring predominantly in the extremities and the retroperitoneum. MFH of the ovary is very rare, with only six cases previously reported. A 67-year-old woman with a right pelvic tumor highly suspicious of ovarian carcinoma was submitted to exploratory laparotomy. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, total omentectomy, pelvic and paraaortic lymphadenectomy with right hemicolectomy along with permanent cutaneous ileostomy were performed. Since a storiform-pleomorphic type of MHF was diagnosed from histopathological and immunohistochemical findings, chemotherapy was proposed as the postoperative treatment. Despite extensive surgery with negative surgical margins, the patient had recurrence of the tumor within four months, and was submitted to secondary surgery. A combination of chemo- and radiotherapy was performed postoperatively, but the patient developed respiratory problems and died one year later from the primary diagnosis.

Postoperative complications--massive transfusions in radical malignant gynecological surgeries.

At the Institute of Gynecology and Obstetrics we examined 24 women who were radically operated on and received massive transfusions during the intraoperative and postoperative period. Twelve developed massive transfusion complications such as urticaria, fever, and respiratory insufficiency known as TRALI (transfusion-related acute lung injury).

Endometriosis and possible malignant transformation.

By examining the cause of infertility for a the period of three years in the two largest hospitals in Belgrade, we found 453 cases of endometriosis out of 683 cases of laparoscopy. During the procedure, removal of endometrial foci, histological examination of the sample and removal of genital and peritoneum abnormalities by laser were carried out. Interestingly, in only 8% of the cases were cancerous changes of the ovary diagnosed. Out of 36 patients with established diagnoses, hysterectomy and bilateral salpingo-oophorectomy were performed in four cases.

Coulometric determination of some antiinflammatory compounds.

A method is presented for the chlorocoulometric assay of small amounts of piroxicam and tenoxicam. This assay is carried out directly by coulometrically titrating the investigated substances with electrogenerated chloride in the presence of methyl orange as indicator. Results are accurate and reproducible. The method can be applied for routine analysis of these substances.

Chlorocoulometric determination of hydrocortisone and hydrocortisone acetate.

A chlorocoulometric method for the determination of small amounts of hydrocortisone and hydrocortisone acetate is presented. The method is simple and rapid, the results obtained are accurate and reproducible. It can be successfully applied to the determination of hydrocortisone and hydrocortisone acetate in pharmaceutical formulations.

Conductometric determination of methenamine.

A method of conductometric titration for determination of methenamine is presented. An aqueous solution of silicotungstic acid is used as titrant. The acid and methenamine form an insoluble compound in which the molar ratio of the acid to methenamine is 1:4. Conductometric curves were obtained, the shapes of which are suitable for accurate and reproducible determination of the end point of titration. The results show reasonable accuracy. Good reproducibility was achieved even when small quantities of methenamine had to be determined.