Early fetal heart ultrasonography as additional indicator for chromosomopathies.

OBJECTIVE: First trial of estimating values of scans of fetal heart structures (FHS) in first trimester of pregnancy, as more primary facts of possible chromosomopathies. MATERIALS AND METHODS: The study included 2,643 fetuses that were examined in first trimester of pregnancy on Sono CT convex (C5-2MHz), endovaginal (ev 8-4MHz), and linear transducers (L12-5MHz) during a period of eight years. Fetal heart was evaluated using appropriate software with broad-band transducers and color Doppler, Sono CT, and HD ZOOM technologies. The scan was performed by three experienced physicians. FHS were based on: left and right ventricle morphology; AV valves (atrioventricular) position and existence of primal ostium; relationship of left ventricle outflow tract (LVOT) and right ventricle outflow tract (RVOT) and great vessels on three vessel view (3VV) and estimation of ductal and aortic arch. RESULTS: Several developments, one being the ability to identify fetuses at risk for cardiac defects combining nuchal translucency (NT), ductus venosus (DV) Doppler, and evaluation of tricuspid regurgitation, have prompted reconsideration of the role of the first trimester prognostic factor of fetal evaluation. In low-risk pregnancies group, 36 (1.8%) fetuses were found to have congenital heart disease (CHD), and in high-risk pregnancies the number of fetuses with CHD was 75 (12%). Genetic amniocentesis or chorionic villus sampling (CVS) was performed in all fetuses with CHD. Forty-two (37.8%) fetuses with CHD were found to have chromosomal anomalies. Out of 111 fetuses with CHD 39 (35.1%) had an nuchal translucency (NT) above three mm. Out of 42 fetuses with chromosomal anomalies and CHD, 29 (69%) had an increased NT. CONCLUSION: Using first trimester fetal echosonography constitutes a further step in the earlier recognition of chromosomopathies, even in low risk groups. Still further steps are necessary as all facts of good clinical practice. In order to offer further benefits during pregnancies, improvements in diagnostics are still required.

Hysterosalpingography versus hysterscopy in intrauterine pathology research of infertile patients.

BACKGROUND: The objective of the present paper is to confirm the validity and reliability of hysterosalpingography (HSG) in intrauterine pathology research of infertile female patients by comparing the hysteroscopy (HC) findings to a "gold standard" test. AIM: To analyze HSG and HC findings in infertility patients. MATERIALS AND METHODS: The research was conducted as a prospective study at the Gynecological and Obstetrics Clinic "Narodni front" in Belgrade. RESULTS: HSG indicated pathological findings in 72.5% of patients whereas HC revealed abnormalities of uterine cavity in 77.5%. In 12.5% of patients, HSG demonstrated a normal uterine cavity, and HC confirmed pathological findings, while in 7.5% of patients with filling defects and irregular shapes on HSG images, HC reported normal findings. In 22.5% of patients normal finding as well as endometrial polyps were reported; congenital malformations (anomalies) were found in 32.5%, submucosal myomas in 12.5% and Asherman's syndrome in 10%. CONCLUSION: HC finding was crucial in final diagnosing.

Influence of regularity of checkups during pregnancy on prevalence of asymptomatic bacteriuria and maternal behaviors regarding urinary infection prevention.

PURPOSE OF INVESTIGATION: T0 investigate how the regularity of checkups in pregnancy influences maternal behavior regarding habits in prevention of urinary tract infection (UTI), the level of information, and finally the prevalence of asymptomatic bacteriuria (AB). MATERIALS AND METHODS: This study included 223 women with regular and 220 women with irregular checkups in pregnancy were given the questionnaire on the following issues: frequency of sexual intercourses during pregnancy, the regularity of bathing and changing of underwear, the direction of washing the genital region after urinating, the regularity of antenatal visits to gynecologist, and the subjective experience concerning the quality of the information received by the healthcare provider. RESULTS: AB was present significantly more frequent in group of participants with irregular controls during pregnancy compared to group with regular checkups in pregnancy. The prevalence of AB was higher in those women who had irregular prenatal checkups. Maternal behaviors related with the risk of urinary infections are more frequent among women with irregular prenatal care. CONCLUSION: Results of the present study emphasize the importance of regular prenatal care in AB prevention.

The glassy behaviour of poorly crystalline Fe2O3 nanorods obtained by thermal decomposition of ferrous oxalate.

Nanorod ferrous oxalate dihydrate (FeC2O4 × 2H2O) which had been synthesized by the microemulsion method, was used as a precursor in the thermal decomposition process performed in air atmosphere. The formation of nanocrystalline hematite as the final product was preceded by the appearence of an intermediate product. Comprehensive study comprising several complementary techniques (x-ray diffraction, transmission electron microscopy, selected area electron diffraction, thermogravimetric/differential thermal analyses and SQUID magnetometry) confirmed that the intermediate product corresponds to the poorly crystalline Fe2O3. Due to the specific nanorod shape and poorly crystalline structure, the investigated Fe2O3 showed high coercive field value of ~0.5 T at 5 K. Special attention in this study was devoted to the peculiar magnetic properties of poorly crystalline Fe2O3, which were thoroughly investigated by employing sophisticated experimental procedures such as relaxation of thermoremanent magnetization for different cooling fields, zero field and field cooled memory effects as well as aging experiments for different waiting times. At low temperatures and weak applied magnetic fields, the investigated system behaves similarly to spin glasses, manifesting slow, collective relaxation dynamics of magnetic moments through memory, rejuvenation and aging effects.

Time-dependent reduction of structural complexity of the buccal epithelial cell nuclei after treatment with silver nanoparticles.

Recent studies have suggested that silver nanoparticles (AgNPs) may affect cell DNA structure in in vitro conditions. In this paper, we present the results indicating that AgNPs change nuclear complexity properties in isolated human epithelial buccal cells in a time-dependent manner. Epithelial buccal cells were plated in special tissue culture chamber / slides and were kept at 37°C in an RPMI 1640 cell culture medium supplemented with L-glutamine. The cells were treated with colloidal silver nanoparticles suspended in RPMI 1640 medium at the concentration 15 mg L⁻¹. Digital micrographs of the cell nuclei in a sample of 30 cells were created at five different time steps: before the treatment (controls), immediately after the treatment, as well as 15 , 30 and 60 min after the treatment with AgNPs. For each nuclear structure, values of fractal dimension, lacunarity, circularity, as well as parameters of grey level co-occurrence matrix (GLCM) texture, were determined. The results indicate time-dependent reduction of structural complexity in the cell nuclei after the contact with AgNPs. These findings further suggest that AgNPs, at concentrations present in today's over-the-counter drug products, might have significant effects on the cell genetic material.

Anti-atherogenic effects of 17ß-estradiol.

Estrogens are secreted primarily by the ovaries and placenta, by the testes in men and also produced by peripheral steroidogenic conversion. The 3 major naturally occurring estrogens are: 17ß-estradiol (E2), estrone and estriol, of which E2 is the predominant and most active. The actions of E2 are mediated by at least 3 different receptors - the classical ERs (ERα and ERß) and G-protein coupled receptor 30 (GPR30). E2 signaling in cardiomyocytes involves ERα- and ERß-independent pathways, and treatment with the E2 receptor antagonists (Selective Estrogen Receptor Modulators- SERMs), which are agonists of GPR30, inhibits cardiac cell growth. Effects of E2 in preventing endothelial dysfunction, a prerequisite of atherosclerosis, are well recognized. Atherosclerosis involves interaction between the cells of the arterial wall endothelial cells (EC) and vascular smooth muscle cell (VSMC), as well as migration of macrophages into wall tunica media. It is predominantly developed at sites with abnormally high shear stress, such as bifurcations or branching of arteries, initiated by an injury to the endothelium and exposure to atherogenic lipids and toxins, such as those contained in tobacco smoke or infectious agents. Animal studies have shown effects of E2 in preventing atherosclerosis, inflammation and endothelial or vascular dysfunction. Gender differences along this pathogenic pathway have been also described. We review the data from the available animal and human studies, which focus on anti-atherogenic effects of E2. These studies represent evidence, albeit indirect, for an inhibitory effect of E2 on the progression of coronary artery atherosclerosis.

Adenosarcoma ovarii in a 51-year-old woman: case report.

This case report presents a 51-year-old woman with an adenosarcoma of ovarian origin which is a very rare tumor. She came for consultation due to abnormal vaginal bleeding. The case also illustrates the difficulty of its correct diagnosis and discusses the possible reasons of wrong preoperative and intraoperative diagnosis.

Prediction of fetal macrosomia with ultrasound parameters and maternal glycemic controls in gestational diabetes mellitus.

PURPOSE OF INVESTIGATION: Evaluation of ultrasound measurements of fetal adipose subcutaneous tissue (ASCT), abdominal circumference (AC), liver length (LL), and amniotic fluid index (AFI) in prediction of fetal macrosomia (FM) and gestational diabetes mellitus (GDM). MATERIALS AND METHODS: In a prospective clinical trial, 280 pregnant women underwent 100 g oral glucose tolerance test (oGTT) at 28th week of gestation (wg) and measurements ofAC, LL, AFI, and ASCT at 32nd, 34th, 36th, and 38th wg. RESULTS: For GDM, the best sensitivity was achieved by ACST at 32nd and 34th wg, the best specificity by LL at 32nd wg (90.6%), the best area under the curve (AUC) by LL at 34th wg (0.944). For FM the best sensitivity was achieved by AC at 32th, 34th, 36th, and 38th wg and by ASCT at 34th wg (94.2%), and the best AUC at 38th wg for AC (0.974). CONCLUSION: Ultrasound parameters of glycemic control were good predictors of FM and GDM.

Efficacy of hyperphosphatemia control in the progression of chronic renal failure and the prevalence of cardiovascular calcification.

BACKGROUND AND AIMS: Chronic kidney disease mineral- and bone disorder (CKD-MBD) has been studied more often in dialysis than in predialysis CKD patients. The association between efficacy of hyperphosphatemia control and chronic renal failure (CRF) progression, prevalence of bone disease and cardiovascular calcification was the objective of the present investigation. MATERIAL AND METHODS: 42 patients with CKD in Stage 5, regularly monitored for 5 years, were divided into Group 1 of 20 patients with normal serum phosphate (sPO4) levels and Group 2 of 22 patients with hyperphosphatemia registered at the majority of checks. Serum urea, creatinine, calcium (sCa) and sPO4 levels were regularly determined in the retrospective 5-year period. At the end of this period iPTH, bone alkaline phosphatase-BAP and inflammation markers (CRP, fetuin-A) were measured, valvular and arterial calcifications were detected by B mode echocardiogram and soft-tissue native radiograms of the pelvis and the wrist. RESULTS: Progression of CRF (1/sCr over time) was faster in Group 2 than in Group 1 (b = -0.0577 vs. -0.0288, p = 0.003) during the study period. Average BAP and iPTH values were similar in both groups and 23/42 patients had PTH > 300 pg/ml. Arterial and valvular calcifications were found in 5/23 patients from Group 1 and 14/22 patients from Group 2 (p = 0.011). Linear regression analysis revealed sPO4 as a predictor for total calcification number, inflammatory diseases as a predictor for valvular calcifications, while sPO4 and iPTH were predictors for arterial calcifications. CONCLUSIONS: More than half the patients with Stage 5 CKD not yet on dialysis exhibited elevated PTH. Faster CRF progression and frequent arterial and valvular calcifications were seen in patients with poor phosphate control and sPO4 was selected as an independent predictor of total calcification score.

High-risk human papillomavirus (HPV) types in patients with squamous intraepithelial lesions (SIL).

The aim of the paper was to determine the probability of joined occurrence of certain HPV types, particularly those with high oncogenic risk and histopathological (HP) findings (LGSIL and HGSIL, i.e., micro invasive and invasive carcinoma) as well as to find out to what extent either presence or absence of HPV can be identified in HP findings. The investigation was carried out on 48 patients. Based on a suspected colposcopy findings, Papanicolaou (Pap) smear and biopsy were performed and a histopathological analysis of the sample was carried out. A cervical smear was made on all the patients for HPV detection and typing. The results in the group with HPV, which showed histological diagnoses of LGSIL in 80% of cases, revealed numbers significantly higher with respect to the same summing up in the group where HPV was not detected (66.6%). HP findings of HGSIL in both groups were diagnosed in almost the same percentage and it should be taken into account that there were 6.7% of patients with Ca in situ in the group of HPV-positive patients. Therefore, it can be concluded that if a diagnosis of LGSIL or HGSIL, in particular, has been made on the basis of HP findings there is a great probability that it is a case of infection by one or more joined types of human papillomaviruses. The presence of virus specific genes in one of the stages of tumor development at the beginning of the infection indicates the viral etiology of tumors. The presence of HPV genome was not proved in 21% of patients with HGSIL. A multiple infection with different HPV types is more often found in patients with LGSIL than in those diagnosed with HGSIL. This demonstrates the selection of high oncogenic types and their persistence during the course of carcinoma progression.

Correlation between atypical colposcopy findings and detection of human papillomavirus (HPV) infection of the uterine cervix.

Reports on the detection of genome human papillomaviruses (HPV) in genital neoplasia differ to a great extent either in the overall prevalence or in the frequency of certain types. The aim of the study was to determine the correlation between the HPV infection and the occurrence of premalignant and malignant diseases of the uterine cervix and to investigate the ratio between clinical features and infection findings starting from the assumption that infection by human papillomaviruses is a key factor in the occurrence of premalignant and malignant disease of the uterine cervix. The investigation was carried out on 48 patients who formed the study group (Group I). Based on suspicious colposcopy findings, a Papanicolaou (Pap) smear and biopsy were performed and a histopathological analysis of the sample was carried out. A cervical smear was done on all the patients for HPV detection and typing. The patients in whom HPV infection was not found formed a control group (C Group). In spite of certain divergences it has not been proved that the ratio between colposcopy findings and HPV type has any statistical importance (chi2 = 3.305; p > 0.05). The distribution of Pap smear results did not shown a significant difference with respect to HPV type (chi2 = 0.105; p > 0.05). When the data are analyzed the diagnosis of low-grade squamous intraepithelial lesions (LGSIL) is evident in 20% of the HPV cases whereas it is significantly lower with respect to the group where HPV was not detected (42.5%). Histopathological (HP) findings of a high-grade squamous intraepithelial lesions (HGSIL) in both groups are diagnosed in approximately the same percentage while 6.7% of cancer in situ was registered in the group of HPV positive patients. Based on this it can be concluded that if a diagnosis of LGSIL or HGSIL in particular has been made on the basis of HP findings there is a great probability that the infection was due to one or more joined types of human papillomaviruses.

Epidemiology and diagnosis of sarcocystosis.

The studies included a total of 788 swine, of which 395 animals were raised on state farms and 393 on privately owned farms. Using artificial digestion (by trypsin) of diaphragm muscles, cystozoites were detected in 193 swine; 24.49% out of 788 animals examined. Among the 395 swine raised on state farms, the presence of cystozoites was demonstrated in 63 (15.95%) of the animals, while in 393 swine from privately-owned farms, cystozoites were found in 130 (33.07%) of those examined. By histological methods cystozoites were detected in 43 swine (18.14%) of the tested animals.

The effect of adding copper onto Lippes Loop IUDs: results from a ten-year study in Yugoslavia.

The present study is the first randomized ten-year comparison of the standard, non-medicated Lippes Loop D and the same device with the addition of 200 mm2 of copper in the form of copper sleeves. The devices were randomly inserted immediately after first trimester medical termination of pregnancy. Out of 400 postabortal IUD insertions, 371 were followed for up to ten years. Gross cumulative life-table accidental pregnancy rates after one year of use were 0.56 for the copper-bearing Lippes Loop and 4.63 for the standard Lippes Loop. After two, four and ten years, these rates were 1.24, 2.70 and 3.62 and 6.03, 7.58 and 14.94, respectively (in all comparisons, rates were significantly different at the 0.05 level or lower). At each time interval, expulsion/displacement rates were 4.49, 4.49, 5.23 and 6.32 for the copper-bearing Lippes Loop and 12.61, 13.29, 15.46 and 19.79 for the standard Lippes Loop (rates were significantly different at the 0.01 level or lower). Differences in removal rates for bleeding and/or pain were not significantly different at any of the follow-up intervals. The lower event rates for copper-bearing Lippes Loop D users indicates that the addition of copper to the Lippes Loop IUD may result in better long-term efficacy profiles for this device among postabortal women. The results also suggest that large, medicated IUDs may be more efficacious for women with larger uteri who often experience higher failure rates due to expulsion or displacement of smaller IUDs into the lower uterine segment.

[Prevention of rheumatic heart defects]. / Preventiva reumatskih srcanih mana.

The study concerned the effect of incomplete or omitted secondary prophylaxis on the onset of rheumatic heart disease as well as the effect of organized secondary prophylaxis on prevention of their Appearance. Of 142 patients with rheumatic heart disease as a result of previous rheumatic fever 39 (27.5%) were on incomplete secondary prophylaxis during one year and 103 (72.5%) had no prophylaxis. As consequence of incomplete or omitted prophylaxis recurrence of rheumatic fever appeared in a high percentage (30.7 of incomplete secondary prophylaxis and 63.1% of omitted prophylaxis). Incomplete and omitted prophylaxis with frequent rheumatic fever recurrence were the main cause of the onset of rheumatic heart disease and invalidism of the Ist IInd degree. On the contrary, during organized secondary prophylaxis the following results were obtained in 224 patients with rheumatic fever (with the average follow-up of 5.8 years): no recurrence of rheumatic fever was registered in patients on regular prophylaxis; in patients on irregular prophylaxis recurrence was noted in 12.2% of patients. In 8 subjects who refused secondary prophylaxis recurrence was established was established in 50% of cases. Of 224 patients with the Ist attack of rheumatic fever during organized secondary prophylaxis rheumatic heart disease were found in 5.35% of patients and in 10% of individuals with rheumatic fever and carditis (112 cases). The organized secondary prophylaxis, introduced in Serbia in 1974, is a reliable and tested procedure in the prevention and gradual eradication of rheumatic heart disease.

[Reactive Yersinia arthritis]. / Reaktivni jersinija artritis.

Yersinia enterocolitica is the cause of acute enteritis in 2 to 3 per cent of cases. In adults it can be a "trigger" of reactive arthritis. Reactive arthritis is characterised by the appearance of sterile arthritis immediately after or during the infection outside the locomotor apparatus. Antibodies for 03 serotype were examined in Yersinia serum in hospitalized patients with the clinical picture of reactive arthritis, because Yersinia, as an intestinal infection provoked by this serotype, is usually the "trigger" of Yersinia reactive arthritis. The antibody titre of 1/160 was found in 33.7 per cent of examined 70 patients, and in 5.8 per cent of that in the control group. Clinical manifestations of reactive arthritis in the group of patients with Yersinia positive antibodies were examined. They were compared with group of patients with Yersinia negative antibodies in the serum.

[The Jones diagnostic criteria for rheumatic fever]. / Jonesovi dijagnozni kriterijumi u reumatskoj groznici.

The apparent fall of rheumatic fever incidence in developed countries and in Yugoslavia is one of the reasons of negligence of the diagnosis of this disease. This fall was associated with mild forms of rheumatic fever (arthritis and mild forms of carditis are the main manifestations) where the beginning resembled other rheumatic disease. Consequently the problem of diagnosis of rheumatic fever is complicated. The early diagnosis of rheumatic fever is very important for the course of the disease, because appropriate measures (secondary prophylaxis) can prevent recurrence and severe rheumatic heart defects. The other disease recent increase of rheumatic fever incidence in the United States is the warning to other countries.