Risk Perception About HIV Among University Students in One of the Last Hotspots for HIV Transmission in Europe.

BACKGROUND: HIV testing in the Northern Kosovo province is challenging, because the infrastructure is being rebuilt after the ethnic conflict. The purpose of this research was to examine self-perceived risk for acquiring HIV infection and factors associated with risk assessment among university students. METHODS: Students completed a questionnaire on socio-demographic data, knowledge about HIV prevention and transmission, attitudes toward people living with (PLHIV) and self-perceived risk for HIV infection. The self-perceived risk was categorized as low, unknown and high. RESULTS: The majority of students (72.5%) assessed their risk as low, 8.5% assessed their risk as high and 19.1% did not know their risk. Compared to low self-perceived risk, high self-perceived HIV risk was associated with being male, having lower knowledge about HIV prevention, less strong Segregation and protection attitude toward PLHIV, stronger Ignorance and indifference attitude toward PLHIV and positive opinion about gays/lesbians. Students who perceived own risk for acquiring HIV as high had lower knowledge about HIV transmission and prevention. However, those who were previously tested for HIV, despite their poorer knowledge about HIV prevention, assess their HIV-related risk as low. CONCLUSIONS: Students assessed their risk of HIV infection mostly as low. Still, lower knowledge of HIV prevention has been consistently associated with a high and unknown risk of HIV. Moreover, being ignorant and indifferent about PLHIV was associated with increased self-perceived HIV risk. These findings highlight the need for continuous specialized HIV-related education to reduce fear and stigma of PLHIV and HIV testing as well as risky behaviors.

Reproductive and Obstetric Outcomes after Fertility-Sparing Treatments for Cervical Cancer: Current Approach and Future Directions.

Cervical cancer is one of the leading causes of cancer-related death in women of reproductive age. The established fertility-sparing approaches for the management of early-stage cervical cancer for women who plan pregnancy are associated with a decline in fecundity and an increased risk of pregnancy complications. This article aims to offer an overview of fertility-sparing approaches and the management of potential subfertility and pregnancy complications after these treatments. An extensive search for the available data about infertility and cervical cancer, fertility-sparing techniques in patients with cervical cancer, fertility treatment, obstetrical complications, and pregnancy outcomes in cervical cancer patients was completed. Fertility-preserving procedures such as loop electrosurgical excision procedure (LEEP), cold-knife conization, and trachelectomy in women diagnosed with cervical cancer can be considered as safe and effective treatments that preserve reproductive potential. Current fertility-preserving procedures, based on the balance of the oncological characteristics of patients as well as their desire for reproduction, allow one to obtain acceptable reproductive and obstetric outcomes in women treated for cervical cancer. Nevertheless, careful monitoring of pregnancies obtained after fertility-preserving procedures is recommended, since this cohort of patients should be considered at higher risk compared with a healthy population.

Gestational Diabetes Mellitus and Antenatal Corticosteroid Therapy-A Narrative Review of Fetal and Neonatal Outcomes.

BACKGROUND: There, we review the pathogenesis of gestational diabetes mellitus (GDM), its influence on fetal physiology, and neonatal outcomes, as well as the usage of antenatal corticosteroid therapy (ACST) in pregnancies complicated by GDM. METHODS: MEDLINE and PubMed search was performed for the years 1990-2022, using a combination of keywords on such topics. According to the aim of the investigation, appropriate articles were identified and included in this narrative review. RESULTS: GDM is a multifactorial disease related to unwanted pregnancy course and outcomes. Although GDM has an influence on the fetal cardiovascular and nervous system, especially in preterm neonates, the usage of ACST in pregnancy must be considered taking into account maternal and fetal characteristics. CONCLUSIONS: GDM has no influence on neonatal outcomes after ACST introduction. The ACST usage must be personalized and considered according to its gestational age-specific effects on the developing fetus.

Biochemical Markers for Prediction of Hypertensive Disorders of Pregnancy.

BACKGROUND: Gestational hypertension (GH) and pre eclampsia (PE) are the most common gestational complications. Several placental biochemical markers are used to predict GH/PE, but with conflicting results. METHODS: The study aim was to estimate the biochemical markers' ability to predict hypertensive disorders in pregnancy. On the first ultrasonographic examination, 104 healthy pregnant women were recruited. At the regular pregnancy check-ups, BMI, blood pressure, occurrence of gestational hypertension (early or late onset), preeclampsia, eclampsia and other complications were recorded. Serum concentrations (in multiples of median - MoM) of human chorionic gonadotropin (HCG) and pregnancyassociated plasma protein A (PAPPA) were measured from the 11th to 14th gestational week, while HCG, alpha feto protein (AFP), estriol and inhibin were determined between the 16th and 19th gestational week. RESULTS: Hypertensive disorders throughout pregnancy were diagnosed in 20.2% women. Early-onset GH was registered in 7 and PE in 6 patients, while 14 had late-onset GH and 10 additional women PE. There were no significant differences (p≥0.05) in biochemical markers concentrations between women with and without GH/PE. PAPPA levels in the first and HCG in the second trimester correlated with early and late GH/PE. Moreover, higher AFP concentrations were registered in women with preeclampsia signs/symptoms. According to ROC analysis, AFP>1.05 MoM properly identified 80% of GH/PE cases. Obtained models imply that HCG, PAPPA and AFP should be used for GH/PE prediction. CONCLUSIONS: Biochemical markers HCG, PAPPA and AFP could be useful in predicting gestational hypertension and preeclampsia. However, different markers should be used for early and late onset GH/PE.

First trimester ultrasonographic parameters in prediction of the course and outcome of monochorionic twin pregnancies.

BACKGROUND/AIM: The aim of the study was to evaluate the association and the potential predictive value of first trimester ultrasonographic parameters on the course and outcome of monochorionic diamniotic twin pregnancies. MATERIALS AND METHODS: A prospective cohort study was undertaken of 39 healthy women with consecutive monochorionic diamniotic twin pregnancies. During first-trimester screening, crown-rump length (CRL) and nuchal translucency (NT) were measured. The intertwin discordance in CRL and NT was determined. As pregnancy outcomes we assessed twins' live-born rates, Apgar scores, birth weight, pregnancy complications, and gestational week of delivery. RESULTS: None of the assessed pregnancy outcomes significantly correlated with standard CRL discordance ≥10%. The newly established cut-off was 3.75 mm for CRL and 1.3 mm for NT. Monochorionic diamniotic twins were delivered in a later gestational week and had better chance of survival if CRL intertwin difference was <3.75 mm. Apgar scores significantly negatively correlated only with NT of corresponding twins. When intertwin NT difference was ≥1.3 mm, twins had lower birth weight and pregnancy complications were more frequent. Regression models show that intertwin CRL difference <3.75 mm is a significant predictor of live-born monochorionic diamniotic twins. CONCLUSION: CRL and NT in monochorionic diamniotic twin pregnancies could indicate pregnancy complications and outcomes.

Correlation of biochemical parameters and neonatal outcome in patients with gestational hypertension.

Hypertensive disorders in pregnancy are one of the leading causes of maternal death in the world and one of the major causes of perinatal mortality. The incidence of hypertensive disorders in pregnancy is 8%-15%. Significant changes of biochemical parameters in cases of hypertensive disorders in pregnancy are increased levels of blood glucose, urea, creatinine, uric acid (hyperuricemia), transaminases, and LDH. The most increased is the level of proteinuria. Bad laboratory results and the intensification of clinical signs, with multiorgan dysfunction, are indications for termination of pregnancy.

Acute abdomen caused by adnexal torsion in the first trimester of pregnancy: a case report.

INTRODUCTION: Adnexal torsion is a rare cause of acute abdominal pain during pregnancy. The clinical and laboratory findings are non-specific. In this paper we present a case of adnexal torsion in the first trimester of pregnancy. CASE OUTLINE: On admission, the patient presented signs of acute abdomen.The pain started few hours prior to admission, and was predominantly localized, occasionally irradiating to the central parts of the lower abdomen, accompanied by nausea and vomiting. Ultrasound revealed viable intrauterine pregnancy and right adnexal mass with small amount of free fluid in the Douglas pouch. After short preoperative evaluation, laparotomy and adnexectomy were performed. Surgery and postoperative followup were uneventful, and histopathology reported torquated corpus luteum cysts. CONCLUSION: The diagnosis of adnexal torsion during pregnancy is difficult, and occasionally remains a diagnostic dilemma. Surgery is inevitable, must be prompt, and comprises adnexectomy.