Infertility is a multidimensional developmental crisis of the individual, couple, family and the population as a whole. This study concentrates on the psychological aspects of infertility treatment ...by in vitro fertilization (IVF). The aim of this study was to examine a connection between certain psychological factors - anxiety, depression, motivation for parenthood, styles of coping with stress - and the outcome of IVF.
The study included 100 primarily infertile women aged 23-38 years, who underwent IVF procedure for the first time, at the Department of Gynaecology and Obstetrics of University Hospital Centre Zagreb. Regarding the outcome of IVF, they were divided into two groups, those with positive outcome (N=50), and those with negative outcome of IVF (N=50). We have applied: general data questionnaire, Parenthood motivation scale, COPE Inventory, and Depression, Anxiety, Stress Scales - 21.
The dimension of motivation for parenthood Relationship and the styles of coping with stress Seeking emotional support, Planning and Active coping proved to be statistically significant predictors of IVF outcome. By increasing the results on the relationship, seeking emotional support and planning subscales, the likelihood of negative outcome was increased. By increasing the results on the active coping subscale, the likelihood of positive outcome was increased. Anxiety and depression symptoms did not prove to be statistically significant predictors of the IVF outcome.
The role of psychological factors is important for understanding the diagnosis and treatment of infertility. They also provide the basis for creating guidelines for specific preventive and educational programs and for special forms of psychological counselling for individuals facing infertility.
This study evaluates the interaction of toxic elements cadmium (Cd) and lead (Pb) due to exposure from cigarette smoking, essential elements, and steroidogenesis in the maternal–placental–fetal unit. ...In a cohort of 155 healthy, postpartum women with vaginal term deliveries in clinical hospitals in Zagreb, Croatia, samples of maternal blood/serum and urine, placental tissue, and umbilical cord blood/serum were collected at childbirth. The biomarkers determined were concentrations of Cd, Pb, iron (Fe), zinc (Zn), copper (Cu), and selenium (Se), and steroid hormones progesterone and estradiol in maternal and umbilical cord blood and the placenta. Three study groups were designated based on self-reported data on cigarette smoking habits and confirmed by urine cotinine levels: never smokers (n = 71), former smokers (n = 48), and active smokers (n = 36). Metal(loid)s, steroid hormones, urine cotinine, and creatinine levels were analyzed by ICP–MS, ELISA, GC–MS, and spectrophotometry. Cigarette smoking during pregnancy was associated with increased Cd levels in maternal, placental, and fetal compartments, Pb in the placenta, and with decreased Fe in the placenta. In active smokers, decreased progesterone and estradiol concentrations in cord blood serum were found, while sex steroid hormones did not change in either maternal serum or placenta. This study provides further evidence regarding toxic and essential metal(loid) interactions during prenatal life, and new data on sex steroid disruption in cord serum related to cigarette smoking. The results indicate that umbilical cord sex steroid levels may be a putative early marker of developmental origins of the future burden of disease related to harmful prenatal exposure to cigarette smoke.
The effect of maternal smoking as a source of exposure to toxic metals Cd and Pb on superoxide dismutase (SOD) and glutathione peroxidase (GPx) activity, metallothionein (MT), Cd, Pb, Cu, Fe, Mn, Se ...and Zn concentrations were assessed in maternal and umbilical cord blood and placenta in 74 healthy mother-newborn pairs after term delivery. Sparse discriminant analysis (SDA) was used to identify elements with the strongest impact on the SOD, GPx and MT in the measured compartments, which was then quantified by multiple regression analysis. SOD activity was lower in maternal and cord plasma, and higher in the placenta of smokers compared to non-smokers, whereas GPx activity and MT concentration did not differ between the groups. Although active smoking during pregnancy contributed to higher maternal Cd and Pb concentrations, its contribution to the variability of SOD, GPx or MT after control for other elements identified by SDA was not significant. However, an impaired balance in the antioxidant defence observed in the conditions of relatively low-to-moderate exposure levels to Cd and Pb could contribute to an increased susceptibility of offspring to oxidative stress and risk of disease development later in life. Further study on a larger number of subjects will help to better understand complex interactions between exposure to toxic elements and oxidative stress related to maternal cigarette smoking.
Uvod: Smrtnost sepse je visoka usprkos antimikrobnim lijekovima, stoga se ispituju imunomodulatorni lijekovi,
između ostalih i statini.
Cilj: Pokazati imaju li bolesnici prethodno liječeni statinima ...lakši klinički oblik i manju smrtnost sepse.
Ustroj: Retrospektivno kohortno, opservacijsko istraživanje, usporedba prethodno liječenih i prethodno neliječenih statinima.
Ispitanici: Sepsa iz opće populacije, bakterijski izolat iz hemokultura, dob ≥ 50 god.
Rezultati: Uključeno 899 bolesnika, 116 (12.9%) prethodno liječenih statinima. Bez statistički značajnih razlika u izraženosti parametara sustavnog upalnog odgovora. Medijan SOFA zbroja u prethodno liječenih statinima iznosio je 2.0 kao i u skupini prethodno neliječenih (p=0.117). Ukupna smrtnost 9.2%, prethodno liječeni 6.0%, prethodno neliječeni 9.7%, (p=0.231). Nema razlike u 28-dnevnoj smrtnosti (log-rank test, p=0.693).
Zaključak: Nema statistički značajne razlike u težini kliničke slike kao ni u smrtnosti sepse između bolesnika prethodno liječenih i prethodno neliječenih statinima.
Usprkos znatnom napretku medicine smrtnost od sepse i danas je i dalje izrazito visoka. Stoga se ulažu velika sredstva u potrazi za novim lijekovima koji modificiraju upalni odgovor domaćina. Nakon ...provedenih eksperimentalnih istraživanja znanstvenici su dokazali protuupalna, imunomodulatorna i antikoagulacijska svojstva inhibitora 3-hidroksi-3-metil-glutaril koenzim A reduktaze, poznatijih pod nazivom statini, a koji se trenutno koriste za kontrolu hiperlipidemije i smatraju se korisnim u prevenciji kardiovaskularnih bolesti. Proveli smo sustavni pregled do sada objavljene literature o povezanosti prethodne uporabe statina sa smrtnošću i drugim kliničkim ishodima sepse iz opće populacije. Pretragom baze podataka PubMed pronađeno je osamnaest istraživanja, dvanaest kohortnih (pet prospektivnih, sedam retrospektivnih), pet randomiziranih kliničkih pokusa i jedno slučaj-kontrola istraživanje. Osam istraživanja ukazuju na povezanost prethodne uporabe statina i smanjene smrtnosti sepse, dok deset radova negira tu povezanost. Iako neke studije sugeriraju da statini imaju pozitivnu ulogu u liječenju bolesnika sa sepsom, većina takvih studija su retrospektivna i imaju metodoloških ograničenja. Zbog toga smatramo da su potrebne veće randomizirane kliničke studije koje bi omogućile donošenje konkretnih zaključaka o uvođenju terapije statinima u kliničku praksu liječenja sepse.
Abstract
Background
The migration of healthcare workers is attracting growing attention worldwide. Attitudes towards emigration develop over the years, and it is possible that, in addition to social ...factors, they are influenced by the characteristics of a person’s personality and the sense of belonging to the social environment. This study aimed to determine the tendencies of final-year medical students’ from Osijek, Croatia, towards emigration after graduation and after specialization, as well as their specialty preferences and to investigate whether introversion and ethnocentrism have an impact on attitudes toward leaving the country in search of employment elsewhere.
Methods
A cross-sectional study was conducted among final-year (6th year) medical students from Osijek, Croatia, in two consecutive academic years – 2014/2015 and 2015/2016. Students completed a questionnaire about sociodemographic characteristics, academic and scientific performance, preferences about their future medical career, the medical specialty of choice, emigration tendencies after graduation and specialization, ethnocentrism and introversion.
Results
There were 124 students who participated in the study (response rate: 96%). A quarter of participants agreed that they are likely or very likely to emigrate after graduation (25.0%) or after specialization (23.39%). Variables associated with the intention to emigrate were specialty preferences (students that prefer endocrinology and psychiatry had the highest emigration tendencies), academic year in which the participants were included (students included in 2014/2015 were more prone to emigrate after specialization, p = 0.060), prior involvement in scientific projects (students with experience in scientific projects expressed higher tendencies to emigrate after graduation, p = 0.023), and ethnocentrism (higher ethnocentrism was associated with a lower tendency towards emigration after specialization, Spearman’s rho = -0.191).
Conclusion
Our finding that a quarter of final-year medical students from the Faculty of Medicine Osijek were considering emigrating from Croatia in search of employment elsewhere after graduation or specialization is not as high as in previous Croatian studies or studies conducted in other European countries. Even though these data may be encouraging, considering the lack of physicians in Croatia, interventions are needed to prevent permanent emigration to protect the future functioning of the Croatian health system. Furthermore, our study did not find significant associations between levels of introversion and ethnocentrism and tendency to emigrate from Croatia. It seems that the phenomenon covering the emigration of students is more complex and influenced by many other factors which were not included in our study.
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