OBJECTIVE: To report a case of successful pregnancy and delivery after IVF and ET in a patient with Swyer syndrome. DESIGN: Case report. SETTING: Unit of Assisted Reproduction, Gynecology and ...Obstetrics Institute, University of Belgrade. PATIENT(S): A 30-year-old patient with 46,XY gonadal dysgenesis. INTERVENTION(S): Chromosomal analysis, diagnostic laparoscopy, IVF using donor oocytes, ET, and cesarean delivery. MAIN OUTCOME MEASURE(S): Successful pregnancy and live birth. RESULT(S): Successful treatment, pregnancy, and delivery. CONCLUSION(S): A patient with 46,XY gonadal dysgenesis in a donor oocyte program, can maintain a normal pregnancy and delivery.
Sarcoidosis is a granulomatous disease of unknown etiology that can affect almost any organ. Although the acute form can have spontaneous regression, a certain number of patients can have a chronic ...form, which leads to an increase in mortality and a decrease in the quality of life. Considering that the risk factors are still unknown, we wanted to compare the characteristics of patients with acute and chronic forms of sarcoidosis in Serbia in order to determine significant differences between them with hopes of contributing to everyday clinical practice. A total of 2380 patients treated in our clinic were enrolled in this study. They were separated into the following two groups: 1126 patients with acute form and 1254 patients with chronic form. They were further compared by gender, smoking status, radiological status, exposition, biomarkers for sarcoidosis, organ involvement, and other comorbidities; the distribution of patients according to regions of Serbia was also noted. Statistical significance was found in radiological findings (p < 0.001), biomarkers (calcium in 24 h urine p < 0.001; chitotriosidase p = 0.001), and the affliction of organs (p < 0.001). The differences noted in this paper could help improve our understanding of this disease.
The aim of this study was to investigate the association of trace element and toxic metal concentrations in blood and the outcome of in vitro fertilization (IVF). The study included 104 consecutive ...patients that underwent assisted reproductive technology (ART) procedures. The following parameters were determined: cadmium (Cd), mercury (Hg), arsenic (As), and lead (Pb); and copper (Cu), zinc (Zn), selenium (Se), and magnesium (Mg). Serum samples were obtained before commencing stimulation. Patients with smoking habit had significantly higher Pb concentrations (
P
= 0.022), as well as higher concentrations of As and Hg but not significantly. All subjects were divided into groups of pregnant and nonpregnant patients. Pregnant patients had lower mean values of Mg (
P
= 0.009), As (
P
< 0.05), and Pb (
P
= 0.034), compared to nonpregnant, and a significant correlation between pregnancy outcome and concentrations of Mg, Cd, and Pb was found. Women who had had delivered had lower Mg (
P
= 0.009) and Cd (
P
= 0.014) concentrations. There was a significant correlation of the negative outcome of IVF procedure with higher concentrations of Pb (
P
= 0.046) and Cd (
P
= 0.012). In conclusion, our results suggest that there is a difference in Mg, Pb, and Cd concentrations between pregnant and nonpregnant women. There was no association between toxic metals and number and quality of oocytes and embryos, while there was with fertilization rate. Concerning trace elements, we did not find the correlation of trace elements with oocyte number and quality, nor with a number of fertilized oocytes, except for Cu. Patients who were pregnant had lower concentrations of Mg.
This study aimed to examine if there is a connection between recombinant FSH dose and OS parameters in serum and the impact on IVF outcome.
This study consisted of 101 participants that went through ...IVF procedures. Parameter that were tested are SOD, SH groups and MDA. Serum samples were drawn before stimulation and on the last day of ovarian stimulation.
Two groups were formed according to the dose of gonadotropins (rFSH). In both groups there were no significant differences in live-birth rate and miscarriage. In both groups mean serum MDA and SH-groups were significantly higher after ovarian stimulation, but mean serum SOD was significantly lower when compared to values before stimulation. There were less patients without OS before stimulation.
Our results suggest that there is a difference in serum concentration in groups SOD, SH groups and MDA at the beginning and at the end ovarian stimulation. On the other hand, dose of rFSH is not related with change of parameters for oxidative stress, quality of oocytes, embryos, fertilization, pregnancies, and miscarriage rate. Patients without oxidative stress before the IVF procedure needed lower doses of gonadotropins during stimulation.
Aspergillosis encompasses a wide range of clinical conditions based on the interaction between
Aspergillu
s and the host. It ranges from colonization to invasive aspergillosis. The human lung ...provides an entry door for
Aspergillus
.
Aspergillus
has virulence characteristics such as conidia, rapid growth at body temperature, and the production of specific proteins, carbohydrates, and secondary metabolites that allow
A. fumigatus
to infiltrate the lung’s alveoli and cause invasive aspergillosis. Alveolar epithelial cells play an important role in both fungus clearance and immune cell recruitment via cytokine release. Although the innate immune system quickly clears conidia in immunocompetent hosts,
A. fumigatus
has evolved multiple virulence factors in order to escape immune response such as ROS detoxifying enzymes, the rodlet layer, DHN-melanin and toxins. Bacterial co-infections or interactions can alter the immune response, impact
Aspergillus
growth and virulence, enhance biofilm formation, confound diagnosis, and reduce treatment efficacy. The gut microbiome’s makeup influences pulmonary immune responses generated by
A. fumigatus
infection and vice versa. The real-time PCR for
Aspergillus
DNA detection might be a particularly useful tool to diagnose pulmonary aspergillosis. Metagenomics analyses allow quick and easy detection and identification of a great variety of fungi in different clinical samples, although optimization is still required particularly for the use of NGS techniques. This review will analyze the current state of aspergillosis in light of recent discoveries in the microbiota and mycobiota.
•Pregnancy-induced hypertension (PIH) is associated with increased risk of pre-term labour.•We have found that Kir6.1, a KATP channels subunit, is down-regulated in myometrium of parturient suffering ...from PIH.•As KATP channels are responsible for uterine quiescence during pregnancy, this explains increased risk of pre-term labour in PIH parturient.
It is generally accepted that activity of K+ channels maintain resting membrane potential and uterine quiescence during pregnancy, which is, at least in part, mediated by down-regulation of ATP-sensitive K+ (KATP) channels. Pregnancy-induced hypertension (PIH) is associated with pre-term and late pre-term labour. Here, we have used real time RT-PCR to compare mRNA levels of KATP channel subunits in PIH parturient and control parturient. We have found that Kir6.1, a pore forming, myometrial KATP channel subunit is down-regulated in PIH patients. This could perfectly explain increased rate of pre-term labour in patients suffering from PIH.
•sFlt-1/PlGF showed significant correlation with number of maternal complications.•An sFlt-1/PlGF cut-off of 377.0 was optimal for predicting maternal complications.•A 377.0 cut-off predicted ...complications with 75.0% sensitivity/ 92.3% specificity.•The sFlt-1/PlGF ROC curves showed superior predictive performance versus PIERS.•The final logistic regression model included sFlt-1/PlGF as sole predictor variable.
Assess soluble FMS-like tyrosine kinase-1/placental growth factor ratio (sFlt-1/PlGF) diagnostic accuracy for predicting adverse maternal outcome in patients with early severe preeclampsia, and whether its predictive performance is superior to full preeclampsia integrated estimate of risk score (PIERS).
Prospective study enrolled patients with early severe preeclampsia (defined by American College of Obstetricians and Gynaecologists 2013 guidelines) admitted to the Clinic for Obstetrics and Gynaecology, Clinical Center of Serbia intensive care unit. Patients underwent delivery to terminate preeclampsia within 48 h of admission. PIERS was generated and blood samples taken at admission. Multiple pregnancies and gestational ages outside 24–34 weeks were excluded. sFlt-1 and PlGF serum concentrations were measured using Elecsys® assays and cobas e 601 analyser. Maternal complications were recorded for seven days post-delivery.
Diagnostic accuracy (sensitivity and specificity), and predictive performance (receiver operating characteristic area under curve AUC) vs. PIERS, of sFlt-1/PlGF for predicting adverse maternal outcome.
Of 89 patients enrolled, 61 were evaluable. Median frequency of adverse maternal outcomes within seven days of delivery was two. Median sFlt-1/PlGF and PIERS were 521·0 and 5·0%, respectively. sFlt-1/PlGF showed greater correlation with complication number than PIERS (Spearman’s rho: 0·728 p < 0·001 and 0·134 p = 0·304, respectively). AUC for sFlt-1/PlGF and PIERS were 0·853 and 0·628, respectively. A 377·0 sFlt-1/PlGF cut-off was optimal for predicting complications (75·0% sensitivity; 92·3% specificity).
sFlt-1/PlGF correlated more closely with number of adverse maternal outcomes than PIERS, and was a superior predictor of maternal complications.
Our aim was to study the effect of GnRH agonist and antagonist protocols of ovarian stimulation on oxidative stress parameters in serum and the influence of oxidative stress parameters change on the ...outcome of IVF cycles.
This prospective study included 82 patients who underwent IVF procedures. We determined SOD, MDA and SH groups in serum. Serum samples were obtained between the second and fourth day of the cycle and on the day of HCG administration during ovarian stimulation.
Patients were divided into two groups depending on the protocol of stimulation. The mean total and mature oocytes number and number of fertilized oocytes were higher in GnRH agonist group. There was no significant difference in biochemical pregnancy, miscarriage and live-birth rate in both groups. Mean serum SOD was significantly lower, while mean serum MDA and SH groups were significantly higher after ovarian stimulation. Delivery rate was higher in patients without OS while miscarriage rate was higher in patients with OS.
Our study confirmed that there is a difference in the concentration of oxidative stress parameters before and after ovarian stimulation. IVF outcome is better in patients without OS after ovarian stimulation. However, the protocol of ovarian stimulation is neither associated with a change in oxidative stress parameters nor with the outcome of ART procedures.
Abstract
We present the case of rare extreme dislocation of subaxial cervical spine, which was challenging regarding type and time of surgery. A 22-year-old patient was injured in a traffic accident, ...from very beginning with signs of spinal shock. Severe traumatic C6/C7 dislocation with resulting transection of the spinal cord was diagnosed with MDCT imaging. The main dilemmas regarding the surgical treatment of this injury referred to the timing of surgery and the choice of surgical approach. We decided to perform posterior surgery at first stage. Postoperative her condition get worsening and on the 16th postoperative day came to the fatal outcome. Despite all the available protocols, in our case, the decision had to be made on the basis of individual multidisciplinary assessment, bearing in mind the mechanism of the injury and the clinical presentation of the injured patient.
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