Antibiotic prophylaxis and inflammatory complications after Cesarean section

Introduction: Gynaecological and obstetric surgeries are high risk operations for the development of postoperative inflammatory complications due to the proximity of the genitourinary tract. The aim of this study was to compare the frequency of inflammatory complications in emergency or elective cases of caesarean sections as well as the frequency of complications related to the method of surgical treatment used.Methods: We analyzed inflammatory complications in 450 caesarean sections, which developed in a one year period from June 1st, 2000. to June 1st 2001. Patients were grouped according to the method of the surgery, and on emergency or elective case. Misgav Ladach or Dorfler surgical methods were used.Results: The most common inflammatory complication was wound infection and the most common risk factors for inflammatory complications were premature rupture of membranes and anemia.Conclusions: Long term use of one antibiotic was the most commonly implemented form of antibiotic prophylaxis

Motivation of health professionals and associates to perform daily job activities

Introduction: Motivation is one of the most complex elements of human behavior, it is the subject of debates by which we answer to the question of why someone behaves in a certain way. The aim of this study wasto examine the factors of motivation for health workers and staff in working with diffi cult patients in intensive care units and to evaluate implementation of motivation factors by managers in their daily work with a team of health professionals.Methods: The study was designed as prospective. It was conducted on 27 employees who work in intensive care units in Clinical Center of Sarajevo University. The survey questionnaire was used with a clear andconcise questions , aimed at testing the factors of motivation for daily work with diffi cult patients, as well as implementation of motivational factors by managers in the organizational unit (OU).Results: Respondents indicated that motivates them, good organization of work - 10 of them (37%), while 26% of respondents indicated that they are motivated by fi nancial gain. In our study 21 (77%) of respondentssaid that their managers infuenced the motivation for a better job. Mobbing at the workplace did not had 80% of respondents, while 8% of respondents stated that they had some form of mobbing, and 12% of respondents give partial response.Conclusions: The survey showed that most respondents have a good motivation factors for the performance of daily activities to work with diffi cult patients. As the main motivating factors respondents reportedgood organization of work, as well as positive examples of their managers

Pathomorphological Characteristics of Trophoblast and Serum Human Chorionic Gonadotropin Levels in Diagnosis of Partial Hydatidiform

Introduction: Partial molar trophoblast degeneration is a benign disease characterised by numerous complications such as an invasive mole and malignant alteration.Methods: This was a retrospective study which recruited 70 pregnant women diagnosed with hydatidiform mole or with physiological pregnancy spontaneously aborted. The pregnant women had similar demographic features and were included in two groups. 35 pregnant women with a molar pregnancy diagnosed during the first trimester were included in the study group; while 35 pregnant women with miscarriages during the fi rst trimester were included in the control group.Results: Examined trophoblast changes were: type of atypia, amount and mass of trophoblast proliferation. Specifi c β HCG serum levels were observed in all pregnant women before the treatment. Pregnantwomen in the study group had statistically signifi cant higher levels of β HCG serum in comparison with the control group (both average levels 60191.37±49662.75 and levels according to gestational age). Statisticallysignifi cant changes of villous trophoblast were observed by the pathomorphological analysis: mild trophoblast atypia (57.14%); pronounced trophoblast mass (45.71%) and mild trophoblast proliferationamount (51.43%).Conclusion: Serum β-HCG level measurements and pathomorphological analysis of chorionic villi are reliable and effective methods in a partial mole diagnostics

The possible role of tumor antigen CA 15-3, CEA and ferritin in malignant and benign disease

<strong>Introduction</strong>: Serum CA15-3 has been one of the most reliable tumor markers used in monitoring of breast cancer patients. To increase its sensitivity, the combined measurement of other tumor markers (CEA and ferritin) with CA15-3 was investigated. The aim of this study was determination of CA 15-3, CEA and ferritin in female patients with breast cancer, lung cancer and mastitis<br /><strong>Methods</strong>: 300 patients with carcinoma, hospitalized at Department of Gynecologic Oncology and Department for Oncology at the University Clinics Center of Sarajevo and 200 healthy subjects were compared.<br /><strong>Results</strong>: In patients with breast cancer the mean value of tumor markers were CEA 155.61 ng/mL, CA 15-3 106.38 U/mL and ferritin 197.03 ng/mL. In patients with lung cancer CEA was 58.97 ng/ml, CA 15-3 40.62 U/<br />mL and ferritin 544.16 ng/mL. Patients with mastitis had CEA 5.17 ng/mL, CA 15-3 112.67 U/mL and ferritin 174.92 ng/mL. The control group had values of tumor markers CEA 1.62 ng/mL, CA 15-3 11.72 U/mL and ferritin 85.35 ng/mL. We found good correlation between CA 15-3 and CEA correlation coeffi cient was r = 0.750. There was a low correlation between CA 15-3 and ferritin with correlation coeffi cient r = 0.274.<br /><strong>Conclusions:</strong> The CA 15-3 and CEA are useful markers in patients with confi rmed diagnosis of breast and lung cancers. The ferritin concentration has not increased in patients with breast cancer but it increased in<br />lung patients. The future study has to make investigations of tumor markers and ferritin in different stage of breast cancer

Monitoring changes in serum 8-isoprostane concentration as a possible marker of oxidative stress in pregnancy

Introduction: Oxidative stress represents a pathophysiological mechanism lying behind occurrence of different acute and chronic diseases. Pregnancy, mainly due to placenta rich with mitochondria, is also being associated with the state of oxidative stress. Numerous markers have been proposed in order to test oxidative stress in pregnancy state, one of them being 8-isoprostane. The aim of this study was to analyse serum concentrations of 8-isoprostane as a possible oxidative stress marker in pregnancy. Methods: Serum concentrations of 8-isoprostane were measured in overall population of 84 woman, between 20 and 30 years of age. Tested population was divided in 2 groups: 42 pregnant woman were classifi ed as being either in the fi rst or second trimester of pregnancy. In the control group healthy nonpregnant women were included. Concentration of 8-isoprostane in serum was determined by commercial 8-isoprostane EIA test kit of Cayman Chemical Company, USA. Results: The 8-isoprostane levels were signifi cantly increased in pregnant women in relation to healthy non pregnant women (p<0.05). The 8-isoprostane levels were signifi cantly increased in second and third trimester of pregnancy (p<0.05). Conclusions: According to the obtained results, 8-isoprostane might be used as a possible marker of oxidative stress in pregnancy state, but not as a biomarker for the risk of complications development in pregnancy in analysed population

Pathomorphological Characteristics of Trophoblast and Serum Human Chorionic Gonadotropin Levels in Diagnosis of Partial Hydatidiform

Introduction: Partial molar trophoblast degeneration is a benign disease characterised by numerous complications such as an invasive mole and malignant alteration. Methods: This was a retrospective study which recruited 70 pregnant women diagnosed with hydatidiform mole or with physiological pregnancy spontaneously aborted. The pregnant women had similar demographic features and were included in two groups. 35 pregnant women with a molar pregnancy diagnosed during the first trimester were included in the study group; while 35 pregnant women with miscarriages during the fi rst trimester were included in the control group. Results: Examined trophoblast changes were: type of atypia, amount and mass of trophoblast proliferation. Specifi c β HCG serum levels were observed in all pregnant women before the treatment. Pregnant women in the study group had statistically signifi cant higher levels of β HCG serum in comparison with the control group (both average levels 60191.37±49662.75 and levels according to gestational age). Statistically signifi cant changes of villous trophoblast were observed by the pathomorphological analysis: mild trophoblast atypia (57.14%); pronounced trophoblast mass (45.71%) and mild trophoblast proliferation amount (51.43%). Conclusion: Serum β-HCG level measurements and pathomorphological analysis of chorionic villi are reliable and effective methods in a partial mole diagnostics

Abnormal colposcopic images in patients with preinvasive cervical lesions

Introduction: The objective of the study was to determine frequency and to compare frequency of the abnormal colposcopic images in patients with low and high grade pre-invasive lesions of cervix.Methods: Study includes 259 patients, whom colposcopic and cytological examination of cervix was done. The experimental group of patients consisted of patents with pre-invasive low grade squamousintraepithelial lesion (LSIL) and high grade squamous intraepithelial lesion (HSIL), and the control group consisted of patients without cervical intraepithelial neoplasia (CIN).Results: In comparison to the total number of satisfactory fi ndings (N=259), pathological findings were registered in N=113 (43.6 %) and abnormal colposcopic fi ndings in N=128 (49.4%). The study did notinclude patients with unsatisfactory fi nding N=22 (8.5%). Abnormal colposcopic image is present most frequently in older patients but there are no statistically important difference between age categories(Pearson Chi-Square 0.47, df -3, p=0.923). Frequency of abnormal colposcopic fi ndings (N=128) is the biggest in pathological cytological (N=113) and HSIL 58 (45.3%), LSIL 36 (28.1%). There is statisticallysignifi cant difference in frequency of abnormal colposcopic images in patients with low-grade in comparison to patients with high-grade pre-invasive cervix lesions (Chi-Square test, Pearson Chi-Square 117.14,df-12 pConclusion: Thanks to characteristic colposcopic images, abnormal epithelium is successfully recognized, but the severity grade of intraepithelial lesion cannot be determined

Pathomorphological Characteristics of Trophoblast and Serum Human Chorionic Gonadotropin Levels in Diagnosis of Partial Hydatidiform

Introduction: Partial molar trophoblast degeneration is a benign disease characterised by numerous complications such as an invasive mole and malignant alteration.Methods: This was a retrospective study which recruited 70 pregnant women diagnosed with hydatidiform mole or with physiological pregnancy spontaneously aborted. The pregnant women had similar demographic features and were included in two groups. 35 pregnant women with a molar pregnancy diagnosed during the first trimester were included in the study group; while 35 pregnant women with miscarriages during the fi rst trimester were included in the control group.Results: Examined trophoblast changes were: type of atypia, amount and mass of trophoblast proliferation. Specifi c β HCG serum levels were observed in all pregnant women before the treatment. Pregnantwomen in the study group had statistically signifi cant higher levels of β HCG serum in comparison with the control group (both average levels 60191.37±49662.75 and levels according to gestational age). Statisticallysignifi cant changes of villous trophoblast were observed by the pathomorphological analysis: mild trophoblast atypia (57.14%); pronounced trophoblast mass (45.71%) and mild trophoblast proliferationamount (51.43%).Conclusion: Serum β-HCG level measurements and pathomorphological analysis of chorionic villi are reliable and effective methods in a partial mole diagnostics

Antibiotic prophylaxis and inflammatory complications after Cesarean section

Introduction: Gynaecological and obstetric surgeries are high risk operations for the development of postoperative inflammatory complications due to the proximity of the genitourinary tract. The aim of this study was to compare the frequency of inflammatory complications in emergency or elective cases of caesarean sections as well as the frequency of complications related to the method of surgical treatment used. Methods: We analyzed inflammatory complications in 450 caesarean sections, which developed in a one year period from June 1st, 2000. to June 1st 2001. Patients were grouped according to the method of the surgery, and on emergency or elective case. Misgav Ladach or Dorfler surgical methods were used. Results: The most common inflammatory complication was wound infection and the most common risk factors for inflammatory complications were premature rupture of membranes and anemia. Conclusions: Long term use of one antibiotic was the most commonly implemented form of antibiotic prophylaxis

Doppler measurements of feto-placental blood stream in pregnant smokers

Introduction: Doppler analysis of the feto-placental and fetal circulation give dynamic information on the condition of the bloodstream during pregnancy, and early detection of fetal hypoxia. The objectives of the study were: testing whether there is influence of smoking on feto-placental circulation; determining whether there is a link to a number of smoked cigarettes during the day; assessing the benefits of Doppler ultrasonographic screening in detection of fetal hypoxia in pregnant women who smoke during pregnancy.Methods: 300 pregnancies were included in the prospective research. With regard to a number of smoked cigarettes the pregnant women were divided into three groups: I. the first group (moderate smokers) consisted of 100 pregnant women who smoked up to 15 cigarettes a day during pregnancy; II. the second group (heavy smokers) 100 pregnant women who smoked more than 15 cigarettes a day during pregnancy and III. the third group (control group) 100 pregnant women who did not smoke during pregnancy. All pregnant women underwent Doppler measurements of blood circulation (determination of resistance index – RI) in the umbilical artery, fetal aorta and middle cerebral artery.Results: The intensity of smoking has influence to circulation because RI in the umbilical artery and fetal aorta is increased and RI is decreased in the middle cerebral artery in pregnant women heavy smokers in comparison to pregnant women moderate smokers.Conclusion: Doppler sonography of the blood vessels could have an important role in detection of hypoxia and monitoring of the condition of the fetus of pregnant women who smoked during pregnancy