Short-term dexamethasone plus acetylsalicylic acid treatment during in vitro fertilization procedure

Objectives: Embryo implantation represents the major limiting step during in vitro fertilization (IVF) procedure. Immu- nological and coagulation abnormalities were shown to have a substantial part in multifactorial etiology of IVF failure. We aimed to investigate the effect of short-term low-dose dexamethasone plus acetylsalicylic acid (ASA) treatment, starting at the time of embryo transfer, on the implantation and clinical pregnancy rates in general IVF population.  Material and methods: Out of 233 consecutive patients undergoing fresh IVF/intracytoplasmic sperm injection (ICSI) cycles 64 received an adjuvant treatment consisting of dexamethasone (0.5 mg/day) plus ASA (100 mg/day) (DA group), starting on the day of embryo transfer. Patients not receiving these medications comprised a control group.  Results: Significantly more patients in DA group had positive ß-hCG values than controls (59.38% vs. 37.67%, p = 0.004) (OR = 2.42, 95% CI: 1.33–4.41). Implantation rate was 26.53% in DA group and 15.92% in controls (p = 0.0294). Clinical preg- nancy rate per started cycle was higher in DA group (43.59%) than controls (28.92%), but the difference was not significant (p = 0.0879; OR = 1.99, 95% CI: 0.89–4.41).  Conclusions: Our study shows a potential benefit of dexamethasone plus ASA adjuvant treatment in females undergoing IVF/ICSI procedure. As these results show improvement of IVF outcome, a greater number of patients undergoing this type and regime of adjuvant treatment should be investigated.

BALKAN ENDEMIC NEPHROPATHY AND MALIGNANT UROTHELIAL TUMORS

One of the features of Balcan endemic nephropathy (BEN) is higher frequency of urothelium malignant tumors, primarily of pyelon (Mtp) and urether (Mtu). Jablanica region is known for the presence of endemic, hypoendemic and non-endemic areas with BEN. The aim of our research was to analyze the appearance of MTUi n endemic settlements of Jablanica region with BEN and to see what the relation of tumor frequency between endemic and non-endemic settlements is. The appearance of MTU was analyzed on the basis of operative protocol data of Urology department, The Health Center in Leskovac and Urology Clinic of The Clinical Center in Nis for the period from 1978 to 2002. We collected data about our patiens regarding their sex, age, the place of living and the place of birth. In order to make classification of settlements we used data of the Institute for Nephrology and hemodialysis (INH) in Nis. Data on total number of population living in these settlements were obtained from the official registration data published in 1981 and 1991. The incidence rate was calculated in the sample of 100,000 people.The average annual incidence rate (AAIR) of MTU in endemic settlements for the considered period is 37.82 (tumors of urether and pyelon - 17.56; malignant tumors of urinary bladder (MTUB 20.26); in hypoendemic settlements the rate is 13.28 (MTp and Mtu - 5.06; MTUB - 8.22); and in non-endemic urban settlements it is 7.35 (Mtu and MTp - 1.04, MTUB - 6.31).AAIR of MTU in endemic areas is 2.85 times higher when compared to hypoendemic areas; it is 6.75 times higher than in non-endemic urban areas, and 5.15 times higher than the rate of non-endemic rural areas. Mtu and MTp are 18.68 times more frequent in endemic settlements than in non-endemic urban areas and 3.47 times more frequent when compared to hypoendemic settlements. The linear trend of the diseased from MTp and MTu in endemic areas of Jablanica region for 25-year period was slowly decreasing according to statistics (y= -0.0054x + 0.59; r2=0.0031.High frequency of Mtu, primarily of Mtu and MTp in areas with BEN, probably points to the common nephropathogenic and cancerogenic etiologic factor, confirming thus the existence of positive correlation between BEN and malignant tumors of upper urothelium (MTUU)

EFFECT OF PUTRESCINE ON INTENSITY OF LIPID PEROXIDATION IN RATS’ BRAIN WITH CHOLESTASIS

Encephalopathy in cholestasis results from accumulation of unconjugated bilirubin (UCB) and hydrophobic bile acids (BA). Toxic BA and UCB induces neurotoxicity (apoptosis of neurons). Putrescine, spermidine and spermine are endogenous polyamines essential for cellular growth, regeneration and differen-tiation. Beneficial effects of putrescine in CNS injury have been attributed to anti-apoptotic ant anti-oxidant properties.The aim of the study was to examine the effect of putrescine at the level of lipid peroxidation in cholestatic brain injury.Wistar rats were divided into 5 groups: I-control, II-sham operated rats, III-treated only with putrescine, IV-bile duct ligated (BDL) rats, V-BDL rats treated with putrescine (150mg/kg BW ip.). The animals were sacrificed after the 9 -day treatment.Administration of putrescine in BDL rats reduces concentration of blood plasma UCB and BA (29.2±3.3 vs. 43.6±5.9 μmol/l and 11.4±0.8 vs. 22.8±2.6 μmol/l; p < 0.001). The lipid peroxidation (MDA) was increased in brain of BDL rats (4.98±0.54 vs. sham operated rats 3.99±0.32 nmol/mg prot; p < 0.001). Putrescine decreased MDA level in brain of V group vs. IV group rats (2.25±0.42 vs. 4.98±0.54 nmol/mg p; p < 0.001). The amplification of cerebral activity of polyamine oxidase (PAO) in BDL rats (1.25±0.09 vs. sham operated rats 0.81±0.09 U/mg prot; p < 0.001), resulted in high local concentrations of 3-acetamidopropanol and H2O2 which lead to oxidative stress and cell death. Administration of putrescine of BDL rats, decreased activity of cerebral PAO compared with BDL rats (1.02±0.07 vs. 1.25±0.09 U/mg prot; p < 0.001).Administration of putrescine in BDL rats results in normalization of cerebral oxidative stress and has protective role after the CNS injury in cholestasis