Implication of Tumor Necrosis Factor - Alpha in Preeclampsia

Introduction: Preeclampsia is an exacerbation of a generalized inflammatory response, physiologically present in the third trimester of pregnancy.Aim: The aim of the study consists in the evaluation of proinflammatory cytokine TNF-α in the context of preeclampsia. Material and Method: A transversal study was performed in three groups of patients: non-pregnant patients, patients with normal pregnancies in the third trimester, patients with preeclampsia. Serum TNF-α levels were determined using the immunometric sandwich EIA method.Results: The results obtained confirm a significant increase (p<0.01) in circulating TNF-α levels in the last trimester of pregnancy, compared to the non-pregnant status. Significantly increased serum TNF-α concentrations (p<0.001) were also found in pregnant patients with preeclampsia, compared to normotensive pregnant women. Conclusion: This proinflammatory cytokine can be a potential marker of the severity of the preeclamptic syndrome, without being an indicator of the fetal status at birth

An overview of innovation sources in SMEs

For SMEs, innovation should be embedded it in the organisational culture in order to enable the creation and integration of the physical and virtual worlds, for an enriched customer experience tailored to their needs. There is a myriad of innovation typologies and levels of analysis present in the literature emanating from many disciplines such as management, psychology, economics, sociology and science (Kristiansen 2012). This article focuses on innovation in order to identify and analyse the types and sources of innovation encountered for SMEs by applying different frameworks and perspectives

Lipid Parameters in Patients with Polycystic Ovary Syndrome

The purpose of our study was to investigate the lipid profile in patients with polycystic ovary syndrome (PCOS). Methods: a retrospective review of the medical records of female patients addressing for a consultation in a private healthcare network in Cluj-Napoca between 2009 and 2011 was performed. Patients with complete lipid profile and without previous treatment were included in the PCOS group. PCOS was diagnosed using Rotterdam criteria for PCOS. Healthy female patients matched for age but without PCOS were included in the control group. Results: Compared with healthy women, women with PCOS presented higher total cholesterol levels (mean difference = 27.5 mg/dl for total cholesterol, p = 0.004) and LDL-cholesterol (mean difference = 38.1 mg/dl, p < 0.001). HDL-cholesterol displayed lower levels in PCOS patients compared with healthy women (44.4±12.2 mg/dl vs. 50.5±12.2 mg/dl, p = 0.02). No difference was observed between groups in terms of triglycerides levels. In regression analysis both total cholesterol and LDL-cholesterol were positively associated only with the presence of PCOS (β = 0.30, p = 0.01 for total cholesterol, β = 0.44, p<0.001 for LDL-cholesterol). No association was observed between HDL-cholesterol levels and the presence of PCOS. Conclusion: The results of our study show that women with PCOS have altered lipid profile, with higher cholesterol levels (both total and LDL) and lower HDL cholesterol compared with healthy women. These lipid parameters were associated with the presence of PCOS and not with parameters describing body weight

Variation of Anti-inflammatory Cytokines in Relationship with Menopause

Aim. The aim of this study was to assess serum levels of the key anti-inflammatory cytokines in women of reproductive age and in pre and postmenopausal women. Material and Method. 175 women were enrolled and were divided into 5 groups (1 – Fertile women; 2 – Pre- and perimenopausal women; 3 – Postmenopausal women; 4 – Surgically-induced menopause; 5 – Chronic inflammation). Multiplex cytokine kits were used to evaluate serum levels of interleukin-4, -10 and -13. We determined the serum levels of follicle stimulating hormone, of luteinizing hormone, 17β-estradiol, progesterone, dehydroepiandrosterone and dehydroepiandrosterone sulfate using sandwich ELISA. Results. IL-4, IL-10 and IL-17 present a statistically significant decrease (p=0.00, p=0.00, respectively p=0.0053) in women with natural or surgically induced menopause (groups 3 and 4), compared with fertile women and premenopausal women (Groups 1, 2 and 5). Serum levels of IL-4 and IL-10 are significantly higher in fertile patients with associated chronic inflammatory diseases (133.5±1.314 pg/ml, respectively 6.406±13.47 pg/ml) than in fertile patients without chronic inflammatory diseases or premenopausal women (84.67±1.22 pg/ml, respectively 0.627±0.714). Conclusions. IL-4 and IL-10, together with IL-17, show significantly lower serum values in patients with natural or surgically induced menopause compared with patients of childbearing age or in premenopause. IL-4 and IL-10 show significantly higher serum values for patients of childbearing age presenting chronic inflammatory pathology compared with patients of childbearing age without chronic inflammatory pathology or premenopausal patients

Evaluation of Leukocytes and Neutrophils, Markers of Inflammatory Syndrome in Preeclampsia

Introduction: In pregnancies with preeclampsia, there is a generalized inflammatory response, which is much more intense than in normal pregnancy. Aim: To evaluate leukocytes and neutrophils in the serum of pregnant women with preeclampsia and to compare these values to normal pregnancy. To investigate a possible relation between the detected values and the severity of preeclamptic syndrome. Material and method: A transversal study was performed in three groups of patients: group 1 (preeclampsia), group 2 (normal pregnancy), group 3 (control). The samples were processed using a multichannel automated hematology analyzer – ACCOS 319. The results obtained were processed by descriptive and comparative statistical methods. Results: A significant increase in leukocyte and neutrophil values was found in preeclampsia compared to normal pregnancy. Also, for group 2 (PE), there was no correlation between the number of leukocytes, neutrophils, respectively, and SBP and uric acid values, but a significant correlation was found between the studied inflammatory markers and DBP values. Conclusions: Leukocyte and neutrophil values can be considered markers of the inflammatory syndrome present in preeclampsia. These parameters were positively correlated with DBP values

Plasma Lipocalin Concentrations in Relation to Visceral Fat, Risk Factor for Endometrial Cancer

Objective The study aims to evaluate the presence of a correlation between visceral fat assessed by ultrasonography and the plasmatic level of lipocalin in patients diagnosed with endometrial cancer. Material and Method The study is a case-control analysis including 2 groups of patients: group I – 44 patients diagnosed with endometrial cancer, group II – 44 patients without gynecological pathology or inflammatory disorders. After the clinical examination and anthropometric measurements, these patients underwent ultrasonography (US) examination, in view of determining the visceral fat. At the patients included in this study, we also determined the plasmatic levels for lipocalin. Results At the patients diagnosed with endometrial cancer, the intraabdominal fat area evaluated by US and the plasmatic level of lipocalin is significantly larger (p<0.0001) compared to the control group. A correlation was also found between the intraperitoneal fat area evaluated by US and the plasmatic level of lipocalin. Conclusions The measurement of the intraperitoneal fat by US in correlation with the plasmatic level of lipocalin can be a screening method for endometrial cancer in obese patients

Comparison of laparoscopic sacrocolpopexy with vaginal reconstructive procedures and abdominal sacrocolpopexy for the surgical management of vaginal vault prolapse: a systematic review and meta-analysis

IntroductionVaginal vault prolapse, also known as apical prolapse, is a distressing condition that may affect women following hysterectomy, necessitating surgical intervention when conservative measures prove ineffective. The surgical management of apical compartment prolapse includes procedures such as laparoscopic sacrocolpopexy (LSCP), abdominal sacrocolpopexy (ASCP) or vaginal reconstructive procedures (VRP). This systematic review and meta-analysis aims to compare the outcomes of these interventions.MethodsA comprehensive search of electronic databases was conducted to identify eligible studies. Fourteen studies comprising a total of 1,289 women were included. The selected studies were analyzed to evaluate outcomes such as duration of surgery, length of hospital stay, blood loss, complication rates, and patient satisfaction.ResultsLSCP did not demonstrate significant advantages over VRP in terms of perioperative or long-term outcomes. However, when compared to ASCP, LSCP showed shorter hospital stay, reduced blood loss, decreased postoperative pain, and lower rates of ileus.DiscussionThis systematic review contributes to evidence-based decision-making for the surgical treatment of vaginal vault prolapse. While LSCP did not exhibit substantial benefits over VRP, it emerged as a preferable option compared to ASCP due to shorter hospital stays and reduced postoperative complications. The findings from this study provide valuable insights for clinicians and patients in selecting the most appropriate surgical approach for vaginal vault prolapse. However, future research should focus on long-term follow-ups, standardizing outcomes, and outcome measures, and evaluating cost-effectiveness to further enhance clinical practice

The Impact of Monocyte to High-Density Lipoprotein Cholesterol Ratio on All-Cause and Cardiovascular Mortality in Patients with Transcatheter Aortic Valve Replacement

Background: Inflammation plays a significant role in the pathogenesis of aortic stenosis. This study aimed to investigate the prognostic value of the monocyte-HDL cholesterol ratio (MHR), a new inflammatory marker, in severe aortic stenosis (AS) patients who underwent transcatheter aortic valve replacement (TAVR). Methods: A total of 125 patients with severe AS who underwent TAVR were assessed. Clinical, echocardiographic and laboratory data relevant to the research were retrospectively obtained from the patients’ records. The MHR was determined by dividing the absolute monocyte count by the HDL-C value. The primary endpoints were overall and cardiovascular mortality. Results: During a median follow-up time of 39 months, primary endpoints were developed in 51 (40.8%) patients (overall mortality) and 21 (16.8%) patients (cardiovascular mortality). A receiver operating characteristic (ROC) analysis showed that by using a cut-off level of 16.16, the MHR predicted the all-cause mortality with a sensitivity of 50.9% and specificity of 89.1%. In predicting cardiovascular mortality, the MHR exhibited a sensitivity of 80.9% and specificity of 70.1% when a cut-off level of 13.56 was used. In the multivariate analysis, the MHR (p p = 0.018; 95% CI: 1.11–3.38) were found to be significant predictors of overall mortality. Conclusions: This study showed a significant elevation in the MHR among patients who experienced all-cause and cardiovascular mortality and this ratio emerged as an independent predictor of all-cause death in patients with severe AS undergoing TAVR