Progesterone – induced blocking factor (PIBF) and Th1/Th2 cytokine in women with threatened spontaneous abortion

Objective: The aim of this prospective study was to compare serum and urine concentrations of progesterone-induced blocking factor (PIBF) and serum concentrations of anti-inflammatory (IL10) and pro-inflammatory (IL6, TNFα, IFNγ) cytokines of women with threatened spontaneous abortion with normal pregnancy and to evaluate the impact of PIBF on outcome of pregnancy. Methods: A sample of 30 women with threatened spontaneous abortion (study group) and 20 healthy pregnant women (control group) between 6th and 24th gestational weeks was studied. Serum and urine PIBF, IL10 and IL6, TNFα, IFNγ cytokine concentrations were measured by enzyme-linked immunosorbent assay (ELISA). Results: Five (16.7%) pregnancies in the study group ended missed abortion vs. none in the control group (P<0.05). Five (20%) threatened aborters delivered between 24th and 37th weeks of gestation, whereas two (10%) preterm deliveries occurred in the controls (P>0.05). PIBF concentrations in urine (19.5±12.9 ng/mL) and serum (214.4±120.6 of patients with threatened abortion were significantly lower than in healthy pregnant women (45.3±33.7 ng/mL and 357.3±159.9 ng/mL, respectively). Women with threatened abortion had significantly lower serum levels of anti-inflammatory cytokine, but levels of proinflammatory cytokines were higher in this group compared with healthy controls. Conclusions: Determination of progesteron-induced blocking factor level in body fluids in early pregnancy might be used for the diagnosis and prognosis of threatened abortion.Peer Reviewe

Impact of Runway Incursion on Air Traffic Satefy

Kontrolori zračnog prometa i piloti svojim postupcima i odlukama direktno utječu na sigurnost letenja, a njihove greške mogu dovesti do neodobrenog ulaska na uzletno-sletnu stazu. Ukoliko dođe do nezgode ili nesreće potrebno je napraviti analizu događaja kako bi se pronašla rješenja i spriječilo ponavljanje istih ili sličnih situacija. Događaji se klasificiraju po ozbiljnosti, a svaki neodobreni ulazak na uzletno-sletnu stazu, kao i događaj koji je na bilo koji način ugrozio sigurnost mora biti istražen. Kako bi klasifikacija događaja bila ispravna potrebno je imati dodatne podatke i informacije. Razvijanjem tehnologije uvode se novi sustavi uz pomoć kojih se poboljšala sigurnost zračnog prometa.Air traffic controllers and pilots with their actions and decisions directly affect safety and their mistakes can lead to runway incursions. In the event of accident or incident it is necessary to make analysis of the occurrence in order to find solutions and to prevent same or similar situations. Occurrence is classified by severity and every runway incursion as well as occurrence that can endanger safety in any way has to be investigated. It is necessary to have additional data and information so that classification could be correct. By developing technology new systems are being implemented that will help improve safety of air traffic

Heterotopna trudnoća kod prirodnog začeća – naše prvo iskustvo: prikaz slučaja

Heterotopic pregnancy refers to the presence of simultaneous pregnancies at two different implantation sites. Heterotopic pregnancy is rare, estimated to occur in 1 per 30,000 pregnancies. We report a case of a 27-year-old woman presented to the emergency department with the diagnosis of ruptured ectopic pregnancy. Careful ultrasound assessment indicated the diagnosis of heterotopic pregnancy. Right salpingectomy with removal of the hemoperitoneum and suction curettage were performed. Our operative diagnosis of heterotopic pregnancy was confirmed by histopathology. Heterotopic pregnancy can occur in the absence of any predisposing risk factors, and the detection of intrauterine pregnancy does not exclude the possibility of the simultaneous existence of ectopic pregnancy. Transvaginal ultrasound and assessment of the whole pelvis, even in the presence of intrauterine pregnancy, can be an important aid in the diagnosis of heterotopic pregnancy.Heterotopna trudnoća odnosi se na istodobnu prisutnost intrauterine i izvanmaterične trudnoće. Učestalost heterotopne trudnoće je 1 na 30.000 trudnoća. Prikazuje se slučaj 27-godišnje pacijentice koja se javila na hitni odjel s dijagnozom rupturirane ektopične trudnoće. Poslije pažljivog ultrazvučnog pregleda postavljena je dijagnoza heterotopne trudnoće. Napravljena je desna salpingektomija, uklanjanje hematoperitoneuma i vakuumska aspiracija intrauterine trudnoće. Naša operativna dijagnoza heterotopne trudnoće potvrđena je histopatološkim nalazom. Heterotopna trudnoća može se pojaviti u odsutnosti bilo kakvih predisponirajućih čimbenika rizika pa otkrivanje intrauterine trudnoće ne isključuje mogućnost istodobnog postojanja ektopične trudnoće. Transvaginalni ultrazvuk i pregled cijele zdjelice, čak i u prisutnosti intrauterine trudnoće, mogu znatno pomoći u dijagnostici heterotopne trudnoće

Impact of Runway Incursion on Air Traffic Satefy

Kontrolori zračnog prometa i piloti svojim postupcima i odlukama direktno utječu na sigurnost letenja, a njihove greške mogu dovesti do neodobrenog ulaska na uzletno-sletnu stazu. Ukoliko dođe do nezgode ili nesreće potrebno je napraviti analizu događaja kako bi se pronašla rješenja i spriječilo ponavljanje istih ili sličnih situacija. Događaji se klasificiraju po ozbiljnosti, a svaki neodobreni ulazak na uzletno-sletnu stazu, kao i događaj koji je na bilo koji način ugrozio sigurnost mora biti istražen. Kako bi klasifikacija događaja bila ispravna potrebno je imati dodatne podatke i informacije. Razvijanjem tehnologije uvode se novi sustavi uz pomoć kojih se poboljšala sigurnost zračnog prometa.Air traffic controllers and pilots with their actions and decisions directly affect safety and their mistakes can lead to runway incursions. In the event of accident or incident it is necessary to make analysis of the occurrence in order to find solutions and to prevent same or similar situations. Occurrence is classified by severity and every runway incursion as well as occurrence that can endanger safety in any way has to be investigated. It is necessary to have additional data and information so that classification could be correct. By developing technology new systems are being implemented that will help improve safety of air traffic

Impact of Runway Incursion on Air Traffic Satefy

Kontrolori zračnog prometa i piloti svojim postupcima i odlukama direktno utječu na sigurnost letenja, a njihove greške mogu dovesti do neodobrenog ulaska na uzletno-sletnu stazu. Ukoliko dođe do nezgode ili nesreće potrebno je napraviti analizu događaja kako bi se pronašla rješenja i spriječilo ponavljanje istih ili sličnih situacija. Događaji se klasificiraju po ozbiljnosti, a svaki neodobreni ulazak na uzletno-sletnu stazu, kao i događaj koji je na bilo koji način ugrozio sigurnost mora biti istražen. Kako bi klasifikacija događaja bila ispravna potrebno je imati dodatne podatke i informacije. Razvijanjem tehnologije uvode se novi sustavi uz pomoć kojih se poboljšala sigurnost zračnog prometa.Air traffic controllers and pilots with their actions and decisions directly affect safety and their mistakes can lead to runway incursions. In the event of accident or incident it is necessary to make analysis of the occurrence in order to find solutions and to prevent same or similar situations. Occurrence is classified by severity and every runway incursion as well as occurrence that can endanger safety in any way has to be investigated. It is necessary to have additional data and information so that classification could be correct. By developing technology new systems are being implemented that will help improve safety of air traffic

Utječu li hormon rasta i inzulinu sličan čimbenik rasta 1 na prognozu u bolesnika s akutnim infarktom miokarda klase killip I-II?

We investigated concentrations and roles of insulin-like growth factor 1 (IGF-1) and its binding protein (IGF1BP-3), growth hormone (GH), insulin, and markers of insulin resistance and inflammation in acute myocardial infarction (AMI). We aimed to assess any possible association between serum GH/IGF-1 axis following AMI and short-term survival rates. A follow up study was performed in 2010. Study group consisted of 75 patients with Killip I and II class AMI. There were 30 control subjects. Blood samples were obtained within 24 hours of admission and analyzed for the aforementioned hormones. Patients were followed-up during 6 months for new cardiac events. Median GH was higher in AMI (0.96; range 0.6-2.4) than in controls (0.26; p<0.001). IGF-1 was significantly lower in AMI (123 vs. 132; p<0.05), and so was the IGF-1/GH ratio (p<0.001) and IGF1BP-3. Insulin was higher in study group, but without statistical significance. However, we found significant between-group differences in other markers of insulin resistance (HbA1c, glycemia, HOMA-IR) and inflammation. Simple linear correlation showed positive correlation between GH and C-reactive protein. All patients with new cardiac events had IGF-1 below median and lower left ventricular ejection fraction. In conclusion, IGF-1 may affect outcome of AMI. GH resistance might be a result of inflammatory/immune response and therefore it could be a useful prognostic marker.Istraživali smo uloge inzulinu sličnog čimbenika rasta (IGF-1), njegovog vezujućeg proteina (IGF1BP-3), hormona rasta (growth hormone, GH), inzulina, biljega inzulinske rezistencije i upale u akutnom infarktu miokarda (AIM). Cilj je bio utvrditi utjecaj osovine IGF-1/GH na kratkoročnu prognozu AIM. U istraživanje provedeno tijekom 2010. godine bilo je uključeno 75 bolesnika s dijagnozom AIM (ispitna skupina) i 30 ispitanika kao kontrolna skupina. Uzorci krvi su uzimani unutar 24 h od prijma i potom analizirani na navedene hormone. Tijekom šestomjesečnog razdoblja pratili smo hoće li doći do pojave novih srčanih događaja; ultrazvučno se određivala ejekcijska frakcija (EF). Medijan GH bio je veći u skupini s AIM nego u kontrolnoj skupini (0,96 prema 0,26; p<0,001); medijan IGF-1 bio je znatno manji u ispitnoj skupini (123 prema 132; p<0,05), baš kao i omjer IGF-1/GH (p<0,001) i IGF-1BP-3. Inzulin je bio viši u ispitnoj skupini, ali razlika nije bila statistički značajna. Utvrđena je statistički značajna razlika u drugim glikemijskim parametrima (glukoza, HbA1c, HOMA IR) i nespecifičnim biljezima upale. Utvrdili smo pozitivnu linearnu korelaciju između GH i C-reaktivnog proteina. Svi bolesnici s novim koronarnim događajima imali su IGF-1 ispod medijana, te nižu EF. U zaključku, IGF-1 bi mogao utjecati na prognozu bolesnika s AIM. Rezistencija na GH je rezultat upalnog/imunog odgovora i mogla bi biti koristan prognostički biljeg

Betaferon u liječenju multiple skleroze

The aim of the study was to analyze the usefulness and side effects of treatment with interferon beta 1B (Betaferon) in patients with the relapsing-remitting form of multiple sclerosis (RRMS). The study included 32 RRMS patients that had completed two-year therapy with interferon beta 1B or were still receiving this therapy. Every six months, patients were clinically evaluated and scored by the Expanded Disability Status Scale (EDSS). Two-year therapy was completed by 11 (34.3%) of 32 RRMS patients. Relapse was verified in 4 (36.36%) patients. The mean EDSS score was 2.45±1.03 at the beginning of therapy and 2.54±0.98 after two-year therapy; the difference was not statistically significant. In 2 (6.25%) patients on therapy for 18 months there was no relapse, and the mean EDSS was 1.75±0.35 (both at therapy introduction and at 18 months). Five (15.62%) patients were on therapy for one year. The mean EDSS was 1.6±1.08 at the beginning of therapy and l.S±0.70 at one year. One patient experienced relapse. Two patients were on therapy for six months. They had no relapses with the same EDSS at six months as at therapy introduction (2.0). At the beginning of 2008, another 12 patients started therapy with interferon beta 1 B. In conclusion, our experience with two-year interferon beta-1B therapy for RRMS is favorable, with a relatively low rate of relapses (36.36%) and without significant worsening on EDSS. The medication side effects were mild and transient.Cilj studije bio je analizirati korist i nuspojave liječenja bolesnika s relapsno-remisijskim oblikom multiple skleroze (RRMS) interferonom beta 1 B (Betaferon). U studiju je bilo uključeno 32 bolesnika s RRMS koji su završili dvogodišnju terapiju interferonom beta 1B ili su ovu terapiju još uvijek primali. Svakih šest mjeseci provodila se klinička procjena bolesnika i procjena prema ljestvici EDSS (Expanded Disability Status Scale). Dvogodišnju terapiju završilo je 11 (34.3%) od 32 bolesnika. Recidiv je dokazan u 4 (36.36%) bolesnika. Prosječan rezultat na ljestvici EDSS bio je 2.45±1.03 na početku liječenja i 2.54±0.98 nakon dvije godine terapije; razlika nije bila statistički značajna. Pet (15.62%) bolesnika bilo je na terapiji jednu godinu. Kod njih je prosječan rezultat na ljestvici EDSS bio 1.6±1.08 na početku terapije i 1.5±0.70 nakon jedne godine liječenja. Recidiv je zabilježen u dvoje (18,18%) bolesnika, dok je jedan bolesnik prekinuo liječenje nakon šest mjeseci. Naša iskustva s dvogodišnjim liječenjem RRMS interferonom beta 1B su povoljna. Bolesnici su imali relativno mali broj recidiva (36.36%) bez znatnijeg pogoršanja na ljestvici EDSS. Nuspojave lijeka bile su prolazne i blage naravi

Veliki agresivni angiomiksom vulve: prikaz slučaja

A 57-year-old multiparous housewife was hospitalized at University Clinical Center with painless, ulcerated, huge tumor of the vulva, which had progressively increased in size during the last five years. It was a firm, ulcerated mass involving the left vulva and measuring 35 cm in diameter. The vaginal orifice was deviated to the right by the tumor. The adnexa and the uterus were normal. The patient underwent total excision of the tumor in general anesthesia, and histology confirmed aggressive angiomyxoma. She had an uneventful postoperative period with satisfactory healing of the wound.Višerotkinja u dobi od 57 godina, domaćica, hospitalizirana je na Univerzitetskom kliničkom centru zbog bezbolnog, ulceriranog, velikog tumora vulve koji je progresivno narastao u posljednjih pet godina. Tumor je bio čvrsta, ulcerirana tvorba na lijevom dijelu vulve, promjera 35 cm. Otvor vagine je povučen prema desno pod djelovanjem tumora. Adneksa i maternica bili su normalni. Izvedena je potpuna ekscizija tumora u totalnoj anesteziji, a histološka dijagnoza je potvrdila agresivni angiomiksom. Rani poslijeoperacijski tijek protekao je bez komplikacija sa zadovoljavajućim zaliječenjem rane