The role of insulin-like growth factor in prediction and prevention of preterm delivery

Background/Aim. Prediction and prevention of preterm delivery remain great challenge. It is important to include in everyday medical practice determination of certain markers that could help identifying pregnant women with preterm delivery. Insulin like growth factor (IGF) is involved in the control mechanism of fetal and placental growth and development. The aim of this study was to examine the presence of insulin-like growth factor binding protein 1 (IGFBP-1) in cervicovaginal secretion of pregnant women with symptoms of preterm labor, but with apparently intact fetal membranes and to point out a possible application of the strip test for detection of phIGFBP-1 in diagnosis of preterm premature rupture of total membranes (PPROM) in everyday medical practice. Methods. The study was performed at the Department for Obstetrics and Gynecology, Clinical Center of Vojvodina between October 2008 and May 2009. The study included 54 pregnant women between 20-35 weeks of gestation (WG), divided into two groups: the study group (16 pregnant women with symptoms of preterm delivery that gave birth before 37 WG) and the control group (38 pregnant women with the normal course of pregnancy that gave birth on term). In cervicovaginal secretion of the examined pregnant women the level of IGFBP-1 was determined by the immunochromatographic assay with monoclonal antibodies 6303 as a detecting antibody (Actim PROM test, Medix Biochemica, Kauniainen, Finland). Results. Gestational age (GA) at delivery in the study group was 32.6 WG and in the control group it was 38.4 WG. Weight of newborns in the study group was 2,021 g and in the control group 3,430 g. IGFBP test was positive in 15 women (93.75%) of the study group, while in the control group it was positive only in 1 woman (2.63%). Conclusion. Test on phIGFBP-1 in cervicovaginal mucus was positive in 93.75% women with preterm delivery, suggesting that this test could be used in diagnosis of silent rupture of fetal membranes and in prediction of preterm delivery

Promene pri preusmeravanju auditivne i vizuelne informacije između hemisvera analizirane kartografskim EEG - om kod deteta sa sindromom hiperaktivnosti

The paper discusses the changes in relations of visual and auditory inputs between the hemispheres in a child with hyperactive syndrome and its effects which may lead to better attention engagement in auditory and visual information analysis. The method included the use of cartographic EEG and clinical procedure in a 10-year-old boy with hyperactive syndrome and attention deficit disorder, who has theta dysfunction manifested in standard EEG. Cartographic EEG patterns was performed on NihonKohden Corporation, EEG – 1200K Neurofax apparatus in longitudinal bipolar electrode assembly schedule by utilizing10/20 International electrode positioning. Impedance was maintained below 5 kΩ, with not more than 1 kΩ differences between the electrodes. Lower filter was set at 0.53 Hz and higher filter at 35 Hz. Recording was performed in a quiet period and during stimulation procedures that include speech and language basis.Standard EEG and Neurofeedback (NFB) treatment indicated higher theta load, alpha 2 and beta 1 activity measured in the cartographic EEG which was done after the relative failure of NFB treatment. After this, the NFB treatment was applied which lasted for six months, in a way that when the boy was reading, the visual input was enhanced to the left hemisphere and auditory input was reduced to the right hemisphere. Repeated EEG mapping analysis showed that there was a significant improvement, both in EEG findings as well as in attention, behavioural and learning disorders. The paper discusses some aspects of learning, attention and behaviour in relation to changes in the standard EEG, especially in cartographic EEG and NFB findings.U radu se analiziraju promene pri preusmeravanju vizuelne i auditivne informacije između hemisfera kod deteta sa sindromom hiperakrivnosti i njihovi efekti koji mogu dovesti do boljeg angažovanja pažnje pri analizi auditivne i vizuelne informacije. Metod je uključio upotrebu kartografskog EEG-a u toku kliničke procedure kod desetogodišnjeg dečaka sa poremećajem pažnje i sindromom hiperaktivnosti, koji je imao theta disfunkciju manifestovanu na standardnom EEG-u. Kvantitativni EEG profil je meren pomoću NihonKohden Corporation, EEG – 1200K Neurofaxaparata, koji obezbeđuje 19 EEG kanala. Elektrode su pozicionirane prema 10/20 Internacionalnom sistemu za pozicioniranje elektroda. Impendanca je bila održavana ispod 5кΩ, sa ne više od 1кΩ razlike između elektroda. Niži filter je bio postavljen na 0,53Hz i viši filter na 35Hz. Snimanje je vršeno tokom mirnog perioda kao i tokom stimulacije koja je uključivala osnove govora i jezika. Standardni EEG i Neurofidbek (NFB) tretman su indikovali više theta opterećenje, alpha 2 i beta 1 aktivnost, merene kartografskim EEG-om, što je urađeno nakon relativnog neuspeha NFB tretmana. Nakon ovoga, primenjen je NBF tretman u trajanju od šest meseci, na način da kada dečak čita vizuelna informacija je prosleđivana levoj hemisferi, a auditivna informacija ograničena na desnu hemisferu. Ponovljene EEG mape su pokazale značajno poboljšanje na planu pažnje i na planu ponašanja i učenja. U radu se diskutuje o određenim aspektima učenja, pažnje i ponašanja u odnosu na promene na standardnom EEGu, posebno kartografskom EEG-u i NFB saznanjima

Preoperative administration of cephalosporins for elective caesarean delivery

Introduction. Antibiotic prophylaxis means administration of antibiotics in prevention of infections. Objective. To investigate the efficacy of a single dose preoperative administration of ceftriaxone and cefazolin in the prevention of intra- and postoperative infections in the parturients without high risk of inflammation. Methods. The first group of 45 pregnant and 4 non-pregnant women were preoperatively administered ceftriaxone in a dose of 2 g, i.v., 10 minutes before the planned surgery. The second group of 45 pregnant and 4 non-pregnant women were preoperatively administered cefazolin in a dose of 2 g i.v., 10 minutes before the planned surgery. The concentrations of antibiotics were estimated immediately and 6 hours following the operation, as well as in the amniotic fluid and umbilical cord in the group of pregnant women. The estimation of antibiotic concentration was done by the method of liquid chromatography. Results. The mean concentrations of antibiotics in the patients following the elective caesarean section were as follows: ceftriaxone - 22.7 μg/l. vs cefazolin - 44.8 μg/l. Six hours later, the concentration of antibiotic decreased, but the concentration of cefazolin was still over the MIC for sensitive bacteria. The mean concentrations of antibiotics following gynaecological surgery in the non-pregnant patients were as follows: ceftriaxone - 12.0 μg/l vs cefazolin - 30.1 μg/l. Six hours later, the concentration of antibiotic decreased. Conclusion. It is most optimal to administer a single-dose of the first generation cephalosporins-cefazolin-immediately following the clamping of the umbilical cord as well as in preoperative prophylaxis in gynaecological operations

Chlorocoulometric determination of hydrocortisone and hydrocortisone acetate

A chlorocoulometric method for the determination of small amounts of hydrocortisone and hydrocortisone acetate is presented. The method is simple and rapid, the results obtained are accurate and reproducible. It can be successfully applied to the determination of hydrocortisone and hydrocortisone acetate in pharmaceutical formulations

Serum magnesium level in the first trimester of pregnancy as a predictor of pre-eclampsia – a pilot study

Objectives: The aim of this study was to evaluate the importance of serum concentration of magnesium (Mg) in the first trimester of pregnancy for predicting pre-eclampsia (PE). Methods: This prospective study included 403 pregnant women over 18, with singleton pregnancy (from 11 to 14 weeks of pregnancy). The subjects were divided into a group who subsequently developed PE (PEKT) (n = 61), and a group of healthy pregnancies with no complications and with normal outcomes (TNT) (n = 342). In the first trimester, urea, creatinine, uric acid, Mg, free beta subunit of human chorionic gonadotrophin, plasma protein A related to pregnancy, and C-reactive protein were determined. We followed all subjects until the end of pregnancy. Results: Serum Mg is significantly lower in PEKT than in TNT group (p < 0.001). The serum first trimester Mg level cutoff at ≤0.81 mmol/L had a sensitivity of 77.0% and specificity of 71.6% for the detection of women with PEKT. The level of serum Mg has the strongest significant positive correlation (p < 0.05) with the week of gestational outcomes (R = 0.442), weight (R = 0.416), and Apgar score (R = 0.343) of the newborns, and the strongest significant negative correlation with the number of miscarriages (R = −0.413), serum creatinine (R = −0.471), and the number of pregnancies (R = −0.326). The week of gestational outcome is predicted with the greatest reliability by the serum Mg. Conclusions: Serum Mg level during the first trimester of pregnancy is a significant prediction tool for PE and could also play an important role in predicting the week of gestational outcome and birth weight of newborns

A Prospective Study of Mid-Trimester MCP-1 Levels as a Predictor of Preterm Delivery

Background: The prevention of preterm delivery (PTD) represents one of the major topics in modern obstetrics. The aim was to design a prospective study and investigate if mid-trimester serum and amniotic fluid levels of MCP-1 could predict the occurence of spontaneous PTD. Methods: The study involved 198 women who underwent genetic amniocentesis and blood sampling in the middle of their trimester. After applying the criteria for inclusion in the study, there were 16 respondents in the study group, and 38 respondents in the control group. Level of MCP-1 in amniotic fluid and serum was measured with commercially available enzyme-linked immunosorbent assays (ELISA) and statistical analysis was conducted. Results: There was no statistically significant difference in serum or amniotic fluid MCP1 levels between PTD and the control groups. Conclusion: The results suggest that MCP-1 is probably not the most relevant marker for predicting PTD. This study provides new normative data for MCP-1 levels in amniotic fluid and maternal sera and is a valuable tool for future diagnostic and comparative studies

Cardiorespiratory disorders of infants of diabetic mothers

Introduction. One of the characteristics of modern era is the explosion of diabetes in the world. Today more than 400,000,000 people suffer from diabetes in the entire world. During the last decade the number of women with the disorder of glucose homeostasis is six to seven times greater than in the previous period. Therefore, the re-evaluation of the impact of glucose intolerance on the course and outcome of pregnancy is very current. Objective. The aim of the study was to evaluate the data on the influence of mothers’ glucose homeostasis disturbances on the occurrence of cardiorespiratory disorders in newborns, as well as their influence on the perinatal outcome. Methods. Prospective examination included 102 newborns in total - 31 infants of mothers with glucose homeostasis disorder (Group I) and 71 infants of healthy mothers (Group II). Average age, body height, body weight, body mass index, parity and illness duration of the pregnant women had been determined, as well as the delivery method. Every newborn was provided with physical examination, Apgar score was calculated, body weight and body length were measured. Also, electrocardiography and brain ultrasound, as well as the basic hematology biochemical and microbiological analysis, were performed within the examinations of the infants. Results. The average weight and obesity incidence with diabetic women was higher than in the control group and their infants were heavier and with lower gestational age. Heart failures were diagnosed in five (16.1%) infants of diabetic mothers and in one (1.4%) infant of a healthy woman (p<0.01). Respiratory disorders were diagnosed in 48.4% infants of diabetic mothers and in 12.6% of healthy mothers (p<0.01). Forty-two percent of infants of diabetic mothers and 19.7% infants of healthy mothers needed additional oxygen. Conclusion. Congenital anomalies of the cardiovascular system and respiratory disorders in the infants of diabetic mothers were six to eight times more frequent than in the infants of healthy mothers