The impact of sweeping the membranes on cervical length and labor: a randomized clinical trial

Objectives: The aim of the study was to investigate to what extent sweeping of the membranes contributes to cervical shortening and if cervical shortening is related to the time to onset of labor and duration of the active phase of labor. Methods: This prospective randomized clinical trial was performed at Baskent University between February and March 2011. Women were randomly assigned to receive membrane sweeping (Sweeping Group) (n=69) or no membrane sweeping (Control Group) (n=71). Cervical length was measured (cervix1) in both groups by examiner 1 and the Bishop Score was determined in the control group and sweeping was performed in the sweeping group by examiner 2. Two days later the patients had another cervical length measurement (cervix 2) by examiner 1, blinded to the group and results of the examiner 2. t test, Mann-Whitney U test and Chi-square test were used for statistical analyses. Results: Cervix 1 was 27.4}8.4 mm and 29.6}8.9 mm (p= 0.14), cervix 2 was 23.3}8.8 mm and 23.8}8.5mm (p= 0.28) and cervical shortening was 5}4 mm and 5}4mm (p= 0.446), time to onset of labor was 6.3}4.6 and 5.7}4.1 (p= 0.38) and duration of labor was 5.8} 2.89 and 5.7} 2.4 (p= 0.82) for the sweeping and the control groups, respectively. Conclusions: Sweeping of the membranes does not reduce cervical length and does not shorten time to onset of labor and duration of the active phase of labor. NCT01309308: Sweeping the Membranes, Cervical Length and Duration of Labor

Acute torsion of the gallbladder: a case report

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Scrotal calcinosis due to resorption of cyst walls: a case report

<p>Abstract</p> <p>Introduction</p> <p>Scrotal calcinosis is a rare benign entity defined as the presence of multiple calcified nodules within the scrotal skin. There are controversies about the origin of this entity. In fact, it is still debatable whether scrotal calcinosis is an idiopathic growth or dystrophic calcification of dartoic muscles. It is also unclear whether scrotal calcinosis originates from inflammation of epidermal cysts affected by mild to moderate inflammation of mononuclear cells, from foreign body granuloma formation followed by resorption of cyst walls or from eccrine epithelial cysts.</p> <p>Case presentation</p> <p>We report a 41-year-old male Turkish patient presenting with a 10-year history of scrotal tumours increasing slowly in size and number. Histopathologically, there was no epithelial lining around the calcified nodules, but there was fibrosis adjacent to atrophic stratified squamous epithelium.</p> <p>Conclusion</p> <p>Results of histopathological examinations suggested that scrotal calcinosis might have been due to resorption of cyst walls. Surgery remains the key for this problem. In cases of non-massive scrotal calcinosis, like the case presented here, excision of the nodules from the affected part of the scrotal wall and repairing the defect with horizontal stitches offer good cosmetic results without relapse.</p

The Effect of Antiseptics on Adipose-Derived Stem Cells

Background: Although chemical antiseptics are the most basic measure to control wound infection and frequently come into contact with subcutaneous adipose tissue, no studies have evaluated their toxicity on adipose tissue and its cell fractions. In the present study, the effects of five different antiseptics on adipose-derived stem cells were evaluated. Methods: Human adipose-derived stem cells were harvested from healthy donors. Adipose-derived stem cell viability was measured after treatment with different concentrations of antiseptics over 5 days. Furthermore, the effect on the proliferation, adipogenic differentiation, and apoptosis/necrosis of adipose-derived stem cells was analyzed. Finally, the mRNA expression of the stem cell markers CD29, CD34, CD73, CD90, and CD105 was detected. Results: Octenisept and Betaisodona significantly reduced cell proliferation and differentiation and led to considerable adipose-derived stem cell necrosis. Octenisept decreased stem cell viability at the lowest concentrations tested, and all stem cell markers were down-regulated by Octeniseptr and Betaisodona. Lavasept and Prontosan both led to reduced stem cell viability, proliferation, and differentiation, and increased apoptosis/necrosis, although the effects were less pronounced compared with Octenisept and Betaisodona. Adipose-derived stem cells survived treatment with mafenide acetate even at high concentrations, and mafenide acetate showed minimal negative effects on their proliferation, adipogenic differentiation, cell death, and stem cell marker expression. Conclusions: Mafenide acetate may be regarded as a feasible antiseptic for the treatment of wounds with exposed adipose tissue because of its low adipose-derived stem cell toxicity. Lavasept and Prontosan are possible alternatives to mafenide acetate. Octenisept and Betaisodona, by contrast, may be used only in highly diluted solutions

Przegląd chorób układu krążenia w ciąży

Abstract With recent advances in prenatal care, the incidence of direct causes of maternal death has declined and indirect causes have gained significant importance. Thromboembolism, hypertension and cardiovascular diseases are the most common indirect causes of maternal death. Acute myocardial infarction, stroke, venous thromboembolism, peripartum cardiomyopathy, aortic dissection and amniotic fluid emboli are responsible for the majority of the maternal deaths from cardiovascular causes. The issue of pregnancy of heart transplant – and Turner syndrome – patients requires extensive research. Obstetricians should possess good knowledge of cardiovascular complications of pregnancy because a high index of suspicion and early diagnosis, together with timely and appropriate interventions may save the life of the fetus and the mother.Streszczenie W związku z rozwojem medycyny, częstość występowania bezpośrednich przyczyn zgonów matek, np. krwotoków, znacząco się zmniejszyła. Jednak obserwuje się wzrost śmiertelności matek spowodowanych innymi, niebezpośrednimi przyczynami takimi jak: choroba zakrzepowo-zatorowa, nadciśnienie indukowane ciążą oraz choroby układu sercowo-naczyniowego. Zawał mięśnia sercowego, udar mózgu, zakrzepica żylna, kardiomiopatia okołoporodowa, tętniak rozwarstwiający aorty oraz zator płynem owodniowym są odpowiedzialne za większość przypadków śmiertelności matczynej wywołanej chorobami układu sercowo-naczyniowego. Na szczególną uwagę zasługują coraz częściej pojawiające się pacjentki po transplantacji serca oraz ciężarne z zespołem Turnera. Położnicy powinni posiadać rozległą wiedzę dotyczącą chorób układu krążenia i możliwych ich powikłań podczas ciąży, ponieważ wczesna diagnoza oraz właściwa interwencja mogą uratować życie płodu i matki

Diagnostyka prenatalna potworniaka regionu krzyżowo-guzicznego – dwa przypadki o różnym przebiegu

Abstract Sacrococcygeal teratoma (SCT) is the most common fetal tumour. It may be readily diagnosed by two-dimensional ultrasonography in the early second trimester. Three-dimensional ultrasonography is recommended as a supplemental examination to obtain further detailed information for multidisciplinary management of SCT. In the following article we present two cases of sacrococcygeal teratomas which exhibited two different courses. In the first case, sacrococcygeal teratoma was diagnosed in the early second trimester. The condition of the fetus worsened during the follow-up and the parents opted for the termination of the pregnancy. The other one presented at a later gestational age. The baby was born alive, immediately operated upon and did well until the age of 1, when we checked her condition for the last time.Potworniak regionu krzyżowo-guzicznego (SCT) jest najczęstszym guzem występującym u płodu. Może być łatwo zdiagnozowany za pomocą ultrasonografii dwuwymiarowej we wczesnym drugim trymestrze. Rekomenduje się wykonanie ultrasonografii trójwymiarowej jako uzupełniającego badania dostarczającego szczegółowych informacji ważnych dla wielodyscyplinarnego postępowania w przypadku SCT. W bieżącym artykule przedstawiamy dwa przypadki potworniaka krzyżowo-guzicznego o różnym przebiegu. W pierwszym przypadku guz został rozpoznany we wczesnym drugim trymestrze ciąży. Stan płodu ulegał stopniowemu pogorszeniu wraz z czasem trwania ciąży, dlatego rodzice zdecydowali się na zakończenie ciąży. W drugim przypadku guz ujawnił się w późniejszym okresie ciąży. Noworodek urodził się żywy, został niezwłocznie zoperowany i rozwija się prawidłowo, co potwierdzono w trakcie wizyty kontrolnej po skończeniu przez dziecko pierwszego roku życia