Ovarian Torsion in Adolescent with Chronic Immune Thrombocytopenia

Ovarian torsions in adolescence are rarity, particularly bilateral, with mostly unknown etiology. Enlargement of the ovary contributes to torsion. Young girl presenting with abdominal pains, nausea and vomiting was for two days suspected and observed as gastroenteritis. By exclusion of gastroenteritis she was admitted for gynecological work-up. Ultrasound showed significantly enlarged right ovary, with tumor-like appearance. At the laparotomy, gynecologist found torsioned, necrotic ovary and ovariectomy was performed. Histology showed massive stromal bleeding (haemorrhage). Asymptomatic enlargement of remaining ovary occurred nine months after the ovariectomy. This enlargement was accompanied with platelets’ fall and the possibility of repeated torsion impended. Thrombocytopenia was suspected from the first moment, but diagnosed after the surgery. Thrombocytopenia in adolescence requires additional attention as possible cause of intra-ovarian bleeding with consecutive enlargement and may lead to torsion. Oral contraceptives regulate dysfunctional bleeding, decrease ovarian volume and by so, may minimize risk of torsion. This strategy proved effective in the case we present

Laboratory medicine in pandemic of COVID-19

After the outbreak in China in the year 2019, severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) quickly spread around the world causing a protracted pandemic. Approximately one-third of infections appear to be asymptomatic. Symptomatic disease is characterized primarily by symptoms of respiratory tract infection of varying severity. But Coronavirus Disease 2019 (COVID-19) is much more than an acute respiratory disease because SARS-CoV-2 affects many organs inducing a vast number of symptoms such as cardiovascular, neurological, gastrointestinal, dermatological, with numerous complications. Short and long-term effects of infection, severe ones, and especially mild forms of the disease which affect a huge number of patients need to be further investigated. Laboratory medicine has a crucial role in early diagnosis of the disease, recognition of the patients who need hospital care, and close monitoring of hospitalized patients to timely identify associated clinical complications as well as follow-up of patients with long-term COVID-19

Značenje koncentracije cinka u sjemenoj tekućini kod muškaraca s dijagnozom neplodnosti

The prevalence and importance of male infertility make it a serious worldwide medical and social problem. The aim of this study was to determine if there were any significant differences in zinc concentrations in seminal fluid in men diagnosed with infertility compared to control group, and if there were, to determine how it affected the number and percentage of sperm cells with normal motility and morphology. A case-control study was conducted in the Osijek-Baranja County from January 2014 to June of 2015. The study included 276 subjects referred to biochemistry laboratory of the Osijek University Hospital Centre, 100 (36.2%) of them with low sperm count confirmed by spermiogram after 3 months. Semen samples were processed according to the World Health Organization criteria, and zinc concentrations were determined using spectrophotometry and direct colorimetry without deproteinization on a chemistry analyzer (Olympus AU 680, Beckman Coulter, Tokyo, Japan). Study results showed the men with low sperm count to be significantly older (Mann Whitney U test: p=0.013) and to have lower zinc levels (χ2-test: p<0.001). Further analysis included 100 (36.2%) patients with low sperm count. In the group of infertile men, those with low sperm count had higher zinc levels compared to men with azoospermia (Mann Whitney U test: p=0.036), suggesting a connection between lower zinc level in seminal fluid and male fertility. Zinc as a biological marker and an antioxidant affects sperm count, motility and morphology. Zinc supplemental therapy could improve seminal parameters in patients diagnosed with low sperm count. Dietary habits of the subjects differ regionally, and future research could make a solid foundation for complementary approach to treatment of male infertility.Muška neplodnost s obzirom na njenu učestalost i važnost predstavlja ozbiljan globalni medicinski i socijalni problem. Cilj ovoga istraživanja bio je utvrditi postoje li značajne razlike koncentracije cinka u sjemenoj tekućini muškaraca s dijagnozom smanjene plodnosti u odnosu na kontrolnu skupinu te ako postoje, utvrditi kako razina cinka djeluje na broj, postotak pokretnih i broj morfološki normalnih spermija. Studija slučajeva i kontrola provedena je na području Osječko-baranjske županije u razdoblju od siječnja 2014. godine do lipnja 2015. godine. U studiju je bilo uključeno 276 ispitanika koji su bili upućeni u biokemijski laboratorij KBC-a Osijek, od kojih je kod 100 (36,2%) ispitanika potvrđena dijagnoza smanjene plodnosti ponovljenim spermogramom nakon 3 mjeseca. Uzorci sjemene tekućine obrađeni su u skladu s kriterijima Svjetske zdravstvene organizacije, a koncentracija cinka određena je spektrofotometrijskom, direktnom kolorimetrijskom metodom bez deproteinizacije na kemijskom analizatoru tipa Olympus AU 680 (Beckman Coulter, Tokyo, Japan). Istraživanje je pokazalo kako su muškarci s dijagnozom smanjene plodnosti značajno stariji (Mann Whitney U test: p=0,013) i imaju značajno niže vrijednosti cinka (χ2-test: p<0,001). Vrijednosti cinka bile su značajno više u skupini ispitanika s dijagnozom smanjene plodnosti kod kojih su nađeni spermiji u odnosu na ispitanike kojima je utvrđena azoospermija (Mann Whitneyev U test: p=0,036). Koncentracija cinka kao značajnog biološkog biljega i antioksidansa utječe na broj, pokretljivost i morfologiju spermija. Nadomjesna terapija cinkom mogla bi poboljšati sjemene parametre kod bolesnika s dijagnozom smanjene plodnosti. Prehrambene navike ispitanika regionalno se razlikuju, a buduća istraživanja mogla bi postaviti dobre temelje za komplementarno liječenje muške neplodnosti