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Vol.11 No.2  

Date: April 2002.

CONTENT:

CROATIAN PERINATOLOGY Past, today and future (Vol.11 No.2, str.53-68)

Authors:

A. Dražančić A. Kurjak

Editorial

Summary:
The past, the actual situation and a view to the future of Croatian perinatology is presented. Under the past are quoted the data upon a primitive obstetrics (midwifery), then the specialization of obstetrics and gynecology since the beginning of 20-th century. The modern perinatology as an interrelation of materno-fetal and neonatal medicine, assisted by other medical branches, started in the sixties of 20-th century, formally in 1968 by the 1-st German Congress and 1-st European Congress of Perinatal Medicine, held in Berlin, when started the European Association of Perinatal Medicine too. In Croatia the Perinatal Section of Croatian Medical Association was founded in 1972. The scientific and professional activity was initiated in the Center (thereafter the Division) of Perinatal Medicine of the Department of gynaecology and obstetrics of the University Medical Center in Zagreb. The activity was soon extended to other University departments in Zagreb and also to bigger maternity hospitals. Perinatological activity was manifested in numerous national (Perinatal Days, Conferences on Perinatal Mortality) and international home-made meetings of perinatal medicine (Alps-Adria meetings, Organization Gestosis meetings, Ian Donald International School of Medical Ultrasound, Erich Saling School of Perinatal Medicine, European School & Recent Advances in Perinatal Medicine etc.). Together with University of Zagreb the postgraduate teachings were organized: Perinatology and Neonatology, Ultrasound in Clinical Medicine, Mother and Infant’s Care; the postgraduate courses: on gynaecology and perinatology, on neonatology, on ultrasound diagnostics. The foundation and development of the journal »Gynaecologia and Perinatologia « is presented. Regarding the future the immediate necessary measures are recommended and suggested the possibilities of developmental biology in the diagnostics and therapy of pathological pregnancy conditions which would be the prevention of subsequent diseases in adult life.

Key words: perinatology, history, Croatia


DOES THE IN VITRO FERTILIZATION PROCEDURE REQUIRE BACTERIOLOGICAL INVESTIGATION OF NORMOZOOSPERMIC EJACULATE? (Vol.11 No.2, str.69-72)

Authors:

Veljko Vlaisavljević, Milan Reljič

Original paper

Summary:
The aim of our study was to compare the fertilization rate in IVF procedures in cases where the ejaculate was not subjected to bacteriologic investigation and in those where bacteriologic investigation of the ejaculate was performed and after which antibiotic therapy followed. Material. From among 241 normozoospermiacs included in the IVF procedure, 56 cases were self-selected for bacteriologic investigation of ejaculate. The fertilization rate and the percentage of cycles with total fertilization failure following IVF was compared with the remaining 185 IVF cycles before which no bacteriologic investigation of ejaculate had been done and the men have received no antibiotic therapy. Results. Bacteria in the ejaculate were isolated in 95% (53/56). The culture remained sterile in 5% (3/56). The most frequently isolated bacteria were Peptostreptococci in 26%, Streptococcus viridans in 24%, Enterococci in 22%, alpha.hemolytic Streptococci in 20%, anaerobic gram-positive bacilli in 18%, anaerobic gram-negative bacilli in 13% and Diphtheroids in 10%. From among the less frequent bacteria, Staphylococcus epidermis and E. coli were assessed in 4%. In 22% of samples, only one bacterial species was isolated, in 38% two and in 40% three or more. There was no statistically significant difference between the groups with regard to the number of oocytes and embryos, the fertilization rate and the percentage of cycles without fertilization. Conclusion. According to our experience, bacteriologic investigation of normozoospermic ejaculate in the IVF procedure and subsequent antibiotic treatment of asymptomatic men with bacteria in the ejaculate bears no influence on the fertilization rate and pregnancy rate in IVF procedure.

Key words:
IVF, bacteriospermia, fertilization, antibiotic treatment


BREAST-FEEDING IN PRETERM INFANTS (Vol.11 No.2, str.73-75)

Authors:

Aleksandra Frković, Antonija Dujmović, Elizabeta Tomašić-Martinis

Original paper

Summary:
The aim. If maternal milk is the best food for a term infant, for a preterm infant it will also be the best for the growth and development of an immature child. The aim of this work was to examine, by retrospective analysis, the frequency of breast-feeding in preterm infants and relate it with some epidemiologic variables (demographic, social, medical). Material and methods. In the period from 1993 to 1999 we analyzed the frequency of breast-feeding in all preterm deliveries from 22 to 36 weeks of gestation except for multiple pregnancies. The clinic for Gynecology and Obstetrics of Clinical Hospital Center Rijeka is the first maternity hospital in Croatia that was proclaimed »Baby Friendly Hospital« by the UNICEF in 1996. We analyzed the following parameters in mothers: the age, matrimonial status, education, course of pregnancy, mode of beginning and delivery termination. In newborns: weight, Apgar score ≤7 at the first and fifth minute, acidosis, intracranial hemorrhage, early neurological signs, respiratory distress syndrome and infections. Results. In the examined period there were 22 119 deliveries out of which 923 (4.17%) were preterm deliveries. Out of the total of 923 preterm infants 453 (49.07%) were breast-fed: from 29 to 32 weeks of gestation 20 (4.41%) newborns, and from 33 to 36 weeks 433 (95.58%) newborns. Apgar score ≤7 at the first minute was present in 97 (21.41%) cases. Apgar score ≤7 at the fifth minute was present in 37 (8.16%) cases. No newborn had acidosis, 8 (1.76%) newborns had intracranial hemorrhage, one had (0.22%) early signs of cerebral disorder, 33 (7.28%) respiratory distress syndrome and 35 (7.72%) infection. Fifty percent of our preterm infants were fed with maternal milk and we continue to make additional efforts to reduce the percentage of non breast-fed children. Mothers who were breast feeding were more frequently primiparae aged from 26 to 35, married, employed and smoked up to 10 cigarettes a day. In mothers who were breast-feeding no children died. Conclusion. Feeding preterm infant with maternal milk should be a part of the intensive care and therapy of such a child.

Key words:
preterm infants, maternal milk


RADIOTHERAPY IN OVARIAN CANCER TREATMENT (Vol.11 No.2, str.76-79)

Authors:

Zora Zakanj, Josip Grgurić, Jelena Bošnjak

Review

Summary:
Radiotherapy as treatment modality after initial surgery is indicated in small selected patient group. It could be applied in all patients in stages Ic, II and III, in cases where no residual tumor was left and/or microscopic disease was present (positive peritoneal washing). For cases of advanced ovarian carcinomas, where there were no signs of disease after chemotherapy on second laparotomy, radiotherapy should be considered for high risk patients: age over 50 with poor differentiated tumors – G III, and patients with massive residual tumors after initial surgery. Histological tumor type, differentiation level, as well as the stage of disease are important factors to make decision about the treatment modality. For clear cell carcinomas and poor differentiated tumors chemotherapy should be the treatment of choice, wherever in other cases radiotherapy is acceptable treatment option. Despite the large number of studies published in past 20 years, the role of radiotherapy in ovarian cancer treatment is not completely clear.

 

Key words:
ovarian cancer, radiotherapy


LACTOFERRIN, CALCIUM, VITAMIN C AND LACTOSE INFLUENCE ON IRON ABSORPTION IN BREASTFED INFANTS (Vol.11 No.4, str.80-84)

Authors:

Zora Zakanj, Josip Grgurić, Jelena Bošnjak

Professional paper

Summary:
World expert associations of pediatricians have been pointing out the importance of natural nutrition, working on several levels for its promotion for the past years. One of the reasons for their acting is a benefit of mother’s milk ingredients’ action on improved iron absorption. In contrast to other milk products, human milk contains glycoprotein lactoferrin, being responsible for an adequate iron absorption from human milk. Besides lactoferrin, for an iron absorption from mother’s milk calcium, quantity of vitamin C and lactose are important as well. All ingredients of mother’s milk are quantity arranged in order to satisfy iron absorption from human milk, even in exlusive breastfed infants during first six month of their lives. Infants on exlusive breastfeeding have developed significantly less deficiency anaemia than infants fed with other milk products. Cow’s milk, compared to other milk products and to iron absorption is not recommended for children during first year of live. All the efforts to adjust adapted milk products to human milk composition have not yet been successful.

Key words:
iron absorption, deficiency anaemia, lactoferrin, natural nutrition, exlusive breastfeeding


PLACENTAL SITE TROPHOBLASTIC TUMOR: CONSERVATIVE THERAPEUTIC APPROACH AND LITERATURE REVIEW (Vol.11 No.2, str.85-90)

Authors:

Ivica Vlatković, Josip Dujella, Zvonimir Vrančić, Nikša Milić, Damir Zudenigo

Case report

Summary:
Placental site trophoblastic tumor is the least common of gestational trophoblastic diseases. Its biologic behavior is different from that of typical choriocarcinoma. Surgery is the cornerstone of therapy and the roles of chemotherapy and radiation remain uncertain. We present a case of 24-year-old woman with placental site trophoblastic tumor and nephrotic syndrome. There was no extrauterine spread which was determined by ultrasonography and computed tomography. In attempt to preserve fertility, hysterotomy and tumor excision was performed.

Key words:
placental site trophoblastic tumor, nephrotic syndrome, Doppler ultrasonography, NMR


THE USE OF STEM CELLS (Vol.11 No.2, str.95-96)

Authors:

F.A. van Assche

Other


Dr. MIJO OVANIN (Vol.11 No.2, str.97-97)

Authors:

Mijo Tomljanović

In memoriam


Prim.dr. BRANKO VUKOVIĆ (Vol.11 No.2, str.98-98))

Authors:

Branko Hodek

In memoriam


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