Current Issue - new design

 
 

Recommendation

Bolesti štitnjače u trudnoći

 

Read more...

Lijekovi u trudnoći i laktaciji

Read more...

 

Vol.22 No.2

Date: April–June 2013

 

CONTENT:

LEPTIN, ADIPONECTIN, INSULIN AND GLUCOSE IN PREGNANT WOMEN WITH TYPE 1 DIABETES (Vol.22 No.2, str.93-93)

Authors:

Edina Berberović, Marina Ivanišević, Josip Juras, Marina Horvatiček, Saša Kralik-Oguić, Behija Berberović*, Josip Đelmiš

Original paper

Summary:
Objective. The aim of this study is to define the influence of Type 1 diabetes on concentrations of glucose,insulin, leptin and adiponectin in maternal and umbilical vein blood. Methods. The study included 120 pregnant women: 60 suffering from Type 1 diabetic pregnancy (T1DM) and 60 from control group (CTRL). Maternal vein blood and umbilical vein blood samples were taken during delivery. Serum insulin, leptin and adiponectin levels were quantified by ELISA. Results. Adiponectin concentration in the mother’s blood was higher in Type 1 diabetic pregnancy than in the control group, with statistically significant difference (p <0.001). Concentrations of leptin and insulin in the umbilical vein blood were higher in Type 1 diabetic pregnancy than in the Control group, with statistically significant difference (p<0.001). Conclusion. Type 1 diabetes mellitus influences on the concentrattions of adipokines in the maternal and umbilical vein blood. Presents results and recent findings about the concentrations and metabolism of adipokines in pregnant women with Type 1 diabetes, open the door to new possibilities and ideas for the investigation of the still underresearched areas.

Key words:
leptin, adiponectin, pregnancy, Type 1 diabetes mellitus


INCIDENCE OF SACROILIACAL DYSFUNCTION USING FUNCTIONAL TESTS IN PATIENTS WITH SACROILIACAL DYSFUNCTION DURING PREGNANCY (Vol.22 No.2, str.98-98)

Authors:

Manuela Filipec, Marinela Jadanec

Original paper

Summary:
Objective. The aim of this study was to determine the incidence of sacroiliac dysfunction during pregnancy and by trimesters of pregnancy, and the possibility to detect sacroiliacal dysfunction during pregnancy using the combination of clinical functional tests. Methods. The sample consisted of 200 pregnant women in each trimester (N=600). In research were used following clinical functional tests in physiotherapy assessment: provocation tests (posterior pelvic pain provocation test, Patrick-Faber test and the modified Trendelenburg test), functional test (active straight leg raise test) and palpatory test (palpation of long dorsal sacroiliac ligament). For the assessment of pain, intensity was used visual analog pain scale (VAS scale) and for assessment of the degree of disability in everyday activities was used Quebec scale. Results. The obtained results indicate the incidence of sacroiliac dysfunction at 38.83% in pregnancy, at 6.5% in the first trimester, at 32% in the second trimester and 78% in the third trimester. The obtained results indicated statistical significance (P<0.05) in the increase intensity of pain by trimesters, with significance (P<0.05) increasing disability while performing everyday activities. Conclusion. The results suggest that combination.

Key words:
diagnostic techniques, pregnancy, sacroiliac joint

 


TREATMENT OF AZOOSPERMIA BY TESE/ICSI PROCEDURE IN CLINICAL HOSPITAL »SVETI DUH« – OUR EXPERIENCE FROM 2010–2013. (Vol.22 No.2, str.103-103)

Authors:

Daria Hafner*, Sanja Vujisić**, Renato Bauman*, Ivana Erceg Ivkošić*, Mladen Stojčić***, Tatjana Pavelić-Turudić*

Case report

Summary:
Aim: to present results of TESE/ICSI procedure in the infertility treatment caused by male factor due to diagnosed azoospermia in Clinical hospital »Sveti Duh« in the time period from 2010–2013. Methods: In that period, we involved 29 couples in TESE/ICSI procedure. In 27/29 cases (93.1%) after TESE procedure from testicular tissue we isolated sperm and performed TESE/ICSI in fresh cycle with 27 females with controlled ovarian stimulation. In 24/27 (88.8%) cases we also cryopreserved testicular tissue. We performed total of 44 TESE / ICSI procedures: in 27 cases TESE/ICSI is performed with isolated sperm from fresh testicular tissue, and in 17 cases from previously cryopreserved testicular tissue. Results: 44 TESE/ICSI procedure resulted with total of 14 pregnancies (31.8% per ET and 29.1% after aspiration): eleven (11/27) pregnancies we achieved with sperm isolated from fresh testicular tissue (40.7%) and three (3/17) pregnancies with sperm isolated from cryopreserved testicular tissue (17.6%). Conclusion: TESE / ICSI procedure is the method of choice in the treatment of male infertility in men diagnosed with azoospermia, and our results are comparable with results of leading world centers.

Key words
azoospermia, infertility, TESE, ICSI

 


SECOND DELIVERY AFTER A PREVIOUS CESAREAN SECTION (Vol.22 No.2, str.109-109)

Authors:

Ljiljana Bilobrk Josipović,* Irma Brković,** Zoran Pocrnja,***Branka Lovrinović,*** Boris Škarica,**** Petar Laco*****

Case report

Summary:
Introduction. Due to constant increase in the number of cesarean sections around the world, labors after previous cesarean section became everyday practice in most of maternity hospitals. Several checklists for vaginal birth after previous cesarean section procedures has been defined and agreed on. Despite that, its percentage is in constant decrease in both developed and developing countries. Objective. In paper presented here, we analyzed second delivery of women with previous cesarean section, according to previously defined criteria. We analyzed modes of delivery for the whole sample, by mother’s age, gestational age and newborn’s birth weight. We also analyzed indications for cesarean section, together with afterbirth complications in mothers for the whole sample and by mode of delivery. Methods. Participants were mothers with second pregnancy, with previous cesarean section, who gave birth at Croatian hospital Dr. Fra Mato Nikoli} at Nova Bila. Data refer to a ten-year period from January 1. 1998. to December 31. 2007. Observational retrograde study was applied. Results. Percentage of elective repeated cesarean sections in the whole sample was 62.11%, of unsuccessful vaginal delivery attempt 13.68% and of successful vaginal birth 24.21%. The largest sub samples were mothers of 21 to 34 years of age, with pregnancy gestational age 37–40+6 weeks and newborn’s birth weights of 2500 to 3999 grams. Within these subsamples, the highest percentage of elective cesarean section was among mothers of ≥35 years of age, gestational age of ≥41 weeks and newborn’s birth weight of ≥4000 grams that is also the largest subgroup of all deliveries (N=185). Unsuccessful vaginal birth attempt was most frequent among mothers younger than 20 years, in-group with gestational age of ≤36+6 weeks and newborn’s weight ≤2499 grams. Successful vaginal birth was most frequent among mothers between 21 and 34 years of age, same in gestational age 37 to 40+6 at ≥41 weeks and newborn’s birth weight ≤2499 grams. Most common indication for cesarean section was previous cesarean section. Postpartum complications occurred in 13.3% of all cases, most commonly after elective cesarean section, and most common complication was postpartum hemorrhage. Conclusion. Vaginal birth after previous cesarean section and elective cesarean section are related to different advantages and risks. Considering that partial rupture of the uterus was found in 0.7% cases, percentage of vaginal birth after previous cesarean section could be significantly increased with the correct selection of parturient women.

Key words
previous cesarean section, vaginal birth after a previous cesarean section, repeated cesarean section


HORMONE REPLACEMENT THERAPY: BENEFITS AND RISKS (Vol.22 No.2, str.116-116)

Authors:

Velimir Šimunić, Dinka Pavišić Baldani, Marina Šprem Goldštajn, Lana Škrgatić

Review

Summery:
Hormone replacement therapy (HRT) has an important role in women with estrogen deficit. Patients in reproductive age with hypoestrogenemic amenorrhea and premature menopause as well as women in climacterium and postmenopause have numerous symptoms and signs of estrogen lack, which may result in a decreased quality of life. Hormone therapy (estrogen/progestogen combination products) is one, but temporally limited option due to increased health risks (growing risk of breast cancer, pulmonary embolism). Hormone replacement therapy for postmenopausal women has been subject of numerous discussions and speculations since 1960´s. According to recent studies, the HRT is recommended in treatment of vasomotor symptoms and urogenital atrophy and prevention of osteoporosis-related fractures. It should be started with lowest but effective dosage during short period and with adequate follow-up. The treatment should be individualized according to needs and risks of postmenopausal women. Although there is no strong scientific evidence, the majority of observational studies have been recommended HRT to be used for five years. HRT moderately increases the risk of breast cancer. It varies with the treatment duration and no with hormone dosage. Opposed estrogens (progesterone-estrogen) in oral form are associated with an increased risk of breast cancer, which increases with use. In 25% of postmenopausal women, HRT increases breast density and therefore decreased sensitivity of mammography testing. HRT is not indicated for primary or secondary prevention of cardiovascular disease. It is contraindicated in patients with symptoms and signs of coronary and cerebrovascular diseases. The HRT usage increases the risk for thromboembolic episodes and is not recommended in patients with history of thromboembolism. The use of progestagens in women in which estrogens are contraindicated may have beneficial effects on postmenopausal symptoms, but recent studies have been shown increased risk of breast cancer and thromboembolic incidents particularly with high doses. Ten years after WHI study decline of HRT use was determined for approximately 70%. At the same time, there is increasing interest and need for alternative treatment methods including phytotherapeutics. However, the evidence is limited with regard to the effectiveness, the clinical use and the costs of alternative treatment methods. Furthermore, last reports have been shown increased incidence of fractures in no treated women and dramatic rise of antidepressants. The aim of the article is to present recent insights about benefits, risks and recommendations for HRT usage.

Key words:
hormone replacement therapy, benefits, risks, recommendation


 

Mjesto održavanja kongresa: Hotel President****, Split, Starčevićeva 1, www.hotelpresident.hr/split
Vrijeme održavanja kongresa: 22.- 24. listopad 2015.