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This study was conducted to analyze the reliability of clinical diagnosis in meniscal tear injuries. From one hundred and three patients with knee problems, arthroscopically in 40 were diagnosed LM (lateral meniscus) tears and in 45 patients MM (medial meniscus) tears. MRI of the knee joint was done before the admission and some of them before the clinical examination. In this study meniscal tears were clinically diagnosed by positive McMurray and Apley test. At all these patients the clinical diagnosis was confirmed during underwent therapeutic arthroscopic knee surgery. The accuracy, sensitivity and specificity were calculated based on MRI and arthroscopic findings. The accuracy of clinical diagnosis in our study was 70% for LM tears and 63.1% for MM tears. Our study revealed high sensitivity and specificity and good accuracy for meniscal injuries of knee joint in comparison to arthroscopy. MRI is an appropriate screening tool for therapeutic arthroscopy, making diagnostic arthroscopy unnecessary in most patients. Magnetic resonance imaging is accurate and non-invasive modality for the assessment of meniscal injuries. It can be used as a first line investigation in patients with soft tissue trauma to knee.

Conditions that affect plasma concentrations of acute-phase proteins include infections, trauma, surgical treatment, burns, tissue ischemia (infarctions), various immunological inflammatory conditions and cancer. The cytokine Interleukin-6 (IL-6) is the main stimulator for the production of numerous acute-phase proteins. It has been established that the induction of C-reactive protein (CRP) and production of serum amyloid A is caused by the cytokines IL-6 and IL-1 or TNF-alpha. Elevated levels of IL-6 during acute injuries or stress are often used as an indicator of systemic inflammation and are predictors of preoperative morbidity. We undertook this prospective randomized study in 90 patients undergoing surgery procedure after high-energy trauma, low-energy trauma and open fracture to define plasma levels of IL-6 and CRP over a 2-week period. We presented our results at seven time points, namely 6 hours pre-operatively and post-operatively in 2, 4, 5, 7 and 14 days respectively. We have attempted to find out whether IL-6 and CRP levels returned to baseline during this study period. In our study, we determined the influence of the examined parameters CRP and IL-6 in plasma on the early detection of surgical postoperative inflammation in operatively treated fractures. With the obtained results of our examined parameters, we can state that is provided a place for the routine procedure of CRP and IL-6 as predictors of possible postoperative inflammation.

Objective To assess the effects of COVID-19 vaccines in women before or during pregnancy on SARS-CoV-2 infection-related, pregnancy, offspring and reactogenicity outcomes.Design Systematic review and meta-analysis.Data sources Major databases between December 2019 and January 2023.Study selection Nine pairs of reviewers contributed to study selection. We included test-negative designs, comparative cohorts and randomised trials on effects of COVID-19 vaccines on infection-related and pregnancy outcomes. Non-comparative cohort studies reporting reactogenicity outcomes were also included.Quality assessment, data extraction and analysis Two reviewers independently assessed study quality and extracted data. We undertook random-effects meta-analysis and reported findings as HRs, risk ratios (RRs), ORs or rates with 95% CIs.Results Sixty-seven studies (1 813 947 women) were included. Overall, in test-negative design studies, pregnant women fully vaccinated with any COVID-19 vaccine had 61% reduced odds of SARS-CoV-2 infection during pregnancy (OR 0.39, 95% CI 0.21 to 0.75; 4 studies, 23 927 women; I2=87.2%) and 94% reduced odds of hospital admission (OR 0.06, 95% CI 0.01 to 0.71; 2 studies, 868 women; I2=92%). In adjusted cohort studies, the risk of hypertensive disorders in pregnancy was reduced by 12% (RR 0.88, 95% CI 0.82 to 0.92; 2 studies; 115 085 women), while caesarean section was reduced by 9% (OR 0.91, 95% CI 0.85 to 0.98; 6 studies; 30 192 women). We observed an 8% reduction in the risk of neonatal intensive care unit admission (RR 0.92, 95% CI 0.87 to 0.97; 2 studies; 54 569 women) in babies born to vaccinated versus not vaccinated women. In general, vaccination during pregnancy was not associated with increased risk of adverse pregnancy or perinatal outcomes. Pain at the injection site was the most common side effect reported (77%, 95% CI 52% to 94%; 11 studies; 27 195 women).Conclusion COVID-19 vaccines are effective in preventing SARS-CoV-2 infection and related complications in pregnant women.PROSPERO registration number CRD42020178076.

Introduction The prevalence of COVID-19 and its impact varied between countries and regions. Pregnant women are at high risk of COVID-19 complications compared with non-pregnant women. The magnitude of variations, if any, in SARS-CoV-2 infection rates and its health outcomes among pregnant women by geographical regions and country’s income level is not known.Methods We performed a random-effects meta-analysis as part of the ongoing PregCOV-19 living systematic review (December 2019 to April 2021). We included cohort studies on pregnant women with COVID-19 reporting maternal (mortality, intensive care admission and preterm birth) and offspring (mortality, stillbirth, neonatal intensive care admission) outcomes and grouped them by World Bank geographical region and income level. We reported results as proportions with 95% confidence intervals (CI).Results We included 311 studies (2 003 724 pregnant women, 57 countries). The rates of SARS-CoV-2 infection in pregnant women varied significantly by region (p

Introduction Rapid, robust and continually updated evidence synthesis is required to inform management of COVID-19 in pregnant and postpartum women and to keep pace with the emerging evidence during the pandemic.Methods and analysis We plan to undertake a living systematic review to assess the prevalence, clinical manifestations, risk factors, rates of maternal and perinatal complications, potential for mother-to-child transmission, accuracy of diagnostic tests and effectiveness of treatment for COVID-19 in pregnant and postpartum women (including after miscarriage or abortion). We will search Medline, Embase, WHO COVID-19 database, preprint servers, the China National Knowledge Infrastructure system and Wanfang databases from 1 December 2019. We will supplement our search with studies mapped by Cochrane Fertility and Gynaecology group, Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), COVID-19 study repositories, reference lists and social media blogs. The search will be updated every week and not be restricted by language. We will include observational cohort (≥10 participants) and randomised studies reporting on prevalence of COVID-19 in pregnant and postpartum women, the rates of clinical manifestations and outcomes, risk factors in pregnant and postpartum women alone or in comparison with non-pregnant women with COVID-19 or pregnant women without COVID-19 and studies on tests and treatments for COVID-19. We will additionally include case reports and series with evidence on mother-to-child transmission of SARS-CoV-2 in utero, intrapartum or postpartum. We will appraise the quality of the included studies using appropriate tools to assess the risk of bias. At least two independent reviewers will undertake study selection, quality assessment and data extraction every 2 weeks. We will synthesise the findings using quantitative random effects meta-analysis and report OR or proportions with 95% CIs and prediction intervals. Case reports and series will be reported as qualitative narrative synthesis. Heterogeneity will be reported as I2 and τ2 statistics.Ethics and dissemination Ethical approval is not required as this is a synthesis of primary data. Regular updates of the results will be published on a dedicated website (https://www.birmingham.ac.uk/research/who-collaborating-centre/pregcov/index.aspx) and disseminated through publications, social media and webinars.PROSPERO registration number CRD42020178076.

Introduction: Matrix metalloproteinases are produced by tumour cells, hence, they may be associated with tumour progression including invasion, migration, angiogenesis and metastasis. Finding prognostic markers to better identify patients with higher risk for poor survival would be valuable in order to customize pre- and postoperative treatment as well as to enable closer follow-up of these patients. Aim of our study was to examineMMP-2, MMP-7 and MMP-9 serum levels and correlated them with pathological data such as stage of the colorectal cancer (CRC) and outcome.Methods: The investigation included 82 patients with operable CRC without distant metastases, who had underwent blood tests in order to determine the MMP-2, MMP-7 and MMP-9 serum levels in the following time periods: preoperatively, 3, 6, 9 and 12 months postoperatively.Results: The values of the investigated MMPs decrease postoperatively and start to increase 6 month later in patients of all stages of the disease, reaching the highest value 12 month postoperatively with statistically important differences of MMP-2, MMP-7 and MMP-7 serum levels in terms of disease staging and defined points of time. Analysis of the results showed that the MMP-2 serum levels obtained 3 and 12 months postoperatively,than MMP-7 serum levels 12 months postoperatively and the MMP-9 serum levels in all analyzed points in time were in significant association with the CRC patients’outcome.Conclusion: The MMP-2, MMP-7 and especially MMP-9 serum values could be important indicators for diagnosis of the patients with CRC and for monitoring of disease progression.

Dijabeticnata nefropatija pretstavuva edna od hronicnite mikrovaskularni komplikacii na dijabetot, so multifaktorijalna i ne do kraj rasvetlena etiopatogeneza. So ogled na toa sto kaj pacientite so dijabet, osobeno kaj onie so dijabeticna nefropatija, se najdeni zgolemeni vrednosti na endotelin-1, se pretpostavuva deka istiot moze da ima znacajna uloga vo razvojot na dijabeticnata nefropatija. Osnovna cel na nasata studija bese da se detektiraat promenite vo plazmatskoto nivo na endotelin-1 po eksperimentalno induciran dijabet, i dijabeticna nefropatija kaj staorci so streptozocin. So ogled na dobro poznatite efekti na AKE-inhibitorite, vo ovaa studija go ispituvavme i vlijanieto na enalapril (AKE inhibitor) na plazmatskite koncentracii na endotelin-1, kako i negovite efekti vo tretmanot na dijabeti~na nefropatija. Ednokratnata i.p. administracija na streptozocin (STZ) predizvika signifikantno zgolemuvanje na plazmatskite koncentracii na endotelin-1, proprateni so jasno izrazeni simptomi i znaci na dijabeticna nefropatija (mikroalbuminurija, zgolemeni urinarni vrednosti na N-acetyl-fl-D-glucosamidase, zgolemeni serumski koncentracii na urea, poliurija). Cetiri nedelniot tretman so enalapril dovede do signifikantno namaluvanje na plazmatskite koncentracii na endotelin-1 i do podobruvanje na simtomite i znacite na dijabeticnata nefropatija. Dobienite rezultati potvrduvaat deka endotelin-1 moze da ima znacajna uloga vo razvojot i progresijata na dijabeticnata nefropatija, a AKE inhibitorite, odnosno enalapril, mozat da ja ublazat i usporat progresijata na dijabeticnata nefropatija

BACKGROUND: The human DAZ gene family includes two autosomal genes, BOULE and DAZL, and a Y-chromosomal DAZ gene cluster. All are RNA-binding proteins and assumed to be master regulators of germline gene expression. We have investigated the impact of two DAZL polymorphisms, located at nucleotide positions 260 (SNP 260) and 386 (SNP 386), on the fertility of Caucasian men. These single nucleotide polymorphisms (SNPs) have been described previously to be associated with spermatogenic failure. METHODS: Blood samples were collected and genomic DNA was extracted from 165 normozoospermic men and 202 oligo- or azoospermic patients, of whom 28 displayed an AZFc deletion. The frequencies of A or G allelic variants in SNP 260 and 386 were analysed via TaqMan allelic discrimination assays. In both cases, the A to G transition leads to a threonine to alanine change. RESULTS: A total of 24.2% of the controls showed a heterozygous nucleotide variant (AG) for the SNP 260 and the remaining 75.8% were homozygous for A. In the AZFc-deleted group, this distribution was significantly different, with 39.3% for AG, 57.1% for AA and 3.6% for GG. However, the increased heterozygosity was not correlated with sperm counts and morphology. The patients without deletions displayed a similar allelic pattern to the controls (24.1% AG/75.9% AA). For SNP 386, only the AA nucleotide variant was found in all subjects studied and in no case was the previously described heterozygous AG variant found. CONCLUSION: In a selected Caucasian population, the DAZL SNP 386 is completely absent and SNP 260 is not associated with spermatogenic failure and therefore does not represent a molecular marker for genetic diagnosis of male infertility. [ABSTRACT FROM AUTHOR]