Search

In most academic discourses, United Nations (UN) programs and initiatives to promote digitalization and womens rights are studied as distinct fields. Less attention has been paid to UN efforts to promote gender equality and protect womens rights by promoting digitalization. The article addresses some of the gaps in the contemporary research of the role of modern international intergovernmental organizations in womens rights protection amidst modern technological development. The study reveals the influence of digitalization on ameliorating the position of women in modern societies and formulates the assessment of the gender gap in using the ICT technologies, as well as analyzes how UN specialized divisions act to ensure digital gender equality. The author concludes that the Sustainable Development Goals (SDGs) approved by the UN in 2015 do not pay enough attention to the importance of digitalization for ensuring the rights of women.

Background Significant risk of bias and limitations in outcome selections in trials evaluating conservative treatments for the management of Pelvic Organ Prolapse (POP) have been highlighted and preclude comparability of outcomes, synthesis of primary studies and high quality evidence. Objectives As systematic review of the reported outcomes is the first step in the process of development of a Core Outcome Set (COS), we aimed to systematically review reporting of outcomes and outcome measures in Randomised Control Trials (RCTs) on conservative treatments for POP and develop an inventory of them for consideration as core outcome and outcome measures sets. We evaluated methodological quality, outcome reporting quality and publication characteristics and their associations among published RCTs. Study Design: Systematic review of RCTs identified from the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE and MEDLINE (Pubmed). RCTs evaluating the effectiveness of conservative interventions for the management of POP were considered for inclusion. Outcomes and outcome measures were obtained from the RCTs and an inventory was created. Outcomes were grouped in domains and themes. Methodological quality, outcome reporting quality and publication characteristics were evaluated and statistically analysed. Results Twenty-five trials (3179 women) were included and reported 31 outcomes and 50 outcome measures. Reporting rates of the outcomes investigated ranged between 4% and 56%. The most commonly reported outcome domains were patient reported symptoms, stage of POP expressed as POP-Q stage, and quality of life. Univariate analysis demonstrated no significant correlations of methodological and outcome reporting parameters. Conclusions There is a need to increase comparability of RCTs. Reporting standardized outcomes included in a COS for conservative interventions for POP will facilitate the comparability across RCTs. While the process of developing COS is in progress, we propose the interim use of the three most commonly reported outcomes in each domain: patient-reported outcomes (symptom distress including bowel and urinary symptoms, sexual function), stage of prolapse and quality of life parameters using validated questionnaires (Pelvic Floor Distress Inventory 20 (PFDI-20), Pelvic Floor Impact Questionnaire/Health related quality of life (PFIQ-7/HRQOL) and Pelvic Organ Prolapse Impact Questionnaire (POPIQ-7).

In evaluating the effectiveness of interventions in perineal trauma research, outcomes reported by patients should have a prominent focus. There is no international consensus regarding the use of either patient-reported outcomes (PROs) or tools used to determine these outcomes (patient-reported outcome measures, PROMs). The objective was to evaluate the selection, reporting and geographical variations of PROs and PROMs in randomised controlled trials (RCTs) on perineal trauma. We performed a systematic review of RCTs in perineal trauma research evaluating outcome and outcome measure reporting. We identified PROs and PROMs and grouped PROs into domains and themes, a classification system based on a medical outcome taxonomy. Of 48 included RCTs, 47 reported PROs. In total, we identified 51 PROs. Outcome reporting consistency was low, with 27 PROs reported only once. Nine PROs were reported more than five times, the most frequent being perineal pain, with no geographical variation in reporting. Four themes encompassing 12 domains were identified. The most frequently reported theme was “Clinical”, with 25 PROs grouped within four domains. “Resource use” and “Adverse events” themes were rarely reported, with only five PROs. PROMs also exhibited variation. Most common were visual analogue scale (VAS; 100 mm), Cleveland Clinic Continence Score, The Faecal Incontinence Quality of Life scale, VAS (0–10) and the McGill Pain Questionnaire. Significant heterogeneity in PROs and PROMs was observed among RCTs. Despite inconsistency, PROs are the most prevalent outcome in perineal trauma research. Patient-reported adverse events are underreported. Their use in determining the effectiveness and safety of interventions makes their integration important in perineal trauma core outcome sets. Identification and grouping of outcomes will assist future core outcome consensus studies.

Aims In overactive bladder (OAB) research, different biomarkers have been proposed as diagnostic tools and may be used to create individual patient profiles. Assessing the diagnostic performance of biomarkers would better outline their utility. Therefore, our aim was to investigate the diagnostic value of four urinary biomarkers: human brain derived neurotrophic factor (hBDNF), malondialdehyde (MDA), h nerve growth factor (hNGF) and h 8-hydroxydeoxyguanosine in women with OAB. These are neurotrophins/oxidative stress markers that have been linked to lower urinary tract symptoms. Methods A total of 105 women were included in the study and distributed in two groups: a group with OAB (n = 53) and a control group (n = 50). The levels of the biomarkers were determined using enzyme-linked immunosorbent assay technique and they were compared between the groups. If the Mann-Whitney test demonstrated a statistically significant difference, receiver operating curves (ROC) analysis was undertaken. Results When normalized to urinary creatinine, hBDNF, MDA, and hNGF showed significantly increased values in women with OAB as compared to controls, whereas 8-OHdG showed no significant difference. The diagnostic performance of these biomarkers was analyzed based on the area under the ROC curve (AUC). MDA had the highest AUC (0.75), followed by hNGF (0.69) and hBDNF (0.67). Conclusions Our findings suggest that MDA, a relatively novel biomarker in OAB research, has a fair performance as a diagnostic tool for OAB. Moreover, urinary neurotrophins (NGF and BDNF) as biomarkers may have a role in the diagnostic pathways of women with OAB symptoms.

Currently, the literature data regarding the concentration of microelements in walnut oil are low, most of them being related to their presence in the walnut core. The purpose of this study was to determine the distribution of essential and toxic mineral elements from walnut oil marketed in Timisoara (Romania) and to evaluate the mineral contribution of this important food in the prevention of cardiovascular diseases. The paper presents the results obtained in determining the content of some essential and toxic microelements of the native walnut oil, used as dietary food. The results obtained from the analysis of the essential and toxic mineral elements, by Inductively Coupled Plasma - Mass Spectrometer (ICP-MS) method, reveal that the walnut oil samples analyzed contain noticeable amounts of: Fe (2,576 - 3,621 mg/kg), Mn (1,876 - 1,783 mg/kg), Zn (1,120 - 1,782 mg/kg), low Cu (0.185 - 0.226 mg/kg), Cr (0.088 - 0.154 mg/kg) and Ni (0.052 - 0.081 mg/kg) and very low Co (0.001 - 0.003 mg / kg). Pb and Cd, elements with pronounced toxic potential, were identified in very low concentrations: 0.020 - 0.031 mg/kg Pb, respectively 0.001 - 0.002 mg /kg Cd. The results obtained when evaluating the mineral intake show that, under the conditions of this experiment, a daily consumption of 30 g of walnut oil cannot be considered as the only additional source of microelements.

Aortic valvulopathies, and especially aortic stenosis (AS), are the most common valvular disorders. Untreated, 50% of patients with severe AS will die within 2-3 years from the onset of symptomatology. The standard treatment consists in the surgical replacement of the aortic valve with mechanical or biological prosthesis. 40 patients were included in the study after replacement of the aortic valve with double disc mechanical prosthesis for severe degenerative AS. The disks of the prosthesis are made of pyrolytic carbon characterized by extreme hardness, which provides wear protection over the years. The ring is composed of a graphite substrate coated with pyrolytic carbon and attached to a suture collar made of polyethylene (polytetrafluoroethylene - PTFE) or polyester (Dacron� or Teflon�). This study evaluates mass regression and left ventricular mass index at three months and one year postoperatively. The regression of the left ventricular mass at 3 months after the surgery is 25.86%, and at one year after the surgery this regression was reduced - 15.11%. The regression of the mass of the left ventricle and especially the premature regression, correlated with the degree of hypertrophy of the left ventricle preoperatively, highlight the beneficial effect of the double disc mechanical prosthesis.

OBJECTIVE Given the high variation of perceptions of women with stress urinary incontinence (SUI), qualitative meta-synthesis in this field appears warranted. We aimed to synthesize evidence on women's experiences of SUI by analyzing qualitative data. METHODS A literature search of Medline, Embase, Scopus, PsycInfo, and CINAHL databases was performed by a CHORUS Working Group, from inception to August 2020. Qualitative studies on women's perspectives on SUI were included. Thematic analysis was used as a conceptual approach to analyze the data and develop a set of overarching themes. The quality of studies was assessed based on the Critical Appraisal Skills Program tool. RESULTS Seven studies were included. Six themes encompassing women's perspectives on SUI emerged: experiencing SUI, awareness of SUI, treatments for SUI, sexuality, communication, and psychosocial effects. The quality appraisal of the studies showed good coherence. CONCLUSION This study revealed six overarching themes, of which treatment had the highest prevalence. Assessment of women's perceptions of SUI in the context of a qualitative meta-synthesis may inform policy and practice around this condition, may guide and help set research priorities, and will ideally contribute to the development of a Core Outcome Set for SUI.

The aim of this study is to document the impact of thyroid hormones on the autonomic nervous system (ANS), expressed by heart rate variability (HRV) and heart rate turbulence (HRT), in patients with hyperthyroidism, compared to controls. Another purpose is to determine if HRV and HRT parameters are significantly correlated with the levels of thyroid hormones and the duration of hyperthyroidism. We studied HRV, in time and frequency domain, and HRT in a group of 113 premenopausal women, with still untreated overt hyperthyroidism, without cardiovascular diseases or risk factors for atherosclerosis, admitted between 2015 and 2018 in the Endocrinology Clinic of our hospital and compared the results with data obtained in 29 healthy controls. Depending on the severity and duration of hyperthyroidism and levels of thyroid hormones, patients were assigned to three groups: mild and moderate hyperthyroidism, severe and recurrent forms. We performed 24 hours Holter monitoring in patients and controls. Regarding HRV parameters in time domain, they were significantly depressed in patients comparing to controls. Referring to HRT, all patients had abnormal, positive values of turbulence onset (TO) and we documented statistically significant differences (p[0.001) when compared to controls. All patients had normal positive values of turbulence slope (TS), which decreased parallel with the severity of hyperthyroidism. In patients with hyperthyroidism, we documented depressed values of HRV parameters in time domain, correlated with the duration and severity of the thyroid disease. Our patients had pathologic values of TO. Although positive, TS values were lower when compared to controls.

The serum level of uric acid (UA) appears to be associated with a variety of cardiometabolic risk factors; however, direct association with the metabolic syndrome (MetS) remains controversial. The aim of this study is to investigate the association between serum levels of UA and the components that define MetS, differentiated by gender. 262 patients were enrolled (132 women and 130 men); mean value of the age: 58.7�16 year. Hyperuricemia was considered when the level of serum UA �7mg/dL in men, and � 6mg/dL in women; MetS was defined according to the IDF criteria. The prevalence of MetS in the studied group was 35.11% and the prevalence of hyperuricemia was 16.79%. Men with hyperuricemia had the highest prevalence of abdominal obesity (87.5% vs. 66.32%, p [0.001) and hypertriglyceridemia (65.62% vs. 45.91%, p [ 0.001) versus men with normal level of serum UA. Women with hyperuricemia also had a significantly higher incidence of abdominal obesity (75% vs. 57.51%, p [0.001), hypertriglyceridemia (58.33% vs. 38.33%, p [0.001), decreased HDL (50% vs. 33.33%, p [0.001) and hyperglycemia (66.66% versus 50%, p [0.001) compared to those with normal levels of serum UA. The majority of men with hyperuricemia have more than 4 of the MetS components. Hyperuricemia had a higher prevalence in patients with MetS, it may be considered as a causal factor of MetS. Elevated levels of serum uric acid were significantly more associated with the increasing number of MetS components. Early detection and treatment of hyperuricemia is essential for preventing the metabolic syndrome and its complications.

The goal of this study is to investigate the relationship between the serum level of uric acid (UA) and metabolic syndrome (MetS) according to age and gender. The study included 395 patients (200 women and 195 men), with a mean age of 53.6�18 years. Hyperucemia (HU) was defined by a serum level UA �7mg/dL in men and � 6mg/dL in women (according to the EULAR guide), and MetS was defined according to the criteria of the International Diabetes Federation (IDF). The prevalence of hyperuricemia in the study lot was 17.21%, and MetS was 35.44%. In women, the prevalence of HU and MetS increases with age: 13.88% of women over 65 years show HU, and 44.44% of them comprise the elements of MetS. In men, HU and MetS do not vary significantly depending on age. MetS has a higher prevalence in HU patients than in HU-free patients. HU prevalence in MetS patients was 32.65% in women versus 46.15% in men. In conclusions, the prevalence of HU and MetS differs significantly according to gender and age. The prevalence of MetS was higher in male subjects of medium age and HU did not vary significantly depending on age. In women, the prevalence of HU and MetS was higher in those over 65 years. Hyperuricemia in middle-aged female patients can predict the MetS development.

Background Studies evaluating cosmetic gynecological interventions have followed variable methodology and reported a diversity of outcomes. Such variations limit the comparability of studies and the value of research-based evidence. The development of core outcome sets (COS) and core outcome measures sets (COMS) would help address these issues, ensuring a minimum of outcomes important to all stakeholders, primarily women requesting or having experienced cosmetic gynecological interventions. Objective This protocol describes the methods used in developing a COS and COMS for cosmetic gynecological interventions. Methods An international steering group within CHORUS, including health care professionals, researchers, and women with experience in cosmetic gynecological interventions from 4 continents, will guide the development of COS and COMS. Potential outcome measures and outcomes will be identified through comprehensive literature reviews. These potential COS and COMS will be entered into an international, multi-perspective web-based Delphi survey where Delphi participants judge which domains will be core. A priori thresholds for consensus will get established before each Delphi round. The Delphi survey results will be evaluated quantitatively and qualitatively in subsequent stakeholder group consensus meetings in the process of establishing “core” outcomes. Results Dissemination and implementation of the resulting COS and COMS within an international context will be promoted and reviewed. Conclusions This protocol presents the steps in developing a COS and COMS for cosmetic gynecological interventions. Embedding the COS and COMS for cosmetic gynecological interventions within future clinical trials, systematic reviews, and practice guidelines could contribute to enhancing the value of research and improving overall patient care. Trial Registration Core Outcome Measures in Effectiveness Trials (COMET) 1592; https://tinyurl.com/n8faysuh International Registered Report Identifier (IRRID) PRR1-10.2196/28032

The goal of the study was to evaluate the influence of the solvent properties on the crystal characteristics of β-cyclodextrin (β-CD) recrystallized from alcohol-water solvent mixtures, with possible applications for the preparation, purifying and complexation of β-CD. For the first time, structure-property relationships (QSPRs) between the hydrophobicity of alcohols or dielectric constant of solvents used for recrystallization of β-CD and its properties (such as crystallinity index, CI) have been obtained. Recrystallized β-CD from water and C1-C4 alcohol-water solutions provide β-CD with higher CI values of 99.4(±5.9)% for ethanol-water (1:4, v/v) as recrystallizing system. This property has a parabolic variation with the logP (octanol/water partition coefficient) of the alcohol (r2 = 0.998). Solvent parameters also influence the β-CD crystal characteristics, as was demonstrated by X-ray diffractometry refinement, infrared spectroscopy and thermal analyses.

Background More than 85% of women sustain different degrees of trauma during vaginal birth. Randomized controlled trials on childbirth pelvic floor trauma have reported a wide range of outcomes and used different outcome measures. This variation restricts effective data synthesis, impairing the ability of research to inform clinical practice. The development and use of a core outcome set (COS) for childbirth pelvic floor trauma aims to ensure consistent use of outcome measures and reporting of outcomes. Methods An international steering group, within CHORUS, an International Collaboration for Harmonising Outcomes, Research and Standards in Urogynaecology and Women’s Health, including academic community members, researchers, healthcare professionals, policy makers and women with childbirth pelvic floor trauma will lead the development of this COS. Relevant outcome parameters will be identified through comprehensive literature reviews. The selected outcomes will be entered into an international, multi-perspective online Delphi survey. Subsequently and based on the results of the Delphi surveys consensus will be sought on ‘core’ outcomes. Discussion Dissemination and implementation of the resulting COS within an international context will be supported and promoted. Embedding the COS for childbirth pelvic floor trauma within future clinical trials, systematic reviews, and clinical practice guidelines is expected to enrich opportunities for comparison of future clinical trials and allow better synthesis of outcomes, and will enhance mother and child care. The infrastructure created by developing a COS for childbirth pelvic floor trauma could be leveraged in other settings, for example, advancing research priorities and clinical practice guideline development.

Background and aims. The microscopic description of the nerve fibers responsible for micturition is useful when planning minimally invasive interventions for refractory overactive bladder such as intravesical botulinum toxin injections. The purpose of this study was to investigate the density of nerves and ganglia within the bladder trigone, with a focus on identifying areas with a higher density. Methods. Urinary bladders were harvested from 3 female cadavers. Following tissue processing, a total of 100 slides stained with hematoxylin and eosin (HE) and immunostained for S100 and CD56 were analyzed. The density of nerve fibers (NFD) and ganglia (GD) in 3 different bladder trigone compartments was analyzed. Results. The NFD in the central compartment (16.2±3.9) was significantly higher than in both the peripheral (p=0.0005) and the intermediary (p=0.01) compartments. The GD was the highest in the peripheral compartment, but it was not significantly different from the other compartments. Conclusions. This microscopic study showed a pattern of distribution with a dominance of nerve fibers in the central compartment and a rather homogenous distribution of the ganglia within the female bladder trigone.

Background: Negative psychological conditions are common in patients with cardiovascular diseases. Although depression has been scrutinized over the years in these patients, only recently has anxiety emerged as another important risk factor. The purpose of this study was to compare the parameters of psychological stress in a population of coronary patients with and without myocardial revascularization procedures and to analyze lifestyle and socio-economic contributors to the state of health of these patients before inclusion in a comprehensive individualized rehabilitation program. Methods: This study included 500 patients with coronary artery disease (CAD) in stable condition divided in 2 groups: 200 patients who underwent coronary artery bypass grafting (CABG) or percutaneous transluminal coronary angioplasty (PTCA) (Group 1) and 300 patients without myocardial revascularization (Group 2) with stable angina or thrombolyzed myocardial infarction. The protocol included screening for anxiety/depression after procedure using three different scales: Duke Anxiety-Depression Scale, Hospital Anxiety and Depression Scale (HADS) and the Type D Personality Scale (DS-14) scale that evaluates negative affectivity (NA) and social inhibition (SI). Results: Significant differences between groups were observed for HAD-A (9.1 &plusmn, 4.18 for Group 1 vs. 7.8 &plusmn, 4.03 for Group 2, p = 0.002) and DUKE scores (30.2 &plusmn, 12.25 for Group 1 vs. 22.7 &plusmn, 12.13 for Group 2, p &lt, 0.001). HAD-A scores (p = 0.01) and DUKE scores (p = 0.04) were significantly higher in patients who underwent PTCA vs. CABG. CAD patients without myocardial revascularization (Group 2, n = 300) presented anxiety in proportion of 72.3% (n = 217) out of which 10.7% (n = 32) had severe anxiety, and 180 patients had depression (a proportion of 60%) out of which 1.3% (n = 4) presented severe depression. The correlation between the presence of type 2 diabetes mellitus (T2DM) and type D personality in revascularized patients (n = 200) was significant (Chi2 test, p = 0.010). By applying multinomial regression according to the Cox and Snell R-square model and multivariate linear regression by the Enter method, we demonstrated that male gender, age and marital status proved significant predictors for psychological stress in our study population. Conclusions: The results obtained in this study provide a framework for monitoring anxiety, depression and type D personality in coronary patients before inclusion in comprehensive rehabilitation programs. Behavioral and psychological stress responses in patients with CAD significantly correlate with risk factors, and could influence the evolution of the disease. Moreover, other factors like gender, income and marital status also seem to play a decisive role. Evaluation of psychological stress parameters contributes to a better individualization at the start of these programs, because it allows adjusting of all potential factors that may influence positive outcomes.

Skin- and mucosal infections, especially purulent, can often cause diagnostic and treatment problems. Therefore, we intend to conduct a microbiological study of isolated bacterial strains from ambulatory patients with various cutaneous-mucosal infections. In isolated strains we determined the sensitivity to antibiotics and we established the phenotypes of resistance in which they fall. We took in account 98 strains isolated by a private laboratory in Timisoara between January 2016 and December 2017. After bacterial identification, sensitivity testing to antibiotics was realized using Kirby-Bauer disc diffusion according to the CLSI standard. Antibiogram was performed for all strains except for Streptococcus pyogenes. By interpreting the antibiograms, the phenotypes of resistance were determined. Most infections were caused by Staphylococcus aureus. In order of frequency following strains were isolated: Staphylococcus aureus (75.52%), Streptococcus pyogenes (11.22%), Pseudomonas aeruginosa (7.14%), E. coli (4.08%) �i Enterobacter spp. (2.04%). S. aureus strains were resistant to penicillin in 94.60% of cases. We observed a higher sensitivity to oxacillin (87.84%), tobramycin (86.49%), gentamycin (87.84%), ciprofloxacin (83.78%) and clindamycin (89.20%). Most strains of S. aureus were of phenotype Peni-R Meti-S (82.44%). 12.16% were of phenotype Peni-R Meti-R (MRSA) and only 5.40% were sensitive to betalactams (Peni-S Meti-S). Gram-negative bacilli strains (Pseudomonas aeruginosa, E. coli, Enterobacter spp.) were less resistant, all being wild strains. Determining antibiotic resistance phenotypes is necessary in order to be able to make the right decision when choosing anti-infectious treatment, but also to prevent the selection of multi-resistant bacterial strains. The presence of MRSA at a rate of 12.16% is an alarm signal because the MRSA strains are multi-resistant to antibiotics with cross-resistance to the betalactams. Resistance usualy extends also to other classes of antibiotics. For a correct diagnosis and treatment, the results of the bacteriological testing need to be corroborated with the clinical signs.

Aims In the current climate of evidence‐based health care, the aim of this meta‐synthesis was to collect and systematically analyse data from primary qualitative studies on pelvic organ prolapse (POP), to identify patient‐centered perspectives on the natural course of POP. Information acquired in this study may be useful for ongoing research towards the development of core outcome sets (COS) in pelvic floor disorders. Methods A CHORUS Working Group performed a standardized search of three different databases (Medline, Embase, Scopus), from inception to October 2019. We selected qualitative studies on women's perspectives on POP that were published in the English language. Three reviewers independently evaluated the quality of eligible papers and highlighted recurrent themes based on patient perspectives. Results Eighteen qualitative studies including a total of 497 patients were assessed in this analysis. Our study revealed five superordinate themes, recurrently encountered in qualitative studies on POP: awareness of POP (6 studies), communication (9 studies), treatments (10 studies), effects on quality of life (6 studies), and self‐image (3 studies). Five out of 10 quality criteria were met by all the studies included, based on an assessment performed using the critical appraisal skills program. Conclusions This is the first synthesis of qualitative studies that address POP‐related experiences of women, highlighting five superordinate themes, of which treatment was the most commonly reported one. This synthesis' findings may guide quantitative research priorities and will hopefully contribute to the development of a COS for POP.

The ANTIATERO-ALIM study was a randomized, parallel design nutritional trial testing functional food (FF) diets against the usual diet recommended in the metabolic syndrome. Functional meals included balsamic vinegar from apples and honey and grape juice enriched with polyphenols from seeds of red grapes. 300 patients with metabolic syndrome were randomized into 4 groups: gr.1: FF + Ω-3 supplements, gr.2: FF, gr.3: Ω-3 supplements, gr.4: control. IRHOMA insulin resistance, plasma lipids and oxidative stress were assessed at inclusion and at 6 months. After 6 months there was a very significant decrease of oxidative stress in group 3, followed by a significant decrease in groups 1 and 2.

CONTEXT: Endometriosis is a common gynecological disease, characterized by ectopic deposits of endometrial tissue outside of the uterine cavity, and it is associated with pelvic pain and infertility, with an important impact on the quality of life. At this point there is a controversy regarding the etiology and pathophysiology of endometriosis and it seems that pro-angiogenic growth factors might be involved, but their role is not completely understood. OBJECTIVE: To evaluate the serum concentration of the main growth factors in patients with diagnosed endometriosis compared to healthy controls. SUBJECTS AND METHODS: A total of 157 women were divided into two study groups (Group I – endometriosis; Group 2 – healthy women). Serum levels of VEGF, G-CSF, GM-CSF, b-FGF, EGF, and HGF were measured with Human Multiplex Cytokine Panels. RESULTS: VEGF serum levels were significantly lower in women with endometriosis compared to controls (1.924±0.145 compared to 1.806±0.078 pg/mL, p

Background and objectives: The objective of this study was to evaluate the potential of first trimester uterine artery Doppler ultrasonography for the early prediction of preeclampsia (PE), in at-risk pregnant women. Materials and Methods: This was a prospective longitudinal study, including 120 Caucasian pregnant women with risk factors for PE. The potential of pulsatility indexes (PI) and notch was assessed as a tool for preeclampsia screening. Results: Doppler examination of the uterine artery performed early at 11&ndash, 14 WA allows the detection of pregnancies that will develop PE with a sensitivity of 61.5% and a specificity of 63.8% based on PI analysis. Predictive power increases slightly by adding bilateral notch (sensitivity = 65.4%, specificity = 66%). Conclusions: Uterine artery Doppler examination is an effective non-invasive screening test for the development of PE in pregnancies at risk, particularly appropriate in health systems with limited means of evaluating other biomarkers.

In rats with surgically induced primary ovarian failure, melatonin may influence intra-retroperitoneal fat and a number of metabolic factors, which are risk factors for a number of disorders, including endometrial cancer (EC). The aim of this study is to investigate the influence of melatonin treatment in female rats with surgically induced menopause on the plasma glucose-regulated protein ​​78 (GRP78) levels as a risk factor of EC. In the current study 40 mice were included. At 14 days post-ovariectomy the animals were exposed to estrogen replacement treatment and combined treatment of estrogen and melatonin. The treatment duration, with products and doses recommended for veterinary use, was 12 consecutive weeks. The plasma estrogen and GRP78 level was measured. Groups which received estrogen associated with melatonin had a lower level of GRP78 compared to the control group. This study supports the idea that melatonin influences plasma estrogen level, which is directly, correlated with plasma GRP78 level, suggesting the implication of GRP78 in the pathogenesis of EC.

Background: Endometriosis is a frequent gynecologic disease with a severe impact on the quality of life in the affected women; its pathogenesis is yet to be fully understood, with an altered immunity as a possible key factor. The present study aimed to investigate the serum anti-inflammatory cytokine profile in the patients with endometriosis compared with the healthy controls. Materials and Methods: One hundred and sixty women were included, divided into two study groups (Group I - endometriosis; Group 2 - healthy women). We evaluated the serum levels of interleukin-1 receptor antagonist (IL-1Ra), IL-2, IL-2R, IL-4, IL-10, IL-13, and IL-15 with the use of Human multiplex cytokine panels. Statistical analyses (normality distribution analysis, independent t-test, Mann-Whitney U-test) were performed using IBM SPSS software (version 22.0) and GraphPad Prism (version 5.00); receiver operating characteristic curve were used to demonstrate the diagnostic performance of the studied markers. Results: The mean serum level of IL-1Ra, IL-4, and IL-10 were significantly higher in women with endometriosis compared to women free of disease from the control group (30.155, 138.459, and 1.489, respectively, compared to 14.109, 84.710, and 0.688, respectively; P < 0.001, P < 0.001, and P = 0.002, respectively.). No significant differences in the mean serum levels of IL-2, IL-13, and IL-15 were observed between the studied groups and IL-2R had a very low detection rate. Conclusion: Endometriosis is associated with elevated levels of anti-inflammatory cytokines, IL-1Ra, IL-4, and IL-10, markers that have a potential role as a prognostic factor for endometriosis.

The aim of the study was to investigate the serum pro-inflammatory cytokine profile in patients with diagnosed endometriosis. Material and methods: The study included 160 women, who were divided in two study groups (Group I – endometriosis; Group 2 – healthy). We evaluated the serum levels of interleukin (IL)-1β, IL-5, IL-6, IL-7, and IL-12, and of tumour necrosis factor α (TNF-α) with the use of Human Multiplex Cytokine Panels. Results: The serum level of IL-1β, IL-6, and TNF-α is significantly higher in women with endometriosis compared to women free of disease, from the control group (mean 10.777, 183.027, and 131.326, respectively, compared to 3.039, 70.043, and 75.285, respectively; p = 0.002, p < 0.001, and p = 0.015, respectively). No significant differences in the serum levels of IL-5 and IL-12 were observed between the studied groups, and IL-7 had a very low detection rate. Conclusions: Women with endometriosis have elevated levels of key pro-inflammatory cytokines, i.e. IL-1β, IL-6, and TNF-α. At the same time, IL-1β and IL-6 could be used as predictors for endometriosis.

Background/aim: The aim of the study was to evaluate the serum concentration of main chemokines and interferons in patients with diagnosed endometriosis. Materials and methods: A total of 160 women were divided in two study groups (group 1 - endometriosis; group 2 - healthy women). Serum levels of IFN-α, IFN-γ, MCP-1, MIP-1α, MIP-1β, RANTES, eotaxin, IL-8, MIG, IP-10, and IL-17A were measured with Human Multiplex Cytokine Panels. Results. Serum levels of IFN-γ, MCP-1, and IL-8 were significantly higher (mean 14.03, 57.24, and 534.24, respectively, compared to 0.58, 20.51, and 259.82, respectively), and serum levels of IP-10 and eotaxin were significantly lower in women with endometriosis compared to the controls (mean 1.15 and 1.01, respectively, compared to 3.90 and 3.22, respectively). Conclusions. According to our results women with endometriosis have elevated levels IFN-γ, MCP-1, and IL-8, and lower serum levels of IP-10 and eotaxin, indicating unbalanced immune activity in endometriosis.

Aims: Embryonic demise is a frequent complication of the first trimester pregnancy. The purpose of this study was to evaluate the correlation between a serum biomarker, the soluble form of the vasculo-endothelial growth factor (sFlt-1) and the distance between the yolk sac (YS) and embryo (DYSE), determined by ultrasonography.Material and methods: The study was a prospective case-control study that included 2 groups of patients – the control group with 81 first-trimester pregnancies in evolution and the case group with 89 first-trimester pregnancies with a potentially reserved evolutivity.Results: A correlation between the serum level of sFlt-1 and DYSE in embryos with crown-rump length (CRL) greater than 5 mm was identified, showing that a DYSE ≤3 mm correlates with a low level of sFlt-1 (p 4 mm correlates with an increased level of sFlt-1 (p

Introduction.The identification of biological markers that indicate an increased risk for the development or recurrence of endometrial cancer (EC) in obese women might be useful for decreasing EC mortality and morbidity. Glucose-regulated protein 78 (GRP78) is a major protein of the endoplasmic reticulum expressed in all normal cells. Overexpression of GRP78 has been reported to be a tumoral biomarker. Increased detection of GRP78 is positively correlated with the tumoral stage and prognosis. This study aimed to identify a correlation between intraperitoneal fat, plasma GRP78 levels, and EC.Materials and Methods.Two groups of patients were included in the study: group I, 44 patients diagnosed with EC, and group II, 44 patients without gynecological pathology or inflammatory disorders. Visceral fat was determined by ultrasound and plasma GRP78 levels were measured.Results. Plasma GRP78 levels were significantly higher in patients with EC compared to the control group. Intraperitoneal fat was in a positive linear correlation with the plasma GRP78 level (p<0.0001).Conclusion.The measurement of the GRP78 level associated with the determination of intraperitoneal fat can be a useful predictor for EC.

Twin reversed arterial perfusion (TRAP) sequence is a rare and severe complication specific to monochorionic twin pregnancies, involving the presence of an acardiac twin and a structurally normal co-twin (pump twin). We report on the case of a33-year-old female with a biamniotic monochorionic twin pregnancy complicated with TRAP sequence and polyhydramnios. The patient underwent fetoscopic termination of the acardiac twin and at 34 gestational weeks (GW) was readmitted with aretroplacental hematoma. The patient gave birth through caesarean section to a living female fetus, weighing 1480 g. To the best of our knowledge, this is the first case reporting a twin pregnancy with TRAP sequence complicated with retroplacental hematoma.

Background. Leiomyomas are a known cause of infertility and recurrent pregnancy loss, with a global incidence of 25-30% and 2.7-10.7% during pregnancy. They can have an unpredictable evolution and determine numerous complications during pregnancy, such as preterm delivery and severe postpartum hemorrhage. Case presentation. This case report presents a successful pregnancy obtained after the removal of 21 leiomyomas by abdominal myometrectomy. A 28-year-old patient, gravida 2, abortus 1, with uterine fibroids, was subjected to multiple abdominal myometrectomy. Four months after surgery, the patient reported amenorrhea for 7 weeks, and intrauterine evolutive pregnancy was confirmed. She had an uncomplicated pregnancy and delivered by caesarean section a healthy female fetus, weighing 2900 g. Conclusion. The management of leiomyomas before obtaining a pregnancy should be highly recommended. To the best of our knowledge, this is the first case reporting a successful pregnancy after the removal of 21 fibroid nodules by abdominal myometrectomy.

Conventional extraction of piperine and its derivatives by stirring the black pepper powder with solvents (ethyl alcohol, chloroform, petroleum ether, diethyl ether, etc.) for 16 to 24 h, or in a Soxhlet device for 16 h, can be replaced by extraction with supercritical fluids (CO 2 , CO + ethanol mixtures) [5, 6], or can be aided by use of microwave irradiation [7]. Separation and identification of the compounds present in pepper (essential oils, alkaloids, etc.) has been achieved by gas chromatography combined with mass spectrometry [8] and by thin-layer chromatography [9, 10]. C. Marutoiu, M.I. Moise, Lucian Blaga University of Sibiu, Faculty of Agricultural Sciences, Food Industry, and Environmental Protection, 7–9, Ion Ratiu Street, 550012 Sibiu, Romania; I. Gogoasa, Banat’s University of Agricultural Sciences and Veterinary Medicine, Faculty of Food Technology, 119 Calera Aradului, 300645 Timisoara, Romania; I. Oprean, O.F. Marutoiu, Babes-Bolyai University, Faculty of Chemistry and Chemical Engineering, 11, Arany Janos Street, 400028 Cluj-Napoca, Romania; C. Tigae, University of Craiova, Faculty of Chemistry, Craiova, Romania; and M. Rada, University of Medicine and Pharmacy Victor Babes, Faculty of Medicine, 2, Eftimie Murgu Place, Timisoara, Romania. Separation and Identification of Piperine and Chavicine in Black Pepper by TLC and GC–MS

Financial stability is the key objective that sustains and empowers investments and economic groth, or scatters the opportunities when lacking. As growth translates to profitability, and profitability is dependent upon solvalibility, the need for a deep knowledge of all potential risks surfaces. This scope is seeken through all the reglementations of the financial markets. Since the last major financial crisis had a less devastating impact on the insurance market and the losses suffered by the insurance companies were smaller than the losses of banks, we will focus on the risk valuation apllied by these insurance companies. The proper valuation of risks is mirrored in the Solvency Capital Requirement calculated,which under Solvency II framework,corresponds to Value-at-Risk of the basic own funds subjected to a confidence level of 99.5% over a one-year period.

We propose a comparative study of sensitivity to antibiotics of Gram-positive germs isolated in urocultures from patients in ambulatory and two wards with surgical risk (urology and obstetrics-gynaecology), and also to establish the resistance phenotypes of these strains.124 strains of Gram-positive cocci were studied: 28 S. aureus strains, 24 strains of coagulase-negative staphylococcus (CNS), 23 Streptococcus aglactiae strains, 1 Streptococcus anginosus strain and 48 Enterococcus spp. strains. The isolated strains came from 4398 urocultures (1889--ambulatory, 1871--urology, 629--obstetrics-gynaecology). Testing of antibiotic sensitivity was performed through Kirby-Bauer disk-diffusion method, with automatic phenotyping (Osiris Evolution system).In ambulatory, the wild phenotype was predominant in all isolated strains (33.33% S. aureus, 50% CNS, 100% Streptococcus aglactiae, 60% Enterococcus spp.). In the urology ward, the following multiresistant strains were isolated: 9 MRSA strains (47.36%), 1 MRSE strain (100%), 1 VRE strain (4.34%). In the obstetrics-gynaecology ward, 7 strains showed multiple antibiotic resistance: 4 MRSA strains (66.66%), 2 MRSE strains (50%), 1 VRE strain (6.66%).Multiresistant strains were isolated in hospital environment, which can be explained by the improper use of antibiotics, the instrumental approach of the urinary tract, and the existence of risk factors in the patients admitted in the above-mentioned wards. Enforcement of efficient nosocomial infection control measures is advisable, as well as a policy for rational antibiotic use.

Our aim is to comparatively study the susceptibility to antibiotics of Enterococcus spp. strains isolated from urocultures of patients admitted in the urology department, as well as from ambulatory patients, and also to establish the resistance phenotypes of these strains.We studied 33 strains of Enterococcus spp.: 10 isolated from a total of 1889 urocultures from ambulatory patients (of which 431 positive) and 23 isolated from 1871 urocultures from patients admitted in the urology department (of which 462 positive). The antibiotic susceptibility was realised by Kirby-Bauer disk-diffusion tests. Statistical analysis of the antibiograms and determining of the resistance phenotypes were performed with automatic reading methods (Osiris--Bio Rad Laboratories), according to the CLSI/NCCLS standard.The wild phenotype was present in 60% of the strains isolated from ambulatory patients, and only in 39.13% in patients admitted in the urology department. In the urology department a multiresistant strain was isolated, displaying Van A (VRE) phenotype, to which was added resistance to beta-lactams, aminoglycosides, macrolides, tetracycline and nitrofurans.In the past decades urinary tract infections with Enterococcus spp., especially the nosocomial ones, have become serious health issues because of the increasing number of cases and the difficulty of treatment of infections caused by multi-resistant strains. In order to limit the spread of these strains, especially VRE strains, in the hospital environment, efficient measures must be instituted for the control of nosocomial infections, accompanied by policies for the rational use of antibiotics.