Purtscher's retinopathy is usually associated with trauma, acute pancreatitis, vasculitis, lupus, and bone fractures. It was rarely described postpartum in patients with preeclampsia as well as associated with HELLP syndrome. We present a case of a multiparous patient aged 44 with severe preeclampsia and postpartum HELLP syndrome complicated with Purtscher-like retinopathy and large ruptured subcapsular liver hematoma that required emergency abdominal surgery after premature delivery of a dead fetus. Postsurgical outcome was favorable regarding both liver function and visual acuity.

Angiogenesis is a critical component of normal implantation and placentation and underlines the importance of vascularization in early pregnancy. Differentiated expression of angiogenesis factors in different decision tissues during different stages of implantation, indicates their involvement in the regulation of vascular remodeling and angiogenesis. Disorders in vascular development may play a role in the pathogenesis of recurrent abortions. The success of implantation, placentation and subsequent pregnancy evolution requires coordination of vascular development and adaptations at both sides of the maternal–fetal interface. The human implantation process is a continuous process, which begins with the apposition and attachment of the blastocyst to the apical surface of the luminal endometrial epithelium and continues throughout the first trimester of pregnancy until the extravillous trophoblast invades and remodels maternal vascularization. Numerous regulatory molecules play functional roles in many processes, including preparation of the endometrial stroma (decidualization), epithelium for implantation, control of trophoblastic adhesion and invasion. These regulatory molecules include cytokines, chemokines, and proteases, many of which are expressed by different cell types, having slightly different functions as the implant progresses

Abnormalities of the umbilical cord, related to morphology, placental insertion, number of vessels and primary tumors, can influence the perinatal outcome and may be associated with other fetal anomalies and aneuploidies. The chapter investigates the most important congenital anomalies of this structure. Single umbilical artery appears to be associated with ventricular septal defects and conotruncal anomalies, hydronephrosis, dysplastic kidneys, esophageal atresia, spina bifida, holoprosencephaly, diaphragmatic hernia, and cystic hygromas. Velamentous insertion of the cord can be associated with trisomy 21, spina bifida, ventricular septal defects, and esophageal atresia. A hypoplastic umbilical artery has an artery-to-artery diameter difference of more than 50%; described anomalies include trisomy 21, polyhydramnios, congenital heart disease, and fetal growth restriction. Pseudocysts are more common than true cysts, and they are strongly associated with chromosomal defects and other congenital anomalies, especially omphalocele, hydrops, and trisomy 18. Other benign masses are teratomas, angiomyxomas, and patent urachus. Alterations in morphology and ultrastructure of the umbilical cord should extend the investigation, since there are associations with chromosomal anomalies.

Tamarix ramosissima (Tamaricaceae) is a small tree that grows spontaneously in Europe and Asia, being considered an invasive species in geographical areas with warm climates. The chemical composition is partially elucidated, being empirically used for antiinflammatory, analgesic, antibacterial and antioxidant effect. Our study aimed to evaluate the total polyphenol and flavonoid content of vegetal extracts and to test in vivo antioxidant therapeutic effect of it, comparative with Vaccinium myrtillus, using streptozotocin-induced diabetic mice. After five weeks the animals were sacrificed and we determined erythrocyte activities of superoxide dismutase, glutathione peroxidase, glutathione reductase and level of lipid peroxides as thiobarbituric acid reactive substances. Antioxidant enzymes had highest activities in mice treated with T. ramosissima extract and the level of lipid peroxides was the lowest. The tested extract had higher content of polyphenols comparative with V. myrtillus. Our results sustain the efficiency of T. ramosissima extracts on normalizing the effects of oxidative stress in diabetes.

Background : The specific mechanism of action of each anesthetic drug on the immune system is still incompletely known. It is important to know how the various anesthetics used in minimally invasive surgery (MIS) act on the inflammatory response because the choice of the anesthetic agent can influence the patient’s immune system. Aim : Evaluation of the effect of anesthetic drugs used for total intravenous anesthesia (Propofol and Midazolam) on the inflammatory response after minimally invasive gynecological surgery. Patients, Materials and Methods : The inflammatory response in 20 female patients who underwent minimally invasive gynecological surgery under which intravenous anesthesia was performed. Depending on the combination of anesthetics used, we subdivided the study group into two groups, Group 1 consisting of the patients ( n =10) who were given for total intravenous anesthesia, the combination with Midazolam+Fentanyl, and Group 2 ( n =10) the patients who received the combination of Propofol+Fentanyl, respectively. Surgical interventional procedures included day surgery: diagnostic and operative hysteroscopy, endometrial ablation, surgical treatment of vulvar disorders. Serological profiling of patients was performed by dosing the serum concentration of nucleotide-binding domain (NOD) and leucine-rich repeat protein 3 (NLRP3) inflammasomes, interleukin (IL)-6, tumor necrosis factor-alpha (TNF- α ), IL-10 before and two hours after the surgical procedure. Results : In our study, we found that in both groups of patients (Midazolam+Fentanyl – Group 1, Propofol+Fentanyl – Group 2), NLRP3 and cytokines concentrations in the serum were higher after MIS than those before MIS. Conclusions : It appears that both Midazolam and Fentanyl and Propofol and Fentanyl have an immunomodulatory action due to the anti-inflammatory effect of both anesthetics. Therefore, anesthesiologists must choose an anesthetic method that uses individualized anesthetic agents, depending on the patient’s immune status and disease.