We compared the number of CD4-positive (CD4) and CD8-positive (CD8) cells in severe and non-severe preeclampsia (PE), and in normal pregnancy. We also evaluated the expression of matrix metalloproteinase 9 (MMP-9) in CD4 and CD8 cells. Immunohistochemistry for CD4 and CD8 was performed on the decidua basalis of 15 severe and 13 non-severe PE women and compared to decidual tissue of 19 normal pregnancies (control group). Co-expression of MMP-9 with CD8 and CD4 cells was determined by double immunofluorescence staining. The median number of CD8 cells/mm was significantly lower for the severe PE group than for the normal pregnancy group, as was the number of CD4 cells and MMP-9CD8 cells. No statistical difference was found between the non-severe PE group and the normal pregnancy group. The significant decrease of CD4, CD8 and MMP-9CD8 cells at the fetal-maternal interface only in the severe PE group suggests that immunological disorders play a role in the pathophysiology of severe PE.
BackgroundThe objective of the study was to compare the effect of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) dietary supplementation on their concentration in total lipids (TL) and lipid fractions of maternal and umbilical vein (UV) blood. The specific objective was to analyze the impact of EPA and DHA supplementation on pregnancy outcome and neonatal birth weight.MethodsWomen were randomly single-blinded (randomized controlled trial; ISRCTN36705743) allocated to the group receiving EPA and DHA supplementation (supplemented group) or the group receiving placebo-corn oil (control group) in the time period from January 1st, 2016 until March 1st, 2017. Women in the supplemented group (n=45) took 360 mg EPA and 240 mg DHA daily while controls (n=42) were given a placebo. Maternal and UV bloods were obtained at delivery. After lipid extraction, phospholipids (PL), cholesterol esters (CE), triacylglycerols (TG) and non-esterified fatty acids were separated by thin layer chromatography and analyzed by gas chromatography.ResultsHigher DHA concentrations in TL (37.24±21.87 mg/L), PL (13.14±8.07 mg/L) and triacylglycerols (2.24±2.21 mg/L) were recorded in mothers from the supplemented group when compared to the study group (TL 21.89±14.53 mg/L; P<0.001; PL 9.33±5.70 mg/L; P=0.013; TG 0.56±0.43 mg/L; P<0.001). Higher DHA concentrations in UV samples were found in TL (11.51±7.34 mg/L), PL (5.29±3.31 mg/L) and triacylglycerols (0.62±0.46 mg/L) from the supplemented groups compared with controls (TL 7.37±3.60 mg/L; P=0.002; PL 3.52±2.19 mg/L; P=0.005; TG 0.40±0.46 mg/L; P=0.035). The ratio of AA:DHA was lower in maternal (2.43) and UV serum (4.0) of the supplemented group than in the control group (maternal 3.85 P<0.001; UV 4.91 P<0.001).ConclusionThe study demonstrated the higher ratio of AA/DHA in the control group indicating that pregnant women on the traditional Herzegovina diet need supplementation with DHA and EPA.
<p><strong>Aim</strong> <br />To determine radiologic, clinic and laboratory characteristics of COVID-19 positive patients with acute arterial occlusion and compare them with post COVID-19 and non-COVID-19 patients.<br /><strong>Methods</strong> <br />In this retrospective study, 53 patients with acute occlusion of peripheral arteries admitted to the University Clinical<br />Hospital Mostar in the period between 29 February 2020 and 30 September 2021 were involved. The first group was made of COVID-19 positive patients, the second group were post COVID-19 patients and a control group were non-COVID-19 patients.<br /><strong>Results <br /></strong>Most patients were males, 37 (69.8%). The average age of COVID positive patients was 66.09&plusmn;11.25 years, post COVID-19 patients 71.33&plusmn;5.22 years and COVID-19 negative patients 69.82&plusmn;1.99 years. Lower extremities were most affected, 38 (71.6%), without significant alteration in the coagulogram. Acute arterial occlusion occurred about 2 weeks after the beginning of COVID-19 or at the time of the first appearance of symptoms.<br /><strong>Conclusion</strong> <br />We have to take special care about patients with risk factors for developing acute arterial occlusion due to thromboembolism or thrombosis 10 days after the beginning of the disease. We also recommend the use of low molecular weight heparin<br />(LMWH) and monitoring coagulation state due to anti Xa and thromboelastometry.</p>
Sažetak. Cilj: Sezamoidni koštano-tetivni kompleks stopala sastoji se od dviju sezamoidnih kostiju -medijalne i lateralne. Kada dođe do njihove ozljede, diferencijalna dijagnoza uglavnom se svodi na onu između frakture i sezamoiditisa. U kliničkoj praksi problem stvara razlikovanje između frakture i sezamoiditisa bipartitne sezamoidne kosti, koja je normalna anatomska varijanta u 7 -30 % ljudi iz opće populacije. Cilj je prikazati slučaj pacijenta s naglo nastalim sezamoidnim bolom koji se javio za vrijeme igranja nogometne utakmice. Prikaz slučaja: 27-godišnji muškarac došao je zbog bola u području palca desnog stopala koji je osjetio za vrijeme nogometne utakmice, 24 sata pred prijam. Bol nije mogao povezati s nekim specifičnim događajem za vrijeme igre, nije pretrpio direktni udarac u stopalo. Kliničkim pregledom u području glave prve metatarzalne kosti plantarno su nađeni minimalni otok i crvenilo. Osjećao je bol na palpaciju i pasivnu dorzifleksiju. Rendgenskim (RTG) snimanjem desnog stopala postavila se sumnja na bipartitnu medijalnu sezamoidnu kost združenu sa sezamoiditisom, ali se zbog dvojbenog nalaza nije isključila diferencijalna dijagnoza frakture. Pacijentu je ordinirana standardna konzervativna terapija, te ga se pratilo na redovitim tjednim kontrolama. Nakon 2 tjedna simptomi su se povukli, a kontrolnim RTG snimkama potvrđena je dijagnoza sezamoiditisa bipartitne kosti. Nakon 6 tjedana pacijent se vratio sportskim aktivnostima. Zaključak: Kada imamo dvojbenu situaciju, sezamoidnim ozljedama najbolje je pristupiti konzervativnom terapijom te nastaviti redovite kontrole pacijenta. Praćenjem kliničkog tijeka i komparacijom kontrolnog RTG-a uspostavlja se konačna dijagnoza. U slučaju persistencije bola i/ili kontrolnog RTG-a koji upućuje na komplikacije treba pristupiti naprednoj slikovnoj dijagnostici te u skladu s nalazom odlučiti o eventualnoj invazivnoj terapiji. Sezamoidne ozljede se u većini slučajeva mogu lako izliječiti, ali postavljanje pogrešne dijagnoze može voditi u nepotrebne komplikacije.Ključne riječi: diferencijalna dijagnoza; sezamoidne kosti; stopalo Abstract. Introduction: The sesamoidal skeletal-tendon complex of the foot consists of two sesamoidal bones -medial and lateral. When their injury occurs, differential diagnosis is usually limited to the fracture and sesamoiditis. In clinical practice, the problem creates a distinction between fracture and sesamoiditis of bipartite sesamoid bone, which is a normal anatomical variant in 7-30% of people in the general population. The aim is to present a patient with acute sesamoid pain, which occured during a soccer match. Case report: The 27-year-old male came due to the pain in the right toe area, which he felt during the soccer match, 24 hours before the admission. He could not associate the pain with any specific event during the game, denying a direct impact on the foot. During the clinical examination there was a discreet swelling and hyperemia in the area of the first metatarsal head. The pain was aggravated on palpation and passiv...
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