Perioperative antibiotic prophylaxis in obstetrics and gynecology

This article reviews current opinions originating from Evidence Based Medicine regarding perioperative antibiotic prophylaxis in obstetrics and gynecology. The appropriate use of antibiotic prophylaxis constitutes one of the most effective preventive tools available for the obstetricians and gynecologists. Lack of antibiotic prophylaxis or their improper use may result in serious iatrogenic harm with potential medical but also economic and legal consequences.     

Complications rate and pregnancy outcome in women who underwent early and mid trimester amniocentesis

OBJECTIVES: Evaluation of the complications rate, as well as pregnancy outcome, in women who underwent early and mid-trimester amniocentesis. MATERIAL AND METHODS: The study was conducted among 454 patients, including 162 women after the procedure performed before 15 gestational week and 292 patients who underwent classic amniocentesis. All patients were hospitalized in Division of Reproduction of University of Medical Sciences in Poznan between 1999 and 2005. The analysis, based both on clinical observations and questionnaire sent to patients, concerned especially the frequency of following complications: miscarriage, premature rupture of membranes and club foot in newborns. RESULTS: Total pregnancy loss rate due to amniocentesis amounted to 1.2% and 0.3% in early and mid-trimester amniocentesis, respectively, not reaching statistical significance. The frequency of club foot in newborns of mothers who underwent amniocentesis did not differ significantly between the groups, although it was four times higher in early amniocentesis group than in patients in whom mid-trimester amniocentesis had been performed. CONCLUSIONS: The safety of early amniocentesis is comparable with safety of mid-trimester amniocentesis.     

Isolated hydrothorax of a fetus--description of the clinical situation

A diagnostic procedure in the medical treatment of middle hydrothorax at haemodynamically efficient fetus has been presented in the research. Container of the liquid in the fetal thorax has been observed since the eleventh week of pregnancy. Infection by TORCH viruses has been excluded and typical 46,XX female karyotype has been found in the cytogenic test. A liquid in the pericardial sack (without any sings of the fetal heart defect) was observed in the ECHO examination from 23 to 37 week of pregnancy. Cesarean section was made after 37 weeks of pregnancy and the new-born baby was found to be in good condition, with body mass of 3130g and 9 points in the Apgar scale. The child cardiologist did not diagnose any heart disorders. Awaiting attitude, while monitoring the state of the fetus, seems to be the right course of action in cases of haemodynamically efficient fetus with isolated hydrothorax.     

The length of menstrual bleeding and the risk of urogenital infections in the context of the activity of hemoglobin-derived microbicidal peptides

OBJECTIVE: Well-known natural unspecific antimicrobial factors acting in the vagina are additionally reinforced during menstrual bleeding by hemocidins--a recently discovered novel class of microbicidal peptides generated proteolytically from hemoglobin. The aim of the presented research was to investigate the relation between the average length of menstrual bleeding and the frequency of urogenital infections. We expected that the shorter menstrual bleeding might increase the risk of urogenital infections because is synonymous with the shorter period of exposition on bactericidal action of hemocidins. STUDY DESIGN: The study contains statistical analysis of an average declared length of menstrual bleeding in the group of 267 young, sexually active women with the symptoms of urogenital infections. The control group consisted of 300 young healthy women. RESULTS: The length of menstrual bleeding in the group of patients with urogenital infections (average 4.35 days) was statistically significantly shorter than in the control group (average 4.95 days). The average length of the menstrual cycle was equal and counted ca. 28 days in both groups. CONCLUSION: The length of menstrual bleeding seems to be a significant factor in the vaginal ecology maintenance.     

Surgical treatment of stress urinary incontinence using the tension-free vaginal tape-obturator system (TVT-O) technique

OBJECTIVE: The purpose of the research was to provide a review of the efficacy of the TVT-O technique for the surgical treatment of stress urinary incontinence (SUI) and to assess surgical and postsurgical complications related to this technique. STUDY DESIGN: An initial assessment was carried out on 44 women who underwent TVT-O surgery between 16 September 2004 and 1 February 2005. The follow-ups after 3 and 12 months were attended by 37 and 35 patients, respectively. All 44 patients were included for the statistical estimation of intra- and postoperative complications, whereas improvement in the quality of life was assessed only in those patients who came for a follow-up visit. To assess the efficacy of the treatment, the participants were surveyed using the King questionnaire on the day preceding surgery and during a follow-up visit 3 and 12 months after surgery. The participants whose scores from the two questionnaires changed > or =90% were deemed to be cured. A considerable improvement in quality of life was recorded when the score was 89-75%. With scores of 74-50%, there was a reduction in SI symptoms. However, when the score was 50-0%, no improvement in quality of life was reported, and in participants with scores <0% the quality of life deteriorated. Statistical analysis was carried out using the Statistical Package for Social Sciences (SPSS) V. 10.0, with the Spearman correlation and Chi-squared tests. The results were considered statistically significant when P<0.05. RESULTS: After 12 months, total cure was achieved in 15 participants (42.8%), significant improvement was noted in 6 (17.1%), SUI symptoms abated in 4 (11.4%), no improvement was noted in 7 (20%), and quality of life deteriorated in 3 (8.7%). CONCLUSION: TVT-O surgery is an efficient and reasonably safe method of SUI treatment in women. The ease of use, short duration of surgery and hospitalisation, minor postsurgical discomfort and a small proportion of complications make this method acceptable to patients. With regard to the results of treatment, additional patients should be analysed for a longer period of time.     

Studies of Selective Recovery of Zinc and Manganese from Alkaline Batteries Scrap by Leaching and Precipitation

Recovery of zinc and manganese from scrapped alkaline batteries were carried out in the following way: leaching in H₂SO₄ and selective precipitation of zinc and manganese by alkalization/neutralization. As a result of non-selective leaching, 95.6–99.7% Zn was leached and 83.7–99.3% Mn was leached. A critical technological parameter is the liquid/solid treatment (l/s) ratio, which should be at least 20 mL∙g⁻¹. Selective leaching, which allows the leaching of zinc only, takes place with a leaching yield of 84.8–98.5% Zn, with minimal manganese co-leaching, 0.7–12.3%. The optimal H₂SO₄ concentration is 0.25 mol∙L⁻¹. Precipitation of zinc and manganese from the solution after non-selective leaching, with the use of NaOH at pH = 13, and then with H₂SO₄ to pH = 9, turned out to be ineffective: the manganese concentrate contained 19.9 wt.% Zn and zinc concentrate, and 21.46 wt.% Mn. Better selectivity results were obtained if zinc was precipitated from the solution after selective leaching: at pH = 6.5, 90% of Zn precipitated, and only 2% manganese. Moreover, the obtained concentrate contained over 90% of ZnO. The precipitation of zinc with sodium phosphate and sodium carbonate is non-selective, despite its relatively high efficiency: up to 93.70% of Zn and 4.48–93.18% of Mn and up to 95.22% of Zn and 19.55–99.71% Mn, respectively for Na₃PO₄ and Na₂CO₃. Recovered zinc and manganese compounds could have commercial values with suitable refining processes.     

Branched-Chain Fatty Acids Alter the Expression of Genes Responsible for Lipid Synthesis and Inflammation in Human Adipose Cells

Recently, we have demonstrated a decreased level of iso-branched-chain fatty acids (iso-BCFAs) in patients with excessive weight. However, it is still unclear whether BCFAs may influence lipid metabolism and inflammation in lipogenic tissues. To verify this, human visceral adipocytes were cultured with three different concentrations of selected iso-BCFA (14-methylpentadecanoic acid) and anteiso-BCFA (12-methyltetradecanoic acid), and then the expression of genes associated with lipid metabolism (FASN—fatty acid synthase; SREBP1—sterol regulatory element-binding protein 1; SCD1—stearoyl-CoA desaturase; ELOVL4—fatty acid elongase 4; ELOVL6—fatty acid elongase 6; FADS2—fatty acid desaturase 2; FADS1–fatty acid desaturase 1) and inflammation (COX-2—cyclooxygenase 2; ALOX-15—lipoxygenase 15; IL-6—interleukin 6) were determined. This study demonstrates for the first time that incubation with iso-BCFA decreases the expression of adipocyte genes that are associated with lipid metabolism (except FASN) and inflammation. These findings suggest that changes in the iso-BCFA profile in obese patients may contribute to adipose inflammation and dyslipidemia. Further studies should evaluate whether iso-BCFA supplementation in obese patients would be beneficial.     

Gallic Acid-Functionalized,TiO2-Based Nanomaterial—Preparation,Physicochemical and Biological Properties

Wound healing and skin tissue regeneration remain the most critical challenges faced by medical professionals. Titanium(IV) oxide-based materials were proposed as components of pharmaceutical formulations for the treatment of difficult-to-heal wounds and unsightly scarring. A gallic acid-functionalized TiO₂ nanomaterial (TiO₂-GA) was obtained using the self-assembly technique and characterized using the following methods: scanning electron microscopy (SEM), transmission electron microscopy (TEM), nanoparticle tracking analysis (NTA), X-ray powder diffraction (XRPD), infrared spectroscopy (IR), Raman spectroscopy and thermogravimetry (TG). Additionally, physicochemical and biological tests (DPPH assay, Microtox^® acute toxicity test, MTT assay) were performed to assess antioxidant properties as well as to determine the cytotoxicity of the novel material against eukaryotic (MRC-5 pd19 fibroblasts) and prokaryotic (Staphylococcus aureus, Escherichia coli, Candida albicans, Aliivibrio fischeri) cells. To determine the photocytotoxicity of the material, specific tests were carried out with and without exposure to visible light lamps (425 nm). Following the results, the TiO₂-GA material could be considered an additive to dressings and rinsing suspensions for the treatment of difficult-to-heal wounds that are at risk of bacterial infections.     

The Influence of Intensive Nutritional Education on the Iron Status in Infants

Iron is an essential nutrient for a child’s proper development at every growth stage. It is crucial for the production of red blood and muscle cells, DNA replication, and the development of the brain, nervous and immune systems. Iron deficiency is the most common micronutrient deficiency in children worldwide. Despite widespread access to nutritional information for children, parents continue to make many feeding mistakes. This study aimed to assess whether any nutritional intervention would affect the iron status in children. The parents of 203 children were randomly assigned to one of two groups: the study group received intensive mobile nutritional education for a year, while the control group received no intervention. Blood tests were performed on both groups at the beginning of the study and one year later. The educational intervention resulted in statistically significantly higher levels of RBC (red blood cells; p = 0.020), HGB (haemoglobin; p = 0.039), HCT (haematocrit; p = 0.036), MCV (mean cell volume; p = 0.018) parameters and iron dietary intake (p ≤ 0.001). Even a non-targeted dietary intervention improves the iron status in children. As iron management is insufficient in most children, an iron-targeted nutritional intervention appears necessary.     

The Effect of Antimony (III) Oxide on the Necessary Amount of Precursors Used in Laser-Activated Coatings Intended for Electroless Metallization

The article presents research on the potential use of organometallic compounds with the addition of antimony (III) oxide Sb₂O₃ as a coating additive that will make coatings susceptible to electroless metallization after prior surface irradiation with 193 nm wavelength laser radiation and a different number of laser pulses. The surface modification and activation effects were assessed by optical-imagining as well as by scanning electron microscopy (SEM) with energy dispersive analysis (EDX). It was found that the presence of Sb₂O₃ in the coating made it possible to reduce the content of the copper complex, causing an intensive surface ablation, resulting in the formation of a conical structure with a higher content of metallic copper nuclei.