Quality of life versus semen parameters

INTRODUCTION: Psychological factors are believed to play an important role in infertility and its treatment Psychological problems may be considered to be risk factors and the cause of reduced infertility, as well as contribute to an unsuccessful outcome of infertility treatment. OBJECTIVES: The aim of the study was to investigate the correlation between semen parameters and quality of life in male patients with fertility problems. MATERIAL AND METHODS: 70 patients with infertility treated in Andrology Clinic were divided into two groups according to semen parameters: bad and good quality of semen. The quality of life has been with the help of Campbell questionnaires. RESULTS: Significantly lower questionnaire score in bad quality of semen group has been observed, in comparison with normozoospermic men. High correlation between concentration, motility and morphology in comparison with the quality of life has been observed in the studied group of patients. CONCLUSION: The quality of life is directly associated with semen parameters such as concentration, motility and morphology of sperm.     

Value of the intraoperative assessment of the depth of myometrial invasion in endometrial carcinoma

OBJECTIVES: The aim of the study was to evaluate the value of intraoperative assessment of depth of myometrial invasion in patients with FIGO stage I of the endometrial carcinoma. MATERIAL AND METHODS: A total number of 112 patients with FIGO stage I of the endometrial carcinoma undergoing surgery were enrolled in the study. All patients had undergone intraoperative assessment of the depth of myometrial invasion performed by a surgeon. The depth was determined as more or less than 50% of myometrial thickness according to FIGO classification. Gross visual estimation of the depth of myometrial invasion at the time of the operation was compared with the final histopathological report. Sensitivity, specificity and positive and negative predictive values of the method were determined by means of statistical analyses. RESULTS: The depth of the myometrial invasion was accurately determined by the surgeon in 82.1% of cases. Sensitivity and specificity were 68% and 82.1%, respectively. The accurate prediction rate of the myometrial invasion in the group of patients with well differentiated (G1) endometrial carcinoma was higher (88.4%) than in group with moderately and low differentiated tumour (78.3%). CONCLUSIONS: The accuracy of macroscopic evaluation of myometrial invasion is high and reaches up to 82.1%. The accurate determination rate increases if the differentiation of tumour is higher.     

Thrombotic thrombocytopenic purpura in pregnancy. A case report

Thrombotic thrombocytopenic purpura (TTP) is characterized by microangiopathic hemolytic anemia and thrombocytopenia, accompanied by microvascular thrombosis that causes variable degrees of tissue ischemia and infarction. About 10-20% of TTP cases are associated with the pregnancy. Preterm delivery and intrauterine fetal death are frequent pregnancy complications of TTP. The following paper presents the case of a 32-year-old woman with TTP relapse at 10 weeks of her second pregnancy. Despite regular fresh frozen plasma transfusions, intrauterine fetal death occurred at 21 weeks of gestation. Current views on TTP management during pregnancy have been presented in the article as well.     

The 3020insC NOD2 gene mutation in patients with ovarian cancer

OBJECTIVE: There is an increasing evidence that genetic factors play a role in the etiology of malignant tumors. Mutations of BRCA1 and BRCA2 genes are responsible for an increased risk of ovarian cancer. The role of mutations in NOD2 gene in this type of neoplasm is still under investigation. THE AIM: The aim of this study was to determine: 1. incidence of NOD 2 3020insC constitutional mutation in a group of consecutive women with ovarian cancer, 2. risk of developing ovarian cancer in patients with NOD2 gene mutation, 3. clinical and pathological features of ovarian cancer in NOD2 gene mutation carriers. PATIENTS AND METHODS: Clinical and pathological data were collected from 257 non-selected patients with primary epithelial ovarian cancer. The researches identified NOD2 3020insC gene mutation. On the basis of patient source documentation we obtained the data concerning the age of patients at diagnosis, histopathological recognition, FIGO stage and morphological grade G. RESULTS: 19 out of 257 women were identified with germ-line 3020insC mutation of NOD2 gene (7.39%). An increased risk of ovarian cancer in NOD2 mutation carriers was not revealed (OR=1.01; p=0.928; 95% Cl=0.61-1.66). The mean age at diagnosis of patients with NOD2 mutation was 54.8 (SD=9.9), while for non-carriers it was 53.2 (SD=10.2). The difference between these frequencies was statistically irrelevant (p=0.550). Clinical and pathological profile of ovarian cancer was made. We assessed the following features: age at disease onset, histopathology, FIGO stage and morphological grade G. For NOD2 mutation carriers no statistically significant features of ovarian cancer were revealed. CONCLUSION: 1. Despite high frequency of constitutional mutations occurrence in NOD2 gene in women with ovarian cancer, genetic testing seem not to be justified in all women diagnosed with this disease. 2. Due to a lack of increased risk of ovarian cancer in NOD2 gene mutation carriers, proceedings for them may not differ from recommendations for general population. 3. It is difficult to determine characteristic clinical and pathological features of ovarian cancer for NOD2 gene mutation carriers.     

Assessment of fetal circulation in the late first trimester--preliminary study

OBJECTIVES: to confirm that fetal echocardiography is indeed possible in late first trimester and that it improves the standard of the so-called "genetic" ultrasound scan. MATERIAL AND METHODS: Early echocardiography was performed in 75 fetuses from high and low risk pregnancies. All fetuses underwent echocardiography examination in 18-22 weeks of gestation and established follow up. RESULTS: The most suitable method of visualization seems to be transabdominal examination, between 13.0-13.6 weeks of gestation, an transvaginal one, between 12.0-12.6 weeks of gestation, with 90% effectiveness. In researched group of 75 fetuses (with established follow up) there were four heart defects (5.3%). Three of them were diagnosed before 14th week of gestation. One case (tetralogy of Fallot) was overlooked. There were two false positive diagnosis verified at 20th week of gestation. CONCLUSIONS: Early echocardiography, especially between 12.0-13.6 weeks of gestation, is a possible and valuable method of diagnosis. Reference evaluation should be performed between 18 and 22 weeks of gestation. In cases with suspected anomalies karyotyping is recommended. Congenital heart disease diagnosed at late first trimester should be treated as the next potential marker of genetic disorder.     

Umbilical cord rupture and vasa previa: a report of a case

Vasa previa is a rare condition, frequently lethal, in which fetal blood vessels coming from the placenta or the umbilical cord cross the entrance of the childbirth channel before presentation. The abnormal blood vessels are result of a velamentous cord insertion or a placental alteration. It happens in 1:3000 births, with a high perinatal mortality. A 16 years-old primigest patient, at 34.6 week of gestation, was admitted to the labor, which has a good evolution, without any complication. A male new born was obtained without hearth rate or vitality, Apgar scale 0-0, weight 2800 grams, who presented an umbilical cord rupture 3 centimeters from its abdominal insertion, no where the fetal blood vessels are unprotected. It is necessary an adequate prenatal care, diagnosis and accurate management, to avoid the mortality by this rare clinical entity.     

糖尿病足患者骨钙素与动脉粥样硬化指标的相关性研究

目的：研究糖尿病足患者血清骨钙素（BGP）水平的变化以及与踝肱指数（ABI）、颈动脉内中膜厚度（IMT）的相关性。方法：选取2012年1月～2014年10月收治的2型糖尿病合并糖尿病足患者78例（DF 组）为研究对象,另选取2型糖尿病无溃疡者52例（DM 组）为对照组,进行影像学和生物化学指标检查。以 ABI 和 IMT 作为评估动脉粥样硬化的指标;采用 SPSS17.0软件进行数据处理。结果：DF 组 BGP 明显低于 DM 组,BGP 与 FPG、HOMA-IR、HbA1c、TG 呈负相关;BGP 与 FINS、HOMA-HBC、HDL-C 呈正相关;采用多元回归分析表明：调整 FPG、FINS、HbAlc、HOMA-IR、TG、TC、LDL-C、HDL-C 后,BGP 与 ABI、IMT 显著相关。结论：糖尿病足患者血清 BGP 水平较糖尿病患者更低;血清 BGP 水平越低,发生动脉粥样硬化的危险性更大;血清 BGP 水平测定可推测糖尿病足溃疡发生的风险。     

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.     

中国人感染H7N9禽流感危险区域预警识别的研究

目的 建立人感染H7N9禽流感发病危险预警模型, 识别禽流感暴发高危险区域并提出预警。方法 收集2013年2月至2014年6月中国地市级人感染H7N9禽流感病例数据及同期地理、气象数据, 通过空间自回归(SAR)模型和广义相加模型(GAM)拟合并量化地理和气象因素对发病的影响, 综合两模型的预测结果建立发病危险预警地图。结果 2014年2月中国人感染H7N9禽流感的实际发病地区全部位于研究构建的发病危险预测区域内;模型预测了疾病的空间移动趋势, 对2014年4、5月北方地区的新发疫情有准确的预警。结论 建立的模型短期预测准确度和精确度较好, 可应用于疫情监测和预警领域, 有助于早期区域预防疫情的流行及暴发。