Well-leg compartment syndrome after gynecological laparoscopic surgery.

Well-leg compartment syndrome in the lower extremities after surgery in the lithotomy position is a rare but severe complication requiring early diagnosis and intervention. Several circumstances predispose to this condition as a consequence of increased intra-compartmental pressure, such as positioning of the legs during operation (lithotomy and Lloyd-Davies positions), a prolonged operation, external compression and vascular insults, both pre- and intra-operatively. To prevent well-leg compartment syndrome it is important to improve knowledge of the condition among surgeons and nursing staff.

Successful pregnancy after uterovaginal anastomosis in patients with congenital atresia of cervix uteri.

We present a case of successful pregnancy after effective uterovaginal anastomosis in a 26-years-old patient with congenital atresia of the cervix uteri. She spontaneously achieved pregnancy after four years of uterovaginal anastomosis. Gestation was at the eighth lunar month and the delivery was done by cesarean section due to rapidly progressing fetal asphyxia.

Hemodynamics of arterial and venous circulation in the intrauterine fetal evaluation.

Introduction: The purpose of each antenatal control focuses on the detection and prevention of hypoxic-ischemic injury and fetal death (1)) using modern biophysical tests and Doppler parameters.

Goal: This study examines the correlation of changes in arterial compared to venous hemodynamics of the fetus and is determined by the most sensitive and most specific Doppler parameter in the assessment of intrauterine fetal status.

Material And Methods: The study was conducted as prospective and included 119 pregnant women.

The incidence of caesarean sections in the university clinical center of kosovo.

Introduction: As in most countries of the world also at Kosovo the rate of Cesarean section from year to year is increasing.

Aim: The main purpose of this paper was to present the incidence of births completed by Caesarean section at the Clinic of Gynecology and Obstetrics of University Clinical Center of Kosovo in Prishtinë.

Material And Methods: This study is retrospective, namely its made by collecting epidemiological data from patients' histories that completed birth by Caesarean section for the period 2000-2006 in this clinic.

Outcome from consecutive ICSI cycles in patients treated with recombinant human LH and those supplemented with urinary hCG-based LH activity during controlled ovarian stimulation in the long GnRH-agonist protocol.

Clinical results were compared in a well-established, assisted reproduction program during the cross-over from highly purified (HP)-human menopausal gonadotropin (hMG) to rhFSH/rhLH. We included the last 33 patients treated with HP-hMG and the first 33 patients receiving rhFSH/rhLH for ovarian stimulation in their first intracytoplasmic sperm injection cycle. Patient baseline characteristics were almost identical in the two groups.

Carney complex and teratoma maturum ovarii--a case report.

This is a case report of an extremely rare Carney complex (CNC) syndrome in a 17-year-old patient. After the decision made by a team of cancer specialists, the patient was admitted to the hospital for surgery because of adnexal tumor associated with ascites and increased Ca 125 tumor marker level. The patient underwent cardiac surgery twice.

Ultrasound evaluation of uterine scar after cesarean section.

Introduction: The rate of attempted vaginal birth after previous cesarean delivery has decreased, while the success rate of such births increased. Advances in surgical techniques, the development of anesthesiology services, particularly endotracheal anesthesia, very quality postoperative care with cardiovascular, respiratory and biochemical resuscitation, significantly reduce maternal mortality and morbidity after cesarean section. Progress and development of neonatal services, and intensive care of newborns is enabled and a high survival of newborn infants.

Added value of umbilical vein flow as a predictor of perinatal outcome in term small-for-gestational-age fetuses.

Objective: To compare umbilical vein (UV) flow with standard Doppler parameters in prediction of adverse perinatal outcome in late-onset small-for-gestational age (SGA) fetuses.

Methods: Umbilical, uterine and middle cerebral arteries, and UV blood flow were evaluated by Doppler before delivery in a cohort of 193 term SGA fetuses. The value of the Doppler parameters to predict risk of emergency delivery for non-reassuring fetal status and neonatal metabolic acidosis was analyzed.

Maternal complications of preeclampsia.

Background: Preeclampsia is classified as mild and severe. It is mild in 75% of cases and 25% presented as severe. In extreme cases the disease can lead to kidney and liver failure, DIC and central nervous system disorders.

Performance of a first-trimester screening of preeclampsia in a routine care low-risk setting.

Objective: We sought to evaluate the effectiveness of an integrated first-trimester screening test to predict preeclampsia (PE).

Study Design: A prospective cohort of singleton pregnancies underwent routine first-trimester screening from 2009 through 2011 (n = 5759). A logistic regression-based predictive model for early- and late-onset PE was constructed based on: maternal characteristics; levels of pregnancy-associated plasma protein-A and free β-human chorionic gonadotropin at 8-12 weeks; and blood pressure and uterine artery Doppler at 11.

High expression of crystallin αB represents an independent molecular marker for unfavourable ovarian cancer patient outcome and impairs TRAIL- and cisplatin-induced apoptosis in human ovarian cancer cells.

Dysregulated apoptotic pathways are regarded as major reasons for chemoresistance development as a particular challenge in ovarian cancer therapy. In search of molecular factors affecting human ovarian cancer cell apoptosis and, consequently, patient survival, we examined tumors of 103 platinum-/taxane-treated ovarian cancer patients by mRNA-array hybridization, qPCR, and immunohistochemistry. We identified high expression of crystallin αB (CRYAB), a proposed negative regulator of tumor necrosis factor-related apoptosis inducing ligand (TRAIL)-mediated apoptosis.

Correlation of human papilloma virus infection with cytology, colposcopy and histopathological examination of the bioptic tissue in low- and high-grade intraepithelial lesions.

Introduction: It is now believed that the majority of cervical cancer is preceded by long-term infection with high-risk types of the human papilloma virus (HPV). The presence of HPV high-risk types (HR-HPV) in the cells of intraepithelial change multiplies the possibility of its progressive development to high-grade cervical precancer and invasive disease.

Aim: This study examined the correlation of HPV infection with cytology, colposcopy, and histopathological examination of the bioptic tissue in low- and high-grade cervical lesions.

Treatment of early heterotopic interstitial (cornual) gestation with subsequent delivery of an intrauterine pregnancy--case report.

We present the case of a 38-year-old woman who was treated for a heterotopic interstitial (cornual) pregnancy diagnosed at the 7th week of gestation. The intervention was performed via transvaginal ultrasound-guided aspiration and instillation of a hypertonic solution of sodium chloride into the cornual sac. The heterotopic comrnual pregnancy was successfully aborted, and the intrauterine pregnancy was successfully maintained with delivery of a healthy newborn.

Role of decreased androgens in the ovarian response to stimulation in older women.

Ovarian testosterone increases the response of antral follicles to stimulation, declines with age, and has effects mediated or potentiated by insulin-like growth hormone I (IGF-I). Increased circulating insulin and IGF-I, exogenous testosterone, and increased local ovarian testosterone concentrations due to aromatase inhibition or exogenous luteinizing hormone/human chorionic gonadotropin are all associated with an increased ovarian response to gonadotropins. These factors should be further investigated alone or in combination for enhancing oocyte yield with fertility treatments, particularly in older reproductive-age women.

Predictors of absence of cervical intraepithelial neoplasia in the conization specimen.

Objective: Over 10% of women who undergo conization for cervical intraepithelial neoplasia (CIN) show no lesion in the surgical specimen. We aimed to determine whether these patients can be identified before conization using clinical, virological and/or cyto-histological characteristics, to avoid unnecessary treatment.

Methods: Of 687 women with CIN treated by conization in the Hospital Clinic of Barcelona between 2008 and 2011, all patients (n=110, 16%) showing no lesion in the surgical specimen were included as the study group.

Transvaginal ultrasound-guided myometrial injection of radiotracer (TUMIR): a new method for sentinel lymph node detection in endometrial cancer.

Objective: The objective of this prospective study was to determine the feasibility, safety and performance of a new method for sentinel lymph node (SLN) detection in endometrial cancer (EC) using transvaginal ultrasound-guided myometrial injection of radiotracer (TUMIR).

Methods: From 2006 to 2011, 74 patients with high-risk EC were included in the study. Twenty-four hours before surgery 148MBq of (99m)Tc-nanocolloid (8mL) was injected into two spots in the anterior and posterior myometrium using an ultrasound-guided transvaginal puncture.

High resolution ultrasound including elastography and contrast-enhanced ultrasound (CEUS) for early detection and characterization of liver lesions in the humanized tumor mouse model.

Purpose: In this study we investigated the sensitivity of high resolution ultrasound (HRU) in the detection of small liver tumors and its microcirculation in a humanized tumor mouse model (HTM). These mice develop a complete human immune system and human breast cancer growth in the liver which allows the investigation of antibody based immunotherapies under human like conditions.

Method: HTM were generated by the co-transplantation of human breast cancer cells and human hematopoietic stem cells.

Ultrasound evaluation of uterine scar after Cesarean section and next birth.

Introduction: Cesarean section (Sectio Caesarea) is a surgical method for the completion of delivery. After various historical modifications of operative techniques, modern approach consists in the transverse dissection of the anterior wall of the uterus. The rate of vaginal birth after cesarean section was significantly reduced from year to year, and the rate of repeated cesarean section is increased during the past 10 years.

Dystocia as a cause of untimely cesarean section.

Background/aim: One of the most frequent indications for cesarean section is dystocia. It is impossible to predict, difficult to identify and coincident with the rapid expiry of the expected time, so it is important to point out some mistakes in expecting vaginal delivery. The aim of this study was to examine the frequency and the length of dystocia-related cesarean delivery, as well as the vitality of the newborn immediately after birth.

Ovarian endometrioma but not deep infiltrating endometriosis is associated with increased serum levels of interleukin-8 and interleukin-6.

Cytokines, and specifically interleukin 6 (IL-6) and interleukin 8 (IL-8), have been associated with the pathogenesis of endometriosis. We studied serum concentrations of IL-6 and IL-8 in patients with deep infiltrating endometriosis (DIE) or ovarian endometriomas (OE), but no other forms of associated endometriosis disease type. We carried out a case-control study including 19 patients with OE alone (OE group), 14 patients with DIE alone (DIE group) and 24 healthy patients without endometriosis (C group).

Usefulness of lung-to-head ratio and intrapulmonary arterial Doppler in predicting neonatal morbidity in fetuses with congenital diaphragmatic hernia treated with fetoscopic tracheal occlusion.

Objective: To explore the potential value of intrapulmonary artery Doppler velocimetry in predicting neonatal morbidity in fetuses with left-sided congenital diaphragmatic hernia (CDH) treated with fetoscopic tracheal occlusion (FETO).

Methods: Observed/expected lung-to-head ratio (O/E-LHR), and intrapulmonary Doppler pulsatility index and peak early-diastolic reversed flow were evaluated within 24 h before FETO in a consecutive cohort of 51 fetuses with left-sided CDH at between 24 and 33 weeks' gestation. Lung Doppler parameters were converted into Z-scores and defined as abnormal if the pulsatility index had a Z-score of > 1.

Recurrent miscarriage, antiphospholipid antibodies and the risk of thromboembolic disease.

Miscarriage affects 15 % of women, and while most are sporadic, there is a subset comprising 2-5 % of couples that suffers recurrent miscarriage (RM). Much work has been carried out to try to identify the RM underlying mechanisms. A subgroup of women with RM has been demonstrated to be in a prothrombotic state before pregnancy.

Feasibility and reproducibility of fetal lung texture analysis by Automatic Quantitative Ultrasound Analysis and correlation with gestational age.

Objective: To evaluate the feasibility and reproducibility of fetal lung texture analysis using a novel automatic quantitative ultrasound analysis and to assess its correlation with gestational age.

Methods: Prospective cross-sectional observational study. To evaluate texture features, 957 left and right lung images in a 2D four-cardiac-chamber view plane were previously delineated from fetuses between 20 and 41 weeks of gestation.

The role of oxidative stress in perinatal hypoxic-ischemic brain injury.

Introduction: The pathogenesis of perinatal hypoxic-ischemic brain damage is highly complex.

Objective: The aim of this study was to assess the role of oxidative stress in hypoxic-ischemic brain injury and subsequent abnormal neurological outcome in infants with perinatal hypoxic-ischemic encephalopathy (HIE). We estimated perinatal oxidative brain damage measuring activity of glutathione peroxidase (GPX) in cerebrospinal fluid (CSF) as an indirect biomarker of free radical production during cerebral hypoxia-ischemia in correlation with the level of intracellular enzyme neuron specific enolase (NSE) in CSF as a biomarker of extend of brain injury.