We present a case of a postmenopausal diabetic hypertensive female with a solitary retroperitoneal myoma (2,025 g) and no smooth muscle (myomatic) nodules on visceral and parietal peritoneum. She complained of chronic pelvic pain in absence of internal female genitalia (except uterine cervix), high frequency of urination, pelvic discomfort, and feeling of heaviness. The patient had undergone hysterectomy with bilateral adnexectomies 13 years ago and she had not had any exposure to exogenous hormones during her reproductive and postmenopausal period of life (oral contraception and hormonereplacement therapy). Several suppositions were made, supporting hormonal genesis of myoma with retroperitoneal localization in postmenopausal age and the significance of eventual presence of concomitant metabolic disturbance for its origin in that age was also emphasized. The known risk factors for growth and development of myoma were also affected by the presence of collateral dismetabolic conditions, which influenced and aggravated the disturbed hormonal balance. That is why they could be considered as a possible additional risk factor.
Summary Preterm birth is the most common cause of perinatal morbidity and mortality worldwide. The routine method for predicting premature birth is the measurement of the cervical length. However, to make a better and more precise prognosis, the cervicovaginal fluid (CVF) was widely inspected through many studies. Its content is used nowadays as a diagnostic method for different conditions. One of the clinical biomarkers used to predict preterm labour in the CVF is the phosphorylated insulin-like growth factor binding protein-1 (pIGFBP-1). This study aimed to evaluate the accuracy of pIGFBP-1 as a predictor of preterm labour when used with cervical biometrics. A prospective, cross-sectional study was conducted on pregnant patients, divided into groups: Group A included participants at risk for premature labour, and Group B -women with an uncomplicated pregnancy. All patients underwent a test for pIGFBP-1, followed by a transvaginal measurement of the cervical length. A total of 32 patients were recruited for the study. Their pregnancy outcomes were followed up. In the group of symptomatic patients, the results were positive in 8 patients, and despite the intensive tocolytic therapy given, 5 of them gave preterm birth within 14 days. There were two patients with a cervical length of less than 10 mm. They both had positive results for pIGFBP-1 and gave spontaneous preterm birth within a few hours. The predictive value of pIGFBP-1 in cases with negative results was high. The leading cause for fetal morbidity and mortality in the twenty-first century remains premature delivery. Many investigations are currently carried out, aiming to facilitate preterm labor prediction and quickly estimate a pregnant woman’s ability to carry to time. The patients at highest risk are detected by measuring the cervical length. Newly searched clinical biomarkers such as fetal fibronectin found in the CVF might help predict preterm birth in time.
Summary Colorectal cancer in pregnant women is rare and represents a diagnostic and therapeutic challenge for clinicians. We present a case of a 38-year-old pregnant woman, diagnosed with colorectal cancer and liver metastases during the 29th week of gestation. After clinical evaluation and making the diagnosis, the patient underwent an emergency cesarean section (C-section) and bypass anastomosis between the transverse colon and sigmoid colon. The babies were born healthy without any complications. After recovery, the mother started treatment with chemotherapy, but two months later she died due to the spread of the disease. Cancer during pregnancy is always a challenge for diagnosis and treatment.
Summary Podocalyxin (PCX) is a glycoprotein member of the CD34 transmembrane sialomucin family and covers the surface of podocytes. It is assumed to be a marker of glomerular endothelial injury. In conditions, podocalyxin excretion in the urine is increased as a result of podocyte injury. Recent studies show that PCX is expressed not only in kidneys but also in the endothelial cells of other organs. Preeclampsia (PE) is characterized by new-onset hypertension, generalized endothelial injury, and glomerular alteration. Having this in mind, in the present study, we aimed to: (1) determine circulating PCX levels in sera of women with preeclampsia and normal pregnancy; (2) explore for an association between PCX and blood pressure and (3) investigate a possible relationship between PCX and routine laboratory markers of cardiac and renal injury/dysfunction. Fifty-five women with preeclampsia were examined. The mean age of patients was 24.9±6 years, and the mean age of the control group of 35 women with normal pregnancies was 24.7±5.4 years. The enzyme-linked immunosorbent assay (ELISA) was used to determine concentrations of PCX. Levels of serum PCX in preeclamptic women were statistically significantly higher than those in women with normal pregnancy: 2.66±0.67 vs. 2.40±0.33 ng/ml (p=0.03). Podocalyxin correlated with SBP (r=0.30; p=0.004), DBP (r=0.35; p=0.0007), uric acid (r=0.32; p=0.002), CPK (r=0.22; 0.03) and its isoenzyme CK-MB (r=0.21; p=0.04). Our results showed significantly higher levels of serum PCX in women with preeclampsia than in healthy pregnancy. Elevated podocalyxin levels are associated with an increase in blood pressure in preeclampsia. We found a relationship between PCX and routine laboratory indicators of cardiac (CPK and CK-MB) and renal injury/dysfunction (uric acid). PCX has the potential as a future preeclampsia diagnostic biomarker.
Introduction: A staggering 30% of deaths in neonates are caused by preterm births. The most common cause of perinatal morbidity and mortality around the world is due to preterm births, also referred to as premature. Hence, the ability to predict preterm births would result in significantly reduced fatalities. The likelihood of predicting a premature birth can be measured by the cervical length; however, there are other diagnostic procedures which utilize the contents of the cervico-vaginal fluid (CVF) for a more precise diagnosis. The latter also aids in detecting other pregnancy related anomalies. The phosphorylated insulin-like growth factor binding protein-1 (pIGFBP-1) is an example of a clinical biomarker which is frequently tested as it proves to be an indicator to predict preterm labour. Aim: Thus, in this study, our aim was to evaluate the accuracy of pIGFBP-1 as a marker of preterm labour when coupled with cervical biometrics. Materials and methods: A cross-sectional study of 32 pregnant women was conducted. The patients were split into 2 groups in which Group A consisted of those at risk of preterm labour and Group B – of women with normal and uncomplicated pregnancies. All participants were tested for pIGFBP-1 along with gathering data of transvaginal measurements of their cervical length. Results: We found in all participants in the study a moderate association between the expression of pIGFBP-1 in the CVF and the onset of preterm birth. Eight patients showed positive results amongst the symptomatic patients and as predicted, within 14 days, 6 of those patients did go into preterm labour. Conclusion: Appropriate scanning for pregnant women can be of excellent value as it has the potential to reduce the number of premature babies being born; this would also mean that the health complications associated with premature births can be prevented.
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