Vaginal delivery and continuous epidural analgesia: should we change our clinical approach?

The aim of the study was to investigate the effects of continuous epidural analgesia (EA) on the course of vaginal delivery with an emphasis on duration of labor and instrumental interventions. In a prospective 2-year trial, the study group included singleton vaginal births between 35 and 41 gestational weeks with a vertex fetus, in which continuous EA with bupivacaine or chirocaine in concentration of 0.125% combined with 2-4 microg of fentanyl or 0.5 microg of sufenta was used. The control group was created randomly from laboring patients with singleton pregnancies but without EA. The groups were adjusted for epidemiological characteristics and compared regarding the obstetric data and perinatal outcome. Student t-test and Mann-Whitney U-test were performed for normally and non-normally distributed results, respectively. Out of 1284 patients, 551 pregnant women were included in the study group and 733 in the control group. The statistically significant differences between the groups related to duration of the first and second stage of labor, frequency of premature rupture of membranes, intrapartal complications, and incidence of operative deliveries were found. Both stages of labor were significantly protracted and the incidence of operative deliveries was higher in the study group of patients compared with controls. There is a need for an active obstetric approach and management of vaginal deliveries of women who receive continuous EA, particularly if it is medically indicated.     

Antioxidant defenses in the ground squirrel Citellus citellus. 2. The effect of hibernation

In spring and autumn, the ground squirrel Citellus citellus is awake and active but in winter it usually hibernates. Reawakening from hibernation involves intense metabolic activity in the interscapular brown adipose tissue (IBAT). The IBAT of hibernation animals showed significant increases in the activities of superoxide dismutase (both copper-zinc and manganese-containing enzymes), glutathione peroxidase, and in the amount of ascorbate present. Glutathione peroxidase also increased in the liver, as did ascorbate in the plasma. These changes were not merely a consequence of exposure to low environmental temperatures. It is proposed that antioxidant defenses are increased in the IBAT of ground squirrels at the onset of hibernation in order to protect the tissue from reactive oxygen species generated as a result of the intense metabolic activity sustained by this tissue during reawakening.     

Chloroform Extract of Underground Parts of Ferula heuffelii: Secondary Metabolites and Spasmolytic Activity

Plants from the genus Ferula L. (Apiaceae) were used for various purposes in traditional medicine of different nations throughout the history. Ferula heuffelii Griseb . ex Heuffel is a perennial species endemic for Balkan peninsula. Ten compounds which belong to classes of prenyl‐furocoumarin‐, prenyl‐dihydrofurochromone‐, prenyl‐benzoyl‐ and prenyl‐benzoylfuranone‐type sesquiterpenoids, as well as sesquiterpene coumarins and phenylpropanoids, were, for the first time, isolated from the CHCl₃ extract of the underground parts of this plant and identified. Furthermore, extract and three isolated compounds, i.e., latifolone ( 1 ), dshamirone ( 4 ), and (2S*,3R*)‐2‐[(3E)‐4,8‐dimethylnona‐3,7‐dien‐1‐yl]‐2,3‐dihydro‐7‐hydroxy‐2,3‐dimethylfuro[3,2‐c]coumarin ( 6 ) were, for the first time, evaluated for their in vitro antispasmodic activities in three experimental models: spontaneous contraction, and ACh‐ and KCl‐induced contraction of an isolated rat ileum. The extract (0.1–1.3 mg/ml) and compound 6 (1–10 μg/ml) exhibited dose‐dependent effect in all three models. Compound 1 (1–6 μg/ml) affected spontaneous contractions and those induced by KCl, while compound 4 (8 μg/ml) displayed only moderate activity with ACh‐induced contractions. It can be concluded that tested compounds contribute to exhibited antispasmodic activity of crude extract. Additionally, extract (0.1–1.3 mg/ml) was tested for in vitro relaxant activity on an isolated rat trachea, and relaxed the KCl‐induced contractions in a dose‐dependent manner.     

Polymorphisms of interleukin-8 and -18 genes and diabetic retinopathy

We evaluated possible roles of interleukin-8 gene polymorphisms (1633T/C-rs2227543, 251A/T-rs4073) and interleukin-18 gene polymorphisms (-607C/A-rs1946518, -137G/C-rs187238) in the development of diabetic retinopathy (DR) in Caucasians with type 2 diabetes. 271 patients with DR and 113 without diabetic retinopathy were enrolled in this cross-sectional study. We did not observe an association between either interleukin-8 gene polymorphisms (1633T/C, 251A/T) or interleukin-18 gene polymorphisms (-607C/A, -137G/C) and diabetic retinopathy in Caucasians with type 2 diabetes. We did not find statistically significant differences in interleukin-8 serum levels between diabetics with the TT and AA genotype and those with other genotypes. The interleukin-18 serum levels between diabetics with the CC genotype of the -607C/A polymorphism and those with other genotypes (AA, AC) were not significantly different. Moreover, we did not observe a statistically significant effect of the tested polymorphisms of either interleukin-8 or interleukin-18 genes on serum levels in diabetics. In conclusion, our study indicates that the examined polymorphisms of interleukin-8 (1633T/C, 251A/T) and interleukin-18 (-607C/A or the -137G/C) genes are not genetic risk factors for diabetic retinopathy. Therefore, they may not be used as genetic markers for diabetic retinopathy in Caucasians with type 2 diabetes.     

Synthesis, structure, and hydrolytic reaction of trans-dichlorobis(diethanolamine-N)palladium(II) with N-acetylated L-histidylglycine dipeptide

The reaction of PdCl2, or K2PdCl4, with diethanolamine (DEA), in the molar ratio 1:2, affords the trans-[PdCl2(DEA)2] complex. X-ray structure analysis of this complex confirmed the formation of the trans-isomer. The complex crystallizes in the space group P42bc. The central Pd(II) ion is coordinated in an almost ideal square-planar fashion with a small deformation of the Cl-Pd-Cl angle (175.6(7) degrees) due to N-H...Cl hydrogen bonding. The N-H group participates in a bifurcated interaction with the two symmetry related Cl- anions. The hydroxyl groups of the diethanolamine ligand form very strong hydrogen bonds between the complex units, thus leading to infinite zigzag (O-H...O-H...O-H..) chains in the crystal packing. The complex units are further connected by weaker intermolecular hydrogen bonds of the N-H...Cl type in a way to form layers parallel to the crystallographic (001) plane. The reaction between the trans-[PdCl2(DEA)2] or trans-[Pd(H2O)2(DEA)2]2+ complex and MeCOHis-Gly dipeptide at 1.5 < pH < 2.0 and at 25 degrees C leads to the regioselective cleavage of the amide bond involving the carboxylic group of the histidine. The cleavage of the substrate was fast and went almost to completion within less than one hour.     

Dietary habits and folate status in women of childbearing age in Croatia

Folic acid and folates have an important role in prevention of neural tube defect that appears in the first weeks of pregnancy, when women are still not aware of their pregnancy, especially when pregnancy is not planned. Since ensuring sufficient quantities of folates and folic acid in this period is essential, dietary habits of childbearing age women are very important. In line with that the intake of folates and folic acid in nutrition of women age group 20-30 years is examined, as well as the frequency of consumption of foodstuffs rich in vitamins and folic acid supplements. Values of folates in serum are presented, dependent on their nutritional habits. Obtained results indicate that in spite of inadequate intake of folates and folic acid from foodstuffs, clinical deficit is not recorded, which is the result of frequent consumption of dietary supplements. In accordance with these dietary habits, differences in the folates status of examinees were observed.     

Age-related and gender-related differences between human vertebral and iliac crest bone--a histomorphometric study on the population of the Mediterranean Coast of Croatia

In this study, osseous tissue was examined in normal adult population that has inhabited areas by the Croatian Adriatic Sea. The most of such studies have shown that women are prone to lose bone connectedness, while men are predisposed to be a stronger constitution and they start with greater bone mass, though. Bone samples from two different anatomic sites were analyzed. The crista iliaca and the lumbar vertebra represent functionally different organs too. We wanted to consider weather the same age- and gender-related changes affect these two organs due to normal aging. Static histomorphometry was used to quantify involution changes in the trabecular bone. Results showed that involution process more severely affects women than men. Age-related structural changes were more prominent in lumbar vertebra than in iliac crest bone. Severe structural changes in lumbar vertebra could subsequently lead to a dysfunctional and deformed vertebral column. Therefore, iliac crest bone biopsies could hardly explain involution process that affects lumbar spine.