Dan Navolan

Early pregnancy serum neopterin concentrations predict spontaneous preterm birth in asymptomatic pregnant women.

Abstract Objective: To investigate if early pregnancy serum neopterin concentrations (EPSN) could predict spontaneous preterm birth (SPB). Methods: EPSN was measured in 92 sera collected from 46 pregnant women with birth at term and 40 sera from 20 pregnant women with preterm birth. Two sera were collected for each case: in the first and early second trimester. Results: EPSN concentrations correlate with gestational age (ρ=0.275, P=0.001), a correlation which was present in both groups: term and preterm birth. EPSN were higher in pregnancies with SPB compared with normal pregnancies (6.27±1.03 vs. 6.04±0.15, P=0.039). Patients with SPB showed a considerable increase of EPSN in the second trimester compared with patients with birth at term (7.30±1.53 vs. 6.16±0.23, P=0.043). A sharper increase was found in the group with SPB before 32 weeks of pregnancy (wp) (9.83±4.36 vs. 6.16±0.23, P=0.016). Pregnant women with an early second trimester serum neopterin value of above 8 nmol/L are associated with a risk of SPB before 32 wp (odds ratio=14.4, P=0.01) and of SPB before 34 wp (odds ratio=3.6, P=0.05), respectively. Conclusions: EPSN increases with the gestational age and predicts SPB in asymptomatic pregnant women.

Inverse Correlation Between IgG-Antihinge Region and Antierythrocyte Autoantibody in Chronic Benign and Malignant Cold Agglutination

Previous reports provided evidence of an immunosuppressive role of natural anti-F(ab′)2 antibodies. If suppressive anti-F(ab′)2 antibodies also regulated the autoantibody production in cold agglutination, one would expect high titers of anti-F(ab′)2 to be associated with low titers of cold agglutinins. Indeed, our previous studies revealed an inverse correlation between IgG-anti-F(ab′)2 and cold agglutinins. Many previous experiments focused on anti-F(ab′)2 of an antiidiotypic nature. Recent epitope mapping showed that anti-F(ab′)2 of healthy persons is not an antiidiotype but recognizes a hinge region sequence. We attempted to answer the question whether this IgG-antihinge antibody is responsible for the previously described association between anti-F(ab′)2 and cold agglutinins. IgG-antihinge and IgG-anti-F(ab′)2 antibody was determined and statistically analyzed in the serum of 334 patients with cold agglutination. Our experiments revealed a strong correlation between the concentrations of antihinge and the previously described anti-F(ab′)2 antibody. The anti-F(ab′)2 activity was competitively inhibited by a synthetic hinge peptide. Moreover, patients with high antihinge titers had low cold agglutinin titers, and vice versa. A stratification according to cold agglutinin specificity and disease etiology showed that the inverse correlation is present only in anti-I and anti-i patients suffering from monoclonal B-lymphocyte proliferation. In conclusion, our results confirm the correlation previously described for anti-F(ab′)2 antibody and antierythrocyte autoantibody and define for the first time an association between an idiotype-independent anti-IgG autoantibody and cold agglutinin.

Psoriasis during pregnancy. A literature review

Psoriasis is a chronic, recurrent inflammatory disorder characterized by the occurrence of well demarcated, erythematous papules and plaques covered by thick, silvery-white scales, generally affecting the elbows, knees, sacral area and scalp. It is a common disorder affecting women during their reproductive years. There is evidence that psoriasis might affect the course of pregnancy and that pregnancy can influence the course of psoriasis. The aim of this paper is to look over the most recent data regarding the impact of psoriasis on pregnancy and vice versa reviewing the current evidence for the safety of topical and systemic treatments for psoriasis during pregnancy.

Multicentric collaborative database in obstetrics and gynecology. Interdisciplinary Multicentric Working Group on Antenatal Research

Notwithstanding the type of study that is planned (retrospective or prospective), a multicentric and interdisciplinary approach assures a much better progress of the data collection than a single center approach does. We present herein the potential applicability of the system adapted by us in the national projects budgeted by the Romanian Academy of Medical Sciences. In our research we use an adapted version of Astraia - a database for women’s health data management. The database allows the documentation of main medical data about pregnant women, birth and neonates. The database was adapted to allow documentation of information about the biological samples collected and stored from patients. Queries were edited to allow identification and recognition of samples in the database. Our previous research recommends our platform for use in the following projects of the Romanian Academy of Medical Sciences: National Registry of Malformations and New Strategies in Health Prevention Measures.

Mammary Paget’s disease - case presentation and a brief review of the literature

Mammary Paget’s disease is a rare form of cancer, which involves the nipple-areola complex. In most cases it is associated with an underlying tumor of the breast. Diagnosis is based on clinical appearance and is confirmed by histopathological examination. Imaging tests play an important role in detecting the associated ductal carcinoma. We present the case of a 90-year-old woman, who presented to our clinic for an erythemato-squamous lesion that covers her entire left nipple. The lesion was previously treated as eczema. Histopathological examination revealed features characteristic of Paget’s disease.

Biotechnological application of human amniotic membrane in skin reconstruction

The human amniotic membrane (HAM) has a long history of use in surgical diagnostic. Therefore, the discoveries of cell populations from HAM, which are capable to differentiate into different skin types have been stimulating further research in characterizing this cells and their biotechnological application. Since the discovery of HAM-derived cell characteristics, the interest of big pharmaceutical industry has become more visible in application to skin grafts. In this context, we provide an overview of the recent progress and future perspectives of HAM-derived cells in skin tissue reconstruction and further biotechnological application.

Cytoreductive surgery for late recurrence after surgically treated stage IV ovarian cancer-a case report

Recurrence is a common finding after surgically treated ovarian cancer even in cases submitted to initially R0 resection. However, it is well known that an aggressive surgical approach is perfectly justified at the moment of relapse, being the only solution in order to increase the survival rates. We present the case of a 62 year old patient who was previously submitted to surgery for stage IV ovarian cancer followed by 6 cycles of adjuvant chemotherapy. At 4 years follow up she was diagnosed with disseminated abdominal recurrences and she was submitted to secondary cytoreduction. Postoperatively, adjuvant chemotherapy with platinum based regimens was instituted.

Flibanserin – a challenging drug in the treatment of hypoactive sexual desire disorder

Hypoactive sexual desire disorder (HSDD) is a condition characterized primarily by the decrease of sexual desire, affecting the quality of life. HSDD seems to be the most common sexual dysfunction in women. Therefore it should not be ignored, but treated. Recently the first drug for the treatment of HSDD, flibanserin, has been approved by FDA. Flibanserin is an agonist at 5-hydroxytryptamine (5HT1A) receptors and antagonist at 5HT2A receptors, acting also on dopamine receptors. It has been approved for premenopausal women but with certain restrictions. It was originally developed as an antidepressant drug, but studies have not supported its safety and efficacy. Its effect in HSDD was observed serendipitously. Studies conducted in North America and Europe have highlighted that flibanserin increases the number of satisfying sexual events and sexual desire, reducing the distress among premenopausal women.