Multiorgan thrombotic disorder in a young patient with primary antiphospholipid syndrome (APS) and ovarian tumor.

Catastrophic antiphospholipid syndrome (CAPS) is a life-threatening condition with high mortality rate besides aggressive multimodal treatment. Underlying triggers of "thrombotic and cytokine storm" include pregnancy, inflammation, trauma, surgery, and infection. The authors present a case of a young female patient with primary antiphospholipid syndrome (APS) who was admitted to the hospital due to abdominal pain caused by ovarian tumor with elevated tumor markers. After the prophylactic anticoagulants and antibiotic treatment, surgery was performed. Suddenly after treatment, her clinical status deteriorated and she died regardless of intensive immunosupresive and anticoagulant therapy attempts. This condition requires all clinical awareness, timely diagnosis, and therapeutical approach, including a better understanding of the pathophysiology that leads to CAPS.

[The effect of complete thymic extract on motility and progressive motility of spermatozoa in asthenozoospermia]. / Dejstvo celokupnog ekstrakta timusa na motilitet i progresivni motilitet spermatozoida kod astenozoospermije.

The thymic gland is involved in immunologic and endocrinologic heomostasis of the body. Neonatal thymectomy of experimental animals leads to gonadal dysgenesis. Both eostrogen and androgen receptors have been identified in thymic epitelial cells, and sex steroids can be modulated by secretion of thymosin. High levels of thymosin alpha-1 in seminal plasma are correlated with sperm count, viability and motility in fertile males as compared to infertile ones. In this study we examined the effects of complete thymic extract on motility and progressive motility of spermatozoa obtained from asthenozoospermic men. In the first part of experiment, we studied the influence of complete thymic extract, as a bioactive medium component, on movement of spermatozoa samples with initial motility lower than 30%, in vitro. The study was carried out on two groups of sperm samples, 40 samples each, obtained by masturbation after a 72-hour-abstinence. After completed liquefaction at room temperature (30-40 min.), we determined the usual parameters of sperm quality. Total motility (M%) and progressive motility (PM%) of spermatozoa were analyzed in 10 microscopic view fields. Each group of sperm samples was prepared by swim-up and swim-down method. Then, we estimated the total motility and progressive motility of "washed" spermatozoa in every sample. In addition, every sample was divided in two equal parts. One part was immediately left in thermostat (control). To the second part we added 0.2 mg of complete thymic extract before incubation (experimental group). Total and progressive motilities were analyzed after 1, 4, 12 and 24 hours of incubation. The t-test was used for statistical analysis of results. The second part of the study was carried out on a group of 10 asthenozoospermic men (volunteers). We examined the influence of complete thymic extract, as intra-muscular injection, in a doze of 150 mg daily, during seven days, on motility and progressive motility of spermatozoa. Sperm samples were obtained by masturbation after four days of abstinence. We compared the parameters before and after the therapy. They were statistically processed by a method of difference. The results showed that the complete thymic extract increased the total and progressive motilities of spermatozoa separated by swim-down method (p < 0.001), in vitro (Table 1-4). The parenteral application of complete thymic extract, statistically significantly increased motility and progressive motility of spermatozoa in asthenozoospermic men (p < 0.05) (Table 5). These findings could be useful in assisted reproductive technology.

Case-control study of congenital malformations.

To determine potentially teratogenic influences in Belgrade, a group of 113 mothers who gave birth to severely malformed infants and a control group of 195 mothers with normal infants were interviewed using a structured questionnaire. Statistically significant differences between the two groups were found in the mother's family history of congenital malformations (P < 0.05) and the mother's diseases during the pregnancy (P < 0.01). Infections in the first trimester were particularly more prevalent in case mothers (OR = 7.70; P < 0.01). Mothers did not differ significantly according to exposure to organic solvents, supportive therapy during the pregnancy, use of oral contraceptives, or other personal habits.

[Wilson's disease and pregnancy]. / Vilsonova bolest i trudnoca.

Wilson's disease is rare autosomal-recessive disorder originated on the basis of metabolic copper over-storage. This is the case report of patient aged 28, who suffers Wilson's disease during last ten years. She has been treated by penicillamine unregularly from the beginning of her disease. She reported three spontaneous abortions in her previous history. She was treated by penicillamin and bedoxin in current pregnancy. Vaginal delivery was completed using oxytocin stimulation. Newborn was male, alive, with body weight of 2900 grams. Apgar score was 8. During puerperal period normal uterine involution was estimated, but lactation was ceased.

[Occurrence of triplet births]. / Ucestalost radjanja trojki.

The authors studied all cases of triplets who were born at the Department of Gynaecology and Obstetrics of University Clinical Centre in Belgrade, over a twenty-year period (1970-1989). Thirty sets of triplets were born in this period. This means that one set of triplets was born per 5845 births. Preterm deliveries occurred in 19 cases. Liveborn children had lower Apgar score. Common birthweight was slightly below 1800 grams. In more than one half of the foetuses malpresentation was found. More than one fourth of sets were delivered by Cesarean section. Total foetal loss reached 23.33% and purified perinatal mortality rate reached 11.11%. The triplet diagnosis on time is important because of the necessary prevention measures and appropriate therapy.

[Evaluation of the reliability of statistics on suicide in Yugoslavia and throughout the world]. / Procena pouzdanosti statistike o samoubistvima u nas i u svetu.

On the basis of WHO reports on suicides the authors studied the problem of suicides in the world. They present the most jeopardized regions. On the basis of data on suicides in Yugoslavia, the authors evaluate this problem within Yugoslavia. They payed special attention to the quality of statistical data on suicides and validity of comparative statistical information on international level.