Cytotoxicity of different concentrations of glycolic acid and its effects on root dentin microhardness - An in vitro study.

The aim of the study was to evaluate the cytotoxicity of different glycolic acid concentrations (GA) and its effects on dentinal microhardness. Cytotoxicity was evaluated after inoculation of test irrigants in the lymphocyte primary culture for 3 min. The tested substances were distilled water(DW); 17% EDTA; QMix; 10% GA; 17% GA; and 25% GA. Counting of total, live and dead cells was performed, obtaining the average percentage of dead cells of each group. For microhardness evaluation, 60 root dentin samples were divided into the same tested groups (n = 10) and immersed in test irrigants for 3 min. Dentin microhardness was evaluated by Vicker test. Specific statistical analysis was made in both tests. Results showed significant lower cytotoxicity for QMix and 10% GA (P < 0.05). Moreover, all test irrigants presented similar values of microhardness than the control group (P > 0.05). In conclusion, lower GA concentration can be an alternative for final irrigation on endodontics.

[Prevention of neonatal group B streptococcal sepsis in Hungary in 2012. Preliminary data of a nation-wide survey]. / A korai kezdetu újszülöttkori B csoportú Streptococcus-szepszis megelozésének helyzete Magyarországon 2012-ben. Egy országos felmérés adatai.

INTRODUCTION: At present, there is no obligatory guideline for the prevention of early-onset neonatal group B streptococcal disease in Hungary. AIM: The aim of the present study was to gain insight into the spontaneously developed preventive strategy of the domestic obstetric divisions and departments in Hungary. METHOD: Standardized questionnaire was sent out to each of the 71 obstetric divisions and departments in Hungary. RESULTS: Overall, 20 (27.4%) of the chairpersons replied, and thus, 39.9% of the total number of live births in Hungary were included in the study. Despite missing public health guidelines, each of the divisions and departments developed their own strategy to prevent neonatal group B streptococcal disease. In 95% of cases, bacterial culture of the lower vagina was the method of identifying pregnant women at risk. In 5% of the cases intrapartum antibiotic prophylaxis was based on risk assessment only. Of the departments using culture-based prophylaxis, 58% departments sampled women after completion of 36th gestational weeks. Antibiotic of choice was penicillin or ampicillin in 100% of cases. Of the study participants, 80% reported on multiple administration of colonized pregnant women after onset of labor or rupture of the membranes. CONCLUSIONS: The authors concluded that the rate of participation in the study was low. However, prevention of early-onset neonatal group B streptococcal infection is a priority of obstetric care in Hungary. Lack of a nation-wide public health policy did not prevent obstetric institutions in this country to develop their own prevention strategy. In the majority of cases and institutions, the policy is consistent with the widely accepted international standards.

Under-expression of CD24 in pre-eclamptic placental tissues determined by quantitative real-time RT-PCR.

BACKGROUND: Pre-eclampsia is a pregnancy-related disorder present in about 5-7% of all pregnancies. CD24 expression was recently reported in different diseases, while it has not yet been determined in pre-eclamptic placental tissues. METHODS: We collected placental tissues from pre-eclamptic (n = 16) and healthy pregnancies (n = 16). We used the quantitative real-time PCR method with a primer-probe system for determination of CD24 gene expression. RESULTS: We measured CD24 concentrations of 18.94 +/- 26.86 ng/microl in the pre-eclamptic and 53.85 +/- 92.05 ng/microl in the healthy placental tissues (p = 0.03). CONCLUSIONS: The quantitative real-time PCR method is suitable to determine CD24 expression in placental tissues. We suppose the low expression of CD24 may cause the enhanced immune reaction and could play a role in the abnormal development of placenta in pre-eclampsia.

Vascular endothelial growth factor (VEGF) polymorphisms in HELLP syndrome patients determined by quantitative real-time PCR and melting curve analyses.

BACKGROUND: The vascular endothelial growth factor (VEGF) has a critical role in vasculogenesis and vascular permeability in several diseases including preeclampsia. There are at least 30 single nucleotide polymorphic (SNP) places on this gene. VEGF G+405C, C-2578A and C-460T SNPs are known to be related to VEGF production. VEGF polymorphisms were studied in preeclampsia, but not in HELLP syndrome. Therefore, we decided to determine the allele and genotype frequencies of VEGF G+405C, C-460T and C-2578A SNPs in healthy pregnant women and HELLP syndrome patients. METHODS: The authors introduced a quantitative real-time PCR method for the determination of the three VEGF SNPs. Blood samples were collected from 71 HELLP syndrome patients and 93 healthy controls. DNA was isolated by using silica adsorption method. The SNPs were determined by quantitative real-time PCR and melting curve analysis using LightCycler. RESULTS: There were significant differences in the allele and genotype frequencies of VEGF C-460T SNP between the two study groups. The T allele was present in 71.1% in the HELLP group, while in 53.8% in the controls (p=0.0014). The TT genotype occurred significantly more frequently in the HELLP group than in the control group (45.1% vs. 21.5%; p (for genotype frequencies)=0.0011). The TT genotype carriers had an increased risk of HELLP syndrome, which was independent of maternal age and primiparity (adjusted odds ratio (OR)=3.03, 95% confidence interval (CI)=1.51-6.08; p=0.002). Although the VEGF G+405C allele and genotype distributions did not differ significantly between the two groups, the CC genotype carriers were also found to have an increased risk for HELLP syndrome after adjustment for maternal age and primiparity (adjusted OR=3.67, 95% CI=1.05-12.75; p=0.041). The VEGF C-2578A SNP was not associated with HELLP syndrome. CONCLUSIONS: The quantitative real-time PCR combined with melting curve analyses is a fast and reliable method for the determination of VEGF SNPs. We found that the VEGF -460TT and +405CC genotype carriers have an increased risk of HELLP syndrome. As these two SNPs were previously observed to be related to production of the VEGF protein, we suppose that these VEGF polymorphisms -- interacting with other genetic and environmental factors - could play a role in the development of HELLP syndrome.

Characteristic laboratory changes in pregnancies complicated by HELLP syndrome.

INTRODUCTION: HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) is a severe, life-threatening form of preeclampsia. Its development is accompanied by significant increase in maternal, as well as fetal, morbidity, and mortality rates. It is essential, therefore, for obstetricians to be familiar with the disease. MATERIALS AND METHODS: In the past 10 years, 107 patients were treated for HELLP syndrome in the intensive care unit (ICU) of the First Department of Obstetrics and Gynaecology, Semmelweis University. During this time, we studied the characteristic laboratory findings of the disease from the day of the diagnosis until the first few postpartum days. RESULTS: HELLP syndrome was present in 0.37% of all women having live births. In our study, the liver enzymes AST, and LDH, and the level of total bilirubin (indicating the degree of hemolysis), and repeated thrombocyte counts were suitable for following the cases. The AST, LDH and bilirubin levels returned to normal between the third and seventh days postpartum. The platelet count passed the critical level of 100,000/microL on the third to fourth day. CONCLUSIONS: We have found that the platelet count, LDH, AST, and total bilirubin levels proved to be useful indicators of the progression of HELLP syndrome.

[The rate of maternal complications in 107 pregnancies complicated with HELLP syndrome]. / Anyai szövodmények elofordulása 107 HELLP-szindrómával szövodött terhesség kapcsán.

INTRODUCTION: HELLP syndrome (Haemolysis, Elevated Liver enzymes, Low platelet count) is a grave, life threatening form of preeclampsia, which was named by Weinstein in 1982, on the basis of characteristic changes in laboratory findings (haemolysis, elevated level of liver enzymes and thrombocytopenia). OBJECTIVE OF THE STUDY: To assess the rate of maternal complications in HELLP syndrome. MATERIAL AND METHODS: In the past ten years, 107 patients were treated for HELLP syndrome at the Intensive Care Unit (ICU) of the 1st Department of Obstetrics and Gynaecology, Semmelweis University. The authors summed up about their experience with the treatment of patients, with special regard to the typical symptoms of HELLP syndrome, the course of the disease, postpartum maternal complications. RESULTS: The frequency of HELLP syndrome in live births was found to be 0.37%. In 96% of the patients the pregnancy was terminated via Caesarean section. Pulmonary oedema was the most common cardiopulmonary complication (11%) and developed in Mississippi Group I in the majority of the cases (21%). Transfusions had to be given quite frequently; 62% of the patients in the study were transfused using erythrocyte preparations. In persistent or progressive cases in the postpartum period, the elimination (uterine curettage and lavage) of factors responsible for the persistence of the disease (toxic and vasoactive agents in the endometrium) resulted in the recovery of one third of the patients. Maternal thromboembolic complications developed in 11% of the patients, each of them was affected in Mississippi Group I, with the lowest platelet count. CONCLUSIONS: The immediate termination of a pregnancy in which HELLP syndrome emerges may save the patient's life. It is recommended to try and lift foci applying uterine curettage and lavage as the first step, if the mothers' condition persists or progresses after delivery. Its development is accompanied by a significant increase in maternal and fetal morbidity and mortality alike, therefore it is essential for the obstetricians to be familiar with the disease.

Follow-up analysis of pregnancies complicated by HELLP syndrome.

AIM: In this study, we investigated the course of subsequent pregnancies in patients with HELLP syndrome and the development of chronic maternal diseases. RESULTS: The study population consisted of 50 patients who were treated for HELLP syndrome at 1(st) Department of Obstetrics and Gynecology, Semmelweis University between January 1, 1995 and December 31, 2004. There were 35 subsequent pregnancies in 25 patients. Of these there were seven miscarriages, one mid-trimester loss. The incidence of premature birth was 40.7%, and neonatal mortality 7.4%. Preeclampsia recurred in twelve pregnancies; it was mild in eight and severe in four cases. HELLP syndrome re-occurred four times in three patients (14.28%). Recurrent hypertension was observed in 24% of the pregnancies. CONCLUSIONS: Pregnancies after a previous pregnancy complicated by HELLP syndrome carry not only an increased chance for HELLP syndrome but also the development of other pathological obstetric conditions and chronic maternal diseases. Hypertension was found to be a maternal disease of increased incidence (24%) in subsequent pregnancies.