Anti-Biofilm and Anti-Quorum-Sensing Activity of Inula Extracts: A Strategy for Modulating Chromobacterium violaceum Virulence Factors

The formation of microbial biofilm is a self-organizing process among bacterial cells, regulated by quorum-sensing (QS) mechanisms, contributing to development of infections. These processes, either separately or in combination, significantly contribute to bacterial resistance to antibiotics and disinfectants. A novel approach to addressing the challenge of treating infections due to antibacterial resistance involves the use of plant metabolites. In recent years, there has been increasing recognition of different phytochemicals as potential modulators. In our study, we evaluated the synergistic effect of chloroform and methanol extracts from Inula species against key virulence factors, including biofilm formation, violacein production, and swarming motility. Each of the 11 examined plant extracts demonstrated the ability to reduce biofilms and pigment synthesis in C. violaceum. Two of the extracts from I. britannica exhibited significant anti-biofilm and anti-quorum-sensing effects with over 80% inhibition. Their inhibitory effect on violacein synthesis indicates their potential as anti-QS agents, likely attributed to their high concentration of terpenoids (triterpenoids, sesquiterpene lactones, and diterpenoids). Scanning electron microscopy revealed a notable reduction in biofilm biomass, along with changes in biofilm architecture and cell morphology. Additionally, fluorescence microscopy revealed the presence of metabolically inactive cells, indicating the potent activity of the extracts during treatment. These new findings underscore the effectiveness of the plant extracts from the genus Inula as potential anti-virulent agents against C. violaceum. They also propose a promising strategy for preventing or treating its biofilm formation.

Metabolomic Profiling and DNA-Fingerprinting of Newly Recorded White-Flowered Populations of Salvia lanigera Poir. in Egypt

Salvia lanigera Poir. is a small herbaceous perennial species with violet flowers that grows in low-altitude deserts, and sandy loam. During the collection of S. lanigera, unusual populations with white flowers were found. Therefore, the two populations (violet- and white-flowered) were subjected to comparative investigations, including DNA fingerprinting, chemical composition, and biological evaluation. The two populations showed DNA variations, with 6.66 % polymorphism in ISSR and 25 % in SCoT markers. GC/MS and UHPLC/HRMS of aqueous methanol extracts, led to the tentative identification of 43 and 50 compounds in both populations. In addition, the structures of nine compounds, including four first-time reported compounds in the species, were confirmed by NMR. Furthermore, the total extracts exhibited weak radical scavenging activity against DPPH and a lower inhibitory effect towards acetylcholinesterase. In conclusion, the obtained data suggested that the white-colored flower could be an additional important character record for the Egyptian S. lanigera.

Phytochemical Profile, Antioxidant Potential, Antimicrobial Activity, and Cytotoxicity of Dry Extract from Rosa damascena Mill

Dry rose extract (DRE) obtained industrially by aqueous ethanol extraction from R. damascena flowers and its phenolic-enriched fraction, obtained by re-extraction with ethyl acetate (EAE) were the subject of this study. 1H NMR of DRE allowed the identification and quantitation of fructose and glucose, while the combined use of HPLC-DAD-ESIMS and HPLC-HRMS showed the presence of 14 kaempferol glycosides, 12 quercetin glycosides, 4 phenolic acids and their esters, 4 galloyl glycosides, 7 ellagitannins, and quinic acid. In addition, the structures of 13 of the flavonoid glycosides were further confirmed by NMR. EAE was found to be richer in TPC and TFC and showed better antioxidant activity (DPPH, ABTS, and FRAP) compared to DRE. Both extracts displayed significant activity against Propionibacterium acnes, Staphylococcus aureus, and S. epidermidis, but showed no activity against Candida albicans. Toxicity tests on normal human skin fibroblasts revealed low toxicity for both extracts with stronger effects observed at 24 hours of treatment that were compensated for over the following two days. Human hepatocarcinoma (HepG2) cells exhibited an opposite response after treatment with a concentration above 350 µg/mL for EAE and 500 µg/mL for DRE, showing increased toxicity after the third day of treatment. Lower concentrations were non-toxic and did not significantly affect the cell cycle parameters of either of the cell lines.

Influence of the Abiotic Elicitors Ag Salts of Aspartic Acid Derivatives, Self-Organized in Nanofibers with Monomeric and Dimeric Molecular Structures, on the Antioxidant Activity and Stevioside Content in Micropropagated Stevia rebaudiana Bert

The use of nanomaterials in biotechnology for the in vitro propagation of medical plants and the accumulation of certain biologically active metabolites is becoming an efficient strategy. This study aimed to evaluate the influence of the concentration (0, 1, 10, 50, and 100 mg L-1) of two types of nanofibers on the growth characteristics, the antioxidant status, and the production of steviol glycosides in micropropagated Stevia rebaudiana Bert. plantlets. The nanofibers were synthesized by aspartic acid derivatives (L-Asp) Ag salts self-organized into nanofibers with two different molecular structures: monomeric, containing one residue of L-Asp with one hydrophilic head which bonds one Ag ion (NF1-Ag salt); and dimeric, containing two residues of L-Asp with two hydrophilic heads which bond two Ag ions (NF2-Ag salt). An increase in the shoots from the explants' number and length, biomass accumulation, and micropropagation rate was achieved in the plants treated with the NF1-Ag salt in concentrations from 1 to 50 mg L-1 after 30 days of in vitro proliferation compared to the NF2-Ag salt. In contrast, the plants grown on MS media supplemented with NF2-Ag salt exhibited an increase in the level of stevioside, rebaudioside A, and mono- (CQA) and dicaffeoylquinic (DCQA) acids as compared to the NF1-Ag salt.

Seedling and adult plant resistance to leaf rust in some Bulgarian common wheat lines

The response of 250 common winter wheat breeding lines was investigated for resistance to the causative agent of Puccinia triticina under conditions of an infected field on the territory of Dobrudzha Agricultural Institute - General Toshevo, Bulgaria, during three successive seasons. Twenty lines with different degrees of resistance under field conditions were selected. Multi-pathotype testing was used to study the response of these lines at seedling stage under greenhouse conditions to individual pathotypes of P. triticina. Based on the response of the lines at seedling and adult stages, we found out that 20 % of them carried race-specific resistance. One of the lines (99/08-52) reacted with full resistance to the pathotypes used under greenhouse conditions. The reaction demonstrated by this line coincided with the response of isogenic lines carrying the genes Lr9, Lr19, Lr22a, Lr22b and Lr25. The other three lines (19/06- 108, 82/08-43 and 82/08-35) showed a resistant reaction to 6 or 5 of the pathotypes used in the study. Their response partially coincided with the reaction of 5 isogenic lines, and the presence of some of these genes in the above lines is quite possible. Lines carrying this type of resistance are to be subjected to further genetic and breeding investigations to prove the presence of a race-specific gene. Twenty-five percent of the lines combined partial race-specific resistance at seedling stage with the resistance of race non-specific nature at adult stage. Forty percent of all studied lines carried race non-specific resistance, and 15 % of the lines possessed resistance of the "slow rusting" type. As a result of the study we carried out, the lines that demonstrated stable resistance to leaf rust can provide sufficient protection of the host and can be included in the breeding programs for developing varieties resistant to P. triticina.

Accuracy of Conventional and Digital Workflows in Partially Edentulous Cases Restored with FPDs over Implants. A Systematic Review

PURPOSE

To compare conventional and digital workflows in terms of accuracy in partially edentulous cases restored with implant-supported restorations.

METHODS

An electronic search in the databases PubMed, Scopus, Web Of Science, and CENTRAL was conducted to identify relevant publications, comparing digital and conventional workflows in partially edentulous cases restored with implant-supported prostheses.

RESULTS

18 articles were included in the systematic review. Ten of the studies were in-vitro, and eight were clinical. Sample sizes varied considerably from 20 to 100. In three studies, three implants were investigated, whereas, in all other instances, accuracy was evaluated on two implants. Substantial heterogeneity in the methodology of the selected studies is evident, which prevents summarising the accuracy outcomes.

CONCLUSIONS

Digital impressions showed similar results in terms of accuracy compared to the conventional approach. There is a lack of uniform criteria for the tolerable misfit, which hampers the ability to transfer in-vitro results to clinical situations. A need for a standardised approach in the evaluation of impression and workflow accuracy is warranted to enable the systematisation and analysis of results from different studies.

Apnoea-hypopnoea index of 5 events·h-1 as a metabolomic threshold in patients with sleep complaints

Background

The apnoea-hypopnoea index (AHI) forms the basis for severity of obstructive sleep apnoea (OSA), a condition expected to reprogramme metabolic pathways in humans. We aimed to identify the AHI breakpoint from which the majority of significant changes in the systemic metabolome of patients with sleep complaints occur.

Methods

In a prospective observational study on symptomatic individuals, who underwent polysomnography for the diagnosis of OSA, profiles of 187 metabolites including amino acids, biogenic amines, acylcarnitines, lysophosphatidylcholines, phosphatidylcholines and sphingomyelins were analysed with liquid chromatography mass spectrometry in peripheral blood drawn at three different time points overnight. Comparisons of rank-transformed data using a general linear model for repeated measures after dichotomising the study group at different AHI levels were applied to define the best cut-off based on Cohen's f.

Results

65 subjects were recruited with a median AHI of 15.6 events·h^-1. The mean Cohen's f over the metabolites was highest (0.161) at an AHI level of 5 events·h^-1 representing the metabolomic threshold. Of the particular between-group differences, eight phosphatidylcholines, nine acylcarnitines and one amino acid (threonine) had significantly lower concentrations in the individuals with an AHI level equal to or above the metabolomic threshold. The metabolomic changes at AHI levels defining moderate and severe OSA were smaller than at an AHI of 5 events·h^-1.

Conclusions

The metabolomic threshold for patients with sleep complaints described in this report for the first time coincides with the AHI threshold required to confirm the diagnosis of OSA.

Chemical Composition and Antioxidant Capacity of the Fruits of European Plum Cultivar “Čačanska Lepotica” Influenced by Different Rootstocks

We investigated the influence of different rootstocks on the content of sugars, organic acids, and antioxidant phenolic compounds in the whole fruit and fruit skin of the European plum cultivar “Čačanska Lepotica”. ¹H NMR of the fruit extracts allowed for the identification of sucrose, α- and β-glucose, sorbitol, fructose, and malic and quinic acids, while LC–DAD–ESIMS showed the presence of neochlorogenic and chlorogenic acids, cyanidin-3-O-glucoside, cyanidin-3-O-rutinoside, peonidin-3-O-glucoside, peonidin-3-O-rutinoside, hyperoside, isoquercitrin, rutin, and unidentified quercetin-3-diglycoside. The quantitation of the sugars, malic and quinic acids by ¹H NMR and phenolic compounds by HPLC–DAD revealed that the rootstock significantly influenced the content of the individual compounds in the fruit skin and fruit. The fruit grafted on “Wavit” rootstock was characterized by significant amounts of neochlorogenic acid, peonidin-3-O-rutinoside, cyanidin-3-O-rutinoside, and sucrose, while the fruit on “GXN-15” was characterized by high levels of sugars, cyanidin-3-O-glucoside, and malic and chlorogenic acids. The fruit skins of plums grafted on “Wavit” were the richest in sugars, organic acids, and phenolic compounds. A good correlation was observed between the content of total phenolics (TPC), flavonoids (TFC), anthocyanins (TAC), and individual phenolic compounds in the extracts of the fruit and the fruit skins and their antioxidant capacity (DPPH, ABTS, and FRAP).

Optimization of microwave-assisted extraction of phenolic compounds from Inula britannica L. using the Box-Behnken design

A closed-vessel microwave-assisted extraction (MAE) of phenolic compounds from the aerial parts of Inula britannica L. using single-factor experiments and the Box-Behnken design with four independent variables (liquid-to-solid ratio, ethanol concentration, extraction time, and temperature) was investigated. The ANOVA results showed that the obtained model was significant at a 95 % confidence level. The extraction parameters for the maximal total phenolic content (46.19 mg GAE/g DM) were determined to be 15.13 ml/g liquid-to-solid ratio, 55.95 % EtOH, 73.74 ºC, and 5.73 min. Compared with classical maceration, the proposed MAE of phenolic compounds from I. britannica saves a lot of time and gives a high extraction yield.

Adaptive and maladaptive perfectionism of graduating medical students

Introduction

Perfectionism, as a multiform trait of character, plays an important role in the formation of motivation of achievements in socially significant activity. Adaptive perfectionism, together with the desire to achieve recognition in one’s professional community and insure the emotional stability. Maladaptive (neurotic) perfectionism is directed towards the achievement of excessively high (non-relevant) standards of activity, a constant anxiety, internal stress and lack of self-confidence

Objectives

To pinpoint the types of perfectionism that graduating medical students at Medical University experience, those who, during all the years of study, showed high academic results

Methods

Forty-nine graduating medical students volunteered to take part in the study, their average mark being not lower than 4.75 (maximum was 5). Their average age was 22.41±0.75. The following scales measured the level of expressiveness of perfectionism: A.A. Zolotareva, Hewitt and Flett, I.I. Gracheva

Results

The results of the study undertaken showed two distinct groups. Students of the first group (79.6%) aimed at high internal standards in their study that would make them very well prepared professionally for their future work as doctors. They consciously accepted the common rules and norms of their society. Students of the other group (20.4%), consciously and subconsciously, estimate their high academic results as a good way of overcoming personal disturbances. They have excessive non-realistic demands towards self and others

Conclusions

The results of our study make it possible for us to suppose that medical students of the second group will experience quite a lot of difficulties in their future professional activity

Disclosure

No significant relationships.

Spectral properties and biological activity of La(III) and Nd(III) Monensinates

The present research is focused on evaluation of complexation ability of Monensic acid (MonH) towards La3+ and Nd3+ ions.

Changes in the SRCD spectrum of Monensinate anion were monitored upon addition of lanthanide(III) ions. The antibiotic undergoes formation of one neutral ([Ln(Mon)3(H2O)3]) and two positively charged complex species of composition [Ln(Mon)2(H2O)2]+ and [Ln(Mon) (H2O)]2+, respectively (Ln = La3+, Nd3+). Neutral complexes were isolated as fine powders and were characterized by IR, FAB-MS and ESI-MS. It is assumed that Monensin acts in bidentate coordination mode via monodentate carboxylate moiety and hydroxyl group, both located at the opposite ends of antibiotic molecule.

Activity of Monensic acid and [Ln(Mon)3(H2O)3] to decrease visible bacteria growth of B. subtilis, S. Lutea and B. mycoides was evaluated by agar hole diffusion method. Results showed that complexation of lanthanide(III) ions to Monensin enhances the activity of non-coordinated ligand.

Antitumor efficacy of compounds was assayed on human triple negative breast cancer and transplantable sarcoma in rat. The cytotoxicity was accessed by MTT test, NR uptake, CV assay and double AO/PI staining. Experimental data revealed that Monensic acid and [Ln(Mon)3(H2O)3] possess concentration- and time-dependent activity, and express promising cytotoxic properties against human and rat permanent cancer cell lines.

The 6 September 2017 X-Class Solar Flares and Their Impacts on the Ionosphere, GNSS, and HF Radio Wave Propagation

On 6 September 2017, the Sun emitted two significant solar flares (SFs). The first SF, classified X2.2, peaked at 09:10 UT. The second one, X9.3, which is the most intensive SF in the current solar cycle, peaked at 12:02 UT and was accompanied by solar radio emission. In this work, we study ionospheric response to the two X-class SFs and their impact on the Global Navigation Satellite Systems and high-frequency (HF) propagation. In the ionospheric absolute vertical total electron content (TEC), the X2.2 SF caused an overall increase of 2-4 TECU on the dayside. The X9.3 SF produced a sudden increase of ~8-10 TECU at midlatitudes and of ~15-16 TECU enhancement at low latitudes. These vertical TEC enhancements lasted longer than the duration of the EUV emission. In TEC variations within 2-20 min range, the two SFs provoked sudden increases of ~0.2 TECU and 1.3 TECU. Variations in TEC from geostationary and GPS/GLONASS satellites show similar results with TEC derivative of ~1.3-1.7 TECU/min for X9.3 and 0.18-0.24 TECU/min for X2.2 in the subsolar region. Further, analysis of the impact of the two SFs on the Global Navigation Satellite Systems-based navigation showed that the SF did not cause losses-of-lock in the GPS, GLONASS, or Galileo systems, while the positioning error increased by ~3 times in GPS precise point positioning solution. The two X-class SFs had an impact on HF radio wave propagation causing blackouts at <30 MHz in the subsolar region and <15 MHz in the postmidday sector.

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine: Brussels, Belgium. 15-18 March 2016

[This corrects the article DOI: 10.1186/s13054-016-1208-6.].

Thirty autosomal insertion-deletion polymorphisms analyzed using the Investigator® DIPplex Kit in populations from Iraq, Lithuania, Slovenia, and Turkey

Thirty autosomal insertion-deletion (InDel) polymorphisms were analyzed in four populations from Iraq, Lithuania, Slovenia, and Turkey using the commercial kit Investigator^® DIPplex. Genotyping issues were encountered for five of the 30 InDels. They were most probably caused by polymorphisms located in the primer binding sites. Population and forensic parameters were calculated. No significant deviations from Hardy-Weinberg equilibrium or significant linkage disequilibrium were detected. The observed heterozygosities ranged from 33% to 61% depending on the marker and the population. The combined probability of exclusion for the 30 markers was 99.7% in all four populations and the matching probabilities were 1 in 3-4×10¹² individuals. The multidimensional scaling plot drawn from F_ST distances showed a good concordance between the relative position of the 15 populations included in the plot and their geographic locations.

High intensity proton injector for facility of antiproton and ion research

The high current ion source with the low energy beam transport (LEBT) will serve as injector into the proton LINAC to provide primary proton beam for the production of antiprotons. The pulsed ion source developed and built in CEA/Saclay operates with a frequency of 2.45 GHz based on ECR plasma production with two coils with 87.5 mT magnetic field necessary for the electron cyclotron resonance. The compact LEBT consists of two solenoids with a maximum magnetic field of 500 mT including two integrated magnetic steerers to adjust the horizontal and vertical beam positions. The total length of the compact LEBT is 2.3 m and was made as short as possible to reduced emittance growth along the beam line. To measure ion beam intensity behind the pentode extraction system, between solenoids and at the end of the beam line, two current transformers and a Faraday cup are installed. To get information about the beam quality and position, the diagnostic chamber with different equipment will be installed between the two solenoids. This article reports the current status of the proton injector for the facility of antiproton and ion research.

[RECONSTRUCTIVE AND COSMETIC SURGERY IN TREATMENT OF VULVAR CANCER]

The aim of our research work was to show our results in the field of reconstructive and cosmetic surgery for vulvar cancer.

MATERIAL AND METHODS

We evaluated 18 patients for 10 years period.

RESULTS

We applied all surgical techniques that are possible at the moment in the world: laps from mons pubis, rhomboid flaps, myocutaneous flaps from gluteal region. We used surgical techniques with the following muscle groups: musculus gracilis, musculus gluteus maximus, musculus tensor fasciae latae, musculus rectus abdominis.

CONCLUSIONS

With our research work we tried to better the quality of life of our patients, to achieve better esthetic and cosmetic effect after very radical surgical interventions connected with vulvar cancer.

[FEMALE STEROID HORMONES - MODULATORS OF IMMUNE RESPONSE TO GENITAL CHLAMYDIA TRACHOMATIS INFECTION.]

In the recent years according to WHO, genital chlamydia is the mos't common sexually transmitted infection. Chlamydia Trachomatis is an intracellular parasite which target are the tubular epithelial cells of the urethra, endocervix, endometrium, endosalpinx, conjunctiva, synovial lining of the joints, Glisson's capsule of the liver Our study, as well as some international researches, shows that in the cases of genital chlamydia there are changes in the ovarian hormones (estradiol and progesterone), their impact on the immune system and their importance for the development and the complications of the infection with Chlamydia trachomatis. The physiological level of the steroid hormones in its turn contributes for the normalization of the local immunity and reduces the possibility of recurrences.

Women with an HbA1c of 41-49 mmol/mol (5.9-6.6%): a higher risk subgroup that may benefit from early pregnancy intervention

AIMS

To examine whether women with an HbA1c of 41-49 mmol/mol (5.9-6.6%) at diagnosis of gestational diabetes are higher risk than women with an HbA1c of < 41 mmol/mol (5.9%) and whether pregnancy outcomes are improved if treated at < 24 weeks' gestation.

METHODS

This was an observational study of women with gestational diabetes diagnosed by early HbA1c screening or subsequent oral glucose tolerance test at < 34 weeks' gestation who delivered at National Women's Health, Auckland, from July 2012 to June 2014. Data were extracted from the hospital database. Women with HbA1c 41-49 mmol/mol (5.9-6.6%) were divided into those seen < 24 weeks (Early, n = 134) and those seen ≥ 24 weeks (Later, n = 151). Those with HbA1c < 41 mmol/mol (5.9%) were labelled Other GDM (n = 661).

RESULTS

The Early and Later groups, compared with Other GDM, had more Polynesian and fewer (non-Indian) Asian women, higher BMI and more required medication (P < 0.001). More were smokers (P = 0.007, 0.02) and more had chronic hypertension (P < 0.001, 0.02). There were higher rates of adverse outcomes in the Later group than the Other GDM group (pre-eclampsia 8.0% vs. 2.4%, P = 0.001, preterm birth 16.6% vs. 8.2%, P = 0.002, neonatal admission 15.5% vs. 9.2%, P = 0.02). Outcomes were similar between the Early group and Other GDM group (pre-eclampsia 1.5% vs. 2.4%, P = 0.5, preterm birth 10.5% vs. 8.2% P = 0.4, neonatal admission 13.6% vs. 9.2%, P = 0.12). Comparing the Early and Later groups, the Early group had less pre-eclampsia, 1.5% vs. 8.0%, adjusted P = 0.03. Other outcomes were not statistically different.

CONCLUSIONS

An HbA1c of 41-49 mmol/mol (5.9-6.7%) identifies a higher-risk group of women with gestational diabetes. Overall, our data support early treatment of women with an HbA1c ≥ 41 mmol/mol (5.9%).

[OVARIAN ANASTOMOSING HEMANGIOMA WITH STROMAL LUTEINIZATION: A CASE REPORT]

In 2009, Montgomery and Epstein coined the term "anastomosing hemangioma" for a newly described variant of capillary hemangioma with an unusual sinusoidal pattern, histologically mimicking angiosarcoma. The lesion was considered unique for genitourinary system with predilection to kidney but we found in the literature only 4 cases of this entity in ovaries. A 70-year-old woman presented with ultrasound visualized myometrial nodules and cystic formation of the right ovary, intraoperatively diagnosed as serous cystadenoma. Hysterectomy with bilateral adnexectomy was performed. The section of the ovary revealed a fortuitous finding in the cortex: circumscribed lesion, 7 mm in diameter, with mahogany brown, spongy appearance. Microscopic examination of H&E-stained slides manifested well-demarcated but un-encapsulated vascular proliferation, composed of tightly packed capillary-sized blood vessels with an anastomosing sinusoidal-like architecture and tortuous "feeding" and "draining" vessels of medium caliber. Endothelial lining featured only mild cytologic atypia and lack of mitotic figures. The lesion was surrounded by luteinized ovarian stroma. Immunohistochemical examination with CD34 highlighted endothelial cells; SMA--supporting stromal cells. The anastomosing hemangioma of the ovary with stromal luteinisation was diagnosed as accidental finding. The authors discuss morphological characteristics of anastomosing hemangioma and the unusual for menopausal women but quite often combination between this lesion in the ovary and stromal luteinisation.

[COMBINED APPLICATION OF FETAL FIBRONECTIN AND INSULIN-LIKE GROWTH FACTOR IN PRETERM DELIVERY DIAGNOSIS--OUR RESULTS]

The insulin-like growth factor IGFBP-1 is a binding protein (IBP-1), also known as placental protein (PP12), is encoded in people as IGFBP-1 gene. The IGFBP-1 is an especially vital hormone in the female reproductive physiology. The presence of it in large quantities in the amniotic fluid can be used as a biochemical marker for preterm birth and premature rupture of membranes. Fetal fibronectin is a high-molecular glycoprotein, that is produced during pregnancy and has a role as biological glue, binding the foetus membranes to the endometrium. fFN can be found in the cervicovaginal secretions until 22nd gestational week and later on during the last trimester (1 to 3 weeks before birth). fFN is usually absent between 24th and 34th gestational week. Thirty sixth (30%) of all the 120 females tested had positive fFN test results and were, therefore, at high risk for preterm delivery. Despite the implemented tocolytic therapy, 15 (12.5%) of them delivered before the 37th gestational week. The results from the investigation for the presence of pLGFBP-1 in 120 pregnant women show that 35.8% (43 women) were positive and 15(12,5%) of them delivered before the 37th gestational week despite the implemented tocolytic therapy In both tests, the average gestational age of the premature fetus was 32.5 ÷ 2.8 gestational weeks.

[CONGENITAL UNILATERAL HYDROTHORAX--A CASE REPORT]

A case of isolated unilateral congenital hydrothorax with unknown etiology, graduated abortion for medical reasons in 23 weeks. The patient was later covered by antenatal care and during the examination one foetus with the massive right-sided hydrothorax was found, (diagnosed by ultrasonography and NMR) The incidence of congenital fetal hydrothorax is estimated at approximately 1 in 15,000 pregnancies. Early ultrasound diagnosis is of paramount importance for the adequate monitoring of the pregnancy and timely proof of deviation in normal fetal development.

[Morphologically qnd immunohistochemically based screening criteria for selection of patients with possible mutation of BRCA1 gene in primary ovarian cancer]

SUMMARY AND AIM: Breast cancer (BC) and Ovarian cancer (OC) are some of the most common cancers affecting women. Environmental factors and genetic alterations are involved in the etiology of both cancers. The main susceptibility genes that predisposed to BC and OC are BRCA1 (BReast CAncer 1) and BRCA 2 (BReast CAncer 2). Those of BC and OC which are due to germline mutation in BRCA 1/2 are defined as hereditary. Because of the expensiveness of genetic testing for mutations in BRCA1 we aimed to select patients with ovarian cancer suitable for genetic testing, on the base of certain morphological and immunohistochemical criteria.

MATERIAL AND METHODS

We have conducted a retrospective analysis of 29 cases with serous papillary OC, taken from the archives of the Department of Clinical Pathology, University Hospital "Dr. G. Stranski" Pleven. We performed morphological assessment and subsequent immunohistochemical study with antibodies against p53, anti BRCA1 and anti proliferative marker Ki-67.

RESULTS

Nineteen (65.52%) of all 29 cases were found with loss of immunohistochemical expression of BRCA1 and we defined them as suitable for genetic testing of BRCA1 mutations.

CONCLUSION

A set of morphological and immunohistochemical criteria allows screening of women that should be referred for genetic testing, as it is expensive, and the incidence of BRCA1 mutations in the general population is very low.

[Diabetes and pregnancy]

We tried to summarize our and foreign experience in the field of diabetes and pregnancy

AIM

Our aim was to detect pregnant women with diabetes mellitus, as well as to introduce screening method for early detection and apply a suitable diet and treatment for these patients.

MATERIAL AND METHODS

Patients with diabetes and pregnancy were researched for the period of 2007-2014 (70 patients).

RESULTS

Introducing a screening method in the second trimester between 24-28 gestational week, applying a suitable diet and treatment lead to better outcome of this disease and to more safe delivery outcome.

CONCLUSION

Future research work will give additional light in this field.