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Butorac D, Potkonjak AM, Kuharić J, Vujić G. Brain metastasis as a first clinical presentation of endometrial cancer: A case report. Eur J Obstet Gynecol Reprod Biol 2024; 296:380-381. [PMID: 38480073 DOI: 10.1016/j.ejogrb.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 03/07/2024] [Indexed: 04/19/2024]
Affiliation(s)
- Dražan Butorac
- Department of Obstetrics and Gynecology, Sestre milosrdnice University Hospital Center, Vinogradska 29, Zagreb, Croatia
| | - Ana-Meyra Potkonjak
- Department of Obstetrics and Gynecology, Sestre milosrdnice University Hospital Center, Vinogradska 29, Zagreb, Croatia.
| | - Josip Kuharić
- Department of Obstetrics and Gynecology, University Hospital Centre Zagreb, Kišpatićeva 12, Zagreb, Croatia
| | - Goran Vujić
- Department of Obstetrics and Gynecology, University Hospital Centre Zagreb, Kišpatićeva 12, Zagreb, Croatia; School of Medicine, University of Zagreb, Šalata 3, Zagreb, Croatia
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Butorac D, Ćelap I, Kačkov Maslać S, Miletić T, Tomašković AH, Turčić P, Rašić D, Stojanović I, Rajković MG. Paraoxonase and arylesterase activity of paraoxonase 1 and oxidative stress parameters in cervical intraepithelial neoplasia. Biochem Med (Zagreb) 2024; 34:030701. [PMID: 38125616 PMCID: PMC10731734 DOI: 10.11613/bm.2024.010701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 09/27/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction Paraoxonase 1 (PON1) is the enzyme that removes carcinogenic radicals from lipids. The aim of the study was to investigate the differences in PON1 activity and oxidation stress parameters between patients with cervical intraepithelial neoplasia (CIN) and healthy controls. Materials and methods The study included 65 women with CIN and 109 healthy women. Lipid parameters were determined on Cobas Integra 400 plus (Roche, Mannheim, Germany). Tiols and reduced glutathione (GSH) were determined spectrophotometric using Eliman reagent. Activity of PON1 was assessed with two substrates, paraoxon and phenylacetate by spectrophotometric method. Malondialdehyde (MDA) was determined by high performance liquid chromatography (Shimadzu Corporation, Kyoto, Japan). Mann-Whitney-test, t-test, χ2-test, correlation and logistic regression was used in statistical analysis. P < 0.05 was considered statistically significant. Results The basal (P = 0.929) and NaCl-stimulated (P = 0.985) PON1 activity and activities standardised on the concentration of high-density lipoprotein (HDL; P = 0.076; P = 0.065, respectively) and apolipoprotein AI (apo AI; P = 0.444; P = 0.499, respectively) as well as PON1 phenotypes (P = 0.842) did not differ significantly between the groups. The PON1 arylesterase activity (53±19 kU/L vs. 77±17 kU/L; P < 0.001) and HDL-standardized activity (37 (28-44) kU/mmol vs. 43 (37-50) kU/mmol; P < 0.001) and apoAI (29±11 kU/g vs. 44±11 kU/g; P < 0.001) was significantly reduced in the CIN group. The concentration of the thiol groups was similar (P = 0.519), of MDA was lower (0.39 (0.27-0.55) µmol/L vs. 0.76 (0.57-1.15) µmol/L; P < 0.001) and of GSH was higher (112.0 (66.0-129.6) µg/mL vs. 53.4 (34.8-134.4) µg/mL; P < 0.001) in the CIN group. Conclusion Reduced PON1 arylesterase activity, lower MDA and higher GSH concentration were observed in CIN patients.
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Affiliation(s)
- Dražan Butorac
- Clinic of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Ivana Ćelap
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
- Department of Medical biochemistry and Hematology, Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| | | | | | - Andrea Hulina Tomašković
- Department of Medical biochemistry and Hematology, Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| | - Petra Turčić
- Department of Pharmacology, Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| | - Dubravka Rašić
- Unit of Toxicology, Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Ivana Stojanović
- Clinic of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Marija Grdić Rajković
- Department of Medical biochemistry and Hematology, Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
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Skelin J, Luk HY, Butorac D, Boon SS, Tomaić V. The effects of HPV oncoproteins on host communication networks: Therapeutic connotations. J Med Virol 2023; 95:e29315. [PMID: 38115222 DOI: 10.1002/jmv.29315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/13/2023] [Accepted: 11/29/2023] [Indexed: 12/21/2023]
Abstract
Human papillomavirus (HPV) infections are a leading cause of viral-induced malignancies worldwide, with a prominent association with cervical and head and neck cancers. The pivotal role of HPV oncoproteins, E5, E6, and E7, in manipulating cellular events, which contribute to viral pathogenesis in various ways, has been extensively documented. This article reviews the influence of HPV oncoproteins on cellular signaling pathways within the host cell, shedding light on the underlying molecular mechanisms. A comprehensive understanding of these molecular alterations is essential for the development of targeted therapies and strategies to combat HPV-induced premalignancies and prevent their progress to cancer. Furthermore, this review underscores the intricate interplay between HPV oncoproteins and some of the most important cellular signaling pathways: Notch, Wnt/β-catenin, MAPK, JAK/STAT, and PI3K AKT/mTOR. The treatment efficacies of the currently available inhibitors on these pathways in an HPV-positive context are also discussed. This review also highlights the importance of continued research to advance our knowledge and enhance therapeutic interventions for HPV-associated diseases.
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Affiliation(s)
- Josipa Skelin
- Division of Molecular Medicine, Ruđer Bošković Institute, Zagreb, Croatia
| | - Ho Yin Luk
- Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR
| | - Dražan Butorac
- Department of Gynecology and Obstetrics, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Siaw Shi Boon
- Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR
| | - Vjekoslav Tomaić
- Division of Molecular Medicine, Ruđer Bošković Institute, Zagreb, Croatia
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Đikić D, Balta V, Pedisić S, Zorić Z, Padovan J, Butorac D, Milić A, Jurić D, Landeka Jurčević I. Polyphenol bioavailability and modulatory potential on brain antioxidative markers in C57BL/6 mouse. PERIOD BIOL 2022. [DOI: 10.18054/pb.v124i1-2.20513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background and purpose: Prunus spinose L. is a traditionally consumed, recently scientifically reexamined plant. Brain bioavailability and functionality of polyphenols (PPH) of blackthorn flower extract (PSE) was investigated.Materials and methods: C57BL/6 mice received oral daily repeated doses of 25 mg/kg body weight of total PSE polyphenols for 28 days. Brain concentrations of individual polyphenols from PSE were determined by UPLC/MS on 1st,7th, 14th, 21st, and 28th day. Brain antioxidative defense markers were examined as indicators of functionality after bioaccumulation.Results: A total of 68.7% PPH present in PSE were detected in the brain. Higher (p≤0.05) Cmax/AUClast in the PSE treatment vs. control group was recorded for 59.1% of brain detected compounds, indicating relatively good bioaccumulation in the brain. The highest present compounds in PSE were not necessarily the ones mostly bioapsorbed in the brain. Kaempherols were not significantly distributed, opposite to phenolic acids, quercetins or epicgaloatechin-3-gallate. The compounds with the highest concentrations on 28th day were 4-p-coumaroylquinonic acid, (-)-epicatechin, quercetin-3-O-rutinoside, quercetin–rhamnoside, kaempherol-3-rutinoside and quercetin-3-gucoside. Brain lipid peroxidation (MDA) decreased (p<0.05) on the 21st and 28th day in the PSE group. Increase (p<0.05) in GSH concentration was observed on the 21st and 28th and SOD activity on the 28th day. Catalase activity was unchanged. It could be hypothesized that highest PPH concentration-ratios, caused reduction of lipid peroxidation by radical scavenging and simultaneous induction of glutathione and SOD pathways.Conclusions: Screened compounds could be candidates for examining or creation of brain targeted “neuro-nutriceuticals” polyphenol mixtures.
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Potkonjak AM, Leniček T, Vuković A, Butorac D, Vraneš HS. 2022-RA-215-ESGO Clinical cases of atypical polypoid adenomyoma: single- center report. Pathology 2022. [DOI: 10.1136/ijgc-2022-esgo.786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Maleš I, Pedisić S, Zorić Z, Elez-Garofulić I, Repajić M, You L, Vladimir-Knežević S, Butorac D, Dragović-Uzelac V. The medicinal and aromatic plants as ingredients in functional beverage production. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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Butorac D, Djaković I, Malčić J, Jokanović L. URETERAL TRIPLICATION ACCIDENTALLY FOUND DURING CERVICAL CARCINOMA OPERATION. Acta Clin Croat 2021; 60:329-331. [PMID: 34744288 PMCID: PMC8564831 DOI: 10.20471/acc.2021.60.02.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 09/27/2017] [Indexed: 11/28/2022] Open
Abstract
Ureteral triplication is a very rare anomaly found in the upper urinary tract. This condition can be connected with a higher incidence of congenital anomalies and predisposition for urinary infections. Operative procedure is considered in cases where symptoms reduce the patient’s quality of life. The type of surgical treatment depends on symptom manifestation. The risk of renal failure is usually a deciding factor, which can be found in conditions such as vesicoureteral reflux, obstruction, ureteral ectopy and recurrent infections. Simultaneous treatment of upper and lower urinary tract can be performed. We report a case of a 38-year-old female patient diagnosed with cervical carcinoma, where ureteral triplication was detected incidentally during a radical operative procedure.
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Affiliation(s)
| | - Ivka Djaković
- 1Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Diagnostic and Interventional Radiology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Jasminka Malčić
- 1Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Diagnostic and Interventional Radiology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Ljubomir Jokanović
- 1Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Diagnostic and Interventional Radiology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
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Košec V, Čukelj M, Djaković I, Butorac D. UTERINE RUPTURE IN THIRD TRIMESTER OF PREGNANCY FOLLOWING CORNUAL RESECTION DUE TO ECTOPIC PREGNANCY. Acta Clin Croat 2021; 60:153-155. [PMID: 34588737 PMCID: PMC8305347 DOI: 10.20471/acc.2021.60.01.23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 12/20/2017] [Indexed: 11/24/2022] Open
Abstract
Uterine rupture during pregnancy is a critical obstetric complication associated with maternal and fetal mortality and morbidity. The risk is increased in patients with a history of previous uterine surgery including cesarean section, myomectomy, salpingectomy, as well as uterine and placental anomalies and polyhydramnios. It can also occur spontaneously. We present a case of uterine rupture in the early third trimester in a woman who had undergone previous laparoscopic removal of the left fallopian tube due to sactosalpinx and laparotomic removal of left uterine horn due to ectopic pregnancy.
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Affiliation(s)
| | - Marijo Čukelj
- Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Ivka Djaković
- Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Dražan Butorac
- Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
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Butorac D, Škrtić B, Čukelj M, Kuna K, Djaković I. TWENTY-YEAR EXPERIENCE WITH LARGE LOOP EXCISION OF THE TRANSFORMATION ZONE AT SESTRE MILOSRDNICE UNIVERSITY HOSPITAL CENTRE. Acta Clin Croat 2019; 58:463-466. [PMID: 31969758 PMCID: PMC6971807 DOI: 10.20471/acc.2019.58.03.09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The 20-year experience with large loop excision of the transformation zone (LLETZ) at Gynecologic Oncology Unit, Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Centre from Zagreb is presented. This retrospective observational study included 1407 women with cervical dysplasia treated by LLETZ technique during the 1995-2016 period. LLETZ was most commonly performed in the 25-35 age group (51%), followed by the 36-45 age group (22%), and least frequently in the >65 age group (2%). Histopathologic results lower than high-grade squamous intraepithelial lesion were found in 23% and high grade squamous intraepithelial lesion or worse findings in 77% of patients. Positive margin as a sign of possible residual dysplasia was found in 25% of cones, 80% of which included endocervical positive margin. Cervical canal biopsy result was positive in 18% of cases. Accurate colposcopy and its findings can help avoid overtreatment, the rate of which was higher than expected in our retrospective study. Long-term follow up is an imperative for proper assessment of the procedure success. This method is the best choice for complete disease removal without unnecessary overtreatment, but it requires continuous education and training of the whole team.
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Affiliation(s)
| | - Bernarda Škrtić
- 1Department of Obstetrics and Gynecology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Obstetrics and Gynecology, Karlovac General Hospital, Karlovac, Croatia
| | - Marijo Čukelj
- 1Department of Obstetrics and Gynecology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Obstetrics and Gynecology, Karlovac General Hospital, Karlovac, Croatia
| | - Krunoslav Kuna
- 1Department of Obstetrics and Gynecology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Obstetrics and Gynecology, Karlovac General Hospital, Karlovac, Croatia
| | - Ivka Djaković
- 1Department of Obstetrics and Gynecology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Obstetrics and Gynecology, Karlovac General Hospital, Karlovac, Croatia
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Djaković I, Leniček T, Beck R, Kraljević Z, Kuna K, Butorac D. Subcutaneous Dirofilariasis in Female Pubic Region - Case Report. Open Access Maced J Med Sci 2019; 7:392-395. [PMID: 30834008 PMCID: PMC6390160 DOI: 10.3889/oamjms.2019.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 11/28/2018] [Accepted: 11/30/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND: Number of reported cases of human dirofilariasis in the last couple of decades has been increasing. Dogs are the main reservoir hosts, while various mosquito species represent/serve as vectors. Human infections are caused by two different parasites: Dirofilaria immitis and Dirofilaria repens. Dirofilaria repens is currently considered to be one of the most rapidly-spreading human and animal parasite species in Europe. Clinical features are characterised by subcutaneous or ocular lesions which can persist for months without any symptoms. The disease is considered to be endemic in Mediterranean countries, central Asia, Israel, and Sri Lanka with increased incidence in Central and East Europe. Apart from the local population, tourists are also susceptible to this disease. Export of domestic animals can transfer parasites between different countries. This disease is rare in Croatia. CASE PRESENTATION: We are presenting a case of a 58-year-old female patient with dirofilariasis of the genital region caused by Dirofilaria repens, confirmed with PCR and sequencing. CONCLUSION: From the clinician point of view, subcutaneous dirofilariasis should be considered as a differential diagnosis in cases of long-lasting subcutaneous swellings.
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Affiliation(s)
- Ivka Djaković
- Sestre Milosrdnice University Hospital Center, Vinogradska 29, Zagreb, Croatia
| | - Tanja Leniček
- Sestre Milosrdnice University Hospital Center, Vinogradska 29, Zagreb, Croatia
| | - Relja Beck
- Department for Bacteriology and Parasitology, Croatian Veterinary Institute, Savska cesta 143, Zagreb, Croatia
| | - Zdenko Kraljević
- Sestre Milosrdnice University Hospital Center, Vinogradska 29, Zagreb, Croatia
| | - Krunoslav Kuna
- Sestre Milosrdnice University Hospital Center, Vinogradska 29, Zagreb, Croatia
| | - Dražan Butorac
- Sestre Milosrdnice University Hospital Center, Vinogradska 29, Zagreb, Croatia
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Abstract
SUMMARY – Rupture of the internal iliac artery is a rare complication in pregnancy that is associated with maternal and fetal morbidity and mortality. We present a case of a 30-year-old primipara admitted to our department in 39th week of gestation after sudden onset of intense abdominal pain. On admission, the patient was pale, tachycardiac, but with normal blood pressure and afebrile. Symptoms of acute abdomen were clear and surgery was indicated. Diagnosis was confirmed during cesarean section. Enlarged gravid uterus compressed the ruptured artery and prevented heavier bleeding. Acute bleeding due to arterial rupture causes severe symptoms, predominantly abdominal pain. Changes in blood count become significant some time after the onset of rupture. As the gravid uterus compressed the arterial rupture, preoperative bleeding was by far less abundant than the bleeding after the baby had been delivered and the size of the uterus decreased. Any cause of acute abdomen during pregnancy (abruption of the placenta, spleen rupture, visceral artery thrombosis) requires urgent surgical treatment, as well as intraoperative and postoperative intensive treatment. Rupture of the internal iliac artery is a rare complication in pregnancy, but has to be considered as a differential diagnosis of abdominal pain.
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Affiliation(s)
| | - Ivka Djaković
- Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Vesna Košec
- Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | | | - Krunoslav Kuna
- Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
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Bolanča IB, Butorac D, Eljuga D, Djaković ID, Ezgeta J, Kuna K, Tučkar NT, Kraljević ZK. Repeated cesarean scar pregnancy – Case report. CLIN EXP OBSTET GYN 2016. [DOI: 10.12891/ceog3127.2016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Perić B, Kruljac I, Šundalić S, Pećina HI, Jović A, Štefanović M, Butorac D, Vrkljan M. Obesity and hypercholesterolemia in patients with prolactinomas: Could DHEA-S and growth hormone be the missing link? Endocr Res 2016; 41:200-6. [PMID: 26864960 DOI: 10.3109/07435800.2015.1135444] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Increasing evidence exists that hyperprolactinemia alters metabolic profile. The mechanism of this effect is unknown. We aimed to investigate the differences between the metabolic profile of patients with prolactinomas and nonfunctional pituitary adenomas and to evaluate the impact of other pituitary hormones on their metabolic profile. METHODS Our retrospective study included 86 consecutive patients with prolactinomas and nonfunctional adenomas (29 prolactinomas and 57 adenomas). Body mass index (BMI), blood pressure, serum prolactin, growth hormone (GH), insulin-like growth factor I (IGF-I), adrenocorticotropic hormone (ACTH), cortisol, urinary free cortisol, triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), dehydroepiandrosterone-sulfate (DHEA-S), testosterone in men, triglycerides, total cholesterol, HDL (high-density lipoprotein) cholesterol, LDL (Low-density lipoprotein) cholesterol, alanine-transaminase, aspartate-transaminase, fasting glucose, and C-reactive protein (CRP) were obtained for all patients. Regression analyses were performed on log-transformed data. RESULTS After adjustment for age, gender, and tumor size, prolactinomas were associated with higher BMI (OR 5.61, 95%CI 1.70-9.51, p = 0.005), LDL cholesterol (OR 3.60, 95%CI 1.35-5.93, p = 0.015), DHEA-S (OR 1.97, 95%CI 1.23-3.72, p = 0.026), and lower GH levels (OR 0.43, 95%CI 0.03-0.84, p = 0.037). In a linear multivariate regression, the association between DHEA-S, GH, and prolactin remained significant even after adjustment for BMI. GH and IGF-I were associated with BMI and LDL cholesterol, but the association diminished after adjustment for serum prolactin. CONCLUSIONS Prevalence of obesity is four times higher in patients with prolactinomas than in patients with nonfunctional adenomas. Higher DHEA-S and lower GH levels in patients with prolactinomas may have an important role in prolactin-induced metabolic effects. Further studies are needed.
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Affiliation(s)
- Božidar Perić
- a Department of Endocrinology, Diabetes and Metabolic Diseases "Mladen Sekso," University Hospital Center "Sestre Milosrdnice," University of Zagreb Medical School , Zagreb , Croatia
| | - Ivan Kruljac
- a Department of Endocrinology, Diabetes and Metabolic Diseases "Mladen Sekso," University Hospital Center "Sestre Milosrdnice," University of Zagreb Medical School , Zagreb , Croatia
| | - Sara Šundalić
- a Department of Endocrinology, Diabetes and Metabolic Diseases "Mladen Sekso," University Hospital Center "Sestre Milosrdnice," University of Zagreb Medical School , Zagreb , Croatia
| | - Hrvoje Ivan Pećina
- b Department of Radiology , University Hospital Center "Sestre Milosrdnice," , Zagreb , Croatia
| | - Andrijana Jović
- b Department of Radiology , University Hospital Center "Sestre Milosrdnice," , Zagreb , Croatia
| | - Mario Štefanović
- c Department of Clinical Chemistry , University Hospital Center "Sestre Milosrdnice," , Zagreb , Croatia
| | - Dražan Butorac
- d Department of Gynecology , University Hospital Center "Sestre Milosrdnice," , Zagreb , Croatia
| | - Milan Vrkljan
- a Department of Endocrinology, Diabetes and Metabolic Diseases "Mladen Sekso," University Hospital Center "Sestre Milosrdnice," University of Zagreb Medical School , Zagreb , Croatia
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Starčević M, Predojević M, Butorac D, Tumbri J, Konjevoda P, Kadić AS. Early functional and morphological brain disturbances in late-onset intrauterine growth restriction. Early Hum Dev 2016; 93:33-8. [PMID: 26759989 DOI: 10.1016/j.earlhumdev.2015.12.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 11/26/2015] [Accepted: 12/09/2015] [Indexed: 10/22/2022]
Abstract
AIMS To determine whether the brain disturbances develop in late-onset intrauterine growth restriction (IUGR) before blood flow redistribution towards the fetal brain (detected by Doppler measurements in the middle cerebral artery and umbilical artery). Further, to evaluate predictive values of Doppler arterial indices and umbilical cord blood gases and pH for early functional and/or morphological brain disturbances in late-onset IUGR. STUDY DESIGN This cohort study included 60 singleton term pregnancies with placental insufficiency caused late-onset IUGR (IUGR occurring after 34 gestational weeks). Umbilical artery resistance index (URI), middle cerebral artery resistance index (CRI), and cerebroumbilical (C/U) ratio (CRI/URI) were monitored once weekly. Umbilical blood cord samples (arterial and venous) were collected for the analysis of pO2, pCO2 and pH. Morphological neurological outcome was evaluated by cranial ultrasound (cUS), whereas functional neurological outcome by Amiel-Tison Neurological Assessment at Term (ATNAT). RESULTS 50 fetuses had C/U ratio>1, and 10 had C/U ratio≤1; among these 10 fetuses, 9 had abnormal neonatal cUS findings and all 10 had non-optimal ATNAT. However, the total number of abnormal neurological findings was much higher. 32 neonates had abnormal cUS (53.37%), and 42 (70.00%) had non-optimal ATNAT. Furthermore, Doppler indices had higher predictive validity for early brain disturbances than umbilical cord blood gases and pH. C/U ratio had the highest predictive validity with threshold for adverse neurological outcome at value 1.13 (ROC analysis), i.e., 1.18 (party machine learning algorithm). CONCLUSION Adverse neurological outcome at average values of C/U ratios>1 confirmed that early functional and/or structural brain disturbances in late-onset IUGR develop even before activation of fetal cardiovascular compensatory mechanisms, i.e., before Doppler signs of blood flow redistribution between the fetal brain and the placenta.
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Affiliation(s)
- Mirta Starčević
- Division of Neonatology, Department of Pediatrics, Clinical Hospital Center "Sestre milosrdnice", Medical School, University of Zagreb, Vinogradska cesta 29, 10000 Zagreb, Croatia
| | - Maja Predojević
- Department of Obstetrics and Gynecology, Clinical Hospital "Sveti Duh", Medical School, University of Zagreb, Sveti Duh 64, 10000 Zagreb, Croatia.
| | - Dražan Butorac
- Department of Obstetrics and Gynecology, Clinical Hospital Center "Sestre milosrdnice", Medical School, University of Zagreb, Vinogradska cesta 29, 10000 Zagreb, Croatia
| | - Jasna Tumbri
- Division of Neonatology, Department of Pediatrics, Clinical Hospital Center "Sestre milosrdnice", Medical School, University of Zagreb, Vinogradska cesta 29, 10000 Zagreb, Croatia
| | - Paško Konjevoda
- Nuclear Magnetic Resonance Center, Ruđer Bošković Institute, Bijenička cesta 54, 10000 Zagreb, Croatia
| | - Aida Salihagić Kadić
- Department of Physiology, Medical School, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia
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Bolanca I, Butorac D, Eljuga D, Djakovic I, Ezgeta J, Kuna K, Tuckar N, Kraljevic Z. Repeated cesarean scar pregnancy - Case report. CLIN EXP OBSTET GYN 2016; 43:774-776. [PMID: 30074338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Cesarehn scar pregnancy (CSP) is a rare location of an ectopic pregnancy implanted within a scar from previous cesarean section, separated from the endometrial cavity. The prevalence ranges from 1:1,800 to 1:2,226 pregnancies. It is a potential life-threatening condition, and if misdiagnosed, can cause serious maternal morbidity from uterine rupture with massive hemorrhage and even death. Until now, no universal treatment guidelines have been established, with treatment options ranging from systemic or local injection of methotrexate (MTX), suction curettage under ultrasound control to surgical treatment, including hysteroscopy and wedge resection of the ectopic pregnancy, via laparotomy or laparoscopy. The authors present a case of a 42-year old woman with two consecutive CSPs. First CSP was un- successfully treated conservatively, followed by ultrasound guided vacuum aspiration of the uterine cavity. Second CSP was treated by laparotomy and a wedge excision of a CSP and repair of a scar with interrupted sutures. The authors also discuss diagnostic pitfalls and treatment modalities.
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Kuna K, Grbavac I, Vuković A, Bilić N, Kraljević Z, Butorac D. Coexistence of ruptured ectopic tubal pregnancy, dermoid and endometriotic cyst with tubo-ovarian abscess in the same adnexa: case report. Acta Clin Croat 2015; 54:103-106. [PMID: 26058252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
A 32-year-old pregnant woman presented to the hospital with abdominal pain and minimal vaginal bleeding. Transvaginal ultrasound revealed visible fluid in pelvic region with suspected tubal rupture, and subsequently laparoscopy was performed. During laparoscopy, additional gynecologic pathologies were noticed. Histopathologic finding showed dermoid and endometriotic cyst, as well as tubo-ovarian abscess in the same adnexa. This case report highlights the necessity of considering multiple diagnoses in the same organic system, which may be encountered by surgeon and histopathologist.
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Butorac D, Celap I, Kačkov S, Robić V, Miletić T, Meštrić ZF, Hulina A, Kuna K, Grubišić TŽ, Rajković MG. Paraoxonase 1 activity and phenotype distribution in premenopausal and postmenopausal women. Biochem Med (Zagreb) 2014; 24:273-80. [PMID: 24969921 PMCID: PMC4083579 DOI: 10.11613/bm.2014.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 04/08/2014] [Indexed: 12/17/2022] Open
Abstract
Introduction Postmenopausal women have higher risk of cardiovascular disease. One of the contributing factors could be reduced activity of anti-atherogenic enzyme paraoxonase 1 (PON1). The aim of this study was to examine differences in the lipid status, paraoxonase and arylesterase PON1 activities and PON1 phenotype in women with regular menstrual cycle and in postmenopausal women. Materials and methods: The study included 51 women in reproductive age (25 in follicular and 26 in luteal phase of the menstrual cycle) and 23 women in postmenopause. Lipid parameters in sera were determined using original reagents and according to manufacturer protocol. PON1 activity in serum was assessed by spectrophotometric method with substrates: paraoxon and phenylacetate. PON1 phenotype was determined by double substrate method. Results: Compared to the women in follicular and luteal phase, postmenopausal women have significantly higher concentration of triglyceride [0.9 (0.7–1.3), 0.7 (0.6–1.0) vs. 1.5 (0.9–1.7) mmol/L; P = 0.002], cholesterol [5.10 (4.78–6.10), 5.05 (4.70–5.40) vs. 6.30 (5.73–7.23) mmol/L; P < 0.001], LDL [3.00 (2.56–3.63), 3.00 (2.70–3.70) vs. 3.90 (3.23–4.50) mmol/L; P < 0.001], and apolipoprotein B [0.88 (0.75–1.00), 0.79 (0.68–1.00) vs. 1.07 (0.90–1.24) mmol/L; P = 0.002]. PON1 basal [104 (66–260), 106 (63–250) vs. 93 (71–165) U/L; P = 0.847] and salt-stimulated paraoxonase activity [210 (131–462), 211 (120–442) vs. 180 (139–296) U/L; P = 0.857] as well as arylesterase activity [74 (63–82), 70 (54–91) vs. 70 (60–81) kU/L; P = 0.906] and PON1 phenotype (P = 0.810) were not different in the study groups. Conclusion: There are no differences in PON1 activity and PON1 phenotype between women with regular menstrual cycle and postmenopausal women.
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Affiliation(s)
- Dražan Butorac
- Clinic of Gynecology and Obstetrics, Medical School University Hospital Sestre Milosrdnice, Zagreb, Croatia
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