Gestational diabetes mellitus (GDM) is associated with various maternal and fetal complications, including long-term cardiovascular risks for affected women. This study aimed to investigate the relationship between GDM and arterial stiffness during pregnancy and 2 months postpartum. A cross-sectional study was conducted with 100 pregnant women of 28–40 weeks of gestation and divided into 2 groups. The groups were divided based on oral glucose tolerance test (oGTT) results: 50 women with GDM and 50 controls with normal oGTT. All participants in the GDM group had a form of GDM that was successfully managed by diet only. Arterial stiffness was assessed using a non-invasive oscillometric device, the Arteriograph® (TensioMedTM Kft, Budapest, Hungary), by measuring the right brachial artery. The results showed that during pregnancy the pulse wave velocity (PWV) was unexpectedly significantly lower in the GDM group compared to controls (8.10 m/s vs. 8.65 m/s, P T< 0.05). Central and brachial augmentation index (AIx) values showed no significant differences between the groups. No differences in PWV or AIx were observed between GDM and control groups 2 months postpartum; however, within the GDM group, central (0.50 % vs. 11.45 %) and brachial (–73.35 % vs. –51.75 %) AIx significantly increased after delivery, indicating postpartum vascular effects of GDM. These findings suggest that even diet-managed forms of GDM can induce vascular changes postpartum, underscoring the importance of early detection and management. Further research is needed to explore the mechanisms underlying these changes and their possible long-term implications for cardiovascular health in post-GDM women.

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Abstract Objective The objective of this prospective study was to assess the concentration and impact of maternal 25(OH)D status on neonatal vitamin D concentrations and early neonatal outcomes in the newborns of mothers who did not take vitamin D supplements during pregnancy. Methods and participants The study is a cohort prospective study of the correlation of VD concentrations in mothers and their newborns. The study included 100 pairs. Results Only 16 mothers had a VD concentration in the reference interval (75–100 nmol/L), while 84 mothers had values less than 75 nmol/L (p<0.001). A significant difference in maternal VD concentration was determined in relation to tobacco consumption habits during pregnancy and placental condition (p<0.001). 95% of the neonates (95/100) of older, obese multigravida, who had hypovitaminosis D and inadequate exposure to sunshine, had normal VD concentrations (the mean=49.27 nmol/L) on the first day of life. The majority of the mothers gave birth to full-termnewborns with normal vitality scores and CRP and bilirubin levels in the reference interval. Conclusion The conclusion of this prospective study is that 84% of the healthy pregnant women had hypovitaminosis D. However 95% of their newborns were born full term, with normal anthropometric measurements, normal vitality scores, and normal VD concentrations. This study also confirmed that there is still no cause-and-effect association between hypovitaminosis D in pregnant women and their offspring with outcome parameters for both.

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Because the maternal immune system is suppressed during pregnancy, pregnant women are a risk group for COVID-19 infection. Thus, this study investigates the pregnancy outcomes of COVID-19-infected women during childbirth.Methods: A retrospective study was performed at the Department of Obstetrics and Gynecology, University Hospital Mostar, that included a total of 65 COVID-19-positive women who delivered between March 2020 and April 2022. The control group consisted of COVID-19-negative women with no detected SARS-CoV-2 infection during pregnancy or labor (n=65). The data for maternal and newborn outcomes were collected from database and medical records.Main findings: The pregnancies of COVID-19-positive women were more often completed by cesarean section (35.4%), compared to the control group (26.2%). There were no significant differences in pregnancy complications such as preterm birth, preeclampsia, gestational hypertension, preterm premature rupture of membranes, fetal growth restriction or perinatal asphyxia between the COVID-19-positive mothers and the control group. The percentage of infected newborns was 4.6% in the COVID-19-positive group.Principal conclusion: The study concludes that COVID-19-positive women experienced more adverse perinatal outcomes compared to the control group, but without statistical significance. Accordingly, the importance of perinatal surveillance of COVID-19-positive pregnancies should be emphasized. Key words: childbirth, maternal and newborn outcomes, COVID-19 infection

While clear cell renal cell carcinoma (ccRCC) is curable, advanced metastatic (mRCC) remains a clinical challenge. We analyzed clinical, pathohistological, and molecular data (Receptor Interacting Protein 5—RIP5 and Vestigial Like Family Member 4—VGLL4 expression) of 55 mRCC patients treated with first-line treatment with sunitinib. The trend of linear increase in the protein expression of RIP5 was observed with the progression of tumor grade. Overall, 80% of RIP5-positive cells were in the control kidneys and high-grade mRCC. On the contrary, RIP5 displayed low expression in grade 2 mRCC (5.63%). The trend of linear decrease in the expression of VGLL4 was observed with the progression of tumor grade. The highest protein expression of VGLL4 was observed in grade 2 (87.82%) in comparison to grade 3 and 4 and control. High expression of RIP5 mRNA was associated with longer first-line overall survival and longer progression-free survival in mRCC. In addition, a high VGLL4 mRNA expression showed better overall survival in patients with ccRCC. In conclusion, high mRNA expression of RIP5 and VGLL4 are important markers of better survival rates in mRCC patients.

Homocysteine is known to be associated with adverse vascular and metabolic effects, as well as pregnancy complications. Its serum levels are influenced by the function of the enzyme methylenetetrahydrofolate reductase (MTHFR) and the dietary intake of folic acid, vitamin B12, and methionine. In this cross-sectional study, we investigated the association of genetic polymorphisms of the MTHFR gene with vitamin status in pregnant women during mandatory folic acid supplementation. The study included 102 pregnant women between 24 and 28 weeks of gestation who were attending regular outpatient examinations at the maternity clinic. Homocysteine, folic acid, vitamin B12 levels, and MTHFR gene polymorphisms (C677T and A1298C) were analyzed. Significant associations were found between vitamin B12 and folic acid levels with homocysteine (P< 0.001), with lower serum levels of these vitamins being associated with higher homocysteine levels. Surprisingly, there was no significant association between MTHFR genetic polymorphisms and serum homocysteine levels, likely attributed to the supplementation of folic acid and vitamin B12 in vitamin supplements for pregnant women, which counteracts the effect of the mutation. Remarkably, a high prevalence of MTHFR gene mutations was found, with the C677T polymorphism present in 56.9% and the A1298C polymorphism in 87.2% of pregnant women. These findings emphasize the importance of adequate folic acid and vitamin B12 intake during pregnancy to regulate homocysteine levels. Although the MTHFR gene mutations were highly prevalent, their influence on homocysteine levels in this population appears to be mitigated by vitamin supplementation. Further research is warranted to explore the impact of these mutations on other aspects of pregnancy outcomes. The trial is registered at Clinicaltrail.gov (NCT04952324).

Introduction: Many epidemiological studies have shown a connection between vitamin D deficiency and increased incidence of type 1 diabetes. Objective: The aim of this study is to determine the impact of vitamin D levels in children with newly diagnosed type 1 diabetes, taking into account the following parameters: gender, place of residence, positive/negative family history, comorbidities. Respondents and methods: The research was conducted through a retrospective analysis of the medical records of the Children's Disease Clinic of the University Clinical Hospital Mostar. The research included a sample of 30 children diagnosed with type 1 diabetes, treated at the Department of Endocrinology and Metabolic Diseases, Clinic for Children's Diseases, University Clinical Hospital Mostar. Results: The research consisted of 30 participants treated at the Department of Endocrinology and Metabolic Diseases, Clinic fo Children's Disease. The sample consists of 40% (n=12) male respondents and 60% (n=18) female respondents. Slightly more than half of the respondnents, 53.3% (n=16) lived in the city, while the remaining 46.7% (n=14) lived in the countryside. Statistical analysis of the patients with newly diagnosed type 1 diabetes, showed that there were significantly more patients (70%) with positive family history of diabetes mellitus than those with negative. In this study, 26.7% (n=8) patients with newly diagnosed type 1 diabetes had comorbidities, compared to 73.3% patients without comorbidities (n=22). Patients living in rural areas had significantly higher values of vitamin D3 concentration compared do those who lived in urban areas. Conclusion: 83.3% of subjects with newly diagnosed type 1 diabetes have a reduced level of vitamin D at the time of diagnosis. Numerous studies have shown a link between vitamin D deficiency and an increased risk of developing diabetes. Due to all of the above, supplementation and control of vitamin D is recommended, especially in children who have a risk in the form of positive family history and comorbidities such as Hashimoto's thyroiditis, and celiac disease from an early age for the purpose of prevention.

Background Spontaneous sternal fracture is an extremely rare cause of chest pain during or after childbirth. To date, only three cases of sternal fracture during childbirth have been reported. This case report represents the first documented case of spontaneous sternal fracture among multiparous women. Case Description A 33-year-old multiparous woman with an uncomplicated medical history is described, who delivered a healthy fourth infant vaginally at 41 weeks of pregnancy. After the previous three deliveries, each child had been breastfed for more than a year, and the third delivery was eight months before conception, and she breastfed until 3 months of pregnancy. During the final stage of labor, while performing the Valsalva maneuver in the lithotomy position, she felt a sharp, severe chest pain. Postpartum work-up included cardioselective enzymes that were within reference values, and radiological work-up confirmed a non-displaced sternal fracture, which was treated conservatively with symptomatic therapy, with complete recovery after 6 weeks. Conclusions This case report suggests the need to consider sternal fracture as a differential diagnostic consideration in women who experience chest pain during or immediately after delivery. Changes in metabolism, especially calcium metabolism during pregnancy and lactation, can result in transient osteopenia and, with increased mechanical stress, cause bone fracture. Special attention should be paid to patients who breastfed immediately before conception or who breastfeed during pregnancy, to vitamin and mineral replacement therapy, adequate nutrition, and physical activity. Timely diagnosis of sternal fracture can significantly reduce the need for expensive and invasive diagnostic tests. Further research is needed on osteopenia in pregnant women, especially multiparous women who are breastfeeding immediately before conception or during pregnancy.