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Szymański JK, Krawczyk A, Starzec-Proserpio M, Raczkiewicz D, Kukulski P, Jakiel G. Can pelvic floor muscle function before surgery determine the outcome of surgical treatment of stress urinary incontinence in women? Neurourol Urodyn 2024. [PMID: 38624023 DOI: 10.1002/nau.25466] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/10/2024] [Accepted: 04/01/2024] [Indexed: 04/17/2024]
Abstract
AIM The study aimed to determine whether pelvic floor muscle (PFM) function before surgery may correlate with the success of surgical interventions for treating stress urinary incontinence (SUI). Our hypothesis was that addressing identified variables in preoperative rehabilitation could potentially improve surgical outcomes. METHODS This prospective observational study was conducted at a single center and enrolled women qualified to mid-urethral tape insertion for SUI between 2020 and 2022. Digital palpation and manometry (Peritron™ 9300 V) were used to evaluate PFM function. The following parameters were acquired: vaginal resting pressure, vaginal pressure during maximal voluntary contraction (MVC), the area under the curve during a 10-second MVC, moreover the ability to perform correct PFM contraction, reflexive PFM contraction during cough and relaxation were assessed. All measurements were performed before the surgical treatment and during follow-up assessments at 1, 3, and 6 months postoperatively. The primary endpoint of the study was defined as objective cure, characterized by a negative cough stress test (CST), along with a subjective assessment based on the Urogenital Distress Inventory-6 (UDI-6) and Incontinence Impact Questionnaire-7 (IIQ-7). RESULTS The study involved 57 eligible female participants, all of whom completed the 6-month follow-up. Objective cure was observed in 75.44% of cases, while subjective cure was reported in 33%. There was no association between PFM parameters and surgical outcomes. CONCLUSION The success of surgical treatment of SUI 6 months postsurgery is not related to preoperative pelvic floor muscle function.
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Affiliation(s)
- Jacek K Szymański
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Agata Krawczyk
- Department of Rehabilitation, Medical University of Warsaw, Warsaw, Poland
| | | | - Dorota Raczkiewicz
- Department of Medical Statistics, Centre of Postgraduate Medical Education, School of Public Health, Warsaw, Poland
| | - Piotr Kukulski
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Grzegorz Jakiel
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
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2
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Szymański JK, Starzec-Proserpio M, Bartosińska-Raczkiewicz D, Krawczyk A, Kukulski P, Jakiel G. Impact of preoperative pelvic floor muscle function on the success of surgical treatment of pelvic organ prolapse. Int Urogynecol J 2024; 35:85-93. [PMID: 37819368 PMCID: PMC10811015 DOI: 10.1007/s00192-023-05653-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/05/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION AND HYPOTHESIS The objective of this study was to identify the potential characteristics of pelvic floor muscles (PFM) in the preoperative assessment that could be associated with post-surgical prolapse severity. We hypothesized that the same variables, if identified, could be addressed in preoperative rehabilitation to improve surgical results. METHODS This was a single-center prospective observational study that included women who underwent surgical pelvic organ prolapse repair between 2020-2022. Genital prolapse was evaluated according to the Pelvic Organ Prolapse Quantification (POP-Q) system. All the participants underwent a PFM assessment, including a vaginal digital assessment and manometry (Peritron™ 9300 V) before surgery and at 1-, 3-, and 6-month follow-ups. Several PFM variables were recorded: vaginal resting pressure, vaginal pressure during maximal voluntary contraction (MVC), area under the curve during a 10-second MVC, ability to correctly contract the PFMs, and reflexive activation during cough and relaxation. The primary endpoint of the analysis was objective surgical success defined as POP-Q 0 or 1 at the 6-month follow-up. Additionally, a change in pelvic floor muscle function was recorded during postoperative visits. RESULTS A total of 106 females were included in the study. Fifty-one were lost during the 6-month follow-up, which is a major limitation of the study. None of the examined parameters evaluating PFM were associated with surgical success. No statistically significant difference was found in MVC and PFM endurance before and after surgery. Post-surgery, a significant change was observed in the vaginal resting pressure and the ability to correct PFM activation and relaxation. CONCLUSIONS Preoperative PFM function is not associated with surgical success 6 months after surgery.
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Affiliation(s)
- Jacek Krzysztof Szymański
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Żelazna 90 Str., 01-004, Warsaw, Poland.
| | | | | | - Agata Krawczyk
- Department of Rehabilitation, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Kukulski
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Żelazna 90 Str., 01-004, Warsaw, Poland
| | - Grzegorz Jakiel
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Żelazna 90 Str., 01-004, Warsaw, Poland
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Florkiewicz-Danel M, Zaręba K, Ciebiera M, Jakiel G. Quality of Life and Sexual Satisfaction in the Early Period of Motherhood-A Cross-Sectional Preliminary Study. J Clin Med 2023; 12:7597. [PMID: 38137665 PMCID: PMC10744264 DOI: 10.3390/jcm12247597] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
The aim of the study was to assess the impact of breastfeeding-related fatigue and family support on the sexuality and quality of life of mothers during early motherhood. A cross-sectional preliminary study was conducted between 1 October 2021 and 15 May 2022 in 65 women being in early postpartum period. We used the authors' questionnaire developed for the purposes of the study; the Sexual Satisfaction Scale for Women-SSS-W; the Mell-Krat scale for women; and the General Health Questionnaire-GHQ28. A significant negative correlation was found between the age of the patients and the reduction in somatic symptoms (GHQ28 questionnaire) (r = -0.315, p = 0.011). Women working professionally achieved significantly higher results in the SSS-W contentment category (r = 0.313, p = 0.014). Frequent sexual activity reduced disorders in social functioning (the GHQ28 questionnaire) (r = -0.107, p = 0.283). Women who breastfed up to 5 times a day (p = 0.033) reached significantly higher SSS-W scores in terms of communication. The partner's help significantly contributed to higher sexual satisfaction in the aspect of compatibility (p = 0.004) and the overall level of satisfaction determined with the SSS-W questionnaire (p = 0.016). The presented study suggests that older mothers who are employed and supported by a partner have a higher level of contentment, sexual satisfaction and quality of life.
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Affiliation(s)
- Maria Florkiewicz-Danel
- Department of Nursing, Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, 00-968 Warszawa, Poland;
| | - Kornelia Zaręba
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences (CMHS), United Arab Emirates University (UAEU), Al Ain 17666, United Arab Emirates
| | - Michał Ciebiera
- 2nd Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education in Warsaw, 01-809 Warsaw, Poland;
- Warsaw Institute of Women’s Health, 00-189 Warsaw, Poland
| | - Grzegorz Jakiel
- 1st Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education in Warsaw, 01-004 Warsaw, Poland;
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Zaręba K, La Rosa VL, Wójtowicz S, Kołb-Sielecka E, Banasiewicz J, Ciebiera M, Jakiel G. The Opinions of Specialists in Obstetrics and Gynecology on the Indications for Pregnancy Termination in Poland-A Preliminary Cross-Sectional Study. Int J Environ Res Public Health 2022; 19:12578. [PMID: 36231879 PMCID: PMC9564862 DOI: 10.3390/ijerph191912578] [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] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/25/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
The physician's decision concerning pregnancy termination is influenced by a number of factors. The study aimed at obtaining the opinions of obstetricians and gynecologists with regard to the indications for pregnancy termination, the readiness to perform the procedure personally and the assessment of the determinants thereof. The survey study was conducted between 1 January 2020 and 31 December 2021 among physicians who performed diagnostic prenatal ultrasonography. A considerable majority of physicians participating in the study did not approve of termination without medical indications (62.5%). A marked majority of them considered the following cases as indications for pregnancy termination: severe fetal defects (90%), lethal defects (91.5%) and a disease threatening maternal life (91.5%). A small group of physicians declared that they were ready to perform a termination without medical indications (12.5%). However, they were ready to perform a pregnancy termination personally in cases of threat to maternal life (77.5%), severe fetal defects (75%), lethal fetal defects (75%) and a pregnancy being a result of rape (75%). No statistical significance was observed with regard to the influence of the respondents' sex, the fact of having children or the workplace on the issue of indications for pregnancy termination. It seems justified to develop case-centered counseling concerning abortion, based on specialists in perinatology, law and ethics, especially in countries with more restrictive abortion law or strongly religious societies.
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Affiliation(s)
- Kornelia Zaręba
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences (CMHS), United Arab Emirates University (UAEU), Al Ain 17666, United Arab Emirates
| | - Valentina Lucia La Rosa
- Unit of Psychodiagnostics and Clinical Psychology, University of Catania, 95124 Catania, Italy
| | - Stanisław Wójtowicz
- Department of Medical Psychology and Medical Communication, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Ewelina Kołb-Sielecka
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 01-813 Warsaw, Poland
| | - Jolanta Banasiewicz
- Department of Medical Psychology and Medical Communication, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Michał Ciebiera
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 01-813 Warsaw, Poland
| | - Grzegorz Jakiel
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 01-813 Warsaw, Poland
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Sieg W, Kiewisz J, Podolak A, Jakiel G, Woclawek-Potocka I, Lukaszuk J, Lukaszuk K. Inflammation-Related Molecules at the Maternal–Fetal Interface during Pregnancy and in Pathologically Altered Endometrium. Curr Issues Mol Biol 2022; 44:3792-3808. [PMID: 36135172 PMCID: PMC9497515 DOI: 10.3390/cimb44090260] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/04/2022] [Accepted: 08/15/2022] [Indexed: 11/23/2022] Open
Abstract
The blastocyst expresses paternally derived alloantigens and induces inflammation during implantation. However, it is necessary for the onset of pregnancy. An abnormal response might result in a pathological course of pregnancy or pregnancy failure. On the other hand, a state of maternal immune tolerance is necessary to ensure the normal development of pregnancy by suppressing inflammatory processes. This article discusses recognized mechanisms and the significance of inflammatory processes for embryo implantation and pregnancy establishment. We would also like to present disorders involving excessive inflammatory response and their influence on events occurring during embryo implantation. The chain of correlation between the processes responsible for embryo implantation and the subsequent physiological course of pregnancy is complicated. Many of those interrelationships are still yet to be discovered. Undoubtedly, their recognition will give hope to infertile couples for the emergence of new treatments that will increase the chance of giving birth to a healthy child.
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Affiliation(s)
| | - Jolanta Kiewisz
- Department of Human Histology and Embryology, Medical Faculty, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-561 Olsztyn, Poland
| | - Amira Podolak
- Department of Obstetrics and Gynecology Nursing, Medical University of Gdansk, 80-210 Gdansk, Poland
- Correspondence:
| | - Grzegorz Jakiel
- Invicta Research and Development Center, 81-740 Sopot, Poland
- The Center of Postgraduate Medical Education, 1st Department of Obstetrics and Gynecology, University of Gdansk, 01-004 Warsaw, Poland
| | - Izabela Woclawek-Potocka
- Department of Gamete and Embryo Biology, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, 10-748 Olsztyn, Poland
| | - Jakub Lukaszuk
- Invicta Research and Development Center, 81-740 Sopot, Poland
| | - Krzysztof Lukaszuk
- Invicta Research and Development Center, 81-740 Sopot, Poland
- Department of Obstetrics and Gynecology Nursing, Medical University of Gdansk, 80-210 Gdansk, Poland
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Słabuszewska-Jóźwiak A, Lukaszuk A, Janicka-Kośnik M, Wdowiak A, Jakiel G. Role of Leptin and Adiponectin in Endometrial Cancer. Int J Mol Sci 2022; 23:ijms23105307. [PMID: 35628118 PMCID: PMC9141615 DOI: 10.3390/ijms23105307] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/07/2022] [Accepted: 05/07/2022] [Indexed: 02/04/2023] Open
Abstract
Endometrial cancer is the most common malignancy of the female genital tract. Obesity is a strong risk factor for endometrial cancer. Adipose tissue is an active endocrine organ that synthesizes biologically active cytokine peptides, called adipokines. Adiponectin and leptin are the main cytokines of adipose tissue, which may influence the development of metabolic diseases and carcinogenesis. In this scenario, we describe the role of leptin and adiponectin in the development of endometrial cancer. A better understanding of the signalling pathway of these cytokines in endometrial cancerogenesis will provide an opportunity for effective target therapy and may be usable in fertility-sparing treatment. In the future, clinical trials focusing on adipokines, molecular biology, and genetics of the tumour will be needed.
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Affiliation(s)
- Aneta Słabuszewska-Jóźwiak
- First Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Żelazna 90 Street, 01-004 Warsaw, Poland;
- Correspondence:
| | - Aron Lukaszuk
- Saint Sophia Hospital, Żelazna 90 Street, 01-004 Warsaw, Poland; (A.L.); (M.J.-K.)
- Invicta Research and Development Center, Polna 64 Street, 81-710 Sopot, Poland
| | - Marta Janicka-Kośnik
- Saint Sophia Hospital, Żelazna 90 Street, 01-004 Warsaw, Poland; (A.L.); (M.J.-K.)
| | - Artur Wdowiak
- Chair of Obstetrics and Gynecology, Faculty of Health Sciences, Medical University of Lublin, 4-6 Staszica St., 20-081 Lublin, Poland;
| | - Grzegorz Jakiel
- First Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Żelazna 90 Street, 01-004 Warsaw, Poland;
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Lukaszuk K, Podolak A, Malinowska P, Lukaszuk J, Jakiel G. Cross-Reactivity between Half Doses of Pfizer and AstraZeneca Vaccines-A Preliminary Study. Vaccines (Basel) 2022; 10:521. [PMID: 35455270 PMCID: PMC9028987 DOI: 10.3390/vaccines10040521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 02/14/2022] [Revised: 03/18/2022] [Accepted: 03/25/2022] [Indexed: 02/02/2023] Open
Abstract
Media reports have caused a significant drop in confidence in the AstraZeneca ChAdOx1 nCoV-19 COVID-19 vector vaccine (Vaxzevria, AstraZeneca Södertälje, Sweden). This has caused many people, already vaccinated with the first dose of AstraZeneca, to refuse vaccination with this product. On the other hand, the increased demand for mRNA vaccines has resulted in a greater shortage of mRNA vaccines and cases of people being vaccinated with the AstraZeneca vaccine after the first dose of the Pfizer/BioNTech BNT162b2 COVID-19 vaccine (Comirnaty, Pfizer/BioNTech, Mainz, Germany). Moreover, currently, 60.9% of the global population have received at least one dose of a COVID-19 vaccine, while only 10% of people in low-income countries have received at least one dose. Even less people are fully vaccinated. The present pilot study evaluated the administration of half doses of AstraZeneca and Pfizer vaccines and included the enrollment of 26 subjects who were vaccinated with a different vaccine the first and second time. The reference group included individuals undergoing vaccination with two full doses of the Pfizer vaccine (21-day interval) monitored for their antibody levels as part of a parallel study. The distribution of antibody levels was not significantly different between those who received the Pfizer vaccine alone and those receiving the AstraZeneca vaccine plus Pfizer or Pfizer and AstraZeneca. To prepare for the next pandemic waves, solving the problem of the matching of booster vaccine to the previously received doses would be advisable. The topic is important and emerging as most of the population in low-income countries is still not vaccinated. We strongly believe that vaccine equity is the most important aspect of vaccination strategies.
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Affiliation(s)
- Krzysztof Lukaszuk
- Invicta Research and Development Center, Polna 64, 81-740 Sopot, Poland; (K.L.); (J.L.); (G.J.)
- Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdansk, 80-210 Gdansk, Poland
| | - Amira Podolak
- Invicta Research and Development Center, Polna 64, 81-740 Sopot, Poland; (K.L.); (J.L.); (G.J.)
- Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdansk, 80-210 Gdansk, Poland
| | - Paulina Malinowska
- Invicta Research and Development Center, Polna 64, 81-740 Sopot, Poland; (K.L.); (J.L.); (G.J.)
| | - Jakub Lukaszuk
- Invicta Research and Development Center, Polna 64, 81-740 Sopot, Poland; (K.L.); (J.L.); (G.J.)
| | - Grzegorz Jakiel
- Invicta Research and Development Center, Polna 64, 81-740 Sopot, Poland; (K.L.); (J.L.); (G.J.)
- 1st Department of Obstetrics and Gynecology, The Center of Postgraduate Medical Education, Zelazna 90, 01-004 Warszawa, Poland
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8
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Lukaszuk K, Podolak A, Jakiel G, Kiewisz J, Woclawek-Potocka I, Lukaszuk A, Rabalski L. Humoral Response after Vaccination with Half-Dose of BNT162b2 in Subjects under 55 Years of Age. Vaccines (Basel) 2021; 9:1277. [PMID: 34835208 PMCID: PMC8619910 DOI: 10.3390/vaccines9111277] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/26/2021] [Accepted: 10/31/2021] [Indexed: 01/14/2023] Open
Abstract
In the context of the ongoing COVID-19 pandemic, using a half-dose schedule vaccination can help to return to normalcy in a cost-efficient manner, which is especially important for low and middle-income countries. We undertook a study to confirm that in adults up to 55 years old, the humoral response to the half-dose (15 µg, 35 participants between 18 and 55 years old) and to the recommended dose (30 µg, 155 participants) in the two-dose three-week interval schedule would be comparable. Antibody levels were measured by the Elecsys Anti-SARS-CoV-2 S assay (Roche Diagnostics, upper detection limit: 2570 BAU/mL) on the day of dose 2 of the vaccine and then 8-10 days later to assess peak response to dose 2. The difference in proportions between the participants who did and did not exceed the upper detection limit 8-10 days after dose 2 was not statistically significant (p = 0.152). We suggest that a half-dose schedule can help to achieve widespread vaccination coverage more quickly and cheaply.
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Affiliation(s)
- Krzysztof Lukaszuk
- Invicta Research and Development Center, 81-740 Sopot, Poland; (K.L.); (A.L.)
- Department of Obstetrics and Gynecology Nursing, Medical University of Gdansk, 80-210 Gdansk, Poland
| | - Amira Podolak
- Invicta Research and Development Center, 81-740 Sopot, Poland; (K.L.); (A.L.)
| | - Grzegorz Jakiel
- The Center of Postgraduate Medical Education, 1st Department of Obstetrics and Gynecology, University of Gdansk, 01-004 Warsaw, Poland;
| | - Jolanta Kiewisz
- Department of Human Histology and Embryology, Medical Faculty, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-082 Olsztyn, Poland;
| | - Izabela Woclawek-Potocka
- Department of Gamete and Embryo Biology, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, 10-748 Olsztyn, Poland;
| | - Aron Lukaszuk
- Invicta Research and Development Center, 81-740 Sopot, Poland; (K.L.); (A.L.)
- The Center of Postgraduate Medical Education, 1st Department of Obstetrics and Gynecology, University of Gdansk, 01-004 Warsaw, Poland;
| | - Lukasz Rabalski
- Laboratory of Recombinant Vaccines, Intercollegiate Faculty of Biotechnology, University of Gdansk, 80-307 Gdansk, Poland
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Lukaszuk K, Woclawek-Potocka I, Jakiel G, Malinowska P, Wdowiak A, Rozanska K, Rabalski L. Humoral Response to SARS-CoV-2 Vaccine of a Patient Receiving Methotrexate Treatment and Implications for the Need of Monitoring. Vaccines (Basel) 2021; 9:vaccines9101151. [PMID: 34696259 PMCID: PMC8541181 DOI: 10.3390/vaccines9101151] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/01/2021] [Accepted: 10/05/2021] [Indexed: 12/23/2022] Open
Abstract
We report a case of monitoring the antibody response to the BioNTech–Pfizer vaccine of a 50-year-old female diagnosed with rheumatoid arthritis undergoing treatment with methotrexate (MTX). Antibody levels were measured 21 days after dose 1 (i.e., on the day of dose 2) and then 8, 14 and 30 days after dose 2 with Elecsys Anti-SARS-CoV-2 S assay (Roche Diagnostics). Patient showed a negative result after dose 1 and had the serum sample retested using a LIAISON® SARS-CoV-2 TrimericS IgG assay (DiaSorin), which showed a positive result. Subsequent samples were tested using both assays. Antibody levels kept increasing but at a much slower rate than in patients not receiving any immunomodulatory therapies. Other research indicates that among patients with autoimmune diseases, those receiving disease-modifying antirheumatic drugs (DMARDs) have higher COVID-19 mortality than those treated with tumor necrosis factor inhibitors (TNFis). These results indicate the need for people with autoimmune diseases to be carefully observed following vaccinations, including testing of antibody levels, and treated as potentially at risk until the effect of vaccination is confirmed. The different available vaccines should also be tested to verify their usefulness in the case of people with autoimmune diseases and those who take different immunomodulatory medications.
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Affiliation(s)
- Krzysztof Lukaszuk
- Department of Obstetrics and Gynecology Nursing, Medical University of Gdansk, 80-211 Gdansk, Poland;
- Invicta Research and Development Center, 81-740 Sopot, Poland;
| | - Izabela Woclawek-Potocka
- Department of Gamete and Embryo Biology, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, 10-243 Olsztyn, Poland;
| | - Grzegorz Jakiel
- The Center of Postgraduate Medical Education, 1st Department of Obstetrics and Gynecology, 01-004 Warsaw, Poland;
| | - Paulina Malinowska
- Invicta Research and Development Center, 81-740 Sopot, Poland;
- Correspondence: (P.M.); (L.R.); Tel.: +48-693271725 (P.M.); +48-795149841 (L.R.)
| | - Artur Wdowiak
- Diagnostic Techniques Unit, Medical University of Lublin, 20-081 Lublin, Poland;
| | | | - Lukasz Rabalski
- Laboratory of Recombinant Vaccines, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland
- Correspondence: (P.M.); (L.R.); Tel.: +48-693271725 (P.M.); +48-795149841 (L.R.)
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Ciebiera M, Ali M, Prince L, Zgliczyński S, Jakiel G, Al-Hendy A. The Significance of Measuring Vitamin D Serum Levels in Women with Uterine Fibroids. Reprod Sci 2021; 28:2098-2109. [PMID: 33108619 PMCID: PMC8262605 DOI: 10.1007/s43032-020-00363-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 10/19/2020] [Indexed: 12/11/2022]
Abstract
Uterine fibroids (UFs) are benign tumors originating from smooth muscle cells and are considered a common pathology that affects numerous women which is a notable socio-economic problem. Several UF risk factors have been identified including black race, obesity, and vitamin D deficiency. Vitamin D is steroid compound with pleiotropic effects on the human body. Vitamin D deficiency is a major public health concern worldwide. Several studies have shown that the majority of UF patients experienced hypovitaminosis D. In addition, sufficient vitamin D serum levels are associated with the reduced risk of UFs. In this review, we present available data highlighting the importance of measuring vitamin D serum levels in women with UFs and women at a high risk for UF development. We proposed a preliminary clinical instruction of 25-hydroxyvitamin D measurements and vitamin D supplementation for clinicians who are involved in the treatment of patients with UFs. Achieving sufficient serum levels of vitamin D might be of interest in patients with UFs. Screening, supplementation, treatment guidelines, and public health strategies for vitamin D deficiency in women with UFs as well as women at a high risk of UF development might be of potential importance as well.
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Affiliation(s)
- Michał Ciebiera
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, ul. Cegłowska 80, 01-809, Warsaw, Poland.
- Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA.
| | - Mohamed Ali
- Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA
- Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Lillian Prince
- Biological Sciences Division: Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Stanisław Zgliczyński
- Department of Internal Diseases and Endocrinology, Central Teaching Clinical Hospital, Medical University of Warsaw, Warsaw, Poland
| | - Grzegorz Jakiel
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, USA
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Abstract
Background Foetal growth restriction (FGR) complicates about 25–47% of twin pregnancies. One or both foetuses can be restricted. Pregnancies with discordant growth of foetuses are associated with a sevenfold increased risk of neonatal morbidity. Materials and methods This is a narrative or traditional literature review. A literature search was performed to present a comprehensive, critical and objective analysis of the current knowledge on growth restriction in twin pregnancies. Results The definitions of FGR in twin pregnancies and selective FGR (sFGR) differ between international societies. In 2019, the Delphi procedure aimed to unify the definitions of sFGR in twin pregnancies. Several growth charts for twins have been published. However, most societies recommend singleton growth charts as better in detecting hypoxic complications of FGR in twin pregnancies. Discordant growth in twins results from placental insufficiency, congenital anomalies, chromosomal aberrations and TORCH infections. Conclusions Definitions and management of sFGR depend on chorionicity. The management aims to protect the properly growing foetus from ischemic complications or in utero death. In most cases, expectant management, strict surveillance and preterm labour are the methods of choice. Due to the co-existence of properly growing and small foetuses in one uterus, determining the appropriate time for delivery is challenging. In the case of preterm labour, even late preterm, antenatal corticosteroid therapy (ACT) in FGR twin pregnancies is beneficial because it decreases neonatal morbidity.
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Affiliation(s)
| | - Grzegorz Jakiel
- Centre of Postgraduate Medical Education, 1st Obstetrics and Gynecology Clinic, Warsaw, Poland
| | - Anna Kajdy
- Department of Reproductive Health, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Michał Rabijewski
- Department of Reproductive Health, Centre of Postgraduate Medical Education, Warsaw, Poland
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Szymański JK, Słabuszewska-Jóźwiak A, Jakiel G. Fowler's Syndrome-The Cause of Urinary Retention in Young Women, Often Forgotten, but Significant and Challenging to Treat. Int J Environ Res Public Health 2021; 18:ijerph18063310. [PMID: 33806865 PMCID: PMC8005021 DOI: 10.3390/ijerph18063310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/19/2021] [Accepted: 03/21/2021] [Indexed: 11/23/2022]
Abstract
Urinary retention in young women is a relatively rare clinical problem and is often underdiagnosed. In particular, functional causes of urinary retention pose a diagnostic challenge. One of them is Fowler’s syndrome, which is associated with impaired urethral relaxation. Fowler’s syndrome is characterized by a large bladder capacity, reduced sensation, increased maximal urethral closure pressure, and detrusor underactivity. Several hypotheses have arisen to explain the cause of urethral relaxation disorders: hormonal changes characteristic of Polycystic Ovary Syndrome (PCOS), causing abnormal stabilization of the muscle membrane, primary failure of relaxation of the striated muscle of the urethra sphincter, and increased urethral afferent activity, inhibiting the bladder afferent signals from reaching the brain by potentiating a spinal mechanism of urinary continence. Currently, sacral neuromodulation is the only intervention that can restore an atypical voiding pattern in women with Fowler’s syndrome. The therapeutic effectiveness exceeds 70%, although the revision rate is relatively high, exceeding 50%. Well-designed, long-term prospective studies comparing sacral neuromodulation (SNM) with other therapies such as pelvic floor muscle physiotherapy are warranted to offer the best patient-tailored treatment.
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13
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Słabuszewska-Jóźwiak A, Malinowska M, Kloska A, Jakóbkiewicz-Banecka J, Gujski M, Bojar I, Raczkiewicz D, Jakiel G. Global Changes of 5-mC/5h-mC Ratio and Methylation of Adiponectin and Leptin Gene in Placenta Depending on Mode of Delivery. Int J Mol Sci 2021; 22:3195. [PMID: 33801130 PMCID: PMC8004251 DOI: 10.3390/ijms22063195] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/08/2021] [Accepted: 03/18/2021] [Indexed: 01/03/2023] Open
Abstract
It was suggested that the epigenetic alterations of the placenta are associated with obesity, as well as the delivery mode. This study aimed to assess the effect of maternal outcome and delivery procedure on global placental DNA methylation status, as well as selected 5'-Cytosine-phosphate-Guanine-3' (CpG) sites in ADIPOQ and LEP genes. Global DNA methylation profile in the placenta was assessed using the 5-methylcytosine (5-mC) and 5-hydroxymethylcytosine (5-hmC) ratio evaluated with the ELISA, followed by target gene methylation patterns at selected gene regions which were determined using methylation-specific qPCR in 70 placentas from healthy, pregnant women with single pregnancy. We found no statistically significant differences in 5-mC/5-hmC ratio between intrapartum cesarean sections (CS) and vaginal deliveries (p = 0.214), as well as between elective cesarean sections and vaginal deliveries (p = 0.221). In intrapartum cesarean sections, the ADIPOQ demethylation index was significantly higher (the average: 1.75) compared to elective cesarean section (the average: 1.23, p = 0.010) and vaginal deliveries (the average: 1.23, p = 0.011). The LEP demethylation index did not significantly differ among elective CS, intrapartum CS, and vaginal delivery groups. The demethylation index of ADIPOQ correlated negatively with LEP in the placenta in the vaginal delivery group (r = -0.456, p = 0.017), but not with the global methylation. The methylation of a singular locus might be different depending on the mode of delivery and uterine contractions. Further studies should be conducted with locus-specific analysis of the whole genome to detect the methylation index of specific genes involved in metabolism.
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Affiliation(s)
- Aneta Słabuszewska-Jóźwiak
- First Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Żelazna 90, 01-004 Warsaw, Poland;
| | - Marcelina Malinowska
- Department of Medical Biology and Genetics, Faculty of Biology University of Gdańsk, Wita Stwosza 59, 80-308 Gdańsk, Poland; (M.M.); (A.K.); (J.J.-B.)
| | - Anna Kloska
- Department of Medical Biology and Genetics, Faculty of Biology University of Gdańsk, Wita Stwosza 59, 80-308 Gdańsk, Poland; (M.M.); (A.K.); (J.J.-B.)
| | - Joanna Jakóbkiewicz-Banecka
- Department of Medical Biology and Genetics, Faculty of Biology University of Gdańsk, Wita Stwosza 59, 80-308 Gdańsk, Poland; (M.M.); (A.K.); (J.J.-B.)
| | - Mariusz Gujski
- Department of Public Health, Medical University of Warsaw, Nielubowicza 5, 02-097 Warsaw, Poland;
| | - Iwona Bojar
- Department of Women’s Health, Institute of Rural Health in Lublin, Jaczewskiego 2, 20-950 Lublin, Poland;
| | - Dorota Raczkiewicz
- Department of Medical Statistics, School of Public Health, Center of Postgraduate Medical Education, Kleczewska 61/63, 01-826 Warsaw, Poland;
| | - Grzegorz Jakiel
- First Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Żelazna 90, 01-004 Warsaw, Poland;
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14
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Ciebiera M, Wrzosek M, Wojtyła C, Zaręba K, Nowicka G, Jakiel G, Włodarczyk M. Vitamin D receptor gene polymorphisms and uterine fibroid incidence in Caucasian women. Arch Med Sci 2021; 17:1643-1650. [PMID: 34900044 PMCID: PMC8641505 DOI: 10.5114/aoms.2019.81748] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 11/03/2018] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Uterine fibroids (UFs) are benign tumors which are derived from the smooth muscle cells of the uterus. Recent studies have demonstrated that the development of UFs can be particularly related to vitamin D and its receptor. Vitamin D comprises a group of fat-soluble steroid compounds which exert powerful, pleiotropic effects all over the human body. These actions are mediated by a specific type of receptor - vitamin D receptor (VDR). Recent findings have focused on the possible role of VDR genetic variations in the development of several types of diseases, e.g. autoimmune system diseases, various cancers and infections. MATERIAL AND METHODS The aim of the study was to evaluate the association between rs731236, rs1544410, and rs2228570 polymorphisms in the VDR (vitamin D receptor) gene and the incidence of UFs in Caucasian women. A total of 197 patients (114 fibroid-positive and 83 controls) were included in this retrospective cohort study. VDR gene polymorphisms rs731236 (TaqI), rs1544410 (BsmI) and rs2228570 (FokI) were determined using TaqMan and Simple Probes. RESULTS No statistically significant differences in the occurrence of selected VDR polymorphisms were observed between UF-positive women and healthy controls. CONCLUSIONS We found no association between rs731236, rs1544410, and rs2228570 VDR polymorphisms and UF incidence in Caucasian women. Larger sample size and multi-ethnic studies are necessary to investigate the matter further.
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Affiliation(s)
- Michał Ciebiera
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Małgorzata Wrzosek
- Department of Biochemistry and Pharmacogenomics, Faculty of Pharmacy with Division of Laboratory Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Cezary Wojtyła
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
- European Observatory of Health Inequalities, State University of Applied Sciences, Kalisz, Poland
| | - Kornelia Zaręba
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Grazyna Nowicka
- Department of Biochemistry and Pharmacogenomics, Faculty of Pharmacy with Division of Laboratory Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Grzegorz Jakiel
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Marta Włodarczyk
- Department of Biochemistry and Pharmacogenomics, Faculty of Pharmacy with Division of Laboratory Medicine, Medical University of Warsaw, Warsaw, Poland
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15
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Szymanski J, Jakiel G, Slabuszewska-Jozwiak A. Pelvic venous insufficiency - an often-forgotten cause of chronic pelvic pain. Ginekol Pol 2020; 91:704-708. [PMID: 33301167 DOI: 10.5603/gp.a2020.0093] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/18/2020] [Accepted: 05/13/2020] [Indexed: 11/25/2022] Open
Abstract
Chronic pelvic pain is a common health problem that afflicts 39% of women at some time in their life. It is a common challenge for gynecologists, internists, surgeons, gastroenterologists, and pain management physicians. Pelvic venous insufficiency (PVI) accounts for 16-31% of cases of chronic pain but it seems to be often overlooked in differential diagnosis. The aim of this article was to summarize current data concerning PVI. The embolization of insufficient ovarian veins remains the gold standard of therapy but the optimal procedure is yet to be determined. Well-designed randomized trials are required to establish the best treatment modalities.
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Affiliation(s)
- Jacek Szymanski
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland.
| | - Grzegorz Jakiel
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
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16
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Zaręba K, Banasiewicz J, Rozenek H, Wójtowicz S, Jakiel G. Peripartum Predictors of the Risk of Postpartum Depressive Disorder: Results of a Case-Control Study. Int J Environ Res Public Health 2020; 17:ijerph17238726. [PMID: 33255386 PMCID: PMC7727836 DOI: 10.3390/ijerph17238726] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/15/2020] [Accepted: 11/21/2020] [Indexed: 12/12/2022]
Abstract
Background: The study aimed at the identification of the risk factors present during delivery, which might be present in prophylactic programs concerning postpartum mood disorders. Material and Method: This was a retrospective comparative study. The study material included data retrieved from the medical records of patients hospitalized in the Teaching Department of Gynecology and Obstetrics of Professor Orłowski Hospital in Warsaw, in the years 2010–2017. The EPDS data of 604 patients were analyzed. The study group included 75 women who obtained at least 12 points in the EPDS and the control group was made up of 75 women who obtained no more than 5 points in the EPDS. Results: The women in whom we noted an increased risk of developing mood disorders had blood loss >1000 mL and had a significantly longer stage II and III of labor than the control group. Other risk factors were cesarean section, vaginal delivery with the curettage of the uterine cavity, slightly lower APGAR scores (0.4 pts), and lower birth weight (approximately 350 g) of the child. Women at a low risk of postpartum mood disorders more commonly underwent episiotomy during delivery (76%). Conclusions: Increased supervision and support should be offered to women who experienced the above-mentioned risk factors.
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Affiliation(s)
- Kornelia Zaręba
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 01-813 Warsaw, Poland;
- Correspondence:
| | - Jolanta Banasiewicz
- Department of Medical Psychology and Medical Communication, Medical University of Warsaw, 02-091 Warsaw, Poland; (J.B.); (H.R.); (S.W.)
| | - Hanna Rozenek
- Department of Medical Psychology and Medical Communication, Medical University of Warsaw, 02-091 Warsaw, Poland; (J.B.); (H.R.); (S.W.)
| | - Stanisław Wójtowicz
- Department of Medical Psychology and Medical Communication, Medical University of Warsaw, 02-091 Warsaw, Poland; (J.B.); (H.R.); (S.W.)
| | - Grzegorz Jakiel
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 01-813 Warsaw, Poland;
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17
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Szymański JK, Starzec-Proserpio M, Słabuszewska-Jóźwiak A, Jakiel G. Is PREHAB in Pelvic Floor Surgery Needed? A Topical Review. Medicina (Kaunas) 2020; 56:E593. [PMID: 33172196 PMCID: PMC7694951 DOI: 10.3390/medicina56110593] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/26/2020] [Accepted: 11/04/2020] [Indexed: 12/03/2022]
Abstract
Pelvic organ prolapse and urinary incontinence affect approximately 6-11% and 6-40% of women, respectively. These pathologies could result from a weakness of pelvic floor muscles (PFM) caused by previous deliveries, aging or surgery. It seems reasonable that improving PFM efficacy should positively impact both pelvic floor therapy and surgical outcomes. Nonetheless, the existing data are inconclusive and do not clearly support the positive impact of preoperative pelvic floor muscle training on the improvement of surgical results. The restoration of deteriorated PFM function still constitutes a challenge. Thus, further well-designed prospective studies are warranted to answer the question of whether preoperative PFM training could optimize surgical outcomes and if therapeutic actions should focus on building muscle strength or rather on enhancing muscle performance.
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Affiliation(s)
- Jacek K. Szymański
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Żelazna 90 str., 00-004 Warsaw, Poland; (J.K.S.); (A.S.-J.); (G.J.)
| | | | - Aneta Słabuszewska-Jóźwiak
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Żelazna 90 str., 00-004 Warsaw, Poland; (J.K.S.); (A.S.-J.); (G.J.)
| | - Grzegorz Jakiel
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Żelazna 90 str., 00-004 Warsaw, Poland; (J.K.S.); (A.S.-J.); (G.J.)
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18
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Ciebiera M, Vitale SG, Ferrero S, Vilos GA, Barra F, Caruso S, Laganà AS, Sierant A, Cianci A, Jakiel G. Vilaprisan, a New Selective Progesterone Receptor Modulator in Uterine Fibroid Pharmacotherapy-Will it Really be a Breakthrough? Curr Pharm Des 2020; 26:300-309. [PMID: 31985366 DOI: 10.2174/1381612826666200127092208] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 01/21/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Vilaprisan (VPR) is a new orally available selective progesterone receptor modulator (SPRM), with anti-proliferative activity against uterine fibroids (UFs). It definitively causes suppression of ovulation and inhibition of proliferation of endometrial, myometrial and UF cells. PURPOSE This review aims to summarize current knowledge on VPR from all studies, including clinical trials, conducted to date and to contextualize the potential role of VPR in future medical regimens for the treatment of UFs. METHODS We performed a literature search in PubMed US National Library of Medicine and Google Scholar databases. Both databases were extensively searched for all original and review articles/book chapters as well as congress abstracts published in English until July 2019. The use of VPR for UF therapy was identified by using the keywords: "uterine fibroids" and "vilaprisan". RESULTS In phase I and II clinical trials, VPR was shown to be effective in ameliorating UF-related clinical symptoms, especially abnormal or excessive uterine bleeding and in shrinking UFs. The tolerability of VPR is roughly similar to that of ulipristal acetate (UPA) and it tends to be more favorable than that of GnRH-agonists. CONCLUSION Presently, all trials examining the utility of VPR for the treatment of UF are halted; likely, due to the recently reported cases of hepato-toxicity with UPA, in addition to non reassuring toxicology results from preclinical long-term testing on rodents, carried out in parallel with late stage testing on humans. An accurate summary of robust data related to the safety of VPR is urgently needed to draw definitive conclusions on the future clinical development of this drug for UF therapy.
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Affiliation(s)
- Michal Ciebiera
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Salvatore G Vitale
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Simone Ferrero
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.,Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - George A Vilos
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Fabio Barra
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.,Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Salvatore Caruso
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Antonio S Laganà
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Antoni Sierant
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Antonio Cianci
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Grzegorz Jakiel
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
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19
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Słabuszewska-Jóźwiak A, Szymański JK, Ciebiera M, Sarecka-Hujar B, Jakiel G. Pediatrics Consequences of Caesarean Section-A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2020; 17:E8031. [PMID: 33142727 PMCID: PMC7662709 DOI: 10.3390/ijerph17218031] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/28/2020] [Accepted: 10/29/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Cesarean section is a surgical procedure, which is the most frequently performed in gynecology and obstetrics. It is commonly believed that an operative delivery is a less painful and safer mode of delivery, which translates into an increasing number of the procedures performed without medical indications. The maternal sequelae of cesarean sections are well elucidated and widely discussed in the literature, while long-term neonatal consequences still remain the issue of research and scientific dispute. The aim of the present paper was to perform a systematic review of current literature regarding pediatrics consequences of cesarean section. METHODS We reviewed available data from PubMed, Science Direct as well as Google Scholar bases concerning early and long-term neonatal sequelae of operative deliveries. The following key words were used: "cesarean section", "caesarean section", "neonatal outcomes", "respiratory disorders", "asthma", "obesity", "overweight", and "neurological disorders". A total of 1636 papers were retrieved out of which 27 were selected for the final systematic review whereas 16 articles provided data for meta-analysis. Statistical analyses were performed using RevMan 5.4. To determine the strength of association between the caesarean section and respiratory tract infections, asthma, diabetes type 1 as well as obesity the pooled odds ratios (OR) with the 95% confidence intervals (CI) were calculated. RESULTS Conducted meta-analyses revealed that caesarean section is a risk factor for respiratory tract infections (pooled OR = 1.30 95%CI 1.06-1.60, p = 0.001), asthma (pooled OR = 1.23 95%CI 1.14-1.33, p < 0.00001) as well as obesity (pooled OR = 1.35 95%CI 1.29-1.41, p < 0.00001) in offspring. CONCLUSIONS The results of the studies included indicated that children delivered by cesarean section more commonly developed respiratory tract infections, obesity and the manifestations of asthma than children delivered vaginally. The risk of developing diabetes mellitus type 1 or neurological disorders in offspring after caesarean section is still under discussion.
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Affiliation(s)
- Aneta Słabuszewska-Jóźwiak
- First Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Żelazna 90 Street, 01-004 Warsaw, Poland; (J.K.S.); (G.J.)
| | - Jacek Krzysztof Szymański
- First Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Żelazna 90 Street, 01-004 Warsaw, Poland; (J.K.S.); (G.J.)
| | - Michał Ciebiera
- Second Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Cegłowska 80 Street, 01-809 Warsaw, Poland;
| | - Beata Sarecka-Hujar
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Kasztanowa 3 Street, 41-200 Sosnowiec, Poland;
| | - Grzegorz Jakiel
- First Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Żelazna 90 Street, 01-004 Warsaw, Poland; (J.K.S.); (G.J.)
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20
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Banasiewicz J, Zaręba K, Bińkowska M, Rozenek H, Wójtowicz S, Jakiel G. Perinatal Predictors of Postpartum Depression: Results of a Retrospective Comparative Study. J Clin Med 2020; 9:jcm9092952. [PMID: 32932622 PMCID: PMC7564238 DOI: 10.3390/jcm9092952] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/06/2020] [Accepted: 09/10/2020] [Indexed: 01/08/2023] Open
Abstract
Postpartum mood disorders occur in a considerable number of women with the most common postpartum disorder being baby blues. The study aimed at the identification of the risk factors present before delivery, which may be comprised in prophylactic programs concerning postpartum mood disorders. The research material includes data retrieved from the medical record of patients delivering in Warsaw in the years 2010–2017 who routinely completed Edinburgh Postnatal Depression Scale (EPDS) after delivery. Data of 604 patients were analyzed. The study group included 75 women who obtained at least 12 points in EPDS, which constituted 12.4% of the whole group (mean = 14.92, SD = 3.05). The control group was made up of 75 women who obtained no more than 5 points in EPDS. A significant correlation was reported between the parity and their order vs. the risk of developing postpartum mood disorders. Women with an increased risk delivered at about 37 gestational weeks, while women in whom the risk of such disorders was low delivered at about 39 gestational weeks. No increased risk was noted in women with premature rupture of membranes. Primigravidas and women who delivered prematurely were the most predisposed to developing postpartum depression and should undergo screening tests in the perinatal period.
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Affiliation(s)
- Jolanta Banasiewicz
- Department of Medical Psychology and Medical Communication, Medical University of Warsaw, 00-575 Warsaw, Poland; (J.B.); (H.R.); (S.W.)
| | - Kornelia Zaręba
- Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 01-004 Warsaw, Poland;
- Correspondence: ; Tel.: +48-662-051-602
| | - Małgorzata Bińkowska
- Department of Gynecologic Oncology and Obstetrics, Center of Postgraduate Medical Education, 00-416 Warsaw, Poland;
| | - Hanna Rozenek
- Department of Medical Psychology and Medical Communication, Medical University of Warsaw, 00-575 Warsaw, Poland; (J.B.); (H.R.); (S.W.)
| | - Stanisław Wójtowicz
- Department of Medical Psychology and Medical Communication, Medical University of Warsaw, 00-575 Warsaw, Poland; (J.B.); (H.R.); (S.W.)
| | - Grzegorz Jakiel
- Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 01-004 Warsaw, Poland;
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21
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Zaręba K, Commodari E, La Rosa VL, Makara-Studzińska M, Ciebiera M, Gierus J, Caruso S, Jakiel G. Religiosity among women undergoing pregnancy termination for medical reasons: the experiences and views of Polish women. EUR J CONTRACEP REPR 2020; 25:381-386. [PMID: 32643985 DOI: 10.1080/13625187.2020.1783652] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES The study aimed to determine the influence of religious and moral beliefs on contraceptive use, assisted reproduction and pregnancy termination in Polish women requesting a termination of pregnancy for medical reasons. METHODS Between 1 June 2014 and 31 May 2016, women deemed eligible for a termination of pregnancy for medical reasons at a Polish tertiary care centre received an anonymous questionnaire comprising 65 items. A total of 150 completed questionnaires were collected. RESULTS Of the respondents, 95% described themselves as Catholics, including 60% practising Catholics. The study revealed a discrepancy between respondents' beliefs and the teachings of the Catholic Church: an overwhelming majority of respondents used contraception, and 79% were in favour of in vitro fertilisation and believed the treatment should be refunded by the state. Interestingly, 66% of the respondents who attended confession did not perceive abortion as sinful. CONCLUSION The study detected a considerable discrepancy between declared religiosity and individual interpretations of the commandments and teachings of the Catholic Church. Despite stating they were Catholics, most women did not perceive abortion as sinful and did not follow the teachings of the Catholic Church regarding the sacraments for deceased children.
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Affiliation(s)
- Kornelia Zaręba
- I Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Elena Commodari
- Department of Educational Sciences, University of Catania, Catania, Italy
| | | | - Marta Makara-Studzińska
- Faculty of Clinical Health Psychology, Jagiellonian University Medical College, Krakow, Poland
| | - Michał Ciebiera
- II Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Jacek Gierus
- Faculty of Clinical Health Psychology, Jagiellonian University Medical College, Krakow, Poland
| | - Salvatore Caruso
- Obstetrics and Gynaecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Grzegorz Jakiel
- I Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Warsaw, Poland
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Janicka M, Filipecka-Tyczka D, Slabuszewska-Jozwiak A, Pietura R, Jakiel G. Successful pregnancy in women with inferior vena cava stenosis - case report and discussion. Ginekol Pol 2020; 91:331-333. [PMID: 32627154 DOI: 10.5603/gp.a2020.0052] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/03/2020] [Accepted: 02/19/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Inferior vena cava syndrome (IVCS) is a heterogenous group of symptoms resulting in obstruction of the main vein inflow . Common reasons are thrombotic changes and tumors. Incidence of inferior vena cava (IVC) anomalies is 0.3% in general population. Iatrogenic IVC lesions caused by catheter insertion play increasing role. Treatment varies depending on the condition. MATERIAL AND METHODS 32-year old patient was diagnosed with IVC stenosis during infertility related preconception evaluation and informed about increased risk in planned pregnancy. Throughout the well progressing pregnancy patient received low molecular weight heparin. RESULTS The diagnosis was confirmed intraoperatively during the planned cesarean section. Early postpartum period was normal and patient was discharged with antithrombotic prophylaxis. CONCLUSIONS Isolated IVC stenosis in pregnancy has not been yet reported in medical literature. Even though IVC anomalies may be associated with other congenital changes, in this case the central venous line treatment in infancy seems to be the most likely cause. Malformations are often accidentally diagnosed because patients are usually asymptomatic. CT and MRI are recommended diagnostic tools. Conservative treatment is recommended for asymptomatic patients, as opposed to surgical treatment for symptomatic. However, due to condition's rarity, there is no evidence based approach management.
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Affiliation(s)
| | | | | | | | - Grzegorz Jakiel
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
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Banasiewicz J, Zaręba K, Rozenek H, Ciebiera M, Jakiel G, Chylińska J, Owczarek K. Adaptive capacity of midwives participating in pregnancy termination procedures: Polish experience. Health Psychol Open 2020; 7:2055102920973229. [PMID: 33343915 PMCID: PMC7731597 DOI: 10.1177/2055102920973229] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
A cross-sectional study was conducted in 181 midwives working in hospitals in Poland. The midwives completed professional psychological tests (CISS questionnaire, EPQ-R questionnaire, OLBI questionnaire) and a questionnaire developed for this study. Midwives participating in pregnancy termination procedures most commonly used the task-oriented coping style. The emotion-oriented coping style was positively related to burnout in the group which performed pregnancy terminations. The analysis showed that the higher the indices of neuroticism, the greater the severity of burnout in both groups. The results indicate the need to conduct an initial assessment of personality resources when employing midwives to the wards.
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Affiliation(s)
- Jolanta Banasiewicz
- Department of Medical Psychology and Medical Communication, Medical University of Warsaw, Poland
| | - Kornelia Zaręba
- I Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Hanna Rozenek
- Department of Medical Psychology and Medical Communication, Medical University of Warsaw, Poland
| | - Michał Ciebiera
- II Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Grzegorz Jakiel
- Department of Medical Psychology and Medical Communication, Medical University of Warsaw, Poland
| | - Joanna Chylińska
- Department of Medical Psychology and Medical Communication, Medical University of Warsaw, Poland
| | - Krzysztof Owczarek
- Department of Medical Psychology and Medical Communication, Medical University of Warsaw, Poland
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Zaręba K, Banasiewicz J, Rozenek H, Ciebiera M, Jakiel G. Emotional Complications in Midwives Participating in Pregnancy Termination Procedures-Polish Experience. Int J Environ Res Public Health 2020; 17:ijerph17082776. [PMID: 32316548 PMCID: PMC7216072 DOI: 10.3390/ijerph17082776] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/11/2020] [Accepted: 04/16/2020] [Indexed: 01/12/2023]
Abstract
Background: Ethically controversial medical procedures, such as the termination of pregnancy, are frequently associated with a discrepancy between personal attitude and values versus requirements related to a professional situation. The study aimed to assess emotional complications in midwives participating in pregnancy termination procedures. Methods: The study included 181 midwives working in state-governed healthcare facilities in central and eastern Poland. The Oldenburg Burnout Inventory (OLBI) and the present authors’ own questionnaire were used in the study. The results indicating the level of occupational burnout were presented in two scales: the exhaustion scale and the disengagement scale. Results: The study revealed that 48% of midwives had never participated in pregnancy termination procedures due to fetal defects. The level of occupational burnout described with the exhaustion factor (t = 2.06; p < 0.041) and disengagement factor (t = 2.96; p < 0.003) was significantly higher in the group of midwives participating in pregnancy termination procedures due to fetal defects than in the group of midwives who did not participate in pregnancy terminations. The most common factors contributing to burnout reported by midwives who participated in pregnancy terminations were: moral dilemmas (68%), seeing the aborted fetus (65%), anticipating the child’s death in case it was born with signs of life (59%) and the lack of professional psychological support for medical personnel (56%). Conclusions: Importantly, pregnancy termination should be performed by persons who find such procedures acceptable from the viewpoint of their value system. It is a protective factor in regards to work with women who undergo terminations. Moreover, developing a system of informational and psychological support for midwives participating in pregnancy termination procedures is also a significant aspect.
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Affiliation(s)
- Kornelia Zaręba
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 01-004 Warsaw, Poland;
- Correspondence: ; Tel.: +48-662-051-602
| | - Jolanta Banasiewicz
- Department of Medical Psychology and Medical Communication, Medical University of Warsaw, 00-575 Warsaw, Poland; (J.B.); (H.R.)
| | - Hanna Rozenek
- Department of Medical Psychology and Medical Communication, Medical University of Warsaw, 00-575 Warsaw, Poland; (J.B.); (H.R.)
| | - Michał Ciebiera
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 01-809 Warsaw, Poland;
| | - Grzegorz Jakiel
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 01-004 Warsaw, Poland;
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Mlodzik N, Lukaszuk K, Sieg W, Jakiel G, Smolarczyk R. Endometrial microbiota — do they mean more than we have expected? Ginekol Pol 2020; 91:45-48. [DOI: 10.5603/gp.2020.0010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 12/04/2019] [Indexed: 11/25/2022] Open
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Bijok J, Kucińska-Chahwan A, Gielniewska-Michalczyk L, Massalska D, Jakiel G, Roszkowski T. The location of the fetal ears: A hint for prenatal diagnosis of agnathia-otocephaly complex. J Clin Ultrasound 2019; 47:369-371. [PMID: 30756395 DOI: 10.1002/jcu.22703] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/20/2019] [Accepted: 01/22/2019] [Indexed: 06/09/2023]
Abstract
Otocephaly is an extremely rare lethal congenital anomaly characterized by the absence or underdevelopment of the mandible. The clinical presentation is variable. Some cases may present with severe micrognathia as the only anomaly seen prenatally. The key to early diagnosis is careful assessment of the location of the fetal ears on 2D ultrasound examination.
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Affiliation(s)
- Julia Bijok
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Anna Kucińska-Chahwan
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | | | - Diana Massalska
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Grzegorz Jakiel
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Tomasz Roszkowski
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
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Ciebiera M, Męczekalski B, Łukaszuk K, Jakiel G. Potential synergism between ulipristal acetate and vitamin D3 in uterine fibroid pharmacotherapy - 2 case studies. Gynecol Endocrinol 2019; 35:473-477. [PMID: 30632825 DOI: 10.1080/09513590.2018.1550062] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 12/16/2022] Open
Abstract
This is a preliminary report of the first cases of successful simultaneous use of ulipristal acetate (UPA) and vitamin D3 in uterine fibroid (UF) oral treatment in humans. We present two cases of 37- and 49-year-old females with clinically symptomatic UFs and vitamin D deficiency. Both patients were treated with a standard 3 months of UPA scheme (5 mg daily) with the additional use of vitamin D3 (7000 IU daily orally). In the 37-year-old female all the symptoms (pain, pressure, frequent urination) decreased, total tumor volume after the treatment changed by 47.8%. In the 49-year-old female most symptoms perished, total tumor volume was reduced by 63.3%. UPA and vitamin D share synergistic anti-fibroid properties. Further studies are necessary to show the exact effect of UPA and vitamin D as co-drugs.
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Affiliation(s)
- Michał Ciebiera
- a Second Department of Obstetrics and Gynecology , The Center of Postgraduate Medical Education , Warsaw , Poland
| | - Błażej Męczekalski
- b Department of Gynecological Endocrinology , Poznan University of Medical Sciences , Poznań , Poland
| | - Krzysztof Łukaszuk
- c Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences , Medical University of Gdańsk , Gdańsk , Poland
- d INVICTA Fertility and Reproductive Center , Gdańsk , Poland
| | - Grzegorz Jakiel
- e First Department of Obstetrics and Gynecology , The Center of Postgraduate Medical Education , Warsaw , Poland
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Kunicki M, Skowrońska P, Pastuszek E, Jakiel G, Smolarczyk R, Łukaszuk K. Do serum androgens influence blastocysts ploidy in karyotypically normal women? Syst Biol Reprod Med 2019; 65:281-287. [PMID: 30994373 DOI: 10.1080/19396368.2019.1601295] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of the study was to determine if serum testosterone (T) and dehydroepiandrosterone (DHEAS) levels are a factor in determining increased risk for embryonic aneuploidy in karyotypically normal women undergoing in vitro fertilization (IVF) and preimplantation genetic testing screening for aneuploidy (PGT-A). This is a retrospective cohort study of IVF cycles with PGT-A performed during 2015-2016. A total of 256 cycles with 725 embryos were initially considered for inclusion. A total of 208 cycles and 595 embryos determined to be either euploid or aneuploid were included in the analysis. The mean age of women was 37.4 ± 4.4 years. There were 193 (32.44%) euploid, and 338 (56.81%) aneuploid blastocysts. Sixty-four (10.76%) had 'no diagnosis' after PGT-A. The 32 embryos with 'no diagnosis' after first PGT-A were biopsied again and after the second analysis, 7 were found to be euploid and 3 aneuploid. The remaining 32 embryos were not reanalyzed due to the lack of patients' consent for the second biopsy. The relationship between embryo ploidy and levels of serum testosterone and dehydroepiandrosterone sulfate was assessed using ordinal multivariable regression analysis. The model, adjusted for both anti-Mullerian hormone (AMH) and age, showed no association between ploidy status and serum levels of the two hormones. We concluded that the serum levels of testosterone and DHEAS do not influence embryo ploidy in karyotypically normal women undergoing IVF. Abbreviations: T: testosterone; DHEAS: dehydroepiandrosterone; IVF: in vitro fertilization; PGT-A: preimplantation genetic testing screening for aneuploidy; AMH: anti-Mullerian hormone; FSH: follicle-stimulating hormone; LH: luteinizing hormone; E2: oestradiol; P: progesterone.
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Affiliation(s)
- Michał Kunicki
- a INVICTA Fertility and Reproductive Center , Warsaw , Poland.,b Department of Gynecological Endocrinology , Medical University of Warsaw , Warsaw , Poland
| | - Patrycja Skowrońska
- c Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences , Medical University of Gdansk , Gdańsk , Poland
| | - Ewa Pastuszek
- c Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences , Medical University of Gdansk , Gdańsk , Poland.,d INVICTA Fertility and Reproductive Center , Gdansk , Poland
| | - Grzegorz Jakiel
- a INVICTA Fertility and Reproductive Center , Warsaw , Poland.,e Department of Obstetrics and Gynecology , The Centre of Postgraduate Medical Education , Warsaw , Poland
| | - Roman Smolarczyk
- b Department of Gynecological Endocrinology , Medical University of Warsaw , Warsaw , Poland
| | - Krzysztof Łukaszuk
- a INVICTA Fertility and Reproductive Center , Warsaw , Poland.,b Department of Gynecological Endocrinology , Medical University of Warsaw , Warsaw , Poland.,c Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences , Medical University of Gdansk , Gdańsk , Poland.,d INVICTA Fertility and Reproductive Center , Gdansk , Poland
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Zareba K, Ciebiera M, Gierus J, Jakiel G. Perceptions of attending medical staff by women accessing pregnancy termination in Poland: a qualitative study. EUR J CONTRACEP REPR 2019; 24:124-129. [PMID: 30931638 DOI: 10.1080/13625187.2019.1590698] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Polish society is strongly influenced by the Catholic Church and Poland has one of the most restrictive abortion laws in Europe. We attempted to gather information by questionnaire from women considering termination of pregnancy (TOP). Women were asked about their perceptions of the attending medical staff and whether they felt they had been fully informed of their rights, as well as about conduct of the procedure itself in light of physicians' use of the 'conscience clause'. METHODS Between June 2014 and May 2016 all women deemed eligible for TOP for medical reasons were asked to complete an anonymous questionnaire (n = 240). A total of 150 questionnaires (62.5%) were returned and analysed. RESULTS Most respondents (95%) lived in a town or city, and a significant number (40%) lived outside the area where the study centre was located. The main reason for such a large group of out-of-region respondents (53%) was the lack of centres offering TOP in the area where the women lived. Only one attending obstetrician did not support a decision to abort the pregnancy. Although 65% of treating physicians supported the woman's decision, only 8% were willing to perform the procedure themselves. CONCLUSION Most regional centres offer no access to TOP, despite the legal right of women to abort their pregnancy in the event of a severe fetal defect. Some physicians refuse to perform abortions, citing conscientious objection. Double standards among treating physicians have been detected, as many support the decision of their patient but refuse to perform the procedure themselves.
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Affiliation(s)
- Kornelia Zareba
- a First Department of Obstetrics and Gynaecology , Centre of Postgraduate Medical Education , Warsaw , Poland
| | - Michał Ciebiera
- b Second Department of Obstetrics and Gynaecology , Centre of Postgraduate Medical Education , Warsaw , Poland
| | - Jacek Gierus
- c Department of Psychiatry, Faculty of Health Sciences , Medical University of Warsaw , Warsaw , Poland
| | - Grzegorz Jakiel
- a First Department of Obstetrics and Gynaecology , Centre of Postgraduate Medical Education , Warsaw , Poland
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Ciebiera M, Włodarczyk M, Słabuszewska-Jóźwiak A, Ciebiera M, Nowicka G, Jakiel G. Vitamin D serum levels in women using contraception containing drospirenone - a preliminary study. Arch Med Sci 2019; 15:554-557. [PMID: 30899309 PMCID: PMC6425194 DOI: 10.5114/aoms.2017.70887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 01/29/2017] [Indexed: 12/14/2022] Open
Affiliation(s)
- Michał Ciebiera
- First Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Marta Włodarczyk
- Department of Pharmacogenomics, Division of Biochemistry and Clinical Chemistry, Medical University of Warsaw, Warsaw, Poland
| | | | - Magdalena Ciebiera
- Students’ Scientific Association at the First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Grażyna Nowicka
- Department of Pharmacogenomics, Division of Biochemistry and Clinical Chemistry, Medical University of Warsaw, Warsaw, Poland
| | - Grzegorz Jakiel
- First Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
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Ciebiera M, Wojtyła C, Łukaszuk K, Zgliczyńska M, Zaręba K, Rawski W, Jakiel G. The role of vitamin D in perinatology. An up-to-date review. Arch Med Sci 2019; 17:992-1005. [PMID: 34336027 PMCID: PMC8314414 DOI: 10.5114/aoms.2019.81747] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 07/05/2018] [Indexed: 02/06/2023] Open
Abstract
The role of vitamin D in perinatology is a subject of major interest in current medicine. There is growing evidence about the role of maternal vitamin D levels in pregnancy outcomes. The aim of this review is to summarize the current literature about the role of vitamin D in perinatology. Evidence from this review suggests associations between low levels of maternal vitamin D and higher risk of certain obstetrical complications. Vitamin D has been found to be related to preeclampsia, gestational diabetes mellitus, low birth weight, and preterm birth. The current literature supports vitamin D supplementation in pregnant women, but more high-quality data are necessary. The problem that remains is how to achieve an optimal 25-hydroxyvitamin D level. To determine the real benefits of vitamin D supplementation in pregnancy, we need high-quality trials in larger groups.
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Affiliation(s)
- Michał Ciebiera
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Cezary Wojtyła
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
- European Observatory of Health Inequalities, State University of Applied Sciences, Kalisz, Poland
| | - Krzysztof Łukaszuk
- Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
| | - Magdalena Zgliczyńska
- Students’ Scientific Association at the First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Kornelia Zaręba
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Wojciech Rawski
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Grzegorz Jakiel
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
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Ciebiera M, Słabuszewska-Jóźwiak A, Zaręba K, Jakiel G. Heterotopic pregnancy - how easily you can go wrong in diagnosing? A case study. J Ultrason 2019; 18:355-358. [PMID: 30763022 PMCID: PMC6444310 DOI: 10.15557/jou.2018.0052] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2018] [Indexed: 12/12/2022] Open
Abstract
Introduction: Heterotopic pregnancy is a rare, but potentially life-threatening pathology. The diagnosis of heterotopic pregnancy is still one of the biggest challenges in modern gynecology. The incidence of those pregnancies in natural conception is about 1:30000. Case presentation: We present an unusual case of a heterotopic pregnancy which was misdiagnosed in the first trimester as a dichorionic twin pregnancy. At 13 weeks of gestation, the patient presented with an acute abdomen, she was diagnosed with a heterotopic pregnancy, and therefore was operated on, with the excision of the ruptured fallopian tube and the ectopic pregnancy performed. Discussion: The presence of an intrauterine pregnancy does not rule out the presence of a coexisting ectopic pregnancy. Clinicians should always keep in mind that a heterotopic pregnancy may occur in a woman of reproductive age. Careful ultrasound scan of the uterus and appendages is a must in all women of reproductive age with clinical symptoms. Introduction: Heterotopic pregnancy is a rare, but potentially life-threatening pathology. The diagnosis of heterotopic pregnancy is still one of the biggest challenges in modern gynecology. The incidence of those pregnancies in natural conception is about 1:30000. Case presentation: We present an unusual case of a heterotopic pregnancy which was misdiagnosed in the first trimester as a dichorionic twin pregnancy. At 13 weeks of gestation, the patient presented with an acute abdomen, she was diagnosed with a heterotopic pregnancy, and therefore was operated on, with the excision of the ruptured fallopian tube and the ectopic pregnancy performed. Discussion: The presence of an intrauterine pregnancy does not rule out the presence of a coexisting ectopic pregnancy. Clinicians should always keep in mind that a heterotopic pregnancy may occur in a woman of reproductive age. Careful ultrasound scan of the uterus and appendages is a must in all women of reproductive age with clinical symptoms.
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Affiliation(s)
- Michał Ciebiera
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education , Warsaw , Poland
| | | | - Kornelia Zaręba
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education , Warsaw , Poland
| | - Grzegorz Jakiel
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education , Warsaw , Poland
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Zaręba K, Makara-Studzińska M, Ciebiera M, Gierus J, Jakiel G. Role of Social and Informational Support while Deciding on Pregnancy Termination for Medical Reasons. Int J Environ Res Public Health 2018; 15:ijerph15122854. [PMID: 30558123 PMCID: PMC6313640 DOI: 10.3390/ijerph15122854] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 09/23/2018] [Accepted: 12/10/2018] [Indexed: 12/31/2022]
Abstract
Background: Poland is a country with restrictive laws concerning abortion, which is only allowed if the mother’s life and health are in danger, in case of rape, and severe defects in the fetus. This paper specifies the forms of support expected by women considering termination from their family, people in their surroundings and professional medical personnel. Methods: Between June 2014 and May 2016 patients eligible to terminate a pregnancy for medical reasons were asked to complete an anonymous survey consisting of sixty questions to determine patient profile and forms of support expected from the society, family and professional medical personnel as well as to assess informational support provided. Results: Women do not take into consideration society’s opinion on pregnancy termination (95%). The majority of the respondents think that financial support from the state is not sufficient to provide for sick children (81%). Despite claiming to have a medium standard of life (75%), nearly half of the respondents (45%) say that they do not have the financial resources to take care of a sick child. The women have informed their partner (97%) and closest family members (82%) and a low percentage have informed friends (32%). Nearly one third (31%) have not talked to the attending gynecologist about their decision. Conclusions: The decision to terminate a pregnancy is made by mature women with a stable life situation—supported by their partner and close family. They do not expect systemic support, as they believe it is marginal, and only seek emotional support from their closest family. They appreciate support provided by professional medical personnel if it is personal.
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Affiliation(s)
- Kornelia Zaręba
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 00-416 Warsaw, Poland.
| | - Marta Makara-Studzińska
- Faculty of Clinical Health Psychology, Jagiellonian University Medical College, 31-501 Krakow, Poland.
| | - Michał Ciebiera
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 01-809 Warsaw, Poland.
| | - Jacek Gierus
- Department of Psychiatry, Department of Health Sciences, Medical University of Warsaw, 05-802 Warsaw, Poland.
| | - Grzegorz Jakiel
- First Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 00-416 Warsaw, Poland.
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Ciebiera M, Łoziński T, Wojtyła C, Rawski W, Jakiel G. Complications in modern hysteroscopic myomectomy. Ginekol Pol 2018; 89:398-404. [PMID: 30091451 DOI: 10.5603/gp.a2018.0068] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 05/29/2018] [Accepted: 05/30/2018] [Indexed: 11/25/2022] Open
Abstract
Uterine fibroids (UFs) are common benign tumors of the female genital tract, diagnosed in almost one-quarter of women of reproductive age. UFs may cause numerous clinical symptoms, including prolonged or heavy menstrual bleeding, pelvic pressure symptoms, pain, infertility and others. Submucous fibroids arise from the muscular part of the uterus and pen-etrate into the uterine cavity. They are mostly managed with the use of hysteroscopic myomectomy (HM), which provides direct visualization from the transcervical approach. The sheer number of HM standards and techniques is reason enough to review the available literature about HM-related complications. HM is a safe and effective treatment in patients with the normal size of the uterus and with no more than a few UFs. The procedure should not be initiated without adequate preparation and diagnosis, using the best methods available.
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Affiliation(s)
- Michał Ciebiera
- I Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education,, Warsaw, Poland.
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Kostro M, Jacyna N, Głuszczak-Idziakowska E, Sułek-Kamas K, Jakiel G, Wilińska M. Factors affecting the differentiation of the Apgar score and the biochemical correlation of fetal well-being - a prospective observational clinical study. Dev Period Med 2018; 22:238-246. [PMID: 30281519 PMCID: PMC8522882 DOI: 10.34763/devperiodmed.20182203.238246] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 05/23/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Objective: The purpose of the study was to identify the features of both the labor and the assisting physicians when evaluating the newborn according to the Apgar score and how these correlate with the biochemical markers of fetal well-being in order to make the Apgar score more objective. PATIENTS AND METHODS Material and methods: A prospective observational clinical study conducted in a 3rd reference level center between 1st April 2014 and 31st March 2015. The study enrolled 17 neonatologists and 1527 term newborns. RESULTS Results: The Apgar score is highest after natural vaginal delivery, lower after instrumental labor (p <0.001). The pH of the umbilical cord blood and lactate concentration correlate better with a high score than with a lowered one. The young age of a physician does not reduce Apgar score reliability. There were no differences in Apgar assessment according to physicians' training and the time of labor. There were no correlations between abnormalities in postnatal central nervous system ultrasound and the Apgar score. CONCLUSION Conclusion: Biochemical tests of umbilical cord blood significantly increase the Apgar score reliability.
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Affiliation(s)
- Maria Kostro
- Klinika Neonatologii SPSK im. prof. W. Orłowskiego CMKP, Warszawa, Polska,Maria Kostro ul. Czerniakowska 231, 00-416 Warszawa tel. 696-650-618
| | - Natalia Jacyna
- Klinika Neonatologii SPSK im. prof. W. Orłowskiego CMKP, Warszawa, Polska
| | | | | | - Grzegorz Jakiel
- I Klinika Ginekologii SPSK im. prof. W. Orłowskiego CMKP, Warszawa, Polska
| | - Maria Wilińska
- Klinika Neonatologii SPSK im. prof. W. Orłowskiego CMKP, Warszawa, Polska
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Ciebiera M, Włodarczyk M, Wrzosek M, Wojtyła C, Błażej M, Nowicka G, Łukaszuk K, Jakiel G. TNF-α serum levels are elevated in women with clinically symptomatic uterine fibroids. Int J Immunopathol Pharmacol 2018; 32:2058738418779461. [PMID: 29809057 PMCID: PMC5977422 DOI: 10.1177/2058738418779461] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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] [Indexed: 11/15/2022] Open
Abstract
Uterine fibroids (UFs) are one of the most common pathologies of the female genital tract. The incidence of UFs has been estimated at 25-80%. Tumor necrosis factor (TNF)-α is a cell-signaling protein involved in systemic inflammation and is one of the cytokines responsible for the acute phase reaction. The aim of the study was to evaluate the impact of clinically symptomatic UFs on TNF-α serum levels. A total of 149 Caucasian women were included: 85 patients admitted for surgery due to clinically symptomatic UFs (n = 85; study group) and 64 age-matched UF-free controls (n = 64). TNF-α serum concentrations between the groups were compared. Receiver operating characteristic (ROC) curves were also used as a statistical model to evaluate TNF-α as a marker for UFs. Mean TNF-α serum concentration in the study group was 0.34 ± 0.14 pg/mL; (in half of the subjects, the level did not exceed 0.39 pg/mL. Mean TNF-α serum concentration in the control group was 0.17 ± 0.09 pg/mL; in half of the subjects, the level did not exceed 0.14 pg/mL. The difference was statistically significant. Using the area under the ROC curve, we found that TNF-α serum concentration of 0.34 pg/mL can be used as a predictor for UFs in selected populations. In our study, we confirmed higher TNF-α serum concentrations in women with clinically symptomatic UFs.
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Affiliation(s)
- Michał Ciebiera
- 1 First Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Marta Włodarczyk
- 2 Department of Biochemistry and Pharmacogenomics, Faculty of Pharmacy with the Laboratory Medicine Division, Medical University of Warsaw, Warsaw, Poland
| | - Małgorzata Wrzosek
- 2 Department of Biochemistry and Pharmacogenomics, Faculty of Pharmacy with the Laboratory Medicine Division, Medical University of Warsaw, Warsaw, Poland
| | - Cezary Wojtyła
- 1 First Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Męczekalski Błażej
- 3 Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
| | - Grażyna Nowicka
- 2 Department of Biochemistry and Pharmacogenomics, Faculty of Pharmacy with the Laboratory Medicine Division, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Łukaszuk
- 4 Department of Obstetric and Gynaecological Nursing, Faculty of Health Sciences, Medical University of Gdańsk, Gdańsk, Poland.,5 INVICTA Fertility and Reproductive Center, Gdańsk, Poland
| | - Grzegorz Jakiel
- 1 First Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
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Ciebiera M, Zaręba K, Jakiel G. Laparoscopic management of uterine cesarean scar dehiscence during mid-trimester misoprostol-induced termination of pregnancy. Taiwan J Obstet Gynecol 2018; 57:611-612. [PMID: 30122590 DOI: 10.1016/j.tjog.2018.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2018] [Indexed: 10/28/2022] Open
Affiliation(s)
- Michał Ciebiera
- First Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland.
| | - Kornelia Zaręba
- First Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Grzegorz Jakiel
- First Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
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Ciebiera M, Włodarczyk M, Ciebiera M, Zaręba K, Łukaszuk K, Jakiel G. Vitamin D and Uterine Fibroids-Review of the Literature and Novel Concepts. Int J Mol Sci 2018; 19:E2051. [PMID: 30011902 PMCID: PMC6073230 DOI: 10.3390/ijms19072051] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/06/2018] [Accepted: 07/12/2018] [Indexed: 02/08/2023] Open
Abstract
This article provides a detailed review of current knowledge on the role of vitamin D and its receptor in the biology and management of uterine fibroids (UFs). Authors present ideas for future steps in this area. A literature search was conducted in PubMed using the following key words: "uterine fibroid" and "vitamin D". The results of the available studies, published in English from January 2002 up to April 2018, have been discussed. Vitamin D is a group of steroid compounds with a powerful impact on many parts of the human body. This vitamin is believed to regulate cell proliferation and differentiation, inhibit angiogenesis, and stimulate apoptosis. Nowadays, hypovitaminosis D is believed to be a major risk factor in the development of UFs. In many studies vitamin D appears to be a powerful factor against UFs, resulting in inhibition of tumor cell division and a significant reduction in its size, however, the exact role of this compound and its receptor in the pathophysiology of UFs is not fully understood. According to available studies, vitamin D and its analogs seem to be promising, effective, and low-cost compounds in the management of UFs and their clinical symptoms, and the anti-tumor activities of vitamin D play an important role in UF biology. The synergy between vitamin D and selected anti-UF drugs is a very interesting issue which requires further research. Further studies about the biological effect of vitamin D on UF biology are essential. Vitamin D preparations (alone or as a co-drugs) could become new tools in the fight with UFs, with the additional beneficial pleiotropic effect.
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Affiliation(s)
- Michał Ciebiera
- Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 00-416 Warsaw, Poland.
| | - Marta Włodarczyk
- Department of Biochemistry and Pharmacogenomics, Faculty of Pharmacy with Division of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland.
- Center for Preclinical Research, Medical University of Warsaw, 02-097 Warsaw, Poland.
| | - Magdalena Ciebiera
- Students' Scientific Association at the Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland.
| | - Kornelia Zaręba
- Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 00-416 Warsaw, Poland.
| | - Krzysztof Łukaszuk
- Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdansk, 80-210 Gdansk, Poland.
- INVICTA Fertility and Reproductive Center, 80-172 Gdansk, Poland.
| | - Grzegorz Jakiel
- Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, 00-416 Warsaw, Poland.
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Bijok J, Massalska D, Kucińska-Chahwan A, Posiewka A, Ilnicka A, Jakiel G, Roszkowski T. Complex malformations involving the fetal body wall - definition and classification issues. Prenat Diagn 2018; 37:1033-1039. [PMID: 28809041 DOI: 10.1002/pd.5141] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 08/01/2017] [Accepted: 08/06/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The objective of the study is to analyse the sonographic features, cytogenetic results and pregnancy outcomes in complex malformations involving the body wall in a large cohort of fetuses with regard to different definitions proposed in the literature. METHOD A retrospective study on 96 fetuses with complex malformations comprising ventral wall, craniofacial structures, limbs and umbilical cord that were evaluated between 1997 and 2015. RESULTS The most common sonographic finding was an extensive ventral wall defect (95.8%; 92/96) comprising liver (94.6%; 87/92), intestine (82.6%; 76/92), heart (17.4%; 16/92) and bladder (8.7%; 8/92). Acrania and encephalocoele were observed in 24 and 9 fetuses (25.0%, 24/96; 9.4%, 9/96), respectively. Limb anomalies were present in 54 fetuses (56.3%; 54/96). Rudimentary or absent umbilical cord was observed in 62 fetuses (64.6%; 62/96). In 79 fetuses, there were additional multiple structural anomalies detected prenatally. None of the currently used definitions encompasses all possible phenotypes of body wall defects present in our cohort. Chromosomal aberrations were seen in 8 out of 60 cases with conclusive cytogenetic result (13.3%, 8/60). CONCLUSION Chromosomal anomalies are common, and karyotyping should be offered. There is a need for a more rigorous classification of complex malformations in order to better understand the underlying pathophysiology. © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Julia Bijok
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Department of Obstetrics and Gynecology, Witold Orlowski Public Teaching Hospital, Warsaw, Poland
| | - Diana Massalska
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Department of Obstetrics and Gynecology, Witold Orlowski Public Teaching Hospital, Warsaw, Poland
| | - Anna Kucińska-Chahwan
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Department of Obstetrics and Gynecology, Witold Orlowski Public Teaching Hospital, Warsaw, Poland
| | - Anna Posiewka
- Department of Obstetrics and Gynecology, Witold Orlowski Public Teaching Hospital, Warsaw, Poland
| | - Alicja Ilnicka
- Genetic Department of the Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Grzegorz Jakiel
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Department of Obstetrics and Gynecology, Witold Orlowski Public Teaching Hospital, Warsaw, Poland
| | - Tomasz Roszkowski
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland.,Department of Obstetrics and Gynecology, Witold Orlowski Public Teaching Hospital, Warsaw, Poland
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Kunicki M, Łukaszuk K, Liss J, Jakiel G, Skowrońska P. Demographic characteristics and AMH levels in rural and urban women participating in an IVF programme. Ann Agric Environ Med 2018; 25:120-123. [PMID: 29575864 DOI: 10.26444/aaem/78944] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The primary aim of this preliminary study was to compare the IVF results of couples living in rural and urban areas. Additionally, the ovarian reserve parameters, such as AMH concentrations, were compared for the same groups. MATERIAL AND METHODS The database of 1,265 women undergoing in vitro fertilization at the Invicta Fertility Center between May 2011-July 2012 were retrospectively analyzed. Women undergoing their first assisted reproductive technology cycle with ICSI, stimulated according to the long protocol, and whose AMH levels were measured using the same DSL kit, were selected. Ultimately, 651 women were included in the study. All participants were categorized based on the area where they live: rural areas, small towns (<100,000 inhabitants) and large cities (>100,000). RESULTS The mean age of the patients living in large cities was significantly higher in comparison to those from rural areas and small towns. A significantly higher pregnancy body mass index (BMI) was found in women from rural areas in comparison to the women living in small and large towns. Serum AMH and inhibin B concentrations, number of ampules of gonadotropins, and antral follicle count (AFC), did not differ significantly among the groups. The study showed no significant differences among the groups in terms of clinical pregnancy rate, both per started cycle and per embryo transfer. CONCLUSIONS No significant differences were found in IVF outcomes among the groups inhabiting rural areas, small and large cities.
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Affiliation(s)
- Michał Kunicki
- INVICTA Fertility and Reproductive Center, Warsaw, Poland
| | | | - Joanna Liss
- INVICTA Fertility and Reproductive Center, Warsaw, Poland
| | | | - Patrycja Skowrońska
- Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdansk, Poland
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41
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Szymański JK, Siekierski BP, Kajdy A, Jakiel G. Post-menopausal vulvovaginal atrophy — an overview of the current treatment options. Ginekol Pol 2018; 89:40-47. [DOI: 10.5603/gp.a2018.0008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 12/15/2017] [Accepted: 01/03/2018] [Indexed: 11/25/2022] Open
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42
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Pastuszek E, Kiewisz J, Skowronska P, Liss J, Lukaszuk M, Bruszczynska A, Jakiel G, Lukaszuk K. An investigation of the potential effect of sperm nuclear vacuoles in human spermatozoa on DNA fragmentation using a neutral and alkaline Comet assay. Andrology 2017; 5:392-398. [PMID: 28297560 DOI: 10.1111/andr.12324] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 11/14/2016] [Accepted: 11/30/2016] [Indexed: 12/29/2022]
Abstract
Presence of vacuoles and degree of sperm DNA damage are considered to be the basic factors used for the assessment of sperm fertilization capacity. We aimed to investigate the link between these two parameters. According to our knowledge, this is the first study where the Comet assay was used to assess the degree of DNA fragmentation of sperm categorized by Motile Sperm Organelle Morphology Examination (MSOME) Grades. Semen samples from 10 patients were assessed. Spermatozoa were graded into four MSOME groups according to the Vanderzwalmen's criteria. A total of 3930 motile spermatozoa were selected one-by-one using an inverted microscope and transferred onto two different slides. The degree of DNA fragmentation was analyzed by alkaline and neutral Comet assay. Results of the neutral Comet assay showed that Grade I spermatozoa (absence of vacuoles) presented significantly lower dsDNA fragmentation level (mean: 3.13 ± 1.17%) than Grade II (maximum of two small vacuoles; mean: 10.34 ± 2.65%), Grade III (more than two small vacuoles or at least one large vacuole; mean: 23.88 ± 8.37%), and Grade IV (large vacuoles associated with abnormal head shapes or other abnormalities; mean: 36.94 ± 7.78%; p < 0.05). Results of the alkaline Comet assay showed that Grade I spermatozoa had significantly lower DNA (ssDNA + dsDNA) fragmentation level (mean: 8.33 ± 3.62%) than Grade III (mean: 25.64 ± 9.15%) and Grade IV (mean: 40.10 ± 9.10%, p < 0.05), but not significantly lower than Grade II (mean: 12.73 ± 5.06%; p > 0.05). Probably, the vacuoles may be responsible for double strand DNA breaks rather than single strand DNA breaks (only 2.39% spermatozoa in MSOME Grade II, 1.76% in III, and 3.16% in IV has single strand breaks). The results demonstrate that lower MSOME grading correlates with lower sperm DNA fragmentation. Therefore, the observation of sperm nuclear vacuoles using real-time optical microscopy without precise DNA fragmentation examination is not sufficient for optimal sperm selection for intracytoplasmic sperm injection.
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Affiliation(s)
- E Pastuszek
- INVICTA Fertility and Reproductive Center, Gdansk, Warsaw, Wroclaw, Poland.,Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
| | - J Kiewisz
- Department of Human Histology and Embryology, Faculty of Medical Sciences, University of Warmia and Mazury, Olsztyn, Poland
| | - P Skowronska
- INVICTA Fertility and Reproductive Center, Gdansk, Warsaw, Wroclaw, Poland.,Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
| | - J Liss
- INVICTA Fertility and Reproductive Center, Gdansk, Warsaw, Wroclaw, Poland
| | - M Lukaszuk
- INVICTA Fertility and Reproductive Center, Gdansk, Warsaw, Wroclaw, Poland
| | - A Bruszczynska
- INVICTA Fertility and Reproductive Center, Gdansk, Warsaw, Wroclaw, Poland
| | - G Jakiel
- INVICTA Fertility and Reproductive Center, Gdansk, Warsaw, Wroclaw, Poland.,Department of Obstetrics and Gynecology, The Medical Center of Postgraduate Education, Warsaw, Poland
| | - K Lukaszuk
- INVICTA Fertility and Reproductive Center, Gdansk, Warsaw, Wroclaw, Poland.,Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland.,Department of Gyneacological Endocrinology, Medical University of Warsaw, Warsaw, Poland
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Ciebiera M, Łukaszuk K, Męczekalski B, Ciebiera M, Wojtyła C, Słabuszewska-Jóźwiak A, Jakiel G. Alternative Oral Agents in Prophylaxis and Therapy of Uterine Fibroids-An Up-to-Date Review. Int J Mol Sci 2017; 18:ijms18122586. [PMID: 29194370 PMCID: PMC5751189 DOI: 10.3390/ijms18122586] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/28/2017] [Accepted: 11/28/2017] [Indexed: 01/18/2023] Open
Abstract
Uterine fibroids (UFs) are the most common tumors of the female genital tract. The effect of UFs on the quality of life and the overall cost of treatment are significant issues worldwide. Tumor size and location are the two specific factors which influence the occurrence of symptoms, the need for, and method of, treatment (some tumors require surgery while some can be treated with selected drugs). Primary prevention and treatment of early UF disease are worthy goals that might have a great impact on health care systems. Several treatments and prophylactic methods can be used in this endeavor. This publication presents current data about lesser-known substances which may have a beneficial effect on the treatment or prophylaxis of UFs and can be administered orally, serving as an alternative to (or complement of) surgery or selective progesterone receptor modulators (SPRMs). Early prevention and treatment of UFs in women from high-risk groups should be our priority. Innovative forms of UF management are under intensive investigation and may be promising options in the near future. Many of them evaluated vitamin D, paricalcitol, epigallocatechin gallate (EGCG), elagolix, aromatase inhibitors (AIs), and cabergoline and deemed them to be safe and effective. The next step in such projects should be properly constructed randomized control trials (RCTs), carried out by successive phases.
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Affiliation(s)
- Michał Ciebiera
- Department of Obstetrics and Gynecology, The Centre of Postgraduate Medical Education, 00-416 Warsaw, Poland.
| | - Krzysztof Łukaszuk
- Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdansk, 80-210 Gdansk, Poland.
- INVICTA Fertility and Reproductive Center, 80-172 Gdansk, Poland.
| | - Błażej Męczekalski
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-513 Poznan, Poland.
| | - Magdalena Ciebiera
- Students' Scientific Association at the I Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland.
| | - Cezary Wojtyła
- Department of Obstetrics and Gynecology, The Centre of Postgraduate Medical Education, 00-416 Warsaw, Poland.
| | - Aneta Słabuszewska-Jóźwiak
- Department of Obstetrics and Gynecology, The Centre of Postgraduate Medical Education, 00-416 Warsaw, Poland.
| | - Grzegorz Jakiel
- Department of Obstetrics and Gynecology, The Centre of Postgraduate Medical Education, 00-416 Warsaw, Poland.
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Podfigurna A, Lukaszuk K, Czyzyk A, Kunicki M, Maciejewska-Jeske M, Jakiel G, Meczekalski B. Testing ovarian reserve in pre-menopausal women: why, whom and how? Maturitas 2017; 109:112-117. [PMID: 29292013 DOI: 10.1016/j.maturitas.2017.11.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 11/08/2017] [Accepted: 11/20/2017] [Indexed: 11/30/2022]
Abstract
Numerous social and environmental factors (environmental hazards, social factors such as education and career, higher economic status desired before the decision is made to have children) influence a women's decision to postpone pregnancy until late reproductive age. In turn, age is related to a fall in ovarian reserve. The main goal of testing ovarian reserve is the identification of women with so-called diminished ovarian reserve (DOR). Additionally, it provides assistance in the counselling of women who are planning to use assisted reproductive techniques (ART). This review examines current methods of testing ovarian reserve and their application. The most useful methods of assessing ovarian reserve are ultrasonographic count of ovarian antral follicles (AFC) and serum tests of both the anti-Müllerian hormone (AMH) level and the third-day level of follicle stimulating hormone (FSH). However, there are limitations to the currently used methods of testing ovarian reserve, especially in relation to their specificity and sensitivity. It is also difficult to predict egg quality based on these tests. The value of screening programmes of ovarian reserve is yet to be determined.
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Affiliation(s)
- Agnieszka Podfigurna
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
| | - Krzysztof Lukaszuk
- INVICTA Fertility and Reproductive Center, Gdańsk, Poland; INVICTA Fertility and Reproductive Center, Warsaw, Poland; Department of Gynecological Endocrinology, Medical University of Warsaw, Warsaw, Poland; Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdansk, Gdańsk, Poland
| | - Adam Czyzyk
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
| | - Michal Kunicki
- INVICTA Fertility and Reproductive Center, Warsaw, Poland
| | | | - Grzegorz Jakiel
- INVICTA Fertility and Reproductive Center, Warsaw, Poland; Department of Obstetrics and Gynecology, Center of Postgraduate Education, Warsaw, Poland
| | - Blazej Meczekalski
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland.
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Ciebiera M, Włodarczyk M, Wrzosek M, Męczekalski B, Nowicka G, Łukaszuk K, Ciebiera M, Słabuszewska-Jóźwiak A, Jakiel G. Role of Transforming Growth Factor β in Uterine Fibroid Biology. Int J Mol Sci 2017; 18:ijms18112435. [PMID: 29149020 PMCID: PMC5713402 DOI: 10.3390/ijms18112435] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 11/08/2017] [Accepted: 11/14/2017] [Indexed: 01/09/2023] Open
Abstract
Uterine fibroids (UFs) are benign tumors of the female genital tract made of the smooth muscle of the uterus. UF growth depends mostly on the influence of the steroid hormones and selected growth factors. Transforming growth factor β (TGF-βs) is a polypeptide that consists of three isoforms: TGF-β1, TGF-β2, and TGF-β3. At present, TGF-β is considered to be one of the key factors in the pathophysiology of UFs. It plays a major role in cellular migration within the tumor, stimulates tumor growth, and enhances tumor metabolism. As a consequence of various dependencies, the synthesis and release of TGF-β in a UF tumor is increased, which results in excessive extracellular matrix production and storage. High concentrations or overexpression of TGF-β mediators may be responsible for clinically symptomatic UFs. The aim of this review was to check the available evidence for the influence of the TGF-β family on UF biology. We conducted their search in PubMed of the National Library of Medicine with the use of the following selected keywords: “uterine fibroid”, “leiomyoma”, and “transforming growth factor β”. After reviewing the titles and abstracts, more than 115 full articles were evaluated. We focused on the TGF-β-related molecular aspects and their influence on the most common symptoms that are associated with UFs. Also, we described how the available data might implicate the current medical management of UFs.
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Affiliation(s)
- Michał Ciebiera
- First Department of Obstetrics and Gynecology, The Centre of Postgraduate Medical Education, 00-416 Warsaw, Poland.
| | - Marta Włodarczyk
- Department of Biochemistry and Clinical Chemistry, Department of Pharmacogenomics, Medical University of Warsaw, 02-097 Warsaw, Poland.
| | - Małgorzata Wrzosek
- Department of Biochemistry and Clinical Chemistry, Department of Pharmacogenomics, Medical University of Warsaw, 02-097 Warsaw, Poland.
| | - Błażej Męczekalski
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-513 Poznan, Poland.
| | - Grażyna Nowicka
- Department of Biochemistry and Clinical Chemistry, Department of Pharmacogenomics, Medical University of Warsaw, 02-097 Warsaw, Poland.
| | - Krzysztof Łukaszuk
- Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdansk, 80-210 Gdansk, Poland.
- INVICTA Fertility and Reproductive Center, 80-172 Gdansk, Poland.
| | - Magdalena Ciebiera
- Students' Scientific Association at the I Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland.
| | - Aneta Słabuszewska-Jóźwiak
- First Department of Obstetrics and Gynecology, The Centre of Postgraduate Medical Education, 00-416 Warsaw, Poland.
| | - Grzegorz Jakiel
- First Department of Obstetrics and Gynecology, The Centre of Postgraduate Medical Education, 00-416 Warsaw, Poland.
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Massalska D, Bijok J, Ilnicka A, Jakiel G, Roszkowski T. Triploidy - variability of sonographic phenotypes. Prenat Diagn 2017; 37:774-780. [DOI: 10.1002/pd.5080] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/23/2017] [Accepted: 05/25/2017] [Indexed: 01/28/2023]
Affiliation(s)
- Diana Massalska
- I Department of Obstetrics and Gynecology; Centre of Postgraduate Medical Education; Warsaw Poland
| | - Julia Bijok
- I Department of Obstetrics and Gynecology; Centre of Postgraduate Medical Education; Warsaw Poland
| | - Alicja Ilnicka
- Department of Genetics; Institute of Psychiatry and Neurology; Warsaw Poland
| | - Grzegorz Jakiel
- I Department of Obstetrics and Gynecology; Centre of Postgraduate Medical Education; Warsaw Poland
| | - Tomasz Roszkowski
- I Department of Obstetrics and Gynecology; Centre of Postgraduate Medical Education; Warsaw Poland
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Jędrzejczak J, Bomba-Opoń D, Jakiel G, Kwaśniewska A, Mirowska-Guzel D. Managing epilepsy in women of childbearing age - Polish Society of Epileptology and Polish Gynecological Society Guidelines. Ginekol Pol 2017; 88:278-284. [PMID: 28580576 DOI: 10.5603/gp.a2017.0053] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 05/31/2017] [Indexed: 11/25/2022] Open
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Zaręba K, Ciebiera M, Bińkowska M, Jakiel G. Moral dilemmas of women undergoing pregnancy termination for medical reasons in Poland. EUR J CONTRACEP REPR 2017; 22:305-309. [DOI: 10.1080/13625187.2017.1326095] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Kornelia Zaręba
- I Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Michał Ciebiera
- I Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Małgorzata Bińkowska
- I Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Grzegorz Jakiel
- I Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Warsaw, Poland
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Kucińska-Chahwan A, Bijok J, Dąbkowska S, Jóźwiak A, Ilnicka A, Nowakowska B, Jakiel G, Roszkowski T. Targeted prenatal diagnosis of Pallister-Killian syndrome. Prenat Diagn 2017; 37:446-452. [PMID: 28233318 DOI: 10.1002/pd.5030] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 01/25/2017] [Accepted: 02/19/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To present five new cases of prenatally diagnosed Pallister-Killian syndrome (PKS) and to propose an approach for a targeted diagnosis. METHOD We retrospectively analyzed ultrasound findings and cytogenetic results in PKS. We also searched through dysmorphology databases for features occurring in PKS that could potentially be seen in prenatal ultrasound examination. RESULTS On the basis of collected data, frequent and distinctive features in fetuses with PKS were established. The most appropriate material and method of testing were proposed. Rhizomelic limb shortening, diaphragmatic hernia, thickened nuchal fold, increased prenasal thickness, polydactyly and polyhydramnios were frequent and distinctive findings in fetuses with PKS. Amniocentesis was the most frequent prenatal procedure for material collection. Percentage of aneuploid cells was higher in amniotic fluid than in cord blood. Cytomolecular tests were useful as confirmation as well as preliminary tests. Cytogenetic identification of the isochromosome was done in all cases except one. CONCLUSIONS In case of ultrasound evaluation of features frequent and distinctive for PKS in second and third trimesters of pregnancy, targeted diagnosis should be considered. Amniotic fluid instead of cord blood collection is preferable. Communication with the laboratory is important because modification of routine procedures enhances a chance for correct diagnosis. © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Anna Kucińska-Chahwan
- I Clinic of Obstetrics and Gynecology, Professor Witold Orłowski Independent Public Clinical Hospital - Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Julia Bijok
- I Clinic of Obstetrics and Gynecology, Professor Witold Orłowski Independent Public Clinical Hospital - Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Sylwia Dąbkowska
- I Clinic of Obstetrics and Gynecology, Professor Witold Orłowski Independent Public Clinical Hospital - Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Anna Jóźwiak
- Department of Genetics, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Alicja Ilnicka
- Department of Genetics, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Beata Nowakowska
- Department of Medical Genetics, Institute of Mother and Child, Warsaw, Poland
| | - Grzegorz Jakiel
- I Clinic of Obstetrics and Gynecology, Professor Witold Orłowski Independent Public Clinical Hospital - Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Tomasz Roszkowski
- I Clinic of Obstetrics and Gynecology, Professor Witold Orłowski Independent Public Clinical Hospital - Centre of Postgraduate Medical Education, Warsaw, Poland
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Bijok J, Warakomska M, Massalska D, Słomska S, Roszkowski T, Jakiel G, Wilińska M. Foeto-maternal haemorrhage: An unexpected challenge. J OBSTET GYNAECOL 2017; 37:818-820. [PMID: 28325083 DOI: 10.1080/01443615.2017.1289159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Julia Bijok
- a Department of Obstetrics and Gynecology , Orlowski Public Teaching Hospital , Warsaw , Poland.,c Centre for Postgraduate Medical Education , Warsaw , Poland
| | | | - Diana Massalska
- a Department of Obstetrics and Gynecology , Orlowski Public Teaching Hospital , Warsaw , Poland.,c Centre for Postgraduate Medical Education , Warsaw , Poland
| | - Sylwia Słomska
- a Department of Obstetrics and Gynecology , Orlowski Public Teaching Hospital , Warsaw , Poland
| | - Tomasz Roszkowski
- a Department of Obstetrics and Gynecology , Orlowski Public Teaching Hospital , Warsaw , Poland.,c Centre for Postgraduate Medical Education , Warsaw , Poland
| | - Grzegorz Jakiel
- a Department of Obstetrics and Gynecology , Orlowski Public Teaching Hospital , Warsaw , Poland.,c Centre for Postgraduate Medical Education , Warsaw , Poland
| | - Maria Wilińska
- b Department of Neonatology , Orlowski Public Teaching Hospital , Warsaw , Poland.,c Centre for Postgraduate Medical Education , Warsaw , Poland
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