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Zyguła A, Sankiewicz A, Sakowicz A, Dobrzyńska E, Dakowicz A, Mańka G, Kiecka M, Spaczynski R, Piekarski P, Banaszewska B, Jakimiuk A, Issat T, Rokita W, Młodawski J, Szubert M, Sieroszewski P, Raba G, Szczupak K, Kluza T, Kluza M, Pierzyński P, Wojtyla C, Lipa M, Warzecha D, Wielgos M, Cendrowski K, Gorodkiewicz E, Laudanski P. Is the leptin/BMI ratio a reliable biomarker for endometriosis? Front Endocrinol (Lausanne) 2024; 15:1359182. [PMID: 38567305 PMCID: PMC10985179 DOI: 10.3389/fendo.2024.1359182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Background The aim of this study was to analyze the concentration of leptin in peritoneal fluid and plasma and to assess their role as potential biomarkers in the diagnosis of endometriosis. Materials & methods Leptin adjusted for BMI (leptin/BMI ratio) was measured using surface plasmon resonance imaging (SPRI) biosensors. Patients with suspected endometriosis were included in the study. Plasma was collected from 70 cases, and peritoneal fluid from 67 cases. Based on the presence of endometriosis lesions detected during laparoscopy, patients were divided into a study group and a control group (patients without endometriosis). Results Leptin/BMI ratio in plasma did not differ between women with endometriosis and the control group (0.7159 ± 0.259 vs 0.6992 ± 0.273, p= 0,7988). No significant differences were observed in peritoneal leptin/BMI ratio levels in patients with and without endometriosis (0.6206 ± 0.258 vs 0.6215 ± 0.264, p= 0,9896). Plasma and peritoneal leptin/BMI ratios were significantly lower in women with endometriosis - related primary infertility compared to women with endometriosis without primary infertility (0.640 ± 0.502 vs 0.878 ± 0.623, p < 0.05). The difference was observed in case of primary infertility, but not in terms of the secondary one. No significant differences were noted between leptin/BMI ratio in the proliferative phase and the secretory phase (0.716 ± 0.252 vs 0.697 ± 0.288, p= 0,7785). Conclusion The results of present study do not support the relevance of leptin concentration determination as a biomarker of the endometriosis. Due to the limited number of samples in the tested group, further studies are needed to confirm its role.
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Affiliation(s)
| | - Anna Sankiewicz
- Bioanalysis Laboratory, Faculty of Chemistry, University of Bialystok, Bialystok, Poland
| | - Agata Sakowicz
- Department of Medical Biotechnology, Medical University of Lodz, Lodz, Poland
| | - Ewa Dobrzyńska
- Chair and Department of Obstetrics, Gynecology and Gynecological Oncology, Medical University of Warsaw, Warsaw, Poland
| | - Agnieszka Dakowicz
- Department of Rehabilitation, Medical University of Bialystok, Bialystok, Poland
| | | | | | - Robert Spaczynski
- Center for Gynecology, Obstetrics and Infertility Treatment Pastelova, Poznan, Poland
- Collegium Medicum, University of Zielona Gora, Zielona Gora, Poland
| | - Piotr Piekarski
- Gynecological Obstetric Clinical Hospital of Poznan University of Medical Sciences, Minimally Invasive Gynecological Surgery, Poznan, Poland
| | - Beata Banaszewska
- Chair and Department of Laboratory Diagnostics, Poznan University of Medical Sciences, Poznan, Poland
| | - Artur Jakimiuk
- Department of Reproductive Health, Institute of Mother and Child in Warsaw, Warsaw, Poland
- Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of Interior, Warsaw, Poland
| | - Tadeusz Issat
- Department of Obstetrics and Gynecology, Institute of Mother and Child in Warsaw, Warsaw, Poland
| | - Wojciech Rokita
- Collegium Medicum, Jan Kochanowski University in Kielce, Kielce, Poland
- Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, Kielce, Poland
| | - Jakub Młodawski
- Collegium Medicum, Jan Kochanowski University in Kielce, Kielce, Poland
- Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, Kielce, Poland
| | - Maria Szubert
- Department of Gynecology and Obstetrics, Medical University of Lodz, Lodz, Poland
- Department of Surgical Gynecology and Oncology, Medical University of Lodz, Lodz, Poland
| | - Piotr Sieroszewski
- Department of Gynecology and Obstetrics, Medical University of Lodz, Lodz, Poland
- Department of Fetal Medicine and Gynecology, Medical University of Lodz, Lodz, Poland
| | - Grzegorz Raba
- Clinic of Obstetric and Gynecology in Przemysl, Przemysl, Poland
- Medical College of Rzeszow University, Rzeszow, Poland
| | - Kamil Szczupak
- Clinic of Obstetric and Gynecology in Przemysl, Przemysl, Poland
- Medical College of Rzeszow University, Rzeszow, Poland
| | - Tomasz Kluza
- Department of Gynecology, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | - Marek Kluza
- Department of Gynecology, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | | | - Cezary Wojtyla
- OVIklinika Infertility Center, Warsaw, Poland
- Women’s Health Research Institute, Calisia University, Kalisz, Poland
| | - Michal Lipa
- Departament of Obstetrics and Perinatology National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
| | - Damian Warzecha
- OVIklinika Infertility Center, Warsaw, Poland
- City South Hospital, Warsaw, Warsaw, Poland
- Department of Biomedical Fundamentals of Development and Sexology, Faculty of Education, University of Warsaw, Warsaw, Poland
| | - Miroslaw Wielgos
- Departament of Obstetrics and Perinatology National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland
- Premium Medical Clinic, Warsaw, Poland
- Medical Faculty, Lazarski University, Warsaw, Poland
| | - Krzysztof Cendrowski
- Chair and Department of Obstetrics, Gynecology and Gynecological Oncology, Medical University of Warsaw, Warsaw, Poland
| | - Ewa Gorodkiewicz
- Bioanalysis Laboratory, Faculty of Chemistry, University of Bialystok, Bialystok, Poland
| | - Piotr Laudanski
- OVIklinika Infertility Center, Warsaw, Poland
- Chair and Department of Obstetrics, Gynecology and Gynecological Oncology, Medical University of Warsaw, Warsaw, Poland
- Women’s Health Research Institute, Calisia University, Kalisz, Poland
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Wolder D, Swat A, Wolak P, Zmelonek-Znamirowska A, Białek K, Rokita W, Kaczmarek P, Świercz G. Enhanced Diagnostic Capabilities: Ultrasound Imaging of Fetal Alimentary Tract Obstruction with Advanced Imaging Technologies. Am J Case Rep 2024; 25:e943419. [PMID: 38444155 DOI: 10.12659/ajcr.943419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
BACKGROUND Congenital malformations of the alimentary tract constitute 5% to 6% of newborn anomalies, with congenital intestinal atresia being a common cause of alimentary tract obstruction. This study explores advanced ultrasound diagnostic possibilities, including 2D, HDlive, HDlive inversion, and HDlive silhouette imaging modes, through the analysis of 3 cases involving duodenal and intestinal obstructions. Congenital malformations of the alimentary tract often present challenges in prenatal diagnosis. The most prevalent defect is congenital intestinal atresia leading to alimentary tract obstruction, with an incidence of approximately 6 in 10 000 births. We focused on advanced ultrasound diagnostic techniques and their applications in 3 cases of duodenal and intestinal obstructions. CASE REPORT Three cases were examined using advanced ultrasound imaging modes. The first patient, diagnosed at week 35 of gestation, revealed stomach and duodenal dilatation. The second, identified at week 32, had the characteristic "double bubble" symptom. The third, at week 31, also had double bubble symptom and underwent repeated amnioreduction procedures. HDlive, HDlive inversion, and HDlive silhouette modes provided intricate visualizations of the affected organs. Prenatal diagnosis of alimentary tract obstruction relies on ultrasound examinations, with nearly 50% of cases being diagnosed before birth. CONCLUSIONS Advanced ultrasound imaging modes, particularly HDlive silhouette, play a crucial role in diagnosing fetal alimentary tract obstruction. These modes offer detailed visualizations and dynamic evaluations, providing essential insights for therapeutic decisions. The study emphasizes the importance of sustained fetal surveillance, a multidisciplinary approach, and delivery in a level III referral center to ensure specialized care for optimal outcomes.
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Affiliation(s)
- Daniel Wolder
- Department of Obstetrics and Gynecology, Jan Kochanowski University of Kielce, Kielce, Poland
| | - Adrian Swat
- Department of Obstetrics and Gynecology, Regional Hospital in Kielce, Kielce, Poland
| | - Przemysław Wolak
- Department of Obstetrics and Gynecology, Jan Kochanowski University of Kielce, Kielce, Poland
| | | | - Katarzyna Białek
- Department of Obstetrics and Gynecology, Medical University of Łódź, Łódź, Poland
| | - Wojciech Rokita
- Department of Obstetrics and Gynecology, Jan Kochanowski University of Kielce, Kielce, Poland
| | - Piotr Kaczmarek
- Department of Obstetrics and Gynecology, Medical University of Łódź, Łódź, Poland
| | - Grzegorz Świercz
- Department of Obstetrics and Gynecology, Regional Hospital in Kielce, Kielce, Poland
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3
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Wróbel M, Zuzanna Z, Ołdak Ł, Kalicka A, Mańka G, Kiecka M, Spaczyński RZ, Piekarski P, Banaszewska B, Jakimiuk A, Issat T, Rokita W, Młodawski J, Szubert M, Sieroszewski P, Raba G, Szczupak K, Kluz T, Kluza M, Pierzyński P, Wojtyła C, Lipa M, Warzecha D, Wielgoś M, Sawicki W, Gorodkiewicz E, Laudański P. Evaluation of Proteasome and Immunoproteasome Levels in Plasma and Peritoneal Fluid in Patients with Endometriosis. Int J Mol Sci 2023; 24:14363. [PMID: 37762666 PMCID: PMC10532336 DOI: 10.3390/ijms241814363] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/07/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Endometriosis is a chronic disease in which the endometrium cells are located outside the uterine cavity. The aim of this study was to evaluate circulating 20S proteasome and 20S immunoproteasome levels in plasma and peritoneal fluid in women with and without endometriosis in order to assess their usefulness as biomarkers of disease. Concentrations were measured using surface plasmon resonance imaging biosensors. Patients with suspected endometriosis were included in the study-plasma was collected in 112 cases and peritoneal fluid in 75. Based on the presence of endometriosis lesions detected during laparoscopy, patients were divided into a study group (confirmed endometriosis) and a control group (patients without endometriosis). Proteasome and immunoproteasome levels in both the plasma (p = 0.174; p = 0.696, respectively) and the peritoneal fluid (p = 0.909; p = 0.284, respectively) did not differ between those groups. There was a statistically significant difference in the plasma proteasome levels between patients in the control group and those with mild (Stage I and II) endometriosis (p = 0.047) and in the plasma immunoproteasome levels in patients with ovarian cysts compared to those without (p = 0.017). The results of our study do not support the relevance of proteasome and immunoproteasome determination as biomarkers of the disease but suggest a potentially active role in the pathogenesis of endometriosis.
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Affiliation(s)
- Monika Wróbel
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland
| | - Zielińska Zuzanna
- Bioanalysis Laboratory, Doctoral School of Exact and Natural Science, Faculty of Chemistry, University of Bialystok, Ciolkowskiego 1K, 15-245 Bialystok, Poland; (Z.Z.); (Ł.O.)
| | - Łukasz Ołdak
- Bioanalysis Laboratory, Doctoral School of Exact and Natural Science, Faculty of Chemistry, University of Bialystok, Ciolkowskiego 1K, 15-245 Bialystok, Poland; (Z.Z.); (Ł.O.)
- Bioanalysis Laboratory, Faculty of Chemistry, University of Bialystok, Ciolkowskiego 1K, 15-245 Bialystok, Poland;
| | - Aleksandra Kalicka
- Faculty of Medicine, Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland;
| | - Grzegorz Mańka
- Angelius Provita Hospital, 40-611 Katowice, Poland; (G.M.); (M.K.)
| | - Mariusz Kiecka
- Angelius Provita Hospital, 40-611 Katowice, Poland; (G.M.); (M.K.)
| | - Robert Z. Spaczyński
- Center for Gynecology, Obstetrics and Infertility Treatment Pastelova, 60-198 Poznan, Poland;
| | - Piotr Piekarski
- Division of Infertility and Reproductive Endocrinology, Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
| | - Beata Banaszewska
- Chair and Department of Laboratory Diagnostics, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
| | - Artur Jakimiuk
- Department of Reproductive Health, Institute of Mother and Child in Warsaw, 01-211 Warsaw, Poland;
- Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of Interior, 02-507 Warsaw, Poland
| | - Tadeusz Issat
- Department of Obstetrics and Gynecology, Institute of Mother and Child in Warsaw, 01-211 Warsaw, Poland;
| | - Wojciech Rokita
- Collegium Medicum, Jan Kochanowski University in Kielce, 25-516 Kielce, Poland (J.M.)
- Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, 25-736 Kielce, Poland
| | - Jakub Młodawski
- Collegium Medicum, Jan Kochanowski University in Kielce, 25-516 Kielce, Poland (J.M.)
- Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, 25-736 Kielce, Poland
| | - Maria Szubert
- Department of Gynecology and Obstetrics, Medical University of Lodz, 90-419 Lodz, Poland; (M.S.); (P.S.)
- Department of Surgical Gynecology and Oncology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Piotr Sieroszewski
- Department of Gynecology and Obstetrics, Medical University of Lodz, 90-419 Lodz, Poland; (M.S.); (P.S.)
- Department of Fetal Medicine and Gynecology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Grzegorz Raba
- Clinic of Obstetric and Gynecology in Przemysl, 37-700 Przemysl, Poland; (G.R.); (K.S.)
- Department of Obstetrics and Gynecology, University of Rzeszow, 35-310 Rzeszow, Poland
| | - Kamil Szczupak
- Clinic of Obstetric and Gynecology in Przemysl, 37-700 Przemysl, Poland; (G.R.); (K.S.)
- Department of Obstetrics and Gynecology, University of Rzeszow, 35-310 Rzeszow, Poland
| | - Tomasz Kluz
- Department of Gynecology, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland; (T.K.); (M.K.)
| | - Marek Kluza
- Department of Gynecology, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland; (T.K.); (M.K.)
| | - Piotr Pierzyński
- OVIklinika Infertility Center, 31 Połczyńska Street, 01-377 Warsaw, Poland; (P.P.); (D.W.)
| | - Cezary Wojtyła
- OVIklinika Infertility Center, 31 Połczyńska Street, 01-377 Warsaw, Poland; (P.P.); (D.W.)
| | - Michał Lipa
- City South Hospital Warsaw, 02-781 Warsaw, Poland;
| | - Damian Warzecha
- OVIklinika Infertility Center, 31 Połczyńska Street, 01-377 Warsaw, Poland; (P.P.); (D.W.)
- City South Hospital Warsaw, 02-781 Warsaw, Poland;
| | - Mirosław Wielgoś
- Premium Medical Clinic, 04-359 Warsaw, Poland;
- Medical Faculty, Lazarski University, 02-662 Warsaw, Poland
| | - Włodzimierz Sawicki
- Department of Obstetrics, Gynecology and Gynecological Oncology, Medical University of Warsaw, 03-242 Warsaw, Poland;
| | - Ewa Gorodkiewicz
- Bioanalysis Laboratory, Faculty of Chemistry, University of Bialystok, Ciolkowskiego 1K, 15-245 Bialystok, Poland;
| | - Piotr Laudański
- OVIklinika Infertility Center, 31 Połczyńska Street, 01-377 Warsaw, Poland; (P.P.); (D.W.)
- Department of Obstetrics, Gynecology and Gynecological Oncology, Medical University of Warsaw, 03-242 Warsaw, Poland;
- Women’s Health Research Institute, Calisia University, 62-800 Kalisz, Poland
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Lisowska-Myjak B, Skarżyńska E, Wróbel M, Mańka G, Kiecka M, Lipa M, Warzecha D, Spaczyński R, Piekarski P, Banaszewska B, Jakimiuk A, Issat T, Rokita W, Młodawski J, Szubert M, Sieroszewski P, Raba G, Szczupak K, Kluz T, Kluza M, Wielgoś M, Laudański P. Investigation of the Changes in Concentrations of Vitamin D-Binding Protein and Lactoferin in Plasma and Peritoneal Fluid of Patients with Endometriosis. Int J Mol Sci 2023; 24:ijms24097828. [PMID: 37175534 PMCID: PMC10178223 DOI: 10.3390/ijms24097828] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 05/15/2023] Open
Abstract
An evaluation of the association between the concentrations of vitamin D-binding protein and lactoferrin in the plasma and peritoneal fluid may facilitate the elucidation of molecular mechanisms in endometriosis. Vitamin D-binding protein and lactoferrin concentrations were measured by ELISA in plasma and peritoneal fluid samples from 95 women with suspected endometriosis as classified by laparoscopy into groups with (n = 59) and without endometriosis (n = 36). There were no differences (p > 0.05) in the plasma and peritoneal fluid concentrations of vitamin D-binding protein and lactoferrin between women with and without endometriosis. In women with endometriosis, there was a significant correlation between plasma and peritoneal fluid vitamin D-binding protein concentrations (r = 0.821; p = 0.000), but there was no correlation between lactoferrin concentrations in those compartments (r = 0.049; p > 0.05). Furthermore, in endometriosis, lactoferrin was found to correlate poorly with vitamin D-binding protein (r= -0.236; p > 0.05) in plasma, while in the peritoneal fluid, the correlation between those proteins was significant (r = 0.399; p = 0.002). The characteristic properties of vitamin D-binding protein and lactoferrin and the associations between their plasma and peritoneal fluid concentrations found in women with endometriosis may provide a novel panel of markers to identify high-risk patients in need of further diagnostic measures.
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Affiliation(s)
- Barbara Lisowska-Myjak
- Department of Biochemistry and Phatmacogenomics, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Ewa Skarżyńska
- Department of Laboratory Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Monika Wróbel
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland
| | | | | | - Michał Lipa
- City South Hospital Warsaw, 02-781 Warsaw, Poland
| | - Damian Warzecha
- City South Hospital Warsaw, 02-781 Warsaw, Poland
- OVIklinika Infertility Center, 01-377 Warsaw, Poland
| | - Robert Spaczyński
- Center for Gynecology, Obstetrics and Infertility Treatment Pastelova, 60-198 Poznan, Poland
| | - Piotr Piekarski
- Division of Infertility and Reproductive Endocrinology, Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Beata Banaszewska
- Chair and Department of Laboratory Diagnostics, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Artur Jakimiuk
- Department of Reproductive Health, Insitute of Mother and Child in Warsaw, 01-211 Warsaw, Poland
- Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of Interior, 02-507 Warsaw, Poland
| | - Tadeusz Issat
- Department of Obstetrics and Gynecology, Insitute of Mother and Child in Warsaw, 01-211 Warsaw, Poland
| | - Wojciech Rokita
- Collegium Medicum, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland
- Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, 25-736 Kielce, Poland
| | - Jakub Młodawski
- Collegium Medicum, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland
- Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, 25-736 Kielce, Poland
| | - Maria Szubert
- Department of Gynecology and Obstetrics, Medical University of Lodz, 90-419 Lodz, Poland
- Department of Surgical Gynecology and Oncology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Piotr Sieroszewski
- Department of Gynecology and Obstetrics, Medical University of Lodz, 90-419 Lodz, Poland
- Department of Fetal Medicine and Gynecology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Grzegorz Raba
- Clinic of Obstetric and Gynecology in Przemysl, 37-700 Przemysl, Poland
- Department of Obstetrics and Gynecology, University of Rzeszow, 35-310 Rzeszow, Poland
| | - Kamil Szczupak
- Clinic of Obstetric and Gynecology in Przemysl, 37-700 Przemysl, Poland
- Department of Obstetrics and Gynecology, University of Rzeszow, 35-310 Rzeszow, Poland
| | - Tomasz Kluz
- Department of Gynecology, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland
| | - Marek Kluza
- Department of Gynecology, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland
| | - Mirosław Wielgoś
- Premium Medical Clinic, 04-359 Warsaw, Poland
- Lazarski University, 02-662 Warsaw, Poland
| | - Piotr Laudański
- OVIklinika Infertility Center, 01-377 Warsaw, Poland
- Department of Obstetrics, Gynecology and Gynecological Oncology, Medical University of Warsaw, 02-091 Warsaw, Poland
- Women's Health Research Institute, Calisia University, 62-800 Kalisz, Poland
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5
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Malmur M, Mlodawski J, Mlodawska M, Misiek M, Adamczyk-Gruszka O, Niziurski P, Gluszek S, Rokita W. Could pelvic floor sonography be a standalone method for excluding genuine stress urinary incontinence in women? Ginekol Pol 2023:VM/OJS/J/68758. [PMID: 36929790 DOI: 10.5603/gp.a2023.0026] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVES Determine whether introital pelvic floor sonography with transvaginal probe (PFS-TV) can be an independent method in the diagnosis of genuine stress urinary incontinence (SUI) and to create a ultrasonographic diagnostic model to objectify diagnostic process. MATERIAL AND METHODS The study involved 315 patients with a history of urinary incontinence problems. Based on the clinical examination and urodynamic examination, the final diagnosis was made. Patients were divided into two groups. Group I included women with SUI and Group II included patients without SUI (OAB and no-UI). Each patient underwent PFS-TV at rest and during straining. The groups were compared in terms of ultrasound parameters. RESULTS Patients from both groups differed statistically in a significant way (p < 0.05) in terms of mean distance between the lower edge of the pubic symphysis at rest 19 mm vs 22 mm (Group I vs Group II) and during straining (D1 and D2) 22 mm vs 26 mm, the average value of the γ angle (at rest (γ1) 37.5° vs 40° and during straining (γ2) and 66° vs 58.5°, average difference value of angle γ during straining and at rest (γ2-γ1) 29° vs 14°, and frequency of urethral funneling 89% vs 17%. Two parameters studied during PFS-TV were included in the logistic regression model used to exclude the stress component of urinary incontinence. Diagnostic test parameters of model were sensitivity 86.6%, specificity 90.4%, accuracy 93.1%. CONCLUSIONS PFS-TV makes it possible to exclude the stress component of urinary incontinence. The developed logistic regression model allows for the objectification of the results of ultrasound examination in patients with urinary incontinence.
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Affiliation(s)
- Mariusz Malmur
- Clinic of Obstetrics and Gynaecology, Provincial Combined Hospital in Kielce, Poland
| | - Jakub Mlodawski
- Collegium Medicum, Jan Kochanowski Univeristy, Kielce, Poland. .,Clinic of Obstetrics and Gynaecology, Provincial Combined Hospital in Kielce, Poland.
| | - Marta Mlodawska
- Collegium Medicum, Jan Kochanowski Univeristy, Kielce, Poland
| | - Marcin Misiek
- Department of Gynecologic Oncology, Holycross Cancer Center, Kielce, Poland, Poland
| | - Olga Adamczyk-Gruszka
- Collegium Medicum, Jan Kochanowski Univeristy, Kielce, Poland.,Clinic of Obstetrics and Gynaecology, Provincial Combined Hospital in Kielce, Poland
| | - Piotr Niziurski
- Collegium Medicum, Jan Kochanowski Univeristy, Kielce, Poland.,Clinic of Obstetrics and Gynaecology, Provincial Combined Hospital in Kielce, Poland
| | | | - Wojciech Rokita
- Collegium Medicum, Jan Kochanowski Univeristy, Kielce, Poland.,Clinic of Obstetrics and Gynaecology, Provincial Combined Hospital in Kielce, Poland
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6
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Laudański P, Rogalska G, Warzecha D, Lipa M, Mańka G, Kiecka M, Spaczyński R, Piekarski P, Banaszewska B, Jakimiuk A, Issat T, Rokita W, Młodawski J, Szubert M, Sieroszewski P, Raba G, Szczupak K, Kluz T, Kluza M, Neuman T, Adler P, Peterson H, Salumets A, Wielgos M. Autoantibody screening of plasma and peritoneal fluid of patients with endometriosis. Hum Reprod 2023; 38:629-643. [PMID: 36749097 DOI: 10.1093/humrep/dead011] [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: 02/13/2022] [Revised: 11/26/2022] [Indexed: 02/08/2023] Open
Abstract
STUDY QUESTION Are there specific autoantibody profiles in patients with endometriosis that are different from those in controls? SUMMARY ANSWER This study did not reveal a significantly higher prevalence of autoantibodies in the studied groups of patients. WHAT IS KNOWN ALREADY Various inflammatory factors are postulated to be involved in the pathomechanisms of endometriosis, and a potential link exists with autoimmune diseases, which may also play an important role. As the diagnosis of endometriosis remains invasive, it can only be confirmed using laparoscopy with histopathological examination of tissues. Numerous studies have focused on identifying useful biomarkers to confirm the disease, but without unequivocal effects. Autoantibodies are promising molecules that serve as potential prognostic factors. STUDY DESIGN, SIZE, DURATION A multicentre, cross-sectional study was conducted over 18 months (between 2018 and 2019), at eight Departments of Obstetrics and Gynaecology in several cities across Poland on 137 patients undergoing laparoscopic examination for the diagnosis of endometriosis. PARTICIPANTS/MATERIALS, SETTINGS, METHODS During laparoscopy, we obtained plasma samples from 137 patients and peritoneal fluid (PF) samples from 98 patients. Patients with autoimmune diseases were excluded from the study. Autoantibody profiling was performed using HuProt v3.1 human proteome microarrays. MAIN RESULTS AND THE ROLE OF CHANCE We observed no significant differences in the expression of autoantibodies in the plasma or PF between the endometriosis and control groups. The study revealed that in the PF of women with Stage II endometriosis, compared with other stages, there were significantly higher reactivity signals for ANAPC15 and GABPB1 (adj. P < 0.016 and adj. P < 0.026, respectively; logFC > 1 in both cases). Comparison of the luteal and follicular phases in endometriosis patients revealed that levels of NEIL1 (adj. P < 0.029), MAGEB4 (adj. P < 0.029), and TNIP2 (adj. P < 0.042) autoantibody signals were significantly higher in the luteal phase than in the follicular phase in PF samples of patients with endometriosis. No differences were observed between the two phases of the cycle in plasma or between women with endometriosis and controls. Clustering of PF and plasma samples did not reveal unique autoantibody profiles for endometriosis; however, comparison of PF and plasma in the same patient showed a high degree of concordance. LIMITATIONS, REASONS FOR CAUTION Although this study was performed using the highest-throughput protein array available, it does not cover the entire human proteome and cannot be used to study potentially promising post-translational modifications. Autoantibody levels depend on numerous factors, such as infections; therefore the autoantibody tests should be repeated for more objective results. WIDER IMPLICATIONS OF THE FINDINGS Although endometriosis has been linked to different autoimmune diseases, it is unlikely that autoimmune responses mediated by specific autoantibodies play a pivotal role in the pathogenesis of this inflammatory disease. Our study shows that in searching for biomarkers of endometriosis, it may be more efficient to use higher-throughput proteomic microarrays, which may allow the detection of potentially new biomarkers. Only research on such a scale, and possibly with different technologies, can help discover biomarkers that will change the method of endometriosis diagnosis. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by a grant from the Polish Ministry of Health (grant no. 6/6/4/1/NPZ/2017/1210/1352). It was also funded by the Estonian Research Council (grant PRG1076) and the Horizon 2020 Innovation Grant (ERIN; grant no. EU952516), Enterprise Estonia (grant no. EU48695), and MSCA-RISE-2020 project TRENDO (grant no. 101008193). The authors declare that there is no conflict of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Piotr Laudański
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.,OVIklinika Infertility Center, Warsaw, Poland.,Women's Health Research Institute, Calisia University, Kalisz, Poland.,Department of Obstetrics, Gynecology and Gynecological Oncology, Medical University of Warsaw, Warsaw, Poland
| | - Gabriela Rogalska
- Clinic of Gynecology, Oncological Gynecology and Obstetrics, Municipal Polyclinical Hospital in Olsztyn, Olsztyn, Poland
| | - Damian Warzecha
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Michał Lipa
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | | | | | - Robert Spaczyński
- Center for Gynecology, Obstetrics and Infertility Treatment Pastelova, Poznan, Poland
| | - Piotr Piekarski
- Division of Infertility and Reproductive Endocrinology, Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Beata Banaszewska
- Chair and Department of Laboratory Diagnostics, Poznan University of Medical Sciences, Poznan, Poland
| | - Artur Jakimiuk
- Department of Obstetrics and Gynecology, Institute of Mother and Child, Warsaw, Poland.,Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of Interior, Warsaw, Poland
| | - Tadeusz Issat
- Department of Obstetrics and Gynecology, Institute of Mother and Child, Warsaw, Poland
| | - Wojciech Rokita
- Collegium Medicum Jan Kochanowski University in Kielce, Kielce, Poland.,Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, Kielce, Poland
| | - Jakub Młodawski
- Collegium Medicum Jan Kochanowski University in Kielce, Kielce, Poland.,Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, Kielce, Poland
| | - Maria Szubert
- Department of Gynecology and Obstetrics Medical, University of Lodz, Lodz, Poland.,Department of Surgical Gynecology and Oncology, Medical University of Lodz, Lodz, Poland
| | - Piotr Sieroszewski
- Department of Gynecology and Obstetrics Medical, University of Lodz, Lodz, Poland.,Department of Fetal Medicine and Gynecology, Medical University of Lodz, Lodz, Poland
| | - Grzegorz Raba
- Clinic of Obstetric and Gynecology in Przemysl, Przemysl, Poland.,University of Rzeszow, Rzeszow, Poland
| | - Kamil Szczupak
- Clinic of Obstetric and Gynecology in Przemysl, Przemysl, Poland.,University of Rzeszow, Rzeszow, Poland
| | - Tomasz Kluz
- Department of Gynecology, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | - Marek Kluza
- Department of Gynecology, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | | | - Priit Adler
- Institute of Computer Science, University of Tartu, Tartu, Estonia
| | - Hedi Peterson
- Institute of Computer Science, University of Tartu, Tartu, Estonia
| | - Andres Salumets
- Competence Centre on Health Technologies, Tartu, Estonia.,Department of Obstetrics and Gynecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia.,Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | - Miroslaw Wielgos
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
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7
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Bartnik P, Kacperczyk-Bartnik J, Goławski K, Sierdziński J, Mańka G, Kiecka M, Lipa M, Warzecha D, Spaczyński R, Piekarski P, Banaszewska B, Jakimiuk AJ, Issat T, Rokita W, Młodawski J, Szubert M, Sieroszewski P, Raba G, Szczupak K, Kluz T, Kluza M, Czajkowski K, Wielgoś M, Koc-Żórawska E, Żórawski M, Laudański P. Plasma and Peritoneal Fluid ZEB Levels in Patients with Endometriosis and Infertility. Biomedicines 2022; 10:biomedicines10102460. [PMID: 36289723 PMCID: PMC9599446 DOI: 10.3390/biomedicines10102460] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 08/14/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/16/2022] Open
Abstract
Zinc finger E-box-binding homeobox 1 (ZEB1) and zinc finger E-box-binding homeobox 2 (ZEB2) are transcription factors that regulate epithelial−mesenchymal transformation (EMT). The aim of this study was to compare levels of ZEB1 and ZEB2 in the peritoneal fluid and plasma between patients with and without endometriosis in order to assess their utility in the diagnostic process. Plasma and peritoneal fluid samples were collected from 50 patients with and 48 without endometriosis during planned surgical procedures in eight clinical centers. Quantitative ZEB1 and ZEB2 levels analyses were performed using a double-antibody sandwich enzyme-linked immunosorbent assay (ELISA). No significant differences were observed in ZEB1 levels in any of the subanalyses nor any differences regarding ZEB2 levels between patients with and without endometriosis. Plasma ZEB2 levels were significantly higher among patients with infertility compared to fertile women (16.07 ± 12.70 ng/L vs. 12.07 ± 11.92 ng/L; p < 0.04). Both ZEB1 and ZEB2 do not seem to have a significant value in the initial diagnosis of endometriosis as a single marker. The differences in ZEB2 plasma levels between patients with and without infertility indicate the possibility of EMT dysregulation in the pathogenesis of adverse fertility outcomes.
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Affiliation(s)
- Paweł Bartnik
- II Department of Obstetrics and Gynecology, Medical University of Warsaw, 00-315 Warsaw, Poland
- Club 35. Polish Society of Gynecologists and Obstetricians, 53-125 Wrocław, Poland
| | - Joanna Kacperczyk-Bartnik
- II Department of Obstetrics and Gynecology, Medical University of Warsaw, 00-315 Warsaw, Poland
- Club 35. Polish Society of Gynecologists and Obstetricians, 53-125 Wrocław, Poland
| | - Ksawery Goławski
- I Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland
| | - Janusz Sierdziński
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, 00-581 Warsaw, Poland
| | | | | | - Michał Lipa
- Club 35. Polish Society of Gynecologists and Obstetricians, 53-125 Wrocław, Poland
- I Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland
| | - Damian Warzecha
- I Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland
| | - Robert Spaczyński
- Division of Infertility and Reproductive Endocrinology, Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Piotr Piekarski
- Division of Infertility and Reproductive Endocrinology, Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Beata Banaszewska
- Chair and Department of Laboratory Diagnostics, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Artur J. Jakimiuk
- Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of Interior, 02-507 Warsaw, Poland
- Center of Reproductive Health, Institute of Mother and Child in Warsaw, 01-211 Warsaw, Poland
| | - Tadeusz Issat
- Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of Interior, 02-507 Warsaw, Poland
- Department of Obstetrics and Gynecology, Institute of Mother and Child in Warsaw, 01-211 Warsaw, Poland
| | - Wojciech Rokita
- Collegium Medicum, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland
- Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, 25-736 Kielce, Poland
| | - Jakub Młodawski
- Collegium Medicum, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland
- Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, 25-736 Kielce, Poland
| | - Maria Szubert
- Club 35. Polish Society of Gynecologists and Obstetricians, 53-125 Wrocław, Poland
- Department of Gynecology and Obstetrics, Medical University of Lodz, 90-419 Lodz, Poland
- Department of Surgical Gynecology and Oncology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Piotr Sieroszewski
- Department of Gynecology and Obstetrics, Medical University of Lodz, 90-419 Lodz, Poland
- Department of Fetal Medicine and Gynecology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Grzegorz Raba
- Clinic of Obstetrics and Gynecology in Przemysl, 37-700 Przemysl, Poland
- Department of Obstetrics and Gynecology, University of Rzeszow, 35-310 Rzeszow, Poland
| | - Kamil Szczupak
- Clinic of Obstetrics and Gynecology in Przemysl, 37-700 Przemysl, Poland
- Department of Obstetrics and Gynecology, University of Rzeszow, 35-310 Rzeszow, Poland
| | - Tomasz Kluz
- Department of Gynecology, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland
| | - Marek Kluza
- Department of Gynecology, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland
| | - Krzysztof Czajkowski
- II Department of Obstetrics and Gynecology, Medical University of Warsaw, 00-315 Warsaw, Poland
| | - Mirosław Wielgoś
- I Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland
| | - Ewa Koc-Żórawska
- II Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Bialystok, 15-089 Białystok, Poland
| | - Marcin Żórawski
- Department of Clinical Medicine, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Piotr Laudański
- I Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland
- OVIklinika Infertility Center, 01-377 Warsaw, Poland
- Correspondence:
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8
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Kacperczyk-Bartnik J, Bartnik P, Goławski K, Sierdziński J, Mańka G, Kiecka M, Lipa M, Warzecha D, Spaczyński R, Piekarski P, Banaszewska B, Jakimiuk A, Issat T, Rokita W, Młodawski J, Szubert M, Sieroszewski P, Raba G, Szczupak K, Kluz T, Kluza M, Czajkowski K, Wielgoś M, Koc-Żórawska E, Żórawski M, Laudański P. Plasma and Peritoneal Poly (ADP-Ribose) Polymerase Levels in Patients with Endometriosis. Biomedicines 2022; 10:biomedicines10102451. [PMID: 36289716 PMCID: PMC9599091 DOI: 10.3390/biomedicines10102451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/15/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022] Open
Abstract
The evidence of poly (ADP-ribose) polymerase (PARP) association with the immune response could be coherent with the immunological theory of endometriosis and suggests the possibility of a new research direction. The aim of the study was to evaluate the levels of PARP in plasma and peritoneal fluid of patients with and without endometriosis. It was a multicenter, cross-sectional study. Plasma and peritoneal fluid samples were collected from patients with and without endometriosis during planned laparoscopic procedures in eight clinical centers. In total, 84 samples of plasma and 84 samples of the peritoneal fluid were included in the final analyses. Double-antibody sandwich enzyme-linked immunosorbent assay was performed in order to assess levels of PARP in collected samples. No statistically significant differences regarding the detected levels of PARP in plasma and peritoneal fluid comparing patients with and without endometriosis were observed. Patients with a history of infertility had significantly higher plasma PARP concentrations (p = 0.04). We have not observed the potential role of PARP concentration levels in plasma nor peritoneal fluid as an endometriosis biomarker. We have determined an association between a higher plasma PARP concentration and a history of infertility.
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Affiliation(s)
- Joanna Kacperczyk-Bartnik
- II Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland
- Club 35, Polish Society of Gynecologists and Obstetricians, 53-125 Wrocław, Poland
| | - Paweł Bartnik
- II Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland
- Club 35, Polish Society of Gynecologists and Obstetricians, 53-125 Wrocław, Poland
| | - Ksawery Goławski
- I Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Janusz Sierdziński
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, 00-581 Warsaw, Poland
| | | | | | - Michał Lipa
- Club 35, Polish Society of Gynecologists and Obstetricians, 53-125 Wrocław, Poland
- I Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Damian Warzecha
- I Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Robert Spaczyński
- Division of Infertility and Reproductive Endocrinology, Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, 60-512 Poznan, Poland
| | - Piotr Piekarski
- Division of Infertility and Reproductive Endocrinology, Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, 60-512 Poznan, Poland
| | - Beata Banaszewska
- Chair and Department of Laboratory Diagnostics, Poznan University of Medical Sciences, 60-512 Poznan, Poland
| | - Artur Jakimiuk
- Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of Interior, 02-507 Warsaw, Poland
- Center of Reproductive Health, Institute of Mother and Child in Warsaw, 01-211 Warsaw, Poland
| | - Tadeusz Issat
- Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of Interior, 02-507 Warsaw, Poland
- Department of Obstetrics and Gynecology, Institute of Mother and Child in Warsaw, 01-211 Warsaw, Poland
| | - Wojciech Rokita
- Collegium Medicum, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland
- Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, 25-736 Kielce, Poland
| | - Jakub Młodawski
- Collegium Medicum, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland
- Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, 25-736 Kielce, Poland
| | - Maria Szubert
- Club 35, Polish Society of Gynecologists and Obstetricians, 53-125 Wrocław, Poland
- Department of Gynecology and Obstetrics, Medical University of Lodz, 90-419 Lodz, Poland
- Department of Surgical Gynecology and Oncology, Medical University of Lodz, Medical University of Lodz, 90-419 Lodz, Poland
| | - Piotr Sieroszewski
- Department of Gynecology and Obstetrics, Medical University of Lodz, 90-419 Lodz, Poland
- Department of Fetal Medicine and Gynecology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Grzegorz Raba
- Clinic of Obstetrics and Gynecology in Przemysl, 37-700 Przemysl, Poland
- Department of Obstetrics and Gynecology, University of Rzeszow, 35-330 Rzeszow, Poland
| | - Kamil Szczupak
- Clinic of Obstetrics and Gynecology in Przemysl, 37-700 Przemysl, Poland
- Department of Obstetrics and Gynecology, University of Rzeszow, 35-330 Rzeszow, Poland
| | - Tomasz Kluz
- Department of Gynecology, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland
| | - Marek Kluza
- Department of Gynecology, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland
| | - Krzysztof Czajkowski
- II Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Mirosław Wielgoś
- I Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Ewa Koc-Żórawska
- II Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Marcin Żórawski
- Department of Clinical Medicine, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Piotr Laudański
- I Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland
- OVIklinika Infertility Center, 01-377 Warsaw, Poland
- Correspondence:
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9
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Goławski K, Soczewica R, Kacperczyk-Bartnik J, Mańka G, Kiecka M, Lipa M, Warzecha D, Spaczyński R, Piekarski P, Banaszewska B, Jakimiuk A, Issat T, Rokita W, Młodawski J, Szubert M, Sieroszewski P, Raba G, Szczupak K, Kluz T, Kluza M, Wielgoś M, Koc-Żórawska E, Żórawski M, Laudański P. The Role of Cadherin 12 (CDH12) in the Peritoneal Fluid among Patients with Endometriosis and Endometriosis-Related Infertility. Int J Environ Res Public Health 2022; 19:ijerph191811586. [PMID: 36141853 PMCID: PMC9517443 DOI: 10.3390/ijerph191811586] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 07/04/2022] [Revised: 09/01/2022] [Accepted: 09/12/2022] [Indexed: 05/27/2023]
Abstract
Cadherin 12 (CDH 12) can play a role in the pathogenesis of endometriosis. The aim of this study was to compare the levels of cadherin 12 in the peritoneal fluid between women with and without endometriosis. This was a multicenter cross-sectional study. Eighty-two patients undergoing laparoscopic procedures were enrolled in the study. Cadherin 12 concentrations were determined using the enzyme-linked immunosorbent assay. The level of statistical significance was set at p < 0.05. No differences in cadherin 12 concentrations between patients with and without endometriosis were observed (p = 0.4). Subgroup analyses showed that CDH 12 concentrations were significantly higher in patients with infertility or primary infertility and endometriosis in comparison with patients without endometriosis and without infertility or primary infertility (p = 0.02) and also higher in patients with stage I or II endometriosis and infertility or primary infertility than in patients without endometriosis and infertility or primary infertility (p = 0.03, p = 0.048, respectively). In total, CDH 12 levels were significantly higher in patients diagnosed with infertility or primary infertility (p = 0.0092, p = 0.009, respectively) than in fertile women. Cadherin 12 can possibly play a role in the pathogenesis of infertility, both in women with and without endometriosis.
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Affiliation(s)
- Ksawery Goławski
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland
| | - Robert Soczewica
- College of Inter-Faculty Individual Studies in Mathematics and Natural Sciences, University of Warsaw, 02-097 Warsaw, Poland
| | - Joanna Kacperczyk-Bartnik
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, 00-315 Warsaw, Poland
- Club 35, Polish Society of Gynecologists and Obstetricians, 53-125 Wrocław, Poland
| | | | | | - Michał Lipa
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland
- Club 35, Polish Society of Gynecologists and Obstetricians, 53-125 Wrocław, Poland
| | - Damian Warzecha
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland
| | - Robert Spaczyński
- Division of Infertility and Reproductive Endocrinology, Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, 60-572 Poznan, Poland
| | - Piotr Piekarski
- Division of Infertility and Reproductive Endocrinology, Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, 60-572 Poznan, Poland
| | - Beata Banaszewska
- Division of Infertility and Reproductive Endocrinology, Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, 60-572 Poznan, Poland
| | - Artur Jakimiuk
- Department of Reproductive Health, Insitute of Mother and Child in Warsaw, 01-211 Warsaw, Poland
- Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of Interior, 02-507 Warsaw, Poland
| | - Tadeusz Issat
- Department of Reproductive Health, Insitute of Mother and Child in Warsaw, 01-211 Warsaw, Poland
- Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of Interior, 02-507 Warsaw, Poland
| | - Wojciech Rokita
- Collegium Medicum, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland
- Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, 25-736 Kielce, Poland
| | - Jakub Młodawski
- Collegium Medicum, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland
- Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, 25-736 Kielce, Poland
| | - Maria Szubert
- Club 35, Polish Society of Gynecologists and Obstetricians, 53-125 Wrocław, Poland
- Department of Gynecology and Obstetrics, Medical University of Lodz, 90-419 Lodz, Poland
- Department of Surgical Gynecology and Oncology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Piotr Sieroszewski
- Department of Gynecology and Obstetrics, Medical University of Lodz, 90-419 Lodz, Poland
- Department of Fetal Medicine and Gynecology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Grzegorz Raba
- Clinic of Obstetrics and Gynecology in Przemysl, 37-700 Przemysl, Poland
- Department of Obstetrics and Gynecology, University of Rzeszow, 35-310 Rzeszow, Poland
| | - Kamil Szczupak
- Clinic of Obstetrics and Gynecology in Przemysl, 37-700 Przemysl, Poland
- Department of Obstetrics and Gynecology, University of Rzeszow, 35-310 Rzeszow, Poland
| | - Tomasz Kluz
- Department of Gynecology, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland
| | - Marek Kluza
- Department of Gynecology, Gynecology Oncology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland
| | - Mirosław Wielgoś
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland
| | - Ewa Koc-Żórawska
- 2nd Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Marcin Żórawski
- Department of Clinical Medicine, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Piotr Laudański
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland
- OVIklinika Infertility Center, 01-377 Warsaw, Poland
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10
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Bomba-Opon DA, Godek B, Czekaj L, Huras H, Jakubiec-Wisniewska K, Janowiec K, Leszczynska-Gorzelak B, Slodzinska M, Zimmer M, Bek W, Rokita W, Zmelonek-Znamirowska A, Kalinka J, Biesiada P, Stanczyk P, Cnota W, Malec M, Laudanski P, Zadykowicz R, Wielgos M. Hyperglycemia in pregnancy - prevalence and perinatal outcomes. A retrospective multicenter cohort study in Poland. Ginekol Pol 2022; 93:1006-1012. [PMID: 35315020 DOI: 10.5603/gp.a2021.0257] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES Hyperglycemia in pregnancy (HIP) is one of the most common complications of pregnancy. Recently adopted new criteria for the diagnosis of HIP as well as the greater prevalence of risk factors could have a significant impact on HIP prevalence. The objective of the study was to assess the rates of HIP and the associated complications. MATERIAL AND METHODS This was a retrospective analysis of clinical records from pregnant women who delivered in eight tertiary hospitals in Poland in 2016. RESULTS The number of pregnant women with hyperglycemia totaled 1280 (7.25%), including gestational diabetes mellitus (GDM) in 1169 (6.62%) women and pregestational diabetes mellitus (PGDM) in 111 (0.63%). In addition to dietary modifications, 477 (41% of the GDM group) women received medical treatment (GDMG2). In women with PGDM multiple daily insulin injections (MDI) were used in 53 (47.7%) cases, continuous subcutaneous insulin infusions (CSII) in 57 (51.3%) cases and one woman was treated with metformin. The rate of cesarean sections was 69.4% and 62.9% for PGDM and GDM, respectively. Large-for-gestational-age (LGA) infants accounted for 38% and 21% of births in the PGDM and GDM groups, respectively. Of note are high rates of hyperbilirubinemia in infants born to mothers treated with insulin (13.5% for PGDM and 14.4% for GDMG2) vs infants born to mothers with diet (GDMG1) (3.4%). CONCLUSIONS In Poland, the prevalence of HIP has nearly doubled in the past twenty years. Even with appropriate management, HIP is a significant risk factor for a cesarean section delivery, bearing an LGA infant and adverse neonatal outcomes.
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Affiliation(s)
- Dorota A Bomba-Opon
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland.
| | - Bartosz Godek
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | | | - Hubert Huras
- Department of Obstetrics and Perinatology Jagielonian University, Cracow, Poland
| | | | - Krzysztof Janowiec
- Department of Obstetrics and Perinatology Jagielonian University, Cracow, Poland
| | | | | | - Mariusz Zimmer
- 2nd Department of Obstetrics and Gynecology, Medical University of Wroclaw, Poland
| | - Wiktor Bek
- 2nd Department of Obstetrics and Gynecology, Medical University of Wroclaw, Poland
| | - Wojciech Rokita
- Department of Obstetrics and Gynecology, The Institute of Medical Sciences Jan Kochanowski University, Kielce, Poland
| | - Anna Zmelonek-Znamirowska
- Department of Obstetrics and Gynecology, The Institute of Medical Sciences Jan Kochanowski University, Kielce, Poland
| | | | - Pawel Biesiada
- Department of Perinatology, Medical University of Lodz, Poland
| | | | - Wojciech Cnota
- Department of Gynaecology and Obstetrics, Medical University of Silesia, Poland
| | - Marzena Malec
- Department of Gynaecology and Obstetrics, Medical University of Silesia, Poland
| | - Piotr Laudanski
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland.,Department of Perinatology, Medical University of Bialystok, Poland
| | - Rafal Zadykowicz
- Department of Perinatology, Medical University of Bialystok, Poland.,Department of Obstetrics, Perinatology and Gynecology, Medical University of Warsaw, Poland
| | - Miroslaw Wielgos
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
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11
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Mlodawski J, Wolder D, Niziurski P, Adamczyk-Gruszka O, Głuszek S, Rokita W. Birth weight prediction by Lee formula based on fractional thigh volume in term pregnancies - is it helpful? Arch Med Sci 2022; 18:79-83. [PMID: 35154528 PMCID: PMC8826885 DOI: 10.5114/aoms.2020.92711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 02/06/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Ultrasonographic estimation of fetal weight (EFW) is a standard obstetrical procedure in daily clinical practice. Formulas for calculating EFW most commonly are a combination of two-dimensional measurements. A relatively new approach is the use of three-dimensional measurements such as fractional thigh volume (TVol) incorporated into specific regression equations. The objective of this study was to compare the Lee formula based on three-dimensional ultrasonographic TVol in the estimation of fetal weight before delivery in term pregnancies to the Hadlock I formula. MATERIAL AND METHODS 2D/3D abdominal ultrasonography was performed in 104 women, 37-41 gestational weeks, and measurements of biparietal diameter, head circumference, abdomen circumference, and femur length, TVol were taken. Using these measurements, we compared the Lee to the Hadlock formulas in EFW. The timing of procedures was measured in 20 randomly chosen patients by an independent observer. RESULTS Mean percentage errors of formulas, Lee vs. Hadlock, were 2.13 ±9.31% vs. -2.02 ±8.79%, (p = 0.001). There was no statistically significant difference in median absolute percentage errors between the two formulas (6.09% vs. 6.10%, p = 0.56). The proportion of newborns with estimated birth weights (BW) within ±10% of actual BW was not significantly different between the two formulas (73% vs. 71%, p = 0.11). There was a significant difference in the proportion of the newborns with estimated BW within ±5% (33% vs. 42%, p = 0.000006). Statistical measurements for test performance in detecting fetuses with BW ≥ 4000 g were sensitivity 85% vs. 60%, specificity 88% vs. 96%, and accuracy 88% vs. 89%. There was no significant difference in the time to perform the measurements (69 s for Lee formula vs. 58 s for Hadlock formula, p = 0.16). CONCLUSIONS Thigh volume measurement incorporated into the Lee single parameter formula is comparable to the Hadlock I formula in terms of accuracy in predicting fetal weight before delivery. There was no significant difference in the time needed for taking necessary measurements between the two groups.
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Affiliation(s)
- Jakub Mlodawski
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Daniel Wolder
- Department of Obstetrics and Gynecology, Provincial Combined Hospital, Kielce, Poland
| | - Piotr Niziurski
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | | | | | - Wojciech Rokita
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
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12
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Kwiatkowski S, Torbe A, Borowski D, Breborowicz G, Czajkowski K, Huras H, Kajdy A, Kalinka J, Kosinska-Kaczynska K, Leszczynska-Gorzelak B, Rokita W, Ropacka-Lesiak M, Sieroszewski P, Wielgos M, Zimmer M. Polish Society of Gynecologists and Obstetricians Recommendations on diagnosis and management of fetal growth restriction. Ginekol Pol 2021; 91:634-643. [PMID: 33184833 DOI: 10.5603/gp.2020.0158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 10/16/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Sebastian Kwiatkowski
- Clinical Department of Obstetrics and Gynecology, Pomeranian Medical University, Szczecin, Poland.
| | - Andrzej Torbe
- Clinical Department of Obstetrics and Gynecology, Pomeranian Medical University, Szczecin, Poland
| | - Dariusz Borowski
- Clinic of Fetal-Maternal, Gynecology and Neonatolgy, Collegium Medicum, Nicolaus Copernicus University in Bydgoszcz, Poland
| | - Grzegorz Breborowicz
- Department of Perinatology and Gynecology, Poznan University od Medical Sciences, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Hubert Huras
- Jagiellonian Univeristy Collegium Medicum, Department of Obstertics and Perinatology, Cracow, Poland
| | - Anna Kajdy
- Department of Reproductive Health, Centre of Postgraduate Medical Education, Warsaw, Poland
| | | | | | | | - Wojciech Rokita
- Department and Clinic of Obstetrics and Gynaecology, Collegium Medicum Jan Kochanowski University in Kielce, Poland
| | - Mariola Ropacka-Lesiak
- Department of Perinatology and Gynecology, Poznan University od Medical Sciences, Poland
| | - Piotr Sieroszewski
- Department of Obstetrics and Gynecology, Medical University of Lodz, Poland
| | - Miroslaw Wielgos
- 1st Chair and Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Mariusz Zimmer
- 2nd Department of Gynecology and Obstetrics, Wroclaw Medical University, Wroclaw, Poland
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13
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Mlodawski J, Mlodawska M, Przybysz N, Bielak A, Detka K, Pasiarski M, Rokita W. Collection of umbilical cord blood and the risk of complications in postpartum women after natural labour in the context of the possibility of umbilical cord stem cells usage in clinical practice. Ginekol Pol 2021; 92:205-209. [PMID: 33576474 DOI: 10.5603/gp.a2020.0179] [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: 03/03/2020] [Accepted: 07/10/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Comparison of changes in peripheral blood venous morphology and the frequency of select complications in patients who underwent umbilical cord blood collection during the third stage of labour by in the utero method compared to patients who did not undergo this procedure. Presentation of current therapeutic possibilities of cord blood stem cells. MATERIAL AND METHODS The study involved 248 patients who had a vaginal delivery and had umbilical cord blood taken by in utero method during the third stage of labour. The control group consisted of the first 400 patients who gave vaginal delivery starting in 2019. Each patient had a venous peripheral blood count taken before delivery and 18 hours after delivery. Changes in the results of laboratory tests and the occurrence of adverse outcomes, such as postpartum curettage, postpartum haemorrhage and manual removal of placenta, in the 3rd and 4th stage delivery periods, were analysed. RESULTS In the blood donor group there were significantly lower haemoglobin (11.32 g/L vs 11.61 g/L, p = 0.004) and haematocrit (32.83% vs 33.82% p = 0.001) concentrations after delivery. Umbilical cord donors had a greater difference in haemoglobin (postpartum minus prepartum) (-1.4 g/L vs -0.9 g/L, p = 000), and haematocrit (-4.05% vs -2.5% , p = 0.000). The study group had a higher percentage of patients with postpartum anaemia (haemoglobin concentration < 10 g/L) (15.9% vs 10.64%, p = 0.05), but the result were borderline significant. The groups did not differ in terms of the percentage of postpartum curettage, PPH, manual removal of placenta, percentage of severe anaemia (Hb < 7g/L) or transfusion requirement. CONCLUSION Collection of umbilical cord blood during the 3rd stage of labour using the in utero method is associated with a statistically significant increase of blood loss and a higher probability of postpartum anaemia. The observed changes are minor and may have little clinical significance in otherwise healthy patients.
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Affiliation(s)
- Jakub Mlodawski
- Collegium Medicum, Jan Kochanowski Univeristy, Kielce, Poland.,Clinic of Obstetrics and Gynaecology, Provincial Combined Hospital in Kielce, Poland
| | - Marta Mlodawska
- Collegium Medicum, Jan Kochanowski Univeristy, Kielce, Poland.
| | - Natalia Przybysz
- Eskulap Student's Scientific Society, Collegium Medicum Jan Kochanowski University in Kielce, Poland
| | - Aleksandra Bielak
- Eskulap Student's Scientific Society, Collegium Medicum Jan Kochanowski University in Kielce, Poland
| | - Karolina Detka
- Clinic of Obstetrics and Gynaecology, Provincial Combined Hospital in Kielce, Poland
| | | | - Wojciech Rokita
- Collegium Medicum, Jan Kochanowski Univeristy, Kielce, Poland.,Clinic of Obstetrics and Gynaecology, Provincial Combined Hospital in Kielce, Poland
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14
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Kocańda K, Rokita W. Istota oraz charakter dowodu z opinii biegłego w polskich procesach cywilnych. Folia Cardiologica 2020. [DOI: 10.5603/fc.2020.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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15
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Mlodawski J, Mlodawska M, Pazera G, Michalski W, Domanski T, Dolecka-Slusarczyk M, Gluszek S, Rokita W. Cerebral palsy and obstetric-neonatological interventions. Ginekol Pol 2020; 90:722-727. [PMID: 31909467 DOI: 10.5603/gp.2019.0124] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 11/07/2019] [Accepted: 11/25/2019] [Indexed: 11/25/2022] Open
Abstract
Cerebral palsy is a disease that puts a great mental burden on caregivers and generates very high social costs. Children with CP require many years of rehabilitation and medical care. The etiology of the disease is undoubtedly multifactorial, and the pathogenesis is associated with focal damage to the central nervous system. One can find descriptions of well-documented interventions in the literature that reduce the risk of CP in certain groups of pregnant and neonatal patients, and interventions that have a potentially protective effect. In this review, we have analyzed the available literature in terms of prenatal and postnatal interventions that may have an impact on reducing the incidence of this condition in children.
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Affiliation(s)
- Jakub Mlodawski
- Department and Clinic of Obstetrics and Gynaecology, Collegium Medicum Jan Kochanowski University in Kielce. .,Department of Obstetrics and Gynaecology, Voivodeship Combined Hospital in Kielce.
| | - Marta Mlodawska
- Collegium Medicum, Jan Kochanowski University in Kielce.,Clinic of Neonatology, Voivodeship Combined Hospital Kielce
| | - Grazyna Pazera
- Clinic of Neonatology, Voivodeship Combined Hospital Kielce
| | - Wojciech Michalski
- Ujastek Obstetric and Gynecological Hospital, Ujastek 3, 31-752 Cracow, Poland
| | - Tomasz Domanski
- Department of Obstetrics and Gynaecology, Voivodeship Combined Hospital in Kielce
| | | | - Stanislaw Gluszek
- Department of General, Oncological and Endocrinological Surgery, Voivodeship Hospital in Kielce.,Collegium Medicum, Jan Kochanowski University in Kielce, Poland
| | - Wojciech Rokita
- Department and Clinic of Obstetrics and Gynaecology, Collegium Medicum Jan Kochanowski University in Kielce.,Department of Obstetrics and Gynaecology, Voivodeship Combined Hospital in Kielce
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16
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Kwiatkowski S, Borowski D, Kajdy A, Poon LC, Rokita W, Wielgos M. Why we should not stop giving aspirin to pregnant women during the COVID-19 pandemic. Ultrasound Obstet Gynecol 2020; 55:841-843. [PMID: 32304612 PMCID: PMC7264504 DOI: 10.1002/uog.22049] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 03/27/2020] [Accepted: 04/06/2020] [Indexed: 05/06/2023]
Affiliation(s)
- S. Kwiatkowski
- Clinical Department of Obstetrics and GynecologyPomeranian Medical UniversitySzczecinPoland
| | - D. Borowski
- Ludwik Rydygier Collegium MedicumBydgoszczPoland
| | - A. Kajdy
- Department of Reproductive Health, Centre of Postgraduate Medical EducationWarsawPoland
| | - L. C. Poon
- Department of Obstetrics and GynecologyThe Chinese University of Hong KongHong Kong SAR
| | - W. Rokita
- Faculty of Medicine and Health SciencesJan Kochanowski UniversityKielcePoland
| | - M. Wielgos
- 1 Department of Obstetrics and GynecologyMedical University of WarsawWarsawPoland
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17
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Kieres P, Mlodawski J, Mlodawska M, Misiek M, Rechberger T, Rokita W. Principal component analysis and internal reliability of the Polish version of MESA and UDI-6 questionnaires. Ginekol Pol 2020; 91:13-16. [DOI: 10.5603/gp.2020.0004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 12/29/2019] [Indexed: 11/25/2022] Open
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18
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Starzyk K, Dybich P, Ciuraszkiewicz K, Rokita W, Wozakowska-Kaplon B. P701 Usefulness of echocardiography in diagnosis and monitoring in patient with pulmonary embolism during pregnancy, a case report. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Pulmonary embolism is one of the leading causes of maternal mortality despite a low incidence of during pregnancy. We present 32-year-old woman, in the 35 week of first pregnancy, admitted to the Intensive Care Unit with dyspnea, tachycardia, cyanosis. Echocardiography confirmed the presence of embolic material in the main trunk of pulmonary artery, spreading to the right pulmonary artery. D-dimer and troponin T level were elevated, BNP remained within the normal range. The risk in PESI scale was assumed as intermediate high. LMWH therapy was initiated, the patient was constantly monitored. Venous thrombotic disease in lower extremities was excluded by ultrasonography. The treatment was carried out under obstetric supervision. The clinical state gradually improved, the patient was hemodynamically stable. Serial echocardiographic testing, revealed gradual regression of changes in the pulmonary trunk. Normalization of troponins and lowering of BNP levels were observed. The pregnancy was terminated in 39 week, by cesarean section (obstetric indications). The LMWH was continued few days after delivery, as the patient started lactation. She decided to terminate lactation in a first week after delivery so the therapy was switched into rivaroxaban for at least 3 months. Echocardiography after 3 month confirmed lack of changes in pulmonary trunk, the risk of pulmonary hypertension was low. Echocardiography can be a method of choice for confirming and monitoring pulmonary embolism during pregnancy, in a situation of high or intermediate clinical risk and good visualization of changes in pulmonary arteries
Abstract P701 Figure. Embolism of pulmonary trunk and RPA
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Affiliation(s)
- K Starzyk
- Swietokrzyskie Cardiology Center, I Cardiology and Electrotherapy Clinic, Kielce, Poland
| | - P Dybich
- Swietokrzyskie Cardiology Center, I Cardiology and Electrotherapy Clinic, Kielce, Poland
| | - K Ciuraszkiewicz
- Swietokrzyskie Cardiology Center, Intensive Cardiac Care Department, Kielce, Poland
| | - W Rokita
- The Jan Kochanowski University, Department of Gynecological and Obstetric Prophylaxis, Faculty of Medicine and Health Sciences, Kielce, Poland
| | - B Wozakowska-Kaplon
- The Jan Kochanowski University, Swietokrzyskie Cardiology Centre, I Cardiology and Electrotherapy Clinic, Kielce, Poland
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19
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Lewitowicz P, Nasierowska-Guttmejer A, Rokita W, Adamczyk-Gruszka O, Gluszek S, Chrapek M, Kolos M, Wrona-Cyranowska A, Misiek M. HPV genotyping and p16/Ki-67 test significantly improve detection rate of high-grade cervical squamous intraepithelial lesion. Arch Med Sci 2020; 16:87-93. [PMID: 32051710 PMCID: PMC6963143 DOI: 10.5114/aoms.2018.80697] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 11/09/2018] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Liquid-based cytology allows to apply modern and specific analyses of hrHPV genotyping in p16/Ki-67 test. All of these together could raise accuracy ratio for high-grade squamous intraepithelial lesion above 90%. The purpose of this study was to evaluate the diagnostic accuracy of LBC, hrHPV testing, and p16/Ki-67 testing in diagnosis of high-grade cervical intraepithelial lesions. MATERIAL AND METHODS The study consisted of 176 women, out of which 50 presented with HSIL (CIN2) SCC (cervical intraepithelial lesion grade 2 squamous cell carcinoma). 126 women with a negative Pap test were pooled into the second group of the study. All patients were resampled for LBC, HPV genotyping, and for the p16/Ki-67 test. The research was carried out between May and December 2017, and second sampling were taken from 1 to 4 months. RESULTS We reported a strong correlation between positive Pap test and hrHPV (p < 0.05) that met accuracy close to 90%. We noted correlations between a positive p16/Ki-67 with a positive Pap test: p < 0.001; 66% sensitivity (95% CI: 51.2-78.8%), 87.8% specificity (95% CI: 75.2-95.4%), 76.8% accuracy (95% CI: 67.2-84.7%), and OR 13.9 (95% CI: 4.9-39.2), especially HSIL and HPV16: p < 0.001; sensitivity (95% CI) 64.0, specificity (95% CI) 98.4, accuracy (95% CI) 88.6, OR (95% CI) 109.3. CONCLUSIONS The results of our study indicate hrHPV genotyping as a good biomarker for the triage of patients with an abnormal cytological report. In our opinion, the hrHPV test reaches the highest level of sensitivity, specificity, and accuracy, and should be considered as crucial diagnostic test in cervical screening.
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Affiliation(s)
- Piotr Lewitowicz
- Department of Pathology, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Anna Nasierowska-Guttmejer
- Department of Pathology, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Wojciech Rokita
- Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
- Department of Obstetrics and Gynecology Province Hospital, Kielce, Poland
| | - Olga Adamczyk-Gruszka
- Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
- Department of Obstetrics and Gynecology Province Hospital, Kielce, Poland
| | - Stanisław Gluszek
- Department of Surgery and Surgical Nursing, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Magdalena Chrapek
- Department of Probability Theory and Statistics, Institute of Mathematics, the Faculty of Mathematics and Natural Sciences, Jan Kochanowski University, Kielce, Poland
| | - Małgorzata Kolos
- Department of Pathology, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | | | - Marcin Misiek
- Clinic of Gynecology, Holy-Cross Oncology Centre, Kielce, Poland
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20
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Dutsch-Wicherek MM, Szubert S, Dziobek K, Wisniewski M, Lukaszewska E, Wicherek L, Jozwicki W, Rokita W, Koper K. Analysis of the treg cell population in the peripheral blood of ovarian cancer patients in relation to the long-term outcomes. Ginekol Pol 2019; 90:179-184. [DOI: 10.5603/gp.2019.0032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 03/12/2019] [Indexed: 11/25/2022] Open
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21
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Suliga E, Rokita W, Adamczyk-Gruszka O, Pazera G, Cieśla E, Głuszek S. Factors associated with gestational weight gain: a cross-sectional survey. BMC Pregnancy Childbirth 2018; 18:465. [PMID: 30509248 PMCID: PMC6276162 DOI: 10.1186/s12884-018-2112-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 03/27/2018] [Accepted: 11/22/2018] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The aim of this study was to describe the dietary patterns in pregnant women and determine the association between diet factors, pre-pregnancy body mass index, socio-demographic characteristics and gestational weight gain. METHODS The analysis was conducted on a group of 458 women. Cut-off values of gestational weight gain adequacy were based on recommendations published by the US Institute of Medicine and were body mass index-specific. Logistic regression analysis was used to assess the risk of the occurrence of inadequate or excessive gestational weight gain. Dietary patterns were identified by factor analysis. RESULTS Three dietary patterns characteristic of pregnant women in Poland were identified: 'unhealthy', 'varied' and 'prudent'. The factor associated with increased risk of inadequate gestational weight gain was being underweight pre-pregnancy (OR = 2.61; p = 0.018). The factor associated with increased risk of excessive weight gain were being overweight or obese pre-pregnancy (OR = 7.00; p = 0.031) and quitting smoking (OR = 7.32; p = 0.019). The risk of excessive weight gain was decreased by being underweight pre-pregnancy (OR = 0.20; p = 0.041), being in the third or subsequent pregnancy compared to being in the first (OR = 0.37; p = 0.018), and having a high adherence to a prudent dietary pattern (OR = 0.47; p = 0.033). CONCLUSIONS Women who were overweight or obese pre-pregnancy and those who quit smoking at the beginning of pregnancy should be provided with dietary guidance to prevent excessive gestational weight gain.
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Affiliation(s)
- Edyta Suliga
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland.
| | - Wojciech Rokita
- Department of Gynecological and Obstetric Prophylaxis, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Olga Adamczyk-Gruszka
- Department of Gynecological and Obstetric Prophylaxis, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Grażyna Pazera
- Clinic of Neonatology at the Regional Polyclinic Hospital, Kielce, Poland
| | - Elżbieta Cieśla
- Department of Developmental Age Research, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Stanisław Głuszek
- Department of Surgery and Surgical Nursing with the Scientific Research Laboratory, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
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Jachymski T, Moczulska H, Guzowski G, Pomorski M, Piątek S, Zimmer M, Rokita W, Wielgoś M, Sieroszewski P. Conservative treatment of abnormally located intrauterine pregnancies (cervical and cesarean scar pregnancies): a multicenter analysis (Polish series). J Matern Fetal Neonatal Med 2018; 33:993-998. [PMID: 30122076 DOI: 10.1080/14767058.2018.1514009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 12/24/2022]
Abstract
Objectives: To analyze the effectiveness and outcome of conservative treatment in cases of abnormally located intrauterine pregnancies (cervical and cesarean scar).Study design: A retrospective analysis was performed of 30 pregnant women hospitalized due to abnormally located intrauterine pregnancies. The analyzed group comprised 24 pregnant women with abnormally located pregnancies. The patients were divided into two groups: the first group consisted of patients treated systemically with methotrexate, while the second of those treated locally by administration of methotrexate (MTX) and/or potassium chloride (KCl) by gestational sac puncture.Results: The analyzed group comprised 24 pregnant women with abnormally located pregnancies. Eight patients were diagnosed with cervical pregnancy (CP) and 16 patients were diagnosed with cesarean scar pregnancy (CSP). Six patients were excluded from the study: two with spontaneous abortions, two heterotopic pregnancies, and two cornual pregnancies. Twelve analyzed patients underwent MTX systemic administration (five patients with CP, seven with CSP). In five patients, systemic treatment was ineffective; they were qualified for additional local therapy with gestational sac (GS) puncture and MTX or KCl administration to the sac and additional administration of MTX to the trophoblast area. In second group of 12 patients (three CP, nine CSP), local treatment (GS puncture with MTX or MTX + KCl) was used as the first line treatment. One patient underwent combined treatment (local + systemic).Conclusions: Conservative treatment should be the gold standard procedure in abnormally located intrauterine pregnancies. It is noticeable that MTX / KCl is more effective in a direct administration to the GS. In four cases, systemic MTX did not produce the desired effects. In these cases, the treatment was assisted by local administration of MTX or KCl, resulting in the termination of an abnormally located pregnancy.
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Affiliation(s)
- Tomasz Jachymski
- Department of Fetal Medicine and Gynaecology, Medical University of Lodz, Lodz, Poland
| | - Hanna Moczulska
- Department of Fetal Medicine and Gynaecology, Medical University of Lodz, Lodz, Poland.,Department of Clinical Genetics, Medical University of Lodz, Lodz, Poland
| | - Grzegorz Guzowski
- Department of Fetal Medicine and Gynaecology, Medical University of Lodz, Lodz, Poland
| | - Michał Pomorski
- II Department of Gynaecology and Obstetrics, Wroclaw Medical University, Wroclaw, Poland
| | - Szymon Piątek
- 1st Department of Obstetrics and Gynaecology, Medical University of Warsaw, Warsaw, Poland
| | - Mariusz Zimmer
- II Department of Gynaecology and Obstetrics, Wroclaw Medical University, Wroclaw, Poland
| | - Wojciech Rokita
- Department of Obstetrics and Gynaecology, the Jan Kochanowski University in Kielce, Kielce, Poland
| | - Mirosław Wielgoś
- 1st Department of Obstetrics and Gynaecology, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Sieroszewski
- Department of Fetal Medicine and Gynaecology, Medical University of Lodz, Lodz, Poland
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Abstract
Diastasis recti abdominis is a condition in which both rectus abdominis muscles disintegrate to the sides, this being ac-companied by the extension of the linea alba tissue and bulging of the abdominal wall. DRA may result in the herniation of the abdominal viscera, but it is not a hernia per se. DRA is common in the female population during pregnancy and in the postpartum period. There is a scant knowledge on the prevalence, risk factors, prevention or management of the abovemen-tioned condition. The aim of this paper is to present the methods of DRA treatment based on the results of recent studies.
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Affiliation(s)
- Agata Michalska
- Institute of Physiotherapy, Jan Kochanowski University in Kielce, Kielce, Poland.
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Polewczyk A, Kurzawski J, Rokita W, Janion M. Large mass on the mitral valve in a woman in the 28th week of pregnancy. Pol Arch Intern Med 2017; 127:633-634. [PMID: 28984285 DOI: 10.20452/pamw.4109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Nasierowska-Guttmejer A, Kędzia W, Wojtylak S, Lange D, Rokita W, Jach R, Wielgoś M. Polish recommendations regarding diagnostics and treatment of cervical squamous intraepithelial lesions according to the CAP/ASCCP guidelines. Ginekol Pol 2016; 87:670-6. [PMID: 27723078 DOI: 10.5603/gp.2016.0066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Accepted: 09/07/2016] [Indexed: 11/25/2022] Open
Affiliation(s)
| | | | | | | | - Wojciech Rokita
- Faculty of Medicine and Health Science, Jan Kochanowski University in Kielce.
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Rokita W, Kedzia W, Pruski D, Friebe Z, Nowak-Markwitz E, Spaczyński R, Karowicz-Bilińska A, Spaczyński M. Comparison of the effectiveness of cytodiagnostics, molecular identification of HPV HR and CINtecPLUS test to identify LG SIL and HG SIL. Ginekol Pol 2012; 83:894-898. [PMID: 23488290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
AIM OF THE PAPER Comparison of conventional cytodiagnostics with molecular identification of DNA and mRNA HPV HR, immunocytochemical test for suppressor protein P16 and nuclear Ki 67 to detect cervical pathology screening of the division to LG SIL and HG SIL. MATERIAL 630 Pap smears were taken from women with suspected cervical pathology were submitted for analysis, together with 558 smears for the presence of DNA HPV HR, 421 swabs for the presence of mRNA HPV HR, 86 swabs for the presence of suppressor protein P16 and nuclear Ki 67. In all of the women standard colposcopy with biopsy and endocervical abrasion were performed. METHOD The study used a classic cytological smear taken on the slide, rated in accordance with TBS classification, colposcopy implemented in accordance with the guidelines of the International Federation of Cervical Pathology and Colposcopy from 2003, molecular diagnostic tests based on identifying DNA, mRNA HPV HR and immunocytochemistry diagnostic test--CINtecPLUS. RESULTS The sensitivity of Pap test identification of CIN 2+ was of 85% and specificity of 23%. Indicators PPV and NPV were respectively 39% and 72%. The accuracy of cytology reached a level of 46%. DNA HPV HR test obtained 91% sensitivity and 33% specificity of the diagnosis of CIN 2+. Its accuracy was 54%. The value of PPV and NPV for molecular diagnostics was respectively 43% and 87%. For mRNA HPV HR test sensitivity of the method was 79%, the specificity was 67%. CINTecPLUS test achieved 100% sensitivity and 67% specificity in the diagnosis of CIN 2+. CONCLUSIONS 1. Conventional cytodiagnostics are inferior in terms of both sensitivity and specificity of molecular test for DNA, mRNA HPV HR and immunocytochemical test for detecting of LG SIL and HG SIL. 2. Immunocytochemical technique shows maximum sensitivity and high specificity of detection of actual precancerous stages--CIN 2+.
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Affiliation(s)
- Wojciech Rokita
- Department of Gynecology and Obstetrics Hospital, NZOZ of St. Alexandra, Kielce, Poland.
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Rokita W, Skawiński D, Zmelonek-Znamirowska A, Kedzia W, Karowicz-Bilińska A, Spaczyński R, Spaczyński M. [Results of pap smears and immunocytochemical detection of the p16 and Ki67 proteins in women with cervical intraepithelial neoplasia and cervical cancer]. Ginekol Pol 2012; 83:822-826. [PMID: 23379189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE The aim of the study was to assess the diagnostic value of pap smears and detection of the p16 and Ki67 proteins in women with cervical intraepithelial neoplasia (CIN). MATERIALS AND METHOD 630 women, aged between 25 and 65, with abnormal pap smears were included into the study All patients had a control pap smear and in each case punch biopsy with endocervical curettage were performed under the control of a colposcope. The presence of p16 and Ki67 proteins was detected using the CINtecPlus test. The results of the research were statistically assessed. RESULTS Abnormal pap smears were found in 82.5% (520/630) of the studied women. In 40% (252/630) of the cases the LSIL changes were found. The recognition of ASC-US concerned 35.2% (222/630) of the patients, and pap smears with the HSIL result were found in 7.3% (46/630) of the women. In 17.5% (110/630) of the patients the result of the cytological examination was normal. Abnormal results of the pap smears were found significantly statistically more frequently (p<0,0001) in women with cervical intraepithelial neoplasia (CIN). The results of the CINtecPlus test were positive in 68,4% of women with CIN and in 33,3% of patients with normal cervix. In the group of women with precancerous lesions (HGSIL/CIN2+) the diagnostic accuracy of the pap smear was 41% for the cytological results ASC-US, 56% LSIL and 73% for detection of HSIL. Immunocytochemical detection of p16 and Ki67 proteins gained the highest accuracy (78%) in recognition of cervical precancerous lesions. CONCLUSION 1. ASC-US and LSIL cytological recognition has low accuracy in the diagnosis of CIN2+ cervical changes. 2. Cytological recognition of HSIL has the highest accuracy in the diagnosis of CIN2+ changes. 3. Immunocytochemical detection of p16 and Ki67 proteins is more accurate in recognizing precancerous states and cervical cancer than cytological examination. 4. Immunocytochemical detection of the p16 and Ki67 proteins can be used to triage patients with atypical squamous cells of undetermined significance and low grade squamous intraepithelial lesions.
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Affiliation(s)
- Wojciech Rokita
- Wydział Nauk o Zdrowiu Uniwersytet Jana Kochanowskiego w Kielcach, Polska.
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Tarka A, Szczepańska M, Rokita W, Józefiak A, Kedzia W. [Risk assessment of chronic HPV HR infection in babies who contacted the virus in the perinatal period]. Ginekol Pol 2011; 82:664-669. [PMID: 22379925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
INTRODUCTION One of the potential ways of HPV transmission to fetuses and newborns is a direct perinatal infection, manifested as juvenile laryngeal papillomatosis (JLP). This applies to children after traditional birth, born to mothers in whom the DNA sequences of the HPV HR in the paraepidermal epithelium of cervix were found during pregnancy and delivery OBJECTIVES Risk assessment of the development of chronic HPV HR infection in babies who had contact with the virus in the perinatal period. MATERIALS AND METHODS During the pre- and perinatal period, research was carried out among 185 pregnant women and a group of 105 newborns (5 pairs of twins), hospitalized in the Delivery Room of the Gynecology and Obstetrics Clinic of the Poznań Medical University between 2005-2007. Cellular material from the uterine cervical canal using a brush-type Cervex Brush was collected from each woman participating in the study and oral swabs using swab sticks were taken from the newborns. The second phase of testing was conducted following the postpartum, 3 to 6 months after the delivery Uterine cervix swabs were re-collected from 28 HPV HR positive women and swab from the mouth and nasopharynx were taken from their children (29 samples--1 pair of twins). The study was conducted with the use of PCR, trade named AMPLICOR Human Papilloma Virus (HPV) Test by Roche. RESULTS DNA HPV HR was found in 55 cases of the cellular material derived from 185 swabs taken from the cervical canal, representing 29.7% of researched women. The chronic HPV HR viral infection was detected in 25 cases out of the 28 HPV HR positive women, representing 89.2% of the study group. Of the 105 infants from whom oral swabs were taken in the perinatal period, presence of DNA HPV HR was found in 2 infants (2%) after traditional birth. Whereas the repeated test, within 3-6 months after delivery revealed the presence of DNA HPV HR viruses in swab oral in 1 infant, who had been DNA HPV HR positive. CONCLUSIONS Perinatal transmission of Human Papillomavirus of the high-risk oncogenic type is rare and concerns below 2% of babies of HPV HR positive mothers. Prolonged infection by the Human Papillomavirus is an extremely rare complication of pregnancy and delivery and concerns below 1% of children of HPV HR positive mothers. Perinatal transmission of the oncogenic type infection of the virus in humans is primarily of the ascending type or occurs during the perinatal period if the delivery was a traditional one.
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Affiliation(s)
- Agata Tarka
- Wydział Nauk o Zdrowiu, Uniwersytet Medyczny w Poznaniu, Polska.
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Wicherek L, Jozwicki W, Windorbska W, Roszkowski K, Lukaszewska E, Wisniewski M, Brozyna AA, Basta P, Skret-Magierlo J, Koper K, Rokita W, Dutsch-Wicherek M. Analysis of Treg Cell Population Alterations in the Peripheral Blood of Patients Treated Surgically for Ovarian Cancer - A Preliminary Report. Am J Reprod Immunol 2011; 66:444-50. [DOI: 10.1111/j.1600-0897.2011.01024.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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Kedzia W, Pruski D, Józefiak A, Rokita W, Spaczyński M. [Genotyping of oncogenic human papilloma viruses in women with HG SIL diagnosis]. Ginekol Pol 2010; 81:740-744. [PMID: 21117301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
INTRODUCTION Development of primary prevention of cervical cancer in other words a vaccination against selected, oncogenic HPV types, entails an increasing importance of epidemiological studies and prevalence of various types of human papilloma virus. The incidence of HPV varies depending on the geographic location of the population. The effectiveness of primary prevention against HPV 16, 18, in the context of reducing the incidence of cervical cancer will depend, among others, on the prevalence of these types in the population and virus-like antigens, which are partially cross-resistant. OBJECTIVE Identification of the most frequent, oncogenic HPV types in women with HG SIL diagnosis from Central and Western Poland to assess the merits of the development of primary prevention. MATERIAL For the purpose of molecular tests identifying the presence of 13 DNA oncogenic virus types, swabs were taken with the cyto-brush from 76 women diagnosed with CIN 2 or CIN 3 (HG SIL). Patients eligible for the study were diagnosed at the Laboratory of Pathophysiology of Uterine Cervix, Gynecology and Obstetrics Clinical Hospital of Karol Marcinkowski University of Medical Sciences. Patients came from Central and Western parts of Poland. METHOD Cell material in which the method of Amplicor HPV (Roche Diagnostics) identified the presence of DNA of oncogenic HPV types was in each case subsequently subjected to genotyping using the molecular test - Linear Array HPV Genotyping (Roche Diagnostics). RESULTS Five most common oncogenic HPV types in order of detection included: 16, 33, 18, 31, 56. Together these five types of virus comprised 75.86% (88/116) of all detected HPV types. CONCLUSIONS 1. In women from Central and Western Poland, diagnosed with HG SIL, the most common HPV genotypes were HPV 16, HPV33, HPV 18, HPV31, HPV56. 2. Two HPV types 16 and 18, against which vaccinations are directed, belong to the group of three genotypes of HPV most commonly identified in the evolution of CIN 2, CIN 3 diagnosed in women from Central and Western Poland.
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Affiliation(s)
- Witold Kedzia
- Klinika Onkologii Ginekologicznej UM im. Karola Marcinkowskiego w Poznaniu.
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Spaczyński M, Karowicz-Bilinska A, Kedzia W, Molińska-Glura M, Seroczyński P, Januszek-Michalecka L, Rokita W, Nowak-Markwitz E. [Costs of population cervical cancer screening program in Poland between 2007-2009]. Ginekol Pol 2010; 81:750-756. [PMID: 21117303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Screening programs may contribute to decreasing the mortality rate in a given population and their main target, in case of cervical cancer; is to find and to cure preclinical stages of this malignancy. Regularly repeated tests in defined time intervals can diagnose the illness at its early stages but the results come with a high cost. Population program of early detection of cervical cancer has been conducted since 2007 and is run by the Central Coordinating Center and 16 regional centers. Funds for promotional, educational, monitoring and medical activities are obtained from the National Health Service. AIM The aim of this study was to present the cost-effectiveness of the Program between 2007 and 2009. MATERIAL AND METHODS The material for the analysis was obtained from the SIMP system, where all the data about women participating in the Program are implemented. The analysis of the cervical carcinoma treatment and procedure costs was made on the basis of the National Health Service estimates. The number of new cervical carcinoma cases was calculated with the help of the newly introduced system code--C53. RESULTS Between 2007 and 2009 the cost of one cytological smear was similar in all regions (about 10 PLN). The highest costs were noted in Lubuski and Swietokrzyski regions. The costs of promotional and educational activities amounted up to 4.5 million PLN. A single cervical smear test cost for one woman has increased in the analyzed years from 3.95 up to 7.34 PLN. The total cost of one woman cytological examination--medical and non-medical elements--was more than 60 PLN. In 2009, 622 new cases of cervical cancer were found thanks to the Program. The cost of one case of cervical cancer diagnosis was 15 000 PLN. The total costs of all cases of cervical cancer in 2009 was 45.5 million PLN. CONCLUSIONS The situation calls for creating new and effective tools for monitoring medical, epidemiological and financial parameters of the Program. Otherwise, the estimates of the health and social impact of the Program will fail to be plausible. Increased attendance at the Program will only marginally lower the costs of the tests. Not to mention, that different means and solutions regarding cervical cancer prevention need to be suggested due to the fact that Polish population does not yet seem to have developed the habit of taking preventive tests.
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Affiliation(s)
- Marek Spaczyński
- Klinika Onkologii Ginekologicznej Uniwersytetu Medycznego w Poznaniu
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Rokita W, Kedzia W, Gaj A, Kulig B. [Economic aspects of using selected biomarkers in cervical cancer screening]. Ginekol Pol 2010; 81:774-777. [PMID: 21117306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Increasing knowledge about the cervical cancer etiology, combined with the development of molecular diagnostics technology using DNA matrix and mRNA matrix, introduced a new quality in cervical cancer screening. Moving the diagnostics from the cellular level into the molecular level allowed not only to identify the existing precancerous states, but also to foresee these pathologies in the stage of cellular or molecular changes using oncogenesis biomarkers. The new diagnostic tools give hope for the improvement of effectiveness of cervical cancer screening and for a significant reduction of costs.
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Affiliation(s)
- Wojciech Rokita
- Oddział Połoinictwa i Ginekologii Szpital Kielecki NZOZ Sw. Aleksandra, Kielce.
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Kedzia W, Józefiak A, Pruski D, Rokita W, Marek S. [Human papilloma virus genotyping in women with CIN 1]. Ginekol Pol 2010; 81:664-667. [PMID: 20973202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
INTRODUCTION Cervical cancer remains a considerable diagnostic and therapeutic problem in Poland. Despite progress in creating an active cancer prevention program in our country Poland occupies one of the last places in the EU in terms of cervical cancer- morbidity and mortality Supplement of secondary prevention of primary prophylaxis-HPV 16, 18 vaccination, offers hope for improvement of the situation. Epidemiology of individual HPV types differs, depending on the geographical location of the study population. So far in Poland, we have had no reliable data on the participation of selected oncogenic HPV types in the development of cervical pathology OBJECTIVE Identification of the most frequent, oncogenic HPV types in women diagnosed with CIN 1, from the Central and Western Poland. MATERIAL In the course of the conducted studies, genotyping of 13 types of human papilloma virus has been done in 126 HPV DNA-positive women diagnosed with CIN 1. METHOD Each cell material in which the presence of HPVDNA identified 13 types of oncogenic human papillomavirus was subsequently subjected to genotyping using the molecular test--Linear Array HPV Genotyping (Roche Diagnostics). RESULTS AND CONCLUSION In women from the Central and Western Poland diagnosed with CIN 1, HPV 16 (53.97%) was the most common, followed by HPV 33 (21.3%), HPV 18 (16.67%), HPV 31 (10.32%), HPV 45 (7.94%), HPV 52 (1.59%). Current HPV vaccines are designed to protect against two of the three most common genotypes, in women diagnosed with CIN 1 in Central and Western Poland.
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Affiliation(s)
- Witold Kedzia
- Klinika Onkologii Ginekologicznej UM im. Karola Marcinkowskiego w Poznaniu.
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Spaczyński M, Karowicz-Bilinska A, Rokita W, Molińska-Glura M, Januszek-Michalecka L, Seroczyński P, Uchlik J, Nowak-Markwitz E. [Attendance rate in the Polish Cervical Cancer Screening Program in the years 2007-2009]. Ginekol Pol 2010; 81:655-663. [PMID: 20973201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND In Poland in 2007, according to the National Cancer Registry 3431 women were diagnosed with cervical cancer and 1907 died. To change the unfavorable epidemiologic situation, in 2005 the Ministry of Health (MH), the National Health Fund (NHF) and the Polish Gynecological Society following WHO/IARC guidelines developed a National Population-Based Cervical Cancer Screening Program. Its implementation and roll-out started in 2006. The target population are women aged 25 to 59 insured in the National Health Fund. A Pap test is done with a three-year interval, free of charge. The system is based on personal invitations sent by regular post. Invitation to screening is supported by a social educational campaign "Choose Life" run under one slogan and logo across the whole country The NHF data base enables identification of women to screen. Pap smears are collected by gynecologists and since 2008 also by midwives trained and certified by the Program National Coordinating Center Pap test results are reported in the Bethesda 2001 system. The Screening Program has its system of quality assurance and control and is supported by a specially designed computer data base called SIMP (System of Information Monitoring in Prophylaxis) with online access to all records. In addition to organized, population-based screening there is also opportunistic screening in Poland practiced either by private gynecological practices or by some units that cooperate with the National Health Fund, but do Pap tests as an element of comprehensive gynecological examination. Those smears are not registered in the SIMP. AIM Our aim was analysis of attendance rate in the Cervical Cancer Screening Program in the years 2007-2009. We also investigated correlation between screening coverage and invitation sending schedule, as well as between coverage and screening accessibility determined by the number of gynaecological practices where Pap smears are collected. MATERIAL AND METHODS Attendance rate in the Screening Program was evaluated for the years 2007, 2008 and 2009. The analysis included screening coverage in all voivodeships in the 12 months of the year as well as the number of gynaecological practices participating in the Program. In addition, the place of residence of screening attenders (urban/rural area) was taken into account. For the analysis the SIMP (System of Information Monitoring in Prophylaxis) data were used. Statistical analysis was performed using Statistica 9.0 software. P-values < 0.05 were considered statistically significant. RESULTS The target population in the years 2007-2009 was 9,727,842 women. Personal invitations were sent to 99.7% of them. Pap Smears were collected from 24.14% of the target women (in 2007--21.25%; in 2008--24.39%; in 2009--26.77%). We noted that the number of 1400 gynecological practices participating in the Program was the minimal value to observe a significant increase in the number of Pap smears collected (p = 0.000). Polish women do not attend screening in the winter months. However when a batch of invitations was sent in the spring or summer months, within two following months we could observe an increase in the number of Pap smears collected (p = 0.000). There are significant differences in the screening uptake in particular regions of Poland (a stable trend). Compared to urban women, rural women participate in the screening more often (p = 0.003). CONCLUSION All Pap test results including opportunistic screening should be registered in the SIMP In the regions where particularly low attendance rates were observed, an intensive promotional campaign should be run to encourage participation in the screening. Also, sending a repeated invitation to non-compliers should be considered. The currently unfavorable schedule of invitation sending should be changed. According to the analysis performed, invitations should be more effective if sent on a regular basis (in small but regular batches), more intensively in the summer and spring months. In the winter season it would probably be better to focus on an extensive media campaign followed by sending a large number of personal invitations.
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Affiliation(s)
- Marek Spaczyński
- Klinika Onkologii Ginekologicznej Uniwersytetu Medycznego w Poznaniu.
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Rokita W, Stanisławska M, Kulig B. [Colposcopy of the vagina--a frequently omitted part of the colposcopic examination]. Ginekol Pol 2010; 81:699-703. [PMID: 20973207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Colposcopy of the vagina is a part of the colposcopic examination which is often omitted. It is an extremely serious mistake that makes the colposcopic examination less valuable. The instrumentarium, technique of the examination and distinctive features of colposcopic images showing vaginal changes have been presented in detail.
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Affiliation(s)
- Wojciech Rokita
- Oddział Potoznictwa i Ginekologii Szpital Kielecki NZOZ Sw. Aleksandra w Kielcach.
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Rokita W, Stanisławska M, Spaczyński M, Nowak-Markwitz E, Kedzia W. [Electrosurgery of cervical changes and its place in cervical cancer prophylaxis]. Ginekol Pol 2009; 80:856-860. [PMID: 20088401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
For many years electrosurgical procedures have been used to treat cervical changes. The equipment and the technique of performing these procedures have evolved considerably during the recent years. The Fisher cone and electrocoagulation of the cervix have been replaced with the LLETZ/LEEP procedure. Low cost, the simplicity of performance, high safety and high therapeutic effectiveness in treating precancerous cervical changes make the LLETZ/LEEP procedure a very good method of accomplishing the cervical cancer preventive program. The indications, contra-indications, the technique of performance along with postoperative complications after the LLETZ/LEEP procedure and the physical basics of electrosurgical procedures were thoroughly presented in the article.
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Affiliation(s)
- Wojciech Rokita
- Oddział Połoznictwa i Ginekologii Szpital Kielecki NZOZ Sw. Aleksandra, Kielce.
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Knafel A, Basta P, Skotniczny K, Paweł M, Krzysztof B, Rokita W, Obrzut B, Wicherek Ł. [Ectopic pregnancy rupture--can it be prevented?]. Ginekol Pol 2009; 80:734-739. [PMID: 19943536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVES To determine risk factors for ectopic pregnancy (EP) rupture based on the patients history and preoperative tests. MATERIALS AND METHODS The retrospective study consisted of 175 women operated on due to EP in the Department of Gynecology and Oncology of the Jagiellonian University between 2000-2008. Tubal rupture was diagnosed at the time of surgery. The patients were then divided into three groups: those who had unruptured EP without bleeding, those who had unruptured EP with hemorrhage into peritoneal cavity and those who suffered ruptured tubal pregnancy Analysis was performed based on the following parameters: patient history preoperative laboratory tests (Hb, Hct, betaHCG), and ultrasound exam. RESULTS Of the 175 cases of ectopic pregnancy included in the study 20% were unruptured without bleeding (A) and 40.6% unruptured with hemorrhage (B) while 39.4% were ruptured (C). There was a positive correlation between the diameter of the tubal lesion measured ultrasonographically and rupture (37.4 +/- 16 for C vs 29.7 +/- 12.9 for A; p=0.04). The gestational age of the groups differed significantly (p=0,001): C (56 +/- 1), A (49 +/- 3), and B (42 +/- 2). There was also a positive correlation between rupture and gravidity (1 +/- 1 for A vs 2 +/- 2 for C; p=0.02). Moreover a positive correlation of borderline significance was discerned between rupture and parity (p=0.06). Additionally the preoperative hemoglobin and hematocrit values were significantly lower in the rupture group (p=0.001). There was no significant difference among the three groups in age, number of abortions, serum betaHCG, endometrial thickness, length of hospital stay or the time elapsed since the most recent pregnancy. CONCLUSIONS Low hemoglobin and hematocrit values, together with higher gravidity at the time of admission, may indicate an increased risk of tubal rupture.
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Affiliation(s)
- Anna Knafel
- Klinika Ginekologii i Onkologii Uniwersytetu Jagiellońskiego w Krakowie
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Rokita W, Stanislawska M, Nowak-Markwitz E, Kedzia W, Spaczyński M, Karowicz-Bilinska A, Bednarek W. O806 Diagnostic hysteroscopy in women with endometrial hyperplasia and endometrial cancer - 9 years of experience, analysis of 142 cases. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)61179-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Magnowska M, Surowiak P, Nowak-Markwitz E, Michalak M, Magnowski P, Rokita W, Kedzia H, Zabel M, Spaczyński M. Analysis of hMLH1 and hMSH2 expression in cisplatin-treated ovarian cancer patients. Ginekol Pol 2008; 79:826-834. [PMID: 19175039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Loss of DNA mismatch repair may result in resistance to platinum- based anticancer drugs. The hMLH1 and hMSH2 proteins play a critical role in the maintenance of genome integrity and are involved in resistance to platinum-based therapy in colorectal cancer, which is deficient in hMLH1 protein and endometrial cancer, as well as in hMSH2 protein. However, the predictive value of MLH1 and MSH2 expression in ovarian cancer cisplatin-resistance is still to be determined. OBJECTIVE The aim of this study was to investigate the expression of hMLH1 and hMSH2 proteins in ovarian carcinoma specimens and to evaluate their prognostic significance by means of overall survival (OS) and progression-free survival rates (PSF). MATERIAL Ovarian cancer tissues were obtained from 61 patients: 45 platinum-sensitive and 16 platinum-resistant. hMLH1 and hMSH2 proteins expression was evaluated by immunohistochemistry, with the use of mouse monoclonal antibodies clone 14 for hMLH1 and clone FE11 for hMSH2. The log-rank test and Kaplan-Meier statistics were used to analyze the relationship between proteins expression and progression free survival, as well as the overall survival. RESULT No significant correlation was found between hMLH1 and hMSH2 expression and overall survival and progression free survival in the group of patients sensitive and resistant to cisplatin. No significant difference was found in proteins expression intensity between the two compared groups of patients. Age of patients, type of cancer histology, FIGO staging, grading, clinical response and CA 125 did not reveal correlation with the expression of the analyzed proteins. CONCLUSION The immunohistochemical expression of hMLH1 and hMSH2 proteins in ovarian cancer has no predictive value in resistance to cisplatin.
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Affiliation(s)
- Magdalena Magnowska
- Department of Gynecology, Obstetrics and Gynecologic Oncology, Division of Gynecologic Oncology, Poznan University of Medical Sciences, Polna
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Kieres P, Rokita W, Stanisławska M, Rechberger T, Gałezia M. [The diagnostic value of chosen questionnaires (UDI 6SF, Gaudenz, MESA, ICIQ-SF and King's Health Questionnaire) in diagnosis of different types of women's urinary incontinence]. Ginekol Pol 2008; 79:338-341. [PMID: 18624108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
THE AIM The assessment of the usefulness of the following questionnaires: UDI 6SF, King's Health Questionnaire, Gaudenz, MESA, ICIQ-SF in diagnosis of different types of women's urinary incontinence. MATERIAL AND METHODS The study included 100 women who were hospitalized in the Department of Urology of St. Rafael Hospital in Czerwona Góra due to urinary incontinence. On the basis of the received data we have compared the data from questionnairies to the results of the urodynamic study. RESULTS The mean age of women was 55.6 years. The stress urinary incontinence (SUI) was diagnosed in 32%, urgent urinary incontinence (UUI) in 10% and mixed urinary incontinence (MUI) in 55% of women, and neurogenic bladder in 3%. The data obtained from the study showed that questionnaires had 98% sensitivity and 50% specificity in diagnosing the type of urinary incontinence in women. CONCLUSIONS 1. Data obtained from the questionnaires fails to offer enough information to make a certain diagnosis of urinary incontinence. 2. The questionnaires: ICIQ-SF, Gaudenz and MESA are effective in the diagnosis of mixed urinary incontinence. 3. In spite of their high sensitivity, the specificity of questionnaires in the diagnosis of urinary incontinence is rather low.
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Affiliation(s)
- Paweł Kieres
- Oddział Urologiczny Szpital im. Sw. Rafała Wojewódzki Specjalistyczny Zespół Opieki Zdrowotnej Gruźlicy i Chorób Płuc w Kielcach.
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Rokita W. [Colposcopy of abnormal transformation zone]. Wiad Lek 2006; 59:486-9. [PMID: 17209344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
UNLABELLED The aim of the study was the determination of colposcopic images of the atypical transformation zone and the estimation of their relationship with cervical intraepithelial neoplasia. MATERIAL AND METHODS 8700 women hospitalized in the Department of Gynaecology and Gynaecologic Oncology of the Municipal Hospital in Kielce between October 1996 and March 2003 were included in this study. In every investigated women the gynaecological examination, PAP smear, vaginal biocenosis, image colposcopy and histological examination were performed. Colposcopic images underwent computer analysis. Patients were divided into two groups. Behind the criterion of the division one accepted the occurrence (group 1) or the lack (the group II) cervical intraepithelial neoplasia in the histological examination. RESULTS Atypical transformation zone occurred in 3.8% of investigated women. The statistical analysis showed the lack of the correlation between occurrence of flat punctation pattern and negative iodine uptake in women with the atypical transformation zone. Acetowhite epithelium, very white or gray opaque epithelium, flat mosaic, coarse mosaic, flat and coarse leukoplakia, coarse punctation and atypical vessels correlated statistically (p < 0.05) with the atypical transformation zone. CONCLUSIONS Acetowhite, very white or gray opaque epithelium, coarse punctation, flat mosaic, coarse mosaic, flat and coarse leukoplakia, coarse punctation, atypical vessels are the characteristic colposcopy images of the transformation zone. There is a correlation between acetowhite epithelium and flat leukoplakia and CIN 1. Coarse punctation, coarse mosaic and coarse leukoplakia correlate with the presence of CIN 3. Flat punctation and negative iodine uptake are not characteristic colposcopy images of the atypical transformation zone.
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Affiliation(s)
- Wojciech Rokita
- Z Oddziału Połoznictwa, Ginekologii i Onkologii Ginekologicznej Szpitala im. św. Aleksandra, Kielcach.
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Malarewicz A, Rokita W. [Electroconization of uterine cervix efficacious method in cervical cancer prophylaxis: analysis of 2555 cases]. Ginekol Pol 1997; 68:473-7. [PMID: 9780507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
The authors tried to assess considerably of the cervical electroconisation in the cervical cancer prophylaxis. The 2555 women with cervical erosions were treated by electroconisation. The electroconisations were performed when cytological and colposcopical examinations were unsuspected and conservative treatment in these cases has failed. Histopathological studies after conisation's samples demonstrated in 97% cases paraphysiological cervical changes. In 3% treated women cervical intraepithelial neoplasia was diagnosed. In one case cervical carcinoma was diagnosed in postoperative material. In this study 97% efficiacy of cervical electroconisation was demonstrated. Authors suggest that cervical electroconisation is recommended method in the treatment of cervical paraphysiological changes and plays important role in cervical cancer prophylaxis.
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Affiliation(s)
- A Malarewicz
- Oddziału Połozniczo-Ginekologicznego Szpitala Miejskiego w Kielcach
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Rokita W, Malarewicz A. [Colposcopy images of cervix in women with Gardnerella vaginalis infection]. Ginekol Pol 1997; 68:487-91. [PMID: 9780510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
Among micro-organisms infecting vagina whose dominant genus is GV anaerobic bacteria are often present. There are reports that GV infections of vagina and uterine cervix, apart from their well-known negative role in obstetrics practice can play a role in carcinogenic processes of uterine cervix. The aim of the study was to assess characteristic colposcopy images of cervix in women with Gardnerella vaginalis infection. The research was carried out on 1180 women hospitalised in the period of 14 months. Many observations lead to conclusions that pathognomic clinic feature of Gardnerella vaginalis infection of uterine cervix is visible in colposcope presence of clean, translucent mucus in external cervical os and opaque vaginal contents in the rear vaginal vault. High hydrogen ion concentration in vaginal contents (pH 6.0 and over) correlates with positive "fishy odour test" of this contents. Gardnerella vaginalis infection of vagina and uterine cervix concerns women with existing erosion-type changes of uterine cervix. Visible in colposcopic test restless and "spotted" images visible after Schiller test are pathognomic colposcopic features of Gardnerella vaginalis infection.
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Affiliation(s)
- W Rokita
- Oddziału Połozniczo-Ginekologicznego Szpitala Miejskiego w Kielcach
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Rokita W, Malarewicz A. [Estimation of cytological smears in women with Gardnerella vaginalis infections of vagina and uterine cervix]. Ginekol Pol 1997; 68:483-6. [PMID: 9780509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
Among micro-organisms infecting vagina whose dominant genus is Gardnerella vaginalis anaerobic bacteria are often present. Well-known damaging tissues and cells features of anaerobic bacteria are taken under consideration as factors which are conductive to generating pathological changes in cervical epithelium. The aim of this study was evaluation of cytological smears (Pap smear, Gram stain and H + E stain) in women with Gardnerella vaginalis infections of vagina and uterine cervix. The research was carried out on 1180 women hospitalised in the prior of fourteen months in Obstetrics-Gynaecological Department of the Municipal Hospital in Kielce. It was proved that characteristic microscopic feature of vagina and uterine cervix Gardnerella vaginalis infection is the absence of lactic acid bacillus, Lactobacillus vaginalis in vaginal contents and a presence of a small number of polynuclear neutrophil leucocytes. Marker cells (clue cells) are easily recognised in microscopic image in vaginal smears stained by Gram's method as well as Papanicolaou method. High sensitivity and specificity of these markers suggest usefulness of cytological smears in diagnosing Gardnerella vaginalis infections.
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Affiliation(s)
- W Rokita
- Oddziału Połozniczo-Ginekologicznego Szpitala Miejskiego w Kielcach
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Rokita W, Szymkiewicz-Malarewicz J, Wydrzyński G, Malarewicz A. [A case of cervix neck pregnancy--report on conservative treatment]. Ginekol Pol 1996; 67:320-1. [PMID: 9138990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Authors presented successful conservative treatment early diagnosed cervical pregnancy. After this procedure abdominal hysterectomy was not necessary.
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Affiliation(s)
- W Rokita
- Oddziału Polozniczo-Ginekologicznego Szpitala Miejskiego w Kielcach
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Malarewicz A, Rokita W. [Cancer and pathologic hyperplasia of endometrial mucosa. Clinical study]. Wiad Lek 1994; 47:840-3. [PMID: 8999698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The authors carried out a tentative evaluation of the factors regarded as increasing the proneness to endometrial cancer development. Particular attention was paid to pathological hyperplasia of the endometrium. The studied material consisted of 592 women (76 with endometrial cancer and 516 with endometrial hyperplasia). The incidence of pathological hyperplasia of the endometrium was six times higher than that of endometrial cancer. Endometrial cancer was found mainly in postmenopausal women. Apart from pathological hyperplasia of the endometrium, among other factors characterizing women developing endometrial cancer, hypertension should be mentioned in the first place. In the postoperative material obtained from women operated on for endometrial cancer (76 cases) and pathological endometrial hyperplasia (244 cases) the character of pathological changes in removed ovaries in 2/3 of the cases pointed to hyperplastic non-malignant lesions. In 1/3 of the women either no pathological changes or only fibrosis and ovarian tissue atrophy were found in the ovaries.
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Affiliation(s)
- A Malarewicz
- Oddziału Połozniczo-Ginekologicznego Szpitala Miejskiego w Kielcach
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Rokita W, Malarewicz A. [Chlamydia trachomatis infections of the cervix and postoperative course]. Ginekol Pol 1994; 65:244-6. [PMID: 7995556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
In the paper authors consider the problem if Chlamydia trachomatis infection of urogenital tract exerts an influence on postoperative course in women who were operated in the gynaecology department. 186 women have been examined in this study. Using the criteria for selective screening for Chlamydia trachomatis infection proposed by Handsfield, 29 women with higher risk for chlamydial infection were seperated. The personal details have been obtained by standardized questionnaire. Using the immunoenzymatic test "Chlamydiazyme" the incidence of Chlamydia trachomatis infection of the cervical canal was studied in 29 women from groups of higher risk for this infection. No Chlamydia trachomatis antigens were found in this group. These results don't answer the question if Chlamydia trachomatis infection of urogenital tract exerts an influence on postoperative course in women who were operated in gynaecology department, because it is to small trial.
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Affiliation(s)
- W Rokita
- Oddziału Połozniczo-Ginekologicznego Szpitala Miejskiego w Kielcach
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