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Pasieczna M, Kuran-Ohde J, Grzyb A, Bokiniec R, Wójcik-Sęp A, Czajkowski K, Szymkiewicz-Dangel J. Value of fetal echocardiographic examination in pregnancies complicated by preterm premature rupture of membranes. J Perinat Med 2024; 0:jpm-2023-0448. [PMID: 38639637 DOI: 10.1515/jpm-2023-0448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 03/10/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVES Cardiopulmonary and infectious complications are more common in preterm newborns after preterm premature rupture of membranes (pPROM). Fetal echocardiography may be helpful in predicting neonatal condition. Our aim was to assess the cardiovascular changes in fetuses from pregnancies complicated by pPROM and possible utility in predicting the intrauterine or neonatal infection, and neonatal heart failure (HF). METHODS It was a prospective study enrolling 46 women with singleton pregnancies complicated by pPROM between 18+0 and 33+6 weeks of gestation and followed until delivery. 46 women with uncomplicated pregnancies served as a control group. Fetal echocardiographic examinations with the assessment of cardiac structure and function (including pulmonary circulation) were performed in all patients. RESULTS Mean gestational age of pPROM patients was 26 weeks. Parameters suggesting impaired cardiac function in fetuses from pPROM were: higher right ventricle Tei index (0.48 vs. 0.42 p<0.001), lower blood flow velocity in Ao z-score (0.14 vs. 0.84 p=0.005), lower cardiovascular profile score (CVPS), higher rate of tricuspid regurgitation (18.2 % vs. 4.4 % p=0.04) and pericardial effusion (32.6 vs. 0 %). Intrauterine infection was diagnosed in 18 patients (39 %). 4 (8.7 %) newborns met the criteria of early onset sepsis (EOS). HF was diagnosed in 9 newborns. In fetal echocardiographic examination HF group had shorter mitral valve inflow time and higher left ventricle Tei index (0.58 vs. 0.49 p=0.007). CONCLUSIONS Worse cardiac function was observed in fetuses from pPROM compared to fetuses from uncomplicated pregnancies.
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Affiliation(s)
- Monika Pasieczna
- 2nd Department of Obstetrics and Gynecology, 37803 Medical University of Warsaw , Warsaw, Poland
| | - Joanna Kuran-Ohde
- 2nd Department of Obstetrics and Gynecology, 37803 Medical University of Warsaw , Warsaw, Poland
- Department of Perinatal Cardiology and Congenital Defects, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Agnieszka Grzyb
- Department of Perinatal Cardiology and Congenital Defects, Centre of Postgraduate Medical Education, Warsaw, Poland
- Department of Cardiology, The Children's Memorial Health Institute, Warsaw, Poland
| | - Renata Bokiniec
- Department of Neonatology and Neonatal Intensive Care, 37803 Medical University of Warsaw , Warsaw, Poland
| | - Agata Wójcik-Sęp
- Department of Neonatology and Neonatal Intensive Care, 37803 Medical University of Warsaw , Warsaw, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, 37803 Medical University of Warsaw , Warsaw, Poland
| | - Joanna Szymkiewicz-Dangel
- Department of Perinatal Cardiology and Congenital Defects, Centre of Postgraduate Medical Education, Warsaw, Poland
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Sieroszewski P, Bomba-Opon D, Czajkowski K, Drews K, Grzesiak M, Leszczynska-Gorzelak B, Scholz A, Kalinka J, Kosinka-Kaczynska K, Kwiatkowski S, Mierzynski R, Preis K, Ropacka-Lesiak M, Swiatkowska-Freund M, Wielgos M, Zimmer M, Huras H. Guidelines of the Polish Society of Gynecologists and Obstetricians on the diagnosis and management of pregnancies complicated by prelabor rupture of the membranes. Ginekol Pol 2024:VM/OJS/J/98339. [PMID: 38506477 DOI: 10.5603/gpl.98339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 11/28/2023] [Indexed: 03/21/2024] Open
Affiliation(s)
- Piotr Sieroszewski
- 1st Department of Gynaecology and Obstetrics, Medical University of Lodz, Poland
| | - Dorota Bomba-Opon
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Krzysztof Drews
- Department of Perinatology and Women's Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Mariusz Grzesiak
- Department of Perinatology, Obstetrics and Gynaecology, Polish Mother's Memorial Hospital Research Institute in Lodz, Poland
| | | | - Anna Scholz
- 1st Department of Obstetrics and Gynecology, CMKP in Warsaw, Poland
| | | | - Katarzyna Kosinka-Kaczynska
- Department of Obstetrics, Perinatology and Neonatology, Center of Postgraduate Medical Education in Warsaw, Poland
| | - Sebastian Kwiatkowski
- Department of Obstetrics and Gynecology, Independent Public Clinical Hospital No 2, Medical University in Szczecin, Poland
| | - Radzislaw Mierzynski
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, Poland
| | - Krzysztof Preis
- The Academy of Applied Medical and Social Sciences Elblag, Poland
| | - Mariola Ropacka-Lesiak
- Department of Perinatology and Gynaecology, Poznan University of Medical Sciences, Poznan, Poland
| | | | | | - Mariusz Zimmer
- 2nd Department of Gynecology and Obstetrics, Wroclaw Medical University, Poland
| | - Hubert Huras
- Department of Obstetrics and Perinatology Collegium Medicum Jagiellonia University Cracow, Poland
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Gutowska K, Koźniewski K, Wąsowski M, Jonas MI, Bartoszewicz Z, Lisik W, Jonas M, Binda A, Jaworski P, Tarnowski W, Noszczyk B, Puzianowska-Kuźnicka M, Czajkowski K, Kuryłowicz A. AGER-1 Long Non-Coding RNA Levels Correlate with the Expression of the Advanced Glycosylation End-Product Receptor, a Regulator of the Inflammatory Response in Visceral Adipose Tissue of Women with Obesity and Type 2 Diabetes Mellitus. Int J Mol Sci 2023; 24:17447. [PMID: 38139276 PMCID: PMC10743952 DOI: 10.3390/ijms242417447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/08/2023] [Accepted: 12/10/2023] [Indexed: 12/24/2023] Open
Abstract
The advanced glycosylation end-product receptor (AGER) is involved in the development of metabolic inflammation and related complications in type 2 diabetes mellitus (T2DM). Tissue expression of the AGER gene (AGER) is regulated by epigenetic mediators, including a long non-coding RNA AGER-1 (lncAGER-1). This study aimed to investigate whether human obesity and T2DM are associated with an altered expression of AGER and lncAGER-1 in adipose tissue and, if so, whether these changes affect the local inflammatory milieu. The expression of genes encoding AGER, selected adipokines, and lncAGER-1 was assessed using real-time PCR in visceral (VAT) and subcutaneous (SAT) adipose tissue. VAT and SAT samples were obtained from 62 obese (BMI > 40 kg/m2; N = 24 diabetic) and 20 normal weight (BMI = 20-24.9 kg/m2) women, while a further 15 SAT samples were obtained from patients who were 18 to 24 months post-bariatric surgery. Tissue concentrations of adipokines were measured at the protein level using an ELISA-based method. Obesity was associated with increased AGER mRNA levels in SAT compared to normal weight status (p = 0.04) and surgical weight loss led to their significant decrease compared to pre-surgery levels (p = 0.01). Stratification by diabetic status revealed that AGER mRNA levels in VAT were higher in diabetic compared to non-diabetic women (p = 0.018). Elevated AGER mRNA levels in VAT of obese diabetic patients correlated with lncAGER-1 (p = 0.04, rs = 0.487) and with interleukin 1β (p = 0.008, rs = 0.525) and resistin (p = 0.004, rs = 0.6) mRNA concentrations. In conclusion, obesity in women is associated with increased expression of AGER in SAT, while T2DM is associated with increased AGER mRNA levels and pro-inflammatory adipokines in VAT.
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Affiliation(s)
- Klaudia Gutowska
- II Department of Obstetrics and Gynecology, Warsaw Medical University, 00-315 Warsaw, Poland; (K.G.); (K.C.)
| | - Krzysztof Koźniewski
- Department of Human Epigenetics, Mossakowski Medical Research Centre, Polish Academy of Sciences, 02-106 Warsaw, Poland; (K.K.); (M.I.J.); (M.P.-K.)
| | - Michał Wąsowski
- Department of General Medicine and Geriatric Cardiology, Medical Centre of Postgraduate Education, 00-401 Warsaw, Poland;
| | - Marta Izabela Jonas
- Department of Human Epigenetics, Mossakowski Medical Research Centre, Polish Academy of Sciences, 02-106 Warsaw, Poland; (K.K.); (M.I.J.); (M.P.-K.)
| | - Zbigniew Bartoszewicz
- Department of Internal Medicine and Endocrinology, The Medical University of Warsaw, 02- 097 Warsaw, Poland;
| | - Wojciech Lisik
- Department of General and Transplantation Surgery, The Medical University of Warsaw, 02-005 Warsaw, Poland;
| | - Maurycy Jonas
- Department of General Surgery, Barska Hospital, 02-315 Warsaw, Poland;
| | - Artur Binda
- Department of General, Oncological and Bariatric Surgery, Medical Centre of Postgraduate Education, 00-401 Warsaw, Poland; (A.B.); (P.J.); (W.T.)
| | - Paweł Jaworski
- Department of General, Oncological and Bariatric Surgery, Medical Centre of Postgraduate Education, 00-401 Warsaw, Poland; (A.B.); (P.J.); (W.T.)
| | - Wiesław Tarnowski
- Department of General, Oncological and Bariatric Surgery, Medical Centre of Postgraduate Education, 00-401 Warsaw, Poland; (A.B.); (P.J.); (W.T.)
| | - Bartłomiej Noszczyk
- Department of Plastic Surgery, Medical Centre of Postgraduate Education, 00-401 Warsaw, Poland;
| | - Monika Puzianowska-Kuźnicka
- Department of Human Epigenetics, Mossakowski Medical Research Centre, Polish Academy of Sciences, 02-106 Warsaw, Poland; (K.K.); (M.I.J.); (M.P.-K.)
- Department of Geriatrics and Gerontology, Medical Centre of Postgraduate Education, 01-826 Warsaw, Poland
| | - Krzysztof Czajkowski
- II Department of Obstetrics and Gynecology, Warsaw Medical University, 00-315 Warsaw, Poland; (K.G.); (K.C.)
| | - Alina Kuryłowicz
- Department of Human Epigenetics, Mossakowski Medical Research Centre, Polish Academy of Sciences, 02-106 Warsaw, Poland; (K.K.); (M.I.J.); (M.P.-K.)
- Department of General Medicine and Geriatric Cardiology, Medical Centre of Postgraduate Education, 00-401 Warsaw, Poland;
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Szewczuk W, Szewczuk O, Czajkowski K, Wałędziak M, Gornicka B, Ilczuk T, Kawecka W, Semczuk A. HPV16 E6 Gene Transcripts in Primary Type II Endometrial Carcinomas. Anticancer Res 2023; 43:5083-5088. [PMID: 37909972 DOI: 10.21873/anticanres.16708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND/AIM Data on the prevalence of human papilloma virus (HPV) DNA in different subtypes of endometrial carcinomas (EC) are limited. PATIENTS AND METHODS We investigated the incidence of HPV16 DNA E6/E7 transcripts in 47 type I (endometrioid-type) tumors and eight type II (non-endometrioid-type) uterine neoplasms applying PCR-based technology. Immunohistochemical staining in HPV16 positive cases was also performed, and seven lymph node metastases were examined for the presence of HPV16 DNA E6/E7. RESULTS None of the type I ECs was positive for HPV16 E6 gene transcripts; however, four out of 8 (50%) type II ECs (two out of four papillary-serous and two out of four clear-cell carcinomas) were positive for HPV16 E6 transcripts. The difference in HPV16 E6 transcripts between endometrioid and non-endometrioid neoplasms was statistically significant (p=0.0011). Apart from the cancer subtype, none of the EC clinicopathological features were related to HPV16 E6 positivity. None of 55 ECs contained an HPV16 E7 gene transcripts. All slides from gene-positive samples revealed intense immunostaining reactions. Interestingly, the virus was not detected in any of seven lymph node metastases, including four from HPV16-positive primary tumors. CONCLUSION HPV16 E6 gene transcripts may be present in ECs, primarily in the non-endometrioid (type II) uterine cancer subtypes. HPV E6/E7 DNA transcripts were not found in lymph node metastases, even when the primary tumors harboured HPV DNA.
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Affiliation(s)
- Wiktor Szewczuk
- Department of Pathology, Military Institute of Medicine, Warsaw, Poland
| | - Oksana Szewczuk
- II Department of Obstetrics and Gynecology, Medical University, Princess Anna Mazowiecka Hospital, Warsaw, Poland
| | - Krzysztof Czajkowski
- II Department of Obstetrics and Gynecology, Medical University, Princess Anna Mazowiecka Hospital, Warsaw, Poland
| | - Maciej Wałędziak
- Department of Surgery, Military Institute of Medicine, Warsaw, Poland
| | | | - Tomasz Ilczuk
- Department of Pathology, Medical University, Warsaw, Poland
| | - Weronika Kawecka
- II Department of Gynecology, Lublin Medical University, Lublin, Poland
| | - Andrzej Semczuk
- II Department of Gynecology, Lublin Medical University, Lublin, Poland
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5
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Sroka-Ostrowska N, Pietrzak R, Pykalo-Gawinska D, Zareba-Szczudlik J, Czajkowski K, Romejko-Wolniewicz E. Eradication of cervical canal colonization associated with prophylactic cervical cerclage: the look further study. Ginekol Pol 2023; 95:92-98. [PMID: 37842993 DOI: 10.5603/gpl.96507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 07/27/2023] [Indexed: 10/17/2023] Open
Abstract
OBJECTIVES The perioperative management of the cervical cerclage procedure is not unified. In general population controlling microbiome cervical status does not affect obstetric outcomes, but it might be beneficial in patients with cervical insufficiency. The aim of our study was to present the obstetric, neonatal and pediatric outcomes of patients undergoing the cervical cerclage placement procedure in our obstetric department using a regimen of care that includes control of the microbiological status of the cervix and elimination of the pathogens detected. MATERIAL AND METHODS Thirty-five patients undergoing cervical cerclage in the 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, were included in the study. The procedure was performed only after receiving a negative culture from the cervical canal. RESULTS Thirty-one (88.6%) patients delivered after the 34th and twenty-eight (80.0%) after the 37th week of gestation. The colonization of the genital tract was present in 31% of patients prior to the procedure, in 42% of patients - during the subsequent pregnancy course and in 48% of patients - before delivery. A total of 85% of patients who had miscarriage or delivered prematurely had abnormal cervical cultures. In patients with normal cervical cultures, and 91.7% of women delivered at term. No abnormalities in children's development were found. CONCLUSIONS Controlling microbiological status of the cervical canal results in better or similar outcomes to those reported by other authors in terms of obstetric and neonatal outcomes. Active eradication of the reproductive tract colonization potentially increases the effectiveness of the cervical cerclage placement.
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Affiliation(s)
- Natalia Sroka-Ostrowska
- Second Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland, Poland
| | - Radoslaw Pietrzak
- Doctoral School Medical University of Warsaw, Poland
- Second Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland, Poland
| | | | | | - Krzysztof Czajkowski
- Second Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland, Poland
| | - Ewa Romejko-Wolniewicz
- Second Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland, Poland
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6
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Weber I, Sienko A, Urban A, Szwed C, Czajkowski K, Basta P, Sienko J. Relationship between the gut microbiome and endometriosis and its role in pathogenesis, diagnosis, and treatment: a systematic review. Ginekol Pol 2023:VM/OJS/J/97581. [PMID: 37772919 DOI: 10.5603/gpl.97581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 09/30/2023] Open
Abstract
Endometriosis is a chronic inflammatory disease affecting approximately 10% of women. It is defined as endometrial tissue outside of the uterus and produces a variety of symptoms including pelvic pain, dysmenorrhea, dyspareunia, and intermenstrual bleeding. Although several theories have been postulated regarding the pathogenesis of endometriosis, no theory has provided a complete explanation, therefore limiting our progress in diagnostic tools and management of endometriosis. Recently, much attention has been paid to the importance and role of the gut microbiome in endometriosis. As defined by Joshua Lederberg - microbiome is a set of the genome of microorganisms inhabiting a human body, including commensal, symbiotic and pathogenic microorganisms. The aim of this systematic review was to conduct a search in the Embase, Medline, and PubMed databases for literature from July 2013 to July 2023 regarding the relationship between the gut microbiome and endometriosis. 147 records were screened, of which 26 met the eligibility criteria, and 16 were included in this review. Our review concludes that patients with endometriosis show an altered gut microbiome, and that this has the potential to provide insight for pathogenesis, markers for diagnosis, as well as therapeutic options for treatment of endometriosis. Future research is necessary to confirm this and further investigate the relationship between the gut microbiome and endometriosis.
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Affiliation(s)
- Isabella Weber
- University of Cambridge, Clinical School of Medicine, Cambridge, United Kingdom
| | - Anna Sienko
- University of Cambridge, Clinical School of Medicine, Cambridge, United Kingdom
| | - Aleksandra Urban
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland, Warsaw, Poland.
| | - Carolyn Szwed
- Department of Social Medicine and Public Health, Medical University of Warsaw, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland, Warsaw, Poland
| | - Pawel Basta
- Department of Gynaecology and Oncology, Jagiellonian University Medical College, Cracow, Poland
| | - Jacek Sienko
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland, Warsaw, Poland
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Sienko A, Cichosz A, Urban A, Smolarczyk R, Czajkowski K, Sienko J. The effect of two anti-inflammatory dietary components, omega-3 and resveratrol, on endometriosis. Ginekol Pol 2023:VM/OJS/J/97573. [PMID: 37768015 DOI: 10.5603/gpl.97573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 09/29/2023] Open
Abstract
Endometriosis is an inflammatory condition defined by the presence of endometrial glands and stroma outside the uterine cavity. Given the substantial body of evidence supporting the role of inflammation in the pathophysiology of various chronic illnesses, the concept of an anti-inflammatory diet has garnered significant attention in recent research. Some nutrients, such as omega-3 fatty acids and resveratrol (RES), have demonstrated distinct anti-inflammatory properties. Therefore, the objective of this systematic review was to search the Embase, Medline, and PubMed databases for literature from August 2008 to August 2023 regarding the effects of two anti-inflammatory dietary components, omega-3 and RES, on endometriosis. A total of 215 records were identified, out of which 58 were screened, 23 met the eligibility criteria, and 19 were included in this review. The results of this systematic review indicate that EPA is suggested to have anti-inflammatory properties and may serve as a potential marker for illness severity. RES offers a range of advantages, including inflammation reduction, angiogenesis suppression, proliferation inhibition, and apoptosis induction. To validate these findings and assess their clinical relevance, future research and clinical trials are warranted.
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Affiliation(s)
- Anna Sienko
- University of Cambridge, Clinical School of Medicine, Cambridge, United Kingdom.
| | - Adrianna Cichosz
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Aleksandra Urban
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Roman Smolarczyk
- Department of Gynaecological Endocrinology, Medical University of Warsaw, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Jacek Sienko
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
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Seremak-Mrozikiewicz A, Nitsch-Osuch A, Czajkowski K, Drews K, Huras H, Kalinka J, Kuchar E, Leszczynska-Gorzelak B, Mastalerz-Migas A, Swiatkowska-Freund M, Wielgos M, Wolski H, Wysocki J, Zimmer M, Sieroszewski P. Guidelines of the Polish Society of Gynecologists and Obstetricians, the Polish Society for Vaccinology, and the Polish Society for Family Medicine on vaccinating women with reproductive plans and pregnant or breastfeeding women. Ginekol Pol 2023:VM/OJS/J/95834. [PMID: 37599569 DOI: 10.5603/gpl.95834] [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] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 06/01/2023] [Indexed: 08/22/2023] Open
Abstract
The following Guidelines present the most up-to-date treatment and management recommendations, which may be modified and altered after detailed analysis of a specific clinical situation, which in turn might lead to future modifications and updates.
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Affiliation(s)
| | - Aneta Nitsch-Osuch
- Department of Social Medicine and Public Health, Warsaw Medical University, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Krzysztof Drews
- Department of Perinatology and Women's Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Hubert Huras
- Collegium Medicum, Jagiellonian University, Cracow, Poland
| | | | - Ernest Kuchar
- Department of Pediatrics with Clinical Decisions Unit, Medical University of Warsaw, Poland
| | | | | | | | | | - Hubert Wolski
- Department of Perinatology and Women's Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Wysocki
- Observation and Infectious Diseases Department of the Specialist Mother and Child Healthcare Group in Poznan, Poland
- Chair and Department of Health Prophylaxis, Medical University of Poznan, Poland
| | - Mariusz Zimmer
- 2nd Department of Gynecology and Obstetrics, Wroclaw Medical University, Poland
| | - Piotr Sieroszewski
- 1st Department of Gynaecology and Obstetrics, Medical University of Lodz, Poland
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Malinowska-Polubiec A, Zawiejska A, Romejko-Wolniewicz E, Poprawski G, Towpik I, Brązert J, Handziuk Z, Czajkowski K. Double diabetes as an effect modifier for adverse perinatal outcome in pregnant women with type 1 diabetes mellitus - a retrospective multicenter cohort study. Front Endocrinol (Lausanne) 2023; 14:1215407. [PMID: 37576969 PMCID: PMC10422044 DOI: 10.3389/fendo.2023.1215407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/05/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Double diabetes (DDiab) is defined as T1DM coexisting with insulin resistance (IR), metabolic syndrome (MetS), and/or obesity. Little evidence is available regarding how frequent DDiab is among T1DM pregnancies and whether it affects the perinatal outcome in this population. Aims of the study To explore the prevalence of DDiab in early pregnancy in the cohort of pregnant women with T1DM and to examine the association between an early-pregnancy DDiab status and fetomaternal complications characteristic for T1DM in pregnancy. Material and methods A retrospective data analysis of the multicenter cohort of N=495 pregnant women in singleton pregnancy complicated with T1DM followed from early pregnancy until delivery in three tertiary referral centers. DDiab status was defined as T1DM plus pre-pregnancy obesity defined as BMI≥30 kg/m2 measured at the first antenatal visit (DDiabOb), or T1DM plus pre-pregnancy IR defined as eGDR (estimated Glucose Disposal Rate) below the 25th centile for the cohort measured at the first antenatal visit (DDiabIR). Proportions of the adverse pregnancy outcomes were compared between DDiabOb and Non-DDiabOb and between DDiabIR and Non-DDiabIR patients. Characteristics of the study group (data presented as mean(SD) or percentage): age: 30.0(5.1) years; age when T1DM diagnosed: 17.5(8.5) years; T1DM duration: 12.0(7,9) years; microvascular complications (White classes R,F,RF): 11.9%, pre-pregnancy counselling: 26.6%, baseline gestational age: 10.5(4.3) weeks, pre-pregnancy BMI: 23.7(4.3) kg/m2; chronic hypertension: 9.1%, gestational hypertension (PIH) 10.7%, preeclampsia (PET): 3.2%; nulliparity 53.8%, smoking in pregnancy: 4.8%, eGWG: 22.4%, DDiabOB: 10.1%; DdiabIR: 25.2%; LGA: 44.0%, and NICU admission: 20.8%. Results (data from the univariate analysis given as OR(95%CI)): both DDiabOB and DDiabIR status increased the risk for eGWG [23.15 (10.82; 55.59); 3.03 (1.80; 5.08), respectively]. DDiabIR status increased the risk for PET [4.79 (1.68;14.6)], preterm delivery [1.84 (1.13; 3.21)], congenital malformation [2.15 (1.07;4.25)], and NICU hospitalization [2.2 (1.20;4.01)]. Both DDiabOB and DDiabIR accurately ruled out PET (NPV 97.3%/98.3%, accuracy: 88.3%/75.6%, respectively), congenital malformation (NPV 85.6%/88.4%, accuracy: 78.9/69.8, respectively), and perinatal mortality (NPV 98.7%/99.2%, accuracy: 88.8%/74.5%, respectively). Conclusions Double diabetes became a frequent complication in T1DM pregnant population. Double diabetes diagnosed in early pregnancy allows for further stratification of the T1DM pregnant population for additional maternal risk.
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Affiliation(s)
| | - Agnieszka Zawiejska
- Department of Medical Simulation, Chair of Medical Education, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Grzegorz Poprawski
- Oncological Gynecology Department, Poznan University of Medical Sciences, Poznan, Poland
| | - Iwona Towpik
- Department of Internal Medicine, Diabetology and Endocrinology, University of Zielona Gora, Zielona Gora, Poland
| | - Jacek Brązert
- Department of Reproduction, Poznan University of Medical Sciences, Poznan, Poland
| | - Zuzanna Handziuk
- 2 Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Czajkowski
- 2 Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
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10
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Gutowska K, Czajkowski K, Kuryłowicz A. Receptor for the Advanced Glycation End Products ( RAGE) Pathway in Adipose Tissue Metabolism. Int J Mol Sci 2023; 24:10982. [PMID: 37446161 DOI: 10.3390/ijms241310982] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 05/18/2023] [Revised: 06/22/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Advanced glycation end products (AGEs) are mediators in the process of cellular dysfunction in response to hyperglycemia. Numerous data indicate that the accumulation of AGEs in the extracellular matrix plays a key role in the development of obesity-related adipose tissue dysfunction. Through binding of their membrane receptor (RAGE), AGEs affect numerous intracellular pathways and impair adipocyte differentiation, metabolism, and secretory activity. Therefore, inhibiting the production and accumulation of AGEs, as well as interfering with the metabolic pathways they activate, may be a promising therapeutic strategy for restoring normal adipose tissue function and, thus, combating obesity-related comorbidities. This narrative review summarizes data on the involvement of the RAGE pathway in adipose tissue dysfunction in obesity and the development of its metabolic complications. The paper begins with a brief review of AGE synthesis and the RAGE signaling pathway. The effect of the RAGE pathway on adipose tissue development and activity is then presented. Next, data from animal and human studies on the involvement of the RAGE pathway in obesity, diabetes, and cardiovascular diseases are summarized. Finally, therapeutic perspectives based on interference with the RAGE pathway are discussed.
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Affiliation(s)
- Klaudia Gutowska
- II Faculty and Clinic of Obstetrics and Gynaecology, Medical University of Warsaw, 00-315 Warsaw, Poland
- Doctoral School, Medical University of Warsaw, Zwirki i Wigury 81, 02-091 Warsaw, Poland
| | - Krzysztof Czajkowski
- II Faculty and Clinic of Obstetrics and Gynaecology, Medical University of Warsaw, 00-315 Warsaw, Poland
| | - Alina Kuryłowicz
- Department of Human Epigenetics, Mossakowski Medical Research Centre PAS, 02-106 Warsaw, Poland
- Department of General Medicine and Geriatric Cardiology, Medical Centre of Postgraduate Education, 00-401 Warsaw, Poland
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Klupa T, Czupryniak L, Dzida G, Fichna P, Jarosz-Chobot P, Gumprecht J, Mysliwiec M, Szadkowska A, Bomba-Opon D, Czajkowski K, Malecki MT, Zozulinska-Ziolkiewicz DA. Expanding the Role of Continuous Glucose Monitoring in Modern Diabetes Care Beyond Type 1 Disease. Diabetes Ther 2023:10.1007/s13300-023-01431-3. [PMID: 37322319 PMCID: PMC10299981 DOI: 10.1007/s13300-023-01431-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/31/2023] [Indexed: 06/17/2023] Open
Abstract
Application of continuous glucose monitoring (CGM) has moved diabetes care from a reactive to a proactive process, in which a person with diabetes can prevent episodes of hypoglycemia or hyperglycemia, rather than taking action only once low and high glucose are detected. Consequently, CGM devices are now seen as the standard of care for people with type 1 diabetes mellitus (T1DM). Evidence now supports the use of CGM in people with type 2 diabetes mellitus (T2DM) on any treatment regimen, not just for those on insulin therapy. Expanding the application of CGM to include all people with T1DM or T2DM can support effective intensification of therapies to reduce glucose exposure and lower the risk of complications and hospital admissions, which are associated with high healthcare costs. All of this can be achieved while minimizing the risk of hypoglycemia and improving quality of life for people with diabetes. Wider application of CGM can also bring considerable benefits for women with diabetes during pregnancy and their children, as well as providing support for acute care of hospital inpatients who experience the adverse effects of hyperglycemia following admission and surgical procedures, as a consequence of treatment-related insulin resistance or reduced insulin secretion. By tailoring the application of CGM for daily or intermittent use, depending on the patient profile and their needs, one can ensure the cost-effectiveness of CGM in each setting. In this article we discuss the evidence-based benefits of expanding the use of CGM technology to include all people with diabetes, along with a diverse population of people with non-diabetic glycemic dysregulation.
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Affiliation(s)
- Tomasz Klupa
- Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland.
| | - Leszek Czupryniak
- Department of Diabetology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Grzegorz Dzida
- Department of Internal Diseases, Medical University of Lublin, Lublin, Poland
| | - Piotr Fichna
- Department of Pediatric Diabetes and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Janusz Gumprecht
- Department of Internal Medicine, Diabetology and Nephrology, Medical University of Silesia, Katowice, Poland
| | - Malgorzata Mysliwiec
- Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdansk, Gdansk, Poland
| | - Agnieszka Szadkowska
- Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, Lodz, Poland
| | - Dorota Bomba-Opon
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Maciej T Malecki
- Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland
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12
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Broś-Konopielko M, Białek A, Johne M, Czajkowski K. Increased LC PUFA Levels in the Serum of Pregnant Women and Their Children as a Result of Dietary Supplementation with 'Omega' Fatty Acids. Nutrients 2023; 15:231. [PMID: 36615888 PMCID: PMC9824740 DOI: 10.3390/nu15010231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/23/2022] [Accepted: 12/30/2022] [Indexed: 01/03/2023] Open
Abstract
Essential fatty acids (EFA) and long-chain polyunsaturated fatty acids (LC PUFA) are considered the most valuable bioactive fatty acids (FA) of the greatest importance for the mother’s and child’s health (e.g., placentation process, labor course, development of the central nervous system, visual acuity, cognitive functions), which results in dietary recommendations concerning EFA and LC PUFA intake in the diet of pregnant women. In this study, we aimed to evaluate the frequency of different food products consumption and ‘omega’ dietary supplements usage in groups of pregnant women. We also measured n-3 and n-6 FA content in serum samples of pregnant women and their children with the GC-FID technique, estimated the efficacy of applied supplementation, and compared the usefulness of different dietary supplements dedicated for pregnant women. ‘Omega’ dietary supplements effectively increased LC PUFA in the maternal blood (EPA, p = 0.0379; DHA p < 0.0001; n-3 PUFA, p < 0.0001), which penetrated the umbilical cord (EPA, p = 0.0131; DHA, p = 0.0288). If fish and seafood consumption is not enough, dietary supplements of the highest quality may provide sufficient LC PUFA without apprehension of MetHg contamination. ‘Omega’ dietary supplementation seems the most efficient way of providing an optimal supply of LC PUFA for the developing child from the earliest stages of development, which will bring advantages in the child’s future life and its health.
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Affiliation(s)
- Magdalena Broś-Konopielko
- II Faculty and Clinic of Obstetrics and Gynaecology, Medical University of Warsaw, Karowa 2, 00-315 Warsaw, Poland
| | - Agnieszka Białek
- Faculty of Medical and Health Sciences, University of Economics and Human Sciences in Warsaw, Okopowa 59, 01-043 Warsaw, Poland
- The Kielanowski Institute of Animal Physiology and Nutrition, Polish Academy of Sciences, Instytucka 3, 05-110 Jabłonna, Poland
| | - Monika Johne
- Faculty of Physical Education, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968 Warsaw, Poland
| | - Krzysztof Czajkowski
- II Faculty and Clinic of Obstetrics and Gynaecology, Medical University of Warsaw, Karowa 2, 00-315 Warsaw, Poland
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13
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Suchta K, Smolarczyk R, Czajkowski K, Rudnicka E, Kokoszka A. Binge Eating Disorder-The Point Prevalence among Polish Women with Polycystic Ovary Syndrome and Validity of Screening Tool for This Population. Int J Environ Res Public Health 2022; 20:546. [PMID: 36612867 PMCID: PMC9819692 DOI: 10.3390/ijerph20010546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/19/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders which is associated with an increased risk of metabolic dysregulation. The elevated prevalence of obesity has been observed in women with PCOS. Since obesity is commonly associated with eating disturbances, including the binge eating disorder (BED), and since the hormonal changes in PCOS patients could influence the food intake model, we decided to estimate the prevalence of BED in PCOS patients and to assess the sensitivity and specificity of the Questionnaire for Binge Eating Screening (QBES) in PCOS patients. METHODS A total of 122 hospitalized women with PCOS aged 16-45 (M = 26; SD = 5.22) took part in the study. Binge eating disorder (BED) was diagnosed according to the DSM-5 diagnostic criteria. QBES was used as a screening tool for BED. RESULTS The point prevalence of BED in PCOS women according to DMS-5 criteria was 51 (42%). At least two positive answers to four QBES items had 100% sensitivity and 91% specificity. Positive answers to even only the first two questions from QBES had 98% sensitivity and 85% specificity. CONCLUSIONS Women with polycystic ovary syndrome are at a very high risk of binge eating behaviors. Screening for eating disorders should be a routine procedure in women with PCOS. The first two questions from QBES are a brief and relatively reliable screening tool that may be used in everyday practice with POSC patients.
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Affiliation(s)
- Katarzyna Suchta
- Department of Gynaecological Endocrinology, Medical University of Warsaw, Karowa 2 Str., 00-315 Warsaw, Poland
| | - Roman Smolarczyk
- Department of Gynaecological Endocrinology, Medical University of Warsaw, Karowa 2 Str., 00-315 Warsaw, Poland
| | - Krzysztof Czajkowski
- II Department of Obstetric and Gynaecology, Medical University of Warsaw, Karowa 2 Str., 00-315 Warsaw, Poland
| | - Ewa Rudnicka
- Department of Gynaecological Endocrinology, Medical University of Warsaw, Karowa 2 Str., 00-315 Warsaw, Poland
| | - Andrzej Kokoszka
- II Department of Psychiatry, Medical University of Warsaw, 02-091 Warsaw, Poland
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14
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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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15
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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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16
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Wołyńczyk-Gmaj D, Majewska A, Bramorska A, Różańska-Walędziak A, Ziemka S, Brzezicka A, Gmaj B, Czajkowski K, Wojnar M. Cognitive Function Decline in the Third Trimester of Pregnancy Is Associated with Sleep Fragmentation. J Clin Med 2022; 11:jcm11195607. [PMID: 36233473 PMCID: PMC9573284 DOI: 10.3390/jcm11195607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/16/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
During late pregnancy, sleep deterioration is regularly observed. In concert with these observations, in previous studies by other researchers, a slight objective cognitive decline in pregnant women has been found. Sleep is essential for memory consolidation. The hypothesis of the study was that cognitive impairment could be related to sleep deterioration during pregnancy. The study included 19 pregnant women in their third trimester of pregnancy (28−40 weeks, median 33 weeks (IQR 32−37)) recruited at the Department of Gynecology and Obstetrics, Medical University of Warsaw, and 20 non-pregnant women as controls. The assessment was performed using the vocabulary subtest from the Wechsler Adult Intelligence Scale (WAIS), D2 Test of Attention, OSPAN task (Operational Span Task) to assess cognitive performance, actigraphy to examine sleep parameters, and a set of self-report instruments: Athens Insomnia Scale (AIS), Beck Depression Inventory (BDI), Ford Insomnia Response to Stress (FIRST), Regenstein Hyperarousal Scale (HS), and Epworth Sleepiness Scale (ESS). Although there were no differences between the groups in WAIS (p = 0.18), pregnant women had worse scores in working memory capacity (overall number of remembered letters: p = 0.012, WM span index: p = 0.004) and a significantly lower score in attention (p = 0.03). Pregnant women also had lower sleep efficiency (p = 0.001), more awakenings from sleep (p = 0.001), longer average awakenings (p < 0.0001), longer wake after sleep onset (WASO, p < 0.0001), and longer total time in bed (p < 0.0001). In psychological assessment, pregnant women had only a higher FIRST score (p = 0.02). Using mediation analysis, we found that frequent awakening might be the major factor contributing to deterioration in working memory performance, explaining almost 40% of the total effect. In conclusion, sleep fragmentation in the third trimester of pregnancy may impair working memory consolidation. Pregnant women often complain about poor daily performance as well as non-restorative sleep. In this study, we showed that there is a relationship between lower sleep quality in pregnancy and worse cognitive functioning. We can expect a cognitive decline in women with sleep disturbances in pregnancy. Therefore, we should pay more attention to the treatment of sleep disorders in pregnancy.
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Affiliation(s)
- Dorota Wołyńczyk-Gmaj
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland
| | - Aleksandra Majewska
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland
| | - Aleksandra Bramorska
- Department of Psychology, University of Social Sciences and Humanities, Chodakowska 19/31, 03-815 Warsaw, Poland
| | - Anna Różańska-Walędziak
- Department of Human Physiology and Patophysiology, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski, 01-938 Warsaw, Poland
| | - Simon Ziemka
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland
| | - Aneta Brzezicka
- Department of Psychology, University of Social Sciences and Humanities, Chodakowska 19/31, 03-815 Warsaw, Poland
| | - Bartłomiej Gmaj
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland
- Correspondence:
| | - Krzysztof Czajkowski
- II Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2, 00-315 Warsaw, Poland
| | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, Nowowiejska 27, 00-665 Warsaw, Poland
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Oleszczuk-Modzelewska L, Malinowska-Polubiec A, Romejko-Wolniewicz E, Zawiejska A, Czajkowski K. What is the "cost" of reducing adverse pregnancy outcomes in patients with gestational diabetes mellitus - risk factors for perinatal complications in a retrospective cohort of pregnant women with GDM. BMC Pregnancy Childbirth 2022; 22:654. [PMID: 35986350 PMCID: PMC9392248 DOI: 10.1186/s12884-022-04980-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 06/07/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a frequent pregnancy complication, affecting the maternal and neonatal health. The new diagnostic strategy for GDM, proposed by the International Association of Diabetes and Pregnancy Study Groups in 2010 and World Health Organization in 2013, raised hope to reduce perinatal complications. The purpose of the study was to compare risk factors influencing maternal and foetal outcomes in a group of pregnant women diagnosed with GDM, and in a group of pregnant women without GDM, regardless of the adopted diagnostic criteria. Also, the aim of the study was to evaluate the impact of risk factors on perinatal results and the "cost" of reducing adverse pregnancy outcomes in patients with GDM. METHODS It was a retrospective study based on the analysis of births given after 37 weeks of pregnancy at the 2nd Department of Obstetrics and Gynaecology, Warsaw Medical University during the years 2013 to 2015. All pregnant women had a 75 g OGTT between the 24th and 28th weeks of pregnancy. The study compared risk factors for perinatal complications in 285 GDM patients and in 202 randomly selected women without GDM. The impact of selected risk factors on perinatal outcomes was analysed. RESULTS Both the diagnosis of GDM and maternal BMI prior to pregnancy, significantly modified the risk of excessive and insufficient weight gain during pregnancy. The parameters significantly influencing the risk of the composite adverse maternal outcome were the maternal abdominal circumference [OR: 1.08 (1.04; 1.11)] and multiparity, which reduced the risk by almost half [OR: 0.47 (0.30; 0.75)]. The maternal abdominal circumference before the delivery was a strong factor correlating with the occurrence of perinatal complications in both the mother and the foetus in the entire cohort. A circumference over 100 cm increased the risk of at least one maternal complication (increased blood loss, soft tissue injury, pre-eclampsia) by almost 40% (OR 1.38, p < 0.001). CONCLUSIONS No differences were found in maternal and foetal outcomes in GDM and non-GDM women except gestational weight gain below Institute of Medicine recommendations. The only "cost" of reducing adverse pregnancy outcomes in GDM patients seems to be lowering gestational weight gain, the future impact of which on GDM pregnant population should be assessed. The maternal abdominal circumference measured before delivery not the severity of carbohydrate intolerance, remained the main predictor for significant perinatal complications.
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Affiliation(s)
- Luiza Oleszczuk-Modzelewska
- 2nd Department of Obstetrics and Gynaecology, Medical University of Warsaw, 2 Karowa St, 00-315, Warsaw, Poland
| | - Aneta Malinowska-Polubiec
- 2nd Department of Obstetrics and Gynaecology, Medical University of Warsaw, 2 Karowa St, 00-315, Warsaw, Poland.
| | - Ewa Romejko-Wolniewicz
- 2nd Department of Obstetrics and Gynaecology, Medical University of Warsaw, 2 Karowa St, 00-315, Warsaw, Poland
| | - Agnieszka Zawiejska
- Department of Medical Simulation, Chair of Medical Education, Poznan University of Medical Sciences, 41 Jackowskiego St, 60-512, Poznan, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynaecology, Medical University of Warsaw, 2 Karowa St, 00-315, Warsaw, Poland
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Kacperczyk-Bartnik J, Bartnik P, Teliga-Czajkowska J, Malinowska-Polubiec A, Dobrowolska-Redo A, Romejko-Wolniewicz E, Sierdzinski J, Golawski K, Czajkowski K. Risk factors associated with neonatal infectious and respiratory morbidity following preterm premature rupture of membranes. Ginekol Pol 2022. [DOI: 10.5603/gp.a2022.0066] [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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19
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Derlatka P, Grabowska-Derlatka L, Halaburda-Rola M, Szeszkowski W, Czajkowski K. The Value of Magnetic Resonance Diffusion-Weighted Imaging and Dynamic Contrast Enhancement in the Diagnosis and Prognosis of Treatment Response in Patients with Epithelial Serous Ovarian Cancer. Cancers (Basel) 2022; 14:cancers14102464. [PMID: 35626067 PMCID: PMC9139226 DOI: 10.3390/cancers14102464] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/09/2022] [Accepted: 05/13/2022] [Indexed: 12/19/2022] Open
Abstract
Background. The aim of our study was to describe the selected parameters of diffusion-weighted imaging (DWI) and perfusion dynamic contrast enhancement (DCE) MRI in primary tumors in patients with serous epithelial ovarian cancer (EOC), as well as in disease course prognosis and treatment response, including bevacizumab maintenance therapy. Materials and Methods. In total, 55 patients with primary serous EOC were enrolled in the study. All patients underwent MR imaging using a 1.5 T clinical whole-body MR system in preoperative DWI and DCE MRI selected parameters: apparent diffusion coefficients (ADC), time to peek (TTP) and perfusion maximum enhancement (Perf. Max. En.) were measured. The data were compared with histopathological and immunochemistry results (with Ki67 and VEGF expression) and clinical outcomes. Results. Higher mean ADC values were found in low-grade EOC compared to high-grade EOC: 1151.27 vs. 894,918 (p < 0.0001). A negative correlation was found between ADC and Ki67 expression (p = 0.027), and between ADC and VEGF expression (p = 0.042). There was a negative correlation between TTP and PFS (p = 0.0019) and Perf. Max. En. and PSF (p = 0.003). In the Kaplan−Meier analysis (log rank), a longer PFS was found in patients with ADC values greater than the median; p = 0.046. The Kaplan−Meier analysis showed a longer PFS (p = 0.0126) in a group with TTP below the mean value for this parameter in patients who received maintenance treatment with bevacizumab. Conclusions. The described relationships between PFS and DCE and DWI allow us to hope to include these parameters in the group of EOC prognostic factors. This aspect seems to be of particular interest in the case of the association of PFS with DCE values in the group of patients treated with bevacizumab.
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Affiliation(s)
- Pawel Derlatka
- Second Department Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315 Warsaw, Poland;
- Correspondence: (P.D.); (L.G.-D.); Tel.: +48-22-5966-512 (P.D.); +48-22-5992-300 (L.G.-D.)
| | - Laretta Grabowska-Derlatka
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a St., 02-097 Warsaw, Poland; (M.H.-R.); (W.S.)
- Correspondence: (P.D.); (L.G.-D.); Tel.: +48-22-5966-512 (P.D.); +48-22-5992-300 (L.G.-D.)
| | - Marta Halaburda-Rola
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a St., 02-097 Warsaw, Poland; (M.H.-R.); (W.S.)
| | - Wojciech Szeszkowski
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a St., 02-097 Warsaw, Poland; (M.H.-R.); (W.S.)
| | - Krzysztof Czajkowski
- Second Department Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315 Warsaw, Poland;
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Czupryniak L, Dzida G, Fichna P, Jarosz-Chobot P, Gumprecht J, Klupa T, Mysliwiec M, Szadkowska A, Bomba-Opon D, Czajkowski K, Malecki MT, Zozulinska-Ziolkiewicz DA. Ambulatory Glucose Profile (AGP) Report in Daily Care of Patients with Diabetes: Practical Tips and Recommendations. Diabetes Ther 2022; 13:811-821. [PMID: 35278195 PMCID: PMC8991298 DOI: 10.1007/s13300-022-01229-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 02/08/2022] [Indexed: 12/01/2022] Open
Abstract
The ambulatory glucose profile (AGP) is now established as the standardised, practical one-page report for graphically presenting a summary of glycaemic control status in patients with diabetes who use continuous glucose monitoring (CGM) systems as part of their daily diabetes care. The AGP report provides both a visual and a statistical summary of the glucose metrics that, as agreed in the 2019 international consensus for assessing glycaemic control, should be analysed in all people with diabetes who are using CGM systems. The AGP report can be analysed in a systematic fashion to understand current glycaemic control and to monitor, in real time, the impact of adjustments to therapy in both type 1 diabetes and type 2 diabetes. Here we provide a practical guide to the glycaemic measures that are summarised in the AGP Report and illustrate the essential components of an AGP review in a series of hypothetical, real-world, patient-centred case studies (see Supplementary Materials).
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Affiliation(s)
- Leszek Czupryniak
- Department of Diabetology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Grzegorz Dzida
- Department of Internal Diseases, Medical University of Lublin, Lublin, Poland
| | - Piotr Fichna
- Department of Pediatric Diabetes, Auxology and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Janusz Gumprecht
- Department of Internal Medicine, Diabetology and Nephrology, Medical University of Silesia, Katowice, Poland
| | - Tomasz Klupa
- Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland
| | - Malgorzata Mysliwiec
- Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdansk, Gdansk, Poland
| | - Agnieszka Szadkowska
- Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, Lodz, Poland
| | - Dorota Bomba-Opon
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Maciej T Malecki
- Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland
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21
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Kacperczyk-Bartnik J, Bartnik P, Teliga-Czajkowska J, Malinowska-Polubiec A, Dobrowolska-Redo A, Romejko-Wolniewicz E, Rudzinski P, Czajkowski K. Results of expectant management in singleton and twin pregnancies complicated by preterm premature rupture of membranes. Ginekol Pol 2022; 93:999-1005. [PMID: 35106749 DOI: 10.5603/gp.a2021.0211] [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: 07/04/2021] [Revised: 10/02/2021] [Accepted: 11/21/2021] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES This study aimed to examine whether expectant management in twin pregnancies with preterm premature rupture of membranes (pPROM) is as safe as in singleton pregnancies. MATERIAL AND METHODS It was a retrospective cohort study comparing pregnancy course and outcome in singleton (n = 299) and twin pregnancies (n = 49) complicated by preterm premature rupture of membranes. Analysed factors included maternal diseases, gestational age at premature rupture of membranes (PROM), management during hospitalization, latency periods between PROM and delivery, gestational age at delivery, neonatal management and outcome. RESULTS The difference in the proportion of patients with latency up to 72 hours, latency between 72 hours and seven days, and latency exceeding seven days were insignificant. The percentage of patients who received intravenous tocolysis and antenatal corticosteroids were similar; however, patients in twin pregnancies more often received incomplete steroids dose (p = 0.01). The occurrence of the positive non-stress test result and signs of intrauterine infection were similar between the groups. No statistically significant differences in the prevalence of neonatal complications except transient tachypnoea of the newborn were identified (24% in the singleton vs 13% in the twin group, p = 0.03). CONCLUSIONS Expectant management of pPROM in singleton and twin pregnancies results in similar perinatal and neonatal outcome. Consequently, in case of no evident contraindications, expectant management of twin pregnancies seems to be equally as safe as in singleton pregnancies. Patients in twin pregnancies may be at higher risk of delivery before administration of full antenatal corticosteroids dose, therefore require immediate management initiation and transfer to a tertiary referral centre.
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Affiliation(s)
| | - Pawel Bartnik
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | | | | | | | | | - Patryk Rudzinski
- Students' Scientific Group affiliated to 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
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Jodzis A, Walędziak M, Czajkowski K, Różańska-Walędziak A. Intrapartum Analgesia-Have Women's Preferences Changed over the Last Decade? Medicina (Kaunas) 2022; 58:medicina58010087. [PMID: 35056395 PMCID: PMC8780736 DOI: 10.3390/medicina58010087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/27/2021] [Accepted: 01/05/2022] [Indexed: 11/16/2022]
Abstract
Background: Global access to social media has supposedly changed women’s awareness about the pharmacological and alternative methods of pain relief during vaginal delivery. The purpose of the study was to analyze changes in women’s preference and opinion about different forms of labor analgesia over the past decade. Materials and methods: The study was designed as an anonymous survey with questions about women’s knowledge and preference of different forms of pain relief in labor. The survey was conducted in 2010 and 2020, with data collected from 1175 women in 2010 and 1033 in 2020. Results: There were no differences between 2010 and 2020 in the proportion of women who wanted to receive analgesia in labor, at, respectively 67.9% of women in 2010 and 73.9% in 2020. About 50% of women chose epidural analgesia as the only efficacious method of pain relief in labor both in 2010 and 2020. There were no differences between the two time-points in the distribution of chosen methods of pain relief. In total, 92.3% of women in 2010 and 94.9% in 2020 thought that they should have the possibility of independent choice of analgesia method before the delivery (p < 0.04). Conclusions: A high proportion of Polish women choose EDA over other pharmacological and nonpharmacological methods of pain relief in labor, and this preference has not changed over the last decade. Increasing women’s knowledge about different methods of intrapartum pain relief may lead to wider use of nonpharmacological methods of pain relief.
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Affiliation(s)
- Agnieszka Jodzis
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315 Warsaw, Poland; (A.J.); (K.C.); (A.R.-W.)
| | - Maciej Walędziak
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Szaserów 128 St., 04-141 Warsaw, Poland
- Correspondence: ; Tel.: +48-261-816-210
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315 Warsaw, Poland; (A.J.); (K.C.); (A.R.-W.)
| | - Anna Różańska-Walędziak
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315 Warsaw, Poland; (A.J.); (K.C.); (A.R.-W.)
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23
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Kosinska-Kaczynska K, Torbé A, Kwiatkowski S, Borowski D, Breborowicz G, Czajkowski K, Czuba B, Huras H, Janiak K, Kajdy A, Kalinka J, Kosinski P, Leszczynska-Gorzelak B, Mierzynski R, Ropacka-Lesiak M, Sieroszewski P, Swiatkowska-Freund M, Wielgos M, Zimmer M. The Polish Society of Gynecologists and Obstetricians Guideline for the diagnostic assessment and management of multiple-gestation pregnancy complicated by fetal growth restriction. Ginekol Pol 2022; 93:256-263. [PMID: 35315031 DOI: 10.5603/gp.a2021.0244] [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] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/09/2021] [Indexed: 11/25/2022] Open
Abstract
The aim of the Guideline is to unify the diagnostic-therapeutic management of multiple-gestation pregnancies complicated by fetal growth restriction in at least one fetus.
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Affiliation(s)
| | - Andrzej Torbé
- Chair of Obstetrics, Gynecology and Neonatology, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, Poland
| | - Sebastian Kwiatkowski
- Chair of Obstetrics, Gynecology and Neonatology, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, Poland.
| | - Dariusz Borowski
- Chair of Obstetrics, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.,I Chair of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Grzegorz Breborowicz
- Chair of Perinatology and Gynaecology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Bartosz Czuba
- Chair of Woman's Health, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, Poland
| | - Hubert Huras
- Chair of Gynaecology and Obstetrics, Medical College, Jagiellonian University in Cracow, Poland
| | - Katarzyna Janiak
- Department of Gynaecology, Procreation and Therapy of Fetus Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Anna Kajdy
- Department of Reproductive Health, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Jaroslaw Kalinka
- I Chair of Gynecology and Obstetrics, Medical University of Lodz, Poland
| | | | | | - Radzislaw Mierzynski
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, Poland
| | - Mariola Ropacka-Lesiak
- Chair of Perinatology and Gynaecology, Poznan University of Medical Sciences, Poznan, Poland
| | - Piotr Sieroszewski
- I Chair of Gynecology and Obstetrics, Medical University of Lodz, Poland
| | | | - Miroslaw Wielgos
- I Chair of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Mariusz Zimmer
- I Chair and Clinic of Gynecology and Obstetrics, Wroclaw Medical University, Wroclaw, Poland
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Wasiak K, Czajkowski K, Frasuńska J. Spinal cord injury during early pregnancy: Problems in the course of rehabilitation and infant care, a case report. J Spinal Cord Med 2021:1-5. [PMID: 34726586 DOI: 10.1080/10790268.2021.1965336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
CONTEXT Spinal cord injury (SCI) sustained during pregnancy may be dangerous to the mother and her child. The risk is associated both with necessary diagnostic work-up and with the therapeutic process (radiographic investigations, surgical procedures, anesthesia, spinal shock, SCI complications, delivery). However, infant care is an enormous challenge for a woman with motor disability. The authors present a case report concerning the problems of treatment, rehabilitation and infant care in an SCI woman. To our knowledge, it is the first paper to describe SCI at such an early stage of gestation (2.5 weeks of gestational age/WGA). FINDINGS A 20-year old paraplegic woman after SCI was pregnant. The period of diagnostics (MRI, X-ray), surgery and rehabilitation was associated with minor complications for the mother and no complications for the child. At discharge from the rehabilitation center the patient presented Th11 paraplegia (AIS-C), 24.5 WGA, and she could walk using a walker with a knee-ankle-foot-orthosis on the right and an ankle-foot-orthosis on the left lower limb. She delivered at 38 WGA via cesarean section (girl, birth weight 2960 g, length 50 cm, APGAR = 9 and 10). Bathing the baby and walking with it were the main problems of the post-delivery period. CONCLUSIONS Factors potentially threatening the mother and child's health in SCI during pregnancy do not always contribute to the complications of the clinical status and health of the child. Comprehensive approach to the treatment, rehabilitation and care of pregnant women with SCI facilitates the course of pregnancy, delivery and child care.
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Affiliation(s)
- Krzysztof Wasiak
- Department of Rehabilitation, Mazovian Rehabilitation Center STOCER, Konstancin-Jeziorna, Poland
| | - Krzysztof Czajkowski
- Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Justyna Frasuńska
- Department of Rehabilitation, Medical University of Warsaw, Warsaw, Poland.,Department of Rehabilitation, Eleonora Reicher National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
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Walędziak M, Kacperczyk-Bartnik J, Bartnik P, Czajkowski K, Kwiatkowski A, Różańska-Walędziak A. The influence of gestational weight gain after bariatric procedures on selected pregnancy outcomes: a single center study. Sci Rep 2021; 11:21120. [PMID: 34702910 PMCID: PMC8548494 DOI: 10.1038/s41598-021-00549-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 10/14/2021] [Indexed: 11/08/2022] Open
Abstract
Pregnancy after bariatric surgery is known to be associated with a higher risk of small for gestational age infants (SGA) and maternal anemia. 71 patients with a history of bariatric surgery, who had at least one pregnancy ended with a delivery of a single live-born neonate after the bariatric surgery were included in the study. The main endpoints were gestational weight gain (GWG), GWG as % of the maternal weight at the beginning of pregnancy (GWG%), maternal anemia, SGA and large for gestational age infants (LGA), neonatal intensive care unit admission (NICU). GWG% was 23.8% ± 14.1 in the LGA group vs 13.9% ± 11.0 in the normal weight neonates group; p < 0.03. Patients diagnosed with anemia before pregnancy had higher GWG% than patients without pre-pregnancy anemia (20.1% ± 11.1 vs 13.4% ± 11.6); p < 0.05. GWG% was higher in patients, whose infants were admitted to NICU (25.3% ± 17.6 vs 14.1% ± 11.0; p < 0.04). GWG% can be considered a risk predictor of the LGA and NICU admissions in bariatric patients. Anemia diagnosed before pregnancy is associated with higher GWG%.
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Affiliation(s)
- Maciej Walędziak
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Szaserów 128 St., Warsaw, Poland.
| | - Joanna Kacperczyk-Bartnik
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., Warsaw, Poland
| | - Paweł Bartnik
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., Warsaw, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., Warsaw, Poland
| | - Andrzej Kwiatkowski
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Szaserów 128 St., Warsaw, Poland
| | - Anna Różańska-Walędziak
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., Warsaw, Poland
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26
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Broś-Konopielko M, Białek A, Oleszczuk-Modzelewska L, Zaleśkiewicz B, Różańska-Walędziak A, Czajkowski K. Nutritional, Anthropometric and Sociodemographic Factors Affecting Fatty Acids Profile of Pregnant Women's Serum at Labour-Chemometric Studies. Nutrients 2021; 13:2948. [PMID: 34578833 PMCID: PMC8470577 DOI: 10.3390/nu13092948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/18/2021] [Accepted: 08/23/2021] [Indexed: 11/16/2022] Open
Abstract
Diet influences the health of pregnant women and their children in prenatal, postnatal and adult periods. GC-FID fatty acids profile analysis in maternal serum and a survey of dietary habits were performed in 161 pregnant patients from the II Faculty and Clinic of Obstetrics and Gynaecology of the Medical University of Warsaw. Their diet did not fulfil all nutritional recommendations regarding dietary fat sources. Olive and rapeseed oil were the most popular edible oils. High usage of sunflower oil as well as high consumption of butter were also observed, whereas fish and fish oil intake by pregnant women was low. A chemometric approach for nutritional data, connected with anthropometric, sociodemographic and biochemical parameters regarding mothers and newborns, was conducted for diet and its impact estimation. It revealed four clusters of patients with differing fatty acids profile, which resulted from differences in their dietary habits. Multiparous women to a lesser extent followed dietary recommendations, which resulted in deterioration of fatty acids profile and higher frequency of complications. Observed high usage of sunflower oil is disquieting due to its lower oxidative stability, whereas high butter consumption is beneficial due to conjugated linoleic acids supply. Pregnant women should also be encouraged to introduce fish and fish oil into their diet, as these products are rich sources of long chain polyunsaturated fatty acids (LC PUFA). Multiparous women should be given special medical care by medical providers (physicians, midwifes and dietitians) and growing attention from the government to diminish the risk of possible adverse effects affecting mother and child.
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Affiliation(s)
- Magdalena Broś-Konopielko
- II Faculty and Clinic of Obstetrics and Gynaecology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Agnieszka Białek
- Department of Biotechnology and Nutrigenomics, Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, 05-552 Magdalenka, Poland
| | | | - Barbara Zaleśkiewicz
- II Faculty and Clinic of Obstetrics and Gynaecology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Anna Różańska-Walędziak
- II Faculty and Clinic of Obstetrics and Gynaecology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Krzysztof Czajkowski
- II Faculty and Clinic of Obstetrics and Gynaecology, Medical University of Warsaw, 02-091 Warsaw, Poland
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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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Jodzis A, Walędziak M, Czajkowski K, Różańska-Walędziak A. A Decade of Wishes-Changes in Maternal Preference of the Mode of Delivery among Polish Women over the Last Decade. Medicina (Kaunas) 2021; 57:572. [PMID: 34205066 PMCID: PMC8226619 DOI: 10.3390/medicina57060572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 11/28/2022]
Abstract
Background and Objectives: The maternal preference of mode of delivery is an important problem in respect of patient's autonomy and shared decision-making. The objective of the study was to obtain information about women's preferences of the mode of delivery and knowledge about the cesarean section and its' consequences. Materials and Methods: The study was based on a survey filled in by 1175 women in 2010 and 1033 women in 2020. Respondents were asked about their preference of mode of delivery, possible factors influencing their decision and their knowledge about risks and benefits of cesarean section. Results: There was a significant increase in the rate of women who declared cesarean section as their preferred mode of delivery, from 43.97% in 2010 to 56.03% in 2020 (p < 0.05). In 2010 26.51% of women thought that choice of mode of delivery should be their autonomic decision, 46.36% preferred decision-sharing with their obstetrician, 25.64% thought that cesarean section should be performed for medical indications only (respectively 34.86%, 44.45% and 19.38% in 2020). Conclusions: There has been a significant increase in the rate of Polish women who prefer cesarean delivery over the last decade, as well as in the rate of women who consider the mode of delivery as their autonomic decision.
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Affiliation(s)
- Agnieszka Jodzis
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315 Warsaw, Poland; (A.J.); (K.C.); (A.R.-W.)
| | - Maciej Walędziak
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, 04-141 Warsaw, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315 Warsaw, Poland; (A.J.); (K.C.); (A.R.-W.)
| | - Anna Różańska-Walędziak
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315 Warsaw, Poland; (A.J.); (K.C.); (A.R.-W.)
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Różańska-Walędziak A, Bartnik P, Kacperczyk-Bartnik J, Czajkowski K, Walędziak M, Kwiatkowski A. Pregnancy after bariatric surgery - a narrative literature review. Wideochir Inne Tech Maloinwazyjne 2021; 16:30-37. [PMID: 33786114 PMCID: PMC7991924 DOI: 10.5114/wiitm.2020.99281] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 06/28/2020] [Accepted: 08/10/2020] [Indexed: 12/30/2022] Open
Abstract
The purpose of this review was to analyze the literature about pregnancy after bariatric surgery. We searched for available articles on the subject from the last decade (2010 to 2020). The positive impact of bariatric surgery on the level of comorbidities and pregnancy and neonatal outcomes cannot be overrated. Weight loss after bariatric surgery reduces the incidence of obesity-related conditions in pregnancy. A pregnancy in a woman after bariatric surgery should be considered a high-risk pregnancy and taken care of by a multidisciplinary team with appropriate micronutrient and vitamin supplementation provided. Optimum time to conception should be chosen following the international recommendations. Every woman after bariatric surgery should be aware of symptoms of surgical complications and immediately contact their surgeon in case of abdominal pain.
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Affiliation(s)
| | - Paweł Bartnik
- 2 Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | | | - Krzysztof Czajkowski
- 2 Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Walędziak
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Andrzej Kwiatkowski
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
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Wesolowska A, Pietrzak B, Kociszewska-Najman B, Wielgos M, Czajkowski K, Wietrak E, Karzel K, Borszewska-Kornacka MK. Barley malt-based composition as a galactagogue - a randomized, controlled trial in preterm mothers. Ginekol Pol 2021; 92:118-125. [PMID: 33751522 DOI: 10.5603/gp.a2020.0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 07/06/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Delayed or insufficient breast milk production, as well as low milk supply, is still a challenging problem to overcome, particularly in the case of preterm delivery. Herbal galactagogues might be a good way to increase milk supply, however, there is a lack of clinical studies confirming their efficacy and safety. The aim of this study was to verify the safety and effectiveness as a galactagogue of the unique galactagogue composition based on barley malt with β -glucan and lemon balm. MATERIAL AND METHODS The study included 117 mothers of preterm infants randomly divided into the Galactagogue Group given galactagogue and the Placebo Group. A complete data set was obtained for 80 participants, divided equally between two groups. Volume of milk expressed by mothers during the first two weeks after delivery was the primary outcome and safety of the product was the secondary outcome. RESULTS Volume of milk recorded on participants' last visit in the Galactagogue Group was significantly higher than in the Placebo Group (95 mL vs 62.5 mL, p = 0.049). The total expressed milk volume during the study was 4209 ± 335 mL in the Placebo Group vs 6036 ± 498 mL (p = 0.003) in the Galactagogue Group. CONCLUSIONS Supplementation with unique Galactagogue composition was safe and increased milk output which allowed achieving target minimal volume of 500 mL per day in first week of lactation in preterm mothers.
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Affiliation(s)
- Aleksandra Wesolowska
- Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Family Hospital, Medical University of Warsaw, Department of Neonatology, Warsaw, Poland.
| | - Bronislawa Pietrzak
- 1st Department of Obstetrics and Gynecology,Faculty of Medicine, Medical University of Warsaw, Poland, Poland
| | - Bozena Kociszewska-Najman
- Department of Neonatology , Faculty of Health Sciences, Medical University of Warsaw, Poland, Poland
| | - Miroslaw Wielgos
- 1st Department of Obstetrics and Gynecology,Faculty of Medicine, Medical University of Warsaw, Poland, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Warsaw Medical University, Warsaw, Poland
| | | | | | - Maria K Borszewska-Kornacka
- Department of Neonatology and Intensive Care Unit, Faculty of Medicine, Medical University of Warsaw, Poland
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Kalinka J, Wielgos M, Leszczynska-Gorzelak B, Piekarska A, Huras H, Sieroszewski P, Czajkowski K, Wysocki J, Lauterbach R, Helwich E, Mazela J. COVID-19 impact on perinatal care: risk factors, clinical manifestation and prophylaxis. Polish experts' opinion for December 2020. Ginekol Pol 2021; 92:57-63. [PMID: 33576491 DOI: 10.5603/gp.a2021.0023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 01/12/2021] [Indexed: 11/25/2022] Open
Abstract
Rapid spread of severe acute respiratory syndrome coranovirus-2 virus (SARS-CoV-2) caused the pandemic of Coronavirus Disease 19 (COVID-19). Clinical course of the disease presents symptoms mainly from the respiratory system such as: cough, dyspnea and fever, and among some patients, can deteriorate even further to acute respiratory distress syndrome (ARDS), eventually leading to death. This outbreak, as well as previous ones (SARS, MERS) pose a significant challenge for health care managers, epidemiologists and physicians. Below we are presenting the clinical profile of the COVID-19 among special group of patients; pregnant women and newborns, who require special clinical management during hospitalization. In the summary of this manuscript, we present practical guidelines for managing pregnant women infected with SARS-CoV-2, labor and care of the newborn of a positive mother, as well as practical guidelines for COVID-19 vaccinations. It is important to stress, that this manuscript is based on information available as of December 2020.
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Affiliation(s)
- Jaroslaw Kalinka
- Departament of Perinatology, I st Chair of Gynecology and Obstetrics, Medical University of Lodz, Poland.
| | - Miroslaw Wielgos
- 1 st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | | | - Anna Piekarska
- Department of Infectious Diseases and Hepatology, Medical University of Lodz, Poland
| | - Hubert Huras
- Department of Obstetrics and Perinatology, Jagiellonian University Collegium Medicum, Cracow, Poland
| | - Piotr Sieroszewski
- Department of Fetal Medicine and Gynaecology, I Chair of Obstetrics and Gynaecology, Medical University of Lodz, Wilenska 37 Str., 94-029 Lodz, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Jacek Wysocki
- Chair and Department of Health Prophylaxis, Poznan University of Medical Sciences in Poznan, Poland
| | | | - Ewa Helwich
- Department of Neonatology, Institute of Mother and Child, Warsaw, Poland
| | - Jan Mazela
- Department of Newborns' Infectious Diseases, Poznan University of Medical Sciences, Poznan, Poland
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Rozanska-Waledziak A, Kacperczyk-Bartnik J, Waledziak M, Bartnik P, Kwiatkowski A, Teliga-Czajkowska J, Czajkowski K. Intrauterine growth retardation after laparoscopic Roux-en-Y gastric bypass - clinical presentation and literature review. Ginekol Pol 2021; 92:226-229. [PMID: 33576472 DOI: 10.5603/gp.a2020.0163] [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: 06/11/2020] [Revised: 08/03/2020] [Accepted: 09/09/2020] [Indexed: 11/25/2022] Open
Abstract
Bariatric surgery is associated with a higher risk of intrauterine growth retardation (IUGR) and small for gestational age neonates. We present two examples of IUGR after laparoscopic Roux-en-Y gastric bypass, both associated with excessive restriction in patients caloric intake, one due to obstetrician's indications and the other resulting from patient's anxiety of weight gain in pregnancy. IUGR was observed accordingly in the 35th and 28th week of pregnancy. The first patient had an urgent cesarean section due to pathological cardiotocography tracings in the 35th week of pregnancy, with the newborn's weight of 1690 g (< 1st percentile). The second patient, admitted in the 28th week with suspected IUGR, had an elective cesarean section in the 36th week, with the newborn's weight of 2095 g (5th percentile). Although malabsorptive mechanisms are known to be involved in the impaired fetal growth after bariatric surgery, patients' and obstetricians' adherence to nutrition and supplementation regimen are of utmost importance. The problem of optimum daily caloric intake, vitamin and micronutrients supplementation in pregnancies after bariatric surgery is presently discussed in the literature. Optimum care and advice for bariatric patients have to be diversified as malabsorptive and restrictive operations lead to changes in metabolism, nutrition and hormonal balance.
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Affiliation(s)
| | | | - Maciej Waledziak
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Pawel Bartnik
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Andrzej Kwiatkowski
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | | | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
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Szewczuk W, Szewczuk O, Czajkowski K, Górnicka B, Ilczuk T, Semczuk A. ARID1A and GPR30 expression patterns characterize the different histological subtypes of endometrial carcinoma. EUR J GYNAECOL ONCOL 2021. [DOI: 10.31083/j.ejgo4206166] [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: 11/06/2022]
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Pospiech K, Czajkowski K. Amniotic fluid lactate level as a diagnostic tool for prolonged labour. J Mother Child 2020; 24:3-7. [PMID: 33470958 PMCID: PMC8258834 DOI: 10.34763/jmotherandchild.20202403.2027.d-20-00011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Prolonged labour can lead to postpartum complications and adverse outcomes for both mother and baby. Measurable parameters can help in the active management of labour, timely diagnosis of dystocia and in the choice of the method of delivery. Progressive uterine contractions are necessary to complete labour successfully. Myometrial fatigue during prolonged labour causes a change from aerobic to anaerobic metabolism, resulting in an accumulation of intramuscular lactic acid and probably a subsequent increase in amniotic fluid lactate concentration. High amniotic fluid lactate level has been associated with ineffective uterine contractions leading to labour arrest. A considerable number of studies conducted so far indicate that the level of lactate in amniotic fluid may be a new non-invasive diagnostic tool for early prediction of prolonged labour and the need for immediate obstetric intervention. Low amniotic fluid lactate level may facilitate a decision to continue vaginal labour by oxytocin augmentation. A high level of amniotic fluid lactate is associated with surgical obstetric procedures. Measuring amniotic fluid lactate level might simplify the patient's allocation to a group, which will benefit from the administration of oxytocin and to a group that will not benefit from further prolongation of labour. This study aimed to briefly review current knowledge on amniotic fluid lactate concentrations measured using standard biochemical methods during the first stage of labour following normal pregnancy, as a possible diagnostic tool for prolonged labour. For this purpose, PubMed, EMBASE, Medline (1990 to July 2020) trials register and reference lists of relevant articles were searched.
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Affiliation(s)
- Kinga Pospiech
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
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Kacperczyk-Bartnik J, Bartnik P, Teliga-Czajkowska J, Malinowska-Polubiec A, Dobrowolska-Redo A, Romejko-Wolniewicz E, Bienko M, Czajkowski K. Comparison of maternal characteristics, pregnancy course, and neonatal outcome in preterm births with and without prelabor rupture of membranes. Ginekol Pol 2020; 91:528-538. [PMID: 33030733 DOI: 10.5603/gp.a2020.0085] [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: 04/14/2020] [Accepted: 05/19/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate pregnancy outcome of patients with prelabor rupture of membranes receiving expectant management and giving birth prematurely in comparison to preterm births of patients with intact membranes. MATERIAL AND METHODS It was a retrospective cohort study comparing maternal and neonatal outcome in two groups of preterm births. The first group included 299 consecutive singleton preterm births complicated by prelabor rupture of membranes. The second group consisted of 349 consecutive singleton preterm births without prelabor rupture of membranes. RESULTS Patients without pPROM underwent Caesarean sections more often than women from the pPROM group (65.3% vs 45.2%; p < 0.001). No statistically significant differences regarding the gestational age during delivery were identified. Lower birth weight was detected in the group with no history of pPROM (p < 0.001). No differences regarding early-onset sepsis were identified and higher percentage of late-onset infections was observed in infants with no history of pPROM (8.9% vs 4.7%; p = 0.04). Pulmonary hypertension was more common in the infants from the pPROM group (4% vs 1.4%; p = 0.049). Neonatal respiratory distress syndrome and respiratory failure were more prevalent in cases of no pPROM history - 20% vs 12.7% (p = 0.02) and 40% vs 25.8% (p < 0.001), respectively. CONCLUSIONS Development of multiple complications in preterm neonates may be more associated with the management, gestational age at birth, and birth weight than with the occurrence of preterm prelabor rupture of membranes.
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Affiliation(s)
| | - Pawel Bartnik
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
| | | | | | | | - Ewa Romejko-Wolniewicz
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Malgorzata Bienko
- Students' Scientific Group affiliated to 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
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36
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Różańska-Walędziak A, Bartnik P, Kacperczyk-Bartnik J, Walędziak M, Kwiatkowski A, Czajkowski K. The effect of bariatric surgery on female sexual function: a cross-sectional study. Sci Rep 2020; 10:12138. [PMID: 32699257 PMCID: PMC7376208 DOI: 10.1038/s41598-020-69176-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 07/08/2020] [Indexed: 12/04/2022] Open
Abstract
The generally negative impact of obesity on female sexuality is well-established. The possible association between bariatric surgery, weight loss, and female sexuality is much less described. The aim of the study was to analyse the possible association between bariatric surgery and female sexual function. It was a cross-sectional study of 623 patients who underwent bariatric surgery between 1999 and 2017. Patients were recruited on the basis of medical records from the Military Institute of Medicine in Warsaw. Patients were invited to complete a questionnaire which consisted of self-designed demographic questions and Female Sexual Function Index (FSFI). The total FSFI score, as well as each subdomain, improved significantly after surgery. The prevalence of low score (< 26.55) was significantly lower after the surgery in comparison to the status prior to the procedure (36.3% vs. 57.5%; p < .001). There were no differences regarding the number of sexually active patients before and after the surgery (75.3% vs. 76.1%; p < .63). There were observed statistically significant, positive correlations between BMI decrease and each subdomain of the FSFI score as well as the total score. Weight loss surgery seems to decrease the risk of sexual dysfunction presence and the advantages are associated with the total BMI loss.
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Affiliation(s)
- Anna Różańska-Walędziak
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315, Warsaw, Poland
| | - Paweł Bartnik
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315, Warsaw, Poland.
| | - Joanna Kacperczyk-Bartnik
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315, Warsaw, Poland
| | - Maciej Walędziak
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Szaserów 128 St., 04-141, Warsaw, Poland
| | - Andrzej Kwiatkowski
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Szaserów 128 St., 04-141, Warsaw, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315, Warsaw, Poland
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Różańska-Walędziak A, Walędziak M, Bartnik P, Kacperczyk-Bartnik J, Janik M, Kowalewski P, Kwiatkowski A, Czajkowski K. The Influence of Bariatric Surgery on Pregnancy and Perinatal Outcomes-A Case-Control Study. J Clin Med 2020; 9:E1324. [PMID: 32370300 PMCID: PMC7291074 DOI: 10.3390/jcm9051324] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Obesity in pregnant women increases the incidence of pregnancy-induced comorbidities and the rate of operative deliveries. PURPOSE OF THE STUDY As bariatric surgery is the reference method of treatment of obesity, we wanted to evaluate its influence on the course of pregnancy and perinatal outcomes. MATERIAL AND METHODS Data was collected from 627 female patients after bariatric surgery, of whom 107 had a history of pregnancy after the surgery, and 345 non-bariatric patients who had a delivery at a tertiary perinatal center. Sixty-one cases were matched (1:1) with controls for age, pre-pregnancy BMI and presence of pre-pregnancy comorbidities. The main endpoints were gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), small (SGA) and large for gestational age infants (LGA) and cesarean sections (CS). RESULTS Patients after bariatric procedures were significantly less likely to have GDM (19.67%/37.7%; p = 0.0433), PIH (11.47%/16.39%; p = 0.6072) and preterm delivery (13.11%/37.7%; p = 0.0026). The CS rate was higher (57.38%/40.98%; p = 0.0987). There was an increased risk of SGA (18.03%/13.11%; p = 0.6072) and a decreased risk of LGA (6.56%/16.39%; p = 0.146). CONCLUSIONS Patients after bariatric surgery have a decreased risk of pregnancy-induced comorbidities, preterm deliveries and LGA infants, with an increase in rate of CS and SGA infants compared to general population matched for pre-pregnancy BMI, age and presence of pre-pregnancy comorbidities.
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Affiliation(s)
- Anna Różańska-Walędziak
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315 Warsaw, Poland; (A.R.-W.); (P.B.); (J.K.-B.); (K.C.)
| | - Maciej Walędziak
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Szaserów 128 St., 04-141 Warsaw, Poland; (M.J.); (P.K.); (A.K.)
| | - Paweł Bartnik
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315 Warsaw, Poland; (A.R.-W.); (P.B.); (J.K.-B.); (K.C.)
| | - Joanna Kacperczyk-Bartnik
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315 Warsaw, Poland; (A.R.-W.); (P.B.); (J.K.-B.); (K.C.)
| | - Michał Janik
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Szaserów 128 St., 04-141 Warsaw, Poland; (M.J.); (P.K.); (A.K.)
| | - Piotr Kowalewski
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Szaserów 128 St., 04-141 Warsaw, Poland; (M.J.); (P.K.); (A.K.)
| | - Andrzej Kwiatkowski
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Szaserów 128 St., 04-141 Warsaw, Poland; (M.J.); (P.K.); (A.K.)
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315 Warsaw, Poland; (A.R.-W.); (P.B.); (J.K.-B.); (K.C.)
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Świderska-Kiec J, Czajkowski K, Zaręba-Szczudlik J, Kacperczyk-Bartnik J, Bartnik P, Romejko-Wolniewicz E. Comparison of HPV Testing and Colposcopy in Detecting Cervical Dysplasia in Patients With Cytological Abnormalities. In Vivo 2020; 34:1307-1315. [PMID: 32354923 DOI: 10.21873/invivo.11906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/02/2020] [Accepted: 02/03/2020] [Indexed: 12/31/2022]
Abstract
AIM The aim of the study was to compare the diagnostic value of HPV testing and colposcopy in patients with abnormal cytology results. PATIENTS AND METHODS A total of 186 women with cytological abnormalities were included in the study. The patients underwent colposcopy examinations and DNA HPV testing of cervical smear with genotyping. RESULTS The HPV test was demonstrated to be more sensitive (79.4%) than specific (60.2%) and was more sensitive than colposcopy for detecting CIN changes (79.4% vs. 73.7%). Combined tests achieved a high sensitivity (90.9%) and negative predictive value (96.1%) in detecting patients with CIN2+ and demonstrated the highest positive predictive value (77.3%) for detecting CIN1+. Colposcopy had a very good specificity (83.5%) and positive predictive value (71.2%) in finding CIN1+ cases. CONCLUSION HPV tests showed a higher sensitivity than colposcopy, but colposcopy results presented higher specificity. Combining HPV testing and colposcopy proved to be the most efficient method for detecting CIN lesions.
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Affiliation(s)
- Joanna Świderska-Kiec
- 2 Department of Obstetrics and Gynaecology, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Czajkowski
- 2 Department of Obstetrics and Gynaecology, Medical University of Warsaw, Warsaw, Poland
| | - Julia Zaręba-Szczudlik
- 2 Department of Obstetrics and Gynaecology, Medical University of Warsaw, Warsaw, Poland
| | | | - Paweł Bartnik
- 2 Department of Obstetrics and Gynaecology, Medical University of Warsaw, Warsaw, Poland
| | - Ewa Romejko-Wolniewicz
- 2 Department of Obstetrics and Gynaecology, Medical University of Warsaw, Warsaw, Poland
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Różańska-Walędziak A, Szewczuk O, Walędziak M, Czajkowski K. Spontaneous unilateral exophthalmos after a vaginal delivery. Eur J Ophthalmol 2020; 31:NP57-NP59. [PMID: 32279535 DOI: 10.1177/1120672120914534] [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] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Spontaneous orbital exophthalmos is an extremely rare incident during a vaginal delivery. In most cases, it is associated with venous malformations and presents spontaneous resolution. CASE DESCRIPTION We report a case of orbital hematoma after vaginal delivery due to a superior ophthalmic vein rupture. The patient presented proptosis of the right eye and diplopia immediately after the delivery and was diagnosed with unilateral orbital hematoma. The patient was given conservative treatment with complete resolution of clinical symptoms 4 weeks after the delivery. CONCLUSION Increased abdominal pressure during a vaginal delivery may lead to a spontaneous orbital hemorrhage.
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Affiliation(s)
| | - Oksana Szewczuk
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Walędziak
- Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
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Kalinowska A, Kułakowska A, Adamczyk-Sowa M, Czajkowski K, Kurowska K, Pietrzak B, Radziszewski P, Rejdak K, Bartosik-Psujek H. Recommendations for neurological, obstetrical and gynaecological care in women with multiple sclerosis: a statement by a working group convened by the Section of Multiple Sclerosis and Neuroimmunology of the Polish Neurological Society. Neurol Neurochir Pol 2020; 54:125-137. [PMID: 32083716 DOI: 10.5603/pjnns.a2020.0015] [Citation(s) in RCA: 2] [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: 07/17/2019] [Revised: 11/13/2019] [Accepted: 11/18/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Multiple sclerosis (MS) is the most common non-traumatic neurological cause of disability in young adults, affecting women 1-3 times more often than men. Several specific challenges arise from the fact that young women diagnosed with MS often have to make decisions related to treatment and family planning at the same time. These issues are connected with fertility, the impact of pregnancy on disease course, the choice of pregnancy timing, and the optimal mode of disease-modifying therapy in the context of a planned pregnancy, contraception, urological complaints, and sexual dysfunction. STATE OF THE ART While MS does not in itself adversely affect fertility, pregnancy or childbirth, pregnancy needs to be carefully planned. This requires the interdisciplinary co-operation of a neurologist, gynaecologist and psychologist. Data on the impact of disease-modifying drugs on foetal development are very limited, and none of these drugs is 100% safe during pregnancy. In the second and third trimesters, MS relapse rate decreases. Unfortunately, it increases within the first 3-6 months after delivery. Adequate disease control should be achieved before pregnancy, as relapse rate in the period of two years preceding pregnancy is one of the strongest predictive factors for post-partum relapses. CLINICAL IMPLICATIONS The following is a statement by a working group of experts in neurology, gynaecology, obstetrics and urology, convened by the Section of Multiple Sclerosis and Neuroimmunology of the Polish Neurological Society, addressing the issues that are specific to the female MS population. The aim of this statement is to provide guidance in pregnancy planning and disease management, both during pregnancy and post-partum. FUTURE DIRECTIONS This statement reflects expert opinion and is not intended to be read as guidelines. It rather provides up-to-date information on how to optimise care of female MS patients of childbearing age.
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Affiliation(s)
- Alicja Kalinowska
- Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan Univerisity of Medical Sciences, 49, Przybyszewskiego st., 60-355 Poznan, Poland.
| | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology, Zabrze; Medical University of Silesia, Katowice, Poland
| | - Krzysztof Czajkowski
- II Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | | | - Bronisława Pietrzak
- I Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Piotr Radziszewski
- Department of General, Oncological and Functional Urology, Medical University of Warsaw, Poland
| | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, Poland
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Sienko J, Gaj P, Czajkowski K, Nowis D. Peroxiredoxin-5 is a negative survival predictor in ovarian cancer. Ginekol Pol 2020; 90:1-6. [PMID: 30756364 DOI: 10.5603/gp.2019.0001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 11/29/2018] [Accepted: 12/02/2018] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Peroxiredoxins (PRDXs) constitute a family of antioxidant enzymes which are also involved in the process of carcinogenesis. They are composed of six identified isoforms (PRDX-1-6) and are supposed to play different roles in tumor progression, depending on type of cancer and member of the PRDX family. The aim of the study was to assess the prog- nostic value of PRDXs in ovarian cancer. MATERIAL AND METHODS a dataset of patients with ovarian cancer from The Cancer Genome Atlas was analyzed. Expression of PRDX-1 to 6 mRNA was evaluated in 260 samples. The prognostic value of PRDXs was assessed using the Cox regression model which included the following clinical and pathological data: age, clinical stage, tumor grade, and residual disease. RESULTS Within the PRDXs family, only higher expression of PRDX-5 was associated with worse overall survival both, in unselected patients and > 50-year-olds. PRDX-5 expression and residual disease were independent negative prognostic factors of patient survival. CONCLUSIONS PRDX-5 is a negative predictor of survival in ovarian cancer.
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Affiliation(s)
- Jacek Sienko
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland.
| | - Paweł Gaj
- Laboratory of Human Cancer Genetics, Center of New Technologies, University of Warsaw, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Dominika Nowis
- Department of Immunology, Center for Biostructure Research, Medical University of Warsaw, Poland.,Laboratory of Experimental Medicine, Center of New Technologies, University of Warsaw, Poland.,Department of Genomic Medicine, Medical University of Warsaw, Poland
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Szewczuk W, Szewczuk O, Czajkowski K, Grala B, Semczuk A. Ovarian adult-type granulosa cell tumor concomitant with simple endometrial hyperplasia: a case study with selected immunohistochemistry. J Int Med Res 2019; 48:300060519886984. [PMID: 31870196 PMCID: PMC7607058 DOI: 10.1177/0300060519886984] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Ovarian adult-type granulosa cell tumors are often associated with endometrial hyperplasia or even uterine cancer. Herein, we present a case report of a 65-year-old female patient who had undergone curettage of the uterine cavity several times due to abnormal and irregular uterine bleeding. Owing to recurrent episodes of vaginal bleeding as well as ineffective pharmacological treatment of simple endometrial hyperplasia without atypia, the patient underwent a laparoscopically-assisted vaginal hysterectomy. Owing to an enlarged right ovary with bluish color, intra-operative pathological examination was immediately performed. Surprisingly, an ovarian adult-type granulosa cell tumor was diagnosed, and the surgery was extended to pelvic lymphadenectomy and omentectomy. Immunohistochemical staining with selected antibodies (Arginase 2, Nidogen 2, BAF250a/ARID1A, GPR30, SF-1/NR5A, and 1LRH-2E1/NR5A2) was also performed. In conclusion, in cases of recurrent vaginal bleeding concomitant with endometrial hyperplasia, the existence of rare ovarian tumors connected with extensive estrogenic stimulation must be taken into account. Immunostaining with selected antibodies (Arginase 2, Nidogen 2, ARID1A, or GPR30) may help elucidate the possible molecular mechanisms associated with the BAF250a/development of various ovarian/endometrial abnormalities.
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Affiliation(s)
- Wiktor Szewczuk
- Department of Pathology, Military Institute of Medicine, Warsaw, Poland
| | - Oksana Szewczuk
- IInd Department of Obstetrics and Gynecology, Medical University, Warsaw, Poland
| | - Krzysztof Czajkowski
- IInd Department of Obstetrics and Gynecology, Medical University, Warsaw, Poland
| | - Bartłomiej Grala
- Department of Pathology, Military Institute of Medicine, Warsaw, Poland
| | - Andrzej Semczuk
- IInd Department of Gynecology, Lublin Medical University, Lublin, Poland
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Sieńko J, Teliga-Czajkowska J, Przytula E, Czajkowski K, Smolarczyk R, Nowis D. Peroxiredoxin-1 as a prognostic factor in patients with ovarian cancer. Ann Agric Environ Med 2019; 26:415-419. [PMID: 31559796 DOI: 10.26444/aaem/105899] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION AND OBJECTIVE Peroxiredoxin-1 (PRDX-1) belongs to a family of antioxidant enzymes and has proved to be a versatile molecule regulating cell growth, differentiation and apoptosis. PRDX1-regulated signaling pathways play an important role in the progression and metastasis of human tumours, especially in breast, esophageal and lung cancers. The aim of the study was to evaluate the expression of PRDX-1 in ovarian cancer tissues, and to test the clinical value of PRDX-1 as a prognostic factor in this malignancy. MATERIAL AND METHODS PRDX-1 expression was assessed by automated immunohistochemistry in tumours taken from 55 patients with ovarian cancer during primary surgery. Specimen were formalin-fixed and preserved in paraffin-embedded blocks. The results were correlated with clinicopathological data. RESULTS A high expression of PRDX-1 was observed in 20% of cases, and was associated with worse compliance to chemotherapy protocol (P<0.002), worse response to chemotherapy (P<0.04), and higher levels of CA 125 after the 1st line treatment (P<0.004). PRDX-1 positive subjects had a significantly lower 5-year disease-free survival (9.1% vs. 42.6%, P<0.01) and a lower 5-year overall survival (9.1% vs. 56.7%; P<0.002). Multivariate analysis showed that a high expression of PRDX-1 is an independent prognostic factor of poor, overall survival (P<0.002) and a disease-free survival (P<0.01). CONCLUSIONS Results of the study show that PRDX-1 expression in tumour tissues can be another biomarker of prognosis in patients with ovarian cancer.
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Affiliation(s)
- Jacek Sieńko
- 2nd Department of Obstetrics and Gynecology, Medical University, Warsaw, Poland
| | | | - Ewa Przytula
- Department of Pathology, The Medical Center of Postgraduate Education, Warsaw, Poland
| | | | - Roman Smolarczyk
- Department of Gynecological Endocrinology, Medical University, Warsaw, Poland
| | - Dominika Nowis
- Department of Immunology, Cenrtre for Biostructure Research, Medical University, Warsaw, Poland
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Teliga-Czajkowska J, Sienko J, Jalinik K, Smolarczyk R, Czajkowski K. Prognostic value of tissue plasminogen activator (tPA) in patients with epithelial ovarian cancer undergoing chemotherapy. Ginekol Pol 2019; 90:235-241. [PMID: 30968388 DOI: 10.5603/gp.a2019.0043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 02/20/2019] [Revised: 03/13/2019] [Accepted: 03/21/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Tissue plasminogen activator (tPA) is a key enzyme for fibrin degradation and the proteolytic defense against formation of the thrombotic endothelial deposits. tPA is involved in carcinogenesis but its exact role in tumor biology is not very well understood and a prognostic value of tPA remains ambiguous in different cancers. The aim of the study was to assess the prognostic value of plasma tPA in patients with epithelial ovarian cancer (EOC) in the course of the first line chemotherapy. MATERIAL AND METHODS the study covered 60 patients with EOC who underwent the 1st line chemotherapy. Plasma tPA was assessed at onset, after 3 and 6 cycles of chemotherapy. The groups were stratified according to tPA level at onset of chemotherapy (low tPA group < 6.5 mg/L, N = 37 and high tPA group > 6.5 mg/L, N = 23). Survival analysis was repeated for the cut-off of tPA level at 6.5 mg/L and 5.1 mg/L after 3 and 6 cycles. RESULTS Only subjects with tPA > 6.5 mg/L at onset of chemotherapy had a significantly lower probability of a 5-year survival (34.8% vs. 72.7%, P < 0.006) and lower chance for disease free survival within 5 years (39.3% vs. 72.7%, P < 0.014). tPA < 6.5 mg/L plasma level evaluated at onset of chemotherapy was an independent marker of better overall survival (RR = 0.44, 95%CI = 0.19-0.98) but not disease-free survival. CONCLUSIONS Plasma tPA may serve as a marker of survival if assessed at onset of the first line chemotherapy in patients with ovarian cancer.
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Affiliation(s)
| | - Jacek Sienko
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland.
| | - Katarzyna Jalinik
- Department of Gynecologic Oncology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland
| | - Roman Smolarczyk
- Department of Gynecological Endocrinology, Medical University of Warsaw, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
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Wender-Ożegowska E, Bomba-Opoń D, Brązert J, Celewicz Z, Czajkowski K, Gutaj P, Malinowska-Polubiec A, Zawiejska A, Wielgoś M. Standards of Polish Society of Gynecologists and Obstetricians in management of women with diabetes. Ginekol Pol 2018; 89:341-350. [PMID: 30010185 DOI: 10.5603/gp.a2018.0059] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 06/08/2018] [Accepted: 06/08/2018] [Indexed: 11/25/2022] Open
Affiliation(s)
- Ewa Wender-Ożegowska
- Division of Reproduction, Poznan University of Medical Sciences, Poznan, Poland., Poland.
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Dobrowolska-Redo A, Teliga-Czajkowska J, Sotowska A, Romejko-Wolniewicz E, Zaręba-Szczudlik JZS, Malinowska-Polubiec A, Kacperczyk-Bartnik J, Czajkowski K. Pregnancy in patient with X-linked hypophosphatemic rickets – management and outcome. CLIN EXP OBSTET GYN 2018. [DOI: 10.12891/ceog4385.2018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Wielgoś M, Bomba-Opoń D, Czajkowski K, Wender-Ożegowska E, Hod M. Towards a European Consensus on Gestational Diabetes Mellitus: A Pragmatic Guide for Diagnosis, Management, and Care. The Polish Diabetes in Pregnancy Study Group and FIGO. Ginekol Pol 2018; 88:46-49. [PMID: 28157246 DOI: 10.5603/gp.a2017.0010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 01/19/2017] [Indexed: 11/25/2022] Open
Affiliation(s)
- Mirosław Wielgoś
- 1st Chair and Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland 2nd Chair and Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland.
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Czajkowski K, Helwich E, Preis K, Grzesiak M, Krekora M, Gulczyńska E, Kornacka K, Zeman K, Maroszyńska I, Respondek-Liberska M. Recommendations “Cardio-Prenatal 2017” From Poland. Prenatal Cardiology 2018. [DOI: 10.1515/pcard-2018-0001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
On 27.10.2017, in the course of the CARDIO-PRENATAL Conference at the Polish Mother’s Memorial Institute and Health Centre in Lodz, we presented, among others, the following problems:
classification of prenatal heart defects, fetal hemodynamic status evaluation in the third trimester, expected neonate’s clinical condition, planned procedures to be conducted just after birth and also planned medical staff to be present in the delivery room. Here are our main recommendations following the meeting and discussion.
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Affiliation(s)
| | - Ewa Helwich
- National Consultant in Charge of Neonatology, Łódź , Poland
| | - Krzysztof Preis
- Provincial Consultant in Charge of Gynaecology & Obstetrics, Gdańsk , Poland
| | - Mariusz Grzesiak
- Provincial Consultant in Charge of Gynaecology & Obstetrics, Łódź , Poland
| | - Michał Krekora
- Deputy Head of the Clinics of Obstetrics & Gynaecology of the Polish Mother’s Memorial Hospital in Łódź , Poland
| | - Ewa Gulczyńska
- Provincial Consultant in Charge of Neonatology, Łódź , Poland
| | | | - Krzysztof Zeman
- Provincial Consultant in Charge of Immunology, Łódź , Poland
| | - Iwona Maroszyńska
- Chairwoman of the Łódź Branch of the Polish Society of Neonatology, Łódź , Poland
| | - Maria Respondek-Liberska
- President of Association for the Development of Prenatal Cardiology, Head of Prenatal Cardiology of the Polish Mother’s Memorial Hospital in Łódź, Head of Fetal Malformations Department, Medical University of Lodz , Poland
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Zareba-Szczudlik J, Pykalo-Gawinska D, Gawinski C, Lewandowski Z, Malinowska-Polubiec A, Dobrowolska-Redo A, Czajkowski K, Wilczynski J, Romejko-Wolniewicz E. New criteria for gestational diabetes mellitus - do they impact the outcome? Neuro Endocrinol Lett 2017; 38:441-448. [PMID: 29298286] [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] [Received: 08/19/2017] [Accepted: 09/11/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The aim of the study was to compare the perinatal outcome of pregnancies in mothers who were diagnosed with gestational diabetes mellitus (GDM) with previous versus current Polish Gynecological Society (PTG) criteria. METHODS 475 patients were divided into three groups. In group A, the patients only met the previous PTG criteria for a GDM diagnosis, i.e., those with a blood glucose level of 140-152 mg/dl 2 hours after administration, a fasting glucose level <92 mg/dl, and a blood glucose level <180 mg/dl 1 hour after administration. Group B included patients complying with both the previous and current PTG criteria for a GDM diagnosis. Group C included patients who only met the current PTG criteria for a GDM diagnosis, i.e., those with a fasting blood glucose level of 92-99 mg/dl, a blood glucose level <180 mg/dl 1 hour and <140 mg/dl 2 hours after administration, respectively. RESULTS Women from group C were characterized by the highest fasting glycaemia in the first trimester of pregnancy (93.0 mg/dL vs. 88.0 mg/dL vs. 83.5 mg/dL, p=0.012) and during the OGTT (p=0.001). Gestational diabetes was diagnosed significantly earlier in patients from group C (23 vs. 26 vs. 26 weeks, p=0.005). The patients from group A significantly less frequently required insulin therapy for proper glycemic control (p=0.035). Women from group A were characterized by lower pre-pregnancy BMI (p=0.001). CONCLUSIONS Current PTG criteria for diagnosing GDM according to the IADPSG allow for identification of women who often require insulin therapy to achieve proper glycemic control.
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Affiliation(s)
| | - Dominika Pykalo-Gawinska
- Students' Scientific Group at the 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Cieszymierz Gawinski
- Students' Scientific Group at the 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | | | | | | | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw , Poland
| | - Jan Wilczynski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw , Poland
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Zareba-Szczudlik J, Romejko-Wolniewicz E, Lewandowski Z, Rozanska H, Malinowska-Polubiec A, Dobrowolska-Redo A, Wilczynski J, Czajkowski K. Evaluation of the amoxicillin concentrations in amniotic fluid, placenta, umbilical cord blood and maternal serum two hours after oral administration. Neuro Endocrinol Lett 2017; 38:502-508. [PMID: 29369602] [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] [Received: 05/08/2017] [Accepted: 07/21/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Amoxicillin is a broad-spectrum beta-lactam antibiotic. Due to its low toxicity, it is commonly used in obstetrics. The objective of this study was to assess amoxicillin concentrations in amniotic fluid, umbilical blood, placenta and maternal serum two hours following oral administration among pregnant women at term and to assess obstetric and non-obstetric factors that might affect amoxicillin's penetration of these tissues. MATERIALS AND METHODS A total of 30 full-term pregnant women who qualified for elective Caesarean delivery were included in the study. Amoxicillin at a dose of 500 mg was administered prior to surgery. Amoxicillin levels were determined by diffusion microbial assay. RESULTS The maternal serum, placental, umbilical blood and amniotic fluid levels of amoxicillin two hours after oral administration were 2.18±1.30 µg/g, 1.00±0.71 µg/g, 1.00±0.73 µg/g, and 0.67±0.59 µg/g, respectively (Table 2). Maternal serum levels of amoxicillin were significantly higher compared to other tissues (p<0.05). CONCLUSION If the target tissues for the use of antibiotic drugs in pregnant patients are the fetus and/or the placenta, the drug should be administered in a higher-than-standard dose than that used to treat infections in non-pregnant patients. Considering that there is a maximum absorbable dose following oral administration, intravenous administration should be considered to prevent failure of antibiotic treatment. A higher dose of amoxicillin should be considered in obese mothers.
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Affiliation(s)
| | | | | | - Hanna Rozanska
- National Veterinary Research Institute in Pulawy, Poland
| | | | | | - Jan Wilczynski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw , Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw , Poland
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