Knowledge of the perinatal care standard among women giving birth to children in the hospitals in Szczecin

Introduction: In order to improve the quality of perinatal care in Poland, the Regulation of the Minister of Health of September 20, 2012 introduced the standards of medical treatment when providing medical care from the field of perinatal care to women during the period of physiological pregnancy, physiological childbirth, postpartum and newborn care ( so-called the standards of perinatal care). Although the standards have been in force for several years, there are still problems with their compliance and their low knowledge among women giving birth. Research objective: Assessment of the level of knowledge about the Standards perinatal care and of Patients' Rights and the rights arising from them by women giving birth in the hospitals in Szczecin. Materials and Methods: The study included 335 women who have given birth in the hospitals in Szczecin. The study was performed since January 2016 till March 20158 by means of a diagnostic survey, based on the author’s questionnaire, developed on the basis of the standards of perinatal care 20th September 2012. Results: Among women giving birth vaginally 42% reported knowledge of the standard. 41% of women who have given birth by caesarean section declared that they know the standard. No statistically significant differences were found between the knowledge or lack of knowledge of the standards in terms age, education, and attend or not at antenatal class. We found statistically significant relationship between the knowledge of the standards and having a birth plan. Conclusions: 1. Knowledge of the standards declared more women, in comparison to the research conducted a few years earlier. Despite this their knowledge is still not high. 2. Women in spite of declaring knowledge of the standard are not aware that they were not followed. 3. There is still a need to educate women and staff on the standards of prenatal care and Patients' Rights

P2Y12 antagonist ticagrelor inhibits the release of procoagulant extracellular vesicles from activated platelets

Background: Activated platelets release platelet extracellular vesicles (PEVs). Adenosine diphosphate(ADP) receptors P2Y1 and P2Y12 both play a role in platelet activation, The present hypothesis hereinis that the inhibition of these receptors may affect the release of PEVs.Methods: Platelet-rich plasma from 10 healthy subjects was incubated with saline, P2Y1 antagonistMRS2179 (100 μM), P2Y12 antagonist ticagrelor (1 μM), and a combination of both antagonists.Platelets were activated by ADP (10 μM) under stirring conditions at 37°C. Platelet reactivity wasassessed by impedance aggregometry. Concentrations of PEVs– (positive for CD61 but negative forP-selectin and phosphatidylserine) and PEVs+ (positive for all) were determined by a state-of-the-artflow cytometer. Procoagulant activity of PEVs was measured by a fibrin generation test.Results: ADP-induced aggregation (57 ± 13 area under curve {AUC] units) was inhibited 73%by the P2Y1 antagonist, 86% by the P2Y12 antagonist, and 95% when combined (p < 0.001 for all).The release of PEVs– (2.9 E ± 0.8 × 108/mL) was inhibited 48% in the presence of both antagonists(p = 0.015), whereas antagonists alone were ineffective. The release of PEVs+ (2.4 ± 1.6 × 107/mL)was unaffected by the P2Y1 antagonist, but was 62% inhibited by the P2Y12 antagonist (p = 0.035),and 72% by both antagonists (p = 0.022). PEVs promoted coagulation in presence of tissue factor.Conclusions: Inhibition of P2Y1 and P2Y12 receptors reduces platelet aggregation and affects therelease of distinct subpopulations of PEVs. Ticagrelor decreases the release of procoagulant PEVs fromactivated platelets, which may contribute to the observed clinical benefits in patients treated with ticagrelor

High-throughput sequencing data revealed genotype-specific changes evoked by heat stress in crown tissue of barley sdw1 near-isogenic lines

Background: High temperature shock is becoming increasingly common in our climate, affecting plant growth and productivity. The ability of a plant to survive stress is a complex phenomenon. One of the essential tissues for plant performance under various environmental stimuli is the crown. However, the molecular characterization of this region remains poorly investigated. Gibberellins play a fundamental role in whole-plant stature formation. This study identified plant stature modifications and crown-specific transcriptome re-modeling in gibberellin-deficient barley sdw1.a (BW827) and sdw1.d (BW828) mutants exposed to increased temperature. Results: The deletion around the sdw1 gene in BW827 was found to encompass at least 13 genes with primarily regulatory functions. A bigger genetic polymorphism of BW828 than of BW827 in relation to wild type was revealed. Transcriptome-wide sequencing (RNA-seq) revealed several differentially expressed genes involved in gibberellin metabolism and heat response located outside of introgression regions. It was found that HvGA20ox4, a paralogue of the HvGA20ox2 gene, was upregulated in BW828 relative to other genotypes, which manifested as basal internode elongation. The transcriptome response to elevated temperature differed in the crown of sdw1.a and sdw1.d mutants; it was most contrasting for HvHsf genes upregulated under elevated temperature in BW828, whereas those specific to BW827 were downregulated. In-depth examination of sdw1 mutants revealed also some differences in their phenotypes and physiology. Conclusions: We concluded that despite the studied sdw1 mutants being genetically related, their heat response seemed to be genotype-specific and observed differences resulted from genetic background diversity rather than single gene mutation, multiple gene deletion, or allele-specific expression of the HvGA20ox2 gene. Differences in the expressional reaction of genes to heat in different sdw1 mutants, found to be independent of the polymorphism, could be further explained by in-depth studies of the regulatory factors acting in the studied system. Our findings are particularly important in genetic research area since molecular response of crown tissue has been marginally investigated, and can be useful for wide genetic research of crops since barley has become a model plant for them

Analiza infekcji występujących u dzieci hospitalizowanych w klinice neonatologii Analysis of infection in children hospitatalized in a neonatology clinik

Wstęp: Najważniejszą zmianą, z jaką spotyka się człowiek w ciągu życia, są jego narodziny. Następuje zmiana otoczenia, ze względnie sterylnego środowiska wewnątrzmacicznego na pozamaciczny. Choroby infekcyjne pozostają jednym z głównych wyzwań w medycynie wśród noworodków. Cel: Celem pracy było określenie czynników ryzyka wpływających na rodzaj występowania infekcji u dzieci hospitalizowanych w Klinice Neonatologii PUM w Policach.Materiał i metody: Do badań zakwalifikowano 55 dzieci przebywających w Klinice Neonatologii PUM w SPSK nr 1 Policach. Powyższa praca jest jednoośrodkowym badaniem obserwacyjnym bazującym na retrospektywnej analizie danych. Analizę statystyczną wykonano w programie The R Project w wersji 3.6.2. Wyniki: Najczęstszym rodzajem infekcji wśród dzieci było zapalenie płuc (56,36%). U wcześniaków istotnie częściej występowało zapalenie płuc (77,42%). Dzieci urodzone zarówno poprzez poród fizjologiczny, jak i cięcie cesarskie częściej chorowały na zapalenie płuc (odpowiednio 40,0% i 65,71%). U noworodków urodzonych w stanie średnim i w stanie dobrym według skali Apgar rozpoznano zapalenie płuc (78,95%; 44,44%). Ponad 52,0% dzieci urodziło się z wagą urodzeniową ≤ 2500 g i istotnie częściej chorowały one na zapalenie płuc (72,41%). W przypadku pobranych wymazów u dzieci przeważał wynik ujemny (58,18%), tak samo jak w wypadku pobranych posiewów (70,91%). Najczęściej wśród dzieci występowały bakterie chorobotwórcze, typu Escherichia coli (14,55%), Klebsiella pneumoniae (14,55%) oraz Enterobacter cloacae (9,09%). Wnioski: 1. Wcześniactwo oraz niska masa urodzeniowa są istotnymi czynnikami ryzyka wpływającymi na występowanie zapalenia płuc u dzieci. 2. Przedwczesne odpływanie płynu owodniowego nie ma szczególnego wpływu na występowanie infekcji u dzieci, ale jeśli wody płodowe odpływają powyżej 6. godzin dominuje u noworodków zapalenie płuc. 3. Dodatni wynik nosicielstwa GBS u matki nie jest jednoznacznym ryzykiem transmisji wertykalnej na noworodka w okresie okołoporodowym.    Introduction.The most important change a person encounters in life is during their birth. There is a change in the environment from a relatively sterile in-utero environment to a retrouterine through. Infectious diseases remain one of the main challenges in medicine among newborns.The aim of the study was to determine the risk factors affecting the type of infection in children hospitalized at the Neonatology Clinic PUM in Police.Material and methods: 55 children from the Neonatology Clinic PUM at SPSK No. 1 in Police were qualified for the study. This work is a single-center observational study based on retrospective data analysis. Statistical analysis was performed in The R Project program, version 3.6.2.Results: The most common type of infection among children was pneumonia (56.36%). Premature babies had a significantly higher incidence of pneumonia (77.42%). Children born both through physiological delivery and caesarean section were more likely to have pneumonia (40.00% i 65.71%). Pneumonia (78.95%; 44.44%) was diagnosed in medium and good fairing newborns according to the Apgar scale. Over 52% of children were born with birth weights ≤ 2500 g and significantly more often they suffered from pneumonia (72.41%). In the case of collected from the children swabs the negative result prevailed (58.18%), as in the case of collected cultures (70.91%). The most common types of pathogenic bacteria among children were: the Escherichia coli (14.55%), Klebsiella pneumoniae (14.55%) and Enterobacter cloacae (9.09%). Conclusions: 1. Prematurity and low birth weight are significant risk factors that affect the occurrence of pneumonia in children. 2. Premature drainage of amniotic fluid has no particular effect on the occurrence of infections in children, but if fetal water drains for more than 6 hours, pneumonia predominates in newborns. 3. Positive maternal GBS carriage is not a clear risk of vertical transmission to the newborn in the perinatal period

Budowanie więzi z dzieckiem w okresie życia prenatalnego i po porodzie przez matki przebywające w wybranych zakładach karnych w Polsce

Wstęp. Zbudowanie więzi między matką a dzieckiem w okresie ciąży i po porodzie jest podstawą do stworzenia jego prawidłowych relacji w przyszłości.Cel pracy. Ocena natężenia więzi między kobietami a ich dziećmi w okresie ciąży, porównując kobiety ciężarne i matki po porodzie, które nie odbywały wyroku, z tymi, które przebywały w ciąży bądź po porodzie w zakładach karnych. Badania przeprowadzono w celu zaobserwowania, czy środowisko więzienne ma wpływ na proces tworzącej się więzi.Materiał i metody. Do przeprowadzenia badań zastosowano ankietę własnego autorstwa oraz standaryzowany kwestionariusz diagnostyczny „Więź z dzieckiem w okresie ciąży” Cranley w opracowaniu Bielawskiej-Batorowicz. Badaniu poddano dwie główne grupy kobiet: więźniarki (50 ankietowanych) oraz kobiety przebywające na wolności (104 ankietowane). Wśród nich przebadano zarówno kobiety ciężarne, jak i kobiety po porodzie.Wyniki i wnioski. Poziom więzi między matką a dzieckiem osiągnął wysokie wartości wśród wszystkich przebadanych grup kobiet. Może to wynikać z faktu, że głównym priorytetem stawianym przez pracowników więziennych placówek jest zapewnianie dziecku bezpieczeństwa i poczucia normalności. Z przeprowadzonych badań wyciągnięto wniosek mówiący o braku wpływu środowiska więziennego na proces tworzenia się więzi między matką a dzieckiem w okresie ciąży. Więźniarki rzadziej komunikowały się z dzieckiem, jednak ich natężenie więzi osiągnęło nieco wyższy poziom niż u kobiet przebywających na wolności. Jednakże zarówno u więźniarek, jak i kobiet przebywających na wolności więź między matką a dzieckiem w okresie ciąży osiągnęła wysokie wartości

Left ventricular remodelling pattern and its relation to clinical outcomes in patients with severe aortic stenosis treated with transcatheter aortic valve implantation

Introduction : Left ventricular hypertrophy (LVH) is a common compensating process in the pressure overload mechanism of aortic stenosis (AS). Aim : To identify a group of patients with a LVH pattern which may alter periprocedural and 1-year outcomes after transcatheter aortic valve implantation (TAVI). Material and methods : Echocardiographic examinations of 226 patients with severe AS treated with TAVI between March 2010 and February 2016 were retrospectively analysed and correlated with echocardiographic parameters and clinical outcomes in the study group. Ultimately 208 patients were enrolled in the study. Based on left ventricular mass index (LVMI) and relative wall thickness (RWT) patients were divided into three categories: concentric remodelling (CR), concentric hypertrophy (CH) and eccentric hypertrophy (EH). Most of the patients with severe AS referred for TAVI were found to have CH (n = 150, 72.8%), then EH (n = 33, 16%) and CR (n = 16, 7.8%). Results : There were no significant differences between groups in terms of periprocedural outcomes or complications. After a mean observation time of 561.8 ±239.0 days, the observed all-cause mortality rate was 19.9%. After multivariable adjustment, CR remained associated with a higher risk of mortality (HR = 4.31; 95% CI: 1.607–11.538; p = 0.004). Conclusions : Left ventricular hypertrophy is common in patients with severe AS prior to TAVI. The LVH pattern does not affect TAVI-related complications. In patients with severe AS referred for TAVI, CR seems to be the least favourable geometry of LVH, increasing the risk of 1-year all-cause death