Expression of selected angiogenesis-related small microRNAs in patients with abnormally increased secretion of glucocorticoids

Introduction: Higher cortisol levels are associated with cardiovascular morbidity and mortality in the elderly, partially resulting from biologic effects of glucocorticoids (GCs) on endothelial cells observed in an experimental setting. These features are replicated in patients with endogenous GC excess (Cushing’s syndrome) or with exogenous hypercortisolism due to excessive pharmacological application of GCs. Both groups present also an increased cardiovascular disease event rate. GCs may also adversely influence recovery after myocardial infarction. Recently it was proposed that microRNAs (miRNAs) — small noncoding RNAs functioning as antisense regulators of gene expression by targeting mRNA — may have a central role in regulating endothelial function through multiple mechanisms. Thus, the purpose of this study was to evaluate the effects of chronic GC excess on the expression of selected endothelium-controlling miRNAs expressed in nucleated cells circulating in peripheral blood (PBNCs) of patients with endogenous hypercortisolism either due to corticotrophin‐independent or corticotrophin‐dependent Cushing’s syndrome (CS). Material and methods: Peripheral blood nuclear cells were collected from 35 healthy subjects and 31 patients with endogenous hypercortisolism as a source of miRNAs. A self-validated individual quantitative RT-PCR study was then performed to evaluate the expression levels of selected miRNAs in PBNCs. Additionally, endothelin-1 (ET-1) expression in peripheral blood was assessed with respect to endothelial dysfunction using Western blotting. Results: The ET-1 expression levels in CS were higher than in controls, confirming endothelial dysfunction in the CS group. Furthermore, miRNA analysis revealed a significantly decreased intracellular expression of selected endothelium-related miRNAs in patients with endogenous hypercortisolism, including miRNA-17-5p, miRNA-126-3p, and miRNA-126-5p, compared to controls. In contrast, two other angiogenic miRNAs, miRNA-150-5p and miRNA-223-3p, were significantly upregulated compared to controls. Conclusions: Cardiovascular events related to hypercortisolism remain a challenging problem in medical practice. This study has demonstrated that the chronic excess of GCs in endogenous CS might induce significant dysregulation of selected miRNAs involved in the control of endothelium biology. However, the lack of knowledge about specific miRNA expression postpones the full understanding of the biological roles of such miRNAs in hypercortisolism. Moreover, dysregulated miRNAs seem to be promising targets for further research, especially to search for potential therapies for several GC-induced cardiovascular complications

Evaluation of indications for amniocentesis in cases of normal fetal ultrasound results

Objectives: The objective of this study was to analyze indications for amniocentesis in cases of patients with normal fetalultrasound results between 11+0 and 13+6 weeks of gestation.Material and methods: The results of first-trimester screening tests performed between 2014 and 2018 on 6,863 patientsof the Prenatal Testing Outpatient Clinic at the Clinical Department of Obstetrics and Gynecology, Pomeranian MedicalUniversity, Szczecin, Poland, were analyzed. The inclusion criteria were a singleton pregnancy and normal results of fetalultrasound between 11+0- and 13+6-weeks’ gestation. Depending on the calculated risk of fetal trisomy 21, the patientswere divided into three groups (group A = RS > 1:300, group B = RS 1:300 – 1:999, group C = RS ≤ 1:1000). Subsequently,values such as PAPP-A and fβ-hCG protein levels and maternal age were analyzed for each of the groups.Results: The patients, 6,310 (91.94%) met the inclusion criteria. A high risk of fetal trisomy 21 was identified for 514 women(8.15%). Group B had 733 (11.62%) and group C 5,063 (80.23%) patients. In group A, an fβ-hCG level of ≥ 2.000 MoM wasshown for 50.97% of the women. A PAPP-A level ranging from 0.001 to 0.499 MoM was observed for 38.72% of groupA patients. The mean maternal age in groups A, B and C was 36.45, 36.08 and 31.64 years, respectively.Conclusions: In the first-trimester, patients with normal ultrasound results obtained during prenatal screening tests, the maincause of an increased risk of trisomy 21 was elevated PAPP-A and fβ-hCG concentrations. According to this paper’s authors,in these cases extension of diagnosis to include other gestational complications, e.g. preeclampsia, should be considered

Neuroendocrine Neoplasms of the Gastrointestinal Tract versus Neuroendocrine Neoplasms of the Gynaecological Tract—Comparison of the Risk Factors and Non-Surgical Treatment Efficacy

Neuroendocrine tumours of the gastrointestinal tract are rare. The incidence has increased in recent years due to improvements in diagnostic methods for detecting these lesions. These tumours have a poor prognosis, especially when detected at an advanced stage. The basis of the treatment is resection, and non-surgical treatments are also standard in the treatment process. The situation is similar in even rarer neuroendocrine tumours of the reproductive tract, which are associated with an equally poor prognosis. In this article, we focus on learning about the risk factors (including genetic mutations) that increase the risk of the disease and comparing the effectiveness of non-surgical treatments—chemotherapy, radiotherapy, peptide receptor radionuclide therapy, somatostatin analogues, and immunotherapy. The efficacy of these treatments varies, and immunotherapy appears to be a promising form of treatment; however, this requires further research

Cutaneous Melanoma versus Vulvovaginal Melanoma—Risk Factors, Pathogenesis and Comparison of Immunotherapy Efficacy

Cutaneous melanoma is a relatively common neoplasm, with fairly well understood pathogenesis, risk factors, prognosis and therapeutic protocols. The incidence of this disease is increasing every year. The situation is different for rare malignancies such as vulvar melanomas and for the even rarer vaginal melanomas. The risk factors for vulvovaginal tumors are not fully understood. The basis of treatment in both cases is surgical resection; however, other types of treatments such as immunotherapy are available. This paper focuses on comparing the pathogenesis and risk factors associated with these neoplasms as well as the efficacy of two groups of drugs—anti-PD-L1 and anti-CTLA4 inhibitors—against both cutaneous melanoma and melanoma of the lower genital tract (vulva and vagina). In the case of cutaneous melanoma, the situation looks more optimistic than for vulvovaginal melanoma, which has a much worse prognosis and, as it turns out, shows a poorer response to immune therapy

Analysis of Nurses’ Attitudes toward Patient Death

(1) The aim of the study was to analyze nurses’ attitudes toward a patient’s death, taking into account the emotions they experience and the general perception of death. (2) The study involved 516 nurses from the West Pomeranian Voivodeship in Poland. The research was carried out using the diagnostic survey method using The Death Attitudes Profile Revisited (DAP-R-PL), the Scale of Fear and Fascination with Death, and a demographic questionnaire. (3) Research has shown that nurses accept the phenomenon of death as a natural process of human life; however, they adopt the attitude of fear of death. Most of the respondents experienced: sadness (73.4%), helplessness (58.5%), and regret (43.6%) due to the patient’s death. (4) Both age, sex, marital status, and place of residence significantly influenced the attitudes of nurses toward the patient’s death. Therefore, it is important to provide psychological support or special education in the case of dealing with the fear of death

The Impact of Uterus Didelphys on Fertility and Pregnancy

Uterus didelphys occurs as a result of abnormal fusion of the paramesonephric ducts and is characterized by complete duplication of uterine horns, cervix, and very often also the vagina or presence of longitudinal vaginal septum. Most women with a uterus didelphys are asymptomatic; some cases may coincide with dyspareunia or dysmenorrhea. The anomaly is associated with a higher risk of miscarriage, preterm labor, breech delivery, and decreased live births. We present the case of a 26-year-old woman (primigravida) who was known to have uterus didelphys. The diagnosis was made when the patient was 23 years old using ultrasound and hysteroscopy. The patient became pregnant after 18 months of efforts. The patient was referred to prenatal care in the 13th week of pregnancy with vaginal bleeding. In the 23rd week of pregnancy, gestation cholelithiasis was diagnosed. The pregnancy progressed without obstetric complications and the fetus developed normally. Due to the vaginal septum and fact that the patient felt stressed, the pregnancy was terminated at term by cesarean section. We concluded that uterus didelphys can be asymptomatic making an early diagnosis difficult. A pregnancy belongs to a high-risk group and more attention should be paid to this case. Cesarean section should be considered, especially in case of the presence of vaginal septum

Evaluation of the Concentration of Selected Elements in Patients with Cancer of the Reproductive Organs with Respect to Treatment Stage—Preliminary Study

(1) Background: The aim of this study was to assess the concentrations of selected elements in female patients with cancer of the reproductive organs, taking into account the stage of treatment. (2) Methods: The study sample consisted of 51 patients with advanced endometrial cancer and ovarian cancer, undergoing chemotherapy. The median age of the studied patients with endometrial cancer was 66.0 years (IQR: from 60.75 to 70.25), and with ovarian cancer―60.0 years (IQR: from 49.0 to 64.0). Each of the qualified women, after consent to participate in the study, had her blood drawn several times (before surgery, the first course of chemotherapy, the third course of chemotherapy, and the sixth course of chemotherapy) in order to determine serum levels of macro- and micronutrients (Na, Mg, Ca, Zn, P, Cu, Fe, Cd, Ni, and Sr). (3) Results: In the study group of patients with cancer of the reproductive tract, the concentrations of iron (p < 0.05). (4) Conclusions: In the studied group of patients with ovarian and endometrial cancer, the applied chemotherapy significantly changed the concentrations of Fe, Na, and Ni, regardless of the type of tumor. Changes in Mg and Cd concentrations resulted from the interaction between the stage of chemotherapy and the type of cancer. The results of serum concentrations of selected elements in women with cancer of the reproductive organs may help understand the physiological changes resulting from the applied chemotherapy

Loneliness and the Degree of Addiction to Shopping and Work among Polish Women: The Mediating Role of Depression

(1) The aim of the research was to try to define the mediating role of depression in the relationship between addiction to shopping and work and loneliness, understood in terms of general loneliness among Polish women. (2) The study was conducted among 556 women. The research was carried out with the use of the diagnostic survey method, using the questionnaire technique: the De Jong Gierveld Loneliness Scale, the Purchasing Behavior Scale, the Work Addiction Risk Test, Beck Depression Inventory, and our own questionnaire. (3) Depression is a mediator in the relationship between the feeling of loneliness and the degree of addiction to shopping (&beta; = &minus;0.0246, z = &minus;2.03, p = 0.043) and in the relationship between the feeling of loneliness and the degree of addiction to work (&beta; = &minus;0.0722, z = &minus;4.002, p &lt; 0.001). The direct impact of the feeling of loneliness on the degree of addiction to shopping (p = 0.237) and work (p = 0.576) is statistically insignificant. (4) Depression plays the role of a mediator between the feeling of loneliness and the degree of addiction to shopping and work. An increase in the level of depression increases the degree of addiction to shopping and work. The mediator&rsquo;s participation lowers the loneliness feeling level

Application of Telehealth in Prenatal Care during the COVID-19 Pandemic—A Cross-Sectional Survey of Polish Women

To reduce the risk of infection of SARS-CoV-2 during commuting to the clinic or due to contact with medical staff, the American College of Obstetricians and Gynecologists has recommended arranging some appointments in the form of “telehealth”. The aim of the study was to assess the access to medical care in pregnancy during the SARS-CoV-2 pandemic and the role of telehealth in the implementation of prenatal care standards. This is a cross-sectional study. The study group included 618 women who were pregnant and/or gave birth in Poland during the COVID-19 pandemic. The majority of the participants experienced difficulties accessing medical care because of the pandemic. The correlation between this experience and the use of the hybrid healthcare model was established. The affiliation to public or private healthcare was irrelevant. There was no relationship between healthcare (private/public or in-person/hybrid) and implementation of the prenatal care standards. To ensure safe access to prenatal care for pregnant women, recommendations for a hybrid pregnancy management model should be created with detailed information regarding which appointments patients must be present for in-person and which can be conducted remotely. To reduce the risks associated with movement and interpersonal contact, all visits during which tests and screenings take place should be conducted in-person; other appointments can be arranged in the form of telehealth

Correlations between Fatty Acid Profile and Body Fat Distribution in Postmenopausal Women&mdash;A Cross Sectional Study

The aim of the study was to assess the fatty acid profile of the whole blood of postmenopausal women, taking into account anthropometric parameters. The study involved 156 healthy women with an average age of 60 (SD = 6.3 years) years who were living in the West Pomerania Province (Poland). An original questionnaire was presented to all patients, conducting anthropometric measurements of them: weight, height, waist and hip circumference, body mass index (BMI), waist&ndash;hip ratio (WHR) and body adipose index (BAI), as well as an assessment of the fatty acid profile by employing gas chromatography. It has been observed that in menopausal women, the concentration of C16:1 increases with respect to their BMI (r = 0.205 p = 0.01). Similar correlations were noted with regard to body weight (C16:1 r = 0.177 p = 0.029). It was also shown that the concentration of C18trans11 (r = &minus;0.166 p = 0.039), 18:2n6 (r = &minus;0.165 p = 0.04) and n6/n9 (r = &minus;0.194 p = 0.015) were negatively correlated with respect to their WHR, while the levels C16:1 (r = 0.22 p = 0.006), C18:1n9 (r = 0.22 p = 0.007), C24:1 (r = 0.251 p = 0.002), MUFA (r = 0.227 p = 0.046) and n9 (r = 0.224 p = 0.005) were correlated positively with respect to their BAI. The fatty acid profile of the whole blood of postmenopausal women is modulated to a poor extent by anthropometric variables. Therefore, more prospective research is warranted