The role of new adipokines in gestational diabetes mellitus pathogenesis

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition dur­ing pregnancy. Explanation of the GDM pathogenesis is important due to preventing gestational complications. During pregnancy there are significant changes in maternal metabolism. Many of these changes are influenced by different adi­pokines produced in the placenta and adipose tissue. The exact role of adipokines in the pathogenesis of GDM remains still unknown. Several adipokines have been analysed throughout gestation and their levels have been suggested as biomarkers of maternal–perinatal outcomes. Some of them have been postulated as significant in the pathogenesis of pregnancy complications like GDM. This report aims to review some of the recent topics of adipokine research that may be of particular importance in patho­physiology and diagnosis of gestational diabetes mellitus. Because of manuscript length limitations, after thorough literature review and in view of the recent evidence, we focus on the one of the most well-known adipokine: adiponectin, and not so well-studied: nesfatin-1, chemerin, ghrelin, and CTRP 1

Adipokines and C-peptide in overweight and obese pregnant women

Objectives: The aim of the study was to evaluate the levels of adipokines such as adiponectin, resistin, leptin as well as C-peptide in overweight and obese pregnant women. Material and methods: The adipokines and C-peptide concentrations were measured in the group of 38 overweight/obese pregnant women (BMI > 25 kg/m2) and in 42 pregnant women of normal weight (BMI < 25 kg/m2) with ELISA tests between 24th and 34th weeks of gestation. Results: The overweight/obese women compared to lean ones were characterized by significantly higher concentrations of leptin (43.44 ± 31.41 vs. 21.29 ± 12.67 ng/mL, p = 0.0001) and C-peptide (2.77 ± 1.88 vs. 2.25 ± 1.42 ng/mL, p = 0.034). There were no significant differences between groups in resistin (17.39 ± 7.59 vs. 15.76 ± 6.64 ng/mL, NS) and adiponectin (6.93 ± 3.52 vs. 8.07 ± 6.53 μg/mL, NS) levels. In the overweight/obese patients, no relationships between the adipokines, C-peptide and CRP concentrations were found. BMI was negatively correlated with the resistin levels (R = –0.406, p = 0.011). The significant correlation between leptin and C-peptide concentrations was observed in the study group (R = 0.517, p = 0.012). In the control group, the negative correlation between adiponectin concentrations and BMI was shown (R = –0.446, p = 0.003). Conclusions: The higher levels of leptin in the overweight and obese pregnant women seem to reflect the leptin resistance condition and the higher levels of C-peptide in this group is suggestive for hyperinsulinemia. The positive correlation between C-peptide and leptin levels but not with resistin and adiponectin might confirm the role of leptin in the hyperinsulinemia development in overweight and obesity during pregnancy

Wieloimienna kraina wygnania Edwarda Zymana

Artykuł jest próbą omówienia najważniejszych kwestii poruszonych w pracy Światy poetyckie Edwarda Zymana, pod redakcją Mariana Kisiela i Bożeny Szałasty-Rogowskiej. Autor przypomina sylwetkę twórczą Edwarda Zymana – poety, prozaika, publicysty i krytyka literackiego, a następnie krótko omawia zawarte w książce artykuły. Przywołanie nowych kontekstów pozwala na reinterpretację twórczości Zymana i wzbogaca badania nad polską literaturą emigracyjną.The article is an attempt to discuss the most important issues raisedin the publication titled Światy poetyckie Edwarda Zymana, edited by Marian Kisiel and Bożena Szałasta-Rogowska. The author refreshes the readers’ memory of Edward Zyman, a poet, prose writer, journalist, and literary critic, and then brieflydiscusses the articles included in the book. New contexts allow for a reinterpretation of Zyman’s work and enrich the studies on Polish émigré literature

Zmiany w systemie realizacji polityki spójności w perspektywie finansowej 2014–2020

Przedmiotem niniejszego artykułu są zmiany planowane w systemie realizacji polityki spójności w perspektywie finansowej 2014–2020. Wybór zagadnień poddanych analizie został dokonany w oparciu o kryterium istotności oraz innowacyjności proponowanych rozwiązań. Podstawę rozważań stanowi propozycja pakietu legislacyjnego rozporządzeń dla polityki spójności, obejmujących również wspólne przepisy dla wspólnej polityki rolnej (WPR) oraz wspólnej polityki rybackiej, który został przedstawiony przez Komisję Europejską w październiku 2011 r., a następnie zmodyfikowany we wrześniu 2012 r. Celem publikacji jest przedstawienie najistotniejszych modyfikacji, które będą miały wpływ na proces programowania, a następnie wdrażania interwencji finansowanych w ramach funduszy polityki spójności (Europejskiego Funduszu Rozwoju Regionalnego, Europejskiego Funduszu Społecznego i Funduszu Spójności) po 2014 r. Analizowane zmiany zostały w miarę możliwości wyznaczane przez syntetyczną formę opracowania, uzupełnione o krótki opis przyczyn wprowadzenia oraz próbę oceny w oparciu o kryterium zasadności i efektywności. The subject of this article are the planned changes in the system of conducting EU Cohesion Policy in the Financial Perspective of 2014–2020. The choice of analysed issues was made on the basis of criteria of signifi cance and innovation of proposed solutions. The foreground of the refl ections is the proposal of legislative regulations for cohesion policy, which also encloses general regulations for Common Agriculture Policy (CAP) and Common Fisheries Policy (CFP), and was presented by the European Commission in October 2011 and modifi ed in September 2012. The aim of this publication is to present the most signifi cant modifi cations which will infl uence the programming process, and as a consequence the implementation of fi nancial interventions as a part of Cohesion Policy Funds (European Regional Development Fund, European Social Fund and Cohesion Fund) after 2014. The analysis of changes is complemented with short description of reasons for their implementation and an attempt of evaluation based on the criterion of relevance and effectiveness

Epigenetic Changes in Gestational Diabetes Mellitus

Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance that appears or is for the first time diagnosed during pregnancy. It can lead to many complications in the mother and in the offspring, so diagnostics and management of GDM are important to avoid adverse pregnancy outcomes. Epigenetic studies revealed the different methylation status of genes in pregnancies with GDM compared to pregnancies without GDM. A growing body of evidence shows that the GDM can affect not only the course of the pregnancy, but also the development of the offspring, thus contributing to long-term effects and adverse health outcomes of the progeny. Epigenetic changes occur through histone modification, DNA methylation, and disrupted function of non-coding ribonucleic acid (ncRNA) including microRNAs (miRNAs). In this review, we focus on the recent knowledge about epigenetic changes in GDM. The analysis of this topic may help us to understand pathophysiological mechanisms in GDM and find a solution to prevent their consequences

Ovarian Cancer and Pregnancy—A Current Problem in Perinatal Medicine: A Comprehensive Review

The frequency of concomitant adnexal tumors in pregnancy is reported to be at 0.15–5.7%, while ovarian cancer complicates 1 in 15,000 to 1 in 32,000 pregnancies, being the second most common gynecologic cancer diagnosed during pregnancy. The aim of this review is to discuss the problem of ovarian cancer complicating pregnancy and the current recommendations for diagnostics and treatment, with an emphasis on the risk to the fetus. A detailed analysis of the literature found in the PubMed and MEDLINE databases using the keywords “ovarian cancer”, “ovarian malignancy”, “adnexal masses”, “ovarian tumor” and “pregnancy” was performed. There were no studies on a large series of pregnant women treated for ovarian malignancies and the management has not been well established. The diagnostics and therapeutic procedures need to be individualized with respect to the histopathology of the tumor, its progression, the gestational age at the time of diagnosis and the mother’s decisions regarding pregnancy preservation. The multidisciplinary cooperation of specialists in perinatal medicine, gynecological oncology, chemotherapy, neonatology and psychology seems crucial in order to obtain the best possible maternal and neonatal outcomes

Adiponectin and Omentin Levels as Predictive Biomarkers of Preterm Birth in Patients with Gestational Diabetes Mellitus

Objective. The aim of this study was to determine any changes in adiponectin and omentin levels in GDM patients who delivered at term and preterm and to evaluate whether adipokines can be useful as a clinical biomarker to predict subsequent preterm delivery. Patients and Methods. The levels of adiponectin and omentin were measured in four groups: (1) women with GDM who delivered at term (n=63); (2) women with GDM who had the symptoms of threatened preterm labor and delivered at term (n=23); (3) women with GDM and spontaneous preterm birth (before 37 completed weeks of gestation) (n=19); (4) women with physiological pregnancy (n=55). Results. In comparison with control group the median adiponectin concentrations were significantly lower in all GDM groups (10737 versus 8879; 7057; 6253 ng/ml, respectively; p<0.01). The median omentin concentrations were also significantly lower in all GDM groups in comparison with control group (469 versus 432; 357; 308 ng/ml, respectively; p<0.01). No significant differences in adiponectin and omentin levels between the GDM, preterm labor, and preterm birth groups were observed. However, there was a trend towards lower adiponectin and omentin levels in preterm birth group. The strong correlations between adiponectin and omentin levels were observed in all groups (R=0.801, p<0.001; R=0.824, p<0.001; R=0.705, p<0.001; R=0.764, respectively; p<0.001). In the univariable logistic regression model, significant correlation between omentin concentrations and preterm birth occurrence was found. Conclusions. Our findings suggest that omentin-1, rather than adiponectin, could be useful as a predictor of preterm birth in patients with gestational diabetes mellitus

Staphylococcal Resistance Patterns, <i>blaZ</i> and SCC<i>mec</i> Cassette Genes in the Nasopharyngeal Microbiota of Pregnant Women

Antimicrobial resistance in Staphylococcus spp. colonising the nasopharynx can create risk factors of therapeutic treatment failure or prophylaxis in pregnant women. Resistance is mostly encoded on plasmids (e.g., blaZ gene for penicillinase synthesis) or chromosomes (e.g., mecA and mecC for methicillin resistance). The mecA gene is part of the chromosomal mec gene cassette (SCCmec), which is also located on the plasmid. The disc diffusion method for the selected drugs (beta-lactams, fluoroquinolones, streptogramins, aminoglicosides, macrolides, oxasolidinones, tetracyclines and other groups) was used. PCR for blaZ, mecA and mecC genes and SCCmec cassette detection and typing were performed. S. aureus (54.4%) and S. epidermidis (27.9%) were the most prevalent and showed the highest diversity of resistance profiles. The blaZ, mecA and mecC genes were reported in 95.6%, 20.6% and 1.5% of isolates, respectively. The highest resistance was found to beta-lactams, commonly used during pregnancy. Resistance to a variety of antimicrobials, including benzylpenicillin resistance in blaZ-positive isolates, and the existence of a very high diversity of SCCmec cassette structures in all staphylococci selected from the nasopharyngeal microbiota of pregnant women were observed for the first time. Knowledge of the prevalence of antimicrobial-resistant staphylococci in the nasopharynx of pregnant women may be important for the appropriate treatment or prophylaxis of this group of patients