Factors affecting self-esteem and disease acceptance in patients from infertile couples

IntroductionInfertility has been diagnosed in millions of people around the world and is described as a complex medical, mental, and social problem that affects many aspects of life. The aim of the study was to extract the determining factors and the level of self-esteem and the degree of acceptance of the disease in infertile patients and to find differences between women and men in this aspect.MethodsA total 456 patients (235 women and 221 men) from infertile couples participated in a cross-sectional study. To collect data a Personal Information Form (PIF), Rosenberg Self-Esteem Scale (SES), and Acceptance of Illness Scale (AIS) were used.ResultsThe overall self-esteem score for the whole sample was 30.50 (15 ± 30) points and for acceptance of the disease 32.4 (8 ± 40) points. In the study group, men obtained a slightly higher level of self-esteem than women (31.00 vs. 30.04 points). Additionally, men had a higher level of acceptance of the disease (33.12 vs. 31.80) than women. Socio-demographic factors such as age and level of education had impact on scores SES and AIS. Clinical factors did not determine the results of SES and AIS, both in the overall sample and in the female and male groups.ConclusionSelf-esteem in patients from infertile couples increases with age and level of education. There are also significant differences between women and men, i.e., positive correlations between the level of education and self-esteem in men and the degree of acceptance of the disease in women

Zespół Takayasu w ciąży – opis przypadku

We present a case report of pregnant woman with Takayasu’s arteritis diagnosed in childhood. The treatment was modified owing to the fact that the patient wished to get pregnant and she conceived spontaneously within the first year after that. Vasculitis activity was low during pregnancy. Hypertension was treated with methyldopa and metoprolol. After the confirmation of pregnancy daily administration of prednizone and enoxaparin (at a dose of 5 mg and 40 mg, respectively) has been started. In the third trimester of pregnancy the values of blood pressure increased. The patient required higher doses of antihypertensive drugs. Proteinuria appeared in the daily urine collection. The values of liver enzymes have increased. Elective cesarean section was performed at 37 weeks of gestation due to narrow oscillations revealed by CTG and weaker fetal movements reported by the mother. A male infant (weight 2840g, Apgar 10) was born. The mother and the child were discharged on day 5 of the postpartum. Treatment with steroids, antihypertensive drugs, thyroxine and enoxaparin was continued. Hypertension and preeclampsia are the most dangerous complications in pregnant women with Takayasu’s disease. They can affect the health status of the mother and the child. Maternal blood pressure should be controlled very accurately on the two superior limbs. Vaginal delivery of the baby is preferred. Cesarean section is indicated when the values of the maternal blood pressure are elevated in the second part of vaginal delivery.Przedstawiamy przypadek ciężarnej z chorobą Takayasu, u której rozpoznanie zostało postawione w dzieciństwie. Pacjentka planowała ciążę, zmodyfikowano u niej leczenie pod kątem koncepcji i zaszła w ciążę spontanicznie w przeciągu roku. Pozostawała pod opieką lekarza ginekologa od 6 tygodnia ciąży. Aktywność zapalenia naczyń przez cały okres ciąży utrzymywała się na niskim poziomie. Ciśnienie tętnicze kontrolowano niskimi dawkami Metyldopy i Metoprolu. Pacjentka otrzymywała 5 mg Prednizonu i Enoxaparinę w dawce 40 mg na dobę. W trzecim trymestrze ciąży wartości ciśnienia tętniczego u pacjentki wzrosły, wymagała wyższych dawek leków hipotensyjnych. W dobowej zbiórce moczu zaobserwowano białkomocz znamienny. Doszło do wzrostu poziomu enzymów wątrobowych. W 37 tyg. ciąży ze względu na zawężoną oscylację w zapisie kardiotokograficznym i słabsze odczuwanie ruchów płodu rozwiązano ciążę cięciem cesarskim. Urodzono noworodka płci męskiej, w stanie ogólnym dobrym o masie 2840 g, który uzyskał 10 punktów w skali Apgar. Okres wczesnego połogu przebiegał bez powikłań i matkę wraz z dzieckiem wypisano do domu w piątej dobie po zabiegu, utrzymując leczenie hipotensyjne, sterydoterapię, heparynę drobnocząsteczkową i leczenie substytucyjne tyroksyną. Nadciśnienie tętnicze i nałożony stan przedrzucawkowy to szczególnie niebezpieczne powikłania u ciężarnych z chorobą Takayasu i stanowią zagrożenie dla dobrostanu płodu oraz zdrowia matki. Systematyczna kontrola ciśnienia tętniczego na obu kończynach górnych powinna być bardzo wnikliwa. Poród drogami natury jest preferowany u tych pacjentek, a w sytuacji gdy nie udaje się opanować wysokich wartości ciśnienia tętniczego w trakcie drugiego etapu porodu, wskazane jest rozwiązanie cięciem cesarskim

Evaluation of miRNA Expression in Patients with Gestational Diabetes Mellitus: Investigating Diagnostic Potential and Clinical Implications

Mateusz Kunysz,1 Marek Cieśla,2 Dorota Darmochwał-Kolarz1 1Department of Obstetrics & Gynecology, Institute of Medical Sciences, College of Medical Sciences, University of Rzeszow, Rzeszow, 35-959, Poland; 2College of Medical Sciences, University of Rzeszow, Rzeszow, 35-959, PolandCorrespondence: Mateusz Kunysz, Email [email protected]: Gestational diabetes mellitus (GDM) is common pregnancy complication (8%), characterized by hyperglycemia resulting from pathological homeostatic mechanisms. There’s a concerning trend of increasing GDM prevalence. New markers, particularly epigenetic ones, are sought for early detection and enhanced care. miRNA are small non-coding RNA molecules. The main goal was to investigate the potential role of miRNA (miR-16-5p, miR-222-3p, miR-21-5p) in GDM and their association with clinical features.Patients and Methods: The study included 72 pregnant patients, with 42 having GDM and 30 in the control group. miRNA expression was measured using ELISA.Results: There were no significant differences in miR-222-3p expression between GDM patients and the control group. The GDM group exhibited a positive correlation between miR-16-5p expression and miR-21-5p expression as well as between miR-16-5p expression and insulin resistance. In the GDM group, a positive correlation was observed between miR-21-5p expression and fasting glucose levels.Conclusion: Results do not confirm the role of miR-222-3p in GDM pathogenesis or as a diagnostic marker. Additionally, a role for miR-16-5p in GDM pathogenesis was observed. Furthermore, a potential role for miR-21-5p in monitoring GDM treatment is indicated.Keywords: gestational diabetes mellitus, miRNA, epigenetics, miR-16-5p, miR-222-3p, miR-21-5

The Need of Personalized Medicine in Coping with Stress during Infertility Treatment

The term personalized medicine was created for oncological patients, but due to its positive clinical results it is now used in many other fields of medicine, including reproductive medicine. The aim of the study was to determine the level of stress and strategies of coping with stress in patients treated for infertility. The study—using a questionnaire developed by the authors, the Perceived Stress Scale-10 (PSS-10), and the Coping Orientation to Problems Experienced Inventory (Mini-COPE)—was conducted among 456 people from infertile couples. Conclusions: More than half of the studied patients demonstrated a high level of stress. The choice of coping strategies was related to the respondents’ gender and level of stress as well as their experience with assisted reproductive technology

Epigenetic Links between Microbiota and Gestational Diabetes

Gestational diabetes mellitus (GDM) is considered a significant and increasing worldwide problem. The growing body of evidence on this topic has allowed us to point out that a hostile intrauterine environment in mothers with GDM via epigenetic mechanisms induces “diabetogenic” and “obesogenic” changes in an offspring’s DNA. This sets a vicious intergenerational cycle of metabolic diseases in motion, gradually deteriorating the health of the human population. One of the most important participants of this process seems to be altered microbiota. There is a chance that the identification of specific epigenetic marks may provide a key for future diagnostic, prognostic and therapeutic solutions in the field of personalised medicine. Given the reversibility of most epigenetic changes, there is an opportunity to improve the long-term health of the human population. In this manuscript, we aim to summarise available data on epigenetic changes among women suffering from GDM and their progeny, in association with alterations in the microbiome

Contained Power Morcellation in Laparoscopic Uterine Myoma Surgeries: A Brief Review

Uterine fibromas are the most common benign uterine tumors. Although the majority of leiomyomas remain asymptomatic, they can cause serious clinical problems, including abnormal uterine bleeding, pelvic pain, and infertility, which require effective gynecological intervention. Depending on the symptoms as well as patients’ preferences, various treatment options are available, such as medical therapy, non-invasive procedures, and surgical methods. Regardless of the extent of the surgery, the preferred option is the laparoscopic approach. To reduce the risk of spreading occult malignancy and myometrial cells associated with fragmentation of the specimen before its removal from the peritoneal cavity, special systems for laparoscopic contained morcellation have been developed. The aim of this review is to present the state-of-the-art contained morcellation. Different types of available retrieval bags are demonstrated. The advantages and difficulties associated with contained morcellation are described. The impact of retrieval bag usage on the course of surgery, as well as the effects of the learning curve, are discussed. The role of contained morcellation in the overall strategy to optimize patient safety is highlighted

Umbilical Cord SFRP5 Levels of Term Newborns in Relation to Normal and Excessive Gestational Weight Gain

Among the new adipokines, secreted frizzled-related protein 5 (SFRP5) is considered to prevent obesity and insulin resistance. The umbilical cord SFRP5 levels have not yet been investigated. The main aim of the study was to investigate whether the umbilical cord SFRP5 concentrations are altered in term neonates born to mothers with excessive gestational weight gain (EGWG). Two groups of subjects were selected depending on their gestational weight gain, i.e. 28 controls and 38 patients with EGWG. Umbilical cord and maternal serum SFRP5 levels were lower in the EGWG group. Umbilical cord SFRP5 concentrations were directly associated with the maternal serum SFRP5, hemoglobin A1c and lean tissue index, umbilical cord leptin levels, as well as newborns’ anthropometric measurements in the EGWG subjects. In multiple linear regression models performed in all the study participants, umbilical cord SFRP5 concentrations depended positively on the maternal serum SFRP5, ghrelin, and leptin levels and negatively on the umbilical cord ghrelin levels, low-density lipoprotein cholesterol, pre-pregnancy body mass index, and gestational weight gain. EGWG is associated with disturbances in SFRP5 concentrations. Obstetricians and midwives should pay attention to nutrition and weight management during pregnancy

Leptin and Ghrelin in Excessive Gestational Weight Gain—Association between Mothers and Offspring

Two-thirds of pregnant women exceed gestational weight gain recommendations. Excessive gestational weight gain (EGWG) appears to be associated with offspring’s complications induced by mechanisms that are still unclear. The aim of this study was to investigate whether umbilical cord leptin (UCL) and ghrelin (UCG) concentrations are altered in full-term neonates born to EGWG mothers and whether neonatal anthropometric measurements correlate with UCL and UCG levels and maternal serum ghrelin and leptin as well as urine ghrelin concentrations. The study subjects were divided into two groups, 28 healthy controls and 38 patients with EGWG. Lower UCL and UCG levels were observed in neonates born to healthy mothers but only in male newborns. In the control group UCG concentrations correlated positively with neonatal birth weight, body length and head circumference. In the control group maternal serum ghrelin levels correlated negatively with neonatal birth weight, body length and head circumference as well as positively with chest circumference. In the EGWG group UCG concentrations correlated negatively with neonatal birth weight and birth body length. UCL correlated positively with birth body length in EGWG group and negatively with head circumference in the control group. In conclusion, EGWG is associated with disturbances in UCL and UCG concentrations