Usefulness of saline infusion sonohysterography and feeding artery imaging in endometrial polyp diagnosis

Objectives: The aim of this study was to assess the usefulness of sonohysterography with feeding artery visualization using transvaginal sonography to diagnose endometrial polyps. Material and methods: We conducted an observational study of 60 perimenopausal patients referred to the Department of Fetal Medicine and Gynaecology, Medical University of Lodz with abnormal uterine bleeding or suspicion of endometrial pathology based on sonography scan. In all 60 patients transvaginal sonography scan showed a possibility of an endometrial polyp. Of these, 46 underwent saline infusion sonohysterography with sonography visualization of a feeding artery. Pathological examination was performed on material collected during hysteroscopy. Results: Sonography detection of endometrial polyp based on feeding artery visualization had a 40% sensitivity, whereas sonohysterographic polyp detection had a sensitivity of 75% and a specificity of 100%. The positive and negative predictive values of saline infusion sonohysterography in diagnosing endometrial polyps were estimated at 75% and 72% (95% CI: 52–86%), respectively. The combination of sonohysterography and feeding artery imaging in transvaginal sonography was 84% sensitive and 95% specific in detecting endometrial polyps. The positive and negative predictive values were: PPV = 96% and NPV = 89%. Conclusion: Saline infusion sonohysterography with feeding artery visualization may become a standard method in the diagnostics of endometrial polyps in perimenopausal women

Noninvasive prenatal test in the first trimester of pregnancy (NT and estimation of β-hCG and PAPP-A) in the diagnosis of fetal abnormalities in Polish population – comparison of the biochemistry own normal ranges and literature reported data

Abstract The aim of study: Estimation of Polish population standards of the concentrations of pregnancy-associated plasma protein - A (PAPP-A) and free beta - human chorionic gonadotropin (β-HCG) in the maternal blood between 10.0 and 13.6 week of pregnancy and comparison of the biochemistry own normal ranges and literature reported data. Estimation the sensitivity of the fetal nuchal translucency measurement, biochemical concentrations of PAPP-A and free β-HCG in detection of the fetal chromosomal abnormalities. Material and methods: 582 women in the age 14 to 46 years old with singleton pregnancies were included to the study. The screening was performed between 10.0 and 13.6 week of gestation. The fetal nuchal translucency, serum concentrations of PAPP-A and free β-HCG were measured. The specific risk was calculated using the Fetal Medicine Foundation software (FTS) by accredited sonographers. Results: Standards for serum concentrations of PAPP-A and free β-HCG in normal pregnancies were determined. The measurement sensitivity of the fetal nuchal translucency in detection of the fetal chromosomal abnormalities was 80% and sensitivity of serum concentrations of PAPP-A and free β-HCG was 40% and 80%. Conclusions: There is no significant differences between estimated biochemistry standards (PAPP-A and free β-HCG) for Polish population and literature reported data. Observed differences in measurements of fetal NT, serum concentrations of PAPP-A and free β-HCG in a control group and the group with the aneuploidies confirmed usefulness of these methods for the first trimester prenatal screening

Rocznik Lubuski (t.32, cz.2): Seksualność człowieka obszary zainteresowań teoretyków i praktyków

Pod redakcją: Zbigniewa Izdebskiego

Metabolic syndrome is associated with similar long-term prognosis in non-obese and obese patients. An analysis of 45 615 patients from the nationwide LIPIDOGRAM 2004-2015 cohort studies

Aims We aimed to evaluate the association between metabolic syndrome (MetS) and long-term all-cause mortality. Methods The LIPIDOGRAM studies were carried out in the primary care in Poland in 2004, 2006 and 2015. MetS was diagnosed based on the National Cholesterol Education Program, Adult Treatment Panel III (NCEP/ATP III) and Joint Interim Statement (JIS) criteria. The cohort was divided into four groups: non-obese patients without MetS, obese patients without MetS, non-obese patients with MetS and obese patients with MetS. Differences in all-cause mortality was analyzed using Kaplan-Meier and Cox regression analyses. Results 45,615 participants were enrolled (mean age 56.3, standard deviation: 11.8 years; 61.7% female). MetS was diagnosed in 14,202 (31%) by NCEP/ATP III criteria, and 17,216 (37.7%) by JIS criteria. Follow-up was available for 44,620 (97.8%, median duration 15.3 years) patients. MetS was associated with increased mortality risk among the obese (hazard ratio, HR: 1.88 [95% CI, 1.79-1.99] and HR: 1.93 [95% CI 1.82-2.04], according to NCEP/ATP III and JIS criteria, respectively) and non-obese individuals (HR: 2.11 [95% CI 1.85-2.40] and 1.7 [95% CI, 1.56-1.85] according to NCEP/ATP III and JIS criteria respectively). Obese patients without MetS had a higher mortality risk than non-obese patients without MetS (HR: 1.16 [95% CI 1.10-1.23] and HR: 1.22 [95%CI 1.15-1.30], respectively in subgroups with NCEP/ATP III and JIS criteria applied). Conclusions MetS is associated with increased all-cause mortality risk in non-obese and obese patients. In patients without MetS obesity remains significantly associated with mortality. The concept of metabolically healthy obesity should be revised