Zaćma wrodzona

Cataract is an eye disease that means opacification of the lens of the eye leading to partial or total blindness. It is common and treatable cause of blindness in children [1]. The prevalence of cataract in children worldwide ranges from 1 to 15 per 10,000. In developed countries, the incidence is 1 to 3 per 10,000 [2]. Cataracts can be detected using a prenatal ultrasound scan performed between 18 and 20 weeks of pregnancy [3,4,5]. Early detection of cataracts and rapid intervention are crucial in the development of normal vision, especially in newborns [4]. The article presents a case report of intrauterine ultrasonographic diagnosis of congenital cataract.                                                                                                                                        Zaćma, inaczej katarakta to choroba oczu polegająca na zmętnieniu soczewki i związaną z tym częściową lub całkowitą ślepotę . Jest ona często występującą uleczalną przyczyną ślepoty u dzieci[1]. Częstość występowania katarakty u dzieci na świecie wynosi od 1 do 15 na 10 000. W krajach rozwiniętych częstość występowania wynosi 1 do 3 na 10 000 [2]. Zaćma może zostać wykryta za pomocą prenatalnego badania USG wykonanego pomiędzy 18. a 20. tygodniem ciąży [3,4,5]. Wczesne wykrycie zaćmy i szybka interwencja mają kluczowe znaczenie w rozwoju prawidłowego widzenia, szczególnie u noworodków [4]. W artykule przedstawiono opis przypadku wewnątrzmacicznego ultrasonograficznego rozpoznania zaćmy wrodzonej.                                                                                                                               &nbsp

Assessment of the level of knowledge about health behaviors and puerperium of various social groups in the Świętokrzyskie Voivodeship during the Covid-19 pandemic

Introduction The puerperium is a period in a woman's life after childbirth, during which systemic changes occur. The woman's body returns to its pre-pregnancy condition. It lasts about 6 weeks. Having a baby and placenta causes changes in the concentration of pregnancy hormones, fluctuations that can negatively affect the behavior of women. In addition, the Covid-19 pandemic may interfere with the clinical condition of the pregnant woman, causing her mental health to deteriorate. Aim of the study: The aim of the study was the assessment of the level of knowledge about health behaviors and puerperium of various social groups in the Świętokrzyskie Voivodeship during the Covid-19 pandemic. Material and methods             The survey covered 603 respondents from the Świętokrzyskie Voivodeship from February to April 2021. 18 subjects were excluded from the study due to incomplete completion of the questionnaire. Ultimately, the analysis was conducted on the data of 584 respondents. The analyzes included women and men aged 19-45, who were divided into four groups. The first group included 130 obstetricians, the second 86 midwives, the third 50 teachers, and the fourth 318 students of the JKU. The Bioethics Committee of the JKU approved the study. Statistical analysis was performer. Results The respondents' knowledge about puerperium was 78.6%. Midwives had the most information, while obstetricians had the least. Participants in all 4 groups have a satisfactory level of knowledge about the duration of the puerperium, the principles of prophylaxis and hygiene in puerperium and feeding the newborn. The respondents obtain their knowledge from books and magazines.  Wstęp Połóg to okres w życiu kobiety, kiedy po porodzie dochodzi do zmian ogólnoustrojowych, które wystąpiły w ciąży tj: inwolucja macicy, gojenie rany krocza, rozpoczęcie laktacji, podjęcie czynności hormonalnych przez jajniki. Trwa on 6 tygodni i dzielimy go na połóg bezpośredni do 24 godzin po porodzie, wczesny 1 tydzień  i późny do 6 tygodni. Urodzenie dziecka i łożyska powoduje obniżenie stężenia hormonów ciążowych tj: laktogen łożyskowy, gonadotropina kosmówkowa.  Stężenie prolaktyny i estrogenów zaczyna wracać do wartości sprzed ciąży. Pierwsza owulacja czyli powrót płodności może wystąpić po 6-8 tyg po porodzie, a u kobiet karmiących piersią nawet po roku ze względu na wysokie stężenie PRL związane z karmieniem piersią. Pandemia mogła negatywnie wpłynąć na przebieg ciąży i połogu, ingerować w stan kliniczny kobiety ciężarnej w konsekwencji kształtując obraz przyszłych pokoleń. W tym czasie u kobiet mogły pojawić się dodatkowe obciążenia psychiczne, które pogarszały stan psychiczny, w wyniku którego mogło dojść do  tzw. zjawiska Baby Blues. Cel pracy Celem badania była ocena poziomu wiedzy na temat zachowań zdrowotnych i połogu różnych grup społecznych województwa świętokrzyskiego w czasie pandemii Covid-19. Materiał i metody                 Badaniem zostało objętych 603 respondentów województwa świętokrzyskiego od lutego do kwietnia 2021 roku. Z badania wykluczono 18 respondentów ze względu na niekompletne wypełnienie  ankiety. Ostatecznie analizę przeprowadzono o dane 584 ankietowanych. Do analiz włączono kobiety i mężczyzn w przedziale wiekowym 19-45 lat, których podzielono na cztery grupy. Do pierwszej grupy zakwalifikowano 130 położnic, drugiej 86 położnych, trzeciej 50 nauczycieli, czwartej 318 studentów UJK. Ankiety od położnic zostały zebrane w Klinice Ginekologii i Położnictwa Wojewódzkiego Szpitala Zespolonego w Kielcach, materiał w pozostałych grupach został zebrany przy pomocy formularza online. Wśród nauczycieli przeważali mieszkańcy małych miast do 50 tys. - 68%, natomiast wśród położnic dotyczyło to środowiska wiejskiego (48,46%). Średni wiek ankietowanych mieścił się w przedziale wiekowym 20-30 lat /65,2%/, między 30 -40 rokiem życia w badaniu wzięło udział 18,2%, powyżej 40 rż- 9,6%,  Osób poniżej 20 r.ż. było 7,1%. W badaniach zastosowano autorski kwestionariusz ankiety za pomocą którego zebrano informacje dotyczące miejsca zamieszkania, wieku, wykształcenia, stanu cywilnego oraz liczby posiadanych dzieci i pytań dotyczących wiedzy na temat połogu. Komisja Bioetyczna Uniwersytetu Jana Kochanowskiego zatwierdziła badanie wiedzy na temat połogu. Informacje niezbędne do przeprowadzenia badania zostały pozyskane w zgodzie z polityką ochrony danych osobowych.                                                              Analiza statystyczna                                                                                                                  Analiza statystyczna przeprowadzona została za pomocą programu komputerowego Statistica 13. Uzyskane wyniki zostały poddane testowi zgodności Chi² zwanemu także testem zgodności Pearsona. Obliczono także współczynniki V Cramera oraz korelacji rangowej Spearmana.                                                                              Wyniki Średnia ocena poziomu wiedzy respondentów wynosi 78,6%. Największy zakres wiedzy posiadały położne, najniższy przedstawiały położnice. Respondenci wszystkich grup mają zadowalający poziom wiedzy na temat czasu trwania połogu, zasad profilaktyki i higieny w tym okresie oraz karmienia noworodka. Swoją wiedzę respondenci pozyskują z książek i czasopism

Parents' knowledge of neonatal transitory conditions and their expectations of the midwife

Introduction The neonatal period is the period of the child's adaptation to life outside the mother's body. The child has to adapt to the changes taking place in its body. After delivery, the new-born baby is assessed according to the Apgar scale. Objective of the study The objective of the study was to assess the parents' knowledge of the transitory conditions of neonates and to identify their expectations towards medical personnel. Material and methods 248 women participated in the study. Inhabitants of large cities accounted for 64.5% of the respondents and 16.2% of the respondents were inhabitants of rural areas. Women aged over 35 accounted for 46.8% of patients, 19.3% were patients between the ages of 26 and 30. Patients between the ages of 30 and 35 also accounted for 19.3%. Patients under 25 years of age accounted for 14.6%. The Bioethics Committee approved the project. Statistical analysis was performed with the use of the Statistica computer program. Results 81% of women displayed knowledge about the duration of the neonatal period. 62% of the respondents knew the effect of vitamin K in preventing the occurrence of haemorrhagic disease in the neonate. Half of the women prefer to feed on demand. A big problem among women in childbed is the lack of access to a psychologist. Conclusions Parents cannot recognize transitory conditions in a neonate. Antenatal education of future mothers influences their pro-health behaviour. Parents source their knowledge from their family, friends, guides and books.Introduction The neonatal period is the period of the child's adaptation to life outside the mother's body. The child has to adapt to the changes taking place in its body. After delivery, the new-born baby is assessed according to the Apgar scale. Objective of the study The objective of the study was to assess the parents' knowledge of the transitory conditions of neonates and to identify their expectations towards medical personnel. Material and methods 248 women participated in the study. Inhabitants of large cities accounted for 64.5% of the respondents and 16.2% of the respondents were inhabitants of rural areas. Women aged over 35 accounted for 46.8% of patients, 19.3% were patients between the ages of 26 and 30. Patients between the ages of 30 and 35 also accounted for 19.3%. Patients under 25 years of age  accounted for 14.6%.          The Bioethics Committee approved the project.      Statistical analysis was performed with the use of the Statistica computer program. Results 81% of women displayed knowledge about the duration of the neonatal period. 62% of the respondents knew the effect of vitamin K in preventing the occurrence of haemorrhagic disease in the neonate. Half of the women prefer to feed on demand. A big problem among women in childbed is the lack of access to a psychologist. Conclusions Parents cannot recognize transitory conditions in a neonate. Antenatal education of future mothers influences their pro-health behaviour. Parents source their knowledge from their family, friends, guides and books

Clinical course and outcome of SARS-CoV-2 infection in multiple sclerosis patients treated with disease-modifying therapies — the Polish experience

Introduction. The aim of this study was to report the course and outcome of SARS-CoV-2 infection in multiple sclerosis (MS) patients treated with disease-modifying therapies (DMTs) in Poland. A major concern for neurologists worldwide is the course and outcome of SARS-CoV-2 infection in patients with MS treated with different DMTs. Although initial studies do not suggest an unfavourable course of infection in this group of patients, the data is limited.Materials and methods. This study included 396 MS patients treated with DMTs and confirmed SARS-CoV-2 infection from 28 Polish MS centres. Information concerning patient demographics, comorbidities, clinical course of MS, current DMT use, as well as symptoms of SARS-CoV-2 infection, need for pharmacotherapy, oxygen therapy, and/or hospitalisation, and short-term outcomes was collected up to 30 January 2021. Additional data about COVID-19 cases in the general population in Poland was obtained from official reports of the Polish Ministry of Health.Results. There were 114 males (28.8%) and 282 females (71.2%). The median age was 39 years (IQR 13). The great majority of patients with MS exhibited relapsing-remitting course (372 patients; 93.9%). The median EDSS was 2 (SD 1.38), and the mean disease duration was 8.95 (IQR 8) years. Most of the MS patients were treated with dimethyl fumarate (164; 41.41%). Other DMTs were less frequently used: interferon beta (82; 20.70%), glatiramer acetate (42; 10.60%), natalizumab (35;8.84%), teriflunomide (25; 6.31%), ocrelizumab (20; 5.05%), fingolimod (16; 4.04), cladribine (5; 1.26%), mitoxantrone (3; 0.76%), ozanimod (3; 0.76%), and alemtuzumab (1; 0.25%). The overall hospitalisation rate due to COVID-19 in the cohort was 6.81% (27 patients). Only one patient (0.3%) died due to SARS-CoV-2 infection, and three (0.76%) patients were treated with mechanical ventilation; 106 (26.8%) patients had at least one comorbid condition. There were no significant differences in the severity of SARS-CoV-2 infection regarding patient age, duration of the disease, degree of disability (EDSS), lymphocyte count, or type of DMT used.Conclusions and clinical implications. Most MS patients included in this study had a favourable course of SARS-CoV-2 infection. The hospitalisation rate and the mortality rate were not higher in the MS cohort compared to the general Polish population. Continued multicentre data collection is needed to increase the understanding of SARS-CoV-2 infection impact on the course of MS in patients treated with DMTs

Cutaneous Toll-like Receptor 9 Pre-Defines Hydroxychloroquine Dosage in Patients with Both Discoid and Subacute Lupus Erythematosus

Background and Objectives: Cutaneous lupus erythematosus (CLE) presents clinically heterogeneous manifestations, partially explained by the different expression of Toll-like receptors (TLRs) type 8 and 9, located to endosomal compartments where they are poised to recognize microbial nucleic acids. This disease is empirically treated with hydroxychloroquine (HCQ), which is hallmarked with a safe and effective profile, but induces a slow and sometimes clinically insufficient therapeutic response. Currently, no biomarkers predictive of response are validated or even proposed in the scientific literature. We aimed to evaluate endosomal TLR type 7, 8 and 9 as predictive biomarkers of HCQ efficacy. Materials and Methods: We conducted a case–control study comparing CLE patients retrospectively assigned to three subgroups based on 3–6-month Cutaneous LE Disease Area and Severity Index (CLASI) reduction upon treatment with HCQ (I = = 40–80% vs. III = >80%). Before HCQ, lesional skin specimens were collected in untreated CLE and through immunohistochemistry; TLR-7, -8 and -9 expression was evaluated in the epidermis and the lymphocytic infiltrate was evaluated in the dermis. Results: Sixty-six lesional skin biopsies were compared with healthy controls. CLE patients displayed lower epidermal expression of total TLR 8 and 9 as well as infiltrating TLR-8, TLR9 + lymphocytes compared to controls. High HCQ responders differed from low responders for TLR-9 positivity (high vs. low) and for the lymphocytic dermal infiltrate (high vs. low). Conclusions: TLR9 could be envisaged as a possible biomarker to predict HCQ response level and dosage in CLE patients

Symptoms after COVID-19 infection in individuals with multiple sclerosis in Poland

(1) Background: To report and analyze the presence of residual symptoms after SARS-CoV-2 infection among Polish patients with multiple sclerosis (MS) treated with different disease-modifying therapies (DMTs). (2) Methods: The study included 426 individuals with MS treated with DMTs and confirmed SARS-CoV-2 infection from 12 Polish MS centers. The data were collected through to 31 May 2021. The information included demographics, specific MS characteristics, course of SARS-CoV-2 infection, and residual (general and neurological) symptoms lasting more than four and 12 weeks after the initial infection. The results were obtained using maximum likelihood estimates for odds ratio and logistic regression. (3) Results: A total of 44.84% patients with MS reported symptoms lasting between four and 12 weeks after the initial infection; 24.41% people had symptoms that resolved up to 12 weeks, and 20.42% patients had symptoms that lasted over 12 weeks. The most common symptoms were: fatigue, disturbance of concentration, attention, and memory, cognitive complaints, and headache. None of the DMTs were predisposed to the development of residual symptoms after the initial infection. A total of 11.97% of patients had relapse three months prior or after SARS-CoV-2 infection. (4) Conclusion: Almost half of individuals with MS treated with different DMTs had residual symptoms after SARS-CoV-2 infection. None of the DMTs raised the probability of developing post-acute COVID symptoms