The assessment of postpartum mood disorders and its risk factors

Wstęp: Celem pracy jest ocena rozpowszechnienia zaburzeń nastroju z uwzględnieniem występowania depresji poporodowej oraz analiza czynników predysponujących do ich występowania. Materiał i metody: Grupą badaną były pacjentki Ginekologiczno-Położniczego Szpitala Klinicznego Uniwersytetu Medycznego w Poznaniu, przebywające na oddziałach poporodowych. Badanie miało charakter kwestionariuszowy. W pracy wykorzystano skalę depresji Becka, Edynburską Skalę Depresji Poporodowej (EPDS) i kwestionariusz własny. Pacjentki wypełniły anonimowy kwestionariusz i skalę depresji Becka w 1.−7. dni po porodzie (n = 184), a następnie przesłano im skalę depresji Becka oraz EPDS po 30 dniach od porodu w celu ponownej oceny nastroju. Uzyskano 41 odpowiedzi zwrotnych. Badanie uzyskało zgodę Lokalnej Komisji Bioetycznej. Wyniki: Wśród badanych pacjentek będących w 1.−7. dniu po porodzie: 11,96% uzyskało wynik świadczący o łagodnej depresji, a 0,54% o umiarkowanej według skali Becka. Po około 30 dniach od porodu wynik ten zwiększył się do 19,51% dla łagodnej i odpowiednio 2,44% dla umiarkowanej depresji. Wnioski: Na podstawie uzyskanych wyników czynnikami predysponującymi do wystąpienia zaburzeń nastroju w 1.−7. dni po porodzie były: nieplanowana ciąża, komplikacje zdrowotne podczas trwania ciąży, pobyt w szpitalu z powodu zagrożenia ciąży, epizody depresji w przeszłości oraz wystąpienie myśli rezygnacyjnych lub samobójczych w przeszłości. Wystąpienie w przeszłości stresującego wydarzenia w postaci poronienia, martwego porodu lub śmierci dziecka wiązało się z uzyskiwaniem niższych wyników w skali Becka przez badane pacjentki. W pracy nie wykazano istotnej statystycznie zależności pomiędzy uzyskanymi wynikami w skali Becka a badanymi czynnikami ocenianymi miesiąc od porodu, analizowana grupa była istotnie mniejsza (n = 41).Introduction: The aim of our study was to estimate the prevalence of mood disorders including postpartum depression and to analyze its potential risk factors. Material and methods: The patients staying in maternity wards at the Gynecological Clinical Hospital of PUMS were examined during their postpartum period. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI) and our own questionnaire. The anonymous questionnaire and BDI were filled by the patients between 1st and 7th day after the delivery (n = 184), then they were asked to fill the BDI and EPDS after 30 days of the childbed (n = 41 patients refilled the survey). The research has obtained permission of the Local Bioethical Commission. Results: During the first week of the childbed, 11.96% of the patients achieved score, which might imply they suffer from mild depression and 0.54% from major depression according to BDI. After the second examination the score increased to 19.51% and 2.44%, respectively. Conclusions: The unplanned pregnancy, health issues during the gestation, hospitalization due to pregnancy complications, no stressful factors in the past like: history of miscarriage, stillbirth or death of the child, episodes of depression in the past, suicidal ideation in the history can be bracketing the risk factors of mood disorders after 1 to 7 days of the childbed. The significant correlation between score of the BDI and the answers in the questionnaire wasn’t demonstrated after 30 days of the postpartum period, however the analyzed group was significantly lower (n = 41)

Left ventricular myxoma complicated by peripheral embolism

Śluzak lewej komory jest bardzo rzadkim, łagodnym guzem pierwotnym serca. Ze względu na umiejscowienie, wielkość oraz ruchomość może być źródłem zatorowości obwodowej. Nawrót śluzaka po chirurgicznym usunięciu jest rzadki i wynosi 0–3% w przypadkach guzów odosobnionych i 12–22% w postaciach występujących rodzinnie. Przedstawiono dwa przypadki śluzaków lewej komory serca powikłanych zatorowością tętnic kończyn dolnych. W pierwszym przypadku u 19-letniego mężczyzny, oprócz zatorowości obwodowej, stwierdzono szybki rozrost guza, który mógł sugerować tworzenie się skrzepliny. W 2. przypadku u 42-letniego mężczyzny 2 miesiące po operacyjnym usunięciu śluzaka zaobserwowano odrośnięcie guza w koniuszku lewej komory oraz pojawienie się dodatkowo dwóch guzów w jamie prawego przedsionka. Cechy kliniczne śluzaka serca zarówno w kontekście powikłań, jak i jego nawrotów nakazują wnikliwą obserwację, w tym kontrolę echokardiograficzną, u wszystkich chorych po chirurgicznym usunięciu tego nowotworu.Left ventricular myxoma is a very rare, benign primary cardiac tumor. Due to its localization, size and mobility, it may be a source of peripheral embolism. The recurrence of myxoma after surgical removal is rare, ranging from 0% to 3% in solitary tumors and 12–22% in the familial type. We report two cases of left ventricular myxomas complicated by arterial embolism. In the first case of a 19-years old male, apart from systemic embolisation, a very fast tumor growth, suggesting thrombus formation, was observed. In the second case of a 42-years old male, the recurrence of myxoma in left ventricle apex was found 2 months after surgical excision, together with de novo development of two additional tumors in the right atrium. Clinical features of cardiac myxoma, both in terms of complications and recurrences, necessitate careful follow up with an echocardiographic control in all patients after tumor removal surgery

High soluble transferrin receptor in patients with heart failure:a measure of iron deficiency and a strong predictor of mortality

Background: Iron deficiency (ID) is frequent in heart failure (HF), linked with exercise intolerance and poor prognosis. Intravenous iron repletion improves clinical status in HF patients with LVEF≤45%. However, uncertainty exists about the accuracy of serum biomarkers in diagnosing ID. Study Aims: 1) to identify the iron biomarker with the greatest accuracy for the diagnosis of ID in bone marrow in patients with ischaemic HF; 2) to establish the prevalence of ID using this biomarker and its prognostic value in HF patients. Methods and Results: Bone marrow was stained for iron in 30 patients with ischaemic HF with LVEF≤45% and 10 healthy controls, and ID was diagnosed for 0‐1 grades (Gale scale). 791 patients with HF with LVEF≤45% were prospectively followed‐up for 3 years. Serum ferritin, transferrin saturation, soluble transferrin receptor (sTfR) were assessed as iron biomarkers. Most patients with HF (25, 83%) had ID in bone marrow, but none of the controls (p<0.001). Serum sTfR had the best accuracy in predicting ID in bone marrow (AUC: 0.920, 95%CI: 0.761‐0.987, for cut‐off 1.25 mg/L sensitivity 84%, specificity 100%). Serum sTfR was ≥1.25 mg/L in 47% of HF patients, in 56% and 46% of anaemics and non‐anaemics, respectively (p<0.05). The reclassification methods revealed that serum sTfR significantly added the prognostic value to the baseline prognostic model, and to the greater extent than plasma NT‐proBNP. Based on internal derivation and validation procedures, serum sTfR ≥1.41 mg/L was the optimal threshold for predicting 3‐year mortality, independent of other established variables. Conclusions: High serum sTfR accurately reflects depleted iron stores in bone marrow in patients with HF, and identifies those with a high 3‐year mortality

Kale (Brassica oleracea L. var. acephala) as a source of dietary fibre

The aim of the work was to determine dietary fibre content (total, soluble and insoluble) in kale. Packages of the vegetable were bought in local stores in Lodz. Dietary fibre content determined during the research was compared with the information given by producers. Conducted research proved that kale is rich in dietary fibre (from 4.36 to 5.05 g per 100 g of product in fresh weight, mostly in form of insoluble dietary fibre). The results of determinations carried out in the laboratory coincide with the data declared by the producers

Evaluation of a gelatin modified poly(ɛ-caprolactone) film as a scaffold for lung disease

Lung transplantation is a necessary step for the patients with the end-stage of chronic obstructive pulmonary disease. The use of artificial lungs is a promising alternative to natural lung transplantation which is complicated and is restricted by low organ donations. For successful lung engineering, it is important to choose the correct combination of specific biological cells and a synthetic carrier polymer. The focus of this study was to investigate the interactions of human lung epithelial cell line NCl-H292 that is involved in lung tissue development with the biodegradable poly(ϵ-caprolactone) before and after its chemical modification to evaluate potential for use in artificial lung formation. Also, the effect of polymer chemical modification on its mechanical and surface properties has been investigated. The poly(ϵ-caprolactone) surface was modified using aminolysis followed by immobilization of gelatine. The unmodified and modified polymer surfaces were characterized for roughness, tensile strength, and NCl-H292 metabolic cell activity. The results showed for the first time the possibility for NCI-H292 cells to adhere on this polymeric material. The Resazurin assay showed that the metabolic activity at 24 hours post seeding of 80% in the presence of the unmodified and greater than 100% in the presence of the modified polymer was observed. The roughness of the poly(ϵ-caprolactone) increased from 4 nm to 26 nm and the film strength increased from 0.01 kN to 0.045 kN when the material was chemically modified. The results obtained to date show potential for using modified poly(ϵ-caprolactone) as a scaffold for lung tissue engineering

Strawberry Polyphenol-Rich Fractions Can Mitigate Disorders in Gastrointestinal Tract and Liver Functions Caused by a High-Fructose Diet in Experimental Rats

In the current study, it was hypothesized that the addition of strawberry polyphenol-rich fractions to a high-fructose diet mitigates disorders in liver functions, lipid metabolism, and in the antioxidant and pro-inflammatory status of rats. Therefore, a fraction rich in ellagitannins and proanthocyanidins (EP), and a fraction containing compounds of both mentioned classes of polyphenols and additionally anthocyanins (EPA), in doses of 0.28 and 0.70 g/100 g, respectively, were added to a standard or a high-fructose diet administered to rats for six weeks. The EPA fraction was more beneficial in alleviating the consequences of consuming excess fructose in the diet than the EP fraction. Probably, that fraction containing considerable amounts of carbohydrates was more extensively metabolized by intestinal bacteria, which resulted in higher levels of cecal short chain fatty acids (SCFAs) as well as cecal and urinal ellagitannin metabolites. As a further consequence, diet supplementation with the EPA fraction caused more favorable changes in the levels of serum interleukin 6 and serum antioxidant capacity of water-soluble substances (ACW), in atherogenicity index lg((triglyceride/high-density lipoprotein cholesterol), hepatic oxidized glutathione as well as reduced to oxidized glutathione ratio). Efforts should be made to develop strawberry polyphenol-rich preparations containing the preferred anthocyanins, which is, however, difficult due to the instability of this class of phenolic compounds during the technological process