The course of pregnancy and delivery in a patient with malaria

Malaria is one of the most common lethal parasitic diseases. Infection is transmitted when an infected female mosquito bites a human introducing the sporozoites into human blood. The article presents the course of pregnancy and delivery in a patient complicated by Plasmodium infection. The patient had repetitive several trips to Tanzania over a short time period before she developed the condition. She had been taking antimalarial medication (proguanil-atovaquone) in a prophylactic dose during and after her first travel to Tanzania. Following her first return to Poland she experienced infection-related symptoms

Subchorionic hematoma as a risk factor of pregnancy and delivery in women with threatening abortion

Summary Objectives: The aim was to present pregnancy complications and outcome in the group of women with subchorionic hematoma (SCH) diagnosed in the first or second trimester of pregnancy. Methods: A retrospective study was performed to compare the perinatal outcome of 41 patients with SCH (study group) with 59 women treated of threatening abortion (control group). Age, obstetric history, the course of pregnancy and obstetric outcomes were analyzed. Results: More SCH patients lost the pregnancy before 22 weeks gestation when Compared to the control group (39.02% vs. 15.3%). The mean age of women in both groups was similar, but a previous loss of pregnancy was more often observed in SCH group (24.4% vs. 9.4%). The majority of SCH women were multiparas (63.25% vs. 43,75%). The frequency of perinatal complications such as premature delivery, intrauterine growth retardation (IUGR) or premature rupture of membranes (PROM), was similar in both groups, but pregnancy-induced hypertension (PIH) was observed more often in SCH group (p=0,008). The percentage of caesarean sections, the average condition of the newborns in Apgar score and weight were similar in both groups. There were no differences either in the frequency of meconium stained fluid or the presence of late decelerations in delivery CTG pattern. The patients with SCH delivered female fetuses more frequently; 81.25 % of those who delivered vaginally had incomplete placenta. Conclusions: 1. SCH is more frequent in multiparas, especially if previous pregnancy loss was reported. 2. About 40% of pregnancies with SCH are lost before 22 weeks gestation; bleeding is a bad prognostic factor. 3. SCH diagnosed at the beginning of pregnancy is a risk factor of PIH in the third trimester. 4. SCH diagnosed in early pregnancy does not influence the method of delivery and does not increase the risk of adverse pregnancy outcome

Acute kidney injury as the most important predictor of poor prognosis after interventional treatment for aortic stenosis

Background: Aortic stenosis (AS) is the most common acquired valvular disease. There are two methods of interventional treatment: surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI). The choice between SAVR and TAVI depends on the assessment of individual perioperative risk and long-term treatment outcomes. It is essential to identify factors that may influence the outcomes of the treatment to minimize their negative effects.Aims: The study aimed to identify the most important risk factor which affects treatment outcomes in patients with AS undergoing SAVR/TAVI.Methods: This study reviewed retrospectively patients with AS who underwent SAVR or TAVI. The primary outcomes included incidences of major adverse cardiovascular events (MACE) defined as cardiovascular death, stroke, and hospitalization for cardiovascular issues assessed over a one-year follow-up period. An occurrence of postprocedural AKI (acute kidney injury) was identified as an independent predictor of MACE. Results: The study included 78 patients, with the same number of subjects in each group (SAVR/TAVI [n = 39]). Twenty-nine patients developed AKI. It was similar in both groups (SAVR [n = 15]; TAVR [n = 14]). In the SAVR group, 13 (33%) patients developed at least one MACE compared to 5 (13%) patients in the TAVI group. AKI and the type of procedure (SAVR) were shown to be significantly and independently associated with the development of MACE (P = 0.01 and P = 0.03, respectively) as shown in the Cox multivariable regression model. Conclusions: Our study demonstrated that AKI is the strongest predictor of major adverse cardiovascular events after using both methods of aortic valve replacement (SAVR/TAVI)

Concordance between coronary computed tomography angiography and coronary angiography in assessing the significance of coronary artery stenosis in patients with multivessel coronary artery disease

Wstęp. Choroba wieńcowa jest jednym z najczęściej występujących problemów kardiologicznych zarówno w Polsce, jak i na świecie. W przypadku wielonaczyniowej choroby wieńcowej (MVD) kwestia dalszego postępowania i leczenia jest jeszcze bardziej skomplikowana. Nieinwazyjne metody obrazowania są powszechnie stosowane w diagnozowaniu choroby wieńcowej. Celem niniejszej pracy była analiza porównawcza wyników tomografii komputerowej tętnic wieńcowych (CCTA) i koronarografii w odniesieniu do zmiennych demograficznych i klinicznych u pacjentów z MVD. Materiał i metody. Badanie przeprowadzono u 106 pacjentów z MVD hospitalizowanych w Klinice Kardiologii Centralnego Szpitala Klinicznego w Łodzi. Analizie poddano dostępne wyniki CCTA i koronarografii, porównując wyniki pod kątem istotności zwężeń w tętnicach wieńcowych w obu badaniach. Przeprowadzono również charakterystykę demograficzną oraz kliniczną analizowanej grupy pacjentów. Wyniki. Znaczną większość pacjentów stanowili mężczyźni (n = 69,8%). Średnia wieku pacjentów wynosiła 69,42 ± 8,28 lat. Czynniki ryzyka choroby wieńcowej były rozpowszechnione w dużym stopniu w badanej populacji. Całościowa zgodność w ocenie istotności zwężeń w tętnicach wieńcowych w badaniu CCTA w porównaniu z koronarografią wynosiła 73% (κ = 0,47). Największa zgodność w ocenie dotyczyła pnia lewej tętnicy wieńcowej 78% (κ = 0,5), a najmniejsza — gałęzi okalającej 69% (κ = 0,34). Wnioski. U pacjentów z MVD występuje umiarkowana zgodność pomiędzy opisem istotności zwężeń w tętnicach wieńcowych w badaniu CCTA w porównaniu do koronarografii. Tomografia komputerowa tętnic wieńcowych, jako metoda nieinwazyjna, jest jednym z narzędzi w początkowej diagnostyce przy podejrzeniu choroby wieńcowej. Czynniki ryzyka choroby wieńcowej są szeroko rozpowszechnione i stanowią istotny problem w analizowanej populacji pacjentów.Introduction. Coronary artery disease (CAD) is one of the most common cardiovascular problems in Poland and worldwide. In the case of multivessel coronary artery disease (MVD), the matter of further management and treatment is even more complicated. The non-invasive diagnostic methods are commonly used in the initial diagnostics of CAD. The following study aimed to perform a comparative analysis of the results of coronary computed tomography angiography (CCTA) and coronary angiography in relation to the demographic and clinical variables in patients with MVD. Material and methods. The study was performed on 106 patients with MVD hospitalised in the Cardiology Department of the Central Clinical Hospital in Lodz. The available results of CCTA and coronary angiography were analysed and compared with regard to the significance of coronary artery stenosis in both examinations. Demographic and clinical characteristics of the analysed group of patients were also performed. Results. The vast majority of the participants were male (n = 69.8%). The average age of the patients was 69.42 ± 8.28 years. Coronary artery disease risk factors were highly prevalent in the study population. The overall concordance in the assessment of the significance of coronary artery stenosis by coronary computed tomography angiography compared with coronary angiography was 73% (κ = 0.47). The highest concordance in the assessment was noted for the left main coronary artery 78% (κ = 0.5) and the lowest for the circumflex branch 69% (κ = 0.34). Conclusions. In patients with MVD, there is a moderate concordance between the description of the significance of coronary artery stenosis in CCTA compared to coronary angiography. Coronary computed tomography angiography as a non-invasive imaging is one of the methods in the initial diagnostics of a suspected CAD. The risk factors of CAD are widespread and represent a significant problem in the analysed patient population

Burden of multimorbidity in a Polish cohort of ambulatory and hospitalized heart failure patients from two large European registry programs: prognostic implications

n/

Impact of Prenatal and Postnatal Diagnosis on Parents: Psychosocial and Economic Aspects Related to Congenital Heart Defects in Children

Congenital heart defects (CHD) are defects detected both prenatally and after birth. They are the most common congenital defects. Despite advances in diagnosis and treatment, CHD remain an important cause of morbidity and mortality in newborns, which has a great impact on economic aspects. It is crucial to provide a holistic approach to the care of children with CHD, including regular cardiac check-ups, appropriate drug treatment, surgical or cardiac interventions as needed, rehabilitation, psychological support, and education for patients and their families. Parents experience a variety of psychological problems. This article summarizes the influence of CHD in the psychological and economic areas

Rs868058 in the Homeobox Gene <i>HLX</i> Contributes to Early-Onset Fetal Growth Restriction

Fetal growth restriction (FGR) is a condition that characterizes fetuses as too small for their gestational age, with an estimated fetal weight (EFW) below the 10th percentile and abnormal Doppler parameters and/or with EFW below the 3rd percentile. We designed our study to demonstrate the contribution of single nucleotide polymorphisms (SNPs) from DLX3 (rs11656951, rs2278163, and rs10459948), HLX (rs2184658, and 868058), ANGPT2 (−35 G > C), and ITGAV (rs3911238, and rs3768777) genes in maternal blood in FGR. A cohort of 380 women with singleton pregnancies consisted of 190 pregnancies with FGR and 190 healthy full-term controls. A comparison of the pregnancies with an early-onset FGR and healthy subjects showed that the AT heterozygotes in HLX rs868058 were significantly associated with an approximately two-fold increase in disease risk (p ≤ 0.050). The AT heterozygotes in rs868058 were significantly more frequent in the cases with early-onset FGR than in late-onset FGR in the overdominant model (OR 2.08 95% CI 1.11–3.89, p = 0.022), and after being adjusted by anemia, in the codominant model (OR 2.45 95% CI 1.23–4.90, p = 0.034). In conclusion, the heterozygous AT genotype in HLX rs868058 can be considered a significant risk factor for the development of early-onset FGR, regardless of adverse pregnancy outcomes in women

Otyłość matki jako czynnik ryzyka perinatalnego

Summary Objective: The aim of the study was to estimate the effect of maternal obesity on pregnancy course, delivery and newborn well-being. Material and methods: Data about women who delivered in PMMH was analyzed and obese pregnant women (pre-pregnancy BMI ≥30) were included in the study group; the rest of the mothers constituted the control group. The pregnancy course, labor and delivery, and newborn well-being were taken into consideration. Results: 4648 women were found in our delivery database, among them 208 (4.48%) were classified as obese. In this group, pregnancy-associated hypertension was common, either non-proteinuric one (8.65% vs 2.39%, p=0.001) or preeclampsia (4.81% vs 1.58 %, pStreszczenie Cel pracy: Celem pracy była ocena wpływu otyłości matki na przebieg ciąży, porodu i stan noworodka. Materiał i metody: Retrospektywnej analizie poddano przebieg porodów pacjentek hospitalizowanych w ICZMP w latach 2004-2006. Grup´ badana stanowiły ciężarne otyłe (przedciążowe BMI ≥30); pozostałe pacjentki stanowiły grupę kontrolną. Analizie poddano przebieg ciąży i porodu oraz stan urodzeniowy noworodków. Wyniki: Wśród 4648 kobiet znalezionych w naszej bazie danych odbytych porodów 208 (4,48%) zostało zakwalifikowanych jako otyłe. W tej grupie pacjentek znacznie częściej występowało nadciśnienie tętnicze związane z ciążą, nadciśnienie tętnicze bez białkomoczu (8,65% vs 2,39%, p=0,001) oraz preeklampsja (4,81% vs 1,58 %,

Association of Single Nucleotide Polymorphisms from Angiogenesis-Related Genes, ANGPT2, TLR2 and TLR9, with Spontaneous Preterm Labor

In this study, we hypothesized that the changes localized at angiopoietin-2 (ANGPT2), granulocyte-macrophage colony-stimulating factor (CSF2), fms-related tyrosine kinase 1 (FLT1) and toll-like receptor (TLR) 2, TLR6 and TLR9 genes were associated with spontaneous preterm labor (PTL), as well as with possible genetic alterations on PTL-related coagulation. This case-control genetic association study aimed to identify single nucleotide polymorphisms (SNPs) for the aforementioned genes, which are correlated with genetic risk or protection against PTL in Polish women. The study was conducted in 320 patients treated between 2016 and 2020, including 160 women with PTL and 160 term controls in labor. We found that ANGPT2 rs3020221 AA homozygotes were significantly less common in PTL cases than in controls, especially after adjusting for activated partial thromboplastin time (APTT) and platelet (PLT) parameters. TC heterozygotes for TLR2 rs3804099 were associated with PTL after correcting for anemia, vaginal bleeding, and history of threatened miscarriage or PTL. TC and CC genotypes in TLR9 rs187084 were significantly less common in women with PTL, compared to the controls, after adjusting for bleeding and gestational diabetes. For the first time, it was shown that three polymorphisms&mdash;ANGPT2 rs3020221, TLR2 rs3804099 and TLR9 rs187084 &mdash;were significantly associated with PTL, adjusted by pregnancy development influencing factors