Koagulopatia ze zużycia jako wiodący objaw zatoru płynem owodniowym -opis przypadku.

Amniotic fluid embolism is a rare and diagnostically challenging obstetric disease of high mortality rate. We present a case of a 33-year old parturient after vaginal birth, who presented with severe hemorrhagic shock with low platelet count and coagulopathy resistant to treatment with plasma, platelets and coagulation factors and despite of surgical management of bleeding. Laboratory findings revealed consumptive coagulopathy. Other symptoms included dyspnea and atelectatic changes on chest x-ray, together with augmentation of the heart with no proof of ventricular insufficiency in echocardiographic examination. The suspected reason of these alterations was amniotic fluid embolism. The patient survived and came back to her usual activity after 22 days of treatment.Zator płynem owodniowym jest rzadkim i ciężkim powikłaniem położniczym trudnym diagnostycznie i obarczonym wysoką śmiertelnością. Prezentujemy przypadek 33-letniej pacjentki po porodzie drogami natury w 36. tygodniu ciąży, u której w kilku godzinach po porodzie zaobserwowano objawy wstrząsu krwotocznego z małopłytkowością i zaburzeniami krzepnięcia utrzymującymi się mimo chirurgicznego zaopatrzenia krwotoku oraz uzupełniania płytek krwi i czynników krzepnięcia. Badania laboratoryjne potwierdziły koagulopatię ze zużycia. Pozostałymi objawami była duszność i rozlane zmiany niedodmowe w rtg klatki piersiowej oraz powiększona sylwetka serca, jednak bez cech przeciążenia komór serca w badaniu echokardiograficznym. Przedstawiony obraz choroby może odpowiadać zatorowi płynem owodniowym. Pacjentka wróciła do zwykłej aktywności po 22 dobach leczenia

Mięśniak komórkowy w więzadle szerokim macicy – opis sytuacji klinicznej i przegląd piśmiennictwa

Myomas are most often benign tumours of the female genital tract. Uterine fibroids are the most common myomas, while uterine cervix and intraligamentary ones are statistically less frequent. The most common histopathological form is the leiomyoma and the least common is the cellular leiomyoma (Mięśniaki są najczęstszymi łagodnymi guzami żeńskich narządów rozrodczych. Mięśniaki macicy rozpoznawalne są najczęściej podczas gdy mięśniaki szyjkowe i międzywięzadłowe występują statystycznie rzadziej. Najczęstszą formą histologiczną mięśniaków jest mięśniak gładkokomórkowy a najrzadziej rozpoznawalną

Trichrome Mallory's stain may indicate differential rates of RNA synthesis in eutopic and ectopic endometrium.

Mallory's triple staining is a histochemical technique used mainly for analysing connective tissues and glands and other tissues. We have described the differences in the nuclear staining between eutopic and ectopic endometrium as well as endometrial hyperplasia and adenocarcinoma using the Mallory's method. The ultrastructural differences between eutopic and ectopic endometrium have been detected. In normal and hyperplastic endometrium the presence of stromal cell nuclei with an increased affinity to aniline blue has been observed. The affinity has disappeared after digestion of tissues with RNase. In cases of endometriosis, independently of cell types, the nuclei have shown affinity to orange G. Similar effects in adenocarcinoma have been noted. The ultrastructural studies have shown that in normal endometrium the stroma contained cells with euchromatic and low electron density cell nuclei. In endometriosis heterochromatic cell nuclei present both in the stroma and within glands have been detected. The results indicate that the Mallory's technique may be a useful tool for recognizing the differences between eutopic and ectopic endometrium. The affinity for aniline blue in normal and hyperplastic endometrium occurs most likely due to increased RNA synthesis. Based on Mallory's staining a similarity between hyperplasia and unchanged endometrium in contrast to similar results of the staining obtained in cases of adenocarcinoma and endometriosis may be suggested

Cechy rozmieszczenia sklepów w przestrzeni wielkomiejskiej na przykładzie Wrocławia - zastosowanie regresji ważonej geograficznie

The purpose of this study is to identify the applicability of the Geographically Weighted Re- gression for determination of relationships between the size of population and the distribution of shops in the urban space. The paper presents the analyzed dependencies and diversities of urban space on the example of Wroclaw. The study includes information concerning e.g.: location of shops, population density and cubic capacity of residential buildings. Theoretical census enumeration areas were used as spatial reference units. Using local statistics of Moran and Getis–Ord, patterns of local spatial dependencies were determined. Attempts were also made to identify determinants of shop distribution using global and spatial regression techniques – Geographically Weighted Regression

Opis przypadku mi´saka prà˝kowanokomórkowego pleomorficznego trzonu macicy

Abstract Pleomorphic rhabdomyosarcoma of the uterus is a rare malignant tumor. It is connected with postmenopausal abnormal vaginal bleeding and abdominal pain. We report a case of a 66-year-old postmenopausal woman diagnosed with abnormal vaginal bleeding and abdominal pain. Vaginal ultrasonography showed enlarged uterus, 82mm x 64mm in size. The patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy with postoperative chemotherapy due to pleomorphic rhabdomyosarcoma of the uterus. The patient died 2,5 years after the surgery as a result of a rapid spread of the neoplastic process. The case of rhabdomyosarcoma, together with the review of the literature, is presented in the following work. We find that the rarity of this histological entity makes it particularly worthy of publication.Mięsak pleomorficzny, prążkowanokomórkowy jest rzadkim nienabłonkowym nowotworem złośliwym mięśnia macicy, występującym u pomenopauzalnych pacjentek, które zgłaszają w wywiadzie nieprawidłowe krwawienia maciczne i dolegliwości bólowe podbrzusza. W opisywanej sytuacji klinicznej 66 letnia wieloródka była hospitalizowana z powodu nieprawidłowego krwawienia z dróg rodnych oraz bólu podbrzusza. W badaniu USG uwidoczniono powiększony trzon macicy o wymiarach 82x64 mm. Przeprowadzono zabieg usunięcia macicy z przydatkami w sposób typowy. W badaniu histopatologicznym, potwierdzonym immunohistochemiczne, stwierdzono postać pleomorficzną mięsaka trzonu macicy. Po operacji pacjentka przeszła chemioterapię. Z powodu przerzutów pacjentka zmarła po około 2,5 roku od leczenia chirurgicznego. Z powodu bardzo rzadkiego występowania postaci pleomorficznej mięsaka prążkowanokomórkowego macicy, ten opis przypadku, łącznie z przeglądem literatury, wart jest opublikowania

Current distribution of Pilularia globulifera L. in Poland : changes of geographical range and habitat preferences

Pilularia globulifera is a subatlantic European fern threatened with extinction. In Poland, it reaches the eastern border of its continuous range. Up to the end of the 20th century, it was observed here in 21 stands; only 2 of them existed by the second half of the century, so the species was categorized as critically endangered. Five new locations have been found in western and northwestern Poland during the last 10 years. Abundant and permanent populations grow in 3 locations, while 2 stands were ephemeral. All the current stands are situated in anthropogenic habitats with spontaneous vegetation, in oligotrophic to eutrophic waters. One of the new localities is about 280 km distant from the eastern range of the limit known previously. Pilularia forms its own plant community Pilularietum globuliferae, enters plots of Ranunculo-Juncetum bulbosi and occurs in mesotrophic to eutrophic rushes of Eleocharis palustris, Phragmites australis, Typha angustifolia and Equisetum fluviatile. Specimens are vigorous and regularly produce sporocarps

The clinical significance of electronic fetal heart rate monitoring in twins

Objectives: Fully effective intrapartum cardiotocographic (CTG) fetal heart monitoring is still missing. Visual analysis is far from credibility. Additional, computerized analysis techniques were proposed however they did not substantially decrease possible risks of fetal asphyxia. In twin pregnancies the problem is even more complicated. Our goal is to find the most valuable parameters in intrapartum CTG surveillance in twins, based on actual FIGO criteria. Material and methods: Study included 58 women in labor who had been admitted to Delivery Department of tertiary care hospital with twin pregnancy in a period of one year. The features of the CTG (e.g., baseline, oscillation, decelerations, brady- or tachycardia) were grouped to create three variables that were closest to the FIGO CTG scale. All three groups were compared according to neonatal status (Apgar score at 5 min ≥ 7 or < 7; pH value in umbilical artery ≥ 7.20, < 7.20 or < 7.10 and BE (base excess) > or ≤ –12). Fetal status and its acid — base equilibrium was compared either with long term variability (LTV), short term variability (STV), or percentage of the signal loss. Results: Out of 58 twin pregnancies, a total of 116 babies were born. One baby was born dead. From this group, 11 deliveries were natural births and 47 deliveries were C-sections. None of the analyzed features (pH, BE, Apgar, CTG features except tracing length, CTG FIGO categories) were statistically different between groups of singleton and twin pregnancies, except percentage of C-sections. No differences were found either for STV or LTV and fetal status.org CTG categories. Conclusions: Prior to cardiotocographic tracing of twins during labor, ultrasound examination should be mandatory. Considerable loss of signal in CTG tracing in twins should provoke ultrasonographic confirmation of the fetal status

Differences in sex hormone levels in the menstrual cycle due to tobacco smoking — myth or reality?

Introduction: Tobacco smoke contains, among others, polycyclic aromatic hydrocarbons (PAHs), heterocyclic analogues, aromatic amines, N-nitrosamines, volatile hydrocarbons, aldehydes, phenols, miscellaneous organic compounds, metals, and inorganic compounds. Tobacco smoking can harm women’s reproductive system and may reduce fertility. The objective of the study was to explore the effect of tobacco smoke on the menstrual cycle due to smoking and second-hand smoke-exposure. Material and methods: The study was performed on 153 women of reproductive age, who received care at the Gynaecological-Obstetric Clinical Hospital of the Poznan University of Medical Sciences. They were divided into three treatment groups: non-smokers, secondhand smokers, and smokers. Comprehensive assessment of all hormone levels: follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17β-oestradiol (E2), and progesterone (P), in the various phases of the menstrual cycle and with concomitant determinations of serum cotinine concentrations was performed. The menstrual cycle was observed with ultrasonography. Results: Cigarette smoking may be an important factor in disrupting reproduction: 1. The increase in the oestradiol E2 level was accompanied by significantly lowered serum cotinine concentrations in tobacco smokers; 2. In smoking patients, the serum level of LH significantly increased on the first days of the menstrual cycle; 3. The higher levels of P (in the 14th and 21st days) were assumed to be the result of a longer menstrual cycle. Conclusions: Active and passive smoking may be an important contributor to reproductive health issues and deserves greater focus in health education programs directed towards women of reproductive age