Skin changes during pregnancy. Is that an important issue for pregnant women?

Objectives: The aim of the study was to investigate the prevalence of self-reported skin complaints during pregnancy, applied treatment and the impact on well-being of pregnant women. Material and methods: We asked 1935 women that were maximum 4 years after labor to fill in our questionnaire. The questionnaire included questions concerning the course of pregnancy, observed skin lesions, applied treatment and influence on the quality of life. Results: Skin changes during pregnancy were reported by 1447 patients (74.78%). The prevalence of self-reported skin complaints were as follows: stretch marks (77.4%), acne (21.6%) and recurrent herpes labialis (11.6%). In 43.67% (n = 632) of women who reported dermatological problems during pregnancy the disease caused significant deterioration in their well-being. Only 168 patients (11.61%) received dermatological treatment from their obstetricians. Dermatological con­sultation required 217 patients (14.99%). For 133 of treated women (25.68%) the recommended treatment was expensive. However, in the majority of patients (379; 73.15%) who received treatment the skin changes resolved after therapy. Skin symptoms resolved significantly faster in the treated group (3.5 ± 4.3 week vs 5.8 ± 6.2 week; p < 0.001). Conclusions: Self-reported skin complaints seem to be a relevant problem during pregnancy. Proper skin care as well as appropriate treatment applied by obstetricians and/or dermatologists may help women to recover

Changes in the parameters of the anterior segment of the eye in pregnant women — literature review

The physiology of pregnancy is a curious issue for specialists from different branches of medicine and science. In this systematic review, the attention was focused on changes in eyes during pregnancy and confinement. To summarise and systematize actual knowledge in eyes’ changes during pregnancy, publications from years 2011–2017 were analysed. Stud­ies about parameters of corneal endothelial cells, corneal biomechanical parameters, keratometric variables, intraocular pressure and biometry of the anterior chamber were compared. The conducted studies demonstrated the unambiguous character of changes only in case of intraocular pressure, which decreased during the II and III trimesters of pregnancy. Inconsistent study methods and low number of examined patients did not enable to draw explicit conclusions in context of other parameters of the anterior segment of the eye in pregnant women. It is indicated to perform further studies on a representative and homogeneous group of female patients

Perioperative factors influencing the mortalit

WSTĘP: Tętniaki aorty brzusznej są uznaną przyczyną zwiększonej śmiertelności w populacji europejskiej. Dlatego ważna jest identyfikacja śródoperacyjnych czynników ryzyka zgonu w okresie okołooperacyjnym. MATERIAŁ I METODY: Prospektywnym badaniem obserwacyjnym, przeprowadzonym w Klinice Chirurgii Naczyniowej Pomorskiego Uniwersytetu Medycznego w Szczecinie, objęto grupę 95 pacjentów z tętniakiem aorty brzusznej w odcinku podnerkowym. Na podstawie kryteriów TASC pacjentów zakwalifikowano do implantacji protezy naczyniowej. Analizowano wpływ czynników hemodynamicznych i metabolicznych na śmiertelność okołooperacyjną. Obserwację badanej populacji prowadzono przez 28 dni. WYNIKI: Wykazano, że wzrost stężenia mleczanów, potasu oraz spadek wartości pH szczególnie w pierwszych minutach po odklemowaniu aorty były zasadniczymi czynnikami zwiększającymi śmiertelność w okresie okołooperacyjnym. Ponadto ryzyko zgonu było zwiększone, jeśli poza znieczuleniem ogólnym nie zastosowano znieczulenia regionalnego. Poza tym nie wykazano istotnego wpływu pozostałych badanych czynników. WNIOSKI: Zastosowanie znieczulenia zewnątrzoponowego u pacjentów poddawanych operacjom tętniaków aorty brzusznej jest istotnym, niezależnym czynnikiem zmniejszającym śmiertelność we wczesnym okresie pooperacyjnym. Natomiast zmniejszenie wartości pH, wzrost stężenia potasu i mleczanów w pierwszych minutach po odklemowaniu aorty może być przydatnym wskaźnikiem służącym do identyfikacji pacjentów zagrożonych zwiększonym ryzykiem zgonu we wczesnym okresie pooperacyjnym.INTRODUCTION: Abdominal aorta aneurysm is a recognized cause of death for the European population. The identification of intra-operative risk factors for perioperative death is of crucial importance for the society. MATERIAL AND METHODS: A prospective observational study was conducted in the Vascular Surgery Department of the Pomeranian Medical University in Szczecin, Poland. The study group consisted of 95 patients, diagnosed with abdominal aorta aneurysm in the sub-renal region scheduled for an operative procedure of straight vascular graft implantation. Patient qualification was fulfilled according to TASC criteria. The influence of preoperative factors, hemodynamic and metabolic parameters on the risk of death in the study population was analyzed. Postoperatively, observation was continued for 28 days. RESULTS: In this study group an increase of lactate, potassium levels or pH decrease during the first minute post cross-clamp release were significant risk factors for perioperative death. The importance of metabolic parameters is a recognized risk factor, however their statistical significance within the first minute post cross-clamp release is in our opinion of crucial importance. Additionally, significantly higher mortality was reported among patients without epidural anaesthesia. No importance of other analyzed parameters was found. CONCLUSIONS: Epidural anaesthesia is an independent factor decreasing mortality in the early postoperative period in patients undergoing abdominal aorta aneurysm repair. A decrease of pH value and increase of lactate and K+ levels within the first minute after aortic cross-clamp release may be a valuable tool in identifying patients with an increased risk of perioperative death after abdominal aorta prosthesis implantation

Genetic Polymorphisms of MMP1, MMP9, COL1A1, and COL1A2 in Polish Patients with Thoracic Aortopathy

Background. The pathogenesis of thoracic aortopathy is complex, and much evidence suggests the influence of genetic factors. Some genes with polymorphisms are widely considered critical factors in the initiation and development of aortic aneurysm. The aim of our study was to analyze the association of genetic polymorphisms of MMP1 rs1799750 (c.-1607G>GG), MMP9 rs3918242 (c.-1562C>T), COL1A1 rs1800012 (c.1245G>T), and COL1A2 rs42524 (c.1645G>C) with predisposition to thoracic aortopathy in Polish patients and with clinical characteristics of these patients. Methods. The study was carried out with 96 patients with thoracic aortopathy (47 patients with ascending aortic aneurysm and 49 patients with thoracic aortic dissection) and 61 control subjects without thoracic aortopathy. The MMP1, MMP9, COL1A1, and COL1A2 polymorphisms were determined by PCR-RFLP. Results. No significant differences in the frequency distributions of MMP1, MMP9, COL1A1, and COL1A2 genotypes or alleles were found (1) between the control group and patients with ascending aortic aneurysm (AsAA), (2) between the control group and patients with thoracic aortic dissection (TAD), or (3) between AsAA and TAD patients. Multivariate logistic regression analysis revealed that MMP1 and MMP9 polymorphisms were associated with the degree of aortic valve regurgitation. Conclusion. The results of our study did not support associations between MMP1, MMP9, COL1A1, and COL1A2 genetic variants with the risk of thoracic artery disease in Polish patients. However, rs1799750 MMP1 and rs3918242 MMP9 seem to be associated with the degree of aortic regurgitation

Relationship between toll-like receptor 2 R753Q and T16934A polymorphisms and Staphylococcus aureus nasal carriage

BACKGROUND: The association among specific single-nucleotide polymorphisms (SNPs) in TLR2 R753Q (rs5743708) and T16934A (rs4696480) and the nasal carriage of Staphylococcus aureus was studied in adults before CABG. METHODS: The TLR2 polymorphisms were genotyped in 299 consecutive patients prepared for a CABG operation. Genotyping was performed using restriction fragment length polymorphism (RFLP) analysis of PCR-amplified fragments. Two nasal swab cultures were taken within 2 weeks before the operation. Subjects were classified as Staphylococcus aureus carriers if at least one culture was positive while those patients with both cultures found to be negative were classified as non-carriers. RESULTS: The prevalence of nasal S. aureus carriage in the final cohort was 22.1% (66/299), while no MRSA was detected in our study group. No significant differences in the TLR2 polymorphisms were observed between the study and the control groups. No associations were found between TLR2 haplotypes and the covariates of age, sex, NYHA, weight, height, BMI, CAD, smoking status and ESlog score. No differences were found between carriers and noncarriers regarding the allelic distribution of the TLR2 T-16934A SNP. Almost 93% of the patients who were screened for the presence of the TLR2 Arg753Gln (rs5743708) were GG wild type homozygous. Twenty one subjects from the study group (7.1%) were GA heterozygous, while no patient in either group was homozygous for the TLR2 Arg753Gln (rs5743708) mutation. TLR2 Arg753Gln genotyping showed that GA heterozygous patients were detected more frequently in the group of Staphylococcus aureus nasal carriers than in non-carrier adults. CONCLUSION: Our results suggest that the carrier status for the GA variant of the TLR2 Arg753Gln (rs5743708) polymorphism may be a risk factor for Staphylococcus aureus carriage.  BACKGROUND: The association among specific single-nucleotide polymorphisms (SNPs) in TLR2 R753Q (rs5743708) and T16934A (rs4696480) and the nasal carriage of Staphylococcus aureus was studied in adults before CABG. METHODS: The TLR2 polymorphisms were genotyped in 299 consecutive patients prepared for a CABG operation. Genotyping was performed using restriction fragment length polymorphism (RFLP) analysis of PCR-amplified fragments. Two nasal swab cultures were taken within 2 weeks before the operation. Subjects were classified as Staphylococcus aureus carriers if at least one culture was positive while those patients with both cultures found to be negative were classified as non-carriers. RESULTS: The prevalence of nasal S. aureus carriage in the final cohort was 22.1% (66/299), while no MRSA was detected in our study group. No significant differences in the TLR2 polymorphisms were observed between the study and the control groups. No associations were found between TLR2 haplotypes and the covariates of age, sex, NYHA, weight, height, BMI, CAD, smoking status and ESlog score. No differences were found between carriers and noncarriers regarding the allelic distribution of the TLR2 T-16934A SNP. Almost 93% of the patients who were screened for the presence of the TLR2 Arg753Gln (rs5743708) were GG wild type homozygous. Twenty one subjects from the study group (7.1%) were GA heterozygous, while no patient in either group was homozygous for the TLR2 Arg753Gln (rs5743708) mutation. TLR2 Arg753Gln genotyping showed that GA heterozygous patients were detected more frequently in the group of Staphylococcus aureus nasal carriers than in non-carrier adults. CONCLUSION: Our results suggest that the carrier status for the GA variant of the TLR2 Arg753Gln (rs5743708) polymorphism may be a risk factor for Staphylococcus aureus carriage