Effectiveness of gabapentin pharmacotherapy in chemotherapy-induced peripheral neuropathy

Objectives: Chemotherapy-induced peripheral neuropathy (CIPN) is a common chemotherapy side effect, but its prevention and treatment remains a challenge. Neurotoxicity may lead to dose limitation or even treatment discontinuation, and therefore potentially affect the efficacy of anticancer treatment and long term outcomes. The practice to administer gabapentin for neuropathy may be applicable, but is limited by insufficient studies. The aim of our study was to assess the presence of chemotherapy-induced peripheral neuropathy in ovarian cancer patients treated with first-line paclitaxel and carboplatin chemotherapy and evaluate the effectiveness of gabapentin in treatment of this condition. Material and methods: 61 ovarian cancer patients treated with first line chemotherapy were included in the study. The first phase of the study was to assess neurological condition of each patient by: neuropathy symptoms scale, McGill’s scale, neurological deficit and quality of life, during the chemotherapy. In the second phase of the study we evaluated the response to gabapentin treatment in a group of patients who developed neuropathy. Results: 78.7% of the patients developed chemotherapy related neuropathy. During the course of chemotherapy these patients experienced significant exacerbation of neuropathy symptoms (p < 0.0001), neuropathic pain (p < 0.0001), neurologic deficit (p < 0.0012) and worsening of quality of life (p < 0.0002). Patients who were qualified to undergo the gabapentin treatment observed improvement in symptoms (p < 0.027), pain (p < 0.027) and neurologic deficit (p < 0.019). Quality of life did not change significantly after gabapentin treatment (p < 0.128). Conclusions: Chemotherapy substantially deteriorates the neurologic condition of the patients and the quality of life. Paclitaxel and carboplatin treated patients may benefit from gabapentin therapy in chemotherapy-induced peripheral neuropathy

Demographic factors determining folic acid supplementation in pregnant and childbearing age women

Objectives: Adequate folate intake constitutes a significant problem in the periconceptional period and early pregnancy but can be achieved by folic acid (FA) supplementation. Low intake of folate may cause numerous negative effects on the pregnancy outcome, including recurrent miscarriage, preeclampsia, fetal hypotrophy, premature delivery, premature placental abruption, and intrauterine fetal death. The aim of the study was to evaluate factors determining FA supplementation in the population of Polish women before and during pregnancy. Material and methods: The study group consisted of 257 women hospitalized postpartum at the Division of Perinatology and Women’s Diseases, Poznan University of Medical Sciences, Poland. We evaluated folic acid intake considering selected demographic data. A structured questionnaire was used to evaluate folic acid intake before and during pregnancy of the investigated women. Results: The vast majority of the investigated women (89.1%) took FA during pregnancy. During the pre-pregnancy period, a statistically significantly higher supplementation of folic acid was observed among women with the monthly income level of > 5000 PLN (p = 0.03), and among women who planned their pregnancy as compared to women who did not plan their pregnancy (p < 0.001). During pregnancy, these differences disappeared. A statistically significantly higher number of secundi- and multiparas did not take FA during pregnancy as compared to primiparas (p = 0.008). No correlation between cigarette smoking and FA intake was observed. Conclusions: Our analysis showed that FA intake increased (by 36.2%) during pregnancy as compared to the pre-pregnancy period, and depended on income, parity, and pregnancy planning

Importance of polymorphic variants of Tumour Necrosis Factor — α gene in the etiology of Intrauterine Growth Restriction

Objectives: Intrauterine growth restriction (IUGR) is one of the main global causes of increased perinatal mortality and fetal and neonatal morbidity. It remains a key challenge for modern perinatal medicine. Negative effects of IUGR are manifested not only in the perinatal period but also at the later stages of life. Proinflammatory cytokines and their polymorphisms are hypothesized to play an important role in IUGR pathomechanisms. The aim of the study was to determine the role of selected polymorphisms (-238G >A, -308G >A and -376G >A) of tumor necrosis factor alpha (TNF-α) in the etiology of intrauterine growth restriction. Material and methods: The study included 120 patients with IUGR (mean age 30.32, mean gestational age 36.34 gestational weeks) and 135 healthy pregnant women (mean age 31.63, average week of delivery 38.76). The investigated polymorphisms were determined by PCR/RFLP methods. Results: Higher frequency of TNF-α mutated allele -308A was found in a subgroup of women whose pregnancy en­ded < 37 weeks (18.5 vs. 12.2% in control , OR = 1.63, p = 0.09) and in the subgroup of women with a score ≥ 3 UAS (20.6 vs. 12.2% in control , OR = 1.86, p = 0.06). Heterozygous genotype -308GA was associated with at least 3 times greater risk of three or four abnormalities in uterine arteries score (41.2 vs. 20.0 in control, OR = 2.80, p = 0.01). Conclusions: The obtained results suggest that the -308G >A TNF-α gene variant may play a role in the etiology of IUGR in the Polish population, but further studies on larger groups are neede

Chlorek dekwaliniowy – atrakcyjna opcja terapeutyczna w leczeniu zakażeń pochwy

Zakażenia pochwy są jedną z najczęstszych przyczyn wizyt w gabinetach ginekologicznych. Zaburzenia fizjologicznejflory bakteryjnej pochwy prowadzą do rozwoju infekcji, których występowanie wiąże się z możliwością rozwojupoważnych powikłań. Istotnymi problemami w codziennej praktyce są występowanie oporności na standardoweleczenie oraz częste nawroty choroby. W pracy przedstawiono aktualny stan wiedzy oraz wytyczne dotyczące skutecznościterapeutycznej i zastosowania w praktyce klinicznej chlorku dekwalinianu