Circulating sclerostin levels in relation to nutritional status, sex hormones and selected bone turnover biochemical markers levels in peri- and postmenopausal women

Objectives: Hormonal changes during the peri- and postmenopausal age, especially decreasing estradiol levels as the result of the expired ovarian function, are an established link of the pathogenesis of postmenopausal osteoporosis. The objective of the study was to examine the association between the circulating sclerostin levels and nutritional status, sex hormones and selected bone markers turnover levels in peri- and postmenopausal women. Material and methods: The study enrolled 84 stable-body mass women (31 perimenopausal and 54 postmenopausal). Anthropometric measurements and serum estrone, testosterone, androstenedione, DHEA-S, osteocalcin, β-CTx, 25-OHVitamin D and sclerostin levels were obtained. Results: There were not any differences between body mass, BMI, body fat and waist circumference between the study groups. The serum androstenedione and DHEA-S levels were similar in both study groups. However, estrone and total testosterone levels were observed to be notably higher in the perimenopausal group, unlike in the postmenopausal group (124.1 pg/mL vs. 98.3 pg/mL, p < 0.01 and 0.3 pg/mL vs. 0.22 pg/mL, p < 0.01, respectively). Higher plasma osteocalcin and β-CTx levels were shown in the postmenopausal rather than in the perimenopausal group (19.8 ng/mL vs. 16.8 ng/mL, p < 0.001 and 0.35 ng/mL vs. 0.29 ng/mL, p < 0.05, respectively). Plasma sclerostin and 25-OH-Vitamin D levels were similar. There was not any correlation between plasma sclerostin levels and the other studied parameters. In the multivariate regression analyses, sclerostin levels were proportional to the androstenedione ones (b = 0.06; p < 0.05) but inversely related to the log10(testosterone) levels (b = -0.18; p < 0.05). Conclusions: Circulating sclerostin levels are similar in peri- and postmenopausal women and are related to the androstenedione and testosterone levels regardless of the nutritional status

Sexuality of disabled athletes depending on the form of locomotion

The main purpose of this study was to determine sexuality of disabled athletes depending on the form of locomotion. The study included 170 disabled athletes, aged between 18 and 45. The entire population was divided into 3 research groups depending on the form of locomotion: moving on wheelchairs (n=52), on crutches (n=29) and unaided (n=89). The research tool was a questionnaire voluntarily and anonymously completed by the respondents of the research groups. The questionnaire was composed of a general part concerning the socio-demographic conditions, medical history, health problems, a part dedicated to physical disability as well as the Polish version of the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI) evaluating sexual life. STATISTICA 10.0 for Windows was used in the statistical analysis. Subjects moving on crutches were significantly older than ones moving on wheelchairs and unaided (34.41 ±11.00 vs. 30.49 ±10.44 and 27.99 ±10.51 years, respectively) (p=0.018). Clinically significant erectile dysfunctions were most often diagnosed in athletes moving on wheelchairs (70.27%), followed by athletes moving on crutches and moving unaided (60% and 35.42%, respectively; p=0.048). Clinical sexual dysfunctions were diagnosed on a similar level among all female athletes. It was concluded that the form of locomotion may determine sexuality of disabled men. Males on wheelchair revealed the worst sexual functioning. Female athletes moving on wheelchairs, on crutches and moving unaided were comparable in the aspect of their sexual life

Sexual Health of Polish Athletes with Disabilities

The purpose of this study was to determine sexual functioning of Polish athletes with disabilities (including paralympians). The study encompassed 218 people with physical disabilities, aged between 18 and 45 (149 men and 69 women). The entire research population was divided into three groups: Polish paralympians (n = 45), athletes with disabilities (n = 126) and non-athletes with disabilities (n = 47). The quality of sexual life of Polish paralympians was measured by using the Polish version of Female Sexual Function Index and International Index of Erectile Function. Clinically significant erectile dysfunctions were most often diagnosed in non-athletes (83.33%) with 50% result of severe erectile dysfunctions, followed by athletes and paralympians with comparable results of 56.98% and 54.17% respectively (p = 0.00388). Statistically significant clinical sexual dysfunctions concerned lubrication, orgasm as well as pain domains, and prevailed among female non-athletes (68.42%, 68.42% and 57.89%). Practising sports at the highest level has a favourable effect on the sexuality of men and women with physical disabilities. Men with physical disabilities manifest more sexual disorders than women, an aspect which should be considered by health-care professionals working with people with disabilities

Paternal engagement during childbirth depending on the manner of their preparation

Objectives: The analysis of the forms of paternal activity depending on the manner of their preparation, including stages of labor. Material and methods: A prospective survey-based study involved 250 fathers who participated in their child’s birth. The fathers included in the study were present during all stages of family-assisted natural labor. The study was conducted one day after childbirth with the use of a survey prepared by the authors. Statistical calculations were conducted using the Statistica PL software. The frequency of individual qualitative features (non-measurable) was assessed by means of a non-parametric χ² (chi-squared) test. The statistical significance level was p < 0.05. Results: A half of the fathers included in the study (52.4%) participated in childbirth with no prior preparation. The dominant form of preparation involved self-education from books, magazines and the Internet (24%). 23.6% of fathers participated in ante-natal classes. The study demonstrated that fathers prepared for childbirth in ante-natal classes more often engaged in the supportive role, provided nursing care and carried out instrumental monitoring during each stage of childbirth. Conclusions: The fathers prepared for childbirth in ante-natal classes more often engage in the supportive role, provide nursing care and carry out instrumental control during each stage of childbirth. Ante-natal classes should be promoted as an optimal form of preparation for active participation in childbirth. Moreover, other forms of paternal ante-natal education as well as continued education in a delivery room should be developed

Circulating omentin-1 levels and inflammation in polycystic ovary syndrome

Objectives: The aim of the study was to analyze interrelation between plasma omentin-1 levels and nutritional status andinflammation in PCOS.Material and methods: A cross-sectional study involving 86 PCOS (47 obese) and 72 Non-PCOS women (41 obese) determinedanthropometric parameters and body composition. Serum glucose, insulin and omentin-1, TNF-α, sTNFRs, IL-6 andsR-IL6 were measured in the fasting state.Results: Plasma omentin-1 levels were significantly lower in the PCOS than in the Non-PCOS group and both correspondingnormal weight and obese subgroups. In three analyzed least-angle regression (LARS) models the lower plasma omentin-1 levels was associated with PCOS occurrence, higher circulating TNF-α and lower IL-6 levels.Conclusions: Suppressed omentin-1 levels in PCOS are characteristic for this disturbance and proinflammatory cytokinesare factors modifying secretion of this adipokine

Circulating vaspin levels and nutritional status and insulin resistance in polycystic ovary syndrome

Objectives: The study aimed to assess the associations between circulating vaspin levels and nutritional status (assessedon tha basis of BMI) as well as insulin resistance in PCOS.Material and methods: Eighty-seven PCOS women, 48 obese and 39 normal weight, were enrolled in the cross-sectionalstudy. Seventy-two Non-PCOS women, 41 obese and 31 normal weight, constituted a control group. Body mass, height andwaist circumference as well as body composition by bioimpedance were measured. In the morning (16h after the last meal)we determined: serum glucose, insulin, androgens, gonadotropin (LH, FSH) and sex hormone-binding globulin (SHBG) aswell as plasma vaspin levels. Standard HOMA-IR formula was used to assess insulin resistance (IR).Results: Plasma vaspin levels were significantly lower in PCOS, both normal weight and obese, than in Non-PCOSgroups. Vaspin levels were similar in normal weight and obese PCOS subgroups. There was no association between plasmavaspin levels and anthropometric parameters in PCOS group. While in Non-PCOS group a negative correlation betweenplasma vaspin levels and body mass (r = –0.26; p < 0.05) was found. We did not observe correlations between plasma vaspinlevels and serum glucose and insulin concentrations as well as HOMA-IR values, however, in multivariable, stepwise backwardregression waist circumference and HOMA-IR values explained 18.0% of plasma vaspin levels variability in the study subjects.Conclusions: PCOS occurrence is associated with decreased vaspin levels. The influence of nutritional status on vaspin levelobserved in Non-PCOS is abolished in PCOS women, possibly by more severe insulin resistance

Use of hormone therapy in gynaecological oncology and therapy of breast cancer

This article presents a review of new literature regarding hormonal therapy of female reproductive system tumours. Hormonal treatment in gynaecological oncology has to retard the course of neoplastic disease and decrease the intensity of its symptoms in patients with hormonally dependent breast cancer, endometrial cancer or ovarian cancer. Drugs belonging to different pharmacological groups are used in hormonal therapy in oncological gynaecology. Hormone therapy is established as an important method of therapy or support for oncological treatment. The physician dealing with therapy of neoplastic diseases has to remember about the advantages and risks of such treatment, and every case should be considered individually

Stan odżywienia i zwyczaje żywieniowe a stężenie estradiolu w surowicy i jego zmiany w czasie okresu przygotowawczego do sezonu rozgrywek ligowych u piłkarek ręcznych i koszykarek

Background: Intense exercise is known to induce menstrual disturbances - irregular menstrual cycles, oligomenorrhea and amenorrhea in female athletes. Menstrual disturbances, followed by hypoestrogenism, are associated with infertility, decreased bone mineral density, high prevalence of stress fractures, and endothelial dysfunction. Objectives: The aim of the study was to assess the effect of nutrition and diet habits on the estradiol level and its changes in the pre-season preparatory period for the league contest match in female handball and basketball players. Materials and methods: Fifty healthy young female handball and basketball players were enrolled into the study before the opening of the season, after a 2-month holiday period, without regular physical activity and diet restrictions. Serum estradiol was determined at the beginning and after 3 months of moderate aerobic training. Each woman was studied between the 3rd and 5th day of her menstrual cycle. In all subjects, medical history was obtained, together with the anthropometric measurements (body mass and height). The body mass index was calculated according to the standard formula. The use of hormonal contraception in the last 3 months, low-caloric diet in the last 6 months, body mass changes of more than 3 kilograms in the last 6 months, secondary amenorrhea and stress fractures in medical history constituted the exclusion criteria. Informed consent was obtained from each participant and the study protocol was approved by the Ethics Committee of the Medical University of Silesia. Materials and methods: Venous blood samples (2ml) for estradiol levels measurements were taken twice: at the beginning of the preparatory period and after three months of moderate aerobic exercise training (20 hours per week). Blood samples were collected according to the kit manufacturer’s recommendations. Serum and plasma samples were stored frozen at -80°C. Serum estradiol was determined by enzyme-linked immunosorbent assay (ELISA) (DRG Instruments GmbH, Marburg, Germany) with a lower limit of sensitivity of 9.714pg/mL; the intra- and inter-assay coefficients of variation were 4.7% and 7.8%. All statistical analyses were performed with the use of Statistica 8.0 software. The results are presented as means±SD. The Wilcoxon rank test was used to compare the before and after exercise measurements. The Mann–Whitney U test was used for subgroups comparisons. The results were considered statistically significant when the p value was less than 0.05. Results: After a 2-month holiday period, without regular physical exercise, p < 0,01) serum estradiol level was significantly lower in the basketball than handball players (48,7±19,6 vs. 62,3±18,9 pg/ml, p < 0,01). Although, no body mass changes were noticed (Δ = - 0,3 ± 0,3 kg), after 3 months of moderate aerobic training estradiol level was significantly decreased in the whole study population (58,0 ± 20,0 vs. 41,4 ± 18,9 pg/ml, p < 0,001). Conclusions: Diet habits and nutrition did not correlate with estradiol plasma levels in female handball and basketball players after a 2-month holiday period. Regular exercises correlate with the decrease of serum estradiol level even without body mass changes.Cel: Celem pracy jest ocena wpływu stanu odżywienia i zwyczajów żywieniowych na stężenie estradiolu w surowicy i jego zmiany w czasie okresu przygotowawczego do rozgrywek ligowych piłkarek ręcznych i koszykarek. Materiał i metody: Badaniem objęto 50 zdrowych, młodych kobiet - piłkarek ręcznych i koszykarek przed rozpoczęciem nowego sezonu przygotowawczego do rozgrywek ligowych, po okresie 2-miesięcznego odpoczynku, bez regularnej aktywności fizycznej i restrykcji dietetycznych. Badane przez 3 miesiące uczestniczyły w treningach okresu przygotowawczego do rozgrywek ligowych. W badaniu oceniano stężenie estradiolu w surowicy krwi początkowo i po upływie 3 miesięcy treningów. Wyniki: Stężenie estradiolu w surowicy po 2 miesiącach wakacji bez treningów było istotnie niższe u koszykarek niż piłkarek ręcznych (48,7±19,6 vs. 62,3±18,9pg/ml,

Knowledge and opinions of patients and medical staff about patients’ rights

Objectives: The awareness of patients’ rights among medical personnel and patients themselves, together with their opinions concerning these rights, is a challenging issue for health professionals. Patients’ rights are very specific legal regulations that have been drafted to protect patients’ dignity and autonomy. The main objective of this research was to assess the knowledge of patients’ rights among medical personnel of health care institutions and among patients themselves. Specific objectives were also adopted, such as: assessment of the impact of the mode of hospital admissions on the knowledge of patients’ rights, analysis of factors influencing the knowledge of patients’ rights and the analysis of sources of knowledge concerning patients’ rights. Material and methods: The study was conducted among two groups: patients and medical personnel. A group of 618 patients (including 411 women and 207 men) and 901 medical professionals (doctors, nurses, midwives) was examined via a questionnaire designed to verify their knowledge of patients’ rights and to collect their opinions on the applicable laws. An integral part of the questionnaire for patients was The Hospital Anxiety and Depression Scale (HADS). Results: The research showed a high knowledge of patient’s rights demonstrated by the surveyed doctors, nurses and midwives. Good knowledge of patients’ rights among healthcare professionals was reflected in good level of informing patients about their rights, which correlates with their high level of awareness. Conclusions: The following conclusions were drawn based on the research: education, seniority and profession determine the knowledge and respecting patients’ rights, the mode of admission to hospital is a factor determining the knowledge of applicable patients’ rights, medical staff’s lack of knowledge about existing patients’ rights has a significant impact on exercising these rights or their violation