Lokalizacja taśmy u pacjentek z niepowodzeniem leczenia wysiłkowego nietrzymania moczu za pomocą slingu podcewkowego

Objectives: The high-pressure zone of the urethra (HPZ), which is crucial for the continence mechanism, extends between the point of the maximum urethral closure pressure and the urethral knee, and has been calculated to lie between 53% and 72% of the functional urethral length. According to recent studies the best results of suburethral slings are achieved when tapes are positioned under this zone. The aim of the study was to determine the location of tapes relative to the urethral length in patients seeking help due to recurrent stress urinary incontinence (SUI) following sling procedures. Material and methods: The study group comprised 61 patients suffering from recurrent SUI following suburethral slings performed from 6 months to 5 years earlier. Forty-nine (80.3%) women were initially treated with a transobturator sling and 12 (19.7%) with a retropubic procedure. Twenty patients had the original sling performed at our department whereas, the other 41 in other institutions. The position of the tapes was determined at the sagittal plane by 3-D transvaginal ultrasound using a linear transducer. The length of the urethra was measured from the bladder neck to the external urethral meatus following the urethral lumen, taking into account its curve. The position of the tapes relative to the percentage of the urethral length was calculated assuming the bladder neck as the proximal end of the urethra. The reference point was set at the midpoint on the tape. Results: Only 13 (21.3%) patients had tapes positioned at 50%-75% of the urethral length. In 45 (73.8%) of women examined the tapes were found under proximal half of the urethra and in 3 (4.9%) distally to the 75% of the urethral length. Conclusions: In most patients in whom slings procedures proved unsuccessful the tapes are located under theproximal half of the urethra, that is outside the HPZ. The position of a tape outside the HPZ may be considered as a cause of suburethral sling failure.Cel pracy: Badania ultrasonograficzne, oceniające położenie taśmy pod cewką moczową u pacjentek leczonych z powodu wysiłkowego nietrzymania moczu (WNM) za pomocą slingu podcewkowego wykazały, że najlepsze rezultaty obserwowane są w przypadku umiejscowienia taśmy pod odcinkiem cewki moczowej odpowiadającym strefie wysokiego ciśnienia (SWC). SWC rozciąga się pomiędzy punktem maksymalnego ciśnienia zamykającego cewkę moczową, a jej kolankiem i obejmuje odcinek pomiędzy 53% a 72% funkcjonalnej długości cewki moczowej. Celem pracy była ultrasonograficzna ocena położenia taśm podcewkowych u pacjentek z niepowodzeniami leczenia WNM. Materiały i metody: Badaniem objęto 61 pacjentek po nieskutecznym leczeniu WNM za pomocą slingow podcewkowych. Zabiegi były wykonane od 6 miesięcy do 5 lat przed momentem badania ultrasonograficznego. Z dostępu przez otwory zasłonione wykonano 49 zabiegow (80,3%), a 12 (19,7%) z dostępu załonowego. U 20 pacjentek wykonano zabiegi w II Klinice Ginekologii Uniwersytetu Medycznego w Lublinie, a 41 w innych ośrodkach. nPołożenie taśm oceniano za pomocą przezpochwowej ultrasonografii wykorzystując sondę liniową o częstotliwości 9-12 MHz. Po uzyskaniu trojwymiarowego obrazu mierzono długość cewki moczowej, w odniesieniu do której określano pozycję taśmy, przyjmując szyję pęcherza moczowego jako początek cewki. Wyniki: Jedynie u 13 (21,3%) pacjentek taśmy były umiejscowione pomiędzy 50 a 75% długości cewki moczowej. U 45 (73,8%) pacjentek, taśmę uwidoczniono pod proksymalną częścią cewki (poniżej 50% jej długości), a u 3 (4,9%) dystalnie do 75% długości cewki moczowej. Wnioski: U większości pacjentek z niepowodzeniem leczenia WNM za pomocą slingow podcewkowych taśmy zlokalizowane są pod proksymalnym odcinkiem cewki moczowej, a więc poza SWC cewki. Dlatego rozważając przyczyny niepowodzenia zabiegow slingowych u pacjentek z nawrotem nietrzymania moczu należy brać pod uwagę nieprawidłowe położenie taśmy

Przedposiłkowe i poposiłkowe zmiany stężeń obu form greliny u osób otyłych i nieotyłych

Introduction: The potentially differential roles of both forms of ghrelin in obesity are undefined, and little is known about desacyl ghrelin’s (DAG) regulation by meals. We aimed to assess changes in acyl ghrelin (AG) and DAG in response to mixed-meal consumption in obese and non-obese subjects.Material and methods: Venous blood for plasma glucose, AG and DAG assays were collected in both groups after an overnight fast and two hours after the consumption of a standard 300 kcal-mixed meal (Nutridrink, Nutricia).Results: Mean fasting values of both AG and DAG were significantly lower in the obese individuals. On the other hand, among non-obese controls, the mean postprandial DAG levels did not change and AG levels decreased, whereas in obese individuals the mean DAG levels after a mixed-meal diminished and AG levels were unchanged.Conclusions: It is necessary to distinguish between the desacylated and acylated forms of ghrelin, as we have shown differential postprandial AG and DAG responses in obese and non-obese individuals. Whether targeting changed proportions between AG and DAG could be a successful strategy in obesity treatment remains a question for future studies. (Endokrynol Pol 2014; 65 (5): 377–381)Wstęp: Niewiele wiadomo jak w otyłości zmienia się wydzielanie obu krążących form greliny — acylowanej (AG) i dezacylowanej (DAG) oraz jak posiłek wpływa u otyłych na stężenie DAG. Dlatego autorzy postanowili ocenić zmiany stężeń obu form hormonu przed i po posiłku w dwóch grupach: z BMI ≥ 30 i < 30 kg/m2.Materiał i metody: W obu grupach pobrano krew żylną na czczo i 2 godziny po podaniu standardowego posiłku zawierającego 300 kcal (Nutridrink, Nutricia). Oznaczono stężenia obu form greliny.Wyniki: Stężenia DAG i AG na czczo były niższe w grupie otyłych niż w kontrolnej grupie osób nieotyłych. Po posiłku u osób bez otyłości nie zaobserwowano zmian stężenia DAG, a stężenie AG zmalało, podczas gdy u otyłych stężenie DAG uległo istotnemu obniżeniu, a AG pozostało bez zmian.Wnioski: Konieczne jest oznaczanie obu form greliny, gdyż — jak wykazano — zmiany ich stężeń po posiłku mogą być zupełnie odmienne u osób otyłych niż w grupie nieotyłych. Odwrócenie zaburzonych proporcji między AG i DAG może okazać się skutecznym sposobem leczenia otyłości. (Endokrynol Pol 2014; 65 (5): 377–381

The Role of −786T/C Polymorphism in the Endothelial Nitric Oxide Synthase Gene in Males with Clinical and Biochemical Features of the Metabolic Syndrome

Background. Extensive evidence, arising from models of endothelial nitric oxide synthase gene (NOS3)-knockout mice supports the role of endothelial malfunction in the pathogenesis of the metabolic syndrome (MS). Aims. The aim of this study was to evaluate the role of −786T/C polymorphism in the etiology of MS and assess previously reported interaction with cigarette smoking. Methods. Based on International Diabetes Federation 2005 criteria, we recruited randomly 152 subjects with MS and 75 subjects without MS. Results. Allelic and genotype frequencies did not differ significantly between both groups. Total cholesterol level (CHOLT) and intima-media thickness of carotid arteries were significantly higher in −786CC homozygotes, in comparison with −786TC and −786TT patients. Regarding current smoking status, −786C allele was associated with higher CHOLT than −786T allele. Conclusion. Our study indicates the putative role of −786T/C polymorphism in the development of hypercholesterolemia, in patients with MS, which might be enhanced by cigarette smoking

The Role of −786T/C Polymorphism in the Endothelial Nitric Oxide Synthase Gene in Males with Clinical and Biochemical Features of the Metabolic Syndrome

Background. Extensive evidence, arising from models of endothelial nitric oxide synthase gene (NOS3)-knockout mice supports the role of endothelial malfunction in the pathogenesis of the metabolic syndrome (MS). Aims. The aim of this study was to evaluate the role of −786T/C polymorphism in the etiology of MS and assess previously reported interaction with cigarette smoking. Methods. Based on International Diabetes Federation 2005 criteria, we recruited randomly 152 subjects with MS and 75 subjects without MS. Results. Allelic and genotype frequencies did not differ significantly between both groups. Total cholesterol level (CHOLT) and intima-media thickness of carotid arteries were significantly higher in −786CC homozygotes, in comparison with −786TC and −786TT patients. Regarding current smoking status, −786C allele was associated with higher CHOLT than −786T allele. Conclusion. Our study indicates the putative role of −786T/C polymorphism in the development of hypercholesterolemia, in patients with MS, which might be enhanced by cigarette smoking

Network-on-Multi-Chip (NoMC) with Monitoring and Debugging Support, Journal of Telecommunications and Information Technology, 2011, nr 3

This paper summarizes recent research on network-on-multi-chip (NoMC) at Poznań University of Technology. The proposed network architecture supports hierarchical addressing and multicast transition mode. Such an approach provides new debugging functionality hardly attainable in classical hardware testing methodology. A multicast transmission also enables real-time packet monitoring. The introduced features of NoC network allow to elaborate a model of hardware video codec that utilizes distributed processing on many FPGAs. Final performance of the designed network was assessed using a model of AVC coder and multi-FPGA platforms. In such a system, the introduced multicast transmission mode yields overall gain of bandwidth up to 30%. Moreover, synthesis results show that the basic network components designed in Verilog language are suitable and easily synthesizable for FPGA devices

Obesity, knowledge of diet and healthy behaviors in children and adolescents from small towns and villages - results of Polish Project of 400 Cities

WSTĘP. Obok predyspozycji genetycznych w rozwoju otyłości ogromną rolę odgrywają czynniki środowiskowe, w tym zachowania zdrowotne oraz wiedza dzieci i młodzieży na temat zdrowego stylu życia. Celem podjętych badań była ocena częstości występowania nadwagi i otyłości wśród dzieci i młodzieży małych miast i wsi oraz znalezienie związku pomiędzy wiedzą i zachowaniami zdrowotnymi dzieci a ryzykiem wystąpienia nadmiaru masy ciała. MATERIAŁ I METODY. Badaniami objęto 1515 osób w wieku 6-18 lat pochodzących z małych miast i wsi. Nadwagę rozpoznawano przy wskaźniku masy ciała dla wieku i płci przekraczającym 90 centyl, otyłość - powyżej 95 centyla. Ocena badanej grupy była realizowana za pomocą sondażu, w jego ramach u wszystkich respondentów zostały przeprowadzone badania kwestionariuszowe, pomiary ciśnienia tętniczego oraz badania antropometryczne (obwodu talii, obwodu ramienia prawego, wzrostu i masy ciała). WYNIKI. Nadwagę rozpoznano u 9,0%, a otyłość u 5,1% respondentów. W grupie wiekowej 14-18 lat u dziewcząt statystycznie istotnie częściej występował nadmiar masy ciała niż u chłopców. Jednocześnie dziewczęta te istotnie częściej niż chłopcy wskazywały na: ciemne pieczywo, wędliny, mięso i drób jako produkty, które należy konsumować, by zachować zdrowie. Starsze dzieci istotnie częściej wskazywały na: stres, palenie tytoniu, spożywanie tłustego mięsa, słodyczy, "bycie grubasem", brak aktywności fizycznej jako czynniki, które są niekorzystne dla zdrowia. Chłopcy więcej czasu spędzali przed monitorem komputera i telewizora niż dziewczęta - wraz z wiekiem zjawisko to było bardziej nasilone. WNIOSKI. Posiadanie wiedzy na temat zdrowego stylu życia nie jest wystarczające do utrzymania prawidłowej masy ciała. Wiedza dziewcząt w tym zakresie, szczególnie w starszych grupach wiekowych, jest większa niż wiedza chłopców, a występowanie nadwagi kształtuje się odwrotnie. W starszych grupach wiekowych zaobserwowano mniejszą aktywność fizyczną spowodowaną dłuższym czasem przebywania przed telewizorem i monitorem komputera. Pomimo świadomości żywieniowej posiadanej przez dzieci nadal istnieje potrzeba ciągłej edukacji w zakresie zdrowego stylu życia. Endokrynologia, Otyłość i Zaburzenia Przemiany Materii 2010, tom 6, nr 2, 59-66INTRODUCTION. Apart from genetic predispositions, environmental factors play huge role, including health behaviors and knowledge of healthy lifestyle in children and adolescents. The aim of the study was to estimate the frequency of overweight and obesity among children and adolescents from small towns and villages and tracing association between the knowledge and health behaviors in children and overweight risk MATERIAL AND METHODS. The research was conducted in a group of 1515 healthy children aged 6-18 from small towns and villages. The questionnaires, blood pressure and anthropometric measurements were done in all studied children. RESULTS. Overweight was diagnosed when body mass index for on age sex identified surpassed 90th centile, and obesity - when it was above 95th centile. Overweight was diagnosed in 9.0%, and obesity in 5.1% of respondents. Excess body mass was statistically more frequently observed in girls then in boys aged 14-18. These girls substantially more frequently pointed at whole meal bread, smoked sausages, meat and poultry as products, which are necessary to keep fit. Older children more often pointed at stress, smoking cigarettes, consuming fatty meat, sweets and "being plump". Lack of physical activity is factor, which damage health. Boys spent more time in front of the computer or TV than girls - as the children grow the phenomenon intensified. CONCLUSIONS. The knowledge of eating habits is not enough to maintain proper body weight. The girls have more knowledge of eating habits than boys, but overweight is more frequently observed in girls. In older group of children lower physical activity was observed as consequence of longer watching TV and using computer. Although children have eating habits knowledge there is a constant need for healthy life style education for children and adolescents. Endocrinology, Obesity and Metabolic Disorders 2010, vol. 6, No 2, 59-6

Pre-operative high-dose-rate brachytherapy in early-stage cervical cancer: long-term single-center results

Purpose: The aim of the study was to report the outcomes of pre-operative high-dose-rate brachytherapy (pHDRBT), followed by hysterectomy in patients with early cervical cancer. Material and methods: From January, 1998 to December, 2003, 113 women with IB1, IB2, and IIA1 cervical cancer (according to International Federation of Gynecology and Obstetrics [FIGO] 2018) were treated with pHDR-BT, and 6 to 8 weeks later followed by radical hysterectomy. Patients found to have positive lymph nodes, residual cervical cancer, involved parametria, or lymphovascular space invasion (LVSI) received post-operative adjuvant therapy. Results: Post-operatively, 81.4% of patients had a complete response to pHDR-BT in the cervix, and 18.6% had residual cervical cancer. Failures occurred in 11/113 (9.7%) patients (all were stage IIA1), with pelvic recurrences in 5/113 (4.4%) and distant metastasis (DM) in 6/113 (5.3%). The 5- and 10-year disease-free survival (DFS) rates were 100% for IB1 and IB2, and 86.4% and 81.3% for IIA1, respectively. Lymph node involvement and/or residual cervical cancer correlated with worse DFS. Two vesicovaginal fistulas were observed (one in a patient treated only with pHDRBT and one in a woman, who underwent adjuvant external-beam radiotherapy [EBRT]). Two rectovaginal fistulas and one case of proctitis were observed in patients treated with adjuvant EBRT. Conclusions: pHDR-BT in early cervical cancer is well-tolerated and effective in sterilizing tumor cells in the cervix. The growing number of publications in this area may help define an optimal therapeutic scheme, but randomized trials are required to determine the best candidates for this treatment modality. In our opinion, cervical cancer patients with FIGO stage IIA1 are not good candidates for pHDR-BT, and could be given this treatment only after rigorous selection, including assessment with state-of-the-art imaging, due to higher probability of treatment failure

I-MOVE multicentre case–control study 2010/11 to 2014/15 : is there within-season waning of influenza type/subtype vaccine effectiveness with increasing time since vaccination?

Influenza vaccines are currently the best method available to prevent seasonal influenza infection. In most European countries one dose (or two doses for children) of seasonal vaccine is given from September to December to the elderly and other target groups for vaccination. In Europe, influenza seasons can last until mid-May (1), and it is expected that vaccination conveys protection on the individual for the duration of the season. In 13/15 reviewed studies on the length of vaccine-induced protection among the elderly, using anti-haemagglutination antibody titres as a proxy for seroprotection levels, seroprotection rates lasted at least >4 months after vaccination (2). However in the 2011-12 influenza season various studies in Europe reported a decrease in influenza vaccine effectiveness (VE) against A(H3N2) over time within the season (3–5). In the United States, a decrease in VE against A(H3N2) with time since vaccination was suggested in the 2007-8 influenza season (6). The observed decrease of VE over time can be explained by viral change (notably antigenic drift) occurring in the season. Drift in B viruses may be slower than in A viruses (7), and A(H3N2) viruses undergo antigenic drift more frequently than A(H1N1)pdm09 viruses (8). The decrease of VE over time can also be explained by a waning of the immunity conferred by the vaccine independently from viral changes. If vaccine-induced protection wanes more rapidly during the season, then depending on the start and duration of the influenza season, the decline of VE may cause increases in overall incidence, hospitalisations and deaths. Changes to vaccination strategies (timing and boosters) may be needed. As anti-haemagglutination antibody titres are not well defined as a correlate of protection (9,10), vaccine efficacy (as measured in trials) or vaccine effectiveness observational studies may be one way to measure vaccine-induced protection. These studies require a large sample size to model VE by time since vaccination and currently, most of the seasonal observational studies lack the precision required to provide evidence for waning immunity. In this study we pooled data across five post-pandemic seasons (2010/11-2014/15) from the I-MOVE (Influenza - Monitoring Vaccine Effectiveness) multicentre case control studies (1,3,11,12), to obtain a greater sample size to study the effects of time since vaccination on influenza type/subtype-specific VE. We measure influenza type/subtype-specific VE by time since vaccination for the overall season, but also in the early influenza phase; under the hypothesis that virological changes are fewer in the early season, but waning of the vaccine effect should be present regardless of time within the influenza phase

I-MOVE Multi-Centre Case Control Study 2010-11: Overall and Stratified Estimates of Influenza Vaccine Effectiveness in Europe

BACKGROUND: In the third season of I-MOVE (Influenza Monitoring Vaccine Effectiveness in Europe), we undertook a multicentre case-control study based on sentinel practitioner surveillance networks in eight European Union (EU) member states to estimate 2010/11 influenza vaccine effectiveness (VE) against medically-attended influenza-like illness (ILI) laboratory-confirmed as influenza. METHODS: Using systematic sampling, practitioners swabbed ILI/ARI patients within seven days of symptom onset. We compared influenza-positive to influenza laboratory-negative patients among those meeting the EU ILI case definition. A valid vaccination corresponded to > 14 days between receiving a dose of vaccine and symptom onset. We used multiple imputation with chained equations to estimate missing values. Using logistic regression with study as fixed effect we calculated influenza VE adjusting for potential confounders. We estimated influenza VE overall, by influenza type, age group and among the target group for vaccination. RESULTS: We included 2019 cases and 2391 controls in the analysis. Adjusted VE was 52% (95% CI 30-67) overall (N = 4410), 55% (95% CI 29-72) against A(H1N1) and 50% (95% CI 14-71) against influenza B. Adjusted VE against all influenza subtypes was 66% (95% CI 15-86), 41% (95% CI -3-66) and 60% (95% CI 17-81) among those aged 0-14, 15-59 and ≥60 respectively. Among target groups for vaccination (N = 1004), VE was 56% (95% CI 34-71) overall, 59% (95% CI 32-75) against A(H1N1) and 63% (95% CI 31-81) against influenza B. CONCLUSIONS: Results suggest moderate protection from 2010-11 trivalent influenza vaccines against medically-attended ILI laboratory-confirmed as influenza across Europe. Adjusted and stratified influenza VE estimates are possible with the large sample size of this multi-centre case-control. I-MOVE shows how a network can provide precise summary VE measures across Europe

Immunisation of migrants in EU/EEA countries: Policies and practices

In recent years various EU/EEA countries have experienced an influx of migrants from low and middle-income countries. In 2018, the “Vaccine European New Integrated Collaboration Effort (VENICE)” survey group conducted a survey among 30 EU/EEA countries to investigate immunisation policies and practices targeting irregular migrants, refugees and asylum seekers (later called “migrants” in this report). Twenty-nine countries participated in the survey. Twenty-eight countries reported having national policies targeting children/adolescent and adult migrants, however vaccinations offered to adult migrants are limited to specific conditions in seven countries. All the vaccinations included in the National Immunisation Programme (NIP) are offered to children/adolescents in 27/28 countries and to adults in 13/28 countries. In the 15 countries offering only certain vaccinations to adults, priority is given to diphtheria-tetanus, measles-mumps-rubella and polio vaccinations. Information about the vaccines given to child/adolescent migrants is recorded in 22 countries and to adult migrants in 19 countries with a large variation in recording methods found across countries. Individual and aggregated data are reportedly not shared with other centres/institutions in 13 and 15 countries, respectively. Twenty countries reported not collecting data on vaccination uptake among migrants; only three countries have these data at the national level. Procedures to guarantee migrants’ access to vaccinations at the community level are available in 13 countries. In conclusion, although diversified, strategies for migrant vaccination are in place in all countries except for one, and the strategies are generally in line with international recommendations. Efforts are needed to strengthen partnerships and implement initiatives across countries of origin, transit and destination to develop and better share documentation in order to guarantee a completion of vaccination series and to avoid unnecessary re-vaccination. Development of migrant-friendly strategies to facilitate migrants' access to vaccination and collection of vaccination uptake data among migrants is needed to meet existing gaps