2D/3D ultrasonography for endometrial evaluation in a cohort of 118 postmenopausal women with abnormal uterine bleedings

Objectives: 2D/3D transvaginal ultrasonography in evaluation of endometrium in postmenopausal women with abnormal uterine bleedings (AUB). Material and methods: 2D/3D transvaginal ultrasonography (TVU) was performed in 118 menopausal women with AUB. Endometrial volume and thickness, uterine volume and endometrial vascularity were evaluated. Complete histologic evaluation of the endometrium was obtained through dilatation & curettage (D&C) and/or hysteroscopy. Accordingly, patients were divided into 3 groups: controls (no endometrial pathology, n = 49), GI (benign endometrial pathology, n = 37), GII (endometrial carcinoma, n = 32). Results: GII had greater thickness and volume of the endometrium, compared to GI and controls. The presence of arterial vascular flow was identified only in GI and GII (51.35% and 93.75%, respectively). Endometrial volume merged together with uterine volume measurements (TVU-3D) showed a strong, statistical significance between GI and GII, allowing differentiation of begin and malignant endometrial pathologies in postmenopausal women. Conclusions: In TVU diagnostics of postmenopausal women with AUB the following play the most significant role: 1) endometrial thickness (TVU-2D); 2) endometrial volume (TVU-3D); 3) uterine plus endometrial volume (TVU-3D); 4) vascularization within the endometrium, allowing to differentiate between pathological and normal endometrium (TVU-2/3D). Evaluation of the endometrial vascularity, both in TVU-2D and TVU-3D technique, does not allow for reliable differentiation between benign lesions and endometrial cancer

Microvesicles released from ectopic endometrial foci as a potential biomarker of endometriosis

Objectives: Angiogenesis is engaged in endometriosis. It is regulated by regulatory factors and cytokines, transported in microvesicles. The purpose was to investigate the presence of MVs with vascular endothelial growth factor (VEGF) and metalloproteinase-9 (MMP-9) in peripheral blood and peritoneal fluid of women operated on for endometrioma or teratoma Material and methods: Microvesicles (MVs) were determined in blood samples and peritoneal fluid samples collected from women aged 20–60 years operated on for endometriosis (test group) and teratoma (control group). The final investigations were performed on 47 patients, who qualified for the study based on the meticulous inclusion criteria. MVs were analyzed by flow cytometry (FACS) using annexin V, antibodies for molecules characteristic of cells from endometriosis foci (keratin 18 (K18), CD105, CD146), and antibodies for intraepithelial vascular growth factor VEGF and metalloproteinase-9 (MMP-9). The sample was double “reading” using flow cytometry (FACSCantoII).  Results: Cytometry analysis confirmed MVs’ presence in plasma and peritoneal fluid collected from patients with both endometriosis and teratomas. A statistically significant higher level of AnnexinV (+) MVs were observed in plasma samples of endometriosis patients. In the control group, there was a higher percentage of double-positive VEGF (+)/MMP-9 (+) and single MMP-9 (+) positive MVs in the serum. In the peritoneal fluid higher frequency of double-positive VEGF (+)/MMP-9 (+) MVs were found in the control group. However, the amount of VEGF (+) / MMP-9 (+) MVs object did not enable to differentiate between the test and control groups. The study was the first, in which MVs were confirmed in plasma and peritoneal fluid in benign adnexa tumors.  Conclusions: Microvesicles are present in peripheral blood and peritoneal fluid samples collected from patients with endometriosis and teratomas. Microvesicles with proangiogenic factors (VEGF and MMP-9) are more abundant in blood and peritoneal fluid samples from patients with teratomas

(Nie) Zapomniana operacja Neugebauera-Le Forta. Pośrodkowe zamknięcie pochwy – bezpieczna i skuteczna procedura zabiegowego leczenia wypadania narządu płciowego u starszych kobiet

Objectives: The aim of the study is to present data concerning Neugebauer-Le Fort operations performed at the Gynecologic Oncology Clinic, Polish Mother’s Health Center Research Institute in Lodz between 2000-2009, including the effects of the surgeries on improving quality of life. Material and methods: Our research included all patients (90 women) operated due to total pelvic organ prolapse (stage IV of POP-Q) in Gynecologic Oncology Clinic. The data was collected retrospectively from medical records. Results of the treatment were evaluated based upon surveys and control checkups. The p-value of 0.05 was considered statistically significant. Results: Mean patient age was 76.5 years. The analysis of medical records showed that 35% of the subjects had a BMI index >30. Out of 90 patients, 53%, 30% and 4% of the women had 2, 3, and 4 natural deliveries, respectively, whereas 16% had forceps delivery. Of the 65 operated patients, in more than 92% all the symptoms connected with pelvic organ prolapse disappeared. Problems with the urinary tract (urinary incontinence ‘de novo’, urinary tract infections) emerged in 13% and constipation in 5% of the women. As far as improved quality of life after the surgery is concerned, 93% of the subjects answered 4 and 5 (in a scale from 1 to 5). Conclusions: Neugebauer-Le Fort surgery is characterized by high effectiveness both, in objective research and subjective ratings of the operated patients. A high safety profile constitutes a great advantage of the surgery, as was confirmed in our study. In carefully selected group of patients with stage IV of POP-Q, Neugebauer-Le Fort surgery is a safe and effective procedure.Neugebauera-Le Forta w Klinice Chirurgii Ginekologicznej ICZMP w Łodzi w latach 2000-2009, z uwzględnieniem efektów zabiegów w kontekście poprawy jakości życia. Materiał i metody: Grupę badaną stanowiły pacjentki (90 kobiet) leczone operacyjnie z powodu całkowitego wypadania narządów płciowych (IV stopień POP-Q) w Klinice Chirurgii Ginekologicznej. Dane dotyczące grupy badanej zostały uzyskane retrospektywnie z historii chorób. Wyniki leczenia oceniono na podstawie ankiet i badań kontrolnych. Dla wnioskowania statystycznego przyjęto poziom istotności p ≤ 0,05. Wyniki: Średni wiek pacjentek operowanych wyniósł 76,5 lat. Analiza dokumentacji medycznej wykazała, że u 35% kobiet wskaźnik BMI wynosił powyżej 30. Spośród 90 pacjentek: 53% miało 2 porody fizjologiczne, 30% 3 porody fizjologiczne, a 4% 4 porody fizjologiczne. Poród kleszczowy odbyło 16% kobiet. Spośród 65 pacjentek, u ponad 92%, dolegliwości związane w wypadaniem narządów płciowych ustąpiły. Nietrzymanie moczu i zaparcia nie ustąpiły po operacji u 3% kobiet. Pojawienie się problemów z układem moczowym po operacji (nietrzymanie moczu de novo, infekcja dróg moczowych) zgłosiło 13% kobiet, zaś u 5% pojawiły się zaparcia. Na pytanie o poprawę komfortu życia po operacji w skali od 1 do 5, 93% kobiet oceniło komfort na 4-5 punktów. Wnioski: Operacja Neugebauera-Le Forta charakteryzuje się wysoką skutecznością, zarówno w badaniach obiektywnych, jak i w subiektywnej ocenie pacjentek. Zaletą operacji jest wysoki profil bezpieczeństwa, potwierdzony wynikami badania. W odpowiednio dobranej grupie chorych z IV stopniem wypadania narządów płciowych operacja Neugebauera-Le Forta stanowi bezpieczną i skuteczną procedurę

Choroba zakrzepowo-zatorowa w okresie menopauzalnym

Venous thromboembolism (VTE) is treated shabbily in gynaecology of the menopausal period. Being a seriouscomplication of neoplasms, operative procedures and – at last – menopausal hormone therapy (MHT), it isundoubtedly noteworthy and calls for in-depth knowledge

Cukrzyca u kobiet menopauzalnych

Diabetes pathogenesis in the menopausal period is influenced by many factors – e.g. the ageing process and absolute postmenopausal hypoestrogenism. The increasing frequency of glucose metabolism disorders – including IGT and type 2 diabetes mellitus (T2DM) – requires implementation of comprehensive menopausal care, focused on prevention of metabolic and cardiovascular effects of diabetes, requiring close cooperation between the gynaecologist and the diabetologist. Proper use of menopausal hormone therapy (MHT) can be an important element of such care

Krwawienia okresu okołomenopauzalnego

Abnormal bleeding is a common problem in the perimenopausal period. Abnormal bleeding causes aredivided into organic and hormonal. The most important issue in diagnostics of this pathology is exclusion oforganic causes, especially of oncologic aetiology. Diagnostics should be based on modern tools such as hysteroscopy,allowing precise imaging and guided biopsy of endometrial tissue. Abnormal bleeding therapy in theperimenopausal period could be operative or conservative, based on hormonal therapy

Skuteczność leczenia migreny akupunkturą u kobiet z zespołem menopauzalnym stosujących hormonalną terapię zastępczą i niestosujących hormonalnej terapii zastępczej

Background: Migraine because of a high morbidity rate generates high expenses for the health-care systemand also for the patients. It triggers decrease of life comfort and frequently obstructs normal functioning. Allauthors of studies pay attention to definite higher incidence in women. Not in all patients is pharmacotherapyeffective; some of them decide on acupuncture exams. Simultaneously women between 48 and 52 years of lifesuffer from menopause. Some of them decide to take hormonal replacement therapy. Aim of the study: In the research we retrospectively subjected to evaluation the effect of therapeuticacupuncture exams carried out because of occurrence of migraine in a group of women in menopausal stage,in two groups: applying and not applying hormonal replacement therapyMaterials and methods: Medical examination survey of 48 patients aged 49-55 with migraine not respondingto pharmacological treatment; 25 of them administer transdermal hormonal replacement therapy. All of patientsundergo a whole cycle of 10 acupuncture treatments. Patients before the first exam and after the whole cycleanswered the question in the questionnaire elaborated for the needs of this research. Furthermore, under usageof acupuncture treatment patients rate its analgesic effectiveness with a ten-point scale.Results: In the group of patients applying HTZ pain ailments regression was faster.Conclusion: Acupuncture is a safe method and recommended in treating migraine. Usage of HTZ in patientspositively influences results of acupuncture therapy

Biocenoza pochwy u kobiet po menopauzie

U kobiet po menopauzie w związku ze znacznym niedoborem hormonów płciowych – głównie estrogenów– dochodzi do zaniku fizjologicznej flory bakteryjnej, a następnie do kolonizacji pochwy przez liczne patogeny.Niedobór estrogenów jest odpowiedzialny za większość dolegliwości ze strony pochwy zgłaszanych przez kobietyw tym okresie. Praca przedstawia, w jaki sposób zmiany hormonalne okresu pomenopauzalnego wpływająna mikroflorę pochwy

Quality of life of chronically mentally ill people in the Lodz region

Mental crisis exerts a negative effect on personal, vocational and social activity. Mental disease is often accompanied by factors reducing the quality of life of patients. Another problem is deeply rooted stereotypes and prejudices functioning in the public opinion, according to which people who suffer from mental disorder should be considered insane and often dangerous for society. In Poland, thanks to, amongst others, the EFS funds, it is possible to finance and implement research concerning quality of life of people who have experienced a mental crisis. The aim of the study was to evaluate the quality of life of people suffering from mental disorders from the Lodz region on the basis of eight points scale assessing their personal, occupational, and social functioning. The study included a group of 101 patients with mental disorders. Participants were selected randomly from mental health institutions functioning in the region of Lodz. To evaluate the quality of life in the group of patients a standardized interview questionnaire was used. Total quality of life index achieved the value of 54.2 points from the maximum possible 100. The result follows a relatively high level of support from relatives, no significant discrimination, and the relatively high rate of household wealth. On the other hand, the lower level of the quality of life was associated with lower level of education as well as lower social and economic activity.Udostępnienie publikacji Wydawnictwa Uniwersytetu Łódzkiego finansowane w ramach projektu „Doskonałość naukowa kluczem do doskonałości kształcenia”. Projekt realizowany jest ze środków Europejskiego Funduszu Społecznego w ramach Programu Operacyjnego Wiedza Edukacja Rozwój; nr umowy: POWER.03.05.00-00-Z092/17-00. Publikacja dofinansowana z budżetu Urzędu Miasta Łodzi w ramach Konkursu ofert na realizację zadania: „Współpraca z wyższymi uczelniami” w zakresie promocji Łodzi jako ośrodka naukowego i akademickieg

Incidence of and mortality from breast cancer among women in Poland in the years 2001-2010

Introduction : Breast cancer is the most common malignant tumour among women. About 15,000 new cases of breast cancer are diagnosed and more than 5,000 women die in Poland every year. The aim of this study was to analyse the incidence and mortality rate of breast cancer among women in Poland in the years 2001-2010. Material and methods: Analysed data concerning the incidence of and mortality from cancer among women were obtained from the National Cancer Registry. Results : The number of new cases reported in 2010 exceeded that reported in 2001 by 3,666. The mortality from breast cancer among women increased by 15.1% by 2009, to subsequently drop by 0.3% in 2010. The standardized incidence rate increased by 7.4 and the standardized mortality rate fell by 1.3 in 2001-2010. Conclusions : In the years 2001-2010 the incidence of breast cancer in women in Poland rose by 30.3%, with an increase of 7.4 in the incidence rate. The highest rise in the incidence and mortality of women due to breast cancer in Poland is reported in the Lodz voivodeship. In the years 2001-2009 the number of women’s deaths due to breast cancer increased slightly, while the mortality rate dropped