Gestational diabetes mellitus/hyperglycaemia during pregnancy in Poland in the years 2010–2012 based on the data from the National Health Fund

Objectives: The incidence of gestational diabetes varies depending on a country and it is extremely difficult to analyse. The aim of the study was to assess the incidence of gestational diabetes in Polish population. Material and methods: Based on the data from the National Health Fund (NHF) the authors analysed reports regarding deliveries performed and then, determined the rates of gestational diabetes/hyperglycaemia during pregnancy and pregestational diabetes in Poland in the years 2010–2012. Results and conclusions: In Poland, the incidence of gestational diabetes was estimated to be 4.665% in 2010, 6.918% in 2011 and 7.489% in 2012. The incidence of pregestational diabetes was 1.067% in 2010, 1.116% in 2011 and 0.932% in 2012

Proliferation and apoptosis of human placental cells exposed to aromatic hydrocarbons

Objectives: The objective of this study is to assess the effect of elevated urinary levels of aromatic hydrocarbons (AH) on the proliferation and apoptosis of human placental trophoblast cells obtained in the course of normal pregnancy in an AH-polluted region. Material and methods: Tissue material was obtained for study purposes from 50 afterbirths from Płock as the study group and 50 afterbirths from Kutno as the control group. The extent and intensity of reactions were analyzed. The levels of phenol and 1-hydroxypyrene in the excreted urine of pregnant (in labor) patients were determined by gas chromatography and colorimetry. The proliferative activity of trophoblast cells was assessed using MPM-2 antibodies against phosphoprotein synthesized upon mitotic induction and Ki-67 antigen while the intensity of apoptosis in trophoblast cells was assessed using p53 and bcl-2 oncoproteins involved in apoptosis-regulating mechanisms. The immunohistochemical reactions were assessed for their extent and intensity. Results: The levels of phenol and 1-hydroxypyrene excreted in the urine were statistically significantly higher in patients from Płock region. The proliferative activity of trophoblast cells was statistically significantly higher in the study group (p < 0.05). The activity of oncoprotein bcl-2 was significantly higher in the study group while the activity of p53 was sig¬nificantly higher in the control group. Pregnancy in an aromatic hydrocarbon-polluted environment has a significantly negative impact on placental tissue. Ad¬aptation mechanisms are induced as manifested by increased proliferative activity within the trophoblast and extensive inhibition of apoptosis in the study group

The duration of pregnancy in ecologically-challenged area. The effects of environmental pollution with aromatic hydrocarbons on the angiogenesis and elements of the mesenchymal tissue of the human placenta

Introduction: The literature presents only few reports regarding the effects of elevated levels of aromatic hydrocarbons (AH) on the functions of the human placenta. The effects of environmental contamination with AH (including phenol and 1-hydroxypyrene) have certain negative effects on parenchymal organs such as human placenta. Objective: The paper aimed to assess the effects of elevated levels of AH on the placental angiogenesis and elements of the mesenchymal tissue of the placenta. Material and methods: Tissue material from 50 afterbirths from Płock constituted a study group, whereas 50 afterbirths from Kutno constituted a control group. Immunohistochemical reactions with the peroxidase method using LSAB kits (DAKO) were performed. The extent and intensity of reactions were analysed. The levels of phenols and 1-hydroxypyrene in the excreted urine of pregnant women (undergoing delivery) were detected using gas chromatography and colorimetry. Results: The levels of phenol and 1-hydroxypyrene in the excreted urine were demonstrated to be statistically significantly higher in patients living in the area of Płock. Statistically significantly higher expression of antibodies indicating placental angiogenesis was observed in the placentas in the Płock group (p &lt; 0.01). Moreover, lower expression of vimentin indicating reactions with proteins in mesenchymal cells was observed in the Kutno group (p &lt; 0.01). Conclusions: Pregnancy in the environment with elevated levels of aromatic hydrocarbons has detrimental effects on the human placenta. The foetus is protected by activation of adaptation and compensation mechanisms that are manifested as significant angiogenesis and greater development and differentiation of mesenchymal cells compared to the control group

Ocena obrazów morfologicznych endometrium u pacjentek z zespołem policystycznych jajników

Abstract Aim: To evaluate endometrial histologic morphology in patients with polycystic ovary syndrome. Material and methods: 93 women, aged 18-35, who were hospitalized in the Gynaecologic Endocrinology Department of Warsaw Medical University due to PCOS have been qualified for the research. All patients had menstrual pattern of oligomenorrhoea and mean cycle length of 49+/-38 days. The control group consisted of 40 healthy women with regular menstrual cycles and no symptoms of hyperandrogenism. In case of each patient the fallowing data were analyzed: age, menarche age, Body Mass Index and endometrium histologic findings. The endometrium was aspirated using the Pipelle probe. Statistic analysis was performed and the values of pStreszczenie Cel pracy: Celem pracy jest ocena obrazów histologicznych endometrium u pacjentek z zespołem policystycznych jajników. Materiał i metodyka: Do badania zakwalifikowano 93 kobiety w wieku 18-35 lat hospitalizowane w Klinice Endokrynologii Ginekologicznej Akademii Medycznej w Warszawie z powodu PCOS. Wszystkie pacjentki miały cykle miesiączkowe o typie oligomenorrhoea, średnia długość cyklu 49+/-38 dni. Grupę kontroląa stanowiło 40 zdrowych pacjentek z regularnymi miesiączkami, bez cech androgenizacji. U każdej pacjentki analizowano następujące dane: wiek metrykalny, wiek menarche, Indeks Masy Ciała (BMI) oraz oceniano obraz histologiczny endometrium po pobraniu materiału przy użyciu sondy Pipelle. Analizy statystycznej dokonano przy pomocy testu mediany oraz testu na równość dwóch frakcji z dwóch prob. Wartości

Use of marijuana for medical purposes

Cannabis is the most popular illicit drug on the European market. Over 16 million young Europeans have used it at least once in the last few years. The recent trends in the consumption of marihuana differ between countries. Some countries face an increase in the prevalence of cannabis use, including Poland, where the level cannabis use has been systematically increasing since the 1990’s. According to a recent ESPAD study, 19% of Polish adolescents aged 15–16 have used cannabis in the last year. Marihuana is also a leading substance when analyzing the data of seizures and crimes. The recent EMCDDA Annual report on the drug situation in Europe notes the increasing potency in cannabis available on the market. Some countries face an increasing number of emergencies caused by marihuana, which was unlikely to have happened previously. In almost all European countries there is an ongoing discussion about loosening marijuana laws or its complete legalization. There is also ongoing discussion on the use of marihuana in therapy as a medicine. Many scientific studies are being conducted in this field. Some of the results are promising; however, there is no well-designed human trial which would unequivocally confirm that medical cannabis is effective as a medicine, or more effective than other medicines on the market. The problem is that the debate on the medical use of marihuana becomes more ideological and less professional. The medical use of marihuana is strongly supported by organizations lobbying for the legalization of cannabis use. Research on the medical use of cannabis should be continued, as there are some promising results supporting therapy in different medical conditions. However, the use of cannabis as a medicine should be discussed only among professionals. If marihuana is to be used for medical purposes, the fact that it is the most popular illicit drug in Europe is irrelevant

COVID-19 during pregnancy one year on — what lessons did we learn?

It is now more than a year since the first case of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) disease (COVID-19) was diagnosed in China. Current data suggest that pregnancy may not only be a risk factor for the development of severe forms of COVID-19, but that the SARS-CoV-2 infection may impact on common pregnancy complications as well. Healthy pregnant women are likely to be more susceptible to viral infection and therefore are at higher risk of developing severe COVID-19 because of adaptive changes in their immune and respiratory systems, their altered endothelial cell functions, and modified coagulation responses. However, studies show that most pregnant women diagnosed with COVID-19 developed mild-to-moderate symptoms and only a few of them have required critical care facilities. In contrast with preeclampsia, preeclampsia-like syndrome can resolve spontaneously following recovery from severe pneumonia and may not be an obstetric indication for delivery. Preeclampsia-like syndrome is one symptom of COVID-19, but its cause is different from obstetric preeclampsia and therefore not connected with placental failure. Vertical transmission of SARS-CoV-2 infection is rare but can probably occur. No evidence has been found that COVID-19 developed during pregnancy leads to unfavourable outcomes in the fetus. Most health authorities indicate that standard procedures should be used when managing pregnancy complications in asymptomatic women with confirmed SARS-CoV-2. Vaccines should not be withheld from pregnant and lactating individuals who otherwise meet the vaccination criteria

Kamizelka defibrylująca w okresie poporodowym u pacjentki z kardiomiopatią

Cardiovascular diseases during pregnancy increase the risk of morbidity and mortality in pregnant women and their children. We present the case of a 37-year-old patient with cardiomyopathy who developed significant deterioration of left ventricular function accompanied by fetal death at 28 gestational week, and who was subsequently provided with a wearable cardioverter defibrillator as a part of sudden cardiac death prevention.Choroby układu sercowo-naczyniowego u kobiet w ciąży zwiększają ryzyko chorobowości i śmiertelności zarówno matek, jak i dzieci. W artykule przedstawiono przypadek 37-letniej pacjentki z kardiomiopatią, u której w 28. tygodniu ciąży doszło do znacznego pogorszenia funkcji lewej komory oraz obumarcia płodu i którą zaopatrzono kamizelką defibrylującą w ramach prewencji nagłego zgonu sercowego

Prognosis of the patients suffered from uterine carcinosarcoma from rural and urban areas

Objectives: Uterine carcinosarcoma is a very aggressive neoplasm. Patients’ median age at diagnosis ranges from 62 to 67 years. The aim of this study was to compare treatment results and prognostic factors for residents of urban and rural areas suffering from uterine carcinosarcoma. Material and methods: Clinical outcomes of 58 uterine carcinosarcoma patients treated in one institution were assessed: 25 residents of rural and 33 of urban areas. All the patients were treated by using surgery followed by chemotherapy (48 pts) or radiotherapy (10 pts). Standard chemotherapy regimen comprised of paclitaxel 175 mg/m2 and carboplatin on day one at area under curve (AUC) six every 21 days. Radiotherapy was performed by combined treatment – tele and brachytherapy. External beam pelvic radiation therapy (EBRT) once a day, five days a week with a daily fraction size of 1.8 Gy over five weeks at cumulative dose 50.4 Gy was the first part of adjuvant treatment. High-dose-rate (HDR) brachytherapy at dose 22.5 Gy was the second part of radiotherapy. Results: A strong correlation between tumor diameter and the presence of lymph node metastasis was observed. Tumor size greater then 4.5 cm correlated with presence of node involvement and this parameter was statistically significant (p = 0.015). There was no significant correlation between other analyzed clinical factors and overall survival. In the period 2004 – 2010 43.5% (10/23) and 50% (14/28) of rural and urban residents, respectively, died due to carcinosarcoma progression. Conclusion: Uterine carcinosarcoma patients in rural and urban areas seem to have similar outcomes.