Genetic association of apolipoprotein E with optic disc size

INTRODUCTION. The purpose of this clinical non-interventional cross-sectional study was to evaluate the role of apolipoprotein E (ApoE) gene alleles (e2, e3, e4) in the determination of optic disc size. MATERIALS AND METHODS. In 32 normal controls, 54 patients with ocular hypertension (OHT), and 96 patients with primary open-angle the optic disc size was determined by planimetry using 15° colour stereo photographs. In all individuals ApoE genotyping was performed. RESULTS. The size of the optic disc was significantly different between subjects with e3e2, e3e3, and e4e3 allele (Kruskal-Wallis-test, Chi-Square: 6.95, p = 0.031; 2.39, 2.77, and 2.78 mm2, respectively). CONCLUSIONS. The results suggest that ApoE gene alleles are associated with optic disc size. ApoE may act as a modulator gene for optic disc morphogenesis

Dietary vitamin and mineral intakes in a sample of pregnant women with either gestational diabetes or type 1 diabetes mellitus, assessed in comparison with Polish nutritional guidelines

Objectives: Maintaining proper nutrition during pregnancy is crucial for pregnant women and especially for who havebeen diagnosed with type 1 diabetes mellitus (T1DM) or who develop gestational diabetes mellitus (GDM).Material and methods: To measure differences in vitamin and mineral intakes among women with normal pregnancies,pregnant women with GDM, and pregnant women with pre-gestational T1DM; and to assess the women’s dietary intakes in comparison with Polish nutritional guidelines. The analysis was conducted among 83 pregnant women (29 GDM patients, 26 T1DM patients and 28 normal pregnancy participants) from whom we collected seven-day 24-hour dietary records during the second part of their pregnancies.Results: There were no statistically significant differences observed for most of the vitamin and mineral intakes across the three groups. However, we did observe a significant difference in the vitamin C and calcium intakes between groups. The mean vitamin C and calcium intakes were significantly higher in the control group than among the diabetic patients. Insufficient dietary calcium intakes were found among 52.3% of the GDM patients and 61.6% of the T1DM participants, while only 28.6% of the normal pregnancy patients experienced a calcium deficiency. The highest incidence of inadequate intake in each of the GDM, T1DM and control groups was observed for vitamin D (100%, 100%, 100%), folate (97.7%, 100%, 100%), iron (97.7%, 100%, 100%), and iodine (97.7%, 92.4%, 85.7%), respectively.Conclusions: Diet alone may not be enough to provide adequate levels of vitamins and minerals for most micronutrients. Supplement use reduces the risk of inadequate intake for many micronutrients, but diet-related issues during pregnancy and pregnancy diagnosed with diabetes remain, and they deserve to be addressed during public health interventions

Dietary macronutrients and fluid intakes in a sample of pregnant women with either gestational diabetes or type 1 diabetes mellitus, assessed in comparison with Polish nutritional guidelines

Objectives: Pregnancy is a critical period during which environmental factors such as nutrition can affect development. Maintaining proper nutrition becomes even more significant when pregnant women have diabetes. The aim of this study was to measure changes in energy and macronutrient intakes among pregnant women and patients diagnosed either with gestational diabetes mellitus (GDM) during pregnancy, or, type 1 diabetes mellitus (T1DM) before pregnancy, and to assess the pregnant women’s dietary intakes in comparison with Polish Institute of Food and Nutrition nutritional guidelines.Material and methods: The analysis was conducted among 83 pregnant women (29 GDM patients, 26 T1DM patients and 28 normal pregnancy patients — the control group) from whom we gathered nutritional data during the second part of their pregnancies. Data on each woman’s diet during pregnancy was collected is self-completed dietary records during seven consecutive 24-hour periods.Results: The mean macronutrient intake of the GDM patients was 32.1% fat, 19.5% protein, and 48.3% carbohydrates; in the T1DM group the results were 34.2%, 19.4% and 46.4% respectively; and in control group they were 31.8%, 17.6% and 50.5% respectively. This study showed that many of the pregnant women did not reach the recommended level of energy intake during pregnancy. Moreover, most of the women exceeded their fat requirements, and fat intake as a proportion of energy intakes also exceeded the guidelines in more than 60% of the women across all groups.Conclusions: The implications and possible causes of excessive fat intake during pregnancy and pregnancies complicated by diabetes are underestimated and undertreated by obstetricians and warrant further investigation, especially in association with gestational weight gain, maternal and fetal perinatal complications, and post-gestational diabetes

Wide-Field Landers Temporary Keratoprosthesis in Severe Ocular Trauma: Functional and Anatomical Results after One Year

Purpose. To evaluate longitudinal functional and anatomical results after combined pars plana vitrectomy (PPV) and penetrating keratoplasty (PKP) using a wide-field Landers intraoperative temporary keratoprosthesis (TKP) in patients with vitreoretinal pathology and corneal opacity due to severe ocular trauma. Material and Methods. Medical records of 12 patients who had undergone PPV/PKP/KP due to severe eye trauma were analyzed. Functional (best-corrected visual acuity) and anatomic outcomes (clarity of the corneal graft, retinal attachment, and intraocular pressure) were assessed during the follow-up (mean 16 months). Results. Final visual acuities varied from NLP to CF to 2 m. Visual acuity improved in 7 cases, was unchanged in 4 eyes, and worsened in 1 eye. The corneal graft was transparent during the follow-up in 3 cases and graft failure was observed in 9 eyes. Silicone oil was used as a tamponade in all cases and retina was reattached in 92% of cases. Conclusions. Combined PPV and PKP with the use of wide-field Landers TKP allowed for surgical intervention in patients with vitreoretinal pathology coexisting with corneal wound. Although retina was attached in most of the cases, corneal graft survived only in one-fourth of patients and final visual acuities were poor

Surgical Management of Traumatic Retinal Detachment with Primary Vitrectomy in Adult Patients

Purpose. To evaluate functional and anatomical results of pars plana vitrectomy (PPV) in the retinal detachment (RD) followed by severe eye trauma. Methods. Retrospective analysis of medical records of forty-one consecutive patients treated with 23-gauge PPV due to traumatic RD. Age, gender, timing of PPV, visual acuity, and presence of intraocular foreign body (IOFB) and proliferative vitreoretinopathy (PVR) were included in the analysis. Results. Mean age of patients was 47 years; the majority of patients were men (88%). Closed globe injury was present in 21 eyes and open globe injury in 20 eyes (IOFB in 13 eyes, penetration injury in 4 eyes, and eye rupture in 3 eyes). Mean follow-up period was 14 months; mean timing of PPV was 67 days. Twenty-seven (66%) eyes had a functional success; 32 eyes (78%) had anatomical success. As a tamponade silicone oil was used in 33 cases and SF6 gas in 8 cases. Conclusions. Severe eye injuries are potentially devastating for vision, but vitreoretinal surgery can improve anatomical and functional outcomes. Among analysed pre- and intra- and postoperative factors, absence of PVR, postoperative retinal attachment, and silicone oil as a tamponade were related to significantly improved visual acuity

Barley malt-based composition as a galactagogue — a randomized, controlled trial in preterm mothers

Objectives: Delayed or insufficient breast milk production, as well as low milk supply, is still a challenging problem toovercome, particularly in the case of preterm delivery. Herbal galactagogues might be a good way to increase milk supply,however, there is a lack of clinical studies confirming their efficacy and safety.The aim of this study was to verify the safety and effectiveness as a galactagogue of the unique galactagogue compositionbased on barley malt with β -glucan and lemon balm.Material and methods: The study included 117 mothers of preterm infants randomly divided into the GalactagogueGroup given galactagogue and the Placebo Group. A complete data set was obtained for 80 participants, divided equallybetween two groups.Volume of milk expressed by mothers during the first two weeks after delivery was the primary outcome and safetyof the product was the secondary outcome.Results: Volume of milk recorded on participants’ last visit in the Galactagogue Group was significantly higher than in thePlacebo Group (95 mL vs 62.5 mL, p = 0.049). The total expressed milk volume during the study was 4209 ± 335 mLin the Placebo Group vs 6036 ± 498 mL (p = 0.003) in the Galactagogue Group.Conclusions: Supplementation with unique Galactagogue composition was safe and increased milk output which allowedachieving target minimal volume of 500 mL per day in first week of lactation in preterm mothers

Polish Society of Gynecologists and Obstetricians Recommendations on diagnosis and management of fetal growth restriction

Polish Society of Gynecologists and Obstetricians Recommendations on  diagnosis and management of fetal growth restrictio

Respiratory distress syndrome in preterm infants: possible impact of surfactant application techniques

Objectives: Prematurity is one of the most important issues in perinatology. The most frequent postnatal pathology connected with prematurity is respiratory distress syndrome (RDS) caused by surfactant deficiency due to lung immaturity. RDS is one of the most frequent causes of mortality and morbidity with short- and long-term consequences. The aim of the study was to compare the effectiveness of individual surfactant supply techniques in the treatment of respiratory disorders in premature infants. Material and methods: In the period from the year 2009 to 2013, there were 198 very premature infants that received surfactant included to this retrospective study.  They were divided into three groups based on the surfactant application method: Premature newborns with substitute ventilation, with supply of surfactant through a traditional endotracheal tube — Average gestational age 26.6 weeks; Mean birth weight 911 g; Average Apgar score 4 in 1st minute, 6 in 5th minute. Premature newborns with exogenous surfactant supplementation — InSure method — Average gestational age 28.3 weeks; Average birth weight 1117 g; Mean Apgar score 6 in 1st minute, 7 in 5th minute. Premature newborns with exogenous surfactant supplementation — Less Invasive Surfactant Administration (LISA) method — Mean gestational age 29.9 weeks; Average birth weight 1444 g; Average Apgar score 7 in 1st minute, 8 in 5th minute. Results: Noninvasive methods of respiratory support and minimally invasive surfactant administration (MISA) significantly reduced the incidence of severe RDS, compared to the traditional method. Conclusions: Non-invasive methods of respiratory support and MISA like LISA and InSure methods were safe and effective in the treatment of RDS

Clinical Study Adjunctive Pessary Therapy after Emergency Cervical Cerclage for Cervical Insufficiency with Protruding Fetal Membranes in the Second Trimester of Pregnancy: A Novel Modification of Treatment

Aim. To evaluate the effectiveness of adjunctive pessary therapy after emergency cervical cerclage (ECC) in improving perinatal outcome in cervical insufficiency with fetal membranes protruding into the vagina. Material and Methods. A retrospective analysis of patients treated at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, between 2008 and 2013. The study group consisted of 15 women treated with ECC and a pessary and the control group consisted of 17 patients treated with cerclage only. Results. The mean gestational age at delivery was significantly higher in the study group (34.7 versus 29.7 weeks, = 0.03). The period between cerclage insertion and delivery was significantly longer in the study group (82.9 versus 52.1 days, = 0.045). The mean neonatal birthweight and neonatal "discharge alive" ratio were higher in the study group, although not statistically significant (2550 g versus 1883 g, = 0.14, and 93.3% versus 70.5%, = 0.18, resp.). NICU hospitalization rates were comparable (33.3% versus 35.3%, = 0.9). Conclusions. Adjunctive pessary therapy allows delaying delivery in women treated with ECC due to cervical insufficiency with protruding fetal membranes. It also seems to improve neonatal outcome, although the differences are not statistically significant. Further prospective study is required to prove these findings