Anti-inflammatory properties of irisin, mediator of physical activity, are connected with TLR4/MyD88 signaling pathway activation

Irisin, an adipomiokine known as a mediator of physical activity, induces the browning of adipose tissue and it has potentially protective properties in the development of obesity-related states, such as insulin resistance, arteriosclerosis, and type 2 diabetes. Despite numerous studies conducted on this factor, still little is known about its impact on the functioning of immunocompetent cells, but its potential anti-inflammatory properties were previously suggested. In the current study we investigated the role of irisin (0–100 nM) in the downstream pathway activation of Toll-like receptor 4 (TLR4) in RAW 264.7 macrophages stimulated with lipopolysaccharide (LPS; 100 ng/mL). The results have shown that irisin in high concentrations (50, 100 nM) significantly decreased the TLR4 and MyD88 protein levels, as well as the phosphorylation of nuclear factor-κB (NF-κB), consequently leading to the reduction in the release of crucial pro-inflammatory cytokines. The above was confirmed for interleukin 1β (IL-1β), tumor necrosis factor α (TNFα), interleukin 6 (IL-6), keratinocyte chemoattractant (KC), monocyte chemotactic protein 1 (MCP-1), as well as for high mobility group box 1 (HMGB1). Moreover, our results indicate that this effect is connected with irisin’s impact on the phosphorylation of mitogen-activated protein kinases (MAPKs), where a significant reduction in p-JNK and p-ERK but not p-p38 was observed. In conclusion, these data suggest that irisin has potentially anti-inflammatory properties connected with the downregulation of downstream pathways of TLR4/MyD88

The extent of lymphadenectomy in endometrial cancer and its effect on blood loss and procedure duration

The clinical staging of endometrial cancer is performed based on surgical-pathological criteria. The extent of lymph node dissection represents a clinical problem. The study was performed in order to assess the occurrence of metastases in iliac and para-aortic lymph nodes as well as to compare selected surgical risk factors in the case of extending the surgery with the dissection of these lymph nodes. The control group included 27 patients undergoing hysterectomy with iliac lymph node dissection; the study group included 30 patients after iliac and para-aortic lymph node removal. The incidence of metastases was assessed as well as the duration of procedure and intraoperative blood loss were compared. Metastases to lymph nodes were found in 10 (17.5%) females. Iliac lymph node metastases were detected in four patients (14.8%) in group I. In group II, metastases were detected in six (20%) patients: isolated para-aortic metastases in two patients (6.67%), para-aortic and iliac metastases in four (13.33%) patients. Statistically significant difference (p = 0.0035) was found in the duration of procedures: the median was 102.5 minutes for iliac lymphadenectomy, and 132.5 minutes for iliac/para-aortic lymphadenectomy; the maximum duration of iliac/para-aortic lymphadenectomy was 20 minutes longer. There was no statistically significant difference in blood loss (p = 0.4980). However, significantly higher maximum blood loss volume was noticeable in the study group. It is necessary to adjust the para-aortic lymphadenectomy in endometrial cancer to patient’s health status as well as to make maximum use of preoperative diagnostics. The procedure should be performed by a specialist experienced in gynecologic oncology to minimize the surgical risk. Information on lymph node status is the most important prognostic factor in endometrial cancer, which allows for a proper qualification for adjuvant therapy

Physical Activity and Depressive Disorders in Pregnant Women—A Systematic Review

Background and Objectives: Pregnancy is a unique period in the life of every woman. The lifestyle of a pregnant woman has a significant impact on her and her child’s health. Regular physical activity is one of the elements that help maintain normal mental and physical well-being. In pregnant women who regularly have moderate physical activity, there is a lower risk of developing obesity and overweight. Physical exercises have an impact on maintaining proper muscular tonus, reduce pain and prepare for the exertion during labour. Based on the available literature, the aim of this study was to present the impact of physical activity on depressive disorders in pregnant women. Materials and Methods: A review of the literature was carried out in the Medline PubMed database. The basic search terms were: “pregnancy” AND “physical activity AND depression”. The work included only English-language publications published in the years 2000−2018. Results: A total of 408 references were found. On the basis of an analysis of titles, abstracts and the language of publication (other than English), 354 articles were rejected, and 54 articles were fully read, of which five were rejected due to lack of access to the full version. Finally, 17 references were included in the review. Conclusions: Physical activity, at least once a week, significantly reduces the symptoms of depression in pregnant women and may be an important factor in the prevention of depression in this period

The role of the apical defect in the pathogenesis of pelvic organ prolapse: cystocele with apical defect

Publikacja recenzowana / Peer-reviewed publicationWprowadzenie: W uroginekologii, zarówno w literaturze, jak i w pracy klinicznej, stosowane są różne systemy oceny obniżenia narządów dna miednicy. Powoduje to trudności w planowaniu leczenia, jak również w ocenie skuteczności stosowanych metod operacyjnych. Do obiektywnej oceny stopnia zaburzeń statyki narządu płciowego służy skala POP-Q (Pelvic Organ Prolapse Quantification). Nie informuje ona jednak o rodzaju defektu. Z kolei podział kliniczny według DeLancey definiuje rodzaj defektu, wskazując anatomiczną przyczynę uszkodzenia, ale nie stopień jego nasilenia. Nie uwzględnia również pojęcia „cystocele z defektem apikalnym”. Materiał i metody: Autorzy zbadali 96 pacjentek, które zgłaszały się celem kwalifikacji do leczenia z powodu objawowego obniżenia narządów miednicy mniejszej. Zastosowano nowy, standaryzowany sposób badania uroginekologicznego. Badanie uwzględniało rodzaj defektu i stopień jego nasilenia na każdym z trzech poziomów dna miednicy. Wyniki: Ten sposób badania pozwolił zidentyfikować zarówno znane już cystocele z defektem środkowym i bocznym, jak również nieopisywane dotychczas cystocele z defektem apikalnym i mieszanym. Wnioski: Autorzy proponują nowy sposób badania uroginekologicznego z jednoczesnym zastosowaniem skali POP-Q i zmodyfikowanej klasyfikacji obniżenia narządów miednicy mniejszej według DeLancey, uwzględniającej wpływ defektu na poziomie I, czyli defektu apikalnego, na obniżenie na poziomie II. Wydaje się, iż taki sposób postępowania daje możliwość skuteczniejszego planowania zabiegów uroginekologicznych, ograniczając jednocześnie odsetek wznów.Introduction: In urogynecology, both in subject literature and in clinical work, different systems for the assessment of pelvic organ prolapse are used. The lack of standardization causes difficulties in treatment planning and in the evaluation of the effectiveness of applied surgical methods. The most commonly used scale is the POP-Q System which describes the severity of the prolapse without taking the type of defect into account. On the other hand, the clinical classification by DeLancey defines the type of defect but does not take its severity into account. The latter classification system also does not include cystocele with apical defect. Material and methods: The authors examined 96 patients presenting for advice of treatment due to symptomatic pelvic floor disease. A new, standardized method of urogycological examination was implemented. The evaluation included the type of defect and its severity at all three pelvic floor levels. Results: This method of examination allowed the identification of both already known cystocele with middle and lateral defects, as well as not yet described cystocele with apical and mixed defects. Conclusions: The authors propose a new, standardized method of urogynecological examination which assumes the simultaneous application of the POP-Q System and the modified classification of lower pelvic organ prolapse by DeLancey which also describes the impact of level I defects (apical defects) on level II prolapse. It seems that this approach allows for more effective planning of urogynecological procedures, while reducing the rate of recurrence

The role of the apical defect in the parthenogenesis of pelvic organ prolapse: cystocele with apical defect

Wprowadzenie: W uroginekologii, zarówno w literaturze, jak i w pracy klinicznej, stosowane są różne systemy oceny obniżenia narządów dna miednicy. Powoduje to trudności w planowaniu leczenia, jak również w ocenie skuteczności stosowanych metod operacyjnych. Do obiektywnej oceny stopnia zaburzeń statyki narządu płciowego służy skala POP-Q (Pelvic Organ Prolapse Quantifi cation). Nie informuje ona jednak o rodzaju defektu. Z kolei podział kliniczny według DeLancey defi niuje rodzaj defektu, wskazując anatomiczną przyczynę uszkodzenia, ale nie stopień jego nasilenia. Nie uwzględnia również pojęcia „cystocele z defektem apikalnym”. Materiał i metody: Autorzy zbadali 96 pacjentek, które zgłaszały się celem kwalifi kacji do leczenia z powodu objawowego obniżenia narządów miednicy mniejszej. Zastosowano nowy, standaryzowany sposób badania uroginekologicznego. Badanie uwzględniało rodzaj defektu i stopień jego nasilenia na każdym z trzech poziomów dna miednicy. Wyniki: Ten sposób badania pozwolił zidentyfi kować zarówno znane już cystocele z defektem środkowym i bocznym, jak również nieopisywane dotychczas cystocele z defektem apikalnym i mieszanym. Wnioski: Autorzy proponują nowy sposób badania uroginekologicznego z jednoczesnym zastosowaniem skali POP-Q i zmodyfi kowanej klasyfi kacji obniżenia narządów miednicy mniejszej według DeLancey, uwzględniającej wpływ defektu na poziomie I, czyli defektu apikalnego, na obniżenie na poziomie II. Wydaje się, iż taki sposób postępowania daje możliwość skuteczniejszego planowania zabiegów uroginekologicznych, ograniczając jednocześnie odsetek wznów.Introduction: In urogynecology, both in subject literature and in clinical work, different systems for the assessment of pelvic organ prolapse are used. The lack of standardization causes diffi culties in treatment planning and in the evaluation of the effectiveness of applied surgical methods. The most commonly used scale is the POP-Q System which describes the severity of the prolapse without taking the type of defect into account. On the other hand, the clinical classifi cation by DeLancey defi nes the type of defect but does not take its severity into account. The latter classifi cation system also does not include cystocele with apical defect. Material and methods: The authors examined 96 patients presenting for advice of treatment due to symptomatic pelvic fl oor disease. A new, standardized method of urogycological examination was implemented. The evaluation included the type of defect and its severity at all three pelvic fl oor levels. Results: This method of examination allowed the identifi cation of both already known cystocele with middle and lateral defects, as well as not yet described cystocele with apical and mixed defects. Conclusions: The authors propose a new, standardized method of urogynecological examination which assumes the simultaneous application of the POP-Q System and the modifi ed classifi cation of lower pelvic organ prolapse by DeLancey which also describes the impact of level I defects (apical defects) on level II prolapse. It seems that this approach allows for more effective planning of urogynecological procedures, while reducing the rate of recurrence

Państwo i Społeczeństwo nr 4, 2017 : Medycyna i zdrowie publiczne

ZE WSTĘPU: Niniejszy numer „Państwa i Społeczeństwa”, poświęcony medycynie i zdrowiu publicznemu, zawiera cztery prace oryginalne, pięć poglądowych i jeden opis przypadku. Istotne miejsce zajmują w nim prace przedstawione podczas XVII Konferencji Naukowej „Państwo, gospodarka, społeczeństwo” w Krakowskiej Akademii im. Andrzeja Frycza Modrzewskiego w czerwcu 2017 r