Zespół policystycznych jajników (PCOS), a ryzyko występowania cukrzycy ciążowej (GDM)

Gestational diabetes mellitus (GDM) is a common complication of pregnancy. In the course of pregnancy, elevated levels of hormones and other proteins having insulin-antagonistic effects lead to higher insulin resistance in peripheral tissues, followed by hyperinsulinemia. Risk factors for the development of GDM have been well-established. However, the debate whether polycystic ovary syndrome (PCOS) may predispose to GDM continues. Patients with PCOS are often affected by obesity, dyslipidemia, hyperinsulinemia ,and tissue-specific insulin resistance. Obesity occurs in 50% of the cases, while tissue-specific insulin resistance is observed in 20-40% of the affected patients. This paper aims at systematizing risk factors that could contribute to the development of GDM, as well as reviewing literature reports and analyses on the occurrence of a potential correlation.Cukrzyca ciążowa (gestational diabetes mellitus – GDM) jest częstym stanem patologicznym wikłającym ciążę. W przebiegu ciąży dochodzi do zwiększenia stężenia w organizmie hormonów oraz innych białek o działaniu antagonistycznym w stosunku do insuliny, co prowadzi do wzrostu insulinooporności tkanek obwodowych, a następnie do hiperinsulinemii. Pomimo, że znane są czynniki ryzyka prowadzące do rozwoju GDM, od lat toczy się dyskusja czy zespół policystycznych jajników (PCOS) może predysponować do wystąpienia cukrzycy ciążowej. U pacjentek z PCOS często występuje otyłość, dyslipidemia, hiperinsulinemia oraz brak wrażliwości tkankowej na insulinę. Otyłość występuje u 50% przypadków, a brak wrażliwości na insulinę u 20-40% pacjentek. Celem poniższego opracowania jest usystematyzowanie czynników ryzyka, które mogłyby u pacjentek z PCOS prowadzić do rozwoju GDM, a także przegląd badań oraz analiz dotyczących występowania potencjalnej korelacji

Allergic bronchopulmonary aspergillosis mimicking lung cancer in a non-asthmatic female patient: a case report

Alergiczna aspergiloza oskrzelowo-płucna (ABPA) jest chorobą płuc, o zmiennym obrazie radiologicznym, wywołaną reakcją nadwrażliwości na antygeny grzybów z rodzaju Aspergillus, najczęściej Aspergillus fumigatus. Alergiczna aspergiloza oskrzelowo- płucna najczęściej występuje u chorych na astmę steroidozależną (1–2% chorych) lub mukowiscydozę (5–15% chorych). Bardzo rzadko chorobę rozpoznaje się u osób bez astmy oskrzelowej. W niniejszej pracy przedstawiono przypadek ABPA u 45-letniej chorej, diagnozowanej wstępnie z powodu podejrzenia raka płuca lewego z poszerzeniem wnęki, u której nigdy nie rozpoznawano astmy oskrzelowej. Po wykonaniu badań rozpoznano ABPA i wdrożono leczenie z poprawą kliniczną, radiologiczną i obniżeniem stężenia immunoglobulin E (IgE). Pneumonol. Alergol. Pol. 2011; 80, 1: 77–81Allergic bronchopulmonary aspergillosis (ABPA) is a lung disease caused by a hypersensitivity reaction to antigens of the Aspergillus species (most frequently Aspergillus fumigatus), with a variable radiographic appearance. ABPA most commonly affects patients with steroid-dependent asthma (1–2%) and patients with cystic fibrosis (5–15%). ABPA is very rarely diagnosed in non-asthmatics. We report a case of ABPA in a 45-year-old female initially evaluated for suspected cancer of the left lung with hilar lymphadenopathy, who had never been diagnosed with asthma. After the diagnostic investigation was complete, the diagnosis of ABPA was established and appropriate treatment was instituted leading to clinical, radiological, and serological improvement (IgE decrease)

Adverse reaction after transfusion of Red Blood Cells in a patient aged 97 years - case report

During hospitalization 97 years old patient had blood transfusion. This procedure lead to overload of cardiovascular system. Pharmacotherapy gradually improved the general condition of the patient. The patient was discharged in a stable state. Doubts arise; when blood should be transfused, in which cases should a blood transfusion be discontinued, what should be the recommendation for a blood transfusion for older people over the age of 90. There is a need for further research in geriatrics regarding the transfusion of blood and its components

Risk factors for cesarean section after using the Foley catheter for labor induction

Objective: The aim of the study was to investigate the value of the Bishop score and ultrasound examination of the cervix in predicting the success of labor induction with the use of the Foley catheter determined by the mode of delivery. Material and methods: Foley catheter induction of labor was performed in 135 pregnancies between 38 to 42 weeks gestation. The study group was divided into two groups, depending of the mode of delivery: vaginal vs. cesarean. Results: The Bishop score was significantly higher in the vaginal delivery group when compared to the caesarean section group (5.2; 95%CI: 4.4 – 6.2 vs. 3.9; 95%CI: 2.8-4.9). Cervical length was not statistically significantly different between the two groups. Multivariate logistic regression showed that patient-specific risk for caesarean section decreases with increasing maternal age and the Bishop score (Detection Rate [DR] of 52% at fixed False Positive Rate [FPR] of 10%). Conclusions: Failure of labor induction with the use of the Foley catheter can be predicted by maternal age and pre-induction Bishop score

Management of blood infection caused by colonization of the vascular port with klebsiella variicola in case of patient treated with palliative chemotherapy

Klebsiella variicola is a bacterial species that was originally identified as a mild endosymbiont in plants, it occurs in humans and cattle. It is a bacterium that has been discovered relatively recently and research on the broader understanding of the pathogen is still underway. Vascular catheters are very often used to receive chemotherapy by patients. The purpose of this work was to present the management of blood infection caused by colonization of the vascular port with klebsiella varicola. The material described can be used to conduct patient pharmacotherapy. Care for a patient with a vascular port should be developed. There is a need to conduct staff training on: proper care and use of the vascular port and Huber needle for pharmacotherapy. Huber needles could be standard material in the list of required equipment in hospital wards to improve patient care with a vascular port

Health behaviour in a group of the 6th year medical students

Wstęp. Rola lekarza nie powinna ograniczać się wyłącznie do zaleceń ściśle związanych z terapią, gdyż lekarz, promując zachowania prozdrowotne, powinien jednocześnie stanowić wzór dla swoich podopiecznych. Cel pracy. Celem badania była ocena zachowań prozdrowotnych studentów VI roku studiów medycznych. Materiał i metody. Autorski kwestionariusz przeprowadzono w grupie 200 studentów VI roku Wydziału Lekarskiego Gdańskiego Uniwersytetu Medycznego w latach akademickich 2013/2014 oraz 2014/2015. Wyniki. Średnie BMI wynosiło 22,2 (SD ± 2,934). 14,5 % (29 studentów) miało nadmierną masę ciała. 79% studentów jadało codziennie śniada­nia. Zapytani o częstość spożywania posiłków studenci najczęściej wskazywali na obiady domowe. 71,5% jadało je minimum 5 razy w tygodniu. Ćwiczenia fizyczne zajmowały średnio 222 minuty tygodniowo (SD ± 152,171). 82,5% osób nie paliło papierosów. Wnioski. Studenci VI roku prowadzą stosunkowo zdrowy styl życia — prawidłowo się odżywiają i uprawiają aktywność fizyczną. Większość studentów ma prawidłową masę ciała. Można zatem wnioskować, że będą dobrym przykładem dla swoich przyszłych pacjentów.Introduction. The role of a physician is not only connected with treatment but also with being a good example for their patients. Aim of the study. The aim of the study was the evaluation of health habits of medical students on the last year of studies. Material and methods. 200 students were questioned within two consecutive academic years. Authors’ own questionnaire was used. Results. Mean BMI of the participating students was 22.2 (SD ± 2.934). 14.5% were overweight. 79% students ate breakfasts every day. 71.5% had dinners at home at least five times a week. Students spent averagely 222 minutes weekly on physical activity. 82.5% students were non-smokers. Conclusions. The lifestyle of students of the 6th year of medical studies is healthy. Students seem to be a good example for their future patients

Exercise-induced motor improvement after complete spinal cord transection and its relation to expression of brain-derived neurotrophic factor and presynaptic markers

<p>Abstract</p> <p>Background</p> <p>It has been postulated that exercise-induced activation of brain-derived neurotrophic factor (BDNF) may account for improvement of stepping ability in animals after complete spinal cord transection. As we have shown previously, treadmill locomotor exercise leads to up-regulation of BDNF protein and mRNA in the entire neuronal network of intact spinal cord. The questions arise: (i) how the treadmill locomotor training, supplemented with tail stimulation, affects the expression of molecular correlates of synaptic plasticity in spinal rats, and (ii) if a response is related to BDNF protein level and distribution.</p> <p>We investigated the effect of training in rats spinalized at low thoracic segments on the level and distribution of BDNF immunoreactivity (IR) in ventral quadrants of the lumbar segments, in conjunction with markers of presynaptic terminals, synaptophysin and synaptic zinc.</p> <p>Results</p> <p>Training improved hindlimb stepping in spinal animals evaluated with modified Basso-Beattie-Bresnahan scale. Grades of spinal trained animals ranged between 5 and 11, whereas those of spinal were between 2 and 4. Functional improvement was associated with changes in presynaptic markers and BDNF distribution. Six weeks after transection, synaptophysin IR was reduced by 18% around the large neurons of lamina IX and training elevated its expression by over 30%. The level of synaptic zinc staining in the ventral horn was unaltered, whereas in ventral funiculi it was decreased by 26% postlesion and tended to normalize after the training. Overall BDNF IR levels in the ventral horn, which were higher by 22% postlesion, were unchanged after the training. However, training modified distribution of BDNF in the processes with its predominance in the longer and thicker ones. It also caused selective up-regulation of BDNF in two classes of cells (soma ranging between 100-400 μm²and over 1000 μm²) of the ventrolateral and laterodorsal motor nuclei.</p> <p>Conclusion</p> <p>Our results show that it is not BDNF deficit that determines lack of functional improvement in spinal animals. They indicate selectivity of up-regulation of BDNF in distinct subpopulations of cells in the motor nuclei which leads to changes of innervation targeting motoneurons, tuned up by locomotor activity as indicated by a region-specific increase of presynaptic markers.</p

Exploring lipophilic antioxidants accumulation in field-grown low temperature-stressed Ephedra monosperma

The seasonal patterns of changes in the content of lipophilic antioxidants $\beta$-carotene ($\beta$-Car), zeaxanthin (Zx), $\alpha$-tocopherol ($\alpha$-Toc), plastoquinone (PQ)/plastoquinol ($PQH_{2}$) were studied in the assimilating shoots of evergreen shrub Ephedra monosperma J.G. Gmel ex C.A. Mey under natural conditions of Central Yakutia. The shortening of the photoperiod and the seasonal decrease in temperature induced a 1.4-fold increase in $\alpha$-Toc content. The fall in the average daily temperature from 0.1 to $-8.1^{\circ}C$ in October led to a decrease in the content of $\beta$-Car as a result of the accumulation of rhodoxanthin (Rhd). In this period a sharp increase in the content of Zx retained overnight was also detected. In winter, elevated content of Zx and $\alpha$-Toc persisted. During September, the content of PQH2 increased by 2.5 times and PQ by 1.4 times (compared to July). The beginning of exposure to freezing average daily temperatures from -3 to $-5^{\circ}C$ led to the depletion of the total PQ pool by 18%. However, the content of $PQ_{tot}$ in the winter months was 1.5 times higher than at the end of July. The results revealed different timing and temperature ranges of variation for individual antioxidants during the development of frost resistance in ephedra