Ginekologia polska最新文献

Sperm DNA integrity assessment provides essential information that traditional semen parameters may not detect. Studies indicate that DNA fragmentation is an independent indicator of semen quality and fertility, which can explain cases of male infertility, especially when basic semen tests show normal results. Using sperm DNA fragmentation assessment techniques should be considered as an addition to traditional semen tests in male infertility diagnostics.

Objectives: Some studies indicate the role of transforming growth factor-beta 1 (TGF-beta 1) in the development of endometriosis. However, the lack is studies assessed its plasma levels as a biomarker of endometrioma. Therefore, this study aimed to analyze plasma, peritoneal, and endometrioma fluid TGF-beta 1 concentrations in women operated on for ovarian endometriosis.

Material and methods: A cross-sectional cohort study involved 56 women operated on for ovarian endometriosis. Body mass, height, and waist circumference were measured, as well as body mass index (BMI) being calculated. Plasma, peritoneal, and endometrioma fluid TGF-beta 1 concentrations were determined by enzyme-linked immunosorbent assay (ELISA).

Results: Levels TGF-beta 1 were significantly higher in plasma than in both fluids (1286.1 pg/mL vs 114.7 pg/mL; p < 0.001 and 114.7 pg/mL vs 33.6 pg/mL; p < 0.001) and in endometrioma fluid than in peritoneal fluid (114.7 pg/mL vs 33.6 pg/mL; p < 0.001). There were also positive correlations between TGF-beta 1 levels in endometrioma and peritoneal fluids and plasma (r = 0.46; p < 0.001; r = 0.30; p < 0.05, respectively). There were no associations between TGF-beta 1 in plasma, endometrioma, peritoneal fluid, and endometriosis stage.

Conclusions: Our results suggest that plasma TGF-beta 1 concentration can be considered as a biomarker of endometrioma.

Objectives: Irisin is an adipomyokine that has an inhibitory effect on inflammation and possesses anticancer activity. It inhibits cancer cell proliferation, metastasis, and invasion through various signaling pathways associated with carcinogenesis. It has been described to be associated with a number of malignancies in various locations. It has been recognized that it may be a biomarker and prognostic factor in some malignancies. In addition, studies indicate irisin's possible role in treating malignant lesions.

Material and methods: In material including 129 cases of endometrial cancer and normal endometrium in a control group of 18 women with uterine myomas.

Results: There were no statistical differences in irisin protein expression. There were also no differences in irisin expression according to clinical stage, type, and histopathological differentiation.

Conclusions: Further clinical studies are needed to evaluate irisin activity in endometrial cancer.

Objectives: Pregnant women are at higher risk of severe course of COVID-19. The vaccination against COVID-19 is recommended in pregnant and breastfeeding women. The aim of the study was to assess the attitude towards vaccination against COVID-19 among Polish pregnant or breastfeeding women.

Material and methods: A cross-sectional survey study was performed from April 20th, 2021, to October 23rd, 2021, using an online questionnaire distributed via social media. Women who weren't Polish or didn't live in Poland were excluded from the study.

Results: The study group consisted of 662 women. Their median age was 32.5 years (interquartile range IQR: 27.25-33.75 years). Most of the women lived in acity with over 500000 inhabitants (333/662, 50.30%), were in a relationship (658/662, 99.40%), had higher education (559/662, 84.44%), were currently employed (326/662, 49.25%), but not in a medical field (574/662, 86.71%). Willingness to be vaccinated was expressed in 231/662 (34.89%) of the surveyed women. A positive attitude towards vaccinations was more common among women working in the medical field (p = 0.006679), with higher education (p = 0.000054), who trusted their doctors (p = 0.003900), thought that vaccines against COVID-19 were effective (p < 0.00001), and those afraid of COVID-19 (p < 0.00001).

Conclusions: The study showed that only one third of the surveyed women wanted to be vaccinated against COVID-19. Women working in the medical field, with higher education, who trusted their doctors, thought that vaccines against COVID-19 were effective, and those afraid of COVID-19 were more prone to be vaccinated against COVID-19 with recommended vaccines. Educational role of healthcare workers might be crucial for increasing the COVID-19 vaccine coverage in pregnant and breastfeeding women.

Objectives: To evaluate the role of human chorionic gonadotropin (hCG) change in the 48 h prior to methotrexate treatment as a predictor for treatment success of ectopic pregnancy.

Material and methods: This was a retrospective cohort study. A total of 179 women who diagnosed with ectopic pregnancy and given a single dose (50 mg/m²) of methotrexate were included in this study from January 1, 2016 to December 31, 2017. Serum hCG levels and clinical data were collected and compared between the success and failure groups, the percentage increment of hCG levels during the 48 hours prior to methotrexate injection was used to create a receiver operating characteristic (ROC) curve to determine the optimal cut-off value for predicting treatment success.

Results: The success rate of treating ectopic pregnancy with a single dose of methotrexate was 70.9%. The optimal cut-off value for percentage increment of serum hCG levels before methotrexate injection was determined to be 12.56%, with a specificity of 60.66% and sensitivity of 55.69%. The area under the receiver operating characteristic curve (AUC) was 0.646 (p < 0.01).

Conclusions: A lower 2-day hCG percentage increment before methotrexate injection was found to be associated with successful treatment of ectopic pregnancy, with a cut-off value of 12.56%. However, caution should be exercised when deciding on methotrexate treatment versus surgery for ectopic pregnancy patients.

Objectives: To assess alexithymia and affective temperament in patients with polycystic ovary syndrome (PCOS) and compare these patients to a group of patients undergoing endocrinological evaluation without a diagnosis of PCOS (non-PCOS). Additionally, the study explored the relationship between affective temperament, alexithymia, body mass index (BMI), and the severity of hirsutism in the PCOS group.

Material and methods: A total of 46 patients with PCOS and 28 non-PCOS patients were recruited for the study. All participants underwent endocrinological and gynecological diagnostics. Alexithymia was assessed using the TAS-20 questionnaire, while affective temperament was evaluated with the TEMPS-A questionnaire.

Results: Both PCOS and non-PCOS patients were found to fall within the "intermediate alexithymic" range. Patients with PCOS exhibited more pronounced cyclothymic temperament (p=0,019), and the difference in irritable temperament was close to statistical significance (p=0,072). In a stepwise linear regression analysis, total alexithymia emerged as a statistically significant positive predictor of BMI in PCOS group (β=0.368, p=0.012).

Conclusions: Patients with PCOS exhibit higher cyclothymic temperament compared to the non-PCOS group. Both groups show "intermediate alexithymia", which could impact treatment adherence and mental health, highlighting the importance of psychological interventions for improving outcomes and quality of life.

Objectives: In recent years, advances in prenatal diagnostics have enabled the identification of congenital abnormalities, including genetically determined disorders, at an early stage of fetal development. Diagnosing a lethal fetal anomaly affects the entire family and is often a traumatic experience for the parents. Perinatal palliative care provided by perinatal hospice is a model of specialized care for families following the prenatal diagnosis of a lethal fetal condition.

Material and methods: After ten years of operation, we analyzed the perinatal palliative care protocol implemented in the Hospital of the Brothers Hospitallers in Katowice, a part of Bonifratres Medical Centre.

Results: We aimed to present the model of perinatal and postnatal care developed at the hospital for families receiving such support in the Silesian agglomeration.

Conclusions: We also wanted to show the importance of perinatal palliative care provided by one team from the prenatal period through delivery until the child's death or until the pediatric hospice provides the care of the child.

Objectives: The French Ambulatory Cesarean Section (FAUCS) is an extraperitoneal cesarean technique aimed at enhancing maternal recovery and reducing postoperative morbidity. While early trials suggest certain benefits over conventional cesarean section (CS), real-world data remains scarce. This study compares maternal and neonatal outcomes between FAUCS and CS in a prospective cohort, with emphasis on perioperative recovery.

Material and methods: This prospective study included women undergoing elective cesarean section (FAUCS or CS) at term (37-40 Hbd) between September 2023 and December 2024. Maternal outcomes included surgery duration, blood loss, time to mobilization, food oral intake, and initiation of breastfeeding. Neonatal outcomes included birth weight, Apgar scores, and umbilical cord arterial pH. Comparisons used t-tests, Wilcoxon tests, or Chi-square tests (p < 0.05; analysis in R).

Results: Sixty-six patients were included (FAUCS: 30; CS: 36). Baseline maternal or obstetric characteristics were comparable. No differences were found in gestational age or birthweight. FAUCS neonates had marginally lower umbilical pH (7.33 ± 0.07 vs 7.36 ± 0.06, p = 0.009). No difference was found in Apgar scores. FAUCS was associated with longer surgery (30.7 ± 4.1 min vs 26.4 ± 10.3 min, p = 0.006), but significantly faster mobilization, food oral intake, and breastfeeding (all p < 0.001). Fundal pressure was used less often (p < 0.001), and instrumental assistance more frequently (p < 0.001) in FACUS. The use of weak opioids was also lower (p = 0.036). The hospital stay was similar.

Conclusions: FAUCS appears to enhance early recovery without compromising maternal or neonatal outcomes, supporting its use in select patients.