Ginekologia polska最新文献

Objectives: This study aimed to investigate the relationship between controlling nutritional status index (CONUT) and prognostic nutrition index (PNI) scores that are used to evaluate nutritional status and GDM. Also, lipid abnormalities and albumin levels in pregnant women with normal glucose tolerance and GDM were researched.

Material and methods: This study was conducted as a retrospective study at Ankara Etlik City Hospital, Turkey. The study included 67 pregnant women with singleton pregnancies (32 pregnant diagnosed with GDM and 35 pregnant known to be normoglycemic).

Results: There were no statistical differences between the groups in terms of maternal age, gravidity, parity, history of miscarriage and weight gain during pregnancy. Body mass index (BMI) was higher in the GDM group (p = 0.001). There was no difference in the CONUT score between the groups (p = 0.254). The PNI score was lower in the GDM group (p = 0.003). Of the laboratory data, only fasting blood glucose, triglycerides (TG) and total cholesterol (TC) were statistically significantly higher, and albumin was lower in the GDM group (p = 0.026, p = 0.007, p = 0.003 and p = 0.003, respectively).

Conclusions: PNI has the potential to be a useful predictor of GDM, whereas CONUT does not. Low albumin levels and increased TG, and TC in the first trimester seem to be significant in the development of GDM.

Objectives: Endometriosis is a common chronic disease in childbearing women and a major cause of infertility. Our study aimed to identify and validate a novel gene signature for diagnosing endometriosis based on histone-related genes (HRGs), and to investigate their biological functions in endometriosis.

Material and methods: RNA sequence data were downloaded from the Gene Expression Omnibus database, and HRGs were retrieved from the GeneCards database. We identified differentially expressed genes using the limma package, and constructed a diagnostic model using the rms package. Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment analyses were performed for visualization, annotation, and integrated discovery. Subsequently, we validated the model using the recall and decision curve analysis (DCA). Additionally, we analyzed the immune microenvironment features using CIBERSORT.

Results: A total of 18 differentially expressed HRGs were identified in patients with endometriosis compared with controls. GO and KEGG enrichment was mainly in spindle organization, positive regulation of the cell cycle process, progesterone-mediated oocyte maturation, and cellular senescence and cell cycle. We obtained a signature of four HRGs (JUNB, FRY, LMNB1, and SPAG1). DCA revealed that the diagnostic model benefits patients with endometriosis, regardless of the incidence. CIBERSORT analysis showed that the number of plasma cells increased significantly in endometriosis samples from all four datasets.

Conclusions: Our findings provide novel insights into the function of HRGs in the development of endometriosis and identify a new signature of four HRGs that may serve as valuable diagnostic markers and therapeutic targets for this disease.

Objectives: to explore the opinions of pregnant and postpartum women on the services provided via remotely conducted consultation and to assess the sense of security of patients under the care conducted remotely my midwives and gynecologists.

Material and methods: An anonymous, self-administered survey questionnaire was completed by 86 women who had at least one telephone consultation with a gynecologist or midwife during pregnancy or after birth. The questionnaire was spread via social media between February 1 and August 1, 2022.

Results: More than half of the surveyed group (51.2%) had 1-3 consultations performed remotely during pregnancy and 53.5% after birth. Phone call only was the most popular form of remote consultations performed during pregnancy (69.8%) and after birth (43.0%). Simple app was used in 10.5% consultations during pregnancy and 4.7% after birth. The predominant reason of the remotely conducted consultation during pregnancy and after birth was the need of getting the prescription or consultation of blood/urine test results (61.6%). Although phone-made medical consultations were a convenience and time-saver for most women, the preferred form of visit is to meet the caregiver in person.

Conclusions: Special times, such pandemic was, requires a different, individual approach, and perhaps thanks to these experiences we will be able to behave wiser in future states of public health emergency. Teleconsultations were an acceptable form of medical consultation to discuss the results, effects of treatment or to write a referral or prescription.

Objectives: Human papillomavirus (HPV) is a prevalent sexually transmitted infection with significant implications for public health. In Poland, a nationwide vaccination program offers a choice between the 9-valent (9v) and 2-valent (2v) HPV vaccines. We aimed to assess the cost-effectiveness of the 9v vs 2v vaccine from the public payer perspective in Poland.

Material and methods: A cost-effectiveness analysis was conducted to compare the public health and economic benefits of using 9v vs 2v vaccine in Poland over 100-year horizon using a previously published deterministic dynamic transmission model. A target population of girls and boys aged 12-13 years was considered. The model was populated with local epidemiological inputs, utilities, and costs, including vaccine and administration costs, as well as costs related to medical procedures for HPV-related diseases.

Results: The 9v vaccine reduced the prevalence of HPV infections and HPV-related diseases substantially more than 2v vaccine when both are compared to no vaccination strategy. The total discounted cost savings of using the 9v vaccine instead of 2v, excluding the vaccine costs, amounted to EUR 66 million. The incremental cost-effectiveness ratio amounted to 8094 EUR per quality-adjusted life year, much below the official cost-effectiveness threshold in Poland set up at the three times the annual gross domestic product per capita. 9v cost-effectiveness ratio remained unchanged when shorter time-horizons of 20, 40, 60, or 80 years were considered.

Conclusions: Using 9v HPV vaccine in Poland is highly cost-effective compared to the 2v vaccine.

Objectives: We aimed to study the values of ultrasound elastography (UE) and progesterone receptor (PR) proteins for the diagnosis and prognostic evaluation of uterine fibroid (UF).

Material and methods: A total of 200 UF patients treated from January 2020 to June 2023 were selected as a UF group, and another 100 healthy women as a healthy group. Routine ultrasound parameters uterine artery pulsatility index (PI), resistance index (RI), and UE parameter strain ratio (SR) were obtained. The relative protein expressions of PRA and PRB in the peripheral blood were detected by Western blotting. The differences in these parameters and relative protein expressions of PRA and PRB were compared. The UF patients were divided into a cure group (n = 159) and a recurrence group (n = 41) according to their prognosis.

Results: The protein expressions of PRA and PRB in the UF group were higher than those in the healthy group (p < 0.05). In the recurrence group, PI and RI were lower, while SR and the protein expressions of PRA and PRB were higher than those in the cure group (p < 0.05). Age at menarche < 13 years old, intramural fibroid, PI, RI, SR, PRA, and PRB were risk factors for recurrence in UF patients (p < 0.05). The efficiency of combination of ultrasound and UE parameters, PRA and PRB for the diagnosis and prognostic evaluation of UF was significantly higher than that of any single indicator ( p < 0.05).

Conclusions: Ultrasound and UE parameters combined with PR proteins have high efficiency for the diagnosis and prognostic evaluation of UF.

Objectives: The main goal is to analyze factors related to brachial plexus injury (BPI) after Shoulder Dystocia (SD).

Material and methods: Longitudinal prospective analysis of SD arose in a tertiary hospital from 1/1st/ 2019 to 12/31st/ 2020. A multivariable logistic regression for BPI after SD and a survival analysis for BPI recovery after SD were performed.

Results: In this period 13,414 deliveries were attended, 10,676 of those were vaginal deliveries (79.6%) reporting 69 cases of SD, with an incidence of 0.65%. SD required 102.1 seconds (SD) 10.8) as an average for solving it. Internal maneuvers were needed in 42.0% of SD reported. Neonatal BPI was suspected in 23 newborns (33.3%) at birth. Neonatal BPI at 48 hours of life was statistically associated with maternal BMI above 30 kg/m² (OR = 7.91; CI95% 1.3-47.7; p = 0.024), > 120 seconds for solving SD (OR = 14.4; CI95% 1.7-121.82; p = 0.014) and operative delivery (OR = 6.8; CI 95% 1.2-37.6; p = 0.028). The BPI recovery was statistically associated with clavicle fracture (HR = 0.31 CI95% 0.10-0.96 p = 0.042) and specific rehabilitation treatment (HR = 9.2 CI 95% 1.87-45.23 p = 0.006).

Conclusions: The following factors were associated with neonatal BPI at 48 hours of life: Maternal BMI above 30 kg/m², operative delivery, or shoulder dystocia that requires more than 120 seconds for solving it. The BPI recovery was associated with clavicle fracture and specific rehabilitation treatment.

Objectives: Endometriosis is a complex, chronic inflammatory disease in which immune system disorders play an important role. Soluble mediators of the immune and inflammatory response, including cytokines, are involved in these processes. Therefore, the aim of the conducted research was to understand the role of selected cytokines belonging to the Interleukin-1(IL-1) family, including IL-36α, IL-36β, IL-36γ, IL-36R, IL-37 and IL-38, in the onset and development of endometriosis by analysing the concentration of the tested molecules and to determine whether their concentration depends on the stage of the disease.

Material and methods: The study group included 60 women who had pelvic endometriosis diagnosed during laparoscopy and subsequently confirmed by histopathology. The reference group consisted of 20 women who had no endometriosis or other pelvic lesions during laparoscopy.

Results: Immunoenzymatic assays were used to determine the concentration of the cytokines studied. In the peritoneal fluid of women with endometriosis, a statistically significant increase in the concentrations of all parameters tested was observed: IL-36α, IL-36β, IL-36γ, IL-36R, IL-37 and IL-38. The concentration of these cytokines depended on the severity of the disease.

Conclusions: Disturbances of the immune system involving the network of cytokines belonging to the IL-1 family occurring in the peritoneal fluid environment testify to the involvement of these molecules in the development of the disease and are one of many factors involved in the pathogenesis of endometriosis. The use of some of them in the treatment of endometriosis may be a hope for effective causal treatment of this disease, but this requires further, more advanced research.