Intrauterine deaths - an unsolved problem in Polish perinatology.

OBJECTIVES: The Polish criteria for "intrauterine death" include fetal demise after 22 weeks of gestation, weighing > 500 g and body length at least 25 cm, when the gestational age is unknown. The rate of fetal death in Poland in 2015 is 3:10,000. In 2020, 1,231 stillbirths were registered. MATERIAL AND METHODS: An analysis using 142,662 births in the period between 2015-2020 in 11 living in Poland. The first subgroup was admitted as patients > 22 to the beginning of the 30th week of pregnancy (n = 229), and the second from the 30th week of pregnancy inclusively (n = 179). In the case of women from both subgroups, there was a risk of preterm delivery close to hospitalization. RESULTS: It was found that stillbirth in 41% of women in the first pregnancy. For the patient, stillbirth was also the first in his life. The average stillbirth weight was 1487 g, the average body length was 40 cm. Among fetuses up to 30 weeks, male fetuses are born more often, in subgroup II, the sex of the child was usually female. Most fetal deaths occur in mothers < 15 and > 45 years of age. CONCLUSIONS: According to the Polish results of the origin of full-term fetuses > 30 weeks of gestation for death in the concomitant antenatal, such as placental-umbilical and fetal hypoxia, acute intrapartum effects rarely, and moreover < 30 Hbd fetal growth restriction (FGR), occurring placental-umbilical, acute intrapartum often.

From Biomarkers to the Molecular Mechanism of Preeclampsia-A Comprehensive Literature Review.

Preeclampsia (PE) is a prevalent obstetric illness affecting pregnant women worldwide. This comprehensive literature review aims to examine the role of biomarkers and understand the molecular mechanisms underlying PE. The review encompasses studies on biomarkers for predicting, diagnosing, and monitoring PE, focusing on their molecular mechanisms in maternal blood or urine samples. Past research has advanced our understanding of PE pathogenesis, but the etiology remains unclear. Biomarkers such as PlGF, sFlt-1, PP-13, and PAPP-A have shown promise in risk classification and preventive measures, although challenges exist, including low detection rates and discrepancies in predicting different PE subtypes. Future perspectives highlight the importance of larger prospective studies to explore predictive biomarkers and their molecular mechanisms, improving screening efficacy and distinguishing between early-onset and late-onset PE. Biomarker assessments offer reliable and cost-effective screening methods for early detection, prognosis, and monitoring of PE. Early identification of high-risk women enables timely intervention, preventing adverse outcomes. Further research is needed to validate and optimize biomarker models for accurate prediction and diagnosis, ultimately improving maternal and fetal health outcomes.

Differences in Velocities of Crucial Body Segments while Executing Roundhouse Kicks for Both Sides.

Lower limb kinematics of the roundhouse kick is a well-known topic studied by many researchers. However, there is a lack of data about the velocity of the core and upper limbs during the execution of this technique. The aim of this study was to evaluate the differences in velocities of all crucial body segments while executing roundhouse kicks for both sides of the body. Thirteen elite taekwon-do athletes participated in this study. They performed kicks to a table tennis ball three times using each leg. The spatial-temporal data of markers placed on toes, knees, hips, shoulders, elbows, hands, and sternum were captured with the use of the Human Motion Lab equipment composed of 10 infrared cameras NIR Vicon MX-T40. There were statistical differences in the maximal velocity of the sternum and opposite shoulder. There were different correlations between the time of acquiring maximal velocities of specific body segments and the maximal velocity of the toe marker for each kicking side. Higher correlations were observed for the left kick despite the participant's declaration of their preference for the right leg. The obtained results facilitate the conclusion that small non-resistant targets require different motor control depending on the kicking side, despite not revealing significant differences between maximal velocity. While such an indicator could be perceived as a suitable benchmark of an athlete's performance, more detailed analysis seems to be required for a better understanding of martial arts techniques.

Influence of gestational diabetes mellitus on outcomes of preinduced labour with dinoprostone vaginal insert.

OBJECTIVES: The aim of this study was to evaluate the effectiveness of labour preinduction using a dinoprostone vaginal insert in patients with gestational diabetes mellitus versus patients undergoing labour induction for other causes. The second aim of the study was to compare perinatal outcomes in both groups. MATERIAL AND METHODS: The study has a retrospective character, conducted in 2019-2021 in a tertiary reference hospital. The following endpoints were assumed for the analysis: natural childbirth, birth occurring within 12 hours of dinoprostone administration and neonatal outcomes. Furthermore, indications of a Caesarean section were analysed. RESULTS: The percentage of natural childbirths was similar in both groups. Furthermore, in both groups, over 80% of patients gave birth within less than 12 hours following dinoprostone administration. Neonatal outcomes (body weight, Apgar score) did not differ statistically. Analysing indications for a Caesarean section, failure in the progress of labour was an indication in 39.5% of cases in the control group, 29.4% of cases in gestational diabetes mellitus (GDM), and 50% of cases in diabetes mellitus (DM). The risk of foetal asphyxia was an indication in 55.8% of cases in the control group, 35.3% of cases in GDM and 50% of cases in DM. Ineffective labour induction - no induction of the contractile function was an indication for a C-section in 4.7% of cases in the control group and 35.3% of cases in GDM; no cases were noted in DM (p = 0.024). CONCLUSIONS: The study demonstrated that patients undergoing labour induction due to GDM using a dinoprostone vaginal insert did not differ in terms of labour duration, oxytocin administration compared to patients undergoing labour induction for other causes. Furthermore, the same rate of Caesarean sections was found in the study group; however, these groups differ in terms of indications, including risk of foetal asphyxia (35.3% vs 55.8%), failure in the progress of labour (29.4% vs 39.5%), and no active labour (1.8% vs 1.5%). The neonatal Apgar score at 1.5 and 10 minutes after birth was similar in both groups.

Birth Weight < 3rd Percentile Prediction Using Additional Biochemical Markers-The Uric Acid Level and Angiogenesis Markers (sFlt-1, PlGF)-An Exploratory Study.

(1) Aim: Ultrasound is the gold standard for assessing fetal growth disorders. The relationship between high sFlt-1/PlGF scores and LBW (low birth weight) was described. In this study, we attempted to assess whether uric acid could be used as a secondary marker in estimating the pregnancy risk associated with LBW. (2) Material and methods: 665 pregnant women with a suspected or confirmed form of placental insufficiency were enrolled. In each of the patients, sFlt-1 and PlGF and uric acid levels were determined. Patients were divided into two groups according to birth weight below and above the third percentile for the given gestational age with the criteria of the neonatal definition of FGR (fetal growth restriction). (3) Results: A significant negative correlation between neonatal birth weight and the uric acid level across the entire study group was observed. We found a significant negative correlation between neonatal birth weight and the uric acid level with birth weights < 3rd percentile. (4) Conclusions: There is a significant link between the uric acid concentration and LBW in the group with placental insufficiency. Uric acid can improve the prediction of LBW. An algorithm for LBW prognosis that makes use of biophysical (ultrasound) and biochemical (uric acid level, angiogenesis markers) parameters yields better results than using these parameters separately from each other.

Uterine Myomas and Sarcomas - Clinical and Ultrasound Characteristics and Differential Diagnosis Using Pulsed and Color Doppler Techniques.

Uterine tumors are a challenge encountered by every gynecologist in clinical practice. In the era of increasing incidence of endometrial cancer in the general population of women at reproductive age, compared to other genital malignancies, we should not forget about other tumors originating from the mucous and muscular layer of the uterus. Clear ultrasonographic differentiation of uterine tumors into benign (myomas) and malignant (sarcomas) lesions may sometimes prove impossible. Myomas, the most common uterine tumors, are characterized by discrete vascularization on color Doppler and high blood flow velocity as well as the lack of early diastolic notch on Doppler ultrasound. Sarcomas, on the other hand, show characteristic rich vascularization. Rapid tumor growth should also be noted when making the diagnosis. There are multiple known causes of uterine tumors. So far, no clear Doppler flow markers have been identified to characterize benign and malignant lesions.

Increased Risk of COVID-19 in Patients with Diabetes Mellitus-Current Challenges in Pathophysiology, Treatment and Prevention.

Coronavirus disease-COVID-19 (coronavirus disease 2019) has become the cause of the global pandemic in the last three years. Its etiological factor is SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus type 2). Patients with diabetes (DM-diabetes mellitus), in contrast to healthy people not suffering from chronic diseases, are characterised by higher morbidity and mortality due to COVID-19. Patients who test positive for SARCoV-2 are at higher risk of developing hyperglycaemia. In this paper, we present, analyse and summarize the data on possible mechanisms underlying the increased susceptibility and mortality of patients with diabetes mellitus in the case of SARS-CoV-2 infection. However, further research is required to determine the optimal therapeutic management of patients with diabetes and COVID-19.

Approach of Pregnant Women from Poland and the Ukraine to COVID-19 Vaccination-The Role of Medical Consultation.

There are many arguments for the safety and efficacy of COVID-19 vaccines in pregnancy. The aim of this study is to describe the level of vaccination acceptance, to find the factors that most influence the decision to vaccinate, and to describe the scale of changes in vaccination acceptance influenced by medical information on the safety, efficacy, and benefits of vaccination among pregnant women. A total of 300 patients completed the questionnaire, including 150 in Poland and 150 in the Ukraine. The level of vaccination acceptance was assessed before and after medical consultation. There were 53 (35.3%) patients with the intention to get vaccinated in Poland and 25 (16.7%) in the Ukraine. After consultation with a physician, this increased to 109 (72.6%) in Poland and 69 (46%) in the Ukraine. The main factors influencing the acceptance of vaccinations were the fear of harming the foetus (OR-0.119, CI-0.039-0.324 p < 0.001), complications in pregnancy (OR-0.073 CI-0.023-0.197 p < 0.001), and limitations in the vaccination programme (OR-0.026 CI-0.001-0.207 p < 0.001). Medical information about the safety, effectiveness and benefits of vaccinations among pregnant women, provided during a medical visit, may increase the acceptance of vaccinations by 105.6%, as among Polish patients, and by 176%, as among pregnant women from the Ukraine.

Kinematic Effects of the Target on the Velocity of Taekwon-Do Roundhouse Kicks.

The phenomena of target kinematic effects under different striking conditions and applying different techniques constitute one of the fields of research for sports biomechanics. However, the influence of some kinematic variables which change under different strike conditions for specific parts of the lower limb remains unknown. The aim of this study was to extend the knowledge on how targets of different shapes or the lack of a physical target would affect maximal velocity registered by a marker placed on the foot, knee and hip during the execution of a roundhouse kick. In total, 15 adult males were included in this study. All participants were taekwon-do elite athletes. The displacement of markers placed on the lateral side of the foot, knee and hip during movement execution was registered by a stereophotogrammetry apparatus. Participants performed taekwon-do roundhouse kicks for three target types (into the air, a table tennis ball and a training shield) applying either a sport or a traditional style. The highest maximal velocity was obtained for kicking into the training shield. When applying the sport style, the highest maximal velocity of foot markers for the executed kicks was registered. Kicking into air resulted in higher velocities for proximal body parts than kicking into a tennis ball, but the effect was reversed for the foot marker. In conclusion, a large resistance target is suitable for athletes' motor preparation as it allows the highest maximum velocity to be reached. Small non-resistant targets are recommended for technical training.

The Approach of Pregnant Women to Vaccination Based on a COVID-19 Systematic Review.

Background and Objectives: Pregnant women are more likely to develop a more severe course of COVID-19 than their non-pregnant peers. There are many arguments for the safety and efficacy of COVID-19 vaccines in pregnant women. The aim of this study is to conduct a systematic review concerning the approach of pregnant women towards vaccination against COVID-19, with particular regard to determinants of vaccination acceptance. Materials and Methods: Articles were reviewed in which the aim was to evaluate-via a survey or questionnaire-the acceptance and decision to undergo vaccination against COVID-19. The articles were subjected to review according to recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). Results: In various studies, the percentage of pregnant women accepting the COVID-19 vaccine was between 29.7% and 77.4%. The strongest factors co-existing with the acceptance of the COVID-19 vaccination in pregnancy were trust in the importance and effectiveness of the vaccine, explicit communication about the safety of COVID-19 vaccines for pregnant women, acceptance of other vaccinations such as those for influenza, belief in the importance of vaccines/mass vaccination in one's own country, anxiety about COVID-19, trust in public health agencies/health science, as well as compliance to mask guidelines. The remaining factors were older age, higher education, and socioeconomic status. Conclusions: This review allowed us to show that geographic factors (Asian, South American countries) and pandemic factors (different threats and risks from infection) significantly influence the acceptance of vaccines. The most significant factors affecting acceptance are those related to public awareness of the risk of infection, vaccine safety, and the way in which reliable information about the need and safety of vaccines is provided. Professional and reliable patient information by obstetricians and qualified medical personnel would significantly increase the level of confidence in vaccination against COVID-19.

Diabetic Mastopathy. Review of Diagnostic Methods and Therapeutic Options.

Diabetic mastopathy is a rare breast condition that may occur in insulin-treated men and women of any age. The etiology is still unclear; however, the autoimmunological background of the disease is highly suspected. The changes in diabetic mastopathy may mimic breast cancer; therefore, its diagnostic process is demanding, and treatment options are not clear and limited. Lesions in DM are usually multiple; therefore, surgical removal is not fully effective. A well-done anamnesis with core-needle biopsy is essential and definitive in most cases. In this review, we summarize up-to-date knowledge of diagnostic methods and therapeutic options for diabetic mastopathy treatment and present three cases of diabetic mastopathy-type lesions in ultrasound and radiological examinations.

Stereophotogrammetry measurement of kinematic target effect as speed accuracy benchmark indicator for kicking performance in martial arts.

PURPOSE: The development of a motion capture system leads to fast and accessible ways of precise testing of athletes and their motor abilities. The striking performance in martial arts and combat sports requires measuring velocity in the context of successful contact with the target. The aim of this study was to present the novel kinematic target effect coefficient and its possible use as a speed accuracy benchmark of performance based on the example of taekwon-do roundhouse and frontal kicks. METHODS: The stereophotogrammetry motion capture setup consists of 10 infrared cameras (NIR Vicon MX-T40). Analysis includes 180 kicks (roundhouse and frontal kicks) performed by 15 adult participants on a master level in taekwon-do. The kinematic target effect comparison includes two targets - a training shield and a table tennis ball hanging from the ceiling. Markers were placed on the lower extremities of participants. Spatial-temporal variables were registered for both kicking legs, techniques, and target types. RESULTS: Both roundhouse and frontal kicks revealed target and marker dependent differences during its execution. The kinematic target effect coefficient values differ for the specific marker and kick type. CONCLUSION: The wireless motion capture systems could be helpful in the training process and an athlete's evaluation before sports competitions.

Determinants of anxiety levels among young males in a threat of experiencing military conflict-Applying a machine-learning algorithm in a psychosociological study.

BACKGROUND: Anxiety could be felt even in objectively peaceful situations, but a vision of conflict could result in increased stress levels. In this article, we aimed to identify hidden patterns of mental conditions and create male profiles to illustrate the different subgroups as well as determinants of anxiety levels among them in accordance with proximity to a possibility of direct exposure to military action. METHODS: A sample of Ukrainian males, in duty as conscripts to military service (n = 392, M±SD = 22.1±5.3) participated in a survey. We used the 36-Item Short Form Health Survey, and State-Trait Anxiety Inventory. In addition to psychological indices, social-demographic data were collected. To discover the number of clusters, the k-means algorithm was used, the optimal number of clusters was found by the elbow algorithm. For validation of the model and its use for further prediction, the random forest machine-learning algorithm, was used. RESULTS: By performing k-means cluster analyses, 3 subgroups were identified. High values of psychological indices dominated in Subgroup 2, while lowest values dominated in Subgroup 3. Subgroup 1 showed a more even distribution among the indices. The strength of the relevance and main determinants of the prediction of the presented model mostly consisted of mental qualities, while socio-demographic data were slightly significant. CONCLUSIONS: There is no clear relevance between proximity or even the experience of military actions and anxiety levels. Other factors, mostly subjective feelings about mental conditions, are crucial determinants of feeling anxiety.

The influence of gender, dominant lower limb and type of target on the velocity of taekwon-do front kick.

PURPOSE: The current study aimed to quantify the main influences and the interactions (joint effects) of gender, leg and type of target on the biomechanics of front kick quality. Through the quantification, we tried to identify the relevant factors related to the kick accuracy and maximum velocity for coaching practice. METHODS: A ten-camera NIR VICON MX40 motion capture system (250 Hz) was used to determine the kicking foot maximum velocity from two well-trained subject groups (8 males and 6 females). Each subject performed both left and right front kicks in a lateral standing position into the air (without a physical target), to a board, to a table tennis ball and to a training shield. The target were set on a height corresponding to a height of solar plexus of each participant. RESULTS: The results showed that all the three factors (gender, leg and type of target) have significant influences on kicking speed ( p < 0.001) and significant interaction (joint effect) was only found between gender and target ( p < 0.001). Further analysis revealed that the males' kicking maximum velocity was affected more by board, while females' one was affected by the size of the target. CONCLUSIONS: The results would seem to suggest that, for males, kick-to-a-board may be the more effective method for increasing kick quality, compared to other type of target. For females, kick-to-a-small-ball appears to be effective method for increasing kick maximum velocity.

Statins and cancers.

Statins (inhibitors of 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase) are a group of drugs used to treat lipid disorders. They inhibit cholesterol synthesis at an early stage of the biosynthesis pathway, thus eliminating numerous metabolites involved in the cycle. Numerous studies point to different possible effects of statins on cancer cells. Statins inhibit growth of a tumor, invasion and metastasis formation. They block the production of isoprenoids, which are necessary for post-translational modifications of many proteins, including those involved in normal cell signaling. They also contribute to the reduction in the expression of vascular endothelial growth factor, sensitize tumor cells to NK cell activity, and modify the body inflammatory response. Due to different pharmacokinetic properties of individual statins, they may have opposite effects on the risk of cancer. Currently, most information on the effects of statins on the risk of developing cancer is obtained from observational studies. The studies have different results depending on the location of cancer. The protective effect of statins was observed in the meta-analysis of numerous studies including prostate cancer, stomach cancer, esophagus cancer, and hepatocellular carcinoma; however, it has not yet been confirmed that statins influence the risk of developing colorectal cancer, breast cancer, or lung cancer. The protective effect of statins on the development of many kinds of cancer can be a valuable and easy way to reduce morbidity. However, further research is necessary to thoroughly determine the value of this group of drugs.

Two techniques of pyramidalis muscle dissection in Pfannenstiel incision for cesarean section.

OBJECTIVES: The aim of the study was to compare two techniques of pyramidalis muscle dissection during cesarean section. MATERIAL AND METHODS: A total of 108 patients undergoing a cesarean section were randomly allocated to group I (N = 57), with the pyramidalis muscle left attached to the rectus muscles, and group II (N = 51), with preservation of the connection between the pyramidalis muscle and the rectus sheath. RESULTS: There were no statistically significant differences between the groups regarding surgery duration, blood loss and postoperative pain. After three months, patients from group II more frequently reported paresthesia in the scar region (47.1 vs. 28.1%; p = 0.041), but their self-assessment of the abdominal appearance and presence of the bulging below the wound were comparable with group I. CONCLUSIONS: None of the two techniques of pyramidalis muscle dissection appear to be superior to the other. The technique leaving the pyramidalis muscle attached to the fascia gave more frequent paresthesia during a 3-month follow-up.