Thousands of Women's Lives Depend on the Improvement of Poland's Cervical Cancer Screening and Prevention Education as Well as Better Networking Strategies Amongst Cervical Cancer Facilities.

Proper targeted cancer prophylaxis reduces the incidence of cancer in all forms; this includes cancers with significant progression potential and poor prognosis. Based on the assumption that one of the risk factors of cervical cancer is the avoidance of screening tests, we analyzed the current scenario of cervical cancer (CC) screening and recommendations in Poland (country with a well-off socioeconomic status). Based on the comprehensive literature review concerning documents of guidelines and recommendations of various bodies, including national ones, data on the implementation of CC screening in Poland, and different models for medium-to-high-income countries, we proposed how the CC screening strategy could be improved. Finally, the new strategy was further developed for those who are prone to not being screened. The proposal on how to improve the Polish CC screening program is the following: refinement of the public education on CC risk factors, popularization of CC screening incentives amongst the public, and improvement of networking strategies between CC screening facilities ("cervical screening clinical"), allowing screenings to be more efficient and rapid. We believe that, to enhance the future quality of life of those with rapid CC progression by catching the disease preemptively and limiting the sequelae of the disease, we have to improve education and access to medical services.

[Mineralization of the basal ganglia as the supposed cause of poor tolerance of zuclopenthixol in a patient with long-term untreated paranoid schizophrenia]. / Mineralizacja jader podstawy jako domniemana przyczyna zlej tolerancji zuklopentyksolu u chorej z wieloletnia nieleczona schizofrenia paranoidalna.

Formations described as intracranial calcifications can appear in the course of diseases of the central nervous system, other systems and organs (e.g. endocrine), but also as a disorder of idiopathic character. They are frequently located in subcortical nuclei and usually constitute an incidental finding. This report presents the case of a patient suffering from paranoid schizophrenia for approximately 40 years, who did not agree to any treatment and was hospitalized against her will because she was the threat to the lives of others. She was treated with zuklopentixol resulting in positive symptoms reduction and considerable improvement in social functioning. Unfortunately neurological symptoms appeared: bradykinesis, rigidity--of the type of the lead pipe, balance, posture and gait abnormalities, disturbances in precise hands movements, double-sided Rossolimo's sign, plantar reflex without the participation of the big toe on the left. Neuroimaging studies have demonstrated changes in the form of lenticular nuclei calcification and reduction of signal intensity in posterior parts of both putamens. Neurological symptoms decreased significantly after switching to atypical neuroleptic (olanzapine), and the patient did not require any additional treatment. Mineralization of the basal ganglia can often be associated with psychiatric disorders and it shouldn't be neglected because it can require modification of pharmacotherapy or additional neurological treatment.

[Risk of diabetes mellitus after pregnancy complicated by gestational diabetes mellitus (GDM)]. / Ryzyko wystapienia cukrzycy po ciazy powiklanej cukrzyca ciazowa (GDM).

OBJECTIVES: The aim of the study was an assessment of glucose tolerance disorders' (GTD) prevalence after pregnancy complicated by GDM. DESIGN: Retro- and prospective clinical study. MATERIAL AND METHODS: The group of 461 women having GDM in their index pregnancies was invited to postpartum glucose metabolism assessment. Of them 192 subjects responded positively. In 47 of them the postpartum diagnosis of diabetes had already been established. The remaining 145 subjects underwent detailed testing that embraced fasting plasma glucose and whole blood HbA1c level measurement. Oral 75-g glucose tolerance test (OGTT) was also performed. RESULTS: OGTT revealed GTD in 55 subjects. Diabetes was found in 8 cases, impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) in 23 and 24 cases respectively. Postpartum GTD appeared in 63.3% of insulin treated subjects (GDM2) compared with 30.1% of women treated with diet only (GDM1). A group with pathological OGTT had mean HbA1c concentration significantly higher compared to the one with normal test results (6.0+/-1.7% vs. 5.1+/-0.3%; p<0.001), although HbA1c>6.0% was observed only in 23.6% women with GTD. Moreover, in 25% of subject with newly diagnosed diabetes HbA1c level did not exceeded 6.0%. CONCLUSIONS: 1. More than 50% of subjects with GDM developed diabetes or other GTD during the first 6 years postpartum. 2. Risk of postpartum GTD is significantly higher in women treated with insulin during pregnancy. 3. HbA1c measurement is less sensitive than OGTT for detection of GTD after pregnancy complicated by GDM.

[The prevalence of gestational diabetes mellitus in Polish population]. / Czestotliwosc cukrzycy ciezarnych (GDM) w Polsce w badaniach przesiewowych.

OBJECTIVE: The aim of the study was to determine the frequency of GDM in different parts of Poland and to assess whether 1 h--glucose plasma levels after 50 g glucose tolerance test (50 g OGTT) reflect the risk of GDM. MATERIAL AND METHODS: A total of 5778 pregnant women were screened with 50 g OGTT between 24 and 28 weeks of gestation. All subjects whose post-challenge glucose levels exceeded 140 mg/dl had 75 g OGTT performed according to WHO criteria. RESULTS: The rate of abnormal screening test results ranged from 8.0% to 20.7% for different regions of Poland, respectively. The pathological 50 g OGTT results were from 140 mg/dl to 320 mg/dl. Screening test results within 140 mg/dl to 149 mg/dl were confirmed by positive 75 g OGTT only in 2.9% subjects. All patients whose 1 h--glucose levels at 50 g OGTT were greater than 190 mg/dl had pathological 75 g OGTT results as well. CONCLUSION: The prevalence of GDM in different parts of Poland ranged from 2.0% to 3.8% (the average 3.4%).