Eating Behaviors and Physical Activity versus the Big Five Personality Traits in Women with a Hereditary Predisposition to Breast or Ovarian Cancer.

The Big Five personality traits-neuroticism, extroversion, openness to experience, agreeableness, and conscientiousness-represent continuous, individual features that affect a number of vital health aspects, including morbidity, self-reported health status, or lifestyle. The aim of this study was to analyze the relationship between the eating behaviors and engagement in physical activity of women with a hereditary predisposition to breast or ovarian cancer and the Big Five personality traits. A total of 357 women, participants of 'The National Program for Families With Genetic/Familial High Risk for Cancer', were included in the study. In the healthy group, the following statistically significant predictors were found in variables: agreeableness-meal frequency (ß = 0.151; p = 0.030); neuroticism-consumption of fruits and vegetables (ß = -0.177; p = 0.016) and cereal products (ß = -0.223; p = 0.002); openness to experience-consumption of plant-based fats (ß = 0.141; p = 0.034) and physical activity (ß = 0.153; p = 0.021). In the cancer group, the frequency of dairy consumption (ß = 0.286; p = 0.003) and physical activity (ß = 0.370; p = 0.000) were found to be statistically significant predictors for the openness to experience variable. Neuroticism is associated with less frequent consumption of fresh fruits and vegetables as well as cereal products. Openness to experience was more often linked with a higher frequency of dairy consumption, plant-based fats, and physical activity. Women with breast or ovarian cancer and a higher openness to experience consumed dairy and engaged in physical activity more often than their peers with the remaining personality traits.

Abdominal complex muscle in women with stress urinary incontinence - prospective case-control study.

Introduction: This study was designed to assess the percentage share of musculus obliquus externus abdominis, musculus obliquus internus abdominis and musculus transversus abdominis activity among women suffering from stress urinary incontinence using ultrasound imaging. Material and methods: The study is a retrospective analysis of prospective collected data of 84 women aged 23-62 years. In the study group are women suffering from grade 1 or 2 stress urinary incontinence according to the Stamey classification; the control group consists of women with no micturition disorders. The abdominal muscles' activity was measured by using ultrasound imaging with assessment of muscle thickness. Results: The analysis of musculus obliquus externus abdominis in anterolateral abdominal wall activity shows a statistically significant difference between study and control groups concerning isometric tension of abdominal muscles (p = 0.012) and lower abdomen tension (p = 0.004). Women with stress urinary incontinence present higher activity of the musculus obliquus externus abdominis than women in the control group. In the case of the musculus obliquus internus abdominis, statistically significant differences were found during tension of the lower part of the abdomen (p = 0.024). Comparison of activity of the musculus transversus abdominis between study and control groups shows a statistically significant difference during isometric tension of abdominal muscles (p = 0.018). Conclusions: The pattern of activity of the assessed muscles differs between the study group and the control group. In the study group, the activity pattern concerns the higher activity of the musculus obliquus externus abdominis and the lower activity of the musculus obliquus internus abdominis and musculus transversus abdominis.

How Urinary Incontinence Affects Sexual Activity in Polish Women: Results from a Cross-Sectional Study.

Urinary incontinence (UI) in women can cause a number of sexual dysfunctions and reduce their quality of life. Sexual health is essential to the self-esteem, emotional state, and overall quality of life. We aimed to assess the quality of sexual life of women with UI. The study included a group of 145 sexually active women diagnosed with UI. The research was conducted using the diagnostic survey method with authorial and validated questionnaires. As many as 49.1% of the respondents reported a deterioration of sexual relations in comparison with the time before the onset of UI symptoms. According to the FSDS-R results, 83.45% of respondents were dissatisfied with their sex life. The higher the result obtained by respondents in the FSDS-R scale, the lower was their quality of life in the IIQ-7 scale (p ≤ 0.002, R = 0.53). The greatest impact was observed in the domains of emotional health and physical activity. The more incontinence symptoms reported by the respondent in the UDI-6 scale, the worse was her sexual satisfaction in the FSDS-R (p = 0.003, R = 0.39). UI in women contributes to the development of sexual dysfunctions, including decreased interest in sexual life, limited intercourse, and dissatisfaction with sexual life.

The Influence of Oral Drotaverine Administration on Materno-Fetal Circulation during the Second and Third Trimester of Pregnancy.

Background and Objectives: The study aimed to evaluate the effect of the oral administration of drotaverine on maternal and fetal circulation as measured by Doppler sonography in women with a risk of preterm birth. Materials and Methods: The present prospective study was conducted on 34 women with singleton pregnancy at 26-36 weeks of gestation. Doppler flow and pulsatility index (PI) assessments of the umbilical artery, fetal middle cerebral artery, and uterine arteries were performed before and 90-120 min after oral drotaverine administration. Results: There were no statistically significant differences between the Doppler assessment (PI Uma-umbilical artery, MCA-middle cerebral artery, and ltUta-left uterine artery) before drotaverine administration and 90-120 min after oral intake, but there were statistically significant differences between the PI assessment of the rtUta (right uterine artery, 0.55 vs. 0.75, p = 0.05) and the mean of the Uta (0.66 vs. 0.74, p = 0.03). For changes in the CUR (cerebro-umbilical ratio) and % changes in the CUR and mean PI of the Uta, there was no correlation with obstetric history, AFI (amniotic fluid index), gestation week, infertility history, systolic pressure, or diastolic pressure. There was a statistically positive correlation between changes in the CUR and % change in the CUR and body weight and in height. Conclusions: Drotaverine has no statistically significant influence on the MCA and Uma PI. The oral administration of drotaverine has an impact on PI rtUta and the mean PI Uta.

Health-related quality of life (Nottingham Health Profile) of women with normal and pathological pregnancy and during delivery: correlation with clinical variables and self-reported limitations.

OBJECTIVE: Pregnancy is often associated with changes in the psychological functioning of women. The present study aimed to analyze the incidence of health problems in pregnant mothers and the influence of these problems on their daily functioning using a survey. MATERIAL AND METHODS: The study included a total of 232 women aged 19-42 years. The tools used in the study were a self-developed questionnaire and the NHP questionnaire. The study was performed among women with pathological pregnancies and healthy pregnancies who delivered. Women with pathological pregnancies had pregnancy-induced hypertension, fetal hypotrophy, cholestasis, or gestational diabetes mellitus. Women with healthy pregnancies were recruited from the hospital ambulatory and cooperating private practices or during admission for delivery. RESULTS: Group K had significantly lowest "TOTAL" intensity in relation to the other groups. For variable "PROBLEMS," a statistically significant difference was found between group K and group P (p=.001) and between group D and group P. CONCLUSIONS: Every woman may experience a different level of satisfaction with life during pregnancy. This is typically determined by the personality of the given individual, as well as by pregnancy-associated emotions. It is important that health care personnel should provide psychological support and follow individual approach for each pregnant woman.

Canonical analysis of concentrations of toxic metals in endometrium of women with gynecological disorders.

OBJECTIVES: Among the main adverse environmental factors, we usually distinguish the impact of heavy metals, especially Cd and Pb. Apart from the carcinogenic and toxic properties, their potential, stimulating estrogen receptors effect (metaloestrogens) is strongly emphasized; as well as participation in gene regulation mechanisms (epigenetic). The aim of this study is to examine if there is a special scheme of concentrations of heavy metals accumulated in the female endometrium in certain pathologies: endometrial hyperplasia, endometrial cancer, endometrial polyps and miscarriages. The control group consisted of patients with abnormal uterine bleeding or functional bleeding with correct histopathological findings. MATERIAL AND METHODS: The study was performed on 92 women. Microwave induced plasma atomic emission spectrometry was used to assess metals concentrations in tissue material and the results of obtained concentrations were converted to µg/kg. The calculations were performed using discriminant and canonical analyses and revealed four discriminant functions. RESULTS: The results showed that metal's tissue concentrations vary in different types of histopathological diagnosis and the scheme of concentrations might be characteristic for analyzed diagnosis. Pb and Al has the most substantial impact on discrimination. CONCLUSIONS: Endometrium may accumulate toxic metals such as: Pb, Cd, Ni, Mn, Cu, Zn, Al, Cr. It can be assumed that there are characteristic distributions of toxic metals concentrations for individual histopathological diagnoses.

How to balance the treatment of stress urinary incontinence among female athletes?

Urinary incontinence in the general population occurs in 7% of non-pregnant women under 39 years old, 17% of those 40 to 59 years old, and 23-32% of those over 60 years old. In athletes the prevalence is higher, especially in high-impact training and gravity sports. Pelvic floor muscles (PFM) have two important roles; they serve as the support for abdominal organs and are crucial for closure of the urethra, vagina and rectum. We present the proper mechanisms of PFM caudal contractions with proper abdominal muscle control to avoid excessive intra-abdominal pressure. Pelvic floor sonography is discussed as the only objective method for pelvic floor examination among sportswomen and a tool which should be used routinely by urophysiotherapists and urogynecologists. A multidisciplinary individualized approach to stress urinary incontinence among athletes is presented including: physiotherapy, diagnostic imaging, use of a pessary, tampons, pharmacologic and surgical treatment. We present guidelines for stress urinary incontinence treatment in sportswomen of different age.

Health-related quality of life (Nottingham Health Profile) in patients with endometriomas: correlation with clinical variables and self-reported limitations.

INTRODUCTION: Endometriosis is a chronic disease that involves the development of endometrium outside the uterine cavity with pain component predominance. The aim of the study was to discuss the occurrence of health problems in patients with endometriomas and simple cysts and the effect of these problems on the daily functioning of the patients. MATERIAL AND METHODS: The study included patients (n = 40) treated laparoscopically and/or by laparotomy due to lesions in the form of endometriomas or simple cysts. The control group (n = 36) consisted of healthy patients of the Gynecological Clinic, with no changes in adnexa confirmed in vaginal ultrasound examination. The original authors' questionnaire and the Nottingham Health Profile Questionnaire (NHP) were used as research tools. RESULTS: Analysis of the correlation with Spearman's test demonstrated a statistically significant relationship between the size of the tumor and the occurrence of sleep disorders only in the group of women suffering from endometriomas (r = -0.348; p = 0.041). Women with endometriomas significantly more often reported problems (Cramer's V) in the sphere of "paid work" (p < 0.001), "housework" (p < 0.001), in social life (p < 0.001), problems in sexual life (p < 0.001) as well as problems in continuing hobbies (p < 0.001) and in spending free time (p < 0.001). CONCLUSIONS: Since the stage of endometriosis does not correlate with subjective complaints, it seems that an additional routine evaluation of quality of life, including an assessment of the severity of the disease, is warranted. Routine use of the Nottingham Health Profile Questionnaire in patients with endometriosis can improve also the assessment of the treatment.

Uterine rupture at 28 weeks of gestation after laparoscopic myomectomy - a case report.

There are many reasons for sterility, and uterine malformations are of the greatest concern. Among uterine disorders, myomas play a significant role and are present in 27% of infertile women. The occurrence of myomas is frequent - 20-40% in women of reproductive age. Thus, for those infertile patients surgical treatment may be needed to preserve an opportunity to conceive. This case report refers to an uterine rupture at 28 weeks of gestation after laparoscopic myomectomy (3 months before conceiving). The myomectomy was conducted correctly and two layers of sutures on the myometrium were performed. The purpose of the myomectomy in a young woman should be well considered. In cases of infertility, removal of the lesions is usually necessary to give the patient a chance of pregnancy. At the same time, the risk of uterine rupture is increased. There are some suggestions referring to myomectomy to reduce the risk of uterine rupture in a subsequent pregnancy. It seems that the method of sewing the uterine closure is crucial. For example, multilayer uterine stitches, preservation of the endometrial cavity, and avoidance of using electrosurgery to prevent devascularization (to avoid haematoma formation) should be taken into consideration to prevent weakness of the wall of the uterus. Uterine scars differ histologically and biochemically.

Identification of toxic metals in human embryonic tissues.

INTRODUCTION: The cause of a significant number of miscarriages remains unexplained. There is a need to identify the potential role of environmental, dietary and lifestyle factors in the risk of pregnancy loss. The present study was the first to investigate the content of miscarried embryonic material with respect to eight metals (aluminium, cadmium, chromium, copper, manganese, nickel, lead and zinc). MATERIAL AND METHODS: Embryonic tissue samples (n = 20) were obtained from women undergoing misoprostol-induced removal of the embryo between the 6th and 9th week of gestation. The content of metals was analyzed using microwave-induced nitrogen plasma atomic emission spectrometry. Based on a short questionnaire, the smoking habits, dietary patterns and place of living of the investigated women were determined. RESULTS: The general mean content of metals (µg/g) decreased in the order copper (33.9) > manganese (24.7) > chromium (13.6) > zinc (13.3) > aluminium (6.5) > nickel (3.0) > lead (2.9) > cadmium (2.5). Profoundly increased concentrations (p < 0.05) of the toxic elements aluminium (over 5-fold), cadmium (over 2-fold) and lead (over 2-fold) were observed in samples obtained from former smoking women. The miscarried material in urban populations also revealed higher levels of cadmium (over 1.5-fold) and lead (over 2-fold) compared to that obtained from women living in rural areas (p < 0.05). No associations with age or diet were found (p > 0.05). CONCLUSIONS: This study identified increased levels of aluminum, cadmium and lead in miscarried embryonic material and suggests some causative factors.

Relation between polyphenols, malondialdehyde, antioxidant capacity, lactate dehydrogenase and toxic elements in human colostrum milk.

The present study investigated the interrelationships between the concentration of total polyphenols (TP), malondialdehyde (MDA), total antioxidant capacity (TAC), lactate dehydrogenase activity (LDH) and content of toxic elements (Al, As, Cd, Ni, Pb) in human colostrum milk (n = 75), and further assessed their potential association with maternal lifestyle characteristics. As and Cd were always below detection limits while Al, Ni and Pb were found at the level of 89.7, 6.2 and 1.3 µg L-1, respectively. Concentrations of TP and MDA, in the studied group were 46.91 ± 21.25 mg GAE L-1 and 0.66 ± 0.27 nmol mL-1, respectively, and were inversely correlated (Rs = -0.32; p < 0.01). TP and TAC increased significantly with maternal consumption of vegetables (Rs = 0.25 and Rs = 0.37, respectively; p < 0.05). Concentration of Al was positively correlated with MDA (Rs = 0.21; p < 0.01) and negatively with TP (Rs = -0.28; p < 0.01). Positive correlation was also found between Pb and MDA (Rs = 0.32; p < 0.01). No association with place of living (urban/rural), women's age and former smoking were found for any studied milk parameter. The results add to the general understanding of factors influencing redox balance in milk and potentially affecting its quality.

Rare-earth elements in human colostrum milk.

Rare-earth elements (REEs) are used in a growing number of applications, and their release to environment has increased over the decades. Knowledge of REEs in human milk and factors that could possibly influence their concentration is scarce. This study evaluated the concentrations of 16 REEs (Ce, Eu, Er, Gd, La, Nd, Pr, Sc, Sm, Dy, Ho, Lu, Tb, Tm, Y, and Yb) in human colostrum milk collected from Polish women (n = 100) with the ICP-OES technique. The concentrations (mean ± SD) of Pr (41.9 ± 13.2 µg L-1), Nd (11.0 ± 4.0 µg L-1), La (7.1 ± 5.2 µg L-1), and Er (2.2 ± 0.8 µg L-1) were found above detection limits. The total mean ± SD concentration of detected REEs was 60.9 ± 17.8 µg L-1. Current smokers displayed significantly increased Nd concentrations compared to women who had never smoked. No other associations between REEs in colostrum milk and age, diet in pregnancy (food supplement use and frequency of fish, meat, and vegetable consumption) or place of living (urban/rural) were found. This study adds to general understanding of the occurrence and turnover of REEs in women and human fluids.

Impact of selected environmental factors on attendance in the Breast and Cervical Cancer Early Detection Programme in the Wielkopolska Province of Poland during 2007-2012.

Breast and cervical cancer represent a significant health and economic issue for Polish society, although if detected early, both can be cured successfully. For this reason, since 2006, according to the National Cancer Combat Programme, population-based screening programmes have been implemented, aimed at reducing the mortality and morbidity for breast and cervical cancer. The aim of this study is to determine which of the selected four environmental factors affect attendance for screening mammography and cytology. Analysis included data from questionnaires filled in during mammography by 582,959 women aged 50-69 years, and 288,142 women during cytology, aged 25-59 years, in 2007-2012 in the Wielkopolska Province of Poland. It was found that the impact of medical staff on the attendance for cytological screening was the strongest statistically significant factor (p = 0,0001). Invitation by name (p=0,001) and other factors (p= 0,0001) also affected the attendance. In the cytological screening, medical staff was the factor that had the greatest impact on attendance. Other factors, such as self-reporting, increased participation in the next screening rounds, although the factors that affect attendance changed over time. Their constant analysis is essential for the efficient and effective evaluation of screening programsme.

Pregnancy in a woman with acromegaly after transsphenoidal partial resection of pituitary macroadenoma - a case report.

Acromegaly is a systemic disease caused by an excessive release of growth hormone and the hypopituitarism, which is induced by macroadenoma local mass effect. The gynecological and obstetric disorders include irregular menstrual cycles, anovulatory cycles and infertility. Therefore, pregnancy in patients affected by the disease is rare. A CASE REPORT: Patient described in this study became pregnant after pharmacological, surgical and infertility treatment. Hence, the following paper presents the course of pregnancy and the discussion of the impact of acromegaly on female fertility, pregnancy, and concerns related to the diagnosis and treatment.

Sonoelastography in the evaluation of capsule formation after breast augmentation - preliminary results from a follow-up study.

INTRODUCTION: There are many indications for breast augmentation, including reconstruction after mastectomy, correction of congenital disorders and cosmetic procedures. The most frequent local complication of this surgery is capsule formation due to fibrosis. The aim of the study was to assess the usefulness of sonoelastography in the evaluation of capsule formation around silicone implants. MATERIAL AND METHODS: The study group included 13 patients aged 20 to 41, who underwent breast augmentation with silicone implants. Their 26 breasts were examined before surgery, 7 and 14 days and a minimum of 8.5 months after surgery. The breast stiffness was assessed with tonometry and shear wave elastography to evaluate elasticity of the breast tissue and capsule formation after surgery. RESULTS: We assessed the correlation between capsular elasticity measured at successive visits and the Baker scale. There were no significant relationships between any pairs of variables (p > 0.05). We also analyzed the correlation between the time of the follow-up and changes in the tissue elasticity of every region - no significant relationship was found. The greatest decrease in pericapsular elasticity was established in lower and inner quadrants. Moreover, there was a significant difference between the elasticity of the tissue before and 1 week after surgery (p < 0.05) and no significant changes in the elasticity before surgery and at the end of the follow-up. CONCLUSIONS: Sonoelastography is precise in evaluation of capsule formation after breast augmentation. It may show changes that cannot be assessed using palpation.

Smith-Lemli-Opitz Syndrome- a challenging prenatal diagnosis.

OBJECTIVES: The aim of the study was to present a case of Smith-Lemli-Opitz syndrome (SLOS) in a fetus of a 33-year-old patient. At 31 weeks of gestation, the following fetal malformations were detected on an ultrasound: atrioventricular septal defect (AVSD), aortic coarctation, shortening of the lower limbs, narrow forehead, hyperthelorism, micrognathia, anteverted nares, ambiguous genitalia, and signs of intrauterine growth restriction. The baby died 11 days after birth. Further genetic screening of the parents revealed the 7-DHCR enzyme mutation in both of them. Although the prenatal diagnosis of SLOS presents a challenge due to the fact that little is known about its prenatal phenotype but it may be vital while attempting to treat the fetus in utero.

Metal accumulation in the human uterus varies by pathology and smoking status.

OBJECTIVE: To evaluate the content of Al, Cd, Cr, Cu, Mn, Ni, Pb, and Zn in human endometrium (END), endocervix (ECX), and endometrial (END-P) and endocervical (ECX-P) polyps in relation to histologic image and female demographic characteristics and habits. DESIGN: Tissues were collected during curettage of the uterine cavity, subjected to histopathologic examination, digested, and analyzed with the use of a microwave induced nitrogen plasma atomic emission spectrometer. Demographic/lifestyle characteristics were assessed with the use of a questionnaire. SETTING: University hospital and research laboratory. PATIENT(S): One hundred nine white Polish women undergoing curettage of the END (n = 60) or ECX (n = 23) or dissection of END-P (n = 16) or ECX-P (n = 10). INTERVENTIONS(S): None. MAIN OUTCOME MEASURE(S): Trace element concentrations in collected tissues. RESULT(S): Histologic states of analyzed END included: normal (n = 22), irregularity (n = 3), polypoid (n = 12), simple hyperplasia (n = 10), leiomyoma (n = 5), and cancer (n = 8); whereas for ECX: normal (n = 10), inflammation (n = 8), irregularity (n = 2), and cervical intraepithelial neoplasia (CIN; n = 3). All elements were identified in the sampled material. Compared with histologically normal tissues, endometrial cancer, hyperplasia, and CIN revealed significantly increased levels of toxic metals (Cd and Pb), altered status of Cu and Mn, and an elevated Cu/Zn ratio. Current and former smoking was associated with significantly higher Cd and Pb levels in investigated tissues. Polyps represented significant accumulators of Al, Cd, Ni, and Pb (END-P) or Al, Cd, and Cu (ECX-P). CONCLUSION(S): The findings of this study are important in understanding the presence and role of metals in the female reproductive system and its pathology.

Have we achieved progress in tocolytic treatment?--results of a retrospective cohort study in a tertiary university hospital.

OBJECTIVES: Beta-agonists play an important role in tocolytic treatment. In light of recent changes in the Polish medical care system, we decided to assess the effectiveness of oral continuous treatment (in 2012) and compare it with a 3-day intravenous administration of fenoterol (in 2013). The aim of our study was to contrast cost and effectiveness of fenoterol therapy in pregnant women at risk of preterm labor during two consecutive years: 2012 - when fenoterol had been widely used (group A), and 2013 when its extensive use had been withdrawn (group B). MATERIAL AND METHODS: Retrospective cohort study of 129 pregnant women: 76 treated with intravenous fenoterol, followed by continuous oral administration (November 2012; group A), and 53 treated with intravenous fenoterol only for 48-72 hours (November 2013; group B). RESULTS: Perinatal outcomes (based on the Apgar score and neonatal weight) were comparable in both groups. Continuous oral application of fenoterol resulted in earlier gestational age at delivery and lower cost of hospitalization among women from group A as compared to group B. Regardless, the difference was not statistically significant (37 hbd vs. 35 hbd, p = 0.626; 4334,700PLN vs. 5232,470PLN, p = 0.533). CONCLUSIONS: A 3-day intravenous application of fenoterol is as effective as oral continuous therapy and is characterized by reduced risk of negative side effects.

Free-ranging domestic cats are characterized by increased metal content in reproductive tissues.

Trace metals may be supportive to mammalian reproduction but also reveal certain toxicities. The present study investigated the content of selected metals (Ca, Cd, Cu, Mn, Mg, Ni, Pb, Zn) in uterine and testicular tissue of free-ranging and household cats and its relation with hair metal status, cats' age, weight, physical activity, diet and inhabited environment. Free-rangers and cats not fed by humans were characterized by higher concentrations of essential metals in their reproductive tissues as well as increased levels of toxic elements, particularly Cd and Ni. No difference in metal status was found for household individuals fed on different varieties of commercial food. Cats inhabiting urbanized areas were characterized by higher Pb levels in their reproductive system. Feline hair was found to be less, if at all, susceptible to environmental, lifestyle and dietary variables and most importantly, did not reflect a metal burden in reproductive tissues.

Impact of heavy metals on the female reproductive system.

INTRODUCTION: It has been recognized that environmental pollution can affect the quality of health of the human population. Heavy metals are among the group of highly emitted contaminants and their adverse effect of living organisms has been widely studied in recent decades. Lifestyle and quality of the ambient environment are among these factors which can mainly contribute to the heavy metals exposure in humans. OBJECTIVE: A review of literature linking heavy metals and the female reproductive system and description of the possible associations with emission and exposure of heavy metals and impairments of female reproductive system according to current knowledge. RESULTS: The potential health disorders caused by chronic or acute heavy metals toxicity include immunodeficiency, osteoporosis, neurodegeneration and organ failures. Potential linkages of heavy metals concentration found in different human organs and blood with oestrogen-dependent diseases such as breast cancer, endometrial cancer, endometriosis and spontaneous abortions, as well as pre-term deliveries, stillbirths and hypotrophy, have also been reported. CONCLUSIONS: Environmental deterioration can lead to the elevated risk of human exposure to heavy metals, and consequently, health implications including disturbances in reproduction. It is therefore important to continue the investigations on metal-induced mechanisms of fertility impairment on the genetic, epigenetic and biochemical level.