[New methods of uterine fibroids treatment]. / Nowe metody leczenia miesniaków macicy.

Uterine fibroids are the most common benign tumors of the uterus. Their main symptoms are prolonged menstrual bleeding, leading over time to a secondary anemia, bleeding and spotting between periods, pelvic pain and infertility. It is recognized that fibroids are the most common indication for surgery in gynecology. Currently radical surgical treatment of fibroids is abandon. Ulipristalu acetate is used in pharmacological treatment. This medicine reduces the growth of fibroids. New non-invasive technique is also MR-guided focused ultrasound surgery using thermal tissue destruction by focusing ultrasound beam. Ability to avoid the often crippling surgery makes conservative methods increasingly popular.

[Role of office hysteroscopy in the diagnosis and treatment of uterine pathology]. / Rola minihisteroskopii w diagnostyce i leczeniu patologii jamy macicy.

Nowadays endoscopic techniques are one of the basic diagnostic and operative methods in gynecology. Laparoscopy and hysteroscopy are the most popular of them. Office hysteroscopy is a modern diagnostic and therapeutic method feasible in an outpatient room because no necessity of anesthesia. It is the first-line procedure in the infertility diagnosis and treatment of uterine pathology such as polyps, submucosal fibroids and adhesions. Limitation of this method is the cervical canal atresia. Contraindications to it are: pregnancy, uterine bleeding, active inflammation of pelvic organs, cervical cancer. Due to the high sensitivity and specificity, simplicity of execution and no need for patient hospitalization, office hysteroscopy becomes important diagnostic and therapeutic procedure in uterine pathologies.

[Chronic inflammation and metabolic syndrome in comparison with other signs belonging to the image of polycystic ovary syndrome]. / Przewlekly stan zapalny oraz zespó1 metaboliczny na tie innych objawów nalezacych do obrazu zespolu policystycznych jajników.

Polycystic ovary syndrome (PCOS) is a disorder which concern even 5-10% of women in reproductive age. PCOS is a cause of hyperandrogenism and menstrual disorders with chronic anovulation. The most common clinical symptoms observed in PCOS are hirsutism, acne and obesity. Patients with PCOS often suffer from metabolic disorders like insulin resistance, hyperinsulinemia, dyslipidemia, arteriosclerosis and other abnormalities of the metabolic syndrome. 35 to 60% of women with PCOS are obese and about 50% of them have insulin resistance and hyperinsulinemia. The pathogenesis of atherosclerosis emphasizes the role of inflammatory processes. There are a number of markers of the inflammation process. They are also observed in PCOS and may indicate an increased risk of cardiovascular disease in women. More than 46% of women with PCOS can be diagnosed with metabolic syndrome. Because of the fact that patients with PCOS are at higher risk group of the earlier development of complications such as diabetes t 2, atherosclerosis, hypertension and cardiovascular system diseases, it is important to carry out metabolic disorders diagnosis in every patient with PCOS. It will help to estimate the risk of complications and allow for the implementation of prevention or treatment of metabolic diseases belonging to the image of PCOS.

Cardiovascular system diseases in patients with polycystic ovary syndrome - the role of inflammation process in this pathology and possibility of early diagnosis and prevention.

Polycystic ovary syndrome is a disorder which affects 5-10% of women in reproductive age. PCOS is a cause of hyperandrogenism, menstrual disorders and infertility. The most common clinical symptoms are hirsutism, acne and obesity. Patients often suffer from metabolic disorders: insulin resistance, hyperinsulinemia, dislipidemia, leading to atherosclerosis and others irregularities of the metabolic syndrome. Patients are in the high risk group for cardiovascular diseases (CVD) development because of the metabolic abnormalities. Obesity is observed in 35-60% of women with PCOS. Lean women with PCOS are also exposed to a greater risk of glucose intolerance development and abnormalities in lipid profile than women without PCOS with comparable BMI. Adipocytes are the source of many compounds of the paracrine and endocrine activity. Some of them are also markers and mediators of inflammation. Increased levels of proinflammatory cytokines in blood can promote atherosclerosis and cardiovascular disease. Markers: IL-18, TNF, IL-6 and hs-CRP are often elevated in patients with polycystic ovary syndrome. An increase in inflammatory markers may be an early indicator of the risk of developing insulin resistance and atherosclerosis, and may become a useful prognostic and therapeutic tool for monitoring patients with PCOS: lean and those with overweight and obesity. Assessment of the concentrations of inflammatory markers may become a very useful test in evaluating the risk of developing atherosclerosis and cardiovascular disease, long before their clinical manifestation. It will also allow for the appropriate prophylaxis.

Insulin resistance assessment in patients with polycystic ovary syndrome using different diagnostic criteria--impact of metformin treatment.

INTRODUCTION AND OBJECTIVE: Polycystic ovary syndrome (PCOS) is one of the most frequent reasons for anovulation in infertile women. It can affect 5%-10% of women of reproductive age. One of the important factors associated with the typical clinical signs and hormonal disorders could be insulin resistance and hyperinsulinaemia. The primary objective of this study was to assess the prevalence of insulin resistance in PCOS women. The secondary objective was to evaluate changes in body mass index (BMI), waist-to-hip ratio (WHR), and insulin sensitivity after 3 months of metformin therapy. MATERIALS AND METHODS: 68 patients were enrolled in the study. In all participants fasting and 2-h post-load glucose and insulin levels, WHR and BMI were evaluated before and after metformin (2 x 850 mg) therapy. Insulin resistance was assessed using G0/I0, G120/I120, and HOMA-IR indexes. RESULTS: Before the treatment, insulin resistance was observed in 26% patients according to HOMA-IR, and in 16% or 28% according to G0/I0 or G120/I120, respectively. Metformin therapy was associated with improvement in insulin sensitivity in HOMA-IR and G120/I120 defined insulin resistant patients. CONCLUSIONS: The percentage of insulin resistant PCOS patients differed depending on the method applied. It is necessary to find a single most useful method to measure insulin resistance. Metformin treatment significantly improves insulin sensitivity in insulin resistant patients.