Effects of epidural analgesia on the course of labor.

OBJECTIVE: The aim of this study was to assess the effects of epidural analgesia on the course of labor. SUBJECTS AND METHODS: The material for the study was obtained from the analysis of 300 medical records of patients delivering under epidural analgesia in the period 2015-2019. A questionnaire by the authors was used as the research tool. Statistical analysis was performed using Fisher's test, Pearson's Chi-square test of independence, and Cramer's V-test. RESULTS: The first stage of labor in primiparas usually lasted six to nine hours, and in multiparas under five hours (p = 0.041). The second stage was shorter in multiparas (p < 0.001). Our five-year analysis demonstrated that the second stage of labor was longer from year to year (p = 0.087). The fetal station had an effect on the duration of the first stage of labor (p = 0.057). After administration of epidurals, the majority of the women bore the pain well (p = 0.052). CONCLUSIONS: Epidural analgesia reduces labor pain, but may also disturb the natural rhythm of labor. This happens even if the moment of application of the analgesia is chosen with the guidance of obstetric indications, and may result in the necessity for surgical intervention.

The impact of premenstrual syndrome on women's quality of life - a myth or a fact?

OBJECTIVE: The aim of this study was to assess the quality of life (QoL) of women with premenstrual syndrome (PMS). PATIENTS AND METHODS: The study involved 231 regularly menstruating women aged 18 years and older. The research was carried out from July 2018 to November 2018 at St. Maksymilian Maria Kolbe Catholic Secondary School in Szczecin, Non-Public Healthcare Center "MEDI-PLUS" in Zwierzyno, and by electronic means. The research instruments used in the study were: the author's questionnaire concerning the severity of individual PMS symptoms (based on the APA criteria for PMDD, included in the Diagnostic and Statistical Manual of Mental Disorders, 4th ed.), and the standardized World Health Organization Quality of Life (WHOQOL-BREF) questionnaire. Statistical analysis was performed using the SPSS 24 statistical package. The Kolmogorov-Smirnov test was used. The level of statistical significance was set as p < 0.05. RESULTS: The QoL of women with PMS was at a medium level. Emotional symptoms were the most severe ones (p = 0.010). The highest QoL scores were obtained for the social relationship domain (p = 0.002), and the lowest for the mental health domain (p = 0.006). CONCLUSIONS: PMS involves significant morbidity, and the health burden it causes is still not fully assessed. Young women constitute a group that shows the greatest need for psychological support because they experience the most severe PMS symptoms.

The influence of support and medical data on the level of illness acceptance, the way of coping with a stressful situation, and mental adjustment to the disease among cancer patients.

OBJECTIVE: The aim of this study was to analyze the behavior of cancer patients. PATIENTS AND METHODS: This survey-based study involved 145 oncological patients and was conducted from July to November 2018. It was performed using an author's questionnaire and three standardized tools: the mini-Mental Adjustment to Cancer Scale, the Acceptance of Illness Scale, and the Coping Inventory for Stressful Situations. RESULTS: The acceptance of illness was at a medium level. Patients who had been ill for longer time periods coped with stress better (p < 0.071) and showed better mental adjustment (p < 0.05 for Positive Redefinition, and p < 0.08 for Fighting Spirit). Patients with benign tumors focused on emotions (p < 0.001) and avoidance (p < 0.005) and were preoccupied with anxiety (p < 0.05). Longer treatment time was associated with a higher ability to cope with stress (p < 0.05). Patients receiving support were characterized by Anxious Preoccupation attitude (p < 0.1), and those who had not got it by Fighting Spirit (p < 01). CONCLUSIONS: Cancer patients have problems coping with new circumstances. They need support and help to understand and accept their situation.

Serum adiponectin in relation to endometrial cancer and endometrial hyperplasia with atypia in obese women.

OBJECTIVES: The aim of this work was to compare concentrations of adiponectin in the serum of obese women with endometrial cancer, endometrial hyperplasia with atypia, and normal endometrium. METHODS: We enrolled 105 obese women treated at the Department of Gynecological Surgery and Oncology of Adults and Adolescents. The patients were allocated to groups depending on the histological diagnosis (R - endometrial cancer, P - polyps, K - normal endometrium). We subdivided group R depending on the stage and grade of cancer. RESULTS: Significantly lower concentrations of adiponectin were found in patients with endometrial cancer (mean 15.28 microg/ml) as compared with polyps (29.94 microg/ml, p < 0.001) or normal endometrium (22.7 microg/ml, p < 0.05). Stage of cancer had no significant effect on the adiponectin level. When cancer grade was compared, lower levels of adiponectin were observed in patients with G3 (12.86 microg/ml) than G1 (19.04 microg/ml, p < 0.05). CONCLUSION: Reduced levels of adiponectin may represent an independent risk factor for endometrial cancer.