Evaluation of adipokines concentrations in plasma, peritoneal, and endometrioma fluids in women operated on for ovarian endometriosis.

Introduction: Some studies indicate the role of selected adipokines in the development of endometriosis. However, a comprehensive assessment of plasma, peritoneal, and endometrioma fluids adipokines concentrations in women with ovarian endometriosis has not yet been performed. Therefore, this study aimed to analyze plasma, peritoneal, and endometrioma fluids selected adipokines concentrations in women operated on for ovarian endometriosis. Materials and methods: A cross-sectional cohort study involved 56 women operated on for ovarian endometriosis. Body mass, height, and waist circumference were measured, and BMI was calculated. Plasma, peritoneal, and endometrioma fluids adiponectin, leptin, omentin resistin, RBP4, and visfatin/NAMPT were determined by ELISA. Results: The highest plasma levels of adiponectin, leptin, omentin, and RBP4 than in the endometrioma and peritoneal fluids were found, while levels of resistin and visfatin/NAMPT were significantly higher in endometrioma fluid than in plasma and peritoneal fluid. In addition, levels of visfatin/NAMPT were significantly higher in peritoneal fluid than in plasma. There were also positive correlations between leptin, RBP4, and adiponectin levels in endometrioma and peritoneal fluids (ρ = 0.28; p < 0.05; ρ = 0.31; p < 0.05; ρ= 0.32; p < 0.05, respectively). There were no associations between adipokines levels in plasma, endometrioma, and peritoneal fluids and endometriosis stage. Conclusion: Our results show that visfatin/NAMPT and resistin may be locally secreted in endometrioma related to inflammation regardless of the stage of endometriosis.

The effect of regular fitness training, sex hormones, and turnover of selected bone markers on sclerostin levels in young women.

Introduction: Regular physical activity (PA) is a recognized factor stimulating bone formation. In recent years, osteocytes have been shown to be involved in the metabolism of bone tissue in addition to osteoblasts and osteoclasts. The aim of the study was to analyze the effects of regular fitness training, sex hormones, and selected bone turnover markers on sclerostin levels in young women. Material and methods: The cross-sectional study involved 78 women including 39 who regularly engaged in fitness training (for 1 h three times a week for 3 months) and 39 leading a sedentary lifestyle. Anthropometric measurements and glucose, lipids, insulin, estradiol, testosterone, free testosterone, androstenedione, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate, intact parathyroid hormone (iPTH), vitamin D, osteocalcin, ß isomer of C-terminal telopeptide of type I collagen (ß-CTx) and sclerostin levels were measured. Results: Activity of women (study group) who were on a high level of PA ranged between 2262 and 6606 MET/min/week (mean, 3843.16; SD = 1230). All of the control group were on low level of PA (198-1617 MET/min/week; mean, 841.06; SD = 302.01). Significantly higher levels of iPTH and ß-CTx were observed in the study than in the control group (p < 0.01). We did not observe differences in vitamin D (p > 0.12), osteocalcin (p > 0.23), or sclerostin levels (p > 0.37) between groups. There were significant negative correlations between log10 sclerostin and log10 DHEA levels (r = -0.24; p < 0.05). A multivariate stepwise backward linear regression model for sclerostin as an independent variable, with the explanatory variables physical activity, estradiol, testosterone, and DHEA levels, did not reveal any effect on changes of sclerostin levels. The model with the explanatory variables vitamin D, iPTH, ß-CTx, and osteocalcin also did not show effects on changes of sclerostin levels. Conclusions: Our results show that regular fitness training, sex hormones, vitamin D, iPTH, ß-CTx, and osteocalcin did not influence circulating sclerostin levels in young women.

Quality of Sex Life in Intestinal Stoma Patients-A Literature Review.

INTRODUCTION: Stoma surgery may reduce the quality of life, including sex life. A literature review was undertaken to explore what factors impact on the sexual health and sexuality of people with a stoma. METHODOLOGY: A review of the literature was undertaken using the online databases Cochrane, PsychInfo, Embase and Pubmed. The search was limited to articles on colostomates and ileostomates in the English language that were peer-reviewed and written in the past 5 years. RESULTS: Intestinal stoma surgery affects many aspects of a patient's life, including body image, relationship with a partner and quality of sex life. The introduction of perioperative educational programmes for patients qualified for ostomy surgery and their relatives will provide the necessary support in the face of physical and mental difficulties that may be associated with the procedure.

Eating Behaviours in Sportswomen from the Silesian Training in Different Sports Disciplines.

Eating disorders are characterized by abnormal, unhealthy eating habits, and disordered body image. In severe cases, it can cause serious health consequences, including cardiac problems, osteoporosis, infertility, or missing menstrual periods. In women competitively training sports, the main cause for disordered eating behaviours are factors associated with dissatisfaction with their appearance and body image and a need to reduce body weight. Factors related to dissatisfaction with one's own appearance and body image, a need to reduce body weight, a negative perception of themselves and their bodies, the pressure in sports circles, and stress are predictors for eating disorders. The aim of the study was to compare eating behaviours, body satisfaction, and taking various actions related to body mass reduction among women training competitively in volleyball, athletics, gymnastics, and young women not participating in sports. MATERIAL AND METHODS: The study covered a group of girls and young women from the Silesian, Poland, who represented three sports disciplines (volleyball, athletics, and gymnastics), of which 30 girls were used as a control group (B). The study was conducted using a study questionnaire. RESULTS: The study participants ate regularly and consumed all food groups during a week. The majority of girls from A1 (83.33%), A3 (53.33%), and B (80%) groups expressed their dissatisfaction with their body weight. In the group of gymnasts, a positive correlation was noted between the need to reduce body weight and regular eating (r = 0.449; p = 0.013). In the group of volleyball players, it was demonstrated that the higher the competitive experience and the greater the training load, the more regular their eating was (r = 0.475; p = 0.009). CONCLUSIONS: The importance of a diagnosis of early signs of eating disorders in girls and women as a basic component contributing to FAT development implies that further studies in this area, as well as education of the entire sports circle are necessary.

Risk of venous thromboembolism during the use of oral estrogen-progestogen hormone therapies in light of most recent research findings.

Two important studies evaluating the safety profile of oral estrogen-progestogen hormonal therapies conducted in standard clinical practice with respect to the venous system were recently published. A large prospective controlled cohort study (PRO-E2) based on the non-inferiority design has shown that the relative risk of developing venous thrombosis (VTE) in women using combined oral hormonal contraceptives (COHC) containing 17ß-estradiol (1.5 mg) and nomegestrol acetate (2.5 mg) (E2/NOMAC) was not statistically different from that in users of COHC containing ethinylestradiol and levonorgestrel (EE/LNG). The aim of the recently presented study was to compare the risk of VTE in patients treated with a product for oral continuous combined menopausal hormone therapy containing 1 mg of 17ß-estradiol and 100 mg of micronized progesterone (1 mgE2/100 mgP4) with patients taking conjugated equine estrogens and medroxyprogesterone acetate (CEE/MPA). The study was based on an analysis of records retrieved from a US health insurance database, and was therefore concerned the real-life clinical practice. The hazard ratio of VTE when comparing 1 mgE2/100 mgP4 with CEE/MPA was 0.70 (95% CI: 0.53-0.92). The difference was found to be statistically significant (p < 0.05). The rewieved studies provide further evidence that the use of hormones bioidentical with endogenous steroids in oral contraception and menopausal hormone therapy creates an opportunity to combine high efficacy with a favorable safety profile.

Contact thermography - a modern method and its role in breast cancer prevention.

Breast cancer is one of the most common oncological conditions among Polish women and is a serious health, social, as well as economic problem. Knowledge of early cancer detection methods, risk factors and prevention methods are key issues in the fight against breast cancer in women. Introduction of modern technologies using contact thermography can be both practical and complementary diagnostic method in relation to mammography or ultrasonography of mammary gland.

Changes in the Sexual Behavior of Partners in Each Trimester of Pregnancy in Otwock in Polish Couples.

The aim of this study was to improve knowledge regarding pregnant couples by assessing changes in their sexual behavior, the reasons for the frequency and forms of intercourse, and the self-sexuality of partners in each trimester of pregnancy. As a result, 100 couples were qualified to take part in the final study, with 100 men and 100 women examined at intervals equivalent to the trimesters of pregnancy. These women (n = 100) and men (n = 100) were partners. Each of the studied couples was assessed in the trimesters of pregnancy. A prospective examination was conducted based on the observation of the same people, which were heterosexual couples, throughout pregnancy. The data used in the study was obtained using Davies' Sexual Satisfaction Scale (DSSS), as well as an original survey on the sexuality of people during pregnancy (SARSS). The survey allowed us to obtain sociodemographic (metrics) information along with information regarding the sexual activity, satisfaction, and sexual attraction of the partners. All questionnaire questions were answered in paper form. There was a statistically significant drop in sexual intercourse from the first trimester in the second and third trimesters. The frequency of masturbation increased in men and decreased in women. The most common cause of sexual abstinence during the pregnancy was cited as fear for the fetus by all genders. A statistical analysis indicated that the average overall scores of the DSSS for the examined women in the first trimester of pregnancy were statistically significantly higher than in the two subsequent trimesters (p < 0.05). Sexual satisfaction, measured through both DSSS and SARSS, was also strongly correlated with the level of satisfaction in the assessment of the partner relationship and with the sense of one's own attractiveness (p < 0.05). Changes in sexual behavior and sexual problems are often exposed or worsened during a first pregnancy and can have negative impacts on a person and the future of relationships. Medical staff should be trained in the assessment of sexual difficulties in people during pregnancy, in order to conduct reliable education and increase the awareness of couples regarding sexual and reproductive health.

Pre and Postoperative Sexual Dysfunction in Patients with Leriche Syndrome-A Prospective Pilot Study.

Background: Recovery of normal arterial inflow in the lower limbs after Leriche's syndrome surgery does not always improve erection. This study assesses the effects of Leriche syndrome on erectile and ejaculatory dysfunction in patients awaiting surgical treatment and the impact of treatment used on sexual dysfunctions. Methods: 35 men with Leriche syndrome aged 61.3 years (SD = 7.74) were assessed for erectile dysfunction. The patients were classified into three groups: aortofemoral bypass (group 1); stenting of the iliac artery (group 2) and aortobifemoral bypass (group 3). The patients were qualified for surgery based on the TASC II guidelines. Follow-up was done 3 months after treatment. Results: The mean preoperative IIEF-5 score was 14. 69 (+/- 5.30), with better preoperative scores obtained by 54.3% of patients. A total of 51.4% and 48.6% of patients, respectively, reported normal erection enabling satisfactory penetration and normal ejaculation before treatment. After surgical treatment, satisfactory erection was reported by 60% of all surgically treated patients, whereas the presence of ejaculation was reported by only 14.2% of patients. Conclusions: The IIEF-5 score is a tool for careful assessment of vascular erectile dysfunctions, it allows for the evaluation of erectile dysfunctions in relation to atherosclerosis risk factors. The treatment strategy used allowed for slight improvement as evidenced to erection but decreasing normal ejaculation.

Position Statement by Experts of the Polish Menopause and Andropause Society on menopausal hormone therapy with an oral combination drug containing oestradiol 1 mg and progesterone 100 mg.

At a meeting held on 20 May 2021, reviewed the available literature on the use of the medicinal product Bijuva® for the relief of menopausal symptoms.

Factors affecting the choice of drospirenone as the component of combined contraceptive pill in daily clinical practice: the results of nation-wide survey.

OBJECTIVES: The aim of the multicenter, open-label, post-marketing, observational survey was to assess doctors' preferences in choosing the progestogen component of the combined contraceptive pill (CCP) and factors affecting this choice in daily clinical practice as well as non-contraceptive reasons use of CCP containing drospirenone (CCPD) and patients' tolerance and satisfaction with the treatment. MATERIAL AND METHODS: This multicenter, open-label, post-marketing, survey was performed nation-wide with the participation of 222 doctors involving and 10,345 patients treated with CCPD. The study questionnaire included questions concerning factors affecting the choice of drospirenone as a component of CCP and assessing prescription pattern of the drug as well as tolerance and satisfaction with the use of CCPD. RESULTS: The doctors frequently declared their choice of drospirenone as the progestogen component of CCP. The most important factors affecting the choice of drospirenone, declared by doctors, were tolerance level, consistent regulation of menstrual cycle and not causing spotting. CCPD was prescribed to patients with irregular menstrual cycles (62.7%) and painful menstruation (46.8%). During follow-up, significantly increased percentage of patients assessed the tolerance of treatment with CCPD as very good (52.5% vs 68.0%; p < 0.01) and very satisfied with its use (61.9% vs 77.8%, p < 0.01). CONCLUSIONS: 1) Drospirenone is frequently chosen progestogen component in CCP by Polish gynecologists due to its good tolerance, consistent regulation of the menstrual cycle and no spotting in patients opinion. 2) CCPD was most frequently used in patients with irregular menstrual cycles and painful menstruation. 3) The patients were satisfied with the use CCPD and treatment was well tolerated.

Knowledge and opinions of patients and medical staff about patients' rights.

OBJECTIVES: The awareness of patients' rights among medical personnel and patients themselves, together with their opinions concerning these rights, is a challenging issue for health professionals. Patients' rights are very specific legal regulations that have been drafted to protect patients' dignity and autonomy. The main objective of this research was to assess the knowledge of patients' rights among medical personnel of health care institutions and among patients themselves. Specific objectives were also adopted, such as: assessment of the impact of the mode of hospital admissions on the knowledge of patients' rights, analysis of factors influencing the knowledge of patients' rights and the analysis of sources of knowledge concerning patients' rights. MATERIAL AND METHODS: The study was conducted among two groups: patients and medical personnel. A group of 618 patients (including 411 women and 207 men) and 901 medical professionals (doctors, nurses, midwives) was examined via a questionnaire designed to verify their knowledge of patients' rights and to collect their opinions on the applicable laws. An integral part of the questionnaire for patients was The Hospital Anxiety and Depression Scale (HADS). RESULTS: The research showed a high knowledge of patient's rights demonstrated by the surveyed doctors, nurses and midwives. Good knowledge of patients' rights among healthcare professionals was reflected in good level of informing patients about their rights, which correlates with their high level of awareness. CONCLUSIONS: The following conclusions were drawn based on the research: education, seniority and profession determine the knowledge and respecting patients' rights, the mode of admission to hospital is a factor determining the knowledge of applicable patients' rights, medical staff's lack of knowledge about existing patients' rights has a significant impact on exercising these rights or their violation.

Recommendations of the Group of Experts of the Polish Society of Gynecologists and Obstetricians regarding gynecological examination and treatment of a minor person (01.01.2020).

The recommendations present the current knowledge and procedures, which can be modified and changed in some cases, after careful analysis of a given clinical situation, which in the future may become the basis for their modification and updating.

The impact of competitive sports on menstrual cycle and menstrual disorders, including premenstrual syndrome, premenstrual dysphoric disorder and hormonal imbalances.

OBJECTIVES: With the considerable increase of female participation in youth sports, it has become crucial for medical professionals, coaches and parents to improve their competitiveness by understanding the conditions for which these females are at elevated risk and mitigating possible health consequences. The aim of this study was to evaluate the effect competitive sports have on the disorders of the menstrual cycle, to investigate the frequency of PMS (premenstrual syndrome)/PMDD (premenstrual dysphoric order) in professional female athletes and to identify risk factors predisposing for PMS and PMDD. Additionally, the levels of selected hormones such as serum estradiol, FSH, LH and prolactin were investigated to identify any hormonal perturbances that might have influence or be the risk factors for menstrual dysfunctions. MATERIAL AND METHODS: The study group consisted of 75 professional athletes (girls and young women at the age of 16-22) who lived on the territory of Silesia. The control group consisted of 50 girls and young women at the same age, who did not practice any sport. The research tools included daily diary of PMS symptoms created in line with The American College of Obstetricians and Gynecologists (ACOG) recommendations and ICD-10 diagnostic criteria, daily diary of PMDD symptoms created according to DSM-V diagnostic criteria of the American Psychiatric Association (APA) and premenstrual symptoms screening tool (PSST). RESULTS: The analysis of menstrual cycle disorders showed statistical significance for heavy menstrual bleeding (p = 0.01) and longer breaks between menstrual bleeds (p = 0.01). PMDD was diagnosed in 8% and PMS in more than 42% of respondents. The incidence of PMDD was not at significant variance between the groups (9.33% in contrast to 6.0%), while incidence of PMS was statistically different in both groups (p = 0.045) (49.33% vs 32.0%). A significant correlation between PMS, average age (p = 0.00001) and menarche age (p = 0.03) in young active athletes has been shown. The risk of PMS increased with age (by 1.71 with each year) (p = 0.0007). CONCLUSIONS: A number of other risk factors predisposing for PMS and PMDD has also been identified. The findings of these researches will enable the athletic care network to provide better care for young female athletes.

Impact of COVID-19 on pregnancy and delivery - current knowledge.

The World Health Organization announced on 12 March 2020 a global pandemic of the new SARS-CoV-2 coronavirus causing COVID-19 disease associated with pneumonia and acute respiratory failure. SARS-CoV-2 has caused so far over 6.66 million recorded cases, of which 393,000 ended in death (as of June 1, 2020). Despite the demographic statistics of incidence, there is no current recording of cases in the group of pregnant or perinatal women. Changes occurring in the female body system during pregnancy also affect and alter the immune system, and as studies based on other viral respiratory infections have shown, the population of pregnant women is at risk of having a severe course of the disease. The aim of the study is to summarize current reports on the course of COVID-19 disease in a group of pregnant women and the possible impact of SARS-CoV-2 on the foetus and vertical transmission, taking into account changes occurring in the woman's immune system during pregnancy. Available advice and recommendations for antenatal and perinatal care of pregnant women during the pandemic period are also included.

Recommendations of the Group of Experts of the Polish Society of Gynecologists and Obstetricians regarding abnormal uterine bleeding in adolescents.

The recommendations present the current knowledge and procedures, which can be modified and changed in some cases, after careful analysis of a given clinical situation, which in the future may become the basis for their modification and updating.

Circulating omentin-1 levels and inflammation in polycystic ovary syndrome.

OBJECTIVES: The aim of the study was to analyze interrelation between plasma omentin-1 levels and nutritional status and inflammation in PCOS. MATERIAL AND METHODS: A cross-sectional study involving 86 PCOS (47 obese) and 72 Non-PCOS women (41 obese) determined anthropometric parameters and body composition. Serum glucose, insulin and omentin-1, TNF-α, sTNFRs, IL-6 and sR-IL6 were measured in the fasting state. RESULTS: Plasma omentin-1 levels were significantly lower in the PCOS than in the Non-PCOS group and both corresponding normal weight and obese subgroups. In three analyzed least-angle regression (LARS) models the lower plasma omentin- 1 levels was associated with PCOS occurrence, higher circulating TNF-α and lower IL-6 levels. CONCLUSIONS: Suppressed omentin-1 levels in PCOS are characteristic for this disturbance and proinflammatory cytokines are factors modifying secretion of this adipokine.