Adiponectin to leptin index as a marker of endometrial cancer in postmenopausal women with abnormal vaginal bleeding: an observational study.

OBJECTIVES: To evaluate the correlation between endometrial cancer and adiponectin plasma concentration, leptin plasma concentration as well as adiponectin to leptin index in the population of postmenopausal women with abnormal vaginal bleeding. DESIGN: An observational study SETTINg: Department of Gynecology and Obstetrics, Specialist Teaching Hospital in Tychy, Poland. Population. 99 women between 47 and 88 years old, in postmenopausal state. METHODS: The cases (54 women) were females hospitalized due to postmenopausal vaginal bleeding in whom dilation and curettage (D&C) was performed and endometrial intraepithelial neoplasia (EIN) was diagnosed in anathomopathology. Hysterectomy was then performed in all cases and the endometrial cancer diagnosis was confirmed. The controls (45 women) consists of females with no postmenopausal uterine bleeding in whom endometrial thickness in transvaginal ultrasound was greater than 5 mm. D&C was than performed and no endometrial neoplasia was detected in any of the subjects. Adiponectin and leptin plasma concentration was measured in both groups. Mein outcome measures. The area under the curve, sensitivity, specificity and cutoffs for adiponectin, leptin and adiponectin to leptin index. RESULTS: Adiponectin, leptin and adiponectin to leptin index were statistically correlated with the risk of endometrial cancer. At the suggested cutoffs, corresponding to the highest accuracy (minimal false-negative and false-positive results), adiponectin to leptin index resulted in the highest sensitivity and specificity compared to adiponectin and leptin alone. CONCLUSIONS: Adiponectin to leptin index due to the highest sensitivity and specificity may be used as a marker of endometrial cancer in postmenopausal women with abnormal vaginal bleeding.

[Awareness of cervical cancer prevention among patients of gynecological outpatient clinic]. / Swiadomosc profilaktyki raka szyjki macicy wsród kobiet zglaszajacych sie do poradni K.

INTRODUCTION: Improvement of cervical cancer statistics in Poland is believed to be one of the main goals of all medical services. Cervical cancer is an easily preventable neoplasm thus effective strategies for its prophylaxis should be proposed and introduced to the whole population of Polish citizens. OBJECTIVES: The aim of the study was to measure the extent of knowledge of females about cervical cancer and its prevention. MATERIAL AND METHODS: 250 female patients of gynecological clinic at the Medical Centre in Krakow, Poland, aged 18-60, were included into the retrospective study The research was based on an original questionnaire designed by the authors containing questions concerning general socio-epidemiological status, as well as cervical cancer epidemiology and HPV infection prevention methods. RESULTS: The majority of respondents (68%) rated their knowledge on cervical cancer prevention strategies as medium. The main sources of information on that prophylaxis were: women's magazines (59% of respondents), media (47%) and Internet (38%). Additionally only one in three women acquired that information from gynecologist The main reason for performing the Pap smear test was the request of the respondent (43% of cases). Only 3% of them attended the test as a result of a personal invitation sent by National Health Service. The main reasons for not attending Pap smear test were: fear of pain (39%), lack of any symptoms (18%), carelessness (15%) and embarrassment (12%). CONCLUSIONS: 1. Knowledge on HPV infections and cervical cancer prevention among women attending gynecological outpatient clinic is insufficient. 2. Education, especially in the field of cervical cancer main risk factors as well as the course of pap smear collection, seems to be necessary in order to reduce the cervical cancer morbidity and the fear of performing pap smear tests.

[Pregnancy and delivery course in overweight and obese women]. / Przebieg ciazy i porodu u ciezarnych z nadmierna masa ciala.

INTRODUCTION: Pregnancy and delivery in case of overweight women require special care. The main means of preventing obstetrical complications is promoting healthy lifestyle and pregnancy weight gain control among females planning the pregnancy as well as prenatal diagnosis and pregnancy/delivery course monitoring. OBJECTIVES: The aim of the study was to evaluate the pregnancy and delivery course in overweight and obese pregnant women. MATERIAL AND METHODS: The study was based on a retrospective analysis of medical files of 132 pregnant women delivering in Gynecology and Obstetrics Clinic in Tychy, Poland. The investigated group was divided into subgroups based on pre-pregnancy body mass index according to World Health Organization Criteria for obesity. The comparative analysis was then performed between the subgroups. RESULTS: The prevalence of bleedings in pregnancy pregnancy induced hypertension, diabetes and urinary tract infections was statistically higher in obese pregnant females. Similarly the rate of shoulder dystocia was statistically higher in the obese and overweight subgroups of women. There were no significant differences between subgroups in mean neonate body length or mean Apgar scores. However the highest neonate body weight was observer in subgroup of overweight females and those with pre-pregnancy normal BMI who gained more than 16 kilograms during pregnancy. CONCLUSIONS: 1. Excessive weight gain in pregnancy is associated with higher risk of pregnancy and delivery complications. 2. Both excessive pre-pregnancy body weight and excessive weight gain in pregnancy increase the risk of perinatal complications.

Quality of life in women with urinary stress incontinence and evaluation of tension-free vaginal tape treatment.

OBJECTIVES: Assessment of quality of life in women stress urinary incontinence (USI) and evaluation of tension-free vaginal tape (TVT) treatment. MATERIAL AND METHODS: The research included a group of 112 women aged 33-78 years. Before as well as 3 and 6 months after the TVT operation, patients were asked to fill in quality of life questionnaires. RESULTS: After 3 months 87.25% of the women reported full regression of USI symptoms, 7.8% an insignificant improvement, and 4.9% did not observe any change. After 6 months 85.71% reported full regression, 9.18% an insignificant improvement, and 5.1% did not observe any change. USI is responsible for a decrease in physical activity. The most uncomfortable symptom is involuntary urine leakage occurring mainly during an effort or sleep. After the TVT procedure, the majority of women confirmed a significant improvement in quality of life. CONCLUSIONS: The TVT procedure is an effective method of treating USI in women: it significantly improves quality of life, with a recovery rate of 85-87%, and a low rate of complications.

[Laparoscopic correction of uterus retroflexion by sewing the round ligament of the uterus to the abdomen fascia in treatment and prophylaxis of pain syndromes]. / Laparoskopowa korekcja tylozgiecia macicy poprzez wszycie wiezadel oblych do powiezi powlok brzusznych w leczeniu i profilaktyce zespolów bólowych.

The use of laparoscopy in diagnosis, investigation, and therapy is very important. The paper describes the laparoscopic technique of correction of a retroflexed uterus. This technique is based on sewing the round ligaments of the uterus to the abdomen fascia. Both simplicity and usefulness of the method are demonstrated.

[Pregnancy and labor after uterine operations]. / Przebieg ciazy i porodu po operacjach na macicy.

OBJECTIVES AND DESIGN: In this study authors analyzed the obstetric history of patients, efficiency of operative treatment and number of obstetric failures, both before and after operation. A special attention was paid to obstetrical past and present history as well as difficulties and complications during the operation. MATERIALS AND METHODS: A group of 25 cases of pregnancy after a myomectomy, Strassmann's or Jones' operation were analyzed. All patients were in age 24-40, an average--33. RESULTS: In all 25 pregnant women authors found: breech presentation (1 case), ingrown placenta (1 case), 3 cases of solid intraperitoneal adhesions and 1 case of uterine cicatrix fissure. CONCLUSIONS: 1. Women after uterine operations require intensive care in pregnancy. 2. Caesarean section is the optimal method of delivery in women after uterine operations.

[Infections of the male urogenital tract and the problem of infertility in the couple]. / Infekcje meskiego ukladu moczowo-plciowego a problem nieplodnosci malzenskiej.

The retrospective analysis of group of 164 men from sterile couples was made. Authors compared spermiograms with bacteriological investigations' results (sperm bacteriology and blots from urethra for present of Chlamydia, Mycoplasma and Ureaplasma). The statistical signification of coincidence of leucospermia and one-species bacterial infection and dependence between leucospermia and pathological spermiogram were found. The positive results of sperm bacteriological investigations were found in normospermic patients too.

[Analysis of obstetrical and gynaecological history of women with urinary stress incontinence]. / Analiza przeszlosci polozniczej i ginekologicznej kobiet z wysilkowym nietrzymaniem moczu.

Urinary leakage is a hygienic and social problem, that concerns women both in reproductive and perimenopausal age. It leads to a life deterioration, depression, and social isolation. Urinary stress incontinence (USI) is one of the most common-type of urine leakage. Characteristic symptom of this disorder there is involuntary leakage of urine during increased intra-abdominal pressure (cough, laugh, sneezing or physical work). There are many various predictive factors of urinary stress incontinence in a large number of publications. One of them, the most important, seems to be a gravidity and labor. 40-82% pregnant women complain of urinary leakage. The main aim of investigation was to determine obstetrical and gynaecological predictive factors of urinary stress incontinence. 53 women with diagnosed USI and qualified to TVT procedure have to fill in questionnaire with row questions about their obstetrical and gynaecological history. Our investigation revealed that significant influence on appearance of USI exert number of spontaneous labors, birth weight >3500 g, lack of substitute hormonal therapy during menopause and hard physical work in the past.

[Effect of the body weight of pregnant women on delivery and the birth state of the newborn]. / Wplyw masy ciala kobiet ciezarnych na przebieg porodu i stan urodzeniowy noworodka.

Systematic and lately even rapid growth of the number of overweight people has been recently observed. In the economically well-developed countries fatness is the real problem of the contemporary man. The evaluation of the body weight of the pregnant women and its influence on the delivery and the birth state of the infants has been the aim of the study. 139 cases of pregnant women with physiological pregnancy have been analyzed. The pregnant women were divided into 4 groups according to the body weight at the early pregnancy which according to WHO criteria was expressed by the body mass index (BMI). The body mass of the delivering woman, date of delivery, way of delivering and probable delivering complications, performed obstetrical procedures, estimated blood loss of the delivering woman, sex, weight and length and the birth state of the infant according to the Apgar scale were evaluated prospectively. Analyzing the body mass of the women at the early pregnancy, underweight was stated at 55 women (39.57%), the proper body weight at 66 cases (47.48%), overweight at 12 cases (8.63%) and the fatness at 6 cases (4.32%). The average body mass index (BMI) at the early pregnancy was 21.63 kg/m2 and its increase during pregnancy was 5.95 kg/m2. It has been found out that the increase of body mass during pregnancy corresponds to the body weight before pregnancy and amounts to 16.22 kg on average. The study has shown more cases of surgical deliveries, greater intrapartum blood loss in the group of overweight and fat women, and greater harm to the vulva/vagina during delivery in the group of underweight women. The best delivery state of the babies has been found out in the group of women with the proper body weight.