Impact of stress urinary incontinence on female sexual activity.

OBJECTIVE: The study aimed to investigate the impact of SUI (Stress Urinary Incontinence) on the sexual activity of women, to assess their sexual functioning, and to show the extent of the problem that SUI poses to the quality of life of women. PATIENTS AND METHODS: The study involved 70 women aged 20-48 years. The inclusion criteria included the presence of stress urinary incontinence, the sexual activity of the women, and the history of no urogynecological intervention. The authorial questionnaire and the Polish version of the Female Sexual Function Index (FSFI) were used. RESULTS: SUI contributes to reducing the frequency of intercourse and even complete resignation from sexual intercourse. There is a correlation between the occurrence of urinary leakage during intercourse and the occurrence of sexual dysfunction (p=0.023). The most common factors limiting sexual activity are decreased libido, fatigue, lack of desire, and lack of body acceptance. However, age (p=0.070), marital status (p=0.091), Body Mass Index (BMI) (p=0.436), as well as the duration of stress urinary incontinence (p=0.36) have no effect on women's sexual activity. The most common ways of dealing with the loss of urine during intercourse include micturition before intercourse, intercourse only in safe places, restriction of physical activity during intercourse, and reduction of intercourse frequency and duration. CONCLUSIONS: SUI in women has a significant effect on their sexual activity. The cause of this state of affairs is multifactorial. Some women try to cope with the problem and have developed a number of strategies that allow them to be sexually active without unpleasant surprises.

Multielemental analysis of 20 mushroom species growing near a heavily trafficked road in Poland.

The aim of this work was to compare 10 mostly edible aboveground and 10 wood-growing mushroom species collected near a heavily trafficked road (approximately 28,000 vehicles per 24 h) in Poland with regard to their capacity to accumulate 26 trace elements (Ag, Al, As, Au, B, Ba, Bi, Cd, Co, Cr, Cu, Fe, Ga, Ge, In, Li, Mn, Ni, Pb, Re, Sb, Se, Sr, Te, Tl, and Zn) in their fruit bodies in order to illustrate mushroom diversity in element accumulation. All analyses were performed using an inductively coupled plasma optical emission spectrometry (ICP-OES) spectrometer in synchronous dual view mode. The aboveground species had significantly higher levels of 12 elements, including Ag, As, Pb, and Se, compared to the wood-growing species. An opposite relationship was observed only for Au, Ba, and Sr. The results of principal component analysis (PCA) and hierarchical cluster analysis (HCA) implied some new relationships among the analyzed species and elements. Of the analyzed mushroom species, lead content in Macrolepiota procera would seem to pose a health risk; however, at present knowledge regarding lead bioaccessibility from mushrooms is quite limited.

Assessment of iron in uterine and testicular tissues and hair of free-ranging and household cats.

Iron (Fe) represents a highly essential element for various biological processes. In spite of this very little is known as regards its status in mammalian reproductive tissues and factors that may potentially influence it. At the same time, there is an ongoing debate as to whether analyses of the Fe content in hair can provide reliable information on its tissue burden. Therefore, the aim of the present study was to investigate the content of Fe in the testicular and uterine tissues, and hair of the domestic cat (Felis catus) and how this content relates to an animal's age, weight, physical activity, inhabited environment and diet. The median Fe content in the feline reproductive tissues amounted to 50.8 ppm and in hair to 180.2 ppm. As found, free-ranging cats were characterized by a significantly higher Fe content in reproductive tissues, particularly in the uterus. Age, weight and physical activity had no effect on determined Fe levels. The type of commercial diet (wet, dry or combined) given to household cats also had no influence upon Fe status in hair and tissue although males fed exclusively on dry food had a lower Fetestis:Fehair ratio. Hair Fe level was positively correlated with that found in the reproductive tissues (Rs=0.30). This study extends the body of information on Fe distribution in felines, demonstrates the difference between free-ranging and household cats and provides evidence that Fe hair status may, at least partially, reflect the status of this element in the feline reproductive system.

Changes in ultrasound shear wave elastography properties of normal breast during menstrual cycle.

UNLABELLED: Elastography is a novel technique capable of noninvasively assessing the elastic properties of breast tissue. Because the risk factors for breast cancer include hormonal status and proliferation, the aim of our study was to estimate the intensity of sonoelastographic changes during the menstrual cycle. METHODS: Eight women aged 20-23 years with regular menstrual cycles underwent B-mode sonography and sonoelastography (ShearWave on Aixplorer, France) on days 3, 10, 17 and 24. RESULTS: Mean values of glandular and fat tissue elasticity did not change statistically significantly during the menstrual cycle as well as glandular to fat tissue ratio. During almost the whole cycle differences between outer and inner quadrants in glandular and fat tissue were statistically significant. The lowest values of elasticity occurred on the 10th day and the highest on the 24th of the menstrual cycle. There were statistically significant differences in elasticity between inner and outer quadrants of both breasts close to day 3 and 17 of the menstrual cycle.

Use of shear wave sonoelastography in capsular contracture before and after secondary surgery: report of two cases.

We present two cases of patients undergoing secondary surgery due to Baker III and IV contracture, with detailed sonoelastography evaluation before and after the surgery. It is probably the first case where the use of sonoelastography has enabled plane colour-coded analysis of regions with different stiffness (Young moduli, kPa). The obtained results have been compared with applanation tonometry.

Efficacy of 12 weeks supplementation of a botanical extract-based weight loss formula on body weight, body composition and blood chemistry in healthy, overweight subjects--a randomised double-blind placebo-controlled clinical trial.

OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of composite extracts in reducing weight, as the main outcome measure. Secondary measures of the study were body composition change. DESIGN: Randomised, double blind, placebo-controlled clinical trial. SETTING: Tertiary university clinic. SUBJECTS: hundred and five subjects, 5 of them withdrawn consent, 2 drop-outs not related to study preparation. INTERVENTION: two tablet per meal concept supposed to generate a "psychological" therapy-like approach during 12 weeks supported by measured physical activity. The tablets 1 (one hour before meals, comprises extracts of Asparagus, Green tea, Black tea, Guarana, Mate and Kidney beans) and 2 (taken half an hour after meals, comprises extracts of Kidney bean pods, Garcinia cambogia, and Chromium yeast) are taken twice daily with two main meals. RESULTS: A significant change of the Body Composition Improvement Index (BCI) was observed in the active extract group compared to placebo (p = 0.012). Weight, BMI, waist-to-hip ratio was not statistically different between groups. Body fat loss was greater in active group (p = 0.011) compared to placebo. A weight loss parameter corrected for exercise was introduced and found to be higher in active group (p = 0.046) than in placebo, meaning that the formula was more efficacious, due to a concurrently performed exercise program--a recommended strategy for life style modification. CONCLUSIONS: A significant change of the Body Composition Improvement Index and the decrease in body fat was statistically significant in active extract subjects compared to placebo. A change in some outcome measures like: weight, BMI failed to produce significant difference between groups.

Evaluation of soluble tumour necrosis factor alpha receptors p55 and p75 in ovarian cancer patients.

PURPOSE: Evaluation of serum TNFalpha receptor 1 (p55) and 2 (p75) concentrations preoperatively in patients with ovarian masses. METHODS: Estimation by ELISA assay in 51 women with ovarian cancer and 16 healthy controls. Mean values and correlations with CA-125, tumour volume index, morphological score, pathological finding and cytoreduction were estimated. RESULTS: Mean concentrations of p55 and p75 in cancer patients were 2006 +/- 1030 pg/ml and 2849 +/- 1092 pg/ml, respectively, whereby for controls 1323 +/- 291 pg/ml and 2386 +/- 475 pg/ml, respectively. The area under the ROC curve for CA-125, p55 and p75 for cancer (FIGO Stages I-IV) were: 0.85 (95% CI 0.75-0.92), 0.73 (95% CI 0.60-0.83) and 0.65 (95% CI 0.50-0.77), respectively. Serum p55 correlated with morphological ultrasound score and CA-125 but not with FIGO stage, tumour grade or tumour volume index. No correlations of p75 with these parameters were observed. CONCLUSION: Estimation of p55 and p75 provide little information in ovarian cancer patients and have poor detecting power.

Serum tumor necrosis factor alpha receptors p55/p75 ratio and ovarian cancer detection.

OBJECTIVE: Early ovarian cancer detection is still very difficult and patients are mostly in advanced stages, with obvious influence on poor prognosis. METHOD: Fifty-one ovarian cancer patients and 16 healthy controls had the serum concentrations of TNF alpha receptor p55, p75 and CA-125 measured prospectively and preoperatively. RESULT: Mean concentrations of TNF alpha receptor p55, p75 and CA-125 in patients with ovarian cancer were higher than in controls. The ratios of p55 and p75 receptor in ovarian cancer and controls were 0.73+/-0.38 and 0.55+/-0.06 respectively. The areas under ROC curve in detecting malignancy (all FIGO stages) were 0.73, 0.65, 0.88 and 0.85 for p55, p75, p55/p75 ratio and CA-125 respectively. The areas under ROC curve in detecting stage I of ovarian cancer were 0.52, 0.60, 0.84 and 0.66 for p55, p75, p55/p75 ratio and CA-125 respectively. CONCLUSION: Serum TNF alpha p55/p75 ratio showed promising value in ovarian cancer detection.

Evaluation of soluble intracellular adhesion molecule-1 (sICAM-1) in benign and malignant ovarian masses.

PURPOSE: To evaluate serum ICAM-1 levels preoperatively in patients with ovarian masses. METHODS: Estimation by ELISA assay in 101 women with pelvic tumours and 16 healthy controls was performed. Correlations of sICAM-1 levels with CA-125, Tumour Volume Index, morphological score and pathological findings were studied. RESULTS: Fifty-one ovarian tumours were malignant, five were borderline and 45 benign. Mean levels of sICAM-1 were respectively, 311.1 +/- 182.9 ng/ml, 172.6 +/- 40.1 ng/ml, 241.8 +/- 74.1 ng/ml and 195.6 +/- 68.7 ng/ml for controls. The area under ROC curve for sICAM-1 was 0.72 (95% CI 0.58-0.82), the cut-off 250 ng/ml, corresponding to 81.3% sensitivity and 52.9% specificity. Serum ICAM-1 correlated with morphological score (r = 0.51, p < 0.001), but not with FIGO stage, tumour grade, Tumour Volume Index and CA-125. CONCLUSION: sICAM-1 concentrations are higher in patients with malignant tumours, but poorly correlate with clinical status. The clinical use alone in ovarian malignancy detection and tumour differentiation seems to have limited application. Combinations of CA-125 and sICAM-1 could improve the test characteristics.

A study of Internet use by doctors and patients in Poland.

We evaluated Internet use in Poland in the field of obstetrics and gynaecology. Questionnaires were sent to 33 hospital departments of obstetrics and gynaecology; 25 replied (76%). The 25 departments contained a total of 275 doctors, 70% of whom (n=193) returned the questionnaire. We also invited 3054 people visiting a gynaecological Website for patients to complete an online form; 161 replied, a response rate of 5.3%. While 84% of the 102 doctors using the Internet were satisfied with Internet medical resources, only 24% of patients were. Patients searched for medical information less frequently than professionals and were younger. About half of the doctors and patients had only modem access to the Internet. The most popular services for professionals were databases and information services; patients were most interested in information on pregnancy, contraceptives, physiology and general female health. Most of the 45% of patients who said that they did not receive sufficient information from doctors could not usually find it on the Internet either.

[Gynecologic endoscopy in the greater region of Poland during 1988-1998]. / Endoskopia ginekologiczna w województwie wielkopolskim w latach 1988-1998.

The aim of the study was to analyze the state and development of the gynaecological endoscopy in the Wielkopolska region in years 1988-1998. The questionnaire included gynaecological and obstetrical departments of 31 hospitals: 1 academic center, 5 former regional hospitals and 25 small hospitals. At the end of 1998 35.5% of departments were equipped with laparoscopes and 9.7% with histeroscopes. There was an increase in the laparoscopic procedures from 151 to 832 estimated in these years, as well as from 181 to 314 hysteroscopies. The detailed analysis of procedures and dynamic of its increase according to the type of hospital is presented. The experience of the staff was also analyzed. We demonstrated the insufficient equipment in the region, in spite of the right tendencies in the spectrum of the endoscopic procedures and the experience of the physicians who perform laparoscopy and hysteroscopy.

[Pathologies observed in barium enema examination in patients with gynecological disorders]. / Zmiany obserwowane we wlewie kontrastowym jelita grubego u pacjentek ze schorzeniami ginekologicznymi.

The aim of our study was to analyse retrospectively 171 patients with gynaecological diseases, who have undergone barium enema examination in Third Teaching Hospital in Poznan between 1992 and 1998. 79 patients were diagnosed with ovarian tumours, in 24 cases their colon was dislocated. Stenosis was detected in 20 women and in five situations inflammatory changes of the colon were present. Malignant infiltration of large intestine was suspected in ten patients. The second group included 24 women diagnosed with tubo-ovarian abscesses and adnexitis. Three of them had dislocated colons. Stenosis of large bowel was detected in 11 patients and inflammatory changes in 8. In the next group of 35 patients' myoma uteri, myometrial endometriosis and carcinoma of colli uteri were detected. Barium enema examination revealed that 10 women had dislocated colons. In the third group stenosis was detected in eight cases, two patients had radiological signs of cancer infiltration and twice inflammatory changes of the large bowel were present. Frequency of radiological changes in barium enema examination was evaluated in the aforementioned groups. Results were compared with group of 33 patients treated for endocrinological disorders, sterility and minor pelvis pain syndrome. Frequency of dislocation of colon was compared with size of changes of ovaries measured during ultrasound examination. Our results showed that barium enema is still an important supplementary examination, which can give a great deal of beneficial information concerning the clinical condition of the patient. This procedure is useful before surgical intervention especially in cases of suspected ovarian cancer. We must underline that the same or similar information can be obtained using other methods without such radiation exposure.

[Coexistence of female sexual organ malformation and urinary tract anomalies]. / Wspólwystepowanie wad zenskich narzadów plciowych z anomaliami rozwojowymi ukladu moczowego.

OBJECTIVES: The aim of the study was to estimate the correlation between sexual organs and urinary tract malformation. MATERIALS AND METHODS: The retrospective analysis of clinical data obtained from 50 patients with sexual organs anomalies diagnosed in the Academic Gynaecological Centre between 1992-1999 was performed. RESULTS: Material included 24 patients with the Meyer-Rokitansky-Küster-Hauser syndrome and 26 with other sexual organs' malformations. Frequency of urinary tract anomalies was 42%, 11 patients with Meyer-Rokitansky-Küster-Hauser syndrome and 11 with other malformations. The gravity of urinary tract anomalies showed no statistical significant difference dependent on the type and symmetry of genital malformation. Urinary tract anomalies were more frequent in cases of asymmetric genital malformation and the difference was statistically significant. CONCLUSIONS: Intravenous urography proofed to be more sensitive than ultrasonography in diagnosing urinary tract anomalies.

[Changes in mammography and breast ultrasonography in women undergoing hormonal replacement therapy]. / Zmiany w mammografii i ultrasonografii gruczolów sutkowych u kobiet poddanych hormonalnej terapii zastepczej.

OBJECTIVES: The aim of this study was to compare changes in mammography and breast ultrasonography in women undergoing Hormonal Replacement Therapy (HRT) and a control group. MATERIALS AND METHODS: Retrospective analysis of clinical documentation form 12.1998 to 11.1999 of 1075 women over 45 years old. COLLECTED DATA INCLUDED: Breast imaging, hormonal therapy, gynecological, obstetrical and oncological interview and examination. Analysis was performed using MS Access DataBase and Statistica v5.0, p = 0.05 was considered significant. RESULTS: 710 women were actually undergoing HRT and 365 were qualified to the control group. Oral HRT was used by 72.2% women, transcutaneous by 24.1% and transvaginal by 3.7%. There were no differences of breast cancer risk factors, age and cancer suspicious changes (relative risk 1.03) in analyzed groups. Suspicious microcalcifications were rarer in women undergoing HRT (relative risk 0.49) while breast cysts (especially to 0.5 cm) were more frequent. There were no statistically significant differences in other changes like: benign breast masses, macrocalcifications and mastopathy. All findings referred to superiolateral quadrant in 50% of HRT women and 56% of control group. CONCLUSIONS: Hormonal Replacement Therapy has no marked influence on changes in mammography and ultrasonography. Among women undergoing HRT, microcysts are more frequent while suspicious microcalcifications are less.

[Evaluation of professional Internet resources' use by gynaecologists and obstetricians]. / Ocena wykorzystania internetu jako zródla informacji fachowej przez ginekologów i polozników.

OBJECTIVES: The aim of this study was to evaluate the use of internet as the additional education tool by gynaecologists and obstetricians. MATERIAL AND METHOD: Prospective questionnaire was sent December 1999 to gynaecological departments of 35 hospitals in Wielkopolska region. Data were collected in MS Access data base until February 25, 2000. Analysis was performed using MS Excel packet. RESULTS: Questionnaires returned from 25 hospitals (71.4%) filled by 193 physicians. About 52.8% of them use the internet for searching professional information. Among internet users 77.4% search Medline data bases, 22.5% use discussion lists, 64.7% search for education possibilities, 67.6% are interested in precise professional topics, 31.4% read the OnLine papers and casuistic, 1.0% has the own www page. The importance of internet was stressed by 84.3% of internet users. Young physicians and those in specialising training are frequent users of internet. CONCLUSION: The access to internet is not satisfactory, but the physicians use all possible internet options.