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Objectives: The aim of the study was to evaluate the risk of occurrence of metabolic syndrome (MS) in females who suffered from gestational diabetes mellitus (GDM)., Patients and Methods: 495 letters were sent to patients with a history of GDM treated in the Department between 1993-2002. One hundred and fifty-three (30.9%) patients who responded positively formed the study group. Out of them 74 had already been treated for diabetes mellitus, and glucose intolerance was found in 5 subjects. Seventy-four patients had been subjected to a 75 g Oral Glucose Tolerance Test, as well as the control group that consisted of 155 subjects, in whom GDM during pregnancy was excluded. In all patients lipid parameters, blood pressure, height, weight and waist circumference were measured and body mass index (BMI) was calculated. Metabolic syndrome was diagnosed according to the modified NCEP-ATP III criteria from 2005 (3 of 5 had to be fulfilled)., Results: Patients from the study group were older than from the control group (p <0.05), higher was their BMI at the time of the index pregnancy, as well as after the observation time (p <0.0001). Metabolic syndrome was developed in 47 (30.7%) patients of the study group and 8 (5.2%) patients from the control group (p <0.001). The study group presented all components of MS significantly more often than the control group--in both groups, we found respectively: abnormal waist circumference--57% vs. 37.6% (p <0.005), hypertension--18.9% vs. 1.9% (p <0.001), elevated fasting glycemia--79.1% vs. 1.9%, hypertriglyceridemia--21.6% vs. 2.6% (p <0.0001), and decreased concentrations of high-density lipoprotein cholesterol--11.1% vs. 2.6% (p <0.005)., Conclusions: Patients who suffered from GDM are at high risk for carbohydrate disturbances and metabolic syndrome in the following year. Therefore, they should be under continuous medical surveillance that would enable early detection and treatment of the metabolic disturbances.

Unlabelled: Gestational diabetes (GDM) is regarded as a predilecting factor for a subsequent development of diabetes or other disturbances in carbohydrate metabolism. The aim of the study was to evaluate the risk of occurrence of failures in carbohydrate metabolism in females who sufferred from GDM, as well as to determine the prognostic values of selected markers that were regarded as factors favouring the development of diabetes mellitus (DM)., Material and Methods: Patients who in the past suffered from GDM were subjected to this study. Out of 153 patients who responded positively to the written invitation to participate in this study, 74 had already been treated for DM. In 5 of them, abnormal glucose tolerance was found, and 74 of this group had been subjected to a 75g OGTT. The control group consisted of 153 subjects, who had given birth at least twice and in whom the metabolic diagnostics performed during the first pregnancy excluded GDM. Results of our study have revealed that patients who in the past had sufferred from GDM constituted a group with high risk for developing disturbances in carbohydrate metabolism or symptoms of metabolic syndrome after pregnancy. The main factors pro the development of the disturbances in carbohydrante metabolism were: overweight, increased fasting glycemia at the time of GDM diagnosis and insulin requirement during pregnancy., Conclusion: High percentage of diagnosis of an impaired carbohydrate metabolism and DM, calls for a special attention toward a group of patients with previous GDM, for a properly directed treatment that would enable a considerable delay in the development of an overt diabetes, as well as would apply a rational therapy, that would result in an optimal control of existing diabetes.

Phonemic hearing it is a typical interdisciplinary problem. Many specialists like pedagogues, psychologists, phoniatricians and speech therapists are interested in this field. So, we may find many definitions describing this kind of hearing. The speech perception and acquisition of speech is a difficult process profoundly hearing impaired children. With the development of the cochlear implant, acoustic input can be provide to these children. Studies documenting the postoperative performance of children with implants have generally shown significant improvements in speech perception and production. On the opposite side--in the group of postlingually deafened adult the speech rehabilitation is quite short. Only a few specialists described their observation about phonemic hearing development in CI-patients. How do it differ from hearing development in healthy population? The aim of this study was to describe the phonemic hearing development in CI-patients. In the ENT Dept. of University of Medical Sciences in Poznań 280 cochlear implantation were performed. They were observe in three groups: pre-, peri- and postlingually deafened ones. We concluded the same order of phonemic hearing development in every group. The time of acquisition differed, and depended of oral language development before implantation. At first they start to distinct voiced and unvoiced phones, than oral-nasal and sharp-soft ones. The most difficult for them was to discriminate fricative and plosive sounds.

Hearing impaired children do not develop oral speech in the same time with the hearing ones. Cochlear implants may change this situation. Implanted deaf children may develop oral speech but only after long speech rehabilitation. Acquisition of language skills should be assesed correctly in every patient. It is important because this therapy is quite expensive. There are many quantitative and qualitative methods used all over the world. In some cases score is calculated as percentage of correctly repeated words. Sometimes it did not reflect true level of language development. 240 people were implanted in Poznań in years 1994-2004. Two years ago, evaluation of changes in the distinctness and discrimination of phonems of cochlear implants children was begun. We found differences between standard speech audiometry and distinctness and discrimination of phonems.

There are many tests prepared for speech evaluation for different age groups and with any disabilities. The percent of correct repeated mono- or bisyllabes words create the final result. Sometimes this score is lower than real oral communication skill of CI patient. In the years 1994-2002 in Poznań 158 cochlear implantations were performed. Since few months the evaluation of the distinctness and discrimination of phonems of cochlear implants children are being conducted. It was found some differences between distinctness and discrimination of phonems and discrimination of words. It means that scores achieved by children in standarized words--tests do not reflect the real level of speech development of each child.