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Marta Kiałka,1 Tomasz Milewicz,1 Krystyna Sztefko,2 Iwona Rogatko,2 Renata Majewska3 1Department of Gynecological Endocrinology, Jagiellonian University, Medical College, Kraków, Poland; 2Department of Clinical Biochemistry, Jagiellonian University, Medical College, Kraków, Poland; 3Department of Epidemiology, Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Kraków, Poland Background: Despite the strong preclinical rationale, there are only very few data considering the utility of metformin as a potential pain therapeutic in humans. The aim of this study was to determine the association between metformin therapy and pressure pain threshold (PPT) in lean women with polycystic ovary syndrome (PCOS). We hypothesized that metformin therapy in lean PCOS women increases PPT. Materials and methods: Twenty-seven lean PCOS women with free androgen index phenotype >5 and 18 lean healthy controls were enrolled in the study. Fifteen of the PCOS women were randomly assigned to be treated with metformin 1,500 mg daily for 6 months. PPT and plasma β-endorphin levels were measured in all women at the beginning of the study and after 6 months of observation. Results: We observed an increase in PPT values measured on deltoid and trapezius muscle in the PCOS with metformin group after 6 months of metformin administration (4.81±0.88 kg/cm², P

An abstract of the study "Continuous Combined Hormonal Replacement Therapy Affects Autonomic Regulation of Heart Rate Variability," by L. Dobrek and P. J. Thor, is presented.

We investigated the associations of base DNA damage level with nutritional status in female students before and after 4 wk of folic acid supplementation (400 µg/d). Nineteen subjects recorded their food, beverage, herb, and spice intake for 2 weekdays and 1 weekend day for 3 wk in a winter month (9 records). All individual questionnaires were computerized, and the amount of dietary compounds were estimated with a specifically developed program linked to recently updated Polish food tables. The alkaline single-cell gel electrophoresis assay (comet assay) with enzyme modification was used for the detection of endogenous DNA damage in individual cells. Blood samples were taken during the study for the evaluation of DNA oxidative damage and uracil misincorporation into DNA. After 4 wk of folate supplementation, blood samples were collected and the comet assay analysis was performed. In addition to estimating the folate intake from daily food intake, we measured plasma concentrations of folate and vitamin B-12. The statistical analysis showed that the measured DNA damage was not associated with energy, complex carbohydrate, or saturated fatty acid intake. However, a positive correlation (P < 0.05) between DNA oxidative damage and flavonoid intake, particularly flavons and flavonols, was observed only after folate supplementation; a negative correlation (P < 0.05) between flavonoid intake and uracil misincorporation was detected before folate supplementation. Moreover, the concentration of folate in serum was negatively associated with uracil misincorporation into DNA. DNA damage was also studied in lymphocytes in vitro after incubation with quercetin. [ABSTRACT FROM AUTHOR]

Visfatin is an adipokine involved in energy metabolism, insulin resistance, inflammation, and female reproduction. Due to limited data about its action in the human placenta, the aims of our studies included the analysis of visfatin expression and immunolocalization in trophoblast cell lines JEG-3 and BeWo as well as in human placentas from normal and pathological pregnancies. Moreover, we also checked the hormonal regulation of visfatin levels and the molecular mechanism of observed changes in JEG-3 cells. Cell culture and placental fragments collection along with statistical analysis were performed using standard laboratory procedures also described in our previous papers. We demonstrated an increased gene and protein expression of visfatin in JEG-3, BeWo cells, while variable expression in maternal and fetal parts of normal/ pathological pregnancy placentas. In addition, the immunolocalization of visfatin was observed in the cytoplasm of both cell lines, the capillary epithelium of the maternal part and syncytiotrophoblasts of the placental fetal part; in all tested pathologies, the signal was also detected in decidual cells. Furthermore, we demonstrated that hormones: progesterone, estradiol, human chorionic gonadotropin, and insulin increased the visfatin levels in JEG-3 cells with the involvement of specific signaling pathways. Taken together, differences in the expression and localization of visfatin between normal and pathological placentas suggested that visfatin may be a potential marker for the diagnosis of pregnancy disorders. In addition, we found that placental levels of visfatin can be regulated by hormones known to modulate the function of placental cells., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Dawid et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Hyperandrogenism is among the most common endocrine disorders in women. Clinically, it manifests as hirsutism, acne, and alopecia. A healthy lifestyle, including nutritious dietary patterns and physical activity, may influence the clinical manifestation of the disease. This study determined the effect of a low-glycemic index anti-inflammatory diet on testosterone levels and sex hormone-binding globulin (SHBG) and clinical symptoms in hyperandrogenic women at their reproductive age., Methods: The study included 44 overweight and obese women diagnosed with hyperandrogenism. The anthropometrics (weight, height, body mass index, waist circumference, hip circumference), physical activity, and dietary habits were assessed using valid questionnaires, scales, stadiometer, and tape meter. The significant p-value was <0.001. Serum testosterone and SHBG levels were measured using automated immunoassay instruments., Results: The intervention based on a low-glycemic index diet with anti-inflammatory elements and slight energy deficit decreased total testosterone levels (p<0.003), increased SHBG levels (p<0.001), and decreased the free androgen index (FAI; p<0.001). Post-intervention, overall well-being was much higher than in the pre-intervention period (p<0.001), and stress was diminished (p<0.001). Western nutritional patterns positively correlate with clinical hyperandrogenism progression, whereas several factors of the low-glycemic index diet with anti-inflammatory elements and slight energy deficit positively associate with reduced clinical hyperandrogenism symptoms., Conclusions: In overweight and obese women, proper selection of diet, introduction of moderate physical activity, and reduction in weight, stress factors, and alcohol consumption translate into several positive effects, including reduced FAI and symptoms such as acne, hirsutism, menstrual disorders, and infertility., Competing Interests: The authors declare that they have no conflict of interest., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Objective: Women who develop GDM present a metabolic condition similar to that found in type 2 diabetes, characterized by impaired insulin response. Due to similar pathophysiologic mechanisms found between type 2DM and GDM, there is a great interest in finding markers that will lead to the understanding of a possible common origin to both diseases. The aim of this study was to determine serum FGF21 levels in 2DM and GDM and its correlation with selected metabolic parameters., Method: The study included 54 2DM patients and 52 nondiabetic individuals (control group 1) as well as 74 GDM women and 32 healthy pregnant controls (control group 2). Serum FGF21 was determined by enzyme-linked immunosorbent assay (ELISA), in all groups, and correlated with biochemical parameters of glucose metabolism and insulin resistance (HbA1c, HOMA index, TG, and HDL cholesterol)., Results: FGF21 concentration was significantly higher in 2DM as compared with control group 1 ( p < 0.01). In the 2DM group, FGF21 was positively correlated with HOMA index ( p = 0.022, R = 0.398). In the GDM group, the positive relationships with FGF21 were observed with glucose ( p = 0.020, R = 0.264) and TG ( p = 0.013, R = 0.283) while HDL-C levels were correlated negatively ( p = 0.004, R = -0.326)., Conclusion: Serum FGF21 levels were significantly higher in 2DM patients than those without diabetes. Moreover, serum FGF21 levels were associated with selected metabolic parameters, suggesting that it may play acrolein glucose and lipid metabolism., Competing Interests: The authors have no conflict of interest to declare., (Copyright © 2023 Katarzyna Gawlik et al.)

The type of diet not only affects the composition of the oral microflora but is also one of the more critical factors associated with an increased risk of Parkinson's disease, PD. This study compared diet preferences and oral microbiota profiles in patients with PD vs. healthy controls. This study compared the oral microbiota composition of 59 patients with PD and 108 healthy controls (without neurodegeneration) using 16S rRNA gene amplicon sequencing. According to results, oral microbiota in patients with PD is different compared from healthy controls. In particular, decreased abundance of Proteobacteria, Pastescibacteria, and Tenercutes was observed. The oral cavity of patients with PD was characterized by the high relative abundance of bacteria from the genera Prevotella , Streptococcus , and Lactobaccillus. There were also differences in food preferences between patients with PD and healthy controls, which revealed significantly higher intake of margarine, fish, red meat, cereals products, avocado, and olives in the patients with PD relative to healthy controls. Strong positive and negative correlations between specific food products and microbial taxa were identified.

The apelinergic system, which includes the apelin receptor (APJ) as well as its two specific ligands, namely apelin and ELABELA (ELA/APELA/Toddler), have been the subject of many recent studies due to their pleiotropic effects in humans and other animals. Expression of these factors has been investigated in numerous tissues and organs-for example, the lungs, heart, uterus, and ovary. Moreover, a number of studies have been devoted to understanding the role of apelin and the entire apelinergic system in the most important processes in the body, starting from early stages of human life with regulation of placental function and the proper course of pregnancy. Disturbances in the balance of placental processes such as proliferation, apoptosis, angiogenesis, or hormone secretion may lead to specific pregnancy pathologies; therefore, there is a great need to search for substances that would help in their early diagnosis or treatment. A number of studies have indicated that compounds of the apelinergic system could serve this purpose. Hence, in this review, we summarized the most important reports about the role of apelin and the entire apelinergic system in the regulation of placental physiology and pregnancy.

Gut microbiome and colonic inflammation can be associated with the predisposition and progression of Parkinson's disease (PD). The presented study aimed to compare gastrointestinal microbiota composition between patients diagnosed with PD and treated only with Levodopa to healthy controls. In this prospective study, patients were recruited in 1 academic hospital from July 2019 to July 2020. The detailed demographic data and medical history were collected using a set of questionnaires. Fecal samples were obtained from all participants. Next-Generation Sequencing was used to assess the microbiota composition. The endpoint was the difference in composition of the gut microbiota. In this study, we enrolled 27 hospitalized PD patients with well-controlled symptoms. The control group included 44 healthy subjects matched for age. Among PD patients, our results presented a higher abundance of Bacteroides phylum, class Corynebacteria among phylum Actinobacteria , class Deltaproteobacteria among phylum Proteobacteria , and genera such as Butyricimonas, Robinsoniella , and Flavonifractor . The species Akkermansia muciniphila , Eubacterium biforme , and Parabacteroides merdae were identified as more common in the gut microbiota of PD patients. In conclusion, the patients diagnosed with PD have significantly different gut microbiota profiles in comparison with healthy controls.

Previously, we demonstrated the expression of apelin and G-protein-coupled receptor APJ in human placenta cell lines as well as its direct action on placenta cell proliferation and endocrinology. The objective of this study was to examine the effect of apelin on placenta apoptosis in BeWo cells and villous explants from the human third trimester of pregnancy. The BeWo cells and villous explants were incubated with apelin (2 and 20 ng/mL) alone or with staurosporine for 24 to 72 h. First, we analysed the dose- and time-dependent effect of apelin on the expression of apoptotic factors on the mRNA level by real-time PCR and on the protein level using Western blot. Next, we checked caspase 3 and 7 activity by Caspase-Glo 3/7, DNA fragmentation by the Cell Death Detection ELISA kit and oxygen consumption by the MitoXpress-Xtra Oxygen Consumption assay. We found that apelin increased the expression of pro-survival and decreased proapoptotic factors on mRNA and protein levels in both BeWo cells and villous explants. Additionally, apelin inhibited caspase 3 and 7 activity and DNA fragmentation in staurosporine-induced apoptosis as also attenuated oxidative stress by increasing extracellular oxygen consumption. The antiapoptotic effect of apelin in BeWo cells was mediated by the APJ receptor and mitogen-activated protein kinase (ERK1/2/MAP3/1) and protein kinase B (AKT). The obtained results showed the antiapoptotic effect of apelin on trophoblast cells, suggesting its participation in the development of the placenta.

The article presents a case of a 28-year-old woman with so-called morulosis - a form of squamous metaplasia of the endometrium, which may mimic malignancy. The term 'morulosis' indicates extensive squamous mulberry-like metaplasia, which in a large part or nearly entirely affects endometrium, whereas in turn, benign squamous metaplasia or single morules, refers to a limited, usually small regional pathology of endometrium. Because the endometrial glands and stroma gradually undergo the process of squamous metaplasia, in a scanty biopsy material the picture may lead to overdiagnosis. In the epithelioid regions small inactive glands with an immunofenotype different from the remaining endometrium might be observed. So far 21 cases have been reported in English literature. The patients (age 19-45) had presented with abnormal bleeding, infertility or after hormonal therapy. The mechanism of the extensive squamous metaplasia of endometrium is still not clear. The prevailing view holds that morulosis appears to be a result of hormonal imbalance. To shed light on possible pathogenic background of morulosis, we present a case of particularly severe extensive squamous metaplasia of the endometrium (morulosis).

Polycystic ovary syndrome (PCOS) as well as hyperprolactinemia can cause infertility. In retrospective study the prolactin levels during the oral metoclopramide test among lean PCOS woman according to four phenotypes and free androgen index (FAI) were compared. The study population consisted of 314 lean PCOS women. The population was divided into four groups according to the FAI and menstrual cycle regularity. The group A consisted 126 women with FAI≥5 and irregular menstruation, the group B- 53 patients with FAI≥5 and regular menstruation. Group C- 70 patients with FAI<5 and irregular menstruation, group D - 65 patients with FAI<5 and regular menstruation. The ratio of prolactin value in 120th minute in the metoclopramide test to the basal prolactin value was higher in group D than in groups A and B. The prolactin basal concentration was higher in patients with FAI≥5 than in patients with FAI<5, (262.9 vs 228.9 µIU/ml; p<0.001). The ratio of prolactin in 60th minute (12.3 vs 16.7; p=0.006) and in the 120th minute (10.9 versus 13.3; p<0.001) of the metoclopramide test to the basal prolactin were lower in patients with FAI≥5. The prolactin secretion in lean PCOS women may be associated with their FAI.

Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder at reproductive age, affecting 6-10% of females in this group. The aetiology of this syndrome is not fully understood. Genetics, endocrinology factors, and the influence of the environment are possible causes of this syndrome. PCOS is characterised by menstrual disorders, hyperandrogenism, and abnormalities in ovarian morphology as well as metabolic disorders. PCOS increases the risk of overweight and obesity, diabetes, endometrial cancer, and cardiovascular diseases such as hypertension along with all its long-term consequences. There are limited studies about cardiovascular disorders, especially hypertension, in postmenopausal women with a history of PCOS. The presented paper is an attempt to briefly summarise literature data concerning the influence of this disease on the incidence of hypertension and blood pressure control in postmenopausal women. Women with PCOS more often present features of metabolic syndrome and have increased cardiovascular risk factors including hypertension. The prevalence of hypertension is 2.5 times higher than in corresponding healthy peers. Furthermore, hyperandrogenaemia is associated with elevated blood pressure independent of the patient's age, insulin resistance, obesity, and dyslipidaemia. In view of this, these patients should be thoroughly screened for hypertensive disorders and educated about the lifestyle modifications that could prevent hypertension later in life., Competing Interests: The authors report no conflict of interest.

Ectopic pregnancy constitutes 2% of all pregnancies. In the last decades, due to the rising amount of caesarean sections, new localization of ectopic pregnancy has been observed - caesarean scar pregnancy (CSP). Cesarean scar pregnancy is an iatrogenic disease and a life-threatening condition which frequency will systematically rise. Because of possible serious complications, CSP should be swiftly diagnosed and treated. The purpose of this retrospective study was to demonstrate different methods of CSP treatment performed between 2015-2018 in the Clinic of Endocrinological Gynaecology and Gynaecology Jagiellonian University Medical College in Cracow. The clinical characteristics, diagnosis, various methods of treatment and clinical outcomes were analysed. Definitive algorithm of CSP treatment is still not established. Pharmacological and operative methods are approved while expectant observation is considered unsafe due to possible risk of complications for the patient, including death.

Polycystic ovary syndrome (PCOS) affects 4-18% of women of reproductive age. The number of reports exploring the lipid profiles among PCOS patients and number of studied patients are limited. The aim of our study was to assess the lipid profile separately in lean and non-lean women with polycystic ovary syndrome divided according to hyperandrogenemia, defined as free androgen index (FAI)≥5. The second aim was to compare the lipid profiles among lean and non-lean PCOS patients with respect to hyperandrogenemia and regularity of menstruation cycles. We evaluated 232 patients from Department of Endocrinological Gynecology, Jagiellonian University Medical College in Krakow diagnosed with PCOS. The population consisted of 166 lean and 66 non-lean women. We observed higher levels of total cholesterol, high-density lipoprotein cholesterol (HDL-C) in lean patients with FAI<5 than in lean patients with FAI≥5. There were no differences in lipid profile between non-lean patients with FAI≥5 and non-lean patients with FAI<5. Among lean patients higher total cholesterol levels were observed in those with irregular menstruation cycles and FAI<5 than in patients with FAI≥5 and regular cycles. There were no differences in lipid profiles between four phenotypes among non-lean PCOS patients., Conclusions: The results of our study showed differences in lipid profile between lean PCOS patients according to their phenotype based on androgens' level. This effect was abandoned by fat tissue mass in non-lean ones. Further studies should be conducted to explore these associations., Competing Interests: None., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Despite some evidence that indicates that the evolution of polycystic ovary syndrome (PCOS) is related to the activity of the endogenous opioid system, and that concentration of plasma β-endorphin levels can increase pain threshold, there are no studies which evaluate pressure pain threshold in the PCOS women population., Methods: In 48 lean women with PCOS and 38 lean women without this disorder plasma β-endorphins and PPT were measured., Results: The β-endorphins level was higher in the PCOS group compared to the controls (15.28±2.49 pg/mL vs. 6.33±1.71 pg/mL, P<0.001). In PCOS group PPTs measured on deltoid and trapezius muscles were higher compared to the controls (9.33±1.3 kg/cm² vs. 5.19±0.57 kg/cm², P<0.001; 8.23±1.04 kg/cm² vs. 4.79±0.55 kg/cm², P<0.001). The β-endorphin levels positively correlated with PPTs in PCOS group. Increase in β-endorphin level of 1 pg/mL was associated with increase of PPT value on deltoid muscle of 0.23 kg/cm² (R=0.632, P=0.011) and of 0.18 kg/cm² on trapezius muscle (R=0.588, P=0.037). There were no correlations between testosterone level and PPT in PCOS group., Conclusions: β-endorphin serum level as well as PPT are higher in lean PCOS group than in controls. We found correlations between β-endorphin levels and PPT in the PCOS group. It may suggest the role of endogenous opioids in the pathogenesis of PCOS and also that the increases in circulating plasma β-endorphins concentration can increases PPT in this group.

In the preset study we measured the concentrations of 16 priority PAHs in maternal blood and placental tissue by using the GC-MS/MS system, and investigated the effects of selected PAHs (naphthalene, anthracene, phenanthrene, pyrene) and mixtures on BeWo and JEG-3 human placental cell line proliferation (Alamar Blue), cytotoxicity (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (XTT), lactate dehydrogenase (LDH), acid phosphatase (AP), endocrine activity (progesterone and estradiol secretion) and apoptosis (cyclin A1, cyclin D2, cdk 2, cdk 4, Bcl-xl, Bax, and caspase-3 protein expression). The concentrations of 16 PAHs in maternal blood were higher than in placental tissue. In JEG-3 cells except for naphthalene, all PAHs studied and their mixtures at maternal doses, and only naphthalene at placental doses, increased XTT, while in BeWo cells, placental doses increased XTT and AP activity. A cell-type dependent action: a proapoptotic effect (increased Bax and caspase-3) in BeWo cells and an antiapoptotic effect (decreased Bax and increased cdk2 and cyclin D1) in JEG-3 cells was observed. Naphthalene, pyrene, and phenanthrene exhibited an endocrine-disrupting effect in JEG3 cells but not in BeWo cells. Our results provide evidence of cell specific effects of selected low molecular weight PAHs on proliferation, the cell cycle, proapoptotic protein expression, and hormone secretion., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Epidemiological studies have shown a link between problems with offspring of couples living in a contaminated environment in comparison to those who live in an uncontaminated environment. We measured the concentrations of 16 priority polycyclic aromatic hydrocarbons (PAHs) in maternal and cord blood. To explore the mechanism of the effects of PAH mixtures on nonluteinized granulosa cells (HGrC1) and granulosa tumor cells (COV434), as well as cell proliferation and apoptosis, we investigated the effect of PAH mixtures on the expression of the aryl hydrocarbon receptor (AHR), aryl hydrocarbon receptor nuclear translocator (ARNT) and aryl hydrocarbon receptor repressor (AHRR) genes, as well as the expression and activity of target genes cytochrome P450 1A1 (CYP1A1) and catechol-O-methyltransferase (COMT). The cells were exposed to mixture 1 (M1), composed of all 16 priority PAHs, and mixture 2 (M2), composed of five PAHs which are not classified as human carcinogens, and which are observed in the highest amounts both in maternal and cord blood. All 16 priority PAHs were bioavailable in maternal and cord plasma, suggesting that perinatal exposure should be considered. In HGrC1 cells, M1 increased AHR and ARNT, but decreased AHRR expression, in parallel with increased CYP1A1 and COMT expression and activity. M2 decreased AHR and AHRR, and increased ARNT, with no effect on CYP1A1 expression and activity; however, it did increase COMT expression and activity. In tumor cells, M1 lowered AHR and up-regulated AHRR and ARNT expression, consequently decreasing CYP1A1 expression and COMT activity. M2 up-regulated AHR and ARNT, down-regulated AHRR, and had no effect on CYP1A1 and COMT expression, but decreased COMT activity. We hypothesise that, dependent on composition, mixtures of PAHs activate the AHR differently through varying transcription responses: in HGrC1, a canonical AHR mechanism of M1, with activation of CYP1A1 important for detoxication, while in COV434, a noncanonical AHR mechanism, probably by activation the nuclear factor NFkB., (Copyright © 2017. Published by Elsevier B.V.)

Introduction: Due to the high incidence of postpartum anxiety disorders and their serious health and social consequences, it is essential to analyze the possible risk factors to identify groups of women particularly vulnerable to cover their proper care and control. The aim of our study was to investigate the relationship between the anxiety in women in the postpartum period, and their living conditions and lifestyle., Materials and Methods: The study was conducted from April to July 2016. We included 102 women in the postpartum period, living in the city of Cracow and the Cracow district. The study was based on a survey of our own authorship, State Anxiety Inventory (STAI) and the Jurczyński’s Inventory of Health Behavior (IZZ)., Results: The anxiety level in women in the postpartum period depends on the conditions of life and health behaviors. The level of health behavior of women in the postpartum period is an average and independent of age, number of children, and the material situation. Residents of cities, women with higher education, who planned pregnancy, have a higher level of health behavior. Good housing conditions have a positive influence on health behavior. Low levels of health behavior significantly affect the severity of maternal anxiety. Residents of the village, women with lower education and who not planning pregnancy have higher levels of anxiety during the postpartum period. Anxiety level of women in the postpartum period is inversely proportional to their housing conditions. Women with a job have lower levels of anxiety than non-working. The anxiety level in women in childbirth does not depend on age or financial situation., Conclusions: The anxiety level in women in the postpartum period, significantly depends on the living conditions and health behaviors. Verification of distinguished factors should be applied appropriately in health promotional activities and prevention programs.

Metformin, a drug of biguanide class, is now one of the most widely used drugs in the treatment of type 2 diabetes. It activates adenosine monophosphate-activated protein kinase (AMPK) and through AMPK activation, inhibits the mammalian target of rapamycin (mTOR) pathway. Recent literature has explored metformin as an option in pain management, given its role in the AMP-activated protein kinase (AMPK) pathway and its ability to modulate pain in animal models. Based on a variety of preclinical pain models, it is now clear that mTOR signaling plays a major role in the sensitization of the nervous system in chronic pain conditions. The activation of AMPK with metformin has led to decreased pain in neuropathic and postsurgical pain models, suggesting that these drugs and this mechanism of actin might be effective in humans. Despite the strong preclinical rationale, there are only very few data considered the utility of metformin as a potential pan therapeutic in humans. Further, randomized studies were needed to identify the role of metformin in pain perception and chronic pain conditions in humans.

Introduction: The aim of our study was to assess the values of total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides before and after treatment with metformin in lean patients with polycystic ovary syndrome (PCOS)., Material and Methods: 32 patients received metformin 1500 mg per day in three divided doses. Lipids measurements were performed twice: before and after 6 months of treatment with metformin., Results: In lean patients with PCOS after treatment with metformin we observed: statistically significant lower LDL-C levels (4.16±0.79 mmol/l vs 3.4±0.86 mmol/l, p<0.05) and triglycerides levels (1.8±0.53 mmol/l vs 1.12±0.64 mmol/l, p<0.05). We observed an increase in HDL values and a decrease in total cholesterol values, but these changes were not statistically significant (1.5±0.71 mmol/l vs 1.71±0.69 mmol/l, p=0.09; 5.87±0.92 mmol/l vs 5.69±0.97 mmol/l, p=0.11)., Conclusion: Our study showed that treatment of 1500 mg metformin for about six months among PCOS women results in an improvement in serum lipid profiles. We observed a significant decrease in LDL-C and triglycerides values after metformin therapy.

Objective: Postmenopausal women are at risk of thromboembolic events. It is unclear whether menopause alters fibrin clot properties. The aim of our study was to assess the effects of menopause and hormone therapy on clot characteristics., Methods: Ex vivo plasma clot permeability, turbidity, and susceptibility to lysis were determined in 70 premenopausal and 70 postmenopausal women (a case-control study). From the postmenopausal group, 30 women were randomly assigned (1:1) to a 24-week oral or transdermal treatment with 17β-estradiol, combined with norethisterone acetate (2 mg + 1 mg/d or 0.05 mg + 5 mg/d, respectively)., Results: Compared with premenopausal women (aged 29.2 ± 2.60 y), postmenopausal women (aged 49.7 ± 3.4 y; P = 0.009) were characterized by higher fibrinogen levels (by 36.8%), lower C-reactive protein levels (by 36.9%), and lower clot permeability (by 10.5%); also after adjustment for fibrinogen (all P < 0.05), with no difference in turbidimetric or fibrinolytic variables. Estrogen plus progestogen therapy led to higher maximal absorbency of fibrin gels by 6.0% (P < 0.05), whereas all other fibrin variables remained unchanged. Compared with transdermal hormone therapy, 24-week oral therapy was associated with higher absorbency of plasma clots by 16% (P < 0.05), without any other changes in fibrin characteristics., Conclusions: Menopause age is associated with the formation of denser fibrin clots. Estrogen plus progestogen therapy has a minor effect on plasma fibrin properties, but leads to the formation of thicker and more branched fibrin fibers, particularly during oral administration.

Aim: Plasma sICAM, sVCAM, endothelin- 1 (ET-1), TNF-a, its soluble receptor levels and nitric oxide production evaluation during standard exercise test in postmenopausal women with mixed hyperlipidemia., Material and Methods: 35 white, normotensive, non-smoking, postmenopusal women. Group A consisted of 24 women normal plasma cholesterol and triglicerides. Group B- 11 women hypercholesterolemic and hypertrigliceridemic. Basic fasting plasma FSH, 17b- -estradiol, total cholesterol, LDL-cholesterol, triglicerides, HDL-cholesterol were measured. Standard exercise test was carried out according to Bruce protocol. During the test blood samples were taken trice (prior to, at peak exercise, at15th minute of recovery). The sICAM, sVCAM, ET-1, TNF-a, its soluble receptor and secretion of nitric oxide were measured. Statistical analysis: Fisher test and t-Welch test were used., Results: There were no differences between groups A and B in mean plasma concentrations of FSH, estradiol and HDL-cholesterol. Mean plasma total cholesterol, triglicerides and LDL-cholesterol levels were higher in group B compared to group A. Plasma levels of sICAM prior to standard exercise test, at peak exercise and at the 15th minute of recovery were significantly lower in group A compared to group B. Mean plasma sVCAM levels did no differ between groups. NO3 plasma levels was significantly higher at peak exercise in group B compared to group A. There were no significant differences between groups in regard to mean plasma NO2, endothelin-1, TNF-a, and TNF-a receptor levels., Conclusion: Plasma soluble intracellular adhesion molecules levels are higher at rest and during exercise in postmenopausal women with atherosclerosis risk factors.

Aim of the Study: To compare effect of six month transdermal 17 β-estradiol supplementation with oral medroxyprogresterone acetate to oral simvastatin treatment on nitric oxide (NO), endothelin-1, β-thromboglobulin, vascular endothelial growth factor (VEGF) and von Willebrand factor (vWF) levels during standard exercise test in post menopausal women., Patients and Methods: 32 women were included to the study. Group 1 treated with 17β-estradiol combined with medroxyprogesterone. Group 2 treated with simvastatin, group 3 was the controls. VEGF plasma levels as well as basal and standard exercise test induced levels of vWF, NO, endothelin- 1, β-thromboglobulin were measured at the beginning of the study, at 3rd and 6th month of the study. During standard exercise test these parameters were measured three times: at the beginning, at peak exercise and at the 15th minute of recovery., Results: 17β-estradiol supplementation and simvastatin treatment reduced basal and exercise test induced endothelin-1 plasma level. 17β-estradiol supplementation gradually increased NO release, whereas simvastatin initially reduced and finally increased nitric oxide release. NO/ET-1 ratio was increased at peak exercise and recovery time in group 1 whereas only at peak exercise in group 2. Basal VEGF plasma level and β-thromboglobulin level at recovery time were reduced after 6 month of simvastatin therapy., Conclusion: Six months long oral simvastatin exerted beneficial influence on endothelial function equal to that of continuous transdermal 17β-estradiol supplementation combined with medroxyprogesterone acetate. Simvastatin only exerted benefical effect on platelet function. The protective effect of both therapies was more pronounced during exercise and recovery time.

A 4-8% of women of reproductive age suffer from the polycystic ovary syndrome (PCOS). The clinical and/ or biochemical hyperandrogenemia is found up to 75% of women with PCOS. It is unclear whether the hyperandogenemia in PCOS is caused directly by this disorder or by obesity. The recent studies have shown that the cortisol level in PCOS patients can be elevated, decreased or comparable to the control group. The aim of our study was to assess the cortisol plasma level in women with body mass index greater than or equal to 25 kg/ m², with and without PCOS. The study population consisted of 17 overweight women with PCOS and 44 overweight women without PCOS. There were not statistically significant differences in the body mass (group 1: 88.9 ± 17.0 kg, vs. group 2: 84.4 ± 15.2 kg; NS) nor the body mass index between both groups (group 1: 31.7 ± 5.9 kg/m², vs. group 2: 30.6 ± 5.4 kg/m²; NS). The groups did not differ in TSH, FSH, estradiol, SHBG, prolactin level at the baseline. There was no statistically significant difference between both groups in the cortisol levels at 5 a.m. and 7 a.m. Our study suggests that there is no difference in the morning and 7 p.m. cortisol level between the women with and without PCOS among the population of women with body mass index greater than or equal 25 kg/m².

The blunt abdominal trauma causes the liver and spleen injury mostly. The rupture of the spleen can also be caused by infectious diseases (mononucleosis), hematologic diseases (Non-Hodgin Lymphoma), rheumatologic diseases (Wegener’s granulomatosis) or diseases of the spleen (splenic hemangioma, splenic artery aneurysm). Also the spontaneous rupture of the spleen can occur. In the literature we can find descriptions of the spontaneous splenic rupture during pregnancy and puerperium period. In the differential diagnosis of the bleeding into the peritoneal cavity, all possible causes, including those less frequent as spontaneous rupture of the spleen, should be taken into account. In the presented case report we describe the case of splenic rupture after caesarean section performed on a woman in a twin pregnancy with HELLP syndrome.