Search

Katarzyna Grzesiak,1 Aleksandra Rył,2 Irena Baranowska-Bosiacka,3 Iwona Rotter,2 Barbara Dołęgowska,4 Marcin Słojewski,5 Olimpia Sipak-Szmigiel,6 Weronika Ratajczak,1 Anna Lubkowska,7 Emilia Metryka,3 Małgorzata Piasecka,1 Maria Laszczyńska1 1Department of Histology and Developmental Biology, Pomeranian Medical University, Szczecin, Poland; 2Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, Szczecin, Poland; 3Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland; 4Department of Laboratory Medicine, Pomeranian Medical University, Szczecin, Poland; 5Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland; 6Department of Obstetrics and Pathology of Pregnancy, Pomeranian Medical University, Szczecin, Poland; 7Department of Functional Diagnostics and Physical Medicine, Pomeranian Medical University, Szczecin, Poland Purpose: The purpose of the study was to assess the relationship between changes in the levels of selected hormones in serum and prostate tissue homogenate in regard to metabolic disorders in patients with diagnosed, surgically treated benign prostatic hyperplasia (BPH). Patients and methods: The study involved a group of 154 men with a diagnosis of BPH with metabolic syndrome (MetS) and without MetS. The serum levels of the hormones – total testosterone, free testosterone, insulin, dehydroepiandrosterone sulfate, estradiol, luteinizing hormone, sex hormone binding globulin (SHBG), and insulin-like growth factor-1 (IGF-1) – were determined using the ELISA method. Prostate tissue sections obtained from the patients during transurethral resection of the prostate were frozen in liquid nitrogen. We determined the levels of the same hormones. Results: There was a statistically significant difference between the groups in terms of serum SHBG levels, but not in the prostate tissue SHBG levels. A similar relationship was observed in regard to IGF-1, the serum levels of which were significantly higher in patients with MetS. MetS had an effect on the ratio of hormone levels in serum to their levels in the prostate tissue. Correlations between the levels of biochemical parameters and the levels of hormones in serum and the prostate tissue of BPH patients with and without MetS demonstrate that serum SHBG levels correlated weakly with waist size and triglyceride levels. Conclusion: The occurrence of MetS in BPH patients was associated with changes in the levels of hormones and proteins. These changes, however, were not always equivalent to changes in the levels of these parameters in prostate tissue. It should also be mentioned that MetS in BPH patients had an influence on a quantitative balance between the levels of SHBG in serum and prostate tissue. Keywords: benign prostatic hyperplasia, hormone levels, metabolic disorders

Substance addiction is a neuropsychiatric disorder characterized by a recurring desire to continue using a substance despite harmful consequences. Brain-derived neurotrophic factor (BDNF) is a protein that plays a role in the activity-dependent remodeling of neural function in adult nervous systems. This study analyzed the association of the rs6265 polymorphism of the BDNF gene in a group of patients addicted to psychoactive substances who were participating in addiction treatment for the first time, in a group of post-relapse psychoactive substance abusers and in a control group. The study also assessed personality and anxiety in all study groups. Statistically significant differences in the frequency of genotypes and alleles were found between all study groups. Compared to the control, both study groups had statistically significantly higher scores for trait and state anxiety. Addicted patients in both groups also had higher scores on the Neuroticism and Openness scales and lower scores on the Extraversion and Agreeableness scales. The results of this study provide further evidence that personality traits, anxiety and the rs6265 polymorphism of the BDNF gene may be risk factors for susceptibility to addiction to psychoactive substances. In addition, they can be a predictor of addiction relapse, but further extensive studies are required to confirm these findings.

Breastfeeding may have a positive effect on glucose metabolism and insulin sensitivity, which may reduce the risk of developing diabetes following gestational diabetes mellitus (GDM). This study aimed to evaluate the effect of breastfeeding and GDM on the body mass composition of the studied women, the levels of leptin, ghrelin, adiponectin, resistin, and insulin, and weight loss during the 6-8-week postpartum period and 1 year after childbirth., Materials and Methods: The study group included 42 women with a singleton pregnancy, diagnosed with GDM between the 24th and 28th week of gestation. The control group consisted of 28 non-diabetic women with a singleton pregnancy. This study was carried out at 6-8 weeks as well as at 1 year postpartum. The women were subjected to body weight measurements and body composition analysis performed using a professional body composition analyzer TANITA DC-430 S MA. Waist circumference and subcutaneous fat was measured. Blood for laboratory tests was taken in the morning, on an empty stomach., Results: It was shown that, regardless of diabetes, exclusive breastfeeding had a significant impact on weight loss at 6-8 weeks postpartum ( p = 0.014785) and lower insulin levels ( p = 0.047). However, there was no effect of breastfeeding on the women's anthropometric measurements or hormone levels one year after delivery, except for the thickness of subcutaneous adipose tissue, which was significantly lower in breastfeeding women ( p = 0.03). One year after delivery, breastfeeding women had a lower BMI ( p = 0.0014), less-thick subcutaneous adipose tissue ( p < 0.001), and a lower risk of obesity ( p = 0.016). There were also higher insulin and ghrelin levels in both breastfeeding and non-breastfeeding women ( p < 0.001), and lower resistin levels in non-breastfeeding women ( p = 0.004). Women who had diabetes during pregnancy had a significantly reduced waist circumference and subcutaneous fat thickness after one year ( p < 0.001 and p = 0.05, respectively)., Conclusions: Having diabetes during pregnancy did not significantly affect the results of anthropometric measurements and hormone levels noted at 6-8 weeks after delivery (the only exception was the thickness of subcutaneous fat tissue, which was greater in women without GDM). This may indicate normalization of carbohydrate metabolism after childbirth; however, the observation period is too short to elucidate long-term metabolic effects. This suggests the need for further research related to GDM and breastfeeding.

The total amount of fat in the milk of nursing mothers depends on maternal reserves, as well as food intake and its synthesis in the mammary glands. The aim of this study was to assess the contents of fatty acids in the milk of women from the West Pomeranian region of Poland with regards to supplementation and the amount of adipose tissue. We also wanted to find out whether these women, who have direct access to the sea and potential access to fresh marine fish, have higher levels of DHA., Methods: We analyzed milk samples obtained 6-7 weeks postpartum from 60 women. The content of fatty acid methyl esters (FAME) in lipids was determined by gas chromatography-mass spectrometry (GC/MS) using a Clarus 600 device (PerkinElmer)., Results: Women using dietary supplements had significantly higher levels of docosahexaenoic acid (DHA) (C22:6 n-3) ( p = 0.000) and eicosapentaenoic acid (EPA) (20:5 n-3) ( p = 0.000). The levels of eicosatrienoic acid (ETA) (C20:3 n-3) and γ-linolenic acid (GLA) increased with the amount of body fat, and the level of DHA was lowest in subjects where body fat exceeded 40% ( p = 0.036)., Conclusions: The contents of fatty acids in the milk of women from the West Pomeranian region of Poland were similar to that reported by other authors. The levels of DHA in women using dietary supplements was also comparable to the values reported worldwide. BMI had an effect on the levels of ETE and GLA acids.

Appropriate gestational weight gain (GWG) favors fewer complications related to pregnancy, delivery, puerperium, and the condition of the fetus and newborn baby. The aim of this study was to evaluate weight gain in women during and after pregnancy, including both women with and without gestational diabetes mellitus (GDM)., Materials and Methods: The study involved 42 singleton pregnant women diagnosed with GDM between the 24th and 28th week of pregnancy. The control group consisted of 28 nondiabetic women with a singleton pregnancy. The pre-pregnancy BMI, intra-pregnancy weight gain, and postpartum body weight were assessed in the participants., Results: There were no statistically significant differences in the values of intra-pregnancy weight gain. Only diabetic women who were also overweight or obese had a significantly higher percentage of weight gain during pregnancy. The analysis of the percentage of weight gain during the entire pregnancy showed differences only in the group of women with pre-pregnancy BMI over 30., Conclusions: There were no significant differences in total pregnancy or mid-pregnancy weight gain between women with and without GDM. Most of the women had too high or too low total-pregnancy and mid-pregnancy weight gain. Therefore it is necessary to control GWG and educate pregnant women about it.

Introduction: Interactions occur between concentrations of metals in the human body and the environment in various geographic locations, which can be of importance for both the proper development and the course of pregnancy., Objective: The aim of the study was to assess the concentrations of Zn, Cu and Cd and Zn:Cu and Zn:Cd molar ratios in the placenta, umbilical cord and in the foetal membrane, and to examine the relationship between concentrations of these elements and the place of residence., Material and Methods: The research material was obtained from 99 healthy women from north-western and central Poland. Data for the study were collected from the medical history and documents of admission to the ward and documents confirming the birth of the newborn. Concentrations of zinc (Zn), copper (Cu) and cadmium (Cd) were determined using the ICP-AES method (spectrophotometry of atomic absorption) in inductively coupled argon plasma., Results: The average concentration of Zn, Cu and Cd in afterbirths was ~ 0.01 mg/kg of dry weight (dw). In central Poland, the results revealed a significant increase in zinc in the membrane (OR=1.098, p=0.002), cadmium in the placenta (OR=1.324, p=0.006), Zn:Cu in the membrane (OR=1.012, p<0.001). In north-western Poland, an increase in copper in the membrane (OR=1.239, p=0.025) was revealed., Conclusions: The use biological materials, such as the placenta, foetal membrane and umbilical cord to assess exposure to heavy metals and necessary elements is justified.

Background: changes in the concentration of magnesium influence numerous processes in the body, such as hormone and lipid metabolism, nerve conduction, a number of biochemical pathways in the brain, and metabolic cycles. As a result, changes in magnesium concentration may contribute to the emergence of such pathologies as depressive and metabolic disorders, including hypertension, diabetes, and dyslipidemia., Methods: blood samples were taken from 342 men whose mean age was 61.66 ± 6.38 years. The concentrations of magnesium, lipid parameters, and glucose were determined using the spectrophotometric method. Anthropometric measurements were performed to determine each participant's body mass index (BMI). Additionally, all participants completed two questionnaires: the Beck Depression Inventory and the author's questionnaire., Results: abnormal levels of magnesium were found in 78 people. The analysis showed that these subjects more often suffered from metabolic disorders such as diabetes mellitus ( p < 0.001), hypertension ( p < 0.001), and depressive symptoms ( p = 0.002) than participants with normal magnesium levels., Conclusion: our research showed that there is a relationship between abnormal levels of magnesium and the presence of self-reported conditions, such as diabetes, hypertension, and depressive symptoms among aging men. These findings may contribute to the improvement of the diagnosis and treatment of patients with these conditions.

Objective: The aim: The research conducted aims at evaluating the way the medical staff functions in the care of the pregnant patient diagnosed with fetal defects., Patients and Methods: Material and methods: 158 midwives took part in the study. The MINI-COPE standardized questionnaire and author's questions were used., Results: Results: During the period when the care was provided for the pregnant patients diagnosed with fetal defects, nearly 50% of the midwives under examination complained about the decline of their wellbeing. 75,3% of the respondents seek help and advice on how to deal with a stressful situation. Ideal for providing a systemic support, the midwives most often chose a psychologist and a psychotherapist. The surveyed who reported no need for a systemic support for the medical staff at the workplace, as the causes of their attitude pointed to their diminished trust in the ward nurse and no place for honest conversations. Most of the midwives surveyed during the care of the patient with the fetal defects experienced stress and bigger mental exhaustion. Over half of the surveyed reported lack of systemic psychological support provided for the medical staff at the workplace., Conclusion: Conclusions: The research indicates the need to introduce courses and training on topics related to how to deal with stressful situations into the education system of medical staff.

Menopause is a natural period resulting from the decrease in hormonal activity of the ovaries. Growing hormonal deficiencies and changes in the body influence a variety of functions in women, leading to depression and decreased quality of life. The relationship between body composition, the severity of depressive and climacteric symptoms and the quality of life of women with type 2 diabetes and healthy women in the perimenopausal period was studied. Statistically significant differences were observed between the study and control groups regarding all body composition parameters except for protein and the content of torso soft tissues ( p < 0.05). In both the study and control groups, resulting symptoms were significantly correlated with numerous body composition parameters (e.g., body mass, fat tissue mass, minerals, abdominal circumference), while symptoms of depression were significantly correlated with similar parameters only in the control group. A statistically relevant relationship was observed between the study and control groups with respect to quality of life in certain domains. The quality of life of women suffering from type 2 diabetes was worse compared with healthy women. Analysis of body composition showed significant differences between healthy women and those with type 2 diabetes. Healthy women showed a tendency to establish a link between body composition and depressiveness.

Development of an addiction is conditioned by many factors. The dopaminergic system has been shown to be the key element in this process. In this paper, we analyzed the influence of dopamine receptor 2 polymorphism rs1076560 in two groups-polysubstance-dependent male patients (n = 299) and the controls matched for age (n = 301). In both groups, we applied the same questionnaires for testing-Mini-international neuropsychiatric interview, the NEO Five-Factor Inventory, and the State-Trait Anxiety Inventory. The real-time PCR method was used for genotyping. When we compared the controls with the case group subjects, we observed significantly higher scores in the second group on both the state and trait scales of anxiety, as well as on the Neuroticism and Openness scales of the NEO-FFI; and lower scores on the scales of Extraversion and Agreeability of the NEO-FFI. The model 2×3 factorial ANOVA of the addicted subjects and controls was performed, and the DRD2 rs1076560 variant interaction was found for the anxiety state and trait scales, and for the NEO-FFI Neuroticism scale. The observed associations allow noticing that analysis of psychological factors in combination with genetic data opens new possibilities in addiction research.

&lt;b&gt;Introduction: &lt;/b&gt;Pressure ulcers and their consequences can occur in any patient regardless of the underlying disease, so the knowledge of their prevention and treatment is extremely important. &lt;br&gt;&lt;b&gt;The aim of the study:&lt;/b&gt; The aim of the study was to analyze the state of students' knowledge on pressure ulcers.&lt;br&gt;&lt;b&gt; Material and methods:&lt;/b&gt; The research was carried out in the Pomeranian Medical University in Szczecin among students of nursing. The study involved 203 full-time students. Data was collected using a questionnaire consisting of 27 questions. The questions addressed the issues of the formation, prevention and treatment of pressure ulcers. The Kolmogorow-Smirnow, Fisher-Snedecor test, (ANOVA) with Spearman's correlation and Student's t-test were applied for statistical analysis. The statistical significance was assumed to be p ≤ 0.05. &lt;br&gt;&lt;b&gt;Results:&lt;/b&gt; Over half of the respondents (57.64%) had a sufficient level of knowledge on pressure ulcers prevention and treatment. The level increased with the duration of the study, the highest was in the last few years, both I and II cycle of studies. The better (the higher) subjects assessed their knowledge about prevention and treatment of pressure ulcers, they were characterized by a higher level of knowledge. &lt;br&gt;&lt;b&gt;Conclusions:&lt;/b&gt; The knowledge of nursing students on pressure ulcers increases with subsequent years of study. The selfassessment of students' knowledge about pressure ulcers, their prevention and treatment is accurate. Students of the consecutive years are better prepared to carry out anti-bedsore prevention. Students are aware of the need to have knowledge, as well as practice in the field of prevention and treatment of pressure ulcers.

Background and Objectives: Abnormal concentrations of bioelements (magnesium, manganese, chromium, copper, zinc) have been associated with physical and emotional dysfunctions, including depression. This association, however, has not been analyzed in testosterone deficiency syndrome (TDS) or patients with depressiveness, i.e., when individual symptoms do not form the picture of a full-syndrome depressive disorder. This study aimed to assess the relationship between concentrations of selected bioelements and the incidence of depressive symptoms in men aged 50 years and older with a concurrent testosterone deficiency syndrome. Material and Methods: Blood samples were taken from 314 men; the mean age of the population was 61.36 ± 6.38 years. Spectrophotometric method for biochemical analysis of magnesium (Mg), manganese (Mn), chromium (Cr), copper (Cu), and zinc (Zn) was used. The diagnosis of testosterone deficiency syndrome (TDS) was based on the total testosterone (TT), free testosterone (FT), estradiol (E2), and dehydroepiandrosterone sulfate (DHEAS) levels by ELISA. Each participant completed the Androgen Deficiency in Aging Male (ADAM) questionnaire, as well as the Beck Depression Inventory (BDI-Ia) measuring the severity of depressive symptoms. Results: Emotional disturbances manifested as depressive symptoms were diagnosed in 28.7% of all participants and testosterone deficiency syndrome in 49.3%. In the TDS group, the analysis showed a significant correlation between the level of manganese ( R = 0.225, p = 0.005) and chromium ( R = 0.185, p = 0.021) with the incidence of depression. Conclusions: The results of our study demonstrated a relationship between manganese and chromium concentrations with the incidence of depression in men aged 50 years and older with a concurrent testosterone deficiency syndrome. This may indicate that there is a correlation between these bioelements, as well as emotional disorders manifested as depressive symptoms in aging men with a diagnosed testosterone deficiency.

Objective: Heterotopic pregnancy is the simultaneous occurrence of intrauterine and ectopic pregnancy. This situation is very rare (1:30 000 pregnancies), while recently, with the development of assisted reproductive techniques, the incidence has increased to 1:100 - 1:500 pregnancies. The aim of the study is to present the situation of coexistence of intrauterine pregnancy and ruptured tubal pregnancy., Patients and Methods: The case concerns a 32-year-old patient in the 12th week of the second pregnancy in whom the only risk factor was the state after Caesarean section and thus possible intraperitoneal adhesions. The ultrasound revealed normal intrauterine pregnancy and a very large amount of free fluid in the smaller pelvis. After immediate surgical intervention, a ruptured right tubal pregnancy was found. Right fallopian tube was removed. After the operation, the patient with the preserved intrauterine pregnancy was discharged from the ward. Further intrauterine pregnancy was normal. Delivery by Caesarean section., Conclusion: Conclusions: The described case indicates that the existence of intrauterine pregnancy does not exclude the existence of ectopic pregnancy and emphasizes the great importance of correctly and accurately carried out ultrasound examination in the first trimester of pregnancy along with appendicitis assessment. Early diagnosis of heterotopic pregnancy reduces the risk of complications.

The Taq1A polymorphism located in the ANKK1 gene is one of the most widely studied polymorphisms in regards to the genetics of behavior and addiction. The aim of our study was to analyze this polymorphism with regard to personality characteristics and anxiety measured by means of the Personality Inventory-(NEO Five-Factor Inventory-NEO-FFI) and the State-Trait Anxiety Inventory (STAI) in polysubstance addicted subjects. The study group consisted of 600 male volunteers, including 299 addicted subjects and 301 controls. Psychiatrists recruited members for both groups. Addiction was diagnosed in the case group. In the control group mental illness was excluded. The same psychometric test and genotyping using the real-time PCR (polymerase chain reaction) method was performed for both groups. The results were investigated by means of multivariate analysis of the main effects Multi-factor ANOVA. Significantly higher scores on the scale of STAI state and Neuroticism and Openness traits, as well as lower scores on the scales of Extraversion, Agreeability, and Conscientiousness, were found in the case group subjects, compared to the controls. Differences in frequency of genotypes and alleles of Taq1A polymorphism between the studied groups were not found. Multi-factor ANOVA of addicted subjects and control subjects and the ANKK1 Taq1A variant interaction approximated the statistical significance for the STAI state. The main effects ANOVA of both subjects' groups were found for the STAI state and trait, the Neuroticism scale, the Extraversion scale, and the Agreeability scale. The ANKK1 Taq1A main effects approximated the statistical significance of the STAI trait. Our study shows not only differences in personality traits between addicted and non-addicted subjects, but also the possible impact of ANKK1 on given traits and on addiction itself.

The aim of the study was to evaluate Hg and Se concentrations and Se:Hg molar ratios in the placenta, umbilical cord and fetal membranes, and to examine the relationship between the concentrations of the elements and selected factors. The study material consisted of the placenta, umbilical cord and fetal membranes obtained from 91 healthy women from northwestern and central Poland. In our study mean Hg and Se concentrations in afterbirth were ~ 0.01 mg/kg dry weight (dw) and ≤ 0.5 mg/kg dw, respectively. Correlation analysis showed negative relationships between placenta weight and Se concentration in the placenta and umbilical cord, as well as between placenta length and Se levels in the umbilical cord. We found negative correlations between THg concentration in the placenta and birth weight and between Se concentration in the placenta and umbilical cord and the morphological parameters of the placenta. Furthermore, we noted new types of interactions in specific parts of the afterbirth. In our study, Se:THg molar ratios ranged from 5 to 626; these values indicate protection against Hg toxicity.

Introduction/Objective : The aim of the study was to show which of the adipose tissue accumulation indicators correlate with testosterone disorders in non-diabetic aging men. Material and methods : 455 non diabetic men, recruited at primary care facilities, aged 50⁻75 participated in the study. The participants underwent anthropometric measurement and ELISA determination of total testosterone (TT), estradiol (E₂), dehydroepiandrosterone sulphate (DHEA-S), sex hormone binding protein (SHBG), and the determination of fasting glucose (FPG), high-density lipids cholesterol (HDL-Ch), and triacylglycerols (TAG) in serum. The following indicators were calculated: body mass index (BMI), waist-to-hip ratio (WHR), lipid accumulation product (LAP), and visceral adiposity index (VAI). Results : Men with testosterone deficiency syndrome (TDS) differed in each of the assessed obesity indices from those without TDS. All of the studied parameters correlated significantly negatively with TT concentration in blood serum, with VAI being the strongest predictor of TDS. It was shown that the threshold value at which the risk of TDS increased was 28.41 kg/m² for BMI, 1.58 for VAI, 104 cm for WC, and 37.01 for LAP. Conclusions : Indicators of fat accumulation that take into account biochemical parameters in assessing lipid metabolism are better markers of actual body fat deposition than indicators based solely on anthropometric measurements. Among them, VAI seems the most suitable biomarker of TDS in non-diabetic aging men.

Introduction : The etiology of benign prostatic hyperplasia (BPH) has not so far been fully explicated. However, it is assumed that changes in the levels of hormones associated with aging can contribute to the development of prostatic hyperplasia. Dihydrotestosterone combines with the androgen receptor (AR) proteins of the prostate gland. Enzyme activity is based on two isoenzymes: type 1 and type 2. 5α-reductase type 1 is encoded by the SRD5A1 gene, and type 2 is encoded by the SRD5A2 gene. The aim of our study was to determine the frequency of the SRD5A1 (rs6884552, rs3797177) and SRD5A2 (rs523349, rs12470143) genes' polymorphisms, and to assess the relationships between the genotypes of the tested mutations, and the levels of biochemical and hormonal parameters in patients with BPH. Material and Methods : The study involved 299 men with benign prostatic hyperplasia. We determined the serum levels of particular biochemical parameters-fasting plasma glucose (FPG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglycerides (TG)-by the spectrophotometric method, using ready reagent kits. The ELISA method was used to determine the levels of the following hormonal parameters and proteins: total testosterone (TT), free testosterone (FT), insulin (I), luteinizing hormone (LH), and sex hormone binding protein (SHBG). Metabolic syndrome was diagnosed. Genotyping was performed by real-time PCR. Results : We analyzed the relationships between the incidence of particular diseases and the genotypes of the SRD5A1 and SRD5A2 polymorphisms among patients with BPH. The BPH patients with the CC genotype of the SRD5A2 rs523349 and rs12470143 polymorphisms were considerably less frequently diagnosed with metabolic syndrome (MetS) ( p = 0.022 and p = 0.023 respectively). Our analysis revealed that homozygotes with the CC of the SDR5A2 rs12470143 polymorphism had visibly higher HDL levels than those with the TT and CT genotypes ( p = 0.001). Additionally, we found that the patients with the CC genotype of the SDR5A2 rs12470143 polymorphism had considerably higher FT levels ( p = 0.001) than the heterozygotes with the CT and the homozygotes with the TT of the genetic variant analyzed in our study. Furthermore, the patients with at least one G allele of the SRD5A2 rs523349 polymorphism had significantly lower SGBG levels ( p = 0.022) compared with the homozygotes with the CC genotype. The presence of at least one A allele (AA + AG genotypes) of the SRD5A1 rs3797177 polymorphism entailed notably lower serum insulin levels than those observed in homozygotes with the GG genotype ( p = 0.033). Conclusions : The study described in this article shows that selected SRD5A1 and SRD5A2 polymorphisms can alter the levels of metabolic and hormonal parameters in patients with BPH. Special attention should be paid to the SDR5A2 rs12470143 polymorphism, which is associated with a change in lipid profile, as well as with the inheritance and incidence rate of MetS among these patients. An analysis of the frequency of this polymorphism among BPH patients could be useful in estimating the risk of getting ill, and planning therapies of concomitant diseases for BPH patients., Competing Interests: The authors declare no conflict of interest.

Background: Although immune system plays a key role in the pathogenesis of both endometriosis and ovarian cancer, its function is different. Therefore, we hypothesized, that selected immune parameters can serve as diagnostic markers of these two conditions. The aim of this study was to compare serum and peritoneal fluid concentrations of sHLA-G, IL-10 and TNF-alpha in women with selected ovarian pathologies: benign serous cysts, endometrioma and malignant tumors. Clinical significance of using them for diagnostic purposes in women with serous ovarian cysts, endometriosis, and ovarian cancer, which in the future may improve the early diagnosis of ovarian diseases., Case Presentation: The study included women treated surgically for benign serous ovarian cysts, ovarian endometrioma and serous ovarian adenocarcinomas. Peripheral blood and peritoneal fluid samples were obtained intraoperatively. Patients with benign serous cysts, endometrioma and ovarian malignancies did not differ significantly in terms of their serum and peritoneal fluid concentrations of sHLA-G. Ovarian cancer patients presented with significantly higher median serum concentrations of IL-10 and TNF-alpha than other study subjects. Median concentrations of IL-10 and TNF-alpha in peritoneal fluid turned out to be the highest in ovarian cancer patients, followed by women with endometrioma and subjects with benign serous cysts. All these intergroup differences were statistically significant. Irrespective of the group, median concentrations of sHLA-G, IL-10 and TNF-alpha in peritoneal fluid were higher than serum levels of these markers., Conclusions: Elevated serum and peritoneal fluid concentrations of IL-10 and TNF-alpha distinguish ovarian malignancies and endometriomas from benign serous ovarian cysts. In contrast to endometriosis, ovarian malignancies are characterized by elevated peritoneal fluid concentrations of IL-10 and TNF-alpha, elevated serum concentrations of IL-10 and low serum levels of TNF-alpha. Serum and peritoneal fluid concentrations of sHLA-G have no diagnostic value in differentiating between ovarian malignancies and endometriomas.

Background: Menopause is the permanent cessation of menstruation due to loss of ovarian follicular activity. A review of the available literature indicates that correlations between the changes that take place in a woman's body after menopause and different genetic variants are still being sought., Methods: The study was conducted in 252 women who had completed physiological menopause. The women were divided into groups according to the time elapsed since menopause. The total concentrations of estradiol and follicle-stimulating hormone were determined by means of electrochemiluminescence. The apolipoprotein E (APOE) and lepitn (LEP) genotypes were determined by real-time PCR and polymerase chain reaction-restriction fragment length polymorphism, respectively., Results: We observed that people with the APOE3/E3 genotype entered menopause insignificantly later compared to other genotypes. Additionally, in the group of patients with the APOE3/E3 genotypes, differences in the E2 concentration were significantly related to the time since their last menstruation. There is no association found in the literature between these polymorphisms of the LEP gene and hormones., Conclusions: To date, attempts to formulate a model describing the association between E2 and FSH concentration with the polymorphisms of various genes of menopause in women have not been successful. This relationship is difficult to study because of the number of nongenetic factors. Environmental factors can explain variation in postmenopausal changes in hormone levels.

Background: As pre- and postnatal depression is a multifactorial disorder, the screening programmes which are currently in use in obstetric clinics remain problematic due to their inadequate standardization and limited efficacy. The evaluation of core risk factors for perinatal depression in the screening process, in addition to routine questionnaire-based tools such as the Edinburgh Postnatal Depression Scale (EPDS), might improve the diagnosis and early treatment of women affected by depression. This study was undertaken to analyze the relationship between personality traits and the risk of perinatal depression in pregnant and postpartum women., Material/methods: For the study, 229 patients (pregnant and postpartum women) admitted to an obstetric hospital in Poland were recruited. Two self-report questionnaires were used: the Edinburgh Postnatal Depression Scale (EPDS) as a screening tool for depressive symptoms and the NEO Five-Factor Inventory (NEO-FFI) for the evaluation of five personality traits in the studied patients., Results: Neuroticism significantly increased the risk of perinatal depressive symptoms in both pregnant and postpartum women (OR=1.23 and OR=1.11, respectively). Personality traits related to a lower risk of perinatal depression in the group of pregnant women included extraversion, openness to experience, high degree of agreeableness and conscientiousness (OR=0.90, OR=0.92, OR=0.90 and OR=0.91, respectively). However, among at-risk postpartum women no additional factors, except neuroticism, affected the prevalence of depressive symptoms., Conclusions: Personality trait like neuroticism as measured by the NEO-FFI is associated with a greater risk of perinatal depression. The NEO-FFI is a useful tool, potentially adding significant value to the program of perinatal depression screening.

Werner's syndrome is an extremely rare genetic disorder of the autosomal recessive type, characterized by features suggesting premature aging in young adulthood. Because of the concomitant hypogonadism, pregnancy among patients with Werner's syndrome occurs extremely rarely. We present a case of a successful outcome of pregnancy complicated by Werner's syndrome in a 34-year-old primigravida. The reason for early delivery by caesarean section, at 34th week of pregnancy, was exacerbation of coronary symptoms, with early signs of cardiac insufficiency. A healthy female child was born in a good condition, with birth weight of 1950 g.

Introduction: Cohabitation existing for ages in all human cultures is becoming more common since the 1960s due to complex changes in postmodern societies. These societies have made the phenomenon of cohabitation the object of adequate theoretical reflection. The aim of this work was to determine whether the marital status of pregnant women affects the severity of perinatal depression., Material and Methods: We enrolled 117 gravida hospitalized in 2006 and 2007 at the Department of Maternal-Fetal Medicine, Pomeranian Medical University. The gestational age ranged from week 32 to 40. The clinical condition of each gravida was assessed during routine obstetric history taking. The Edinburgh Postnatal Depression Scale by Cox, Holden, and Sagovski was used as the screening test for perinatal depression., Conclusions: 1. The marital status of the gravida with emphasis on cohabitation is a significant correlate of perinatal depression and its risk. 2. Clinical examination should concentrate not only on the physical and medical condition but also on the psychosocial status of the patient as the predictor of perinatal depression. 3. All pregnant women living in informal partnerships should be offered psychological support.

Objectives: The aim of the following study was to assess personality profiles of pregnant and postpartum women with symptoms of perinatal depression and to estimate the differences in their real and ideal self image in the sphere of psychological needs., Material and Methods: 50 pregnant (between 32-40 weeks of gestation) and 26 postpartum women (2-5 days after the delivery) were recruited for the study. Edinburgh Postnatal Depression Scale (EPDS) was used as a screening test for symptoms of pre- and postnatal depression. Personality profiles were evaluated by means of the Adjective Check List (ACL) with 15 need scales., Results: Postpartum women in comparison to pregnant patients described their self image at a statistically significant higher level as far as the needs for domination, nurturance, affiliation, heterosexuality and exhibition were concerned. No significant differences were observed in these groups of patients in the domain of ideal self image., Conclusions: 1/ pregnant and postpartum women, suffering from perinatal depressive disturbances, differ in terms of the self-assessment of some of their real psychological needs, but do not differ in terms of the ideal self image; 2/ observed differences between pregnant and postpartum women are basically consistent with the change of the role which is associated with the pregnancy and postpartum period; 3/ a positive change of the real self image, which is connected with the maternal role in the postpartum period, takes place in women irrespectively of their depression; 4/ observed multiple and significant differences between the ideal and real self image in pregnant as well as postpartum women with perinatal depressive disturbances indicate their lack of self-acceptance which requires individualized psychological intervention.

Objectives: The aim of this study was to assess if the marital status, especially cohabitation, of pregnant and postpartum women, has any influence on the incidence of perinatal depression symptoms., Material and Methods: 117 pregnant women (at 32-40 weeks of gestation) and 105 postpartum patients (2-5 days after the delivery) were included in the study. The Edinburgh Postnatal Depression Scale (EPDS) was used as a screening test for symptoms of pre- and postnatal depression. The risk of appearance of depressive symptoms was assessed in three groups of pregnant and postpartum patients - married, unpartnered and cohabitating., Results: By means of the EPDS test, symptoms of perinatal depression were found in 17% of pregnant and 10% of postpartum women. In comparison to married women, the risk of appearance of depressive symptoms in unpartnered pregnant patients was almost 10-times higher (OR=9.34; 95% CI 1.42, 201.77), and several hundred times higher in cohabitating pregnant women (OR=975.86; 95% CI 116.73, 19502.00); the risk of depressive symptoms in postpartum unpartnered women was more than 2 times higher (OR=2.4; 95% CI 0.59, 9.72) and more than 20 times higher in cohabitating postpartum mothers (OR=23.2; 95% CI 5.89, 91.51)., Conclusions: 1. the marital status of pregnant and postpartum women has a substantial influence on the risk of the development of perinatal depressive symptoms; this risk is highly increased in a group of cohabitating women compared to patients remaining in a formal partnership as well as women who live unpartnered, 2. clinical evaluation of women in the perinatal period should include the assessment of their psychosocial status, which can constitute a predicting factor of perinatal depression, 3. pregnant women living in informal partnership should be put under strict psychological surveillance.

Objectives: The aim of the following study was to establish whether there is any connection between an elevation of anxiety experienced by women during pregnancy or postpartum and their styles of coping with stressful situations, as well as to assess if those factors influence higher risk of incidence of perinatal depressive symptoms., Material and Methods: A total of 229 patients admitted to the Department of Foeto-Maternal Medicine, Pomeranian Medical University, Szczecin in 2006-2007, were recruited for the study. By means of the Edinburgh Postnatal Depression Scale (EPDS), a study group of 76 pregnant and postpartum women with high risk of perinatal depression was assigned, as well as a control group of 153 patients without such risk. The level of anxiety and ways of coping in stressful situations were measured by means of the CISS (Coping Inventory for Stressful Situations) and STAI (State-Trait Anxiety Inventory) questionnaires., Results: It has been shown that specific styles of coping in stressful situations and Anxiety-state or Anxiety-trait have substantial influence on higher risk of perinatal depressive symptoms in women., Conclusions: 1) The risk of perinatal depressive symptoms is associated with ways of coping with stressful situations or Anxiety-state and Anxiety-trait, 2) the risk of perinatal depression among pregnant women increases with an elevation of emotion-concentrated styles of coping in stressful situations, 3) the risk of perinatal depression among postpartum women increases with an elevation of emotion-concentrated ways of coping in stressful situations and engagement in substitute activities, 4) analysis of undertaken research indicate for suitableness of early diagnosis of specific styles of coping in stressful situations in order to implement proper therapy directed at the reduction of the risk of perinatal depression.

Objectives: The aim of the study was to evaluate the effect of intrapartum amnioinfusion in the presence of meconium stained amniotic fluid., Material and Methods: 93 women with meconium-stained amniotic fluid were assigned to receive amnioinfusion or no amnioinfusion (128 women). The trials were evaluated for fetal distress syndrome, route of delivery, fetal acidemia, Apgar score at 1 and 5 min., meconium aspiration syndrome, postpartum endometritis and maternal hospital stays., Result: Amnioinfusion in cases of meconium-stained fluid did not improve the number of fetal distress symptoms during fetal heart rate monitoring. Amnioinfusion was associated with a significant decrease of neonatal acidemia although it did not improve Apgar score. In our study amnioinfusion was not associated with reduction in the incidence of neonatal outcome and puerperial complications.

Introduction: To investigate whether HLA-G gene polymorphism is associated with adverse pregnancy outcome, we screened exons 2, 3, 4 of HLA-G gene in 59 women with reproductive failure and 36 fertile women. The HLA-G 10108 allele was more common in the group of examined women than in women from the control group (OR = 5,9; p = 0,09), but this difference was not statistically significant., Results: We conclude that the HLA-G 10108 allele might influence pregnancy outcome in the Polish population, but further studies are needed in this regard.

Aim: The aim of the study is to identify HLA-DQA1, HLA-DQB1 allele and to assess the risk of early pregnancy loss of women, couples with reproductive failure in the first trimester of pregnancy in comparison with fertile women, couples. The study group (B) enrolled 61 couples with reproductive failure and the control group (C) enrolled 20 fertile couples with at least 2 children., Method: HLA-DQA1 gene typing was performed using PCR-sequence-specific primer (SSP) on the high resolution level according to established procedure of labeling and using the detection kit (FASTYPE DQASSP Typing, FASTYPE DQA "High Resolution" Typing Sheet) purchased from Bio-Synthesis (USA)., Results: In female patient the highest risk quotient was associated with alleles HLA-DQA 01101/0105 OR 7.19 (95% CI 1.18-5.23; p=0.03) and HLA-DQB5 OR 3.67 (95% CI=1.11-12.0; p=0.037). The lowest but statistically significant risk of pregnancy failure in this group was related to allele HLA-DQB6 OR 0.48 (95% CI=0.22-1.04; p=0.087). In patient and control couples the significantly increased risk of pregnancy failure was related to the frequency of HLA-DQB5 allele OR 2.3 (95% CI 1.09-4.82; p=0,035). The lowest risk quotient in the patient couples was associated with HLA-DQ 0302/0303 allele OR 0.44 (95% CI 0.14-1.36; p=ns)., Summary: HLA-DQA and HLA-DQB allele might influence pregnancy outcome in the Polish population, but further studies are necessary in this regard.

It can be supposed that relation between HLA-G polymorphism and sHLA-G protein expression are associated with successful embryo implantation and pregnancy maintenance. The aim of the study was the estimation specific differences in expression of sHLA-G and sHLA- class I antigens in women with reproductive failure in comparison with fertile women. The study sample enrolled 80 women, divided into 2 groups. The study group (B) enrolled 60 women with reproductive failure including 20 women with 3 recurrent spontaneous abortions in the first trimester of pregnancy (RSA), 20 women with empty sac (ES) and 20 women with 3 consecutive in-vitro fertilization failures (IVFf). The control group (C) enrolled 20 fertile women with at least 2 children. Soluble HLA- class I antigens (sHLA-I) and soluble HLA-G (sHLA-G) were determined using ELISA test kits from IBio Vendor Labolatory Medicine, Inc. HLA-G allele found in individuals in our study were identified by comparing the obtained bp sequences of exon 2., 3. and 4. with bp sequences of HLA-G antigen published at the Nolan Research Institute website. The highest concentration of sHLA-I is noted among women with HLA-G 10401 allele which differed significantly for the mean sHLA-I concentration calculated for all the remaining alleles (p<0.0001). The most prevalent alleles were: HLA-G 10101, 10102 and 10108 with sHLA-I concentrations among women bearing those alleles significantly lower in comparison to the HLA-G 10401 carriers (p<0.001). Allele 10101 and 10102 was related to the lower significantly plasma sHLA-I concentrations than 10108 allele (p<0.02). Lowest mean sHLA-G values were observed in the IVFf group with significant difference from the remaining groups (p<0.05). To conclude, sHLA-G molecules is associated to certain HLA-G alleles and imply that sHLA-G levels are under genetic control. Low concentration sHLA-G seems to be prognostically important in IVF failure.

Unlabelled: THE AIM of the study was an evaluation of the relationship between histological chorioamnionitis and cord blood soluble intercellular adhesion molecule-1 (sICAM-1) and CRP levels., Material and Methods: in the group of 152 neonates observed for early onset infection (clinical and laboratory signs) the relationship between histological chorioamnionitis and cord blood sICAM-1 (ELISA) and CRP (turbidimetric method) levels was assessed. All these newborns were born in the years 2002-2004 to mothers with risk factors of perinatal infection., Results: histological chorioamnionitis (ChA) was found in 50 cases, while early onset infection signs occurred in 112 neonates. The percentage of ill and healthy newborns in group with ChA and without ChA was similar. There were significantly higher sICAM-1 (p<0.001) levels in neonates from pregnancy complicated with ChA than without ChA (179 +/- 68.7 v. 147 +/- 30.8 ng/ml). There was not such difference in the CRP levels. There was also a significant positive correlation between cord blood sICAM-1 and ChA in the whole analyzed group of patients (r=0.26; p<0.001) and in the group of ill neonates (r=0.37; p<0.0001). There was a significant difference (p<0.001) in sICAM-1 levels between ill and healthy neonates from the group with ChA (191,8 +/- 73.9 v. 143,4 +/- 31.9 ng/ml) but not without ChA. No difference was found in sICAM-1 levels between groups of healthy neonates born after pregnancy complicated and not complicated with ChA., Conclusions: coexistence of ChA and early onset infection in neonates enhanced the cord blood sICAM-1 levels. Healthy newborns born from pregnancy complicated by ChA do not react by increasing cord blood sICAM-1 levels. It is not possible to exclude early onset infection in neonates on the basis of normal cord blood sICAM-1 levels, because ill newborns born after pregnancy not complicated with ChA also do not react with increasing sICAM-1 production at birth.

Unlabelled: THE AIM of this study was to evaluate the usefulness of determining the concentration of procalcitonin (PCT) in the blood of pregnant women, in amniotic fluid and in umbilical blood as a predictor of intrauterine or infant infection., Material and Methods: the study was conducted on the following material: pregnant women s blood, amniotic fluid and umbilical blood taken during delivery from 60 women and 60 infants. In this group there were 30 vaginal deliveries and 30 deliveries by caesarean section. The PCT concentration was determined by an immunoluminometrical method (ILMA) using two antigen specific monoclonal antibodies; method sensitivity was 0.3 ng/ml. The determining precision was 5-10%. In statistical analysis the U Mann- Whitney test, chi square and ROC curve were employed. A p value less then 0.05 was considered as statistically significant., Results: statistically significant increase in concentration of PCT (p<0.049) was found in umbilical blood of infants whose mothers had intrauterine infection, while such a correlation was not found either in the pregnant women's blood nor in the amniotic fluid. The low levels of AUC indicators found in all analyzed systemic fluids indicate minor usefulness of PCT as an indicator allowing predictions of infant infections. PCT concentrations in the amniotic fluid in comparison with concentrations of PCT in pregnant women's blood and in umbilical blood showed the highest value as a predictor of infection in infants after delivery (respectively AUC - 0.599; 0.582; 0.545). However, low levels of indicator LR - 1.35 demonstrate a nonsignificant value of this indicator as a predictor of infection in infants independent of infection in pregnant women, infection in pregnant women and their infants, or premature delivery., Conclusions: 1. Clinical symptoms of infection in pregnant women are accompanied by increased concentration of PCT in the umbilical blood. 2. The absence of symptoms of infection in a pregnant woman, infection in infant or simultaneous infection in infant and pregnant woman is not a predictor of concentrations of PCT in pregnant woman blood, in amniotic fluid nor in umbilical blood. 3. Examining the concentration of PCT in blood of pregnant women, in amniotic fluid and in umbilical blood is not a clinically useful indicator predicting intrauterine infection in infant.

Unlabelled: THE AIM of this study was to evaluate the usefulness of determining concentrations of sICAM-1 in amniotic fluid as an indicator of intrauterine infection in pregnant women and infants., Material and Methods: the study was conducted on a group of 60 pregnant women by taking samples of amniotic fluid during delivery. Thirty of the women in the group had normal delivery and 30 had Caesarean section. The women were divided into three subgroups: 1) with (n-30) or without (n-30) symptoms of infection in the infant; with (n-21) or without (n-39) symptoms of intrauterine infection in the pregnant woman; with (n-14) or without (n-23) symptoms of simultaneous infection in both mother and child; with premature termination of pregnancy (n-17) or term delivery (n-43). Concentrations of sICAM-1 were determined by ELISA method using monoclonal antibodies specific for sICAM-1, and the use of Quantikine kit from the firm RD Systems Europe Ltd. Statistical analysis was conducted using the U Mann-Whitney test, chi square and ROC (Receiver Operating Characteristic) curve. LR (likelihood ratio) was also determined., Results: statistically significantly higher concentrations of sICAM were detected in the amniotic fluid of the group of mothers with intrauterine infection, symptoms of simultaneous infection in both mother and child and in the group with premature pregnancy termination - respectively p<0.02; p<0.001; and p<0.0001. ROC analysis, taking into account infection in infants (AUC- 0.623) allowed the determination of a cut off value of sICAM concentration in amniotic fluid of 422 ng/ml. That value is clinically useful for confirming intrauterine origins of symptoms of infection in pregnant women (sensitivity - 52.9%, specificity - 86.8%, LR - 5.03). It might also be useful in predicting infection in infants born of women who showed symptoms of infection before delivery (sensitivity - 72.7%, specificity - 95.7%, LR - 16.73)., Conclusions: 1. Clinical symptoms of intrauterine infection in pregnant women, simultaneous infection in both mother and child and premature pregnancy termination are correlated with significant increase of sICAM concentrations in the amniotic fluid. 2. An increase of sICAM concentration in the amniotic fluid >422 ng/ml allows confirmation of intrauterine origin of infection symptoms in pregnant women and allows the prediction of infection in infants born of women who showed symptoms of infection.

In the presented article we report hypotheses, opinions and confirmed results of investigations concerning immunological mechanisms, that play a role in the physiological pregnancy maintenance, natural reproduction failure and artificial reproductive techniques (ART) as well as abilities to diagnose immunological disorders. We pointed the important role of histocompatibility antigens such are class I and class II major histocompatibility antigens with their soluble forms (HLA-I; HLA-II), DQ-alpha and DQ-beta alleles as well as non classic antigens: HLA-G, HLA-C, HLA-E, in modulation of cellular and humoral response, which represent potential alloimmunological mechanism for pregnancy losses. The accurate report of immunological mechanism for recurrent spontaneous abortions caused by maternal production of phospholipid antibodies in antiphospholipid syndrome (APS) or other antibodies implicated as etiological factors in reproductive autoimmune failure syndrome (RAFS) has been demonstrated. We present the utility of identification of, so-called, reproductive immunophenotype, where an increase of some serum lymphocyte subpopulations anticipating pregnancy loss is frequently observed. In the study we describe recommendations and diagnostic capabilities for detection of immunological disturbances in patients undergoing evaluation for repeated pregnancy loss, which could be helpful in choosing the form of therapy.

Objective: Clinical outcome of pregnancy in patients with recurrent pregnancy losses treated with IVIG during their current pregnancy., Material and Methods: The study group consisted of 10 pregnant women with 3-5 spontaneous abortions. Any genetic, anatomical or infectious abnormalities were excluded as well as antiphospholipid antibody syndrome and negative lymphocytotoxic test. The treatment consisted of passive immunotherapy by means of intravenous administration of immunoglobulin (IVIG) at a dose of 0.4 g/kg b.w. Therapy was commenced at week 5-6 of gestation, infusions were repeated every 3-4 weeks until 28th week of gestation in 5-, 3- and 1-day protocols. In 2 patients that therapy followed active immunotherapy with paternal lymphocytes., Results: Eight (80%) patients bore healthy babies (3 preterm); in 2 cases embryos died at 6-7 week of gestation., Conclusions: The results confirm the efficacy of IVIG in pregnant patients with recurrent spontaneous abortions in whom likelihood of immunological pattern of pregnancy failures is high.