Publications by authors named "Agnieszka Brodowska"

48 Publications

Estrogen and Progesterone Receptor Immunoexpression in Fallopian Tubes among Postmenopausal Women Based on Time since the Last Menstrual Period.

Int J Environ Res Public Health 2021 Aug 31;18(17). Epub 2021 Aug 31.

Department of Histology and Developmental Biology, Pomeranian Medical University, Żołnierska 48, 71-210 Szczecin, Poland.

Existing data on the expression of estrogen receptor (ERα) and progesterone receptor (PR) in fallopian tubes in postmenopausal women are mostly inconclusive. Therefore, we assessed ERα and PR immunoexpression in the oviducts of these women. One hundred postmenopausal women were divided into three groups based on time elapsed since the last menstrual period: (A) 1-5 years, (B) 6-10 years, and (C) ≥11 years. In all groups, both in the glandular epithelium and stroma of the ampulla and isthmus of the oviduct, immunolocalization of ERα and PR were noted. The glandular epithelium of the ampulla showed a higher percentage of PR-positive cells than the isthmus in each group. Regarding ERα, there were no significant differences. In the glandular epithelium in both the ampulla and isthmus, the percentage of ERα- and PR-positive cells was significantly higher than that in the stroma in each study group and higher in the A group than in the C group. In conclusion, in postmenopausal women, time elapsed since the last menstrual period in the fallopian tubes was positively correlated with the following: (1) the epithelium showed vacuolation of cytoplasm with greater frequency, (2) the proportion of ciliated cells decreased, and (3) the percentage of ERα- and PR-positive cells also decreased. The obtained results indicate a significant decrease in ERα and PR expression depending on the time that has elapsed since the last menstruation, which is undoubtedly related to the loss of the reproductive function of the patients.
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http://dx.doi.org/10.3390/ijerph18179195DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8430669PMC
August 2021

The Content of Minerals in the PCOS Group and the Correlation with the Parameters of Metabolism.

Nutrients 2021 Jun 28;13(7). Epub 2021 Jun 28.

Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland.

Polycystic ovary syndrome (PCOS) is a common disease in women of childbearing age. It is characterized by excessive androgen production, ovulation disorders, and developing metabolic syndrome. The aim of the study was to check whether selected minerals were related to the pathophysiological mechanisms of PCOS. The concentrations of minerals were determined using an inductively coupled atomic plasma-emission spectrometer (ICP-AES Jobin Yvon JY-24). Blood samples from PCOS and control women were collected, processed, and digested with a microwave system in women with PCOS with and without insulin resistance and in the control group. It was found: zinc (Zn)-10.14 ± 2.11, 9.89 ± 1.44 and 10.30 ± 1.67; nickel (Ni) 0.001 ± 0.0009, 0.001 ± 0.0006 and 0.002 ± 0.00001; iron (Fe) 868.0 ± 155.8, 835.3 ± 156.4 and 833.0 ± 94.6; manganese (Mn) 0.017 ± 0.006, 0.017 ± 0.008 and 0.020 ± 0.009; copper (Cu) 0.714 ± 0.129, 0.713 ± 0.114 and 0.761 ± 0.146; magnesium (Mg) 48.4 ± 8.3, 50.0 ± 8.4 and 45.3 ± 10.7; sodium (Na) 374.3 ± 84.3, 396.3 ± 66.6 and 367.9 ± 88.9; potassium (K) 2541.8 ± 330.9, 2409.6 ± 347.1 and 2336.9 ± 211.4 (µg/g). Some micronutrient deficiencies may have a negative effect on the lipid profile in PCOS patients (Ni, Na). Further studies are needed to better understand dependencies.
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http://dx.doi.org/10.3390/nu13072214DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8308369PMC
June 2021

[Probiotics intake as gut-microbiota modulating therapy in an interdisciplinary aspect].

Pol Merkur Lekarski 2020 Aug;49(286):279-281

Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin.

The gut microbiota was defined as one of the endocrine organs. It consists of many various microorganisms with huge metabolic potential. An imbalance of the gut microbiota was assessed as one of risk factors for various metabolic, infectious, and inflammatory disorders, but also stress-related disorders. Link between the gut microbiological environment and the development of such pathologies as: metabolic syndrome, diabetes, obesity, inflammatory bowel disease, colorectal cancer, depression, anxiety disorders, attention deficit hyperactivity disorder or PCO syndrome has been proven. Diet with probiotics intake could be effective in the prevention and treatment of many diseases and associated metabolic disorders. Increasing the amount of "beneficial" gut microbiota may favorably affect the functioning of the whole organism. Treatment options for specific diseases must be compliant with the guidelines of recommendations for these disorders. However, probiotic supplementation can positively strengthen the results of this treatment. It is recognized that probiotics, by increasing beneficial intestinal microflora, inhibit development of pathogens and change metabolic and enzymatic activity. It reduces inflammation and positively regulates immunologic activity of intestines. On the base of conducted studies beneficial effects of probiotic supplementation in patients with metabolic, endocrine and mental disorders were noted. Prebiotics and probiotics influence on modification of gastrointestinal microflora. Changes of gut microbiota, by diet with probiotics intake, cause the maintenance of gut epithelial barrier integrity and may be useful in prevention and treatment of many diseases and concomitant metabolic disorders. It may have potential implications for protection against adverse, long-term health consequences of these disorders.
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August 2020

The Effect of Selected Exercise Programs on the Quality of Life in Women with Grade 1 Stress Urinary Incontinence and Its Relationship with Various Body Mass Indices: A Randomized Trial.

Biomed Res Int 2020 2;2020:1205281. Epub 2020 Jul 2.

Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, Poland.

Aims: The aim of the study was to analyze the influence gymnastics has on the quality of life (QOL) in women with grade 1 stress urinary incontinence (SUI) and to determine the relationship between the outcome and selected body weight indices: body mass index (BMI) and waist-to-hip ratio (WHR).

Methods: A randomized study of 140 women (45-60 years) with grade 1 SUI. The subjects were randomly assigned to a 3-month training for pelvic floor muscles and a transverse abdominal muscle (PFM + TrA, = 70) or PFM alone ( = 70). The QOL was determined with the questionnaire International Consultation on Incontinence Modular Questionnaire-Lower Urinary Tract Symptoms Quality of Life (ICIQ LUTS QOL), before and after the program.

Results: Women with BMI < 30 kg/m benefited more from the PFM + TrA program with respect to physical limitations and embarrassment domains, whereas patients with a gynoid body type (WHR < 0.8) benefited more in terms of physical and social limitations, SUI-evoked emotions, severity measures, and embarrassment domains.

Conclusions: After the PFM + TrA training, women with WHR < 0.8 had a better QOL than those with WHR > 0.8.
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http://dx.doi.org/10.1155/2020/1205281DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7354637PMC
April 2021

National and regional trends in the prevalence of polycystic ovary syndrome since 1990 within Europe: the modeled estimates from the Global Burden of Disease Study 2016.

Arch Med Sci 2021 6;17(2):343-351. Epub 2019 Aug 6.

Department of Gynecology, Endocrinology and Gynecologic Oncology, Pomeranian Medical University, Szczecin, Poland.

Introduction: The exact prevalence of polycystic ovary syndrome (PCOS) is difficult to assess due to the clinical heterogeneity of this condition, the lack of a universal definition as well as the lack of studies comparing differences within and between ethnic groups across geographical regions.

Material And Methods: Using a modeling approach, we analyzed the data from Global Burden of Disease Study 2016 and extracted the national and regional estimates on PCOS prevalence since 1990 in females aged 15-49 years by country and three major European regions: Western, Central, and Eastern.

Results: The average prevalence of PCOS in Europe was 276.4 cases per 100,000 (95% uncertainty interval (UI): 207.8-363.2). The estimates varied markedly across countries and regions, with the highest rates per 100,000 in the Czech Republic (460.6) and the lowest in Sweden (34.10); other Nordic countries, Germany, and the UK had relatively low rates as well. The rates in Central and Eastern Europe were more than three times higher than those in Western countries. They were comparable among Eastern countries, ranging from 406.4 in Lithuania to 443.1 in Russia. Within Central Europe, PCOS prevalence was lowest in Turkey and Albania, while in the majority of the remaining countries, the prevalence ranged between 420 and 440 per 100,000. Between 1990 and 2016, the rates across European regions were relatively stable.

Conclusions: We found highly variable national and regional prevalence of PCOS among European females. Our estimates encourage the search at the population level for new environmental and genetic determinants of PCOS.
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http://dx.doi.org/10.5114/aoms.2019.87112DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7959048PMC
August 2019

Association between the Urinary Bladder Volume and the Incidence of "De Novo" Overactive Bladder in Patients with Stress Urinary Incontinence Subjected to Sling Surgeries or Burch Procedure.

Biomed Res Int 2019 12;2019:9515242. Epub 2019 Feb 12.

Department of Gynecology, Endocrinology and Gynecologic Oncology, Pomeranian Medical University in Szczecin, Poland.

The aim of the study was to compare the incidence of "de novo" overactive bladder (OAB) after sling surgeries and Burch procedure and to analyze the effect of the preoperative bladder volume on the incidence of this condition. This prospective trial included 290 female patients with stress urinary incontinence (SUI) who were subjected to sling surgeries (TOT or TVT, n=170) or Burch procedure (n=120). Urodynamic testing was performed prior to the surgery and 6 months thereafter. The presence of OAB was diagnosed on the basis of subjective symptoms and urodynamic parameters. The incidence of OAB 3 at 6 months postsurgery was the highest in patients who were subjected to the Burch procedure (14.2% and 17.5%, respectively). The incidence of OAB at 6 months turned out to be significantly higher in patients subjected to the Burch procedure with preoperative bladder volumes greater than 353 ml. We observed the significant postoperative decrease in the bladder volume of women who developed this complication following the Burch procedure. Among surgeries for stress urinary incontinence, Burch procedure is associated with the greatest risk of overactive bladder development. Probably, one reason for the higher incidence of overactive bladder after Burch procedure is the intraoperative reduction of the urinary bladder volume.
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http://dx.doi.org/10.1155/2019/9515242DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390252PMC
July 2019

The Effect of Pelvic Floor Muscles Exercise on Quality of Life in Women with Stress Urinary Incontinence and Its Relationship with Vaginal Deliveries: A Randomized Trial.

Biomed Res Int 2019 6;2019:5321864. Epub 2019 Jan 6.

Department of Gynaecology, Endocrinology and Gynaecologic Oncology, Pomeranian Medical University, Unii Lubelskiej 1 str., 71-252, Szczecin, Poland.

Introduction: Urinary incontinence (UI) is a health problem affecting the quality of women's lives (QOL) at various life stages. Stress urinary incontinence (SUI) can be caused by previous vaginal deliveries and is especially likely to occur in the perimenopausal period. The most commonly recommended first-choice treatment methods involve exercises for the pelvic floor muscles (PFM). The aim of this study was to assess the impact of isolated PFM exercises and combined training of the PFM and the m.transversus abdominis (TrA) muscle on the QoL of patients with SUI with regard to the number of vaginal deliveries.

Material And Methods: 137 women with SUI were qualified for analysis (mean age 53,1 ± 5,5). To assess the effectiveness of PFM training QOL questionnaire was used (ICIQ-LUTS qol). PFM training for groups A (PFM+TrA) and B (PFM) was intended for 12 weeks. Statistica v. 12.0 PL, StatSoft, USA, was used for statistical calculations.

Results: The analysis demonstrated that conservative treatment based on the A training program (PFM + TrA) yielded statistically significantly better results than the B program (PFM), with the improvement observed in such QoL domains as the performance of household duties, physical activity and travelling, social limitations, emotions, sleep problems and fatigue, the frequency of changing panty liners, fluid intake control, and embarrassment.

Conclusion: Both the combined training of the PFM and the synergistic (TrA) muscle and the isolated PFM exercises improve the QoL of women with SUI. Nonetheless, the combined PFM and TrA muscle physiotherapy is more effective. The exercises for the PFM and the synergistic muscle give better results in women who have given birth fewer than three times than isolated PFM exercises.
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http://dx.doi.org/10.1155/2019/5321864DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6339740PMC
May 2019

Treatment of ovarian endometrial cysts in the context of recurrence and fertility.

Adv Clin Exp Med 2019 Mar;28(3):407-413

Department of Gynecology, Endocrinology and Gynecologic Oncology, Pomeranian Medical University, Szczecin, Poland.

An approach to ovarian endometrial cysts has changed considerably during recent years, especially in regard to treatment of recurrent endometriosis, fertility sparing and infertility management. Surgical treatment is the primary therapeutic option. The most efficient types of treatment are radical procedures involving adhesiolysis, removal of the cyst along with its capsule and any remaining endometriotic foci. However, small asymptomatic cysts should not be treated surgically, especially in patients older than 35 years. Surgical treatment can be considered in infertile women and those who failed to get pregnant despite 1-1.5 years of trials, as well as in cases in which in vitro fertilization is not an option. Also large cysts, with more than 4 cm in diameter, should be treated surgically due to the risk of their rupture or torsion. The most efficient preventive measure for recurrent ovarian endometriosis is unilateral oophorectomy with sparing the contralateral ovary. Such a procedure should be considered in women who are no longer interested in childbearing or present with another endometriotic cyst in the same ovary. The role of pharmacotherapy is fairly limited; it should be considered in patients in whom diffuse endometriosis is associated with pain. Therapeutic agents from the following groups can be used: estrogen-progestin preparation, gestagens, including progesteronereleasing intrauterine systems and gonadotropin-releasing hormone agonists. Women with infertility should get pregnant as soon as possible, and in patients who failed to get pregnant and/or are older than 35 years, in vitro fertilization should be the treatment of choice.
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http://dx.doi.org/10.17219/acem/90767DOI Listing
March 2019

[Polycystic ovary syndrome - current state of knowledge].

Pol Merkur Lekarski 2018 Jun;44(264):296-301

Department of Gynecology, Endocrynology and Gynecologic Oncology, PUM, Szczecin, Poland.

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder, affecting 5-10% women of reproductive age. It is one of the most common causes of functional infertility and a clinical problem that can be faced by doctors of many specialities. PCOS is characterized by hyperandrogenism, oligoovulations and metabolic disorders. ESHRE/ASRM (2003) or AES (2006) criteria are used to diagnose a patient with polycystic ovary syndrome. Although a lot of studies are carried out, ethiology and pathogenesis of PCOS is still not clear. The treatment must be long-term, causal and depending on the patient's expectations. The fundamental part of the therapy are lifestyle modifications and weight loss. Losing as little as 5% of body mass increases frequency of ovulations, chances of pregnancy and improves hormonal profile. First-line therapy is clomiphene citrate and for hyperandrogenism reduction combined oral contraceptive pill is frequently used. Metformin, not only improves carbohydrate metabolism, but also increases ovulations' frequency and chances of pregnancy. Metabolic syndrome, diabetes mellitus type 2, hypertension and higher risk of endometrial cancer are characteristic for patients with PCOS.
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June 2018

Influence of Pb and Cd levels in whole blood of postmenopausal women on the incidence of anxiety and depressive symptoms.

Ann Agric Environ Med 2018 Feb 28;25(2):219-223. Epub 2018 Feb 28.

Department of Nursing, Pomeranian Medical University, Szczecin, Poland.

Introduction: To-date, the influence of heavy metals such as Pb or Cd on mental functioning, and especially on the occurrence of depressive and anxiety-related disorders, has not been well understood.

Objectives: 1) Assessment of Pb and Cd levels in whole blood of postmenopausal women. 2) Assessment of the severity of anxiety and depressive symptoms depending on Pb and Cd levels in whole blood of postmenopausal women.

Material And Methods: The survey-based study involved 198 healthy postmenopausal women from West Pomeranian province in Poland. It was performed using the Primary Care Evaluation of Mental Disorders (PRIME-MD), Beck's Depression Inventory (BDI), and the State-Trait Anxiety Inventory (STAI). The second part of the study was based on biochemical analysis of the levels of heavy metals (Pb, Cd).

Results: The mean level of Pb was 19.85 ± 8.99 µg/l and Cd 0.87±0.98 µg/l; these levels were within normal ranges. Analysis of the mean levels of Pb and Cd in whole blood of postmenopausal women in relation to the severity of depressive symptoms did not reveal statistically significant differences. Correlation analysis demonstrated a statistically significant (p<0.05) negative correlation (-0.22) between the level of Pb and the severity of anxiety as a state. Correlations between the levels of Pb and Cd and the severity of anxiety as a trait were not statistically significant.

Conclusions: The mean Pb and Cd levels in whole blood of healthy postmenopausal women did not exceed acceptable limits. The study did not confirm a relationship between the levels of selected heavy metals and the severity of anxiety and depressive symptoms in healthy women. However, there was a relationship between the level of Pb and the severity of anxiety as a state.
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http://dx.doi.org/10.26444/aaem/85929DOI Listing
February 2018

Assessment of ovarian reserve as an indicator of fertility and health consequences in patients with chronic kidney disease stages 3-4.

Gynecol Endocrinol 2018 Nov 19;34(11):944-948. Epub 2018 Jun 19.

b Department of Nephrology, Transplantology and Internal Diseases , SPSK2 , Szczecin , Poland.

The aim of the study was to evaluate whether ovarian reserve depends on chronic kidney disease. Twenty-four patients, 23-45 years with chronic kidney disease (CKD) stages 3-4 were included in the study. All the patients underwent transvaginal ultrasounds to assess antral follicle count (AFC) and ovarian volume. The serum samples were obtained on days 3-5 of the menstrual cycle from all participants for anti-Mullerian hormone (AMH), follicle stimulating hormone (FSH), and estradiol (E2) levels. On the base of the study, it was concluded that the most sensitive parameters of ovarian reserve are AMH and AFC. AMH levels and number of antral follicles in both ovaries were statistically significantly lower in the group of patients with CKD than in control ones. But there were no significant differences in the ovarian volumes (right and left ovary), FSH and E2 levels between study and control groups. Ovarian reserve is not dependent on the duration of CKD and hormonal parameters of ovarian reserve like FSH and estradiol (E2) are not dependent on the presence or absence of proteinuria in patients with CKD, but the most sensitive parameter - AMH is significantly lower in patients with CKD and proteinuria.
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http://dx.doi.org/10.1080/09513590.2018.1473364DOI Listing
November 2018

Modelling the Ozone-Based Treatments for Inactivation of Microorganisms.

Int J Environ Res Public Health 2017 10 9;14(10). Epub 2017 Oct 9.

Institute of General Food Chemistry, Faculty of Biotechnology and Food Sciences, Lodz University of Technology, 90-924 Lodz, Poland.

The paper presents the development of a model for ozone treatment in a dynamic bed of different microorganisms (, , , , , , ) on a heterogeneous matrix (juniper berries, cardamom seeds) initially treated with numerous ozone doses during various contact times was studied. Taking into account various microorganism susceptibility to ozone, it was of great importance to develop a sufficiently effective ozone dose to preserve food products using different strains based on the microbial model. For this purpose, we have chosen the Weibull model to describe the survival curves of different microorganisms. Based on the results of microorganism survival modelling after ozone treatment and considering the least susceptible strains to ozone, we selected the critical ones. Among tested strains, those from genus were recognized as the most critical strains. In particular, and possessed the highest resistance to ozone treatment because the time needed to achieve the lowest level of its survival was the longest (up to 17.04 min and 16.89 min for reduction on juniper berry and cardamom seed matrix, respectively). Ozone treatment allow inactivate microorganisms to achieving lower survival rates by ozone dose (20.0 g O₃/m³ O₂, with a flow rate of 0.4 L/min) and contact time (up to 20 min). The results demonstrated that a linear correlation between parameters and in Weibull distribution, providing an opportunity to calculate a fitted equation of the process.
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http://dx.doi.org/10.3390/ijerph14101196DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5664697PMC
October 2017

Quality of Life in Women with Stage 1 Stress Urinary Incontinence after Application of Conservative Treatment-A Randomized Trial.

Int J Environ Res Public Health 2017 05 30;14(6). Epub 2017 May 30.

Department of Medical Rehabilitation, Pomeranian Medical University, Szczecin, 71-210, Poland.

Stress urinary incontinence (SUI) influences quality of life in female patients. In this study, we used ICIQ LUTS QoL (The International Consultation Incontinence Questionnaire Lower Urinary Tract Symptoms quality of life) to determine the quality of life (QoL) in various domains in patients with stage 1 SUI. The study included 140 perimenopausal women subjected to urodynamic tests at the Department of Gynaecology, Endocrinology and Gynaecologic Oncology, Pomeranian Medical University, Police (Poland) in 2013-2015. The study subjects were divided into two groups, A and B. Each patient completed two questionnaires, an original survey developed by the authors and the validated ICIQ LUTS QoL. Two exercise programs, each lasting for 3 months and consisting of 4 weekly sessions, were recommended to the study subjects. The program for Group A included exercises for pelvic floor muscles (PFM) with simultaneous tension of the transverse abdominal muscle (TrA), and the program for Group B, PFM exercises without TrA tension. After completing the exercise programs, patients with stage 1 SUI, both from Group A and from Group B, showed a significant improvement in most QoL domains measured with ICIQ LUTS QoL. However, more beneficial effects of the training were observed in the group subjected to PFM exercises with TrA tension.
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http://dx.doi.org/10.3390/ijerph14060577DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486263PMC
May 2017

Ozone in the food industry: Principles of ozone treatment, mechanisms of action, and applications: An overview.

Crit Rev Food Sci Nutr 2018 6;58(13):2176-2201. Epub 2017 Jul 6.

a Institute of General Food Chemistry, Faculty of Biotechnology and Food Sciences , Lodz University of Technology , Lodz , Poland.

The food contamination issue requires continuous control of food at each step of the production process. High quality and safety of products are equally important factors in the food industry. They may be achieved with several, more or less technologically advanced methodologies. In this work, we review the role, contribution, importance, and impact of ozone as a decontaminating agent used to control and eliminate the presence of microorganisms in food products as well as to extend their shelf-life and remove undesirable odors. Several researchers have been focusing on the ozone's properties and applications, proving that ozone treatment technology can be applied to all types of foods, from fruits, vegetables, spices, meat, and seafood products to beverages. A compilation of those works, presented in this review, can be a useful tool for establishing appropriate ozone treatment conditions, and factors affecting the improved quality and safety of food products. A critical evaluation of the advantages and disadvantages of ozone in the context of its application in the food industry is presented as well.
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http://dx.doi.org/10.1080/10408398.2017.1308313DOI Listing
December 2018

Searching for the relationship between the parameters of metabolic syndrome and the rs17782313 (T>C) polymorphism of the gene in postmenopausal women.

Clin Interv Aging 2017 22;12:549-555. Epub 2017 Mar 22.

Department of Nursing, Pomeranian Medical University in Szczecin.

Metabolic syndrome (MS) is widespread in the human population, and its incidence is continuously increasing, generating serious health problems. The purpose of this study was to find the relationship between the parameters of MS and the melanocortin type 4 receptor () gene polymorphism in postmenopausal women. The study involved 344 healthy Polish women, who had their last menstrual cycle 1 year ago or earlier. The study included blood analysis, survey, and body measurements. The mean age was 58.5±6.6 years. An increased body mass index was observed in 65.7% and abdominal obesity in 80.3% of the study population. MS was diagnosed in 40.7% of all participants, including 39.3% of women with the T/T genotype and 44.7% of those with the C/X genotype ( test; >0.05). A logistic regression model showed that the probability of MS was higher in patients with the C/X genotype (odds ratio =1.25) ( test; >0.05). The study concluded that MS is a very common condition among postmenopausal women. The C/X genotype of the gene seems to predispose postmenopausal women to developing some MS symptoms.
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http://dx.doi.org/10.2147/CIA.S129874DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367763PMC
July 2017

Cardiovascular system diseases in patients with polycystic ovary syndrome - the role of inflammation process in this pathology and possibility of early diagnosis and prevention.

Ann Agric Environ Med 2016 12;23(4):537-541

Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University, Szczecin, Poland.

Polycystic ovary syndrome is a disorder which affects 5-10% of women in reproductive age. PCOS is a cause of hyperandrogenism, menstrual disorders and infertility. The most common clinical symptoms are hirsutism, acne and obesity. Patients often suffer from metabolic disorders: insulin resistance, hyperinsulinemia, dislipidemia, leading to atherosclerosis and others irregularities of the metabolic syndrome. Patients are in the high risk group for cardiovascular diseases (CVD) development because of the metabolic abnormalities. Obesity is observed in 35-60% of women with PCOS. Lean women with PCOS are also exposed to a greater risk of glucose intolerance development and abnormalities in lipid profile than women without PCOS with comparable BMI. Adipocytes are the source of many compounds of the paracrine and endocrine activity. Some of them are also markers and mediators of inflammation. Increased levels of proinflammatory cytokines in blood can promote atherosclerosis and cardiovascular disease. Markers: IL-18, TNF, IL-6 and hs-CRP are often elevated in patients with polycystic ovary syndrome. An increase in inflammatory markers may be an early indicator of the risk of developing insulin resistance and atherosclerosis, and may become a useful prognostic and therapeutic tool for monitoring patients with PCOS: lean and those with overweight and obesity. Assessment of the concentrations of inflammatory markers may become a very useful test in evaluating the risk of developing atherosclerosis and cardiovascular disease, long before their clinical manifestation. It will also allow for the appropriate prophylaxis.
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http://dx.doi.org/10.5604/12321966.1226842DOI Listing
December 2016

[New methods of uterine fibroids treatment].

Pol Merkur Lekarski 2016 Dec;41(246):303-305

Pomeranian Medical University in Szczecin, Department of Gynecology, Endocrinology and Gynecologic Oncology.

Uterine fibroids are the most common benign tumors of the uterus. Their main symptoms are prolonged menstrual bleeding, leading over time to a secondary anemia, bleeding and spotting between periods, pelvic pain and infertility. It is recognized that fibroids are the most common indication for surgery in gynecology. Currently radical surgical treatment of fibroids is abandon. Ulipristalu acetate is used in pharmacological treatment. This medicine reduces the growth of fibroids. New non-invasive technique is also MR-guided focused ultrasound surgery using thermal tissue destruction by focusing ultrasound beam. Ability to avoid the often crippling surgery makes conservative methods increasingly popular.
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December 2016

The role of serological testing for Chlamydia trachomatis in differential diagnosis of pelvic pain.

Ann Agric Environ Med 2016 Sep;23(3):506-10

Departament of Gynecology and Urogynecology, Pomeranian Medical University, Szczecin, Poland.

Introduction: Pelvic pain is typically associated with pelvic inflammatory disease (PID). The most common cause of PID is Chlamydia trachomatis. The aim of this study was to verify the role of serological testing for Chlamydia trachomatis in patients with suspected PID.

Materials And Method: The retrospective study included 185 patients with pelvic pain hospitalized at the Department of Obstetrics and Gynecology in 2003 and 2004. Titers of anti-Chlamydia trachomatisIgG and IgA were measured by means ELISA immunoassays. Erythrocyte sedimentation rate (ESR), serum concentration of C-reactive protein (CRP) and leukocyte count (WBC) were also determined. Final diagnosis was established on the basis of laparoscopic examination.

Results: The presence of anti-Chlamydia trachomatis antibodies correlated significantly with abnormal values of ESR, WBC and CRP. The most common laparoscopic pathology were pelvic adhesions, typically found in women with elevated titers of anti-Chlamydia trachomatis IgG. Cconclusion. Serological examination for Chlamydia trachomatis is helpful in evaluation of patients with suspected PID. Elevated titers of anti-Chlamydia trachomatis antibodies are frequently associated with laparoscopic evidence of pelvic adhesions and inflammation.
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http://dx.doi.org/10.5604/12321966.1219196DOI Listing
September 2016

Zika virus intrauterine infections from the obstetrician's perspective.

Ginekol Pol 2016 ;87(7):538-9

Department of Epidemiology and Management, Pomeranian Medical University, Szczecin, Poland.

Zika virus (ZIKAV) infections could potentially occur in Poland due to international travel made by its nationals to regions where the Aedes mosquito is active. A causal relationship between prenatal ZIKAV infection and microcephaly and other serious brain anomalies has been found due to the time association between the infection in pregnancy and a presence of congenital nervous system malformations, together with the detectable pathogen in amniotic fluid and fetus's tissues. Two ZIKAV infection cases of pregnant women who were diagnosed with fetal microcephaly in the state of Paraiba, Brazil, later described in Ultrasound Obstetrics and Gynecology by Oliveira Mello et al. are discussed, in the context of the possible introduction of ZIKAV into Poland and the role the obstetrician should play in the detection and rapid reaction to potential threats. According to recommendations of international agencies for disease control and prevention, Polish obstetricians who take care of pregnant women and of those planning to become pregnant in the nearest future, and declaring travels to areas of the Aedes mosquito activity, should advise their patients to consider postponing travel or if they must travel, to take necessary precautionary measures to avoid mosquito bites. Pregnant women who have travelled to areas with ZIKAV transmission, or whose male partners had travelled to such areas and returned in the period of their female part-ner's pregnancy, should be monitored appropriately in the context of congenital abnormalities, including microcephaly.
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http://dx.doi.org/10.5603/GP.2016.0040DOI Listing
July 2018

Analysis of Relations Between the Level of Mg, Zn, Ca, Cu, and Fe and Depressiveness in Postmenopausal Women.

Biol Trace Elem Res 2017 Mar 30;176(1):56-63. Epub 2016 Jul 30.

Department of Nursing, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210, Szczecin, Poland.

Numerous observations suggest a possible connection between the levels of Mg, Zn, Fe, and Zn and the incidence of depressive symptoms. Depression is two to three times more common in women than in men. The menopausal period is extremely conducive to depressive disorders. The aim of this study was to assess the severity of depressive symptoms in postmenopausal women depending on the levels of Mg, Zn, Ca, Cu, and Fe. The study included 198 healthy postmenopausal women at the average age of 56.26 ± 5.55 years. In the first part of the study, standardized research tools were used, namely the Primary Care Evaluation of Mental Disorders (PRIME-MD) and the Beck Depression Inventory (BDI). The second part involved biochemical analysis of Mg, Zn, Ca, Cu, and Fe levels in blood serum. The lowest Cu levels were observed in women without depressive symptoms (1.07 ± 0.22 mg/l) and the highest in those with severe depressive symptoms (1.19 ± 0.17 mg/l), (p ≤ 0.05). The lowest Mg levels were observed in women with depressive symptoms (14.28 ± 2.13 mg/l), and the highest in women without depressive symptoms (16.30 ± 3.51 mg/l), (p ≤ 0.05). The average serum Mg levels (15.75 ± 3.23 mg/l) decreased compared to the reference values (18.77-24 mg/l). What is striking is a potential relation between the levels of Mg and Cu and depressiveness. Our results indicate to a higher vulnerability to depression in a group of women with lower levels of Mg and higher levels of Cu.
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http://dx.doi.org/10.1007/s12011-016-0798-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5309309PMC
March 2017

The Impact of Ozone Treatment in Dynamic Bed Parameters on Changes in Biologically Active Substances of Juniper Berries.

PLoS One 2015 14;10(12):e0144855. Epub 2015 Dec 14.

Institute of Fermentation Technology and Microbiology, Faculty of Biotechnology and Food Sciences, Lodz University of Technology, Lodz, Poland.

The development of the parameters of ozone decontamination method assuring the least possible losses of biologically active substances (essential oils and polyphenols) and their activity in common juniper (Juniperus communis (L.)) berries was studied. Ozone treatment in dynamic bed was conducted 9 times. The process was conducted under different ozone concentrations (100.0; 130.0; 160.0 g O3/m3) and times (30, 60, 90 min). After each decontamination, the microbiological profile of the juniper berries was studied, and the contaminating microflora was identified. Next to the microbiological profile, the phenolic profile, as well as antioxidant activity of extracts and essential oils were determined. The total polyphenol content (TPC), composition of essential oils, free radical-scavenging capacity, total antioxidant capacity, ferric-reducing antioxidant power (FRAP), beta-carotene bleaching test (BCB) and LC-MS polyphenol analysis were carried out. The study reveals that during short ozone contact times, higher amounts of TPC, 15.47 and 12.91 mg CE/g of extract, for samples 100/30 and 130/30, respectively, were demonstrated. Whereas samples 100/60, 130/60, 100/90, and 160/90 exhibited the lowest amount of phenolics. The highest antioxidant activity was found in the methanol extract obtained from ozonated berries which exhibited the lowest IC50 in all the antioxidant assays, such as DPPH, FRAP, and BCB assays. Ozone treatment showed noteworthy potential and its usage in food manufacturing and as an alternative decontamination method should be considered.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0144855PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4678966PMC
June 2016

[Role of office hysteroscopy in the diagnosis and treatment of uterine pathology].

Pol Merkur Lekarski 2015 Oct;39(232):251-3

Pomeranian Medical University in Szczecin, Department of Gynecology and Urogynecology.

Nowadays endoscopic techniques are one of the basic diagnostic and operative methods in gynecology. Laparoscopy and hysteroscopy are the most popular of them. Office hysteroscopy is a modern diagnostic and therapeutic method feasible in an outpatient room because no necessity of anesthesia. It is the first-line procedure in the infertility diagnosis and treatment of uterine pathology such as polyps, submucosal fibroids and adhesions. Limitation of this method is the cervical canal atresia. Contraindications to it are: pregnancy, uterine bleeding, active inflammation of pelvic organs, cervical cancer. Due to the high sensitivity and specificity, simplicity of execution and no need for patient hospitalization, office hysteroscopy becomes important diagnostic and therapeutic procedure in uterine pathologies.
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October 2015

[Pro-health prevention in perimenopausal women with regard to estrogen treatment].

Pol Merkur Lekarski 2015 Jul;39(229):53-5

Pomeranian Medical University of Szczecin, Poland: Department of Gynecology and Urogynecology.

According to the latest demographic forecast in Poland is observed the progressive aging of the population with growing population of perimenopausal women. This is a special time in woman's life, in which there are many metabolic changes, neurovegetative symptoms and mental changes. All of them are connected with decreased concentration of sex hormones. Very important in this period are health behaviors, including healthy lifestyle, regular exercises and proper diet. Highly effective in removing menopausal symptoms is hormone replacement therapy. It also prevents the effects of metabolic disorders. This therapy is primary prevention of cardiovascular diseases and osteoporosis, depression, Alzheimer's and Parkinson's disease and urogenital atrophy. It also has to delay the process of aging. Clinical studies of HERS, WHI and MWS caused extreme caution in the use of hormone replacement therapy and distrust for this therapy between doctors and their patients. It is therefore important to establish priorities for action and individualized therapy, depending on the indications and contraindications for its use.
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July 2015

Evaluation of the relationship between 5-HTT and MAO gene polymorphisms, mood and level of anxiety among postmenopausal women.

Int J Environ Res Public Health 2014 Dec 24;12(1):268-81. Epub 2014 Dec 24.

Department of Psychiatry, Pomeranian Medical University in Szczecin, 26 Broniewskiego St., 71-460 Szczecin, Poland.

Objective: The aim of this study was to analyze how mood and anxiety level are related to the functional genetic polymorphism in the promoter region of SLC6A4 (5-HTTLPR) and the 30-bp VNTR polymorphism in the MAO A promoter region.

Methods: The study involved 272 postmenopausal women from Poland. The authors employed the State-Trait Anxiety Inventory for measuring levels of anxiety, the Mood Adjective Check List for measuring mood, and genetic tests.

Results: Analysis did not show any statistically significant differences in the mean levels of anxiety, and mood disorders in women in relation to genotypes of the 5-HTTLPR (SLC6A4) polymorphism and the 30-bp VNTR polymorphism in the MAO A promoter region. However, these problems were more severe among women with s/s genotype. In the case of MAO A gene polymorphism, the level of anxiety was higher in women with a 4/4 genotype.

Conclusions: The study did not prove the possibility of the identification of homogeneous groups of women with an elevated risk of developing anxiety and mood disorders during the post-menopausal period. Nevertheless, it showed that respondents with s/s genotype of the 44-bp polymorphism in the 5-HTT (SLC6A4) promoter region had the highest average anxiety levels both as a state and as a trait. Furthermore, the analysis of the 30-bp VNTR polymorphism in the MAO A promoter region demonstrated slight differences in anxiety levels between the women, indicating that those with a 4/4 genotype had higher severity of anxiety symptoms.
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http://dx.doi.org/10.3390/ijerph120100268DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306861PMC
December 2014

Immunoexpression of aromatase cytochrome P450 and 17β-hydroxysteroid dehydrogenase in women's ovaries after menopause.

J Ovarian Res 2014 10;7:52. Epub 2014 May 10.

Department of Physiology Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland ; Stem Cell Biology Program, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA.

Background: Menopause results in a lack of regular menstrual cycles, leading to the reduction of estrogen production. On the other hand, ovarian androgen synthesis is still present at reduced levels and requires expression of several steroidogenic enzymes.

Methods: This study was performed on 104 postmenopausal women hospitalized due to uterine leiomyomas, endometriosis, and/or a prolapsed uterus. Patients were divided into three groups depending on the time from menopause. Group A patients experienced menopause 1-5 years before enrollment in the study (42 women). Group B included women who had their last menstruation 5-10 years before the study (40 women). Group C consisted of 22 women who were more than 10 years past menopause. Hysterectomy or removal of the uterine corpus with adnexa was performed during laparotomy. We evaluated the expression of aromatase cytochrome P450 (CYP 19) and 17β-hydroxysteroid dehydrogenase (17β HSD) by employing immunohistochemistry.

Results: Activity of 17β-HSD and CYP19 was demonstrated in the cytoplasm of stromal cells of postmenopausal ovaries, epithelium cells coating the ovaries, vascular endothelial cells, and epithelial inclusion cysts. However, overall expression of both 17β-HSD and CYP 19 decreased with time after menopause.

Conclusion: Demonstration of the activity of the key enzymes of ovarian steroidogenesis, CYP 19 and 17β-HSD, confirms steroidogenic activity in the ovaries of postmenopausal women. Nevertheless, ovarian steroidogenic activity decreases with time, and its significant decrease occurs 10 years after menopause.
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http://dx.doi.org/10.1186/1757-2215-7-52DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4030461PMC
October 2015

Insulin resistance assessment in patients with polycystic ovary syndrome using different diagnostic criteria--impact of metformin treatment.

Ann Agric Environ Med 2013 ;20(3):528-32

Department of Gynaecology and Urogynaecology, Pomeranian Medical University, Szczecin, Poland.

Introduction And Objective: Polycystic ovary syndrome (PCOS) is one of the most frequent reasons for anovulation in infertile women. It can affect 5%-10% of women of reproductive age. One of the important factors associated with the typical clinical signs and hormonal disorders could be insulin resistance and hyperinsulinaemia. The primary objective of this study was to assess the prevalence of insulin resistance in PCOS women. The secondary objective was to evaluate changes in body mass index (BMI), waist-to-hip ratio (WHR), and insulin sensitivity after 3 months of metformin therapy.

Materials And Methods: 68 patients were enrolled in the study. In all participants fasting and 2-h post-load glucose and insulin levels, WHR and BMI were evaluated before and after metformin (2 x 850 mg) therapy. Insulin resistance was assessed using G0/I0, G120/I120, and HOMA-IR indexes.

Results: Before the treatment, insulin resistance was observed in 26% patients according to HOMA-IR, and in 16% or 28% according to G0/I0 or G120/I120, respectively. Metformin therapy was associated with improvement in insulin sensitivity in HOMA-IR and G120/I120 defined insulin resistant patients.

Conclusions: The percentage of insulin resistant PCOS patients differed depending on the method applied. It is necessary to find a single most useful method to measure insulin resistance. Metformin treatment significantly improves insulin sensitivity in insulin resistant patients.
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April 2014

[Chronic inflammation and metabolic syndrome in comparison with other signs belonging to the image of polycystic ovary syndrome].

Pol Merkur Lekarski 2013 Apr;34(202):228-31

Pomorski Uniwersytet Medyczny w Szczecinie, Klinika Ginekologii i Uroginekologii.

Polycystic ovary syndrome (PCOS) is a disorder which concern even 5-10% of women in reproductive age. PCOS is a cause of hyperandrogenism and menstrual disorders with chronic anovulation. The most common clinical symptoms observed in PCOS are hirsutism, acne and obesity. Patients with PCOS often suffer from metabolic disorders like insulin resistance, hyperinsulinemia, dyslipidemia, arteriosclerosis and other abnormalities of the metabolic syndrome. 35 to 60% of women with PCOS are obese and about 50% of them have insulin resistance and hyperinsulinemia. The pathogenesis of atherosclerosis emphasizes the role of inflammatory processes. There are a number of markers of the inflammation process. They are also observed in PCOS and may indicate an increased risk of cardiovascular disease in women. More than 46% of women with PCOS can be diagnosed with metabolic syndrome. Because of the fact that patients with PCOS are at higher risk group of the earlier development of complications such as diabetes t 2, atherosclerosis, hypertension and cardiovascular system diseases, it is important to carry out metabolic disorders diagnosis in every patient with PCOS. It will help to estimate the risk of complications and allow for the implementation of prevention or treatment of metabolic diseases belonging to the image of PCOS.
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April 2013

The 5HTT and MAO-A polymorphisms associate with depressive mood and climacteric symptoms in postmenopausal women.

Prog Neuropsychopharmacol Biol Psychiatry 2013 Aug 23;45:125-30. Epub 2013 May 23.

Laboratory of Propedeutics in Nursing, Pomeranian Medical University, Szczecin, Poland.

Objective: The aim of this study was to assess the influence of the 44-bp polymorphism in the 5HTTLPR (SLC 6A4) (serotonin-transporter-linked polymorphic region, solute carrier family 6 member 4) promoter region and the 30-bpVNTR (variable number of tandem repeats) polymorphism in the MAO-A (monoamine oxidase A) promoter region on the prevalence of depressive mood and the severity of climacteric symptoms in postmenopausal women.

Material And Methods: The study involved 630 women from northern Poland who had their last menstrual period at least one year before the study. The women did not abuse alcohol or cigarettes, had not been diagnosed as having endocrinological, cancerous or mental diseases, and had not received psychiatric treatment by the time. This survey-based study was performed using the following research instruments: the Beck Depression Inventory (BDI), to evaluate depressive symptoms, and the Blatt-Kupperman Menopausal Index, to measure the severity of climacteric symptoms.

Results: The average age of the women was 57.5 ± 6.4 years. Depressive symptoms of different severity according to the BDI were diagnosed in 29.2% of the women (minor-18.6%, moderate-7.1%, severe-3.5%) and according to the Blatt-Kupperman Menopausal Index were diagnosed in 42% of the women (minor-24.1%, moderate-9.2%, severe-8.7%). Allele 'l' was significantly more common in the women without climacteric symptoms than those with minor, moderate or severe climacteric complaints (p ≤ 0.05). There was a significant correlation between the severity of climacteric and depressive symptoms (p ≤ 0.05). The women who had severe climacteric symptoms also had more severe depressive symptoms.

Conclusions: 1. The 5HTTLPR gene polymorphism contributes to climacteric symptoms in postmenopausal women. 2. The Blatt-Kupperman Menopausal Index is an instrument which can not only be used for the measurement of the severity of climacteric symptoms but also the early detection of perimenopausal women at the risk of developing depressive symptoms.
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http://dx.doi.org/10.1016/j.pnpbp.2013.05.007DOI Listing
August 2013

CYP17 and CYP19 genetic variants are not associated with age at natural menopause in Polish women.

Reprod Biol 2012 Dec 9;12(4):368-73. Epub 2012 Nov 9.

Department of Histology and Developmental Biology, Pomeranian Medical University, Szczecin, Poland.

The aim of the study was to investigate associations between two common polymorphisms of CYP17 and CYP19, encoding key enzymes of estrogen biosynthesis, and age at menopause in Polish women. One hundred fifty women after menopause (49.5±3.8 years), with no previous history of hormone replacement therapy took part in the study. The genetic control group consisted of 150 newborns from the same population. We investigated an association between the age at menopause and the single nucleotide polymorphism T→C in the 5' untranslated region (promoter) of the CYP17 gene (c.-34T>C; rs743572 - MspA1) or the number of tetranucleotide repeats [TTTA](n) (rs60271534) including deletion/insertion (D/I) of a 3 bp sequence in intron 4 of the CYP19 gene. CYP17 polymorphism was analyzed by PCR-RFLP and CYP19 by PCR and capillary electrophoresis. In the case of CYP17 polymorphism, 28.7% and 36.7% wild homozygous (TT), 50.7% and 46.0% heterozygous (TC), as well as 20.6% and 17.3% mutated homozygous (CC) types were identified in the subjects and controls, respectively. The frequency of mutated alleles (C) was 46.0% vs. 40.3% (p=0.19). In the case of CYP19 polymorphism, 34.0% and 32.0% of homozygotes (1_1), 50.7% and 51.3% of heterozygotes (1_2), 15.3% and 16.7% of homozygotes (2_2) were identified in the subjects and controls, respectively. No association between the studied CYP17 or CYP19 polymorphisms and age at menopause was found in Polish women.
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http://dx.doi.org/10.1016/j.repbio.2012.10.011DOI Listing
December 2012
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