Publications by authors named "Aleksandra Marciniak"

25 Publications

  • Page 1 of 1

An assessment of the effectiveness of regional analgesia after VATS measured by an objective method for assessing testosterone, cortisol, α-amylase, sIgA, and β-endorphin levels - a randomised controlled trial.

Endokrynol Pol 2021 23;72(2):133-142. Epub 2021 Feb 23.

Department of Anaesthesiology, Intensive Care, and Emergency Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Zabrze, Poland.

Introduction: Thoracic surgeries are associated with intense postoperative pain. General opioid analgesia is still the main anaesthetic method. Due to the large number of opioid-induced side effects, alternative methods of pain relief are sought. One of them is the use of balanced analgesia, which consists of regional analgesia, non-opioid painkillers, and small doses of opioids.

Material And Methods: The objective of this study was to assess the effectiveness of preoperative thoracic paravertebral block (ThPVB) in the treatment of postoperative pain after video-assisted thoracic surgery (VATS) by measuring hormone levels in blood serum or saliva. It was a randomised, open-label study conducted in a single university hospital setting between May 2018 and September 2019. In total, 119 patients were scheduled for elective video-assisted thoracic surgery. Performed interventions included: preoperative thoracic paravertebral block with 0.5% bupivacaine, followed by postoperative oxycodone combined with nonopioid analgesics. Follow-up period comprised first 24 hours and one, two, and six months after surgery. Main outcomes were measured by pain intensity assessed using the Numerical Rating Scale (NRS) and the levels of the following hormones: testosterone, cortisol, α-amylase activity, sIgA, and β-endorphin.

Results: A total of 119 patients were randomised into two groups and, of these, 49 were subsequently excluded from the analysis. The final analysis included 37 patients from the study group and 33 from the control group. There were no statistically significant differences in the analysed parameters the relative change T1-T0. There was a tendency towards statistical significance in the relative change T2-T0 in testosterone levels. At rest, no statistically significant differences were found between groups and time in the percentage of patients with NRS ≥ 1. During cough, the percentage of patients with NRS ≥ 1 was higher at T1 and T2 time points in the ThPVB group. Of the factors considered, only α-amylase levels statistically significantly increased the chance for higher NRS score after a month [OR = 1.013; 95% PU: 1.001-1.025; p < 0.01].

Conclusions: ThPVB is effective and safe for patients undergoing VATS. It can be an effective alternative for general anaesthesia using high doses of opioids.
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http://dx.doi.org/10.5603/EP.a2021.0004DOI Listing
February 2021

Design, Synthesis and Comprehensive Investigations of Pyrrolo[3,4-]pyridazinone-Based 1,3,4-Oxadiazole as New Class of Selective COX-2 Inhibitors.

Int J Mol Sci 2020 Dec 17;21(24). Epub 2020 Dec 17.

Department of Medicinal Chemistry, Wroclaw Medical University, Borowska 211, 50-556 Wroclaw, Poland.

The long-term use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) in treatment of different chronic inflammatory disorders is strongly restricted by their serious gastrointestinal adverse effects. Therefore, there is still an urgent need to search for new, safe, and efficient anti-inflammatory agents. Previously, we have reported the Mannich base-type derivatives of pyrrolo[3,4-]pyridazinone which strongly inhibit cyclooxygenase, have better affinity to COX-2 isoenzyme and exert promising anti-oxidant activity. These findings encouraged us to perform further optimization of that structure. Herein, we present the design, synthesis, molecular docking, spectroscopic, and biological studies of novel pyrrolo[3,4-]pyridazinone derivatives bearing 4-aryl-1-(1-oxoethyl)piperazine pharmacophore -. The new compounds were obtained via convenient, efficient, one-pot synthesis. According to in vitro evaluations, novel molecules exert no cytotoxicity and act as selective COX-2 inhibitors. These findings stay in good correlation with molecular modeling results, which additionally showed that investigated compounds take a position in the active site of COX-2 very similar to Meloxicam. Moreover, all derivatives reduce the increased level of reactive oxygen and nitrogen species and prevent DNA strand breaks caused by oxidative stress. Finally, performed spectroscopic and molecular docking studies demonstrated that new compound interactions with bovine serum albumin (BSA) are moderate, formation of complexes is in one-to-one ratio, and binding site II (subdomain IIIA) is favorable.
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http://dx.doi.org/10.3390/ijms21249623DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766220PMC
December 2020

Detailed Insight into the Interaction of Bicyclic Somatostatin Analogue with Cu(II) Ions.

Int J Mol Sci 2020 Nov 20;21(22). Epub 2020 Nov 20.

Department of Inorganic Chemistry, Wroclaw Medical University, Borowska 211A, 50-556 Wroclaw, Poland.

Somatostatin analogues are useful pharmaceuticals in peptide receptor radionuclide therapy. In previous studies, we analyzed a new bicyclic somatostatin analogue (BCS) in connection with Cu(II) ions. Two characteristic sites were present in the peptide chain: the receptor- and the metal-binding site. We have already shown that this ligand can form very stable imidazole complexes with the metal ion. In this work, our aim was to characterize the intramolecular interaction that occurs in the peptide molecule. Therefore, we analyzed the coordination abilities of two cyclic ligands, i.e., P1 only with the metal binding site and P2 with both sites, but without the disulfide bond. Furthermore, we used magnetic circular dichroism (MCD) spectroscopy to better understand the coordination process. We applied this method to analyze spectra of P1, P2, and BCS, which we have described previously. Additionally, we analyzed the MCD spectra of P3 ligand, which has only the receptor binding site in its structure. We have unequivocally shown that the presence of the Phe-Trp-Lys-Thr motif and the disulfide bond significantly increases the metal binding efficiency.
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http://dx.doi.org/10.3390/ijms21228794DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7699899PMC
November 2020

[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

Design, synthesis, biological evaluation and in silico studies of novel pyrrolo[3,4-d]pyridazinone derivatives withpromising anti-inflammatory and antioxidant activity.

Bioorg Chem 2020 09 19;102:104035. Epub 2020 Jun 19.

Department of Chemistry of Drugs, Wroclaw Medical University, Borowska 211, 50-556 Wroclaw, Poland.

Novel Mannich base analogues of pyrrolo[3,4-d]pyridazinone 7a,b-13a,b are designed and synthesized as potential anti-inflammatory agents. The title compounds are obtained via convenient one-pot synthesis with good yields. Their structures and properties are described by spectroscopic techniques and elemental analyses. The aim of this study is to evaluate the inhibitory activity of the new derivatives against both cyclooxygenase isoforms COX1 and COX2 as well as their cytotoxicity. The results clearly indicate that the tested compounds 7a,b-13a,b are not toxic, all show better affinity towards isoform COX-2, and some of them act as selective COX-2 inhibitors. Moreover, every examined derivative of pyrrolo[3,4-d]pyridazinone demonstrates better inhibitory activity towards COX-2 and a superior COX-2/COX-1 selectivity ratio compared to the reference drug meloxicam. Molecular docking studies confirm that compounds 7a,b-13a,b preferably bind COX-2 and all of them bind to the active site of cyclooxygenase in a way very similar to meloxicam. Subsequently, taking into account that inflammation is strongly correlated with oxidative stress and both of these processes can potentiate each other, synthesized Mannich bases are evaluated for potential antioxidant activity. Most of the investigated derivatives reduce induced oxidative and nitrosative stress. Moreover, compounds 7a,b, 8a, 10a,b, 11b, 12a,b-13a,b protect chromatin from oxidative stress and decrease the number of DNA strand breaks caused by intracellular growth of free radicals. Finally, a study of the binding mechanism between compounds 7a,b-13a,b and bovine serum albumin (BSA) was carried out. According to spectroscopic and molecular docking studies, all examined derivatives interact with BSA, which suggests their potential long half-life in vivo.
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http://dx.doi.org/10.1016/j.bioorg.2020.104035DOI Listing
September 2020

Synthesis, Cyclooxygenases Inhibition Activities and Interactions with BSA of -substituted 1-pyrrolo[3,4-c]pyridine-1,3()-diones Derivatives.

Molecules 2020 Jun 25;25(12). Epub 2020 Jun 25.

Department of Inorganic Chemistry, Wroclaw Medical University, ul. Borowska 211a, 50-556 Wrocław, Poland.

Inhibition of cyclooxygenase is the way of therapeutic activities for anti-inflammatory pharmaceuticals. Serum albumins are the major soluble protein able to bind and transport a variety of exogenous and endogenous ligands, including hydrophobic pharmaceuticals. In this study, a novel -substituted 1-pyrrolo[3-c]pyridine-1,3(2)-diones derivatives were synthesized and biologically evaluated for their inhibitory activity against cyclooxygenases and interactions with BSA. In vitro, COX-1 and COX-2 inhibition assays were performed. Interaction with BSA was studied by fluorescence spectroscopy and circular dichroism measurement. The molecular docking study was conducted to understand the binding interaction of compounds in the active site of cyclooxygenases and BSA. The result of the COX-1 and COX-2 inhibitory studies revealed that all the compounds potentially inhibited COX-1 and COX-2. The IC value was found similar to meloxicam. The intrinsic fluorescence of BSA was quenched by tested compounds due to the formation of A/E-BSA complex. The results of the experiment and molecular docking confirmed the main interaction forces between studied compounds and BSA were hydrogen bonding and van der Waals force.
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http://dx.doi.org/10.3390/molecules25122934DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355801PMC
June 2020

The Binding Ability of a Bicyclic Somatostatin Analogue Towards Cu(II) Ions.

Chem Biodivers 2020 Aug 20;17(8):e2000307. Epub 2020 Jul 20.

Department of Inorganic Chemistry, Wroclaw Medical University, Borowska 211 A, 50-556, Wroclaw, Poland.

Somatostatin (SST) analogues have aroused the interest of scientists for years. This group of compounds is used in the diagnosis and treatment of neuroendocrine tumors. However, new molecules useful as radiopharmaceuticals in targeted therapy are still searched for. Bicyclic peptides seem to be very interesting in this context. These molecules are associated with beneficial properties. In this work, we present studies on the binding ability of the bicyclic analogue of somatostatin toward Cu(II) ions which could potentially be a chelator for copper radionuclides. The research is focused on the analysis of Cu(II) interactions with the metal binding cycle of the ligand and the influence of the receptor binding site on the coordination process. This is a novelty in comparison to the SST analogues used in medicine, where a metal ion is coordinated by a chelator and connected with a bioactive molecule by the linker. In this work, we present the first coordination study for a bicyclic ligand. The obtained results showed that the complexes with only imidazole donors are characterized by significantly higher stability in comparison to the other peptides.
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http://dx.doi.org/10.1002/cbdv.202000307DOI Listing
August 2020

Paranasal sinus disease could be a reason for unsuccessful immunotherapy of inhalant allergy in children.

Am J Otolaryngol 2020 Jul - Aug;41(4):102504. Epub 2020 Apr 19.

Chair and Department of Paediatric Otolaryngology, Phoniatrics and Audiology, Medical University of Lublin, Antoni Gębala Street No. 6, 20-093 Lublin, Poland.

Purpose: The aim of this study was to evaluate the role of paranasal sinuses condition assessed in computed tomography on inhalant allergen desensitization effects.

Materials & Methods: Retrospective analysis of medical records of children undergoing allergen immunotherapy in outpatient otolaryngology clinic of University Children Hospital in Lublin was performed. Control group consisted of children who underwent allergen immunotherapy and obtained satisfying effects; study group consisted of children who did not experience significant improvement after desensitization therapy.

Results: Computed tomography of nose cavity and paranasal sinuses exposed numerous pathologic changes affecting both, control and study group. Blockage of ostiomeatal complex was twice more common in children who did not respond adequately to desensitization therapy. In our study group, radiological findings suggesting rhinosinusitis were found in 73% of patients, while retention cysts in maxillary sinuses were discovered in 27% of patients.

Conclusions: Pathological findings in paranasal sinuses in computed tomography may arise from uncontrolled allergic rhinitis. If chirurgical management is indicated, allergen immunotherapy should be postponed until total recovery from operational procedure and repeated.
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http://dx.doi.org/10.1016/j.amjoto.2020.102504DOI Listing
August 2020

Predictive Factors of Response to Selective Progesterone Receptor Modulator (Ulipristal Acetate) in the Pharmacological Treatment of Uterine Fibroids.

Int J Environ Res Public Health 2020 01 28;17(3). Epub 2020 Jan 28.

Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland.

Selective progesterone receptor modulator ulipristal acetate (UPA) is a drug used in management of symptomatic myomas. It was observed that the response to UPA treatment in uterine myomas varied amongst patients. An attempt was thus made at establishing predictive factors conducive to better reaction to treatment with UPA. The aim of this study was to assess the efficacy of UPA treatment in women with myomas, depending on pretreatment myomas' volume, number of myomas, age of patients, estrogenic status of women, and pretreatment blood flow in uterine arteries. The study included patients with one to four myomas. The UPA treatment was a preparation stage for surgical treatment in all patients. The study group was divided into the subgroups according to pretreatment myomas' volume, number of myomas, age of patients, estrogenic status of women, and pretreatment blood flow in uterine arteries. A better effect of reduction in size of myomas after UPA treatment was noted when pretreatment myomas' volume was lower than 30 cm. A significant reduction in fibroids' size was observed after UPA therapy independently of the number of myomas and age of patients. A good response after the UPA therapy was observed when pretreatment estradiol concentration was below 50 pg/mL and when uterine artery resistance index (RI) was above 0.8. Our research demonstrates that treatment with ulipristal acetate is an efficient method in preoperative preparation of patients with uterine fibroids. The most important factor of positive response to UPA therapy is myoma volume. The number of myomas and patient's age do not interfere with effects of UPA therapy. Pretreatment estradiol concentration is significant, yet secondary for the effects of therapy. The UPA therapy has no impact on blood flow in the uterine arteries and no adverse influence on estradiol concentrations.
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http://dx.doi.org/10.3390/ijerph17030798DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7037608PMC
January 2020

Asymptomatic radiological changes in computer tomography in children with head trauma.

Otolaryngol Pol 2019 Jun;73(5):5-11

Katedra i Klinika Otolaryngologii Dziecięcej, Foniatrii i Audiologii Uniwersytetu Medycznego w Lublinie, Polska.

Introduction: Computed tomography is an important imaging technique in Emergency Units. Thanks to its popularity, radiological changes are found in healthy children more commonly. The aim of this paper is to evaluate the incidence of maxillary sinus radiological changes in children with head trauma who admitted to the Emergency Unit of the University Children Hospital in Lublin.

Material And Methods: A retrospective analysis of computed tomography scans of children suffering from head trauma admitted to the Emergency Unit of the University Children Hospital in Lublin was carried out. A group of 425 patients was analyzed.

Results: Maxillary findings were present in 81 cases (19.06%); in 38 patients (8.94%) the changes were unilateral, while in 43 (10.12%) they were bilateral. Maxillary mucosal thickening was the most common radiological abnormality, present in almost 12% of the investigated cases (approximately 62% of all revealed changes). Maxillary total opacification as an isolated finding was found in younger children only. Retention cysts and maxillary polyps were found with a similar low frequency as maxillary opacification but in elder children only.

Discussion: Asymptomatic radiological changes in computed tomography scans are common. Maxillary mucosal thickening is the most frequent asymptomatic abnormality. Maxillary polyps and pseudocysts are rare in the paediatric population. Maxillary opacification suggests other more significant pathologies and requires further diagnostics. Physicians should avoid diagnosing patients with sinusitis without proper examination and based on radiological abnormalities only. Paediatric patients with revealed maxillary changes should remain under regular laryngological control.
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http://dx.doi.org/10.5604/01.3001.0013.2459DOI Listing
June 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

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

Somatostatin analogues labeled with copper radioisotopes: current status.

J Radioanal Nucl Chem 2017 13;313(2):279-289. Epub 2017 Jun 13.

Department of Inorganic Chemistry, Wroclaw Medical University, Borowska 211A, 50-556 Wroclaw, Poland.

Peptide receptor radionuclide therapy (PRRT) is a promising way to treat patients with inoperable tumors or metastatic neuroendocrine tumors. This therapeutic strategy is using radiolabeled peptides, which are capable of selective biding to receptors overexpressed in the cancer cells. One of the group of receptor-avid peptide used in the PRRT are the analogues of somatostatin (SST) connected to the complexes of radionuclides (e.g. Y, Lu or In). Many studies have shown that radiopharmaceuticals based on Cu radioisotopes are promising for the diagnosis and treatment of various cancers. This mini-review focuses on recent developments and summarises the results of multiple studies addressing SST agonists and antagonists radiolabeled to Cu radioisotopes.
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http://dx.doi.org/10.1007/s10967-017-5323-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5533839PMC
June 2017

Fetal programming of the metabolic syndrome.

Taiwan J Obstet Gynecol 2017 Apr;56(2):133-138

Department of Obstetrics and Perinatology, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland.

Prenatal development is currently recognized as a critical period in the etiology of human diseases. This is particularly so when an unfavorable environment interacts with a genetic predisposition. The fetal programming concept suggests that maternal nutritional imbalance and metabolic disturbances may have a persistent and intergenerational effect on the health of offspring and on the risk of diseases such as obesity, diabetes, and cardiovascular diseases.
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http://dx.doi.org/10.1016/j.tjog.2017.01.001DOI Listing
April 2017

The Coordination Abilities of New Cyclic Analogs of Somatostatin.

Int J Pept Res Ther 2017 23;23(1):135-143. Epub 2016 Jul 23.

Department of Inorganic Chemistry, Wroclaw Medical University, Borowska 211A, 50-556 Wrocław, Poland.

Two new somatostatin analogs with a characteristic part of the sequence -c(Cys-Phe-Trp-Lys-Thr-Cys)- and with two histidine and two aspartic acid moieties in their structures were synthesized and analyzed in terms of their coordination abilities with copper (II) ions. Both peptides bind Cu(II) effectively. Ligands form 4N complexes with [Formula: see text] binding mode in a basic range of pH. But in spite of very similar sequences of the two peptides a significant difference in the effectiveness of the binding of copper (II) ions was observed.
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http://dx.doi.org/10.1007/s10989-016-9546-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5306305PMC
July 2016

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

[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

[Urinary stress incontinence - one of basic diseases of modern society].

Pol Merkur Lekarski 2015 Jan;38(223):51-4

Pomerianian Medical University of Szczecin, Poland, Department of Ginecology and Uroginecology.

One of the most common women's chronic diseases is urine incontinence (UI). Currently considered to be a social disease of women in all age groups. The etiology of urine incontinence is multifactorial and the most common is stress urinary incontinence (SUI). UI is a interdisciplinary problem, lying in the sphere of interests of different specialties. According to the recommendations of the Polish Gynecological Society IU diagnostics can be divided into a preliminary stage and specialized stage. Initial diagnosis should start by gathering medical history and it can be completed by quality of life questionnaire. Today, one of the non-invasive diagnostic methods is the ultrasound study. In a situation where diagnosis can not be placed or when surgical treatment is needed, the patient should have urodynamic study. Conservative methods and surgery are used in the treatment of SUI. Conservative procedure should be the first choice in patients with symptoms of IU. Over 200 types of various operations have been described in the history of the surgical treatment of SUI. Until now the most common are: Burch colposuspension, TVT and TOT and implantation of an artificial sphincter.
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January 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

Novel short-chain analogues of somatostatin as ligands for Cu(II) ions. Role of the metal ion binding on the spatial structure of the ligand.

J Inorg Biochem 2012 Dec 7;117:10-7. Epub 2012 Sep 7.

Department of Inorganic Chemistry, Wroclaw Medical University, Szewska 38, 50-139 Wroclaw, Poland.

In this paper we present the studies on coordination abilities of two short-chain analogues of somatostatin with free N-terminal and protected amino group towards copper (II) ions. The octreotide is the most popular analogue of the somatostatin (peptide hormone) used in medicine. Somatostatin analogues are used in diagnosis and treatment of the neuroendocrine tumors. Both analyzed analogues are characterized by the presence of two His instead of Cys residues in characteristic fragment of native peptide. We characterize coordination abilities of the ligands using potentiometric and spectroscopic methods. His-analogues of somatostatin are effective ligands for copper (II) ions. Both peptides are able to form the complexes with the cyclic structure.
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http://dx.doi.org/10.1016/j.jinorgbio.2012.08.023DOI Listing
December 2012

Leptin concentrations in patients with polycystic ovary syndrome before and after met-formin treatment depending on insulin resistance, body mass index and androgen con-centrations--introductory report.

Folia Histochem Cytobiol 2009 ;47(2):323-8

Department of Reproduction and Gynecology, Pomeranian Medical University, Szczecin, Poland.

Polycystic ovary syndrome (PCOS) is an endocrinological and metabolic disorder which may concern about 3-8% of women. Some PCOS women have the increased leptin concentration in blood serum. Leptin concentration is higher in patients with high body mass index (BMI) and impaired tissue sensitivity to insulin. The aim of this study was to determine leptin concentrations in PCOS patients before and after metformin treatment depending on BMI, insulin resistance calculated on the basis of the Homeostasis Model Assessment (HOMA) index, as well as concentrations of androgens: testosterone and androstendion. Such values as BMI, insulin resistance according to the HOMA index, and concentrations of androstendion, testosterone and leptin were determined in 35 patients with PCOS before and after 3-month metformin treatment administered in daily doses of 2 x 850 mg. Increased leptin levels before the therapy were observed in 91.3% (21 out of 23) of obese patients, in 75% (9 out of 12) non-obese patients, in 100% (8 patients) insulin resistance women, in 81.5% (22 out of 27) insulin sensitive patients, in 94.7% (18 out of 19) women with elevated androstendion concentration and in 75% (12 out of 16) with normal androstendion concentration, in 93.7% (15 out of 16) patients with increased testosterone concentration and in 78.9% (15 out of 19) patients with testosterone concentrations within the normal range. After treatment statistically significant decrease in leptin concentration was obtained in the patients with BMI
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http://dx.doi.org/10.2478/v10042-009-0032-0DOI Listing
April 2010

[The results of surgical treatment urinary stress incontinence of Burch and TVT methods independent of position of pelvic organ].

Pol Merkur Lekarski 2009 Jul;27(157):14-8

Pomorska Akademia Medyczna w Szczecinie, Klinika Rozrodczości i Ginekologii.

Unlabelled: Urinary incontinence is a social disease. In age-various women groups it appears in abort 15-30%. After menopause urinary incontinence frequency increases to 40%. In most cares stress urinary incontinence (SUI) demands surgical treatment. There are many treatment opinions, but there is no 100% effective method.

Aim Of The Study: In this research two surgical treatment methods (Burch suspension vs tension-free vaginal tape - TVT method) for urinary incontinence were compared.

Material And Methods: The study was undertaken in 295 women. After carefully diagnostic (interview, ultrasound, assessment of risk factors) of SUI patients were qualified to Burch suspension or TVT method. Effects were assessed after 24 postoperative months.

Results: Total lost of complaints was obtained in 65% after TVT In case of retroflexio of uterus percent of recoveries was lower--about 30%, independently on a type of operation. Even small agree of cervical descent get worse a treatment effects. Clinical effects were confirmed by ultrasound (angle between urethra and bladder, distance between symphysis and urethra before and treatment).

Conclusions: Result of surgical treatment of urinary incontinence is about 65% of improvement regardless of surgical method. Retroflexio of uterus and cervical descent make this result even worse.
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July 2009

[The role of leptin in polycystic ovary syndrome].

Pol Merkur Lekarski 2008 Oct;25(148):390-3

Pomorska Akademia Medyczna w Szczecinie, Klinika Rozrodczości i Ginekologii.

Polycystic ovarian syndrome (PCOS) is the most common cause of functional infertility. It concerns 5-10% women of reproductive age. PCOS is connected with many clinical symptoms, mostly menstrual disorders like oligomenorrhoea with chronic anovulation. In laboratory assays hyperandrogenism is found. In some patients also metabolic disturbances like insulin resistance, hyperinsulinemia, dyslipidemy, and hyperleptinemia are found. Ultrasound characteristic features polycystic ovaries. In 2003 on Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group Meeting new PCOS criteria were defined. Recent studies revealed that increased leptin concentration is characteristic for PCOS patients. It can be connected with coexistence of impaired glucose tolerance and obesity, nevertheless still more studies concerning role of leptin in PCOS pathogenesis are needed.
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October 2008
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