Beata Pięta

Vaginal hysterectomy with bipolar coagulation forceps (BiClamp) as an alternative to the conventional technique

PurposeThe aim was to identify the advantages and disadvantages of using bipolar coagulation forceps in vaginal hysterectomy and to compare the effects of this method with those of the conventional technique.MethodsA group of 30 patients was operated on with bipolar coagulation forceps and the next 30 were operated on using the traditional method. The following parameters were observed: duration of procedure, blood loss, complications, postoperative pain, hospitalization time and cost of treatment.ResultsThe duration of the surgical procedure and hospitalization time were similar in both groups. Blood loss was lower in the BiClamp group. There were no serious complications in either group. In one case with BiClamp, laparotomy was performed to stop persistent bleeding; the after-effects of the laparotomy were not statistically significant. The patients in the BiClamp group reported less pain, experienced shorter recuperation times and incurred lower treatment costs.ConclusionsThe BiClamp technique is a good alternative to traditional hysterectomy methods as it causes lower blood loss during surgery, causes less post-operative pain and is economically more favorable for the patient and hospital.

The role of ghrelin, leptin and insulin in foetal development

INTRODUCTION AND OBJECTIVE The growing epidemic of childhood obesity has forced scientists to search for methods to prevent feeding disorders. Increasing interest in appetite regulating hormones has revealed their influence on energy homeostasis after birth or even in utero. STATE OF KNOWLEDGE The presence of ghrelin in the stomach of human foetuses and the distinctive production in the pancreas of neonates suggests the role of ghrelin in pre- and post-natal development. The neonatal period appears to be a critical time for the formation of adipose tissue-hypothalamus circuits, thus the amount of adipocytes in foetal life may be a major regulator of food intake. Insulins orexigenic effect in the arcuate nucleus of the hypothalamus can be a major modulator of foetal development. OBJECTIVE This review, based on available literature, aims to analyses the role of appetite regulating hormones in foetal development. SUMMARY Different concentrations of hormones, such as ghrelin, leptin and insulin during foetal life raises the question whether or not they can be modulated, thereby avoiding obesity before birth. Children with pancreas agenesis showed smaller body size at birth, which emphasises the probable role of insulin in foetal growth. Study of sheep foetuses with IUGR confirmed these finding. Appetite-regulating hormones show different roles in foetal development and seem to be essential in the perinatal period.

Odds ratio analysis in women with endometrial cancer.

Introduction Despite the progress in diagnosis and treatment of malignant tumours, the effects of treatment are insufficient. Reduction of the risk of cervical, ovarian, and endometrial cancer is possible by introducing preventative actions. Aim of the study The aim of the thesis is the analysis of selected risk factors that may affect the increase or decrease in the odds ratio of developing endometrial cancer. Material and methods The study was conducted among patients of the Gynaecology and Obstetrics Hospital of Poznań University of Medical Sciences in the years 2011-2013. The research included a total of 548 female respondents aged between 40 and 84 years. Women responded to questions assessing elements of lifestyle such as consumption of alcohol, smoking, and eating certain groups of foods. Results The respondents consuming fruits and vegetables several times a week have a reduced risk of odds ratio and the OR is 0.85; 95% CI: 0.18-4.09, compared to the women who rarely consume vegetables and fruits. Consumption of whole-wheat bread several times a week reduces the risk of developing the cancer, OR = 0.59; 95% CI: 0.14-2.47, compared to women not consuming wholegrain bread at all. Respondents who consumed red meat, such as veal, pork, and lamb in the amount of 101-200 g per day have an increased risk of developing the disease: OR = 2.16; 95% CI: 1.09-4.28, compared to women not consuming red meat at all. Conclusions A diet rich in fruit and vegetables, onions, garlic, whole grains, and beans should be introduced in order to reduce the risk of endometrial cancer. The consumption of red meat and white pasta should be reduced or even eliminated.

Material awareness on natural feeding.

INTRODUCTION Natural breastfeeding is the only proper way to feed newborns and infants because it ensures their proper development. Breastfeeding enhances health and protects against the development of many diseases in childhood and adulthood. The primary benefits of breastfeeding include reduced incidences of infection in the respiratory system as well as a reduction in gastrointestinal and systemic infections. The benefits of breastfeeding also include decreased inflammation and improved immunity to disease in the infant. Further benefits of breastfeeding are reduced incidences of type 1 diabetes, Crohns disease, and rheumatoid arthritis. OBJECTIVE The aim of the study was to assess the degree of knowledge on maternal breastfeeding among current expecting mothers. MATERIALS AND METHOD The study comprtisded 147 mothers hospitalized in the Gynecology-Obstetrics Hospital University of Medical Sciences in Poznań, Poland, during late July - August 2012. RESULTS For 139 (93.88%) of the surveyed women, breastfeeding was a priority regarding the health of the child. Respondents most often used professional literature in order to gain knowledge about breastfeeding (63.27%). The least popular way of acquiring knowledge was through the media (27.21%). CONCLUSIONS Analysis of the collected material on the surveyed women showed that women have a diverse range of knowledge about breastfeeding. Currently, breastfeeding is required to be promoted and supported by midwives, paediatricians and other health professionals.

I What Do We Know About Hysterectomy

A total hysterectomy is the most common type of gynecologic surgery and may be performed to treat many diseases that affect the uterus including: abnormal uterine bleeding, uterine fibroids, endometriosis and chronic pelvic pain, anatomic uterine defects, uterine prolapse and cancer (Reich, 2003). Based on German studies from 2005 and 2006 (overall 305 015 hysterectomies performed during the study period) the hysterectomy rate for benign diseases of the genital tract among women aged 20 or older (3.6 out of 1000 women) was higher than in Sweden but lower than in the US or Australia (Gupta, 2006, Stang 2011). The United States still has the highest incidence of hysterectomy, with about 550 000 women undergoing this operation annually, at a cost of more than

Influence of socio-economic factors on emotional changes during the postnatal period

5 billion. The rate of this procedure in the USA is 5.4/1000 women, whereas in Italy it is 3.7/1000 and in Norway only 1.2/1000 women (Manyonda, 2003).

Modifiable lifestyle factors and ovarian cancer incidence in women

OBJECTIVES The aim of the study was to identify socio-economic factors that may influence the emotional changes which occur among new mothers in the first days postpartum. MATERIAL AND METHODS A group of 541 women completed a questionnaire consisting of 30 multiple-choice questions, Edinburgh Postnatal Depression Scale (EPDS), and Hospital Anxiety and Depression Scale (HADS). Statistical calculations were performed with the use of Statistica v.10 and Cytel Studio v. 9.0.0. RESULTS The findings revealed the presence of factors which might increase the risk of mood disorders during the postpartum period. CONCLUSIONS Women who demonstrate warning symptoms should be screened for postnatal emotional changes and mood swings during their hospitalization after delivery. EPDS seems to be a suitable tool for early detection of emotional disturbances.

[Correlation between intensity of menopausal symptoms and cognitive domain assessed with CNS-VS tests].

INTRODUCTION A correct diet plays an important role in the prevention of malignant tumours. The risk of the disease may be reduced by introducing a number of changes to the daily diet. The most important changes concern the amount of fat in the diet, dietary fibre, antioxidants in the food and the reduction of substances having a significant impact on the development of malignant tumours. OBJECTIVE The aim of the study is to analyse the role of selected modifiable lifestyle factors affecting the development of ovarian cancer. MATERIAL AND METHODS The study covered healthy women and women with diagnosed ovarian cancer. A total of 850 women aged between 21-84 were studied. The study included women visiting the Gynaecology and Obstetrics Hospital of the University of Medical Sciences in Poznan, Poland, between 2011-2013. Patients recognized with malignant ovarian cancer were qualified into the study based on the histopathological examination of the material obtained during surgery. RESULTS Respondents who consumed fruit and vegetables several times a week have the odds ratio OR = 0.29 level; 95% CI 0.04-2.01 (p =.2085), compared to women not consuming fruit and vegetables at all. Consumption of 100 g of French fries and potato chips several times a week, results in a 2-fold increase in ovarian cancer. The OR for this group of women amounts to 2.06; 95% CI 0.53-7.99 (p=.2966). CONCLUSIONS A diet rich in fruit and vegetables, including bulb vegetables, and grain products containing whole grains, should be introduced. It is recommended that the consumption of popular fast foods be eliminated.

Risk assessment for breast cancer.

INTRODUCTION Numerous publications suggest that many cognitive domains deteriorate with age. As far as postmenopausal women are concerned, the question remains whether the process is caused only by an ageing brain or also by the menopause. The objective of this research was to analyze a possible correlation between intensity and duration of menopausal symptoms and the level of cognitive domains measured with CNS-VS tests among post-menopausal women. METHODOLOGY The group under examination included 383 postmenopausal women (at least 2 years after their last menstruation) from South-Eastern Poland. The following inclusion criteria were used: age 50-65, good overall health status, at least primary level of education, and FSH>30 mlU/ml. Cognitive domains were assessed using the CNS - VitalSigns diagnostic device. The intensity of menopausal symptoms was measured with the Kupperman Index and the Greene Scale. The statistical analysis was conducted with the use of the Statistica software. RESULTS There were no significant relations between age at last menstruation and cognitive domains. BMI was oositively correlated with the Neurocognitive index (NCI) and memory visual memory processing speed, and executive functions. The intensity of menopausal symptoms measured with the Greene Scale was negatively correlated with NCI and most of the cognitive domains, whereas symptoms measured with the Kupperman Index were negatively correlated with NCI and visual memory CONCLUSIONS Our findings suggest a correlation of the intensity and duration of menopausal symptoms with the revel of cognitive domain among menopausal women. The most significant consequences resulting from changes in the cognitive domains included psychological and vasomotor symptoms, as well as - to a lesser extent - somatic symptoms.

The assessment of selected factors influencing intent to get pregnant in the Greater Poland Region

Cancer prevention and treatment are among the greatest challenges for health care systems worldwide nowadays (Zatonski, 2003). Primary prevention constitutes a serious challenge because of the multitude and diversity of factors playing a role in carcinogenesis. Furthermore, numerous factors such as