Małgorzata Romanik

Is the plasma anti-Müllerian hormone (AMH) level associated with body weight and metabolic, and hormonal disturbances in women with and without polycystic ovary syndrome?

OBJECTIVE The aim of the study was to analyze interrelation between AMH levels and body weight, metabolic, and hormonal status in normal and overweight weight women with and without polycystic ovary syndrome (PCOS). STUDY DESIGN Eighty-seven women (54 normal weight and 33 overweight) diagnosed with PCOS and 50 apparently healthy women - Non-PCOS (28 normal weight and 22 overweight) were enrolled. The body weight and height were measured and BMI was calculated. In addition to serum glucose, lipids, androgens, FSH, LH, SHBG and insulin, AMH were assessed in fasting state and free androgens index (FAI) was calculated. The insulin resistance was assessed based on the homeostasis model of assessment-insulin resistance (HOMA-IR). RESULTS Plasma AMH levels were similar in normal weight and overweight PCOS groups (9.6±3.5 vs. 11.2±4.5ng/mL, respectively), and as expected markedly higher than in both Non-PCOS groups (2.5±0.8 and 2.3±0.7ng/mL, respectively). There were no correlations between BMI and AMH levels in all study groups. A significant positive correlation between HOMA-IR, free testosterone concentrations or FAI and AMH levels were found (R=0.31, p<0.001; R=0.91, p<0.001 and R=0.62, p<0.001, respectively). Moreover, there was positive correlation between total or LDL cholesterol and AMH levels (R=0.22, p<0.05 and R=0.31, p<0.05, respectively) and a negative one between HDL cholesterol and AMH levels (R=-0.17, p<0.05) in all study subjects. CONCLUSIONS The plasma AMH level is associated with insulin resistance but not with BMI per se. Increased circulating AMH level seems to reflect the disturbances of gonadotrophins release in PCOS. It seems that AMH level may be used not only as new surrogate marker of ovarian hyperandrogenism in PCOS but also as a potential new cardiovascular risk factor.

Occurrence of Ureaplasma parvum and Ureaplasma urealyticum in Women with Cervical Dysplasia in Katowice, Poland

The aim of this study was to evaluate the occurrence of genital mycoplasmas, especially Ureaplasma parvum and Ureaplasma urealyticum, in women with atypical squamous cells of undetermined significance (ASCUS), low grade squamous intraepithelial lesions (LSIL) and high grade squamous intraepithelial lesions (HSIL), compared to women with normal cytology living in Katowice, Poland. Two sterile swabs were used to obtain material from the posterior vaginal fornix of 143 women with squamous intraepithelial lesions and 39 healthy women: first for general bacteriology, second for detection of urogenital mycoplasmas using Mycoplasma IST2 kit. From each positive Mycoplasma IST2 culture DNA was isolated and PCR was performed for identification of U. parvum and U. urealyticum. Mycoplasma IST was positive in 34.1% cases. Urogenital mycoplasmas were demonstrated in women with HSIL significantly more often compared to women with LSIL, ASCUS, and with normal cytology. DNA of U. parvum was demonstrated in majority of Mycoplasma IST2-positive cases, U. urealyticum DNA-only in 9 (4.9%). Predominance of 3/14 serovars of U. parvum was demonstrated. U. urealyticum biovar 2 was present more often in women with squamous intraepithelial lesions.

Prevalence of ureaplasmas in HPV-positive women with squamous intraepithelial lesions in Upper Silesia, Poland

We read with interest the study by Denks et al. entitled ‘Coinfection of Chlamydia trachomatis, Ureaplasma urealyticum and human papillomavirus among patients attending STD clinics in Estonia’. [1]. These authors described a significant association of C. trachomatis with high-risk HPV types and also with U. urealyticum in women visiting Estonian STD clinics. They did not find an association of U. urealyticum with HPV status. In our study we evaluated the occurrence of Ureaplasma parvum (U. parvum) and Ureaplasma urealyticum (U. urealyticum) in HPV-positive women with different cytological smear results ASCUS (Atypical Squamous Cells of Undetermined Significance), LSIL (Low Grade Squamous Intraepithelial Lesions), HSIL (High Grade Squamous Intraepithelial Lesions). Our study included 182 (mean age 39.5 y) nonpregnant, menstruating, sexually active women with similar socioeconomic status, who attended the Department of Medical Microbiology of Medical University of Silesia in Katowice (south Poland, c. 5,000,000 population) for microbiological diagnosis. Women included in this study were Neisseria gonorrhoeae-negative, bacterial vaginosis BV-negative (by Nugent and Amsel criteria) and did not use oral or vaginal contraceptives and antibiotics/antimycotics within at least 4 weeks before examination. All women gave informed consent for this study, approved by the Bioethical Committee of the Medical University of Silesia. According to cervix cytology (The Bethesda System, 2001), the following subgroups were identified: 67 women (mean age 40.5 y) with ASCUS, 49 women (mean age 36.6 y) with LSIL, 22 with HSIL (mean age 34.1 y) and 39 (mean age 39 y) with normal cytology; in 5 cases SCC (squamous cell carcinoma) was diagnosed. Cervical and vaginal swabs were taken from each of 182 studied women for the determination of C. trachomatis (AMPLICOR Chlamydia trachomatis, Roche Molecular Systems, USA), HPV (AMPLICOR HPV, Roche Molecular Systems, USA, for high-risk HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) and urogenital mycoplasmas, respectively. Sterile swab was used to obtained material from the posterior vaginal fornix for the detection of mycoplasmas (urea-arginine broth transport medium). Culturing of genital mycoplasmas was performed using Mycoplasma IST2 (bioMérieux, France) according to the manufacturer’s instructions. Isolation of DNA was performed with appropriate columns (DNeasy Tissue Kit, Qiagen). PCR identification of ureaplasmas in Mycoplasma IST2positive samples was performed according to Kong et al. [2]. Statistical analysis was performed by x and Mann-Whitney U-test (pB0.05 was statistically significant). In study groups of women with ASCUS, LSIL, HSIL and with normal cytology, HPV DNA was detected in 25.4%, 46.9%, 95.5%, and 17.9%, respectively. In all 5 cases of SCC, HPV DNA was

Outpatient post-partum antibiotic prescription: method of identification of infection control areas demanding improvements and verification of sensitivity of infection registration

Objectives To evaluate data on outpatient antibiotic use in women post-labour as a potential method of monitoring infections in this group of patients. Methods Demographic and antibiotic prescription data originated from the registries of the National Health Fund (pol. Narodowy Fundusz Zdrowia). The measure of antibiotic use in this study was the percentage of women who purchased the drugs from prescriptions and DDDs. Results Among 67917 females who gave birth in the years 2013-14, 5050 (7.4%) purchased antibiotics prescribed by the obstetrician only. The average number of antibiotics bought per person was equivalent to ∼14 DDDs; in most cases (95.7%) these were β-lactams. Antibiotic use occurred significantly more frequently among younger patients (11.5% patients <18 years of age), those living in rural areas (8.2%) and those who underwent Caesarean section (8.1%). No significant differences were found between the reported day of labour and the post-partum use of antibiotics. Conclusions Antibiotic prescribing data can be used to verify/complement the information originating from hospital infection registries to monitor rates of infection in obstetric patients.