Przemysław Oszukowski

Anti-phlogistic and Immunocompetent Effects of Acupuncture Treatment in Women Suffering from Chronic Pelvic Inflammatory Diseases

Thirty-nine women of reproductive age suffering from chronic pelvic inflammatory disease (PID) for at least two years, previously treated pharmacologically with no effect, were enrolled in a four-week therapeutic protocol consisting of 12 acupuncture treatments performed with the frequency of three per week. In each female patient at baseline and after the study, pain score and the following parameters in blood serum were evaluated: concentration of immunoglobulin M (IgM), albumins, alpha1-globulins, alpha2-globulins and gamma-globulins, erythrocyte sedimentation rate (ESR) and white blood cell (WBC) count. During the study, we obtained a significant drop in ESR and IgM levels together with a rise in gamma-globulin concentrations. A significant decrease (from 4.89 +/- 0.82 to 0.63 +/- 1.05) in pain score was obtained. The other parameters remained unchanged. These results suggest that acupuncture treatment of PID exhibits a clear anti-inflammatory and immunocompetent effect.

Clinical and immunological condition of newborns of mothers treated for recurrent spontaneous abortions with paternal lymphocytes immunization

OBJECTIVE The aim of this study was to evaluate the clinical condition at birth and some laboratory parameters in newborns of mothers treated for recurrent spontaneous abortion (RSA) of unknown etiology with paternal lymphocytes immunization. STUDY DESIGN The study comprised 104 newborns delivered by 102 women with RSA, who underwent alloimmunization and 90 randomly chosen control newborns. The following parameters were analysed in two groups of newborns: general condition at birth, physical development, course of adaptation period, values of hematological and immunological (percentage of CD3, CD4, CD8, CD19 and CD3/CD25 lymphocytes, chemiluminescence of neutrophils at rest and stimulated with opsonized zymosane) parameters in umbilical arterial blood. RESULTS No statistically significant differences were noted between the two groups of newborns as to the duration of pregnancy, birth weight, general condition at birth, occurrence of complications in the adaptation period and values of studied hematological and immunological parameters. CONCLUSION These results suggest that immunization with paternal lymphocytes in women with RSA of unknown etiology not only creates better prognosis for the outcome of the pregnancy, but is also safe for the fetus and the newborn.

Combined screening for early and late pre-eclampsia and intrauterine growth restriction by maternal history, uterine artery Doppler, mean arterial pressure and biochemical markers

BACKGROUND Pre-eclampsia is a systemic disease connected with high maternal and fetal morbidity and mortality. Despite significant progress achieved in perinatal medicine, pre-eclampsia is still one of the most significant current problems in obstetrics. OBJECTIVES The aim of the study was to establish diagnostic algorithms for early and late pre-eclampsia (PE) and intrauterine growth restriction (IUGR). MATERIAL AND METHODS A total of 320 pregnant women between 11 + 0 and 13 + 6 weeks of gestation were recruited for a case-control study. The study group consisted of 22 patients with early PE, 29 patients with late PE and 269 unaffected controls. The following parameters were recorded: maternal history, mean arterial pressure (MAP), mean uterine artery pulsatility index (UtA-PI), and the concentrations of placental growth factor (PlGF), pregnancy-associated plasma protein A (PAPP-A) and free beta-human chorionic gonadotropin (free β-hCG). RESULTS A multivariable stepwise logistic regression analysis indicated that the best screening model for the prediction of early PE is based on a combined analysis of maternal risk factors, UtA-PI and PlGF levels (sensitivity: 91%; specificity: 84%). The best screening model for the prediction of late PE is based on a combined analysis of maternal risk factors, UtA-PI and MAP (sensitivity: 85%; specificity: 83%). The most effective screening model for the prediction of IUGR is based on a combined analysis of maternal risk factors, UtA-PI and PlGF concentrations (sensitivity: 91%; specificity: 83%). CONCLUSIONS The integrated model of screening established in this study can be a valuable method to identify patients at increased risk of developing pre-eclampsia and related complications. The ability to predict the occurrence of pre-eclampsia in early pregnancy would enable maternal and fetal morbidity to be reduced through the introduction of strict obstetric surveillance as well as planned delivery in a reference center.

Fetal Macrosomia, Polyhydramnios and Cardiac Anomalies may be Helpful to Predict Poor Outcome in Neonate – Case Report of a Possible Fetal Rasopathy with Sonographic and Neonatal Findings and Genetic Evaluation.

Abstract This is a case report about very rare findings in 2nd half of pregnancy (after normal 1 trimester scan ) at 18th week of gestation fetal macrosomia was detected unrelated to maternal diabetes, and acceleration fetal growth later on with unusual cardiac abnormalities (fetal cardiomegaly, cardiomyopathy, partial abnormal venous connection ). Progressive features of congestive heart failure with polyhydramnios in a fetus with estimated 5500 g predicted a poor outcome and severe neonatal condition, which was presented and discussed with the parents to be. Casearean section was performed at 33rd weeks of gestation due to maternal dyscomfort, severe legs edema and her tachypnoe. Baby boy was delivered with birth weight of 5050g, Apgar 4 with mutiple tumors. Conservative care was introduced and neonated died on the 3rd day. Differential diagnosis was discussed with special attention to Costello syndrome however without proved by genetic make-up from neonatal blood.

Współczesne metody monitorowania dobrostanu płodu w ciąży powikłanej wewnątrzmacicznym zahamowaniem wzrastania.

Intrauterine growth restriction (IUGR) is one of the most important problems in current perinatology. The number of complications such as intrauterine fetal hypoxia, preterm and operative labours, intrauterine demises and neonatal deaths are signifcantly higher among pregnant women with IUGR. The proper monitoring and assesement of the fetal well-being are crucial to make the right decision about optimal time and mode of delivery.

Endometrial and cervical cancer: incidence and mortality among women in the Lodz region

Introduction By the early 21st century the most common cancer of female genitals in Poland was cervical cancer. Now endometrial cancer ranks first. The aim of this study was to analyse the incidence and mortality of endometrial and cervical cancer among women in the Lodz region. Material and methods Data on the incidence and mortality of endometrial and cervical cancer among inhabitants of the Lodz region were obtained from the National Cancer Registry and Bulletin of Cancer Cases in the Lodz region. The analysis covered ten consecutive years beginning in 2001. Results The number of new cases reported in 2010 exceeded that observed in 2001 by 181. The standardized incidence rate of endometrial cancer increased by 6.3, while the standardized incidence rate of cervical cancer decreased by 1.4. Conclusions In the years 2001-2010, the incidence of endometrial cancer increased by 88.3% and that of cervical cancer decreased by 6.5% among inhabitants of the Lodz region. In the years 2001-2010, mortality of endometrial cancer increased by 24.5% and that of cervical cancer decreased by 12.6%. In 2010, the highest crude incidence rates in the Lodz region of both endometrial and cervical cancer at 39.1 were recorded in the district town of Piotrków.

The toxic impact of local anaesthetics in menopausal women: causes, prevention and treatment after local anaesthetic overdose. Local anaesthetic systemic toxicity syndrome

Gynaecologists often use local anaesthetics in their medical practice. Some concomitant diseases during the menopausal period may cause problems during the qualification of postmenopausal women for general anaesthesia in gynaecological surgery. Many authors suggest the application of local analgesia for particular kinds of gynaecological surgery procedures performed on postmenopausal women, taking into consideration health determinants. While applying local anaesthetics, the possibility of their overdose has to be taken into account. Generalised toxic symptoms which appeared after the local anaesthesia are rare, but potentially are lethal complications. Toxic symptoms after local anaesthetic administration are manifested after accidental administration of a medicine into a blood vessel, when extravascular administration of a large volume of a local anaesthetic is absorbed into a bloodstream or with the reproducible doses of local anaesthetics which are administered when metabolism does not work sufficiently and cannot eliminate these substances. Clinical overdose of local anaesthetics is manifested by disorders in two systems. Firstly, the pathological symptoms come from the central nervous system (CNS). In the second phase, the pathological symptoms will additionally appear in the cardiovascular system. The aim of the present thesis is to remind clinical manifestations of the local anaesthetic overdose and suggest the management of patients with the aforementioned symptoms, especially in the case of intravenous lipid emulsions which have the status of an antidote in life-threatening conditions caused by cardiotoxic effects of local anaesthetics.

Incidence of and mortality from breast cancer among women in Poland in the years 2001-2010

Introduction Breast cancer is the most common malignant tumour among women. About 15,000 new cases of breast cancer are diagnosed and more than 5,000 women die in Poland every year. The aim of this study was to analyse the incidence and mortality rate of breast cancer among women in Poland in the years 2001-2010. Material and methods Analysed data concerning the incidence of and mortality from cancer among women were obtained from the National Cancer Registry. Results The number of new cases reported in 2010 exceeded that reported in 2001 by 3,666. The mortality from breast cancer among women increased by 15.1% by 2009, to subsequently drop by 0.3% in 2010. The standardized incidence rate increased by 7.4 and the standardized mortality rate fell by 1.3 in 2001-2010. Conclusions In the years 2001-2010 the incidence of breast cancer in women in Poland rose by 30.3%, with an increase of 7.4 in the incidence rate. The highest rise in the incidence and mortality of women due to breast cancer in Poland is reported in the Lodz voivodeship. In the years 2001-2009 the number of womens deaths due to breast cancer increased slightly, while the mortality rate dropped.

Values of Acid-Base Balance Parameters in Newborns in Relation to the Symptoms of EPH Gestosis

EPH gestosis is one of the most common factors aggravating newborn conditions at birth. The aim of this paper was to establish which of the parameters (hypertension, proteinuria or edema) have the most considerable effect on the infants general conditions. The investigation was carried in 300 newborns, including 82 mothers with the symptoms with EPH gestosis. The close relation between bad condition of newborns and the lowering of pH in blood taken from umbilical artery in the case of hypertension gestosis was noted.