ABSTRACT
Infertility has been recognized as a civilizational disease. One of the most common causes of infertility is polycystic ovary syndrome (PCOS). Closely interrelated immunometabolic mechanisms underlie the development of this complex syndrome and lead to infertility. The direct cause of infertility in PCOS is ovulation and implantation disorders caused by low-grade inflammation of ovarian tissue and endometrium which, in turn, result from immune and metabolic system disorders. The systemic immune response, in particular the inflammatory response, in conjunction with metabolic disorders, insulin resistance (IR), hyperadrenalism, insufficient secretion of progesterone, and oxidative stress lead not only to cardiovascular diseases, cancer, autoimmunity, and lipid metabolism disorders but also to infertility. Depending on the genetic and environmental conditions as well as certain cultural factors, some diseases may occur immediately, while others may become apparent years after an infertility diagnosis. Each of them alone can be a significant factor contributing to the development of PCOS and infertility. Further research will allow clinical management protocols to be established for PCOS patients experiencing infertility so that a targeted therapy approach can be applied to the factor underlying and driving the "vicious circle" alongside symptomatic treatment and ovulation stimulation. Hence, therapy of fertility for PCOS should be conducted by interdisciplinary teams of specialists as an in-depth understanding of the molecular relationships and clinical implications between the immunological and metabolic factors that trigger reproductive system disorders is necessary to restore the physiology and homeostasis of the body and, thus, fertility, among PCOS patients.
ABSTRACT
The aim of present study was retrospective analysis of the frequencies of occurrence of the most common microorganisms isolated from blood cultures in the Medical University in Gdansk from 2000 to 2002. The blood patterns were taken from adult patients with symptoms suggesting bacteriemia. During the 3 year study period 31788 blood samples were obtained, of which 5520 (17.37%) were positive. The number of Gram-positive bacteria isolated from blood increased and the rate of Gram-negative bacteria decreased over the study period. In addition the increase of frequency of Candida, VRE and Escherichia coli was noted. The number of infections caused by MRSA and Gram-negative ESbetaL+ diminished during time of observation. Acquaintance on the most frequently isolated organisms from blood patterns and they antimicrobial susceptibility should guide the choice of empiric antimicrobial regimens for patients with bacteriemia.
