[Research-based assessment of antibiotic resistance of beta hemolytic group B streptococci]. / Ocena opornosci paciorkowców beta hemolizujacych grupy B na podstawie badan wlasnych.

UNLABELLED: Since the 1950s, beta hemolytic streptococcus group B have constituted the major etiological factor of perinatal infections. GBS colonization of the genital tract among pregnant women is diagnosed between 35 and 37 weeks of gestation, and is associated with approximately 25% risk of neonatal early-onset infections (EOD). The infection is severe among 1-3% of the newborns, and usually results in sepsis or pneumonia. beta-lactam antibiotics are drugs of choice to prevent vertical infection of group B streptococcus. In case of hypersensitivity to penicillin among pregnant women, second line drugs are macrolides and lincosamides. OBJECTIVE: In light of numerous reports on the decreasing susceptibility of GBS, the aim of this study was to characterize the isolated strains of Streptococcus agalactiae in terms of their resistance to antibiotics. MATERIAL: The study included 395 pregnant women in the third trimester of pregnancy hospitalized in the Department of Perinatology and Department of Gynecology and Obstetrics, Medical University of Lodz, between 02.2010 -02.2012. METHODS: Vagino-rectal swabs were collected from all pregnant women. We recovered 121 GBS positive isolates. Identification was based on the streptococcal agglutination test. Antimicrobial susceptibility was determined by disk diffusion method. RESULTS: A positive result for GBS colonization was found among 89 patients, representing 22.5% of the studied population. Inducible MLSB resistance to erythromycin and clindamycin was 23.1% and 10.7% of the isolated strains, respectively Constitutive MLSB resistance was detected in 14.9% of the cases. CONCLUSIONS: The obtained results confirm that all GBS isolates are sensitive to beta-lactam antibiotics and prove that phenotypes resistant to macrolides and clindamycin are becoming more widespread. This leads to the conclusion that regular supervision of drug sensitivity of Streptococcus agalactiae is necessary

Disrupted rapid eye movement sleep predicts poor declarative memory performance in post-traumatic stress disorder.

Successful memory consolidation during sleep depends on healthy slow-wave and rapid eye movement sleep, and on successful transition across sleep stages. In post-traumatic stress disorder, sleep is disrupted and memory is impaired, but relations between these two variables in the psychiatric condition remain unexplored. We examined whether disrupted sleep, and consequent disrupted memory consolidation, is a mechanism underlying declarative memory deficits in post-traumatic stress disorder. We recruited three matched groups of participants: post-traumatic stress disorder (n = 16); trauma-exposed non-post-traumatic stress disorder (n = 15); and healthy control (n = 14). They completed memory tasks before and after 8 h of sleep. We measured sleep variables using sleep-adapted electroencephalography. Post-traumatic stress disorder-diagnosed participants experienced significantly less sleep efficiency and rapid eye movement sleep percentage, and experienced more awakenings and wake percentage in the second half of the night than did participants in the other two groups. After sleep, post-traumatic stress disorder-diagnosed participants retained significantly less information on a declarative memory task than controls. Rapid eye movement percentage, wake percentage and sleep efficiency correlated with retention of information over the night. Furthermore, lower rapid eye movement percentage predicted poorer retention in post-traumatic stress disorder-diagnosed individuals. Our results suggest that declarative memory consolidation is disrupted during sleep in post-traumatic stress disorder. These data are consistent with theories suggesting that sleep benefits memory consolidation via predictable neurobiological mechanisms, and that rapid eye movement disruption is more than a symptom of post-traumatic stress disorder.

Hypothalamic amenorrhea in a Camurati-Engelmann disease--a case report.

OBJECTIVE: A case report of a patient diagnosed with Camurati-Engelmann Disease (CED) in association with the functional hypothalamic amenorrhea disturbances. CED is a very rare genetically determined disorder classified as a type of bone dysplasia. DESIGN: Case report. SETTING: Department of Gynecological Endocrinology, 3rd grade Medical University Hospital. PATIENT: Twenty-one years old female patient with CED admitted to the hospital because of primary amenorrhea. Her history revealed skeletal deformities and hearing impairment. METHODS: Clinical examination, ultrasound, laboratory evaluations (including serum gonadotropins (FSH, LH) at basal state and after stimulation with gonadotropin-releasing hormone, serum basal estradiol) radiological studies (X-ray of the head, the lumbar spine and lower extremities; a computed tomography of the head), G-banding karyotype, polymerase chain reaction and DNA sequencing. Hormonal serum evaluations were made using an enzyme-linked immunosorbent assay. The exon 4 of the transforming growth factor beta 1 gene was amplified by a polymerase chain reaction and the product was directly sequenced. RESULTS: The hormonal analysis was characteristic for the hypogonadotropic hypogonadism. Radiological and molecular analyses confirmed CED diagnosis. CONCLUSIONS: The hypothalamic amenorrhea in a patient with CED may be explained as a consequence of fat hypotrophy and very low body mass index. Therefore, impairment within hypothalamic-pituitary axis in patients with CED should be treated with special attention.

Semen quality in men from subfertile couples from the region of Lódz (Poland) according to the new reference values recommended by WHO 2010.

The semen analysis is the main diagnostic tool for evaluating the male fertility potential. The standard semen analysis includes evaluation of the sperm concentration, motility, and their morphology. The most important question is whether the results from semen analysis may be accurate markers for male fertility. Therefore, we retrospectively studied sperm quality among men attending the infertility clinic due to reproductive problems consistent with the WHO manual from 1999, which were reassessed according to the manual from 2010. Semen results from 571 males from couples undergoing fertility investigation were analyzed. All subjects included in the study had no abnormalities during examination. In 64 samples (11.2%), a leukocyte count above 1 x 10(6)/ml was found and their semen volume (median 3.2 ml) was significantly lower in comparison with the group without leukocytes (3.6 ml; p <0.001). Normal semen parameters were found in 290 subjects (50.8%) according to the 1999 manual and in 362 men (63.4%) according to the 2010 manual. The normozoospermia group, according to the 2010 manual, had a significantly lower percentage of sperm with progressive motility, motile sperm concentration, and total number of motile sperm in comparison with the normozoospermia group according to the manual from 1999. It seems that routine semen analysis is not sufficient to estimate male fertility potential and some men with normal semen parameters may be subfertile. Further investigations are needed.

[Evaluation of carbetocin (pabal) efficacy in the prevention of the postpartum hemorrhage in women after cesarean section--preliminary report]. / Ocena skutecznosci stosowania karbetocyny w profilaktyce krwawien poporodowych u kobiet po cieciu cesarskim--doniesienie wstepne.

OBJECTIVES: The aim of this study was to evaluate the efficacy of carbetocin in prevention of PPH in women after cesarean section. MATERIAL AND METHODS: We enrolled 60 patients who had undergone cesarean section in tertiary referential center, Department of Perinatology, Medical University of Lodz, Poland, between January and June 2008. Each patient obtained a single 100 microg dose of carbetocin intravenously during cesarean section, immediately after the delivery of the baby and prior to the delivery of the placenta. We evaluated postoperative blood parameters in 2 and 12 hours after the operation, the proportion of patients requiring additional uterotonic agents and adverse events in the whole population and in the group of women with high risk of PPH. RESULTS: 58.1% of patients underwent emergency and 41.3% elective cesarean section delivery. The risk factor of PPH was identified in 38 women (63.3%). The results of this study indicate that carbetocin produces rapid and long-lasting uterine tone. A small drop in mean hemoglobin and hematocrit levels 2 and 12 hours after the operation was observed. 15% of patients required the use of additional uterotonic agents. In the group of women with high risk of PPH, carbetocin appeared to be effective in 79% of the patients. Only 11.4% of patients had minor adverse events. CONCLUSIONS: Carbetocin appears to be an effective new drug in the prevention of postpartum hemorrhage, not only among women undergoing cesarean section but also in the group of women with PPH risk factors.

[Anesthesia for fetal therapy on the eve of 21st century--possibilities, hazards and perspectives]. / Znieczulenie w terapii plodu u progu XXI wieku--mozliwosci, zagrozenia i perspektywy.

Fetal therapy is a new branch of medicine, developing quickly now, that deals with diseases and congenital anomalies diagnosing and therapy in an unborn child--in utero. Nowadays, fetus has become a fully-privileged patient for medical and surgical therapies. The aim of the review is to present the possibilities of anesthesia for fetal therapy now at hand, to delineate general tendencies of further development and to highlight dangers and controversies. Fetal therapy is a fascinating and dynamically developing field of medicine which has practically gone beyond the limits of a medical experiment. Methods utilised are accepted, although still raise numerous controversies of medical and ethical nature. However, progress in perinatology, medical technique and pharmacology and in study on human genome raise optimism and allow to believe that in close future fetal therapy will be broadly accepted as a routine therapeutic method.

[Comparison between computerized cardiotocography analysis in triplet and singleton pregnancies]. / Porównanie wyników komputerowej analizy kardiotokogramów w ciazy trojaczej i pojedynczej.

OBJECTIVES: Triplet pregnancies have higher perinatal morbidity and mortality rates than singleton pregnancies. In modern perinatology computer cardiotocography is one of the best methods of fetus state assessment. DESIGN: The research was based on computer analysis of cardiotocograph printouts. MATERIALS AND METHODS: The studies were made on 39 pregnant women in 27-36 week of gestation. The women were hospitalized in the Clinic of Perinatology I Department of Gynecology and Obstetrics, Medical University of Lodz and divided into two groups. First consisted of 30 singleton, second of 9 triplet pregnancies. RESULTS: Computer analysis of cardiotocograph printouts was performed and compared between the triplet and singleton pregnancy groups and presented in forms of tables. CONCLUSIONS: In the studded group of triplet pregnancy statistically significant higher number of high episodes, accelerations, fetal movements and signal loss were observed. The Apgar score and arterial cord pH was not different between the both groups.

[Monitoring of labour and delivery in the presence of meconium stained amniotic fluid by pulse oximetry]. / Pulsoksymetryczne monitorowanie porodu w przypadku obecnosci smólki w plynie owodniowym.

OBJECTIVES: Evidence of meconium-stained amniotic fluid during labor suggests implementation of close monitoring of fetal well-being. DESIGN: Our purpose was to compare fetal oxygen saturation between cases with normal and meconium stained amniotic fluid. MATERIALS AND METHODS: Fetal oxygen saturation was continuously recorded with use of Nellcor N-400 fetal pulse oximeter in 30 control cases of term labour of normal, and 30 cases of meconium stained amniotic fluid. Distribution of fetal oxygen saturation values during 5 periods of labour was analyzed and compared between the examined groups, and presented in forms of Tables, together with neonatal umbilical artery pH values, Apgar score, birth weight and percentage of caesarian sections performed. RESULTS: No significant differences in fetal oxygen saturation, neonatal umbilical artery pH, birth weight and caesarian sections rate were observed between analyzed groups. Newborns 1-th minute Apgar score (mean value) and base excess was lower in meconium group compared to control group. CONCLUSIONS: Our data demonstrate, that fetal oxygen saturation trends to decrease during labour in fetuses in both groups.

[Socio-economic factors of 1991-2000 Kalisz pulmonary tuberculosis (ptb) incidences appraisal]. / Czynniki spoleczno-bytowe w ocenie zachorowan na gruzlici pluc w kaliszu w latach 1991-2000.

UNLABELLED: An appraisal of socio-economic factors that might have influenced the number of pulmonary tuberculosis (PTB) incidences in Kalisz, i.e. an average size town, was performed. MATERIAL AND METHODS: The study concerned overall 376 PTB cases (265 men and 111 women) reported in 1991-2000. RESULTS: Out of the patients subject to the study 50.8% were single. 26.9% produced elementary education degrees, 56.6% had graduated from vocational schools, 10.9% had attended secondary schools, and 5.6% had completed higher education. 25.5% were employed on terms of employment. 78.1% were labour with permanent income. 37.2% were pensioners. 10.4% were receiving state-subsidized living wages, 3.7% were obtaining social wages. 2.7% were supported by their parents. 20.5% claimed no permanent income. 12.0% were dwelling in one-room flats, 61.7% in two- or three-room ones, and 22.6% in four-room or even bigger apartments. 3.7% were homeless. 75.0% were cigarette smokers, and 21.0% were abusing alcohol. 2.7% did not own any housing, were smokers and were abusing alcohol. Cigarette smoking, other (apart from terms of employment) maintenance source and vocational education degree were typical of majority of the subjects (75.0 - 56.6%). CONCLUSIONS: The factors that had influenced the higher number of PTB cases among men than women were: simultaneous alcohol abuse, cigarette smoking (M : F 78,0) and homelessness among men only. One-room dwelling (M : F 8,0), other maintenance sources, i.e. the dole (M : F 5,5), no permanent income (M : F 5,4), social wages (M : F 3,4) and vocational education (M : F 4,0) could have proved equally influential.

[Smell and taste in drug addicts]. / Zachowanie sie wechu i smaku u osób uzaleznionych od narkotyków.

The main objective of this study was to establish the degree of influence of various illicit drugs, taken into the body in different ways, on the senses of smell and taste. Other possible factors, that might have caused disturbances in normal functioning of both senses, were outlined. The studied group consisted of 48 drug addicts, between the age of 16 and 48 years, addicted to various illicit drugs for several years. Olfactory testing included two methods. First quantitative method described by Elsberg and Levy, modified by Pruszewicz, was used to establish the smell detection threshold. Then the University of Pennsylvania Smell Identification Test was used as a method for odor identification. The sense of taste was tested with the use of method described by Krarup and modified by Pruszewicz. The results showed disturbances in olfactory performance (combined in both method) in 52.1% of all drug abusers, and 16.7% of them were diagnosed with ageusia when the sense of taste was tested. The route of administration of illicit drugs proved to be a statistically significant factor that might have caused disturbances of smell perception and identification in the study group. Drug abusers who were taking drugs intravenously and those who smoked and inhaled various drugs had the most significant olfactory problems. Both means for assessing smell function were statistically compared and the results showed that approximately 75% of drug users with olfactory disturbances had olfactory problems in both tests.

[Thermography in the early detection of breast cancer--our own experiences]. / Termografia we wczesnej diagnostyce raka piersi--wlasne doswiadczenia.

In combination with X-ray mammography and clinical examination thermography adds to the accuracy of breast cancer diagnosis. Thermographic examinations can be repeated at short intervals with no radiation hazard to the patient. However, performing and interpreting thermograms requires meticulous training. It was found that women with an abnormal thermogram are at a higher risk and have a poorer prognosis. A change in the thermal pattern is often the earliest sign of a cancer. The authors believe that the fault lies in misinterpretation of the thermogram, rather than the thermogram itself. Computer stimulations could be an adjunct tool to help the clinician in the interpretation.

[Cat scratch disease--diagnostic problems]. / Choroba kociego pazura--trudnosci diagnostyczne.

Etiology, epidemiology and clinical symptoms of Mollaret's disease, also known as Cat-scratch disease, were described. Four cases of treated patients were presented. One patient with a history of type I Diabetes mellitus presented clinical symptoms of Mollaret's disease, however, after investigation he was finally diagnosed with malignant lymphoma and was given chemotherapy. In other cases some symptoms were also doubtful, but the final diagnoses were made upon positive results of serological reactions and all patients recovered completely after a few week antibiotic treatment. All patients had frequent contacts with cats. A significant divergence between the results of histopathological, serological and ultrasonographic findings lead to a conclusion that a certain diagnosis of Cat-scratch disease can only be made with the use of positive results of serological reactions.

[Current data about fungi prevalence in various ontocenoses in women during procreation period]. / Aktualne dane o prewalencji grzybów w róznych ontocenozach u kobiet w okresie prokreacji.

The aim of study was to analyse fungi prevalence in three ontocenoses (vagina, oral cavity and anus) in women during procreation period, which should be helpful in developing prophylactic programmes for pregnant womem, newborns and infants infected with fungi. In 716 examined women (age 20-45 years), 1411 samples of appropriate biological materials were taken and inoculated in the fluid Sabouraud medium and then axenic fungi strains were isolated in Sabouraud agar. High fungi prevalence in three ontocenoses of examined women was noted. Mean percentage for ontocenosis was: 39% +/- 1.8% for vagina, 42.18% +/- 1.8% for oral cavity and 25.03 +/- 1.6% for anus. These data indicate the necessity for further examinations of multifocal fungal infection in women during procreation period.