Seronegative hepatitis C virus infection in Polish blood donors-Virological characteristics of index donations and follow-up observations.

Nucleic acid testing (NAT) was implemented in Poland in 1999 for screening of plasma for fractionation and for all blood donors in 2002. To analyze seronegative NAT-positive samples representing hepatitis C virus (HCV) window-period (WP) in the years 2000 to 2016 and to determine infection outcome. We analyzed results of 17 502 739 donations screened in minipools (6-48) or individually. Index samples underwent viral load (VL) quantification, genotyping and Ag, and anti-HCV re-testing using chemiluminescence (CMIA), electrochemiluminescence (ECLIA), and fourth-generation enzyme-linked immunosorbent assay (IV EIA) assays. HCV-seronegative infections were identified in 126 donations (7.2/mln donations; 95% confidential intervals, 6.0-8.6). Frequency of NAT yields was decreasing over time. Of the initial 126 seronegative index cases 106 were retested: 32.1% were reactive in IV EIA, 11.3% in ECLIA, and 1.9% in CMIA. The lowest VL correlated with absent anti-HCV and HCV Ag, while VL was highest when the antigen was detectable and then it decreased when anti-HCV appeared at a level detectable by sensitive third generation tests while retesting. The proportion of genotype 1 was 38.9% in samples positive only for HCV RNA and 71.4% in samples that were anti-HCV reactive in re-testing. In parallel, genotype 3 frequency was 50% in the former group and 21% in the latter. NAT is an effective measure to limit HCV transmission by transfusion and IV EIA seems to have higher clinical sensitivity than ECLIA. Samples representing likely successive phases of early HCV infection were characterized by different genotype distribution probably due to very early elimination of genotype 3.

Influence of the surface electrostimulation controlled by muscle contraction on the bioelectric muscle activity and restoration of the hand function in cerebral stroke patients.

BACKGROUND: Impaired limb mobility is the most troublesome condition in patients after cerebral stroke. The application of the electrode-glove might reduce dysfunctions in patients treated due to stroke. OBJECTIVE: The electrode-glove use in rehabilitation is investigated. The study was conducted on 54 patients aged 28 - 72 (the mean age 54.3 ± 10.3) with hemiparesis who had suffered from cerebral stroke. The patients from Group 1 were applied bipolar stimulation of forearm muscles (flexors and extensors of the wrist joint and hand) with the use of two flat electrodes of the same size. With regards to Group 2, in the study used an electrode-glove. METHODS: The excitation threshold was determined once a week with the use of the EMG. SECONDARY OUTCOMES: The evaluation of the electromyographic bioelectric activity of flexor and extensor muscles in the forearm, of the functional mobility of the hand according to the Brunnström test and of the functional mobility of the hand according to the seven-graded task Frenchay scale. RESULTS: The authors of the study observed a much greater improvement in the function of the hand in Group 2, where the mean value increased by 2.1 points. With regards to Group 1, the mean value increased by 1 point and the differences of the results in the studied groups after the therapy were statistically significant (p = 2.830). CONCLUSIONS: The electrical stimulation method controlled/triggered by muscle contractions is an effective method of normalization of muscle tension in the forearm and hand as well as restoration of the hand function in patients with cerebral stroke.

Emergency contraception in a country with restricted access to contraceptives and termination of pregnancy, a prospective follow-up study.

OBJECTIVE: Poland has a restrictive abortion law. Emergency contraception (EC) is expensive and available only on prescription, which is not easily obtainable in public health care. We aimed to identify the main reasons for EC requests, observed failure rates and the type and incidence of adverse effects. DESIGN: Prospective single-center observational study. POPULATION: A cohort of women living in Warsaw, who requested EC. METHODS: Data were collected via a questionnaire completed by healthcare providers prescribing EC, and included age, date of the request, previous EC use, time from intercourse to clinic visit and day of menstrual cycle on which intercourse took place. MAIN OUTCOME MEASURES: Reason for EC request, time lapse between unprotected intercourse and EC use, age of women requesting EC, reported cases of pregnancy. RESULTS: A total of 4655 women requested EC. Of these 62.9% (n = 2928) were ≤25 years old. During follow up, 0.75% (31 individuals) became pregnant. Adverse effects of hormonal EC were rare and mild. The main reason for requesting EC was problems associated with condoms (63.2%, n = 2609). The mean interval between unprotected intercourse and EC use was 21.2 h, but 26.7 h when EC failed (n.s.). Considering intake within and after 24 h, the difference was significant (p < 0.05). CONCLUSIONS: Women living in Warsaw seeking EC used the EC product very soon after unprotected intercourse, and this was probably one of the most important reasons for the low pregnancy rates in the studied population.

[The effect of tobacco smoking during pregnancy on concentration of pro-hepcidin and some parameters of iron metabolism in matched-maternal cord pairs]. / Wplyw palenia tytoniu przez kobiety ciezarne na stezenia pro-hepcydyny i wybrane parametry metabolizmu zelaza we krwi matki i we krwi pepowinowej noworodka.

Iron deficiency relatively observed in pregnant women is assumed to be enhanced by cigarette smoking. Hepcidin, a peptide hormone produced by the liver as pro-hepcidin, has recently emerged as a central mediator of iron metabolism. Hepcidin regulates intestinal iron absorption, macrophage iron release, and the placental passage of iron. Maternal smoking is associated with increased fetal iron requirements and stimulates fetal erythropoiesis. This is probably through a hypoxic effect on the fetus, and is dose related to the maternal smoking level. It is known that anemia and hypoxia suppress hepcidine mRNA expression. Therefore the aim of the study was to estimate the effect of tobacco smoking on serum pro-hepcidin levels and some iron parameters in pregnant women and umbilical cord blood. We also studied correlation between pro-hepcidin and others iron markers in mothers and their newborns. Healthy, pregnant women (n = 50), patients of Clinical Department of Obstetrics and Gynecology, Institute of Mother and Child were divided into groups nonsmoking and smoking according to questionnaire declaration. Serum concentrations of pro-hepcidin were determined by immunoenzymathic method using a commercial pro-hepcidin assay (DRG, Germany). Levels of ferritin and transferrin were measured by immunoturbidimetric method and iron by photometric test with ferrozine using HORIBA ABX kits (France) and Cobas Mira analyser (Roche, Switzerland). Levels of hemoglobin and hematocrite were determined using commercially available kits on Pentra 60 analyser (ABX, France). We observed that the mean concentration of pro-hepcidin in serum of smoking pregnant women was statistically lower than in tobacco abstinent (101.9 +/- 28.6 ng/ml vs 88.3 +/- 18.2 ng/ml; p < 0.01). Levels of others studied iron markers were similar in both group except total iron concentration, which was 20% lower in smoking mothers than in nonsmoking ones. In umbilical cord blood of infants born to smoking women level of pro-hepcidin was significantly lower than in tobacco abstinent (54.2 +/- 14.0 ng/ml vs 76.8 +/- 21.4 ng/ml, p < 0.0001). We observed positive correlation between concentrations of that prohormone in serum of mothers and cord blood of their newborns in nonsmoking group (r = 0.54; p < 0.02) as well as in smoking ones (r = 0.68; p < 0.05). In addition, concentrations of ferritin, transferin and total iron were lower by 30%, 13% and 20% respectively in cord blood of smoking than nonsmoking group. The differences were statistically significant (p < 0.05). Our analysis revealed no correlation between serum pro-hepcidin levels and other studied parameters of iron status both in the mothers and children groups. Our results indicate that tobacco smoking during pregnancy affected pro-hepcidine levels in serum of mothers and their newborns. Low concentrations of some iron markers in umbilical cord blood suggest that mother's smoking could lead to subclinical iron deficiency in fetus. No anemia were observed in both studied groups of mothers that could explain no relationships between pro-hepcidin and others parameters of iron status.

[Concentrations of pro-hepcidin in serum of pregnant women and in umbilical cord blood]. / Stzenia pro-hepcydyny w surowicy kobiet ciezarnych oraz krwi pepowinowej.

OBJECTIVES: The aim of the study was to detect the presence of pro-hepcidin in the serum of pregnant women and in umbilical cord blood. Additionally, correlations between pro-hepcidin and other iron parameters were analyzed. MATERIAL AND METHODS: Our study consisted of 32 healthy, pregnant women, patients of Clinical Department of Obstetrics and Gynaecology, Institute of Mother and Child (IMC). Serum concentrations of pro-hepcidin were determined with the use of immunoenzymathic method, levels of ferritin and transferrin with immunoturbidimetric method and iron with photometric test. Hemoglobin and hematocrite were determined on hematological analyzer Pentra 60. The study was conducted at the Department of Biochemistry IMC. RESULTS: The mean concentration of pro-hepcidin in the serum of pregnant women was 102.0+/-30.7 ng/ml and ranged from 51.5 to 187.1 ng/ml. Level of pro-hepcidin in the serum of the umbilical cord blood was 77.05+/-21.2 ng/ml (range: 41.9-125.9 ng/ml), which amounted up to about 75% of that found in mothers, thus making the differences were statistically significant (p<0.01). We observed a positive correlation between concentrations of that prohormone in the serum of mothers and cord blood (r=0.60; p<0.01). Our analysis revealed no correlations between the serum pro-hepcidin levels and other studied parameters of iron status, both in the mothers and children groups. CONCLUSIONS: Our results indicate that concentrations of pro-hepcidin are detectable in the serum of mothers, as well as in the umbilical cord blood, and positively correlate with each other. No anemia or subclinical iron deficiency that could explain no correlation with others parameters of iron status was observed.

[The effectiveness and acceptability of oral contraceptives (Logest), containing 20 micrograms ethinylestradiol and 75 micrograms gestodene]. / Badanie skutecznosci i akceptacji stosowania pigulek antykoncepcyjnych Logest, zawierajacych 20 g etynyloestradiolu i 75 g gestodenu.

OBJECTIVES: The aim of the study was to evaluate the efficacy and acceptability of the use of oral contraceptives Logest, containing 20 micrograms ethinylestradiol and 75 micrograms gestodene (in one tablet). DESIGN: Observational study (during the period of six months) on the healthy women visiting gynecological clinics and asking for establishment of contraception with the use of oral contraceptives. MATERIALS AND METHODS: The observation was carried out on 800 patients who were included (with use including/excluding criteria) to the study. The study was carried out during the period of October 1999-March 2001. Patients were asked to use the Logest intermittently during the period of 6 months (21 days of administration followed by 7 days break, and than again 21 days of administration etc). The administration of Logest was followed up. Basic examination and qualification for the use of oral contraceptive was taken during the first visit. Re-examinations were taken after 3 and 6 month of usage of the study drug. RESULTS: High efficacy, good tolerance and acceptability of Logest administration was observed. Neither cases of non effectiveness, nor serious adverse events, during the Logest administration were reported. CONCLUSIONS: 95.7% of the patients which completed the study, declared that the oral contraception with use of Logest was "very well accepted" or "well accepted".