Novel biomarkers of overactive bladder syndrome.

The social aspect of overactive bladder syndrome (OAB) and the lack of objective diagnostic methods for this syndrome have spurred research into its potential biomarkers which can constitute useful diagnostic tools, while also allowing the evaluation of the intensity of clinical symptoms and the efficacy of implemented pharmacotherapy in OAB patients. Due to the complex etiopathogenesis of this syndrome, the researchers are seeking biomarkers connected with inflammation or nerve growth. The aim of this review was to analyse the latest literature data regarding potential biomarkers in OAB. The most promising opportunities are connected with the diagnostic use of the nerve growth factor (NGF), the brain derived neurotrophic factor (BDNF), C-reactive protein (CRP), prostaglandins and cytokines. Despite the most promising results to date having been obtained with regards to neurotrophic factors, it seems that, at the moment, none of these meets the criteria for becoming an isolated OAB marker. It is also suggested that the combined use of several biomarkers will facilitate obtaining the appropriate level of specificity and selectivity to allow their use in clinical practice.

When and how should we treat cesarean scar defect - isthmocoele?

The reported number of cesarean sections in Poland is approximately 30% and is associated with increasing number of early and late complications. The myometrial discontinuity at the site of previous cesarean section is known in the literature as "isthmocoele", "niche", "pouch" or cesarean scar defect. In most cases presence of isthmocoele has no clinical significance, but in some patients it may cause abnormal uterine bleeding, dysmenorrhea, dyspareunia, pelvic pain or be associated with secondary infertility. This defect may be treated by laparoscopy, hysteroscopy or vaginal surgery.

Association between functional variant of inflammatory system gene (PSMA6) and end-stage kidney disease.

BACKGROUND: The proteasome system is involved in several disorders. The 5' untranslated region of PSMA6 gene contains a single nucleotide polymorphism (SNP) -8 C/G, associated with diabetes, myocardial infarction and coronary artery disease. METHODS: We examined 584 patients with end-stage kidney disease (ESKD) and 430 controls. All were genotyped for -8 C/G SNP by polymerase chain reaction and restriction analysis. RESULTS: We observed lower frequency of CG + GG genotypes in patients than in controls (20 vs. 42 %, p = 0.0038). The odds ratio of 0.34 (95 % CI 0.26-0.45) suggests association of CG + GG with decreased risk of ESKD. We investigated the association between PSMA6 polymorphism and LVH present in 54 % of patients. There was a significant association of CG + GG genotype with LVH, with over 75 % of CG + GG in patients with LVH. This effect was independent from other common causes of LVH-age (OR 1.12, p = 0.643) and hypertension (OR 1.72, p = 0.422). CONCLUSION: We demonstrated for the first time that PSMA6 polymorphism might be a protective factor for ESKD. On the other hand, CG + GG genotypes are independently related to LVH in ESKD patients.

Power morcellation for women undergoing laparoscopic supracervical hysterectomy - safety of procedure and clinical experience from 426 cases.

OBJECTIVES: Minimally invasive gynaecological surgeries are performed for several malignant and nonmalignant indications. The aim of our study was to evaluate the rate of unexpected malignancies among women who underwent laparoscopical supracervical hysterectomy (LASH) with power morcellation. MATERIAL AND METHODS: The retrospective analysis included clinical data of 426 consecutive female patients who underwent LASH with power morcellation due to presumed benign disorders (78.4% - symptomatic uterine fibromas, 12.7% - abnormal uterine bleeding, 8.9% - suspicion of uterine adenomyosis) between January 2011 and December 2015. Pre-malignant or malignant preoperative abnormalities in the cervix and the uterine corpus were contraindications for LASH. RESULTS: The unexpected malignancies were found in four patients from study group: one ovarian cancer located on the inner part of simple ovarian cyst and 3 endometrial carcinomas (0.9%) were documented. All these patients underwent abdominal reoperations and no histological abnormalities were detected in the extirpated cervix and adnexa. CONCLUSIONS: The incidence of unintended endometrial carcinoma in morcellated uterus after LASH was relatively small. However, careful pre-operative counseling should be undertaken in order to exclude the possibility of any malignant disease in uteri among women scheduled to power morcellation.

Coexistence of pemphigus foliaceus and acquired hemophilia A: A case report.

Pemphigus foliaceus (PF) is an autoimmune bullous dermatosis with anti-desmoglein-1 autoantibodies. Acquired hemophilia A (AHA) is a rare coagulation disorder with a high mortality rate, caused by anti-factor VIII immunoglobulin G antibodies leading to spontaneous severe hemorrhages into skin, muscles or soft tissues. This coagulopathy may be associated with malignancies, drug reactions and autoimmune disorders including bullous dermatoses. Herein, we demonstrate a first report of AHA in the course of pemphigus foliaceus. A 55-year-old woman presenting with extensive, erosive, crusted, scaly skin lesions was diagnosed with PF based on histopathological and immunofluorescent examination, confirmed by the presence of anti-desmoglein-1 antibodies on enzyme-linked immunoassay. She developed extensive internal hemorrhages and prolonged external bleeding after laparotomy. Based on coagulation tests, AHA was diagnosed. Simultaneous remission of pemphigus and coagulopathy occurred with immunosuppressants and recombinant activated factor VII.

[Ovarian cancer during pregnancy--presentation of three cases and current diagnostic and treatment algorithms]. / Rak jajnika w ciazy--opisy trzech przypadków oraz aktualne algorytmy postepowania diagnostyczno-terapeutycznego.

INTRODUCTION: Malignant tumors are rarely diagnosed during pregnancy and their incidence ranges from 2.4% to 5.7%. Ovarian cancer is ranked fifth among all cancer types and second among all genital cancers diagnosed during pregnancy The course of the disease is asymptomatic in most cases and the initial diagnose is typically made during a routine ultrasound examination. Management of ovarian cancer during pregnancy presents a considerable challenge due to the absence of clear standards of treatment. OBJECTIVES: We present three clinical cases of patients suffering from ovarian cancer diagnosed during pregnancy a review of the literature, as well as possible therapeutic options. RESULTS: Three different clinical scenarios in patients with ovarian cancer diagnosed during pregnancy have been presented. In addition, we reviewed current diagnostic and therapeutic algorithms for patients with ovarian cancer and co-existing pregnancy. CONCLUSIONS: Approximately 5% of ovarian tumors diagnosed in pregnancy are malignant. There are no treatment standards for ovarian cancer diagnosed during pregnancy. Surgical treatment and the subsequent chemotherapy in the 2nd trimester of pregnancy appear to be safe for both, the mother and the child. However, the potential risks and benefits associated with the treatment have to be thoroughly analyzed on a case-by-case basis, to establish optimal diagnostic and treatment algorithms.