Clinical use of redox biomarkers for diagnosis of male infertility.

The aim of the study was to analyze the activity of antioxidant enzymes (glutathione reductase, catalase, superoxide dismutase) and malondialdehyde (MDA) levels in a population of men with abnormal semen parameters and in a population of men diagnosed with normozoospermia. This study was performed using data collected at the Infertility Treatment Clinic 'Genesis' , Bydgoszcz, Poland, between 1 January 2011 and 31 December 2017. A total number of 321 men meeting the inclusion criteria were selected and divided into the control group (162 men) and the infertility group (159 men). The activities of superoxide dismutase (SOD), catalase (CAT), and glutathione reductase (GR) were measured using ready-made kits; lipid peroxidation intensity was determined by the thiobarbituric acid method. No statistically significant differences were found for the activity of SOD, GR, CAT between the groups. MDA values measured in the serum of patients in the healthy group were higher than in the group with semenological disorders. Although our study did not demonstrate the usefulness of the above blood tests, further studies are needed to explore the potential use of assessing redox parameters to develop new diagnostic and therapeutic approaches for male infertility.

Relationships between CD34-, CD105- and bcl-2-Expression Levels and Contrast-Enhanced Ultrasound-Based Differential Diagnosis of Adnexal Tumours.

The relationships between CEUS parameters of adnexal tumours and postoperative immunohistochemical assessments of CD34, CD105 and bcl-2 were analysed. This study aimed to investigate whether contrast-enhanced ultrasonography (CEUS) parameters depend on the microvascular density of the tumour lesion found after surgery. Fifty-one patients with a diagnosis of adnexal tumours were included in this single-centre, prospective study. Participants underwent preoperative CEUS (contrast-enhanced ultrasound). Colour Doppler enhancement characterisation parameters (Ystart, Ymax and S) were determined. Immunohistochemical examination of histological specimens of the adnexal lesions was then carried out to determine the expression levels of the CD34, CD105 and bcl-2 proteins. Relationships between the aforementioned parameters were investigated. No significant statistical correlations were observed between CD34, CD105 and bcl2 expression levels and CEUS parameters, independently of whether the operated lesion was malignant or benign. Transvaginal CEUS is diagnostic for the detection of pathological neoplastic vascularisation of an adnexal lesion independent of the density of microcapillaries found postoperatively.

Comparison of 3- and 6-Month Outcomes of Combined Oral L-Carnitine Fumarate and Acetyl-L-Carnitine Therapy, Included in an Antioxidant Formulation, in Patients with Idiopathic Infertility.

The male factor is responsible for infertility in about 35-40% of all cases. Idiopathic oligo- and/or astheno- and/or therato-zoospermia is one of the most common male fertility disorders and remains a significant therapeutic challenge. The primary cause of idiopathic male infertility remains unknown but seems to be associated with oxidative stress. Objective: The use of antioxidative formulation to improve qualitative and quantitative deficiencies in the male gametes.In total, 78 subjects were treated with a combination of 1,725 mg L-carnitine fumarate, 500 mg acetyl-L-carnitine, 90 mg vitamin C, 20 mg coenzyme Q10, 10 mg zinc, 200 µg folic acid, 50 µg selenium, and 1.5 µg vitamin B12 (Proxeed® Plus, Sigma-Tau, Italy) for 6 months; the preparation was taken twice daily from the time idiopathic infertility was diagnosed. Basic seminal parameters were evaluated by a European Society of Human Reproduction and Embryology (ESHRE) -certified embryologist following the fifth edition of the World Health Organisation (2010) guidelines at three time points: at baseline and 3 and 6 months of treatment.Improvements in semen parameters (differing in terms of dynamics) were evident at 3 months and gradually improved over the 6 months of treatment. Each parameter: sperm concentration, total sperm count, sperm total and progressive motility improved significantly after treatment except for the percentage of sperm of abnormal morphology and ejaculate volume.Proxeed Plus was effective for patients with idiopathic infertility; however, a long treatment period is needed to achieve optimal results.

Lifelong immunoglobulin replacement is not always necessary: A case description of a patient with recurrent infections and hypogammaglobulinemia.

Humoral immunodeficiency with accompanying infections is an indication for human immunoglobulin replacement therapy. Whether treatment will be lifelong or necessary only temporarily depends on the nature of deficiency: primary (persistent) or secondary (persistent or transient). It is not always easy to distinguish between primary and secondary immunodeficiency, especially in adults. The article presents a case of a 39-year-old patient with anamnesis and medical tests results that suggested primary humoral immunodeficiency. The deficiency was diagnosed for the first time at the age of 38, when the patient was pregnant. The patient was qualified for immunoglobulin G replacement therapy. Clinical improvement was achieved. After the end of pregnancy, systematic improvement in immunological parameters was observed, suggesting the resolution of immunodeficiency. A decision was made to discontinue immunoglobulin replacement. Due to the ability to respond to vaccine, confirmed during diagnosis, preventive vaccines were recommended. There was no recurrence of serious infections. The clinical course finally enabled a diagnosis of secondary immunodeficiency. The presented case shows the importance of an active approach to the diagnostic and therapeutic process, constant assessment of clinical course, monitoring of IgG concentrations, and the awareness that in the situation when we do not have a genetic confirmation of the disease, the diagnosis may change.

[Evaluation of the efficacy and safety of Foley catheter pre-induction of labor]. / Ocena skutecznosci i bezpieczenstwa preindukcji porodu cewnikiem Foley'a.

INTRODUCTION: Labor induction is being increasingly used (15-30% of pregnancies). The most common indications include late pregnancy preeclampsia, intrauterine fetal growth retardation (IUGR), hypertension. Preinduction by speeding up the ripening of the cervix increases the chances of successful induction. There are mechanical and pharmacological methods of pre-induction: the Foley catheter hygroscopic dilators, prostaglandin gel, misoprostol. There are various schemes of labor pre-induction and the differences relate primarily to duration of catheter time, amniotomy or the start of the oxytocin. Numerous studies on pre-induction and induction of labor aimed to compare the efficacy of these different methods. The effectiveness of the Foley catheter is usually assessed by comparing cervical maturity (Bishop score) and ripening of the cervix, evaluated in centimeters, before and after removing the cathetec time to labor since pre-induction and the number of births. In order to select the appropriate method, its safety for the mother and the fetus/newborn needs to be assessed. According to most authors, the use of a Foley catheter does not cause over-stimulation of the uterus, does not increase the risk of rupture or intrauterine infection, and does not adversely affect the fetus and newborn. AIM OF THE STUDY: To assess the efficacy and safety of labor pre-induction using a Foley catheter MATERIAL AND METHODS: The study included 109 women hospitalized between 03.01.2011 and 11.30.2011, who underwent labor pre-induction with a Foley catheter The inclusion criteria were: one fetal pregnancy longitudinal cephalic fetal position, completed 36 weeks of pregnancy fetal bladder preserved, Bishop score < 5 points. The exclusion criteria were: placenta previa, uterine infection, unexplained bleeding, abnormal fetal heart rate, and other reasons preventing vaginal delivery such as fetal weight above 4500 g. Vaginal swabs for the presence of Streptococcus agalactiae (GBS) were obtained from each patient. In case of a positive result perinatal antibiotic prophylaxis was administered before insertion of the catheter The study group was divided into two subgroups according to parity: primiparous and multiparous. Indications for induction, method of pregnancy termination, the pregnancy and its complications were evaluated. The condition of the newborns was evaluated using the Apgar score, cord blood pH and infant birth weight. We analyzed cervical ripeness (Bishop score) before the insertion and after the removal of the catheter and serum C-reactive protein (CRP) before and 20 hours after insertion. CRP was not studied in pregnant women diagnosed with GBS colonization. The results were compared between the subgroups. An increase in the Bishop score to> 5 and delivery within 12 hours since the planned removal of the catheter regardless of the method of pregnancy and the use of oxytocin, was considered as successful induction of labor RESULTS: Catheter pre-induction was performed in 109 pregnant women, what amounted to 7.87% all of deliveries in our department during the analyzed period. Mean patient age was 29.3 +/- 5.35 years, mean duration of pregnancy 40 weeks of gestation (+/- 1 week 5 days), and primiparas constituted 66.06% of all cases. The most common indication for labor induction was post-term pregnancy (55.05%), hypertension and preeclampsia (16.51%). The following complications were observed in the study group after insertion of the catheter: 8 (7.34%) cases of premature rupture of the membranes (PROM), but none of them occurred in the process of inserting the catheter 11 (10.09%) women had the catheter removed (patients request) due to pain and the feeling of discomfort before the scheduled time, 2 (1.84%) cases of bleeding (in the first case the cesarean section was performed and the baby was born in a good overall condition, in the second case the bleeding subsided spontaneously). There was a statistically significant increase in the Bishop score for the entire study group and in the two subgroups. Mean increase in the Bishop score was 2.68 +/- 1.39 points for the entire cohort (p < 0.005). The rate of successful pre-induction resulting in a delivery was 69.4%, with vaginal births accounting for 66.67% of all cases. Also, 30.66% of the pregnant women did not require the use of oxytocin. The most common indication for cesarean section was threatening intrauterine fetal asphyxia. Higher efficiency of pre-induction was found in the multiparous group. The observed increase in CRP (p < 0.005) was within the normal range for pregnant women (< 12 mg/I). None of the patients showed any clinical signs of infection. Mean birth weight of the infants was 3392 +/- 644.72 g, mean Apgar score was 9.5 +/- 0.80 and mean cord blood pH was 7.3 +/- 0.08. CONCLUSIONS: The Foley catheter is an effective method of inducing cervical maturation. The Foley catheter is safe method of labor induction for the mother fetus and newborn.

[The phenomenon of alcoholism in Poland as a legal issue]. / Zjawisko alkoholizmu w Polsce jako zagadnienie prawne.

Alcoholism is a problem of a social value. About 140 million people worldwide suffer from alcoholism. Research has demonstrated adverse effects of alcohol. In the scientific project were confirmed: increased risk of cancer, liver disease, abnormal course of pregnancy and development of fetus. Among alcoholics are frequent phenomena of criminal behavior, accidents and trauma. The Polish Constitution granted the right to health citizens. The consequence of the above mentioned constitutional guarantee is the duty of the state that consists in caring for the functioning of a society free from addictions and alcohol problems. The basic legal act in this field is the Act on Upbringing in Sobriety and Counteracting Alcoholism. The state policy in the fight against alcoholism is implemented at various levels of both government and local government. The established National Agency for Solving Alcohol Problems drafts a National Programme for Prevention and Solving Alcohol Problems every year. Also important are public awareness campaigns conducted to raise awareness about the negative effects of alcohol.

[Prevalence of tobacco smoking among medical staff at Department of Obstetrics and Gynecology Collegium Medicum in Bydgoszcz]. / Rozpowszechnienie palenia tytoniu wsród pracowników Kliniki Poloznictwa i Chorób Kobiecych Collegium Medicum w Bydgoszczy.

Smoking increases the risk of cancer, cardiovascular and respiratory diseases. It has been proven, that cigarette smoking has adverse effects on pregnancy and children health. The particularly important role in efforts to reduce cigarette smoking accounts for representatives of health care. The aim of this study was to analyze the prevalence of smoking among employees of the Clinic. An anonymous questionnaire about smoking cigarettes was prepared. This study involved 135 people. Smokers accounted for 29% of respondents. The highest percentage of smokers was among the lower staff--42%, the lowest among physicians--15%. Nurses and midwives represented the highest average of cigarettes smoked per day--15, in contrast to physicians--11.70% questionned smoked a cigarette in stressful situations. Ban on smoking in the hospital wasn't respected by 31% of smokers. Among non-smokers 62% do not tolerate smoking in their environment. The prevalence of smoking among health staff is still a common phenomenon. It is important to implement educational programs for the staff of healthcare facilities in order to raise the awareness on smoking hazards. It is necessary to effectively enforce the ban on smoking in hospitals by both the hospital mastership and nonsmoking staff and patients.