Static Magnetic Field Reduces the Anticancer Effect of Hinokitiol on Melanoma Malignant Cells-Gene Expression and Redox Homeostasis Studies.

BACKGROUND: Melanoma malignant is characterized by a high mortality rate, accounting for as much as 65% of deaths caused by skin cancer. A potential strategy in cancer treatment may be the use of natural compounds, which include hinokitiol (ß-Thujaplicin), a phenolic component of essential oils extracted from cypress trees. Many studies confirm that a high-induction SMF (static magnetic field) has anticancer effects and can be used as a non-invasive anticancer therapy in combination with or without drugs. AIM: The aim of this experiment was to evaluate the effect of a static magnetic field on melanoma cell cultures (C32 and COLO 829) treated with hinokitiol. METHODS AND RESULTS: Melanoma cells were exposed to a static magnetic field of moderate induction and hinokitiol. The research included determining the activity of the antioxidant enzymes (SOD, GPx, and CAT) and MDA concentration as well as the gene expression profile. CONCLUSION: Hinokitiol disturbs the redox homeostasis of C32 and COLO 829 melanoma malignant cells. Moreover, a static magnetic field has a protective effect on melanoma malignant cells and abolishes the anticancer effect of hinokitiol.

Can pelvic floor muscle function before surgery determine the outcome of surgical treatment of stress urinary incontinence in women?

AIM: The study aimed to determine whether pelvic floor muscle (PFM) function before surgery may correlate with the success of surgical interventions for treating stress urinary incontinence (SUI). Our hypothesis was that addressing identified variables in preoperative rehabilitation could potentially improve surgical outcomes. METHODS: This prospective observational study was conducted at a single center and enrolled women qualified to mid-urethral tape insertion for SUI between 2020 and 2022. Digital palpation and manometry (Peritron™ 9300 V) were used to evaluate PFM function. The following parameters were acquired: vaginal resting pressure, vaginal pressure during maximal voluntary contraction (MVC), the area under the curve during a 10-second MVC, moreover the ability to perform correct PFM contraction, reflexive PFM contraction during cough and relaxation were assessed. All measurements were performed before the surgical treatment and during follow-up assessments at 1, 3, and 6 months postoperatively. The primary endpoint of the study was defined as objective cure, characterized by a negative cough stress test (CST), along with a subjective assessment based on the Urogenital Distress Inventory-6 (UDI-6) and Incontinence Impact Questionnaire-7 (IIQ-7). RESULTS: The study involved 57 eligible female participants, all of whom completed the 6-month follow-up. Objective cure was observed in 75.44% of cases, while subjective cure was reported in 33%. There was no association between PFM parameters and surgical outcomes. CONCLUSION: The success of surgical treatment of SUI 6 months postsurgery is not related to preoperative pelvic floor muscle function.

Impact of preoperative pelvic floor muscle function on the success of surgical treatment of pelvic organ prolapse.

INTRODUCTION AND HYPOTHESIS: The objective of this study was to identify the potential characteristics of pelvic floor muscles (PFM) in the preoperative assessment that could be associated with post-surgical prolapse severity. We hypothesized that the same variables, if identified, could be addressed in preoperative rehabilitation to improve surgical results. METHODS: This was a single-center prospective observational study that included women who underwent surgical pelvic organ prolapse repair between 2020-2022. Genital prolapse was evaluated according to the Pelvic Organ Prolapse Quantification (POP-Q) system. All the participants underwent a PFM assessment, including a vaginal digital assessment and manometry (Peritron™ 9300 V) before surgery and at 1-, 3-, and 6-month follow-ups. Several PFM variables were recorded: vaginal resting pressure, vaginal pressure during maximal voluntary contraction (MVC), area under the curve during a 10-second MVC, ability to correctly contract the PFMs, and reflexive activation during cough and relaxation. The primary endpoint of the analysis was objective surgical success defined as POP-Q 0 or 1 at the 6-month follow-up. Additionally, a change in pelvic floor muscle function was recorded during postoperative visits. RESULTS: A total of 106 females were included in the study. Fifty-one were lost during the 6-month follow-up, which is a major limitation of the study. None of the examined parameters evaluating PFM were associated with surgical success. No statistically significant difference was found in MVC and PFM endurance before and after surgery. Post-surgery, a significant change was observed in the vaginal resting pressure and the ability to correct PFM activation and relaxation. CONCLUSIONS: Preoperative PFM function is not associated with surgical success 6 months after surgery.

The influence of adalimumab treatment on the systemic gene expression in patients with psoriatic arthritis - preliminary report.

Introduction: The primary goal of psoriasis treatment is to reduce the inflammatory response and associated complications. In severe cases of psoriasis that are resistant to local treatment (e.g., keratolytic preparations) and at least two types of general treatment methods (e.g., retinoids and cyclosporine A), biological therapy is used. This study aimed to assess the systemic effects of adalimumab at a given stage of treatment in patients with psoriatic arthritis and evaluate how the drug can improve the clinical condition of the patients. Material and methods: The study group consisted of patients with diagnosed psoriatic arthritis, while the control group consisted of individuals from whom peripheral blood mononuclear cells were obtained. The effects of the administration of adalimumab were assessed by analyzing the gene expression using oligonucleotide microarrays. Result: The apoptosis process was found to be one of the overrepresented categories (the PANTHER classification system 13.1 program, overrepresentation test, p < 0.05). The dermatological indexes decreased, indicating an improvement in the clinical conditions of the patients 3 months after the first dose of adalimumab. Conclusions: We found that adalimumab affects apoptosis, which is crucial in the development and course of psoriasis. The differential gene expression in peripheral blood mononuclear cells of patients with psoriatic arthritis indicated the potential systemic effects of adalimumab therapy. The analyses of dermatological (the Psoriasis Area and Severity Index, body surface area and Dermatology Life Quality Index) and inflammatory (Biernacki's reaction) parameters revealed the effectiveness of the therapy.

Phenolic acids and a static magnetic field change the expression of transforming growth factor ß isoforms in amelanotic melanoma cells.

BACKGROUND: Melanoma is an aggressive type of cancer that can metastasize to numerous other organs. TGFß is one of the key signaling pathways in melanoma progression. Previous studies on various types of cancer have shown that both: polyphenols and a static magnetic field (SMF) can be potential chemopreventive/therapeutic agents. Therefore, the aim of the study was to evaluate the effect of a SMF and selected polyphenols on the transcriptional activity of TGFß genes in melanoma cells. METHODS AND RESULTS: Experiments were performed on the C32 cell line treated with caffeic or chlorogenic acids, and with simultaneous exposure to a moderate-strength SMF. The RT-qPCR method was used to determine the mRNA level of genes encoding the TGFß isoforms and their receptors. The concentration of the TGFß1 and TGFß2 proteins were also measured in the cell culture supernates. The first response of C32 melanoma cells to both factors is the reduction of TGFß levels. Then, mRNA level of these molecules returned to values close to pre-treatment level by the end of experiment. CONCLUSION: Our study results demonstrate the potential of polyphenols and a moderate-strength SMF to support cancer therapy by altering TGFß expression, which is a very promising topic for the diagnosis and treatment of melanoma.

The MAP2K2 Gene as Potential Diagnostic Marker in Monitoring Adalimumab Therapy of Psoriatic Arthritis.

BACKGROUND: MAP kinases are some of the cascades that are specialized in the cell's response to external stimuli. Their impaired functioning can be observed during the course of psoriatic arthritis. Currently, the best-known class of biological drugs is the inhibitors of the proinflammatory cytokine TNF-α, including adalimumab. OBJECTIVE: The aim of this study was to assess changes in the expression of MAP kinase genes in patients with psoriatic arthritis treated with adalimumab, as well as to determine which of the analyzed transcripts could be used as a diagnostic or therapeutic target. METHODS: An analysis was performed on the total RNA extracted from PBMCs of patients with psoriatic arthritis before and after three months of adalimumab therapy as well as from a control group. Changes in the expression of the mitogen-activated protein kinase genes were assessed using the HG-U133A 2.0 oligonucleotide microarray method, while the obtained results were validated using the real-time RT-qPCR method. RESULTS: Using the oligonucleotide microarray method, 14 genes coded for proteins from the MAPK group were identified with at least a two-fold change of expression in the control group and during adalimumab therapy. Validation of the results confirmed a statistically significant decrease in the transcriptional activity of the MAP2K2 gene in the group of patients three months after the administration of adalimumab relative to the control group. CONCLUSION: Adalimumab therapy alters the expression of MAPK-coding genes. The assessment of the number of MAP2K2 mRNA molecules can potentially be used in diagnostic analyses or in monitoring adalimumab therapy.

The Apoptotic Effect of Caffeic or Chlorogenic Acid on the C32 Cells That Have Simultaneously Been Exposed to a Static Magnetic Field.

The induction of apoptosis is one of the main goals of the designed anti-cancer therapies. In recent years, increased attention has been paid to the physical factors such as magnetic fields and to the natural bioactive compounds and the possibilities using them in medicine. Hence, the aim of this study was to evaluate the anti-tumor effect of caffeic or chlorogenic acid in combination with a moderate-strength static magnetic field on C32 melanoma cells by assessing the effect of both factors on the apoptotic process. The apoptosis of the C32 cells was evaluated using a flow cytometry analysis. The expression of the apoptosis-associated genes was determined using the RT-qPCR technique. The caspase activity and the concentration of the oxidative damage markers were also measured. It was found that phenolic acids and a static magnetic field trigger the apoptosis of the C32 cells and also affect the expression of the genes encoding the apoptosis regulatory proteins. In conclusion, our study indicated that both of the phenolic acids and a static magnetic field can be used supportively in the treatment of melanoma and that caffeic acid is more pro-apoptotic than chlorogenic acid.

The effect of a static magnetic field and baicalin or baicalein interactions on amelanotic melanoma cell cultures (C32).

BACKGROUND: Baicalin and baicalein have antioxidant, anti-inflammatory, hepatoprotective and anti-cancer properties. However, it is not known how a static magnetic field will modify these properties. Therefore, the aim of our study was to evaluate the simultaneous exposure of melanoma cells to flavones and the static magnetic fields that are generated by permanent magnets on the gene expression and the activity of the antioxidant enzymes that are associated with the antioxidant defense system. METHODS AND RESULTS: Melanoma cells that had been treated with baicalin or baicalein were subjected to a static magnetic fields with a moderate induction. The static magnetic field was emitted by permanent magnets and the cell cultures were carried out in special test chambers. The research included determining the activity of the antioxidant enzymes (superoxide dismutase, glutathione peroxidase and catalase) as well as the gene expression profile. The addition of the flavones to the cell cultures at a concentration of 50 µmol/L resulted increase in the expression of the SOD1, SOD2 and GPX1 genes compared to the nontreated cell cultures. Simultaneous exposure of the melanoma cells to static magnetic field and baicalin or baicalein reduced their mRNA levels compared to the cultures to which only baicalin or baicalein had been added. The change in gene expression was accompanied by changes at the protein level associated with an increase in the activity of antioxidant enzymes. CONCLUSION: We showed that baicalin or baicalein have anticancer properties by disturbing the redox homeostasis in melanoma cells and also increases the antioxidant system gene expression. There was also an antagonistic interaction between the studied flavones and the static magnetic field, which cause a decrease in the anticancer effects of baicalin or baicalein.

Expression of genes related to inflammation - IL-6, IL-8, and IFN-γ in monitoring ustekinumab therapy: preliminary results.

Introduction: Psoriasis is classified as an inflammatory and autoimmune disease. Changes in the concentration profile of some cytokines, such as interleukin-12 (IL-12), IL-23, and IL-17, play a key role in its pathogenesis. IL-6, IL-8 and interferon- γ (IFN-γ) are also hallmark cytokines in a psoriatic cytokine network. Cytokine-blocking drugs, which are a part of the inflammatory cascade, are now increasingly popular. One of them is ustekinumab, directed against IL-12 and IL-23, but also indirectly against other interleukins, which take part in the inflammatory reaction. Due to the complexity of inflammation pathways, new molecular markers are still being sought. Regardless of the type of therapy used, they allow to determine its effectiveness, signal the lack or loss of sensitivity to treatment. Aim: To evaluate the expression profile of genes related to the inflammatory reaction - IL-6, IL-8, and IFN-γ - in patients with psoriasis, depending on the duration of ustekinumab therapy. Material and methods: The material for the study was the PBMCs of 14 patients suffering from psoriasis who were treated with ustekinumab. Monitoring was performed after 16, 28, and 40 weeks of therapy. The gene expression of IL-6, IL-8, and IFN-γ was measured using the RT-qPCR method. Results: There was a statistically significant increase in the expression of IL-6 and IFN-γ genes in psoriasis patients, depending on the duration of ustekinumab therapy. Conclusions: The increase in mRNA copy numbers of the pro-inflammatory IL-6 and IFN-γ genes in the following weeks of therapy may suggest that patients treated with ustekinumab may progressively develop resistance to biological treatment.

A static magnetic field changes the expression profile of the transforming growth factor ß family genes in human cells that have been treated with fluoride ions.

One of the molecular pathways that can be modified in cells that are under the influence of fluoride exposure is the transforming growth factor ß (TGFß) signaling pathway. It has also been shown that the effect of static magnetic field on the cellular processes is linked to the activation of many important signal cascades. Therefore, the aim of this study was to evaluate whether the SMF changes the expression profile of TGFß family genes in NaF-treated human cells. The expression of the genes linked with TGFß were analyzed using the oligonucleotide microarrays technique and the expression of the TGFß isoforms was determined using the RT-qPCR and ELISA techniques. Our research showed that SMF modified the activity of the TGFß-related genes and that their levels are altered by fluoride. This offers hope for planning future therapeutic strategies for the diseases that are associated with changes in the TGFß signaling.

Analysis of molecular and clinical parameters of 4-year adalimumab therapy in psoriatic patients.

INTRODCUTION: Through interaction with receptors TNFR1 and TNFR2, TNF-α activates a signal path, which exacerbates an inflammatory process, constituting an inseparable element of psoriasis. AIM: To evaluate changes in the expression of TNF-α, TNFR1, TNFR2 during the 4-year-long adalimumab therapy in psoriatic patients, searching for the correlation between molecular and clinical markers. In addition, the role of miRNAs was analysed. MATERIAL AND METHODS: Whole blood and serum samples of psoriatic patients treated with adalimumab constituted material for the study. Changes in the expression of TNF-α and its receptors were evaluated with the use of the RTqPCR method and MALDI ToF mass spectroscopy, PASI, BSA, DAS28 indexes were used for the clinical analysis of the patients, while the role of miRNA molecules was determined basing on microrna.org database. RESULTS: Different TNF-α expression patterns were determined in patients with observed resistance to the medicine. We found that there is a correlation between the molecular markers of an inflammatory process and the clinical indexes. The bioinformatic analysis indicates the potential role of miRNAs in the regulation of expression of the analysed genes. Changes in the profile of TNF-α during adalimumab therapy are significantly determined by the individual variability and susceptibility to the biological medicine or its loss. CONCLUSIONS: TNF-α seems to be a useful marker to evaluate the efficacy of therapy and occurring resistance to the medicine. A complex mechanism for the regulation of the analysed gene expression was underlined, which involved the potential role of miRNAs.

The impact of the co-exposure of melanoma cells to chlorogenic acid and a moderate-strength static magnetic field.

A static magnetic field (SMF) or the bioactive compounds that are found in foods are potential agents that can be used to support cancer therapy. Therefore, the aim of our study was to assess the impact of the SMF that are induced by neodymium magnets on the culture growth and antioxidant status of melanoma cells that had been treated with chlorogenic acid (CGA). The melanoma cells, the control and those that had been treated with CGA, were put in special magnetic test chambers that generated a 0.7 T magnetic field. The mRNA levels of the antioxidant enzymes were analyzed using RT-qPCR. The activity of SOD, GPx, and CAT was measured in the cell lysates. While the expression and activity of the antioxidant enzymes was inhibited relative to the untreated cells as a result of the CGA treatment (1 mmol/L), it was not after the CGA treatment in combination with an SMF. The demonstrated cytotoxicity of CGA (1 mmol/L) and its inhibition of the antioxidant enzymes suggests the usefulness of phenolic compounds as a supporting pharmacological treatment for melanoma. PRACTICAL APPLICATIONS: Phenolic acids and their derivatives, which are the bioactive components of the human diet, are signal molecules that transfer information from the external environment that affects the level of gene expression in cells. This study suggests the usefulness of phenolic compounds as a supporting pharmacological treatment for melanoma and seems to be important for the development of experimental oncology.

Apoptosis in Autoimmunological Diseases, with Particular Consideration of Molecular Aspects of Psoriasis.

Apoptosis is a natural physiological process involving programmed cell death. Thanks to this process, it is possible to maintain the homeostasis of the body and the immune system. Dysfunctions of this mechanism lead to development of autoimmune diseases such as psoriasis; these diseases are chronic and treatment is extremely difficult. In psoriasis (a skin disease), apoptosis disorders are manifested by keratinocyte proliferation dysfunction. Autoimmune diseases coexisting with psoriasis include multiple sclerosis, autoimmune thyroid disease, and diabetes, but the common pathogenesis of these diseases is not fully understood. Given the heterogenous nature and chronic and recurrent course of psoriasis, the selection of an effective therapeutic strategy is still a problem. This literature review was focused on the process of apoptosis as a factor in the development of autoimmune diseases, with particular emphasis on psoriasis. The work also includes a review of therapeutic methods of psoriasis based on the latest literature.

Anti-apoptotic effect of a static magnetic field in human cells that had been treated with sodium fluoride.

Static magnetic field (SMF) is widely used in industry, in consumer devices and diagnostic medical equipment, hence the widespread exposure to SMF in the natural environment and in people occupationally exposed to it. In environment and in some workplaces, there is a risk of exposure also to various chemicals. Environmental factors can affect the cellular processes which can be the cause of the development of various pathological conditions. Therefore, the aim of this study was to assess the effect of SMF on the expression of the apoptosis-related genes in human fibroblast cultures that had been co-treated with fluoride ions. The control and NaF-treated cells were subjected to the influence of SMF with a moderate induction. The flow-cytometric analysis showed that the fluoride ions reduced the number of viable cells and induced early apoptosis. However, exposure to the SMF reduced the number of dead cells that had been treated with fluoride ions. Moreover, specific genes that were involved in apoptosis exhibited a differential expression in the NaF-treated cells and exposure to the SMF yielded a modulation of their transcriptional activity. Our results suggest some beneficial properties of using a moderate-intensity static magnetic field to reduce the adverse effects of fluoride.

mRNA level of ROCK1, RHOA, and LIMK2 as genes associated with apoptosis in evaluation of effectiveness of adalimumab treatment.

BACKGROUND: Psoriasis is a multifactorial autoimmune disease, which underlies the abnormalities of the apoptotic process. In cases of psoriasis and psoriatic arthritis, biological treatment is used. This study aimed to determine any changes in the expression of the genes associated with apoptosis in patients with psoriatic arthritis treated with adalimumab and to assess any phenotypic modifications based on changes in dermatological indexes. METHODS: The study included 20 patients with psoriatic arthritis treated biologically and 20 healthy volunteers. The research material consisted of peripheral blood mononuclear cells (PBMCs) from which the total RNA was isolated. Changes in the gene expression were determined using oligonucleotide microarrays and RT-qPCR. The clinical condition was assessed based on selected indicators: PASI, BSA [%], DAS28, and DLQI, which were determined every 3 months. RESULTS: There were changes in the expression of genes associated with apoptosis. Significant differences were found for ROCK1, RhoA, and LIMK2 expression profiles in PBMCs. At the initial stage of treatment, a decrease in the PASI and BSA rates was observed. At the later stages, the values of these indicators increased once again. There were correlations between the changes in these genes' expression and the dermatological markers. CONCLUSION: Adalimumab influences the expression of genes related to apoptosis and the values of dermatological indicators of patients. Changes in the expression level of genes associated with apoptosis suggest that ROCK1, RhoA, and LIMK2 may be genes that can potentially be indicators of treatment effectiveness and lack of response to biological treatment.

Adalimumab changes the expression profile of selected BCL-2 family genes.

Biological drugs are an alternative to treatment of psoriasis and psoriatic arthritis. Adalimumab is a representative of the anti-TNF group. The underlying of this disease is a cellular homeostasis disorder-apoptosis. Many proteins are involved in the apoptosis induction pathways, including those from the BCL-2 family. The aim of the study was to perform a transcriptional analysis of the genes coding selected proteins from the BCL-2 family in patients treated with adalimumab therapy, and to determine the direction of these changes. The test materials were peripheral blood mononuclear cells. The cells were obtained from 20 patients with psoriatic arthritis who were being treated with adalimumab (study group) and 20 healthy volunteers (control). The gene expression profile was determined using the real-time quantitative reverse transcription polymerase chain reaction technique. Statistically significant changes were observed in the expression level of the BNIP3, BNIP3L, and BCL2L1 genes (p < .05) during a 24-month observation of therapy. We indicated that adalimumab therapy has an impact on the expression of the analyzed genes, which may constitute a new class of molecular markers for assessing the effectiveness of a therapy. It appears that the BNIP3L gene could be used as a potential diagnostic marker of psoriasis.

Comparison of patient comfort after coronary angiography by standard arterial access approaches.

BACKGROUND: Radial access during coronary angiography has become an increasingly popular alternative to femoral access. The procedural outcomes and complications of these two approaches have been thoroughly evaluated; however, no studies have focused exclusively on the postprocedural quality of life of patients. AIM: To determine and compare both methods from the patient's point of view. METHODS: Data were gathered from 165 consecutive patients scheduled for elective coronary angiography (from October 2011 to June 2012). The choice of the access site was left at operator's discretion. Femoral and radial groups consisted of 91 and 74 patients, respectively. Quality of life was assessed by the Short Form of the McGill Questionnaire and a self-designed questionnaire (Questionnaire II) consisting of eight questions evaluating the procedure-specific aspects of recovery time. After three months from index hospitalisation post-discharge interviews were conducted using a modified version of Questionnaire II with an additional two questions. RESULTS: Patients from the transfemoral approach group characterised their pain (according to McGill Questionnaire) more often as aching (mean value ± SD: 0.84 ± 1.2 vs. 0.21 ± 0.6; p = 0.003), heavy (0.29 vs. 0.027; p = 0.02), and exhausting (0.22 ± 0.7 vs. 0.07 ± 0.2; p = 0.037). Moreover, in Questionnaire II they indicated tenderness of the puncture site (0.42 ± 0.8 vs. 0.23 ± 0.07; p = 0.00004) more frequently. CONCLUSIONS: The quality of life of patients who underwent coronary angiography from radial access was remarkably better in terms of pain characteristic and overall discomfort.

Habitat preferences of two sparrow species are modified by abundances of other birds in an urban environment.

Every species has certain habitat requirements, which may be altered by interactions with other co-occurring species. These interactions are mostly ignored in predictive models trying to identify key habitat variables correlated with species population abundance/occurrence. We investigated how the structure of the urban landscape, food resources, potential competitors, predators, and interaction between these factors influence the abundance of house sparrow Passer domesticus and the tree sparrow P. montanus in sixty 25 ha plots distributed randomly across residential areas of the city of Poznan (Poland). The abundance of the house sparrow was positively correlated with the abundance of pigeons but negatively correlated with human-related food resources. There were significant interaction terms between abundances of other urban species and habitat variables in statistical models. For example, the abundance of house sparrow was negatively correlated with the abundance of corvids and tree sparrows but only when food resources were low. The abundance of tree sparrows positively correlated with density of streets and the distance from the city center. The abundance of this species positively correlated with the abundance of corvids when food resources were low but negatively correlated at low covers of green area. Our study indicates that associations between food resources, habitat covers, and the relative abundance of two sparrow species are altered by the abundance of other urban species. Competition, niche separation and social facilitation may be responsible for these interactive effects. Thus, biotic interactions should be included not only as an additive effect but also as an interaction term between abundance and habitat variables in statistical models predicting species abundance and occurrence.

[Genetic background of sarcoidosis]. / Uwarunkowania genetyczne sarkoidozy.

Sarcoidosis is a multisystemic disease of unknown pathogenesis. Its characteristic feature is formation of noncaseating granuloma in involved organs. The current etiologic hypothesis suggests that an unknown antigen/ agent might promote granuloma formation in hosts genetically susceptible to Th1 - response. The network of interactions between immunocompetent cells (mainly Th1-lymphocytes and macrophages) and the influence of many cytokines and chemokines lead to the sarcoid granuloma formation. The variations in prevalence and incidence of this disease in individuals from different ethnic, racial groups or families show, that the genetic factors are also involved in sarcoidosis etiology. Although there is a clear genetic influence on the risk of sarcoidosis, the relation between clinical course of the disease is an area for further exploration in the future.

[Comparative analysis of labor in twin pregnancies in years 1987-91 and 1997-2001]. / Analiza porównawcza prowadzenia porodu w ciazy blizniaczej w okresie 1987-91 i 1997-2001.

OBJECTIVE: The aim of the study was to evaluate the course of twin pregnancy deliveries with particular regard to parity, the way of pregnancy termination, indications for cesarean section and sterility treatment. MATERIALS AND METHODS: The studied material consisted of two groups of patients who gave birth to twins in our clinic: the first one of 62 women in years 1997-2001 and the second group of 92 women in years 1987-1991. The average age of patients was 29.4 vs 28.7 respectively. RESULTS: There were 48.3% of primiparas in the first group, comparing to 44.5% in the second. The average time of pregnancy termination was 35 vs 35.97 Hbd respectively. Premature labours contributed to 80.6% vs 52% of all cases, which was statistically significant (p<0.001). Obstetrical procedures were applied in 6.5% vs 25% of cases respectively (p = 0.003). The indications for cesarean section have changed in regard to the position of the second fetus (when first in cephalic longitudinal lie, second in other than cephalic) and therefore contributed to 78.5% of cases in first and only 12.5% in second group. Thus the application of obstetrical procedures on the second fetus decreased to 18.2% vs 63% (p=0.002). In both groups cesarean sections were most often performed when the position of the first fetus was other than cephalic. In both groups the mediana of Apgar score of the second twin was lower than of the first. But the number of stillborns and general neonatal deaths significantly decreased over the years (0.8% and 2.4% vs 4.9% and 5.36%). Comparing both studied groups, the rate of the twin pregnancy after sterility treatment is rising: 16% vs 7.6%. CONCLUSIONS: The significance of the second twin position as an indication for cesarean delivery has risen over the years, thereby displacing the use of obstetrical procedures in those cases. In spite of earlier pregnancy termination and higher premature labour rate, there is a significant drop in the number of stillborns and neonatal deaths. In the age of infertility treatment, the number of twin pregnancy is rising.