Background: Sjögren's syndrome is an autoimmune disease primarily affecting women around the age of 50, but can also occur in women of reproductive age, leading to serious maternal-fetal complications during pregnancy. The exact cause of this condition is not entirely understood, however, it is assumed to attack the exocrine glands, leading to impairment of their function. Additionally, an increased risk of developing lymphomas, particularly non-Hodgkin lymphoma is recognized among affected patients. Objective: To illustrate the management of pregnancy in a patient with Sjögren's syndrome and non-Hodgkin's lymphoma and the achievement of obstetric success without maternal-fetal complications. Case report: In the article, a 36-year-old pregnant patient with Sjögren's syndrome history, two miscarriages, and non-Hodgkin's lymphoma is presented. Due to unexpected pregnancy, the patient discontinued lymphoma treatment. Through the pregnancy, fetal well-being, blood flow, and maternal health were meticulously monitored, showcasing successful obstetric management. Due to Sjögren's syndrome, fetal atrioventricular conduction was monitored weekly from the 16th to the 30th week, showing no abnormalities. Additionally, during the course of pregnancy gestational diabetes, cervical insufficiency treated with pessary insertion, anemia and thyroid insufficiency were diagnosed. Multidisciplinary care addressed these issues, allowing our patient to give birth to a healthy child at 37 weeks via cesarean section. Conclusion: Pregnancies in Sjögren's syndrome patients pose elevated risks due to the presence of antibodies causing tissue damage and complications. These antibodies contribute to fetal myocardial issues and congenital heart conditions. Regular fetal heart ultrasounds, especially for those positive for Ro/SS-A antibodies, are crucial between the 16th and 31st weeks. Maternal-fetal complications include a higher risk of preterm delivery and lower birth weight of the offspring, often due to fetal growth restriction. Additionally, considering the potential for oncohematologic disorders in adults, comprehensive obstetric care is essential for minimizing complications risk.
Nationwide HPV vaccination programme funded by the state aimed at girls and boys aged 12–13 years old was implemented in Poland in June 2023. After the first six weeks the estimated HPV vaccination coverage in the target population was 7%. The aim of the study was to determine what types of beliefs and concerns are associated with HPV vaccines among population living in rural areas and searching for possibilities of increasing HPV vaccine coverage.
Methodology
It was a cross-sectional survey study performed by means of paper questionnaires distributed to mothers, grandmothers and teachers during parents' gathering in a primary school in a rural area in Holy Cross Province in Poland. The mean age of surveyed women was 38 (between 19–63 years old). Altogether 170 surveys were collected. Descriptive statistics was used for results analysis. The surveys were collected before introduction of nationwide HPV vaccination programme funded by the state.
Results
Five percent of surveyed women vaccinated their children against HPV. Ten percent of respondents were recommended by a physician to vaccinate their child against HPV. Eighty-three percent of surveyed women believed that vaccination is an effective protection against HPV caused diseases. Forty-three percent answered that HPV vaccine leads to sexual promiscuousness among adolescents. Ninety-six percent stated that HPV vaccine should be funded by the state and that in such condition – 86% would have vaccinated their daughter and 87% would have vaccinated their son. Most common reported reasons for not vaccinating children against HPV were: no physician's recommendation (58%), unawareness of such possibility (44%), and price (26%).
Conclusion
Main barriers associated with low HPV vaccination rate were unawareness of such possibility and high price. After inclusion of HPV vaccinations in the recommended vaccine schedule funded by the state, further increase in HPV vaccine coverage could be achieved by educating parents and adolescents.
Inflammatory bowel diseases (IBD), which include ulcerative colitis (UC) and Crohn's disease (CD), are chronic intestinal inflammatory disorders with an unknown etiology. They are characterized by chronic recurrent inflammation of the intestinal mucosa and lead to a significant decrease in the quality of life and death of patients. IBD are associated with suppression of normal intestinal microflora, including a decrease in bacteria, producers of short chain fatty acids (SCFAs), exhibiting anti-inflammatory and protective properties. Among the various methods of intestinal microflora correction, fecal microbiota transplantation (FMT), which engrafts the fecal microbiota from a healthy donor into a patient recipient, is of a particular interest. As a result, a positive therapeutic effect is observed, accompanied by the restoration of the normal intestinal microflora of the patient. A significant drawback of the method is the lack of standardization. Metabolites produced by intestinal microflora, namely SCFAs, allow objective assessment of the functional state of the intestinal microbiota and, consequently, the success of the FMT procedure. Using gas chromatography and nuclear magnetic resonance spectroscopy techniques, we have analyzed concentrations and molar ratios of SCFAs in fecal samples of 60 healthy donors. Results were in good accord when comparing two methods as well as with published data. Analysis of SCFAs in feces of patients with UC (19 patients) and CD (17 patients) revealed a general decrease in the concentration of fatty acids in the experimental groups with significant fluctuations in the values in experimental groups compared to control group of healthy donors. On the limited group of IBD patients (6 patients with UC and 5 patients with CD) concentration of SCFAs before and within 30 days of observation after FMT was determined. It was shown that FMT had a significant impact on the SCFAs levels within 1 month term; tendency to reach characteristics of healthy donors is unambiguously traced for both diseases.Vospalitel'nye zabolevaniia kishechnika (VZK), k kotorym otnosiat iazvennyĭ kolit (IaK) i bolezn' Krona (BK), kharakterizuiutsia khronicheskim retsidiviruiushchim vospaleniem slizistoĭ kishechnika neizvestnoĭ étiologii i privodiat k sushchestvennomu snizheniiu kachestva zhizni i k smerti patsientov. VZK assotsiirovany s podavleniem normal'noĭ kishechnoĭ mikroflory, v tom chisle s umen'sheniem kolichestva bakteriĭ — proizvoditeleĭ korotkotsepochechnykh zhirnykh kislot (KZhK), obladaiushchikh protivovospalitel'nymi i zashchitnymi svoĭstvami. Sredi razlichnykh sposobov korrektsii mikroflory kishechnika osoboe vnimanie issledovateleĭ privlekaet transplantatsiia fekal'noĭ mikrobioty (TFM), vvedenie v organizm patsienta mikrobioty, poluchennoĭ ot zdorovogo donora. V rezul'tate TFM, kak pravilo, nabliudaetsia polozhitel'nyĭ terapevticheskiĭ éffekt, soprovozhdaiushchiĭsia vosstanovleniem normal'noĭ mikroflory kishechnika patsienta. Sushchestvennym nedostatkom metoda iavliaetsia otsutstvie standartizatsii. Metabolity, produtsiruemye kishechnoĭ mikrofloroĭ, v chastnosti KZhK, pozvoliaiut dostatochno ob"ektivno otsenit' funktsional'noe sostoianie mikrobioty kishechnika i, sledovatel'no, uspeshnost' protsedury TFM. Metodami gazovoĭ khromatografii i spektroskopii iaderno-magnitnogo rezonansa byli proanalizirovany kontsentratsii i moliarnye sootnosheniia KZhK iz fekaliĭ 60 zdorovykh donorov. Éti metabolity pokazali khoroshee sootvetstvie kak pri sravnenii dvukh metodov mezhdu soboĭ, tak i pri sopostavlenii s literaturnymi dannymi. Analiz KZhK v fekaliiakh bol'nykh IaK (19 patsientov) i BK (17 patsientov) vyiavil obshchee snizhenie kontsentratsiĭ KZhK v issleduemykh gruppakh po sravneniiu s kontrol'nymi obraztsami s sushchestvennymi kolebaniiami znacheniĭ vnutri issleduemoĭ gruppy. Na ogranichennoĭ vyborke patsientov s VZK (6 patsientov s IaK i 5 patsientov s BK) opredeleny kontsentratsii KZhK do i v techenie 30 dneĭ nabliudeniia posle provedeniia TFM. V vybrannom vremennom diapazone TFM okazyvaet éffekt na urovni KZhK. Nesmotria na to, chto v techenie 30 dneĭ profil' KZhK, kharakternyĭ dlia zdorovykh donorov, ne vosstanavlivaetsia polnost'iu, tendentsiia k ego dostizheniiu odnoznachno proslezhivaetsia dlia oboikh zabolevaniĭ.
