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.
This study aimed to examine whether expectant management in twin pregnancies with preterm premature rupture of membranes (pPROM) is as safe as in singleton pregnancies.It was a retrospective cohort study comparing pregnancy course and outcome in singleton (n = 299) and twin pregnancies (n = 49) complicated by preterm premature rupture of membranes. Analysed factors included maternal diseases, gestational age at premature rupture of membranes (PROM), management during hospitalization, latency periods between PROM and delivery, gestational age at delivery, neonatal management and outcome.The difference in the proportion of patients with latency up to 72 hours, latency between 72 hours and seven days, and latency exceeding seven days were insignificant. The percentage of patients who received intravenous tocolysis and antenatal corticosteroids were similar; however, patients in twin pregnancies more often received incomplete steroids dose (p = 0.01). The occurrence of the positive non-stress test result and signs of intrauterine infection were similar between the groups. No statistically significant differences in the prevalence of neonatal complications except transient tachypnoea of the newborn were identified (24% in the singleton vs 13% in the twin group, p = 0.03).Expectant management of pPROM in singleton and twin pregnancies results in similar perinatal and neonatal outcome. Consequently, in case of no evident contraindications, expectant management of twin pregnancies seems to be equally as safe as in singleton pregnancies. Patients in twin pregnancies may be at higher risk of delivery before administration of full antenatal corticosteroids dose, therefore require immediate management initiation and transfer to a tertiary referral centre.
The objective of this study was to compare the effects of two betamethasone dosage regimens on selected parameters in mothers and on the status of the preterm newborn.The analysis included 121 patients who gave birth by gestational week 35 and within 7 days after the completion of a full course of steroid treatment (24 mg). The study group consisted of 45 patients receiving six 4-mg doses of betamethasone every 8 h. The control group consisted of 76 patients receiving two 12-mg doses of betamethasone separated by 24 h.After treatment, a significant increase in the leukocyte count was observed in the control group. Significant reductions in the erythrocyte counts, hemoglobin levels and hematocrit after treatment were also found in the control group. The post-natal status of newborns did not differ significantly between groups. The betamethasone dosage regimen used did not affect the incidence of moderate and severe respiratory disorders, intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), retinopathy (ROP), infection, hyperbilirubinemia or anemia in neonates. Mild respiratory disorders were slightly more common in the study group.A reduction in the single steroid dose administered to patients at risk of premature birth may reduce maternal side-effects.
Wstep. Przedstawiono zalozenia metodyczne oraz wstepny etap realizacji wlasnego projektu „Breast-POL” — wykorzystania zdolności sensorycznych niewidomych i niedowidzących masazystow do przesiewowych badan palpacyjnych w diagnostyce raka piersi. Materialy i metody. Motywacją podjecia poprawnych metodycznie badan w tym kierunku byly: 1. Zachecające i szeroko reklamowane doniesienia niemieckie (jednak o duzym stopniu ogolności i bez podania adekwatnej metodyki), 2. Dane teoretyczne o hiperkompensacji innych zmyslow niz wzrok u niewidomych, 3. Wstepne informacje o wdrozeniu niewidomych do palpacyjnych diagnostycznych badan przesiewowych w krajach rozwijających sie. Wyniki. W badaniu na modelu stwierdzono istotnie wyzszą czulośc (63,0% vs 47,5%) i istotnie nizszą swoistośc (89,6% vs 93,7%) w rozpoznawaniu zmian patologicznych w grupie osob niewidzących w porownaniu z widzącymi. Wnioski. Badanie osob niewidzących wykazalo istotnie wyzszą skutecznośc w wykrywaniu zamian patologicznych w piersiach, natomiast nieistotną w sensie klinicznym roznice pod wzgledem zdolności do wykluczania takich zmian.
Background: N-substituted 3-amino-1H-indazoles represent an interesting class of biologically active compounds. Among them, derivatives containing phenylurea moiety are of particular interest. Such compounds have been found to possess inhibitory activity against cancer cell growth. Additionally, various oxazoline-containing compounds have also been designed as potential anticancer agents. Objective: The aim of this work was to obtain a new class of N-substituted 3-amino-1H-indazole derivatives with cytotoxic activity towards cancer cells. Method: Two series of 1-[1-(4,5-dihydrooxazol-2-yl)-1H-indazol-3-yl]-3-phenylurea and 3- phenylthiourea derivatives 7-17 and 18-22, respectively, were prepared and screened for their potential in vitro cytotoxic activities against lung carcinoma LCLC-103H cell line using a crystal violet microtiter plate assay. Results: All the urea derivatives, except the compound 8, were inactive at a concentration of 20 μM attainable in cancer cells, while the thiourea derivatives showed a pronounced cancer cell growth inhibitory effects. The most potent 1-[1-(4,5-dihydrooxazol-2-yl)-1H-indazol-3-yl]-3-ptolylthiourea (19) exhibited cytotoxicity on the lung cancer LCLC-103H and cervical cancer SISO cell lines at a concentration of 10 µM. Moreover, compound 19 displayed cytostatic activity against pancreas cancer DAN-G cell line. Conclusion: The 1-[1-(4,5-dihydrooxazol-2-yl)-1H-indazol-3-yl]-3-phenylthiourea derivatives described herein may serve as a useful scaffold for the search for novel anticancer agents. Keywords: Alzheimer's disease, anticancer agents, Cytotoxic activity, 1-[1-(4, 5-dihydrooxazol-2-yl)-1H-indazol-3-yl]-3- phenylureas, 1-[1-(4, 5-dihydrooxazol-2-yl)-1H-indazol-3-yl]-3-phenylthioureas, synthesis.
The aim of the study was to compare the perinatal outcome of pregnancies in mothers who were diagnosed with gestational diabetes mellitus (GDM) with previous versus current Polish Gynecological Society (PTG) criteria.475 patients were divided into three groups. In group A, the patients only met the previous PTG criteria for a GDM diagnosis, i.e., those with a blood glucose level of 140-152 mg/dl 2 hours after administration, a fasting glucose level <92 mg/dl, and a blood glucose level <180 mg/dl 1 hour after administration. Group B included patients complying with both the previous and current PTG criteria for a GDM diagnosis. Group C included patients who only met the current PTG criteria for a GDM diagnosis, i.e., those with a fasting blood glucose level of 92-99 mg/dl, a blood glucose level <180 mg/dl 1 hour and <140 mg/dl 2 hours after administration, respectively.Women from group C were characterized by the highest fasting glycaemia in the first trimester of pregnancy (93.0 mg/dL vs. 88.0 mg/dL vs. 83.5 mg/dL, p=0.012) and during the OGTT (p=0.001). Gestational diabetes was diagnosed significantly earlier in patients from group C (23 vs. 26 vs. 26 weeks, p=0.005). The patients from group A significantly less frequently required insulin therapy for proper glycemic control (p=0.035). Women from group A were characterized by lower pre-pregnancy BMI (p=0.001).Current PTG criteria for diagnosing GDM according to the IADPSG allow for identification of women who often require insulin therapy to achieve proper glycemic control.
Atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL) are the two most common results of positive Pap smears.The aim of this study was to compare the management of patients with ASCUS and LSIL.All procedures were performed between 2003 and 2014 in an outpatient clinic affiliated to a tertiary referral center, and included Pap smears, colposcopy, histology and invasive treatment.There were 131 patients in the ASCUS group and 84 in the LSIL group. Further negative cytological results were obtained more frequently among the ASCUS group than the LSIL group [relative risk (RR)=1.18, 95% confidence interval (CI)=1.33-2.40; p<0.001]. Histological results revealed higher occurrence of cervical intraepithelial neoplasia grade III or invasive squamous cancer in the LSIL group than the ASCUS group [RR=6.8 (95% CI=0.95-144.63), p=0.033]. Patients from the LSIL group more frequently required invasive treatment [RR=2.53, 95% CI=1.40-4.67, p=0.001].Diagnosis of ASCUS is associated with more frequent cases of total remission in follow-up Pap smears and requires for less-invasive management.
Background: Physical activity is an element of a healthy lifestyle and is safe in most pregnancies. The aim of this study was to assess the impact of physical activity levels before and during pregnancy on pregnancy outcomes for both the mother and child. Methods: A cross-sectional survey was conducted on a population of Polish women. An anonymous questionnaire was distributed electronically via maternity and parental Facebook groups. Results: The final research group included 961 women. The analysis showed that physical activity 6 months before pregnancy was associated with a lower risk of gestational diabetes mellitus (GDM), but physical activity during pregnancy showed no such association. In all, 37.8% of women with low activity in the first trimester, in comparison to 29.4% of adequately active women, gained an excessive amount of weight during pregnancy (p = 0.0306). The results showed no association between activity level and pregnancy duration, type of delivery or newborn birth weight. Conclusions: Our study indicates that physical activity during the preconception period is crucial to GDM occurrence.
Shoulder dystocia remains an obstetric emergency. Maternal diabetes is considered to be one of the major risk factors for shoulder dystocia. The aim of this study was to analyze antepartum and peripartum risk factors and complications of shoulder dystocia in diabetic and non-diabetic women.We performed a retrospective analysis of 48 shoulder dystocia cases out of 28,485 vaginal deliveries of singleton, live-born infants over a 13 year period: 13 cases were diagnosed in diabetic women and 35 cases in non-diabetic women.The study was conducted in the 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland, from January 2000 to December 2012.Compared to non-diabetic women, diabetic patients had significantly higher pre-pregnancy body weight (83.4±23.8 kg vs. 62.5±10.9 kg, p=0.002), higher pre-pregnancy BMI (30.2±6.8 kg/m2 vs. 22.9±4.3 kg/m2, p=0.0003), and lower gestational weight gain (11.4±6.2 kg vs. 16.0±4.7 kg, p=0.01). Diabetic women with shoulder dystocia were more likely to deliver before completion of the 38th week of gestation (30.8% vs. 5.7%, p=0.02) and had a higher incidence of 1st and 2nd stage perineal tears compared with the non-diabetic group (23.1% vs. 0%, p=0.02). There were two cases of symphysis pubis dehiscence in non-diabetic women. Children of diabetic mothers had a significantly higher birth weight (4,425.4±561.6 g vs. 4,006.9±452.8 g, p=0.03). Children of diabetic mothers with dystocia were at significantly higher risk of peripartum injuries (92.3% vs. 45.7%). A significant difference was observed in the percentage of brachial plexus palsy (61.5% vs. 17.1%). Children of diabetic women experiencing shoulder dystocia were more frequently affected by Erb's brachial plexus palsy and respiratory disturbances. These children had an increased likelihood of birth weights above the 90th percentile (not necessarily reaching 4,000 g) compared to children born to non-diabetic mothers.Shoulder dystocia in women with diabetes mellitus during pregnancy was associated with earlier gestational age of labor, and these women were more frequently overweight. The newborns of diabetic mothers after shoulder dystocia appeared to be at an increased risk for perinatal morbidity compared to the newborns of non-diabetic mothers experiencing this complication.
Background: Mirror syndrome (MS) is a pregnancy-related condition characterized by fetal, placental and maternal edema. Methods: We report a case of MS with severe postpartum presentation following stillbirth, shoulder dystocia, McRoberts maneuver, anterior shoulder disimpaction and manual posterior shoulder delivery together with serum soluble fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio results. Results: A 33-year-old patient G3P0A2 at 34 weeks gestation was referred with fetal Ebstein anomaly and fetal hydrops. At 36 weeks of gestation, examination revealed fetal demise with placental hydrops. Delivery of a stillborn child was complicated by shoulder dystocia. Twelve hours postpartum patient developed massive edema and acute kidney injury. Five days postpartum serum creatinine level (CrL) peaked and the sFlt-1/PlGF ratio was elevated. Twelve days after delivery CrL normalized and edema resolved. Conclusions: Shoulder dystocia may increase the severity of postpartum MS. The sFlt-1/PlGF ratio may be useful for MS management.
