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Dermoscopy — 3rd Conference of the Section of Dermoscopy and Other Skin Imaging Techniques (DiTOS) of the Polish Dermatological Society — Abstracts
No full textUnmasking metabolic clues: adipsin, irisin and osteopontin as biomarkers in polycystic ovary syndrome and their impact on metabolic dynamics: a case-control study
No full textObjectives: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age, often associated with metabolic alterations. This study assessed serum levels of adipsin, irisin, and osteopontin in patients with PCOS and examined their correlations with metabolic parameters.
Material and methods: A case-control study was conducted involving 96 women with PCOS and 80 healthy controls. Serum levels of adipsin, irisin, and osteopontin were measured; demographic, clinical, and metabolic characteristics were evaluated.
Results: Patients with PCOS were significantly younger than controls (p < 0.001). The PCOS group included a significantly greater proportion of obese individuals (p = 0.013). Patients with PCOS exhibited elevated serum adipsin (p = 0.020) and reduced osteopontin (p < 0.001) levels relative to controls; obesity and age influenced these differences. Osteopontin demonstrated superior predictive power for PCOS diagnosis [area under the curve (AUC) = 0.802] compared with adipsin (AUC = 0.602). A combination of osteopontin and adipsin yielded the highest predictive value (AUC = 0.817) among double or triple biomarker combinations.
Conclusions: This study identified potential associations among adipsin, osteopontin, irisin, and PCOS. Further research is warranted to elucidate their roles and clinical implications in PCOS and its metabolic alterations. The findings highlight the impact of age and obesity on these biomarkers and their relationships with PCOS, providing insight into the syndrome's complex pathophysiology
Novel surgical vaginal rejuvenation technique involving cosmetic reconstruction of the vaginal outlet
No full textObjectives: Vaginal rejuvenation surgery became increasingly popular due to evolving societal perceptions, aiming to address both aesthetic concerns and female sexual dysfunction (FSD). This prospective cohort study aimed to investigate a novel approach aimed at preserving clitoral function while reconstructing the perineum in vaginal rejuvenation surgery, elucidate its procedural intricacies, evaluate short-term surgical outcomes, and assess changes in female sexual function and satisfaction postoperatively, using validated scoring systems, the Female Sexual Function Index (FSFI) and Sexual Satisfaction Scale for Women (SSS-W).
Material and methods: Fifty sexually active patients undergoing elective female cosmetic genital surgery were included. Demographic data and surgical procedures were documented. Preoperative and postoperative 6th-month FSFI and SSS-W scores were collected. The Shapiro–Wilk, McNemar chi-square, and Wilcoxon tests were employed to evaluate the statistical outcomes.
Results: Significant improvements were observed in FSFI domains, particularly in satisfaction (p < 0.001), pain (p < 0.001), and overall sexual function (p = 0.002) postoperatively. Patients with preoperative FSD demonstrated significant improvements in the arousal (p = 0.014), satisfaction (p < 0.001), and pain (p < 0.001) domains, as well as overall sexual function (p < 0.001). Notably, desire (p = 0.006), lubrication (p = 0.010), orgasm (p = 0.035), and satisfaction (p < 0.001) domains improved significantly in patients without preoperative FSD. Sexual Satisfaction Scale for Women questionnaire results corroborated these findings, showing significant enhancements in various domains of sexual satisfaction postoperatively.
Conclusions: Vaginal rejuvenation surgery shows promise in enhancing female sexual function and satisfaction. However, it is crucial to recognize that FSD is a multifaceted disease, influenced by a range of physiological, psychological, and social factors that extend beyond the scope of a single surgical intervention
Ectopic pregnancy — a comparision of treatment methods in terms of effectiveness and impact on fertility
No full textObjectives: The aim of this study was to compare the available methods of treating a pregnancy located in the fallopian tube with regard to their efficacy and impact on patient fertility.
Material and methods: The retrospective study involved a total of 217 patients treated at the Department of Fetal Medicine and Gynaecology at the Medical University of Lodz between 2018 and 2023. Medical records were analysed and a telephone survey was carried out to assess the follow-up of patients after discharge from the Department.
Results: 84% of patients were qualified for surgical treatment achieving a combined success rate of both methods (salpingotomy and salpingectomy) close to 100%. No positive effect on fertility of preserving the fallopian tube after pregnancy termination compared to removal of the fallopian tube was observed. The method with the highest risk of recurrent fallopian tube pregnancy was salpingotomy.
Conclusions: The results of this study show surgical treatment as the option for the treatment of pregnancy located in the fallopian tube. Appropriate qualification of patients allows to choose optimal therapeutic strategy. A positive effect on further fertility of the salpingotomy strategy compared to salpingectomy has not been demonstrated
Effects of gestational diabetes mellitus with different birth weight on genetic metabolism of newborns. A retrospective cohort study
No full textObjectives: To investigate the effects of gestational diabetes mellitus (GDM) with different birth weights on neonatal genetic metabolism.
Material and methods: 1252 patients with GDM diagnosed at Changzhou Maternal and Child Health Care Hospital from 2017 to 2021 were categorized into three groups: fetal growth restriction (G1), normal birth weight (G2), and macrosomia (G3). The levels of amino acids, free carnitine (CO) and acylcarnitine in neonates were detected using tandem mass spectrometry.
Results: There were no differences in age, height, predelivery weight or gravida across groups. G3 had the highest parity and fasting blood glucose levels (p < 0.0001). G1 exhibited the highest rates of cesarean section, neonatal asphyxia, and insulin utilization (p < 0.0001). Neonatal genetic metabolism analysis revealed that in G1 citrulline levels were the highest, with significantly elevated levels of leucineornithine and valine (p < 0.001). CO was also the highest (p < 0.001). The levels of isovalerylcarnitine, octanoylcarnitine and 18-carbodienoylcarnitine increased, while malonylcarnitine/3-hydroxy-butyrylcarnitine, hexadecanoylcarnitine, hexadecenoylcarnitine, 3-hydroxy-hexadecenoylcarnitine and 3-hydroxy-hexadecanoylcarnitine decreased (p < 0.05). In G2, methionine levels decreased (p < 0.001), whereas decenoylcarnitine, dodecanoylcarnitine, dodecenoylcarnitine and myristoylcarnitine levels increased (p < 0.001). In G3, proline decreased significantly (p < 0.001), and CO was the lowest (p < 0.001). Propionylcarnitine and octenoylcarnitine levels increased, whereas butyrylcarnitine decreased (p < 0.05).
Conclusions: Gestational diabetes mellitus with different birth weights influences neonatal genetic metabolism in distinct ways. Therefore, neonatal screening for inherited metabolic disorders provides insights into the metabolic levels of offspring of patients with GDM in early life
Magnetic resonance imaging-based radiomic model to predict the risk of intraoperative massive hemorrhage in patients with cesarean scar pregnancy
No full textObjectives: Development of magnetic resonance imaging (MRI)-based radiomic models to predict the risk of intraoperative massive hemorrhage in patients with cesarean scar pregnancy (CSP).
Material and methods: CSP patients (n = 126) from Center 1 were randomly assigned in a 7:3 ratio into a training set (n = 88) and an internal validation set (n = 38), and patients (n = 32) from Center 2 into an external validation set. Afterward, the clinical and radiomic features related to intraoperative massive hemorrhage were fed into the k-nearest Neighbor (KNN), support vector machine (SVM), Light Gradient Boosting Machine (Light GBM), and Multi- Layer Perception (MLP) to construct predictive clinical, radiomic, and combinatorial models. The performance of these models was assessed using area under curve (AUC), Delong's test, Decision Curve Analysis (DCA), and calibration curves. Youden's index was used to determine the optimal threshold.
Results: Eleven radiomic characteristics were found to be substantially linked to intraoperative massive hemorrhage. The combined in the gestational sac and peripheral to the gestational sac (IP) model (AUC = 0.959), constructed by MLP, had the best performance, with an optimal risk threshold of 0.180, as compared to the clinical model (AUC = 0.500) and the nomogram (AUC = 0.283). DCA and calibration curves demonstrated the IP model’s good clinical predictive performance.
Conclusions: The IP model for CSP was superior to the other models in this study in predicting the risk of intraoperative massive hemorrhage, which was significantly increased when the risk threshold exceeded 0.180. The model may help clinicians make individualized treatment decisions
Stężenie triglicerydów i jego istotny związek z częstością występowania choroby wieńcowej u biorców trzustki z cukrzycą typu 1 — badanie przekrojowe
No full textObjective: Coronary artery disease (CAD) and its complications significantly affect the post-transplant prognosis in pancreas recipients. This study aimed to evaluate the associations between CAD and its major risk factors (RFs) and to identify the strongest modifiable predictor of CAD in potential pancreas recipients with type 1 diabetes (T1D). Materials and methods: This is a prospective, crosssectional study. Patients with T1D qualified for simultaneous pancreas-kidney transplantation or pancreas transplantation alone were enrolled. The diagnosis of CAD was based on invasive coronary angiography. The major cardiovascular RFs included in the analyses were hypertension, lipid profile, obesity, and smoking. Results: The study population included 113 patients with a median age of 40 (35–46) years. The median duration of T1D was 26 years (23–32), and 61.9% of participants (n = 70) were on hemodialysis. CAD was found in 31 (27.4%) participants. Multivariate logistic regression analysis demonstrated that age (OR 1.159; 95% CI: 1.062–1.265, p = 0.001), the concentration of triglycerides (TG) (OR 4.534; 95% CI: 1.803–11.403, p = 0.001), and hemodialysis (OR 4.027; 95% CI: 1.13–14.358, p = 0.032) were independently associated with the prevalence of CAD in this cohort. Finally, the concentration of TG was the only modifiable RF that was independently associated with the prevalence of CAD. Conclusions: Fasting TG levels were positively associated with the prevalence of CAD in potential pancreas recipients with T1D. The concentration of TG has the potential to serve as a modifiable RF or at least as an important biomarker in this group and should be included in the cardiological pre-transplant assessment.Cel: Choroba wieńcowa (CAD, coronary artery disease) i jej powikłania znacząco wpływają na rokowania po przeszczepie u biorców trzustki. Celem niniejszego badania była ocena powiązań między CAD i jej głównymi czynnikami ryzyka oraz zidentyfikowanie najistotniejszego modyfikowalnego predyktora CAD u potencjalnych biorców trzustki z cukrzycą typu 1 (T1D, type 1 diabetes). Materiał i metody: Przeprowadzone badanie miało charakter prospektywny i przekrojowy. Do badania włączono pacjentów z T1D zakwalifikowanych do jednoczesnego przeszczepu trzustki i nerki bądź też samegoprzeszczepu trzustki. Rozpoznanie CAD opierało się na wynikach inwazyjnego badania koronarograficznego. Głównymi uwzględnionymi w analizach czynnikami ryzyka sercowo-naczyniowego były nadciśnienie tętnicze, profil lipidowy, otyłość i palenie tytoniu. Wyniki: Populację badania stanowiło 113 pacjentów z medianą wieku 40 (35–46) lat. Mediana czasu odrozpoznania T1D wynosiła 26 lat (23–32), a 61,9% uczestników (n = 70) było hemodializowanych. CAD stwierdzono u 31 (27,4%) uczestników. W wyniku wieloczynnikowej analizy regresji logistycznej stwierdzono, że wiek [iloraz szans (OR, odds ratio) 1,159; 95% przedział ufności (CI, confidence interval): 1,062–1,265, p = 0,001), stężenie triglicerydów (TG)(OR 4,534; 95% CI: 1,803–11,403, p = 0,001) i poddawanie się dializom (OR 4,027; 95% CI: 1,13–14,358, p = 0,032) były w badanej kohorcie niezależnie związane z częstością występowania CAD. Jedynym modyfikowalnym czynnikiem ryzyka wykazującym niezależny związek z częstością występowania CAD było stężenie TG. Wnioski: Stężenie TG na czczo było dodatnio związane z częstością występowania CAD u potencjalnych biorców trzustki z T1D. Stężenie TG może być potencjalnie modyfikowalnym czynnikiem ryzyka lub co najmniej ważnym biomarkerem w tej grupie pacjentów i powinno być uwzględniane w ocenie kardiologicznej przed transfuzją
Utilizing biomarkers for rapid assessment of headache in the emergency department
No full textINTRODUCTION: Headache is a common presenting complaint in emergency departments (EDs), accounting for 2–5% of admissions. Although most headaches are benign, 4–5% are associated with life-threatening secondary pathologies. Accurate and rapid diagnosis is crucial, yet a standardized protocol for imaging and laboratory assessments is lacking. This study evaluates hematologic parameters as diagnostic tools for predicting acute pathologies in patients presenting with headaches. MATERIAL AND METHODS: This retrospective study included 199 headache patients and 191 controls, aged 18 and above, who presented to the Ankara Etlik City Hospital between October 1 and December 15, 2022. Hematologic parameters, including neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-platelet ratio (NPR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), were analyzed, and compared with non-contrast brain computed tomography findings in patients with severe headaches. RESULTS: NLR and NPR were significantly elevated in patients with acute pathologies on brain imaging. While platelet levels did not differ, indices like PLR and SII were elevated, indicating their diagnostic potential. Female patients were more prevalent; however, severe headaches and intracranial pathologies were more common in older male patients. CONCLUSIONS: Hematologic parameters such as NLR, NPR, and SII serve as cost-effective, accessible biomarkers for stratifying headache patients in the ED. These markers can guide decisions on further imaging, particularly in high-risk populations. Future multicenter studies should validate these findings and explore their integration into clinical decision-making algorithms
Levodopa and dopamine agonist phobia in Parkinson’s Disease — does it really matter? A survey on treatment patterns in Polish tertiary centres
No full textAim of study. To investigate the treatment strategies of Parkinson’s Disease (PD) among movement disorder specialists in tertiary centres in Poland, and how literature warnings (levodopa and dopamine agonist phobia) have influenced their practice.
Material and methods. The survey was conducted between 30 November, 2020 and 18 October, 2021, in four Polish tertiary referral centres for PD (two in Gdansk, one in Sosnowiec, and one in Warsaw). Movement disorder specialists collected information on the treatment of 494 consecutive patients diagnosed with PD. The questionnaire included information on the age of the patient, the duration of PD, the Hoehn&Yahr (H&Y) stage, comorbidities, pharmacotherapy, and advanced PD therapies i.e. deep brain stimulation (DBS), levodopa/carbidopa intestinal gel (LCIG), and continuous subcutaneous apomorphine infusions (CSAI).
Results. Levodopa was the most prescribed medication (n = 465/494), followed by dopamine agonists (n = 292/494). The mean dose of levodopa was 810.58 ± 473.11 mg, and it did not exceed 2,000 mg/d in 98.5% of patients. The mean doses of dopamine agonists used were relatively low (ropinirole 8.64 ± 3.94 mg, pramipexole base 1.76 ± 0.65mg). Amantadine (n = 197/494) and MAO-B inhibitors (n = 202/494) were prescribed less frequently. Catechol-o-methyltransferase (COMT) inhibitors (n = 7/494) and anticholinergics (n = 4/494) were rarely used in the studied population. Complex polytherapy with three or more PD medications was the most often used treatment strategy (n = 223/494).
Conclusions and clinical implications. Levodopa remains the gold standard in PD treatment in tertiary movement disorder centres in Poland. Dopamine agonists formed the second most frequently prescribed group of medications; however, the observed low dosages of both levodopa and dopamine agonists may suggest a cautious approach by clinicians. Amantadine and MAO-B inhibitors (mainly rasagiline) constituted important elements of PD pharmacotherapy. The high prevalence of complex polytherapy underlines the complexity of PD management, the cautious use of single medication at high doses, and the need for personalised therapeutic strategies