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Biomedical subjects

A Cyganek

Publications and source records attributed to A Cyganek.

17 recordsLinked to original sources
PubMed2005

Pregnancy and delivery after liver transplantation.

AIM: According to statistics, women constitute one-third of all liver recipients and approximately 75% of female recipients are of reproductive age. Successful liver transplantation in these patients results in the restoration of menstrual function and fertility. The aim of this study was to assess the course of pregnancy and delivery in liver-transplanted women. MATERIALS AND METHODS: We retrospectively analyzed data of 138 liver-transplanted women, aged from 18 to 63 years, who underwent regular gynecological evaluations. Among 77 patients of reproductive age, 11 women conceived and delivered babies. RESULTS: All patients have successfully delivered. The mean gestation age at delivery was 36.5 weeks. All neonates were delivered in a good state with no congenital abnormalities. Common pregnancy complications were preterm birth, anemia, intrahepatic cholestasis, and infection. In 1 case, graft rejection was observed due to willful discontinuation of immunosuppressive therapy. Two spontaneous vaginal deliveries and 9 caesarean sections were performed. All caesarean sections were performed for obstetrical indications: fetal intrauterine asphyxia (n = 4), breech presentation (n = 2), threatening intrauterine infection (n = 2), and preterm twin delivery (n = 1). CONCLUSION: High-risk pregnancies in liver-transplanted women are generally associated with good outcomes, although an increased rate of preterm labor, intrauterine infections, anemia, and cholestasis were observed. Pregnancy did not seem to impair graft function or accelerate rejection in patients receiving immunosuppressive therapy.

Adult↗
PubMed2005

Multiple neoplastic lesions of the lower genital tract in a human papilloma virus-infected kidney-pancreas allograft recipient: a case report.

States of immunodeficiency are associated with an increased rate of certain cancers. Immunosuppressed allograft recipients are at high risk of Human Papilloma Virus (HPV)-related de novo malignancies. A female pancreas plus kidney transplant patient developed multiple genital malignancies within 6 years. The genome of human papilloma virus type 16 was detected in malignant lesions obtained from surgical procedures. All detected lesions were removed at an early state of development.

Adolescent↗
PubMed2004

Absence of teratogenicity of sirolimus used during early pregnancy in a liver transplant recipient.

We describe the case of successful delivery in a 21-year-old woman who became pregnant 3 years after liver transplantation and who received sirolimus during the first 6 weeks of gestation. Sirolimus was discontinued when ultrasonography revealed a pregnancy, she was switched to tacrolimus and prednisone was continued. The course of pregnancy was uneventful; there were no signs or symptoms of graft rejection. Due to fetal intrauterine threatening asphyxia the pregnancy was concluded by cesarean section in the 39th gestational week, delivering a healthy, 2950 g, Apgar 10, female infant.

Adult↗
PubMed2002

Efficacy and tolerability of low-dose transdermal estrogen (Oesclim) in the treatment of menopausal symptoms.

OBJECTIVE: To establish the proportion of symptomatic postmenopausal women who can be satisfactorily maintained on a low HRT dose of 25 microg/day 17-beta-estradiol (Oesclim 25 transdermal patches), after 8 weeks of treatment. STUDY DESIGN AND PATIENTS: This was a multicenter open label non-comparative trial. Treatment was initiated with 25 microg/day dosage, which could be increased to 50pg/day if required after 8 weeks, according to clinical evaluation. Sequential treatment with an oral progestogen was also given for > or = 12 days/month in all non-hysterectomized women. The primary criterion for evaluation of efficacy was the proportion of patients who remained on Oesclim 25 after 8 weeks of treatment in comparison to patients requiring Oesclim 50. RESULTS: Sixty-two patients were included in the study and 60 were treated. 88.3% of treated patients [CI: 78.7-94.9] fulfilled the primary criterion, remaining with the Oesclim 25 dosage after 8 weeks of treatment. All clinical menopausal symptoms showed a decrease from baseline to the end of the study. The mean daily number of vasomotor symptoms decreased from 8.2 (+/- 5.6) at baseline, for the entire treated population, to 1.0 (+/- 2.2) and 1.0 (+/- 1.2) at the end of the study in patients remaining with Oesclim 25 and in those requiring Oesclim 50, respectively. At the interim visit, patients in the Oesclim 50 group had a higher number of symptoms than those maintained on Oesclim 25. The global efficacy of the treatment was evaluated as very effective/effective by 93% of all patients and very good/good by investigators for 91% of their patients. Overall 91% of all patients evaluated the global tolerability as very well/well, while investigators rated it very good/good for 97% of their patients. The vast majority of all patients (93%) were very satisfied/satisfied with the trial treatment, and 90% of them were willing to continue the study drug. CONCLUSION: Oesclim low dose (25microg) hormonal transdermal therapy was efficient in management of climacteric symptoms in this 16-week study. The good acceptance of the treatment was associated with its high efficiency and tolerability.

Administration, Cutaneous↗
PubMed2001

[Actinomyces adnexitis in a woman].

The course of actinomycetic infections in two females with IUD is presented. Both patients needed surgery. Literature review taking into a special consideration laboratory diagnosis has been performed. Infection caused by other than Actinomyces israelii species was observed.

Actinomycosis↗
PubMed2001

[Pregnancy delivery and newborn in female kidney recipients].

OBJECTIVE: During the past few years a great development of clinical transplantology has taken place. Organ transplantation permits the best and quickest biological, clinical and social rehabilitation of patients. The subsidence of hormonal disturbances, which are responsible for irregular ovarian cycles and ovulation, has been observed among women with stable graft function. Such patients often become capable of conceiving and possessing offspring. With an increasing frequency of such occurrences, the pregnancy and delivery in the female transplant recipients is now becoming one of the major problem of contemporary perinatology. The aim of this study was to summarize our experience with the pregnancy, delivery and the state of newborn in female kidney transplant recipients. MATERIALS AND METHODS: 25 female kidney-transplant recipients who became pregnant were observed during pregnancy. The age of the patient was between 23 and 38 years. 32 pregnancies were followed up. The duration and complications of pregnancy, mode of delivery and newborns condition were analyzed. RESULTS: Miscarriages were observed in 47% of cases. Among patients who got birth, premature delivery was observed in 53%. Two stillbirths took place. 91% neonates were born in good condition. Preterm delivery occurred in 53%. Average birth weight was lower then observed at healthy pregnant women. No congenital defects were observed. CONCLUSIONS: In kidney transplant recipients who became pregnant the increased incidence of spontaneous abortion and preterm delivery was observed. Newborns delivered by those patients had decreased birth weight. No congenital defects were noted among those babies.

Abortion, Spontaneous↗
PubMed2000

[The efficacy of low estrogen transdermal therapy in climacteric symptoms management].

The aim of the study was to evaluate the efficacy and tolerability of low doses estrogen transdermal system treatment in management of climacteric symptoms. On the basis of performed researches it seems to be reasonable to start hormonal replacement therapy with the very low dosage of estrogen to achieve sufficient results and avoid side effects.

Administration, Cutaneous↗
PubMed1994

[Clinical treatment results of treating androgenization symptoms in women with preparation Diane-35].

26 women with androgenization: hirsutism, acne, seborrhea, aged 18-30 were treated with Diane 35 during at least 12 cycles. In investigated group of patients acne was in remission in 82.4% after 3 cycles, seborrhea was reduced in 85.5% after 3 cycles and in 96.2% after 6 cycles. Hirsutism was reduced only in 19.2% women after 12 cycles. Diane 35 was well tolerated and effective in contraception all investigated women.

Acne Vulgaris↗
PubMed1994

[Clinical observations using the new contraceptive preparation containing gestagen].

31 women aged 26-35 were observed during hormonal contraception with Femovan (in Poland registered as Femoden). The aim of the study was an analysis of effectiveness, influence on menstrual cycles and adverse effects in Femovan users. The conclusions of the study indicated that Femovan is very effective in contraception (Pearl index = 0). It provides good cycle control. It reduced in 50% women nausea and breast tenderness which occurred before starting of contraception. There were not body gain and elevated blood pressure in any women. Acne was reduced in 40% women after 3 months of using.

Acne Vulgaris↗
PubMedDate not supplied

Safety and efficacy of hormonal therapy in menopausal kidney-allograft recipients.

AIM: A higher risk of premature menopause and osteoporosis has been observed in female kidney-allograft recipients, providing particular indications for hormonal therapy. We have summarized our 10-year-experience with hormonal therapy in menopausal kidney transplant recipients. MATERIALS AND METHODS: From 1995 to 2004, hormonal therapy was administered to 54 kidney transplant recipients. At onset of therapy the ages of the women ranged from 31 to 52 years, and the period from transplantation from 3 months to 13 years. The mean time on therapy was 4.2 years. All patients received transdermal estradiol (E(2)) in combination with oral progestin. RESULTS: Total regression of climacteric symptoms was reported in 75% of patients. After 3 months of the therapy follicle stimulating hormone (FSH) and E(2) levels normalized: FSH from 129 +/- 30.1 IU/L to 38.3 +/- 26.1 IU/L and E(2) from 18.5 +/- 5.8 pg/mL to 98.6 +/- 33.2 pg/mL. No significant change was noted in serum creatinine. Eleven patients developed abnormal uterine bleeding but none had premalignant or malignant lesions of the uterus on endometrial curettage. No incidence of breast cancer was noted during mean treatment period of 5.2 years. Seventeen patients discontinued therapy for medical indications: one for profound thrombophlebitis and 16 for significant deterioration of liver function. Twelve women made their own decision to discontinue therapy. CONCLUSION: Hormonal replacement therapy was effective with no negative impact either on graft function or sex organs among kidney transplant recipients. Liver parameter monitoring seemed to be essential for safe continuation of treatment.

Adult↗
PubMedDate not supplied

Patient with liver epithelioid hemangioendothelioma treated by transplantation: 3 years' observation.

Epithelioid hemangioendothelioma (EHE) is a rare neoplasm of vascular origin, but unknown etiology that occurs in the liver, lungs and other organs. Its hepatic form (HEHE) generally behaves as a low-grade malignant tumor with a slowly progressive phenotype. Surgical resection or liver transplantation (OLT) has been recommended after diagnosis. We present a 30-year-old woman with primary HEHE of the liver treated by OLT in 2002. Her medical history started 3 years prior when an abdominal ultrasound examination revealed multiple focal changes in the liver. The histopathological diagnosis from a needle biopsy was carcinoma cholangiogenes desmoplasticum. For 2 years the patient was treated with chemotherapy combinations. To explain the lack of efficacy of chemotherapy, a laparoscopic biopsy was performed and HEHE diagnosed. Immunohistochemistry revealed positive staining for the factor VIII-related antigens, CD34 and CD31, which have been previously described as HEHE markers. The patient underwent OLT in March 2002. In the first month after OLT, the thyroid stimulating hormone concentration was elevated but they continuously decreased from 11.4 to 2.4 uIU/mL in May 2002 and thereafter remains normal. After 3 years observation the patient presented with good liver function and no signs of tumor recurrence. We concluded that immunohistochemical staining for characteristic endothelial cell markers may facilitate the correct diagnosis of HEHE. After diagnosis, OLT followed by immunosuppressive therapy, consisting of basiliximab, corticoids, low doses of tacrolimus and temporary administration of rapamycin, may be safe and effective. Monitoring of thyroid-stimulating hormone concentrations should be performed in patients with HEHE.

Adult↗
PubMedDate not supplied

High rate of endometrial hyperplasia in renal transplanted women.

UNLABELLED: A high rate of endometrial hyperplasia, an estrogen-dependent premalignant lesion of the endometrium, has been observed among female kidney allograft recipients. The aim of the study was to evaluate the incidence of endometrial abnormalities among renal transplanted women with abnormal uterine bleedings. MATERIAL AND METHODS: A retrospective analysis compared 45 renal transplanted women who underwent dilatation and curettage for abnormal uterine bleeding between January 1999 and September 2004 with 90 consecutive, nontransplanted, control patients who underwent dilatation and curettage for the same reason in 2004. RESULTS: Thirty-one cases (69%) of endometrial hyperplasia and one case (2%) of endometrial cancer were detected among the renal allograft recipients. The majority of transplant patients (28 cases, 62%) developed endometrial hyperplasia without atypia successfully treated with progestagens. There were 29 cases (32%) of hyperplasia without atypia, 2 cases (1%) of atypical hyperplasia, and 4 cases (4%) of endometrial cancer in the control group. CONCLUSIONS: Renal transplanted women seem to have an extremely high risk of endometrial hyperplasia. The majority of cases may be successfully treated with progestagens. Immunocompromised renal graft recipients, however, show other risk factors for carcinogenesis. Thus, frequent clinical surveillance should be recommended in this group of patients, also because there is conflicting evidence with regard to the risk of progression to carcinoma among untreated patients.

Adult↗
PubMedDate not supplied

Outcome of four high-risk pregnancies in female liver transplant recipients on tacrolimus immunosuppression.

Pregnancies in women after liver transplantation are considered high risk due to the greater rate of complications observed in immunosuppressed graft recipients. We report successful outcomes of four high-risk pregnancies in female liver transplant recipients on tacrolimus-based immunosuppression. The patients, aged 23 to 32 years, at the time of conception were 12 to 59 months from transplantation (mean 30 months). Preterm labor was the most important pregnancy complication observed in these patients. One episode of acute graft rejection was observed. A variable demand for tacrolimus was noted during pregnancy. Despite complications all four pregnancies were successful. The mean gestational age at delivery was 34.4 weeks. The birth weight of the newborns varied from 1410 to 3490 g (mean 2303 g) and the mean Apgar score was 8. No structural malformations or early complications were observed in the newborns. Excluding the patient with acute rejection, the remaining three cases showed all liver parameters to remain stable.

Adult↗
PubMedDate not supplied

Function of the ovaries in female kidney transplant recipients.

OBJECTIVES: One of the effects of an improved general health state after successful kidney transplantation in women of reproductive age is recurrence of regular menstrual function. MATERIALS AND METHODS: Sixty-three ovarian cycles in female kidney transplant recipient, aged from 18 to 44 years, at 1.5 to 15 years after transplantation, were compared with 50 cycles of healthy women. We monitored the menstrual cycle duration as well as follicle stimulation hormone (FSH), leutinizing hormone (LH), estradiol, progesterone, prolactin, creatinine, and testosterone serum concentrations as well as hematocrit and obtained sonographic observations of ovarian follicle growth and ovulation. RESULTS: Of the recipients, 68.1% had regular menstrual cycles. Ovulatory cycles were observed in 45% of patients. Estradiol concentration established in the first phase of the cycle was significantly higher among the transplanted group (mean value 226.86 +/- 97.45 pg/mL vs 140.00 +/- 61.00 in the controls). A significantly lower level of progesterone (15.05 +/- 17.34 ng/mL vs 30.79 +/- 18.48 ng/mL in the controls) and of testosterone were observed in kidney recipients. Other hormonal parameters did not differ significantly between the groups. CONCLUSIONS: Similar serum FSH, LH, and prolactin concentrations as well as increased levels of estrogens were observed in kidney transplant recipients compared with healthy nonrecipients. The rate of ovulatory cycles in regularly menstruated kidney graft recipients was similar to that of healthy women. Stabilization of graft function resulted in restoration of normal ovarian hormone metabolism and ovulatory cycles in female kidney transplanted recipients.

Adolescent↗
PubMedDate not supplied

Cornual pregnancy--a case report.

Ectopic pregnancy is a rare phenomenon in mammals. The most common localization is an oviduct, ovary and abdominal cavity. Confirmation of the ectopic pregnancy is always a difficult medical problem. The diagnosis is mainly based on the patient's history and gynecological examination. This paper concerns a case report of cornual pregnancy, diagnosed in the 20th week of pregnancy. The diagnostic difficulties and procedures, surgical management and the patient's and newborn's outcome was described.

Adult↗