Biomedical subjects

Jan Wilczyński

Publications and source records attributed to Jan Wilczyński.

At least 19 recordsLinked to original sources

PubMed2006

Detection of cytomegalovirus in human placental cells by polymerase chain reaction.

Human cytomegalovirus (HCMV) is the most common cause of viral intrauterine infection. Progress in rapid, specific, and dependable detection of HCMV has recently been achieved by the use of DNA hybridization techniques and other molecular methods. We examined 21 placentas after delivery for the presence of HCMV DNA by polymerase chain reaction (PCR). To test the reliability of the PCR for the detection of HCMV DNA in clinical specimens, two simple PCR assays and a real-time quantitative PCR were used. PCR analysis of villous and decidual cells showed that HCMV DNA was present in 16 placentas (76.2%). Transmission of HCMV infection to chorionic villi was confirmed in 11 organs (52.4%), and congenital infections in newborns were detected in 9 cases (42.8%). These results suggest that HCMV genome detection in placentas at later gestational ages is common. Our results demonstrated that detection of HCMV DNA in placental tissues by DNA amplification provides a specific and sensitive method for diagnosis of intrauterine HCMV infection.

Adult↗

PubMed2006

[Nasal bone biometry in the second trimester of gestation].

OBJECTIVES: To determine physiological variability range of the analyzed biometrical parameters and to establish optimal circumstances for fetal nasal ultrasound biometry. To evaluate preliminarily the value of fetal nasal biometry in the screening for aneuploidy. DESIGN: Ultrasound measurement of nasal bones length and nasal width in healthy fetuses and in fetuses with common aneuploidies. MATERIALS AND METHODS: Measurements of the analyzed parameters were undertaken in 681 euploid fetuses and 9 fetuses with common aneuploidies. Nasal bones length was measured with accordance to the same set of rules as determined by Cicero et al. in their publication relating to the first trimester nasal bones assessment. Nasal width was measured in the coronal plane between the alae. RESULTS: Relationship between the examined parameters and gestational age was described. The normal variability range of the analyzed parameters was determined and percentile charts created. In three out of five examined fetuses with trisomy 21 the nasal bones length was below the 5th percentile. In one out of five trisomy 21 fetuses the nasal width was over the 95th percentile. Regrettably the paucity of data obtained from affected fetuses does not allow drawing statistically founded conclusions. CONCLUSIONS: Fetal nasal biometry seems to be a valuable screening marker of trisomy 21 in the second trimester, requiring further studies.

Anthropometry↗

PubMed2006

[Food products as a natural source of vitamins for pregnant women].

Although diet of pregnant women very often require supplementation with proper vitamins, food should be the basic source of them. Different food products consist of different amounts of vitamins. That is why the proper choice of natural sources of vitamins seem while to be the most important white preparing a diet. Sources of some vitamins are mentioned in the project. It also points out some factors that have impact on the availability and assimilation of the vitamins. The project states also that before pharmacological supplementation of vitamins the estimation of intake of vitamins from natural sources is needed.

Diet↗

PubMed2006

[Occurrence of plasmic and platelet prothrombotic polymorphisms in women in childbirth].

DESIGN: Plasmic pro-thrombotic factors as well as pro-thrombotic platelet glycoprotein mutations have been shown to play an important role in the mechanism of the thrombo-embolic disease. However, there is no published study evaluating the role of above mentioned genetic factors in the thrombo-embolic episodes in women in childbirth. OBJECTIVE: The aim of the study was to evaluate the role of selected genetic factors in appearance of thrombo-embolic complications in the women in childbirth, and to determine if there is the coexistence of selected platelet glycoprotein polymorphisms and factor V Leiden mutations. MATERIAL AND METHODS: 71 cases of women in child birth with thrombo-embolic disease were analyzed. Selected demographic characteristics, and genetic pro-thrombotic factors like factor V Leiden mutation, and pro-thrombotic platelet glycoprotein GP Ia, and GP IIIa polymorphisms were examined. RESULTS: Amongst pro-thrombotic platelet glycoprotein polymorphisms moderately pro-thrombotic heterozygous A1/A2, and heterozygous C/T were most prevalent. The least common were strongly pro-thrombotic homozygous A2/A2, and T/T. Analysis of the factor V Leiden mutation revealed statistically significant difference in the presence of allele A, which determines the prothrombotic tendencies in its carrier. CONCLUSIONS: Our study shows that factor V Leiden mutation, and investigated platelet GP Ia, and GP IIIa polymorphisms frequently coexist. Moreover, presence of factor V Leiden mutation is a risk factor for thrombo-embolic disease in the women in childbirth.

Adult↗

PubMed2006

[Prenatal ultrasound findings in complete trisomy 9].

This case report describes a 40-year-old woman, primigravida. On 13,3 weeks of gestation we diagnosed an abnormal flow pattern in the umbilical artery and abnormal hyperechogenic structure in fetal abdomen. In next sonographic examination on 16 weeks of gestation we diagnosed ventriculomegaly and ahydramnion. We also observed spina bifida, hyperechogenic kidneys, abnormal flow pattern in the umbilical vein and pulmonary valve insufficiency. We performed genetic amniocentesis. We observed complete trisomy in cytogenetic examinations. The woman opted for an elective TOP according to the Polish Abortion Act on 20 weeks of gestation.

Abnormalities, Multiple↗

PubMed2006

[Massive fetomaternal hemorrhage--case report].

Massive fetomaternal hemorrhage is defined as a loss of more than 30-50ml of fetal blood, transferred into maternal circulation. It can lead to severe anemization of the fetus and its consequences such as fetal hydrops or stillbirth. We present a case in which the diagnosis was based on the decresased fetal movement and pathological cardiotocography record. The Kleihauer-Betke test revealed a high percentage of fetal cells and allowed to state a proper diagnosis. An immediate cesarean section was performed and the lab tests confirmed severe anemization of the newborn.

Adult↗

PubMed2006

[Obstetrical results in women who underwent intrauterine invasive procedures during the pregnancy].

OBJECTIVE: The aim of this study was retrospective analysis of the results of pregnancies among women who had intrauterine invasive procedures (IIP)--amnioinfusion, amnioreduction, cordocentesis and shunts, based on the materials from Polish Mother's Memorial Hospital Research Institute in 2000-2003. MATERIAL AND METHODS: 320 women performed IIP: amnioinfusions due to the oligohydramnion (frequently connected with congenital fetal abnormalities) or premature rupture of membranes. Amnioreduction due to the polihydramnion (also in a twin pregnancy with TTTS syndrome). Implantation of shunts in fetal abnormalities--hydrocephalus, megabladder, CALM. Cordocentesis--diagnostic or therapeutic in a fetal immunisatio anty-Rh factor and fetal arrhythmias. RESULTS: The total percentage of pregnancy failure after IIP was 53.2%. The best results were in the groups with hydrocephalus and immunisatio anty Rh factor, the worst in the group of patients with severe oligohydramnion due to the congenital abnormalities of fetuses' kidney. The most frequent early complications after IIP were premature rupture of membranes (12.2%), fetal hypoxia (13.7%) and premature constrictions of uterus (8.4%). 21.3% of patients delivered in less than 5 days after IIP ( delivery or abortion) due to the early complications or after resolving the obstetrical situation, e.g. the genetic reason of fetal abnormalities or lethal abnormalities. More complications were connected with amnioinfusion than with amnioreduction. Cordocentesis seemed not to be connected with more often appearing of fetal hypoxia. CONCLUSION: (1) IIP are connected with a big percentage of pregnancy failure, but it is more a result of fetal serious disease than a intrauterine procedure. (2) Performing an amnioinfusion or cordocentesis in severe oligohydramnion gives a quick diagnosis of fetal potential abnormalities and makes it possible to outlook the fetal prognosis. (3) Patients should be as early as possible qualificated to IIP to avoid complications caused by the primary fetal disease. (4) Patients for IIP should be carefully selected and prepared. They need very strict observation for a fetal well-being and monitoring the infective factors after the procedure.

Female↗

PubMed2006

[Umbilical cord entanglement in monoamniotic twin preganacy--case presentation and literature review].

Monoamniotic twins are at most increased risk of perinatal complications with perinatal mortality of 28-60 % reported in literature. The most specific complication to monoamniotic twins is entanglement and (or) knotting of the cords leading to intrauterine death of both (more often) or one twin. In first presented case 1, 23-year-old primigravida in 33wks of twin monoamniotic gestation was reffered to our Institute due to intrauterine death of one co-twin caused by umbilical cord entanglement. In second case, 26-year-old multigravida in monoamniotic twin gestation was admitted to our institution. A serious umbilical cord entanglement was observed and a presence of true knot of umbilical cord was suspected. Presented cases indicate that establishing a chorionicity and amniocity in twin pregnancy is an essential part of ultrasound examination. The diagnosis of cord entanglement in monoamniotic twin pregnancy enables a forecasting of possible complications. According to the established diagnosis future protocols of perinatal management could be proposed. Due to possible complications counseling and management of monoamniotic twins should be performed in tertiary medical centers.

Adult↗

PubMed2005

[Acardiac fetus--morphological and clinical aspects].

The authors described 6 cases of serious complication of the multiple pregnancies with twin-to-twin transfusion syndrome (TTTS) sub form twin reverse arterial perfusion (TRAP) with development of acardiac fetus. It was established that this anomaly is an extremely rare complication of multiple pregnancies and very uncommon congenital malformation disclosed in fetuses and newborns. Acardiac "recipient" fetuses may have different morphological forms and often their birth weight is higher than that of the "donor" fetuses. The latter represent morphologic features of circulatory overload due to the necessity of supplying blood to the amorphous acardiac fetus. They are usually born preterm with circulatory insufficiency, intrauterine hypoxia and with developmental anomalies. Survival of one of the "donor" fetus implies the necessity of early diagnosis to detect pregnancy pathology, possible intrauterine intervention and monitoring of the healthy twin.

Diseases in Twins↗

PubMed2005

[Overweight and obesity as common risk factors for gestational diabetes mellitus (GDM), perinatal macrosomy in offspring and type-2 diabetes in mothers].

UNLABELLED: Gestational diabetes mellitus (GDM) affects about 5% of all pregnancies and results in an increased incidence of Caesarean sections, perinatal traumas and neonatal complications. Macrosomy, i.e., an excessive birth-weight is observed in newborns from these pregnancies. In the majority of cases, diabetes regression is observed directly after pregnancy termination, however, in 15-60% of these patients, diabetes mellitus develops in later years of life. The goal of the study was an assessment of the risk factors for GDM development in gestation, perinatal macrosomy in offspring from GDM-affected pregnancies and overt diabetes mellitus in women after GDM. MATERIAL AND METHODS. The study involved 146 women with GDM and 1806 women with normal carbohydrate metabolism during pregnancy, 506 newborns of gestational diabetic mothers and 993 newborns of healthy mothers, as well as 200 women with a history of GDM during the years 1990-1999 (the mean time period after GDM - 3.1 +/- 6.0 years). The recognized risk factors of GDM and perinatal macrosomy were evaluated, together with the incidence of overt diabetes mellitus after GDM-affected pregnancy. RESULTS: An analysis of multifactor logistic regression demonstrated that the independent risk factors for GDM include: BMI 3 25 kg/m2 before pregnancy (OR - 2.38), the history of diabetes in family (OR - 1.67), and the third pr further pregnancy (OR - 1.81) - p < 0.05. In turn, experienced obstetric failures and delivery of child with macrosomy features revealed insignificant - p > 0.05. Perinatal macrosomy correlated with mother's BMI and glycaemia during the 2nd hour of diagnostic test (75 g OGTT). No correlations were observed among mother's age, fasting glycaemia levels and HbA1c in mothers. In the group of GDM-affected women, diabetes mellitus type 2 was diagnosed in 34 (17.0%) patients. The the actual BMI > 25 kg/m2 and glycaemia values in the 2nd hour of diagnostic test in the course of GDM diagnosis (p < 0.05). The risk of diabetes was not enhanced in that group of women by family history of diabetes, the age of GDM onset (< 25 years of life), the week of gestation when GDM was diagnosed (< 25 hbd), and the type of GDM therapy (insulin vs. diet) p > 0.05 CONCLUSIONS: Overweight and obesity are both risk factors of gestational diabetes mellitus, delivery of child with macrosomy features and of overt diabetes mellitus later in life.

Adult↗

PubMed2005

[Antibiotic administration in preterm delivery].

DESIGN: Although an association between subclinical intrauterine infection and preterm birth is well established, there is conflicting evidence regarding the benefits of antibiotic administration in women in preterm labor. OBJECTIVES: We attempted to determine the effect of antibioticotherapy in mothers on congenital neonatal infection. MATERIALS AND METHODS: The study group consisted of 1049 pregnant women with imminent preterm labor hospitalized in Clinics of The Research Institute Polish Mother's Memorial Hospital. RESULTS: 244 women delivered preterm and no significant difference in neonatal outcomes could be detected in two groups with intact membranes and preterm premature rupture of membranes. CONCLUSIONS: The results of this study do not support the routine use of antibiotic administration in women with preterm labor.

Adult↗

PubMed2005

[Early amnion rupture and fetal and newborn defects as an obstetrical and pathomorphological problem].

OBJECTIVES: Early amnion rupture (EAR, EARS, EAROD) may be the cause of amniotic bands and sheets development, which may lead to different fetal defects--from minor finger amputation, chiloschisis or palatoschisis to major amputation, acranius, deep paroschisis or broad body covering cleavage. DESIGN: The aim of this report was to analyse cases of fetal malformation, which might have been caused by EARS. MATERIALS AND METHODS: A retrospective analysis of 3173 autopsies performed within a span of 14 years (1989-2003). RESULTS: Among 744 cases of malformations 14 cases of fetuses and newborns presented developmental anomalies, which probably were the consequences of EARS. CONCLUSIONS: The EARS is probably more frequent than it is generally presumed, but it is very often impossible to find remnants of bands and sheets. Nevertheless, the presence of at least two typical anomalies excludes a different cause than early amnion rupture and amniotic bands.

Abnormalities, Multiple↗

PubMed2004

Species distribution and influence of glycemic control on fungal infections in pregnant women with diabetes.

OBJECTIVES: (1) To find the distribution of species among fungal strains isolated from pregnant women with diabetes mellitus (DM), gestational diabetes (GDM) and healthy controls (CON); (2) to analyse the influence of glycemia on the prevalence of fungi in different body sites. METHODS: Mycological examinations were performed in 251 pregnant women: 119 diabetic (47 DM, and 72 GDM) and 132 controls. Samples were collected from vagina, rectum and oral cavity of all women and cultured on Sabouraud media. RESULTS: A total of 212 fungal strains were isolated, 12 fungal species were identified: 89.6% of the strains belonged to Candida gender, 10.4% to Saccharomyces, Geotrichum, Rhodotorula and Trichosporon genera. The prevalence of fungi, respectively, in vagina and rectum, was significantly higher in diabetics with poor glycemic control when stratified (<100 mg/dl, 100-120 mg/dl and >120 mg/dl) both the mean week glucose levels (MWGL) levels (p = 0.03, p = 0.03) and glycemia 90 min after breakfast (p = 0.04, 0.03). No difference was found in the prevalence of fungi and glycolised hemoglobin (HbA1). CONCLUSIONS: MWGL showed an association between glycemia and prevalence of fungi. However, no relation was found between HbA1 and fungal infections in well controlled diabetic pregnancies.

Adult↗

PubMed2004

Activity of hydrolytic enzymes in fungi isolated from diabetic pregnant women: is there any relationship between fungal alkaline and acid phosphatase activity and glycemic control?

Ability to respond to environmental changes and secretion of hydrolases are considered to be important for Candida virulence. In this study we determined and compared the activities of 19 different hydrolases of the fungal strains isolated from diabetic and non-diabetic pregnant women. We also looked for the presence of a relationship between hydrolase activities and glycemic control, and, furthermore, evaluated the influence of gestational age on the activity of hydrolases. Mycological examinations were performed for 119 diabetic pregnant women: 47 with diabetes mellitus type I (DM), 72 with gestational diabetes (GDM), and for 132 healthy women (CON). Samples were collected from the vagina, rectum and oral cavity and cultured on Sabouraud media. The fungal hydrolase activities were evaluated using the API ZYM test (bioMerieux). For the 19 different fungal hydrolases tested, 13 activities were present in the isolated fungal strains. The activity of alkaline phosphatase (ALP) in vaginal strains (p=0.028) and acid phosphatase (ACP) in strains from the vagina (p=0.006) and rectum (p=0.049) was significantly lower in DM than in GDM and CON women. In conclusion, we describe for the first time that fungi isolated from pregnant diabetic women have lower activity of both phosphatases compared to fungi isolated from healthy women. Furthermore, similar differences of mean ALP and ACP activities were observed in the course of pregnancy in strains from the vagina and rectum of DM and CON women. However, strains from DM had lower activity at each stage of pregnancy. The highest activity of ALP and ACP was detected at the beginning, then declined, and had the lowest values between the 24(th) and 33(rd) week of gestation. After that period the activity of both phosphatases increased.

Acid Phosphatase↗

PubMed2004

Pregnancy complications and perinatal outcome in diabetic women treated with Humalog (insulin lispro) or regular human insulin during pregnancy.

BACKGROUND: Pregnancy outcome in diabetic women is strictly related to glycemic control during pregnancy. The aim of our study was to compare pregnancy outcome between patients subjected to intensive insulin therapy using regular human insulin and those treated with insulin lispro (Humalog). MATERIAL/METHODS: Group A (n=25) was treated with Humalog, and the control group B (n=46) with regular human insulin. Mean age, duration of diabetes, presence of chronic diabetic complications (according to the White classification) parity, and BMI did not differ between groups. RESULTS: The mean HbA1c concentrations in groups A and B were respectively: 7.8+/-1.4% vs. 7.5+/-1.5% in the first trimester, 6.4+/-0.8% vs. 6.5+/-1.6% in the second, and 6.7+/-0.7% vs. 6.3+/-1.2% in the third (no significant differences). The duration of pregnancy was 36.4+/-3.9 weeks in group A and 37.1+/-1.9 weeks in group B, while the mean neonatal birth weight was 3467+/-790 and 3367+/-666 g, respectively. Neither the frequency of preterm labor and cesarean section nor the frequency of fetal macrosomia and hypoglycemia differed between groups. There was only one malformed infant in the human insulin-treated group, and no statistical difference in the rate of spontaneous abortion between groups. Also, there were no differences in the frequencies of occurrence of hypertension (essential and pregnancy induced) and urinary tract infections. CONCLUSIONS: The course of pregnancy and perinatal outcome is comparable in intensively treated diabetic women regardless of the short-acting insulin used. Humalog appears to be a safe alternative to human insulin in the treatment of diabetes during pregnancy.

Adult↗

PubMed2004

[Human metapneumovirus--new identified virus infecting human respiratory tract].

Some information regarding some characteristics of new identified virus, causing human respiratory diseases (named human metapneumovirus--hMPV) has been written. Moreover, areas of existing, frequency of infections, the possibility of diagnosis have been included. This virus has been isolated and identified by Dutch researcher, van den Hoogen, for the first time in 2001. It is suggested that hMPV belongs to Paramyxoviridae family, Pneumovirinae subfamily, Metapneumovirus genus, but it has not been confirmed by the Committee of the Taxonomy of Viruses, yet. This virus has been reported and demonstrated to be present mostly in children, but also in elderly people over 65, in Europe, North America, Australia and Asia, suggesting a worldwide distribution. Serological studies showed that all children in Netherlands had been exposed to hMPV by the age of 5; it means that infections with hMPV are common in the childhood. The presence of antibodies in retrospective serum and the presence of virus in numerous retrospective specimens taken from individuals with respiratory infections in which an etiologic agent was not initially detected indicates that this virus had been circulating in human beings for at least 50 years. Clinical diseases associated with hMPV appears to be similar to those ones associated with human respiratory syncytial virus (hRSV), ranging from mild upper respiratory tract infection to bronchiolitis and bronchopneumonia. Preliminary studies indicate that hMPV should be added to the list of pathogens associated with severe respiratory tract infections in immunocompromised patients and in chronic respiratory diseases patients (eg. asthma).

Adult↗

PubMed2003

Lymphocyte subset distribution and cytokine secretion in third trimester decidua in normal pregnancy and preeclampsia.

BACKGROUND: Excessive Th1 activity in peripheral blood plays a probable role in the pathogenesis of preeclampsia. The aim of the study was to investigate whether disturbed local immune reactions are also present in decidua. METHODS: Flow cytometric analysis of CD3, CD19, CD56/CD16, CD4, CD8, CD4/CD29, CD4/CD45RA, CD4/CD45RO, CD8/CD28, CD3/CD69 lymphocyte subsets isolated from third trimester decidua of pregnants with preeclampsia (n=21) and pregnant controls (n=11) subjected to elective caesarean sections. Spontaneous and phytohemaglutynine stimulated "in vitro" secretion of IL-2, IL-4, IL-6, IL-10, IL-12, IFN-gamma and TGF-beta by decidual lymphocytes was studied by ELISA. For the statistical significance of differences between the groups the U Mann-Whitney test was performed (confidence interval P<0.05). RESULTS: Preeclamptic patients were characterized with an increased percentage of the CD3-/CD56+CD16+, CD8+/CD28+ and decreased percentage of CD3+, CD19+, CD4+/CD45RA+ lymphocytes. The profile of secreted cytokines shifts in favor of Th1 activity (extremely high IFN-gamma and low IL-6 and IL-10 secretion). Decidual IL-12 secretion in preeclamptic patients is decreased compared to controls. CONCLUSION: Changes in NK and T lymphocyte subsets followed with Th1 cytokine IFN-gamma over-activity, could affect local immunoregulatory mechanisms in third trimester decidua of preeclamptic patients.

Antigens, CD↗

PubMed2003

[Wernicke's encephalopathy due to hyperemesis gravidarum].

A report of 33 years old female with Wernicke's encephalopathy is presented. The disease was secondary to hyperemesis gravidarum, started from the 6th week of pregnancy. Neurological symptoms as nystagmus, headache, vertigo, disturbance of consciousness and ataxia are described, as well as difficulties in finding out the right diagnosis. We present the therapy with vitamin B1. The subsequent course of the pregnancy was uncomplicated and resulted in a birth--by caesarean section of a healthy male infant, weighted 2790 grams. However, four months later after the delivery, the patient is not yet completely recovered and still demands thiamine supplementation.

Adult↗