Biomedical subjects

Jerzy Sikora

Publications and source records attributed to Jerzy Sikora.

9 recordsLinked to original sources

PubMed2006

The obstetrical history in patients with Pfannenstiel scar endometriomas--an analysis of 81 patients.

INTRODUCTION: The participation of immune tolerance during pregnancy was suggested to be an important factor predisposing to the implantation of decidual cells after cesarean section in Pfannenstiel scar. Delivery at term is related to the termination of immune tolerance to fetal antigens that is maintained throughout pregnancy. Substantial proportion of cesarean section deliveries is performed before the onset of true term labor. The aim of this study was to analyze the clinical symptoms of spontaneous beginning of labor in pregnant women in whom cesarean sections were performed and in whom Pfannenstiel scar endometriomas were observed during follow-up. MATERIALS AND METHODS: We have retrospectively analyzed 81 patients following the surgical removal of scar endometrioma after cesarean section. Obstetrical histories of cesarean sections in the number of 5,370 preceding the occurrence of the scar endometrioma were analyzed. These data were collected in six different Gynecological and Obstetrical wards in Malopolska Province in Poland. Analysis of data was started by the retrospective evaluation of regular uterine contractions, uterine cervix ripening before cesarean section and the indications for surgery. RESULTS: In 67 women from the group of 81 patients cesarean sections were performed with unripe uterine cervix and without the presence of regular uterine contractions. Elective indications for cesarean sections were predominant in this group of women. The relative risk of scar endometriomas occurrence following cesarean sections performed before onset of labor in comparison to cesarean sections following spontaneous onset of labor was statistically significantly higher [RR = 2.16, 95% CI = 1.21-3.83; OR = 2.18, 95% CI = 1.22-3.89]. CONCLUSIONS: Cesarean section performed before spontaneous onset of labor may increase substantially the risk of occurrence of scar endometriomas.

Adult↗

PubMed2004

[Significant aortic valve stenosis in the prenatal period--diagnosis, treatment, outcome. Two-center study].

OBJECTIVE: Retrospective analysis of the spectrum of fetal aortic valve stenosis with completed neonatal follow-up. METHODS: Fetal echocardiograms of 12 fetuses with aortic stenosis (AS) were analyzed. Mean gestational age at the time of diagnosis was 29.6 weeks. RESULTS: In all 12 cases critical AS has been detected. The left ventricle was estimated as small in three cases, in 7 cases as enlarged and hypokinetic LV (SF<28%) and in the next two cases the LV was well formed. In 6 AS cases, endocardial fibro-elastosis has been detected. Six fetuses presented mitral valve insufficiency; in three cases small LV mitral valve stenosis was diagnosed. Cardiomegaly occurred in 7 cases, including 5 cases with HA/CA > 0.5. Hypoplastic aorta has been detected in 2 cases and in one coarctation of the aorta. Retrograde flow in aortic arch and poor left ventricular function was diagnosed in ten cases. In 2 fetuses extracardiac malformations were present: hydrocephalus and pylorostenosis. In 83% of the cases CS had been performed and 17% were delivered vaginally (2 intrauterine fetal deaths). Four neonates had been qualified to percutaneous balloon valvuloplasty, in three cardiac surgery had been performed. Three neonates with AS (25%) survived--two after valvuloplasty (one of them required also cardiac surgery) and one after Norwood procedure. CONCLUSIONS: 1. Poor prognostic factors for neonates with critical fetal AS were as follows: small LV, retrograde flow in aortic arch, poor left ventricular function and presence of extracardiac anomalies. 2. Neonates who survived with fetal SA, had isolated CHD and well formed LV (also with endocardial fibroelastosis).

Aortic Valve Stenosis↗

PubMed2003

Androgen and SHBG serum concentrations in late post-menopause women.

BACKGROUND: The purpose of our study was to evaluate androgen and SHBG concentration in the blood serum of late post-menopausal women. MATERIAL/METHODS: We examined women between 65 and 75 years of age and compared their results to those of a group of women in reproductive age. All the subjects, in addition to medical and gynecologic examinations, had determinations done of bound testosterone, free testosterone, androstenedione, dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulphate (DHEAS), sex hormone binding globulin (SHBG), and estradiol. RESULTS: The mean concentration of bound testosterone was found to be higher in postmenopausal women than in young women. The concentration of free testosterone did not vary, while the concentration of androstenedione was lower in the postmenopausal women, as were the DHEA and DHEAS concentrations. The mean SHBG concentration was higher in the postmenopausal women, and lower in obese postmenopausal women than in non-obese women. No differences were found in terms of the examined parameters between subjects with cardiovascular diseases and those without, or between smokers and non-smokers. CONCLUSIONS: The extinction of ovary function and aging of a woman is related to secondary changes of androgen concentrations in blood serum. In late postmenopausal women, the SHBG concentration increases, which is related to the increase of total testosterone concentration in blood serum. Obesity affects the reduction of SHBG concentration in blood serum in postmenopausal women. Cardiovascular diseases and smoking have no significant effect on androgen concentration and SHBG changes in blood serum in postmenopausal women.

Adult↗

PubMed2003

[Analysis of cases with fetal extrasystole coexisting with cardiac and extracardiac pathology].

OBJECTIVE: The paper presents a review of cases with fetal extrasystole coexisting with different cardiac and extracardiac pathology. DESIGN: The aim of the study is to analyse the results of echocardiographic examinations of fetuses with premature atrial contractions (PAC) quantitatively significant (bigeminy, trigeminy) or coexisting with other abnormal findings in fetal heart or other extracardiac pathologies. MATERIAL AND METHOD: Selected group of 33 (24%) fetuses from 135 with fetal extrasystole was analyzed. The mean gestational time of diagnosis was 29.2 + 4.1 weeks. RESULTS: Quantitatively significant arrhythmia (bigeminy, trigeminy) was diagnosed in 14 fetuses. Blocked PAC (2:1) occurred in two cases causing fetal bradycardia. Premature atrial extrasystole coexisting with different type of arrhythmias were diagnosed in 10 cases (4 x with SVT, 4 x with sinus bradycardia, 2 x with ventricular extrasystole). Heart defects in the analyzed group with PAC were recognized in two fetuses (1 x d-TGA, 1 x heterotaxy syndrome--common a-v canal). Myocarditis was diagnosed in 3 (9%) cases. From the group of 33 fetuses 6 newborns died (1 x d-TGA, 1 x T18, 1 x myocarditis, 1 x circulatory centralization). Mortality in the analyzed group was 18.2%. CONCLUSION: In cases of fetal arrhythmias echocardiography should be widely applied in order to evaluate the kind of arrhythmia, sufficiency of circulation and coexistence of heart defects, extracardiac malformations or functional abnormalities with arrhythmia in fetal circulation.

Arrhythmias, Cardiac↗

PubMed2003

[Significance of group B streptococcus (GBS) infections in parturient women].

OBJECTIVES: Maternal infections of group B streptococcus (GBS) has recently been associated with preterm labor and early onset of neonatal infections. DESIGN: The aim of this study was to determine the incidence of GBS infections in parturient women, as well as, GBS infections influence on the pregnancy duration, cesarean section rate, birth weight and Apgar score. MATERIALS AND METHODS: A total of 701 cervical swabs were taken and cultured from pregnant women, who came to delivered to Department of Obstetrics and Gynaecology of Silesian Medical School from 1st of January to 30th of September 2002. Results of cervical swabs cultures were clinically analyzed. Mann Whitney test was used to perform statistical analysis. RESULTS: In 23 of 701 women (3.3%) who were admitted to our department GBS infections were detected. In women with GBS, preterm birth and low birth weight, as well as, low Apgar score were more frequently observed. CONCLUSIONS: Positive--GBS infection cervical swabs was found in 23 of 701 parturient women (3.3%) who were admitted to our department. In women with GBS, higher preterm birth rate, as well as, higher cesarean section rate performed because of intrauterine infection were observed, but the differences were not statistically significant.

Adult↗

PubMed2003

[Prenatal and postnatal cardiologic evaluation of normal twin from acardiac twin pregnancy--case report].

The aim of the paper was to describe dynamic changes in 'pump twin's' circulatory system within clinical observation, indication analysis for premature delivery due to cardiovascular findings and long-term postnatal follow up. In echocardiographic examination of 'pump twin' no structural heart defects but functional changes in cardiovascular system have been detected (cardiomegaly, right heart disproportion, tricuspid valve regurgitation). Within 10-week observation polyhydramnios did not increased significantly, no amnioreduction procedures had been performed. Due to single umbilical artery in 'pump twin' a cytogenetic examination had been performed revealing a normal karyotype. When the first signs of abnormal Doppler flows appeared such as increased PI of umbilical artery and DV and cardiomegaly with TR--caesarean section was performed at 33 weeks of gestation. Echocardiography performed in the first day of life findings: right atrium and ventricle enlargement, significant tricuspid valve regurgitation (V max 3 m/s), a prenatally undetected, small perimembrane-part ventricular septal defect. At the age of 6-months a non-significant VSD with tricuspid valve septal leaflet closure and ASD II has been confirmed. The infant is systematically followed-up by paediatricians, cardiologists and neurologists and her further neurodevelopment appears to be slightly retarded.

Adult↗

PubMed2003

[Analysis of mode of delivery in cases with fetal premature atrial contractions].

OBJECTIVE: Premature atrial contractions are common in obstetrical practise but there is little information available on recommended management and mode of delivery. DESIGN: The aim of the study was to describe our clinical experience in the management of fetal arrhythmia including the indications for certain time and way of labour. MATERIALS AND METHODS: 128 fetuses with diagnosed supraventricular arrhythmia described as atrial extrasystole were examined. They were divided into 3 main groups: group I (84 fetuses) with single PAC, group II (37 fetuses) with quantitatively significant arrhythmia or accompanied by another kind of arrhythmia and group III (7 fetuses) associated with extracardiac abnormalities. RESULTS: Among 128 fetuses with supraventricular arrhythmia, 44 cases (31%) required systematic monitoring. Quantitatively significant arrhythmia was recognized in 15 cases, blocked bigeminy (2:1) in 2 fetuses, 10 cases were accompanied by another arrhythmias: 4x SVT, 4x sinus bradycardia, 2x premature ventricular contractions (PVC). There were 3 fetuses diagnosed with heart defects and 7 with extracardiac malformations. Fetal echocardiography revealed additional functional circulatory changes in 7 fetuses with premature atrial contractions. Myocarditis was recognized in 2 fetuses. The mode of delivery was analyzed in 128 cases. In the first group 27 patients (32%) underwent caesarean section, in the second group--23 (62%), in the third group 3 patients (43%), respectively. Cardiac indications for caesarean section equalled 22% of all the indications occurring in fetuses suffering from arrhythmia. CONCLUSIONS: Caesarean section is much more commonly performed among fetuses diagnosed with arrhythmia accompanied by another fetal anomalies comparing to the group of fetuses with isolated arrhythmia. Although there are no particular cardiac indications for such way of delivery, total amount of caesarean sections performed in that group is really great. Above all, it may suggest that the obstetrician is under pressure of stress while making decision concerning caesarean section performance, even when there are no other indications and the condition of fetus is stable enough.

Adult↗

PubMed2002

[Do preterm infants differ from healthy newborns by endothelin para/endocrine function?].

We measured plasma concentration of endothelin-1 (ET-1), nitric oxide metabolites (NOx) and von Willebrand factor (vWF) in maternal and umbilical cord blood in 11 spontaneous (SN), 11 elective cesarean section (CC) and 13 preterm deliveries. Plasma concentrations of ET-1 in umbilical cord blood of preterm infants and systemic blood withdrawn 4 days after birth was higher then in respective healthy infants delivered by natural forces or elective cesarean section. Positive correlation were found between ET-1 and NOx (p < 0.05) and between ET-1 and vWF (p < 0.05) in maternal blood with preterm delivery. In umbilical cord of preterm infants a negative correlation between ET-1 and Apgar score was noticed. Higher concentrations of ET-1, NOx and vWF found in umbilical cord blood of preterm infants as compared with respective values assessed in healthy infants delivered per vaginam or by cesarean section respectively seem to be induced by hypoxia.

Cesarean Section↗

PubMed2002

[Diagnostic problems in recognizing structural pathology of the heart during the prenatal period].

The aim of our study was to analyse the results of echocardiographic examinations of 28 fetuses with structural heart abnormalities referred for echocardiographic examination from January 1996 to May 2001 along with their follow-up. Fetal heart anomalies were diagnosed in 2.1% of all of the examined fetuses (28/1319). Among 28 cases of structural anomalies, there were 23 cases of heart defects, 4 cases of cardiomyopathy, and one case of intracardiac tumors. In 5 cases, heart defects were accompanied by arrhythmias while in 2 cases, heart defects were accompanied by congestive heart failure. Extracardiac malformations coexisted with heart defects in 11 fetuses. Eight newborns were operated shortly after birth. The mortality rate in the examined group was 64%.

Arrhythmias, Cardiac↗