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Biomedical subjects

Krzysztof Czajkowski

Publications and source records attributed to Krzysztof Czajkowski.

At least 19 recordsLinked to original sources
PubMed2006

Uteroplacental circulation in early pregnancy complicated by threatened abortion supplemented with vaginal micronized progesterone or oral dydrogesterone.

OBJECTIVE: To compare the influence of vaginal micronized progesterone and oral dydrogesterone supplementation on uteroplacental circulation in early pregnancy that is complicated by threatened abortion. DESIGN: Randomized, parallel group, double-blind, double dummy-controlled study. SETTING: Tertiary care university hospital. PATIENT(S): Fifty-three patients with threatened abortion and a living embryo. INTERVENTION(S): Three hundred milligrams of micronized vaginal progesterone or 30 mg of oral dydrogesterone daily supplementation for 6 weeks, serial transvaginal Doppler ultrasound measurement of pulsatility index, resistance index, and systolic/diastolic ratio of the spiral arteries, the uterine arteries, and the intrachorionic area. MAIN OUTCOME MEASURE(S): Uteroplacental blood flow. RESULT(S): The study demonstrated that vaginal progesterone administration, but not oral dydrogesterone treatment, results in the decrease in the spiral artery pulsatility and resistance index and systolic/diastolic ratio. Insignificant decrease in pulsatility index and resistance index of the uterine artery was observed at >9 weeks and was not associated with treatment regimen. Dydrogesterone treatment was only accompanied by the decrease in the uterine artery systolic/diastolic ratio. CONCLUSION(S): Vaginal progesterone and oral dydrogesterone supplementation have a different influence on the uteroplacental circulation in early pregnancy that is complicated by threatened abortion.

Abortion, Threatened↗
PubMed2005

[Course of pregnancy and delivery in patients with pregestational diabetes mellitus].

INTRODUCTION: Pregnancy in a woman with pregestational diabetes mellitus (PGDM) is associated with increased risk of complications in both the mother and the fetus. A close surveillance is strongly recommended in these pregnancies. OBJECTIVES: The aim of the study was to assess perinatal outcome in pregnancies complicated by PGDM. STUDY DESIGN: The study covered 127 pregnancies with PGDM. Apart from perinatal outcome the patient's age, past obstetric history, the duration of perinatal diabetic care and the course of pregnancy were taken into consideration. Diabetes mellitus was classified according to White. RESULTS: 37.8% of patients were diagnosed PGDM B class, 38.6%--C class, 15.7%--D class, 1.6%--F class and 6.3%--RF class. Less than half of women (45.5%) remained under medical care since the first trimester. The arterial hypertension was the most common complication of pregnancy and occurred in over 18% of studied pregnancies. The incidence of preterm delivery was 41.7%. Cesarean section was performed in 55.9% of patients. 16.6% of the neonates had a birth weight below 2500 g. 4 neonates were stillborn (2.4%) and the next 3 ones (2.4%) died within the first month following the delivery. Congenital heart defects were found in 8.7% of offsprings. CONCLUSIONS: Despite the progress in perinatal care pregestational diabetes mellitus is still associated with increased risk of maternal and fetal mortality and morbidity.

Female↗
PubMed2005

[Epidural analgesia and the course of delivery in term primiparas].

OBJECTIVES: Epidural analgesia provides the most effective pain control during labor. Of great concern is its influence on the course of delivery and perinatal complications. DESIGN: The aim of the study was to assess the effect of epidural analgesia on the course of delivery and perinatal outcome. MATERIALS AND METHODS: 609 deliveries among 1334 (323 women with epidural analgesia (53%) and 548 without epidural analgesia (47%)) met the following criteria: primipara, singleton, live pregnancy, > =37 weeks' gestation, cephalic presentation of a fetus, lack of contraindication for vaginal delivery. The incidence of instrumental deliveries and fetal distress, duration of the first, second and third stage of labor, perinatal outcome, perinatal complications and perinatal blood loss and were analyzed. RESULTS: The incidence of fetal distress during second stage of labor was significantly higher in the epidural group (12.69 vs. 6.99%, P=0.02). The incidence of fetal distress during first stage of labor did not differ in both groups (10.53% vs. 8.74%, NS). Cesarean sections rate was similar in epidural and non-epidural group (17.7 vs. 18.2%, NS). Among vaginal deliveries duration of the first and second stage of labor was longer in epidural group (6.5+/-2.4 vs. 5.4+/-2.5 godz., P=0,000003 and 47.3+/-34.8 vs. 29.1+/-25.8 min., P=0.000003) and this was independent of period of time between onset of first stage of labor and epidural analgesia. Oxitocin use was significantly more frequent in the epidural group (20.6 vs. 10.3%, P<0.004). There were no statistically significant differences in the rates of instrumental vaginal deliveries, 1 and 5-minute Apgar scores, length of third stage of labor and perinatal blood loss in patients with and without epidural analgesia. Perinatal outcome did not depend on previous use of epidural analgesia or mode of analgesia for the operation in cesarean section subgroup. CONCLUSION: Epidural labor analgesia is associated with slower progress of labor but has no adverse effect on perinatal outcome and perinatal complications.

Adult↗
PubMed2004

Renal function and lipid metabolism in pregnant renal transplant recipients.

OBJECTIVE: To estimate renal function and lipid metabolism in pregnant renal transplant recipients. STUDY DESIGN: The study covered 64 women during the third trimester of pregnancy including 33 renal transplant recipients (the study group) and 31 healthy women (the control group). Serum concentrations of uric acid, urea, creatinine, electrolytes, total protein, albumin, acid-base balance and blood cell count were examined to assess renal function. Moreover, the levels of the following lipid metabolism parameters were estimated: (1) total lipids (TL), (2) total LDL fraction (TLDL), (3) total cholesterol (TCh), (4) free cholesterol (fCh), (5) free/total cholesterol (fCh/TCh) ratio, (6) phospholipids (PhL), (7) total cholesterol/phospholipids (fCh/PhL) ratio, (8) triglycerides (TG), (9) HDL-cholesterol (HDL-Ch), (10) LDL-cholesterol (LDL-Ch) and (11) LDL-Ch/HDL-Ch ratio. 'The effect of immunosuppressants (cyclosporine, prednisone and azathioprine) on serum lipid levels was estimated in the study group. The mean maternal age, gestational age and BMI did not differ in both groups. RESULTS: Pregnant renal transplant recipients presented mild renal insufficiency during the third trimester resulting in the increase in serum level of uric acid (P<0.001), urea (P<0.001), creatinine (P<0.001), and Cl- (P<0.001). Proteinuria (1.19+/-1.9 g/24 h) leading to hypoproteinemia (P<0.001) and hypoalbuminemia (P<0.05) confirmed renal function impairment in the study group. Additionally, the diagnosis of renal insufficiency was supported by mild acidosis reflected by a drop in pH (P<0.001). standard HCO3- (P<0.001) and base excess (P<0.001). The women with renal grafts presented vital lipid metabolism disturbances illustrated by the elevated levels of: (1) TL by 72% (P<0.001), (2) TLDL by 21% (P<0.001), (3) TCh by 16% (P<0.001), (4) fCh by 34% (P<0.001), (5) fCh/TCh ratio by 21% (P<0.001), (6) PhL by 28% (P<0.001), (7) TG by 53% (P<0.001), (8) LDL-Ch by 13% (P<0.05) and (9) LDL-Ch/HDL-Ch ratio by 23% (P<0.001). No difference in HDL-Ch level between the two groups was found. Hyperlipidemia in pregnant kidney recipients was associated with immunosuppressive treatment and depended on cyclosporine treatment regimen. Treatment with azathioprine and prednisone was associated with elevated serum levels of examined lipids. CONCLUSION: Serum lipid abnormalities are significantly influenced by the administered dosages of immunosuppressants.

Acidosis↗
PubMed2004

Extremely elevated activity of serum alkaline phosphatase in gestational diabetes: a case report.

We report a case of a 25-year-old pregnant woman with gestational diabetes and increased activity (25-fold) of placental isozyme of alkaline phosphatase. Abdominal ultrasonographic scan revealed no hepatobiliary disease. After delivery, the alkaline phosphatase level decreased but did not return to the reference range. Similar abnormalities were found in the patient's first-degree relatives, which included a mother and a sister.

Adult↗
PubMed2004

[Newborn of a mother with HELLP syndrome].

HELLP syndrome is a serious complication of pregnancy with characteristic appearances between 22 to 26 weeks of gestation. Clinical classification in three groups, is based on platelet count. Early diagnosis and appropriate management allow women to achieve a mortality rate below 1%. Neonatal complications are strongly associated with a newborn's immaturity and class of HELLP syndrome. In both presented cases despite identical maternal treatment (steroids because of I st class of HELLP syndrome) neonatal clinical courses were different due to the differences in gestational age. However, appropriate prenatal and neonatal care in tertiary centers was successful.

Adult↗
PubMed2004

[Genetic amniocentesis in the II Department of Obstetrics and Gynecology of the Medical University of Warsaw].

OBJECTIVE: Characteristic of patients, indications, outcomes and complications of genetic amniocentesis. MATERIAL AND METHODS: Retrospective analysis of 420 women who underwent genetics amniocentesis from January 1999 to 2001. It was done by ultrasound-guided insertion of a 22-gauge needle from 12 to 19 week's gestation. From 9 ml to 24 ml of amniotic fluid were removed for cytogenic analysis. RESULTS: The mean maternal age was 37.6 +/- 4 years. The mean gestational age of amniocentesis was 14.2 +/- 1.2 weeks. 416 (99%) women were in singleton pregnancy, 3 (0.7%) in twin pregnancy and one (0.2%) in triplet pregnancy. The most common indication for amniocentesis was maternal age over 35 years (366 cases - 87%). Chromosomal abnormalities were identified in 23 cases (5.5%). Any neural tube defects were observed. In 6 (1.4%) cases the cell culture of amniotic fluid was unsuccessful and procedure was repeated. 2 (0.4%) women lost pregnancy during 7 days after procedure. 4 patients (0.9%) had amniotic fluid leakage, of which no ended in fetal loss. 1 (0.2%) had pain in hypogastrium after amniocentesis, all delivered at term. CONCLUSIONS: The pregnancy loss rate in women who underwent genetics amniocentesis was 0.4%. The most common indication for genetic amniocentesis was maternal age over 35 years. Chromosomal abnormalities were detected in 5.4% of the fetuses.

Adult↗
PubMed2003

[Assessment of pregnancy and labour outcome and the condition of the newborn in primiparous women aged 35 and older].

OBJECTIVE: To assess the effect of maternally advanced age on pregnancy and labour outcome. MATERIAL AND METHODS: Pregnancies of 95 primiparous women aged 35 or older were compared with pregnancies of 130 women aged 20-30 with respect to pregnancy complications and labour outcome. RESULTS: Women aged 35 or older had cesarean section three times as often as women in the 20-30 year group old. Advanced maternal age compared with younger age was associated with a significantly higher rate of diabetes, hypertensive disorder, thrombocytopenia and intrauterine growth retardation. CONCLUSIONS: Primiparous women aged 35 or older are at an increased risk of complications in pregnancy and are at a higher risk of cesarean section compared with younger women.

Adult↗
PubMed2003

[Pregnancy and delivery course in patients with gestational diabetes mellitus].

OBJECTIVES: The aim of the study was to assess mother and fetal outcome in gestational diabetic women. MATERIALS AND METHODS: The study covered 689 patients with gestational diabetes mellitus. All women had been taken care of II Department of Obstetrics and Gynecology Warsaw Medical University in 1997-2001 years. The following parameters were analyzed: the patients ages, past obstetric experience, gestational age of GDM diagnosis, pregnancy complications, delivery course and neonatal outcomes. RESULTS: Among study group 11.9% patients required insulin to maintain blood glucose concentration in normal range. GDM was mostly (44.1%) diagnosed between 29 and 34 weeks of pregnancy. At the recommended gestational age of screening tests--24-28 weeks--there were detected only 33.4% GDM. The most frequent pregnancy complication was imminent preterm delivery (16.7%). Delivery at term occurred of 89.1% of cases. Percentage of preterm deliveries was 10.9%. Spontaneous vaginal deliveries were the most frequent (72.5%). 23.2% women were delivered by Cesarean section. The most frequent indication of surgical labor were the symptoms of intrauterine fetal asphyxia (35.6%) and cephalo-pelvic disproportion (26.3%). Most of the newborn (83.3%) had normal birth weight between 2500 g and 4000 g. Among infants the most frequent complications were: hyperbilirubinemia (17.3%) and hypoglicemia (15.6%). Intranatal death occurred in 0.1% of cases, whereas neonatal death--0.4%. Congenital defects were found in 4.3% of all offspring. The most frequent congenital malformation was heart defect--1.3% of newborns (almost half of all congenital defects) CONCLUSIONS: Early diagnosis of gestational diabetes mellitus and specialists obstetric surveillance prevent of pregnancy complications and perinatal mortality, morbidity.

Adult↗
PubMed2003

[Evaluation of fetal heart anatomy at the end of the first trimester and the beginning of the mid-trimester].

OBJECTIVE: To evaluate fetal heart anatomy in the late first and in the early second trimester. MATERIALS AND METHODS: The study included 75 fetuses between 11 and 19 weeks' gestation. Exams were performed using transabdominal or transvaginal probes. RESULTS: The proportion of cases successfully visualized to all cases in particular week of pregnancy was following: 11 week--0/1 (0%), 12--1/1 (100%), 13 week--1/1 (100%), 14--18/23 (79%), 15--6/9 (67%), 16--23/27 (86%), 17--4/5 (80%), 18--6/6 (100%), 19--2/2 (100%). In 11 weeks' gestation two ventricles and two atrias could be imaged. Anatomy was seen from 12 weeks' gestation with transvaginal and from 13 weeks' gestation with transabdominal transducers. Two tricuspid regurgitations were detected. The interventricular septum was the most difficult structure to visualize in all cases. The grey scale alone was not sufficient for accurate examination of the heart and it was necessary to use colour Doppler to confirm normal forward flow to both ventricles and to identify outflow tracts. CONCLUSIONS: 1. Successful visualization of the heart in early pregnancy is possible from 12 weeks' gestation with transvaginal and from 13 weeks' gestation with transabdominal probe. 2. Fetal echocardiography between first and second trimester should lead to better understanding of fetal hemodynamics in normal and abnormal fetuses and help to introduce new therapeutic treatment in some cases.

Abdominal Wall↗
PubMed2003

[Analysis of complications of the tension-free vaginal tape procedure for surgical treatment of female stress urinary incontinence].

OBJECTIVE: The most common types of urinary incontinence in women are stress, urge and mixed incontinence. Stress urinary incontinence may be caused by an urethral hypermobility and internal sphincter deficiency (ISD). There are over 100 different surgical procedure for the treatment of female stress incontinence. Tension-free vaginal tape (TVT) is a new anti-incontinence surgical technique which was first described by Ulmsten in 1996. The aim of the study was to evaluate the complications of tension-free vaginal tape (TVT) for the surgical treatment of female stress incontinence. METHODS: The study group was consisted of 162 women, aged 32-84. All patients had a basic evaluation that included a history, frequency/volume chart, questionnaire of micturition (self-made), physical examination, stress test, Bonney test, urinalysis and bacterial culture of urine. Women with mixed urinary incontinence and who underwent surgical treatment of SUI in the past had been done urodynamic investigation. The operation was carried out under epidural, subarachnoid and general anesthesia. The TVT procedure was performed as described by Ulmsten. The follow-up was done after 1 day, 1 and 3 and 6 months since the operation. RESULTS: Among complications related to the procedure were 11 cases of cystotomy, 5 cases of urinary retention requiring four days catheterization, 3 cases of bleeding from the vagina, 14 cases of detrusor instability de novo. In 4 cases occurred postoperative obstinate pain. In 4 cases occurred recurrent urinary tract infection. None complication required invasive treatment. No evidence of defect healing or rejection of the tape was found. CONCLUSIONS: We conclude that the TVT procedure is safe method of the surgical treatment of urinary stress incontinence associated with a low complications.

Adult↗
PubMed2002

Stimulation of TNF-alpha production by 2-(1-adamantylamino)-6-methylpyridine (AdAMP) - a novel immunomodulator with potential application in tumour immunotherapy.

The immunomodulatory effects of a recently synthesized adamantane derivative of aminopyridine - 2-(1-adamantylamino)-6-methylpyridine (AdAMP) - were tested on normal and neoplastic cells in vitro. When incubated with TNF-alpha gene-transduced mouse melanoma cells (B78/TNF), AdAMP significantly enhanced basal production of TNF-alpha by these cells, both by "high" and "moderate" TNF-alpha-producer cells. A similar TNF-alpha production-enhancing effect was observed in cultures of human ovarian carcinoma cells (CAOV1) which spontaneously produce TNF-alpha but not in cultures of tumour cells incapable of TNF-alpha secretion. RT-PCR analysis showed that the enhancement of TNF-alpha production by AdAMP was associated with an increase in TNF-alpha mRNA expression in the treated cells. The results of an electrophoretic mobility shift assay (EMSA) showed that AdAMP significantly activated nuclear factor kappaB (NF-kappaB) in both CAOV1 and B78/TNF cells. The role of NF-kappaB in enhancement of TNF-alpha production was confirmed in experiments in which MG132, an inhibitor of NF-kappaB activation, reversed the effect of AdAMP. Unexpectedly, dexamethasone, a potent antiinflammatory agent and a strong inhibitor of TNF-alpha production in vivo, increased both spontaneous and AdAMP-augmented production of TNF-alpha in in vitro cultures of ovarian carcinoma cells and B78/TNF cells. AdAMP also enhanced TNF-alpha secretion by LPS-induced monocytes. AdAMP-induced augmentation of TNF-alpha production by B78/TNF cells was accompanied by morphological changes in the treated cells and a decrease in their adherence to fibrinogen and collagen IV. In view of these properties, AdAMP seems to be a therapeutically promising compound with potential application as an adjuvant augmenting the efficacy of cancer vaccine-based therapies or in the local treatment of certain tumours.

Adamantane↗
PubMed2002

[Curettage immediately after delivery].

The purpose of the study was to compare indications for curettage directly after delivery with histologic findings. Only in 51% there was a histologic confirmation of placental or membrane tissue. Residences indications of the suspected retained placenta were wrong in 70% cases. The curetting of 75% of the patients experiencing post partum bleeding revealed no fragments of placental or membrane tissue.

Adolescent↗
PubMedDate not supplied

[Sex during pregnancy and risk of premature labour].

Sexual life in pregnancy may be connected with preterm delivery. This fact, which is observed in clinical practice, is not confirmed by, references. There are no modern, well conducted trials about the risk of premature labour as a result of sexual activity. The concentration of fetal fibronectin is false, when the examination is performed before 24 hours from the last sexual intercourse.

Coitus↗
PubMedDate not supplied

[Sexuality in pregnant women].

The aim of the study was to evaluate the effects of pregnancy on women's sexuality. The studies were conducted using questionnaires to interview 120 women from 35 weeks' of gestation or just after the delivery. There were no medical contraindications for sexual intercourse in pregnancy in this group. More than half of respondents reported a decrease in libido during gestation. A reduction in coital frequency, oral intercourse, gratification of coitus, caress of breasts or genitals and erotic dreams occurred during pregnancy. Lateral position was mainly used during coitus in pregnancy. Most of women didn't discuss the problems of sexual activity in pregnancy with their obstetricians.

Adult↗
PubMedDate not supplied

[Effectiveness of cervical cerclage and pessary in the treatment of isthmo-cervical insufficiency].

The aim of this study was comparison of gestation, labour, puerperium and condition of newborns in women with cervical incompetence treated with cerclage or pessary. The interval from treatment to delivery was longer in women with pessary. In women who had cervical cerclage tocolysis was applied more frequently. Among patients with pessary kolpitis was found more often. Gestational age at delivery, the way of a labour, condition of newborns and complications during puerperium didn't differ significantly between both groups.

Adolescent↗
PubMedDate not supplied

[Effect of bethametasone on blood cell count and C-reactive protein in patients with threatened preterm delivery].

UNLABELLED: The objective of the study was to determine changeableness of blood cells count, hemoglobin (HGB) and hematocrit (HCT) within the peripheral blood of patients who received betamethasone during treatment of threatened preterm delivery. 65 patients at increased risk of preterm delivery received intramuscular injections of betamethasone 3 x 4 mg/day for fetal lung maturity and to decrease the risk of CNS trauma in newborns. RBC, HGB, HCT, WBC, neutrophils count and CRP level were measured before treatment and on the 1th, 2nd and 7th days after first dose of betamethasone. The steroid administration caused a significant decrease in RBC, HGB and HCT: The lowest levels were noticed on 2nd day. Statistically significant changes were observed between before and 1st day (p < 0.0001), before and 2nd day (p < 0.0001), before and Ist week (p < 0.05), 1st day and 1st week (p < 0.006), 2nd day and Ist week (p < 0.005). The level of WBC and neutrophils were increased. Their peak levels were noticed on 1st day. Statistically significant changes were observed between before and 1st day (p < 0.0001), before and 1st week (p < 0.0003), 1st day and 1st week (p < 0.0001), 2nd day and 1st week (p< 0.001). After 3 days there was a significant decrease of WBC and neutrophils count. CONCLUSIONS: Intramuscular administration of 12 mg betamethasone per day caused decrease of the RBC, HGB and HCT account and elevation of the WBC and neutrophil count. All these parameters normalized after about 7 days.

Betamethasone↗