OBJECTIVES: In this study, we aimed to investigate serum alarin levels during the 24th to 28th weeks of gestation in women with newly diagnosed gestational diabetes mellitus (GDM), and to explore the possible correlation...OBJECTIVES: In this study, we aimed to investigate serum alarin levels during the 24th to 28th weeks of gestation in women with newly diagnosed gestational diabetes mellitus (GDM), and to explore the possible correlation between alarin levels and maternal and neonatal clinical outcomes. MATERIAL AND METHODS: A prospective cohort study including 64 women with pregnancies complicated by GDM and 64 women with healthy pregnancies (control group) was performed. Serum alarin levels were quantified using the enzyme-linked immunosorbent assay (ELISA) method, and their diagnostic utility was assessed through receiver operating characteristic (ROC) curve analysis. Furthermore, the relationships between alarin levels and various clinical parameters were statistically analysed. RESULTS: The mean maternal serum alarin levels were notably elevated in the GDM group compared to the control (12.3 ± 1.4 ng/mL vs 7.8 ± 0.8 ng/mL; p < 0.05). ROC curve analysis demonstrated a high discriminatory capacity, with an AUC of 0.84 (95% CI: 0.77-0.92). However, no statistically significant correlations were observed between alarin levels and obstetric or neonatal parameters, including gestational age at delivery, polyhydramnios, preterm birth, hypertensive complications, fetal growth restriction, APGAR scores and NICU admissions. CONCLUSIONS: Our results highlight the possible role of alarin as a promising biomarker for the identification of GDM.
This review article explores the psychological dimension of gynecological disorders in girls and young women, emphasizing the need for interdisciplinary approaches in medical care. Gynecological conditions such as endome...This review article explores the psychological dimension of gynecological disorders in girls and young women, emphasizing the need for interdisciplinary approaches in medical care. Gynecological conditions such as endometriosis, polycystic ovary syndrome (PCOS), and disorders of sex development (DSD) often co-occur with psychological challenges including depression, anxiety, body image issues, and identity-related stress. The chronic nature of symptoms, delayed diagnosis, and potential implications for fertility intensify the emotional burden, particularly during adolescence - a developmental stage crucial for self-esteem and identity formation. Psychological interventions such as cognitive-behavioral therapy (CBT), progressive muscle relaxation (PMR), mindfulness, psychoeducation, and family support are reviewed for their therapeutic potential. The integration of psychologists into gynecological teams improves communication, treatment adherence, and emotional well-being. The paper also discusses the importance of tailored communication with young patients and their families, addressing stigma, and ensuring privacy and autonomy. Incorporating psychological care into gynecological treatment contributes to a holistic model that not only addresses physical symptoms but also enhances psychological resilience, quality of life, and long-term health outcomes. The authors advocate for routine psychological screening in gynecological settings and the implementation of interdisciplinary standards of care.
OBJECTIVES: Breasts play a significant role in body image and are perceived as a symbol of femininity and sexuality, which makes a cancer diagnosis particularly difficult on an emotional level. Subjective experiences of...OBJECTIVES: Breasts play a significant role in body image and are perceived as a symbol of femininity and sexuality, which makes a cancer diagnosis particularly difficult on an emotional level. Subjective experiences of depression significantly and negatively affect the sexual lives of patients who have undergone mastectomy, thereby reducing their quality of life by influencing physical, social, and emotional aspects. MATERIAL AND METHODS: The study was conducted among 151 women diagnosed with breast cancer and took place from September 2025 to January 2026. The diagnostic survey method was employed, along with the following research tools: Female Sexual Function Index (FSFI), Beck Depression Inventory (BDI), Perceived Stress Scale (PSS-10), the Coping Inventory-Mini-COPE, and self-administered questionnaire. RESULTS: Among the studied group of patients, 47% reported a subjective feeling of depression, and 68.2% were observed to have sexual dysfunction. The FSFI scale domains correlated significantly negatively with the PSS-10 and Beck Depression Scale. The total FSFI score correlated significantly positively with the Mini-COPE scale. Only one domain, namely self-blame, correlated significantly negatively. Factors influencing sexual dysfunction included the type of treatment (immunotherapy), depressive factors, and the coping strategy of self-blame. CONCLUSIONS: The Female Sexual Function Index (FSFI) showed a negative correlation with both PPS-10 and BDI. Among the coping strategies assessed by the Mini-Cope, only one domain negatively correlated with total FSFI. Mental state and the type of treatment were significant factors influencing sexual dysfunction in women with breast cancer treated surgically.
OBJECTIVES: The aim of our study is to evaluate the tubal patency and pregnancy outcomes after tubal reanastomosis in patients who previously underwent tubal ligation but currently desire fertility. MATERIAL AND METHODS:...OBJECTIVES: The aim of our study is to evaluate the tubal patency and pregnancy outcomes after tubal reanastomosis in patients who previously underwent tubal ligation but currently desire fertility. MATERIAL AND METHODS: The study encompassed patients who underwent tubal ligation between January 2015 and November 2021 and were subsequently referred to City Hospital and University Hospital for further fertility treatment. Five patients who had undergone myomectomy with tubal re-anastomosis were excluded from the study. These patients were scheduled for hysterosalpingography (HSG) two months post-operation, and their tubal patency rates were assessed. Additionally, the pregnancy rates and outcomes were analyzed. RESULTS: The pregnancy rate following tubal re-anastomosis was 50.2%, with a live birth rate of 44.6%. Among the patients who achieved pregnancy, 74.1% reached full term. Hysterosalpingography (HSG) revealed bilateral tubal patency in 35 patients (74.4%) and unilateral tubal patency in 12 patients (25.5%). Finally, 9 patients (15.7%) declined to undergo HSG following the procedure. CONCLUSIONS: Should the patients seeking pregnancy have normal gynecological examinations, ultrasound results, hormone profiles, comorbidity screenings, and a normal spermiogram of the husband, tubal re-anastomosis should be considered, particularly in patients under 40 years of age.
OBJECTIVES: This study aimed to compare the effects of traditional childbirth (TC), water birth (WB) and the combination of WB and five-element music therapy (FEMT) on maternal childbirth experiences and clinical outcome...OBJECTIVES: This study aimed to compare the effects of traditional childbirth (TC), water birth (WB) and the combination of WB and five-element music therapy (FEMT) on maternal childbirth experiences and clinical outcomes. MATERIAL AND METHODS: A total of 314 women who delivered at our hospital between November 2022 to June 2023 were enrolled and divided into three groups: the TC group (n = 126), the WB group (n = 95) and the WB-FEMT group (n = 93), which included labour pain relief through FEMT and WB. Data were collected, compared and analysed, including labour duration, first-stage labour pain duration, postpartum blood loss, neonatal Apgar scores, scores on the Labour Agentry Scale (LAS) and scores on the Childbirth Experience Questionnaire (CEQ2.0). RESULTS: The first-stage labour duration and overall labour duration were significantly shorter in the WB and WB-FEMT groups than in the TC group (p < 0.001, respectively). Pain scores in the WB-FEMT group were significantly lower than in the WB and TC groups, and postpartum blood loss was significantly less than that in the TC group (p = 0.007). The WB-FEMT group showed the highest neonatal Apgar score (p < 0.001). Moreover, maternal satisfaction with the childbirth experience in the WB-FEMT group was higher, with significantly better LAS and CEQ2.0 scores than in the TC group (p < 0.001, respectively). CONCLUSIONS: The study demonstrates that WB and WB-FEMT are superior to TC in labour duration, pain management and postpartum recovery. The WB-FEMT combination significantly enhanced maternal psychological comfort. Offering diverse childbirth options can better meet the physiological and psychological needs of mothers, ultimately promoting the health of both mothers and newborns.
OBJECTIVES: To prospectively assess the association between pre-gestational (BMI), sonographically measured abdominal subcutaneous fat thickness (ASFT), and the total daily insulin dose required to achieve optimal glycem...OBJECTIVES: To prospectively assess the association between pre-gestational (BMI), sonographically measured abdominal subcutaneous fat thickness (ASFT), and the total daily insulin dose required to achieve optimal glycemic control in patients diagnosed with gestational diabetes mellitus (GDM). MATERIAL AND METHODS: This prospective, multicenter study included 91 pregnant women with GDM who required insulin therapy, recruited from two tertiary care centers. Demographic data, anthropometric measurements (BMI, ASFT), and laboratory parameters (oral glucose tolerance test [OGTT], HbA1c) were collected. ASFT was measured at the level of the umbilicus using a standardized ultrasound protocol. The relationships between total daily insulin dose, BMI, and ASFT were evaluated using correlation analysis. Statistical analyses were conducted using IBM SPSS Statistics 25.0, with a significance threshold of p < 0.05. RESULTS: The mean age of the participants was 31.84 ± 6.22 years. The average BMI was 31.81 ± 5.08 kg/m², and the mean ASFT was 19.36 ± 7.77 mm. The mean total daily insulin dose required to maintain glycemic control was 26.20 ± 14.35 units. Correlation analysis demonstrated a statistically significant positive relationship between the total daily insulin dose and both ASFT (r = 0.294, p < 0.01) and BMI. In addition, ASFT was positively correlated with fasting glucose levels on the OGTT (r = 0.329, p < 0.01) and HbA1c values (r = 0.313, p < 0.01). CONCLUSIONS: Elevated BMI and increased abdominal subcutaneous fat thickness are significantly associated with higher daily insulin requirements in GDM. Abdominal subcutaneous fat thickness, as a non-invasive, readily accessible, and objective ultrasound marker, is a valuable adjunct to BMI for predicting insulin needs in GDM management.
OBJECTIVES: The aim is to identify objective anatomical and clinical predictors of surgical difficulty in vaginal natural orifice transluminal endoscopic surgery (V-NOTES) hysterectomy. MATERIAL AND METHODS: This prospec...OBJECTIVES: The aim is to identify objective anatomical and clinical predictors of surgical difficulty in vaginal natural orifice transluminal endoscopic surgery (V-NOTES) hysterectomy. MATERIAL AND METHODS: This prospective cohort study included 65 patients who underwent hysterectomy with V-NOTES for benign conditions. Parameters such as the uterocervical angle (UCA), cervical length (CL), the sliding sign, and the stage of pelvic organ prolapse (POP-Q) were measured before surgery. The independent effects of these factors on high surgical difficulty, as defined by a surgeon-assessed Likert score of at least 4, were analysed using multivariate logistic regression. RESULTS: High surgical difficulty was reported in 27.7% of patients. Multivariate analysis identified three independent risk factors for increased surgical difficulty: a negative sliding sign (indicative of adhesions), significant cervical elongation and a narrow uterocervical angle. In contrast, advanced pelvic organ prolapse (POP-Q stage ≥ II) was identified as a protective factor, significantly reducing the likelihood of high surgical difficulty. The final predictive model incorporating these four markers demonstrated good discriminative performance [area under the curve (AUC) = 0.84, 95% confidence interval (CI): 0.73-0.95]. CONCLUSIONS: Preoperative assessment of the sliding sign, cervical length, and uterocervical angle, combined with the POP-Q stage, can reliably predict surgical difficulty in V-NOTES hysterectomy. Our predictive model (AUC = 0.84) provides surgeons with a practical tool to help them select and counsel patients more effectively. However, these findings are based on a single-centre cohort and require external validation.
OBJECTIVES: Gynecological cancers remain a major health challenge. Natural phenolics such as caffeic acid (CA) and its derivative caffeic acid phenethyl ester (CAPE) have been investigated for anticancer potential, but t...OBJECTIVES: Gynecological cancers remain a major health challenge. Natural phenolics such as caffeic acid (CA) and its derivative caffeic acid phenethyl ester (CAPE) have been investigated for anticancer potential, but their comparative effects are not fully established. This study evaluated the anticancer activity of CA and CAPE in vitro, focusing on cytotoxicity (MTT) and modulation of NF-κB, p53, and caspase-7 pathways in PA-1 cells, complemented by in silico digital twin simulations in HeLa cells. MATERIAL AND METHODS: PA-1 cells were treated with CA or CAPE (0-200 µM) for 24 h and 48 h. Mallory's trichrome staining assessed cell morphology. Viability was measured by MTT assay, while NF-κB, p53, and caspase-7 levels were quantified by ELISA (mean ± SD). IC₅₀ values were determined using four-parameter logistic regression. Statistical significance was analysed with Friedman ANOVA (p < 0.05). In parallel, an ODE-based digital twin model simulated dose-dependent cytotoxicity and pathway activation in HeLa cells. RESULTS: Both CA and CAPE reduced PA-1 viability in a dose- and time-dependent manner, with CAPE exerting stronger effects. CA produced prolonged NF-κB activation, modest p53 elevation, and moderate caspase-7 induction. CAPE caused transient NF-κB activation followed by suppression, robust p53 upregulation, and marked caspase-7 induction, reflecting enhanced apoptosis. Digital twin simulations reproduced these dynamics, reinforcing CAPE's stronger pro-apoptotic profile. CONCLUSIONS: CA and CAPE both show anticancer activity, with CAPE demonstrating greater efficacy. Integration of in vitro assays with digital twin simulations strengthens mechanistic interpretation and highlights CAPE as a promising anticancer candidate.
OBJECTIVES: This study aims to examine the correlation between neonatal reactions and umbilical artery half peak systolic velocity deceleration time (UA HPSVDT). MATERIAL AND METHODS: For the research, participants were...OBJECTIVES: This study aims to examine the correlation between neonatal reactions and umbilical artery half peak systolic velocity deceleration time (UA HPSVDT). MATERIAL AND METHODS: For the research, participants were selected among 24-40 weeks pregnant women. While the study group consisted of those with fetal growth restriction (FGR), the control group included the rest. To determine UA HPSVDT and certain Doppler parameters, Doppler ultrasonography was used and within a week before delivery, the middle cerebral artery (MCA Doppler was obtained). Likewise, a peri-operatively taken blood sample made it possible to determine Cord blood pH. Apgar scores of neonates were assessed within the 1-5th minutes. RESULTS: In terms of fetal weight, cord blood pH, 1st and 5th minute Apgar scores and UA HPSVDT (for all parameters p < 0.01), a significant statistical difference was found between FGR and control groups. On the other hand, a significant correlation among neonatal weight, cord blood pH, 1-5th minute Apgar scores and UA HPSVDT were observed. It was clear that in the FGR group (for all parameters p < 0.01), the Apgar scores, cord blood pH, and neonatal weight decreased as the UA HPSVDT decreased. However, between UA HPSVDT and other variables, no remarkable statistical significance was determined. CONCLUSIONS: The research makes it clear that the UA HPSVDT time is related to umbilical artery of blood pH levels and post-natal Apgar scores; therefore, it can be useful for efforts to minimize the rate of mortality and morbidity in perinatal practices.
OBJECTIVES: This study aimed to evaluate the impact of cleavage stage embryo ratings on pregnancy outcomes following frozen embryo transfer (FET) and their correlation with blastocyst grades. MATERIAL AND METHODS: A retr...OBJECTIVES: This study aimed to evaluate the impact of cleavage stage embryo ratings on pregnancy outcomes following frozen embryo transfer (FET) and their correlation with blastocyst grades. MATERIAL AND METHODS: A retrospective cohort study was conducted on 854 FET cycles from January 2018 to August 2024. Participants were women undergoing FET with cryopreserved embryos. Exclusion criteria included multiple initial in vitro fertilization (IVF) attempts, advanced age, chromosomal abnormalities, and uterine anomalies. Embryo quality was assessed at the cleavage and blastocyst stages, and FET protocols were tailored to each patient. The primary outcome was clinical pregnancy rate, defined by ultrasound-detected fetal heartbeat. Data was analyzed using SPSS 19.0, with logistic regression to adjust for confounders. RESULTS: The overall pregnancy rate was 53.98% (461/854). Significant differences in pregnancy rates were observed among blastocyst grades, with Grade 1 achieving the highest rate (60.37%). Lower cleavage stage embryo grades (Grade 3 and Grade 4) were associated with reduced pregnancy odds (OR = 0.63 and OR = 0.50, respectively, p < 0.05). Other factors influencing pregnancy outcomes included female age and anti-Müllerian hormone (AMH) levels. The study underscores the importance of cleavage stage embryo ratings, particularly for Grade 2 embryos, in the context of FET procedures using ovulation induction cycle (OIC) and intracytoplasmic sperm injection (ICSI). CONCLUSIONS: Cleavage stage embryo ratings significantly affect pregnancy outcomes following FET. Higher ratings correlate with better pregnancy rates, highlighting the importance of comprehensive embryo quality assessment.
OBJECTIVES: Hysterectomy is the most commonly performed gynecological surgery and one of the most frequent operations worldwide. Although approximately 90% of hysterectomies are performed for non-oncological indications,...OBJECTIVES: Hysterectomy is the most commonly performed gynecological surgery and one of the most frequent operations worldwide. Although approximately 90% of hysterectomies are performed for non-oncological indications, several surgical approaches are available, including abdominal, laparoscopic, vaginal, robotic- assisted, and vNOTES techniques. With the rapid evolution of minimally invasive procedures, it is crucial to extend their application to hysterectomy, offering patients faster recovery and earlier return to daily activities. The aim of this study was to evaluate temporal trends in surgical approaches to hysterectomy in a reference gynecologic center in Poland, with a particular focus on the adoption of minimally invasive techniques. MATERIAL AND METHODS: We retrospectively analyzed hysterectomies performed for non-oncological indications between 2014 and 2024. Different surgical approaches to uterine removal were compared, and temporal trends in the proportion of minimally invasive procedures were assessed. RESULTS: Over the 10-year study period, 2,421 hysterectomies were performed. The proportion of minimally invasive procedures increased markedly from 23.5% in 2014 to 70.8% in 2024. The Cochran-Armitage trend test confirmed a statistically significant upward trend in the adoption of minimally invasive techniques (Z = 12.22, p < 0.001). Log-linear modeling showed an annual percent change of 9.0% (95% CI 4.9-13.3%) toward increased use of minimally invasive surgical procedures. CONCLUSIONS: The past decade has witnessed a paradigm shift in the surgical management of hysterectomy in our center, with minimally invasive techniques becoming the standard of care. This transition has provided significant benefits, underscoring the importance of further promoting minimally invasive surgery in gynecology.
Chronic pelvic pain of venous origin (CPPVO) is a common yet frequently underdiagnosed condition that affects women's quality of life. This review analyzes studies from 2019 to 2024 on the effectiveness and safety of pel...Chronic pelvic pain of venous origin (CPPVO) is a common yet frequently underdiagnosed condition that affects women's quality of life. This review analyzes studies from 2019 to 2024 on the effectiveness and safety of pelvic vein embolization. While pharmacological treatments offer limited relief, embolization of pelvic varicose veins has shown significant symptom improvement with acceptable complication rates. Studies report high patient satisfaction and long-term efficacy. Further research is needed to optimize qualifiaction for the procedure. Interdisciplinary collaboration between gynecologists, vascular surgeons and interventional radiologists remains crucial for effective CPPVO management.
INTRODUCTION: Intravenous leiomyomatosis (IVL) is a rare condition characterized by the proliferation of uterine smooth muscle cells within the lumen of vascular vessels. Despite its histologically benign nature, IVL can...INTRODUCTION: Intravenous leiomyomatosis (IVL) is a rare condition characterized by the proliferation of uterine smooth muscle cells within the lumen of vascular vessels. Despite its histologically benign nature, IVL can invade cardiac vessels, leading to severe complications such as circulatory failure and heart blockade. This underscores the critical need for accurate diagnosis and comprehensive preoperative management to prevent fatal outcomes. RESULTS: A previously healthy 41-year-old woman was admitted to Gynecology Department following abnormal findings on a routine abdominal ultrasound (USG). The USG revealed a pelvic tumor accompanied by extensive thrombosis of the ovarian veins and inferior vena cava (IVC). Abdominal magnetic resonance imaging (MRI) showed an enlarged myomatous uterus measuring 85 x 70 x 60 mm with two oval-shaped focal lesions near the left ovary, measuring 50 x 50 x 45 mm and 80 x 50 x 60 mm. Additionally, vascular CT revealed a free-floating thrombus extending from the ovarian veins, right common iliac vein (CIV), IVC, and into the right atrium. The patient was scheduled for a single-step surgery. She underwent a total abdominal hysterectomy (TAH) with bilateral salpingo-oophorectomy (BSO), followed by sternotomy with extracorporeal circulation (ECC) to remove the tumor from the circulatory tract. Postoperative histopathological examination confirmed the diagnosis of IVL. CONCLUSION: Patients with IVL extending into the circulatory system should be managed by multidisciplinary teams comprising oncological gynecologists, as well as vascular and cardiothoracic surgeons. This collaborative approach ensures radical surgical resection, which is essential in preventing future recurrences of IVL.
Cervical cancer is considered one of the most common cancers leading to deaths among women worldwide. It is caused by infection with the human papillomavirus (HPV), which is transmitted mainly through sexual contact. HPV...Cervical cancer is considered one of the most common cancers leading to deaths among women worldwide. It is caused by infection with the human papillomavirus (HPV), which is transmitted mainly through sexual contact. HPV vaccination is regarded as an efficient tool in reducing the incidence of cervical cancer. However, despite the effectiveness of vaccines and implementation of vaccination programs, many countries face challenges with unsatisfactory vaccination rates, which may result from limited public trust or insufficient knowledge. Social marketing campaigns are implemented in many countries to promote HPV vaccination as a part of cervical cancer prevention. Despite being relatively new, social marketing is used to encourage a transformation in attitudes and behaviors towards those beneficial for health. The objective of this study is to determine the application of social marketing in the prevention of cervical cancer caused by HPV infection worldwide and to analyze selected social marketing campaigns conducted in various countries (Australia, Japan, Denmark, the United States of America, Peru, and Nigeria). As indicated by the analysis, social marketing tools are more advanced in developed countries that dispose of a greater number of organizations compared to developing countries. While some campaigns focused solely on the topic of HPV vaccination, others expanded their scope to include additional preventive measures. The most frequently used distribution channel was the Internet. Nevertheless, social marketing tools are still not being fully used in the prevention of cervical cancer, particularly that caused by HPV infection. There remains room for improvement on this topic worldwide.
OBJECTIVES: Polycystic ovary syndrome (PCOS) is a chronic endocrinopathy associated with a wide range of psychological disorders. Recent literature suggests a correlation between PCOS and cognitive linguistics disorders....OBJECTIVES: Polycystic ovary syndrome (PCOS) is a chronic endocrinopathy associated with a wide range of psychological disorders. Recent literature suggests a correlation between PCOS and cognitive linguistics disorders. This study aimed to analyze the relationship between sex hormones, metabolic markers, and cognitive linguistic performance in patients with PCOS. MATERIAL AND METHODS: 48 women with PCOS and 56 healthy control women were included in the study. Standardized questionnaires were used to assess depressive symptoms [the Beck Depression Inventory (BDI-II)] and linguistic capability [the Wechsler Vocabulary Subtest of the Wechsler Adult Intelligence Scale-Revised (WAIS-R) test and "Łatysz" non-word reading test]. Baseline cognitive function was evaluated using the Mini-Mental State Examination (MMSE). Laboratory tests included measurements of serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, dehydroepiandrosterone sulfate (DHEA-S), sex hormone binding globulin (SHBG), glucose, insulin, cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG), and total cholesterol (TC). Oral glucose tolerance test (OGTT) results were also obtained. RESULTS: We observed significant differences in testosterone, DHEA-S, SHBG, insulin, insulin measured in 120-minute post-OGTT, and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) values between women with and without PCOS. A negative correlation was found between the Wechsler Vocabulary Subtest of the WAIS-R test and testosterone, LDL, insulin, and HOMA-IR. Our study revealed a negative correlation between "Łatysz" non-word reading test and testosterone and a positive correlation between "Łatysz" non-word reading test and 120-minute post-OGTT blood glucose concentrations. CONCLUSIONS: Our results suggest that there is a relationship between hormonal, metabolic markers, and cognitive functions in patients suffering from PCOS.