Elzbieta Grochans

Publications of Elzbieta Grochans

• Functional polymorphism of matrix metalloproteinase-9 (MMP-9) gene in alcohol dependence: family and case control study.

  Authors: Agnieszka Samochowiec, Anna Grzywacz, Leszek Kaczmarek, Przemyslaw Bienkowski, Jerzy Samochowiec, Paweł Mierzejewski, Ulrich W Preuss, Elzbieta Grochans, Andrzej Ciechanowicz

  Brain research. 02/2010; 1327:103-6.

  Matrix metalloproteinases (MMP) are extracellularly acting endopeptidases, whose substrates are extracellular matrix and adhesion proteins. In the gene polymorphism studies MMP-9 has been suggestedMatrix metalloproteinases (MMP) are extracellularly acting endopeptidases, whose substrates are extracellular matrix and adhesion proteins. In the gene polymorphism studies MMP-9 has been suggested to be involved in the pathogenesis of heart disease, cancer, bipolar disorder, and schizophrenia. In animal models MMP-9 has been shown to play a key role in a variety of neuronal plasticity phenomena, including learning and memory as well as drug addiction. We studied 139 families, Caucasians, with no history of psychiatric disorder of ICD-10 other than alcohol or nicotine dependence. The control subjects were 136 unrelated individuals, matched for ethnicity and gender, with no mental disorder. Alcohol and family history of alcoholism were assessed by means of a structured interview, based on the Polish version of SSAGA (Semi-Structured Assessment on Genetics in Alcoholism). We found a statistically significant preferential transmission of the T allele (known to produce higher gene transcriptional activity) from parents to alcoholics (59%, p=0.046). In a case-control study genotype TT and T alleles were significantly more frequent in the alcoholics than in the controls (OR=2.6). Our results suggest that the MMP-9 gene may play a role in the pathogenesis of alcohol dependence.

• [Assessment of the impact of some sociodemographic factors on the quality of life of patients with multiple sclerosis].

  Authors: Beata Karakiewicz, Celina Stala, Elzbieta Grochans, Iwona Rotter, Bozena Mroczek, Liliana Zaremba-Pechmann, Maria Laszczyńska, Marta Giezek

  Annales Academiae Medicae Stetinensis. 01/2010; 56(3):107-12.

  Multiple sclerosis is the most common cause of disability among young people, affecting the emotional and intellectual condition of the patient. Assessment of the quality of life enables long-termMultiple sclerosis is the most common cause of disability among young people, affecting the emotional and intellectual condition of the patient. Assessment of the quality of life enables long-term planning of the strategy of support and thus should constitute a permanent part of care for multiple sclerosis patients. The aim of this study was to assess the impact of gender, age, duration of the disease, and economic status of multiple sclerosis patients on the quality of life in separate domains. A diagnostic survey was conducted in 64 patients with multiple sclerosis. We administered a questionnaire developed by us with questions referring to sociodemographic data of the patients. We also used the standard SF-36 questionnaire with eight scales. No significant differences between male and female SM patients were noted as regards the quality of life in each scale. Wealthy patients experienced a higher quality of life as regards the general health and physical functioning in comparison to patients with a middle economic status. There was no effect of the place of residence on the quality of life. Elderly patients and patients with long-term multiple sclerosis had a poorer quality of life in the physical functioning, general health, vitality, and role-emotional domains. 1. Gender and place of residence of multiple sclerosis patients has no effect on any of the scales of the quality of life. 2. High economic status favors a higher quality of life in the physical functioning and general health scales. 3. Age and long duration of multiple sclerosis are important factors decreasing the quality of life in most scales.

• Reasons for giving up breastfeeding and support during problems with lactation in the north-western part of Poland.

  Authors: Dorota Cwiek, Dorota Branecka-Woźniak, Dorota Fryc, Elzbieta Grochans, Witold Malinowski

  Annales Academiae Medicae Stetinensis. 01/2010; 56(2):129-32.

  Breastfeeding is the optimal way of feeding for neonates and infants. Its duration is of vital importance for the child's development and health. The World Health Organization recommends exclusiveBreastfeeding is the optimal way of feeding for neonates and infants. Its duration is of vital importance for the child's development and health. The World Health Organization recommends exclusive breastfeeding until the end of the sixth month of life. Many mothers give up breastfeeding earlier than recommended. Professional and non-professional support plays a great role in motivation to start and continue breastfeeding. The aim of this study was to determine how long infants from Szczecin, the capital city of the North-Western region of Poland, are breastfed, what are the reasons for giving up breastfeeding, and whether mothers obtain support in case of problems with lactation. One hundred randomly chosen mothers with children aged 12-18 months, living in Szczecin, were examined. A questionnaire was administered to the mothers during a direct interview. Prior to the interview, consent of the mothers to participate in the study was obtained. More than 8% of the mothers gave up breastfeeding during the first month after delivery, 68% were breastfeeding till the end of the third month, 31.5% were breastfeeding till the end of the sixth month, and only 2% continued to breastfeed for one year or longer. The most frequent reasons for giving up breastfeeding were: return to work (43.4%), small volume of milk (29.3%) and child's reluctance to suck (18.5%). 62% of breastfeeding women benefited from support during lactation problems but only 6% visited an outpatient breastfeeding service or joined a breastfeeding mothers support group. Support was obtained from the family midwife (37%), pediatrician (32%), and midwife at an outpatient clinic (25.8%). Most women (74.2%) were satisfied with the support. (1) It is necessary to promote breastfeeding so that all women could decide to start breastfeeding after childbirth. 2. As the percentage of women who continue breastfeeding after the sixth month of the infant's life is unsatisfactory, mothers should be encouraged to breastfeed longer. (3) A system of professional lactation support for breastfeeding mothers should be developed.

• [Self-care and demand for social support in women with infertility].

  Authors: Dorota Cwiek, Dorota Branecka-Woźniak, Dorota Fryc, Elzbieta Grochans, Magdalena Rygielska

  Annales Academiae Medicae Stetinensis. 01/2009; 55(2):35-8.

  The prevalence of infertility among married couples is growing. It is estimated that every fifth married couple in Poland is infertile. Infertility is often a source of significant stress for theThe prevalence of infertility among married couples is growing. It is estimated that every fifth married couple in Poland is infertile. Infertility is often a source of significant stress for the spouses. It is therefore important to provide professional support, demonstrate interest, listen to the problem, and be present in difficult moments. Social support considerably reduces the feeling of abandonment, fosters self-care, accelerates recovery, strengthens coping, and helps modify views and habits or attitudes towards treatment. The aim of this study was to assess self-care in women with infertility and to identify the most common sources of social support. The study group consisted of 100 women diagnosed or treated for infertility at the Department of Reproduction and Gynecology, Pomeranian Medical University in Szczecin. The diagnostic poll was done with the aid of a standardised research tool--the Social Support Scale Questionnaire by Danuta Zarzycka. The study protocol was approved by the Bioethics Committee of the Pomeranian Medical University. The study was performed between July 2005 and March 2007. (1) Self-care in women with infertility is adequate. (2) Women with infertility usually expect professional support from a physician; the role of the nurse is undervalued. Thus, the role of the nurse and midwife needs further promotion.

• [Analysis of some pro-health behaviors of pregnant women after a childbirth education class]

  Authors: Dorota Cwiek, Elzbieta Grochans, Ilona Sowińska-Gługiewicz, Przemysław Wysiecki

  Wiadomości lekarskie (Warsaw, Poland : 1960). 02/2004; 57 Suppl 1:48-51.

  Nowadays the school of childbirth is one of the most important forms of antenatal education. The aim of the study was to compare some pro-health behaviours of women after courses at school ofNowadays the school of childbirth is one of the most important forms of antenatal education. The aim of the study was to compare some pro-health behaviours of women after courses at school of childbirth with pro-health behaviours of women without such education. A group of 129 women after courses at schools of childbirth who were hospitalized in the Chair and Department of Obstetrics and Perinatology of Pomeranian Medical University in Szczecin were introduced into the study. The control group contained 165 women who did not take part in any antenatal education. The questionnaire was a research tool; it was completed 2-5 days after childbirth and also patients' documentation was analyzed. The test results were statistically analyzed. Investigations showed that woman attending classes at school of childbirth were highly aware of pro-health behaviours during pregnancy; they often changed their lifestyle during pregnancy, they smoked less frequently, they had more appointments with their obstetricians and they earlier had their first medical visit. It seems necessary to intensify the classes of nourishing during pregnancy at schools of the childbirth, because no statistically significant differences in the increase of body mass were showed. Moreover, it is necessary to educate every pregnant woman of the hygiene, nourishing and stimulant abuse during pregnancy not only at schools of the childbirth, but also during obstetric consultation.

• [Assessment of social and professional support offered to patients during their stay in a rooming-in at a maternity ward]

  Authors: Elzbieta Grochans, Ryszard Czajka

  Wiadomości lekarskie (Warsaw, Poland : 1960). 02/2004; 57 Suppl 1:91-4.

  The improvement of quality of care on maternity wards concerns not only the medical activities. Professional activities minimalizing the occurrence of difficult situations of woman in puerperalThe improvement of quality of care on maternity wards concerns not only the medical activities. Professional activities minimalizing the occurrence of difficult situations of woman in puerperal period are of great importance as well. The aims of the study were: 1) to evaluate the accessible social support and the need of professional support in women during their staying on maternity ward in rooming-in system; 2) to establish the correlation between accessible social support the need of professional one. Studies were conducted at one of maternity wards in Szczecin working in rooming-in system. Studied group were primiparas (n = 100), reference group consisted of multiparous females (n = 100). The following tools were introduced into the study: Modified Social Support Scale and Author's questionnaire on Demand for Support in maternity ward in rooming-in system. The results of investigations show, that the need of professional support was more often expressed in the study group (p < 0.001). It reached an average--high level. There was no significant difference concerning an accessible social support in both groups. No correlation was showed between accessible social and professional support. CONCLUSIONS: 1. Primiparas require special puerperal care and professional support as well. 2. High, accessible social support has no influence on need of professional support in women during their stay on maternity ward in rooming-in system.

• [Nursing support at a rooming-in maternity ward]

  Authors: Elzbieta Grochans

  Annales Academiae Medicae Stetinensis. 01/2003; 49:367-84.

  The international congress called "Birth Quality-Life Quality" has been a key scientific event in Poland resulting in great changes in perinatal care. Improvements in the quality of care at maternityThe international congress called "Birth Quality-Life Quality" has been a key scientific event in Poland resulting in great changes in perinatal care. Improvements in the quality of care at maternity wards were not limited to purely medical issues. Attention became increasingly focused on psycho-social problems of women after parturition. Emphasis is now directed to support by the doctors and nurses and efforts to acquaint young mothers with the benefits of natural feeding, as well as to prepare them for taking good care of their child. Social support is seen as an important tool in the improvement of care over the mother and child. The present study has classified social support according to J. House as informational, emotional, instrumental and worthing. Informational support consists of methods to cope with specific problems that require delivery of information and teaching of new skills. Emotional support focuses on demonstrating care, winning trust and showing empathy. Instrumental support is reflected by delivery of goods or services to persons in need. Finally, worthing support aims at promoting self-esteem. The aim of this study was (1) to analyze the determinants of informational, emotional, instrumental and worthing support and to compare the needs for different types of support among primiparas and multiparas at an obstetrics ward with the rooming-in system; (2) to study correlations between availability and demand for social support; (3) to determine the expectations of patients as to sources of informational, emotional, instrumental and worthing support and as to methods and means used during delivery of informational support. The study was done in a group of 200 women giving birth at the Department of Obstetrics and Perinatology, Pomeranian Medical University in Szczecin. A special questionnaire was developed to determine the needs for support. A modified Social Support Score was also used. It was found that the demand for all determinants of informational support was greater among primiparas than multiparas. In the lactation part, significant differences were noted for 25 determinants (Tab. 1). Similarly, significant differences were noted for 13 determinants of neonatal care and nursing (Tab. 2) and for 9 determinants of postpartum self-care (Tab. 3). A large demand for most determinants of emotional support was noted in the study and reference groups. Statistically significant differences (p < 0.05) were revealed as to 3 determinants representing feeling of safety by the woman during hospitalization (Tab. 4). It was found that the demand for all determinants of instrumental support was greater among primiparas than multiparas (Tab. 5). There were no significant differences in worthing support needs (Tab. 6). Primiparas significantly more often expected informational and instrumental (p < 0.001), as well as emotional support (p < 0.05) (Tab. 7) in comparison to multiparas. The need for social support at a maternity ward was found to be independent of the available support (Tab. 8). The most frequently expected source of informational support is the nurse/midwife at the maternity ward, as well as the doctor at the ward and the outpatient unit. Worthing and instrumental support is usually expected of the husband and the family. The usual methods of delivering support include discussions, training, and demonstration. Brochures remain the preferred vehicle for delivering support (Tab. 9).

• [Research on associations between selected polymorphisms of genes DRD2, 5HTT, GRIK3, ADH4 and alcohol dependence syndrome].

  Authors: Elzbieta Grochans, Anna Grzywacz, Iwona Małecka, Agnieszka Samochowiec, Beata Karakiewicz, Jerzy Samochowiec

  Psychiatria polska. 45(3):325-35.

  Alcohol abuse is a complex multifactorial disease. It is believed that alcohol dependence is mostly caused by genetic (40-50%) and environmental (50-60%) factors. The aim of this study was to assessAlcohol abuse is a complex multifactorial disease. It is believed that alcohol dependence is mostly caused by genetic (40-50%) and environmental (50-60%) factors. The aim of this study was to assess the relation between the alcohol dependence syndrome (ADS) and the polymorphism of the selected genes (GRIK3, 5HTT, ANKK1, ADH4). The study was conducted in the Department and Clinic of Psychiatry, the Pomeranian Medical University in Szczecin in the years 2006-2008. It involved 100 patients hospitalised with Alcohol Dependence Syndrome (ADS). DNA polymorphisms were detected using the polymerase chain reaction (PCR). Statistical calculations were done with SPSS version 9.0. The chi-square test was applied to calculate the differences in the frequency of allelic forms. Comparison between the patients with ADS and the patients from the control group demonstrated statistically significant association of ADH4 (rs1800759) with the alcohol dependence syndrome. Both the A/A genotype and the A allele were more common in patients with ADS. Also, analysis of the association of the ANKK1 gene revealed statistically significant differences (p = 0.004) between the ADS group and the control group. No statistically significant differences considering other associations were found. Our results suggest that the analysed polymorphisms ofANKK1 and ADH4 can play an important part in the pathogenesis of alcohol abuse. The greater study group would increase the statistical power of the study and help to isolate homogeneous sub-groups of patients.

• [The effects of lead level in the blood on social functioning in children with developmental disabilities].

  Authors: Małgorzata Szkup-Jabłońska, Beata Karakiewicz, Elzbieta Grochans, Anna Jurczak, Liliana Zaremba-Pechmann, Iwona Rotter, Grazyna Nowak-Starz, Jerzy Samochowiec

  Psychiatria polska. 45(5):713-22.

  The aim of the study was to assess the relationship between lead levels in children's blood and the development of social disorders. Lead levels were measured in every child's blood test andThe aim of the study was to assess the relationship between lead levels in children's blood and the development of social disorders. Lead levels were measured in every child's blood test and following on from that the influence of this toxin on children's behaviour was assessed. Manfred Cierpka questionnaire was used as the assessment tool examining children's family relationships and Children's Health Questionnaire Parent Form-28 was used to assess the subjects' health profile. The statistical analysis revealed a statistically significant relationship between lead concentration in the child's blood and whether or not the child was able to meet social expectations (p = 0.018), form affective relationships (p = 0.046), its nervousness (p = 0.024) and a generally lower assessment of his/her behavior in comparison with the peer group (p = 0.024). Neurotoxic influence of lead on the developing child's organism results in developmental disabilities in its behaviour. These dysfunctions can lead to disorders in the child's social development and they can hinder its functioning. An increased concentration of metal toxins in the child's blood can be responsible for difficulties in meeting social expectation, which in turn is connected with increased nervousness and disorders in forming relationships. Children facing these problems often receive negative marks for their behaviour in comparison with the peer group. Such difficulties can lead to the child's social exclusion and predispose it to making antisocial or criminal decisions in the future.