[Show abstract][Hide abstract]ABSTRACT: The purpose of this investigation was to describe a distribution of cytomegalovirus (CMV) single and multiple genotypes among infected pregnant women, their fetuses, and newborns coming from Central Poland, as well as congenital cytomegaly outcome. The study involved 278 CMV-seropositive pregnant women, of whom 192 were tested for viral DNAemia. Human cytomegalovirus (HCMV) genotyping was performed for 18 of 34 pregnant women carrying the viral DNA and for 12 of their 15 offspring with confirmed HCMV infections. Anti-HCMV antibodies levels were assessed by chemiluminescence immunoassay (CLIA) and enzyme-linked fluorescence assay (ELFA) tests. Viral DNA loads and genotypes were determined by real-time polymerase chain reaction (PCR) assays for the UL55 gene. In the pregnant women, we identified HCMV gB1, gB2, gB3, and gB4 genotypes. Single gB2, gB3, or gB4 genotypes were observed in 14 (77.8 %) women, while multiple gB1-gB2 or gB2-gB3 genotypes were observed in four (22.2 %). Maternal HCMV genotypes determined the genotypes identified in their fetuses and newborns (p ≤ 0.050). Half of them were infected with single HCMV gB1, gB2, or gB3 genotypes and the other half with multiple gB1-gB2 or gB2-gB3 genotypes. Single and multiple genotypes were observed in both asymptomatic and symptomatic congenital cytomegaly, although no gB3 genotype was identified among asymptomatic cases. In Central Poland, infections with single and multiple HCMV strains occur in pregnant women, as well as in their fetuses and neonates, with both asymptomatic and symptomatic infections. HCMV infections identified in mothers seem to be associated with the viral genotypes in their children.
Full-text Article · Oct 2014 · European Journal of Clinical Microbiology
[Show abstract][Hide abstract]ABSTRACT: Panniculectomy is a surgical procedure that involves removal of the skin and fat excess which facilitates access to the peritoneal cavity. In the paper we present three cases of morbidly obese women (BMI: 46.3-59.5) who were treated in the Department of Gynecology and Oncological Gynecology in Lodz. One of the patients underwent an operation due to the presence of a large cervical myoma. Two another women were treated for endometrial cancer. During all of the three procedures panniculectomy was the first stage of the operation.
[Show abstract][Hide abstract]ABSTRACT: Carcinoma of the Bartholin’s gland is very rare, comprises below 2% of Bartholin’s gland lesions and adenoid
cystic carcinoma (ADC) is one of the most uncommon variants and accounts for 10-15% of Bartholin’s
gland malignancies. There is no consensus on treatment of ADC of the Bartholin’s gland: reported cases were
treated with local excision or vulvectomy with or without lymphadenectomy followed or not by radiotherapy.
The survival of patients varies significantly, so we present a case of interdisciplinary treatment of ADC resulting
in 15 years’ survival. The patient was initially treated with local excision, but the margins were not clear. Then
vulvectomy, inguinal lymphadenectomy and adjuvant brachytherapy were performed resulting in 7 years free of
the disease. Relapses were excised by abdominoperineal amputation of the rectum and distal part of the vagina
with sigmoideostomy, excisions of local recurrences in vagina and metastasectomy of isolated lung metastases.
The patient died manifesting multiple lung metastases 15 years after the initial diagnosis. Based on our experience
and world literature, in cases of adenoid cystic carcinoma of the Bartholin’s gland, vulvectomy with
or without lymphadenectomy should be considered as a treatment of choice and in patients with positive
margin, surgery should be extended by adjuvant radiotherapy
[Show abstract][Hide abstract]ABSTRACT: Congenital cytomegaly is caused by intrauterine mother-to-fetus HCMV transmission and constitutes the most common vertical infection.
The aim of the study was to analyze the viremia level in maternal blood and its influence on the course and duration of pregnancy as well as newborn condition.
The material included blood samples collected from 117 pregnant women with serological features of HCMV infection and from 29 neonates hospitalized at DFMMG in Lodz between 1999 and 2009. The presence of HCMV DNA in the maternal and fetal blood was tested using real-time PCR.
Prevalence of maternal viremia was observed to increase the risk of viremia in neonates, as compared to children born to mothers with no viremia. However; lack of HCMV DNA in maternal blood does not exclude fetal infection in utero. Newborn condition assessed by Apgar scores was significantly lower in the group of infants born to mothers with serological features of acute cytomegaly (p < 0.05).
The assessment of viremia level in maternal blood can be helpful in assessing the risk of intrauterine infection in the fetus as well as in predicting the neonatal outcome of newborn.
[Show abstract][Hide abstract]ABSTRACT: Human cytomegalovirus is a common etiological agent of infections and is the most common cause of intrauterine infections. Due to the scale and importance of infections during pregnancy in this study we investigated the incidence of specific IgG and IgM antibodies directed against HCMV in population of Polish pregnant women.
The retrospective study included 1332 pregnant women who were hospitalized at the DFMMG in Lodz between 1999 and 2009. In this group, 117 women had serological features of acute cytomegalovirus infections (study group) and 51 women were seronegative for IgG, IgM and IgA antibodies (control group). HCMV infections in pregnant women were diagnosed by serological assays (IgG, IgM, IgA, IgG avidity) and clinical symptoms.
Seroprevalence of CMV IgG was estimated to be 76.7% (n=985). Anti-HCMV immunoglobulin M antibodies were detected in 13% of pregnant women (n=179).
There was no significant correlation between the prevalence of IgG and IgM antibodies and factors such as maternal age, parity a number of births, place of residence and marital status.
[Show abstract][Hide abstract]ABSTRACT: The primary cancer of the vagina is a rare neoplasm of the female genital tract. Among all the risk factors for a squamous cell carcinoma of vagina, the human papillomavirus (HPV) infection is mentioned most frequently. Probably for this reason, the likelihood of development of primary cancer of the vagina is higher in women with the history of cervical dysplasia (CIN) and cancer. The article presents the case of a woman who had a hysterectomy with bilateral salpingo-oophorectomy for recurrent CIN. The postoperative pathological investigation confirmed the completeness of the excision. Almost 3.5 years after surgery, the primary cancer of vagina (at the IVA stage according to FIGO) was detected. After ineffective chemotherapy (8 courses) the patient underwent the surgical removal of the upper 2/3 of the vagina, partial resection of the bladder with left ureteric orifice and ureter transplantation, and bilateral systemic pelvic and inguinal lymphadenectomy. Subsequently, the woman was referred for the external beam radiotherapy.
[Show abstract][Hide abstract]ABSTRACT: Human cytomegalovirus (HCMV) is the most common congenital infection. HCMV strains display genetic variability in different regions. Distribution of HCMV genotypes in the population of congenitally infected newborns from Central Poland and viral load in newborns' blood is described and discussed. HCMV isolates were analysed by sequencing at three sites on the genome: the UL144 tumour necrosis factor-alpha (TNFα)-like receptor gene, the US28 beta-chemokine receptor gene and the UL55 envelope glycoprotein B (gB) gene. The newborns' blood was examined for HCMV DNA with a nested (UL144, UL55) or heminested (US28) polymerase chain reaction, and the genotypes were determined by sequence analysis. HCMV DNA was detectable in 25 out of 55 examined newborns born by HCMV-infected mothers (45.5%). The blood viral load in mother-infant pairs was determined. Most of the newborns had identical virus genotype, gB2 (96%), UL144 B1 (88%) and US28 A2 (84%). These genotypes were detected in all newborns with asymptomatic congenital infection. The occurrence of UL144 B1 or US28 A2 genotypes in the babies examined was significant in comparison to other genotypes (p=0.0002 and p=0.040 respectively). There was no association between specific gB subtypes in all patients groups (p=0.463). There was no correlation between HCMV genotypes and the outcome.
Full-text Article · Nov 2011 · European Journal of Clinical Microbiology
[Show abstract][Hide abstract]ABSTRACT: The aim of our analysis was to retrospectively analyze the course of pregnancy and delivery in the group of Polish women, aged from 15 to 25.
We analyzed 345 woman, aged 15-25, treated in the KMMPiG ICZMP in Lodz between the years 2000 and 2006. The investigated patients were divided into two groups: 15-18-year-olds constituted the research group and 19-25-year-olds, that is the control group. Factors which have been taken into consideration included: pregnancy history, ultrasound examinations, delivery mode, birth weight and the APGAR score.
62.7% (n = 69) delivered naturally, 30.9% (n = 34) by caesarean section and 6.36% (n = 7) by forceps in the group of adolescents and 67.6% (n = 159), 32.4% (n = 71) and 2% (n = 5) (p = 0.379; OR 1.27) in the control group. 25.5% (n = 26) of the adolescent women (< 37 week of gestation, WG) and 20.7% (n = 48) of the controls (p = 0.39; OR 1.31) had a pre-term delivery. There were 3.9% multiparas in the group of teenagers and 20.7% among adolescents (p = 0.001). Fetal malformations were diagnosed prenatally in 13.7% (n = 14) of newborns delivered by adolescents mothers and 11.6% (n = 27) in the control group (p = 0.591; OR 1.21).
Despite the dangers connected with the young age of the mother, the results of this study allow us to state that teenage pregnancy usually has a correct course and does not differ significantly from the pregnancy of an adult woman.