BACKGROUND/AIMS: The ewe is increasingly being used as an animal model for pelvic floor disorders. The aim was to further characterize changes in the vaginal properties during its entire lifespan. METHODS: Vaginal tissues were collected at different stages of reproductive life (neonatal, prepubescence, nulliparous, primiparous, multiparous, and menopausal; ≥6 ewes/group). Vaginal size, as well as active and passive biomechanics, was measured. Microscopy included thickness of glycogen, epithelium, lamina propria and muscularis thickness, densities of collagen, elastin, smooth muscle, and nerves. RESULTS: Vaginal dimensions increase during adolescence, peak at reproductive levels, and decrease sharply after ovariectomy. One year after first delivery, the distal vagina gets more compliant, yet this is reversed later in life. The thickness of glycogen staining epithelial layers changed with puberty and menopause. The epithelium was markedly thicker after multiple deliveries. The thickness of lamina propria and muscularis increased in puberty and in nulliparous. Semi-quantitative collagen assessment demonstrated a lower collagen and higher elastin content after first and multiple deliveries. CONCLUSION: The changes in the ovine vaginal wall during representative moments of her lifespan parallel those observed in women.
- Klíčová slova
- Biomechanics, Delivery, Genital tract, Menopause, Reproduction, Sheep, Vagina,
- MeSH
- dlouhověkost fyziologie MeSH
- menopauza fyziologie MeSH
- modely u zvířat MeSH
- ovarektomie MeSH
- ovce MeSH
- parita fyziologie MeSH
- rozmnožování fyziologie MeSH
- těhotenství MeSH
- vagina anatomie a histologie fyziologie MeSH
- zvířata MeSH
- Check Tag
- těhotenství MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND/AIMS: Goodpasture syndrome (GS) is an autoimmune disease affecting mainly the kidneys and lungs. This review article focuses on GS occurring during pregnancy, which can seriously threaten the lives of both mother and fetus. We summarize the current clinical diagnosis and management of GS in pregnancy. METHODS: A profound literature search was carried out to review all published articles or case studies reporting on GS in pregnancy. We extracted the following data from each case: patient age, parity, gestational age, therapy of GS during pregnancy, pregnancy outcome, neonatal outcome, mode of delivery, and the patient's kidney status. We describe in detail how a recent case of GS diagnosed in pregnancy was successfully treated. RESULTS: A review of the available literature revealed 4 cases of GS in pregnancy. The average patient age was 29.3 ± 2.5 years, and most were primiparous, with an average parity of 1.3 ± 1.5. The average gestational age at the time of diagnosis was 12.5 ± 5.9 weeks. The therapies of GS during pregnancy were remarkably varied. Furthermore, the neonatal outcomes were also quite individual among the observed cases. CONCLUSION: The occurrence of GS during pregnancy is very rare. This unusual pregnancy complication is associated with significant maternal and fetal morbidity. The management of GS during pregnancy requires intensive care and multidisciplinary cooperation.
BACKGROUND: To compare the prevalence of impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) in lean and overweight/obese women with polycystic ovary syndrome (PCOS), with the data from a normal population sample. METHODS: PCOS-affected women fulfilling ESHRE diagnostic criteria underwent an oral glucose tolerance test. Prevalence of IGT and T2DM in control sample of white healthy females was extracted from the published data from NHANES II. RESULTS: In 225 women with PCOS, IGT was present in 6/104 (5.8%) lean and in 15/121 (12.4%) overweight/obese women. T2DM was present in 1/104 (1.0%) lean and in 3/121 (2.5%) overweight/obese PCOS women. In a sample of 643 women from NHANES II, the crude rate of IGT was 5.9%. IGT was significantly more common only in the overweight/obese PCOS subgroup as compared to the NHANES II cohort (chi(2) = 5.99, p < 0.01). CONCLUSIONS: IGT was found significantly more frequently only in overweight/obese PCOS subjects in comparison with healthy controls.
- MeSH
- diabetes mellitus 2. typu krev epidemiologie MeSH
- dospělí MeSH
- glukózový toleranční test MeSH
- krevní glukóza metabolismus MeSH
- lidé MeSH
- mladý dospělý MeSH
- obezita krev MeSH
- porucha glukózové tolerance krev MeSH
- prevalence MeSH
- retrospektivní studie MeSH
- syndrom polycystických ovarií krev MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- krevní glukóza MeSH
AIM: The purpose of this study was to determine the changes of biochemical risk factors for thromboembolisms using different administration routes of early estrogen replacement therapy. METHODS: In a 12-week prospective, randomized crossover trial, estradiol was administered orally (2 mg daily) or transdermally (0.05 mg daily). Forty-five healthy early postmenopausal women were included into the study within 12 weeks after hysterectomy and oophorectomy. Forty-one women (age 49 +/- 6 years) completed the study, and their data were analyzed. The hemocoagulation parameters were determined prior to beginning of the study and at the end of each treatment period, separated by a 1-week washout period. RESULTS: After oral therapy, the average tissue factor pathway inhibitor levels decreased statistically significantly (p < 0.0001) from 87.5 +/- 39.1 to 68 +/- 37.49 ng/ml. The plaminogen activator inhibitor-1 levels also decreased statistically significantly (p = 0.001) after the oral estrogen therapy from 11.39 +/- 12.02 to 5.0 +/- 5.27 IU/l. These changes were also significant when compared with the nonsignificant changes after the transdermal therapy. No significant changes occurred in the levels of D-dimers. After both treatment methods, the antithrombin III and fibrinogen levels decreased, but within their physiological ranges. CONCLUSIONS: Oral administration of estrogen statistically significantly reduced the tissue factor pathway inhibitor and plasminogen activator inhibitor-1 levels when compared with the transdermal route. These changes cannot be unambiguously considered risky, and the zero change of D-dimers suggests that there was no activation of the coagulation cascade. We consider the neutral effect of the transdermal therapy more beneficial.
- MeSH
- antithrombin III analýza MeSH
- aplikace kožní MeSH
- aplikace orální MeSH
- dospělí MeSH
- estradiol aplikace a dávkování MeSH
- estrogenní substituční terapie * MeSH
- estrogeny aplikace a dávkování MeSH
- fibrinogen analýza MeSH
- hemostáza MeSH
- inhibitor aktivátoru plazminogenu 1 krev MeSH
- klinické křížové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- postmenopauza krev účinky léků MeSH
- rizikové faktory MeSH
- tromboembolie krev MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
- randomizované kontrolované studie MeSH
- srovnávací studie MeSH
- Názvy látek
- antithrombin III MeSH
- estradiol MeSH
- estrogeny MeSH
- fibrinogen MeSH
- inhibitor aktivátoru plazminogenu 1 MeSH
AIMS: To assess whether vaginal labor after a previous caesarean section in a low gestational week performed by means of a high placed U-section technique could be recommended by obstetricians as a sufficiently safe method of choice for pregnant women. METHODS: Of 309 pregnant women with a history of a high placed U-section, 166 (53.7%) met the criteria for the subsequent vaginal delivery and agreed with it. In 78%, vaginal labor started spontaneously and in 22% it was induced due to postterm pregnancy or preterm rupture of membranes. RESULTS: Vaginal labor was successful in 72.3% of women. Deliveries after spontaneous onset of uterine contractions (80%) were considerably more successful. In the group of women with induced labor, the success rate was below 50%. Uterine rupture was not encountered in the study group. CONCLUSIONS: Vaginal labor after a previous high placed U-section is a sufficiently safe method of choice for selected groups of pregnant women, but it has to be mentioned that selecting criteria can only minimize and not entirely exclude the risk of uterine rupture.
- MeSH
- císařský řez metody MeSH
- lidé MeSH
- novorozenec nedonošený MeSH
- novorozenec MeSH
- porodní hmotnost MeSH
- prospektivní studie MeSH
- ruptura dělohy prevence a kontrola MeSH
- studie případů a kontrol MeSH
- těhotenství MeSH
- vaginální porod po císařském řezu metody MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND/AIM: Not only the process of childbirth itself, but also processes during pregnancy seem to be strongly associated with urinary incontinence (UI). According to some epidemiological studies, UI during pregnancy occurs in 23-70% of the pregnant women. These studies also documented some risk factors (e.g., race, age, or body mass index). The aim of our study was to explore the prevalence of UI during pregnancy in the Czech Republic. METHODS: 474 primiparas who gave birth at our maternity ward from June 14, 2004, through January 31, 2005, received a questionnaire. The questionnaire concentrated on the occurrence and presentation of UI before and during pregnancy. RESULTS: 339 women (72%) completed the questionnaire. UI and the length of pregnancy are significantly related. We found a baseline UI prevalence before pregnancy of 17%, but before delivery one of 64%. We did not find any statistically significant relation between the prevalence of UI during pregnancy and body mass index before pregnancy as well as before delivery, weight gain during pregnancy, age, and birth weight. CONCLUSION: Our results show that pregnancy is a risk factor for the development of UI.
- MeSH
- inkontinence moči epidemiologie etiologie MeSH
- lidé MeSH
- parita * MeSH
- prevalence MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
BACKGROUND AND AIM: Adiponectin is regarded as a possible link between adiposity and insulin resistance. Ghrelin and leptin are considered as signals of energy status. We evaluated the relationships between these peptides, androgens and insulin sensitivity in women affected by polycystic ovary syndrome. METHODS: Thirty-six women with PCOS were examined with euglycemic hyperinsulinemic clamp (to determine M/I, index of insulin sensitivity). Leptin, ghrelin, adiponectin, androgens, and SHBG were determined. Statistics was done using correlation analysis and backward stepwise multiple regression. RESULTS: The positive correlation of adiponectin with testosterone remains significant even after adjustment for BMI (p = 0.01), M/I (p = 0.009) and for both M/I and BMI (p = 0.02). In multiple regression with testosterone, M/I, leptin and ghrelin as independent variables, the model including testosterone (p = 0.03) and ghrelin (p = 0.002) explained 49% of the variability (p < 0.0012) of adiponectin. CONCLUSIONS: Both adiponectin and ghrelin can be involved in the pathophysiology of PCOS but their relation must be delineated further.
- MeSH
- adiponektin krev MeSH
- androgeny krev MeSH
- biologické markery krev MeSH
- dospělí MeSH
- ghrelin MeSH
- globulin vázající pohlavní hormony metabolismus MeSH
- glykemický clamp MeSH
- index tělesné hmotnosti MeSH
- inzulinová rezistence MeSH
- leptin krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- peptidové hormony krev MeSH
- regresní analýza MeSH
- syndrom polycystických ovarií krev epidemiologie MeSH
- testosteron krev MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- adiponektin MeSH
- androgeny MeSH
- biologické markery MeSH
- ghrelin MeSH
- globulin vázající pohlavní hormony MeSH
- leptin MeSH
- peptidové hormony MeSH
- testosteron MeSH
The authors evaluate the effects of 2 months of treatment with 250 mg flutamide daily on adrenal steroidogenesis (ACTH test) and metabolic parameters (lipids, insulin resistance) in 12 PCOS women aged 33.8 +/- 7.5 years and with a BMI of 33.6 +/- 4.2 kg/m2. Significant decreases in basal DHEA-S (p < 0.0001), DHEA (p < 0.01) and androstenedione (p < 0.05), in the ACTH-stimulated levels of DHEA-S (p < 0.0001), testosterone (p < 0.05) and in ACTH-stimulated 17beta-hydroxysteroid dehydrogenase activity (p < 0.01) were observed. No significant change in basal blood glucose, insulin, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides or in insulin resistance, as estimated by the insulin tolerance test, was found. Flutamide is effective in reducing adrenal androgen production in overweight women, but has no effect on lipid spectrum or on insulin resistance.
- MeSH
- 17-hydroxysteroidní dehydrogenasy metabolismus MeSH
- adrenokortikotropní hormon MeSH
- androgeny biosyntéza MeSH
- androstendion krev MeSH
- antagonisté androgenů farmakologie MeSH
- dehydroepiandrosteron krev MeSH
- dehydroepiandrosteronsulfát krev MeSH
- dospělí MeSH
- flutamid farmakologie MeSH
- index tělesné hmotnosti MeSH
- inzulin metabolismus MeSH
- inzulinová rezistence MeSH
- lidé MeSH
- lipidy krev MeSH
- nadledviny účinky léků metabolismus MeSH
- obezita komplikace metabolismus MeSH
- sekrece inzulinu MeSH
- steroidy biosyntéza MeSH
- syndrom polycystických ovarií komplikace metabolismus MeSH
- testosteron krev MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- 17-hydroxysteroidní dehydrogenasy MeSH
- adrenokortikotropní hormon MeSH
- androgeny MeSH
- androstendion MeSH
- antagonisté androgenů MeSH
- dehydroepiandrosteron MeSH
- dehydroepiandrosteronsulfát MeSH
- flutamid MeSH
- inzulin MeSH
- lipidy MeSH
- steroidy MeSH
- testosteron MeSH
The objective of the study was to find predictors of a successful therapy with metformin in polycystic ovary syndrome. 24 women with polycystic ovary syndrome were examined (oral glucose tolerance test and gonadotropin-releasing hormone analogue test) before and after a 6-month course of metformin (1 g/day). In 58% of the women, a significant improvement in the menstrual cycle pattern was observed. After a treatment course, a significant reduction in gonadotropin-releasing hormone analogue stimulated levels of testosterone (p < 0.05), free testosterone index (p < 0.01), luteinizing hormone (p < 0.05), and estradiol (p < 0.01) was found. The best prediction of the improvement in menstrual cyclicity after metformin was achieved with a combination of basal values of 17-hydroxyprogesterone, testosterone, sex hormone binding globulin, and androstenedione. These variables correctly classified 86.7% of the responders. The best predictor of changes in the index of free testosterone after metformin treatment was the combination of estradiol and androstenedione in the gonadotropin-releasing hormone analogue test, with basal testosterone correctly classifying 91.7% of the subjects.
- MeSH
- inzulinová rezistence MeSH
- lidé MeSH
- menstruační cyklus účinky léků MeSH
- metformin terapeutické užití MeSH
- předpověď MeSH
- syndrom polycystických ovarií farmakoterapie patofyziologie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- metformin MeSH
In preeclampsia the cytotrophoblast invasion of the decidual vessels is reduced. The endothelia in the decidual vessels may influence cytotrophoblast invasion and remodeling of decidual spiral arteries. The decidual endothelial cells from preeclamptic placentas produce less matrix metalloproteinase-1 (MMP1) than those from normal placentas. MMPs form a group of enzymes that are capable of degrading components of extracellular matrix. The present study investigated the prevalence and possible association of an insertion of guanine in the promoter of the MMP1 gene in pregnancy-induced hypertension, preeclampsia and eclampsia in the Czech population. This was a case-control study. No differences were observed in genotype frequencies between cases and controls. The insertion of the guanine in the promoter of the MMP1 gene does not appear to increase the risk of development of pregnancy-induced hypertension, preeclampsia and eclampsia.
- MeSH
- dospělí MeSH
- frekvence genu genetika MeSH
- genetická predispozice k nemoci genetika MeSH
- genotyp MeSH
- hypertenze etiologie genetika MeSH
- jednonukleotidový polymorfismus genetika MeSH
- kardiovaskulární komplikace v těhotenství * MeSH
- lidé MeSH
- matrixová metaloproteinasa 1 genetika MeSH
- mladiství MeSH
- polymerázová řetězová reakce MeSH
- preeklampsie genetika MeSH
- promotorové oblasti (genetika) genetika MeSH
- rizikové faktory MeSH
- studie případů a kontrol MeSH
- těhotenství MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
- Názvy látek
- matrixová metaloproteinasa 1 MeSH
