The reported number of cesarean sections in Poland is approximately 30% and is associated with increasing number of early and late complications. The myometrial discontinuity at the site of previous cesarean section is known in the literature as "isthmocoele", "niche", "pouch" or cesarean scar defect. In most cases presence of isthmocoele has no clinical significance, but in some patients it may cause abnormal uterine bleeding, dysmenorrhea, dyspareunia, pelvic pain or be associated with secondary infertility. This defect may be treated by laparoscopy, hysteroscopy or vaginal surgery.

The social aspect of overactive bladder syndrome (OAB) and the lack of objective diagnostic methods for this syndrome have spurred research into its potential biomarkers which can constitute useful diagnostic tools, while also allowing the evaluation of the intensity of clinical symptoms and the efficacy of implemented pharmacotherapy in OAB patients. Due to the complex etiopathogenesis of this syndrome, the researchers are seeking biomarkers connected with inflammation or nerve growth. The aim of this review was to analyse the latest literature data regarding potential biomarkers in OAB. The most promising opportunities are connected with the diagnostic use of the nerve growth factor (NGF), the brain derived neurotrophic factor (BDNF), C-reactive protein (CRP), prostaglandins and cytokines. Despite the most promising results to date having been obtained with regards to neurotrophic factors, it seems that, at the moment, none of these meets the criteria for becoming an isolated OAB marker. It is also suggested that the combined use of several biomarkers will facilitate obtaining the appropriate level of specificity and selectivity to allow their use in clinical practice.

Objectives: Minimally invasive gynaecological surgeries are performed for several malignant and nonmalignant indications. The aim of our study was to evaluate the rate of unexpected malignancies among women who underwent laparoscopical supracervical hysterectomy (LASH) with power morcellation. Material and methods:The retrospective analysis included clinical data of 426 consecutive female patients who underwent LASH with power morcellation due to presumed benign disorders (78.4% -symptomatic uterine fibromas, 12.7% -abnormal uterine bleeding, 8.9% -suspicion of uterine adenomyosis) between January 2011 and December 2015. Premalignant or malignant preoperative abnormalities in the cervix and the uterine corpus were contraindications for LASH. Results:The unexpected malignancies were found in four patients from study group: one ovarian cancer located on the inner part of simple ovarian cyst and 3 endometrial carcinomas (0.9%) were documented. All these patients underwent abdominal reoperations and no histological abnormalities were detected in the extirpated cervix and adnexa. Conclusions:The incidence of unintended endometrial carcinoma in morcellated uterus after LASH was relatively small. However, careful pre-operative counseling should be undertaken in order to exclude the possibility of any malignant disease in uteri among women scheduled to power morcellation.

Pemphigus foliaceus (PF) is an autoimmune bullous dermatosis with anti-desmoglein-1 autoantibodies. Acquired hemophilia A (AHA) is a rare coagulation disorder with a high mortality rate, caused by anti-factor VIII immunoglobulin G antibodies leading to spontaneous severe hemorrhages into skin, muscles or soft tissues. This coagulopathy may be associated with malignancies, drug reactions and autoimmune disorders including bullous dermatoses. Herein, we demonstrate a first report of AHA in the course of pemphigus foliaceus. A 55-year-old woman presenting with extensive, erosive, crusted, scaly skin lesions was diagnosed with PF based on histopathological and immunofluorescent examination, confirmed by the presence of anti-desmoglein-1 antibodies on enzyme-linked immunoassay. She developed extensive internal hemorrhages and prolonged external bleeding after laparotomy. Based on coagulation tests, AHA was diagnosed. Simultaneous remission of pemphigus and coagulopathy occurred with immunosuppressants and recombinant activated factor VII.

BackgroundThe proteasome system is involved in several disorders. The 5′ untranslated region of PSMA6 gene contains a single nucleotide polymorphism (SNP) −8 C/G, associated with diabetes, myocardial infarction and coronary artery disease.MethodsWe examined 584 patients with end-stage kidney disease (ESKD) and 430 controls. All were genotyped for −8 C/G SNP by polymerase chain reaction and restriction analysis.ResultsWe observed lower frequency of CG + GG genotypes in patients than in controls (20 vs. 42 %, p = 0.0038). The odds ratio of 0.34 (95 % CI 0.26–0.45) suggests association of CG + GG with decreased risk of ESKD. We investigated the association between PSMA6 polymorphism and LVH present in 54 % of patients. There was a significant association of CG + GG genotype with LVH, with over 75 % of CG + GG in patients with LVH. This effect was independent from other common causes of LVH—age (OR 1.12, p = 0.643) and hypertension (OR 1.72, p = 0.422).ConclusionWe demonstrated for the first time that PSMA6 polymorphism might be a protective factor for ESKD. On the other hand, CG + GG genotypes are independently related to LVH in ESKD patients.

A B S T R A C TEctopic pregnancy is a significant problem in women of childbearing potential and affects up to 2% of them. The most common ectopic pregnancy localization is the ampullary area of the Fallopian tube. Patient with spontaneous ectopic pregnancy located in the tubal stump after an ipsilateral adnexectomy performed with a laparotomy due to mucinous cystadenoma was operated by laparoscopy. Remnant of Fallopian tube with ectopic pregnancy was removed.

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