PurposePremature ovarian insufficiency (POI) is defined as the cessation of the ovarian function before the age of 40 years. POI aetiology may be related to iatrogenic or endogenous factors and in many cases remains unclear. The aim of this review was to characterize the long-term consequences of POI.MethodsThe available literature regarding the long-term consequences of POI from MEDLINE has been reviewed.ResultsLack of ovarian steroids synthesis has serious consequences for women’s health. The short-term effects are similar to spontaneous menopause and refer mainly to the climacteric syndrome. In a longer perspective, POI affects a variety of aspects. It obviously and drastically reduces the chances for spontaneous pregnancies. Oestrogen loss leads also to urogenital atrophy. The most common urogenital symptoms include vaginal dryness, vaginal irritation and itching. The urogenital atrophy and hypoestrogenism interferes also with sexual functioning. Patients with POI are threatened by a decrease in bone mineral density (BMD). POI women also experience psychological distress and some studies have shown an increased risk of neurodegenerating diseases. Overall, POI women have a shortened life expectancy, mainly due to cardiovascular disease. Some studies have reported a reduced risk of breast cancer in this group of patients.ConclusionsIn conclusion there are several well-characterized health risks in POI women. With every patient, an individualized approach is required to properly recognize and prevent these risks.

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Study Objectives: Deterioration in sleep quality seems to be a natural consequence of physical changes during pregnancy. It is still unclear if insomnia in pregnancy is associated with the same factors as chronic insomnia in the general population. The aim of this study was to explore the determinants of insomnia during pregnancy. Methods: The study included 266 women (mean age: 30.6 ± 5 years, weeks of pregnancy: 36 [interquartile range 32-38]) recruited at the Department of Gynecology and Obstetrics, Medical University of Warsaw. The assessment of variables was performed using the Athens Insomnia Scale (AIS), Beck Depression Inventory (BDI), Regestein Hyperarousal Scale (HS), Epworth Sleepiness Scale (ESS), General Practice Physical Activity Questionnaire, and a semi-structured interview about different sleep disorders. Results: Almost 40% of the women in our study received a diagnosis of insomnia based on AIS cutoff scores. The between-group analyses indicated that HS score, BDI score, eating at night, legs tingling, nightmares, snoring, and myoclonus differentiated the groups of individuals with insomnia from those without insomnia. Other variables were not significantly different between the groups. We divided individuals with insomnia in terms of insomnia duration: 49% developed insomnia at least 1 year before the study onset and 39.6% during pregnancy. For further analyses we used only the women in whom insomnia developed during pregnancy. Logistic regression confirmed that depressive symptoms (BDI) and eating at night were significant predictors of insomnia in pregnancy. Conclusions: Depressive symptoms and night eating are key factors related to insomnia developed during pregnancy.

Existing standards of the management of the diabetic patients are not efficient enough, and further improvement is needed. The major objective of this paper is to present and discuss the therapeutic effectiveness of an intensive care telematic system designed and applied for intensive treatment of pregnant type 1 diabetic women. The developed system operates automatically, every night transferring all the data recorded during the day in the patient's glucometer memory to a central clinical unit. In order to assess the efficiency of the designed and developed system, a 3-year randomized prospective clinical trial was conducted, using the study group and the control group, each consisting of 15 pregnant type 1 diabetic women. All patients were treated by the same diabetologist. In the presented analysis, two indices calculated weekly were used for the assessment of glycemic control: MBG represents mean blood glucose level, and the universal J-index is sensitive to the glycemic level and glycemic variations. The most important results from the study concern: (a) better glycemic control in the study group in comparison with the control group during the course of treatment, as assessed by the average differences of the MBG and J indices calculated weekly (n = 24) (deltaMBG = -3.2 +/- 4.3 mg/dL, p = 0.0016, deltaJ = -1.4 +/- 2.3, p = 0.0065); (b) much more similar results in glycemic control among members of the study group compared to each other, than among members of the control group compared to each other, as indicated by significantly lower variations of the applied glycemic control indices (SDMBG: 11.9 vs. 18.7 mg/dL, p = 0.0498; SDJ: 6.5 vs. 10.9, p = 0.0318); (c) the observed tendency of a better glycemic control for patients with a lower level of intelligence (IQ < 100) supported by the telematic system in comparison with all other assessed groups of patients. The last result was not statistically significant (p > 0.05). This telematic intensive care system improved the effectiveness of diabetes treatment during pregnancy. It also allows the diabetologist's strategy to be much more precise than if it were conducted without telematic support. This telematic system is inexpensive and simple in use.

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