AimsThe genetically polymorphic cytochrome P450 (CYP) enzyme CYP2C9 metabolizes most sulphonylurea oral hypoglycaemic agents. The aim of this study was to test the hypothesis that individuals with genotypes predicting low CYP2C9 activity may be at a higher risk of severe drug-associated hypoglycaemia. MethodsIn a case-control study, 20 diabetic patients admitted to the emergency department with severe hypoglycaemia during sulphonylurea drug treatment were compared with a control group of 337 patients with type 2 diabetes but without a history of severe hypoglycaemia. A large sample of 1988 healthy Caucasian subjects served as a second control group. ResultsThe CYP2C9 genotypes * 3/ * 3 and *2/*3 that are predictive of low enzyme activity were more common in the hypoglycaemic group than in the comparison groups (10% vs < 2%, respectively: odds ratio 5.2; 95% confidence interval 1.01, 27). Furthermore, the diabetic patient group with severe hypoglycaemia exhibited lower body mass indexes, higher rates of renal failure, were older compared with the diabetic group without severe hypoglycaemia, and were being treated with higher doses of glibenclamide. ConclusionsThese findings suggest that among other factors, individuals with genetically determined low CYP2C9 activity are at an increased risk of sulphonylurea-associated severe hypoglycaemia. Thus, genotyping might be a tool for the better prediction of adverse effects caused by oral hypoglycaemic agents.

Introduction Urinary incontinence (UI) is a health problem affecting the quality of women's lives (QOL) at various life stages. Stress urinary incontinence (SUI) can be caused by previous vaginal deliveries and is especially likely to occur in the perimenopausal period. The most commonly recommended first-choice treatment methods involve exercises for the pelvic floor muscles (PFM). The aim of this study was to assess the impact of isolated PFM exercises and combined training of the PFM and the m.transversus abdominis (TrA) muscle on the QoL of patients with SUI with regard to the number of vaginal deliveries. Material and Methods 137 women with SUI were qualified for analysis (mean age 53,1 ± 5,5). To assess the effectiveness of PFM training QOL questionnaire was used (ICIQ-LUTS qol). PFM training for groups A (PFM+TrA) and B (PFM) was intended for 12 weeks. Statistica v. 12.0 PL, StatSoft, USA, was used for statistical calculations. Results The analysis demonstrated that conservative treatment based on the A training program (PFM + TrA) yielded statistically significantly better results than the B program (PFM), with the improvement observed in such QoL domains as the performance of household duties, physical activity and travelling, social limitations, emotions, sleep problems and fatigue, the frequency of changing panty liners, fluid intake control, and embarrassment. Conclusion Both the combined training of the PFM and the synergistic (TrA) muscle and the isolated PFM exercises improve the QoL of women with SUI. Nonetheless, the combined PFM and TrA muscle physiotherapy is more effective. The exercises for the PFM and the synergistic muscle give better results in women who have given birth fewer than three times than isolated PFM exercises.

Stress urinary incontinence (SUI) influences quality of life in female patients. In this study, we used ICIQ LUTS QoL (The International Consultation Incontinence Questionnaire Lower Urinary Tract Symptoms quality of life) to determine the quality of life (QoL) in various domains in patients with stage 1 SUI. The study included 140 perimenopausal women subjected to urodynamic tests at the Department of Gynaecology, Endocrinology and Gynaecologic Oncology, Pomeranian Medical University, Police (Poland) in 2013–2015. The study subjects were divided into two groups, A and B. Each patient completed two questionnaires, an original survey developed by the authors and the validated ICIQ LUTS QoL. Two exercise programs, each lasting for 3 months and consisting of 4 weekly sessions, were recommended to the study subjects. The program for Group A included exercises for pelvic floor muscles (PFM) with simultaneous tension of the transverse abdominal muscle (TrA), and the program for Group B, PFM exercises without TrA tension. After completing the exercise programs, patients with stage 1 SUI, both from Group A and from Group B, showed a significant improvement in most QoL domains measured with ICIQ LUTS QoL. However, more beneficial effects of the training were observed in the group subjected to PFM exercises with TrA tension.

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Introduction: Kinesiotaping (KT) is one of the newest methods commonly used in many medical sciences: neurology, orthopaedics and traumatology, oncology, gynaecology and obstetrics, and in paediatrics. Due to its special properties, KT can be used depending on individual needs and problems during rehabilitation.Aim: This article presents a systematic review of the clinical effectiveness of using KT in physiotherapy. Conclusions: KT method is widespread in different medical sciences and is a good method supporting rehabilitation and pharmacological treatment. Due to its special properties it can be used in children, adults, and also pregnant women. Keywords: kinesiotaping, physiotherapy. STRESZCZENIEWstęp: Kinesiotaping (KT) jest metodą terapeutyczną, która znalazła zastosowanie w różnych dziedzinach medycyny: neurologii, ortopedii i traumatologii, onkologii, ginekologii i położnictwie oraz w pediatrii. Dzięki swoim specy icznym właściwościom KT może być stosowany w zależności od indywidualnych potrzeb i problemów podczas usprawniania. Cel: Celem pracy był przegląd piśmiennictwa dotyczącego skuteczności KT w izjoterapii.Wnioski: Kinesiotaping ze względu na szerokie zastosowanie w różnych dziedzinach izjoterapii może być dobrą metodą wspomagającą leczenie zarówno farmakologiczne, jak i usprawniające w wielu schorzeniach, a ze względu na swoje specy iczne właściwości może być stosowany u dzieci, dorosłych, a także u kobiet w ciąży. Słowa kluczowe: kinesiotaping, izjoterapia. WSTĘPKinesiotaping (KT) -plastrowanie dynamiczne jest jedną z metod izjoterapii rozwijającą się na świecie od ponad lat. Najczęściej wykorzystywany jest w terapii sportowców, ale od wielu lat również w izjoterapii różnych schorzeń [ ]. W Azji rozpowszechniony był w latach ., w USA i w Europie w latach . ubiegłego wieku, a w Polsce dopiero od r. Twórcą KT jest dr Kenzo Kase -lekarz chiropraktyk. Zauważył on, iż ból jest często wynikiem dysfunkcji mięśni i tkanek mięśniowo--powięziowych wokół stawów. Celem metody KT jest: normalizacja funkcji mięśni, poprawienie przepływu krwi i limfy, redukcja bólu, poprawienie propriocepcji, wspieranie procesów gojenia się tkanek oraz przywrócenie tkankom normalnego funkcjonowania [ , ]. Obecnie metoda ta stosowana jest w wielu dziedzinach medycyny. Jej podstawowym zadaniem jest wspomaganie układu mięśniowo -powięziowego poprzez zastosowanie różnego rodzaju aplikacji. Kinesiotaping może być stosowany zarówno jako metoda samodzielna, jak i uzupełniająca wcześniej zastosowaną terapię [ , , , , , , , , , , , , , , ]. Do terapii używa się specjalnych w % bawełnianych dynamicznych plastrów pokrytych hipoalergicznym akrylowym klejem aktywowanym ciepłem, układającym się w warstwy o kształcie sinusoidalnym. Pomimo to istnieje jednak ryzyko wystąpienia reakcji alergicznej wynikającej z połą-czenia substancji stosowanych do przygotowania skóry przed aplikacją (np. spirytus, środki myjące z hipoalergicznym klejem stosowanym do plastrów) [ , , ]. Plastry są naklejane na papier z napięciem ok. -% (naprężenie począt...

In SH associated with glimepiride therapy, no correlation between glimepiride serum concentrations and the protracted stimulation of insulin and C-peptide was observed. The secretion of glucagon and epinephrine as counterregulatory hormonal responses was unaffected. Protracted increased release of cortisol might be a medium-term indicator of glimepiride-associated SH.

In patients approaching the insulin-deficient end of the spectrum of type 2 diabetes the hormonal responses to SH are comparable to those in patients with longstanding type 1 diabetes. Thus, in advanced type 2 diabetes the risk of developing SH may be similar to that in individuals with type 1 diabetes.

Background: Chronic pelvic pain affects approximately 15% of reproductive age women. It is mainly caused by adhesions (20–40%). Despite CPP being the main symptom of endometriosis, the disease is confirmed by laparoscopy only in 12–18% of cases. The aim of this study was to evaluate the results of laparoscopy in women with CCP and to assess the sensitivity and specificity of elements of an interview and clinical examination. Materials and methods: The study included 148 women with CPP. Each patient underwent laparoscopy. In laparoscopy, the presence of endometriosis and/or peritoneal adhesions was confirmed. Then, the sensitivity and specificity and the positive and negative predictive value of endometriosis symptoms or abnormalities in the gynecological examination were statistically calculated. Results: After previous surgery, adhesions were found in almost half (47%) of patients. In patients without a history of surgery, adhesions were diagnosed in 6.34% of patients. Endometriosis without coexisting adhesions was more often diagnosed in women without previous surgery (34.9%), compared to 10.58% in the group with a history of surgery (p < 0.05). Conclusions: Intraperitoneal adhesions are most common in women after pelvic surgery and with chronic ailments. The best results for sensitivity, specificity, positive predictive value, and negative predictive value in the diagnosis of endometriosis are found in women with irregular menstruations during which the pain increases. Laparoscopy still remains the primary diagnostic and therapeutic method for these women.