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Paweł J. Stanirowski graduated from the Medical University of Warsaw (Poland) and obtained his M.D. degree in 2010. He completed his one-year post-graduate internship at the Mazovian Bródno Hospital in 2011 and started specialisation in obstetrics and gynecology as part of residency of the Ministry of Health, in the Department of Obstetrics, Gynecology and Oncology, II Faculty of Medicine at the Medical University of Warsaw. Currently, he has been working in the 1st Department of Obstetrics and Gynecology at the Medical University of Warsaw as an assistant/ researcher. His main interests focuse on the issues of transplacental nutrient transfer (in particular GLUT- mediated) in pregnancies complicated by diabetes mellitus and fetal growth disorders as well as on the utilisation of a new ultrasound markers in the assessment of intrauterine fetal growth. In 2018 Paweł J. Stanirowski obtained his PhD and ob/gyn specialist titles. He is the first author of original and review publications and an active reviewer in Polish and international journals.
Introduction Gestational diabetes mellitus (GDM) is a glucose intolerance occurring in 3%–10% of pregnant women and being a risk factor for multiple maternal and fetal complications. The risk of perinatal complications is proportional to the level of maternal hyperglycaemia. Proper glycaemic control is therefore one of the key elements of GDM therapy. Until recently, determination of blood glucose concentration was performed using glucose meters, which involved multiple fingerpricks. Nowadays, due to the flash glucose monitoring (FGM) availability, it is possible to collect measurements at any time without routine puncturing. The aim of the presented study is to assess the impact of FGM on the efficacy of treatment in population of patients diagnosed with GDM. Methods and analysis This is a prospective, randomised study, that will recruit 100 women at 24–28 weeks of gestation at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland. Women diagnosed with GDM, who will meet the inclusion criteria, will be individually randomised to the FGM or self-monitoring of blood glucose groups. Further on, clinical and laboratory results of the mother and their newborns will be collected for analysis during the course of pregnancy. Primary outcome is mean glycaemia result in each group after 1 month analysis and percentage of results in the target glycaemic range. The secondary objectives will be to compare the two groups for maternal and neonatal outcomes in conjunction with long-term glycaemic control using blood glycated haemoglobin and fructosamine serum concentrations. Ethics and dissemination The study is exempt from regional ethics review due to its nature of quality improvement in patient care. The study has been approved by the Bioethics Committee at the Medical University of Warsaw and the patient privacy protection boards governing over the recruitment sites. Results of the study will be presented in peer-reviewed journals and at conferences. Trial registration number NCT04422821.
Agata Majewska; Paweł Stanirowski; Mirosław Wielgoś; Dorota Bomba-Opoń. Flash glucose monitoring in gestational diabetes mellitus: study protocol for a randomised controlled trial. BMJ Open 2021, 11, e041486 .
AMA StyleAgata Majewska, Paweł Stanirowski, Mirosław Wielgoś, Dorota Bomba-Opoń. Flash glucose monitoring in gestational diabetes mellitus: study protocol for a randomised controlled trial. BMJ Open. 2021; 11 (3):e041486.
Chicago/Turabian StyleAgata Majewska; Paweł Stanirowski; Mirosław Wielgoś; Dorota Bomba-Opoń. 2021. "Flash glucose monitoring in gestational diabetes mellitus: study protocol for a randomised controlled trial." BMJ Open 11, no. 3: e041486.
Background The aim of the study was to evaluate the ultrasound-derived measurements of the fetal soft-tissue, heart, liver and umbilical cord in pregnancies complicated by gestational (GDM) and type 1 diabetes mellitus (T1DM), and further to assess their applicability in the estimation of the fetal birth-weight and prediction of fetal macrosomia. Methods Measurements were obtained from diet-controlled GDM (GDMG1) (n = 40), insulin-controlled GDM (GDMG2) (n = 40), T1DM (n = 24) and healthy control (n = 40) patients. The following parameters were selected for analysis: fetal sub-scapular fat mass (SSFM), abdominal fat mass (AFM), mid-thigh fat/lean mass (MTFM/MTLM) and inter-ventricular septum (IVS) thicknesses, heart and thorax circumference and area (HeC/HeA; ThC/ThA), liver length (LL), umbilical cord/vein/arteries circumference and area (UmC/UmA; UvC/UvA; UaC/UaA) together with total umbilical vessels (UveA) and Wharton's jelly area (WjA). Regression models were created in order to assess the contribution of selected parameters to fetal birth-weight (FBW) and risk of fetal macrosomia. Results Measurements of the fetal SSFM, AFM, MTFM, MTFM/MTLM ratio, HeC, HeA, IVS, LL, UmC, UmA, UaC, UaA, UveA and WjA were significantly increased among patients with GDMG2/T1DM as compared to GDMG1 and/or control groups (p < .05). The regression analysis revealed that maternal height as well as fetal biparietal diameter, abdominal circumference (AC), AFM and LL measurements were independent predictors of the FBW (p < .05). In addition, increase in the fetal AFM, AC and femur length (FL) was associated with a significant risk of fetal macrosomia occurrence (p < .05). The equation developed for the FBW estimation [FBW(g) = − 2254,942 + 17,204 * FL (mm) + 105,531 * AC (cm) + 131,347 * AFM (mm)] provided significantly lower mean absolute percent error than standard formula in the sub-group of women with T1DM (5.7% vs 9.4%, p < .05). Moreover, new equation including AC, FL and AFM parameters yielded sensitivity of 93.8%, specificity 77.7%, positive predictive value 54.5% and negative predictive value of 97.8% in the prediction of fetal macrosomia. Conclusions Ultrasound measurements of the fetal soft tissue, heart, liver and umbilical cord are significantly increased among women with GDM treated with insulin and T1DM. In addition to standard biometric measurements, parameters, such as AFM, may find application in the management of diabetes-complicated pregnancies.
Paweł Jan Stanirowski; Agata Majewska; Michał Lipa; Dorota Bomba-Opoń; Mirosław Wielgoś. Ultrasound evaluation of the fetal fat tissue, heart, liver and umbilical cord measurements in pregnancies complicated by gestational and type 1 diabetes mellitus: potential application in the fetal birth-weight estimation and prediction of the fetal macrosomia. Diabetology & Metabolic Syndrome 2021, 13, 1 -14.
AMA StylePaweł Jan Stanirowski, Agata Majewska, Michał Lipa, Dorota Bomba-Opoń, Mirosław Wielgoś. Ultrasound evaluation of the fetal fat tissue, heart, liver and umbilical cord measurements in pregnancies complicated by gestational and type 1 diabetes mellitus: potential application in the fetal birth-weight estimation and prediction of the fetal macrosomia. Diabetology & Metabolic Syndrome. 2021; 13 (1):1-14.
Chicago/Turabian StylePaweł Jan Stanirowski; Agata Majewska; Michał Lipa; Dorota Bomba-Opoń; Mirosław Wielgoś. 2021. "Ultrasound evaluation of the fetal fat tissue, heart, liver and umbilical cord measurements in pregnancies complicated by gestational and type 1 diabetes mellitus: potential application in the fetal birth-weight estimation and prediction of the fetal macrosomia." Diabetology & Metabolic Syndrome 13, no. 1: 1-14.
Obesity and diabetes increase the risk of complications during gestation and at delivery. The aim of this study was to compare the perinatal outcomes in the populations of diabetic and obese Polish women, based on the results of a national survey performed in years 2012 and 2017, as well as to determine the risk factors of the gestational diabetes mellitus (GDM). Questionnaires from 6276 women were collected. Obese women constituted 5.5% and 7.5% of study population in years 2012 and 2017, respectively. Among women whose pregnancies were complicated by diabetes mellitus, GDM constituted the most common type of glucose intolerance during both time periods (2012: 89% vs. 2017: 85.6%). In the group of obese women an insignificant increase in the rate of induced deliveries was noted (2012: 9.9% vs. 2017: 11.7%), whereas the fetal birth-weight decreased significantly (2012: 3565g vs. 2017: 3405g, p < 0.05). In the group of diabetic pregnant women the percentage of cesarean sections, labour inductions and fetal birth defects was characterized by an insignificant upward trend. Risk of GDM was significantly increased in women aged over 35 years—(2012: OR 1.9 (95% CI: 1.1–2.9) and 2017: OR = 2.1 (95% CI: 1.5–2.9), p < 0.05—, as well as in overweight women—2012: OR 1.8 (95% CI: 1.2–2.7) and 2017: OR 2.6 (95% CI: 1.9–3.4), p < 0.05—during both analysed time periods. Based on the study results, it is necessary to develop population-based programmes to prevent obesity and to introduce and enforce the rules of appropriate screening for glucose tolerance disorders during pregnancy.
Cezary Wojtyla; Pawel Stanirowski; Pawel Gutaj; Michal Ciebiera; Andrzej Wojtyla. Perinatal Outcomes in a Population of Diabetic and Obese Pregnant Women—The Results of the Polish National Survey. International Journal of Environmental Research and Public Health 2021, 18, 560 .
AMA StyleCezary Wojtyla, Pawel Stanirowski, Pawel Gutaj, Michal Ciebiera, Andrzej Wojtyla. Perinatal Outcomes in a Population of Diabetic and Obese Pregnant Women—The Results of the Polish National Survey. International Journal of Environmental Research and Public Health. 2021; 18 (2):560.
Chicago/Turabian StyleCezary Wojtyla; Pawel Stanirowski; Pawel Gutaj; Michal Ciebiera; Andrzej Wojtyla. 2021. "Perinatal Outcomes in a Population of Diabetic and Obese Pregnant Women—The Results of the Polish National Survey." International Journal of Environmental Research and Public Health 18, no. 2: 560.
Objectives To evaluate the impact of placental anastomoses on the intrauterine growth of monochorionic (MC) twins. Methods A prospective study was conducted in a group of 53 MC twins. Intrapartally umbilical cords were clamped to identify placental sides corresponding to each twin. The postnatal dye injection technique was administered to evaluate vascular anastomoses, their number and type and visualize placental territory sharing patterns. Data from digital analysis were correlated with obstetrical follow-up. Results Vascular anastomoses were revealed in 88.7% of cases. Arteriovenous (AV) anastomoses occurred in 75.4% and arterioarterial (AA) in 71.1% while venovenous (VV) in 26.4%. In the subgroup of MC twins without placental anastomoses, significantly higher birthweight difference and discordance were revealed when compared to MC twins without anastomoses (382.0 vs. 22 g; P = 0.03 and 49.14% vs. 16.02%; P = 0.03). On the other hand, in subgroups of MC twins with at least one AA anastomosis, twins’ birthweights were similar (p = ns) despite significantly higher placental territory sharing discordance (30.44% vs. 15.81%; P = 0.31). Conclusions Vascular anastomoses have a major impact on the intrauterine growth of MC twins. In certain cases, they may cause specific complications; however, in general, they regulate intertwin blood exchange and may compensate unequal placental territory.
Michał Lipa; Przemysław Kosinski; Paweł Stanirowski; Mirosław Wielgos; Dorota Bomba-Opon. Vascular anastomoses in intrauterine growth in monochorionic twins. Journal of Perinatal Medicine 2020, 48, 539 -543.
AMA StyleMichał Lipa, Przemysław Kosinski, Paweł Stanirowski, Mirosław Wielgos, Dorota Bomba-Opon. Vascular anastomoses in intrauterine growth in monochorionic twins. Journal of Perinatal Medicine. 2020; 48 (6):539-543.
Chicago/Turabian StyleMichał Lipa; Przemysław Kosinski; Paweł Stanirowski; Mirosław Wielgos; Dorota Bomba-Opon. 2020. "Vascular anastomoses in intrauterine growth in monochorionic twins." Journal of Perinatal Medicine 48, no. 6: 539-543.
During pregnancy fetal growth disorders, including fetal macrosomia and fetal growth restriction (FGR) are associated with numerous maternal-fetal complications, as well as due to the adverse effect of the intrauterine environment lead to an increased morbidity in adult life. Accumulating evidence suggests that occurrence of fetal macrosomia or FGR, may be associated with alterations in the transfer of nutrients across the placenta, in particular of glucose. The placental expression and activity of specific GLUT transporters are the main regulatory factors in the process of maternal-fetal glucose exchange. This review article summarizes the results of previous studies on the expression of GLUT transporters in the placenta, concentrating on human pregnancies complicated by intrauterine fetal growth disorders. Characteristics of each transporter protein found in the placenta is presented, alterations in the location and expression of GLUT isoforms observed in individual placental compartments are described, and the factors regulating the expression of selected GLUT proteins are examined. Based on the above data, the potential function of each GLUT isoform in the maternal-fetal glucose transfer is determined. Further on, a detailed analysis of changes in the expression of glucose transporters in pregnancies complicated by fetal growth disorders is given, and significance of these modifications for the pathogenesis of fetal macrosomia and FGR is discussed. In the final part novel interventional approaches that might reduce the risk associated with abnormalities of intrauterine fetal growth through modifications of placental GLUT-mediated glucose transfer are explored.
Paweł Jan Stanirowski; Michał Lipa; Dorota Bomba-Opoń; Mirosław Wielgoś. Expression of placental glucose transporter proteins in pregnancies complicated by fetal growth disorders. Protein-Protein Interactions in Human Disease, Part A 2020, 123, 95 -131.
AMA StylePaweł Jan Stanirowski, Michał Lipa, Dorota Bomba-Opoń, Mirosław Wielgoś. Expression of placental glucose transporter proteins in pregnancies complicated by fetal growth disorders. Protein-Protein Interactions in Human Disease, Part A. 2020; 123 ():95-131.
Chicago/Turabian StylePaweł Jan Stanirowski; Michał Lipa; Dorota Bomba-Opoń; Mirosław Wielgoś. 2020. "Expression of placental glucose transporter proteins in pregnancies complicated by fetal growth disorders." Protein-Protein Interactions in Human Disease, Part A 123, no. : 95-131.
A randomised controlled trial (RCT) recruited women undergoing caesarean section (CS) in Poland. The aim of the trial was to assess the efficacy of a dialkylcarbamoyl chloride (DACC)-impregnated surgical dressing (bacterial-binding dressings) compared with standard of care (SoC) in preventing surgical site infection (SSI). The aim of the present analysis was to evaluate the cost-effectiveness of the bacterial-binding dressings in the context of the UK National Health Service (NHS). The clinical trial randomised patients to a bacterial-binding dressing (n=272) or a standard surgical dressing (n=271). The study recorded the presence of SSI and associated resource use up to 14 days postoperatively. To generalise results to the NHS, UK unit costs were applied to resource use recorded in the trial. An alternative approach applied a single UK-specific episode cost per SSI. There were 543 women recruited to the trial. SSI rates were 5/272 (1.8%) and 14/271 (5.2%) for bacterial-binding dressings and SoC, respectively (p=0.04). Patients in the bacterial-binding dressing group had six fewer outpatient visits and 33 fewer hospital bed-days. The mean length of SSI-attributable hospitalisation was 2.36 days. Applying UK unit costs at 2017 prices to resource use recorded in the trial, costs of SSI prophylaxis and treatment were £48.97 and £24.69 per patient in the SoC and bacterial-binding dressing groups respectively, a difference of £24.27 (49.6%) per patient. The alternative costing approach produced a cost saving of £119 (57.6%) per patient with the bacterial-binding dressing. Use of bacterial-binding dressings following CS has the potential to reduce the incidence of SSI and costs to the NHS.
Paweł Jan Stanirowski; Heather Davies; Jessica McMaster; Stuart Mealing; Włodzimierz Sawicki; Krzysztof Cendrowski; John Posnett. Cost-effectiveness of a bacterial-binding dressing to prevent surgical site infection following caesarean section. Journal of Wound Care 2019, 28, 222 -228.
AMA StylePaweł Jan Stanirowski, Heather Davies, Jessica McMaster, Stuart Mealing, Włodzimierz Sawicki, Krzysztof Cendrowski, John Posnett. Cost-effectiveness of a bacterial-binding dressing to prevent surgical site infection following caesarean section. Journal of Wound Care. 2019; 28 (4):222-228.
Chicago/Turabian StylePaweł Jan Stanirowski; Heather Davies; Jessica McMaster; Stuart Mealing; Włodzimierz Sawicki; Krzysztof Cendrowski; John Posnett. 2019. "Cost-effectiveness of a bacterial-binding dressing to prevent surgical site infection following caesarean section." Journal of Wound Care 28, no. 4: 222-228.
Nabil Abdalla; Robert Piorkowski; Seweryn Trojanowski; Alicja Jakimiuk; Wieslaw Malicki; Pawel Stanirowski; Krzysztof Cendrowski; Wlodzimierz Sawicki. Different and non-specific ultrasound features of two uterine sarcoma subtypes: Case series. European Journal of Obstetrics & Gynecology and Reproductive Biology 2019, 234, e228 -e229.
AMA StyleNabil Abdalla, Robert Piorkowski, Seweryn Trojanowski, Alicja Jakimiuk, Wieslaw Malicki, Pawel Stanirowski, Krzysztof Cendrowski, Wlodzimierz Sawicki. Different and non-specific ultrasound features of two uterine sarcoma subtypes: Case series. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2019; 234 ():e228-e229.
Chicago/Turabian StyleNabil Abdalla; Robert Piorkowski; Seweryn Trojanowski; Alicja Jakimiuk; Wieslaw Malicki; Pawel Stanirowski; Krzysztof Cendrowski; Wlodzimierz Sawicki. 2019. "Different and non-specific ultrasound features of two uterine sarcoma subtypes: Case series." European Journal of Obstetrics & Gynecology and Reproductive Biology 234, no. : e228-e229.
Nabil Abdalla; Alicja Jakimiuk; Robert Piorkowski; Seweryn Trojanowski; Wieslaw Malicki; Pawel Stanirowski; Krzysztof Cendrowski; Wlodzimierz Sawicki. Pre-surgical diagnostic challenges for coincidental three pathologies (endometrial cancer, ovarian serous cyst and endometriotic cyst): case report. European Journal of Obstetrics & Gynecology and Reproductive Biology 2019, 234, e228 .
AMA StyleNabil Abdalla, Alicja Jakimiuk, Robert Piorkowski, Seweryn Trojanowski, Wieslaw Malicki, Pawel Stanirowski, Krzysztof Cendrowski, Wlodzimierz Sawicki. Pre-surgical diagnostic challenges for coincidental three pathologies (endometrial cancer, ovarian serous cyst and endometriotic cyst): case report. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2019; 234 ():e228.
Chicago/Turabian StyleNabil Abdalla; Alicja Jakimiuk; Robert Piorkowski; Seweryn Trojanowski; Wieslaw Malicki; Pawel Stanirowski; Krzysztof Cendrowski; Wlodzimierz Sawicki. 2019. "Pre-surgical diagnostic challenges for coincidental three pathologies (endometrial cancer, ovarian serous cyst and endometriotic cyst): case report." European Journal of Obstetrics & Gynecology and Reproductive Biology 234, no. : e228.
Aim. This study compared the diagnostic performance of the Risk of Ovarian Malignancy Algorithm (ROMA) and HE4 and CA125 for the presurgical differentiation of adnexal tumors. Material and Methods. This prospective study included 302 patients admitted for surgical treatment due to adnexal tumors. The ROMA was calculated depending on CA125, HE4, and menopausal status. Results. Fifty patients were diagnosed with malignant disease. In the differentiation of malignant from nonmalignant adnexal tumors, the area under curve (AUC) was higher for ROMA and HE4 than that for CA125 in both the premenopausal and postmenopausal subgroups. In the differentiation of stage I FIGO malignancies and epithelial ovarian cancer from nonmalignant pathologies, the AUC of HE4 and ROMA was higher than that of CA125. The ROMA performed significantly better than CA125 in the differentiation of all malignancies and differentiation of stage I FIGO malignancies from nonmalignant pathologies ( p = 0.043 and p = 0.025 , resp.). There were no significant differences between the ROMA and the tumor markers for any other variants. Conclusions. The ROMA is more useful than CA125 for the differentiation of malignant (including stage I FIGO) from nonmalignant adnexal tumors. It is also as useful as HE4 and CA125 for the differentiation of epithelial ovarian cancer from nonmalignant adnexal tumors.
Nabil Abdalla; Robert Piorkowski; Michal Bachanek; Pawel Stanirowski; Krzysztof Cendrowski; Wlodzimierz Sawicki. Does the Risk of Ovarian Malignancy Algorithm Provide Better Diagnostic Performance Than HE4 and CA125 in the Presurgical Differentiation of Adnexal Tumors in Polish Women? Disease Markers 2018, 2018, 1 -12.
AMA StyleNabil Abdalla, Robert Piorkowski, Michal Bachanek, Pawel Stanirowski, Krzysztof Cendrowski, Wlodzimierz Sawicki. Does the Risk of Ovarian Malignancy Algorithm Provide Better Diagnostic Performance Than HE4 and CA125 in the Presurgical Differentiation of Adnexal Tumors in Polish Women? Disease Markers. 2018; 2018 ():1-12.
Chicago/Turabian StyleNabil Abdalla; Robert Piorkowski; Michal Bachanek; Pawel Stanirowski; Krzysztof Cendrowski; Wlodzimierz Sawicki. 2018. "Does the Risk of Ovarian Malignancy Algorithm Provide Better Diagnostic Performance Than HE4 and CA125 in the Presurgical Differentiation of Adnexal Tumors in Polish Women?" Disease Markers 2018, no. : 1-12.
Primary transitional cell carcinoma of the fallopian tube is a very rare condition. We present a case of a 70-year-old asymptomatic Caucasian patient with an irregular solid right adnexal mass of 67 × 35 × 59 mm which was discovered during routine ultrasound pelvic examination. There was no acoustic shadow and the patient did not feel pain during examination. No evidence of metastases or ascites was found by ultrasound. There was moderate vascularization of the mass. The mass was considered malignant according to the subjective assessment of the examiner. Serum level of CA125 was elevated to 519 U/ml. The results of logistic regression model LR2 according to the International Ovarian Tumor Analysis (IOTA) group was 64.4%, suggesting the malignant nature of the mass. The IOTA-ADNEX model showed 97% probability of malignancy, probably (85.5%) stage II-IV ovarian cancer. The risk of malignancy being borderline, stage I and metastatic was 0.6%, 3.9% and 7%, respectively. Omitting CA125 in the IOTA-ADNEX model slightly decreased the probability of malignancy to 81.3%, still most likely (54.2%) stage II-IV ovarian cancer. The results of risk of malignancy indices RMI I-IV were 1557, 2076, 1557 and 2076, respectively, reflecting the malignant nature of the mass. The final diagnosis was transitional cell carcinoma of the fallopian tube, stage IIIc according to FIGO.
Nabil Abdalla; Anna Wnuk; Seweryn Trojanowski; Alicja Jakimiuk; Pawel Stanirowski; Krzysztof Cendrowski; Wlodzimierz Sawicki. Presurgical diagnostic difficulties in an asymptomatic patient with primary transitional cell carcinoma of the oviduct: case report. Menopausal Review 2018, 17, 91 -93.
AMA StyleNabil Abdalla, Anna Wnuk, Seweryn Trojanowski, Alicja Jakimiuk, Pawel Stanirowski, Krzysztof Cendrowski, Wlodzimierz Sawicki. Presurgical diagnostic difficulties in an asymptomatic patient with primary transitional cell carcinoma of the oviduct: case report. Menopausal Review. 2018; 17 (2):91-93.
Chicago/Turabian StyleNabil Abdalla; Anna Wnuk; Seweryn Trojanowski; Alicja Jakimiuk; Pawel Stanirowski; Krzysztof Cendrowski; Wlodzimierz Sawicki. 2018. "Presurgical diagnostic difficulties in an asymptomatic patient with primary transitional cell carcinoma of the oviduct: case report." Menopausal Review 17, no. 2: 91-93.
Aims. To assess whether replacing CA125 with HE4 in the classical formulas of risk of malignancy indices (RMIs) can improve diagnostic performance. Methods. For each of 312 patients with an adnexal mass, classical RMIs 1–4 were computed based on ultrasound score, menopausal status, and serum CA125 levels. Additionally, modified RMIs (mRMIs) 1–4 were recalculated by replacing CA125 with HE4. Results. Malignant pathology was diagnosed in 52 patients (16.67%). There was no significant difference in diagnostic performance (area under the receiver operating characteristic curve [AUC]) between each classical RMI and its corresponding mRMI. In the entire sample, the AUC was 0.899, 0.900, 0.895, and 0.908 for classical RMIs 1–4 compared to 0.903, 0.929, 0.930, and 0.931 for mRMIs 1–4. In premenopausal patients, the AUC was 0.818, 0.798, 0.795, and 0.802 for classical RMIs 1–4 compared to 0.839, 0.875, 0.876, and 0.856 for mRMIs 1–4. In postmenopausal patients, the AUC was 0.906, 0.895, 0.896, and 0.906 for classical RMIs 1–4 compared to 0.907, 0.923, 0.924, and 0.930 for mRMI 1–4. Conclusions. Use of HE4 instead of CA125 did not significantly improve diagnostic performance of RMIs 1–4 in patients with an adnexal mass.
Nabil Abdalla; Robert Piórkowski; Paweł Stanirowski; Krzysztof Cendrowski; Włodzimierz Sawicki. Can Replacing CA125 with HE4 in Risk of Malignancy Indices 1–4 Improve Diagnostic Performance in the Presurgical Assessment of Adnexal Tumors? BioMed Research International 2017, 2017, 1 -12.
AMA StyleNabil Abdalla, Robert Piórkowski, Paweł Stanirowski, Krzysztof Cendrowski, Włodzimierz Sawicki. Can Replacing CA125 with HE4 in Risk of Malignancy Indices 1–4 Improve Diagnostic Performance in the Presurgical Assessment of Adnexal Tumors? BioMed Research International. 2017; 2017 ():1-12.
Chicago/Turabian StyleNabil Abdalla; Robert Piórkowski; Paweł Stanirowski; Krzysztof Cendrowski; Włodzimierz Sawicki. 2017. "Can Replacing CA125 with HE4 in Risk of Malignancy Indices 1–4 Improve Diagnostic Performance in the Presurgical Assessment of Adnexal Tumors?" BioMed Research International 2017, no. : 1-12.
Purpose: The aim of the study was to analyze the correlations between the expression of glucose transporters GLUT-1, GLUT-4, and GLUT-9 in human term placenta and selected maternal and fetal parameters in pregnancies complicated by diabetes mellitus (DM). Materials and methods: Placental samples were obtained from healthy control (n = 25) and diabetic pregnancies, including diet-controlled gestational diabetes mellitus (GDMG1) (n = 16), insulin-controlled gestational diabetes mellitus (GDMG2) (n = 6), and pregestational DM (PGDM) (n = 6). Computer-assisted quantitative morphometry of stained placental sections was performed to determine the expression of selected glucose transporter proteins. For the purposes of correlation analysis, the following parameters were selected: type of diabetes, gestational age, maternal prepregnancy body mass index (BMI), gestational weight gain, third trimester glycated hemoglobin concentration, placental weight, fetal birth weight (FBW) as well as ultrasonographic indicators of fetal adiposity, including subscapular (SSFM), abdominal (AFM), and midthigh (MTFM) fat mass measurements. Results: In the PGDM group, the analysis demonstrated positive correlations between the placental expression of GLUT-1, GLUT-4, and GLUT-9 and FBW, AFM, and SSFM measurements (p < .05). Similarly in the GDMG2 patients positive correlations between GLUT-4 expression, FBW and SSFM were observed (p < .05). In the multivariate regression analysis, only the type of diabetes and FBW were significantly associated with GLUTs expression (p < .001). In addition, maternal prepregnancy BMI significantly contributed to GLUT-1 expression (p < .001). Conclusions: The study results revealed that placental expression of GLUT-1, GLUT-4, and GLUT-9 may be involved in the intensification of the fetal growth in pregnancies complicated by GDM/PGDM.
Paweł Jan Stanirowski; Dariusz Szukiewicz; Michał Pyzlak; Nabil Abdalla; Włodzimierz Sawicki; Krzysztof Cendrowski. Analysis of correlations between the placental expression of glucose transporters GLUT-1, GLUT-4 and GLUT-9 and selected maternal and fetal parameters in pregnancies complicated by diabetes mellitus. The Journal of Maternal-Fetal & Neonatal Medicine 2017, 32, 650 -659.
AMA StylePaweł Jan Stanirowski, Dariusz Szukiewicz, Michał Pyzlak, Nabil Abdalla, Włodzimierz Sawicki, Krzysztof Cendrowski. Analysis of correlations between the placental expression of glucose transporters GLUT-1, GLUT-4 and GLUT-9 and selected maternal and fetal parameters in pregnancies complicated by diabetes mellitus. The Journal of Maternal-Fetal & Neonatal Medicine. 2017; 32 (4):650-659.
Chicago/Turabian StylePaweł Jan Stanirowski; Dariusz Szukiewicz; Michał Pyzlak; Nabil Abdalla; Włodzimierz Sawicki; Krzysztof Cendrowski. 2017. "Analysis of correlations between the placental expression of glucose transporters GLUT-1, GLUT-4 and GLUT-9 and selected maternal and fetal parameters in pregnancies complicated by diabetes mellitus." The Journal of Maternal-Fetal & Neonatal Medicine 32, no. 4: 650-659.
Subamniotic Haematoma Associated with an Uneventful Labour
Nabil Abdalla; Robert Piorkowski; Paweł Stanirowski; Krzysztof Cendrowski; Wlodzimierz Sawicki. Subamniotic Haematoma Associated with an Uneventful Labour. Sultan Qaboos University Medical Journal [SQUMJ] 2017, 17, e366 -367.
AMA StyleNabil Abdalla, Robert Piorkowski, Paweł Stanirowski, Krzysztof Cendrowski, Wlodzimierz Sawicki. Subamniotic Haematoma Associated with an Uneventful Labour. Sultan Qaboos University Medical Journal [SQUMJ]. 2017; 17 (3):e366-367.
Chicago/Turabian StyleNabil Abdalla; Robert Piorkowski; Paweł Stanirowski; Krzysztof Cendrowski; Wlodzimierz Sawicki. 2017. "Subamniotic Haematoma Associated with an Uneventful Labour." Sultan Qaboos University Medical Journal [SQUMJ] 17, no. 3: e366-367.
Can ultrasound be helpful in selecting optimal management methods for pregnancies complicated by placental non-trophpblastic tumors?
Nabil Abdalla; Robert Piórkowski; Paweł Stanirowski; Monika Pazura; Krzysztof Cendrowski; Włodzimierz Sawicki. Can ultrasound be helpful in selecting optimal management methods for pregnancies complicated by placental non-trophpblastic tumors? Journal of Ultrasonography 2017, 17, 116 -122.
AMA StyleNabil Abdalla, Robert Piórkowski, Paweł Stanirowski, Monika Pazura, Krzysztof Cendrowski, Włodzimierz Sawicki. Can ultrasound be helpful in selecting optimal management methods for pregnancies complicated by placental non-trophpblastic tumors? Journal of Ultrasonography. 2017; 17 (69):116-122.
Chicago/Turabian StyleNabil Abdalla; Robert Piórkowski; Paweł Stanirowski; Monika Pazura; Krzysztof Cendrowski; Włodzimierz Sawicki. 2017. "Can ultrasound be helpful in selecting optimal management methods for pregnancies complicated by placental non-trophpblastic tumors?" Journal of Ultrasonography 17, no. 69: 116-122.
Gestational diabetes mellitus and pregestational diabetes mellitus constitute carbohydrate metabolism disorders, which, if not diagnosed and adequately treated, lead to serious and often life-threatening pregnancy complications. According to a recently formulated hypothesis, some diabetes-related complications, such as fetal macrosomia, may be the result of disturbances in the transplacental transport of nutrients—in particular, excessive maternal-fetal glucose transfer. Throughout pregnancy, glucose flux across the placenta is mediated by the group of facilitative glucose transporters (GLUT), the expression of which in different placental compartments is the precondition for effective glucose uptake from maternal blood and its subsequent transfer to the fetal circulation. In diabetes-complicated pregnancies, the location, expression and activity of glucose transporters are modified to an extent that results in alterations in the maternal-fetal glucose exchange, potentially leading to an excessive supply of energy substrates to the fetus. This paper reviews the literature on the expression and activity of glucose transporter proteins—GLUT-1, GLUT-3, GLUT-4, GLUT-8, GLUT-9 and GLUT-12—in the human placenta, with a special focus on diabetes-complicated pregnancy. The characteristics of transporters in conditions of maternal normoglycemia and modifications occurring in the diabetic placenta are summarized, and the factors responsible for the regulation of the expression of selected isoforms are described. Finally, the impact of alterations in the placental expression of the aforementioned members of the GLUT family on intrauterine fetal development in pregnancies complicated by diabetes mellitus is discussed. Résumé Le diabète sucré gestationnel et le diabète sucré prégestationnel sont des anomalies du métabolisme des glucides qui, si elles ne sont pas diagnostiquées et adéquatement traitées, mènent à des complications de grossesse qui sont sérieuses et qui menacent le pronostic vital. Selon une hypothèse récemment formulée, certaines complications liées au diabète telles que la macrosomie fœtale peuvent résulter des perturbations dans le transport transplacentaire des nutriments, particulièrement le transfert excessif du glucose entre la mère et le fœtus. Tout au long de la grossesse, le flux transplacentaire du glucose est médié par la famille des facilitateurs du transport de glucose (GLUT), dont l'expression dans les différents compartiments placentaires est la condition préalable à une absorption efficace du glucose provenant du sang maternel et à son transfert subséquent à la circulation fœtale. Lors de grossesses compliquées d'un diabète, la localisation, l'expression et l'activité des transporteurs de glucose sont modifiées à un point tel qu'elles entraînent des altérations dans les échanges du glucose entre la mère et le fœtus, qui pourraient mener à un approvisionnement excessif en substrats énergétiques du fœtus. Le présent article porte entre autres sur une revue de la littérature sur l'expression et l'activité des protéines de transport du glucose—GLUT1, GLUT3, GLUT4, GLUT8, GLUT9 et GLUT12—dans le placenta humain et souligne plus particulièrement la grossesse compliquée d'un diabète. Nous résumons les caractéristiques des transporteurs lors d'un état de normoglycémie chez la mère et les modifications placentaires associées au diabète, et décrivons lesfacteurs responsables de la régulation de l'expression de certaines isoformes. En conclusion, nous discutons des conséquences des altérations de l'expression placentaire des membres de la famille des GLUT ci-dessus sur le développement intra-utérin du fœtus lors de grossesses compliquées d'un diabète.
Paweł Jan Stanirowski; Dariusz Szukiewicz; Monika Pazura-Turowska; Włodzimierz Sawicki; Krzysztof Cendrowski. Placental Expression of Glucose Transporter Proteins in Pregnancies Complicated by Gestational and Pregestational Diabetes Mellitus. Canadian Journal of Diabetes 2017, 42, 209 -217.
AMA StylePaweł Jan Stanirowski, Dariusz Szukiewicz, Monika Pazura-Turowska, Włodzimierz Sawicki, Krzysztof Cendrowski. Placental Expression of Glucose Transporter Proteins in Pregnancies Complicated by Gestational and Pregestational Diabetes Mellitus. Canadian Journal of Diabetes. 2017; 42 (2):209-217.
Chicago/Turabian StylePaweł Jan Stanirowski; Dariusz Szukiewicz; Monika Pazura-Turowska; Włodzimierz Sawicki; Krzysztof Cendrowski. 2017. "Placental Expression of Glucose Transporter Proteins in Pregnancies Complicated by Gestational and Pregestational Diabetes Mellitus." Canadian Journal of Diabetes 42, no. 2: 209-217.
Cancer and pregnancy rarely coincide. Gynecological cancers are among the most common malignancies to occur during pregnancy, and chemotherapy with or without surgery is the primary treatment option. The main concern of administering chemotherapy during pregnancy is congenital malformation, although it can be avoided by delaying treatment until after organogenesis. The dose, frequency, choice of chemotherapeutic agents, time of treatment commencement, and method of administration can be adjusted to obtain the best maternal treatment outcomes while simultaneously minimizing fetal toxicity. Use of chemotherapy after the first trimester, while seemingly safe, can cause fetal growth restriction. However, the exact effect of chemotherapy on such fetal growth restriction has not been fully established; information is scarce owing to the rarity of malignancy occurring during pregnancy, the lack of uniform treatment protocols, different terminologies for defining certain fetal growth abnormalities, the influence of mothers’ preferred options, and ethical issues. Herein, we present up-to-date findings from the literature regarding the impact of chemotherapy on fetal growth.
Nabil Abdalla; Magdalena Bizoń; Robert Piórkowski; Paweł Stanirowski; Krzysztof Cendrowski; Włodzimierz Sawicki. Does Chemotherapy for Gynecological Malignancies during Pregnancy Cause Fetal Growth Restriction? BioMed Research International 2017, 2017, 1 -7.
AMA StyleNabil Abdalla, Magdalena Bizoń, Robert Piórkowski, Paweł Stanirowski, Krzysztof Cendrowski, Włodzimierz Sawicki. Does Chemotherapy for Gynecological Malignancies during Pregnancy Cause Fetal Growth Restriction? BioMed Research International. 2017; 2017 ():1-7.
Chicago/Turabian StyleNabil Abdalla; Magdalena Bizoń; Robert Piórkowski; Paweł Stanirowski; Krzysztof Cendrowski; Włodzimierz Sawicki. 2017. "Does Chemotherapy for Gynecological Malignancies during Pregnancy Cause Fetal Growth Restriction?" BioMed Research International 2017, no. : 1-7.
Various studies in placental tissue suggest that diabetes mellitus alters the expression of glucose transporter (GLUT) proteins, with insulin therapy being a possible modulatory factor. The aim of the present study was quantitative evaluation of the expression of glucose transporters (GLUT-1, GLUT-4, GLUT-9) in the placenta of women in both, uncomplicated and diabetic pregnancy. Additionally, the effect of insulin therapy on the expression of selected glucose transporter isoforms was analyzed. Term placental samples were obtained from healthy control (n = 25) and diabetic pregnancies, including diet-controlled gestational diabetes mellitus (GDMG1) (n = 16), insulin-controlled gestational diabetes mellitus (GDMG2) (n = 6), and pre-gestational diabetes mellitus (PGDM) (n = 6). Computer-assisted quantitative morphometry of stained placental sections was performed to determine the expression of selected glucose transporter proteins. Morphometric analysis revealed a significant increase in the expression of GLUT-4 and GLUT-9 in insulin-dependent diabetic women (GDMG2 + PGDM) as compared to both, control and GDMG1 groups (p < .05). Significantly increased GLUT-1 expression was observed only in placental specimens from patients with PGDM (p < .05). No statistically significant differences in GLUT expression were found between GDMG1 patients and healthy controls. The results of the study confirmed the presence of GLUT-1, GLUT-4 and GLUT-9 proteins in the trophoblast from both, uncomplicated and diabetic pregnancies. In addition, insulin therapy may increase placental expression of GLUT-4 and GLUT-9, and partially GLUT-1, in women with GDMG2/PGDM.
Paweł Jan Stanirowski; Dariusz Szukiewicz; Michał Pyzlak; Nabil Abdalla; Włodzimierz Sawicki; Krzysztof Cendrowski. Impact of pre-gestational and gestational diabetes mellitus on the expression of glucose transporters GLUT-1, GLUT-4 and GLUT-9 in human term placenta. Endocrine 2016, 55, 799 -808.
AMA StylePaweł Jan Stanirowski, Dariusz Szukiewicz, Michał Pyzlak, Nabil Abdalla, Włodzimierz Sawicki, Krzysztof Cendrowski. Impact of pre-gestational and gestational diabetes mellitus on the expression of glucose transporters GLUT-1, GLUT-4 and GLUT-9 in human term placenta. Endocrine. 2016; 55 (3):799-808.
Chicago/Turabian StylePaweł Jan Stanirowski; Dariusz Szukiewicz; Michał Pyzlak; Nabil Abdalla; Włodzimierz Sawicki; Krzysztof Cendrowski. 2016. "Impact of pre-gestational and gestational diabetes mellitus on the expression of glucose transporters GLUT-1, GLUT-4 and GLUT-9 in human term placenta." Endocrine 55, no. 3: 799-808.
Seweryn Trojanowski; Anna Słomka; Paweł Stanirowski; Krzysztof Cendrowski; Włodzimierz Sawicki. A rare case of asymptomatic rupture of the uterine horn in the full-term pregnancy as a consequence of laparoscopic salpingectomy. Ginekologia Polska 2016, 87, 780 -780.
AMA StyleSeweryn Trojanowski, Anna Słomka, Paweł Stanirowski, Krzysztof Cendrowski, Włodzimierz Sawicki. A rare case of asymptomatic rupture of the uterine horn in the full-term pregnancy as a consequence of laparoscopic salpingectomy. Ginekologia Polska. 2016; 87 (11):780-780.
Chicago/Turabian StyleSeweryn Trojanowski; Anna Słomka; Paweł Stanirowski; Krzysztof Cendrowski; Włodzimierz Sawicki. 2016. "A rare case of asymptomatic rupture of the uterine horn in the full-term pregnancy as a consequence of laparoscopic salpingectomy." Ginekologia Polska 87, no. 11: 780-780.
Background: Surgical site infections (SSI) occur in 1.8%–9.2% of women undergoing cesarean section (CS) and lead to greater morbidity rates and increased treatment costs. The aim of the study was to evaluate the efficacy and cost-effectiveness of dialkylcarbamoyl chloride (DACC) impregnated dressings to prevent SSI in women subject to CS.Methods: Randomized, controlled trial was conducted at the Mazovian Bródno Hospital, a tertiary care center performing approximately 1300 deliveries per year, between June 2014 and April 2015. Patients were randomly allocated to receive either DACC impregnated dressing or standard surgical dressing (SSD) following skin closure. In order to analyze cost-effectiveness of the selected dressings in the group of patients who developed SSI, the costs of ambulatory visits, additional hospitalization, nursing care, and systemic antibiotic therapy were assessed. Independent risk factors for SSI were determined by multivariable logistic regression.Results: Five hundred and forty-three women undergoing elective or emergency CS were enrolled. The SSI rates in the DACC and SSD groups were 1.8% and 5.2%, respectively (p = 0.04). The total cost of SSI prophylaxis and treatment was greater in the control group as compared with the study group (5775 EUR vs. 1065 EUR, respectively). Independent risk factors for SSI included higher pre-pregnancy body mass index (adjusted odds ratio [aOR] = 1.08; [95% confidence interval [CI]: 1.0–1.2]; p < 0.05), smoking in pregnancy (aOR = 5.34; [95% CI: 1.6–15.4]; p < 0.01), and SSD application (aOR = 2.94; [95% CI: 1.1–9.3]; p < 0.05).Conclusion: The study confirmed the efficacy and cost-effectiveness of DACC impregnated dressings in SSI prevention among women undergoing CS.
Paweł Jan Stanirowski; Magdalena Bizoń; Krzysztof Cendrowski; Włodzimierz Sawicki. Randomized Controlled Trial Evaluating Dialkylcarbamoyl Chloride Impregnated Dressings for the Prevention of Surgical Site Infections in Adult Women Undergoing Cesarean Section. Surgical Infections 2016, 17, 427 -435.
AMA StylePaweł Jan Stanirowski, Magdalena Bizoń, Krzysztof Cendrowski, Włodzimierz Sawicki. Randomized Controlled Trial Evaluating Dialkylcarbamoyl Chloride Impregnated Dressings for the Prevention of Surgical Site Infections in Adult Women Undergoing Cesarean Section. Surgical Infections. 2016; 17 (4):427-435.
Chicago/Turabian StylePaweł Jan Stanirowski; Magdalena Bizoń; Krzysztof Cendrowski; Włodzimierz Sawicki. 2016. "Randomized Controlled Trial Evaluating Dialkylcarbamoyl Chloride Impregnated Dressings for the Prevention of Surgical Site Infections in Adult Women Undergoing Cesarean Section." Surgical Infections 17, no. 4: 427-435.
Incisional surgical site infections (SSIs) occur in approximately 1.8-9.2% of patients undergoing cesarean section (CS) and contribute to prolonged hospitalization time and increased treatment costs. Dressings impregnated with dialkylcarbamoyl chloride (DACC) are an innovative approach to wound treatment based on a solely physical mechanism of action, and therefore can be used safely and without time restrictions in women during the puerperal and lactation period. A single-blinded randomized, controlled pilot study was conducted at the Mazovian Bródno Hospital, a tertiary care hospital, between December 2013 and March 2014, and it evaluated the presence of superficial and deep SSIs in patients during the first 14 days after a CS. Patients were randomly allocated to receive treatment with either a DACC dressing or a standard surgical dressing. One hundred and forty-two patients after planned or emergency CS were enrolled in the study. No significant differences between the groups were observed with regard to patients' basic demographic and perioperative characteristics. The rate of superficial and deep SSIs was 2.8% in the group of patients who received a DACC dressing compared to 9.8% in the group with a standard surgical dressing (p = 0.08). Patients with SSIs who received a standard surgical dressing required systemic antibiotic therapy significantly more frequently (p = 0.03). Based on the logistic regression model developed, the pre-pregnancy body mass index was the only statistically significant risk factor for SSI (p = 0.015). The results of the pilot study indicate a decreasing tendency of the SSI rate in patients after a CS who received DACC impregnated dressings.
Paweł Stanirowski; Anna Kociszewska; Krzysztof Cendrowski; Włodzimierz Sawicki. Dialkylcarbamoyl chloride-impregnated dressing for the prevention of surgical site infection in women undergoing cesarean section: a pilot study. Archives of Medical Science 2016, 5, 1036 -1042.
AMA StylePaweł Stanirowski, Anna Kociszewska, Krzysztof Cendrowski, Włodzimierz Sawicki. Dialkylcarbamoyl chloride-impregnated dressing for the prevention of surgical site infection in women undergoing cesarean section: a pilot study. Archives of Medical Science. 2016; 5 (5):1036-1042.
Chicago/Turabian StylePaweł Stanirowski; Anna Kociszewska; Krzysztof Cendrowski; Włodzimierz Sawicki. 2016. "Dialkylcarbamoyl chloride-impregnated dressing for the prevention of surgical site infection in women undergoing cesarean section: a pilot study." Archives of Medical Science 5, no. 5: 1036-1042.