BackgroundLeptin physiology in children is crucial for diagnosing and managing pediatric endocrine and metabolic disorders. The aim of this study was to assess the values of leptin, leptin receptor (sOB-R), and free leptin index (FLI) depending on age and sex in healthy Polish children and adolescents.Materials and methodsA total of 236 children and adolescents aged 1–18 years were recruited. Leptin and leptin receptor concentrations were determined by immunoenzymatic methods. FLI values were calculated as leptin divided by sOB-R concentrations. In 114 children between the ages of 5 and 10 years, a measurement of fat mass was assessed by dual-energy X-ray absorptiometry.ResultsThe studied groups of girls and boys were of similar age and did not differ in terms of weight, height, body mass index (BMI), BMI Z-score values, or leptin receptor concentrations. Leptin concentrations and FLI were higher by about 50% (p=0.006; p=0.051, respectively) in girls than boys. Positive correlations were found between leptin and age, BMI, and BMI Z-score values (r=0.562, r=0.563, p=0.397; p<0.001, respectively), and even stronger between FLI and age, BMI, and BMI Z-score values (r=0.670, r=0.632, p=0.409; p<0.001, respectively).ConclusionsThe results concerning leptin and leptin receptor concentrations and FLI values in healthy individuals may be useful in clinical practice in early identification of children and adolescents with an unfavorable adipokine profile resulting in a predisposition to the development of obesity and obesity-related complications. These markers may also be helpful in monitoring therapy effectiveness in patients with obesity, diabetes, and metabolic syndrome.

Peripartum cardiomyopathy (PPCM) and HELLP syndrome are rare, life-threatening pregnancy-associated conditions. PPCM, a dilated cardiomyopathy, presents with heart failure during the peripartum period. In comparison, HELLP syndrome involves hemolysis, elevated liver enzymes, and low platelet count. Symptoms of these conditions often mimic normal physiological discomforts and can be confused with typical peripartum issues. We report a unique case of a 24-year-old primigravida presenting with PPCM and HELLP syndrome. Timely diagnosis and multidisciplinary management resulted in her recovery, owing to a high level of clinical suspicion for her symptoms. Six-month follow-up showed normalisation of her cardiac function and complete clinical resolution.

IntroductionA urethral meatus located in the region of the coronal sulcus accounts for approximately 25% of all hypospadias cases. Numerous surgical methods exist for the correction of this penile anomaly. According to the literature, the complication rate for this treatment ranges from 2% to 25%.ObjectiveThe aim of this study is to assess the outcomes of coronal hypospadias treatment in boys operated on using a surgical method developed at the Department of Paediatric and Adolescent Surgery, Institute of Mother and Child.Material and methodsBetween 2005 and 2023, 265 boys, aged 14 to 20 months, underwent surgery for coronal hypospadias. The operative technique involves a longitudinal incision of the dorsal part of the urethral meatus, parallel incisions of the glans, and the placement of a mattress suture encompassing the glans and the urethral apex bilaterally in the midline. Subsequently, any ventral penile curvature is corrected, and the frenulum, the normal shape of the prepuce (foreskin), and the penile skin are reconstructed. In all operated boys, a follow-up assessment was conducted at least one-year post-surgery, evaluating the location of the external urethral meatus, penile curvature, the appearance of the prepuce and penile skin, and the presence of any urethrocutaneous fistulas.ResultsOf the 265 operated boys, a correctly positioned external urethral meatus was observed in 254. No patient was found to have penile curvature. The shape of the prepuce and skin was deemed normal in 256 patients. Re-reconstruction of the urethra was required in 8 patients due to meatal retraction and in 3 patients due to a fistula. The postoperative observation period was a minimum of one year.ConclusionsBased on the results of this study and a comparison with literature data, it can be concluded that the surgical method for treating coronal hypospadias developed at the Department of Surgery, Institute of Mother and Child, yields good functional results and a satisfactory cosmetic appearance of the penis.

BackgroundThe incidence of endometrial cancer is increasing globally. Cancer stem cells are now considered the driving force for tumour recurrence and metastasis. We studied whether the proportion of cancer stem cell population and stemness gene expression differ in type I and type II endometrial cancer.Materials and methodsType I and type II endometrial tumour tissues were obtained from patients who underwent hysterectomy. The tumour tissue was digested using collagenase, and we established a primary culture. In the primary cultures established from these two types of cancer, we used flow cytometry to measure the proportion of the cancer stem cell population expressing CD 133 and CXCR4 on its surface. We also looked for the expression of genes related to stemness, regulators of stemness, and markers of metastasis in both these cancer types.ResultsWe found that the proportion of cancer stem cell population that expresses CD133 and CXCR4 was higher in type II endometrial cancer than in type I endometrial cancer. Also, genes (Nanog, ALDH, EZH2) related to stemness and aberrant transcriptome were found to be upregulated in type II endometrial cancer.ConclusionOur study demonstrates that the proportion of stem cells in type 2 endometrial cancer is higher than in type I endometrial cancer. The findings of this study should lead us to investigate with a larger sample size and see if the increase in the stem cell population in type II endometrial cancer may be the reason for its poor prognosis.

BackgroundThis was a prospective observational study to compare efficacy and safety of iron sucrose (FeS) and ferric carboxymaltose (FCM) in pregnancy conducted over 18 months at a tertiary hospital.MethodsPregnant women between 14 to 36 weeks gestation with moderate to severe iron deficiency anemia were enrolled in the study. The primary outcome was a rise in haemoglobin after 14 and 28 days. Change in red cell indices, serum iron studies, symptomatic improvement, adverse effects, and neonatal outcomes were also compared.Results95 pregnant women with anemia were included in the study. Mean rise in haemoglobin after 14 days was significantly higher in the FeS group than in the FCM group (2.25 ± 0.91 g/dL vs. 1.69 ± 0.98 g/dL, p value = 0.01), but rise in median serum ferritin was significantly more in the FCM group (148.55 vs. 310.6; p < .001). No significant adverse effect was noted in any group.ConclusionInjectable iron preparation FeS results in an early rise in haemoglobin, while FCM leads to a higher rise in iron stores as seen by a rise in serum ferritin. As FCM requires fewer hospital visits, it is more convenient to the patient.

The aim of this study was to determine the association of immune response and lipid metabolism genes with the development of pre-eclampsia and related acute cerebral circulatory disorders in Kazakh women. Minor allele frequencies of immune response and lipid metabolism genes were determined in 1,800 healthy participants stored in the Miras Biobank of the Scientific Centre of Obstetrics, Gynaecology, and Perinatology Joint Stock Company. The main results of the study showed that TLR4 (rs4986790), PLEKHA1 (rs2281673), PLEKHG1 (rs9478812), APOE (rs7412), FTO (rs1421085) and LPL (rs285) genes were in genetic equilibrium (p > 0.05), indicating that the sample was representative and there were no significant evolutionary pressures on the studied genes. The frequencies of minor alleles in the studied sample of Kazakhs were: TLR4 - 3.3%, PLEKHA1 - 5.9%, PLEKHG1 - 27.0%, APOE - 7.8%, FTO - 28.3% and LPL - 36.0%. The obtained data can be used for further genetic studies, as well as for the development of individualised strategies for the prevention and treatment of pre-eclampsia and related complications. The identified genetic markers may help in early detection of women at increased risk of developing these conditions, which will contribute to improving clinical outcomes and reducing maternal and perinatal mortality.

Breastfeeding is the ideal nutrition for the first half of an infant's life. It contains the right nutrients for the physical and mental development of the infant. In general, however, fewer than 50% of infants under six months are exclusively breastfed globally. This study aims to determine if Greece's exclusive breastfeeding rates comply with WHO and UNICEF recommendations and to explore the variables that affect the lengthening of exclusive breastfeeding. This cross-sectional study was conducted in four municipalities of South Athens, Greece from July 2018 to June 2019 in day care centers. The sample of study consisted of 674 mother-child couples. The study was approved by the Department of Nursing at the University of the Peloponnese, as well as the municipal day care centers. The mothers were informed about the purpose of the study. 236 (35.01%) women in the sample breastfed exclusively for six months or more, of which 106 (44.91%) women continued breastfeeding for one year, and 22 (9.32%) women until two years. Exclusive breastfeeding, satisfaction with the process, gestational diabetes, excess and normal maternal weight at the time of the study are statistically significant factors for increasing the duration of exclusive breastfeeding. Exclusive breastfeeding rates in Greece fall short of WHO and UNICEF targets, with only 35.01% of mothers breastfeeding exclusively for six months.

ObjectiveRecurrent Pregnancy Loss (RPL) is a significant pregnancy complication with a multifactorial aetiology and is a vital reproductive health concern that globally affects 2–5% of women. Polymorphic gene variation causes alteration in FOXP3 gene that impairs the Treg cells which leads to complications in pregnancy outcome. Thus, we aimed to study an association between FOXP3 polymorphic variations (rs3761548 and rs3761549) and RPL.Material and methodsThis case control study comprised of 120 RPL cases and 150 healthy multiparous women as control group with at least one full term pregnancy and no history of pregnancy loss matched to cases according to age and geographic origins. Genotyping for FOXP3 was analyzed by polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP).ResultsSignificantly higher frequency of FOXP3 −3279 C/A (rs 3761548)heterozygous AC and homozygous AA was found in RPL cases than controls (63.3% vs. 46%, O.R = 2.53): p = 0.0006 and (11.7% vs. 8%; O.R 2.68): p = 0.03 respectively. Moreover, the dominant model (AC +AA) and allele A were seen implicated more in RPL cases vs. healthy control (75% vs. 54%; O.R = 2.5): p = 0.0005 and (43.3% vs. 31%; O.R = 1.7): p = 0.003. For FOXP3 −2383 C/T (rs 3761548), homozygous genotype TT was significantly higher in RPL cases than the control group against the wild type CC genotype with O. R= 3.49 (p = 0.04). Further, FOXP3 (rs 3761548) genotypes AC+AA were significantly associated between cases and control in terms of women without any known family history (p = 0.0009) and consanguinity (p = 0.0002), respectively.ConclusionThe study concludes that both the variants of FOXP3 gene, C/A (−3279) and C/T (−2383) are significantly associated with an increased risk for recurrent pregnancy losses.

BackgroundThis study aimed to calculate a pharmacoeconomic indicator, specifically the cost-effectiveness coefficient, for treating paediatric bronchial asthma with combined regimens of bronchodilators and inhaled corticosteroids.Material and methodsThis study involves 54 children aged 6 to 12 years, who were divided into 6 groups depending on the age and severity of bronchial asthma. Treatment effectiveness is calculated by subtracting the percentage difference between exacerbation frequency and the number of patients. The calculation of pharmacoeconomic data was conducted using the cost-effectiveness ratio (CER).ResultsFor the treatment of mild bronchial asthma, the drug Berodual is used for inhalation through a nebuliser, moderate therapy is conducted using a combination of Flixotide and Salbutamol, and severe is stopped by a combination of Symbicort and Salbutamol. From the results obtained, notably, the CER for mild severity was 0.077 for children aged 6–8 years and 0.171 for the age group 9–12 years; for moderate severity, the CER values were 0.27 for the group 6–8 years and 0.35 for the category 9–12 years; severe asthma had the following indicators: 0.506 and 0.798 for groups aged 6–8 and 9–12, respectively.ConclusionThis study’s results indicate that the most cost-effective treatment regimen is in the age groups of 6–8 years. However, the calculation of drug dosages directly depends on the patient’s age and the severity of the disease. Further actions in scientific works should be directed to conducting empirical, statistical studies in the field of pharmacoeconomics of bronchial asthma among children from the standpoint of the state.

Background/AimsThe proteome, lipidome, glycome, and metabolome of human milk are critical for newborn nutrition and health, and offer personalised, non-pharmacological interventions. This systematic review aims to characterise the omics components of human milk according to maternal health and lactation phases, summarising current knowledge based on high-resolution analytical techniques.MethodsWe conducted a systematic review according to the PRISMA 2020 guidelines. The search was performed between August and September 2022 using Medline, EMBASE, Scopus, LILACS, and Web of Science. Observational studies that analysed human milk at any lactation stage using mass spectrometry or nuclear magnetic resonance to characterise nutrients, biomolecules, or bioactive compounds were included. In total, 55 full-text articles were included in this study.ResultsGlycomics is the most frequently studied omics, followed by proteomics, metabolomics, and lipidomics. Analyses revealed that maternal comorbidities and lactation phases influence the composition of human milk. Fucosylated HMOs showed a protective role against infectious diseases, while elevated levels of protease inhibitors were found in milk from allergic mothers and elevated immunoglobulins were present in milk from mothers with COVID-19. Endocannabinoid profile is associated with improved neonatal sucking ability, while fatty acid-derived metabolites are correlated with infant growth. Distinct omics patterns have also been identified in mothers with diabetes, hypothyroidism, and obesity.ConclusionUnderstanding the omics profile of human milk can guide precise nutrition and improve human milk substitutes. Further research integrating omics data with maternal and infant outcomes will be essential to advance knowledge and support infant health.