Objectives: Regular and moderate physical activity during uncomplicated pregnancy has been considered beneficial for both the expectant mother and her unborn child. It reduces the risk of gestational diabetes mellitus (GDM) and preeclampsia.The aim of the study was to assess women's knowledge concerning specific aspects of physical activity during uncomplicated pregnancy. Material and methods:A cross-sectional survey study on a sample of Polish women in a tertiary referral centre was performed. A questionnaire that was validated in the Polish language was based on the Committee Opinion of American College of Obstetricians and Gynaecologists, which was published in December 2015. Sociodemographic parameters in relation to specific aspects of physical activity during pregnancy were analysed.Results: A total of 259 (92.5%) women were aware of the beneficial impact of physical activity on the course of pregnancy. Higher education was associated with greater awareness (p = 0.001). Regarding the optimal frequency and recommended duration of exercise, the overall rates of correct answers were only 106 (38.1%) and 167 (59.6%), respectively. The most common sources of information on physical activity during pregnancy were the Internet (81, 50.0%) and books (62, 38.3%). Doctors and midwives instructed the respondents only in 36 (22.4%) and 31 (18.9%) cases, respectively.Conclusions: Women's knowledge about physical activity during pregnancy seems satisfactory. However, awareness concerning the optimal duration and frequency of exercise, as well as recommended voluntary activities during pregnancy, should be improved. Medical professionals may also reinforce their role as a provider of reliable information, resulting in the prevention of many pregnancy complications.

Pheochromocytoma/paraganglioma (PPGL) are neuroendocrine tumors that frequently produce and release catecholamines. Catecholamine excess can manifest in several cardiovascular syndromes, including cardiomyopathy. PPGL-induced cardiomyopathies occur in up to 11% of cases and are most often associated with an adrenal pheochromocytoma (90%) and rarely with a paraganglioma derived from the sympathetic ganglia (10%). PPGL-associated cardiomyopathies can be chronic or acute, with takotsubo cardiomyopathy being the most often reported. These two types of PPGL-induced cardiomyopathy seem to have different pathophysiological backgrounds. Acute catecholaminergic stress inundates myocardial β-adrenoceptors and leads to left ventricle stunning and slight histological apoptosis. In chronic cardiomyopathy, prolonged catecholamine exposure leads to extended myocardial fibrosis, inflammation, and necrosis, and ultimately it causes dilated cardiomyopathy with a low ejection fraction. Sometimes, especially in cases associated with hypertension, hypertrophic cardiomyopathy can develop. The prognosis appears to be worse in chronic cases with a higher hospital mortality rate, higher cardiogenic shock rate at initial presentation, and lower left ventricular recovery rate after surgery. Therefore, establishing the correct diagnosis at an early stage of a PPGL is essential. This mini-review summarizes current data on pathophysiological pathways of cardiac damage caused by catecholamines, the clinical presentation of PPGL-induced cardiomyopathies, and discusses treatment options.

Diabetes is a chronic metabolic disorder with a rapidly growing incidence worldwide. It is currently classified into two main types, type 1 and type 2 diabetes, based on status of the autoantibodies directed at the β-cell. However, it does not reflect the complexity of diabetes and the broad spectrum of the clinical manifestations, particularly in type 2. In this review we present the evolution of the World Health Organization (WHO) classification of diabetes, with a focus on newly introduced categories – hybrid forms of diabetes and unclassified diabetes. We compare the WHO diabetes subgroups with the American Diabetes Association (ADA) approach to this issue. Since the current classification systems do not reflect all the factors leading to hyperglycaemia in type 2 diabetes, we present novel approach to phenotyping diabetes in adults based on six variables (age at diagnosis, body mass index [BMI], C-peptide based homeostasis model assessments of β-cell function and insulin resistance, haemoglobin A1c and glutamic acid decarboxylase antibodies [GADA] status) which allowed to distinguish five replicable groups of patients in Swedish cohort with different clinical presentations. The understanding heterogeneity of diabetes helps to classify the patients more adequately, but none of classifications is optimal. Including combination of genetic, metabolomic and clinical factors into classification schemas will pave the way towards personalized medicine in diabetes and will presumably result in more effective treatment of the patients.

Vulvar intraepithelial lesions are a heterogenic group of diseases, which can be easily misdiagnosed. The case of a 61-year-old woman with a history of genital intraepithelial lesions and infection with HPV is presented. Her main complaint was vulvar pruritus. Vulvoscopy revealed the presence of two skin lesions: the first one had the morphology of lichen sclerosus, and the second of a Bowenoid lesion. The biopsy of the first lesion revealed vulvar intraepithelial neoplasia, whereas cells of squamous vulvar cancer were identified in the second lesion. After staging, the patient was advised to undergo hemivulvectomy and lymphadenectomy. The coexistence of morphologically diverse vulvar skin lesions may cause difficulties with diagnosis and the selection of an adequate treatment. Long-term follow-up and regular examination are essential for diagnosis of vulvar malignancies in the early stage.

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