Expression of sex steroid receptors and aromatase in adipose tissue in different body regions in men with coronary artery disease with and without ischemic systolic heart failure.

Background: The hormonal metabolism of adipose tissue differs across regions of fat. This issue has never been verified in male patients with coronary artery disease (CAD) with and without systolic heart failure (SHF).Methods: We examined 90 male patients with CAD with and without SHF and 42 healthy controls.Results: In patients with CAD with and without SHF, androgen receptor (AR) expression in adipose tissue of the lower leg was higher than AR expression of the thoracic wall and epicardial adipose tissue (EAT) (both p < .0001 for SHF patients and both p < .001 for patients without SHF). Expression of aromatase in adipose tissue of the lower leg among patients with CAD and SHF was higher than aromatase expression of the thoracic wall and EAT (p < .001 and p < .05, respectively), and in patients without SHF, it was higher only than aromatase expression of the thoracic wall (p < .05). There were no differences in expression of estrogen receptor (ER) between three regions of adipose tissue both in men with CAD with and without SHF.Conclusions: In male patients with CAD, site-related differences of adipose tissue in expression of AR and aromatase are present regardless of coexisting SHF with the highest hormonal activity within peripheral subcutaneous adipose tissue.

The quality of life with regard to the sexual sphere and acceptance of the disease in young adults suffering from multiple sclerosis.

Introduction: Multiple sclerosis as a disease of various dynamic and unpredictable consequences at different periods of the disease can lead to quality of life reduction. One of the guarantors for maintaining a good quality of life is accepting the disease. The aim of the study was to evaluate the quality of life, taking into account the sexual sphere and acceptance of the disease among young adults with multiple sclerosis. Material and methods: The study included 120 people of both sexes, aged from 18 to 35 years of age suffering from multiple sclerosis during remission, independent in everyday activities or requiring a minimum of help. The study used a questionnaire MSQOL-54 instrument and the AIS scale. The statistical analysis used the following: Kruskal-Wallis test, Mann-Whitney test, Chi2, Spearman coefficient. Program Statistica 7.1 was also used. The level of significance was p <0.05. Results: The overall quality of life increases with the acceptance of the disease (Spearman r-0.364; p=0.000). It has been demonstrated the existence of significant statistical positive correlation between satisfaction with the sexual sphere and acceptance of the disease (Spearman's r 0.271; p=0.005) and satisfaction with the sexual sphere and quality of life (Spearman's r 0.467; p=0.000). Conclusion: The factor determining the quality of life of patients with MS is the acceptance of the disease. Satisfaction with sexual life is a significant factor in assessing the quality of life by patients and the acceptance of their illness.

Bone marrow iron depletion is common in patients with coronary artery disease.

BACKGROUND/OBJECTIVES: Iron deficiency (ID) may be an important, treatable co-morbidity complicating cardiovascular diseases, but considerable uncertainty exists about the diagnostic accuracy of blood tests. Accordingly, we investigated the relationship between blood tests for ID and iron stores in bone marrow aspirates, the diagnostic gold-standard for ID, in patients with stable coronary artery disease (CAD). METHODS: Bone marrow aspirates were obtained from 65 patients with stable CAD undergoing cardiac surgery and 10 healthy controls. ID was defined as depleted extracellular iron stores (0-1 grade according to Gale scale) accompanied by ≤10% of erythroblasts containing iron. RESULTS: Bone marrow ID was found in 31 (48%) patients with CAD but in none of the controls (p<0.01). Amongst patients with CAD, ID was present in 10 of 16 (63%) with and 21 of 49 (43%) without anaemia (p=0.17). The clinical profiles of patients with and without ID were similar. Of circulating biomarkers of ID, serum soluble transferrin receptor had the strongest association with bone marrow ID (area under curve: 0.876±0.048, 95% confidence interval: 0.762-0.948, for cut-off of ≥1.32mg/L-sensitivity: 67%, specificity: 97%). CONCLUSIONS: Almost half of patients with stable CAD have profound bone marrow iron depletion that can be accurately assessed non-invasively using serum soluble transferrin receptor.

The level of negative emotions, coping with stress and social support for parents of children suffering from epilepsy.

INTRODUCTION: Child epilepsy can be source of negative emotions and stress in pa- rents. Social support is an external personal resource coupled with the process of coping with difficult situations. AIM: The aim of the study evaluation the severity of negative emotions and ways of dealing with the stress of parents of children with epilepsy in relation to the received social support. MATERIALS AND METHODS: The study was conducted in one of the children's hospitals in Malopolska, on 213 parents (148 women and 65 men) aged 21 to 66 years. The study used: HADS-M (Hospital Anxiety and Depression Scale Modified HADS-M, BSSS (Berlin Social Suport Scale), Inventory for Measurement Coping Mini-COPE and the author's questionnaire. Statistical analysis used Pearson and Spearman's correlation and Mann-Whitney test and t-test. Calculations were performed using IBM SPSS Statistics 20 Statistical significance was p ≤0.05. RESULTS: The dominant emotion that accompanied the parents was anxiety. Parents have used more strategies based on active coping, and seeking emotional support or instrumental. It has been shown there is a correlation between the level of intensity of negative emotions and social support, and also correlation between social support and ways of coping with stress. CONCLUSION: Parents expressed negative emotions but not of high severity which may be related to the choice of active coping strategies. Steps should be taken not only to assess the prevalence of negative emotions in a group of parents, but also to reduce the level of their intensity by exposing the importance of social support.

Anabolic deficiencies in men with systolic heart failure: do co-morbidities and therapies really contribute significantly?

BACKGROUND: Deficiencies of anabolic hormones are common in men with heart failure (HF). It remains unclear whether the deranged metabolism of these hormones is the pathophysiological element of HF itself or is the consequence of co-morbidities or/and treatment in HF. METHODS: We examined 382 men with systolic HF. Serum hormones (i.e. total testosterone [TT], DHEAS, IGF-1) were assessed using immunoassays, serum free testosterone (eFT) - using the Vermeulen equation. RESULTS: Prevalence of TT and eFT deficiencies was similar in men with HF aged < versus ≥60 years (23% and 32% for TT and eFT deficiencies). Deficiencies in DHEAS and IGF-1 were more common in younger (63% and 92%) than older patients (48% and 73%). In men <60 years, TT deficiency was accompanied by the therapy with digoxin, eFT deficiency - the therapy with digoxin and the presence of diabetes, DHEAS deficiency - the therapy with loop diuretic (all p < 0.05). In men ≥60 years, TT deficiency - the therapy with loop diuretic, DHEAS deficiency - the therapy with spironolactone and digoxin, and hsCRP, IGF-1 deficiency - the high hsCRP (all p < 0.05). CONCLUSIONS: Deficiencies in anabolic hormones are common in younger and older men with HF. Some therapies (but not major co-morbidities) may contribute to anabolic deficiencies.

The level of perceived stress of parents of children with cancerous disease - mechanisms of dealing with stress and social support.

INTRODUCTION: Cancerous disorders are the second most common cause of death among children. Blood cancer is a stressful and traumatic situation for the child, as well as the parents. To overcome the stress of child's illness parents adopt different coping styles. In overcoming these difficulties, the invaluable role is played by social support they receive from medical staff, family or institution. AIM: To assess the feeling of stress for parents of children diagnosed with blood cancer, to determine how they choose to deal with stress in a difficult situation. MATERIAL AND METHODS: The study group consisted of 63 parents of children diagnosed with blood cancer. The study used the PSS-10 scale to assess the stress experienced by parents, 40 GP ISEL scale to assess social support, Inventory Ways to Measure Coping and the author's questionnaire. RESULTS: High perception of stress was observed among parents. It was found that the strategy based on active coping (taking action to improve the situation) got the highest scores among the strategies for coping with stress. The study showed that parents can most often count on material support. CONCLUSIONS: The feeling of stress severity among parents is high, particularly among women and people with higher education. The actions of medical team should take into account the needs of parents in raising and maintaining the resources to adapt to the difficult situation of child's disease.

Negative emotional states of patients with oncological disease and social support.

For many people diagnosed cancer and the treatment process is connected with emergen- ce and long-term existence of many negative emotions such as: depression, anxiety and stress. The aim of this study was to evaluate the intensity of negative emotional states of people diagnosed with cancer and the need for social support, as well as, exploration of the interdependence between these variables. Statistical analysis showed a significant correlation between the occurrence of disorders and border states, of both anxiety and depressive character and high level of stress in the test.

[Differentiation between vegetation and lead associated thrombus - role of PET scan in difficult diagnostic process]. / Roznicowanie wegetacji ze skrzeplina na elektrodzie kardiowertera-defibrylatora-rola PET w trudnym procesie diagnostycznym.

We report a case of a 59 year-old man with hypertrophic cardiomyopathy who developed a pathological structure attached to the lead of cardioverter-defibrillator that has been detected by echocardiography. The authors describe a difficult differential diagnostic process aiming at the differentiation between cardiac device-related infective endocarditis and lead-associated thrombus. Imaging of the heart with a pathological structure using PET scan seems to be useful in these clinical circumstances.