Determinants of Professional Activity After Kidney and Liver Transplantation: Questionnaire Development and Validation.

BACKGROUND: Organ transplantation is currently the treatment of choice in end-stage organ failure. Organ replacement therapy compensates for most of organ function loss and offers recipients the potential for an independent life; nevertheless, the employment rate after kidney or liver transplant is low vs the general population. The purpose of this study was to create a questionnaire for kidney and liver transplant patients that comprehensively assesses factors affecting employment among these people including demographic, physical, and psychosocial variables. MATERIAL AND METHODS: The study was based on a self-prepared questionnaire developed by a team of specialists in the field of medicine, rehabilitation, psychology, and employment. The questionnaire contained 5 parts: demographic data, professional factors, medical factors, physical factors, and psychological factors. The normalization sample consisted of 64 individuals (women and men) aged between 18 to 45 years 1 to 5 years after kidney or liver transplant. The Determinants of Professional Activity after Kidney and Liver Transplantation Questionnaire (DPATQ) was developed based on descriptive statistics, Spearman ρ coefficient, principal component analysis, Cronbach α, and item response theory analysis. RESULTS: The Cronbach α reliability coefficient for the psychological part reached 0.88. CONCLUSION: The DPATQ is a new method for measuring post-transplant adaptation and other factors influencing employment status. It offers good psychometric reliability. The DPATQ may be useful in the preparation process of vocational rehabilitation programs or in research studying problems with employment after solid organ transplant.

Effect of Successful Treatment of Hepatitis C Virus Infection Recurrence With Direct-Acting Antiviral Agents on Physical Performance in Liver Transplant Recipients.

BACKGROUND: Hepatitis C virus (HCV) infection deregulates function of many organs and systems, affecting patient's daily functioning. The results of treatment of HCV infection recurrence after liver transplantation have improved significantly as a result of the introduction of direct-acting antiviral agents (DAA). This study was aimed at prospective assessment of the effect of HCV elimination with DAA on physical performance of liver transplant recipients. METHODS: Eight women and 21 men, median age 61.3 (range, 20.1-71.5) years, participated in the study. Assessment of serum total bilirubin, alanine and aspartate aminotransferase, muscle strength, body composition, and 6-minute walk test (6MWT) were performed before treatment and 12 weeks after the end of the treatment period. RESULTS: In the 6MWT test we observed significant subjective (dyspnea: 58.3% pretreatment vs 27.6% posttreatment, P = .018; fatigue: 96.6% pretreatment vs 51.7% posttreatment, P = .0001) and objective improvement (distance: 415.4 meters pretreatment vs 505.2 meters posttreatment, P < .0000001). We did not observe an increase in muscle mass nor improvement in blood biochemical parameters. CONCLUSION: A significant objective and subjective improvement in physical performance was seen in liver transplant recipients after successful treatment of HCV infection with DAA.

Clinical Significance of Gastrointestinal Carriage of Klebsiella Pneumoniae-Producing Extended-Spectrum Beta-Lactamases in Kidney Graft Recipients.

The burden of Klebsiella pneumoniae (KP) producing extended-spectrum beta-lactamases (ESBL+) urinary tract infections (UTIs) is a growing problem after kidney transplantation (KTX). The study was aimed at evaluating the incidence of KP ESBL+ gut colonization in KTX recipients and its correlation with clinical outcomes with special regard to UTIs. The study included all KTX patients hospitalized in our department between January 2014 and December 2016. During this period 2018 KTX patients were admitted: 605 in 2014, 750 in 2015, and 663 in 2016, respectively. Screening for drug-multiresistant Enterobacteriaceae gut carriage was performed in 104 patients (2014), 122 (2015), and 166 (2016). In 2014, 2015, and 2016, 18 (17.3%), 26 (21.3%), and 30 (18.1%) patients had positive test results, and 44 (42.3%), 36 (29.5%), and 45 (27.4%) KTX patients were diagnosed with KP ESBL+ UTI. In 2014, KP ESBL+ UTI was diagnosed in 30 (34.9%) cases with negative anal swab and in 14 patients (77.8%) with positive test result (P = .0008). In 2015, KP ESBL+ UTI was diagnosed in 21 patients (21.9%) with negative anal swab and in 15 (57.7%) with positive test result (P = .0004). In 2016, KP ESBL+ UTI was diagnosed in 24 patients (17.8%) with negative anal swab and in 21 (72.4%) with positive test result (P = .000001). In conclusion, we have revealed a strong association between gut K. pneumoniae colonization, female sex, and MPA intake and KP ESBL+ urinary tract infections in kidney transplant recipients. Our results indicate the very important role of KP ESBL+ screening, while strategies of identified carriers require further research.

Fast calcium signals in Drosophila motor neuron terminals.

Drosophila is a powerful model for neuroscientists, but physiological techniques have not kept pace with advances in molecular genetics. We introduce a reliable assay for intracellular calcium dynamics in Drosophila larval motor neuron terminals, and a new physiological solution that improves the longevity of the larval preparation. By loading calcium indicators into motor neuron terminals through cut axons, we obtained a high signal-to-noise ratio with confocal microscopy, and good temporal resolution of calcium-dependent fluorescence changes. We provide an estimate for the resting intracellular calcium concentration, the first description of calcium kinetics for a single action potential (AP), and improved resolution of calcium kinetics during AP trains. The very rapid decay of the calcium signal following a single AP (tau ~60 ms) indicates a previously unreported fast calcium extrusion mechanism in Drosophila motor neuron terminals well suited for sustaining physiological processes during the high rates of impulse activity which drive locomotor activity.

[Family labor from the father's point of view]. / Poród rodzinny postrzegany z perspektywy ojca.

Family labor becomes increasingly popular in our country. The aim of the study was answering the question: what the main motive for the men attending to labor was, whether fathers were satisfied of their participation and what the main reason of their satisfaction was. The study was performed in the district and local hospitals in south-eastern Poland during 7 months. 110 fathers were in the study group, 78 (70.9%) of urban population, and 32 (29.1%) of rural. The obtained results indicate firm acceptance of such a way of labor among majority of fathers. It was supported by the fact that almost all of them were satisfied of their participation in labor, and wished to attend the next one. The main reason for inclining them for the participation in labor was the granting of the partners' request, and internal willing. The source of satisfaction from sharing of the labor was providing the safety for the partner and setting up early contact with the baby. Significant influence of the labor schools on the feeling of readiness for delivery and the level of father's satisfaction were not evident.

[Changes of SHBG concentrations in postmenopausal women]. / Zmiany stezen SHBG we krwi wystepujace u kobiet po menopauzie.

Sex hormone-binding globulin (SHBG) is a serum (serous) glycoprotein binding estrogens and androgens with high affinity. Hepatic synthesis of SHBG and serous protein concentration are related to the following factors: age, sex steroids and thyroid hormones concentrations, obesity. Along with aging process, an increase of SHBG concentration is observed in both sexes. The following paper confirms a relation between age and SHBG concentration (positive correlation, p < 0.001) and a relation between body mass index (BMI) and SHBG. Concentration (r = -0.35, p < 0.039). In our studies it was found out that SHBG in postmenopausal women with recent hip fractures was significantly lower than in a group of women without fractures. The authors suggest that the determination of serum SHBG concentration might be assumed as a screening test for evaluation of the hip fracture risk in postmenopausal women.

[Hyperandrogenism as a frequent cause of hirsutism]. / Hiperandrogenizm jajnikowy czesta przyczyna hirsutyzmu.

Excessive hair growth in androgens sensitive areas of female body is called hirsutism and it is a symptom of masculinization. Intensity of hirsutism in particular areas of the body is individual and it depends on the androgens excess rate, or increased sensitivity of hair follicles with normal androgens rate in the serum. There were 84 patients analysed, all of them hospitalized in Department of Gynecological Endocrinology Silesian Medical Academy in Katowice. The aim of this study is to check the correlation between the occurrence and intensity of hirsutism and androgens rate in the serum. In the group of patients with hirsutism the androgens rate was excessed in 72 patients but in 12 women there was an idiopathetical hirsutism diagnosed.

Effects of p53-expressing adenovirus on the chemosensitivity and differentiation of anaplastic thyroid cancer cells.

We investigated the p53 status and the ability of exogenous wildtype (wt) p53 to affect chemosensitivity in three anaplastic thyroid carcinoma cell lines (BHT-101, SW-1736, and KAT-4). All three cell lines had nonfunctional p53. Treatment with mitomycin C or adriamycin did not result in accumulation of p53 or induction of p21WAF1/CIP1 or Mdm-2 and did not cause Rb dephosphorylation. BHT-101 and KAT-4 cells had mutant p53. SW-1736 cells were functionally mutant because of marked down-regulation of wt p53 messenger ribonucleic acid, representing a novel mechanism of p53 dysfunction. Infection with a p53-expressing adenovirus (Ad-p53) induced high levels of p21 and Mdm-2 proteins. In BHT-101 cells, induction of p21 and Mdm-2 was evident 10 h after infection. In KAT-4 cells, induction of p21 and Mdm-2 was observed 1 day after infection, and continued to increase over the ensuing 24 h. SW-1736 cells demonstrated intermediate kinetics. Sensitivity to the cytotoxic effect of Ad-p53 paralleled the kinetics of p21/Mdm-2 induction. BHT-101 cells were most sensitive to killing by Ad-p53, with an IC50 of less than 2 multiplicity of infection; SW-1736 cells were intermediate in sensitivity; KAT-4 cells were resistant. All three cell lines became more sensitive to adriamycin after wt p53 expression, with a 10-fold decrease in IC50 values. The latter observation may make a combination of wt p53 and chemotherapeutic drugs an attractive modality for treating anaplastic thyroid cancer.

The protective role of pyridine N-oxide in cytotoxicity and genotoxicity of hydrogen peroxide and adriamycin.

Scavenging and cytotoxic activity of pyridine N-oxide was investigated in cultured V3 and CHO cells. Pyridine N-oxide was effective in suppressing the cytotoxic effects induced in these systems both by hydrogen peroxide and adriamycin and preventing the production of chromosomal aberrations by these compounds. On the other hand superoxide dismutase inhibited the cytotoxic activity of pyridine N-oxide.

Time-of-day-induced priming effects on verbal and nonverbal dichotic tasks in male and female adult subjects.

Normal adults (32 males and 32 females) were tested for time-of-day related shifts in laterality and priming on two dichotic listening tasks using consonant-vowel combinations (CVs) and musical melodies. The predicted time-of-day effect on melodies was due to males showing low report in the morning, but not the afternoon, suggesting increased right hemisphere involvement in the afternoon. A time-of-day-induced priming effect on the laterality index for CVs differentiated males and females. Males tested morning-first were more lateralized than females, who in turn were more lateralized when tested afternoon-first. A time-of-day-induced priming effect on the laterality index for music indicated those tested afternoon-first showed an overall left ear advantage (LEA), whereas those tested morning-first showed an overall right ear advantage (REA). On raw music scores a sex-linked, time-of-day-induced priming effect was due to the prior presentation of CVs--that is, cognitive priming. Other priming effects on music were evident for order of stimulus presentation and order of ear attended. Implications for theory, research and pedagogy are discussed.