Patient anxiety of verticalization on day 0 after a Cesarean section.

PURPOSE: The ERAS protocol recommends fast mobilization of a patient along with providing psychological comfort; however, early verticalization can generate mental discomfort. In the post-operative period after Caesarean section (CC), a patient may experience pain, anxiety and negative affect. The main aim of the study was to investigate levels of patient anxiety concerning verticalization on day 0 after CC using. Also, the dependence between anxiety of verticalization and the following: pain, anxiety as a permanent disposition, resistance to pain, negative and positive emotions, and positive orientation was described. METHODS: The study included 150 women on day 0 after their CC. The measurement of anxiety concerning verticalization, pain, and also negative and positive emotions was conducted twice. During the first measurement, variables such as anxiety levels as a constant disposition, level of pain resistance and positive orientation were also monitored. RESULTS: Patients upon arrival at the post-operative room declared a higher level of anxiety of verticalization (p < 0.05) (Median = 4; IQR = 5) when compared to 6 h after surgery (Median = 3; IQR = 4). A weak correlation of anxiety and pain was noted (r = 0.264; p < 0.01) in the second measurement. In both measurements, negative emotions and pain resistance proved to be the strongest variables explaining anxiety concerning verticalization. CONCLUSIONS: Low levels of pain experienced by a patient after CC do not explain the variance in anxiety of verticalization. The use of the Numerical Rating Scale (NRS) of anxiety allows care givers to gain patients' psychological perspective in different moments after CC.

Identification of Fruit-Associated QTLs in Winter Squash (Cucurbita maxima Duchesne) Using Recombinant Inbred Lines.

Cucurbita maxima Duchesne squash and pumpkins are cultivated world-wide. Cucurbita maxima fruits are produced for fresh market and are valuable for food processing. Therefore, fruit characteristics and yield are the traits of high economic importance for breeders. To date, the genetic basis of fruit-associated traits in C. maxima have been poorly understood. In the present study, we evaluated fruit-associated traits and conducted quantitative trait locus (QTL) analysis using recombinant inbred lines (RILs) derived from a cross of two inbred lines with different fruit morphotypes. Phenotypic data for nine fruit traits (earliness, weight, number per plant, yield per plant, length and diameter, shape index, flesh thickness, sucrose content and dry matter content) were collected for RILs in two open-field experiments. Pairwise analysis of the phenotypic data revealed correlations among the fruit and yield-associated traits. Using a previously developed genetic map, we identified 26 QTLs for eight traits. The QTLs were found in 10 locations on eight chromosomes of C. maxima. The QTLs were detected across experiments and explained up to 41.4% of the observed phenotypic variations. Major-effect QTLs for multiple fruit-associated traits were clustered on chromosome 4, suggesting that this genomic region has been under selection during diversification and/or domestication of C. maxima.

Differentiation of single lymphoma primary cells and normal B-cells based on their adhesion to mesenchymal stromal cells in optical tweezers.

We have adapted a non-invasive method based on optical tweezers technology to differentiate between the normal B-cells and the B-cell non-Hodgkin lymphoma (B-NHL) cells derived from clinical samples. Our approach bases on the nascent adhesion between an individual B-cell and a mesenchymal stromal cell. In this study, a single B-cell was trapped and optically seeded on a mesenchymal stromal cell and kept in a direct contact with it until a stable connection between the cells was formed in time scale. This approach allowed us to avoid the introduction of any exogenous beads or chemicals into the experimental setup which would have affected the cell-to-cell adhesion. Here, we have provided new evidence that aberrant adhesive properties found in transformed B-cells are related to malignant neoplasia. We have demonstrated that the mean time required for establishing adhesive interactions between an individual normal B-cell and a mesenchymal stromal cell was 26.7 ± 16.6 s, while for lymphoma cell it was 208.8 ± 102.3 s, p < 0.001. The contact time for adhesion to occur ranged from 5 to 90 s and from 60 to 480 s for normal B-cells and lymphoma cells, respectively. This method for optically controlled cell-to-cell adhesion in time scale is beneficial to the successful differentiation of pathological cells from normal B-cells within the fine needle aspiration biopsy of a clinical sample. Additionally, variations in time-dependent adhesion among subtypes of B-NHL, established here by the optical trapping, confirm earlier results pertaining to cell heterogeneity.

Genetic mapping of ovary colour and quantitative trait loci for carotenoid content in the fruit of Cucurbita maxima Duchesne.

The high content of carotenoids, sugars, dry matter, vitamins and minerals makes the fruit of winter squash (Cucurbita maxima Duchesne) a valuable fresh-market vegetable and an interesting material for the food industry. Due to their nutritional value, long shelf-life and health protective properties, winter squash fruits have gained increased interest from researchers in recent years. Despite these advantages, the genetic and genomic resources available for C. maxima are still limited. The aim of this study was to use the genetic mapping approach to map the ovary colour locus and to identify the quantitative trait loci (QTLs) for high carotenoid content and flesh colour. An F6 recombinant inbred line (RIL) mapping population was developed and used for evaluations of ovary colour, carotenoid content and fruit flesh colour. SSR markers and DArTseq genotyping-by-sequencing were used to construct an advanced genetic map that consisted of 1824 molecular markers distributed across linkage groups corresponding to 20 chromosomes of C. maxima. Total map length was 2208 cM and the average distance between markers was 1.21 cM. The locus affecting ovary colour was mapped at the end of chromosome 14. The identified QTLs for carotenoid content in the fruit and fruit flesh colour shared locations on chromosomes 2, 4 and 14. QTLs on chromosomes 2 and 4 were the most meaningful. A correlation was clearly confirmed between fruit flesh colour as described by the chroma value and carotenoid content in the fruit. A high-density genetic map of C. maxima with mapped loci for important fruit quality traits is a valuable resource for winter squash improvement programmes.

Genetic mapping of psl locus and quantitative trait loci for angular leaf spot resistance in cucumber (Cucumis sativus L.).

One of the most important cucumber diseases is bacterial angular leaf spot (ALS), whose increased occurrence in open-field production has been observed over the last years. To map ALS resistance genes, a recombinant inbred line (RIL) mapping population was developed from a narrow cross of cucumber line Gy14 carrying psl resistance gene and susceptible B10 line. Parental lines and RILs were tested under growth chamber conditions as well as in the field for angular leaf spot symptoms. Based on simple sequence repeat and DArTseq, genotyping a genetic map was constructed, which contained 717 loci in seven linkage groups, spanning 599.7 cM with 0.84 cM on average between markers. Monogenic inheritance of the lack of chlorotic halo around the lesions, which is typical for ALS resistance and related with the presence of recessive psl resistance gene, was confirmed. The psl locus was mapped on cucumber chromosome 5. Two major quantitative trait loci (QTL) psl5.1 and psl5.2 related to disease severity were found and located next to each other on chromosome 5; moreover, psl5.1 was co-located with psl locus. Identified QTL were validated in the field experiment. Constructed genetic map and markers linked to ALS resistance loci are novel resources that can contribute to cucumber breeding programs.

Physiological Hypoxia (Physioxia) Impairs the Early Adhesion of Single Lymphoma Cell to Marrow Stromal Cell and Extracellular Matrix. Optical Tweezers Study.

Adhesion is critical for the maintenance of cellular structures as well as intercellular communication, and its dysfunction occurs prevalently during cancer progression. Recently, a growing number of studies indicated the ability of oxygen to regulate adhesion molecules expression, however, the influence of physiological hypoxia (physioxia) on cell adhesion remains elusive. Thus, here we aimed: (i) to develop an optical tweezers based assay to precisely evaluate single diffuse large B-cell lymphoma (DLBCL) cell adhesion to neighbor cells (mesenchymal stromal cells) and extracellular matrix (Matrigel) under normoxia and physioxia; and, (ii) to explore the role of integrins in adhesion of single lymphoma cell. We identified the pronouncedly reduced adhesive properties of lymphoma cell lines and primary lymphocytes B under physioxia to both stromal cells and Matrigel. Corresponding effects were shown in bulk adhesion assays. Then we emphasized that impaired ß1, ß2 integrins, and cadherin-2 expression, studied by confocal microscopy, account for reduction in lymphocyte adhesion in physioxia. Additionally, the blockade studies conducted with anti-integrin antibodies have revealed the critical role of integrins in lymphoma adhesion. To summarize, the presented approach allows for precise confirmation of the changes in single cell adhesion properties provoked by physiological hypoxia. Thus, our findings reveal an unprecedented role of using physiologically relevant oxygen conditioning and single cell adhesion approaches when investigating tumor adhesion in vitro.

Sexual and reproductive health knowledge in cystic fibrosis female patients and their parents.

INTRODUCTION: The changing outcomes for young cystic fibrosis (CF) patients means that reproductive health issues have become an integral part of CF management. AIM: The aim of this study was to investigate the knowledge and experiences of reproductive and sexual health issues in women with CF and to investigate the knowledge and reproductive health attitudes of their parents. MAIN OUTCOME MEASURES: Assessment of reproductive and sexual health knowledge in female CF patients and their parents. METHODS: A questionnaire study directed to 120 Polish women with CF aged 16 years and older and their parents. RESULTS: Sixty-four patients and their parents responded to the questionnaire. Sixty-eight percent of the patients started sexual intercourse at a mean age of 19.2 years. Eighty-four percent of all sexually active women reported that they did not use any form of contraception. Only 32.8% of women understood the problems connected with their own and male fertility in CF. Popular scientific publications and other CF patients were identified as the most important source of information. Only 23% of parents understood the problems connected with female fertility in CF; 44% of parents thought that man with CF had normal fertility. Seventy-five percent of the women and 40% of the parents felt that sexual health discussions should begin between age 12 and 14 years with a CF doctor and the mother. CONCLUSIONS: Our study showed that significant knowledge gaps exist regarding fertility issues in both CF patients and CF parents. Women with CF have some general knowledge about sexual issues but insufficient knowledge to have a safe sexual life. The results helped us to develop the educational program for CF patients.

Long-term benefits of inhaled tobramycin in children with cystic fibrosis: first clinical observations from Poland.

BACKGROUND: Respiratory disease is the major cause of mortality in cystic fibrosis (CF) patients and inhaled antibiotic therapy may contribute to the stabilization of lung function. OBJECTIVES: This is a small, open, uncontrolled, observational study of clinical experience obtained with 2 years of maintenance treatment with inhaled tobramycin in 12 children and adolescents with CF. METHODS: Twelve subjects aged 6-18 years infected by Pseudomonas aeruginosa were qualified for treatment with inhaled tobramycin. Pulmonary function, weight and height, clinical status, and chest X-ray were continually monitored. After an active 2-year treatment period, results of all measured parameters in our patients were compared with their previous results (2-year period before treatment with tobramycin). RESULTS: During 2 years before treatment with tobramycin solution for inhalation (TOBI), pulmonary function decline was observed, the median value of FEV(1) change was -7.6% (lower quartile -13.1, upper quartile -5.9). After 2 years of treatment, FEV(1) percent predicted value declined by 1.5% (lower quartile -11.1, upper quartile 3.7) from baseline; 2 years of TOBI therapy significantly reduced lung function decline (p = 0.049). There were no significant changes in thoracic gas volume and specific airway resistance before and after treatment. Two years of TOBI therapy significantly improved body mass index (p = 0.02). TOBI treatment significantly delayed progression of pulmonary X-ray changes assessed by Brasfield score (p = 0.02). CONCLUSIONS: We found that patients with CF can gain substantial benefits from long-term TOBI treatment, including reduced pulmonary function decline, delayed progression of pulmonary X-ray changes and improved weight gain in growing children and adolescents.

[Serum and sputum eosinophil cationic protein levels and clinical status in cystic fibrosis patients]. / Stezenia eozynofilowego bialka kationowego w surowicy i plwocinie a stan kliniczny chorych na mukowiscydoze.

UNLABELLED: Recent studies have emphasied the role of eosinophils and it's metabolites in the pathogenesis of lung disease in cystic fibrosis. This study was designed to assess the relationship between serum and sputum ECP levels and clinical status of cystic fibrosis patients. MATERIAL AND METHODS: 30 patients, aged 6-30 with moderate cystic fibrosis were recruited. Spirometry, weight and high, and Shwachman-Kulczycki score were measured, and serum and sputum samples were obtained for measurements of the eosinophil cationic protein (ECP). RESULTS: We observed significant inverse correlation between sputum ECP levels and BMI (p<0.001) and FEV1 (p<0.001), and not significant inverse correlation between sputum ECP levels Shwachman-Kulczycki score (p=0.057). There was no signifi cant correlation between sputum ECP levels and FEF25/75% and between serum ECP levels and measured clinical parameters. CONCLUSIONS: Results of this study suggest influence of eosinophil inflammation in respiratory tract on clinical status of CF patients.

Effects of montelukast treatment on clinical and inflammatory variables in patients with cystic fibrosis.

BACKGROUND: In cystic fibrosis (CF), the inflammatory process contributes to progressive lung tissue damage. Cysteinyl leukotrienes have been found in the sputum of patients with CF at high concentrations sufficient to cause potent biological effects. OBJECTIVE: To evaluate the effect of anti-inflammatory treatment with montelukast sodium in patients with CF. METHODS: Twenty-six patients aged 6 to 18 years were recruited to this 20-week, randomized, double-blind, placebo-controlled, crossover trial. Patients received montelukast or placebo for 8 weeks in addition to their regular CF treatment. Before and after treatment, findings from spirometry, whole-body plethysmography, and the clinical wheezing and cough scales were evaluated. At the same time, serum and sputum samples were obtained for the measurement of eosinophil cationic protein, interleukin 10 (IL-10), IL-8, and myeloperoxidase levels. RESULTS: Twenty-three patients completed the study. Compared with placebo use, montelukast treatment significantly improved forced expiratory volume in I second, peak expiratory flow, and forced expiratory flow between 25% and 75% and significantly decreased cough and wheezing scale scores (P < .001 for all). There were no significant changes in vital capacity, thoracic gas volume, airway resistance, and residual volume after treatment. Compared with placebo use, montelukast treatment decreased serum and sputum levels of eosinophil cationic protein and IL-8, decreased sputum levels of myeloperoxidase, and increased serum and sputum levels of IL-10 (P < .001 for all). CONCLUSIONS: Montelukast may have measurable anti-inflammatory properties in patients with CF.

[Pregnancy in cystic fibrosis patients--investigational study]. / Ciaza u kobiet chorych na mukowiscydoze--badanie ankietowe.

AIM: The purpose of this study was to investigate the consequences of pregnancy on women with CF and to clarify the impact of the disease on newborn health. METHODS: It was a retrospective study; a postal questionnaire was sent to 12 woman having a registered pregnancy in National Cystic Fibrosis Registry between 1984 and 2004 (2 to 23 years after delivery). RESULTS: There was a 100% response rate. 16 pregnancies have been reported (4 patients had two pregnancies); there were 16 live births of which 11 (69%) were premature, 10 (62%) of newborns had low weight. There was one neonatal death. The mean prepregnancy FEV1 (% predicted) and BMI (kg/m2) were 56,6 +/- 14,8% (range 35-95) and 19,9 +/- 1,5 (range 18-23) respectively. The mean FEV1 during pregnancy was 47,7 +/- 15,1% (range 23-87), mean maternal weight gain during pregnancy was 5,5kg. There was a significant decline in FEV1 during pregnancy (16.6 +/- 6,4%, p<0.05) as compared to prepregnancy values. Two women had diabetes mellitus and two developed gestational diabetes. Mean postpregnancy (12 months after delivery) FEV1 was 54.1 +/- 18.8% (range 22-103) and mean BMI was 18.7 +/- 1.8 kg/m2 (range 15-22). There was a significant postpregnancy decline in FEV1 (6.2 +/- 10.6%, p=0.027) and in BMI (1 +/- 1.14 kg/m2, p<0.01) as compared to prepregnancy values. Microbiological status remains unchanged. 11 patients are alive; one patient died 11 years after delivery. The mean follow up time was 8.5 +/- 3.6 years (range 2-23). CONCLUSIONS: Pregnancy was well tolerated in our population of CF women, although affected the rate of yearly decline in FEV1 and BMI. Increased risk of premature and low newborn weight were observed. All pregnancies in CF women should be planned and monitored by CF team.

The ECP/Eo count ratio in children with asthma.

We hypothesized that the serum eosinophil eationic protein (ECP) concentration to peripheral blood eosinophil count ratio (ECP/Eo ratio), reflecting active eosinophils, could better correlate with asthma severity in asthmatic patients, than each of these parameters alone. One hundred twenty children with mild to moderate persistent stable asthma were included into the study. At the first visit, previous asthma medications were withheld and patients were administered beta-2 agonists "as needed." At the second visit peripheral blood eosinophil count, serum ECP, sIL-2R, and sICAM-1 were measured, and spirometry and histamine challenge tests were performed. During the study, patients filled daily diary cards to assess symptoms score. One hundred seventeen patients completed the study. The univariate logistic regression analysis showed that asthma severity is related to PC20H, ECP, ECP/Eo ratio, sIL-2R, and sICAM-1. In general, patients with higher level of ECP, ECP/Eo ratio, sIL-2R, sICAM-1 and with lower PC20H exhibited the higher risk of moderate asthma. Multivariate regression analysis showed that only PC20H and ECP/Eo ratio were the best predictors of asthma severity; higher PC20H (1 mg/mL change) slightly decrease (OR = 0.656; 95% CI: 0.44-0.99) and higher ECP/Eo ratio (0.1 pg/cell change) increase (OR = 1.84; 95% CI: 1.02-3.34) a risk of moderate asthma. These data show that the ECP/Eo ratio is a better and more useful marker than ECP or peripheral blood eosinophil count separately in assessing asthma in children.

[Early intervention of specialist in children with bronchial asthma as a result of Prevention Program of Allergic Diseases in children]. / Wczesna interwencja alergologa w astmie oskrzelowej u dzieci jako efekt Programu Prewencji Chorób Alergicznych.

Nowadays allergic diseases are one of the most important challenges in medicine because of healthful and economical consequences. Early diagnosis and correct treatment of allergic diseases, especially bronchial asthma have become a very important problem. For this purpose, prophylactic and treatment allergic programs are created. In this paper authors describe results of prophylactic program for allergic disease in children in Lódz district in years 2000-2001. Program improved access to specialists and allowed early diagnosis of bronchial asthma and other allergic diseases in children.

[Retrospective analysis of the results of Allergic Diseases Prevention Program in children in the Lódz area]. / Retrospektywna analiza wyników Programu Prewencji Chorób Alergicznych u dzieci w regionie lódzkim.

Growing prevalence of allergic diseases requires concentrating on patients' education, prevention, suitable organization of medical care as well as the early diagnosis. It the presented retrospective study of the results of Prevention Allergic Diseases Programme in children in Lodz region in years 2000-2003 was analysed. Analysis of medical records of patients undergone preventive program showed: solid growth of number of patients with allergic disease in frames of Programme, the solid growth of percentage of new diagnosed allergic diseases, essential changes in structure of diagnosed allergic diseases during Programme, particularly visible in the youngest age group up to 5 years of age as well as the systematic fall in number of hospitalization from asthma and atopic dermatitis. With attention on growing number of referred patients Program should be continued and with the reason of still missing good medical care in children of Lodz region.

[Effect of montelukast on lung function and clinical symptoms in patients with cystic fibrosis]. / Wplyw montelukastu sodu na czynnosc pluc i objawy kliniczne u chorych na mukowiscydoze.

Inflammatory process contributes to progressive lung tissue damage in cystic fibrosis (CF). Cysteinyl leukotrienes have been found in the sputum of CF patients at concentrations sufficient to cause potent biological effect. This study was designed to assess the effect of anti-inflammatory treatment with montelukast sodium in CF patients. Twelve patients, aged 6-29 were recruited. It was 20 week, placebo-controlled, and randomized, double blind, crossover trial. At first and last week of each treatment course spirometry and whole body plethysmography parameters (FEV1, PEF, FEF25/75%, VC, TGV, Raw and RV) and clinical wheezing and cough scale were measured. In montelukast group significant improvement in FEV1 (mean +/- SD, 54.6 +/- 22.6 before and 62 +/- 19.0 after treatment, p=0.0112) and FEF25/75% (28.9 +/- 23.0 before and 37.5 +/- 25.5 after treatment, p=0.0053) were observed. Compared with placebo montelukast significantly improved FEV1 (p=0.0032), PEF (p=0.0298) and FEF25/75% (p=0.0091). There was no significant difference in VC, TGV, Raw and RV. Montelukast compared with placebo significantly decreased cough (p<0.0001) and wheezing (p=0.0002) score. In summary, therapy with montelukast may provide clinical benefit to patients with CF.

[Cost of pharmacologic treatment and their determinants in ambulatory care of cystic fibrosis patients]. / Koszty leczenia farmakologicznego i ich uwarunkowania w opiece ambulatoryjnej nad chorymi na mukowiscydoze.

Life expectancy of cystic fibrosis (CF) patients has improved following the introduction of modem therapies. Length of life has been most important determinant of cost of medical care in each population. The aim of this study was to evaluate the cost of pharmacologic treatment and their determinants served by patients and medical insurance. Medical records of our CF center patients from year 2003 were analysed. The annual cost of pharmacologic treatment in our patients in 2003 averaged PLN 26595.91; of total costs 74% were from DNase, 7% from drugs classified as "other", 6.2% from pancreatic enzymes. Individual annual costs served by patients averaged from PLN 979.67 to 10805.57 (mean PLN 6059.63). Mean annual cost "per patient" served by medical insurance averaged PLN 26595.91; 70% of costs were from DNase, 15% from inhaled corticosteroids and bronchodilators. 68% of drug costs were served by medical insurance, 32% by patient. We found significant correlation between cost served by patients (p1), by medical insurance (p2) and age (p1, p2<0.0001) and severity of disease--defined based on percent expected FEV1 (p1=0.006; p2=0.001). Severity of disease and patients age were important determinants of pharmacologic treatment cost in CF patients.

[Two cases of cystic fibrosis treated as bronchial asthma in children]. / Dwa przypadki mukowiscydozy leczonej jako astma oskrzelowa u dzieci.

Cystic fibrosis (CF) is the most frequent genetic disorder occurring in Caucasian, followed to preterm death. Clinical diagnosis of CF is set in infant or early childhood. Late diagnosis of CF is most often caused by non-typical course of the disease, rarely by misdiagnosis and not taken CF into account in differential diagnosis. In this paper we present two cases of misdiagnosis lung and digestive symptoms, treated as asthma bronchiale.

[Bronchial asthma--epidemiology, public and economic problems]. / Astma oskrzelowa--epidemiologia, problemy spoleczne i ekonomiczne.

In this review, authors described epidemiology of asthma in regards to mortality and disability caused by the disease. In particular, long-time statistical analyses of asthma mortality in United States and Great Britain has been shown. Specific mortality factors between United States and Regional Health Authority of Lodz were compared. Economical costs of asthma management were studied, taking United States as an example. The review also focused on variety of preventive and counteraction programs, for example the national health program--'Prevention and treatment of asthma and allergic diseases'.

[Preliminary results of prophylactic program of allergic diseases in children in Lodz district]. / Wstepna ocena Programu Prewencji Chorób Alergicznych u dzieci w regionie Lódzkim.

Allergic diseases are one of the most important problems in medicine. As a consequence of increased frequency of allergic diseases, negative health, economical and social problems appear. To eliminate these consequences prophylactic programmes are created. In this paper preliminary results of Prophylactic Program of Allergic Diseases in Children in Lodz district in 2000-2001 years is presented.