Should we be afraid of long-term cardiac consequences in children with multisystem inflammatory syndrome? Experience from subsequent waves of COVID-19.

The purpose of the study was to assess and compare short- and long-term cardiac complications of the multisystem inflammatory syndrome in children (MIS-C) by predominant severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants throughout the pandemic. The analysis of prospectively collected data comparing cardiac complications of MIS-C during and after hospitalization across the original/alpha, delta, and omicron waves. Cardiac complications were defined as cardiac failure with systolic function impairment or hypotension or abnormalities in echocardiographic findings (decrease in LVEF, FS, valvular insufficiency, pericardial effusion, or coronary artery abnormalities). A total of 120 patients with MIS-C admitted to the Children's Hospital of Krakow between November 1, 2020, and May 5, 2023, were included in the study (74 during original/alpha dominance, 31 delta, and 15 omicron). Patients in the omicron group were found to be younger than those in the alpha and delta groups (37 vs. 75 vs. 80 months, p = 0.03). The frequency of cardiac failure with systolic function impairment or hypotension was diagnosed more frequently in the original/alpha and delta groups than in the omicron group (44.59% vs. 41.94% vs. 13.33%, p = 0.08) also echocardiographic abnormalities changed, with rates of 60.8%, 35.5%, and 13.3% (p < 0.001) accordingly. The multivariable regression revealed an older age (OR = 1.19, 95% CI = 1.07-1.33, p = 0.002) as the only independent factors of cardiac failure with systolic function impairment or hypotension. In all patients, signs of cardiac failure resolved during the hospitalization. Moreover, in 98.3% of patients, all echocardiagraphic abnormalities resolved completely during the observation period.    Conclusion: The cardiac complications of MIS-C appeared to advance less severely in younger children during the Omicron outbreak. In long-term observation, symptoms of cardiac failure resolve completely. Similarly, also echocardiographic abnormalities normalize in the vast majority of patients. What is Known: • Knowledge about the long-term cardiac complications of MIS-C is still evolving and uncertain. • The greatest concern of MIS-C is cardiac complications, including cardiac failure and coronary artery dilatation. What is New: • Long-term observations revealed complete resolution of cardiac complications in the vast majority of patients with MIS-C, irrespective of the dominant variant. • Cardiac complications of MIS-C were less common in younger children during subsequent pandemic waves in our patient population.

Comparison of the course of multisystem inflammatory syndrome in children during different pandemic waves.

The purpose of this study is to assess the rate, clinical picture, and management of multisystem inflammatory syndrome in children (MIS-C) during the different COVID-19 variants of concern (VOC) domination periods. This was a retrospective analysis of prospectively collected data. The incidence and clinical picture of MIS-C during the original/Alpha (group 1) and Delta/Omicron (Group 2) variant domination periods were compared. Among 108 eligible patients, 74 (68.5%) were hospitalized during the group 1 domination period, and 34 (31.5%) were hospitalized during the group 2 domination period. The median (Me) patient ages were 76 months (interquartile range [IQR] 35-130) and 73 months (IQR 45-118), and 61% and 65% of patients were male, respectively. There was no significant difference in the presence of positive SARS-CoV 2 antibody test results (IgM or IgG) between the groups (84 vs. 90%; p = 0.54).No differences between groups were observed in fever duration prior to admission (Me [IQR]: 5 days [3-6] vs. 5 days [4-6]; p = 0.26) or the presence of mucocutaneous (95 vs. 100%; p = 0.41), circulatory (70.3 vs. 61.8%; p = 0.86), neurological (6.8 vs. 2.9%; p = 0.662), or gastrointestinal symptoms (84 vs. 79%; p = 0.59). Respiratory symptoms were more common in group 2 (70 vs. 91%; p = 0.015). The need for intensive care unit admission was similar in both groups (16.2 vs. 17.6%, p = 1.0). No deaths occurred in the entire cohort. The studied children were characterized by high C-reactive protein and procalcitonin levels, concentrations of ferritin within normal limits, lymphopenia, moderate hypoalbuminemia, and high B-type natriuretic peptide/brain natriuretic peptide (NT-proBNP) concentrations; however, there were no differences between the groups. Intravenous immunoglobulins were administered as a first-line treatment for almost all patients. There was no significant difference in corticosteroid administration between the groups (87% vs. 74%; p = 0.11); however, the summary dose of methylprednisolone was higher in group 2 (Me [IQR]″ 12.6 mg/kg [10.5-17.8] vs. 16.4 mg/kg [13.3-19.5]; p = 0.03). The median length of stay was 11 days [IQR]: [9-14] and 10 days [8-12], respectively (p = 0.065). CONCLUSION: The clinical course of MIS-C is similar in subsequent pandemic waves; however, the incidence of MIS-C seems to be decreasing. WHAT IS KNOWN: • The clinical picture of COVID-19 is evolving. Multisystem inflammatory syndrome in children (MIS-C) is a relatively new serious disease connected with SARS-CoV-2 infection, and in subsequent waves of the pandemic, new cases of the disease have been recorded. WHAT IS NEW: • The clinical picture of MIS-C is not specific, but the course is still severe. • The incidence of MIS-C during the different pandemic waves is decreasing and the diagnosis in the period of lower prevalance is challenging.

Neurogenic bladder symptom score: Polish translation, adaptation and validation of urinary disorder-specific instrument for patients with neurogenic lower urinary tract dysfunction.

INTRODUCTION: There is no comprehensive and specific questionnaire translated, adapted and validated in the Polish language for evaluating symptoms, quality of life and complications associated with the neurogenic lower urinary tract dysfunction (NLUTD). The aim of this study was to translate, culturally adapt and validate a Polish version of the Neurogenic Bladder Symptom Score (NBSS) for patients who experience NLUTD. MATERIAL AND METHODS: Standardised guidelines and well-established methods were used for translation and cross-cultural adaptation of the NBSS. Adult patients with multiple sclerosis and spinal cord injury completed the NBSS, the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), the International Prostate Symptom Score (IPSS) and the SF-Qualiveen. Responses were recorded twice within a 14-day period. RESULTS: Two hundred seventy-four Polish-speaking patients with NLUTD were included in the study. Content validity was optimal. Significant relationships between NBSS (Incontinence) and ICIQ-SF, NBSS (Storage and Voiding) and IPSS, and NBSS (Quality of Life) and SF-Qualiveen confirmed good construct/criterion validity. An intercorrelation study revealed that internal consistency was good for the total NBSS and specific domains (Cronbach's alpha >0.7). Test-retest reliability (reproducibility) demonstrated strong stability (intra-class correlation coefficients >0.7 for the total NBSS). No ceiling or floor effects were present. CONCLUSIONS: The Polish NBSS demonstrated good measurement properties for a large cohort of patients with NLUTD. It is a suitable tool to assess NLUTD symptoms, consequences and quality of life. The Polish NBSS will support routine clinical practice of all types of physicians in Poland who care for patients with NLUTD.

Accuracy and prognostic value of variant histology and lymphovascular invasion at transurethral resection of bladder.

OBJECTIVES: To evaluate the concordance rate of lymphovascular invasion (LVI) and variant histology (VH) of transurethral resection (TUR) with radical cystectomy (RC) specimens. Furthermore, to evaluate the value of LVI and VH at TUR for predicting non-organ confined (NOC) disease, lymph node metastasis, and survival outcomes. PATIENTS AND METHODS: Two hundred and sixty-eight patients who underwent TUR and subsequent RC were reviewed. Logistic regression analyses were performed to evaluate the association of LVI and VH with NOC and lymph node metastasis at RC. Cox regression analyses were used to estimate recurrence-free survival (RFS) and cancer-specific survival (CSS). RESULTS: LVI and VH were detected in 13.8 and 11.2% of TUR specimens, and in 30.2 and 25.4% of RC specimens, respectively. The concordance rate between LVI and VH at TUR and subsequent RC was 69.8 and 83.6%, respectively. They were both associated with adverse pathological features such as lymph node metastasis and advanced stage. TUR LVI and VH were both independently associated with lymph node metastasis and TUR VH was independently associated with NOC. On univariable Cox regression analyses, TUR LVI was associated with RFS and CSS while TUR VH was only associated with RFS. Only TUR LVI was independently associated with RFS. CONCLUSION: Detection of LVI is missed in a third of TUR specimens while VH seems more accurately identified. TUR LVI and VH are associated with more advanced disease and LVI predicts disease recurrence. Assessment and reporting of LVI and VH on TUR specimen are important for risk stratification and decision-making.

Effect of dietary supplementation with Yarrowia lipolytica or Saccharomyces cerevisiae yeast and probiotic additives on growth performance, basic nutrients digestibility and biochemical blood profile in piglets.

The objective of the study was to compare the efficiency of dietary supplementation of two species of yeast, Yarrowia lipolytica (YL) and Saccharomyces cerevisiae (SC), with or without the addition of a probiotic, on growth performance, basic nutrients digestibility and blood profile in piglets. The experiment was conducted on 360 weaned piglets (180 barrows and 180 gilts). Each treatment comprised 60 piglets. The piglets (27-day-old) were assigned to the following dietary treatments: (a) basal control (C) diet, (b) C diet + probiotic (Bacillus licheniformis and Bacillus subtilis-2 × 109  CFU/kg of feed), (c) C diet + 3% Y. lipolytica (YL-2 × 1010  CFU/g), (d) C diet + 3%YL + probiotic, (e) C diet + 3% S. cerevisiae (SC-3 × 1010  CFU/g) and (f) C diet + 3% SC + probiotic. Blood for analysis was collected from a total of 36 piglets at the end of the experiment, that is, 56 days after weaning. During the entire experiment, significantly greater weight gain was observed in the piglets receiving YL. The addition of the probiotic supplement and SC yeast reduced the daily feed intake during day 16-56 and from day 0 to 56 of the experiment. A better feed conversion ratio (FCR) during day 0-56 of the experiment was noted after addition of the probiotic and yeast. The use of YL yeast in diets for piglets had a more beneficial effect on weight gain and FCR than SC. Moreover, the addition of YL modulates lipid metabolism in piglets, as indicated by the reduced levels of TCH, LDL and TG and increased level of HDL in the plasma. The combined use of either YL or SC with a probiotic is not recommended in piglet rearing, as it does not substantially improve growth performance and health in comparison with yeast alone.

Assessment of knowledge concerning urology among medical students in Poland.

BACKGROUND AND OBJECTIVE: Urological diseases represent a significant health issue worldwide. Presented study aimed at assessing current urological knowledge and confidence in performing urological diagnostic and therapeutic procedures among medical students at Jagiellonian University Medical College in Poland and compare it on different stages of the undergraduate medical education. MATERIAL AND METHODS: We designed an anonymous survey distributed among Polish students from 1st to 6th year of medical studies, before and after clinical urology course. Questions concerned general urological knowledge, prostate diseases, erectile dysfunction, and self-reported practical urological skills. RESULTS: Overall, 437 respondents participated in the survey. Mean total test score in our study group was 50.08%, mean general urological knowledge score was 53.44%, mean prostate diseases knowledge score was 55.43%, mean erectile dysfunction score was 36% and mean practical skills score was 45.83%. Mean total test score increased with consecutive years of studies (R = 0.58; p <0.001). The risk of an above average total test score was significantly influenced by the urology course (OR = 7.95, 95%CI = 1.81-34.84, p = 0.006) and the year of medical studies (4th-6th vs. 1st-3rd) (OR = 5.16, 95%CI = 3.41-7.81, p <0.001). Practical skills score above average was significantly more frequent in the group after the urology course (OR = 6.75, 95%CI = 1.54-29.58, p = 0.011). CONCLUSIONS: Results of this study reveal low mean scores obtained by students, even after completing the urology course, which implies that curriculum requires further development. Urological knowledge and self-assessed practical skills increased with years of medical education. The urology course improved the score obtained in our survey, both in terms of total test score and practical skills.

The effect of different dietary levels of dl-methionine and dl-methionine hydroxy analogue on the antioxidant and immune status of young turkeys.

The hypothesis postulating that the antioxidant and immunological effects of dietary methionine (Met) in young turkeys (1-8 weeks of age) can be differentiated by level and source of Met was investigated in this study. A total of 544 female Hybrid Converter turkeys were divided into four groups and fed diets in which Met content was tailored through supplementation with dl-methionine (dl-Met) or dl-methionine hydroxy analogue (MHA) to levels recommended by NRC (1994) (Groups dl-MetL and MHAL) and exceeding them by 50% (Groups dl-MetH and MHAH). Regardless of its source, the increased dietary Met content led to significantly higher body weight gains but had no effect on feed conversion rates. Moreover, an increased Met content lowered lipid peroxide concentrations in breast meat and increased selected indicators of the plasma antioxidant status like uric acid levels, activity of superoxide dismutase (SOD), glutathione (GSH) concentrations, the ferric-reducing ability of plasma (FRAP), increased immunoglobulin A (IgA) plasma levels and decreased interleukin 6 levels. In comparison with dl-Met, MHA decreased the activities of SOD and catalase, and GSH concentrations in plasma. A dosage by source interaction revealed that the lower MHA content was associated with the lowest plasma GSH concentrations, FRAP values and activities of SOD and catalase. The higher dietary MHA level resulted for most parameters similar values, except for a decrease in lipid peroxide concentrations and an increase in plasma IgA levels. It can be concluded that an increased dietary dl-Met and MHA content (about 150% of the recommendations given by NRC 1994) not only increased the growth rate of young turkeys but also improved their antioxidant status. MHA appears to be a less desirable source of dietary Met for young turkeys when the inclusion level of Met matches the current recommendations. Therefore, a further debate is needed to establish the dietary requirements for Met in poultry.

The effect of dietary methionine levels on fattening performance and selected blood and tissue parameters of turkeys.

A total of 490 eight-week-old female Hybrid Converter turkeys (body weight 4.11 ± 0.03 kg) were divided into 5 groups with 7 replicates of 14 birds each. For 8 weeks, basal diets were supplemented with methionine (Met) at following levels (weeks 9-12/weeks 13-16 of age): Group 1 - 0.34/0.29%, Group 2 - 0.39/0.34%, Groups 3 and 4 - 0.45/0.38% and 0.51/0.41%, respectively, Group 5 - 0.58/0.47%. Only in the first feeding phase the body weight gain (BWG) was affected by Met levels with the significantly highest BWG in Group 3. No treatment effects were found for feed conversion ratio, carcass yield, carcass composition and meat colour. The blood superoxide dismutase activity was significantly highest in Groups 2 and 3. The concentrations of reduced glutathione in the liver were linearly increased (p = 0.018), whereas the ratio of reduced glutathione to oxidised glutathione was highest in Group 3 (quadratic contrast, p = 0.004). It can be concluded that turkeys from Group 3 (Met levels age depending 15% and 10% above recommendations by NRC) were characterised by a well-balanced physiological response. Attention should be paid to the immune response of birds to higher dietary Met levels: plasma IgA concentrations decreased, whereas IL-6 and TNF-α levels increased in turkeys fed diets with the highest Met content.

Nutritional and Antioxidative Benefits of Dietary Macroalgae Supplementation in Weaned Piglets.

This study explores the effects of dietary brown macroalgae (Ascophyllum nodosum) inclusion on digestibility and blood biochemical indices and redox markers in piglets fed diets with varying levels (0%, 0.6% and 1%) of macroalgae from 18 to 64 days of age. Macroalgae significantly influenced lipid profiles, reducing total cholesterol levels (quadratic contrast p = 0.001) and demonstrating an increase in high-density lipoprotein cholesterol levels, particularly with 1% macroalgae inclusion (linear contrast p < 0.001), with a decrease in low-density lipoprotein cholesterol in both macroalgae-supplemented groups (linear contrast p = 0.001). Additionally, macroalgae had a positive impact on the activities of antioxidative enzymes (ferric-reducing ability of plasma, superoxide dismutase, reduced glutathione) and reduced lipid peroxidation products (lipid hydroperoxide, malondialdehyde) in the blood, liver tissue, and intestinal epithelium of the ileum, suggesting enhanced antioxidative defense mechanisms. These changes were dose-dependent; in blood plasma, they exhibited both a linear and quadratic response, while in the tissues, the response was primarily linear. Additionally, an increase in the digestibility of crude fat in macroalgae-supplemented groups was observed (linear contrast p < 0.001), highlighting their potential role in improving nutrient absorption and digestion. The study findings emphasize the health benefits of natural, seaweed-based additives in diets, particularly in managing oxidative stress and improving lipid profiles, and highlight the potential of macroalgae as a natural dietary supplement to improve antioxidant systems and lipid metabolism in piglets.

Nutritional Value and Physicochemical Properties of Male and Female Broad-Breasted Bronze Turkey Muscle.

Colored varieties of turkeys, such as the broad-breasted Bronze, not currently subject to intensive breeding work, are kept only in amateur breeding and treated rather as ornamental poultry. They are raised in extensive systems, which undoubtedly affects the quality of the meat obtained. Consumers are looking for meat with specific and unique sensory qualities; hence, the interest in meat from turkeys with a slower-than-typical growth rate, such as the broad-breasted Bronze, is justified. The object of this research was to analyze the physicochemical properties and nutritional value (amino acid, fatty acid, and antioxidant profile) of the breast and thigh muscles of broad-breasted Bronze turkeys with regard to gender. It was shown that gender had little effect on muscle chemical composition, amino acid, and fatty acid content (p > 0.05), as well as most oxido-reduction indices. However, significant differences were noted in muscle quality traits such as color brightness (L*; turkeys > indors; p = 0.023), proportion of red (a*; turkeys < indors; p = 0.048) and yellow (b*; turkeys > indors; p = 0.039), and water absorption (turkeys < indors; p = 0.009). The type of muscle also had a significant effect on quality characteristics. Higher a*, b*, C*, pH, water absorption, and thermal leakage were shown in the femoral muscle (p < 0.001), while L* and h were higher in the pectoral muscle (p < 0.001). Turkey meat was characterized by a high proportion of unsaturated fatty acids (MUFA + PUFA ~68%), favorable FA index values, and low lipid oxidation indices. Thigh muscles (especially turkey) were more caloric, and contained significantly (p < 0.001) more fat and all major FA groups. Breast muscles (especially of turkeys) were characterized by a high protein content (about 25%) and a high proportion of essential amino acids. The data obtained indicate that broad-breasted Bronze turkeys can provide high-quality meat, and are an excellent option for meeting modern consumer needs.

A previously unknown variant of the calcaneofibular ligament.

The lateral ankle joint is composed of three ligaments: the anterior talofibular ligament (ATFL), posterior talofibular ligament (PTFL) and calcaneofibular ligament (CFL). The ATFL and CFL demonstrate morphological variation, especially regarding their shape and number of bands. During standard anatomical dissection, an unusual type of triple CFL was observed: the CFL was composed of two bands originating on the lateral malleolus, and the presence of a lateral talocalcaneal ligament (LTC) originating on the talus bone. The insertion point of each band was located on the calcaneal bone. An understanding of these anatomical patterns provides a clearer view of ankle joint biomechanics, and improved the planning and performance of surgical treatment.

Sexual activity in a large representative cohort of Polish men: Frequency, number of partners, correlates, and quality of life.

INTRODUCTION: Sexual activity of men has been evaluated at the population-level in different regions of the world. However, reliable data are lacking for Eastern Europe. Therefore, the aim of this study was to analyze the frequency of sexual activity and the number of sexual partners in a large representative cohort of Polish men. METHODS: We performed a cross-sectional investigation with computer-assisted web interviews. Participants were stratified by age (≥18 years) and place of residence. The most recent population census was used to produce a population-representative sample of respondents. Men's sexual activity was then correlated with multiple variables. RESULTS: We enrolled 3001 men, representative for age and place of residence, including adequate proportions of respondents from urban and rural areas. Most Polish men were sexually active, predominantly having had sex at least weekly with one partner. Almost 18% of respondents declined sexual intercourse and/or sexual partner in the prior year. The highest sexual activity was observed for men 35-44-years-old (for sex frequency) and 18-24-years-old (for partner number), living in medium-sized cities, employed, and married (for sex frequency) or divorced (for partner number). Erectile dysfunction negatively affected the frequency of sexual activity and lowered the number of sexual partners, although premature ejaculation did not have any effect. Frequency of sexual activity and number of sexual partners correlated well with psychological distress, quality of sex life, and overall life quality. Whereas lifestyle habits including smoking and alcohol intake decreased the likelihood of sexual activity, all analyzed comorbidities did not affect sex life. CONCLUSIONS: This study of men's sexual activity was the first population-representative and nationwide investigation performed in Poland. Most Polish men were sexually active and sexual activity correlated with multiple variables including sociodemographic factors, erectile functioning, mental distress, overall and sex-specific quality of life, and lifestyle habits.

The assessment of bladder cancer resectability with bimanual palpation: A prospective study in laparoscopy and open cystectomy patients.

PURPOSE: To evaluate the value of examination under anesthesia (EUA) in the assessment of bladder resectability during cystectomy. MATERIALS AND METHODS: This prospective study included consecutive patients undergoing cystectomy for bladder cancer at a single center between June 2017 and October 2020. EUA was conducted before cystectomy by two urologists who assessed the bladder for limited mobility. One examiner was blinded to the imaging results. Soft tissue surgical margin status in the pathological evaluation of a cystectomy specimen served as a measure of resectability. We used multivariable logistic regression models to assess whether EUA performed by blinded or non-blinded examiners is associated with soft tissue positive surgical margins (PSMs) and to calculate the fraction of new information added by such an examination in addition to selected clinical variables. RESULTS: Among the 134 patients analyzed, limited bladder mobility was indicated by the blinded and non-blinded examiners in 23 (17.2%) and 21 (15.7%) cases, respectively. PSMs were identified in 22 (16.4%) patients, more often in patients with limited bladder mobility as assessed by the blinded (odds ratio [OR] 6.7; 95% confidence interval [CI], 1.9-24.2) and non-blinded examiners (OR 12.9; 95% CI, 2.9-57.5). The fraction of new information added by the blinded and non-blinded examiners was 48.6% and 57.7%, respectively. The enrichment of patients who underwent pure laparoscopic cystectomy (n = 102; 76%) and the inclusion of patients for emergent surgery may limit the generalizability of our findings. CONCLUSIONS: The identification of limited bladder mobility during preoperative EUA yielded prognostic information on surgical margin status. Our findings suggest that EUA has the potential to provide valuable insights in the assessment of bladder resectability. However, further research in a larger cohort of patients is warranted to validate and expand on these findings.

[Surgical management of severe Peyronie's disease]. / Chirurgiczne leczenie ciezkich postaci choroby Peyronie.

Peyronie's disease (lat. induratio penis plastica) is a process of the fibrotic plaques oand other localized fibrotic conditions have been considered to be the result of an abnormal size, pain and improved penile curvature. At early stages intralesional injections may decrease penile curvature and decrease plaque volume although the exact mechanism of action on Peyronie disease is unknown. In serious cases surgery is recommended, based on ultrasound examination, cavernosography and cavernosometry. There are three mail surgical procedures to correct the curvature in Peyronie's disease: Nesbit plication, plaque excision followed by skin grafting, another autograft or synthetic material, and implantation of a penile prosthesis Aim of this study is to present our experience in surgical treatment of severe stadium in Peyronie's disease. Peyronie plaque was excised in 8 man, previously potent with severe satium of the disease. In every case saphenous autograft replacing excised plaque was used. In every case was not intra and postoperative complications. All patients reported satisfactory cosmetic and functional result. The satisfactory result of the treatment of severe stadium Peyronie disease is based on the surgical method. Saphenous graft is effective, safe and successful technique in our knowledge.

[Hypertension in obese children and adolescents]. / Nadcisnienie tetnicze u otylych dzieci i nastolatków.

BACKGROUND: The frequency of arterial hypertension (AHT) in children is around 3.2-4.5% nowadays, however 3-4 decades ago it was below 1.5%. In obese children AHT is 3-5 times more frequent than in lean children. AIM: Retrospective evaluation of frequency of AHT and metabolic complications in obese children and adolescents. MATERIAL AND METHODS: One hundred seventy children and adolescents (100 girls) at the mean age of 14.6 years (range: 10-18 years) diagnosed with simple obesity admitted to The Department of Pediatric and Adolescent Endocrinology in Krakow, Poland were assessed in the study. Patients were divided into three groups: 1- obese normotensive (n=43), 2- obese prehypertensive (n=31), 3- obese hypertensive (n=96). Blood pressure (BP) was assessed by Korotkow method. The result was expressed as a mean of 3 independent BP measurements. Biochemical analysis included oral glucose tolerance test with assessments of glucose, insulin and HOMA-IR (the homeostatic index for insulin resistance) as well as lipid profile and uric acid measurements. RESULTS: AHT was found in 96 patients (55.8%), in 53 girls (52%) and 43 boys (61.4%). Prehypertensive values of BP were found in 31 patients (18 girls). Systolic AHT was found in 90 patients (52.9%), diastolic AHT in 56 patients (32.9%), and both systolic and diastolic AHT in 50 patients (29.4%). In group 3. BMI was higher than in group 1. BMI correlated significantly with systolic and diastolic BP. Uric acid levels were higher in group 3. than in group 1., and higher in patients with diastolic AHT. Basal insulin levels were higher in diastolic AHT patients and poststimulatory insulin was higher in systolic AHT patients. HOMA-IR was higher in patients with diastolic AHT than in patients with normal diastolic BP. Lipid profile did not differ between the groups, however the highest percentage of patients with abnormal lipid profile was found in group 2. CONCLUSION: An early endocrine referral in pediatric obese patients is advisable to monitor complications of obesity.

Effect of the inclusion of extruded flaxseed in the diet of fattening pigs on lipid metabolism and tissue redox status.

The aim of the study was to evaluate the effect of a diet containing extruded flaxseed (Linum usitatissimum L.) on the fatty acid composition of the loin, blood lipid parameters, and the redox status of tissues of finishing pigs. A total of 160 weaners (about 30-110 kg BW) were assigned to four experimental groups of 40 animals each (5 replicates with 8 individuals each). Group C (control) received a diet in which the fat source was soybean oil, while in groups 2FE, 4FE and 6FE soybean meal was replaced with extruded flaxseed in the amount of 2%, 4% or 6%, respectively. The diet containing extruded flaxseed reduced cholesterol levels in the blood plasma of pigs (grower 2FE and 6FE vs. C; finisher 2FE, 4FE and 6FE vs. C) and loin muscle (2FE, 4FE and 6FE vs. C). A decrease in the atherogenic LDL-C fraction and in the content of triacylglycerols was also noted in the blood plasma of grower and finisher pigs receiving flaxseed (2FE, 4FE and 6FE vs. C). The beneficial effects noted in the experimental pigs also included an increase in the overall content of n-3 PUFAs, especially ALA (18:3 n-3), and a reduction in the n-6/n-3 ratio. This was especially evident at 4% and 6% inclusion of flaxseed. The highest proportion of flax (6%) in the blend increased lipid peroxidation, as evidenced by the increase in the content of LOOH and MDA in the blood plasma of grower and finisher pigs. For this reason, a 4% share of flaxseed in the diet of fattening pigs seems to be optimal, while higher levels require an additional supply of exogenous antioxidants.

The effect of thyme herb in diets for fattening pigs on their growth performance and health.

To enrich pork with valuable n-3 PUFA, it is common practice to include flaxseeds in the swine diet. However, due to the high susceptibility of these acids to oxidation, this treatment requires an additional supply of antioxidants. Thyme herb can be used for this purpose, which in addition to high antioxidant activity is characterized by numerous health-promoting properties. The present study aimed at evaluating the impact of the inclusion of 1% and 3% of thyme herb in mixtures with 4% of extruded flaxseeds as a source of n-3 PUFA on the performance results and health status of fatteners. The experiment was carried out on 120 weaners with an initial body weight of about 30 kg and kept until the end of fattening. They were divided into three experimental groups of 40 animals each (5 pens with 8 pigs in each). The control group (C) consisted of pigs receiving a base mixture with 4% of extruded flaxseeds. In the experimental groups, an additional 1% (T1) or 3% (T3) of thyme herb was added to the mixture. By supplementing the diet with 3% of thyme, an increase in average daily weight gain (P = 0.001) and a better feed conversion ratio (P < 0.001) were obtained. This could be the result of an improvement in the small intestine histology (greater villus height-P < 0.001) and better digestibility of basic nutrients (especially crude protein-P < 0.05) found in experimental animals. In addition to these effects, thyme herb supplementation contributed to the stimulation of immune mechanisms (increase in the number of WBC-P ≤ 0.05; plasma IgA - P < 0.05 and IgG-P < 0.005, and the level of lysozyme-P < 0.05). The obtained results indicate the advisability of the use of thyme as a feed additive beneficially influencing the health and performance results in pigs. The obtained results indicate the advisability of the use of thyme as a feed additive beneficially influencing the health and performance results in pigs.

Antioxidant status in the blood, liver, and muscle tissue of turkey hens receiving a diet with alfalfa protein concentrate.

This study aimed to investigate the impact of the oxidative potential of turkeys fed a diet with alfalfa protein concentrate (APC), used throughout the rearing period or periodically at 2-wk intervals. The research material consisted of 6-wk-old BIG 6 turkey hens kept in pens, 5 birds per pen in 6 replicates. The experimental factor was the addition of APC to the diet in the amount of 15 or 30 g/kg of diet. APC was administered in 2 ways: birds received a diet with APC throughout the experiment or periodically. In the latter case, the birds received the diet with APC for 2 wk, and then for 2 wk they received the standard diet without APC. Levels of nutrients in the diet; flavonoids, polyphenols, tannins, and saponins in APC; uric acid, creatinine, bilirubin, and some antioxidants in the blood; and enzyme parameters in the blood and tissues of turkeys were determined. The use of APC in the diet stimulated antioxidant processes, which could be seen in the values of the pro-oxidant-antioxidant parameters of the tissues and blood plasma of turkeys. The significant reduction in the H2O2 level (P = 0.042) and slight reduction in the MDA level (P = 0.083), accompanied by an increase in catalase (P = 0.046) activity in the turkeys continuously receiving APC in the amount of 30 g/kg of diet, as well as the increase in plasma antioxidant parameters (vitamin C, P = 0.042 and FRAP, P = 0.048) in these birds, reflects improvement in their antioxidant status. Thus continuous use of the APC supplement in the amount of 30 g/kg of diet proved to be a better feeding practice to optimize oxidative potential than periodic inclusion of APC.

Effect of Thyme (Thymus vulgaris L.) Used in Diets with Extruded Flaxseed on the Antioxidant and Lipid Profile of the Blood and Tissues of Fattening Pigs.

Thyme has strong antioxidant properties and, therefore, can reduce the intensity of oxidative processes taking place in the body. The study aimed to assess whether the addition of thyme to diets for fattening pigs containing extruded flaxseeds, a source of n-3 PUFAs, which are particularly susceptible to oxidation, would have a positive effect on redox status and lipid metabolism. The experiment was conducted using 120 weaners (WBP × Neckar crosses) of about 30 kg BW, which were kept until the end of fattening (about 110 kg BW) and divided into three groups of 40 pigs. The control group received a diet with 4% extruded flaxseed. In groups T1 and T3, 1% or 3% of thyme was added to the basal diet. The introduction of 3% thyme resulted in a decrease in the total cholesterol level in the blood and the loin muscle. Moreover, an increase in SOD and CAT activity and a decrease in FRAP and LOOH was noted. Following supplementation with 3% thyme, the n-3 PUFA content and n-3/n-6 ratio increased, while the SFA content was significantly reduced. The results of the studies indicate that thyme has a positive effect on the redox status and lipid profile of the blood and muscles.

Effect of Fermented Rapeseed Meal in Feeds for Growing Piglets on Bone Morphological Traits, Mechanical Properties, and Bone Metabolism.

Quality feed is essential for correct bone development and proper functioning of animals. Post-weaned piglets experience a radical change in eating behaviour that can influence their feed intake. For this reason, functional feed additives and ingredients that can be used in post-weaning feeds are needed. The objective of this study was to evaluate the effects of partially replacing wheat with rapeseed meal fermented using Bacillus subtilis strain 87Y on overall bone quality and bone metabolism in weaner piglets. From the 28th day of life, barrows were fed either a standard wheat-based diet or a diet containing 8% fermented rapeseed meal (FRSM) with or without a feed additive containing enzymes, antioxidants, probiotics, and prebiotics. The experimental period lasted 60 days, after which femur quality indices were assessed. Differences in bone length and weight were observed, but there were no changes in bone mineralization or bone mid-diaphysis morphometrical traits between treatments. FRSM inclusion reduced bone mid-diaphysis biomechanical properties, but these changes were dependent on feed-additive supplementation. Analysis of the levels of serum bone turnover markers suggests the intensification of bone resorption in FRSM-fed groups as deoxypyridinoline levels increase. The results obtained warrant further research on what the disturbances in bone mechanical properties and metabolism observed in FRSM-fed weaners means for the subsequent fattening period.