Beliefs and sentiments of parents vaccinating their children - small town perspective in Poland: a preliminary study.

OBJECTIVES: Since 2009 the number of unvaccinated children in Poland has been regularly increasing. The purpose of the study was to learn what parents who decide to vaccinate their children feel and believe about their children's vaccines and in particular to find out how these sentiments and beliefs affect their attitude and decision-making with reference to vaccinations. METHODS: The interviews were conducted during an immunization visit of parents whose children are covered by immunization schedule; 53 parents aged 23 to 48 years took part in the study. Most study participants were high school or university graduates living in rural areas. Children were 1 week to 5 years old. Thematic analysis was used to analyse interview data. RESULTS: Identified factors shaping the parents' positive attitude to vaccination included conviction of necessity of vaccines (effective disease prevention, safety, favourable benefit-to-risk ratio, and concerns about the child). The general anti-vaccination belief was that vaccines are unnecessary. External factors, mainly authority figures and media broadcasts, affect parents' beliefs and decisions. CONCLUSIONS: Various factors affect parents' decision concerning immunization of their children. Both compulsory and recommended vaccines should be provided free-of-charge. Choice overload should be reduced. Paediatricians should address parental vaccine hesitancy.

DASH diet decreases CXCL4 plasma concentration in patients diagnosed with coronary atherosclerotic lesions.

BACKGROUND AND AIMS: Aim of this study involved assessment of the intensive intervention concerning lifestyle based on the DASH diet model on plasma concentration of CXCL4 chemokine among patients with coronary atherosclerosis. METHODS AND RESULTS: The Dietary Intervention to Stop Coronary Atherosclerosis in Computed Tomography Study randomized patients with stable CAD to an interventional group (n = 41), where DASH diet was implemented and the control group (n = 40) without dietary intervention. Dietary counselling was provided to DASH group during all 6 control visits within 6 months of observation. During the study, body weight and body composition were controlled using the bioimpedance method. CXCL4 concentration was determined with the use of ELISA test. Within the DASH group, a significant decrease in body weight, a decrease in high sensitivity C-reactive protein concentration (-0.32 ± 2.8 mg/l; p < 0.05), as well as a decrease in CXCL4 concentration (-3.35 ± 3.4 ng/ml; p < 0.0001) were observed. Occurring changes were not statistically significant within the control group. CONCLUSIONS: DASH diet lessens CXCL4 concentration among patients with a stable CAD, however, further research is necessary in order to confirm aforementioned results and evaluate the impact on atherosclerotic plaque. THIS TRIAL WAS REGISTERED AT: www.clinicaltrials.gov as NCT02571803.

Cardioprotective Mechanisms of Cocoa.

Cardiovascular diseases are the main cause of deaths in highly developed countries. Dietetic interventions that involve recommendations for consumption of products with a confirmed health-improving action are an important aspect of prevention of cardiovascular diseases. Cocoa is an alimentary product with significant cardioprotective potential due to its high content of bioactive compounds. The aim of the present study was to review the most recent literature concerning the effectiveness and mechanisms of action of compounds contained in cocoa with regard to selected cardiovascular risk factors and cardiometabolic markers. Study results indicate that cocoa consumption, especially in the form of dark chocolate with high flavonoid content, may be a good strategy to diminish cardiovascular risk due to its beneficial effect on platelet aggregation, decreasing blood pressure, diminishing dyslipidemia, and decreasing blood plasma glucose concentration. Many studies have shown that cocoa-derived flavonoids have antioxidant and anti-inflammatory activity and also play a significant role in preventing insulin resistance. However, in order to completely confirm the potential cardiovascular benefits, it is necessary to conduct larger and longer studies, also with regard to potential dangers associated with long-term consumption of large amounts of flavonoids and determination of a safe and effective dose. Key teaching points Cocoa consumption may be a good strategy in diminishing cardiovascular risk. Beneficial effects on platelet aggregation, blood pressure, dyslipidemia, glycemia, as well as antioxidant and anti-inflammatory activity are observed. There is a need to conduct larger and longer studies to determine a safe and effective dose of cocoa flavonoids.

Efficacy and safety of BRAF inhibitors and anti-CTLA4 antibody in melanoma patients-real-world data.

PURPOSE: In the management of melanoma, BRAF inhibitors yield fast disease control; however, the duration of response does not last very long. Ipilimumab-an anti-CTLA4 antibody on the other hand-provides longer-lasting results of treatment but achieves less favorable responses. The aim of this study was to assess the efficacy and safety of novel drugs for advanced melanoma in daily routine practice. METHODS: A retrospective observational study was conducted on all Polish patients (1170 patients), diagnosed with advanced metastatic melanoma, treated with the following drugs: vemurafenib, dabrafenib, and ipilimumab. The antitumor efficacy of these agents was retrospectively assessed by Response Evaluation Criteria in Solid Tumors in the case of BRAF inhibitors and by Immune-Related Response Criteria in the case of ipilimumab therapy. Adverse events were assessed in relation to the morphologic parameters of blood, nephrotoxicity, and hepatotoxicity. RESULTS: The overall response to treatment with BRAF inhibitors (vemurafenib and dabrafenib) was similar with a slightly better outcome in the group treated with vemurafenib. Compared to clinical trials, the objective response rate was slightly worse for both BRAF inhibitors (30% and 42% for dabrafenib and vemurafenib, respectively), as well as the immune-related response for ipilimumab (1%). There was no significant difference in patient's response rates regardless of what lines of treatment (first, second, or next) vemurafenib was applied in. A few severe adverse events (mostly anemia and hyperbilirubinemia) were observed during treatment. CONCLUSIONS: The lack of evidence in responses observed regardless of what line of treatment vemurafenib was applied in suggests there is no clinical reason for restricting BRAF inhibitors to only the first line of therapy. Our study confirms that novel agents brought about a major advancement in the management of melanoma. In line with literature, BRAF inhibitors and ipilimumab significantly improved the antitumor response rate with manageable adverse events.

Adherence to guidelines for pharmacological treatment of young adults with myocardial infarction in Poland: Data from Polish Registry of Acute Coronary Syndromes (PL-ACS).

WHAT IS KNOWN AND OBJECTIVE: Myocardial infarction (MI) in young adults accounts for up to 10% of all cases. Regarding life expectancy and professional activity, it is extremely important to restore and maintain young patients' full performance. Therefore, secondary prevention is especially vital in this group of patients. The paper focuses on the analysis of pharmacotherapy in young MI patients in Poland, assessing disparities between the European Society of Cardiology guidelines and clinical practice, and regional differences among the provinces. METHODS: The analysis was conducted using the data from a nationwide, observational, multicentre, prospective study-the Polish Registry of Acute Coronary Syndromes (PL-ACS). The data were collected from patients ≤45 years old with MI who were hospitalized in the period 2010-2014. RESULTS AND DISCUSSION: A retrospective study included 6367 MI patients. They constituted 3.9% of all the patients with MI in Poland. Despite the fact that during hospitalization regional differences were observed in case of acetylsalicylic acid (range 70.3%-93.8%), ß-blockers (range 50.0%-79.6%), statins (range 53.4%-85.7%) and angiotensin-converting enzyme inhibitors (range 46.9%-75.0%), the majority of patients received the drugs according to the guidelines. Regional differences found at discharge also regarded those medications, but the range of observed variations was smaller. On average, three-quarter of patients received guideline-recommended medications. Still, in some provinces, almost a quarter of patients were administered those medications only at discharge. WHAT IS NEW AND CONCLUSION: In the study population, there were significant differences between the provinces regarding pharmacotherapy during hospitalization, which concerned major groups of medications. However, pharmacotherapy indicated at discharge revealed fewer regional differences and adhered to guideline recommendations to a greater extent. Nevertheless, there is still some room for improvement, especially with regard to pharmacotherapy during hospitalization.

Replacement of saturated and trans-fatty acids in the diet v. CVD risk in the light of the most recent studies.

OBJECTIVE: To present and discuss results of the most recent studies pertaining to the effects of consumption of different types of fatty acids on the risk of CVD. The aim was also an attempt to answer the question of whether a revision of the current recommendations is necessary. DESIGN: A review of prospective cohort studies, systematic reviews and meta-analyses published in 2014-2017 on the effects of SFA and trans-fatty acid (TFA) intakes as well as various models of their replacement in the diet on CVD risk. RESULTS: Results of the new large prospective cohort studies pertaining to the effect of SFA consumption on CVD risk are contradictory. Similarly, the recent meta-analyses of clinical trials related to the effects of SFA substitution on CVD risk provided extremely different results, which is related to the application of different inclusion and exclusion criteria. Differences in results of randomised controlled trials may be caused by different methodologies of dietary parameter changes, varying duration of studies, as well as the time at which they were carried out. CONCLUSIONS: It is extremely difficult to extrapolate results of recent studies to contemporary recommendations. It seems that there is a need for properly randomised studies on large groups, with good control of dietary and non-dietary parameters, which account for not only the sum of SFA and TFA, but also their source. Only such studies will allow for full evaluation of an effect of substituting SFA and TFA on cardiovascular risk.

Drug adulteration of food supplements: A threat to public health in the European Union?

Food supplements have been playing an increasingly important role in the consumers' awareness nowadays. They are widespread and - according to popular belief - healthier and safer than synthetic drugs. In the European Union (EU) food supplements are classified as foodstuffs and thus not subjected to any specific safety assessments prior to commercialisation. With the growing popularity of food supplements, there is an increased need for more effective control of their production and distribution. The aim of this study was to examine the food notifications, recorded since 2003 via the EU RASFF database with particular regard to recent years, as well as to evaluate the involvement of different EU state structures in the fight against drug-adulterated food supplements with regard to efficacy and safety. In recent years, the number of RASFF notifications in the category of dietetic foods, food supplements and fortified foods, especially related to unauthorised composition, has increased significantly. The majority of EU Member States authorities, who responded to the study, consider drug-adulterated food supplements to be a public health threat. However, the competences of different official structures within the Member States concerning such products do not appear to be clearly defined. Regulators should thus think of stricter legislative solutions to increase the safety of public health.

Drug Combinations as the New Standard for Melanoma Treatment.

OPINION STATEMENT: Advanced melanoma is related to a very grim prognosis and fast progression. Until recently, there has been no indicated treatment that would affect the disease's outcome. However, the progress in immunotherapy and molecular therapy has significantly changed the unfavourable prognosis of melanoma progression and its short survival rate. Both approaches have improved patients' outcomes and provided renewed hope for successful treatment. Moreover, in order to further enhance patients' outcomes and to avoid mechanisms of tumour resistance, investigators attempted a combined approach. Targeted therapy combinations allowed a better response rate and progression-free survival than monotherapy with one of the agents. Another promising combination, but with limiting toxicities, is a concurrent immuno- and molecular-targeted therapy. It is suspected that complimentary usage of these drugs may lead to synergism, providing robust and quick tumour responses as well as long-lasting effects. Results of currently ongoing clinical trials that investigate combination strategies in melanoma are expected to provide more mature data about the effectiveness and the safety profile of those therapies. Until more robust results of these studies occur, the best management of advanced and metastatic melanoma is immunotherapy with anti-PD1 drugs or targeted therapy with concomitant BRAF and MEK inhibitor. However, which of these two options should be used first is still under discussion.

Can inter-faculty relationships improve future collaboration between physicians and community pharmacists in Poland?

Pharmaceutical care requires interprofessional collaboration between pharmacists and physicians. The aim of this paper is to determine the nature of inter-faculty relationships between medical and pharmacy students and its possible influence on the attitudes of medical students towards pharmacists and pharmaceutical care. The study was conducted using anonymous questionnaire administered to all medical students at the Medical University of Warsaw, Poland. The study involved 404 medical students (265 women and 139 men). Fifty-four percent of students reported that they maintained relationships with pharmacy students. Students had mixed views about the nature of the interprofessional relationship between physicians and pharmacists. Only 22% (n = 87) of the students had heard about pharmaceutical care. However, a number expressed interest in this form of collaboration in their future professional career. Students also claimed that they did not consider themselves prepared for the future collaboration with pharmacists in providing pharmaceutical care services, but they would like to participate in relevant interprofessional workshops with pharmacy students. The results from this study suggest that social relationships between medical and pharmacy students may have some effect on how pharmacists and their role is perceived and also on medical students' attitudes towards pharmaceutical care.

Association between low-dose folic acid supplementation and blood lipids concentrations in male and female subjects with atherosclerosis risk factors.

BACKGROUND: Folic acid (FA) is one of the B complex vitamins. It is thought that FA deficiency promotes atherosclerosis formation in arterial endothelium. FA, acting through reducing homocysteine (Hcy) levels, may contribute to decreased cholesterol (Ch) synthesis. The aim of this study was to analyze the association of low-dose folic acid supplementation with blood lipids concentrations in subjects with atherosclerosis risk factors. MATERIAL/METHODS: The study enrolled 124 Caucasian individuals (60 M, ages 20-39; and 64 F, ages 19-39) with atherosclerosis risk factors (family history of premature ischemic stroke, arterial hypertension, dyslipidemia, overweight and obesity, cigarette smoking, and low level of physical activity). The participants were asked to take FA at a low dose of 0.4 mg/24 h for 12 weeks. RESULTS: FA levels increased in females (6.3 vs. 12.5 ng/dL; p=0.001) and males (6.4 vs. 11.4 ng/dL; p=0.001) and Hcy levels decreased (10.6 vs. 8.3 µmol/L; p=0.001 and 11.5 vs. 9.3; p=0.001, respectively). A significant reduction in mean concentration of total cholesterol in females (203.4 vs. 193.1 mg/dL; p=0.001) and in males (209.5 vs. 201.9; p=0.002) was observed. The low-density lipoprotein cholesterol (LDL-C) levels decreased in females and in males (107.4 vs. 99.9 mg/dL; p=0.001 and 121.5 vs. 115.1; p=0.002, respectively). The apoAI concentrations increased in smoking women and in men with BMI≥25 kg/m2 (p=0.032 and p=0.024, respectively). CONCLUSIONS: Low-dose FA supplementation has a beneficial effect on blood lipids through decreasing concentrations of total cholesterol and LDL-C and increasing concentrations of apoAI.

Is there an effect of folic acid supplementation on the coagulation factors and C-reactive protein concentrations in subjects with atherosclerosis risk factors?

INTRODUCTION: Folic acid (FA) may delay the formation of atherosclerotic lesions. Increased plasma levels of von Willebrand factor (VWF) are observed in cardiovascular disease, which leads to higher risk of thrombosis. Fibrinogen (Fb) is a well-documented risk factor of cardiovascular disease. The aim of this study was to analyze the effect of FA supplementation on the Fb, VWF and C-reactive protein (CRP) plasma concentrations in subjects with atherosclerosis risk factors. MATERIAL/METHODS: The study enrolled 124 Caucasian individuals (60 M, 64 F) with atherosclerosis risk factors--family history of premature ischaemic stroke, arterial hypertension, dyslipidaemia, overweight and obesity, cigarette smoking and low physical activity. The participants were asked to take FA in the low dose of 0.4 mg/24 h for three months. RESULTS: After FA supplementation a significant reduction of the VWF concentrations in females (76.6 vs 72.3%; p=0.028) and in males (75.5 vs 66.9%; p=0.001) was observed. Among women and men with dyslipidaemia concentrations of VWF decreased after FA supplementation (76.8% vs 69.6%; p=0.003 and 76.7% vs 67.8%; p=0.001 respectively). Among females and males with BMI ≥25 kg/m² concentrations of VWF decreased only in men (77.6% vs 66.5%; p=0.001). In female and male smokers supplementation of FA decreased VWF concentrations (82.5% vs 74.4%; p=0.012 and 76.6% vs 69.5%; p=0.036 respectively). DISCUSSION: The results of our study suggest that there is an effect of FA supplementation on VWF concentrations in subjects with atherosclerosis risk factors.

Applicability of tools to identify potentially inappropriate prescribing in elderly during medication review: Comparison of STOPP/START version 2, Beers 2019, EU(7)-PIM list, PRISCUS list, and Amsterdam tool-A pilot study.

Potentially inappropriate prescribing (PIP) is one of the major risk factors of adverse drug events in elderly patients. Pharmacotherapy assessment criteria may help reduce the instances of PIP among geriatric patients. This study aimed to verify the applicability of selected tools designed to assess prescribing appropriateness in elderly and to identify PIP in the study population. Based on pharmacist-led medication reviews that were performed among patients attending senior day-care centers based in Poland, aged 65 years and over, the following tools were applied for assessing the appropriateness of pharmacotherapy: PILA (patient-in-focus listing approach): STOPP/START v.2 and Amsterdam tool, DOLA (drug-oriented listing approach): PRISCUS list, and DOLA+: Beers criteria v.2019 and the EU(7)-PIM list-the criteria oriented on medications requiring indications. Fifty patients participated in the study. The prevalence of prescribing issues in the study population was very high and ranged from 28% to 100%, depending on the criteria applied. The highest number of PIP cases was identified based on the PILA criteria: STOPP/START v.2 (171, a mean of 3.4 PIP cases per patient), and the Amsterdam criteria (124, a mean of 2.5 PIP cases per patient). The lack of protective vaccinations against pneumococci identified using the START criterion was found to be the most common PIP (identified in 96% of the patients). Proton-pump inhibitors (PPIs) were identified as the most problematic group of medications. The STOPP, EU(7)-PIM and Beers criteria revealed cases of inappropriate prolonged PPI use, whereas the Amsterdam tool identified cases where PPIs should have been prescribed but were not. The highest number of PIP cases in the study population were identified with the PILA tools, and on this basis the most comprehensive assessment of pharmacotherapy appropriateness in geriatric patients was conducted. Further studies should be designed, covering a larger group of patients across different healthcare settings (inpatient and outpatient), with access to comprehensive patient data.

Usefulness of MCP-1 Chemokine in the Monitoring of Patients with Coronary Artery Disease Subjected to Intensive Dietary Intervention: A Pilot Study.

Monocyte chemotactic protein-1 (MCP-1) plays an important role in the entire atherosclerotic process, from atherogenesis to destabilisation of the atherosclerotic plaque. The purpose of this study is to evaluate the effect of the dietary approaches to stop hypertension (DASH) diet in patients with coronary artery disease on the MCP-1 plasma concentration and to evaluate the potential usefulness of this chemokine as a marker of change in the volume and composition of coronary plaque. MATERIAL AND METHOD: As part of the dietary intervention to stop coronary atherosclerosis in computed tomography (DISCO-CT) study, patients were randomised to an intervention group (n = 40) in which the DASH diet was introduced, and to a control group (n = 39) with no dietary intervention. In the DASH group, dietary counselling was provided at all follow-up visits within 12 months of the follow-up period. MCP-1 plasma concentration was determined using enzyme-linked immunosorbent assay (ELISA). Coronary plaque analysis was performed using a semi-automated plaque analysis software system (QAngioCT, Medis, The Netherlands). RESULTS: In the DASH group, MCP-1 plasma concentration significantly decreased by 34.1 pg/mL (p = 0.01), while in the control group, the change in MPC-1 was not significant. Significant inverse correlations were revealed for the change in MCP-1 plasma concentration and change in the consumption of vitamin C and dietary fibre both in the DASH (r = -0.519, p = 0.0005; r = -0.353, p = 0.025, respectively) and in the control group (r = -0.488 p = 0.001; r = -0.502, p = 0.001, respectively). In patients with the highest decrease in percent atheroma volume (PAV), a significant positive correlation was observed between the change in MCP-1 plasma concentration and changes in PAV (r = 0.428, p = 0.033) and calcified plaque component (r = 0.468, p = 0.018), while the change in noncalcified plaque component correlated inversely with change in MCP1 (r = -0.459, p = 0.021). CONCLUSION: Dietary intervention based on the DASH diet model reduces the MCP-1plasma concentration, mostly due to an increased intake of plant-derived, fibre-rich foods and antioxidants. The change in MCP-1 plasma concentration seems to reflect changes in the atheroma volume and proportions between the calcified and non-calcified plaque elements.

The Effect of Intensive Dietary Intervention on the Level of RANTES and CXCL4 Chemokines in Patients with Non-Obstructive Coronary Artery Disease: A Randomised Study.

BACKGROUND: Inflammation is the key pathophysiological mechanism of the initiation and progression of atherosclerosis. The study objective was to assess the effects of a dietary intervention based on the model of the dietary approaches to stop hypertension (DASH) diet on the levels of chemokines RANTES and CXCL4 in patients with non-obstructive coronary artery disease. METHODS: As part of Dietary Intervention to Stop Coronary Atherosclerosis in Computed Tomography (DISCO-CT) study, patients were randomised to an intervention group (n = 40), where the DASH diet was introduced along with optimal pharmacotherapy, and to a control group (n = 39), with optimal pharmacotherapy alone. In the DASH group, systematic dietary counselling was provided for the follow-up period. RANTES and CXCL4 levels were determined using ELISA. RESULTS: In the DASH group, the RANTES level insignificantly reduced from 42.70 ± 21.1 ng/mL to 38.09 ± 18.5 ng/mL (p = 0.134), and the CXCL4 concentration significantly reduced from 12.38 ± 4.1 ng/mL to 8.36 ± 2.3 ng/mL (p = 0.0001). At the same time, an increase in the level of both chemokines was observed in the control group: RANTES from 34.69 ± 22.7 to 40.94 ± 20.0 ng/mL (p = 0.06) and CXCL4 from 10.98 ± 3.6 to 13.0 5± 4.8 ng/mL (p = 0.009). The difference between the changes in both groups was significant for both RANTES (p = 0.03) and CXCL4 (p = 0.00001). The RANTES/CXCL4 ratio reduced in the control group (from 3.52 ± 2.8 to 3.35 ± 2.8; p = 0.006), while in the DASH group, an increase was observed (from 3.54 ± 1.7 to 4.77 ± 2.4; p = 0.001). CONCLUSIONS: A 12-month-long intensive dietary intervention based on DASH diet guidelines as an addition to optimal pharmacotherapy causes changes in the levels of chemokines CXCL4 and RANTES and their mutual relationship in comparison to conventional treatment.

Does the progeny of premature ischemic stroke sufferers need intensive interest of physicians oriented toward primary prevention? A pilot study.

BACKGROUND: Few studies focus on the progeny of stroke patients with respect to the occurrence of other potential risk factors. METHODS: The study group covered 60 males and 62 females whose parents had suffered premature ischemic stroke (PIS); the control group comprised of 41 males and 47 females whose parents had no history of premature vascular event (mean age: 28.4 and 27.1 years, respectively). Examination of both the groups consisted of evaluation of their diet, measurement of arterial blood pressure and body mass index (BMI). Moreover, blood test was carried out and concentration of biochemical stroke risk factors was determined. RESULTS: The adult progeny of parents with a history of PIS followed a deficient, unbalanced, and nonvaried diet. Their average blood pressure and BMI reached higher values, compared with the results obtained in the control group (125.7±16.06 vs. 122.64±10.83 mmHg; 24.27±3.98 vs. 22.54±2.69 kg/m, respectively; P<0.05). The same applies to average concentrations of the triglycerides 1.22±0.76 vs. 1.06±0.54 mmol/l; total cholesterol (5.34±1.16 vs. 4.82±0.89 mmol/l), low-density lipoprotein-cholesterol (2.95±0.97 vs. 2.52±0.73 mmol/l), total homocysteine (11.22±4.22 vs. 10.18±2.45 µmol/l), and fibrinogen (2.91±0.68 vs. 2.78±0.6 g/l) (P<0.05). CONCLUSION: Adult children of PIS sufferers show different stroke risk factor profiles than the control group. It may indicate a need for preventive activities for this group in the future. Family occurrence of stroke requires further detailed studies on a larger cohort of patients from risk group.

Older adults' strategies to prevent episodic medication non-adherence: results from a qualitative study.

Purpose The purpose of the study was to explore methods and routines used by older adults to remember to take medications. METHODS: The study was conducted using face-to-face interviews with a convenient sample of older people, who take at least one medication for the treatment of a chronic condition. Interviews were recorded and transcribed verbatim. Thematic analysis was used to analyse the collected data. RESULTS: Participants (10 men and 28 women, mean age: 79.5) described the methods that aid them in remembering to take their medications. The study identified three content categories: incorporation of medication habits into daily schedule and routine, use of medication aids; and assistance and support from family. CONCLUSION: Older people have less difficulty taking their medication regularly if it becomes another habit as part of a daily routine. Health-care professionals should promote various methods to support medication management.

Role of NLRP3 inflammasome in the development of bladder pain syndrome interstitial cystitis.

Although it has been proposed that NOD-like receptor protein 3 (NLRP3) inflammasome activation may have an important contribution to the onset of bladder pain syndrome/interstitial cystitis (BPS/IC), as of today there is still insufficient evidence to accept or to reject this hypothesis. However, taking into consideration that inflammasomes have been already shown as important mediators of cyclophosphamide-induced bladder inflammation and that some studies have also revealed human bladder epithelium expresses high levels of NLRP3, such a hypothesis seems to be reasonable. The purpose of this review is to discuss a scenario that NLRP3 inflammasome is a crucial player in the development of this disease. Identification of a novel mediator of bladder inflammation and pain could lead to emerging new therapeutic strategy and the first causative therapy.

[Selected dietary atherosclerosis risk factors in offspring of patients with premature ischemic stroke]. / Wybrane zywieniowe czynniki ryzyka miazdzycy u potomstwa chorych z przebytym przedwczesnym niedokrwiennym udarem mózgu.

UNLABELLED: There are currently multiple reports which conclude that there is a correlation between cardiovascular risk factors, including wrong dietary habits, and occurrence of these factors in families. AIM OF THE STUDY: To evaluate daily intake of selected dietary items, which have influence on premature development of atherosclerosis, in adult offspring of patients who underwent premature ischemic stroke. MATERIAL AND METHODS: 54 patients were included in the study: 21 males, aged 21-38 years (average 25.8 yrs.) and 33 women aged 19-39 years (average 28.2 yrs.). All of them were examined including medical history, physical examination and fasting blood draw. Dietary habits were evaluated with the method of 24-hour history using a questionnaire developed by Institute of Food and Diet in Warsaw, Poland (Instytut Zywnosci i Zywienia). Intake of selected dietary components (dietary cholesterol, fiber, vitamins E, C, B6, B12 and folic acid) was assessed using a computer program "Dietician 2" ("Dietetyk 2") which had been developed by the Institute of Food and Diet. RESULTS: In males, compared to females, there was a significantly higher (p < 0.05) level of daily calorie intake (2400.8 +/- 716.2 vs 1583.1 +/- 584.3 kcal) as well as intake (expressed in percentage of daily allowance) of dietary cholesterol (106.8 +/- 46.2 vs 62.9 +/- 42.8), fiber (70.6 +/- 28.2 vs 52.0 +/- 22.2), vitamin E (98.4 +/- 49.8 vs 63.5 +/- 33.9), folate (53.9 +/- 23.1 vs 37.8 +/- 16.4) and vitamin B12 (99.0 +/- 58.3 vs 57.2 +/- 44.5). There were also significantly higher levels of the following parameters in 22 normal-weight females compared to 11 overweight/obese females: daily calorie intake (1735.2 +/- 613.2 vs 1278.9 +/- 387.7 kcal) as well as intake (expressed in percentage of daily allowance) of dietary cholesterol (73.9 +/- 44.8 vs 40.9 +/- 29.2), folate (42.3 +/- 17.0 vs 28.7 +/- 10.9) and vitamin B12 (68.2 +/- 48.0 vs 35.1 +/- 26.4). CONCLUSIONS: The examined offspring (especially daughters) of a parent with premature ischemic stroke ate insufficient, unbalanced and monotonous diet, which impaired their nutrition. This should motivate family physicians to put greater interest in primary prevention in this group of patients. Overweight and obese women were put at even greater risk because such diet was added to other atherosclerosis risk factors, i.e. family history of premature ischemic stroke and increased body mass.

SOX10-MITF pathway activity in melanoma cells.

Melanoma is one of the most dangerous and lethal skin cancers, with a considerable metastatic potential and drug resistance. It involves a malignant transformation of melanocytes. The exact course of events in which melanocytes become melanoma cells remains unclear. Nevertheless, this process is said to be dependent on the occurrence of cells with the phenotype of progenitor cells - cells characterized by expression of proteins such as nestin, CD-133 or CD-271. The development of these cells and their survival were found to be potentially dependent on the neural crest stem cell transcription factor SOX10. This is just one of the possible roles of SOX10, which contributes to melanomagenesis by regulating the SOX10-MITF pathway, but also to melanoma cell survival, proliferation and metastasis formation. The aim of this review is to describe the broad influence of the SOX10-MITF pathway on melanoma cells.